On the novel Corona virus and my niece

I have been busy following up the outbreak of COVID19 and the research work of its infection mechanism and of related possibilities for treatment. It seems overshooting has started in such big cities as Tokyo. The administration has not increased as many test cases as required yet. The number of infected cases published by the government is not reliable. It is underestimated. Some researchers in mathematical epidemiology has proposed to reduce the contact rate among people to 80% of the usual setting to the government. But the politicians were concerned only about its depressing effects on economy and has modified it to 70% by themselves. Outing is not legally forbidden yet. Most importantly, the government won't compensate the economic loss due to closing down of businesses, which may result in less effective restriction of businesses. These are the reasons why the overshooting is starting. We won't be able to escape from the overshooting even if we are in a countryside 50 miles north of Tokyo. The collapse of healthcare system due to overshooting is of primary concern at present.

I am thrilled to look over some research papers on the virus, especially with its phylogeny, the mechanism how it binds to the cell wall receptor and invade into the cell. The pathophysiology of ARDS is precisely understood as a mechanism of cytokine storms and cytokine release syndrome. Different reagents are being tried to inhibit each process. The progress of such researches sure overwhelms me. Hopefully, some of them will turn effective in clinical settings. I find myself excited to see what is going on in this field. The unfavorable aspect of such research results is that the virus could mutate frequently so that it may escape from effect of possible vaccine. They say it will take 1.5 years to obtain effective vaccine.   

Several days ago, I have received an e mail from my niece. It is the girl whom I have played the piano trio last September together with a violinist friend. I have described about it in this blog then.

 http://nuttycellist-unknown.blogspot.com/2019/09/playing-at-small-concert.html

We were planning performing another piano trio at a concert this fall. We would have started practice in March or April. But, due to this novel Corona virus outbreak, we had to cancel both. In the e mail, niece has told us we should postpone practice planned in May. She, working as a head nurse at a ward of National Cancer Center in Tokyo, has quarantined herself at home since she had close contacts with a couple of colleague nurses infected with the virus at the hospital about 2 weeks ago. The PCR test has turned out negative for her. And she is returning to the work tomorrow.

Surprisingly, her ward would accomodate those patients with COVID19 according to the Tokyo Metropolitan Government's request. The government should have prepared much more beds for the patients with this disease. At least during Feb. and Mar. since the outbreak began and burned up. The government had wanted to hold the Olympic games this summer until IOC decided to postpone it in the end of Mar. They have not prepared for this situation going on now. That is why National Cancer Center, which is least equipped with such infectious disease patients, should accept the patients of COVID19 now.

I am sure she should work in the environment where she and her colleague staff are threatened for infection all the time from now without such facility/equipment as negative pressure chamber. I wonder if sufficient number of PPE is provided for the staff. Infection control is a highly specific field in health care. I wonder if they could practice it without any previous training.

It may become like field hospital, I am afraid. It might be an unprecedented experience for her not only as a nurse but also as a human. She has not expressed any emotional reaction to this drastic change in her job. I suppose she might worry about herself and her family as well. As her mother, my elder sister, used to say, however, she has been a kind of lady invulnerable to fear in her life. I guess as well as hope that she would do well with her new responsibility.

Workers of healthcare are always required to be ready for such an occasion. I have experienced the scary situation when SARS cases occurred in our country in 2003. At my small private practice not equipped with protective gear etc, I felt nervous seeing my patients. The administration has not given any support such as providing N95 masks or protective gawn etc. Without support, economical and of logistics, it was hard for us to do with it. I am afraid my niece should work with insecure feeling. I sincerely wish she will get it through and may grow as a nurse when the outbreak is settled down. It is her calling she has chosen after her grandmother, that is my mother, and her mother.