No smooth sailing for health centers key to Gifu’s COVID-19 response

In April, after COVID-19 infection clusters were confirmed at a nightclub and a restaurant in the city of Gifu, workers at the Gifu Public Health Center in Kakamigahara, Gifu Prefecture, were inundated with calls.

Reiko Inoue, a 56-year-old public health nurse at the center, said the situation at that time left her completely exhausted. “If it went on, I thought I would collapse,” she said.

A total of 61 people, including some living outside the city of Gifu, were confirmed to have been infected in clusters identified at the nightclub on April 3 and at the restaurant on April 9. The rising number of cases triggered significant concern among people in the prefecture.

At that time, contacting the coronavirus consultation centers that were set up at public health centers was more or less the only way to get a polymerase chain reaction (PCR) test to confirm infection. There was a steady stream of calls from those seeking the tests, both residents and medical institutions.

Twelve public health nurses at the Gifu center responded to calls — sometimes up to almost 200 a day — that came through to eight telephone lines at the center. The nurses referred those who were feeling sick and were suspected of being infected to designated medical facilities.

Once someone was found to be infected, the nurses would look for a facility where the patient could be hospitalized, identify places they had visited, find people who had been in close contact with them and call them every day for two weeks to check their health condition. The number of tasks quickly soared.

In order to identify related cases of infection, the nurses had to call those known to be infected with the virus and people they had associated with to get the necessary information. But not all of them were cooperative.

“You have to clarify relationships while taking privacy into account,” Inoue said. In order for people to disclose whom they had met, when and where, “you have to be very careful,” she said. “They will tell you the truth only after you have built a trusting relationship with them.”

The situation was the same at the Gifu City Public Health Center in the city of Gifu. Since there were initially only five staff members, they had to work late into the night, sometimes going home after 3 a.m.

“We were constantly pressed for time and we didn’t have enough knowledge because it was a new virus,” said Junko Setta, 47, a public health nurse at the center. “We were also very worried ourselves.”

The center received 4,672 calls in April, as residents grew increasingly worried and irritated over the spread of infections.

The team struggled with remarks from callers asking who was infected, slamming the public health centers for not being able to do more, asking if staff would take responsibility for the crisis and telling them to “go to hell.”

The shortage of staff was solved after the Gifu Municipal Government increased the number of staff at the center to 47.

On April 13, the Gifu Prefectural Government and the Gifu Municipal Government created a joint task force to cope with clusters, helping authorities share information on infected people in and outside the city.

When the two stores where clusters had occurred agreed to disclose their names, it became easier for authorities to identify people who had visited them.

“There were many cases where people who visited the stores contacted us to take the test,” said Izumi Kato, 48, an official responsible for infectious disease control at the Gifu City Public Health Center.

But disclosing information also led to a flood of rumors online. One of the infected patients who was hospitalized said they were afraid of going home, and were thinking of moving in fear of becoming the subject of rumors in the neighborhood.

“The psychological burden on the patients is immeasurable,” Kato said. “We want to disclose as much information as possible to prevent the further spread of infections, but that could also lead to prejudice and discrimination in some cases.”

This section features topics and issues from the Chubu region covered by the Chunichi Shimbun. The original article was published June 12.