At first glance, the humble office of Heart — an aptly named nursing station in Tokyo’s Katsushika Ward — seems like any other.

The scene appears unremarkable: the morning humdrum of nurses discussing patients or chatting about weekend plans as they prepare for the day’s home visits, methodically packing supplies into timeworn backpacks while drivers patiently wait by the door.

Look closer, though, and one might notice that the nurses are wearing handmade gowns fashioned from repurposed dress shirts. On the walls, multiple fans have been forcibly installed to provide better circulation, and in the corner lies a towering pile of hand sanitizer, surgical masks, gloves and gowns bought in bulk to circumvent a supply crunch.