苦闘、恐怖、悲痛…新型コロナ最前線で闘う医療従事者たちの現状

【ローマＡＦＰ＝時事】医師や看護師、その他の医療従事者は、この新型コロナウイルスのパンデミック（世界的な大流行）の中で意図せず英雄となり、世界各地のバルコニーや通りからは彼らに感謝の拍手が送られている。（写真はスペイン・マドリード近郊の病院で、新型コロナウイルスによる同僚の死を受け集まった医療従事者ら）
　病院職員らは大量に押し寄せる患者の対応に追われる一方、医療物資不足にも直面し、さらに自身も新型ウイルスに感染するという恐怖とも向かい合っている。患者の治療に当たる中で、胸が張り裂けるような決断を迫られる状況も数多くある。
　ＡＦＰの記者たちはこのパンデミックの最前線の真相を知るため、世界各地の医療従事者から話を聞いた。

■着替えに４０～５０分、手洗いと消毒に６０～７５分
　世界で最も多くの犠牲者が出ている国の一つであるイタリアでは、多数の医師や看護師が新型ウイルスに感染して亡くなっており、医療従事者からも多くの感染者が出ている。
　首都ローマにあるトル・べルガータ病院の新型コロナウイルス感染症（ＣＯＶＩＤ-１９）集中治療ユニットで看護コーディネーターを務めるシルバーナ・デ・フロリオ氏は、感染を避けるためにマスクとフェースシールド、手袋、スクラブ（医療用衣服）を適切に着用する重要性を強調した。
　それらを着用するのに「特定の時間は設けていないが、７時間勤務の場合、着替えるだけでだいたい４０～５０分必要だと見積もっている」とフロリオ氏は述べ、「手洗いと手指の消毒に関しては、１日約６０～７５分かけている」と明かした。

■「熱がなければ復帰できる」と言われ…
　米ニューヨークで看護師として働くベニー・マシューさん（４３）は、適切な医療用衣服を着用しないで少なくとも４人の患者の治療に当たり、新型ウイルスに感染したと述べた。
　その後間もなくして熱が下がると、勤務先の病院はマシューさんに仕事に戻るよう求めたという。
　マシューさんは「熱がなければ仕事に復帰できると言われた。熱がないことが病院側の唯一の基準だった」と述べ、「マスクを着用して仕事に戻るよう言われた。スタッフが足りていないため、現場に戻ることが私の義務だと思った」「ただ同僚や、まだ感染していない患者に病気をうつしてしまうんじゃないかと心配だった」と語った。

■「悪夢の中を生きている」
　感染症を専門とするフィリピン首都マニラのサン・ラザロ病院の医師たちは、人類にとって最も厄介な接触感染との闘いには慣れていたが、ＣＯＶＩＤ-１９のようなものを目の当たりにしたことはなかったという。
　自身も感染リスクの高い世代に当たるフェルディナンド・デグズマン医師（６０）は、「悪夢の中を生きているようだ」と話す。
　集中治療室と人工呼吸器の数に限りがあるため、医師たちは恐ろしい判断を迫られている。
　デグズマン医師は「われわれは神を演じたくはない」「ただ、臨床医は判断を下さなければならない」と語った。
　また、多くの医療従事者が帰宅を恐れている。デグズマン医師は「みんな家族を心配している」と語った。【翻訳編集ＡＦＰＢＢＮｅｗｓ】
〔ＡＦＰ＝時事〕（2020/04/16-09:53）

Doctors, nurses and healthcare workers have become the unwitting heroes of the coronavirus pandemic, winning applause from balconies and streets around the world.
From Yaounde to Rome to New York, the pandemic has infected more than 1.9 million people and claimed 118,000 lives.
Hospital workers are dealing with a huge influx of patients, while also facing a lack of equipment in many cases and the fear of becoming infected themselves. Often, they face heartbreaking decisions while treating their patients.
AFP journalists spoke to healthcare workers around the world to find out what it's really like to be on the frontline in the coronavirus pandemic.
- ITALY: 'We can't get sick' -
In Italy, one of the worst affected countries, dozens of doctors and nurses have died from COVID-19 and thousands of healthcare workers have become infected.
Silvana de Florio, nursing coordinator in the COVID-19 intensive care unit of the Tor Vergata Hospital in Rome, underlined the importance of being appropriately kitted out with masks, visors, gloves, scrubs and suits to avoid contagion.
We don't set aside a specific amount of time for it, but we have estimated that for a seven-hour shift, about 40-50 minutes is spent just on getting dressed, she said.
In terms of hand washing and hand decontamination, we are talking about 60-75 minutes per day, she said after scolding a care worker for not wearing a mask.
Medical staff can't get sick -- not so much because of their ability to work, but because it would not be fair.
- ECUADOR: the morgues are full -
In the Pacific port city of Guayaquil in Ecuador, a sick nurse makes no attempt to hide her anger: 80 of her colleagues have been infected and five have already died.
Ecuador is one of the worst affected countries in South America, with hundreds of dead bodies lying inside homes because the morgues are full.
We went to war without any weapons, said the 55-year-old nurse, who spoke on condition of anonymity.
The necessary equipment was not ready when this (the pandemic) was already happening, devastating Europe, said the nurse, who is resting at home as there is no space in the hospitals.
Patients with severe symptoms were arriving at her emergency department, but due to a lack of tests, they were treated as if they had the flu and sent home.
We had no personal protective equipment (PPE) but we could not refuse to treat the patients, she said.
- UNITED STATES: Lack of equipment -
In the United States, Judy Sheridan-Gonzalez, president of the New York State Nurses Association, also complained about the lack of protective gear for medical workers.
We don't have the arms and the armour to protect ourselves against the enemy, she said at a recent protest outside a hospital.
Benny Mathew, a 43-year-old nurse in New York, said he caught the virus after caring for at least four patients without adequate medical dress.
Not long afterwards, when his fever had subsided, the hospital asked him to come back to work.
They told me if you don't have fever you can come on work -- that was their only criteria, he said.
I was told to wear a mask and come to work. We don't have enough staff so I think it was my duty to come back.
But I was worried that I was going to transmit the disease to my coworkers, to the patients who don't already have it, he added.
With more than 195,000 confirmed cases of COVID-19 and around 10,000 deaths, New York state is the epicentre of the pandemic in the US, the worst affected country so far.
- PHILIPPINES: Doctors playing God -
The doctors at Manila's San Lazaro hospital, a specialist centre for infectious diseases, are used to battling humanity's nastiest contagions -- but they've never seen anything like COVID-19.
Suspected coronavirus cases have died at triage, terrified patients grow outraged when they can't get tested immediately and the doctors have to manage the anxiety they could be carriers too.
It's a living nightmare, said doctor Ferdinand de Guzman, who at 60 years old is himself in a high-risk group.
With a limited number of intensive care rooms and ventilators, the doctors are burdened with horrific judgements.
We don't like to play God, de Guzman said. Clinicians just have to make decisions.
Many are afraid to go home after work. We are worried about our families, de Guzman said.
We always reserve one or two beds for (hospital) employees. We never had this problem before, ever.
- CAMEROON: 'We are afraid' -
Roger Etoa, a doctor in Cameroon, one of the worst-affected countries in sub-Saharan Africa, admits that fear of catching the disease also affects healthcare workers.
I live with my wife and children, the 36-year-old said. When I arrive in the evening I rush to the shower, but it is difficult to stop the children from jumping on you.
Etoa is the director of a healthcare centre in Douala, the capital of Cameroon.
As a precaution, he's started taking chloroquine, a drug used to treat malaria.
We don't yet know if it works preventively or even curatively, but I prefer (to take it) just in case, he said.
Early studies have shown that chloroquine, may be effective in the treatment and prevention of COVID-19, though more evidence is needed.
We are afraid, like the rest of the population. Afraid that our masks or suits are not fitted properly when we are dealing with a patient who is showing symptoms, the doctor said.
We're obviously afraid of catching it. When you get up in the morning and you have a bit of a headache, you ask yourself, 'What if this is it? What if it's our turn to get the virus?'
- SPAIN: Patients left alone -
Antonio Alvarez, a nurse in the intensive care unit at Vall d'Hebron, the biggest hospital in Barcelona, described the heartbreaking daily task of phoning a family member to say goodbye to their loved ones -- from behind the protective glass.
It's difficult to see patients who are alone and have no family with them, the 33-year-old said.
They're saying goodbye from the door and it's probably the last time they'll see them since funeral ceremonies have been banned, he said.
If it was a member of my family, I wouldn't be able to stand just sitting there and seeing them behind the door, Alvarez said.
It's a very difficult situation.
- TURKEY: 'Like a war' -
Everyone is working like crazy, as though it was a war, said Nuri Aydin, director of the Cerrahpasa Faculty of Medicine at Istanbul University.
The atmosphere here is not like a normal workplace, but a battlefield, he said during a visit to the hospital.
Istanbul, a metropolis with some 15 million residents and Turkey's economic capital, has around 60 percent of confirmed COVID-19 cases in the country.
Many healthcare workers are sleeping in hotels or converted student dormitories, afraid of infecting their families.
What they are doing is superhuman. There's no price for the work of healthcare workers, they're in the service of humanity, Aydin said.
- GERMANY: Neighbourly solidarity -
Thomas Kirschning is a senior doctor and intensive care coordinator in the German city of Mannheim, near the border with France.
The city recently sent home two French patients from Colmar, aged 64 and 68, after nursing them back to health.
It was very motivating for the team that we were able to help, he said.
We still had capacity in Mannheim, and it went without saying... that we would take care of these patients while there was an urgent situation in France.
Kirschning feels a little nervous when returning home to his wife and two daughters.
I'm doing everything I can to make sure nothing happens when I come home, he said.
We might not get as close as we normally would if it wasn't for this pandemic. We are all a little bit worried -- my family are worried for me, but of course I am also worried for my family.
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