Problems against coronavirus disease 2019 based on the experience of responding to a large-scale infection cluster

<p>【Introduction】</p><p>The identification of an infection cluster within a medical institution causes distress among front-line healthcare workers. In such situations, organizational management is important since several tasks, such as the identification of transmission routes, taking a decision on whether to continue the provision of medical care, and coordination with external organizations, must be performed under constantly changing circumstances. Herein, we report the course of action for responding to a crisis from the viewpoint of organizational management through our experience of managing a large-scale cluster of coronavirus disease 2019 (COVID-19) in a hospital.</p><p>【Actual case】</p><p>At first, some employees tested positive for COVID-19; subsequently, a cluster of 231 infected people, including 94 patients, 97 hospital staff members, and 40 family members of the patients or staff members, was identified in an acute care hospital that played a central role in community healthcare. The contact tracing team of the national COVID-19 cluster task force and a commander disaster medical assistance team (DMAT) provided support in this situation.</p><p>【Discussion】</p><p>Although the countermeasure headquarters was established early and measures to contain the infection was implemented, the situation was unmanageable due to the unexpected spread of the infection. Moreover, the members of the headquarters were also infected. Therefore, the cooperation of not only infection control specialists but also physicians who oversee organizational management is essential to manage a large-scale infection cluster. Parties requesting support are required to take measures as needed.</p>