Photo/Illutration Tsunehiro Shimizu, director of the infectious diseases internal medicine department at Kyoto City Hospital, speaks during a recent interview. (Ryosuke Nonaka)

KYOTO--A doctor here who successfully treated two COVID-19 cases says patients with mild symptoms can recover through normal treatment but stresses the importance of preventing severe outbreaks, particularly in-hospital infections.

Tsunehiro Shimizu, director of the infectious diseases internal medicine department at Kyoto City Hospital, treated two patients with mild pneumonia caused by the novel coronavirus.

The patients, both in their 20s, were admitted to the hospital and have since been released.

“When a patient has mild symptoms, it is not easy to distinguish if the pathogen of pneumonia is the novel coronavirus or something else, except by conducting a polymerase chain reaction (PCR) test," Shimizu said in a recent interview with The Asahi Shimbun.

Pneumonia is diagnosed based on the presence of white shadows on a lung X-ray or a computed tomography scan.

Shimizu said images of the two patients’ lungs showed signs of a mild case of pneumonia and the shadows were either extremely small or obscure, which is similar to the appearance of another type of pneumonia.

Since there is no medication to directly treat the novel coronavirus, Shimizu prescribed them antifebriles in the hospital.

“We have no choice but to await the recovery of patients themselves,” Shimizu said. “And they gradually recovered without us doing anything in particular.”

The patients partook of regular hospital meals, Shimizu said.

At the same time, Shimizu took thorough preventive measures against the spread of in-hospital infection.

Patients were required to wear a face mask to avoid spreading the virus through coughing and sneezing. Plates and utensils were discarded after patients used them.

Doctors and nurses wore a face mask, headwear, protective goggles, an apron-shaped hazmat suit and gloves when they saw the patients.

The patient’s room was segregated from others by double-entry doors.

Medical staff donned and took off their protective gear between the doors. When they pulled off clothing likely contaminated with the virus, they turned the garments inside out so as not to touch the outer portion with their bare hands.

All the suspect gear were disposed of. At every step in the process, staff washed their hands.

“(Staff) need to be trained to properly put on and take off their gear,” Shimizu said.

Kyoto City Hospital is designated a Type II medical institution for specified infectious diseases.

It is specially equipped to deal with diseases such as COVID-19; for example, air pressure inside the hospital is kept low and exhaust outlets are covered with filters to prevent the outflow of pathogens.

During an outbreak of a new type of influenza in 2009, the hospital received 200 outpatients a day, which threw it into a state of chaos.

The government on Feb. 17 announced guidelines for when the public should go see a doctor when they suspect a possible case of the novel coronavirus.

Hospitals and clinics are expected to receive more outpatients who complain of mild cold-like symptoms and are worried about COVID-19.

“It will be harder (for medical staff) to see outpatients when they want to devote more time to hospitalized patients with severe symptoms,” Shimizu said. “I hope hospitals of a certain size will take a role in treating COVID-19 patients, while consulting the government and doctor’s organizations.”

To stop the spread of the novel coronavirus at this point is impossible, Shimizu said.

“It is important to prevent the increase in the number of severe patients," he said. "Just like regular influenza, we just have to urge the public to take preventive measures thoroughly, such as washing the hands.