Photo/Illutration A doctor after collecting a sample to administer a polymerase chain reaction (PCR) test (Provided by Tokyo Medical and Dental University’s Medical Hospital)

Several white tents shaped like a tunnel sit near the main entrance of Tokyo Medical and Dental University’s Medical Hospital in the capital’s Bunkyo Ward.

A team of doctors and nurses from the general medicine department administers polymerase chain reaction (PCR) tests in the tents on people suspected of being infected with the novel coronavirus.

“Once a health care worker gets infected with the virus, or an in-hospital infection occurs, I fear we will not be able to provide high quality specialized medical treatment,” said Yousuke Takemura, chair of the general medicine department, explaining why the makeshift tents are necessary.

Local governments and medical organizations in Tokyo are trying new ways to coordinate health care to combat the outbreak--scaling up much-needed testing and better protecting front-line workers.

Health organizations are quickly learning to work as a team as the rapidly spreading virus outstrips the availability of PCR tests nationwide.

The new “specimen collection tents" at Tokyo Medical and Dental University’s Medical Hospital, set up in late March and running since early April, each contain tables, chairs and computers.

Medical staff check patients’ body temperatures, blood oxygenation levels and symptoms such as coughing.

When they need to swab a patient’s throat, staff move to another tent, where negative pressure equipment is set up, to reduce the risk of infection. They wear N-95 masks, face shields, gowns and other personal protective equipment while doing the testing.

The hospital receives an average of some 2,000 outpatients a day. As of mid-April, the hospital is running PCR tests on about 10 patients daily.

But the testing is only available to those with flu symptoms who have been to the hospital, and only after a doctor deemed their testing necessary.

Still, some people just show up at the hospital, mistakenly thinking they can take a PCR test.

Other organizations are trying out different approaches to hold their local health care system together, as a rise in infections heaps an extra burden on existing structures.

Shinjuku Ward’s total number of infected people was about 20 in late March, but jumped to 227 as of April 18.

The National Center for Global Health and Medicine (NCGM) in the ward became overwhelmed with testing requests, making it difficult for the hospital to treat severe COVID-19 patients.

Ward officials are setting up a new PCR testing system to improve its availability and effectiveness by coordinating with other health care facilities and a local doctors’ organization.

Under the new system, doctors in clinics see patients either in person or by phone and provide a reference letter to those who need to take the test.

Those patients then go to a PCR testing spot set up at a hospital, where medical staff from the hospital and the ward’s doctors’ organization administer tests.

Currently, about 120 patients with mild cases of COVID-19 are resting at home in the ward because an influx of patients has overwhelmed the hospital’s bed capacity.

But when a patient’s condition suddenly deteriorates, it is almost impossible for medical staff to find a hospital that has room for them.

Under the new coordinated triage system, ward officials assigned the NCGM, as well as three university hospitals, to treat severe patients. Four other hospitals meanwhile take care of patients with moderate symptoms.

Patients with mild symptoms are expected to stay at home or a hotel.

Officials said the new system lets them make sure hospitals help each other locate beds for patients with worsening conditions.

A ward official said it is designed to “make a clear distinction between the role of local health care facilities and public health centers.”

“With that, hopefully, specialized hospitals can focus on treating severe patients and we can prevent a medical meltdown from happening.”

(This article was written by Masatoshi Toda and Yuko Matsuura.)

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