Photo/Illutration Medical staff treat patients taken by ambulance to Shonan Kamakura General Hospital in Kamakura, Kanagawa Prefecture, on April 27. (Tokiko Tsuji)

KAMAKURA, Kanagawa Prefecture--Shonan Kamakura General Hospital accepts 14,000 ambulance deliveries annually, one of the largest ambulance intakes among hospitals across Japan.

Its motto: “We accept all emergency patients.”

Its medical staff live by the expression, even amid reports other hospitals have been turning away ambulances carrying patients suspected of having the new coronavirus--causing many ambulance crews to struggle with long waits before locating hospitals willing to take their patients.

The place is busy. Doctors there treat 40 to 50 patients a day who might be infected with the coronavirus, exhibiting respiratory symptoms and fevers.

Doctors said as they confront the virus, they are taking measures to protect themselves as much as possible. But the open approach does not come without risk.

“I would be lying if I told you I am not afraid,” said Hiroshi Yamagami, 41, the chief of the hospital’s medical emergency center. “But I am fighting to sustain local health care.”

Patients infected with COVID-19 who appear to have no symptoms can still spread the virus.

“I am telling our staff that every patient and every staff might be infected with the virus, and so we should be careful as much as possible,” Yamagami said.

He said even small measures are important to avoid an outbreak in the busy hospital, such as careful handwashing, wearing masks in the office and not having meals while sitting face to face with others.

The hospital provides masks and goggles to all medical staff and urges its patients to wear masks. When staff treat patients, they wear protective clothing.

But they still risk becoming infected when performing various tasks, such as intubating patients to hook them up to ventilators.

Ambulances arrive daily. On April 26, the hospital admitted a man in his 70s who had a fever and difficulty breathing, a suspected COVID-19 case.

The emergency authority asked six hospitals in the prefecture to accept him, but they all refused.

One hour later, he was brought to this hospital. The doctor put him on a ventilator, but he died on April 27.

Many patients who have cold symptoms or difficulty breathing also come to the outpatient section.

Posters displayed in the hospital said, “Please talk to our staff if you have symptoms, such as coughing, throat pain or difficulty breathing.”

Patients with such symptoms are guided to the emergency department.

Nurses triage some feverish patients to a makeshift ward for outpatient treatment for such cases, built in a parking lot.

Health care workers who are part of the local medical association, along with doctors from various sections at the hospital, treat patients there in shifts.

Commissioned by the prefecture, the hospital opened the makeshift building nearby with 31 beds for coronavirus patients with moderate symptoms on April 23.

It plans to build another--a larger one that could accommodate 180 patients in the future.

The medical emergency center of the hospital also treats patients with the most severe symptoms.

The hospital is not specially designated by the state to treat patients with infectious diseases difficult to control. But with the spread of the coronavirus, the number of patients suspected to be infected with the virus has increased.

Even if that number increases further, Yamagami said the hospital will not waver from its motto.

“We would like to do our best to prevent the collapse of medical care by combining local powers,” Yamagami said. “We accept all patients.”

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