Will to Survive: 900 Days in the COVID Ward

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September 2021.

A medical team faces an extremely rare type of emergency.

A pregnant COVID-19 patient is in critical condition.

We've got the baby.
Suction!

The mother gives birth while on an ECMO heart-lung machine.

Hang in there.

Over the past two-and-a-half years, this hospital has treated more than 1,000 COVID patients in serious condition.

Without the guidance of an established treatment plan, the medical workers have effectively been fighting the virus in the dark.

Deceased patients are wrapped in plastic sheets to eliminate the risk of infection.

Wrapping the patients is so painful.

Others make it back from the brink of death, and are reunited with their loved ones.

You'll be back to your best soon.

We're right here with you.

You'll keep fighting this thing, right?

Keep fighting.

Doctors also try to fight long COVID through trial and error.

I think we're getting there.

Our job isn't so much to cure them
as it is to support them.

We try to empower the patients and
make them believe in themselves.

One hospital's chronicle of its long battle against the coronavirus.

St. Marianna University Hospital is located in Kawasaki City, just outside Tokyo.

It's the area's main hospital designated to treat COVID-19 patients - especially those with severe symptoms.

An NHK crew has been covering the workers, and the patients and their family members at this hospital for two and a half years.

The hospital has 167 medical professionals including doctors, nurses, and clinical engineers.

They have taken in more than 1,000 seriously ill COVID patients, and saved the lives of nearly 900 of them.

We're so happy for you.

Congratulations.

How does it feel to be back outside?

Can you breathe the fresh air?

Okay, let's go.

Dr. Fujitani Shigeki is in charge of the ward for seriously ill COVID patients.

He is a critical care expert.

She was looking well, sounding upbeat.

"Are you worried about her in particular?"

I hope she gets better and comes back
just to visit - and brings her child with her
to meet all the staff.

Good morning.
Can you speak? No?

Over the course of their daily battle with the coronavirus, Fujitani and his team have become convinced of one thing.

The most important thing
is the patients' will to survive.

We have to give them strength.

Family members, the patients themselves,
and us, the doctors.

We're all in this together.

It's not just the doctors who cure patients.

That's something I keep reminding myself.

Summer of last year.

Pregnant COVID patients arrive one after another.

They have been turned away by other hospitals that said they could not treat them.

We now have two pregnant patients.
One is on ECMO.

It's too soon for her to give birth.

Sakamoto Natsuko is in her 40s and 7 months pregnant.

Her condition is especially dangerous.

Her lungs show up all white in an X-ray, which means they are barely functioning.

A pregnant woman needs more oxygen
because she's breathing for two.

Her lungs are strained to begin with.

Natsuko works in sales for a manufacturing company.

She had just married and was about to take maternity leave when she became infected.

The team fitted her with an ECMO, a machine that adds oxygen to a patient's blood.

It's considered a last resort treatment for COVID.

Natsuko is unconscious and in critical condition.

The doctors are planning an early Caesarean section to deliver the baby.

We might not be able to save
the mother's life otherwise.

We think it would be difficult
to keep the fetus inside much longer.

Our priority is to save the mother,
even if we can't save the fetus.

But a surgical operation while on an ECMO could lead to massive bleeding, jeopardizing the lives of both the mother and the baby.

There's a bit of hardening here.

Right after the doctors decide on a C-section, one of the nurses notices a change in Natsuko's appearance.

She is frowning.

She is not due for another 3 months, but is suddenly showing signs of labor.

Just as we were going to do a C-section
to save her life...

she unconsciously signaled to us
that she was ready to give birth.

Get us a shadowless lamp.

We'll resuscitate the baby
if we can't intubate in time.

The doctors say it's as if the fetus sensed the mother's condition and caused premature labor to save her life.

Obstetricians and midwives rush to the critical care center from their usual places of work.

We've got the baby.
Suction!

It's a girl - weighing only 933 grams.

She's not breathing.

Could you prepare for pumping?

The team takes emergency measures to get the baby to start breathing.

You're a strong girl.

Come on!
Hang in there!

Okay everyone. Great job!

The baby's life is saved.

The impossible just happened.

It's a miracle.
We've never seen anything like it.

Not just one miracle, but a
combination of many miracles.

Now we have to save the mother.

We want them to be able to
live as a family.

The baby is confirmed uninfected by the coronavirus.

But the mother is still fighting for her life.

- Is she conscious?
- No.

- But there's some body movement?
- Yes.

- Still not responsive?
- No.

She is not in the clear, even after giving birth.

She remains in serious condition for more than a month.

Her condition is worse than
when she first got here.

We still can't take her off the ECMO.

When she regains consciousness,
she starts coughing a lot.

If this severe coughing continues...

the blood oxygen saturation level
could plunge to just 80%.

She's in pain.
We need to stop her coughing.

Natsuko is not showing signs of recovery.

The team tries every possible method of treatment.

One, two, three.

Nurses shift her body, placing her in the prone position to make it easier for her lungs to function.

They also give her Remdesivir and steroids to alleviate her symptoms.

All the while Fujitani keeps talking to her, trying to pull her back from the brink of death.

She's still not fully conscious.
We haven't got there yet.

But we keep calling out to her.

We're waiting for her to heal herself.
Waiting for any signs of recovery.

"What's this photo?"

A nurse suggests placing a photo of her husband and daughter above her bed.

She's in a haze,
drifting in and out of consciousness.

We hope the love of her family
can bring her back.

We're all in this fight together -
the patient and the entire medical team.

The team continues to fight desperately to save Natsuko's life.

One month later...

"Wow, she can hold a pen?"

"Since when?"

- Two or three days ago.
- "Two or three days!"

- She's out of danger now.
- "What a surprise!"

We waited so long for this moment.

How are you feeling?

You're regaining your strength.

You don't remember anything, do you?

You were fighting for your life all this time.
So was your baby.

Your baby is doing well now.

She'll be able to go home soon.

Natsuko is still on a ventilator and cannot talk.

She arrived at the hospital when she had only just gotten married.

- She's having a tough time?
- Yes, she says she wants to leave.

- You want to leave here?
- You want to go home, right?

You want to go home?

Emotionally exhausted.

Feeling bad for my husband.

I've caused everyone so much trouble.

I know you want to go home.
We're doing our best.

Once the tube comes out,
you'll be able to breathe better.

I'll be back, okay?

Stay strong.

Natsuko tests negative for the coronavirus.

But she is still slow to recover.

This is not good.

"Is it serious?"

Just when we were getting her ready
to breathe on her own...

A hole developed in her right lung.

We're still in the middle of this fight.

There are many complications.
It's like being attacked from all sides.

There is a hole in her lung, and blood clots near her heart.

These complications are often seen in serious COVID cases.

Fujitani and his team know from experience exactly what to do.

They remove the clots and operate on the lung.

Natsuko's condition continues to fluctuate.

One of the nurses makes a suggestion.

She hasn't breastfed or bathed her baby - things a mother usually does right away.

She can wear gloves.

We should let her touch her baby -
even if it's through gloves.

Mother and child have been kept apart.

The team wants them to have some time together, while avoiding the possibility of infection.

Hello, is Dr. Goto there?

Fujitani consults the OB-GYN.

How is the baby doing?

Can we bring her to meet her mother
if the isolation period is over?

She hasn't even touched her baby yet.

It probably hasn't hit her yet
that she's given birth.

We want to let her bond with her baby.

You have to keep fighting now.

It' been 3 months since the delivery...

Natsuko's husband arrives for the first meeting between mother and child.

Hello. Here she is.

Here's her face.

And her head.
The head.

She stopped crying.
Wow, she really did.

Great job, mommy.

Look, she's calmed down.

She's smiling.
Look at that smile.

Thank you, mommy.

You did great.

She's looking at you.

Amazing.
She knows it's her mother.

Wasn't that nice?

The baby is healthy.

She knows how hard you worked,
giving birth to her despite being unwell.

The hospital isn't only helping those with serious symptoms.

Last year, it started an outpatient service for people suffering from apparent long-term effects, receiving more than 600 patients.

Little is known about the causes of what is known as "long COVID."

This woman says she's been in constant fatigue and pain for over 6 months.

My ankles hurt.

- Do you feel pain here?
- Yes.

- How about here?
- There, too.

One patient says he can no longer recognize words.

This, I can understand.
But not beyond this point.

I see the characters
but can't decipher them.

I see.

Neural tests reveal diminished blood flow to the occipital lobe, the part that processes visual information.

The doctors try a magnetic treatment to increase blood flow to the brain.

The procedure is commonly used in post-stroke rehabilitation.

I can read it.

It makes sense.

I used to go through everything
letter by letter...

- Can you understand what you see?
- Yes, as soon as I see it.

- "You know what it means?"
- I do.

I think we're getting there.

The treatment works for some people
but not others.

We still don't know why.
We're in the trial-and-error phase.

Hello.

Many people are worried their symptoms will never end.

One of the priorities of the long COVID outpatient service is emotional support.

Sayaka, a high school student, has been coming to the hospital since last summer.

It feels like my heart is being squeezed.
I feel it every now and then.

Do you also break out in a cold sweat?

Yes.

Please stand here.

As soon as she stands, she feels short of breath, and her pulse quickens by nearly 30 beats per minute.

I'm sweating just standing here.

Sayaka was a star on her junior high school volleyball team.

She had just enrolled in a special sports program for high school when she was infected with the coronavirus.

She only experienced mild symptoms at the time, but has felt unwell ever since.

It took 3 months for doctors to determine she was suffering from long COVID.

My teacher suggested I see an
ENT specialist.

They said I had no symptoms,
but they saw how I teeter when I stand, and suggested psychiatric help.

I had no idea what was causing it...
That was the most difficult part.

Sayaka receives counseling after each trip to the hospital.

She is under the care of nurse Yoshioka Chieko, who specializes in palliative care.

I used to think, "What's the point of
being enrolled in my course...

when I can't even move my body?"

But now, I just want to be able to
play again.

Never mind where or how.

So that's how you feel now.

- I know how hard you've been working.
- Yes.

Think of us as your cheerleaders.

Talk it over with your doctors.
I hope we can find a good way forward.

- Yes...sorry.
- It's okay.

You're doing great, talking to us about it.

I'm sorry it's always such a
sad conversation.

Her symptoms persist.

Sayaka finally gives up on resuming her club activities.

She also decides to transfer to a school that offers a correspondence course.

My body can't keep up with my mind.
I've come to terms with that.

I think a part of me already considered
transferring as an option.

But I kept avoiding the inevitable.

Honestly, my dreams,
my aspirations, are over.

I was forced to give them up.

"Where did you get this?"

Ms. Yoshioka gave it to me
for Christmas.

Yoshioka wrote Sayaka a note at a time when she felt like there was no way out.

"You faced many unexpected challenges.
But overcame each and every one."

"I hope you're healthy
and have a 2022 that's full of smiles."

"You should push yourself,
but never force yourself to suffer."

I was so surprised
a nurse would do this for me.

She makes it easy for me to talk.
I'm able to tell her everything.

We visited Natsuko 4 months after she gave birth in the ICU.

"Wow."

- "She's come so far."
- Yes, it's really amazing.

- "She's brushing her teeth."
- She can also walk.

She's still on the ventilator but is
training herself to walk again.

Her body is finally starting to respond to the various treatments.

You've made amazing progress.

I'm astonished.

You're almost at the point where you'll
be able to breathe on your own again.

Yes, keep it up.

Make sure you get plenty of nutrition.

"Meat and fish?"

Yes.

You have a really tenacious spirit.

It's a miracle. Really, a miracle,
that you've come this far.

You have your baby and husband.
They helped you hang in there.

You're almost done.
We can see the finish line.

Keep up the good work and you'll
be able to go off the ventilator.

- "Will I be off the ventilator soon?
- Yes, I think so.

I'll be back, okay?

Stick with the daily rehab.

Two days later.

Natsuko's baby is growing steadily and can finally go home.

"You can finally see your baby."

It's been a while, right?

"You can hold her."

"I wonder if I can hold her.
She's gotten so big."

"We've been monitoring her weight.
She's about 3,500 grams."

"She's growing very well."

Mother and baby are both in stable condition and are allowed some time together.

Let's turn here.

There she is.

Can you see her adorable outfit?

She holds her baby for the first time.

It's your mommy. Hi, mommy.

She's staring at you.

She's smiling.

Their time together lasts only 20 minutes.

Your husband is waiting
for you to come home.

Let's keep getting better,
one step at a time.

You set another personal record
during rehab today.

More than 100 people have died from COVID-19 at the hospital.

Some patients spend their final moments alone, without family or friends.

The hospital is trying to do more to help family members who are struggling because they cannot visit their loved ones.

At the start of the pandemic, the doctors briefed families of seriously ill patients with worst-case scenarios.

It's a very serious case of pneumonia
caused by COVID-19.

The condition is deteriorating faster
than in any case we've ever seen.

But now, they try to offer more optimistic prognoses.

The worst is over.
The focus now is rehab.

We're going to continue helping restore
the patient's bodily functions.

You need to explain in a way
that allows the family to stay positive.

They can't even see the patient.

They are sitting at home worried sick, with no idea of how their
loved one is doing.

Hearing a bad prognosis might cause
them trauma.

Be considerate and humane
when you talk to them.

I try to provide the
best medical care possible.

But I think I may have lacked
consideration for some family members.

In March 2021, the hospital began a new care service for grieving family members.

When you're in there with him, feel free
to talk to him and hold his hand.

Family members wearing protective gowns spend time with a patient who passed away.

There's a bit of swelling.

You held on for a long time,
with the help of everyone at the hospital.

You were brave.

Don't worry about my sister.
I'll take care of her.

The hospital still provides support to some bereaved family members.

Did your feelings about your husband's
death change over time?

I see. So, at first it was too hard
to even look at his photo.

She said, "I was so sad. It felt like time
had stopped. The days just went by..."

"I had no one to talk to."

"I was sad, lonely, and upset at myself."

"I got infected first and gave it to him.
I've felt guilty ever since."

I think a lot of people are
suffering like this.

The priority as ER staff
is to save lives.

But when treating patients, there's a need
to pay attention to their families, too.

That's also very important.

I haven't been able to interact with them
like this during the pandemic.

Sayaka, the high school student, is still suffering from the effects of long COVID.

She is at the hospital to undergo a new form of treatment.

Let's begin.

Medical staff apply an anti-inflammatory drug to a part of the nasal cavity that is swollen.

The treatment has been effective in relieving fatigue and dizziness in some patients.

Are you feeling okay?

During a recent counseling session with Nurse Yoshioka, Sayaka starts to smile again.

- Can I say something silly?
- Of course.

Snow Man released a live DVD.
I wanted to get the first edition...

Then you should have reserved a copy!

There is something Sayaka is curious about.

Can I ask about your job?
What do you do exactly?

I'm a nurse.

I'm a nurse and also something called
a Certified Nurse.

Basically, I studied to get certified
in a specific field.

I specialize in palliative care.

That sounds difficult.

No, it's not.
Look it up.

"Okay, here's a question..."

Long COVID has made it difficult for Sayaka to focus on her studies.

But she's still working hard.

I want to be completely cured.

I want to be physically active again.

I need to get my confidence back.

Here's a letter for our team.
It's a message of encouragement.

The hospital receives letters from across the country.

"It's a battle with no end in sight."

"The way you fight for patients reminds me
of the toughness of a bundle of grain."

The bundles symbolize our teamwork.

I think the sender made it by hand.

Lots of people are rooting for us.

It's encouraging.

- Some messages for the team.
- Thank you.

Share it with everyone.
Let's keep up the good work.

More than 160 people work at the critical care center.

Not a single one has left their job in the two-and-a-half years of the pandemic.

How are you feeling?

- Doing better?
- Yes, I'm feeling a lot better.

Doctor, your bottom is glowing.

It's Doctor Firefly.

The new mother, Sakamoto Natsuko, is still recovering.

Is this from yesterday?

Wow. She's so plump.

You must be ready to go home.

After giving birth while on an ECMO machine, she remained in critical condition for 4 months.

She then developed a series of complications, but kept fighting, one day at a time.

After 6 months at the hospital, Natsuko is finally taken off the ventilator.

- Good morning.
- Good morning.

I can talk now.

- You can talk?
- Yes.
- "Wow."

- Starting today, all of a sudden.
- From today?

"What? Since when?"

- After I got some sleep.

- "Do you feel any shortness of breath?"
- No.

"That's great."

- "Congratulations."
- Yes, I'm so happy.

"Doctor, isn't this amazing?"

- Yes, it's incredible.
- "I'm so surprised."

- Here's a video.
- Wow, she's doing great.

"Oh, wow."

Natsuko is finally going home.

- I'm so happy for you.
- Thank you.

Good morning.

The incisions have healed.

She was in the hospital for nine and a half months.

Thank you so much.

You've been given a second life by God.

I don't know how many crises you faced
but you overcame each and every one.

Thank you again.

It's been a tough battle to survive,
for you and all of us here.

Take care.

It's been a year since Sayaka sought help at the outpatient service for long COVID.

- How are you doing?
- I'm feeling great.

I don't have any symptoms.
I can play volleyball without medication.

That's great.
You're back to your best.

I'd say you don't need us anymore.

Really?

This is your last visit.

OK. Wow. It feels surreal.

It took a full year.

Hello.

Nurse Yoshioka is here to see her one last time.

- I've never felt better.
- You look well. That's great.

- The treatment's over.
- I'm happy for you!

I promise I won't come back.
At least, I'll try not to.

- Thank you for all your help.
- You're welcome.

Enjoy the rest of your time in high school.

- Thanks, I have to study for the entrance exams.
- Good luck.

Sayaka has no problem playing sports now.

She is also interested in working as a psychological counselor.

My experience with COVID made me
rethink the direction of my future.

I was at a very low point for a while.
I think there are others just like me.

I want to help them.

Natsuko is now training to improve the strength of her lungs.

5, 6, 7, 8, 9, 10...

OK.

I'm so happy we're
spending this day together.

The family is celebrating their daughter's first birthday.

The baby girl who weighed just 933 grams at birth is now over 7 kilograms.

I'm sure my wife will be
completely fine again by the time our daughter starts
primary school.

I hope so.

It's been 900 days since we started covering the hospital's COVID ward.

- You want me to change this?
- If possible.

The doctors continue to fight the virus, confident in their patients' will to survive.

Some people they have treated have made what the doctors say are "miraculous" recoveries.

Medicine has made great progress.
But there's still a lot that's unknown.

People have the innate ability to survive.

We doctors only lend a hand.
That's what I believe.

I want to save
all the lives I can.

The battle against the coronavirus continues.