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The number of novel coronavirus clusters is surging at facilities for the elderly. The central and local governments should provide nursing homes with thorough support, rather than leaving the handling of the infectious disease solely in their hands.
According to the Health, Labor and Welfare Ministry, 95 clusters were found at facilities for the elderly in the past week, exceeding the 20 found at drinking and dining establishments and the 55 at medical institutions. An increasing number of residents have died in nursing homes because no hospitals can be found to admit them, according to the ministry.
It is important to expand — first and foremost — polymerase chain reaction (PCR) tests for these facilities to detect who is infected as soon as possible.
The central government has called for the local governments of the 10 prefectures for which the state of emergency remains in place to conduct intensive testing for staff at facilities for the elderly by the end of March, because many residents have been infected by staff members. Regular testing should be conducted for such facilities, including for users of day-care services and employees from other businesses who often visit.
Some facilities for the elderly have not implemented sufficient measures against coronavirus infections. It is necessary for prefectural governments to urge nursing homes anew to check their virus prevention measures, while also giving them instructions on such matters as drawing up business continuity plans.
When residents become infected, a nursing home’s initial response is important to preventing the virus from spreading, such as setting up zones to separate those who are infected from others.
The central government has called for prefectural governments to dispatch support teams to facilities when residents or staff are infected with the virus. Prefectural governments should prepare as soon as possible to dispatch specialized doctors and nurses.
However, there are few doctors who specialize in infectious diseases. Of the medical institutions designated by the government to deal with infectious diseases, only about 35% reportedly have such specialists. If a prefectural government finds it difficult to dispatch a support team to a facility within its administrative area, it should consider cooperating with the central government to have such teams dispatched from other prefectures.
If infected patients also suffer from dementia, hospitals tend to be reluctant to admit them, out of concerns such as these patients wandering around. In some cases, infections spread within nursing homes while patients are recuperating there because no hospitals are available to admit them. It is urgent to offer support to hospitals that accept these patients, such as by providing subsidies.
It is also important to improve nursing care services. When residents are infected, many members of the staff cannot work as they are designated as having had close contact with the patients. Some local governments dispatch support personnel who have registered in advance. It is hoped similar systems will be established in other parts of the country.
The government has said that vaccinating staff at nursing homes will start in April, at the same time as for the elderly. It is hoped that members of this profession will have opportunities to receive vaccinations as soon as possible.
Other issues for elderly patients infected with the virus include rehabilitation and health care management after they are discharged from the hospital.
In some cases, medical practitioners visit residents at their nursing homes based on advice from infectious disease specialists. This approach enables elderly patients to be released from the hospital at an early stage because the practitioners will take care of them after the discharge. By making use of such personnel, it is hoped that efforts will be accelerated to establish a scheme to provide nursing homes with seamless support, from conducting medical examinations for their residents to providing care after they leave the hospital.
