Japan’s near-emergency targets restaurants even as omicron plagues nursing homes
TOKYO – The COVID-19 quasi-state of emergency measures that the Japanese government decided on February 10 to extend to 13 prefectures mainly apply to restaurants and bars, but the bulk of new cases are in children and of the elderly, including a slew of clusters of infections in facilities for the elderly.
“Even when we take a resident to their room, they come out, and the process repeats over and over again. It’s hard to completely isolate our residents,” said the manager of an infection-hit Tokyo nursing home clusters in mid-January. lamented.
The first confirmed infection involved a resident in his 80s. Some of the residents have dementia and therefore struggle to follow staff instructions, including on coronavirus protocols. The virus spread and by the end of January a total of 23 people – 13 residents and 10 staff – had COVID-19. It took between two days and a week for the public health center to arrange hospitalization, and some were never hospitalized. There was at least one person whose symptoms worsened while waiting for a bed and only got one after being taken to hospital by ambulance and registering as an inpatient.
The public health center, which was still inundated with phone calls, asked the nursing home to return previously submitted documents and asked questions that had already been asked and answered. The care home manager said: “We were at an impasse because we couldn’t ask the public health center to give us instructions on next steps, such as ending recovery periods.”
The rise in cluster infections in aged care facilities shows no sign of stabilizing. According to statistics from the Ministry of Health based on information provided by local governments, there were 62 clusters between January 10 and 16, 136 between January 17 and 23, 252 between January 24 and 30, and 292 between January 31 and February 6. The number has quintupled in a month, far exceeding the figure (43 cases at its peak) during the fifth wave of coronavirus in the summer of 2021.
The Department of Health, Labor and Social Care has long prioritized responding to cluster infections in care homes for the elderly, as they can directly lead to an increase in severe cases and deaths. The ministry compiled measures such as infection control and quarantine procedures, and securing relief personnel, and instructed facilities and communities to prepare through local governments.
But the omicron variant of the coronavirus spreads faster than its predecessors, and experts have pointed to transmission risks during the virus’s incubation period, before symptoms appear. Public health centers are overwhelmed by the influx of coronavirus patients, and their response to facilities with confirmed cases has been slow in some cases. Meanwhile, the implementation of the measures has not progressed, with the percentage of people having received their third dose of the coronavirus vaccine – which was first made available to the elderly – only reaching 7 .9% of the national population on February 10. .
In addition, it now takes a long time to get the test results. At Heiiku-kai, a medical company that conducts medical visits to institutions for the elderly, mainly in the Kanto region of eastern Japan, the number of PCR tests requested by those involved in nursing is doubling every week.
Results were available within a day or two through Heiiku-kai’s contracted testing facility. But now, due to the surge in demand for the tests, it takes three to four days to get the results. Without a positive test result, hospitals will not accept patients. It is difficult to provide excretion and feeding assistance to a resident of the facility while isolating them from others.
Also, infected people often do not notice they have the virus, as omicron can cause mild or no symptoms. This stimulates transmission within an institution.
“We need to isolate those who test positive as quickly as possible, and at the same time we need public support that allows staff to be off duty immediately when they show cold symptoms,” Kazue said. Ota, director of Heiiku-kai.
(Japanese original by Yuki Nakagawa, Lifestyle and Medical News Department)