Support needed for care homes as COVID-19 group infections hit Japan [Mainichi Editorial]

From The Mainichi Shimbun

April 4th 2020

Japan has been seeing group infections of the new coronavirus at welfare facilities for the elderly and people with disabilities. At the Hokuso Ikusei-en facility for those with intellectual disabilities in the Chiba Prefecture town of Tonosho, east of Tokyo, some 90 people, or roughly 60% of the facility users and workers, have tested positive for the virus. The average age of the facility’s residents is close to 60, and it is feared that those infected could suffer severe symptoms of COVID-19.

While the Hokuso Ikusei-en residents each live in individual rooms, they dine in groups and also work together when engaging in workshops such as gardening. Each worker is tasked with caring for several residents. With a group of people living in a shared space, the risks of infection are inevitably high.

The viral outbreak within the facility apparently stems partly from the fact that severely disabled residents were unable to tell the workers about changes in their physical condition. It’s difficult to prevent infections completely even if hand-washing and disinfection measures are implemented.

Once a person is confirmed to have been infected with the new coronavirus, they will be subject to a hospital stay, even if the symptoms are mild, as long as there are enough hospital beds to accommodate COVID-19 patients. In cases of those with intellectual disabilities, however, they could become mentally unstable when removed from their care homes or separated from care workers, but hospitals cannot spare extra staff to assist the disabled patients.

The Hokuso Ikusei-en residents with mild COVID-19 symptoms are being treated at the facility by doctors and nurses dispatched there. If an outbreak occurs at other care centers, those facilities will have no choice but to handle the situation in a similar way. At the same time, it’s essential to separate infected residents from those who aren’t infected to prevent the further spread of the virus. Workers attending to COVID-19 patients should also be limited to mitigate the risk.

Care workers at welfare facilities do not necessarily have expert knowledge on infectious diseases. It’s therefore important for the central government to promptly dispatch experts on infection prevention to such places. Local governments, meanwhile, should secure medical facilities to accept those who develop severe symptoms and need to be hospitalized.

An increase in virus infections among care workers will obstruct the daily operations of care facilities. Local authorities need to work out plans to secure care workers.

It is also absolutely necessary for care centers for the elderly to be cautious about group infections. The COVID-19 fatality rate is especially high among senior citizens, and older residents face a greater risk when they have a chronic disease.

A group infection was separately confirmed at a nursing home for the elderly in Fukuoka Prefecture. The government’s expert panel is calling for related parties to consider restricting care home residents in regions that have been seeing outbreaks from going outside or staying overnight outside the facilities.

Those who live at such welfare centers have reasons they cannot stay at their own homes. These facilities not only need to prevent the further spread of the virus but to provide ongoing care. There is an urgent need for local governments to build support systems that will enable such facilities to quickly deal with infections.