How to Prevent the Spread of COVID-19 Infection in Elderly Facilities? "Zoning" is difficult in urban areas 

2022.5.4 06:30
The Tokyo Metropolitan Government is focusing on countermeasures for elderly facilities in preparation for the "7th Wave" of the new coronavirus. In the sixth wave, more than 300 people were infected and died in elderly care facilities. The Tokyo Metropolitan Government is focusing on how to prevent the spread of infection on the assumption that the virus will be brought into the facilities. However, the unique circumstances of urban areas, with their small premises, make it difficult to take countermeasures, and some on-site workers have expressed their anguish, saying, "There is a limit to what we can do to prevent the spread".

A scene from a video created by the Tokyo Metropolitan Government that introduces the procedure for infection control at a facility for the elderly = from YouTube

◆Refused to transport and died

"If the isolation is good ...". A man who is the deputy director of a nursing home in Tokyo regretted. After the first infection was discovered in early February, the highly infectious Omicron strain spread rapidly within the facility, forming a cluster of 39 people in two weeks. A male resident in his late 80s had a worsening colorectal illness after infection. During the emergency transport, he was refused by a nearby hospital, saying that "corona patients were unacceptable," and died after being taken to a hospital more than 30 kilometers away.

◆30% of deaths in the 6th wave are in elderly care facilities

According to the Tokyo Shimbun's tally, of the 994 people who died in the sixth wave of outbreaks between January and March 2022, 312 died as a result of infection in elderly care facilities, accounting for about 30% of the total. The number of outbreaks of clusters was as high as that of nursery schools and schools, which brings to mind the reality that the infection spread within the facilities of the elderly, resulting in a string of deaths.
In order to prevent the spread of infection in nursing homes, "zoning" that separates areas with and without patients is effective. The deputy director understood the need, but recalled, "There was only room for the capacity, and there was a limit to creating an extra room for putting on and taking off protective clothing."

◆There is no choice but to share one dining room and bathroom

What bothered the staffs was the structure of the facilities unique to urban areas. Unlike rural areas, dining rooms and bathrooms cannot be built on each floor, and there is only one in the building. 70 users had to use it jointly, and the deputy director said, "I noticed that the infection had spread evenly throughout the facility."

The Tokyo Metropolitan Government

Therefore, on April 28, the Tokyo Metropolitan Government opened a dedicated window where facilities can consult on infection control measures without having to go through the public health department. Facility personnel can now consult on matters such as zoning and the proper way to dispose of protective clothing. The newly established "rapid response support team," consisting of nurses and others, will visit facilities within 24 hours to "provide advice on countermeasures according to the actual situation at the site" in the event of an infected person at a facility. It is assumed that it will be possible to visit 10 facilities per day.

◆Hurry to secure a transfer destination

In the 6th wave, deaths due to worsening of underlying diseases after infection were conspicuous, and approximately 20% of the deaths were due to causes other than COVID-19.
 Although the Tokyo Metropolitan Government secured a maximum of 7,229 corona beds for the 6th wave, the rapid increase in the number of infected people caused a shortage of beds, making it difficult for users of elderly care facilities to be hospitalized. In reflection of this, the Tokyo Metropolitan Government is working to secure more beds for the elderly who need nursing care and for elderly patients who have completed their corona treatment to be transferred to other hospitals.
 However, as was the case with the sixth wave of cases that exceeded expectations, if more people are infected than expected, the immediate response support team and the hospital beds for COVID-19 patients may not be able to keep up with the response. The Tokyo Metropolitan Government official said, "We would like to create an environment where the elderly can receive medical treatment with peace of mind.

This article is composed using Google Translate customized exclusively for The Chunichi Shimbun. The translation may have limited accuracy.