EDITORIAL: Shift in focus to protect elderly now key COVID-19 issue

Fresh cases of COVID-19 appear to be rising again after a brief lull. Tackling the latest resurgence requires the government to address issues that surfaced in the “sixth wave” that started sweeping the nation early this year.

Protecting elderly people in poor health remains a vital challenge. Although the Omicron variant, which drove the sixth wave, is more transmissible than previous strains, it is less likely to cause severe health complications. This strain spawned cluster infections in numerous facilities for elderly people, mostly nursing homes. As the BA.2 sub-variant of Omicron, which is even more contagious, is now fast becoming dominant, the government has no time to waste in taking effective steps to protect the elderly.

Earlier this week, the health ministry asked local administrations to adopt specific measures to deal with this challenge. They include establishing a system to dispatch medical support teams to facilities for elderly people within 24 hours after a new COVID-19 case is confirmed and surveying all such facilities to ascertain whether residents are able to receive appropriate medical treatment through visits by doctors.

Only a small portion of care facilities for the elderly are legally required to have doctors or other health care workers on hand at all times. During the sixth wave, many cases emerged in Tokyo and Osaka in which infected facility residents were left without access to medical examination and treatment as they could not be admitted to hospitals.

Learning from these experiences, the government has shifted its focus by upgrading the level of health care within facilities instead of trying to transfer infected patients to hospitals.

This is a reasonable approach because reports emerged where changes in life circumstances caused by hospitalization exacerbated patients’ conditions. In providing medical care to such elderly patients, it is also important to give proper consideration to how to maintain their quality of life by treating them at facilities, instead of hospitals.

However, those who require immediate hospitalization should be swiftly transferred.

A mountain of problems must be addressed.

The principal goal of policy support for facilities for the aged should be to prevent the spread of infections among residents and staff. This requires providing timely and appropriate guidance and advice in response to the prevailing situation, providing materials and training staff members. All this requires solid financial support.

However, ensuring that facilities for senior citizens and medical institutions cooperate more closely is not as easy as it sounds.

A survey by Osaka Prefecture, which experienced an exceptionally high number of deaths among aged COVID-19 patients, found that most of the more than 3,600 facilities for the elderly in the prefecture maintain cooperative arrangements with specific medical institutions. But only 30 percent of those facilities are able to obtain prescriptions for COVID-19 drugs.

In its efforts to bolster cooperative tie-ups, prefectural authorities are seeking to expand a system to swiftly dispatch medical teams to facilities. Some local governments are making similar efforts. To improve this approach, municipal and prefectural authorities should share their knowledge and expertise about the challenges involved and possible solutions.

Securing effective cooperation between nursing care facilities and medical institutions was a sticky health care policy issue even before the pandemic hit.

Each elderly patient has unique health care needs. It is crucial to provide detailed information and explanations to patients and their families and also to create effective working relationships among local governments, medical institutions and facilities in such cases.

All these challenges must be tackled effectively to improve the nation’s ability to deal with the pandemic, now in its third year.

–The Asahi Shimbun, April 8

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