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Message from the Mayor about further enhancing health care support for long term care facilities (2022.6.22)

Last updated date:2022/6/22

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I would like to share an update on how we are working to strengthen our COVID-19 health care support for long term care facilities.

During the sixth wave of COVID-19 infections, more people than ever before were infected by the Omicron variant, and cases of severe illness, especially among elderly residents, made implementing cluster control measures at long term care facilities a key issue.

It is essential to take appropriate measures to help residents in long term care facilities who are at high risk of severe illness if infected. Our data about medical care issues from the some 1,000 local facilities was not comprehensive, so in collaboration with the prefectural government, we conducted a survey to get a better understanding of the current conditions.

The survey asked whether each long term care facility has a medical institution they cooperate with, and whether their doctors make visits to the facility.

More specifically, we asked if there were doctors on call from the cooperating medical institution who could be dispatched if a facility resident tested positive, whether they could conduct PCR tests, decide if hospitalization was required, or provide treatment (set up intravenous drips, provide oral medication, or prescribe other drugs, etc.).

While the term “long term care facility” covers a variety of services, including special nursing homes, health care facilities for the elderly, and private nursing homes, they comprise 1,056 local facilities. We sent the survey to all of them, and enjoyed a relatively high response rate of 86%, meaning 909 facilities responded.

In response to whether they have a cooperating medical institution or a doctor on call, 95% of the 909 facilities said “Yes,” so 5% have neither.

I would also note that the survey also included facilities that do not require a cooperating medical institution. Based on these results, then, 95% of facilities can provide some form of medical care.

Moving from general medical questions to specific COVID-19 concerns, we asked if the cooperating medical institution would dispatch a doctor or perform a house call if a positive case were identified. I think it is common to provide this service for elderly people who become ill, but we asked if they would do so in the context of the coronavirus, and 71% answered “yes.”

To summarize, of the 909 responses from long term care facilities, 71% reported that they can request a doctor’s visit from their cooperating medical institution or that doctors are on call.

On the other hand, 24% said they could not request house calls or doctor visits, and 5% that they do not have a cooperating medical institution, suggesting that one-fourth to a third of facilities may require improved health care support.

While many facilities have cooperating medical institutions, nearly 30% would be unable to provide medical intervention if a resident tested positive.

After determining that we needed to improve health care support for those facilities based on the results of the survey, we decided to further enhance medical support measures in cooperation with the Yokohama Medical Association and Yokohama Pharmaceutical Association. Specifically, when a positive case is identified, Y-AEIT will confirm the patient’s physical condition and survey the facility. Doctors assigned to the facility or through the cooperating medical institution will respond if able. On the other hand, if the facility has no such arrangement, we can respond through our new collaborative system. Specifically, the Yokohama Medical Association will be able to provide consultations online or by phone, or make visits in person to 29% of facilities. They can also prescribe antiviral drugs, neutralizing antibody therapy, and determine whether or not a patient can be hospitalized. The Yokohama Pharmaceutical Association will be able to coordinate with pharmacists delivering medications to the facility when doctors request prescriptions. We hope to prevent residents in long term care facilities from becoming seriously ill through these new partnerships.

That's it for this COVID-19 response update.

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