Prevention and Control of COVID-19 in Imperfect Condition: Practical Guidelines for Nursing Homes by Japan Environment and Health Safety Organization (JEHSO)

Sae Ochi, Michio Murakami, Toshihiko Hasegawa and Yoshinori Komagata
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Sae Ochi: Department of Laboratory Medicine, The Jikei University School of Medicine, Tokyo 105-8461, Japan
Michio Murakami: Division of Scientific Information and Public Policy, Center for Infectious Disease Education and Research, Osaka University, Osaka 565-0871, Japan
Toshihiko Hasegawa: Research Institute of Future Health, Tokyo 113-0022, Japan
Yoshinori Komagata: Department of Nephrology and Rheumatology, Kyorin University School of Medicine, Tokyo 181-8611, Japan

IJERPH, 2021, vol. 18, issue 19, 1-12

Abstract: Infection control at nursing homes is a top priority to address the COVID-19 pandemic because people who are the most vulnerable to the pathogen live in close contact. Currently, control measures specifically for nursing homes often ignore under-resourced condition of the facilities. To make guidelines assuming realistic conditions, an expert meeting with 16 members established the key challenges in nursing homes, the basics of infection control, and the major transmission routes. A list of existing guidance was compiled and each item in the list was peer-reviewed by eight experts considering three aspects: significance, scientific validity, and feasibility. Factors related to the nursing home environment, the nature of SARS-CoV-2 transmission, and patient characteristics were identified as the causes of difficulties in infection control at nursing homes. To develop realistic prevention measures in under-resourced condition such as nursing homes, we may need to accept there are no perfect control measures that can achieve zero risk. Instead, the guidelines are based on the concept of deep defense, and practical checklists with 75 items were established. The evaluation of nursing homes by independent organizations using the checklists would be helpful to achieve sustainable infection control.

Keywords: COVID-19; nursing homes; health management; disaster risk reduction for health; deep defense; infection control (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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