Photo/Illutration The manager of an elderly care facility in the Tokai region explains what measures were used after an infection cluster broke out. (Shino Matsuyama)

Staffing shortages have forced some nursing care centers to ask employees infected with the novel coronavirus to continue working to care for similarly infected elderly residents, despite legal stipulations against such work.

Operators have said that some seniors need help for such basic tasks as eating and using the toilet, and not having workers on hand could put the survival of the elderly residents at risk.

“Elderly care facilities cannot close their doors,” said a man who operates a group nursing home in Okinawa Prefecture. “We must continue to look after those who use our facilities.”

In late January, one resident at the facility developed a fever and was later confirmed with COVID-19. Subsequent testing found that eight of the nine other residents there were infected along with nine of the 12 staff members.

Many of the residents only had mild symptoms, so a decision was made to have them recuperate at the group home.

Normally, the group home has three workers during the day and two at night. But after the virus hit the workers, the center lacked enough workers to look after the residents.

Okinawa Prefecture had a program of dispatching staff from other care facilities to places facing labor shortages. However, the company commissioned by the prefecture to provide such personnel said there were no available substitutes because of the spread of infections.

Staff at the group home who were infected volunteered to continue working, and the manager asked those who were asymptomatic to come to the group home to help out.

The infectious diseases prevention law imposes restrictions on infected individuals from continuing to work.

The manager said public health office staff and medical staff dispatched under a prefectural government program to administer COVID-19 medicine seemed aware of what was going on at the group home, but they said nothing about it.

After five days of this arrangement, a replacement worker was finally dispatched to the group home.

All of the infected residents and staff have fully recovered.

“While the workers would normally have recuperated at home, we also had to look after the residents,” the manager said. “I feel the workers most strongly held that sense of responsibility. I had no choice but to ask those infected to continue working.”

AVOID TESTING TO KEEP WORKING

A similar situation unfolded in the Tokai region, where an outbreak in mid-January infected about 25 residents and staff at an elderly care facility.

With many workers taking time off to recuperate, only seven could continue working, about half of the number needed to staff the facility.

The initial plan was to hospitalize the infected residents. But COVID-19 hospital beds were already in short supply in the area, so only a few residents with medium symptoms could receive hospital treatment.

As the elderly care facility continued with its operations, the manager developed a fever and sore throat.

But the manager did not go for testing because “I would not be allowed into the facility if the test result was positive. And who would look after the residents if I was not there?”

Staff took extra measures to prevent a further spread of the virus.

Even residents who were not infected were quarantined in their rooms.

And two zones were set up for those infected and those free of COVID-19.

Whenever meals were delivered to residents’ rooms or when staff moved from one zone to the other, they always replaced their face masks, face shields, caps, gowns and gloves. On some days, the workers ended up using 100 gowns.

Toward the end of January, the facility was finally able to move back to normal operations once the infection cluster had subsided.

But some residents showed diminished cognitive skills during their long period of being isolated in their rooms.

Health ministry officials said they never envisioned infected facility staff looking after senior citizens, so a study would be conducted before deciding on what course to take.

(This article was written by Tomoe Ishikawa and Shino Matsuyama.)

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