Responses to COVID-19 Clusters in Long-term Care Facilities of Japan

Abstract

From April 21, 2020, 10 febrile individuals were recorded on the second floor of a 4-storey long-term care facility. SARS-CoV-2 PCR test confirmed that 9 were positive, and they were admitted to our hospital. On April 27 of the same year, PCR tests were performed, and positive results were obtained for, 21 residents, 1 short stay, and 6 staff members. Of these, 22 positive cases were quarantined on the second floor, and the negative cases were moved to the third and fourth floors. We performed zoning on the second and third floors and constructed a virtual ward on the electronic medical record in the hospital so that examinations and medication infusions could be ordered, and the resident's condition could be grasped at the hospital. Blood and urine tests were conducted at the facility, and if it was determined that a close examination was necessary, they were transferred to the hospital.

A second PCR test was performed on 69 people on May 13, 2020, and 15 people from the second floor were positive, as well as three from the third floor who were then moved to the second floor. From May 27 to June 19, 2020, the PCR test was repeated four times, and it was determined that all residents were negative twice in a row and that the cluster had converged. During this period, six people died due to complications, such as pneumonia and multiple organ failure, with a mortality rate of 14.3%.