'In Graying Japan, Many Are Vulnerable but Few Are Being Tested' diff viewer (6/7)

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In Graying Japan, Many Are Vulnerable but Few Are Being Tested	In Graying Japan, Many Are Vulnerable but Few Are Being Tested
2020-06-02 09:30:23 UTC	2020-06-03 01:48:49 UTC (about 16 hours later)
TOKYO — My Home Harumi, a nursing home in central Tokyo, is on lockdown.	TOKYO — My Home Harumi, a nursing home in central Tokyo, is on lockdown.
Volunteers, service providers and even family members are turned away in hopes of keeping the center sealed against the spreading coronavirus. A sense of crisis pervades the home as employees wear masks, constantly wash their hands and disinfect every surface, said its deputy director, Kumi Iwasaki.	Volunteers, service providers and even family members are turned away in hopes of keeping the center sealed against the spreading coronavirus. A sense of crisis pervades the home as employees wear masks, constantly wash their hands and disinfect every surface, said its deputy director, Kumi Iwasaki.
It’s a life-or-death mission: The virus kills older people at a far higher rate. The battle is being waged all across Japan, which has the highest proportion of elderly people in the world, as the number of reported cases in the country has steadily climbed to 230, with 11 deaths, mostly among people in their 80s. Globally, nearly 3,000 people have died, the vast majority in China.	It’s a life-or-death mission: The virus kills older people at a far higher rate. The battle is being waged all across Japan, which has the highest proportion of elderly people in the world, as the number of reported cases in the country has steadily climbed to 230, with 11 deaths, mostly among people in their 80s. Globally, nearly 3,000 people have died, the vast majority in China.
Other countries with aging populations, like South Korea and Italy, which have both experienced recent surges in infections, are also facing acute challenges. Those two countries have done just what experts recommend: They have moved quickly to test large numbers of people so they can be treated and isolated from others.	Other countries with aging populations, like South Korea and Italy, which have both experienced recent surges in infections, are also facing acute challenges. Those two countries have done just what experts recommend: They have moved quickly to test large numbers of people so they can be treated and isolated from others.
But after weeks of caution, the Japanese government has only just begun to take more aggressive action, most notably by moving to close schools for a month. That step, though, was aimed at the young, who often show only mild symptoms or none at all when infected, not vulnerable older people, who sometimes develop severe pneumonia.	But after weeks of caution, the Japanese government has only just begun to take more aggressive action, most notably by moving to close schools for a month. That step, though, was aimed at the young, who often show only mild symptoms or none at all when infected, not vulnerable older people, who sometimes develop severe pneumonia.
All the while, officials have maintained strict constraints on testing for the virus, which has only added to the fears about risks to the elderly.	All the while, officials have maintained strict constraints on testing for the virus, which has only added to the fears about risks to the elderly.
South Korea is conducting more than 10,000 tests a day; Japan, by contrast, is performing only a tiny fraction of that. What’s more, the Japanese authorities recommend that elderly patients be tested for the coronavirus only after they have had a fever for at least two days (for most others, it is four days).	South Korea is conducting more than 10,000 tests a day; Japan, by contrast, is performing only a tiny fraction of that. What’s more, the Japanese authorities recommend that elderly patients be tested for the coronavirus only after they have had a fever for at least two days (for most others, it is four days).
That may be too late for many older people, said Masahiro Kami, a physician and executive director of the Tokyo-based nonprofit Medical Governance Research Institute.	That may be too late for many older people, said Masahiro Kami, a physician and executive director of the Tokyo-based nonprofit Medical Governance Research Institute.
“What we know is that older patients are the most vulnerable, and once they get sick or ill, they quickly deteriorate,” Dr. Kami said. “They should definitely not wait two days.”	“What we know is that older patients are the most vulnerable, and once they get sick or ill, they quickly deteriorate,” Dr. Kami said. “They should definitely not wait two days.”
He speculated that the limitations might be driven by politics, as Prime Minister Shinzo Abe seeks to keep the spread of the virus from derailing the Tokyo Olympics. “It may be Abe or someone around him wants to downplay the number of infections or patients because of the upcoming Olympics,” Dr. Kami said.	He speculated that the limitations might be driven by politics, as Prime Minister Shinzo Abe seeks to keep the spread of the virus from derailing the Tokyo Olympics. “It may be Abe or someone around him wants to downplay the number of infections or patients because of the upcoming Olympics,” Dr. Kami said.
Whatever the motivation, given Japan’s large aging population — about 29 percent of its population, some 36 million, are 65 or older — experts said the country’s testing gap could leave the most vulnerable people exposed.	Whatever the motivation, given Japan’s large aging population — about 29 percent of its population, some 36 million, are 65 or older — experts said the country’s testing gap could leave the most vulnerable people exposed.
“What you’re telling me is that Japan is a senior living facility at a larger scale,” said Dr. William Schaffner, a professor of preventive medicine and infectious diseases at Vanderbilt University Medical Center in Nashville. “That would motivate me, if I were the minister of health, to test more broadly and to open up testing.”	“What you’re telling me is that Japan is a senior living facility at a larger scale,” said Dr. William Schaffner, a professor of preventive medicine and infectious diseases at Vanderbilt University Medical Center in Nashville. “That would motivate me, if I were the minister of health, to test more broadly and to open up testing.”
Mr. Abe promised on Saturday to make testing more widely available. Speaking at a news conference, he acknowledged that the screenings had been insufficient and said that the government would add the procedures to the national health insurance plan and expand the number of locations able to administer them.	Mr. Abe promised on Saturday to make testing more widely available. Speaking at a news conference, he acknowledged that the screenings had been insufficient and said that the government would add the procedures to the national health insurance plan and expand the number of locations able to administer them.
Japan currently has the capacity to conduct about 4,000 tests a day, but it has carried out less than half that number on any given day since the crisis began, according to statistics provided by the health ministry.	Japan currently has the capacity to conduct about 4,000 tests a day, but it has carried out less than half that number on any given day since the crisis began, according to statistics provided by the health ministry.
That approach differs dramatically from those of other places in East Asia that have been hit by the virus.	That approach differs dramatically from those of other places in East Asia that have been hit by the virus.
South Korea, which reported on Saturday that cases in the country had risen to 3,150, has offered drive-through testing in Daegu, a hard-hit city, and other places, while in Hong Kong, clinics have begun to give residents kits that allow them to take the tests at home and send them to a lab.	South Korea, which reported on Saturday that cases in the country had risen to 3,150, has offered drive-through testing in Daegu, a hard-hit city, and other places, while in Hong Kong, clinics have begun to give residents kits that allow them to take the tests at home and send them to a lab.
“You wonder, if they were testing nearly as much as South Korea is testing, what would the actual number be? How many cases are lurking and just aren’t being caught?” said Tobias Harris, an expert on Japanese politics at Teneo Intelligence in Washington.	“You wonder, if they were testing nearly as much as South Korea is testing, what would the actual number be? How many cases are lurking and just aren’t being caught?” said Tobias Harris, an expert on Japanese politics at Teneo Intelligence in Washington.
Making the problem worse, only a small number of public health centers in Japan have been authorized to provide the tests, which can be processed by just five companies selected by the government, creating a potential bottleneck.	Making the problem worse, only a small number of public health centers in Japan have been authorized to provide the tests, which can be processed by just five companies selected by the government, creating a potential bottleneck.
That has forced clinics to turn patients away, even when they are presenting serious symptoms like high fever, according to news reports and statements from the Japan Medical Association, which said it had begun looking into the issue.	That has forced clinics to turn patients away, even when they are presenting serious symptoms like high fever, according to news reports and statements from the Japan Medical Association, which said it had begun looking into the issue.
Erika Tamada, 33, a nursery school teacher from Hyogo Prefecture who lives with her 59-year-old parents, 83-year-old grandfather and younger sister, said both her mother and grandfather had had fevers and other symptoms, including runny noses and coughs.	Erika Tamada, 33, a nursery school teacher from Hyogo Prefecture who lives with her 59-year-old parents, 83-year-old grandfather and younger sister, said both her mother and grandfather had had fevers and other symptoms, including runny noses and coughs.
But neither of them has been able to get tested for the virus, by local public health clinics or by the hospital they visited. Ms. Tamada said she was taken aback when a doctor at a health center told them to “wash hands, gargle and just work hard not to get infected.”	But neither of them has been able to get tested for the virus, by local public health clinics or by the hospital they visited. Ms. Tamada said she was taken aback when a doctor at a health center told them to “wash hands, gargle and just work hard not to get infected.”
~~Updated June 1, 2020~~	Updated June 2, 2020
	Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.	Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.	States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.	Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.	Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)	If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
More than 40 million people — the equivalent of 1 in 4 U.S. workers — have filed for unemployment benefits since the pandemic took hold. One in five who were working in February reported losing a job or being furloughed in March or the beginning of April, data from a Federal Reserve survey released on May 14 showed, and that pain was highly concentrated among low earners. Fully 39 percent of former workers living in a household earning $40,000 or less lost work, compared with 13 percent in those making more than $100,000, a Fed official said.	More than 40 million people — the equivalent of 1 in 4 U.S. workers — have filed for unemployment benefits since the pandemic took hold. One in five who were working in February reported losing a job or being furloughed in March or the beginning of April, data from a Federal Reserve survey released on May 14 showed, and that pain was highly concentrated among low earners. Fully 39 percent of former workers living in a household earning $40,000 or less lost work, compared with 13 percent in those making more than $100,000, a Fed official said.
Yes, but make sure you keep six feet of distance between you and people who don’t live in your home. Even if you just hang out in a park, rather than go for a jog or a walk, getting some fresh air, and hopefully sunshine, is a good idea.
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.	Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.	The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.	If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.	If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
Charity Navigator, which evaluates charities using a numbers-based system, has a running list of nonprofits working in communities affected by the outbreak. You can give blood through the American Red Cross, and World Central Kitchen has stepped in to distribute meals in major cities.
It is not clear why Japan lags behind other governments in the region in its ability to test for the virus.	It is not clear why Japan lags behind other governments in the region in its ability to test for the virus.
Yasuyuki Kato, a professor of infectious diseases at the International University of Health and Welfare in Narita, Japan, said the country had been largely untouched by past outbreaks of coronaviruses, such as SARS and MERS, giving it a false sense of security.	Yasuyuki Kato, a professor of infectious diseases at the International University of Health and Welfare in Narita, Japan, said the country had been largely untouched by past outbreaks of coronaviruses, such as SARS and MERS, giving it a false sense of security.
Among the “neighboring countries of China, only Japan has no experience of managing any of the diseases,” he said, adding that there was “insufficient preparedness” for handling an emerging illness.	Among the “neighboring countries of China, only Japan has no experience of managing any of the diseases,” he said, adding that there was “insufficient preparedness” for handling an emerging illness.