INA JAFFE discussed the situation in US nursing homes, which account for more than one-third of all US deaths related to COVID-19.

• The devastating impact of COVID-19 on US nursing homes was due to poor infection control measures in the facilities. Even prior to the pandemic, approximately 390,000 lives are lost in US nursing homes every year to infections, and having people with underlying medical conditions living in close quarters was one of the reasons COVID-19 spread easily in long-term care facilities.

• Certified Nursing Assistants (CNAs) are the main staff providing direct care in nursing homes and they tend to be poorly paid. It is common for them to work in more than one facility and as such, they can carry the virus from one facility to another.

• In facilities where families often assist in caring for their loved one, lockdowns have caused such hands-on care to be lost. This has added to the burden on caregivers in the facilities and to the emotional stress on the residents.

• One strategy in the US that has proven effective in curbing the spread of the virus through nursing homes has been the concept of “cohorting,” or physically separating people who have been exposed to the virus from others.

REIKO HAYASHI shared country data on the impact of COVID-19 and stressed the importance of looking at statistics to capture the big picture.

• From a comparative perspective, the number of fatalities in the United States has been dramatically higher than in Japan or other Asian countries, and the spread of the disease has been much faster. Moreover, the gender balance of fatalities showed clear differences: in Japan, older men were more likely to be the victims compared to older women, but in the United States more fatalities occurred among women aged 85 years or older.

• In Japan, the ratio of COVID-19 fatalities that occurred in long-term care facilities was not as high as in the United States. This may have been thanks to early warnings issued to the staff of those facilities.

• There are many older persons in Japan who utilize long-term care services such as day-care facilities and home-care visits, but these services were suspended during the state of emergency, leaving family caregivers to shoulder the responsibilities of providing elder care.

• The use of smartphones and other technologies by older persons can alleviate social isolation, and therefore further efforts are needed to disseminate those types of communication tools.

• Due to the economic crisis caused by COVID-19, the mass media raised the concern that suicides might increase. However, according to data from the Police Agency, the number of cases in April decreased by 19.8 percent compared to the previous year, which was the sharpest decline in the past five years. This highlights the need to focus on sound statistical evidence rather than anecdotal cases.

ROHAIZAT HASSAN, who served as a member of the management secretariat of COVID-19 Hospital of University Kebangsaan Malaysia (UKM), shared the situation in Malaysia and the approaches taken by the government.

• A recent analysis of data obtained in Malaysia showed that about 67 percent of the COVID-19 deaths in the country were above 60 years old, so it was clear that older people have been severely affected.

• Based on Malaysia’s sociocultural and religious contexts, most older people choose to live with their family members compared to receiving institutionalized care. Those older people who were living alone, however, tended to be isolated during the Movement Control Orders (MCOs).

• In light of the situation of social isolation, Malaysia has taken a multisectoral approach in which the government has provided funding to telecommunication companies, enabling them to offer a package of 1GB of free data and unlimited WhatsApp usage, which has helped families stay connected.