Minireview / Open Access

DOI: 10.31488 /heph.149

Challenges for People Living with Chronic Health Problems in COVID-19 Epidemic Control-Exploring the Future Structure of InclusiveSociety in Japan

Tomoko Tachibana*

  1. Affiliation: Center for Public Health Informatics, National Institute of Public Health

*Corresponding author: Tomoko Tachibana, MD, MPH, PhD, Mailing address: 2-3-6 Minami, Wako city, Saitama prefecture 351-0197, Japan, ;Tel: +81-48-458-6206;Fax: +81-48-469-0326

Keywords: chronic health problems, COVID-19 epidemic countermeasure, disability, chronic diseases, inclusive society, agile society, mature society

Introduction

Along with the progress of medical treatment and the change of disease structure, the number of people who have some health problems such as chronic diseases and live a social life is increasing [1,2]. The author positioned people who live with "social, physical and psychological problems" due to various causes such as sequelae, disabilities and aging as "people living with chronic health problems (hereinafter 'chronic patients')," and has discussed the future measures[3-5].In the mature society* defined by the author, it is necessary to build measures that can deal with all diversifying people while considering such chronic patients.

In 2019, a pandemic due to COVID-19 occurred, and even in Japanese society, people have been required to carry out economic activities with enhanced infection prevention. In this paper, I explored the issues of COVID-19 infectious disease in 2020 (as of July 12) for chronic patients in Japan at first. Then I explored the future structure of inclusive society, through COVID-19 epidemic countermeasure in 2020 (as of July 12) for chronic patients in Japan.Author’s note: A mature society* is a “society that can aim for ‘matured death’ by preventing ‘premature death’.

Covid-19 infectious disease epidemic in japan

(as of July 7th) [6-8] On January 30, 2020, WHO (World Health Organization) declared that the novel coronavirus infection (COVID-19) represents an "internationally-concerned public health emergency." In Japan, on February 1, 2020, the Ministry of Health, Labor and Welfare issued a document notification to the prefectural health administration departments (bureaus) requesting the establishment of a medical system for the new coronavirus infection, COVID-19. The state of COVID-19 epidemic in Japan and overseas, and the government's countermeasures, have been published on the website.

Problem Analyses of the Covid-19 Epidemic Control Measures on People with Chronic Health Problems　[news program analysis]

As a measure to prevent the spread of COVID-19 infection, Japan declared a state of emergency on April 7, 2020, based on the law. All Japanese people were asked to "Self-restraint of unnecessary/unurgent going out." We decided to try to identify issues in measures for chronic patients, in our telework. The research target is the coverage of "New Coronavirus Measures" and "Disability/Intractable Disease/Welfare" in the programs broadcast by NHK (Japan Broadcasting Corporation),[9] which is a Japanese public broadcaster.　As a result, 15 programs were targeted for problem analysis.Furthermore, through watching the program, I theoretically extracted the problem of countermeasures for people living with chronic health problems in COVID-19 epidemic control measures (Table 1)[10].

Table 1. Results of monitoring impacts on chronic patients, and extracted issues

Y/M/D

News Program Name

Extracted problems

2020/03/09

 

○       Medical care children

“New Corona Child SOS vol.1 Medical Care Child”

Review the inventory management method for necessary items

ü   Hand sanitizer

ü   Alcohol cotton

ü   Disposable vinyl gloves

2020/04/12

○       Challenges for the visually impaired

“New Corona impact on the visually impaired (1) Work and life”

ü Hygiene products

ü Continued work and daily life due to difficulty in securing helpers

2020/05/03

○       Visually impaired navigation radio

"New corona impact on the visually impaired (2) Welfare facilities and blind schools"

ü Review of system for facility use and management

ü Most users use public transportation. Handrail contact is essential when moving, so there is a high risk of infection. It is necessary to consider a welfare facility management system and method that takes measures to prevent the spread of infectious diseases.

2020/05/17

 

○       Visually Impaired Navi Radio “New Corona: Impact on the visually impaired (3) To overcome the crisis of cultural activities”

ü Cultural activity crisis

ü Livelihood and employment problems for the visually impaired

2020/05/19

○     [E-tele] Heartnet TV “New Corona: How to protect? Living for the disabled”

ü Anxiety about helper infection

ü Infectious diseases at home

ü Countermeasures for infection in my home "When a helper comes to my home"

2020/05/24

○       Public opinion　"Is it possible to protect persons with disabilities or prevent the spread of infection?"

ü 10 points to reduce contact with people by 80%"

ü New lifestyle

2020/05/25

○       "Naming variety Japanese name!

[Name of infectious disease]"

ü Pandemic naming should prevent prejudice against discrimination by giving place names.

2020/05/26

○       [E-tele]

Hato Net “Confronting Corona of People with Disabilities”

2020/05/26

○       Public opinion

"Is it possible to protect persons with disabilities or prevent the spread of infection?"

ü Infectious disease correspondence in facility

2020/05/27

○       Heart net "infectious disease correspondence in facility"

2020/06/05

○       On the other side of the corona (1)

What you could see as "everyone with a disability" Dr. Kumagai S.

ü Transition to "social model of disability"

ü People with disabilities can be defined as people who are not fit for the social environment at the time. It means that there are situations in which the social environment does not fully meet my needs. At the pandemic, everyone felt more or less inconvenient and everyone was disabled.

ü From the perspective of a social model, the fact that all persons with disabilities have occurred and everyone has experienced inconvenience may be an opportunity for “solidarity” as never before. The consciousness that "there are many people who are as painful as I am" directs the vector toward "solidarity," but on the extension of everyone's spare time, "dividing" is done by excluding others. there is a possibility.

ü Divided or solidarity, "knowing" is important for that.

ü There is a gap in the “presence or absence of vulnerability” in the sense of susceptibility to infection, and this is actually leading to the selection of lives.

ü The general agreement is that "medical resources must be provided to more vulnerable people within limited medical resources."

2020/06/22

○       [Special feature] Protecting lives from flood damage (1) "Evacuation behavior" for people with disabilities

2020/06/23

○       [Special feature] Protecting lives from water damage (2) "Evacuation life" for people with disabilities

2020/0623

○       Intellectual disability

How to prevent outbreaks? Wisdom of facilities and sites for people with disabilities

2020/06/30

○       Mirairo Research

For the Issue Resolution

The Japan Society for Travel Medicine and the Japan Society for Occupational Health published as a joint document on May 11, 2020, the “New Coronavirus Infectious Diseases Control Guide for Workplaces (First Edition)”[11]. The guide emphasized measures: such as "reducing contact with other people" for those who are in charge of measures for new-type coronavirus infections in the workplace.In the situation where people are separated from each other, human weaknesses such as discrimination and division are likely to become apparent unless sufficient dialogue is conducted.This is because individuals who originally have different values are required to accept each other's way of thinking and to transform their own way of thinking while interacting with each other and to grow with each other.In the analysis of this study, “Dissemination of "correct knowledge" to prevent discrimination and prejudice from spreading,” “Dissemination of a "social model of disability"[10] that suggests all became disabled (= having shared inconvenience) in a pandemic,” etc. can be cited as a subject for chronic patients due to the COVID-19 epidemic. At the scene, it would be necessary to be taken infection countermeasures according to each "disability characteristics."To that end, it is necessary to create an environment in which "chronic patients such as persons with disabilities can make their own choices" and to change their consciousness.Based on this, the author proposed further developed the plan of “Clarification Survey of Issues” and the “Survey of Actual Issues (Validity Survey)” through Web surveys (Web interviews/Web questionnaires) by utilizing the issues searched in this study.

In the United Nations, the Secretary-General's statement has been issued in May 2020 as a guideline entitled "Policy Brief: A Disability-Inclusive Response to COVID-19"[12]. In this document, it was told "How we should create an "agile society," from the perspective of "how we should treat people with disabilities inclusively under a pandemic," "How we should maintain accessibility.""Agile" means high maneuverability.When an unexpected and unexpected trouble occurs, the organization/society that quickly grasps and recovers it is called an “agile organization” or “agile society.”Agile organizations and societies can expect to be able to respond to chronic health problems such as disabilities that this paper has focused on.

With Japan's declining birthrate and aging population progressing, Japan will transition to a comprehensive regional support system by the start of 2025[13]. Looking at Japan's population outlook for 2040, it is said that aging of the population and a decrease in the working population will become apparent, and an increase in the number of medical professionals cannot be expected. Not only infectious diseases but also health damage caused by disasters such as heavy rains occur all over the country every year [14], and it is true that Japan needs an "agile society." Therefore, in the future, Japan will be required to realize health care 2035[15], linked with the movement toward achieving Society 5.0 (IT society) [16] and SDGs[17], while effectively utilizing limited medical resources. To that end, it seems that a paradigm shift is needed in the awareness of each and every citizen. In the UK in the 1990s, self-care and other activities were promoted under the NHS Constitution's philosophy that "patients and citizens also support the system as a member" [18-20].It is thought that these overseas experiences and ideas should be used as references when Japan considers rebuilding the medical system in the future.

Acknowledgements

This research was supported by the 52nd Medical Grant, Taiju Life Welfare Foundation.

Disclosure of Interest

This research was supported by the Taiju Life Welfare Foundation's 52nd Medical Grant, "Study on the Development and Evaluation of a Self-Management Program to Support the Social Life of Patients with Epilepsy after Stroke." For this study, none of the authors have a COI status to disclose.

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Received: June04, 2020;
Accepted: July 13, 2020;
Published: July15, 2020.

To cite this article : Tachibana T.Challenges for People Living with Chronic Health Problems in COVID-19 Epidemic Control-Exploring the Future Structure of Inclusive Society in Japan.Health Education and Public Health. 2020; 3:4.

© Tachibana T.2020.