Public health centers in areas affected by the novel coronavirus pandemic are dealing with a heavy workload. The central and local governments should work together to speed up strengthening the public health center system.
The Health, Labor and Welfare Ministry plans to establish a system to dispatch public health nurses across local governments, to support public health centers in areas affected by large-scale infections. It is hoped that the system will be operated flexibly.
To prevent large-scale cluster infections, it is essential that personnel with expert knowledge in infectious diseases respond promptly and contain the spread at an early stage. Public health nurses are responsible for tracing patients and people they have been in close contact with, to identify routes of infection.
The ministry has already dispatched public health nurses from other public health centers, universities and related academic societies to health centers in Saitama City and Okinawa Prefecture.
In addition to the dispatched public health nurses assisting with local activities, the entities that dispatched them also appreciated the opportunity, with one saying, "We could learn procedures of tracing." It is significant that local public health nurses will gain practical experience, preparing them for a pandemic that may occur this autumn or later.
The government plans to establish human resource banks in each prefecture. Potential public health nurses, who are qualified but not working, will reportedly be registered.
When dealing with infectious diseases, it is essential to repeatedly train people in advance and have them be thoroughly versed in the day-to-day operations. The central government will need to help local governments prepare for the smooth acceptance of dispatched public health nurses.
It is important to prevent public health centers from ceasing to function in the event of a local outbreak. Local governments should implement all possible measures to ensure that medical tests and treatments are not affected by the hiatus of health center operations.
To do so, it is necessary to create an environment in which public health nurses can focus on highly specialized work. General staff, including support staff, can likely handle such tasks as telephone counseling, transporting specimens to testing institutions and conveying inpatients to medical institutions.
It is also urgent to consider strengthening the system of public health centers over the medium to long term.
Under the Community Health Law, which was established in 1994, such services as maternal and child health were transferred to municipal governments. The mergers and closures of public health centers has progressed and the number of such centers has dropped to almost half. The average number of staff is about 50 people per center. This is not enough to respond to a crisis.
In addition to prefectural governments, public health centers are established by a variety of bodies, including government-designated major cities, government-designated core cities and the special wards in Tokyo. In light of the fact that prefectural and municipal governments have been slow to share information on the spread of the novel coronavirus among themselves, strengthening mutual cooperation is an urgent task.
Infectious disease pandemics are expected in the future. The functions of public health centers must be improved, and public health nurses must be trained in a strategic manner.
-- The original Japanese article appeared in The Yomiuri Shimbun on Aug. 31, 2020.
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