Reconstruction of a resilient and secure community and medical care system in the coronavirus era - English translation of the Japanese opinion released from the Science Council of Japan

Abstract

Background: Over 3 years have passed since the outbreak of novel coronavirus disease 2019 (COVID-19), a disease associated with a high risk of severe illness and death among older individuals. This period has brought to light regional and social issues, including issues in overall and regional healthcare, that existed before the epidemic. "COVID-19-related frailty" is defined as secondary damage to health caused by inactivity and disconnection from human interaction owing to prolonged isolation among older individuals. Now in its fourth year, COVID-19 cannot be taken lightly, even though it is now a Category 5 infectious disease. Looking at it from the perspective of the Corona (COVID-19)/post-Corona (COVID-19) era and society, it is necessary to reconstruct regional communities in which active residents can resume their activities, a resilient regional society from multiple perspectives, and a medical and care system that can give the public a sense of security, all of which will lead to the development of local communities.

Current situation and problems: Weak healthcare systems in emergencies such as emerging infectious diseases and disasters The COVID-19 pandemic has posed challenges in the management of older individuals in Japan. These challenges are common to those encountered with other emerging infectious diseases and disasters; however, the pandemic has emphasized the vulnerability of older adults. End-of-life care and advance care planning do not function during a contingency The COVID-19 pandemic has had a significant effect on the end-of-life (EOL) care of older adults, with the lack of implementation and dysfunction of advance care planning (ACP) identified as the biggest factors. This has made it difficult for this population to share their values, intentions, and life goals with their families and healthcare providers. Inadequate use of information and communication technology and the latest technologies Disparity in the digital field (digital divide) is more pronounced among older individuals. Consequently, the benefits of new technologies, such as digitalization and robotics, have not fully reached older individuals, leading to social isolation and frailty in this population. Various secondary health outcomes have emerged as a result of the COVID-19 pandemic The influence of misinformation and disinformation following the outbreak of the COVID-19 pandemic has accelerated secondary health outcomes, as excessive isolation in life has become prolonged. The inability of older individuals to screen information is a source of major concern. Furthermore, older adults are generally vulnerable to information technology and often face difficulty in accessing correct information. Lack of human resources in the field of public health The promotion of vaccine development, therapeutic drug development, and measures to prevent serious illnesses among older adults remain major challenges, especially following the COVID-19 pandemic. Information gathering and analysis during normal times are also important issues in the public health, medical care, and nursing care sectors. A shortage of human resources for this purpose has also become evident.

Content of opinion: The COVID-19 pandemic has led to the compilation of a vision for the future of the aging Japanese society from the viewpoint of individual health as well as from a broader viewpoint of the systems in the medical community, local community, and environment. These views will be reflected in the policies (including cross-ministerial flow) of academic associations such as the Japan Geriatrics Society; the Ministry of Health, Labor and Welfare; the Ministry of Education, Culture, Sports, Science and Technology; the Ministry of Economy, Trade and Industry; the Ministry of Land, Infrastructure, Transport and Tourism; the Cabinet Office; and various professional organizations. Healthcare systems that respond promptly to other emerging infectious diseases, disasters, and contingencies should be reconstructed As an issue that can commonly arise during the COVID-19 pandemic and other emerging infectious diseases, disasters, and other contingencies, a healthcare system designed for the older population, the most vulnerable segment of the population, must be developed. EOL care and ACP that is fully respected even in a contingency should be accelerated ACP should be implemented from an early stage, so that all parties involved can share values, intentions, and life goals with family members and healthcare personnel such that they are reflected in EOL care. This will enable older individuals to live as they desire until EOL. Use of information and communication technology and new technologies should be promoted to actively build new regional communication Disparities in the digital field (digital divide) must be eliminated to create an environment that enables everyone to benefit from digitalization. Furthermore, new regional communication systems, wherein the perspective of mobility support is key, must be created to prevent social isolation. The secondary health outcomes caused by the COVID-19 disaster among older individuals should be prevented through a multifaceted approach Utmost attention must be paid to preventing the occurrence of secondary health outcomes through a multifaceted approach that includes raising awareness regarding health maintenance and providing appropriate information related to health maintenance. Research in the field of public health must be promoted to strengthen human resource development in this area, with a focus on analyzing information on health, medical care, and long-term care from ordinary times Continuous support must be provided even before the occurrence of emergencies to facilitate basic research that will lead to clinical applications. Researchers at universities and research organizations, in particular, must strive to promote these activities. In addition, the government (local and national governments that have data and the national government that supports research and human resource development) must also commit to playing an important role in such research activities. Geriatr Gerontol Int 2025; 25: 481-490.

Keywords: COVID‐19 pandemic; advance care planning; frailty; resilient and secure community; super‐aged society.