By Cheng Shi^1,4, Bo Hu², Menglong Feng^3,4 and Gloria Wong¹

^{1The University of Hong Kong}

^{2Care Policy and Evaluation Centre, LSE}

³Renmin University of China

^{4China Association of Social Security}

Last updated, 16^th April

Key points:

• In Mainland China, the national ministries and commissions have issued and updated a package of guidelines and circulars to support long-term care. Those policies mandated a high level of cross-sectoral collaboration and prioritization of long-term care services for older people.
• A steering committee for providing guidance and integrating resources, and an integrative IT system for information and data sharing are crucial for the prompt and efficient reactions.
• Key measures focus on coordinating acute and long-term care, preventing the virus spread in care homes, supporting for the home-dwelling older people with no or less care due to the COVID-19 and psychological counselling.
• From the containment phase into the mitigation stage, the Chinese Government now focuses on the provision of regular health and social care services for older people.

Introduction

After a long-period of lockdown in mainland China, the number of new cases of COVID-19 appears to be under control, with most new cases being imported cases at the moment. Individual regions are preparing for returning to normal services, in accordance to the regional risk level. Provision of regular health and social care services for older people is now the focus.

Policies to support Long-Term Care during the COVID-19 outbreak

Older persons have been recognized as a vulnerable population to COVID-19 and have drawn widespread attention in mainland China. A package of guidelines and circulars to support long-term care have been issued since late January by national ministries and commissions, such as the Joint Prevention and Control Mechanism of the State Council, the Ministry of Civil Affairs and the National Health Commission. In response to the complex situation and in order to prevent the further spread of COVID-19, a Central Leadership Group for Epidemic Response has been established and response mechanism was initiated with multi-sectoral involvement in joint prevention and control measures. These included the Guidelines for prevention and control of COVID-19 in care homes, which have been quickly issued and circulated since the spread of COVID-19 and updated in early February. The Guidelines mandated a high level of cross-sectoral collaboration and prioritisation of long-term care services for older people. As the COVID-19 situation has recently appeared to be contained and under control in mainland China, more focus is given to returning services to normal based on the level of risks in different regions. Among these policies, we highlighted some effective measures as follows:

Whole Long-Term Care sector measures

• A steering committee for providing guidance and integrating resources set up under a government-led collaboration and mutual support among stakeholders;
• An integrative IT system for information and data sharing between service providers and local governments. Care providers are encouraged to share experiences and exchange information promptly by messaging app, online meeting or phone contacts.

Coordinating acute and long-term care

• An emergency medical service plan for care homes residents was launched locally to provide prompt medical care
• Provision of healthcare service, medical resources, pharmaceutical and personal protective equipment to care homes is fast-tracked
• A referral system set up with specific care homes and designated hospitals for COVID-19

 Care home measures

• Strict regulations and restrictions on entry into residential care facilities, including a 14-day quarantine before check-in or returning to care homes for all residents, care workers and other staff, for preventing the potential risk of the virus spread.
• All gathering activities suspended  
• Face-to-face visits by people from outside the care homes are prohibited during this period
• Staff and residents in care homes are required to have their health status checked every day, and sent to the hospital as soon as possible if a fever or any other symptoms were noted[1]
• Staff are required to wear a mask when meeting with residents
• Care homes are required to prepare a temporary isolation room for people with symptoms

Community and home-based services

• All community-based service facilities such as day care centres are suspended during the lockdown period to ensure social distancing
• Older people who live alone, with intensive care needs, or whose family carer is in quarantine or is a healthcare worker were provided with a service such as home-based or temporary residential care

Psychological counselling

• Psychological support services for older people requiring care and their family carers were strengthened, with prompt assessment and intervention
• In Hubei province and other regions heavily impacted by the COVID-19, interdisciplinary teams consisting of mental health professionals, social workers and other staff provided mental health services and support to persons who have confirmed, suspected, or cured COVID-19, and to their families and the general public.

References (in English):

State Council urges better epidemic prevention and control in civil affairs service facilities: http://www.xinhuanet.com/english/2020-02/28/c_138828394.htm

Eight precautions and health tips are summarized for nursing homes: 

http://covid-19.chinadaily.com.cn/a/202003/23/WS5e787250a3101282172814e7.html

References (in Chinese only):

Feb-7: ?????????????????????????????????????????, http://www.mca.gov.cn/article/xw/tzgg/202002/20200200024221.shtml

Feb-17????????????????????????????????, http://www.nhc.gov.cn/xcs/zhengcwj/202002/c26a0ca4a58d47489c5781493b2ac624.shtml

Feb-18??????????????????????????, http://www.nhc.gov.cn/xcs/zhengcwj/202002/f4edc0bba70b4844a83a6217e3ffab04.shtml

Feb-22???????????????????????????????, http://www.nhc.gov.cn/xcs/zhengcwj/202002/080e205ea47649e99daa8d36d58d9dfe.shtml

Feb -25??????????????????????????? ??????????????????????, http://www.nhc.gov.cn/jws/s3581r/202002/e7307a4c19a14a6fb16603d16dcf9854.shtml

Feb -25??????????????????????????????????????, http://www.mca.gov.cn/article/xw/tzgg/202002/20200200024953.shtml

Feb -28?????????????????????????????????????????????, http://www.gov.cn/zhengce/content/2020-02/28/content_5484533.htm

March-5????????????????????????????????????????,  http://www.mca.gov.cn/article/xw/tzgg/202003/20200300025295.shtml

March -6???????????????????????????????, http://www.mca.gov.cn/article/xw/tzgg/202003/20200300025373.shtml

March -7????????????????????????????????????????????????, http://www.gov.cn/zhengce/content/2020-03/07/content_5488352.htm

March -18?????????????????????, http://www.nhc.gov.cn/jkj/s3577/202003/0beb22634f8a4a48aecf405c289fc25e.shtml

March -20 ????????????????????????, http://www.nhc.gov.cn/yzygj/s7659/202003/c24669ab06324ad080ef7282cd26cf0a.shtml

Suggested citation:

Shi C, Hu B, Feng M and Wong G (2020) Report from Mainland China: Policies to Support Long-Term Care During the COVID-19 Outbreak. Country report in LTCcovid.org, International Long-Term Care Policy Network, CPEC-LSE, 18^th April 2020.

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[1] Many care home staff members live in the same care homes where they work