How Japan, which has the world's oldest population, has so far managed to keep its nursing homes safe during the pandemic

• Japan, which has the oldest population in the world, has about 1 million people living in nursing homes, while the US has about 1.2 million, Reuters reported.
• Despite similar numbers, 14% of Japan's 1,225 COVID-19 deaths by August 30 were elderly people in nursing homes.
• In comparison, 40% of the US's 180,000 COVID-19 deaths were people living in nursing homes, according to the Washington Post.
• One of the reasons for Japan's success is that there is an expectation that the elderly will be looked after and not neglected, and because of this nursing homes are closely monitored.

Despite a huge elderly population, Japan has had few COVID-19 deaths in nursing homes. Experts say it comes down to a culture that respects the elderly, and because people took the pandemic seriously from the beginning.

Japan has the oldest population in the world — more than 28% of its population is older than 65, equating to about 36 million people, the average life expectancy is over 81 years old, and the average age is 47.

About 1 million people in Japan live in nursing homes, compared to 1.2 million people in the US, Reuters reported.

Despite that similarity, 14% of Japan's 1,225 COVID-19 deaths by August 30 were people living in nursing homes, according to the Washington Post.

In comparison, 40% of the US's 180,000 COVID-19 deaths were people living in nursing homes. In the US, it's gotten to the point where nursing homes are described as "death pits."

Not that Japan's nursing home response has been perfect. In April, the system was inundated with a wave of coronavirus infections, and there have been more than 100 clusters in nursing homes.

In August, Business Insider's Rhea Mahbubani reviewed inspections reports for 220 US care facilities that were flagged for violations. Numerous reports said nursing homes had a lack of hygiene and infection control, unmet medical and nutritional needs, and neglect.

One of the reasons the coronavirus has not hit Japan's nursing homes harder is that Japanese society expects the elderly to be looked after, not neglected, and that nursing homes are closely monitored, the Post reported.

National Institute of Population and Social Security Research deputy director-general Reiko Hayashi told the Post that Japan's quick reaction helped early in the year, restricting the movements of visitors and staff at nursing homes when the pandemic was spreading.

Since early March, the majority of Japan's nursing homes banned family visits, Reuters reported.

National Center for Global Health and Medicine infectious-disease expert Kayoko Hayakawa told the Post that Japan's nursing homes also have high expectations for hygiene, and strict "day-to-day precautions" were already in place to stop infections.

"Japan's elderly care facilities have taken great care in protecting the elderly, not just from this virus but from norovirus, influenza, and other germs," she said.

At one nursing home near Tokyo, called Cross Heart home, staff members took their own temperatures, filled out medical history forms, disinfected themselves, and ensured access to residents was closely monitored.

The only time some family members were allowed in was if a patient was close to dying.

Cross Heart home's head caregiver Chihiro Kasuya told the Post: "The very basic principle of elderly care is washing your hands at each step of your work: Take care of someone, wash your hands, do another job, wash your hands. But now it is even more thorough."

Staff members don't all wear masks, since it's detrimental for communication with patients. The focus is instead to keep the coronavirus out from the beginning.