At 11:07 p.m. on 13 February 2021, an earthquake with a magnitude of 7.3 struck Fukushima,
Japan, which was considered to be an aftershock of the Great East Japan Earthquake
(GEJE) that occurred in March 2011.
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A tsunami of up to 20 cm was observed as result of this earthquake. In addition to
the damage to numerous houses, expressways and railroads, mainly in Miyagi and Fukushima
prefectures, as of 15 February, 152 residents were injured; fortunately, there were
no fatalities and the damage was limited.
This was the first major earthquake since the outbreak of the novel coronavirus disease
(COVID-19) in Wuhan, China, in December 2019 and the SARS-CoV-2 outbreak in Japan.
Evacuation shelters were opened to affected residents in the hardest-hit municipalities.
In Soma City, a northern coastal municipality in Fukushima Prefecture, where the Japanese
seismic intensity scale was 6 upper in this quake, 2 evacuation shelters were opened
40 min after the earthquake hit and 87 people, including many elderly, had evacuated
by 2:30 a.m. To prevent the spread of COVID-19, in addition to hand disinfection and
body temperature checks, two buildings on the same site were prepared for the zoning
of people with fever. In the gymnasium, which served as the evacuation shelter, tents
with open roofs were set up at intervals of approximately two meters and contained
a single household (Figure 1). There was a swift and adequate response, possibly because
the damage was limited and the earthquake hit the municipality that had experienced
the GEJE and the Fukushima Daiichi Nuclear Power Plant (FDNPP) accident. In contrast,
this event highlighted the importance of preparing for the evacuation of residents
in the COVID-19 era.
Figure 1.
Roof-free tents for ventilation, which can be ventilated for infection measure, were
set up for evacuees in a gymnasium in Soma City 40 min after an earthquake on 13 February
2021. This photograph was taken by Naomi Ito, an author of this commentary, on 16
February 2021.
The importance of controlling communicable diseases during natural disasters was recognized
even before the COVID-19 pandemic.
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,
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For example, in Japan, hospital admission rates and estimated morbidity of pneumonia
had significantly increased immediately after the Great Hanshin-Awaji Earthquake in
1995.
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It has been suggested that influenza virus, norovirus and tuberculosis infections
may have occurred in evacuation shelters after the GEJE.
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,
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In light of these cases, the need to train experts in infectious disease control during
disaster evacuation was suggested even before the COVID-19 pandemic in Japan, one
of the most disaster-prone areas worldwide.
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The evacuation response to natural disasters during the COVID-19 pandemic requires
more attention. For example, evacuations associated with hurricanes in the COVID-19
pandemic may accelerate the spread of infection, emphasizing the need to carefully
consider the destination of residents’ evacuation.
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Recent reports also suggested that disasters may exacerbate infections, especially
among the poor.
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Considering the importance of countermeasures against infectious diseases during past
disasters, organizations such as the World Health Organization, the Cabinet Office,
Government in Japan and the Japan Medical Association issued strategies for evacuation
shelter use under the COVID-19 pandemic, calling for the attention of the public and
municipalities.
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The strategy recommends opening as many evacuation shelters as possible, including
hotels and public facilities, limiting the number of people in each evacuation shelter
and dispersing evacuation. In public facilities (e.g. school gymnasiums), it is also
recommended to consider social distance by using one area for a family and allowing
more space between areas. Particularly in areas with the ongoing COVID-19 pandemic,
it is crucial to respond to residents who have contracted COVID-19 and who are receiving
home treatment.
Notably, evacuation among the vulnerable, such as the elderly and the disabled, requires
special attention. At this time, such vulnerable populations are likely to be affected
more if the scale of the disaster is larger. Even vulnerable residents who should
evacuate should not be deterred from doing so for fear of being infected with COVID-19.
From the experience of the FDNPP accident, the evacuation of the vulnerable may pose
a heavier physical and mental burden.
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A major challenge is that these vulnerable populations are also highly vulnerable
to COVID-19. Thus, significant care must be taken to ensure that infection control
and minimizing the health impacts of evacuation on them can be implemented safely
at the same time. During the COVID-19 pandemic, protecting the health of vulnerable
populations requires further consideration.
Conflict of interest: None declared.