JMA Disaster Headquarters Status Reports

20:00, April 5, 2011

Previously the JMA requested doctors to refrain from long-term prescription of Thyradin S Tablets and other Thyradin (levothyroxine sodium) formulations, because production had been halted due to the effects of the earthquake. The JMA has now received word from Aska Pharmaceutical Co., Ltd., that partial production and shipment of this drug began on March 25. Also, at the request of the Ministry of Health, Labour and Welfare (MHLW), Sandoz K.K. will import levothyroxine sodium from Germany and expects to start delivering this supply by mid April. Sandoz is also considering increasing production in Japan. Accordingly, the JMA requests doctors to strive for the most suitable prescriptions and dosages at the minimum necessary for the time being.

Nursing Care Services
The Health and Welfare Bureau for the Elderly in the MHLW sent out a notification to all parties concerned regarding "The Securing of Nursing Care Services in Evacuation Shelters, Etc., for Elderly Persons Affected by the Disaster." The notification is in a Q&A format and includes the following points:
1) Home-helpers can come to evacuation shelters.
2) Day services can be used from evacuation shelters.
3) Nursing care services can be used without a health insurance card, as long as the patient's name, address, and date of birth are known.
4) In cases where the disaster caused the need for nursing care, a Care Authorization Application should be filed as soon as possible. There are also instances where services received before application can be authorized as an exceptional case.
5) The service user charge does not need to be paid by persons whose assets were significantly damaged in the disaster.
6) Persons who evacuated to a different municipality because of the disaster can receive nursing care services without transferring their residency.
7) Persons whose walking stick or wheelchair was lost may rent another one.
Please consult your municipality or other relevant organization about the above matters.

Enteral Nutrients
The Health Policy Bureau in the MHLW issued an office memorandum about enteral nutrients on April 1. Production has been suspended for Ensure Liquid (250 ml cans) and Ensure H (250 ml cans), but production has been increased for Ensure Liquid (500 ml bags) and Ensure H (500 ml bags) as well as the alternative product Racol Liquid (Enteral formula for tube or oral feeding) for Enteral Use. However, supplies, including existing inventories, are forecast to be as much as 20% short during April and May. From June supplies will return to the pre-disaster level, and so greater inventories than usual should not be kept. Also, although there are products used as similar medical diets, they will increase patients' out-of-pocket burden and so priority should be given to their use for post-operative patients and others who truly need them.

Food Sanitation Committee
On April 4 the Food Sanitation Committee in the MHLW's Pharmaceutical Affairs and Food Sanitation Council confirmed the Guidelines offered by the Nuclear Safety Commission as an emergency measure on March 17 as regulations for radioactive substances in food stemming from the accident at the Fukushima Daiichi nuclear power plant. As indicated in the previous status report, many people are of the opinion that the regulations are still difficult to understand for medical professional and the public.

The problem of radiation exposure has the potential of becoming an ongoing national issue. The JMA intends to take up this problem broadly by planning lectures and symposia for JMA members or the public in the future, mainly in the JMA Committee on Safe Livelihood of the Nation, as a form of risk communication.

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