The effect of social fear on the establishment of fever standards in rural hospitals during the coronavirus disease (COVID-19) pandemic

The coronavirus disease (COVID-19) pandemic has complicated the work of general physicians due to the vagueness of fever standards. Because of the high virulence of the causative virus, the disease is rapidly spreading worldwide, even reaching the rural areas in Japan. During the first wave of the pandemic, the Japanese government set the standard as a temperature of 37.5°C lasting for more than four days. However, after the government deleted this standard from its website, there was confusion in the medical institutions, as they struggled to set their fever standards. As a result, social fear might force healthcare professionals to bring down the standard for fever to increase the sensitivity and identify patients with COVID-19 more accurately. During the second wave, the fever standard was set at 37°C to enable high sensitivity. Subsequently, general physicians had to approach many people with temperatures higher than 37°C who came to the hospital seeking treatment for their symptoms or to visit their families. People seek to avoid contracting the COVID-19 infection for health-related and social reasons. When there is a possibility of healthcare professionals testing positive, hospitals may have to shut down and face criticism from society, as the mass media generally accuses these hospitals of mismanagement.