八、防控知识
PART EIGHT
Knowledge About COVID-19 Prevention and Control
1. 正确使用口罩
口罩是预防呼吸道传染病的重要防线,可以降低新冠病毒感染风险。口罩不仅可以防止病人喷射飞沫,降低飞沫量和喷射速度,还可阻挡含病毒的飞沫核,防止佩戴者吸入。
新冠肺炎疫情发生以来,口罩在疫情防控中起着重要作用。2020年1月30日,国家卫生健康委印发《预防新型冠状病毒感染的肺炎口罩使用指南》。2月5日,国务院应对新冠肺炎疫情联防联控机制印发《预防新型冠状病毒感染口罩选择与使用技术指引》。3月17日,根据疫情防控形势向好和复工复产需要,联防联控机制修订形成《公众科学戴口罩指引》,从普通公众、特定场所人员、职业暴露人员以及重点人员进行分类,并对不同场景下戴口罩提出科学指引的建议。
口罩佩戴的基本原则是科学合理佩戴、规范使用、有效防护。根据相关指南、指引建议,在非疫区空旷且通风场所不需要佩戴口罩,进入人员密集或密闭公共场所需要佩戴口罩。在疫情高发地区空旷且通风场所建议佩戴一次性使用医用口罩;进入人员密集或密闭公共场所,佩戴医用外科口罩或颗粒物防护口罩。特殊人群如可能接触疑似或确诊病例的高危人群,建议佩戴医用防护口罩(N95及以上级别)并佩戴护目镜。
佩戴医用外科口罩时,鼻夹侧朝上,深色面朝外,上下拉开褶皱,使口罩覆盖口、鼻及下颌;按捏鼻夹,使之贴紧鼻梁,防止侧漏。佩戴口罩前按规程洗手,佩戴时避免接触口罩内侧。口罩佩戴2-4小时更换一次,如口罩脏污、变形、损坏、有异味时也要及时更换。口罩摘下后应将接触口鼻的一面朝里叠好,如需再次使用,可悬挂在洁净、干燥通风处,或将其放置在清洁、透气的纸袋中;如不再使用,应放入固定丢弃处,避免交叉感染。儿童不宜佩戴成人口罩,家长要帮助儿童正确佩戴口罩,并随时关注佩戴情况,年龄极小的婴幼儿不能佩戴口罩,易引起窒息。
1. Using Facemasks Properly
Facemasks are important for preventing infectious respiratory diseases and lowering the risk of COVID-19 infections. Facemasks can prevent patients from spraying droplets, reduce the amount and speed of droplets, and protect the wearers from inhaling droplet nucleus of the virus.
Facemasks have been effective in preventing and controlling COVID-19. On January 30, the NHC published a Guide on Facemask Usage Against Novel Coronavirus-infected Pneumonia. On February 5, the Joint Prevention and Control Mechanism of the State Council published the Technical Guidelines for Selecting and Using Facemasks Against Novel Coronavirus Infection.
On March 17, in response to work resumption as the disease prevention and control improved, the Joint Prevention and Control Mechanism published a Guide on Proper Usage of Facemasks by the Public, providing advice for wearing facemasks under different conditions for the general public, people at specific areas, people with occupational exposure, and key population groups.
Facemasks should be worn and used properly to ensure effective protection. According to relevant guidance, in areas not affected by the disease, facemasks are unnecessary in open and well-ventilated places, but people should wear facemasks when entering crowded or enclosed public places. In high-risk areas, people should wear disposable medical masks in open and well-ventilated places, and wear surgical masks or respirators of grade N95 when entering crowded or enclosed public places. Special groups who may contact suspected or confirmed cases should wear goggles and respirators of grade N95 or above.
When wearing surgical masks, hold the mask with the nose strip on top and the dark-colored side facing outward, pull the mask over the mouth, nose and chins, and pinch the nose strip to conform to the shape of the nose.
Wash hands according to procedures before wearing a mask and avoid touching the inside of the mask.
Replace the mask every two to four hours, and change the mask when it is dirty, contaminated, distorted, damaged or smelly.
Take off the mask with the side touching the nose and mouth folded inward, hang the mask in clean, dry, ventilated place or put it in a clean and ventilated paper bag for reuse.
Dispose the mask in a specific garbage bin to avoid cross infection.
Children should not wear the facemasks for adults, and parents should help their children wear facemasks properly.
Babies cannot wear facemasks, which can pose suffocation risks.
2. 尽量减少外出活动
每个人是自己健康第一责任人。新冠肺炎疫情期间,除了政府和相关部门采取的防控措施外,每位公民做好个人防护,减少不必要的外出、聚集等行为,是对自己和他人健康负责,也是维护公众安全的应尽义务。
根据国家卫生健康委发布的《新型冠状病毒肺炎诊疗方案(试行第七版)》,目前所见传染源主要是新型冠状病毒感染的患者。无症状感染者也可能成为传染源。经呼吸道飞沫和密切接触传播是主要的传播途径。人群普遍易感。在备餐和聚餐过程中,人群相互之间都是密切接触者,咳嗽、打喷嚏甚至近距离交谈产生的飞沫,可直接传播给整个聚会人群,极易造成疾病传播,为疾病流行提供有利条件。因此,减少人员出行,避免参加集会、聚会是阻断疫情的重要措施。
加强个人防护,还要减少到公共场所活动,尤其是一些人员密集、空气流动性差的公共场所,如商场、餐厅、影院、车站、机场、码头、展览馆等。这是因为,公共场所人员多、流动量大、人员组成复杂,一旦有病毒携带者,很容易造成人与人之间的传播,进而引发病毒感染和疫情扩散。
2. Minimizing Outings
Everyone is the first person responsible for his/her health. During the outbreak of COVID-19, on top of the prevention and control measures taken by the government and relevant agencies, every citizen should be responsible for their own and others’ health, and fulfil the due diligence to maintain public security by protecting themselves and reducing non-essential outings and gatherings.
According to the Diagnosis and Treatment Protocol for COVID-19 (Trial Version 7) published by the NHC, patients infected by the novel coronavirus are the main source of infection. Asymptomatic coronavirus carriers are possible source of infection. Major ways of transmission are respiratory droplets and close contact with infected people. All people are vulnerable to COVID-19. While preparing meals or dining together, people are in close contact with each other. Droplets spread by coughing, sneezing and even talking in close distance may directly transmit to the whole group, which can easily spread the disease and facilitate the prevalence of the disease. Therefore, reducing outings and avoiding gatherings and parties are important measures to interrupt the transmission of the disease.
People should strengthen personal protection by reducing visits to public places, especially where is crowded or poorly ventilated, such as shopping malls, restaurants, cinemas, stations, airports, wharves and exhibition centers. These public places are crowded with people from everywhere and have high population mobility, and virus carriers are easy to cause people-to-people transmission, incur virus infections, and spread the disease.
3. 保持手卫生
除了外出佩戴口罩,洗手也是预防传染病最简单、最有效的措施之一。日常工作、生活中,人们的手不断接触到被病毒、细菌污染的物品,手上的病原体可以通过手和口、眼、鼻的粘膜接触进入人体。洗手可以简单有效地切断这一传播途径,有效降低感染新冠病毒的风险。
为避免病毒经手传播,应尽量减少接触公共场所的公共物品和部位,同时注意勤洗手。以下情况应及时洗手:外出归来,戴口罩前及摘下口罩后,接触过泪液、鼻涕、痰液和唾液后,咳嗽打喷嚏用手遮挡后,护理患者后,准备食物前,用餐前,如厕后,接触公共设施或物品后(如扶手、门柄、电梯按钮、钱币、快递等物品),接触婴幼儿及哺乳喂食前,处理婴幼儿粪便后,接触动物或处理动物粪便后等。如不确定手是否清洁时,避免用手接触口鼻眼;打喷嚏或咳嗽时,用手肘衣服遮住口鼻。
正确的洗手方法是:使用流动水和肥皂或洗手液洗手,每次洗手应揉搓20秒以上,确保手心、手指、手背、指缝、指甲缝、手腕等处均被清洗干净。不方便用流动水洗手时,可使用含酒精的免洗洗手液。
3. Keeping Hands Clean
Besides wearing facemasks when going out, washing hands is also one of the simplest and most effective ways to prevent infectious disease. In daily work and life, people may touch items contaminated by viruses and bacteria, and pathogens on their hands can get into their bodies through the mucosae of mouth, eyes and nose. Washing hands can easily and effectively interrupt transmission through mucosae and reduce the risk of COVID-19 infections.
To avoid transmission of the virus through hands, people should avoid touching items and facilities at public places and wash hands frequently. They should wash hands under the following conditions:
* before putting on facemasks;
* before preparing and eating food;
* before touching, feeding or breastfeeding babies;
* after coming back from outside;
* after taking off facemasks;
* after touching tears, nasal discharge, sputum and saliva;
* after coughing and sneezing;
* after caring for patients;
* after using the toilet;
* after touching public facilities or items (such as handrails, doorknobs, elevator buttons, coins and express parcels);
* after cleaning baby stools; and
* after touching animals or cleaning their stools.
People should avoid touching mouth, nose and eyes when not sure whether their hands are clean, and sneeze or cough into the elbow.
The right way of hands washing is: Wash the hands with soap or liquid soap and running water, rub the hands for over 20 seconds each time, and make sure the palms, fingers, the back of the hands, nails, and the wrists and all other parts of the hands are cleaned. If running water is not available, use an alcohol-based hand sanitizer instead.
4. 健康监测与就医
发热、咳嗽和呼吸困难可能是呼吸道感染或其他严重疾病导致的症状。应密切关注健康状况,如果出现发热、咳嗽等症状,应注意戴口罩等个人防护,及时就近就医。
公民应主动做好个人与家庭成员的健康监测,尽可能减少与有呼吸道疾病症状(如发烧、咳嗽或打喷嚏等)的人密切接触,自觉发热时要主动测量体温。家中有儿童的,可早晚摸试其额头,如有发热及时为其测量体温。
发生以下两种情况时应及时到当地指定医疗机构进行排查诊治:一是出现发热(腋下温度≥37.3℃)、咳嗽、气促等急性呼吸道感染症状;二是有武汉及周边地区,或其他有病例报告社区的旅行史或居住史,或发病前14天内曾接触过来自武汉及周边地区,或其他有病例报告社区的旅行史或居住史的发热伴呼吸道症状的患者,或出现聚集性发病。
前往医院的路上,应佩戴医用外科口罩或N95口罩,尽量避免乘坐公共交通工具,路上打开车窗。在路上和到医院时,尽可能离其他人至少1米距离。就医时,应如实详细讲述患病情况和就医过程,告知医生近期旅行居住史、人员和动物接触史等,配合医生开展相关调查。
4. Health Monitoring and Going to Hospital
Fever, cough and breathing difficulties might be induced by respiratory infections and other severe diseases. People should closely monitor their health conditions, take personal protection measures like wearing facemasks, and go to see a doctor nearby when they display symptoms like fever and coughing.
Citizens should monitor their health and that of their family members, minimize close contact with people who have symptoms of respiratory diseases (such as fever, cough or sneezing), and take temperature when feeling feverish. If there are children at home, parents can touch their foreheads in the morning and evening, and take their temperature in time if they have a fever.
People should go to local designated medical institutions for health check, diagnosis and treatment under the following two circumstances: (1) displaying symptoms of respiratory infections such as fever (with axillary temperature ≥37.3℃), coughing and shortness of breath; or (2) having traveled to or lived in Wuhan or surrounding areas or communities where confirmed cases have been reported, or having contact, within 14 days before feeling ill, with patients who have fever and symptoms of respiratory infections and have traveled to or lived in Wuhan or surrounding areas or communities where confirmed cases have been reported, or having involved in clustered cases.
On the way to see a doctor, people should wear surgical masks or respirators of grade N95, avoid taking public transportation, and open the window of the vehicle they take. They should keep at least 1 meter from others on the way to and after arriving at the hospital. They should tell the doctor in detail about their conditions, their recent travel and residence history, and their contact with people and animals, and cooperate with the doctor in relevant investigations.
5. 保持良好卫生和健康习惯
在新冠肺炎疫情期间,做好防护措施的同时,保持良好卫生和健康习惯可以有效降低感染风险。国家卫生健康委在2020年1月27日发布的《新型冠状病毒感染的肺炎防控公众预防指南汇编》中介绍了保持良好卫生和健康习惯的主要做法:居室勤开窗,经常通风;家庭成员不共用毛巾,保持家居、餐具清洁,勤晒衣被;不随地吐痰,口鼻分泌物用纸巾包好,弃置于有盖垃圾箱内;注意营养,适度运动;不要接触、购买和食用野生动物(即野味),尽量避免前往售卖活体动物(禽类、海产品、野生动物等)的市场;家庭备置体温计、医用外科口罩或N95口罩、家用消毒用品等物资。
5. Maintaining Good Hygiene and Health Habits
During the outbreak of the COVID-19, while taking good protective measures, maintaining good hygiene and health habits can effectively reduce the risk of infection. On January 27, the NHC released a Guidebook on Public Prevention of Novel Coronavirus-infected Pneumonia, which suggested the following ways to maintain good hygiene and health habits:
* Frequently open the windows of your house for better ventilation;
* Do not share towels with your family members;
* Keep your home and tableware clean;
* Sun-cure your clothes and quilts often;
* Do not spit;
* Wrap your oral and nasal secretion with tissue and throw it in a covered dustbin;
* Balance your nutrition and exercise moderately;
* Do not touch, buy and eat wild animals (gamey), and avoid visiting the market that sells live animals (poultry, seafood and wild animals);
* Have thermometer, surgical or N95 masks, and domestic disinfectants at home.
6. 不接触、购买和食用野生动物
野生动物是指所有非经人工饲养而生活于自然环境下的各种动物。许多野生动物带有多种病毒,如果人与之接触,可能将病毒传播给人类。如艾滋病、莱姆病、埃博拉病毒、亨德拉病毒、猴痘、SARS、MERS以及新冠病毒等,都是通过野生动物传播到人类。
中国早在1988年就颁布了《中华人民共和国野生动物保护法》,规定禁止出售、购买、利用国家重点保护野生动物及其制品,禁止生产、经营使用国家重点保护野生动物及其制品制作的食品,或者使用没有合法来源证明的非国家重点保护野生动物及其制品制作的食品。
新冠肺炎疫情发生以来,滥食野生动物的突出问题及其对公共卫生安全构成的巨大隐患,引起社会广泛关注。2020年2月24日,第十三届全国人民代表大会常务委员会第十六次全体会议通过全面禁止非法野生动物交易、革除滥食野生动物陋习、切实保障人民群众生命安全的决定,为维护公共卫生安全和生态安全,保障人民群众生命健康安全提供有力的立法保障。为了人类健康,个人不要接触、捕猎、贩卖、购买、加工、食用野生动物。
6. No Touching, Buying and Eating of Wild Animals.
Wild animals refer to all kinds of animals that live in a natural environment without artificial rearing. Many wild animals carry multiple viruses that can be transmitted to humans through contact. Viruses like AIDS, Lyme disease, Ebola virus, Hendra virus, monkey pox, SARS, MERS, and novel coronavirus can spread to humans through wild animals.
China promulgated the Law on the Protection of Wildlife in 1988, which prohibits the sale, purchase and utilization of wildlife that are under special state protection and their products, and prohibits the production and sale of food made of wildlife that are under special state protection and their products, or of food made of wildlife that are not under special state protection and their products without proof of legal source.
After the outbreak of the COVID-19 epidemic, the prominent problem of eating wild animals and the huge potential dangers to public health have aroused wide concerns. On February 24, the 16th plenary meeting of the Standing Committee of the 13th National People’s Congress decided to thoroughly ban illegal wildlife trade and break the bad habit of eating wild animals, so as to effectively guarantee the safety of the people’s lives. This decision provided strong legislative guarantee to safeguard public health and ecological security and to protect people’s lives and health. For the sake of human health, people must not touch, hunt, sell, buy, process, or eat wild animals.
7. 家庭防控
家庭是社会的细胞,也是抗击疫情的基础力量和重要防线。目前诸多新冠肺炎病例中,家庭聚集性感染的特征较为突出,这是因为多人长时间聚集在同一空间,很容易造成病毒传播扩散,出现“一人感染,一家传染”的情况。
家庭防控主要指为防止疫情扩散,以家庭为单位,在社区的指导下,各自做好自我管理和家庭管理。国家卫生健康委在2020年1月27日发布的《新型冠状病毒感染的肺炎防控公众预防指南汇编》中介绍了“家庭新型冠状病毒感染的肺炎预防指南”,提供了适用于家庭场所的日常预防建议:一是避免去疾病正在流行的地区;二是减少到人员密集、尤其是空气流动性差的公共场所活动三是不要接触、购买和使用野生动物,避免前往售卖活体动物的市场,禽肉蛋要充分煮熟后食用;四是居室保持清洁,勤开窗通风;五是随时保持手卫生六是外出佩戴口罩七是保持良好卫生和健康习惯八是主动做好个人及家庭成员的健康监测九是准备常用物资,如体温计、一次性口罩、家用消毒用品等。此外,该《指南》还对家庭成员出现可疑症状时的情况提供了防控建议,强调如家庭成员出现新冠肺炎可疑症状,应及时佩戴口罩并就医;如家庭中有人被诊断为新冠肺炎患者,其他家庭成员如果经判定为密切接触者,应接受14天医学观察;患者和密切接触者应避免与无症状的其他家庭成员近距离接触;对有症状的家庭成员经常接触的地方和物品进行消毒等。
7. Family Prevention and Control
The family is the cell of society and an important place of defense against the epidemic. Among novel coronavirus cases, family infections are prominent. The gathering of people in the same space for a long time can easily cause virus spreading and result in “infection of a whole family by one confirmed member.”
The Guidebook on Public Prevention of Novel Coronavirus-infected Pneumonia issued by the NHC made the following suggestions for family members:
* Avoid visiting areas where the disease is prevalent;
* Reduce visits to crowded public places, especially places of poor ventilation;
* Do not touch, buy and eat wild animals; avoid visiting markets that sell live animals, and cook poultry, eggs and meat thoroughly;
* Keep your home clean and open windows frequently for better ventilation;
* Maintain hand hygiene;
* Wear a mask when going out;
* Keep good personal hygiene and health habits;
* Monitor health conditions of yourself and your family members;
* Keep necessary medical supplies at home, such as thermometer, disposable masks and domestic disinfectants.
The Guidance suggested that family members with suspicious symptoms should wear masks and seek prompt medical advice; when one family member is diagnosed with COVID-19, other members, if identified as close contacts, have to take medical observation for 14 consecutive days; patients and close contacts should avoid close contact with other family members who have no symptom; and the places where the family member with symptoms stays and the objects he/she frequently touches should be sterilized.
8. 公共场所防控
公共场所是公众进行社会活动的重要载体,也是防控传染病发生流行的重点环节,公共场所卫生安全关系人民群众健康和经济社会发展。为加强疫情防控,2020年1月30日,国务院应对新冠肺炎疫情联防联控机制印发《公共场所新型冠状病毒感染的肺炎卫生防护指南》,对宾馆、商场、影院、游泳馆、博物馆、候车(机)室、办公楼等人群经常聚集活动的公共场所和工作场所的卫生防护提出措施指引和操作要求。
公共场所卫生操作方面,重点做好物体表面清洁消毒,对高频接触的物体表面(如电梯间按钮、扶手、门把手等),可用含氯消毒剂、消毒湿巾进行喷洒或擦拭;加强餐(饮)具的消毒、衣服、被褥、座椅套等纺织物及卫生洁具的清洁消毒;加强通风换气,保持场所内空气流通,首选自然风;定期清洗空调滤网,未使用空调时应关闭回风通道;确保场所内洗手设施运行正常,配备足量洗手液、速干手消毒剂或感应式手消毒设施;加强垃圾分类管理,及时收集并清运,定期对垃圾桶等垃圾盛装容器进行消毒清洁;设立应急区域,当出现疑似或确诊病例时,及时到该区域进行暂时隔离和规范处理;在场所内显著区域,开展防控健康宣教。
个人防护方面,工作人员要做好“三注意”,即注意个人卫生防护、注意手卫生、注意身体状况。流动人员要减少聚集,减少不必要的外出,如果外出应做好个人防护和手卫生,在人口较为密集的公共场所,建议佩戴医用口罩、勤洗手等;办公楼等场所要加强对来访人员健康监测和登记等工作。
8. Public Places Prevention and Control
Public places are where the general public take part in social activities, therefore they are a key link in the prevention and control of infectious diseases. These places are related to people’s health and economic and social development.
On January 30, the Joint Prevention and Control Mechanism of the State Council published a Guide on Health Protection of Novel Coronavirus-infected Pneumonia in Public Places, listing suggestions and requirements for health protection in public places and workplaces where people often gather, such as hotels, shopping malls, cinemas, swimming pools, museums, waiting rooms and lounges, and office buildings.
* For hygienic practices in public places, it is important to clean and disinfect the surface of objects. Spray or wipe the surfaces with high frequency of contact (elevator buttons, handrails and door handles) with chlorine-containing disinfectants and disinfectant wipes;
* Ensure disinfection of food (drinking) utensils, sanitary ware, and textiles such as clothes, bedding and seat covers;
* Well ventilate the rooms, with natural wind preferred;
* Clean the air conditioning filters regularly, and close the air return channel if not in use;
* Ensure normal operation of hand washing facilities and adequate hand sanitizers, quick-dry hand disinfectants or inductive hand disinfection facilities;
* Strengthen garbage classification management, timely collection and removal of garbage, and regular disinfection and cleaning of garbage cans and other containers;
* Set an emergency area for temporary isolation and standard treatment of suspected or confirmed cases;
* Post health education materials about epidemic prevention and control in a conspicuous place in the site.
In terms of personal protection, the staff should pay attention to personal protection, hand hygiene, and physical condition. Mobile personnel should reduce gatherings and unnecessary outings. They must make sure of personal protection and hand hygiene if going out. In crowded public places, it is recommended to wear medical masks and wash hands frequently. Health monitoring and registration of visitors shall be made at office buildings and other places.
9. 公共交通工具防控
公共交通工具具有人流量大、人员来源复杂、密切接触可能性大等特点,仅仅靠采取消毒措施切断传播途径来预防疾病传播具有较大难度。因此,应通过加强人员管理、环境卫生及消毒、健康宣教等措施,保障公共交通工具上人员的安全健康。
国家卫生健康委在2020年1月27日发布的《新型冠状病毒感染的肺炎防控公众预防指南汇编》中,对飞机、火车、地铁、公共汽车和轮船等公共交通工具的卫生防护提供措施建议。1月29日,国务院应对新型冠肺炎疫情联防联控机制印发《公共交通工具消毒操作技术指南的通知》,指导汽车、火车、飞机、轮船等公共交通工具做好消毒工作,防止新冠肺炎通过交通工具传播和扩散。
公共交通工具防控建议主要包括:发生疾病流行地区的公共交通工具在岗工作人员应佩戴医用外科口罩或N95口罩,并每日做好健康监测;公共交通工具建议备置体温计、口罩等物品;增加公共交通工具清洁与消毒频次,做好清洁消毒工作记录和标识;保持公共交通工具良好的通风状态;保持车站、车厢内的卫生整洁,及时清理垃圾;做好人员工作与轮休安排,确保司乘人员得到足够休息。
9. Public Transportation Prevention and Control
Public transportation features large flow of people, complex personnel source, and high possibility of close contact. It is difficult to prevent the spread of disease by only taking disinfection measures to cut off the transmission route. Measures such as strengthening personnel management, environmental sanitation and disinfection, and health education should be taken to ensure the safety and health of passengers.
The NHC provided recommendations on hygienic protection of public transportation such as planes, trains, subways, buses and ships in the Guidebook on Public Prevention of Novel Coronavirus-infected Pneumonia released on January 27. On January 29, the Joint Prevention and Control Mechanism of the State Council issued a notice on applying the Technical Guidelines for Disinfection of Public Transportation, which provided disinfection suggestions of cars, trains, planes and ships to prevent the spread of the novel coronavirus through vehicles.
The suggestions included:
* On-duty staff of public transportation in epidemic areas should wear surgical or N95 masks, and carry out daily health monitoring;
* Public transportation should have thermometers, masks and other items on them;
* Increase the frequency of cleaning and disinfection of public transportation, and make records and identification;
* Maintain good ventilation;
* Keep the station and carriage clean and tidy, and clean up the garbage in time;
* Schedule proper personnel work and rotating shifts to ensure the crew get enough rest.
10. 办公场所防控
办公场所防控主要指在办公区域进行的疫情防控管理。随着复工复产、人员陆续返岗,办公区域人员密度大、停留时间长、人员构成复杂,增加了办公场所的防控工作难度。国家卫生健康委在2020年1月29日发布的《新型冠状病毒防控指南(第一版)》中,提供了办公场所防控指南,即工作人员要自行健康监测,若出现新冠状病毒感染的可疑症状(包括发热、咳嗽、咽痛、胸闷、呼吸困难、乏力、恶心呕吐、腹泻、结膜炎、肌肉酸痛等),不要带病上班;若发现新型冠状病毒感染的可疑症状者,工作人员应要求其离开;公用物品及公共接触物品或部位要定期清洗和消毒;保持办公场所内空气流通;洗手间要配备足够的洗手液,确保供水设施运行正常;保持环境卫生清洁,及时清理垃圾等。
此外,各地还就疫情期间办公场所防控和工作人员防护提出措施建议。例如,建立主体责任制,明确办公场所内各单位各部门的具体职责;办公场所所在建筑的经营管理者要建立租用户名录清单,建立楼宇、院落出入口体温监测、人员登记等防控措施;建立有针对性的防控工作方案;强化员工健康监测制度;加强重点岗位重点部门的风险梳理和应对措施;优化工作流程,降低感染风险;建立弹性工作制;减少会议等不必要的人群聚集性活动;保持办公场所室内空气流通;加强日常清洁和预防性消毒措施等。
10. Office Prevention and Control
Office prevention and control mainly refers to epidemic prevention and control management in the workplace. With the resumption of work and production and the return of personnel, the office area has a high density of staff with long stay and a complex composition, which increases the difficulty of prevention and control.
The Prevention and Control Protocol for Novel Coronavirus (1st Edition), released by the NHC on January 29, provided a guide to workplace prevention and control:
* The staff should monitor their own health.
* A sick employee should not come to work in case of suspicious symptoms of novel coronavirus pneumonia (such as fever, cough, pharyngalgia, chest distress, breathing difficulties, fatigue, nausea, diarrhea, conjunctivitis, and muscle soreness).
* People with suspected symptoms of the disease should be refused to enter the workplace.
* Regularly clean and disinfect public goods and items or parts that are frequently touched by people.
* Maintain indoor ventilation in the workplace;
* Ensure sufficient hand sanitizers and proper operation of water supply facilities in the washroom;
* Keep the workplace clean and tidy, and clean up the garbage in time.
Various localities also adopted detailed measures for the prevention and control of office areas. These included:
* Specify responsibilities of each unit in the office area;
* The operator of the building where the office is located draw up a list of tenants, and take temperature check and personnel registration at the building or courtyard entrance;
* Make targeted work plans for prevention and control;
* Strengthen staff health monitoring;
* Conduct risk analysis and work out counter measures for key posts and key departments;
* Optimize workflow to reduce the risk of infection;
* Adopt flexible work hours;
* Reduce unnecessary meetings and other gatherings;
* Maintain indoor ventilation;
* Strengthen daily cleaning and preventive disinfection.
11. 养老机构防控
老年人群是新冠病毒易感高危人群,自我防护意识普遍较弱,因此,老年康复、护理、养老等机构应做好在院老年人群的防护措施。2020年1月底,国家民政部发出通知,要求各地全力做好养老机构新冠肺炎疫情防控工作,确保老年人安全健康。
根据国家卫生健康委在2020年1月29日发布的《新型冠状病毒防控指南(第一版)》,养老机构防控疫情的主要措施包括日常预防措施,以及有老人出现可疑症状时的应对措施。疾病流行期间,建议养老机构实施封闭式管理,原则上不接待外来人员走访慰问,老人不能离院外出,不再接受新入住老人,必须外出的老人回到养老机构后应密切观察。此外,养老机构还应建立老人和工作人员的健康档案,每日开展晨检和健康登记;建立探访人员登记制度,所有外来探访人员应佩戴医用外科口罩;倡导老人养成经常洗手的好习惯,确保环境清洁卫生。如有老人出现可疑症状时,及时为其安排单间进行自我隔离,由医护人员对其健康状况进行评估,视病情状况送至医疗机构就诊,并暂停探访活动。
11. Nursing Homes Prevention and Control
The elderly are a vulnerable and high-risk group of the novel coronavirus with weak self-protection awareness. The institutions for elderly rehabilitation, nursing, and elderly care should take protective measures for the elderly.
In late January 2020, the Ministry of Civil Affairs issued a notice requesting all localities to make every effort to prevent and control the novel coronavirus in elderly care institutions to ensure the safety and health of senior citizens.
According to the Prevention and Control Protocol for Novel Coronavirus (1st Edition), major measures to be taken by the elderly care institutions included daily preventive measures and counter measures in case of suspicious symptoms of elderly people.
During the epidemic outbreak, the elderly care institutions were recommended to perform closed management. Technically they should not receive visitors from outside, the elderly should not leave the institutions, and the institutions should not accept new arrivals. The elderly who have to go out should be put under close observation after returning to the nursing home.
The old-age care institutions should establish health records for the elderly and staff, and conduct daily morning check-up and health registration; conduct registration of visitors and demand all visitors wear surgical masks; encourage the elderly to wash hand frequently and keep their rooms clean and tidy.
In case of suspicious symptoms of an elderly, the institution should promptly arrange a single room for quarantine, ask the medical staff to assess his/her health status, send him/her to the medical institution for treatment depending on the condition, and suspend visits to the elderly.
12. 幼儿园、学校防控
幼儿园、学校是幼儿、学生集体生活的场所,易感人群集中,易导致交叉感染。为科学精准指导各类学校做好新冠肺炎疫情防控工作,维护师生员工生命安全、维护校园正常生活教学秩序,2020年3月12日,国家教育部应对疫情工作领导小组办公室组织编写的《幼儿园新冠肺炎防控指南》《中小学校新冠肺炎防控指南》《高等学校新冠肺炎防控指南》出版上线,对幼儿园、学校做好应对疫情工作具有指导意义。
幼儿园、学校防控疫情的主要措施包括:返校前有过疫情高发地区(如武汉等地区)居住史或旅行史的学生,建议居家观察14天期满再返校;学生返校后应每日监测体温和健康状况,尽量减少不必要外出,避免接触其他人员;学生与其他师生发生近距离接触的环境中,要正确佩戴医用外科口罩或N95口罩,尽量缩小活动范围;学校密切监测学生的健康状态,每日两次测量体温,做好缺勤、早退、请假记录,如发现学生中出现可疑症状,应立刻向疫情管理人员报告,配合医疗卫生机构做好密切接触者管理和消毒等工作;学校应尽量避免组织大型集体活动,教室、宿舍、图书馆、活动中心、食堂、礼堂、教师办公室、洗手间等公共活动区域加强通风清洁,配备洗手液、手消毒剂等;校方对因疫情、因病误课的学生开展网络教学、补课,对于因病耽误考试的学生,应安排补考,不应记入档案。
12. Kindergartens and Schools Prevention and Control
Kindergartens and schools are places where young children and students live together, who are vulnerable to diseases and easily suffer cross-infection.
To accurately guide various schools on epidemic prevention and control, protect the health of children and teachers, and maintain normal teaching order, the leading group on virus prevention of the Ministry of Education on March 12 released different guides on COVID-19 prevention and control in kindergartens, primary and middle schools, and colleges and universities.
For the sake of epidemic prevention and control, the students should do the following:
* Stay at home for a 14-day observation before returning to school if they have a travel or residence history from areas hit hard by the epidemic (such as Wuhan and other areas);
* Monitor their body temperature and health every day after returning to school, reduce unnecessary outdoor activities and avoid contact with others;
* Properly wear surgical or N95 masks when in close contact with their teachers and schoolmates, and minimize the scope of activities.
Schools should do the following:
* Monitor the health condition of students, take their body temperature twice a day, and make records of absence, early leave and leave;
* Report to epidemic management staff in case of suspicious symptoms among students, and cooperate with medical and health institutions in the management of close contacts and disinfection work;
* Avoid organizing large-scale collective activities;
* Ensure ventilation and cleaning in public activity areas such as classrooms, dormitories, libraries, activity centers, canteens, auditoriums, teacher offices and toilets, and equip these places with hand sanitizers and hand disinfectants;
* Provide online teaching and make-up classes that students have missed due to the epidemic and illness;
* Arrange make-up exams for students who miss exams due to illness, which will not be recorded in the archives.
13. 老年人防控
老年人免疫功能弱,是传染病的易感人群和高危易发人群,本次新冠肺炎疫情的危重症人群中老年人居多。2020年1月28日,国家卫生健康委印发《关于做好老年人新冠肺炎疫情防控工作的通知》,要求将老年人的疫情防控作为当前的重要工作来抓,采取有效措施,切实降低老年人感染率,尽最大努力减少重症和死亡病例。全国老龄工作委员会办公室发布的《给老年朋友的一封信》倡议,老年人要科学防控,不要过度恐慌;尽量减少外出,做好个人防护;注重补充营养和食品卫生;合理适度锻炼身体;主动学习相关防护知识等。
根据国家卫生健康委在2020年1月29日发布的《新型冠状病毒防控指南(第一版)》,老年人群的主要防控措施包括:确保老人掌握预防新冠肺炎的个人防护措施、手卫生要求、卫生和健康习惯,避免共用个人物品,注意通风,落实消毒措施;倡导老人养成经常洗手的好习惯;老人出现可疑症状时,应自我隔离,避免与其他人员近距离接触,由医护人员对其健康状况进行评估,视病情状况送至医疗机构就诊,注意及时佩戴医用外科口罩,并避免乘坐公共交通工具;曾与可疑症状者有无有效防护的密切接触者,应立即登记,并进行医学观察;减少不必要的聚会、聚餐等群体性活动,不安排集中用餐等。此外,若出现可疑症状的老人被确诊为新冠肺炎,其密切接触者应接受14天医学观察。病人离开后(如住院、死亡等),应及时对住所进行终末消毒。
13. Prevention and Control for the Elderly
The elderly with weak immune function are susceptible and high-risk groups of infectious diseases, and they are the majority of the severe and critical cases among the COVID-19 patients.
On January 28, the NHC issued a notice on epidemic prevention and control among the elderly, requiring effective measures to reduce the infection rate, severe cases and deaths. The Office of the National Working Committee on Aging published a letter calling for the senior citizens to take scientific measures against the disease and not to panic; reduce outdoor activities and have personal protection; balance nutrition and ensure food hygiene; exercise moderately; and take protective tips.
According to the Prevention and Control Protocol for Novel Coronavirus (1st Edition), the main prevention and control measures for the elderly included:
* Learn necessary personal protective ways against the disease, keep hands clean, and maintain hygiene and health habits;
* Avoid sharing personal items, keep ventilation, and take disinfection measures;
* Wash hand frequently;
* Take self-quarantine and avoid close contact with others in case of suspicious symptoms, and ask the medical staff assess their health status and send them to medical institution for treatment depending on the condition;
* Wear surgical masks and avoid taking public transportation when going to hospital;
* Anyone who has taken no effective protection when having close contact with someone with suspicious symptoms should be registered immediately and put under medical observation;
* Reduce unnecessary gatherings, dinner parties and other group activities, and avoid collective dining.
If the elderly with suspicious symptoms are diagnosed with the novel coronavirus, their close contacts need to receive 14 days of medical observation. After the patient leave (such as hospitalization and death), the residence must be disinfected in time.
14. 儿童防控
儿童是新冠肺炎的易感人群之一。2020年2月2日,国务院应对新冠肺炎疫情联防联控机制发出通知,要求做好儿童和孕产妇新冠肺炎疫情防控工作。
根据国家卫生健康委在2020年1月29日发布的《新型冠状病毒防控指南(第一版)》,儿童群体的主要防控措施包括:尽量避免外出,不到人员密集和空间密闭的场所,不走亲访友,不与有呼吸道感染症状的人接触,确需外出的要正确佩戴口罩,做好防护措施;要养成打喷嚏或咳嗽时用纸巾或袖肘遮住嘴巴、鼻子的习惯;如果有发烧、生病的情况,一定要配合家长及时去医院就医;家长要加强居室通风,做好室内消毒,创造清洁生活环境,外出回家后洗手更衣再接触儿童;家长要教会儿童正确的洗手方法,督促儿童勤洗手、不乱摸,适度运动、合理膳食、作息规律,帮助儿童养成良好的卫生习惯等。
14. Prevention and Control for Children
Children are one of the vulnerable groups of the novel coronavirus. On February 2, the Joint Prevention and Control Mechanism of the State Council issued a notice on ensuring effective control of the children and pregnant women.
According to the Prevention and Control Protocol for Novel Coronavirus (1st Edition), the main prevention and control measures for children included:
* Reduce outdoor activities as much as possible, avoid going to crowded or poorly ventilated spaces, and avoid visiting relatives and friends or contact with people who have symptoms of respiratory tract infection;
* Take good protection such as wearing a facial mask while going out;
* Cover mouth and nose with tissue or elbow when sneezing or coughing;
* Go to hospital with parents in time in case of a fever or illness;
* Parents should improve room ventilation, and do indoor disinfection to create a clean living environment;
* After returning from public areas, parents should wash hands and change clothes before contacting children;
* Parents should teach children correct way of hand washing, urge children to wash their hands frequently, avoid touching public objects, balance nutrition and exercise moderately, work and rest regularly, and help children develop good health habits.
15. 学生防控
学生的身体健康牵涉到千家万户,是疫情防控的关键和重中之重。2020年1月29日,国家教育部宣布各地在疫情防控期间做好延期开学的准备,中小学应在延迟开学期间“停课不停教、不停学”。2020年2月2日, 国家卫生健康委发布《新冠病毒防控指南(第一版)》,对学生群体防控做出明确规定。
根据国家卫生健康委在2020年1月29日发布的《新型冠状病毒防控指南(第一版)》,学生群体的主要防控措施包括:寒假期间,有疫情高发地区(如武汉等地区)居住史或旅行史的学生,自离开疫情高发地区后,居家或在指定场所医学观察14天;各地学生均应尽量居家,减少走亲访友、聚会聚餐,减少到人员密集的公共场所活动;每日进行健康监测,并根据社区或学校要求向社区或学校指定负责人报告。寒假结束时,学生如无可疑症状,可正常返校;如有可疑症状,应报告学校或由监护人报告学校,及时就医,待痊愈后再返校;返校途中,乘坐公共交通工具时全程佩戴医用外科口罩或N95口罩,随时保持手卫生,做好旅途中健康监测,避免与可疑症状人员近距离接触;若旅途中出现可疑症状,应主动戴上医用外科口罩或N95口罩,尽量避免接触其他人员,并视病情及时就医;如需前往医疗机构就诊时,应主动告知旅行居住史,妥善保存旅行票据信息,配合相关密切接触者调查等。
15. Prevention and Control for Students
The health of students involves thousands of families, which is the key and top priority of epidemic prevention and control. On January 29, the Ministry of Education proposed all regions postpone the new school term during the epidemic prevention and control period, and primary and middle schools “suspend classes with non-stopping teaching and learning” during the period.
According to the Prevention and Control Protocol for Novel Coronavirus (1st Edition), the students should do the following:
* Stay at home or in a designated place for 14-day medical observation after their departure if they have a travel or residence history from areas hit hard by the epidemic (such as Wuhan and other areas) during the winter vacation;
* Stay at home, reduce visits to relatives and friends, parties and collective dining, and reduce visits to crowded public areas;
* Conduct daily health monitoring and report to the designated people as required by the community or school.
* Return to school at the end of winter vacation if having no suspicious symptoms;
* Report to the school if having suspicious symptoms, seek medical advice in a timely manner, and return to school after recovery;
* Wear surgical or N95 masks on public transportation on the way back school, keep hand hygiene, do health monitoring, and avoid close contact with people of suspicious symptoms;
* Wear surgical or N95 masks in case of suspicious symptoms during the journey, avoid contact with others, and seek medical advice in a timely manner depending on the condition;
* Inform the doctor about travel and residence history, preserve the travel tickets and information, and cooperate with the investigation about close contacts.
16. 有疾病流行地区居住旅行史人员防控
根据国家卫生健康委在2020年1月29日发布的《新型冠状病毒感染的肺炎防控公众预防指南汇编》,在两周内有武汉等疾病流行地区居住、旅行史的人员应做好登记、隔离和酌情就医等防控措施,具体包括:尽快到所在村支部或社区登记,减少外出活动,尤其是避免到人员密集的公共场所活动;从离开疾病流行地区时开始,连续14天进行自我健康状况监测,每天两次;条件允许时,尽量单独居住或居住在通风良好的单人房间,并尽量减少与家人的密切接触;若出现可疑症状(包括发热、咳嗽、咽痛、胸闷、呼吸困难、轻度纳差、乏力、精神稍差、恶心呕吐、腹泻、头痛、心慌、结膜炎、轻度四肢或腰背部肌肉酸痛等),应根据病情及时就诊;就医途中,应佩戴医用外科口罩或N95口罩;避免乘坐公共交通工具前往医院,路上打开车窗,注意时刻佩戴口罩、随时保持手卫生,尽可能远离其他人(至少1米),若路途中污染了交通工具,建议使用含氯消毒剂或过氧乙酸消毒剂,对所有被呼吸道分泌物或体液污染的表面进行消毒。
16. Prevention and Control for People with Travel and Residence History in Epidemic Areas
According to the Guidebook on Public Prevention of Novel Coronavirus-infected Pneumonia, released by the NHC on January 29, people who have lived in or traveled to epidemic areas like Wuhan in the previous two weeks should take prevention and control measures, including registration, quarantine, and getting medical attention as appropriate.
Specifically, they should do the following:
* Register at local community or village administration as soon as possible, and avoid outdoor activities, especially visits to crowded public places;
* Monitor their health conditions twice a day for 14 consecutive days starting from the day of leaving the epidemic areas;
* Stay alone or in well-ventilated single rooms, if possible, and minimize close contacts with family members;
* Seek medical advice immediately if they have suspicious symptoms related to COVID-19 (such as fever, cough, sore throat, chest distress, breathing difficulties, mildly poor appetite, fatigue, feebleness, nausea or vomiting, diarrhea, headache, palpitation, conjunctivitis, mild myalgia in limbs or the lumbodorsal area);
* On the way to hospital, wear a surgical or N95 mask, and avoid taking public transportation; have the car windows remain opened for good ventilation; keep the mask on and hands clear all the time; and stay at least one meter from other people;
* Disinfectants containing chlorine or peracetic acid are recommended to sterilize all surfaces of the vehicle if contaminated by their respiratory secretions or body fluids.
17. 居家隔离人员防控
居家隔离是科学防控的必要手段,也是阻止病毒传播蔓延的重要方法之一。为指导居家隔离医学观察的人员做好个人防护,预防和控制感染,国家卫生健康委在2020年2月5日印发的《新冠肺炎防控中居家隔离医学观察感染防控指引(试行)》中,对居家隔离医学观察随访者、居家隔离医学观察人员及其家庭成员或室友等相关人员的感染防控措施作出详细介绍。
根据该防控指引,居家隔离医学观察人员感染防控应注意:可选择家庭中通风较好的房间隔离,多开窗通风,保持房门随时关闭,在打开与其他家庭成员或室友相通的房门时先开窗通风;不随意离开隔离房间,必须离开隔离房间时,先戴好外科口罩,洗手或手消毒后再出门;尽可能减少与其他家庭成员或室友接触,保持1米以上距离并尽量处于下风向;避免使用中央空调;保持充足休息和充足营养,最好在隔离房间内进食、饮水,分时段共用卫生间,用后通风并用酒精等消毒剂对身体接触的物体表面清洁消毒;讲究咳嗽礼仪,咳嗽时用纸巾遮盖口鼻,不随地吐痰,纸巾及口罩用后丢入专门的带盖垃圾桶内;用过的物品及时清洁消毒;按居家隔离医学观察通知,每日上下午测量体温,自觉发热时随时测量并记录,出现发热、咳嗽、气促等急性呼吸道症状时,及时联系隔离点观察人员。
此外,居家隔离医学观察人员的家庭成员、室友、物业保洁人员、保安人员等需接触居家隔离观察对象时,也应注意防控,正确穿戴和摘脱防护用品。
17. Prevention and Control for People Under Home Quarantine
Home quarantine is a scientific way and an important means to contain the virus from spreading. The Guidelines on Medical Observation at Home for COVID-19 Prevention and Control (Trial), released by the NHC on February 5, detailed the measures for people under home quarantine and their family members/roommates, and staff conducting follow-up visits to them.
According to its suggestions, people under home quarantine and medical observation should do the following:
* Stay in a well-ventilated room, and keep windows open for ventilation but door closed;
* Open the window of their room for ventilation before opening the door that connects to where family members or roommates live;
* Avoid leaving the room, and wear a surgical mask, wash or sanitize hands before going out, if they must;
* Minimize contacts with family members or roommates, keep a distance of at least one meter from them, and try to be in the downwind direction;
* Not use the central air-conditioning;
* Get adequate rest and nutrition, and eat and drink in their own room;
* Timeshare bathrooms, and after usage, keep the bathroom ventilated, and use alcohol and other disinfectants to sterilize all the surfaces of objects that are subject to physical contacts;
* Practice the Cough Etiquette: covering mouth and nose with a tissue when coughing; no spitting; and putting the used tissues and masks into special waste receptacles with covers;
* Clean and disinfect immediately all objects they have used;
* Follow the notice for medical observation at home to measure body temperature every morning and afternoon or anytime when they have a fever;
* Contact staff at the quarantine center if they develop acute respiratory symptoms such as fever, cough, and panting.
If family members, roommates, staff of property management, cleaning and security, and other people need to come into contact with the people under medical observation at home, they are recommended to correctly wear and remove protective suits.
18. 居家发热患者防控
冬春季节,呼吸道传染病高发,普通感冒、流感和新型冠状病毒感染的肺炎均可导致发热,但症状各有不同。如普通感冒通常表现为打喷嚏、流鼻涕、咽喉不适等明显的上呼吸道症状,而全身症状较轻,不发热或仅有短暂发热。流感多为高热,全身症状较重,伴有畏寒、头痛、全身酸痛、鼻塞、流涕、干咳、胸痛、恶心、食欲不振等表现。新型冠状病毒感染的肺炎以发热、乏力、干咳为主要表现,少数患者伴有鼻塞、流涕、腹泻等症状。
根据国家卫生健康委在2020年1月29日发布的《新型冠状病毒防控指南(第一版)》,如果出现发热、咳嗽等症状,以下任一情况,建议采取居家隔离的方式进行观察,一是症状轻微,体温低于38℃,无明显气短、气促、胸闷、呼吸困难,呼吸、血压、心率等生命体征平稳;二是无严, 重呼吸系统、心血管系统等基础疾病及严重肥胖者。
《指南》建议,居家发热患者应注意休息,营养均衡,饮食宜清淡;多饮温水,少饮冰凉饮料,保证脾胃功能正常;避免盲目或不恰当使用抗菌药物;严格正确佩戴口罩,与家人分餐,与家人保持距离1.5米以上;怕冷、发热、肌肉酸痛、咳嗽者,可选用具有解热散寒、清热解毒、宣肺止咳类中成药;乏力倦怠,恶心、食欲下降、腹泻者,可选用具有化湿解表类中成药;发热伴有咽痛明显者,可选用具有清热解毒利咽功能类中成药;发热伴有大便不畅者,可加用具有通腑泻热类制剂。此外,如果居家发热患者体温升高至38.5℃以上,可采取温湿毛巾或冰贴等物理降温措施,建议口服解热镇痛类、清热解毒类中成药。如果患者体温持续2小时以上不退,出现胸闷、气短、心率增快、腹泻或呕吐加重,建议到定点医院、发热门诊就诊。如果呼吸频率出现呼吸频率≥30次/分,伴呼吸困难及口唇发绀等表现,应拨打120急救电话,由急救医护人员转运到定点医院、发热门诊救治。
18. Prevention and Control for Fever Patients at Home
Winters and springs see high incidences of respiratory infections. Common cold, influenza and COVID-19 can all lead to fever, but they are different in other symptoms. The symptoms of a common cold are obvious in the upper respiratory tract, such as sneezing, runny nose, and sore throat, and also there may be some mild general symptoms with transient fever or no fever. People with influenza may have severe general symptoms, often including high fevers, and other signs such as feeling chills, headaches, body aches, runny or stuffy nose, dry cough, chest pain, nausea, and lack of appetite. The symptoms of COVID-19 mainly are fever, fatigue, and dry cough. A few patients also have runny or stuffy noses, diarrhea and other signs.
According to the Prevention and Control Protocol for Novel Coronavirus (1st Edition), home quarantine is recommended for those with symptoms of fever and cough if any of the following is met: (1) body temperature below 38℃, mild symptoms without obvious shortness of breath, tachypnea, chest distress, or breathing difficulties, and steady vital signs including breath, blood pressure and heart rate; (2) no severe underlying disorders in the respiratory or cardiovascular system, and no severe obesity.
As advised in the Protocol, fever patients at home should get good rest, keep a light and well-balanced diet, and take warm water instead of cold drinks to ensure normal functions of the spleen and stomach. Blind or improper use of antibiotics should be avoided. Separate meals are encouraged at home. They should wear a mask correctly, and maintain at least 1.5-meter distance from other family members.
For symptoms of feeling chills, fever, myalgia and cough, Chinese patent medicines (CPMs) for releasing heat, dissipating cold, detoxifying, and diffusing the lung to suppress cough could be taken; for fatigue, nausea, loss of appetite, and diarrhea, CPMs for resolving dampness and releasing the exterior; for fever and obvious sore throat, CPMs for releasing heat, detoxifying, and soothing the throat; and for fever and poor bowel movement, Chinese medicine preparations for relaxing the bowels and purging heat could be added.
If the temperature of a fever patient at home rises above 38.5℃, such measures as warm and wet towels and ice sticks could be used for physical cooling, and oral administration of CPMs for releasing heat, easing pain, and detoxifying is recommended.
If the high temperature remains for more than 2 hours and the symptoms of chest distress, shortness of breath, as well as increased heart rate, diarrhea or vomiting are developed, it is advised to visit a designated hospital or fever clinic.
If the respiratory frequency is higher than 30/minute, and there are symptoms of breathing difficulties and blue lips, call 120 for first aid to send him/her to a designated hospital or fever clinic by medical personnel.
19. 疑似病例防控
国家卫生健康委在2020年1月22日发布的《新型冠状病毒感染的肺炎防控方案(第二版)》中,明确提出了新冠肺炎病例监测方案、流行病学调查方案、可疑暴露者和密切接触者管理方案以及实验室检测技术指南,提出加强组织领导、病例发现与报告、流行病学调查等9项防控措施,指导各级各类医疗机构、各级疾控机构开展病例监测、发现和报告工作。根据该防控方案,疑似病例的定义为:有三项临床表现,即发热,具有肺炎影像学特征,发病早期白细胞总数正常或降低,或淋巴细胞计数减少;同时,具有发病前14天内有武汉旅行史或居住史,或发病前14天内曾接触过来自武汉的发热伴有呼吸道症状的患者,或有聚集性发病或与确诊病例有流行病学关联等任何一项流行病学史的患者。
该防控方案指出,医疗机构发现符合疑似病例、确诊病例定义的患者时,应按要求开展流行病学调查、进行临床标本采集与相关病原检测;加强隔离、消毒和防护工作,对疑似病例进行单间隔离治疗。
19. Prevention and Control for Suspected Cases
In the Protocol for Novel Coronavirus-infected Pneumonia Prevention and Control (2nd Edition), released on January 22, the NHC laid out guidelines for monitoring of the patients, epidemiological investigations, and management of suspicious exposures and close contacts, and technical guidelines for laboratory testing. Nine measures of prevention and control, including strengthening organization and leadership, case detection and report, and epidemiological investigation, were provided to guide healthcare facilities and disease control centers at all levels on monitoring, detecting and reporting infections.
According to the Protocol, the definition of suspected cases considers both clinical and epidemiological features. There are three clinical manifestations: fever; radiographic imaging consistent with pneumonia; and normal or decreased white blood cell count, or decreased lymphocyte count in the early stages of the disease. The epidemiological history includes: history of travel to or residence in Wuhan within 14 days prior to the onset of the disease; contact with a patient from Wuhan with fever and respiratory symptoms within 14 days prior to the onset of the disease; clustered cases; or epidemiological relation with confirmed cases. A suspected case is defined by having all the three clinical manifestations plus any of the epidemiological history criteria.
It is stated in the Protocol that if patients who meet the definitions of suspected or confirmed cases are detected, healthcare facilities should conduct epidemiological investigations, specimen collections and lab testing, and strengthen measures for quarantine, disinfection, prevention and control. Suspected cases should be quarantined and treated in single rooms.
20. 医疗机构就诊防护
国家卫生健康委在2020年1月30日印发的《新冠病毒感染不同风险人群防护指南》中,对需要到医疗机构就诊的出行人员提出防护建议:佩戴医用外科口罩,并保持手清洁;尽量避免乘坐地铁、公交车等交通工具,避免前往人群密集的场所;就诊时应主动告知医务人员相关疾病流行地区的旅行居住史,以及与他人接触情况,配合医疗卫生机构开展相关调查。
同时,医疗机构应做好就诊患者的管理,合理配置医务人员,降低医疗机构内感染的风险;发现疑似或确诊感染新冠病毒的患者时,依法采取隔离或控制传播措施,并按照规定对患者的陪同人员和其他密切接触人员采取医学观察及其他必要的预防措施;不具备新冠肺炎救治能力的医疗机构,应及时将患者转诊到定点救治医院。
20. Prevention and Control for Visiting Medical Institutions
In the Guide on Protecting People Against Different Risks of Novel Coronavirus Infection, released on January 30, the NHC provided the following advice to individuals who need to visit a medical institution:
* Wear a surgical mask and keep hands clean;
* Avoid taking subway, bus or other public transportation, and avoid going to crowded places;
* Inform medical staff of their histories of travel to or residence in the epidemic regions and contacts with others, and cooperate with the medical institution to carry out relevant investigations.
Medical institutions should strengthen patient management, allocate medical staff properly, and reduce the risks for hospital-acquired infection. When a suspected or confirmed case is identified, quarantine or containment should be taken in accordance with law, and medical observation and other necessary precautions should be provided to the patient escorts and other close contacts. The institutions lack of the capability for treating COVID-19 should transfer the patients to designated hospitals in a timely manner.