What is the Covid-19 ?

The circulating coronavirus is a newly discovered coronavirus, International Committee on Taxonomy of Viruses called SARS-Cov-2. People are generally susceptible because they lack immunity to new strains of the virus.

What causes new Covid-19?

Caused by the SARS-COV-2 coronavirus, WHO named the disease caused by the SARS-COV-2 infection COVID-19, most of which can lead to pneumonia, called new coronavirus pneumonia/new coronavirus pneumonia.

What are the etiological characteristics of theCovid-19?

Coronaviruses are unsegmented single-stranded positive-strand RNA viruses, so named because of the shape of a corolla that protrudes outwards from the viral envelope.

The virus is sensitive to ultraviolet radiation and heat. Ether, 75% ethanol, chlorine-containing disinfectants, Peracetic acid and chloroform can inactivate the virus effectively at 56 °C for 30 minutes, while chlorhexidine can not.

What is the source of transmission of the Covid-19?

At present, the main source of infection is the new coronavirus infection in patients. Asymptomatic infections can also be a source of infection.

What is the route of transmission of the Covid-19?

Respiratory droplets and close contact are the main routes of transmission. The possibility of aerosol transport exists in the relatively closed environment when exposed to high concentration aerosol for a long time. As novel coronavirus can be isolated from faeces and urine, it should be noted that faeces and urine can cause aerosol or contact transmission.

What are the populations susceptible to Covid-19?

People are generally susceptible.

What is droplet transmission?

Foam: generally considered to be diameter > 5um of the water-bearing particles, foam through a certain distance (generally 1 meters) into the susceptible mucosal surface.

Formation of droplets:

(1) coughing, sneezing or talking;

(2) perform respiratory invasive procedures such as sputum aspiration or tracheal intubation, turning over, backslapping, and cardiopulmonary resuscitation to stimulate coughing.

What is contact transmission?

Direct contact: the spread of a pathogen by direct contact with the mucous membrane or skin.

(1) the entry of blood or blood-borne fluids into the body through mucous membranes or broken skin;

(2) transmission by direct contact with secretions containing a pathogen.

What is aerosol transmission?

Aerosol transmission refers to the formation of the nucleus, which is made up of protein and pathogen, and can be carried to a distance by the form of aerosol.

What are close contacts?

Contact with one of the following cases (observed and confirmed) after the onset of illness:

(1) cases of common residence, study, work or other persons in close contact;

(2) health-care workers, family members or other persons who have similar close contact with the case but have not taken effective protective measures in the course of diagnosis, treatment, nursing care or visiting the case;

(3) other patients and accompanying staff in the same ward;

(4) the same means of transport and close contacts as the case;

(5) persons who are assessed to be qualified after investigation by the on-site investigators.

What are the clinical manifestations of patients with Covid-19?

Based on current epidemiological investigations, the incubation period ranges from 1 to 14 days, with a maximum of 3 to 7 days. To fever, dry cough, weakness as the main performance. A small number of patients with nasal congestion, runny nose, sore throat, myalgia and diarrhea and other symptoms. Some children and the newborn case symptom may not be typical, displays for vomit, the diarrhea and so on digestive tract symptom or only displays for the spirit weak, the shortness of breath. Mild patients only showed low fever, mild fatigue, and no pneumonia. From the current admission of cases, the majority of patients with a good prognosis, a few patients in critical condition. The prognosis of the elderly and those with chronic underlying diseases was poor. In children, the symptoms are relatively mild.

How to identify and observe new cases of coronary pneumonia clinically?

Suspected cases:

Combined with the following epidemiological history and clinical manifestations:

  1. Epidemiological history: A History of travel or residence in the Wuhan and surrounding areas, or other communities with case reports, within 14 days prior to the onset of symptoms; exposure to novel coronavirus (nucleic acid test positive) within 14 days prior to onset; Exposure to patients with fever or respiratory symptoms from Wuhan and surrounding areas, or from the community with reported cases, within 14 days prior to onset of symptoms; Cluster onset (2 or more cases of fever or respiratory symptoms within 2 weeks in small areas such as home, office, school class, etc. .).
  2. Clinical manifestations: Fever or respiratory symptoms; imaging features of novel coronavirus pneumonia; normal or decreased white blood cell count, normal or decreased lymphocyte count.

Has any one of the epidemiological histories, and is consistent with any 2 of the clinical manifestations. No clear epidemiological history, consistent with the clinical manifestations of 3.

Confirmed case:

The suspected cases also had one of etiological or serological evidence: real-time fluorescent RT-PCR was positive for novel coronavirus nucleic acid, the virus gene sequencing was highly homologous with known novel coronavirus; New coronavirus-specific IgM antibody and IgG antibody were positive in serum (from negative to positive or 4 times higher in convalescence than in acute phase) .

What are the clinical types of Covid-19?

Divided into light, ordinary, heavy and critical heavy.

What is the differential diagnosis of new coronary pneumonia?

The mild manifestations of novel coronavirus infection should be differentiated from upper respiratory tract infections caused by other viruses covid-19  is distinguished from other known viral pneumonia and Mycoplasma pneumoniae infections such as influenza virus, adenovirus, respiratory syncytial virus, and non-infectious diseases such as vasculitis, dermatomyositis, and organic pneumonia.

What are the prevention and control measures for Covid-19?

(1) standard precautions;

(2) preventive measures against air transmission;

(3) contact and droplet precautions: wash hands frequently and wear a face mask when going out;

(4) ventilation of the room;

(5) cleaning and disinfection: the novel coronavirus is sensitive to heat. It can be inactivated by soaking in 56 °C hot water for 30 minutes, 75% alcohol, chlorine-containing disinfectant, chloroform and other fat solvents.

Common sense of protection

What is the role of hand washing in the prevention of respiratory tract diseases?

Proper hand washing is one of the most effective measures to prevent diarrhoea and respiratory tract infections. The National Center for Disease Control and Prevention, WHO and the U. S. CDC and other authorities recommend soap and water (running water) to wash hands fully.

The seven step formula and essentials

(1) inside: the Palm KNEADS against each other;

(2) outside: rub the back of the palm of the hand;

(3) clip: Palm to palm, fingers crossed rubbing;

(4) bow: arch your fingers, interlock your hands, and knead the bone protrusion;

(5) large: the thumb of one hand holding the other is turned and rubbed;

(6) set: five fingers together, the fingertips on the other palm, rotating rub;

(7) wrist: hold the wrist of the other hand in one hand and rotate it.

When do you need to wash your hands?

(1) before and after the transmission of the document;

(2) after coughing or sneezing;

(3) before, during and after the preparation of food;

(4) before eating;

(e) after using the toilet;

(6) when hands are dirty;

(7) after contact with others;

(8) after contact with animals;

After going out.

Travel outside without water, inconvenient to wash one’s hands, how to do?

Use alcohol-based hand sanitizers to clean your hands. Human coronavirus is acid-and alkali-resistant and sensitive to organic solvents and disinfectants. 75% alcohol inactivates the virus, so alcohol-based products that reach a certain concentration can be used as an alternative to soap and running water.

How to use a mask properly?

(1) whether it is a disposable mask or a medical mask, there are both sides. Take disposable masks, most of the color is dark on the front, the front should face out, please read the specific mask packaging instructions;

(2) make sure that the metal strip is on top of the mask and not on the other way around. After making clear the face, back, upper end and lower end of the mask, wash your hands first to make sure the mask is correct. Then hang the two ends of the string over your ears

(3) after the mask is worn, press the metal strips on both sides of the bridge of the nose with both hands so that the upper end of the mask is close to the bridge of the nose. Then stretch the mask downward so that the mask does not leave any wrinkles. It is best to cover the nose and mouth.

Use of face masks

(1) during the epidemic period of Covid-19,  non-medical high-risk general staff advised to wear to use the medical mask or surgical mask only once, and can appropriately extend the use of mask time, repeated use. Masks are for personal use only and can not be used interchangeably among personnel. Wash your hands before wearing the mask and avoid touching the inside of the mask. Mask dirty, deformation, damage, there is a strange smell to be replaced in time.

(2) the mask should be replaced immediately if it is contaminated by respiratory/nasal secretions or other body fluids.

(3) if the mask needs to be used again, it can be hung in a clean, dry and ventilated place or placed in a clean and ventilated paper bag. Masks should be stored separately to avoid contact with each other and to identify mask users.

(4) the standard medical respirator can not be cleaned, nor can it be disinfected by means of disinfectants, heating, etc. .

How do special groups wear masks?

(1) pregnant women wearing protective masks, should pay attention to their own conditions, the choice of better comfort products;

(2) elderly people and those with chronic heart and lung diseases should seek professional advice from their doctors as they may experience discomfort or even aggravate their existing conditions;

(3) the child is in the growth stage, the face shape is small, chooses the child protection mask.

III. Disposition in the face of special circumstances

How should be treated when be polluted by patient’s blood, humoral fluid, secretion?

Disinfection should be carried out when:

(1) if the skin is contaminated by pollutants: immediately remove the pollutants, and then use a disposable absorbent material dipped in 0.5% iodophor chlorine-containing disinfectant and hydrogen peroxide disinfectant wipe disinfection for more than 3 minutes, clean with clean water;

(2) if the mucosa is polluted by pollutants, it should be rinsed with a large amount of normal saline;

(3) if the clothes are contaminated: treat them according to the clothes of the patient. If there is no visible contamination, steam or boil them for 30 minutes, or soak them in 500 mg/l chlorine-containing disinfectant for 30 minutes, then wash them regularly, expensive clothing can be sterilized by Oxirane method.

How should the febrile population be managed during the epidemic period of new coronary pneumonia?

(1) not in line with the current epidemiological history, only fever, body temperature below 37.3 °C, recommended strict home isolation, drink plenty of warm boiled water, temperature test 1 to 2 days, no improvement, to outpatient, emergency treatment, wear a mask when out;

(2) does not accord with the current epidemiological history, fever higher than 37.3 °C, have sore throat and cough, should go to outpatient department, Emergency Department, listen to the Doctor’s arrangement;

(3) fever patients who meet the current epidemiological history should wear surgical masks or N95 masks, stay away from other people as far as possible on the road and in hospitals, and go to fever clinic for consultation and follow the Doctor’s instructions.

How do we respond to panic when an epidemic strikes?

(1) keep your life stable. It’s important to maintain a healthy routine.

(2) accept and be aware. There are so many things in life that you can’t do. Accept yourself and stop blaming yourself.

(3) make a list of pleasant reactive events and write down those that make you happy, such as a phone call with a good friend, a hot bath, aerobic exercise, playing games with your family, completing a long-delayed project..

(4) put down your phone, stop obsessing about the outbreak, and do the things on Your Pleasure Response list.

(5) when there is a stress reaction (such as sleep deprivation, loss of appetite, memory loss, poor concentration, physical weakness, poor energy, or the symptoms of the new coronary pneumonia described on the internet may also be accompanied by dry pharyngitis, chest tightness and dizziness due to psychological suggestion) , seek professional help in time.

(6) the patients who have been diagnosed as new type of coronavirus pneumonia (those with severe illness and above in-hospital treatment) , the first-line medical staff, the disease control staff and the management staff should seek professional evaluation and intervention.


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