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Keywords to Understand China: The Fight Against COVID-19

  PART SEVEN

  Unity Is Strength.

  1. Xi Jinping Inspecting Frontline Epidemic Prevention and Control

  On February 10, 2020, Xi Jinping inspected COVID-19 prevention and control work in Beijing. On March 2, he visited the scientists and researchers working against the coronavirus in the capital city.

  On March 10, the Chinese president went to Wuhan, the main battleground, to inspect the prevention and control work. He visited the Huoshenshan Hospital and the Donghu Xincheng Community, where he greeted the front-line medical workers, People’s Liberation Army (PLA) commanders and soldiers, community workers, police officers, grassroots officials and those designated from higher levels, volunteers, patients and residents. He encouraged them to fight with confidence to win the battle against the epidemic. During his visit to the residential quarters, the president waved to the residents undergoing home quarantine and encouraged them to “join the efforts and fight together.” He urged local officials to guarantee the supply of fresh fish, which is well liked by Wuhan people. Xi praised the healthcare workers as “the most admirable people” in the new era, and expressed deep gratitude from the Party and the whole nation to the Wuhan people. Xi Jinping chaired a teleconference after the field inspection. It was the first time he “met” with officials from across Hubei Province in this way after a teleconference to coordinate national epidemic prevention and control and economic and social development on February 23, and another on poverty elimination on March 6.

  Xi told the conference that the epidemic containment in Hubei and Wuhan is trending on a positive direction, with initial progress achieved in stabilizing the situation and turning the tide. However, the task remains arduous. At this critical moment, people must be sober-minded, remain alert, continue the efforts and continue to take epidemic prevention and control as the top priority and the most important task. All prevention and control measures should be implemented down to the last detail, to defend Wuhan and Hubei and win the war against the epidemic.

  Xi pointed out that the response to the epidemic is a big test of China’s governance system and capacity. There are both experience and lessons. People should take a long-term view, draw experience and lessons for the future, and work swiftly to address inadequacies and fix weak links in the governance system, so as to consolidate the institutional defense to ensure people’s health and safety. Efforts should be made to enhance urban governance as well as urban and rural community management. People should develop “full-cycle management” awareness, and explore new ways of modernizing the governance of mega cities.

  2. Medical Workers

  After the outbreak of COVID-19, a vast number of medical workers bid farewell to their loved ones and went in harm’s way. As warriors in white, they devoted every effort to save patients. Xi Jinping spoke highly of the medical workers on the front line, calling them “the most admirable people” in the new era, messengers of brightness and hope, the most beautiful angels, and true heroes.

  Xi Jinping made instructions on different occasions about the care for the medical workers fighting against the epidemic. He emphasized that medical workers are the backbone in beating the epidemic, and they shall be well protected and given full support. The front-line medics shall have access to sufficient protective equipment and daily necessities, and have off-days in rotation and psychological counseling. The pay package, additional subsidies and epidemic prevention allowances for the medical staff should be fully delivered, their worries be lifted, and incentive mechanism be further improved, so that they will stay strong and healthy to fight the epidemic.

  During the anti-epidemic combat, the PLA, central ministries and commissions, provinces, autonomous regions and municipalities directly under the central government altogether dispatched more than 340 medical teams consisting of over 42,000 healthcare workers to aid Hubei. As the conditions turned for the better, the medical teams completed their mission and withdrew in an orderly manner. A poster depicting the back of “soldiers in white” with the words “Thank you for fighting for us” went viral on the internet, as it voiced the heartfelt gratitude of the people of Wuhan and Hubei.

  3. PLA Commanders and Soldiers

  After the outbreak of the coronavirus, the PLA resolutely implemented the decisions and deployment of the CPC Central Committee, and promptly launched joint prevention and control mechanism. Emergency teams were drawn to the front line, becoming an indispensable force in the anti-epidemic fight.

  At the meeting held on February 23 to promote nationwide epidemic control and economic and social development, Xi Jinping pointed out that the PLA commanders and soldiers had acted upon orders and were brave to fight a tough battle, which demonstrated the political character of the people’s army and their loyalty to the Party and the people.

  “If a war befalls, the PLA is ready to fight when the call comes.” Under the unified command of the CPC Central Committee, more than 10,000 PLA medical staff rushed to the front line and devoted themselves to saving lives. They were among the first to start receiving patients and treating the seriously ill in the isolated wards. Over 1,000 troops and 100 vehicles were mobilized every day to assist the local epidemic prevention and control departments in transporting and unloading medical supplies, cleaning and disinfecting, and posting guards. Militias were dispatched by provincial military commands (garrison commands) to assist local authorities in managing visitors, disinfecting public places, performing vigilance duty, delivering goods and materials, communicating epidemic prevention to the public and other tasks.

  “Soldiers are always be ready to go to the battlefield!” From strengthening leadership to rushing to aid Wuhan, from treating the ill to providing comprehensive support, from organizing emergency-related scientific researches to expanding personnel and material delivery capacity, the PLA has once again demonstrated the sheer force of putting people first: Where there is emergency, there is the pioneering people’s army; where there is a need, there is the dedicating people’s army.

  4. Community Workers

  There are two fronts in the battle against the epidemic: hospital – the life-saving front, and community – the epidemic prevention and control front. When inspecting the epidemic prevention and control in Beijing, Xi Jinping emphasized that communities are the forefront of joint prevention and control, and also an effective defense line against importation of cases and intra-city/region transmission. We can effectively curb the spread if we hold firm the defense line in the communities.

  During his inspection in Wuhan, Xi visited Donghu Xincheng Community and talked with the community workers. He called community workers “temporary prime minister of the alleys,” who have to handle all kinds of matters that relate to people’s livelihood.

  In the battle against the epidemic, the community workers had overcome various difficulties such as insufficient manpower, limited resources, hard conditions and imperfect protective measures, and remained steadfast at the city’s front line of defense. As all the communities in Wuhan were under grid-based management, grid managers, officials designated from higher levels, volunteers and building coordinators formed different groups to serve the residents. There were telephone communication groups responsible for answering hotline questions for residents, report groups tracking and monitoring residents’ health status with daily telephone inquiries, and purchasing groups buying vegetables and medicines for the residents in need.

  A great number of community workers and volunteers across the country delivered necessities to self-isolated residents at home on a daily basis, followed up their health conditions, and helped residents see doctors, transfer to hospitals or get consultation. Their dedication shored up a strong defense line in the communities.

  5. Police Officers

  The public security organs across China resolutely implemented the instructions given by President Xi Jinping and the decisions and plans made by the CPC Central Committee. The whole police force was mobilized to join the battle. They went all out to combat the epidemic, guard against risks, and ensure safety and stability. The public security officers and police support officers met difficulties head on and remained steadfast to their posts, devoting all their efforts to tackling the virus and maintaining stability.

  The public security organs at provincial, municipal and county levels each dispatched 15%, 20%, and 30% of their police forces to support the communities. In total, 342,000-plus police officers worked tirelessly at the front line, risking their lives to protect the people and maintain security. As of April 2, 60 police officers and 35 police support officers sacrificed their lives at the front line, and 20 of them were posthumously honored as second-class heroes.

  “If the epidemic does not recede, the police will not retreat.” In the war against COVID-19, a vast number of police officers made great contribution to the society-wide prevention and control. Not only did they punish criminal and other illegal activities that hindered the anti-epidemic fight or undermined social stability, they also went to great lengths to support the resumption of work and production, thus contributing to the positive trending of epidemic prevention and control in China.

  6. Grassroots Officials

  Grassroots units are at the forefront of the battle against the epidemic, and at the first line of resuming work and production. At the meeting held on February 3 by the Standing Committee of the Political Bureau of the CPC Central Committee, Xi Jinping emphasized opposition to excessive bureaucracy and the malpractice of going through motions, so that grassroots officials can devote fully to epidemic prevention and control.

  Grassroots officials have no protective suits to wear. They only have masks. They have no power of law enforcement. They are just familiar faces to the locals. They are responsible for managing the communities, and serve as the “errand runner,” “broadcaster” and “security officer” of the people.

  During the outbreak, they were kept busy checking every block for epidemic screening, leaving no stone unturned. They arranged medical observation of suspected cases, coordinated the distribution of protective equipment, and spread knowledge of epidemic prevention to the general public. As “trustworthy friends of the people,” they safeguarded people’s wellbeing with concrete actions.

  7. Officials Designated from Higher Levels

  Epidemic prevention and control is a war that involves every one of the country. As long as a people’s defense line is put in place and the communities are well defended, the spread of the virus can be effectively curbed. When inspecting the epidemic prevention work in Beijing on February 10, Xi Jinping emphasized the need to empower communities to implement prevention and control measures, making every community a strong bastion defending the epidemic. His request sounded the “rally call” to focus on community-centered battle against the virus.

  The prevention and control work in the communities are complicated. It is an arduous task to do blanket tracking on cases and exercise grid-based management, while attending to the reasonable and essential needs of residents and maintaining orderly operation of the communities.

  In order to create synergy and strengthen community defense line, numerous Party and government officials were designated to work in the communities. Their arrival greatly relieved the shortage of manpower. They assisted community workers in personnel screening, temperature check, disinfection and isolation, publicity and guidance, and logistics support, building a solid anti-epidemic defense for the residents. They worked side by side with local community workers, public security officers, grassroots officials and volunteers, forming a powerful inter-agency force to carry out society-wide actions.

  8. Volunteers

  According to incomplete statistics, more than 50,000 volunteers joined the efforts in battling the epidemic in Wuhan, a city with a population of 10 million. “We will not retreat if the epidemic has not receded.” This is the pledge of all volunteers across the country.

  Among these volunteers were CPC members, ex-servicemen, students and deliverymen. Different in age and gender, and coming from different walks of life and different countries, they were totally dedicated to the high-risk and high-intensity work on the front line.

  Many volunteers served as drivers for front-line doctors and nurses to and from work, or as 24-hour standby for sending residents with fever for medical treatment. Many helped the self-isolated residents buy vegetables and medicines. Some launched targeted fund-raising programs and coordinated the purchase of protective equipment and delivered them to the forefront; some mobilized college students to offer free online tutoring for the children of front-line medical workers. Some volunteers acted as announcers in Wuhan’s temporary hospitals in an effort to soothe the patients and medical workers. Many a little makes a mickle. The efforts of the vast number of volunteers offered a warm light at the time of the anti-epidemic war.

  9. Patients

  After the outbreak of COVID-19, Chinese medical workers have done their utmost to treat the patients. By the end of March, the oldest COVID-19 patient cured was 103 years while the youngest only 17 days. On March 10, during his inspection in Hubei, Xi Jinping expressed sympathy to the patients, tried to boost their morale, and asked them to follow the doctor’s advice for recovery at an earlier date.

  In the treatment of COVID-19, the severe and critical cases – the key to bringing down the fatality rate – were given top priority. To crack this toughest nut, Chinese medical workers have worked out different ways to treat the severe cases, with the goal of raising the cure rate and lowering the fatality rate. These included setting up a visiting team of academicians, forming an expert group, updating the treatment plan seven times, organizing an emergency intubation team for COVID-19 patients, and promoting clinical use of traditional Chinese medicines.

  In Wuhan, the number of beds in 11 hospitals designated for the treatment of severe and critical cases exceeded 9,000. More than 13,000 intensive care health professionals from 90-plus national and provincial medical teams participated in the treatment of severe cases, accounting for nearly 10% of the national intensive care personnel resources. By March 31, more than 76,000 patients had been cured and discharged, with a cure rate of 93.5%. Among them, more than 63,000 were in Hubei, with a cure rate of over 93%.

  10. Ordinary People

  Under the Party’s leadership and deployment, the whole nation did not panic in the face of COVID-19. Rather, they developed a rational understanding of the virus, and adopted a science-based approach to epidemic prevention and control. During his inspection in Hubei, Xi Jinping highlighted the need to closely rely on the people, fully mobilize them and improve their ability to serve and protect themselves. He requested that the basic livelihood of the people be ensured and “the last mile” service problems be solved.

  In this nationwide war against the epidemic, the people voluntarily stayed at home, reduced outings, and led a “stay-at-home lifestyle” by doing almost everything online, from sending New Year greetings, to working, teaching and buying things. They supported the community work in this way, in a joint effort to safeguard the hard-won achievements in epidemic prevention and control. While doing their own parts to combat the epidemic, the general public also assisted Wuhan and other parts of Hubei through a variety of forms, demonstrating the spirit of great love.

  On March 23, the Central Leading Group for COVID-19 Prevention and Control made the judgment on the development of the epidemic: The spread of the epidemic in China, with Wuhan as the main battleground, had been basically contained, which was a milestone in the anti-epidemic fight. This was an impressive “test report” as a result of the concerted efforts of the whole nation. It was also a strong boost to the Party, the PLA and the people of all ethnic groups in China to continue to work together for the ultimately victory over the epidemic.

 

  PART EIGHT

  Knowledge About COVID-19 Prevention and Control

  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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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.

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