BEIJING, March 23 (Xinhua) -- China has been continuously updating its prevention and control protocol for COVID-19 according to change of situations as well as new research findings.
Such protocol informs local governments about latest findings on the disease, especially those crucial for prevention and control work, while provides work guidance in areas such as detecting and reporting new COVID-19 cases and clusters, carrying out epidemiological investigation and response as well as managing confirmed patients' close-contacts.
Local governments are hence required to take targeted and precise measures based on their specific risk levels in a bid to carry out prevention, control as well as treatment in a scientific, efficient and effective manner.
Here is the main content of the latest protocol:
Etiological and Epidemiological Characteristics
The virus belongs to the Betacoronavirus.
Incubation period ranges 1-14 days, mostly 3-7 days.
People infected with the COVID-19 is the main driver for transmission. Asymptomatic infections can be a source of transmission
Transmitted mainly via droplets and fomites during close unprotected contact between an infector and infectee. Transmission also possible for long-time exposure to high intensity aerosol-generating situations. Other possible ways of transmission to be identified and determined.
Everyone is assumed to be susceptible.
Monitoring Definitions
Suspect cases are those with epidemiological link and clinical presentations.
Confirmed cases are suspected cases with etiological or serological evidence.
Asymptomatic infections are those with no clinical presentations but test positive for COVID-19 etiological or serological tests
A cluster is where 2 or more confirmed cases (or asymptomatic infections) reported within 14 days in a small scope area, combined with transmission or exposure possibilities
Close contacts are people who have close unprotected contact with suspected or confirmed cases within 2 days before symptom-onset by suspected or confirmed cases, and people who have close unprotected contact with asymptomatic infections within 2 days of their sample taken.
Precise and Targeted Measures
level of risk is evaluated at each county/district level based on population and case number, i.e., whether has zero cases, sporadic cases, clusters or wide spread transmission, and choose appropriate measures accordingly.
Low risk areas mainly focus on preventing importation cases.
Medium risk areas focus on preventing wide spread transmission within the area as well as importation of new cases.
High risk areas focus on preventing wide spread transmission and exportation of cases while adopt stringent overall management and control.
The Principle of Early Identification, Early Reporting, Early Isolation, and Early Treatment
Early Identification
Diagnoses and report by medical institutions, health monitoring at community and company level.
Nationwide monitoring using existing unclear pneumonia, influenza-like-illness (ILI) and severe acute respiratory infection (SARI) surveillance systems.
Health quarantine at ports
Health monitoring on close contacts
Early Reporting
Report on suspected, confirmed, and asymptomatic infection cases filed electronically within 2 hours.
Report should be edited timely when suspected cases removed or confirmed, as well as when asymptomatic infections show symptoms.
Report of emergency should be filed electronically for first case or cluster detected for particular county/district.
Early Isolation
Suspected and confirmed cases isolated or receive treatment at designated hospitals
A further 14-day quarantine management and health monitoring for discharged patients
14-day designate-place quarantine for asymptomatic infections
Early Treatment
Isolation, hospitalization, diagnoses, and treatment should be carried wide and fast.
Improve hospital admission and curing ratio while lower infection and fatality ratio
Epidemiological Investigation
24 hours on top for single case investigation
Investigation into clusters ASAP upon detection
Report filed electronically after investigation
Close Contact Tracing and Management
Designate-place quarantine for close contacts, home-quarantine with medical observation allowed for situations when designate-place quarantine difficult to conduct
Quarantine and observation period should be 14 days starting from last contact with confirmed and asymptomatic infections.
Sample Collection and Laboratory Test
Institutions that conduct testing should provide lab-test results within 12 hours.
All original samples for clusters with more than 5 confirmed cases should be sent to Chinese Center for Disease Control and Prevention for review.
Prevention and Control for Key Places, Institutions and Groups
Key places refer to public places and public transportations.
Key institutions include enterprises, schools, nurseries, elderly care centers, disable people care centers, and regulatory facilities.
Key groups include all people come to China from overseas, employees, migrant workers as well as back-to-school teachers and students.
Transmission Control, Disinfection and Staff Protection in Hospitals and Special Facilities
Strict transmission prevention and control in hospitals
Disinfection in specific facilities and personnel protection
Keep the Public Well-informed for Better Understanding of the Virus and Risks
Provide prevention and control knowledge to the public and enhance health education for key groups
Follow public opinion trends and respond to people’s questions and needs
Other Supporting Measures
Follow the principle of placing prevention as top priority while combining prevention and timely treatment under scientific guidance
Carry out prevention and control work in a coordinated manner through information and data sharing as well as regular discussion meetings
Enhance professional trainings
Further deploy technology in infectious disease prevention and control
Encourage and support the use of traditional Chinese medicine (TCM) in effectively treating patients
Note: Full protocal in Chinese is originally published by China's National Health Commission and is available on its official website nhc.gov.cn. (Edited by Niu Huizhe with Xinhua Silk Road, niuhuizhe@xinhua.org)