Cai Haodong
Experts explain their doubts
At present, the current round of new crown pneumonia epidemic that first occurred in Nanjing is still spreading.
On the 13th of this month, in response to the current epidemic prevention and control situation and the characteristics of the population, the National Health Commission and relevant departments revised the guidelines for wearing masks and the guidelines for the protection of key populations in key places and key units, including chess and card rooms, cruise ships, theaters, etc. It is designated as a high-risk place that needs to be protected well.
According to the previous epidemic information released by the disease control department, we learned that airport cleaning personnel, ground service personnel, chess and card rooms, cruise ships, and theaters in this round of the epidemic are all important links in the infection chain.
Under the epidemic situation, life will continue. Today I will use a few typical examples from this round of epidemic to talk about which people are at greater risk of contracting the new crown virus and which places are at higher risk of spreading the new crown virus, so as to help everyone be more targeted. Protect yourself and prevent and control unknown risks.
Why cleaning is a "high-risk" position
The source of the Nanjing epidemic has been investigated, which was caused by the irregular protection of airport cleaning staff when cleaning the aircraft with the imported epidemic.
Therefore, many people believe that airport cleaners are a high-risk group of new crown virus infections.
There is nothing wrong with this view.
However, there are many jobs at the airport. Why is the cleaning post the first to bear the brunt?
One of the job responsibilities of cleaning staff is to dispose of garbage, and the garbage may contain items and food discarded by the infected person, and the saliva and droplets of the infected person may be attached to the garbage.
Therefore, we say that garbage is the most dangerous. People who come into contact with garbage that may be contaminated by the virus are all people at high risk of infection by the new coronavirus.
Airplanes, trains, hospitals and other places are relatively densely populated with high mobility, and the risk of infection is high. Relevant cleaning personnel need to learn and insist on scientifically disposing of garbage to protect themselves from infection.
For example, in an infectious disease hospital, after an infectious disease patient is discharged, the ward is firstly terminally disinfected and ventilated by opening the windows, and then cleaning and garbage removal are performed to eliminate the source of infection as much as possible.
Therefore, all cleaning staff should pay attention to the reasonable arrangement of cleaning procedures. The confined space can be disinfected first, and then cleaned up; cleaning staff should wear protective clothing to work, and the protective clothing should not be taken out of the working environment after the work is completed. Dispose of after disinfection; special lines should be set up for garbage removal, and garbage should be sorted and processed to reduce environmental pollution.
In addition, there is another kind of garbage that is the most dangerous, that is, used disposable masks, paper towels, etc.
Disposable masks and paper towels directly touch the mouth and nose of a person, and they also directly touch the secretions of the respiratory tract. Disposal of them will cause environmental pollution. The new coronavirus forms aerosols in the air, which can lead to the spread of diseases.
Disposable masks and tissues in trains, airplanes, and hospitals should be collected and treated uniformly like medical waste.
Enclosed indoor performances are prone to form a high-concentration virus environment
In this round of the epidemic, there were many cases of new coronary pneumonia related to travel to Zhangjiajie, and Zhangjiajie subsequently closed all attractions.
In addition, some tourist attractions in Zhuzhou, Changde, Xi'an, Longchuan and other places have also been temporarily closed due to the epidemic.
So, is travel a risk factor for contracting the new coronavirus?
What are the risks in the natural scenery and indoor performances in the scenic area?
Zhangjiajie is a famous scenic spot in my country. According to official data, the number of tourists to Zhangjiajie during the May 1st holiday this year alone reached 1.541 million.
When the outbreak occurred, it was the peak summer tourist season. One day before Zhangjiajie closed the scenic spot, there were still more than 700 tour groups with 11,900 people coming to travel.
With so many tourists, most of them have not been infected, and the trajectory of the infected people all point to a performance of "Charming Xiangxi".
This shows what?
Analyzing from the characteristics of infectious diseases, this shows that the natural scenic area in Zhangjiajie is relatively safe, because the air in the scenic area is flowing, and the virus discharged from the human respiratory tract is quickly dispersed, diluted and inactivated by the wind.
However, this is not the case in the environment of watching the performance. Due to the hot weather, the indoor air conditioner is turned on, the environment is relatively closed, and the crowd is dense, the air is not flowing, and the virus is discharged from the respiratory tract of the infected person. It is easy to form a high-concentration virus environment. Good masks or other omissions (such as touching the nose and mouth with your hands) can cause infection.
The lesson we should learn from this epidemic in Zhangjiajie is not to not be able to touch the natural scenery. The outdoor environment of the scenic spot is not essentially different from the outdoor environment of the park. Under the premise of good air fluidity, as long as the air flow is good, it should be kept above 1 meter. Social distancing is relatively safe, with corresponding protective measures.
The important point is not to participate in performances and activities in confined and crowded places, and not to concentrate on shopping in scenic spots or closed shopping malls in parks.
Will the rapid spread of chess and card rooms happen?
"Grandma Nanjing" went to Yangzhou to visit relatives and played cards in the chess and card room for 4 days, causing many people in the chess and card room to be infected with the new crown virus. So far, more than 40 new crown cases have been found to be related to the chess and card room.
What crisis is hidden in the chess and card room that will cause the new crown virus to spread so fast?
This is closely related to the characteristics of closed spaces, densely populated and highly mobile places.
The chess and card room is a place for public leisure and entertainment, with a wide area of communication and complicated interpersonal relationships.
Moreover, most chess and card rooms are small and the distance between the card tables is very close. Many people gather to play cards, especially in the summer when the doors and windows are closed and the air conditioner is turned on. The air is easy to become dirty.
Another reason is that people who like to entertain in the chess and card room have almost no sense of risk. They stay for a few hours or even longer. Some people chat, some eat, and they keep touching the cards in their hands without wearing a mask.
Once an infected person enters, it is naturally very easy to cause the spread of the disease. If the infected person goes out and socializes, the transmission chain will continue to extend.
In fact, not only chess and card rooms, mahjong halls, karaoke halls, Internet cafes, indoor playgrounds, etc., are all high-risk places to spread the virus.
We suggest that the public in high-risk or low-risk areas should stay away from chess and card rooms, indoor playgrounds, etc. Otherwise, a rapid spread chain like this Yangzhou chess and card room may appear.
You can increase outdoor activities, such as Tai Chi, practicing aerobics, outdoor jogging, visiting the park, etc., which can not only entertain your body and mind, but also exercise your body and keep your body and mind in good condition.
Hospital escort is an important hidden danger of "hospital sense"
Here we need to talk about the recent Zhengzhou epidemic.
The source of the epidemic has been identified as a serious hospital infection, caused by an imported case from abroad. Most of the infected were hospitalized patients and their escorts, as well as caregivers and cleaning staff.
In the current special environment, inpatients have been screened for new coronavirus nucleic acid when they are admitted. They are sick and have limited range of activities during hospitalization, but their escorts and caregivers are different. They can often travel inside and outside the hospital. Larger and more contacts.
Due to the particularity of hospitals, nurses and cleaning staff exist as an indispensable and indispensable group. However, they generally have low entry barriers, insufficient training in disinfection and isolation, and serving different patients, which has become one of the important hidden dangers of hospital infections. one.
The hospital infection incident that occurred in Zhengzhou once again sounded the alarm. The hospital should minimize the number of inpatient escorts, strengthen the training of nurses and cleaning staff on epidemic prevention, and scientifically limit their scope of activities to reduce the risk of nosocomial infections.
In short, we must be aware that in the global environment of fighting against the new crown epidemic, roads are long and the virus may be volatile. The control of the epidemic in the previous period was the result of national efforts. Now we are facing extremely infectious diseases. "Delta", as well as other unknown mutant viruses, as long as we are a little slack, we may be wiped out.
Therefore, the normalization and scientificization of epidemic prevention and control will be the focus of prevention and control for a long period of time in the future.
(Author: Retired Chief Physician of Beijing Ditan Hospital, Deputy Editor-in-Chief of "Journal of Adverse Drug Reactions")
Disease control
Pay attention to these 6 points when wearing masks scientifically
Masks are an important line of defense to prevent respiratory infectious diseases and can reduce the risk of new coronavirus infection.
Masks can not only prevent the patient from spraying droplets, reduce the amount and speed of droplets, but also block the virus-containing droplet nuclei and prevent the wearer from inhaling.
Even if you get the new crown pneumonia vaccine, you must continue to wear a mask.
Wear masks scientifically and do the following 6 points.
1. Clean your hands. Pay attention to hand hygiene daily. Wash your hands before putting on the mask and after removing the mask, and throw the mask into the trash can.
2. Before distinguishing the front and back of wearing the mask, put the nose clip side of the mask up and the dark side facing out.
If the mask has no color difference, it can be judged according to the folds of the mask, and the folds are downward to the outside.
3. When wearing the mask tightly, place your fingers in the middle of the metal nose clip with both hands and move your fingertips along the sides of the nose clip while pressing inward until the nose clip is completely pressed into the shape of the bridge of the nose.
At the same time, quickly inhale, check whether air leaks from the edge of the mask including the bridge of the nose, and then adjust the nose clamp.
4. It is not necessary to take off the mask when sneezing or coughing. If you are not used to it, you can take off the mask and cover your mouth and nose with a tissue or elbow.
5. When nurses help children to organize the masks, they should do a good job of hand hygiene, and do not touch the children's masks, face or head with dirty hands.
6. Change the mask frequently. If you find that the mask is obviously wet or dirty, it is recommended to replace it with a new mask immediately to avoid affecting the protective effect.
(Source: China Center for Disease Control)
Epidemic prevention reminder
What's new in the new protection guide
On the 13th of this month, the National Health Commission announced the "Guidelines for the Public and Key Occupations to Wear Masks (August 2021)" and the "Guidelines for the Normalization of Prevention and Control of New Coronary Pneumonia Epidemics in Key Units and Key Units in Key Places" (August 2021) Monthly)".
Among them, what new changes have been made in epidemic prevention and control measures?
Expansion of the use of masks
The cumulative use time is clear
The National Health Commission mentioned in the notice that due to the long-lasting epidemic, the protection awareness of the public and related practitioners has declined, and there are paralyzing thoughts and fluke psychology such as not having to wear masks after vaccination, and implementing epidemic prevention measures and personal protection. There are loopholes.
Under this premise, the "Guidelines for the Public and Key Occupational Groups to Wear Masks (August 2021)" put forward new requirements for the use of masks.
Masks are also required in crowded outdoor places
For the general public, in addition to wearing masks in confined places, they also need to wear them when they are in crowded open air squares, theaters and parks and other outdoor places.
In addition, it is recommended that the public keep some high-level protective masks daily in their homes. When family members have nasopharyngeal discomfort, coughing, sneezing and fever and other symptoms and go to the hospital, they should wear higher-level masks to fully prevent the risk of transmission.
The cumulative use time of each mask does not exceed 8 hours
The public wear masks daily, and proper use, storage and cleaning are the keys to maintaining the effectiveness of masks.
1. Wear a mask correctly, make sure that the mask covers the mouth, nose and chin, and the nose clip should be compacted;
2. Masks need to be replaced in time when they are dirty, deformed, damaged or peculiar, and the cumulative wearing time of each mask should not exceed 8 hours;
3. It is not recommended to reuse masks that have been used in cross-regional public transportation or in hospitals and other environments;
4. Masks that need to be reused should be hung in a clean, dry and ventilated place when not in use;
5. If you feel stuffy, short of breath and other discomfort while wearing a mask, you should go to an open and ventilated place to remove the mask immediately;
6. Bring spare masks when you go out and store them in the original packaging bags or clean storage bags to avoid squeezing and deformation. Discarded masks are classified as other garbage for disposal.
"Triple" increased to 85 categories
Added chess and card room and cleaners, etc.
Compared with the previous “triple” (key places, key units, and key groups) protection guidelines, the types of “triple” in the new version of the guidelines have been increased from 65 to 85.
In terms of key places and key units, the sanitary protection requirements for 10 types of places and units such as docks, ports, chess and card rooms (Mahjong Hall), cruise ships (sightseeing boats), theaters, etc. have been increased; in key groups, airport cleaners have been added , Hygiene protection requirements for 10 key groups of people, including cleaning personnel for overseas and domestic flights, airport drivers, and auxiliary police officers at the airport.
According to the current epidemic situation, the guidelines have strengthened the requirements for health monitoring, vaccination, nucleic acid testing, cleaning and disinfection, and emergency treatment for the key places and key units involved; strict implementation of masks and vaccination for key populations involved , Disinfection and other protection requirements.
To enter the chess and card room, a temperature test code is required to wear a mask
The chess and card room (Mahjong Hall) is a newly added place in this revision of the guidelines, and it is also a kind of densely populated and relatively confined place.
For such places, one is to check the body temperature of the people entering the place and verify the health code to prevent people from high-risk areas from entering; the second is to reduce the number of customers and stay time, increase the distance between the card tables, and reduce the gathering of people; The entry personnel are required to wear masks.
City cruises (sightseeing boats) are also newly added places in this revision of the guidelines. The main risk points are crowds of people, small spaces and relatively closed spaces.
The guidelines suggest that it is advisable to stop using fully enclosed cruise ships (sightseeing boats); for those that are not fully enclosed, perform temperature testing and health code verification, and adopt methods such as booking tickets and sitting at intervals to reduce the density of personnel, and people on board wear masks throughout the journey.
In addition, life service places such as shopping malls, swimming, fitness, etc. must do a good job of temperature testing and health code verification, and at the same time require staff to wear medical surgical masks or higher-level masks throughout the process.
Strictly implement reservation and current limit in scenic spots and performance venues
The recent epidemic in some cities is closely related to the opening of tourist attractions or semi-open performance venues. The reason may be that the public has relaxed personal protection in such venues, and the venues have not effectively controlled the number of audiences, which has increased the risk of outbreaks of clustered epidemics.
The guidelines propose that the “double registration” of health code verification and body temperature testing shall be implemented for admissions, and those who are normal can enter; the staff should be vaccinated thoroughly, a health monitoring system should be established, and if symptoms occur, they should seek medical treatment in time; strictly implement personnel appointments Flow restriction measures, promote online real-name ticket purchases and e-tickets, encourage the use of online payment, and minimize direct contact; arrange for special personnel to manage the performance site, remind the audience to wear masks correctly, take seats with numbers, and keep a safe distance.
In addition, the on-site interaction before and after the performance was cancelled.
Airport cleaners regularly test nucleic acids
The guidelines pointed out that airport cleaners, overseas and domestic flight cleaners, and airport drivers are all high-risk personnel, and they are also weak links exposed by the recent epidemic.
In response to the above problems, stricter epidemic prevention measures should be implemented, including: active vaccination and regular nucleic acid testing; non-essential contact with people in other positions during work, non-essential non-necessary visits to high-risk places such as inbound aircraft and imported goods; During the cleaning and disinfection process, appropriate disinfectants should be used in accordance with the requirements of the corresponding specifications and guidelines to ensure the effective disinfection effect; the cleaning staff and driver positions and rest areas of the inbound flight should be fixed to avoid mixed use and mixed flow; inbound flights or domestic flights Where there is a medium or high risk area in the city where the origin is located, the garbage and waste collected by the cleaning staff shall be treated uniformly in accordance with relevant regulations.
Elderly people avoid going to crowded confined places
Special groups such as the elderly are high-risk groups. The guidelines mainly put forward protection requirements for the elderly in elderly care institutions and homes.
Elderly care institutions perform body temperature detection, verify health codes and register for visitors, and only those with normal body temperature can enter; visits are not allowed during closed management, and if visits are allowed during non-closed management, control the number of visitors, activity area and frequency of visits, if necessary Can implement appointment management.
The elderly at home should take personal protection and wear a mask when going out, but the elderly with chronic lung disease or heart disease should wear a mask under the professional guidance of a doctor; avoid going to crowded and confined places, such as chess and card rooms (Mahjong Hall) Wait.