How can we do a better job of transferring people at risk from the New Crown Pneumonia
epidemic?
The new coronavirus (2019-nCoV, hereinafter referred to as the new coronavirus) belongs to the β genus of coronaviruses, is sensitive to ultraviolet light and heat, and lipid solvents such as ether, 75% ethanol, chlorine disinfectants, peracetic acid, and chloroform can effectively inactivate the virus. The population is generally susceptible. The main sources of infection are confirmed cases of new coronary pneumonia and asymptomatic infected persons; the main means of transmission is through respiratory droplets and close contact, in a relatively closed environment through aerosol transmission, contact with objects contaminated by the virus may also cause infection.
●Vehicle reserves and scheduling
Establishment of isolation transfer vehicle reserves scheduling program, each county (district) in principle to determine the 10 buses, do a good job of the transfer vehicle transformation plan; each vehicle with 2-3 drivers, included in the list of transporters, do a good job of the training exercise, the occurrence of an outbreak of priority testing to ensure that the timely on duty.
Infected persons in principle by the 120 ambulance for transfer, close contacts and other risk personnel transfer using buses and other vehicles that accommodate a large number of passengers for transfer. According to the needs of the epidemic call the appropriate number of vehicles to ensure that the transfer of special vehicles, strictly physical isolation of the cab and compartment, the car set up a special area for the placement of contaminated items, equipped with protective gear, disinfectant, rapid hand disinfectant and medical waste bags and other protective supplies.
●Personnel transfer
01
Cases and asymptomatic infected
Transfer vehicle requirements
①Transfer ambulances need to have the basic conditions for the transfer of patients with respiratory infectious diseases, as far as possible, the use of negative-pressure ambulances for transfer.
② dedicated vehicle, cab and compartment strictly sealed isolation, the car set up a special area for the placement of contaminated items, equipped with protective gear, disinfectant, rapid hand disinfectant and medical waste bags.
③ The transfer should be kept closed, the transfer of the vehicle in a timely manner after the final disinfection, open windows and ventilation, the use of hydrogen peroxide spray or chlorine disinfectant wipe disinfection of the carriage and its object surface.
④ When transferring serious cases, the vehicle should be equipped with the necessary life support equipment to prevent further deterioration of the patient's condition during the transfer process.
Personnel transfer
Confirmed cases and asymptomatic infected people transferred to the designated medical institutions or square cabin hospitals for isolation treatment. During the transfer process, the transferred personnel should do a good job of personal protection, standardize the wearing of medical protective masks and gloves. If there are personnel vomiting, spitting, should immediately use disposable absorbent materials with sufficient amount of disinfectant or disinfectant dry towels to cover the vomit, remove the vomit, and then disinfect the vomit contaminated floors, walls and other disinfectant treatment.
Staff protection
When transferring cases, medical staff should wear protective clothing, gloves, caps, protective masks, protective screens or goggles; the driver should wear work clothes, protective masks, gloves. After the transfer of a full set of protective items must be replaced in a timely manner.
Feverish patients need to be transported with reference to the above requirements.
02
Closely Contacted Persons
Vehicle Arrangement and Transfer Requirements
Vehicle Arrangement:
After receiving the list of people to be transferred, the information of the people to be transferred should be verified, and the vehicles should be reasonably scheduled according to the principle of proximity based on the place of residence of the person and number of people to be transferred.
Transfer requirements:
Transfer to do a good job before the organization and management of personnel, the community prevention and control team to notify the transfer of personnel in the community organization to do a good job in the transfer of the relevant personnel isolation preparations. In the process of transfer to keep abreast of the progress of the transfer of personnel isolation, for special reasons for home isolation medical observation of personnel, to the flow of timely feedback to the group and the community where the case is located, the organization to do a good job of home isolation medical observation. Close contacts should be transferred to a centralized isolation point within eight hours, and cannot be transferred in the same vehicle with a positive nucleic acid test.
People transfer
① When transferring. According to the transfer list count and check the number of people on board, do a good job of personal protection and vehicle ventilation. Control the number of people in the same car during the transfer, try to sit at intervals, do a good job of personal protection, standardize the wearing of N95/KN95 particulate matter protective masks or above level masks and gloves, to reduce mutual communication. Transit process if there is a person vomiting, spitting, should immediately use disposable absorbent material with sufficient amount of disinfectant or disinfectant dry towels to cover the vomit, remove the vomit, and then vomit contaminated ground, walls and other disinfectant treatment.
② Work connection. After arriving at the isolation point, check with the staff at the isolation point the number of transporters, and hand over the list of transporters.
③ After the end of the transfer. Final disinfection of the vehicle, open windows and ventilation, use hydrogen peroxide spray or chlorine disinfectant wipe disinfection of the carriage and its object surface.
Staff protection
Transportation staff should wear protective clothing, gloves, work cap, N95/KN95 particulate matter protective masks or the above level of masks; the driver should wear overalls, wear N95/KN95 particulate matter protective masks or the above level of masks, gloves. The full set of protective articles shall be replaced in time after transshipment.
03
Entrants
The contents of vehicle preparation, transfer requirements and transfer personnel protection requirements for the transfer of entrants refer to the implementation of close contacts.
02
New Crown Pneumonia Outbreak
What about disinfecting the source of the outbreak?
At present, the Omicron variant has become the dominant epidemic strain in both imported and indigenous outbreaks outside of China. Existing research suggests that the Omicron variant has a shorter average incubation period, mostly 2-4 days, stronger transmission capacity, faster transmission, lower infectious dose, weakened pathogenicity, and stronger immune escape ability, and the existing vaccines are still effective in preventing this variant from The existing vaccine is still effective in preventing severe illness and death caused by this mutant strain.
●Determination of the scope and target of disinfection
Determine the scope and target of on-site disinfection based on epidemiological findings. Disinfect the environment and objects that may be contaminated during the hospitalization (square cabin) and transfer of cases or asymptomatic infected persons at any time. Final disinfection should be carried out after the case or asymptomatic infected person has lived or moved around, such as residence, workplace, place of study, place of diagnosis and treatment, means of transfer, and other places that may be contaminated after his/her departure [e.g., hospitalization (square cabin), discharge (square cabin), transfer to another hospital, death]. Final disinfection is not required for sites with no obvious contaminants that are briefly passed by cases or asymptomatic infected persons.
●Method selection
Depending on the environmental risk, degree of contamination and characteristics of the items, chemical disinfection methods such as disinfectant spraying, misting, wiping, soaking, etc., or physical disinfection methods such as ultraviolet rays, circulating air disinfectors, etc., or closed sealing, prolonged static storage, or harmless treatment according to the disposal of medical wastes, etc., can be selected.
●Disinfection measures
Disinfection at any time
Disinfection at any time in a timely manner for cases or asymptomatic infected persons during hospitalization and transfer, patients' excreta, vomit, bodily fluids and their contaminated environments and objects, disinfection methods, see disinfection of common contaminated objects, and the disinfection products used should comply with the relevant national hygiene standards, norms and product quality requirements, and the hygiene safety Evaluation of qualified.
Final disinfection
After the transfer of cases or asymptomatic infected persons, final disinfection should be carried out on the places where they lived or were active and other places that may be contaminated to ensure that there is no more presence of pathogens in the places and the various items therein after the final disinfection.
The final disinfection procedure is carried out in accordance with Appendix A of the General Rules for Disinfection of Epidemic Sources (GB19193-2015). Before on-site disinfection, the object and scope of disinfection should be fully understood, and under the premise of ensuring safety and effectiveness, the disinfection method that has little impact on the environment and items should be selected. Final disinfection in low-temperature environment should follow the requirements of low-temperature disinfection technology.
●Disinfection precautions
On-site disinfection should ensure that the disinfection products used are legal and effective, and that the selected disinfection methods are scientific and feasible. On-site disinfection, according to the site conditions and the requirements of the relevant standards, choose qualified and effective personal protective equipment, under the premise of good personal protection, in strict accordance with the work program to implement disinfection.
Disinfection implementation unit should have the ability to disinfect on-site, the operator should be trained in disinfection, mastering the basic knowledge of disinfection and personal protection, familiar with the use of disinfection equipment and disinfectant preparation. Disinfection implementation unit in each disinfection work should be good disinfection records, including disinfection object, disinfection area (volume), disinfectant concentration (or disinfectant instrument strength), dose, time of action, etc..
Strengthen on-site disinfection evaluation. All on-site disinfection of infected areas should be evaluated in the process, and problems are found to be rectified in time to ensure that the disinfection process is effective. According to the actual needs of the site and the relevant requirements of the "Evaluation Standards for On-site Disinfection during New Crown Pneumonia Epidemics" (WS/T774-2021), the disinfection effect evaluation is carried out when necessary.