Coronavirus Pneumonia Editor’s note from China:
Recently, the National Health and Medical Commission issued Announcement No. 1 of 2020, incorporating pneumonitis infected by new coronavirus into the Class B infectious diseases stipulated in the Law of the People’s Republic of China on the Prevention and Control of Infectious Diseases, and taking preventive and control measures for Class A infectious diseases. Incorporated into the management of quarantine infectious diseases as stipulated in the “People’s Republic of China Frontier Health and Quarantine Law”. At this time, China ’s traditional Spring Festival is approaching. The “Spring Festival” travels from south to north, the “visiting friends” walk down the streets, and the “ceremonies” are common. This is undoubtedly a huge challenge for the prevention and control of new type of coronavirus pneumonia. .
Wang Lixiang, former director, professor and doctoral supervisor of the Third Emergency Medical Center of the PLA General Hospital, and director of the Institute of Cardiopulmonary Resuscitation of Nanjing Medical University, points out that reconstructing the etiquette health culture and promoting new etiquette have an era of prevention and control of new coronavirus pneumonia significance. From the perspective of daily etiquette, Wang Lixiang gave suggestions for the prevention and control of new coronavirus pneumonia and other infectious diseases.
The social etiquette of the handshake originated from the West, and has gradually become a meeting etiquette accepted by countries around the world in both diplomacy and daily life. But people are no stranger to the fact that handshake etiquette can spread disease. The sweat glands on the hands, especially the palms, are the most developed. A pair of unwashed hands contains 800,000 germs, 3.8 billion germs are hidden in one gram of nail scale, and an average of 150 germs are carried on each hand. The main vector of infectious gastrointestinal diseases. Ebola has been shown to be widespread in patients’ body fluids, including sweat, and is easily spread by shaking hands.
In ancient China, when people met with their hands arched on their chests, they not only reflected the civilized etiquette of ancient China, but also formed an invisible barrier. As Mr. Lin Yutang said, the traditional etiquette of Chinese people is healthier than that of Westerners, because Chinese people “hold” their own hands (arched hands) and do not need to hold others’ hands. Arching salutes, protecting yourself and healthy others.
Second, wear mask
As a new type of coronavirus, it is mainly transmitted through respiratory droplets. Therefore, wearing a mask is considered as one of the main preventive measures. Mouth and nose are the main entry points for dust particles to enter the body. It is necessary to choose a suitable mask for protection.
When using a mask, you should pay attention to: 1. The outer layer of the mask often accumulates a lot of dirt, bacteria and other dirt in the outside air. Usually, it is better to prepare a few more masks for replacement, and you should change and wash them once a day. 2. People with heart or respiratory problems (such as asthma and emphysema), pregnancy, and special people with dizziness, dyspnea and sensitive skin after wearing should avoid wearing masks. 3. When the mask is contaminated by foreign matter such as blood stains or droplets, if the respiratory resistance becomes larger, or the mask is damaged, it should be replaced in time. 4. If you wear a mask for a long time, it will make the nasal mucosa fragile and lose the original physiological function of the nasal cavity. Therefore, you cannot wear a mask for a long time. Wearing a mask should have low breathing resistance, light weight, hygienic wear, and convenient maintenance. It is the best state to prevent external germs while not causing discomfort to your life.
In ancient times, people in the court began to cover their noses and noses with silk scarves in order to prevent dust and breath pollution. If it is unclean, everyone will cover it. “
Third, hand care “ritual”
Wearing face masks, washing hands frequently, indoor ventilation and ventilation, and home and personal hygiene are the key measures to prevent this new type of coronavirus pneumonia. Hands have the widest exposure to the outside world, and there are many opportunities to spread acute infectious diseases. We advocate that people, like medical staff, clean their hands with a seven-step washing method to reduce the spread of infectious diseases.
The first step (inside): wash your hands with running water to wet your hands, apply hand sanitizer (or soap), palms facing each other, fingers rubbing together, rubbing each other; second step (outside): wash the back side of the fingers, rub the palms of your hands along the back of your fingers, rub each other, The hands are exchanged; the third step (clamp): the palms of the palms on the sides of the palms are opposite to each other, and the hands are rubbed against each other along the seams; the fourth step (bow): the backs of the fingers are bent to bend the joints of the fingers. Rotate and rub the palms of your hands, and exchange your hands; Step 5 (Large): Wash your thumbs, rotate and rub your thumbs with your other hands, and exchange your hands; Step 6 (stand): Wash your fingertips and bend the joints of your fingers, and close your fingertips Rotate and rub on the palm of your other hand, and exchange your hands; Step 7 (Wrist): Wash your wrists and arms, rub your wrists and arms, and exchange your hands. Particular attention should be paid to thoroughly washing the parts wearing rings, watches and other decorations (rings, watches, and other accessories should also be cleaned if possible), and the accessories on the hands should be removed first and then thoroughly cleaned. Scale “of the SAR.
Fourth, clearing the voice is “polite”
Most of the viruses are transmitted through the air and are hidden in the human respiratory tract. The clearing function of airway mucus cilia is an important defense barrier for the respiratory tract. For example, the virus can be hidden in nowhere through the timely “throat clearing” of the human respiratory tract, and the removal of the virus requires secretion of respiratory mucosa Can only be done with the help of mucus. Among them, the “quality and quantity” of mucus is positively related to the removal of the virus. When the mucus becomes viscous, it cannot flow upward through the human breath and cannot clear the virus, which causes the virus to multiply and cause disease in the body. Whether it is the influenza virus or the new coronavirus that recently occurred in Wuhan, they are all serious infectious diseases of the respiratory tract. How to make the mucus non-sticky and fully mobilize the defense function of the mucous cilia of the respiratory tract, and clear the mucus to help clear the throat. Respiratory virus. “
The first is sufficient water to help the mucus discharge. In the winter, it is more dry, and the right amount of water is especially important. Adults are about 2500 ml / day. Sufficient moisture can make the body actively secrete thin mucus, and drive foreign matter such as germs to discharge, promote airway cleanliness, and protect the health of the body.
The second is proper humidity to help discharge mucus. The spread of the virus peaks when the humidity is relatively low (20% -35%), and peaks again when the humidity is 65%. It is not so easy to spread when the humidity is around 50%, and it is not transmitted at all when the humidity exceeds 80%. In terms of humidity alone, the most suitable indoor humidity should be 40% to 60%. Combined with the characteristics of virus transmission, keeping the humidity of the respiratory tract mucosa at about 50% will help the cilia of the mucosal surface to swing and help the mucus discharge.
The third is to ban smoking to help expel mucus. The viscosity and elasticity of airway mucus are mainly from mucin. Mucin mainly exists in the mucus of the trachea, bronchi, gastrointestinal tract, and reproductive tract. Smoking can stimulate the microenvironment of the airway to be acidic, which increases the viscosity of mucin, making air The mucus is thick and difficult to discharge. The fourth is that abdominal cough helps to expel mucus. Cough has the protective effect of removing foreign body and secretions from the respiratory tract. We advocate active cough in a timely manner, and through the active movement of airway mucous cilia, the purpose of promoting mucus flow to expel the virus is achieved. For abdominal cough, you must first learn to breathe inwardly, inhale deeply through your nose, feel the abdomen swell, then retract your lips, and slowly exhale through your mouth. At this time, you feel that the abdomen retracts inward (that is, the abdomen goes down with your breath) , So repeated practice. Before preparing for a cough, take several deep and slow abdominal breaths, take a deep breath and hold your breath for 3-5 seconds, and perform a short and powerful cough from the chest for 2-3 times. (Above), help the stomach to cough hard, open mouth to cough up sputum, and achieve the effect of clearing the throat to expel the virus. Abdominal cough is more effective at several points in the body’s position during the day.
V. Elbow Exercises
Because you cover your mouth and nose with your hands when sneezing, your hands full of foam often become a “hotbed” for germs to spread quickly. If you do n’t wash your hands right away, it may be transmitted to others. If you change your elbow to cover your mouth and nose when you sneeze, most of the mouth foam will remain on your sleeve or arm. In comparison, your elbow is more likely to be in close contact with others than your hands. Indeed, It’s a way to “protect yourself and others.”
Six, sole care
Someone did a survey. After a two-hour meeting, there were more than 800 sputum traces left on the ground. Of the 91 samples of sputum collected, 4 were detected by Mycobacterium tuberculosis; I have also conducted field investigations, and there are more than 40 places where the sewage is scattered on the sidewalks within 2 kilometers.
The soles are in close contact with the ground every day, and they often follow people to move from home to house. They are highly mobile. If they do not pay attention to their hygiene, they will become a terrible source of “invisible” pollution and an important medium for spreading diseases. Assume that the sputum person is a patient with a new type of coronavirus, and his sputum will contain a large number of germs. If stepped on by a pedestrian, the germs will be stored in the soles of the shoes, not to mention contaminating the ground, but also floating into the air, and more Most bacteria will be brought to the floor in the home, and if inhaled, people may be infected. Therefore, it is necessary to pay attention to the hygiene of soles and reduce the pollution of soles.
Provide everyone with several ways to keep the soles hygienic: first, you must change your shoes before entering the house; secondly, clean the soles in a timely manner, it is best to wear gloves when cleaning, and use disinfectant, do not brush the shoes after brushing the soles Inside or inside. Families with conditions can purchase a sole cleaning machine at home, which will be easier to clean. At the same time, regularly clean things that the soles of shoes, such as shoe cabinets and shoe racks, often come into contact with. Finally, I call for the installation of a sole cleaning machine in front of public places, which should be replaced, cleaned, and disinfected regularly by a special person; special places such as hospitals and laboratories promote the use of disposable shoe covers.
Seven, one meter see – Coronavirus Pneumonia
When the cold season is approaching and someone in your family has a cold, one of the best ways to avoid infection is to keep a distance of more than one meter from people who have already caught the cold, which is also a safe distance for people to spread droplets. Especially in public places, it has more practical significance for preventing pneumonia from new coronavirus infection.
A distance of one meter can be seen everywhere in life: keep a safe distance of one meter in bank withdrawals; one meter is the best distance for conversations between people; the safety line on trains and subway platforms is also the same Meter … In order to ensure safety, such a meter distance is really indispensable in life. As we all know, air droplet transmission is a way of transmitting infectious diseases through the air. Pathogens are disseminated by the source of infection through secretions and droplets from coughing, sneezing, speaking, and inhaling and infecting susceptible persons. Generally speaking, when droplets containing a large number of pathogens are discharged into the environment, large droplets quickly land on the ground, while small droplets stay in the air for a short time and are limited to the source of infection. Therefore, close contact with the source of infection creates opportunities for droplet transmission, and it is relatively safe from 1 meter away from the source of infection. Such transmission is more likely to occur in crowded public places such as stations, schools, temporary shelters, and prisons. Influenza viruses, meningococci, and pertussis, which are less resistant to the environment, are often transmitted this way. Methods to prevent droplet-borne diseases include respiratory hygiene, cough etiquette, surgical masks, and maintaining social distance (> 1 meter). Foreign research reports show that the probability of being infected with a cold virus is reduced by more than 90% when it is more than one meter away from a cold person. Keep a distance of more than one meter from others in public places, which is also a safe distance for people to spread droplets.
Eight, the dust “net” – Coronavirus Pneumonia
At present, the main method of sanitation cleaning in most urban areas in China is to rely on sanitation workers to clean the ground. This method often brings dust and will undoubtedly increase the spread of infectious diseases. Therefore, direct cleaning with a broom will cause the virus to attack susceptible people with the help of dust, flying floc and other vectors. It is undoubted that this “dust move everyone” type cleaning method is not conducive to the prevention of pneumonia caused by new coronavirus infection and should cause Environmental health managers are highly alert.
In order to prevent the spread of germs, cut off the transmission of diseases, and improve sanitation cleaning methods, it is imperative: First, to change from “dust” cleaning to “dust-free” cleaning, sanitation workers can use water spray to wet the ground first, and then clean the ground after people Residues are really raised without dust and other foreign objects. Second, we must avoid cleaning during peak hours of work. Sanitation workers should use flexible working hours as much as possible to avoid susceptible people to the greatest extent, so that cleaning time does not meet peak hours of work flow such as commuting and schooling. Third, cleaning must be changed to adsorption, which can be equipped with a high-powered vacuum cleaner. According to the characteristics of the community, a spray cleaning method can be used. Fourth, the manual cleaning and mechanical cleaning operations should be combined. The urban management department should increase the self-cleaning scope of the city’s main and secondary arterial sprinkler trucks, increase the frequency and time limit of operations, and make up for the lack of manual cleaning. Fifth, we must combine ground cleaning with aerial spraying. Sanitation workers should change their minds and pay attention to the sky while paying attention to the cleanliness of the ground. It can be sprayed with a disinfectant solution (such as peracetic acid) through a sprayer, which can quickly kill a variety of microorganisms such as viruses, and can also achieve benign effects such as dust reduction, flocculation reduction, and humidified air. This comprehensive three-dimensional cleaning method is conducive to the purpose of cutting off the transmission path.
Ninth, don’t make – Coronavirus Pneumonia
After the death of the human body, metabolism stops, immune functions disappear, and various microorganisms begin to proliferate rapidly. Studies show that within 24-30 hours of death, the total number of bacteria per gram of tissue and per ml of tissue fluid in the remains is 3 million to 3.5 million. Such a large number of microorganisms breed and reproduce in human remains, and it is difficult to prevent them from spreading during the farewell ceremony of admiring the remains.
The spread of pathogenic microorganisms is mainly manifested in the following four aspects: First, it directly harms funeral personnel. In order to hold the corpse farewell ceremony, funeral personnel should perform procedures such as plastic surgery, handling, resettlement, and parking. In the process of contacting the remains, the funeral personnel’s chances of infection will inevitably be increased. Second, there is a hidden danger of infection in the remains. Since most of the deceased are old and sick, clinically proven that the main cause of death is infection. The incidence of infectious diseases of funeral personnel is 2-3 times higher than that of the general population; the third is the pollution of the funeral environment. The blood, body fluids, and hair of the body, gauze and gloves used to scrub the body are important sources of infection in funeral sites. If not handled properly, it can easily cause secondary pollution and bring potential harm to people’s health. Fourth, to mourners Bring physical and mental harm. Due to the shrinkage of the tissues and cells of the remains, the organs deformed. Although they were facelifted, they were eventually distorted. Coupled with the deep sorrow and dignified atmosphere, there were also many frail and sick people who participated in the farewells of the remains. Due to the psychological difficulty of bearing these, accidents occurred on the spot It’s not uncommon.
The prevention and control of the new coronavirus requires not only scientific containment methods, but also changes in people’s behaviors and etiquette. Changing unscientific and sanitary funeral etiquette has become an inevitable choice for people. The body’s farewell to this current funeral etiquette is an important way to spread infectious diseases and an invisible killer that wastes resources and pollutes the environment and affects people’s physical and mental health. It should be reformed. It is suggested to change the body farewell to the image farewell, and use the new funeral ceremony to establish the modern funeral etiquette of the people.
For the prevention and control of the new type of coronavirus pneumonia today, the introduction of new rituals is to restore the rituals, wear the rituals for mouth and nose, wash the rituals for hand protection, have the rituals for clearing the throat, and learn the rituals for the elbow and arm., Coronavirus Pneumonia in sole support, “Li” in one meter, “Li” in dust reduction, “Li” in relics, and reconstruction of the etiquette health culture are of era significance for the prevention and control of infectious diseases such as new coronavirus.
The author Wang Lixiang is the former director, professor and doctoral.
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