Guidance for the Public on Protective Measures Against Coronavirus Disease - Bureau of Disease Prevention and Control of National Health ...
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Guidance for the Public
on Protective Measures Against
Coronavirus Disease
Bureau of Disease Prevention and Control of National Health
Commission of the People’s Republic of China
Chinese Center for Disease Control and Prevention
Guidance for the Public
on Protective Measures Against
Coronavirus Disease
Bureau of Disease Prevention and Control of National Health
Commission of the People’s Republic of China
Chinese Center for Disease Control and Prevention
新型冠状病毒肺炎公众防护手册 ： 英文 ／ 中国疾病 预防控制中心编著 ； （ 加 ） 黄如玉译 ． －－ 北京 ： 五洲传 播出版社 ， ２０２０．３ ＩＳＢＮ ９７８－７－５０８５－４４３３－５ Ⅰ ． ①新… Ⅱ ． ①中… ②黄… Ⅲ ． ①日冕形病毒－ 病毒病－肺炎－预防 （ 卫生 ） －手册－英文 Ⅳ ． ① Ｒ５６３．１０１－６２ 中国版本图书馆 ＣＩＰ 数据核字 （２０２０） 第 ０４２１１３ 号 新型冠状病毒肺炎公众防护手册 : 英文 作 者：中国疾病预防控制中心 译 者：（ 加 ） 黄如玉 审 校：岳 凌 出 版 人：荆孝敏 责任编辑：姜 珊 助理编辑：宋 歌 书籍设计：北京宣是国际文化传播有限公司 出版发行：五洲传播出版社 地 址：北京市海淀区北三环中路 ３１ 号生产力大楼 Ｂ 座 ６ 层 邮 编：１０００８８ 电 话：０１０－８２００５９２７， ８２００７８３７ 网 址：ｗｗｗ．ｃｉｃｃ．ｏｒｇ．ｃｎ， ｗｗｗ．ｔｈａｔｓｂｏｏｋ．ｃｏｍ 印 刷： 版 次：２０２０ 年 ３ 月第 １ 版第 １ 次印刷 字 数：１５ 千字 开 本：３２ 开 印 张：１ 定 价：２５．００ 元
Editorial Board
Editors in chief: Li Xinhua, Gao Fu
Associate editors in chief: Feng Zijian, Liu Jianjun
Editors: Li Zhongjie, Cui Ying, Wang Zijun, Feng Luzhao,
Qin Ying, Sun Chengxi, Mou Di, Zhang Jian
Sun Junling, Wang Lei, Zhang Li, Xia Hongwei
Yang Jian, He Bin, Su Xiaoge, Zhang Muli
Cheng Ying, Zheng Jiandong, Wu Yuan, Li Peilong
Guo Haoyan
3
Foreword
Viruses travel across borders. At present, the
outbreak of COVID-19 is spreading exponentially
across the world with multiple epicenters. In the
face of this common challenge, all countries in the
world should watch out for and help one another. As
a responsible big country, China actively supports
and participates in international cooperation to fight
the epidemic, spares no effort to safeguard regional
and international public health and security, and
promotes the building of a community with a shared
future for mankind.
This booklet is to disseminate knowledge about
COVID-19 and to provide a clearer picture of the
epidemic situation, so that people can stay calm,
be better prepared, and protect themselves more
effectively.
4
Contents
I. Coronaviruses and the Novel Coronavirus
What is the novel coronavirus?..................................1
Does the novel coronavirus spread from person to
person?...............................................................................2
II. Coronavirus Disease
Transmission of the disease........................................3
What are the symptoms of COVID-19?.....................4
What are close contacts?.............................................5
When to seek medical help?.......................................7
What to do if you suspect you are infected?...............8
III. Effective Prevention and Treatment
Is there a cure for COVID-19?...................................9
How to wear a surgical mask properly?...................12
How to wash your hands properly?..........................13
5
How to protective yourself effectively?...................15
What to do if a family member shows suspicious
symptoms?........................................................................18
Medical observation at home for close contacts.......19
Protective measures for the elderly and the young
..........................................................................................22
Disinfection measures for homes with COVID-19
patients..............................................................................22
How to enhance your immunity and take other
protective measures?........................................................23
IV. Stay calm and do not panic
Are antibiotics effective for COVID-19?.................24
How to dispose of a used face mask properly?........25
6
I. Coronaviruses and the Novel
Coronavirus
What is the novel coronavirus?
Coronaviruses are a large group of viruses. They are known to
cause diseases ranging from the common cold to more severe diseases
such as the Middle East respiratory syndrome (MERS) and severe
acute respiratory syndrome (SARS). The novel coronavirus (2019-
nCoV, later known as severe acute respiratory syndrome coronavirus
2 or SARS-COV-2) first identified in Wuhan, China, is a new type of
coronavirus that has not been found in humans before.
Coronaviruses and the Novel Coronavirus 1
Does the novel coronavirus spread
from person to person?
Yes. The virus mainly spreads via respiratory droplets and
contact. There is a possibility of aerosol transmission in the case of
long exposure to high concentration of aerosol containing the virus in
a relatively closed environment. People are generally susceptible to
the virus.
2 Coronaviruses and the Novel Coronavirus
II. Coronavirus Disease
Transmission of the disease
People can get infected when they have close
and direct contact with droplets or breath of
Respiratory droplets infected persons when they sneeze, cough or
speak nearby.
Infection can also be caused when one
touches these droplets that have landed on
Transmission Contact objects and surfaces with their hands and
then touches his/her mouth, nose, or eyes
with contaminated hands.
Aerosol transmission is also possible when
Aerosol (possible) one is exposed to high concentrations of
aerosol in a relatively closed environment
for a long time.
Coronavirus Disease 3What are the symptoms of
COVID-19?
According to the latest epidemiological studies, the incubation
period for COVID-19 is 1–14 days, most commonly 3–7 days. Major
symptoms include fever, dry cough and fatigue. Some patients may
have nasal congestion, runny nose, sore throat, myalgia, or diarrhea.
In severe cases, patients may develop difficulty breathing and/or
hypoxemia around one week after the onset. Critical patients may see
their symptoms progress rapidly to acute respiratory distress syndrome
(ADRS), septic shock, refractory metabolic acidosis, coagulopathy,
multi-organ failure, etc. It is worth noting that severe and critical
patients may have had moderate to low fever, or even no fever at all.
Their chest radiographs show multiple small shadowy patches and
interstitial changes, especially visible in the extrapulmonary bands.
Later, the patients develop multiple ground-glass opacities in both
lungs. Severe cases suffer pulmonary consolidation while less pleural
effusion. Mild cases may only have low fever and mild tiredness,
without any sign of pneumonia.
4 Coronavirus DiseaseWhat are close contacts?
Close contacts refer to people who have had close and
unprotected contact (within one meter) with suspected or confirmed
cases two days before the onset or before the test in the case of
asymptotic infection. Specific situations are described as follows:
1. People who live, study, work together with a suspected or
confirmed case, or a person with asymptotic infection, or have close
contacts in other ways such as working close to each other, sharing the
same classroom or living in the same housing space.
2. Medical staff, family members, or other people who treat,
take care of, or visit a suspected or confirmed cases or a person
with asymptotic infection, or have had close contact in other similar
ways, such as paying a visit or staying with the person in a closed
environment; other patients in the same ward and their caregivers.
3. People who share the same transportation vehicle and have
had close contact with a suspected or confirmed case, or a person with
asymptotic infection, including caregivers, peers (family, colleagues,
friends, etc.), or other passengers and flight attendants found likely
to have had close contact with the person through investigation
and evaluation. Depending on the means of transportation, specific
guidelines for determining close contacts are given as follows:
(1) For civil aircraft, close contacts include:
a) Under normal circumstances, passengers in the same row and
three rows in front of and three rows behind the infected person’s seat
in a civil aircraft cabin, as well as flight attendants who provide cabin
services in the area;
Coronavirus Disease 5b) All passengers in the cabin of civil aircraft with no HEPA
filter; and
c) Others who are known to have had close contact with the
infected person shall also be considered close contacts.
Other passengers on a normal civil flight shall be regarded as
general contacts.
(2) For a railway passenger train, close contacts include:
a) On a fully enclosed air-conditioned train, all passengers and
crew members in the same hard-seat or hard-sleeper car, or in the
same compartment on a soft-sleeper train, with the infected person;
b) On a non-fully enclosed train, passengers in the same soft-
sleeper compartment, or those in the same and adjacent compartments
of a hard-seat or hard-sleeper car, and crew members serving the area;
and
c) Others who are known to have had close contact with the
infected person.
(3) For a car or bus, close contacts include:
a) All passengers traveling in the same enclosed air-conditioned
bus with the infected person;
b) In the case of a ventilated bus, the driver, attendants and
passengers in the three rows in front of and three rows behind the
infected person’s seat; and
c) Others who are known to have had close contact with the
infected person.
(4) For a cruise ship, close contacts include:
a) All passengers in the same cabin as the infected person and
crew attendants who provide services to that cabin; and
b) Any people who have had contact with the infected person
6 Coronavirus Diseasewhen he/she is having severe symptoms such as a high fever, sneezes,
cough and vomit, regardless of the duration of the contact.
4. Others who are classified as close contacts based on evaluation
by on-site investigators.
In determining who are close contacts and analyzing possible
source of infection for an infected case, multiple factors shall be
taken into consideration, including the patient’s symptoms, the way of
contact with the patient, the protective measures during the interaction,
and the extent of exposure to contaminated environment and objects.
When to seek medical help?
For adults who have generally been healthy, medical help is
recommended when they have symptoms such as fever, respiratory
infections, or acute gastrointestinal problems that are not relieved or
continue to progress after symptomatic treatment, or they develop
other suspicious symptoms such as shortness of breath, diarrhea,
or when family members also show symptoms that may indicate
COVID-19. Older people, pregnant women, and people who have
chronic conditions such as diabetes, immunodeficiency, hepatic and/
or renal insufficiency, and cardio-
cerebral vascular diseases are at
a higher risk of developing into
severe COVID-19 cases and they
should seek medical help upon the
onset of any suspicious symptom.
Coronavirus Disease 7What to do if you suspect you are
infected?
If you suspect that you are infected with the virus, that is, if you
have suspicious symptoms (including fever, dry cough, fatigue, nasal
congestion, runny nose, sore throat, myalgia, and diarrhea), avoid
crowds, wear a face mask, isolate yourself, keep distance from your
family members, ensure good ventilation and personal hygiene, and
go to a nearby fever clinic of a designated hospital for COVID-19
cases as soon as possible. When seeing a doctor at the clinic, tell the
doctor whom you have been in contact with and be cooperative for the
necessary investigation.
8 Coronavirus DiseaseIII. Effective Prevention and
Treatment
Is there a cure for COVID-19?
Based on available information and experience accumulated so
far, the disease has a good prognosis and can be cured. A small number
of patients can become critically ill, though. Prognosis tends to be
poor for the elderly and those with chronic underlying diseases, while
children usually show relatively mild symptoms.
Effective Prevention and Treatment 9Wear Face Mask Wisely
○ Recommended √ Optional
No mask Surgical Particle Protective Face
or ordinary mask respirator face mask respirator
mask (GB2626)
for medical with P100
(YY0469)
Single-use sue filter
People and setting medical face
(GB19083)
mask
(YY/T0969)
Fever clinic in affected
√ ○ √
areas
Medical staff in
√ ○ √
isolation wards
People performing
Intubation,
○ ○
tracheotomy and other
High risk
high-risk procedures
Service providers
in isolated areas
(janitors, dead ○ √
body management
personnel, etc.)
Epidemiological
investigators for
√ ○
confirmed and
suspected cases
ER staff ○
Epidemiological
Relatively high risk
investigators for close ○
contacts
People testing related
○
samples
10 Effective Prevention and TreatmentNo mask Surgical Particle Protective Face
or ordinary mask respirator face mask respirator
mask (GB2626)
for medical with P100
(YY0469)
Single-use sue filter
People and setting medical face
(GB19083)
mask
(YY/T0969)
Medical staff or other
people working at
√ ○
normal outpatient
clinics or wards
People working at
√ ○
crowded places
Medium risk
Administrative staff,
police officers, security
guards, delivery
√ ○
workers, etc. working
in outbreak-related
settings
People in home
isolation and those √ ○
who live with them
Ordinary people who
○
stay in large crowds
People who work
in a crowded indoor ○
environment
Relatively low risk
Ordinary people who
○
visit a hospital
Children and students
in kindergartens and ○
schools
People who stay at
○
home
People who stay
Low risk
○
outdoors
People who work,
study or stay at well- ○
ventilated places
Effective Prevention and Treatment 11How to wear a surgical mask
properly?
1. Put on the face mask with the darker-colored side facing
outwards and the metallic strip uppermost.
2. Pull the mask so that it covers your nose, mouth and chin.
3. Press the metallic strip with your fingers so that it fits the
bridge of your nose tightly.
4. Adjust the mask so it fully fits your face.
It is recommended to replace the mask every 2 to 4 hours if
possible, and replace it whenever the mask becomes wet or has
secretions on it.
12 Effective Prevention and TreatmentHow to wash your hands properly?
Wet your hands with running water, apply liquid hand soap
or bar soap to form a good lather, and rub for at least 15 seconds.
Specifically:
1. Rub your hands palm to palm.
2. With your fingers linked through the other hand, use your right
palm to rub the back of your left hand. Then swap.
3. Link your fingers together, facing each other, into clasped
hands. Then rub your palms and fingers together.
4. Cup your fingers together, with your right hand over and your
left hand under. With your fingers interlocked, rub the backs of them
against your palms. Then swap.
5. Enclose your right hand around your left thumb and rub as you
rotate it, then swap.
6. Rub your fingers over your left palm in a circular motion, then
swap.
7. Rub your right wrist with clasped left hand, then swap.
Rinse thoroughly with running water.
Wet your hands with running Apply liquid hand soap or bar
water soap to form a good lather
Effective Prevention and Treatment 13Rub for at least 15 seconds. Specifically
2. With your fingers linked through the other
1. Rub your hands palm to palm.
hand, use your right palm to rub the back of
your left hand. Then swap.
3. Link your fingers together, facing 4. Cup your fingers together, with your right
each other, into clasped hands. Then hand over and your left hand under. With
rub your palms and fingers together. your fingers interlocked, rub the backs of
them against your palms. Then swap.
5. Enclose your right hand 6. Rub your fingers over your left
around your left thumb and palm in a circular motion, then
rub as you rotate it, then swap. swap.
7. Rub your right wrist with clasped
Rinse thoroughly with running water.
left hand, then swap.
14 Effective Prevention and TreatmentAfter cough or sneeze
After touching fixtures in public areas, e.g. door knob
Before, during and after food preparation
Before a meal
When
After using the restroom
After contact with infected persons, their secretions, or their
belongings that have not been thoroughly disinfected after their use
After contact with animals or feces
When visibly dirty, wash with liquid hand soap or bar soap under
running water
Wash your
How
hands
Otherwise, wash with liquid hand soap or bar soap under running
water, or use alcohol hand sanitizer
Note Avoid touching eyes, nose, and mouth with hands
How to protective yourself
effectively?
1. Minimize social activities.
(1) Avoid infected areas.
(2) Reduce visits and gatherings and stay at home as much as
possible.
(3) Avoid crowded public places, especially places with poor
ventilation, such as public baths, hot spring resorts, cinemas, Internet
cafes, KTVs, shopping malls, stations, airports, docks, exhibition
halls, etc.
Effective Prevention and Treatment 152. Personal protection and hand hygiene
(1) Wear a face mask when going out: Single-use medical face
mask for visits to general public places, regular clinics, and for public
transportation rides; surgical mask for visit to a fever clinic.
(2) Keep your hands clean: Minimize contacts with objects in
public places; wash your hands with liquid hand soap or bar soap
under running water, or use alcohol hand sanitizer upon returning from
public places, after coughing or sneezing into your hands, before meal
or after using the restroom. Where this cannot be done, wear gloves
(any kind that does not keep your fingers exposed) and keep them dry.
After removing the gloves, wash your hands thoroughly. Refrain from
touching your mouth, nose, and eyes with unwashed hands; cover your
mouth and nose with your elbow when sneezing or coughing.
3. Monitoring personal health and seeking medical help when
necessary
(1) Monitor the health conditions of yourself and your family
members. Take your temperature when you feel feverish. If there
are children in the family, take their temperature every morning and
evening.
(2) In the case of any suspicious symptom, wear a face mask
and visit a nearby clinic for medical help. Possible symptoms of
16 Effective Prevention and TreatmentCOVID-19 include fever, fatigue, cough, sore throat, chest tightness,
shortness of breath, nausea and vomiting, diarrhea, conjunctivitis,
myalgia, etc. Try to avoid metro, bus or other means of public
transportation and avoid places where people gather on your way to
the clinic. When seeing a doctor, inform the doctor of your recent
travel to and stay in infected areas, as well as whom you have had
contact with since the onset of your symptoms, and be cooperative for
necessary investigation.
4. Maintain good personal hygiene and habits
(1) Keep your home well ventilated.
(2) Do not share towels among family members; keep your living
environment and utensils clean; and do the laundry frequently.
(3) Spit, blow your nose, sneeze or cough into tissue paper and
dispose of used tissue in a covered trash bin.
(4) Eat well and exercise moderately.
(5) Stay away from wild animals; do not purchase or consume
any of them; avoid markets that sell live animals (poultry, aquatic
animals, wild animals, etc.).
(6) Keep thermometers, single-use medical face masks, and
household disinfectants at home.
Effective Prevention and Treatment 17What to do if a family member
shows suspicious symptoms?
1. In the case of any suspicious COVID-19 symptoms (including
fever, dry cough, fatigue, nasal congestion, runny nose, sore throat,
myalgia and diarrhea), go to a designated medical institution to take
the tests as soon as possible, and stay isolated for medical observation
if instructed to.
2. Avoid taking public transportation such as metro and bus, and
avoid crowds.
3. Inform your doctor of your travel to and stay in infected areas,
as well as whom you have had contact with since the onset of the
symptoms, and be cooperative for necessary investigation.
4. In the case of home isolation for medical observation, all
family members should wear single-use medical face masks or surgical
masks. People with symptoms should avoid contact with other family
members as much as possible and keep a distance of at least one meter
when in the same room.
5. If someone in the family is confirmed to have COVID-19,
all family members who are identified as close contacts should stay
isolated for 14 days for medical observation.
6. If a family member is confirmed to have COVID-19, his living
space, daily items, clothing, bedding, dining utensils, etc. all need to
through terminal disinfection before use.
18 Effective Prevention and TreatmentMedical observation at home for
close contacts
Those who are defined as close contacts of a confirmed
COVID-19 case should stay home for 14 days of medical observation
starting from the day of their last contact with the confirmed case or
person with asymptomatic infection. They need to keep in touch with
healthcare workers in the process and be informed of the key points of
the observation, self-care and preventive measures such as hand wash,
ventilation, protection, and disinfection. Specific recommendations are
as follows:
1. Close contacts should stay in a well-ventilated single room
and receive no visitor.
2. Reduce activities and minimize the areas they share with
family members. Keep all shared spaces (e.g. kitchen, bathroom, etc.)
well ventilated (e.g. by keeping windows open).
3. Do not share a room with any family member. If this is
impossible, always keep a distance of at least one meter. Breastfeeding
may continue.
4. Family members should wear a surgical mask that fits tightly
when entering the living space of the close contact. Avoid touching
and adjusting the mask before getting out of the space. Replace the
mask immediately when it gets wet or contaminated. Wash hands
thoroughly after removing and disposing of the mask.
Effective Prevention and Treatment 195. After any direct contact with or getting out of the living space
of the close contact, wash hands thoroughly. Clean the hands before
preparing food and before and after meals. For visibly dirty hands,
use liquid hand soap or bar soap under running water; otherwise, one
may either wash the hands with soap and running water, or use alcohol
hand sanitizer. (Note: Use alcohol cautiously to avoid accidental
swallowing or fire).
6. After washing your hands with soap under running water, use
disposable paper towels to dry the hands. If not available, wipe with a
clean towel and replace it when it gets wet.
7. Materials used to cover the nose and mouth for occasional
cough or sneezes should be discarded immediately, or cleaned properly
after use (e.g. washing with soap/detergent and water).
8. Family members should minimize contact with the close
contact and his/her personal items. For example, avoid sharing
toothbrushes, cigarettes, utensils,
meals, drinks, towels, bath towels,
sheets, etc. Dining utensils should be
cleaned with steam sterilization after
use.
9. Chlorine disinfectant and
peracetic acid disinfectant are
recommended for frequent cleaning
and disinfection of frequently touched
20 Effective Prevention and Treatmentsurfaces such as bedside tables, bed
frames and other bedroom furniture.
Clean and disinfect surfaces of bathroom
and toilet fixtures at least once a day.
10. Wash the clothes, sheets, bath
towels, towels, etc. of the close contact in
a washing machine with 60–90℃ water and regular laundry detergent,
and then completely dry the laundry. Put the individual’s bedding in a
laundry bag. Avoid shaking it and keep it off your skin and your own
clothing.
11. Wear a face mask, disposable gloves and protective clothing
(such as a plastic apron) before cleaning and touching the surfaces,
clothing or bedding contaminated by the secretions of the close
contact. Clean and disinfect hands before putting on and after taking
off gloves.
12. If the close contact show suspicious symptoms, including
fever, chills, dry cough, expectoration, nasal congestion, runny
nose, sore throat, headache, fatigue, myalgia, joint pain, shortness
of breath, dyspnea, chest tightness, conjunctival congestion, nausea,
vomiting, diarrhea, abdominal pain, etc., report it to the health
authority immediately, and send the individual to a designated medical
institution for diagnosis, treatment, laboratory tests and screening.
Effective Prevention and Treatment 21Protective measures for the elderly
and the young
Humans are generally susceptible to the novel coronavirus,
and COVID-19 occurs to the elderly, young adults, and children all
the same. The elderly and children should take protective measures,
such as washing their hands frequently, wearing face masks, having
balanced and nutritious diet, exercising moderately, keeping their
living environment clean, and maintaining good ventilation for their
homes.
Disinfection measures for homes
with COVID-19 patients
After the patient leaves (hospitalization, death or release from
isolation, etc.), terminal disinfection should be performed in the
home, including the living room floor, walls, surfaces of tables, chairs
and other furniture, door handles, the patient’s utensils, clothing
and bedding and other daily items, toys, bathroom, etc. Terminal
disinfection is usually done by professionals, please contact your
local center for disease control and prevention. Family members of a
confirmed patient are usually identified as close contacts and should
undergo medial observation for 14 days.
22 Effective Prevention and TreatmentHow to enhance your immunity and
take other protective measures?
1. Cover your mouth and nose with tissue paper or handkerchief
when coughing, sneezing or having a runny nose.
2. Keep a distance of at least one meter with other people.
3. Avoid crowds as much as possible and ensure good ventilation
when staying indoors.
4. Exercise more to enhance your immune system.
5. Rest well and avoid staying up late and overwork to maintain
good immunity.
Effective Prevention and Treatment 23IV. Stay calm and do not panic
Are antibiotics effective for
COVID-19?
Antibiotics are used to treat bacterial infections. COVID-19
has a virus as its pathogen and antibiotics are not effective either for
prevention or treatment. Taking antibiotics may even cause adverse
drug reactions and destroy the normal intestinal flora.
24 Stay calm and do not panicHow to dispose of a used face mask
properly?
Face masks worn by uninfected people do not have the risk of
spreading the coronavirus and can be disposed of following general
requirements of domestic waste classification. Face masks used by
suspected cases and their caregivers should be collected and disposed
of as medical waste. After disposing of such face masks, be sure to
wash your hands.
Stay calm and do not panic 25Price: RMB 25
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