ABSTRACT
OBJECTIVE: To explore the key points of infection prevention and control in the transition process and early stage of closure of medical institutions that have been transferred to closed due to the outbreak of COVID-19. METHODS: Based on the national technical guidelines for the prevention and control of COVID-19 and relevant documents, combined with the experience of participating in the prevention and control of COVID-19 in various places, the author explored and analyzed the common problems and the key points of infection prevention and control during the transition to close management and the initial period of closure due to the COVID-19 epidemic. RESULTS: Hospitals transferred to closed-off management due to the outbreak of COVID-19 often encountered problems such as incompatibility of the original management system, lack of awareness of secondary control, and insufficient knowledge and skills. When transferred to closed management, epidemiological investigations should be actively carried out, management and control should be graded and classified, and various personnel in the hospital should be arranged reasonably. Infection prevention and control work should be quickly transferred into an anti-epidemic state. On the basis of meeting the needs of infection prevention and control, hospital reconstruction and air-condition use assessment should be carried out quickly, and attention should be paid to the infection risk prevention and control of personnel and treatment behaviors in the process of diagnosis and treatment. At the same time, it is necessary to pay attention to continuous infection risk monitoring, and achieve necessary terminal disinfection. CONCLUSION: When medical institutions are transferred to closed-off management due to the outbreak of COVID-19, the risk of infection prevention and control involved in the process of functional transformation should be fully considered to prepare for the COVID-19 outbreak actively, and to accumulate experience in preventing possible future infectious diseases transmitted through the respiratory tract.
ABSTRACT
In order to summarize the experience of COVID-19 prevention and control, review the glorious course of the 70th anniversary of China's patriotic health campaign, and realize the Healthy China. This paper summarizes the great achievements of China's patriotic health campaign in the past 70 years, and reviews the trend of sustainable vector management, especially the progress of China and Zhejiang Province in the construction of patriotic health campaign organization, vector monitoring, early warning, informatization, prevention and control and research work in the last 10 years. The results found that the patriotic health campaign has significantly improved the health level of the Chinese people. Zhejiang Province has demonstrated and led the comprehensive monitoring of vector and vector infectious diseases, and exploration of sustainable vectors management in rural area, first to carry out the "construction of eliminate four vector villages focusing on mosquito-free and fly-free", and promoted the patriotic health campaign at a high level. The paper considers that the patriotic health campaign is a successful practice of our Party's mass line to health prevention. The experience of COVID-19 prevention and control shows that, Prevention and control the communicable disease needs the concept of patriotic health campaign and the support of public health, all for the people's health, The Times call for a patriotic health campaign with Inheritance of history, rich connotation and innovative methods. We must re-understand the extreme importance of communicable disease prevention and control, pay more attention to the potential harm of vectors in the cross-species transmission of communicable diseases, give full play to the unique role of patriotic health campaign in disease prevention and control and safeguarding people's health, and accelerate the Healthy China action.
ABSTRACT
OBJECTIVE: To test the suitability of medical protective masks worn by medical staff and explore the factors that affect the results of qualitative suitability tests. METHODS: A total of 221 medical and administrative staff who participated in the prevention and control of the COVID-19 epidemic in a designated hospital were recruited as the study objects, and the qualitative suitability testing was carried out by using bittering agent aerosol method (3 MTMFT-30) approved by the Occupational Safety and Health Administration (OSHA). RESULTS: Totally 201 were qualified for the sensitivity test, including 169 (84.1%) objects with level 1 sensitivity, 30 (14.9%) objects with level 2 sensitivity, 2 (1.0%) objects with level 3 sensitivity. Among the 201 objects, 188 passed the first test, 5 objects passed the second test, and 8 objects did not pass the test, with the pass rate 96.02%. The analysis of influencing factors showed that the BMI index affected the result of the suitability test (P<0.05), however, the genders, ages, wearing glasses, double chin, size of face, wearing goggles, shape of face length, width of nose and submandibular arc length of the two tragus points were not the influencing factors for the result of qualitative suitability test. CONCLUSION: This foldable medical protective mask has a high pass rate in the qualitative suitability test, and the BMI is one of the influencing factors;first-line medical staff can verify the airtightness of the medical protective mask through the qualitative suitability test so as to choose the appropriate medical protective masks.
ABSTRACT
OBJECTIVE: To collect aerosol from isolation wards of a designated COVID-19 hospital and conduct the nucleic acid test so as to provide scientific basis for prevention and control of COVID-19. METHODS: The air aerosol specimens were collected from layout sites in the isolation wards of the hospital by using bioaerosol collector, and the COVID-19 nucleic acid test was carried out for all of the specimens by using fluorescent polymerase chain reaction(PCR) and digital PCR. RESULTS: A total of 86 aerosol samples were collected, all of which were tested negative for the fluorescent PCR, the result of the digital PCR test showed that 14 air aerosol samples were tested positive for COVID-19 nucleic acid, with the detection rate 16.28%. The toilets of the patients and taking-off area of protective supplies of healthcare workers were the major places where the specimens were tested positive. The positive rate of nucleic acid test was significantly higher in in intensive care units than in common wards, however, there was no significant difference in the positive rate of nucleic acid among the aerosol specimens in different wards(?-2=7.871, P=0.248);there was no significant difference in the positive rate of nucleic acid of aerosol between the patients with CT value more than 30 and the patients with CT value no more than 30(?-2=0.232, P=0.630). CONCLUSION: There are still viral nucleic acids in the air aerosol of the isolation wards during the middle and late disease course of the COVID-19 patients, but the copy number of novel coronavirus is not large in the specimens. The detection rate of the viral nucleic acid is high in the aerosol of the wards that are crowed and poorly ventilated and are associated with the cases. It is necessary for the health care workers to take good care of themselves, keep the environment well ventilated and do a good job in environmental cleaning and disinfection and air purification.
ABSTRACT
OBJECTIVE: To analyze the consistency between the objective and qualitative suitability test results of medical N95 protective masks and the subjective evaluation results of the wearers so as to provide scientific basis for selection of protective masks. METHODS: A survey was conducted among 221 staff in Nanjing COVID-19 designated hospitals from Aug 11, 2021 to Aug 29, 2021. A questionnaire designed by bitterness aerosol method (3 MTMFT-30) approved by Occupational Safety and Health Administration (OSHA) was used to collect and investigate the data on the spot, and the data were statistically analyzed by using SPSS23.0 software. RESULTS: The result of sensitivity test showed that 201 (90.95%) staff passed the test, including 169 (76.47%) staff with grade 1 sensitivity, 30 (13.57%) staff with grade 2 sensitivity and 2(0.90%) staff with grade 3 sensitivity. In terms of objective and qualitative suitability test, the passing rate was 92.04% (185/201), 188 staff passed the first test, 5 staff passed the second test. In terms of the subjective evaluation of the wearers, 111 staff had good subjective overall feeling, accounting for 55.22%;the scores of mouth opening assisted breathing, mask smell and facial muscle adjustment were (2.10+or-0.58) points, (2.13+or-0.42) points and (2.46+or-0.56) points, respectively, significantly lower than (2.55+or-0.50) points of the overall subjective evaluation score, and there was significant difference in the sealing ability of mask before the subjective evaluation and after adjusting by facial muscles (?~2=17.840, P<0.05). The results of objective qualitative suitability test were not consistent with the subjective evaluation of the wearers, and the kappa value was 0.174 (P< 0.001). CONCLUSION: In the objective and qualitative suitability test, the medical N95 protective mask has high safety performance. On the basis of good suitability, it can increase the wearing comfort of the mask, improve the overall subjective evaluation of the wearer, and make full use of the test results to reasonably select and effectively use the protective mask.
ABSTRACT
BACKGROUND: Little is known about severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta variant of concern (VOC)-contaminated environmental surfaces and air in hospital wards admitting COVID-19 cases. Our study was designed to identify high-risk areas of Delta VOC contamination in the hospital and provide suggestions to in-hospital infection control. We analyzed the SARS-CoV-2 Delta VOC contamination in the air and environmental surface samples collected from a hospital in Nanjing, China. METHODS: We collected data on clinical features, laboratory tests, swab tests, and hospital wards, identified the factors associated with environmental contamination, and analyzed patients' hygiene behaviors during hospitalization. RESULTS: A total of 283 environmental surface and air samples were collected from a hospital admitting 36 COVID-19 patients. Twelve swab samples from ten patients were positive. Toilet seats had the highest contamination rate (11.8%), followed by bedside tables (8.2%), garbage bins (5.9%), and bedrails (1.6%). The median time of symptom onset to surface sampling was shorter in the positive environment group than in the negative environment group (11 vs. 18 days; P=0.001). The results indicated that environmental surface contamination was associated with positive anal swabs [odds ratio (OR) 27.183; 95% CI: 2.359-226.063; P=0.003] and the time from symptom onset to surface sampling (OR 0.801; 95% CI: 0.501-0.990; P=0.046). The survey revealed that 33.3% of the patients never cleaned or disinfected their bedside tables or toilets, and 8.3% of them only cleaned their bedside tables or toilets. More than half of the patients often (25%) or always (30.6%) put the used masks on their bedside tables. Only 16.7% of the patients threw the masks into the specific garbage bin for used masks. CONCLUSIONS: The SARS-CoV-2 Delta VOC was detected on environmental surfaces, especially toilet seats and bedside tables, within a median time of 11 days after symptom onset. Our study provided potential predictors for environmental surface contamination, including positive anal swabs and the time from symptom onset to sampling. Disinfecting high-risk environmental surfaces should be emphasized in hospital wards, especially for patients in the early stage of COVID-19.
ABSTRACT
OBJECTIVE: To investigate the use of personal protective equipment (PPE) of healthcare workers (HCWs) in the room where confirmed COVID-19 patients are admitted and understand the current status of prevention. METHODS: The healthcare workers who from medical aid teams in Hubei in 30 hospitals were randomly selected by the trained staff for hospital infection prevention, the basic characteristics of the enrolled subjects and the use of PPE were recorded, and the questionnaires were filled out through questionnaire star. RESULTS: The survey found that all the healthcare workers received theoretical training and practical training on the use of PPE before entering the isolation ward, 95.56% (2 433) of them were inspected or supervised by someone when they put on or took off PPE. 86.57% (2 204) of the healthcare workers wore two layers of masks at the same time, most of whom (1621, 63.67%) wore medical surgical mask and respirator at the same time. 57.50% (1 464) of the healthcare workers used goggles or face shield, 42.50% (1 082) of whom used goggles and face shield at the same time. 95.25% (2 425) of the healthcare workers wore coverall and disposable gown at the same time. 96.62% (2 460) of the healthcare workers wore boot covers and shoe covers at the same time. The proportion of the healthcare workers who wore two-layer hats was the highest (70.54%), and the proportion of the healthcare workers who wore two-layer gloves was also the highest (57.31%). CONCLUSION The use of PPE of the HCWs who are from the medical aid teams has effectively prevented the COVID-19 infection, achieving a 'zero infection' among the 42.6 thousand HCWs. However, there are excessive use of PPE, and the rational use of PPE needs to be further standardized and explored.