• 1.General questions -
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    What is the novel coronavirus (COVID-19)?

    Viruses are non-cellular microorganisms, with small size, simple composition and one kind of nucleic acid, that can multiply only in living cells.

    As a positive-sense single-stranded RNA virus, coronavirus is a large family of viruses that exist widely in nature. It is named after corona for the corona-looking spikes that protrude from the envelopes of the virus. Coronavirus can cause multiple diseases in humans and animals, including respiratory diseases, gastrointestinal diseases, neurological diseases such as Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS).

    In the recent epidemic outbreak control, among the patients with pneumonia of an unknown cause first identified in Wuhan, the virus isolated from their lower respiratory tract is a new type of coronavirus, named as COVID-19 by the World Health Organization (WHO), which also named the disease caused by the virus COVID-19 (Coronavirus disease 2019).

    As a Group Beta coronavirus, the COVID-19 has an envelope and round or oval particles with a diameter of 60-140nm, and is often polymorphic. COVID-19 is sensitive to ultraviolet rays and heat and be effectively inactivated by 56 ° C for 30 minutes and lipid solvents such as ether, 75% ethanol, chlorine-containing disinfectants, peracetic acid, and chloroform. However chlorhexidine cannot effectively inactivate the virus.

    The genetic characteristics of the COVID-19 are significantly different from SARSCoV and MERS-CoV. Current researches have shown that it has a homology of more than 85% with bat SARS-like coronavirus (bat-SL-CoVZC45).

    (Reference: Microbiology (Eighth Edition), National Prescribed Textbooks for the Undergraduate Programme between 2011 and 2015, Health Education Manual for COVID-19 Control issued by National Health Commission and China Health Education Center; Diagnosis and Treatment Protocol for COVID-19 (Trial Version 7) issued by National Health Commission and National Administration of Traditional Chinese Medicine; Press Conference of China-WHO Joint Mission on COVID-19 on February 24th, 2020)

    Source: Chinese Center for Disease Control and Prevention

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    What are the routes of transmission for COVID-19?

    Respiratory droplets and close contact transmission are the main routes of transmission. There is the possibility of aerosol transmission in a relatively closed environment for a long time exposure to high concentrations of aerosol. As novel coronavirus can be isolated from feces and urine, attention should be paid to aerosol or contact transmission by environmental pollution caused by feces and urine.

    (Reference: Diagnosis and Treatment Protocol for COVID-19 (Trial Version 7) issued by National Health Commission and National Administration of Traditional Chinese Medicine)

    Source: Chinese Center for Disease Control and Prevention

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    Which population groups are more susceptible to the COVID-19 infection?

    The whole population is susceptible. Whether or not individuals will be infected depends mainly on their contact with COVID-19 infected patients or other individuals with asymptomatic infections. In the elderly and those with chronic underlying diseases, their conditions may progress faster, be more severe, and have a poorer prognosis after infection.

    (Reference: Health Education Manual for COVID-19 Control issued by National Health Commission and China Health Education Center)

    Source: Chinese Center for Disease Control and Prevention

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    What are the common symptoms after infection?

    COVID-19 (Coronavirus disease 2019) refers to pneumonia caused by the 2019-nCoV infection, which is mainly manifested by fever, fatigue, and dry cough. A few patients have symptoms such as nasal congestion, runny nose, sore throat, myalgia and diarrhea. In many severe patients, breathing difficulty and/or hypoxemia occurs after one week, and those critical cases can quickly progress to acute respiratory distress syndrome, septic shock, and metabolic acidosis and coagulation dysfunction that are difficult to be corrected, and multiple organ dysfunction syndrome (MODS), etc. Notably, severe and critical patients may have moderate to low-grade fever or even no obvious fever during the course of the disease.

    Some children and neonatal cases may have atypical symptoms, manifested as gastrointestinal symptoms such as vomiting and diarrhea, or only manifested as looking inactive and having shortness of breath.

    Mild cases only show low-grade fever, mild fatigue, and no signs of pneumonia.

    Most patients have good prognosis, and a few patients are critically ill. Deaths are more common in the elderly and those with chronic underlying conditions. The clinical course of pregnant women with COVID-19 is similar to that of patients of the same age. Symptoms in children are relatively mild.

    (Reference: Diagnosis and Treatment Protocol for COVID-19 (Trial Version 7) issued by National Health Commission and National Administration of Traditional Chinese Medicine)

    Source: Chinese Center for Disease Control and Prevention

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    How can we distinguish between common cold, influenza and COVID-19 infection?

    First, the pathogens of these three diseases are different. Second, the symptoms of the COVID-19 are different from those of the common cold and influenza. The common cold is usually manifested through upper respiratory symptoms, such as nasal congestion, runny nose, and sneezing. But there are no obvious fever, fatigue, headache, joint pain, aches and pains, or loss of appetite. Generally speaking, for patients of common cold, they have more severe upper respiratory symptoms, but mild constitutional symptoms.

    Influenza is a contagious respiratory infection caused by influenza viruses, which is characterized by acute onset. Patients may develop symptoms such as high-grade fever, sore throat, headache, muscle aches, fatigue, and loss of appetite, etc.

    The main symptoms of COVID-19 include fever, fatigue and dry cough, and a few patients also have symptoms of nasal congestion, runny nose, sore throat and diarrhea, etc. In mild cases, only low-grade fever and mild fatigue are observed, with no symptoms of pneumonia. The diagnosis needs to be combined with epidemiological history and laboratory test results.

    (Reference: Health Education Manual for COVID-19 Control issued by National Health Commission and China Health Education Center)

    Source: Chinese Center for Disease Control and Prevention

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    How long is the incubation period of COVID-19 infection?

    Based on the current epidemiological investigation, the symptoms of COVID-19 may appear in as few as 1 day or as long as 14 days after exposure, mostly 3-7 days.

    (Reference: Diagnosis and Treatment Protocol for COVID-19 (Trial Version 7) issued by National Health Commission and National Administration of Traditional Chinese Medicine)

    Source: Chinese Center for Disease Control and Prevention

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    Will the COVID-19 mutate?

    As a novel infectious disease, the possibility of virus mutation over a period of time cannot be ruled out. Based on the knowledge of coronavirus or virology as a whole, no mutation has been found. The differences between the viruses detected are very small, less than 1%. These differences are still being identified and further monitoring is needed. (Press Conference of the State Council Information Office on January 26th, 2020)

    The whole-genome sequencing of 104 COVID-19 strains isolated from different locations confirmed that the homology reached 99.9%. Based on this result, the WHO investigation group concluded that no significant mutation had been found. (Press Conference of China-WHO Joint Mission on COVID-19 on February 24th, 2020)

    Source: Chinese Center for Disease Control and Prevention

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    What is clustering infections?

    Clustering infections of COVID-19 underlines two or more cases found with fever and respiratory symptom in a small area (office, family, school, etc.) within two weeks. We should pay attention to such cases, and do nucleic acid testing if other clinical manifestations are seen.

    Source: Press conference of the joint prevention and control mechanism of the State Council

  • 2.Diagnosis and treatment
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    How to detect COVID-19?

    Routine laboratory tests:

    In the early stages of the disease, peripheral WBC count is normal or decreased and the lymphocyte count decreases. Some patients have an increase in liver enzymes, lactate dehydrogenase (LDH), muscle enzymes and myoglobin. Elevated troponin is seen in some critically ill patients. Most patients have elevated C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) and normal procalcitonin. In severe cases, D-dimer increases and peripheral blood lymphocytes progressively decrease. Severe and critically ill patients often have elevated inflammatory factors.

    Etiology tests:

    In the samples of nasopharyngeal swabs, sputum, lower respiratory tract secretions, blood and feces collected, RT-PCR or /and Next Generation Sequencing (NGS) can detect the RNA of COVID-19. Detection of lower respiratory tract specimens (sputum or tracheal aspirate) is more accurate. Samples should be submitted for examination as soon as possible after collection.

    Serology tests:

    Specific IgM antibodies to COVID-19 are mostly detected 3 to 5 days after onset, IgG antibody titers of recovery period are 4 times or more higher than that of acute phase.

    (Reference: Diagnosis and Treatment Protocol for COVID-19 (Trial Version 7) issued by the General Office of the National Health Commission and the Office of the National Administration of Traditional Chinese Medicine)

    Source: Chinese Center for Disease Control and Prevention

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    How to diagnose COVID-19 infection?

    Suspected cases: a comprehensive analysis is conducted based on epidemiological history and clinical manifestations. Cases that meet any one condition of the epidemiological histories and have any two conditions of the clinical manifestations. If there is no clear history of epidemiology, then the case should meet three conditions of the clinical manifestations.

    History of Epidemiology:

    1) Travel or residence history in Wuhan and its surrounding areas or other communities with reported cases within 14 days before the onset of the disease.

    2) History of contact with COVID-19 infected patients (the result of nucleic acid test is positive) within 14 days before the onset of the disease.

    3) Contact with patients with fever or respiratory symptoms from Wuhan and its surrounding areas or other communities with reported cases within 14 days before the onset of the disease.

    4) Cluster infection: within 2 weeks, 2 or more cases of fever and/or respiratory symptoms occurred in small areas such as homes, offices, and school classes.

    Clinical manifestations:

    1) Fever and / or respiratory symptoms;

    2) Having the imaging features of COVID-19: multiple patchy shadows and interstitial changes are found in the early stage, especially in the lung periphery. And then the conditions develop into multiple ground-glass opacities (GGO) and infiltration shadows. Severe cases may develop consolidation of lung tissue, with incidence of hydrothorax being rare;

    3) The total leukocyte count is normal or decrease, or the lymphocyte count is normal or decrease in the early stage of the disease.

    Confirmed case: suspected case with one of the following etiology or serological evidences:

    1) The result of RT-PCR used to detect the nucleic acid of COVID-19 is positive;

    2) The result of virus gene sequencing analysis is highly homologous with the known COVID-19.

    3) Serum IgM antibodies and IgG antibodies to COVID-19 are positive; serum IgG antibodies to COVID-19 turn from negative to positive or the IgG antibody titers of recovery period are 4 times or more higher than that of acute phase.

    Asymptomatic infection: those who have no clinical symptoms, positive for COVID-19 tests of their respiratory tract specimens or serum-specific IgM antibodies to COVID-19. It is mainly found through close contact screening, cluster infection investigation and source trace investigation.

    (Reference: Prevention and control of COVID-19 (Sixth Edition) issued by National Health Commission; Diagnosis and Treatment Protocol for COVID-19 (Trial Version 7) issued by the General Office of the National Health Commission and the Office of the National Administration of Traditional Chinese Medicine)

    Source: Chinese Center for Disease Control and Prevention

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    Symptoms after 2019-nCoV infection, what attention should be paid to when COVID-19 infected patients go to the hospital?

    After being infected with the COVID-19, mild cases only show low-grade fever, mild fatigue, and no signs of pneumonia. The main clinical manifestations of COVID-19 infection are fever, fatigue, and dry cough. A few patients have symptoms such as nasal congestion, runny nose, sore throat, myalgia and diarrhea. In many severe patients, breathing difficulty and/or hypoxemia occurs after one week, and those critical cases can quickly progress to acute respiratory distress syndrome, septic shock, and metabolic acidosis and coagulation dysfunction that are difficult to be corrected, and multiple organ dysfunction syndrome (MODS), etc. Notably, severe and critical patients may have moderate to low-grade fever or even no obvious fever during the course of the disease.

    Some children and neonatal cases may have atypical symptoms, manifested as
    gastrointestinal symptoms such as vomiting and diarrhea, or only manifested as looking inactive and having shortness of breath.

    If suspected of COVID-19, the hospitals will transfer the patients to the designated hospital for quarantine treatment, and carry out etiological detection. The patient should provide a truthful and detailed account of the disease situation and the history of seeking medical treatment, especially recent history of travel and residence in Wuhan, history of contact with patients with infected or suspected patients, history of animal contact, and so on.

    (Reference: Diagnosis and Treatment Protocol for COVID-19 (Trial Version 7) issued by the General Office of the National Health Commission and the Office of the National Administration of Traditional Chinese Medicine; PUMCH COVID-19 Prevention and Precautions Handbook issued by Chinese Academy of Medical Sciences and Peking Union Medical College Hospital)

    Source: Chinese Center for Disease Control and Prevention

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    What are the treatments for COVID-19?

    Suspected and confirmed cases should be isolated and treated in designated hospitals with effective isolation and protective conditions, and suspected cases should be isolated in a single room. Multiple confirmed cases can be admitted to the same ward, and critical cases should be admitted to ICU as soon as possible.

    General treatments: patients should rest on the bed and receive strengthened supportive care to ensure sufficient energy intake; attention should be paid to water and electrolyte balance to maintain the stability of the internal environment, and vital signs and finger oxygen saturation should be closely monitored.

    Complete blood count, urinalysis, CRP, biochemical indicators (liver enzyme, myocardial enzyme, renal function, etc.), blood coagulation function, arterial blood gas analysis, chest imaging should be monitored according to the conditions of the cases. Cytokines testing should be performed if conditions permit.

    Effective oxygen therapy measures should be provided in time, including nasal cannula, oxygen masks and high-flow nasal cannula oxygen therapy. Mixing hydrogen with inhaled oxygen (H2 / O2: 66.6% / 33.3%) can be used if it is available.

    Anti-virus treatment: doctors may administer atomization inhalation of Interferon-α (for adults: 5 million U or equivalent dose, added with 2 ml sterile injection water, atomization inhalation twice a day), Lopinavir/ Ritonavir (for adults: 200mg/50mg per pill, 2 pills per serving, twice a day, the course of treatment should not exceed 10 days), Ribavirin (it is recommended to use it in combination with Interferon-α or Lopinavir/ Ritonavir, for adults 500mg each injection, iv. two to three times a day, the course of treatment should not exceed 10 days). Chloroquine phosphate (for adults (18-65 years old): if weight >50kg, 500 mg each time, twice a day for 7 days; if weight <50kg, 500 mg each time and twice a day on the first and second days, 500 mg each time and once a day for the third to seventh days) and Arbidol (for adults: 200 mg, three times a day, the course of treatment should not exceed 10 days).

    Attention should be paid to adverse reactions of the above medications, contraindications (such as chloroquine is contraindicated in patients with heart disease), and interaction with other medications. The efficacy of the tested medications currently should be further evaluated in clinical applications. It is not recommended to use 3 or more antiviral medications at the same time, and the use of related drugs should be stopped when there are intolerable side effects. For the treatment of infected pregnant women, we should calculate the gestational age, choose medications that have less impact on the fetus as much as possible, and consider whether to treat after pregnancy termination, followed by adequately informing the patients.

    Anti-bacterial treatment: avoid inappropriate use of antibiotics, especially the combination with broad-spectrum antibiotics.

    (Reference: Diagnosis and Treatment Protocol for COVID-19 (Trial Version 7) issued by the General Office of the National Health Commission and the Office of the National Administration of Traditional Chinese Medicine)

    Source:Chinese Center for Disease Control and Prevention

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    What is the role of traditional Chinese medicine (TMC) in treating patients with COVID-19?

    This disease belongs to the category of plague in traditional Chinese medicine (TCM), caused by the epidemic pathogenic factors. According to the recent clinical treatment and efficacy observations of traditional Chinese medicine, on February 6, 2020, the General Office of the National Health Committee and the Office of the State Administration of Traditional Chinese Medicine recommended "Lung cleansing & detoxifying decoction" for use in all regions.

    Recommended prescription: Ephedra 9g, Zhigancao 6g, Almond 9g, Gypsum 15-30g (fried first), Guizhi 9g, Zixie 9g, Zhuling 9g, Baizhu 9g, Zhiling 15g, Bupleurum 16g, Scutellaria baicalensis 6g, and Pinellia 9g, Ginger 9g, aster 9g, winter flower 9g, shoot dry 9g, asarum 6g, yam 12g, coriander fruit 6g, tangerine peel 6g, aquilegia 9g.

    Suggested use: Traditional Chinese medicine decoction pieces for decocting in water. One dose per day, twice in the morning and evening (forty minutes after a meal), take with warm water, and three doses a course.

    If conditions permit, the patient can take half a bowl of rice soup each time after taking the medicine, and can take up to one bowl if the patient has a dry tongue and is deficient in bodily fluids. (Note: If the patient does not have a fever, the amount of gypsum should be little. If having a fever or strong heat, the amount of gypsum can be increased). If the symptoms improve but do not fully recover, then take the second course of treatment. If the patient has special conditions or other underlying diseases, the prescription of the second course of treatment can be modified based on the actual situation and the medicine should be discontinued when the symptoms disappear.

    Scope of application: It is suitable for light, ordinary and severe patients, and can be used reasonably in combination with the actual situation of patients in the treatment of critically ill patients.

    (Reference: Diagnosis and Treatment Protocol for COVID-19 (Trial Version 7) issued by the General Office of the National Health Commission and the Office of the National Administration of Traditional Chinese Medicine)

    Source: Chinese Center for Disease Control and Prevention

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    What is the prognosis of infected patients?

    According to the cases currently treated, most of the patients have a good prognosis and a few are in severe condition. The prognosis of the elderly and patients with chronic underlying diseases is relatively poor. The clinical course of pregnant women with COVID-19 is similar to that of patients of the same age. Symptoms in infected children are relatively mild.

    (Reference: Diagnosis and Treatment Protocol for COVID-19 (Trial Version 7) issued by the General Office of the National Health Commission and Office of the National Administration of Traditional Chinese Medicine)

    Source: Chinese Center for Disease Control and Prevention

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    What attention should be paid to discharged patients?

    The designated hospitals should make good contact with the grass-roots medical institutions where the patients live, share the medical records and discharged patient information to the patient's jurisdiction or the residential committee and the grass-roots medical and health institutions intime.

    After discharge, it is recommended to continue to monitor self-health for 14 days, wear a mask, and if possible, live in a single room with good ventilation. Avoid close contact with family members, eat separately, keep hands clean and avoid outdoor activities.

    It is recommended to go to the hospital for a follow-up visit at the 2nd and 4th week after discharge.

    (Reference: Diagnosis and Treatment Protocol for COVID-19 (Trial Version 7) issued by the General Office of the National Health Commission and the Office of the National Administration of Traditional Chinese Medicine)

    Source: Chinese Center for Disease Control and Prevention

  • 3.Pregnant women and children
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    Are children and pregnant women susceptible population group?

    Pregnant women are susceptible to 2019-nCoV, and are more likely to have complications, or even progress to severe conditions; whether there is mother to child vertical transmission and its impact on the fetus remains unclear.

    At present, generally speaking, children are a susceptible group, but the clinical severity of children is mainly light and common type, and the proportion of severe cases is relatively low.

    Some children and neonatal cases may have atypical symptoms, manifested as gastrointestinal symptoms such as vomiting and diarrhea, or only manifested as looking inactive and having shortness of breath. The clinical course of pregnant women with COVID-19 is similar to that of patients of the same age. Symptoms in infected children are relatively mild.

    Source: Chinese Center for Disease Control and Prevention

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    What is the advice for the self-monitoring and management for pregnant women?

    Pay attention to the changes in body temperature and weight every day, check if there are respiratory tract infection symptoms and monitor the fetal movement regularly.

    For women in the early stage of pregnancy, if ultrasound has confirmed the intrauterine pregnancy, and in the case of slight abdominal pain or a small amount of bleeding, you can stay at home for rest and observation; in case of repeated irregular small amount of bleeding, ultrasonic examination should be carried out after making appointment with and consulting the doctor of Obstetrics and Gynecology in good time to rule out embryo arrest; if the abdominal pain is aggravated or the blood volume is increased or the intrauterine pregnancy has not been confirmed by ultrasound, you should
    consult the obstetrician by telephone in time, and follow the doctor's advice to seek care.

    Source: Chinese Center for Disease Control and Prevention

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    What is the advice for the antenatal visits for pregnant women?

    During the peak epidemic period, if there is no special situation (such as gestational age, and if special examination is required etc), pregnant women can consult with their obstetricians to postpone the antenatal visits as appropriate and monitor the fetal intrauterine conditions (fetal movement) at home. When it is necessary to take the antenatal visit, you should make an appointment in advance, equip yourself with good protection, and try to shorten your stay at the hospital. Pregnant women with pregnancy complications should strictly follow the doctor's advice. In case of abnormal conditions during pregnancy  (headache, unclear vision, palpitation, shortness of breath, high blood pressure, vaginal bleeding or abnormal discharge, abnormal abdominal pain, abnormal fetal movement, etc.) or delivery signs, you should seek medical advice in time. Don't delay care seeking for fear or worry.

    Source: Chinese Center for Disease Control and Prevention

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    What is the recommended course of actions for pregnant women when they feel sick?

    When pregnant women develop mild symptoms such as nasal congestion and throat irritation, for those with history of traveling to or living in the high epidemic areas, or close contact with coronavirus infected patients within the past 14 days, and with no fever, they can stay at home for full rest and observation, monitor their body temperature and observe the development of
    symptoms by themselves every day.

    If a pregnant woman has a history of traveling or living in a high epidemic area, or having close contact with a patient diagnosed with coronavirus infection within the past 14 days, she should stay at home or in a designated place for medical observation according to the requirements. During the observation, the pregnant woman should pay close attention to her own symptoms and fetal movements. She should contact the community management or medical observation staff to inform them her health status accurately, and seek medical care in a timely manner in case of the suspicious symptoms relating to the Novel Coronavirus Pneumonia, including fever, cough, sore throat, chest distress, breathing difficulty, fatigue, nausea and vomiting, diarrhea, conjunctivitis, muscle pain, etc.

    For the treatment of infected pregnant women, we should calculate the gestational age, choose medications that have less impact on the fetus as much as possible, and consider whether to treat after pregnancy termination, followed by adequately informing the patients. Pregnant women with severe or critical COVID-19 should terminate the pregnancy with caesarean delivery being the first choice.

    Source: Chinese Center for Disease Control and Prevention

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    What is the best way for pregnant women to stay mentally healthy during this period?

    1) Pregnant women should pay reasonable attention to the epidemic situation, understand the epidemic situation and relevant protection knowledge from regular channels, and reduce the panic, worry and anxiety caused by frequent receiving information reports from various channels.

    2) Communicate with relatives, friends, colleagues, etc. by telephone or internet, share their feelings, comfort and encourage each other, and get psychological support.

    3) Under the protection of science, we should try our best to maintain normal life and work, ensure nutrition and exercise, so as to maintain normal mood; we can also shift our attention and relieve psychological pressure by listening to music, painting, reading, etc.

    4) During the period of isolation, pregnant women should face up to their own situation, accept their own bad emotions, and face up to and accept the isolation environment. 

    5) When self psychological adjustment is difficult, we can use the hotline of network of psychological intervention institutions to seek professional help.

    Source: Chinese Center for Disease Control and Prevention

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    What do pregnant women need to pay attention to when going out for hospital visits?

    If you are not going to the hospital for prenatal checkups, you should go to the nearest facility that can meet your needs and have a small number of outpatients; give priority to the essential and urgently needed medical examinations and operations; make appointments and preparations before the consultation, and get familiar with the layout of the hospital and steps of the checkup. You are advised to shorten your stay at the hospital. For the antenatal checkups, you should choose a hospital where you registered your pregnancy and all the files are kept and equip yourself with sound personal protection for the hospital visit.

    On the way to the hospital and in the hospital, you should keep yourself warm so as to not catch a cold; pregnant women and accompanying family members should wear medical surgical masks or N95 masks throughout the way; you can carry hand sanitizer or disinfectant wipes to maintain hand hygiene; keep the distance between people as much as possible (more than 1 meter) both on the way to and in the hospital. 

    Avoid public transportation when going out for hospital visits. You can choose to take a taxi or drive a car. If necessary, open the windows for air circulation in the car.

    After touching the door handles, curtains, or doctor's white coat in the hospital, remember not to touch your mouth, nose, or eyes. If you cannot wash your hands with running water in time, try to use alcohol free disinfectant.

    After going back home, you should properly dispose of your masks, change your clothes, wash your hands, and wash the exposed face and different parts exposed on the face. Clothing worn for the hospital visit should be washed and disinfected as soon as possible, with the jacket placed in a place with good ventilation. 

    Source: Chinese Center for Disease Control and Prevention

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    How should parents help protect children in daily family protection?

    Do not take children to visit relatives, friends, parties, and group lunch or dinners. Do not allow acquaintances to touch infants or children or speak to children at close distance. Avoid contact with people with respiratory infections and people who have been in high epidemic areas within the past two weeks.

    Parents or caregivers should wash their hands frequently. Children should also wash their hands frequently. Adults should wash your hands carefully before playing with your child. Parents need to change clothes and shoes when coming home from outside and wash their hands before holding the child. Educate or help your child to wash hands with soap or running water after eating, playing, coughing, sneezing, or touching saliva and secretions. If you cough or sneeze, you should cover your mouth and nose with a tissue. Then, immediately throw the contaminated tissue into a covered trash bin, and wash your hands carefully with running water. If it's too late to cover yourself with a tissue, you should cover with a curved elbow and then wash your arms carefully.

    Do not try the food with your mouth and then feed it to the child, let alone chewing the food with your mouth before feeding it to the child (including feeding your child after blowing on the hot food), and do not share tableware with your child. Do not kiss, exhale, or gasp to the children, or blow on the hot food. Disinfect children's toys and articles regularly. 

    Source: Chinese Center for Disease Control and Prevention

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    Any advice to keep the living environment healthy and clean?

    Ideally the room(s) should be kept clean with fresh air, and suitable temperature. The room(s) should be ventilated regularly every day, except for extreme cold weather when the room(s) should be kept warm. When ventilating, you can move your child to another room to prevent them from catching a cold.

    Family members should avoid sharing towels and drinking from the same glasses and cups. Serving chopsticks and spoons should be used. Dishes should be thoroughly washed after each meal. It is recommended to steam the tableware for ten minutes after the water gets boiled.

    Disinfect children's toys and articles regularly.

    Source: Chinese Center for Disease Control and Prevention

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    How should children choose masks?

    Children should choose N95 masks as the first option if possible, followed by children's surgical masks. Children should also be guided to use the masks correctly. As masks are not recommended to infants under one year old, passive protection should be adopted for this group. Namely, caregivers should wear masks.

    Source: Chinese Center for Disease Control and Prevention

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    What should be aware of to help the children to wear masks correctly?

    1) Before wearing masks, children should carefully read and correctly understand the instructions with the help of their parents for the appropriate use of protective masks.

    2) Parents should watch their children’s situations closely when wearing masks. Should their children feel uncomfortable when wearing masks, parents should make timely adjustments or stop their children from wearing masks immediately.

    3) Given that masks for adults cannot fully fit children as they have smaller faces, it is not recommended for children to wear masks intended for adults which have a tightfitting requirement.

    Source: Chinese Center for Disease Control and Prevention

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    How to help children to learn to wear a mask?

    Many children do not like wearing masks for the following reasons: some feel that the masks are too stuffy and can cause breath shortness; some feel that the mask straps are too tight and painful for their ears; some simply feel uncomfortable, and others are afraid to wear masks or find wearing masks ugly.

    First, parents should buy child-friendly masks that are suitable for their children. Generally, these masks may have some patterns or colors, which are easier for children to accept. For older children, parents can use storytelling to tell their children why everyone wears a mask and the risks of not wearing a mask. When wearing the masks, the children should be helped to adjust the position of the mask, to make them feel more comfortable and less resistant. For younger children, parents can learn to wear masks together with the children, by looking to the mirror together with role-playing, playing games, and storytelling. Parents should not rush to put the masks on children’s faces at first. You are advised to try several times to make them feel less resistant and strange to wear masks. If the children find wearing masks unacceptable, they should stay at home as much possible and maintain good hand hygiene. Parents should maintain personal protection and clean, disinfect, ventilate their homes, so as to indirectly protect their children.

    Source: Chinese Center for Disease Control and Prevention

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    What is the dietary advice for children during the epidemic period?

    It is advised to pay attention to food hygiene, fully cook the meat and eggs, separate cutting boards and knives for raw and cooked food. One should not touch, purchase or consume wild animals.

    Breast milk is the best "drug" to improve the immunity of newborns. Therefore, infants under 6 months should be exclusively breastfed, and for those over 6 months, it is recommended to continue breastfeeding up to 24 months while transiting to complementary feeding. 

    Source: Chinese Center for Disease Control and Prevention

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    What is the advice for children's activity routine and sleep?

    Children should not watch TV or use electronic products for a long time while staying at home. Or rather, exercise or appropriate activities should be arranged for them. For school- age children, they should continue with their learning, and after finishing their homework, they can also join the parents in cleaning the house. Parents of infants and young children can massage and move the limbs of their children. All children staying at home should go to bed on time to ensure adequate sleep.

    You are advised not to take your children out as much possible, especially to public places or confined spaces, maintain children's daily routine with adequate sleep and balanced nutrition, and choose open parks for proper outdoor activities, or indoor exercise at home, so as to enhance their immunity.

    Source: Chinese Center for Disease Control and Prevention

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    What should parents do if the child gets sick?

    When your child/children develop(s) symptoms such as cough and fever, and he/she did not have any previous outside activities or contact at all with COVID-19 infected patients, then parents can monitor the children's temperature first, and care for the child/children at home as a normal respiratory infection. If the temperature continues to persist or even rise, or if the cough worsens, breathing difficulty occurs, or child has poor mental state, it is recommended that the child/children be taken to the nearest hospital that has a pediatric clinic, for checkups and treatments as prescribed by a doctor.

    Source: Chinese Center for Disease Control and Prevention

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    Is there a risk of cross-infection when a child is ill and goes to the hospital?

    Parents should not be reluctant to take their children to the hospital for fear of cross-infection. Children's diseases, especially young children's, can obviously change in a very short period of time; staying at home may delay the treatment. When seeing a doctor, children and parents must take proper protective measures. Avoid going to the hospital during rush hours if it is not an emergency.

    Source: govt.chinadaily.com.cn

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    What measures should be taken by schools and and nurseries and kindergartens?

    In the environment where students have close contact with other teachers and students, they should correctly wear medical surgical masks or N95 masks to minimize the scope of activities. Schools should closely monitor the health status of students, monitor their body temperatures twice a day, and keep a record of absence, leaving class/school early, and leave requests. If suspicious symptoms are found among students, schools should immediately report to the epidemic management staff and cooperate with hospitals and CDC for management of close contact and disinfection.

    Schools should try to avoid organizing large group activities. Adequate ventilation and cleaning are advised for classrooms, dormitories, libraries, activity centers, canteens, auditoriums, teacher's offices, toilets and other activity areas. Soap liquid and hand sanitizer should be provided as appropriate for such venues.

    Source: Chinese Center for Disease Control and Prevention

  • 4.Questions on protection
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    How can the public prevent COVID-19?

    1) Develop good personal hygiene habits. Pay attention to personal hygiene. Cover your mouth and nose with a tissue when coughing or sneezing. Wash your hands frequently. Do not touch your mouth, eyes, and nose with dirty hands, and do not spit on the ground.

    2) Avoid dinner parties. People who have dinner together are in close contact with each other. The droplets produced by coughing and sneezing can directly contaminate the whole group of people who have dinner together and easily cause the spread of disease. In order to prevent the spread of the COVID-19, please do not have dinner together.

    3) Avoid public places. There are many people in public places with large turnover and complicated personnel composition. Once there are virus carriers, it is easy to cause human-to-human transmission, especially in crowded public places with poor air mobility, such as shopping malls, restaurants, cinemas, internet cafes, KTV, stations, airports, docks and exhibition halls.

    4) Open the window frequently for ventilation. The indoor environment is airtight, easy to cause bacteria breeding, increasing the risk of human infectious disease. Frequent window ventilation can effectively reduce the content of indoor pathogenic microorganisms and other pollutants, the ultraviolet ray in the sun and sterilization. Therefore, windows should be opened every morning, noon and night for at least 15 minutes.

    5) Keep the room clean. The door handle, remote control, mobile phone, telephone landline, toilet ring, children's toys, etc. are commonly used by family members. After being contaminated by germs, these items become important carriers and media for disease transmission. For the health of family members, they should always be cleaned with a wet towel or paper towel, if necessary, use a household disinfectant.

    6) Wash your hands frequently. A variety of diseases can be transmitted by hand. For example, food contaminated by germs can spread digestive tract diseases, rubbing the eyes can transmit red eye disease, keratitis and other diseases, and pulling the nose can transmit respiratory diseases. Wash your hands promptly after returning home, before and after meals, and covering your mouth and nose with your hands when coughing or sneezing. When washing your hands, use running water and soap or hand sanitizer.

    7) Wear a mask when going out. The public should wear disposable medical masks (children choose products with equivalent performance) when going out to public places, seeking medical treatment (except for fever clinics), and taking public transportation. Do not spit on the ground. Wrap nose and nose secretions with tissue paper, and dispose of them in a covered dustbin.

    8) Develop a healthy lifestyle. Reasonable diet, not overeating, meat and eggs should be thoroughly cooked. Don't smoke, and don't drink too much. Balance work and rest, not staying up late, and do proper exercises.

    9) Health monitoring. Try to avoid close contact with people who have symptoms of respiratory diseases such as fever, coughing or sneezing. Active temperature measurement when you feel consciously feverish. If there is a child in the family, touch the child's forehead in the morning and evening. If there is a fever, take a temperature measurement. If you find any symptoms of fever, dry cough, or fatigue in your family, please seek medical advice immediately.

    10) Do not touch, hunt, process, transport, kill or eat wild animals.

    (Reference: Health Education Manual for COVID-19 Control issued by China Health Education Center under guidance of Department of Publicity of National Health Commission)

    Source: Chinese Center for Disease Control and Prevention

    .
    What are close contacts?

    Close contact refers to persons who have not taken adequate protection from close contact (within 1 meter) since 2 days before the onset of symptoms of suspected cases and confirmed cases, or since 2 days before the sampling were collected from asymptomatic patients. The specific contact conditions are as follows:

    1) Cohabitation, study, work, or other close contacts, such as working close to one another, studying in the same classroom or living in the same house;

    2) Health care workers, family members, or other people who have similar close contact during diagnosing, treating, nursing and visiting the case, such as visiting the patients or staying with the patients in a closed environment, other patients in the same ward and their caregivers;

    3) People who travel in the same vehicle and have close contact, including caregivers and accompanying people (family, colleagues, friends, etc.) on the vehicle, or other passengers and stewards who are in possible close contact with cases (suspected cases, confirmed cases) and infected people (mild cases, asymptomatic infections) after investigation and evaluation;

    4) People who are assessed by the field investigators as persons in contact with close contacts.

    (Reference: Prevention and control of COVID-19 (Fifth Edition) issued by National Health Commission)

    Source: Chinese Center for Disease Control and Prevention

    .
    What should I do as a close contact?

    Close contacts should be taken for centralized medical observation. In areas where conditions do not permit, home-based isolation medical observation can be adopted, close contacts should take their temperature at least 2 times a day, and pay attention to fever, dry cough and other respiratory symptoms or diarrhea and other gastrointestinal symptoms. The medical observation period is 14 days after the last unprotected contact with the cases or cases with asymptomatic infection. After the suspected cases are ruled out, close contacts can be released from medical observation. Close contacts of confirmed cases and those with asymptomatic infections, if the tests are negative during the medical observation period, need to continue until the observation period expires.

    People in centralized or home-based isolation medical observation should live relatively independently, minimize contact with co-residents, clean and disinfect medical observation sites, and avoid cross-infection. Do not go out during the observation period. People can only go out with the approval of the medical observation management staff, and wear disposable surgical masks and avoid going to crowded places.

    Health risks should be notified to those who are in the same traffic, such as airplanes, trains, and ships, and those who are not in close contact with each other in living, studying, and working. They should seek medical attention in time if they have symptoms of respiratory infections such as fever and dry cough, and diarrhea and conjunctival congestion, also they should actively inform the recent activity history.

    (Reference: Prevention and control of COVID-19 (Sixth Edition) issued by National Health Commission, COVID-19 Cases Close Contact Management Plan issued by National Health Commission)

    Source: Chinese Center for Disease Control and Prevention

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    During the medical observation, what symptoms of close contacts need to seek medical attention?

    During the medical observation, once the close contact has any symptoms (including fever, chills, dry cough, productive cough, nasal congestion, runny nose, sore throat, headache, fatigue, muscle aches, joint pain, shortness of breath, dyspnea, chest tightness, conjunctival congestion, nausea and vomiting, diarrhea, abdominal pain, etc.), it should be immediately reported to the local health department. According to the regulations, diagnosis and treatment are required in the designated hospitals, and the sampling should be collected for laboratory screening tests. If the result of the screening test suggested it is a suspected case or a confirmed case, medical observation should be performed on those who are in close contact with the case.

    (Reference: Prevention and control of COVID-19 (Fifth Edition) issued by National Health Commission)

    Source: Chinese Center for Disease Control and Prevention

    .
    Why should close contacts be observed for 14 days?

    The isolation period of an infectious disease is determined based on the incubation period of the disease. The incubation period refers to the period from the invasion of the pathogen to the clinical symptoms. The incubation period of COVID-19 is 1-14 days, mostly 3-7 days, and it is contagious during the incubation period. Considering the incubation period of diseases caused by other coronaviruses, the relevant information of the COVID-19 infection cases, and the current prevention and control efforts, the medical observation period for close contacts is set to 14 days.

    (Reference: Health Education Manual for COVID-19 Control issued by China Health Education Center under guidance of Department of Publicity of National Health Commission)

    Source: Chinese Center for Disease Control and Prevention

    .
    How to wash your hands properly?

    Handwashing is one of the most direct and effective ways to reduce bacteria and viruses in your hands. Proper handwashing is the key. Proper handwashing refers to washing hands with running water and soap or liquid soap. Each hand should be rubbed for more than 20 seconds. Make sure that the palms, fingers, back of hands, finger seams, nail seams, wrists are cleaned. You can use an alcohol-based hand sanitizer if soap and water are not available.

    Wash your hands correctly:

    1) Wet hands under running water.

    2) Take an appropriate amount of liquid soap (soap) and apply it evenly to the entire palm, back of the hand and fingers.

    3) Rub your hands carefully for at least 15 seconds.

    4) Rinse hands thoroughly under running water.

    5) Hold up some water, rinse the faucet, and then close the faucet (if it is an induction controlled faucet, do not do this step).

    6) Dry your hands with a clean towel or paper towel, or air dry them.

    Seven-step hand-washing method to prevent COVID-19:

    1) Wash palms: fingers close together, rub your hands palm to palm.

    2) Wash back of hands: with your fingers linked through the other hand, use your right palm to rub the back of your left hand, then exchange.

    3) Wash fingers: link your fingers together, facing each other, then rub your palms and fingers together.

    4) Wash back of fingers: bend your fingers into an empty fist, rotate the knuckles in the palm of the other hand, and then exchange.

    5) Wash thumbs: hold the thumb of the other hand with one hand, rotate and rub, and then exchange.

    6) Wash fingertips: put your five fingertips together, put them in the palm of the other hand, rotate and rub, and then exchange.

    7) Wash wrists: hold the wrist of the other hand, rotate and rub, and then exchange.

    (Reference: Health Education Manual for COVID-19 Control issued by National Health Commission and China Health Education Center)

    Source: Press conference of the joint prevention and control mechanism of the State Council

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    What are the symptoms in need of medical attention?

    If both of the following conditions are met, you should go to the outpatient clinic of the designated hospital:

    1) Fever (armpit temperature ≥37.3 °C), cough, shortness of breath and other symptoms of acute respiratory infections;

    2) Patients with a history of travel or residence in Wuhan and surrounding areas, or other areas with local cases of continuous transmission, or who have been exposed to feverish patients with respiratory symptoms who come from Wuhan and surrounding areas, or other areas with local cases of continuous transmission within 14 days before the onset of illness, or a small cluster of people are infected.

    Medical surgical masks or N95 masks should be worn on the way to and throughout the hospital visit. Avoid using public transportation. You can take a private car or call an ambulance. Keep away from other people as much as possible on the road and in the hospital at a safe distance of 1.5m-2m (at least 1m). When you seek medical treatment, you should truthfully explain your conditions and the history of medical treatment. In particular, tell the doctor about your recent travel and residence history in Wuhan, history of contact with pneumonia patients or suspected patients, animal contact history, etc.

    (Reference: Health Education Manual for COVID-19 Control issued by National Health Commission and China Health Education Center; PUMCH COVID-19 Prevention and Precautions Handbook issued by Chinese Academy of Medical Sciences and Peking Union Medical College Hospital)

    Source: Press conference of the joint prevention and control mechanism of the State Council

    .
    How should patients with other diseases seek medical treatment during the epidemic period?

    In principle, during the epidemic period, except for severely ill patients who must seek medical attention immediately, general people should minimize their visit or do not visit to the hospital; and if they must seek medical treatment, they should choose the nearest medical institution that can meet the needs and has a small number of outpatients. If hospital visits are essential, one should take up the essential and urgently needed medical examinations and operations, and leave other checkups and operations later dates. If you can choose a department, try to avoid the fever clinic and emergency department.

    Patients and accompanying family members should wear medical surgical masks or N95 masks on the way to and within the hospital. If possible, avoid going to the hospital by public transportation. Keep your hands clean at all times, and prepare a portable hand sanitizer containing alcohol. Keep as much distance as possible (at least 1 meter) with other people on the way and in the hospital.

    (Reference: Guidelines for Public Prevention of COVID-19 issued by Chinese Center for Disease Control and Prevention)

    Source: Chinese Center for Disease Control and Prevention

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    Is it safe to receive a package from a country or region where a virus has been found?

    Yes, it's safe. Those who receive the packages are not at risk of getting infected by the COVID-19. From the experience of other coronaviruses, we know that this type of virus does not survive long on objects such as letters or parcels.

    (Reference: Answers to Common Questions About COVID-19 by WHO)

    Source: Chinese Center for Disease Control and Prevention

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    Can patients cured of novel coronavirus pneumonia be infected again?

    After the patient is cured, there is a small chance of re-infection. If positive results occur again after discharge, it may be due to different sensitivity of the virus nucleic acid detection kit. In general, cured patients develop antibodies and have little chance of re-infection.

    Source: govt.chinadaily.com.cn

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    How is correct disinfection carried out in different places under different circumstances?

    At isolation wards and patients' residences, concurrent and terminal disinfection should be carried out. Disinfection frequency should be increased on the surface of objects in crowded places such as hospitals, airports and stations. Cleaning and disinfection on door handles and elevator push buttons that have high frequency contacts should be strengthened. Garbage, feces and sewage should be collected and harmlessly treated. Individuals must maintain hand hygiene.

    Source: govt.chinadaily.com.cn

    .
    Can 75% alcohol be sprayed directly on clothes?

    The probability is very low for the virus to infect people through contaminated clothes. The general public does not need to disinfect clothes if they have not been to hospitals, visited patients or contacted people suspected to have symptoms. Although alcohol will not corrode clothing, it is highly combustible. If sprayed on clothes, it becomes easier for them to catch fire in case of high temperatures, open flames or static electricity. So it is not suggested to spray alcohol on clothes.

    Source: Press conference of the joint prevention and control mechanism of the State Council

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    Will the virus stain the hair?

    Generally, people do not need to wash or disinfect their hair after returning home. An infection of COVID-19 depends on certain conditions, such as the amount of virus in droplets and the virus activity. According to research so far, the virus is sensitive to some external conditions, including ultraviolet light and heat. Normally the probability is quite low for people to get stained with high-density active virus on their hair if they go outdoors or general public venues. Therefore it is not necessary to keep up more than a daily washing routine.

    Source: Press conference of the joint prevention and control mechanism of the State Council

    .
    Whether infrared thermometer is harmful to people’s health?

    The operating principle of the infrared thermometer is transferring radiant power to electric signal when human body’s thermal infrared radiation is detected by the sensor. The thermometer does not send infrared ray to human body, but receive thermal infrared radiation, and it is harmless to both eyes and body.

    Source: Press conference of the joint prevention and control mechanism of the State Council

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    Can air purifiers filter virus?

    Air purifiers commonly seen in market are not required to be able to eliminate pathogenic microorganism such as virus. As a result, air purifiers do not necessarily filter virus. Families are recommended to ventilate their rooms on a daily basis.

    Source: Press conference of the joint prevention and control mechanism of the State Council

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    Should mobile phones be disinfected after being outside every time?

    Mobile phones, which we touch very frequently, do need more cleaning and disinfection than usual. Mobile phones should be powered off after getting back home from outside every time. Wipe the surface of the mobile phone with 75 percent alcohol or disinfection products that do no damage to electronic products, like disinfected wet tissue, after it completely cools down. Hands should also be sanitized appropriately. It is not necessary to do this if the phone was not used outside.

    Source: Press conference of the joint prevention and control mechanism of the State Council

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    Can central air conditioners be used?

    The type, sanitary condition of the outlet, and air supply range should be understood before using the central air conditioner. Most central air conditioners are safe to use. When using the central air conditioner with an all-air system, the air-return valve should be closed to use full fresh air mode. When using the central air conditioner with primary air fan-coil system, the air in different rooms should be independent from each other and the fresh air should be set at the highest level. Clean and disinfect the air outlet, air inlet, and filters. If there were infected or suspected patients within the range of air supply, central air-conditioning should be turned off and disinfected, and it should not be used before passing the hygiene evaluation.

    Source: Press conference of the joint prevention and control mechanism of the State Council

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    Is it necessary to wear gloves when going outside?

    Wearing gloves, like cotton or fabric gloves (latex gloves are unnecessary), can reduce contamination of your hands. However, the best way to prevent spread is to wash your hands.

    Source: Press conference of the joint prevention and control mechanism of the State Council

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    Do meats or vegetables carry the novel coronavirus (COVID-19)?

    It is not likely for the novel coronavirus to contaminate vegetables, meats or fruits through droplet transmission and direct contact.

    Wash vegetables, meats and fruits with running water, cook vegetables and meats before eating, peel fruits whenever possible, and separate chopping boards and knives for raw food from those for cooked food.

    The novel coronavirus can be effectively inactivated by 56 ° C for 30 minutes, while the cooking temperature can reach 100° C or even higher.

    Wash hands after processing food.

    Source: Press conference of the joint prevention and control mechanism of the State Council

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    Does the novel coronavirus survive longer on smooth surfaces?

    It is difficult for microorganisms to survive on clean and smooth surfaces; but they live longer in places that are dark, moist and dirty.

    Source: Press conference of the joint prevention and control mechanism of the State Council

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    How can we protect ourselves inside vehicles and elevators?

    People can be infected after touching elevator buttons and door handles, not because the virus can live longer on them, but the buttons and handles are frequently touched.

    Here are three measures to prevent infection:
    1. Increase disinfection frequency appropriately;
    2. Avoid directly touching buttons and handles;
    3. Rub hands with disinfectants after direct contact.

    Source: Press conference of the joint prevention and control mechanism of the State Council

    .
    How will people’s health and the environment be affected if disinfectants are frequently used?

    Repeatedly spraying disinfectant in a large area should be avoided, because it can cause environmental pollution.

    If disinfectants are sprayed to bodies a lot, they can be absorbed through breathing and skin, which is harmful to health.

    It is safe to frequently use disinfectants designed for hands.

    Source: Press conference of the joint prevention and control mechanism of the State Council

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    Can the blood plasma of cured patients be used for treatment?

    Convalescent plasma is effective for treating patients in severe conditions, according to clinical research.

    Source: Press conference of the joint prevention and control mechanism of the State Council

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    Does plasma collection harm donors’ health?

    Plasma collection is drawing plasma out of blood and transfusing back red blood cells and other blood components. About 200-300 ml plasma is collected from each donor.

    The donor’s plasma will recover in one or two weeks, and there is little damage to his or her body.

    Source: Press conference of the joint prevention and control mechanism of the State Council

    .
    How do you protect yourself when you go to the hairdresser's for a haircut?

    Wear a mask at all times and try not to chat with the hairdresser. The distance between customer seats should be more than 1.5 meters. Clean and disinfect hands after touching anything in the store.

    Source: govt.chinadaily.com.cn

  • 5.Questions on masks
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    How to choose a mask?

    During the COVID-19 epidemic, it is recommended to choose the right type of mask, and not to overprotect it. According to the type and risk level of the works of disease prevention and control, the following guidelines are proposed.

    No mask or non-medical mask

    Recommended for low-risk people:

    ● Indoor and community residents;

    ● Those engaged in outdoor activities, including children, students in open spaces;

    ● Those who work in a well-ventilated workplace.

    Those who stay at home or in well-ventilated locations with low population density may not require masks.

    Non-medical masks, such as cotton gauze, activated carbon, and sponges, have certain protective effects, and can also reduce the spread of droplets caused by coughing, sneezing and talking.

    Disposable medical mask (children choose products with similar performance)

    Recommended for people with a lower risk of exposure:

    ● Public in densely populated areas such as supermarkets, shopping malls, vehicles, elevators.

    ● Indoor office environment;

    ● Patients attending medical institutions (except for fever clinic);

    ● Children in kindergartens, students, etc who are engaged in intensive learning and activities.

    Medical surgical mask

    Recommended for people with a medium risk of exposure:

    ● General outpatient, medical staff in the ward, etc.;

    ● Staff in densely populated places, including those in hospitals, airports, railway stations, subways, ground buses, airplanes, trains, supermarkets, restaurants, etc.

    ● Personnel engaged in administrative management that related to the epidemic, and professionals such as police, security, courier, etc.;

    ● Patients with fever or suspected case that are isolated at home, and persons living with them.

    Particulate respirators mask (children choose products with similar performance)

    Recommended for people with a higher risk of exposure:

    ● Medical staff working in the emergency department, etc.;

    ● Public health physicians who conduct epidemiological investigations of close contacts.

    ● Testing personnel of environmental and biological samples related to the epidemic.

    Medical protective mask

    Recommended for personnel with high-risk of exposure:

    ● All staff working in the wards, ICUs, and observation rooms for patients with COVID-19 (confirmed cases, suspected cases), including clinicians, nurses, nurse assistants, cleaners, mortuary staff, etc.

    ● Doctors and nurses of fever clinics at designated medical institutions in the affected areas;

    ● Public health physicians who conduct epidemiological investigations of confirmed and suspected cases;

    Wear safety goggles or face shields in the first aid of infected patients and during tracheal intubation and bronchoscopy. When there is a shortage of medical protective masks, you can choose to replace them with N95/KN95 and above standard particulate respirators masks. You can also choose self-priming filter respirators (full or half facepiece) with particulate filter cotton, and powered air-purifying respirator has better protection.

    (Reference: Guidelines for the Selection and Use of COVID-19 Masks in Different Populations issued by National Health Commission; Health Education Manual for COVID-19 Control issued by National Health Commission and China Health Education Center)

    Source: Chinese Center for Disease Control and Prevention

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    How to wear medical surgical masks?

    1) The dark side faces outwards, and the side with the metallic strip faces upwards;

    2) Fold up and down to cover the nose and chin;

    3) Mold the metallic strip to make it close to the bridge of the nose to prevent side leakage.

    (Reference: Health Education Manual for COVID-19 Control issued by National Health Commission and China Health Education Center)

    Source: Chinese Center for Disease Control and Prevention

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    How to wear protective masks (take KN95 or N95 masks as examples)?

    1) The side with the logo faces outwards, and the side with the metallic strip faces upwards;

    2) Fasten the elastic straps that fixes the mask, or position the elastic straps around both ears to fit snugly over the face.

    (Reference: Health Education Manual for COVID-19 Control issued by National Health Commission and China Health Education Center)

    Source: Chinese Center for Disease Control and Prevention

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    How to wear headbands masks?

    1) Hold the mask body with one hand, put fingertips on the metallic nose strip, let the two headbands hang freely under the back of the hand;

    2) The metallic strip faces up, let the mask cover the chin, the upper headband is worn on the top of the head, and the lower headband is worn on the neck;

    3) Starting from the middle of the metallic strip with both index fingers, press down on it while moving to both sides to shape the shape of the bridge of the nose.

    (Reference: Health Education Manual for COVID-19 Control issued by National Health Commission and China Health Education Center)

    Source: Chinese Center for Disease Control and Prevention

    .
    How to wear ear-loops masks?

    1) Face the side without the nose clip, and pull the ear straps with both hands, so that the nose strip faces up;

    2) Let the mask against your chin;

    3) Pull the ear straps to the back and adjust them to feel comfortable;

    4) Starting from the middle of the metallic strip with both index fingers, press down on it while moving to both sides to shape the shape of the bridge of the nose. Pinching the nose strip with one hand will cause sharp angles and air leakage, and reduce shielding performance. The nose strip should be pressed with both sides at the same time.

    Whether it is a headbands or ear-loops mask, an air impermeability test is required after wearing. Cover the mask with both hands and breathe. If you feel that gas leaks from the nose strip, you should readjust it. If you feel that gas leaks from both sides of the mask, you need to further adjust the position of the headbands and earloops; if it still leaks, you need to change another one.

    (Reference: Health Education Manual for COVID-19 Control issued by National Health Commission and China Health Education Center)

    Source: Chinese Center for Disease Control and Prevention

    .
    How to change, store, and dispose of masks?

    During the epidemic of the COVID-19, the use of masks can be appropriately extended (time of use, frequency of use) on the premise of protecting public health:

    1) The medical protective masks have a service life, and the masks are for exclusive use. They cannot be used cross-personally. High-risk personnel need to change masks after re-entering after finishing work, eating (drinking water), and using the toilet.

    2) The mask should be changed if it is contaminated by the patient's blood, respiratory/nasal secretions, and other body fluids.

    3) Higher risk personnel need to change masks after receiving highly suspected patients.

    4) Masks worn by other risk level people can be used repeatedly. Wash your hands before wearing the mask, and avoid touching the inside of the mask when wearing it. Masks need to be changed in time if they are dirty, deformed, damaged, or smelly.

    If you need a re-use a mask, you can hang it in a clean, dry and ventilated place, or place it in a clean, breathable paper bag. Masks need to be stored separately to avoid contact with each other and identify the user of the mask. Medical protective masks cannot be cleaned, nor can they be disinfected by disinfectants, heating, etc. Cotton gauze masks can be cleaned and disinfected. Other non-medical masks are handled according to their instructions.

    The masks used by healthy people can be disposed of according to the requirements of domestic garbage classification. Masks worn by suspected or confirmed cases should not be discarded randomly. They should be treated as medical waste and disposed of in strict accordance with relevant procedures for medical waste.

    (Reference: Health Education Manual for COVID-19 Control issued by National Health Commission and China Health Education Center)

    Source: Chinese Center for Disease Control and Prevention

    .
    When a person wears a face mask with exhalation valve, is it risky for others to be around?

    The unidirectional exhalation valve on a face mask let the expired gas out of the mask without being filtered. If patients diagnosed with COVID-19 wear such masks, they may let out virus. Diagnosed patients and suspected cases should not wear such masks.

    Source: Press conference of the joint prevention and control mechanism of the State Council

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    Can disposable masks be disinfected with alcohol spray after use and reused?

    Disposable masks can be used repeatedly if used in a place with low-risk infection possibility and kept clean and complete, especially if the inner layer is not polluted. They should also be placed in a clean, dry and ventilated place. In addition, disinfectants, including medical alcohol, will reduce the protection capability of the masks, so it is not appropriate to spray alcohol on a mask for disinfection.

    Source: Press conference of the joint prevention and control mechanism of the State Council

    .
    Can masks be used repeatedly, or disinfected in a microwave oven?

    You do not have to throw away a disposable mask after use for one time. It is not recommended to disinfect masks with a microwave oven. In general, people do not have to wear more specialized N95 and KN95 masks designed to offer protection to medical workers.

    Source: Press conference of the joint prevention and control mechanism of the State Council

    .
    Without a mask, will a person get infected when in contact with a COVID-19 patient for a short time, e.g. 50s or 15s?

    The possibility of infection depends on the distance between you and the patient and your protective measures. Without protection, it is highly risky to get infection in close contact with a patient who is talking, coughing or sneezing. Before the epidemic is under control, people in crowded places are suggested to protect themselves with masks.

    Source: Press conference of the joint prevention and control mechanism of the State Council

    .
    Is it safe to remove the mask for security checks at railway stations and airports?

    In security checks, masks shall be removed for facial recognition, and it is unlikely to get infected in such short time. During the process, people should keep proper distance from each other and stand behind the safety line while waiting.

    Source: Press conference of the joint prevention and control mechanism of the State Council

    .
    Is wearing a mask still necessary in low-risk areas?

    Low-risk areas are not risk-free areas. Personal protection from the coronavirus is still a must. Sound hygienic habits should be well maintained, including wearing masks, frequent hand washing, ventilation, cleaning, coughing with mouth covered by tissues or elbows rather than bare hands, avoiding crowds, keeping a safe distance from colleagues, and dining separately. That will help lower the risk of getting infected.

    Source: Press conference of the joint prevention and control mechanism of the State Council

    .
    How should children choose masks?

    Children should choose N95 masks as the first option if possible, followed by children's surgical masks. Children should also be guided to use the masks correctly. As masks are not recommended to infants under one year old, passive protection should be adopted for this group. Namely, caregivers should wear masks.

    Source: Chinese Center for Disease Control and Prevention

    .
    What should be aware of to help the children to wear masks correctly?

    1) Before wearing masks, children should carefully read and correctly understand the instructions with the help of their parents for the appropriate use of protective masks.

    2) Parents should watch their children’s situations closely when wearing masks. Should their children feel uncomfortable when wearing masks, parents should make timely adjustments or stop their children from wearing masks immediately.

    3) Given that masks for adults cannot fully fit children as they have smaller faces, it is not recommended for children to wear masks intended for adults which have a tightfitting requirement.

    Source: Chinese Center for Disease Control and Prevention

    .
    How to help children to learn to wear a mask?

    Many children do not like wearing masks for the following reasons: some feel that the masks are too stuffy and can cause breath shortness; some feel that the mask straps are too tight and painful for their ears; some simply feel uncomfortable, and others are afraid to wear masks or find wearing masks ugly.

    First, parents should buy child-friendly masks that are suitable for their children. Generally, these masks may have some patterns or colors, which are easier for children to accept. For older children, parents can use storytelling to tell their children why everyone wears a mask and the risks of not wearing a mask. When wearing the masks, the children should be helped to adjust the position of the mask, to make them feel more comfortable and less resistant. For younger children, parents can learn to wear masks together with the children, by looking to the mirror together with role-playing, playing games, and storytelling. Parents should not rush to put the masks on children’s faces at first. You are advised to try several times to make them feel less resistant and strange to wear masks. If the children find wearing masks unacceptable, they should stay at home as much possible and maintain good hand hygiene. Parents should maintain personal protection and clean, disinfect, ventilate their homes, so as to indirectly protect their children.

    Source: Chinese Center for Disease Control and Prevention

  • 6.Home prevention
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    What are the home precautions?

    1) During the epidemic period, ordinary families are recommended to open the windows and ventilate rooms.

    2) The surface of the ground, table, furniture and other objects should be cleaned daily and disinfected regularly.

    3) Family members do not share towels, keep their rooms and tableware clean, and air quilts and clothes frequently.

    4) Monitor the health of family members and yourselves. Active temperature measurement when you feel consciously feverish.

    5) After going home, wash your hands with soap and running water, or disinfect your hands with an effective disinfectant.

    6) When some family members have suspicious symptoms, they should be sent to the hospital on time, while others should protect themselves by quarantine measures. After the consultation, the isolation room and items contacted (such as the living room floor, bathroom, furniture countertops, door handles, and dining utensils) should be disinfected. Wash your hands immediately after disinfection.

    (Reference: Guidelines for Public Prevention of Pneumonia Caused by COVID-2019 Infection issued by Chinese Center for Disease Control and Prevention; PUMCH COVID-19 Prevention and Precautions Handbook issued by Chinese Academy of Medical Sciences and Peking Union Medical College Hospital)

    Source: Chinese Center for Disease Control and Prevention

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    How should bathrooms be disinfected during the outbreak?

    For the general public, hands should be carefully washed after using the toilet. If there were no confirmed and asymptomatic patients, or close contacts at home, it’s enough to do general cleaning for the bathroom. If there were close contacts at home, it would be better to provide them an independent bathroom. If no spare bathroom is available, the bathroom should be cleaned every day with a disinfectant that contains chlorine, such as 84 disinfectant. Levers, seat and the interior of the toilet, as well as the door handle of the bathroom, should also be cleaned with disinfectant.

    Source: Press conference of the joint prevention and control mechanism of the State Council

  • 7.Workplace prevention
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    Is wearing a face mask a must?

    The answer would almost always be a yes. Whatever the settings involving people gathering, wearing a mask is one of the most effective ways to protect you from infection as COVID-19 mainly transmits through inhalable droplets. Disease control experts advise that people should wear face masks through the working day.

    What is the exception? Well, you might not need a mask when there are no other people under the same roof.

    Source: Xinhua

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    What employers should do to ward off the virus?

    One good start point is establishing health files of employees. Tracking their travel records and current health status can be very useful in identifying suspected cases and timely quarantine and treatment if needed. Employers should also adopt flexible office hours and other methods to avoid large gatherings, and put more distance between employees.

    Besides, employers should introduce routine sterilization and ventilation in the workplace. Equip your workplace with hand sanitizer and other disinfectants, and provide your employees with face masks — the must-haves.

    Source: Xinhua

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    How to have safe meetings?

    First, keep the meeting room well ventilated;

    Second, clean and disinfect the surface of the desk, doorknob and the floor before and after the meeting;

    Third, reduce and shorten meetings, limit the presence, widen the distance between people and ensure they are masked;

    Last but not least, convene online whenever possible.

    Source: Xinhua

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    What to do if an employee or a member of the business is confirmed infected? Is a shutdown necessary?

    The top priority is to find out the close contacts, put them under quarantine, and seek immediate medical treatment when there is a problem. If the infection has not been detected in an early stage and extensive spread takes place, the organization should undergo certain disease prevention and control measures.

    In case of early detection and close contacts passing strict medical observation procedures, an operation shutdown will not be necessary.

    Source: Xinhua

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    Are we supposed to shut down the central air-conditioning?

    Yes. When there is a local epidemic outbreak, you should not only shut down the central AC but also disinfect the whole workplace thoroughly. Whether or not to have the AC back will then depend on an evaluation of your workplace's exposure and readiness.

    Source: Xinhua

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    How to cope with employee's fear and anxiety over infection?

    Inform your employees with the facts about COVID-19 prevention and control and encourage them to take proper personal protection. Seek professional psychological consulting services if needed.

    Besides, employers should be ready to prevent and curb discrimination against confirmed or suspected cases within the business.

    Source: Xinhua

  • 8.Public places prevention
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    How to prevent COVID-2019 infection in public places?

    1) On the way to and from work: Wear disposable medical masks or N95 masks properly. Try not to use public transportation. Walking, cycling, or taking a private car or shuttle are recommended. Try to avoid touching any items in the car with your hands. After returning home, remove your mask and wash your hands first.

    2) In the dining hall: Have meals in staggered batches instead of having all the people at once. It is recommended that employees bring their lunch boxes if possible and bring them back to the office to eat after purchasing the food to avoid the crowd.

    3) Maintain air circulation in public places, open the windows for ventilation frequently, and avoid gatherings with many people.

    4) Keep the environment clean and clean up the garbage in time.

    5) In epidemic areas, the public should try their best to avoid going to public places, especially places with dense crowds and poor air circulation.

    (Reference: Guidelines for Public Prevention of Pneumonia Caused by COVID-2019 Infection issued by Chinese Center for Disease Control and Prevention; PUMCH COVID-19 Prevention and Precautions Handbook issued by Chinese Academy of Medical Sciences and Peking Union Medical College Hospital)

    Source: Chinese Center for Disease Control and Prevention

  • 9.Travel
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    How to protect yourself when traveling?

    1) Avoid close contact with anyone who has a cold or flu-like symptoms.

    2) Gloves are recommended when on board. Seat armrests, backrests, toilet door handles, doors, and poles are all public spaces. Do not directly contact your eyes, nose, and mouth after touching them with your hands to avoid contact transmission. Wash your hands with soap and water or alcohol-based hand sanitizer.

    3) Cover your mouth and nose with a tissue or sleeve cuff or curved elbow when you cough or sneeze, then wash your hands.

    4) Wear masks all the time, you can wear disposable medical masks or N95 masks.

    5) Eat only thoroughly cooked hot food.

    6) If you currently have a fever or cough, please avoid traveling.

    7) If you are sick during the trip, please notify the flight or train attendants in time, seek medical help as soon as possible, and inform the medical staff of your travel history.

    8) Self-monitoring of your health should be carried out twice a day for 14 consecutive days, starting from leaving the epidemic areas. If condition permits, try to live alone or in a well-ventilated single room, and minimize close contacts with your families.

    (Reference: Guidelines for Public Prevention of COVID-19 issued by Chinese Center for Disease Control and Prevention; Health Education Manual for COVID-19 Control issued by National Health Commission and China Health Education Center)

    Source: Chinese Center for Disease Control and Prevention

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    What are some prevention measures when traveling by air?

    Do not arrive excessively early. Getting to the airport five hours ahead of your flight will only increase your chances of contracting the virus. Wear a face mask during the entire journey. Avoid unnecessary conversations with strangers, and sit away from others when possible.

    Source: Xinhua

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    Can thermometers be brought onto the plane?

    Yes and no. A mercury thermometer is not allowed in your carry-on luggage, but you can bring a digital thermometer with you as long as the rated energy of the lithium battery does not exceed 100Wh or the lithium content does not exceed 2 grams. Still, as travelers are now normally required to have their temperatures taken before getting onto the plane, it is not necessary to bring a thermometer.

    Source: Xinhua

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    What are things I should keep in mind during a taxi ride

    Both the driver and you should wear masks. Leave the door open for a few minutes before getting inside for ventilation. Open the window during the ride — fresh air is better than air conditioning for ventilation purposes.

    Source: Xinhua

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    Is it riskier to take the subway or a cab?

    As long as you are in public space, there are risks of contracting the virus. So rather than worrying about the type of transportation you take, it is more important that you wear a mask at all times and wash hands as soon as you get home.

    Source: Xinhua

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    What are some tips for driving?

    Again ventilation is the key thing to keep in mind. Also, have some masks, hand disinfectants or disinfectant paper towels in your car. If you happened to give someone with symptoms a ride, make sure you disinfect door handles, seats and the steering wheel afterwards.

    Source: Xinhua

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    What about a long-haul bus?

    Sit away from others when you can. Ask the driver to stop at a service area every two hours so you can get fresh air.

    Source: Xinhua

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    What measures are taken to ensure the safety of inbound and outbound travelers?

    All entry and exit personnel must make health declarations. Customs will check whether they have symptoms and whether they have been to countries and regions where the epidemic occurred within 14 days. In China, the declaration card has been translated into more than 10 languages, and a mini-program for mobile devices has been developed to allow online declaration.

    Source: Xinhua

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    Can recycled subway tickets transmit virus?

    The major routes of transmission of novel coronavirus are still respiratory droplets and direct contact, so wearing a mask and keeping hands clean are the most effective ways to prevent infections. Although it's highly unlikely recycled subway tickets are contaminated with the virus, to avoid the possibility people are encouraged to use a personal transportation card or pay for the ticket via an app. After taking public transportation, washing hands is necessary.

    Source: Press conference of the joint prevention and control mechanism of the State Council

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    How should I protect myself when driving private cars?

    Maximize ventilation when taking a private car. Personal protective items and disinfectant should be used in cars, such as masks and disinfectant wipes. After returning to cars from public places, hands should be well sterilized. If someone with suspected symptoms has taken a car, it is suggested to roll down the window and disinfect surfaces touched by him or her, such as the door handles. If suspected or confirmed COVID-19 patients have taken the car, the interior articles and surfaces, as well as the air conditioning system, should be disinfected under the guidance of professionals, and other passengers should accept quarantine according to regulations.

    Source: Press conference of the joint prevention and control mechanism of the State Council

  • 10.Dining out
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    How should I protect myself when lining up at restaurants?

    Wear masks, avoid conversations, and keep a safe distance from other diners. Remember to cover nose and mouth with tissues or elbow when sneezing. Avoid touching surface areas that are frequently touched by others when getting your food. Use QR code as the main payment method as much as possible instead of cash.

    Source: Press conference of the joint prevention and control mechanism of the State Council 

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    How should I protect myself when dining out?

    Sit at a clean table with good ventilation. Wash hands with liquid soap under a running tap or disinfectants. Avoid contaminating the inside of the mask when loosening it before dining. Instead of facing other diners, it is better to be seated in the same direction at least one meter apart. Try to finish the meal as quickly as possible with little conversation. Get your food to go if the restaurant is crowded. And leave the restaurant right after finishing eating.

    Source: Press conference of the joint prevention and control mechanism of the State Council

  • 11.Shopping
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    Some shopping malls recently restarted operation. How can they carry out epidemic prevention and control work?

    They should strengthen indoor air circulation, clean and disinfect regularly every day, and increase disinfection frequency for object surfaces with high frequency contact. Conduct temperature measurement at the entrance and avoid allowing crowds to gather in the mall. Employees and customers should wear masks in the mall and keep their distance when communicating.

    Source: govt.chinadaily.com.cn

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    How should I protect myself when shopping?

    Try to avoid peak times at malls and supermarkets when shopping, so weekdays or early morning might be a better choice. Stairs are a safer option when shopping on lower floors; escalators are better than elevators when shopping on upper floors. Avoid crowded elevators. Keep nose and mouth well masked in the elevator and keep a safe distance from others. In addition, keep the hands uncontaminated.

    Source: Press conference of the joint prevention and control mechanism of the State Council

  • 12.Going to hospitals
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    How can non-fever patients protect themselves in hospitals?

    Avoid going to fever clinics;

    Reduce waiting time by making appointments with doctors online;

    Wear disposable medical masks or higher grade ones;

    Don’t touch objects in hospitals casually;

    Carry disinfectants and disinfect hands after touching public facilities in hospitals, or wear gloves.

    Source: Press conference of the joint prevention and control mechanism of the State Council

    .
    What do pregnant women need to pay attention to when going out for hospital visits?

    If you are not going to the hospital for prenatal checkups, you should go to the nearest facility that can meet your needs and have a small number of outpatients; give priority to the essential and urgently needed medical examinations and operations; make appointments and preparations before the consultation, and get familiar with the layout of the hospital and steps of the checkup. You are advised to shorten your stay at the hospital. For the antenatal checkups, you should choose a hospital where you registered your pregnancy and all the files are kept and equip yourself with sound personal protection for the hospital visit.

    On the way to the hospital and in the hospital, you should keep yourself warm so as to not catch a cold; pregnant women and accompanying family members should wear medical surgical masks or N95 masks throughout the way; you can carry hand sanitizer or disinfectant wipes to maintain hand hygiene; keep the distance between people as much as possible (more than 1 meter) both on the way to and in the hospital. 

    Avoid public transportation when going out for hospital visits. You can choose to take a taxi or drive a car. If necessary, open the windows for air circulation in the car.

    After touching the door handles, curtains, or doctor's white coat in the hospital, remember not to touch your mouth, nose, or eyes. If you cannot wash your hands with running water in time, try to use alcohol free disinfectant.

    After going back home, you should properly dispose of your masks, change your clothes, wash your hands, and wash the exposed face and different parts exposed on the face. Clothing worn for the hospital visit should be washed and disinfected as soon as possible, with the jacket placed in a place with good ventilation. 

    Source: Chinese Center for Disease Control and Prevention

    .
    Is there a risk of cross-infection when a child is ill and goes to the hospital?

    Parents should not be reluctant to take their children to the hospital for fear of cross-infection. Children's diseases, especially young children's, can obviously change in a very short period of time; staying at home may delay the treatment. When seeing a doctor, children and parents must take proper protective measures. Avoid going to the hospital during rush hours if it is not an emergency.

    Source: govt.chinadaily.com.cn

  • 13.Immigration and exit-entry
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    Are foreigners allowed to entry or exit as usual during the period of epidemic prevention and control?

    The Chinese government has taken a series of strong measures since the outbreak of pneumonia caused by novel coronavirus. As President Xi Jinping stated, China has full confidence and capability to win the battle against the novel coronavirus outbreak. At present, except for the lockdown of the exit channel of Wuhan ports, all port visa agencies are operating as usual. Visa-free transit policy for foreigners is still effective. All land, sea and air ports of China are functioning. Foreigners can enter or exit as usual with their valid international travel documents.

    At present, it is helpful to the epidemic prevention and control by reducing cross border movements. Foreigners could make reasonable travel arrangements to China and stay or reside in China as usual. Due to entry restrictions adopted by some countries and regions, it is advised that foreigners who need to exit from China, should learn in advance entry requirements of destination countries or regions to avoid financial and time losses in case of any entry refusals. Those who travel to countries or regions without entry restrictions, are advised to arrive at exit ports well ahead of departure time for necessary checks. Foreigners having fever with symptoms of acute respiratory infection such as cough or breathing difficulties, should avoid international travels and seek immediate medical treatment at the nearest hospitals. Information such as recent activities as well as close contacts should be provided to relevant authorities for any necessary control measures.

    Source: National Immigration Administration

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    How do foreigners apply for visas, stay or residence permits during the period of epidemic prevention and control?

    All exit-entry administration authorities (EEA) in China will be in full service for extension and issuance of visa and stay or residence permits to ensure foreigners' legitimate stay in China. Urgent services for emergency situations will also be provided. To avoid crowds gathering risks, the EEA authorities will make arrangements for services on appointments. Foreigners could make appointments in advance for any applications. For those institutions which host high numbers of foreigners, such as universities, scientific research institutes and business enterprises, the EEA authorities will allow additional agent service or provide other necessary conveniences depending upon the situation.

    Source: National Immigration Administration

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    How to deal with the situation that a foreigner’s visa, stay or residence permit expires during the epidemic prevention and control?

    According to Exit and Entry Administration Law of the PRC, foreigners should exit China or apply for extension at the EEA authorities before the visa, stay or residence permit expires. In light of the relevant laws and regulations and current situation, those who are unable to exit as scheduled or extend the visas, stay or residence permits due to the reason of epidemic prevention and control shall be given a lighter or mitigated or be exempted from punishment by the EEA authorities depending upon circumstances.

    Source: National Immigration Administration

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    What can foreigners do to cooperate during the epidemic prevention and control?

    It is advised that foreign friends enhance sense of self-protection, avoid crowded public places and take effective preventive measures. It is strongly suggested to actively cooperating with local communities and inviting entities to take preventive measures, abiding by relevant laws and regulations and following instructions of public security organs, NIA authorities, hygiene & health authorities. In case of having a fever with symptoms of acute respiratory infection such as cough or breathing difficulties, foreigners should report to the local communities, NIA authorities or hygiene & health authorities and cooperate actively in medical treatment and epidemic control. NIA authorities at all levels will work closely with relevant departments for the epidemic prevention and control to provide consultancy to foreigners, assist in disease screening and diagnosis with medical departments as well as dealing with other difficulties and problems encountered by foreigners during their stay in China.

    Source: National Immigration Administration

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    Are Chinese mainland residents allowed to exit or enter as usual?

    At present, except for the lockdown of the exit channel of Wuhan ports, all land, sea and air ports of China are in normal service. Chinese mainland residents could exit or enter with their valid international travel documents. All immigration inspection agencies of NIA will continue to provide services and conveniences for Chinese nationals, and coordinate with relevant hygiene & health authorities to conduct necessary epidemic checks. In view of the epidemic prevention and control situation as well as entry restrictions adopted by some countries and regions, in order to ensure health and safety of travelers and maintain exit and entry order, it is advised that Chinese mainland residents make reasonable travel plans and avoid unnecessary financial and time costs. Based on currently available information, countries including DPRK, Kazakhstan, Malaysia, the Philippines, Australia, ROK, Qatar, Japan, Vietnam, India, Britain, Indonesia, France, Myanmar, Italy, the United Arab Emirates, Sri Lanka as well as Hong Kong, Macao SAR and Taiwan region have adopted entry restrictions for travelers from Chinese mainland. If travelers are in urgent need of exit from Chinese mainland, it is advised to make travel arrangements after consulting with relevant diplomatic representative agencies, airlines or the inviting entities of the destination counties or regions.

    Source: National Immigration Administration

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    Could Chinese citizens apply for travel documents such as passports at the EEA authorities?

    In order to ensure health and safety of Chinese citizens and foreigners, reduce risks of cross-border movements for the epidemic prevention and control, maintain normal exit and entry order, it is advised that Chinese mainland residents make reasonable travel plans, and postpone applications of travel documents unless in emergency. At present, the EEA of Hubei Province has suspended accepting travel documents applications from Chinese citizens. Normal services will be resumed according to the situation of the epidemic prevention and control. Application services are suspended in EEA of other provinces during Chinese Spring Festival holiday. Under normal circumstances, the application centers except for Hubei province will be back into service after Chinese Spring Festival holiday.

    Applicants could contact local EEA authorities in advance for further information about opening time of application centers and relevant requirements. To avoid crowds gathering and unnecessary travels, applicants in need could confirm the time for submitting applications by online appointment, so that EEA authorities could provide better services and enhance efficiency. Applicants in urgent need for travel documents (including those in Hubei province) could contact local EEA authorities at any time for urgent applications.

    Source: National Immigration Administration

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    Are travelers allowed to exit and enter through ports of Wuhan?

    International travelers can enter China through ports of Wuhan (referring to Wuhan Tianhe International Airport and Hankou ferry terminal). Due to the lockdown of the exit channels of Wuhan ports, exits through any ports of Wuhan can only be permitted with approval.

    Source: National Immigration Administration

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    Could Chinese mainland residents go through e-channels as usual?

    Some of immigration inspection agencies may close some e-channels for the moment due to current situation of the epidemic prevention and control. Under such circumstances, travelers should go through manual inspection channels. It is advised for travelers to follow instructions of NIA officers and go through border clearance formalities according to relevant regulations.

    During the epidemic prevention and control period, immigration officers at manual inspection channels may work together with relevant authorities and take necessary preventive measures such as taking travels’ temperatures and making inquiries about travel itineraries and close contacts. Cooperation by the travelers will be appreciated., Immigration inspection agencies will make efforts to guarantee border inspection waiting time no more than 30 minutes for Chinese citizens at large ports and smooth border clearance for foreign visitors.

    Source: National Immigration Administration

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    How to deal with the situation that some travelers have already obtained endorsements to Hong Kong, Macao SAR and Taiwan region but cannot travel due to the epidemic?

    At present, regional authorities of Hong Kong, Macao SAR and Taiwan region have conducted travel restrictions for Chinese mainland residents. For those who have obtained endorsements to Hong Kong, Macao SAR and Taiwan region but fail to enter within the validity of endorsements because of the epidemic, EEA authorities will, after clearance of the epidemic, issue the same type of endorsements with the same validity free of charge according to the holder’s wishes.

    Source: National Immigration Administration

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    How to deal with the situation that travelers have suspicious symptoms?

    If travelers have symptoms of acute respiratory infection, such as cough and breathing difficulties, they should suspend travels immediately, stay far away from the crowds and seek treatment at the nearest medical institutions. The NIA authorities will provide necessary assistance as well.​​​

    Source: National Immigration Administration

What is the novel coronavirus (COVID-19)?

Viruses are non-cellular microorganisms, with small size, simple composition and one kind of nucleic acid, that can multiply only in living cells.

As a positive-sense single-stranded RNA virus, coronavirus is a large family of viruses that exist widely in nature. It is named after corona for the corona-looking spikes that protrude from the envelopes of the virus. Coronavirus can cause multiple diseases in humans and animals, including respiratory diseases, gastrointestinal diseases, neurological diseases such as Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS).

In the recent epidemic outbreak control, among the patients with pneumonia of an unknown cause first identified in Wuhan, the virus isolated from their lower respiratory tract is a new type of coronavirus, named as COVID-19 by the World Health Organization (WHO), which also named the disease caused by the virus COVID-19 (Coronavirus disease 2019).

As a Group Beta coronavirus, the COVID-19 has an envelope and round or oval particles with a diameter of 60-140nm, and is often polymorphic. COVID-19 is sensitive to ultraviolet rays and heat and be effectively inactivated by 56 ° C for 30 minutes and lipid solvents such as ether, 75% ethanol, chlorine-containing disinfectants, peracetic acid, and chloroform. However chlorhexidine cannot effectively inactivate the virus.

The genetic characteristics of the COVID-19 are significantly different from SARSCoV and MERS-CoV. Current researches have shown that it has a homology of more than 85% with bat SARS-like coronavirus (bat-SL-CoVZC45).

(Reference: Microbiology (Eighth Edition), National Prescribed Textbooks for the Undergraduate Programme between 2011 and 2015, Health Education Manual for COVID-19 Control issued by National Health Commission and China Health Education Center; Diagnosis and Treatment Protocol for COVID-19 (Trial Version 7) issued by National Health Commission and National Administration of Traditional Chinese Medicine; Press Conference of China-WHO Joint Mission on COVID-19 on February 24th, 2020)

Source: Chinese Center for Disease Control and Prevention