Handbook Of COVID-19 Prevention And Treatment

- Apr 02, 2020-

Part One Prevention and

Control Management

I. Isolation Area Management

1Fever Clinic

1.1 Layout

(1) Healthcare facilities shall set up a relatively independent fever clinic including an

exclusive one-way passage at the entrance of the hospital with a visible sign;

(2) The movement of people shall follow the principle of “three zones and two passages”:

a contaminated zone, a potentially contaminated zone and a clean zone provided

and clearly demarcated, and two buffer zones between the contaminated zone and the

potentially contaminated zone;

(3) An independent passage shall be equipped for contaminated items; set up a visual

region for one-way delivery of items from an office area (potentially contaminated zone) to

an isolation ward (contaminated zone);

(4) Appropriate procedures shall be standardized for medical personnel to put on and take

off their protective equipment. Make flowcharts of different zones, provide full-length

mirrors and observe the walking routes strictly;

(5) Infection prevention and control technicians shall be assigned to supervise the medical

personnel on putting on and removing protective equipment so as to prevent contamination;

(6) All items in the contaminated zone that have not been disinfected shall not be removed.

1.2 Zone Arrangement

(1) Set up an independent examination room, a laboratory, an observation room, and a

resuscitation room;

(2) Set up a pre-examination and triage area to perform preliminary screening of patients;

(3) Separate diagnosis and treatment zones: those patients with an epidemiological history

and fever and/or respiratory symptoms shall be guided into a suspected COVID-19 patient

zone; those patients with regular fever but no clear epidemiological history shall be guided

into a regular fever patient zone.

1.3Patient Management

(1) Patients with fevers must wear medical surgical masks;

(2) Only patients are allowed to enter the waiting area in order to avoid overcrowding;

(3) The duration of the patient’s visit shall be minimized so as to avoid cross infections;

(4) Educate patients and their families about early identification of symptoms and essential

preventative actions.

1.4 Screening, Admission and Exclusion

(1) All healthcare workers shall fully understand the epidemiological and clinical features of

COVID-19 and screen patients in accordance with the screening criteria below (see Table 1);

(2) Nucleic acid testing (NAT) shall be conducted on those patients who meet the screening

criteria for suspected patients;

(3) Patients who do not meet the screening criteria above, if they do not have a confirmed

epidemiological history, but cannot be ruled out from having COVID-19 based on their

symptoms, especially through imaging, are recommended for further evaluation and to obtain a

comprehensive diagnosis;

(4) Any patient who tests negative shall be re-tested 24 hours later. If a patient has two negative

NAT results and negative clinical manifestations, then he or she can be ruled out from having

COVID-19 and discharged from the hospital. If those patients cannot be ruled out from having

COVID-19 infections based on their clinical manifestations, they shall be subjected to additional

NAT tests every 24 hours until they are excluded or confirmed;

(5) Those confirmed cases with a positive NAT result shall be admitted and treated collectively

based on the severity of their conditions (the general isolation ward or isolated ICU).