It was December 31, 2019, when pneumonia was detected in Wuhan, China. The cause was unknown, yet was immediately reported to the WHO country office. After the intensive analysis of data, coordination with global relations, and the increment in supplies, the outbreak was considered differently.

The novel coronavirus disease 2019 was declared a Public Health Emergency of International Concern last January 30, 2020. It has become prevalent in 201 countries and territories. Furthermore, it has affected two international conveyances, the Diamond Princess cruise ship in Yokohama, Japan, and the MS Zaandam cruise ship of Holland America.

With that, everybody is advised to stay at home and observe some precautionary measures. The Zhongnan Hospital of Wuhan University Novel Coronavirus Management and Research Team and the Evidence-Based Medicine Chapter of China International Exchange and Promotive Association for Medical and Health Care (CPAM) recently announced clinical practice guidelines for COVID-19.

Guidance For People With Possible Exposure

Anyone who had or suspected exposure to carriers of COVID-19 should adhere to strict self-quarantine for 14 days. If symptoms such as cough and fever are observed, contact a hospital and inform them about the monitoring process. Ask them to arrange the patient’s ride heading to the hospital as he is prohibited to take public transportation. Methods of transportation can include an ambulance or a private vehicle of which windows are open for better ventilation. The vehicle must be disinfected with a chlorine-containing solution (500mg/L).

As a priority strategy, wear an N95 mask. If none, a disposable surgical mask can be used as an alternative. Also, observe 1-meter distance from everybody if in public, especially when inside the hospital, waiting to be accommodated. Close contacts should also conduct monitoring for themselves. These are people who accompany patients to the hospital for laboratory examinations. Proper respiratory hygiene and etiquette must be observed.

Isolation and Home Care Guidance for PUM

For patients with mild symptoms, a single-occupancy room with efficient ventilation is advised. Materials and household items used by the patient must be used only by him; they should be daily washed and sanitized with a chlorine-containing solution (500mg/L). The patient’s activity and relatives’ visit must be restricted. The wearing of a medical mask or use of a paper towel and bent elbow to cover the mouth when coughing or sneezing is required.

Home Caregiver Guidance

The caregiver of a patient under monitoring should be a fit and healthy family member who has never been diagnosed with any disease in the past. As he strictly maintains a one-meter distance for the patient, he should be wearing an N95 surgical mask or a disposable surgical mask. After having contact with the patient, the caregiver must wash his hands properly and disinfect with alcohol or hand sanitizer. Lately, there has been a scarcity of hand cleanser stocks in groceries and drugstores due to high demand, but a China hand sanitizer manufacturer can provide antiviral supplies even to foreign markets.

 

Home caregivers should also wash and disinfect hands before and after eating, after traveling to the washroom, as you enter the house from outdoor, and before leaving the room of the patient. According to the guidelines, he must wear double-layer disposable gloves when “handling the patient’s feces or urine, providing oral and respiratory care, and cleaning the patient’s room”. When putting on and removing the gloves, hands must be washed cleansed as well.

Treatment Guidance

For caregivers, monitor the vital signs of the patient as he goes on bed rest. Vital signs include heart rate, pulse rate, blood pressure, respiratory rate, and oxygen saturation. Give supportive treatment to the patient and make sure that he ingests adequate energy and hydration. This is to keep constant electrolyte and acid-base levels.

Moreover, the patient’s blood cell count must be monitored. He needs effective oxygen therapy as well, in order to breathe well since he might be experiencing some difficulty in allowing air to travel to and fro his lungs.

Antibiotic Therapy

Perform bacteriological surveillance to the patient and administer the right antibacterial drugs once a secondary infection is involved. If tests are conducted and secondary bacterial infection can’t be eliminated from patients with mild symptoms, it is possible to administer antibacterial drugs intended against community-acquired pneumonia, such as amoxicillin. Meanwhile, those with severe symptoms should be provided with practical antibacterial treatment to exclude all possible pathogens. It can be done with debilitating therapy while waiting for the bacteria to be discovered.

Other Medications

Ibuprofen can be administered as an antipyretic medication for the treatment of a symptomatic patient with a fever whose temperature exceeds 38.5℃ (101.3℉). Proton pump inhibitors must be used in order to alleviate stress ulcers and gastrointestinal bleeding of patients with high-risk factors. Mechanical ventilation for 48 hours or even more, is included in these risk factors. Others involve coagulation dysfunction, liver disease, renal replacement therapy, etc.

Patients with dyspnea, wheezing, and coughing can use selective (M1, M3) receptor anticholinergic prescriptions in order to lower the possibility of lung congestion and to enhance respiratory functions.

For citizens, frontliners, and government officials, let us all submit to the recommendations of WHO and global governance in order to successfully put an end to this life-threatening virus named novel coronavirus disease 2019. Many lives have been taken away, and more cases are being recorded each day as thousands of people around the world are battling against COVID-19. Let us stay at home and prevent the further spread of this disease. Lastly, let us maintain proper respiratory hygiene and wash our hands frequently.

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