DXY Tips on Home Isolation has been translated into English and Italian

In response to the outbreak of the new coronavirus pneumonia in various parts of the world, the “Global View of Wuhan” Volunteer Group selected and translated some important information from the recommendations on epidemic prevention of DXY (the largest physician community in China). “DXY Tips on Home Isolation”, which introduces the matters needing attention on home isolation, has been translated and published in three language including Chinese, English and Italian (1). It mainly includes the following issues:

• What is the difference between new coronavirus and influenza?
• How to protect at home?
• Will I be infected by the elevator?
• How to take care of children during an outbreak?
• There are pregnant women at home. What should I pay attention to during the epidemic?

DXY tips on home isolation

Difference between COVID-19 and common flu

Key symptom of infected COVID-19: shortness of breath (dyspnea)

The regular flu shares the same symptoms as that of COVID-19 pneumonia. Therefore, it is difficult to tell the differences between the two diseases by simply looking at symptoms like fever, headache, muscle weakness and general malaise. However, most patients with COVID-19 pneumonia have lower respiratory infection symptoms as dyspnea.

You should be alert if you find yourself get cold with shortness of breath.

It is of vital importance of the seventh day after any contact with suspected or confirmed patients

In the Diagnosis and Treatment of Pneumonia Infected by Novel Coronavirus (4th trial edition) pressed on 27th January by China General Office of the National Health Commission, a detail is mentioned as follows.

Based on current epidemiological investigation, incubation period was set as 3–7 days, which ranges from 1–14 days, and dyspnoea will arise after about a week in most cases of serious conditions.

Recommendations to prevent the spread of COVID-19 at home

Will open windows increase the chance of infection?

Actually, opening windows and fresh air will help to reduce the amount of viruses that may exist indoors, and also help to renew indoor air. Diluted outdoor air is almost impossible to bring viruses indoors. If your family members are suspected acute respiratory infection patients, open the window but keep the door closed during ventilation. Ventilation system is not recommended in case the air in the sick people’s room entering into the clean areas.

When home isolation is needed?

It is recommended to have home isolation, if you or your family are.

Suspected COVID-19 patients with mild symptoms

People who diagnosed by doctors with suspected COVID-19 who have mild symptoms should receive isolation and medical care at home.

Close contacts (have contacted with people who have COVID-19 and are ill)

Close contacts who have close contact with confirmed patients or highly suspected patients should receive isolation and expecting medical care at home.

All of the following conditions belong to close contacts and may need home isolation. Please see a doctor or contact local health department ASAP if you are:

• Living, studying or working with confirmed patients or having any other forms of close contact;
• Having treated, nursed or visited confirmed patients without effective protective measures;
• Having been hospitalized in the same room with confirmed patients.
• Having been using the same means of transportation as well as had close contact with the confirmed patients.

Note: we call for your special attention to the last one. Please closely follow train and flight tracing announcements issued by local government, media or other relevant authoritative channels. If you find yourself once in the same carriage or flight with confirmed cases, you NEED to be isolated at home and contact the local health department.

People (who) considered necessary to be isolated by the local health department.

If you have fever (body temperature above 38 °C/100.5 F) with any of the following conditions, please go to the hospital for diagnosis:

• Shortness of breath, chest tightness as well as asthma;
• Having close contact with confirmed COVID-19 patients;
• Patients with existing medical conditions such as high blood pressure, heart problems, diabetes or liver and brain damages;

Note: this is only for adults outside the epicenters. There should be higher standards in epicenters.

During home isolation

Stay in a specific room that satisfies following conditions

• Good ventilation: make sure there is at least one window allotted to the individual quarantined. It would be the air outlet of the whole house, which can protect the other area of your house from polluted air.
• Separated restroom;
• Wooden and metal furniture are preferred, which are easier to be disinfected. You can also choose to cover a layer of disposable plastic cloth on your fabric or leather furniture.
• Items in the room should be as few as possible, which can reduce the chance of infection and save from the trouble of future cleaning.

Necessary materials for home isolation mainly include: disinfection and nursing supplies, daily necessities, etc.

• Thermometer: take the temperature once in the morning and once in the evening per day to track your health;
• Respiratory masks: N95 masks or disposable surgical masks;
• Disinfectant: chlorine disinfectant;
• Alcohol: 75% alcohol, alcohol spray, alcohol pads, etc.;
• Soap/hand sanitizer: regular soap and hand sanitizer are fine. If you choose instant hand sanitizer, please make sure it contains high alcohol concentration;
• Tissue: multi-layer waterproof tissue is preferred;
• Exclusive garbage bag and lidded garbage can: used to deal with waste masks and other secretions;
• Disposable or personal towels.

During the period of home isolation, the changes of illness should be evaluated as follows

People isolated at home are advised to take their temperature at least twice a day, observe and record changes in their health condition until their symptoms do not get worse and gradually improve.

Symptoms to watch for are: cough, breathing with difficulty or shortness of breath, chest tightness, body aches, diarrhea, etc.

If the temperature drops gradually and the symptoms gradually improve, it means your health condition is getting better. Just keep watching.

If one or more of these symptoms persist and there is no sign of improvement, contact local hospital as soon as possible.

Would you get infected by taking the elevator?

The elevator is a closed tight space. Sharing one elevator with a virus carrier, you may get infected through his/her droplets spread by cough, sneeze, or talk.

If droplets fall on buttons or walls, the virus can be spread to other persons by contact. They may get infected by touching their mouth, nose or eyes before washing hands.

But don’t worry, prevention only requires remembering following three phrases:

• Wear mask when taking the elevator;
• Don’t touch your face when you are outside;
• Wash your hands when you get home.

A popular practice in China is to wrap your fingers in the tissue before touching buttons in the elevator, which is a good alternative if you have no glove.

Note: special attention: do not touch the polluted surface (such as the outside surface of the mask and the tissue in which your fingers are wrapped before); If you do, wash your hands with soap and water for 20 seconds as soon as possible.

How to take care of children

How to protect your children when going out

Don’t go out if possible, that is the best way to protect your children.

• If have to, drive private car or take taxi, and use less public transportation such as buses and subways where people are crowded. Walking is the best choice for near destinations.
• Both parents and children should wear masks and ensure timely replacement, and do not touch the outside surface of masks, so as to avoid the virus transferring to the hands.
• Carry instant hand sanitizer and other disinfectant products with you, disinfect your children’s hands in time if they touch other things, and try to keep children from sucking fingers, rubbing eyes and nose before fully-disinfection.
• Wash your hands in the right way once you get home, change your and your children’s outer clothes in case of any possible spread of the virus.

Catering for children during the epidemic

Make sure the food is thoroughly cooked, especially meat and eggs.

• Raw and cooked food should be treated with different sets of kitchen tools and put in separate bowls; Wash hands when you switch between possessing raw and cooked food; After cooking, wash your hands before touching your children.
• In addition, since the COVID-19 can be transmitted through saliva, it is imperative to keep your child from eating food that has been tasted by others and not to cool your children’s food by blowing. It is advised to use separate dishes and serving utensils, which can help to avoid cross-contamination.
• So, can you feed your children with chicken, duck and fish? Yes, but make sure it’s fully cooked. Until now, there is no evidence showing that the COVID-19 can be spread through regular meat and seafood.
• But be aware that both meat and eggs must be fully cooked before eating. Meanwhile be careful not to buy poultry or seafood from unknown sources. Do not touch live birds without protection.

Recommendations for pregnant women to prevent from COVID-19

Precautions in pregnancy check-ups

During the epidemic, pregnant moms need to note the following things when going for pregnancy check-ups:

• Avoid taking public transport. You can go by taxi, uber or your private car.
• Avoid staying in hospital for a long time. You can ask your family to line up for you and then find a ventilated place with fewer people while waiting. Don’t stay indoors for long.
• Always wear an N95 mask or a medical mask from home to hospital. Gloves are also recommended.
• Bring hand sanitizer or sanitizing wipes anytime with you to maintain hand hygiene when it’s not convenient for you to wash hands.
• Avoid touching eyes, nose or mouth with your hands. The virus can spread through contact.
• Dispose of used masks in a proper way upon getting home. Remember to change your clothes, wash your hands and face in time.
• Keep distance from the others (at least one meter or three feet away) when you are on the way and in hospital.

Can new moms keep breastfeeding their babies during the epidemic?

• If you are healthy and want to breastfeed your baby, please remember to wash your hands regularly. Pay attention to hygiene of those body parts where you will have close contact with your baby.
• Follow the guidelines of home isolation. Wear a medical mask and carefully wash your hands before intimate contact with your baby. Keep your wrists, arms and outerwear clean.
• Breastfeeding is not recommended under these circumstances:
  • You are a suspected COVID-19 patient;
  • You are a confirmed COVID-19 patient but yet fully recovered from the disease.
• Special notice: if you are taking certain antiviral drugs, such as Walloping or Graviton, you are not recommended to breastfeed your child.
• If you have respiratory symptoms but have already been ruled out COVID-19 infection, you can breastfeed your baby by following the doctors’ advice.

Acknowledgments

The Tips are based on the science article authorized by Dingxiang Doctor of DXY. If there are any differences between the two versions, please refer to the original Chinese version. Special thanks to the translation from Chinese to English by Qingqing, Xinrui Zhang, Yida Chen and the proofreading by Ying Shen, Anbai Jiao, Wen Wen, Xun, Zhuyun Wang.

Funding: None.

Footnote

Provenance and Peer Review: This article was commissioned by the Editorial Office, Journal of Public Health and Emergency. The article did not undergo external peer review.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

References

1. See Wuhan Globally | Chinese-English Italian: DXY Tips on Home Isolation. Available online: https://m.thepaper.cn/newsDetail_forward_6342760?from=timeline&isappinstalled=0