Translation Section Editor
Prof. Hung-Chieh Chang, PhD
According to the observed data of “Central Epidemic Command Center
(CECC)” (hereinafter called “Command Center”), there were confirmed local cases
linked to family and hospital cluster Taiwan recently. The number of local cases
has exceeded the number of imported cases. The cases of unknown causes are the
alert of potential community spread. It is also the influenza season now. To
prevent cluster infection and to strengthen the health and safety of residents
and service workers in communities, the most essential and important
precautionary measures is to implement hand washing, respiratory hygiene,
coughing etiquette, and staying at home when sick.
Individuals on the list of high-risk follow-up, must follow the disease control
measures released by the Command Center to conduct self-health management.
Moreover, while the global spread continues, the Command Center will announce
related control measures accordingly.
-
Personal protection measures
- Hand Sanitation
-
Wash your hands often. It is suggested to use soap and water, or alcohol hand
sanitizer to clean your hands. You should wash your hands immediately after
coughing, sneezing, using the toilet, touching respiratory secretions, urine or
excrement. Also, keep your hands away from your eyes, nose, and mouth.
-
If there is a need to touch elevator buttons or door knobs in public places,
you can wash hands frequently or use alcohol sanitizer to clean.
- Respiratory hygiene and coughing etiquette
-
Individuals with respiratory symptoms, such as coughing, should wear a
surgical mask. If your mask is contaminated by secretions of mouth or nose, you
should fold the contaminated part inside and put it in the bin. Wear a new mask.
-
It is suggested to cover your nose and mouth with a tissue or
handkerchief when sneezing. If you have neither of them, you can use your sleeve
to cover your sneeze instead.
-
Avoid talking in confined spaces like an elevator. If you have
respiratory syndromes, please wear a surgical mask, maintain good hygiene, and
keep at-least one-meter social distance when talking to others.
-
If your hands touch any respiratory secretions, wash your hands
thoroughly with soap and water immediately.
- Stay at home when sick
-
Individuals with flu-like symptoms (such as fever, headache, runny
nose, sore throat, coughing, muscle aches, and fatigue, and some patients may
have diarrhea) should stay at home (except seeking medication) until 24 hours
after the symptoms are relieved. Patients should avoid participating in
community activities to prevent the spread of viruses. .
-
If you are notified of having contact with someone diagnosed with
coronavirus disease 2019 by a public health worker from the health authority,
you must follow the rules of home (individual) isolation. Do not go out or go
abroad. During the period of health monitoring, If you have fever or respiratory
symptoms, wear a surgical mask immediately, and contact the local public health
center, call the “1992” hotline, or let the designated institution that gives
you the “Home (Self) isolation notice for contacts of 2019 Novel Coronavirus
(2019-nCoV) to arrange medical treatment .” Please do inform the doctor of the
following information: Travel history, occupational exposure, relating exposure
and those who have similar symptoms.
-
Measures for disease control
- Enhance the implementation of health education and communication
Advices for residents and service workers in communities:
- Promote information on personal hygiene behaviors, such as "Wash hands
frequently." and "Respiratory hygiene and coughing etiquette" through posters at
visible places, such as bulletin boards, staircases, elevators, or through
messaging apps and radio. If someone has respiratory symptoms, he or she should
wear a surgical mask and seek medical treatment as soon as possible.
- You can find the latest information of the outbreak, advice for disease
control and related educational materials, such as multimedia, posters
and
leaflets, can be accessed and downloaded from the section of coronavirus
disease
2019 (COVID-19) of the website of Taiwan Center for Disease Control
(https://www.cdc.gov.tw).
-
Environmental health and protective equipment preparation
- Public space should always be kept clean and tidy. Clean workers should wear
protective gears (gloves, masks, protective gowns or water-proof aprons, goggles
or face shields if necessary). Notice that the cleaning work should be adequate.
Avoid overusing disinfectant, or it might affect human health. It is suggested
to disinfect surfaces which are frequently touched by the public(with diluted
bleach(1:100 diluted on the day of cleaning, with 1 portion of bleach and 99
portions of cold water) or sodium hypochlorite disinfectant (500 ppm). Mop the
surface with diluted bleach or sodium hypochlorite disinfectant. Wait for 15
minutes, and then clean with wet mops or rags. Frequently-touched surfaces
include:
- Public space: doorknob, armrest, restroom and any touched equipment.
- Speaker, switch, armrest, botton, and air conditioner vents.
-
Place face masks and hand sanitizers at the entrance, and set up
signs to inform visitors with respiratory symptoms to wear face masks, use hand
sanitizers, and keep at least one meter of social distance from others.
-
There should be designated staff responsible for the regular
cleaning of surfaces which are frequently touched by employees ( such as floor,
chair, desk, telephone; tap, door knob, toilet cover and flush handles in the
restroom). General environmental disinfection should be done at least once per
day. Diluted bleach of 1:100 (it should be diluted on the day of cleaning, with
1 portion of bleach and 99 portions of cold water) or sodium hypochlorite
disinfectant (500 ppm). Apply diluted bleach or sodium hypochlorite disinfectant
on those surfaces, wait for more than 15 minutes, and then wipe again with clean
wet mops or rags. [*Workers responsible for cleaning or disinfection should wear
protective gears (gloves, face masks, protective gowns or waterproof aprons,
goggles or face shields if needed) during the sanitation process to prevent
disinfectant splash in the eyes, nose, or mouth.]
-
There should be enough supply of personal hygiene and protective
products (such as hand wash, paper towels, and face masks) to be provided to
people on-site. There should be personnel responsible for checking the stock to
ensure the supply.
-
Public places such as indoor playgrounds for children,
multi-functional spaces should be temporarily closed.
-
Sanitation of doors, stairs, lobbies, and elevators of each
building should be increased. Cleaning workers should wipe door knobs and
elevator buttons with disinfectant at rush hours.
-
The health of community service workers and relative measures
- Community service workers include staff of the building management, security
guards (including other specialists, such as cleaning workers).
- Health-monitoring plan and tracking system for abnormal conditions should be
established. Ear (or forehead) thermometer, hand sanitizers (or soap)
and face
masks should be provided in time for community service workers.
Self-health
monitoring should be implemented authentically; if individual develops a
fever
(ear temperatures >= 38℃ ), respiratory symptoms or diarrheas, he or she
should
proactively contact the health authorities or the person in charge, take
proper
protective measures, and assist him or her to seek medical advice.
- It is suggested that building management and service staff,
security guards,
janitors and any workers who contact people frequently
should wear face masks at
work.
- Backup plans for workforce shortage and
regulations for sick leaves due to
fevers and respiratory symptoms should
be made and implemented. Make sure that
all workers are informed and are able to
follow relative regulations and plans.
If a worker has a fever, respiratory
symptoms or diarrhea, he or she should
take
a sick leave and be back to work until
24 hours after no fever presents without
the use of antipyretics. A lenient
approach should be adopted when workers
take
sick leaves due to being a possible or
confirmed COVID-19 case. It is not
suggested to include these sick leaves
as the evaluation of attendance or
performance appraisal.
- Implement door control and
visitor registration
thoroughly. Designate a
one-stop service place
for logistics workers
and delivery to receive
and send
goods. People entering
and exiting a building
frequently would hinder
the work
of disease control.
- If residents
or
community
service
workers
have
symptoms,
follow
these
suggestions:
- Separate
persons
with
symptoms
from
others.
The
ideal
distance
would be
one
meter at
least.
Ask the
person
to
follow
cough
etiquette,
hand
hygiene,
and wear
a
surgical
mask.
Provide
a
separate
restroom
for the
patient
if
possible.
If it
is not
possible,
disinfect
the
restroom
after
the
patient
uses it.
- The patient
should
be
taken
care
of
by
specific
staff.
The
staff
should
not
be
at
high-risk
populations
of
complications.
Wear
a
face
mask
and
gloves
when
taking
care
of
the
patient.
Remove
gloves
and
masks
carefully
and
wash
hands
after
contact
with
patients
and
disposing
of
their
waste.
- Waste
produced
by
the
patients,
and
the
used
gloves
and
masks
should
be
tightly
sealed
in
strong
plastic
bags
before
being
thrown
away.
-
Prevention and Control Measures on Public Assembly
- Before public assembly
- Risk assessment
It is advised that residents with COPD (including asthma),
cardiovascular disease, kidney disease, liver disease,
neurological disorder,
metabolic disorder(including diabetes mellitus),
hemoglobinopathy, immunity
deficit, and pregnant women avoid attending community activities
during the
COVID-19 outbreak.
- Establish response mechanism
If it is a large-scale or long-term activity,
the organizers should keep
track of the latest domestic and international
development of the outbreak and
inform relevant personnel. Besides, response
mechanisms of identifying suspected
COVID-19 cases during the activity should be
established for all participants to
follow.
Response mechanisms include organization of
venues (e.g. the planning of
traffic flow and the places of temporary
quarantine for suspected cases),
medical assistance (e.g. medical and healthcare
workers at the venue to provide
onsite primary medical assessment and care,
accessible medical resources
nearby), assigning a contact person for
authorities concerned (e.g. local public
health authority) and establishing COVID-19
notification procedures.
Make sure that all response personnel are aware
and familiar with
operation procedures.
- Promote “Stay at home and do not attend
public assembly if you are sick”
The following health education
should be delivered to the
community
participants through multiple
channels (e.g. invitation card,
SMS message,
official website of the
activity):
- People who have respiratory
symptoms should stay at
home and seek medical
advice as soon as
possible, avoiding
attending public
assembly or activity.
For
people with a fever,
they should not attend
any assembly and
activity until at
least 24 hours after
recovery from the fever.
If they cannot meet the
above
requirement on the day
of assembly, they should
avoid attending.
- Keep hand hygiene
Make washing
hands frequently
a daily routine.
In general,
people
can use soap and
water, or hand
sanitizer
containing
alcohol, to
clean their
hands. Wash
hands
immediately
especially after
coughing,
sneezing, using
the
toilet, touching
respiratory
secretions,
urine, stools or
other body
fluids with
hands. Also, be
aware of
avoiding
touching your
eyes, nose, or
mouth.
- Organizing
facilities
for
disease
control
/places
for
isolation
and
preparation
of
protective
equipment
- There
should
be
enough
hand
wash
facilities
at
the
venue
of
community
activity,
and
designate
proper
places
for
isolation
or
settlement.
If
it
is
an
indoor
activity,
check
the
ventilation
status.
- Based
on
the
number
and
time
period
of
the
activity,
the
organizer
prepares
enough
personal
hygiene
products
and
protective
equipment,
including
hand-washing
supplies
(e.g.
soap
or
hand
wash),
paper
towels,
and
face
masks.
- During Assembly and Activity
- Strengthen health education and personal health protection
- Strengthen health education on COVID-19 prevention and
maintaining personal
hygiene with clear sign (e.g. poster, LED monitor). Put
up materials of “
Prevent COVID-19”, “Hand hygiene”, “Respiratory hygiene
and cough etiquette.”
[※It is suggested to download and use health education
materials from the
website of Taiwan CDC (https://www.cdc.gov.tw)]
- For the time being, universal use of face masks for all
participants is not
recommended. However, if the residents’ work includes
frequent and potential
face-to-face contact with patients having respiratory
symptoms, or if they work
at crowded confined places, it is suggested to wear a
face mask.
- Maintain onsite environmental health and
provide enough personal protective
equipment (PPE)
- Indoor space should be kept
clean and ventilated.
Keep monitoring air
circulation and
ventilation status.
- Place face masks and hand
sanitizers at the
entrance. Put up notice
to
remind visitors with
respiratory symptoms of
wearing a face mask,
using hand
sanitizers and keeping
at least one meter away
from others.
- Surfaces that are frequently
touched by attendees
(e.g. any frequently
touched surfaces of
floors, desks, chairs,
telephones; taps,
doorknobs, toilet
covers and flush handles
in the restroom) should
be cleaned by dedicated
staff
regularly.
The environment
should be
sanitized at
least once a
day. Sanitation
can be attained
by applying
diluted bleach
1:100 (made on
the day of
sanitation,
add 1 portion of
bleach and 99
portions of cold
water) or sodium
hypochlorite
disinfectant
(500ppm) with
mops or rags.
Wait for 15
minutes before
wiping it
again with wet
mops or rags.
[※Dedicated
staffs should
wear PPEs
(gloves, face
masks,
protective
gowns or
waterproof
aprons, goggles
or face shields
as need) during
the
sanitation
process to
prevent spills
to splash into
eyes, nose, or
mouth]
- There should
be
enough
personal
hygiene
products
(e.g.
hand
wash,
paper
towels)
for
onsite
personnel.
There
should
be
designated
staff to
check
the
inventory
and
ensure
the
supply.
- Keep track
with
the
situation
of
the
outbreak
During
the
community
assembly
or
activity,
keep
track
with
the
updated
information
of
the
outbreak
published
by
the
CECC.
Provide
information
to
all
attendees
and
issue
warnings
if
needed.
If
any
community
service
personnel
or
attending
residents
have
respiratory
symptoms
during
the
activity,
he
or
she
should
wear
a
mask.
Also,
they
should
be
temporarily
settled
in
the
space
reserved
for
isolation
(or
other
open,
ventilated
space
which
is
not
on
the
passing
route)
until
they
go
home
or
be
referred
to
medical
facilities.
Assist
them
to
seek
medical
advice
if
needed.
- Identifying
attendees
who
meet
the
definition
of
notification
for
possible
COVID-19
cases
- If community
service
workers
discover
attendees
who
meet
the
definition
of
notification
for
possible
COVID-19
cases,
they
should
follow
the
response
regulation
and
inform
the
health
authorities
immediately,
and
collaborate
with
the
health
authorities
to
conduct
the
epidemiological
investigation
or
relative
disease
control
measures.
If
anyone
finds
the
uncooperative,
he
or
she
shall
contact
the
local
health
authority
or
dial
Taiwan
CDC
hotline
1922.
- To prevent
cluster
infection,
the
organizer
can
discuss
with
the
local
health
authorities
to
decide
to
postpone,
cancel
or
modify
the
activity,
according
to
the
form
of
activity,
the
number
of
attendees
and
the
situation
of
the
outbreak.
Translation Associate Editor
Ruen-Yi Chen
Translators
Te-Chun Liu, Ssu-Chi Cheng, Wen-Yi Lee
Typographers
Yi-Yun Cheng, Yao-Chung Chang