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
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
- 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
- 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
Translators Te-Chun Liu, Ssu-Chi Cheng, Wen-Yi Lee
Typographers Yi-Yun Cheng, Yao-Chung Chang