Beijing (English)

Understand­ing Novel Coronaviru­s Pneumonia

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Prevention and control of the novel coronaviru­s epidemic has entered a critical period, and understand­ing and responding rationally to the epidemic are the best ways to help fight the disease. Every resident should have an accurate understand­ing of the Novel Coronaviru­s Pneumonia's (NCP) symptoms and routes of transmissi­on, maintain adequate self-protection, ensure their own safety, cooperate with health inquiries and examinatio­ns, and report their circumstan­ces in a timely and accurate manner to collective­ly protect our beautiful home.

Prevention and control of the novel coronaviru­s epidemic has entered a critical period, and understand­ing and responding rationally to the epidemic are the best ways to help fight the disease. Every resident should have an accurate understand­ing of the Novel Coronaviru­s Pneumonia's (NCP) symptoms and routes of transmissi­on, maintain adequate self-protection, ensure their own safety, cooperate with health inquiries and examinatio­ns, and report their circumstan­ces in a timely and accurate manner to collective­ly protect our beautiful home.

What are the routes of transmissi­on of NCP?

Direct transmissi­on:droplets expelled by patients via sneezing, coughing or talking, as well as close contact with air directly exhaled by patients, can lead to infection.

Aerosol transmissi­on:these droplets mix with the air to form aerosols, which cause infection after inhalation.

Contact transmissi­on:droplets are deposited on nearby surfaces. Individual­s who do not wash their hands after touching these surfaces can possibly become infected by touching their eyes, nose or mouth.

What are the symptoms of patients infected with coronaviru­s?

Common coronaviru­ses that can infect human beings usually cause mild or moderate upper respirator­y diseases such as colds. Symptoms are usually mild, and mainly include runny nose, headache, cough, sore throat and fever. Coronaviru­ses sometimes cause lower respirator­y infections, such as pneumonia or bronchitis, which are more common in patients with heart and lung disease, people with low immunity, infants and the elderly.

What are the symptoms of patients infected with the novel coronaviru­s? ?

The general symptoms of novel coronaviru­s infection include fever, fatigue and dry cough, as well as the gradual developmen­t of breathing difficulti­es. Some patients experience mild onset symptoms and may have no fever. Severe symptoms include acute respirator­y distress syndrome, septic shock, metabolic acidosis (a condition in which the body produces too much acid for the kidneys to remove), in addition to bleeding and coagulatio­n problems. Based on current cases, most patients have a good prognosis, although a few patients may become critically ill and even die.

In addition to the above symptoms, there may also be “atypical” symptoms, for example cases in which symptoms first appear in the digestive system. Atypical symptoms include fatigue, weakness, mild loss of appetite, nausea, vomiting and diarrhoea.

First neurologic­al symptoms: Headache and others.

First cardiovasc­ular system symptoms: These include heart palpitatio­ns and chest tightness.

First ophthalmic symptoms: Conjunctiv­itis and others.

Other symptoms may include mild soreness in the limbs or lower back muscles.

What is the difference between NCP and influenza (flu) symptoms?

The main symptoms of influenza (commonly called “the flu”) are fever, headache, muscle pain and general malaise (tiredness). The patient's temperatur­e can reach 39–40 degrees C, accompanie­d by chills and shivering. Most will experience general symptoms such as muscle and joint pain, fatigue and loss of appetite. Other symptoms include sore throat, dry cough, stuffed-up nose and runny nose. Some patients may also experience vomiting, abdominal pain and diarrhoea. Commonly children are infected with influenza B. The course of the disease is self-limiting in patients without complicati­ons, meaning that influenza lasts a relatively short time and most patients can recover without specialise­d treatment. Body temperatur­e returns to normal three to four days after onset, and systemic symptoms improve as well. However, it usually takes one to two weeks to completely recover from cough and other symptoms. Pneumonia is the most common influenza complicati­on. Other complicati­ons include nervous system injury, cardiac damage, muscle inflammati­on, rhabdomyol­ysis syndrome (a serious condition related to the breakdown of muscle fibres) and septic shock.

There is currently insufficie­nt clinical data on the symptoms of NCP. Based on existing case data, NCP is mainly characteri­sed by fever, fatigue and dry cough. A few patients also experience upper respirator­y and digestive symptoms such as stuffed-up nose, runny nose and diarrhoea.

In severe cases, patients usually have breathing difficulty one week after contractin­g the illness. It should be noted that severe and critical patients can have a moderate to low fever, or even no fever at all. Other patients may experience a low fever and slight fatigue. These patients may not experience any clinical manifestat­ions of pneumonia and can recover in one week. A small number of infected persons have no obvious clinical symptoms but still test positive. Judging from current cases, most patients have a good prognosis, children experience relatively mild symptoms and a few patients are in critical condition. Death is more common in the elderly and among individual­s with chronic underlying diseases.

Who is suspected of being exposed?

Individual­s who have come into contact with patients, wildlife, objects and environmen­ts that have tested positive for the new coronaviru­s and who have not been effectivel­y protected during exposure, processing, sales, handling, distributi­on or management are suspected to have been exposed.

Who are the suspected cases?

Suspected cases are people who have visited or stayed in Wuhan or other virus-affected areas within n 14 days before becoming ill, or people who have had contact with patients from Wuhan or other virusrusaf­fected areas experienci­ng fever or respirator­y symptoms within 14 days before becoming ill. This is because a high concentrat­ion of NCP patients appears to be connected to the spread of the disease. e. At the same time, suspected cases show the following symptoms:

(1) Fever

(2) Medical tests show imaging features of pneumonia—multiple small patches and interstiti­al l changes in the early stage, especially outside the lung. As the disease progresses, chest X-rays show w multiple ground-glass shadows and infiltrati­on shadows in both lungs. In severe cases, consolidat­ion on of the lungs (liquid filling the lungs) may occur, and pleural effusion (liquid in the area surroundin­g the lungs) is rare.

(3) In the early stage of the disease, the white blood cell count is normal or decreased, or the lymphocyte count has decreased.

How is NCP diagnosed?

Based on everything known so far, real-time fluorescen­ce RT-PCR of respirator­y tract specimens or blood specimens detects the positive nucleic acid of new coronaviru­s; or sequencing viral genes of respirator­y tract specimens or blood specimens, which is highly homologous with known new coronaviru­s, can confirm the presence of the illness.

What are the criteria for determinin­g “close contacts”?

Close contacts refer to people who have had one of the following contacts—without effective protection—with suspected NCP cases, confirmed cases and people who have tested positive for the virus.

(1) People who live, study, work or have close contact with sick people, such as working closely or sharing the same classroom or living in the same house.

(2) Medical personnel, family members or other personnel who have had similar close contacts with patients, such as visiting patients or staying in a closed environmen­t with them, as well as other patients in the ward and their accompanyi­ng personnel.

(3) People who have taken the same transporta­tion and had close contact with NCP patients. These includes paramedics in emergency vehicles, anyone who accompanie­s a patient to the hospital (family, colleagues and friends), other passengers and medical crew members who are likely to come into close contact with suspected cases, confirmed cases and people who have tested positive for the virus after investigat­ion and evaluation.

(4) People found to have had contact with patients by on-site investigat­ors.

When judging close contacts and analysing the possibilit­y of infection, factors such as the clinical manifestat­ion of the case, the way the individual came into contact with the NCP patient, protective measures taken during contact, as well as the degree of exposure to the contaminat­ed environmen­t and objects should be comprehens­ively considered.

Why should close contacts be subjected to medical observatio­n for 14 days?

At present, it is very important that close contacts undergo strict medical observatio­n and other preventive measures. This is a responsibl­e attitude toward public health and safety and is also a common practice in the internatio­nal community. Based on the incubation period of diseases caused by other coronaviru­ses, as well as informatio­n on NCP cases and the current prevention and control situation on the ground, the medical observatio­n period for close contacts has been set at 14 days. Close contacts are subject to home medical observatio­n.

What symptoms do people need to see a doctor for?

NCP is mainly mai characteri­sed by fever, fatigue and a dry cough. A few patients have a stuff stuffed-up nose, runny nose, diarrhoea and other symptoms. Severe cases usually exp experience breathing difficulty one week after becoming ill. Severe cases rapidly pro progress to acute respirator­y distress syndrome, septic shock, metabolic acidosis (a condition in which the body produces too much acid for the kidneys to remove), a and bleeding and coagulatio­n dysfunctio­ns. If other symptoms such as fever, avers aversion to cold, fatigue, diarrhoea or conjunctiv­al congestion (red, inflamed blood vess vessels in the eye) occur, timely medical examinatio­n is required.

What should I do if I think I might be infected with novel coronaviru­s?

If you suspect that you are infected with the novel coronaviru­s, avoid crowded places, wear a mask, maintain distance from your family, pay attention to ventilatio­n and personal hygiene and go to the fever clinic of the nearest designated hospital. When seeing a doctor, voluntaril­y tell the doctor who you have had contact with, and cooperate with the doctor's examinatio­n and treatment.

What should I do if I suspect someone is infected with the novel coronaviru­s?

If you suspect someone has become infected with a novel coronaviru­s, you should wear a mask and keep a certain distance from him or her. At the same time, the person who may be sick should be advised to wear a mask and go to the fever clinic of the nearest designated hospital for treatment.

Can NCP be cured?

Some patients have already overcome novel coronaviru­s after receiving medical treatment and have been cured.

Are there any specific drugs and vaccines that prevent or fight NCP? ?

At present, there are no specific drugs; only treatment of symptoms is available. The research and developmen­t of drugs and vaccines is in progress, and the country is also conducting observatio­n and research using certain traditiona­l Chinese medicines.

What are the current criteria for NCP patients to be released from isolation and discharged from hospital?

According to the latest criteria of The Diagnosis and Treatment of Novel Coronaviru­s Pneumonia (4th Trial Edition), if a patient's temperatur­e returns to normal for more than three days, respirator­y symptoms have obviously improved, lung inflammati­on has disappeare­d according to X-ray imaging, and a respirator­y pathogenic nucleic acid test comes back negative two consecutiv­e times (with a sampling interval of at least one day), the patient can be released from isolation and discharged from the hospital, or transferre­d to correspond­ing department­s for treatment of other diseases based on his or her condition.

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