Q&A - Part 35

(Continued from June 27, 2020)

Second, for families without grandparents to rely on, such as some dual- breadwinner families, local governments issued regulations requiring employers to allow employees to take care of their children with pay. For example, Beijing issued Notice on Wages and Benefits for Employees with Childcare Needs during the Period of School Closure due

to the COVID-19 Outbreak. It stipulates that each household may have one parent to care for their children at home. This situation is regarded as that the employee cannot work normally as a result of governments implementing quarantine measures or other emergency measures. In this case, the enterprises should pay their employee wages as usual. In a document titled Policies on strict epidemic control and prevention to help enterprises resume production, the Hangzhou Government stressed that enterprises are encouraged to allow one parent of dual breadwinner families to care for their children at home with pay. These families have children enrolled into kindergartens or primary schools but have no helpers for childcare during school closure resulted from epidemic outbreak.

Third, for college students and students in the stage of compulsory education, the education department has introduced various measures, encouraging local education sectors and after-school education institutions to provide learning resources and support services. The aim is to help solve students’ practical problems to realize the goal of keeping learning amid class suspension ( refer to Question 28 for

details). The Ministry of Education has issued the Guidance on Organizing and Managing Online Teaching in Higher Education Institutions During the COVID- 19 Outbreak, offering nine instructions for higher education institutions to continue teaching and learning while classes are suspended. Additionally, the Ministry of Education has launched the National Online Cloud Classroom, providing high-quality online courses to students. Author: Hao Zhirong, Center for International Knowledge on Development

A: As the epidemic continues to spread, the world has witnessed rapidly rising demands and a widening supply gap of ventilators. Including the United States, Italy, the United Kingdom and Spain, countries with a large number of confirmed cases have been struggling to meet their demands by purchasing globally and expanding production domestically. Why are ventilators so critical in the treatment of COVID-19 patients?

Breathing difficulties are one of the clinical symptoms of severe COVID-19 patients. When the new coronavirus attacks patients’ lungs, complications such as pneumonia and Acute Respiratory Distress Syndrome ( ARDS) may occur. According to the Clinical Guidance for COVID-19 Pneumonia Diagnosis and Treatment (7th edition) released by the Chinese National Health Commission (NHC), in severe cases, patients present dyspnea and/or hypoxemia within one week after onset and some of them may rapidly deteriorate to ARDS. The World Health Organization ( WHO) estimated that about 13% of confirmed cases turned critically ill and could have breathing difficulties. In such cases, using instruments to support or replace breathing is the only solution.

Ventilators are vital medical devices in improving human respiratory function. During the process of inhalation, lung volume increases and alveoli expands as a result of the contraction of respiratory muscles. Then inhalation occurs because of the pressure gradient between atmosphere and thoracic cavity. In contrast, during exhalation, respiratory muscles relax and alveoli contracts. Then exhalation happens due to increased pressure within the thoracic cavity. When patients encounter breathing difficulties, ventilators can help achieve the pressure gradient, thus replacing, controlling or changing patients’ breathing. Ventilators can be divided into two categories. In noninvasive ventilation, patients receive breathing support through a face mask, nasal mask or a helmet. If the condition does not improve or gets worse, tracheal intubation and invasive mechanical ventilation should be performed timely. ( To be continued on July 2, 2020)