[置顶]COVID bilingual corpus

zh-CN en-US
新型冠状病毒感染的肺炎公众预防提示 Public Prevention of Pneumonia Caused by Novel Coronavirus
新型冠状病毒感染的肺炎是一种新发疾病,公众应切实加强预防。 The pneumonia caused by novel coronavirus is a newly-found disease from which the public should strengthen prevention.
为帮助外国人了解掌握相关预防知识,国家移民管理局根据中国疾控中心发布的公众预防提示整理。 In order to help foreigners understand and master the relevant knowledge of prevention, National Immigration Administration has compiled and translated this guide according to the Public Prevention Notes provided by the Chinese Center for Disease Control and Prevention.
一、尽量减少外出活动 I. Reduce outdoor activities as much as possible
1、避免去疾病正在流行的地区。 1.Avoid visiting areas where the disease is prevalent.
2、建议疫情防控期间减少走亲访友和聚餐,尽量在家休息。 2. It is recommended to make less visits to relatives and friends and dining together during the epidemic prevention and control, and stay at home as much as possible.
3、减少到人员密集的公共场所活动,尤其是空气流动性差的地方,例如公共浴池、温泉、影院、网吧、KTV、商场、车站、机场、码头、展览馆等。 3. Try to avoid visits to crowded public areas, especially places of poor ventilation, such as public bathrooms, hot springs, cinemas, internet bars, Karaokes, shopping malls, bus/train stations, airports, ferry terminals and exhibition centers, etc.
二、个人防护和手卫生 II. Personal Protection and Hand Hygiene
1、建议外出佩戴口罩。 1. It is recommended that a mask shall be worn when going out.
外出前往公共场所、就医和乘坐公共交通工具时,佩戴医用外科口罩或N95口罩。 A surgical or N95 mask shall be worn when visiting public areas, hospitals or taking public transportation.
2、保持手卫生。 2.Keep your hands sanitized.
减少接触公共场所的公共物品和部位。 Try to avoid touching public objects and parts in public areas.
从公共场所返回、咳嗽手捂之后、饭前便后,用洗手液或香皂流水洗手,或者使用含酒精成分的免洗洗手液。 After returning from public areas, covering your cough, using the restroom, and before meals, please wash your hands with soap or liquid soap under running water, or use alcoholic hand sanitizer.
不确定手是否清洁时,避免用手接触口鼻眼。 Avoid touching your mouth, nose or eyes when you are unsure whether your hands are clean or not.
打喷嚏或咳嗽时,用衣肘遮住口鼻。 Cover your mouth and nose with your elbow when sneeze or cough.
三、健康监测和就医 III. Health Monitoring and Seeking Medical Attention
1、主动做好个人与家庭成员的健康监测。 1. Monitor the health conditions of your family members and yourself.
自觉发热时要主动测量体温。 Measure your temperatures when you feel like having a fever.
家中有小孩的,要早晚摸小孩的额头,如有发热要为其测量体温。 If you have kid(s) at home, touch the kid’s forehead in the morning and at night. Measure the kid’s temperature in case of fever.
2、若出现可疑症状,应主动戴上口罩及时就近就医。 2. Wear a mask and seek medical attention at nearby hospitals in case of suspicious symptoms.
若出现新型冠状病毒感染可疑症状(包括发热、咳嗽、咽痛、胸闷、呼吸困难、轻度纳差、乏力、精神稍差、恶心呕吐、腹泻、头痛、心慌、结膜炎、轻度四肢或腰背部肌肉酸痛等),应根据病情,及时到医疗机构就诊。 Go to medical institution in a timely manner in case of the suspicious symptoms relating to the pneumonia caused by novel coronavirus are found. Such symptoms include fever, cough, pharyngalgia, chest distress, dyspnea, mildly poor appetite, feebleness, mild lethargy, nausea, diarrhea, headache, palpitation, conjunctivitis, mildly sore limb or back muscles, etc.
并尽量避免乘坐地铁、公共汽车等交通工具,避免前往人群密集的场所。 Try to avoid taking metro, bus and other public transportation and visiting crowded areas.
就诊时应主动告诉医生自己的相关疾病流行地区的旅行居住史,以及发病后接触过什么人,配合医生开展相关调查。 Tell the doctor your travel and residence history in epidemic areas, and who you met after you got the disease. Cooperate with your doctor on the relevant queries.
四、保持良好卫生和健康习惯 IV. Keep Good Hygiene and Health Habits
1、居室勤开窗,经常通风。 1. Frequently open the windows of your house for better ventilation.
2、家庭成员不共用毛巾 2. Do not share towels with your family members.
保持家居、餐具清洁 Keep your home and tableware clean.
勤晒衣被 Sun-cure your clothes and quilts often.
3、不随地吐痰, 3. Do not spit.
口鼻分泌物用纸巾包好,弃置于有盖垃圾箱内。 Wrap your oral and nasal secretion with tissue and throw it in a covered dustbin.
4、注意营养,适度运动。 4. Balance your nutrition and exercise moderately.
5、不要接触、购买和食用野生动物(即野味) 5. Do not touch, buy or eat wild animals (gamey).
尽量避免前往售卖活体动物的市场。 Try to avoid visiting markets that sell live animals.
6、家庭备置体温计、医用外科口罩或N95口罩、家用消毒用品等物资。 6. Prepare thermometer, surgical or N95 masks, domestic disinfectant and other supplies at home.
(公共场所)消毒、通风以及体温检测 disinfection, ventilation and body temperature monitoring (in public areas)
N95口罩 N95 mask/respirator
避免去人多的地方 avoid crowds
病毒变异 virus variation
病毒的蔓延 spread of a virus
病毒分离 virus isolation
病毒突变 virus mutation
病毒携带者 virus carrier
病毒性肺炎 viral pneumonia
病死率(致死率) fatality/mortality/death rate
不明原因肺炎 pneumonia of unknown etiology/cause
超级传播者 super spreader
传播方式 mode of transmission
传染途径 route of transmission
传染性 transmissibility; infectivity
戴口罩 to wear a mask
低氧血症 hypoxemia; low blood oxygen
顶格处罚 the maximum penalty
定点医院 designated hospitals
遏制疫情蔓延 to contain the outbreak
二代病例 second-generation case
发病率 incidence rate
发热病人 patients with fever; febrile patients; fever patients
发热门诊 fever clinic
防护服 protective suit
飞沫传播 droplet transmission
肺脓肿 lung abscess
封城 A city is on lockdown./A city goes into lockdown.
负压救护车 negative pressure ambulance
感染性休克 septic shock
干咳 dry cough
高血压 hypertension; high blood pressure
隔离治疗 to receive treatment in isolation
关闭景点 to close scenic spots
国际关注的突发公共卫生事件 Public Health Emergency of International Concern (PHEIC)
国际卫生条例 International Health Regulations (IHR)
国家卫生健康委员会(国家卫健委) National Health Commission (NHS)
国家医疗保障局(国家医保局) National Healthcare Security Administration (NHSA)
果子狸 masked palm civet
海鲜市场 seafood market
含酒精洗手液 alcohol-based hand rub/sanitizer
行走的传染源 mobile source of infection
核酸检测 nucleic acid testing (NAT)
红外体温测量仪 infrared thermometer
哄抬价格 price gouging
呼吸道 respiratory tract
呼吸道疾病(呼吸系统疾病) respiratory diseases
呼吸急促(气促) shortness of breath; panting
呼吸困难 dyspnea; respiratory distress; breathing difficulties
呼吸器官 respiratory organs
活体农贸市场 live animal market
火神山医院 Huoshenshan Hospital (in Wuhan)
基因结构 genetic structure
基因序列 genetic sequence
急性呼吸窘迫综合征 acute respiratory distress syndrome (ARDS)
监测体温 to monitor body temperature
检测样本 test sample
检疫所 quarantine office
减少外出 to make fewer trips outside
健康筛查 health screening
健康申报表 health declaration form
接触传播 contact transmission
接触者追踪 contact tracing
结膜炎 conjunctivitis; pink eye
解除医学观察 to be discharged from medical observation
紧平衡 in tight balance
抗病毒药 antiviral drug
控制人口流动 to curb population flow
口罩 facemask; mask
跨境采购 cross-border procurement
雷神山医院 Leishenshan Hospital (in Wuhan)
两周观察期 two-week observation period
临床表现 clinical picture
临床数据 clinical data
流感 influenza; flu
流行病学调查(流调) epidemiological investigation
旅行限制 travel restrictions
瞒报 to underreport
密切接触者 close contact
启动重大突发公共卫生事件一级响应 to activate first-level public health emergency response
潜伏期 incubation/latent period
勤洗手/仔细洗手 to wash your hands often/carefully
取消大型集会 to cancel mass gatherings
确诊病例 confirmed case
人传人 person-to-person/human-to-human transmission
日常基本生活物资 daily necessities
散在病例 sporadic case
上呼吸道感染 upper respiratory tract infection (URTI)
神经系统 nervous system
肾功能 renal function
湿货市场 wet market
世卫组织 World Health Organization (WHO)
输入性病例 imported case
双肺浸润性病灶 infiltration in both lungs
死亡率 mortality rate
糖尿病 diabetes; diabetes mellitus
特定传染病 specific infectious disease
特殊报销政策 special reimbursement rules
体温检测 to check body temperature
体温检测热像仪 thermal imaging camera for temperature monitoring
调减市内公交 to reduce the frequency of bus services in the city
停运长途汽车 to halt long-distance buses
突发公共卫生事件 public health emergency
退烧药 febrifuge; antipyretic
囤积食物 to stock up on food
外源性感染 exogenous infection
卫生机构 health institution
无症状的潜伏期 silent/asymptomatic incubation period
无症状携带者 asymptomatic carrier
消毒湿巾 disinfectant/antiseptic wipes
消毒液 disinfectant; antiseptic solution
消化系统 digestive system
心血管病 cardiovascular disease
胸闷 chest distress; chest oppression
宿疾、慢性病 chronic ailment; chronic disease
延迟开学 to postpone the reopening of schools
延长春节假期 to extend the Chinese New Year holiday
严重急性呼吸道感染 severe acute respiratory infection (SARI)
严重急性呼吸综合征(非典) severe acute respiratory syndrome (SARS)
药店 pharmacy; drugstore
野味 bushmeat; game
一次性手套 disposable gloves
一线医护人员 frontline health workers
医疗从业者 medical practitioner; healthcare professional
医疗机构 medical institution
医疗人员 medical personnel; health workforce; health workers
医疗物资紧缺 shortage of medical supplies
医学观察 medical watch; medical observation
医用外科口罩 surgical mask
医院/院内感染 nosocomial infection; hospital-acquired infection
疑似病例 suspected case
乙类传染病 Category B infectious diseases
易感人群 susceptible/vulnerable population
疫情 epidemic; outbreak
疫情防控 epidemic prevention and control
疫区 affected area
隐性感染 covert/silent/inapparent/subclinical infection
应急医院 makeshift hospital
预防措施 preventive measure
暂停海外团队旅行 to suspend overseas group tours
早发现、早隔离 early detection and early isolation
掌握情况,不漏一人 to have full knowledge of the situation (of the community) and leave no one unchecked
诊断、治疗、追踪和筛查 diagnosis, treatment, tracing and screening
诊断器具 diagnostic tool/kit
职业暴露 occupational exposure
治愈率 recovery rate
中东呼吸综合征 Middle East respiratory syndrome (MERS)
中国疾病预防控制中心(中国疾控中心) Chinese Center for Disease Control and Prevention (China CDC)
钟南山 Zhong Nanshan, a prominent Chinese expert in respiratory diseases (and a hero of the 2003 fight against SARS)
重症 severe case
重症监护病房 intensive care unit (ICU)
竹鼠 bamboo rat
自觉接受医学观察 to present yourself to medical observation
自我隔离 to quarantine yourself in your home; self-monitored quarantine
2019新型冠状病毒 2019 novel coronavirus (2019-nCoV)
中央应对新型冠状病毒感染肺炎疫情工作领导小组(中央应对疫情工作领导小组) Leading Group of the CPC Central Committee for Novel Coronavirus Prevention and Control
“钻石公主”号邮轮 Diamond Princess cruise ship
《新型冠状病毒感染的肺炎诊疗方案》 Guidelines on the Novel Coronavirus-Infected Pneumonia Diagnosis and Treatment
《中华人民共和国传染病防治法》 Law of the People’s Republic of China on Prevention and Treatment of Infectious Diseases
CT影像 computed tomography imaging
IgM抗体检测 IgM antibody test
保障医疗防护物资供应 ensure the supply of medical protective equipment
并发症状 syndrome | symptoms of complications
不漏一户、不漏一人 leave no one unscreened
差异化精准防控策略 precise and differentiated epidemic control strategies
超长潜伏期 ultra-long incubation period
驰援武汉 race against the clock to assist Wuhan
初发症状 incipient symptoms
错峰上下班 staggered rush hour plan
打好武汉保卫战 win the battle against the coronavirus and protect the city of Wuhan
打击假冒伪劣 crack down on fake and shoddy products
杜绝瞒报漏报 say NO to concealing or underreporting infections
对口支援 pairing assistance (a national strategy in China for one province or a major city to provide assistance to a designated region in need of help)
方舱医院 temporary treatment centers
防控力量向社区下沉 empower communities to prevent and control the spread of the coronavirus
防止大规模社区传播 prevent the wide spread of the coronavirus in communities
防止信息恐慌 prevent panic and manage information properly
防止疫情跨境传播 prevent the epidemic from spreading across borders
分区分级精准防控 a region-specific, multi-level targeted approach to epidemic prevention and control
粪口传播 fecal-oral transmission
感染控制、检验、特诊、放射诊断科室 infection control, clinical laboratory, special service and radiodiagnosis departments
隔空诊疗 online diagnosis and treatment
隔离病房 isolation ward
公开、透明、负责任态度 an open, transparent and responsible manner
拐点 turning point
冠状病毒工作组 Coronavirus Study Group (CSG)
国际病毒分类委员会 International Committee on Taxonomy of Viruses (ICTV)
国家公共卫生应急管理体系 the national public health emergency management system
国家市场监管总局 State Administration for Market Regulation (SAMR)
国家药品监督管理局 National Medical Products Administration (NMPA)
国家中医药管理局 National Administration of Traditional Chinese Medicine (NATCM)
国务院联防联控机制 the Joint Prevention and Control Mechanism of the State Council
呼吸机 ventilator / respirator
恢复期血浆 convalescent plasma therapy
吉利德科学公司 Gilead Sciences
疾病预防控制机构 disease prevention and control institutions
集中患者、集中专家、集中资源、集中救治 treating the infected in dedicated facilities by senior medical professionals from all over the country and with all necessary resources
甲类传染病 category A infectious diseases
甲型 H1N1流感 2009 H1N1 Flu
坚持全国一盘棋 ensure a coordinated national response
坚决打赢疫情防控的人民战争、总体战、阻击战 be determined to fight and win the battle against the epidemic by mobilizing all resources, and blocking the spread of the virus
减免养老、失业以及工伤这三项社会保险单位的缴费 reduction in or an exemption from required premiums to be paid by employers for their employees’ old-age, unemployment and work-related injury insurances
交叉感染 cross infection
禁止密集聚会 ban mass gatherings
居家办公 work from home
举国机制 nationwide mechanism
开足马力(满负荷生产) go full steam ahead | operate at full capacity
抗病毒治疗 antiviral therapy
抗击疫情第一线 the front line of the battle against the epidemic
抗生素治疗 antibiotic therapy
科学防治、依法防治、精准防治、深入落实 implementation of science-based, legal, and targeted measures in the prevention and control of the epidemic
可重复使用口罩 reusable mask
临床试验 clinical trials
临床诊断病例 clinically diagnosed cases
临床症状 clinical signs and symptoms
临时医院 improvised hospital
流行病学史 historical epidemiology
旅行限制 travel restriction
贸易禁令 trade restriction
没有硝烟的战争 a war without smoke
密切跟踪、及时分析、迅速行动 closely monitor, timely analyze, and swiftly respond to the epidemic
逆行者 people who brave a dangerous situation
普通病区 inpatient ward
岂曰无衣,与子同裳 Fear not the want of armor, for mine is also yours to wear. | Together we stand, my armors thine.
气溶胶传播 aerosol transmission
氢氧治疗仪 oxy-hydrogen breathing machine
全球防范监测委员会 Global Preparedness Monitoring Board (GPMB)
全球公共卫生安全 global public health security
群防群控 strengthen society-wide efforts to prevent and control the epidemic
山川异域,风月同天 While mountains and rivers separate us, we enjoy the same moonlight under the same sky. | miles apart but close at heart
社区疫情防控 community-based epidemic prevention and control
生活必需品 necessities of life | daily necessities
生命重于泰山 Saving lives is of paramount importance.
世卫组织驻华代表处 WHO China Representative Office
试剂盒 test kit
室内空气流通 indoor ventilation
收治率 patient admission rate
数字医疗服务 digital medical services
四抗二平衡(所谓“四抗”,第一是抗病毒;第二是抗休克;第三是抗低氧血症;第四是抗继发感染。“二平衡”,即维持水电解质、酸碱平衡以及维持微生态平衡) combined use of anti-viral, anti-shock, anti-hypoxemia medication, and measures to prevent secondary infections maintain the water and electrolyte balance, acid-base balance and microecological balance
随访和复诊 follow-up and subsequent visits
特效药 specific medicine
特异性抗体 specific antibody
提高救治水平 improve the quality of medical treatment
同情用药 compassionate use of a drug (use a drug not yet approved under the compassionate use program)
统筹疫情防控与经济社会秩序恢复 implementation of epidemic prevention and control measures in tandem with those aimed at getting the economy and society back to normal
投我以木桃,报之以琼瑶 You throw a peach to me, I give you a white jade for friendship.
Array | You toss me a peach, I give you a white jade in return.
突出重点、统筹兼顾、分类指导、分区施策 focus on key issues, strengthen coordination, give sector-specific guidance, and apply different policies for different areas
外防输入 内防扩散 prevent the spread of the coronavirus from both within and without of a city (or an area)
网上就业服务 online recruitment services
卫生检疫 health quarantine
卫生系统 health system
武汉病毒所 Wuhan Institute of Virology
武汉胜则湖北胜,湖北胜则全国胜 If Wuhan wins, Hubei wins. If Hubei wins, the whole country wins.
向疫情全面宣战 declare an all-out war on the epidemic
新型冠状病毒成功分离 successful isolation of a novel coronavirus
血浆治疗 infusions of blood plasma
一人一方案 | 一人一团队 a dedicated team and a personalized treatment plan for each patient
医学排查 medical screening
医学巡查 medical inspection
疫情防控国家重点医疗物资保障调度平台 the national distribution center /platform for major anti-epidemic medical supplies
疫情峰值 epidemic peak
疫情监测 epidemic monitoring
疫情就是命令,防控就是责任 Go where there is epidemic, fight it till it perishes.
疫情可防、可控、可治 an epidemic that can be prevented, controlled and stopped
疫情无国界,人间有真情 Virus knows no borders, but the worst of times reveals the best in people.
英雄的城市 heroic city
优先通行、免费通行 priority and toll-free access
有序复工 resume production in an orderly manner
云办公软件 cloud-based office tools
在线教育 online education
在线问诊 online medical inquiries
在线直播 live streaming
增强收治能力 raise the hospital admission capacity
智慧医疗 smart medical care
中国红十字会 Red Cross Society of China
中国红十字基金会 Chinese Red Cross Foundation (CRCF)
中国人民解放军军事医学科学院 Academy of Military Medical Sciences
中西医结合/中西医并用 combined use of TCM and Western medicine
中医治疗 TCM (traditional Chinese medicine) therapy
重大疫情防控体制机制 the mechanism for major epidemic prevention and control
重症病区 special ward (for patients with severe conditions)
重症监护病区 intensive care unit (ICU)
最美逆行者 heroes in harm’s way (the brave, unhesitating rescuers who rush to the epicenter of the virus) | brave rescuers who go in the teeth of danger
做好返程人员疫情防控 take measures to help returnees from infected regions in order to prevent any possible spread of the coronavirus
做好重点地区疫情防控 strengthen epidemic prevention and control in key regions
新型冠状病毒感染的肺炎 防治知识手册 Handbook of Prevention and Treatment of the Pneumonia Caused by the Novel Coronavirus (2019-nCoV)
天津市互联网信息办公室 Cyberspace Administration of Tianjin
微医互联网总医院 WeDoctor Digital General Hospital
微医天津互联网医院 WeDoctor Tianjin Digital Hospital
2020年1月 Jan-20
第一部分 病原特点 Part I Pathogen Characteristics
1.什么是冠状病毒? 1. What are coronaviruses?
2.冠状病毒有什么样的理化特性? 2. What are the physical and chemical characteristics of the coronavirus?
3.可感染人的冠状病毒有哪些? 3. What are the coronaviruses that can infect people?
4.什么是新型冠状病毒感染的肺炎? 4. What is pneumonia caused by the novel coronavirus?
5.感染新型冠状病毒的患者临床表现有哪些? 5. What are the clinical manifestations of someone infected with a novel coronavirus?
6.有针对新型冠状病毒的疫苗吗? 6. Is there a vaccine for a novel coronavirus?
7.与患者密切接触者如何定义? 7. How to define whether a person is in close contact with the patients?
8.为什么要对密切接触者医学观察14天? 8.Why should close contacts be observed for 14 days?
9.如果接到疾控部门通知,您是一位密切接触者,该怎么办? 9. If you are informed by the disease control department that you are a close contact, what should you do?
10.新型冠状病毒感染能治疗吗? 10. Can the novel coronavirus infection be treated?
11.新型冠状病毒感染重症病例基本的应对策略有哪些? 11. What are the basic coping strategies for severe cases of novel coronavirus infection?
第二部分 疫情形势 Part II Epidemic Situation
12.当前疫情发展态势是什么? 12. What is the current situation of epidemic evolution?
13. 为什么短短几天增加了这么多确诊病例? 13.Why are confirmed cases increasing so quickly in just a few days?
14. 防控疫情的关键在哪里? 14. What is the key to prevent and control the outbreak?
15. 当前防控最有效的办法是什么? 15. What is the most effective way to prevent and control the outbreak at present?
16. 新型冠状病毒传染源是什么? 16. What is the infection source of novel coronavirus?
17. 新型冠状病毒人传人吗? 17. Can novel coronaviruses be transmitted from person to person?
18. 人会通过哪些途径被传染? 18. By which ways will people be infected?
19. 新型冠状病毒会变异吗? 19. Will the novel coronavirus mutate?
20. 新型冠状病毒感染是否会像SARS一样凶猛? 20. Will the novel coronavirus infection be as fierce as SARS?
第三部分 防控常识 Part III Prevention and Control Knowledge
21. 新型冠状病毒感染肺炎的病例监测措施主要有哪些? 21. What are the main monitoring measures for pneumonia caused by the novel coronavirus?
22. 如何预防被新型冠状病毒感染? 22. How to prevent the novel coronavirus infection?
23. 接触动物有什么特别需要注意的事项? 23. What should be paid special attention to when coming into contact with animals?
24. 当出现了发热、咳嗽等症状时,一定要去医院吗? 24. When there are fever, cough, and other symptoms, do you have to go to the hospital?
第一部分病原特点 Part I Pathogen Characteristics
1.什么是冠状病毒? 1. What are coronaviruses?
冠状病毒是自然界广泛存在的一大类病毒。 Coronavirus is a kind of virus widely existing in nature.
它是目前已知核糖核酸(RNA)病毒中基因组最大的病毒,该病毒形态在电镜下观察类似于王冠而得名。 It is the largest known RNA virus in the genome and is named coronavirus, as its form is similar to the crown under the electron microscope.
冠状病毒仅感染脊椎动物,与人和动物的多种疾病有关,可引起人和动物呼吸道、消化道和神经系统疾病。 Coronavirus only infects vertebrates and is related to many diseases of humans and animals. It can cause respiratory tract, digestive tract, and nervous system diseases of humans and animals.
2.冠状病毒有什么样的理化特性? 2. What are the physical and chemical characteristics of the coronavirus?
冠状病毒对热敏感,56°C30分钟、乙醚、75%乙醇、含氯消毒剂、过氧乙酸和氯仿等脂溶剂均可有效灭活病毒。 Coronavirus is sensitive to heat and can be effectively inactivated by 56 °C for 30 minutes, ethyl ether, 75% ethanol, chlorine-containing disinfectant, peracetic acid, and chloroform.
3.可感染人的冠状病毒有哪些? 3. What are the coronaviruses that can infect people?
迄今为止,除新型冠状病毒外,共发现6种可感染人类的冠状病毒(HCoV-229E、HCoV-OC43、SARS-CoV、HCoV-NL63、 HCoV-HKU1和MERS-CoV)。 So farI in addition to the new coronavirus, we have found six kinds of coronaviruses such like HCoV-229E, HCoV-OC43, SARS-CoV, HCoV-NL63, HCoV-HKU1, and MERS-CoV that can infect humans.
其中4种在人群中较为常见,致病性较低,一般仅引起类似普通感冒的轻微呼吸道症状。 Four of them are common in the population, with low pathogenicity, generally only causing mild respiratory symptoms similar to the common cold.
另外2种是我们熟知的SARS (严重急性呼吸道综合征) 冠状病毒和MERS (中东呼吸综合征) 冠状病毒。 The other two are well-known SARS (Severe Acute Respiratory Syndrome) coronaviruses and MERS (Middle East Respiratory Syndrome) coronaviruses.
4.什么是新型冠状病毒感染的肺炎? 4. What is the pneumonia caused by a novel coronavirus?
新型冠状病毒感染的肺炎是2019年12月在中国中部湖北省武汉市发现的,证实由一种新型冠状病毒引起的急性呼吸道传染病。 Pneumonia caused by the novel coronavirus was found in central China’s Wuhan City, Hubei Province in December 2019. It has been proved to be an acute respiratory infectious disease caused by a new type of coronavirus.
此新型冠状病毒是以前从未在人体中发现的冠状病毒新毒株,世界卫生组织将该冠状病毒命名为2019-nCoV,即新型冠状病毒。 The new coronavirus is a new strain of coronavirus that has not yet been previously found in the human body. The World Health Organization named the coronavirus 2019-nCov, namely a new coronavirus.
5. 感染新型冠状病毒的患者临床表现有哪些? 5. What are the clinical manifestations of someone infected with a novel coronavirus?
以发热、乏力、干咳为主要表现。 Fever, weakness and dry cough are the main manifestations.
鼻塞、流涕等上呼吸道症状少见。 Nasal obstruction, runny nose and other upper respiratory symptoms are rare.
约半数患者多在一周后出现呼吸困难,严重者快速进展为急性呼吸窘迫综合征、脓血症休克、难以纠正的代谢性酸中毒和出凝血功能障碍。 About half of the patients develop dyspnea after one week, and the severe cases develop rapidly into ARDS (Acute Respiratory Distress Syndrome), septic shock, difficult-to-tackle metabolic acidosis and bleeding and coagulation dysfunction.
值得注意的是重症、危重症患者病程中可为中低热,甚至无明显发热。 It should be noted that the course of severe and critical patients can be moderate to low fever or even no obvious fever.
部分患者起病症状轻微,可无发热,多在1周后恢复。 Some patients have mild onset symptoms. These patients may have no fever and recover after 1 week.
多数患者预后良好,少数患者病情危重,甚至死亡。 Most patients have a good prognosis, while a few patients are in critical condition or even death.
6.有针对新型冠状病毒的疫苗吗? 6. Is there a vaccine for a novel coronavirus?
针对新疾病,目前尚无可用疫苗。 There is no vaccine available for the new disease.
开发新疫苗可能需要相当长时间。 It may take a long time to develop a new vaccine for it.
7. 与患者密切接触者如何定义? 7. How to define whether a person is in close contact with the patient?
密切接触者是指与病例共同居住、学习、工作或其他有密切接触的人员 Close contacts refer to people who live, study, work or have close contact with the case
诊疗、护理、探视病例时未采取有效防护措施的医护人员、家属或其他与病例有类似近距离接触的人员 medical staff, family members or other people who have similar close contact with the case without taking effective precautions when diagnosing, treating, nursing or visiting the case
病例同病室的其他患者及陪护人员 other patients and caregivers in the same ward with the case
与病例乘坐同一交通工具并有近距离接触人员 people who take the same vehicle with the case and have close contact with the case
现场调查人员调查后经评估认为符合条件的人员。 and people who are evaluated as the qualified by the field investigators.
8.为什么要对密切接触者医学观察14天? 8.Why should close contacts be observed for 14 days?
参考其他冠状病毒所致疾病潜伏期,此次新型冠状病毒病例相关信息和当前防控实际,将密切接触者医学观察期定为14天,并对密切接触者进行居家医学观察。 Referring to the incubation period of other diseases caused by coronaviruses, the new coronavirus case-related information, and current prevention and control practice, the medical observation period of close contacts was set as 14 days, and the close contacts should be observed at home.
9.如果接到疾控部门通知,您是一位密切接触者,该怎么办? 9.If you are informed by the disease control department that you are a close contact, what should you do?
按照要求进行居家医学观察 You can carry out home medical observation as required.
定期接受医生的随访 Receive regular follow-up visits from doctors.
如果出现发热、咳嗽等异常临床表现,及时向当地疾病预防控制机构报告,在其指导下到指定医疗机构进行排查、诊治等。 In case of abnormal clinical manifestations such as fever and cough, report to local disease prevention and control institutions in time, and under their guidance, go to designated medical institutions for troubleshooting, diagnosis, and treatment, etc.
10. 新型冠状病毒感染能治疗吗? 10. Can the novel coronavirus infection be treated?
世界卫生组织已发布了针对疑似新型冠状病毒感染造成严重急性呼吸道感染的临床处置指南。 The World Health Organization (WHO) has released a clinical guideline for severe acute respiratory tract infection caused by suspected novel coronavirus infection.
目前对于新型冠状病毒所致疾病缺乏特异治疗方法,但采用国家卫健委推出的诊疗方案,采用一些抗病毒药物可能具有一定效果。 At present, there is no specific treatment for the disease caused by 2019-nCoV. But using the diagnosis and treatment launched by the National Health Commission, using some antiviral drugs to treat patients may have a certain effect.
此外,对感染者的辅助护理可能非常有效。 In addition, supplementary care for infected people may be very effective.
11.新型冠状病毒感染重症病例基本的应对策略有哪些? 11. What are the basic coping strategies for severe cases of novel coronavirus infection?
预检分诊,识别并分类严重急性呼吸道感染(SARI)患者 Set up pre-examination triage, so that the patients with severe acute respiratory infection (SARI) can be identified and classified
立即实施正确的感染预防与控制措施(IPC) immediately implement the correct infection prevention and control measures (IPC)
早期支持治疗与监控 early support treatment and monitoring
采集临床标本用于实验室诊断 collect clinical specimens for laboratory diagnosis
处理低氧性呼吸衰竭及急性呼吸窘迫综合征(ARDS) deal with hypoxic respiratory failure and acute respiratory distress syndrome (ARDS)
脓毒性休克的管理 management of septic shock
并发症的预防 prevention of complications
抗病毒治疗 antiviral treatment
妊娠患者的特别注意事项。 special precautions for pregnant patients.
第二部分 疫情形势 Part II Epidemic Situation
12.当前疫情发展态势是什么? 12. What is the current situation of epidemic evolution?
近期,湖北省武汉市等多个地区发生新型冠状病毒感染的肺炎疫情。 Recently, 2019-nCoV infected pneumonia outbroke in Wuhan City, Hubei Province, and other regions.
截至2020年1月30日24时,国家卫生健康委收到31个省(自治区、直辖市)和新疆生产建设兵团累计报告确诊病例9692例,现有重症病例1527例,累计死亡病例213例,累计治愈出院病例171例,共有疑似病例15238例。 As of at 24:00, January 30th, the National Health Commission received the information from 31 provinces (areas and cities) and Xinjiang Production and Construction Corps that there were 9,692 confirmed cases, of which 1,527 severe cases, 213 death cases, and 171 cases who have been cured.There are 15,238 suspected cases now.
目前累计追踪到密切接触者113579人(北京市核减21例),当日解除医学观察4201人,共有102427人正在接受医学观察。 At present, there are 113,579 close contacts (Beijing removed 21 cases after double-check), and 4,201 people who have been removed from medical observation, 102,427 people who have been put under medical observation.
累计收到港澳台地区通报确诊病例28例:香港特别行政区12例,澳门特别行政区7例,台湾地区9例。 28 confirmed cases have been reported from Hong Kong, Macao and Taiwan, including 12 in Hong Kong Special Administrative Region, 7 in Macao Special Administrative Region, and 9 in Taiwan.
13. 为什么短短几天增加了这么多确诊病例? 13. Why are confirmed cases increasing so quickly in just a few days?
因为有了病毒核酸检测试剂盒。 Because a virus nucleic acid detection kit has been developed.
近日,国家相关科研机构迅速研发出病毒核酸检测试剂盒,核酸检测试剂盒能通过PCR的方法快速确定病例的样品中是否有特定的基因序列的存在。 Recently, the related national scientific research institutions developed a virus nucleic acid detection kit rapidly. The detection kit can confirm whether there is a specific gene sequence in case samples or not by using a PCR-based approach.
也就是说,新型冠状病毒相当于有了身份证,病例的样品只要一对比就可以快速判断。 In other words, a novel coronavirus can be identified by detection kit; samples of cases can be judged quickly by comparison.
14.防控疫情的关键在哪里? 14. What is the key to prevent and control the outbreak?
防治的关键是防止出现超级传播者。 The key is to prevent "super spreaders”.
武汉市减少输出是非常重要的一个方面,武汉市会有很严格的筛查检测措施,特别是体温检测,体温高的不建议离开武汉市。 Reducing the outflow of the people in Wuhan City is very important, and strict screening detection measures are taken in Wuhan City, especially body temperature detection. Those who have high body temperature are not recommended to leave Wuhan.
2020年1月23日凌晨,武汉市采取了封城措施,这是至关重要的防控关键步骤。 The city limited inflow and outflow of people on January 23, 2020,which was the key measures to prevent and control the outbreak.
15.当前防控最有效的办法是什么? 15. What is the most effective way to prevent and control the outbreak at present?
早发现、早报告、早诊断、早隔离、早治疗是最有效的。 Early detection, early reporting, early diagnosis, early isolation, and early treatment are the most effective measures.
对已经确诊的病人进行有效隔离治疗,减少接触是极为重要的。 It is extremely important for the confirmed cases to get an effective isolation treatment to decrease transmission.
16.新型冠状病毒传染源是什么? 16. What is the infection source of novel coronavirus?
目前新型冠状病毒传染源尚未找到。 The infection source of 2019-nCoV has not yet been found.
这次发现的新型冠状病毒基因序列与SARS冠状病毒接近 The gene sequence of 2019-nCoV is similar to the SARS coronavirus.
而SARS冠状病毒已经证实起源于野生动物(蝙蝠)携带的冠状病毒 However, SARS coronavirus has been proved to stem from the coronavirus that wild animals (bat) carry.
目前收治病例多数有武汉市"华南海鲜市场”暴露史,这个市场同时还销售活体野生动物,摊主和顾客都有机会接触野生动物携带的冠状病毒。 At present, most cases admitted have exposure history of "Huanan Seafood Market," where the wild animals were sold, and vendors and customers there have the chance to be in contact with wild animals-carried coronavirus.
17.新型冠状病毒人传人吗? 17. Can novel coronaviruses be transmitted from person to person?
武汉市和广东省均发现人传人病例,截止到1月21日,武汉市已有15名医务人员感染,这证实了疫情可以人传人。 The cases by human-to-human transmission were found in Wuhan City and Guangdong Province; as of January 21, 2020, there were 15 health care workers infected in Wuhan City, which confirmed the virus could have human-to-human transmission.
18.人会通过哪些途径被传染? 18. By which ways will people be infected?
2020年1月27日,由国家卫生健康委员会办公厅、国家中医药管理局办公室联合印发的《新型冠状病毒感染的肺炎诊疗方案(试行第四版)》指出,经呼吸道飞沫传播是主要的传播途径,亦可通过接触传播。 On January 27, 2020, the Diagnosis and Treatment of Pneumonia Infected by Novel Coronavirus (4th trial edition) pressed by the General Office of the National Health Commission and the General Office of the National Administration of Traditional Chinese Medicine points out that the main transmission route is droplet transmission, plus contact transmission.
19.新型冠状病毒会变异吗? 19. Will the novel coronavirus mutate?
新型冠状病毒是以前从未在人体中发现的冠状病毒新毒株,病毒变异仍需严密监控。 The 2019-nCoV is a new strain of coronavirus that has not yet been previously found in human body, so the virus mutation still needs to be monitored closely.
20.新型冠状病毒是否会像SARS一样凶猛? 20. Will the novel coronavirus be as fierce as SARS?
研究显示,新型冠状病毒与SARS具有同源性,相似性约为70%,与MERS相似性约为40%。 The studies show that 2019-nCoV is homologous with SARS, with the similarity of about 70% and with MERS, about 40%.
新型冠状病毒与SARS相比传染性较弱,但与人体呼吸道上皮细胞仍具有较强亲和力,提示其对人体有一定感染能力。 Compared with SARS, 2019-nCoV has weak infectivity, but a good affinity with human respiratory epithelial cells, indicating certain infectivity for humans.
第三部分 防控常识 Part III Prevention and Control Knowledge
21.新型冠状病毒感染肺炎的病例监测措施主要有哪些? 21. What are the main monitoring measures for the pneumonia caused by the novel coronavirus?
各级各类医疗机构在新型冠状病毒感染的肺炎监测和日常诊疗过程中,应提高对新型冠状病毒感染的肺炎病例的诊断和报告意识。 In the course of pneumonia monitoring and daily diagnosis and treatment of 2019-nCoV infection, medical institutions at all levels and of various types should enhance the awareness of diagnosis and reporting of pneumonia cases of 2019-nCoV infection.
对于不明原因发热、咳嗽等症状的病例,应注意询问发病前14天内的行踪或可疑暴露史,野生动物接触史,及其与类似病例的密切接触史。 For cases with fever, cough and other symptoms of unknown causes, they should pay attention to inquiring about the suspected exposure history within 14 days before the onset of the disease, the history of contact with wild animals, and the history of close contact with similar cases.
22.如何预防被新型冠状病毒感染? 22. How to prevent the novel coronavirus infection?
(1)做好冬春季呼吸道传染病预防 (1) Make efforts to prevent respiratory infectious disease in winter and spring
目前正处于冬春季传染病高发季节,市民要增强卫生健康意识,加强锻炼,规律作息,提高自身免疫力。 It is presently in the high-incidence season of the winter and spring infectious diseases, the public should enhance health awareness, do more exercise, have a regular work and rest to improve their immunity.
注意保持室内空气流通,避免到封闭、空气不流通的公众场合和人多集中地方,外出时可佩戴口罩。 Keep proper indoor ventilation, avoid poorly ventilated and crowded places; medical masks shall be worn when going out.
外出回家后,及时洗手、洗鼻。 Wash hands and nose when coming home.
如有发热和其他呼吸道感染症状,特别是持续发热不退,及时到医疗机构就诊。 If fever and other respiratory symptoms, especially persistent fever occurs, go to hospitals as soon as possible.
(2)正确佩戴口罩 (2) Wear medical masks correctly
戴口罩是阻断呼吸道分泌物传播的有效手段。 Wearing medical masks is an effective way of interrupting respiratory droplets transmission.
选择医用外科口罩能很好地预防呼吸道疾病。 Medical masks can prevent respiratory diseases properly.
一次性医用口罩佩戴时,要将折面完全展开,将嘴、鼻、下颌完全包住,然后压紧鼻夹,使口罩与面部完全贴合。 When wearing disposable medical masks, fully unfold folded surface, and cover mouth, nose, and lower jaw entirely, then compress nose clip, so masks and face are in full contact with each other.
戴口罩前应洗手,或者在戴口罩过程中避免手接触到口罩内侧,减少口罩被污染的可能。 Wash hands before wearing medical masks or avoid touching the inner side of masks while wearing masks to reduce masks pollution risk.
分清楚口罩的内外、上下,浅色面为内,应该贴着嘴鼻,深色面朝外;金属条(鼻夹)一端是口罩的上方。 Distinguish the inside and outside and up and down of masks, i.e., the light surface is the inside of masks, which closes to mouth and nose, and the dark surface is the outside of masks; the metal strip (nose clip) side is the upside of masks.
要定期更换、不可戴反,更不能两面轮流戴。 Replace masks regularly; avoid wearing reversely, and even both sides.
(3)正确洗手 (3) Wash hands properly
在餐前便后、外出回家、接触垃圾、抚摸动物后,要记得洗手。 Remember to wash hands before eating, after toilet, coming home, coming into contact with garbage and touching animals.
洗手时,要注意用流动的水和使用肥皂(皂液)洗手,揉搓的时间不少于15秒 When washing hands, use running water and soap (liquid soap), with no less than 15 seconds for rubbing hands.
为了方便记忆,揉搓步骤简单归纳为七字口诀: "内-外-夹-弓-大-立-腕”。 For the convenience of memory, rubbing steps are as follows.
- Both hands rub with palm to palm - Both hands cross and rub with palm to hand back - Fingers cross and rub with palm to palm - Fingers entwine and rub rotationally - Rub hands rotationally with thumb in the palm - Rub hands with fingertip in the palm - Wash wrist
23.接触动物有什么特别需要注意的事项? 23. What should be paid special attention to when coming into contact with animals?
避免接触野生禽畜、野生动物及其排泄物和分泌物,避免购买活禽和野生动物;避免前往动物农场和屠宰场、活禽动物交易市场或摊位、野生动物栖息地等场所。 Avoid coming into contact with wild livestock, wildlife, and their droppings and secretions, and avoid the purchase of live poultry and wildlife. Avoid visiting animal farms and slaughterhouses, live poultry and animal markets or stalls, wildlife habitats and so forth.
必须前往时要做好防护,尤其是职业暴露人群; People, especially occupationally exposed persons must take precautions when having to go the places mentioned above,.
避免食用野生动物。 Avoid eating wild animals.
24.当出现了发热、咳嗽等症状时,一定要去医院吗? 24.When there are fever, cough and other symptoms, do you have to go to the hospital?
普通的感冒、流感、急性的上呼吸道感染、咽炎、支气管炎及扁桃体炎都可能出现咽痛、咳嗽、鼻塞、流涕、打喷嚏等症状。 The symptoms such as pharyngeal pain, cough, nasal congestion, runny nose, sneezing, and so on may occur in the common cold, influenza, acute upper respiratory tract infection, pharyngitis, bronchitis, and tonsillitis.
当出现以上症状时,一般判断是普通的呼吸道感染。 When the above symptoms appear, it is generally a common respiratory tract infection.
而感染新型冠状病毒的患者临床主要表现为发热、乏力、干咳,较少出现鼻塞、流涕等上呼吸道症状。 However, the patients infected with the 2019-nCoV mainly have fever, fatigue, and dry cough with less symptoms of the upper respiratory tract such as nasal congestion, runny nose.
目前一些城市的医院聚集了大量的呼吸道疾病患者。 At present, hospitals in some cities gather a large number of patients with respiratory diseases.
如果直接去医院就诊,不但不能有效的获取有用信息,还容易造成交叉感染。 If they go to the hospital directly, they cannot effectively obtain useful information and are prone to get cross-infection.
不用恐慌 Don't be panic.
不要随便外出,做好自我身体状况观察 Don't go out casually, and do a good job of observing your physical condition.
另外,结合SARS的治疗经验教训,充分发挥我国独特的医疗体系优势,采用中西医结合可能具有重要的价值。 In addition, combined with the experience and lessons of SARS treatment, we can know that we could give play to the unique advantages of China's medical system by using the combination of traditional Chinese and Western medicine which may have important value.
经国务院批准,国家卫生健康委将新型冠状病毒感染的肺炎纳入《中华人民共和国传染病防治法》规定的乙类传染病,采取甲类传染病的预防、控制措施;并纳入《中华人民共和国国境检疫法》规定的检疫传染病管理。 Upon approval from the State Council, the National Health Commission includes 2019-nCoV-infected pneumonia into category B infectious disease specified in the Law of the People's Republic of China on the Prevention and Treatment of Infectious Diseases, and prevention and control measures for category A infectious diseases are taken; quarantinable disease management specified in Frontier Health and Quarantine Law of The People's Republic of China are followed.
当出现了发热、咳嗽等症状,而自己又无法准确判断时,建议通过微医互联网总医院在线问诊后再做决定。 When a person has fever, cough, and other symptoms, and cannot accurately judge by himself, it is recommended to make a decision based on the WeDoctor's Digital general hospital online consultation.
北京疾控向海外华人发出5点防控建议 Health Tips for Overseas Chinese
北京疾控部门特向海外华人提出了防控建议: We hereby provide the following prevention and control suggestions for the overseas Chinese:
1.持续关注当地的疫情变化,按照所在国家和地区防控传染病的法律法规,以及疫情防控要求积极配合当地政府开展疫情防控,落实好防控措施。 1.Follow the local epidemic situation, and actively cooperate with the local government accordingly in carrying out prevention and control measures pursuant to infectious diseases related laws and regulations of the country or region you are in.
2.密切关注我国外交部、中国疾控中心以及北京市疾控中心等官方机构网站,了解新冠肺炎防控要求和健康提示。 2.Follow information published on websites of the Ministry of Foreign Affairs of the People’s Republic of China, Chinese Center for Disease Control and Prevention, Beijing Center for Diseases Prevention and Control and other official agencies to see the prevention and control requirements and health tips with regard to COVID-19.
3.做好个人防护措施。 3.Eight personal protective measures:
一是要保持良好个人卫生,勤洗手、多饮水,经常换洗衣物。 First, maintain good personal hygiene, wash hands frequently, drink more water, and change and wash clothes frequently.
外出回家、饭前便后一定要洗手;接触可能被污染的物品后必须洗手,或用手消毒剂消毒。 Wash hands after coming back home, before eating meals and after using the toilet; hands must be washed or disinfected with hand disinfectant after touching articles that may be contaminated.
二是外出乘坐公共交通工具、厢式电梯、室内公共场所等密闭环境时,应正确佩戴口罩。 Second, wear a face mask when going out, getting into an elevator, taking public transportation, or in other closed environments.
三是保持居住环境清洁,建议每日通风2~3次,每次30分钟以上,通风时注意保暖,防止着凉。 Third, keep the living environment clean. It is recommended to ventilate 2-3 times a day for more than 30 minutes each time while keeping yourself warm during ventilation.
四是集体用餐时,尽量避开就餐高峰,减少与他人近距离接触。 Fourth, avoid the peak time for meals in public places and reduce close contact with others.
五是接待外来人员时,双方均应佩戴一次性医用口罩,尽量不握手,不拥抱,注意保持一米以上距离。 Fifth, wear a mask when receiving visitors. Avoid shaking hands, giving hugs, and maintain a distance of more than one meter.
六是尽量避免聚餐和到人员密集的公共场所活动,尤其是空气流动性差的地方,如影剧院、酒吧、网吧、商场、车站、码头、展览馆、博物馆、公共浴池、温泉等。 Sixth, avoid dinner parties and activities in crowded public places, especially places with poor air flow, such as theaters, bars, internet cafes, shopping malls, stations, docks, exhibition halls, museums, public baths, hot springs, etc.
七是不随地吐痰,打喷嚏或咳嗽时用手肘或纸巾遮住,不要用手接触口鼻眼。 Seventh, avoid spitting anywhere, use elbows or paper towels to cover your mouth and nose when sneezing or coughing. Avoid touching your mouth, nose and eyes with hands.
口鼻分泌物或吐痰时用纸巾包好,弃置于有盖垃圾箱内。 Wrap nasal and oral secretions or spits with paper towels and dispose of them in covered dustbins.
八是如与他人合租住所或借住在别人家里,要观察有关人员有无发热、就诊等异常情况。 Eighth, if you share a room with others or live in other people’s home, you need to observe whether the relevant personnel are running a fever, receiving medical treatment or having other abnormal conditions.
4.若出现发热、干咳等症状,不要带病工作、学习,佩戴一次性医用口罩,请及时就近在当地医疗机构进行诊疗,并告知医务人员相关接触史。 4.If you have a fever, dry cough and other symptoms, please stop working or studying immediately. You should wear a mask, seek medical treatment at the nearest medical institution, and inform the medical personnel of your relevant contact history.
就诊期间尽量不要触摸就诊环境中的相关物品,尽量避免下意识地触摸自己的口、鼻及眼部。 During the treatment, avoid touching articles in the clinic, and avoid subconsciously touching your mouth, nose and eyes.
5.在疫情流行期间,不要恐慌,除非必要,尽可能不要外出旅行,严格按照当地及我国驻外使馆的相关建议和要求进行国际旅行。 5.During the COVID-19 outbreak period, please keep calm, and do not travel unless it’s necessary. Please make international travels in strict accordance with the relevant recommendations and requirements of local authorities and Chinese embassies.
如果成为新冠肺炎病例的密切接触者,应取消旅行或旅游安排,就地进行隔离医学观察。 If you have been a close contact of COVID-19 cases, you should cancel travel and conduct isolated medical observation on site.
世界卫生组织已将新冠肺炎疫情全球风险级别上调为“非常高”。 The World Health Organization has raised the global risk assessment level of COVID-19 to “very high”.
因此需要每个国家、每个人共同携手,努力抗击疫情。 Therefore, it is necessary for every country and every person to work together to fight against the epidemic.
新冠肺炎防治手册 Handbook of COVID-19 Prevention and Treatment
浙江大学医学院附属第一医院临床经验 Compiled According to Clinical Experience of the First Affiliated Hospital, Zhejiang University School of Medicine
寄 语 Editor’s Note:
面对全新的未知病毒,共享与合作是最好的药方。 Faced with an unknown virus, sharing and collaboration are the best remedy.
这本手册的出版,是对过去两个月医护人员体现出来的勇气与智慧的最好的纪念方式之一。 The publication of this Handbook is one of the best ways to mark the courage and wisdom our healthcare workers have demonstrated over the past two months.
感谢所有参与编写人员,在救治病患的同时,把宝贵的经验汇编成册提供全球医疗同行借鉴。 Thanks to all those who have contributed to this Handbook, sharing the invaluable experience with healthcare colleagues around the world while saving the lives of patients.
感谢来自国内医疗同行的帮助,你们提供的经验对我们来说既是启发更是激励。 Thanks to the support from healthcare colleagues in China who have provided experience that inspires and motivates us.
感谢马云公益基金会发起这个项目和阿里健康的技术支持,使得本手册能够为那些正与疫情搏斗的人们提供帮助。 Thanks to Jack Ma Foundation for initiating this program, and to AliHealth for the technical support, making this Handbook possible to support the fight against the epidemic.
本手册用于公益传播。 The Handbook is available to everyone for free.
由于时间仓促,书中难免会存在一些瑕疵和不 However, due to the limited time, there might be some errors and defects.
足,欢迎读者批评指正。 Your feedback and advice are highly welcomed!
梁廷波 Prof. Tingbo LIANG
《新冠肺炎防治手册》主编 Editor-in-Chief of the Handbook of COVID-19 Prevention and Treatment
浙江大学医学院附属第一医院教授 Chairman of The First Affiliated Hospital, Zhejiang University School of Medicine
前 言 Foreword
这是一场前所未有的战争,全球人类面对着同一个敌人———新型冠状病毒。 This is an unprecedented global war, and mankind is facing the same enemy, the novel coronavirus.
第一战场是医院,而医务工作者是我们的战士。 And the first battlefield is the hospital where our soldiers are the medical workers.
要确保这场战争能赢,首先要确保我们的医务人员能得到足够的资源保障,包括技术和经验的输入。 To ensure that this war can be won, we must first make sure that our medical staff is guaranteed sufficient resources, including experience and technologies.
也要确保我们能让医院成为消灭病毒的战场,而不是被病毒击垮。 Also, we need to make sure that the hospital is the battleground where we eliminate the virus, not where the virus defeats us.
因此马云公益基金会和阿里巴巴公益基金会紧急召集了一批刚刚从“抗疫”战场回来的优秀医务人员。 Therefore, Jack Ma Foundation and Alibaba Foundation have convened a group of medical experts who have just returned from the frontlines of fighting the pandemic.
在浙江大学医学院附属第一医院的组织下,迅速出版了这本新冠肺炎的临床救治经验。 With the support of The First Affiliated Hospital, Zhejiang University School of Medicine (FAHZU), they quickly published a guidebook on the clinical experience of how to treat this new coronavirus.
希望给全世界正在抗疫一线的和即将加入战争的各国医务人员一些建议和参考。 The treatment guide offers advice and reference against the pandemic for medical staff around the world who are about to join the war.
感谢浙江大学医学院附属第一医院的医务工作者。 Thanks to the medical staff from FAHZU.
在冒着巨大风险救治新冠患者的同时,夜以继日亲自执笔写下了救治经验,形成这本手册。 While taking huge risks in treating COVID-19 patients, they wrote down their treatment experience day and night in this Handbook.
过去的五十多天,浙大一院收治了104名确诊患者,其中重症和危重症患者78人。 Over the past 50 days, 104 confirmed patients have been admitted to FAHZU, including 78 severe and critically ill ones.
医务人员在巨大的压力和风险下,创造了三个零的奇迹:医务人员零感染,感染患者零漏诊和危重患者零死亡。 Thanks to the pioneering efforts of medical staff and the application of new technologies, to date, we have witnessed a miracle. No staff is infected, and there is no missed diagnosis or patient deaths.
这是奇迹,更是财富。 Today, with the spread of the pandemic, these experiences are the most valuable sources of information and the most important weapon for medical workers on the battlefield.
面对全新的疾病,作为最早遭遇疫情的中国,一切隔离、诊疗、防护和康复都是从零开始,但是我们希望因为这本手册的问世,至少其它国家的医生和护士在走上这个特殊的战场时,可以有很多借鉴,不必从零开始。 This is a brand-new disease, and China was the first to suffer from the pandemic. Isolation, diagnosis, treatment, protective measures, and rehabilitation have all been started from scratch, but we hope that with the advent of this Handbook doctors and nurses in other affected areas can learn from our experience when entering the battlefield and they won't have to start from zero.
这次的大流行,是全球化时代人类共同面临的一次挑战。 This pandemic is a common challenge faced by mankind in the age of globalization.
此时此刻,只有不分你我,分享资源、经验和教训,才是我们赢得胜利的唯一机会。 At this moment, sharing resources, experiences and lessons, regardless of who you are, is our only chance to win.
因为流行病最终的药方不是隔离,而是合作。 Because the real remedy for epidemics is not isolation, but cooperation.
这场战争,才刚刚开始。 This war has just begun.
目 录 Contents
防控管理 Part One Prevention and Control Management
一. 隔离区域管理 I. Isolation Area Management
二. 工作人员管理 II. Staff Management
三. COVID-19相关个人防护管理 III. COVID-19 Related Personal Protection Management
四. COVID-19疫情期间院感流程 IV. Hospital Practice Protocols during COVID-19 Epidemic
五. 数字化支撑疫情防控 V. Digital Support for Epidemic Prevention and Control
诊疗经验 Part Two Diagnosis and Treatment
一. 多学科协作个性化治疗 I. Personalized, Collaborative and Multidisciplinary Management
二. 病原学与炎症指标检查 II.Etiology and Inflammation Indicators
三. COVID-19患者肺部影像学表现 III. Imaging Findings of COVID-19 Patients
四. COVID-19患者诊治中支气管镜技术的应用 IV. Application of Bronchoscopy in the Diagnosis and Management of COVID-19 Patients
五. COVID-19诊断与临床分型 V. Diagnosis and Clinical Classification of COVID-19
六. 抗病毒治疗及时消除病原体 VI. Antiviral Treatment for Timely Elimination of Pathogens
七. 抗休克及抗低氧血症维持生命体征 VII. Anti-shock and Anti-hypoxemia Treatment
八. 抗继发感染合理使用抗菌药物 VIII. The Rational Use of Antibiotics to Prevent Secondary Infection
九. 肠道微生态平衡营养支持 IX. The Balance of Intestinal Microecology and Nutritional Support
十. COVID-19患者的ECMO支持 X. ECMO Support for COVID-19 Patients
十一. COVID-19康复者恢复期血浆治疗 XI. Convalescent Plasma Therapy for COVID-19 Patients
十二. 中医分型治疗提高疗效 XII. TCM Classification Therapy to Improve Curative Efficacy
十三. COVID-19患者用药管理 XIII. Drug Use Management of COVID-19 Patients
十四. COVID-19患者心理干预 XIV. Psychological Intervention for COVID-19 Patients
十五. COVID-19患者康复治疗 XV. Rehabilitation Therapy for COVID-19 Patients
十六. COVID-19患者肺移植 XVI. Lung Transplantation in Patients with COVID-19
十七. COVID-19患者出院标准及随访计划 XVII. Discharge Standards and Follow-up Plan for COVID-19 Patients
护理经验 Part Three Nursing
一. 高流量吸氧(HFNC)患者护理 I. Nursing Care for Patients Receiving High-Flow Nasal Cannula (HFNC) Oxygen Therapy
二. 机械通气患者护理 II. Nursing Care in Patients with Mechanical Ventilation
三. ECMO日常管理及监护 III. Daily Management and Monitoring of ECMO (Extra Corporeal Membrane Oxygenation)
四. 人工肝护理 IV. Nursing Care of ALSS (Artificial Liver Support System)
五. CRRT护理 V. Continuous Renal Replacement Treatment (CRRT) Care
六. 一般护理 VI. General Care
一. COVID-19患者医嘱范例 I. Medical Advice Example for COVID-19 Patients
二. 线上咨询诊疗服务流程 II. Online Consultation Process for Diagosis and Treatment
第一部分 防控管理 Part One Prevention and Control Management
一. 隔离区域管理 I. Isolation Area Management
发热门诊 Fever Clinic
1.1布局设置 1.1 Layout
1)医疗机构应设相对独立的发热门诊,医院入口处有发热门诊专用单向通道且有明显标识; (1) Healthcare facilities shall set up a relatively independent fever clinic including an exclusive one-way passage at the entrance of the hospital with a visible sign;
2)人员流向按照“三区两通道”原则,设有污染区、潜在污染区、清洁区,分区明确,污染区与潜在污染区之间设置两个缓冲区; (2) The movement of people shall follow the principle of “three zones and two passages”: a contaminated zone, a potentially contaminated zone and a clean zone provided and clearly demarcated, and two buffer zones between the contaminated zone and the potentially contaminated zone;
3)设置独立污物通道;设置可视传递间进行办公区(潜在污染区)向隔离病房(污染区)的单向物品传递; (3) An independent passage shall be equipped for contaminated items; set up a visual region for one-way delivery of items from an office area (potentially contaminated zone) to an isolation ward (contaminated zone);
4)应制定医务人员穿脱防护用品的流程、按区域步骤制作流程图和配置穿衣镜,严格遵守行走路线; (4) Appropriate procedures shall be standardized for medical personnel to put on and take off their protective equipment. Make flowcharts of different zones, provide full-length mirrors and observe the walking routes strictly;
5)配备感染防控技术人员督导医务人员防护用品的穿脱,防止污染; (5) Infection prevention and control technicians shall be assigned to supervise the medical personnel on putting on and removing protective equipment so as to prevent contamination;
6)在污染区的所有物品未经消毒处理,不得带离污染区域。 (6) All items in the contaminated zone that have not been disinfected shall not be removed.
1.2分区设置 1.2 Zone Arrangement
1)设置独立的检查室、化验室、留观室、抢救室、药房、收费处等; (1) Set up an independent examination room, a laboratory, an observation room, and a resuscitation room;
2)设置预检分诊处,对患者做好初步筛查; (2) Set up a pre-examination and triage area to perform preliminary screening of patients;
3)对诊疗区域进行分区:有流行病学接触史且伴有发热及或呼吸道症
状,进入新冠疑似区域;无明确流行病学接触史的进入普通发热患者区
域。
(3) Separate diagnosis and treatment zones: those patients with an epidemiological history and fever and/or respiratory symptoms shall be guided into a suspected COVID-19 patient zone; those patients with regular fever but no clear epidemiological history shall be guided into a regular fever patient zone.
1.3患者管理 1.3 Patient Management
1)发热门诊患者必须佩戴医用外科口罩; (1) Patients with fevers must wear medical surgical masks;
2)仅允许患者本人进入候诊区,减少人员聚集; (2) Only patients are allowed to enter the waiting area in order to avoid overcrowding;
3)尽量减少发热门诊患者等候时间,避免交叉感染; (3) The duration of the patient’s visit shall be minimized so as to avoid cross infections;
4)做好患者及家属宣教,提早识别症状并采取基本预防措施。 (4) Educate patients and their families about early identification of symptoms and essential preventative actions.
1.4筛查、收治及排除 1.4 Screening, Admission and Exclusion
1)所有医务人员应掌握COVID-19流行病学特点与临床特征,按照诊疗规范标准(见表1)对患者进行筛查; (1) All healthcare workers shall fully understand the epidemiological and clinical features of COVID-19 and screen patients in accordance with the screening criteria below (see Table 1);
2)对符合疑似筛查标准的患者进行核酸检测; (2) Nucleic acid testing (NAT) shall be conducted on those patients who meet the screening criteria for suspected patients;
3)对不符合疑似筛查标准的,如无明确流行病学史,但症状尤其是影像学不能排除者,建议专家会诊后综合判断; (3) Patients who do not meet the screening criteria above, if they do not have a confirmed epidemiological history, but cannot be ruled out from having COVID-19 based on their symptoms, especially through imaging, are recommended for further evaluation and to obtain a comprehensive diagnosis;
4)首次核酸检测结果为阴性的间隔24小时复测,两次阴性且临床表现可排除的,予以出院。 (4) Any patient who tests negative shall be re-tested 24 hours later. If a patient has two negative NAT results and negative clinical manifestations, then he or she can be ruled out from having COVID-19 and discharged from the hospital.
临床表现不可排除的,继续间隔24小时持续复测,直至排除或确诊; If those patients cannot be ruled out from having COVID-19 infections based on their clinical manifestations, they shall be subjected to additional NAT tests every 24 hours until they are excluded or confirmed;
5) 确诊病例应定点集中收治,并评估病情严重程度(普通隔离病房收治或重症监护隔离病房收治)。 (5) Those confirmed cases with a positive NAT result shall be admitted and treated collectively based on the severity of their conditions (the general isolation ward or isolated ICU).
表1 COVID-19疑似病例筛查标准表 Table 1 Screening Criteria for Suspected COVID-19 Cases
流行病学史 Epidemiological History
① 发病前14天内,有病例高发地区或国家旅行史或居住史; ① Within 14 days before the onset of the disease, the patient has a travel or residence history in the high-risk regions or countries;
②发病前14天内,与新型冠状病毒感染者(核酸检测阳性者)有接触史; ② Within 14 days before the onset of the disease, the patient has a history of contact with those infected with SARS-CoV-2 (those with a positive NAT result);
③发病前14天内,曾接触过来自病例高发地区或国家的发热或有呼吸道症状的患者; ③ Within 14 days before the onset of the disease, the patient had direct contact with patients with fever or respiratory symptoms in high-risk regions or countries;
④ 聚集性发病(2周内在小范围如家庭、办公室、学校班级等场所,出现2例及以上发热和/或呼吸道症状的病例)。 ④ Disease clustering (2 or more cases with fever and/or respiratory symptoms occur at such places as homes, offices, school classrooms, etc. within 2 weeks).
临床表现 Clinical Manifestations
① 发热和/或呼吸道症状; ① The patient has fever and/or respiratory symptoms;
② 具有以下肺炎影像学特征:早期呈现多发小斑片影及间质改变,以肺外带明显。 ② The patient has the following CT imaging features of COVID-19: multiple patchy shadows and interstitial changes occur early, particularly at the periphery.
进而发展为双肺多发磨玻璃影、浸润影,严重者可出现肺实变,胸腔积液少见; The conditions further develop into multiple ground-glass opacities and infiltrates in both lungs. In severe cases, the patient may have lung consolidation and rare pleural effusion;
③ 发病早期白细胞总数正常或降低,或淋巴细胞计数减少。 ③ The white blood cells count in the early stage of the disease is normal or decreased, or the lymphocyte count decreases over time.
符合任1条流行病学史,且符合任2条临床表现无流行病学史,且符合3条临床表现 The patient meets 1 epidemiological history and 2 clinical manifestations.
无流行病学史,且符合3条临床表现 The patient has no epidemiological history and meets 3 clinical manifestations.
无流行病学史,符合1-2条临床表现,但影像学不能排除 The patient has no epidemiological history, meets 1-2 clinical manifestations, but cannot be excluded from COVID-19 through imaging.
是否为疑似 Suspected Case Diagnosis
专家会诊 Expert consultation
隔离病区 Isolation Ward Area
2.1适用范围 2.1 Scope of Application
包括隔离留观病区、隔离病区、隔离重症监护病区。 The isolation ward area includes an observation ward area, isolation wards, and an isolation ICU area.
建筑布局和工作流程应符合医院隔离技术规范等有关要求。 The building layout and workflow shall meet the relevant requirements of the hospital isolation technical regulations.
设置负压病区的医疗机构应按相关要求实施规范管理。 Medical providers with negative pressure rooms shall implement standardized management in accordance with relevant requirements.
严格限制人员出入。 Strictly limit access to isolation wards.
2.2布局设置 2.2 Layout
参照发热门诊 Please refer to fever clinic.
2.3病室要求 2.3 Ward Requirements
1)疑似患者和确诊患者分病区安置; (1) Suspected and confirmed patients shall be separated in different ward areas;
2)疑似患者单人单间,病室内配备有独立卫生间等生活设施,确保患者活动范围固定于隔离病室内; (2) Suspected patients shall be isolated in separated single rooms. Each room shall be equipped with facilities such as a private bathroom and the patient’s activity should be confined to the isolation ward;
3)确诊患者可同病室安置,床间距≥1.2米。 (3) Confirmed patients can be arranged in the same room with bed spacing of not less than 1.2 meters (appx 4 feet).
病室内配备有独立卫生间等生活设施,确保患者活动范围固定于隔离病室内。 The room shall be equipped with facilities such as a bathroom and the patient’s activity must be confined to the isolation ward.
2.4患者管理 2.4 Patient Management
1)谢绝家属探视和陪护,患者可携带电子通信设备与外界沟通; (1) Family visits and nursing shall be declined. Patients should be allowed to have their electronic communication devices to facilitate interactions with loved ones;
2)开展就诊患者教育,使其了解新冠病毒的防护知识,指导其佩戴外科口罩、正确洗手、咳嗽礼仪、医学观察和居家隔离等。 (2) Educate patients to help them prevent further spread of COVID-19, and provide instructions on how to wear surgical masks, proper handwashing, cough etiquette, medical observation and home quarantine.
二. 工作人员管理 II. Staff Management
工作管理 Workflow Management
1)工作人员进入隔离区域前,对穿脱个人防护用品必须经过严格培训和考核,合格后才能进入; (1) Before working in a fever clinic and isolation ward, the staff must undergo strict training and examinations to ensure that they know how to put on and remove personal protective equipment. They must pass such examinations before being allowed to work in these wards.
2)工作人员实行小组制模式。 (2) The staff should be divided into different teams.
组内人员分时段进入隔离区域(污染区),建议每次在隔离区域时间一般不超过4小时; Each team should be limited to a maximum of 4 hours of working in an isolation ward. The teams shall work in the isolation wards (contaminated zones) at different times.
3)集中安排治疗、检查、消毒等工作,减少工作人员进出隔离病房频率; (3) Arrange treatment, examination and disinfection for each team as a group to reduce the frequency of staff moving in and out of the isolation wards.
4)下班前应当进行个人卫生处置,并注意呼吸道与黏膜的防护。 (4) Before going off duty, staff must wash themselves and conduct necessary personal hygiene regimens to prevent possible infection of their respiratory tracts and mucosa.
健康管理 Health Management
1)隔离区域一线工作人员(医护、医技、物业后勤)统一安排隔离住宿,不得自行外出; (1) The front-line staff in the isolation areas – including healthcare personnel, medical technicians and property & logistics personnel – shall live in an isolation accommodation and shall not go out without permission.
2)提供营养膳食,增强医务人员免疫力; (2) A nutritious diet shall be provided to improve the immunity of medical personnel.
3)为所有上岗的员工建立健康档案,一线工作人员主动开展健康监测,包括体温和呼吸系统症状等;联合专家协助解决各种心理、生理问题; (3) Monitor and record the health status of all staff on the job, and conduct health monitoring for front-line staff, including monitoring body temperature and respiratory symptoms; help address any psychological and physiological problems that arise with relevant experts.
4)如出现发热等不适,应立即进行单独隔离,并进行新冠病毒核酸检测排查; (4) If the staff have any relevant symptoms such as fever, they shall be isolated immediately and screened with an NAT.
5)隔离区域一线工作人员需结束隔离区工作的,应进行新冠病毒核酸检测,为阴性后定点集中隔离14天,方可解除医学观察。 (5) When the front-line staff including healthcare personnel, medical technicians and property & logistics personnel finish their work in the isolation area and are returning to normal life, they shall first be NAT tested for SARS-CoV-2. If negative, they shall be isolated collectively at a specified area for 14 days before being discharged from medical observation.
三. COVID-19相关个人防护管理 III. COVID-19 Related Personal Protection Management
防护等级 Protection Level
一级防护 Level I protection
二级防护 Level II protection
三级防护 Level III protection
防护用品 Protective Equipment
一次性工作帽 Disposable surgical cap
一次性外科口罩 Disposable surgical mask
工作服 Work uniform
必要时戴一次性乳胶手套或(及)穿一次性隔离衣 Disposable latex gloves or/and disposable isolation clothing if necessary
一次性工作帽 Disposable surgical cap
医用防护口罩(N95) Medical protective mask (N95)
工作服 Work uniform
一次性医用防护服 Disposable medical protective uniform
一次性乳胶手套 Disposable latex gloves
一次性工作帽 Disposable surgical cap
医用防护口罩(N95) Medical protective mask (N95)
工作服 Work uniform
一次性医用防护服 Disposable medical protective uniform
一次性乳胶手套 Disposable latex gloves
全面型呼吸防护器或正压式头套 Full-face respiratory protective devices or powered air-purifying respirator
适用范围 Scope of Application
预检分诊、普通门诊 Pre-examination triage, general outpatient department
发热门诊 Fever outpatient department
隔离病区(含重症监护病区) Isolation ward area (including isolatedintensive ICU)
疑似/确诊患者非呼吸道标本检验 Non-respiratory specimen examination of suspected/confirmed patients
疑似/确诊患者影像学检查 Imaging examination of suspected/confirmed patients
疑似/确诊患者手术器械的清洗 Cleaning of surgical instruments used with suspected/confirmed patients
疑似/确诊患者可能发生呼吸道分泌物、体(血)液喷射或飞溅的工作时(如气管插管、气管切开、纤维支气管镜、胃肠镜等) When the staff performs operations such as tracheal intubation, tracheotomy, bronchofibroscope, gastroenterological endoscope, etc., during which, the suspected/confirmed patients may spray or splash respiratory secretions or body fluids/blood
为确诊/疑似患者实施手术、尸检 When the staff performs surgery and autopsy for confirmed/suspected patients
新冠核酸检测 When the staff carries out NAT for COVID-19
1.所有医疗场所工作人员均佩戴医用外科口罩; 1. All staff at the healthcare facilities must wear medical surgical masks;
2.急诊、感染科门诊、呼吸科门诊、口腔科、普通内镜检查(如胃肠镜、纤维支气管镜、喉镜等)工作人员在一级防护的基础上,医用外科口罩升级为医用防护口罩(N95); 2. All staff working in the emergency department, outpatient department of infectious diseases, outpatient department of respiratory care, department of stomatology or endoscopic examination room (such as gastrointestinal endoscopy, bronchofibroscopy, laryngoscopy, etc.) must upgrade their surgical masks to medical protective masks (N95) based on Level I protection;
3.疑似/确诊患者呼吸道标本采集时二级防护基础上戴防护面屏。 3. Staff must wear a protective face screen based on Level II protection while collecting respiratory specimens from suspected/confirmed patients.
四. COVID-19疫情期间院感流程 IV. Hospital Practice Protocols during COVID-19 Epidemic
COVID-19相关个人防护用品穿脱流程 Guidance on Donning and Removing Personal Protective Equipment (PPE) to manage COVID-19 Patients
1.更换专用工作服、工作鞋 1. First put on special work clothes and work shoes
2.执行手卫生 2. Wash hands
3.戴一次性帽子 3. Put on a disposable surgical cap
4.戴医用防护口罩(N95) 4. Put on a medical protective mask (N95)
5.戴里层一次性丁腈/乳胶手套 5. Put on inner disposable nitrile/latex gloves
6.戴护目镜,穿防护服 6. Put on goggles and protective clothing
7.戴外层一次性乳胶手套 7. Put on disposable latex gloves
8. 穿戴完毕 8. Donning completed
穿个人防护用品: Protocol for Donning PPE:
更换专用工作服、工作鞋 —— 执行手卫生 —— 戴一次性帽子 —— 戴医用防护口罩(N95)—— 戴里层一次性丁腈手套/乳胶手套——戴护目镜,穿防护服(备注:对于无脚套防护服,加穿防水靴套),穿一次性隔离衣(根据需要),戴面屏/正压呼吸头罩(根据需要)——戴外层一次性乳胶手套 Put on special work clothes and work shoes → Wash hands → Put on disposable surgical cap →Put on medical protective mask (N95) → Put on inner disposable nitrile/latex gloves → Put on goggles and protective clothing (note: if wearing protective clothing without foot covers, please also put on separate waterproof boot covers), put on a disposable isolation gown (if required in the specific work zone) and face shield/powered air-purifying respirator(if required in the specific work zone) → Put on outer disposable latex gloves
1.更换手套 1. Replace the outer gloves with new ones
2.脱隔离衣,连外层手套 2. Remove protective clothing along with outer gloves
3.摘除护眼罩 3. Remove goggles
4.摘口罩 4. Remove mask
5.摘帽子 5. Remove cap
6.脱里层一次性乳胶手套 6. Remove inner disposable latex gloves
7.脱除完毕 7. Removal completed
脱个人防护用品: Protocol for Removing PPE:
手卫生,去除外表面肉眼可见血体液污染物 —— 手卫生,更换外层手套 ——摘去正压呼吸头罩或自吸过滤式全面罩/面罩(根据需要)——手卫生——脱一次性隔离衣,连外层手套(根据需要)——手卫生,戴外层手套 —— 进入缓冲区 ① —— 手卫生,脱防护服,连外层手套(里面反转在外,往下卷)(备注:如有防水靴套,一并脱去)—— 手卫生 —— 进入缓冲区 ② —— 手卫生,摘除护眼罩 —— 手卫生,摘口罩 —— 手卫生,摘帽子 —— 手卫生,脱里层一次性乳胶手套 ——手卫生,离开缓冲区 ② —— 手卫生,沐浴更衣,进入清洁区 Wash hands and remove visible bodily fluids/blood contaminants on the outer surfaces of both hands
→ Wash hands replace outer gloves with new gloves → Remove powered air-purifying respirator or self-priming filter-type full-face mask/mask (if used) → Wash hands → Remove disposable gowns along with outer gloves (if used) → Wash hands and put on outer gloves → Enter Removal Area No. ①→ Wash hands and remove protective clothing along with outer gloves (for gloves and protective clothing, turn inside out, while rolling them down) (note: if used, remove the waterproof boot covers with clothing) → Wash hands → Enter Removal Area No. ② → Wash hands and remove goggles →Wash hands and remove mask → Wash hands and remove cap → Wash hands and remove inner disposable latex gloves → Wash hands and leave Removal Area No. ② → Wash hands, take a shower, put on clean clothes and enter the clean area.
隔离病区环境消毒流程 Disinfection Procedures for COVID-19 Isolation Ward Area
2.1地面、墙壁的消毒 2.1 Disinfection for Floor and Walls
1)有肉眼可见污染物时,应先完全清除污染物(按血液体液等溢出处理); (1) Visible pollutants shall be completely removed before disinfection and handled in accordance with disposal procedures of blood and bodily fluid spills;
2)用1000mg/L含氯消毒液拖地、喷洒或擦拭消毒; (2) Disinfect the floor and walls with 1000 mg/L chlorine-containing disinfectant through floor mopping, spraying or wiping;
3)消毒作用时间不少于30分钟; (3) Make sure that disinfection is conducted for at least 30 minutes;
4)每日三次,有污染时随时消毒。 (4) Carry out disinfection three times a day and repeat the procedure at any time when there is contamination.
2.2物体表面的消毒 2.2 Disinfection of Object Surfaces
1)有肉眼可见污染物时,应先完全清除污染物(按血液体液等溢出处理); (1) Visible pollutants should be completely removed before disinfection and handled in accordance with disposal procedures of blood and bodily fluid spills;
2)用1000mg/L含氯消毒液或含氯消毒湿巾擦拭,作用30分钟后清水擦拭干净,每日三次(如有污染时随时消毒); (2) Wipe the surfaces of objects with 1000 mg/L chlorine-containing disinfectant or wipes with effective chlorine; wait for 30 minutes and then rinse with clean water. Perform disinfection procedure three times a day (repeat at any time when contamination is suspected);
3)擦拭时应按从洁到污的顺序:先擦接触较少的物体表面,再擦拭经常接触的物体表面(擦完一个物表更换一块湿巾)。 (3) Wipe cleaner regions first, then more contaminated regions: first wipe the object surfaces that are not frequently touched, and then wipe the object surfaces that are frequently touched. (Once an object surface is wiped clean, replace the used wipe with a new one).
2.3空气消毒 2.3 Air Disinfection
1)等离子空气消毒机可以在有人环境下使用,可持续运行进行空气消毒; (1)
Plasma air sterilizers can be used and continuously run for air disinfection in an environment with human activity;
2)无等离子空气消毒机,也可以使用紫外线灯消毒,照射时间1小时,每日三次。 (2) If there is no plasma air sterilizers, use ultraviolet lamps for 1 hour each time. Perform this operation three times a day.
2.4排泄物及污水处置 2.4 Disposal of Fecal Matter and Sewage
1)在进入市政排水管网前需进行消毒处理,定时投加含氯消毒剂,(初次投加,有效氯40mg/L以上),并确保消毒1.5小时; (1) Before being discharged into the municipal drainage system, fecal matter and sewage must be disinfected by treating with chlorine-containing disinfectant (for the initial treatment, the active chlorine must be more than 40 mg/L). Make sure the disinfection time is at least 1.5 hours;
2)消毒后污水应当符合医疗机构水污染物排放标准,总余氯量达10mg/L。 (2) The concentration of total residual chlorine in the disinfected sewage should reach 10 mg/L.
COVID-19患者血液体液呕吐物等溢出处理流程 Disposal Procedures for Spills of COVID-19 Patient Blood/Fluids
3.1少量(<10mL)血液体液溢出 3.1 For spills of a small volume (< 10 mL) of blood/bodily fluids:
1)方案一:含氯消毒湿巾(含有效氯5000mg/L)覆盖作用后去除污
染物,再用含氯消毒湿巾(含有效氯5000mg/L)擦拭2遍;
(1) Option 1: The spills should be covered with chlorine-containing disinfecting wipes (containing 5000 mg/L effective chlorine) and carefully removed, then the surfaces of the object should be wiped twice with chlorine-containing disinfecting wipes (containing 500 mg/L effective chlorine);
2)方案二:用一次性吸水材料如纱布、抹布等,沾取5000mg/L的含氯消毒液,小心移除。 (2) Option 2: Carefully remove the spills with disposable absorbent materials such as gauze, wipes, etc., which have been soaked in 5000 mg/L chlorine-containing disinfecting solution.
3.2大量(>10mL)血液体液溢出 3.2 For spills of a large volume (> 10 mL) of blood and bodily fluids:
1)首先放置好隔离标识; (1) First, place signs to indicate the presence of a spill;
2)采用方案一或方案二执行操作: (2) Perform disposal procedures according to Option 1 or 2 described below:
①方案一:用清洁吸附巾(含过氧乙酸,每张可吸附1L)吸附溢出液体,作用30分钟,去除污染物后进行清洁; ① Option 1: Absorb the spilled fluids for 30 minutes with a clean absorbent towel (containing peroxyacetic acid that can absorb up to 1 L of liquid per towel) and then clean the contaminated area after removing the pollutants.
②方案二:使用含吸水成分的消毒粉或漂白粉完全覆盖,或用一次性吸水材料完全覆盖后用足量的10000mg/L的含氯消毒液浇在吸水材料上(或采用能达到高水平消毒的消毒干巾),作用30分钟以上,小心清除干净。 ② Option 2: Completely cover the spill with disinfectant powder or bleach powder containing water-absorbing ingredients or completely cover it with disposable water-absorbing materials and then pour a sufficient amount of 10,000 mg/L chlorine-containing disinfectant onto the water-absorbing material (or cover with a dry towel which will be subjected to high-level disinfection). Leave for at least 30 minutes before carefully removing the spill.
3)患者溢出的排泄物、分泌物、呕吐物等采用专门容器收集,用含20000mg/L含氯消毒剂,按污染物、消毒剂比例1:2浸泡消毒2小时; (3) Fecal matter, secretions, vomit, etc. from patients shall be collected into special containers and disinfected for 2 hours by a 20,000 mg/L chlorine-containing disinfectant at a spill-to-disinfectant ratio of 1:2.
4)清除污染物后,对污染的环境物体表面进行消毒; (4) After removing the spills, disinfect the surfaces of the polluted environment or objects.
5)盛放污染物的容器可用含有效氯5000mg/L的消毒剂溶液浸泡消毒30分钟,然后清洗干净; (5) The containers that hold the contaminants can be soaked and disinfected with 5,000 mg/L active chlorine-containing disinfectant for 30 minutes and then cleaned.
6)清理的污染物按医疗废物集中处置; (6) The collected pollutants should be disposed of as medical waste.
7)使用后物品均放入双层医疗废物垃圾袋,按医疗废物处理。 (7) The used items should be put into double-layer medical waste bags and disposed of as medical waste.
COVID-19相关可复用医疗器械消毒 Disinfection of COVID-19 Related Reusable Medical Devices
4.1正压头套消毒 4.1 Disinfection of powered air-purifying respirator
正压式头套 Powered air-purifying respirator
电机及背带 Motor and strap
电池表面 Battery surface
颗粒物滤盒 Particulate filter box
呼吸管 Breathing tube
禁止拆下过滤盒 DO NOT detach the filter box
使用1000mg/L含氯消毒剂进行多次反复擦拭,作用30分钟 Repeatedly wipe them with 1000 mg/L chlorine-containing disinfectant and let the disinfectant work for 30 minutes
使用1000mg/L含氯消毒剂
进行浸泡,作用30分钟
Soak in 1000 mg/L chlorine-containing disinfectant for 30 minutes
软布蘸取清洗液(清水)反复均匀擦拭所有部分清水冲洗 Wipe all parts repeatedly and evenly with a soft cloth dipped in the cleaning liquid (clean water)
Wash it with clean water
待干燥后放入自封袋中备用 Let parts dry and place them in a zip lock bag for future use
不要让液体进入主机出风口或电机 Note: Do not let liquid enter the main unit air outlet or motor.
擦拭时需小心清洁位于电机底部的电池触点周围,不要直接接触电池触电。 Note: Please be careful when wiping the battery contacts located at the bottom of the motor. Do not touch the battery contacts directly.
在下次使用或储存之前,确保该区域完全干燥。 Make sure this part is completely dry before next use or storage.
擦拭外表时注意不要触碰滤芯处; Note: Do not touch the filter element when cleaning the outer surface.
根据产品说明书滤芯使用时间及时更换。 Replace the filter element according to the product’s instructions.
备注:以上头罩部分的消毒流程仅针对可复用头罩(一次性头罩除外)。 Note: The disinfection procedures for protective hood described above are only for reusable protective hoods (excluding disposable protective hoods).
4.2消化内镜及支气管镜清洗消毒处理流程 4.2 Cleaning and Disinfection Procedures for Digestive Endoscopy and Bronchofibroscopy
1)将内镜及复用按钮放入0.23%过氧乙酸水槽中(测试消毒液浓度,确保有效使用); (1) Soak the endoscope and reusable valves in 0.23% peroxyacetic acid (confirm the concentration of the disinfectant before use to make sure it will be effective);
2)连接内镜各通道灌流管路,用50毫升注射器往管路里注入0.23%过氧乙酸液体,使之充分充盈,静置5分钟; (2) Connect the perfusion line of each channel of the endoscope, inject 0.23% peroxyacetic acid liquid into the line with a 50 mL syringe until fully filled, and wait for 5 minutes;
3)卸除灌流管路,用一次性内镜专用清洗刷刷洗内镜各腔道及按钮; (3) Detach the perfusion line and wash each cavity and valve of the endoscope with a disposable special cleaning brush;
4)按钮放入含酶超声波震荡仪震荡,内镜连接各通道灌流管路,用50毫升注射器往管路里注入0.23%过氧乙酸液体,持续冲洗5分钟,注入空气干燥1分钟; (4) Put the valves into an ultrasonic oscillator containing enzyme to oscillate it. Connect the perfusion line of each channel with the endoscope. Inject 0.23% peroxyacetic acid into the line with a 50 mL syringe and flush the line continuously for 5 minutes. Inject air to dry it for 1 minute;
5)用50毫升注射器往管路里注入清水,持续冲洗3分钟,注入空气干燥1分钟; (5) Inject clean water into the line with a 50 mL syringe and flush the line continuously for 3 minutes. Inject air to dry it for 1 minute;
6)进行内镜的泄露测试; (6) Perform a leakage test on the endoscope;
7)放入全自动内镜洗消机,设置高水平消毒进行处理; (7) Put in an automatic endoscopic washing and disinfection machine. Set a high level of disinfection for treatment;
8)送消毒供应中心,环氧乙烷灭菌。 (8) Send the devices to the disinfection supply center to undergo sterilization with ethylene oxide.
4.3其他可复用医疗器械预处理 4.3 Pre-treatment of Other Reusable Medical Devices
1)无明显污染物时先用含氯消毒剂1000mg/L浸泡至少30分钟; (1) If there are no visible pollutants, soak the device in 1000 mg/L chlorine-containing disinfectant for at least 30 minutes;
2)有明显污染物时用含氯消毒剂5000mg/L浸泡至少30分钟; (2) If there are any visible pollutants, soak the device in 5000 mg/L chlorine-containing disinfectant for at least 30 minutes;
3)干燥后,密闭打包送消毒供应中心。 (3) After drying, pack and fully enclose the devices and send them to the disinfection supply center.
COVID-19相关感染性织物消毒流程 Disinfection Procedures for Infectious Fabrics of Suspected or Confirmed Patients
5.1感染性织物 5.1 Infectious fabrics
1)患者使用的衣物、床单、被套、枕套; (1) Clothes, bed sheets, bed covers and pillowcases used by patients;
2) 病区床帘; (2) Ward area bed curtains;
3) 环境清洁使用的地巾。 (3) Floor towels used for environmental cleaning.
5.2收集方法 5.2 Collection methods
1) 第一层用一次性水溶性塑料袋包装,用配套扎带封装; (1) First, pack the fabrics into a disposable water-soluble plastic bag and seal the bag with matching cable ties;
2) 第二层用塑料袋包装,用鹅颈式封口,用扎带封装; (2) Then, pack this bag into another plastic bag, seal the bag with cable ties in a gooseneck fashion;
3) 最后装黄色织物袋用扎带封口; (3) Finally, pack the plastic bag into a yellow fabric bag and seal the bag with cable ties;
4) 贴特殊感染标识及科室名称,送洗衣房。 (4) Attach a special infection label and the department name. Send the bag to the laundry room.
5.3存储和洗涤 5.3 Storage and washing
1) 注意与其他感染性织物(非新冠)分开存放,专机洗涤; (1) Infectious fabrics should be separated from other infectious fabrics (non-COVID-19) and washed in a dedicated washing machine;
2) 使用含氯消毒剂洗涤消毒,温度90度,时间不少于30分钟。 (2) Wash and disinfect these fabrics with chlorine-containing disinfectant at 90 ℃ for at least 30 minutes.
5.4运输工具消毒 5.4 Disinfection of transport tools
1) 运输工具专用; (1) Special transport tools should be used specifically for transporting infectious fabrics;
2) 运送感染性织物后一用一消毒; (2) The tools shall be disinfected immediately each time after being used for transporting infectious fabrics;
3) 采用有效氯1000mg/L含氯消毒液擦拭,作用30分钟后,清水擦拭干净。 (3) The transport tools should be wiped with chlorine-containing disinfectant (with 1000 mg/L active chlorine). Leave disinfectant for 30 minutes before wiping the tools clean with clean water.
COVID-19相关医疗废物处理流程 Disposal Procedures for COVID-19 Related Medical Waste
1)疑似或确诊患者所有的废弃物都应视为医疗废物; (1) All waste generated from suspected or confirmed patients shall be disposed of as medical waste;
2)产生的医疗废物放入双层医疗废物袋,鹅颈式封口,扎带封装,喷洒含1000mg/L含氯消毒液; (2) Put the medical waste into a double-layer medical waste bag, seal the bag with cable ties in a gooseneck fashion and spray the bag with 1000 mg/L chlorine-containing disinfectant;
3)利器置入塑料利器盒内,封口后喷洒含1000mg/L含氯消毒液; (3) Put sharp objects into a special plastic box, seal the box and spray the box with 1000 mg/L chlorine-containing disinfectant;
4)置入医疗废物转运箱,上贴特殊感染标识,密闭转运; (4) Put the bagged waste into a medical waste transfer box, attach a special infection label, fully enclose the box and transfer it;
5)专人定时按指定路线回收至医废暂存点,定点单独存放; (5) Transfer the waste to a temporary storage point for medical waste along a specified route at a fixed time point and store the waste separately at a fixed location;
6)由医疗废物回收机构回收处置。 (6) The medical waste shall be collected and disposed of by an approved medical waste disposal provider.
COVID-19相关工作人员职业暴露处理流程 Procedures for Taking Remedial Actions against Occupational Exposure to COVID-19
发生COVID-19相关职业暴露 Occurrence of COVID-19 related occupational exposure
完整皮肤暴露 Intact skin exposure
破损皮肤暴露 Damaged skin exposure
眼睛等黏膜暴露 Exposure of mucous membranes, such as the eyes
锐器伤 Sharp object injury
呼吸道直接暴露 Direct exposure of respiratory tract
干净的纸巾或纱布去除污物,在用0.5%碘伏或75%酒精擦拭消毒3分钟以上,流动水冲洗干净 Remove the contaminants with clean tissues or gauze, then apply 0.5% iodophor or 75% alcohol to the skin and let the solution sit for at least 3 minutes for disinfection, thoroughly
flush with running water
用大量生理盐水冲洗或0.05%碘伏冲洗消毒 Flush with plenty of normal saline or 0.05% iodophor for disinfection
近心端向远心端挤出血液-流动水冲洗伤口-75%酒精或0.5%碘伏消毒 Squeeze blood out from proximal end to distal end → Flush the wound with running water → Disinfect with 75% alcohol or 0.5% iodophor
Immediately leave the isolation area.
立即离开隔离区,用大量生理盐水或0.05%碘伏漱口,用棉签蘸75%酒精轻轻旋转擦拭鼻腔 Gargle with plenty of normal saline or 0.05% iodophor. Dip a cotton swab into 75% alcohol, and wipe in a circular motion the nasal cavity gently
撤离隔离区,进入指定隔离房间 Evacuate from the isolation area and enter the designated isolation room
报告相关部门 Report to relevant departments
除完整皮肤暴露外,其余情况暴露者单间隔离观察14天,如有症状及时报告相关部门 Isolate and observe people with exposures other than intact skin exposure for 14 days. In case of symptoms, report to the relevant departments in a timely manner
1)皮肤暴露:被大量肉眼可见的患者体液、血液、分泌物或排泄物等污物直接污染皮肤; (1) Skin exposure: The skin is directly contaminated by a large amount of visible bodily fluids, blood, secretions or fecal matter from the patient.
2)粘膜暴露:被肉眼可见的患者体液、血液、分泌物或排泄物等污物直接污染粘膜(如眼睛、呼吸道); (2) Mucous membrane exposure: Mucous membranes, such as the eyes and respiratory tract are directly contaminated by visible bodily fluids, blood, secretions or fecal matter from the patient.
3)锐器伤:被直接接触了确诊患者体液、血液、分泌物或排泄物等污物的锐器刺伤; (3) Sharp object injury: Piercing of the body by sharp objects that were directly exposed to the patient's bodily fluids, blood, secretions or fecal matter.
4)呼吸道直接暴露:在未戴口罩的确诊患者1米范围内口罩脱落,暴露口或鼻。 (4) Direct exposure of respiratory tract: Falling off of a mask, exposing the mouth or nose to a confirmed patient (1 miter away) who is not wearing a mask.
COVID-19患者相关手术感控流程 Surgical Operations for Suspected or Confirmed Patients
8.1手术室环境及人员防护要求 8.1 Requirements for Operation Rooms and Staff PPE
1)安排在负压手术室。 (1) Arrange the patient in a negative pressure operating room.
提前开启负压手术室,保持合适温度、湿度及负压; Verify the temperature, humidity and air pressure in the operation room;
2)备齐手术必需物品,尽量使用一次性的手术物品; (2) Prepare all required items for the operation and use disposable surgical items if possible;
3)所有进入手术间参与手术人员(包括手术医生、麻醉医生、洗手护士、手术室巡回护士)均在缓冲间穿戴好防护用品:戴双层帽子,医用防护口罩,医用护目镜,医用防护服,靴套,乳胶手套,正压头套; (3) All surgical personnel (including surgeons, anesthesiologists, hand-washing nurses, and charge nurses in operating room) should put on their PPE in the buffer room before entering the operating room: Put on double caps, medical protective mask (N95), medical goggles, medical protective clothing, boot covers, latex gloves, and powered air-purifying respirator;
4)手术操作人员及洗手护士在以上基础上穿戴一次性无菌手术衣、无菌手套; (4) The surgeons and the hand-washing nurses should wear disposable sterile operating clothes and sterile gloves in addition to the PPE as mentioned above;
5)患者根据情况可戴一次性帽子及一次性外科口罩; (5) Patients should wear disposable caps and disposable surgical masks according to their situation;
6)缓冲间巡回护士在负压手术间缓冲区内负责物品传递; (6) The charge nurses in the buffer room are responsible for delivering items from the buffer area to the negative pressure operating room;
7)手术期间,关闭缓冲间及手术间门,手术间达到负压状态方可实施手术; (7) During the operation, the buffer room and the operating room shall be tightly closed, and the operation must be carried out only if the operation room is under negative pressure;
8)杜绝无关人员进入该手术间。 (8) Irrelevant personnel shall be excluded from entering the operating room.
8.2手术后的终末消毒处理流程 8.2 Procedures for Final Disinfection
1)医疗废物:按新冠相关医疗废物处理; (1) Medical waste shall be disposed of as COVID-19 related medical waste;
2)可复用医疗器械:按新冠相关可复用医疗器械消毒流程消毒处理; (2) Reusable medical devices shall be disinfected according to the disinfection procedures of SARS-CoV-2 related reusable medical devices;
3)医用织物:按新冠相关感染性织物消毒流程消毒处理; (3) Medical fabrics shall be disinfected and disposed of according to the disinfection procedures for SARS-CoV-2 related infectious fabrics;
4)物体(器械台、操作台、手术床等仪器设备)表面: (4) Surfaces of objects (instruments and devices including device table, operating table, operating bed, etc.);
①有肉眼可见血液、体液污染时,应先完全清除污染物再消毒(按血液体液等溢出处理); ① Visible blood/bodily fluid pollutants shall be completely removed before disinfection (handled in accordance with disposal procedures of blood and bodily fluid spills).
②无肉眼可见污染物时,使用含1000mg/L有效氯的消毒剂擦拭保持作用30分钟; ② All surfaces shall be wiped with a disinfectant containing 1000 mg/L active chlorine and allowed to sit for 30 minutes with the disinfectant.
5)地面、墙壁: (5) Floors and walls:
①有肉眼可见血液、体液污染时,应先完全清除污染物再消毒(按血液体液等溢出处理); ① Visible blood/bodily fluid pollutants shall be completely removed before disinfection (handled in accordance with disposal procedures of blood and bodily fluid spills).
②无肉眼可见污染物时,使用含1000mg/L有效氯的消毒剂擦拭保持作用30分钟; ② All surfaces shall be wiped with a disinfectant containing 1000 mg/L active chlorine and allowed to sit for 30 minutes with the disinfectant.
6)室内空气:关闭层流、送风;使用紫外线灯照射消毒至少1小时;再开启机组自净至少2小时。 (6) Indoor air: Turn off the fan filter unit (FFU). Disinfect the air by irradiation by ultraviolet lamp for at least 1 hour. Turn on the FFU to purify the air automatically for at least 2 hours.
COVID-19疑似/确诊患者尸体处理流程 Procedures for Handling Bodies of Deceased Suspected or Confirmed Patients
1)个人防护:工作人员做好个人防护:穿戴工作服、一次性工作帽、一次性手套和长袖加厚橡胶手套、医用一次性防护服、医用防护口罩或动力送风过滤式呼吸器、防护面屏、工作鞋或胶靴、防水靴套、防水围裙或防水隔离衣等; (1) Staff PPE: The staff must make sure they are fully protected by wearing work clothes, disposable surgical caps, disposable gloves and thick rubber gloves with long sleeves, medical disposable protective clothing, medical protective masks (N95) or powered air purifying respirators (PAPRs), protective face shields, work shoes or rubber boots, waterproof boot covers, waterproof aprons or waterproof isolation gowns, etc.
2)尸体护理:用3000-5000mg/L的含氯消毒剂或0.5%过氧乙酸棉球或纱布填塞患者口、鼻、耳、肛门、气管切开处等所有开放通道或创口; (2) Corpse care: Fill all openings or wounds the patient may have, such as mouth, nose, ears, anus and tracheotomy openings, by using cotton balls or gauze dipped in 3000-5000 mg/L chlorine-containing disinfectant or 0.5% peroxyacetic acid.
3)包裹:用浸有消毒液的双层布单包裹尸体,装入双层密闭防渗漏含氯消毒液的尸体包裹单; (3) Wrapping: Wrap the corpse with a double-layer cloth sheet soaked with disinfectant, and pack it into a double-layer, sealed, leak-proof corpse wrapping sheet soaked with chlorine containing disinfectant.
4)由医院隔离病区工作人员经污染区至专用电梯送出病区,派专用车辆直接送至指定地点尽快火化; (4) The body shall be transferred by the staff in the isolation ward of the hospital via the contaminated area to the special elevator, out of the ward and then directly transported to a specified location for cremation by a special vehicle as soon as possible.
5)终末消毒:病室及电梯进行终末消毒。 (5) Final disinfection: Perform final disinfection of the ward and the elevator.
五.数字化支撑疫情防控 V. Digital Support for Epidemic Prevention and Control
降低患者就诊交叉感染风险 Reduce the Risk of Cross Infection when Patients Seek Medical Care
1)提供并引导公众利用互联网医院功能处理慢病等非紧急医疗需求,减少实体医院人流量,降低就诊的交叉感染风险; (1) Guide the public to get access to non-emergency services such as chronic diseases treatment online so as to decrease the number of visitors in healthcare facilities. Doing so minimizes the risk of cross infection.
2)对于必须前往医院的患者,通过互联网医院精确预约就诊时段,给予交通、停车、到达时间、防护措施、分诊信息、室内导航等必要的指导,并提前在线做好患者的全面资料收集,提高诊疗效率,减少患者在医院滞留时间; (2) Patients who must visit healthcare facilities should make an appointment through other means, including Internet portals, which provides necessary guidance in transportation, parking, arrival time, protective measures, triage information, indoor navigation, etc. Collect comprehensive information online by patients in advance to improve the efficiency of diagnosis and treatment and limit the duration of the patient’s visit.
3)引导患者充分利用数字化自助设备,减少人群接触,降低交叉感染风险。 (3) Encourage patients to take full advantage of digital self-service devices to avoid contact with others so as to lower the risk of cross infections.
降低医务人员工作强度和感染风险 Lower Work Intensity and Infection Risk of Medical Personnel
1)通过远程会诊、远程MDT,汇聚专家智慧,给疑难病症以最佳治疗方案; (1) Collect shared knowledge and experience of experts through remote consultation and multidiscipline team (MDT) to offer the optimum therapeutics for difficult and complicated cases.
2)利用移动查房和远程查房,减少医务人员不必要的暴露风险,降低工作强度,节约防护物资; (2) Take mobile and remote rounds to lower unnecessary exposure risks and work intensity of medical personnel while saving protective supplies.
3)通过电子健康码和提前推送的在线流行病学调查问卷,掌握患者最新的健康状况,一方面指导患者,特别是发热或疑似患者有效分流就诊;另一方面,保证医务人员在各个业务节点均能提前识别患者健康状况,有效防范感染风险; (3) Access the patients’ latest health conditions electronically through health QR codes (note: everyone is required to obtain a GREEN code through the health QR system to travel around the city) and online epidemiological questionnaires in advance to provide triage guidance to the patients, especially those with fever or suspected cases, while effectively preventing the risk of infection.
4)利用发热门诊患者专科电子病历和新冠肺炎CT影像AI系统,降低工作强度,快速识别疑似患者,减少漏诊。 (4) Electronic health records of patients in fever clinics and the CT imaging AI system for COVID-19 can help reduce the work intensity, quickly identify highly-suspected cases and avoid missed diagnoses.
快速响应抗疫紧急需求 Rapid Response to Emergency Needs of COVID-19 Containment
1)基于云医院系统弹性扩展业务所需的数字化基础资源,即时部署疫情应急响应所需的信息系统,
例如新设立的发热门诊、发热留观室和隔离病房等抗疫专设部门所需的数字化系统;
(1) Basic digital resources required by a cloud-based hospital system allows for immediate usage of the information systems needed for emergency response to the epidemic, such as the digital systems equipped for newly established fever clinics, fever observation rooms and isolation wards.
2)利用互联网架构的医院信息系统,一方面实现医务人员在线培训并一键部署使用系统,另一方面方便系统运维人员实时远程维护,快速发布业务所需新功能。 (2) Utilize the hospital information system based on the Internet infrastructure frame to conduct online training for healthcare workers and one-click deployment system, and to
facilitate the operation and support engineers to perform remote maintenance and new functions update for medical care.
【浙一互联网医院—互联网医疗典范】 【FAHZU Internet + Hospital - A Model for Online Healthcare】
自疫情发生以来,浙一互联网医院快速加入浙江省互联网医院新冠肺炎义诊通道,开设专家团队义诊,提供24小时免费在线答疑,为全国乃至全球的患者提供远程医疗服务,让患者足不出户就能享受到浙大一院优质医疗服务,也减少了因为就医而引起的疫情播散和院内交叉感染。 Since the outbreak of COVID 19, FAHZU Internet+ Hospital quickly shifted to offer online healthcare through Zhejiang’s Online Medical Platform with 24-hour free online consultation, providing telemedicine service to patients in China and even around the world.
Patients are provided access to the first-rate medical services of FAHZU at home, which reduces the chances of transmission and cross infection as a result of their visits to the hospital.
截至3月14日,浙一互联网医院共在线服务患者逾万人。 As of March 14, over 10,000 people have used the FAHZU Internet+ Hospital online service.
●浙江省互联网医院使用说明 ·Instructions for Zhejiang Online Medical Platform:
①下载支付宝APP; ① Download Alipay app;
②打开支付宝(国内版)便可进入“浙江省互联网医院平台”; ② Open Alipay (China Version) and find “Zhejiang Provincial Online Medical Platform”;
③选择医院(浙江大学医学院附属第一医院); ③ Choose a hospital (The First Affiliated Hospital, Zhejiang University School of Medicine);
④咨询申请,等待接诊; ④ Post your question and wait for a doctor to respond;
⑤医生接诊后会有消息提醒,打开支付宝,点击【朋友】-【生活号】; ⑤ A notification will pop up when a doctor replies. Then open Alipay and click Friends;
⑥点击【浙江省互联网医院平台】,进入查看详情,进入咨询。 ⑥ Click Zhejiang Online Medical Platform to see more details and start your consultation.
【构建浙大一院国际医生交流平台实践】 【Establishing the International Medical Expert Communication Platform of the First Affiliated Hospital, Zhejiang University School of Medicine】
随着疫情发展,为了提高国际救治水平,浙大一院联合阿里巴巴创建了 “浙大一院国际医生交流平台”,通过在线实时多语言翻译、远程音视频会议等功能实现国内外医生的即时抗疫经验交流,达到全球信息资源共享。 Due to the spread of the COVID-19 epidemic, the First Affiliated Hospital, Zhejiang University School of Medicine (FAHZU) and Alibaba jointly established the International Medical Expert Communication Platform of FAHZU with an aim to improve the quality of care and treatment and promote the sharing of global information resource. The platform allows medical experts all over the world to connect and share their invaluable experience in the fight against COVID-19 through instant messaging with real-time translation, remote video conferencing, etc.
●浙大一院国际医生交流平台使用说明 ·Instructions on the International Medical Expert Communication Platform of The First Affiliated Hospital, Zhejiang University School of Medicine
呼吸道标本采集、核酸检测和病毒培养等操作,个人防护应按照BSL-3级实验室防护要求。 Personal protection should be taken in accordance with BSL-3 laboratory protection requirements for Respiratory tract specimen collection, nucleic acid detection and virus culture operations.
血常规、生化、免疫检验等常规检验操作,个人防护应按照BSL-2级实验室防护要求。 Personal protection in accordance with BSL-2 laboratory protection requirement should be carried out for biochemical, immunological tests and other routine laboratory tests.
标本运送应采用符合生物安全要求的专用运输罐和运输箱。 Specimens should be transported in special transport tanks and boxes that meet biosafety requirements.
所有实验室废弃物均应严格高压消毒处理。 All laboratory waste should be strictly autoclaved.
三. COVID-19患者肺部影像学表现 III. Imaging Findings of COVID-19 Patients
肺部影像学检查在COVID-19诊断、疗效监测及出院评估中具有重要价值。 Thoracic imaging is of great value in the diagnosis of COVID-19, monitoring of therapeutic efficacy, and patient discharge assessment.
检查方法首选肺部高分辨率CT;对于不便搬动的危重型患者,可选择床旁X线检查。 A high-resolution CT is highly preferable. Portable chest X-rays are helpful for critically ill patients who are immobile.
一般于入院当日行基线肺部CT检查,若治疗后疗效不理想,2~3d后可复查肺部CT;治疗后症状稳定或好转,可5~7d后复查 CT for baseline evaluation of patients with COVID-19 is usually performed on the day of admission, or if ideal therapeutic efficacy is not reached, it can be re-performed after 2 to 3 days. If symptoms are stable or improved after treatment, the chest CT scan can be reviewed after 5 to 7 days.
危重型患者须每日复查床边胸片。 Daily routine portable chest X-rays are recommended for critically ill patients.
COVID-19患者肺部CT早期多表现为位于肺外带、胸膜下、下叶分布的多发性斑片状磨玻璃阴影,病灶长轴多与胸膜平行; COVID-19 at the early stage often presents with multifocal patchy shadows or ground glass opacities located in the lung periphery, subpleural area, and both lower lobes on chest CT scans. The long axis of the lesion is mostly parallel to the pleura.
部分磨玻璃样病灶内可见小叶间隔增厚和小叶内间隔增厚,呈细小网格状,为“铺路石征“; Interlobular septal thickening and intralobular interstitial thickening, displaying as subpleural reticulation namely a "crazy paving" pattern, is observed in some ground glass opacities.
少数病例可表现为单发、局部病变,或表现为沿支气管分布、伴周边磨玻璃样改变的结节/斑片状病灶。 A small number of cases may show solitary, local lesions, or nodular/ patchy lesion distributed consistent with bronchus with peripheral ground glass opacities changes.
病情进展多发生在病程7-10天,可表现为病灶范围扩大,大片肺实变,内可见支气管充气征。 Disease progression mostly occurs in the course of 7-10 days, with enlarged and increased density of the lesions compared with previous images, and consolidated lesions with air bronchogram sign.
危重症患者可表现为实变范围进一步扩大,全肺密度增高实变,呈“白肺”征像。 Critical cases may show further expanded consolidation, with the whole lung density showing increased opacity, sometimes known as a "white lung".
病情缓解后,磨玻璃样阴影可完全吸收,部分实变病灶会遗留条索样或网格样纤维化病灶。 After the condition is relieved, the ground glass opacities can be completely absorbed, and some consolidation lesions will leave fibrotic stripes or subpleural reticulation.
对于病变累及多叶,尤其是动态观察发现病灶范围增大者,须警惕疾病加重。 Patients with multiple lobular involvement, especially those with expanded lesions should be observed for disease exacerbation.
具备典型肺部CT表现者,即使核酸检测阴性,亦应隔离并连续行核酸检测(见图1-6)。 Those with typical CT pulmonary manifestations should be isolated and undergo continuous nucleic acid tests even if the nucleic acid test of SAR-CoV-2 is negative.
COVID-19肺CT典型表现: Typical CT features of COVID-19 :
图1、图2 磨玻璃渗出; Figure 1, Figure 2: patchy ground glass opacities;
图3 结节及斑片状渗出; Figure 3: nodules and patchy exudation;
图4、图5 肺实变; Figure 4, Figure 5: multifocal consolidation lesions;
图6 广泛实变,表现为“白肺 Figure 6: diffuse consolidation, "white lung".
四. COVID-19患者诊治中支气管镜技术的应用 IV. Application of Bronchoscopy in the Diagnosis and Management of COVID-19 Patients
支气管镜技术在COVID-19患者诊治中具有以下价值: Flexible bronchoscopy is versatile, easy to use, and well tolerated in mechanically ventilated COVID-19 patients. Its applications include:
1)留取深部气道标本,提升病毒核酸检出阳性率及病原体培养准确率,合理指导抗菌药物应用; (1) Collection of Respiratory specimens from the lower Respiratory tract (i.e. sputum, endotracheal aspirate, bronchoalveolar lavage) for SARS-CoV-2 or other pathogens guides the selection of appropriate antimicrobials, which may lead to clinical benefits. Our experience indicates that lower respiratory specimens are more likely to be positive for SAR-CoV-2 than upper Respiratory specimens.
2)吸痰,清除血痂,解除气道梗阻; (2) Can be used for localization of the site of bleeding, cessation of hemoptysis, sputum or blood clots removal; if the site of bleeding is identified by bronchoscopy, local injection of cold saline, epinephrine, vasopressin, or fibrin as well as laser treatment can be per formed via the bronchoscope.
3)协助建立人工气道,引导气管插管或经皮气管切开; (3) Assist in the establishment of artificial airways; guide tracheal intubation or percutaneous tracheotomy.
4)气道内给药,如滴注α-干扰素、N-乙酰半胱氨酸。 (4) Drugs such as infusion of α-interferon and N-acetylcysteine can be administrated via the bronchoscope.
危重症患者气管镜下可见支气管粘膜广泛充血肿胀,管腔内大量粘液样分泌物潴留,严重者可见粘稠胶冻样痰液堵塞气道,见图7。 Bronchoscopic views of extensive bronchial mucosal hyperemia, swelling, mucus-like secretions in the lumen and jelly-like sputum blocking the air way in critically ill patients.
(Figure 7).
图7 COVID-19气管镜下表现:支气管粘膜肿胀充血;管腔内见大量粘液样分泌物 Figure 7: Bronchoscopic manifestations of COVID-19: bronchial mucosa swelling and congestion; large amounts of mucus secretions in the lumen
五. COVID-19诊断与临床分型 V. Diagnosis and Clinical Classification of COVID-19
临床上应做到早诊断、早治疗、早隔离。 Early diagnosis, treatment and isolation should be carried out whenever possible.
动态观察肺部影像、氧合指数、细胞因子水平,早期发现有重症、危重症倾向的患者。 Dynamic monitoring of lung imaging, oxygenation index and cytokine levels are helpful for early identification of patients who may develop into severe and critical cases.
SARS-CoV-2核酸阳性是COVID-19确诊的金标准,但核酸检测存在假阴性现象,因此对于肺部CT高度疑似COVID-19者,即使核酸检测阴性,可先按临床诊断病例处理,进行隔离治疗并连续进行标本联合送检。 A positive result of the nucleic acid of SARS-CoV-2 is the gold standard for the diagnosis of COVID-19. However, considering the possibility of false negatives in nucleic acid detection, suspected cases characteristic manifestations in CT scans can be treated as confirmed cases even if the nucleic acid test is negative. Isolation and continuous tests of multiple specimens should be carried out in such cases.
COVID-19诊断标准遵循我国新冠病毒肺炎诊疗方案,综合流行病学史(包括聚集性发病)、临床症状(发热和呼吸道症状)、肺部影像、SARS-CoV-2核酸检测、血清特异性抗体等因素来明确诊断。 The diagnostic criteria follow Protocol s for the Diagnosis and Treatment of COVID-2019. A confirmed case is based on epidemiological history (including cluster transmission), clinical manifestations (fever and Respiratory symptoms), lung imaging, and result s of SARS-CoV-2 nucleic acid detection and serum-specific antibodies.
临床上分为: Clinical Classifications:
轻型,临床症状轻微,影像学未见肺炎表现; Mild Cases
The clinical symptoms are mild and no pneumonia manifestations can be found in imaging.
普通型,具有发热、呼吸道等症状,影像学可见肺炎表现; Moderate Cases
Patients have symptoms such as fever and Respiratory tract symptoms, etc. and pneumonia manifestations can be seen in imaging.
重型,成人符合下述任何一条者:呼吸频率≥30次/min;或静息状态下指氧饱和度≤ Severe Cases
Adult s who meet any of the following criteria: Respiratory rate ≥ 30 breaths/min;
93%;或者动脉血氧分压(PaO2)/吸氧浓度(FiO2)≤300mmHg;肺部影像学显示24-48小时内病灶明显进展>50%者按重型管理; oxygen saturation ≤ 93% at a rest state; arterial partial pressure of oxygen (PaO2)/oxygen concentration (FiO2) ≤ 300 mmHg.
Patients with > 50% lesions progression within 24 to 48 hours in lung imaging should be treated as severe cases.
危重型,符合以下情况之一者:出现呼吸衰竭且需要机械通气;或者出现休克;或者合并其他器官功能衰竭需ICU监护治疗。 Critical Cases
Meeting any of the following criteria: occurrence of Respiratory failure requiring mechanical ventilation; presence of shock; other organ failure that requires monitoring and treatment in the ICU.
针对危重型,我们根据氧合指数、呼吸系统顺应性等情况,进一步分为早期、中期、晚期。 Critical cases are further divided into early, middle and late stages according to the oxygenation index and compliance of Respiratory system.
●早期:100mmHg<氧合指数≤150mmHg,呼吸系统顺应性≥30mL/cmH2O,未合并肺以外脏器功能衰竭的,通过积极抗病毒、抗细胞因子风暴、对症支持处理,恢复机会较大。 ● Early stage: 100 mmHg  index ≤150 mmHg; compliance of Respiratory system ≥30 mL / cmH2O; without organ failure other than the lungs. The patient has a great chance of recovery through active antiviral, anti-cytokine storm, and supportive treatment.
●中期:指氧合指数60mmHg<氧合指数≤100mmHg,30mL/cmH2O>呼吸系统顺应性≥15mL/cmH2O,可同时合并其他脏器功能轻中度受损。 ● Middle stage: 60 mmHg < oxygenation index ≤100 mmHg; 30 mL/cmH2O > compliance of Respiratory system ≥15 mL/cmH2O; may be complicated by other mild or moderate dysfunction of other organs.
●晚期:指氧合指数≤60mmHg,呼吸系统顺应性<15mL/cmH2O两肺弥漫性实变,需要人工膜肺支持,或出现其他重要脏器功能衰竭的,死亡风险显著提高。 ● Late stage: oxygenation index ≤ 60 mmHg; compliance of Respiratory system <15 mL/cmH2O; diffuse consolidation of both lungs that requires the use of ECMO; or failure of other vital organs. The mortality risk is significantly increased.
六. 抗病毒治疗及时消除病原体 VI. Antiviral Treatment for Timely Elimination of Pathogens
抗病毒治疗越早越好,可以减少重症、危重症的发生。 An early antiviral treatment can reduce the incidence of severe and critical cases.
COVID-19虽然缺乏有明确临床证据的有效抗病毒药物,根据我国新冠病毒肺炎诊疗方案,结合冠状病毒结构特征,现阶段我们采取的抗病毒策略如下: Although there is no clinical evidence for effective antiviral drugs, currently the antiviral strategies based on the characteristics of SAR-CoV-2 are adopted according to Protocols for Diagnosis and Treatment of COVID-19: Prevention, Control, Diagnosis and Management.
抗病毒方案 Antiviral Treatment
我们以洛匹那韦/利托那韦片2片po q12h联合阿比多尔片200mg po tid作为基础方案;使用该方案,49例患者出现第一次病毒核酸检测阴性平均时间为12d(95%可信 At FAHZU, lopinavir/ritonavir (2 capsules, po q12h) combined with arbidol (200 mg poq12h) were applied as the basic regimen. From the treatment experience of 49 patients in our hospital, the average time to achieve negative viral nucleic acid test for the first time was 12 days (95% CI: 8-15 days).
区间8~15d),持续病毒核酸检测阴性时间(持续2次以上病毒核酸检测阴性且两次
间隔24h)为13.5d(95%可信区间9.5~17.5d)。
The duration of negative nucleic acid test result (negative for more than 2 times consecutively with interval ≥ 24h) was 13. 5 days (95% CI: 9.5 - 17.5 days).
基础方案效果不佳,可以尝试使用磷酸氯喹(18岁-65岁成人。体重>50公斤者,每次500mg bid;体重<50公斤者,第一、二天每次500mg bid,第三至第七天每次500mg qd)。 If the basic regimen is not effective, chloroquine phosphate can be used on adults between 18- 65 years old (weight ≥ 50 kg: 500 mg bid; weight ≤ 50 kg: 500 mg bid for first two days, 500 mg qd for following five days).
我国新冠病毒肺炎诊疗方案推荐使用干扰素雾化吸入治疗,我们建议在负压病房进行。因雾化易诱发气溶胶播散,不建议普通病房内开展雾化吸入治疗。 Interferon nebulization is recommended in Protocols for Diagnosis and Treatment of COVID-19. We recommend that it should be performed in negative-pressure wards rather than general wards due to the possibility of aerosol transmission.
根据艾滋病患者用药经验,达芦那韦/考比司他的不良反应相对较轻,体外病毒抑制试验具有一定程度抗病毒活性,对不耐受洛匹那韦/利 Darunavir/cobicistat has some degree of antiviral activity in viral suppression test in vitro, based on the treatment experience of AIDS patients, and the adverse events are relatively mild.
托那韦的患者,在通过伦理审查后可考虑口服达芦那韦/考比司他(1片 qd)或者法匹那韦(首剂1600mg,后续600mg tid)代替。 For patients who are intolerant to lopinavir/ritonavir, darunavir/cobicistat (1 tablet qd) or favipiravir (star ting dose of 1600 mg followed by 600 mg tid) is an alternative option after the ethical review.
不建议同时应用3种及以上抗病毒药物。 Simultaneous use of three or more antiviral drugs is not recommended.
疗程 Course of Treatment
磷酸氯喹疗程≤7天;其他方案的疗程尚未确定,一般为2周,或痰液病毒核酸检测结果持续3次以上阴性可考虑停用抗病毒药物。 The treatment course of chloroquine phosphate should be no more than 7 days. The treatment course of other regimens has not been determined and are usually around 2 weeks. Antiviral drugs should be stopped if nucleic acid test results from sputum specimens remain negative for more than 3 times.
七. 抗休克及抗低氧血症维持生命体征 VII. Anti-shock and Anti-hypoxemia Treatment
COVID-19从重型向危重型发展时,患者可出现严重低氧血症、细胞因子风暴、继发重型感染,进而发生休克,出现组织灌注障碍,甚至多器官功能衰竭,治疗上以纠正诱发因素和液体复苏为主。 During the progression from the severe to critically ill stage, patients may develop severe hypoxemia, cytokine cascade and severe infections that might develop into shock, tissue per fusion disorders, and even multiple organ failure. Treatment is aimed at incentive removal and fluid recovery.
人工肝血液净化系统可迅速清除炎症介质,消除细胞因子风暴,可阻断休克和低氧血症、呼吸窘迫的发生。 The artificial liver support system (ALSS) and blood purification can effectively diminish inflammatory mediators and cytokine cascade and prevent the incidence of shock, hypoxemia and Respiratory distress syndrome.
酌情使用糖皮质激素 Usage of Glucocorticoids when Necessary
对于重型、危重型,早期、适量、短程糖皮质激素治疗既有利于控制细胞因子炎症风暴,阻止病情进展,缩短病程,又可避免长期大量使用糖皮质激素导致的不良反应和并发症。 Appropriate and short-term use of corticosteroids to inhibit cytokine cascade and to prevent disease progression should be considered for patients with severe COVID-19 pneumonia as early as possible. However, a high dose of glucocorticoids should be avoided due to adverse event s and complications.
1.1适应证 1.1 Indication for Corticosteroids
①符合重型、危重型诊断者可早期使用; ① for those in severe and critically ill stage;
②高热(体温超过39°C)持续不退; ② for those with persistent high fever (temperature above 39°C);
③影像学提示受累肺叶面积大(30%以上肺叶受累),有磨玻璃渗出; ③ for those whose computerized tomography (CT) demonstrated patchy ground-glass attenuation or more than 30% area of the lungs are involved;
④肺部影像学表现进展迅速且受累面积明显增多(48h复查肺部CT提示进展超过50%); ④ for those whose CT demonstrated rapid progression (more than 50% area involved in pulmonary C T images within 48 hours);
⑤IL-6≥5倍正常值上限。 ⑤ for those whose IL-6 is above ≥ 5 ULN.
1.2使用方法 1.2 Application of Corticosteroids
根据炎症损伤程度,甲泼尼龙琥珀酸钠(甲强龙)常规起始剂量每天0.75~1.5mg/kg分1~2次静脉注射;对于常规剂量不能控制体温,或者细胞因子仍然显著升高的重症患者可以考虑40mg q12h,危重症患者可以使用40mg-80mg q12h。 Initial routine methylprednisolone at a dose of 0.75~1.5 mg/kg intravenously once a day (nearly 40 mg once or twice a day) is recommended. However, methylprednisolone at a dose of 40 mg q12h can be considered for patients with falling body temperature or for patients with significantly increased cytokines under routine doses of steroid. Even methylprednisolone at a dose of 40 mg-80 mg q12h can be considered for critical cases.
治疗期间,密切监测体温、血氧饱和度,每隔2~3d复查血常规、C反应蛋白、细胞因子、生化指标、血糖、肺部CT等评估病情及疗效。 Closely monitor body temperature, blood oxygen saturation, blood routine, C-reactive protein, cytokines, biochemical profile and lung CT every 2 to 3 days during the treatment as necessary.
如病情改善,体温正常,或肺部影像有吸收,则每3~5d激素减半,减至每日20mg/d后序贯甲泼尼龙(美卓乐)口服,根据病情确定疗程。 The dosage of methylprednisolone should be halved every 3 to 5 days if medical conditions of patients are improved, the body temperature normalizes, or involved lesions on CT are significantly absorbed. Oral methylprednisolone (Medrol) once a day is recommended when the intravenous dose is reduced to 20 mg per day. The course of corticosteroids in not defined; some expert s have suggesting ceasing corticosteroids treatment when patients are nearly recovered.
1.3治疗期间注意事项 1.3 Special Consideration during Treatment
①治疗前完善结核菌感染T细胞斑点(T-SPOT)试验、乙型肝炎病毒和丙型肝炎病毒标志物等检测,避免在激素治疗过程中激活潜在感染; ① screening of TB by T-SPOT assay, HBV and HCV by antibody assay should be performed before corticosteroid therapy;
②根据情况应用质子泵抑制剂、钙剂预防并发症; ② proton pump inhibitors could be considered to prevent complications;
③监测血糖,一旦出现血糖升高,皮下注射胰岛素控制血糖; ③ blood glucose should be monitored. High blood glucose should be treated with insulin when necessary;
④监测血钾,纠正低钾血症; ④ low serum potassium should be corrected;
⑤监测肝功能,及时进行护肝治疗; ⑤ liver function should be monitored closely;
⑥出现多汗、自汗者,可试用中药; ⑥ traditional Chinese herbal medicine may be considered for patients who are sweating;
⑦出现兴奋、睡眠障碍者,临时给予镇静催眠药。 ⑦ sedative-hypnotics can be administered temporarily for patients with sleep disorder.
人工肝治疗消除细胞因子风暴 Artificial Liver Treatment for Suppression of Cytokine Cascade
人工肝系统集成血浆置换、吸附、灌流,血液/血浆滤过等技术,用于清除炎症介质、内毒素及中小分子有毒有害物质,补充白蛋白、凝血因子等有益物质,调节水电解质、酸碱平衡;能阻断“细胞因子风暴”,纠正休克,减轻肺部炎症,改善呼吸功能;同时有助于恢复机体免疫稳态、改善体内代谢紊乱状态、有利于容量精准管理、改善肝、肾等多器官功能,以提高重型、危重型患者的救治成功率,降低病死率。 The artificial liver support system (ALSS) can conduct plasma exchange, adsorption, per fusion, and filtration of inflammatory mediators such as endotoxins and harmful metabolic substances of small or medium molecular weight. It can also provide serum albumin, coagulation factors, balance fluid volume, electrolytes and acid-base ratio, and manifest anti-cytokine storms, shock, lung inflammation, et al. In doing so it can also help to improve multiple organ functions including the liver and kidney. Thus, it can increase treatment success and reduce the mortality of severe patients.
2.1适应证 2.1 Indication for ALSS
①血炎症因子(如IL-6等)浓度≥正常上限5倍,或每日上升速度≥1倍; ① serum inflammatory indicator (such as IL-6) level rises to ≥ 5 ULN, or rising rate is ≥1 time per day;
②肺部影像学快速进展,CT或X线提示肺受累百分比每天进展10%或以上; ② involved area of pulmonary C T or X-ray images ≥10% progression per day;
③基础疾病需要人工肝治疗患者; ③ artificial liver support system is required for the treatment of underlying diseases.
符合①+②的患者,或符合③的患者。 Patients meeting ① + ②, or patients meeting ③.
2.2相对禁忌证 2.2 Contraindications
在危重型患者抢救中,无绝对禁忌证,但出现以下情况须谨慎使用: There is no absolute contraindication in the treatment of critically ill patients. However, ALSS should be avoided in the following situations:
①严重活动性出血或弥漫性血管内凝血者; ①Severe bleeding disease or disseminated intravascular coagulation;
②对治疗过程中所用血制品或药品如血浆、肝素和鱼精蛋白等严重过敏者; ② Those who are highly allergic to blood component s or drugs used in the treatment process such as plasma, heparin and protamine;
③急性脑血管意外或严重颅脑损伤者; ③ Acute cerebrovascular diseases or severe head injury;
④慢性心功能不全,心功能分级为III级及以上者; ④ Chronic cardiac failure, cardiac functional classification ≥ grade III;
⑤尚未纠正的低血压、休克; ⑤ Uncontrolled hypotension and shock;
⑥严重的心律失常。 ⑥ Severe arrhythmia.
建议进行血浆置换联合血浆吸附或双重血浆分子吸附、灌流及滤过,血浆置换量建议2000mL以上。 Plasma exchange combined with plasma adsorption or dual plasma molecular adsorption, per fusion, and filtration is recommended according to the patients’ situation. 2000 mL of plasma should be exchanged when ALSS is per formed.
具体操作方案请参考《人工肝血液净化系统应用于重型、危重型新型冠状病毒肺炎治疗的专家共识》。 Detailed operating procedures can be found in the Expert Consensus on the Application of Artificial Liver Blood Purification System in the Treatment of Severe and Critical Novel Coronavirus Pneumonia.
我院经过人工肝治疗的危重型患者,ICU住院时间明显缩短;血清细胞因子IL-2/IL-4/IL-6/TNF-α水平显著下降,呼吸改善,氧饱和度提升。 ALSS significantly reduces the time that critically ill patients stay in the ICU in our hospital. Typically, the level s of serum cytokines such as IL-2/IL-4/IL-6/TNF-α are remarkably decreased, and oxygen saturation is significantly improved after ALSS.
氧疗纠正低氧血症 Oxygen Therapy for Hypoxemia
COVID-19呼吸功能受损以低氧血症最为突出。 Hypoxemia can present due to impaired Respiratory functions by COVID-19.
如何及时、有效地纠正低氧血症、缓解患者呼吸窘迫和缺氧导致的继发器官损伤和功能障碍对改善患者预后具有重要意义。 Oxygen supplementation treatment can correct hypoxemia, relieving secondary organ damage caused by Respiratory distress and hypoxemia.
3.1氧疗 3.1 Oxygen therapy
1)氧疗同时持续指氧饱和度监测 (1) Continual oxygen saturation monitoring during oxygen therapy
大多数患者初期氧合并不差,但部分患者氧合功能可能快速恶化。 Some patients do not necessarily have impaired oxygenation functions at the onset of infection but may manifest rapid deterioration in oxygenation over time.
因此,氧疗同时建议持续指氧饱和度监测。 Therefore, continual monitoring of oxygen saturation is recommended, before and during oxygen therapy.
2)氧疗时机 (2) Oxygen therapy as soon as possible
不吸氧情况下指氧饱和度(SpO2)>93%,且无明显呼吸窘迫症状时,可不给予氧疗。 Oxygen therapy is not necessary for patients with oxygen saturation (SpO2) of more than 93% or for patients without obvious symptoms of Respiratory distress without oxygen treatment.
部分COVID-19重型患者虽然PaO2/FiO2<300,但呼吸窘迫症状却不明显,建议氧疗。 Oxygen therapy is strongly recommended to the patients with symptoms of Respiratory distress. It should be noted that some severe patients with PaO2/FiO2 < 300 had no obvious symptoms of Respiratory distress.
3)氧疗目标 (3) Treatment goal of oxygen therapy
建议维持氧饱和度目标SpO293%-96%。若合并慢性II型呼吸衰竭,降低氧饱和度目标至SpO288%-92%;日常活动下SpO2频繁降至85%以下时,提高氧浓度至92%-95%,监测PaCO2水平。 The treatment goal of oxygen therapy is to maintain the oxygen saturation (SpO2) at 93%-96% for patients without chronic pulmonary disease and at 88%-92% for patients with chronic type II Respiratory failure. Specially, the oxygen concentration should be increased to 92%-95% for patients whose SpO2 drops below 85% frequently during daily activities.
4)控制性氧疗 4) Control oxygen therapy
PaO2 /FiO2 是比较准确的评价氧合功能指标。 PaO2/FiO2 is a sensitive and accurate indicator of oxygenation function.
若病情进展、PaO2 /FiO2<300mmHg的患者,FiO2的稳定性、可监测性非常重要。 The stability and monitorability of FiO2 are very important for patients with disease progression and PaO2/FiO2 below 300 mmHg.
推荐首选控制性氧疗。 Controlled oxygen therapy is the preferred treatment.
静息状态下SpO2 <93%、PaO2 /FiO2 <300mmHg(1mmHg=0.133kPa)、呼吸频率>25次/min或影像学表现进展明显时,建议给予高流量吸氧(HFNC),患者佩戴外科口罩。 High-flow nasal cannula (HFNC) oxygen therapy is recommended for patients with the following conditions: SpO2< 93%; PaO2/FiO2< 300 mmHg (1 mmHg = 0.133 kPa); Respiratory rate > 25 times per min at bed; or remarkable progression on X-ray imaging. Patients should wear a surgical mask during HFNC treatment.
对于PaO2/FiO2介于200-300mmHg且患者无明显胸闷气促主诉时,HFNC的气流量应从低水平开始,逐渐达到40-60L/min。 The air flow of HFNC oxygen therapy should star t at a low level and gradually increased up to 40-60 L/min when PaO2 is between 200-300 mmHg so that patients do not feel obvious chest tightness and shortness of breath.
对于明显呼吸窘迫的患者,可直接给予60L/min的初始流量。 An initial flow of at least 60 L/min should be given immediately for patients with obvious respiratory distress.
部分患者氧合指数较低(<100mmHg),但一般情况较好,对于这部分患者是否立即行气管插管,最重要的是关注原发病进展状况,综合评估患者全身状态、代偿能力及疾病发展趋势。 Tracheal intubation for patients is dependent on disease progression, systemic status and complication of patients for those with stable situation but with a low oxygenation index (<100 mmHg). Thus, detailed evaluations of the clinical condition of patients is very important before decision making.
如果HFNC高流量(60L/min)高浓度吸入(>60%)1-2小时内患者氧合指数持续降低(<150mmHg)或呼吸窘迫症状明显加重或合并其他脏器功能不全,尽早气管插管。 Tracheal intubation should be per formed as early as possible for patients with an oxygenation index less than 150 mmHg, worsening symptoms of Respiratory distress or multiple organ dysfunction within 1-2 hours after high-flow (60 L/min) and high-concentration (> 60%) HFNC oxygen therapy.
对于高龄(>60岁)合并症多或PaO2/FiO2<200mmHg的患者,建议收住重症医学科。 Older patients (> 60 years old) with more complications or PaO2/FiO2 less than 200 mmHg should be treated in ICU.
3.2机械通气 3.2 Mechanical Ventilation
1)无创通气(Noninvasive Ventilation, NIV) (1) Noninvasive Ventilation (NIV)
COVID-19部分重症患者可快速进展至ARDS,过高的通气驱动和NIV可能加重肺损伤。 Some severe patients progress to ARDS rapidly.
NIV导致的胃肠胀气和患者不耐受可能引起吸入性肺炎。 Excessive inflation pressure may cause gastric distension and intolerance which contribute to aspiration and worsen lung injury.
我们不推荐对HFNC治疗失败的患者常规使用NIV。 NIV is not strongly recommended in COVID-19 patients who fail HFNC treatment.
若患者合并急性左心衰竭或慢性阻塞性肺病或免疫抑制时,可短期使用(不超过2h)并密切监测,若患者窘迫症状或PaO2/FiO2无明显改善,尽早气管插管。 A short-term (less than 2 hours) use of NIV can be closely monitored if the patient has acute left heart failure, chronic obstructive pulmonary disease or is immunocompromised. Intubation should be per formed as early as possible if improvement of Respiratory distress symptoms or PaO2/FiO2 is not observed.
NIV建议使用双回路的呼吸机; NIV with a double circuit is recommended.
使用单管路无创呼吸机时在面罩和呼出阀之间加装病毒过滤器;选择合适型号的面罩,减少漏气导致的病毒播散风险。 A virus filter should be installed between the mask and the exhalation valve when applying NIV with a single tube. Suitable masks should be chosen to reduce the risk of virus spread through air leakage.
2)有创机械通气(Invasive Mechanical Ventilation,IMV) (2) Invasive Mechanical Ventilation
①COVID-19危重症患者有创机械通气的原则 ① Principles of invasive mechanical ventilation in critically ill patients
在保障患者基本通气和氧合需求的同时如何降低机械通气相关性肺损伤在COVID-19患者治疗过程中至关重要。 It is important to balance the ventilation and oxygenation demands and the risk of mechanical ventilation-related lung injury in the treatment of COVID-19 .
●严格限定潮气量4~8mL/kg理想体重。 ·Strictly set the tidal volume to 4 – 8 mL/kg.
通常情况下,肺顺应性越低,预设的潮气量也应越小; In general, the lower the lung compliance, the smaller the preset tidal volume should be.
●控制平台压<30cmH2O(1cmH2O=0.098kPa)、驱动压<15cmH2O; ·Maintain the plat form pressure < 30 cmH2O (1 cmH2O = 0.098 kPa) and driving pressure <15 cmH2O.
●根据ARDSnet规范进行PEEP设定; ·Set PEEP according to the ARDS’s protocol.
●通气频率18~25次/min,允许适度的高碳酸血症; ·Ventilation frequency: 18-25 times per minute. Moderate hypercapnia is allowed.
●潮气量过大、平台压和驱动压过高时,加强镇静镇痛、甚至给予肌肉松弛药。 ·Administer sedation, analgesia, or muscle relaxant if the tidal volume, platform pressure and driving pressure are too high.
②肺复张 ② Lung Recruitment
肺复张可能改善ARDS患者肺病变的不均一性,但同时存在严重的呼吸、循环并发症。 Lung recruitment improves the heterogeneous distribution of lesions in patients with ARDS.
我们不推荐常规使用肺复张手法;若要使用,首先进行肺可复张性评估。 However, it may result in severe respiratory and circulatory complications and therefore, the lung recruitment maneuver is not routinely recommended. The assessment of lung expandability should be performed prior to the application.
3)俯卧位通气 (3) Prone Position Ventilation
COVID-19危重症患者大多对俯卧位通气有良好反应,氧合和肺部力学可在短时间内得到明显改善。 Most critically ill patients with COVID-19 respond well to prone ventilation, with a rapid improvement of oxygenation and lung mechanics.
我们建议对PaO2/FiO2<150mmHg或影像表现较重的患者在无禁忌的情况下常规进行俯卧位通气,每次16小时以上。 Prone ventilation is recommended as a routine strategy for patients with PaO2/FiO2 < 150 mmHg or with obvious imaging manifestations without contraindications. Time course recommended for prone ventilation is more than 16 hours each time.
当仰卧位4小时以上患者PaO2/FiO2仍>150mmHg时可暂停俯卧位通气。 The prone ventilation can be ceased once PaO2/FiO2 is greater than 150 mmHg for more than 4 hours in the supine position.
对于尚未插管、无明显呼吸窘迫但氧合较差、影像学表现为明显的肺重力依赖区实变的患者,可尝试清醒俯卧位通气。 Prone ventilation while awake may be attempted for patients who have not been intubated or have no obvious respiratory distress but with impaired oxygenation or have consolidation in gravity-dependent lung zones on lung images.
每次持续4小时以上,根据效果和耐受性调整,每天可以反复多次俯卧位。 Procedures for at least 4 hours each time is recommended. Prone position can be considered several times per day depending on the effects and tolerance.
4)预防返流误吸 (4) Prevention of Regurgitation and Aspiration
常规进行胃残余量和胃肠功能评估, Gastric residual volume and gastrointestinal function should be routinely evaluated.
尽早给予适量的肠内营养。 Appropriate enteral nutrition is recommended to be given as earlier as possible.
推荐留置鼻肠管进行空肠内营养、留置胃管进行持续减压; Nasointestinal feeding and continuous nasogastric decompression are recommended.
转运前停止肠内营养,50mL空针抽吸;无禁忌时采用30°半坐位等。 Enteral nutrition should be suspended and aspiration with 50 mL syringe be done before transfer. If no contraindication exists, a 30° semi-sitting position is recommended.
5)液体管理 (5) Fluid Management
过多的液体输注常可显著加重COVID-19患者低氧血症。 Excessive fluid burden worsens hypoxemia in COVID-19 patients.
在保证患者循环灌注的情况下应严格控制液体入量,对减少肺部渗出、改善氧合有积极作用。 To reduce pulmonary exudation and improve oxygenation, the amount of fluid should be strictly controlled while ensuring the patient's perfusion.
6)呼吸机相关性肺炎(VAP)预防策略 (6) Strategies to Prevent Ventilator-Associated Pneumonia (VAP)
①选择合适型号的气管插管; ①Select appropriate type of endotracheal tube;
②使用带声门下吸引的气管插管(q2h,每次20mL空针筒抽吸); ② Use a endotracheal tube with subglottic suction (once every 2 hours, aspirated with 20 mL empty syringe each time);
③确保气管插管的位置、深浅合适,妥善固定、避免牵拉; ③Place the endotracheal tube at the right position and correct depth, fix properly and avoid pulling;
④维持气囊压力30~35cmH2O(1cmH2O=0.098kPa),q4h监测一次; ④ Maintain the airbag pressure at 30 - 35 cmH2O (1 cmH2O = 0.098 kPa) and monitor every 4 hours;
⑤涉及体位变动时进行气囊压力监测、冷凝水处理(双人配合倾倒,倒入预置含氯消毒液的加盖容器中)、气囊上分泌物处理; ⑤ Monitor the airbag pressure and deal with water condensates when the position changes (two people cooperate in dumping and pouring the water condensates into a capped container containing a pre-made disinfectant chlorine solution); deal with secretions accumulated in the airbag;
⑥及时清理患者口鼻分泌物。 ⑥ Clean up secretions from the mouth and nose timely.
7)撤机拔管时机和策略 (7) Weaning of Ventilation
当患者PaO2/FiO2>150mmHg时,可积极减停镇静剂唤醒,条件允许尽早拔管;采用HFNC或NIV进行拔管后的续贯呼吸支持。 Sedatives is reduced and discontinued before awakening when the patient’s PaO2/FiO2 is more than 150 mmHg. Intubation withdrawal should be performed as earlier as possible if permitted. HFNC or NIV is used for sequential respiratory support after withdrawal.
八. 抗继发感染合理使用抗菌药物 VIII. The Rational Use of Antibiotics to Prevent Secondary Infection
COVID-19是病毒感染性疾病,轻型及普通型患者不建议预防性使用抗菌药物; COVID-19 is a disease of viral infection, therefore antibiotics are not recommended to prevent bacterial infection in mild or ordinary patients;
重型患者需要结合具体情况谨慎决定是否预防性使用抗菌药物, it should be used carefully in severe patients based on their conditions.
对于病变范围广、气道分泌物多、原有慢性气道疾病伴下呼吸道病原体定植史、使用糖皮质激素(按泼尼松计)≥20mg×7d等情况的患者可考虑酌情使用抗菌药物,可选药物包括喹诺酮类、第二或第三代头孢菌素、β-内酰胺酶抑制剂复方制剂等; Antibiotics can be used with discretion in patients who have the following conditions: extensive lung lesions; excess bronchial secretions; chronic airway diseases with a history of pathogen colonization in the lower Respiratory tract; taking glucocorticoids with a dosage ≥ 20 mg × 7d (in terms of prednisone). The options of antibiotics include quinolones, the second or third generation cephalothins, β-lactamase inhibitor compounds, etc.
危重型患者,尤其是接受有创机械通气的患者可考虑预防性使用抗菌药物, The antibiotics should be used for the prevention of bacterial infection in critically severe patients, especially those with invasive mechanical ventilation.
根据患者个体高危因素选择抗菌药物,包括碳青霉烯类、β-内酰胺酶抑制剂复方制剂、利奈唑胺、万古霉素。 The antibiotics such as carbapenems, β-lactamase inhibitor compounds, linezolid and vancomycin can be used in critically ill patients according to the individual risk factors.
在治疗期间须密切监测患者症状、体征、血常规、C反应蛋白、降钙素原等指标,出现病情变化须临床综合判断, The patient’s symptoms, signs and indicators such as blood routine, C-reactive protein, and procalcitonin, need to be closely monitored during the treatment. When the change of a patient’s condition is detected, a comprehensive clinical judgment needs to be made.
在不能排除继发感染时须第一时间留取合格标本进行涂片、培养,进行核酸、抗原抗体检测以便尽早明确感染病原体。 When the secondary infection cannot be ruled out, qualified specimen need to be collected for testing by smear preparation, cultivation, nucleic acid, antigen and antibody, in order to determine the infectious agent as early as possible.
出现下述情况可经验性使用抗菌药物:①咳痰增多、痰液颜色变深,尤其是出现黄脓痰;②体温升高,且不能用原发疾病加重解释;③白细胞、中性粒细胞数显著增多;④降钙素原≥
0.5ng/mL;⑤病毒感染无法解释的氧合指数恶化或循环障碍及其他提示细菌感染的病情改变。
Antibiotics can be empirically used in the following conditions: ① more expectoration, darker sputum color, especially yellow pus sputum; ② the rise of body temperature which is not due to exacerbation of the original disease; ③ the marked increase of white blood cell s and/or neutrophil s; ④ procalcitonin ≥ 0.5 ng/mL; ⑤ Exacerbation of oxygenation index or circulator y disturbance that are not caused by the viral infection; and the other conditions suspiciously caused by bacteria infections.
病毒感染造成细胞免疫功能下降、糖皮质激素和/或广谱抗菌药物使用等因素导致部分COVID-19患者有继发真菌感染风险,须对危重患者行呼吸道分泌物微生物监测,包括涂片、培养;对可疑患者及时检测血或支气管肺泡灌洗液D-葡聚糖(G试验)、半乳甘露聚糖(GM试验)。 Some COVID-19 patients are at the risk of secondary fungal infections due to weakened cellular immunity caused by viral infections, the use of glucocorticoid and/or broad-spectrum antibiotics. It is necessary to do Respiratory secretions microbiological detections such as smear preparation and cultivation for critically ill patients; and provide timely D-Glucose (G-test) and galactomannan (GM-test) of blood or bronchoalveolar lavage fluid for suspected patients.
以下患者须警惕侵袭性念珠菌病,可考虑给予氟康唑或棘白菌素类抗真菌治疗: It is necessary to be vigilant with possible invasive candidiasis infection and anti-fungal therapy.
①广谱抗菌药物使用7天及以上;②胃肠外营养;③ 接受有创检查或治疗;④两个或以上部位来源的标本培养念珠菌阳性;⑤G实验明显升高。 Fluconazole or echinocandin can be used in the following conditions: ① patients are given broad-spectrum antibiotics for seven days or more; ② patients have parenteral nutrition; ③ patients have invasive examination or treatment; ④ patients have positive candida culture in the specimen obtained from two body part s or more; ⑤ patients have significantly increased result s of G-test.
以下患者须警惕侵袭性肺曲霉病, It is necessary to be vigilant with possible invasive pulmonary aspergillosis.
可考虑给予伏立康唑、泊沙康唑或棘白菌素类治疗:①糖皮质激素使用7天及以上;②粒细胞减少或缺乏;③慢性阻塞性肺病且既往气道标本培养曲霉阳性;④GM明显升高。 Anti-fungal therapy such as voriconazole, posaconazole, or echinocandin are considered to be used in the following conditions: ① patients are given glucocorticoid for seven days or more; ② patients have agranulocytosis; ③ patients have chronic obstructive pulmonary disease and aspergillus culture are tested positive in the specimen obtained from the airway; ④ patients have significantly increased result s of GM-test.
九. 肠道微生态平衡营养支持 IX. The Balance of Intestinal Microecology and Nutritional Support
COVID-19患者由于病毒直接侵犯肠道黏膜、抗病毒抗感染等治疗药物影响,部分患者合并腹痛、腹泻等消化道症状。 Some COVID-19 patients have gastrointestinal symptoms (such as abdominal pain and diarrhea) due to direct viral infection of the intestinal mucosa or antiviral and anti-infective drugs.
经检测COVID-19患者存在肠道微生态失衡,表现为肠道的乳酸杆菌、双歧杆菌等有益菌明显减少。 There has been report that the intestinal microecological balance is broken in COVID-19 patients, manifesting a significant reduction of the intestinal probiotics such as lactobacillus and bifidobacterium.
肠道微生态失衡可能会导致肠道细菌异位,引起继发感染,因此要重视肠道微生态调节剂和营养支持对维持微生态平衡的治疗。 Intestinal microecological imbalance may lead to bacterial translocation and secondary infection, so it is important to maintain the balance of intestinal microecology by microecological modulator and nutritional support.
微生态制剂干预 Microecologics Intervention
1)微生态调节剂可减少细菌移位与继发感染。 (1) Microecologics can reduce bacterial translocation and secondary infection.
微生态调节剂增加肠道优势菌,抑制肠道有害菌,减少毒素产生,减少菌群失调导致的感染。 It can increase dominant gut bacteria, inhibit intestinal harmful bacteria, reduce toxin production and reduce infection caused by gut microflora dysbiosis.
2)微生态调节剂可改善患者消化道症状,部分患者出现消化道症状,微生态调节剂可以通过抑制肠黏膜萎缩,使粪便中水分减少,改善粪便性状和次数,减轻腹泻等症状。 (2) Microecologics can improve the gastrointestinal symptoms of patients. It can reduce water in feces, improve fecal character and defecation frequency, and reduce diarrhea by inhibiting intestinal mucosal atrophy.
3)有条件的医院可进行肠道菌群分析。 (3) The hospital with relevant resources can perform intestinal flora analysis.
根据菌群分析结果,尽早发现肠道菌群紊乱,及早调整抗菌药物、给予益生菌制剂,减少肠道菌群移位和肠源性感染的发生。 Therefore, the intestinal flora disturbance can be discovered early according to the results.
Antibiotics can be adjusted timely and probiotics can be prescribed. These can reduce the chances of intestinal bacterial translocation and gut-derived infection.
4)营养支持是维持肠道微生态平衡的重要手段。 (4) Nutrition support is an important means to maintain intestinal microecological balance.
在有效评估营养风险、胃肠道功能以及误吸风险的基础上,及时实施肠内营养支持。 Intestinal nutrition support should be applied timely on the basis of effective evaluations of nutritional risks, gastroenteric functions, and aspiration risks.
营养支持 Nutrition Support
重型和危重型新冠肺炎病人在严重应激状态下,存在较高营养风险。 The severe and critically ill COVID-19 patients who are in a state of severe stress are at high nutritional risks.
早期营养评估、胃肠道功能评估、误吸风险评估和及时营养支持对病人的预后很重要。 Early evaluations of nutrition risk, gastrointestinal functions and aspiration risks, and timely enteral nutritional support are important to the patient’s prognosis.
1)首选经口进食:早期开通肠内营养,提供营养支持,滋养肠道,改善肠粘膜屏障及肠道免疫功能,维持肠道微生态。 (1) Oral feeding is preferred. The early intestinal nutrition can provide nutritional
support, nourish intestines, improve intestinal mucosal barrier and intestinal immunity, and maintain intestinal microecology.
2)肠内营养路径:重型和危重型患者往往有急性胃肠功能损伤,表现为腹胀腹泻,甚至胃瘫。 (2) Enteral nutrition pathway. Severe and critically ill patients of ten harbor acute gastrointestinal damages, manifested as abdominal distension, diarrhea, and gastroparesis.
对于气管插管病人,建议留置空肠营养管,行幽门后喂养。 For patients with tracheal intubation, intestinal nutrition tube indwelling is recommended for post-pyloric feeding.
3)营养液选择: (3) Selection of nutrient solution.
对于肠道损伤病人建议选择预消化的短肽制剂,便于肠道吸收和利用。 For patients with intestinal damage, predigested short peptide preparations, which are easy for intestinal absorption and utilization, are recommended.
肠道功能较好的病人,可以选择热能较高的整蛋白制剂。 For patients with good intestinal functions, whole-protein preparations with relatively high calories can be selected.
血糖高的患者,考虑选择适合控制血糖的营养制剂。 For hyperglycemia patients, nutritional preparations which are beneficial to glycemic controlling are recommended.
4)能量供应:每公斤体重25-30kcal,目标蛋白量为1.2-2.0g/kg·d。 (4) Energy supply. 25-30 kcal per kg body weight, the target protein content is 1. 2-2.0 g/kg daily.
5)营养输注方式: (5) Means of nutritional supply.
营养泵匀速输注,从小剂量开始逐步加量,有条件的可以行营养液加热,减少喂养不耐受。 Pump infusion of nutrients can be used at a uniform speed, star ting with a low dosage and gradually increasing. When possible, the nutrients can be heated before feeding to reduce intolerance.
6)对于有误吸高风险的老年病人和腹胀明显的患者,可考虑暂行肠外营养支持,待病情好转后再逐步过渡到自主饮食或肠内营养。 (6) The elderly patients who are at high aspiration risks or patients with apparent abdominal distention can be supported by parenteral nutrition temporarily. It can be gradually replaced by independent diet or enteral nutrition after their condition improves.
十. COVID-19患者的ECMO支持 X. ECMO Support for COVID-19 Patients
COVID-19是攻击肺泡为主要靶点的新型高传染性疾病,重症患者主要累及肺部,导致严重呼吸衰竭。 COVID-19 is a novel, highly infectious disease primarily targeting pulmonary alveoli, which damages primarily the lungs of critically ill patients and leads to severe Respiratory failure.
体外膜肺氧合治疗(Extracorporeal membrane oxygenation,ECMO)在COVID-19的应用,需要关注:干预时机与方式、抗凝与出血、与机械通气的配合、清醒ECMO与早期康复训练、撤机标准、合并症处置等。 For the application of extracorporeal membrane oxygenation (ECMO) in COVID-19 treatment, medical professional s need to pay close attention to the following: the time and means of intervention, anticoagulant and bleeding, coordination with mechanical ventilation, awake ECMO and the early rehabilitation training, strategy of handling for complications.
ECMO干预时机 ECMO Intervention Timing
1.1挽救性ECMO 1.1 Salvage ECMO
机械通气支持状态下,72h采用保护性通气策略及俯卧位通气等措施,发生以下情况之一,需要考虑进行挽救性ECMO干预: In the state of mechanical ventilation support, measures such as lung protective ventilation strategy and prone position ventilation have been taken for 72 h. With the onset of one of the following conditions, salvage ECMO Intervention needs to be considered.
1)PaO2/FiO2<80mmHg(不论PEEP水平); (1) PaO2/FiO2 < 80 mmHg (regardless of what the PEEP level is);
2)Pplat≤30,PaCO2>55mmHg; (2) Ppl at ≤ 30 mmHg, PaCO2 > 55 mmHg;
3)出现气胸,漏气量>1/3潮气量,持续时间>48h; (3) The onset of pneumothorax, air leakage > 1/3 tidal volume, duration > 48 h;
4)循环恶化,去甲肾上腺素剂量>1μg/(kg×min); (4) Circulation deterioration, the dosage of norepinephrine > 1 μg/(kg×min);
5)心肺复苏进行体外生命支持ECPR。 (5) Cardio-pulmonary resuscitation in vitro life support ECPR.
1.2替代性ECMO 1.2 Replacement ECMO
对病情评估认为患者不适合长时间进行机械通气维持,无法达到预期目标,立即采用ECMO方式进行替代,出现以下情况之一,应该考虑进行ECMO替代: When the patient is not suitable for long-term mechanical ventilation support, i.e., the patient is not able to obtain the expected result s, ECMO Replacement needs to be adopted immediately. With the onset of one of the following conditions, ECMO Replacement needs to be considered.
1)肺顺应性减退,采用肺复张干预方法后,呼吸系统顺应性<10mL/cmH2O; (1) Decreased lung compliance. After the pulmonary recruitment maneuver, the compliance of the Respiratory system < 10 mL/cmH2O;
2)纵膈气肿或者皮下气肿持续加重,并且预期48h内无法降低机械通气支持参数; (2) Persistent exacerbation of pneumomediastinum or subcutaneous emphysema. And the parameters of mechanical ventilation support cannot be reduced within 48 h, according to the estimation;
3)PaO2/FiO2<100mmHg,采用常规方法72h无法改善。 (3) PaO2/FiO2 < 100 mmHg. And it cannot be improved by routine methods in 72 h.
1.3早期清醒ECMO 1.3 Early Awake ECMO
部分患者经过评估,使用机械通气预期高参数维持时间>7d,且符合清醒ECMO的必要条件,可能从中获益,需要符合以下所有标准: Early awake ECMO can be applied to patients who have been supported by mechanical ventilation with the expected high parameters for more than 7 days and who meet the necessary conditions of awake ECMO. They might benefit from it. All the following conditions must be met:
1)患者意识清醒,有充分的配合度,能够理解ECMO运行的方式和维护要求; (1) The patient is in a clear state of consciousness and is fully compliant. He or she understands how ECMO works and its maintenance requirements;
2)没有合并神经肌肉疾病; (2) The patient is not complicated with neuromuscular diseases;
3)肺部损伤评分Murry>2.5分; (3) Pulmonary damage score Murry > 2.5;
4)肺部分泌物不多,人工辅助吸引间隔>4h; (4) Few pulmonary secretions. The time interval between the two airway suction procedures > 4 h;
5)血流动力学稳定,无需血管活性药物辅助。 (5) Stable hemodynamics. Vasoactive agents are not required for assistance.
置管方式 Cathetering Methods
COVID-19多数ECMO维持时间>7d,应该尽量采用seldinger方法超声
引导下外周置管,减少切开置管带来的出血损伤与感染风险,尤其对于早期清醒ECMO的患者。
Because the ECMO supporting time for most COVID-19 patients is greater than 7 days, the seldinger method should be used as much as possible for the ultrasound guided peripheral catheter insertion, which reduces the bleeding damages and infection risks brought about by intravascular cathterization by venous angiotomy, especially for the early awake ECMO patients.
血管条件差,无法通过超声方法判断选择合适插管的患者,或者seldinger方法失败的患者才考虑进行切开置管。 Intravascular catheterization by venous angiotomy may be considered only for the patients with bad blood vessel conditions, or the patients whose catheterization cannot be identified and selected by ultrasound, or the patients whose seldinger technique failed.
模式选择 Mode Selection
1)单纯呼吸功能损伤患者首选V-V模式,不应该为了可能发生的循环问题首选V-A模式; (1) The first choice for the patients of Respiratory impairment is the V-V mode. The V-A mode should not be the first option just because of the possible circulation problems.
2)对于合并心功能损害的呼吸衰竭患者,PaO2/FiO2<100mmHg,需要采用V-A-V模式,总流量应该>6L/min,采用限流方式维持V/A=0.5/0.5; (2) For the Respiratory failure patients complicated with cardiac impairment, PaO2/FiO2 < 100 mmHg, the V-A-V mode ought to be selected with the total flux > 6 L/min and V/A = 0.5/0.5 is maintained by current limiting.
3)COVID-19患者没有严重呼吸衰竭,但是合并严重心血管事件导致心源性休克,应该采用V-A模式ECMO辅助,但仍然需要IPPV支持,且避免进行清醒ECMO。 (3) For the COVID-19 patients without severe Respiratory failure but complicated with serious cardiovascular outcomes leading to cardiogenic shock, the V-A assisted by ECMO mode ought to be selected. But IPPV support is still needed and the awake ECMO should be avoided. the awake ECMO should be avoided.
流量设定与氧供目标 Flux Set-value and Target Oxygen Supply
1)初始流量应>80%心排量CO,且自循环比例<30%; (1) The initial flux > 80% cardiac output (CO) with a self-cycling ratio < 30%.
2)维持过程应保持SPO2 >90%,且机械通气或其他氧疗支持FiO2<0.5; (2) SPO2 > 90% is to be maintained. FiO2 < 0.5 is supported by mechanical ventilation or the other oxygen therapy.
3)为保证目标流量,体重80kg以下患者首选22Fr静脉accesscanula,80kg以上患者选择24Fr。 (3) To ensure the target flux, 22 Fr (24 Fr) vein access canula is the first choice for the patient with a body weight below (above) 80 kg.
通气目标设定 Ventilation Setting
调节sweep gas水平,维持正常通气目标: Normal ventilation maintenance by adjusting the sweep gas level:
1)初始气流调节,Flow:sweepgas=1:1,基本目标维持PaCO2<45mmHg,对于合并COPD患者应该PaCO2<80%基础水平; (1) The initial air flow is set to be Flow: sweep gas = 1:1. The basic target is to maintain PaCO2 < 45mmHg. For the patients complicated with COPD, PaCO2 < 80% basal level.
2)应该保留患者自主呼吸强度,自主呼吸频率respiratoryrate,
10
(2) The patient’s spontaneous Respiratory strength and Respiratory rate (RR) should be maintained, with 10 < RR < 20 and without chief complaint of breathing difficulty from the patient.
3)V-A模式sweepgas设定应该保证氧合器膜后血流PH:7.35-7.45。 (3) The sweep gas setup of the V-A mode needs to ensure the 7.35-7.45 PH value of the bloodstream out of the oxygenator membrane.
抗凝与出血防范 Anti-Coagulation and Bleeding Prevention
1)初始上机肝素应用,对于无活动性出血及无内脏出血且血小板>50×10
/L,首剂负荷量推荐50IU/kg;
(1) For the patients without active bleeding, without visceral bleeding, and with platelet count > 50×109/L, the recommended initial heparin dosage is 50 U/kg.
2)合并出血风险或血小板<50×10^9/L,肝素首剂负荷量25IU/kg; (2) For the patients complicated with bleeding or with platelet count < 50×109/L, the
recommended initial heparin dosage is 25 U/kg.
3)抗凝维持剂量目标建议以aPTT(活化凝血酶原时间)40-60sec为目标,同时参考D-dimer的变化趋势; (3) The activated partial thromboplastin time (aPPT) being 40 —60 sec is proposed to be
the target of anticoagulation maintenance dosage. The trend of D-dimer change should be considered at the same time.
4)无肝素运行建议,对于出现需要控制的活动性出血,或者致命性出血,在无法停止ECMO支持的情况下,全肝素涂层环路与插管且血流量>3L/min,可以考虑进行无肝素运行,建议运行时间<24h,且需要准备替换设备与耗材; (4) Heparin-free operation may be per formed in the following circumstances: the ECMO support must continue but there is fatal bleeding or active bleeding that has to be controlled; whole heparin coated loop and catheterization with blood flow > 3 L/min.
The recommend operation time < 24 hour. Replacement devices and consumables need to be prepared.
5)关于肝素抵抗,部分肝素使用条件下,出现aPTT无法达标,且凝血发生,应该监测血浆抗凝血酶III(ATIII)活性,若出现活性降低,需要补充新鲜冰冻血浆来恢复肝素敏感性; (5) Heparin resistance. Under some conditions of heparin usage, aPTT is not able to reach the standard and blood coagulation happens. In this case, the activity of plasma antithrombin III (ATIII) needs to be monitored. I f the activity reduces, fresh frozen plasma needs to be supplemented to restore heparin sensitivity.
6)关于肝素相关性血小板减少症,heparin induced thrombopenia(HIT)。怀疑HIT发生,建议采用血浆置换治疗,或者采用阿加曲班药物替代。 (6) Heparin induced thrombopenia (HIT). When HIT happens, we recommend to perform plasma exchange therapy, or to replace heparin with argatroban.
ECMO合并机械通气的撤离 Weaning from ECMO and Mechanical Ventilation
1)V-V ECMO合并机械通气的患者,如果符合清醒ECMO条件,建议首先尝试撤除人工气道,除非已合并ECMO相关并发症,或者预期撤除所有机械辅助时间<48h。 (1) If a patient treated by V-V ECMO combined with mechanical ventilation satisfies the awake ECMO condition, we suggest to first tr y to remove the artificial air way, unless the patient has ECMO related complications, or the expected time of removal of all the assisting machines is less than 48 h.
2)对于气道分泌物过多,需要频繁辅助人工吸引清除,且预计采用长时间机械通气的患者,符合PaO2/FiO2>150mmHg时间>48h,肺部影像表现好转稳定,机械通气压力相关损伤已经控制,可以首先撤除ECMO辅助,不建议保留ECMO插管。 (2) For a patient who has too much air way secretions that frequent artificial suction clearance is needed, who is expected to have a long-term mechanical ventilation support , who satisfies the conditions PaO2/FiO2 > 15 0 mmHg and time > 4 8 h, whose lung image changes for the better, and whose damages related to mechanical ventilation pressure have been controlled, the ECMO assistance may be removed. It is not recommended to keep ECMO intubation.
十一. XI.
COVID-19康复者恢复期血浆治疗 Convalescent Plasma Therapy for COVID-19 Patients
自从1891年Behring及Kitasato报道白喉抗毒素血浆具有治疗效果以来,已成为急性传染病治疗的一项重要的病原体免疫治疗手段。 Since Behring and Kitasato reported the therapeutic effect s of diphtheria antitoxin plasma in 1891, plasma therapy has become an important means of pathogen immunotherapy for acute infectious diseases.
新发突发传染病重症和危重症患者病情迅速进展 The disease progression is rapid for severe and critically ill patients of an emerging infectious disease.
起病早期存在病原体直接损伤靶器官,进而诱导严重的免疫病理损伤,被动免疫抗体能够高效、直接中和病原体,减少靶器官损害进而阻断随后的免疫病理损伤。 In the early phase, the pathogens damage the target organs directly and then lead to severe immuno-pathological damage. The passive immune antibodies can effectively and directly neutralize the pathogens, which reduces the damage of the target organs and then block the subsequent immune-pathological damages.
WHO在多次全球重大疫情爆发期间亦曾强调“恢复期血浆位于潜在疗法列表的前端,并且曾被用于其他疾病的暴发中”。 During multiple global pandemic outbreaks, WHO also emphasized that “convalescent plasma therapy is one of the most recommended potential therapies, and it has been used during other epidemic outbreaks”.
2019年新型冠状病毒(COVID-19)肺炎爆发以来,由于无特效治疗手段,初期病死率较高,全社会高度关注疫情,能有效降低其危重症病死率的临床治疗手段是避免民众发生恐慌的关键。 Since the outbreak of COVID-19, the initial mortality rate was rather high due to the lack of specific and effective treatment s. As mortality rate is an important metric that the public concerns, clinic treatment s which can reduce the fatality rate of critical cases effectively are key to avoid public panic.
本院作为浙江省省级定点收治医院,承担杭州地区部分患者和全省各地市的危重症患者的临床救治工作,预期具备充足的恢复期血浆潜在供体以及需要接受治疗的危重症患者。 As a provincial-level hospital in Zhejiang province, we have been responsible to treat the patients from Hangzhou and the critically ill patients of the province. There are abundant potential convalescent plasma donors and critically ill patients who need convalescent plasma treatment in our hospital.
血浆采集 Plasma collection
除满足常规无偿献血健康要求,并遵循相应流程外,还应注意以下内容: In addition to the common requirement s of blood donation and procedures, the following details should be noted.
1.1采集对象: 1.1 Donors
康复出院满2周(深部呼吸道样本新冠病毒核酸检测转阴时间≥14天);年龄≥18周岁且≤55周岁;男性体重>50kg,女性体重>45kg;停用糖皮质激素≥1周;距离上一次献血>2周。 At least two weeks after recover y and being discharged (the nucleic acid test of the sample taken from the lower Respiratory tract remains negative≥14 days). 18 ≤ Age ≤ 55. The body weight>50 kg (for male) or >45 kg (for female). At least one week since last glucocorticoid usage. More than two weeks since last blood donation.
1.2采集方法: 1. 2 Collection Method
单采血浆,每次200-400mL(根据健康征询情况)。 Plasmapheresis, 200-400 mL each time (based on medical consultation).
1.3采集后检测:除外一般质量检测和血液传播疾病相关检测外,血浆样本还应当送检: 1.3 Post-Collection Testing
In addition to the general quality test and the test of blood-borne disease, the blood samples need to
be tested for:
1)SARS-CoV-2病毒核酸检查; (1) Nucleic acid testing for SARS-CoV-2;
2)稀释160倍检测SARS-CoV-2特异性IgG、IgM定性试验或稀释320倍后送检总抗体定性试验,有条件的应当保留>3mL血浆用于病毒中和试验。 (2) 160-fold dilution for the qualitative test of SARS- CoV-2 specific IgG and IgM detection; or 320-fold dilution for the qualitative test of whole antibody detection. If possible, keep > 3 mL plasma for the viral neutralization experiments.
应当注意的是,我们在比对病毒中和试验滴度和发光法IgG抗体定量检测的数据中发现目前的SARS-CoV-2特异性IgG抗体检测不能很好体现血浆实际病毒中和能力,建议首选病毒中和试验,或选择稀释320倍后的血浆总抗体水平检测。 The following should be noted. During the comparison of virus neutralization titer and luminescent IgG antibody quantitative detection, we found that the present SARS-CoV-2 specific IgG antibody detection does not fully demonstrate the actual virus neutralization capability of the plasma.
Therefore, we suggested the virus neutralization test as the first choice, or test the overall antibody level with the 320-fold dilution of the plasma.
恢复期血浆临床应用 Clinical Use of the Convalescent Plasma
2.1适应证 2.1 Indication
1)呼吸道病毒检测阳性的重症、危重症COVID-19患者; (1) Severe or critically ill COVID-19 patients tested positive in Respiratory tract test;
2)非重症、危重症患者如存在免疫抑制情况,或病毒核酸检测CT值较低,且出现肺部病灶迅速进展者。 (2) The COVID-19 patients who are not severe or critically ill, but in a state of immunity suppression;
or have low CT values in the virus nucleic acid testing but with a rapid disease progression in the lungs.
注:原则上恢复期血浆不建议用于病程超过3周的COVID-19患者, Note: In principle, the convalescent plasma should not be used on COVID-19 patients with disease course exceeding three weeks.
但我们实际临床应用中发现,在病程>3周且呼吸道样本病毒核酸检测持续阳性的患者中应用恢复期血浆治疗,能起到加快病毒清除,提高患者血液淋巴细胞和NK细胞数量,降低血乳酸水平以及改善肾功能的作用。 But in clinical applications, we found that the convalescent plasma therapy is effective for patients with a disease course exceeding three weeks and whose virus nucleic acid test s continuously to show positive from Respiratory tract s specimen. It can speed up virus clearance, increase the numbers of the plasma lymphocytes and NK cell s, reduce the level of plasma lactic acid, and improve renal functions.
2.2禁忌证 2.2 Contraindication
1)既往血浆输注过敏史,枸橼酸钠、亚甲蓝过敏史; (1) Allergy history of plasma, sodium citrate and methylene blue;
2)自身免疫性疾病病史、选择性IgA缺乏症患者应当经临床医师评估后谨慎使用。 (2) For patients with history of autoimmune system diseases or selective IgA deficiency, the application of convalescent plasma should be evaluated cautiously by clinicians.
2.3输注方案
通常给与1次输注量≥400mL,或予多次每次≥200mL的恢复期血浆治疗。
2.3 Infusion plan in general, the dosage of convalescent plasma therapy is ≥400 mL for one infusion, or ≥ 200 mL per infusion for multiple infusions.
十二. 中医分型治疗提高疗效 XII. TCM Classification Therapy to Improve Curative Efficacy
分型分期 Classification and Stage
COVID-19可分为初期、中期、重症期及恢复期。 COVID-19 can be divided into early, middle, critical and recover y stages.
初期以寒湿郁肺和外寒内热两型为主;中期以寒热错杂为先;重症期为疫毒内闭多见;恢复期重在肺脾气虚。 At the early stage, the disease has two main types: “wet lungs” and “external cold and internal heat.” The middle stage is characterized by “intermit tent cold and heat.” The critical stage is characterized by “internal block of epidemic toxin.” The recovery stage is characterized by “qi deficiency in lung-spleen.”
该病初期为寒湿证,因兼有发热,可以寒热并用。 The disease initially belongs to wet lung syndrome. Due to fever, both intermit tent cold and heat treatment s are recommended.
中期寒湿热兼见,中医属寒热错杂,故寒热并用,调其升降。 In the middle stage, cold, dampness, and heat coexist, belonging to “cold-heat mixture” in terms of TCM. Both cold and heat therapy should be considered.
中医之治则“热者寒之”,治热以寒,但寒药易伤阳,导致脾胃虚寒,出现中焦寒热错杂之象,也需寒热并用。 According to the theory of TCM, heat should be treated with cold drugs. But cold drugs impair Yang and lead to a cold spleen and stomach and cold-heat mixture in the middle-Jiao.
该病寒热错杂证常见,采用寒热并用法取得了优于其他疗法的效果。 Therefore, in this stage both cold and heat therapies should be considered. Because cold-heat symptoms are commonly seen in COVID-19 patients, the cold-heat therapy is better than other approaches.
分型论治 Therapy Based on Classification
1)寒湿郁肺:治宜散寒化湿,芳香解表。药选麻黄6g、杏仁10g、薏苡仁30g、甘草6g、黄芩15g、藿香10g、芦根30g、贯众15g、茯苓20g、苍术12g、厚朴12g。 (1) Wet lungs Ephedra Herb 6 g, Semen Armeniacae Amarumg 10 g, Coix Seed 30 g, Liquoric Root 6 g, Baical Skullcap Root 15 g, Huoxiang 10 g, Reed Rhizome 30 g, Cyrtomium Rhizome 15 g, Indian Buead 20 g, Chinese Atractylodes Rhizome 12 g, Officinal Magnolia Bark 12 g.
2)外寒内热:治宜清泄肺热、辛凉解表。药选麻黄9g、生石膏30g、杏仁10g、甘草6g、黄芩15g、瓜蒌皮20g、枳壳15g、厚朴12g、肺形草20g、桑白皮15g、半夏12g、茯苓20g、桔梗9g。 (2) External cold and internal heat Herba Ephedrae 9 g, Raw Gypsum Fibrosum 30 g, Semen Armeniacae Amarumg 10 g, Liquoric Root 6 g, Baical Skullcap Root 15 g, Pericarpium Trichosanthis 20 g, Fructus Aurantii 15 g, Officinal Magnolia Bark 12 g, Tripterospermum Cordifolium 20 g, White Mulberry Root-bark 15 g, Pinellia Tuber 12 g, Indian Buead 20 g, Platycodon Root 9 g.
3)寒热错杂:治宜平调寒热、分消湿热。 (3) Intermit tent cold-heat
药选半夏12g、黄芩15g、黄连6g、干姜6g、大枣15g、葛根30g、木香10g、茯苓20g、浙贝母15g、薏苡仁30g、甘草6g。 Pinellia Tuber 12 g, Baical Skullcap Root 15 g, Golden Thread 6 g, Dried Ginger 6 g,
Chinese Date 15 g, Kudzuvine Root 30 g, Costustoot 10 g, Indian Buead 20 g, Thunberg Fritillary Bulb 15 g, Coix Seed 30 g, Liquoric Root 6 g.
4)疫毒内闭:治宜清热解毒,镇惊开窍。 (4) Internal block of epidemic toxin
以安宫牛黄丸灌服治疗。 Use cheongsimhwan for treatment.
5)肺脾气虚:治宜健脾益肺,补气固表。 (5) Qi deficiency of lung and spleen
药选黄芪30g、党参20g、炒白术15g、茯苓20g、砂仁6g、黄精15g、半夏10g、陈皮6g、山药20g、莲子15g、大枣15g。 Membranous Milk vetch Root 30 g, Pilose Asiabell Root 20 g, Roasted Largehead Atract ylodes Rhizome 15 g, Indian Buead 20 g, Fructus Amomi 6 g, Siberian Solomonseal Rhizome 15 g, Pinellia Tuber 10 g, Tangerine Peel 6 g, Wingde Yan Rhizome 20 g, Semen Nelumbinis 15 g, Chinese Date 15 g.
以上按分型选用相应处方,每日一剂,水煎两次,早晚分服。 Patients in different stages should take different approaches. One dose per day. Boil the medicine in water. Take it every morning and evening.
十三. COVID-19患者用药管理 XIII. Drug Use Management of COVID-19 Patients
COVID-19患者合并基础疾病、用药种类复杂、涉及特殊人群用药。 COVID-19 patients are often complicated with underlying diseases receiving multiple types of drugs.
临床药物治疗时应关注药物不良反应和相互作用,避免药源性器官损伤,提高救治成功率。 Therefore, we should pay more attention to the adverse drug reactions and drug interactions so as to avoid drug-induced organ damage and improve the success rate of treatment.
甄别药物不良反应 Identification of adverse drug reactions
研究显示,使用洛匹那韦联合阿比多尔为主的抗病毒方案,肝功能异常发生率为51.9%,多元分析显示抗病毒药物和合并用药数是引起患者肝功能异常的独立危险因素。 It has been demonstrated that the incidence of abnormal liver function is 51.9% in COVID-19 patients who have received lopinavir/ritonavir combined arbidol antiviral treatment. Multivariate analysis revealed that antiviral agent s and more concomitant medications are two independent risk factors of abnormal liver function.
应加强患者不良反应的监测,减少不必要的合并用药。 Therefore, monitoring of the adverse drug reactions should be strengthened; the unnecessary drug combinations should be reduced.
抗病毒药物的主要不良反应: The main adverse reactions of antiviral agents include:
1)洛匹那韦/利托那韦他和达芦那韦/考比司他:引起腹泻、恶心、呕吐,肝酶与黄疸
升高、血脂异常,乳酸增高等不良反应,停药后可恢复。
(1) Lopinavir /ritonavir and darunavir/cobicistat: diarrhea, nausea, vomit, the increase of serum aminotransferase, jaundice, dyslipidemia, the increase of lactic acid.Symptoms will recover after drug withdrawal.
2)阿比多尔:肝酶及黄疸升高,与洛匹那韦联用时,发生率更高,停药后一般可恢复,偶可引起心率减慢,需避免与美托洛尔、普萘洛尔等β受体拮抗剂合用,心率低于60次/min时建议停药。 (2) Arbidol:the increase of serum aminotransferase and jaundice. When combined with lopinavir, the incidence rate is even higher. The symptoms will recover after drug withdrawal . Sometimes a slowdown of the hear t could be induced; thus it is necessary to avoid the combination of arbidol with β–receptor inhibitors such as metoprolol and propranolol . We suggest to stop taking the drugs when the heart rate drops below 60/min.
3)法匹拉韦:可引起血尿酸升高、腹泻、中性粒细胞降低、休克、暴发性肝炎、急性肾损伤等不良反应,尤见于老年或合并细胞因子风暴的患者。 (3) Fapilavir: elevation of plasma uric acid, diarrhea, neutropenia, shock, fulminant hepatitis, acute kidney injury. The adverse reactions were commonly seen in elderly patients or patients complicated with cytokine storm.
4)磷酸氯喹:可引起头晕、头痛、恶心、呕吐、腹泻、各种皮疹等,心脏骤停是最严重不良反应,眼部病变是最主要不良反应,用药前检查心电图,禁用于心律失常(如传导阻滞)、视网膜疾病,以及听力减退等患者。 (4) Chloroquine phosphate: dizziness, headache, nausea, vomit, diarrhea, different kinds of skin rash. The most severe adverse reaction is cardiac arrest. The main adverse reaction is the ocular toxicity. An electrocardiogram needs to be examined before taking the drug. The drug should be prohibited for patients with arrhythmia (e.g., conduction block), retinal disease, or hearing loss.
进行血药浓度监测 Therapeutic Drug Monitoring
需要治疗药物监测(therapeutic drugmonitoring,TDM)的抗病毒和抗菌药物血药 Some antiviral and antibacterial drugs need therapeutic drug monitoring (TDM).
浓度与剂量调整见表1,一旦发现血药浓度异常,应结合患者临床症状、合并用药,进行方案调整,实行个体化给药。 Table 1 presents the plasma concentrations of such drugs and their dosage adjustment. Upon the onset of aberrations of plasma drug concentration, the treatment regimens need to be adjusted by considering the clinical symptoms and concomitant drugs.
表1 COVID-19患者常见TDM药物的浓度范围及注意事项 Table 1 The range of concentrations and points for attention of the common TDM drugs for the COVID-19 patients
药品名称 Drug names
采血时间点 Time points of blood collection
治疗浓度范围 剂量调整原则 The range of concentrations Principles of dosage adjustment
(峰)给药后30min内 (peak) 30 min after drug administration
(谷)给药前30min内 (trough) 30 min before drug administration
洛匹那韦:(谷)>1μg/mL(峰)<8.2μg/mL lopinavir: (trough)> 1 μg/mL (peak) < 8.2 μg/mL
与疗效和毒副反应相关。 Correlated with drug efficacy and side effects.
当日给药前10min内 10 min before the drug administration
1~8μg/mL 1~8 μg/mL
当日给药前10min内 10 min before the drug administration
1~16μg/mL 1~16 μg/mL
需结合病原学检测的MIC解读血药浓度监测结果,进而调整用药方案。 Interpretation and adjust the plasma drug concentration based on MIC of the pathogen testing
当日给药前30min内 30 min before the drug administration
10~20mg/L(重症MRSA感染时推荐15~20mg/L) 10~20 mg/L (15~20mg/L for the severe MRSA infection)
谷浓度与感染治疗失败率和肾毒性相关,浓度过高需减少频次或单次剂量。 The trough concentration correlates with the failure rate of anti-infective therapy and renal toxicity. When the concentration is overly high, reduction of drug frequency or single dose is required.
当日给药前30min内 30 min before the drug administration
2~7μg/mL 2~7 μg/mL
谷浓度与骨髓抑制不良反应相关,需密切监测血三系水平。 The trough concentration correlates with myelosuppression adverse reactions.
The blood routine test needs to be closely monitored.
当日给药前30min内 30 min before the drug administration
1~5.5μg/mL 1~5.5 μg/mL
谷浓度与疗效和肝功能受损等不良反应相关 The trough concentration correlates with the therapeutic efficacy and adverse reactions such as impaired liver function.
注意潜在的药物相互作用 Paying attention to the potential drug interactions
由于抗病毒药物如洛匹那韦/利托那韦经肝脏CYP3A酶代谢,如有多重用药时须仔细排查可能的药物相互作用,合理选择药物。 Antiviral drugs such as lopinavir/ritonavir are metabolized through the enzyme CYP3A in the liver. When patients receiving concomitant medications, the potential drug interactions need to be carefully screened.
有关抗病毒药物与常见基础疾病用药的相互作用见表2。 Table 2 shows interactions bet ween antiviral drugs and common drugs for underlying diseases.
表2 抗病毒药物与常见基础疾病用药的相互作用 Table 2 Interactions bet ween antiviral drugs and common drugs for underlying
药品名称 Drug names
可能的相互作用 Potential interactions
联合用药禁忌 Contraindication in combined medication
与 CYP3A 代谢的药物 (例如他汀类、他克莫司等免疫抑制剂、伏立康唑)可导致合用药物的血浆浓度升高,导致利伐沙班AUC增加153%,阿托伐他汀AUC增加5.9倍,咪达唑仑AUC增加13倍,要注意临床症状及TDM的监测; When combined with drugs associated with CYP3A metabolism (e.g., statins, immunosuppressors such as tacrolimus, voriconazole), the plasma concentration of the combined drug may increase; leading to 153%, 5.9 folds, 13 folds increase of the AUC of rivaroxaban, atrovastatin, midazolam, respectively. Pay attention to clinical symptoms and apply the TDM.
严禁与胺碘酮(致命性心律失常)、喹硫平(严重昏迷)、辛伐他汀(横纹肌溶解)等联合使用; Combined use with amiodarone (fatal arrhythmia), quetiapine (severe coma), simvastatin (rhabdomyolysis) is prohibited.
达芦那韦/考比司他 darunavir/ cobicistat
与主要经由CYP3A和/或CYP2D6代谢的药品联合用药时可导致此类药品血浆浓度升高;相互作用药物参考洛匹那韦/利托那韦; When combined with drugs associated with CYP3A and/or CYP2D6 metabolism, the plasma concentration of the combined drugs may increase.
参考洛匹那韦/利托那韦; See lopinavir/ ritonavir.
与CYP3A4及UGT1A9底物、抑制剂和诱导剂之间存在药物相互作用 It interacts with CYP3A4, UGT1A9 substrates, inhibitors, and inducers.
①茶碱可使法匹拉韦生物利用度上升; Theophyllinum increases the bioavailability of fapilavir.
②可使乙酰氨基酚生物利用度上升到1.79倍; It increases the bioavailability of acetaminophen by 1.79 folds.
③与吡嗪酰胺联合使用可使血液中尿酸水平升高; Its combination with pyrazinamide increases the plasma uric acid level.
④与瑞格列奈联合使用会导致瑞格列奈血药浓度升高。 Its combination with repaglinide increases the plasma repaglinide level.
严禁与莫西沙星、阿奇霉素、胺碘酮等可能导致Q-T间期延长的药物合用。 Prohibit to combine with the drugs that may lead to the prolonged Q-T interval (such as moxifloxacin, azithromycin, amiodarone, etc.).
注:“—”无相关资料;TDM:治疗药物监测;AUC:药时曲线下面积; Note:“—”: no relevant data;TDM:therapeutic drug monitoring;AUC:area under the curve;
UGT1A9:尿苷二磷酸葡萄糖苷酸基转移酶1A9 UGT1A9:uridine diphosphate glucosidase 1A9.
特殊人群避免用药损伤 Avoiding medical damage in special populations
特殊人群包括孕妇、肝肾功能不全,机械通气、连续肾脏替代治疗(Continuousrenal replacement therapy, CRRT)、体外膜肺氧合治疗(Extracorporeal membrane oxygenation,ECMO)等患者 Special populations include pregnant women, patients with hepatic and renal insufficiency, patients supported by mechanical ventilation, patients under continuous renal Replacement therapy (CRRT) or, extracorporeal membrane oxygenation (ECMO), etc.
在给药过程中注意以下事项: The following aspect s need to be noted during drug administration.
1)孕妇患者,可选用洛匹那韦/利托那韦,禁用法匹拉韦、磷酸氯喹等; (1) Pregnant women
Lopinavir/ritonavir tablets could be used. Favipiravir and chloroquine phosphate are prohibited.
2)肝功能不全患者,尽量选择原形经肾脏排泄的药物,比青霉素类、头孢菌素类等; (2) Patients with hepatic insufficiency Drugs that are excreted unchanged through the kidney are preferred, such as penicillin and cephalosporins, etc.
3)肾功能不全患者(包括血液透析患者),尽量选择经肝脏代谢或肝肾双通道排泄的药物,比如利奈唑胺、莫西沙星、头孢曲松等; (3) Patients with renal insufficiency (including those on hemodialysis)
Drugs that are metabolized through the liver or excreted through the liver-kidney double channels are preferred, such as linezolid, moxifloxacin, ceftriaxone, etc.
4)CRRT持续24h患者,万古霉素建议负荷剂量1g,维持剂量0.5g,q12h,亚胺培南日剂量不建议超过2g。 (4) Patients under CRRT for 24h For vancomycin, the recommended regimen is: loading dose 1 g
and maintenance dose 0.5 g, q12h. For imipenem, the maximum daily dosage should not exceed 2 g.
十四. COVID-19患者心理干预 XIV. Psychological Intervention with COVID-19 Patients
新冠肺炎患者的心理反应和精神症状 The psychological stress and symptoms of COVID-19 patients
新冠肺炎患者确诊后常常会表现出懊悔自责、孤独无助、悲观抑郁、焦虑恐慌、烦躁失眠等症状,部分患者会出现惊恐发作。 Confirmed COVID-19 patients often have symptoms such as regret and resentment, loneliness and helplessness, depression, Anxiety and phobia, irritation and sleep deprivation. Some patients may have panic at tacks.
在隔离病房的心理评估显示,约48%的新冠肺炎确诊患者在入院初期存在心理反应,大多数是应激状态下的情绪反应。 Psychological evaluations in the isolated wards demonstrated that, about 48% of confirmed COVID-19 patients manifested psychological stress during early admission, most of which were from their emotional response to stress.
危重症患者有较高 The percentage of delirium is high among the critically ill patients.
比例出现谵妄,个案报道新冠病毒所致脑炎,伴有意识不清、烦躁等精神症状。 There is even a report of encephalitis induced by the SARS-CoV-2 leading to psychological symptoms such as unconsciousness and irritability.
建立动态心理危机评估预警机制 Establishing a dynamic mechanism for evaluation and warning of psychological crisis
在入院后每周及出院前动态监测COVID-19对患者个体心理应激、情绪、睡眠、压力等精神状态的影响程度。 Patients’ mental states (individual psychological stress, mood, sleep quality, and pressure) should be monitored every week after admission and before discharge.
采用自评工具:心理健康自评量表(SRQ-20)、抑郁症筛查量表(PHQ-9),广泛性焦虑筛查量表(GAD-7)。 The self-rating tools include: Self-Reporting Questionnaire 20 (SRQ-20), Patient Health Questionnaire 9 (PHQ-9)and Generalized Anxiety Disorder 7 (GAD-7).
他评工具:汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、阴性与阳性症状量表(PANSS)。 The peer-rating tools include: Hamilton Depression Rating Scale (HAMD), Hamilton Anxiety Rating Scale (HAMA), Positive and Negative Syndrome Scale (PANSS).
在隔离病房特殊环境下,建议患者在指导下通过手机进行问卷自评,医生可以采用面对面或语音连线下进行访谈和量表评估。在防护服穿戴下建议更多的肢体语言交流。 In such a special environment as the isolated wards, we suggest that patients should be guided to complete the questionnaires through their cell phones. The doctors can interview and perform scale assessing through face-to-face or online discussion.
基于评估结果进行相应的干预和处理 Intervention and treatment based on the assessment
3.1干预和处理原则 3.1 Principles of Intervention and treatment
对于轻症患者,建议采用非药物心理干预,自助式心理调适可采用呼吸放松训练、正念训练。 For mild patients, psychological intervention is suggested. Psychological self-adjustment includes breathing relaxation training and mindfulness training.
中重症患者,建议药物联合心理干预治疗模式。 For moderate to severe patients, Intervention and treatment by combining medication and psychotherapy are suggested.
可给予新型抗抑郁药、抗焦虑药以及苯二氮卓类药物等改善情绪和睡眠问题。 New antidepressants, anxiolytics, and benzodiazepines can be prescribed to improve the patients’ mood and sleep quality.
第二代抗精神病药物如奥氮平、喹硫平改善幻觉、妄想等精神病性症状。 The second generation antipsychotics such as olanzapine and quetiapine can be used to improve psychotic symptoms such as illusion and delusion.
3.2老年患者的精神类药物选择 3.2 The recommendation of psychotropic medications in elderly patients
新冠肺炎在中老年人群中高发,常常共患高血压、糖尿病等躯体疾病,因此,在选择精神类药物时需充分考虑药物间的相互作用以及对呼吸的影响。 Middle-aged or elderly COVID-19 patients’ medical situations are often complicated by physical diseases such as hyper tension and diabetes. Therefore, when selecting psychotropic medications, the drug interactions and their effects on respiration must be fully considered.
推荐使用西酞普兰、艾司西酞普兰等改善抑郁焦虑
情绪;苯二氮卓类药物如艾司唑仑、阿普唑仑等改善焦虑和睡眠质量;奥氮平、喹硫平等改善精神病性症状。
We recommend using citalopram, escitalopram, etc. to improve depression and Anxiety symptoms; benzodiazepines such as estazolam, alprazolam, etc. to improve Anxiety and sleep quality; olanzapine, quetiapine, etc. to improve psychotic symptoms.
十五. COVID-19患者康复治疗 XV. Rehabilitation Therapy for COVID-19 Patients
COVID-19重型、危重型患者,在急性期和恢复期,均表现有不同程度的功能损害。其中以呼吸功能障碍、躯体运动功能障碍、认知功能障碍尤为明显。 Severe and critically ill patients suffer from different degrees of dysfunction, especially Respiratory insufficiency, dyskinesia and cognitive impairment, during both acute and recovery stages.
重型、危重型患者康复治疗 Rehabilitation therapy for severe and critically ill patients
康复早期介入的目的是改善呼吸困难,帮助患者缓解症状、缓解焦虑抑郁情绪,减少并发症的发生。 The goal of early rehabilitation Intervention is to reduce breathing difficulties, relieve symptoms, ease anxiety and depression and lower the incidence of complications.
康复早期介入的流程:康复评估—治疗—再评估。 The process of early rehabilitation intervention is: rehabilitation assessment - therapy - reassessment.
1.1康复评估 1.1 Rehabilitation assessment
在一般临床评估的基础上,尤其注意功能的评估,包括呼吸、心脏、运动、ADL评估。 Based on general clinical assessment, especially functional evaluation, including respiration, cardiac status, motion and ADL should be emphasized.
重点关注呼吸康复评估,主要包括评估胸廓活动度、测定膈肌活动幅度、观察呼吸模式和频率等。 Focus on respiratory rehabilitation assessment, which includes the evaluation of thoracic activity, diaphragm activity amplitude, respiratory pattern and frequency, etc.
1.2康复治疗 1. 2 Rehabilitation therapy
COVID-19重症危重症患者的康复治疗主要包括体位管理、呼吸训练,和物理因子治疗。 The rehabilitation therapy of severe or critically ill COVID-19 patients mainly includes position management, Respiratory training, and physical therapy.
1)体位管理。 (1) Position management.
患者体位摆放可以减少痰液对于呼吸道的影响,尤其是对于改善患者的V/Q尤其重要。 Postural drainage may reduce the influence of sputum on the Respiratory tract, which is especially important to improve the patient’s V/Q.
合理体位可以利用重力作用使肺叶或者肺段气道分泌物引流排出。 Patients must learn to tip themselves into a position which allows gravity to assist in draining excretion from lung lobes or lung segment s.
对于镇静和意识障碍的患者,在生理状况允许的情况下,可采用起立床或抬高床头(30°-45°-60°)。 For patients using sedatives and suffering from consciousness disturbance, a standing-up bed or the bed head elevation (30°-45°-60°) may be applied if the patient’s condition permits.
站位状态是静息最佳通气体位,可有效增加患者通气效率,维持肺容积。 Standing is the best body position for breathing in a resting state, which can effectively increase the patient’s respiratory efficiency and maintain lung volume.
在患者能耐受的情况下,尽量争取保持患者的站位并可逐渐增加站位时间。 As long as the patient feels good, let the patient take a standing position and gradually increase the time standing.
2)呼吸运动训练。 (2) Respiratory exercise.
呼吸运动能使肺部充分的扩张,帮助肺泡和气道中的分泌物向大气道排出,避免痰液集聚在肺底部,增加肺活量,增强肺功能。 Exercise can fully expand the lungs, help the excretions from pulmonary alveoli and air way expel into the large air way so that sputum would not accumulate at the bottom of the lungs. It increases the vital capacity and enhances lung function.
其中深慢呼吸、扩胸配合肩部外展呼吸是两种主要的呼吸运动训练技术。 Deep-slow breathing and chest expansion breathing combined with shoulder expansion are the two major techniques of Respiratory exercises.
①深漫呼吸:指吸气时尽量调动膈肌主动参与,呼吸尽量深慢,避免浅快呼吸造成的通气效率降低。 Deep-slow breathing: while inhaling, the patient should try his/her best to move the diaphragm actively. The breathing should be as deep and slow as possible to avoid the reduction of Respiratory efficiency caused by fast-shallow breathing.
该呼吸方式比胸式呼吸做功低,潮气量、通气灌注比优,可用于呼吸急促时候调整呼吸。 Compared with thoracic breathing, this kind of breathing needs less muscle strength but has better tidal volume and V/Q value, which can be used to adjust breathing when experiencing short of breath.
②扩胸配合肩部外展呼吸:增加肺通气效应。 Chest expansion breathing combined with shoulder expansion: Increase pulmonary ventilation.
做深慢呼吸,吸气时做扩胸、配合肩外展;呼气时含胸,肩内收。 When taking a deep-slow breath, one expands his/her chest and shoulders while inhaling; and moves back his/her chest and shoulders while exhaling.
由于病毒性肺炎特殊病理性因素,呼吸时尽量避免长时间闭气,以免增加呼吸功、氧耗及心脏负担。 Due to the special pathological factors of viral pneumonia, suspending breathing for a long time should be avoided in order not to increase the burden of Respiratory function, and the heart, as well as oxygen consumption.
同时,注意避免动作速度过快,尽量调整 Meanwhile, avoid moving too fast.
至12-15次/min呼吸频率为佳。 Adjust the Respiratory rate at 12-15 times/min.
3)主动循环技术。 (3) Active cycle of breathing techniques.
可有效清除支气管分泌物、改善肺功能,同时不加重低氧血症和气流阻塞。 It can effectively remove bronchus excretion and improve lung function without exacerbation of hypoxemia and air flow obstruction.
该技术由三个阶段(呼吸控制、胸廓扩张、呵气),根据患者情况选择构成方式,并进行反复循环。 It consists of three stages (breathing control, thoracic expansion and exhalation). How to form a cycle of breathing should be developed according to the patient’s condition.
4)呼气正压训练器。 (4) Positive expiratory pressure trainer.
COVID-19患者肺间质结构破坏严重。 The pulmonary interstitium of COVID-19 patients has been severely damaged.
在机械通气中一般采取低压力低潮避免造成肺间质损伤。 In mechanical ventilation, low pressure and low tidal volume are required to avoid damages to the pulmonary interstitium.
因此脱机后可采取低压呼气正压训练器 可帮助分泌物由低容量肺段向高容量肺段移动,降低排痰难度、减少排痰做功。 Therefore, after the removal of mechanical ventilation, positive expiratory pressure trainer can be used to help the movement of excretions from the low volume lung segment s to the high-volume segments, lowering the difficulty of expectoration.
通过振荡气流产生呼气正压,振动气道,达到一定气道支撑效应,再通过高呼气流速,松动痰液、移除分泌物。 Expiratory positive pressure can be generated through air flow vibration, which vibrates the air way to achieve air way supporting. The excretions can then be removed as the high-speed expiratory flow moves the excretions.
5)物理因子治疗。 (5) Physical therapy.
包括超短波、振荡器、体外膈肌起搏器,肌肉功能电刺激等等。 This includes ultrashort wave, oscillators, external diaphragm pacemaker, electrical muscle stimulation, etc.
十六. COVID-19患者肺移植 XVI. Lung Transplantation in Patients with COVID-19
肺移植是终末期慢性肺病的有效治疗手段,据文献报道,鲜有用于治疗急性传染性肺部疾病。 Lung transplantation is an effective treatment approach for final-stage chronic lung diseases.
However, it is rarely repo ted that lung transplantation has been per formed to treating acute infectious lung diseases.
我院根据目前临床实践结果,总结出以下体会,供同行参考。 Based on current clinical practice and result s, FAHZU summarized this chapter as a reference for medical workers.
总体遵循探索性,抢救性,高选择,高防护的
原则,在充分、合理、优化的内科治疗后,肺部病变仍无明显好转,严重威胁生命安全时,需考虑肺移植评估。
In general, following the principles of exploration, doing the best to save life, highly selective and high protection, if lung lesions are not significantly improved after adequate and reasonable medical treatment, and the patient is in critical condition, lung transplantation could be considered with other evaluations.
移植前评估 Pre-transplantation assessment
1)年龄:建议<70岁,70岁以上患者需谨慎评估其他脏器功能及术后恢复能力; (1) Age: It is recommended that the recipients are not older than 70. Patients over 70 years old are subject to careful evaluation of other organ functions and postoperative recovery capability.
2)病程:虽然病程长短与疾病严重程度无直接相关性 (2) The course of the disease: There is no direct correlation between the length of the disease course and the severity of the disease.
但对于病程短于4-6周者,需充分评估是否给予充分的药物、呼吸机辅助和ECMO的支持; However, for patients with short disease courses (fewer than 4-6 weeks), a full medical assessment is recommended to evaluate whether adequate medication, ventilator assistance, and ECMO support have been provided.
3)肺功能状态:肺部CT、呼吸机、ECMO参数可作为参考,需充分评估是否存在逆转机会; (3) Lung function status: Based on the parameters collected from lung CT, ventilator, and ECMO, it is necessary to evaluate whether there is any chance of recovery.
4)其他大脏器功能评估:多数危重症患者长期处于镇静状态,意识状态的判断十分重要的,有条件者建议行头颅CT、脑电图检查。 (4) Functional assessment of other major organs: a. Evaluation of the consciousness status of patients in critical condition using brain CT scan and electroencephalography is crucial, as most of them would have been sedated for an extended period;
心脏评估包括心电图、心超,重点评估右心大小,肺动脉压力,以及左心功能情况。 b. Cardiac assessments, including electrocardiogram and echocardiography that focus on right heart size, pulmonary artery pressure and left heart function, are highly recommended;
血清肌酐、胆红素都应纳入评估范围,合并肝功能衰竭、肾功能衰竭者应等待肝肾功能好转; c.The level s of serum creatinine and bilirubin should al so be monitored; for patients with liver failure and renal failure, they should not be subjected to lung transplantation until the functions of the liver and kidney are recovered.
5)新冠病毒核酸检测:最少连续2次核酸检测阴性,每次间隔24小时 (5) The nucleic acid test of COVID-19: The patient should be tested negative for at least two consecutive nucleic acid tests with a time interval longer than 24 hours.
考虑目前复阳情况增多,建议增加到连续3次阴性以上。 Given the increased incidents of COVID-19 test result returning from negative to positive after treatment, it is recommended to revise the standard to three consecutive negative results.
理想情况为所有体液标本,包括血、痰、鼻咽、肺泡灌洗液、尿液、粪便均阴性 Ideally, negative results should be observed in all body fluid samples, including blood, sputum, nasopharynx, broncho-alveolar lavage, urine, and feces.
但考虑实际操作问题,至少痰、肺泡灌洗液标本检测为阴性; Considering the difficult y in operation, however, at least the testing of sputum and broncho-alveolar lavage samples should be negative.
6)感染状态评估:随着住院时间延长,部分新冠肺炎患者合并多重细菌感染,充分评估目前感染控制情况 (6) Assessment of infection status: With the extended in-patient treatment, some COVID-19 patients may have multiple bacterial infections, and thus a full medical assessment is recommended to evaluate the situation of infection control, especially for multidrug-resistant bacterial infection.
尤其是多重耐药菌感染,需建立术后抗菌药物治疗方案,预估术后感染进展风险; Moreover, post-procedure antibacterial treatment plans should be formed to estimate the risk of post-procedure infections.
7)新冠肺移植术前评估流程:由重症监护室医生团队提出→多学科积极讨论(MDT)→完善全面检查→分析处理相对禁忌症→术前康复创
造肺移植条件。
(7) The preoperative medical assessment process for lung transplantation in COVID-19 patients: a treatment pl an proposed by the ICU team → multidisciplinary discussion →comprehensive medical evaluation → analysis and treatment of relative contraindications → pre-habilitation before lung transplantation.
请参考2014 ISHLT共识:肺移植受者选择(更新版)。 Please refer to The 2014 ISHLT Consensus: A consensus document for the selection of lung transplantation candidates issued by the International Society for Heart and Lung Transplantation (updated in 2014).
十七. COVID-19患者出院标准及随访计划 XVII. Discharge Standards and Follow-up Plan for COVID-19 Patients
出院标准 Discharge standards
1)体温正常(耳温<37.5°C)至少3d; (1) Body temperature remains normal for at least 3 days (ear temperature is lower than 37.5 °C);
2)呼吸道症状明显好转; (2) Respiratory symptoms are significantly improved;
3)病毒核酸检测连续2次以上阴性(每次间隔>24h),有条件医疗机构可同时行粪便病毒核酸检测; (3) The nucleic acid is tested negative for Respiratory tract pathogen twice consecutively (sampling interval more than 24 hours); the nucleic acid test of stool samples can be per formed at the same time if possible;
4)肺部影像学检查结果病灶较前明显好转; (4) Lung imaging shows obvious improvement in lesions;
5)无其他需要住院治疗的合并症或并发症; (5) There is no comorbidities or complications which require hospitalization;
6)不吸氧情况下SpO2>93%; (6) SpO2 > 93% without assisted oxygen inhalation;
7)经医院多学科团队专家组讨论并认可达到出院标准。 (7) Discharge approved by multi-disciplinary medical team.
出院后用药 Medication after discharge
一般患者无需继续服用抗病毒药物。 Generally, antiviral drugs are not necessary after discharge.
若有轻度咳嗽、胃纳不佳、舌苔偏厚等问题时,可采用对症处理;对于部分肺部病灶较多,核酸转阴时间<3天的病人,可考虑继续带抗病毒药。 Treatments for symptoms can be applied if patients have mild cough, poor appetite, thick tongue coating, etc.
Antiviral drugs can be used after discharge for patients with multiple lung lesions in the first 3 days after their nucleic acid are tested negative.
居家隔离 Home isolation
出院后患者仍须居家隔离2周。 Patients must continue two weeks of isolation after discharge.
建议居家隔离条件: Recommended home isolation conditions are:
①有独立的生活区,需勤通风、勤消毒; ① Independent living area with frequent ventilation and disinfection;
②避免与家中的婴幼儿、老人及免疫功能低下者接触; ② Avoid contacting with infant s, the elderly and people with weak immune functions at home;
③患者及患者的家属须佩戴口罩,勤洗手; ③ Patients and their family members must wear masks and wash hands frequently;
④每日测量体温2次(早晚),密切关注机体的变化。 ④ Body temperature are taken twice a day (in the morning and evening) and pay close attention to any changes in the patient’s condition.
针对每一位出院患者,医院安排随访医生专人专管 A specialized doctor should be arranged for each discharged patient’s follow-ups.
在出院后48h内进行第一次电话随访 The first follow-up call should be made within 48 hours after discharge.
在出院后1周、2周及1个月的时间节点进行门诊随访,根据患者情况进行。 The outpatient follow-up will be carried out 1 week, 2 weeks, and 1 month after discharge.
血液标本肝肾功能、血常规;痰液及粪便标本病毒核酸检测;肺功能评估;肺部CT复检。 Examinations include liver and kidney functions, blood test, nucleic acid test of sputum and stool samples, and pulmonary function test or lung CT scan should be reviewed according to the patient’s condition.
在出院后3个月及6个月的时间节点进行电话随访。 Follow-up phone call s should be made 3 and 6 months after discharge.
复阳患者的处理 Management of patients tested positive again after discharge
我院严格执行出院标准。 Strict discharge standards have been implemented in our hospital.
已出院的患者在随访中未发现痰液、粪便核酸再次阳性情况。 There is no discharged case in our hospital whose sputum and stool samples are tested positive again in our follow-ups.
但已有较多的报道参照我国指南推荐的标准(间隔24h连续2次咽拭子核酸阴性+体温正常3天+症状明显好转+肺部影像吸收好转),患者在复诊中发现核酸阳性。 However, there are some reported cases that patients are tested positive again, after being discharged based on the standards of national guidelines (negative results from at least 2 consecutive throat swabs collected at an interval of 24 hours; body temperature remaining normal for 3 days, symptoms significantly improved; obvious absorption of inflammation on lung images).
这主要与标本留取、检测假阴性有关, It is mainly due to sample collection errors and false negative testing results.
针对此类患者,我们建议: For these patients, the following strategies are recommended:
1)按COVID-19患者标准进行隔离; (1) Isolation according to the standards for COVID-19 patients.
2)继续给予前期有效的抗病毒方案治疗; (2) Continuing to provide antiviral treatment which has been proved to be effective during prior hospitalization.
3)在肺部影像进一步好转,痰液、粪便SARS-COV-2核酸持续阴性3次(每次间隔24h)后出院; (3) Discharge only when improvement is observed on lung imaging and the sputum and stool are tested negative for 3 consecutive times (with an interval of 24 hours).
4)出院后按上文提到的居家隔离及随访要求进行观察。 (4) Home isolation and follow-up visits after discharge in accordance with the requirement s mentioned above.
第三部分 护理经验 Part Three Nursing
一. 高流量吸氧(HFNC)患者护理 I. Nursing Care for Patients Receiving High-Flow Nasal Cannula (HFNC) Oxygen Therapy
使用前充分宣教,必要时使用小剂量镇静药物。 Provide detailed information of the HFNC oxygen therapy to get the patient’s cooperation before implementation. Use low dose sedative with close monitoring if necessary.
根据患者鼻腔直径选择合适的鼻塞导管。 Choose a proper nasal catheter based on the diameter of the patient's nasal cavity.
使用时先贴减压敷料,调节好鼻塞固定带松紧,避免引起颜面部皮肤器械相关性压力损伤。 Adjust the head strap tightness and use decompression plaster to prevent device-related pressure injuries on the facial skin.
根据患者病情和耐受情况调节氧浓度、流量及温度,及时添加湿化水。 Maintain the water level in the humidifier chamber. Titrate the flow rate, the fraction of inspired oxygen (FiO2), and the water temperature based on the patient’s respiratory demands and tolerance.
使用期间若患者出现血流动力学不稳定、辅助呼吸肌运动明显、氧合持续不改善、意识状态恶化、呼吸频率持续>40次/min、大量气道分泌物等表现时,及时报告医生,考虑是否需要中止HFNC氧疗,及时行气管插管机械通气。 Report to the attending physician to seek medical decision of replacing HFNC by mechanical ventilation if any of the followings occur: hemodynamic instability, respiratory distress evidenced by obvious contraction of accessory muscles, hypoxemia persists despite oxygen therapy, deterioration of consciousness, the respiratory rate > 40 breaths per minute continuously, significant amount of sputum.
分泌物处理 Treatment of Secretions
患者自行或在护士的帮助下用纸巾擦拭口水、鼻涕、痰液,包裹后丢入预置含氯2500mg/L消毒水的一次性密闭容器中。 Patients’ drool, snot, and sputum should be wiped with tissue paper, be disposed in a sealed container with chlorine-containing disinfectant (2500 mg/L).
或直接用口腔吸引管吸入预置含氯2500mg/L消毒水的收集器。 Alternatively, secretions can be removed by oral mucus extractor or suctioning tube and be disposed in a sputum collector with chlorine-containing disinfectant (2500 mg/L).
二. 机械通气患者护理 II. Nursing Care for Patients with Mechanical Ventilation
气管插管配合 Intubation Procedures
限制保证患者安全所需的最低医护人数,佩戴正压头套。 The number of the medical staff should be limited to the minimum number that can ensure the patient’s safety. Wear powered air-purifying respirator as PPE.
插管前,充分镇痛、镇静,必要时肌松,同时做好血流动力学监测。 Before intubation, perform administration of sufficient analgesia and sedative, and use muscle relaxant if necessary. Closely monitor the hemodynamic response during intubation.
操作完成后30分钟内,房间里减少人员走动,持续等离子空气净化消毒。 Reduce movement of staff in the ward, continuous purify and disinfect the room with plasma air purification technology for 30 min after completion of intubation.
镇痛镇静、谵妄管理 Analgesia, Sedation and Delirium Management
每日确定镇痛镇静目标,q4h评估镇痛程度(CPOT),q2h评估镇静深度(RASS/BISS),滴定调节镇痛镇静药物。 Determine the target pain management goal every day. Assess pain with every 4 hours (Critical-Care Pain Observation Tool, CPOT), measure sedation with every 2 hours (RASS/BISS). Titrate the infusion rate of analgesics and sedatives to achieve pain management goals.
明确引起疼痛的操作前预镇痛。 For the known painful procedures, preemptive analgesia is administered.
每班行CAM-ICU谵妄筛查,尽早识别阳性患者。 Perform CAM-ICU delirium screening in every shift to ensure an early diagnosis of COVID-19 patients.
落实谵妄预防集束化策略:处理疼痛,最小化镇静,沟通交流,促进睡眠,早期活动等。 Apply centralization strategy for delirium prevention, including pain relief, sedation, communication, quality sleep, and early mobilization are used.
VAP的预防 Prevention of Ventilator-Associated Pneumonia (VAP)
执行VAP预防Bundle。包括:遵循手卫生制度;如无禁忌症,患者床头抬高30~45°;q4h~q6h进行1次口腔护理,采用一次性吸唾牙刷;维持气囊压30~35cmH2O,并q4h监测;经胃管管饲营养液,q4h监测胃残留量;每天评估能否撤机;使用可冲洗的气管导管,进行声门下分泌物持续低负压吸引,加间断q1h~q2h10mL注射器抽吸,根据实际囊上分泌物的量调整抽吸频次。 The ventilator bundle is used to reduce VAP, which includes hand washing; raising the tilt angle of the patient's bed by 30-45° if no contradiction is presented; oral care every 4 to 6 hours by using a disposable oral mucus extractor; maintain endotracheal tube (ETT) cuff pressure at 30-35 cmH O every 4 hours; enteral nutrition support and monitor gastric residual volume every 4 hours; evaluating daily for ventilator removal; using washable tracheal tubes for continuous subglottic suctioning combined with 10 mL syringe suctioning every 1 to 2 hours, and adjusting the suctioning frequency according to the actual amount of secretions.
声门下滞留物的处置: Dispose retentate below the glottis:
用10mL注射器抽吸囊上分泌物后立即抽吸适量含氯2500mg/L的消毒水,连接针帽,放入锐器盒中。 the syringe containing the subglottic secretions is immediately used to aspirate an appropriate amount of chlorine-containing disinfectant (2500 mg/L), then be re-capped and disposed of in a sharp container.
吸痰的护理 Sputum Suction
1)吸痰:使用密闭式吸痰管、密闭式抛弃型集痰袋,减少气溶胶及飞沫。 (1) Use a closed sputum suction system, including closed suction catheter and closed disposable collection bag, to reduce the formation of aerosol and droplets.
2)采集痰液标本:使用密闭式吸痰管配套使用的集痰器,减少飞沫暴露。 (2) Collection of sputum specimen: use a closed suction catheter and a matching collection bag to reduce exposure to droplets.
呼吸机管道冷凝水的处理 Disposal of Condensation from Ventilators
使用一次性双回路自带加热导丝的呼吸机管路,自动加水湿化罐,减少冷凝水的产生。 Use disposable ventilator tubing with dual-loop heating wire and automatic humidifier to reduce the formation of condensation.
及时倾倒冷凝水,使用预置含氯2500mg/L消毒水的加盖容器,双人配合将管道积水倒入加盖容器后,直接放入可达90°C的清洗机进行自动清洗消毒。 Two nurses should cooperate to dump the condensation promptly into a capped container with chlorine-containing disinfectant (2500 mg/L). The container can then be directly put in a washing machine, which can be heated up to 90 °C, for automatic cleaning and disinfection.
俯卧位通气护理 Nursing Care for the Prone Position Ventilation (PPV)
翻身前做好充分准备,妥善固定导管,检查所有导管接口,减少脱开的风险。 Before changing the position, secure the position of tubing and check all the joints to reduce the risk of disconnection.
翻转后q2h进行体位改变。 Change the patient’s position every 2 hours .
三. ECMO日常管理及监护 III. Daily Management and Monitoring of ECMO (Extra Corporeal Membrane Oxygenation)
ECMO灌注师专人管理,每小时检查并记录:转速、血流量,氧流量、氧浓度,控温仪是否转流、设置及实际温度;膜肺有无血块,管路有无打折、压迫,静脉管路有无抖动;患者尿色有无变红或深棕色;遵医嘱监测膜前/膜后压力。 ECMO equipment should be managed by ECMO perfusionists and the following items should be checked and recorded every hour: Pump flow rate/rotation speed; blood flow; oxygen flow; oxygen concentration; ensuring that the temperature controller is flowing; temperature setting and actual temperature; preventing clots in circuit; no pressure to the cannulae and the circuit tubing is not kinked, or no “shaking” of ECMO tubes; patient's urine color with special attention to red or dark brown urine; pre & post membrane pressure as required by the doctor.
每班检查并记录:置管深度、管路固定情况、各接口是否牢固,控温仪水位线,机器电源、气源连接情况;每班检查穿刺处有无渗血、肿胀,测量双下肢腿围、观察术侧下肢是否肿胀、末梢血运情况如足背动脉搏动、皮温、颜色等。 The following items during every shift should be monitored and recorded: Check the depth and fixation of cannula to ensure that the ECMO circuit interfaces are firm, the water level line of the temperature controller, the power supply of the machine and the connection of the oxygen, the cannula site for any bleeding and swelling; measure leg circumference and observe whether the lower limb on the operation side is swollen; observe lower limbs, such as dorsalis pedis artery pulse, skin temperature, color, etc.
每日监测:膜后血血气分析。 Daily monitoring: Post membrane blood gas analysis.
抗凝管理:ECMO抗凝管理的基本目标是适度抗凝,在避免凝血过度激活的前提下保证一定的凝血活性,即维持抗凝、凝血和纤溶的平衡。 Anticoagulation management: The basic goal of ECMO anticoagulation management is to achieve a moderate anticoagulation effect, which ensures that certain coagulation activity under the premise of avoiding excessive activation of coagulation. That is to maintain the balance among anticoagulation, coagulation and fibrinolysis.
置管时给予负荷剂量肝素钠注射(25-50IU/kg),转流期间予肝素钠维持(7.5-20IU/kg/h),根据APTT结果进行调整,APTT目标40-60s;抗凝期间尽量减少皮肤穿刺次数,各项操作动作轻柔,密切观察有无出血情况。 The patients should be injected with heparin sodium (25-50 IU/kg) at the time of intubation and maintained with heparin sodium (7.5-20 IU/kg/h) during the pump flow period. The dosage of heparin sodium should be adjusted according to APTT results which should be held between 40-60 seconds. During the anticoagulation period, the number of skin punctures should be reduced as less as possible. Operations should be taken gently. The status of bleeding should be observed carefully.
实行“超保护性肺通气”策略,最大程度地避免或减少呼吸机相关肺损伤发生,建议初始潮气量<6mL/kg、保留自主呼吸强度,保持呼吸频率10-20次/min。 Implement the "ultra-protective lung ventilation" strategy to avoid or reduce the occurrence of ventilator-related lung injury. It is recommended that the initial tidal volume is < 6 mL/kg and the intensity of spontaneous breathing is retained (breathing frequency should be between 10-20 times/min).
密切观察患者生命体征变化,维持MAP60-65mmHg、CVP<8mmHg、SpO2>90%,监测尿量、电解质情况。 Closely observe the vital signs of patients, maintain MAP between 60-65 mmHg, CVP < 8 mmHg, SpO 2 Handbook of COVID-19 Prevention and Treatment
> 90%, and monitor the status of urine volume and blood electrolytes.
输液、输血尽量膜后输注,避免输注脂肪乳、丙泊酚等药物。 Transfuse through the post membrane, avoiding infusion of fat emulsion and propofol.
根据日常监测管理记录,每班评估ECMO氧合器功能。 According to the monitoring records, evaluate the ECMO oxygenator function during every shift.
四. 人工肝护理 IV. Nursing Care of ALSS (Artificial Liver Support System)
人工肝护理主要分为治疗期护理和治疗间歇期护理,护理人员应严密观察病情、规范操作流程、关注重点环节、及时处理并发症,以便顺利完成人工肝治疗。 ALSS nursing care is mainly divided into two different periods: nursing care during treatment and intermittent care. Nursing staff should closely observe the conditions of patients, standardize the operating procedures, focus on key points and deal with complications timely in order to successfully complete ALSS treatment.
治疗期护理 Nursing Care during Treatment
治疗期护理指每次人工肝治疗过程中的护理,整体操作流程可归纳为:操作人员自身准备-患者评估-装机-预冲-上机-参数调节-下机-记录, It refers to nursing during each stage of ALSS treatment. The overall operation process can be summarized as follows: operator’s own preparation, patient evaluation, installation, pre-flushing, running, parameter adjustment, weaning and recording.
以下为各环节护理重点: The following are the key points of nursing care during each stage:
1)操作人员自身准备: (1) Operator's own preparation
全面落实并执行三级及以上防护措施。 Fully adhere to Level III or even more strict protective measures.
2)患者评估: (2) Patient assessment
患者基本情况及病情,尤其过敏史、血糖、凝血功能、氧疗情况及镇静状态,清醒患者关注其心理状态;评估患者导管功能状态。 Assess the patient's basic conditions, especially allergy history, blood glucose, coagulation function, oxygen therapy, sedation (for sober patients, pay attention to their psychological state) and catheter function status.
3)装机和预冲: (3) Installation and pre-flushing
治疗管路及耗材尽量选择闭环,避免患者血液体液暴露;按照拟定治疗模式选择相应仪器、管路及其他耗材,熟悉治疗耗材的基本性能。 Use consumables with closed-loop management while avoiding the exposure to patient's blood and body fluids. The corresponding instruments, pipelines and other consumables should be selected according to the planned treatment mode. All basic functions and characteristics of the consumables should be familiarized.
4)上机: (4) Running
建议起始引血速度≤35mL/min,避免速度过快导致低血压;实时监测生命体征。 It is recommended that the initial blood draw speed is ≤ 35 mL/min to avoid low blood pressure which might be caused by high speed. Vital signs should be monitored as well.
5)参数调节: (5) Parameter Adjustment
体外循环稳定后,根据治疗模式调节各项治疗参数及报警参数;早期、足量使用抗凝剂,维持量根据各治疗压力随时调整。 When the patient's extracorporeal circulation is stable, all treatment parameters and alarm parameters should be adjusted according to the treatment mode. A sufficient amount of anticoagulant is recommended in the early stage and the anticoagulant dose should be adjusted during the maintenance period according to different treatment pressure.
6)下机: (6) Weaning
采用液体+重力组合回收法;回收速度≤35mL/min;下机后按新冠病毒感染防控要求处理医疗废物,对治疗室及治疗仪器进行清洁消毒。 Adopt "liquid gravity combined recovery method"; the recovery speed ≤ 35 mL/min; after weaning, medical waste should be treated in accordance to the SARS-Cov-2 infection prevention and control requirements and the treatment room and instruments should be cleaned and disinfected as well.
7)记录: (7) Recording
患者生命体征、人工肝用药情况、人工肝治疗参数以及特殊情况备注等。 Make accurate records of the patient's vital signs, medication and treatment parameters for ALSS and take notes on special conditions.
间歇期护理 Intermittent Care
1)迟发型并发症的观察和处理:过敏反应、失衡综合征等。 (1) Observation and treatment of delayed complications:
Allergic reactions, imbalance syndromes, etc.;
2)人工肝置管护理:每班观察局部情况并记录;预防导管相关性血栓护理;每48小时进行导管专业维护。 (2) ALSS Intubation Care:
Medical staff during each shift should observe the patient's conditions and make records;
prevent catheter-related thrombosis; carry out professional maintenance of the catheter every 48 hours;
3)人工肝置管拔管护理:拔管前血管超声检查;拔管后置管侧下肢制动6小时,24小时内卧床休息,观察局部创面情况。 (3) ALSS Intubation and Extubation Care:
Vascular ultrasonography should be performed before extubation. After extubation, the lower limb with the intubation side of patients should not be moved in 6 hours and the patient should rest in bed for 24 hours. After extubation, the surface of the would to be observed.
五. CRRT护理 V. Continuous Renal Replacement Treatment (CRRT) Care
治疗前准备患者的准备: Preparation before CRRT
建立有效血管通路,一般行中心静脉置管,首选颈内静脉。 Preparation for patient: establish effective vascular access. Generally, central vein catheterization is performed for CRRT, with the internal jugular vein preferred.
如同时有ECMO治疗,可将CRRT治疗整合入ECMO系统;设备、耗材、超滤用药准备。 A CRRT device can be integrated into the ECMO circuit if the two are applied at the same time. Prepare equipment, consumables, and ultrafiltration medication before CRRT.
治疗中护理 In-treatment Care
1)血管通路的护理: (1) Vascular Access Care:
中心静脉置管的患者每24小时进行专业导管护理一次,妥善固定通路,避免扭曲、受压。 Perform professional catheter care every 24 hours for patients with central venous catheterization to properly fix access to avoid distortion and compression.
CRRT整入ECMO治疗时需双人核对连接方法及连接的紧密性。 When CRRT is integrated into ECMO treatment, the sequence and the tightness of the catheter connection should be confirmed by two nurses.
建议CRRT的引出端及回输端均在氧合器后。 Both the outflow and the inflow CRRT lines are suggested to be connected behind the oxygenator.
2)严密监测患者神志及生命体征变化,准确计算液体出入量;严密观察体外循环凝血情况,有效处理报警,确保机器顺畅运转;q4h监测血气分析,评估内环境电解质酸碱平衡;置换液的配置应严格遵守无菌操作原则,现配现用,标示清晰。 (2) Closely monitor consciousness and the vital signs of patients; accurately calculate the fluid inflow and outflow. Closely observe blood clotting within the cardiopulmonary bypass circuit, respond effectively to any alarms, and ensure that the machine is operating properly.
Assess the electrolyte and acid-base balance in the internal environment through blood gas analysis every 4 hours. The replacement liquid should be prepared freshly and labeled clearly under strict sterile conditions.
治疗后护理 Postoperative Care
1)监测患者血常规、肝肾功能、凝血功能。 (1) Monitor blood routine, liver and kidney function and coagulation function.
2)持续进行治疗的机器每24h擦拭消毒一次,耗材及废液按院感要求处置。 (2) Wipe the CRRT machine every 24 hours if continuous treatment is applied. Consumables and wasted liquid should be disposed in accordance with hospital requirements to avoid nosocomial infection.
六. 一般护理 VI. General Care
监测患者生命体征,特别是意识、呼吸频率、血氧饱和度等变化。 Patient vital signs should be continuously monitored, especially changes in consciousness, respiration rate and the oxygen saturation.
观察患者的咳嗽、咳痰、胸闷、呼吸困难及紫绀情况,动态监测血气分析,及时发现病情变化,改变氧疗策略或实施急救。 Observe symptoms such as cough, sputum, chest tightness, dyspnea, and cyanosis. Monitor arterial blood gas anlysis closely. Timely recognition of any deterioration to adjust strategies of oxygen therapy or to take urgent response measures.
关注高PEEP,高压力支持下气道压力、潮气量和呼吸频率变化,观察有无发生气压伤。 Pay attention to ventilator associated lung injury (VALI) when under high positive end-expiratory pressure (PEEP) and high-pressure support. Closely monitor changes in airway pressure, tidal volume and respiratory rate.
预防误吸 Aspiration Prevention
1)胃潴留的监测与护理:营养泵持续幽门后喂养以减少胃食管反流,有条件时超声评估胃动力和胃潴留情况,胃排空好的患者不建议常规评估。 (1) Gastric retention monitor: perform continuous post-pyloric feeding with a nutrition pump to reduce gastroesophageal reflux. Evaluate gastric motility and gastric retention with ultrasound if possible. Patient with normal gastric emptying are not recommended for routine assessment;
2)q4h评估胃潴留量:<100mL则回输,>100mL则汇报医生后决定。 (2) Evaluate gastric retention every 4 hours. Re-infuse the aspirate if the gastric residual volume is < 100 mL; otherwise, report to the attending physician;
3)转运期间误吸的预防:转运前,停止鼻饲,回抽胃内残余量,胃管接负压袋引流; (3) Aspiration prevention during patient transportation: before transportation, stop nasal feeding, aspirate the gastric residues and connect the gastric tube to a negative pressure bag.
转运中,保持床头抬高30°。 During transportation, raise the patient’s head up to 30°;
4)经鼻高流量吸氧治疗患者误吸的预防:q4h巡查避免湿化过度或湿化不足管路积水现象并及时处理,警惕误入气道引起呛咳和误吸,保持鼻塞位置高度高于机器和管路水平,及时处理管路冷凝水。 (4) Aspiration prevention during HFNC: Check the humidifier every 4 hours to avoid excessive or insufficient humidification. Remove any water accumulated in the tubing promptly to prevent cough and aspiration caused by the accidental entry of condensation into the airway. Keep the position of the nasal cannula higher than the machine and tubes.
Promptly remove condensation in the system.
实施导管相关性血流感染、导尿管相关尿路感染策略。 Implement strategies to prevent catheter-related bloodstream infection and catheter- related urinary tract infection.
预防皮肤压力性损伤(包括器械相关压力性损伤)、失禁性皮炎、医用黏胶相关性皮肤损伤,使用风险评估量表筛选高危患者,实施预防策略。 Prevent pressure-induced skin injuries, including device-related pressure-induced injuries, incontinence-associated dermatitis and medical adhesive-related skin injuries. Identify patients at a high risk with the Risk Assessment Scale and implement preventive strategies.
患者入院、病情变化时进行VTE风险评估,筛查高危患者,落实预防策略。 Assess all patients upon admission and when their clinical conditions change with the VTE risk assessment model to identify those who are at a high risk and implement preventive strategies.
监测凝血功能及D-二聚体变化,关注VTE相关临床表现。 Monitor coagulation function, D-dimer levels and VTE-related clinical manifes- tations.
体弱、呼吸急促、氧合波动明显者协助进食,进食期间加强氧合监测。 Assist eating for patients who are weak, short of breath or those with an obvious fluc- tuating oxygenation index. Intensify oxygenation index monitoring on these patients during meals.
不能经口进食者,早期开通肠内营养,每班评估患者肠内营养耐受情况,根据评估结果调整肠内营养速度和量。 Provide enteral nutrition at early stages for those who are unable to eat by mouth. During each shift, adjust the enteral nutrition rate and quantity according to the tolerance of enteral nutrition.
一. COVID-19患者医嘱范例 I. Medical Advice Example for COVID-19 Patients
COVID-19轻型患者医嘱范例 Medical Advice of Mild COVID-19 Cases
1.1诊疗医嘱 1.1 Ordinary
空气隔离、血氧饱和度监测、鼻导管吸氧 Air isolation, blood oxygen saturation monitoring, oxygen therapy with nasal cannula
1.2检查医嘱 1.2 Examinations
2019新型冠状病毒RNA测定(三位点)(痰) qd 2019 Novel Coronavirus RNA Detection (Three Sites) (Sputum) qd
2019新型冠状病毒RNA测定(三位点)(粪便)qd 2019 Novel Coronavirus RNA Detection (Three Sites) (Feces) qd
血常规、生化、尿常规、粪便常规+OB、凝血功能+D二聚体、血气分析+乳酸、ASO+RF+CPR+CCP、ESR、PCT、ABO+RH血型、甲状腺功能、心肌酶+血清肌钙蛋白定量、常规四项、呼吸道病毒、细胞因子、G/GM试验、血管紧张素转化酶测定 Blood routine, biochemical profile, urine routine, stool routine + OB, coagulation function + D dimer, blood gas analysis + lactic acid, ASO + RF + CPR + CCP, ESR, PCT, ABO + RH blood type, thyroid function, cardiac enzymes + quantitative assay of serum troponin, four routine items, respiratory virus test, cytokines, G/GM test, angiotensin converting enzyme
肝胆胰脾超声、心脏超声、肺部CT Liver, gallbladder, pancreas and spleen ultrasound, echocardiography and lung CT scan
1.3药物医嘱 1.3 Medication
阿比多尔片 200mg po tid Arbidol tablets 200 mg po tid
洛匹那韦利托那韦片 2片 po q12h Lopinavir/Ritonavir 2 tablets po q12h
干扰素喷雾剂 1喷 pr.nar tid Interferon spray 1 spray pr. tid
COVID-19普通型患者医嘱范例 Medical Advice of Moderate COVID-19 Cases
2.1诊疗医嘱 2.1 Ordinary
空气隔离、血氧饱和度监测、鼻导管吸氧 Air isolation, blood oxygen saturation monitoring, oxygen therapy with nasal cannula
2.2检查医嘱 2.2 Examinations
2019新型冠状病毒RNA测定(三位点)(痰) qd 2019 Novel Coronavirus RNA Detection (Three Sites) (Sputum) qd
2019新型冠状病毒RNA测定(三位点)(粪便)qd 2019 Novel Coronavirus RNA Detection (Three Sites) (Feces) qd
血常规、生化、尿常规、粪便常规+OB、凝血功能+D二聚体、血气分析+乳酸、
ASO+RF+CPR+CCP、ESR、PCT、ABO+RH血型、甲状腺功能、心肌酶+血清肌钙蛋白定量、常规四项、呼吸道病毒、细胞因子、G/GM试验、血管紧张素转化酶测定
Blood routine, biochemical profile, urine routine, stool routine + OB, coagulation function + D dimer, blood gas analysis + lactic acid, ASO + RF + CPR + CCP, ESR, PCT, ABO + RH blood type, thyroid function, cardiac enzymes + quantitative assay of serum troponin, four routine items, respiratory virus test, cytokines, G/GM test, angiotensin converting enzyme
肝胆胰脾超声、心脏超声、肺部CT Liver, gallbladder, pancreas and spleen ultrasound, echocardiography and lung CT scan
2.3药物医嘱 2.3 Medication
阿比多尔片 200mg po tid Arbidol tablets 200 mg po tid
洛匹那韦利托那韦片 2片 po q12h Lopinavir/Ritonavir 2 tablets po q12h
干扰素喷雾剂 1喷 pr.nar tid Interferon spray 1 spray pr.nar tid
NS100ML+氨溴索30mg ivgtt bid NS 100 mL + Ambroxol 30mg ivgtt bid
COVID-19重型患者医嘱范例 Medical Advice of Severe COVID-19 Cases
3.1诊疗医嘱 3.1 Ordinary
空气隔离、血氧饱和度监测、鼻导管吸氧 Air isolation, blood oxygen saturation monitoring, oxygen therapy with nasal cannula
3.2检查医嘱 3.2 Examinations
2019新型冠状病毒RNA测定(三位点)(痰) qd 2019 Novel Coronavirus RNA Detection (Three Sites) (Sputum) qd
2019新型冠状病毒RNA测定(三位点)(粪便)qd 2019 Novel Coronavirus RNA Detection (Three Sites) (Feces) qd
血常规、生化、尿常规、粪便常规+OB、凝血功能+D二聚体、血气分析+乳酸、ASO+RF+CPR+CCP、ESR、PCT、ABO+RH血型、甲状腺功能、心肌酶+血清肌钙蛋白定量、常规四项、呼吸道病毒、免疫球蛋白+补体、细胞因子、G/GM试验、血管紧张素转化酶测定 Blood routine, biochemical profile, urine routine, stool routine + OB, coagulation function + D dimer, blood gas analysis + lactic acid, ASO + RF + CPR + CCP, ESR, PCT, ABO + RH blood type, thyroid function, cardiac enzymes + quantitative assay of serum troponin, four routine items, respiratory virus test, cytokines, G/GM test, angiotensin converting enzyme
肝胆胰脾超声、心脏超声、肺部CT Liver, gallbladder, pancreas and spleen ultrasound, echocardiography and lung CT scan
3.3药物医嘱 3.3 Medication
阿比多尔片 200mg po tid Arbidol tablets 200 mg tid
洛匹那韦利托那韦片 2片 po q12h Lopinavir/Ritonavir 2 tablets po q12h
干扰素喷雾剂 1喷 pr.nar tid Interferon spray 1 spray pr.nar tid
NS 100
mL+甲强龙40mg ivgtt qd
NS 100 mL + methylprednisolone 40 mg ivgtt qd
NS100mL+泮托拉唑针40mg ivgtt qd NS 100 mL + pantoprazole 40 mg ivgtt qd
钙尔奇 D 1片 po qd Caltrate 1 tablet qd
免疫球蛋白针 20g ivgtt qd Immunoglobulin 20 g ivgtt qd
NS100mL+氨溴索30mg ivgtt bid NS 100 mL + Ambroxol 30 mg ivgtt bid
COVID-19危重型患者医嘱范例 Medical Advice of Critical COVID-19 Cases
4.1诊疗医嘱 4.1 Ordinary
空气隔离、血氧饱和度监测、鼻导管吸氧 Air isolation, blood oxygen saturation monitoring, oxygen therapy with nasal cannula
4.2检查医嘱 4.2 Examinations
2019新型冠状病毒RNA测定(三位点)(痰) qd 2019 Novel Coronavirus RNA Detection (Three Sites) (Sputum) qd
2019新型冠状病毒RNA测定(三位点)(粪便)qd 2019 Novel Coronavirus RNA Detection (Three Sites) (Feces) qd
血常规、ABO+RH血型、尿常规、粪便常规+OB、常规四项、呼吸道病毒、甲状腺功能、
常规心电图、血气分析+电解质+乳酸+GS、 G/GM试验、血培养 ONCE
Blood routine, ABO + RH blood type, urine routine, stool routine + OB, four routine items, respiratory virus test, thyroid function, electrocardiogram, blood gas analysis + electrolyte + lactic acid + GS, G/GM test, blood culture ONCE
血常规、生化、凝血功能+D二聚体、血气分析+乳酸、纳尿肽、心肌酶、血清肌钙蛋白定量、免疫球蛋白+补体、细胞因子、痰培养、CRP、PCT qd Blood routine, biochemical profile, coagulation function + D dimer, blood gas analysis +
lactic acid, natriuretic peptide, cardiac enzyme, quantitative assay of serum troponin, immunoglobulin + complement, cytokine, sputum culture, CRP, PCT qd
葡萄糖测定 q6h Blood glucose measurement q6h
肝胆胰脾超声、心脏超声、胸部床边摄片、肺部CT Liver, gallbladder, pancreas and spleen ultrasound, echocardiography and lung CT scan
4.3药物医嘱 4.3 Medication
阿比多尔片 200mg po tid Arbidol tablets 200 mg po. tid
洛匹那韦利托那韦片 2片 po q12h(或达芦那韦 1片 po qd) Lopinavir/Ritonavir 2 tablets q12h (or darunavir 1 tablet qd)
NS 10mL+甲强龙40mg iv q12h NS 10 mL + methylprednisolone 40 mg iv q12h
NS100mL+泮托拉针40mg ivgtt qd NS 100 mL + pantoprazole 40 mg ivgtt qd
免疫球蛋白针 20g ivgtt qd Immunoglobulin 20 g ivgtt qd
胸腺肽针1.6mg ih biw Thymic peptides 1.6 mg ih biw
Ns10mL+氨溴索30mg iv bid NS 10 mL + Ambroxol 30 mg iv bid
Ns 50mL+异丙肾上腺素2mg iv-vp once NS 50 mL + isoproterenol 2 mg iv-vp once
人血白蛋白 10g ivgtt qd Human serum albumin 10 g ivgtt qd
NS100mL+哌拉西林他唑巴坦 4.5g ivgtt q8h NS100 mL + piperacillin/tazobactam 4.5 ivgtt q8h
肠内营养混悬液(白普力)500mL 鼻饲法 bid Enteral nutrition suspension (Peptisorb liquid) 500 mL nasogastric feeding bid
国家卫生健康委国家中医药管理局《新型冠状病毒肺炎诊疗方案(试行第七版)》 National Health Commission and National Administration of Traditional Chinese Medicine of the People's Republic of China. Protocols for Diagnosis and Treatment of COVID-19 (7th Trial Version)
国家卫生健康委《新型冠状病毒肺炎防控方案(第六版)》 National Health Commission of the People's Republic of China. Protocols for Prevention and Control of COVID-19 (6th Version)
中国疾病预防控制中心《新型冠状病毒肺炎流行病学调查指南》 Chinese Center for Disease Control and Prevention. Guidelines for Epidemiological Investigation of COVID-19
中国疾病预防控制中心《新型冠状病毒肺炎病例密切接触者调查与管理指南》 Chinese Center for Disease Control and Prevention. Guidelines for Investigation and Management of Close Contacts of COVID-19 Patients
中国疾病预防控制中心《新型冠状病毒肺炎实验室检测技术指南》 Chinese Center for Disease Control and Prevention. Technical Guidelines for COVID-19 Laboratory Testing
中国疾病预防控制中心《特定场所消毒技术指南》 Chinese Center for Disease Control and Prevention. Technical Guidelines for Disinfection of Special Sites
中国疾病预防控制中心《特定人群个人防护指南》 Chinese Center for Disease Control and Prevention. Guidelines for Personal Protection of Specific Groups
浙江省市场监督管理局.新冠肺炎疫情防控技术指南第3部分:医疗机构:DB33/T 2241.1—2020 Technical Guidelines for Prevention and Control of COVID-19, Part3: Medical Institutions, Local Standards of Zhejiang Province DB33/T 2241.3—2020
中国疾病预防控制中心.新型冠状病毒肺炎疫情分布 Chinese Center for Disease Control and Prevention. Distribution of Novel Coronavirus Pneumonia
中国疾控中心在武汉华南海鲜市场检出大量新型冠状病毒 China CDC has Detected Novel Coronavirus in Southern China Seafood Market of Wuhan
国家卫生健康委关于新型冠状病毒肺炎暂命名事宜的通知
中华人民共和国国家卫生健康委员会疾病预防控制局.
Notification of Novel Coronavirus Pneumonia Temporarily Named by the National Health Commission of the People’s Republic of China Bureau of Disease Control and Prevention, National Health Commission of the People’s Republic of China.
新型冠状病毒感染的肺炎纳入法定传染病管理 Novel coronavirus infection pneumonia is included in the management of notifiable infectious diseases
国家感染性疾病临床医学研究中心,传染病诊治国家重点实验室. National Clinical Research Center for Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases.
人工肝血液净化系统应用于重型、危重型新型冠状病毒肺炎治疗的专家共识[J]. 中华临床感染病杂志,2020,13.DOI:10.3760/cma.j.issn.1674-2397.2020.0003. Expert Consensus on Novel Coronavirus Pneumonia Treated with Artificial Liver Blood Purification System
医院简介 Overview of FAHZU
医院拥有庆春、余杭、之江等6大院区,浙江大学医学院附属第一医院是集医疗、教学、科研、预防、保健为一体的“国家队”医院,首批委省共建国家医学中心、国家区域医疗中心。 With six campuses, it has now evolved into a medical center integrating health care, medical education, scientific research and preventative care.
医院综合排名全国第14,连续10年保持浙江第一,其中传染病学连续六年蝉联全国第一。 In terms of overall strength, FAHZU is ranked 14 th in China.
浙江大学医学院附属第一医院建院于1947年,是浙江大学创建的首家附属医院。 Founded in 1947, The First Affiliated Hospital, Zhejiang University School of Medicine (FAHZU), is the earliest affiliated hospital of Zhejiang University.
床位数4000余张,2019年门急诊量达500万人次,出院21.43万人次。 There is a total of 4,000 beds available to patients in FAHZU.Its main campus handled 5 million emergency and outpatient visits in 2019.
医院现有职工6500余人,正高职称364人,副高职称545人,拥有中国工程院院士、国家杰青、“长江学者”特聘教授等顶尖人才。 As a large-size general hospital, it currently has over 6,500 employees, including academicians of the Chinese Academy of Engineering, National Distinguished Young Scholars and other outstanding talents.
医院以综合实力雄厚、医疗质量过硬、学科特色鲜明享誉海内外。多年来,医院在器官移植、胰腺疾病、传染病、血液病、肾脏病、泌尿系疾病、临床药学等学科领域享有盛名,建立了现代化胰腺癌规范诊治创新技术体系,成功开展肝脏、胰腺、肺、肾、小肠和心脏等多器官移植手术。 Over the years, FAHZU has successfully developed a number of renowned programs in organ transplantation, pancreatic diseases, infectious diseases, hematology, nephrology, urology, clinical pharmacy, etc. FAHZU helps many realize the radical resection of cancer and enjoy long-term survival. FAHZU is also an integrated provider of liver, pancreas, lung, kidney, intestine and heart transplantation.
自2003年以来,医院在抗击SARS,H7N9禽流感和新冠肺炎过程中获得了丰富的经验,先后在NEJM、Lancet、Nature、SCIENCE等主刊均有论著发表,授权专利300余项,出版专著200余部。 In the fight against SARS, H7N9 avian flu and COVID-19, it has gained rich experience and fruitful results. As a result, its medical professionals have published many articles in journals such as New England Journal of Medicine, the Lancet, Nature and Science.
医院长期以来持续推动全球范围内的交流合作,与美国斯坦福大学、美国约翰霍普金斯医院等30余家世界顶尖高校和医疗机构建立了深厚的合作关系。 FAHZU has been extensively engaged into overseas exchanges and collaboration. It has established partnerships with over 30 prestigious universities around the world.
此外,同时医院将先进技术和优秀人才向匈牙利、印度尼西亚、马来西亚等中东欧和东南亚国家辐射,取得了丰硕的医学外交成果。 Productive achievements have also been accomplished through exchange of our medical experts and technologies with Indonesia, Malaysia and other countries.
医院牢记“以卓越的医疗品质促进人类健康”的使命,坚持“科技引领,创新发展,科学管理,优质服务”的发展思路,秉承“严谨求实”的核心价值观,致力于为患者提供高品质的医疗服务,早日成为国际一流的医学中心。 Adhering to the core value of seeking truth with prudence, FAHZU is here to offer quality health care to everyone in need.
马云公益基金会 Jack Ma Foundation
浙江大学 Zhejiang University
阿里云 Alibaba Cloud
领导能力、应对能力、组织动员能力、贯彻执行能力 the ability to lead, respond, mobilize, and to execute orders
科学战疫 science-based approach in fighting the epidemic
国家疫苗储备制度 national vaccine reserve system
疫情防控预警预测机制 early warning and forecasting mechanism for epidemic prevention and control
调整应急响应等级 to adjust the emergency response level
生物安全法 biosecurity law
国家生物安全风险防控和治理体系建设 to develop a national biosecurity risk control and management system
深化疫情防控国际合作 deeper international cooperation on epidemic prevention and control/containment measures
两年户口和档案托管 two-year custodian service for household registration and personal files
拓宽就地就近就业渠道 to create more jobs locally
援企、稳岗、扩就业 to assist businesses, stabilize employment, and create more jobs
优先吸纳贫困劳动力务工就业 to prioritize the employment of poor migrant workers
减免企业社会保险费 reduction of and exemption from corporate social insurance premiums
社保延缴 (to allow) deferred social security contributions
社保制度 social insurance system; social security system
优惠帮扶举措 preferential support measures
发挥医疗救助资金的兜底保障作用 to make full use of the medical assistance fund to ensure that medical bills (of COVID-19 patients) are paid promptly
做好工伤认定和待遇保障 (to streamline/implement procedures) to identify and facilitate compensation for work-related infections
安全距离 safe distance
防雾霾口罩 anti-smog mask
口罩产能 mask output
口罩预约 mask reservation and purchase
过滤性能 filtering performance
含酒精的消毒液 alcohol-based disinfectant
消毒机器人 disinfecting robot
抗菌洗手液 antibiotic hand sanitizer
注意下水道的通畅 to ensure that sewers are not clogged
入户检测 door-to-door testing
严控境外疫情输入 strict control of imported infection
暂时隔离区域 area for temporary quarantine
加强病毒溯源和传播机理研究 to strengthen research on the traceability and transmission mechanism of the virus
分享病毒基因序列 to share the genetic sequence of the virus
紧急救治 emergency treatment
外科处置 surgical treatment
修订诊断标准 revision of diagnostic criteria
应收尽收 All suspected and confirmed patients should be admitted to the hospital.
应治尽治 All confirmed patients should be treated.
心理疏导 psychological counseling
分区严格隔离 strict quarantine
污染集中处理 centralized treatment of medical waste
医疗垃圾处理 medical waste disposal
慕课 MOOC (Massive Open Online Courses)
网上面试 online interview
网上签约 to sign an employment contract online
员工健康监测和报告 employee health monitoring and reporting
出行轨迹 travel records
返岗证明 health certificate for returning to work
个人行程证明 proof of travel; travel records
共享员工 employee sharing
缓解用工荒 to address labor shortage
产业扶贫 poverty alleviation by developing industries
消费扶贫 poverty alleviation by consuming products and services from poor areas
服务消费 consumption of services
实物消费 consumption of products
助农 to support farmers and agriculture
把被抑制、被冻结的消费释放出来 to stimulate consumption stifled by the outbreak
送货机器人 (self-driving) delivery robot
社区批发计划 community wholesale program
无接触销售 non-physical-contact sales service
有效地填补供需缺口 to effectively fill the gap between supply and demand
健康码 health code
健康申报 declaration of health status
绿码 green (health) code
绿色通道 green channel
无接触电梯按钮 virtual elevator buttons
客座率 passenger load factor (PLF)
春节返乡高峰 Spring Festival travel rush
昼夜不停的施工进度 around-the-clock construction
假阴性 false negative
L型冠状病毒 L-type coronavirus
S型冠状病毒 S-type coronavirus
体外膜肺氧合 extracorporeal membrane  oxygenation (ECMO)
磷酸氯喹 chloroquine phosphate
负压房间 negative pressure room
基础性疾病 underlying medical conditions
病人专用通道 entrance for patients
医护人员专用通道 entrance for medical staff
半污染区 partially contaminated area
污染区 contaminated area
检疫区 quarantine area
清洁区 clean area
不获全胜决不轻言成功。 We will not proclaim success until we have secured the final victory over COVID-19.
沧海横流,方显英雄本色。 True heroes arise in times of hardship.
公共卫生安全是人类面临的共同挑战。 Public health security is a common challenge for humanity.
生命安全和生物安全领域的重大科技成果是国之重器。 Major scientific and technological achievements in the fields of life safety and biosecurity are of vital importance to our country.
这是一次危机,也是一次大考。 This is a crisis and also a test.
中国力量、中国精神、中国效率 China has demonstrated strength, character and efficiency in fighting against the epidemic.
负责任大国 a responsible major country
聚集性疫情 outbreak in clusters
二级传播(继发性传播) secondary transmission
疫情高发区 severely-hit regions (areas); areas (regions) with high infection rates
23日零时起所有目的地为北京的国际客运航班均从指定的第一入境点入境 All International Flights to Beijing Redirected
依据《中华人民共和国国境卫生检疫法》和《中华人民共和国民用航空法》有关规定,决定所有目的地为北京的国际客运航班均从指定的第一入境点入境。 In accordance with relevant provisions of the Frontier Health and Quarantine Law of the People’s Republic of China and the Civil Aviation Law of the People’s Republic of China, it is decided that all international passenger flights bound for Beijing will be diverted to designated first points of entry into China.
现公告如下: It is hereby announced as follows:
一、自3月23日零时(北京时间)开始,所有目的地为北京的国际始发客运航班均须从天津、石家庄、太原、呼和浩特、上海浦东、济南、青岛、南京、沈阳、大连、郑州、西安12个指定的第一入境点入境。 1. Starting from 00:00 of March 23 Beijing Time, all international passenger flights bound for Beijing will be diverted to the following twelve (12) designated first points of entry: Tianjin, Shijiazhuang, Taiyuan, Hohhot, Shanghai Pudong, Jinan, Qingdao, Nanjing, Shenyang, Dalian, Zhengzhou and Xi’an.
各航空公司航班指定的第一入境点可以在民航局、航空公司官网上查询。 The designated first points of entry for the specific flights operated by airlines can be found on the official website of CAAC and the websites of airlines.
二、乘坐上述国际航班的旅客在第一入境点实施检疫并办理入境手续,行李清关。 2. Passengers on the international flights shall go through quarantine inspection and customs clearance formalities and claim baggage at the first points of entry.
检疫符合登机条件的旅客可搭乘原航班入京。 Passengers who passed quarantine inspection can fly to Beijing on the original flight.
腹舱所带货物在北京清关。 Customs clearance for belly-held cargo shall be conducted in Beijing.
三、目的地为北京的国际航班指定第一入境点的安排及相关措施将根据疫情变化情况适时调整。 3. Timely adjustment to the designated first points of entry for international flights bound for Beijing and relevant measures will be made based on the epidemic development.
中国民用航空局 Civil Aviation Administration of China
中华人民共和国外交部 Ministry of Foreign Affairs of the People’s Republic of China
中华人民共和国国家卫生健康委员会 National Health Commission of the People’s Republic of China
中华人民共和国海关总署 General Administration of Customs of the People’s Republic of China
国家移民管理局 National Immigration Administration
一、疫情防控期间外国人是否可以正常出入境? I. Are foreigners allowed to entry or exit as usual during the period of epidemic prevention and control?
答:疫情发生后,中国政府采取了一系列的有力应对措施。 Answer: The Chinese government has taken a series of strong measures since the outbreak of pneumonia caused by novel coronavirus.
习近平总书记指出,我们完全有信心、有能力打赢这场疫情防控阻止战。 As President Xi Jinping stated, China has full confidence and capability to win the battle against the novel coronavirus outbreak.
目前,除武汉口岸关闭离汉通道外,我国口岸签证机关仍正常运转,外国人过境免签政策未作调整,各陆、海、空口岸继续对外开放运转,外国人可凭有效的出境入境证件正常出入境。 At present, except for the lockdown of the exit channel of Wuhan ports, all port visa agencies are operating as usual. Visa-free transit policy for foreigners are still effective. All land, sea and air ports of China are functioning. Foreigners can enter or exit as usual with their valid international travel documents.
目前情况下减少人员跨境流动有助于有效防控疫情。 At present, it is helpful to the epidemic prevention and control by reducing cross border movements.
外国人可根据实际合理安排来华行程,外国人可继续在华停留居留。 Foreigners could make reasonable travel arrangements to China and stay or reside in China as usual.
对于确需出境的外国人,鉴于部分国家和地区已针对疫情实施相应的入境管制措施,建议提前了解清楚目的地国家或地区对人员入境的规定和做法,避免因无法入境造成费用和时间损失; Due to entry restrictions adopted by some countries and regions, it is advised that foreigners who need to exit from China, should learn in advance entry requirements of destination countries or regions to avoid financial and time losses in case of any entry refusals.
前往国家、地区允许入境的,应当提前到达出境口岸,留出足够时间接受相关部门检查; Those who travel to countries or regions without entry restrictions, are advised to arrive at exit ports well ahead of departure time for necessary checks.
已经出现发热并伴有咳嗽、呼吸困难等急性呼吸道感染症状的,不应进行国际旅行,应当立即就近接受诊治,并如实向有关管理人员说明近期活动和密切接触人员等情况,以便有关部门迅速采取排查措施。 Foreigners having fever with symptoms of acute respiratory infection such as cough or breathing difficulties, should avoid international travels and seek immediate medical treatment at the nearest hospitals. Information such as recent activities as well as close contacts should be provided to relevant authorities for any necessary control measures.
二、疫情防控期间外国人如何办理签证延期、停留居留证件? II. How do foreigners apply for visas, stay or residence permits during the period of epidemic prevention and control?
答:疫情防控期间,全国公安机关出入境管理部门将继续为外国人提供签证延期和停留居留证件办理服务,保障外国人合法停留居留,对有紧急需要的将加急办理相关证件。 Answer:All Exit and Entry Administration(EEA) authorities in China will be in full service for extension and issuance of visa and stay or residence permits to ensure foreigners' legitimate stay in China. Urgent services for emergency situations will also be provided.
为有效避免人员聚集,公安机关出入境管理部门结合实际将安排预约办证服务,外国人可提前联系、合理安排办证时间。 To avoid crowds gathering risks, the EEA authorities will make arrangements for services on appointments. Foreigners could make appointments in advance for any applications.
对接待外国人较多的高校、科研院所、企事业单位等机构,出入境管理部门将根据办证需求,视情允许代办证件或提供其他必要的办证便利。 For those institutions which host high numbers of foreigners, such as universities, scientific research institutes and business enterprises, the EEA authorities will allow additional agent service or provide other necessary conveniences depending upon the situation.
三、疫情防控期间外国人签证、停居留证件过期怎么办? III. How to deal with the situation that a foreigner’s visa, stay or residence permit expires during the epidemic prevention and control?
答:根据我国出境入境管理法规定,外国人应在签证、停留居留证件到期前出境,需要继续在华停留居留的应当到公安机关出入境管理部门办理签证、停留居留证件延期手续。 Answer: According to Exit and Entry Administration Law of the PRC, foreigners should exit China or apply for extension at the EEA authorities before the visa, stay or residence permit expires .
根据有关法律规定和当前实际,对因疫情防控原因难以按时出境且无法及时办理签证、停居留证件延期手续的,移民管理机构可依法依规视情从轻、减轻或免予逾期居留处罚。 In light of the relevant laws and regulations and current situation, those who are unable to exit as scheduled or extend the visas, stay or residence permits due to the reason of epidemic prevention and control shall be given a lighter or mitigated or be exempted from punishment by the EEA authorities depending upon circumstances.
四、在华停留居留外国人应当如何配合疫情防控? IV. What can foreigners do to cooperate during the epidemic prevention and control?
答:广大外国朋友增强自我防护意识,尽量不要到人群密集地方活动,采取科学预防措施,主动配合所在社区和单位、接待机构实施疫情防控措施,自觉遵守相关法律法规,服从公安机关、移民管理机构、卫生健康等部门采取的防控管理措施。 Answer: It is advised that foreign friends enhance sense of self-protection, avoid crowded public places and take effective preventive measures. It is strongly suggested to actively cooperating with local communities and inviting entities to take preventive measures, abiding by relevant laws and regulations and following instructions of public security organs, NIA authorities, hygiene & health authorities.
如出现发热并伴有咳嗽、呼吸困难等急性呼吸道感染症状,应及时报告社区、卫生健康或移民管理机构,积极配合诊治和疫情排查。 In case of having a fever with symptoms of acute respiratory infection such as cough or breathing difficulties, foreigners should report to the local communities, NIA authorities or hygiene & health authorities and cooperate actively in medical treatment and epidemic control.
各级移民管理机构将进一步会同有关部门开展在华外国人防控服务咨询工作,协助医疗卫生机构进行筛查诊治,帮助解决停留居留期间遇到的困难和问题。 NIA authorities at all levels will work closely with relevant departments for the epidemic prevention and control to provide consultancy to foreigners, assist in disease screening and diagnosis with medical departments as well as dealing with other difficulties and problems encountered by foreigners during their stay in China.
五、中国内地居民目前是否可以正常出入境? V. Are Chinese mainland residents allowed to exit or enter as usual?
答:目前,除武汉关闭离汉通道外,全国陆、海、空对外开放口岸运转正常,中国内地居民可凭有效的出境入境证件正常出入境。 Answer: At present, except for the lockdown of the exit channel of Wuhan ports, all land, sea and air ports of China are in normal service. Chinese mainland residents could exit or enter with their valid international travel documents.
国家移民管理局所属各口岸出入境边防检查机关将继续为回国人员提供相应的便利和服务,并配合有关卫生医疗机构开展必要的疫情排查。 All immigration inspection agencies of NIA will continue to provide services and conveniences for Chinese nationals, and coordinate with relevant hygiene & health authorities to conduct necessary epidemic checks.
根据疫情防控工作需要和一些国家、地区已针对新冠肺炎疫情实施入境管制措施的情况,为保障中外人员身体健康和生命安全,维护正常出入境秩序,我们建议近期有出国出境计划的内地居民合理确定出行时间,避免可能造成的不必要损失。 In view of the epidemic prevention and control situation as well as entry restrictions adopted by some countries and regions, in order to ensure health and safety of travelers and maintain exit and entry order, it is advised that Chinese mainland residents make reasonable travel plans and avoid unnecessary financial and time costs.
据目前掌握,目前已有朝鲜、哈萨克斯坦、马来西亚、菲律宾、澳大利亚、韩国、卡塔尔、日本、越南、印度、英国、印度尼西亚、法国、缅甸、意大利、阿联酋、斯里兰卡、澳大利亚等国家和港澳台地区对来自中国内地(大陆)的旅客入境采取了限制性措施。 Based on currently available information, countries including DPRK, Kazakhstan, Malaysia, the Philippines, Australia, ROK, Qatar, Japan, Vietnam, India, Britain, Indonesia, France, Myanmar, Italy, the United Arab Emirates, Sri Lanka as well as Hong Kong, Macao SAR and Taiwan region have adopted entry restrictions for travelers from Chinese mainland.
如确有需要出国出境,建议您提前向有关国家或地区驻华代表机构、航空公司或境外接待单位了解清楚目的地国家或地区采取的入境管控措施情况再作安排。 If travelers are in urgent need of exit from Chinese mainland, it is advised to make travel arrangements after consulting with relevant diplomatic representative agencies, airlines or the inviting entities of the destination counties or regions.
六、目前中国公民可以到公安机关出入境管理部门办理普通护照等出入境证件吗? VI. Could Chinese citizens apply for travel documents such as passports at the EEA authorities?
答:为保护中外人员生命安全和身体健康,减少人员跨境流动影响疫情,维护正常出入境秩序,建议内地居民合理安排出国出境计划,非特别急需的可暂缓申办出入境证件。 Answer: In order to ensure health and safety of Chinese citizens and foreigners, reduce risks of cross-border movements for the epidemic prevention and control, maintain normal exit and entry order, it is advised that Chinese mainland residents make reasonable travel plans, and postpone applications of travel documents unless in emergency.
目前,湖北省公安机关出入境管理部门已暂停受理中国公民出入境证件申请,恢复受理申请时间将视疫情防控情况确定。 At present, the EEA of Hubei Province has suspended accepting travel documents applications from Chinese citizens. Normal services will be resumed according to the situation of the epidemic prevention and control.
其他地方公安机关出入境管理部门因春节长假暂时关闭窗口服务。 Application services are suspended in EEA of other provinces during Chinese Spring Festival holiday.
如无特别情况,春节假期结束后,除湖北省以外的公安机关出入境管理窗口将继续开放。 Under normal circumstances, the application centers except for Hubei Province will be back into service after Chinese Spring Festival holiday.
有关当事人可提前联系当地公安机关出入境管理部门了解窗口开放信息和相关证件申办要求。 Applicants could contact local EEA authorities in advance for further information about opening time of application centers and relevant requirements.
为减少人员聚集、避免奔波往返,确有需要的申请人可通过网上预约等渠道确定提交申请的具体时间,以便各窗口单位更好地提供办证服务,提高受理审批效率。 To avoid crowds gathering and unnecessary travels, applicants in need could confirm the time for submitting applications by online appointment, so that EEA authorities could provide better services and enhance efficiency.
各地(包括湖北省内人员)确有特殊事由需紧急办理出入境证件的,可随时联系各地公安机关出入境管理部门申请进行个案审批。 Applicants in urgent need for travel documents (including those in Hubei Province) could contact local EEA authorities at any time for urgent applications.
七、目前湖北武汉口岸是否能够正常出入境? VII. Are travelers allowed to exit and enter through ports of Wuhan?
答:目前,各国人员可以从湖北武汉地区的对外开放口岸(即武汉天河机场、汉口港)正常入境。 Answer: International travelers can enter China through ports of Wuhan (referring to Wuhan Tianhe International Airport and Hankou ferry terminal ).
因离汉出境通道已关闭,未经批准不安排人员通行。 Due to the lockdown of the exit channels of Wuhan ports, exits through any ports of Wuhan can only be permitted with approval.
八、目前中国内地居民是否能通过自助通道办理边检手续? VIII. Could Chinese mainland residents go through e-channels as usual?
答:根据口岸疫情防控工作需要,部分口岸出入境边防检查机关可能暂时关闭部分自助查验通道,在这种情况下旅客应经人工查验通道通关。 Answer: Some of immigration inspection agencies may close some e-channels for the moment due to current situation of the epidemic prevention and control. Under such circumstances, travelers should go through manual inspection channels.
请出入境旅客自觉服从现场工作人员引导,按规定办理通关查验手续。 It is advised for travelers to follow instructions of NIA officers and go through border clearance formalities according to relevant regulations.
疫情防控期间,口岸出入境边防检查机关人工查验通道可能配合有关主管部门采取检测体温、询问行程及密切接触者情况等必要的筛查措施,请广大出入境人员自觉配合。 During the epidemic prevention and control period, immigration officers at manual inspection channels may work together with relevant authorities and take necessary preventive measures such as taking travels’ temperatures and making inquiries about travel itineraries and close contacts .
各口岸出入境边防检查机关将确保大型口岸中国公民通关等候时间不超过30分钟,外国人出入境顺畅。 Cooperation by the travelers will be appreciated., Immigration inspection agencies will make efforts to guarantee border inspection waiting time no more than 30 minutes for Chinese citizens at large ports and smooth border clearance for foreign visitors.
九、已经办理赴港澳台签注但因疫情无法在签注有效期内赴港澳台的如何处理? IX. How to deal with the situation that some travelers have already obtained endorsements to Hong Kong, Macao SAR and Taiwan region but cannot travel due to the epidemic?
答:据掌握,目前港澳台地区主管部门对内地(大陆)居民作出了限制入境规定。 Answer: At present, regional authorities of Hong Kong, Macao SAR and Taiwan region have conducted travel restrictions for Chinese mainland residents.
对持有往来港澳台签注、受疫情影响未能在签注有效期内入境港澳台地区的,公安机关出入境管理部门将在疫情解除后,根据持证人意愿免费重新办理相同种类和有效期的签注。 For those who have obtained endorsements to Hong Kong, Macao SAR and Taiwan region but fail to enter within the validity of endorsements because of the epidemic, EEA authorities will, after clearance of the epidemic, issue the same type of endorsements with the same validity free of charge according to the holder’s wishes.
十、旅客出入境途中出现疑似疫情症状怎么办? X. How to deal with the situation that travelers have suspicious symptoms?
答:出入境人员如出现发热并伴有咳嗽、呼吸困难等急性呼吸道感染症状,应当立即停止出入境旅行、自觉远离人群,并到就近的医疗卫生机构就医。 Answer: If travelers have symptoms of acute respiratory infection, such as cough and breathing difficulties, they should suspend travels immediately, stay far away from the crowds and seek treatment at the nearest medical institutions.
口岸或驻地的移民管理机构也将提供必要的协助。 The NIA authorities will provide necessary assistance as well.
吸烟者感染COVID-19的风险较高吗? Are smokers and tobacco users at higher risk of COVID-19 infection?
吸烟者可能较易感染COVID-19。 Smokers are likely to be more vulnerable to COVID-19
吸烟意味着手指(以及可能被污染的卷烟)与嘴唇接触,从而会增加病毒经过手入口的可能性。 as the act of smoking means that fingers (and possibly contaminated cigarettes) are in contact with lips which increases the possibility of transmission of virus from hand to mouth.
另外,吸烟者还可能已有肺病或肺活量减少,这将大大加剧他们患重症的风险。 Smokers may also already have lung disease or reduced lung capacity which would greatly increase risk of serious illness.
吸水烟等烟草制品的人经常共用烟嘴和吸管,这可能会助长COVID-19在公共场所和社会环境中的传播。 Smoking products such as water pipes often involve the sharing of mouth pieces and hoses, which could facilitate the transmission of COVID-19 in communal and social settings.
导致氧气需求增加或身体正确使用氧气能力减弱的病症(如肺炎)会使患者面临较高的严重肺部疾病风险。 Conditions that increase oxygen needs or reduce the ability of the body to use it properly will put patients at higher risk of serious lung conditions such as pneumonia.
二十国集团领导人应对新冠肺炎特别峰会声明(全文) Extraordinary G20 Leaders’ Summit Statement on COVID-19
前所未有的新冠肺炎大流行深刻表明全球的紧密联系及脆弱性。 The unprecedented COVID-19 pandemic is a powerful reminder of our interconnectedness and vulnerabilities.
病毒无国界,需要本着团结精神,采取透明、有力、协调、大规模、基于科学的全球行动以抗击疫情。 The virus respects no borders. Combatting this pandemic calls for a transparent, robust, coordinated, large-scale and science-based global response in the spirit of solidarity.
我们坚定承诺建立统一战线应对这一共同威胁。 We are strongly committed to presenting a united front against this common threat.
我们对逝者以及全球人民面临的苦难深感悲痛。 We are deeply saddened by the tragic loss of life and the suffering faced by people around the world.
当前最紧迫的任务是应对疫情及其对健康、社会和经济等带来的复杂影响。 Tackling the pandemic and its intertwined health, social and economic impacts is our absolute priority.
在继续抗击新冠肺炎的同时,我们向所有一线医务工作者表示感谢与支持。 We express our gratitude and support to all frontline health workers as we continue to fight the pandemic.
二十国集团致力于同世界卫生组织、国际货币基金组织、世界银行集团、联合国以及其他国际组织一道,在各自职责范围内采取一切必要行动以战胜疫情。 The G20 is committed to do whatever it takes to overcome the pandemic, along with the World Health Organization (WHO), International Monetary Fund (IMF), World Bank Group (WBG), United Nations (UN), and other international organizations, working within their existing mandates.
我们决心通过各自和集体行动,不遗余力做好以下几方面工作: We are determined to spare no effort, both individually and collectively, to:
保护生命; Protect lives.
保障人们的工作和收入; Safeguard people’s jobs and incomes.
重振信心、维护金融稳定、恢复并实现更强劲的增长; Restore confidence, preserve financial stability, revive growth and recover stronger.
使对贸易和全球供应链的干扰最小化; Minimize disruptions to trade and global supply chains.
向所有需要的国家提供帮助; Provide help to all countries in need of assistance.
协调公共卫生和财政措施。 Coordinate on public health and financial measures.
抗击新冠肺炎大流行 Fighting the Pandemic
我们承诺采取一切必要公共卫生措施,争取提供足够资金来抑制此次大流行病,以保护人民,特别是最脆弱群体。 We commit to take all necessary health measures and seek to ensure adequate financing to contain the pandemic and protect people, especially the most vulnerable.
我们将共享实时、透明信息,交换流行病学和临床数据,共享研发所需的物资,加强全球公共卫生体系,包括支持全面实施《国际卫生条例(2005)》。 We will share timely and transparent information; exchange epidemiological and clinical data; share materials necessary for research and development; and strengthen health systems globally, including through supporting the full implementation of the WHO International Health Regulations (IHR 2005).
我们将扩大产能,以满足不断增长的医疗用品需求,并确保以可负担的价格,尽快向最需要的地方合理、广泛提供。 We will expand manufacturing capacity to meet the increasing needs for medical supplies and ensure these are made widely available, at an affordable price, on an equitable basis, where they are most needed and as quickly as possible.
我们强调面对此次全球卫生危机,负责任的公众信息传播至关重要。 We stress the importance of responsible communication to the public during this global health crisis.
我们要求卫生部长分享最佳实践,并在四月的部长级会议前采取一系列二十国集团紧急行动以共同抗击此次大流行病。 We task our Health Ministers to meet as needed to share national best practices and develop a set of G20 urgent actions on jointly combatting the pandemic by their ministerial meeting in April.
我们完全支持并承诺进一步增强世卫组织在协调国际抗疫行动方面的职责,包括保护一线医疗工作者,提供医疗用品,特别是诊断工具、诊疗方法、药品和疫苗。 We fully support and commit to further strengthen the WHO’s mandate in coordinating the international fight against the pandemic, including the protection of front-line health workers, delivery of medical supplies, especially diagnostic tools, treatments, medicines, and vaccines.
我们承认有必要采取紧急短期举措,以加强全球应对新冠肺炎的努力。 We acknowledge the necessity of urgent short-term actions to step up the global efforts to fight the COVID-19 crisis.
我们将与利益相关者共同努力,尽快填补世界卫生组织“新型冠状病毒战略防范和应对方案”中的资金缺口。 We will quickly work together and with stakeholders to close the financing gap in the WHO Strategic Preparedness and Response Plan.
我们承诺在自愿基础上,立即向世卫组织新冠肺炎团结应对基金、流行病防范创新联盟和全球疫苗免疫联盟提供资源。 We further commit to provide immediate resources to the WHO’s COVID-19 Solidarity Response Fund, the Coalition for Epidemic Preparedness and Innovation (CEPI) and Gavi, the Vaccine Alliance, on a voluntary basis.
我们呼吁所有国家、国际组织、私人部门、慈善团体和个人提供捐资。 We call upon all countries, international organizations, the private sector, philanthropies, and individuals to contribute to these efforts.
为了捍卫未来,我们承诺大幅增加防疫支出以增强各国、地区和全球应对潜在传染病暴发的准备。 To safeguard the future, we commit to strengthen national, regional, and global capacities to respond to potential infectious disease outbreaks by substantially increasing our epidemic preparedness spending.
这将加强对所有人的保护,尤其是受传染病严重影响的弱势群体。 This will enhance the protection of everyone, especially vulnerable groups that are disproportionately affected by infectious diseases.
我们进一步承诺共同增加疫苗和药品研发基金,利用数字技术并加强科研全球合作。 We further commit to work together to increase research and development funding for vaccines and medicines, leverage digital technologies, and strengthen scientific international cooperation.
我们将遵循有效、安全、公平、可及和可负担目标,加强包括私营部门在内的协调力度,快速研发、生产和分配诊断工具、抗疫药物和疫苗。 We will bolster our coordination, including with the private sector, towards rapid development, manufacturing and distribution of diagnostics, antiviral medicines, and vaccines, adhering to the objectives of efficacy, safety, equity, accessibility, and affordability.
我们要求世界卫生组织与有关组织合作,评估大流行病防范方面的不足,并在未来几个月内向财政和卫生部长联席会议报告,以期建立关于大流行病防范和应对的全球倡议。 We ask the WHO, in cooperation with relevant organizations, to assess gaps in pandemic preparedness and report to a joint meeting of Finance and Health Ministers in the coming months, with a view to establish a global initiative on pandemic preparedness and response.
该倡议将充分利用现有项目,延续全球防范领域工作重点,并作为一个普遍、有效、持续的筹资和协调平台,以加速疫苗、诊断和治疗的开发和使用。 This initiative will capitalize on existing programs to align priorities in global preparedness and act as a universal, efficient, sustained funding and coordination platform to accelerate the development and delivery of vaccines, diagnostics and treatments.
维护世界经济 Safeguarding the Global Economy
我们承诺竭尽所能,使用现有一切政策工具,降低此次大流行病对经济和社会造成的损害,恢复全球增长,维持市场稳定并增强经济韧性。 We commit to do whatever it takes and to use all available policy tools to minimize the economic and social damage from the pandemic, restore global growth, maintain market stability, and strengthen resilience.
我们正采取迅速而有力的措施,支持经济,保护劳动者、企业,特别是中小微企业,以及受影响最严重的部门,并通过适当的社会保护措施来保护脆弱群体。 We are currently undertaking immediate and vigorous measures to support our economies; protect workers, businesses—especially micro-, small and medium-sized enterprises—and the sectors most affected; and shield the vulnerable through adequate social protection.
我们正在向全球经济注入超过5万亿美元,以作为有针对性的财政政策、经济措施和担保计划的一部分,抵消大流行病对社会、经济和金融的影响。 We are injecting over $5 trillion into the global economy, as part of targeted fiscal policy, economic measures, and guarantee schemes to counteract the social, economic and financial impacts of the pandemic.
我们将继续采取有力、大规模的财政支持措施。 We will continue to conduct bold and large-scale fiscal support.
二十国集团的集体行动将扩大影响,确保连贯,形成合力。 Collective G20 action will amplify its impact, ensure coherence, and harness synergies.
应对措施的规模和范围将重振全球经济,为保护工作岗位和恢复经济增长奠定坚实基础。 The magnitude and scope of this response will get the global economy back on its feet and set a strong basis for the protection of jobs and the recovery of growth.
我们要求财政部长和央行行长定期协调并制定《二十国集团应对新冠肺炎行动计划》,并同国际组织紧密合作,迅速提供适当的国际金融援助。 We ask our Finance Ministers and Central Bank Governors to coordinate on a regular basis to develop a G20 action plan in response to COVID-19 and work closely with international organizations to swiftly deliver the appropriate international financial assistance.
我们支持各国央行根据授权采取特别措施。 We support the extraordinary measures taken by central banks consistent with their mandates.
各国央行已采取行动支持信贷流向家庭和企业,增强金融稳定,以及加强全球市场流动性。 Central banks have acted to support the flow of credit to households and businesses, promote financial stability, and enhance liquidity in global markets.
我们对央行扩大货币互换额度表示欢迎。 We welcome the extension of swap lines that our central banks have undertaken.
我们还支持为确保金融体系持续支持经济而采取的监管措施,并欢迎金融稳定理事会宣布协调此类措施。 We also support regulatory and supervisory measures taken to ensure that the financial system continues to support the economy and welcome the Financial Stability Board’s (FSB) announced coordination of such measures.
我们欢迎国际货币基金组织和世界银行尽最大程度运用各种工具支持有需要的国家,作为全球协调行动的一部分,并要求它们定期向二十国集团更新此次大流行病的影响,汇报应对举措及政策建议。 We also welcome the steps taken by the IMF and the WBG to support countries in need using all instruments to the fullest extent as part of a coordinated global response and ask them to regularly update the G20 on the impacts of the pandemic, their response, and policy recommendations.
我们将继续应对低收入国家因疫情导致的债务脆弱性风险。 We will continue to address risks of debt vulnerabilities in low-income countries due to the pandemic.
我们还要求国际劳工组织和经合组织监测大流行病对就业的影响。 We also ask the International Labour Organization (ILO) and the Organisation for Economic Cooperation and Development (OECD) to monitor the pandemic’s impact on employment.
应对疫情对国际贸易造成的干扰 Addressing International Trade Disruptions
为满足民众所需,我们将努力确保重要医疗用品、关键农产品和其他商品和服务的正常跨境流动,并努力解决全球供应链中断问题,从而保障全人类的健康和福祉。 Consistent with the needs of our citizens, we will work to ensure the flow of vital medical supplies, critical agricultural products, and other goods and services across borders, and work to resolve disruptions to the global supply chains, to support the health and well-being of all people.
我们承诺继续共同努力促进国际贸易,协调应对措施,避免对国际交通和贸易造成不必要的干扰。 We commit to continue working together to facilitate international trade and coordinate responses in ways that avoid unnecessary interference with international traffic and trade.
旨在保护健康的应急措施将是有针对性、适当、透明和临时的。 Emergency measures aimed at protecting health will be targeted, proportionate, transparent, and temporary.
我们要求贸易部长评估大流行对贸易的影响。 We task our Trade Ministers to assess the impact of the pandemic on trade.
我们重申实现自由、公平、非歧视、透明、可预期和稳定的贸易投资环境以及保持市场开放的目标。 We reiterate our goal to realize a free, fair, non-discriminatory, transparent, predictable and stable trade and investment environment, and to keep our markets open.
加强全球合作 Enhancing Global Cooperation
我们将同一线国际组织,特别是世界卫生组织、国际货币基金组织、世界银行以及多边和区域开发银行一道,迅速果断开展合作,部署强有力、协调一致、快速的一揽子金融计划,并填补各自政策工具箱中的空白。 We will work swiftly and decisively with the front-line international organizations, notably the WHO, IMF, WBG, and multilateral and regional development banks to deploy a robust, coherent, coordinated, and rapid financial package and to address any gaps in their toolkit.
我们已准备好加强全球金融安全网。 We stand ready to strengthen the global financial safety nets.
我们呼吁这些组织进一步协调行动,包括通过与私营部门的协调,以支持新兴国家和发展中国家应对新冠肺炎带来的卫生、经济和社会冲击。 We call upon all these organizations to further step up coordination of their actions, including with the private sector, to support emerging and developing countries facing the health, economic, and social shocks of COVID-19.
我们对各国特别是发展中国家和最不发达国家,尤其是非洲和小岛国,面临的严峻挑战深表关切。这些国家的卫生体系和经济恐难以应对挑战。我们同样对难民和流离失所者面临的特殊风险深表关切。 We are gravely concerned with the serious risks posed to all countries, particularly developing and least developed countries, and notably in Africa and small island states, where health systems and economies may be less able to cope with the challenge, as well as the particular risk faced by refugees and displaced persons.
我们认为加强非洲卫生防御是提升全球卫生韧性的关键。 We consider that consolidating Africa’s health defense is a key for the resilience of global health.
我们将加强能力建设和技术援助,特别是对高危群体。 We will strengthen capacity building and technical assistance, especially to at-risk communities.
我们准备好调动更多发展和人道主义资金。 We stand ready to mobilize development and humanitarian financing.
我们要求有关高级别官员密切协调,支持全球应对疫情影响的努力,包括根据各国法规采取适当的边境管理措施,并在必要时为撤回公民提供协助。 We task our top relevant officials to coordinate closely in support of the global efforts to counter the pandemic’s impacts, including through proportionate border management measures in accordance with national regulations and to provide assistance where necessary to repatriate citizens.
我们珍视为保证人民健康而推迟举行大型公共活动的做法,特别是国际奥委会关于将奥运会调整至不晚于2021年夏季举行的决定。 We value the efforts to safeguard our people’s health through the postponement of major public events, in particular the decision by the International Olympic Committee to reschedule the Olympic Games to a date no later than summer 2021.
我们赞赏日本决心完整举办2020年东京奥运会和残奥会,以此象征人类的坚韧不拔。 We commend Japan’s determination to host the Olympic and Paralympic Games Tokyo 2020 in their complete form as a symbol of human resilience.
我们准备好迅速应对,并根据需要进一步采取行动。 We stand ready to react promptly and take any further action that may be required.
我们愿根据形势需要再次召集会议。 We express our readiness to convene again as the situation requires.
应对疫情比以往任何时候都更需要全球行动、团结和国际合作。 Global action, solidarity and international cooperation are more than ever necessary to address this pandemic.
我们坚信,通过密切合作,我们必将战胜困难。 We are confident that, working closely together, we will overcome this.
我们将保护人类生命,恢复全球经济稳定,并为强劲、可持续、平衡和包容性增长奠定坚实基础。 We will protect human life, restore global economic stability, and lay out solid foundations for strong, sustainable, balanced and inclusive growth.
COVID-19检测 Testing for COVID-19
实验室检测可以确认呼吸道样本中的COVID-19病毒。 There are laboratory tests that can identify the virus that causes COVID-19 in respiratory specimens.
各州和地方公共卫生部门已经收到CDC提供的试剂盒,而医疗提供者的试剂盒来自商业生产商。 State and local public health departments have received tests from CDC while medical providers are getting tests developed by commercial manufacturers.
所有这些试剂盒均为实时逆转录-聚合酶链反应(RT-PCR)检测试剂盒,可在4 至 6小时内提供结果。逆转录-聚合酶链反应 All of these tests are Real-Time Reverse Transcriptase (RT)-PCR Diagnostic Panels, that can provide results in 4 to 6 hours.
谁应接受检测 Who should be tested
并非每个人都需要接受COVID-19检测。 Not everyone needs to be tested for COVID-19.
以下信息可帮助您确定是否需要护理或检测。 Here is some information that might help in making decisions about seeking care or testing.
大多数人出现轻微症状并能够居家康复。 Most people have mild illness and are able to recover at home.
对于此病毒,目前尚无已批准的针对性治疗方法。 There is no treatment specifically approved for this virus.
检测结果可能有助于确定您应与谁联系。 Testing results may be helpful to inform decision-making about who you come in contact with.
CDC已提供谁应接受检测的指南,但是否进行检测应由州和本地卫生部门及/或个体临床医生酌情决定。 CDC has guidance for who should be tested, but decisions about testing are at the discretion of state and local health departments and/or individual clinicians.
临床医生应与所在州和本地卫生部门合作,通过公共卫生实验室或与临床或商业实验室合作协调检测。 Clinicians should work with their state and local health departments to coordinate testing through public health laboratories, or work with clinical or commercial laboratories.
如何获取检测 How to get tested
如果您出现COVID-19症状并希望接受检测,请尝试联系您所在州或当地卫生部门或医疗提供者。 If you have symptoms of COVID-19 and want to get tested, try calling your state or local health department or a medical provider.
虽然这些试剂盒的供给已增加,但仍然可能很难找到提供检测的地点。 While supplies of these tests are increasing, it may still be difficult to find a place to get tested.
检测后怎么做 What to do after you are tested
如果您的COVID-19检测结果呈阳性,请参见"如果您生病了或护理病人"页面。 If you test positive for COVID-19, see If You Are Sick or Caring for Someone.
如果您的COVID-19检测结果呈阴性,则说明在收集您的样本时,您可能没有被感染。 If you test negative for COVID-19, you probably were not infected at the time your specimen was collected.
但是,这并不意味着您不会生病。 However, that does not mean you will not get sick.
可能的情况是,收集样本时,您还处于感染早期,之后您的检测结果也可能呈阳性,或者您在此次检测之后被感染,随后出现疾病症状。 It is possible that you were very early in your infection at the time of your specimen collection and that you could test positive later, or you could be exposed later and then develop illness.
换言之,阴性检测结果并不能排除之后生病的可能。 In other words, a negative test result does not rule out getting sick later.
CDC预计COVID-19会在美国广泛传播。 CDC expects that widespread transmission of COVID-19 in the United States will occur.
在接下来的几个月中,美国大部分人口都将接触此病毒。 In the coming months, most of the U.S. population will be exposed to this virus.
您应继续采取所有CDC建议的保护措施,保护您和他人不被传染。 You should continue to practice all the protective measures recommended to keep yourself and others free from illness.
参见"如何保护自己"。 See How to Protect Yourself.
额外信息:美国食品药品管理局 SARS-CoV-2诊断检测常见问题(FAQ)。 Additional information: U.S. Food and Drug Adminstration FAQs on Diagnostic Testing for SARS-CoV-2.
如果您病情严重,请立即寻求医疗帮助 If you are very sick get medical attention immediately
何时寻找医学治疗 When to Seek Medical Attention
如果您出现以下COVID-19身体状况,请立刻寻求医疗救助,紧急警告信号包括: If you develop emergency warning signs for COVID-19 get medical attention immediately. Emergency warning signs include*:
呼吸困难 Trouble breathing
胸口持续疼痛或感到压迫 Persistent pain or pressure in the chest
精神恍惚或无精打采 New confusion or inability to arouse
嘴唇或脸色发紫 Bluish lips or face
冠状病毒症状 Symptoms of Coronavirus
老年人和存在潜在健康问题的人,如心脏病、或肺病、或糖尿病患者似乎更有可能因 COVID-19疾病而出现更严重的并发症。 Older adults and people who have severe underlying medical conditions like heart or lung disease or diabetes seem to be at higher risk for developing more serious complications from COVID-19 illness.
需要留意的症状 Watch for symptoms
对于确诊的新型冠状病毒肺炎2019(COVID-19)病例,患者症状包括轻度症状、重度症状,甚至死亡。 Reported illnesses have ranged from mild symptoms to severe illness and death for confirmed coronavirus disease 2019 (COVID-19) cases.
这些症状可能在接触病毒2-14天后出现(基于MERS-CoV病毒潜伏期)。 These symptoms may appear 2-14 days after exposure (based on the incubation period of MERS-CoV viruses).
发烧
咳嗽
呼吸困难
Fever
Cough
Shortness of breath
何时寻找医学治疗 When to Seek Medical Attention
如果您出现以下COVID-19身体状况,请立刻寻求医疗救助,紧急警告信号包括*: If you develop emergency warning signs for COVID-19 get medical attention immediately. Emergency warning signs include*:
呼吸困难
胸口持续疼痛或压迫感
精神恍惚或无精打采
嘴唇或脸色发紫
Trouble breathing
Persistent pain or pressure in the chest
New confusion or inability to arouse
Bluish lips or face
本列表并未包括所有症状。 *This list is not all inclusive.
如有其它严重或让人担心的症状,请咨询您的医生。 Please consult your medical provider for any other symptoms that are severe or concerning.
如何保护自己 How to Protect Yourself
老年人和患有严重基础病的人,如心脏病或肺病或糖尿病患者似乎更有可能因 COVID-19 疾病而出现更严重的并发症。 Older adults and people who have severe underlying medical conditions like heart or lung disease or diabetes seem to be at higher risk for developing more serious complications from COVID-19 illness.
了解其传播方式 Know How it Spreads
目前没有任何疫苗能够预防新型冠状病毒肺炎(COVID-19)。 There is currently no vaccine to prevent coronavirus disease 2019 (COVID-19).
预防疾病的最佳方式是避免接触到此病毒。 The best way to prevent illness is to avoid being exposed to this virus.
此病毒主要通过人传人的方式进行传播。
密切接触的人之间(约6英尺内)。
The virus is thought to spread mainly from person-to-person.
Between people who are in close contact with one another (within about 6 feet).
通过感染患者咳嗽或打喷嚏时产生的飞沫。 Through respiratory droplets produced when an infected person coughs or sneezes.
这些飞沫可以附着到附近的人的嘴巴或鼻子上,甚至可能被吸入肺部。 These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs.
保护自己的措施有 Take steps to protect yourself
经常清洁您的双手 Clean your hands often
经常使用肥皂和水洗手,时间不短于20秒,特别是当您出入公共场所后,或者擤鼻涕、咳嗽或打喷嚏之后。 Wash your hands often with soap and water for at least 20 seconds especially after you have been in a public place, or after blowing your nose, coughing, or sneezing.
如果无法马上找到肥皂和水,可使用酒精含量至少为60%的手部消毒液。 If soap and water are not readily available, use a hand sanitizer that contains at least 60% alcohol.
将其涂满您的双手,然后双手相互搓揉直至感到干燥。 Cover all surfaces of your hands and rub them together until they feel dry.
避免用未洗过的手接触眼口鼻。 Avoid touching your eyes, nose, and mouth with unwashed hands.
避免近距离接触 Avoid close contact
避免与病人近距离接触
如果COVID-19正在您的社区中传播,请与他人保持一定的距离。
Avoid close contact with people who are sick  Put distance between yourself and other people if COVID-19 is spreading in your community.
这对于患重病的风险较高的人群尤为重要。 This is especially important for people who are at higher risk of getting very sick.
保护他人的措施有: Take steps to protect others
生病后请待在家中 Stay home if you’re sick
如果您已生病,请待在家中,除非需要外出接受医学护理。 Stay home if you are sick, except to get medical care.
了解生病后应该做什么。 Learn what to do if you are sick.
咳嗽及打喷嚏时掩住口鼻 Cover coughs and sneezes
当您咳嗽或打喷嚏时用纸巾或肘部内侧掩住口鼻。 Cover your mouth and nose with a tissue when you cough or sneeze or use the inside of your elbow.
将用过的纸巾扔进垃圾桶。 Throw used tissues in the trash.
立即用肥皂和水洗手,时间不短于20秒。 Immediately wash your hands with soap and water for at least 20 seconds.
如果无法马上找到肥皂和水,可使用酒精含量至少为60%的手部消毒液来洗手。 If soap and water are not readily available, clean your hands with a hand sanitizer that contains at least 60% alcohol.
生病时请佩戴口罩 Wear a facemask if you are sick
如果您已生病:您应在周围有其他人(例如与其他人共处一室或同坐一辆车)时以及进入医务人员办公室前佩戴口罩。 If you are sick: You should wear a facemask when you are around other people (e.g., sharing a room or vehicle) and before you enter a healthcare provider’s office.
如果您无法佩戴口罩(例如因为这会导致呼吸困难),您应在咳嗽和打喷嚏时尽可能掩住口鼻,而为您提供护理的人员应在进入您的房间时佩戴口罩。 If you are not able to wear a facemask (for example, because it causes trouble breathing), then you should do your best to cover your coughs and sneezes, and people who are caring for you should wear a facemask if they enter your room.
了解生病后应该做什么。 Learn what to do if you are sick.
如果您没有生病:您无需佩戴口罩,除非您正在照顾病人(并且此病人无法佩戴口罩)。 If you are NOT sick: You do not need to wear a facemask unless you are caring for someone who is sick (and they are not able to wear a facemask).
口罩可能供应不足,因此应当尽量留给护理人员使用。 Facemasks may be in short supply and they should be saved for caregivers.
清洁和消毒 Clean and disinfect
每天对经常触摸的表面进行清洁和消毒,包括桌面、门把手、电灯开关、台面、扶手、书桌、电话、键盘、马桶、水龙头和水槽。 Clean AND disinfect frequently touched surfaces daily. This includes tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets, and sinks.
对脏污的表面进行清洁:消毒之前先使用清洁剂或肥皂和水进行清洁。 If surfaces are dirty, clean them: Use detergent or soap and water prior to disinfection.
消毒方法: To disinfect:
大多数已在EPA注册的常见家用消毒剂均可有效使用。 Most common EPA-registered household disinfectants will work.
请使用适合相应表面的消毒剂。 Use disinfectants appropriate for the surface.
选择包括: Options include:
稀释家用漂白剂。 Diluting your household bleach.
通过以下方式制作漂白剂溶液: To make a bleach solution, mix:
每加仑水混合5大汤匙(1/3杯)漂白剂 5 tablespoons (1/3rd cup) bleach per gallon of water
每夸脱水混合4茶匙漂白剂
遵照制造商有关使用方法和正确通风的说明。
4 teaspoons bleach per quart of water  Follow manufacturer’s instructions for application and proper ventilation.
进行检查以确保产品没有过期。 Check to ensure the product is not past its expiration date.
绝对不要将家用漂白剂与氨或任何其他清洁剂混合。 Never mix household bleach with ammonia or any other cleanser.
未过期的家用漂白剂经过适当的稀释后可以有效地杀灭冠状病毒。 Unexpired household bleach will be effective against coronaviruses when properly diluted.
酒精溶液。
确保溶液中的酒精含量至少为70%。
Alcohol solutions.
Ensure solution has at least 70% alcohol.
其他已在EPA注册的常见家用消毒剂。 Other common EPA-registered household disinfectants.
基于对更难杀灭的病毒的检测数据,杀灭新兴病毒性病原体的功效已得到EPA批准外部图标的产品预计能够有效地用于COVID-19。 Products with EPA-approved emerging viral pathogens external icon claims are expected to be effective against COVID-19 based on data for harder to kill viruses.
使用所有清洁和消毒产品时,请遵照制造商的说明(例如浓度、使用方法和接触时间等) Follow the manufacturer’s instructions for all cleaning and disinfection products (e.g., concentration, application method and contact time, etc.).
在家中照顾家人 Caring for someone at home
大多数COVID-19患者的病情较轻,应在家中进行康复治疗。 Most people who get sick with COVID-19 will have only mild illness and should recover at home.
*居家护理有助于阻止COVID-19的传播,并帮助保护容易因COVID-19患上重病的人群。 * Care at home can help stop the spread of COVID-19 and help protect people who are at risk for getting seriously ill from COVID-19.
COVID-19会在近距离接触(约6英尺以内)的人之间通过被感染者咳嗽或打喷嚏时产生的呼吸飞沫进行传播。 COVID-19 spreads between people who are in close contact (within about 6 feet) through respiratory droplets produced when an infected person coughs or sneezes.
如果您在家中照顾家人,请监控紧急迹象、防止细菌传播、治疗各种症状,并仔细考虑应在何时结束居家隔离。 If you are caring for someone at home, monitor for emergency signs, prevent the spread of germs, treat symptoms, and carefully consider when to end home isolation.
注意:老年人以及有肺病、心脏病或糖尿病等严重的潜在健康问题的各年龄段人群因COVID-19疾病而产生更严重并发症的风险更高,因此应在症状开始后立即寻求健康护理。 Note: Older adults and people of any age with certain serious underlying medical conditions like lung disease, heart disease, or diabetes are at higher risk for developing more serious complications from COVID-19 illness and should seek care as soon as symptoms start.
监控病人的症状是否在恶化。 Monitor the person for worsening symptoms.
了解紧急警告体征。 Know the emergency warning signs.
随时备好病人的医务人员联系信息。 Have their healthcare provider’s contact information on hand.
如果病人的病情加重,请通过电话联系其医务人员。 If they are getting sicker, call their healthcare provider.
如需急救,请致电911并告知调派人员病人已经感染或疑似感染COVID-19。 For medical emergencies, call 911 and notify the dispatch personnel that they have or are suspected to have COVID-19.
如果您出现以下COVID-19身体状况,请立刻寻求医疗救助,紧急警告信号包括*: If you develop emergency warning signs for COVID-19 get medical attention immediately. Emergency warning signs include*:
呼吸困难 Trouble breathing
胸口持续疼痛或压迫感 Persistent pain or pressure in the chest
精神恍惚或无精打采 New confusion or inability to arouse
嘴唇或脸色发紫 Bluish lips or face
本列表并未包括所有症状。 This list is not all inclusive.
如有其它严重或让人担心的症状,请咨询您的医生。 Please consult your medical provider for any other symptoms that are severe or concerning.
在照顾病人时防止细菌的传播 Prevent the spread of germs when caring for someone who is sick
让病人待在一个房间内,并尽可能远离其他人,包括您自己在内。 Have the person stay in one room, away from other people, including yourself, as much as possible.
如果可能的话,让病人使用单独的卫生间。 If possible, have them use a separate bathroom.
避免共用个人家用物品,例如盘子、毛巾和床上用品 Avoid sharing personal household items, like dishes, towels, and bedding
如果有口罩,可以让其在与他人(包括您)接触时佩戴口罩。 If facemasks are available, have them wear a facemask when they are around people, including you.
如果病人无法佩戴口罩,您应在与其共处一室时佩戴口罩(如果有口罩)。 It the sick person can’t wear a facemask, you should wear one while in the same room with them, if facemasks are available.
如果病人需要接触到他人(在房间内、在车中或医生办公室内),则这些人应当佩戴口罩。 If the sick person needs to be around others (within the home, in a vehicle, or doctor’s office), they should wear a facemask.
经常使用肥皂和水洗手,时间应不短于20秒,尤其是在接触到病人后。 Wash your hands often with soap and water for at least 20 seconds, especially after interacting with the sick person.
如果无法马上找到肥皂和水,可使用酒精含量至少为60%的手部消毒液。 If soap and water are not readily available, use a hand sanitizer that contains at least 60% alcohol.
将其涂满您的双手,然后双手相互搓揉直至感到干燥。 Cover all surfaces of your hands and rub them together until they feel dry.
避免触摸眼口鼻。 Avoid touching your eyes, nose, and mouth.
每天清洁所有经常接触的表面,如柜面、桌面、门把手。 Every day, clean all surfaces that are touched often, like counters, tabletops, and doorknobs
根据标签说明使用家用清洁喷雾或擦巾。 Use household cleaning sprays or wipes according to the label instructions.
彻底清洗衣物。 Wash laundry thoroughly.
如果衣物上有污渍,请佩戴一次性手套,以防止脏污的衣物在您洗衣时接触到您的身体。 If laundry is soiled, wear disposable gloves and keep the soiled items away from your body while laundering.
取下手套后应立即洗手。 Wash your hands immediately after removing gloves.
避免任何人做不必要的拜访。 Avoid having any unnecessary visitors.
如果对于病人护理有任何其他疑问,请联系其医务人员或者所在州或当地卫生部门。 For any additional questions about their care, contact their healthcare provider or state or local health department.
提供症状治疗 Provide symptom treatment
确保病人饮用大量液体以保持身体水分充足,并在家中休息。 Make sure the sick person drinks a lot of fluids to stay hydrated and rests at home.
非处方药可能有助于缓解症状。 Over-the-counter medicines may help with symptoms.
对于大多数人而言,症状会持续数天,并在一周后缓解。 For most people, symptoms last a few days and get better after a week.
何时结束居家隔离(待在家中) When to end home isolation (staying home)
已感染COVID-19并待在家中(居家隔离)的患者可以在下列条件下停止居家隔离: People with COVID-19 who have stayed home (are home isolated) can stop home isolation under the following conditions:
如果患者不通过检测以确定其是否仍然具有传染性,其可以在发生了下列三种情况后离家外出: If they will not have a test to determine if they are still contagious, they can leave home after these three things have happened:
至少72个小时没有发烧(即在不使用退烧药的情况下连续三天没有发烧) 并且 They have had no fever for at least 72 hours (that is three full days of no fever without the use medicine that reduces fevers) AND
其他症状改善(例如咳嗽或气短得到改善) 并且自开始出现症状已经过去至少7天 other symptoms have improved (for example, when their cough or shortness of breath have improved) AND at least 7 days have passed since their symptoms first appeared
如果患者将接受检测以确定其是否仍然具有传染性,其可以在发生了下列三种情况后离家外出: If they will be tested to determine if they are still contagious, they can leave home after these three things have happened:
已经没有发烧(不使用退烧药的情况下) 并且 They no longer have a fever (without the use medicine that reduces fevers) AND
其他症状改善(例如咳嗽或气短得到改善) 并且 other symptoms have improved (for example, when their cough or shortness of breath have improved) AND
间隔24小时的连续两次检测呈阴性。 They received two negative tests in a row, 24 hours apart.
其医生将遵守CDC指导方针 Their doctor will follow CDC guidelines.
尹力主持召开省应对新冠肺炎疫情应急指挥部第二十一次会议 Yin Li Presides Over the 21st Meeting to Respond to COVID-19 Outbreak
3月20日,省委副书记、省长、指挥部指挥长尹力主持召开省应对新型冠状病毒肺炎疫情应急指挥部第二十一次会议, On March 20, Yin Li, Deputy Secretary of the CPC Sichuan Provincial Committee, Governor of the People's Government of Sichuan Province and head of the emergency response headquarters, presided over the Twenty-first Meeting to Respond to COVID-19 Outbreak.
学习贯彻中央政治局常委会会议精神,听取外事工作组和成都市、绵阳市、乐山市、宜宾市有关工作汇报,安排部署严防境外疫情输入和加快恢复正常生产生活秩序等重点工作。 He guided the attendees to study and implement the key points of the meeting of the Standing Committee of the Political Bureau of the CPC Central Committee, listened to the work reports of the foreign affairs working group, Chengdu, Mianyang, Leshan and Yibin, and made deployments on preventing imported cases from overseas and accelerating the restoration of production and life order.
会议强调,全省各地各部门要切实把思想和行动统一到中央部署要求上来,总结深化前一阶段防控工作,巩固拓展来之不易的疫情防控成果,研判把握疫情形势,及时调整工作着力点和应对举措,严防境外疫情输入,推动加快复工复产,恢复正常生产生活秩序。 The meeting stressed that departments at all levels throughout Sichuan Province should resolutely integrate their minds and actions into the deployments and requirements of the central government, summarize and deepen the prevention and control work in the previous stage, study and judge the epidemic situation, timely adjust the work focus and counter-measures, prevent imported cases from overseas, promote the resumption of work and production, and bring the production and life order back on track.
一要进一步完善防控措施,严防境外疫情输入。 First, Sichuan should further improve the prevention and control measures and strictly prevent imported cases from overseas.
成都市要继续落实口岸属地责任,机场、海关、边防等部门单位要一体联动,各市(州)要积极参与配合,细化落实场内、途中、场外防控责任。 Chengdu should continue to implement port territorial responsibility, airport, customs, border defense and other departments should coordinate with each other, and all cities (autonomous prefectures) should actively cooperate to refine the implementation of on-site, on-way and off-site prevention and control responsibilities.
对近14天有境外旅居史的来川人员要加强摸排和信息共享,逐一落实管控措施,妥善做好服务保障,实现“找得到、管得住、服务好”。 Sichuan should strengthen screening and information sharing for inbound personnel who have traveled or lived overseas in the past 14 days, implement respective control measures for individuals, and properly provide service guarantee.
在此基础上,各地要尽快恢复居民社区正常管理,恢复和规范医疗机构正常工作,充分发挥各专业方面的防控作用。 On this basis, all regions in Sichuan should resume the normal management of residents' communities as soon as possible, resume and regulate the normal operation of medical institutions, and give full play to the prevention and control role of all professional aspects.
二要加快推动服务业复工复业,有序组织学生复学。 Second, Sichuan should speed up the resumption of service industry and organize students to return to school in an orderly manner.
要根据实际情况,取消审批备案手续,推动餐饮业经营复苏,同时大力倡导健康用餐方式; Based on the actual situation, Sichuan should cancel the approval and filing procedures, promote the resumption of the catering industry, and vigorously advocate healthy dining methods;
要有序开放公共文化设施和旅游景区景点,科学管理参观人员流量; Sichuan should open public cultural facilities and scenic spots in an orderly manner, and scientifically manage the flow of visitors;
要抓紧研究细化制定复学方案,做好相关准备工作。 Sichuan should promptly study, refine and formulate the plan to resume school education, and make full preparations for the resumption work.
三要加大政策落实和帮扶力度,着力提高企业复工复产效率。 Third, Sichuan should strengthen the implementation of policies and increase support, and strive to improve the resumption efficiency of enterprises.
及时兑现支持政策,打通产供销、人流、物流堵点,助力企业提振信心、恢复发展,尽快达产满产; Sichuan should timely implement supporting policies, remove the obstacles blocking production, supply and sales of products, as well as people flow and logistics, help enterprises boost confidence, resume operation, and reach design capacity as soon as possible;
要加快推进重点项目建设,及时帮助解决用工、原材料供应等问题,努力形成更多实物工作量; Sichuan accelerate the construction of key projects, help solve problems threatening labor force and raw material supply in time, and strive to form more physical workload;
要千方百计增加就业岗位,及时调整取消妨碍劳动者返岗复工的限制性规定,最大限度满足企业用工需要。 Sichuan should make every effort to increase employment, and timely adjust or remove the restrictions imposed on work resumption, so as to meet the employment needs of enterprises to the greatest extent.
四要抢抓发展机遇,全力稳定经济增长。 Fourth, Sichuan should seize the development opportunities to stabilize economic growth.
落实川渝党政联席会议部署,加快推动双城经济圈重大项目建设。 To realize this goal, Sichuan should implement the deployments made by the First Session of Sichuan-Chongqing Party and Government Joint Meeting for Promoting Construction of Chengdu-Chongqing Economic Circle, and promote the construction of major projects under the Chengdu-Chongqing Economic Circle framework.
大力培育发展新兴产业和新兴消费业态,多措并举稳外贸稳外资,推动经济转型升级发展。 Sichuan should foster and develop emerging industries and emerging consumption formats, take multiple measures to stabilize foreign trade and foreign investment, and promote the upgrading of the economy.
有脱贫任务的地方要全力攻坚,坚决夺取收官之战全面胜利。 Regions shouldered with the responsibility of poverty alleviation should spare no effort to fulfill their responsibilities, so as to win an all-out victory in the final battle.
会议要求,加快推动企业复工复产的同时,要严格落实安全生产责任,加强安全隐患排查整治,坚决遏制安全生产事故发生。 The meeting pointed out that while promoting the resumption of work and production of enterprises, relevant departments should strictly implement the work safety responsibility, strengthen the screening and rectification of potential safety hazards, and resolutely prevent accidents threatening work safety.
要及时回应部分受疫情影响较大群体的诉求和关切,加强对特殊困难群体的帮扶,保障他们的基本生活,确保社会大局稳定。 Departments concerned should  respond to the appeals and concerns of the groups heavily affected by the epidemic in a timely manner, strengthen the assistance to people living in dire poverty, and guarantee their basic life, so as to ensure the overall social stability.
省指挥部副指挥长、各工作组负责人等参加会议。 Deputy heads of the emergency response headquarters and the heads of the working groups attended the meeting.
四川省外事办公室关于新型冠状病毒疫情信息的通报(二十六) Foreign Affairs Office of Sichuan Province Update on the Epidemic of Novel Coronavirus Disease (COVID-19) in Sichuan Province(XXVI)
2020年3月27日 Mar. 27th, 2020
一、疫情情况 I. Briefing on the epidemic
据省卫生健康委发布信息,3月26日,我省新型冠状病毒肺炎新增1例确诊病例(境外输入),无新增治愈出院病例,无新增疑似病例,无新增死亡病例。 Latest updates by the Health Commission of Sichuan Province:1 new case (imported from overseas) of novel coronavirus disease was confirmed in Sichuan Province with no new suspected case and no new fatal case, while no patient has been newly cured and discharged from hospital on Mar. 26th.
新增确诊患者情况: Details about newly confirmed case:
涂某,女,62岁,3月22日从美国经广州,3月23日抵达成都后即接受隔离医学观察和动态诊疗,3月26日确诊,相关密切接触者均已实施追踪和集中隔离医学观察。 Tu **, Female, 62 years old, departed from USA and transferred via Guangzhou on Mar. 22nd, arrived in Chengdu on Mar. 23rd. The patient had been undergoing quarantine and medical observation upon arrival in Chengdu and was confirmed on Mar. 26th. Tracing of related close contacts is being done and related close contacts have been quarantined at designated place for further medical observation.
〔确诊患者(含输入病例)具体情况由各市(州)卫生健康委进行通报〕 (The Health Commission of belonging city will notify specific situation of confirmed cases ).
截至3月27日0时,我省累计报告确诊病例548例(其中9例为境外输入)。 As of 00:00 of Mar. 27th, 548 cases have been reported in Sichuan Province accumulatively (9 of the cases are imported from overseas).
正在住院隔离治疗9人,死亡3人,治愈出院536人,现有疑似病例0例,正在接受医学观察709人。 At present, there are 9 under treatment in quarantine, 3 fatal cases, and 536 patients have been discharged from hospital after recovery. Of the traced close contacts, there is no suspected case, 709 are still under medical observation.
截至目前,未发现外国人在川感染新型冠状病毒的病例。 Till now, no foreigner has been confirmed infected COVID-19 in Sichuan.
我省183个县(市、区)全部为低风险区。 All 183 counties (cities or districts) are low-risk counties (cities or districts) in Sichuan Province.
二、关注热点 II. Public focuses
(一)中国民用航空局发布《关于疫情防控期间继续调减国际客运航班量的通知》 i. The Civil Aviation Administration of China publishes “Notice on Further Reducing International Passenger Flights during the Epidemic Prevention and Control Period”
3月26日,中国民用航空局发布《关于疫情防控期间继续调减国际客运航班量的通知》。 The Civil Aviation Administration of China publishes “Notice on Further Reducing International Passenger Flights during the Epidemic Prevention and Control Period” on Mar. 26th.
主要内容如下: The main content is as follows:
1. 以民航局3月12日官网发布的“国际航班信息发布(第5期)”为基准,国内每家航空公司经营至任一国家的航线只能保留1条,且每条航线每周运营班次不得超过1班;外国每家航空公司经营至我国的航线只能保留1条,且每周运营班次不得超过1班。 1. On the basis of the Information on International Flight Plans (Phase Five) released on the official website of CAAC on March 12, each Chinese airline is only allowed to maintain one route to any specific country with no more than one flight per week; each foreign airline is only allowed to maintain one route to China with no more than one weekly flight.
2. 请各航空公司根据上述要求,提前向民航局运行监控中心申请预先飞行计划。 2. Airlines shall, in accordance with the requirements above, apply for Pre-Flight plans to the Operation Supervisory Center of CAAC in advance.
3. 各航空公司按照本通知的要求调减航班涉及的航线经营许可和起降时刻等予以保留。 3. The Operating Permits and take-off/landing slots, etc. associated with the flights cut by airlines in accordance with requirements of this Notice will be retained.
4. 各航空公司要严格执行民航防控工作领导小组办公室印发的最新版《运输航空公司疫情防控技术指南》。在抵离中国的航班上采取严格的防控措施,确保客座率不高于75%。 4. Airlines shall strictly implement the latest edition of Preventing Spread of Coronavirus Disease 2019 (COVID-19) Guideline for Airlines issued by the Office of China Civil Aviation Prevention and Control COVID-19 Leading Group, take stringent prevention and control measures on the flights to/from China and ensure passenger load factor no higher than 75%.
5. 根据疫情防控需要,我局可能出台进一步收紧国际客运航班总量的政策,请各航空公司密切关注、提前研判,做好已售机票的延期、退票等处置工作。 5. In accordance with the need for epidemic containment, CAAC may issue policy to further reduce the total number of international passenger flights. Airlines therefore are required to closely follow information released, analyze the situation and make contingency plans in advance, and handle in a proper way the issues such as extension and refund of sold air tickets, etc.
6. 各航空公司可利用客机执行全货运航班,不计入客运航班总量。 6. Airlines may operate all-cargo flights with passenger aircraft, which will not be counted against the total number of passenger flights operated.
7. 各航空公司根据本通知第一条调整的航班计划自2020年3月29日起执行。 7. Flight plans adjusted by airlines in accordance with paragraph 1 of this Notice shall be implemented as of March 29, 2020.
8. 本通知自发布之日起生效,截止日期另行通知。 8. This Notice shall take effect on the date of its issuance, and the expiration date will be notified separately.
自本通知生效之日起,民航发〔2020〕11号通知失效。 As of the date of taking effect of this Notice, the Notice MHF [2020] No. 11 issued by CAAC shall become invalid.
(二)中华人民共和国外交部、国家移民管理局发布《关于暂时停止持有效中国签证、居留许可的外国人入境的公告》 ii. Ministry of Foreign Affairs of the People’s Republic of China National Immigration Administration’s “Announcement on the Temporary Suspension of Entry by Foreign Nationals Holding Valid Chinese Visas or Residence Permits”
3月26日,中华人民共和国外交部、国家移民管理局发布《关于暂时停止持有效中国签证、居留许可的外国人入境的公告》。 Ministry of Foreign Affairs of the People’s Republic of China National Immigration Administration releases “Announcement on the Temporary Suspension of Entry by Foreign Nationals Holding Valid Chinese Visas or Residence Permits” on Mar. 26th.
主要内容如下: The main content is as follows:
鉴于新冠肺炎疫情在全球范围快速蔓延,中方决定自2020年3月28日0时起,暂时停止外国人持目前有效来华签证和居留许可入境。 In view of the rapid spread of COVID-19 across the world, China has decided to temporarily suspend the entry into China by foreign nationals holding visas or residence permits still valid to the time of this announcement, effective from 0 a.m., 28 march 2020.
暂停外国人持APEC商务旅行卡入境。 Entry by foreign nationals with APEC Business Travel Cards will be suspended as well.
暂停口岸签证、24/72/144小时过境免签、海南入境免签、上海邮轮免签、港澳地区外国人组团入境广东144小时免签、东盟旅游团入境广西免签等政策。 Policies including port visas, 24/72/144-hour visa-free transit policy, Hainan 30-day visa-free policy, 15-day visa-free policy specified for foreign cruise-group-tour through Shanghai Port, Guangdong 144-hour visa-free policy specified for foreign tour groups from Hong Kong or Macao SAR, and Guangxi 15-day visa-free policy specified for foreign tour groups of ASEAN countries will also be temporarily suspended.
持外交、公务、礼遇、C字签证入境不受影响。 Entry with diplomatic, service, courtesy or C visas will not be affected.
外国人如来华从事必要的经贸、科技等活动,以及出于紧急人道主义需要,可向中国驻外使领馆申办签证。 Foreign nationals coming to China for necessary economic, trade, scientific or technological activities or out of emergency humanitarian needs may apply for visas at Chinese embassies or consulates.
外国人持公告后签发的签证入境不受影响。 Entry by foreign nationals with visas issued after this announcement will not be affected.
这是中方为应对当前疫情,参考多国做法,不得已采取的临时性措施。 The suspension is a temporary measure that China is compelled to take in light of the outbreak situation and the practices of other countries.
中方愿与各方保持密切沟通,做好当前形势下中外人员往来工作。 China will stay in close touch with all sides and properly handle personnel exchanges with the rest of the world under the special circumstances.
中方将根据疫情形势调整上述措施并另行公告。 The above-mentioned measures will be calibrated in light of the evolving situation and announced accordingly.
暂停有传播2019新型冠状病毒危险的移民和非移民类特定增列人员入境 SUSPENSION OF ENTRY AS IMMIGRANTS AND NONIMMIGRANTS OF CERTAIN ADDITIONAL PERSONS WHO POSE A RISK OF TRANSMITTING 2019 NOVEL CORONAVIRUS
美利坚合众国总统 BY THE PRESIDENT OF THE UNITED STATES OF AMERICA
公告 A PROCLAMATION
2020年1月31日,我发布第9984号公告(暂停有传播2019新型冠状病毒危险的移民和非移民类人员入境和为解除这项危险采取的其他适当措施)。 On January 31, 2020, I issued Proclamation 9984 (Suspension of Entry as Immigrants and Nonimmigrants of Persons Who Pose a Risk of Transmitting 2019 Novel Coronavirus and Other Appropriate Measures To Address This Risk).
我认为一种新型冠状病毒(后被重新定名为“SARS-CoV-2”并能引发2019冠状病毒病COVID-19)(“SARS-CoV-2”或“病毒”)有可能通过要求入境美国的受感染者广泛传播,对我们的运输系统和基础设施的安全及国家安全构成威胁。 I found that the potential for widespread transmission of a novel (new) coronavirus (which has since been renamed “SARS-CoV-2” and causes the disease COVID-19) (“SARS-CoV-2” or “the virus”) by infected individuals seeking to enter the United States threatens the security of our transportation system and infrastructure and the national security.
当时由于这种病毒的爆发以中华人民共和国为中心,我暂停并限制了所有在入境或准备入境美国前14天内身在中华人民共和国境内的所有外国人入境,香港和澳门特别行政区除外,特定例外情况除外。 Because the outbreak of the virus was at the time centered in the People’s Republic of China, I suspended and limited the entry of all aliens who were physically present within the People’s Republic of China, excluding the Special Administrative Regions of Hong Kong and Macau, during the 14-day period preceding their entry or attempted entry into the United States, subject to certain exceptions.
2020年2月29日,考虑到SARS-CoV-2在伊朗伊斯兰共和国持续发生人传人的情况,我发布第9992号公告(
暂停有传播2019新型冠状病毒危险的移民和非移民类特定增列人员入境),暂停和限制在入境美国或准备入境美国前14天内曾身在伊朗伊斯兰共和国境内的所有外国人入境,特定例外情况除外。
On February 29, 2020, in recognition of the sustained person-to-person transmission of SARS-CoV-2 in the Islamic Republic of Iran, I issued Proclamation 9992 (Suspension of Entry as Immigrants and Nonimmigrants of Certain Additional Persons Who Pose a Risk of Transmitting 2019 Novel Coronavirus), suspending and limiting the entry of all aliens who were physically present within the Islamic Republic of Iran during the 14-day period preceding their entry or attempted entry into the United States, subject to certain exceptions.
美国疾病控制与预防中心(Centers for Disease Control and Prevention,CDC)作为卫生与公众服务部(Department of Health and Human Services)的一部分,已确定这种病毒对公众健康构成了严重威胁,并继续采取措施防止其传播。 The Centers for Disease Control and Prevention (CDC), a component of the Department of Health and Human Services, has determined that the virus presents a serious public health threat, and CDC continues to take steps to prevent its spread.
但CDC和各州及地方的卫生部门资源有限,一旦美国持续发生病毒大规模人传人的现象,公共卫生系统可能不堪重负。 But CDC, along with State and local health departments, has limited resources, and the public health system could be overwhelmed if sustained human-to-human transmission of the virus occurred in the United States on a large scale.
持续的人传人现象有可能导致公共卫生、经济、国家安全和社会的连锁后果。 Sustained human-to-human transmission has the potential to cause cascading public health, economic, national security, and societal consequences.
世界卫生组织(World Health Organization)已确定申根地区(Schengen Area)多国正发生持续的SARS-CoV-2人传人现象。 The World Health Organization has determined that multiple countries within the Schengen Area are experiencing sustained person-to-person transmission of SARS-CoV-2.
本公告涉及的申根地区有26个欧洲国家;奥地利、比利时、捷克共和国、丹麦、爱沙尼亚、芬兰、法国、德国、希腊、匈牙利、冰岛、意大利、拉脱维亚、
列支敦士登、立陶宛、卢森堡、马耳他、荷兰、挪威、波兰、葡萄牙、斯洛伐克、斯洛文尼亚、西班牙、瑞典和瑞士。
For purposes of this proclamation, the Schengen Area comprises 26 European states: Austria, Belgium, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Slovakia, Slovenia, Spain, Sweden, and Switzerland.
目前,申根地区是中华人民共和国以外COVID-19确诊病例最多的地区。 The Schengen Area currently has the largest number of confirmed COVID-19 cases outside of the People’s Republic of China.
截至2020年3月11日,26个申根地区国家已出现17,442例,711例死亡,且出现传染率持续高增长的现象。 As of March 11, 2020, the number of cases in the 26 Schengen Area countries is 17,442, with 711 deaths, and shows high continuous growth in infection rates.
截至2020年3月9日,申根地区已向53个国家输出21例COVID-19。 In total, as of March 9, 2020, the Schengen Area has exported 201 COVID-19 cases to 53 countries.
此外,申根地区国家之间的人员自由流动使管理病毒扩散的工作遇到困难。 Moreover, the free flow of people between the Schengen Area countries makes the task of managing the spread of the virus difficult.
美国政府无法对持续从申根地区抵达的所有旅行人员进行有效的评估和监控。 The United States Government is unable to effectively evaluate and monitor all of the travelers continuing to arrive from the Schengen Area.
这种病毒有可能通过从申根地区要求入境美国的受感染者在不被察觉的情况下传播,对我们的运输系统和基础设施的安全及国家安全构成威胁。 The potential for undetected transmission of the virus by infected individuals seeking to enter the United States from the Schengen Area threatens the security of our transportation system and infrastructure and the national security.
鉴于保护美国境内人员不受这种有害传染性疾病的危害具有重要意义,我决定为美国的利益采取行动,限制和暂停所有在入境或准备入境美国前
14天内身在申根地区的所有移民或非移民类外国人入境美国。
Given the importance of protecting persons within the United States from the threat of this harmful communicable disease, I have determined that it is in the interests of the United States to take action to restrict and suspend the entry into the United States, as immigrants or nonimmigrants, of all aliens who were physically present within the Schengen Area during the 14-day period preceding their entry or attempted entry into the United States.
美国和申根地区国家的商业自由往来仍然是美国的经济要务。我仍然承诺促进我们各国之间的贸易往来。 The free flow of commerce between the United States and the Schengen Area countries remains an economic priority for the United States, and I remain committed to facilitating trade between our nations.
为此,我,唐纳德·特朗普(Donald J. Trump),美利坚合众国总统,根据美利坚合众国宪法(Constitution
)和法律赋予我的权力,包括移民和国籍法(Immigration and Nationality Act)212(f)和215(a)款,美国法典(United States Code)第8篇1182(f)和1185(a)款及第3篇301款,谨此宣布,除本公告第二部分涉及的人员外,本公告第一部分所述之人员无限制地入境美国可对美国的利益造成损害,对这类人员的入境应有某种约束、限制和例外。
NOW, THEREFORE, I, DONALD J. TRUMP, President of the United States, by the authority vested in me by the Constitution and the laws of the United States of America, including sections 212(f) and 215(a) of the Immigration and Nationality Act, 8 U.S.C. 1182(f) and 1185(a), and section 301 of title 3, United States Code, hereby find that the unrestricted entry into the United States of persons described in section 1 of this proclamation would, except as provided for in section 2 of this proclamation, be detrimental to the interests of the United States, and that their entry should be subject to certain restrictions, limitations, and exceptions.
为此我宣布以下诸项: I therefore hereby proclaim the following:
第一部分。 Section 1.
暂停和限制入境。 Suspension and Limitation on Entry.
除本公告第二部分规定之例外情况,限制和暂停所有在入境或准备入境前14天内身在申根地区内的所有移民或非移民类外国人入境美国。 The entry into the United States, as immigrants or nonimmigrants, of all aliens who were physically present within the Schengen Area during the 14-day period preceding their entry or attempted entry into the United States is hereby suspended and limited subject to section 2 of this proclamation.
第二部分。 Sec. 2.
暂停和限制入境的适用范围。 Scope of Suspension and Limitation on Entry.
(a) (a)
本公告第一部分之规定不适用于: Section 1 of this proclamation shall not apply to:
(1) 任何美国合法永久居民; (i) any lawful permanent resident of the United States;
(2) 配偶为美国公民或合法永久居民的任何外国人; (ii) any alien who is the spouse of a U.S. citizen or lawful permanent resident;
(3) 作为美国公民或合法永久居民之父母或合法监护人的任何外国人,但该美国公民或合法永久居民须未婚并不满21岁; (iii) any alien who is the parent or legal guardian of a U.S. citizen or lawful permanent resident, provided that the U.S. citizen or lawful permanent resident is unmarried and under the age of 21;
(4) 作为美国公民或合法永久居民之兄弟姐妹的任何外国人,但双方均须未婚并不满21岁; (iv) any alien who is the sibling of a U.S. citizen or lawful permanent resident, provided that both are unmarried and under the age of 21;
(5) 作为美国公民或合法永久居民之子女、领养子女或被监护人的任何外国人,或作为即将被领养者凭IR-4或 IH-4签证寻求入境美国者。 (v) any alien who is the child, foster child, or ward of a U.S. citizen or lawful permanent resident, or who is a prospective adoptee seeking to enter the United States pursuant to the IR-4 or IH-4 visa classifications;
(6) 任何应美国政府邀请为控制或缓解病毒传播相关事务之目的旅行的外国人; (vi) any alien traveling at the invitation of the United States Government for a purpose related to containment or mitigation of the virus;
(7) 任何作为非移民并持有非移民C-1、D或C-1/D签证以航空机组人员或海员身份前往美国的外国人。 (vii) any alien traveling as a nonimmigrant pursuant to a C-1, D, or C-1/D nonimmigrant visa as a crewmember or any alien otherwise traveling to the United States as air or sea crew;
(8) 任何符合下列条件的外国人 (viii) any alien
(A) (A)
凭下列签证之一寻求进入美国或从美国过境者:根据A-1、A-2、C-2、C-3(作为外国政府官员或官员的直系亲属)、E-1
(作为驻美台北经济文化代表处[TECRO]或驻美台北经济文化办事处[TECO]雇员或雇员直系亲属)、G-1、 G-2、G-3、G-4、北约-1 至北约-4或北约-6(或凭此等北约签证类别作为非移民寻求进入美国者);
seeking entry into or transiting the United States pursuant to one of the following visas: A-1, A-2, C-2, C-3 (as a foreign government official or immediate family member of an official), E-1 (as an employee of TECRO or TECO or the employee’s immediate family members), G-1, G-2, G-3, G-4, NATO-1 through NATO-4, or NATO-6 (or seeking to enter as a nonimmigrant in one of those NATO categories); or
(B) (B)
其旅行符合《联合国总部协定》(United Nations Headquarters Agreement)第11条规定范围者; whose travel falls within the scope of section 11 of the United Nations Headquarters Agreement;
(9) 由美国卫生与公众服务部部长通过CDC主任或其指定人员认定其入境对输入、传播或散布该病毒不具有重大风险之任何外国人; (ix) any alien whose entry would not pose a significant risk of introducing, transmitting, or spreading the virus, as determined by the Secretary of Health and Human Services, through the CDC Director or his designee;
(10) 由国务卿、国土安全部长或各自指定人员根据司法部长或其指定人员的建议,认定其入境有助于促进美国重大执法目标之任何外国人; (x) any alien whose entry would further important United States law enforcement objectives, as determined by the Secretary of State, the Secretary of Homeland Security, or their respective designees, based on a recommendation of the Attorney General or his designee;
(11) 由国务卿、国土安全部长或各自指定人员认定其入境符合美国国家利益之任何外国人;或 (xi) any alien whose entry would be in the national interest, as determined by the Secretary of State, the Secretary of Homeland Security, or their designees; or
(12) 美国武装部队成员及其配偶和子女。 (xii) members of the U.S. Armed Forces and spouses and children of members of the U.S. Armed Forces.
(b) (b)
本公告所述之任何内容不应解释为可影响任何个人的庇护资格、停止递解或为执行《禁止酷刑和其他残忍、不人道或有辱人格的待遇或处罚约》(Convention Against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment)按美国法律和规定提供的保护。 Nothing in this proclamation shall be construed to affect any individual’s eligibility for asylum, withholding of removal, or protection under the regulations issued pursuant to the legislation implementing the Convention Against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, consistent with the laws and regulations of the United States.
第三部分。 Sec. 3.
实施和执行。(a)
国务卿应根据经与国土安全部长咨商制定的程序执行本公告中与各类签证相关的内容。
Implementation and Enforcement. (a) The Secretary of State shall implement this proclamation as it applies to visas pursuant to such procedures as the Secretary of State, in consultation with the Secretary of Homeland Security, may establish.
国土安全部长应根据经与国务卿咨商制定的程序执行本公告中与外国人入境相关的内容。 The Secretary of Homeland Security shall implement this proclamation as it applies to the entry of aliens pursuant to such procedures as the Secretary of Homeland Security, in consultation with the Secretary of State, may establish.
(b) (b)
国务卿、运输部长和国土安全部长须按照适用法律确保没有任何受本公告禁止的外国人乘坐空中交通工具前往美国。 Consistent with applicable law, the Secretary of State, the Secretary of Transportation, and the Secretary of Homeland Security shall ensure that any alien subject to this proclamation does not board an aircraft traveling to the United States.
(c) (c)
国土安全部长可制定有关标准和程序,确保本公告在美国所有入境口岸(包括各口岸之间的旅行)得到执行。 The Secretary of Homeland Security may establish standards and procedures to ensure the application of this proclamation at and between all United States ports of entry.
(d) (d)
凡通过欺诈、故意谎报重大事实或非法入境逃避本公告实施的外国人,均应作为重点对象由国土安全部递解出境。 An alien who circumvents the application of this proclamation through fraud, willful misrepresentation of a material fact, or illegal entry shall be a priority for removal by the Department of Homeland Security.
第四部分。 Sec. 4.
终止。 Termination.
本公告在总统予以解除前始终有效。 This proclamation shall remain in effect until terminated by the President.
卫生与公众服务部长(Secretary of Health and Human
Services)将根据第9984号公告第五部分修订款,建议总统继续、修订或终止本公告。
The Secretary of Health and Human Services shall recommend that the President continue, modify, or terminate this proclamation as described in section 5 of Proclamation 9984, as amended.
第五部分。 Sec. 5.
生效日。 Effective Date.
本公告于东部夏令时间2020年3月13日下午11时59分生效。 This proclamation is effective at 11:59 p.m. eastern daylight time on March 13, 2020.
本公告不适用于乘坐预定抵达美国的航班在东部夏令时间2020年3月13日下午11时59分前起飞的人员。 This proclamation does not apply to persons aboard a flight scheduled to arrive in the United States that departed prior to 11:59 p.m. eastern daylight time on March 13, 2020.
第六部分。 Sec. 6.
可分割性。 Severability.
美国的政策是最大程度地执行本公告以增进国家安全、公共安全和美国的外交政策利益。 It is the policy of the United States to enforce this proclamation to the maximum extent possible to advance the national security, public safety, and foreign policy interests of the United States.
(a) (a)
如果本公告某一条款,或者对任何人或任何情况使用任何条款被认定无效,本公告的其余条款和条款的实施对其他人或情况不因此而受影响; if any provision of this proclamation, or the application of any provision to any person or circumstance, is held to be invalid, the remainder of this proclamation and the application of its provisions to any other persons or circumstances shall not be affected thereby; and
(b) (b)
如果本公告的任何条款,或者对任何人或情况实施条款因缺乏某些程序要求而被认定无效,行政分支有关官员将落实这些程序要求使之符合现行法律和任何适用的法庭命令。 if any provision of this proclamation, or the application of any provision to any person or circumstance, is held to be invalid because of the lack of certain procedural requirements, the relevant executive branch officials shall implement those procedural requirements to conform with existing law and with any applicable court orders.
第七部分。 Sec. 7.
总则。 General Provisions.
(a) 本公告任何部分都不应被解释为削弱以下方面或使之受到其他影响: (a) Nothing in this proclamation shall be construed to impair or otherwise affect:
(i) (i)
法律授予某一行政部门或机构或者其主管的权力;或者 the authority granted by law to an executive department or agency, or the head thereof; or
(ii) (ii)
管理和预算办公室(Office of Management and Budget)主任的与预算、行政或立法提案相关的职能。 the functions of the Director of the Office of Management and Budget relating to budgetary, administrative, or legislative proposals.
(b) (b)
本公告将遵照适用的法律付诸实施,并取决于拨款。 This proclamation shall be implemented consistent with applicable law and subject to the availability of appropriations.
(c) (c)
本公告不代表也不构成任何一方可与美国、其各部、机构或实体、其官员、雇员或代理人或其他任何人对立的实质性或程序性的可由法律或平衡法实施的权利或福利。 This proclamation is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person.
为此,我谨于公元贰千零二十年之三月十一日,美利坚合众国独立贰百四十四年在此签名为证。 IN WITNESS WHEREOF, I have hereunto set my hand this eleventh day of March, in the year of our Lord two thousand twenty, and of the Independence of the United States of America the two hundred and forty-fourth.
唐纳德·特朗普(DONALD J. TRUMP) DONALD J. TRUMP
中日韩举行新冠肺炎问题特别外长视频会议 Foreign Ministers of China, Japan and the ROK Hold a Special Video Conference on COVID-19
2020年3月20日,应中方倡议,国务委员兼外长王毅同韩国外长康京和、日本外相茂木敏充举行中日韩新冠肺炎问题特别外长视频会议。 On 20 March, upon the initiative of China, State Councilor and Foreign Minister Wang Yi held a special video conference on COVID-19 with Foreign Minister Kang Kyung-wha of the ROK and Foreign Minister Toshimitsu Motegi of Japan.
王毅表示,感谢韩方和日方积极响应中方倡议,以视频方式共同举行新冠肺炎问题三国特别外长会议,这体现了我们在重大挑战面前团结协作、共克时艰的坚定决心,展示了我们携手战胜疫情、致力于维护正常交往合作的积极意愿。 Wang Yi expressed his appreciation to the ROK and Japan for actively responding to China's initiative on holding a special video conference on COVID-19 and noted that this has reflected our firm determination to work together in the face of major challenges to overcome difficulties and our strong will to work hand in hand to fight the epidemic in a commitment to maintain normal exchanges and cooperation.
王毅介绍了中国在习近平主席亲自部署指挥下,在统筹推进疫情防控和经济社会发展工作取得的积极进展, Wang Yi gave a briefing on the progress China has made under the leadership and command of President Xi Jinping in advancing epidemic prevention and control while pursuing economic and social development.
并表示面对突如其来的疫情,三国加强合作,共渡难关是必然选择。 Wang said that facing the sudden outbreak of COVID-19, it is a natural choice for the three countries to strengthen cooperation to tide over the difficulties together.
中方建议三国共同采取有效措施,巩固各自抗疫成果;有序恢复三国经贸合作,为促进地区及全球经济作出贡献; China suggests that the three countries jointly take effective measures to consolidate their respective achievements in fighting the epidemic and resume economic cooperation and trade among the three countries in an orderly manner to contribute to promoting the regional and global economy.
同各国分享抗疫经验,与国际社会一道应对疫情挑战。 The three countries should also share their experience in fighting the epidemic with other countries and work with the international community to meet the challenges posed by COVID-19.
相信在三国共同努力下,我们一定能够早日驱散阴霾,彻底战胜疫情, It is believed that with the concerted efforts of the three countries, we will be able to dispel the dark shadow of the disease at an early date and win a final victory.
三国之间的友谊和互信也将进一步深化,合作水平进一步提升。 In the meantime, the friendship and mutual trust among the three countries will also be further deepened and cooperation be enhanced.
康京和、茂木敏充感谢中方就抗击疫情向两国提供支持和帮助,介绍了各自国家抗击疫情的努力和进展。 Kang Kyung-wha and Toshimitsu Motegi thanked the Chinese side for providing support and assistance to their respective countries in fighting COVID-19 and briefed Wang on the efforts and progress that the ROK and Japan have made in responding to the epidemic.
他们表示,当前疫情在全球发展,危及三国及世界人民福祉, They noted that the spread of COVID-19 around the world has endangered the well-being of the peoples of the three countries and beyond,
三方有必要团结一致,共享信息,相互协助,共迎挑战,阻止疫情蔓延,并尽量减少对三国必要经贸往来的影响,维护地区发展与安全稳定。 therefore it is necessary for China, the ROK and Japan to get united, share information and assist each other to meet challenges together, prevent the spread of the epidemic and minimize the impact on the essential economic exchanges and trade among the three countries so as to uphold regional development, security and stability.
王毅表示,此次视频会议开得十分及时,也十分成功。 Wang Yi noted that the video conference was quite timely and successful.
我们就共同应对新冠肺炎疫情深入交换了意见,在此前三方工作层会议基础上,凝聚了新的重要共识。 We had an in-depth exchange of views on jointly responding to COVID-19 and built new and important consensus on the basis of the previous tripartite meeting at the working level.
我们同意加强三方合作,共同遏制疫情发展。 We agree to strengthen China-Japan-ROK cooperation to curb the spread of COVID-19.
我们同意探讨相互衔接的联防联控机制,有效防止疫情跨境传播。 We agree to explore a joint prevention and control mechanism to effectively prevent the cross-border spread of the epidemic.
我们同意寻求共同接受的办法,努力维护与经贸合作有关的必要人员往来,稳定三国产业链、供应链。 We agree to seek mutually acceptable solutions to maintain necessary people-to-people exchanges related to economic cooperation and trade and stabilize the industrial chain and supply chain of the three countries.
我们同意尽早召开三国卫生部长会议,加强信息分享,开展药物、疫苗研发合作。 We agree to hold a meeting of health ministers of the three countries as soon as possible to strengthen information sharing and carry out cooperation in drug and vaccine research and development.
我们同意以共同抗疫为契机,不断增进三国民众间的友好感情。 We agree to take the joint fight against COVID-19 as an opportunity to keep enhancing the friendship among the three peoples.
我们还一致同意积极承担国际责任,提高全球公共卫生水平,携手为全球抗疫斗争作出应有贡献。 We also agree to actively shoulder our international responsibility to improve global public health and work hand in hand to make due contribution to the global fight against COVID-19.
个人防护装备短缺使全球卫生工作者面临危险 Shortage of personal protective equipment endangering health workers worldwide
世卫组织呼吁制造业和政府将产量提高40%,以满足日益增长的全球需求。 WHO calls on industry and governments to increase manufacturing by 40 per cent to meet rising global demand.
世界卫生组织(世卫组织)警告,由于需求暴增、恐慌性购买、囤积和滥用,导致个人防护装备的全球供应受到干扰且形势日趋严重,使生命受到新型冠状病毒和其他传染病的威胁。 The World Health Organization has warned that severe and mounting disruption to the global supply of personal protective equipment (PPE) – caused by rising demand, panic buying, hoarding and misuse – is putting lives at risk from the new coronavirus and other infectious diseases.
医务工作者依赖个人防护装备来保护自己和患者,一方面避免遭受感染,另一方面也防止传染给其他人。 Healthcare workers rely on personal protective equipment to protect themselves and their patients from being infected and infecting others.
但是,由于手套、医用口罩、呼吸器、护目镜、面罩、防护服和围裙等用品的获取途径有限造成了短缺,致使医生、护士和其他一线工作人员在护理2019冠状病毒病患者时装备不足,处于危险境地。 But shortages are leaving doctors, nurses and other frontline workers dangerously ill-equipped to care for COVID-19 patients, due to limited access to supplies such as gloves, medical masks, respirators, goggles, face shields, gowns, and aprons.
“不能保障供应链,将使世界各地的医务工作者面临真实而重大的风险。 “Without secure supply chains, the risk to healthcare workers around the world is real.
制造业和政府必须迅速采取行动增加供应,放松出口限制,并采取措施阻止投机和囤积行为。 Industry and governments must act quickly to boost supply, ease export restrictions and put measures in place to stop speculation and hoarding.
“不首先保护卫生工作者,我们就不可能遏制2019冠状病毒病。”世卫组织总干事谭德塞博士说。 “We can’t stop COVID-19 without protecting health workers first,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus.
自2019冠状病毒病疫情开始以来,各种价格飙升。 Since the start of the COVID-19 outbreak, prices have surged.
外科口罩的价格上涨了五倍,N95口罩的价格上涨了两倍,防护服的价格上涨了一倍。 Surgical masks have seen a sixfold increase, N95 respirators have trebled and gowns have doubled.
交货可能需要几个月时间,市场投机很普遍,存货通常卖给出价最高者。 Supplies can take months to deliver and market manipulation is widespread, with stocks frequently sold to the highest bidder.
世卫组织迄今已向47个国家运送了近50万套个人防护装备,但用品正在迅速耗尽。 WHO has so far shipped nearly half a million sets of personal protective equipment to 47 countries, but supplies are rapidly depleting.
根据世卫组织建模,为应对2019冠状病毒病,每月估计需要8900万个医用口罩, Based on WHO modelling, an estimated 89 million medical masks are required for the COVID-19 response each month.
多达7600万双医检手套,而护目镜的国际需求每月为160万副。 For examination gloves, that figure goes up to 76 million, while international demand for goggles stands at 1.6 million per month.
世卫组织最新指导文件呼吁在卫生保健环境中合理妥善使用个人防护装备,并有效管理供应链。 Recent WHO guidance calls for the rational and appropriate use of PPE in healthcare settings, and the effective management of supply chains.
世卫组织正与各国政府、制造业和大流行病供应链网络合作,以促进提高产量并确保为遭受严重影响和面临风险的国家分配有关资源。 WHO is working with governments, industry and the Pandemic Supply Chain Network to boost production and secure allocations for critically affected and at-risk countries.
世卫组织估计,为满足日益增长的全球需求,制造业必须将产量提高40%。 To meet rising global demand, WHO estimates that industry must increase manufacturing by 40 per cent.
政府应当制定激励措施,鼓励制造业提高产量。 Governments should develop incentives for industry to ramp up production.
这包括放松对个人防护装备和其他医疗用品的出口和分销限制。 This includes easing restrictions on the export and distribution of personal protective equipment and other medical supplies.
世卫组织每天都在提供指导,支持有保障的供应链,并向有需要的国家提供关键装备。 Every day, WHO is providing guidance, supporting secure supply chains, and delivering critical equipment to countries in need.
新型冠状病毒感染的肺炎与流感有何区别? The novel coronavirus and the flu - the differences and similarities you need to know
起源于中国武汉市的新型冠状病毒已扩散至12个国家,与季节性流感有很多相似之处。 The novel coronavirus, which originated in the Chinese city of Wuhan and has now spread to 12 countries, has much in common with seasonal flu.
它们都是病毒感染,有相似的症状,最重要的是,可以在人与人之间传播。 They are both viral infections, share similar symptoms and - crucially - can spread from human to human.
北半球大部分地区正处于流感季节,区分两者对于阻止新型冠状病毒的传播至关重要。 In the midst of flu season in much of the northern hemisphere, telling the difference between the two will be vital in stopping its spread.
新型冠状病毒感染症状与流感相似吗? Are the symptoms similar to that of the flu?
人类冠状病毒(一共有四种)可引起类似流感的呼吸道感染:虽然许多症状很轻微,但两者都可导致肺炎并致命。 Human coronaviruses, of which there are four, can cause respiratory infections similar to flu: while many symptoms are mild, both can lead to pneumonia and become lethal.
然而,雷丁大学的病毒学教授伊恩·琼斯说,这种新型冠状病毒比“典型的流感感染”更为严重。 However, the novel coronavirus is more serious than a "typical influenza infection," says Ian Jones, a professor of virology at the University of Reading.
这种病毒似乎更容易深入肺部,因此会出现肺炎的症状:肺部积水,肺功能不佳,病人呼吸困难。” This virus appears to go further down into the lungs than would generally be the case, therefore giving you symptoms of pneumonia: the lungs becoming flooded, they don't function very well and the patient gets into breathing difficulty."
为什么它比流感更可怕? Why is it more feared than the flu?
虽然流感和新型冠状病毒的死亡率和症状可能很相似,但人类抗击病毒的能力却有很大不同。 While the mortality rates and symptoms of flu and novel coronavirus may end up being similar, humans' ability to fight off the viruses differ greatly.
人类天生就会对季节性流感产生抗体,科学家们每年都会研制出流感疫苗。 Humans have naturally built up antibodies to seasonal flu and scientists have developed annual vaccines to fight it.
琼斯警告说,这种新型冠状病毒有可能成为流行病,“人们普遍对此没有免疫力,因此有可能在全球范围内传播。” During a pandemic, which the new coronavirus has the potential to become, "there is no immunity in the population so you have potential for a global spread," warns Jones.
人们对流感也很熟悉,这降低了人们的担忧。 There is also a widespread familiarity with flu, which dampens concern.
正如同在2015年前后达到顶峰的埃博拉病毒和寨卡病毒,由于对其性质缺乏了解,人们对这种新型冠状病毒的担忧加剧。 As with the Ebola epidemic and the Zika virus, both of which peaked in the middle of the last decade, fears around the new coronavirus are compounded due to a lack of knowledge over its nature.
它和流感一样容易传染吗? Is it as easy to catch as the flu?
流感可以在相隔6英尺的人们之间传播,主要是由患者咳嗽或打喷嚏时的飞沫引起。 Flu can spread from person to person from up to six feet away, largely caused by liquid emitted when the inflicted cough or sneeze.
感染者通常在发病后三天左右具有传染性,不过传染期可能会延长至一周以上。 Those infected are usually contagious for around three days following the beginning of their illness, although this time-frame could stretch to over a week.
而对于新型冠状病毒来说,所有这些仍然是一个谜。 All this and more remains a mystery in regards to the new coronavirus.
为了了解疫情的严重性,琼斯敦促关注国际病例是否会导致第二代传播。 To understand the virility of the outbreak, Jones urges a focus on whether or not international cases lead to secondary infections.
他解释说:“如果没有,那就意味着病毒传播力减弱:很明显,飞机上的所有人(从疫区起飞)都没有感染。” "If they don't," he explains, "it would suggest that the virus doesn't transmit quite so well: clearly all the people on the airplane (that traveled from an infected zone) didn't get it."
如果你认为患病了,应该怎么做? What you should do if you think you have it?
在有确诊感染病例的国家,医嘱是类似的。 Medical advice is similar across those countries with confirmed cases of the infection.
在法国,当局要求那些认为自己被感染的人叫救护车,而不是去医院,因为他们可能会把病毒传给其他人 In France, authorities are asking those who think they are infected to call an ambulance rather than visiting a hospital, where they could potentially pass on the virus.
中国和德国也提出了类似的建议。 Similar advice has been issued in China and Germany.
一、三天内决定“封城” No.1 Lockdown in THREE DAYS
在1月23日,在发现新冠病毒爆发后,中国政府正式宣布武汉“封城”,城中居民一律不得离开。 On January 23rd, the Chinese government ordered people in Wuhan, where the new coronavirus was first discovered, not to leave the city, effectively putting it on lockdown.
这是一个艰难的抉择,但中国在确定新冠肺炎可以造成人际传播之后,仅仅三天之内就做出了这个决定。 It was a tough decision to make, and China took it in less than three days after it became evident that human-to-human transmission had occurred.
在当时,没人知道后果会怎么样。 At the time, no one knew what the consequences would look like.
从地图里可以看到,湖北省处于中国地理位置的正中,而武汉是有超过一千四百万人口的大城市。 You can see that Hubei Province is in the center of China, and Wuhan is a city of more than FOURTEEN million people.
还有一个重要的时间节点:武汉“封城正好发生在中国除夕夜前一天,1月24日就是除夕了。 Keep in mind that Wuhan was quarantined just ONE day before the Chinese New Year's Eve, which fell on January 24th.
当时也正值春运时期,世界上最大的年度人口流动就在春运期间,一月之间大约可能有将近三十亿次往返客流,全国上下回老家团聚,之后返岗工作。 That time coincides with Chunyun, the world's largest annual human migration, with three billion trips expected during that month as people returned home to celebrate the new year with their loved ones...
所以设想一下,如果当时中国没有做出“封城”决定的话,后果会怎么样。 So imagine what would have happened if China had not made that decision.
二、十天内建成临时医院 No.2: Emergency hospitals IN TEN DAYS
“中国速度”世界闻名,但在危急时刻,中国也不停在突破自己的极限。 China is known for "China speed," but the country has outdone itself in times of crisis.
十天内,从零开始,建成一座医院绝不是夸夸其谈...... Building a hospital in ten days from scratch is no easy feat...
但是当时的情况是,武汉各大医院人满为患,而新感染人数也在不断攀升, But with almost every hospital in Wuhan flooded with patients and amid surging numbers of new infections,
所以别无选择,只能建造更多的医院容纳病人。 There was only one option available – and that is to build more hospitals.
正常情况下,一个正规医院的建成至少需要6-8个月。 It normally takes at least 6 to 8 months to construct a new hospital.
武汉十天内建成的火神山医院有一千张床位,以及30张ICU病床。 The first facility China built in Wuhan has 1,000 beds and 30 intensive care units.
中国倾全国之力,调动军队以及全国的医护人员驰援武汉,确保医院的建成以及正常运转...... China mobilized military and medical staff from all over the country to help build and operate the hospital...
所以第二个经验是:兵贵神速,速度至上。 So once again, the lesson learned here is SPEED IS A TOP PRIORITY.
三、十四天自我隔离制度 No.3: Self-quarantine for 14 DAYS
在北京,这里实行了一项非常严格的“十四天自我隔离制度“。 So here we are in Beijing. We have a strict "14-day self-quarantine rule".
如果你和从湖北地区来的人有过任何接触,你将会被隔离14天...... If you were in contact with people who traveled from or to Hubei Province you will be quarantined for 14 days...
如果你在疫情期间有过离京记录,你将会被隔离14天...... If you travelled outside the city you will be quarantined for 14 days...
如果和你同住的人在疫情期间有过离京,你将会被隔离14天...... If you share a room with someone who has traveled outside the city you will be quarantined for 14 days...
如果你的体温超过37.3度,你将会被隔离14天...... If your body temperature is over 37.3 degrees Celsius you will be quarantined for 14 days...
如果在你的居住的附近发现了任何确诊或疑似病例,你将会被隔离14天...... If you have people nearby who are infected by COVID-19 you will be quarantined for 14 days...
为什么会被隔离14天呢?根据专家研究,新冠病毒的潜伏期一般在14天左右,所以才有这样的隔离制度。 But why 14 days - because that is exactly the incubation period for COVID-19, according to scientists of course.
四、严格控制每日活动轨迹 No.4: Control of daily activities
但是即便是没有外出,没有去过外地的人,生活也不是像平常一样便利。 But even for those who decided not to travel and stay where they are, things weren't exactly easy.
疫情爆发最开始的几周,电影院,公园,博物馆以及艺术场所几乎全部关闭。只有少数餐馆还开着。 Movie theaters, parks, museums and art galleries were all closed and only a handful of restaurants stayed open in the first few weeks of the outbreak.
唯独在持续运营的就是便利店以及超市,但即便这些地方,也都采取了相应的防控措施。 Business only operated in convenience stores and supermarkets – and even there, specific measures were in place.
就像去其他任何地方一样,所有人都必须戴口罩,这点从未变过。 Like everywhere else, wearing a face mask was – and still is – a MUST.
进入任何封闭的公共场所之前,都必须在入口处测量体温。 You also can't set foot inside any closed public space without having your body temperature taken at the door.
有些公司以及居民住宅区准备了详细的信息记录表,用于记录所有人的每日活动轨迹,包括
去过的地方,使用的交通方式,接触的人等等。
And in certain neighborhoods, residents had to fill out a form with information about the places they've visited, the public transport modes they've taken and the people they've dealt with...
五、远程工作 No.5: Working from home
如此前所未有的大规模瘟疫,对中国经济所造成的影响非常不容乐观。 Such an unprecedented epidemic can easily dealt a heavy blow to China's economy.
为了防止疫情对经济造成巨大损失,我们不能坐以待毙。 So to stop that from happening we can't just stay home and doing nothing.
然而大家并不只是呆在家里,大家都在家正常上班。
大家在家也并不只是完成工作。
People weren't just sitting AT home. They were working from home.
And they weren't just finishing their work online.
购物,点外卖,和朋友聊天,所有人把日常活动尽量转移到室内进行。 They were also shopping, ordering food and socializing without setting foot outside.
面对重大疫情,不同的国家有不同的应对。 When facing hardship, different countries respond differently.
在这个危急时刻,中国选择迅速反应面对。 During this emergency, China chose urgency.
这个国家做出的每一个决定,都是在最短的时间内、为了最大的效果而做出的。 Everything the country did, it did with minimal time for maximal effect.
新冠病毒是全人类都将面临的一项重大挑战, The new coronavirus is a global threat for all humans,
在这个关键时刻,速度至上,是否能在第一时间迅速反应,决定了防控工作的成败。 And at this stage, speed is the most important thing in prevention work.
我们知道,防控措施必不可少,毕竟生命诚可贵。 We know that precautions must be taken because life is just too precious to lose.
日前,南非外交部照会告南在华公民可通过南非驻华使馆微信公众号、网站查询所需信息,并可拨打应对疫情热线电话联系南非驻华使领馆。 The Department of International Relations and Cooperation of the Republic of South Africa has sent a diplomatic note to the Ministry of Foreign Affairs of People’s Republic of China, stating that South African expats in China can access information about the 2019-nCoV pneumonia through the official WeChat account and the official website of the South African Embassy in Beijing and dial the hotlines for enquires regarding the epidemic with the South African Embassy and Consulate-General.
南非驻华使馆 135 0105 9041 South African Embassy in Beijing: +86 135 0105 9041
南非驻上海总领馆 159 0045 4282 Consulate-general of South Africa in Shanghai: +86 159 0045 4282
依你们所处的时区,大家早上好,下午好,晚上好。 Good morning, good afternoon and good evening, wherever you are.
现在已有50多万例COVID-19确诊病例和2万多人死亡。 There are now more than half a million confirmed cases of COVID-19 and more than 20,000 deaths.
这些都是惨痛的数字,但我们也要记住,在世界各地,超过10万人已经康复。 These are tragic numbers, but let's also remember that around the world, more than 100,000 people have recovered.
昨天,我有幸在二十国集团领导人特别会议上发言。 Yesterday, I had the honour of addressing an extraordinary meeting of leaders from the G20 countries.
我传递了三个信息:我们必须战斗、团结和引导。 My message was threefold: we must fight, unite and ignite.
用我们掌握的一切资源来阻遏病毒。
团结起来共同抗击这场大流行。
Fight to stop the virus with every resource at our disposal;  Unite to confront the pandemic together.
面对一个共同的敌人,我们全人类命运休戚与共。 We are one humanity, with one, common enemy.
任何国家都无法单独抗击,我们唯有一同抗疫。 No country can fight alone; we can only fight together.
激发二十国集团的强大工业能力和创新能力,生产和分发拯救生命所需的工具。 And ignite the industrial might and innovation of the G20 to produce and distribute the tools needed to save lives.
我们还必须向子孙后代作出承诺,绝不让这一惨剧重演。 We must also make a promise to future generations, saying never again.
病毒暴发是生活中的一个客观现实,而它们能造成多大损害,则是我们能够管控的。 Viral outbreaks are a fact of life. How much damage they do is something we can influence.
我感谢二十国集团国家承诺抗击这一大流行病,捍卫全球经济,解决国际贸易混乱问题,并加强全球合作。 I thank the G20 countries for their commitment to fight the pandemic, safeguard the global economy, address international trade disruptions and enhance global cooperation.
这对于不属于二十国集团但将会受到二十国集团所做决定影响的国家尤为重要。 This is especially important for countries who are not part of the G20 but will be affected by decisions made by G20 countries.
今天早些时候,我们举行了一次通报会,来自世界各地约50位卫生部长参加了通报会,中国、日本、大韩民国和新加坡在会上分享了各自的经验和教训。 Earlier today, we held a briefing with around 50 Ministers of Health from around the world at which China, Japan, the Republic of Korea and Singapore shared their experiences and the lessons they have learned.
对于哪些措施行之有效,共同得出以下几个结论: Several common themes emerged about what has worked:
需要及早发现和隔离确诊病例; The need for early detection and isolation of confirmed cases;
识别、跟踪和隔离接触者; Identification, follow-up and quarantine of contacts;
需要优化医护安排; The need to optimize care;
需要沟通,建立信任和促进社区参与抗疫。 And the need to communicate to build trust and engage communities in the fight.
各国还提到了若干共同挑战。 Countries also expressed several common challenges.
全球个人防护装备长期短缺已成为我们拯救生命能力的一个迫在眉睫的威胁。 The chronic global shortage of personal protective equipment is now one of the most urgent threats to our collective ability to save lives.
世卫组织已向74个最需要的国家运送了近200万套个人防护装备,我们正准备向另外60个国家运送类似数量的防护装备。 WHO has shipped almost 2 million individual items of protective gear to 74 countries that need it most, and we’re preparing to send a similar amount to a further 60 countries.
但需要的东西远不止于此。 But much more is needed.
唯有通过国际合作和国际团结才能解决这种问题。 This problem can only be solved with international cooperation and international solidarity.
当医务工作者处于危险之时,我们都处于危险之中。 When health workers are at risk, we’re all at risk.
低收入和中等收入国家的医务人员应该得到与最富裕国家医务人员同样的保护。 Health workers in low- and middle-income countries deserve the same protection as those in the wealthiest countries.
为了支持我们对所有国家大力开展病例调查和检测的呼吁,我们也在紧急争取大规模增加世界各地的生产能力和检测能力。 To support our call on all countries to conduct aggressive case-finding and testing, we’re also working urgently to massively increase the production and capacity for testing around the world.
研发是国际合作最重要的一个领域。 One of the most important areas of international cooperation is research and development.
疫苗距离我们还很远,至少需要12至18个月时间。 A vaccine is still at least 12 to 18 months away.
同时,我们认识到迫切需要治疗工具来治病救人。 In the meantime, we recognize that there is an urgent need for therapeutics to treat patients and save lives.
今天,我们高兴地宣布,在挪威和西班牙,第一批患者将很快入组,加入“团结试验项目”。该试验将比较四种不同抗COVID-19药物或药物组合的安全性和疗效。 Today we are delighted to announce that in Norway and Spain, the first patients will shortly be enrolled in the Solidarity Trial, which will compare the safety and effectiveness of four different drugs or drug combinations against COVID-19.
这是一项历史性的试验,它将大大缩短为获得关于何种药物具有疗效的可靠证据所需要的时间。 This is a historic trial which will dramatically cut the time needed to generate robust evidence about what drugs work.
超过45个国家参与了这项试验,更多的国家表示了兴趣。 More than 45 countries are contributing to the trial, and more have expressed interest.
参加试验的国家越多,我们得出结果的速度就越快。 The more countries who join the trial, the faster we will have results.
与此同时,我们呼吁个人和国家不要使用未证明对治疗COVID-19有效的疗法。 In the meantime, we call on individuals and countries to refrain from using therapeutics that have not been demonstrated to be effective in the treatment of COVID-19.
医学史上不乏在文章里或试管里起作用的药物的例子,但它们对人体并无作用或实际上有害。 The history of medicine is strewn with examples of drugs that worked on paper, or in a test tube, but didn't work in humans or were actually harmful.
例如,在最近的埃博拉疫情中,在临床试验比较时发现,一些被认为有效的药物不如其他药物有效。 During the most recent Ebola epidemic, for example, some medicines that were thought to be effective were found not to be as effective as other medicines when they were compared during a clinical trial.
我们必须基于证据,没有捷径可图。 We must follow the evidence. There are no short-cuts.
我们还需要确保,使用未经证实的药物不会造成这些本用于治疗某些疾病且有疗效的药物出现短缺。 We also need to ensure that using unproven drugs does not create a shortage of those medicines to treat diseases for which they have proven effective.
随着大流行的发展和更多国家受到影响,我们越来越了解哪些工具有效而哪些工具无效。 As the pandemic evolves and more countries are affected, we are learning more and more lessons about what works and what doesn't.
世卫组织继续支持各国采取应对措施。 WHO is continuing to support all countries in the response.
我们已经在网站上发布了40多份指导性文件,为政府、医院、医务工作者、公众等提供了详细的循证建议。 We’ve published more than 40 guidance documents on our website, providing detailed, evidence-based recommendations for governments, hospitals, health workers, members of the public and more.
超过100万卫生工作者通过世卫组织网上公开课程(OpenWHO.org)接受了培训。 More than 1 million health workers have been trained through our courses on OpenWHO.org.
我们将继续进行更多的培训。 We will continue to train more.
我们还高兴地通报,COVID-19团结应对基金在两周内已收到来自20.3万名个人和机构超过1.08亿美元的捐款。 We’re also delighted to report that the COVID-19 Solidarity Fund has now received donations of more than US$ 108 million in just two weeks, from 203,000 individuals and organizations.
感谢每一位捐款人和每一个捐款机构。 Thank you to each and every one of you.
我们的WhatsApp健康提醒英文版目前在全球拥有超过1200万用户,阿拉伯文、法文和西班牙文版也于今天发布。 The English version of our WhatsApp Health Alert now has more than 12 million users globally, and the Arabic, French and Spanish versions were launched today.
将增加更多的语言,包括孟加拉语、汉语、印地语、库尔德语、葡萄牙语、俄语、索马里语、乌尔都语、斯瓦希里语等。 More languages will be added, including Bangla, Chinese, Hindi, Kurdish, Portuguese, Russian, Somali, Urdu, Swahili and more.
我之前说过,这样的危机既能彰显人类最闪亮之处,也可揭示人性最丑陋的一面。 I’ve said before that crises like this bring out the best and worst in humanity.
我们最近看到盗用世卫组织、我个人名字和COVID-19实施诈骗、网络攻击和假冒行为有增无已。 We have recently seen an increase in scams, cyberattacks and impersonation using WHO, my name and COVID-19.
我非常感谢各国工作人员向世卫组织网络安全小组提供重要的网络安全信息。 I am very grateful to those working in various national organizations providing critical cybersecurity intelligence to the WHO Cybersecurity team.
感谢各位与我们一道努力保护那些依赖世卫组织信息系统和数字工具的卫生系统、卫生工作者和普通民众。 Thank you for your efforts to work with us to protect the health systems, health workers and members of the general public who rely on our information systems and digital tools.
特别感谢微软在这方面的协助。 Special thanks to Microsoft for assisting on this.
我想以新加坡卫生部长颜金勇在今天通报会上所说的话作为结束语。 I’d like to end with something Singapore’s Minister of Health, Gan Kim Yong, said during today’s briefing.
这场战疫刚刚开始。 We are only at the beginning of this fight.
我们需要头脑冷静,团结一心,共克顽敌。 We need to stay calm, stay united and work together.
谢谢大家。 I thank you
联合国人道主义事务负责人马克·洛科克今天从中央应急基金中拨款1500万美元,用于资助全球遏制2019冠状病毒病的努力。 UN Humanitarian Chief Mark Lowcock today released US$15 million from the Central Emergency Response Fund (CERF) to help fund global efforts to contain the COVID-19 virus.
在发表该声明的同时,世界卫生组织(世卫组织)将冠状病毒疫情的全球风险提升至了“非常高”这一风险评估的最高级别。 The announcement came as the World Health Organization (WHO) upgraded the global risk of the coronavirus outbreak to "very high" – its top level of risk assessment.
世卫组织表示,只要切断病毒传播链,仍有机会控制住该病毒。 The WHO has said there is still a chance of containing the virus if its chain of transmission is broken.
意大利、伊朗伊斯兰共和国和大韩民国病例的突然增加令人深感关切。 The sudden increases of cases in Italy, the Islamic Republic of Iran and the Republic of Korea are deeply concerning.
目前巴林、伊拉克、科威特和阿曼存在与伊朗有关联的病例,而阿尔及利亚、奥地利、克罗地亚、德国、西班牙和瑞士则存在与意大利有关联的病例。 There are now cases linked to Iran in Bahrain, Iraq, Kuwait and Oman, along with cases linked to Italy in Algeria, Austria, Croatia, Germany, Spain and Switzerland.
联合国的资金已经发放给世卫组织和联合国儿童基金会(儿基会),将用于资助开展一系列必要活动,包括监测病毒传播、调查病例和支持国家实验室的运作。 The UN funding has been released to the WHO and the United Nations Children’s Fund (UNICEF). It will fund essential activities including monitoring the spread of the virus, investigating cases, and the operation of national laboratories.
世卫组织曾呼吁提供6.75亿美元用于抗击冠状病毒疫情。 The WHO has called for US$675 million to fund the fight against coronavirus.
如果各国采取强有力的措施,及早发现病例,隔离和护理患者,并追踪接触者,就有机会遏制病毒的传播。 There is a window of opportunity to contain the spread of the virus if countries take robust measures to detect cases early, isolate and care for patients, and trace contacts.
紧急救济协调员兼主管人道主义事务的副秘书长马克·洛科克说:“我们还没有看到病毒肆意传播的证据。 Emergency Relief Coordinator and Under-Secretary-General for Humanitarian Affairs, Mark Lowcock said: “We do not yet see evidence that the virus is spreading freely.
只要这种情况维持下去,我们就仍有机会阻止疫情蔓延。 As long as that’s the case, we still have a chance of containing it.
“但必须采取迅速和强有力的措施,及早发现病例,隔离和护理患者,并追踪接触者。 “But swift and robust action must be taken to detect cases early, isolate and care for patients, and trace contacts.
我们必须立即行动起来,阻止这一病毒危及更多人的生命。 We must act now to stop this virus from putting more lives at risk.
“这笔联合国应急基金拨款将支持卫生系统薄弱的国家,加强其发现和应对工作的力度。 “This grant from the UN’s Emergency Fund will help countries with fragile health systems boost their detection and response operations.
这将可能挽救数百万脆弱人口的生命。” It has the potential to save the lives of millions of vulnerable people.”
目前是疫情的关键时刻。 This is a critical juncture in the outbreak.
重点是要遏制2019冠状病毒病,为此必须加强监测、开展彻底的疫情调查以确定接触者并采取适当措施防止进一步传播。 The focus is on containing COVID-19 by strengthening surveillance, conducting thorough outbreak investigations to identify contacts and applying appropriate measures to prevent further spread.
世卫组织总干事谭德塞说:“我们最大的担忧之一就是病毒可能向卫生系统薄弱的国家传播。 Tedros Adhanom Ghebreyesus, WHO Director-General, said: “The potential spread of the virus to countries with weaker health systems is one of our biggest concerns.
这些资金将有助于支持这些国家做好检测和隔离病例的准备,保护其医务工作者,并为患者提供有尊严的治疗和适当护理。 These funds will help support these countries get ready for detecting and isolating cases, protecting their health workers, and treating patients with dignity and appropriate care.
这将帮助我们挽救生命并击退该病毒。” This will help us save lives and push back the virus”
儿基会在受影响各国的社区带头采取预防行动,包括进行风险沟通,向学校和诊所提供卫生和医疗用品包,并监测疫情的影响,以支持医护、教育和社会服务的连续性。 UNICEF is leading on preventative actions in communities across the affected countries with risk communication, providing hygiene and medical kits to schools and health clinics and monitoring the impact of the outbreak to support continuity of care, education and social services.
儿基会执行主任亨丽埃塔·福尔说:“在这个关键的时刻,我们必须尽一切努力抗击疫情。 “At this pivotal moment, every effort must be made to push back against the outbreak,” said UNICEF Executive Director Henrietta Fore.
这些资金至关重要,将支持全球努力加强薄弱的卫生系统,并让儿童、孕妇和家庭了解保护自己的方法。” “These crucial funds will support our global efforts to bolster weaker health systems and inform children, pregnant women and families about how to protect themselves.”
中央应急基金自2006年启动以来,已向100多个国家提供了60多亿美元,帮助了无数人。 Since it was launched in 2006, CERF has provided more than $6 billion to over 100 countries and helped hundreds of millions of people.
一、疫情防控期间外国人是否可以正常出入境? I. Are foreigners allowed to entry or exit as usual during the period of epidemic prevention and control?
答:疫情发生后,中国政府采取了一系列的有力应对措施。 Answer: The Chinese government has taken a series of strong measures since the outbreak of pneumonia caused by novel coronavirus.
习近平总书记指出,我们完全有信心、有能力打赢这场疫情防控阻止战。 As President Xi Jinping stated, China has full confidence and capability to win the battle against the novel coronavirus outbreak.
目前,除武汉口岸关闭离汉通道外,我国口岸签证机关仍正常运转,外国人过境免签政策未作调整,各陆、海、空口岸继续对外开放运转,外国人可凭有效的出境入境证件正常出入境。 At present, except for the lockdown of the exit channel of Wuhan ports, all port visa agencies are operating as usual. Visa-free transit policy for foreigners are still effective. All land, sea and air ports of China are functioning. Foreigners can enter or exit as usual with their valid international travel documents.
目前情况下减少人员跨境流动有助于有效防控疫情。 At present, it is helpful to the epidemic prevention and control by reducing cross border movements.
外国人可根据实际合理安排来华行程,外国人可继续在华停留居留。 Foreigners could make reasonable travel arrangements to China and stay or reside in China as usual.
对于确需出境的外国人,鉴于部分国家和地区已针对疫情实施相应的入境管制措施,建议提前了解清楚目的地国家或地区对人员入境的规定和做法,避免因无法入境造成费用和时间损失; Due to entry restrictions adopted by some countries and regions, it is advised that foreigners who need to exit from China, should learn in advance entry requirements of destination countries or regions to avoid financial and time losses in case of any entry refusals.
前往国家、地区允许入境的,应当提前到达出境口岸,留出足够时间接受相关部门检查; Those who travel to countries or regions without entry restrictions, are advised to arrive at exit ports well ahead of departure time for necessary checks.
已经出现发热并伴有咳嗽、呼吸困难等急性呼吸道感染症状的,不应进行国际旅行,应当立即就近接受诊治,并如实向有关管理人员说明近期活动和密切接触人员等情况,以便有关部门迅速采取排查措施。 Foreigners having fever with symptoms of acute respiratory infection such as cough or breathing difficulties, should avoid international travels and seek immediate medical treatment at the nearest hospitals. Information such as recent activities as well as close contacts should be provided to relevant authorities for any necessary control measures.
二、疫情防控期间外国人如何办理签证延期、停留居留证件? II. How do foreigners apply for visas, stay or residence permits during the period of epidemic prevention and control?
答:疫情防控期间,全国公安机关出入境管理部门将继续为外国人提供签证延期和停留居留证件办理服务,保障外国人合法停留居留,对有紧急需要的将加急办理相关证件。 Answer:All Exit and Entry Administration(EEA) authorities in China will be in full service for extension and issuance of visa and stay or residence permits to ensure foreigners' legitimate stay in China. Urgent services for emergency situations will also be provided.
为有效避免人员聚集,公安机关出入境管理部门结合实际将安排预约办证服务,外国人可提前联系、合理安排办证时间。 To avoid crowds gathering risks, the EEA authorities will make arrangements for services on appointments. Foreigners could make appointments in advance for any applications.
对接待外国人较多的高校、科研院所、企事业单位等机构,出入境管理部门将根据办证需求,视情允许代办证件或提供其他必要的办证便利。 For those institutions which host high numbers of foreigners, such as universities, scientific research institutes and business enterprises, the EEA authorities will allow additional agent service or provide other necessary conveniences depending upon the situation.
三、疫情防控期间外国人签证、停居留证件过期怎么办? III. How to deal with the situation that a foreigner’s visa, stay or residence permit expires during the epidemic prevention and control?
答:根据我国出境入境管理法规定,外国人应在签证、停留居留证件到期前出境,需要继续在华停留居留的应当到公安机关出入境管理部门办理签证、停留居留证件延期手续。 Answer: According to Exit and Entry Administration Law of the PRC, foreigners should exit China or apply for extension at the EEA authorities before the visa, stay or residence permit expires .
根据有关法律规定和当前实际,对因疫情防控原因难以按时出境且无法及时办理签证、停居留证件延期手续的,移民管理机构可依法依规视情从轻、减轻或免予逾期居留处罚。 In light of the relevant laws and regulations and current situation, those who are unable to exit as scheduled or extend the visas, stay or residence permits due to the reason of epidemic prevention and control shall be given a lighter or mitigated or be exempted from punishment by the EEA authorities depending upon circumstances.
四、在华停留居留外国人应当如何配合疫情防控? IV. What can foreigners do to cooperate during the epidemic prevention and control?
答:广大外国朋友增强自我防护意识,尽量不要到人群密集地方活动,采取科学预防措施,主动配合所在社区和单位、接待机构实施疫情防控措施,自觉遵守相关法律法规,服从公安机关、移民管理机构、卫生健康等部门采取的防控管理措施。 Answer: It is advised that foreign friends enhance sense of self-protection, avoid crowded public places and take effective preventive measures. It is strongly suggested to actively cooperating with local communities and inviting entities to take preventive measures, abiding by relevant laws and regulations and following instructions of public security organs, NIA authorities, hygiene & health authorities.
如出现发热并伴有咳嗽、呼吸困难等急性呼吸道感染症状,应及时报告社区、卫生健康或移民管理机构,积极配合诊治和疫情排查。 In case of having a fever with symptoms of acute respiratory infection such as cough or breathing difficulties, foreigners should report to the local communities, NIA authorities or hygiene & health authorities and cooperate actively in medical treatment and epidemic control.
各级移民管理机构将进一步会同有关部门开展在华外国人防控服务咨询工作,协助医疗卫生机构进行筛查诊治,帮助解决停留居留期间遇到的困难和问题。 NIA authorities at all levels will work closely with relevant departments for the epidemic prevention and control to provide consultancy to foreigners, assist in disease screening and diagnosis with medical departments as well as dealing with other difficulties and problems encountered by foreigners during their stay in China.
五、中国内地居民目前是否可以正常出入境? V. Are Chinese mainland residents allowed to exit or enter as usual?
答:目前,除武汉关闭离汉通道外,全国陆、海、空对外开放口岸运转正常,中国内地居民可凭有效的出境入境证件正常出入境。 Answer: At present, except for the lockdown of the exit channel of Wuhan ports, all land, sea and air ports of China are in normal service. Chinese mainland residents could exit or enter with their valid international travel documents.
国家移民管理局所属各口岸出入境边防检查机关将继续为回国人员提供相应的便利和服务,并配合有关卫生医疗机构开展必要的疫情排查。 All immigration inspection agencies of NIA will continue to provide services and conveniences for Chinese nationals, and coordinate with relevant hygiene & health authorities to conduct necessary epidemic checks.
根据疫情防控工作需要和一些国家、地区已针对新冠肺炎疫情实施入境管制措施的情况,为保障中外人员身体健康和生命安全,维护正常出入境秩序,我们建议近期有出国出境计划的内地居民合理确定出行时间,避免可能造成的不必要损失。 In view of the epidemic prevention and control situation as well as entry restrictions adopted by some countries and regions, in order to ensure health and safety of travelers and maintain exit and entry order, it is advised that Chinese mainland residents make reasonable travel plans and avoid unnecessary financial and time costs.
据目前掌握,目前已有朝鲜、哈萨克斯坦、马来西亚、菲律宾、澳大利亚、韩国、卡塔尔、日本、越南、印度、英国、印度尼西亚、法国、缅甸、意大利、阿联酋、斯里兰卡、澳大利亚等国家和港澳台地区对来自中国内地(大陆)的旅客入境采取了限制性措施。 Based on currently available information, countries including DPRK, Kazakhstan, Malaysia, the Philippines, Australia, ROK, Qatar, Japan, Vietnam, India, Britain, Indonesia, France, Myanmar, Italy, the United Arab Emirates, Sri Lanka as well as Hong Kong, Macao SAR and Taiwan region have adopted entry restrictions for travelers from Chinese mainland.
如确有需要出国出境,建议您提前向有关国家或地区驻华代表机构、航空公司或境外接待单位了解清楚目的地国家或地区采取的入境管控措施情况再作安排。 If travelers are in urgent need of exit from Chinese mainland, it is advised to make travel arrangements after consulting with relevant diplomatic representative agencies, airlines or the inviting entities of the destination counties or regions.
六、目前中国公民可以到公安机关出入境管理部门办理普通护照等出入境证件吗? VI. Could Chinese citizens apply for travel documents such as passports at the EEA authorities?
答:为保护中外人员生命安全和身体健康,减少人员跨境流动影响疫情,维护正常出入境秩序,建议内地居民合理安排出国出境计划,非特别急需的可暂缓申办出入境证件。 Answer: In order to ensure health and safety of Chinese citizens and foreigners, reduce risks of cross-border movements for the epidemic prevention and control, maintain normal exit and entry order, it is advised that Chinese mainland residents make reasonable travel plans, and postpone applications of travel documents unless in emergency.
目前,湖北省公安机关出入境管理部门已暂停受理中国公民出入境证件申请,恢复受理申请时间将视疫情防控情况确定。 At present, the EEA of Hubei Province has suspended accepting travel documents applications from Chinese citizens. Normal services will be resumed according to the situation of the epidemic prevention and control.
其他地方公安机关出入境管理部门因春节长假暂时关闭窗口服务。 Application services are suspended in EEA of other provinces during Chinese Spring Festival holiday.
如无特别情况,春节假期结束后,除湖北省以外的公安机关出入境管理窗口将继续开放。 Under normal circumstances, the application centers except for Hubei Province will be back into service after Chinese Spring Festival holiday.
有关当事人可提前联系当地公安机关出入境管理部门了解窗口开放信息和相关证件申办要求。 Applicants could contact local EEA authorities in advance for further information about opening time of application centers and relevant requirements.
为减少人员聚集、避免奔波往返,确有需要的申请人可通过网上预约等渠道确定提交申请的具体时间,以便各窗口单位更好地提供办证服务,提高受理审批效率。 To avoid crowds gathering and unnecessary travels, applicants in need could confirm the time for submitting applications by online appointment, so that EEA authorities could provide better services and enhance efficiency.
各地(包括湖北省内人员)确有特殊事由需紧急办理出入境证件的,可随时联系各地公安机关出入境管理部门申请进行个案审批。 Applicants in urgent need for travel documents (including those in Hubei Province) could contact local EEA authorities at any time for urgent applications.
七、目前湖北武汉口岸是否能够正常出入境? VII. Are travelers allowed to exit and enter through ports of Wuhan?
答:目前,各国人员可以从湖北武汉地区的对外开放口岸(即武汉天河机场、汉口港)正常入境。 Answer: International travelers can enter China through ports of Wuhan (referring to Wuhan Tianhe International Airport and Hankou ferry terminal ).
因离汉出境通道已关闭,未经批准不安排人员通行。 Due to the lockdown of the exit channels of Wuhan ports, exits through any ports of Wuhan can only be permitted with approval.
八、目前中国内地居民是否能通过自助通道办理边检手续? VIII. Could Chinese mainland residents go through e-channels as usual?
答:根据口岸疫情防控工作需要,部分口岸出入境边防检查机关可能暂时关闭部分自助查验通道,在这种情况下旅客应经人工查验通道通关。 Answer: Some of immigration inspection agencies may close some e-channels for the moment due to current situation of the epidemic prevention and control. Under such circumstances, travelers should go through manual inspection channels.
请出入境旅客自觉服从现场工作人员引导,按规定办理通关查验手续。 It is advised for travelers to follow instructions of NIA officers and go through border clearance formalities according to relevant regulations.
疫情防控期间,口岸出入境边防检查机关人工查验通道可能配合有关主管部门采取检测体温、询问行程及密切接触者情况等必要的筛查措施,请广大出入境人员自觉配合。 During the epidemic prevention and control period, immigration officers at manual inspection channels may work together with relevant authorities and take necessary preventive measures such as taking travels’ temperatures and making inquiries about travel itineraries and close contacts .
各口岸出入境边防检查机关将确保大型口岸中国公民通关等候时间不超过30分钟,外国人出入境顺畅。 Cooperation by the travelers will be appreciated., Immigration inspection agencies will make efforts to guarantee border inspection waiting time no more than 30 minutes for Chinese citizens at large ports and smooth border clearance for foreign visitors.
九、已经办理赴港澳台签注但因疫情无法在签注有效期内赴港澳台的如何处理? IX. How to deal with the situation that some travelers have already obtained endorsements to Hong Kong, Macao SAR and Taiwan region but cannot travel due to the epidemic?
答:据掌握,目前港澳台地区主管部门对内地(大陆)居民作出了限制入境规定。 Answer: At present, regional authorities of Hong Kong, Macao SAR and Taiwan region have conducted travel restrictions for Chinese mainland residents.
对持有往来港澳台签注、受疫情影响未能在签注有效期内入境港澳台地区的,公安机关出入境管理部门将在疫情解除后,根据持证人意愿免费重新办理相同种类和有效期的签注。 For those who have obtained endorsements to Hong Kong, Macao SAR and Taiwan region but fail to enter within the validity of endorsements because of the epidemic, EEA authorities will, after clearance of the epidemic, issue the same type of endorsements with the same validity free of charge according to the holder’s wishes.
十、旅客出入境途中出现疑似疫情症状怎么办? X. How to deal with the situation that travelers have suspicious symptoms?
答:出入境人员如出现发热并伴有咳嗽、呼吸困难等急性呼吸道感染症状,应当立即停止出入境旅行、自觉远离人群,并到就近的医疗卫生机构就医。 Answer: If travelers have symptoms of acute respiratory infection, such as cough and breathing difficulties, they should suspend travels immediately, stay far away from the crowds and seek treatment at the nearest medical institutions.
口岸或驻地的移民管理机构也将提供必要的协助。 The NIA authorities will provide necessary assistance as well.
李克强:要高度重视防治无症状感染者 Premier calls attention to asymptomatic COVID-19 cases
“要高度重视防治无症状感染者。”李克强总理3月26日主持召开中央应对新冠肺炎疫情工作领导小组会议时强调。“无症状感染者”全称是“新冠病毒无症状感染者”,指无临床症状、但呼吸道等标本新冠病毒病原学检测阳性者。 Great attention should be paid to taking preventive measures and treating cases exhibiting no clinical symptoms but testing positive for novel coronavirus disease (COVID-19), said Premier Li Keqiang at a meeting of the leading group on novel coronavirus prevention and control on March 26.
李克强会上指出,疫情发生之初,我们集中主要精力救治新冠病毒有症状感染者,尤其是重症和危重症病人。 At the beginning of the COVID-19 outbreak, the focus was on saving and treating symptomatic patients, especially those in a severe or critical condition,
现在要持续巩固国内疫情防控阶段性成果,在全力救治重症和危重症病人、做好社区防控的同时,高度重视“防治无症状感染者”等群众日益关注的问题。 Premier Li said, emphasizing the need to continue this effort coupled with community-level prevention and control to preserve the current hard-won progress in battling the virus. Now, he said, the prevention and treatment of asymptomatic patients is an urgent priority.
“无症状感染者究竟有无传染性? 病情会不会进一步发展变化?卫健委要组织专家认真研判,拿出科学防治方案。 这是我们巩固疫情防控成果、防止出现防控漏洞的重要内容。” "The National Health Commission should organize experts to carefully study the infectiousness of asymptomatic cases and the evolution of their condition before creating science-based plans for prevention and treatment. This is crucial for us to push ahead with the anti-virus fight without omitting any link,"
总理说,“有关部门要严肃认真对待这一问题,实事求是、及时公开回应社会关切。” the Premier said, adding that related authorities should take it seriously and respond to public concerns in an open, timely and truthful manner.
“无论是通过哪种途径发现的无症状感染者,都要根据医疗规则制定明确的科学防治方案,坚决遏制可能形成的新的病毒感染和疫情传播。”总理说。 The Premier urged designing scientific prevention and treatment solutions suited to detecting asymptomatic infections according to medical rules and resolutely curbing potential new virus infection and spread.
李克强表示,新冠肺炎疫情发生以来,有关部门一直在根据情况变化不断调整诊疗方案,对于出现无症状感染者这一情况,也要因应变化、科学应对。 Since the outbreak of the disease, related agencies have been adjusting the diagnosis and treatment plan to epidemic dynamics, and now the same scientific responsiveness and adaptation should be reflected in coping with asymptomatic infections, he said.
“总之,我们的目的就是一个:全力保障人民群众的生命健康安全。”总理说。 "In the final analysis, the sole aim is to do our utmost to safeguard the life and health of the people," he added.
外交部副部长郑泽光向拉美和加勒比国家驻华使节通报新冠肺炎疫情防控情况 Vice Foreign Minister Zheng Zeguang Briefs Diplomatic Envoys of Latin American and Caribbean States to China on Prevention and Control of the Novel Coronavirus Disease
2020年2月24日,外交部副部长郑泽光分别同巴西驻华大使瓦莱、智利驻华大使施密特、墨西哥驻华大使贝尔纳尔、哥伦比亚驻华大使蒙萨尔韦、秘鲁驻华大使克萨达、特立尼达和多巴哥驻华大使西丹辛格、哥斯达黎加驻华大使德尔加多通电话,通报中方疫情防控情况,并就双边关系交换意见。 On February 24, 2020, Vice Foreign Minister Zheng Zeguang had phone calls respectively with Brazilian Ambassador to China Paulo Estivallet, Chilean Ambassador to China Luis Schmidt, Mexican Ambassador to China Jose Bernal, Colombian Ambassador to China Luis Monsalve Hoyos, Trinidad and Tobago's Ambassador to China Stephen Seedansingh and Costa Rican Ambassador to China Rodrigo Delgado Soto, briefing them on the Chinese side's efforts in combating the novel coronavirus disease and exchanging views on bilateral relations.
郑泽光表示,新冠肺炎疫情爆发以来,各位使节代表的国家以不同方式向中国表达了慰问和支持,中方对此表示诚挚谢意。 Zheng Zeguang said, since the onset of the epidemic, your countries have conveyed sympathies and support to China in many ways, for which the Chinese side expresses sincere gratitude.
郑泽光指出,在习近平主席亲自指挥、亲自部署下,中国人民万众一心、众志成城,对疫情采取了最全面、最严格、最彻底的防控举措。 Zheng Zeguang said, under the personal command and deployment of President Xi Jinping, the Chinese people have united as one and taken the most comprehensive, rigorous and thorough measures.
经过艰苦努力,目前疫情防控形势积极向好的态势正在拓展。 Thanks to all the arduous efforts, the positive momentum of control and prevention is expanding.
我们完全有信心、有能力、有把握打赢这场疫情防控阻击战。 We are confident and capable of winning the battle against the epidemic.
中方将继续秉持构建人类命运共同体的理念,与世界卫生组织和各国加强沟通,开展防控合作,共同维护国际公共卫生安全。 The Chinese side will continue to uphold the vision of a community with a shared future for mankind, strengthen communication with the World Health Organization and all countries, and carry out prevention and control cooperation to jointly safeguard international public health security.
郑泽光指出,疫情对中国经济的冲击是短期的、总体上是可控的,中国经济长期向好的基本面没有改变。 Zheng Zeguang noted, the outbreak's impact on the Chinese economy will be short-lived and generally manageable. The fundamentals sustaining China's economy will remain unchanged in the long run.
我们将毫不放松抓好疫情防控工作,不获全胜决不轻言成功,同时采取强有力政策举措,确保实现今年经济社会发展目标任务。 While we make unremitting efforts to control the outbreak, we are also adopting a range of strong policies to strive to achieve this year's targets for economic and social development.
中方愿同拉美和加勒比国家共同努力,深化各领域友好合作,推动双边关系迈上新台阶。 The Chinese side is willing to work with Latin American and Caribbean states to deepen friendly cooperation in various areas and elevate bilateral relations to new highs.
七国使节感谢郑泽光所作通报,积极评价中国卓有成效的疫情防控工作,感谢中方采取有力举措保障各国在华人员健康和安全。 The ambassadors from the seven countries thanked Zheng Zeguang for the briefing, spoke positively of China's effective efforts in prevention and control of the epidemic, and thanked the Chinese side for efficiently protecting the health and safety of various nationals in China.
他们表示,十分看好中国经济发展前景,愿加强其所代表的国家同中国在疫情防控及其他领域的合作。 They are optimistic about the prospects of China's economy, and are willing to enhance cooperation between their countries and China in epidemic control and other areas.
疫情发生以来,巴西向中国捐助了大批医用口罩, Since the outbreak of the epidemic, Brazil has donated a large number of medical masks to China.
特立尼达和多巴哥捐助了两批防护物资, Trinidad and Tobago has donated two batches of protective supplies.
哥斯达黎加等多个拉美和加勒比国家也捐助了口罩、医用手套等医疗物资。 Costa Rica and several other Latin American and Caribbean states have also donated medical supplies such as masks and gloves.
世卫组织总干事2020年3月23日在2019冠状病毒病(COVID-19)疫情媒体通报会上的讲话 WHO Director-General's opening remarks at the media briefing on COVID-19 - 23 March 2020
2020年3月23日 23-Mar-20
依你们所处的时区,大家早上好,下午好,晚上好。 Good morning, good afternoon and good evening, wherever you are.
不到6个月前,世卫组织与国际足联签署了一项协议,双方承诺通力合作,通过足球运动促进健康。 Less than 6 months ago, WHO and FIFA signed an agreement to work together to promote health through football.
当时我们并不知道会出现一种新型病毒,使我们社会的众多领域陷入停顿,包括万人瞩目的足球比赛。 We didn’t know then what we know now – that a new virus would emerge that would bring many parts of society to a standstill – including the beautiful game.
许多足球赛事已经停止。在这一艰难时期,我们的合作变得更加重要。事实上,它给了我们一个超乎以前想象的更紧密合作的契机。 Many football matches have stopped – but our collaboration has become even more important during these difficult times. In fact, it’s given us the opportunity of working together more closely than we imagined.
足球可以激发成千上万人尤其是年轻人的兴致,这是公共卫生官员无法企及的。 Football can reach millions of people, especially younger people, that public health officials cannot.
今天,我非常高兴欢迎我的好兄弟,国际足联主席詹尼·因凡蒂诺谈一谈我们联合发起的 “传递适当信息,踢走冠状病毒” 宣传运动。 Today it’s my great pleasure to welcome my dear brother Gianni Infantino, President of FIFA, to talk about our joint campaign to “Pass the message to kick out coronavirus”.
我还愿借此机会感谢国际足联向COVID-19团结应对基金慷慨捐款1000万美元。 I’d also like to take this opportunity to thank FIFA for its generous contribution of US$10 million to the COVID-19 Solidarity Response Fund.
该基金仅在10天之内就已从18.7万多名个人和组织筹集到了7000多万美元,用于帮助一线医务工作者开展拯救生命的工作,医治患者,推进治疗方法和疫苗研究。 To date, the fund has raised more than US$70 million, in just 10 days, from more than 187,000 individuals and organizations, to help health workers on the front lines to do their life-saving work, treat patients and advance research for treatments and vaccines.
我还要感谢抖音捐助了1000万美元,并提供宝贵的支持,帮助广大的年轻用户获得可靠的健康信息。 I would also like to thank TikTok for its contribution of US$10 million, and for its valuable support in helping to reach its large, young audience with reliable health information.
说到这里,我们新的WhatsApp健康警报信息服务自上周五推出以来,短短4天就吸引了1000万用户。它直接向手机用户提供可靠的健康信息。 Speaking of which, our new WhatsApp Health Alert has now attracted 10 million users since we launched it last Friday – this is just in 4 days –delivering reliable health information directly to their mobile phones.
我们的网站首页上有如何注册的详细信息。本周将推出阿拉伯语、法语和西班牙语版。这是与人们保持直接联系的最佳方式。 Details on how to sign up are on the front page of our website. The Arabic, French and Spanish versions will be launched this week, and this is the best way to be connected directly with people.
所以谢谢你,詹尼,谢谢你的支持和整个足球界的支持。 So thank you, Gianni, for your support, and the support of the whole footballing community.
现在我想请你讲几句话。今天是你的生日。所以,我要说,亲爱的兄弟,祝你生日快乐!非常感谢你今天能与会。 I’d now like to give you the floor to say a few words, but I would also like to recognize that it’s your birthday today. So I would like to say happy birthday, my dear brother, and thank you so much for joining us today.
[国际足联主席詹尼·因凡蒂诺先生作了简短讲话,随后世卫组织亲善大使阿利松·贝克尔作了简短发言] [MR GIANNI INFANTINO, PREISDENT OF FIFA MADE BRIEF REMARKS, FOLLOWED BY WHO GOODWILL AMBASSADOR ALISSON BECKER]
谢谢你们,詹尼和阿利松。 Thank you, Gianni and Alisson.
现在,我想继续谈一谈COVID-19大流行的情况。 I’d now like to continue with the rest of my remarks on the COVID-19 pandemic.
现在全世界几乎每个国家都向世卫组织报告了COVID-19病例,病例总数超过了30万例。 More than 300,000 cases of COVID-19 have now been reported to WHO, from almost every country in the world.
这实在太令人心碎。 That's heartbreaking.
大流行目前呈加速趋势。 The pandemic is accelerating.
从报告的第一例到报告首个10万病例用了67天,到报告第二个10万病例用了11天,到报告第三个10万病例仅仅用了4天。 It took 67 days from the first reported case to reach the first 100,000 cases, 11 days for the second 100,000 cases and just 4 days for the third 100,000 cases.
大家可以看到这一病毒是多么猖獗。 You can see how the virus is accelerating.
但我们不要被统计数字吓倒。我们不是听凭摆布的旁观者,可以采取行动改变这场大流行的发展轨迹。 But we’re not prisoners to statistics. We’re not helpless bystanders. We can change the trajectory of this pandemic.
数字之所以重要,是因为它们不仅仅是数字。 Numbers matter, because they’re not just numbers.
它们反映的是人们被彻底搅乱的生活和家庭。 They’re people, whose lives and families have been turned upside down.
最重要的是我们如何加以应对。 But what matters most is what we do.
单靠防守是赢不了足球比赛的,还必须反击。 You can't win a football game only by defending. You have to attack as well.
要求人们呆在家里以及采取其他保持人际距离的措施是减缓病毒传播和争取时间的重要方式,但它们属于防守措施。 Asking people to stay at home and other physical distancing measures are an important way of slowing down the spread of the virus and buying time – but they are defensive measures.
为了赢得胜利,我们需要采取积极和有针对性的策略向病毒发起进攻,检测每一个疑似病例,隔离和处理每一个确诊病例,追踪并隔离每一个密切接触者。 To win, we need to attack the virus with aggressive and targeted tactics –  testing every suspected case, isolating and caring for every confirmed case, and tracing and quarantining every close contact.
我们注意到,一些国家正在艰难实施这些进攻性措施。 We recognize that some countries are struggling with the capacity to carry out these offensive measures.
一些国家的情况表明,从国内受影响较小的地区调动资源是提高能力的一种途径。 Several countries have shown that mobilizing resources internally from less-affected regions is one way to increase capacity.
我们也感谢一些国家派遣了紧急医疗队前往需要支持的其他国家去救治病人和对医护人员进行培训。 We’re also grateful that several countries have sent Emergency Medical Teams to care for patients and train health workers in other countries that need support.
这是国际团结互助的光辉典范。 This is an incredible example of international solidarity.
但这绝不是意外。 But it’s not an accident.
多年来,世卫组织一直与各国合作,为这类意外情况建立一个紧急医疗队网络,从而提供高质量的专业医务工作者的快速增援能力,部署他们救死扶伤。 WHO has been working with countries for years to build a network of Emergency Medical Teams for exactly this eventuality, to provide surge capacity of high-quality health professionals who can be deployed to care for patients and save lives.
但是只有当医护人员能够安全地工作时,他们才能有效地完成任务。 But health workers can only do their jobs effectively when they can do their jobs safely.
我们继续收到世界各地医护人员被大量感染的惊人报道。 We continue to hear alarming reports from around the world of large numbers of infections among health workers.
即使我们做对了所有其他事情,但倘若我们不优先考虑保护医护人员,许多人也会因为本来可以挽救他们生命的医护人员生病而丧生。 Even if we do everything else right, if we don’t prioritize protecting health workers, many people will die because the health worker who could have saved their life is sick.
正如你们所知,世卫组织一直与许多合作伙伴一道努力合理分配个人防护装备和确定使用重点。 As you know, WHO has been working hard with many partners to rationalize and prioritize the use of personal protective equipment.
要解决这些救生工具的全球短缺问题,需要从原材料到成品,疏通供应链的每一个环节。 Addressing the global shortage of these life-saving tools means addressing every part of the supply chain, from raw materials to finished product.
为减缓病毒传播而采取的措施,可能会加剧基本防护装备以及制造它们所需材料的短缺,进而产生意想不到的后果。 Measures put in place to slow the spread of the virus may have unintended consequences by exacerbating shortages of essential protective gear, and the materials needed to make them.
解决这一问题需要全球一级作出政治承诺和政治协调。本周,我将与20国集团的国家元首和政府首脑对话,请他们共同努力,增加产量,取消出口禁令,确保按需公平供应。 Solving this problem requires political commitment and political coordination at the global level. This week, I will be addressing heads of state and government from the G20 countries. Among other issues, I will be asking them to work together to increase production, avoid export bans and ensure equity of distribution, on the basis of need.
20国集团需要团结一致。这些国家占全球国内生产总值的80%以上。如果20国集团做出政治承诺和高度团结,将有助于我们向前迈进,全力抗击这一大流行。 We need unity in the G20 countries, who have more than 80% of global GDP. Political commitment at the G20 means strong solidarity that can help us to move forward and fight this pandemic in the strongest way possible.
20国集团领导人在世界事务中发挥着举足轻重的作用,团结一致最为重要。 The most important ask to G20 leaders is solidarity, to act as one, because they have the biggest stake in the world, in all respects.
我们还认识到,迫切需要找到有效的治疗方法。 We also recognize that there is a desperate need for effective therapeutics.
迄今为止尚无任何经证明对COVID-19十分有效的治疗方法。 There is currently no treatment that has been proven to be effective against COVID-19.
很高兴看到各方在大力研究COVID-19。 It’s great to see the level of energy now being directed to research against COVID-19.
但小规模、观察性和非随机性的研究不会给我们带来所需要的解决办法。 Small, observational and non-randomized studies will not give us the answers we need.
在没有正确证据的情况下使用未经测试的药物,可能会带来虚假的希望,甚至弊大于利,导致治疗其他疾病所需的基本药物的短缺。 Using untested medicines without the right evidence could raise false hope, and even do more harm than good and cause a shortage of essential medicines that are needed to treat other diseases.
世卫组织为此启动了“团结试验项目”,以尽快获得强有力的高质量证据。 That’s why WHO has launched the SOLIDARITY trial, to generate robust, high-quality evidence as fast as possible.
我很高兴许多国家加入了这一项目,这将有助于我们加快速度和提高数量。 I’m glad that many countries have joined the SOLIDARITY trial, that will help us to move with speed and volume.
报名参加“团结试验项目”和其他大型研究的国家越多,就能越快找出疗效好的药物,进而挽救更多的生命。 The more countries that sign up to the SOLIDARITY trial and other large studies, the faster we will get results on which drugs work, and the more lives we will be able to save.
最后,我想提醒大家,虽然COVID-19正在成为全世界关注的焦点,但还有另一种本可预防和治疗的呼吸系统疾病每年夺走150万人的生命。这就是我们熟知的结核病。 I'd like to end by reminding everyone that although COVID-19 is dominating the world's attention, there's another respiratory disease that is both preventable and treatable, but which kills 1.5 million people every year - and that disease is the old-timer, tuberculosis.
明天是世界结核病日。我们就此提醒世界各国领导人履行其承诺,结束这一古老而可怕的疾病造成的痛苦和死亡。 Tomorrow is World TB Day – an opportunity to remind world leaders of the commitments they have made to end the suffering and death caused by this ancient and terrible disease.
世界正紧急大力抗击COVID-19疫情。 The world is rightly responding to COVID-19 with urgency and purpose.
我们也要呼吁国际社会怀着同样的紧迫感和使命感抗击结核病,造福各国人民,构建更健康、更安全和更公平的世界。 We call on the global community to harness that same urgency and purpose for the fight against tuberculosis – and for a healthier, safer, fairer world for everyone.
让我们行动起来,踢走冠状病毒。 The rule of the game: to kick out coronavirus.
谢谢大家。 I thank you.
别让“傲慢与偏见”毁掉人类的共同战“疫” Don't let "Pride and Prejudice" Ruin Mankind's Collective Efforts of Combating the Pandemic
3月15日,白天大使在马来西亚主流媒体及新闻网站上以中、英、马来文三语发表《别让“傲慢与偏见”毁掉人类的共同战“疫”》,全文如下: On 15 Mar, Chinese Ambassador Bai Tian published a signed article on Malaysian Chinese,  English and Malay newspaper.
“偏见让我无法去爱别人,傲慢让别人无法来爱我”。 “Prejudice keeps us from accepting each other, while pride keeps us from loving each other.”
这是后世读者对19世纪英国小说家简·奥斯汀所著《傲慢与偏见》一书的经典感言。 This is a classical reflection drawn by readers from Pride and Prejudice, a masterpiece written by Jane Austen, an English novelist in the 19th century.
这部小说讲述的是人与人之间的情感,给我留下深刻印象的是,傲慢与偏见成为了人与人之间交往的阻碍。 This novel, telling stories that happened between young men and women on their subtle feelings and emotions, impressed me most by a lesson drawn from it: pride and prejudice can be major obstacles that keep people from judging and treating each other fairly.
其实国与国的交往也是一样。 This lesson may also apply to relations between nations.
坦诚相交,与邻为善,能成就敦睦邦交的佳话。尔虞我诈、以邻为壑,会酿成对抗冲突的苦果。 Honesty and sincerity will win you good friends, yet cheating and blackmailing can only produce enemies.
殷鉴不远,世人恒应戒之慎之。 This is a lesson human history has witnessed not long ago, which no one should forget or prove it again.
2020年一开场就让全世界所有人感到揪心,一场突如其来的疫情席卷全球。 The beginning of the year 2020 shocked the whole world with an unanticipated outbreak of COVID-19, spreading all over the world almost overnight.
自疫情爆发,我每天都在关注进展,担忧焦虑,常常夜不能寐。 Ever since the outbreak, I have been keeping a close eye on its development every day, worried and concerned about the situation in China and for the people who are infected. These days I often have difficulties falling asleep at night.
最近疫情似乎发生了变化,抗击疫情正从一场中国的“人民战争”向“全球战争”转变。 Though a little bit relived about the situation in China, I do not feel cheered up at all because things seem to have undergone dramatic changes recently, the combating of COVID-19 has evolved from an “people’s war” in China to a “global war” in the world.
令我感到鼓舞的是,中国各地包括疫情重灾区湖北在内的情况都在好转,曙光已出现在隧道尽头。 What is relieving and encouraging to me is that things are getting better day by day in all parts of China, including Hubei province, the most severely hit area of the pandemic, and we are seeing the light at the end of the tunnel.
3月12日,中国各地新增确诊案例首次降至个位数,除湖北外其他中国省市的本地新增确诊病例连续5日归零,仅剩一些境外输入性病例。 Up until midnight of 12th March, the newly confirmed cases in China have decreased, for the first time, to one-digit number. Every province in China, except Hubei, has witnessed for 5 consecutive days of zero newly local confirmed cases, with only a few imported ones from abroad.
中国正在赢得抗疫斗争的关键胜利。 China is winning this war against COVID-19.
令我担忧的是,疫情正迅速在全球扩散蔓延。 Yet, what worries me is the rapid spreading of the virus all over the world.
3月11日晚,世界卫生组织宣布,新冠肺炎疫情已经构成全球大流行。谭德赛总干事表示:“我们为它的令人震惊的传播程度和严重性,以及各国令人震惊的不作为深感担忧。” On the night of 11th March, WHO Director-General Dr. Tedros Adhanom announced that “the COVID-19 can be characterized as a pandemic” and he is “deeply concerned both by the alarming levels of spread and severity, as well as by the alarming levels of inaction (of some countries).”
世卫组织访华专家组组长布鲁斯·艾尔沃德近日表示,随着国际病例的不断增加,他接到的电话也越来越多。 Dr. Bruce Aylward, head of the WHO-China Joint Mission on COVID-19 recently said, and I quote, that “Now that cases (outside China) are picking up, and my phone is ringing much more.
很多人问他中国是怎么做到的? People are saying: how did China do that? What did they do exactly?
我们该怎么办? What can we do?”
他的答案是,需要速度、资金和决心。 And his answer is simple: China’s counterattack can be replicated, but it will require speed, money, imagination and political courage.
1月中下旬疫情在中国武汉大规模爆发后,中国政府采取了最果断、最决绝、最全面的疫情防控措施。 Since the pandemic outbreak in Wuhan in mid-late January, the Chinese government has been decisive and resolute in taking the most stringent and comprehensive measures to curb its spreading.
果断封闭疫情中心武汉、迅速兴建多家医院、全国统一调配资源支援湖北、各省市创造性实行小区封闭式管理,这一系列举措显示了中国政府的大国担当,显示了中国医务者的专业精干,显示了中国人民的坚韧和自觉。 A series of measures have been taken, showing clearly to the world China’s keeping to its commitments as a responsible major power in the world, the professionalism and devotedness of Chinese medical workers, and the resilience and self-discipline of Chinese people. These measures include the quick and decisive lockdown of Wuhan, the epicenter of the epidemic, fast construction of mobile cabin hospitals, nationwide coordination and dispatch of resources to Hubei Province as well as the close-off management of residential communities in other provincial and municipal units across the country in accordance with their own situations.
2月24日,中国—世卫组织联合专家考察组发布调查报告指出,中国面对前所未知的病毒采取了历史上最勇敢、最灵活、最积极的防控措施,避免或至少预防了10万病例的发生,构建起防止疫情传播的强有力第一道防线。 On 24th February, a report issued by the WHO-China Joint Mission on COVID-19 has pointed out that, in combating this novel virus, China has adopted “the most ambitious, agile and aggressive measures ever taken in history, probably preventing at least tens of thousands even hundreds of thousands of cases, making itself the solid frontline in defending mankind against this virus”.
为此中国和中国人民付出了巨大的生命和物质代价,避免了疫情更大范围爆发。 China has paid a huge price as a consequence of this, suffering from a huge loss in both human and material resources, yet saving the whole world a bigger loss and damage.
考察组外方组长布鲁斯·艾尔沃德更动情地说:“我们要认识到武汉人民所做的贡献,世界欠你们的。” Dr. Bruce Aylward, touched by Chinese people’s sacrifice, said emotionally that “to the people of Wuhan, it is recognized that the world is in your debt.”
在中国正在为抗击疫情做出巨大努力的同时,却总有些杂音绕耳,挥之不去。 While China is busy combating the virus, there are some unkind and discordant noises in the air.
给中国“带帽子”的有之。 There are the ones who played the old trick of naming and shaming China.
个别西方媒体将新冠病毒称作“中国病毒”、“武汉肺炎”; Some western media intentionally named the COVID-19 as “China Virus” or “Wuhan Pneumonia”;
美国反华政客造谣说新冠病毒是从武汉实验室泄露的生化武器; some anti-China U.S. politicians made up a fancy story that COVID-19 is the biochemical weapon leaked from labs in Wuhan;
美国《华尔街日报》称中国为“亚洲病夫”; the U.S. Wall Street Journal referred Chinese as the “Real Sick Man of Asia”;
德国《明镜周刊》刊登“新型冠状病毒:中国制造”的煽动性封面文章; the German Der Spiegel had a cover article with the title “Coronavirus, Made in China”;
近日,美国一名电视主持人还妄称“新冠病毒发源于中国”,要求中国人正式道歉。 an American TV host even arrogated that since “the coronavirus originated from China”, China should say sorry to the rest of the world.
世界卫生组织卫生紧急项目负责人迈克尔·瑞安指出,“冠状病毒是全球现象,在全世界都存在。 Dr. Michael J. Rhan, Executive Director of WHO Health Emergencies Program, pointed out that, “coronavirus are a global phenomenon; they exist on a global basis.
它们在某个地方出现,是自然史上的不幸事件,重要的是我们不要去责怪其地理来源,而是关注如何应对及遏制病毒。” It’s an unlucky accident of history or nature that they emerge in a certain place and it’s really important that we don’t start to ascribe blame to geographic origin and that we look at this in terms of how we respond, how we contain and how we stop this virus.
中国权威呼吸病专家、中国工程院院士钟南山也表示,疫情首先出现在中国,不一定发源在中国。 Dr. Zhong Nanshan, a topnotch respiratory expert and an academician of the Chinese Academy of Engineering also said that, the pandemic first breaking out in China does not necessarily mean that it originated from China.
但无论病毒源自哪里,中国同其他出现疫情的国家一样,都是病毒的受害者,都面临疫情的挑战。 No matter where this virus came from, China, like any other affected countries, are all victims of this virus, and are facing the same unprecedented challenge of fighting this pandemic.
而包括马来西亚公共卫生学家Sai Kit Lam在内的全球27名顶尖科学家的联名强烈谴责,更令新冠病毒系人为制造的阴谋论贻笑大方。 A group of 27 prominent public health scientists globally, including Mr. Lam Sai Kit, a renounced public health expert from Malaysia, have signed on a statement strongly condemning conspiracy theories suggesting that COVID-19 does not have a natural origin, leaving those who invented the conspiracy a laughing stock of the whole world.
也有媒体指出,2009年美国爆发H1N1流感,其后迅速蔓延到214个国家和地区,造成数十万人丧生,是否这些国家和病例都应该要求美国道歉? Some media pointed out that back in 2009, H1N1 first broke out in the U.S., then spreading to more than 214 countries and regions, causing thousands of deaths. Should these countries and people ask the U.S. to apologize for that?
幸灾乐祸的有之。 There are the ones who take pleasure in China’s misfortune.
一些外国媒体不知是出于认知偏差,还是刻意为之,一味批评、嘲笑中国,无视中国在抗击疫情方面所做出的卓绝努力和付出的巨大代价,极尽贬低、批评、诋毁,甚至言论暴露出种族歧视的倾向,令中国人民感伤和不解,也让不少其他国家的读者感到不满甚至愤慨。 Some foreign media, taking a blind eye to China’s strenuous efforts and great sacrifice made in this battle, have kept disparaging and defaming China, either out of misperception or on purpose. They even have used words with apparent allusion to racism in their publications, which dismayed and upset Chinese people, and aroused resentfulness and even indignation among readers of many other countries.
更可悲的是,一些西方政客,面对人类共同的传染病威胁,依然沉溺在“逢中必反”的政治逻辑中,对中国进行指责。 What is worse, some western politicians, obsessed with the ossified political logic of “opposing whatever China is doing”, keep pointing fingers at China, even at the critical moment of the whole world being endangered by the virus.
武汉封城前,中国是动作迟缓,措施不力;武汉封城后,中国是侵犯人权、漠视自由。 Interestingly, China was criticized for being clumsy and inefficient before the lock-down of Wuhan; and accused as a violator of human rights and intruder of people’s freedom after the lockdown.
在他们眼中,只要是中国的,就一无是处。 In their world, China is just wrong in everything.
相比疫情,藏匿于某些人心中的傲慢、偏见、仇恨,是比新冠病毒更难解的“心魔”。 Compared to the dreadful virus, the pride, prejudice and hatred, hidden deep somewhere in some people’s minds, are actually more vicious monsters, which are danger to all.
正如菲律宾外交部长洛钦所言:“有些政府和个人将一次全人类威胁当作地缘政治工具,这是一种可耻的堕落。” Just as the Philippine foreign minister Teodoro Locsin has said: “We must deplore the lies spread by governments and people who are stooping so low as to use a threat against all humanity as an instrument of geopolitical strategy. Shame on them.”
疫情就像一面镜子,既照出了伪善者的居心叵测,也映照出了一些真朋友的肝胆相照。 The pandemic is like a magic mirror, which tells true friends from false ones.
让我感动的是,在中国人民抗击疫情的过程中,很多国家的社会各界友好人士通过各种方式对中国提供弥足珍贵的支持。 What touched me most is the sincere concern and generous support given by people from different social circles of different countries. They have provided valuable and timely support and assistance in varied forms to China for combating the pandemic which Chinese people will always remember and cherish dearly.
在马来西亚,无论是政府,民间组织,还是个人,都以各自独特的方式,积极向中国施以援手,或捐款捐物支持中国,或制作歌曲、视频为中国人民加油打气。 In Malaysia, the government, social organizations and individuals have offered their helping hand to China and Chinese people. Some have donated materials and money, some have composed songs and made videos to boost Chinese people’s spirit.
捐赠有价,情义无价。 The donation can be priced yet the friendship in it is priceless.
马来西亚人民的每一声“加油”、每一份帮助,展现的都是雪中送炭的大爱大义,都是“遇山一起爬,遇沟一起跨”的真挚情谊! Every call of “China, stay strong”, every piece of aid, coming from our Malaysian friends, is a manifestation of true love and friendship, with the same spirit of the Malay idiom I like most-- “Bukit sama didaki, luruh sama dituruni”.
中国有句话“投我以木桃,报之以琼瑶。” There is a Chinese saying which goes “You spare a peach to me, I give you a white jade for friendship.”
中国人民最念旧情、感恩情,永远不会忘记各国人民对中国的支持帮助和鼓励祝福。 Chinese people cherish friendship, appreciate kindness, and always remember others’ help and support especially in times of difficulties.
中国将在毫不放松继续做好本国疫情防控工作的同时,继续为全球的抗疫斗争做出贡献。 China will continue to fight against the pandemic with perseverance and resolution, making its due contribution to the global fight against COVID-19.
中国已向世界卫生组织和各国分享新冠肺炎诊疗防控方案, Now, China has shared its experiences and lessons learnt from its combat with WHO and other affected countries, including the methods of medical treatments and ways of social mobilization in curbing the virus.
近日还向伊朗、韩国、意大利等疫情最为严重的国家派出医疗专家组、提供医护物资和病毒检测试剂等援助。 Besides, China has sent expert groups, medical resources, and virus test kits to the most severely hit countries of Iran, South Korea, and Italy.
作为抗击疫情经验最丰富的国家,中国将当仁不让成为全球抗击疫情的中坚力量。 Having the best knowledge of combating the pandemic, China has no hesitation in shouldering on its responsibility as the backbone of the global collective coalition of combating the pandemic.
病毒是全人类的共同敌人。 This virus is a common enemy to all mankind.
人类已事实上成为命运共同体,团结合作才是抗疫的最有力武器。 As a matter of fact, people of different countries have already formed a community of a shared future. Only unity and cooperation can be the most powerful weapon in defeating this pandemic.
当前,我们必须用科学战胜愚昧,用合作抵制偏见,共同织就疏而不漏的全球病毒“天网”。 Now, all countries should work together to weave a global web to contain the spread of this virus. To achieve this, we should rely on science other than blind faith, on cooperation other than prejudice.
大敌当前,各国人民是同舟共济还是以邻为壑? With the vicious virus enemy confronting all of us, there are different choices to make. Is it to offer a helping hand or give a hostile blow to others;
是并肩作战还是隔岸观火? to fight side by side with one and another or stand by waiting and seeing;
是雪中送炭还是落井下石? to give support and solace to the injured ones or add insult to them?
答案不言自明。 The right choice is easy to tell.
《傲慢与偏见》中的主要人物有个比较幸福的结局,可能也是由于他们最终放下了心中的傲慢与偏见。 The main characters in Pride and Prejudice had a fairly happy ending, probably because they had finally given up their pride and prejudice.
期待我们的现实世界也能放下心中执念,早日迎来彻底战胜病毒的幸福结局。 I hope that people in the real world can also realize and finally give up their obsessions, so that we can all head for the happy ending of winning the final victory of this global war against the pandemic in the near future.
携手抗疫 共克时艰 Working Together to Defeat the COVID-19 Outbreak
中华人民共和国主席 习近平 Remarks by H.E. Xi Jinping
President of the People's Republic of China
——在二十国集团领导人特别峰会上的发言 At the Extraordinary G20 Leaders' Summit
(2020年3月26日,北京) Beijing, 26 March 2020
尊敬的萨勒曼国王, Your Majesty King Salman bin Abdulaziz Al Saud,
各位同事: Dear Colleagues,
大家好!首先,我谨对萨勒曼国王和沙特方面为这次会议所做的大量沟通协调工作,表示衷心的感谢! It is good to join you. Let me begin by expressing my sincere appreciation to His Majesty King Salman and Saudi Arabia for having done tremendous work of communication and coordination to make this summit possible.
面对突如其来的新冠肺炎疫情,中国政府、中国人民不畏艰险,始终把人民生命安全和身体健康摆在第一位, Facing the COVID-19 outbreak that caught us all by surprise, the Chinese government and Chinese people have been undaunted as we took on this formidable task. From day one of our fight against the outbreak, we have put people's life and health first.
按照坚定信心、同舟共济、科学防治、精准施策的总要求, We have acted according to the overall principle of shoring up confidence, strengthening unity, ensuring science-based control and treatment and imposing targeted measures.
坚持全民动员、联防联控、公开透明,打响了一场抗击疫情的人民战争。 We have mobilized the whole nation, set up collective control and treatment mechanisms and acted with openness and transparency. What we fought was a people's war against the outbreak.
经过艰苦努力,付出巨大牺牲,目前中国国内疫情防控形势持续向好,生产生活秩序加快恢复,但我们仍然丝毫不能放松警惕。 We have put up a strenuous struggle and made tremendous sacrifices. Now the situation in China is moving steadily in a positive direction. Life and work are quickly returning to normal. Yet, there is no way we will lower our guard or relax control.
在中方最困难的时候,国际社会许多成员给予中方真诚帮助和支持,我们会始终铭记并珍视这份友谊。 At the most difficult moment in our fight against the outbreak, China received assistance and help from a lot of members of the global community. Such expressions of friendship will always be remembered and cherished by the Chinese people.
重大传染性疾病是全人类的敌人。 Major infectious disease is the enemy of all.
新冠肺炎疫情正在全球蔓延,给人民生命安全和身体健康带来巨大威胁,给全球公共卫生安全带来巨大挑战,形势令人担忧。 As we speak, the COVID-19 outbreak is spreading worldwide, posing enormous threat to life and health and bringing formidable challenge to global public health security. The situation is disturbing and unsettling.
当前,国际社会最需要的是坚定信心、齐心协力、团结应对,全面加强国际合作,凝聚起战胜疫情强大合力,携手赢得这场人类同重大传染性疾病的斗争。 At such a moment, it is imperative for the international community to strengthen confidence, act with unity and work together in a collective response. We must comprehensively step up international cooperation and foster greater synergy so that humanity as one could win the battle against such a major infectious disease.
在此,我愿提出以下4点倡议。 For that to happen, I would like to put forth four proposals.
第一,坚决打好新冠肺炎疫情防控全球阻击战。 First, we need to be resolute in fighting an all-out global war against the COVID-19 outbreak.
国际社会应该加紧行动起来,坚决遏制疫情蔓延势头。 The community of nations must move swiftly to stem the spread of the virus.
我愿在此提议,尽早召开二十国集团卫生部长会议,加强信息分享,开展药物、疫苗研发、防疫合作,有效防止疫情跨境传播。 In this regard, I propose that a G20 health ministers' meeting be convened as quick as possible to improve information sharing, strengthen cooperation on drugs, vaccines and epidemic control, and cut off cross-border infections.
要携手帮助公共卫生体系薄弱的发展中国家提高应对能力。 G20 members need to jointly help developing countries with weak public health systems enhance preparedness and response.
我建议发起二十国集团抗疫援助倡议,在世界卫生组织支持下加强信息沟通、政策协调、行动配合。 I propose a G20 COVID-19 assistance initiative for better information sharing and policy and action coordination with the support of the World Health Organization.
中方秉持人类命运共同体理念,愿同各国分享防控有益做法,开展药物和疫苗联合研发,并向出现疫情扩散的国家提供力所能及的援助。 Guided by the vision of building a community with a shared future for mankind, China will be more than ready to share our good practices, conduct joint research and development of drugs and vaccines, and provide assistance where we can to countries hit by the growing outbreak.
第二,有效开展国际联防联控。 Second, we need to make a collective response for control and treatment at the international level.
病毒无国界。 This is a virus that respects no borders.
疫情是我们的共同敌人。 The outbreak we are battling is our common enemy.
各国必须携手拉起最严密的联防联控网络。 All must work together to build a strongest global network of control and treatment that the world has ever seen.
中方已经建立新冠肺炎疫情防控网上知识中心,向所有国家开放。 China has set up its online COVID-19 knowledge center that is open to all countries.
要集各国之力,共同合作加快药物、疫苗、检测等方面科研攻关,力争早日取得惠及全人类的突破性成果。 It is imperative that countries pool their strengths and speed up research and development of drugs, vaccines and testing capabilities in the hope to achieve early breakthrough to the benefit of all.
要探讨建立区域公共卫生应急联络机制,提高突发公共卫生事件应急响应速度。 Discussions are also needed regarding the establishment of regional emergency liaison mechanisms to enable quicker response to public health emergencies.
第三,积极支持国际组织发挥作用。 Third, we need to support international organizations in playing their active roles.
中方支持世界卫生组织发挥领导作用,制定科学合理防控措施,尽力阻止疫情跨境传播。 China supports WHO in leading the global efforts to develop science-based and proper control and treatment and minimize cross-border spread.
我建议,二十国集团依托世界卫生组织加强疫情防控信息共享,推广全面系统有效的防控指南。 I call on G20 members to enhance anti-epidemic information sharing with the support of WHO and to promote control and treatment protocols that are comprehensive, systematic and effective.
要发挥二十国集团的沟通协调作用,加强政策对话和交流,适时举办全球公共卫生安全高级别会议。 The G20 platform for communication and coordination may be used to increase policy dialogue and exchange, and a high-level meeting on international public health security may be convened in due course.
中国将同各国一道,加大对相关国际和地区组织的支持力度。 For China, we will be happy to join other countries and scale up support for relevant international and regional organizations.
第四,加强国际宏观经济政策协调。 Fourth, we need to enhance international macro-economic policy coordination.
疫情对全球生产和需求造成全面冲击,各国应该联手加大宏观政策对冲力度,防止世界经济陷入衰退。 The outbreak has disrupted production and demand across the globe. Countries need to leverage and coordinate their macro policies to counteract the negative impact and prevent the world economy from falling into recession.
要实施有力有效的财政和货币政策,促进各国货币汇率基本稳定。 We need to implement strong and effective fiscal and monetary policies to keep our exchange rates basically stable.
要加强金融监管协调,维护全球金融市场稳定。 We need to better coordinate financial regulation to keep global financial markets stable.
要共同维护全球产业链供应链稳定,中国将加大力度向国际市场供应原料药、生活必需品、防疫物资等产品。 We need to jointly keep the global industrial and supply chains stable. What China will do in this regard is to increase its supply of active pharmaceutical ingredients, daily necessities, and anti-epidemic and other supplies to the international market.
要保护妇女儿童,保护老年人、残疾人等弱势群体,保障人民基本生活。 What's more, we also need to protect women, children, the elderly, people with disabilities and other vulnerable groups, and provide for people's basic needs.
中国将继续实施积极的财政政策和稳健的货币政策,坚定不移扩大改革开放,放宽市场准入,持续优化营商环境,积极扩大进口,扩大对外投资,为世界经济稳定作出贡献。 China will continue to pursue a proactive fiscal policy and prudent monetary policy. We will continue to advance reform and opening-up, widen market access, improve the business environment, and expand imports and outbound investment to contribute to a stable world economy.
我呼吁二十国集团成员采取共同举措,减免关税、取消壁垒、畅通贸易,发出有力信号,提振世界经济复苏士气。 I want to call on all G20 members to take collective actions - cutting tariffs, removing barriers, and facilitating the unfettered flow of trade. Together, we can send a strong signal and restore confidence for global economic recovery.
我们应该制定二十国集团行动计划,并就抗疫宏观政策协调及时作出必要的机制性沟通和安排。 The G20 needs to draw up an action plan and promptly set up communication mechanisms and institutional arrangements for anti-epidemic macro policy coordination.
各位同事! Dear Colleagues,
值此关键时刻,我们应该直面挑战、迅速行动。 Now is a crucial moment, a time for us to rise up to challenge and act with swiftness.
我坚信,只要我们同舟共济、守望相助,就一定能够彻底战胜疫情,迎来人类发展更加美好的明天! I am convinced that through solidarity and mutual assistance, we will prevail over this outbreak and we all will embrace a brighter future for mankind!
谢谢大家。 Thank you.
世卫组织总干事2020年3月25日在2019冠状病毒病(COVID-19)疫情媒体通报会上的讲话 WHO Director-General's opening remarks at the media briefing on COVID-19 - 25 March 2020
这场大流行疫情不仅对健康,而且对生活的诸多方面都造成了巨大影响。 The pandemic continues to take a massive toll not just on health, but on so many parts of life.
昨天,日本政府和国际奥林匹克委员会作出了艰难但明智的决定,推迟了今年的奥运会和残奥会。 Yesterday, the Government of Japan and the International Olympic Committee took a difficult but wise decision to postpone this year’s Olympic and Paralympic Games.
我感谢安倍首相和国际奥委会成员为保护运动员、观众和工作人员的健康而做出的牺牲。 I thank Prime Minister Abe and the members of the IOC for making this sacrifice to protect the health of athletes, spectators and officials.
我们期待着明年的奥运会和残奥会更加盛大,成为全人类共同命运的辉煌庆典。我期待着届时出席盛会。 We look forward to next year's Olympics and Paralympics, which we hope will be an even bigger and better celebration of our shared humanity – and I look forward to joining.
我们曾经战胜过许多大流行病和危机。这次我们也会获胜。 We have overcome many pandemics and crises before. We will overcome this one too.
问题是我们将付出多大的代价。 The question is how large a price we will pay.
已经有1.6万多人丧失了生命。我们知道,还会有更多人殒命。到底有多少,取决于我们现在做出的决定和采取的行动。 Already we have lost more than 16,000 lives. We know we will lose more – how many more will be determined by the decisions we make and the actions we take now.
为了减缓COVID-19的传播,众多国家采取了前所未有的措施,付出了巨大的社会和经济代价,如关闭学校和工商业,取消体育赛事,要求人们呆在家里,保全健康。 To slow the spread of COVID-19, many countries have introduced unprecedented measures, at significant social and economic cost – closing schools and businesses, cancelling sporting events and asking people to stay home and stay safe.
我们知道,这些国家现正考虑评估何时以及如何能够放松这些措施。 We understand that these countries are now trying to assess when and how they will be able to ease these measures.
答案在于各国在实施这些全民措施时是如何执行的。 The answer depends on what countries do while these population-wide measures are in place.
要求人们呆在家里,停止人口流动,是在争取时间,减轻卫生系统的压力。 Asking people to stay at home and shutting down population movement is buying time and reducing the pressure on health systems.
但光凭这些措施本身并不能扑灭疫情。 But on their own, these measures will not extinguish epidemics.
这些行动的目的是实行更精准和有的放矢的措施,阻止传播和拯救生命。 The point of these actions is to enable the more precise and targeted measures that are needed to stop transmission and save lives.
我们呼吁所有采取封锁措施的国家利用这段时间来迎战病毒。 We call on all countries who have introduced so-called “lockdown” measures to use this time to attack the virus.
你们已经营造了第二个机会之窗。问题是,如何利用好它? You have created a second window of opportunity. The question is, how will you use it?
我们建议采取六项关键行动。 There are six key actions that we recommend.
首先,扩大、培训和部署医护人员和公共卫生工作者的队伍; First, expand, train and deploy your health care and public health workforce;
第二,建立系统,找出社区中每一例疑似病例; Second, implement a system to find every suspected case at community level;
第三,提高检测的数量、能力和可及性; Third, ramp up the production, capacity and availability of testing;
第四,确定、改造和配备用于治疗和隔离病人的设施; Fourth, identify, adapt and equip facilities you will use to treat and isolate patients;
第五,制定明确的隔离接触者的计划和程序; Fifth, develop a clear plan and process to quarantine contacts;
第六,政府各部门调整工作重点,努力抑制和控制COVID-19。 And sixth, refocus the whole of government on suppressing and controlling COVID-19.
这些措施是抑制和阻止传播的最好方法,这样当解除限制措施时,病毒就不会再次急剧传播。 These measures are the best way to suppress and stop transmission, so that when restrictions are lifted, the virus doesn’t resurge.
任何国家最不愿意看到的是当重启学校和工商业后,由于病毒死灰复燃而被迫再度关闭。 The last thing any country needs is to open schools and businesses, only to be forced to close them again because of a resurgence.
大举寻找、隔离、检测、治疗和追踪的强力措施,不仅是摆脱极端的社会和经济限制措施的最佳和最快方法,也是避免采取这种限制措施的最好方法。 Aggressive measures to find, isolate, test, treat and trace are not only the best and fastest way out of extreme social and economic restrictions – they’re also the best way to prevent them.
仍有150多个国家和地区境内病例数不到100例。 More than 150 countries and territories still have fewer than 100 cases.
这些国家如果现在就采取同样大刀阔斧的行动,仍有机会防止社区传播,避免一些在其他国家目睹的更严重的社会和经济代价。 By taking the same aggressive actions now, these countries have the chance to prevent community transmission and avoid some of the more severe social and economic costs seen in other countries.
这对于许多卫生系统脆弱的国家来说尤其重要。在这些国家中,如果像一些发生社区传播的国家那样出现病人数量暴增情况,卫生系统可能会完全崩溃。 This is especially relevant for many vulnerable countries whose health systems may collapse under the weight of the numbers of patients we've seen in some countries with community transmission.
今天,我同联合国秘书长安东尼奥·古特雷斯、 Today I joined United Nations Secretary-General Antonio Guterres,
负责联合国人道主义事务协调厅的副秘书长马克·洛科克 Under-Secretary General for UNOCHA Mark Lowcock
和联合国儿童基金会执行主任亨丽埃塔·福尔一道发起了全球人道主义呼吁,呼吁支持已经遭受多年严重人道主义危机影响的最脆弱国家。 and UNICEF Executive Director Henrietta Fore to launch the Global Humanitarian appeal, to support the most fragile countries who have already suffered years of acute humanitarian crises.
这远不止是一场健康危机。联合国各机构决心团结一致,努力保护世界上最脆弱的人民免受病毒及其后果的影响。 This is much more than a health crisis, and we’re committed to working as one UN to protect the world’s most vulnerable people from the virus, and its consequences.
我们还欢迎秘书长呼吁全球停火。我们都面临共同的威胁,而战胜这一威胁的唯一途径是:全人类团结一致,共克时艰。 We also welcome the Secretary-General’s call for a global ceasefire. We are all facing a common threat, and the only way to defeat it is by coming together as one humanity, because we’re one human race.
我们感谢向COVID-19团结应对基金捐款的20多万个人和组织。 We’re grateful to the more than 200,000 individuals and organizations who have contributed to the COVID-19 Solidarity Response Fund.
自不到两周前推出以来,该基金已经筹集了9500多万美元。 Since we launched it less than two weeks ago, the fund has raised more than US$95 million.
我要对葛兰素史克公司今天慷慨捐助1000万美元深表感谢。 I would like to offer my deep thanks to GSK for its generous contribution of US$10 million today.
虽然我们特别关注脆弱国家,但所有国家都有脆弱人口,例如老年人。 Although we are especially concerned about vulnerable countries, all countries have vulnerable populations, including older people.
老年人凝聚了我们社会的集体智慧。他们是我们家庭和社区的重要和宝贵的成员。 Older people carry the collective wisdom of our societies. They are valued and valuable members of our families and communities.
但是他们患COVID-19严重并发症的风险更高。 But they are at higher risk of the more serious complications of COVID-19.
我们正在倾听老年人的意见以及照料他们或为他们服务的人们的意见,以确定如何能以最好的方式支持他们。 We are listening to older people and those who work with and for them, to identify how best we can support them.
我们需要共同努力保护老年人免受病毒侵害,并确保满足他们的食物、燃料、处方药和人际交往需求。 We need to work together to protect older people from the virus, and to ensure their needs are being met – for food, fuel, prescription medication and human interaction.
社交距离并不意味着社会距离。 Physical distance doesn’t mean social distance.
我们都需要以任何可能的方式定期问候独居或住在养老院的年长父母、邻居、朋友或亲属,让他们知道自己多受爱戴和重视。 We all need to check in regularly on older parents, neighbours, friends or relatives who live alone or in care homes in whatever way is possible, so they know how much they are loved and valued.
这些事情在任何时候都很重要,但在危机期间更为重要。 All of these things are important at any time, but they are even more important during a crisis.
最后,COVID-19大流行凸显了以生动和新颖方式传达公共卫生信息的必要性。 Finally, the COVID-19 pandemic has highlighted the need for compelling and creative communications about public health.
去年,世卫组织宣布举办首届人人健康电影节。参赛作品的数量、质量和多样性远远超出了我们的预期。 Last year, WHO announced our first Health for All Film Festival. The volume, quality and diversity of entries far surpassed our expectations.
我们收到了来自110个国家的1300多份参赛作品。我们今天宣布了45部描绘重要健康专题的优秀短片的入围名单。 We received more than 1,300 entries from 110 countries, and today we are announcing a short list of 45 excellent short films about vital health topics.
我们还宣布将由各位杰出的评委对入围名单进行评选,获胜者将于五月份公布。 We are also announcing a distinguished panel of jurors who will judge the short list, with the winners to be announced in May.
我们将在未来几周在世卫组织网站和社交媒体频道上播放所有入围电影。 We will be showing all the short-listed films in the coming weeks on our website and social media channels.
在这个艰难时刻,电影和其他媒体不仅是传达重要健康信息的强有力途径,还能带给人们最强大的药物:希望。 In these difficult times, film and other media are a powerful way not only of communicating important health messages, but of administering one of the most powerful medicines – hope.
谢谢大家。 I thank you.

蓝奏云下载地址:

语料库翻译此处内容已经被作者隐藏,请输入验证码查看内容
验证码:
请关注本站微信公众号,回复“微信验证码”,获取验证码。在微信里搜索“语料库翻译”或者“tmxhub”或者微信扫描右侧二维码都可以关注本站微信公众号。

本文由来源 浙江大学医学院附属第一医院,由 Tmxchina 整理编辑,其版权均为 浙江大学医学院附属第一医院 所有,文章内容系作者个人观点,不代表 语料库 对观点赞同或支持。如需转载,请注明文章来源。
16
Tmxchina

发表评论