感染者如何在家自行有效隔离 / Effective quarantine: guide for treating COVID-19 at home

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Hospitals in Wuhan have become full and are sending patients home, telling them to quarantine themselves. If the virus spreads and this ends up happening to you or someone in your family, don’t panic. A friend who studied contagious diseases at Harvard told me “sending people home and telling them to quarantine themselves isn’t necessarily a bad solution as long as they don’t have pre-existing conditions and do effectively quarantine.”

武汉的医院已经超负荷,很多感染者被告知自行回家隔离,如果这发生在您或者您家人身上,请不要惊慌。我一个哈佛大学传染病学专业的朋友告诉我:“只要患者本身没有其他的疾病且能够进行有效的隔离,回家隔离不一定是个坏法子。”

So how do you “effectively” quarantine yourself or a family member? This short guide is intended to serve as a basic process that you can follow if you find yourself in this scary situation. It is partially adapted from CDC recommendations for airline and cruise ship staff, which I will link below in case you wish to read more.

那么,如何进行“有效”地隔离自己或家人?如果你碰到了这种情况,本文提供了一个基本的隔离指南。本文部分改编自《美国疾病控制中心针对航空公司和游轮工作人员的建议》,如果希望阅读更多美国疾病控制中心的建议,请查看下方链接。

What you will need / 您将需要些什么

Absolutely necessary:

  • Soap, or if no soap is available, a hand sanitizer that is alcohol-based and contains at least 60% alcohol
  • A way of covering the sick person’s coughing and sneezing (ideally face mask, but tissues are fine too if masks are sold out)
  • Plastic bags for throwing away bodily waste and other contaminated materials (if no bags are available, use a washable trash can temporarily until you are able to buy them)

绝对必备:

  • 肥皂,如果没有肥皂,酒精类洗手液也可以,酒精含量至少为60%
  • 咳嗽、打喷嚏时进行遮掩的工具(最好是戴外科口罩,但如果外科口罩卖完了,纸巾遮掩也可以起一定作用)
  • 塑料垃圾袋,用来装所有接触过患者的(尤其是口腔、呼吸道分泌物以及粪便)生活垃圾或其他感染物(如果塑料袋用完,在买到塑料袋之前,可以暂时使用可清洗的垃圾桶)

Ideal if you can get them:

  • Fever-reducing medicines: (1) ibuprofen, brand name Advil, or (2) paracetamol, also known as acetaminophen, brand name Tylenol
  • A disinfectant to clean bathrooms and other surfaces touched by the sick person, containing: (1) formaldehyde, (2) hydrogen peroxide, or (3) alcohol
  • Disposable, impermeable gloves
  • Respirator or face mask for caregiver
  • Eye goggles or some other form of eye protection (glasses or sunglasses are better than nothing if goggles are not available)
  • Disposable cleaning cloth or towels

推荐配备 :

  • 退烧药:(1)Advil牌布洛芬,或(2)Tylenol牌扑热息痛,也称为对乙酰氨基酚
  • 消毒剂,用于清洁厕所和患者接触的其他表面,该消毒剂包含:(1)甲醛,或(2)过氧化氢,或(3)酒精
  • 一次性不透水手套
  • 给护理人员准备的防病毒口罩或外科口罩
  • 护目镜或其他形式的眼部防护(如果没有护目镜,眼镜或太阳镜也行,总比没有好)
  • 一次性清洁布或毛巾

Setting up the area / 设置隔离区

The goal is to give the sick person basic survival items (water, food, fever-reducing medicine) without becoming infected. If possible, give the sick person their own room, and assign only one person in the family to interact with the sick person as the caregiver. If your apartment is too small to give them their own room, mark a distance of 2 meters on the floor with an object and instruct your family that no one is to go closer without taking precautions.

设置隔离区的目的在于避免护理人员给患者提供基本生存物品(水,食物,退烧药)时而被感染。如果条件允许,给患者一个专门的隔离房间,而且只固定一个家庭成员和患者接触。如果公寓太小,无法给患者专门的隔离房间,可以在距离患者至少两米的地板上用物品标记成隔离区,并告知家人未采取足够防护措施严禁靠近隔离区。

Place a small stool, table, or other object near the sick person so they can reach water and other necessities without getting up, since severe pneumonia symptoms may make it extremely difficult for them to move.

由于肺炎症状严重时可能导致患者很难移动身体,所以患者床边最好摆放一个床头柜、小凳子、桌子或其他类似的东西,这样他们就可以不起床就能伸手拿到水以及其他必需品。

Process for sick person / 患者注意事项

If a face mask is available, the sick person should wear it at all times. The purpose of the face mask is to stop water droplets from dispersing throughout the room when the person coughs or sneezes. For this to work, the absorbent fabric of the face mask should completely cover the mouth and nose (see image). If a face mask is not available or if it is uncomfortable for the sick person, tissues will serve the same function.

如果能买到外科口罩,患者应该一直戴着外科口罩。戴外科口罩的目的是防止患者咳嗽或打喷嚏时飞沫在整个房间内扩散。正确的外科口罩佩戴方式,应能完全覆盖嘴和鼻子(见图)。如果没有外科口罩或患者戴外科口罩时感到不适,患者打喷嚏或者咳嗽时用纸巾遮住也能起到部分作用。

Image source: Hong Kong Centre for Health Protection / 图片来源:香港卫生防护中心

This is extremely important because flu droplets can survive in the air for several hours, and can survive on hard surfaces for 24 hours. However, they only survive approximately 15 minutes on the specialized absorbent fabric of face masks and tissues.

上述这点非常重要,因为流感飞沫可以在空气中存活数小时,并且可以在坚硬的表面上存活24小时,但它们只能在外科口罩和纸巾上存活约15分钟。

The sick person should dispose of all tissues and other items they have touched or left bodily waste on very carefully  so the caregiver can collect the trash without being exposed to additional chance of contamination.

患者在丢弃自己接触过的(尤其是口腔、呼吸道分泌物以及粪便)纸巾或其他垃圾时应注意包裹,避免让护理人员清理垃圾桶时增加额外的感染风险。

Additionally, the sick person should touch as few surfaces as possible if they need to move around the apartment or use the bathroom. They should inform the caregiver of any hard surfaces they touched in the bathroom and other places.

此外,如果患者需要在公寓内走动或使用厕所等,应尽可能少地和家中物品接触。患者应及时将自己接触到的任何物体表面告知护理人员。

Process for caregiver / 护理人员注意事项

Before going into the sick person’s room, the caregiver should put on adequate protection. Ideally, this means a respirator, goggles, disposable gloves, and clothes that cover all or most exposed skin.

在进入患者的房间之前,护理人员应采取足够的防护措施。理想情况下,护理人员需要穿戴防病毒口罩,护目镜,一次性手套和可以遮掩所有或大部分裸露皮肤的防护服。

Respirators differ from face masks because instead of just being a cloth covering the face, they additionally have a filter that can keep out flu particles. For this to work, the respirator must create a tight seal around the face of the wearer. This can be uncomfortable, so the CDC recommends face masks for extended use, and respirators only when direct interaction with patients is necessary. If you are able to get a respirator, it should be at least N95 (US standard) or FFP3 (EU standard).

防病毒口罩与外科口罩的区别在于,防病毒口罩不仅可以遮掩口鼻,而且还可以过滤流感病毒颗粒。戴防病毒口罩时必须在佩戴者面部周围形成紧密的密封。这可能令人不舒服,因此美国疾病控制中心建议长时间使用外科口罩,仅在需要与患者直接接触时才戴防病毒口罩。如果您能够买到防病毒口罩,防病毒口罩至少为N95(美国标准)或FFP3(欧盟标准)。

If you do not have a respirator or face mask, do not worry, the caregiver will just need to be more careful and try to reduce the time spent interacting with the sick person. The sick person should be extremely careful not to cough, sneeze, or even talk in the direction of the caregiver if they do not have a respirator. Additionally, while this probably has limited effectiveness, if nothing else is available the caregiver can try putting something over their face to cover it (ex. wrap it with a scarf, cover it with a bag).

如果您已暂时购买不到防病毒口罩或外科口罩,不必恐慌,只是护理人员需要更加小心,要减少与患者接触的时间。如果没有防病毒口罩或者外科口罩,患者应十分小心,不要对着护理人员咳嗽、打喷嚏,甚至不要朝护理人员的方向说话。此外,如果没有其他可用防护工具,护理人员可以尝试用其他东西将脸部把包起来 (例如,用围巾包住,用袋子罩住),当然,这种方法的效果可能有限。

The Wuhan virus has been confirmed to transmit through the eyes. This does not just mean that the eyes were touched with contaminated hands, but rather that the eyes became exposed to flu particles in the air. If you can buy goggles that create a seal against the face, they would be ideal. If not, at least have the caregiver use glasses or sunglasses to protect against the largest particles which may be spread by coughing, sneezing, or speaking. In the case that you do not have any eye protection, also ask the sick person to be extremely careful not to cough, sneeze, or even talk in the caregiver’s direction.

武汉病毒已被证实可通过眼睛传染。这不仅意味着不能用不干净的手揉碰眼睛,还意味着眼睛可能暴露在具有病毒颗粒的空气中。如果您可以购买防护密闭性强的护目镜,那是最好。否则,应至少要让护理人员戴上眼镜或太阳镜,以防止咳嗽、打喷嚏或说话而排出的大颗粒飞沫。 如果您没有任何眼睛防护,患者同样也要特别小心,不要对着护理人员咳嗽、打喷嚏,甚至不要朝护理人员的方向讲话。

If available, disposable gloves should be used in all interactions with the sick person. Be extremely careful that the caregiver not touch the outside part of the gloves when removing them (see image). They should throw away gloves after removing them: do not reuse gloves. Even though they were wearing gloves, the caregiver must still wash their hands with soap after removing them.

如果可能的话,在与患者的所有接触中都应使用一次性手套。护理人员在脱掉手套时,应特别小心,避免接触到手套的外部(见图)。取下手套后,应立即扔掉手套。请勿重复使用手套。此外,尽管 接触 患者时戴着手套,护理人员在脱掉手套后仍必须用肥皂洗手。

Image source: CDC / 图片来源:美国疾病控制中心

Both the sick person and care giver must wash their hands properly. The CDC recommends washing for at least 20 seconds. Make sure to wash between the fingers and up to your wrists. Do not turn off the water after washing your hands: use a disposable towel if available, or a small towel or other cloth that you exclusively use to turn off the water if not. Make sure the caregiver does not use the same towel as the sick person to dry their hands.

患者和护理人员都必须正确地洗手。美国疾病控制中心建议至少清洗20秒。确保手指之间以及手指到手腕的部分都进行了充分的清洗。洗手后请勿用手关水龙头:如果可能的话,使用一次性毛巾来关,如果没有的话,可使用一块小毛巾或抹布专门来关水龙头。注意护理人员和患者不能使用同一块毛巾擦手。

Finally, if possible the caregiver should have clothing that they put on immediately before interacting with the sick person and take off immediately afterward. Ideally this clothing would be impermeable or at least thick and cover as much exposed skin as possible.

最后,如果可能的话,护理人员应在与患者接触之前穿好防护衣服,接触完之后应立即脱下。 防护衣服最好是不透水的,或者至少应该够厚,且能尽可能多的覆盖裸露的皮肤。

The caregiver must be aware at all times of what constitutes a contaminated surface and what is safe to touch. Anything the caretaker touches with gloves still on is contaminated. Anything the sick person comes into physical contact or even close proximity with is contaminated. This includes the caretaker’s clothing, gloves, and even the external portion of their respirator or face mask, if they have one. Have the caretaker wash their hands after touching anything that is contaminated. If items or clothing that are contaminated must be reused at a later time, put them in a safe place where no one will touch them until the caretaker uses them again with disposable gloves on.

护理人员必须十分清楚哪些物体表面受污染以及哪些可以安全触摸。护理人员戴着手套接触过的的任何物品都是被污染的。任何患者身体接触或离患者非常近的任何东西都是被污染的。这就包括护理人员的衣服,手套,甚至是防病毒口罩或外科口罩的外部。护理人员在接触了任何被污染的物品后,应及时洗手。如果已被污染的物品或衣服必须重复使用,请将它们放在一个没有人可以触碰到的安全区域,只能由护理人员戴上一次性手套再次使用它们。

Best of luck to everyone in Wuhan, and in the rest of China. Stay safe, and 加油.

祝大家新年一切平安。武汉加油!中国加油!

Special thanks to Joseph Chen from the Peking University School of Transnational Law for translating into Chinese.

Additional resources / 其他资源:

Author Nicholas Andonie

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