Chinanews.com, May 9 (Xinhua) According to the website of the Chinese Embassy in India, the global COVID-19 epidemic is rebounding, and a new wave of epidemics in India is coming fiercely. In order to better help Chinese compatriots in India to do a good job in safety protection, on April 28, 2021, Ambassador Sun Weidong specially invited well-known Chinese epidemic prevention experts to hold a video symposium with Chinese compatriots in India to answer questions about epidemic prevention and safety from a professional perspective. Now, the questions that everyone is concerned about are compiled into a "Personal Protection Booklet for COVID-19" to share with compatriots in India, so as to jointly do a good job in epidemic prevention and protection and ensure life safety and health.

1. About the epidemic situation in India

(I) At present, what is the difference between the double mutation and triple mutation viruses in India and the previous new coronavirus? In the case of the prevalence of mutant viruses, India has more than 300,000 new infections every day. What problems need to be paid attention to? Are there more effective preventive measures?

According to the existing genome data, this round of Indian epidemic is mainly caused by double mutation strains, which are comparable to the British mutation strains and higher than the South African strains. In addition, one of the mutation sites of the Indian mutant may be related to immune escape, so the international community has paid wide attention to the situation of this round of Indian mutants.

Currently, the Indian mutant has been detected in more than 20 countries, but other countries have not experienced a large outbreak similar to that in India. Therefore, it is still effective to control the epidemic by continuing to adhere to non-drug intervention measures such as early detection, early diagnosis, early isolation, and early treatment of cases, tracking and management of close contacts, and strict implementation of control measures in the communities where the epidemic is located, while accelerating the promotion of vaccination of the population and establishing an immune barrier as soon as possible.

Specific recommendations for epidemic prevention and control in overseas institutions:

1. Complete the full COVID-19 vaccination of all relevant personnel as soon as possible;

2. Strictly implement personnel health monitoring. When suspicious symptoms are found, they should seek medical treatment in time, and take strict single-person single-room isolation and observation measures for contacts as soon as possible;

3. Maintain social distance and minimize indoor activities. If you must organize and participate in indoor activities, the number of participants should be strictly controlled. In principle, the distance between people should be kept at more than 1 meter, and all participants should strictly take personal protection measures, wear masks, and strictly disinfect their hands;

4. Do not organize or participate in gatherings;

5. The work schedules of various departments can be appropriately adjusted within the institution, and dining in restaurants can be cancelled to reduce the chances of gathering and contact;

6. Strict closed management can be adopted within the institution to reduce or avoid the entry and exit of personnel, and adjust to an online or non-face-to-face working mode.

(II) Based on the current situation of the epidemic in India and the government's prevention and control measures, to what extent will the epidemic in India develop in the future?

At present, India has had more than 300,000 new cases per day for 13 consecutive days, constantly breaking the highest single-day record since the outbreak, and also breaking the highest single-day record for new cases in a single country. The Indian government predicted on April 25 that this round of epidemic may reach its peak in mid-May, with new confirmed cases per day or as high as 500,000. This is similar to the prediction of some foreign experts that it will take another three weeks for the Indian epidemic to reach its peak.

At present, India's own resources and capabilities alone are no longer able to cope with the rapidly rising epidemic. The World Health Organization and many countries including China have successively provided medical resources such as oxygen production equipment, as well as professional personnel and financial assistance to India. Considering the assistance of the international community, if India can increase its epidemic prevention efforts, it may gradually reverse the epidemic situation in the near future. The trend of the epidemic in the next few weeks is particularly critical. Otherwise, the current high incidence will continue for weeks or even months, and even lead to further deterioration of the situation.

II. About the transmission of the virus

(I) How long does the virus survive in the air or on various objects? Will objects that confirmed patients have touched, such as door handles, lunch boxes, food bags, fruits, etc., carry the new coronavirus and become a route of transmission?

The new coronavirus remains active in the air for less than 3 hours; it can survive for a longer time on some surfaces, such as cardboard for 24 hours, plastic and steel surfaces for 2-3 days, and surgical masks for 7 days. At present, the main transmission routes of the new coronavirus are respiratory droplets and contact transmission. Object surfaces contaminated by new coronavirus infected people may spread the virus. In order to prevent infection with the new coronavirus through contact with objects, it is recommended to maintain good hand hygiene and disinfect mobile phones and express personal items at the personal level; at the institutional management level, it is recommended to disinfect the environment, especially for elevator buttons, door handles, stair handrails and other objects with a high probability of hand contact. Regular disinfection should be carried out.

(II) Can the new coronavirus be transmitted through air and aerosols? How to prevent it? For example, does the floor drain cover in the bathroom need to be blocked?

The main transmission routes of COVID-19 are droplet and contact transmission. Under certain conditions, there is a risk of airborne transmission, such as medical procedures that can generate aerosols on COVID-19 patients in medical facilities, singing (KTV or chorus), exercising with COVID-19 patients in poorly ventilated rooms, and other activities that generate a large amount of aerosols. The main way to prevent airborne transmission is to ventilate the room well and open windows as much as possible to promote indoor and outdoor air circulation. For floor drains in the bathroom, especially in high-rise residential buildings, check whether the water seal of the floor drain is dry.

(III) Will pets carry COVID-19, such as dogs and cats?

Human pets (cats, dogs, ferrets) can be infected with the new coronavirus, but chickens, ducks, cattle, pigs, and mice are not easily infected and spread. Existing evidence shows that the risk of animal infection leading to human COVID-19 transmission is generally low, but the infection and transmission risks of different animals may be different and should be treated differently. Domestic pets have limited activity areas, are not prone to large-scale epidemics, and are unlikely to aggravate the spread of the virus. Large-scale infection of farmed animals may be transmitted back to humans, and management should be strengthened. Stray animals may play a role as a bridge between humans and wild animals, and management should also be strengthened.

(IV) It is reported that cold chain ingredients can also be contaminated with viruses and become a source of infection. How should kitchen workers prevent it?

First, you can get a COVID-19 vaccine to prevent infection; second, make sure you are in good health before taking up your post and conduct health monitoring; take personal protection during work, such as wearing masks, gloves, and work clothes; pay attention to personal hygiene, such as covering your mouth and nose when coughing or sneezing, and try to avoid touching your mouth, nose, and eyes with your hands, and strengthen hand hygiene, such as washing hands frequently.

III. About the handling of the epidemic

(I) How to distinguish whether you are infected with the new coronavirus or a common cold? What are the main symptoms? If you have sneezing, runny nose, sore throat, but no fever or cough, how should you self-examine? In India, you cannot go out for medical treatment. If you feel unwell, how can you quickly self-identify whether you are infected? How to save yourself if you are infected with COVID-19?

The general symptoms of a cold are a little discomfort in the throat, runny nose, and nasal congestion, and generally there is no fever. If you have fever, headache, cough, muscle and joint pain, etc., this is a possible manifestation of influenza, and of course, the new crown will also have similar manifestations. But the new crown is not the same as the flu. The fever and headache of influenza are more obvious; there are a large number of asymptomatic infections of the new crown, so there may be no symptoms, but there will be some characteristics, such as the smell and taste disorders of the new crown patients are more prominent. If there is no fever, cough, shortness of breath, and no muscle and joint pain, but there are smell and taste disorders, you should pay special attention. The difference between influenza and the new crown is actually manifested in: the headache of the new crown patient is not obvious, while the fever, headache, and muscle and joint pain of influenza are more obvious; the new crown is fever accompanied by shortness of breath, and taste and smell disorders are more. In actual situations, it is difficult to distinguish between the two. If you have fever, shortness of breath, cough, etc., you must pay special attention to it. It may be a new crown infection, especially in the epidemic area. At present, there is also a run on medical resources in India. If you have obvious shortness of breath and difficulty breathing, you still have to go to the hospital for treatment.

(II) If a confirmed person has difficulty breathing, how can you minimize the risk if you can't find a medical ventilator? Can portable oxygen cylinders be used in emergencies? (Such as the oxygen cylinders used for mountaineering)

If you have difficulty breathing or shortness of breath, you should pay special attention to it. This is a sign of possible pneumonia and severe illness. Early intervention is necessary, and the best way is to breathe oxygen. Of course, rest and no exercise are also important. If you have shortness of breath, especially if you are old or have underlying diseases, you should breathe oxygen in time. Generally, portable oxygen cylinders are mask-type. After buckling them, press the button twice while inhaling, take a deep breath, then stop, exhale slowly, buckle the mask again, press it for one or two seconds and take a deep breath, then exhale, and repeat this operation to effectively increase the oxygen saturation. Because the severity of the new crown disease is often due to the failure to solve the early hypoxemia in time, resulting in multiple organ involvement. Organs are very sensitive to ischemia and hypoxia, especially the heart, liver, and kidneys. Therefore, if you have difficulty breathing, you can save yourself at home. If you can't go to the hospital for the time being, or if there are no such conditions in the hospital, then use a portable oxygen cylinder to breathe oxygen directly, which is a very effective means.

For example, there are finger oximeters for sale in India (a small device that measures blood oxygen saturation by clamping it on the index finger, which is automatic, battery-powered, and carried by doctors). It is recommended that you buy one. Especially for the elderly, it is recommended to keep one at home. Finger oximeters are helpful for deciding whether to inhale oxygen and how to inhale oxygen after breathing difficulties. Generally, you can feel at ease if the oxygen is above 95%. If it is below 95%, you can inhale oxygen, but if it is below 93%, you have to go to the hospital for timely medical treatment. Finger oximeters can be used at home and in groups in emergencies. Some wearable devices such as Huawei watches and bracelets have the function of measuring blood oxygen, which can measure blood oxygen saturation, but it is not as accurate as professional ones. It can be used as a reference.

(III) In India, due to the medical run and the collapse of the medical system, if Chinese personnel cannot go to the hospital for treatment after being diagnosed, how can they treat themselves and what medicines should they take? How should we take the existing Chinese patent medicines (Isatis root, antiviral granules, honeysuckle, Lianhua Qingwen capsules)? It is said on the Internet that taking antibiotics can relieve symptoms. Is it true? If true, which type of antibiotics are recommended?

If you have fever, olfactory impairment, etc. at home, you can use some Chinese medicine. The Chinese patent medicines recommended in our diagnosis and treatment plan this time are Lianhua Qingwen Capsules, Jinhua Qinggan Capsules, and Shufeng Jiedu Capsules. Of course, Huoxiang Zhengqi Pills and Zhengqi Water Oral Liquid can also be used, which can also help relieve symptoms and play a certain role in the early stage. Antiviral granules, honeysuckle, etc. can also be eaten, but don't eat too much at one time. It is enough to choose two. Eating too much has side effects.

Regarding the question of whether to use antibiotics when fever occurs, antibiotics are ineffective for the new crown alone. However, for the elderly and those with underlying diseases, such as those with chronic bronchitis, there may be a combined bacterial infection, because after the upper respiratory tract barrier is damaged, bacteria may take advantage of the opportunity to enter, and the same is true for influenza, and secondary infection will occur. This requires a good judgment. If you are in the hospital, you can check the blood routine to see if there is a bacterial infection. If you have a fever, runny nose, and cough with yellow sputum, and you cannot go to the hospital, it is recommended to use antibiotics, and azithromycin and quinolones can be used.

(IV) After the diagnosis of COVID-19, the fever symptoms recur repeatedly, and the fever rebounds after the symptoms subside. Is it an inherent characteristic of COVID-19 or does it vary from person to person?

Many people do not have a fever with COVID-19. Some milder ones have a fever that passes in one or two days, or they may have a fever for three, five or even longer days. If the patient has a fever again after the fever stops, one possibility is that the virus enters the lungs and blood from the upper respiratory tract, and the whole body is infected, and the fever worsens; the second possibility is that you should pay attention to secondary bacterial infection and use antibiotics. If the fever is two stages, it is recommended to add antibiotics. But it is best to go to the hospital to check blood routine, chest X-ray, etc., and treat under the guidance of a doctor.

(V) What are the main damages of COVID-19 to the human body, and will there be sequelae?

The incidence of sequelae after COVID-19 infection is very low. Most patients are self-limited. The so-called self-limitation means that without special treatment, most patients can eliminate the virus they are infected with and recover. However, if the condition is more serious, pneumonia, even severe pneumonia, and multiple organ damage occurs, organ dysfunction will occur, including renal dysfunction and liver damage, but most patients can recover. Some patients will develop pulmonary fibrosis, and after they recover, they will also experience shortness of breath when going upstairs or exercising. It just takes a while to recover, so don't worry, recover slowly, and there are rarely serious sequelae. Good protection is the most important thing, don't get infected. In daily life, you must wear a mask in the elevator and in a small confined space, and take good protection, because the risk of aerosol transmission in a small confined space is still very high.

IV. About vaccination

(I) What is the effective period of vaccine protection (inactivated/adenocarcinoma vector/RNA)? How long is the effective period of China's Sinovac/Sinopharm vaccine? Can I get a booster shot after the antibodies disappear?

At present, the global data on vaccine protection period and durability are not sufficient. This is because the vaccine has only been on the market for about half a year, and the time available for us to observe is not long. Judging from the current data, the protection time of the vaccines currently on the market outside China can be at least half a year. Whether it will be longer requires further observation.

There is currently no correlation indicator between antibody level and protection effect, and there is no policy to recommend booster vaccination based on antibody test results. At this stage, according to the Technical Guidelines for the Use of China's New Crown Vaccine (First Edition), booster vaccination is not recommended for the time being, but with the development of the epidemic, the advancement of vaccine use and the accumulation of world research data, countries are considering whether it is necessary to strengthen.

(II) Are inactivated vaccines (Sinopharm, Sinovac) effective against India's double and triple mutant viruses? What is the effect? Indians who have been vaccinated with Indian vaccines are still infected. Does this mean that no matter what vaccine, it has failed in the face of mutant viruses?

There are currently no research results on the neutralizing activity of domestic vaccines against Indian mutant virus strains. Judging from the results of studies on other virus variants, the neutralizing activity of existing vaccines outside China has decreased to a certain extent, but this does not mean that the vaccine is ineffective against variants. The degree of decline may be related to both the vaccine and the variant, and the effectiveness of the vaccine against variants needs further study. Vaccination is much better than not being vaccinated. The real-world research results of the Sinovac vaccine found that vaccination with the Sinovac vaccine can significantly reduce severe illness, reduce the incidence of 60%-70%, reduce severe illness and death, and the protection efficiency is very high. From this perspective, even if there are virus mutations, we must hurry up to get vaccinated.

(III) How long does it take to get vaccinated again after being vaccinated with the Sinovac vaccine in China? If you need to get vaccinated again, if there is no domestic vaccine of the same brand, can you cross-vaccinate with foreign vaccines?

As answered in the previous question, we are currently studying whether we need to boost immunity. According to the China COVID-19 Vaccine Technical Guide (First Edition), those who have completed two doses of vaccination are not recommended to be vaccinated again (reinforced immunization); currently, two doses of inactivated vaccine are sufficient. If the same vaccine product cannot be used to complete the vaccination due to special circumstances such as vaccine supply or vaccination of recipients in different places, domestic vaccines of the same type from other companies can be used to complete the vaccination, but there is no replacement vaccination with foreign vaccines at present. For sequential (cross) vaccination, more research data is needed.

(IV) Is it recommended to get Indian or foreign vaccines? Does China recognize vaccination in India? Will getting Indian or foreign vaccines cause inconvenience in applying for green codes or entry testing when returning to China?

According to the results of the Phase III clinical trial of the Indian inactivated vaccine, the effectiveness is 78%, which is similar to the effectiveness of domestic vaccines. If only Indian vaccines or other non-domestic vaccines can be vaccinated in India, considering the current epidemic situation and the high risk of infection, it is recommended to consider vaccination. At present, the relevant departments are also studying and preparing for the mutual recognition of international vaccination certificates and the application for green codes in China, so you can pay close attention.

(V) China has been vaccinated with inactivated vaccines (Sinopharm, Sinovac), but the antibody test is IgM negative and IgG is less than 1. Does it mean that there is no antibody? What is the difference in protective measures compared with those who test positive? If the antibody IgG drops from more than 7 at the beginning to 1.x, does it still have defensive capabilities?

At present, according to the China's new crown vaccine use technical guidelines (first edition), routine antibody testing is not recommended after vaccination as a basis for immune success or failure, and most other vaccines are also not recommended for routine antibody testing.

New crown IgG and IgM testing is mainly used as an auxiliary laboratory test indicator for case diagnosis in the absence of vaccination, and should be considered in combination with clinical manifestations, etc., but it is not accurate as a determination of whether protective antibodies have been produced after vaccination, and the test results of commercially available kits vary greatly, so the interpretation of antibody test results needs to be cautious. At present, there is no standard method to evaluate the protective effect of vaccines using IgM and IgG indicators.

(VI) What is the impact of the mutation of the new coronavirus on the human immune system?

As a new virus, the human body lacks immunity to the new coronavirus regardless of whether it mutates, so it has caused a global pandemic of the disease. In this case, regardless of the mutation of the virus, we quickly vaccinate and activate the human immune system to produce a certain degree of antibodies, thereby obtaining corresponding protection. So I hope everyone will get vaccinated as much as possible and believe in vaccines. However, if the virus mutates significantly, a certain degree of immune "escape" may occur, so scientists have been monitoring virus mutations and their impact on vaccines.

(VII) Is it recommended that children receive local vaccines?

Currently, the target of China's new crown vaccine is still adults aged 18 and above, and does not include adolescents and children under 18. This will be further recommended with the results and progress of clinical trials. In the current situation, the protection of children requires the use of measures such as keeping distance, wearing masks, and washing hands frequently. We are also continuing to pay attention to the progress of vaccine clinical trials in various places.

V. Disinfection and protection

(I) How long does it take to ventilate the things you buy before you can use them? Or how to disinfect them? How to disinfect daily vegetables and fruits, such as spraying disinfectants, can they evaporate on their own? Or can the disinfectant be washed off? Does the ultraviolet disinfection stick work?

Ventilation cannot kill viruses. Viruses die naturally in the environment. First, it is related to temperature. The higher the temperature, the easier it is to die. Second, it is related to humidity. The higher the humidity, the easier it is to die. Third, it is related to light intensity. The longer it is exposed to the sun, the easier it is to die. Fourth, it is related to organic matter. If there are more dirt on it, the virus is not easy to die. Fifth, it is related to the characteristics of the material, which has been introduced before. So many factors add up, and it is also related to time. The longer the time, the more likely these viruses will die. So in response to this situation, if we buy things that can be exposed to the sun first, let them dry in the sun. If they are not in a hurry to use, try to keep them for a long time.

Some things need to be kept fresh and used in time. We can clean and disinfect them. If they can be washed during cleaning, they can be washed with water. In fact, as long as they are water-resistant and not afraid of water, washing is also a good disinfection. Most microorganisms and viruses can be washed away. If it is a smooth surface, 99.99% can be washed away. The first thing we emphasize on hand hygiene is washing hands. Disinfection can also be done by choosing some food disinfectants, such as hydrogen peroxide, chlorine-containing disinfectants, and chlorine dioxide. If there is no disinfectant, we can use heating to disinfect. Hot water at 56 degrees for 30 minutes can kill the virus. The residue of the disinfectant is related to the composition of the disinfectant itself and the object to be disinfected. In terms of composition, if it is alcohol, it is very volatile, and it will all evaporate after a few minutes without any residue; if hydrogen peroxide, chlorine-containing disinfectants, or chlorine dioxide are used as food disinfectants, they can be washed off with water after use, and it can be guaranteed to be harmless if washed clean. There are also some that cannot be used for food disinfection, such as formaldehyde, glutaraldehyde and other aldehydes, and some such as quaternary ammonium salts, which have strong adhesion and are not good for washing food directly. Therefore, when disinfecting, it is necessary to reasonably choose effective and safe disinfectants. When cleaning and disinfecting, you must pay attention to personal protection. Pay attention to: first, wear gloves; second, wear a waterproof apron when necessary; third, don't touch your hands everywhere when operating. After the operation, three things should be done: first, the garbage should be cleaned up in time; second, the environment should be cleaned and disinfected; third, the hand hygiene should be done well, that is, wash hands and disinfect hands correctly.

Ultraviolet disinfection sticks use ultraviolet rays to disinfect, which can generally be used to disinfect the surface of objects. It is difficult to effectively disinfect the parts of vegetables and fruits that have many layers and are difficult to reach by direct irradiation. Large ultraviolet lamps are not recommended for personal use because long irradiation time is harmful to people. Small, handheld ultraviolet disinfection sticks take a long time to achieve disinfection effects, which are usually not very meaningful. Maybe one hour or half an hour can have a certain disinfection effect locally, but people can't stand holding it for a long time, and staring at it for a long time is also harmful to the human eye. If you must use it, pay attention to whether the disinfection time is enough, whether the irradiation intensity is enough, whether the distance is relatively close, and take good protection.

(II) In view of the current Indian mutant virus, can conventional measures such as wearing medical masks meet the protection needs? India's mutant virus this time is said to have begun to spread through the air. Is it useless to wear a mask? What should we do to protect ourselves in epidemic prevention?

China's original protective measures are still effective in India. Wearing a mask is still one of the most effective protective measures against respiratory infectious diseases. For airborne transmission (i.e. aerosol transmission), N95 masks, medical protective masks, and medical surgical masks can prevent viruses from entering the human respiratory system and effectively prevent infected people from emitting viruses through breathing. Their filtration efficiency reaches more than 95%. Wearing an N95 mask can completely prevent the virus from spreading through the air. Medical protective masks add a splash-proof function on the basis of N95. If you go to a particularly high-risk place, wear an N95 mask or a special Chinese medical protective mask. If the number of people is sparse, it is also okay to wear an ordinary protective mask, which can also play a better protective role. In addition to wearing masks, there are also measures such as strengthening hand hygiene (correct hand washing and hand disinfection), maintaining social distance, and staying at home if you can. These measures are still effective.

(III) When wearing a mask in daily life, is it more effective to wear one layer of ordinary medical masks and one layer of N95 masks? Which one should be worn outside? How long does it take for the two masks to become ineffective?

From the perspective of protection, wearing a multi-layer mask does not make much sense. Putting an ordinary medical mask inside an N95 mask will affect the tightness of the N95 mask. The general public can achieve protection by wearing a single mask correctly. Moreover, wearing a multi-layer mask will increase breathing resistance and reduce comfort.

It is more important to choose the right type of mask in different environments and wear it correctly. In public places, you can choose to wear a disposable medical mask or an ordinary medical surgical mask. If you may come into contact with patients with suspected respiratory infections, it is recommended to wear an N95 mask.

The wearing time of a mask is related to factors such as the degree of environmental pollution, ambient temperature and humidity, respiratory frequency and respiratory volume. The recommended wearing time of various masks is N95≤8 hours, medical protection and medical surgical masks 6 to 8 hours. It is recommended that the mask be changed every half a day. If the mask is tight, it is also possible to change it once a day.

(IV) Questions about children's epidemic prevention measures:

1. How long should children wear masks when exercising outdoors? Will it cause damage to children's lungs?

Wearing a mask during outdoor sports will increase breathing resistance. In a study of healthy young male volunteers, it was found that wearing medical masks and FFP2/N95 during exercise had a significant negative impact on vital capacity (FEV, EV and PEF). Although there are no relevant studies on children, it is not recommended to wear a mask during outdoor sports, and a certain distance should be maintained during outdoor sports.

Children do not need to consider wearing masks when there is no one outdoors. If there are many people, it is recommended that children do not go out. It is best not to wear masks when children are outdoors if there are few people, especially for children under 5 years old. Wearing masks is a safety risk. If they are not careful, they may suffocate.

2. Is there anything special for children to pay attention to in epidemic prevention and protection?

Children should wear masks correctly, implement hand hygiene measures correctly, maintain a safe distance, avoid going to closed public places, and pay attention to diet to improve their body immunity.

If the local epidemic is particularly serious, it is recommended that children do not go to school for the time being and stay at home for a while until the epidemic subsides before going out again, to protect themselves and their families and avoid bringing the virus home. Children are lively by nature. If they go out to play, they should try to go to open places. Do not wear masks if possible.

3. Under what circumstances do children need to wear N95 masks and when do they wear disposable masks?

If you must wear a mask, wear an N95 mask in crowded and high-risk places, and wear an ordinary mask in low-risk places. It is recommended that children do not go to crowded places if possible. Children should avoid going to high-risk places such as medical institutions and enclosed public places. For children in community activities, WHO has given the following mask-wearing recommendations during the epidemic:

(1) Children aged 5 years and under should not

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