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          Interim Guidance for Preventing the Spread of Coronavirus Disease 2019 (COVID-19) in Homes and Residential Communities


          發布時間:2020-02-24 02:36  當前瀏覽量為:   【字體:


          Interim Guidance for Preventing the Spread of Coronavirus Disease 2019 (COVID-19) in Homes and Residential Communities

           

          (This guidance provides clarification regarding evaluation for home isolation and a new section with information regarding preventative steps for household members, intimate partners, and caregivers in a nonhealthcare setting of a person with symptomatic, laboratory-confirmed COVID-19 infection)

          This interim guidance is based on what is currently known about the epidemiology of COVID-19 and the transmission of other viral respiratory infections. CDC will update this interim guidance as needed and as additional information becomes available.

          Coronaviruses are a large family of viruses, some causing illness in people and others that circulate among animals, including camels, cats, and bats. Rarely, animal coronaviruses can infect people exposed to infected animals, and then spread among people, as has been seen with MERS-CoV and SARS-CoV, and likely now with COVID-19. This interim guidance may help prevent this virus from spreading among people in their homes and in other residential communities.

          This interim guidance is intended for:

          * People with confirmed or suspected COVID-19 infection, including persons under investigation, who do not need to be hospitalized and who can receive care at home (see Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus (COVID-19));

          * People with confirmed COVID-19 infection, who were hospitalized and then determined to be medically stable to go home (see Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus (COVID-19));

          * Household members, intimate partners, and caregivers in a nonhealthcare setting of a person with symptomatic, laboratory-confirmed COVID-19 infection.

           

          Prevention steps for

          1、People with confirmed or suspected COVID-19 infection (including persons under investigation) who do not need to be hospitalized and People with confirmed COVID-19 infection who were hospitalized and determined to be medically stable to go home

          Your healthcare provider and public health staff will evaluate whether you can be cared for at home. If it is determined that you do not need to be hospitalized and can be isolated at home, you will be monitored by staff from your local or state health department. You should follow the prevention steps below until a healthcare provider or local or state health department says you can return to your normal activities.

          2、Stay home except to get medical care

          You should restrict activities outside your home, except for getting medical care. Do not go to work, school, or public areas. Avoid using public transportation, ride-sharing, or taxis.

          3、Separate yourself from other people and animals in your home

          People: As much as possible, you should stay in a specific room and away from other people in your home. Also, you should use a separate bathroom, if available.Animals: Do not handle pets or other animals while sick.  See COVID-19 and Animals for more information.

          4、Call ahead before visiting your doctor

          If you have a medical appointment, call the healthcare provider and tell them that you have or may have COVID-19 infection. This will help the healthcare provider’s office take steps to keep other people from getting infected or exposed.

          5、Wear a facemask

          You should wear a facemask when you are around other people (e.g., sharing a room or vehicle) or pets and before you enter a healthcare provider’s office. If you are not able to wear a facemask (for example, because it causes trouble breathing), then people who live with you should not stay in the same room with you, or they should wear a facemask if they enter your room.

          6、Cover your coughs and sneezes

          Cover your mouth and nose with a tissue when you cough or sneeze. Throw used tissues in a lined trash can; immediately wash your hands with soap and water for at least 20 seconds or clean your hands with an alcohol-based hand sanitizer that contains 60 to 95% alcohol, covering all surfaces of your hands and rubbing them together until they feel dry. Soap and water should be used preferentially if hands are visibly dirty.

          7、Clean your hands often

          Wash your hands often with soap and water for at least 20 seconds or clean your hands with an alcohol-based hand sanitizer that contains 60 to 95% alcohol, covering all surfaces of your hands and rubbing them together until they feel dry. Soap and water should be used preferentially if hands are visibly dirty. Avoid touching your eyes, nose, and mouth with unwashed hands.

          8、Avoid sharing personal household items

          You should not share dishes, drinking glasses, cups, eating utensils, towels, or bedding with other people or pets in your home. After using these items, they should be washed thoroughly with soap and water.

          9、Clean all “high-touch” surfaces everyday

          High touch surfaces include counters, tabletops, doorknobs, bathroom fixtures, toilets, phones, keyboards, tablets, and bedside tables, every day. Also, clean any surfaces that may have blood, stool, or body fluids on them. Use a household cleaning spray or wipe, according to the label instructions. Labels contain instructions for safe and effective use of the cleaning product including precautions you should take when applying the product, such as wearing gloves and making sure you have good ventilation during use of the product.

          10、Monitor your symptoms

          Seek prompt medical attention if your illness is worsening (e.g., difficulty breathing). Before seeking care, call your healthcare provider and tell them that you have, or are being evaluated for, COVID-19. Put on a facemask before you enter the facility. These steps will help the healthcare provider’s office to keep other people in the office or waiting room from getting infected or exposed. Ask your healthcare provider to call the local or state health department. Persons who are placed under active monitoring or facilitated self-monitoring should follow instructions provided by their local health department or occupational health professionals, as appropriate.

          If you have a medical emergency and need to call 911, notify the dispatch personnel that you have, or are being evaluated for COVID-19. If possible, put on a facemask before emergency medical services arrive.

          11、Discontinuing home isolation

          Patients with confirmed COVID-19 should remain under home isolation precautions until the risk of secondary transmission to others is thought to be low. The decision to discontinue home isolation precautions should be made on a case-by-case basis, in consultation with healthcare providers and state and local health departments.

           

           

          Recommended precautions for household members, intimate partners, and caregivers in a nonhealthcare setting1 of

          A patient with symptomatic laboratory-confirmed COVID-19 infection or A patient under investigation

          Household members, intimate partners, and caregivers in a nonhealthcare setting may have close contact2 with a person with symptomatic, laboratory-confirmed COVID-19 or a person under investigation. Close contacts should monitor their health; they should call their healthcare provider right away if they develop symptoms suggestive of COVID-19 (e.g., fever, cough, shortness of breath) (see Interim US Guidance for Risk Assessment and Public Health Management of Persons with Potential 2019 Novel Coronavirus (COVID-19) Exposure in Travel-associated or Community Settings.)

           

          Close contacts should also follow these recommendations:

          * Make sure that you understand and can help the patient follow their healthcare provider’s instructions for medication(s) and care. You should help the patient with basic needs in the home and provide support for getting groceries, prescriptions, and other personal needs.

          * Monitor the patient’s symptoms. If the patient is getting sicker, call his or her healthcare provider and tell them that the patient has laboratory-confirmed COVID-19. This will help the healthcare provider’s office take steps to keep other people in the office or waiting room from getting infected. Ask the healthcare provider to call the local or state health department for additional guidance. If the patient has a medical emergency and you need to call 911, notify the dispatch personnel that the patient has, or is being evaluated for COVID-19

          * Household members should stay in another room or be separated from the patient as much as possible. Household members should use a separate bedroom and bathroom, if available.

          * Prohibit visitors who do not have an essential need to be in the home.

          * Household members should care for any pets in the home. Do not handle pets or other animals while sick.  For more information, see 2019-nCoV and Animals.

          * Make sure that shared spaces in the home have good air flow, such as by an air conditioner or an opened window, weather permitting.

          * Perform hand hygiene frequently. Wash your hands often with soap and water for at least 20 seconds or use an alcohol-based hand sanitizer that contains 60 to 95% alcohol, covering all surfaces of your hands and rubbing them together until they feel dry. Soap and water should be used preferentially if hands are visibly dirty.

          * Avoid touching your eyes, nose, and mouth with unwashed hands.

          * You and the patient should wear a facemask if you are in the same room.

          * Wear a disposable facemask and gloves when you touch or have contact with the patient’s blood, stool, or body fluids, such as saliva, sputum, nasal mucus, vomit, urine.

          Throw out disposable facemasks and gloves after using them. Do not reuse.

          When removing personal protective equipment, first remove and dispose of gloves. Then, immediately clean your hands with soap and water or alcohol-based hand sanitizer. Next, remove and dispose of facemask, and immediately clean your hands again with soap and water or alcohol-based hand sanitizer.

          * Avoid sharing household items with the patient. You should not share dishes, drinking glasses, cups, eating utensils, towels, bedding, or other items. After the patient uses these items, you should wash them thoroughly (see below “Wash laundry thoroughly”).

          * Clean all “high-touch” surfaces, such as counters, tabletops, doorknobs, bathroom fixtures, toilets, phones, keyboards, tablets, and bedside tables, every day. Also, clean any surfaces that may have blood, stool, or body fluids on them.

          Use a household cleaning spray or wipe, according to the label instructions. Labels contain instructions for safe and effective use of the cleaning product including precautions you should take when applying the product, such as wearing gloves and making sure you have good ventilation during use of the product.

          * Wash laundry thoroughly.

          Immediately remove and wash clothes or bedding that have blood, stool, or body fluids on them.

          Wear disposable gloves while handling soiled items and keep soiled items away from your body. Clean your hands (with soap and water or an alcohol-based hand sanitizer) immediately after removing your gloves.

          Read and follow directions on labels of laundry or clothing items and detergent. In general, using a normal laundry detergent according to washing machine instructions and dry thoroughly using the warmest temperatures recommended on the clothing label.

          * Place all used disposable gloves, facemasks, and other contaminated items in a lined container before disposing of them with other household waste. Clean your hands (with soap and water or an alcohol-based hand sanitizer) immediately after handling these items. Soap and water should be used preferentially if hands are visibly dirty.

          * Discuss any additional questions with your state or local health department or healthcare provider.

           

          Footnotes

          1、Home healthcare personnel should refer to Interim Infection Prevention and Control Recommendations for Patients with Known or Patients Under Investigation for 2019 Novel Coronavirus (COVID-19) in a Healthcare Setting

          2、Close contact is defined as—

          being within approximately 6 feet (2 meters) of a COVID-19 case for a prolonged period of time; close contact can occur while caring for, living with, visiting, or sharing a health care waiting area or room with a COVID-19 case

          – or –

          having direct contact with infectious secretions of a COVID-19 case (e.g., being coughed on)

           

           

           

           

           

           

           

          預防 2019 年新型冠狀病毒 (2019-nCoV) 傳播給家庭和社區中其他人的暫行指南

           

          (本指南對居家隔離評估進行了說明,并在新章節中提供了有關有癥狀、且經實驗室確診的 COVID-19 感染者的家庭成員、親密伴侶和非醫療機構的看護者的預防措施信息)

          本暫行指南基于目前已知的有關 COVID-19 的流行病學和其他病毒性呼吸道感染傳播的情況。美國疾病控制與預防中心 (CDC) 將根據需要并在獲得更多信息后,更新此暫行指南。

          冠狀病毒是一大類病毒,其中一些會導致人類患病,而另一些會在動物(包括駱駝、貓和蝙蝠)之間傳播。在罕見情況下,動物冠狀病毒可能會感染暴露于感染動物的人,然后在人群中傳播,例如在中東呼吸綜合征冠狀病毒 (Middle East respiratory syndrome coronavirus, MERS-CoV) 和嚴重急性呼吸綜合征冠狀病毒 (severe acute respiratory syndrome coronavirus, SARS-CoV)(英文版)中所見到的情況,現在 COVID-19 可能也有這種情況。本暫行指南將有助于預防這種病毒在家庭和其他住宅社區的人群中傳播。

          此暫行指南適用于以下情況:

           

          * 已確診或疑似 COVID-19 感染、但無需住院并且可以接受居家治療的患者(包括正在接受檢查的人)(請參閱《針對無需住院的 2019 年新型冠狀病毒 (COVID-19) 患者實施居家治療的暫行指南》)(英文版);

          * 已確診 COVID-19 感染、并且曾經住院治療且隨后經確定病情穩定而出院回家的患者(請參見《針對無需住院的 2019 年新型冠狀病毒 (COVID-19) 患者實施家庭護理的暫行指南》)(英文版);

          * 有癥狀、且經實驗室確診的 COVID-19 感染患者的家庭成員、親密伴侶和非醫療機構中的看護者。

          針對以下情況的預防措施

          1、已確診或疑似 COVID-19 感染但無需住院的患者(包括正在接受檢查的人員)和已確診 COVID-19 感染、并且曾經住院治療且經確定病情穩定而出院回家的患者

          您的醫務人員和公共衛生工作人員將評估您是否可以在家中進行治療。如果確定您無需住院并且可以居家隔離,您將由當地或州衛生部門的工作人員進行監測。您應該遵循以下預防措施,直到醫務人員、當地或州衛生部門告知您可以恢復正?;顒?。

          2、除就醫外,請留在家里

          除了去看醫生外,您應該限制出門活動。不要去工作場所、學?;蚬矆鏊?。避免乘坐公共交通工具、拼車、或乘出租車。

          3、將自己與家中其他人和動物隔離

          患者:您在家時應盡可能留在特定房間中,并與家中其他人隔離。此外,如果可能的話您應使用單獨的洗手間。

          動物:生病時,不要觸摸寵物或其他動物。  如需更多信息,請參見《COVID-19 和動物》。

          4、就診之前先打電話

          在您預約就診之前,請致電醫務人員并告訴他們您感染了 COVID-19 或疑似感染。這將有助于診所的人員采取措施,以免其他人受到感染或暴露。

          5、戴口罩

          在您接近其他人(如共處一室或在同一輛車子里)或寵物時,或進入診所或醫院前,應戴上口罩。如果您因為某些原因,比如無法呼吸,而不能戴口罩時,那些跟您住一起的人應避免跟您共處一室。一旦他們進入您的房間必須戴口罩。

          6、遮擋咳嗽和噴嚏

          在咳嗽或打噴嚏時請用紙巾遮掩口鼻。將用過的紙巾扔進帶塑料袋的垃圾桶中;立即用肥皂和水洗手至少 20 秒,或立即用含至少 60% 至 95% 酒精的酒精類手部消毒液進行手部消毒,將消毒液涂滿全手,搓揉直到手干爽??吹绞峙K了,首選用肥皂和水清洗。

          7、經常清潔雙手

          經常用肥皂和水洗手至少 20 秒,或用含 60% 至 95% 酒精的酒精類手部消毒液進行手部消毒,將消毒液涂滿全手,搓揉直到手干爽??吹绞峙K了,首選用肥皂和水清洗。避免用未清洗過的手觸碰眼睛、鼻子和嘴巴。

          8、避免共用個人物品

          您不應與家里的其他人或寵物共用碗碟、飲水杯、杯子、餐具、毛巾或床上用品。一旦使用這些物品后,應用肥皂和水對其進行徹底清洗。

          9、每天清潔所有“高頻接觸”的物體表面

          高頻接觸的物體表面包括柜臺、桌面、門把手、洗手間用具、廁所、手機、鍵盤、平板電腦和床旁桌子。另外,清潔可能帶血、糞便或體液的任何表面。根據標簽說明使用家用清潔噴霧劑或濕巾。標簽中包含了安全有效使用清潔產品的說明,包括您在使用產品時應采取的預防措施,例如佩戴手套,以及確保在使用產品期間通風良好。

          10、監測您的癥狀

          如果您的病情惡化(例如呼吸困難),請立即就醫。在就診之前,請致電醫務人員并告訴他們您感染了 COVID-19 或懷疑被感染。在進入診所或醫院前戴上口罩。這將有助于診所的人員采取措施,以免診所或候診室的其他人受到感染或暴露。要求您的醫務人員致電當地或州衛生部門。已經被監測或提供自我監測的人應適當遵循當地衛生部門或職業衛生專業人員的指示。

          如果您出現緊急醫療情況,需要致電 911,請通知調度人員您已感染或疑似感染 COVID-19。如果可能,在緊急醫療服務到達之前戴上口罩。

          11、終止隔離

          確診為 COVID-19 感染的患者應繼續在家隔離,直到被認為二次傳染給他人的風險降低。在個案的基礎上咨詢醫生、州和地方衛生部門作出終止家庭隔離措施的決定。

           

          針對以下人員的家庭成員、親密伴侶和非醫療機構中的看護者的推薦預防措施1

          有癥狀、且經實驗室確診的 COVID-19 感染患者或者正在接受檢查的患者家庭成員、親密伴侶和非醫療機構中的看護者可能會密切接觸2有癥狀、且經實驗室確診的 COVID-19 患者或正在接受檢查的患者。密切接觸者應監測其健康;如果他們出現疑似 COVID-19 的癥狀(例如發燒、咳嗽、呼吸急促),應立即致電其醫務人員(請參閱《美國針對在旅行或社區環境中潛在暴露于 2019 年新型冠狀病毒 (COVID-19) 的人員的風險評估和公共衛生管理的暫行指南》)(英文版)。

          密切接觸者還應遵循以下建議:

          * 確保您了解并可幫助患者遵循醫務人員的藥物和治療指示。您應該幫助患者獲得居家基本需求,并在購買雜貨、處方藥和其他個人需求方面提供支持。

          * 監測患者的癥狀。如果患者病情加重,請致電其醫務人員,并告訴他們該患者患有實驗室確診的 COVID-19。這將有助于醫務人員的診所采取措施,以免診所或候診室的其他人受到感染。要求醫務人員致電當地或州衛生部門以獲取其他指導。如果患者有緊急醫療情況,而您需要致電 911,請通知調度人員該患者已感染或疑似感染 COVID-19

          * 家庭成員應待在其他房間或盡可能與患者隔離。家庭成員應使用單獨的臥室和衛生間(如果有)。

          * 禁止非必要的客人到家里來。

          * 家庭成員應照顧家中的任何寵物。生病時,不要觸摸寵物或其他動物。  如需更多信息,請參見《2019-nCoV 和動物》。

          * 確保家里的共用空間通風良好,例如使用空調或在天氣允許的情況下,打開窗戶。

          * 經常清潔雙手。經常用肥皂和水洗手至少 20 秒,或用含 60% 至 95% 酒精的酒精類手部消毒液,將消毒液涂滿全手,搓揉直到手干爽??吹绞峙K了,首選用肥皂和水清洗。

          * 避免用未清洗過的手觸碰眼睛、鼻子和嘴巴。

          * 如果您和患者共處一室,您們都應戴口罩。

          * 在您觸摸或接觸患者的血液、糞便或體液(如唾液、痰液、鼻粘液、嘔吐物、尿液)時,請戴一次性口罩和手套。

          在使用后,丟棄一次性口罩和手套。請勿重復使用。

          脫下個人防護裝備時,應先脫下并丟棄手套。然后,立即用肥皂和水或酒精類手部消毒液清潔雙手。接下來,脫下并丟棄口罩,并立即用肥皂和水或酒精類手部消毒液再次清潔雙手。

          * 避免與患者共用生活用品。請勿共用碗碟、飲水杯、杯子、餐具、毛巾、床上用品或其他物品。在患者使用這些物品后,應對其進行徹底清洗(請參閱下文“徹底清洗衣物”)。

          * 每天清潔所有“高頻接觸”的物體表面,如柜臺、桌面、門把手、洗手間固定裝置、廁所、手機、鍵盤、平板電腦和床旁桌子。另外,清潔可能帶血、糞便或體液的任何表面。

          根據標簽說明使用家用清潔噴霧劑或濕巾。標簽中包含了安全有效使用清潔產品的說明,包括您在使用產品時應采取的預防措施,例如佩戴手套,以及確保在使用產品期間通風良好。

          * 徹底清洗衣物。

          立即取下并洗滌帶血液、糞便或體液的衣物或床上用品。

          處理污染物品時應戴上一次性手套,污染物品應遠離您的身體。脫下手套后,立即用肥皂和水或酒精類手部消毒液清潔雙手。

          閱讀并遵循洗衣或衣物標簽和清潔劑標簽上的指示。通常應根據洗衣機的說明使用普通的洗衣粉,并采用衣物標簽上建議的最高溫度徹底烘干。

          * 將所有使用過的一次性手套、口罩和其他污染物品放入帶有塑料袋的容器中,然后再將其放入其他居家垃圾中。處理完這些物品后,請立即清潔雙手(用肥皂和水或酒精類手部消毒液)??吹绞峙K了,首選用肥皂和水清洗。

          * 與您所在州或當地衛生部門或醫務人員討論任何其他問題

           

          腳注

          1、居家治療人員應參閱《針對醫療護理機構的已確診感染 2019 年新型冠狀病毒 (COVID-19) 的患者或正接受檢查的患者的預防和控制感染暫行建議》(英文版)

          2 密切接觸的定義是—

          長時間位于 COVID-19 患者周圍約 6 英尺(2 米)的范圍內;在照顧 COVID-19 患者、與其同住、探訪或共用醫療候診區或房間時,可能會發生密切接觸

          – 或者 –

          直接接觸 COVID-19 患者的傳染性分泌物(例如咳嗽飛沫)

           

           

           

           

           

           

           

           

           

           

           

           

           

           

           

           

           

           

           

           

           

           

           

           

           

           

           

           

           

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