The city reserves enough according to the proportion of local resident population.

According to the proportion of 60 permanent residents per 10,000 population, sufficient centralized isolation rooms will be reserved in the city, and the isolation resources will be well utilized in coordination with surrounding cities.

Epidemic situation disposal

After the outbreak, it is necessary to immediately start the command system, quickly complete the transformation between normal and emergency mechanisms, set up a front-line command center with the prefecture (city) as the unit, coordinate the joint prevention and control mechanism of provinces, cities and counties, operate in a flat way, make overall arrangements for resources, and take decisive countermeasures.

(a) the source of infection control.

1. Confirmed cases. After the diagnosis, it should be transported to the designated medical institution or the receiving hospital within 2 hours. After the case is cured and discharged, it should be monitored at home for 7 days.

2. Suspected cases. If a suspected case is found, samples should be collected immediately for nucleic acid detection and review. During this period, one person should be isolated in a single room, and the COVID-19 nucleic acid test is negative twice in a row (the sampling time is at least 24 hours apart), so the diagnosis of suspected cases can be ruled out.

3.

Asymptomatic infected person. According to the management of mild cases, centralized isolation medical observation was carried out in Fangcang Hospital for 7 days, 6 and 7 days.

Nasopharyngeal swabs are collected every day for nucleic acid detection (the sampling interval is at least 24 hours). For example, the Ct values of N gene and ORF gene are ≥35 (fluorescence quantitative PCR

Detection method, the threshold is 40, the same below), or the detection is negative (fluorescence quantitative PCR detection method, the threshold is lower than

35, the same below), can lift the centralized isolation medical observation in the hospital; If the above conditions are not met, continue to be isolated in the receiving hospital until it is full.

Step out of the standard. During the period of centralized isolation medical observation, the patient's condition should be well monitored, and after reaching the diagnostic standard of confirmed cases, it should be corrected as confirmed cases in time. 7, after lifting the centralized isolation medical observation, should continue.

Daytime family health monitoring.

4.

Those who are positive for nucleic acid test after discharge (cabin). After the last infected person was discharged from the hospital (cabin), the respiratory tract samples were positive for nucleic acid detection. If there were no symptoms and signs, the nucleic acid detection ct was performed.

Value ≥35, no longer manage and judge close contacts; Such as the Ct value of nucleic acid detection

Value and other dynamic changes to quickly assess its spread risk, if there is a spread risk according to the management of infected people, determine and control its * * * live,

* * * Close contacts with frequent work contacts, etc. , do not need to judge close contact; If there is no risk of transmission, it is judged that there are no managers and close contacts.

Such as fever, cough and other clinical manifestations, or

CT images show that lung lesions are aggravated, and they should be immediately transported to designated medical institutions for classified management and treatment according to the condition. Such as nucleic acid detection Ct

Value ≥35, and there is no need to track and control its close contacts; Such as nucleic acid detection Ct

value

(2) Process control and delineation and control of risk areas (personnel).

1.

Epidemiological investigation. After the outbreak, according to the principle of territorial management, the special class (working group) established by the joint prevention and control mechanism of the city where the medical and health institution reporting the case is located will carry out epidemiological investigation. The on-site diversion team composed of health, disease control, public security and other departments carried out their work according to the division of work.

Take the way of combining on-site traffic adjustment and telephone traffic adjustment, and after being verified and confirmed by the front personnel,

Arrive at the scene within 2 hours, complete the core information investigation of the case within 4 hours, complete the preliminary epidemiological investigation report within 24 hours, and update the epidemiological report dynamically according to the progress of the epidemic. The content and focus of epidemiological investigation should be dynamically adjusted according to the progress and scale of the epidemic.

For early detection, few cases and no continuous spread in the community, it is necessary to quickly carry out accurate epidemiological investigation, conduct detailed investigation on the past contact history and activity trajectory of the cases, clarify the source of infection of the cases, determine close contacts, close contacts, exposed personnel in epidemic-related places and other risk personnel, and delineate risk areas.

When the epidemic situation develops further, the number of cases increases obviously, and the community continues to spread, so it is difficult to clarify the transmission chain. In addition, the community has been designated as a medium-high risk area to implement closed control measures management, and the focus of epidemiological investigation has been adjusted to grasp the basic information of the case, the onset time, and the positive time of the first nucleic acid test. , close contact tracking and epidemic analysis.

For key cases, such as uncontrolled population infection, such as material support personnel, couriers, volunteers, community service personnel, and new infected people in the final stage of effective control of the epidemic, detailed and accurate flow adjustment should be carried out.

2.

Judgment and management of close contacts and other risk personnel. According to the case action trajectory and epidemiological information, with the support of "three public (industrial)" collaborative multi-sector technical means and big data information, public health professionals can quickly and accurately determine close contacts, close contacts and exposed personnel in epidemic-related places. Give priority to identifying and managing close contacts with high risk of infection, such as frequent contact with cases and long duration. For crowded and complicated cases (such as restaurants, entertainment places, supermarkets and other closed space places), the scope of judging close contacts can be appropriately expanded. Close contacts take "7"

Medical observation of centralized isolation in the air +3

Measures for the Administration of Daytime Home Health Monitoring (hereinafter referred to as "7+3" Management Measures), do not go out during home health monitoring, do personal protection when going out for medical treatment and other special circumstances, and try to avoid taking public transport. Centralized isolation of medical observation

1, 2, 3, 5 and 7 days for nucleic acid detection, and on the third day of family health monitoring for nucleic acid detection. When a large-scale epidemic occurs, in order to alleviate the serious shortage of resources in centralized isolation points,

For close contacts, the measures of "centralized isolation medical observation for 5 days+home isolation medical observation for 5 days" can be adopted, and the 1, 2, 3 and 5 of centralized isolation medical observation can be adopted.

Nucleic acid detection was carried out once a day, and the second and fifth days of medical observation were isolated at home.

Perform nucleic acid detection once a day. The isolation management period starts from the last exposure, and returns to the place of residence in a "point-to-point" closed loop after the centralized isolation is lifted.

Living, eating, working (studying) and entertainment (such as chess and cards, Kara) with close contacts with high risk of infection.

OK) Close contact is judged as close contact for a long time. Close contacts should be isolated at home for 7 days, and their body temperature and symptoms should be monitored every day. At 1, 4 and 7,

Perform nucleic acid detection once a day. For example, during the close contact's medical observation at home, the close contact's nucleic acid test is negative, while during the close contact's medical observation, the corresponding close contact's first two nucleic acid tests are negative, which can be in the seventh.

Medical observation of removing home isolation: If the results of the first two nucleic acid tests of close contacts are positive, close contacts will be adjusted to close contacts and managed as close contacts.

If people are exposed in epidemic-related places such as wedding (funeral) banquets, restaurants, supermarkets, shopping malls and farmers' markets that are in contact with suspected cases, confirmed cases and asymptomatic infected people, but they do not meet the principle of close contacts and close contacts, nucleic acid detection measures shall be taken for people with high risk of infection after risk assessment.

3.

Division and prevention of risk areas. After the occurrence of local epidemic, according to the trajectory of cases and asymptomatic infected persons and the risk of epidemic spread, high, medium and low risk areas are delineated.

Domain. Areas where cases and asymptomatic infected people live, as well as workplaces and activities with frequent activities and high risk of epidemic spread, are classified as high-risk areas. High-risk regional principle

Internationally, the residential area (village) is defined as a unit, and the risk area can be adjusted according to the results of traffic survey and judgment, and measures such as "home-to-home service" can be adopted. High-risk area for 7 consecutive years

For three days, no new infection fell to the middle risk area, and for three consecutive days, no new infection fell to the low risk area. Cases and asymptomatic infected people will stay and move for a while.

Workplaces, activity places and other areas that may have the risk of epidemic spread are classified as medium-risk areas, and the scope of risk areas is defined according to the results of flow investigation and judgment. Take "people" in medium-risk areas as an example.

No new infections were reduced to low-risk areas for 7 consecutive days. Other areas in the counties (cities, districts and banners) where the middle and high risk areas are located are low risk.

Area, take "personal protection, avoid gathering" and other preventive measures, people in low-risk areas should stay away from the city 48

Negative proof of hourly nucleic acid test. After all the high-risk areas are removed, all counties (cities, districts and banners) will implement normalized prevention and control measures.

In the process of epidemic disposal, if the risk of individual cases and asymptomatic infected people spreading to their residence, workplace and activity area is low, and close contacts have been controlled in time, and it is judged that there is no risk of community transmission, the risk area may not be delineated.

4.

Investigation and control of risk personnel. When it is found that infected persons, close contacts, close contacts, exposed persons in epidemic-related places and people in middle and high-risk areas flow out of the local area, the local joint prevention and control mechanism should be set to 2.

Hours, through the national epidemic prevention and control management platform or letter, issued a survey list (including identity information, contact number,

Contact information, last exposure time and other information needed for inspection and control), and timely send cross-regional inspection and control information through the established inter-city "point-to-point" cross-regional inspection and control mechanism. After receiving the investigation information, the investigation team will quickly investigate the relevant personnel and take measures such as sending short messages, nucleic acid testing and health monitoring.

Isolation and other control measures, to ensure that the control measures of each risk personnel are put in place, and after receiving the investigation information, 24

The preliminary investigation and control results will be fed back to the epidemic area within hours to form an information closed loop. Non-epidemic areas should also take the initiative to investigate the influx of people in high-risk areas to prevent the spread of the epidemic.

Yes, there are high-risk areas.

For those who have lived in China for 7 days, they were isolated for medical observation for 7 days, and nucleic acid detection was carried out on 1, 2, 3, 5 and 7 days. Right, medium risk area 7

Those who have lived in China for several days will be observed in home isolation medicine for 7 days, with the observation number of home isolation medicine 1, 4 and 7.

Perform nucleic acid detection once a day; Do not have the conditions for home isolation medical observation, take centralized isolation medical observation; The management period starts from leaving the risk area. For those who have lived in low-risk areas for 7 days, 3

Complete nucleic acid detection twice in a few days and do a good job in health monitoring. Measures for the administration of overflow personnel in high-risk areas within the jurisdiction of provinces (autonomous regions and municipalities directly under the Central Government) shall be formulated and promulgated by local governments.

(3) Regional nucleic acid detection.

On the basis of epidemiological investigation, according to the size of the population in the epidemic area, whether the source of infection is clear, whether there is a risk of community transmission, whether the transmission chain is clear, etc., according to the principle of risk size and classification,

Determine the scope, frequency and sequence of the detection population, formulate an operable nucleic acid detection scheme, and quickly organize and dispatch nucleic acid detection forces (including third-party detection institutions)

Avoid the spread of the epidemic caused by delayed detection of positive infected people. Set sampling points reasonably and organize nucleic acid sampling to prevent cross-infection. Based on the risk assessment results,

Dynamically adjust the range and frequency of nucleic acid detection to prevent the spread of the epidemic. When the regional nucleic acid detection capacity is insufficient, antigen detection can be used as a supplement to quickly coordinate the support of nucleic acid detection power.

(4) personnel transfer.

After the local epidemic, the transshipment vehicles should be applauded. Confirmed cases and asymptomatic infected persons should be immediately transferred to designated medical institutions or receiving hospitals for treatment or isolated observation, and negative pressure ambulances should be used as much as possible when transferring.

Close contacts should arrange special vehicles in

Within 8 hours, it will be transported to a centralized isolation place so that it can be separated as soon as possible and quickly. Personnel organization and management should be done well before transshipment.

In accordance with the principle of proximity, rational allocation of centralized isolation points and dispatching vehicles, timely grasp the progress of transshipment, and resolutely put an end to the transshipment of infected people and close contacts. Sit in an orderly manner during transshipment, control the number of people in the same car, keep the interval as far as possible, and strictly implement personal protection and vehicle disinfection measures to avoid cross-infection. Reach the isolation point

After that, do a good job of personnel transfer.

(5) Isolation management.

Reasonable selection of centralized isolation places, in accordance with the "three zones and two channels", that is, isolation zone, work preparation zone (living area and material security zone), buffer zone, staff channel,

The standard setting and standardized management of isolated personnel channels can only be put into use after being evaluated by experts in the fields of hospital infection prevention and control. According to the local 60-year-old resident population.

Reserve enough centralized isolation rooms according to the ratio of/10,000 people, and coordinate with surrounding cities to make good use of isolation resources. After the local epidemic, the provincial joint prevention and control institutions should immediately start the centralized isolation point scheduling and echelon activation mechanism. Workers in isolated places should receive standardized training before taking up their posts, and implement vaccination, health monitoring, nucleic acid detection, personal protection and closed-loop management measures. Do a good job of medical waste disposal and garbage removal in isolated places in strict accordance with the standards. Strictly do single rooms to prevent cross-infection. When the isolation is released, the samples of people, things and environment are simultaneously tested for nucleic acid. If the results are all negative, the centralized isolation can be lifted; If the article or environmental nucleic acid test is positive, the centralized isolation can be lifted only after the possibility of infection by the isolated personnel is ruled out. In principle, the medical staff at the isolation point are responsible for sampling the isolated personnel. When the centralized isolation point is positive, the risk of cross-infection at the isolation point should be investigated in time. The medical observation of home isolation should be carried out under the guidance of community medical staff, living alone or in a single room, using separate toilets as far as possible, doing personal protection and minimizing contact with other family members. My cohabitant and I are not allowed to go out during the medical observation of home isolation. Don't go out during home health monitoring, and do personal protection when going out for medical treatment and other special circumstances, and try to avoid taking public transportation.

(6) Traceability investigation.

For cases with unknown source of infection, quickly carry out traceability investigation, adhere to the same investigation of people, things and environment, and give priority to the source investigation of "person-to-person transmission". Through epidemiological investigation, virus genome sequencing, nucleic acid screening, dynamic detection of serum antibodies and big data, we analyzed and demonstrated one by one from the aspects of people, goods and environment, comprehensively judged the source, transmission route and transmission chain relationship of the virus, and paid close attention to the genetic variation of the virus. If there is evidence that the articles and environment are the source of infection, the methods of first sealing, then sampling and then disinfection should be adopted to avoid the loss of evidence.

(7) disinfection.

In the process of transferring cases or asymptomatic infected persons, the environment and articles that may be polluted by them should be disinfected at any time; After the transfer, carry out terminal disinfection on the residences and activity places that may be contaminated; When leaving the hospital (cabin), personal belongings should be disinfected before being taken out of the hospital (cabin).

In areas where closed control measures are implemented, such as medium and high-risk areas, preventive disinfection is mainly carried out for residential buildings, places (points) for ensuring epidemic prevention materials, garbage storage points, express delivery points and other regional environments. Before disinfection in rural areas and villages in cities, a disinfection plan should be formulated according to the actual situation of local environment and living conditions.

On-site disinfection process evaluation should be carried out to ensure the effectiveness of disinfection process; Disinfection effect evaluation can be combined with on-site demand in proportion to spot check. The final disinfection of the closed isolation point of the final cabin of the shelter hospital needs to be evaluated. See Annex 10 Technical Guide for Disinfection of Epidemic Spots in COVID-19 for details.

(8) Mental health services.

All localities should formulate psychological intervention programs for people affected by the epidemic, sort out local online and offline psychological service resources, and establish and improve psychological intervention teams for epidemic prevention and control. build

Establish and improve psychological specialist classes set up at the municipal level, psychological specialists set up in county-level general hospitals or specialized hospitals, and psychological specialist centers set up in community health service centers (township hospitals).

We should intervene in the "three specialties" service network, establish and improve the psychological hotline service, and strengthen the popularization of mental health knowledge to all kinds of people. When there is a cluster epidemic, increase the heart.

Strengthen health science education, organize mental health and mental health professionals to carry out targeted psychological intervention for patients and their families, isolated personnel, frontline staff for epidemic prevention and control, etc.

(9) Release of epidemic information.

After the outbreak, the local joint prevention and control institutions shall release relevant information such as the epidemic situation and risk areas within 5 hours. The epidemic information shall be based on the data directly reported by the network, and a press conference shall be held no later than the next day, and a daily routine press conference mechanism shall be established. Organize experts in related fields to solve doubts and doubts through media interviews, popularize protection knowledge, and respond to hot issues in a timely manner.