At the end of 2019, a pneumonia outbreak caused by a novel coronavirus in Wuhan disrupted the Spring Festival travel rush in most parts of China.
According to Li Bin, Vice Minister of the National Health Commission, as of 24:00 on January 21, the National Health Commission had received reports of 440 confirmed cases of pneumonia caused by the novel coronavirus from 13 provinces (autonomous regions and municipalities) across the country, with a cumulative total of 9 reported deaths, including 3 new deaths, all of which were in Hubei Province.
The infection of 14 medical staff in Wuhan with the novel coronavirus has touched everyone's hearts.
On January 21, Wuhan Mayor Zhou Xianwang responded to the incident, stating that the cross-infection originated from a neurosurgery patient. The patient was not diagnosed with the infection before admission, and developed a fever after surgery, by which time it was too late.
"This is a profound lesson, and it is related to the fact that our understanding of the dangers and spread of this virus was not at such a high level from the beginning."
For this reason, the treatment guidelines for the novel coronavirus have imposed strict requirements on the protective equipment of medical personnel: masks, goggles, gloves, protective clothing, shoe covers, etc.
As the epidemic in Wuhan continues to spread, comprehensive protective measures for the general public must also be implemented.
Among all populations, changes in the immune system and cardiopulmonary function during pregnancy make pregnant women more susceptible to infectious diseases. In particular, pregnant women and those who contract influenza within two weeks postpartum are more likely to develop complications, even severe influenza, and are prone to pneumonia.
Today (January 22), the "Rapid Guidelines for the Diagnosis and Treatment of Novel Coronavirus Pneumonia" formulated by the expert group of Tongji Hospital affiliated to Huazhong University of Science and Technology also clearly pointed out that the condition of the elderly and pregnant women progresses relatively faster.
This novel coronavirus pneumonia can occur in both immunocompromised and immunocompetent individuals, and is related to the amount of virus exposure. Even with a normal immune system, infection can occur upon exposure to a large quantity of the virus at once.
For people with weakened immune systems, such as the elderly, pregnant women, or those with liver or kidney dysfunction, the disease progresses relatively faster and becomes more severe.
However, people with normal immune function may experience severe inflammatory response after infection, leading to acute respiratory distress syndrome (ARDS) or sepsis, so it should not be taken lightly.
What are the symptoms of novel coronavirus pneumonia?
Pregnant women are already a high-risk group for pneumonia caused by influenza, and the symptoms caused by novel coronavirus infection are similar to those of influenza virus, respiratory syncytial virus, rhinovirus, adenovirus and other viruses that can cause pneumonia.
However, these viral infections have a relatively low probability of causing pneumonia, and the number of cases is relatively small. Therefore, you should not take pneumonia symptoms lightly and should seek medical attention promptly to rule out the possibility of infection.
Clinically, COVID-19 is characterized by fever as the main symptom, which may be accompanied by mild dry cough, fatigue, shortness of breath, diarrhea, etc., while symptoms such as runny nose and sputum are rare.
Patients typically develop respiratory distress after one week, and in severe cases, it can rapidly progress to acute respiratory distress syndrome, septic shock, uncorrectable metabolic acidosis, and coagulation dysfunction.
Some patients have mild symptoms at onset, and may not have fever or other clinical symptoms, and most recover after one week. Most patients have a good prognosis, but a small number of patients become critically ill or even die.
How is COVID-19 treated?
To prevent the flu, many expectant mothers are recommended to get the flu vaccine, but there is currently no specific vaccine or antiviral drug for the novel coronavirus. Treatment still needs to focus on symptomatic and supportive care.
Avoid blind or inappropriate antibiotic treatment, especially the combined use of broad-spectrum antibiotics.
At the same time, glucocorticoids should be used with caution, because these drugs are a double-edged sword against viruses. On the one hand, they can suppress the body's immune function and may lead to viral dissemination. On the other hand, they can reduce lung inflammation and help improve symptoms of hypoxia and respiratory distress.
For patients with mild symptoms, it is recommended to administer antibiotics for community-acquired pneumonia, such as moxifloxacin or azithromycin, intravenously or orally, depending on the patient's condition.
For severely or critically ill patients, empirical antimicrobial agents are administered to treat all possible pathogens.
For patients with sepsis, antimicrobial drugs should be administered within one hour of the initial patient assessment.
The WHO's "2019 Novel Coronavirus Guidelines" state that pregnant women suspected or confirmed to have the novel coronavirus should be treated according to the recommended adult protocol ("Latest Guidelines! WHO 2019 Novel Coronavirus Guidelines (First Chinese Translation) Released!"), while also taking into account the physiological factors of pregnancy.
When using exploratory treatment options, an individual benefit-risk analysis must be conducted, based on the potential benefits to the mother and the safety of the fetus, and consultation with obstetric specialists and ethics committees is necessary. Decisions regarding emergency delivery and termination of pregnancy are based on multiple factors: gestational age, maternal condition, and fetal stability. Consultation with obstetric, neonatology, and ICU specialists is essential, depending on the mother's specific circumstances.
How to prevent COVID-19?
First, choose the right mask. The recommended priority order is: N95 mask = medical protective mask > medical surgical mask > ordinary medical mask > mask without manufacturer information, certification, or quality certification.
When wearing a mask, first check for airtightness. A simple test is to put on the mask and exhale forcefully; air should not leak from the edges of the mask. Second, do not touch or squeeze the mask with your hands to prevent virus contamination. Finally, change the mask promptly (every 2-3 days; change immediately if contaminated).
Secondly, choose appropriate prevention and disinfection methods, and do not believe or spread rumors.
Since the outbreak of the Wuhan pneumonia, there have been increasing calls to hoard Banlangen (Isatis root) and fumigate with vinegar, which were even touted as a "golden combination" for prevention.
A message that Academician Zhong Nanshan suggested gargling with salt water to prevent the virus circulated widely, but Zhong Nanshan's team had to come out and refute it: the novel coronavirus invades the respiratory tract, and gargling cannot clean the respiratory tract.
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Based on previous studies on SARS-CoV and MERS-CoV, coronaviruses are sensitive to heat. Maintaining the temperature at 56°C for 30 minutes, or using lipid solvents such as ether, 75% ethanol, chlorine-containing disinfectants, peracetic acid, and chloroform can effectively inactivate the virus.
However, the acetic acid in acetic acid is insufficient to kill the virus, and Banlangen (Isatis root) is ineffective against coronaviruses, as SARS has already proven.
Li Lanjuan, a member of the National Health Commission's expert group and a renowned infectious disease expert in my country, said in an interview: "At home, we now advocate that dishes and chopsticks be disinfected regularly with a sterilizer or boiled to 100℃ to kill other viruses. Therefore, we should eat cooked food and avoid raw food. We should wash our hands before meals and after using the toilet. These are some hygiene tips that we should all learn in our daily lives, and we hope that everyone can do them well."
Finally, it's important to emphasize the importance of personal hygiene and respiratory etiquette. Wash your hands with soap and running water for at least 20 seconds after returning home (refer to the professional seven-step handwashing method used in hospitals). If you don't have access to hand sanitizer, you can use it instead. When you sneeze or cough, cover your mouth and nose with a tissue or your elbow, and avoid rubbing your eyes immediately.
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