Nội dung toàn văn Decision 343/QD-BYT 2020 promulgation of Interim Guidelines for monitoring prevention of COVID-19
MINISTRY OF HEALTH
SOCIALIST REPUBLIC OF VIETNAM
Hanoi, February 07, 2020
PROMULGATION OF “INTERIM GUIDELINES FOR MONITORING, PREVENTION AND CONTROL OF COVID-19”
THE MINISTER OF HEALTH
Pursuant to the Government's Decree No. 75/2017/ND-CP dated June 20, 2017 defining functions, tasks, entitlements and organizational structure of the Ministry of Health;
Pursuant to the Prime Minister’s Decision No. 173/QD-TTg dated February 01, 2020 on declaration of nCoV epidemic;
At the request of Director of General Department of Preventive Medicine - the Ministry of Health,
Article 1. “Interim Guidelines for monitoring, prevention and control of COVID-19” is promulgated together with this Decision.
Article 2. “Interim Guidelines for monitoring, prevention and control of COVID-19” shall be applied at preventive medicine facilities and other health facilities nationwide.
Article 3. This Decision comes into force from the day on which it is signed and replaces Decision No. 181/QD-BYT dated January 21, 2020 on promulgation of “Interim Guidelines for monitoring, prevention and control of COVID-19”.
Article 4. Chief of the Ministry Office, the Ministerial Chief Inspector, Directors of Departments of the Ministry of Health, Directors of Institute of Hygiene and Epidemiology and Pasteur Institutes; heads of health departments of other ministries and relevant units are responsible for implementation of this Decision./.
MONITORING, PREVENTION AND CONTROL OF COVID-19
(Promulgated together with Decision No. 343/QD-BYT dated February 07, 2020 of the Ministry of Health)
I. GENERAL CHARACTERISTICS
COVID-19 (previously known as 2019-nCoV) is a Group A acute contagious disease. WHO’s declaration of public health emergency has caused international concern about this disease. First cases are discovered in Wuhan city of China on December 03, 2019. By the end of February 06, 2020, there have been 28.276 nCoV cases in 28 countries and territories with 565 deaths, Including 28.018 cases in 31/31 provinces and cities of China with 563 deaths. This disease is transmittable between humans. The incubation period is about 14 days. Symptoms include fever, cough, shortness of breath; may cause serious pneumonia, acute respiratory failure and death, especially in people with chronic diseases. Detection of the disease can be hard due to unclear symptoms in certain cases. In Vietnam, there have been confirmed cases of people from affected area of China and contracted in Vietnam. There have been no cure and vaccine for this disease.
This document contains guidelines for provincial authorities and relevant units on monitoring, prevention and treatment of the disease according to epidemic situation.
1. Definitions of suspected cases, confirmed cases, close contacts and other probable cases
1.1. Suspected cases
A suspected case is a person who is suspected of COVID-19 infection if he/she has at least one of the symptoms including fever, cough, shortness of breath or pneumonia, and:
- Enters Vietnam from or through China within 14 days from the date of entry;
- Enters Vietnam from another affected country or territory other China (according to information from WHO and the Ministry of Health) and has been in close contact with a person with suspected or confirmed COVID-19 infection within 14 days before onset of symptoms.
- Has gone to, stayed in or returns from an cluster in Vietnam within 14 days before onset of symptoms; or
- Has close contact with a person with confirmed or suspected COVID-19 infection in Vietnam within 14 days before onset of symptoms.
1.2. Confirmed cases
A confirmed case is suspected case who tests positive for COVID-19.
1.3. Close contacts (within 2 meters from a person with a confirmed case or with a suspected case having symptoms) include
a) Health workers who directly involve in epidemiological investigation, collect specimens, perform tests, provide care or treatment for people with confirmed or suspected infection; health workers and other attendants who have contact with people with confirmed or suspected infection or enter treatment rooms of people with suspected or confirmed infection during performance of their duty.
b) People in the same household as a confirmed case or a suspected case while having symptoms.
c) People working or staying in the same room as a confirmed case or a suspected case while having symptoms.
d) People in the same travel group, working group or team, and any person having close contact with a confirmed case or suspected case while having symptoms.
e) People sitting in the same row, the next two rows in the same road/rail/air trip as a confirmed case or suspected case while having symptoms.
1.4. Other probable cases
a) People entering Vietnam from or through Hubei province of China within 14 days from the date of entry.
b) People entering Vietnam from or through China (except Hubei province) within 14 days from the date of entry.
2.1. A cluster means a specific geographical area (neighborhood, village, unit, etc.) that has 1 confirmed case or more.
2.2. A cluster is considered eliminated when there are no new cases for 21 days from the last confirmed case.
3. Monitoring contents
3.1. Where there is no confirmed case in a province
Suspected cases should be detected, quarantined and tested as soon as practicable. Monitoring contents include:
- Combine monitoring at border checkpoints with monitoring at health facilities and in communities, especially at border checkpoints for inbound travelers from China and affected countries and territories by taking body temperature, observation and other methods as instructed in Appendix 1 and Appendix 2.
- Monitoring, epidemiological investigation, testing of specimens from suspected cases according to Forms 1, 2 and 3 enclosed herewith.
- Monitoring close contacts and other probable cases for 14 days from the last date of contact
- Monitoring through early detection of suspected cases.
- Reporting according to 3.5 of this document.
3.2. Where there is a confirmed case and the disease has not widely spread in the province
Detect new confirmed cases in communities and health facilities; organize quarantine and treatment to eliminate clusters; minimize the spread of the disease. Monitoring contents include:
- Continue monitoring to detect suspected cases at border checkpoints, health facilities and communities as instructed by the Ministry of Health in Appendix 1 and Appendix 2.
- Monitoring, epidemiological investigation, testing of specimens from all suspected cases according to Forms 1, 2 and 3 enclosed herewith.
- Monitoring close contacts and other probable cases for 14 days from the last date of contact
- Enhanced monitoring of suspected viral pneumonia at health facilities; monitoring through early detection of suspected cases in communities. Specimens from these cases must collected and tested for COVID-19/
- Reporting according to 3.5. of this document.
3.3. In case of widespread transmission of the disease
Widespread transmission is when there are more than confirmed cases in 02 districts, district-level cities or district-level towns (hereinafter referred to as “districts”) or more in 30 days
Ensure early detection and elimination of new clusters while maintaining control of existing clusters; minimize the spread of the disease. Monitoring contents include:
- Continuous monitoring to detect suspected cases at border checkpoints, health facilities and communities as instructed by the Ministry of Health in Appendix 1 and Appendix 2.
- In unaffected districts: carry out monitoring, epidemiological investigations, collect and test specimens from suspected cases according to Form 1 to 3 enclosed herewith.
- In districts that have confirmed cases:
+ Carry out monitoring, epidemiological investigation, collect of specimens from at least 5 first confirmed cases of the new cluster. Next cases shall be tested as requested by Epidemiology Institutes and Pasteur Institutes.
+ Suspected cases in clusters shall be considered confirmed cases and subject to epidemic control measures.
- Close contacts and other probable cases shall be closely monitored for 14 days from the last date of contact
- Enhance monitoring of suspected viral pneumonia at health facilities. Specimens from these cases must be collected and tested for COVID-19.
- Submit reports according to 3.5 of this document.
3.4. Collection, preservation and transportation of specimen: See Appendix 3 hereof
3.5. Communication and reporting
- Submit reports in accordance with regulations of the Ministry of Health. To be specific:
+ Disease control centers of provinces shall list and monitor health status of every confirmed case, suspected cases, close contacts and other probable cases in their provinces; submit daily reports (Form 7) and lists of confirmed cases and suspected cases (Form 4) to Epidemiology Institutes and Pasteur Institutes before 20:00.
+ Epidemiology Institutes and Pasteur Institutes shall list and monitor health status of every confirmed case, suspected cases, close contacts and other probable cases in their areas; submit daily reports (Form 7) and lists of confirmed cases and suspected cases (Form 4) to General Department of Preventive Medicine before 9:00 of the next day.
+ General Department of Preventive Medicine shall submit reports on confirmed cases, suspected cases, close contacts and other probable cases to the Office of the Ministry of Health before 10:00 of the next day, according to which the Ministry of Health shall submit a consolidated report to the National Steering Committee.
- Publish information and submit Group A infectious disease reports in accordance with the Law on prevention and control of infectious diseases; Circular No. 54/2015/TT-BYT dated December 28, 2015 on declaring and reporting infectious diseases.
- Epidemic declaration shall be made and withdrawn in accordance with the Prime Minister’s Decision No. 02/QD-TTg dated January 28, 2016.
III. PREVENTIVE MEASURES
1. Non-specific preventive measures
The people, on their own initiative, should apply the following preventive measures:
- Avoid going to affected areas. Avoid crowds. In case a crowd is unavoidable, personal protective measures such as wearing facemasks and washing hands with soap, etc. should be applied.
- Avoid direct contact with people with acute respiratory diseases (fever, cough, shortness of breath); where facemasks properly and maintain a 2-meter distance when contact is necessary.
- People having fever, cough, difficult breathing shall inform the nearest health facility for advice, diagnosis and treatment. Inform the health facility by phone of the symptoms and recent travel details; avoid crowds. Students who have symptoms or are suspected of having the infection should not go to school and should inform the health authority.
- Maintain personal hygiene; frequently wash hands in water stream with soap or common antiseptic solution for at least 20 seconds; use mouthwash; avoid placing hands on eyes, nose and mouth to avoid infection.
- Cover the mouth and nose when coughing or sneezing, best with a cloth or napkin or sleeve to minimize spread of respiratory fluids. Do not spit in public places.
- Ensure food safety, only eat cooked food.
- Do not buy, sell or come into contact with wild animals.
- Keep the body warm; improve health by eating, resting, exercising and healthy lifestyle.
- Increase ventilation in houses by opening doors and windows; avoid using air conditioners.
- Frequently clean the floor, door knobs, surfaces in houses and offices, schools and factories, etc. with soap and common detergents or other antiseptic solutions as instructed by health authorities.
2. Specific preventive measures
There have been no specific preventive measures for this disease.
3. Quarantine at borders
- Monitor and request inbound travelers to make health declarations in accordance with the Government's Decree No. 89/ND-CP dated June 25, 2018.
- Quarantine and health measures at border checkpoints for infectious diseases shall be carried out in accordance with the Government's Decree No. 101/2010/ND-CP.
4. Ensure adequacy of supplies, chemical and equipment in case of an outbreak.
IV. EPIDEMIC CONTROL MEASURES
1. Implement the preventive measures specified in (III)
2. Implement the following measures:
2.1. For confirmed cases and suspected cases
- Implement strict quarantine and treatment at health facilities to minimize complications and deaths. Minimize movement of patients except when strictly necessary to avoid transmission of the disease. The quarantine shall last until the patient recovers and is discharged from hospital.
- Wear facemasks properly when having contact with other people to avoid spreading the disease.
- Treatment shall be provided according to instructions of the Ministry of Health. Dead bodies shall be processed in accordance with Circular No. 02/2009/TT-BYT dated May 26, 2009 on hygiene in burial and cremation.
2.2. For close contacts and other probable cases
a. Health workers
- Always use personal protective equipment such as medical facemasks, goggles, gloves, protective clothing, shoe covers, etc. when coming into contact with patients;
- Wash hands with soap and antiseptic solution before and after every visit to a patient and the patient room.
- Avoid close contact (less than 2 m) and minimize duration of contact with patients.
- Compile a list to monitor daily health status of health workers coming in close contacts with patients.
- Health workers who have symptoms shall be put in quarantine and tested as prescribed.
- Health workers who are pregnant or have a chronic disease (bronchial asthma, chronic pulmonary heart disease, renal failure, liver failure, heart failure, cancer, diabetes mellitus, immunodeficiency, etc.) should avoid physical contact with patients.
b. For close contacts mentioned in 1.2.b, c, d, e of Part II and other probable cases mentioned in 1.4.b of Part II:
- Carry out investigation and compile a list of close contacts and other probable cases. The list shall contain their names, addresses, personal phone numbers.
- Health authorities shall call, send message or otherwise contact other probable cases without close contact (people in the same road/rail/air trip, meeting, travel group, etc. with a person with confirmed infection) to instruct them to implement home isolation, monitor their own health and inform health authorities when having symptoms.
- Home isolation shall be implemented as instructed by the Ministry of Health.
2.3. In patients’ households:
- Implement the preventive measures specified in III.1
- Maintain hygiene and ventilation of the house; frequently clean the floor, doorknobs and surfaces in the house with common detergents such as soap and other antiseptic solutions.
2.4. In communities, schools, factories and offices
- Implement the same preventive measures as households.
- Closure of schools, offices, factories, construction sites shall be decided by the President of the People’s Committee of the province in consideration of epidemic situation in the area, with account taken of socio-economic impacts of such decision.
- Avoid formation of crowds, especially at festivals; consider postpone festivals; special cases should be commented by with the Prime Minister; reduce the scale of ongoing festivals; use facemasks as recommended by the Ministry of Health: health people without symptoms of respiratory disease do not have to wear facemasks or can use cloth facemasks.
- People with confirmed or suspected infection shall be promptly kept in quarantine at health facilities.
- Inbound travelers from or through Hubei province of China shall be quarantine at quarantine zones assigned by the People’s Committees of provinces as instructed by the Ministry of Health.
- Home isolation shall apply to inbound travelers from or through China (except Hubei province) within 14 days from the date of entry and close contacts as instructed by the Ministry of Health.
- Cooperate with competent authorities in assurance of security and order at quarantine zones.
2.6. Prevention of infection at treatment facilities
Apply patient classification; quarantine and treat patients, apply infection prevention measures for health workers and caretakers of patients and other patients at the same facility treatment as instructed by the Ministry of Health.
2.7. Sterilization and environmental recovery in clusters
- The patient’s home and adjacent houses shall be sterilized by cleaning the floor, doorknobs and surfaces with 0,5% active chlorine solution. The amount of solution will vary according to the seriousness of contamination in the cluster.
- The means of transport of the patient shall also be sterilized with 0,5% active chlorine solution.
- Other relevant areas shall be washed or sprayed with 0,5% active chlorine solution as decided by epidemiological officials based on epidemic situation. Every contaminated area and areas suspected of or at risk of contamination shall be sterilized.
The Ministry of Health shall keep updating and revising these guidelines according to the epidemic situation, results of epidemiological investigations and epidemiological studies, virological studies, clinical symptoms and recommendations of WHO./.
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