Published by

SCPG Publishing Corporation

125 Maiden Lane #14E
New York，NY，10038
USA
Original title：新型冠状病毒感染的肺炎学生防护读本
Prevention and Protection Handbook against COVID-19

Originally published in Chinese by Shanghai Scientific &

Technological Education Publishing House Co., Ltd., 2020
Copyright © 2020 by SCPG Publishing Corporation
This is an Open Access ebook published by SCPG Publishing
Corporation. It is distributed under the terms of the Creative
Commons Attribution-NonCommercial 4.0 (CC BY-NC) License.
COVID-19 pneumonia was prevalent in China in January 2020
and now is spreading almost all around the world. This book aims
to help the public better understand the knowledge about the novel
coronavirus, and guide them to protect themselves effectively as well.

ISBN：978-1-938368-47-9 (Paperback)
978-1-938368-48-6 (E-book)
Contents

Part Ⅰ General Knowledge

1. What are coronaviruses? / 01
2. What is 2019-nCoV? / 03
3. How can 2019-nCoV spread to human? / 04
4. What is the infectivity of 2019-nCoV? How long is
the incubation period? / 05
5. Who are susceptible to 2019-nCoV? / 05
6. How can 2019-nCoV be transmitted? / 06
7. How long can 2019-nCoV survive in vitro? / 07
8. What's the clinical symptom when people infected
with 2019-nCoV? / 08
9. What's the difference among COVID-19, common
cold and influenza? / 09
10. Is there any vaccine for COVID-19? / 11
11. What kind of infectious disease does the
COVID-19 belong to? / 12
12. What are the preventive treatment measures to
deal with the epidemic of infectious diseases? / 13
Part Ⅱ Coping Strategies
1. What precautions should be taken to prevent
COVID-19? / 15
ⅰ
2. How to choose a mask? / 18
3. Appropriate masks management / 19
4. What are the situations to change a mask? How to
dispose of a used mask? / 20
5. How to wash hands appropriately? / 21
6. How to disinfect properly at home? / 23
7. How to disinfect properly on campus? / 24
8. Is it necessary to disinfect your daily articles, coats
and other personal objects? / 24
9. How to keep healthy living habits at home? / 25
10. Why we need to ban the consumption of wild
animals? / 26
11. How to pay attention to our diets? / 28
12. How to boost immunity to prevent respiratory
diseases? / 29
13. What should we do when there is a suspect case of
COVID-19 around? / 30
14. How to take care of yourself when going out
during the epidemic? / 30
15. What should people do before returning to their
place if they have a history of residence or travel in a
high-risk area? / 32
16. What should students pay attention to before and
after returning to campus? / 32

ⅱ
17. How to collaborate with school or company to
prevent and control the epidemic? / 34
18. How to view the epidemic in a scientific and
rational way? / 35
19. How individuals adjust psychologically during the
epidemic? / 35
Part Ⅲ Methods of Treatment
1. What to do when there are suspicious symptoms of
the COVID-19 ？ / 37
2. What are the differences between the COVID-19
and the common pneumonia? / 38
3. How to diagnose COVID-19? / 38
4. What is the treatment of the COVID-19? Can it be
cured? / 39
5. Why patients with COVID-19 are required to be
isolated? / 40
6. Why we need to prevent "super-spreader"
events? / 40
7. Who are close contacts with patients? / 41
8. What is medical observation? / 42
9. Who need medical observation? / 43
10. Will the cured COVID-19 patients get reinfection
rapidly? / 43

ⅲ
Part Ⅳ Dispelling Rumors
1. Are young people unlikely to be infected by 2019-
nCoV? / 44
2. Can Radix Isatidis defend against the COVID-19? / 45
3. Can simmering vinegar prevent COVID -19? / 45
4. Does smoking prevent viral infection? / 46
5. Can we drink spirits to fight against coronavirus? / 47
6. Can salt water kill the virus? / 47
7. Can taking antibiotics in advance prevent
COVID-19? / 48

ⅳ
 Part Ⅰ
General Knowledge

1 What are coronaviruses?

Coronaviruses are a large family of viruses in the natural
world. They have small sizes, only 100 nanometers or so
in diameter, and can only be visible under the electron
microscopes. A coronavirus has a roughly spherical
shape and has many protuberances on its surface. If we
put the coronavirus on a football, we cannot see the
spikes unless the football is enlarged to the moon size.
Do spikes of coronaviruses look like a crown? Yes.
Because of their characteristic crown-like appearance,
the coronavirus (abbreviation: CoV) is named after
corona, which means any structure that resembles a
crown in shape.
Coronavirus is an RNA virus, which has one single outer
membrane enveloping several genes. It is easy to mutate
because its genetic material is a single-stranded RNA.

8
There is a cluster of members in the coronavirus family.
Only six kinds of coronaviruses infecting human beings
had been found before December 2019. Four of them
make people mild symptoms of common cold, and
generally recover within two weeks. But the other two
are violent infections, once infected, they can cause
serious respiratory diseases. One is named severe acute
respiratory syndrome virus (SARS-CoV), which caused
the SARS epidemic in China in 2003; the other one is
named Middle East respiratory syndrome virus (MERS-
CoV), which was first found in the Middle East in 2012.
【Links】
Coronavirus is an important pathogen that mainly
causes respiratory and gastrointestinal diseases. In
1937, a coronavirus was firstly isolated from a chicken,
which caused avian infectious bronchitis. This virus
can seriously damage the poultry species, which has
a diameter of 60-200 nm, and is polymorphous, suck
like, sphere or ellipse.
So far, scientists have found about 15 types of different
coronaviruses. They can infect mammals such as mice,
dogs, cats, wolves, horses, pigs and cows, as well as
chickens and other birds.
The human coronavirus was first detected from a nasal
sample of patient with common cold in 1960s. Under
the electron microscope, it has been found that the virus
9
has the coronal structure on its outer surface and it has
spines on the viral membrane. The whole virus is like a
corona. The spinous process of different coronaviruses
has obvious differences. There are tubular inclusions in
cells infected with coronavirus sometimes.

2 What is 2019-nCoV?
At the end of 2019, a novel coronavirus was identified
as the cause of a cluster of pneumonia in Wuhan, the
provincial capital of Hubei China. It rapidly spreads,
resulting in an epidemic throughout China and a threat
of global pandemics. The World Health Organization
(abbreviation: WHO) designates this new virus as 2019-
nCoV and the disease as COVID-19.
2019-nCoV is a novel coronavirus that had never been
found in humans before. It belongs to the family of
coronavirus, which associates with SARS-like CoV.
10
Full-genome sequencing indicated that the coronavirus
that causes COVID-19 is different from both SARS-
CoV and MERS-CoV. The relationship between them is
just like brothers and sisters in a big family. Every person
has his/her own temper, manner and attitude. Similarly,
these viruses also have different manifestations and they
are so different genetically.

3 How can 2019-nCoV spread to human?

The novel coronavirus’ transmission mechanisms is
incomplete currently. Studies show the spread of 2019-
nCoV may be similar to SARS-CoV whose hosts are
bats. And the routes of transmission are likely to be
the same: they are likely transmitted among birds and
mammals, with bats being host to the largest variety of
genotypes. Finally, human beings become the infectors
after touching these wild animals carrying the virus.
Person-to-person spread is thought to occur mainly via
patient with COVID-19. Transmission of 2019-nCoV
from asymptomatic individuals has been reported.
What are natural host and intermediate host?

Natural host is a kind of organism that provides a long-

term and stable parasitic environment for pathogens,
but it will not cause disease due to the infection of the
pathogen itself. As the name suggests, intermediate
host is the host in the intermediate stage. It can also
11
provide nutrition and protection for parasites, but
only temporarily. The intermediate host often acts as a
medium to "transport" the pathogen to the "terminal",
that is, the final host.

4 What is the infectivity of 2019-nCoV? How

long is the incubation period?
The novel coronavirus has a certain intensity of
transmission. Theoretically, one patient can transmit the
virus to 2-3 individuals without safety precautions. 2019-
nCoV is not limited to limited human transmission
but can continue to be transmitted to humans. The
incubation period for 2019-nCoV is thought to be
within 14 days following exposure, with most cases
occurring approximately 3-7 days after exposure. It may
also be contagious during the incubation period.

5 Who are susceptible to 2019-nCoV?

People are generally susceptible to 2019-nCoV. The
elderly and those with basic diseases are seriously ill after
exposure, and there is evidence to children and babies
infected with 2019-nCoV. Pneumonia caused by the
novel coronavirus can occur in immunocompromised
and immune competent population, which is related to
the amount of virus exposed. In case of a lot of viruses
are exposed at once, there is a high risk of infection even
12
if people have normal immune function, which means
whether infected mainly depends on the chance of
contact. In the same exposure opportunities, the elderly,
people with chronic diseases or people with abnormal
immune function are susceptible to be infected.

6 How can 2019-nCoV be transmitted?

Person-to-person spread is thought to occur mainly via
respiratory droplets and contact. However, given the
current uncertainty regarding transmission mechanisms,
spreads via air and stool specimens remain unknown.
A. respiratory droplets transmission
Generally, droplets are defined that watery particles with
a diameter greater than 5 microns. The droplet particles
are easy to settle, and bigger ones will not be suspended in
the air for a long time. The droplets can enter the mucosal
surface within a short distance (generally 1-2 m). Daily
face-to-face talking, coughing, and sneezing can cause
droplets to spread. Therefore, wearing a mask seems an
effective prevention, as well as keep your distance from
others as much as possible (at least 1-2 m).
B. Contact transmission
Contact transmission includes direct contact and
indirect contact.

13
Direct contact transmission refers to the transmission of
the virus through direct contact of mucous membrane
or skin. If there are symptoms of suspected infection,
kissing is not recommended, including the custom of
kissing cheeks with simple greetings.
Indirect contact transmission refers to the transmission
caused by touching contaminated objects that
something with the virus on. If hands are contaminated
by feces (such as stool, which has been still unsure) or
secretions (such as droplets accompanied by coughing
and sneezing), or daily necessities (learning supplies,
bedding, toys, tableware, clothing and etc.) are touched
by hand which has been contaminated, then the
contaminated hand touches the nose, mouth and eyes,
the virus will be able to enter the body through mucous
membranes. Therefore, washing your hands frequently
is the most important precautionary measure.

7 How long can 2019-nCoV survive in vitro?

After all, 2019-nCoV is a novel coronavirus we never
really knew before. The knowledge and information
about the new virus is still very limited on account of
the absence of authoritative researches. Owing to the
highly correlated heredity between 2019-nCoV and
SARS-CoV, we can read lots of research outputs and
documents about SARS-CoV as a reference.
14
• Survive about 48 hours on the surface of non-water-
absorbing materials
• Survive about 6 hours on the surface of water-
absorbing materials
• Survive more than 48 hours in tap water
These show that SARS-CoV is not resistant to drying.
It has different survival time in different humidity
environment. In dry situations, the survival time of
SARS-CoV does not exceed 24 hours.
The novel coronavirus has a similar structure to SARS-
CoV, so the survival time of 2019-nCoV on the surface
of the article can be referenced to the data of SARS-CoV.
That is to say, in the door handle, elevator keys and other
parts, 2019-nCoV can survive for almost 48 hours.

8 What's the clinical symptom when people

infected with 2019-nCoV?
Fever, fatigue, and dry cough are the major
manifestations of human infection with the 2019-
nCoV, and a few patients have symptoms such as nasal
congestion, runny nose, and diarrhea. Severe cases often
have dyspnea after one week, and severe cases get worse
rapidly to acute respiratory distress syndrome, septic
shock, metabolic acidosis and coagulopathy.

15
It is worth noting that a few severe and critically ill
patients only have a low-grade fever, even without
obvious fever during the course of the syndrome.
Some patients only have a low fever, slight fatigue, no
pneumonia manifestations, and usually recover after one
week.
9 What's the difference among COVID-19,
common cold and influenza?
A. Common cold
"Common cold" generally refers to upper respiratory
tract infections that mainly manifest nasopharyngeal
symptoms caused by cold, fatigue, etc. It's a common
acute upper respiratory tract viral infectious disease.
Symptoms of colds are mainly nasal congestion, runny
nose, sneezing, no obvious fever, no obvious changes in
physical strength or appetite. There are few symptoms
such as headache, joint pain, and general discomfort.
People with colds usually have severe upper respiratory
symptoms, but mild systemic reaction, and they are not
life threaten. After 1 to 2 weeks, most patients recover
themselves and symptoms disappear. Colds can occur
all year round, frequently in winter and spring, but there
will be no pandemic.
B. Seasonal influenza
Seasonal Influenza, called flu for short, refers to an acute
16
respiratory disease caused by an influenza virus infection,
which not only infects the upper respiratory tract, but
also causes lower respiratory tract infections, also known
as pneumonia. Influenza patients have an acute illness,
severe symptoms, and systemic symptoms. Common
symptoms for high fever, the body temperature may
rise above 39℃ at the beginning within a day or two,
and symptoms such as headache, muscle aches, fatigue,
and loss of appetite are obvious. The elderly, children,
obese, pregnant women or people at high risk such as
basic diseases may have severe pneumonia. Patients with
milder symptoms can recover themselves within 3 to
14 days, while severe patients can be life-threatening or
even die.
There is often an epidemic of the flu in the winter and
spring, commonly types of seasonal influenza-A and
B. Influenza viruses are easy to mutation and are highly
contagious. They are generally transmitted through
droplets and contact. The population is generally
susceptible and it has a high incidence. It is an important
public health issue of global concern.
C. COVID-19
The symptoms of COVID-19 pneumonia are diverse.
Asymptomatic carriers of 2019-nCoV do not get sick,
and the virus is detected only in the respiratory tract.
17
Mild patients have only a slight fever, cough, chills,
and physical discomfort. Severe patients have a gradual
illness by a process of exacerbation. Early symptoms,
especially in first three to five days, are mainly fever,
cough, and increasing fatigue. After one week, the
condition gradually worsens and develops into
pneumonia, or even severe pneumonia, with accelerated
breathing, respiratory failure, and multiple organs
injuries, etc.

10 Is there any vaccine for COVID-19?

The 2019-nCoV is a newly discovered virus, and there
are currently no vaccinations against infection. Scientists
at home and abroad have started to research and
develop vaccine and made significant progress. But just
as the development of new drugs will take a long time, a
kind of new vaccines is also difficult to come out in the
short term. Because of the absence of effective vaccines,
active isolation and cut-off transmission are still one
of the most effective measures against COVID-19
epidemic.

18
 11 What kind of infectious disease does the
COVID-19 belong to?
In January 20th, 2020, approved by the State Council,
COVID-19 has been embodied into the Law of the
People's Republic of China on Prevention and Control
of Infectious Diseases as B class infectious, but the level
of precaution according to A class.
【Links】
The Law of People's Republic of China on the
Prevention and Treatment of Infectious Diseases
divides infectious diseases into 3 classes: A, B and C.
Class A infectious refers to plague and cholera.
Class B infectious refers to COVID-19, AIDS, viral
hepatitis, poliomyelitis, human infection of highly
pathogenic avian influenza, measles, epidemic
hemorrhagic fever, rabies, epidemic encephalitis
B, dengue fever, anthrax, bacterial and amebic
dysentery, tuberculosis, typhoid fever and paratyphoid
fever, epidemic cerebrospinal meningitis, pertussis,
diphtheria, neonatal tetanus, scarlet fever, brucellosis,
gonorrhea, syphilis, leptospirosis, schistosomiasis,
malaria.
Class C infectious refers to influenza, mumps, rubella,
acute hemorrhagic conjunctivitis, leprosy, epidemic
19
and endemic typhus, kala azar, hydatidosis, filariasis,
infectious diarrhea other than cholera, bacterial and
amoebic dysentery, typhoid and paratyphoid.

12 What are the preventive treatment measures

to deal with the epidemic of infectious diseases?
China has established a relatively complete response
system to prevent an outbreak of infectious diseases.

inspection and diagnosis authoritative information

isolation and treatment disinfection and medical observation

transport confirmed cases epidemiological survey

20
Health administrative departments, disease prevention
and control institutions and medical institutions will be
in accordance with relevant emergency plans, organize
and mobilize forces to work together to prevent the
spread of infectious diseases and reduce the hazard.

21
 Part Ⅱ
Coping Strategies

1 What precautions should be taken to prevent

COVID-19?
A. Reduce activities outside as much as possible
• Keep away from epidemic areas.
• Reduce family visit, no gathering together.
• Avoid going to crowded public places, especially those
with poor air mobility.
B. Pay attention to personal protection
• Wear a mask when you go out.
Put a medical surgical or N95 mask on when go to see a
doctor by public vehicles.
• Keep hand hygiene at anytime.
Reduce frequency of touching public items. Wash hands
with hand sanitizer or soap. If soap and water are not
22
available, use hand antiseptic rinse free gel.
Avoid touching your eyes, nose and mouth with
unwashed hands. Cover your mouth and nose with a
tissue or your elbow instead of covering your mouth by
hand when you sneeze or cough.
One of the best ways to prevent the spread of illness is to
wash hands frequently. The most effective way to do is
to wash your hands if visibly dirty, after returning from
outside, using the toilet, before eating, before and after
preparing food, after blowing your nose, coughing or
sneezing.
Teach children to throw away the tissue and wash hands
immediately.

• Pay attention to personal hygiene.

Take a shower regularly. Wash hands after returning
from outside meanwhile remember to clean nose and
23
mouth. Change clean underwear and coat regularly.
C. Carry on health monitoring and seek medical care
early
• Prepare a thermometer at home. Have a daily health-
check and report to the assigned administrator of
community or school as required.
• Go to a hospital as near as possible if you have fever,
cough, sore throat, chest pain, respiratory distress,
fatigue, nausea, vomiting, diarrhea, conjunctivitis,
muscle ache, respiratory symptoms and report to your
school actively.
D. Pay attention to home hygiene and health
• Clean and disinfect frequently touched household
objects and surfaces in your house. Improve room
ventilation by opening windows as much as possible.

• Maintain touched household objects and table wares

clean. Frequent drying of clothes and quilts, timely
24
taking out the trash. Sterilize home indoor environment
with an alcohol-based disinfectants.
• Pay attention to food safety and keep healthy diet habits.

2 How to choose a mask?

• If you are healthy, you only need to wear a mask
when take care of a suspected patient with 2019-nCoV
infection.
• Wear a mask if you have coughing or sneezing.
• Before wearing a mask you must wash your hands
clean by alcohol-based hand rub or soap.
• If you wear a mask, then you must know how to put it
on and dispose of it properly.
2019-nCoV is mainly transmitted through respiratory
droplets. Wearing masks is an effective means to block
the spread of respiratory droplets.
The protection ranks of masks(from high to low): N95
mask > surgical mask> medical mask > cotton mask。
Wearing Surgical or N95 masks is the preferred choice
to prevent 2019-nCoV infection.
Wearing a standard medical mask is one of the
prevention measures to limit spread of certain respiratory
diseases. To some degree, masks do function as a barrier
25
to pathogen avoiding inhalation of the mouth and nose,
owing to the hydrophobic layer of the surface of the
medical surgical mask. In high risk situations, such as in
health care facilities, or need to contact the sick directly,
N95 mask can provide a relatively adequate level of
protection and other equally relevant measures should
be adopted.
There are two types of N95 mask depends on breathing
valve. N95 has breathing valve can only prevent the
wearer according to the one-side protection, which is
unsuitable in public under 2019-nCoV outbreak now.
3 Appropriate masks management
(1) Wash your hands at first.
(2) Identify front and behind, up and down of a mask.
The light-colored side is behind, the dark-colored side is
front, and the edge with metal strip is upside.
(3) Avoid touching the inside face of the mask when wearing.
(4) Cover mouth and nose by extend the folded surface
completely.
(5) Press the nose clip to make sure the mask wearing
seamlessly.
All kinds of masks can only isolate the virus on the
surface of the mask. While in use, avoid touching the
26
mask. Squeezing a humid mask by hand may bring the
risk of infection.
Do not touch the outer and inner surfaces but remove
the lace from ears carefully.

4 What are the situations to change a mask? How

to dispose of a used mask?
Change a single-use surgical mask every 4 hours, and
6-8 hours for N95 mask. Change your mask as soon as
possible in following situations:
• Respiratory distress
• Masks be worn
• Masks leakage
• Masks are contaminated（blood or respiratory
secretions）
• Used in isolation ward or close contact with sick
• Smelly

27
Pathogens stick on a used mask when in the same room
with the affected individual. Dispose of the material
immediately in a plastic bag after using instead of
putting it in your bags or pockets. Then throw the bag
into dry bin or special bin. After that, wash your hands
immediately.

5 How to wash hands appropriately?

2019-nCoV can be transmitted through contacts.
Washing hands is the effective way for prevention.
Advise to wash hands in following situations:
• Returning from outside
• Before eating
• Before and after toilet
• Before wearing and after taking off a mask
• After touching respiratory secretions, including
covering mouth and nose when coughing or sneezing
with disposable paper tissue
• Handle wound before and after
• After touching animals, animals' food and excreta
• After disposing rubbish and visible soiled Perform
hand hygiene frequently, using soap, hand sanitizer and
flowing water or at least 60% alcohol-based hands free
disinfectant if soap and water are not available.
28
Remember following pithy formula: more than 20
seconds with 7 moments for hand hygiene. You can
sing twice the song of Happy Birthday for evaluating
the time duration. "Inside, outside, clip, arch, big, erect,
wrist" are the 7 keys to hand hygiene.
(1) Inside: Palm to palm
(2) Outside: Right palm over left dorsum, then in reverse
(3) Clip: palm to palm with fingers interlaced
(4) Arch: back of fingers to opposite palms with fingers
interlocked
(5) Big: rotational rubbing of right thumb clasped in left
palm, then in reverse
(6) Erect: rotational rubbing of fingertips and the thumb
of right hand on left palm, then in reverse
(7) Wrist: rotational rubbing of right wrist with left palm,
then in reverse

29
 6 How to disinfect properly at home?
2019-nCoV can't tolerate heating. It can be killed with
30 minutes at 56℃. 2019-nCoV can also be killed by
chlorine disinfectants, alcohol, ethyl ether, iodine and
peroxides.
84 liquid disinfectant, bleaching powder or other
chlorine containing disinfectant (more than or equal
to 500 mg/L) can be used to prepare a solution with
an effective chlorine concentration to disinfect. For
heat-resistant items (such as tableware and some toys),
boiling in the water is simple and effective. Tableware,
vegetables and fruits can also be disinfected by soaking
in 5‰ potassium permanganate for 1 minute, then rinse
with clean water.
High concentrations of alcohol can be used to disinfect,
but they are flammable. Please keep watching for
30
spraying alcohol away from fire. Alcohol and 84
disinfectant must be stored and used separately.

7 How to disinfect properly on campus?

Keep classrooms with good airiness.
Clean and disinfect routinely touched desks, chairs and
other surfaces of objects.
Put hand sanitizer in the toilet and hands free
disinfectant in the classroom.
Clean up garbage in time.

8 Is it necessary to disinfect your daily articles, coats

and other personal objects?
2019-nCoV can be transmitted through contact. 2019-
nCoV may enter the body through the mucosa of nose
and mouth by contaminated hands after touching
contaminated articles. It may reduce the possibility of
infection to disinfect the daily articles, clothes and other
personal objects, such as keys, mobile phone.
The simplest disinfection method is to spray 75%
medical alcohol on the surface or wipe it with a
proportioned disinfectant for daily learning supplies,
keys, mobile phones and other personal items. Coats
should be hung on the balcony or ventilation place
31
nearby window after taking off. The virus cannot be
survive for a long time if it leaves human body. Coats
can also be washed in a drum washing machine with
high temperature boiling function, which is also effective
in sterilization.

9 How to keep healthy living habits at home?

People should keep healthy living habits to improve
immunity and prevent virus infection.
(1) Do not share towels, toothbrushes and gargle cups
with families. Preferably eat separately by using personal
dishes.
(2) Please keep a proper distance with other people and
cover your mouth and nose with a disposable tissue
when you cough or sneeze. If a cough or sneeze sneaks
up on you and no tissue is available, cover your mouth
and nose by your upper sleeves or a bended elbow. No
spitting. Use paper tissues to blow your nose. Throw

32
away the used tissue into a closed bin immediately.
(3) Pay attention to eye hygiene. Avoid using electronic
devices or watching TV for long hours. Children should
be limited to use iPad or smart phoneless than 15
minutes each time and no more than one hour per day
during holidays. Take a 10-minute brief break to have a
rest and look out into the distance after using electronic
devices every 30-40 minutes. It is recommended that
screen time should be no more than 2 hours per day for
children, including smart phones, computers, TV and
other electronic devices.
(4) Get enough sleep and don't stay up late. Primary
school students need 10 hours of sleep per night, junior
students need 9 hours, senior students 8 hours, while
adults 7 hours per night.

10 Why we need to bar the consumption of wild animals?

There have been new epidemic and pandemics emerged
around the world in recent history, including SARS,
highly pathogenic avian influenza, Ebola, MERS, etc.
33
Originating from animal sources is the common feature
of these diseases.
Current researches show that bats are most likely the
source of infection of 2019-nCoV. The virus may be
transmitted to some kind of wild animals through bats,
and then humans who contacted with these animals
would be infected possibly.
Farm-raised animals like pigs, cattle, sheep and common
poultry such as chickens, ducks and geese have been
vaccinated. Animals will not infect human if they don't
carry the virus. It is likely that human have not been
exposed to some virus from wild animal before. Once
mutation occurs, the virus could easily be transmitted
to human and cause infection because human may
not have the immunity to it. As a result of the virus'
evolution and adaption to human, it can spread easily
person to person and pose a pandemic threat. The rapid
development of globalization and high-efficiency global
transport network may enable the contagious disease
spread from a small village to the whole world and
become a global public health concern.
Therefore, the most effective and easy way to prevent
the epidemic disease is to stay away from wild animals,
minimize the invasion to wild animal habitat, and ban
the consumption of wild animals.
34
 11 How to pay attention to our diets?
Do not eat wild animals and dead animal meat or
aquatic products of unknown origin. Avoid eating
food left overnight. It should be reheated and cooked
thoroughly before you eat it. Do not go to restaurants
without a Food Sanitation Permit when dining out.
It is important to make sure that food is thoroughly
cleaned and cooked before eating, especially meat and
eggs. There may have parasites, bacteria, or viruses in
raw meat and thus it has a certain risk of infection if not
thoroughly cooked. People with a chronic condition
or those immunocompromised individuals may have
influenza-like symptoms, such as diarrhea, vomiting,
and septicemia, etc. after eating undercooked meat or
eggs. Stay extra safe: If the burger's not hot enough and
you have to cook it longer. High heat cooking helps to
sterilize and disinfect the food.

Use separate plates and cutlery for cooked and raw

foods. For example, chopsticks used to pick up raw
35
food in hot pot should not be used for cooked foods.
Containers, cutting boards and utensils should be
separated to avoid cross contamination.

12 How to boost immunity to prevent respiratory

diseases?
We need to follow these tips in boosting immunity:
(1) Stay positive and optimistic. Stress and negative
emotions can suppress the immune system, resulting in a
lower immune response against cold and other diseases.
(2) Regular physical exercises. Aerobic exercises,
including sit-ups, push-ups, high knee march, run in
place, and jump rope, are suitable to workout at home.
Exercising 30-45 minutes and 5 days per week can help
to strength your immunity. Put on trainers and control
the intensity and voice when exercise at home to avoid
disturbing your neighbors.
(3) Get enough sleep. Adequate sleep helps the increase
of the T cells and B cells to facilitate the fighting against
the virus and bacteria. Adolescents need 8-10 hours of
sleep each night.
(4) Maintain a balanced diet. Take vitamins and mineral
supplements daily. No picky eating or overeating.

36
 13 What should we do when there is a suspect
case of COVID-19 around?
If you suspect that you have been around someone who
has got COVID-19, you should wear a mask and keep
a safe distance away (one meter or more). Avoid close
contact with those suspected. Suggest those people to
wear a mask and go to the nearest designated hospital's
fever clinic for test and treatment.

14 How to take care of yourself when going out

during the epidemic?
On January 29, 2020, the Joint Prevention and Control
Mechanism of the State Council issued guidelines for
public transportation disinfection, which include the
advices for travelers on how to protect themselves
against the virus.
Firstly, wear masks and gloves. Travelers are advised

37
to wear medical surgical masks (or other higher level
masks) and discard them at the end of the trip. Travelers
are also suggested to wear gloves if possible. Disposable
gloves cannot be reused. Reusable gloves should
be disinfected and cleaned after use by steaming or
boiling for 30 minutes, or soaking in 500mg/ L chlorine
containing disinfectant for 30 minutes.
Secondly, keep good hand hygiene. Travelers should
pay attention to hand hygiene. Wash hands after the
trip. Alcohol-based hand sanitizer can be used. Hand
sanitizer containing chlorine or hydrogen peroxide can
also be used under special conditions. If there are visible
pollutants, wash your hands with hand sanitizer under
flowing water before disinfection.
Thirdly, adopt social distancing practices. Travelers are
required to keep certain distance away each other when
taking public transportation.
Finally, support work of the public transport staff.
Follow the instruction and guidance of public transport
staff and enhance self-protection measures. If there are
any suspected or confirmed case around, follow the
instructions of the staff and undergo a self-quarantine for
medical observations. Follow the official arrangements
for screening, medical checks and investigation. Do not
leave without permission.
38
 15 What should people do before returning to
their place if they have a history of residence or
travel in a high-risk area?
According to epidemic prevention and control
measures, people with a history of live or travel to
epidemic area are required to undergo a 14-day
quarantine at home or in designated facilities for medical
observations after they return.
(1) Timely report to the school, company and local
residents. Do not go outside arbitrarily during self-
quarantine period especially crowded public places.
Avoid taking public transportation.
(2) Monitor the symptoms and signs for 14 consecutive
days after leaving the epidemic area. Temperature
should be measured as twice a day in the morning
and afternoon respectively. At the meantime, observe
whether there is any suspicious symptom of the novel
coronavirus infection.
(3) Seek medical help and report if there is any
suspicious symptom. You will be not allowed to return
to your company until the disease is recovered.

16 What should students pay attention to before

and after returning to campus?
Students have no suspicious symptoms or history of
39
live or travel to epidemic area can return to campus
when the winter holiday ends. It is necessary to visit
the hospital and report to the school if there are any
suspicious symptoms.
(1) On the return trip to campus
Medical surgical masks or N95 masks and gloves should
be worn on during the whole trip when taking public
transportation.
Maintain good hand hygiene and reduce touching
the public transportation. Clean your hands by using
alcohol-based hand rub or soap and flowing water
before eating, after toilet, touching the public places and
using the hands to cover the cough. Avoid touching
the mouth, nose and eyes when you are unsure whether
your hands are clean or not. Always remember to cover
your mouth and nose by tissues or your bended elbow
when sneezing or coughing.
(2) After returning to campus
Students and teachers shall wear face masks properly
when talking to each other face-to-face. Try to narrow
the scope of activities and cut nonessential going out to
avoid contacts.
【Links】
Once feeling sick on the return trip, students should
40
go to hospital as soon as possible. It is advised that
students voluntarily report a history of live or travel
to epidemic area and people that close contacted
to collaborate with doctors in following medical
investigation.
Keep the ticket information of the flight, high-speed
train, and coach bus etc. properly to collaborate with
the investigation of close contacts.

17 How to collaborate with school or company

to prevent and control the epidemic?
Schools and companies will collaborate with healthcare
facilities to manage the close contacts and disinfections.
Everyone needs to measure temperature twice a day. It
will be timely reported to epidemic management staff
when any suspicious symptoms noted.
Large-scale activities will not be allowed to be organized.
Windows are opened often to help with ventilation in
the classrooms, offices, dormitories, libraries, activity
centers, canteens, auditoriums, and toilets etc. Hand
hygiene should be addressed and hand sanitizers and
disinfectants should be prepared.
All people should follow the instructions and
arrangements of the administration, obey the rules,
strictly regulate behaviors, and perform health
management.
41
 18 How to view the epidemic in a scientific and
rational way?
Facing of the epidemic, some people are indifferent
and neglect; while some people are overreacting. They
check the progress of the epidemic repeatedly, browse
or spread some news which has no reliable sources or
evidence. Neither of the attitudes is commendable. We
need to take a scientific and rational attitude towards the
epidemic prevention and control. It is the most powerful
weapon for us to fight against the epidemic.
Firstly, we should fully believe in the prevention and
control of epidemic of governments, the scientific
guidance of scientists, medical staffs and professionals.
We also should be confident in defeating the virus and
stay positive. Secondly, we should follow the correct
information that released by the government and
professional media. Do not believe or spread rumors.

19 How individuals adjust psychologically during

the epidemic?
Facing of the epidemic, some individuals may appear
stress response, presented as excessive anxiety, memory
impairment, and lack of concentration etc. Therefore,
individual psychological adjustment is needed.

42
Somehow self-psychological adjustment is as important
as fighting against the epidemic.
First of all, we can offer ourselves positive self-suggestion
that the epidemic will eventually pass. Secondly, we
should maintain a normal life in the epidemic. Arrange
our daily life properly and have a regular work and rest.
Thirdly, we can draw attention to our hobbies (such as
reading, painting, etc.) to effectively ease our stress.
Students shall arrange the study time properly and make
their attention as diverse and efficient as possible.
In addition, you can also have "cloud" communication
with friends to maintain normal social interaction
online. Family members should encourage each other.
Stay healthy mentally and do not spread panic emotion.

43
 Part Ⅲ
Methods of Treatment

1 What to do when there are suspicious symptoms

of the COVID-19?
Do not be disconcerted if there are symptoms of
fever, fatigue and dry cough because it does not mean
the COVID-19. However, when a person has a fever
(axillary temperature ≥ 37.3 ℃ ), cough and short of
breath with a history of live or travel in the epidemic
area, or a history of contact with the patient who has
fever or respiratory symptoms in the previous 14 days,
or cluster-infected cases noted, the individual shall go to
the local designed hospital's fever clinic.

44
 2 What are the differences between the COVID-19
and the common pneumonia?
The COVID-19 is caused by the novel coronavirus
named 2019-nCoV which is highly contagious. The
main symptoms are fever, fatigue and dry cough.
Some patients are mild and recover quickly. However,
some patients are worse illness and develop to severe
pneumonia. Complications include difficulty in
breathing, coagulation disorders, and multiple organ
failures.
The common pneumonia is caused by bacteria, virus
and mycoplasma and so on. Generally, the condition of
common pneumonia is milder and is lower infectious.

3 How to diagnose COVID-19?

The diagnosis of COVID-19 can be made according to
the epidemiological history and clinical manifestations.
If there is a history of living or traveling to epidemic area,
a history of contact with the patient from epidemic area
with fever or respiratory symptoms, a history of contact
with patients with confirmed COVID-19, or cluster-
infected cases, meanwhile with clinical manifestations,
including fever, radiographic evidence of pneumonia
and blood test result, suspected cases can be diagnosed
with one of the histories plus two of the clinical
manifestations.
45
The laboratory approach to test the novel coronavirus is
the real-time reverse-transcription–polymerase-chain-
reaction (RT-PCR) method. The sample of throat swab,
nose swab and blood specimen can be tested. Suspected
cases can be diagnosed as confirmed cases if the RT-
PCR test positive or the specimen tested matches the
corona virus by a whole-genome sequencing test.

4 What is the treatment of the COVID-19? Can

it be cured?
There is no specific treatment for COVID-19 at
present. However, patients with COVID-19 can receive
supportive care to help relieve symptoms accordingly,
which can effectively improve their condition. In
addition, traditional Chinese medicine has somewhat an
effect on the COVID-19. Up to now, part of the cases
have been recovered and discharged from hospitals all
over the country. There is no specific antiviral treatment
available for COVID-19 currently. Based on the
previous studies, α interferon nebulization can be used
in the early stage of the disease. Lopinavir and Ritonavir
can also be chosen. A few adaptive randomized placebo-
controlled clinical trials have been conducted to evaluate
the safety and efficacy of novel therapeutic agents in
hospitalized adult patients diagnosed with COVID-19.

46
 5 Why patients with COVID-19 are required
to be isolated?
The infection source of the novel corona virus remains
unknown. It can spread from human to human. Patients
diagnosed with COVID-19 should be isolated to prevent
the transmission of the virus. Epidemic of COVID-19
can only be controlled by isolating the source of
infection, cutting off or interrupting transmission routes,
and special care for the most susceptible people. Early
detection and early isolation are the most effective
measures for the epidemic prevention and control.

6 Why we need to prevent "super-spreader" events?

"Super-spreader" is an epidemiological term. Generally,
a person might infect 2-3 people averagely in theory if
there is no precaution. A super spreader will infect more
than 10 people. It does not mean the virus mutates,
instead, it is due to significantly large amount of the
virus that the infected person spread to others. During
47
the SARS epidemic in 2003, there had super spreader
infected dozens of people and even spread to other
continents in the world. Therefore, we need to try to
prevent "super-spread events"(SSEs) in the epidemic
prevention and control.

7 Who are close contacts with patients?

People are defined as close contacts if they meet one
of the following with COVID-19 patients including
suspected and confirmed cases.
(1) People who live, study, and work or have close
contact with the confirmed case;
(2) Medical staff, family members or other people who
have similar close contact with the case without taking
effective precautions when diagnosing, treating, nursing
or visiting the confirmed case;
(3) Other patients and caregivers in the same ward with
the confirmed case;
(4) People who take the same vehicle with the case and
have close contact with the confirmed case;
(5) People who is evaluated as the qualified by the field
investigators.

48
 8 What is medical observation?
Medical observation refers to taking quarantine
measures according to the longest incubation period
of the infectious disease for the suspected cases and
those who have a close contact with the confirmed or
suspected cases. During the medical observation period,
the health status from close contacts will be observed
and recorded to see whether they are infected or not.
This will not only facilitate the early diagnose and early
treatment in the incubation and progress period of
the infection, but also help to reduce and avoid the
transmission of pathogens to healthy population. This
is a medical protection measure for suspected patients,
close contacts and people around them.
The following symptoms and signs should be observed:
(1) Fever. Measure the temperature twice a day.
(2) Cough.
(3) Short of breath or difficulty with breathing.
(4) Other early onset symptoms including chills,
body ache, sore throat, headache, diarrhea, nausea or
vomiting, and runny nose.
If there are abnormal clinical symptoms, such as
fever and cough, timely report to doctors and go to
designated hospitals for troubleshooting, diagnosis and
treatment.
49
 9 Who need medical observation?
People who have close contact with the confirmed
patients and suspected patients need to receive the
medical observation as well as suspected patients.
Putting close contacts under medical observation is a
responsible attitude to protect the life security and health
of people. It is also the universal approach to prevent
and control the epidemic. The medical observation
period of close contacts was set as 14 days in this
COVID-19 epidemic. People will be discharged if there
is no symptom and sign occurred.

10 Will the cured COVID-19 patients get

reinfection rapidly?
Patients with COVID-19 infection usually have
produced antibodies after an infection and remain safe
in a certain period of time, which generally lasts for a
few months. From the long term, the virus mutation
or decrease of protective antibodies could be possible.
People may get reinfection with the same virus. The
novel coronavirus is a single-strand RNA virus which
is easy to mutate. Therefore, it is difficult to form a
persistent immunity. It is certain that COVID-19
patients who has been cured and discharged are now
healthy, however, preventive measures such as wearing a
mask and washing hands frequently are also required.

50
 Part Ⅳ
Dispelling Rumors

1 Are young people unlikely to be infected by

2019-nCoV?
Rumor
Older people who have weaker immune functions are
more susceptible. Young people and children seem
less vulnerable to corona virus. Therefore, do not take
seriously.
Truth
There is no evidence to support it. The novel
coronavirus is a new-found virus and people are
generally susceptible to the virus. People from all age
groups shall take steps to protect themselves from
the virus. It is more important to pay attention to the
prevention in children because their immune system are
immature and are not strong enough. There have been
COVID-19 infections reported in children nationally,
even the youngest is only 1 month old. We can never
rest on our oars!
51
 2 Can Radix Isatidis defend against the
COVID-19?
Rumor
After the rumors that the Radix Isatidis (called
Banlangen in Chinese) may prevent SARS and H7N9
avian influenza, now there is a saying that Radix Isatidis
could defend against the COVID-19.
Truth
There is no evidence to support it. As a common
Chinese herbal medicine, Radix Isatidis has the effect
of clearing away heat and detoxifying. It has a certain
effect in treating febrile diseases such as wind colds and
common colds, etc. However, there is no evidence for
the effectiveness of preventing and treating COVID-19.

3 Can simmering vinegar prevent COVID -19?

Rumor
Rumors have been claimed that simmering vinegar
indoor will disinfect and kill the virus in the air and thus
prevent the air-borne disease. Someone even advocated
that simmering vinegar and drinking Radix Isatidis are
"golden partner" for prevention against 2019-nCoV
infection.
Truth
It is totally wrong. One of the ingredients in the vinegar
52
is acetic acid. It is one type of the disinfectant that has
been used in the hospital to wipe the surface of objects
and instruments, rather than spray it into the air. More
importantly, the concentration of acetic acid in a bottle
of vinegar is only 5% at most which is not effective for
disinfection at all.
Simmering vinegar cannot protect you from the
infection with novel corona virus. Instead, it has
some side effects. The vaporization of acetic acid may
cause irritation to the respiratory mucosa, resulting in
throat discomfort, nausea and dyspnea. It may cause
respiratory diseases in children, elderly and people with
a history of asthma.

4 Does smoking prevent viral infection?

Rumor
Internet rumors have been alleged that smoking could
prevent viral infection. It is claimed that the tobacco
particles can evenly cover the surface of lung cells,
forming a "nano-scale mask" to block the invasion of
virus for people.
Truth
This rumor has been circulated for more than ten
years. In fact, smoking can not help to prevent the virus
infection, neither cause irritation to the respiratory tract.
The harmful substances in tobacco will damage lung
53
function and decrease immune function, resulting in an
increase of the probability of respiratory virus infection.
Secondhand smoke will also interfere with the health
of people around. In addition, it will increase the risk
of virus infection because you can't wear a mask when
smoking and your hands will touch your mouth and
nose possibly.

5 Can we drink spirits to fight against coronavirus?

Rumor
A picture has been spread on the internet recently which
is the interview with Chinese Academician Zhong
Nanshan. The subtitle at the bottom of the picture
showed "drink spirits to fight against coronavirus".
Truth
This picture is a fake screenshots by Photoshop. Experts
stated that the 75% alcohol is effective at killing the virus,
so it can be used to disinfect the hands, commonly used
items such as mobile phones, or often touched surfaces.
However, spirits will only be absorbed and metabolized,
and will not disinfect the virus at all.

6 Can salt water kill the virus?

Rumor
Rumors began to spread online recently saying that
it is advised to use salt water gargling before going to
the hospital or other public places and after back to
54
home in the letter named "Antivirus tips from Chinese
Academician Zhong Nanshan". It has been claimed that
salt water can kill the virus or bacteria that incubated in
the throat and thus prevent the infection.
Truth
Academician Zhong Nanshan and his research team
debunk the lies that salt water gargle helps to clean the
mouth and throat and can help people recover from
pharyngitis. However, the novel coronavirus infects the
respiratory tract where salt water gargles does not reach
to help. Furthermore, there is no evidence that salt water
can kill the novel coronavirus.

7 Can taking antibiotics in advance prevent

COVID-19?
Rumor
Rumors alleged that people should keep standby
antibiotics at home. 2019-nCoV can be prevented by
taking antibiotics in advance.
Truth
The current epidemic is caused by virus. Antibiotics
can work against bacterial infections but not viruses.
Antibiotics overuse or improper use, especially the
combination of broad-spectrum antibiotics, should
be avoided. In addition, improper prophylactic use of
antibiotics will destroy the bacteria balance in the body
and cause certain health risks.
55
 Contributors
Liu Zhongmin, Wang Tao
Zhou Minjie, Li Jun
Shen Jian, Han Jing, Sun Feng, Shi Jiahua, Zhou Runv,
Bo Lulong, Chen Yalu, Wu Yue

Proofread by
Lu Hongzhou, Wang Tong

Translated by
Wang Tao, Shen Jian, Jiang Benran, Chen Fei