Chapter 2 Interpretation of the Prevention and Control Plan of Corona Virus Disease 2019

(Fourth Edition)

To better guide and promote prevention and control work of Corona Virus Disease 2019(COVID-19)nationally, National Health Commission of the People’s Republic of China revised the Prevention and Control Plan of Corona Virus Disease 2019, and formed the fourth edition, based on the current epidemic situation and reality. The main revisions are as follows:

1. Based on the current scientific research on the 2019-nCoV, the descriptions of the etiology section and epidemiology section of 2019-nCoV were added in the whole plan.

2. In the surveillance plan, the epidemiology description and judgment principles of suspected cases have been adjusted in the “Definition of Surveillance” section for provinces except Hubei. The description of that“Wuhan or other areas where local cases continue to spread” in the third edition has been changed to “Wuhan and its surrounding areas or other communities with case reports” in the fourth edition. Besides, the judgment principle of “satisfying any one of the epidemiological histories and two of the clinical manifestations(item 1 and item 2, or item 2 and item 3)” is adjusted to “satisfying any one of the epidemiological exposure histories as well as any two of the clinical manifestations”, which further increases the sensitivity of surveillance for suspected cases.

3. As for Hubei province, unique definitions of surveillance of suspected cases, clinically diagnosed cases and confirmed cases have been added,which extends range of the suspected cases in Hubei compared with other provinces.

4. In addition, the surveillance case definition is adjusted to “confirmed cases, suspected cases and asymptomatic carriers”, and “mild cases” has been deleted and included in the clinical classification. Descriptions of detecting ways, methods and relief requirements of medical observation for asymptomatic carriers have also been added in the surveillance plan.

5. What’s more, the number of clustered cases has been adjusted to “more than five”, whose specimens need to be sent to the Chinese Center for Disease Control and Prevention for review and confirmation in the surveillance plan.

6. In the epidemiological investigation plan, the investigation contents of suspected cases are defined as basic information and the situation of close contacts, and network reports of case questionnaires are not required before the definite diagnosis, so as to reduce the work load of grassroots.

7. Management measures of close contacts and asymptomatic carriers have been adjusted. In areas where conditions are permitted, placing close contacts under intensive medical observation is required. It is emphasized that asymptomatic carriers should be placed under intensive medical observation in principle.

8. Although the route of fecal-oral transmission is still unclear, this plan has put forward corresponding measures and requirements in laboratory examinations, close contacts management, protection of specific populations and disinfection of specific sites, etc. to reduce the risk of fecal-oral transmission.