en-us	Background  
zh-cn	引言 

en-us	This is the first edition of guidance on infection prevention and control (IPC) strategies for use when COVID-19 is suspected. It has been adapted from WHO’s Infection prevention and control during health care for probable or confirmed cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection, based on current knowledge of the situation and experience with severe acute respiratory syndrome (SARS) and MERS. 
zh-cn	本文是怀疑发生新型冠状病毒感染时使用的感染预防和控制策略指导文件第一版，系在世卫组织《中东呼吸综合征冠状病毒感染可能或确诊病例治疗期间的感染预防和控制》基础上根据目前对中国和其他发现病例国家情况的了解及严重急性呼吸综合征冠状病毒和中东呼吸综合征冠状病毒经验改编。 

en-us	WHO will update these recommendations as new information becomes available. 
zh-cn	世卫组织将在获得新信息时更新这些建议。 

en-us	This guidance is intended for health care workers (HCWs), health care managers, and IPC teams at the facility level but it is also relevant for national and district/provincial levels. 
zh-cn	本指导文件针对设施一级医护人员、管理人员及感染预防和控制团队，但对国家和省市级也有意义。

en-us	Full guidelines are available from WHO. 
zh-cn	完整的指南可从世卫组织获得。 

en-us	Principles of IPC strategies associated with health care for suspected COVID-19. 
zh-cn	与疑似新型冠状病毒感染治疗有关的感染预防控制策略的原则 

en-us	To achieve the highest level of effectiveness in the response to the COVID-19 outbreak using the strategies and practices recommended in this document, an IPC programme with a dedicated and trained team or at least an IPC focal point should be in place and supported by the national and facility senior management. 
zh-cn	要通过采用本文件推荐的策略和做法最有效地应对2019新型冠状病毒疫情，应设立感染预防和控制规划，配备训练有素的全职团队并得到国家和设施高级管理层的支持。

en-us	In countries where IPC is limited or inexistent, it is critical to start by ensuring that at least minimum requirements for IPC are in place as soon as possible, both at the national and facility level, and to gradually progress to the full achievement of all requirements of the IPC core components according to local priorities. 
zh-cn	在感染预防控制措施有限或不存在的国家，关键是先确保在国家和设施层面都尽快满足感染预防控制的最低要求，并根据本地确定的重点和工作计划逐步全面满足所有感染预防控制要求。 

en-us	IPC strategies to prevent or limit transmission in health care settings include the following:  
zh-cn	预防或限制医疗机构内传播的感染预防控制策略包括： 

en-us	ensuring triage, early recognition, and source control (isolating patients with suspected COVID-19);  
zh-cn	落实分诊、早期识别和源头控制（隔离疑似感染新型冠状病毒的患者）； 

en-us	applying standard precautions for all patients;  
zh-cn	针对所有患者采取标准预防措施； 

en-us	implementing empiric additional precautions (droplet and contact and, whenever applicable, airborne precautions) for suspected cases of COVID-19;  
zh-cn	对疑似新型冠状病毒感染病例实施经验性的额外预防措施（飞沫和接触，酌情采取空气传播预防措施）； 

en-us	implementing administrative controls;  
zh-cn	实施行政控制； 

en-us	using environmental and engineering controls. 
zh-cn	实施环境和工程控制。 

en-us	Ensuring triage, early recognition, and source control. 
zh-cn	落实分诊、早期识别和源头控制 

en-us	Clinical triage includes a system for assessing all patients at admission, allowing for early recognition of possible COVID-19 and immediate isolation of patients with suspected disease in an area separate from other patients (source control). 
zh-cn	临床分诊包括建立制度对所有患者在入院时进行评估，以便及早识别可能的2019新型冠状病毒感染，并立即隔离疑似感染者，将其安排在与其他患者分开的区域(源头控制）。

en-us	To facilitate the early identification of cases of suspected COVID-19, health care facilities should: 
zh-cn	为促进及早发现疑似新型冠状病毒感染病例，医疗机构应： 

en-us	encourage HCWs to have a high level of clinical suspicion; 
zh-cn	鼓励医护人员保持高度临床怀疑态度； 

en-us	establish a well-equipped triage station at the entrance to the facility, supported by trained staff; 
zh-cn	在入口处设置设备完善的分诊台并安排训练有素的工作人员； 

en-us	institute the use of screening questionnaires according to the updated case definition. 
zh-cn	根据最新的病例定义使用筛查问卷

en-us	post signs in public areas reminding symptomatic patients to alert HCWs. 
zh-cn	在公共场所张贴标志，提醒有症状患者告知医护人员）。 

en-us	Hand hygiene and respiratory hygiene are essential preventive measures. 
zh-cn	最基本预防措施是促进手卫生和呼吸卫生。 

en-us	Applying standard precautions for all patients  
zh-cn	针对所有患者采取标准预防措施 

en-us	Standard precautions include hand and respiratory hygiene, the use of appropriate personal protective equipment (PPE) according to a risk assessment, injection safety practices, safe waste management, proper linens, environmental cleaning, and sterilization of patient-care equipment. 
zh-cn	标准预防措施包括手卫生和呼吸卫生、根据风险评估结果使用合适的个体防护装备、注射安全措施、安全废物管理、被服洗消、环境清洁和患者护理设备的消毒。 

en-us	Ensure that the following respiratory hygiene measures are used: 
zh-cn	确保采取以下呼吸卫生措施： 

en-us	ensure that all patients cover their nose and mouth with a tissue or elbow when coughing or sneezing; 
zh-cn	确保所有患者在咳嗽或打喷嚏时用纸巾或肘部掩住口鼻； 

en-us	offer a medical mask to patients with suspected COVID-19 while they are in waiting/public areas or in cohorting rooms; 
zh-cn	在候诊/公共场所或集合室向疑似2019新型冠状病毒感染患者提供医用口罩； 

en-us	perform hand hygiene after contact with respiratory secretions. 
zh-cn	接触呼吸道分泌物后采取手卫生措施。 

en-us	HCWs should apply WHO’s My 5 Moments for Hand Hygiene approach before touching a patient, before any clean or aseptic procedure is performed, after exposure to body fluid, after touching a patient, and after touching a patient’s surroundings. 
zh-cn	医护人员应根据世卫组织《手卫生的五个时刻》在以下五个时刻采取手卫生措施：接触患者前；进行任何清洁或无菌操作前；体液暴露后；触碰到患者后；触碰患者周围环境后。 

en-us	hand hygiene includes either cleansing hands with an alcohol-based hand rub or with soap and water; 
zh-cn	手卫生措施包括用含酒精成分的免洗洗手液或肥皂和水清洁双手；  

en-us	alcohol-based hand rubs are preferred if hands are not visibly soiled; 
zh-cn	如果手部没有明显污垢，最好使用含酒精成分的免洗洗手液； 

en-us	wash hands with soap and water when they are visibly soiled. 
zh-cn	手部有明显污垢时用肥皂和水清洗双手。 

en-us	The rational, correct, and consistent use of PPE also helps reduce the spread of pathogens. 
zh-cn	合理、正确、一贯地使用个体防护装备也有助于减少病原体传播。

en-us	PPE effectiveness depends strongly on adequate and regular supplies, adequate staff training, appropriate hand hygiene, and appropriate human behaviour.  
zh-cn	使用个体防护装备的有效性在很大程度上取决于充足和经常的物资供应、充分的人员培训和恰当的手卫生措施，特别是人的行为要恰当。 

en-us	It is important to ensure that environmental cleaning and disinfection procedures are followed consistently and correctly. 
zh-cn	确保前后一贯地正确遵守环境清洁和消毒程序十分重要。

en-us	Thoroughly cleaning environmental surfaces with water and detergent and applying commonly used hospital- level disinfectants (such as sodium hypochlorite) are effective and sufficient procedures. 
zh-cn	使用水和清洁剂彻底清洁环境表面并使用医院常用消毒剂（例如次氯酸钠）的做法有效且充分。

en-us	Medical devices and equipment, laundry, food service utensils, and medical waste should be managed in accordance with safe routine procedures. 
zh-cn	应根据常规安全程序管理医疗器械和设备、被服、餐食服务用具和医疗废物。 

en-us	Implementing empiric additional precautions 
zh-cn	.实施经验性的额外预防措施 

en-us	Contact and droplet precautions 
zh-cn	针对接触和飞沫的防护 

en-us	in addition to using standard precautions, all individuals, including family members, visitors and HCWs, should use contact and droplet precautions before entering the room of suspected or confirmed COVID-19 patients; 
zh-cn	除采取标准预防措施外，所有人（包括患者家人、探访者和医护人员）在进入疑似或确诊新型冠状病毒患者的病房前均应采取针对接触和飞沫的预防措施； 

en-us	patients should be placed in adequately ventilated single rooms. 
zh-cn	患者应安置在通风良好的单人病房。

en-us	For general ward rooms with natural ventilation, adequate ventilation is considered to be 60 L/s per patient; 
zh-cn	对于自然通风的普通病房，每位患者的通风量应达到60升/秒; 

en-us	when single rooms are not available, patients suspected of having COVID-19 should be grouped together; 
zh-cn	如果没有单人病房可用，怀疑感染新型冠状病毒的患者应该安排在一起； 

en-us	all patients，beds should be placed at least 1 metre apart regardless of whether they are suspected to have COVID-19; 
zh-cn	所有患者的病床之间应该至少相距1米，不管他们是疑似还是确诊感染新型冠状病毒； 

en-us	where possible, a team of HCWs should be designated to care exclusively for suspected or confirmed cases to reduce the risk of transmission; 
zh-cn	在可能的情况下，应指定一组医护人员专门照顾疑似或确诊病例，以减少传播风险； 

en-us	HCWs should use a medical mask (for specifications, see reference 2); 
zh-cn	医护人员应使用医用口罩 

en-us	HCWs should wear eye protection (goggles) or facial protection (face shield) to avoid contamination of mucous membranes; 
zh-cn	医护人员应佩戴眼睛保护（护目镜）或面部保护（防护面罩）设备，以避免粘膜污染； 

en-us	HCWs should wear a clean, non-sterile, long-sleeved gown; 
zh-cn	医护人员应穿着清洁、无菌的长袖袍服； 

en-us	HCWs should also use gloves; 
zh-cn	医护人员应戴手套； 

en-us	the use of boots, coverall, and apron is not required during routine care; 
zh-cn	在日常护理期间，无须使用靴子、连体工作服及围裙； 

en-us	after patient care, appropriate doffing and disposal of all PPE and hand hygiene should be carried out. 
zh-cn	在护理完患者后，应正确脱下所有个体防护装备并采取手卫生措施。

en-us	A new set of PPE is needed when care is given to a different patient; 
zh-cn	此外，护理不同患者时，需要一套新的个体防护装备； 

en-us	equipment should be either single-use and disposable or dedicated equipment (e.g. stethoscopes, blood pressure cuffs and thermometers). 
zh-cn	设备应为一次性，即用即弃或者专用（例如听诊器、血压袖带和体温计）。

en-us	If equipment needs to be shared among patients, clean and disinfect it between use for each individual patient (e.g. by using ethyl alcohol 70%); 
zh-cn	如果设备需要多位患者共用，两次使用之间须进行清洗和消毒 (例如使用70%的乙醇）; 

en-us	HCWs should refrain from touching eyes, nose, or mouth with potentially contaminated gloved or bare hands; 
zh-cn	医护人员应避免用可能被污染的手套或裸手触摸眼睛、鼻子或口部； 

en-us	avoid moving and transporting patients out of their room or area unless medically necessary. 
zh-cn	除非医学上有需要，否则应避免移动和运送患者离开病房或病区。

en-us	Use designated portable X-ray equipment or other designated diagnostic equipment. 
zh-cn	使用指定的便携式x光机和/或其他指定的诊断设备。

en-us	If transport is required, use predetermined transport routes to minimize exposure for staff, other patients and visitors, and have the patient wear a medical mask; 
zh-cn	如果需要运送患者，应采用事先确定的运送路线并让患者戴上医用口罩，以尽量减少工作人员、其他患者和探访者的暴露； 

en-us	ensure that HCWs who are transporting patients perform hand hygiene and wear appropriate PPE as described in this section; 
zh-cn	确保运送患者的医护人员根据本部分内容采取手卫生措施并穿着适当的个体防护装备； 

en-us	notify the area receiving the patient of any necessary precautions as early as possible before the patient’s arrival; 
zh-cn	在患者抵达前尽早通知接收患者的病区采取任何必要的预防措施； 

en-us	routinely clean and disinfect surfaces with which the patient is in contact; 
zh-cn	定期清洁和消毒患者接触的表面； 

en-us	limit the number of HCWs, family members, and visitors who are in contact with suspected or confirmed COVID-19 patients; 
zh-cn	限制与2019新型冠状病毒疑似和确诊患者有接触的医护人员、家属和探访者的数量； 

en-us	maintain a record of all persons entering a patient’s room, including all staff and visitors. 
zh-cn	记录所有进入病房的人员，包括所有工作人员和探访者。 

en-us	Airborne precautions for aerosol-generating procedures. 
zh-cn	针对产生气溶胶的操作的空气传播预防措施 

en-us	Some aerosol-generating procedures, such as tracheal intubation, non-invasive ventilation, tracheotomy, cardiopulmonary resuscitation, manual ventilation before intubation, and bronchoscopy, have been associated with an increased risk of transmission of coronaviruses. 
zh-cn	一些产生气溶胶的操作会增加传播冠状病毒（严重急性呼吸综合征冠状病毒和中东呼吸综合征冠状病毒）的风险，例如气管插管、无创通气、气管切开术、心肺复苏、插管前人工通气和支气管镜 检查。 

en-us	Ensure that HCWs performing aerosol-generating procedures: 
zh-cn	确保进行产生气溶胶的操作的医护人员： 

en-us	perform procedures in an adequately ventilated room - that is, natural ventilation with air flow of at least 160 L/s per patient or in negative- pressure rooms with at least 12 air changes per hour and controlled direction of air flow when using mechanical ventilation; 
zh-cn	在充分通风的房间里操作，即每个患者的空气流量至少为160升/秒的自然通风房间或每小时至少换气12次且使用机械通风时可以控制空气流动方向的负压房间; 

en-us	use a particulate respirator at least as protective as a US National Institute for Occupational Safety and Health (NIOSH)-certified N95, European Union (EU) standard FFP2, or equivalent. 
zh-cn	使用防颗粒物呼吸器，其防护程度至少应达到美国国家职业安全卫生研究所认证的N95、欧盟FFP2标准或同等标准。

en-us	When HCWs put on a disposable particulate respirator, they must always perform the seal check. 
zh-cn	使用一次性防颗粒物呼吸器时，必须检查密封是否良好。

en-us	Note that facial hair (e.g. a beard) may prevent a proper respirator fit; 
zh-cn	注意，如果佩戴者有胡须，可能造成呼吸器不能正确贴合; 

en-us	use eye protection (i.e. goggles or a face shield); 
zh-cn	保护眼睛（即使用护目镜或防护面罩）； 

en-us	wear a clean, non-sterile, long-sleeved gown and gloves. 
zh-cn	穿着干净、无菌的长袖袍服和手套。

en-us	If gowns are not fluid-resistant, HCWs should use a waterproof apron for procedures expected to create high volumes of fluid that might penetrate the gown; 
zh-cn	如果长袍不耐液体，在进行预计会产生大量液体并可能渗透进袍服的操作时，医护人员应使用防水围裙; 

en-us	limit the number of persons present in the room to the absolute minimum required for the patient’s care and support. 
zh-cn	将房间里的人数限制在患者护理和支持所需的绝对最低限度。 

en-us	Implementing administrative controls  
zh-cn	实施行政控制 

en-us	Administrative controls and policies for the prevention and control of transmission of COVID-19 within the health care setting include, but may not be limited to: establishing sustainable IPC infrastructures and activities; 
zh-cn	医疗机构内预防和控制2019新型冠状病毒感染传播的行政控制措施和政策包括但不仅限于以下：建立可持续的感染预防控制基础设施和开展活动；

en-us	educating patients’ caregivers; 
zh-cn	教育患者的护理人员；

en-us	developing policies on the early recognition of acute respiratory infection potentially caused by COVID-19 virus; 
zh-cn	制定促进及早识别可能由2019新型冠状病毒造成的急性呼吸道感染的政策；

en-us	ensuring access to prompt laboratory testing for identification of the etiologic agent; 
zh-cn	确保及时进行实验室检测以查明病原体；

en-us	preventing overcrowding, especially in emergency departments; 
zh-cn	防止过度拥挤，特别是在急诊部；

en-us	providing dedicated waiting areas for symptomatic patients; 
zh-cn	为有症状的患者提供专门的等候区；

en-us	appropriately isolating hospitalized patients; 
zh-cn	适当隔离住院患者；

en-us	ensuring adequate supplies of PPE; 
zh-cn	确保个体防护设备的充足供应；

en-us	and ensuring adherence to IPC policies and procedures for all aspects of health care. 
zh-cn	确保医疗机构各方面工作遵守感染预防控制政策和程序。 

en-us	Administrative measures related to health care workers. 
zh-cn	与医护人员有关的行政措施 

en-us	provision of adequate training for HCWs; 
zh-cn	为医护人员提供足够培训； 

en-us	ensuring an adequate patient-to-staff ratio; 
zh-cn	确保充足的医护人员和患者配比； 

en-us	establishing a surveillance process for acute respiratory infections potentially caused by COVID-19 virus among HCWs; 
zh-cn	在医护人员中建立针对可能由新型冠状病毒引起的急性呼吸道感染的监测程序； 

en-us	ensuring that HCWs and the public understand the importance of promptly seeking medical care; 
zh-cn	确保医护人员和公众了解及时就医的重要性； 

en-us	monitoring HCW compliance with standard precautions and providing mechanisms for improvement as needed. 
zh-cn	监测医护人员遵守标准预防措施的情况，并酌情建立改进机制。 

en-us	Using environmental and engineering controls  
zh-cn	实施环境和工程控制 

en-us	These controls address the basic infrastructure of the health care facility and aim to ensure adequate ventilation in all areas in the health care facility, as well as adequate environmental cleaning. 
zh-cn	这些控制措施针对医疗机构的基本基础设施。其目的是确保医疗机构内各区域都有足够的通风和充分 环境清洁。 

en-us	Additionally, separation of at least 1 metre should be maintained between all patients. 
zh-cn	此外，所有患者之间应保持至少1米的空间距离。

en-us	Both spatial separation and adequate ventilation can help reduce the spread of many pathogens in the health care setting. 
zh-cn	空间分隔和充分通风有助于减少许多病原体在医疗机构内的传播。 

en-us	Ensure that cleaning and disinfection procedures are followed consistently and correctly. 
zh-cn	确保前后一贯地正确遵守环境清洁和消毒程序。

en-us	Cleaning environmental surfaces with water and detergent and applying commonly used hospital disinfectants (such as sodium hypochlorite) is effective and sufficient. 
zh-cn	使用水和清洁剂彻底清洁环境表面并使用医院常用消毒剂（例如次氯酸钠）的做法有效且充分。

en-us	Manage laundry, food service utensils and medical waste in accordance with safe routine procedures. 
zh-cn	应根据常规安全程序管理被服洗消、餐食服务用具和医疗废物。 

en-us	Duration of contact and droplet precautions for patients with COVID-19. 
zh-cn	针对新型冠状病毒感染患者的接触和飞沬预防措施的持续时间 

en-us	Standard precautions should be applied at all times. 
zh-cn	任何时候都应该实施标准预防措施。

en-us	Additional contact and droplet precautions should continue until the patient is asymptomatic. 
zh-cn	额外的接触及飞沫预防措施应持续到患者不再出现症状。

en-us	More comprehensive information about the mode of virus transmission is required to define the duration of additional precautions. 
zh-cn	要明确额外预防措施的持续时间，还需要更全面地了解2019新型冠状病毒感染的传播模式。 

en-us	Collecting and handling laboratory specimens from patients with suspected COVID-19. 
zh-cn	采集和处理疑似2019新型冠状病毒感染患者的实验室标本 

en-us	All specimens collected for laboratory investigations should be regarded as potentially infectious. 
zh-cn	所有为实验室调查目的采集的样本均应视作具有潜在传染性。

en-us	HCWs who collect, handle, or transport clinical specimens should adhere rigorously to the following standard precaution measures and biosafety practices to minimize the possibility of exposure to pathogens. 
zh-cn	采集、处理或运送任何临床标本的医护人员应严格遵守以下标准预防措施和生物安全措施，以尽量减少接触病原体的可能性,。 

en-us	ensure that HCWs who collect specimens use appropriate PPE (i.e. eye protection, a medical mask, a long-sleeved gown, and gloves). 
zh-cn	确保采集标本的医护人员使用适当的个体防护装备(即护眼、医用口罩、长袖袍服和手套）。

en-us	If the specimen is collected during an aerosol-generating procedure, personnel should wear a particulate respirator at least as protective as a NIO SH-certified N95, an EU standard FFP2, or the equivalent; 
zh-cn	如果采取产生气溶胶的操作采集标本，工作人员应佩戴防颗粒物呼吸器，其防护程度至少应达到美国国家职业安全卫生研究所认证的N95、欧盟FFP2标准或同等标准； 

en-us	ensure that all personnel who transport specimens are trained in safe handling practices and spill decontamination procedures; 
zh-cn	确保所有运送标本的工作人员都接受过安全处置和溢出后去污程序的培训; 

en-us	place specimens for transport in leak-proof specimen bags (secondary containers) that have a separate sealable pocket for the specimen (a plastic biohazard specimen bag), with the patient’s label on the specimen container (the primary container), and a clearly written laboratory request form; 
zh-cn	把标本放入防漏样本袋（即二次容器）内运送，该标本袋应有单独可密封的口袋用于放标本（即防生物危害塑料标本袋），患者标签在标本容器（主容器）上，此外还应有填写清楚的检验申请单； 

en-us	ensure that laboratories in health care facilities adhere to appropriate biosafety practices and transport requirements, according to the type of organism being handled; 
zh-cn	确保医疗机构的实验室根据处理的生物类型遵守适当的生物安全规定和运送要求； 

en-us	deliver all specimens by hand whenever possible. 
zh-cn	尽可能派人手运送所有标本。

en-us	DO NOT use pneumatic-tube systems to transport specimens; 
zh-cn	不要使用气动输送管系统运送标本； 

en-us	document clearly each patient’s full name, date of birth and “suspected COVID-19” on the laboratory request form. 
zh-cn	在相应的检验申请单上清楚写明患者的全名、出生日期和怀疑感染的新型冠状病毒。

en-us	Notify the laboratory as soon as possible that the specimen is being transported. 
zh-cn	尽快通知实验室即将运送标本。 

en-us	Recommendation for outpatient care  
zh-cn	门诊护理建议 

en-us	The basic principles of IPC and standard precautions should be applied in all health care facilities, including outpatient care and primary care. 
zh-cn	感染预防控制的基本原则和标准预防措施应适用于所有医疗机构，包括门诊和初级卫生保健机构。

en-us	For COVID-19, the following measures should be adopted: 
zh-cn	针对2019新型冠状病毒感染应采取以下措施： 

en-us	triage and early recognition; 
zh-cn	分诊和早期识别； 

en-us	emphasis on hand hygiene, respiratory hygiene, and medical masks to be used by patients with respiratory symptoms; 
zh-cn	强调有呼吸道症状的患者的手卫生、呼吸卫生及医用口罩的使用； 

en-us	appropriate use of contact and droplet precautions for all suspected cases; 
zh-cn	对所有疑似病例均适当采取针对接触和飞沫的预防措施； 

en-us	prioritization of care of symptomatic patients; 
zh-cn	优先诊治有症状的患者； 

en-us	when symptomatic patients are required to wait, ensure they have a separate waiting area; 
zh-cn	当有症状的患者需要等候时，确保他们有一个单独的等候区； 

en-us	educate patients and families about the early recognition of symptoms, basic precautions to be used, and which health care facility they should go to.
zh-cn	教育患者和家属及早识别症状并采取基本预防措施，告知他们应向哪些医疗机构求诊。