By Dr. Pan Lijun, Chinese Center for Disease Control and Prevention

Due to the novel coronavirus epidemic (COVID-19), persons with disabilities have to stay indoors for a long time, doing much less exercise but having much more screen time than before, which inevitably affects their physical and mental health. If they go outdoors or go to a crowded place for shopping or seeing the doctor, inadequate health protection might leave them exposed to the coronavirus that might be on the surface of objects or in respiratory droplets. This paper, in view of the health risks faced by persons with disabilities when staying at home, going outdoors, buying daily necessities and seeing the doctor, puts forward protective measures.

I. Staying at Home and Doing Outdoor Activities

  1. Keep the thermometer, mask, hand disinfectant, qualified disinfectant liquid and other anti-epidemic articles at hand.
  2. Do a good job in health monitoring by taking temperature every morning and evening. Should such suspected symptoms as fever, dry cough, fatigue, nasal congestion, runny nose, sore throat and diarrhea appear, the guardians, care givers or family members should be informed promptly.
  3. When the environmental temperature is agreeable, windows should be opened for ventilation every day to increase indoor air circulation; windows should be opened twice or three times a day, 20 to 30 minutes each time. Please keep warm and avoid catching cold.
  4. To use the split air conditioner, the following steps are recommended:
    • Clean the air conditioner in the first place. We should disconnect the power supply of the air conditioner, and wipe the dust off the shell with a damp cloth without dripping water; follow the instructions to open the cover plate, remove the filter screen, wash the dust off the filter screen with tap water, let it dry in the air or dry it with dry cloth, install the filter screen and close the cover plate. Then we can turn on the air conditioner and use the cool mode to check whether the air conditioner is in normal operation.
    • Ensure ventilation before using the air conditioner. Before turning on the split air conditioner, the first thing is to open the doors and windows for ventilation for 20-30 minutes, and it is recommended that the air conditioner operates at the maximum air volume for more than 5-10 minutes before the doors and windows are closed. After the split air conditioner is turned off, the doors and windows shall be
      opened for ventilation. For crowded areas (like meeting rooms) that use the split air conditioner for a long time, there should be a 20-30 minute ventilation every two or three hours. Indoor temperature should be kept no lower than 26℃ .If the indoor temperature demand can be met, it is suggested that the doors and windows should not be completely closed when the air conditioner is running.
  5. Increase the frequency of cleaning and disinfecting toilets and tableware. The disinfectant can be diluted into disinfectant liquid according to the instructions to wipe or soak the sanitary ware.
    Gloves must be worn before using disinfectant. As the disinfectant is very corrosive and irritant, if there is no glove to block the contact between the skin and the disinfectant, it will cause serious irritation to the skin and mucous membrane as well as slight pain to the hands
  6. Avoid sharing towels with other family members; frequently expose clothes and quilts to the sun; develop a good personal hygiene habit; refrain from spitting anywhere; cover the nose and mouth with tissue or elbows when sneezing.
  7. Ensure good nutrition, eat properly, exercise moderately and ensure enough sleep to improve the immune system.The specific suggestions are as follows:
    • Ensure food diversity and have a balanced diet
    • We should try to have more than 12 kinds of food a day and more than 25 kinds a week. We should take more fresh fruits and vegetables, at least 300 grams of vegetables and 200 grams of fruits every day, and preferably dark vegetables should account for more than a half of the intake. We should increase the intake of aquatic products which should be taken at least three times a week, and we should eat 5-7 eggs a week. The average daily intake of fish, poultry, eggs and lean meat should be 120-200 g. We should increase the consumption of milk and legumes, and take 300 grams of liquid milk or equivalent amount of dairy products every day. People with lactose intolerance can choose yogurt or low lactose milk products, avoid drinking milk on an empty stomach, drink many times but a small amount of milk each time, or drink milk while taking grains.We should take 25 grams of soy be an products in addition to a proper amount of nuts each day.
    • Keep a light diet and drink enough waterSteamed, boiled and stewed food is healthier than the smoked, pickled, fried food which one should try to avoid. The intake of cooking oil and salt should be respectively
      no more than 30 grams and 5 grams per person per day. We must drink 7-8 cups of
      water (1500-1700 ml) per day, but wine is not recommended.
    • Maintain a healthy weight and pay at tension to chronic disease managementIt is advisable to weigh yourself once a week, avoid sitting for a long time, and get up once an hour; make the best use of the home conditions to do physical exercises, and engage in moderate physical activities for more than 150 minutes per week; and monitor the risk factors of chronic diseases such as blood glucose, blood lipid and blood pressure every three months to improve your self-management of chronic diseases.
  8. Wash hands frequently. Do not touch your eyes, mouth or nose with the dirty hand. Wash hands with hand sanitizer (or soap) in running water after returning from outdoors, after coughing and hand covering, and before meal and after toilet. We should wash hands in the right way or rub hands with quick drying hand sanitizer.
  9. Meat and eggs should be thoroughly cooked before eating.
  10. Do not drop in others’ home gather, dine together or treat each other to dinner.
  11. We should try to avoid going out when feeling sick, avoid crowded places, and wear masks when going outdoors.
  12. Keep warm when going out. We should wear masks when we go to crowded public places, take public transport at ion or come in close contact with other people.
  13. While living with quarantined family members at home, we should do a good job in cleaning and disinfection, strengthen personal protection, and wear masks.
  14. It is inadvisable to lie in bed for a long time; instead we should move on the ground at appropriate times.
  15. We should wear masks during rehabilitation training, and the training should be appropriate in intensity. Hand hygiene should be immediately done at the end of the training.

II. Shopping for Daily Necessities

  1. Farm Market
    • Before entering the farm market, it is necessary to evaluate the sanitation, ventilation or people flow of the market. If sewage, vegetable leaves and other waste scatter in the market, it shows the market is in poor health management and should be avoided. If the market is found with a dense flow of people, poor ventilation and relatively closed space, it should be avoided as well.
    • Wear a mask and take disinfecting wipes with you. In a crowded place or in close contact with others (within 1 meter), persons with disabilities should wear masks, strengthen hand hygiene, carry quick drying hand disinfectant or disinfecting wipes, and cover the nose and mouth with tissue or elbows when sneezing.
    • Commodity selection. When selecting goods, we should try to select packed vegetables, fruits or meat in the zone with few people, reduce conversation with the salesperson, keep a distance of more than 1 meter from others when purchasing goods, use non-direct contact payment such as scanning payment, and try to avoid cash payment.
    • Make the stay at the farm market as short as possible. We should leave the stall or the farm market as soon as possible after the payment
  2. Shopping malls and supermarkets
    • Before entering the shopping malls and supermarkets, it is necessary to evaluate the sanitation, ventilation or people flow therein. If there is any strange smell, it indicates that the place has poor ventilation. It is recommended not to enter or reduce trips to the place.
    • Wear a mask and take disinfecting wipes with you. Persons with disabilities should wear masks when they are in close contact with others (within 1 meter), like in selecting commodities, queuing for weighing, etc. After selecting the goods or directly touching the frequently contacted objects’ surfaces with hands, like the elevator buttons, handrails, etc., it is necessary to wipe the hands with the quick drying hand disinfectant or disinfecting wipes, and it is necessary to cover the mouth and nose with tissue paper or elbows when sneezing.
    • Selection of goods and payment. We should try to buy prepackaged products, choose indirect payment, and try to avoid cash payment.
    • Reduce direct contact with the shopping cart, storage cabinet, elevator button, escalator handrail, toilet door handle and other public equipment and facilities. After the unavoidable contact, it is advisable to wash hands in the right way or rub hands with quick drying hand disinfectant.
    • After the payment, we should leave the shopping malls and supermarkets as soon as possible.
    • Means of transportation. It is recommended to take private cars or ride shared bicycles to shopping malls and supermarkets, and try to reduce the use of public transportation and in particular crowded buses.

III. Medical Treatment

  1. Select the nearest hospital as required, make an appointment for registration online or by telephone in advance, learn about the medical treatment process of the medical institution during the epidemic, get familiar with the location of the department to see the doctor, and immediately leave the hospital after the treatment.
  2. Wear a mask throughout the medical treatment, ensure proper personal hygiene, avoid touching the mouth, eyes and nose with hands, and cover the mouth and nose with tissue and elbows when sneezing or coughing.
  3. Ensure good hand hygiene, try to avoid touching the door handle, registration machine, ATM and other objects, wash hands in time or rub hands with quick drying hand disinfectant after the unavoidable contact with the objects.
  4. When waiting and queuing, we should keep a distance of more than 1 meter from others, and try to choose stairs over elevators. If you take the elevator, avoid the over-crowded elevator.
  5. Private cars are preferred. If you take public transportation, please keep a safe distance from other passengers and try to keep windows open for ventilation when you take buses and taxis.
  6. After returning home, wash hands in running water with hand sanitizer (or soap) or directly rub hands with quick drying hand sanitizer.
  7. After returning home, change the coat immediately and wash the clothes as soon as possible. In case of contact with any one with suspected symptoms in the hospital, it is necessary to disinfect the coat by physical means as soon as possible, namely, to boil it at above 56℃ for 30 minutes or dry it for 20 minutes at above 80℃ in the dryer, and use chemical disinfectant to soak and disinfect it for further disinfection.