By China Rehabilitation Research Center for Hearing and Speech Impairment

COVID-19 is a new highly infectious disease, and people of all age groups including children are susceptible to it. But the disease can be effectively prevented by reducing going outside in public, maintaining good personal hygiene habits and taking protective measures. This article puts forward some protective measures to keep the disease away from children with disabilities.

I. How to do a good job in personal protection?

1. Minimize the time of staying outside
(1) Avoid areas severely hit by the epidemic.
(2) During the epidemic, refrain from visiting or dining together with relatives and friends and try to stay at home.
(3) Avoid crowded public places and especially places with poor ventilation, such as public baths, hot springs, cinemas, Internet bars, KTV bars, shopping malls, stations, airports, docks, exhibition halls, etc.

2. Personal protection and hand hygiene
(1) Wear a mask when going out. Wear a surgical face mask or N95 mask when going to public places, seeing a doctor, or using public transportation.
(2) Keep hands clean. Try to avoid contact with public facilities in public places; use hand sanitizer or soap to wash hands in running water or use alcohol-based hand sanitizer after returning from public places, after coughing and covering the mouth and nose with hands, and after using toilet and before meal; avoid touching the mouth, nose and eyes with hands when we are not sure whether the hands are clean or not; cover the mouth and nose with tissue when sneezing or coughing, and cover the mouth and nose with elbows and cloth when there is no tissue paper.

3. Do a good job in health monitoring and medical treatment
(1) Do a good job in monitoring the health of our own as well as our family members. Parents of children with disabilities should take their children’s temperature twice a day, in the morning and evening.
(2) Should any suspected symptoms of COVID-19 appear, like fever, cough, fatigue, sore throat, chest distress, dyspnea, mild nausea, nausea and vomiting, diarrhea, headache, palpitation, conjunctivitis, mild limbs or lump muscles, the patient in concern should wear a mask and seek medical treatment nearby. He/she should try to avoid public transportation like subway and bus as well as crowded places. When visiting the doctor, he/she should truthfully tell the doctor his experience (if any) of travelling to or staying in the epidemic-hit areas as well as his contact with confirmed cases or suspected cases of COVID-19, in a way to cooperate with the doctor to carry out relevant investigations.

4. Ensure proper hygiene and develop healthy habits

(1) The windows should be frequently opened for ventilation. At least a 30-minute ventilation a day should be ensured.
(2) Family members should avoid sharing towels, keep home furnishings and tableware clean, and frequently expose the clothes and quilts to the sun.
(3) Don’t spit on the floor, wrap the mouth and nose secretions with tissue, and then discard
them in a covered garbage can.
(4) Ensure good nutrition and exercise properly.
(5) Keep at hand such materials as the thermometer, surgical face mask or N95 mask and household disinfection articles, etc.

II. How to protect children with disabilities in daily life?

1. If possible, we should avoid taking children out, and in particular avoid public places or closed space, like shopping malls, theaters, hot springs, children’s entertainment centers, etc. If going out is absolutely necessary, we should try to avoid public transportation and stay at least 1 meter away from other people.
2. During the epidemic, it is suggested to postpone or cancel the routine health examination for children, to avoid going to the hospital, and to cancel the centralized rehabilitation training.
3. Don’t take children to visit relatives and friends, to join in parties or to dine together with others. The acquaintances shall not be allowed to touch babies or talk with kids at a close distance. And we should avoid contact with the people with respiratory infection and those who have been to the areas severely hit by the epidemic over the past two weeks.
4. The room shall be kept clean with fresh air and proper temperature. Ventilation should be ensured every day and we must keep ourselves warm in extremely cold weather. The children should be taken away from the room being ventilated to avoid catching cold.
5. Parents and caregivers should wash their hands properly before having fun with or conducting rehabilitation training for the children with disabilities, change clothes and shoes after going home, and wash hands before touching the kids. They should remind or help children to wash their hands with hand sanitizer or soap in running water before meal and after using toilet, playing games, coughing, sneezing, and contacting saliva and secretion.
6. Reduce the chance of infection. Family members should avoid sharing towels and cups; instead they should use serving chopsticks and spoons. We should avoid kissing children, and breathing and panting to them. Moreover, children’s toys and articles should be disinfected regularly.
7. Breast milk is the best “medicine” to boost the newborn’s immune system. Pure breastfeeding should be ensured for the infants less than 6 months old. It is recommended to continue breastfeeding the infants of more than six months old till they reach 24 months while complementary food is properly fed to them. However, if the mother is a confirmed or suspected case of COVID-19, breastfeeding should be suspended and the mother should be isolated till her full recovery.
8. Between receiving the instruction for reopening the institution after the end of the epidemic and resuming centralized rehabilitation training, all rehabilitation institutions for children with disabilities should do a good job in disinfecting the environment as well as the playing and teaching equipment and tools, formulating the epidemic prevention and control management plan, and stocking anti-epidemic protection materials.

III. How to protect children with disabilities when they go out?

1. If it is necessary to see a doctor, the parents should make sure the children wear a mask on the condition that they do not suffer any discomfort like breathing difficulty. The super young kids cannot wear masks for the risk of suffocation. If children have to go out, it is suggested to keep them away from unprotected people as far as possible. In principle, masks are not required in open space, but in crowded or closed places, to wear a mask is a must.
2. It is recommended to carry tissue and alcohol-based hand sanitizer when going out. When coughing or sneezing, you should cover your mouth and nose with tissue. The tissue used to cover your mouth and nose or wipe your nose should be wrapped up and discarded into a covered dustbin. When it is inconvenient to wash hands in running water while staying outdoors, parents should use alcohol-based hand sanitizer to disinfect their hands after coughing, sneezing and wiping their kid’s nose. Special wet wipes should be used for infants.
3. We should wear gloves when going out and any daily gloves, except wet gloves, are acceptable. We should try to reduce contact with public facilities and certain parts of public places. We should remind children not to touch things here and there when they go out, and ask them to avoid touching the mouth, nose and eyes with their hands when they are not sure whether their hands are clean or not.
4. After returning home, the first thing it to take off clothes and change shoes, and then it is to wash hands and face properly. If the children cooperate, their nose and mouth can be cleaned. The clothes and gloves worn when going out as well as the articles carried along should be cleaned and disinfected in time if they are suspected of being exposed to the virus (like after visiting a fever clinic).

IV. Points of attention for children to wear masks

1. It is recommended that children choose products that meet the protection standards and are labeled as particulate protective masks for children or teenagers.
2. It is hard for an adult mask to properly fit a small child’s face, so it’s not recommended for children to wear adult masks.
3. Before helping children put on masks, parents should carefully read and correctly understand the instructions, so as to help the children use masks correctly.
4. Parents should always pay attention to whether the children feel comfortable with the mask. If children feel uncomfortable when wearing the mask, adjustment should be made or the mask should be taken off in time.

V. What to do when children fall ill?

If a child has cough, fever or other symptoms, and it is confirmed that he/she has not gone outside and has no contact with anyone infected by the epidemic, the temperature of the child can be monitored and his/her condition should be treated as common respiratory tract infection at home. If the fever persists, cough worsens, dyspnea occurs, or the mental state is poor, it is recommended to bring the child to see a doctor at the nearest hospital where pediatric outpatient service is offered. Please refer to the requirements issued by National Center for Disease Control and Prevention or relevant health management department for personal protection precautions when going to the hospital.

VI. What to do when the children’s care-givers show suspected symptoms?
When suspected symptoms of novel coronavirus infection are found in the parents or other caregivers of the children, like fever, dry cough, fatigue, sore throat, chest distress, dyspnea, nausea and vomiting, diarrhea, conjunctivitis, muscle soreness, etc., masks should also be worn at home, and medical treatment should be sought and isolation should be done in time. It is suggested that the children should be kept out of contact with the suspected case until the latter’s body temperature returns to normal for more than 3 days. During the isolation period, the children should be temporarily taken care of by other reliable caregivers.

If the parents or caregivers who have close contact with the children are diagnosed as suspected or confirmed cases, the children need to be quarantined at home for medical observation. If quarantine for medical observation cannot be done at home, it can be done at an institution. The medical observation shall last 14 days, starting from the last contact with the case without effective protection. Once the infection is ruled out by the results of case investigation, the medical observation can be terminated.

VII. How to do rehabilitation training for children with disabilities during the epidemic?

Parents should make full use of the rehabilitation knowledge to do home-based rehabilitation, keep in touch with the rehabilitation service institutions, and obtain online professional guidance on rehabilitation provided by the specialized service institutions, so as to reduce the impact of the epidemic on the children’s rehabilitation, and improve the effect of the home-based rehabilitation training.