Health Times reporter Xu Shiyu
As of 11:00 on December 27, there were 635 locally confirmed cases in Xi'an. A Health Times reporter combed through the circulation and found that the first case of the current round of epidemic in Xi'an was a member of the special class of the hotel in baqiao district of Xi'an City, which was reported on December 9.
The reporter found that netizens in many places complained about the feedback, some isolated hotels were set up in downtown areas, surrounded by schools; some of the staff had no medical background and other issues.
Emergency remodeled isolated hotel. Courtesy of respondents
Some of the quarantined hotels are located in the downtown area, and there are schools scattered around
A netizen in Weiyang District, Xi'an City, told the Health Times reporter that the hotel next door to a kindergarten was set as an epidemic isolation hotel on January 9, only a wall away from the kindergarten, and only more than 100 meters away from a primary school in Weiyang District. It is hoped that the relevant departments will consider the surrounding environment, withdraw this isolation point, and find a suitable place again.
The Health Times reporter combed the epidemic information in various places and found that some of the quarantined hotels in Xi'an and Guangzhou were set up in downtown areas or near schools, and then caused occupational exposure infections due to staff picking up garbage and other reasons. On December 9, Shaanxi reported a new locally confirmed case, a member of the special working class of the hotel in baqiao district of Xi'an City, and the cause of infection was occasional occupational exposure. Health Times reporter searched the hotel in Baqiao District, Xi'an City on the map and found that the hotel is close to Xi'an Chanba First Middle School and Chanba Fourth Kindergarten, and the walking distance between the hotel and the kindergarten and middle school is only 500 meters.
On December 4, Guangzhou Baiyun District reported that the staff of an inbound quarantine hotel had a positive nucleic acid test result. As early as September this year, the staff of the entry quarantine hotel in Guangzhou's Yuexiu District also found a person with a positive nucleic acid test during routine testing, and according to the Guangzhou Municipal Health Commission, the case was caused by an exposure infection when picking up garbage. The reporter inquired about the map and found that there were many primary and secondary schools in Yuexiu District, such as Huanshi Road Primary School in Yuexiu District, the Affiliated Middle School of Guangzhou University, the Yuexiu School of Guangdong Experimental Middle School, and the Seventeenth Middle School of Guangzhou City.
Netizens in many places have reported that the location of the isolated hotel is improper, especially the proximity to the school. Some hotels were removed after residents complained.
The hotel is emergency renovated, and the training time of some staff is extremely short
"We received a notice on the same day to temporarily rebuild and arrange isolation points, and the quarantined people stayed in the hotel for isolation that night." A staff member of an isolated hotel in Hailar City, Inner Mongolia, told reporters that in response to the epidemic in Manzhouli, a large number of quarantined people in Manzhouli went to the Hailar Hotel for isolation, and their hotel completed emergency transformation on the same day.
The reporter interviewed the staff of shandong Qingdao, Zhejiang Jinhua, Jiangxi Shangrao and other isolation hotels and found that the requisitioned isolation hotels were previously ordinary hotels, and after requisition, the local disease control department and the hospital hospital infection department delineated the three districts and two channels, and installed ultraviolet rays. Because the time for partial use is relatively tight, it is generally within 24 hours.
The owner of an isolated hotel in qingdao's south district of Shandong province revealed to the Health Times reporter that its hotel has been operating as an isolated hotel for one and a half years, "less than 50 people need to be equipped with a doctor, a nurse, more than 50 people need to be equipped with 4 medical care." Our hotel has a group of about 70 quarantined personnel, equipped with 6 public security, 2 fire protection, 4 medical care, and more than 10 hotel staff. A cycle is generally 14 or 21 days, during which no one can leave the store. The hotel operator said that before each isolation, Qingdao Municipality organized anti-infection training for all staff, and the public security was responsible for monitoring all aspects of the hotel for 24 hours.
According to the "Guidelines for the Design of Temporary Facilities for Medical Isolation and Observation (Trial)" issued by the General Office of the National Health Commission and the General Office of the Ministry of Housing and Urban-Rural Development on May 17, the location of temporary facilities for medical isolation and observation should be located in areas with good geological conditions, close to medical resources, complete municipal supporting facilities, convenient transportation, and quiet environment, and should be far from pollution sources, densely populated areas, kindergartens, schools, elderly care facilities and other places for susceptible people.
Qiao Fu, an expert of the Hospital Infection Prevention and Control Group of the Joint Prevention and Control Mechanism of the State Council and the Hospital Infection Department of West China Hospital of Sichuan University, told the Health Times reporter that from the perspective of infectious diseases, in the case of closed-loop management, the school will not have an impact on the isolation point of 500 meters, but the isolation hotel should be guaranteed to be away from pollution sources, densely populated areas, kindergartens, schools, elderly care facilities and other vulnerable population places. Necessary safety isolation facilities should be set up between temporary medical isolation and observation facilities and the surrounding environment, and between various functional areas.
A hospital staff member in Jinhua, Zhejiang Province, told the Health Times reporter that after the hospital took over a local isolation hotel, it uniformly conducted 2 to 3 hours of anti-infection training for the staff and the medical staff stationed there, and the staff of the hotel itself had no medical background, mostly waiters, cleaning and other personnel. The training content includes wearing and taking off protective clothing, killing routes, garbage disposal, etc., and the training duration is not more than half a day.
"The staff of the hospital's infection department browses and monitors 24 hours a day to see if there are any epidemic prevention problems, and then corrects the errors in time after finding loopholes." The staff of the above-mentioned hospital infection department told reporters that because the hotel staff has no medical background, it is easy to cause exposure infection, and in the case of long-term training and practice cannot be guaranteed, it can only be corrected and guided by monitoring and actual operation.
Hospital sense experts: Establish a long-term training system, focusing on infection prevention and control for non-medical staff
Why do quarantined hotels still have repeated outbreaks? In this regard, Qiao Fu, an expert of the Hospital Infection Prevention and Control Group of the Joint Prevention and Control Mechanism of the State Council and the Hospital Infection Department of west China Hospital of Sichuan University, told the Health Times reporter that there are four difficulties in prevention and control in the isolated hotel.
First of all, unlike specially established isolation stations such as Guangzhou International Health Station, most of the isolation hotels are not set up in accordance with isolation standards, but emergency transformation, and it is difficult to fully meet the anti-infection requirements when transforming. Isolation hotels generally have three districts and two passages, including cleaning areas, medical observation areas and buffer zones in the middle, and emergency renovation hotels should plan the routes for staff, quarantined people, and garbage in and out to avoid cross-infection.
The composition of isolated hotel staff is more complex, including professional medical staff, ordinary hotel staff, community workers, cleaning personnel, security personnel, etc., it is difficult for non-professionals to strictly meet the requirements of correctly wearing and taking off protective clothing and killing in a short period of time, but they need continuous training and strict training. Improper handling can easily lead to accidental exposure to infection.
The workload of isolated hotel staff is large, and it is difficult to implement personnel management and item classification management in accordance with strict epidemic prevention requirements, and there may be loopholes. There may be gaps in the management of infection prevention behavior by staff when performing high-risk operations, and medical waste residues, etc. may cause exposure to infection.
The sealing and control area outside the isolated hotel is not strict enough, and the treatment of sewage and dirt is not strict enough, which may lead to the accidental entry of idle people in the periphery and cause infection.
Medical isolation and observation of temporary facilities functional composition. Source National Health Commission
In the future, how to achieve a more scientific and accurate epidemic prevention in the quarantine hotel? Qiao Fu suggested that a more perfect access system and training system for isolated hotel staff should be established. The direct induction of randomly selected personnel can easily lead to improper operation, and corresponding training should be carried out to achieve personnel induction after qualification.
Secondly, the emergency transformation of the isolation hotel should be strictly in accordance with the design of the temporary facilities for medical isolation and observation of the National Health and Health Commission, delineate the work preparation area, the health passage area and the isolation area, establish the corresponding physical barrier, and cannot only temporarily isolate through plastic film, demarcation and other phenomena.
Third, reasonably arrange personnel supervision, supervise and standardize isolation work, feedback whether the operation behavior meets the requirements of infection prevention and control at any time, and timely adjust and improve.
Fourth, rationally arrange manpower to ensure adequate rest for staff.
Focus on the anti-infection awareness of non-medical staff, and strengthen training for personnel without medical backgrounds such as cleaning and security.
The surrounding area is strictly sealed and controlled to prevent the spread of infection caused by the entry and exit of idle people from outside.
Finally, it is necessary to strictly treat sewage and medical waste to avoid secondary infection.