Wuhan experts share COVID-19 treatment experience with Italian peers
WUHAN, March 5-- Three Chinese medical experts from Tongji Hospital in Wuhan on Wednesday shared their experiences treating the novel coronavirus disease (COVID-19) with their Italian peers who made inquiries on a video call.
Enrico Ammirati, a cardiologist in the department of anesthesia and ICU of Niguarda Hospital, raised questions concerning the criterion of wards, treatment schemes of cytokine storm and COVID-19, protection of medics.
The Milan-based Niguarda Hospital is the oldest one in the city and one of the largest comprehensive medical facilities in Italy, where the number of confirmed coronavirus cases now stands at more than 3,000. The hospital has vacated a building and has so far admitted more than 200 COVID-19 patients.
"It's pretty hard for hospitals in any country around the world to provide a negative pressure ward for every single COVID-19 patient," said Wang Daowen, a cardiologist at the Tongji Hospital affiliated with Huazhong University of Science and Technology.
Wang told Ammirati about their solutions by refitting general wards -- turning air conditioners off and adding doors to separate the ward into clean, semi-contaminated and contaminated areas.
The treatment of severe and critical COVID-19 patients can refer to that of fulminant myocarditis, Wang said, since cytokine storms were found in patients with both diseases in terms of pathophysiological mechanism.
Tongji experts also shared pictures of level-3 protection and the use of protective masks and suits.
Since no specific antiviral drugs have been discovered in the academic circle, supportive and symptomatic therapies were mainly used for most COVID-19 patients who have been cured, said Zhou Ning, a cardiologist at Tongji.
"We have the experience of fighting SARS and massive data on COVID-19 in Wuhan," Wang said. "It's incumbent on us to share with international peers."
As enveloped viruses are surrounded by a lipid host cell membrane, which is not robust, the COVID-19 virus is likely to be more sensitive to chlorine and other oxidant disinfection processes than many other viruses, such as coxsackieviruses, which have a protein coat. For effective centralized disinfection, there should be a residual concentration of free chlorine of ≥0.5 mg/L after at least 30 minutes of contact time at pH<8.0.A chlorine residual should be maintained throughout the distribution system.
Toilets and the handling of faeces
If a bedpan is used, after disposing of excreta from it, the bedpan should be cleaned with a neutral detergent and water, disinfected with a 0.5% chlorine solution, and then rinsed with clean water; the rinse water should be disposed of in a drain or a toilet or latrine. Other effective disinfectants include commercially available quaternary ammonium compounds, such as cetylpyridinium chloride, used according to manufacturer’s instructions, and peracetic or peroxyacetic acid at concentrations of 500−2000 mg/L.