This Handbook of COVID-19 Prevention and Treatment was compiled according to clinical experience at The First Affliated Hospital, Zhejiang University School of Medicine

Editor’s Note

Faced with an unknown virus, sharing and collaboration are the best remedy.

The publication of this Handbook is one of the best ways to mark the courage and wisdom our healthcare workers have demonstrated over the past two months.

Thanks to all those who have contributed to this Handbook, sharing the invaluable experience with healthcare colleagues around the world while saving the lives of patients.

Thanks to the support from healthcare colleagues in China who have provided experience that inspires and motivates us.

Thanks to Jack Ma Foundation for initiating this program, and to AliHealth for the technical support, making this Handbook possible to support the fight against the epidemic.

The Handbook is available to everyone for free. However, due to the limited time, there might be some errors and defects. Your feedback and advice are highly welcomed!

Prof. Tingbo LIANG Editor-in-Chief of the Handbook of COVID-19 Prevention and Treatment Chairman of The First Affiliated Hospital, Zhejiang University School of Medicine

Foreword

This is an unprecedented global war, and mankind is facing the same enemy, the novel corona-virus. And the first battlefield is the hospital where our soldiers are the medical workers.

To ensure that this war can be won, we must first make sure that our medical staff is guaranteed sufficient resources, including experience and technologies. Also, we need to make sure that the hospital is the battleground where we eliminate the virus, not where the virus defeats us.

Therefore, the Jack Ma Foundation and Alibaba Foundation have convened a group of medical experts who have just returned from the frontlines of fighting the pandemic. With the support of The First Affiliated Hospital, Zhejiang University School of Medicine (FAHZU), they quickly published a guidebook on the clinical experience of how to treat this new coronavirus. The treatment guide offers advice and reference against the pandemic for medical staff around the world who are about to join the war.

My special thanks goes out to the medical staff from FAHZU. While taking huge risks in treating COVID-19 patients, they recorded their daily experience which is reflected in this Handbook. Over the past 50 days, 104 confirmed patients have been admitted to FAHZU, including 78 severe and critically ill ones. Thanks to the pioneering efforts of medical staff and the application of new technologies, to date, we have witnessed a miracle. No staff were infected, and there were no missed diagnosis or patient deaths.

Today, with the spread of the pandemic, these experiences are the most valuable sources of information and the most important weapon for medical workers on the frontline. This is a brand-new disease, and China was the first to suffer from the pandemic. Isolation, diagnosis, treatment, protective measures, and rehabilitation have all started from scratch. WE hope that this Handbook can provide doctors and nurses in other affected areas valuable information so they don’t have to enter the battlefield alone.

This pandemic is a common challenge faced by mankind in the age of globalization. At this moment, sharing resources, experiences and lessons, regardless of who you are, is our only chance to win. The real remedy for this pandemic is not isolation, but cooperation.

This war has just begun.

Contents

Part One Prevention and Control Management

I. Isolation Area Management 1

II. Staff Management 4

III. COVID-19 Related Personal Protection Management 5

IV. Hospital Practice Protocols during COVID-19 Epidemic 6

V. Digital Support for Epidemic Prevention and Control 16

Part Two Diagnosis and Treatment

I. Personalized, Collaborative and Multidisciplinary Management 18

II.Etiology and Inflammation Indicators 19

III. Imaging Findings of COVID-19 Patients 21

IV. Application of Bronchoscopy in the Diagnosis and Management of COVID-19 Patients 22

V. Diagnosis and Clinical Classification of COVID-19 22

VI. Antiviral Treatment for Timely Elimination of Pathogens 23

VII. Anti-shock and Anti-hypoxemia Treatment 24

VIII. The Rational Use of Antibiotics to Prevent Secondary Infection 29

IX. The Balance of Intestinal Microecology and Nutritional Support 30

X. ECMO Support for COVID-19 Patients 32

XI. Convalescent Plasma Therapy for COVID-19 Patients 35

XII. TCM Classification Therapy to Improve Curative Efficacy 36

XIII. Drug Use Management of COVID-19 Patients 37

XIV. Psychological Intervention for COVID-19 Patients 41

XV. Rehabilitation Therapy for COVID-19 Patients 42

XVI. Lung Transplantation in Patients with COVID-19 44

XVII. Discharge Standards and Follow-up Plan for COVID-19 Patients 45

Part Three Nursing

I. Nursing Care for Patients Receiving High-Flow Nasal Cannula (HFNC) Oxygen Therapy 47

II. Nursing Care in Patients with Mechanical Ventilation 47

III. Daily Management and Monitoring of ECMO (Extra Corporeal Membrane Oxygenation) 49

IV. Nursing Care of ALSS (Artificial Liver Support System) 50

V. Continuous Renal Replacement Treatment (CRRT) Care 51

VI. General Care 52

Appendix

I. Medical Advice Example for COVID-19 Patients 53

II. Online Consultation Process for Diagosis and Treatment 57

References 59

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