Information on epidemiology of SARS-CoV-2 which is available today indicates that infection occurs especially often at the unprotected contact between people (for example, at home or in hospital). At the same time the significant role is played by an airborne way of transfer. On the available information infection comes through allocations from a respiratory path, besides, through cough and sneezing and also through various medical and dental procedures which are followed by formation of aerosol (for example, an intubation of a trachea or a bronkhoskopiya). It is necessary to consider also indirect infection, for example, through contacts with hands or contact of surfaces in medical institutions. It is considered that drops with a virus can get on surfaces and objects, and then to infect the person who touched them through the subsequent touches with hands to eyes, a nose or a mouth. At the same time drops, as a rule, do not extend further six steps (about two meters) and are not late in air. The virus can remain viable within several hours, getting on a surface of objects. On steel surfaces and on plasticity it can remain up to 2–3 days. But the question of whether the virus during such time spent in external environment is capable to keep the pathogenic functions, remains open. Also there is disputable a question of whether SARS-CoV-2 in natural medium (by means of more fine particles can be transferred only in the air way, than drops which remain in air a long span and can be transferred to considerable distance).
The interval during which the person with COVID-19 remains infectious, is definitely not defined. It is considered that the coronavirus can be transmitted before emergence of clinical symptoms and during the entire period of a disease. These data are based on data on virus RNA identification in samples of a secretion of airways that not necessarily indicates allocation by the patient of virus particles, capable to infection. Concentration of virus RNA in samples from the upper airways is highest during the period after the beginning of manifestation of symptoms and decreases in process of the course of a disease.
The outcome from these data and also experience of fight against other coronaviruses, in general is considered that sanitary and hygienic events should be held also, as well as with the previous epidemics of SARS and MERS. According to the available information on an etiology of the SARS-CoV-2 virus and the analysis of ways of transfer, at least at an early stage of an infection, there is obviously pronounced participation of the upper airways.
The problem of the sanitary and hygienic events held in hospitals and out-patient and polyclinic institutions consists in the maximum minimizing spread of an infection in healthcare institutions. At hospitalization of patients it is necessary to provide a possibility of placement in the single isolated chamber with the certain bathroom and also to give special preference to the isolated rooms with the lock/platform. Joint isolation of several patients is possible under a number of conditions. Risks of infection via ventilation systems which are capable to extend a contagium need to be estimated on the place and also to minimize.
It is necessary to use skilled staff for patient care of COVID-19 which whenever possible to separate from personnel which look after other patients. The personnel have to use the individual protection equipment (IPE), requirements to which are stated in a number of recommendations. SIZ needs to be put on to an entrance to chamber of the patient, and at an exit to leave in the lock/platform. The hygiene of hands is also of great importance. Disinfection of hands is used by special means of antiviral action which is carried out after putting on of gloves and before an exit from chamber of the patient. Also disposable gloves have to be used. Regular observation of the state of health of medical personnel is necessary.
For disinfection it is necessary to use means with antiviral effect (effective against viruses with a cover). Daily disinfection with wiping of surfaces to which patients contact is necessary (for example, bedstands, the bathroom, door handles). In need of an action for disinfection can be carried out on and other surfaces where there is a risk of existence of an infection. All products of medical prescription to which directly contacted infected (for example, the device ECG, a stethoscope and so on) after use have to be disinfected. Thermal ways of disinfection have to be in a priority if there is such opportunity, otherwise disinfectants are used.
If transportation of patients in hospital is necessary, then health workers of the office accepting the patient have to be beforehand informed. It is necessary to move patients on one. If the condition of the patient allows, he has to use a medical mask.