Academician of the Chinese Academy of Engineering, President of Macau University of Science and Technology, Chair Professor Liu Liang

The Novel Coronavirus Pneumonia (NCP) refers to an acute contagious disease caused by infection of the “2019 novel coronavirus (2019-nCoV)”, and its clinical symptoms include fever, cough, and tiredness, etc., and some infected individuals show no observable symptoms. Since its earliest emergence in Wuhan, Hubei Province, in December of 2019, up to February 2, 2020, there have been 17205 confirmed infected cases (8 cases in Macao), and an accumulated death toll of 361 cases. Due to its strong contagiousness and fast spread speed, it has posed a major thread to the Chinese people’s health and life. Nevertheless, at this stage there are still no special vaccines or treatment drugs for the virus, and the most effective preventive measures remain to avoid infection through airborne respiratory droplets, early discovery and early isolation. As a result, better prevention and control of the further spread of the virus would require close attention, cooperation and participation from each individual citizen.

Pathogenic characteristics

It remains unknown as to how long the 2019 novel coronavirus is able to stay alive when off the bio-carrier. However, it is known that the novel coronavirus belongs to the coronavirus family, and shares an 85% homogeneity similarity with SARS related bat coronavirus (bat-SL-CoVZC45); thus, a reference point here is that SARS coronavirus is able to stay alive 2-3 days on surfaces of soil, glass, metal and plastics. The novel coronavirus proves to be sensitive to ultraviolet (UV) light and heat, and therefore 30 minutes’ heat of 56 °C, 75% ethanol, ether, or disinfects with chlorine are all capable of killing the virus.

Epidemiological characteristics

Source of infection: patients infected by the novel coronavirus (including asymptomatic carrier infected by the 2019-nCoV)。

Transmission routes: through respiratory droplets, close contact, and possibly fecal-oral

Susceptible individuals: all populations are susceptible to the virus; elderly populations and patients with existing diseases infected by the virus tend to develop more severe symptoms.

Key prevention and control measures

Strict control of human mobility: prevention and control decisions and measures for a major contagious disease should be based on the pathogenic features and epidemiological features of the contagious disease, and priority should always be placed in the life safety of the people. Once an improperly decided policy or delay is made, disastrous consequences will follow. The novel coronavirus has proved to be capable of human to human transmission through respiratory droplets with an incubation period of 3 to 14 days, and infected carriers proved to be already highly contagious in early asymptomatic periods. This has posed great challenges for prevention and control of the epidemic. As a result, 31 provinces (including regions and cities) across the entire nation have announced to activate the first class response mechanism under a major public health emergency and have taken a series of major preventive and control measures, including locking down the epidemic-stricken zones, restriction of entry, exit and gathering of people, restriction or closing markets/gatherings and other crowd-gathering activities, closing public venues (such as parks, hot springs, cinemas and Internet bars, etc.), and suspension of work, industries and school. Such restrictive measures are key to prevention of human mobility and gatherings and cutting off the human-to-human transmission route, and therefore play a tremendously significant role in successful prevention and control of the NCP. As an international tourist destination, Macao has high population density and high human mobility, which has increased the difficulty to prevent and control epidemics. At this point, the virus is at its peak in transmission, and it is extremely important to place priority of prevention and control measures in control of input carriers to Macao; thus, it is necessary to take more restrictive border-crossing measures and reduce human mobility.

Strict self-protection: Another key to prevention and control of the NCP lies in each individual doing a good job to protect himself/herself, i.e., self-protection. This requires each resident to take up his responsibilities as a citizen, duly observe the anti-NCP regulations and guidelines by the nation and the Macao S.A.R. Government, carry out a citizen’s duties, and put forth efforts to protect oneself so as to neither be infected by others nor infect others. In particular, each individual needs to observe the following “7 Points”: 1^st, try to avoid going out or travelling; 2^nd, avoid gathering or going to people-gathering places; 3^rd, wear facial masks in correct ways (many people now wear masks in incorrect ways); 4^th, attend to hands’ hygiene particularly; avoid infection caused by hand-touching door handles, elevator buttons, bathroom taps, and other items easily contaminated by viruses; wash hands frequently and thoroughly with running water or using disinfectants such as 75% ethanol; wash every part of the hands; 5^th, protect your eyes; avoid touching your eyes with your hands because once your hands are infected with viruses, it’s very likely that the viruses infect you via your eye membranes; 6^th, keep your room ventilated properly, allowing movement of fresh air; 7^th, avoid fecal-oral transmission; remember to pour water to the bathroom sewers every day to keep them from being dry and remember to close the toilet cover when flushing the toilet. What’s more, people required to be isolated following the national or Macao S.A.R. Government’s guidelines should cooperate proactively and duly observe the guidelines.

Fully exert the integration of Chinese medicine and western medicines in treatment

The NCP, by the definition of the Traditional Chinese Medicine, falls under the disease category of “Warm Diseases” or “Warm Epidemics”; the TCM has a rich documentation of such diseases and effective remedies, and has gained direct experience from the treatment of the 2003 SARS using TCM. Given that the severity of the NCP at the current moment and the shortage of effective drugs specially for NCP, it is even more worthwhile to fully exert the role of Chinese medicines. TCM produces effect by integration of multiple approaches and multiple target points rather than simply killing the viruses directly. More importantly, TCM reduces damages to the organs and tissues by protecting their main faculties, therefore helps to strengthen their power to fight against the viruses, and by doing so treats and cures diseases. The major essence of dialectic diagnosis and treatment of TCM lies in seizing the commonality of diseases and the individuality of individuals, which remains the main mode and methodology for clinical treatments using TCM. For treatment of the NCP, to identify designated hospitals or hospital quarters and incorporate dialectic TCM treatment constitutes an important measure for treatment based on integration of Chinese medicine and western medicines; however, when the epidemic spreads quickly or when the infected patients increase quickly, such a measure would be unlikely to satisfy tens of thousands of patients. When such a particular scenario happens, we should gather experts to analyze the NCP patients based on stages, identify the common symptoms of various patients at a particular stage when treated using TCM, formulate unified treatment remedies for each stage (or period) of the disease, and decoct and prepare unified TCM “soup packets”, incorporate the remedies into “regular treatments”, dispatch the packets to all designated hospitals and quarters to serve all patients, including patients under critical conditions, who would have to take in the soup via nasal feeding. Adopting such measures would enable more patients to be treated using TCM. By doing so, the advantages of integrated Chinese medicine and western medicines will be exerted to the fullest. In daily life, for the purpose of health keeping, people would need to rely on a balanced diet. Vulnerable crowds such as the elderly and the sick could try to take in supplementary Chinese Medicines with moderate effects, and should avoid spicy items that disseminate warmth or bitter and cold items that eliminates heat.