Hu and Mao: Emergency Management of Mental Hospitals during the Outbreak of COVID-19
The 2019 novel coronavirus disease (COVID-19) has spread out almost the world. It was first found out in Wuhan, quickly infected other provinces in China. The confirmed and suspected cases increased sharply. By March 6th 80,651 citizens have been infected, 3,070 died in China. The whole world is affected by the infectious disease. The tremendous need to cope with the outbreak of COVID-19 required great amount medical staff joining the treatment.
The coronavirus has been confirmed to be transmitted from person to person [1]. Currently, fast spread infection and high lethality had made the public panic. The increasing number of patients and suspected cases, have caused public worry about becoming infected. Identified and suspected patients may fear the consequence of this infection. The mental health of citizen and medical health-care workers urgently needed help during this period [2,3]. However, it is of great significance to protect healthy workers. To prevent medical staff infection, Hangzhou Seventh People’s Hospital, as a psychiatric hospital, take emergent measures as follows.

To employee:

1. Provide protective equipment such as surgical masks, hats and gloves for doctors and nurses. Isolation suits are supplied for those who treat fever patients. Wards have been sterilized strictly.
2. Monitor temperature twice a day. Show health code which is developed by Ali based on big data intelligent monitoring if the person have ever been to the affected area. People and vehicles come in different entrances for convenient temperature monitoring.
3. Organize network training instead of face to face meeting about protection of COVID-19. Check hand hygiene and medical waste disposal.
4. Chinese medicine has been provided for employee since traditional Chinese medicine proved to be effective preventing the Corona Virus Disease [4].
5. Do not eat in the cafeteria. Box lunch is provided avoiding cluster infection. According to reports, employee from a Beijing company have been infected when eating in canteen.
6. Interns who have been back home for the Spring Festival are requested delaying back to hospital. Those who have come from other cities are demanded self isolation for 14 days according to regulations.

To inpatient:

Learn lessons from infected prison in Wuhan, strict management is taken entering the ward.
1. Temperature is monitored and health code is needed. Epidemiological history is collected and recorded in detail.
2. Blood test and chest CT are required when patient is hospitalized. Only if the result is normal, hospitalization is allowed.
3. Patients who have fever or come from infected area need to watch closely and live in separate ward.
4. Form a specialized team for fever patients. Wear isolation clothing and take professional training. Self protection is the top priority.
5. No visiting during the period. Family cannot enter the ward unless the condition requires.

To outpatient:

1. Temperature is monitored and health code is needed. Epidemiological history is collected.
2. Prescription can extend to 3 months for chronic patients in order to reduce visiting hospitals. Therefore, reduce the chance of infections in hospital.
3. One patient at a time. Only one patient get into the office. After the clinic, doctors do not return to the ward in case of cross infection.
4. Provide network consulting. The convenience of internet and smart phones made it possible for psychiatrists and mental health centers to provide online medical care during the COVID-19 epidemic [5].
Our hospital has taken urgent steps, such as online counseling and regional isolation, to relieve the pressure on clinical counseling and reduce cross-contamination. Therefore, Hangzhou 7th Hospital’s emergency management program can extenuate the burden, protect healthy workers and reduce the probability of cross infections. It is vital to create emergency management plan suitable for mental hospital correspondingly.

The authors have no potential conflicts of interest to disclose.

REFERENCES

1. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395:497–506.
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2. Bao Y, Sun Y, Meng S, Shi J, Lu L. 2019-nCoV epidemic: address mental health care to empower society. Lancet 2020;395:e37–e38.
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3. Xiang Y, Yang Y, Li W, Zhang L, Zhang Q, Cheung T, et al. Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed. Lancet Psychiatry 2020;7:228–229.
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4. Luo H, Tang QL, Shang YX, Liang SB, Yang M, Robinson N, et al. Can Chinese medicine be used for prevention of corona virus disease 2019 (COVID-19)? A review of historical classics, research evidence and current prevention programs. Chin J Integr Med 2020;26:243–250.
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5. Liu S, Yang L, Zhang C, Xiang YT, Liu Z, Hu S, et al. Online mental health services in China during the COVID-19 outbreak. Lancet Psychiatry 2020;7:e17–e18.
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