Infection Control
againstNovel Coronavirus

Autumn 2020
Illustrations & sentences byMasataka Shimotsuma MD
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Contents
What is novel coronavirus ?

P.3

Three infection patterns of novel coronavirus

P.4"Five scenes" to increase the infection risk

P.6

Mechanism and symptoms of novel coronavirus

P.8

Countermeasures process against novel coronavirus

P.10

Now why mask is necessary ?

P.12

When can't keep a social distance, wear a mask

P.14

Clean hands when touching nose, eyes or mouth

P.16

Be aware of fingertips and clean hands

P.18

When family infected …

P.20

Gargle after returning home or before going to bed
When you get home, wash your hands, gargle, and wash face.
Before going to bed, gargle to reduce viruses in the mouth.

2What is novel coronavirus ?

Novel coronavirus is thought to have occurred around November 2019
when the bat coronavirus infects humans.

The new corona was first confirmed in Japan in January 2020.
Of the 3713 passengers aboard the Diamond Princess passenger shipthat returned to Yokohama Port in February,
712 (about 20%) were infected with novel coronavirus.
A lot about novel coronavirus was learned by analyzing and investigating the infection
on this cruise ship experience.
3Three infection patterns of novel coronavirus③ Micro droplets① Droplet
infection

When speaking loudly, micro droplets (lessthan 1/100 mm) are spread.
They keep floating in the air for 20 minutes. If
you inhale them, you may be at risk of getting
infected.

② Contact
infection
Hand wash to prevent
contact infections

Coughing people
should wear a mask

A closed space is dangerous!
Ventilate to blow off micro droplets※ Micro droplets are more widespreadthan droplet infections

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The three common points of clusters ...
The infection risk is low, when normally walk around the city or shopping,provided wearing a mask.（ Chairman Shigeru Omi ）Do not
SealDense
Get close

Do notSpeakloudlySufficient
infection
control

These three are the points ofcountermeasures
Lecture at the Japanese Societyof Infectious Diseases
on August 20, 2020

Chairman of novel coronavirus control subcommitteeby the government

When speak loudly,
both droplets and micro droplets spread out.

Be careful not to
get infected withnovel coronavirusMicro droplets

In gym lockerDroplets
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"Five scenes" to increase the infection risk
Unmasked conversations in cars and buses are risky

Let's wear amask

Let's ventilate
wellSocial gatherings with drinking alcohol6

Conversation without a mask
karaokeShared living in a small spacesuch as a dormitory room

At break room,smoking area

7changingroom,"Five scenes" of the infection risk
① Social gatherings with drinking② Large number of people with eating anddrinking for a long time
③ Conversation without a mask
④ Communal living in a small space⑤ Switching seats
Ministry of Health, Labor and Welfare,
October 23, 2020

Mechanism and symptoms of novel coronavirus
Novel coronavirus enters by binding to special receptors on the mucous
membranes in body. This is a receptor for regulating blood pressure
however it happens to stick to novel coronavirus.

② Invades into the body①

Bind to the receptor

Receptors on the facial
mucosa are the nasal
mucosa, eye conjunctiva,
oral mucosa, and tongue.
As the skin has no
mucous membranes,
there are no receptors.

Olfactory
disorderDysgeusia

The skin is a naturalbarrier

8Symptoms of novel
coronavirus

Cerebral infarction(cerebral thrombosis)

FeverCoughRunny nose / Olfactory disorder
Dysgeusia

Pneumonia
Pulmonary embolus

Sore throat
Myocardial infarction
Kidney failure
Diarrhea

Deep lower limbs
Venous thrombosis※As inflammation progresses
due to infection, blood tends
to clot in blood vessels
throughout the body, resulting
in secondary advanced
symptoms such as deficits
shown in red letters.

Children are lesssusceptible to infection by
fewer receptors.

Children may be infected when they are
exposed to large amounts of novel
coronavirus in a short time, even though
they have few receptors.

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Countermeasures process against
novel coronavirus
Basically important towear Mask and Hand Wash
Hand washing is oneof the important
traditional ways
before meals.

Droplet infection

Mask

Wear a mask when you can't
keep a distance from people10Micro droplets

Ventilation

Micro droplets generated by a loud voice can stay in the air for a long time in lessventilated space, then there is a risk of infection even if sitting far away. Ventilate theroom well to blow off these micro droplets.

Hand washingand Disinfection

Contact
Infection

Disinfect the parts
where everyone
touches often
Let's clean
our hands

11Now why mask is necessary ?
One among three people infectedwith novel coronavirus had no symptoms
33
nosymptoms

43
mildly ill

28
severely ill

104 Severity PCR-positive patients (Diamond Princess ship)
Average age 68 years (47-75 years)(reported by the Self-Defense Forces Central Hospital)

We can not find who is spreading novel coronavirus!

When you can't get enough
distance (1 to 2m),wear a mask

Keep a sufficient distancewhen you are not wearing a mask

1ｍ1ｍ12

Novel coronavirus
shed is the highest
before the onset

Infected

2 daysbefore onset

Onset

10 day after

Wear mask even though no cough2 Daysbeforeonset

Onset
No symptoms

It is said the period to infect others is from 2 days before theonset to 7 to 10 days after the onset.

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When can't keep a social distance, wear a mask

BeforeWhen you have a cough, wear a mask
① Mask

② Cover your mouthand nose with tissue③ Cover your mouthand nose with sleeves

3 etiquettes against coughing
Regardless ofcoughing

Now

When you can't keep a distance from others,
wear a mask

Hey you, too close. Wear mask

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When you can't keepa distance from others,
wear mask
regardless coughing

Universal-kun gives everyone masks※ Also called “Universal Masking"Surgical Mask（ Non-woven ）Cloth Mask (cotton, gauze, etc.)

Nose wire

Absorbs breath
liquidCloth masks areeasy to breathe,when you speak
loudly, they may
pass small
droplets.

Catch them byattaching particlesBlock droplets

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Clean hands when touching nose, eyes or mouth

The skin is okay!
butitchy nose ...

OhI feel goodAt very this moment ...

Novel coronavirus
binds to receptors on
the mucous membraneof the nose andinvades the body16

Mass floatingof novel coronaviruses

Novel coronavirus is still safe on your hands.
Cover with “Hay fever glasses" and “Mask" to prevent novel
coronavirus against to bind the receptors !

It is important the mask fits snugly on the face,and be careful there is no gaps around thenose and cheeks.

Disinfect or rinse
novel coronavirus on yourhands before touching nose,eyes and mouth

The fingertips carrynovel coronavirus to
the nasal receptors

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Be aware of fingertips and clean hands

At first, sterilize
your fingertips witha pool ofdisinfectant

Hand washwith soap and running water

Disinfect fingers

In order not to get rough skin surface...
Whisk the soap well. Do not wash strongly.
Gently wash on the skin.
Do not wipe strongly. Moisturize well.

①

Whisk well and wash both hands②③

Wash while twisting your thumb

Wash your fingertips④

Wash the base of your nails

18Ways for disinfecting hands① Use enough to disinfect your entire fingers② At first disinfect your fingertips, nails, and thumbs,
that are likely forgotten③ Then dry them well1①

Make a “Big Pool"in the palm of your hand

“Big Pool"
ofdisinfectant

2③ When the right hand is finished,
move the liquid to the right hand palm
to disinfect the left hand by adding one
push② Put your fingertips on thepuddle and disinfect yournails.

3④ Disinfect the thumb,between fingers, palm, backof hand, and wrist⑤ Disinfect thoroughly until
dry up19

When family infected …
UnwellIsolation

Influenza ？

Novel coronavirus ？
Novel coronavirus Infection

Influenza infection

The initial symptoms resemble the flu andcommon cold.
The main symptoms arefever, cough, malaise, and respiratory distress.
Diarrhea (10%),Dysgeusia (17%)
Olfactory disorder (15%)

Onset with a sudden feverof 38-39 °C or higher.
In addition to respiratory symptoms,
it is accompanied by systemic symptoms suchas headache, lumbago pain, muscle pain,
arthralgia, and general malaise.

When no one can tell it's novel coronavirus or influenza
Call a local clinic or hospital

Production Member✚ Japanese Red Cross Toyota College of Nursing
Masataka SHIMOTSUMA, MD, Ph.D.
（Infection Control Doctor）

Naotsune HOSONO, Ph.D.

Ver.1: 26 November 2020

(English Translator)

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