First, universal mask wearing of HCWs in healthcare settings was implemented at the early stage of the pandemic in China. In the middle of January, the National Health Commission of China, an equivalent of Ministry of Health, issued a national guidance for COVID-19 prevention and control, in which HCWs were required to wear masks in clinical duties. This guidance was issued before the large-scale wave of COVID-19 cases exporting from Wuhan, the capital city of Hubei province, to other parts of China. Our hospital implemented the policy of universal mask wearing for HCWs on January 17, three days prior to the identification of our first COVID-19 case…

Second, quick responses were made to secure the supply of personal protective equipment (PPE) including masks. The consumption of PPE is high when tackling COVID-19 and how to secure supply in this pandemic is a pivotal issue. Our hospital responded quickly to place large orders of PPE…

Third, we have adopted a higher standard of protection in China, compared with the World Health Organization guidelines against COVID-19.5 The main difference is that we used fluid-resistant protective clothing (coverall) with long sleeve and conjoined cap rather than uncapped isolation garment, as well as use respirators (i.e. N95 or European Union standard FFP2) rather than medical surgical masks, in wards dedicated for COVID-19 patients. A respirator, double rubber gloves, eye protection (i.e. goggles or a face shield), coverall and shoe covers were the standard equipment in contacting with COVID-19 patients in China.

Fourth, COVID-19 patients were centralized for management in designated hospitals in China, which was a national policy. Each county and each city have at least one designated hospital for COVID-19. Such a centralized approach could make use of limited medical resource efficiently and also significantly reduced risks of acquiring COVID-19 for HCWs in non-designated hospitals, which constituted the majority of healthcare institutions…

Last, the stringent lockdown and community control measures curbed the transmission in community and therefore significantly minimize risks of being infected outside hospitals…