
ΛΟΙΜΩΞΗ ΑΠΟ ΤΟ ΝΕΟ ΚΟΡΩΝΟΪΟ SARS–CoV-2 (COVID-19)
ΟΔΗΓΙΕΣ ΓΙΑ ΝΗΠΙΑΓΩΓΕΙΑ
31 Αυγούστου 2020
Σκοπός των παρακάτω οδηγιών είναι η ενημέρωση των εκπαιδευτικών και του άλλου προσωπικού των Νηπιαγωγείων της χώρας (και μέσω αυτών και των μαθητών και των οικογενειών τους) σχετικά με την επαναλειτουργία των σχολείων από τον Σεπτέμβριο του 2020, τη λοίμωξη COVID-19, τα μέτρα πρόληψης της διασποράς του ιού, τις απαραίτητες ενέργειες σε περίπτωση εμφάνισης περιστατικού ύποπτου για λοίμωξη COVID-19 και γενικά την ασφαλή επαναλειτουργία των Νηπιαγωγείων.
Η συνέχιση της λειτουργίας των σχολείων κατά τη διάρκεια της πανδημίας – που αναμένεται ότι θα συνεχιστεί κατά τους επόμενους μήνες– είναι εξαιρετικά σημαντική. Η παρουσία των παιδιών στο σχολείο, ιδιαίτερα αυτών που είναι μικρής ηλικίας, είναι απαραίτητη και δεν μπορεί να αντικατασταθεί με την αποκλειστική εξ αποστάσεως ηλεκτρονική διδασκαλία. Η παρουσία στο σχολείο είναι σημαντική για την εκπαιδευτική διαδικασία, την απόκτηση νέων γνώσεων και την ανάπτυξη δεξιοτήτων. Επιπλέον, οι δημιουργικές σχέσεις με τους συμμαθητές και τους διδάσκοντες, η συμμετοχή στο παιχνίδι και τις αθλητικές δραστηριότητες έχουν μεγάλη σημασία για την κοινωνική και συναισθηματική ολοκλήρωση των παιδιών και των εφήβων, τη σωματική και ψυχική τους υγεία. Η πλήρης λειτουργία του σχολείου είναι σημαντική και για τους εργαζόμενους γονείς που έτσι έχουν τη δυνατότητα να συμμετέχουν στην παραγωγική διαδικασία.
Η έναρξη της σχολικής χρονιάς γίνεται με πλήρη λειτουργία των σχολείων. Ωστόσο, άλλες μορφές λειτουργίας (π.χ. εξ αποστάσεως διαδικτυακή διδασκαλία σε συνδυασμό με εναλλάξ παρουσία στο σχολείο μέρους των μαθητών) μπορεί να απαιτηθούν εάν τα επιδημιολογικά δεδομένα μεταβληθούν –είτε στο σύνολο της χώρας είτε σε επιμέρους πιο επιβαρυμένες περιοχές– και θα πρέπει να υπάρχει ετοιμότητα για αυτό.
Η ασφαλής λειτουργία των σχολείων έχει θεμελιώδη σημασία, ώστε να προληφθεί κατά το δυνατόν η διασπορά του ιού στον χώρο των σχολείων. Εξαιρετικά σημαντικό είναι επίσης, στη περίπτωση που υπάρξουν κρούσματα σε μια σχολική μονάδα, να περιχαρακωθεί η διασπορά, ώστε να μειώσει τον αριθμό δευτερογενών κρουσμάτων ιδιαίτερα σε άτομα που ανήκουν σε ευάλωτες ομάδες του πληθυσμού.
Η ασφαλής λειτουργία των Νηπιαγωγείων βασίζεται στη συστηματική εφαρμογή πολλαπλών μέτρων προφύλαξης που λειτουργούν ως σύνολο:
- προσπάθεια για λειτουργία του Νηπιαγωγείου σε σταθερές ομάδες παιδιών οι οποίες συστηματικά δεν έρχονται σε επαφή μεταξύ τους, όσο είναι εφικτό
- συχνή και ορθή εφαρμογή υγιεινής των χεριών (πλύσιμο με σαπούνι και νερό ή/και εφαρμογή αντισηπτικού χεριών)
- συστηματική χρήση κατάλληλης προστατευτικής μάσκας (υφασμάτινης ή απλής χειρουργικής) από τους νηπιαγωγούς και το λοιπό προσωπικό των Νηπιαγωγείων· συνιστάται η ευρεία χρήση υφασμάτινης μάσκας από το προσωπικό, αλλά μπορεί να χρησιμοποιείται και απλή χειρουργική μάσκα
- εξοικείωση των παιδιών άνω των 4 ετών με την ορθή εφαρμογή υφασμάτινης μάσκας και χρήση της από τα παιδιά με έμφαση στην εκπαιδευτική διαδικασία
- καλός αερισμός των αιθουσών, καθαριότητα χώρων και τακτική εφαρμογή απολυμαντικού σε επιφάνειες
- αποφυγή μεγάλων συναθροίσεων μαθητών και επίσκεψης στο σχολείο άλλων ατόμων όταν αυτό δεν είναι απαραίτητο
- αποχή από το σχολείο όσων εκδηλώνουν πυρετό ή/και άλλα συμπτώματα συμβατά με COVID-19, προστασία μαθητών και εκπαιδευτικών που ανήκουν σε ευάλωτες ομάδες.
Τα μέτρα αυτά επεξηγούνται αναλυτικά παρακάτω.
Είναι σημαντικό να ορίζονται και να συμφωνούνται σε τοπικό επίπεδο οι ακριβείς τρόποι εφαρμογής των γενικών αρχών των μέτρων προφύλαξης στα σχολεία, με πρωτοβουλία και επινοητικότητα τόσο σε σχέση με την όλη οργάνωση της σχολικής ζωής όσο και σε σχέση με την αξιοποίηση χώρων και άλλων πόρων που ενδεχομένως διατίθενται στην κάθε σχολική και ευρύτερη κοινότητα.
Πληροφορίες για τη λοίμωξη COVID-19 στα παιδιά και το ρόλο των σχολικών μονάδων στη μετάδοση του ιού
Η λοίμωξη COVID-19 (Corona Virus Disease 2019) οφείλεται στον ιό SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) ο οποίος μεταδίδεται από άνθρωπο σε άνθρωπο μέσω αναπνευστικών σταγονιδίων που αποβάλλονται μέσω της ομιλίας και ιδιαίτερα μέσω βήχα ή πταρμού, ή με άμεση ή έμμεση επαφή με εκκρίσεις του αναπνευστικού συστήματος (δηλαδή μέσω μολυσμένων χεριών όταν αυτά έρχονται σε επαφή με το στόμα, τη μύτη ή τα μάτια, ή με επιμολυσμένες επιφάνειες). Ο μέσος χρόνος επώασης της νόσου, δηλαδή το χρονικό διάστημα που μεσολαβεί μεταξύ της μόλυνσης και της εκδήλωσης των συμπτωμάτων, είναι 5-6 ημέρες, ενώ κυμαίνεται από 2 έως 14 ημέρες.
Λιγότερο από 5% των καταγεγραμμένων κρουσμάτων στην Ευρωπαϊκή Ένωση αφορά παιδιά, ενώ διεθνώς το ποσοστό των προσβεβλημένων παιδιών κυμαίνεται από 1-7%, σύμφωνα με τα δεδομένα του Παγκόσμιου Οργανισμού Υγείας. Η λοίμωξη COVID-19 στα παιδιά συνήθως εκδηλώνεται με ηπιότερα συμπτώματα ή είναι ασυμπτωματική και εμφανίζει σημαντικά μικρότερη θνητότητα. Ειδικότερα, στην Ευρωπαϊκή Ένωση η θνητότητα σε ηλικίες κάτω των 19 ετών υπολογίζεται σε ποσοστό 0,03%.
Τα συχνότερα συμπτώματα της λοίμωξης COVID-19 στα παιδιά είναι πυρετός και βήχας. Άλλα συμπτώματα που μπορεί να εμφανιστούν είναι:
- Δυσκολία στην αναπνοή
- Μυαλγίες
- Ρίγος
- Πονοκέφαλος
- Δυσκαταποσία
- Ρινική καταρροή/συμφόρηση
- Ναυτία / έμετος
- Κοιλιακός πόνος, διαρροϊκές κενώσεις
Σύμφωνα με τα δεδομένα του Ευρωπαϊκού Κέντρου Ελέγχου και Πρόληψης Νοσημάτων (ECDC) το ποσοστό των νοσηλευόμενων παιδιών είναι υψηλότερο στην ηλικιακή ομάδα 0-4 ετών (10%), ενώ το αντίστοιχο ποσοστό για τα παιδιά ηλικίας 5-11 ετών και 12-18 ετών, έχει βρεθεί 3% και 4% αντίστοιχα. Τα νεογνά και τα βρέφη αποτελούν την πιο ευάλωτη ηλικιακή ομάδα μεταξύ των παιδιών για την εμφάνιση σοβαρής λοίμωξης. Η συνύπαρξη υποκείμενων νοσημάτων σε παιδιά και εφήβους, αποτελεί παράγοντα κινδύνου για την εκδήλωση σοβαρής νόσου και ανάγκης νοσηλείας σε Μονάδες Εντατικής Θεραπείας. Σε κάποιες χώρους έχουν αναφερθεί μεμονωμένα περιστατικά παιδιών με πολυοργανικό φλεγμονώδες σύνδρομο, που εκδηλώνεται έπειτα από έκθεση στον ιό SARS-CoV-2 και αποτελεί συστηματική εκδήλωση της νόσου με επίμονο πυρετό και δυσλειτουργία ζωτικών οργάνων. Σπάνιες επίσης επιπλοκές της νόσου στα παιδιά, είναι η μυοκαρδίτιδα και η νεφρική δυσλειτουργία.
Αποτελέσματα μελετών καταδεικνύουν ότι τα παιδιά δεν αποτελούν τη συνήθη πηγή μετάδοσης του ιού SARS-CoV-2, σε αντίθεση με το ρόλο που διαδραματίζουν στη διασπορά άλλων αναπνευστικών ιών όπως ο ιός της εποχικής γρίπης.
Σύμφωνα με τα μέχρι στιγμής διαθέσιμα δεδομένα, η πλειονότητα των παιδιών με λοίμωξη COVID-19, έχει καταγραφεί στο πλαίσιο ενδοοικογενειακής μετάδοσης. Από τα αποτελέσματα διερεύνησης περιστατικών που ανιχνεύθηκαν σε σχολικό περιβάλλον, προκύπτει ότι η μετάδοση της νόσου μεταξύ των παιδιών και από παιδιά σε ενήλικες είναι μάλλον ασυνήθης και συνεπώς, με την προϋπόθεση της συστηματικής εφαρμογής των απαραίτητων μέτρων προφύλαξης, οι εκπαιδευτικές μονάδες δεν αποτελούν περιβάλλον με αυξημένη δυναμική διασποράς του ιού σε σχέση με ανάλογους χώρους κοινωνικής δραστηριότητας των παιδιών.
Από τα στοιχεία του ECDC προκύπτει ότι η αναστολή λειτουργίας των σχολικών μονάδων όταν δε συνδυάζεται με άλλα μέτρα, δεν φαίνεται να συμβάλλει αποτελεσματικά στον περιορισμό της διασποράς του ιού στην κοινότητα και δεν προσφέρει επιπλέον προστασία για την υγεία των παιδιών.
Χρήση μάσκας
Η χρήση μάσκας προτείνεται από τον ΠΟΥ και τη UNICEF ως μέρος ενός συνόλου μέτρων δημόσιας υγείας, όπως η τήρηση κοινωνικών αποστάσεων, η υγιεινή των χεριών, η αναπνευστική υγιεινή και ο επαρκής φυσικός αερισμός των κλειστών χώρων, για την πρόληψη και τον έλεγχο της μετάδοσης συγκεκριμένων αναπνευστικών ιών συμπεριλαμβανομένων των ιών SARS-CoV-2 και γρίπης.
Δεδομένου ότι ο ιός μεταδίδεται μέσω σταγονιδίων που παράγονται από άτομο που έχει μολυνθεί είτε εμφανίζει συμπτώματα είτε όχι, η χρήση της μάσκας προστατεύει το άτομο που τη φορά αλλά ακόμη περισσότερο τους άλλους. Η ευρεία χρήση της μάσκας συμβάλλει σημαντικά στον περιορισμό της μετάδοσης της λοίμωξης και κατά συνέπεια στη διατήρηση της κοινωνικής δραστηριότητας και τη συνέχιση της εκπαιδευτικής διαδικασίας.
Η σωστή χρήση μάσκας έχει αποδειχθεί ότι είναι ασφαλής και μπορεί να προστατεύσει αποτελεσματικά από τη μετάδοση της λοίμωξης.
Η αποτελεσματική εφαρμογή της μάσκας σε διάφορα επίπεδα των εκπαιδευτικών βαθμίδων προϋποθέτει τη συνεκτίμηση των αναπτυξιακών δεξιοτήτων των παιδιών και τη συστηματική εκπαίδευσή τους στις ορθές διαδικασίες εφαρμογής και απόρριψης όπως και την καθοδήγηση και ενεργητική επίβλεψη της συμμόρφωσης σε αυτές. Κατά τη διάρκεια της σχολικής ημέρας και σε συνθήκες ηρεμίας των παιδιών στην τάξη, οι εκπαιδευτικοί μπορούν σε τακτά διαστήματα να δίνουν τη δυνατότητα στα παιδιά για «διάλειμμα μάσκας» ώστε να επέρχεται αποφόρτιση των παιδιών και να ενισχύεται η σωστή χρήση της μάσκας.
Περισσότερες πληροφορίες για την ορθή χρήση μάσκας από τα παιδιά περιλαμβάνονται στο Παράρτημα ΙΙ.
(Α) Βασικές αρχές για τον περιορισμό της διασποράς του ιού και την ασφαλή λειτουργία Νηπιαγωγείων
Γενικές οδηγίες
- Είναι σημαντικό να γίνεται συστηματική εκπαίδευση των παιδιών με επαναλαμβανόμενες δραστηριότητες εφαρμογής των μέτρων προφύλαξης για την εξοικείωση των μικρών παιδιών, με κατάλληλο για την κάθε ηλικία τρόπο.
- Είναι, επίσης, σημαντικό να συνεχιστούν ή να διαμορφωθούν οι δυνατότητες για πραγματοποίηση οργανωμένης διαδικτυακής εκπαίδευσης εάν το επιβάλουν οι συνθήκες καθώς και στην περίπτωση παιδιών που δεν θα είναι δυνατή η προσέλευσή τους στο σχολείο λόγω σοβαρού νοσήματος, σύμφωνα με το Παράρτημα Ι.
- Σε κάθε σχολική μονάδα πρέπει να γίνουν οι απαραίτητες ρυθμίσεις ώστε τα άτομα του προσωπικού που ανήκουν σε ομάδες αυξημένου κινδύνου να αναλαμβάνουν εργασίες που έχουν πολύ χαμηλό κίνδυνο έκθεσης ή δεν απαιτούν προσέλευση στο σχολείο (Καθορισμός ομάδων αυξημένου κινδύνου για σοβαρή λοίμωξη COVID 19. Αριθμ. ΔΙΔΑΔ/Φ.64/346/9011ΦΕΚ Β’ 1856/15.05.2020)
1. Μέτρα για την αποτροπή εισαγωγής του ιού στο χώρο του Νηπιαγωγείου
- Όλα τα παιδιά και τα μέλη του προσωπικού που εμφανίζουν πυρετό ή/και άλλα συμπτώματα συμβατά με λοίμωξη COVID-19, απαγορεύεται να προσέρχονται στο Νηπιαγωγείο. Στις περιπτώσεις αυτές συστήνεται η επικοινωνία από την οικογένεια με ιατρό και εξατομικευμένη αξιολόγηση σχετικά με την ένδειξη εργαστηριακού ελέγχου για την ανίχνευση του ιού.
- Ενημέρωση και ευαισθητοποίηση γονέων για τη συμμόρφωση στη δέσμευση αυτή και τον εκ των προτέρων εναλλακτικό προγραμματισμό. Επίσης, πρόβλεψη για τη διατήρηση της ασφαλούς λειτουργίας του Νηπιαγωγείου σε περιπτώσεις απουσίας του προσωπικού λόγω ασθένειας
- Σύσταση προς τους γονείς για έλεγχο των παιδιών για ενδεχόμενη εμφάνιση συμπτωμάτων (πιθανώς και με θερμομέτρηση) πριν την αναχώρησή τους από το σπίτι
- Το προσωπικό που υποδέχεται τα παιδιά, πριν την είσοδο στο χώρο υποβάλλει ερωτήσεις για να επιβεβαιώσει την απουσία πυρετού ή/και άλλων συμπτωμάτων και εκτιμά αδρά την υγεία των προσερχόμενων παιδιών, και σε περίπτωση υποψίας προβλήματος συζητά το θέμα με γονέα/κηδεμόνα.
- Γονείς/κηδεμόνες με συμπτώματα λοίμωξης του αναπνευστικού ή/και πυρετό δεν επιτρέπεται να συνοδεύουν τα παιδιά και σε περίπτωση που επιβεβαιωθεί λοίμωξή τους από το νέο κορωνοϊό SARS-CoV-2, θα πρέπει να ενημερώνουν άμεσα τον υπεύθυνο του Νηπιαγωγείου και να ακολουθούν τις οδηγίες για κατ’ οίκον απομόνωση του οικογενειακού περιβάλλοντος συμπεριλαμβανομένων των παιδιών.
- Κάθε άτομο (παιδί ή μέλος του προσωπικού) που έχει έρθει σε στενή επαφή με επιβεβαιωμένο περιστατικό COVID-19 δεν θα προσέρχεται στο Νηπιαγωγείο για 14 ημέρες μετά την τελευταία επαφή με τον ασθενή και στο διάστημα αυτό θα παρακολουθείται στενά η υγεία του για το ενδεχόμενο εμφάνισης συμπτωμάτων.
- Κάθε σχολική μονάδα πρέπει να καταγράφει συστηματικά τις αναφορές για συμπτώματα συμβατά με COVID-19 σε παιδιά ή/και μέλη του προσωπικού και να παρακολουθεί την πορεία τους.
- Στη φάση της προσαρμογής των παιδιών στο Νηπιαγωγείο είναι δυνατόν να επιτραπεί σε έναν γονέα/κηδεμόνα να παραμείνει για λίγη ώρα με το παιδί στον χώρο του Νηπιαγωγείου με σχολαστική τήρηση των κανόνων υγιεινής (τήρηση αποστάσεων γονέα – παιδιού από τα υπόλοιπα άτομα, χρήση μάσκας από τον γονέα, κατά την προσέλευση εφαρμογή αντισηπτικού χεριών από τον γονέα ή πλύσιμο χεριών με σαπούνι και νερό). Επίσης, προτείνεται η διαδοχική προσέλευση σε προκαθορισμένη ώρα των γονέων που θα συνοδεύουν παιδιά στην περίοδο της προσαρμογής τους, ώστε να αποφευχθεί ο συνωστισμός και να διασφαλίζεται η τήρηση των αποστάσεων.
2. Μέτρα περιορισμού των στενών επαφών μεταξύ των παιδιών, του προσωπικού και των γονέων/κηδεμόνων
- Κύριο μέτρο περιορισμού των στενών επαφών για τα μικρά παιδιά, και ιδίως τα παιδιά των Νηπιαγωγείων, είναι ο διαχωρισμός τους σε μικρές ομάδες που αποτελούνται σταθερά από τα ίδια παιδιά και δεν αναμιγνύονται μεταξύ τους. Ο ακριβής τρόπος εφαρμογής αυτού του μέτρου εξαρτάται από τις συνθήκες του κάθε επιμέρους χώρου.
- Συστήνεται οι δραστηριότητες των τμημάτων να πραγματοποιούνται σε μία συγκεκριμένη αίθουσα για κάθε ομάδα παιδιών και με το ίδιο προσωπικό.
- Θα πρέπει να αποφεύγεται η ανάμιξη και αλληλεπίδραση παιδιών από διαφορετικά τμήματα/αίθουσες καθώς και η οργάνωση διατμηματικών εκδηλώσεων ή ομαδικών δραστηριοτήτων και παιχνιδιών
- Προτείνεται η οργάνωση του χρόνου και της δημιουργικής απασχόλησης να περιλαμβάνει την δημιουργία μικρών υποομάδων παιδιών σε κάθε αίθουσα, ώστε να διευκολύνεται το έργο των εκπαιδευτικών για την τήρηση των αποστάσεων και των μέτρων υγιεινής.
- Προτείνεται η αποφυγή ή η τροποποίηση της χρήσης κοινόχρηστων χώρων όπως η τραπεζαρία. Τα γεύματα μπορούν να προσφέρονται στις αίθουσες, ή εάν δεν μπορούν να γίνουν οι απαιτούμενες χωροταξικές ρυθμίσεις για αυτό, η τραπεζαρία θα χρησιμοποιείται σε διαφορετικούς χρόνους για κάθε ομάδα παιδιών, ώστε να αποφευχθεί ο συνωστισμός ή/και η ανάμιξη παιδιών από διαφορετικές ομάδες
- Ανάλογα με τη διαθέσιμη υποδομή και τη χωροταξική διάταξη, προτείνεται και ο καταμερισμός των τουαλετών και νιπτήρων ώστε να γίνεται η χρήση τους τμηματικά από συγκεκριμένες ομάδες παιδιών
- Αποφυγή του συνωστισμού και περιορισμός των επαφών μεταξύ παιδιών-γονέων-προσωπικού κατά την προσέλευση και αποχώρηση από το Νηπιαγωγείο. Εφαρμογή πρακτικών μέτρων για τήρηση αποστάσεων (π.χ. γραμμές στο δάπεδο).
- Είσοδος στο χώρο μόνο των παιδιών και του απαραίτητου προσωπικού. Τα παιδιά θα παραλαμβάνονται από συγκεκριμένο μέλος του προσωπικού πριν την είσοδο στο χώρο του Νηπιαγωγείου και θα οδηγούνται στην αίθουσα.
- Εάν υπάρχουν κλιματιστικά μπορούν να χρησιμοποιούνται με ανοιχτά παράθυρα και τις περσίδες προσανατολισμένες σε κάθετη ροή. Εάν υπάρχουν ανεμιστήρες οροφής μπορούν να χρησιμοποιούνται με ανοιχτά παράθυρα και σε χαμηλή ένταση όσο αυτό είναι δυνατόν. Ανεμιστήρες οριζόντιας ροής πρέπει να αποφεύγονται επειδή μπορεί να μεταφέρουν σταγονίδια σε μεγαλύτερη απόσταση.(Περισσότερες πληροφορίες για την ασφαλή χρήση κλιματισμού: 2020-08-03-Εγκύκλιος-κλιματιστικά-ΨΥ5Ε465ΦΥΟ-ΦΤΟ.pdf)
- Οργάνωση λειτουργίας με βέλτιστη αξιοποίηση των εξωτερικών χώρων για δραστηριότητες και παιχνίδι. Αποφυγή ανάμιξης στο προαύλιο των παιδιών που δεν ανήκουν στην ίδια ομάδα ή τμήμα. Μπορεί να χρησιμοποιηθεί ειδική διαγράμμιση στο προαύλιο για την οριοθέτηση του «χώρου» κάθε ομάδας παιδιών. Εάν υπάρχει η δυνατότητα, προαυλισμός σε διαφορετικό χρόνο ή/και χώρο.
3. Τήρηση κανόνων ατομικής υγιεινής
- Eκπαίδευση των παιδιών ανάλογα με τις δυνατότητες της ηλικίας τους και συστηματική εφαρμογή της υγιεινής των χεριών. Προϋπόθεση είναι η εξασφάλιση υποδομών και υλικών, όπως νιπτήρες με τρεχούμενο νερό και υγρό σαπούνι καθώς και αλκοολούχα αντισηπτικά διαλύματα που θα εφαρμόζονται πάντα με την επίβλεψη ή βοήθεια ενήλικα.
- Η υγιεινή των χεριών πρέπει να εφαρμόζεται από παιδιά και προσωπικό
- Κατά την είσοδο στο χώρο
- Όταν τα χέρια είναι εμφανώς λερωμένα (σαπούνι και νερό)
- Πριν και μετά:
- Την προετοιμασία ή τη χορήγηση γεύματος
- Το γεύμα
- Τη χρήση της τουαλέτας ή την αλλαγή πάνας
- Μετά:
- Την επαφή με εκκρίσεις ή σωματικά υγρά
- Το παιχνίδι σε εξωτερικό χώρο
- Το χειρισμό απορριμμάτων
- Το πλύσιμο των χεριών με υγρό σαπούνι και νερό, για τουλάχιστον 20 δευτερόλεπτα, θα ακολουθείται από προσεκτικό στέγνωμα με χάρτινες χειροπετσέτες μιας χρήσης και απόρριψή τους στους κάδους απορριμμάτων.
- Εναλλακτικά, συστήνεται η εφαρμογή αλκοολούχου αντισηπτικού διαλύματος, πάντα με την επίβλεψη ή βοήθεια του εκπαιδευτικού προσωπικού ώστε να διασφαλίζεται η ορθή διαδικασία
- Τήρηση των κανόνων αναπνευστικής υγιεινής. Σε βήχα ή φτέρνισμα, κάλυψη της μύτης και του στόματος με το μανίκι στο ύψος του αγκώνα ή με χαρτομάντιλο, απόρριψη του χρησιμοποιημένου χαρτομάντιλου στους κάδους απορριμμάτων και επιμελές πλύσιμο των χεριών
- Αποφυγή επαφής χεριών με τα μάτια, τη μύτη και το στόμα
- Αποφυγή κοινής χρήσης προσωπικών αντικειμένων και ατομικών παιχνιδιών
- Τα παιδιά δεν πρέπει να πίνουν νερό απευθείας από τη βρύση με το στόμα, καθώς και να χρησιμοποιούν κοινά σκεύη όπως ποτήρια και μπουκάλια. Είναι καλό το κάθε παιδί να έχει σταθερά το δικό του ποτήρι ή παγούρι.
- Αποφυγή στενής επαφής, εφόσον αυτό είναι δυνατό, με οποιοδήποτε άτομο εμφανίζει πυρετό ή συμπτώματα από το αναπνευστικό, όπως βήχα ή πταρμό
- Για την καλύτερη εκπαίδευση των παιδιών, μπορεί να τοποθετούνται σε διάφορους χώρους του Νηπιαγωγείου αφίσες ή εικόνες με τον ενδεδειγμένο τρόπο εφαρμογής των μέτρων ατομικής υγιεινής
- o Συνιστάται η χρήση προστατευτικής μάσκας από τα παιδιά άνω των 4 ετών μετά από την εξοικείωσή τους με τον τρόπο χρήσης της και με έμφαση στην εκπαιδευτική διαδικασία
- o Η καθολική χρήση προστατευτικής μάσκας από το εκπαιδευτικό και άλλο προσωπικό των Νηπιαγωγείων είναι απαραίτητη σε όλους τους κλειστούς χώρους. Η χρήση της μάσκας είναι απαραίτητη επίσης κατά την ετοιμασία ή/και επιμέλεια φαγητού. Σε εξωτερικούς χώρους, η εφαρμογή της μάσκας είναι απαραίτητη όταν υπάρχει συνωστισμός. Η σωστή χρήση της μάσκας είναι πολύ σημαντική (https://eody.gov.gr/covid-19-odigies-gia-ti-chrisi-maskas-apo-to-koino/ και Παράρτημα II)
- Συνιστάται η χρήση υφασμάτινης μπλούζας εργασίας από το προσωπικό των Νηπιαγωγείων, η οποία πρέπει να πλένεται συχνά (εάν είναι δυνατόν καθημερινά) με κοινό απορρυπαντικό σε υψηλή θερμοκρασία (60° C).
- Τα αλκοολούχα αντισηπτικά πρέπει να φυλάσσονται μακριά από τα παιδιά Νηπιαγωγείου και να χρησιμοποιούνται μόνο υπό επίβλεψη, καθώς έχουν αναφερθεί περιπτώσεις δηλητηρίασης από αυτά.
4. Ενίσχυση των προγραμμάτων καθαριότητας χώρων και καθαρισμού ή/και εφαρμογής απολυμαντικού σε επιφάνειες, αντικείμενα και εξοπλισμό
Συστηματικός φυσικός αερισμός χώρων
Καθαριότητα σε χώρους, επιφάνειες και αντικείμενα:
Παρασκευής και χορήγησης γευμάτων (πριν και μετά κάθε χρήση)
Φιλοξενίας και δραστηριοτήτων
Συχνά αγγιζόμενες επιφάνειες, παιχνίδια
Τουαλέτες
Χώρους ξεκούρασης και ύπνου
Προσπάθεια εξασφάλισης κατά το δυνατόν εξοπλισμού και παιχνιδιών ατομικής χρήσης (π.χ. ατομική κασετίνα με μολύβια και μαρκαδόρους). Ο εξοπλισμός και τα παιχνίδια που χρησιμοποιούνται από περισσότερα παιδιά (πάντα της ίδιας μικρής ομάδας) πρέπει να περιορίζονται στο ελάχιστο.
Τα παιδιά ΔΕΝ πρέπει να φέρνουν μαζί τους παιχνίδια στο Νηπιαγωγείο (π.χ. μπάλες, κούκλες κλπ.).
Σχετικά με τις μπάλες, τα παιδιά κάθε τμήματος ή ομάδας πρέπει να παίζουν μόνο μεταξύ τους χρησιμοποιώντας συγκεκριμένη μπάλα (ή μπάλες), με την έγκριση ή/και επίβλεψη εκπαιδευτικού. Οι μπάλες πρέπει να πλένονται με σαπούνι και νερό και να εφαρμόζεται σ’ αυτές απολυμαντικό στο τέλος κάθε ημέρας (ή και κατά τη διάρκειά της εάν εναλλάσσονται τα τμήματα ή οι ομάδες παιδιών που παίζουν με αυτές), σύμφωνα με όσα γράφονται στην επόμενη ενότητα και το Παράρτημα.
Τακτικός καθαρισμός παιχνιδιών και αντικειμένων:
Για την καθημερινή καθαριότητα παιχνιδιών που δεν έχουν έρθει σε επαφή με σωματικά υγρά και εκκρίσεις των παιδιών συστήνεται πλύσιμο με σαπούνι/ απορρυπαντικό και χλιαρό νερό. Τα παιχνίδια μπορούν να τοποθετούνται σε σκεύος με σαπουνόνερο μακριά από τα παιδιά, να καθαρίζονται επιμελώς με τριβή στο τέλος της ημέρας και στη συνέχεια να στεγνώνουν πριν την επαναχρησιμοποίησή τους την επομένη.
Παιχνίδια και αντικείμενα που έχουν έρθει σε επαφή με τη στοματική κοιλότητα ή άλλες σωματικές εκκρίσεις των παιδιών πρέπει να πλένονται με σαπούνι/ απορρυπαντικό και νερό, και κατόπιν, αφού ξεπλυθούν και στεγνώσουν, να γίνεται εφαρμογή απολυμαντικού.
Ως απολυμαντικό μπορεί να χρησιμοποιείται αλκοολούχο διάλυμα 70-90%, μαντηλάκι εμποτισμένο με αιθυλική αλκοόλη 70% ή άλλο απολυμαντικό με εγκεκριμένη από τον ΕΟΦ μικροβιοκτόνο/ ιοκτόνο δράση, λαμβάνοντας υπόψη και τη συμβατότητά του με το υλικό κατασκευής των παιχνιδιών. Στις περιπτώσεις χρήσης απολυμαντικού χρειάζεται ξέβγαλμα με νερό και στέγνωμα πριν τη χρήση των παιχνιδιών/ αντικειμένων από τα παιδιά.
Το άτομο που καθαρίζει τα παιχνίδια/ αντικείμενα πρέπει να φορά γάντια.
Τα βιβλία και τα άλλα είδη από χαρτί που χρησιμοποιούνται δεν χρειάζονται ειδικό καθαρισμό ή εφαρμογή απολυμαντικού.
Απομάκρυνση παιχνιδιών που δεν μπορούν να πλένονται / απολυμαίνονται συχνά (π.χ. υφασμάτινα, λούτρινα κ.λπ.). Παιχνίδια που δεν πλένονται / απολυμαίνονται ΔΕΝ πρέπει να χρησιμοποιούνται.
ΠΡΟΣΟΧΗ!
- Τα είδη καθαρισμού και απολύμανσης πρέπει να βρίσκονται μακριά από τα παιδιά
- Καλός αερισμός και πρόληψη εισπνοής ερεθιστικών και πιθανώς τοξικών ουσιών κατά τον καθαρισμό/ εφαρμογή απολυμαντικού
Στο ΠαράρτημαIII περιλαμβάνονται λεπτομερείς οδηγίες για τη διαδικασία καθαρισμού και εφαρμογής απολυμαντικών σε επιφάνειες και εξοπλισμό.
Επισημαίνεται ότι ΔΕΝ ενδείκνυται η απολύμανση με ψεκασμό ή εκνέφωση των εσωτερικών ή εξωτερικών χώρων, σύμφωνα και με τις συστάσεις του Παγκόσμιου Οργανισμού Υγείας (https://www.who.int/publications-detail/cleaning-and-disinfection-of-environmental-surfaces-inthe-context-of-covid-19).
5. Διαχείριση ύποπτου κρούσματος
- Σε κάθε σχολική μονάδα ορίζεται ένας υπεύθυνος για τη διαχείριση υπόπτων κρουσμάτων λοίμωξης COVID-19, με τον αναπληρωτή του.
- Ο υπεύθυνος ενημερώνει και εκπαιδεύει το προσωπικό σχετικά με την έγκαιρη αναγνώριση και τη διαχείριση υπόπτων κρουσμάτων λοίμωξης COVID-19.
Εάν κάποιο παιδί εμφανίσει συμπτώματα συμβατά με λοίμωξη COVID-19
- Επικοινωνία με την οικογένεια για παραλαβή του παιδιού
- Απομόνωση σε προκαθορισμένο καλά αεριζόμενο χώρο, με επίβλεψη, μακριά από τα υπόλοιπα παιδιά
- Εφαρμογή υγιεινής χεριών και αναπνευστικής υγιεινής
- Εξοπλισμός ατομικής προστασίας για το προσωπικό (μάσκα, γάντια, ποδιά αδιάβροχη και οφθαλμική προστασία με γυαλιά ή ασπίδα προσώπου, σε περίπτωση κινδύνου εκτίναξης βιολογικών υγρών/αναπνευστικών εκκρίσεων)
- Χρήση απλής χειρουργικής μάσκας με την προϋπόθεση ότι η χρήση της δεν αντενδείκνυται (Παράρτημα ΙΙ), γίνεται καλά ανεκτή από το παιδί και μπορεί να αποφευχθεί η επαφή της εξωτερικής της επιφάνειας με τα χέρια, τα μάτια και το πρόσωπο του παιδιού.
- Επιμελής καθαρισμός του χώρου και τοπική εφαρμογή απολυμαντικού στις επιφάνειες μετά την αναχώρηση του παιδιού με χρήση εξοπλισμού ατομικής προστασίας (Παράρτημα ΙΙΙ)
- Ιατρική αξιολόγηση και σύμφωνα με την κρίση του θεράποντος ιατρού, εφόσον το παιδί εμφανίζει συμπτώματα συμβατά με λοίμωξη COVID-19, θα πρέπει να γίνει κατά προτεραιότητα μοριακό διαγνωστικό τεστ
- Εν αναμονή του αποτελέσματος, το παιδί παραμένει σε απομόνωση και κατ’ οίκον νοσηλεία, σε καλά αεριζόμενο δωμάτιο, ενώ το Νηπιαγωγείο συνεχίζει κανονικά τη λειτουργία του (https://eody.gov.gr/neos-koronoios-covid-19-odigies-gia-frontida-ypoptoy-kroysmatos-sto-spiti/).
Εάν κάποιος νηπιαγωγός ή άλλο μέλος του προσωπικού εμφανίσει συμπτώματα συμβατά με λοίμωξη COVID-19
- Αποχώρηση από το χώρο του σχολείου όταν είναι εφικτό.
- Ιατρική αξιολόγηση και σύμφωνα με την κρίση του θεράποντος ιατρού, εφόσον τα συμπτώματα είναι συμβατά με λοίμωξη COVID-19, θα πρέπει να γίνει κατά προτεραιότητα μοριακό διαγνωστικό τεστ
- Εν αναμονή του αποτελέσματος, ο νηπιαγωγός ή το άλλο προσωπικό παραμένει σε απομόνωση και κατ’ οίκον νοσηλεία, σε καλά αεριζόμενο δωμάτιο, ενώ το Νηπιαγωγείο συνεχίζει κανονικά τη λειτουργία του (https://eody.gov.gr/neos-koronoios-covid-19-odigies-gia-frontida-ypoptoy-kroysmatos-sto-spiti/).
Σε περίπτωση που το μοριακό τεστ για τον νέο κορωνοϊό είναι θετικό
- Ενημερώνεται άμεσα ο διευθυντής/τρια της σχολικής μονάδας και ο ΕΟΔΥ
- Ο ΕΟΔΥ ή άλλη αρμόδια υπηρεσία σε περιφερειακό ή τοπικό επίπεδο επικοινωνεί με τον υπεύθυνο της σχολικής μονάδας για να γίνει η επιδημιολογική διερεύνηση και ιχνηλάτηση όλων των πιθανών επαφών του κρούσματος (προσωπικού και παιδιών κ.λπ.),
- Ενδελεχής καθαρισμός και τοπική εφαρμογή απολυμαντικού στις επιφάνειες των χώρων που κινήθηκε το κρούσμα (για οδηγίες, βλ. Παράρτημα)
- Το παιδί ή ο ενήλικας μπορεί να επιστρέψει μετά την παρέλευση τουλάχιστον 10ημέρου από την έναρξη των συμπτωμάτων ΚΑΙ την πάροδο 24 ωρών από την πλήρη υποχώρηση του πυρετού (χωρίς τη λήψη αντιπυρετικών) και την ύφεση των συμπτωμάτων του
- Τα παιδιά και οι εκπαιδευτικοί της ίδιας ομάδας/τμήματος θα απομακρυνθούν από το σχολείο, με οδηγίες για στενή παρακολούθηση της υγείας τους και εφόσον δεν εκδηλώσουν κάποιο ύποπτο σύμπτωμα, θα επιστρέψουν μετά από 14 ημέρες. Για τα απαραίτητα μέτρα στην περίπτωση εκπαιδευτικού με θετικό τεστ ο οποίος/η οποία έχει έρθει σε επαφή με περισσότερα άτομα ή τμήματα, θα πρέπει να γίνεται ειδική κάθε φορά εκτίμηση κινδύνου.
- Η ενδεχόμενη απομάκρυνση παιδιών/ προσωπικού και άλλων τμημάτων ή και ολόκληρου του σχολείου θα εξετάζεται κατά περίπτωση ανάλογα με την εκτίμηση κινδύνου που θα προκύπτει κατά την ιχνηλάτηση των επαφών.
Σε περίπτωση που το μοριακό τεστ για τον νέο κορωνοϊό είναι αρνητικό
- Το παιδί ή ο ενήλικας μπορεί να επιστρέψει στο σχολείο μετά την πάροδο τουλάχιστον 24 ωρών από την πλήρη υποχώρηση του πυρετού (χωρίς τη λήψη αντιπυρετικών) και την ύφεση των συμπτωμάτων του.
ΠΑΡΑΡΤΗΜΑΤΑ
ΠΑΡΑΡΤΗΜΑ I
Παιδιά για τα οποία δίνεται η γενική σύσταση μακροχρόνιας αποχής από το σχολείο και χρήσης τηλε-εκπαίδευσης λόγω σοβαρού υποκείμενου νοσήματος
Τα δεδομένα από τη βιβλιογραφία σχετικά με τον κίνδυνο που διατρέχουν παιδιά με υποκείμενα νοσήματα από τη λοίμωξη με SARS-CoV-2 είναι περιορισμένα καθώς πρόκειται για ένα νέο ιό. Οι παρακάτω πίνακες ενδέχεται να τροποποιηθούν στο μέλλον καθώς αυξάνονται οι γνώσεις μας σχετικά με τη λοίμωξη από SARS-CoV-2 και ανάλογα με τα επιδημιολογικά δεδομένα. Σε κάθε περίπτωση, η απόφαση για μακροχρόνια αποχή από το σχολείο πρέπει να λαμβάνεται εξατομικευμένα με προσεκτική στάθμιση της κατάστασης υγείας κάθε παιδιού από τον θεράποντα ιατρό σε συνεργασία με την οικογένεια.
1. Παιδιά που λαμβάνουν χημειοθεραπεία για κακοήθεια ή μετά από ομόλογη μεταμόσχευση αιμοποιητικών κυττάρων εάν έχουν παρέλθει λιγότερο από 6 μήνες από την ολοκλήρωσή της.
2. Παιδιά μετά από αλλογενή μεταμόσχευση αιμοποιητικών κυττάρων εάν έχουν παρέλθει λιγότεροι από 12 μήνες.
3. Παιδιά μετά από μεταμόσχευση συμπαγούς οργάνου εάν έχουν παρέλθει λιγότεροι από 24 μήνες.
4. Παιδιά με δρεπανοκυτταρική αναιμία.
5. Παιδιά με σοβαρή συγγενή ή επίκτητη ανοσοανεπάρκεια(HIVκαι CD4<500)
6. Παιδιά υπό χρόνια κορτιζονοθεραπεία (prednisolone>20mg/μέρα)
7. Παιδιά με σοβαρή χρόνια νεφρική νόσο ή νεφρική ανεπάρκεια
8. Παιδιά με αιμοδυναμικά σημαντική συγγενή καρδιοπάθεια ή γνωστή μυοκαρδιοπάθεια
9. Παιδιά με χρόνια, σοβαρή πνευμονοπάθεια, όπως κυστική ίνωση με αναπνευστική ανεπάρκεια ή παιδιά με σοβαρό και μη ελεγχόμενο άσθμα, σύμφωνα με τη γνωμάτευση εξειδικευμένου κέντρου. 10. Παιδιά με σύνθετα μεταβολικά ή νευρολογικά προβλήματα
ΠΑΡΑΡΤΗΜΑ II
A. ΟΔΗΓΙΕΣ ΓΙΑ ΤΟΝ ΤΡΟΠΟ ΧΡΗΣΗΣ ΤΗΣ ΠΡΟΣΤΑΤΕΥΤΙΚΗΣ ΜΑΣΚΑΣ
Γιατί οι άνθρωποι φορούν μάσκες αυτήν την περίοδο;
- Γιατί ο νέος κορωνοϊός ή αλλιώς SARS-CoV-2 μπορεί να προκαλέσει λοίμωξη του αναπνευστικού και άλλες εκδηλώσεις της νόσου COVID-19.
- Γιατί η λοίμωξη αυτή μπορεί να μην προκαλέσει συμπτώματα ή τα συμπτώματα να είναι πολύ ήπια. Μερικοί όμως άνθρωποι, όπως αυτοί που έχουν αυξημένο κίνδυνο (π.χ. μεγάλης ηλικίας), μπορεί να νοσήσουν πολύ σοβαρά, να χρειαστούν μακρόχρονη νοσηλεία στο νοσοκομείο ή να κινδυνεύσει και η ζωή τους.
- Γιατί, παρά το γεγονός ότι οι ομάδες ατόμων που νοσούν σοβαρά είναι συνήθως άτομα που έχουν και άλλα προβλήματα υγείας ή είναι μεγάλης ηλικίας, καμιά φορά μπορεί να νοσήσουν σοβαρά ακόμη και νεαρά σε ηλικία άτομα ή παιδιά που δεν έχουν πρόβλημα υγείας
- Γιατί ακόμη και άτομα που δεν έχουν συμπτώματα μπορούν να μεταδώσουν τον ιό μέσω των σταγονιδίων που εκπέμπονται όταν μιλούν, τραγουδούν και ιδιαίτερα όταν φτερνίζονται ή βήχουν.
- Γιατί η μετάδοση του ιού είναι πολύ εύκολη όταν η απόστασή μας είναι μικρότερη από ενάμιση μέτρο.
Γιατί η μάσκα είναι ένα δυνατό όπλο για να περιορίσουμε τη διασπορά του νέου κορωνοϊού;
- Γιατί περιορίζει την έκθεση μας στα σταγονίδια των άλλων που «φιλοξενούν» τον ιό στο φάρυγγα τους και έτσι μπορεί να μας προφυλάξει από το να κολλήσουμε κι εμείς τον ιό.
- Γιατί προστατεύει τους γύρω μας από τον ιό που πιθανόν έχουμε εμείς στο φάρυγγα μας, ακόμη και χωρίς να έχουμε συμπτώματα.
- Γιατί η χρήση μάσκας από όλους μας θα αποτρέψει νέο μεγάλο κύμα πανδημίας και την ανάγκη για τη λήψη αυστηρών περιοριστικών μέτρων στην περιοχή όπου ζούμε.
- Γιατί η μάσκα, η διατήρηση απόστασης από τους άλλους και η υγιεινή των χεριών είναι το χρυσό τρίπτυχο για να συνεχίσουμε ήρεμα τη ζωή μας.
Οδηγίες για τη σωστή χρήση της μάσκας
α. Πώς φοράω τη μάσκα
- Πριν εφαρμόσω τη μάσκα στο πρόσωπό μου:
Πλένω προσεκτικά τα χέρια μου με νερό και σαπούνι για τουλάχιστον 20 δευτερόλεπτα. Ξεπλένω με τρεχούμενο νερό, σκουπίζω τα χέρια με χειροπετσέτα μιας χρήσης, κλείνω με αυτήν την βρύση και την πετάω στον κάδο απορριμμάτων.
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Τρίβω καλά τα χέρια με αλκοολούχο αντισηπτικό υγρό μέχρι αυτό να στεγνώσει. ΔΕΝ ξεχνώ κανένα σημείο των χεριών και επιμένω ανάμεσα στα δάκτυλα.
- Με στεγνά και καθαρά χέρια αφαιρώ τη καθαρή μάσκα μου από το σακουλάκι που τη φυλάω, πιάνοντάς τη από το λαστιχάκι.
- Φέρνω τη μάσκα προσεκτικά στο πρόσωπό μου ώστε η ανοιχτόχρωμη πλευρά (εσωτερική) να ακουμπήσει τη μύτη και το στόμα μου κρατώντας το λαστιχάκι ακόμη με το χέρι.
- Με το άλλο χέρι εφαρμόζω το ένα λάστιχο στο αυτί μου και με αργή και προσεκτική κίνηση περνάω το δεύτερο λάστιχο και στο άλλο αυτί.
- Όταν τοποθετήσω και τα δύο λαστιχάκια στα αυτιά μου, φέρνω τα δάκτυλά μου στις δύο πλευρές της μύτης και πιέζω το έλασμα που έχει η μάσκα ώστε να αγκαλιάσει τη μύτη μου και συνεχίζω την απαλή κίνηση προς και πάνω στα ζυγωματικά μου.
- Τραβώ με ήπιες κινήσεις τη μάσκα από την κάτω πλευρά ώστε να ξεδιπλώσει και να αγκαλιάσει το πηγούνι μου.
- Ελέγχω ότι η μάσκα έχει εφαρμόσει καλά στο πρόσωπό μου και την νιώθω άνετα. Δοκιμάζω να μιλήσω για να καταλάβω ότι όταν χρειαστεί να το κάνω, αυτή δεν θα πέσει από τη μύτη μου.
- Θυμάμαι πάντα ότι εάν η μάσκα δεν εφαρμόζει απόλυτα στο στόμα και την μύτη μου και αφήνει κενά στο πρόσωπο μου δεν προσφέρει προστασία, αντιθέτως απλά με δυσκολεύει.
- Tip!! Κάντε εφαρμογή μπροστά στον καθρέπτη τις πρώτες φορές ώστε να είστε σίγουροι για τις κινήσεις όταν δεν θα έχετε αυτήν την δυνατότητα.
β. Πως χειρίζομαι τη μάσκα – τα ΠΡΕΠΕΙ…
- Φορώ μάσκα σε εσωτερικούς χώρους και σε εξωτερικούς χώρους όταν υπάρχει συνωστισμός.
- Φορώ μάσκα που δεν είναι χαλαρή στο πρόσωπό μου.
- Χρησιμοποιώ πάντα καθαρή και χωρίς φθορές μάσκα.
- Φυλάω τη μάσκα σε καθαρό σακουλάκι πριν την φορέσω.
- Τοποθετώ τη μάσκα μέσα στο σακουλάκι κρατώντας την από το ένα λάστιχο.
- Τοποθετώ την κάθε μάσκα σε ξεχωριστό σακουλάκι.
- Έχω πάντα μαζί μου στο σχολείο τουλάχιστον δύο μάσκες (σε ξεχωριστά σακουλάκια η καθεμιά).
- Αφαιρώ τη μάσκα από το πρόσωπό μου τραβώντας ταυτόχρονα και τα δύο λαστιχάκια.
- Τρίβω τα χέρια μου με αντισηπτικό διάλυμα μετά την αφαίρεση της μάσκας.
- Χειρίζομαι σωστά τη μάσκα που θέλω να αφαιρέσω για λίγο: αφαιρώ τη μάσκα όπως περιγράφηκε παραπάνω, την κρατώ από τα λαστιχάκια και την διπλώνω με την εσωτερική πλευρά προς τα μέσα, την τοποθετώ στο σακουλάκι της.
- Πλένω κάθε μέρα τις μάσκες που έχω χρησιμοποιήσει την ίδια μέρα
- Πλένω τη μάσκα καλά, στο χέρι ή σε πλυντήριο, χρησιμοποιώ νερό σε υψηλή θερμοκρασία τουλάχιστον 60°C, και όταν στεγνώσει τη σιδερώνω καλά και την τοποθετώ σε καθαρό σακουλάκι.
- Η μάσκα είναι το πιο προσωπικό μου αντικείμενο.
- Tip!! Χρησιμοποιείτε σακουλάκια μεγαλύτερων διαστάσεων από τη μάσκα για να διευκολύνονται οι κινήσεις σας. Τα σακουλάκια τροφίμων είναι μια εύκολη λύση.
γ. Πώς χειρίζομαι τη μάσκα – τα ΔΕΝ …
Δεν αφαιρώ τη μάσκα μου όταν βρίσκομαι σε εσωτερικούς χώρους ή σε εξωτερικούς χώρους όταν η απόσταση είναι μικρότερη του ενάμιση μέτρου από άλλο άτομο. Αυτές ακριβώς είναι οι καταστάσεις που χρειάζεται να προστατευθώ με τη μάσκα.
Δεν κατεβάζω την μάσκα όταν θέλω να μιλήσω σε κάποιον. Όταν μιλάω απελευθερώνονται σταγονίδια, αυτή τη διαδικασία θέλω να σταματήσω με τη χρήση της μάσκας.
Δεν αγγίζω το μπροστινό μέρος της μάσκας. Η μάσκα συγκρατεί σταγονίδια που φέρουν τον ιό, έτσι ο ιός μπορεί να περάσει στα χέρια μου και στη συνέχεια να αγγίξω και να μολύνω το πρόσωπό μου και άλλα αντικείμενα και επιφάνειες.
Δεν αφήνω την μάσκα να πέσει από τη μύτη μου. Εάν κατέβει η μάσκα και θέλω να τη διορθώσω, πιέζω ξανά το έλασμα και τραβώ σε καλύτερη θέση τα λαστιχάκια. Εφαρμόζω υγιεινή των χεριών αμέσως μετά από αυτήν την κίνηση.
Δεν κατεβάζω τη μάσκα στο πηγούνι μου ούτε αφήνω έξω μύτη ή στόμα. Με αυτόν τον τρόπο ακυρώνω την προστασία που δίνει η μάσκα, ενώ η εξωτερική πλευρά της μάσκας βρίσκεται πολύ κοντά στο στόμα μου και υγραίνεται. Επιπλέον όταν την ανεβάσω θα επιμολύνω τα χέρια μου και το πρόσωπό μου.
Δεν φορώ μάσκα που νιώθω υγρή. Η υγρή μάσκα δυσκολεύει την αναπνοή και παύει να προσφέρει προστασία.
Δεν φορώ μάσκα που είναι βρώμικη ή έχει φθορές (σχισίματα ή οπές). Η βρώμικη μάσκα είναι περισσότερο επικίνδυνη παρά προστατευτική, ενώ η φθαρμένη δεν προστατεύει και δίνει ψευδές αίσθημα ασφάλειας.
Δεν μοιράζομαι τη μάσκα μου με κανέναν άλλο, ακόμη και εάν αυτός είναι το πιο κοντινό μου άτομο, και δεν την αφήνω εκτεθειμένη στα αγγίγματα άλλων. Η κοινή χρήση ή η ανταλλαγή μάσκας δεν επιτρέπεται. Αν γίνει, σημαίνει αυτόματα ότι μοιράζομαι με άλλον τα μικρόβια που αυτή έχει συγκρατήσει.
Δεν αφήνω τη μάσκα μου σε επιφάνειες (καρέκλες, θρανία, τραπεζάκια κλπ.). Η μάσκα επιμολύνεται και ταυτόχρονα μολύνει τις επιφάνειες.
Δεν χρησιμοποιώ ποτέ το ίδιο σακουλάκι για διαφορετικές μάσκες, η κάθε μάσκα έχει το δικό τους σακουλάκι. Τα μικρόβια από τις βρώμικες μάσκες μολύνουν το σακουλάκι, επιβιώνουν μέσα σε αυτό για πολλές ώρες και θα μολύνουν και άλλη μάσκα εάν τοποθετηθεί εκεί.
Β. ΟΔΗΓΙΕΣ ΓΙΑ ΤΗ ΧΡΗΣΗ ΜΑΣΚΑΣ ΣΕ ΕΙΔΙΚΕΣ ΟΜΑΔΕΣ ΠΑΙΔΙΩΝ
Τα δεδομένα από τη βιβλιογραφία σχετικά με τον κίνδυνο που διατρέχουν παιδιά με υποκείμενα νοσήματα από τη λοίμωξη με SARS-CoV-2 είναι περιορισμένα καθώς πρόκειται για ένα νέο ιό. Οι παρακάτω πίνακες ενδέχεται να τροποποιηθούν στο μέλλον καθώς αυξάνονται οι γνώσεις μας σχετικά με τη λοίμωξη από SARS-CoV-2 και ανάλογα με τα επιδημιολογικά δεδομένα.
Παιδιά για τα οποία θα πρέπει να εξετάζεται το ενδεχόμενο χρήσης χειρουργικής μάσκας
Η χρήση της χειρουργικής μάσκας έναντι της απλής υφασμάτινης θα πρέπει να συζητηθεί με τον θεράποντα ιατρό για παιδιά με υποκείμενα νοσήματα όπως φαίνονται στον παρακάτω πίνακα:
1. Παιδιά με προηγούμενο ιστορικό σοβαρής ανοσοκαταστολής (χημειοθεραπεία, μεταμόσχευση αιμοποιητικών κυττάρων ή συμπαγούς οργάνου).
2. Παιδιά με ινοκυστική νόσο.
3. Παιδιά που λαμβάνουν βιολογικούς παράγοντες, όπως είναι τα παιδιά με ρευματολογικά νοσήματα ή φλεγμονώδη νόσο του εντέρου.
4. Παιδιά με μεσογειακή αναιμία.
5. Παιδιά με σακχαρώδη διαβήτη.
Παιδιά για τα οποία συστήνεται η ΜΗ χρήση μάσκας
1. Παιδιά με γνωσιακή, αναπτυξιακή, ψυχική διαταραχή ή διαταραχή συμπεριφοράς.
2. Παιδιά με σοβαρό νευρολογικό ή μυϊκό ή άλλο νόσημα που τα εμποδίζει να χειριστούν τη μάσκα τους.
Υγιή παιδιά που αντιδρούν στη χρήση μάσκας
Τόσο οι γονείς όσο και οι εκπαιδευτικοί θα πρέπει να κατανοήσουν ότι η πανδημία ανατρέποντας την καθημερινότητα όλων μας, εύλογα δημιουργεί αναστάτωση και ανασφάλεια στα παιδιά. Παιδιά τα οποία έχουν πολλές απορίες ή παρουσιάζουν αντίδραση στη χρήση μάσκας δεν σημαίνει υποχρεωτικά ότι εμφανίζουν αγχώδη διαταραχή ή φοβία. Αντίθετα, ενδέχεται τα παιδιά αυτά να έχουν ανάγκη για περισσότερη πληροφορία. Τονίζεται ότι τόσο οι γονείς όσο και οι εκπαιδευτικοί, πριν μιλήσουν στα παιδιά θα πρέπει πρώτα οι ίδιοι να έχουν ενημερωθεί και πειστεί για την αναγκαιότητα και ασφάλεια της χρήσης της μάσκας. Ιδιαίτερη σημασία έχει το παιδί να μη λαμβάνει αντικρουόμενα μηνύματα από τους ενήλικες του περιβάλλοντος. Η πληροφορία θα πρέπει να προσφέρεται με τρόπο κατάλληλο ανάλογα με το αναπτυξιακό επίπεδο του παιδιού. Η Ελληνική Παιδοψυχιατρική εταιρεία Ελλάδος (www.hscap.gr) έχει ετοιμάσει οδηγίες για γονείς και εκπαιδευτικούς αναφορικά με την αντιμετώπιση φόβου και άγχους των παιδιών για τη νόσο COVID-19. Τέλος, προτείνεται, σε ειδικές περιπτώσεις παιδιών που μπορεί να εμφανίζουν φοβία, αγχώδεις διαταραχές ή ανασφάλεια, σχετικά με τη χρήση μάσκας ή και τη νόσο COVID-19, η εξατομικευμένη προσέγγιση με τη συνδρομή τόσο των αρμόδιων εκπαιδευτικών όσο και ειδικών επιστημόνων ψυχοκοινωνικής υποστήριξης.
Καταστάσεις κατά τις οποίες η χειλεοανάγνωση είναι σημαντική
Σε περιπτώσεις που η χειλεοανάγνωση είναι σημαντική για την επικοινωνία ή/και την εκπαίδευση των παιδιών (π.χ. λογοθεραπεία, κωφά παιδιά κλπ.), αντί για συνήθη μάσκα, μπορεί τα παιδιά ή/και οι εκπαιδευτικοί να χρησιμοποιούν διαφανή ολοπρόσωπη προστατευτική προσωπίδα ή ειδική υφασμάτινη μάσκα με διαφανές πρόσθιο τμήμα στο μέρος του στόματος.
ΠΑΡΑΡΤΗΜΑ III
ΕΚΠΑΙΔΕΥΤΙΚΑ ΙΔΡΥΜΑΤΑ: ΔΙΑΔΙΚΑΣΙΑ ΚΑΘΑΡΙΣΜΟΥ ΚΑΙΕΦΑΡΜΟΓΗΣ ΑΠΟΛΥΜΑΝΤΙΚΩΝ ΣΕ ΕΠΙΦΑΝΕΙΕΣ ΚΑΙ ΕΞΟΠΛΙΣΜΟ
ΕΟΔΥ, Αύγουστος 2020
Ο καθαρισμός και η εφαρμογή απολυμαντικών μειώνουν τον κίνδυνο διασποράς λοιμώξεων, απομακρύνοντας και σκοτώνοντας, αντίστοιχα, τους μικροοργανισμούς από τις επιφάνειες. Συνεπώς, η συχνή, καθημερινή και συστηματική καθαριότητα και εφαρμογή απολυμαντικών στις επιφάνειες και τον εξοπλισμό των σχολικών μονάδων κρίνεται κομβικής σημασίας για τη διαχείριση της πανδημίας COVID-19.
- Διαδικασία καθημερινής καθαριότητας και εφαρμογής απολυμαντικών
- Οι χώροι των εκπαιδευτικών ιδρυμάτων θα πρέπει να αερίζονται καλά α/ στα διαλείμματα και κατά τη διάρκεια των μαθημάτων εφόσον το επιτρέπουν οι κλιματικές συνθήκες, και β/ πριν και κατά τη διάρκεια του καθαρισμού τους.
- Οι συχνά αγγιζόμενες επιφάνειες θα πρέπει να καθαρίζονται συχνότερα από ότι συνήθως και κυρίως μεταξύ της χρήσης από διαφορετικούς μαθητές. Θα πρέπει να περιορίζεται η κοινή χρήση επιφανειών ή/και αντικειμένων, εφόσον είναι εφικτό, ή αυτές/αυτά θα πρέπει να καθαρίζονται και να απολυμαίνονται μεταξύ διαφορετικών χρηστών.
- Οι επιφάνειες καθαρίζονται με σαπούνι και νερό ή απορρυπαντικό και νερό, σύμφωνα με τις οδηγίες που αναγράφονται στη συσκευασία. Το καλό τρίψιμο είναι απαραίτητο για την απομάκρυνση των ρύπων και των μικροοργανισμών.
- Στις επιφάνειες που χρησιμοποιούνται ή αγγίζονται συχνά ακολουθεί, μετά τον καθαρισμό, εφαρμογή απολυμαντικού. Συνήθεις επιφάνειες που χρησιμοποιούνται ή αγγίζονται συχνά είναι: τουαλέτες, βρύσες, πόμολα, τραπέζια ή πάγκοι εργασίας κοινής χρήσης, κουπαστή σκάλας, κουμπιά σε ασανσέρ ή κουδούνια, διακόπτες ηλεκτρικού, πληκτρολόγια ή συσκευές τηλεφώνου κοινής χρήσης, έδρες εκπαιδευτικών ή θρανία όταν οι χρήστες τους εναλλάσσονται κ.ά..
- Για την εφαρμογή απολυμαντικού πρέπει να έχει προηγηθεί καθαρισμός της επιφάνειας, ξέβγαλμά της με νερό και στέγνωμα. Το καλό τρίψιμο και ο σωστός χρόνος εφαρμογής του απολυμαντικού είναι απαραίτητα για την καταστροφή των μικροοργανισμών.
- Γνωστές απολυμαντικές ουσίες είναι το υποχλωριώδες νάτριο (χλωρίνη) και η αιθυλική αλκοόλη (καθαρό οινόπνευμα, προσοχή όχι μπλε φωτιστικό οινόπνευμα). Στο εμπόριο κυκλοφορούν και άλλα απολυμαντικά με βακτηριοκτόνο και ιοκτόνο δράση εγκεκριμένα από τον Εθνικό Οργανισμό Φαρμάκων (ΕΟΦ). Επίσης στο εμπόριο κυκλοφορούν εγκεκριμένα από τον ΕΟΦ προϊόντα με καθαριστικές και απολυμαντικές ιδιότητες ταυτόχρονα.
- Συστήνεται η εφαρμογή απολυμαντικού διαλύματος υποχλωριώδους νατρίου (οικιακή χλωρίνη) σε συγκέντρωση 0.1% (=1000 ppm διαθέσιμου χλωρίου), δηλαδή αραίωση 1:50 (20ml:1000ml) όταν η αρχική συγκέντρωση της χλωρίνης είναι 5%, για τουλάχιστον 1 λεπτό, η οποία είναι αποτελεσματική για την καταστροφή των μικροοργανισμών. Το διάλυμα υποχλωριώδους νατρίου πρέπει να ετοιμάζεται πριν από τη χρήση του και να χρησιμοποιείται εντός 24 ωρών. Εναλλακτικά, μπορούν να χρησιμοποιηθούν αλκοολούχα διαλύματα με 70%-90% συγκέντρωση αιθυλικής αλκοόλης για τουλάχιστον 1 λεπτό.
- Ο καθαρισμός ή/και η εφαρμογή απολυμαντικού σε επιφάνειες ή εξοπλισμό που χαρακτηρίζονται ως ευαίσθητες/οι θα πρέπει να γίνονται σύμφωνα με τις οδηγίες του κατασκευαστή.
- Οι επιφάνειες δεν θα πρέπει να αγγίζονται μέχρι να στεγνώσουν από τον καθαρισμό ή/και την εφαρμογή του απολυμαντικού.
- Καθαρισμός και εφαρμογή απολυμαντικού θα πρέπει να γίνεται και στον εξοπλισμό καθαριότητας πολλαπλών χρήσεων (π.χ. κάδοι σφουγγαρίσματος, σφουγγαρίστρες) μετά από κάθε χρήση. Συνιστάται η χρήση ξεχωριστού εξοπλισμού καθαριότητας μεταξύ των τουαλετών και των υπόλοιπων χώρων (γραφεία, τάξεις, κ.ά.).
- Το προσωπικό καθαριότητας κατά τη διάρκεια της εργασίας του πρέπει να φορά στολή/ρόμπα εργασίας και γάντια μιας χρήσεως, τα οποία θα πρέπει να αλλάζει τακτικά. Μετά την αφαίρεση των γαντιών θα πρέπει να ακολουθεί υγιεινή των χεριών (πλύσιμο με νερό και σαπούνι ή εφαρμογή αλκοολούχου αντισηπτικού για 20 δευτερόλεπτα) και, αφού τα χέρια στεγνώσουν καλά, να χρησιμοποιείται νέο ζευγάρι γαντιών. Πρόσθετος εξοπλισμός ατομικής προστασίας, όπως μάσκα, προστατευτικά γυαλιά και αδιάβροχη ποδιά, μπορεί να χρειάζεται κατά την παρασκευή διαλυμάτων, ανάλογα με το καθαριστικό/απολυμαντικό που χρησιμοποιείται και τη διαδικασία καθαρισμού, για την προστασία του προσωπικού καθαριότητας, ιδιαίτερα εάν υπάρχει κίνδυνος πιτσιλίσματος.
- Κατά τη διάρκεια του καθαρισμού πρέπει να αποφεύγεται ο ψεκασμός, η πρόκληση πιτσιλίματος και το σήκωμα ή η ανάδευση σκόνης (π.χ. σκούπισμα, τίναγμα μοκέτας, χαλιού ή άλλων μαλακών υλικών).
- Η στολή/ρόμπα εργασίας θα πρέπει να πλένεται τακτικά και να μην τινάζεται πριν το πλύσιμό της.
- Οδηγίες καθαρισμού και εφαρμογής απολυμαντικού μετά από επιβεβαιωμένο περιστατικό COVID-19
- Ο χώρος ή οι χώροι (π.χ. γραφεία, τουαλέτα, κοινόχρηστοι χώροι, αίθουσες, τραπεζαρία) που χρησιμοποιήθηκαν από το επιβεβαιωμένο περιστατικό με COVID-19, θα πρέπει να αερίζονται με φρέσκο αέρα για τουλάχιστον 1 ώρα και μετά να ακολουθεί καθαρισμός και εφαρμογή απολυμαντικού σε όλες τις επιφάνειες και τον εξοπλισμό.
- Οι επιφάνειες καθαρίζονται με σαπούνι και νερό ή απορρυπαντικό και νερό, σύμφωνα με τις οδηγίες που αναγράφονται στη συσκευασία. Το καλό τρίψιμο είναι απαραίτητο για την απομάκρυνση των ρύπων και των μικροοργανισμών.
- Στις επιφάνειες, μετά τον καθαρισμό, το ξέβγαλμα με νερό και το στέγνωμα, ακολουθεί εφαρμογή απολυμαντικού. Το καλό τρίψιμο και ο σωστός χρόνος εφαρμογής του απολυμαντικού είναι απαραίτητα για την καταστροφή των μικροοργανισμών.
- Γνωστές απολυμαντικές ουσίες είναι το υποχλωριώδες νάτριο (χλωρίνη) και η αιθυλική αλκόολη (καθαρό οινόπνευμα, προσοχή όχι μπλε φωτιστικό οινόπνευμα). Στο εμπόριο κυκλοφορούν και άλλα απολυμαντικά με εγκεκριμένη από τον Εθνικό Οργανισμό Φαρμάκων (ΕΟΦ) βακτηριοκτόνο και ιοκτόνο δράση.
- Συνιστάται η εφαρμογή απολυμαντικού διαλύματος υποχλωριώδους νατρίου (οικιακή χλωρίνη) σε συγκέντρωση 0.1% (=1000 ppm διαθέσιμου χλωρίου), δηλαδή αραίωση 1:50 (20ml:1000ml) όταν η αρχική συγκέντρωση της χλωρίνης είναι 5%, για τουλάχιστον 1 λεπτό, η οποία είναι αποτελεσματική για την καταστροφή των μικροοργανισμών. Το διάλυμα υποχλωριώδους νατρίου πρέπει να ετοιμάζεται πριν από τη χρήση του και να χρησιμοποιείται εντός 24 ωρών. Εναλλακτικά, μπορούν να χρησιμοποιηθούν αλκοολούχα διαλύματα με 70%-90% συγκέντρωση αιθυλικής αλκοόλης για τουλάχιστον 1 λεπτό.
- Ο καθαρισμός ή/και η εφαρμογή απολυμαντικού σε επιφάνειες ή εξοπλισμό που χαρακτηρίζονται ως ευαίσθητες/οι θα πρέπει να γίνονται σύμφωνα με τις οδηγίες του κατασκευαστή.
- Οι επιφάνειες δεν θα πρέπει να αγγίζονται μέχρι να στεγνώσουν από τον καθαρισμό και την εφαρμογή του απολυμαντικού.
- Ο εξοπλισμός καθαρισμού, όπου αυτό είναι εφικτό, συνιστάται να είναι μίας χρήσεως (π.χ. πανιά καθαριότητας). Ο εξοπλισμός καθαριότητας που είναι πολλαπλών χρήσεων (π.χ. κάδοι σφουγγαρίσματος, σφουγγαρίστρες) πρέπει να καθαρίζεται και να γίνεται εφαρμογή απολυμαντικού μετά από κάθε χρήση. Συνιστάται η χρήση ξεχωριστού εξοπλισμού καθαριότητας μεταξύ των τουαλετών και των υπόλοιπων χώρων (γραφεία, τάξεις, κ.ά.).
- Το προσωπικό καθαριότητας κατά τη διάρκεια της εργασίας του πρέπει να φορά τον απαραίτητο εξοπλισμό ατομικής προστασίας πάνω από τη στολή/ρόμπα, ο οποίος αποτελείται από:
- Χειρουργική μάσκα
- Αδιάβροχη ρόμπα με μακριά μανίκια, μίας χρήσης (ή υγροαπωθητική ρόμπα με μακριά μανίκια και επιπρόσθετα πλαστική ποδιά)
- Γάντια μίας χρήσης
- Προστατευτικά γυαλιά
- Το προσωπικό καθαριότητας θα πρέπει να αλλάζει τακτικά τα γάντια. Μετά την αφαίρεση των γαντιών θα πρέπει να ακολουθεί υγιεινή των χεριών (πλύσιμο με σαπούνι και νερό ή εφαρμογή αλκοολούχου αντισηπτικού για 20 δευτερόλεπτα) και αφού τα χέρια στεγνώσουν καλά να χρησιμοποιείται νέο ζευγάρι γαντιών.
- Πρέπει να ακολουθείται ο σωστός και ασφαλής τρόπος εφαρμογής, αφαίρεσης και απόρριψης του εξοπλισμού ατομικής προστασίας με συχνή υγιεινή χεριών, σύμφωνα με τις οδηγίες: https://eody.gov.gr/wp-content/uploads/2020/03/PPE-donning-doffing.pdf, https://eody.gov.gr/wp-content/uploads/2020/03/covid-19-maska.pdf
Γενικές επισημάνσεις
- Ο καθαρισμός των επιφανειών με σαπούνι και νερό ή απορρυπαντικό και νερό απομακρύνει τους ρύπους και τους μικροοργανισμούς από τις επιφάνειες. Η εφαρμογή απολυμαντικών καταστρέφει τους εναπομείναντες μικροοργανισμούς που έχουν επιμολύνει επιφάνειες και αντικείμενα, μειώνοντας ακόμα περαιτέρω τον κίνδυνο διασποράς του ιού .
- Η χλωρίνη δεν πρέπει να αναμειγνύεται με αμμωνία και άλλου είδους απορρυπαντικά/ καθαριστικά.
- Θα πρέπει να ακολουθούνται οι οδηγίες του κατασκευαστή σχετικά με την αραίωση των απολυμαντικών με νερό, το χρόνο εφαρμογής τους, το χρόνο αερισμού του χώρου, την αποθήκευσή τους καθώς και τον συνιστώμενο εξοπλισμό προστασίας του προσωπικού καθαριότητας.
- Τα προϊόντα καθαρισμού και απολύμανσης πρέπει να φυλάσσονται πάντα μακριά από τα παιδιά.
- Τα προϊόντα καθαρισμού και απολύμανσης δεν πρέπει να χρησιμοποιούνται από ή κοντά σε μαθητές και η χρήση τους πρέπει να γίνεται πάντα σε χώρο που αερίζεται επαρκώς, έτσι ώστε να αποφεύγεται η εισπνοή τυχόν αναθυμιάσεων από το προσωπικό ή/και τους μαθητές.
- Κατά τη χρήση καθαριστικών και απολυμαντικών το προσωπικό καθαριότητας θα πρέπει να αποφεύγει την εισπνοή τους και την άμεση επαφή με το δέρμα με τη χρήση γαντιών και το πλύσιμο των χεριών με σαπούνι και νερό για τουλάχιστον 20 δευτερόλεπτα.
- Η παρασκευή των απολυμαντικών (π.χ. αραίωση χλωρίνης κλπ.) πρέπει να γίνεται σε χώρο που αερίζεται καλά, και κατ’ αυτήν το προσωπικό θα πρέπει να φορά ελαστικά γάντια, αδιάβροχη ποδιά και κλειστά παπούτσια για προστασία από τα χημικά που περιέχονται. Η χρήση προστατευτικών γυαλιών και μάσκας μπορεί να είναι επίσης απαραίτητα εάν υπάρχει κίνδυνος πιτσιλίσματος.
- Ο προαύλιος χώρος καθαρίζεται με σαπούνι και νερό ή κοινά απορρυπαντικά και νερό
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