Today is April 8, 2022.
Wuhan “unblocked” two years ago today. After a 76-day lockdown to fight the epidemic, Wuhan successfully controlled the spread of the new crown epidemic and won the first battle of mankind against the new crown virus.
Wuhan was the most severely affected city at the time, with a population of 11 million and more than 50,000 confirmed infections.
Two years later, Shanghai reported 824 new cases of new coronary pneumonia and 20,398 asymptomatic infections yesterday. Shanghai, with a population of 24 million, has accumulated more than 130,000 infected people in this round of the epidemic, and the infection rate has surpassed that of Wuhan. It is the epicenter of the epidemic in China today.
From Wuhan to Shanghai, it looks like a similar scene, but we are actually facing a completely different epidemic.
How has the epidemic changed in the past two years?
The world is different
Two years ago, Wuhan was the sole epicenter of the global outbreak. What China and the world is facing is a completely unremarkable opponent. All of our measures are carried out in the process of testing. Many times, we can only choose more than less. We use a knife to kill chickens, and protect the health of the people to the greatest extent in the fog.
Two years have passed, and the center of the world epidemic has long been far away from China, and preventing imported cases from abroad has become the focus of epidemic prevention.
After experiencing the ravages of viruses around the world, human beings have a more detailed and in-depth understanding of the new crown virus, and various prevention and control measures have emerged as the times require. There are also testing grounds.
Global COVID-19 infections to surpass 500 million
Image source: Lilac Garden・Dr. Lilac Epidemic Map
The spread of the virus has changed significantly
The virus affecting Shanghai today, although it is still the new coronavirus, is completely different from that of Wuhan back then.
The original strain of the new coronavirus raging in Wuhan has experienced transmission and mutation around the world, and different mutants have dominated the mainstream in different periods. What is popular in Shanghai today is the new coronavirus Omikron BA.2 variant. From a virological and epidemiological point of view, Omicron BA.2 is not the same virus as the original strain.
BA.2 is much more contagious. R0 changed from 2.79 of the original strain to 9.1. The so-called R0 refers to the state of no epidemic prevention intervention, and one infected person can infect several people. The original strain could infect fewer than 3 people, but now it can infect more than 9 people.
BA.2 is significantly less pathogenic. The case fatality rate after infection with the original strain that year was 34 to 68 times that of seasonal influenza, and today’s BA.2 has a lower case fatality rate than influenza in the UK. (Case fatality rate is the number of people who died divided by the total number of infected people)
Increased contagiousness means that the protective isolation used may be useless, and the virus is likely to spread before you take action. The reduction in pathogenicity means that the large cost of protection may not be exchanged for the benefit, but is only used on a group of people with almost no symptoms.
Original strain put UK PM in ICU for 3 days
The Queen recovers quickly from the new strain
Image source: Internet
Broad protection with additional vaccine
BA.2 The current reduced pathogenicity, in addition to changes in the virus itself, is also related to the widespread use of the new crown vaccine in humans.
Wuhan had no vaccine at all. As of today, 89% of people in China have received at least one dose of the new crown vaccine, and 86% have completed two basic vaccinations.
BA.2 is subject to immune escape, and basal vaccination does not establish excellent protection against BA.2. Current evidence shows that whether it is an mRNA vaccine or an inactivated vaccine, boosted vaccination can play a role in preventing infection from causing severe illness.
People after booster vaccination can become infected, but severe illness and death are rare. For the elderly, vaccines are the strongest protection available.
The overall vaccination situation in China is good, but the vaccination of the elderly who need more protection is not ideal. Only 50.7% of the elderly over the age of 80 have completed the basic vaccination, and there are 52 million elderly people over the age of 60 who have not completed the basic vaccination.
If there is not enough vaccine protection, even if the pathogenicity of BA.2 is low, it can also cause more deaths due to the disease because it can infect more people.
Please be sure to bring your parents to complete the vaccination, as well as the booster shot.
This is an invaluable opportunity that many medical experts have won for us over two years.
Detection capabilities are improving rapidly
A nucleic acid test is required to confirm a new coronavirus infection. The epidemic has also spawned rapid progress in China’s nucleic acid detection technology.
In Wuhan two years ago, there were many suspected cases in the notification, but the nucleic acid detection ability could not keep up, and the symptoms were obvious and it was impossible to determine whether it was a new coronavirus infection. The Wuhan infection numbers seen today will actually be low, and a large number of people have not had time to check and diagnose.
More than a month after the closure of the city, Wuhan already has a strong testing capacity. In the 18 days from May 14th to June 1st, nearly 1,000 tests were completed in the city. The nucleic acid census of 10,000 people completed an average of more than 500,000 tests a day, setting an astonishing record for the world at that time.
In the following two years, in the local epidemic situation across the country, everyone has become accustomed to our super nucleic acid detection capabilities, and the whole city has been tested many times. Shanghai now has a maximum daily nucleic acid testing capacity of 8.85 million. Infections will be invisible in the face of efficient and widespread testing.
In addition to accurate nucleic acid testing, more convenient antigen self-testing has also become an auxiliary inspection method.
From no cure to choice
With the advancement of drug research and development, many treatments in the ICU in Wuhan are no longer used. More drugs that stand out from clinical trials and practice, including the monoclonal antibody drug Ambavirumab/Romisevir, and the new antiviral drug Paxlovid, have entered the first-line clinical practice in Shanghai and are ready to be used when needed.
Clinical trials observed an 89% reduction in severe illness and mortality with the use of Paxlovid.
COVID-19 treatment is no longer the drug-free state it was two years ago.
Disease outcomes are different
The burden of care varies
Viruses, drugs, tests, vaccines… all the changes are intertwined, and the final data also changes.
The final death toll among the 50,000 infected people in Wuhan was 3,869, and the rate of severe and critical illness exceeded 26%. The main force of national support for Wuhan is top-notch infectious diseases, critical care medical experts and various medical equipment such as ventilators.
The 130,000 infected people in Shanghai so far have only 1 case of severe infection, and more than 96% of the asymptomatic infections. The main tasks of the medical staff who came from the support are nucleic acid testing and basic care in Fangcang shelter hospitals. A large number of specialists have yet to come into play.
What we are facing is actually a completely different threat from the epidemic.
What remains the same in change
The new crown and the fight against the epidemic have been a race against time that has lasted for two years. Although two years have passed, and the virus and society have undergone tremendous changes, there are still many things that have not changed in this long-distance race.
Personal protection remains important
Since the beginning of the epidemic, we have paid more and more attention to personal physical protection, including social distancing, wearing masks, and washing hands frequently. After two years, the habits cultivated in Wuhan have formed muscle memory today.
Shanghai Metro staff persuade passengers to wear masks
Image source: Xinmin Evening News
Centralized isolation is still an important preventive measure
Beginning on February 3, 2020, in the face of the severe situation, experts recommend requisitioning large venues to build makeshift hospitals to treat and isolate a large number of patients with mild symptoms. After more than 30 hours, the construction of Jianghan Fangcai Hospital (reconstructed from the Wuhan International Convention and Exhibition Center) was completed, and then the warehouses were opened to treat patients.
The newly built and renovated Fangcang shelter hospitals have added more than 35,000 beds for Wuhan, and at the peak, nearly 15,000 beds were opened at the same time, providing a solid foundation for Wuhan to accept all patients.
In the subsequent anti-epidemic process, in the face of several major epidemic challenges, the strategy of “centralized isolation” played an important role.
As of today, Shanghai has built 4 municipal-level shelters that can provide about 38,000 beds. 21,000 beds have been completed and delivered in each district-level shelter, and nearly 20,000 beds are under construction and will be delivered in the near future. A total of nearly 80,000 beds. Neighboring provinces such as Jiangsu and Zhejiang have also prepared centralized isolation points with 60,000 beds for patients in Shanghai and have been put into use one after another.
Left: Wuhan Sports Center Fangcang
Right: Shelter at Shanghai International Convention and Exhibition Center
Photo source: Xinhuanet/The Paper
National support, go to Wuhan, and also go to Shanghai
Sudden large number of infectious cases requiring additional medical support.
From the beginning of New Year’s Eve in 2020 to March 17, according to statistics from the National Health Commission, more than 42,000 medical personnel from 346 medical teams have been dispatched across the country to arrive in Hubei. Among them, the number of medical personnel supporting Wuhan reached 31,207, including medical teams from 29 provinces (autonomous regions and municipalities) and the Xinjiang Production and Construction Corps.
Recently, medical forces across the country have gathered again. At present, more than 38,000 medical personnel and 2.38 million tubes of nucleic acid testing force have been dispatched from 15 provinces to support Shanghai.
Left: Shanghai Aid Medical Team from New Year’s Eve
Right: Wuhan medical team arriving in Shanghai community
Image source: CCTV
Shanghai, recreate the victory in Wuhan?
Wuhan lifted its lockdown 2 years ago today. At that time, no one thought that the new crown epidemic would ravage the world until today, nor did they realize how precious the victory in Wuhan was.
China has controlled the epidemic at a huge cost and protected the health of more people in Wuhan. The establishment of the quarantine model for the isolation of patients and the suspension of the city are all successful experiences.
2 years later, Shanghai has also entered a state of lockdown. Faced with an opponent that spreads rapidly but with weakened disease, faced with enormous pressure on people’s livelihood, faced with the tight allocation of medical resources, balancing the interests of all parties and striving for the greatest victory is a test of today’s Shanghai.
Dynamic clearing is still the foundation of fighting the epidemic, but the epidemic has changed, and our policies can also make more rapid and scientific changes.
We have taken a few small steps, including more user-friendly zoning and strict control, replacing large-scale nucleic acid testing with more self-tests, updating vaccination procedures, introducing advanced medicine. I have also seen some positive discussions, and are discussing rationally about home isolation, vaccine introduction, guarantee logistics and medical resources. You should stick to the right direction and continue to make adjustments.
COVID-19 is a challenge we all face together. Asking for help, despair, support, shouting, mutual assistance… In the fight against the epidemic, we have seen many hardships in life, and we have also seen countless touching glimmers.
Please remember those heroic people who are famous or silent in the epidemic prevention, and please do your best to help those who are troubled by the epidemic.
I hope that the people of Shanghai can return to normal life as soon as possible, and I hope that the epidemic prevention policy will keep pace with the times and continue to update, which will benefit each of us in the future.
On the eve of the victory in Wuhan, the elderly watched the sun with doctors in Shanghai
Image source: CCTV News
This article reviewer
Planning
Planning: Vic Sheep, Eric | Producer: Feidi
Cover image source: Zhanku Hailuo