On March 15, the official website of the National Health and Health Commission released the “New Coronary Virus Pneumonia Diagnosis and Treatment Program (Trial Ninth Edition)” (hereinafter referred to as the “Ninth Edition”). Compared with the eighth edition, the new version of the diagnosis and treatment plan The plan has been revised in terms of monitoring findings, classified treatment, and release from isolation.
What is particularly concerning is that the “Ninth Edition” proposes that light cases should be managed by centralized isolation, and when the condition worsens, they will be transferred to designated hospitals for treatment; the Ct value that was judged to be positive in the past is 35 The above patients can now be released from isolation management or discharged from hospital.
No more hospitalization for mild symptoms? Can a positive person lift the quarantine? Doesn’t it mean that the new crown variant is getting more and more powerful? Why does the “ninth edition” plan still make these seemingly loose changes? In fact, every step of adjustment is backed by scientific data.
No more hospitalization for mild cases
“According to the previous plan, if the nucleic acid test is positive, it will be admitted to the hospital. Yesterday’s plan was just changed.” China Traditional Chinese Medicine Continuing Education Think Tank Overseas Dong Yafeng, a specially-appointed expert, told a reporter from Science and Technology Daily on the 16th that such “loosening” adapts to the current situation and reflects the scientific and pragmatic attitude of epidemic prevention and control.
The situation that Dong Yafeng mentioned refers to the fact that more than 1.2 billion people in my country have completed the entire vaccination process, and the resulting clinical changes in the new coronavirus infection.
“Vaccination has greatly reduced the rate of relapse and fatality rate, which is very obvious from the data.” Dong Yafeng said that although the overall domestic data has not yet been fully released, data from other regions can be seen. Notice the difference.
The mass vaccination of vaccines is invisibly changing the situation in which humans fight against the new coronavirus. Dong Yafeng said that when herd immunity reaches a certain level, asymptomatic infections and mild infections are less likely to worsen, and they can even heal themselves, so they do not need to be admitted to the hospital.
In response to the changes in the admission and treatment policies for asymptomatic infected persons and mildly ill patients, the relevant documents also explained that: this adjustment is based on the reflections in various places that “patients with Omicron variant strains are infected with asymptomatic infections”. The majority of cases are patients and mild cases, most of them do not need too much treatment, and all admission to designated hospitals will take up a lot of medical resources” and other opinions.
The vaccine booster needle writing plan
For the entire population, the immune barrier is not enough to support the loosening of the admission policy.
“The vaccination work of the elderly population still needs to be strengthened.” Dong Yafeng emphasized that the statistics of deaths of new crown patients continue to indicate that the strengthening of the elderly is very important. For example, recent data from Hong Kong show that after the completion of the third booster shot, the mortality rate of new coronavirus infection among elderly people aged 60-69 may even be lower than the mortality rate of influenza. The mortality rate of vaccinated elderly is 4 times higher.
The latest data from the press conference of the Joint Prevention and Control Mechanism of the State Council on March 15 shows that at present, 65% of severe patients with new coronary pneumonia in my country are the elderly over 60 years old, and the elderly are classified as severe. Of those, 65% were not vaccinated.
For this reason, the “Ninth Edition” especially added the content of vaccination in the prevention content, emphasizing the strengthening of immunization.
At present, 211.6 million people aged 60 and above in my country have completed the whole course of vaccination, and the total number of people in this age group is 264 million. There are still tens of millions of elderly people in the country who have not completed the full course of vaccination, and a considerable number of elderly people who have completed the vaccination have not received booster shots.
“The adjustment of the diagnosis and treatment plan is closely related to the level of herd immunity. The specific measures are relaxed and strengthened. In the diagnosis and treatment of mild cases, there is no need to be hospitalized. At the same time, more emphasis is placed on vaccination and booster vaccination.” Dong Yafeng believes that, The “Ninth Edition” released this time has achieved a degree of relaxation and comprehensive coordination.
Positive can also be released from quarantine?
The criteria for release from isolation and discharge have also changed in the “Ninth Edition”: “two consecutive negatives” have been changed to “two consecutive Ct values ≥35 or negative”.
What is the Ct value? Why can you lift the quarantine if you exceed 35?
The Ct value is a count. In order to detect the viral nucleic acid in the body, the nucleic acid will be increased first during nucleic acid detection. Li Jinming, deputy director of the National Health Commission’s Clinical Testing Center, explained: Nucleic acid detection is exponentially amplified, 1 becomes 2, 2 becomes 4, 2 to the 10th power is 1024, and 2 to the 20th power is 1 million. 2 to the 30th power is 1 billion, and 2 to the 40th power is 1 trillion.
When a person has a high viral load, very few cycles are detected, so the Ct value is low. And if the viral load in a person’s body is a trace amount, it takes 40 cycles to detect, that is, from 1 to 1 trillion, which means that there is basically no virus. Therefore, the upper limit of the Ct value was previously 40.
However, further research shows that the Ct value is set to be too high as 40, which is difficult to correctly reflect the infection status. Since the infected person in the recovery period has a nucleic acid Ct value of ≥35, it cannot be isolated from the sample. The virus is gone, and the close contacts have not been found to be infected. Therefore, those who were previously identified as positive with a Ct value of 35≤Ct≤40 can be regarded as negative according to the “Ninth Edition” plan and can be released from isolation or discharged.
Many experts, including Academician Zhong Nanshan, have said that human understanding of the new coronavirus is far from enough. With the continuous deepening of clinical research and scientific research, the general strategy of “foreign defense against import, internal defense against rebound” and the general policy of “dynamic clearing” will remain unswerving, scientifically adjust my country’s anti-epidemic strategy, and coordinate epidemic prevention and control and economic and social development. Create conditions for my country’s economic and social development.