“If we can limit the gathering and movement of people to the greatest extent and prevent cross-infection, it is optimistic that the end of April will usher in the turning point of the epidemic.”
Writing | Jun Ling
Source | “Medical Community” Public Account
On April 7, Shanghai added 824 new confirmed local cases of new coronary pneumonia and 20,398 asymptomatic infections.
There is still no turning point in this round of the epidemic. Wu Ganyu, a first-level inspector of the Shanghai Municipal Health Commission, said at a press conference on epidemic prevention and control today (8th) that the number of positive infections found through regional screening has been at a high level in recent days, indicating that there is still community transmission. The situation of epidemic prevention and control is complex and severe.
Tianjin Nankai University Huang Senzhong’s team released a briefing on the epidemic situation on the 6th, predicting that the current round of epidemic in Shanghai will gradually calm down in early May, and the number of new cases in a single day will drop to less than 100.
“Optimistically predicting the inflection point of the epidemic at the end of April”
Since March 1, as of 24:00 on April 7, Shanghai has reported a total of 131,524 local positive infections, including 127,131 asymptomatic infections and 4,393 confirmed cases.
The forecast model of Huang Senzhong’s team shows that as of April 30, the current round of epidemic in Shanghai is expected to cause 133,294 to 166,482 infections. Until April 10 at the latest, the number of new people in Shanghai will drop to less than 10,000 in a single day, and it will further drop to less than 1,000 from April 17 to 23.
But judging from the current epidemic trend in Shanghai, virology expert Chang Rongshan believes that the forecast is slightly optimistic. After the “global static management” in Shanghai, a large number of infected people are still detected every day. Chang Rongshan believes that the current inflection point cannot be judged, and it is closely related to the next prevention and control strategy.
A study published yesterday in The Lancet suggested that the duration of acute symptoms of infection with the Omicron variant was on average 2-3 days shorter than that of the delta variant. Chang Rongshan further told the “medical community” that the peak of transmission of confirmed patients is about the third to fifth day, and the transmission drops sharply after 6 days. Asymptomatic infections are only contagious in part of the period, usually on the 3rd to 5th day.
Therefore, according to the characteristics of the virus, the number of asymptomatic infections will peak in about 5 days since Shanghai started “global static management” in April, but the data of the past few days shows that the number of cases still remains is rising. Chang Rongshan believes that cross-infection may exist in large-scale nucleic acid testing.
Professor Miao Xiaohui, a specialist in infectious diseases, also pointed out in a recent post on his personal account that it is necessary to understand the possibility of “secondary infection” during the sampling process. “If it is possible, how high is the probability? At present, the number of infected volunteers in various communities is gradually increasing, and many residents who have been closed for more than two 14 days have also become positive infected people a month later. Why is this?”
Combining the exponentially increasing transmission power of the Omicron variant and the current large infection base, Chang Rongshan believes that continuous nucleic acid testing for many days is not very effective. In the future, antigen detection should be more widely used.
“The time of ‘staying at home’ will continue to be extended, but the antigen test should be used intensively first. Negative residents should ensure that they stay at home, and those with positive antigen tests should be reviewed separately and excluded for several consecutive days. After the risk, we will focus on the negative residents for a nucleic acid test.”
“If we can limit the gathering and movement of people to the greatest extent and prevent cross-infection, it is optimistic that the end of April will usher in the turning point of the epidemic.” Chang Rongshan said.
Today, Shanghai launched a new round of nucleic acid or antigen testing across the city. A volunteer from a street in Yangpu District, Shanghai told the “medical community” that she was notified that the area she was in charge of would sample the residents with previous nucleic acid abnormalities for the next 3 days, and the residents who had initially ruled out the risk would be tested for antigens at home every day. detection.
With limited medical resources,
Who should be the focus?
Whether the confirmed infected person can be transported in time to get treatment and prevent the virus from spreading in society is also another key factor affecting the trend of the epidemic.
In the early morning of today (8th), Weibo user @KAIDI018 posted that a pregnant woman living downstairs in her house had been diagnosed with the infection for several days, and she has not yet been admitted to her home alone. The “medical community” contacted the pregnant woman. At around 5 pm today, she was just sent to a designated hospital for treatment, but it lasted for nearly 6 days from the time she developed symptoms of the disease to her admission.
She told the “medical community”:
“On April 2, I started to have headaches, coughs, general muscle aches, intermittent breathing difficulties and other symptoms. I did not have a fever at that time.”
“After notifying the neighborhood committee, on the evening of April 3, the medical staff came to my door to conduct nucleic acid sampling. On the 5th, I received a notification from the CDC and the test was positive. When the call to notify the transfer, my husband was also taken to the hotel for isolation, but no one came to pick me up. Due to the worsening symptoms, I called 120 twice, but after learning that I was a ‘positive pregnant woman’, the other party responded that I could not be treated. .”
“We live in a shared house and share the living room and bathroom with 5 other people. Two of the residents who have been diagnosed recently have not been admitted, and the other 3 have been tested negative. We only Can use common space in batches with good protection.”
At 5:00 p.m., she contacted the “medical community” and informed that she was in the transfer vehicle and would be sent to the South Hospital of Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine. At the same time, it was introduced that the two infected persons who lived with him have also received a transfer notice.
How many hospitals in Shanghai can currently admit patients with COVID-19? On April 1, Ning Guang, president of Ruijin Hospital Affiliated to Jiaotong University School of Medicine, introduced at a press conference on epidemic prevention and control that Shanghai has now identified Ruijin North Hospital, Huashan North Hospital, Public Health Center, and Geriatrics Center as designated hospitals.
On April 7, Wu Qianyu introduced at a press conference on epidemic prevention and control in Shanghai that a number of designated hospitals have been opened one after another, giving priority to the treatment of patients diagnosed with common types and above, as well as some patients with mild symptoms. and asymptomatic infections, including pregnant women, children, the elderly, etc.
It is unclear how much the total number of hospital admissions in designated hospitals in Shanghai can currently be reached. However, as the number of cases continues to increase, Jin Dongyan, a professor and virology expert at the School of Biomedical Sciences of the University of Hong Kong, previously told the “medical community” that whether it is an asymptomatic infection or a confirmed case, it is crucial to formulate a corresponding plan and optimize the order of transfer and admission. important.
It is reported that among the 4,393 confirmed cases in Shanghai, 15% are 18 years old and below, 69% are 18 to 60 years old, and 16% are 60 years old and above. Among all infected people, the youngest is 10 days old and the oldest is 98 years old.
With limited medical resources, who should be given priority attention? Jin Dongyan said that the living conditions are poor, and the co-occupiers with dense dwellings should be placed in the transfer priority.
“On the other hand, pregnant women, the elderly, and various groups with underlying diseases and weak immune systems should also be admitted as soon as possible.”
Fan Jia, academician of the Chinese Academy of Sciences and president of Zhongshan Hospital Affiliated to Fudan University, also emphasized at today’s press conference on epidemic prevention and control in Shanghai that special groups such as women, children and the elderly should be paid attention to, and close observation should be made. changes in his condition.
Source: Medicine
Editor in charge: Zheng Huaju
Proofreading: Zang Hengjia
Plate making: Xue Jiao