The new crown pneumonia epidemic is still circulating around the world, and the Omicron strain has become the main epidemic strain. The latest “New Coronavirus Pneumonia Diagnosis and Treatment Plan (Trial Version Ninth)” jointly issued by the National Health Commission and the State Administration of Traditional Chinese Medicine has made new adjustments to case discovery and reporting procedures, case admission, and antiviral treatment. The content of treatment was revised and improved, and it was clarified that centralized isolation management was implemented for mild cases.
Optimize case discovery and reporting procedures
The new version of the diagnosis and treatment plan adds antigen detection as a supplement on the basis of nucleic acid detection to further improve the ability of early detection of cases.
The plan requires that suspected cases or those with positive antigen test results should undergo nucleic acid testing immediately or be transferred to a qualified superior medical institution for nucleic acid testing. Those with a positive nucleic acid test result will be quarantined in a centralized manner or sent to a designated hospital for treatment, and will be reported directly online in accordance with regulations.
Li Jinming, deputy director of the National Health Commission’s Clinical Laboratory Center, said that nucleic acid testing is still the “gold standard” for determining new crown infection, and antigen testing cannot replace nucleic acid testing.
Categorized and treated cases
According to local reports, “patients with Omicron variant strains are mainly asymptomatic infections 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. Mild cases are subject to centralized isolation management, and relevant centralized isolation places cannot isolate inbound personnel, close contacts and other groups at the same time. During the isolation management period, symptomatic treatment and condition monitoring should be done well. If the condition worsens, it should be transferred to a designated hospital for treatment; ordinary, severe, and critical cases and cases with severe high-risk factors should be centrally treated in designated hospitals. Cases should be admitted to ICU for treatment as soon as possible, and patients with high-risk factors and a tendency to become severely ill should also be admitted to ICU for treatment.
Further standardize antiviral treatment
Include two specific anti-new coronavirus drugs approved by the State Food and Drug Administration into the diagnosis and treatment plan, namely: PF- 07321332/ritonavir tablets (Paxlovid) and domestic monoclonal antibodies (ambavirumab/romisevirumab injection).
The content of traditional Chinese medicine treatment has been revised and improved
Relevant experts said that the plan combines the clinical treatment experience of various places, strengthens the application of traditional Chinese medicine non-drug therapy, and adds acupuncture and moxibustion. Contents of treatment: Combined with the characteristics of children, add content related to traditional Chinese medicine treatment for children.
Adjustment of management of release from isolation, discharge standards and precautions afterward
According to reports, relevant domestic studies have shown that convalescent infected persons are in the nucleic acid Ct When the value is ≥ 35, the virus could not be isolated from the sample, and the close contacts were not found to be infected.
Accordingly, the new version of the diagnosis and treatment plan will change the “two consecutive negative nucleic acid tests of respiratory specimens (sampling time interval of at least 24 hours)” in the release of isolation management and discharge criteria to “two consecutive new coronavirus nucleic acid tests”. The Ct value of both N gene and ORF gene is ≥35 (fluorescence quantitative PCR method, the threshold value is 40, and the sampling time interval is at least 24 hours), or two consecutive new coronavirus nucleic acid tests are negative (fluorescence quantitative PCR method, the threshold value is lower than 35, the sampling time should be at least 24 hours apart)”.
In addition, the plan changed “continue 14-day isolation management and health status monitoring after discharge” to “continue 7-day home health monitoring after release of isolation management or discharge”.