【Reporter Zhao Juejuan Wanlin from Global Times-Global Web Report】The National Health and Health Commission released the “New Coronavirus Pneumonia Diagnosis and Treatment Plan (Trial Ninth Edition)” (referred to as the “Plan”) on the evening of the 15th, involving the addition of antigen detection as a Key revisions of several matters such as supplementing, classifying and treating cases, and adjusting the standards for release from isolation. In an interview with a reporter from the Global Times on the 15th, a number of experts analyzed that the “Plan” represents an exploration of the gradual adjustment of the epidemic prevention policy under the requirements of more scientific, precise and normalization, and targeted for how to better distribute the Provide guidance on medical resources and avoiding medical runs.
The National Health and Medical Commission stated that the “Plan” was formed on the basis of careful research on the transmission characteristics and case characteristics of mutant strains such as Delta and Omicron, and in-depth analysis of relevant research results. Compared with the eighth edition, the new “Proposal” optimizes and optimizes case discovery and reporting procedures. On the basis of nucleic acid detection, antigen detection is added as a supplement to further improve the ability of early detection of cases. At the same time, according to the opinions reflected in various places, “patients with Omicron variant strains are mainly asymptomatic infections and mild cases, and 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 plan requires centralized isolation and management of mild cases, and centralized treatment of ordinary, severe, critical cases and cases with severe high-risk factors in designated hospitals.
The “Plan” also reduces the nucleic acid CT value of the isolation management and discharge standards from 40 to 35, and changes “continue to 14-day isolation management and health status monitoring after discharge” to “release isolation management” Or continue home health monitoring for 7 days after discharge.”
A domestic infectious disease expert told the Global Times reporter that there are two starting points for the adjustment of the “Plan”: first, in order to adapt to the highly contagious and mild Omicron mutant strains. It has the characteristics of more cases and relatively low fatality rate; secondly, it allows medical resources to be allocated and used more rationally. Jin Dongyan, an expert in biological virology at the University of Hong Kong, commented that the “Plan” is more accurate, more scientific, and more normalized based on reality.
The adjustment of the “Plan” is directly related to the current domestic epidemic situation. Lei Zhenglong, deputy director of the National Health Commission’s Bureau of Disease Control and Prevention, said on the 15th that from March 1 to 14, more than 15,000 infected people had been reported in the local epidemic, affecting 28 provinces. The current local clustered epidemics are characterized by many points, wide areas, and frequent occurrences. The epidemic prevention and control situation in my country is severe and complex, and epidemic prevention and control are more difficult. The new crown pneumonia epidemic prediction team of the Western Ecological Security Collaborative Innovation Center of Lanzhou University predicted on the 14th that the current round of epidemic is expected to infect about 35,000 people.
In the face of the menacing epidemic, medical resources in some areas are already in short supply. Jilin Province, which has more than 3,000 newly confirmed cases in a single day, is currently the most severe province. Previously, there have been cases where individual areas faced a rapid rise in the epidemic and insufficient capacity to expand medical resources, resulting in limited centralized treatment in a short period of time. As of the 14th, nearly 1,000 medical and nucleic acid testing personnel from several provinces have traveled to Jilin to support the fight against the epidemic.
Experts believe that the “Plan” takes into account the challenges faced by some areas, and establishes a more scientific hierarchical management model, which uses limited medical resources on the “knife edge”, aiming to avoid individual areas. The health care system of the United States has been overwhelmed by the rapid increase in the number of infected people, and there has even been a medical run.
Lu Hongzhou, head of the Shenzhen Anti-epidemic Expert Group and president of the Shenzhen Third People’s Hospital, told the Global Times reporter that the biggest effect of the adjustment of the “Plan” is to release medical resources, such as adjusting the discharge from the hospital. Standards, the length of hospital stay for patients is reduced, and no centralized isolation is required after meeting the discharge standards, all of which contribute to the scientific allocation of medical resources. Jin Dongyan said that most of the infected people in Omicron are mild cases, especially after vaccination, the symptoms are milder, and too much medical care for these cases may be a waste of resources. The purpose of triage is to separate risks so that resources can be used to treat patients who really need them.
The above-mentioned unnamed infectious disease expert mentioned that Hong Kong, which is experiencing the fifth wave of the epidemic, was once overwhelmed due to the limited number of beds and the rapid increase in the number of infected people in Omicron. If all patients, including those with mild symptoms, go to the hospital for treatment, it will cause a run on medical resources, or even collapse, which will lead to higher fatalities, including patients with new crown infections and non-new crown infections.
Another lesson the Hong Kong outbreak has shown is that failure to vaccinate the elderly leads to a marked increase in case fatality rates. Chen Xi, an associate professor at the Yale School of Public Health, told the Global Times reporter that the fatality rate of the current round of the epidemic in Hong Kong is higher than that of European and American countries. The main reason is that the elderly have died due to insufficient vaccination rates.
The elderly in the mainland also face a low vaccination rate, which increases the risk of severe illness and even death. Jiao Yahui, director of the Medical Administration and Hospital Administration Bureau of the National Health and Medical Commission, said on the 15th that the elderly, especially those with underlying diseases, are high-risk groups in the new coronary pneumonia epidemic, and the risk of severe illness is very high. According to current statistics, about 65% of critically ill patients are elderly people over 60 years old. Among older adults with the severe type, 65% were not vaccinated.
Experts including Chen Xi also emphasized that although the domestic epidemic prevention policy is in a period of adjustment, it is still necessary to adhere to the “dynamic clearing”, and the conditions for large-scale relaxation or even “lying flat” are not yet available. .
Lu Hongzhou said that the “Plan” is a manifestation of the implementation of “dynamic clearing” in combination with the current situation of China’s anti-epidemic situation, and it may be adjusted in the future, which is a manifestation of continuous scientific understanding of the epidemic.