People’s Daily Health Client Reporter Qiu Yue
“The next two to three months may be the peak period of population infection. In this case, how to triage patients is It is very important to allocate limited medical resources to those with severe and critical illness, as well as high-risk groups," Lin Bingliang, standing committee member and secretary-general of the Infectious Diseases Branch of the Chinese Society of Preventive Medicine and director of the Department of Infectious Diseases at the Third Affiliated Hospital of Sun Yat-sen University. Said in an interview with People's Daily Health Client on December 9.
Fever clinic of Beijing Friendship Hospital on December 9
About 90% of mild and asymptomatic infections can be treated at home
“I had a fever yesterday. It was 39°C. I didn’t have any antipyretics or antigen reagents at home, so I wanted to go to the hospital to see if I could feel reassured. But when I went to the fever clinic of Beijing Chaoyang Hospital, the queue was several kilometers away, so I went home. I've tested negative for the antigen, so I'm relieved," Dongzi, who lives in Beijing, told the People's Daily Health Client reporter.
On December 7, the Comprehensive Team of the Joint Prevention and Control Mechanism of the State Council issued the "New Ten Rules" for optimizing and implementing epidemic prevention and control, further clarifying the rules for the scientific classification and treatment of infected persons: asymptomatic infected persons and mild cases who are eligible for home isolation. Cases are generally quarantined at home; grassroots medical and health institutions should play the role of "bottom of the network" and family doctors' health "gatekeepers" to promote the implementation of hierarchical and classified management.
On the same day, the Comprehensive Group of the Joint Prevention and Control Mechanism of the State Council issued the "Work Plan for Graded Diagnosis and Treatment of COVID-19 Using the Medical Alliance as a Carrier", which clarified that it is necessary to build a graded diagnosis and treatment service network for patients with symptoms related to COVID-19 and to clarify the grading. The diagnosis and treatment process, at the same time, strengthens the hierarchical and classified treatment and referral of patients infected with the new coronavirus.
According to Lin Bingliang, about 90% of the infected people in Omicron are mild or asymptomatic. The symptoms of mild patients mainly include fever, cough, sore throat, muscle aches, etc. This is For some patients, if they do not have high-risk factors for severe illness, they do not need to panic too much and can just stay in isolation at home and take some symptomatic drugs during the period. The vast majority of people infected with Omicron will recover in about 7 days, and these patients do not actually need to occupy medical resources. However, if the condition changes, for example, taking antipyretics for many days in a row does not work, it is recommended to seek medical treatment in time.
It is key to carry out prevention and control work in key institutions such as nursing homes and hospitals
“Another thing we have repeatedly emphasized is how to protect the elderly.” Lin Bingliang pointed out, It is necessary to do a good job in prevention and control in nursing homes, welfare homes and other institutions, especially during the expected peak period of infection in the future. It is recommended that these institutions continue to use the more stringent prevention and control measures in the past and reduce visits. Visitors must have a negative nucleic acid certificate. It is also best for staff to take nucleic acid tests every day to avoid bringing the virus into nursing homes and other institutions where the elderly gather, otherwise the infection will easily spread once it occurs.
Lin Bingliang also said that it is also important to do a good job in preventing infection among medical staff. "At this time, medical staff must protect themselves even more, because there must be many critically ill patients in the hospital. We medical staff are not afraid of infection, but we are afraid of bringing the virus to these critically ill patients after infection."
"In short, doing a good job in epidemic prevention and control in key institutions is one of the priorities for the next step. It is recommended that these institutions still do a good job in nucleic acid testing. Antigen testing cannot completely replace nucleic acids." Lin Bingliang said.
Related reports:
Academician Li Lanjuan: Asymptomatic infections are not patients and there is no need to panic
On December 8, the People’s Daily Health Client exclusively interviewed China Li Lanjuan, academician of the Academy of Engineering and director of the State Key Laboratory of Diagnosis and Treatment of Infectious Diseases.
Li Lanjuan, academician of the Chinese Academy of Engineering. Photo provided by interviewee
People’s Daily Health Client: Epidemic prevention policies in various regions are gradually optimized. What signals are released from the perspective of the development pattern of infectious diseases?
Academician Li Lanjuan: The adjustments made now are based on scientific research and should be said to be a very correct decision. Judging from the law of occurrence and development of infectious diseases, the morbidity rate of infectious diseases is often very high in the initial stage of epidemics. Everyone is also susceptible to the virus, which can easily lead to severe infections. In the early stage of the new coronavirus epidemic, strict screening, strict isolation, and control are required. We must eliminate the source of infection, cut off transmission routes, and treat every patient at all costs, so that the COVID-19 epidemic can be effectively controlled and people's health protected.
As the new coronavirus mutates, from the original strain to the Delta virus, and now to the Omicron mutant strain, the incidence rate is getting lower and lower, which is also in line with the law of changes in infectious diseases. . Recently, the country has issued 20 measures and proposed 10 measures, which fully reflects our country's high-level precise and scientific prevention and control, protects the life safety and health of the people to the greatest extent, and minimizes the impact of the epidemic on the people's production and living order and economic and social development.
People’s Daily Health Client: At present, what data can directly prove that the pathogenicity and virulence of the Omicron variant are significantly weakened compared to the original strain?
Academician Li Lanjuan: According to international and domestic monitoring data, it is confirmed that compared with the original strain and Delta and other mutant strains, the Omicron mutant strain and its evolutionary branches are still more transmissible, but their pathogenicity Compared with the original strain and mutant strains such as Delta, the virulence is significantly weakened, but the transmissibility is still strong.
The Omicron variant mainly invades the upper respiratory tract, causing significantly fewer cases of severe hospitalization or death than previous variants, and its virulence and pathogenicity are significantly reduced. According to data released by Singapore, the case fatality rate of the Omicron variant during the epidemic in Singapore from January to November 2022 was 0.45‰, which was much lower than the 3.6‰ of the Delta variant from June 2021 to January 2022. fatality rate.
Information map of Academician Li Lanjuan
People’s Daily Health Client: What will be the focus of my country’s epidemic prevention and control in the future?
Academician Li Lanjuan: In the future, asymptomatic infections do not need to be the focus of epidemic prevention and control. The focus of prevention and control should be mainly shifted to "preventing severe disease and reducing death." At the same time, we must strengthen the protection of key groups of people affected by COVID-19. It is necessary to continue to popularize COVID-19 vaccination, strengthen the protection of key groups with low immune function such as the elderly and chronic diseases, and ensure the treatment of their basic diseases.
People’s Daily Health Client: Will the new coronavirus continue to mutate in the future? What attitude should we maintain towards the continued mutation of the virus?
Academician Li Lanjuan: The new coronavirus will continue to mutate during the natural spread in the future. Like influenza viruses, mutations of the new coronavirus often cause changes in biological properties such as antigenicity, transmissibility, pathogenicity, and drug sensitivity, thereby affecting the effectiveness of currently used drugs and vaccines. We must also pay close attention to virus mutation, study the relationship between virus mutation and pathogenicity, and promptly discover mutant viruses that may cause major harm to human health. At present, with the popularization of vaccination in my country and the launch of many antiviral drugs on the market, coupled with the country's investment in medical resources at all levels and adequate response preparations, the public does not have to worry about the virus continuing to mutate in the future.
People’s Daily Health Client: Most of the infected people are asymptomatic and have mild symptoms. How should residents view it? What suggestions do you have?
Academician Li Lanjuan: Most of the infected people with the Omicron virus that is currently circulating around the world are asymptomatic and have mild symptoms.
On June 27, 2022, the "Novel Coronavirus Pneumonia Prevention and Control Plan" issued by the Comprehensive Team of the Joint Prevention and Control Mechanism of the State Council in response to the new coronavirus pneumonia epidemic pointed out that asymptomatic infections refer to the etiology of the new coronavirus. Those who test positive but have no relevant clinical manifestations. It is mainly discovered through nucleic acid testing and source tracking of close contacts and close contacts, entry personnel, risk occupational groups, personnel in key institutions and places, and people included in community management.
At the same time, the plan points out that the new coronavirus belongs to the beta coronavirus and the population is generally susceptible. The source of infection is mainly confirmed cases of COVID-19 and asymptomatic infected persons. The main transmission routes are through respiratory droplets and close contact. It is also transmitted through aerosol in a relatively closed environment. Infection may also occur after contact with items contaminated by the virus.
Although asymptomatic infections are contagious, asymptomatic infections are not patients and there is no need to panic. Asymptomatic infections are called "hidden infections" in our infectious disease textbooks. In most viral infectious diseases, asymptomatic infections are the most common manifestation, and their number often far exceeds overt infections. Asymptomatic infection is not a disease. After asymptomatic infection, most people can obtain varying degrees of specific immunity, which is of positive significance in preventing the spread of the epidemic.
People’s Daily Health Client: Everyone is the first person responsible for their own health. What suggestions do you have? How should ordinary residents take daily protection?
Academician Li Lanjuan: First of all, we must understand that even if the virus is infected, most people are asymptomatic, so don’t panic. Pay attention to personal hygiene habits, wash hands frequently, exercise reasonably, take personal protection when going out, and wear a mask when going to crowded places. If the infected person has no symptoms, he or she does not need treatment. They should monitor their health. If symptoms such as fever and cough occur, they can receive symptomatic treatment. Those with obvious symptoms can go to fever clinics for diagnosis and treatment. Vaccination with the COVID-19 vaccine is still an effective way to prevent severe illness. All those who meet the vaccination requirements should be vaccinated. Those who meet the requirements for booster immunization should receive booster immunization in a timely manner.