Experts interviewed:
Famous respiratory disease expert, Chinese Medical Association Respiratory Disease Branch Former Chairman Liu Youning
Chief Physician of the Infectious Disease Department of the Second Affiliated Hospital of Xi’an Jiaotong University in Shaanxi
Binzhou City People’s Hospital of Shandong Province Department of Diseases Deputy Chief Physician Zuo Kai
Assistant Physician Yang Changgeng in Nanchenzhuang Village Clinic, Fengjiazhai Town, Guangzong County, Xingtai City, Hebei Province
Global Times Health Client Reporter Wang Shuying Guo Shiying
On the evening of December 26, 2022, the National Health The Commission issued the " Overall Plan on the Implementation of "Class B and B Controls" for Novel Coronavirus Infection (hereinafter referred to as the "Overall Plan"), and renamed " Novel Coronavirus Pneumonia" to " Novel Coronavirus Infection" ;From January 8, 2023, the new crown infection will be adjusted from "Class B A tube" to "B category B tube", no longer implement isolation, no longer determineclose contacts, no longer delineate high and low risk areas , No quarantine infectious disease management measures will be taken for entry personnel and goods.
On December 27, Liang Wannian, leader of the expert group of the National Health Commission’s New Crown Epidemic Response and Disposal Work Leading Group, explained that when interpreting the “Overall Plan”, there are currently 40 statutory infectious diseases in my country, of which 2 are Class A and 27 are Class B. , 11 species of Class C. Class A infectious diseases include plague , cholera . Class B infectious diseasesincludes new coronavirus pneumonia,infectious atypical pneumonia,AIDSetc. Among them, new type of coronavirus pneumonia, infectious atypical pneumonia, and anthrax pulmonary anthrax, take prevention control measures for Class A infectious diseases. Class C infectious diseases are infectious diseases for surveillance and management, including influenza, etc.
The "Class B Control" prevention and control policy that has been implemented for 3 years is about to be adjusted. What impact will it have on the future life of Chinese people? In response to the 12 main measures put forward in the "Overall Plan", the " Global Times Health Client" specially invited experts in respiratory and infectious diseases and grassroots medical staff to interpret and discuss.
Question 1: What do you think about the renaming of "new coronavirus pneumonia" to "new coronavirus infection"?
Liu Youning, a well-known respiratory expert and former chairman of the Respiratory Branch of the Chinese Medical Association: The new crown epidemic broke out at the end of 2019, and its naming is a process. It was originally named "pneumonia of unknown cause" because most patients had pneumonia symptoms at that time, and the cause was unknown. Later, the virus was identified, so it was named " new coronary pneumonia ". Later, a considerable number of patients had no symptoms of pneumonia, so I think it should be called "new crown infection" more accurately. On February 8, 2020, I expounded this point of view through the media. Since the amicron mutant strain became the main epidemic strain, the pathogenicity has weakened, and the number of cases of pneumonia after infection has decreased. Therefore, it is obviously inappropriate to call it "new coronary pneumonia", which may cause panic among the people. Considering that pneumonia only reflects the more serious illness after virus infection and cannot summarize the clinical characteristics of all infected patients, it is of special significance to change the name of "new crown pneumonia" to "new crown infection", which is not only more in line with the current disease characteristics and hazards, It also helps to reduce the panic of the public, and can treat the disease calmly and objectively.
Question 2: What do you think of my country's adjustment of the new coronavirus infection from "Class B and A tubes" to "Class B and B tubes"?
Liu Youning: The reason why was originally designated as "Class B Tube A" is because the disease is particularly contagious and has a relatively high fatality rate, especially when the original virus broke out in Wuhan. I think it is very appropriate to manage "Class B and A" infectious diseases, and the actual effect is to save many lives. With the change of the disease, especially the mutation of the virus, in the past six months, the whole world, including my country, has become dominated by the mutant strain of Omicron, which is highly contagious but pathogenicThe power and fatality rate were greatly reduced. Moreover, the Omicron mutant strain has been popular for some time, and we are familiar with it. If it continues to be managed according to the "Class B Control", it will affect the normal production and living order. In this case, it is very timely and correct to adjust it to "Class B Pipe".
Question 3: The "Overall Plan" proposes to strengthen epidemic monitoring and response. Why should we continue to evaluate the virus transmission, pathogenicity, immune escape ability, and monitor the infection level of the community after the "Class B and B Control"?
Liu Youning: If a relatively high proportion of the population is infected with the new crown, it will form a certain immune barrier. But how long the immune barrier can last is still unclear. If you are infected once, you may be infected a second time. If the virus mutates, you will be more likely to be infected again, so we need to monitor the specific situation of this virus. In addition, I think it is very meaningful to monitor the antibody level of the population. If the antibody level of the population is high, it means that the autoimmunity is relatively strong, and we can feel more at ease.
Question 4: After the "Class B and B pipe", will the hospital face a run in a short time?
Dang Shuangsuo, Chief Physician of the Infectious Diseases Department of the Second Affiliated Hospital of Xi'an Jiaotong University in Shaanxi Province: After three years of fighting the epidemic, the national medical system has made active reserves and accumulated a lot of experience in diagnosis, treatment, prevention and other links. If there are occasional peaks similar to the current one in the later stage, for example, if a large number of infected people appear in the city in the short to medium term, it will indeed increase the pressure on the hospital, but this is temporary after all. At present, under the strong planning, management, and promotion of the Health and Medical Commission, on the one hand, hospitals will do a good job in managing critically ill patients based on existing experience; It is used in the intensive care unit for early diagnosis and treatment and active rescue of critically ill patients. Therefore, I think that even if the number of patients increases, the hospital's treatment capacity is still guaranteed.
Question 5: The "Overall Plan" proposes to increase investment in medical resources and construction. In response to the peak of the epidemic, what work has the hospital done? What is the current situation of fever clinic , emergency department , respiratory ward, and intensive care unit?
Party Double Lock: In response to the new crown epidemic, our hospital has mainly done the following work. First, strengthen the service capacity of fever clinics. Doctors conduct triage after simple screening of fever patients. For patients who need to be hospitalized, we will classify them into specific departments according to their basic conditions. Second, expand the capacity of the intensive care unit, and consult with experts from the whole hospital to formulate treatment plans for some severe patients. For some critically ill patients, we will open up green channels to ensure that they can be treated as soon as possible. At present, various tasks are carried out relatively smoothly. Now some doctors have not recovered after being infected, and the doctors who are working are under a lot of pressure. I hope the common people can understand this, and we medical workers will do our best to carry this wave of the biggest peak.
Zuo Kai, Deputy Chief Physician of Infectious Diseases Department, Binzhou People's Hospital, Shandong Province: In addition to sending staff to the fever clinic, our hospital also opened an online fever clinic, which greatly relieved the pressure on the offline. In addition, the hospital has established a multidisciplinary consultation team for critically ill patients, and has added wards according to the number of patients. At present, we still have a ward waiting for use, which can be opened at any time to ensure that patients can receive effective treatment. In general, our hospital has adopted various measures, such as online appointments, hierarchical diagnosis and treatment, and , from fever clinics to critical care, to alleviate the impact of the epidemic. I believe that with the orderly deployment of leaders at all levels and the efforts of medical staff, we can cope with the impact of this epidemic.
Question 6: The "Overall Plan" proposes to strengthen epidemic prevention and control in rural areas. Are medicines and medical equipment adequate in rural areas at present? Is the referral mechanism smooth? Many young people are afraid to go home during the Chinese New Year because they are worried about infecting people in their hometown. How do you deal with it?
Yang Changgeng, Assistant Physician at Nanchenzhuang Village Clinic, Fengjiazhai Town, Guangzong County, Xingtai City, Hebei Province: The current main problem of epidemic prevention and control in rural areas is that some people do not listen to advice and have poor awareness of epidemic prevention. In addition, if the number of patients increases rapidly, there will be a shortage of drugs. There were one or two hundred patients at most in the previous day.The epidemic in Li has basically been brought under control without much impact.
Liu Youning: I think rural areas should be alert to the peak of the epidemic. At present, the pandemic is still concentrated in urban areas with large populations and abundant medical resources, and the peak of the epidemic in rural areas may lag behind. If the number of critically ill patients soars sharply, it will increase the pressure on primary medical units . It is recommended that grassroots medical institutions cooperate with higher-level hospitals to establish relevant plans for online consultation and timely referral, so as to relieve pressure in a timely manner and save patients' lives.
Party double lock: The Spring Festival has been the most important festival for Chinese people since ancient times, and going home for reunion is the common emotional need of everyone. In view of the possible peak of transmission during the Spring Festival, I think rural areas cannot relax. First, it is recommended that people who go home for the New Year travel at off-peak times to improve protection awareness; second, continue to promote vaccination in rural areas; third, it is recommended that communities and towns conduct a thorough investigation before the festival, popularize epidemic prevention knowledge to villagers, and do relevant emergency response plan.
Question 7: The "Overall Plan" proposes to treat patients in different categories. If there are patients with relatively severe symptoms in the village, how can they be referred to higher-level hospitals?
Yang Changgeng: Severe patients can directly dial 120 to go to county hospital for treatment.
Zuo Kai: We belong to a tertiary general hospital, which treats critically ill patients and some patients with basic diseases that cannot be treated by designated hospitals.
Question 8: The "Overall Plan" proposes to do a good job in health surveys of key populations and classified and graded health services. How should grassroots units, communities, and families judge severely infected patients?
Liu Youning: For communities and families, determining which patients need to go to the hospital and what level of illness is the most important thing. One is that the body temperature remains high. After taking antipyretics, the body temperature is still above 38°C, so it is necessary to seek medical treatment in time; the other is early detection of pneumonia. If conditions permit, you can prepare a oximeter at home and to monitor at any time. If the blood oxygen saturation drops by 5% on top of the basic value, attention should be paid. If there is no instrument at home, you can observe the breathing rate of the elderly. If breathing suddenly becomes short of breath, such as an increase from 20 to 30 breaths per minute, and you feel dyspnea and urgency, you should also seek medical attention in time. In terms of life, it is recommended that the elderly should minimize going out, and if there is a shopping need, try to purchase it through the Internet or by entrusting young people at home. If conditions permit, certain isolation measures can be taken to try not to get sick and to get sick late.
Question 9: The "Overall Plan" proposes to strengthen the prevention and control of key institutions. Elderly care institutions are special. How should we protect the vulnerable group of elderly people?
Liu Youning: If the epidemic situation in the nursing home is not well controlled, it is equivalent to nosocomial infection in the hospital, which will cause the virus to spread inside, and the consequences will be very serious. According to the experience of Hong Kong, it will not only bring huge losses to the elderly care institutions, but also bring great harm to the health of the elderly. In my opinion, in order to deal with the new wave of epidemics, the most fundamental measure for elderly care institutions is to vaccinate. After completing the basic immunization , the booster vaccination will be carried out. On the other hand, elderly care institutions should optimize internal management, and regularly carry out nucleic acid testing for the elderly according to specific conditions, so as to detect infected persons early and send them to hospitals in time to avoid internal transmission in the elderly care institutions.
Question 10: The "Overall Plan" proposes to further increase the vaccination rate of the elderly new coronavirus vaccine. How do you feel positive after vaccine ? What are the worries of the elderly who do not get vaccinated?
Liu Youning: Although vaccination cannot prevent new crown infection, it can prevent severe illness and reduce death. This result is very credible and important. According to statistics in Hong Kong, the difference between those who have not been vaccinated, those who have had one injection, two injections, and those who have received booster injections is very different after being infected with the new crown. We have also seen in medical practice recently that compared with the elderly who have been vaccinated, the proportion of infected people who have not been vaccinated has indeed developed into a higher proportion of severe diseases, and it is more difficult to rescue. Many elderly people worry that vaccines are not safe. In fact, vaccines are safe for the vast majority of elderly people, including those with chronic diseases. Therefore, it is recommended that the elderly get vaccinated in time.If infected within six months to suspend vaccination. In addition, the effect of mixing different types of vaccines is better. For example, the first two shots are inactivated vaccine , and the third shot can be replaced with other types of vaccines.
Question 11: The "Overall Plan" proposes to advocate adherence to personal protection measures. After the "Class B and B pipes", how long do people need to persist in hygiene habits such as wearing masks and washing hands frequently?
Party double lock: At present, our country is in a critical period of prevention and control. The new coronavirus is still mutating, and the elderly and those with low immunity may be infected repeatedly, so it is very necessary to wear a mask. One is to avoid infection. With a distance of one meter, talking with a mask can isolate 90% of the virus; the other is that even if infected, the amount of virus is small and the symptoms will be relatively mild. In addition to wearing a good mask, hand hygiene and room ventilation twice a day are also crucial in preventing infection. Of course, in some open outdoor places and office areas with fixed personnel, you can relax appropriately; but when you arrive at unfamiliar places with dense crowds such as stations and airports, you must consciously do a good job of personal protection. Through this fight against the new crown, the health awareness of the whole people should be improved, and it will also help reduce the threat of other infectious diseases to human health. ▲
