On April 9, Heilongjiang Province has 1 newly confirmed local case and 3 asymptomatic infections, breaking the province’s 29-day record of no newly confirmed local cases. As of 18:00 on April 16, the virus chain has infected 36 people in Harbin, including 23 confirmed cases and 13 asymptomatic infections.
According to the report, the source of the infection chain was a "previously infected person with new coronary pneumonia" who returned to Harbin from the United States on March 19. In these 29 days, how did the new crown pneumonia virus break through the layers of prevention and control infecting 36 people, and how did the prevention and control of the overseas epidemic and hospital infection in Harbin fall?
breakthrough in the first line of defense:
overseas cases infected with local cases
On March 19, the 22-year-old woman Han returned to Harbin from the United States. At around 22:00 that night, they were transferred to Fulijiangwan Community, Daoli District, Harbin City by "hand in hand". Mr. Han, who was quarantined at home, had no illness or symptoms during the quarantine period. The nucleic acid test was negative on March 31 and April 3, and the home quarantine was lifted. In the two antibody tests on April 10 and April 11, IgM was negative and IgG was positive.
"New Coronary Pneumonia Seventh Edition Diagnosis and Treatment Plan" mentioned that a positive IgM antibody indicates a recent infection, and a positive IgG antibody indicates a longer infection period or a previous infection, so Han was identified as a "previously infected person with new coronary pneumonia."
When and where was Han infected abroad? It is meaningless to pursue this. People care about how the virus spread after Han returned to China? According to a joint investigation by the Harbin CDC and the public security investigation agency, Han may have infected Cao, who lives in the same building and unit.
Cao and Han are neighbors upstairs and downstairs, living in rooms 402 and 302 respectively, and they don't know each other. According to the report analysis, the building where Cao and Han live is one elevator, and the entire unit shares an elevator. The elevator may be the same space that the two have touched together. In addition, another possibility is that there is a chance of disease transmission due to the housing structure of the two adjacent floors.
Although the specific disease transmission and relevance of the two are still under investigation, it is undeniable that the return of overseas personnel to "home isolation" without "centralized isolation" provides the possibility of super transmission.
Fang Zhenghui, Secretary-General of the Harbin Municipal Government, introduced at a press conference on April 15 that Harbin’s relevant quarantine policy is divided into two phases based on March 20. After March 20, Harbin has a high risk to all overseas and domestic All personnel entering (returning) to Kazakhstan will be quarantined for 14 days. On March 19, Mr. Han, who returned to Harbin, carried out home isolation observation in accordance with the policies at the time.
China Centers for Disease Control and Prevention Chief Expert of Epidemiology Wu Zunyou once explained at a press conference of the State Council’s Joint Prevention and Control Mechanism why foreigners are not advocated for home isolation. For those who have entered the country, if symptoms appear, it has actually caused transmission. The new coronary pneumonia has been contagious in the late incubation period. If the immigrants are quarantined in the family and have life contact with family members, the spread has already occurred when symptoms appear. If centralized isolation, this phenomenon can be avoided.
According to the explanation of the Secretary-General of the Harbin government, Han’s “home isolation” was issued before March 20 when Harbin issued a policy to isolate people returning from overseas, which means that Han’s home isolation is not inappropriate.
However, a reporter from the Health Times found that according to the "Warming Reminders for the Prevention and Control of Inbound Epidemics" issued by the Foreign Affairs Office of the Heilongjiang Provincial People's Government on March 6, immigrants from countries with severe epidemics need to be isolated for 14 days.
If Harbin conducts a "centralized quarantine" on Mr. Han who returned to Harbin on March 19, he may have maintained the first line of defense against the importation of overseas epidemics, and there will be no subsequent "1 pass 36" super spread incident.
The new crown virus has torn a hole in Harbin.
The second line of defense breakthrough:
dinner leads to a new round of infection
In this super transmission event in Harbin, Guo Mouming has become an important node figure in the new round of transmission.
He is the one new local confirmed case officially notified on April 10, and he is also the key figure in breaking the 29-day absence of local new cases in Heilongjiang Province.
So, people have to ask, what is the relationship between Guo and Cao?
Cao is an asymptomatic infected person (converted to a confirmed case on April 14). According to official reports, Cao’s family members have frequent contacts, and the virus spread rapidly in Cao’s home. Cao's boyfriend Li and mother Wang Moling were both infected. And the boyfriend of his mother Wang Mouling is Guo Mouming.
Guo Mouming, 54 years old, lives in Hongwei Road, Daowai District, Harbin. On April 7, Guo Mouming, accompanied by his girlfriend Wang Mouling, went to the fever clinic of the Second City Hospital for treatment. After investigation, Guo Mouming's temperature was 37.5℃ and Accompanied by coughing and other symptoms, lung CT showed obvious symptoms. The expert diagnosed a suspected case of new coronary pneumonia and was transferred to a designated hospital for isolation and treatment. On April 9, the expert group's consultation identified him as a confirmed case of new coronary pneumonia.
The confirmed patient Guo Mouming and his girlfriend Wang Mouling (a person with asymptomatic infection) had a dinner with Chen's family on March 29, which laid an ambush for a new round of clustered cases.
87-year-old Chen and Guo Mouming are good friends. On March 29, 87-year-old Chen took his two sons with Guo Mouming and Wang Mouling for a dinner with 7 people.
has 5 people infected. Chen and his two sons are both confirmed cases.
"Clustered epidemics are the focus of prevention and control!" Zeng Guangzeng, chief epidemiologist at the Chinese Center for Disease Control and Prevention, said. Based on the current understanding of the characteristics of pneumonia caused by the new coronavirus, it has been found that some cases are mild and some are infectious during the incubation period. Some people do not have any obvious signs in the early stage, but are infectious. After the incubation period, they will have fever, dry cough and other symptoms. In the process of gatherings and dinners, it is impossible to judge whether the people gathered together are infectious.
During gatherings and dinners, frequent communication with each other, eating and drinking water, is the best way to spread the virus. Since this disease has a strong ability to spread from person to person, it is extremely important to reduce contact between people. The National Health Commission and many other departments have reminded that in order to avoid cross-infection caused by crowd gatherings, it is necessary to reduce going out, prevent gatherings, and not go to crowded places, and be responsible for themselves and others.
"At present, the epidemic has not completely ended, and we are still facing the pressure of imported cases abroad and the huge risk of transmission from asymptomatic infections. Therefore, we still have to comply with relevant regulations such as not having meals, not gathering, and wearing masks when going out. There must be no chance of luck.” Yu Chengbo, chief physician of the Department of Infectious Diseases, the First Affiliated Hospital of Zhejiang University School of Medicine, reminded.
third line of defense breakthrough:
hospital has 26 cases of infected
Chen's infection is unfortunate, however, this chain of transmission is still spreading.
, 87-year-old Chen, who was infected at a dinner party, was hospitalized with a stroke. As of April 16, 26 people in two hospitals had been infected. The new crown virus suddenly took off and the situation began to become serious.
From April 2nd to April 5th, after dinner, Chen was hospitalized in Harbin No. 2 Hospital due to stroke; from April 7th to April 9th, he was in the No. 1 Affiliated Harbin Medical University because of fever. Hospitalized treatment.
"Before Chen was admitted to the hospital, we checked him in accordance with relevant regulations, and found no abnormalities, and was admitted to the hospital. According to our understanding, Chen did not show relevant symptoms before." Harbin Second Hospital The staff told the Health Times reporter.
However, it is for this reason that Chen who was in the hospital caused the infection of 26 patients in the same ward and their family members in the two hospitals.
's rare "nosocomial infection" shocked the public, and also tightened up the medical institutions in various places that are gradually returning to treatment.
Lin Minggui, chief physician of the Department of Infectious Diseases at Beijing Tsinghua Chang Gung Memorial Hospital, believes that strict quarantine measures should be taken, inpatients should be screened strictly, and patients should be isolated to avoid infection in the hospital.
In response to the nosocomial infection that occurred in this incident, on the evening of April 14, Harbin held an epidemic prevention and control meeting. The meeting proposed to follow the work requirements of the provincial party committee, the provincial government and the provincial prevention and control headquarters, and combine the new epidemic prevention and control. The situation, new changes, refine and improve the hospital prevention and control process, strictly prevent cross-infection in the hospital, and comprehensively improve the level of hospital infection prevention and control.
On April 15, the Standing Committee of the Harbin Municipal People’s Congress released a list of cadres’ appointment and removal, showing that 60-year-old Qin Deliang was removed from the post of director of the municipal health committee.
tracing the source, the whole process of resuming, we can see three lines of defense. If we hold any pass and node, it is possible to avoid the consequences of "1 pass 36".
Due to the emergence of a new local epidemic, as of 3 pm on April 11, Harbin has investigated and traced 456 close contacts. Harbin has adopted measures such as closed control and disinfection of the residential community units and related activity sites involved.
In addition, the start of junior high school graduation on April 17 has also been postponed...
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