What are frontline healthcare practitioners going through to stop the invasion of strains?

The new crown mutant strain Omicron (Greek letter Omicron) officially invaded our country, how did the front-line prevention and control system react?

On December 14, the news came out at the press conference on epidemic prevention and control in Guangzhou that a 67-year-old inbound man had tested positive for nucleic acid during home isolation in Guangzhou after being released from centralized isolation in other places, and the virus was sequenced and identified as a variant of Omicron. Up to now, a total of 11 cases of infection have been found in China, including 1 case in Guangzhou, 1 case in Tianjin and 9 cases in Hong Kong.

As defined by WHO as a "strain of concern", The Overall Global Risk Assessment of Omi kerong is "very high" and is likely to be widely disseminated around the world. At present, 77 countries and regions around the world have reported the Ormicron variant. There have been deaths in the UK. The UK health department expects the Strain to become the main epidemic strain in the capital, London, within 48 hours; the Danish government also expects the strain to become "mainstream" in the capital Copenhagen within this week.

In Chinese mainland, Tianjin and Guangzhou are in the front line of "anti-Olympic" defense. China's county health has noted that frontline prevention and control actions may bring inspiration to other places.

Tianjin: Delineate a special ward, a full-time team for diagnosis and treatment

On December 13, the Tianjin Municipal Epidemic Prevention and Control Command announced the first case of the Aomi Kerong variant in the Chinese mainland at the press conference. The patient was a returnee who had entered Tianjin with a normal body temperature and no abnormalities in the declaration. After the customs quarantine inspection and sampling, the whole process of closed-loop management is transferred to the centralized isolation medical observation point in Xiqing District. On December 9, the nucleic acid test result of the new crown virus was positive, that is, he was transferred to Haihe Hospital by 120 ambulance.

Gu Qing, director of the office of the Tianjin Municipal Covid-19 Epidemic Prevention and Control Headquarters and director of the Tianjin Municipal Health Commission, introduced that in order to prevent the spread of the Aomi Kerong variant virus in the hospital, Tianjin has specially demarcated a special ward for people infected with the Aomi Kerong variant virus, and at the same time a special medical team will treat them. At present, Tianjin implements closed-loop management measures for inbound personnel. That is, starting from the landing of the aircraft, the inspection of health identification cards, the examination of body temperature, and the investigation of vaccination history and epidemiological history are carried out. Anyone with suspicious symptoms such as respiratory tract or fever will be transported to a designated hospital in a timely manner through a 120 closed-loop transfer vehicle. For passengers without symptoms, special transportation buses will be used to directly transfer to the isolation point in a closed loop for single-person single-room isolation. At the same time, the environment through which the inbound personnel pass will be strictly eliminated.

Guangzhou: The epidemic prevention and control has been upgraded

Guangzhou officials released news that the case involved was quarantined from a foreign city on November 27, during which several nucleic acid tests were negative. On December 11, after lifting the isolation, he returned to Guangzhou by plane (CA1837) and was transferred to his home in Yuexiu District for home isolation in a closed loop; on the 12th, the Huale Street Community Health Service Center routinely collected nucleic acid samples for him, and reported the results positive for the first screening in the early morning of the 13th, and was later confirmed to be the Aomi Kerong variant. It can be seen from this case that although the Aumechjong virus has broken through the first line of defense for 2 weeks of entry quarantine, it is worth noting that as an important port city of the country, in the competition with Omikeron, Guangzhou's approach is as follows.

Current levels of nucleic acid testing can detect The Omicron virus

Judging from the details of the case released in Guangzhou, although the virus broke through the defense line of entry isolation, it was successfully arrested in the second line of defense - home isolation. This is closely related to the effective detection of primary medical institutions. It can be seen from this case that the primary medical institutions in Guangzhou, represented by the Huale Street Community Health Service Center, can effectively detect the Omicron virus under the existing sampling and nucleic acid detection levels. A spokesman for the Guangzhou Cdron Control also said that the Aomi Kerong variant does not affect the sensitivity and specificity of existing nucleic acid detection reagents in China.

Whole genome sequencing with a nasal swab

Whole genome sequencing is the gold standard for identifying virus strains. Previously, officials in Hebei and other places used throat swabs when sequencing the virus in epidemic prevention and control. It is worth noting that the guangdong identification of the Omikejong virus strain, the use of nasal swabs.

According to professionals, throat swabs are divided into two categories: nasopharyngeal swabs and oropharyngeal swabs, the two sampling paths are different, oropharyngeal swabs are oropharyngeal swabs, and nasal nasal swabs are nasopharyngeal swabs. At present, most hospitals most commonly use oropharyngeal swabs because this method is convenient for collection and less painful. However, studies have shown that the viral load of nasopharyngeal swabs is significantly higher than that of oropharyngeal swabs, and the detection rate is higher. In nasopharyngeal swab sampling, a swab swab is extended deep into the nasal cavity all the way to the nasopharynx, and the secretions are taken for smearing. Since it is necessary to go through the nasal cavity, the nasal swab and the throat swab are slightly painful. If there is structural abnormalities in the nasal cavity, it is possible to swab a cotton swab, which does not easily reach the nasopharynx through the nasal cavity or damage the nasal mucosa, causing local bleeding or discomfort such as pain.

Three districts fine classification

Facing the Opmy Kerong virus, preventing its spread, and coordinating economic and social development, Guangzhou's approach is also commendable. In addition to routine actions such as circulation adjustment and investigation, Guangdong implements the "three-zone classification" precise prevention and control (see below), and implements centralized isolation for all close connections, and strictly implements "home isolation and staying at home" in the sub-close connection. At the same time, the public involved in the prevention and control of the epidemic will be given a "yellow code", and some nucleic acid sampling medical institutions will be planned to provide 24-hour nucleic acid sampling services for those who hold yellow codes.

The three areas of accurate prevention and control are classified as follows:

Sealing and control area: The building where the case's home is located (No. 65, Tiansheng Village) implements regional closed management. All residents in the sealing and control area were transferred to centralized isolation places for centralized medical observation. The terminal disinfection of the case's home and its surroundings was strengthened, the buildings in the control area were comprehensively disinfected, and disinfection drugs were also released in the sewage pipes. After disinfection, two rounds of environmental testing were carried out to expand the scope of sampling, and the current tests are negative. The Guangzhou Municipal Transportation Bureau has adjusted the transportation arrangements in the prevention zone.

Control area: Other buildings near the building of the case's home (No. 56 to 64 and No. 66 of Tiansheng Village), the implementation of "people do not leave the area, strictly prohibit gathering", in principle, at home, all personnel to implement "three days two tests" nucleic acid sampling. Yuexiu District dispatched 450 party members and cadres and volunteers to arrange special personnel to be on duty 24 hours a day, contact supermarkets and fresh express delivery, set up temporary storage points without contact, and do a good job in allocating and supplying residents' daily necessities. In particular, we should do a good job in ensuring the lives and medical services of 30 elderly people, patients, disabled people, pregnant women, children and other people in need of care in the control area. As of noon today, about 650 material deliveries have been completed.

The prevention areas are: the area around the case community (east to Taojin North Road, south to Huanshi East Road, north to Guangzhou-Shenzhen Railway Line, west to Luhu Road) to implement "strengthen social control, strictly restrict personnel gathering", personnel to implement two nucleic acid collections, and health monitoring.

To reduce the flow of personnel, Guangzhou requires that the citizens of the above-mentioned control areas and key places not leave the spike unless necessary, and some bus stations in the control area have been adjusted, and the operation of cruise cars and online ride-hailing vehicles in the prevention area has been suspended. Since December 14, all passengers departing from Baiyun Airport must check the itinerary code on the basis of measuring temperature and checking the health code.

The toxicity of Omikejong is controversial or favored by young people

In the case of the Opmiqueron epidemic, many countries have stepped up their vigilance, although experts still disagree on its toxicity. Jin Dongyan, a virology expert at the University of Hong Kong in China, said in an interview with the media, "There is no evidence that Omicron is a strong strain, and from the prediction point of view, its toxicity is relatively weak." International experts have also analyzed that early evidence suggests that the Omilton strain "has reduced COVID-19 symptoms, shortened hospital stays, reduced number of people needing oxygen, and reduced number of people in intensive care units".

Zhang Wenhong, director of the Department of Infectious Diseases at Huashan Hospital affiliated to Fudan University, is skeptical of such views. In his speech at the 2021 Greater Bay Area Science Forum On Life Sciences sub-forum on December 12, Zhang Wenhong clearly pointed out: "Some views believe that Omicron is a 'live attenuated vaccine', which is not sufficient evidence so far." In view of the future scenario of Global Communication of Omicron, Zhang Wenhong put forward several ideas: 1. The best situation: local transmission, weak virulence; global transmission, virulence is weak. As a result, the current austerity policy will be gradually relaxed. 2. Acceptable situation: strong transmission, strong virulence, strong vaccine strengthening and effectiveness. Vaccines are needed to strengthen vaccination to accelerate the spread. 3. Grim future: strong transmission, strong virulence, vaccine strengthening ineffective. New vaccine strategies are needed to tighten prevention and control strategies.

It is worth noting that Omi Kerong may have the ability to immunize to escape. Dr Catherine Smallwood, senior emergency officer at the World Health Organization's European office, said in an interview that according to current data from many countries, "the spread of this wave of Theomilon outbreak is young, healthy and vaccinated people". Data released by Denmark on the 12th showed that 70% of the 3437 cases of Aumicron were under the age of 40. The European Centre for Disease Control also said that in the early cases of Aumicron, 72% of patients were under the age of 40. Data from the U.S. Centers for Disease Control and Prevention also show that of the 43 infections to date, most are under the age of 40, and nearly 80 percent of patients are fully vaccinated.

A domestic epidemiologist interviewed by the media said that China's response to the new crown variant strains such as Omicron, in addition to the dynamic zeroing policy, has two hands to prepare for vaccine prevention and control measures, one is to change the strain, and the other is to strengthen the needle. It is understood that at present, China has successfully isolated the Omiljung variant strain, and carried out research in the relevant P3 laboratory, and the research results will be used as an important basis for whether to replace the inactivated vaccine strain.

WHO is urging countries to pay more attention to the Opmi-Kerong strain: while the symptoms of infection with the Aomiqueron variant are less severe, a large number of cases of infection can overwhelm health systems.

"Omi kerong is not so terrible, the current vaccine is still protective, whether it is necessary to change the target of the vaccine still needs to be observed for two or three weeks, at present, the key is to do a good job in prevention and control." Zhong Nanshan, an academician of the Chinese Academy of Engineering, said. For the public, wearing masks, social distancing, washing hands frequently, ventilating frequently, vaccinate, reducing unnecessary entry and exit, and doing a good job of health monitoring are still effective ways to prevent infection.

It is gratifying that China's first new coronavirus neutralizing antibody combination treatment drug with independent intellectual property rights has been listed. The drug is used to treat adult and adolescent patients who test positive for the novel coronavirus and are accompanied by risk factors for progression to severe COVID-19. The drug has undergone rigorous randomized, double-blind, placebo-controlled studies. Zhang Linqi, professor at Tsinghua University School of Medicine, director of the Center for Global Health and Infectious Diseases Research and the Center for Comprehensive HIV/AIDS Research at Tsinghua University, said that combination therapy has shown excellent safety and protection in international multi-center trials, and is the only antibody drug in the world that has so far carried out the evaluation of the therapeutic effect of patients with mutant strains and obtained optimal data.

The source | county health

The author | Song Pan