Notice on Printing and Distributing the Diagnosis and Treatment Plan for Novel Coronavirus Pneumonia (Trial Version 9).
National Health Office Medical Letter [2022] No. 71
Health Commissions and Traditional Chinese Medicine Administration Bureaus of all provinces, autonomous regions, municipalities directly under the Central Government and the Xinjiang Production and Construction Corps:
At present, the new coronavirus pneumonia epidemic is still circulating worldwide, the Omicron strain has replaced the Delta strain as the main epidemic strain, the clinical manifestations of patients with new coronavirus pneumonia have shown new characteristics, and new drugs for the treatment of new coronavirus pneumonia have been listed, and the treatment experience and treatment methods have been further enriched. In order to further scientifically and standardize the diagnosis and treatment of novel coronavirus pneumonia, we organized experts to revise the relevant contents of the "Diagnosis and Treatment Plan for Novel Coronavirus Pneumonia (Trial Eighth Revised Edition)" and formed the "Diagnosis and Treatment Plan for Novel Coronavirus Pneumonia (Trial Ninth Edition)". It is hereby issued to you, please refer to the implementation.
Annex: Diagnosis and Treatment Plan for Novel Coronavirus Pneumonia (Trial Version 9)
General Office of the National Health Commission
Office of the State Administration of Traditional Chinese Medicine
March 14, 2022
Diagnosis and treatment plan for novel coronavirus pneumonia
(Trial Ninth Edition)
Key points for the revision of the Diagnosis and Treatment Plan for Novel Coronavirus Pneumonia (Trial Version 9).
In order to further do a good job in the medical treatment of new coronavirus pneumonia and effectively improve the level of standardized and homogeneous diagnosis and treatment, the National Health Commission and the State Administration of Traditional Chinese Medicine organized experts to revise the "Diagnosis and Treatment Plan for Novel Coronavirus Pneumonia (Trial Eighth Revised Edition)" and formed the "Diagnosis and Treatment Plan for Novel Coronavirus Pneumonia (Trial Ninth Edition)", and issued it for reference and implementation in various places. The new version of the diagnosis and treatment plan is formed on the basis of careful study of the transmission characteristics and case characteristics of mutant strains such as Delta and Omikerong, and in-depth analysis of relevant research results. The key revisions are as follows:
The first is to optimize the case detection and reporting procedures. On the basis of nucleic acid detection, antigen detection is added as a supplement to further improve the early detection capacity of cases. At the same time, the efficiency of diagnosis or exclusion of suspected cases is improved, requiring those whose suspected cases or antigen test results are positive to immediately undergo nucleic acid testing or closed-loop transfer to higher-level medical institutions with conditions for nucleic acid testing. Those who have a positive nucleic acid test result shall be subject to centralized isolation management or sent to a designated hospital for treatment, and directly reported online in accordance with regulations.
The second is to classify and treat cases. According to the opinions reflected in various places, "the patients of the Aomi Kerong mutant strain are mainly asymptomatic infected and mild cases, most of them do not need too much treatment, and all of them will occupy a lot of medical resources in designated hospitals", and further improved the classification and treatment measures for cases:
1. Mild cases are subject to centralized isolation management, and relevant centralized isolation sites cannot isolate people entering the country, close contacts and other groups at the same time. During the isolation and management period, symptomatic treatment and disease monitoring should be done, and if the condition worsens, it should be transferred to a designated hospital for treatment.
2. Ordinary, severe, critical cases and cases with severe risk factors should be treated intensively in designated hospitals, of which severe and critical cases should be included in the ICU as soon as possible, and patients with high risk factors and severe disease tendencies should also be admitted to the ICU for treatment.
The third is to further standardize antiviral treatment. Two specific anti-coronavirus drugs approved by the State Food and Drug Administration were written into the diagnosis and treatment plan, namely: PF-07321332/ritonavir tablets (Paxlovid) and domestic monoclonal antibodies (amphavir monoclonal antibody/romizumab injection).
The fourth is to revise and improve the content of traditional Chinese medicine treatment. Combined with the experience of clinical treatment in various places, the application of non-drug therapies of traditional Chinese medicine has been strengthened, and the content of acupuncture treatment has been increased; combined with the characteristics of children's patients, the relevant content of children's traditional Chinese medicine treatment has been increased.
The fifth is to adjust the management of release from isolation, the criteria for discharge, and the precautions for lifting isolation management and post-discharge. Relevant domestic studies have shown that when the nucleic acid Ct value of the recovering person is ≥ 35, the virus cannot be isolated from the sample, and the close contacts have not been found to be infected. Accordingly, the new version of the diagnosis and treatment plan modifies the "negative nucleic acid test of two consecutive respiratory specimens (sampling time interval is at least 24 hours apart)" in the criteria for dissociation management and discharge to "two consecutive nucleic acid detection N gene and ORF gene Ct values are ≥35 (fluorescence quantitative PCR method, the limit value is 40, the sampling time interval is at least 24 hours), or two consecutive negative nucleic acid tests for the new coronavirus (fluorescence quantitative PCR method, the boundary value is less than 35, Sampling time is at least 24 h apart)". Revise "Continue 14 days of isolation management and health monitoring after discharge" to "release from isolation management or continue home health monitoring after discharge".