China's epidemic prevention policy, which has been under strict case management and close tracking, has been adjusted for the first time in two years.
On March 15, the Medical Administration Bureau of the National Health commission issued the "On Printing and Distributing the Diagnosis and Treatment Plan for Novel Coronavirus Pneumonia (Trial Ninth Edition)" (hereinafter referred to as the "Ninth Edition"), which is revised based on the study of the transmission characteristics and case characteristics of mutated strains such as Delta and Omi kerong, and on the basis of in-depth analysis of relevant research results, and its revision mainly includes: the implementation of classified admission of cases, the adjustment of the nucleic acid testing standards for new crown at the time of discharge, etc.
These two changes can not only alleviate the tension of medical resources, but also reduce the control time and control resources, and further alleviate the pressure of urban prevention and control.
Since the patients of the Omikejong 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, so the ninth edition proposes to classify and treat cases. Among them, mild cases are subject to centralized isolation management, and relevant centralized isolation places 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.
Ordinary, severe, critical cases and cases with severe high risk factors should be treated intensively in designated hospitals, of which severe and critical cases should be admitted to the ICU for treatment as soon as possible, and patients with high risk factors and severe disease tendencies should also be admitted to the ICU for treatment.
"Clinically, even if they are admitted to a designated hospital, patients with mild diseases are not treated with drugs. At present, drug treatment is mainly for ordinary, severe and critical cases. A clinician said.
However, in the previous diagnosis and treatment plan, mild, ordinary, severe, and critical cases were admitted to the hospital together, which often caused a shortage of beds in medical institutions.
At 9 o'clock on February 21, Hohhot City, Inner Mongolia Autonomous Region, carried out the third round of nucleic acid testing. Xinhua News Agency photo.
At the press conference on the prevention and control of the epidemic in Jilin Province on March 15, Zhang Li, deputy director of the Jilin Provincial Health Commission, said that Changchun City and Jilin City have completed the construction of 5 square cabin hospitals (1 in Changchun City and 4 in Jilin City) and vacated 7 medical institutions. At present, there are 22,880 treatment beds in the province.
From 9:00 a.m. on March 1 to March 15, a total of 6,347 confirmed cases were announced in Jilin Province, including 6,298 mild cases, 48 ordinary cases, and 1 severe case. Jiao Yahui, director of the Medical Administration Bureau of the National Health commission, said at the press conference of the Joint Prevention and Control Mechanism of the State Council on the 15th that as of the morning of March 15, there were 8201 cases of hospitalized cases in Jilin Province, of which 2 cases of critical illness and 2 cases of heavy disease in Jilin City, and 2 cases of heavy disease in Changchun City, accounting for about 4% of the ordinary type. That is, more than 95% of patients are asymptomatic infected and mild cases.
"According to the total number of data disclosed in a single day in Jilin Province, there are only 49 cases that really need hospitalization." An epidemiologist said.
The number of new infections in Jilin Province in a single day in recent days. CBN finishing.
At the same time, the Ninth Edition stipulates that the "two consecutive negative nucleic acid tests for respiratory specimens (sampling time interval of at least 24 hours apart)" in the criteria for the release of isolation management and discharge are modified 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 limit value is less than 35, Sampling time is at least 24 h apart)".
This means that when the Ct value is greater than 35, it is not counted as positive for nucleic acid.
"Previously, ct values between 0 and 40 were considered positive, but the research data showed that when the Ct value is greater than 35, the close contacts will not be infected, so this part of the 'infected people' do not have the ability to spread, and then isolate them, which will involve more people and isolation resources." A professional in the field of nucleic acid diagnosis said that according to the characteristics of the past epidemic, setting the Ct value range is larger, which can fish out more infected people, and block the epidemic on a larger scale and faster, because the larger the Ct value range, the more positive infected people will be detected. But in the current case of the Omikeron mutant, this method is no longer suitable.
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.
Tang Jinling, Chair Professor of the Chinese Academy of Sciences and Head of the Department of Epidemiology and Bioinformatics, has been worried about "insufficient isolation" or becoming the cause of the out-of-control epidemic in Aomi Kerong in a city. "Tracing and isolating infected people has been a key measure for us to achieve dynamic clearance in the past two years. What are the shortcomings of this measure? The short board is the measure that the ability is the first to reach the top, where the ability has a clear ceiling and cannot be improved quickly. Tang Jinling believes that when the isolation demand is greater than the upper limit of the isolation capacity, the "trigger" of the epidemic is out of control.
Tang Jinling believes that there is obviously an upper limit to the city's centralized isolation capacity, and this upper limit is the total number of rooms in the city that can be used to centrally isolate the source of infection (infection + close connection). When this total exceeds the total number of existing isolation rooms, the extra infected and close contacts will not be able to be isolated centrally, and they will have to be left at home or in society. "When the activities of the source of infection cannot be strictly, centrally and effectively controlled, they are not far from getting out of control."
In addition, the Ninth Edition revised "14 days of isolation management and health monitoring after discharge" to "7 days of home health monitoring after discharge from isolation management" was revised.