According to the news on the website of the National Health Commission on March 15, the National Health Commission issued the "Diagnosis and Treatment Plan for Novel Coronavirus Pneumonia (Trial Version 9)" and issued it to all localities for reference and implementation.
The COVID-19 protocol has been adjusted in a number of places.
The plan says that the centralized isolation management of mild cases, centralized isolation places can not 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.
On the basis of nucleic acid detection, antigen detection is added as a supplement to further improve the early detection capacity of cases.
The Ct values of the criteria for the management of release from isolation and discharge have also been adjusted accordingly, from the previous 40 to 35 of the international standard.
The plan changes "continue 14 days of isolation management and health monitoring after discharge" to "7 days of home health monitoring after discharge from isolation management" is revised.
In addition, the program also writes two specific anti-coronavirus drugs approved by the State Food and Drug Administration into the diagnosis and treatment plan, namely: PF-07321332/ritonavir tablets (Paxlovid) and domestic monoclonal antibodies (amphavir monoclonal antibody/romizumab injection).
What signal does this revision send? Does it mean an adjustment of prevention and control policies?
Shenzhen Satellite TV reporters interviewed Wang Guiqiang, a member of the medical treatment expert group of the joint prevention and control mechanism of the State Council, a member of the Expert Advisory Committee of the National Immunization Program, and the director of the Department of Infectious Diseases of the First Hospital of Peking University.
Wang Guiqiang, member of the medical treatment expert group of the joint prevention and control mechanism of the State Council, member of the Expert Advisory Committee of the National Immunization Program, and director of the Department of Infectious Diseases of the First Hospital of Peking University
Wang Guiqiang interpreted that the centralized isolation management of mild cases is based on the following considerations: First, mild cases are less harmful and do not require special treatment intervention, but need to be isolated, and then observed, once the condition becomes serious, it can be transferred to a medical institution in time.
Second, if the epidemic breaks out on a large scale, medical resources are limited, beds are limited, and medical institutions will be overwhelmed, so patients with mild diseases do not have to go to medical institutions if their condition does not worsen.
In fact, the plan also clearly states that according to the opinions reflected in various places, "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", and further improve the classification and treatment measures for cases.
"It's a scientific hierarchical management model." Wang Guiqiang analyzed that under the general circumstances of mild asymptomatic, observation can be done, but it is necessary to centralize isolation management, because it is true that some mild patients will have changes in their condition, need medical care, and implement monitoring and observation.
As for ordinary, severe, critical cases and cases with severe high-risk factors, they should be treated intensively in designated hospitals, of which severe and critical cases should receive intensive treatment as soon as possible, and patients with high-risk factors and severe predisposition should also receive intensive treatment.
"The purpose of this is to effectively isolate and avoid transmission on the one hand; second, to detect the tendency of mild to severe disease in time, and to treat patients in time after mild diseases are aggravated; third, to enable those patients who need treatment intervention to get timely and effective treatment interventions and reduce the case fatality rate." Wang Guiqiang said.
Wang Guiqiang analyzed the Shenzhen Satellite TV direct news reporter that the diagnosis and treatment plan revised the nucleic acid Ct value, which is based on previous studies, if the nucleic acid Ct40 is followed, the standard is set relatively loosely, resulting in many patients being delayed in discharging, and these people are no longer infectious. The results of the "human challenge" in the United Kingdom show that the virus cannot be isolated in about ten days, but if the standard of Ct40 is followed, the nucleic acid test result may still be positive, so the patient cannot be discharged, resulting in a long-term stay in a medical institution, occupying a bed, which is not conducive to the recovery of patients, as well as the treatment of other seriously ill patients, so the diagnosis and treatment plan has been adjusted.
"It should be said that the adjustment of the diagnosis and treatment plan is also to adapt to the characteristics of the current Highly contagious, mild cases and relatively low cases of the Aomi Kerong strain, and also takes into account the rational application and allocation of medical resources." Wang Guiqiang concluded.
Wang Guiqiang stressed that this is not a signal to prevent and control "lying flat", but a strategy of scientific hierarchical management.
Author | Tang Ping is a direct news reporter of Shenzhen Satellite TV