The implementation of centralized isolation management in mild cases is a signal of "lying flat"?
Nowadays, 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.
Therefore, the National Health Commission issued the Notice of the Diagnosis and Treatment Plan for Novel Coronavirus Pneumonia (Trial Version 9) (hereinafter referred to as the Ninth Edition Diagnosis and Treatment Plan).
The Ninth Edition of the Diagnosis and Treatment Plan has many revisions compared with the previous edition, which also emphasizes that the implementation of centralized isolation management for mild cases is why it should be revised? And what signals are released?
There are 5 important revisions to the COVID-19 treatment plan
1. Increase antigen detection as a supplement
According to the Ninth Edition of the Diagnosis and Treatment Plan, the case detection and reporting procedures are optimized, and antigen detection is added as a supplement on the basis of nucleic acid detection to further improve the ability to detect cases early.
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.
2. Implement centralized isolation and management of mild cases
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.
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.
3. Two specific anti-coronavirus drugs are written into the diagnosis and treatment plan
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).
4. Revise the criteria for lifting isolation management and discharge
According to the Ninth Edition of the Diagnosis and Treatment Plan, relevant domestic studies have shown that when the recovering period of infected people ≥ 35 nucleic acid Ct value, the virus could not be isolated from the sample, and the close contacts were not 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".
5. Add content related to the treatment of traditional Chinese medicine in children
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.
Why should mild cases be centralized and isolated?
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, explained in an interview that the centralized isolation and management of mild cases is based on the following considerations:
First, mild cases are less harmful and do not require special therapeutic intervention, but need to be isolated, then observed, and 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.
"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.
Source / National Health Commission official website, Shenzhen Satellite TV, China News Network