There are nearly 300 million patients with confirmed chronic diseases in China, involving respiratory asthma, tumors, chronic kidney disease, liver disease, HIV, pediatrics, gynecology, psychosocial and other chronic diseases. According to the Chinese Center for Disease Control and Prevention, the number of deaths caused by chronic diseases in the mainland accounts for 88% of the total deaths, and the resulting disease burden accounts for more than 70% of the total disease burden.
Taking cardiovascular disease as an example, more than 4 million Chinese people die of the disease every year, and about one cardiovascular patient dies every 8 seconds.
Text | Wu Ni
Editor| Yang Zhongxu
Cartographer | Li Ziya
In the more than two years of living with COVID-19, what has changed you the most?
According to media surveys, 98% of respondents pay more attention to personal hygiene, develop the habit of washing hands frequently, wearing masks, and adopting a meal sharing system, and are prepared to continue to maintain it after the epidemic is over.
Unconsciously, the small episode of the epidemic has had a profound impact on the public's concept of life, hygiene habits and behavior.
On March 11, a new syllable was played - the National Health Commission issued the "Application Plan for Antigen Detection of The New Coronavirus (Trial)". In just one week, antigen detection products have undergone approval and collection, and they have quickly joined the battlefield against Omicron BA.2.
Antigen testing is an important addition to nucleic acid testing, making home-based self-testing feasible. In the view of industry experts, behind the transformation of the detection scene, what awaits the public is a huge change in group consciousness - citizens no longer passively accept the government's organization and services, but need to purchase at their own expense, self-testing, and conscious protection.
"The increase in antigen detection methods helps to put the battlefield of epidemic prevention and control in front of the family, enhance the health awareness of the people, and promote individuals and families to play the role of the first responsible person for health," Wu Jing, director of the Chronic Disease Center of the Chinese Center for Disease Control and Prevention, told CaijianDao, "The concept of disease prevention and control is common, and enhancing the health responsibility and awareness of individuals is not only the requirement of infectious disease prevention and control, but also helpful for the prevention and control of chronic diseases." ”
The prescient sees the same thing. Yin Ye, a well-known popular science writer and CEO of Huada Group, also told Caijian Dao that home antigen testing is a vivid health management lesson for 1.4 billion people. Zhou Shenglai, honorary chairman of the Disease and Health Management Professional Committee of the Chinese Hospital Association and chairman of the Hospital Development Expert Committee of the China County Hospital Presidents Alliance, also said in an exclusive interview with Caijian Dao that home antigen testing will become a "catalyst" for chronic disease management. How do catalytic reactions occur? And listen to Zhou Shenglai one by one.
01 What will antigen testing change?
"CaiJian Dao": The "Diagnosis and Treatment Plan for Novel Coronavirus Pneumonia (Trial Ninth Edition)" was announced on March 15, proposing to increase antigen detection as a supplement on the basis of nucleic acid testing to improve the ability to detect cases early. What do you think of the revision of the COVID-19 nucleic acid testing standards?
Zhou Shenglai: The increase in antigen detection methods is one of the signs that the mainland's epidemic prevention and control has entered a new stage.
Combined with this revision and the "Application Plan for The Detection of Antigens of the New Coronavirus (Trial)", it can be found that antigen detection, as an important supplement to nucleic acid detection, is mainly suitable for large-scale screening self-examination. When home-based self-testing becomes feasible, the risk of cross-infection during the gathering of people will be avoided to some extent.
According to the application plan for antigen detection of the new crown virus (trial), the applicable groups of antigen testing include those who go to primary medical and health institutions for treatment, accompanied by respiratory tract, fever and other symptoms and have symptoms within 5 days; isolation and observation personnel, including those who are home isolation observation, close contact and sub-close connection, entry isolation observation, sealing and control area, and community residents who have antigen self-testing needs.
From a higher level, antigenic reagents enter the family, which is intended to arouse the awareness of individuals and families as the first responsible person for health, and help to normalize and accurately prevent and control the new crown pneumonia.
Cai Jian Dao: Why are individuals and families "the first responsible persons for health"?
Zhou Shenglai: In the past, the medical reform paid more attention to the satisfaction of citizens' health rights and interests, ignoring the health responsibilities of each citizen to the family and society.
In 1992, the World Health Organization (WHO) published a number of factors affecting the health and longevity of individuals, of which 15% depend on genetic factors, 10% on social and environmental factors, 8% on medical factors, 7% on climatic factors, and 60% on autologous rehabilitation factors (lifestyle, etc.).
Since the way of life of an individual is the main factor affecting his or her own health, citizens should take primary responsibility for their own health. Moreover, personal health is related to the prosperity and development of the whole country and society, and it is also an obligation to the country and society to be responsible for their own health.
We cannot delegate all the responsibility for health to governments. People's need for health is both the most basic and the highest. The government under the conditions of the market economy is a "limited government", which assumes the responsibility of basic medical care and cannot meet the unlimited health needs.
Cai Jian Dao: How does antigen testing play a role in bringing the sense of responsibility back into place?
Zhou Shenglai: Antigen testing puts the first threshold of COVID-19 prevention from the hospital and the community to the family. This means that citizens no longer passively accept the organization and services of the government, but need to buy at their own expense, test themselves, and consciously protect themselves. The transformation of roles and the improvement of participation will help enhance citizens' awareness and understanding of the new crown virus, so that the concept of normalization prevention and control and the awareness of health responsibility can penetrate into every family. The cultivation of prevention and control habits and health responsibility awareness is expected to play an important role in the management of chronic diseases.
02 The logic of chronic diseases and the prevention and treatment of infectious diseases is the same
Cai Jian Dao: You and Director Wu Jing both mentioned that the experience of covid-19 epidemic prevention and control can be transferred to the management of chronic diseases, why is there such a connection between the two?
Zhou Shenglai: The new crown epidemic has lasted for 2 years, and as of 00:00 on March 18, the cumulative number of confirmed cases in Chinese mainland is 124123, and the number of deaths is 4636.
In contrast, chronic diseases are much more serious. There are nearly 300 million patients with confirmed chronic diseases in China, involving respiratory asthma, tumors, chronic kidney disease, liver disease, HIV, pediatrics, gynecology, psychosocial and other chronic diseases. According to the Chinese Center for Disease Control and Prevention, the number of deaths caused by chronic diseases in the mainland accounts for 88% of the total deaths, and the resulting disease burden accounts for more than 70% of the total disease burden. Taking cardiovascular disease as an example, more than 4 million Chinese people die of the disease every year, and about one cardiovascular patient dies every 8 seconds.
Chronic diseases are far more harmful to families and society than highly transmitted diseases, and we need to pay more attention. The COVID-19 pandemic has stimulated the health awareness of the whole people and provided an opportunity for the prevention and treatment of chronic diseases.
Chronic diseases, also known as "lifestyle diseases", cannot rely solely on treatment, but must pay attention to prevention and management, similar to the logic of new crown prevention and treatment. If the spirit and experience of fighting the epidemic can be applied to the prevention and treatment of chronic diseases, I believe that Breakthroughs can be made in the prevention and treatment of chronic diseases in China.
Cai Jian Dao: In your opinion, what is the ideal model for disease management,including chronic diseases and infectious diseases??
Zhou Shenglai: First of all, the hospital cannot be satisfied with the diagnosis and treatment of difficult and complicated serious diseases, and should participate in disease prevention while treating the disease. How? First, allocate medical resources to chronically ill patients in the midstream and intervene in advance to avoid worsening their condition or organ damage. Second, the prevention and treatment gate is placed upstream, and the population that has not yet been clinically confirmed but has the risk factors for major diseases is screened out and managed in advance. In general, the construction of a new medical service model of "integration of four lines of defense" is to build a medical and health service system covering the whole life cycle, namely downstream life-saving and injury-saving, midstream disease management, upstream health management and source eugenics.
Second, government departments at all levels should re-understand the status and role of health. Improving the people's health level is a solid foundation for the great historical rejuvenation of the Chinese nation and a leading project. Moreover, in the process of establishing a public health system, it is necessary to adhere to the principle of prevention and the combination of prevention and treatment.
The most important thing is to let the people of the whole country realize that health is the most valuable asset of individuals and families, and let the management of chronic diseases return to the family. There are many measures to improve health in family life, and the National Health Commission has put forward the initiative of "three minus three health" in the "Healthy China Action", calling on the public to reduce salt, oil and sugar. On this basis, people can also regularly monitor themselves through household health testing products.
Whether it is epidemic prevention and control or chronic disease prevention and control, it should be changed from the above three aspects in order to build a modern health system that is compatible with high-quality development.
(The author is a researcher of Caijing, and Yang Yan and Zhang Yuqi also contributed to this article)