March 19 at 3:00 p.m
Joint prevention and control mechanism of the State Council
Hold a press conference
Disease Control Bureau of the National Health Commission, Medical Administration and Medical Administration Bureau
Vaccine R&D special class, China Center for Disease Control and Prevention
Experts from Beijing Ditan Hospital attended
Introduce the situation related to epidemic prevention and control and vaccination work
And answer questions from the media
Let's take a look at it with the editor
Q
What changes have taken place in the national epidemic situation in recent days?
A
Lei Zhenglong, deputy director of the Disease Control Bureau of the National Health Commission and a first-level inspector: At present, the fourth wave of the new crown epidemic in the world is still operating at a high level, from March 1 to 18, the mainland has reported more than 29,000 cases of new crown pneumonia infection, affecting 28 provinces, of which 1 province in Jilin Province has reported more than 10,000 cases. Another 4 provinces have reported more than 1,000 cumulative cases, and 10 provinces have reported cumulative cases between 100 and 1000 cases. Overall, the local epidemic situation in the mainland is still in the development stage, and many provinces are facing the prevention and control of the epidemic in many cities in the same period. The comprehensive group of the joint prevention and control mechanism of the State Council continues to guide the epidemic areas to strictly implement various prevention and control measures, quickly carry out nucleic acid screening, quickly trace the source of circulation, timely standardize centralized isolation, strictly control communities, timely carry out regional coordination, achieve "dynamic clearance" of the social surface as soon as possible, and resolutely adhere to the bottom line of no large-scale rebound of the epidemic.
At this stage, the number of cases is still growing rapidly, what are the key points and difficulties in domestic epidemic prevention and control?
Wu Zunyou, chief expert of epidemiology of the Chinese Center for Disease Control and Prevention: The current epidemic situation is very grim, and the focus of prevention and control work can be seen from two aspects: first, for areas where the epidemic has already occurred, it is necessary to cut off the spread as soon as possible, prevent the spread, and prevent the spread; second, for areas where the epidemic has not occurred, it is necessary to prevent the occurrence of new epidemics, especially in places where personnel are relatively concentrated, such as schools, prisons, nursing homes and other crowded places.
The difficulty of prevention and control work lies in how to find all infected people in time. The detection of these infected people provides us with important information to cut off the spread. The first is "in time", we must intercept the virus before it spreads. The second is "all", on the entire chain of transmission, all people who may be infected must be found out, to avoid omissions, and missed cases may be the source of the new chain of transmission. In order to be timely and comprehensive, we also have some new technologies to help us find infected people. The first is the application of big data. In the process of epidemiological investigation, big data is used to help us sort out the entire chain of transmission and find all possible infected people in the chain of transmission as much as possible. The second is nucleic acid testing, the so-called "nucleic acid testing of all employees". Nucleic acid testing is very important, one is timely, the other is comprehensive. When we carry out full testing within the determined local scope, we must complete it in a short period of time, it is best to complete a round of testing in 1-3 days, and it must be fast. Each round of testing must complete the screening of all populations within the local range, can not screen a part of the missing part, if we can do timely full screening, in general, 3-4 rounds of nucleic acid screening can basically achieve zero cases at the social level, we must pay attention to prevent omissions. If there are omissions in each round, there may be 7, 8 or 8-10 rounds of infection at the social level, so it is very important to be timely, fast and comprehensive.
Another point that needs to be emphasized is that when we diagnose an infected person, because the condition of each infected person is changing, it may be in the early stage of infection at the time of diagnosis, and it is an asymptomatic infected person or a mild case. A few days ago, the diagnosis and treatment guidelines issued by the Health commission specifically mentioned that for mild cases and asymptomatic infected people, management in some centralized isolation places, in these management places should also be equipped with certain medical personnel, for the discovery of asymptomatic infected people or mild cases, symptoms of aggravation should be transferred to designated hospitals for treatment in time, if we do these work well, it is very helpful for prevention and control work and timely control of the epidemic.
The current round of epidemic situation presents the characteristics of multi-faceted and wide-ranging, what is the overall situation of medical treatment in this round of epidemic?
Jiao Yahui, director of the Medical Administration Bureau: The current round of epidemics in our country has shown a wide range of points, the main epidemic strain is the Aomi Kerong mutation, and the case growth in some provinces is relatively fast. As of 24:00 on March 18, the total number of infected people in hospitals nationwide was 29,127. From the perspective of the disease, it is mainly mild and asymptomatic infections, accounting for more than 95%. Some of them are due to advanced age, complicated by underlying diseases, or have not been vaccinated, and some are more severe, but the proportion is not much, and the proportion of severe and critical disease is less than 0.1%. If you pay attention to the news, the epidemic data released this morning has 2 deaths in Jilin, one of the 2 deaths is of advanced age, and the other is also older than 60 years old, both with serious underlying diseases, one of which has not been vaccinated against new crown pneumonia. Their COVID-19 condition itself is not severe, it is mild, and the direct cause of death is the underlying disease.
In general, our country has a very rich experience in medical treatment, and the effect of medical treatment is also the best in the world. Now our medical treatment work as a whole is very smooth, especially after the release of the ninth edition of the diagnosis and treatment plan, we have guided all localities to take a classified treatment of cases, which highlights the scientific precision, ordinary, severe and high-risk factors of patients concentrated treatment to designated hospitals, other mild cases and asymptomatic infected people to take isolation management, the current local basically use is the construction of square cabin hospitals to treat mild cases and asymptomatic infected people.
On the one hand, we are taking symptomatic and antiviral treatment for patients according to the more optimized ninth edition of the diagnosis and treatment plan, because this ninth edition of the treatment plan also has a clear antiviral treatment drug. We have counted the demand for small molecule antiviral drugs in various provinces, and fed back the demand for drugs to the relevant departments, and more targeted drug supply to these places to support medical treatment. We adhere to the established integration of traditional Chinese and Western medicine, and the threshold is moved forward, and patients who meet the criteria for income ICU are admitted to the ICU in a timely manner. We have also set up sub-ICU wards in many designated hospitals, and admitted these patients with high-risk factors to sub-ICU wards, and strive to interrupt the course of the disease at this stage and no longer enter the ICU to become a severe case.
On the other hand, we have sent national experts to provinces with more cases and greater pressure for treatment, and adopted the method of on-site guidance. For Jilin Province, we also sent a national medical team to directly participate in the medical treatment of cases. On the one hand, the experts we sent paid attention to the treatment of patients in designated hospitals, and on the other hand, they also went to the square cabin hospital for rounds. The round-trip clinic in the cabin hospital is conducive to our early detection of cases with high-risk factors and changes in the condition, and referral to the designated hospital for targeted medical treatment. Overall, the effect of medical treatment is still very good.
The mainland has launched the development of a covid-19 vaccine for the Aumechjong variant, what is the latest progress in this work?
Zheng Zhongwei, head of the vaccine research and development working group of the scientific research group and director of the Science and Technology Development Center of the National Health Commission: As we all know, on November 26 last year, the World Health Organization officially marked the Omi kerong variant as a noteworthy variant, more than four months have passed, and now the Omikejong mutation has become the main epidemic strain in the world. It is characterized by its fast propagation speed and strong concealment. Recent studies at home and abroad have shown that although we have seen an increased risk of the Omiljunn variant on the vaccinated person to break through the infection, the current study shows that the Omiljung variant does not completely escape the existing vaccine. That is, if we complete the full vaccination process, we can still effectively reduce the risk of hospitalization, severe illness and death caused by the Omilkerong variant. If we carry out the vaccination of the booster needle, it can also effectively reduce the risk of breakthrough infection caused by the Omi kerong variant strain. Therefore, existing vaccinations, as well as vaccinations with booster needles, are still effective against the Omikejung variant. If you notice, just yesterday, the technical person in charge of the World Health Organization also made a special clarification on this, or called on everyone, especially the vulnerable population, to accelerate the vaccination of the new crown virus vaccine as soon as possible.
Of course, recently seeing the epidemic of the Olmi kerong variant, especially the breakthrough of the infection, we all urgently hope to be able to use the vaccine against the Omicron variant as soon as possible, and our mood is the same as everyone else. But here I still want to emphasize that as we all know, vaccines are special products for healthy people, and safety is the first. While we are advancing the speed of vaccine development against the Aomi Kerong variant, we always adhere to the scientific principles of safety and efficacy first. In fact, from the very beginning of the Emergence of the Omikejong variant, our country's vaccine development team has been in action. So far, the progress is relatively fast, and the research and development of vaccines for the monovalent and multivalent vaccines of the Opichron variant has made positive progress, and the preclinical research has been completed relatively fast, and the declaration materials for clinical trials are being submitted to the national drug regulatory department on a rolling basis. For example, our inactivated vaccine, we have carried out the unit price, as well as Delta + Omikejong bivalent, as well as the prototype strain + Delta + Omikejong trivalent vaccine research and development work, has basically completed the preclinical research, and has been manufactured to verify. Our recombinant protein vaccine also has the research and development of alpha + beta + delta + Omicron quadrivalent vaccine, and is applying for overseas clinical trials. Our adenovirus vector vaccine has also been optimized for vaccine strain preparation and preclinical studies are underway. Our mRNA vaccine is also actively advancing some preclinical research efforts. In addition, some of our previous vaccines, in the process of the phase III clinical sequential study promoted overseas, have also obtained some protective data for the Aumecreon variant.
In general, as soon as the Omilon variant and the previous variant appeared, our vaccine development unit took action in a timely manner. The basic principle we follow is "it is better to prepare than not to use it, and it is never to be used without preparation".
We note that the ninth edition of the diagnosis and treatment plan states that mild cases should be subject to centralized isolation management. In addition, is centralized isolation a model of a square cabin hospital or a one-person-to-one model? Is it necessary for the public to worry that centralized isolation of mild cases will increase the risk of infection? How to avoid it?
Li Xingwang, chief expert of the Infectious Disease Diagnosis and Research Center of Beijing Ditan Hospital: We know that Aomi Kerong is now the main epidemic strain, and this epidemic strain may spread very secretly and more densely in epidemiology, resulting in a large number of infected people in a short period of time. But clinically, the symptoms of these infected people are relatively mild, that is to say, more than 90% of patients are very mild cases, just some symptoms of upper respiratory tract infections, in other words, these patients do not need to be hospitalized. In the face of such infected people who do not need to be hospitalized but are infectious, we must also centralize their management, admission to the hospital will cause a waste of medical resources, more infected people will cause a run on medical resources, so it is necessary to establish isolation points, concentrate them in isolation points for isolation, and be managed by medical personnel, which is conducive to the health recovery of patients and the control of disease transmission.
Just mentioned the problem of single rooms, because they are all infected, so there is no need for single room isolation. However, people who cannot be isolated at the isolation point, such as close contacts with a negative nucleic acid test, can be isolated at the same time, so that cross-infection will occur. As for whether cross-infection will occur when they are placed in the isolation point, I think this is unnecessary to worry, because at the isolation point, we have good isolation facilities, and our staff are closed-loop management, as long as they do a good job of personal protection, disinfection and isolation, it will not cause the spread of infection.
The cumulative number of confirmed cases in Hong Kong has now exceeded 1 million, how does the National Health Commission judge the latest epidemic development in Hong Kong? At present, does Hong Kong need to carry out nucleic acid testing for all employees as soon as possible? Do you need to work with measures to reduce community footfall?
Mi Feng, spokesperson of the National Health Commission and deputy director of the Department of Publicity: The epidemic situation in Hong Kong is of great concern to the people of the whole country. At present, the epidemic situation in Hong Kong has entered a high platform period, the rapid upward momentum has been controlled, and shown a downward trend of shocks, and the positive infected people are still at a high level of 20,000-30,000 per day in recent days, the situation is still grim, and the pressure is still very large. The central government attaches great importance to and fully supports the prevention and control of the epidemic in Hong Kong, and has sent many groups of experts and working forces to support the SAR government in implementing the main responsibility for prevention and control. The Hong Kong SAR Government has taken "reducing severe illness, reducing deaths, and reducing infections" as a phased work goal, and strives to do a good job in the prevention and control of key groups, key institutions and key areas, and regards the elderly as a priority group for care.
According to the experience of prevention and control in the mainland, nucleic acid testing is an important means to find potential sources of infection in the community. The timing of nucleic acid testing should take into account a variety of factors such as the core purpose, the current situation of the epidemic situation, the ability to implement conditions, and follow-up disposal measures. I believe that the HKSAR Government has the wisdom to make appropriate arrangements.
We will continue to support and assist the Hong Kong SAR Government and the people of all walks of life in Hong Kong to stabilize the epidemic as soon as possible in accordance with the needs of epidemic prevention and control and the requirements of the Hong Kong SAR Government.
At the previous press conference of the joint prevention and control mechanism of the State Council, it was repeatedly emphasized that it is necessary to ensure the normal medical needs of the masses during the epidemic. How to ensure the needs of the masses in the areas where the epidemic occurred, especially the special groups and key groups, and what measures are taken to open up the "last meter" of medical treatment?
Jiao Yahui, director of the Medical Administration Bureau: At the time of the outbreak of the epidemic, how to protect the normal medical service needs of the broad masses of the people is also a problem that we should focus on. The situation that affects the people to see a doctor mainly occurs during the clustered epidemic period, and the impact on the people in the sealing and control areas and the control areas is the greatest. Since 2020, we have been constantly summarizing the experiences and practices of various localities, issuing a series of documents, putting forward corresponding requirements, and making deployments and arrangements. We require all relevant hospitals to set up buffer areas in emergency departments, rescue rooms, operating rooms, and wards to admit and treat patients when the nucleic acid test results are unknown, and we have repeatedly stressed that medical institutions should strictly implement the first diagnosis responsibility system and the emergency and critical care rescue system, and must not use any reason, especially whether there is a nucleic acid test result as a reason for prevaricating refusal and delaying treatment. The reason why we want to implement classified treatment in the revision of the ninth edition of the diagnosis and treatment plan is also to allocate medical resources more scientifically and reasonably.
This is very important on how to solve the "last meter". On the one hand, we require that we focus on the most urgent needs, such as those that need regular treatment, tumor radiotherapy and chemotherapy, hemodialysis patients, and the other is pregnant women, as well as special groups, such as the elderly and children. Then there are the acute and critical cases, which must protect their medical needs. We require that we make full use of the advantages of Internet diagnosis and treatment to solve the needs of the people for daily medical treatment and medication.
To sum up, to solve the "last meter", one is to solve the "one out and one in", and the other is to solve the "one come and one return". "One out and one in" is to solve the problem that the people who need to see a doctor for medical treatment, especially the people in the sealing and control area and the control area, can go out of the community, because we know that the sealing and control area is not out of the house, and the control area is not out of the community. First of all, these people have the need to see a doctor, so that he can get out of the door of the community, so it is necessary to solve this problem. Another is "one entry", that is, to solve the door that can enter the hospital. Entering the door of the hospital, we require that nucleic acid testing should not be used as a precondition, and any hospital must strictly implement the system of first diagnosis responsibility and emergency and critical care.
To solve the problem of "one come and one back" is to solve the problem of transportation when ordinary people go to see a doctor, and to have transportation to let him go to the hospital. If the resources can meet the demand, for the urgent and critical, you can use 120 ambulances to deliver. For other regular treatments, we ask the local government to coordinate the solution, requisition or use volunteer vehicles, and send them to the hospital for treatment. After the visit, there must be a vehicle to ensure that they will be sent back. When we go to the place where the epidemic occurred, sometimes we solve the problem of "going away", but we do not solve the problem of "going back". So we are now demanding that we solve the problem of "one out and one in" and "one back and one back".
I know that there are good practices in many places now, and we require that in the place where the epidemic occurs, especially for the sealing and control areas, we must accurately understand the situation of patients with these special diagnosis and treatment needs, so that we can do a clear count, the situation is clear, and their needs are more accurately connected to the door management of the community, and know how many patients with special needs need to be treated in this community. Then there is the accurate docking of the corresponding medical institutions, such as tumor radiotherapy and chemotherapy, dialysis, medical institutions know how many patients with medical needs in these areas, more accurate docking between supply and demand matching problems.
According to media reports, WHO experts recently confirmed that the "Deltakron" strain has been found in several countries, and the appearance of this new virus variant is expected. How do experts view the harm of new mutant strains recombined from strains? How should we respond?
Wu Zunyou, chief epidemiologist at the Chinese Center for Disease Control and Prevention: Recently the World Health Organization did confirm the emergence of a new strain, which is a new mutant strain that is recombined after a patient infected with both Delta and Omikron strains. At present, it has been observed that this recombinant strain is recombinant from Delta AY.4 and Omikejong BA.1, the main body is the Delta strain, and the secondary protein part is mainly composed of the Omikeron strain. The strain is now being identified mainly in a few European countries, and the number of reported cases is only a few dozen. From these limited data, whether it is epidemiological or clinical manifestations, no significant changes have been observed, and it is similar to the original strains of Delta and Omicron. However, due to the relatively short time for the new strain to be discovered and the relatively small number of cases, there is no way to draw conclusions about the pathogenicity, infectivity and ability to escape the vaccine. Therefore, now the World Health Organization and relevant countries are closely monitoring this strain, understanding its movements, and if it changes, it will remind the world in time.
We know that the mutation of the virus has been happening in the past two years, whether it is the mutated strain Delta, Omicron, or the new mutant strain, the prevention and control practice of the past two years or so has proved that our normalized prevention and control measures can effectively prevent and control the large-scale epidemic caused by the mutated strain. For ordinary people, we must mainly implement three prevention and control measures: First, vaccination. If there is no vaccination, we must pay close attention to vaccination, and those who need to be given a strong injection should be given a strong injection, and the vaccination of vaccines is the basis of our prevention and control. The second is to adhere to the implementation of public health measures for normalized prevention and control. Wearing masks, maintaining social distancing, paying attention to hand hygiene, and maintaining ventilation in crowded places are all routine prevention and control measures that are effective for the prevention and control of mutated strains. Third, we must pay attention to the changes in the epidemic situation, and more importantly, we must abide by the relevant regulations on epidemic prevention and control in the work unit or residential community, as well as the various places we go to, and we must abide by these regulations and implement these measures.
What is the latest progress in vaccine development along other different technology routes?
Zheng Zhongwei, head of the vaccine research and development working group of the scientific research group and director of the Science and Technology Development Center of the National Health Commission: As we all know, since the outbreak of the new crown epidemic in 2020, in March 2020, we have laid out 5 technical routes of vaccine research and development. Up to now, the research and development of the mainland's new crown virus vaccine can still be confidently said that we are always in the first phalanx of the world. Specifically, we have achieved full coverage of clinical trials along 5 technical routes.
At present, the mainland has 29 vaccines entering clinical trials, accounting for 19% of the world; 16 have carried out phase III clinical trials abroad, accounting for 27% of the world; 7 have been approved for conditional listing or emergency use, accounting for 21% of the world; 2 have been included in the World Health Organization's emergency use list, accounting for 20% of the world.
Specifically, at present, we have 6 inactivated vaccines that have entered the clinical stage, 12 recombinant protein vaccines that have entered the clinical stage, 5 adenovirus vector vaccines that have entered the clinical stage, and 5 mRNA and DNA vaccines, which is commonly known as nucleic acid vaccines, have entered the clinical stage. Many of these vaccines are undergoing phase III clinical trials abroad.
The adenovirus vector inhalation vaccine of special concern to everyone, as well as the attenuated influenza virus vector nasal spray vaccine, are currently undergoing phase III clinical trials abroad.
A few days ago, we released the latest version of the diagnosis and treatment plan, which adjusted the criteria for discharge, and when the Ct value of nucleic acids is mentioned≥ 35, you can be discharged. What does ≥35 mean, and is it possible that patients during this period will still be contagious?
Li Xingwang, chief expert of the Infectious Disease Diagnosis and Treatment and Research Center of Beijing Ditan Hospital: Everyone is very concerned about this issue. Let me first say a problem, the current positive value of the nucleic acid test has not changed, some people mistakenly think that the new version of the diagnosis and treatment plan has changed the positive value of the nucleic acid test from 40 to 35, in fact, there is no change, which is conducive to our early detection of cases. In the past two years, virological studies have found that in patient specimens with a Ct value of more than 35, almost no live virus can be isolated, and the virus cannot be obtained to indicate that the specimen is not infectious. At the same time, in the epidemiological study, we found that we had a lot of so-called Fuyang cases in the early stage, for these Fuyang cases, we found that he did not cause infection to his close contacts after he went out, and the Ct value of these so-called Fuyang cases was basically above 35, indicating that there was no contagiousness. The same is true of inpatients, many patients in the recovery period, the Ct value rose to more than 35 in a week, but it did not meet the standard of turning negative, in view of the fact that these patients are not contagious, so living in the hospital is a waste of medical resources. Therefore, according to these studies, the new version of the diagnosis and treatment plan adjusts the nucleic acid detection standard at the time of discharge and release from isolation to a Ct value of ≥35, at which time you can be discharged.
What is the current status of COVID-19 vaccination in mainland China? In particular, the vaccination situation has been strengthened.
Lei Zhenglong, deputy director of the Disease Control Bureau of the National Health Commission and a first-level inspector: According to the deployment of the joint prevention and control mechanism of the State Council, our committee guides all localities to continue to further standardize the implementation of vaccination in accordance with the principles of knowledge, consent and voluntariness, strengthen publicity and guidance, and make overall plans to strengthen immunization against the new crown virus vaccine and the vaccination of various groups. According to the characteristics of different groups of people and the actual work, innovate service forms, optimize service quality, and ensure that vaccination work is carried out in a safe and orderly manner. As of March 18, the country has reported a cumulative total of 3,218,716,000 doses of COVID-19 vaccines, and the total number of vaccinated people has reached 1,273,811,000 people, of which 1,239,706,000 people have been fully vaccinated and 649,156,000 people have been immunized. People over the age of 60 were vaccinated against 221.829 million people, of which 211.819 million were vaccinated, and the full vaccination rate of people over 60 years old reached 80.27%. Studies have shown that boosting immunity can further improve the immune effect and is also an effective means to reduce the incidence of severe illness and death. In the practice of prevention and control, the new crown vaccination highlights the protective effect on the elderly, but from the current vaccination situation in various places, there is still room for further improvement in the vaccination rate of the elderly in some areas. Here again, we recommend that the elderly who have not yet been vaccinated should be vaccinated as soon as possible, and those who meet the conditions for enhanced immunization should complete the intensive immunization in a timely manner. For the sake of their own health, they must be vaccinated as soon as possible and actively.
The recently released ninth edition of the protocol mentions two newly approved antiviral drugs, are these two drugs currently used clinically? How will its application change the treatment of COVID-19? There is also a question that everyone is more concerned about, what is the price of these two drugs, if used, the cost is borne by the state or by the individual?
Li Xingwang, chief expert of the Infectious Disease Diagnosis and Treatment and Research Center of Beijing Ditan Hospital: These two drugs have been seen by everyone, and it has been included in the new version of the diagnosis and treatment plan. In the treatment of the new crown, one of the problems we are very concerned about is how to prevent patients from turning from light to heavy, how to reduce the rate of severe illness and mortality, and thus improve the treatment rate, these two drugs probably provide such a weapon. These two drugs can be seen from the results of the previous clinical research data that for the so-called mild, ordinary patients who may become severe or even die, when used within 5 days of the onset of the disease, his hospitalization rate and case fatality rate are significantly reduced, which is just in line with our clinical needs. Therefore, I think that after these two drugs were included in the diagnosis and treatment plan, the doctors had these drugs in their hands, which had a great effect on us to improve the treatment rate and reduce the mortality rate.
Due to the long-term normalization of the epidemic, many people have developed a period of burnout. For the daily protection is more and more lax, coupled with the fact that the weather is getting hotter and hotter, some people do not want to wear masks, is there some good way to prevent the occurrence of psychological desensitization?
Wu Zunyou, chief expert of epidemiology at the Chinese Center for Disease Control and Prevention: Judging from the situation of the new crown epidemic for more than two years, the new crown pneumonia cannot disappear in a short period of time, so our struggle with the new crown will be a long-term, we cannot change the reality of the long-term existence of the epidemic, we adjust ourselves, we face such a reality, adjust our mentality. The human mentality is very strong, if we adjust our expectations in time, adjust our mentality, we can still adapt to the long-term nature of the new crown epidemic, and we need to make long-term daily prevention and control measures to bring about life changes. At the same time, we should see that in the past two years or so, we have made great achievements in the fight against the new crown, including that we have summarized a set of measures for controlling the epidemic and preventing infection, including our diagnostic reagents, which can give diagnosis in a timely manner, as well as vaccine research and development and wide application, as well as the treatment of cases of Chinese and Western medicine, which are all things that we can effectively control the epidemic and reduce the harm of the epidemic to mankind. We believe that with the progress of science, humanity will eventually defeat the new crown pneumonia.
The new crown pneumonia diagnosis and treatment plan is revised, mild cases are centralized isolation management, and ordinary, severe, critical cases and patients with high-risk factors for severe illness are treated in designated hospitals. Do asymptomatic infected people be classified as mild cases?
Jiao Yahui, Director of the Medical Administration Bureau: First answer the first question, why do we implement classified admission. On the one hand, based on the actual situation of the current clinical cases, on the other hand, based on the previous research on the cases of different variants of the new coronavirus, we have now observed that the Characteristics of the Olmikron strain are short course, rapid transmission, and hidden symptoms, on the one hand, it may be due to the virus itself, on the other hand, the vaccination rate of our national vaccine is relatively high, so the proportion of mild cases and asymptomatic infected people is quite high, accounting for more than 95%. For mild cases and asymptomatic infected people, there is no need to take too many medical and intervention measures, in order to be able to more accurately and scientifically treat the ordinary, severe and high-risk factors of pneumonia that really need to be treated, so that medical resources can play their due role more scientifically and accurately, we put forward the principle of classified treatment.
The first question, for classified treatment, I would like to emphasize or clarify that although asymptomatic infected and mild cases are not admitted to designated hospitals, we require centralized isolation and management of them. First of all, because these infected people are nucleic acid positive or infectious, their centralized isolation management facilities and our centralized isolation and management of close personnel facilities, to be strictly distinguished, although these people are isolated management, but can not be put together isolation. Secondly, it should be emphasized that for centralized isolation management, whether it is a square cabin hospital or a centralized isolation management facility, it is still necessary to have medical personnel to manage these asymptomatic infected and mild cases. The main purpose of centralized management is to give them certain symptomatic treatment, because mild cases still have certain symptoms, such as fever, cough, nasal congestion, etc., so medical staff still have to give them corresponding symptomatic treatment and treatment such as integrated traditional Chinese and Western medicine. In addition, it is also necessary to observe the condition, if the condition of these asymptomatic infected people and mild cases changes, especially if there is an aggravating trend, it is also necessary to timely refer them to the designated hospital for further treatment.
The second question is about asymptomatic infected people. Because the diagnosis and treatment plan is full of confirmed cases, the confirmed cases are mild, ordinary and severe, critical. Asymptomatic infected people have no symptoms and are not confirmed as confirmed cases, but they are positive for nucleic acid or contagious. Therefore, in the prevention and control plan, requirements are also put forward for asymptomatic infected people, and isolation management should be carried out. It is not that asymptomatic infected people are treated as mild cases, but that asymptomatic infected people and mild cases must be centrally isolated and managed by medical personnel, and there will be some cases in the incubation period and early stage of the disease among asymptomatic infected people, and as the disease progresses, some asymptomatic infected people will turn into mild cases, so it is a dynamic change process.
In terms of centralized management of mild cases, what is the referral process for mild cases, and should they be transferred to the isolation point after the diagnosis is made in the designated hospital?
Jiao Yahui, director of the Medical Administration Bureau: First of all, it can be clearly said that there is no need to send all nucleic acid-positive patients to the designated hospital first, and then transfer to the centralized isolation and management facilities, or directly transfer to the square cabin hospital, which does not require such a process. Because more than 95% of us are now asymptomatic infected and mild cases, when nucleic acid positive personnel are found, they can be transferred to the square cabin hospital first, but for those with high risk factors, such as advanced age, underlying diseases, pregnant women, children, super obese people, heavy smokers, etc., when the nucleic acid test is positive, we will directly ask them to be sent to the designated hospital. For the manifestations of pneumonia, in fact, from a clinical point of view, doctors are very clear that the manifestations of pneumonia are generally symptoms of the lower respiratory tract, cough will be very serious, and there will be high fever, there will be symptoms of the whole body. For these, the doctor will transfer them directly to the designated hospital through preliminary judgment. Therefore, we require that if we find that patients who may be above the ordinary type in the cabin hospital, they should be referred to the designated hospital. On the one hand, it is required to be equipped with vehicle mobile CT in the cabin hospital, and for those with obvious manifestations of pneumonia, CT examination should be done to determine whether there is pneumonia. If it is clear that there is pneumonia through this test, it is necessary to refer to the designated hospital immediately. We also require specialists to visit the cabin hospital every day, experienced specialists, they can also detect these patients with more severe symptoms in time, and then referral to the designated hospital.
Why is it important to say that the elderly are vaccinated? What is the difference between vaccination and non-vaccination against COVID-19?
Zheng Zhongwei, head of the vaccine research and development working group of the scientific research group and director of the Science and Technology Development Center of the National Health Commission: The necessity of vaccination for the elderly has been repeatedly emphasized many times. At the press conference held by the State Council's new office just yesterday, the responsible comrades of the National Health Commission also answered the questions of reporters and friends. Here I also have some information to share with you, once again stressing the need to speed up the vaccination of the elderly as soon as possible.
First of all, to talk to you about the common sense of the prevention and control of an infectious disease, just now Mr. Wu Zunyou and Director Jiao Yahui have talked about the prevention and control of infectious diseases is three principles: First, the discovery and management of the source of infection. That's what we're doing testing and isolation for. The second is to block the transmission route. Wearing masks and maintaining social distancing, including isolation, are also aimed at interrupting transmission routes. The third is to protect susceptible people. Judging from the work of epidemic prevention and control in various countries and regions around the world over the past two years, we can see that if we violate common sense and principles, we will bear a huge price, and the biggest price is the loss of life, especially the loss of life on a large scale. The new crown virus is a new virus, the whole population is susceptible, and among the susceptible people, the most vulnerable are the elderly. Because the elderly tend to have most underlying diseases and their immunity is relatively weak, once an infection occurs, the risk of severe illness and death is very high compared to adults and children. Our country due to the prevention and control of the epidemic, we do not have statistics in this regard, we look at the global data, the world so far, the number of deaths due to new crown pneumonia has exceeded 6 million, from the data reported by various countries, the average age is about 70 years old. According to cdc statistics, compared with young people aged 18-29, his data is constantly changing, the risk of hospitalization is increased by 4 times and the risk of death is increased by 65 times in people aged 65-74 years, and the risk of hospitalization is increased by 8 times compared to those aged 18-29 years, and the risk of death is increased by 140 times. People over the age of 85 had a 12-fold increased risk of hospitalization and a 340-fold increased risk of death. Recently, we have also seen that there has been a large-scale outbreak of the new crown epidemic in Hong Kong, and we have also seen reports that the mortality rate of vaccinated people is 0.04%, and the mortality rate of unvaccinated people is 1.25%, and the difference between the two is more than 30 times. More than 90 per cent of the deaths reported in Hong Kong are elderly. It can be seen that vaccination is effective in reducing the severity and death of the elderly.
Here is another data to share with you, as you know, the UAE was the first country to approve phase III clinical trials in our country, and in June 2020, it approved the Chinese vaccine to carry out phase III clinical trials in the UAE. This is a country of nearly 10 million people, as of the beginning of this year, its target population vaccination rate is 96% of the target population, the vaccination rate of reinforced needles is close to 50%, and the vaccine used in China accounts for 70%. We also see some data from reports and statistics, from January 1 to March 17 this year, his new crown pneumonia epidemic is also in the epidemic, but only about 150 deaths. In the past month, there have been only 9 deaths, and we can see that the vaccination of the new crown vaccine is very effective in reducing the severe illness and death of the most vulnerable part of the elderly in the susceptible population.
Second, everyone may be very concerned about the unsafe of the elderly with the new crown virus vaccination, and I also have a data here to tell you. At present, the elderly who have received the Chinese new crown vaccine in the world have been hundreds of millions of doses, the highest age, overseas is 106 years old, domestic is also 106 years old. After relevant statistics, the rate of adverse reactions in the elderly is slightly lower than that of young people, so the new crown virus vaccine is safe for the elderly. Another point I would like to emphasize is that there may be elderly people who feel that I stay at home and rarely go out, or in remote rural areas, and do not go out of town, so my risk of infection should be very small. I would say that this kind of thinking is extremely dangerous. Now with the epidemic of the Omiljung variant, because of its characteristics, and the increase in vaccination coverage, there are more and more asymptomatic infected people, and if we, the families of asymptomatic infected people, return home, it is bound to bring the risk of infection to the elderly. Not long ago we saw a report that a grandson was an asymptomatic infected person who went home to see his 99-year-old grandmother, and as a result, the 99-year-old grandmother was infected.
Because the mainland has done a good job in epidemic prevention and control, our country's vaccination strategy is based on high-risk groups, key groups, and finally gradually transition to the elderly over 60 years old. Due to the high risk in foreign countries, they are vaccinated from the elderly step by step, which causes the current vaccination rate of the elderly to be very low. If we are to build a strong immune barrier, this shortcoming must be filled. Only by increasing the vaccination rate of the elderly can we truly win the initiative and time for the prevention and control of the epidemic in our country. Therefore, I once again appeal to accelerate the vaccination rate of the elderly, especially the elderly, because this is good for individuals, families, society and the country.
Currently, there are clusters of outbreaks in some schools. How can children and adolescents be protected?
Wu Zunyou, chief expert of epidemiology at the Chinese Center for Disease Control and Prevention: People who are not infected with the new crown virus and who have not received the new crown vaccination are not resistant to the new crown virus, and if they have close contact with the infected person, or have been exposed to the virus, it is possible to be infected. Children and adolescents can also be infected if they come into close contact with someone infected with COVID-19.
In terms of personal protection, the protective measures for children and adults should be the same. The first is vaccination, which is the foundation. The second is the normalization of prevention and control measures, such as wearing masks, maintaining hand hygiene, maintaining ventilation, maintaining social distancing and wearing masks in places where people are concentrated outside the campus, and the daily implementation of these measures is very important.
Another point to pay special attention to, if children and adolescents are infected with the new crown virus, generally speaking, the symptoms are relatively mild, or they do not feel the self, the feeling is relatively light, and it is easy to be ignored at this time. During the epidemic period, especially in places where children and adolescents are more concentrated, such as schools, it is necessary to strengthen symptom monitoring in order to timely detect students who may be infected, so as to control the epidemic in the bud.
Yunnan Network (ID: yunnancn) according to CCTV, China Network Live Finishing
Edit: Zhai Xinran
![The fight against the epidemic has entered a difficult period, how to protect the vulnerable elderly? Zhang Wenhong: Vaccines are the bottom line[fig]](data:image/gif;base64,R0lGODlhAQABAIAAAP///wAAACwAAAAAAQABAAACAkQBADs=)