Recently, when the national sporadic epidemic situation is rising and falling, and the prevention and control in some areas is being tightened, some "coexist with the virus" and "the case fatality rate is close to the flu Why can't it be released?" Negative remarks continue to emerge "rhythmically", using some specious views to question China's epidemic prevention policy.
On April 9, at the Fang Cabin Hospital of Shanghai Cross-Mining Center, the first four recovered people who completed the discharge procedures walked out of the hospital. (Source: Xinhua News Agency)
In the face of these public opinion interferences, the Life Times (search for "LT0385" in WeChat can be concerned) reporter interviewed a number of authoritative experts, who firmly stated that no matter how tightly the epidemic prevention is stepped up, the mainland must adhere to the "dynamic zero clearance" policy at this stage, and resolutely cannot "lie flat".
Experts interviewed
Lu Hongzhou, president of the Third People's Hospital of Shenzhen
Professor Tan Xiaodong, School of Public Health, Wuhan University
Professor Chen Youhua, School of Sociology, Nanjing University
Jieliang Chen, Associate Professor of Pathogenic Biology, School of Basic Medical Sciences, Fudan University
This article is written by | Life Times reporter Gao Yang Zhang Jian Li Zhenyu Niu Yulei
This article was edited | Ren Linxian
Some countries that advocate lying flat are costly
In the more than two years of fighting against the new crown virus, many countries have abandoned the "clearance" policy, chosen to take the "herd immunity route", gradually relaxed epidemic prevention measures, and "coexisted with the virus". However, as early as March this year, the World Health Organization warned that several European countries, including Germany, France and the United Kingdom, had lifted restrictions too "crudely" to prevent the spread of the epidemic, and are now facing a new wave of outbreaks from the Aumi kejung subtype mutant strain BA.2.
United Kingdom: Infection rate, case fatality rate increased
UK: Infection rates, case fatality rates, hospitalizations, and health care absenteeism have all risen significantly, and the economy is likely to shrink by 2% in the second quarter.
The UK is a typical representative of the choice of "herd immunity", starting from February 24, 2022, the English region has cancelled all epidemic prevention measures; from April 1, the country has cancelled all mandatory measures for epidemic prevention and control. This has been followed by an increase in the rate of COVID-19 infections, especially among people over the age of 55.
In London, England, patients were taken to hospital.
According to the National Bureau of Statistics, 4.9 million people were infected in the UK in the week from March 20 to 26, or 1 in every 13 people, and hospitals reported a total of 988 COVID-19 deaths, up 36% from 725 deaths two weeks ago (7-13 March). In addition, the number of hospitalizations and medical absenteeism rates have also risen, and many office spaces have been empty due to covid-19 infection, and labor shortages are affecting aviation, education, agriculture and other fields.
The report of Sanjay Rajar, the chief economist at Deutsche Bank UK, said the UK economy is heading for recession, predicting growth to shrink by 2% in the second quarter. On April 8, British Prime Minister Boris expressed remorse for "lying flat", saying that he did not rule out the possibility of another lockdown due to the new crown epidemic.
France: Someone died while waiting for treatment
France: Multiple infections, doctors shut down, and deaths while waiting for treatment.
A few days ago, France, Germany and other countries are also gradually relaxing epidemic prevention restrictions. On April 5, it was reported in France that in the emergency room of a hospital, 90% of the staff were closed due to illness, some wards were forced to close, many patients needed to go through a long wait on stretchers, and even last month, patients died from waiting for treatment. On April 7, French Health Minister Wei Lang said that at present, the daily new confirmed cases in France are stable at 140,000 to 150,000, of which about 6% of the new cases are secondary infections, and the number of new hospitalizations will reach a high level in the next few days.
France saw a rebound to its peak.
Germany's Federal Ministry of Health originally planned to implement the measures of no longer staying at home for COVID-19 infected people from May 1 this year, but within 48 hours, Health Minister Carl Lauterbach posted on social media one after another: "The administrative decision not to quarantine after infection is wrong!" "COVID-19 is not the flu!" Lauterbach also announced that the health department will continue to notify all infected people to stay at home.
United States: Life expectancy declines across the population
UNITED STATES: Nearly 1 million people have died of COVID-19, and life expectancy across the population has rarely declined.
Former US President Trump once preached that the new crown epidemic is a "big flu", once ignored epidemic prevention, and let the United States fall into a state of uncontrolled epidemic. After Biden took office, although he issued compulsory mask orders and vaccination measures, he still could not reverse the situation of ineffective anti-epidemic. On March 26 this year, the national restriction on masks was lifted, but for fear of repeated infections, many people would rather eat at home and eat a minimum guarantee than take the risk of going to work.
The Brookings Institution estimates that 1.6 million U.S. laborers are unable to work or work full-time because of the after-effects of COVID-19. Data from Johns Hopkins University in the United States show that the current number of new crown infection cases in the United States exceeds 80 million; the number of deaths is nearly 1 million, of which the elderly account for more than 3/4. According to a new study published in the Washington Post, the U.S. response to the epidemic is the worst in 20 rich countries, with life expectancy falling from 78.86 years in 2019 to 76.6 years in 2021, a rare decline in the history of the new crown.
Japan, South Korea: The epidemic rebounded
In Asia, Japan and South Korea have also tried to relax their epidemic prevention policies.
On March 22, after Japan lifted its key epidemic prevention measures in 18 prefectures, including Tokyo, the epidemic rebounded quickly, and many Japanese experts believe that the seventh wave of the epidemic has begun, which may be related to the relaxation of epidemic prevention and the spread of the Omikejong BA.2 strain.
South Korea has also relaxed social distancing restrictions since March, extending the opening hours of public places, and it was not long before South Korea became the country with the largest number of new confirmed cases in the world in a week, with 600,000 new confirmed cases in a single day. Most worryingly, many children are becoming covid-19 recipients.
People tested for the new coronavirus in Seoul, South Korea, March 13.
Why the mainland insists on "dynamic zero clearance"
In the past two years, the mainland's epidemic prevention and control has been continuously adjusted and improved with the changes in the situation, from the emergency containment stage of the sudden epidemic, to the exploration stage of normalized prevention and control, and then to the current "dynamic clearance" stage of the whole chain, and the anti-epidemic results of "strict prevention and death" have been obvious to all.
Statistics show that in the whole year of 2021, 31 provinces (municipalities directly under the central government, autonomous regions) reported a cumulative total of 15,243 confirmed cases, with a cumulative death of 2 people, and a case fatality rate of 0.013%. According to data from Johns Hopkins University in the United States, as of April 10, the global COVID-19 case fatality rate was 1.24%, and the case fatality rate in China (including Hong Kong, Macao and Taiwan) was 0.85%.
Shanghai road closure due to the epidemic.
When interviewed by the "Life Times" reporter, they unanimously said that under the new crown epidemic, some European and American countries called "lying flat" and "coexisting with the virus" because they have experienced a wide range of infections and a large number of deaths, weighing the advantages and disadvantages of epidemic control and economic and social development, and then chose to compromise. In order to minimize losses, adhere to "dynamic zeroing" is undoubtedly the most scientific, economical and effective choice.
COVID-19 is far more harmful than influenza
Chen Jieliang, an associate professor of pathogenic biology at Fudan University's School of Basic Medical Sciences, said that some people's advocacy of "new crown pneumonia is a big flu" is very wrong. The current seasonal influenza case fatality rate is 0.01% to 0.1%, and the basic infection number R0 value is about 3 (that is, 1 infected person can infect 3 people); as of April 10, the global COVID-19 case fatality rate is 1.24%, and the currently circulating Omilon strain R0 value is 8 to 12. It can be seen that the new crown is far more harmful than the flu. The mainland population base is large, once the epidemic prevention policy is liberalized, it is likely to appear large-scale infection, even if the case fatality rate is very small, the total number of deaths will be huge.
The emergence of new strains that are more harmful is not excluded
Lu Hongzhou, president of the Third People's Hospital of Shenzhen and academician of the American Academy of Microbiology, said that as long as the spread of the new crown virus is not blocked, the virus will continue to mutate and recombine in the carrier, and the epidemic will not end. "We hope to gradually adopt a policy of liberalization as appropriate after there are weaker mutant strains, but based on the harmfulness of the current epidemic strains, it is certainly not possible." Chen Jieliang said that although the symptoms of the Omikerong mutant strain after infection are mild, the strain is very harmful, and the toxicity of the new strain in the future cannot be determined.
Today, the combination of Aomikron BA.1 and BA.2, XE, has emerged, and its propagation speed is 10% to 40% higher than that of BA.2. WHO has recently reminded governments and scientists to be prepared for the new coronavirus to mutate in animals and return to humans.
Large-scale infections can lead to a larger run on medical resources
Chen Youhua, a professor at the School of Sociology of Nanjing University, said that once the prevention and control of the new crown epidemic is released, the infection will definitely increase on a large scale. At present, the vaccination rate of the elderly is still relatively low, and the severe illness rate and case fatality rate may increase significantly, which will run on the medical resources for ordinary needs. "Some people think that measures such as isolation and containment waste medical resources, which is a misunderstanding." Tan Xiaodong, a professor at the School of Public Health of Wuhan University, pointed out that infection with the new crown will induce and aggravate basic diseases such as hypertension and diabetes, further aggravate the occupation of medical resources, and if the infection of these groups is prevented, it can save a lot of medical resources and reduce the medical burden.
Secondary casualties increase the burden of death
Chen Jieliang said that for individuals, the case fatality rate of Aomi Kerong is lower than that of previous mutant strains, but for the group, the spread is much faster, the base of infected people is much larger, and the casualties caused by secondary disasters caused by resource runs will be more, such as deaths caused by other diseases that cannot be treated in time. In the United Kingdom, the case fatality rate was 16 people per 100,000 during the Delta strain epidemic, and during the Epidemic of the Olmiquerong strain, the case fatality rate was 22 people per 100,000, including the cause of secondary injury.
Re-infection may occur with many sequelae
"The new coronavirus, from the earliest mutant strain Alpha, to Delta, Olmikeron, and then to the newly emerging recombinant strain XE, is repeatedly transmitted, not infected with a lifelong immunity." Lu Hongzhou said that the sequelae that may occur after the infection with the new crown will last for a long time, including extreme tiredness, shortness of breath, chest pain, memory and attention problems, loss of taste and smell, and joint pain. Recently, another post-covid-19 sequelae has been valued by experts: the risk of diabetes will increase by nearly 40%, and it is currently impossible to cure. As Zhong Nanshan, an academician of the Chinese Academy of Engineering, said: "In the struggle between man and the virus, the highest human right is human life, a healthy life." "Therefore, the current epidemic prevention and control in the mainland should minimize the infection rate and case fatality rate."
Herd immunity is not reliable
Lu Hongzhou said that asymptomatic infected people, like symptomatic and severely ill patients, will excrete a contagious virus. In the long-term visits after the recovery of patients diagnosed with new crown, it was found that 8% of patients did not produce neutralizing antibodies, and those who produced neutralizing antibodies, the titer of antibodies will also drop rapidly, which proves that "herd immunity" is not advisable, and it is still necessary to cooperate with prevention and control measures such as isolation.
Strict prevention and control at the same time to do several balances
COVID-19 prevention and control measures are not static, but are constantly adjusted according to the development of the epidemic and its impact on the entire socio-economic development.
According to the news released by the National Health Commission, since March, the local epidemic situation in the mainland has shown a wide range of epidemics, intertwined with large-scale epidemics and sporadic epidemics, and frequent spillover cases and sequelae. However, the practice of effective epidemic control in many places proves that the strict and tight measures such as isolation, control, sealing and screening to deal with the local cluster epidemic caused by the Omikerong mutation are still effective, scientifically necessary, and the established policy of "dynamic clearance" can be achieved. But experts point out that in order to prevent people from feeling "tired" about the epidemic, we need to make several balances.
On April 9, medical staff at the Dongjing Town Community Health Service Center taught an elderly person to use a "nucleic acid code" in the Zhonghai Yueting Community in Shanghai's Songjiang District. (Source: Xinhua News Agency)
Balancing the "control" and "prevention" of the epidemic. "The mainland has not yet reached the most difficult period in dealing with Omicron." Tan Xiaodong said that the risk of sudden outbreaks in various major cities is still very large, but from risk to real outbreak, there is actually a "window period". If local governments seize this precious time and make full preparations, they will be able to reduce losses more than strengthening prevention and control after the outbreak. For example, early screening, redistribution of community medical resources, advance planning of cabin hospitals and designated hospitals, etc. The epidemic in Shanghai has exposed the lack of community medical resources, which also reminds all localities of the urgent need to consolidate community medical care and ensure that community medical care can do a good job in disease monitoring and treatment in a timely manner.
On April 9, in the Guangfu residential area, Zhang Hua, director of the neighborhood committee, performed sterilization treatment at the nucleic acid testing site. (Source: Xinhua News Agency)
Balance the "force" and "temperature" of management. Tan Xiaodong said that the prevention and control of the epidemic must be "strictly guarded against death", but the normal needs of life and medical services should not be delayed. Chen Youhua also said that for hemodialysis, critical and severe diseases, temporary labor and other groups, all localities should open corresponding green channels in advance when formulating epidemic prevention policies; at the same time, they should allocate manpower, material resources and transportation resources to ensure the supply of basic daily necessities for the people; they should pay attention to the needs of special groups such as infants and young children and the elderly, and formulate humanized isolation measures.
The "small house" and "big gain" that balance people's livelihood. Chen Youhua said that the core of the current epidemic prevention policy choice is "how to obtain the greatest prevention and control effect at the minimum social cost". After the normalization of prevention and control, everyone also found that the epidemic has dealt a certain blow to the social economy and residents' lives, but if the control is completely abandoned, the harm can also be seen from the failure lessons of some foreign countries. Therefore, in the context of the normalization of epidemic prevention and control on the mainland, local management needs to pay attention to the rational allocation of resources, on the one hand, to ensure the strict control of epidemic areas and high-risk areas, and to control the spread of the epidemic as soon as possible; on the other hand, it is also necessary to ensure policy flexibility, not to increase layer by layer, and not to engage in prevarication everywhere. Chen Jieliang added that prevention and control should be precise and graded. For example, only regular screening and hierarchical management are done in high-risk groups, and no epidemic areas do not have to do full nucleic acid to reduce the impact on people's lives.
Finally, experts called for the joint efforts of the whole people to fight the epidemic, and everyone should do a good job of balancing mentality, actively cooperate with epidemic prevention measures, do not believe rumors, actively vaccinate, use xenophragm vaccines to vaccinate sequentially if necessary, do a good job of personal protection, and do not need to reach densely populated areas. ▲
Editor of this issue: Liu Yunxuan