It has been a month and a half since the UK lifted all epidemic prevention and control measures in England and implemented "coexistence with covid-19". Since the United Kingdom became the first Western power to completely lift the epidemic prevention restrictions, countries have relaxed and wavered in the prevention and control measures of the new crown virus, and the United States has successively lifted some prevention and control restrictions and is optimistic about the development of the epidemic.
In early March, the case fatality rate of COVID-19 in the UK fell to 0.03%, even lower than the flu. In the early stages of "coexistence", the United Kingdom seems to have delivered a satisfactory answer, and the voice of "coexistence with the new crown" has become more and more loud.
On April 12, at the press conference of the joint prevention and control mechanism of the State Council, Lei Zhenglong, deputy director of the Disease Control Bureau of the National Health Commission, said that from March 1 to April 11, the cumulative number of local infections reported nationwide exceeded 320,000, affecting 30 provinces (autonomous regions and municipalities). The mainland has always adhered to the general policy of "dynamic zero clearance", emphasizing the word "fast", strictly controlling and blocking the spread of the epidemic in a timely manner.
The COVID-19 pandemic is still having a serious impact on people's lives, where will the balance clock of "dynamic zeroing" or "coexistence with covid-19" swing?
The "coexistence with COVID-19" view is not a reason to "lie flat"
On March 22, an article published in the journal Nature objectively evaluated the Swedish government's various epidemic prevention and control strategies and recommendations.
The Swedish people have a high degree of trust in the authorities and those in power, and it is reported that Sweden was fully prepared for the epidemic of the new crown virus at that time to prevent its serious development. However, in 2020, Sweden's COVID-19 case fatality rate was 10 times higher than that of neighboring Norway.
Sweden's response to the pandemic in this wave of the pandemic has been unique, characterized by a laissez-faire approach to moral, ethical and scientific issues, which is a problem in the structure of Swedish society. There is more emphasis on protecting the "image of Sweden" rather than saving and protecting lives or evidence-based approaches.
They have never worn masks, never stopped classes, never closed the city, and counted on "herd immunity" for 2 years. But this country, which has given up epidemic prevention since the beginning of the epidemic, has completely failed.
This small country of only 10 million people now has 18,365 COVID-19 deaths and a mortality rate of 1,790 per million people.
The number of new confirmed COVID-19 cases and deaths (per million) in Sweden and the United Kingdom differ significantly from China. Between January and the end of February 2022, new COVID-19 cases peaked in Sweden, with nearly 4,000 new cases per million people. From the end of January to the end of April 2022, sweden saw a peak in the number of new deaths, and the trend of development exceeded that of the United Kingdom.
Figure 1 China, the United Kingdom, and Sweden add new confirmed COVID-19 cases and deaths per million people every day
From the analysis of the cumulative number of confirmed covid-19 cases, the United Kingdom and Sweden show a curve of growth and a sustained growth trend, compared with the cumulative case curve in China.
Figure 2 Cumulative number of confirmed COVID-19 cases per million people in China, the United Kingdom and Sweden
The UK, which coexists with COVID-19, has rebounded
From 24 February to 8 April, there was a marked pick-up in the number of DEATHS from COVID-19 diseases in the UK.
The UK advocates "coexistence with the new crown", and after the lifting of prevention and control measures, the epidemic began to rebound, reaching a peak on March 6, 2022, an increase of 21.33% over the previous week, and the case fatality rate rose to 30.23% on April 8.
Figure 3 Week-by-week change in confirmed COVID-19 mortality
In the more than one month of coexistence with the virus, the number of new crown disease cases, the number of new crown tests, the positive rate and the reproduction rate have gradually rebounded.
Figure 4 The number of new COVID-19 cases in the UK, testing, positivity rate, and reproduction rate curves
As can be seen from the curve, since the end of February 2022, the number of COVID-19 patients hospitalized in the UK has more than doubled compared with the previous one, and has continued to grow over time to a new high.
Figure 5 Number of hospitalizations per million people in the UK per week due to COVID-19
Notably, the surge in hospitalizations has also been linked to mutated strains. At this stage, the main prevalent strain in the UK is the Aomikron BA.2 subtype.
In addition, a combination of the Omiljun variant BA.1 and BA.2, called XE, has emerged in the United Kingdom. A March 25 notice from the UK Health Security Agency (UKHSA) confirmed that the XE variant has 637 confirmed cases and is still spreading rapidly, possibly more contagious than BA.2.
When studying epidemic prevention strategies, one point that should not be overlooked is that the more people infected with the new crown virus, the more it will promote the emergence and accumulation of its mutations. The more contagious XE variant has emerged, and the future epidemic situation is still at great risk in other countries.
"Herd immunity" that may not be achieved
"At present, given the cunning nature of the new crown virus, herd immunity may not be possible, and the goal should be to find a way to coexist with the virus." That's based on a new article published in the Journal of Infectious Diseases by officials such as President Joe Biden's chief medical adviser, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID).
Officials from the National Institute of Allergy and Infectious Diseases said: "There are significant barriers to achieving complete herd immunity with COVID-19." In the first few months of the pandemic, the idea of herd immunity quickly went mainstream. A 2020 study estimated that the herd immunity threshold for the original strain was about 67 percent.
But in June 2021, during a surge caused by the more contagious Delta variant, some infectious disease experts tried to recalculate the proportion of the population needed to achieve herd immunity, raising the target to 80 percent and 90 percent from previous estimates of 50 percent, 60 percent or 70 percent. However, the rapid change of the virus has led to the emergence of a contagious and super-hidden Omi kerong, who has not yet had time to achieve the goal of "herd immunity", and has been infected by the virus.
On April 6, German Health Minister Karl Lauterbach explained the "wavering" of Germany's new crown prevention and control policy, saying that he thought that Omi Kerong was a "big flu" and was indeed a light enemy!
Omi kerong is by no means a "big flu"
Professor Zou Yuhua of the School of Public Health of Guangdong Pharmaceutical University told the health community that the view that "Omi Kerong is a big flu" is not valid. Because the flu is very seasonal, the seasonality, regularity, and case fatality rate of the disease are relatively clear. Although the symptoms of the currently circulating Omiljung strain are mild, as of April 5, the fifth wave of the epidemic in Hong Kong has accumulated more than 1.16 million infections, with a cumulative total of 8136 deaths, with a case fatality rate of 0.70%, which means that an average of 7 out of 1,000 infected people have died. The death toll from Hong Kong's fifth wave of the outbreak, triggered by Omi Kerong, is much higher than the total number of deaths caused by the previous four waves.
Between August and October 2021 in the United Kingdom, the Delta strain was predominantly endemic, with a mortality rate of 16 people per 100,000 people, while between November 2021 and January 2022, the Olmikron strain was predominantly endemic, with a mortality rate of 22 people per 100,000 population. The death rate in the United States also increased from 40 per 100,000 to 42 per 100,000 over the same period. At present, from the perspective of the US epidemic data, the number of deaths caused by the new crown virus has exceeded one million, and the case fatality rate is extremely high, including many of the "hard work" of Omicron.
Therefore, mild symptoms do not mean that they can be treated the same as "flu", and we still need to be vigilant against the harm of Aumechjong.
According to the data of the fifth wave of covid-19 in Hong Kong, it can be seen that among the 8430 patients who died of illness, 16.7% (1409 cases) of the patients were aged 70-79 years old, and about 70.9% of the patients were aged 80 years and above.
Figure 6 Number of COVID-19 cases and deaths in Hong Kong, China 丨Source: Hong Kong COVID-19 Wave 5 data
The proportion of hong Kong's local residents in the elderly population is low, but the proportion of deaths is significantly higher than that of other age groups. It can be seen that the damage to the health of the elderly by the new crown virus is extremely obvious.
Figure 7 Proportion of case fatality rates in Hong Kong by age 丨Source: Hong Kong COVID-19 Wave 5 data
In addition, the number of unvaccinated people is still large (figure 6), and the vaccination status of children and the elderly is not optimistic, and vaccination rates are low (figure 8). At the same time, the completion rate of complete vaccination is low, and the number of people receiving the third dose of the vaccine is significantly lower than the first two doses. Unbalanced vaccinations may also be an important factor in the concentration of case fatality rates primarily in older populations.
Figure 8 Vaccination status of people of all ages in Hong Kong 丨 Source: Hong Kong COVID-19 wave 5 data
A study comparing the COVID-19 case fatality rates reported in Hong Kong, China in 2022 with the COVID-19 case fatality reports in Chinese mainland 2020 found that the Case Fatality Rate of the Omiljung strain decreased significantly among young people, but the higher the case fatality rate increased with age, which is consistent with Hong Kong's summary.
A cohort study paper published in The Lancet on 16 March 2022 had a similar view on the risk of hospitalization and the risk of death caused by the Novel Coronavirus Omilton (B.1.1.529) and Delta (B.1.617.2) variants in the UK.
Figure 9 Comparison of hospitalization, risk of death and age group of Aomi Kerong and Delta strains
The study found significant differences in age in the severity of Omi kerong relative to Delta cases (Figure 9).
Compared to Delta, the risk of hospitalization after infection (which does not necessarily result in admission) decreased by 44% (HR estimate, 95% CI 0.54–0.58) and the risk of hospitalization and death decreased by 59% (HR estimate, 0.39–0.43) and 69% (HR estimate, 0.26–0.27), respectively.
The researchers also found that the risk of infection in Omicron and Delta varied with age. Among them, the risk of infection, hospitalization and death was reduced by 75% in patients aged 60 to 69 years, and the risk of infection, hospitalization and death was reduced by 53% in people aged 80 years and older, but the risk of infection, hospitalization and death was increased in people under 10 years of age. This shows that although the overall toxicity of Omikejong has weakened, the infectivity to children has not decreased but has increased.
This also confirms that the World Health Organization strongly recommends that children, the elderly and other high-risk groups give priority to vaccination and defense protection is scientific and reasonable.
On April 9, Professor Zhang Wenhong, head of the Shanghai Municipal Expert Group for Medical Treatment of New Coronary Pneumonia and director of the National Center for Infectious Diseases, stressed that in this wave of epidemics, special attention should be paid to the protection of vulnerable people; the second stage of the fight against the epidemic is coming, because of its asymptomatic volume, strong concealment, and the battle of zero is more difficult to fight.
Professor Zou Yuhua said that "dynamic zeroing" can be done in response to the epidemic in Shanghai, and the domestic confrontation with the virus has lasted for more than two years, and "zeroing" has been carried out in different areas where the outbreak occurred, just like the occurrence of "mountain fire", which will be eliminated in a period of time, and if there is an irregular outbreak, it can be eliminated.
Resources:
[1] Tommy Nyberg.et al. Comparative analysis of the risks of hospitalisation and death associated with SARS-CoV-2 omicron (B.1.1.529) and delta (B.1.617.2) variants in England: a cohort study[J]. THE LANCET. Published:March 16, 2022.DOI:https://doi.org/10.1016/S0140-6736(22)00462-7
[2] The UK spent a month with COVID-19, with deaths soaring 36% and hospitalizations peaking again. Metz Med.2022.04.07.
[3] Thought Amiqueron was a "big flu"? Light enemy. World Wide Web.2022.04.08.
[4] https://www.covidvaccine.gov.hk/pdf/5th_wave_statistics.pdf
[5] Prepare a table of dishes and two tables of guests? Zhang Wenhong: Fighting with Omicron, a piece of the puzzle can not be less. Xinmin Evening News 2022.04.09 15:34
[6] Shanghai epidemic latest news (updated daily).2022.04.09 07:58 Shanghai released.
[7] Jilin City achieves zero social clearance. Xinhua. 2022.04.08 17:12
[8] Nele Brusselaers, David Steadson,et al. Evaluation of science advice during the COVID-19 pandemic in Sweden[J]. Nature. Published: 22 March 2022
[9] Fauci: Herd immunity to SARS-CoV-2 may be‘unattainable’. Last Updated: April 7,2022 at 8:20 a.m.ET.First Published: April 5, 2022 at 7:28 a.m. ET
[10] Shanghai's largest cabin hospital has admitted the first batch of infected people! How does the "four-leaf clover" become a large cabin? Youth Shanghai 2022.04.10 18:50
[11] Jiutai District of Jilin City and Changchun City achieved the goal of zeroing out social aspects. Health Report 2022.04.09 20:36
12] UK outbreak data. World Health Organization.
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Written by | Li Tong