As the number of positive infected people increased, the number of severe and critical cases in Shanghai also increased.
Why are there an increase in severe and fatal cases?
As of 24:00 on April 23, 160 severe patients and 19 critically ill patients were treated in designated medical institutions. Positive infections with underlying diseases, especially the elderly, are at higher risk of severe illness or even death.
At the press conference on epidemic prevention and control held on the 24th, Zhao Dandan, deputy director of the Shanghai Municipal Health Commission, introduced that since the current round of epidemics, there have been 87 deaths in the city, including 48 males and 39 females, with an average age of 81.10 years and the largest 101 years old. The above cases are all complicated by severe multi-organ underlying diseases and are critically ill, including advanced malignant tumors, severe cardiovascular diseases (coronary heart disease, heart failure, hypertension, etc.), neurological diseases (cerebral hemorrhage, cerebral infarction, etc.), end-stage cirrhosis, diabetes, uremia, etc. The immediate cause of death is underlying illness.
Tu Guowei, chief physician of the Department of Critical Care Medicine of Zhongshan Hospital and deputy head of the medical treatment team of the designated hospital of the Minhang District Gymnasium, believes that the increase in death cases does not mean that the virus toxicity is increasing, nor does it mean that there are systemic problems in our treatment plan. Patients with advanced age and underlying diseases, after superimposed on the new crown infection, are prone to gradual multi-organ insufficiency in the treatment process, which eventually leads to an increase in death cases.
To this end, Shanghai is taking comprehensive measures to carry out rescue and treatment work from the three levels of prevention and treatment of mild to severe diseases, the treatment of new crown and basic diseases, and the treatment of traditional Chinese and Western medicine.
At present, Shanghai has strengthened the treatment capacity of municipal designated hospitals, bringing together more than 360 critical care medical experts with rich clinical diagnosis and treatment experience in the city, plus experts supported by other provinces and cities, and jointly formed 9 critical care teams and stationed in 8 municipal designated hospitals.
At the same time, we actively deploy municipal medical resources to support municipal designated hospitals, set up a team of 53 municipal experts with rich clinical experience in 15 specialties, implement list management for severe patients in municipal designated hospitals, and conduct multidisciplinary joint rounds and consultations at fixed times every day, and carry out treatment for one person and one policy.
In addition, 8 municipal expert rescue teams composed of more than 300 experts have been established. Each expert group is responsible for the designated hospitals and cabin hospitals in 2 districts, and carries out joint diagnosis in coordination with the district-level expert group.
Tu Guowei said that in the battle against the epidemic, they are taking on more and more responsibilities. Taking the designated hospital of the Minhang Gymnasium where he works, for example, compared with more than a month ago, the patients admitted to the hospital have undergone some changes. From the previous treatment of asymptomatic and mild patients, to the current main treatment of new crown pneumonia with a variety of underlying diseases, such as hypertension, diabetes, chronic renal insufficiency, chronic cardiac insufficiency and other basic diseases, there are also some advanced age, disability, dementia, tumors and other special patients, these patients need more refined care and specialized treatment.
Square Cabin Transfer Designated Hospital How to do it?
Including seriously ill patients, the admission and treatment of people infected with the new crown virus is an important part of the nine major actions of Shanghai's social clearance.
At present, some cabin hospitals in Shanghai have been transformed into regional designated hospitals, and the capacity has been completed, including the New International Expo Center Cabin Hospital. According to the reconstruction plan, the cabin councillor has converted two of the original 10 cabins into a designated hospital, and as of the 24th, the designated hospital has admitted a total of 240 people.
In the Lingang Fanggang Hospital, there are also some areas that have been transformed into designated hospitals, and 2,000 beds have been transformed.
Tu Guowei said that in the specific transformation process, the characteristics of elderly patients will be fully considered, and facilities such as toilets and wheelchairs will be added to carry out aging transformation. At the same time, due to the improvement of nursing requirements, it is also necessary to provide assistance from medical teams from other provinces to enrich the medical force and jointly undertake the work of designated hospitals.
From a professional point of view, he introduced that elderly patients older than 60 years old, patients with underlying diseases such as cardiovascular diseases, chronic lung diseases, tumors, immune deficiencies, and unvaccinated patients, they are relatively easy to develop into severe diseases. For these high-risk groups, it is necessary to identify risk factors as soon as possible, detect changes in early warning indicators as soon as possible, use antiviral drugs cautiously, and actively treat primary diseases to avoid developing into severe diseases.
For patients with complex conditions, Tu Guowei said that they have established a consultation system within the medical team to comprehensively evaluate patients from a multidisciplinary perspective. They have also established a sound referral system for patients whose condition worsens and are in need of further treatment or surgery.
Omikron is not a "big flu"
For a long time, some people have believed that the symptoms after infection with Omicron are generally mild, and there is no need to engage in "dynamic clearance". In response to this view, Liang Wannian, head of the expert group of the National Health Commission's leading group for epidemic response and handling, said that the severity of Aomi Kerong is much higher than that of influenza in terms of both transmission speed and case fatality rate, and once prevention and control is relaxed, it will cause a large number of severe diseases and deaths.
Liang Wannian said that from the perspective of case fatality rate, the average case fatality rate of influenza in the world is 0.1%, while the case fatality rate of the Aumechjong variant, real-world data show that the average case fatality rate is about 0.75%, about 7 to 8 times that of influenza, and the case fatality rate of the elderly, especially the elderly over 80 years old, is more than 10%, which is nearly 100 times that of ordinary influenza.
Tu Guowei also agreed with Liang Wannian, who believes that especially for some elderly patients with risk factors, the overall case fatality rate will still be much higher than that of influenza.
He pointed out that Shanghai has a very large elderly population base, and at the same time, there are many patients with underlying diseases, and the health hazards to these patients will be very large. Therefore, in line with the principle of people first and life first, the implementation of "dynamic zeroing" and the final control of the epidemic can protect the safety of everyone's life.
(Look at the news Knows editor Zhao Xin)