The second wave of coronavirus infections peaked.
But what is the real infection rate in the population? No one knows.
On May 22, Academician Zhong Nanshan said that according to the forecast model, the second wave of the epidemic peaked in mid-April, peaked at about 40 million / week at the end of May, and peaked at about 65 million / week at the end of June. However, he also cautioned that this is a model-based calculation prediction, which "may not be accurate."
The Chinese Center for Disease Control and Prevention has not updated the new crown epidemic data for a whole month, and the model predictions are too professional and distant. For ordinary people, they can only speculate about the current infection situation in their city through "surrounding statistics".
Disturbing news came one after another. Internationally, Singapore's Prime Minister Lee Hsien Loong was diagnosed for the first time, and domestic respiratory wards were full again; People infected for the first time have successively posted "two bars" in the WeChat circle of friends, saying that they have finally "caught up"; Most of the people with secondary infection lose interest in posting pictures, and their current state can only be judged by the empty workplace.
In the past half a month, the discussion of the crowd and the "new crown epidemic search index" on the search engine have all indicated that the second wave of new crown infection peak is coming.
However, the social gears have not stopped. Industry conferences are full of friends, and peers seize every opportunity to communicate and exchange; Concerts and football matches were held as scheduled, full of seats, and three years of depression made entertainment a rigid need; In places where people gather in universities and hospitals, staff with the second infection still insist on going to work.
Under the peak of the second wave of infection, whether or not the new crown has become a "flu"-like disease, it seems to have been "fluized" by society.
Whether it's trivialized or taken seriously: when people no longer have data on the second wave of infections, does that mean it doesn't matter anymore? In the future, will the new crown be accompanied by humans like the flu? How many times will there be "superinfection" and when is it a head?
New crown data not released, secondary infection peak "seeing is believing"
Following the large-scale group infection less than half a year, the new crown virus has once again attracted everyone's attention.
Is the coronavirus epidemic again? Seeing that there are friends, classmates, and family members around them who have been infected for the second time, and frequently brushing pictures of antigen reagents "two bars" in WeChat friend circles, many people have questions.
The answer is yes, and the caregivers feel more directly.
According to the observation of the director of the intensive care department of a third-class hospital in central cities, the latest round of ICU admission to the new crown patient was around May, and the patient was an elderly person who had never been infected before.
In Beijing, Yan Ming (pseudonym), director of the infection department of a hospital, felt that the number of new crown patients began to increase at the end of April and climbed rapidly in May, "Our hospital sees hundreds of people every day, and some large hospitals see two or three hundred people a day, which is now close to the peak level."
In the respiratory ward of a tertiary hospital in the north, the 12 beds in the 4 positive wards are almost full.
"The patient turned negative or was discharged, the bed was vacant, but soon new positive patients were admitted in." Department doctor Shan Hua (pseudonym) introduced that this is almost the only "special" measure that the hospital currently has to deal with the new crown infected people of Class B tube - let positive patients live together.
A number of doctors told Eight Points that the new crown patients received by the hospital, especially the new crown hospitalized patients, are mainly elderly people who are infected for the first time, and even 80% can be accounted for.
The first infection is still accompanied by challenges for people with weak immunity, "with large-scale pneumonia, unilateral pneumonia", but compared with the previous infection peak, "all lungs are white", the severity has become lighter.
Among the second new crown infection patients admitted to Yan Ming, although some have moderate pneumonia, there has not been a single case of severe disease so far. "For most people, the second infection is less severe than the first."
"There were more patients with the first infection in early May, and now the number of patients with secondary infection is gradually increasing," Yu Changping, chief physician of the Department of Respiratory and Critical Care at Wuhan University People's Hospital, said. At present, those who are not infected are more likely to be infected, but the number of secondary infections will gradually increase. ”
Healthcare workers are also inevitably infected with the new crown twice.
Some people took this opportunity to make up for the "new crown leave" that was not taken last year - the last sudden new crown outbreak, many medical staff continued to work while enduring the pain of illness, and some hospitals promised to transfer the leave period, but the medical staff has not rested because of the subsequent influenza A epidemic.
Others still need to bring illness to work, especially among nurses.
A local nurse in Beijing told Eight Points that after the outbreak of the new crown epidemic last time, many nurses from other places resigned, and almost all departments of the hospital had a "nurse shortage".
Universities have also responded to the wave of infections.
According to Eight Points Jianwen, some colleges and universities require that students with two bars of antigen test results report the results to the counselor, and they can freely choose to self-isolate in the dormitory or go to the school's health station to isolate alone. However, for two weeks at the beginning of this month, the quarantine site was full, and students who wanted to isolate alone had to go to another campus 5 kilometers away.
In general, in the second wave of new crown infections that cannot be ignored, the public's cognition and judgment of this round of new crown infections are almost entirely based on their own and their observations of surrounding phenomena.
Statistics and big data are "silent" in this round of popularity.
The weekly report on new crown infection from the Chinese Center for Disease Control and Prevention has not been updated for a whole month.
Since January this year, the Chinese Center for Disease Control and Prevention has released the national new crown infection situation every week, which seems to have formed a pattern, but after April 29, the weekly report data has not been released again.
The "National Novel Coronavirus Infection Epidemic Situation" released by China CDC on April 29, 2023 is the latest public epidemic data so far.
At the press conference of the joint prevention and control mechanism of the State Council at the end of last year, Yin Wenwu, chief physician of the Department of Communication and Prevention of the Chinese Center for Disease Control and Prevention, said that the frequency of new crown virus announcements will be dynamically adjusted according to the situation of the epidemic, and eventually return to Class B infectious diseases announced once a month.
Although according to the requirements of the Law on the Prevention and Control of Infectious Diseases, only "health administrative departments regularly publish information on the epidemic of infectious diseases nationwide", there are no clear requirements for the frequency of publication. But the previous rule was that the Chinese Center for Disease Control and Prevention released information on national infectious disease outbreaks once a month.
Perhaps, in the national epidemic profile of statutory infectious diseases in May, we will see that the new coronavirus infection is no longer released separately, but officially returns to one of the Class B infectious diseases, and has been announced monthly since then.
The Beijing Municipal Center for Disease Control and Prevention is also updating the weekly epidemic report every week, but the content is simple, only including the number of types and cases of statutory infectious diseases reported in the city that week, as well as the top 5 diseases with the highest number of reported cases.
Some media speculated based on the fact that the new crown infection occupied the first place in the number of reported cases for 4 consecutive weeks, and the total number of statutory infectious diseases reported in the city in the 20th week was nearly 4 times that of the 17th week, and the second peak of new crown infection seems to have arrived.
The first signs appeared at the end of April, from "new crown" to "A stream" to "new crown"
The new coronavirus is like "filling the gaps".
A number of infectious disease experts said that a large proportion of those infected in this round of infections were "survivors" of the tsunami last December.
Virologist Chang Rongshan also pointed out that in this round of infection, the proportion of secondary infection accounts for only 10%, which is more like "replenishing yang" - the virus is "sweeping up" people who are not infected.
In fact, this peak of infections began to appear at the end of April.
According to the "National Novel Coronavirus Infection Epidemic Situation" released by China CDC on April 29, 2023, since December 9, 2022, the number of positive new coronavirus nucleic acid tests and the positive rate among the reported population in mainland provinces have shown a trend of "first increasing and then decreasing", and the number of positive people fluctuated and decreased after reaching a peak in December last year, falling to 2,661 cases on April 20, 2023.
However, in the last week of April, that is, April 21~April 27, the number of positive people began to show an upward trend again, and the number of cases increased again to 6752 on April 27.
The description in this report of "trends in the positive rate of influenza-like cases in sentinel hospitals across the country" also suggests an important message - since the 49th week of 2022 (December 9), the positive rate of new coronavirus and influenza virus positivity of influenza-like cases has shown a clear "one after another" state.
Source: "National Novel Coronavirus Infection Epidemic Situation" on April 29, 2023
A similar situation has occurred in Hong Kong. Jin Dongyan, a professor at the School of Biomedical Sciences at the University of Hong Kong's Li Ka-shing School of Medicine, found that it has been nearly a year since the peak of the new crown in Hong Kong in April last year, and after the peak, the first seasonal flu peak in three years appeared in April this year.
This shows that Hong Kong's experience is highly similar to that of the mainland.
Since the full liberalization, first the new crown infection frenzy swept the country, and then the abnormal arrival of influenza A lingered for more than a month; Now that the weather is getting hot, the flu has died down, and the new crown has begun to rise again, there is a sense of "you sing and I appear".
Take Beijing, for example. On May 24, the Beijing Municipal Health Commission released the 20th week of 2023 epidemic weekly report, showing that the number of reported cases of the new crown in Beijing has been ranked first for four consecutive weeks. Between weeks 17 and 20, the number of reported noble infectious diseases in the city soared from 6,438 to 25,544, which means that in just 4 weeks, the number of new coronavirus infections has increased nearly 4 times.
This means that the new crown is recrowding out the ecological niche of respiratory infectious diseases.
A few days ago, Zhong Nanshan, an academician of the Chinese Academy of Engineering and a well-known expert, predicted that the peak of the second wave of the new crown epidemic in 2023 will occur at the end of June.
"The large-scale population movement during the May Day holiday is the main reason for the recent significant local epidemic in some areas." Chang Rongshan concluded. According to data from the Ministry of Transport, during the May Day holiday, the total number of passengers sent by railways, highways, waterways and civil aviation across the country is expected to exceed 270 million, and the new variant of XBB 1 is highly contagious, with an R0 value of about 18, which is not difficult to explain the recent positive infestation.
At the same time, antibodies after the recovery of the new crown virus are also influencing factors.
Hong Kong epidemiologist Ming Weijie found that the new crown is showing a periodic infection pattern. Over time, "the barrier to infection is weakening and the risk of reinfection is increasing." ”
But many experts say that in big cities such as Beijing and Shanghai, the peak of the epidemic may come sooner. "It's already the peak now." Yan said he believed the number could fall by early June.
The fluctuation of outpatient volume shows this change from the side: taking a clinic in Shanghai as an example, the average daily outpatient volume reached about 300 cases around May 20, five or six times more than normal; At the end of May, it fell by another third.
But horizontally, the crest is not the same. Yan Ming found that compared with the surge in the number of fever clinics in Beijing, there were fewer cases of new crown infection in Jiangxi in early May, and the rate of medical attendance and hospitalization were not high, and the second wave of the new crown outbreak was still brewing.
Regardless of the speed of the process, countless evidence points to the phases of the new crown. At least for a long time, the new crown will occupy a place in the list of infectious diseases.
The peak of the second wave of infections is approaching, and the social gears have not stopped again. But this time, how to live peacefully with the new crown is becoming a new challenge.
The pathogenicity of the mainstream strain XBB has become weaker, and the third and fourth waves of infection are unknown
Whether it is a doctor or an ordinary person, the common feeling is that the burden on the body after the recent infection does not seem to be so heavy.
When the time came in May, the mainstream variant of the new crown has become the XBB series. Chen Cao, a researcher at the Institute of Virology of the Chinese Center for Disease Control and Prevention, once pointed out that surveillance data showed that the proportion of Omicron XBB series variants continued to be high, accounting for 95.2% of the collection sequences from May 15 to May 21.
Jin Dongyan believes that the pathogenicity of XBB series variants is weakening. "XBB has been in Singapore for a year, and the rate of severe disease, hospitalization and mortality has been very low and going down." The XBB series variant usually has an Rt value (real-time transmission index of the epidemic) below 2, and "it does not spread well".
"The only thing we have seen in the past three years is that this virus is getting weaker and weaker, which is a common sense and a truth." Professor Jiang Qingwu, an epidemiologist and professor from the School of Public Health of Fudan University, concluded.
On the other hand, the immune barrier formed by last winter's wave of infections in more than seventy percent of the population is also at work. "The vast majority of people in this wave in May this year were not infected, which shows that the last infection still formed an effective immune barrier." Virology expert Chang Rongshan said.
After the "mild" peak, will we usher in the third and fourth waves of the epidemic in the future?
Disappointingly, although the impact is gradually decreasing, the new coronavirus seems to have made up its mind to "take root" in the human world, and even tried to write its own fragments into the human genome. Making it disappear like SARS in a short period of time no longer seems possible.
The situation in Hong Kong, China, may serve as a reference for the mainland. In February ~ April 2022, after experiencing a "tsunami"-like peak of infection, Hong Kong experienced three waves of epidemic peaks. The time is half a year later, September, December ~ January 2023, and now.
According to Phoenix Satellite TV, Hong Kong is currently experiencing a new round of the epidemic, with an average of more than 6,000 people visiting the emergency department of public hospitals every day, and about 480~500 confirmed cases reported every day. However, Liu Yulong, an expert adviser to the Hong Kong SAR government, believes that "this is a small wave, which seems to have peaked in early May." ”
Jin Dongyan judged that at most 3%~5% of people affected by the XBB series variant at the same time in Hong Kong, "this wave of peaks adds up to less than 20%, which is similar to the intensity of seasonal influenza, but it may be more frequent."
Wei Sheng, a professor of epidemiology at the School of Public Health and Emergency Management of Southern University of Science and Technology, stressed that for the new crown virus, it is not yet possible to predict the likely strains of the epidemic like influenza, and then produce vaccines in advance. "The coronavirus is mutating faster than ever before, and we don't know enough about it." Wei Sheng said that it is difficult to say that we have defeated the new crown.
This reminds us that we can't equate coronavirus with influenza yet.
Jiang Qingwu said that the new coronavirus will be at a low level of transmission most of the time, and occasionally you can see more cases in small areas, "or local outbreaks." He further believes that the next "outbreak season" may be after November, when the decline in immunity levels of the population meets the season of respiratory disease transmission, creating another peak period of infection. The spread of the new crown will be "more and more regular".
In the face of the next possible peak of infection, what needs to be done is still to protect susceptible people, especially to clarify the follow-up vaccination strategy for infected people as soon as possible.
According to the plan issued by the Joint Prevention and Control Comprehensive Group of the State Council on April 6, Chinese mainland currently eligible for vaccination is limited to: (1) those who are not infected and have not completed the established immunization schedule; (2) People who have been infected and have not completed basic immunization.
In Hong Kong, China, the elderly after 3 months of infection can receive a free booster shot of the new crown vaccine; Young people 6 months after infection can pay for a booster shot.
Standing at the time node of the peak of the second wave of infection and looking into the future, the third and fourth waves may be unavoidable, but its lethality may become smaller and smaller.
"The recent outbreak has not had a significant crest, showing a typical endemic epidemic." Chang Rongshan said.
Jiang Qingwu believes that the presence of the new crown virus in the public will be further reduced in the future, "the public does not need to pay too much attention, professional issues are left to professionals to judge."
You can be indifferent to the new crown virus, but after 3 years of the new crown epidemic, there are some things that must not return to square one.
Ming Weijie emphasized, "Our relatively weak public education should be strengthened by the new crown epidemic, educating the public on how to protect themselves and others in the face of infectious diseases, otherwise the lessons we have learned in the past few years will not be gained." ”
Written by Song Xinze, Tian Wei, and Niu Yitong
Yan Yucheng and Li Lin are responsible for editing
This article was first published on the WeChat public account "Eight Points Jianwen" and may not be reproduced without authorization