Li Lanjuan, an infectious disease expert, said that most of the patients with “white lung” were severe patients, and the proportion of “white lung” caused by Omicron infection was very low.
Today is the first day of 2023. Happy New Year’s Day to everyone! Let’s continue to look at the latest progress in the prevention and control of the domestic epidemic, as well as some issues that everyone is most concerned about.
Academician Chen Saijuan’s team: The infection in Beijing, Shanghai, Guangzhou and Chongqing is coming to an end around New Year’s Day
Chen Saijuan, an academician of the Chinese Academy of Sciences, said on December 31, 2022 that among people who have recently experienced symptoms of new coronavirus infection, severe illness is mainly concentrated in the elderly with underlying diseases; New Year’s Day and the Spring Festival are coming, and rural areas with relatively weak medical resources are all Needs to be focused.
Academician of the Chinese Academy of Sciences, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Chen Saijuan’s team from National Major Infrastructure for Translational Medicine (Shanghai), and Fan Xiaohong’s team from Shanghai Public Health Clinical Center jointly tackled key problems and published a research paper “Preliminary Analysis of my country’s 2022 Autumn and Winter” in Frontiers of Medicine Omicron subtype diversity and epidemiological characteristics in COVID-19.The researchers preliminarily judged that the number of people infected with this round of Omicron epidemic will come to an end around New Year’s Day in 2023 in Beijing, Guangzhou, Shanghai, Chongqing and other cities.
Based on the mathematical simulation analysis of the data of the main urban area and suburbs of Chongqing, the research team believes that the peak of the epidemic has been delayed in the suburbs, and the peak of infection will be significantly enhanced during the Spring Festival travel season due to the accelerated spread of the epidemic. For Sichuan, Shaanxi, Gansu, Qinghai and other provinces, it is estimated that the peak of infection in rural areas and small and medium-sized urban areas will appear in the middle and late January of 2023.
Omicron (English name Omicron; Pango naming system number: B.1.1.159) is currently designated by the World Health Organization as a mutant strain of the new coronavirus that deserves close attention. Compared with the early mutant strains of the new coronavirus (such as Alpha, Beta, Gamma, Delta), Omicron’s ability to infect and immune escape is significantly enhanced, but its ability to invade the lungs and cause severe toxicity is significantly weakened. With the changes in the transmission route of the virus brought about by the evolution of the epidemic, multiple subtypes of Omicron are spreading in the country at the same time.
Chen Saijuan’s team and Fan Xiaohong’s team jointly tackled key problems to assess the transmission mode of the Omicron strain in the country after the adjustment of epidemic prevention measures, the possible proportion of severe patients among symptomatic infections, and the trend of this wave of epidemics in large cities and rural areas in central and western China. The researchers analyzed the Omicron subtypes that are currently prevalent in the country, the proportion of critically ill patients among the infected and hospitalized patients, and used mathematical modeling to simulate and predict the trend of the epidemic. Academician Chen Saijuan said: “We conducted a random sampling study of infected persons in Shanghai this autumn and winter, conducted genome sequencing and molecular epidemiological analysis of the new coronavirus; continuously monitored the types of new coronaviruses circulating in China, and evaluated the infectivity of each mutant strain at the same time. and pathogenicity to judge the development of the epidemic.”
By sequencing the genomes of hundreds of samples randomly selected from patients admitted to the Shanghai Public Health Clinical Center during the autumn and winter of 2022, the research team obtained 369 high-quality full-genome sequences of the new coronavirus. These virus genomes contain a total of 30 Aomecron subtype strains, of which 355 (95.95%) genome sequences are concentrated in 5 Aomecron sublineages, and the main strains include those that have been reported to be prevalent in Beijing, Guangzhou and other places. BF.7 and BA.5.2 and BQ.1 and XBB recently appeared in Europe and America.
It is understood that combined with the travel history and infection contact history of the infected person,The researchers proved that those with a history of exposure to the epidemic in Beijing or Guangzhou mainly carried the BF.7 and BA.5.2 substrains respectively; those infected who entered Shanghai from overseas mainly carried BQ.1 and XBB; while the local infected people in Shanghai except BA.5.2 , there are a number of Omicron sub-strains with a relatively high proportion. No new coronavirus variants have been identified in these results.
The study pointed out that medical resources in rural areas and small and medium-sized cities and towns in China are relatively scarce, and there are a large number of elderly people and people with underlying diseases; the movement of urban and rural population during the Spring Festival travel season will greatly affect the trend of the epidemic. The research team believes that there is an urgent need to start an emergency plan for the spread of the Omicron epidemic to rural areas, allocate more medical resources to rural grassroots, do a good job in emergency use of effective drugs and new vaccines, and do a good job in anti-new coronavirus specific drugs and The production, storage, distribution and clinical rational use of auxiliary drugs and traditional Chinese medicines with definite curative effects; implement classified and layered treatment, and strengthen the ability to treat severe cases in small and medium-sized towns; continue to accurately use non-pharmaceutical public health measures (wearing N95 masks in indoor spaces, Maintain social distance, appropriately increase the frequency of public transportation to avoid crowding, etc.), strive to reduce the peak of the epidemic, and relieve the heavy pressure on the medical system and medical staff.
The research team also proposes to continue to do a good job of full-course immunization of high-risk groups, and start the fourth dose of booster vaccination for high-risk groups; strengthen the popularization of personal and family prevention and control knowledge and skills, do a good job in health promotion and risk communication, and protect people especially those who are in difficulty. To ensure the life and health of the community, to ensure China’s smooth escape from the epidemic, and to promote the orderly recovery and development of the social economy.
About “white lung”, Li Lanjuan’s latest research and judgment!
How to treat pneumonia caused by new coronavirus? Are vaccinations still effective? In response to issues of general concern to the people, on December 30, 2022, the National Health and Medical Commission invited Li Lanjuan, an academician of the Chinese Academy of Engineering and an expert in infectious diseases, to respond.
Experts believe that, on the whole, the current cases of infection in my country are mainly mild and asymptomatic cases. The lung images of mild cases are normal. Some patients have gastrointestinal symptoms such as diarrhea. Most people’s body temperature gradually returned to normal within 3 to 5 days. Only a very small number of patients continued to have high fever and symptoms were more obvious, and developed into pneumonia or even “white lung”.
“Generally, the white area in the lung image reaches 70% to 80%, and we call it ‘white lung’ clinically.. Most of the patients with ‘white lung’ were severe patients, and the proportion of ‘white lung’ caused by Omicron infection was very low. “Li Lanjuan said that at present,For severe and critical illness, it is recommended to use “four anti-two balance” treatment, namely anti-virus, anti-shock, anti-hypoxemia, anti-secondary infection, and pay attention to maintaining water-electrolyte balance and micro-ecological balance.
Li Lanjuan emphasized that many rumors on the Internet need to be clarified. For example, the new crown vaccine is ineffective, which is wrong. Although there is still a chance of infection after vaccination, there is already a large amount of clinical evidence that the new crown vaccine can significantly reduce the severe and fatality rate after infection. Vaccines are a very important weapon for us to overcome the epidemic. Others believe that prevention and control measures are no longer necessary for the new crown, which is also wrong. As a Class B infectious disease, we must not only avoid being infected ourselves, but also prevent spreading it to others. During the epidemic, we still need to take basic measures such as wearing masks, maintaining social distance, and washing hands frequently.
“Once infected by the new coronavirus, antiviral treatment should be carried out in an early and timely manner to reduce the development of severe illness. If high fever and shortness of breath persist, seek medical treatment in time. It is best to bring your own blood oxygen monitor at home. If the monitoring value is lower than 93, even if If the symptoms are not obvious, you should also seek medical examination in time.” Li Lanjuan said.
50! The latest approval from the State Food and Drug Administration →
On December 30, 2022, after review by the State Food and Drug Administration, Anhui Shenlan Medical Technology Co., Ltd.’s new coronavirus antigen detection reagent product was approved. up to now,The State Food and Drug Administration has approved 50 new coronavirus antigen detection reagent products。
The drug supervision and management department will strengthen the post-market supervision of relevant products to protect the safety of patients with medical devices.
Does the new crown attack the reproductive system?here comes the answer
Many people infected with the new coronavirus still cough after turning negative, and some netizens also reported that they have menstrual disorders and abnormal uterine bleeding after infection. What is the reason for still coughing after turning negative, and how to relieve it? Does the new coronavirus attack the human reproductive system? The National Health Commission organized authoritative experts to respond.
“Recently, most of the infected people have symptoms of acute upper respiratory tract infection such as fever, sore throat, and cough. Many people will still have a long-lasting cough after turning negative. We generally believe that a cough that lasts for more than three weeks is a subacute cough. Among them , The most common is coughing after infection.” said Lin Jiangtao, deputy director of the Respiratory Center of the China-Japan Friendship Hospital.
Lin Jiangtao introduced that the cause of post-infection cough is the damage of the bronchial mucosa or the exposure of sensory nerves caused by upper respiratory tract infection, which increases the sensitivity to various external stimuli. Therefore, physical and chemical stimuli such as temperature drop, smoking smoke, and kitchen fume may cause severe coughing.
“Increased cough sensitivity after turning negative is not an infection. At this time, neither antiviral nor antibacterial drug treatment is needed, and it can recover on its own.” Lin Jiangtao said that patients with cough after infection should avoid various irritations to the respiratory tract Sexual factors, if the symptoms are severe and affect work, study and rest, you can go to the hospital for treatment. Doctors usually treat the symptoms with cough medicines, and some Chinese patent medicines are also very effective.
“From the perspective of traditional Chinese medicine, after the infected person turns negative, they will be in a state where the exogenous pathogens are about to be exhausted. At this time, some lungs will have abnormal physiological functions, which will lead to coughing.” Zhu Yong, chief physician of the Department of Respiratory Medicine, Beijing Hospital of Traditional Chinese Medicine affiliated to Capital Medical University According to the introduction, according to the specific situation of the patient, the treatment method of clearing the lung or moistening the lung can be adopted, and better results will be achieved.
Some netizens said that after being infected with the new coronavirus, menstrual disorders and abnormal uterine bleeding occurred, and they suspected that the new coronavirus attacked the human reproductive system. In this regard, Yang Xin, chief physician of the Department of Obstetrics and Gynecology at Peking University People’s Hospital, said,There is currently no evidence that infection with the new coronavirus has an impact on the reproductive system.
“The regulation of menstruation is affected by the cerebral cortex, hypothalamus, pituitary gland, and ovarian function. It is a strict reproductive endocrine axis. Many external influences such as high pressure and physical discomfort may affect menstruation. Therefore, abnormal menstruation occurs in infected persons It does not show that the new coronavirus directly affects the reproductive system.” Yang Xin said.
Zhang Wenhong: I have been infected…
On December 29, 2022, the work schedule of Zhang Wenhong, leader of the Shanghai New Crown Epidemic Prevention and Treatment Expert Group and director of the Infectious Diseases Department of Huashan Hospital Affiliated to Fudan University, is also a microcosm of the recent busy state of Shanghai treatment experts. In the evening of the same day, during his work break, Dr. Zhang Wenhong accepted an exclusive interview with People’s Daily Dajiangdong Studio.
The number of infected people in Shanghai is now in the tens of millions
Reporter: Please introduce the main characteristics of this wave of new coronavirus infection in Shanghai and the recent treatment of patients.
Zhang Wenhong:Shanghai will reach the peak of infection on December 22, 2022. According to estimates, the current number of infections is in the tens of millions.Assuming that 0.5% of the 10 million infected people in Shanghai need to be hospitalized, it means that 50,000 people will need to be hospitalized in the next few weeks. All major hospitals will admit thousands of people without exception, and those who are particularly critical will need respiratory support. Therefore, although the proportion of severe cases among the infected population is low, the base number is large, and the absolute number of people is still large. This is the characteristic of this wave of Omicron infection—we are facing the severe situation that all countries have experienced at the beginning of the epidemic. challenge.
At present, Shanghai is making every effort to improve the ability to treat critically ill patients. From grassroots health institutions to tertiary hospitals, all doctors and nurses are engaged in an all-out battle against Omicron. The first is to improve the treatment capabilities of grassroots communities, including increasing the number of treatment sites, training medical personnel, providing oxygen therapy and antiviral drugs, and formulating standardized diagnosis and treatment manuals, so that more patients can receive effective treatment within the “golden 72 hours” of onset, Let critically ill patients be referred to higher-level hospitals through the hierarchical diagnosis and treatment system as soon as possible. The second is to expand the number of beds in secondary and tertiary hospitals, optimize the admission and treatment process, so that critically ill patients in emergency departments can be admitted within 24 hours as much as possible, and complete all the new crown rescue procedures. In the Huashan Hospital where I work, in addition to the hundreds of beds in various districts of the Infectious Diseases Department, some two-floor beds in other departments have been allocated today as a public platform for centralized treatment in the hospital.
Let vulnerable people get timely treatment within the “golden 72 hours”
Reporter: Compared with the previous ones, what are the characteristics of the response and treatment of this wave of epidemics? Do doctors have newer drugs or treatments?
Zhang Wenhong: After these three years, we have formed many standardized procedures for treatment. Through the research and analysis of previous deaths and severe cases, we found that vaccination can effectively reduce the rate of severe cases and mortality. Through multi-party publicity and vigorous promotion, many people have completed the full vaccination. We have also made certain preparations in terms of antiviral drugs, respiratory support, ICU wards and equipment.
In the treatment process, according to the characteristics of severe new coronary pneumonia, early use of oxygen therapy to correct hypoxia, use of hormones to improve inflammation and early anticoagulant treatment, etc. Generally speaking, the peak of critical care will soon follow the peak of infection. The weapon to deal with it is to deploy medical resources with the greatest efforts and non-stop spirit, from primary hospitals to tertiary hospitals, with the fastest speed Seize the 72-hour “golden time” treatment, whether it is early primary medical treatment in the community or emergency treatment of critically ill patients, we must strive to achieve faster and earlier, in order to compete with death for time and life, and strive to reduce the rate of severe illness ,mortality rate.
Reporter: The elderly and vulnerable groups with underlying diseases are the most concerned groups in this wave of infections. Shanghai, which has a high degree of aging, has made any preparations for the protection and treatment of vulnerable groups?
Zhang Wenhong: There are 88,000 elderly people living in nursing homes in Shanghai, 22,000 people living in nursing homes, there are 700,000 to 800,000 elderly people with various underlying diseases living at home, and more than 5 million elderly people over the age of 60. Shanghai has made a comprehensive investigation on this.
In addition to promoting vaccination, our idea earlier was to try our best to protect the elderly and vulnerable groups from being infected in this wave of epidemics, so we implemented closed management of nursing homes, and advised the elderly to stay at home, avoid going out, and avoid square dancing and mahjong. Crowd infection peak line, delaying their infection time. However, in the rapid tsunami-like spread of Omicron, the infection rate of the elderly is still relatively high, and the number of critically ill patients is also increasing. Now entering the critical period of the decisive battle, Shanghai is working hard to send medical resources to the elderly, so that the vulnerable people can receive timely treatment within the “golden 72 hours”. All districts in Shanghai are organizing the distribution of medical resources to nursing homes and nursing homes, and the municipal expert group is also connecting with the grassroots by region to strengthen consultation, ward rounds, and training.
This time, it’s an all-out power showdown between us and Omicron. There is no opportunity to make things happen. It is not that the tertiary hospitals can open a few more intensive care units to solve the problem of treatment. It is necessary to mobilize effectively from the grassroots to the center. Every family must also know how to protect the vulnerable population and under what circumstances to go to the hospital for treatment; Every community health center can also expand the treatment force as much as possible…
Struggling to hold on to the threshold of infection of vulnerable groups, this pandemic, we can grit our teeth and pass.
“Infected, my symptoms are very mild”
Reporter: Some people say that BA.5 or BF.7, the main strain of infection in this wave of infection, is more “virulent”. Is it reasonable?
Zhang Wenhong: The current main strains are all widely circulated abroad.Some scholars have done a comparison of virulence, and the severity rate and mortality rate of BA.5 and BF.7 are very close to those of the first generation Omicron.After infection, many people feel severe symptoms such as fever and muscle aches, and they have given fancy names, such as “blade strain” and “dry rice strain”, but such people are still mild. Severe cases are clearly defined in medicine: dyspnea, oxygen saturation below 93%; CT scans show extensive infiltration of the lungs, large shadows or even white lungs. If oxygen inhalation is useless, and tracheotomy and mechanical ventilation are required, it is a critical illness. We have carried out continuous monitoring of the virus genome, and no new special strains have been found so far. Shanghai is currently mainly BA.5 and BF.7, and the proportion of them causing severe illness is clear.
Reporter: Have you ever been infected with Omicron? Are the symptoms severe?
Zhang Wenhong: I have been infected, and my symptoms are very mild. On the first day, I rested at home and held six or seven online meetings; on the second day, I went to the positive ward for rounds. No one around thought I was infected, because I was in the ward and working every day. I’ve had my fourth shot, and my own experience has made me even more pro-vaccination.
Reporter: Since the beginning of the epidemic, you have always emphasized the importance of strengthening nutrition, especially protein intake. Why should so much attention be paid to nutritional issues in the treatment of respiratory diseases?
Zhang Wenhong: When participating in the epidemic treatment and ward rounds, I have seen many cases. In 2020, many imported cases from abroad are often due to frequent transfers on the road, no three meals, lack of nutrition, and the condition quickly worsens after infection. During the Shanghai epidemic from April to June this year, many elderly people suddenly left nursing homes and other familiar environments and went to shelters or isolation hotels. Coupled with lung infections and changes in underlying diseases, their nutritional intake was affected and their resistance dropped significantly. Symptoms suddenly worsen.
This time, we also found that due to the shortage of emergency medical resources, it is difficult for patients stranded in the emergency department to ensure sufficient nutritional supply. Remedial measures may not be effective. However, if the nutritional quality is good and the immunity level is good, the patient may carry it through.
Nutrition is the basis for treating COVID-19 infection. Nourishment leads to resistance. The importance of nutrition cannot be overemphasized. I hope that during this period of time, all infected people or elderly people who are observing at home must pay special attention to increasing nutrition, including a diverse and balanced intake of vegetables, carbohydrates, etc., and the intake of high-quality protein is the most important thing.
Omicron “will bite”
Reporter: At the beginning of 2022, you said that you studied the medical images of Omicron-infected people, not the “big flu”, and believed that this mutant strain “will bite people”. What did you see on the image? Now look, where does it mainly “bite”?
Zhang Wenhong: At that time, many people believed that Omicron only invaded the upper respiratory tract, and its virulence decreased. Compared with the Delta strain, the virulence of Omicron was indeed significantly reduced. At the beginning of 2022, Shanghai will assume the function of the main entry point for international flights, and imported cases will continue. I watched the film and saw that the overall incidence of severe cases of Omicron is decreasing, but there are still pneumonia manifestations in vulnerable groups. The actual clinical situation tells us that it cannot be said that Omicron will not affect everyone. Dangerous, will not invade the lungs.
Influenza has been prevalent in the world for more than 100 years, and we have also established a certain degree of cross immunity. The new crown is a new virus. If the infection spreads widely, the risk will be magnified rapidly. More recently, we can see more clearly thatOmicron does “bite,” and vulnerable people can develop pneumonia symptoms, some even requiring intubation.The rate of severe cases of Omicron is not high, but it is also wrong to say that it is all upper respiratory tract symptoms and “does not bite”. The base of infected people in China is so huge, even if it only “bites” a few bites, it will bite all the elderly and vulnerable people, and it will make us feel very painful and anxious.
We are now in the stage of the first wave of impact of Omicron, which is particularly rapid after the opening, and it is particularly difficult. It is necessary to gather the power of the whole society and expand medical treatment.
Source of this article:Brokerage China, the original title: “The latest research and judgment! Academician Chen Saijuan’s team: The infection in Beijing, Shanghai, Guangzhou and Chongqing is coming to an end! Zhang Wenhong: I have been infected, and the current infection in Shanghai is tens of millions.”
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