Face-to-face 丨 Interview with Liang Wannian: Why can China's plan provide reference for the world?

The New Coronary Pneumonia epidemic is a major public health incident that has the fastest spread, the widest infection range, and the most difficult prevention and control since the founding of New China. It is also a major test of China's governance system and capabilities.

This week, a reporter from the column "Face to Face" interviewed Liang Wannian, the team leader of the National Health and Health Commission's New Crown Outbreak Response Work Group, in Wuhan to talk about the epidemic he experienced.

"Fengcheng" decision-making is difficult to reduce the occurrence of hundreds of thousands or more diseases

At 0:00 on April 8, 2020, countless people are waiting for this moment. At this moment, all 75 control and control card points in Wuhan from Han were removed, and Wuhan, known as the thoroughfare of nine provinces, resumed its connection with the outside world. From the start of "closing the city" on January 23 to the lifting of the ban on April 8, the city with a population of tens of millions was shut down for a full 76 days.

Liang Wannian: "Fengcheng" mainly considered that the disease was already contagious at that time, plus the large number of people on the eve of the Spring Festival, and the Chinese traditional culture to be reunited during the Spring Festival, its aggregation will increase further. In this case, if effective measures are not taken, the main epidemic center in Wuhan may spread the epidemic through the movement and gathering of people in a short period of time. But Wuhan has a population of nearly 10 million people. It is very difficult to make such a decision by isolating it so that the whole city does not move and the population stays still.

Reporter: If you do not take measures to "close the city", what will be the result?

Liang Wannian: The joint expert group of the World Health Organization and China has a basic judgment. This measure can at least reduce the incidence of hundreds of thousands of diseases, and some scholars can reduce the incidence of millions of diseases. It is safe to say that this measure reduces the occurrence and death of a large number of patients.

If there is no intervention, a new crown patient may infect three to four people

Since the end of December 2019, the Wuhan Center for Disease Control has detected cases of unexplained pneumonia. Research, prevention, diagnosis, treatment, and notification of this new disease have been ongoing. On January 20, 2020, the National Health Commission issued an announcement to include the new coronary pneumonia in the Class B infectious diseases as prescribed by the Infectious Disease Prevention and Control Act and take the prevention and control measures for the Class A infectious diseases; Administration of quarantine and infectious diseases as stipulated in the Law.

Liang Wannian: In theory to judge the spread of a disease and pathogen, the concept of basic fertility is often used. Simply put, if a patient can spread several people by himself without intervention at all . The current understanding of the disease, its basic fertility, the range of research by different scholars in different countries is probably between 2.2 and 6.4. Some mainstream views believe that its spreading power should be between 3 and 4. This ratio Seasonal flu is higher than SARS, which leads to exponential outbreaks.

Who will support who stays and how to hold the four lines of defense across the country?

The emergence of a large number of patients in a short period of time has a great impact on the local medical system in Wuhan. Under the centralized and unified leadership of the Party Central Committee, the national medical system was mobilized urgently. On New Year's Eve, the first medical team to support Hubei arrived in Wuhan. As of March 8, a total of 346 medical teams with 42,600 medical personnel were supporting Wuhan and Hubei. Because the number of diagnosed patients in Hubei is also increasing and continuing to be high, medical resources are scarce, rescue materials are urgent, and the Party Central Committee urgently deploys and coordinates 19 provinces to support 16 cities in Hubei Province except Wuhan. Support staff and local staff carry out epidemiological investigations, community prevention and control, and treatment of severe and mild illnesses.

Liang Wannian: When we adjusted, we considered the four lines of defense across the country. We regard Wuhan, Hubei as the first line of defense and a central line of defense. Use the capital Beijing as the second line of defense. Some provinces around Wuhan include Zhejiang and Shanghai as the third line of defense. Other provinces across the country serve as the fourth line of defense. Each line of defense has specific and different allocations, strategies and measures of specific medical resources. At the same time, we have comprehensively considered the epidemic situation in each province, and the medical and health resources in each province, especially the number and structure of doctors, and combined these two effectively to make some preliminary judgments. What kind of epidemic will it occur in the future? What is the biggest medical demand? On this basis, we have targeted medical staff from various provinces.

"Two Mountains" and the shelter hospital reflect China's speed, strength and wisdom

Race against time and race against death. When the beds in Wuhan were seriously insufficient and there was an urgent need to expand the beds, more than 40,000 construction workers came from all directions and started construction day and night. Hundreds of millions of netizens "cloud supervisors" built two hospitals in Vulcan and Raytheon in more than ten days. Then, in a very short period of time, Wuhan built 16 square cabin hospitals one after another, and started the general assault of "receivables and full receipts".

Liang Wannian: How to expand the bed? We soon built Vulcan Mountain and Thor Mountain Hospitals. How to quickly convert some existing buildings? In fact, this is borrowed from the tent hospital in the past emergency medical rescue, that is, the patient can be admitted and even surgery can be performed by opening the tent. Our gymnasium exhibition center is tall and spacious. With a little renovation of water, electricity, and lighting, it can quickly become a hospital. In fact, it is very difficult and demanding. It is not only to build a space for him to have a bed to sleep, but more importantly, this bed must have certain treatment facilities, corresponding supporting measures, and ventilation. There are heating and so on, these measures must keep up. At the earliest time, in 29 hours, three square cabin hospitals were built. This shows the speed of China, the strength of China and the wisdom of the Chinese.

Traditional medicine plays a role in the integration of Chinese and Western medicine treatment has become a bright spot

After a series of combined measures, Wuhan and even Hubei have truly realized early detection, early reporting, early isolation, and early treatment. The principle of “patients, centralized experts, centralized resources, and centralized treatment” will concentrate critically ill patients to the medical institutions with the strongest comprehensive strength, and high-level expert teams will implement “one person, one policy” for treatment. In the entire process of epidemic prevention and treatment, the combination of Chinese and Western medicine has become a bright spot.

Liang Wannian: For the treatment of new coronary pneumonia in our country, the combination of Chinese and Western medicine has been used extensively and has achieved very good results, especially in the treatment of mild patients, the effect has been very obvious. The well-being of the Chinese. In addition to using Western medicine for treatment, we have used our own traditional medicine for treatment, which has played a very important role.

From questioning to admiration, what changed the attitude of the experts of the WHO team?

Starting from January 3, 2020, China will regularly communicate with the World Health Organization, relevant national and regional organizations, and China ’s Hong Kong, Macao and Taiwan regions in a timely and proactive manner. On January 5, the World Health Organization notified for the first time cases of unexplained pneumonia reported in Wuhan, China. In mid-February, China and the World Health Organization formed the China-WHO New Coronary Pneumonia Joint Experts Investigation Team and went to Beijing, Guangdong, Sichuan and Hubei for a nine-day field investigation. The team members include scientists from the US Centers for Disease Control and National Institutes of Health. Liang Wannian served as the Chinese team leader of the joint investigation team.

Liang Wannian: I have been in contact with them for nine days. They have made several changes. When they first came, they always felt that the strictest containment strategy adopted by China could be effective? They doubt whether this containment can be operated and can it be implemented on the ground? After they came to look, they believed. The second is for Hubei, especially Wuhan, can such a large medical pressure be handled? Will it cause social chaos and panic? Because the slogan we mentioned at that time was to receivable and remedial. They saw our designated hospital and our square cabin hospital, and they believed it. The third is the acceptance of the strict social control measures by the common people. When they went to Wuhan, they were very moved when they saw that the people sacrificed themselves and were isolated at home. This is what they feel the most.

Producer 丨 Zhang Shifeng

Edit 丨 Hongfei Zhang

(Editor Han Yonghui)