Is national nucleic acid testing necessary? Can full staff inspection bring full staff safety? Bai Yansong asks Feng Zijian

  A few days ago, the whole city of Wuhan launched a "ten-day battle" for nucleic acid screening of all new coronaviruses. On the evening of the 14th, Feng Zijian, deputy director of the Chinese Center for Disease Control and Prevention and the Joint Liaison Group of the State Council ’s Joint Prevention and Control Mechanism, made a guest appearance on the "News 1 + 1" program to introduce the relevant situation of nucleic acid detection in Wuhan and responded to the hot topic of the epidemic.

1.Wuhan conducts nucleic acid testing for all staff, what is the contact group's assessment?

  Feng Zijian: On March 8, after Wuhan achieved zero new cases of confirmed cases, medical institutions have been expanding the scope of nucleic acid testing. Since this time, there have been positive testers every day, they are asymptomatic infections. Recently, there has been another cluster epidemic outbreak in Wuhan, which indicates that the early virus transmission in Wuhan has not been completely blocked. The measures taken by Wuhan City for the detection of nucleic acids by all employees are positive actions, and they are very intensive in social mobilization.

2. Can all nucleic acid tests identify all potential patients?

  Feng Zijian: Expanding the test will definitely find more people with asymptomatic infections. What needs to be seen is that virus transmission is a dynamic process, and detection is done at a point in time. Therefore, it is not easy to realize all the infected persons or the source of infection through one-time, one-time detection.

  3. According to reports, the cost of nucleic acid testing for all staff in Wuhan is about 2 billion. If promoted nationwide, the cost is about 280 billion. Some analysts believe that compared with the huge loss of epidemic prevention and control, the testing cost of 280 billion can be afforded. Can all staff testing be promoted nationwide? Will full inspection bring security to all employees?

  Feng Zijian: First of all, there is no need to do nationwide testing. At present, China has deployed relevant arrangements with a very wide coverage, which can play a very good role in detecting potential sources of infection and infected people.

  Secondly, expanded testing is conducive to discovering potential sources of infection. In addition to factors such as economics and efficiency, we must also consider our testing capabilities. Even if nationwide testing is carried out, all sources of infection or infected persons cannot be fully discovered.

4. Is there a more optimized solution for expanding the nucleic acid detection range?

  Feng Zijian: At present, we will focus more on the detection range and target the priority detection groups. Older urban areas, communities with densely rented foreign residents, urban-rural junctions, and residential areas around large markets can be given priority testing; in areas where positive testers or asymptomatic infected persons are found, the scope of testing has also been expanded. Help to improve the detection efficiency.

  Since the 9th, six local cases have appeared in Dongxihu District, Wuhan City, Hubei Province, all of which have appeared in the same community. The first patient was 89 years old and had a history of hypertension, cerebral infarction, and hepatic cysts. He had not been out of the community after the Spring Festival. He had fever symptoms in March and cured himself by taking medication. The nucleic acid test was positive in May. Subsequently, five people who were in close contact with each other were successively infected.

5. Was the 89-year-old patient in the Wuhan epidemic epidemic a source of infection?

  Feng Zijian: In this clustered epidemic, 6 cases were confirmed cases and 7 cases were asymptomatic. From the current analysis results, the 89-year-old patient's first case, the disease manifestation in March may not be related to new coronary pneumonia, may be infected with new coronary pneumonia in April.

  After investigation, the first case was an asymptomatic infected person who was found on April 25. He is a tenant living in a bungalow in the community and is a foreigner who came to Wuhan, but the source of his infection is still uncertain. According to analysis, the first case of asymptomatic infection introduced the virus into the bungalow area, and first transmitted it to the wife of the 89-year-old patient. The old couple had more contact with the tenant on weekdays, and the interaction was more active, which led to subsequent outbreaks.

6. A few days ago, there were 6 new local cases in Dongxihu District of Wuhan, and about 70,000 people related to them will be tested. What are the results?

  Feng Zijian: At present, 13 confirmed patients and positive detections have been found, mainly concentrated in an old community in the Dongxihu District. There is a bungalow in this community. Tenants who live in Wuhan from other places live in it. These 10 positive testers are all bungalow tenants. In addition, three cases of asymptomatic infections were found in the two residential buildings adjacent to the bungalow, and the cases were distributed in a foci. The probability of this epidemic spreading further is very low, and there is no need to over-interpret and worry.

  What needs to be seen is that the expansion of the detection range is a process. In the early stage of the cluster epidemic in Wuhan, the detection was mainly aimed at close contacts of these confirmed cases or asymptomatic infected persons, and community residents living very close to it . On this basis, the detection scope has been extended to the relevant personnel in the community and surrounding areas where the bungalow area where the epidemic occurred, including a very large building materials market. In general, the total number of tests is very large, about 60,000 to 70,000. At present, 20,000 to 30,000 tests have been completed. At present, the test results are all negative, and no new asymptomatic infections or positive detections have been found.

7. The prevention and control of epidemic situation in Wuhan is unprecedented, why is the epidemic situation repeated? What characteristics does this reflect?

  Feng Zijian: The new crown virus continues to show complexity, the most prominent feature is the recessively infected people, they are light cases, but play a very important role in the transmission process. So far, we have not completely blocked the spread of the virus. It is very difficult to completely block the spread of the virus.

8. Recently, there have been several local epidemic outbreaks in China. Do our prevention and control targets need to be adjusted in time?

  Feng Zijian: At present, most areas of China have basically blocked the local spread of the virus, and new outbreaks have rarely occurred, especially clustered outbreaks, which shows that the early transmission has been blocked. The clustered epidemic in Suifenhe, Shulan and other places is mainly caused by the subsequent clustered transmission caused by the imported virus.

  In the case of strict prevention of the epidemic situation, the domestic epidemic prevention and control measures are very similar to the game of "playing hamsters". To find together, we must deal with it accurately. With regard to the spread of the epidemic in the world, our prevention and control measures also need to consider the economic and social affordability, and then establish and adjust prevention and control goals and strategies.

9. How to judge the current epidemic prevention and control situation?

  Feng Zijian: First of all, the main threat now comes from overseas imports, and occasionally it will cause small-scale gathering epidemics. We have taken very strong countermeasures. For most regions, the risk of public infection and morbidity is very low.

  Secondly, the epidemic situation is continuing to spread around the world. In the future, it may also face the pressure of prevention and control of the global epidemic situation, or even the pressure of importing the impact of the epidemic situation. We must develop good hygiene habits, and the protective habits we developed some time ago should be maintained, including wearing masks, maintaining social distance, reducing the number of people gathering places, the elderly to minimize going out, washing hands, ventilating, coughing and sneezing. Cover, etc., let these hygiene habits become the new normal of our lives.