Newsweek丨Why didn't the second wave of epidemic occur in China?

　　In almost two days last weekend, 138 new cases of asymptomatic infections were added to the Kashgar area, and everyone’s heart seemed to tighten again, but in the next four days, the Kashgar area was completed. More than 4.7 million nucleic acid tests were conducted, and the epidemic was controlled within a certain range.

　　Some people commented that in China, the time it takes to control the sudden outbreak is getting shorter and shorter.

This is closely related to our mobilization capabilities, isolation measures, especially nucleic acid testing capabilities.

　　However, apart from facing sudden local epidemics, how do we

?

Completed testing of more than 4.7 million employees in 4 days

　　Since the first case of asymptomatic infection was detected in Kashgar, Xinjiang last Saturday, the local calm under normalized prevention and control has been broken.

From the allocation of medical resources to the prevention and control of the community at the grass-roots level, many people have turned their attention to this western city.

On the evening of the second day after the first case of asymptomatic infection was discovered, the Information Office of the People's Government of Xinjiang Uygur Autonomous Region held the first press conference of the epidemic to inform the traceability of the current situation.

　　After the first case of asymptomatic infection was detected, Kashgar area began free nucleic acid testing for all employees. On the second day, the number of asymptomatic infections increased to 138, and on the third day, it increased to 164. With the scale of nucleic acid testing With the expansion of the disease, the scope of infected persons has gradually become clear.

Abu Duke Remu, an employee of a factory in Shufu County, said:

Free nucleic acid testing is good for us and has a sense of security. We must protect ourselves and cooperate fully.

　　It is reported that the total number of people to be tested in Kashgar is over 4.74 million. In order to complete the test as soon as possible, the Xinjiang and Kashgar epidemic prevention and control headquarters have transferred nucleic acid testing personnel from Aksu, Hotan and other places to support Kashgar. Foreign aid has been injected. Let the local nucleic acid detection capabilities be improved.

Pati Guli, a nurse at the Uyghur Medical Hospital of Shufu County:

There are 10 people in our team. Nucleic acid testing will start at 10:30 (on the 27th). About 500 people can be collected in one hour.

During the sampling process, we have all three levels of protection to ensure the safety of the whole process and the effective samples.

The average sampling time in these two days exceeded 10 hours.

　　In order to improve the detection efficiency, the local adopts the "mixed test" method of combining 5 people's throat swabs into one tube. If 5 people's samples are positive, they will be tested separately.

By October 27, the Kashgar area had completed the inspection of more than 4.7 million employees.

Wang Xijiang, Deputy Director of the Center for Disease Control and Prevention of Kashgar:

After 3 days of continuous fighting day and night, by 17:00 on the 27th, the nucleic acid test of all employees in Kashgar was completed. Except for the reported 183 people in Shufu County, the rest were all positive. Negative.

At present, the possibility of the spread of the epidemic can be basically ruled out.

　　Although most of the nucleic acid-positive persons detected this time are asymptomatic infections, it is still possible to turn into confirmed cases in the future.

This also tests the deployment of local medical resources. At present, the National Health and Construction Commission has sent experienced experts such as Qiu Haibo and Zheng Ruiqiang to Xinjiang for support.

Wang Lixia, head nurse of the ward of the Xinjiang New Coronary Pneumonia Targeted Treatment Hospital:

Most of our medical staff have participated in the rescue work during the Aid Hubei and the last Urumqi epidemic, and have rich experience in fighting the new coronary pneumonia virus.

Yang Yining, member of the Xinjiang New Coronary Pneumonia Medical Treatment Expert Team: After the

expert's study and judgment, it was found that many of our patients in this epidemic are young and middle-aged (mainly), mainly asymptomatic infections.

At present, precise and scientific treatment has been carried out based on the treatment principle of one person, one policy, both priority and combination of Chinese and Western medicine.

We have established a corresponding early warning system and early warning indicators, which is to closely observe and prevent the transition from mild to severe.

　　At the same time, the material security of Kashgar residents has also attracted much attention.

Every morning, the Kashgar Cookland Agricultural Products Wholesale Market will usher in the peak of entering the market. Large trucks full of fresh vegetables will enter the market one by one after being killed.

Zhao Dan, a merchant in the Kashgar Cookland Agricultural Products Wholesale Market:

My truck is about 30 tons

I come from Aksu. There are six or seven varieties of pickled peppers, spicy peppers, and carrots. Basically, one truck per three days and two days, the quantity is sufficient. , To ensure the supply of vegetables.

　　The reporter visited and learned that the recent daily trading volume of the Kashgar Cookland Agricultural Products Wholesale Market was about 800 tons. As of October 28, the inventory of the three primary vegetable wholesale markets in Kashgar was more than 4,000 tons. For local residents in Kashgar , The supply of grain, oil, meat and basic daily necessities is sufficient; and for foreigners visiting Kashgar, the air, railway, and roads in the Kashgar area are all normal.

Zhang Sheng, deputy general manager of Kashgar Shache Airport, Xinjiang Airport Group:

All flights are entering and leaving the port normally. Check-in counters have been added to avoid

passengers. At the same time, all the commuter buses between the airport and Kashgar are also in normal operation. .

　　In this Kashgar epidemic, no large-scale "closed city" measures were taken in the entire region, but scientific personnel control was carried out while ensuring safety.

It is understood that people who come to Kashgar from other places do not need to be isolated or carry nucleic acid test reports. They only need to implement measures such as wearing masks, taking body temperature, and scanning the health code; personnel who leave Kashgar can also leave normally with a negative nucleic acid report within 7 days.

Bai Yansong: In

this epidemic in Kashgar, the initial asymptomatic infections were found during routine nucleic acid testing, but it was relatively rare that within two days, 138 cases of asymptomatic infections were found at once, even In the first two days, there has not been a confirmed case, and the proportion of asymptomatic infections is increasing in our mid-to-late epidemic prevention and control. This aspect is closely related to the improvement and popularization of our nucleic acid testing capabilities.

But on the other hand, it is also inseparable from the extremely cunning virus. Asymptomatic infection is a safer way to survive, but the threat to us is too great. How should we face it?

Why is the proportion of asymptomatic infections high?

　　The high proportion of asymptomatic infections is an important feature of this outbreak in Shufu County, Kashgar Prefecture, Xinjiang.

Beginning with the discovery of the first asymptomatic infection at the age of 17, in the three days before October 24th, 25th, and 26th, 164 local cases were all asymptomatic infections.

Wang Xijiang, Deputy Director of the Center for Disease Control and Prevention of Kashgar Prefecture, Xinjiang: In

this outbreak in Shufu County, the proportion of asymptomatic infections is high. This is largely due to our timely and efficient nucleic acid testing. Infected patients were

before they developed symptoms. Through nucleic acid detection and active screening.

This is very beneficial for us to control the epidemic.

　　Some people who are asymptomatically infected by the new coronavirus will never get sick or show symptoms, and some will eventually get sick after passing the incubation period.

On October 27, the fourth day of the outbreak in Shufu County, 22 asymptomatic infections were converted to confirmed cases.

Lu Hongzhou, a member of the National Health Commission’s Disease Prevention and Control Expert Committee: The

epidemic was discovered at an early stage, so most of these early infected people were in the asymptomatic period and the incubation period, etc., so this factory is also a young man. You know that most young adults have no symptoms or are mildly ill after being infected. This is why they were found to be asymptomatic infections at first, but after a period of time, basically, there will be a certain proportion of asymptomatic infections. Symptomatic infected persons develop symptoms.

　　In the eyes of disease control experts, judging from the recent rounds of epidemics that have occurred in China, the high proportion of asymptomatic infections and mild patients has become a common feature.

Zeng Guang, a member of the high-level expert group of the National Health Commission:

There are few critically ill patients and almost no deaths, but asymptomatic infections account for a large proportion. Our trend has been continuing this trend.

The situation in China is different from abroad. In foreign countries, the epidemic situation is always on a high platform. It is spreading. In China, it is cleared every time, and then it will be cleared after partial clearing. The source of each case found is Those who are far away from high-risk groups, there are few elderly people, few chronic patients, and more young adults, so the symptoms are relatively mild. We are cautiously optimistic about the situation in China, so we must clear it when we come. If you don’t clear it, it will become popular. , It must involve high-risk groups.

　　Asymptomatic infection can also be the source of infection, and because there are no symptoms, it is not easy to be detected, so it should not be taken lightly.

In this outbreak in Shufu County, Kashgar, the first case of asymptomatic infection was found in Shufu County's weekly "should be checked" nucleic acid test.

Lu Hongzhou, a member of the Expert Committee of Disease Prevention and Control of the National Health Commission:

After the last outbreak in Urumqi (July), especially in many port cities along the border, regular and This kind of periodic mixed inspection, under the condition of routine testing, found this case of positive infection in a 17-year-old child.

　　In June of this year, the State Council's Joint Prevention and Control Mechanism Comprehensive Team requested that nucleic acid testing for eight key groups of populations be "examined as necessary."

At the end of September, Qingdao Port Dagang Company found 2 cases of asymptomatic infections during the routine test, and these two loading and unloading workers were included in the regular inspections of the "all inspections required".

In the October outbreak in Qingdao Chest Hospital, the first two cases of asymptomatic infection were discovered during routine nucleic acid testing before hospitalization.

These cases show that regular nucleic acid testing and monitoring of key populations is an important measure to eliminate hidden dangers under the normalization of the epidemic.

Zeng Guang, a member of the high-level expert group of the National Health Commission: It

can be said that this is the case in our country. More than 999% of the people are susceptible. Just so many susceptible people are equal to dry firewood. You, a patient, is a torch. It burns a lot. If you find out that he (patient) controls him, he won’t burn anymore. Why is there no second wave of epidemics in our country? In fact, any epidemic may happen (trigger) a second wave. We all If it died, it was quickly cleared.

　　To quickly respond to the epidemic, higher requirements are placed on disease control systems at all levels, especially grassroots disease control teams.

In terms of research and judgment of the epidemic situation, on-site epidemiological investigations and laboratory testing, etc., making up for the shortcomings of grassroots disease control talents is an inevitable requirement for improving the major epidemic prevention and control system and improving the public health system.

Zeng Guang, a member of the high-level expert group of the National Health Commission:

Our on-site epidemiology training is still not enough. We should have such talents in every county. We now only have a few hundred graduates, and the graduates are highly concentrated in the east. Regions, concentrated in big cities.

The more the frontier, the greater the problem of public health security, where the strength is the weakest, the staff is the least, the treatment is the lowest, and the people are the least able to retain. You can see that there are problems there, and you can only rely on temporary help from the mainland, but what about the locals? In this way, how strong local people are and how they can retain talents, this needs to be changed.

Bai Yansong:

From now on, the battle against the new crown virus may be a relatively long process, and our understanding of it does have a process from shallow to deep.

As early as January 29 this year, a doctor at Tongji Hospital in Wuhan issued a warning that asymptomatic infections can also infect people, but our understanding of asymptomatic infections has gone through a long time.

When it comes to the source of infection, looking back at the clustered epidemic situation in Beijing's newly developed market, the source of the virus is also very likely to be cold-chain imported foods in high-risk areas overseas.

After half a year, who would have thought of this source of infection?

So what should we do now?

Strictly control the import of the food chain

　　On Thursday, the latest progress in tracing the source of the newly-occurring virus in Beijing has been made. Multi-departmental studies have found that the source of the virus is most likely to be imported cold-chain food in areas with high epidemics abroad. Cold-chain transportation may be a new way for the spread of the new crown virus. The capital has provided a basis for optimizing the normalization of epidemic prevention and control.

More than four months have passed since Beijing ended 56 days without new local confirmed cases to the new progress in virus traceability.

Zeng Guang, a member of the high-level expert group of the National Health Commission:

This investigation process, called medical detectives, is the same as public security detectives, and even more difficult. We are in this detective process and require detailed epidemiological investigations.

　　Over the past few months, in addition to spending time and effort to find the source of the virus to block its spread, the monitoring and early warning of the virus have been added layer by layer to achieve real-time monitoring.

The day before the press conference, the General Administration of Customs took emergency preventive measures on fishing boats and cold storage in the two countries because of the positive detection of new coronavirus nucleic acid in the outer packaging samples of aquatic products in the cold storage.

Lu Hongzhou, a member of the National Health Commission’s Disease Prevention and Control Expert Committee: The

virus has a characteristic. The lower the temperature, the longer it can survive. These workers engaged in seafood processing have been infected, and there is no better control in the local area. A sneeze hit the outer packaging, resulting in a virus on the outer packaging.

Wu Zunyou

,

to prevent importation, we must guard against both people and objects, especially imported frozen seafood and meat pollution.

The environment of the enterprise must be tested regularly, and the employees must be checked for nucleic acid regularly.

　　In mid-October, during the traceability investigation of Qingdao's new crown pneumonia epidemic by China CDC, live new crown virus was isolated on the outer packaging of imported cold chain food. This was the first time in the world, and it also provided an important chain of evidence for the traceability of the epidemic in my country.

According to incomplete statistics, since July, at least nine places in China have successively tested positive for the new coronavirus on imported frozen food or packaging.

Recently, relevant departments have issued two technical guidelines for this, requiring health tracking of relevant practitioners and strict disinfection of the outer packaging of high-risk imported cold chain foods.

Lu Hongzhou, member of the National Health Commission’s Disease Prevention and Control Expert Committee:

We can use our prevention and control experience to move the barriers forward to these other companies, and the source will be controlled.

　　The cold chain supervision is gradually upgraded.

On Monday, the Beijing Municipal Administration of Market Supervision and the Beijing Municipal Bureau of Commerce jointly issued the "Notice" to establish a unified "Beijing Cold Chain Food Traceability Platform", which will be used since November 1.

Yang Yang, the person in charge of the Beijing Fresh Food Warehouse of an e-commerce platform: For

products in high-risk areas, we need to look at its quarantine report. The nucleic acid test proves to be negative. After the platform of Beijing Cold Chain, the QR code of Beijing Cold Chain is generated. Commodity storage.

　　To put it simply, overseas cold chain food "entry", production and processing, circulation and sales, logistics and warehousing, etc., and then to the consumer's table, all links require input of information, and consumers can scan the code to view.

Lu Hongzhou, member of the National Health Commission’s Disease Prevention and Control Expert Committee:

We have

the fence for epidemic prevention even more. If we can trace the source through the QR code, we can quickly locate and retrieve all this batch of related goods. , You can avoid the spread of this epidemic.

Zeng Guang, a member of the high-level expert group of the National Health Commission:

I named it

.

We used to know three-level prevention. Primary prevention is to prevent the occurrence of diseases. It refers to the common people-wear masks and get vaccinations; secondary prevention is to find that the epidemic situation is quickly controlled; and for tertiary prevention, problems have occurred, how to minimize losses .

There was also a zero-level prevention before. For example, after we traced the source, we discovered (virus) in the management of food hygiene.

　　Cold chain forward prevention, cold chain QR code traceability, normal epidemic prevention and control need to be more timely and accurate.

Public health experts said that in the future construction of a healthy China, prevention will be placed in a more important position. More effective "prevention" and strengthened monitoring and early warning will become a solid guarantee for building a strong public health system.

Zeng Guang, a member of the high-level expert group of the National Health Commission:

We are improving. We have accepted the early lessons of Wuhan. In our newly revised infectious disease prevention and control law, we must attach great importance to what is encouraged, that is, no matter where the information comes. Don't talk about whether it is a rumor. You have to figure out whether there are reasonable elements in it and whether there are elements that can be suspected.

Even the common people have the right to report the epidemic. This kind of thinking is a fundamental way to increase the sensitivity of epidemic reporting.

Lu Hongzhou, a member of the National Health Commission’s Disease Prevention and Control Expert Committee:

I hope that our early warning and forecasting system will be as accurate as weather forecasts in the future. We need to know what pathogenic microorganisms are in our surrounding environment that may potentially infect us humans of.

These pathogenic microorganisms are identified, identified and isolated. We use this pathogenic microorganism to conduct animal experiments, pathogenesis research, vaccine research, and drug research. Then, once an epidemic is really caused in the future, we can have drugs and vaccines. Up.

Bai Yansong:

Under the background that the 2020 epidemic hits humanity, China, which bears the brunt of the new five-year plan, will naturally further put people’s life safety and health in the first place, and prevention has also been given priority. In a more prominent position in the construction of Healthy China.

It can be said that since there can be no well-off without the health of the people, there can be no modernization in China without the modernization of the public health system. We can look forward to the future more optimistically!

　　Producer丨Xu Xin

　　Video production丨 Zhang Dapeng, Guo Jialing, Xu Xin

　　Edit丨Ma Yichen