(Fighting New Crown Pneumonia) "Drifting Islands": What kind of warning does the "Diamond Princess" cruise ship give?
China News Agency, Beijing, February 23, by title: "Drifting Island": What kind of warning does the "Diamond Princess" cruise ship give?
Author Guo Chaokai Zhang Ziyang Li Jingze
Before stepping down on the "Princess Diamond" cruise, Hong Kong passenger Huang Yaxin decided to put on her makeup in honor of "returning to this world". The sudden outbreak of new crown pneumonia made the luxury cruise ship arrive 15 days later than expected.
Data map: Japan's "Diamond Princess" cruise.
The supposedly joyous trip was "dead in the middle", and the virus spreading around caused many cruise ships such as the "Diamond Princess" to almost turn into "drifting islands", which provided epidemiologically how to prevent epidemics in closed places The observation samples of control work also bring more warnings to the world.
17.1% infection rate does not represent true level of transmission
17.1%-This is the infection rate of the "Diamond Princess" cruise ship currently docking at Yokohama Port, Japan.
On January 20, a patient with New Crown Pneumonia boarded the "Diamond Princess". In less than a month, the New Crown virus spread rapidly in the cruise ship. As of February 20, the Diamond Princess cruise ship with a total number of 3,711 people, a total of 634 passengers were infected with the new crown virus, which means that one out of every six people on the ship is infected, which has also become the most concentrated outside of mainland China. Outbreak area.
On February 19 local time, the stranded passengers of the "Diamond Princess" cruise ship officially started disembarking.
Japanese officials said on the 22nd that 23 of those who had disembarked were not tested for the new crown virus during the medical observation period starting on February 5. According to Tochigi, Japan, a 60-year-old woman from the county disembarked from the "Diamond Princess" on the 19th and was diagnosed on the 22nd.
The high infection rate has drawn much attention to the cruise ship. According to the Japanese Ministry of Health, Labour and Welfare, two Japanese died on the "Princess Diamond" on February 20, both of whom were over 80 years old. This is the first time the cruise has reported deaths. The emergence of deaths is even more worrying about the morbidity of passengers on board, and does the 17.1% infection rate reflect the true level of the virus?
Huang Bo, deputy director of the Institute of Basic Medical Sciences of the Chinese Academy of Medical Sciences, said in an interview with China News Agency that the "Diamond Princess" cruise is a special case and cannot be used as a criterion to estimate the infection rate of new crown pneumonia. "The high infection rate is mainly due to two reasons. One is that there are more elderly people with basic diseases on the cruise ship. The other is that the highly stressed mental state after being quarantined causes the immunity of passengers to decline, which gives the new crown virus the opportunity. Causes a high incidence of disease. "Public data show that passengers aged 60 and over account for about 80.4% of the total number of" Princess Diamond ".
Although the transmission index (R0) of the new coronavirus has not yet been determined, multiple papers from authoritative medical journals such as The Lancet have locked its transmission index between 2.0 and 4.0. In other words, each infected person is expected to The virus spread to another two to four people. Zeng Guang, chief scientist of epidemiology at the Chinese Center for Disease Control and Prevention, said in an interview that from the available information, the "Diamond Princess" cruise transmission index is around 3.0, but its actual transmission index should be greater than 3.0. From this perspective, the infection rate of the "Diamond Princess" cruise ship did not exceed the academic judgment.
Sample of a typical study in an enclosed location
After the outbreak, the Japanese government has formally quarantined the passengers of the "Diamond Princess" since February 5. Three meals a day are provided by the crew on the cruise ship, and passengers stay at home. The joy on board was like a music box with the pause button pressed, but the epidemic was still spreading.
On February 19 local time, the stranded passengers of the "Diamond Princess" cruise ship officially started disembarking.
According to Hu Yuexiang, senior captain and chief trainer of China Ocean Shipping Group, modern ships and cruise ships are highly enclosed places. Ventilation inside the cabin is regulated by central air-conditioning, which is divided into external circulation and internal circulation. The internal circulation system will increase the virus. Risk of transmission.
As a large-scale tourism product, cruise personnel have strong mobility, high degree of aggregation, and strong airtightness. The above characteristics highly match the conditions for aerosol transmission. Some experts here speculate that, in addition to droplet transmission and close contact transmission, aerosol transmission is an important reason for the high infection rate of Diamond Princess.
This speculation was endorsed by Zeng Guang. Previously, Guangguang pointed out that the possibility of aerosol as one of the transmission routes has never been ruled out in China. The sixth edition (trial version) of the New Coronary Pneumonia Diagnosis and Treatment Plan clearly identified the existence of aerosol transmission in the transmission route. Possibly due to the impact of the "Diamond Princess" cruise event in Japan.
At present, most of the information about the "Diamond Princess" is issued by media reports in various countries, and there is no academic professional papers and reports. Zeng Guang believes that professional judgment needs more professional reports to support it. The "Diamond Princess" cruise ship provided a typical research sample for understanding the natural history of the disease epidemic and the prevention and control of the epidemic. Experts are very concerned about this cruise, how the virus spread on the cruise, where it started, what process it went through, how to evaluate the route of transmission including aerosol, and hope that the Japanese government and the public health community can disclose its details as soon as possible. Important for us to understand epidemiology. "
Imperative for international cruise reform?
In fact, the "Diamond Princess" cruise ship is not the only cruise ship in the epidemic. Since the outbreak of the new crown pneumonia outbreak, the "Westerdam" cruise has recently confirmed the first case of new crown pneumonia, and the cruise plans of the "World Dream" and "Aquarius" have also been affected to varying degrees.
The emergence of the new crown virus has given the international community new thoughts on the prevention and control of the cruise industry. Zeng Guang pointed out: "The occurrence of the" Diamond Princess "incident reminds the world that international cooperation is needed to deal with such problems." He believes that the structure design of international luxury cruise ships in the future deserves rethinking and that epidemiology should be equipped on cruise ships And public health experts, and emergency training for crew members.
"In a closed environment like (cruise), if there are experienced epidemiologists at the scene, I don't think the situation will be as bad as it is now." Zeng Guang believes that the "Diamond Princess" cruise event is a disaster for human society. It is also a test. In the future, the cruise industry needs to reach an international consensus and form an international response plan. "It is imperative that cruise structure design reforms be put on the agenda of all parties at an early date."
Ye Xinliang, deputy director of the Shanghai International Cruise Economic Research Center, also said that the next step should be to establish and improve the emergency response plan for public health emergencies on cruise ships, and form a "general plan + customs disposal process + cruise port plan + cruise company plan". . Aiming at the weak link in the previous prevention and control, the relevant inspection equipment of the port was upgraded, and the "joint prevention and control mechanism of the port area" was continuously optimized.
From February 19 to 21, some passengers who had negative nucleic acid test results were allowed to evacuate from the "Diamond Princess" cruise ship one after another. When the passengers finally ended the 14-day "imprisonment" and set foot on land again, they were greeted with a new round of unknown isolation. (Finish)