News 1 + 1 丨 How to treat the newly added local cases? How to implement normalized prevention and control? Bai Yansong Wu Zunyou, an epidemiologist at the China Center for Disease Control
Since May 7, Shulan City, Jilin Province has added 15 locally confirmed cases; on May 10, Shenyang City, Liaoning Province has added a new local confirmed case. The case was taken by high-speed train from Jilin City to Shenyang on May 5; Since May 9, Wuhan City, Hubei Province has newly confirmed 6 cases, all from the same community. How to treat these new local cases? How to implement normalized prevention and control of the epidemic situation? "News 1 + 1" Bai Yansong, Wu Zunyou, chief expert in epidemiology at the China Center for Disease Control and Prevention, interprets it for you.
New coronary pneumonia is far more complicated than SARS. Sporadic case reports are expected
Wu Zunyou: This situation is expected. When we first connected to "News 1 + 1" on January 30, I told everyone that the tailing will be quite long, and now it has been confirmed that the tailing is quite long. When we see daily sporadic case reports, especially reports of positive testers, we know that sporadic occurrences will occur. Regarding "zero cases", everyone has a different expectation. During the SARS epidemic in 2003, when there were zero cases and no new reported cases occurred after the double clearing, many people remembered the history or experience of the SARS epidemic. In my mind, when the new coronary pneumonia appears "zero", we also hope to be like SARS. New coronary pneumonia is far more complicated than SARS, and our knowledge about it is still very limited. From the perspective of its mode of transmission, difficulty in prevention and control, and clinical manifestations, it is much more complicated and difficult than SARS. Its understanding has been further improved.
Jilin Shulan's first diagnosed laundry worker is not necessarily the source
Wu Zunyou: After the outbreak of the epidemic, the epidemiological investigation tried to find the source, and it was indeed difficult to find the source. Yesterday, the Chinese Center for Disease Control and Prevention also sent professionals to Shulan to assist in the investigation. From the current situation, it is not easy to judge whether the first patient diagnosed is the source patient. This lesbian is a laundry worker. At present, there is a speculation that she may be the source of this gathering epidemic, but there is another possibility that there is still a real source that has not been discovered, which may be caused by this time. The main source of transmission, these require more epidemiological investigations, or require biological means to analyze and speculate. There is also a possibility that the incubation period of some patients may be longer than that of this laundry worker. He may have transmitted it to this laundry worker, and the latent period of this laundry worker is relatively short, which may occur in two or three days, and the real source The patient may become ill seven or eight days after the infection, and the incubation period is infectious. If this is the case, it is very difficult to judge who passed it to whom.
Is the diagnosed patient of Jilin Shulan related to the Russian entry patient?
Wu Zunyou: What needs to be done right now is to analyze the genetic sequence of the viruses of this group of patients with aggregated cases and the viruses of patients entering from Russia to see their homology. If the homology is very consistent, it can be presumed It is related to the case of Russian entry cases, and it is difficult to determine the specific relationship.
Jilin Shulan diagnosed that the laundry worker was infected by clothes, is it possible?
Wu Zunyou: A few days ago, there was a research report about the virus content in the air. In the space where the isolation suit is replaced, the virus content in the air is higher. That is to say, if the medical staff is in the ward, his clothes may be infected with virus. During the process of taking off, the virus content in the air is higher. Does this suggest that there are similar situations in Shulan's cluster cases? These also provide a new idea for our analysis.
Bai Yansong: There is a folk saying that the case in Shulan is now determined to be a laundry worker of the Public Security Bureau. The Public Security Bureau will be involved in picking up people (Russian immigrants) from April 8th to 30th. Are people infected during the public security process?
Wu Zunyou: There is such a possibility.
Tips for confirmed cases from Jilin to Shenyang: take protective measures to take closed transportation
Wu Zunyou: During our travels, we are likely to encounter infected patients, or patients in the incubation period. It also reminds us that we must adhere to protective measures in a traffic-tight environment. For such a case, he will have many infected people along the way, and it also reminds us that it is very difficult to investigate the close contacts completely, it is also very difficult, there may be missing close contacts, and the missing close contacts If he is infected or sick, it will cause a new mass epidemic.
Normalized epidemic prevention does not mean that the epidemic situation has no daily protection measures and must be done
Wu Zunyou: For normalization, everyone may have a different understanding. Many people understand that is normalization an epidemic? Is it possible to completely return to the living conditions before the new coronary pneumonia epidemic occurred? This is not what it actually means. The so-called normalization means that we can basically resume normal life and work when we take protective measures. In a normalized environment, we still need to follow the requirements of the prevention and control guidelines in the places where people gather and in closed places. It is still necessary to take protective measures, especially when we are traveling, we must pay attention to protection.
Why is the first confirmed case in Wuhan Dongxihu Community so long from March to May?
Bai Yansong: The day before yesterday, Wuhan announced a confirmed case in the community. The initial judgment was that the cause was a previous community infection. However, this case had symptoms in March, and then the symptoms disappeared. Until now, the diagnosis has been confirmed. How to analyze his history of onset for more than two months?
Wu Zunyou: We have also noticed that this patient actually has more than one such case in Wuhan, and some may have a course of 30 days, 40 days, or even 50 days. For the rehabilitation of patients with new coronary pneumonia, it mainly depends on the patient's immunity and resistance. The patient's immunity is strong, he can remove the virus in a short time. If the patient's resistance is weak, then he cannot remove the virus. The virus may stay in the body for a long time. This shows that when people are old and have low immunity, the course of the disease may be very long, and there may be recurrence. This is also a place where new coronary pneumonia is different from SARS and other diseases. According to the analysis of the disease spectrum of different age groups, the more young people, especially children, have a higher proportion of asymptomatic infections, and the younger people have milder symptoms, all of which point to the symptoms presented by the patient and the speed of recovery. Related to immunity.
What reminder does the 6 new cases in Wuhan come from the same community?
Wu Zunyou: As long as there is no real "zero" in the community, or there are still positive tests in the community (all have risks). A considerable number of people who test positive and have asymptomatic infections have very mild symptoms that he can't feel himself. These are still infectious. After he infects the patient, the infected person may or may not have symptoms. With or without symptoms, he still has the risk of spreading to other people, and the community should still be vigilant and strengthen prevention.
Mainly for nucleic acid detection in key areas and key populations
Netizen: The five newly confirmed cases in Wuhan yesterday came from the Changqing Street community. Does this mean that carpet screening is needed for asymptomatic patients? Do we need to perform nucleic acid testing on the entire population to screen for asymptomatic infections?
Wu Zunyou: Is everyone doing large-scale screening nucleic acid tests? In fact, it is not necessary, mainly in key areas and key people. As the netizen said just now, large-scale screening is still necessary. In those communities without cases, there is no need for everyone to do screening, mainly for key posts, key populations, and key communities. People come for large-scale screening.
Wuhan's ultra-long-onset confirmed cases suggest that the cunning nature of the new coronary pneumonia virus cannot currently determine how it coexists with humans
Wu Zunyou: Our knowledge of the new Pneumococcal pneumonia virus is still very limited. This limitation prevents us from researching or determining the way in which it will coexist with humans in the future. At present, it will not disappear as quickly as SARS. It is uncertain how long it will coexist with humans or coexist with us in a form of epidemic. On the other hand, its clinical manifestations are also very special. The case of the 80-year-old man you just mentioned also shows that its clinical manifestations are very special. These are our understanding of the new coronary pneumonia virus.
Sporadic cases will no longer cause a certain scale of epidemics
Wu Zunyou: I don't think there will be a small peak. After more than three months of hard work, we have succeeded in controlling new coronary pneumonia, and we have achieved at least a lot of experience. These experiences will not cause sporadic cases to cause a certain scale of epidemic. Because our surveillance system, as long as the cases are found, timely investigation and timely tracking, the epidemic can be extinguished quickly, and there should be no small epidemic peaks.
Netizen: What should I do if the weather is getting hotter and more people cannot wear it?
Wu Zunyou: The question of masks is indeed a very complicated and scientific issue. For open areas, in the family, you can not wear masks; in public places, especially in closed environments, even if it is very hot, It is still necessary to wear a mask. There is no indication that after the weather is hot, there will be no transmission of new coronary pneumonia. Regarding such data, the weather is not hot enough that we cannot wear masks. We still have to overcome some difficulties and insist on wearing masks. Before there is no definite evidence, we cannot take off the mask completely.
Does inaccurate temperature measuring gun affect the prevention and control effect?
Wu Zunyou: We are not the only ones who rely on body temperature measurement and symptom monitoring. Some patients have fever, some do not have a fever at the beginning, and some cough and fatigue. The monitoring of these comprehensive symptoms is also very important.
The protective measures cannot be given up when the infectious personnel gather when the patients with new coronary pneumonia have no clinical symptoms
Wu Zunyou: I want to remind you that New Coronary Pneumonia is particularly contagious, especially when the patient has not yet developed clinical symptoms. The first one or two days will be contagious. For everyone, to prevent new coronary pneumonia, we still have to persevere, and in places where people gather, we still have to insist on wearing masks. These protective measures can not be given up.