The phenomenon of Fuyang reappears everywhere, how should we view the new crown Fuyang correctly?

(Fighting New Coronary Pneumonia) The phenomenon of rejuvenation is reappearing everywhere, how should we view the new crown rejuvenation correctly?

　　China News Service, Beijing, January 27th, title: The phenomenon of Fuyang reappears everywhere, how should we treat the new crown Fuyang correctly?

　　Author Guo Chaokai

　　Since January this year, at least seven places including Shanghai, Beijing, and Shaanxi have reported cases of re-yang of new crown patients, and the number of cases is close to 40.

Since last year, South Korea, Cambodia and many other countries have also received and reported cases of rejuvenation of new crown patients.

Why do COVID-19 patients recover?

What is the probability of Fuyang?

Are Fuyang patients contagious?

Experts here authoritatively interpret the issues related to rejuvenation of new crown patients after recovery.

Causes of Fuyang: false negatives?

Second infection?

　　During the epidemic, the phenomenon of Fuyang occurred from time to time.

As early as the end of February last year, Wuhan, Guangzhou and other places reported that a small number of patients were positive for nucleic acid retest after recovery and discharge.

The Shanghai Municipal Health Commission revealed on the 25th that more than 30 cases of Fuyang have been found in Shanghai during the 14-day quarantine period.

　　Why do patients who have recovered and discharged from the hospital have rejuvenation?

The current mainstream opinion of experts believes that “false negatives” in nucleic acid testing and secondary infections are the main reasons for patients to recover.

　　Liu Youning, a well-known respiratory expert at the Chinese People's Liberation Army General Hospital, said in an interview with a reporter from China News Agency that Fuyang can be divided into two major categories. The first category is the early cure, which has turned negative when discharged from the hospital, and turned positive after a short review.

This situation is mostly due to "false negatives" caused by imperfect specimen collection or insufficient reagent sensitivity in the last nucleic acid test.

The second category is when several months have passed since the illness, the nucleic acid was found to be positive again.

There are two possibilities for this situation. One is a second infection. Although there are not many confirmed cases, it does exist.

Second, in some patients, especially those with weakened immune function, the body's immunity and the virus are in a "stalemate" state, causing the patients to carry the virus for a long time.

　　In response to the "false negative" problem, Wang Daming, a researcher at the Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, said that any test has a minimum detection limit.

If the new coronavirus in the patient's body is below the minimum detection limit of the test reagent, it cannot be detected theoretically, resulting in negative nucleic acid.

In addition, the nucleic acid results presented by different detection methods such as throat swabs, nasal swabs and anal swabs are also different.

　　The phenomenon of re-yang caused by secondary infection is also worthy of attention.

On August 24, 2020, the world's first second-infected COVID-19 patient appeared in Hong Kong. The patient was 142 days apart before and after the two infections. Whole-genome sequencing revealed that the two infections had different genetic genetic lines.

The emergence of this case provides a new explanation for the recovery of yang in patients with new coronary disease.

Are Fuyang patients contagious?

　　Zhong Nanshan, an academician of the Chinese Academy of Engineering, once pointed out that most of the so-called "Fuyang" should be nucleic acid fragments rather than the virus itself. At present, most Fuyang patients are not infectious.

Zhang Wenhong, director of the Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, said that Fuyang does not have significant clinical significance and will not cause a large-scale outbreak in the epidemiological history.

　　Are Fuyang patients contagious?

Since last year, the results of follow-up studies in many hospitals may provide some reference.

A study conducted by the joint team of Wuhan Jinyintan Hospital and Peking Union Medical College Hospital on Fuyang patients pointed out that 9 patients had lived closely with their families for 258 person-days before Fuyang, but nucleic acid and antibody tests confirmed no close contact. The person becomes infected.

　　In foreign countries, the local disease control department in South Korea conducted virus isolation and culture on the nasopharyngeal swab samples of 108 Fuyang patients, and the results were all negative.

The Korean Centers for Disease Control and Prevention believes that there is no evidence to show that patients with COVID-19 are infectious.

So far, no cases of infection due to contact with Fuyang patients have been reported in South Korea.

　　In Liu Youning's view, a positive nucleic acid does not mean that the patient has a live virus, but it is clinically difficult to judge whether the virus in the patient's body is alive or dead. Therefore, facing the patient's recovery, we still cannot take it lightly.

Wang Daming also emphasized that as long as the new coronavirus is detected in the patient's body, theoretically there is still the possibility of infection.

How to deal with patients with COVID-19?

　　Previous official data released in May of last year showed that the overall occurrence of Fuyang cases in China is 5%-15%, and the incidence of Fuyang varies greatly in different places.

　　Now it has been more than half a year since the release of the data. With the gradual in-depth study of the new coronavirus and the improvement of treatment methods by scientists, has the probability of rejuvenation of patients with new coronavirus reduced?

Wang Daming said that the medical resources in the early stage of the epidemic are relatively tight. In order to treat as many patients as possible, patients can be discharged after their symptoms are reduced and meet the discharge standards. Therefore, the early recovery rate is slightly higher.

At this stage, whether it is the cure and discharge standard or the follow-up follow-up after discharge, it is more in place than before. In theory, the rate of rejuvenation will decrease.

　　With the normalization of epidemic prevention and control, how should localities respond to the challenges posed by Fuyang patients?

Tong Zhaohui, an expert from the New Coronary Pneumonia Medical Treatment Group of the National Health Commission of China, gave advice.

He pointed out that most Fuyang patients do not have clinical symptoms such as respiratory tract and fever.

In the face of Fuyang patients, they should first be isolated again, and then recheck blood routine, nucleic acid, CT imaging and other indicators, and be discharged after the 14-day isolation period expires and the nucleic acid turns negative.

The interviewed experts also emphasized that rejuvenation of COVID-19 patients is a small probability event, and the public need not panic too much about the rejuvenation of COVID-19.

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