It's a critical period of anti-epidemic.
In the past two years, my country has continuously improved the level of precise prevention and control of regional, hierarchical and differentiated, and quickly and effectively dealt with clustered epidemics in local areas.
The anti-epidemic deployment based on evidence-based medicine and scientific research will push us closer to the goals expected by the people.
It took only 18 days for the emergence of 30,000 new coronavirus pneumonia patients!
Since March, new cases have been reported in Jilin, Guangdong, Fujian and other places, and the number of new coronavirus pneumonia infections in my country has increased by thousands every day.
Behind the soaring numbers, the epidemic prevention and control work in various places is in full swing.
Zhang Wenhong, director of the Department of Infectious Diseases at Huashan Hospital, said bluntly: "(Now is) the most difficult period in the two years since the fight against the epidemic."
For more than two years, my country's new crown pneumonia epidemic prevention and control has once again sounded the alarm.
It is still the general policy of "dynamic clearing", but compared with the Wuhan city closure that flashes back to people's memory from time to time, is the anti-epidemic dilemma we face today the same as it was two years ago?
The "confinement time" of infected people is getting shorter and shorter, how can the new plan achieve it?
On March 15, a plan considered to be the most scientific so far - "New Coronary Virus Pneumonia Diagnosis and Treatment Plan (Trial Version 9)" was released.
According to this plan, if an infected person is treated successfully, he will be able to return home in about 7-10 days, while if the previous plan is followed, it will take at least one month.
"(Previously) the average length of stay in Shanghai (confirmed cases) was 15 days, and after being discharged from the hospital, they had to go to the isolation point for 14 days of isolation." Zhang Wenhong previously explained at the press conference.
The new plan lowers the nucleic acid compliance requirements, which means shortening the length of hospital stay.
On the whole, it has greatly shortened the "confinement time" of infected people, which makes people applaud.
As a general anti-epidemic guide, the "Diagnosis and Treatment Plan for Novel Coronavirus Pneumonia" is self-evident in its importance in the anti-epidemic layout.
The continuous update of the diagnosis and treatment plan in the past two years has been revised from the first edition to the ninth edition.
Counting the changes, it will not be difficult to find changes in the depth of understanding of new coronary pneumonia in scientific research, clinical, disease control and other fields.
For example, a reporter from Science and Technology Daily found that until the fifth edition of the diagnosis and treatment plan was released, the classification of patients with new coronary pneumonia was "light".
Asymptomatic symptoms, no inflammation in the lungs, but still contagious—that's the definition of mild.
Li Xingwang, a member of the National Medical Expert Group and chief expert of the Infectious Diseases Diagnosis and Research Center of Beijing Ditan Hospital, explained that adding the classification of light patients is on the one hand to isolate and treat these patients to better control the source of infection, on the other hand A more detailed description of the patient's basic characteristics was achieved.
It is precisely based on the adjustment of case classification two years ago that the new plan proposes centralized isolation and management of mild cases.
Today, the vast majority of people with mild symptoms do not need to be hospitalized again, which not only greatly saves medical resources, but also shows that my country has a considerable grasp of the treatment and symptom control of mild cases.
Zhang Wenhong explained that the scientific nature of the diagnosis and treatment plan makes everyone more confident in the future fight against the epidemic.
"When the earliest diagnosis and treatment plan was formulated, we didn't know anything about the new coronavirus, and we made it with our medical experience while treating it. From the first edition to the ninth edition, we have obtained more and more scientific evidence, The diagnosis and treatment plan for COVID-19 will eventually become the most reasonable plan based on science.”
"Poke yourself to tears", can self-testing antigen at home really work?
"It is really possible to issue more self-testing boxes on a pilot basis. People who test positive will consciously reduce their walking, avoid cross-infection, and save a lot of workload of flow adjustment and random inspection..." A medical staff from Shenzhen told the new The antigen self-test box is full of expectations. As an ordinary soldier who is still fighting continuously, he hopes that the new method can bring about an early diversion of the huge workload, so that he and his comrades who are tired and paralyzed in front of the operating table can take a breath.
As of March 20, according to data released by the State Food and Drug Administration, the State Food and Drug Administration has approved 17 new coronavirus antigen detection reagent products.
In Shanghai, the antigen self-test has been put in place quickly, and the self-test experience of "stabbed myself to tears in seconds" and "better than the hospital" has become the latest hot topic.
Antigen detection detects proteins on the viral envelope, while nucleic acid detection detects RNA in viruses.
Antigen testing does not require high-end equipment, it is fast, simple, and can be tested at home like a pregnancy test stick.
The disadvantage is that it can be judged negative and may miss positive.
With antigen testing, everyone in home quarantine can become an "outpost" for the detection of the new crown pneumonia epidemic.
This was unimaginable two years ago.
Now we can use antigen detection products, which stems from the scientific research layout two years ago.
As early as the early stage of the epidemic, the national emergency research project supported many companies in the research and development of antigen detection reagents.
Antigen detection results can be observed with the naked eye within 20 minutes. This short-term and fast advantage has become a useful supplement to fight against the new coronavirus Omicron variant.
Two years ago, the method to determine infection and which indicators to determine infection were also unresolved.
At that time, due to the limited nucleic acid detection capabilities, methods such as "imaging features of pneumonia" were also proposed for the diagnosis of patients with new coronary pneumonia.
As my country's nucleic acid testing capabilities have been greatly improved in an organized and institutionalized manner, the cost of nucleic acid testing has dropped significantly, and nucleic acid testing has become an effective means of screening and diagnosis.
From encouraging medical institutions to carry out nucleic acid testing as long as they have the conditions, to the present, a total of 12,400 institutions across the country have carried out nucleic acid testing services for the new coronavirus, and it took my country only a little more than two years.
"my country is the world's leader in nucleic acid testing." At the press conference of the State Council's joint prevention and control mechanism on March 15, Jiao Yahui, director of the National Health Commission's Medical Administration and Hospital Administration, spoke in numbers: The country's overall nucleic acid testing capability has been It reaches 46.09 million tubes/day. On this basis, my country has broken through the mixed inspection technology of "5 mixed 1", "10 mixed 1" and "20 mixed 1" one by one, which means that the mixed inspection capacity has reached 46.09 million tubes/day. 20 times.
Not only that, mobile detection forces including air membranes, shelters, and mobile detection vehicles have been comprehensively strengthened. They have played the role of "reinforcement troops" in the outbreak of clustered epidemics in the region, and can quickly supplement the sharply increasing demand for nucleic acid testing. , to provide strong support for the implementation of the general policy of "dynamic clearing".
In the race against the virus, my country's nucleic acid detection capabilities have gone from backward to leading.
Today, antigen testing is available and ready to fight.
So far, diversified detection methods, including antigen detection, nucleic acid detection, and antibody detection, have formed a step-by-step detection system with a faster response speed, which can efficiently search for Omicron variants with stronger concealment.
52 million Chinese elderly lack new crown immunity, how to make up for the shortcomings?
"The prevalence of the Omicron variant has brought greater harm to the elderly. The number of deaths and severe illnesses among elderly people who do not receive vaccines has exceeded the highest level in history in some countries and regions." Chief Immunization Program of the China Center for Disease Control and Prevention Expert Wang Huaqing said.
"According to existing statistics, 65% of severe patients are elderly people over 60 years old, and 65% of elderly people with severe type have not been vaccinated." Jiao Yahui said.
"The vaccination rate of the new crown vaccine among the elderly in my country is relatively low. In some provinces and cities, the vaccination rate of the elderly over the age of 80 is less than 30%, and the vaccination rate of the elderly over the age of 70 is less than 50%." Zheng Zhongwei, director of the Science and Technology Development Center of the National Health Commission, said.
Against the Omicron variant, these anti-epidemic experts who have been fighting against the new crown pneumonia epidemic for more than two years are not afraid of anything else, but they are afraid that 52 million Chinese elderly still lack the new crown immunity.
In the seventh edition of the diagnosis and treatment plan two years ago, the "susceptible population" column was described as: the population is generally susceptible.
Now, this column has been added: Some immunity can be obtained after infection or after receiving the new coronavirus vaccine.
In a short sentence, it includes a huge project of establishing an immune barrier for the whole population.
Two years ago, the new coronavirus vaccine was still in the stage of development and clinical trials. Whether the new coronavirus vaccine could be successfully developed, how effective, and how safe... These questions were all unanswered.
Today, my country has vaccinated 3.2 billion doses of the new crown vaccine, and has provided more than 2.1 billion doses of the new crown vaccine to more than 120 countries and international organizations.
China's new crown vaccine has faced many doubts along the way.
However, my country's vaccine team has finally proved itself with scientific and rigorous research and development standards, complete and detailed clinical trial data, and excellent performance in many countries.
On December 15, 2020, my country officially launched the vaccination of key groups of people. On December 30, 2020, my country's first new crown vaccine was launched, and the whole people were vaccinated for free.
Facing the frequent mutation of the virus, Shao Yiming, a member of the expert group for vaccine research and development of the joint prevention and control mechanism scientific research team of the State Council, pointed out: "Once the research shows that the vaccine needs to be updated, Chinese enterprises have the ability to provide it in time."
The confidence and strength support the national immune barrier against the new coronavirus and its various variants. The large-scale vaccination of vaccines has invisibly changed the situation we are fighting against the new coronavirus.
"The population has a certain level of immunity." Liang Wannian, head of the expert group of the National Health Commission's New Coronary Pneumonia Epidemic Response Leading Group, took this as the primary factor in "China has a certain ability to resist the spread of the epidemic" in the new crown pandemic.
However, there are still 52 million Chinese elderly people who have not been vaccinated against the new crown. In China's entire population immunity barrier, if the vital "door latch" of the elderly is missing, it will be difficult to usher in the final victory in the fight against the epidemic.
What is the current situation of my country's self-developed new crown special drugs?
"The drugs that had no effect before or whose effects were uncertain were all deleted, and the antibody drug and another small molecule drug independently developed by my country came up." Zhang Wenhong said bluntly about the changes in drugs when interpreting the ninth edition of the diagnosis and treatment plan. not shy.
For a time, there was no drug available to deal with this brand new virus for a period of time.
"Good medicine for a big epidemic", traditional Chinese medicine took the lead in forming three medicines and three prescriptions by virtue of the thick accumulation of classics and the convenience and accessibility of finished medicines.
On March 2, 2021, the traditional Chinese medicine Sanfang Qingfei Paidu Granules, Huashi Baidu Granules and Xuanfei Baidu Granules, which played an important role in the fight against the new crown pneumonia epidemic, were approved for marketing.
"These three prescriptions are all explored in practice, and they are clinically effective." Zhang Boli, an academician of the Chinese Academy of Engineering, said that traditional Chinese medicine optimizes and combines classic prescriptions, and at the same time adds experimentally effective Chinese medicine components to develop symptomatic Chinese medicines This is also a way to quickly screen, evaluate and develop new drugs.
In the exploration of chemical drugs and biological drugs, China's new crown drug research and development team took the initiative to "reveal the list" with years of technical accumulation.
On December 8, 2021, my country's first anti-new coronavirus drug, the combination therapy of the new crown monoclonal neutralizing antibody ambavirumab and romisevirumab, was approved for marketing.
On December 30, 2021, the new crown oral drug VV116 jointly developed by Chinese scientific research institutes and enterprises was approved for use in Uzbekistan.
More drug R&D teams are developing rapidly.
According to the latest statistics from the State Drug Administration, as of the end of February 2022, more than 50 new crown drugs have been approved for clinical trials in my country, and three small molecule drugs, including azvudine, have entered the third phase In the clinical trial stage, the industry has high hopes.
Many companies have started the "dual promotion" mode of R&D and production.
For example, Ascletis announced on March 15 that its ASC10, which has a similar principle to the approved Pfizer small molecule drug, has optimized the production process to reduce costs and improve efficiency while considering more environmentally friendly synthesis methods. .
"According to the routine new drug research and development process, we will not pay attention to production costs and production capacity so early." The relevant person in charge of Ascletis Pharmaceuticals said that the epidemic situation urges new drug research and development urgently, and also expects relevant departments to take substantial measures to speed up the approval.
In response to the expectations of the industry, on February 22, the "Drug Evaluation Center to Accelerate the Review of Innovative Drug Marketing Application Review Work Procedures (Trial)" solicited external opinions, and the emphasis on communication in the procedure became the biggest highlight.
The COVID-19 pandemic has accelerated the entire chain of new drug research and development at an efficient and steady pace.
I believe that it will not take too long, and the special medicines that are cheap and high-quality, can prevent and cure will become a sharp weapon in the fight against the epidemic.
The Omicron variant may have evolved from an AIDS patient. What about the next variant?
Although we have made progress enough to control the "war situation" in the above-mentioned diagnosis and treatment plans, detection systems, immune barriers, and effective drugs, there has never been a "foolproof" in the language system of infectious disease prevention and control.
More than two years later, it's not that it anymore.
From the prototype strain to Alpha, Beta, Delta, Omicron... There will always be some "changeable weirdos" from time to time in the more than 30,000 bases of the new coronavirus.
D614G, N501Y... These prisoner-like serial numbers indicate the queuing positions of the viral genome base sequences.
From the sequence reading in the early stage of the epidemic, to now, virology experts can interpret key sites one by one and associate them with infectivity, invasion mode, etc., human beings have disassembled the new coronavirus.
We are learning about the new coronavirus faster than other pathogens.
But the rate of mutation of the virus is no less.
Beta variants were discovered in South Africa in May 2020, alpha variants were discovered in the UK in September, delta variants were discovered in India in October, and gamma variants were discovered in Brazil in November…
The "spike" of infection data brought about by the mutant strain then flattened out. After being surprised and accepted, people began to adapt to the mutation of the new coronavirus, thinking that the virus mutation does not seem to escape the "Five Fingers Mountain".
Until the sudden appearance of the Omicron variant.
It did not play the card according to common sense, and more than 30 mutant amino acids appeared on key proteins at once (in the past, it was single digits).
"The source of the Omicron variant is still unknown, but it is determined that it did not evolve from other mainstream variants." Jin Dongyan, a professor at the School of Medicine at the University of Hong Kong, believes that among the several speculations about the source, the Omicron variant is derived from It is more plausible that it evolved in immunocompromised people (such as AIDS patients).
A study published in "Cell" showed that immune-compromised patients will gather various mutant strains, and these mutant strains will not be able to be cleared and stay in the body for a long time, and will converge in time and space, which will lead to a large number of mutations that coexist with each other. Mutations.
Whether the Omicron variant will be the last big mutation of the new coronavirus is still unknown.
Vaccines against Omicron mutants were rapidly developed, and multivalent vaccines that can prevent multiple mutants are also ready.
But people should always be vigilant: as long as a global pandemic exists, the virus has a chance to break through the existing immune barrier, and no one can be immune.
Looking back more than two years ago, people suddenly encountered the new crown epidemic and felt uneasy. Thousands of medical staff dressed in white and went retrograde. Leishenshan and Huoshenshan were settled and resolved, and Fangcang shelter hospitals reversed the passive situation... China has successfully survived the emergency outbreak. containment phase.
In the past two years, my country has adhered to the principle of "foreign prevention of importation and internal prevention of rebound", continuously improving the level of precise prevention and control of regional and hierarchical differentiation, and quickly and effectively deal with clustered epidemics in local areas.
Wearing masks, washing hands frequently, ventilating often, and avoiding gatherings have become everyone's "subconscious". The protection of vaccines, the improvement of treatment capabilities, and the sufficient redundancy of medical resources will give the future anti-epidemic work the confidence to deal with it calmly.
Two years later, in the critical period of anti-epidemic, how to resolve the predicament?
"Anti-epidemic with wisdom." Zhang Wenhong summed it up in one word. He said: "Anti-epidemic deployment based on evidence-based medicine and scientific research will push us closer to the goals expected by the people." (Zhang Jiaxing)