1. What is the background of the introduction of the "Overall Plan"?
Since the outbreak of the novel coronavirus infection, the Party Central Committee with Comrade Xi Jinping as the core has attached great importance to the prevention and control of the epidemic, comprehensively strengthened the centralized and unified leadership of the prevention and control work, insisted on the supremacy of the people and the supremacy of life, and dynamically optimized and adjusted the prevention and control measures according to the time and situation , constantly improving the level of scientific and precise prevention and control, withstood multiple rounds of impacts from the global epidemic, and successfully avoided the widespread prevalence of relatively strong pathogenic original strains and delta mutant strains in my country, greatly reducing severe illness and death , It also bought precious time for the preparation of resources such as vaccines, drug development and application, and medical treatment.
The number of epidemics and deaths in my country has remained at the lowest level in the world, the health of the people has been steadily improving, and the overall planning of economic development and epidemic prevention and control has achieved the best results in the world.
At present, experts at home and abroad generally believe that the general direction of mutation of the new coronavirus is less pathogenic, more prone to upper respiratory tract infection and shorter incubation period.
The Omicron mutant strain has become the dominant strain in the world. Although the number of people infected is large, the pathogenicity has decreased significantly compared with the early stage, and the resulting disease will gradually evolve into a common respiratory infectious disease.
Comprehensively considering factors such as virus characteristics, epidemic situation, vaccination, medical resource preparation, and prevention and control experience, my country has the basic conditions to adjust the new coronavirus infection from "Class B and A control" to "B and B control".
The prevention and control of the novel coronavirus infection in my country is facing new situations and new tasks, and the prevention and control work has entered a new stage.
2. Why was "New Coronary Pneumonia" renamed "New Coronavirus Infection" in the "Overall Plan"?
For what considerations?
On January 20, 2020, after being reported to the State Council for approval, the National Health and Health Commission issued an announcement to include the new type of coronavirus pneumonia ("New Coronary Pneumonia") into the Class B infectious diseases stipulated in the "Law of the People's Republic of China on the Prevention and Control of Infectious Diseases", and adopt Prevention and control measures of Class A infectious diseases.
At that time, it was named "New Coronary Pneumonia", mainly considering that most of the cases in the early stage of the epidemic showed pneumonia.
After the mutant strain of Omicron became the main epidemic strain, the pathogenicity weakened, and only a very small number of cases showed pneumonia.
Considering that pneumonia only reflects the more serious illness after virus infection, and cannot summarize the clinical characteristics of all infected persons, the name of "new coronary pneumonia" was changed to "new coronavirus infection", which is more in line with the current characteristics and hazards of the disease.
3. What is the time schedule for the implementation of "Class B and B Management" in the "Overall Plan"?
How to make a smooth and orderly transition?
What adjustments will be made to the work objectives after the implementation of "Class B and B Management"?
The "Overall Plan" clearly states that from January 8, 2023, "Class B and B Control" will be implemented for new coronavirus infections.
According to the Law on the Prevention and Control of Infectious Diseases, isolation measures will no longer be implemented for people infected with the new coronavirus, and close contacts will no longer be identified; high and low risk areas will no longer be demarcated; patients infected with the new coronavirus will be treated in different grades and medical insurance policies will be adjusted in a timely manner; testing strategies Adjusted to "willing to do all inspections"; adjust the frequency and content of epidemic information releases.
According to the Frontier Health and Quarantine Law, no quarantine and infectious disease management measures will be taken for entry personnel and goods.
All localities and departments should follow the guidance of Xi Jinping Thought on Socialism with Chinese Characteristics for a New Era, give full play to the advantages of the system, insist on putting people first and life first, adhere to scientific prevention and control, precise policy implementation, improve response preparations, adjust prevention and control measures, unify rules, classify guidance, Prevent risks and ensure the smooth and orderly implementation of "Class B and B Management".
After the implementation of "Class B and B Management", the prevention and control work objectives should focus on "health protection and severe disease prevention", and corresponding measures should be taken to protect the lives and health of the people to the greatest extent and minimize the impact of the epidemic on economic and social development.
4. What are the main countermeasures after the implementation of the "Class B and B Control" for the new coronavirus infection?
The first is to further increase the vaccination rate of the new coronavirus vaccine among the elderly, and promote the second dose of booster immunization among people at high risk of severe illness.
The second is to prepare drugs and testing reagents related to the treatment of new coronavirus infection to meet the needs of patients for medication and testing.
The third is to increase investment in the construction of medical resources, focusing on the preparation of inpatient beds and intensive care beds.
The fourth is to adjust the crowd testing strategy. Community residents are "willing to check everything" according to needs, and no longer carry out nucleic acid screening for all staff.
The fifth is to classify and treat patients according to the severity of the disease.
The sixth is to do a good job in the health survey and grading services of key population groups in the community, find out the combined underlying diseases and vaccination status of the elderly aged 65 and above in the jurisdiction, and provide classified and grading health services.
The seventh is to strengthen the prevention and control of key institutions such as elderly care institutions, social welfare institutions, hospitals, schools, preschool education institutions, and large enterprises, and strictly prevent the risk of clustered epidemics in the venues.
The eighth is to strengthen the prevention and control of epidemics in rural areas, and provide medical protection for high-risk groups such as the elderly in rural areas and patients with underlying diseases.
The ninth is to strengthen the monitoring and response of the epidemic situation, study and judge the development trend of the epidemic situation, and take appropriate measures to restrict gathering activities and personnel movement in accordance with the law to suppress the peak of the epidemic situation.
The tenth is to advocate adherence to personal protection measures and implement the concept that everyone is the first person responsible for their own health.
The eleventh is to do a good job in information release and publicity and education, comprehensively and objectively publicize and interpret the purpose and scientific basis of adjusting the new coronavirus infection from "Class B and A" to "B and B".
The twelfth is to optimize the management of personnel exchanges between China and foreign countries. Personnel coming to China will undergo nucleic acid testing 48 hours before departure, cancel nucleic acid testing and centralized isolation for all staff after entry, and cancel the "five ones" and passenger load factor restrictions on the number of international passenger flights. Control measures.
5. How does the "Overall Plan" arrange for the further promotion of the vaccination of the elderly against the new crown virus?
Vaccination is one of the important measures for epidemic prevention and control, and it is an effective means to prevent severe diseases and reduce deaths.
From an individual point of view, it can effectively protect the health and life safety of the elderly; from the point of view of the whole society, it can effectively reduce the risk of running out of medical and health resources.
After the implementation of "Class B and B control" for new coronavirus infection, high-risk groups such as the elderly continue to face the risk of being infected. The "Overall Plan" made arrangements for the vaccination work again, requiring further strengthening of organization and mobilization, and scientific evaluation of vaccination contraindications. Accelerate the improvement of vaccine booster immunization coverage, especially among the elderly.
6. What are the requirements for vaccine selection and time interval when boosting immunization?
At present, all 13 vaccines approved for conditional marketing or emergency use can be used for the second dose of booster immunization, including 4 new vaccines for emergency use. Sequential booster immunization is recommended first, or contain Omicron strain or Vaccines with good cross-immunity to Omicron strains.
All localities will follow the deployment of the joint prevention and control mechanism of the State Council, carefully organize the implementation, optimize the service form, and continue to do a good job in the vaccination of the elderly against the new crown virus.
People at high risk of infection, people aged 60 and over, people with serious underlying diseases, and people with low immunity can receive a second dose of booster immunization 6 months after completing the first dose of booster immunization Inoculation.
7. How should medical and health institutions at all levels and types prepare for the treatment of new coronavirus infection-related drugs and testing reagents?
How to improve the accessibility of medicines and antigen detection reagents?
Drugs related to novel coronavirus infection are indispensable in the treatment process and are an important guarantee for medical treatment.
In order to make preparations for the treatment of new coronavirus infection-related drugs and testing reagents to meet the needs of the masses, the "Overall Plan" clearly requires that, on the one hand, medical institutions above the county level dynamically prepare for new coronavirus infection according to their daily use for three months. Relevant traditional Chinese medicines, anti-new coronavirus small-molecule drugs, antipyretic and cough-relieving drugs and other symptomatic drugs; according to the classification and classification of diagnosis and treatment requirements, asymptomatic infections without serious underlying diseases, mild cases of self-care at home, grass-roots medical and health institutions, drug retail Institutions, etc. should also make corresponding preparations to ensure the availability of drugs. Primary medical and health institutions should dynamically prepare Chinese medicines, symptomatic treatment drugs and antigen detection reagents related to new coronavirus infection according to 15-20% of the serving population. In densely populated areas Increase as appropriate.
The joint epidemic prevention and control mechanism (leading group, headquarters) in various places should assume the leadership responsibility for the preparation of pharmaceutical reagents, and guide all types of medical and health institutions at all levels to prepare pharmaceuticals and testing reagents.
On the other hand, each province should calculate the demand for drugs in advance based on factors such as population base, epidemic situation, and proportion of various types of cases, and provide the results of the calculation to relevant departments to guide enterprises to actively do a good job in ensuring the supply of drugs, and guide reasonable The orderly and precise delivery has effectively alleviated the difficulties of patients in purchasing and administering medicines, and passed the peak period of the epidemic smoothly.
8. What medical resources are needed to prepare for the implementation of the "Class B and B Control" for novel coronavirus infection?
How do medical institutions at all levels provide medical services?
my country's epidemic prevention and control is facing new situations and new tasks.
It is a "first move" and "key move" to prepare for medical treatment resources.
The "Overall Plan" requires all localities to increase investment in construction, complete the task of preparing medical resources as soon as possible, and focus on preparing hospital beds and intensive care beds.
The first is to further strengthen the establishment of fever clinics. Fever clinics in hospitals above the second level should be set up and opened as much as possible. All qualified primary medical and health institutions have opened fever clinics (outpatient clinics), equipped with sufficient medical resources to meet the needs of patients. need.
The second is to take prefecture-level cities as units, and according to the population size, quickly upgrade and transform qualified shelter hospitals into sub-(quasi) designated hospitals, and ensure sufficient medical resources.
The third is to strengthen the setting of intensive care beds in designated hospitals.
In provincial capital cities and central cities that play the role of regional medical centers, their designated hospitals should also set up independent hemodialysis centers, delivery rooms, and pediatric wards to meet the treatment needs of special patients.
At the same time, it is necessary to form a multidisciplinary medical team, establish a counterpart guidance relationship with higher-level hospitals, and ensure medical quality and safety.
The fourth is to require secondary hospitals to build and renovate intensive care units according to standards, to ensure that each intensive care unit can be used at any time, as a useful supplement to the intensive care resources of tertiary hospitals.
The fifth is to require tertiary hospitals to strengthen the preparation of intensive care resources, rationally allocate intensive care personnel, ensure that comprehensive ICU monitoring units can be used at any time, and ensure that intensive care resources are doubled within 24 hours by building convertible intensive care units.
Organize medical staff to carry out professional training in critical care medicine in advance, and rapidly expand the strength of the critical care medical team.
Establish a working model of mixed grouping of critical care medical professionals and other trained medical staff to ensure that the medical treatment of critically ill patients is carried out in an orderly manner.
9. Which groups of people need to carry out antigen or nucleic acid testing after the new coronavirus is infected with "Class B and B tubes"?
The "Overall Plan" stipulates that community residents are "willing to do all the inspections" as needed, and no longer carry out nucleic acid screening for all staff.
In order to ensure the testing needs of residents, the community is required to retain a certain number of convenient nucleic acid testing points, and retail pharmacies, drug online sales e-commerce companies, etc. must have sufficient supplies of antigen testing reagents.
At the same time, considering that medical institutions, elderly care institutions, social welfare institutions and other places where vulnerable groups are concentrated, the risk of severe illness among vulnerable groups is relatively high. Once the source of infection is introduced, clustered epidemics are prone to occur. Therefore, it is proposed to carry out antigen or Nucleic acid testing: one is to carry out antigen or nucleic acid testing for outpatients and emergency patients with fever and respiratory infection symptoms admitted to medical institutions, hospitalized patients with high risk of severe illness, and symptomatic medical staff; Staff and care recipients in social welfare institutions and other places where vulnerable groups are concentrated should carry out antigen or nucleic acid testing on a regular basis; third, community residents at high risk of severe illness, such as elderly people aged 65 and above, long-term hemodialysis patients, and severe diabetes patients, etc. Infants and young children under the age of 3 should be guided to carry out antigen testing in a timely manner after they develop symptoms such as fever, or go to a convenient nucleic acid testing point set up in the community for nucleic acid testing; Fourth, when outsiders enter places where vulnerable groups gather, check the negative nucleic acid test certificate within 48 hours And carry out antigen detection on the spot.
10. How to implement hierarchical diagnosis and treatment?
How to ensure timely treatment for those at high risk of severe illness?
The "Overall Plan" requires the establishment of a hierarchical diagnosis and treatment system relying on the medical consortium, and medical institutions at all levels and types within the medical consortium have their own functional positioning to meet the medical needs of patients.
Grassroots medical and health institutions mainly do a good job in population health monitoring and health management, especially for the elderly with underlying diseases and other severe high-risk groups to implement graded health services; the secondary hospitals in the medical consortium mainly provide technical support to improve grassroots doctors' awareness of high-risk groups. The identification, diagnosis and treatment capabilities of the residents, and at the same time do a good job in the diagnosis and treatment of common diseases and frequently-occurring diseases of the residents; the medical consortium leads the tertiary hospitals to be responsible for the treatment of acute and critical patients, and provides green services for the elderly under primary health management when their conditions change and they need to see a doctor. aisle.
While improving the ability to treat severe cases at the grass-roots level, it is also necessary to improve the ability of grass-roots doctors to identify, diagnose, and treat high-risk groups, strengthen the work of classification and treatment, and guide localities to establish a responsibility system for divisions. Third-level general hospital sub-block responsibility system.
In accordance with the principle of sub-regional package, each tertiary general hospital has a scope of responsibility, and the corresponding treatment of elderly severe and critical patients with new crown virus infection in the designated area, to achieve "full coverage" of the contract management of elderly severe patients.
What needs to be pointed out is that the scope of responsibility is delineated by sub-areas, and it does not mean that it is only responsible for the admission and treatment of patients within the designated area. No hospital may use the designated area as a reason to shirk or refuse to admit critically ill patients transferred from other areas.
For tertiary hospitals, the delineation of responsibility areas is relative, and the implementation of the first-diagnosis responsibility and emergency rescue system is absolute.
The medical treatment group of the joint prevention and control mechanism of the State Council will improve the supervision and assessment mechanism for the treatment of elderly critically ill patients in tertiary hospitals, establish a "daily report" system for the admission of elderly critically ill patients and positive patients in tertiary hospitals, and incorporate the admission status into the performance evaluation of tertiary public hospitals.
11. Which groups of people should carry out the health survey clearly in the "Overall Plan"?
How to promote classified and graded health services?
Mainly for the elderly aged 65 and above, especially those with underlying diseases (including coronary heart disease, stroke, hypertension, chronic obstructive pulmonary disease, diabetes, chronic kidney disease, tumors, immune deficiencies, etc.) and their vaccination status of the new coronavirus Conduct a thorough investigation.
The classification comprehensively considers the basic disease conditions, the new coronavirus vaccination status, and the degree of risk after infection, etc., and is a standard formulated by experts for comprehensive research and judgment.
The first-level service is mainly for the general population to carry out health education and guide the elderly who have not received the booster vaccine, and those who meet the vaccination requirements after the doctor's evaluation should be vaccinated as soon as possible.
The second-level service is based on the first-level service. For sub-key populations and asymptomatic or mildly symptomatic infected persons treated at home, grassroots medical and health institutions will guide and implement them through the Internet, video, telephone, remote or offline methods based on actual conditions. Antigen detection, health monitoring, health consultation, medication guidance, etc.
In case of persistent high fever, dyspnea, and finger oxygen saturation less than 93%, referral should be made as soon as possible.
Primary medical and health institutions will conduct follow-up visits as needed until the end of home treatment and observation.
The community (village) assists in the implementation of the management of home treatment of infected persons, provides guidance and assistance in seeking medical treatment for regular medical needs, and assists in providing services such as purchasing and delivering medicines.
The third-level service is mainly for the key population. On the basis of the second-level service, for the disabled elderly or elderly infected persons with limited mobility, the treatment method will be determined after evaluation by the expert team or the superior hospital determined by the county (city, district) health department. .
Communities (villages) and grassroots medical and health institutions assist in the referral of key populations of infected persons and those in urgent medical needs.
12. What provisions does the "Overall Plan" make for the prevention and control of epidemics in key institutions?
The "Overall Plan" requires that elderly care institutions, social welfare institutions, psychiatric hospitals and other places where people gather, take internal zoning management measures based on the conditions of the facilities.
When the epidemic is severe, the local party committee and government or the joint prevention and control mechanism will adopt closed management in a timely manner after scientific evaluation, and report to the higher-level competent department to prevent the risk of introduction and spread of the epidemic, timely discover, treat and manage infected persons, establish and improve the transfer mechanism of infected persons, With the green channel mechanism of medical institutions for treatment, the infected personnel in the institutions are transferred and given priority for treatment in the first time, and the clustered epidemics in the places are controlled.
Medical institutions should strengthen personal protection guidance for medical staff and patients, strengthen daily disinfection and ventilation in the premises, and reduce the risk of virus transmission in the premises.
Schools, preschool education institutions, large enterprises and other key institutions where personnel gather should do a good job in personnel health monitoring, and take timely measures to reduce human contact after an epidemic occurs to slow down the development of the epidemic.
When the epidemic is severe, key party and government agencies and key industries should in principle require staff to "two points and one line" and establish a personnel rotation mechanism.
13. What requirements does the "Overall Plan" put forward for rural areas to prepare for the epidemic?
For what considerations?
Considering the actual situation of the relatively weak foundation of epidemic prevention and control in rural areas and the relative shortage of medical and health resources, in order to minimize the impact of the epidemic peak on rural areas and protect the life safety and health of rural residents to the greatest extent, the "Overall Plan" will As an important aspect of regional epidemic prevention and control, we have detailed and implemented various epidemic response preparations.
Do a good job in publicity and education for rural residents, give full play to the role of the county, township, and village medical and health networks, do a good job in health surveys for key populations, strengthen the allocation of medical resources, and provide sufficient relevant treatment drugs and equipment.
Relying on the county-level medical community to improve the medical security capacity of the new coronavirus infection in rural areas, establish a convenient channel for referral of severe patients, coordinate urban and rural medical resources, establish and improve the counterpart assistance mechanism between general hospitals and county-level hospitals, and provide rural elderly, chronic Provide medical protection for high-risk groups such as patients with basic diseases.
According to the regional epidemic situation and the wishes of residents, appropriately control the scale and frequency of gathering activities such as rural fairs, temple fairs, and cultural performances.
14. What requirements does the "Overall Plan" put forward for epidemic monitoring?
What issues should be paid attention to during the epidemic response?
According to the requirements of the "Overall Plan", after the implementation of "Class B and B Control" for new coronavirus infection, it is necessary to continue to dynamically track the mutation of the virus at home and abroad, evaluate the changes in the characteristics of virus transmission, pathogenicity, and immune escape ability, and track and judge in time. Take targeted measures.
At the same time, it is necessary to monitor the infection level of the community population, monitor the outbreak of the epidemic in key institutions, dynamically grasp the scale, scope, intensity and virus mutation of the epidemic, and judge the development trend of the epidemic.
In addition, continue to rely on the national infectious disease network direct reporting system to conduct real-time and online monitoring of statutory infectious disease case information.
In the process of epidemic response, special attention should be paid to comprehensively assessing the epidemic intensity, medical resource load, and social operation in real time, and appropriate measures such as restricting gathering activities and personnel movement should be dynamically adopted in accordance with the law to suppress the peak of the epidemic and protect people's lives and health to the greatest extent. health, and minimize the impact of the epidemic on economic and social development.
15. What are the requirements of the "Overall Plan" on how to be the first responsible person for one's own health?
After the implementation of "Class B and B Control" for new coronavirus infection, individuals are encouraged to continue to maintain good hygiene habits, strengthen personal protection, and seek medical treatment according to the requirements.
The "Overall Plan" pointed out that everyone is the first person responsible for their own health. Everyone should continue to adhere to good hygiene habits such as wearing masks and washing hands frequently, maintain interpersonal distance in public places, and complete vaccines and strengthen immunizations in a timely manner.
When the epidemic is severe, the elderly, pregnant women, and children with underlying diseases should avoid going to crowded places as much as possible.
Asymptomatic infections and mild cases should implement self-care at home, reduce contact with co-residents, rationally use symptomatic treatment drugs in accordance with relevant guidelines, do a good job of health monitoring, and seek medical treatment in a timely manner if the condition worsens.
16. What optimizations has the "Overall Plan" made to the management of the exchange of Chinese and foreign personnel?
According to the requirements of the "Overall Plan", first, personnel coming to China should undergo a nucleic acid test 48 hours before their departure. Those with a negative result can come to China without applying for a health code at our embassy or consulate abroad, and fill in the result in the customs health declaration card.
If positive, relevant personnel should come to China after turning negative.
The second is to cancel the nucleic acid testing and centralized isolation of all staff after entry.
Those who have a normal health declaration and no abnormality in the routine quarantine at the customs port can be released to enter the society.
The third is to cancel the "five ones" and passenger load factor restrictions on the number of international passenger flights control measures.
Fourth, all airlines continue to do a good job in on-board epidemic prevention, and passengers must wear masks when boarding.
The fifth is to further optimize the arrangements for foreigners to come to China, such as resumption of work and production, business, study abroad, family visits, reunions, etc., and provide corresponding visa convenience.
Passenger entry and exit at sea and land ports will be gradually resumed.
According to the international epidemic situation and various service guarantee capabilities, the outbound travel of Chinese citizens will be resumed in an orderly manner.