Face-to-face 丨 How is the timing of the adjustment of prevention and control policies determined? Interview with Liang Wannian
According to the decision-making and deployment of the Party Central Committee and the State Council, starting from January 8, 2023, my country's new coronavirus infection will be adjusted from "Class B and A management" to "B and B management".
This is another major adjustment of the epidemic prevention and control policy since the beginning of 2020, three years after my country implemented Class A prevention and control measures for infectious diseases against the new coronavirus infection.
This week, the "Face to Face" column interviewed Liang Wannian, leader of the expert group of the National Health Commission's Epidemic Response and Disposal Leading Group.
Reporter: Starting from the first ten days of December 2022, 20 articles and 10 new articles have been issued successively, up to the current overall plan for "Class B and B Regulations".
Frankly speaking, many people found it unexpected and did not expect to make such a quick strategic adjustment in such a short period of time. What was the main basis at that time?
Liang Wannian, leader of the expert group of the National Health Commission's Epidemic Response and Disposal Leading Group:
When the epidemic reaches the end of 2022, there will be changes in several aspects, and we feel that it is time for further optimization and adjustment.
The first is the pathogenicity of pathogens, which has indeed undergone significant changes and is declining; second, the level of active immunity of the entire Chinese people is significantly improving, such as vaccination, especially for the elderly and some high-risk groups Vaccination, the proportion of vaccinations has reached a certain requirement; in addition, from the comprehensive analysis of some methods of medicine, some resource preparations for severe treatment, etc., it is an opportunity. This opportunity is based on a basic premise. We cannot eradicate the virus, especially the Omicron mutant strain, which spreads to more than 20 people in one person. It spreads so fast that it is almost impossible not to be infected. No country in the world has achieved it. .
So in this case, we have to make a choice, how to effectively balance our epidemic prevention and control and social and economic development?
Use resources where they are most needed to maximize efficiency, so I think this kind of adjustment is active, not everyone. Some people may think that it is because you can't defend yourself, you are passive, and you have to adjust , which is not the case.
Especially in the first ten days of December 2022, with the rapid spread of the new crown Omicron virus, many cities in my country experienced infection peaks, and the focus of epidemic prevention and control began to shift from infection prevention and control to medical treatment.
Liang Wannian, leader of the expert group of the National Health and Medical Commission's Epidemic Response and Disposal Leading Group:
After we changed from "Class B and A management" to "B and B management", there are actually several major changes: one is from the past infection prevention to prevention Severe illness, death prevention, and medical run-off prevention; Second, in the past, the first front of our prevention and control was the community, unit, and port, but now the most important front and the first frontier of prevention and control are medical institutions. Therefore, our medical staff have to stand in the front line again; thirdly, in the past, we used average resources for nucleic acid testing, isolation, and tracking of close contacts for the whole population. Now the most important change is to focus on key points People, key institutions, key units, especially the prevention and control of key groups such as the elderly.
After the implementation of the "Class B and B Management" policy adjustment, ensuring the health and safety of the elderly has become a top priority.
Reporter: After major strategic adjustments, what is the assessment of the risks that these elderly people may encounter?
Liang Wannian, leader of the expert group of the National Health Commission's Epidemic Response and Disposal Work Leading Group:
Because of the global data, the data released by some countries where the epidemic is endemic and the WHO, including some epidemic situations in our country, it is very clear that the main severity of this disease is The people who died and died were elderly people, so if the epidemic spreads further, these people will be the first to suffer.
Reporter: From the perspective of national and social development, it is necessary to weigh all factors and make a decision.
But let's take a closer look. If there is an elderly person in our family who encounters such a critical situation, how should we face all this?
Liang Wannian, leader of the expert group of the National Health Commission's Epidemic Response and Disposal Leading Group:
In some of our epidemics this time, some elderly people may be sick, or even seriously ill, and some have passed away. We feel very heavy about this.
But it is an undeniable fact that this disease spreads too widely and too fast.
It is indeed a major threat to our human beings, our life safety and health, and under these circumstances, we must do everything possible to reduce this hazard.
This major adjustment coincides with the cold winter, and winter is a period of high incidence of basic diseases such as respiratory tract and cardiovascular and cerebrovascular diseases in the elderly. Some people worry that with the gradual release of various prevention and control measures, the health of the elderly with underlying diseases will be affected. threaten.
Reporter:
At that time, we said that the most important thing is to consider the elderly, because if they let go, their bodies will be the first to be severely injured, but now we are also carrying out "Class B and B tubes" in the middle of winter, making A major strategic adjustment, so is there a better season than this?
Liang Wannian, leader of the expert group of the National Health and Medical Commission’s Epidemic Response and Disposal Leading Group:
If you look at the disease alone, can it reduce some superimposed effects if you don’t make adjustments in winter, but the virus of this disease is especially serious now. The virulence of this mutant strain of Rong is now weak. We think it is best for us to adjust some relevant strategies and measures for this mutant strain at this time, that is, when the adjustment is appropriate , is the result of a comprehensive judgment.
Liang Wannian introduced that the reason why he chose to adjust the epidemic prevention and control policy at the current time is also directly related to the actual situation of the elderly population in our country being vaccinated against the new crown vaccine.
Liang Wannian, leader of the expert group of the National Health Commission's Epidemic Response and Disposal Leading Group:
I was sent to Hong Kong on February 10th, 2022, to the central expert group. The first thing I did when I went to Hong Kong was the death of 94 people. % are elderly.
I analyzed it carefully later. At that time, the vaccination rate in Hong Kong was more than 86%, but the vaccination rate of the elderly was less than 15%. This is the problem I saw immediately.
Our vaccination rate was more than 80% at that time, and the vaccination rate of the elderly was less than 40% a few months ago.
Reporter:
Now?
Liang Wannian, head of the expert group of the National Health Commission's Epidemic Response and Disposal Leading Group:
Now it is more than 80%.
The protection efficiency against severe illness and death after vaccination is good, but the duration of antibodies is limited.
In June and July of 2023, the season is good, and there are few respiratory diseases, so it is best to release it. However, in June and July, the protection of active immunity produced by the vaccination of our elderly population is declining.
Reporter: What about the summer of 2022 if we move forward six or seven months?
Liang Wannian, leader of the expert group of the National Health and Medical Commission's Epidemic Response and Disposal Leading Group:
It was not possible at that time. At that time, our entire elderly population and our entire booster vaccination level did not meet our expected protection effect.
The overall rate of vaccination for the elderly was relatively low at that time, so we took advantage of these window periods to further strengthen the vaccination of the elderly.
As all parts of the country have entered the peak of the new crown virus infection, the number of virus-infected patients, including the elderly, has increased sharply. The fever clinics, emergency departments, and critical care departments of hospitals are overcrowded and overloaded.
Reporter:
The country is now making great efforts to pay attention to and treat the elderly.
But the reality is that even if the medical resources are running at full capacity, they will not be able to absorb so many elderly people flocking to the hospital for a while, and there will be some elderly people lying on emergency beds in the hospital lobby. hurry.
Liang Wannian, leader of the expert group of the National Health and Medical Commission's Epidemic Response and Disposal Leading Group:
Because the disease is coming too fast, a large number of infections in a short period of time, especially the elderly need to come to the hospital, and it is inevitable that our medical resources will be exhausted in a short period of time. There are some shortages, so the country, including medical institutions at all levels, is doing everything possible to give medical treatment and prevent medical run-off a priority strategic consideration.
Reporter:
Now everyone still feels that although you have made preparations, you don't think the preparations are sufficient?
Liang Wannian, leader of the expert group of the National Health Commission's Epidemic Response and Disposal Leading Group:
From a global perspective, no country dares to say that it is ready, and such and such problems will inevitably arise.
Whether it is North America, Europe, or some other related countries, when an epidemic peaks, there will be a certain degree of medical resource shortage for a period of time. I think this is not just a situation in China.
The key question now is, in this situation of shortage and relatively tight resources, what measures should be taken to determine the priority targets for treatment, to implement hierarchical diagnosis and treatment, and to truly make some high-risk groups the highest priority? people were treated in a timely manner.
After the implementation of the "Class B and B Control" plan, the nucleic acid testing and centralized isolation of all staff after entry will be cancelled, and those who come to China will undergo nucleic acid testing 48 hours before departure, and those with negative results can come to China.
Some commentators believe that this has created convenience for the entry of people coming to China, but at the same time it has also increased the risk of imported new coronaviruses from abroad.
Reporter:
New problems have emerged now. For example, XBB, a new strain with stronger immune escape ability, has appeared in some foreign countries. Then it will also come in. People are concerned about the new mutant strains that are coming in waves. , There is always worry or even fear in my heart.
Liang Wannian, leader of the expert group of the National Health Commission's Epidemic Response and Disposal Leading Group:
As we change from "Class B and A management" to "B and B management", we will make some adjustments to some related measures for foreign defense imports, but we will not It's not that we don't care about it at all. In fact, we are monitoring these imported cases at the entire port.
The mutant strain of XBB has been found in more than 70 countries around the world, and our country has actually imported it, and some cities have it.
But on the whole, it is still a subtype under the mutant strain of Omicron, so according to general scientific principles, it may be immune evasion ability is increasing, but its overall pathogenicity is now no matter whether it is from the United States or not. , or some other countries, did not find significant changes in its pathogenicity.
Reporter:
Is it possible to make people suffer so much like our current popular BA.5 or BF.7?
Liang Wannian, leader of the expert group of the National Health Commission’s Epidemic Response and Disposal Leading Group:
As a public health expert, I understand that no one can guarantee that XBB will not form a dominant epidemic strain in China in the future, but from the perspective of infectious diseases From the perspective of the epidemic law, because our country has just experienced this wave of epidemic peaks, it can be said that most of our population has developed corresponding immunity or resistance.
XBB itself is a subtype of the Omicron strain. I think it has very little room for it to become a dominant strain in a short period of time.
What will it be like in another six months or a year?
I dare not say.
But at least in the short term, its space is very small. It will not say that there will be another wave of XBB like Beijing's BF.7. The probability is extremely low.
At present, the new crown XBB series mutant strain XBB.1.5 is triggering a new wave of infections in Europe and the United States.
According to the news released by the China Centers for Disease Control and Prevention, from October to December 2022, my country has discovered 199 imported XBB cases, of which 4 were imported cases of XBB.1.5, and no local cases of XBB.1.5 have been detected yet.
According to expert analysis, in the short term, the possibility of large-scale epidemics caused by XBB series mutant strains including XBB.1.5 in my country is extremely low.
Moreover, there is no evidence that XBB.1.5 is more likely to cause severe diarrhea or other clinical manifestations of the gastrointestinal tract than other strains.
Reporter:
In the past week, there was a phenomenon, because of the emergence of a new mutant strain of XBB, so in cyberspace, everyone was sending a message saying that they should prepare some norfloxacin and a medicine for diarrhea. Everyone They started buying one after another.
It was later proved that the information was not true, but when faced with waves of new mutant strains, who should we trust?
Liang Wannian, leader of the expert group of the National Health and Medical Commission's Epidemic Response and Disposal Leading Group:
I think the government will pass some suggestions from experts and understand the disease, and will release some relevant information and guidelines in a timely manner; Tighten a string, not all the information is correct, you must be vigilant.
In the prevention and control of the new crown infection, from the perspective of public health, in addition to the harm caused by viral diseases, another great harm is the information epidemic, that is, when various information rumors come out, it also affects people. Some influences, such as anxiety, etc., in fact, also need to be strictly guarded against.
Starting from January 7, our country has entered a 40-day Spring Festival travel season. Many people are also worried that with the large-scale population migration, will it trigger a new round of new crown virus infection peaks?
Reporter:
In the past period of time, some cities have experienced the peak of infection, so will the impact on the upcoming Spring Festival travel peak be smaller than expected?
Liang Wannian, leader of the expert group of the National Health Commission's Epidemic Response and Disposal Leading Group:
From the perspective of the country as the basic unit, many provinces have reached their peak, and some have even shown a downward trend.
If many of us have passed the peak, the flow of the Spring Festival will cause a relatively large second or third wave. This possibility cannot be ruled out, but the probability is relatively small, and even if there is, it will not be a too big peak.
Reporter:
So it won't be as serious as the time you have experienced?
Liang Wannian, leader of the expert group of the National Health Commission's Epidemic Response and Disposal Leading Group:
Yes, definitely not.
Because after we have gone through this wave, the vast majority of people who are infected have relevant immunity, and it will not be as high as the wave we experienced before, and another wave will come all at once.
However, changes in the population structure of infections must be considered. For example, some elderly people in rural areas do not go out at home. They may be infected due to the flow of the Spring Festival when they visit relatives and friends. In addition, the conditions of medical treatment and various aspects in rural areas are not as good as those in cities. Therefore, it is necessary to prevent the occurrence of medical runs in rural areas, especially the problem of how to get timely medical treatment after the elderly are infected.
Recently, the Joint Prevention and Control Mechanism of the State Council and the Central Rural Work Leading Group issued the "Strengthening the Current Work Plan for the Prevention and Control of Novel Coronavirus Infection in Rural Areas" to guide rural areas in coping with the challenges of epidemic prevention and control brought about by the movement of people at the end of the year and the beginning of the year.
Liang Wannian, leader of the expert group of the National Health and Medical Commission's Epidemic Response and Disposal Work Leading Group:
How to strengthen rural prevention and control, I think the simplest one is to ensure that the elderly in rural areas are taken care of. The second point is that once hospitalization is required, no matter whether it is to a designated hospital or a severe case, there must be a quick referral to be able to receive treatment in time; the third point is to have medicine for rural use.
Reporter:
Can it be done now?
Liang Wannian, leader of the expert group of the National Health Commission's Epidemic Response and Disposal Leading Group:
We must do everything possible.
I believe that no one can avoid short-term and partial deficiencies, but once these problems are discovered, we must take quick measures and we will be able to solve this problem soon. We should be confident in this.
(CCTV news client reporter丨Dong Qian)