Always avoiding the new crown is not the way! Experts: positives become the norm, downgrade management is more reasonable

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As 2022 draws to a close, with the continued optimization of epidemic prevention and control measures, the country is pressing the “accelerator button” to resume work and production.

For example, the resumption rate of the top 100 enterprises in Beijing Economic and Technological Development Zone reached 100%; the cumulative resumption rate of major projects in Chongqing reached 99.5%; Guangzhou City, Shenzhen City and many other places have issued several rounds of consumption vouchers since December, looking forward to regaining the city’s fireworks.

However, at the same time, the number of newly crowned infected people everywhere is also in a period of rapid growth. The vast majority of infected people soon returned to work and continued to embrace their new lives after a few days of rest and recovery.

During the morning rush on December 14, Beijing subway traffic picked up, but it was still much less than in the past

There are also some industries and enterprises to promote the resumption of work and production face difficulties, many enterprises because of the emergence of a large number of positive infected, business operations a sad cloud; take-away, courier and other service industries because of the high risk of infection, high salary but difficult to find a person, urban services suffered a heavy blow; some schools, but also because of one or two students appear antigen-positive, the entire offline teaching said to stop, students delayed delay in school ……

In the face of the current situation, a number of experts told Life Time that always avoiding the new crown is not the way to go. Nowadays, the harm of Omicron strain has been greatly reduced, and infected people can generally turn negative in about a week. We can only manage the new crown like the flu to really help all industries to restore power in a safe and orderly manner, and let all people return to their normal working life as soon as possible.

Positive becomes the norm for new crown downgrade management is more reasonable

In recent times, the number of positive New Guan infections in Beijing has increased significantly, and the trend of rapid spread of the epidemic still exists. A large number of asymptomatic infected people or light cases recovered at home, and some industries were once in a semi-stoppage due to positive cases, “ten mixed one” positive nucleic acid tests, and scarce customers.

For example, after the Xidan Pearl Mall resumed business on December 7, there was very little traffic, and the average arrival rate of merchants in the whole building was less than 20%, so they finally had to shorten their business hours and suspend business on some floors. A senior class in a city in Hunan province, the class suspended offline teaching and went home to self-isolation because of a positive student.

“Winter is supposed to be the high season for respiratory diseases, and at present, a large increase in newly crowned infections is inevitable, with major cities such as Beijing and Shanghai nearing the peak of infection, and second- and third-tier cities and rural areas likely to continue to increase for some time before reaching the peak of infection.” Zhang Dan, chief physician and director of the Division of Infectious Diseases at Peking University Shougang Hospital, said that as more and more positive cases emerge, Omicron has begun a massive epidemic, and the focus of epidemic prevention and control and health care will have to shift from prevention and control of infection to treatment.

Sun Dongdong, a professor at Peking University School of Law and an expert in health law, said that by Dec. 14, it had been a full week since the “new ten articles” were put into effect. According to the law of virus metabolism, the number of infections in Beijing may decrease after about Dec. 21. As more and more people have “first-hand experience” with the virus, their understanding of Omicron will become more accurate, and the phenomenon of drug hoarding and medical crowding will gradually ease. However, it is true that some employers are overreacting to the infection and raising the bar on their own, and some employees are reluctant to return to work for fear of infection, which is preventing people from returning to their normal lives. Realistically, we should scientifically recognize the Omicron variant strain. Although the infection varies greatly among individuals and the severity of symptoms varies from person to person, it is basically an upper respiratory tract infection that does not bring about lung damage. Therefore, we should treat it as seasonal influenza and put the management of the new crown drop category on the agenda.

Tan Xiaodong, a professor at Wuhan University School of Public Health, also said that there will be a transition period for the policy, and it is expected that in January next year, the new crown will return to the management of class B infectious diseases. In the future, the management of Omicron is going to be on par with the management of other winter infectious diseases such as influenza. It is always the case that the normal operation of the whole, or even the whole society, is affected because of positive individuals, which is contrary to the social vitality and the purpose of policy optimization desired by the public.

Asymptomatic, mildly ill people should return to work

At present, ordinary young and middle-aged patients infected with Omicron are mostly asymptomatic or mildly ill, and the course of illness is usually 5-7 days. Those who have received the new crown vaccine and completed booster immunization have a shorter and milder course of illness.

According to the criteria of “Guidelines for Home Treatment of New Coronavirus Infected Persons” issued by the Integrated Group of Joint Prevention and Control Mechanism of the State Council, home treatment of persons with significantly improved symptoms or no significant symptoms, negative self-test antigen and two consecutive nucleic acid tests with Ct value greater than or equal to 35 (the interval between two tests is greater than 24 hours) can end home treatment and resume normal life and going out.

However, at this stage, due to the lack of nucleic acid testing power, many communities can no longer do home nucleic acid testing services, some communities can directly refer to two negative antigen can be released from home isolation.

“Asymptomatic infected people at home does not have practical significance.” Zhang Dan said, from the perspective of prevention of infectious diseases, in order to cut off the transmission route, positive infected people should be home until two nucleic acid tests are negative, but only if the new coronavirus in a limited range of transmission. And as the positive population increases, according to the data pattern of foreign transmission, around January next year, the infection rate of our population will increase to about 60% to 70%, and around March next year, it may reach 90%. It can be said that almost everyone is “positive” after a while. If all positive infected people are managed at home, society may be paralyzed for a long time, so it is necessary to consider alternative solutions to maintain the productive life of the whole society. In the face of manpower shortages in many industries, asymptomatic and mild cases should be allowed to return to work, and this is a program that many institutions have begun to implement. For example, in response to the surge in demand for medical treatment, many healthcare institutions have had to return asymptomatic and mildly ill healthcare workers to work.

The practice of the HKSAR government is that the return to work of a population can be judged according to the severity of the symptoms of a new crown.

1 Seriously ill patients have to be hospitalized. Serious illness refers to those with 10 types of symptoms related to New Guan pneumonia such as fever, dry cough, malaise, sore throat, loss of taste and smell, nasal congestion, runny nose, conjunctivitis, myalgia, diarrhea, etc. after a positive nucleic acid for New Guan, and with a confirmed diagnosis of pneumonia on imaging.

2 Patients with mild cases may return to work after remission. Light cases that can be treated at home can return to work after taking medication and proper rest, and after the symptoms have subsided without affecting physical strength.

3 Asymptomatic infected patients can go to work normally. If there are no typical symptoms of new crown, or only mild weakness and headache, which do not affect work, you can go to work normally.

However, a distinction needs to be made according to the intensity of the work an individual is engaged in and the degree of physical tolerance. For example, people who are engaged in heavy physical work should change to light physical work or rest even if they are asymptomatic infected people who appear to be unable to perform their work.

Protecting key populations and focusing on areas with weak medical resources

Sun Dongdong believes that if we want to fully promote the resumption of work and production, we must conscientiously implement the Law on Prevention and Control of Infectious Diseases, rationalize the epidemic prevention policies such as the “20 articles” and “10 new articles”, and adhere to the “prevention-oriented, combined with prevention and control, relying on science and the masses” policy. The work policy of infectious disease prevention and control is “prevention-oriented, combined with prevention and treatment, classification management, relying on science, relying on the masses”.

First of all, the premise and basis of resuming work and school is to adhere to the implementation of a series of policies and measures, guidelines, active symptomatic treatment of key populations, as far as possible to prevent combined bacterial infections, inducing damage to vital organs, etc.

Secondly, the current new crown pneumonia is a class B infectious disease according to the management of class A. It is recommended that the new crown be reduced to class B management, while the simple upper respiratory tract infection caused by Omicron, reduced to class C management, and influenza is also class C.

In addition, in the resumption of work and production has been the urgent need of the people, especially near the Spring Festival, the health code and the implementation of various types of codes around the world should be abolished as soon as possible, because it has lost the significance of epidemiological investigation. In particular, the current health code and nucleic acid testing regulations are still contradictory. For example, health codes and negative nucleic acid certificates are no longer checked when taking public transportation and going to public places such as parks, and negative nucleic acid certificates are required for dine-in restaurants and work in many places, but community nucleic acid testing sites have been gradually withdrawn, and social nucleic acid site test results are delayed, causing many people to delay their work and dining inconveniences.

Of course, the abolition of the health code does not mean that you can completely relax your vigilance, for some special institutions, such as nursing homes, psychiatric hospitals, etc., it is still necessary to strictly manage the nucleic acid test.

Once again, individuals and institutions such as enterprises and institutions should take up the corresponding responsibility. Sun Dongdong stressed that the most crucial thing is to “rely on the masses” to fight the new crown. Asymptomatic infected people, patients with minor illnesses and people recovering from infection should wear N95 masks and do hand hygiene after returning to work. At the same time, organizations should be “programmed” to strengthen workplace environmental health management, reduce the risk of aerosol transmission, regular disinfection and ventilation of premises, and take appropriate measures to enhance the immunity of personnel. For example, enterprises should encourage their employees to be physically active between work hours and do interval exercises; schools can encourage students to do more outdoor activities during school hours. Everyone should insist on scientific prevention of the epidemic. Only on the basis of not hiding from the new crown, not being afraid of the new crown and correctly understanding the epidemic, making rational judgments about the situation and working together with all people can overcome the difficulties.

Tan appealed: “We can’t just focus on big cities; medical resources in second- and third-tier cities and rural areas are relatively weak, and vulnerable people such as children, the elderly and pregnant women are even larger. At present, the first-tier cities such as North, Shanghai and Guangzhou are reaching or have reached the peak of infection, and the second- and third-tier cities and rural areas are in the rising number of infections, with a window of one to two weeks left, which is our most important moment!”

1 Get ICU, critical care and other resources ready

Recently, the “Work Plan to Enhance the Medical Protection Capability of New Coronavirus Pneumonia in Rural Areas by Relying on County Medical Community”, which was studied and developed by the State Council’s Joint Prevention and Control Mechanism for Response to the New Coronavirus Pneumonia Epidemic, also clearly proposes that medical services for new coronavirus pneumonia in rural areas should be well prepared to ensure timely treatment of infected patients with high risk of serious illnesses such as advanced age combined with underlying diseases, and in rural areas, county medical communities should be used as a carrier to enhance County hospitals’ ability to treat serious illnesses, and play the role of health monitoring in township health centers and village health offices to minimize the rate of serious illness and death.

2 Strengthen health education

Relevant government departments and mass media, through extensive publicity and education, should guide society to scientifically and correctly understand Omicron and guide individuals to do a good job in health management, including scientific disinfection and ventilation of the home environment, daily nutritional balance and scientific exercise. At present, most people only need home treatment after the emergence of symptoms, and must first focus on observation, not indiscriminate use and abuse of drugs, otherwise it will bring more harm.

In addition, the current priority should be to ensure that hospital patients, elderly people in nursing homes and other key people’s drug needs, I hope that people do not blindly rush to buy and hoard drugs, which will lead to difficulties in purchasing drugs for people who really need them.

3 Get a booster shot as soon as possible

Medical workers, the elderly, pregnant women and children should be the first to receive the fourth vaccination. on December 13, the State Council should joint prevention and control mechanism comprehensive group issued the “implementation plan for the second dose of booster vaccination for the new coronavirus vaccine”, proposing the second dose of booster vaccination among people at high risk of infection, elderly people over 60 years old, people with more serious underlying diseases and people with low immunity.

The last two weeks is the golden time for booster vaccination, and it is also an effective means to reduce the rate of serious illness and death. Relevant populations should be vaccinated as soon as possible, and sequential booster immunization (the type of vaccine used for the booster is different from the previous two doses) is recommended as a priority.