Why adhere to the "dynamic zero", why can not "coexist" with the virus? The National Health Commission experts said these five points

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On October 13, the State Council joint prevention and control mechanism held a press conference to introduce the scientific and precise to do a good job in the prevention and control of the epidemic situation.

Now the virus is spreading fast, but the infected people are mainly mild and asymptomatic, the virus is so light, why can’t we “coexist” with the virus, why do we pay a lot of efforts to insist on “dynamic zero”? In response to the above questions, Liang Wannian, head of the expert group of the National Health Commission’s Leading Group for Epidemic Response and Disposal, explained five reasons at the meeting.

First, Liang Wannian explained the concept and core meaning of “dynamic zero”.

First, the Chinese government’s “dynamic zero” anti-epidemic policy and strategy is determined by the concept of “people first, life first”. Secondly, based on the current understanding of the characteristics of the virus, especially the direction of its mutation and the changes in its harmfulness after mutation, including the understanding of the disease, it is not possible to completely eradicate the virus, nor is it possible to guarantee that there will not be a single case or an epidemic. The core of this policy is to interrupt the epidemic, not to eliminate the virus, and not to allow one case to appear. In short, the core of “dynamic zero” is to stop the continuous community transmission of the epidemic and prevent the formation of a large-scale epidemic or the rebound of a large-scale epidemic. To achieve “dynamic zero”, there are two key words that are most important, one is fast, fast detection, fast disposal; the second is precision, accurate identification of the epidemic, accurate delineation of the scope of the epidemic area, accurate epidemiological investigation, accurate determination and management of close contacts, accurate clinical treatment, and ultimately accurate balance between epidemic prevention and control and Socio-economic development.

Second, there are two different perspectives for measuring the magnitude of an epidemic’s harm. The common international public health perspective is to stand from a population perspective and use indicators such as mortality and excess mortality to measure the epidemic, rather than from a morbidity and mortality, individual perspective. For the Omicron variant, it is true that its disease and death rates are decreasing compared to previous variants and the original strain, but because it is spreading faster, spreading more insidiously, and the immune escape phenomenon is gradually increasing, the total morbidity rate is high, which means that there will be a large number of infections in the population. A higher number of infections multiplied by the individual morbidity and mortality rate will result in a relatively high number of deaths, and the population mortality rate will be higher than that of influenza, and no less than that of the original strain and other mutant strains, which shows that its overall harm to humans has not seen a significant decline, and this is an important indicator for the World Health Organization and various countries to judge its harm.

In addition, the excess mortality rate, which means that the emergence of this disease affects not only the seriousness and death of patients infected with the disease, but it may also lead to a crowding of medical resources, which affects the demand for other normal medical services and may lead to unnecessary deaths in normal conditions. In scientific terms, the measurement of such additional deaths due to the impact of the epidemic is called “excess deaths”. This is calculated by comparing the total number of deaths this year with the total number of deaths in the country or region last year or in the previous three years, and if there are no other explanatory factors, the excess deaths are attributed to the epidemic. The current situation is that the excess deaths caused by the new crown pneumonia epidemic either by the original strain or by the previous mutant strains, especially the Omicron mutant strain, are still relatively high and have been studied at more than 100 per 100,000.

Third, the total population of China is large, the proportion of the elderly population is high, the elderly population of 267 million, which is a very large base, at the same time there are a large number of patients with underlying diseases, these people are at high risk of infection with the new coronary pneumonia virus, the probability of serious illness or even death after infection is higher than the general population. Combined with the effect of prevention and control in the previous period, the overall rate of NCCV infection in our population is low and the natural immunity acquired is not strong. Although a certain level of immunity is acquired through vaccination, the escape of new mutant strains of this immunity is increasing. Therefore, if we relax and do not “dynamically clear”, we will inevitably cause a large number of infections, which may lead to a large number of serious illnesses and even a large number of deaths in the elderly population and those with underlying diseases. This is intolerable, so we must do our best to protect ourselves.

Fourth, there is still no way to fully grasp the scientific knowledge of what direction the new coronavirus will change in the future, and how virulent, pathogenic and harmful it will be after mutation. But one thing is certain in the scientific community, this virus will always change, change is its normal state. The Omicron variant is certainly not the last variant of the new coronavirus, there is a great deal of uncertainty, in this case adhere to the existing prevention and control strategy, adhere to the “dynamic zero” general policy, the last three years of prevention and control results proved to be effective, feasible and scientific. “In the face of these uncertainties, we should use a deterministic strategy, deterministic approach to combat this uncertainty.”

Fifth, the long-term harm of this disease should be considered. Now internationally, scientists from various countries are very concerned and worried about the sequelae of infection with the new crown, and some studies have shown that a certain percentage of infected people will experience a variety of sequelae such as fatigue, breathing difficulties, neurocognitive impairment, etc. The pathogenic mechanism and eventual duration of this condition are not fully understood scientifically, unlike general influenza and known diseases.

Liang Wannian said, based on the above considerations, China’s current general policy of “dynamic zero” is necessary.