Reporter : Huang Hui
Editor : Chen Haifeng
Publisher : Central Commission for Discipline Inspection, National Supervision and Administration Commission website via China News Network
Translation, editing : Gan Yung Chyan
/ KUCINTA SETIA
As of 12 am on 15 July 2020, Beijing had no new cases of newly diagnosed novel coronavirus pneumonia (covid) for 10 consecutive days. The Ministry of Culture and Tourism issued a notice in the evening of 14 July that localities can resume cross-provincial team travel and "air ticket + hotel" business under the premise of epidemic prevention and control. On 14 July, the Civil Aviation Administration of China (CAAC) approved the first batch of international passenger award flights such as China Eastern Airlines flight MU2573/4 and flight MU593/4... Various indications indicate that life affected by the epidemic has gradually become normal. The website of the Central Commission for Discipline Inspection, the National Supervision Commission, interviewed Wu Zunyou, the chief expert in epidemiology of the Chinese Center for Disease Control and Prevention, and asked him to make judgments about zero cases and the future epidemic situation.
In the future, the epidemic in the People's Republic of China (PRC) will be dominated by imported cases, and sporadic cases will continue to occur in some places, and it is difficult to blockade by prefecture-level cities.
Reporter: There are zero newly confirmed cases in Beijing for 10 consecutive days, and there are sporadic imported cases in individual areas of the country every day. Please determine what kind of trends and characteristics the next epidemic situation may show?
Wu Zunyou: This shows that, first of all, the covid outbreak and its associated transmission in the Xinfadi wholesale market in Beijing have basically been terminated. My country has once again returned to the epidemic characteristics of sporadic imported cases.
Secondly, the global epidemic situation shows a continuous rising characteristic. From the perspective of all continents, the epidemic situation in the Americas, Asia, Africa and the Middle East has gradually increased. Only the European regional epidemic situation is stable, but it still maintains a high epidemic level.
Thirdly, the epidemic situation in various countries has been unevenly developed. Some countries experienced a period of epidemic peaks. Due to effective prevention and control measures, the epidemic situation has been well controlled, including PRC, Japan, South Korea, Italy, Spain, Germany, and the United Kingdom.
Fourthly, the epidemic situation in some countries continued to rise all the way and almost lost control. For example, in the United States, the number of new cases reported daily increased from more than 20,000 cases two weeks ago to more than 40,000 cases, and then continued to rise to more than 50,000 cases. In recent days, it has exceeded 60,000 cases. Professor Anthony Fauci, an infectious disease expert in the United States, said that due to the weak prevention and control measures in the United States, the daily reported new cases may reach 100,000 cases. Brazil is closely followed by the United States, with 40,000 cases reported daily. In addition, the epidemic situation in India has risen all the way, with more than 20,000 new cases reported daily.
Fifthly, some countries have rebounded to varying degrees after the epidemic situation was better controlled, including Japan, South Korea, and Singapore. With the resumption of production and resumption of operations in most countries, the epidemic rebound in some countries will become a common phenomenon.
Sixthly, China's epidemic situation has been squeezed in two ways. First, it is similar to the sudden epidemic situation in the Xinfadi wholesale market in Beijing and the epidemic situation in the Wuhan Huanan Seafood Market. The reason has not yet been identified. Second, as more and more flights resume, more cases are imported overseas The pressure is increasing. For example, on June 11, 17 passengers on China Southern Airlines flight 1 were nucleic acid positive; on June 27, 6 passengers on Sichuan Airlines flight 1 were nucleic acid positive.
Finally, I am confident that PRC will not have a second serious epidemic similar to that in Wuhan at the beginning of the year. This confidence mainly comes from two practical cases: First, from January to February, 30 provinces (autonomous regions and municipalities) other than Hubei have successfully controlled the spread of outbreaks caused by inflow cases in Hubei. City) The total number of cases is controlled within 2,000 cases. In fact, only four provinces of Guangdong, Henan, Zhejiang and Hunan have more than 1,000 cases, and the other provinces have less than 1,000 cases. The second is the control of the spread of local epidemics in Northeast China and Beijing Xinfadi. The control of sudden outbreaks has fully demonstrated that all parts of the country have the ability to control the outbreak in a timely manner. In the future, the epidemic in my country will be dominated by imported cases, and sporadic cases will continue to occur in some places, and it is difficult to lock down prefecture-level cities.
The prevention and control strategy adopted at this stage can basically maintain a low level of domestic epidemic situation
Reporter: With the resumption of work and production, it will inevitably bring more demand for resumption. There are still many cases in the world. The domestic epidemic situation has basically blocked the local spread. With the increase in the flow of people inside and outside the country, how to solve this contradiction?
Wu Zunyou: Still rely on precise prevention and control. Taking the measures taken by Beijing in response to a sudden new coronary pneumonia epidemic in the Xinfadi wholesale market as an example, it fully embodies the guiding ideology of "scientific prevention and control and precise policy enforcement". There are several aspects worth summing up, for reference in the future to deal with similar epidemic situations. First, the public's awareness of the epidemic situation and prevention and control have increased, which is particularly important for controlling the rapid spread of respiratory infectious diseases. For example, the earliest diagnosed cases had a strong sense of prevention and control throughout the consultation process. Wearing a mask and not taking public transportation did not cause infection to a family member or close contact person. More importantly, he can also use his memories to indicate where he might be infected. Second, disease control personnel have strong awareness and ability to sensitively capture important information from the epidemiological investigation of early cases, pay attention to the new wholesale market in a timely manner, and determine the source of infection. Thirdly, the joint defense and joint control response mechanism established by the government department is sensitive and acts quickly. It closes the newly developed market as soon as possible, blocks personnel who may be exposed, and promptly and decisively cuts off the propagation route. The fourth is to use big data to lock the market that has left the new development area, including those who have left the risk of exposure in Beijing, and provide scientific and technological support for blocking the further spread of the virus. Fifth, high-risk personnel in Beijing were accurately identified, leaving Beijing was restricted, and proliferation was prevented. Sixth, determine the nucleic acid screening strategy, actively search for those who have been infected and have not yet infected, and block their spread before the virus spreads. Seventh, the high- and low-risk epidemic risk levels and timely adjustments have minimized the impact of the sudden epidemic on the work and life of the general public.
The occurrence of infectious diseases has its inherent laws, and understanding its natural laws is very important for effective control of the epidemic. To achieve precise prevention and control, we must fully apply the natural laws of understanding to prevention and control practices. For example, the definition of close contacts: at what distance and in what way is the close contact? If a passenger tests positive for the SARS-CoV-2 nucleic acid, are the passengers and staff of the entire train considered close contacts? Generally speaking, for covid, the passengers in the first three rows and the back three rows of the patient’s seat should be close contacts. There is no need to treat all passengers in the entire cabin as close contacts, not to mention the entire train. All passengers and staff are close contacts.
Or in terms of close contact, usually the patient is contagious 1-2 days before the onset of symptoms. When a patient is diagnosed with a new coronary pneumonia case, the patient is in close contact during the period from the first symptom onwards to the time of visit People who are close contacts are pushed forward. Those who contacted within 2 days before the first symptoms appear are also close contacts. There is no need to count people who have been in contact with the patient one week or even 10 days before the onset of symptoms as close contacts.
These all reflect the concept of precise prevention and control. In short, if you grasp the two dimensions of time and space, you can accurately prevent and control the virus spread.
The most important challenge PRC is currently facing is importing cases from abroad. The new Coronary Pneumonia virus cannot disappear within a short period of time. As long as no country can achieve zero reset, my country will always be threatened by imported cases.
The prevention and control strategy adopted at this stage can basically maintain a low level of domestic epidemic situation. As PRC's international routes are gradually re-opened, imported cases may gradually increase. The current fuse strategy adopted by our country partially resolves this contradiction to a certain extent. However, the current level of resuming flights is still very limited, and it is still far from meeting the basic requirements of resuming production and international exchanges, exchanges, and trade. Resolving this contradiction cannot be achieved overnight. It requires a running-in process to find the best balance between epidemic control and resumption of production.
There is no need to excessively pursue the control goal of zero cases, as long as the epidemic situation is controlled at a low level, and the basic social and economic development requirements can be guaranteed, this is the best strategy.
Reporter: What social cost will it bring if we pursue zero cases? Should we pursue zero cases?
Wu Zunyou: The pursuit of zero cases is the highest level of infectious disease prevention and control, and also the most important indicator for achieving complete control of infectious diseases. When a new infectious disease is very difficult to control to zero case level, or to control and maintain the zero case level, and the social and economic costs required are particularly huge, we need to reconsider prevention and control strategies and prevention and control goals.
When people pursue zero cases, they are often worried that "a spark can burn the prairie", and if a case is not handled properly, it may cause a chain reaction, triggering a "domino effect", which spreads ten to ten, making the epidemic uncontrollable. . In fact, the epidemic of infectious diseases has its own rules.
According to the epidemic law of infectious diseases, the basic regeneration index of an infectious disease, that is, an average of several people per patient. When this regeneration index is greater than 1, the number of infectious diseases will increase, and the epidemic will show an upward trend. When this regeneration index drops to less than 1, the number of infectious diseases will decrease and the epidemic situation will decline. The basic regeneration index of New Coronary Pneumonia is between 2-6, that is, without any prevention and control measures, the average patient can infect 2-6 people. The basic regeneration index is affected by the density of the population and the way people interact. When the prevention and control measures of wearing a mask and keeping a social distance of 1 meter are adopted, the basic regeneration index drops to less than 1, and the epidemic will be controlled.
Therefore, there is no need to excessively pursue the control goal of zero cases. As long as the epidemic situation is controlled at a low level and the basic social and economic development requirements can be guaranteed, this is the best strategy.
The total resources of any society are limited, and there are many other diseases that affect human health. Over-emphasis on the complete control of the new coronary pneumonia epidemic may result in a loss of balance, making other diseases more harmful to the health and life safety of the people than the new coronary pneumonia epidemic. How to find the best balance to maximize the health benefits of the people is a new proposition before us.
Wearing a mask is a protective measure that I always adhere to. In addition, it includes insisting on frequent hand washing and opening windows while riding in the car.
Reporter: During the epidemic, we noticed that you have a lot of social activities. How do you protect yourself in public places now?
Wu Zunyou: Taking me as an example, I am still assisting in the Beijing Center for Disease Control. My main task is to assist in investigating why a local virus transmission center has been formed in the Xinfadi wholesale market, and how the new coronavirus was first introduced. The new market. To complete these tasks, my main activities include participating in video conferences, face-to-face meetings with relevant staff, coordinating with relevant departments, on-site investigations, interviews with early patients, and transportation. In these activities, wearing a mask is always a protective measure. In addition, insist on washing hands frequently, opening windows and ventilating while riding.
SARS-CoV-2 has been prevalent for more than half a year. Although we have limited knowledge about it, but for more than 6 months, our knowledge of the characteristics of this virus has grown rapidly. Everyone needs to realize that the SARS-CoV-2 cannot disappear in a short time and will coexist with humans for a long time. We may, at least for a considerable period of time in the future, never return to the way we lived and worked before the end of December 2019. In other words, the coronavirus may change the way people live and work from then on.
We need to recognize and gradually accept the fact that sporadic input cases in PRC, and even a small number of subsequent cases, will become the norm in our lives. For the general public, learn to accept this reality as soon as possible.
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