Reporter : Li Mingzi / Publisher : China News Weekly / Translation, editing : Gan Yung Chyan, KUCINTA SETIA / Image : Covid infection at Hebei Oujing Holiday Hotel, near Shijiazhuang Zhengding Airport
In the afternoon of 7 January 2021, at a press conference on epidemic prevention and control held in Shijiazhuang, Hebei Province, Shijiazhuang Deputy Mayor Meng Xianghong introduced that all vehicles and personnel in Shijiazhuang city are not allowed to leave the city, and people in Gaocheng District, a high-risk area, are not allowed to leave the local area.
According to the official website of the Hebei Provincial Health Commission, on 6 January 2021, there were 51 newly confirmed cases of local covid and 69 local asymptomatic infections in Hebei Province. As of 7 January, the number of new infections in Hebei Province rose to 234 within five days, of which 90 were confirmed cases, and 144 local asymptomatic infections are still under medical observation.
Judging from the location of the confirmed cases, at least 81 cases are from Gaocheng District, Shijiazhuang. Only three administrative villages, Xiaoguozhuang Village, Liujiazuo Village and Nanqiaozhai Village have more than 72 confirmed cases. The villages are all located near Shijiazhuang Zhengding International Airport, about 10 kilometres away from the airport.
Where did the virus come from and how did it spread to local villagers? At the press conference on Shijiazhuang's response to the new crown epidemic held in the evening of 6 January, the spokesperson said that traceability is still in progress.
The earliest onset may be in mid to early December
Looking back on the itinerary of all the confirmed patients this time, a total of 6 people mentioned that they had attended a wedding banquet at a hotel or restaurant near Airport North Road on 28 December 2020. Another man worked in the back kitchen of a restaurant near Airport North Road. He was diagnosed on 6 January.
So far, there have been two frequently repeated itinerary intersections. The seven people all came from "Xiaoguozhuang Village, Zengcun Town, Gaocheng District", and appeared at "a hotel near Airport North Road" on the same day.
According to villagers in Xiaoguozhuang Village, the restaurant where the wedding was held on 28 December was called "Oujing Ecological Garden Restaurant (Shijiazhuang Airport Store)." Gaode's map shows that the Oujing Ecological Garden Restaurant is located in the North Ring Road of the airport, in the Hebei Oujing Holiday Hotel opposite the T1 terminal of Shijiazhuang Zhengding International Airport. At present, the Shijiazhuang Oujing Ecological Garden Restaurant and Shijiazhuang Oujing Holiday Hotel near the airport have been closed for disinfection. It is about 10 kilometres from Xiaozhuang Village to the airport and only 20 minutes by car.
The earliest symptom of these 7 people was a 66-year-old man who had sore throat as early as 23 December 2020. During this period, he did not take medicine and did not see a doctor. From 24 to 27 December 2020, he did not go out at home. On 28 December, he attended a wedding at a hotel on North Airport Road and did not leave his house from 29 December 2020 to 1 January 2021. He self-medicated at night of 2 January as he felt unwell. On 3 January, the whole village was tested for nucleic acid, and the test result of the man was positive. On the same day, he was transferred by a 120 negative pressure ambulance to Shijiazhuang Fifth Hospital. He was diagnosed as an asymptomatic infection, and he was converted to a confirmed case (common type) on 4 January 2021.
Liang Lianchun, Director of the Department of Infectious Diseases, Beijing You'an Hospital, Capital Medical University, once publicly introduced that the course of covid is 4-14 days, and when the disease is advanced, clinical symptoms such as cough, chest tightness, wheezing, and dyspnea appear clinically. Jiang Qingwu, an epidemiologist and former dean of the School of Public Health of Fudan University, said in an interview that the patient may indeed have been infected before this period. In other words, the 66-year-old confirmed patient has been infected in the first half of the year, as early as mid-December.
According to the announcement on the official website of the Civil Aviation Administration of China on 5 June 2020, based on changes in the epidemic situation, it was decided to adjust the destination to Beijing's designated first entry point for international passenger flights. After the adjustment, there are 16 designated first entry points for international passenger flights destined for Beijing, including Shijiazhuang. In addition, in accordance with the circuit breaker instruction issued by the Civil Aviation Administration on 31 October, 14 passengers on Air China's CA910 flight (Moscow to Shijiazhuang) that entered on 24 October had a positive nucleic acid test. Starting from 9 November 2020, CA910 was suspended for a month.
On 6 January 2021, "China CDC Weekly" and "China Centers for Disease Control and Prevention Weekly (English)" published an article written by the Center for Disease Control and Hebei Provincial Center for Disease Control and Prevention, which stated that the centre confirmed the confirmed cases in Shijiazhuang on 2 January (A ) while Xingtai confirmed case (B) samples were sequenced. The results showed that the virus strain did not have any relationship with the genomes of imported cases reported in China and the domestic clustered epidemic caused by imported cases. The traceability of the virus that caused the epidemic caused by the secondary transmission caused by the local epidemic in various parts of the country is underway.
Further analysis revealed that samples A and B are highly similar, and both belong to the mutation characteristics of the branch gene locus of the European family branch I/B.1.1.123 of the L genotype, suggesting that the source of the virus infection in the first case in the two cities belongs to the same source of transmission. It is in the same transmission chain and does not contain the key amino acid mutations of the new South African and British strains. A search in the global public database revealed that the genome sequences of A and B have 10 identical nucleotide variations with some Russian genome sequences uploaded in July. Although there are few common mutation sites, the three specific sites detected from the Russian strain only appeared in this Hebei strain, and the virus may have originated from this Russian strain.
"From the results of virus traceability, the virus is imported from abroad, but whether it is related to the airport, there is still no clear evidence from epidemiological investigations and environmental testing, and it is still under investigation." Feng Zijian, Deputy Director of the Chinese Center for Disease Control and Prevention said in an interview with "China News Weekly" earlier.
Poor vigilance in rural grassroots clinics
According to publicly-discussed information, multiple confirmed patients had already developed symptoms in late December.
In addition to the 66-year-old male patient who developed symptoms on 23 December 2020, two of the confirmed cases on 6 January reported that they had symptoms as early as 25 December 2020.
Lu Fei, Director of the Shijiazhuang Center for Disease Control and Prevention, introduced at a press conference earlier that the Hebei epidemic is characterized by a high incidence. According to the trajectory of confirmed patients on the 6th announced by the Hebei Provincial Health Commission, new cases were also found outside Gaocheng District, the only high-risk area in the country.
One of the patients lives in Zhengding County, Shijiazhuang City, but she often returns to her mother-in-law's house in Liujiazuo Village. Another 30-year-old male patient lives in Binhe Community of Xingtang County, about 30 kilometers away from Xiaoguozhuang Village, and drove for about 1 hour. Strangely, he said he had been active in Xingtang County's jurisdiction and had never been there before. The itinerary of the case is as follows:
In the morning of 27 December 2020, the male patient drove back to his home in Binhe Community, Xingtang County from Yushe County, Jinzhong City, Shanxi Province; on the morning of 31 December, he drove to the gate of Longcheng School in Xingtang County to pick up his family, and rode a tram to the bridge in the afternoon, attended foreign language tutoring class, then dinner at the father-in-law’s house in Anxia Village, Zhaiying Township, Xingtang County. He shopped at his biscuits shop and Zhaozhao supermarket on 1 January 2021. He did not leave home on 2 January. He arrived by car on 3 January at Tang County Longcheng School to pick up his family. On 4 January, the patient did not go out. On 5 January, he felt unwell and went to the nearby Yunfeng Clinic for treatment, and drove to Xingtang County Traditional Chinese Medicine Hospital for a nucleic acid test. The result was positive and on 6 January the 120 negative pressure transfer vehicle transferred him to the Fifth Hospital of Shijiazhuang, where he was diagnosed as a confirmed case.
How the patient in Xingtang County was infected is currently unknown. According to public traffic information, a new 35-year-old female patient in Liujiazuo Village, Gaocheng District, went on a trip with him on 6 January. On 1 January, he drove to his mother's house in Binhe District, Xingtang County, and also went to the Xingtang County Traditional Chinese Medicine Hospital on 5 January for a nucleic acid test. The result was positive.
A staff member of the Xingtang County Government stated that the nucleic acid test has been completed for the people in Binhe District. The staff of Xingtang County Hospital of Traditional Chinese Medicine concluded the interview and said that the hospital is currently operating normally. If nucleic acid testing is required, personnel from outside Xingtang County will go to the new hospital area for testing according to regulations, while local residents will be tested in the old hospital area.
In the announced case schedule, there is another patient with no history of contact, male, 69 years old, a resident of Shijiazhuang Economic and Technological Development Zone in Gaocheng District. The patient is in poor health and limps. Due to the cold weather, he has not been out at home since mid-November 2020. On 4 January, the nucleic acid screening was positive; on 5 January he was sent to Shijiazhuang Fifth Hospital by a 120 negative pressure ambulance. On 6 January, he was diagnosed as a confirmed case.
"The virus spreads secretly for a period of time" has become an expert consensus. Lu Hongzhou, secretary of the Party Committee of the Public Health Clinical Center affiliated to Fudan University, also said that they have found that antibodies have been found in some people, and it takes a week or two from infection to appearance of antibodies.
In addition, on 28 Decembe 2020, a 55-year-old female villager from Liujiazuo Village, Gaocheng District, came to the village clinic because she felt unwell, and stayed at home until December 31 without going out. On New Year's Day 2021, she went to the village clinic again for treatment, and that day she also went to work at the Lijie Furniture Factory in Dongqiaozhai Village. On 6 January, she was diagnosed as a confirmed case through investigation.
Another female villager from Liujiazuo Village visited the village clinic twice before the diagnosis on 4 January. At 6 o'clock in the morning on 25 December last year, this lady and her daughter-in-law accompanied her granddaughter to take a taxi from the village to the respiratory department of Hebei Children's Hospital for treatment. They were referred to Xinle City Hospital at 12 noon and returned home. The next day, her lover drove her to the Xiaoguozhuang Village Infirmary for medical treatment, and received an infusion for four days. On 2 January 2021, this lady went to Gaocheng North Street Clinic again. The nucleic acid test was not performed until the Gaocheng District People’s Hospital on 3 January, and the result was positive. At 11 pm, he was transferred by a negative pressure ambulance to the No. 5 Hospital of Shijiazhuang City. He was confirmed a severe case on 4 January.
In the publicly polled information, 11 people had been to the village clinic due to symptoms such as discomfort or obvious cough, headache, and a 66-year-old confirmed patient went to the Chengyuan Village Clinic in Zengcun Town due to fever on 1 January. It now appears that these situations have not been reported in time.
"This Hebei epidemic mainly occurred in rural areas, which also reminds us that we have not emphasized enough on epidemic prevention and control in rural areas." Lu Hongzhou told China News Weekly that after the infection in rural areas, grassroots clinics are not vigilant. This is the current situation. For the weak links in prevention and control, training should be strengthened to detect infected patients early.
Regarding the development trend of the Hebei epidemic, Lu Hongzhou commented, “Clustered cases are inevitable, but China cannot have a major epidemic.” Lu Hongzhou analyzed that firstly, the government attaches great importance to strict prevention and control to ensure that the people are supreme and lives are supreme. Secondly, deeply influenced by traditional Confucian culture, the people can obey orders and implement strict prevention and control measures; third, with the aid of a powerful information tracking system, all relevant close contacts and close contacts can be found; finally, through the development of nucleic acid effective prevention and control can be achieved through detection work, identification of infected patients, early detection and early isolation.
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