Publisher : People's Daily / Translation, editing : Gan Yung Chyan, KUCINTA SETIA
The end of 2020 is severely cold. Local covid cases spread one after another with virus tracking and partial closures. At the same time, China announced that the SARS-CoV-2 (CCP virus) vaccination is free for all. What is the outlook for the development of the epidemic in 2021? From Shanghai to the whole country, what are the risks and pressures of epidemic prevention and control? How urgent is the vaccination, and who must be vaccinated? The Spring Festival is coming. Will people face a new wave of communication crisis? ...
To this end, Da Jiangdong Studio interviewed Dr. Zhang Wenhong at the end of the year. In the conference room of the Department of Infectious Diseases of Huashan Hospital affiliated to Fudan University, Zhang Wenhong, who completed an expert consultation at the Shanghai Public Health Clinical Center in the morning, participated in a video network conference and a hospital meeting in the afternoon, and was about to go on a business trip to do an on-site investigation of tuberculosis prevention and treatment, spent nearly two hours accepting a series of follow-up questions, and gave the truth about the epidemic situation research and judgment and prevention and control matters.
Question 1: There are imported cases every day, and local cases appear in many provinces and cities. Can Shanghai stand up with the pressure?
Shanghai receives more than 50% of China's international flights, and every day imported cases from abroad account for more than half of the country. The risk of virus transmission has always existed and the pressure of prevention and control is great, but Shanghai has done a good job of closed-loop management.
Some time ago, there were local cases at Shanghai Pudong Airport. At that time, there were many different voices. Some people thought that the entire airport should be closed and classified as a medium-risk area. However, Shanghai immediately investigated the source of the virus and the city government and the expert team jointly agreed The meeting decided to close only one cargo area at the airport, the passenger area remains open, and Shanghai has not closed. Once shut down, outside flights will not be able to get in, which will have a great impact on not only Shanghai, but also the entire country. Shanghai cannot be closed easily, nor can it be half-closed and half-open, otherwise the exchanges between China and overseas will be greatly reduced.
How to control the epidemic in the early controllable range through precise prevention and control, while ensuring the normal operation of the city? There are many plans in Shanghai. Once a new case is found, the most important thing is to trace the source clearly and deal with the cause of the epidemic. If it is only treated downstream of the disease, the number of patients will increase.
There were local infections at Pudong Airport, and Shanghai did several things. First, it raised the quarantine level of cargo areas and further strengthened the quarantine of overseas cargoes. At the same time, vaccinated the vulnerable and high-risk groups. The first infected people were those who had direct contact with freight or frozen seafood, and then passed them on to others. When these people are vaccinated, the virus cannot be spread from person to person; strengthen the quarantine of goods and allow some high-risk goods to be placed for another week or two after customs clearance. Even if the packing box contains the virus, there will be a good automatic sterilization process. To deal with the epidemic, we must focus on the root, the source, and the cause of the source. This is the key to precise prevention and control.
Shanghai's epidemic prevention and control, the fastest traceability, to achieve full vaccination of foreign-related cold chain and cargo contacts
More than 1,000 imported cases have been cured in Shanghai. With so many imported cases, it was discovered that they were infected after they did not appear through closed-loop management. If Shanghai were to shut down and kill the whole city, the cost would be very high if all citizens were tested and all employees were isolated. We must try our best to achieve normal management, which requires very high management requirements for each link, and there must be no mistakes at all.
Question 2: The epidemic prevention and control has been normalized for so long. Is there still much interaction between the Shanghai Municipal Government and your expert team?
The Shanghai leaders interacted very well with the expert group, and prevention and control measures were easily put in place. The city government convenes a meeting every half a month, sometimes every week. Recently, our expert team will analyze the risks of the recent imported epidemic, including the risks caused by the British mutant virus to us, and conduct comprehensive communication. The main leaders of Shanghai also regularly convene expert groups to meet to exchange views on the issues they care about. On the day of the local cases in Pudong, the city leaders and experts did not sleep much. Several fronts were launched at the same time. They were all rushing to track patients, isolate relevant communities, and conduct nucleic acid tests. One night late, one day late, it won't work. Like a war.
It is impossible to expect "zero cases" at all times, but to "dynamically clear" within a period of time, the entire city can maintain normal operation. How can society be normalized if it is closed as soon as there are cases?
Question 3: The vaccine that is regarded as the "solution" has emerged. Looking at the development of the epidemic in the world, how long will our prevention and control be normalized?
After Biden was elected, the United States has a 100-day vaccination plan to vaccinate high-risk groups with 100 million doses, which means that 50 million people have been successfully vaccinated within 100 days. If the plan is successful, plus the 20 million people who have been infected, it will be 70 million...
If half of the people are vaccinated, the epidemic will have an inflection point in June and July 2021, and it may play a role by the end of the year, and the world will have a chance to communicate. Once the world is interconnected, flights increase, and internal and external exchanges increase, even if people who board the plane have nucleic acid reports or vaccination reports, it does not mean that imported cases will drop sharply, and our import risks will still increase. This is a gradual process.
The so-called high-risk groups, first of all, are those with a high fatality rate. For example, foreign countries give priority to vaccination for people over 65. In this way, the mortality rate of patients with the new crown will soon drop to the level close to the flu, entering the normalization stage, and patients no longer need to be admitted to the hospital, as long as they receive the infectious department of each general hospital. At that time, medical staff must be vaccinated to prevent nosocomial infections.
Doctor Zhang Wenhong has been vaccinated
China wants to roll out vaccination. Several of our doctors, including myself, received the vaccine yesterday. We will monitor for a long time to see how the antibody level is. In the long run, we still rely on vaccines, not national isolation, so we must be fully prepared for vaccination.
Question 4: Is there any risk of large-scale emergency vaccination?
China’s vaccines have been tested in phase II at home, and phase III clinical trials have been done abroad, because we don’t have enough cases. It is an international practice to bridge the clinical data of vaccine phase III. After the vaccine is injected, its safety, protection, and protection time will be further evaluated.
Don't worry too much about the protection rate of the vaccine. In my opinion, the current vaccine clinical research data are affected by many factors. The protection rate does not need to be as high as 95%, and 60% or more than 70% can be widely vaccinated. Vaccine coverage is more important than protection. Increasing the coverage of the Chinese population by vaccines will have a good effect overall.
Inactivated vaccines are safe as a whole. They only have short-term risks, such as possible allergies or local pain. They are not unique to this vaccine. All vaccines are like this. If you can’t use this vaccine, it means that other inactivated vaccines cannot be used. China has used inactivated vaccines for a long time, such as polio vaccine and hepatitis A vaccine, and some are attenuated vaccines, such as chickenpox. It causes more adverse reactions. To receive the vaccine, we must give the people some time.
Generally speaking, 2 to 4 weeks after the second shot of vaccination, your level of antibody protection will be relatively high and you will be in a protected state. Before that, even if you were vaccinated, there was still a risk of exposure to the virus.
Question 5: How should the vaccination plan be arranged, and will the CCP leader get the injection first?
Voluntary vaccination, first of all, we must call on people who are prone to illness and infection to vaccinate first. Front-line workers such as customs and airport freight should all be vaccinated because they are exposed to cargo and cold chain transportation are risky. The second key population refers to those with higher mortality after infection, such as the elderly population. There are very few cases in China, and the risk of infection is small. But by the end of next year, there may be problems if the vaccination is not completed.
It is an encouragement for medical staff. It has not yet reached the compulsory vaccination stage. The chance of encountering local cases in the first time is very low. Fever clinic staff are protected, wearing isolation gowns and N95 masks. However, it is difficult for freight haulers to ensure that they always wear masks or protective clothing. Free and compulsory vaccinations should be given to those who work in such departments and on the front line. Ordinary people can wait.
Key populations must be vaccinated, and the vaccination rate of the entire population is preferably 70%, otherwise the virus may spread in the gaps of the coverage network.
Vaccination should be covered from high-risk groups to 70% of the entire population
I have said on many occasions that the leader should get the vaccine first. Everyone can see that the leader will be okay, and feel more at ease-sooner or later, the leader will fight early. It can also serve as an example.
Question 6: The virus has mutated in the UK, and various countries have suspended flights. Is the virus more "poisonous"? Will existing vaccines be ineffective due to more mutations?
Countries close flights, mainly London closed the city first, and British outbound flights are mainly in London. The closure of London is related to the loss of control of the local epidemic. Is the out-of-control of the epidemic caused by the mutation of the virus, or is it because of Christmas, many people can't sit at home, go out for purchases, activities, and negligent prevention and control work? The mutated virus strain is related to the aggravation of the British epidemic. What caused it? It is not very clear now.
Will existing vaccines fail due to virus mutation? Probably not. The ineffectiveness of all vaccines will not occur before vaccination. Looking at it now, the serotype of the vaccine has not changed, and we are also watching. Before the data comes out, we cannot say that the mutation of the virus directly caused the increase in cases, or that the virus has become more virulent. This is also what the WHO said. If we catch the virus mutation from the UK, we will culture it and cross it with our existing antibody serum. If it can be combined, it means that our vaccine is useful.
Question 7: After New Year's Day, it will soon be the Spring Festival holiday and the student winter vacation. How big is the risk of epidemic prevention and control facing China?
Traffic is crowded during the Spring Festival, and once there are sporadic cases, it will increase the risk of transmission. But last National Day there was a intensive trip of the people across the country, and China has withstood the test. The Spring Festival risk is greater than the National Day. The weather on National Day was not so cold, and the virus did not survive for so long in the environment. At that time, everyone was playing outdoors; the Spring Festival travel activities were mainly concentrated indoors, which increased the risk. There were basically no local cases in China during the National Day, and now there are many local cases in China, which has sounded the alarm about the risks of Spring Festival travel.
This year's Spring Festival, I hope everyone will stick to the original strategy of fighting the epidemic together and face the risks squarely. Avoid gatherings to be minimized, and don't hold gatherings with too many people. However, the local cases are still sporadic. Apart from taking corresponding measures in the middle-risk areas, everyone cannot be required to stay at home and not go out during the Spring Festival.
Question 8: After the Spring Festival, what should we do on the journey home?
Spring Festival Message
On the road, try to minimize unnecessary gatherings. For example, on the train, you should wear a mask and bring delicious dry food. Don't run in and out and squeeze with all kinds of people. Wash your hands and take off your coat at home. There is no risk if you do it, this is the first. Second, children should avoid visiting and minimize long-distance travel.
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