Professor Wang Guangfa, head of the respiratory and critical care medicine department at Peking University First Hospital, warned that most people infected with Omicron were not critically ill. The vast majority of BF.7, which is predominantly endemic in Beijing, is actually symptomatic, with high fevers, and brings in more critically ill patients. The next week or two will see a spike in severe cases, so health care providers should prepare early.
December 19, 0-24 hours, 31 provinces (autonomous regions and municipalities directly under the central government) and the Xinjiang Production and Construction Corps reported 2722 new confirmed cases. Among them, 66 cases imported from abroad (36 cases in Guangdong, 10 cases in Sichuan, 5 cases in Beijing, 5 cases in Shanghai, 3 cases in Inner Mongolia, 2 cases in Liaoning, 2 cases in Shandong, 1 case in Tianjin, 1 case in Heilongjiang, 1 case in Shaanxi); 2,656 cases of local cases (1,075 cases in Guangdong, 456 cases in Beijing, 189 cases in Chongqing, 137 cases in Jiangxi, 125 cases in Fujian, 115 cases in Hunan, 106 cases in Shanghai, 93 cases in Sichuan, 85 cases in Yunnan and 85 cases in Sichuan). 93 cases, 85 cases in Yunnan, 47 cases in Zhejiang, 45 cases in Tianjin, 45 cases in Henan, 32 cases in Shandong, 26 cases in Shaanxi, 21 cases in Inner Mongolia, 17 cases in Heilongjiang, 13 cases in Shanxi, 12 cases in Hebei, 5 cases in Jilin, 4 cases in Jiangsu, 4 cases in Hainan, 3 cases in Guangxi and 1 case in Guizhou). There were 5 new deaths, all local cases, in Beijing; no new suspected cases.
The day of the new cure discharged 2017 cases, of which 89 cases imported from abroad, local cases 1928 cases (Guangdong 917 cases, Beijing 288 cases, Yunnan 191 cases, Chongqing 93 cases, Liaoning 67 cases, Fujian 62 cases, Sichuan 59 cases, Zhejiang 36 cases, Shaanxi 32 cases, Inner Mongolia 29 cases, Heilongjiang 29 cases, Shandong 29 cases, Henan 21 cases, Hainan 15 cases, Jiangsu 11 cases, Hebei 8 cases, Guizhou 7 cases, Tianjin 6 cases, Shanxi 6 cases, Shanghai 4 cases, Hubei 4 cases, Hunan 4 cases, Tibet 4 cases, Qinghai 3 cases, Jilin 2 cases, Xinjiang 1 case), lifting the medical observation of close contacts 61019 people, the number of serious cases increased by 23 cases compared with the previous day.
Outside the importation of existing confirmed cases of 467 cases (no serious cases), no existing suspected cases. The cumulative number of confirmed cases is 28,708, the cumulative number of cured and discharged cases is 28,241, and there are no fatal cases.
As of 24:00 on December 19, according to 31 provinces (autonomous regions and municipalities directly under the central government) and Xinjiang Production and Construction Corps report, the existing confirmed cases of 35976 cases (of which 276 are serious cases), the cumulative number of cured and discharged from the hospital 341902 cases, the cumulative total of 5242 deaths, the cumulative total of 383175 reported cases of confirmed cases, the existing suspected cases of 19 cases. The cumulative number of close contacts traced to 15,329,166 people, still under medical observation of close contacts 291,547 people.
The cumulative notification of confirmed cases received from Hong Kong, Macao and Taiwan is 9077536 cases. Among them, 487553 cases in Hong Kong SAR (106,301 discharged from hospitals and 11210 deaths), 1569 cases in Macao SAR (1115 discharged from hospitals and 13 deaths), and 8588414 cases in Taiwan (13742 discharged from hospitals and 14913 deaths).
Experts remind: the vast majority of Beijing's epidemic BF.7 have symptoms, will usher in the peak of serious illness
"The peak of infection of this new crown epidemic is not generally high, is the epidemic tsunami, in the past week we have felt." Professor Wang Guangfa, director of the Department of Respiratory and Critical Care Medicine at Peking University First Hospital, warned in a recent interview with Medical Daily that the peak of serious illnesses will come in the next week or two, so medical institutions should prepare early.
So what should healthcare organizations prepare for? Can you get infected with New Crown again in the short term? Will the new crown virus become less pathogenic the more it mutates? Wang Guangfa gave his answers.
What's next for the epidemic?
Beijing was one of the first cities to be hit by the outbreak. Wang Guangfa revealed that the epidemic, the peak of serious illness has not yet arrived, medical resources have been relatively tight, coupled with a lot of infected medical staff, the past week, all hospitals are quite difficult. Wang Guangfa's department is infected medical staff is quite a lot, the good thing is that soon will be able to return to work one after another, so that the pressure on manpower will be lighter.
Next, although the staff will be less nervous, but the patient volume will also come up immediately, following the peak of infection, the peak of serious illness will soon come. The new crowns are characterized by the fact that they don't come up with severe illnesses right away, but rather 5-7 days after infection, so the peak of severe illnesses will come later than the peak of infection. In addition, there is a time course for the exacerbation of the underlying disease triggered by the infection of the new crown.
In summary, the peak of severe disease will occur in the next one to two weeks.
What should happen next?
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Since it has been predicted that there will be a peak of serious illnesses, Wang Guangfa said that the new crown is a respiratory infectious disease that mainly involves the respiratory system, and there is a possibility of severe pneumonia, respiratory failure, acute respiratory distress syndrome, etc., so the respiratory and critical care departments bear the brunt of the problem. In addition, winter is supposed to be the peak of the incidence of cardiovascular and cerebrovascular diseases, but also to pay attention to the new crown infection will aggravate the underlying disease.
From the point of view of treatment, it is mainly the various ICUs in hospitals that are mainly responsible for critical care, including respiratory ICUs, comprehensive ICUs, internal medicine ICUs, emergency ICUs, and even pediatric NICUs and PICUs. our critical care beds per 100,000 people are 10, and in developed countries like the U.S. it is 30, and the U.S. has also experienced a run on health care resources at the peak of the epidemic infections, and it can be foreseen that we will also face the same situation. It is foreseeable that we will certainly face this problem too.
So hospitals should act quickly to, first, expand as many intensive care beds as possible. Secondly, they should be equipped with good treatment equipment. Medical institutions should centralize the management and deployment of ventilators and other equipment, and if possible, purchase additional ventilators as soon as possible. Thirdly, organize a critical care team. It is difficult to develop a mature critical care team in the short term, and it is necessary to integrate the critical care teams in hospitals. Fourthly, apart from improving the ability to treat critical illnesses, it is also necessary to raise the awareness of preventing critical illnesses. Although vaccination is important, we still need to pay high attention to patients with high risk of death and high risk of serious illness. These patients should be treated with antiviral drugs early, which is able to reduce the rate of serious illness from the past experience of treatment.
How has the response differed from place to place?
This time, the emergence of the peak of the epidemic around the world is sequential, and some areas have yet to arrive. Wang Guangfa reminded that the absence of a run on medical resources is a key factor in the high success rate of critical care. Areas where the epidemic is not yet serious should hurry to prepare resources, and those that have reached the peak of infection should actively prepare resources for critical care, organize critical care teams, and use medical resources rationally.
Most people infected with Omicron are not critically ill, and medical institutions should grade patients so that low-risk patients can go home, and high-risk patients, even if they are mild or common, should be admitted to the hospital. The treatment needs of non-New Crown patients should also be taken into account. Omicron is so contagious and spreads so fast that nosocomial infections are hard to avoid, which requires hospitals to do some vacating and co-ordinating, merging wards and freeing up resources to be targeted to the most urgently needed departments.
Because of the difference in climate between the north and the south, although the peak of the epidemic in the south is also very high, but the proportion of severe cases may not be so high, unlike the north came so ferocious. Different regions, the epidemic base level is not the same, the risk of transmission is not the same, affected by population density, population mobility and other factors, the peak will have some sequential around. Those areas where the peak has not yet arrived, there must be no chance, hurry up and take action to prepare the fever clinic, emergency and intensive care resources.
Fever clinic drugs should be well-stocked, so that, to be able to divert patients, so that the mildly ill home. Emergency can be admitted, patients can not be backlogged in the emergency department, so the death rate will inevitably be high, to make space to set up a buffer zone, the emergency backlog of patients classified and screened to ensure that patients with serious illnesses have a place to save treatment. The fever clinic, emergency and ICU revitalization, the hospital is very important to the overall treatment.
How long will the current peak of the new crown outbreak last?
Wang Guangfa said the peak of this outbreak will probably last until after the Spring Festival. After the Spring Festival the country as a whole will have slowed down the trend, but the basic return to normal may not be until the end of February, early March. But it is also important to note that there may be another small peak after heating is stopped in the north.
Over the past three years, people have done a good job of wearing masks, not only to prevent new crowns, but also to prevent respiratory transmitted diseases such as influenza. Although the intensity of influenza epidemics has diminished over the past three years, but at the same time the level of influenza antibodies in the community is also low, when the influenza virus re-emerges, it is possible to cause stronger epidemics than in the past, so even if you have had a new crown, or advocate that you do not easily take off the masks, especially to crowded places, but also to wear a good mask.
Do large numbers of secondary infections occur in the short term?
For many people worried about the problem of secondary infection, Wang Guangfa said, the new crown virus is indeed special, generally about six months of antibodies can not be detected or very low, in addition to antibodies against the wild strain of the cross-protective effect of Omicron has also been weakened, which is an objective fact, but it is not completely unprotected, the vaccine should still have confidence.
This widespread infection will generate herd immunity, and this herd immunity is against the current prevalent strains (BF.7 and BA.5.2), so the likelihood of repeat infections in the short term is relatively small, but the possibility of long term re-infections exists, but the percentage won't be particularly high, so we don't need to worry too much about this. The problem now is that we have a medical squeeze caused by a large number of infections in the short term, and subsequent reinfections will not have the peak of infections that we have today, and we will be a little more comfortable coping with that at that point.
Can the new coronavirus mutate again?
Mutations of the new coronavirus are inevitable, and are not determined by human will. The mutation of Neocoronaviruses should be viewed objectively. It is true that we are now seeing omikujon spreading faster and faster, becoming more transmissible and less pathogenic. However, the vast majority of BF.7, which is predominantly endemic in Beijing, is actually symptomatic, with high fevers, and brings in more seriously ill patients. Of course, there are no statistics yet to know exactly how many serious illnesses have occurred, but that's different from what we've seen reported in the media in the past.
Wang Guangfa specifically cautioned that humans are not the only hosts for the new coronavirus, and many animals are as well. We do not know, perhaps in animals also become lighter and lighter, but at a certain point and then passed to the human community, in the human body performance is not necessarily also light. Therefore, we must not think that the new crown will definitely become weaker and weaker. Its direction of mutation may or may not be like this in human society, and the law of evolution in the animal kingdom is even less clear. You can't just study the new crown strains isolated from human society, but someone has to do the monitoring of the new crown virus in the animal kingdom.
In short, we have to be realistic about the new coronavirus, neither completely belittle it, nor regarded as a beast of prey, from the scientific really understand it, recognize it, and then formulate our strategy, do not pat your head, do not guess out of thin air.