China's current stage of critical care capacity and medical resource reserves how? The National Health Commission introduced on the 9th said that China's critical care medicine beds close to the level of 10 / 100,000 people, the total number of beds 138,100, of which 106,500 in tertiary care institutions. At the same time, the total number of critical care physicians is 80,500 people, "convertible ICU" reserve physician 106,000 people, the total number of critical care nurses is 220,000 people, "convertible ICU" nurses 177,700 people.
Zhong Ming, director of the Department of Critical Care Medicine at Zhongshan Hospital affiliated with Fudan University, told China Business News that the program for critical care treatment is already very clear at this stage, and what needs to be solved is the problem of "management", i.e., once an order of magnitude of patients come in, whether our resources can be accommodated; and if medical resources are overloaded, how to respond to maintain a stable order. If medical resources are overloaded, how to cope with the situation so as to maintain a stable order and enable patients to receive timely treatment. This is the crux of the matter, and it is also a major test at the moment.
First Financial: Are medical institutions ready to provide treatment for serious illnesses?
Zhong Ming: From the existing national regulations, the comprehensive ICU of tertiary hospitals needs to reach 4% of the total number of beds; the specialized ICUs will transform the convertible ICU beds according to the ratio of 4% of the total number of beds, and can be quickly converted into critical ICU resources within 24 hours when needed; and ensure that the comprehensive ICUs and convertible ICUs can reach 8% of the total number of beds in hospitals. I believe that tertiary hospitals around the world will be deployed according to these standards.
From our team, we actually had certain expectations about the future adjustment of epidemic prevention measures earlier. These expectations include: within a short period of time, there will be an increase in the absolute number of critically ill patients that need to be treated, and there will be a great demand for critical care medical resources, so the rationing of the relevant medical equipment, medical and nursing positions, and so on, has also been predicted in advance.
Currently, our ICU has made corresponding reserves, and we have also made corresponding plans in accordance with the requirements of ICU wards and sub-ICU wards. But in fact, the current situation of a hospital does not represent the overall situation of the community, or should be viewed as a whole.
First Financial: How to dynamically adjust the critical care strategy in the next period?
Zhong Ming: Obviously, if there are a lot of new infections in a period of time, and most of them have to go to the hospital, it will be a huge challenge for the rationing of medical resources, so we have been emphasizing that the majority of the people do not need to go to the hospital, which will result in the crowding of medical resources.
At the same time, we need to optimize the relevant processes. There must not be a steep increase in patients, but a certain trend of increasing numbers so that we can pay attention in advance. As a result, firstly, the work intensity of critical care, including the related health care workers, will be greatly increased, and secondly, the work role of some of the health care workers will need to be shifted to treat new crown patients. Overall, health care workers will be working harder to commit to their jobs.
First Financial: Combining your experience of going to the Wuhan outbreak in 2020 and your subsequent support in Jilin and Hainan, what will be different in the current treatment of severe new crowns?
Zhong Ming: We were somewhat unfamiliar with the new coronavirus at the time of the Wuhan outbreak in 2020, but unlike at that time, at this stage, we actually have a very clear program for the treatment of the severe disease itself, and what is most lacking is not really the knowledge of how to go about treating it.
What needs to be addressed at this stage is the "management" aspect, i.e. whether our resources can cope with the number of patients coming in, and how to cope with the overloading of healthcare resources in order to maintain a stable order so that patients can be treated in a timely manner, which is the core of the matter and is a major test at the moment.
To this end, the ability to optimize and allocate resources is particularly important. The overall medical staff is still the same, but under certain circumstances, if the ICU medical manpower is insufficient, it is necessary to temporarily mobilize some of the critical care medicine background of the medical staff and join the ICU work. We need to optimize the mechanism, space, and equipment for critical care while keeping the number of existing staff the same.
Zhong Ming chugs along in Jilin. Source: Zhongshan Hospital official microblogging
First Financial: How will the trend of the new crown epidemic develop?
Zhong Ming: The new crown positive home quarantine, in fact, means that the new crown will be spread in the community, but it is also an important step under the optimization of anti-epidemic measures.
It is expected that the trend of the new crown outbreak will reach the peak of infection within 1 month. But the modeling of when it will end after that is more complicated. The reason is that viral infection and recovery do not occur at the same time. From the perspective of healthcare organizations, infection at the same time will cause a concentration of people and strain on healthcare resources; therefore, an orderly and gradual approach to healthcare will allow healthcare organizations to have a greater ability to respond, but relatively this cycle will also be lengthened.
At this stage, our department is not currently treating any new crown-positive patients, but our "consortium" organizations are ready.
First Financial: How should the elderly and people with underlying diseases manage themselves?
Zhong Ming: Elderly people and people with underlying diseases have been recognized as a special and priority group.
These people should strengthen self-monitoring of their health during their stay at home, and if they find any aggravation of their primary illnesses or worsening of their symptoms such as chest tightness or shortness of breath, they should seek medical treatment in a timely manner. At the same time, the condition of the elderly, basic patient groups can also test the value of blood oxygen saturation, once the value of blood oxygen saturation is low also need to consult a doctor.
Additionally, for nursing homes, a special category of institutions, it is recommended to do active, positive, relatively closed management, try not to let the momentum of the new crown infection spread to the nursing home, where the population are vulnerable susceptible people.
First Financial: How can we prevent asymptomatic, mildly infected people from turning to serious illness?
Zhong Ming: First of all, for the general population, it is necessary to carry out vaccination; secondly, if the general population is infected with the need for regular rest, to maintain the normal functioning of the immune system, only vulnerable special groups need to do a good job of health monitoring, including the need to measure body temperature, as well as the use of fingertip oximetry to monitor the oxygen saturation level; once again, it is the self-perceived symptoms of the perception of the original basic disease, old and slow disease, related symptoms, including the original basic disease, the old and slow disease, the symptoms of the original basic disease. The first thing you need to do is to get a good understanding of how to use the Internet and how to use the Internet.