She is a community doctor in a Shanghai suburb, and in the last week, the average daily number of people in her district receiving the new crown vaccine has been about seven times higher than before.
She lamented that many elderly people who had been reluctant to get vaccinated for a long time had also come over, saying they "used to be afraid of the risks of getting vaccinated, but now they think it's more risky not to get vaccinated."
The new situation of epidemic prevention, November 29, the State Council Joint Prevention and Control Mechanism issued "to strengthen the vaccination of the elderly new coronavirus vaccination program", requiring the focus on the elderly over 60 years of age, to enhance the vaccination rate.
Compared with other age groups, China's elderly basic immunization and booster vaccination rates are low, data from the National Disease Control and Prevention Administration show that as of Nov. 28, the number of people over 60 years old fully vaccinated accounted for 86.42 percent of the elderly population, while the number of people aged 80 years old or older fully vaccinated accounted for only 65.8 percent of the population aged 80 years or older.
In the opinion of Feng Zijian, a public ****health expert, the unvaccinated elderly happen to be the ones most in need of vaccine protection, with advanced age and chronic illnesses being independent risk factors for developing serious illnesses or even death after contracting the new crown.
"A blood lesson," said virologist Jin Dongyan, recalling the Hong Kong outbreak this spring, was that of the 10,000 people who died locally from the new crowns, 70 percent were unvaccinated, 90 percent had underlying diseases, and the median age was 86 years.
The key to getting out of the epidemic may lie in protecting our "soft underbelly".
"Vaccine hesitation"
Since December, Chen Guanghua has been busy counting the vaccination rate of the elderly in his district, divided into two age groups, 60 to 79 years old, and 80 years old and above, counting the first shot, the whole vaccination and booster vaccination.
He is a grassroots epidemic prevention officer in Chongqing, where the street includes six communities, seven villages, 4,682 elderly people over 60 years of age***, and the first dose of vaccination rate for people over 80 years of age is 75.76%. These days, persuading the elderly to get vaccinated is not an easy task.
He told reporters that some rural elderly people feel that they do not go out much, there is no need for vaccination; there are also some elderly people let him sign a pledge to bear the consequences before agreeing to vaccination, "they are worried about any adverse reactions after the injection."
He observed that some elderly people traveled two hours to take the initiative to do the nucleic acid test, but were hesitant to be vaccinated.
Medical staff at the health center in Chen Guanghua's town vaccinated the elderly.
Chen Guanghua's helpers include a pair of empty-nested elderly people whose daughters married in the provinces and have not returned home for years. Usually he often go to the old man's home to visit, the old man is hanging smile. But last summer, he suggested the old man to go to the health center vaccination, the grandfather's face "all of a sudden collapsed".
The old man said he had a heart condition, "Once there is an accident, I come to you? My children are out of town."
Despite Chen Guanghua repeatedly explained, not in the acute attack period of the disease, does not affect the vaccination, you can "call the doctor over to see the specifics before making a decision". But the old man also did not change his mind.
Feng Zijian, executive vice president and secretary-general of the Chinese Preventive Medical Association, told Punch News in an interview that earlier contraindications to the vaccine and cautionary circumstances are more stringent, and that many elderly people and people with chronic illnesses have been excluded from the scope of vaccination.
Chen Guanghua recalled that most of the rural elderly have underlying diseases such as high blood pressure and diabetes, for which they have a reference value for vaccination, but there is some flexibility in implementation. For the elderly over 80 years old, they will assess the physical condition, to see if it is appropriate to vaccinate, mobility is not easy to give door-to-door vaccination.
Cheng Qiang, 84, of Chongqing, suffers from cataracts and osteoporosis. His son, Zheng Zhijun, told reporters that his father rarely goes out, except for a trip to the hospital for shingles in 2019. Last year, he reported his father's underlying illness to the community, which told him he could skip the vaccine in this case. So, to date, his father has not been vaccinated.
Compared with the previous, the latest vaccination program for the elderly, the scope of contraindications has been greatly narrowed, and only a severe allergy to the vaccine is listed as an absolute contraindication. Zheng Zhongwei, director of the Science and Technology Development Center of the National Health and Health Commission and head of the vaccine research and development task force working group, said on December 7 that chronic diseases such as diabetes and hypertension in the elderly are not absolute contraindications to the new crown vaccination, as long as they are in the stabilization period, they can be vaccinated.
Feng Zijian said that in order to be prudent, the new vaccination program has added a few articles: for example, acute infectious diseases in the fever stage, serious chronic diseases in the acute exacerbation period, or serious chronic diseases life has entered the terminal stage, to delay vaccination.
"There are very few contraindications to not being able to get the vaccine or not being suitable for the vaccine, especially the inactivated vaccine, very, very few, and that's determined by the doctor." In the opinion of Kim Dongyan, a professor at the University of Hong Kong Li Ka Shing Faculty of Medicine, advanced age and those with underlying medical conditions are prioritized for vaccination worldwide.
Kim Dongyan told Punch News that Hong Kong has previously experienced public distrust of vaccines. "Self-media articles saying that people have been vaccinated and developed leukemia or diabetes are nonsense. Because more people get vaccinated, there would have been some who got sick or even died, and this is an incidental event."
For this reason, the HKSAR government has made public a list of the incidence of vaccinated and non-vaccinated people suffering from diabetes and so on, "to make it clear at once."
In Jin Dongyan's view, now is the period of change, the first thing to do is to do a good job of civic education and policy advocacy. "The elderly over 80 years old, vaccination is implemented, the death is completely avoidable." He cited the example of Hong Kong in May after raising the vaccination rate, the mortality rate of new crowns fell to one-fifth to one-sixth of the original; antigen-positive after the timely administration of oral antiviral drugs, the mortality rate can be reduced by another seventy-six percent.
"Now there are many observations, after a booster shot, continued for 12 months, there is still a very good protection against severe illness and death." Feng Zijian told reporters that preventing serious illnesses can also ease resource constraints in medical institutions during the rising phase of the epidemic.
"The most vulnerable people"
After the epidemic prevention was optimized, Zhou Guangjun felt more pressure.
He is a nursing home administrator in a prefecture-level city in Henan province. The home is home to more than 200 elderly people, 80 percent of whom are more than 80 years old. Last year, the local vigorously promote vaccination, the elderly in the hospital heard that free, most of them are willing, the elderly are not rejected, they want to "vaccination free to travel".
But it did not occur to me that almost all of the children are opposed - the elderly in nursing homes need to be vaccinated by their children to sign an informed consent. "Some said there was no need to vaccinate the elderly when they were old, some said the elderly had chronic diseases that could not be vaccinated, and some worried that the vaccine was not safe and did not agree to vaccination."
Eventually, some seniors decided to bypass their children and went to the hospital to get vaccinated themselves. Today, there are about 30 vaccinated seniors in the nursing home, which, according to Zhou Guangjun, is already counted as a nursing facility with a high vaccination rate in the area. His own 85-year-old grandmother, because of her advanced age and suffering from heart failure and pulmonary edema, was not vaccinated.
Infections in the institution hang like a sword over Zhou Guangjun's head. There are a few old people in the home who like to go out on tricycles to meet friends, "Once infected with the new crown brought back to the home, the consequences are unimaginable." In addition, there are also a number of disabled elderly people living in the home, they need to live in the care of the caregiver, have not been vaccinated.
Similarly worried is Li Yang, the head of a senior living company in Shanghai. In the past three years, the nursing home he manages has had zero infections, and 70 to 80 percent of the elderly have been vaccinated. After the recent change in vaccination policy, he is worried about those who have not yet been vaccinated.
Many of these seniors are over 80 years old and have underlying medical conditions. Previously, the authorities did not recommend vaccination, and their children had concerns. Recently, Li Yang received a notice from his superiors to increase the proportion of vaccination in the hospital, and he is trying to communicate with the elderly and their families.
As of Nov. 28, the number of people aged 60 or older who had been fully vaccinated accounted for 86.42 percent of the elderly population, while the number of people aged 80 or older who had been fully vaccinated accounted for only 65.8 percent of the population aged 80 or older. File photo
At this point, Gan Mei, who lives in Lanzhou, was still hesitant to vaccinate her mother.
Her mother, 75, has diabetes, as well as a metastatic lung tumor that is being treated with targeted drugs. Recently, her neighborhood was unsealed, and several friends and family members around her are "yang".
She wants to vaccinate her mother, but is not sure if she can. Previously, she saw a hospital in the circle of friends of the popularity of the question and answer, mentioned malignant tumors in the stable period can be vaccinated, if the disease is in progress, it is not recommended to vaccinate, which makes her very entangled, I do not know the mother's situation belongs to which one.
Feng Zijian had suggested in an interview that elderly people hospitalized in medical institutions should be prescribed vaccines by their doctors and offered vaccinations at the hospitals, as well as door-to-door services for those who find it inconvenient to go to the vaccination sites. "It's important to tell the public that we have a period of time in the future where the risk of possible infections is going to increase dramatically, and to take the time to get vaccinated and get protection."
"We are in a race against the virus, especially those who don't get vaccinated." How to get the medicine to those who want it the fastest and earliest, and keep those who don't need it from hoarding it in large quantities, also tests ingenuity, Kim Dongyan said.
He suggested that, when necessary, to the elderly a reverse isolation, "square pods can be partially converted into hospice facilities, there is an epidemic, did not vaccinate, and there is no opportunity to use the drug, with reverse isolation, but also can save some lives."
Compared to the senior citizens, the vigorous elderly around 60 years of age vaccination willingness is higher.2020 epidemic just started, Zhou Guangjun's nursing home closed management for the first time, the hospital around 60 years of age in the old people's emotions are a little agitated, because it affects them out of the house activities. Now the nursing home has been closed or semi-closed management for three years.
"They want an early return to normal living order and are willing to be vaccinated." Li Yang's senior living company also manages a community-based service center for the elderly that provides daily services to nearly 20,000 elderly people in the community, who are aged 60 to 70, and had a vaccination rate of about 40 percent last month.
Recently, the service center has been calling seniors who haven't yet been vaccinated one by one to encourage them to get vaccinated. "Some people went to get vaccinated as soon as they got the call for fear of getting infected." Elderly people are mainly in the service center during the day, now, Li Yang prepared antigen, to the elderly in and out to do, "do not dare to relax."
December 5, Zhou Guangjun also received the requirements of the higher authorities, nursing homes continue to closed management, he is still waiting for the next step in the notice.
The "capillaries" of epidemic prevention
After December, more villagers came to Zhou Chunhua's clinic to consult on epidemic prevention, and most of them were "worried that the elderly children at home could not withstand.
Zhou Chunhua is a village doctor in Hebei province. Her village has more than 400 people, the past three years, the implementation of strict prevention and control measures, twice a week, the whole village nucleic acid, "the villagers have a fear of the virus," the epidemic adjusted, they do not know much about the characteristics of the virus, related policies.
Zhou Chunhua communicated with villagers who came to consult on how to do a good job of home protection.
Zhou Chunhua said some people began to hoard cold medicine, "no one bought, the clinic will hoard one or two boxes, now there are always people ask, open to 10 boxes of 8 boxes, said to give the elderly at home to hoard."
Lianhua Qingdian capsule sold out. In the last two months, the upstream suppliers to the purchase price from 11 yuan to 18 yuan a box, Zhou Chunhua helpless villagers said, "There is really no more, you relax than anything strong."
And Zhou Chunhua similar, recently in Shanghai, a community health center doctor Peng Chang also busy a lot.
There are about 8,000 people over the age of 65 in her district, and the vaccination rate is about 95 percent. Recently, the number of inoculations has been skyrocketing.
At the clinic, she often hears residents talking. One part worries that they or the elderly won't be able to carry the disease when the vaccination is optimized; another feels that the symptoms of Omicron are so mild that they don't need attention.
What she and her colleagues say is that "Omicron is characterized by mild symptoms, and the symptoms may be more pronounced in the elderly and children", "Prepare fever-reducing medicines and thermometers in advance", and "Psychologically, you don't have to worry about it too much"
What she and her colleagues say is that "Omicron is characterized by mild symptoms, and the symptoms of the elderly and children may be more pronounced. worry"
Recently the community health center streaming group do not have to track the trajectory of the sub-mikron personnel, but the community home isolation residents to increase, in order to deal with emergencies, the power of the medical care are transferred to the medical care. early December, Peng Chang they set up an emergency response team, medical staff to return to two points of a line, the full standby status.
"Sometimes I don't dare to sleep too well in the middle of the night for fear of not being able to hear the call." It's still pretty tough, but Peng feels the team is "under less psychological pressure."
The residents welcome the fact that they don't have to install door magnets in their homes from the past. "The whole set of new processes down, the residents have a lot better attitude towards us, both sides of the state to ease a lot." Peng Chang said.
At this time, in Chongqing, Chen Guanghua's health center has also formed a team of family doctors. Each team consists of a doctor, nurse and village doctor each, and one team corresponds to one family, educating villagers about the virus and vaccinations. "There are only a handful of people who are currently eligible but not vaccinated in our area."