Data screen
Yang Xiaobing introduced that Wuhan has been sampling and monitoring in two sentinel hospitals, Wuhan First Hospital and Wuhan Children's Hospital, once a week, with 20 throat swab samples each time. From mid-February, 65438 began to increase to 40 copies each time. This week, Jinyintan Hospital was added as a sampling sentinel hospital. According to the monitoring data, the Omicron mutant prevalent in Wuhan is still BA.5.2. From June+10, 5438 to now, all the viruses detected in the collected samples are BA.5.2 mutants, and no other types of viruses have been found.
Affected by many factors such as the cold climate, many people in this epidemic have symptoms after virus infection, mainly including fever, cough, muscle pain, dry throat, stuffy nose and diarrhea. And the symptoms of upper respiratory tract are obvious. There are also cases of pulmonary inflammation, but the proportion of pulmonary inflammation is relatively small relative to the number of patients.
The National Health and Wellness Committee issued an announcement on February 26th, 65438, renaming novel coronavirus as novel coronavirus infection. From June 5438+/KLOC-0 to October 8, 2023, the infection in COVID-19 was changed from "Class A tube" to "Class B tube".
Yang Xiaobing introduced that there are currently 40 legal infectious diseases in China, including 2 Class A infectious diseases, 27 Class B infectious diseases and 1 1 species. Class A infectious diseases include plague and cholera. After the occurrence of Class A infectious diseases, the time limit for reporting the epidemic situation, the isolation of patients and pathogen carriers, the treatment methods and the treatment of epidemic spots and epidemic areas are all enforced. Class B infectious diseases, including COVID-19, SARS, AIDS and viral hepatitis, need strict control measures. Class C infectious diseases are infectious diseases monitored and managed, including influenza and mumps.
After three years' changes, the main characteristics of infection in COVID-19 have evolved into symptoms of upper respiratory tract infection, such as fever, headache, sore throat and cough, while pneumonia is no longer the main symptom, and its health hazards have also been significantly reduced. However, it should be noted that novel coronavirus infection is still one of the pathogens causing lung inflammation. If you don't recover for a long time after infection, and cough, fever, chest tightness and other aggravations occur, you should seek medical advice in time to prevent aggravation.
Yang Xiaobing pointed out that according to the Law on the Prevention and Control of Infectious Diseases, after the implementation of "B and B tubes" for novel coronavirus infection, isolation measures will no longer be implemented for COVID-19 infected people, and close contacts will no longer be judged; COVID-19 infected people are classified for treatment. The goal of the follow-up prevention and control work will focus on "protecting health and preventing serious and serious diseases" and take corresponding measures to protect people's lives and health to the maximum extent.
Extended reading
Virologist Chang Rongshan: At present, no original strain can be found, and "white lung" may be bacterial invasion.
◎ Chang Rongshan said that white lung is an imaging feature of alveolar injury caused by lung infection, and it is not a unique disease of Omicron infection. Bacterial infection, influenza virus infection or adenovirus infection may cause white lung.
◎ It should be reminded that many cases of COVID-19 infection have lung symptoms after turning negative, which is probably due to the decline of human immunity and bacterial invasion after virus removal.
Every reporter Lin, every editor Dong
On the evening of February 26, 65438, the words "original plant" and "big white wind" rushed to the hot search. A screenshot circulated on the Internet shows that a young and middle-aged nurse in a hospital suffered from mild chest tightness and suffocation for more than a week after fever, and her fingertip oxygen saturation decreased, and her chest X-ray was close to her white lung. Another screenshot shows that some people suspect that young and middle-aged Great White Lung was infected by strains other than Omicron, including the original strain from COVID-19.
On the evening of 26th, Chang Rongshan, a domestic virologist, accepted a telephone interview with a reporter from National Business Daily. He made it clear that from the sequencing results of domestic strains and the iterative pedigree of popular strains, it is impossible to have the original strain in China at present, and "the possibility of Delta is very, very small". The culprit of "white lung" which is highly concerned by the public may not be entirely from COVID-19.
Chang Rongshan Image source: Photo courtesy of respondents
Chang Rongshan said that white lung is an imaging feature of alveolar injury caused by lung infection, and it is not a unique disease of Omicron infection. Bacterial infection, influenza virus infection or adenovirus infection can all cause white lung.
It should be reminded that many cases of COVID-19 infection have lung symptoms after turning negative, which is probably due to the decline of human immunity after virus removal, and bacteria take advantage of it.
Besides COVID-19, bacterial infection may also be the cause of "white lung" in hospitals.
Chang Rongshan said that from the perspective of microbial ecology, people with normal immunity are unlikely to be infected with bacteria and viruses at the same time, or both viruses at the same time. An intuitive example is that patients infected with COVID-19 are rarely infected with influenza virus at the same time. However, for virus-infected people with low immunity, they are easily infected by other bacteria and have clinical symptoms of related bacterial infections. This kind of co-infection mostly occurs in the respiratory tract, and the situation is more serious.
It is worth noting that the scene of "young and middle-aged white lungs" in this screenshot is in the hospital. If the situation is true, this is a typical nosocomial infection.
According to the guidelines for diagnosis and treatment of hospital-acquired pneumonia, pneumonia can be divided into community-acquired infection and hospital-acquired pneumonia according to the classification of places obtained. The former refers to the infection before hospitalization, the incubation period when hospitalization, and the onset after hospitalization; The latter refers to various types of lung inflammation caused by pathogens such as bacteria, fungi, mycoplasma, viruses or protozoa, which occurs within 48 hours after the patient is admitted to hospital, and there is no incubation period of infection.
This means that in addition to coronavirus infection, there are many pathogens in hospitals that may pose a health threat to people with low immune function. According to public information, the most common pathogens of nosocomial infection are gram-negative bacilli and gram-positive cocci. The former is the most common bacteria in hospitals, among which Escherichia coli and Klebsiella pneumoniae are more common. The latter includes methicillin-resistant Staphylococcus aureus and Staphylococcus epidermidis.
Image source: Picture Network -400 1076 12.
"Omicron eroded the upper respiratory tract and caused mucosal damage. In addition, during the epidemic period of colds and flu, there are many bacteria and viruses in the mouth, and mixed infections are very common. "
Chang Rongshan believes that many cases are pulmonary symptoms that reappear after turning negative, mostly because the virus in the body has been cleared but the immunity has not fully recovered, which provides opportunities for bacterial invasion. Chang Rongshan said, for example, young and middle-aged nurses with white lung symptoms spread through the Internet are likely to be asymptomatic or slightly infected with COVID-19. After returning to work, my body's resistance was weak, and I was infected with bacteria in the hospital, which was not caused by the original COVID-19 strain suspected by netizens, nor by Delta, Delta and Omicron's recombinant COVID-19 strain.
"There are many rumors on the Internet at present." Chang Rongshan said that from a scientific point of view, it is absolutely impossible to find the original strain at present, and the possibility of Delta is very, very small. This is because samples from all over the country have been sequenced for coronavirus genes. "There are basically no reports about Delta strain or Deltarchon strain in the second half of this year."
Moreover, judging from the transmission and immune escape of several strains of Omikrongya, Delta or Deltarkon are lower than BA5 and BF7 strains in Omicron, and their human adaptability is far weaker than the latter. "Assuming that the medical staff are infected with Delta or Delta Talqiong, according to the mortality analysis of overseas XBC strains, the mortality rate of medical staff in these hospitals is about 2%, but no such data has been seen at present."
According to Xinhua News Agency reported on the 27th, Xu Wenbo, director of the Institute of Virology of China CDC, said that from the beginning of 65438+February to the present, China CDC has completed the whole genome sequencing of 1 142 cases through sampling investigation, and found that the subfamilies of Omicron mutants BA.5.2 and BF.7 are absolutely dominant in the national epidemic, and the total of them is more than 80%. In addition, there are seven subfamilies of Omicron mutants.
"White lung" is easy to miss the best treatment time, and blood oxygen concentration is an important self-test index.
According to the "Ten Thousand Anti-COVID-19 Raiders" published by the official account of Huashan Infection WeChat on February 8, 65438, the core is one: Do you need to go to the hospital if you have COVID-19? 99.5% of infected people may not need to go to the hospital.
According to an article published by Xinhua News Agency on February 13 13, experts from the joint prevention and control mechanism in the State Council said that from the current national case data, asymptomatic and mild cases after Omicron infection accounted for more than 90%.
Image source: "Xinhua News Agency" WeChat official account
Chang Rongshan believes that at present, the public is confused about this statement because the definitions of asymptomatic infection and mild infection in medicine are different from general cognition. However, it is worth noting that although the proportion of pneumonia symptoms after infection with Omicron is not high, the early symptoms of pneumonia are hidden, overlapping with cold symptoms, and the gold treatment time is short. In addition, it may appear in the stage of co-infection, so being extra careful is an invisible killer for COVID-19 patients.
According to an article published on 20021,in a retrospective cohort study of patients in Wuhan, China, 28/19 1 patients were infected with culture-positive bacteria, and all but one of them died. Half of the non-survivors experienced bacterial infection, while only 1% of the survivors. In later studies in Wuhan and Spain, a similar pattern of higher incidence of bacterial infection among dead patients was also reported.
Image source: NIH official website
In addition to coronavirus pneumonia-19, influenza has also reported a similar pattern-especially the retrospective analysis of the epidemic situation of 19 18 shows that the universality of bacterial participation in death cases supports the conclusion that more than 95% of the mortality rate is directly attributed to secondary bacterial pneumonia.
In addition, previous studies have shown that in cold and dry areas, the mortality rate of respiratory diseases such as pneumonia will rise sharply, so northern residents should be vigilant.
Unfortunately, because the symptoms of pneumonia overlap with the early symptoms of COVID-19, going to the hospital depends more on patients' self-perception, and many patients often die because they miss the best treatment time.
Chang Rongshan said that many "big white lungs" had blood oxygen levels below 90% before hospitalization, but they did not feel respiratory distress. "So, if there is an oximeter at home, self-test blood oxygen is an important indicator to judge whether there is a possibility of pneumonia and whether it is necessary to go to the hospital. 93% or 9 1% may be the reference value for medical treatment. "