Shanghai has entered the period of rapid infection in COVID-19. "Several experts present here have been infected."
During the training, Professor Zhang Wenhong listed the first peak and duration of the Omicron virus epidemic in the United States, Britain, Singapore and Hong Kong.
"Recently, everyone has seen more and more people infected with COVID-19. Several experts here have been infected. Fortunately, most of them are mild or asymptomatic. " Zhang Wenhong said that according to the data of Shanghai, the virulence of Omicron showed a trend of obvious decline, invisible transmission and widespread transmission. Shanghai has entered the stage of rapid infection, and the number of cases in COVID-19 has increased exponentially. We should be prepared. This epidemic will last for 2-4 months, and it will gradually emerge in the first half of next year.
"Singapore was released in 65438+ 10 this year, and reached the peak of the epidemic within one month, until April this year 15. Taiwan Province Province of China was released in April this year, and the number of cases declined in August. There are still 20,000 infections every day at the trough. " According to the epidemic data of Singapore, Taiwan Province and China, Zhang Wenhong predicted the possible situation of this epidemic in Shanghai.
He believes that when necessary, in order to avoid centralized infection and level the infection curve, measures such as online classes in schools and home office work in infected units will be taken.
He analyzed the evolution and pathogenic characteristics of COVID-19 in detail. "COVID-19 is not a strange virus. Seven COVID-19 viruses are known to infect humans. In gene sequencing, α strain 229E, NL63 and β strain OC43, HKU 1 of COVID-19 species are the most common. "
"Common to what extent? Basically, you get infected every year, and it's repeated-let your body build an immune barrier. Although the virus is constantly mutating, the symptoms after infection will be mild. These viruses belong to the cold virus. " He warned that despite three years of evolution, the Omicron strain has evolved into a lighter virus sequence. However, the violation of vulnerable groups still exists. Especially the elderly over 80 years old are the main potential serious patients. In addition to age, chronic kidney disease, hypertension and some nervous system diseases, as well as lack of vaccination, are all possible factors for the susceptible population to become serious after infection.
Zhang Wenhong once again stressed that places where vulnerable and high-risk groups are concentrated, such as nursing homes, must be protected in reverse. Only when the whole society establishes a very good immune barrier and medical resources are sufficient can the door of nursing homes be slowly opened.
Community medical institutions are the "moat" of higher-level hospitals, and they implement triage strategies to treat critically ill patients in time.
65438+February 18, Professor Zhang Wenhong gave training on related topics at the training meeting on medical treatment of COVID-19 infection organized by Shanghai Health and Health Commission.
"In recent years, we have adhered to' dynamic clearing' to better protect the vulnerable groups. The morbidity and mortality in COVID-19 are very low, and few patients develop into severe diseases. " Zhang Wenhong said that because the treatment of COVID-19 patients in the past three years was concentrated in designated hospitals, community doctors mainly engaged in nucleic acid testing and sheltered hospitals, and did not intervene in case treatment in designated hospitals. In the face of a new wave of epidemic, most asymptomatic mild patients will be treated at home or in community medical institutions. It is estimated that 99% of patients will be concentrated in primary community medical institutions, and community doctors will become the backbone to win this epidemic.
Zhang Wenhong suggested that family doctors and community doctors can provide medical support for patients with mild illness at home by telephone. Hospitals and social drug supply systems should be reserved in advance to meet the public demand through internet hospitals, community health systems and online pharmacy systems. At the same time, community doctors must closely monitor the vital signs of high-risk groups, such as patients over 60 years old, to prevent them from developing into severe diseases. These patients should be screened out as soon as possible, and cases with common, severe, critical and severe high-risk tendencies should be referred to higher-level medical institutions in time for orderly diversion to avoid a run on medical resources.
Zhang Wenhong revealed that at present, Shanghai has matched ICU resources for secondary and tertiary hospitals, and prepared infection wards and convertible ICU wards.
He reminded that if the secondary and tertiary hospitals are saturated, symptomatic support treatment should be carried out in community primary hospitals. For example, the blood oxygen saturation index of patients admitted to community hospitals has dropped sharply, and the imaging indications are getting worse and worse. Community doctors should promptly carry out pre-treatment including glucocorticoid therapy, antiviral therapy and anticoagulant therapy while contacting secondary and tertiary hospitals for referral. The most important thing is mask oxygen therapy. For some patients, they may get through oxygen therapy, and there is no need to send them to a higher hospital. "Don't wait!" Therefore, to ensure that community medical institutions have enough nasal tubes and masks and ensure medical resources such as oxygen supply, "medical resource reserve is the key to win a new round of support war."
Zhang Wenhong believes that the current difficulty lies in the triage judgment of patients with home isolation, and when to determine that patients with home isolation need referral. He suggested that community health service centers in various districts and streets in Shanghai need to establish accounts and bases for high-risk patients such as pregnant women, newborns, tumor radiotherapy and chemotherapy, and hemodialysis. At the same time, smooth community referral channels.
Zhang Wenhong said that at present, Shanghai's drug reserves for treating COVID-19 patients are sufficient. However, if the hoarded drugs are snapped up at will on the Internet, no sick people will buy these drugs, and patients in COVID-19 will not be able to buy these drugs. He suggested that the pressure of drug supply in medical institutions should be alleviated through community medical service management and online and offline adjustment.
"The most important thing now is that community doctors transfer 1% patients to secondary and tertiary hospitals through their triage strategy, and secondary and tertiary hospitals will save 1% patients. Community hospitals and secondary and tertiary hospitals are very important, and triage and treatment can not be ignored. If the grass-roots units in the community can't do well, there will be a run on ICU beds in Shanghai's second-and third-tier hospitals, and so will China. As long as the grassroots hospitals are well done, they will certainly win this epidemic. "
Zhang Wenhong said that to win the battle from dynamic clearing to dynamic optimization, the biggest contributor must be community-based medical care, and the whole medical system should pay more attention to and reward community doctors.
Extended reading:
Zhang Wenhong: 2-4 months. The peak will be a "reverse protection" for the elderly.
When will this round of epidemic peak come? When can I leave? Can medical resources hold up? How to protect the elderly at home?
This weekend, Dr. Zhang Wenhong attended relevant professional meetings and made the latest judgment!
Small farmers laid out the key points for everyone.
* This round of epidemic should be prepared for 2 to 4 months;
*
Grassroots doctors at the community level will face
More than 99% epidemic prevention pressure in COVID-19;
*
At this stage when the peak of infection is coming, we should protect the elderly very well. He specifically proposed a
The concept of "reverse protection" is to prevent viruses from entering the living space of the elderly.
Video screenshot
According to the report of China Business News, it was launched this morning.
Zhang Wenhong, Director of Infectious Diseases Department of Huashan Hospital affiliated to Fudan University,
Take Singapore as an example;
The mortality rate in Singapore is 0.06%, which is far lower than the flu.
Singapore, on the other hand, was liberalized from 65438+ 10 to 1, and it didn't reach a low point until April 15.
During the period, it lasted about 4 months.
Zhang Wenhong said that it will take 2-4 months to prepare for this epidemic!
Community-level junior doctors
Will face more than 99%
Epidemic prevention pressure in COVID-19.
Dr. Zhang Wenhong said at the meeting:
Next, grassroots doctors at the community level will face more than 99% epidemic prevention pressure in COVID-19 to avoid a large number of patients impacting secondary and tertiary hospitals;
At the same time, secondary and tertiary hospitals need to do intensive care to minimize mortality.
Zhang Wenhong emphasized that in general treatment, in addition to monitoring the condition of COVID-19 patients and antibacterial treatment,
At the community level, there are two things that must be done: "one is to equip with nasal catheters, and the other is to equip with masks;" If conditions permit, mixed inhalation of hydrogen and oxygen can be used. In addition, in severe and critical cases, such as the deterioration of patients' oxygen and indicators and the rapid progress of imaging, glucocorticoid and other treatments were taken while being referred to higher hospitals. "
"Our community doctors will face the biggest wave of COVID-19 infection in history this time." Zhang Wenhong said that in recent years, our COVID-19 treatment has been carried out in designated hospitals, and community doctors often help Fangcang Hospital or do some nucleic acid tests.
But this time, more COVID-19 patients will be concentrated in the community.
"Reverse protection" for the elderly!
as ... as possible
Avoid viruses from entering their living space.
65438+February 65438+July, at the 2022 China-US High-end Forum on Clinical Microbiology and Infectious Diseases, Zhang Wenhong said
At this stage when the peak of infection is coming, we should protect the elderly very well.
"If the elderly have not been vaccinated, they should reduce their activities and wear masks when they come out.
When you go to see the elderly, you have to wear a mask before you go.
Finally, I hope that the elderly can be vaccinated and have better drug protection. "
Zhang Wenhong said: "Judging from the Shanghai data,
The virulence of Omicron strain has obviously decreased, but its aggression against vulnerable people still exists. Especially the elderly over 80 years old, are also the main severe patients. In addition to age, chronic kidney disease, hypertension and some nervous system diseases are the main causes of illness in vulnerable people. Most deaths or serious cases occur in people who have not been vaccinated. So,
Vaccination is very important to protect vulnerable people. "
"Now, our focus is on
To fully protect the elderly, we should do a good job in three aspects:
First of all, once the infection has symptoms, it should be given adequate drug treatment;
Second, it is recommended that they be fully vaccinated;
Third, during the epidemic, they will be provided with a reverse protection to prevent the virus from entering their living space. "
Zhang Wenhong expressed the hope that more new vaccines against Omicron will come out as soon as possible, which is also of great value in preventing vulnerable people from being infected with Omicron. "Nevertheless,
Vaccination of existing vaccines still helps us to form a certain immunity to Omicron. "
Getting out of the epidemic is a foregone conclusion!
"COVID-19" is hard to appear again.
A strain that spreads faster
"It is a foregone conclusion that we are about to get out of this epidemic, and this trend will not be reversed." Zhang Wenhong also said in the 17 forum.
"When the COVID-19 epidemic appeared, we knew that the virus spread far faster than the influenza virus, and humans generally had no immunity to this virus." Zhang Wenhong said that human beings have never achieved the goal of controlling infectious diseases by destroying a species. So after the flu was born in the world, it gradually reached a balance with our human immune system. With the vaccination and widespread infection of the vaccine, it will maintain a certain stable state with infectious diseases. "
Zhang Wenhong said that COVID-19 is also facing the same situation. "At present, it can be seen from various studies that after vaccination, the evolutionary pressure of the virus is great, which greatly reduces the number of times of virus evolution after vaccination. Finally, what we saw today was that the Omicron strain finally won. The strain has a certain escape effect on human immunity, and its R0 value is close to the level of 16- 18, which is out of the family of Omicron strains.
It is difficult to produce another virus strain that spreads faster now. "
Be fully prepared,
Don't relax or panic!
Especially to protect the elderly!
Do you remember?
Let's spend this winter safely!