After more than a year, after two rounds of epidemics, Delta and Omicron, the Joint Prevention and Control Mechanism of the State Council released a new version of the "Novel Coronavirus Pneumonia Prevention and Control Plan." During this period, the "three-zone" zoning plan was

After more than a year, after experiencing two rounds of epidemics Delta and Omicron,The Joint Prevention and Control Mechanism of the State Councilhas released a new version of the "Novel Coronavirus Pneumonia Prevention and Control Plan" (hereinafter referred to as the "Plan"). During this period, the "three-zone" zoning plan was released, a new version of the diagnosis and treatment plan was released, antigen testing was launched, Pfizer's small molecule oral drugs were approved, and the implementation guidelines for nucleic acid testing organizations were revised. While large-scale epidemics in Shanghai, Jilin and other places subsided, my country's epidemic prevention and control After the overall situation stabilizes and improves, now is the window period for optimization and adjustment.

In addition to revising the previously announced improvements or adjustments to the regulations on ports, disinfection, vaccination, antigen testing, and the classified treatment of asymptomatic infected sent makeshift hospitals , the "Plan" mainly shortens the isolation management of risk personnel. During the deadline, the standards for delineating closed control areas and medium- and high-risk areas were unified, and the frequency of nucleic acid testing for high-risk occupational groups was increased. The

"Plan" includes both major changes and comprehensive optimization and refinement of details, such as clarifying the objects and rules for isolation and monitoring. The text of the plan has been increased from 18 pages to 22 pages; among the original 12 attachments, two have been added, and each original attachment has been improved.

At the press conference of the Joint Prevention and Control Mechanism of the State Council on June 28, Lei Zhenglong, deputy director of the National Health Commission's Bureau of Disease Control and Prevention and first-level inspector, said that the revision of the "Plan" was mainly based on several considerations, including the epidemic situation. Changes, research found that the virus mutated characteristics. In addition, the Comprehensive Team of the Joint Prevention and Control Mechanism of the State Council carried out a one-month campaign in seven cities including Dalian, Suzhou, Ningbo, Xiamen, Qingdao, Guangzhou and Chengdu between April and May. The new crown pilot research work on optimizing epidemic prevention and control measures has obtained a large amount of scientific basis. The "Plan" combines the prevention and control practices of various places, especially the experience and lessons of large-scale epidemic management in Shanghai, Jilin and other places, and also refers to the guidelines issued by the World Health Organization (WHO) in the first half of the year.

Lei Zhenglong particularly emphasized that the ninth version of the prevention and control plan is an optimization and adjustment of prevention and control measures, and it is by no means a relaxation of prevention and control. The key is to control the key risks that should be controlled, implement what should be implemented, and cancel what should be eliminated. Resolutely cancel it and further improve the scientific nature and accuracy of epidemic prevention and control.

Tan Xiaodong, a professor at the School of Public Health of Wuhan University, said in an interview with a reporter from Red Star News that the new version of the plan comprehensively clarified many regulations, and with unified standards, they can be followed and implemented. In the future, we can implement scientific and precise policies and see less "one size fits all."

Behind the changes in the plan:

Most of the Omicrons were detected within 7 days, and the quarantine period for close contacts and immigrants was shortened by half

At the press conference of the Joint Prevention and Control Mechanism of the State Council on June 28, Deputy Director of the Supervision Bureau of the National Health Commission Cheng Youquan introduced that the joint prevention and control mechanism at the national and provincial levels has set up a special task force to rectify the problem of "overweighting at all levels", set up a website and telephone reporting channels, and collected clues from the society about violations of the "Nine Prohibitions" for epidemic prevention and control.

The "Nine Don'ts" include that you are not allowed to arbitrarily expand the scope of travel restrictions from medium- and high-risk areas to other areas; you are not allowed to take restrictive measures such as forced return and quarantine for people from low-risk areas; you are not allowed to arbitrarily extend the travel restrictions. , control time in high-risk areas; it is not allowed to arbitrarily expand the scope of risk personnel who take isolation and control measures; it is not allowed to arbitrarily extend the isolation and health monitoring time of risk personnel.

The "Plan" has made many adjustments based on the incubation period characteristics of the Omicron variant. The old version of the "Plan" previously mentioned that the incubation period of new coronavirus pneumonia is 1-14 days, mostly 3-7 days. At a press conference on June 28, Wang Liping, a researcher at the Transmission Prevention and Control Division of the Chinese Center for Disease Control and Prevention, said that research has found that the average incubation period of Omicron mutants is shortened, mostly 2-4 days; most of them can be recovered within 7 days. Check out.

"Plan" optimizes and adjusts the isolation management period and method of risk personnel. has adjusted the isolation and control time for close contacts and immigrants from "14 days of centralized isolation medical observation + 7 days of home health monitoring" to "7+3". The close contact control measures have been adjusted from "7 days of centralized isolation and medical observation" to "7 days of home isolation and medical observation".In the determination of close contact, it is defined as a person who has been in close contact with a person with a higher risk of infection for a long time.

html On June 30, Mr. Zhang told the Red Star News reporter that he was very happy to learn that the quarantine period had been shortened after he had been stranded in Belarus and returned to his country. He began to quarantine after landing that day, and the policy of the city where he landed has been changed to "7+3". Because he lives in Yinchuan, Ningxia, the community also informed him that morning that home health monitoring after returning home will no longer be 7 days, but 3 days.

In addition, the "Plan" renames general contacts to persons exposed in epidemic-related places, and the control measures are changed from the need to register to "take nucleic acid testing measures for personnel with a higher risk of infection after risk assessment. Carry out a nucleic acid test every day." The "Plan" also proposes that when a large-scale epidemic occurs, in order to alleviate the serious shortage of resources in centralized isolation points, "5+5" control measures can be adopted for close contacts.

Wang Liping emphasized that this is a further optimization of prevention and control measures based on the popular characteristics of the Omicron variant . It will not increase the risk of epidemic spread and is a reflection of precise prevention and control.

Tan Xiaodong believes that the basis for this adjustment is very scientific and can effectively utilize isolation resources. According to his understanding, this is also consistent with Wuhan’s relevant experience.

Previously, in early May, Beijing took the lead in publicly announcing that it would shorten the quarantine time for incoming personnel, close contacts, sub-closed contacts, and high-risk personnel. In June, many places announced that they would adjust the centralized quarantine time for immigrants to 7 days or 10 days.

The "Five Ones" policy for international flights has also changed. The State Council executive meeting on May 23 decided to implement 33 measures in 6 aspects, including the orderly increase of domestic and international passenger flights and the formulation of measures to facilitate the exchange of personnel from foreign companies. At a press conference on June 17, the Civil Aviation Administration of China also stated that under the coordination of the Joint Prevention and Control Mechanism of the State Council, the Civil Aviation Administration of China is negotiating with some countries to gradually and steadily increase regular international passenger flights to meet the needs of personnel exchanges. Red Star News reporters noted that the three major airlines have resumed some international flights. Recently, the Civil Aviation Administration of China has also adjusted the circuit breaker mechanism for international flights. The statistical time has been adjusted from 7 days to 5 days after landing, which reduces the possibility of circuit breaker.

Red Star News also noticed that in the past two days, many Chinese embassies abroad have released news to relax prevention and control requirements before returning to the country, including only requiring two nucleic acid tests within 48 hours, allowing transit to third countries, Saudi Arabia, , Sri Lanka and other countries The closed-loop quarantine before boarding has also been cancelled. Moreover, many embassies resumed processing visas to visit relatives in China in June.

In addition, in the past, whether it was a closed control area or a medium- and high-risk area, the main criterion for downgrade was generally no new infections for 14 days, while the new version of the plan is no new infections for 7 days. The tracing of travel history in epidemic areas is also clearly limited to 7 days. The definition of a cluster epidemic was changed from 5 or more cases and asymptomatic infections detected within 14 days to 2 or more cases within a week.

Changes in risk zone standards: Control measures can be implemented if only one infected person occurs

The "Plan" unifies the delineation and control of closed control areas and medium- and high-risk areas. The solution connects and corresponds the two types of risk area delineation standards and prevention and control measures, integrates and uniformly uses the concepts of high, medium and low risk areas, and forms a new risk area delineation and control plan.

Looking back at the history of the concept of risk zones, in April 2020, our country entered the stage of normalized epidemic prevention and control. The Joint Prevention and Control Mechanism of the State Council issued the "Notice on Adjusting the New Crown Pneumonia Epidemic Zoning and Grading Standards to Implement Precise Control Measures", which defined medium- and high-risk zones. Setting standards have been improved. According to the standards for medium- and high-risk areas disclosed by the Centers for Disease Control and Prevention in many places, if cases stay in an area for a long time and no more than 10 locally confirmed cases occur within 14 days, or a cluster epidemic occurs, the area is classified as a medium-risk area; if Areas with 10 or more locally confirmed cases, or 2 or more cluster epidemics, are designated as high-risk areas. Since then, some regions have further improved their local standards; the zoning in various places has become increasingly precise, even down to units and stores.

After the outbreak began, in September 2021, the Joint Prevention and Control Mechanism of the State Council issued the "New Coronavirus Pneumonia Epidemic Community Prevention and Control Plan" and introduced an additional "three-zone" division standard, namely the closed area, the control area and the prevention area.Lei Zhenglong once explained at the press conference that this is to detect and control people infected with the new coronavirus early and effectively curb the spread of the epidemic in the community.

Red Star News reporters carefully compared and found that, in addition to the frequency of nucleic acid testing and downgrade standards, the "New Crown Pneumonia Epidemic Risk Area Delimitation and Control Plan" attached to the "Plan" basically follows the "New Crown Pneumonia Epidemic Community Prevention and Control Plan" divided into "three zones" Plan", including delineation standards, prevention and control measures, lifting standards, as well as working mechanisms, division of responsibilities and organizational guarantees. High, medium and low risk areas correspond to containment, control and prevention areas.

Risk area delineation and lifting standards and prevention and control measures

The delimitation standards of medium and high-risk areas have not previously included asymptomatic infections, and the delimitation standards of the new version of the "Plan" are basically consistent with the previous "Three Zones" and are no longer based on The number of cases, but the movement trajectory of infected people and the risk of epidemic spread. Tan Xiaodong believes that the new standards for medium- and high-risk areas are more accurate than the old standards. Once an infected person appears, control measures can be implemented; under the old standards, the area will be upgraded to a medium- and high-risk area only if cases continue to occur, and the response speed is slow.

Among them, for high-risk areas, "Plan" proposes that buildings and courtyards where positive infections have been found can be tested first, and nucleic acid tests can be conducted in an orderly manner after negative results. Regarding the management and control of risk areas in

, the "Plan" clearly states that on the premise of strictly implementing personal protection, each household can arrange for one person per day to go to the designated area to purchase or sell goods in accordance with the "time-sharing and orderly, zone-limited flow" method. Contactless collection of online shopping items. In the "three-zone" plan, this provision is one person per household every 2-3 days.

low-risk areas and corresponding prevention areas are no longer low-risk areas in the previous sense that the public is accustomed to. The "Plan" states that counties (cities, districts, banners) where local epidemics have not occurred must effectively implement regular epidemic prevention and control measures and do not need to delineate risk areas. For low-risk areas in counties (cities, districts, banners) where the epidemic occurs, preventive measures of "personal protection and avoidance of gatherings" are adopted, and cross-city movement requires a 48-hour negative nucleic acid test certificate.

html On June 30, according to news released by Sixian County, Anhui Province, the high, medium and low-risk areas delineated by Sixian County, Anhui Province were released according to the new version of the "Plan". A total of 43 high-risk areas and 8 medium-risk areas were delineated.

How to control personnel with cross-provincial spillover risks? The new "Plan" clarifies that

medium and high-risk areas are an important basis for local governments to control the inflow of people from other areas. "Plan" clarifies the control measures for cross-provincial spillover risk personnel in high, medium and low-risk areas: Personnel with a 7-day history of staying in high-risk areas will be subject to 7-day centralized isolation medical observation; personnel in medium-risk areas will be subject to 7-day home medical observation ; People in low-risk areas do not need to be quarantined, but are required to be tested twice every three days.

However, for the management of spillover personnel in medium and high-risk areas within each province (autonomous region, municipality directly under the Central Government), the "Plan" mentions that each locality shall formulate and publish it to the outside world.

On the afternoon of the second day after the "Plan" was released, the Ministry of Industry and Information Technology announced that it would cancel the "star" mark on communication itinerary cards with immediate effect. The Ministry of Industry and Information Technology stated that this is to support the efficient coordination of epidemic prevention and control and economic and social development, and to facilitate the travel of users.

Red Star News reporters noticed that starting from that night, the health codes or one-code pass in Xi'an, Hangzhou, Nantong and other places began to use label colors and exclamation points to display travel history.

html On June 30, Wu Zunyou posted on Weibo explaining that the "star" mark only reminds someone that they have visited cities with medium- and high-risk areas within 14 days. It does not mean that the user has actually visited these medium- and high-risk areas, that is, it cannot Reflects the actual risk level of those marked with an "asterisk". With the continuous improvement of scientific prevention and control and precise implementation of policies, the requirements for the division of medium and high-risk areas and prevention and control management have become more refined and precise. The prompting effect of the "star" mark on the communication itinerary card plays an important role in the specific implementation of the new prevention and control strategy. Difficult to implement.

"Canceling the 'asterisk' mark will be conducive to the implementation of the main measures of the "Novel Coronavirus Pneumonia Prevention and Control Plan (Ninth Edition)". Canceling the 'asterisk' mark will no longer provide protection for those who may over-prevent the epidemic and even allow The 'overwhelming' approach to epidemic prevention provides no excuses," Wu Zunyou wrote.

Cheng Youquan emphasized at a press conference on June 28 that it has recently been discovered that some places have arbitrarily imposed quarantine and other restrictive measures on people from epidemic areas such as Shanghai. All relevant places should strictly follow the ninth edition of the "Plan" and make immediate corrections and Rectification. According to Shanghai's announcement, starting from 0:00 on July 1, Shanghai will adjust the control measures for people leaving and returning to Shanghai, and the control measures for risk areas and spillover risk personnel will be calibrated to the new version of the "Plan".

Mentioned from 40 times to 77 times: The frequency of nucleic acid testing for risk occupational groups is encrypted

How does the new version of the "Plan" deal with the rapid spread and strong concealment of the Omicron variant?

The epidemic monitoring requirements of the "Plan" emphasize the combination of symptom monitoring and nucleic acid testing. The "Plan" clarifies and details monitoring, especially the requirements for nucleic acid testing. According to rough statistics by Red Star News reporters, in the text of the "Plan", "nucleic acid" appears 40 times in the eighth page, and 77 times in the ninth page.

Wang Liping introduced at the press conference of the Joint Prevention and Control Mechanism of the State Council held on June 28 that the "Plan", on the basis of previous normalized monitoring, has encrypted the frequency of nucleic acid testing for risk occupational groups, and will include direct contact with entry personnel, items, and the environment. Nucleic acid testing for personnel and other personnel will be adjusted to once a day; nucleic acid testing for employees with densely populated areas, frequent contacts, and high mobility will be adjusted to twice a week. After a local epidemic occurs, the frequency of nucleic acid testing will be increased based on the risk of epidemic spread.

Routine nucleic acid testing for high-risk professionals is an important means of "early detection." Red Star News reporters noticed that the old version of the plan stipulated that the above two groups of people should have nucleic acid testing once a week for all or sampling. The plan also makes detailed nucleic acid testing requirements for personnel in key institutions and places.

Nucleic acid testing requirements for high-risk professionals and personnel in key institutions and sites

In addition, the "Plan" adds new drug monitoring requirements, and also adds antigen testing as a supplementary method for epidemic monitoring.

The "Plan" also clarifies regional nucleic acid testing strategies in different scenarios. optimizes the start and end conditions and corresponding procedures for regional nucleic acid testing after the outbreak of the epidemic in provincial capital cities, cities with a population of more than 10 million, general cities, and rural areas. Nucleic acid detection strategy.

If the person who returns positive has no symptoms and no risk of transmission, they will no longer be managed and judged for close contact.

Red Star News reporters also noticed many details added to the new version of the "Plan".

There is a unified basis for the management of people who have recovered from positive symptoms. The new version of the diagnosis and treatment plan released by in March lowered the Ct value standard for nucleic acid testing at discharge (cabin) to 35, and the subsequent 14-day isolation management was adjusted to 7-day home monitoring. But since then, the Fuyang phenomenon has caused controversy. According to the response at the Shanghai epidemic press conference on May 4, Shanghai’s regulations at that time were that discharged (vacant) persons were not included in the community screening targets, and a nucleic acid test was carried out on the 7th day of home health monitoring. The Ct value of the nucleic acid test was

In this regard, the new version of the "Plan" makes detailed provisions: COVID-19 infected patients who are discharged from the hospital (cabin) and the people who live with them under community management will undergo a nucleic acid test on the 3rd and 7th day after discharge (cabin).

If a patient returns positive, the "Plan" stipulates that if no symptoms or signs appear, only the nucleic acid test Ct value

At a press conference of the State Council Information Office on March 18, Jiao Yahui, Director of the Medical Administration and Medical Administration Bureau of the National Health Commission Zeng explained that domestic research on patients who returned positive as well as and data showed that patients who returned positive did not cause the spread of the epidemic.

In addition, the "Plan" also adds Ct value requirements for virus whole-genome sequencing specimens included in viral gene mutation monitoring. A press conference on June 28 stated that the number of infections with the BA.4 and BA.5 subclades of Omicronium found in imported cases in my country showed signs of gradually increasing, and the transmissibility and immune escape of BA.4 and BA.5 The ability is slightly enhanced, and the difficulty of prevention and control will increase. The new version of the prevention and control "Plan" released during the

window period may be tested for more new mutant strains in the future.

(At the request of the interviewee, Mr. Zhang is a pseudonym)

Red Star News reporter Hu Yiwen Wu Yang Beijing report

Editor Tan Wangyu

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