Harbin local epidemic is still spreading, with 4 new confirmed cases on April 18.
This wave of local epidemics that have continued from April 9 to the present day, except for the 13th, there have been new confirmed cases and asymptomatic infections of in recent days. According to the latest announcement from the Heilongjiang Provincial Health Commission this morning (20th): From 0:00 to 24:00 on April 19, 2020, 3 new confirmed cases (3 in Harbin) were added in Heilongjiang Province and 3 new asymptomatic infections (3 in Harbin).
As of 24:00 on April 18, There have been 54 infections in (36 confirmed cases and 18 asymptomatic infections) in Harbin and Han, a 22-year-old female international student who returned to Harbin from the United States. has traced a total of 17,325 close contacts, 16,493 people have been released from medical observation, and 832 people are still under medical observation.
This wave of local epidemic, is a previous infected person, Han, who may have been infected to Cao by sharing the polluted environment. The virus has been spread for several rounds, and finally more than 40 people were directly or indirectly transmitted through the 87-year-old hospitalized man, including 6 nurses and 1 doctor, and the virus is still spreading.
undoubtedly, there is insufficient prevention and control over the spread of the local epidemic. The Harbin Municipal Party Committee and Municipal Government have made a written and in-depth review to the Heilongjiang Provincial Party Committee and Provincial Government. The Heilongjiang Provincial Commission for Discipline Inspection and Supervision held 18 party members, cadres and public officials who failed to effectively prevent and control the epidemic, including the deputy mayor, director of the Municipal Health Commission, deputy district mayor and leading cadres of the three hospitals. The notice stated that the responsibilities were not fulfilled properly and there were loopholes in epidemic control measures.
However, besides poor prevention and control, is there any lessons worth learning for this wave of local epidemic?
There are two points worth paying attention to: 1. The sharing of the polluted environment and the spread of the virus cannot be underestimated. 2. The new coronavirus is so contagious that it is beyond imagination. There are still unknown factors that need us to explore in epidemic prevention and control.
As of 24:00 on April 18, the epidemic transmission chain.
After 4 tests in 23 days of entry
Han Mou did not identify confirmed cases
Why has it become the source of transmission?
Recalling the beginning of this wave of epidemic, the public will focus on Han, a 22-year-old female international student.
Han is not a confirmed case, so why has it become the source of transmission?
is different from the fact that some overseas personnel returned to China secretly and concealed their whereabouts with illness, which led to the spread of the epidemic. Han met the epidemic control regulations from returning to China to quarantine at home.
According to the Harbin Health Commission's notice, Han arrived from the United States from March 19 and transferred it to his home in Jiangwan Community, Duoli District, Harbin City by "hand-handing" and implemented home isolation observation in accordance with the policy regulations at the time.
The so-called "hand-handed hand" means that from the airport to the entrance of the community, there is health control throughout the whole process. This means that after Han returned to China, he made a health declaration according to regulations, and the local disease control department also implemented the control measures according to regulations.
Some netizens questioned why overseas personnel did not have centralized quarantine when they returned to China? The official reply was that Han returned from the United States on March 19. According to the policy at that time, he only quarantined people returning from Japan, South Korea, , Iranian , and Italy. All incoming personnel will be quarantined on the spot only from the 21st.
Han's nucleic acid test was negative on March 31, and the antibody tests IgM and IgG were both negative. On April 3, Han was isolated for 14 days, and the nucleic acid test was negative again and he was released from home quarantine.
On April 9, a local confirmed case in Harbin appeared in Guo Mouming. Through epidemiological investigation and big data comparison and traceability analysis, it was found that Cao Mou was infected with her boyfriend Li Mou, his mother Wang Mouling and her mother's boyfriend Guo Mouming. Cao has no history of traveling in Wuhan and other epidemic areas, nor has he been exposed to new coronavirus carriers, so why has he become a source of infection?
Harbin Center for Disease Control and Prevention investigated and found that Cao and Han were neighbors upstairs and downstairs, and they didn’t know each other. The notice stated that on April 10 and 11, the Centers for Disease Control and Prevention conducted two antibody tests on Han, of which both IgM were negative and IgG were positive. They were diagnosed as a previous infection with the new coronary pneumonia (imported from abroad).
That is to say, since , Han returned to China on March 19 to April 11, he received four tests in 23 days, but none of them were identified as confirmed cases.
However, Han may be the source of infection.
Harbin Center for Disease Control and Prevention investigated that the unit is one elevator and one household. The entire unit shares an elevator, and there is a common space that may be contaminated. Due to the house structure and other reasons, there is also the possibility of virus transmission between the two adjacent floors, and the two have the conditions for contagion.
shared the environment that is polluted, causing the epidemic to spread
SARs Leave a lesson
This is not an isolated case.
Beijing's first imported related case was also accused of sharing a contaminated environment and causing infection.
Liu developed symptoms such as fever on March 10, and took medication during the period and was diagnosed as a confirmed case of new coronary pneumonia on March 23. The epidemiological investigation found that Liu's neighbor Li arrived in Beijing from the UK on March 5 and was quarantined at home. He took the stairs to the community to apply for an entry and exit permit and went to the hospital for treatment. On March 12, he was diagnosed as a confirmed case.
investigation believes that both of them have been taking stairs recently, and Liu may have been exposed to the stair environment polluted by Li before March 11, causing illness.
In fact, due to the pollution of the environment, it existed when the SARS epidemic broke out 17 years ago.
At the end of March 2003, a large number of people and sudden SARS epidemic broke out in Taoda Garden in Hong Kong. On March 26, 7 people were infected in 5 households in Block E, Taoda Garden, and there have been family infections one after another. As of April 15, the number of infections reached 321. After investigation, the patient at the source of the incident was a 33-year-old man. After developing SARS, he went to his brother's residence in Block E, Taoda Garden, and used the toilet due to diarrhea. Later, his younger brother and his wife and two nurses who were caring for him in the hospital were confirmed to be infected with SARS.
Taoda Garden has a total of 321 infected people, 40% are concentrated in Block E. Finally, after investigation, experts concluded that the culprits of the SARS outbreak in Taoda Garden were sewer pipes and floor drains. Most of the U-shaped water collectors in the floor drains of the home bathroom have failed to play a role in air isolation due to drying up.
At that time, relevant Hong Kong departments conducted tests in a unit in Building E and found that when the bathroom's exhaust fan is started, the air would flow backwards from the sewage pipe through the floor drain into the bathroom. These airflows may distribute aerosol stored in the sewage pipe into the bathroom, and the bathroom's air pumping fan may also discharge these aerosols to the patio, and finally the virus-containing aerosols enter other houses through the windows. This is the fundamental reason for the SARS outbreak in Hong Kong Taoda Gardens back then.
The transmission power of the new coronavirus is so strong
beyond our imagination
Back to the spread of the epidemic, that is to say, Han, who had been infected with the new coronavirus, may have spread the new coronavirus through the environment and transmitted the new coronavirus to his unfamiliar neighbor Cao.
Another question is here.
After four tests, Han was not identified as a confirmed case (not yet). The virus in the body may not be detected or is weak during the test period. Why can the virus be transmitted through the shared environment?
According to the transmission chain, Cao was diagnosed as an asymptomatic infected person (later revised as a confirmed case), and transmitted the new coronavirus to his boyfriend Li (asymptomatic infected person), his mother Wang Mouling (asymptomatic infected person) and his mother's boyfriend Guo Mouming (confirmed case). It can be confirmed that these people are familiar with each other and have face-to-face contact with each other.
Afterwards, Guo Mouming and Wang Mouling had a dinner with Chen Mou's family. 87-year-old Chen Mou and his two sons participated in the dinner and were diagnosed with infection. Chen visited the Second Hospital of Harbin City and the First Hospital of Harbin Medical University due to stroke, causing many patients, accompanying staff and medical staff in the same ward of both hospitals to be infected.
As of 24:00 on April 18, there have been 54 infections in this wave of epidemic in Harbin, including 36 confirmed cases and 18 asymptomatic infections. Except for the 8 infected cases, Cao, Li, Wang, Guo, Chen’s father and son, and Chen’s second daughter-in-law, the other 46 infected cases were all related to the infection during Chen’s hospitalization.
Among the 46 infected people, Chen’s two daughters had accompanied his father in the hospital or had direct contact with two brothers, resulting in infection; while many of the other 44 infected people may not have direct contact with Chen.
Analysis of these 44 infected patients has three characteristics: 1. There are all ages, with a large age span. The youngest is a 13-year-old middle school student and the oldest is 81 years old. 2. There are 13 people over 60 years old, most of whom have underlying diseases. After being infected with the new coronavirus, it brings difficulties to subsequent treatment. 3. A small number of people have direct contact with Chen, and most of them have indirect contact with Chen, and are infected only because of the same ward.
In addition, these infected people were infected mainly in early April, when the epidemic alarm has not been lifted. Most Harbin citizens wear masks when going out, especially when they are in hospitals. In this case, so many people are infected through indirect contact. You can imagine how powerful the virus is spreading.
Of course, it is not ruled out that some infected people may not wear masks, but among the confirmed cases, 6 nurses and 1 doctor, must have worn masks even if they are not "fully armed" at work, and they may even be N95 masks with better protective performance than ordinary citizens, but they are still caught.
This is not January when the COVID-19 epidemic just broke out. Some hospitals in Wuhan were in short supply of protective materials, and some medical staff were short of protective equipment, so they were also careless and were infected. Harbin had already experienced the epidemic test in April, but medical staff were still diagnosed with infection.
In addition to the hospital's own prevention and control loopholes, the relevant responsible persons are careless, and the virus itself has strong transmission ability beyond our imagination.
Article source: Reprinted by Southern Metropolis Daily, Qianjiang Evening News, CCTV.com
