"What are the discharge criteria for patients with new coronavirus pneumonia?" "Are patients with new coronavirus pneumonia contagious after being discharged from the hospital?" "What regulations do people who have been cured or discharged from isolation and observation need to comply with after returning to the community?" "How should cured patients be treated for re-positive resilience? Is there a possibility of infecting others?"...
Recently, a group of patients with new coronavirus pneumonia in Guiyang recovered and were discharged from the hospital. The reporter interviewed Zhang Xiangyan , the leader of the Guizhou Provincial Medical Treatment Expert Group and the temporary party secretary of the Provincial General Mountain Hospital , Zhang Xiangyan . She said that based on current research and clinical experience, no cases of transmission have been observed in patients with COVID-19 after being cured and discharged from hospital and asymptomatic infection of were released from medical observation.
1. What are the criteria for discharge of patients with COVID-19?
Zhang Xiangyan: The "Diagnosis and Treatment Plan for the New Coronavirus Pneumonia (Trial Ninth Edition)" clearly stipulates the discharge standards for confirmed patients: 1. Body temperature returns to normal for more than 3 days; 2. Respiratory symptoms improve significantly; 3. Pulmonary imaging shows that acute exudative lesions have improved significantly; 4. The Ct values of the N gene and ORF gene of the new coronavirus nucleic acid tests are ≥35 ( fluorescence quantitative PCR method, the limit value is 40, the sampling time is at least 24 hours apart), or the nucleic acid test of the new coronavirus are negative (fluorescence quantitative PCR method, the limit value is less than 35, the sampling time is at least 24 hours apart). Those who meet the above conditions can be discharged.
Asymptomatic infected persons have been released from isolation management standards: the Ct values of the N gene and ORF gene of the new coronavirus nucleic acid tests are ≥35 (fluorescence quantitative PCR method, the limit value is 40, the sampling time is at least 24 hours apart), or the nucleic acid test of the new coronavirus is negative (fluorescence quantitative PCR method, the limit value is below 35, the sampling time is at least 24 hours apart), and the isolation management can be released.
2. Are cured and discharged from hospital with COVID-19 or asymptomatic infections released from isolation management?
Zhang Xiangyan: According to current domestic and foreign research, it is not contagious.
The nucleic acid Ct value of patients with cured and discharged from hospital or asymptomatic infected people who have been released from isolation management is ≥35. According to current domestic and foreign research data, when the nucleic acid Ct values are ≥35, the live virus can no longer be isolated from the sample. Therefore, no cases of transmission caused by the new coronary pneumonia patients being cured and discharged from hospital or asymptomatic infections have been released from medical observation, and no infection has been found in their close contact with . Secondly, most infected people produce protective neutralizing antibodies in their bodies. It can be said that compared with uninfected people, they have extremely low chances of being infected by the same strain. In addition, before the cured and discharged patients with COVID-19 or asymptomatic infections who have been released from isolation and management leave the hospital, the hospital will conduct terminal disinfection of relevant items and environments, including cleaning and disinfecting of the items they carry, such as the cured patients' luggage, clothing, personal items, etc.
3. What personal protection and testing should be done when the asymptomatic infected person who has been cured or who has been released from isolation management when returning to his or her place of residence?
Zhang Xiangyan: According to the requirements of the "Diagnosis and Treatment Plan for the New Coronavirus Pneumonia (Trial Ninth Edition)", after the new coronavirus pneumonia patients are cured or released from isolation management, the things to be paid attention to are: after being discharged from the hospital, you must undergo 7 days of home health monitoring, wear a mask, and live in a well-ventilated single room with conditions to reduce close contact with your family, share food and eat well, keep a good hand hygiene, and avoid going out.
Home Health Monitoring is a potential risk for infected people in the recovery period. From the perspective of self-esteem, others, and social responsibility, home health monitoring is required. During home health monitoring, you should measure your body temperature once a day in the morning and evening, and pay attention to your own health status. If you have symptoms such as fever, dry cough, fatigue, sore throat, loss of smell (taste), diarrhea, etc., you should report it to the community manager in a timely manner. When visiting medical institutions during home health monitoring, medical personnel should be actively informed of their previous medical history and other conditions.
4. How should patients with new coronary pneumonia be treated after being cured? Is it contagious?
Zhang Xiangyan: "Re-positive" means that after the infected person is released from isolation or discharged from the hospital, the nucleic acid test for of the new coronavirus is positive again (Ct value <40).> new coronavirus should not be discriminated against after being discharged from the hospital.
's management of "re-positive" patients. The "New Coronavirus Pneumonia Prevention and Control Plan (Ninth Edition)" clearly defines the important basis for nucleic acid testing Ct value, pointing out that after the previous infected person was discharged from the hospital (cabin), the nucleic acid test of respiratory samples was positive. If there are no symptoms and signs and the nucleic acid testing Ct value ≥35, they will no longer be managed, and there is no need to determine close contacts.
Whether the "re-positive" person is contagious first depends on its Ct value . For those who recovered from positive, the Ct value of nucleic acid tests is generally ≥35. If there are no symptoms and no management is required, they are safe in life and work. Past facts have also proved that these re-positive COVID-19 recoverers did not cause infection or infection in the surrounding population. The nucleic acid positive is only because the nucleic acid fragment of the virus is detected, that is, a "dead virus", and the current research has found that most of them belong to this situation and there is no risk of infection.
However, if the nucleic acid test Ct value of the "re-positive" person is less than 35, the transmission risk should be quickly evaluated in combination with the disease course and dynamic changes of the Ct value. If there is a transmission risk, it is managed by the infected person, and close contacts who have frequent contacts such as living and working together, but there is no need to determine the close contacts (second close contacts). That is to say, the test results of the re-positive person do not affect the division of risk areas of the building and community where they are located; if there is no transmission risk, the re-positive patients will no longer be managed, and frequent contacts such as living and working together will not be judged as close contacts.
Zhang Xiangyan said that as a designated hospital for treatment of new coronavirus pneumonia in Guizhou Province, the Provincial General Mountain Hospital strictly implements the "Diagnosis and Treatment Plan for the New Coronavirus Pneumonia (Trial Ninth Edition)", standardizes the prevention and control of hospital infections and medical treatment, and provides good patient service guarantees. Whether it is the clinical cure of of confirmed cases, or the asymptomatic infections are discharged from medical isolation and observation, all links have been rigorously evaluated by provincial authoritative experts before returning to the family. Please rest assured. Zhang Xiangyan reminds that we must believe in the power of science and professionalism, and do not need to be overly nervous. We must maintain a good mood, eat a balanced diet, ensure adequate sleep, and exercise moderately, because the most effective medicine is the body's own immunity. At the same time, wearing a mask, keeping distance, washing hands frequently, ventilating more, and not gathering are still the most effective protection measures.
Source: Guiyang Evening News
