has gone from 20 items to the new 10 items, and has significantly relaxed the isolation, nucleic acid testing and the use of health codes, announcing the end of an era of epidemic prevention and control.
Today, the pace of letting go is getting faster and faster, and everyone realizes that the possibility of infection is needed to face. Kim Dongyan, a professor at the School of Biomedicine at the University of Hong Kong, became popular recently. Professor Jin Dongyan pointed out that mainland China has suddenly relaxed epidemic prevention measures and has not prepared well. It is winter again, and the epidemic may have a tsunami-like outbreak. He said that situations like the fifth wave in Hong Kong from February to April this year may occur.
Jin Dongyan also said that once the epidemic in mainland China breaks out like Hong Kong, it may not end within two months. He took Taiwan as an example and pointed out that Omickron has not declined since the outbreak of the epidemic.
In fact, Feng Zijian, former deputy director of the China Center for Disease Control and Prevention, also mentioned that under the impact of the first wave of large-scale epidemics, the infection in the population will reach 60%, and eventually 80% to 90% of people will be infected.
Whether it is the relaxation of Taiwan and Hong Kong, the situation is not optimistic. According to Taiwan’s “ United News Network ” report, Taiwan added 37 new deaths in COVID-19 and 149 intermediate and severe cases on the 8th. One of the cases was a man in his 40s who had received four doses of vaccine , and had a history of chronic illness. He died about one month after the infection on November 11. From January to the present, there are 37,916 cases of moderate to severe diseases, of which 13,730 are the deaths.
According to relevant data, the number of people infected with new crown in Hong Kong has been hovering between 9,000 and 12,000 every day. As of yesterday, a total of 10,651 people have died in the five waves of the epidemic in Hong Kong.
: Taiwan’s severe illness rate and mortality rate compare China’s population basis. How to deal with this wave of medical shock wave in China needs to be prepared early.
has gone from strict lockdowns to relaxation of code reductions. China's three-year dynamic zeroing policy has suddenly emerged as a "U-turn". The situation of soaring infection rates in various places may have become a reality. From the current point of view, the people are not prepared both psychologically and in action.
infection rate has become a witness fact, and hospital pressure is getting bigger and bigger
Currently, the pressure of domestic hospitals fever clinic shows signs of pressure. To this day, some cities have actually been fully opened. With the relaxation of control and the cancellation of routine nucleic acid testing, the public is well aware of the data released so far and is no longer referenceable.
There are more and more positive around many people, including the author. In the community where I live, there are several cases of positive home isolation in recent days. Including the 4th floor where I am located and the 5th floor next door, all of which have abnormal nucleic acid test results. They have been diagnosed and are in home isolation, and many people around me are getting more and more worried.
As various places gradually relax, the pressure has come to the hospital, and many local fever clinics are ushering in the first wave of impact. Judging from the situation in Guangzhou, first of all, the pressure on fever clinics is getting greater and greater. Baiyun District fever clinic has doubled its capacity and operated 24 hours a day. In the past, once a hospital was positive, it was necessary to report it to the disease control department, determine close contacts within the hospital, and block and disinfect within a clear scope.
Simply put, hospitals need to go through the processes of "positive-closed-disinfection-review", but now it can't be done. There are a large number of positive patients in fever clinics in many hospitals in Guang states, and medical staff are even infected. Including the nearby tertiary hospital where I am located.
Recently, a doctor from Guangzhou Grade A Hospital revealed that from December 5, positive medical care in the hospital will no longer be considered as hospital infection, and medical care for positive patients will no longer be included in close contacts. Because medical staff have zero infections, it is difficult to do so at present and must be changed.
Of course, it is not just Guangzhou, the pressure on fever clinics has been emerging all over the country. According to Southern Metropolis Daily , the phenomenon of "positive-closed-disinfection-review" has also appeared in many places in recent days, including Shenzhen, Wuhan, Kunming, Changchun, etc.
In addition, recently, a chief doctor of the obstetrics and gynecology department of Hubei Grade A Hospital posted a message saying that after the release, more and more positives were found. Overnight, the infectious department was full and half of the doctors in the department caught a cold and locked up.
This is not an alarmist statement from the doctor. According to a recent report by China News Weekly , an emergency department doctor in a tertiary hospital in Wuhan revealed that his department first diverts emergency patients. Patients with symptoms such as fever within the past three days went to the fever clinic, and patients without symptoms of fever went to the emergency room. But in the past week, the number of patients in both places has increased.
On December 7, a long queue was lined up outside the hospital's fever clinic, "and patients with positive nucleic acid have been found in the fever clinic and emergency clinic in the past few days." The doctor mentioned that among the 101 patients received by the fever clinic the day before, 52 of them tested positive for nucleic acid.
, which has always been at the forefront of public opinion, is not to mention Baoding . According to the key points of recent exchanges between experts from Baoding Hospital, it is estimated that the current infection rate in Baoding is about 15% to 20%. It only took about 2 weeks from relaxation to reaching the current infection rate. As the number of positive medical staff continues to increase, the departure rate has increased significantly, and the pressure of insufficient staff is emerging.
Judging from the current situation, the impact of the epidemic on medical institutions is emerging, and some hospitals are also infected with medical staff. At present, many hospitals recommend that most patients with mild COVID-19 should not pour into the hospital, as it is prone to cross infection. However, most people do not know the criteria for 's judgment on mild and severe symptoms. Based on concerns about personal health and family, especially children, large-scale influx into hospitals is still inevitable. However, hospitals cannot refuse diagnosis and treatment on the grounds of mild symptoms, which often leads to medical runs.
It can be seen from this that domestic medical institutions and the public are not prepared for infection. However, although the medical resources in some cities are currently under impact, it is not the most difficult time. With the super contagious ability of Omickron , it is estimated that starting around the Spring Festival, cities that are ahead will usher in real peaks one after another. That is the time when the real difficulties come.
Domestic medical institutions need to reserve more resources for the treatment of severe cases and doctor protection
If calculated according to the first wave of infection rate predicted by disease control experts, then as long as 20% or even 10% of them have to go to the hospital, it is unbearable for the medical systems of major cities.
Therefore, for medical institutions, on the one hand, needs to change the management model as soon as possible and build the tiered diagnosis and treatment network. In the past, many hospitals still did not respond and took a refusal to positive patients.
Fortunately, the National Health Commission has recently stated that hospitals cannot refuse to treat patients with nucleic acid positive, but they must divide the diagnosis and treatment areas for nucleic acid positive and the diagnosis and treatment areas for nucleic acid negative. It is also emphasized that all hospitals at level 2 or above must open fever clinics, and all should be set up and all should be opened.
On the other hand, it is imperative to make medical staff familiar with the rules and procedures of the diagnosis and treatment of the new crown as soon as possible, and to be able to quickly identify patients with severe and severe tendencies.
Judging from the experience of Hong Kong and Taiwan, needs to leave more resources to severe illness and reduce mortality. According to current research, 99% of infected people are asymptomatic or mild, and these people do not need to go to medical institutions. However, there is no clear statement on how to deal with the new crown infection group in a layered manner, how to let the public judge whether they are mild or severe, and how to treat mild symptoms. This actually requires clear guidance from local hospitals and governments.
Especially at present, if a large number of mild symptoms are pouring in, hospitals cannot refuse treatment. How to avoid conflicts between doctors and patients and hidden conflicts between society also requires thinking and relevant plans.
In addition, it is the protection of doctors. On the third day after the "New Ten" came out, many medical institutions have been infected by patients and medical staff in hospitals. Judging from the situation in Guangzhou, the current positive medical care is no longer considered hospital infection, and the medical care who receives positive patients is no longer considered close contact.
This means that the pressure on medical infection is getting greater and greater. Under the impact of medical resources, the core problem is to keep the existing doctor staff from reducing. But the reduction in doctor staff is a foreseeable general trend. More and more people are pouring into hospitals, and fewer doctors are getting fewer. How to deal with this contradiction?
Especially if the positive doctor treats negative patients, if cannot be avoided, once the doctor infects the patient, how can we avoid irrational social conflict between doctors and patients?
The author previously pointed out that in addition to the emergency department, it is best to retain nucleic acid testing for patients in some departments, especially fever clinics. If the doctor's line of defense is lost or affected, the future situation may become more and more difficult. However, the National Health Commission has recently introduced new measures. In addition to the critically ill admission, it takes 48 hours of nucleic acid, which actually sets a line of defense for this special scenario of the hospital.
But this is not enough. From the perspective of the hospital's preparation direction, first of all, in addition to the classified treatment of patients in the fever clinic, each specialized ward needs to expand the COVID-19 isolation ward; on the other hand, it is necessary to dispatch medical personnel more efficiently and prevent hospital infections as much as possible.
Hospitals should make more preparations for pediatrics
In fact, from the perspective of medical shock waves, pediatrics are at the forefront of the pressure, because in the eyes of many parents, they can tolerate their infections, but if the child has a recurring fever, it is difficult to bear it and not go to the hospital. However, if the parental infection occurs in a family, it is difficult for the child to avoid it. Therefore, giving priority to medical treatment in children may become a consensus among many families.
Moreover, in children's specialized hospitals, the number of consultations has always been large in winter. A Shanghai pediatrician said that in addition to the new coronavirus and influenza, there are also some common diseases in children such as respiratory syncytial virus . There are some similarities in clinical manifestations of these epidemics, so it is often difficult for parents to distinguish. At the beginning of social epidemic prevention and control, parents often rush to the hospital out of anxiety after children develop symptoms.
Nowadays, there are also pediatricians in Guangzhou who have leaked the Internet that there are too many children with COVID-19, and doctors in pediatric fever clinics are insufficient staff and the pressure is getting greater and greater.
But from today's perspective, the pressure on hospitals is getting greater and greater, and the shortcomings of insufficient staff have emerged, especially the lack of doctors in pediatrics. In Guangzhou, doctors from Grade A hospitals also said in an interview that is mainly concerned about the possible staffing problems of medical staff and the congestion during peak periods in pediatric outpatient clinics. Many hospitals are not ready at present.
For hospitals, it is necessary to establish a tiered diagnosis and treatment system as soon as possible, and the pediatric fever clinic needs to expand its capacity as much as possible to cope with the pressure of future pediatric medical treatment. Because if this wave of shock is not dealt with well, various social conflicts and doctor-patient conflicts may also erupt in a concentrated manner.
Avoid a medical run tsunami, and cannot lie down
At the moment when the impact wave of the epidemic is emerging, we still need to have a precise, scientific and realistic epidemic prevention attitude and new ideas, but the new ideas cannot be equated with lie down lie down.
There are Taiwanese people on the Internet to suggest that the mainland should not be lying flat. There are 515 hospitals in Taiwan Province. Among the top 200 well-known hospitals in the world, Taiwan Province occupies 14, the number one in Asia, and has such good medical resources. However, from January to June 9, an average of 21 deaths in 10,000 people.
Shanghai has a population of 24 million, with only 398 hospitals. 99% of our mainland cities are not as good as first-tier cities. In the view of Yin Yong, director of the respiratory department of Shanghai Children's Medical Center, since the epidemic, the country has attached great importance to the construction, management and infection prevention and control of fever clinics. , but there are still limited health services in township health centers and community health services that can set up fever clinics.
Therefore, the medical run tsunami may be a big problem that is about to face.
The national policy level is relaxing control, but it is still emphasizing precise prevention and control. However, from the perspective of various places, it is actually being fully liberalized.Although it may not be realistic to say that it is necessary to clear zero, it is not realistic to completely let it go. Precise prevention and control flatten the curve, control the number of infections within a certain range, and ensure the hospital's pressure limit, and there will be no large-scale growth of more than 100,000 or hundreds of thousands, resulting in a medical run. This may still be an important aspect that needs to be considered.
From the current point of view, needs to have plans for possible out-of-control situations, and cannot completely infer the situation in the mainland from the Hong Kong and Taiwan model. Some netizens pointed out incisively that Hong Kong and Taiwan medical care is made by appointment, and they are relaxed, and the medical run is not serious. If the epidemic prevention is relaxed in China, everyone will get used to eating big people and stay in the hospital even if they are sick and have no money. In that case, the medical run will be very serious and the medical system will be paralyzed directly. How does the medical system cope with the upcoming epidemic medical impact? How to establish a complete medical expansion, grading, diversion and medical treatment system at present is urgent.
Author: Wang Xinxi TMT Senior Commenter This article is not allowed to be reproduced without permission
