Source: The Paper News
The Paper News Comprehensive Report
On December 20, the Joint Prevention and Control Mechanism of the State Council held a press conference to introduce the situation of medical services for key groups.
Is vaccination worse than infection Omicron ?
Is vaccination inferior to being infected with Omicron once? Wang Huaqing, chief expert of the immunization program of the Chinese Center for Disease Control and Prevention, responded that although the pathogenicity of the currently circulating Omicron strain is somewhat weakened compared with other mutant strains that have been popular in the past, there is still a risk of severe illness and death; and the risk of severe illness and death will be reflected in all age groups. "It's just that the risk of severe illness and death among the elderly, which we emphasized in the past, will be higher among the entire population. In addition, the proportion of people with underlying diseases will also be higher."
Wang Huaqing said that many studies have shown that Compared with people who have completed the full course or enhanced immunity of the new coronavirus vaccine, the risk of hospitalization, severe illness, and death among people who have not been vaccinated is quite different , which also includes young people and adults. Where this risk exists to some extent, it can be reduced through vaccination. "Therefore, we recommend that those who have not been vaccinated should still be vaccinated, and those who have not completed the booster vaccination should complete the booster vaccination as soon as possible. Whether they are the elderly, adults or young people, this risk should be reduced to a relatively low level."
It is not recommended to deliberately infect new crown
Wang Guiqiang, director of the Department of Infectious Diseases at Peking University First Hospital, Wang Guiqiang said that at present, the pathogenicity of Omicron has been significantly reduced, but some patients still develop clinical symptoms after infection, including fever, muscle and joint pain, sore throat, etc., which will seriously affect the quality of life and normal work. Although Omicron is currently very contagious and the pressure for prevention and control is great, we still hope that the epidemic will not cause a large outbreak in a short period of time, because once a large number of patients appear in a short period of time, it will seriously affect the entire social order and people's livelihood. At the same time, it will also cause huge pressure or even crowding of medical institutions, affecting their daily treatment of acute and critical patients. Although Omicron is highly contagious, most infections after infection are self-limiting, with relatively low pathogenicity or severity. Intentional infection is not advocated or recommended.
Wang Guiqiang said that the elderly and people with underlying diseases, especially the elderly who have not received the vaccine , must take good protection and not be infected with during the peak of the first round of the epidemic. infection at this peak of the epidemic may cause uneven distribution or crowding of medical resources, resulting in severe patients not receiving timely and effective treatment. The elderly must take good protection, including those in nursing homes and those with underlying diseases who are bedridden at home. In addition, special attention must be paid to avoiding infection. Elderly people who have not been vaccinated must continue to be vaccinated.
"In the current stage of rapid growth of the first round of the epidemic, as time goes by, the number of infections increases and the rapid rise will slow down. This is a general rule. However, after a period of time, with large-scale social activities, including Spring Festival travel or the extensive development of various social activities, there may be a new round of epidemics. The emergence of this epidemic in waves may eventually form a certain herd immunity barrier, and the incidence rate will drop significantly. We hope that there will be no large-scale outbreaks." Wang Guiqiang said.
BQ.1 and XBB branches have been discovered in many places
Xu Wenbo, director of the Institute of Virology of the Chinese Center for Disease Control and Prevention Xu Wenbo introduced that BQ.1 and XBB are new mutant branches of Omicron. Internationally, some European and American countries have gradually shown that they are dominant strains, and is mainly characterized by increased transmissibility and immune evasion capabilities. However, its pathogenicity is not significantly different from other series of Omicron variants, and the severe disease rate and mortality rate have not increased significantly in countries where BQ.1 and XBB are prevalent.
Regarding the question of whether it will cause a new round of epidemic once it is introduced into our country, Xu Wenbo said that our country has monitored the introduction of BF.7, BQ.1, and The sub-branches were imported into my country's , and 50 sub-branches caused associated local cases or outbreaks, including BQ.1 and XBB. Among them, BQ.1 and its sub-branches were detected in 49 cases in 9 provinces, and the XBB sub-blade was detected in 11 cases in 3 provinces. BQ.1 and XBB have not yet formed a dominant spread in my country. Currently, they are still dominated by BA.5.2 and BF.7, but their spread advantage will gradually increase, and may form a common cycle with BA.5.2, BF.7 and other more than 50 input sub-branches.
Preventing BQ.1 and XBB is actually the same as preventing other Omicron variants. The measures taken are to monitor whether there are changes in its pathogenicity and whether there are further mutations in its genome. If there are any changes in its clinical characteristics, the Chinese Centers for Disease Control and Prevention will link the clinical characteristics with the genomic characteristics for research and judgment. However, there have been no reports of increased severe illness and death caused by BQ.1 and XBB at home and abroad.
Xu Wenbo said that prevention must be done well, and we are the first persons responsible for our own health.
Is it possible
that the new coronavirus strain will undergo greater changes in the future?
Xu Wenbo, director of the Institute of Virology of the Chinese Center for Disease Control and Prevention, said that since its emergence in November 2021, as of December 18, 2022, Omicron has evolved from 5 branches, BA1 to BA5, into 709 sub-branches. Among them, 72 are the recombinant viruses , and SBB is one of the 72 species. The Omicron series strains continue to mutate. As long as they circulate among the population, they will replicate, and genome mutations will occur during replication. There are two forms of mutation. One is that the virus itself mutates, causing antigenic site mutations, leading to immune escape. So immune escape is the main one, and now its mutation trend is from the earliest early strains, initially Alpha is dominant, then delta , then BA1 replaces delta, then BA2 replaces BA1, and finally BA5 replaces BA2. Domestic strains are very sensitive to the Omicron series, so BA5.2 is dominant. The entire mutation trend is dominated by immune escape. Immune escape will lead to an increase in population transmission advantage. This is its mutation trend.
Secondly, will it become more contagious and lethal in the future? is less likely than . Now Omicron has evolved into 709 sub-branches. The hospitalization, severe disease and death cases are significantly lower than those of the early Delta strain and other VOC mutant strains. The 700 branches have not seen an increase in severe disease and death. Generally speaking, the possibility of future mutation trends becoming significantly increased in pathogenicity is relatively small. On the whole, the possibility of producing a strain that is both highly contagious and highly pathogenic is relatively small.
Will reinfection with the new coronavirus
cause damage to the immune system ?
Wang Guiqiang, director of the Department of Infectious Diseases at Peking University First Hospital, said reinfection is secondary infection , which refers to being infected with the new coronavirus again after a period of time after infection. From the current data, the risk of reinfection or secondary infection with Omicron strain is higher than that of delta strain and the original strain. From the perspective of the time of secondary infection, there is generally an interval. It cannot be said that the infection will be reinfected soon after infection. The probability of reinfection with the same strain is extremely low. Even if it is infected, there will be no obvious symptoms. It is generally a mild case. Secondary infection refers to a breakthrough infection after the mutant strain. The time interval between breakthrough infection is closely related to the clinical manifestations. The shorter the interval, the milder the symptoms. The longer the interval, the more severe the symptoms. This is directly related to the protective antibody immunity in our body.
Wang Guiqiang said that Swedish research found that the symptoms of second or third infection with different strains of Omicron were very mild, and they were basically asymptomatic or mild cases. Of course, we also have to pay attention to some elderly people.The U.S. Veterans Agency conducted a study and found that among elderly veterans, if they are infected again, some patients will worsen or even die. Therefore, we have always emphasized that when infected by the Omicron strain, we must pay attention to the elderly and protect them. This is crucial. Even if you have been infected, when new viral strains arrive, you still need to take personal protection, especially the elderly and people with underlying diseases.
Wang Guiqiang emphasized that it is very clear that vaccination can effectively reduce the risk of severe illness and death. An Italian study found that vaccination can reduce the occurrence of secondary infections and reduce the probability of hospitalization after infection. Elderly people with underlying medical conditions still need to be vaccinated.
What is the current standard for judging deaths from COVID-19?
Wang Guiqiang, director of the Department of Infectious Diseases at Peking University First Hospital, said that as the pathogenicity of the Omicron virus strain has significantly decreased, if vaccination is widely popularized, the death characteristics of people infected with the new coronavirus will change greatly. Most patients in the epidemic in Wuhan died of new coronavirus and respiratory failure . The current Omicron strain mainly invades the upper respiratory tract after infection, and the proportion of pneumonia in the lower respiratory tract is relatively low. There are also some cases of pneumonia, which rarely leads to respiratory failure. This has also been seen in clinical practice. At present, the main causes of death after infection with the Omicron strain are underlying diseases, the elderly, and other diseases. Very few people actually die directly from respiratory failure caused by the new coronavirus infection.
Wang Guiqiang said that in order to scientifically and realistically reflect the death situation caused by the new coronavirus epidemic, the National Health Commission recently organized experts to conduct demonstrations and issued corresponding notices to clearly judge the relevant death cases. There are mainly two aspects. Deaths caused by pneumonia and respiratory failure caused by the new coronavirus are classified as deaths caused by the new coronavirus infection. Deaths caused by other diseases, basic diseases, such as cardiovascular and cerebrovascular diseases, , myocardial infarction and other diseases are not classified as deaths caused by the new coronavirus. In order to better standardize the statistics of deaths caused by the COVID-19 epidemic, corresponding training is also being carried out, and consultation and death discussions must be used to finally determine whether the patient died of COVID-19 or other underlying diseases. We do not shy away from the dangers of COVID-19, but at the same time we must treat the dangers of COVID-19 scientifically.
How soon can I get vaccinated after being infected with COVID-19?
Wang Huaqing said that if you have recently been confirmed to be infected with the new coronavirus, it is not recommended to get the new coronavirus vaccine in the near future. At present, the immune protection produced by a simple infection is not as strong as the mixed immunity produced by infection and vaccination, so vaccination is recommended in the future. According to the current technical guidelines for new coronavirus vaccination, if you are diagnosed with the new coronavirus, there should be a gap of more than 6 months between the time of infection and the time of vaccination. Of course, our immune strategy will be continuously improved and adjusted in the future as we understand the disease, the vaccine, and the need for disease control.
It is not recommended to cover the sweat to reduce fever in infants.
Wang Quan, director of the emergency department of Beijing Children's Hospital, said that the only antipyretic drug available for children over 42 months old and under 6 months old is acetaminophen . Children under 2 months old cannot take antipyretic drugs by mouth. Therefore, it is recommended that babies under 2 months old, including newborns, must go to the hospital in time once they have a fever.
Wang Quan said that it is not recommended to reduce fever in infants by covering their sweat.. The reason is that the development of the baby's temperature regulation center is not perfect, and skin heat dissipation is a very important way to reduce fever. If the child is covered with too many clothes or quilts, the child will not be able to dissipate heat through the skin. When the child is covered with heat, their body temperature may become higher and higher, even reaching more than 40 degrees. This is not uncommon in clinical practice. Moreover, some children may develop severe fever syndrome, which may lead to serious complications such as respiratory failure, dehydration, and neurological damage, and may even be life-threatening.
Therefore, when these children have a fever, in addition to the help of medical staff, parents should try to create a relatively cool and ventilated environment for their children, and reduce clothing appropriately to improve the child's comfort.
How to relieve cough after being infected with COVID-19?
Yang Ting, deputy director of the Respiratory Center and the Department of Respiratory and Critical Care Medicine of the China-Japan Friendship Hospital, introduced that coughing and sputum production will occur not only after infection with the new coronavirus, but also with many respiratory virus infections. The early symptoms of infection, such as fever, nasal congestion, and runny nose, have improved, but the symptoms of coughing and sputum production remain. We call this infection or post-cold cough.
This is mainly due to the virus damaging the airway mucosa, which leads to an enhanced smooth muscle response and prone to airway contraction. Some people present with dry cough, and they can just use symptomatic painkillers, both Chinese and Western medicines. Some people have phlegm. In the early stage, it is foamy phlegm, and in the later stage, it is sticky phlegm or yellow and thick phlegm. At this time, it is recommended to add some phlegm-reducing drugs. If the phlegm turns from white to yellow and becomes thick, then it is considered that there may be a combined bacterial infection. At this time, antibiotic is used for treatment, which usually takes 3-5 days.
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