[Text/Observer.com columnist Zhang Zhonglin]
On November 11, the National Health and Medical Commission issued the "Notice on Further Optimizing COVID-19 Prevention and Control Measures and Doing Scientific and Accurate Prevention and Control Work" (hereinafter referred to as the 20th Article), which significantly modified the ninth version of the currently implemented COVID-19 prevention and control plan. Among them, several measures related to entry epidemic prevention have also caused certain concerns when the domestic epidemic has not subsided.
Among the twenty articles, four are related to civil aviation, accounting for 20%. These adjustments are considered by others to be "good" for the civil aviation industry, but in the eyes of some people, they are a disguised form of "flattering". What I need to point out in this regard is that the civil aviation industry has been one of the industries hardest hit by the epidemic in the three years since the epidemic. The entire industry has incurred losses of hundreds of billions, and has obviously affected the livelihood security of employees. However, this does not mean that civil aviation people want to "lay flat".
From what I have observed around me, even though there are some complaints, they still implement the various epidemic prevention requirements and regulations to the letter, and there is no "compromising" behavior. Because everyone knows that civil aviation is the first barrier, and only by guarding this barrier can people across the country live a normal life. Therefore, I will analyze the civil aviation-related parts of the 20 Articles to clear up any doubts.
(5) For employees in high-risk positions who have completed closed-loop operations, the "7-day centralized quarantine or 7-day home quarantine" has been adjusted to "5-day home health monitoring". During the period, is assigned management, and a nucleic acid test will be conducted on the 1st, 3rd, and 5th days. Do not go out unless necessary. Those who really need to go out should not go to crowded public places or take public transportation.
Closed-loop work is currently a requirement for workers in high-risk positions. Typical high-risk positions are positions related to isolation points and international entry at airports. The closed-loop requirements for high-risk positions are constantly changing. The current closed-loop work model is a summary of experience after the outbreak of the Nanjing Airport epidemic in July 2021. On the basis of the original "four concentrations, two fixed", closed-loop personnel are clearly required to implement 14+7, that is, 14 days of closed-loop work followed by 7 days of centralized isolation (some units use 14+7+7, and the extra 7 days refers to home health monitoring).
In the past year or so, as far as I know, all units involved in international entry have implemented this system to an extremely high standard. Therefore, some accidental occupational exposure infections were basically discovered in a closed loop and did not cause spillover to society.
However, a major problem caused by the 14+7+7 (or 7-day centralized quarantine) is that the 7-day quarantine reduces the personnel turnover efficiency of high-risk workers (the non-working period is not only the 7-day centralized quarantine, but also includes the time to go home to rest), making it difficult to schedule shifts and causing certain psychological problems and family conflicts. With the gradual increase in the number of international flights, the above-mentioned problems caused by the 7-day centralized isolation system for high-risk personnel have become more and more serious.
At the press conference on the 12th, Chang Jile, deputy director of the National Administration of Disease Control and Prevention, explained this series of measures. He mentioned that if high-risk personnel in closed-loop management of strictly implement closed-loop management measures, the detection rate of -positive would be only 1.6/100,000. This number is somewhat surprisingly low, but as the number officially released by the National Bureau of Disease Control and Prevention at the press conference, there is every reason to believe it to be true, and it is also consistent with my understanding of the occupational exposure to infections among closed-loop personnel at airports responsible for international inbound flights.
For example, there was a closed-loop infection incident in the first half of this year. Because the infected person had complete protective measures, thorough implementation of epidemic prevention measures (keeping distance, not taking off masks in the break room, etc.), and an extremely single activity trajectory that did not cause transmission, the flow control trajectory was exemplary. The fundamental reason for this is that the professionalism of closed-loop workers in high-risk positions in terms of protection and the constant tightening of epidemic prevention measures have made the positivity rate low enough. Moreover, closed-loop staff in high-risk positions in civil aviation need daily nucleic acid tests according to the civil aviation epidemic prevention and control guidelines, which is enough to detect positive during closed-loop work. During the five-day health monitoring during non-working periods, if we strictly implement three checks every five days and do not go out unless necessary, even if there are occasional spills, it will still be controllable.
At Shanghai Pudong Airport, staff help passengers carry their luggage. See the watermark for image source
(7) Cancel the circuit breaker mechanism for inbound flights, and adjust the negative nucleic acid test certificate from two negative nucleic acid tests within 48 hours before boarding to one negative nucleic acid test certificate within 48 hours before boarding.
Since the inbound flight circuit breaker policy was implemented in June 2020, together with the "Five Ones", it has become the core policy of the Civil Aviation Administration for international inbound flights for quite some time. As for the content of the circuit breaker policy, I think everyone knows that I will not go into details here. What needs to be pointed out here is that the "Five Ones" policy implemented together with the circuit breaker has been de facto no longer implemented as the number of international inbound flights approved by the Civil Aviation Administration of China has gradually increased over the past year or so. The circuit breaker policy has been adjusted many times over the past two years and has been gradually relaxed. The most recent policy modification is to adjust the circuit breaker standard from 5 people on a flight to 4% of passengers, which greatly reduces the probability of flight circuit breaker. Now, it is unexpected and reasonable to completely cancel the circuit breaker.
There are different opinions on the cancellation of the circuit breaker policy, and various speculations are endless. Some celebrities even claimed that the US government’s reciprocal retaliation for the circuit breaker made the Civil Aviation Administration of China “go crazy” and therefore cancel it. I can only face such nonsense with a smile. It is true that the U.S. government retaliates against the flight circuit breaker, but the reciprocal retaliation is at the level of a kindergartener. This article will not go into the details. You can see my related article at the beginning of the year.
In my opinion, there are several reasons for canceling the flight circuit breaker policy and changing the requirement for entry nucleic acid certificates from twice every 48 hours to once every 48 hours:
1. When the flight circuit breaker was strictly controlled and implemented before, the domestic epidemic prevention and control situation was that there were only single-digit or even 0 new cases per day across the country, while the number of positive cases in the closed-loop quarantine for entry has been in the dozens every day. Under this circumstance, imported cases are the main contradiction in my country's epidemic prevention and control, and strict control to prevent importation is a normal choice. At a time when the epidemic situation is at a high level across the country, the domestic epidemic has become the main contradiction and the risk of imported cases brought by immigrants has become a secondary contradiction. Moreover, canceling the circuit breaker does not mean that inbound travelers will no longer be quarantined. The centralized quarantine system will still be implemented (the adjustment from 7+3 to 5+3 will be discussed in detail later).
2. As epidemic prevention and control policies in various countries around the world tend to be uncontrolled, nucleic acid testing institutions have also decreased accordingly. The previous requirement was that two nucleic acid tests need to be done at different testing institutions before they can be recognized, which objectively caused a lot of trouble for returnees to conduct nucleic acid tests that meet the entry requirements. The adjustment to once within 48 hours has greatly facilitated returnees and immigrants, and will provide certain convenience on the basis of controllable risks.
3. Canceling the flight circuit breaker can significantly reduce the disruption caused by the flight circuit breaker to returnees returning home. It has been two and a half years since the beginning of the Five Years. Everyone knows how difficult it has been to buy a flight ticket back home in the past two and a half years. A military industry system friend I know went on a business trip abroad and started buying air tickets to return home in June. He was not able to return to the country until the end of August - this was quite lucky. With the number of inbound flights already significantly reduced compared to before the epidemic, you can understand how desperate it is to finally buy a ticket only to encounter a circuit breaker and cancel it.
in "How to treat the "Twenty Measures to Optimize Prevention and Control Work"? "There is an analysis in the article "There are 10 circuit breaker flights involved in 7 days, about 2,000-3,000 people, and an average of 300-400 people per day. If the circuit breaker is cancelled, the interference to international passenger journeys will be greatly alleviated. The number of arrivals will increase by 3-4%. However, these flight volumes will not lead to a significant increase in the risk of entry. Nucleic acid The probability of infection in the period from the end to the time of boarding and the probability of missing cases in a shorter quarantine period have a greater impact on the import of the epidemic. "I strongly agree with this analysis. The cancellation of the circuit breaker is the result of a comprehensive consideration of epidemic prevention and control, the ability to accept inbound flights, necessary international exchanges, and humanitarian .
(9) It is clarified that the positive criterion for entry personnel is the nucleic acid test Ct value.
There is not much controversy about this article. The essence is that due to the extremely strong contagiousness of the foreign Omicron virus, a large number of entry personnel after "should be infected" are actually positive recovered personnel. Therefore, it is understandable to apply the standard for discharged (exit) positive personnel (CT ≥ 35) in the ninth edition to the entry personnel. And in Article 20, it is emphasized that only "home quarantine for three days and two tests" will be implemented only if the person is confirmed to have been infected after risk assessment. This means that if it is not a previous infection but a new infection, it will still be treated as a positive case.
The ninth edition of COVID-19 prevention and control contains relevant provisions on those who test positive after leaving the cabin.
Therefore, we can consider this article to be based on the foreign epidemic situation and personnel infection status, and synchronize the diagnostic standards of recovered persons with domestic standards to avoid unnecessary waste of medical resources.
(10) For immigrants, the "7-day centralized quarantine + 3 days of home health monitoring" will be adjusted to "5-day centralized quarantine + 3 days of home quarantine". During this period, they will be assigned a code to manage and they will not be allowed to go out. After immigrants complete quarantine at the first point of entry, they must not be quarantined again at the destination. A nucleic acid test will be conducted on the 1st, 2nd, 3rd, and 5th days of centralized isolation medical observation, and a nucleic acid test will be conducted on the 1st and 3rd days of home isolation medical observation.
The most concerning thing about this article is that the centralized closed-loop time and management method of inbound personnel have been adjusted from "7+3" to "5+3", which shortened the centralized quarantine time by 2 days, and also caused the greatest controversy. However, it should be noted that in the original "7+3", in addition to the 7 days of centralized isolation, the additional 3 days are home health monitoring. Although the definition of home health monitoring is "staying at home and not going out, measuring body temperature and other symptoms every day, and conducting nucleic acid tests three times in three days", in reality, the "staying at home and not going out" of home health monitoring is rarely implemented, and no one may even stop people from going out for shopping. In this case, the only thing that can truly implement "7+3" is a 7-day closed-loop centralized quarantine.
In the new version of "5+3", in addition to the 5 days of centralized quarantine, the adjustment from 3 days of home health monitoring to 3 days of home quarantine. There is no need to say much about the difference between home isolation and home health monitoring. Community and grassroots personnel will pay much greater attention to and implement the quarantine measures accordingly. Therefore, from a practical point of view, the essence of the adjustment from "7+3" to "5+3" is to change from 7 days of isolation to 8 days of isolation, except that 3 days are spent at home, and certain isolation management tasks are handed over to the community to reduce the burden of centralized isolation.
As for the five-day centralized quarantine, the National Center for Disease Control and Prevention also gave a certain explanation at the press conference, that is, when the Ninth Edition faced Omicron BA2, the positive detection rate was 89.1% in 5 days and 97.3% in 7 days. Therefore, the "7+3" was formulated. The incubation period of BA5 and BA2.76 currently faced has been shortened, reaching a positive detection rate of 94.5% in 5 days and 99.7% in 7 days. It can be seen that the adjustment is still based on sufficient scientific evidence and is not decided by tapping the forehead.
Looking at this "Twenty Articles" adjustment, I feel that there is a certain deviation from the public's perception and expectations, but it seems quite reasonable under the further release of detailed data and explanations. Each adjustment of the "Twenty Points" is based on the experience, statistical data and research conclusions of the previous stage, and is scientific.
The main reason why people think that the previous epidemic prevention policy is too liberal compared to the previous epidemic prevention and control work is that our country's prevention and control resources were generally sufficient in the previous stage of epidemic prevention and control, and we had the conditions to implement "saturated prevention and control" like "saturated rescue". However, the current epidemic prevention and control situation across the country and the existing resources are not enough for us to continue to implement "saturated prevention and control" today. Therefore, it is inevitable to distinguish the main contradictions from the secondary contradictions, concentrate the epidemic prevention resources in key areas, and make certain trade-offs in secondary areas.
As someone who has been working on epidemic prevention for two and a half years, in my opinion, the "Twenty Articles" have nothing to do with being flat. Instead, they put forward higher requirements for epidemic prevention and control. They need to go all out or even perform beyond the level to achieve the expected goals. This is undoubtedly a huge challenge for grassroots epidemic prevention workers.As the Joint Prevention and Control Mechanism of the State Council said in its authoritative response to the "Twenty Measures", it is important to implement and organize the measures well, and to implement and implement the twenty measures to the letter.
Detailed rules for the implementation of the Twenty-Point Measures are gradually being announced in various regions, but I believe that local governments will definitely adhere to the principle of "people first, life first" when carrying out epidemic prevention work, and do a good job in epidemic prevention responsibly, and this is also the fundamental purpose of the Twenty-Point Measures.
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