At present, the prevention and control of the new crown epidemic has entered a new stage.
"With the gradual adjustment of epidemic prevention measures, scientific assessment and prediction of the scale and direction of the current epidemic will be of great value in guiding the public and the public health system to respond to the epidemic." Chen Saijuan, academician of the Chinese Academy of Engineering and professor of Shanghai Jiao Tong University School of Medicine, told " China Science Journal ".
To this end, she and her collaborators conducted a random sampling of infected persons in Shanghai this autumn and winter, and conducted genome sequencing and molecular epidemiological analysis of the new coronavirus. Continue to monitor the types of new coronavirus prevalent in the country, and simultaneously evaluate the infectivity and pathogenicity of each variant strain to determine the development of the epidemic.
Recently, the team of Academician Chen Saijuan and the team of Fan Xiaohong of Shanghai Public Health Clinical Center jointly published a research paper "Primary assessment of the diversity of Omicron sublineages and the epidemiologicfeatures of autumn/winter 2022 COVID-19 wave in Chinese mainland" in Frontiers of Medicine.
The following is the main content of her conversation with China Science News.
"China Science News": Hello, Academician Chen, please introduce to us the main scientific findings in your paper.
Chen Saijuan: We conducted genome sequencing on 378 randomly selected samples from patients admitted to the Shanghai Public Health Center during the autumn and winter of 2022, and obtained 369 high-quality new coronavirus full genome sequences.
molecular evolutionary tree analysis found that these viral genomes contained a total of 30 Omicron subtype strains recorded in the Global Initiative for Sharing All Influenza Data (GISAID) database, of which 355 (95.95%) genome sequences were concentrated in 5 Omicron subtypes. The main strains include BF.7 and BA.5.2 that have been reported to be prevalent in Beijing and Guangzhou, and BQ.1 and XBB that have recently appeared in Europe and the United States.
combined with the travel history and infection contact history of infected people, proved that people with a history of contact with the epidemic in Beijing or Guangzhou mainly carried BF.7 and BA.5.2 substrains respectively; infected people entering Shanghai from overseas mainly carried BQ.1 and XBB; and among local infected people in Shanghai, in addition to BA.5.2, there are multiple Omicron substrains that account for a relatively high proportion. No new coronavirus variants have been found in these results.
"China Science Journal" : There is currently a lot of discussion about the proportion of severe/critically ill patients among new coronavirus infected people. Do you have more accurate data?
Chen Saijuan: Based on public information, our research team analyzed the changes in the number of severe/critically ill patients and the total number of infected people in this wave of the epidemic as of November 29, 2022, and found that the number of severe/critically ill patients increased with the increase in the number of infected people, with the proportion reaching 0.035%.
This is a proportion based on data from the initial stage of this wave of epidemic. With the recent rapid growth of the epidemic and the increasing involvement of high-risk groups, this proportion may increase. Next, it is important to master and publish the exact data. We would rather fully estimate the difficulties so that we can respond more calmly.
According to general rules, high-risk groups evolve into severe and critical patients 2-3 weeks after admission. Therefore, the research team analyzed the clinical evolution of 5,706 symptomatic new coronavirus infection patients admitted to the Shanghai Public Health Center from September 1, 2022 to December 26, 2022. After comprehensive medical observation and diagnosis, 5,533 patients showed mild and common types (96.97% in total), and the remaining 173 patients progressed to severe/critical disease (3.03% in total). Among these 173 people, 153 had underlying diseases aggravated by COVID-19 infection, and the other 20 people were only infected with COVID-19.
We also found that, in addition to older patients (over 55-60 years old), male patients also have a significantly higher risk of developing severe/critical illness.
"China Science News": You have also established a mathematical model to simulate the changing curve of the number of infected people.Based on this model, what is the likely direction of the Omicron epidemic in the future?
Chen Saijuan: Based on previous infection data from routine nucleic acid tests in Beijing, Guangzhou, Shanghai, Chongqing and other places, we have initially determined that in the above-mentioned major cities, the peak of infection in this round of Omicron epidemic will come to an end around New Year's Day in 2023.
However, mathematical simulation analysis based on data from the main urban area and suburbs of Chongqing suggests that the peak of the epidemic is delayed in the suburbs, but during the Spring Festival travel period, its infection peak will be significantly enhanced due to the accelerated spread of the epidemic.
predicts the progress of the epidemic among people in Sichuan, Shaanxi, Gansu, Qinghai and other provinces and non-provincial capital cities. Coupled with the increased movement of people during the Spring Festival, it is estimated that the peak infection peak in rural and small and medium-sized urban areas will occur around mid-January 2023.
"China Science News": Based on your scientific findings, how should we respond to the next epidemic?
Chen Saijuan: From our analysis results, we can draw the following conclusions: First, there are currently multiple Omicron subtypes circulating in the country at the same time; second, among people who have recently developed symptoms of new coronavirus infection, severe cases are mainly concentrated in the elderly with underlying diseases; third, from New Year's Day to the Spring Festival, the new coronavirus epidemic will mainly affect rural and small and medium-sized urban areas; fourth, urban and rural population mobility during the Spring Festival will greatly affect the trend of the epidemic.
Due to the relative lack of medical resources in rural areas and small and medium-sized towns, and the large number of elderly people and people with underlying diseases, there is an urgent need to launch an emergency plan for the spread of the Omicron epidemic to rural areas, allocate more medical resources to rural grassroots, and prepare emergency use licenses for effective drugs and new vaccines, in addition to paxlovid, which has been approved for marketing. and azivudine , VV116 independently developed in my country has been proven to be safe and effective, and we look forward to receiving emergency use authorization from the regulatory authorities.
Produce the production, reserve, distribution and clinical rational use of specific anti-COVID-19 drugs and auxiliary drugs, as well as traditional Chinese medicines with proven efficacy; implement classified and stratified treatment to strengthen the ability to treat severe cases in small and medium-sized towns; continue to make accurate use of non-pharmaceutical public health measures (wearing N95 masks in indoor public spaces, maintaining social distance, and using appropriate public transportation means Increase the number of shifts to avoid overcrowding, etc.), strive to reduce the peak of the epidemic, and relieve the heavy pressure on the medical system and medical staff; continue to fully immunize high-risk groups, and start the fourth immune booster shot for high-risk groups; strengthen the popularization of prevention and control knowledge and skills in individual households, do a good job in health publicity and risk communication, and protect the lives and health of the people, especially those in need.
With such a multi-pronged approach, the incidence of severe and critical illness can be further reduced significantly, so that the mortality rate can be effectively controlled and people's health can be better protected.
We firmly believe that with the selfless dedication and superb treatment of the medical system and medical workers, as well as the improvement of the public's independent health awareness, the battle against the new coronavirus infection epidemic will surely come to a good end, ensuring that our country can smoothly emerge from the epidemic and promote the orderly recovery of social and economic development.
Related paper links:
https://journal.hep.com.cn/fmd/EN/10.1007/s11684-022-0981-7
column editor: Zhang Wu Text editor: Song Hui Source of title picture: Shangguan title picture Picture editor: Yong Kai
Source: Author: Science Network
