Half of Shanghai is sealed and controlled!

In the past three days, the daily number of new infections in Shanghai has exceeded 2,000, and the number of infected people on the 27th has reached 3,500
.

At 20:00 on March 27th, Shanghai issued a notice to carry out a new round of diced and gridded nucleic acid screening across the city, making this large city with nearly 25 million people a hot spot in the country
.

The notice requires that from 5:00 on March 28, nucleic acid screening will be implemented in batches with the Huangpu River as the boundary
.

In the first batch, Pudong, Punan and adjacent areas will be closed and controlled first, and nucleic acid screening will be carried out, and the closure will be lifted at 5:00 on April 1
.

At the same time, key areas in the Puxi area continued to implement closure and control management

In the second batch, starting from 3:00 on April 1, according to the principle of pressing forward, the Puxi area will be closed and controlled, and nucleic acid screening will be carried out, and the closure will be lifted at 3:00 on April 5
.

This means that Shanghai, China's largest city, has entered the general screening of "governance across the river", and the two areas will be sealed and controlled in turn and nucleic acid screening will be carried out
.

According to the requirements of the notice, in the closed area, the residential area will be under closed management, all personnel will stay at home, and personnel and vehicles will only enter and exit; the operation of buses, subways, ferries, taxis, and online car-hailing will be suspended; all enterprises will be closed.
Production or home office
.

As a result, Shanghai has pressed the "pause button" in stages and regions
.

The day before, at the Shanghai epidemic prevention and control press conference on March 26, Wu Fan, a member of the Shanghai New Coronary Pneumonia Medical Treatment Expert Group and vice president of Shanghai Medical College of Fudan University, said: "Shanghai must not be locked down!"

Wu Fan pointed out, "Shanghai plays an important role in the national economic and social development, and even has an impact on the global economy
.

" Shanghai adopts the method of key areas + non-key areas, nucleic acid detection + antigen self-examination to restore daily life, which is also an effective measure to restore daily life with the smallest cost and the fastest speed

It has been observed from the outside that the above statement means that Shanghai has unified the division of closed and controlled areas into preventive areas under the two concepts of "key areas" and "non-key areas"
.

Wu Jinglei, director of the Shanghai Municipal Health Commission, introduced that "full coverage" and "combined screening" will be carried out in accordance with the "combination of nucleic acid detection and antigen detection".
For non-key areas, antigen kits are issued to enter the home, and residents are required to self-test
.

It was the first day of antigen screening in Shanghai.
On this day, more than 14 million people were tested for antigens in the city
.

On March 22, the National Health and Medical Commission issued the "Regional Implementation Guidelines for Novel Coronavirus Nucleic Acid Testing Organizations (Third Edition)".
Compared with the old version, the new version changed "full staff" to "regional", and the size of the region depends on the needs of epidemic prevention and control.
decide
.

In addition, all provinces and cities (including megacities with a permanent population of more than 10 million in urban areas) are required to match sampling and testing forces according to the target of completing nucleic acid testing in the city within 24 hours, regardless of population size

The new version of the "Guide" proposes that if social risks are not controlled and the risk points are unclear, one round of regional nucleic acid testing will continue to be carried out every day
.

When the social risks are under control and the risk points are basically identified, key areas can be divided according to the distribution of cases for the relevant streets, communities and communities, and the key areas will be inspected once a day, and the non-key areas will be inspected every other day or 3 times depending on the situation.

All localities can promote the monitoring mode of "antigen screening and nucleic acid diagnosis" in combination with the relevant requirements of the new coronavirus antigen detection, and increase antigen detection as a supplementary means of regional nucleic acid detection
.

On March 24, Zhang Wenhong, director of the Department of Infectious Diseases of Huashan Hospital Affiliated to Fudan University, explained it, saying that this indicates that the future anti-epidemic will gradually enter a new stage.
will be updated gradually
.

Zhang Wenhong said that the speed of Omicron, in a sense, if it is not fast, we have no chance to outperform Omicron
.

On March 28, it was announced at a press conference on the prevention and control of the new coronary pneumonia epidemic in Shanghai that a new round of nucleic acid screening was launched in Shanghai
.

This round of nucleic acid screening was carried out simultaneously with the original gridded screening including antigen detection

On March 28, Hu Xijin commented: Those who mock and criticize Shanghai, I think they are too short-sighted
.

He pointed out that the exploration of Shanghai happened at a time when Omicron continued to attack all parts of China and seriously disrupted production and life, and the outside world was determined to break through no matter what the cost
.

Shanghai's pursuit of more accurate epidemic prevention can be said to embody the real needs of Chinese society.

"I personally want to believe that the Chinese society's exploration of precise prevention and control will not stop after Shanghai
.

Dynamic clearing is a firm consensus and belief in this country.

New York, the largest city in the United States and Shanghai, the largest city in China under the epidemic

New York, the largest city in the United States and Shanghai, the largest city in China under the epidemic

Since the outbreak of the epidemic, New York City has experienced three epidemic peaks, the first peak in March 2020, when the hospitalization rate and mortality rate of patients were high (see Figure 1)
.

By January 2022, the positive cases of the new crown reached a high peak, but the number of hospitalized cases and deaths were far lower than the data at the peak of the first epidemic

Figure 1 Three peak cases of the epidemic in New York City

Professor Wu Fan of Columbia University Medical Center stated in the Shanghai Medical Association's "Chinese Journal of Infectious Diseases" consensus interpretation series event on March 19, 2022 that the new coronavirus will mutate over time, which may be a simple "mutation" ", or possibly a mixed "variant" of several new mutations
.

As new coronavirus variants are constantly being discovered, it shows the important role of genetic variant monitoring
.
The World Health Organization (WHO) strongly recommends that countries and regions around the world conduct tracking of new coronavirus variants.
The purpose of tracking is mainly reflected in the prevention and control of transmission, reinfection, vaccine effectiveness, and severity
.

Figure 2 The purpose of monitoring the new crown mutants reflects 1.
The Omicron strain replaces the delta strain:

1.
The Omicron strain replaces the delta strain:

As can be seen from the number of cases in New York City carrying the variant strain of the new coronavirus, the number of cases of the delta strain has dropped to a very low level by the end of 2021, and Omicron has replaced delta in the dominant position, starting from January 2022.
Since then, more than 99.
6% of the pathogenic strains are Omicron
.

Figure 3 Omicron and Delta strain 2, Omicron causes symptoms more like the common cold

2.
Omicron causes symptoms more like the common cold

Prof.
Wu Fan made a comparative analysis of the clinical manifestations of infection with the Omicron strain, Delta, influenza, and the so-called "cold"
.
Indicates that the symptoms caused by Omicron are more like the common cold
.

The cough caused by Omicron is uncommon and very mild, but it has some obvious symptoms of upper respiratory tract infection, such as runny nose, sneezing, and sore throat, especially sore throat
.
No fever, shortness of breath and other symptoms, occasional headache or fatigue (see Figure 4)
.

Figure 4 Clinical manifestations of patients infected with Omicron variants 3.
How to deal with the new crown?

3.
How to deal with the new crown?

(1) The basic management rules of New York City state that you should know how to take care of yourself and protect others
.
include:

stay home and do not go out unless you need to get necessary medical care;

Please seek medical advice by phone or video to inquire about treatment;

Currently, New York recommends a combination of oral Nirmatrelvir 300 mg and ritonavir 100 mg (Paxlovid) for mild to moderate COVID-19 non-hospitalized patients aged ≥ 12 years, weighing ≥ 40 kg and at high risk of disease progression.
2 times a day for 5 days
.

Get help in an emergency
.
If you have an emergency, such as difficulty breathing, call 911 immediately
.

(2) Continue to increase vaccination to improve immunity

A high-quality vaccine remains a key defense tool
.
Professor Wu Fan said that the purpose of increasing the proportion of vaccination is that even if some people get sick, it will not bring down the entire medical system
.

In New York, a third dose is recommended for people with weakened immune systems
.
Anyone 5 years old and older is eligible for free vaccinations, 12 years old and older can get a free booster shot, citizens can get vaccinated at doctor's clinics, pharmacies and vaccination points across the city, targeting city residents 65 years and older or people with disabilities , you can get free transportation/vaccination at home
.

Professor Wu Fan mentioned that the application of vaccines has played an important role in the process of resisting the virus
.
Over the past two years, the United States has seen more than 79 million cases of Covid-19, some of whom have been infected more than once
.
More than 96 million people in the U.
S.
have been vaccinated three times; the vast majority of Americans now have some immunity to the virus that causes Covid-19, a huge step toward eliminating the disease
.

4.
Street mobile testing vehicles and antigen testing kits—strengthen investigation and early detection

4.
Street mobile testing vehicles and antigen testing kits—strengthen investigation and early detection

Professor Wu Fan emphasized that the detection of the new coronavirus and the timely detection of infected persons are the top priority
.
In order to facilitate the testing of the masses, New York City does not need to queue up for nucleic acid testing, and provides mobile testing vehicle services (see Figure 5)
.

Figure 5 Mobile monitoring vehicle service

In this round of local epidemic situation in Jilin Province, mobile nucleic acid detection vehicles also appeared
.

"I want to give some advice to our community, that is, the location of our nucleic acid testing is a little far from our community, and it is not safe for several communities to come to one point for testing.
Can we set up one in each community? Nucleic acid testing sites
.
" At the nucleic acid testing site in Jilin Street, Erdao District, Changchun City, a resident made a suggestion
.

"Additional sites require venues and personnel.
At present, there is no suitable site for the establishment of sites in the jurisdiction, and the existing site staff are just enough, and the staffing of additional sites is a big problem.
.
.
" After brainstorming, The Jilin Sub-district Party Working Committee proposed the "fixed + mobile" point setting method
.

Jilin Sub-district further detailed planning, from vehicle personnel to location settings, from network equipment to power supply issues, and finally set up 3 mobile nucleic acid detection vehicles within the jurisdiction, each detection vehicle is equipped with 1 laptop and 2 scanners.
Input personnel, 2 inspection personnel, and 2 order maintenance personnel solve network problems through mobile phone hotspots, and contact nearby merchants to solve computer charging problems
.

After obtaining the approval of the district epidemic prevention and control headquarters, the street officially set up three mobile nucleic acid testing vehicles within the jurisdiction on March 11
.
On March 21, the number of mobile nucleic acid testing vehicles will be increased to 12
.
It has achieved the purpose of reducing the gathering of residents, making it easier for residents to be nearby, and completing nucleic acid testing easily, and avoiding the increase in the infection rate due to the mobility of residents
.

5.
Antigen monitoring at home

5.
Antigen monitoring at home

Professor Wu Fan said that home testing is widely recommended in New York, mainly antigen testing (antigen testing kits)
.
This testing strategy can reduce the pressure of medical testing, allowing patients to self-manage at home and travel less
.

If the new crown test is positive, you must be at home (isolated) for at least 5 days from the date of symptoms, during which time, monitor the development of the disease yourself, and if the disease worsens, you can contact a doctor by phone or video for diagnosis
.
After 5 days, if the symptoms disappear, you can wear a mask to go out, otherwise, you still need to isolate at home
.

At the same time, New York has made a more precise definition of a close contact: that is, anyone who has been within 6 feet (about 1.
83 meters) of a confirmed case of the new crown within 24 hours and a total of 15 minutes or more
.

Figure 6 Home test (antigen test kit)

Where is China's epidemic prevention strategy heading?

Where is China's epidemic prevention strategy heading?

"The new crown is not so scary, but the battle is difficult to fight
.
" In the early morning of March 24, Zhang Wenhong, director of the Department of Infectious Diseases at Huashan Hospital Affiliated to Fudan University, published a long article on Weibo, and made an analysis and interpretation of the current situation of the new crown epidemic
.
He further pointed out that the screening big data tells us that a positive sign is quietly emerging.
The proportion of rolling screening cases in non-controlled areas is gradually decreasing, accounting for only 10% of the total cases, indicating that the social epidemic is gradually under control
.

Zhang Wenhong said that although the inflection point of the epidemic has not yet appeared, the conditions for forming an inflection point have gradually been met
.

On March 15, the National Health and Medical Commission issued the ninth edition of the "New Coronary Virus Pneumonia Diagnosis and Treatment Plan", requiring the implementation of centralized isolation management for mild cases.
Symptomatic treatment and condition monitoring should be done well.
If the condition worsens, it should be transferred to a designated hospital for treatment
.

Mild cases do not require hospitalization, which greatly reduces the pressure of hospital diagnosis and treatment
.

At the same time, China has optimized the detection strategy of the new coronavirus in response to the currently powerful Omicron strain.
According to the needs of epidemic prevention and control, the comprehensive team of the Joint Prevention and Control Mechanism of the State Council has decided to promote "antigen screening and nucleic acid diagnosis".
The detection mode is based on nucleic acid detection, and antigen detection is added as a supplement
.

Combined with the management models of "home testing" and "video/telephone diagnosis and treatment" for COVID-19 positive patients in New York City, what are the differences between my country's management models of "antigen testing" and "centralized isolation of mild cases"?

Professor Zou Yuhua from the School of Public Health of Guangdong Pharmaceutical University told the health community that the implementation of the contract service system of family doctors abroad is very mature
.
Our country emphasizes the concept of "people's health as the center", adopts necessary centralized isolation, strictly controls the spread of infectious diseases among the population, and ensures orderly economic and social development
.

Guidance cards, code scanning boxes, small speakers.
.
.
In Shanghai Cannes City, the largest residential community in Shanghai, in order to guide residents to take the building as a unit to participate in the test in time and batches, volunteers carry various service "artifacts" with them
.

286 buildings and about 40,000 residents entered the arena in an "athlete-like" way.
With the collective assistance of service personnel, the test was completed in an orderly manner within 48 hours
.

From March 16 to 20, Shanghai carried out large-scale nucleic acid screening in key and non-key areas
.
According to the distribution of abnormal screening personnel, Shanghai has repeatedly narrowed the "screening circle" step by step, and on this basis, scientifically cut into pieces, continued to carry out accurate screening for high-risk areas, managed risk sources in a timely manner, and also sorted out high-risk areas.
Hidden "Lightning" dropped
.

On March 28, it was announced at a press conference on the prevention and control of the new coronary pneumonia epidemic in Shanghai that a new round of nucleic acid screening was launched in Shanghai
.
This round of nucleic acid screening was carried out simultaneously with the original gridded screening including antigen detection
.

In the early morning of March 24, Zhang Wenhong published a long article on Weibo, proposing, "In the future, fighting the epidemic and maintaining the normalization of life should be placed in a position as important as dynamic clearing
.
"

"City closures", "bus and subway suspensions", "nucleic acid screening", "the establishment of makeshift hospitals", "delayed school enrollment", and "home office" have greatly affected people's normal life and normal social and economic development.
It is difficult for small and medium-sized enterprises to resume work and production, and enterprises cannot maintain the status quo of normal operations
.
There are also people who report that "the living in the closed area is not adequately cared for, the closure time is too long, and the repeated closure of the hospital makes it difficult to see a doctor
.
"

In response to these circumstances, Zhang Wenhong said that we must not only control the epidemic, but also protect the lives of residents, keep medical channels unobstructed, and at the same time ensure the survival of private small and micro enterprises
.
Maintain the normalization of residents' lives and the rational and sustainable development of the economy
.

The fight against the epidemic is not over yet, and life has to go on
.

References

References

[1] Zhang Wenhong: The inflection point of the epidemic has not yet appeared, but the conditions for forming an inflection point have gradually been met.
Lilac Garden.
2022-03-24

[1] Zhang Wenhong: The inflection point of the epidemic has not yet appeared, but the conditions for forming an inflection point have gradually been met.
Lilac Garden.
2022-03-24

[2] Jilin Street, Erdao District, Changchun City innovatively set up a "mobile nucleic acid detection vehicle" to achieve a new breakthrough in nucleic acid detection.
NetEase News
.
2022-03-22

[2] Jilin Street, Erdao District, Changchun City innovatively set up a "mobile nucleic acid detection vehicle" to achieve a new breakthrough in nucleic acid detection.
NetEase News
.
2022-03-22

[3] Initiatives on Strengthening Mass Prevention of New Coronary Pneumonia.
Gansu Provincial Health Commission.
2022-03-17

[3] Initiatives on Strengthening Mass Prevention of New Coronary Pneumonia.
Gansu Provincial Health Commission.
2022-03-17

[4] Policy Interpretation of the New Coronavirus Antigen Detection Application Scheme (Trial).
Medical Administration and Hospital Administration.
National Health Commission.
2022-03-11

[4] Policy Interpretation of the New Coronavirus Antigen Detection Application Scheme (Trial).
Medical Administration and Hospital Administration.
National Health Commission.
2022-03-11

[5] Implementing the "New Play" of Sliced ​​and Gridded Screening - The Shanghai "epidemic" line hits.
Overseas Network.
2022-03-26.

[5] Implementing the "New Play" of Sliced ​​and Gridded Screening - The Shanghai "epidemic" line hits.
Overseas Network.
2022-03-26.