Important adjustments! The new version of the new coronavirus infection diagnosis and treatment plan was announced

Interpretation of the "Diagnosis and Treatment Plan for Novel Coronavirus Infection (Trial Version 10)"

In order to further do a good job in the medical treatment of new coronavirus infection and effectively improve the level of standardized and homogeneous diagnosis and treatment, the National Health Commission and the State Administration of Traditional Chinese Medicine organized the revision of the "Diagnosis and Treatment Plan for Novel Coronavirus Pneumonia (Trial Version 9)" according to the optimization and adjustment of relevant requirements for the optimization and adjustment of new coronavirus infection Class B tube and epidemic prevention and control measures, combined with the characteristics of the Omicron variant and the characteristics of infected people, and formed the "Diagnosis and Treatment Plan for Novel Coronavirus Infection (Trial Version 10)
。 The key revisions are as follows:

First, the name of the disease has been adjusted

According to the "Overall Plan on the Implementation of "Class B and B Management" for Novel Coronavirus Infection" by the Comprehensive Group of the Joint Prevention and Control Mechanism of the State Council, the name of the disease was changed from "new coronavirus pneumonia" to "new coronavirus infection"
.
The main consideration is that the new coronavirus is highly pathogenic in the early stage of the epidemic, and most of them have pneumonia manifestations
clinically.
With the continuous mutation of the new crown virus, after the Omicron strain becomes the main epidemic strain, the pathogenicity of the virus is weakened, and the infection of the human body is mainly manifested as cough, fever, sore throat, etc.
, and only a small number of infected people will progress to pneumonia
.
Therefore, "new coronavirus infection" can more accurately reflect the characteristics of
the disease.

2.
No longer determine "suspected cases"

With the increasing abundance of diagnostic methods and the continuous improvement of diagnostic efficiency, the new coronavirus infection can now achieve timely, rapid and accurate diagnosis
through nucleic acid and antigen detection.
In most cases, there will be no situation
where the epidemiological history and clinical manifestations are consistent with the characteristics of the disease but the etiology test cannot be determined for a long time.
Therefore, in order to further improve the clinical diagnosis efficacy rate and better achieve rapid admission, the tenth version of the plan no longer determines "suspected cases"
.

Third, add a positive new coronavirus antigen test as a diagnostic criterion

Antigen testing has good detection sensitivity in infected patients with high viral
loads.
With the continuous maturity of antigen detection technology and the continuous improvement of detection accuracy, people infected with new coronavirus infection, especially those with strong contagion, can be diagnosed
in time through antigen testing.
And considering that most infected people are treated at home, antigen testing is simple to operate, which is convenient for infected people to conduct rapid self-testing
.
Therefore, the tenth version of the diagnosis and treatment plan added "positive new coronavirus antigen test"
to the diagnostic criteria.

4.
Further optimize "clinical typing"

From the clinical manifestations of the disease, the common type generally represents the most common typical manifestation
of the disease.
The early pathogenicity of the new coronavirus is strong, and a considerable number of infected people have typical pneumonia manifestations, so the classification method of "light, common, heavy, critical" is adopted in clinical classification
.
With the continuous mutation of the virus, especially since the epidemic of the Omicron strain, the virulence of the virus has gradually weakened, the characteristics of the disease have changed significantly, most infected people have mild symptoms, and the proportion of pneumonia has been greatly reduced
.
In order to better reflect the characteristics of the disease, the tenth version of the plan has adjusted the clinical classification, mainly according to the severity of the infected person's condition, divided into "light, medium, heavy, critical", which is more in line with clinical reality
.

V.
Cases are no longer required to be "centrally isolated and treated"

With the implementation of Class B and B measures, people infected with the new coronavirus can choose home treatment or go to medical institutions according to the needs of their condition treatment, and all kinds of medical institutions can admit patients
infected with the new coronavirus.
To this end, the 10th version of the plan adjusted the admission strategy according to the situation, and no longer required centralized isolation and treatment of cases
.

Sixth, the treatment method has been further improved

The first is to incorporate the anti-new coronavirus treatment drugs that have been approved for marketing in China into the new version of the diagnosis and treatment plan to further enrich the antiviral treatment methods
.
The second is to further improve the diagnostic standards and early warning indicators for severe and critical cases, scientifically and accurately determine the severe cases of new coronavirus infection, and at the same time add the elderly who are not fully vaccinated to the high-risk group of severe disease, and add vital signs monitoring, especially the index of finger oxygen saturation monitoring after rest and activity, to the early warning indicators
of severe disease.
The third is to further strengthen the concept of co-treatment of new coronavirus infection and underlying diseases, emphasizing that it is necessary to strengthen the monitoring of indicators related to the underlying diseases of infected people, and give corresponding treatment for the underlying diseases, which is more conducive to promoting the comprehensive recovery of patients
.
Fourth, the clinical manifestations and treatment related contents of pediatric cases were further optimized, the characteristics of children infected with Omicron strain were proposed in combination with clinical practice, the early expected warning indicators of severe cases in children were improved, and treatment plans
were provided for special situations such as acute laryngitis and neurological complications that may occur in children infected.
Fifth, the relevant content
of traditional Chinese medicine treatment has been further improved.
The guidance on the treatment of traditional Chinese medicine for severe and critical cases has been strengthened, and the methods of medication with symptoms have been increased, which is more in line with the clinic
.
On this basis, the TCM treatment plan for pediatric cases was further improved, acupuncture treatment methods were added, and corresponding TCM treatment measures
were provided based on the obvious cough of some patients during the recovery period.

VII.
Adjust the "discharge criteria"

After the implementation of the new coronavirus infection Class B and B measures, the isolation management of infected people will no longer be strengthened, but can be diagnosed and treated
according to Class B infectious diseases.
To this end, the tenth version of the plan no longer requires the nucleic acid test results of infected patients when they are discharged, but clinicians will conduct comprehensive research and judgment
based on the patient's new coronavirus infection, diagnosis and treatment of underlying diseases or other diseases, and health recovery.

When the patient's condition improves significantly, vital signs are stable, body temperature is normal for more than 24 hours, lung imaging shows significant improvement in acute exudative lesions, can be switched to oral drug therapy, and there are no complications requiring further treatment, discharge can be considered
.

8.
Adjust infection prevention and control in medical institutions

After the adjustment of the epidemic prevention and control policy, all medical institutions have the possibility of receiving cases of new coronavirus infection, and we have adjusted the relevant content of infection prevention and control in medical institutions in the tenth version of the diagnosis and treatment plan, so that the infection prevention and control measures are more scientific and accurate, more targeted and operable
.
The first is to further implement the pre-examination and triage system of outpatient emergency departments and do a good job in patient triage
.
At the same time, patients and accompanying persons are instructed to wear medical surgical masks or medical protective masks, and hand hygiene, respiratory hygiene and cough etiquette guidance
are provided.
The second is to strengthen the cleaning, disinfection and ventilation
of consultation rooms, wards, offices and duty rooms.
The third is to implement personal protection requirements
for medical personnel according to the risk of exposure.
The fourth is to standardize the treatment of medical waste and implement terminal disinfection
after patients are transferred out or left the hospital.