Beijing Municipal Health And Wellness Commission: The capacity-building of epidemic prevention and treatment needs new ideas.

In this outbreak, Beijing has stood the test of great pressure to prevent and control.
with the domestic new crown pneumonia epidemic prevention and control into the normal, in response to the public health emergency management system construction, improve the ability and level of response to major public health emergencies, Beijing has also carried out a profound summary and deployment.
recently, around the topic of capacity-building in public health prevention and treatment, The Beijing Municipal Health And Wellness Commission Party Secretary and Director Lei Haichao accepted an exclusive interview with the Health Daily, we listen to the "first-in-command" about the "war epidemic" in Beijing experience.
: Beijing Municipal Health And Wellness Commission Party Secretary, director of the outbreak prevention and control in Beijing has gone through several stages, is it a systematic summary of the analysis of the results and losses? Effectively strengthen the monitoring and early warning capacity, in order to detect earlier, timely block the occurrence of potential major outbreaks, Beijing has what kind of consideration? From the outbreak input from Wuhan in January, to the overseas outbreak input at the end of February, to the new outbreak on June 11th, the outbreak prevention and control work in Beijing has understiged three rounds of impact, is the most domestic outbreak risk type, the longest duration of prevention and control.
Since the beginning of March, the Beijing Municipal Health and Health Commission has submitted to the city's epidemic prevention and control leading group every day a "foreign outbreak risk dynamic analysis" report, that is, to reflect the global epidemic situation, but also focus on tracking and analysis of 70 countries of morbidity, death and importation of cases in China.
beginning in late March, the report begins with a summary of the "policy recommendations" section, which mainly reflects the need to strengthen, improve and innovate in the context of the global outbreak situation, in accordance with the needs of prevention and control efforts.
May 16, the 13th Plenary Session of the 12th Committee of the Communist Party of China in Beijing held a review and adoption of the Opinions on Strengthening the Construction of the Capital's Public Health Emergency Management System.
"Several Opinions" is from the aforementioned "policy recommendations", containing Beijing to fully prevent and control the outbreak of new crown pneumonia made many efforts and thinking.
from March to the present, "Overseas Outbreak Risk Dynamic Analysis" has been compiled in nearly 200 issues, together with the daily excerpt of "Overseas Outbreak Reference", which together provides strong support for the decision-making of epidemic prevention and control.
the outbreak of neo-crown pneumonia suddenly, it really let us see the shortcomings in the early warning and prediction of the outbreak, strengthen the capacity-building of major outbreak surveillance and early warning needs new design and thinking.
the 2008 Beijing Olympic Games, Beijing set up an active monitoring network for symptoms of infectious diseases such as fever and diarrhea in 144 medical and health institutions.
analysis of new outbreaks found that cold-chain items carrying the new coronavirus pollute the environment and also lead to human infection.
this means that early warning and surveillance of infectious disease symptoms based on hospitals alone is not sufficient, and that early detection of infectious diseases requires early warning of healthy populations and environmental monitoring.
Outbreak early warning monitoring is extratroted to population and environmental monitoring, and in theory, the first infected and uninfred person and the first contaminated environmental sample can be screened, but this means that significant monitoring and significant economic input are technically possible but not economically affordable.
need to find a cost-benefit balance point from the perspective of health economics, reasonably determine the scope of monitoring objects, monitoring frequency.
population and environmental monitoring does not guarantee that every risk will be "caught", but it will reduce the chance of "missing out" risk, a leap forward in the concept of early warning of infectious disease surveillance, and Beijing has begun to push ahead with this work.
center in Tongzhou District of the new site construction has also been included in the agenda, the future experimental testing and early warning capabilities will be significantly improved.
in the prevention and control of the epidemic, specifically see the public health field of which short boards and weaknesses? What are the suggestions for filling the board, strength and weakness? This outbreak shows us that the theoretical epidemiological epidemic analysis and prediction capabilities need to be strengthened urgently.
At the beginning of the epidemic prevention and control in Beijing, epidemiological investigation was still dominated by traditional face-to-face interviews, and with the assistance of the credit bureau and various mobile communication operators, big data analysis technology began to be applied to epidemiological investigation, improving accuracy and efficiency.
lack of big data analytics teams and channels, the Agency's modeling and forecasting capabilities have not been effectively developed, lagging behind information technology units.
is also an important direction for strengthening the CDC talent pool and capacity-building in the future.
the outbreak, the development and application of automatic speech conversion system greatly improved the efficiency of streaming report writing, and the application of these new technologies and means has achieved good results.
But the structured database of the disease prevention and control system does not support the analysis of the full information of the flow report, and the value contained in the unstructured text information in a large number of flow reports is buried and far from being exploited.
information technology, such as artificial intelligence, still need to be involved in the in-depth excavation of concilio reporting information.
the importance of strengthening nucleic acid testing for epidemic prevention and control in the case detection process has been proved by practice.
strengthening the research and development of "good, fast and many" pathogen detection technology, and supporting primary health care service institutions to carry out pathogen detection, is an important direction to improve the ability of epidemic prevention and control.
Although rapid detection technology has been developed, nucleic acid testing time has been significantly shortened, but the biggest problem is that the pathogen identification has not yet broken the P2 laboratory dependence, testing time is still at the hour level, individual to minute-level detection equipment is too low to cope with the need for a large number of tests in a short period of time.
in response to other possible future outbreaks of infectious diseases, the supply of supplies is extremely important.
to explore the establishment of national, provincial, municipal, county, institutions, families six-level material reserve mechanism, at the same time, masks should also be regarded as important materials for storage.
the outbreak of neo-crown pneumonia hit, if there was such a family reserve mechanism, each family has a two-week amount of masks, one will not cause a big social panic, and the other can largely block the early spread.
addition, the state should strengthen ECMO, CART and other high-end medical equipment research and development and production capacity reserves.
for clinical institutions, what impact and reflection has the new crown pneumonia outbreak brought to the whole industry? Hospital sense prevention and control in medical institutions still need to be improved and strengthened.
important role in detecting potential infectious disease patients, blocking in-hospital infections, setting up fever clinics, and regulating isolation observation, but these alone are not enough.
Fever is indeed a common symptom of most infectious diseases, but not the only symptoms, new coronary pneumonia is an example, patients may not develop fever in the early stages of the disease, but diarrhea, changes in smell, changes in taste and other symptoms, these infected people may not enter the fever clinic and enter other clinical departments, no doubt this will cause a huge risk.
, all personnel in medical institutions should routinely adhere to basic protective measures such as wearing masks.
the "three-zone, two-channel" setting applies to all hospital areas? In order to avoid confusion and disorder, should the visitation system, which was strictly controlled during the outbreak, be maintained? Hospital facilities should minimize hand-to-hand operation, can it be controlled by inductive or voice interaction? All these issues deserve serious consideration by the whole industry.
in medical treatment, whether it is a general hospital or a specialist hospital, there are many aspects of capacity that need to be strengthened.
the outbreak, there were only 112 negative pressure wards in Beijing, which increased to 290 during the outbreak, but still could not meet demand.
this end, Beijing clearly proposed that the city's negative pressure wards in 2022 to increase to 700.
in the capital, where there is also a lack of negative pressure wards in the face of large-scale outbreaks.
addition, some hospitals correct, standardized use of ECMO, respiratory monitoring and other equipment capacity is insufficient, but also exposed in this outbreak of a clinical short board, these basic resources and capacity reserves need to be strengthened.
capacity-building in emergency and emergency response is also a focus of attention.
the initial outbreak of neo-crown pneumonia, there were fewer than 40 negative-pressure ambulances in Beijing, and after the emergence of overseas import cases, most of them concentrated in the capital airport to transport related passengers, still some stretched.
with the development of the epidemic, Beijing has been strengthening the capacity of first aid transport of infectious diseases, negative pressure ambulances have increased to 115.
addition, China's general hospital, disease control agencies emergency rescue team construction is still insufficient, in strengthening the professional modular integrated emergency rescue mobile team construction still need to make efforts.
major public health emergencies, public health emergency management depends not only on the field of health care, from a macro-social management perspective, what kind of comments and suggestions? First of all, China should strengthen the construction of the rule of law in the field of public health, and improve the legislative guarantee for the prevention and control of major epidemics.
in the field of medical and health care, but the focus of legislation is mainly on professional and technical considerations, infectious diseases when the social control and other aspects of public management legislation urgently need to be filled.
Beijing is promoting the process of local legislation from the perspective of public health emergencies, infectious disease prevention and control, patriotic health campaigns, etc., the principle of legislation is to clarify the relationship and responsibilities of the Quartet of territories, industries, units and individuals.
from the perspective of social governance, improve the capacity of public health prevention and control, but also pay special attention to the unity of prevention and control technology and social management functions.
In the field of infectious disease prevention and control, the technical treatment of patient discovery, disease treatment and so on is very important, but the control of infectious sources, blocking the transmission chain, protecting vulnerable populations and other social control measures to prevent and control the spread of the epidemic is also very important, the two can cooperate with each other, close cooperation in order to better and faster control the epidemic, which requires a high degree of unity at the legislative level.
specific to the reform of the disease prevention and control system, the management and business technology relationship within the system should also be straightened out.
the reform of Beijing is to strengthen the coordination and efficiency of the municipal and district secondary institutions and strengthen the management relationship.
the same time, strengthen the business integration between public health and clinical medicine, doctors to the disease prevention and control institutions to exercise, public health personnel should also go to the hospital to learn, training both public health and clinical expertise.
public health prevention and treatment capacity-building, to prevent the emergence of two bad tendencies.
is to prevent the emergence of "heavy control and light prevention".
to truly implement the "prevention-oriented" health work policy, to strengthen more resources to the disease prevention and control links to be filled in the loopholes, weaknesses and short boards.
second is to prevent the emergence of "heavy and light people".
some places attach importance to equipment and facilities investment, to invest in the construction of a large number of hardware facilities, the acquisition of a large number of technical equipment, but ignored the talent pool capacity training and construction.
in the field of public health, training leading talents, professional backbone, building the talent team, improve the level of ability, is the fundamental plan and the key to the problem.
Liu Zhiyong Source: Beijing Center for Disease Control and Prevention Copyright Notice: All text, images and audio and video materials that indicate "Source: Mets Medicine" or "Source: MedSci Originals" are owned by Mets Medical, are not authorized, and may not be reproduced by any media, website or individual, and shall be reproduced with the words "Source: Mets Medicine".
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