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Has the rate of severe COVID increased? Is pneumonia related to vaccination? How can vulnerable populations be prevented? On December 30, the National Health Commission invited Zhang Wenhong, an authoritative expert, director of the National Medical Center for Infectious Diseases, and director of the Department of Infectious Diseases of Huashan Hospital affiliated to Fudan University, to respond
to these questions.
to these questions.
Zhang Wenhong believes that the current round of the epidemic is currently at the peak of infection, even if the severe disease rate of Omicron has decreased compared with the previous Delta, but no matter how low the incidence of severe disease, combined with China's huge population base, the number of severe patients will double up, "Every year China's seasonal influenza caused by pneumonia will also have a seasonal peak, pneumonia disease burden is also very heavy, the recent increase in the number of pneumonia and severe cases, mainly because of the increase in cases of infection in a short period of time, but the overall probability of severe disease is still very low
。 ”
。 ”
——Some new crown infected people show "white lung" phenomenon on lung CT, is this related to infection with the original strain of the new crown virus or the Delta strain?
In this regard, Zhang Wenhong said that the current strain circulating in Shanghai is still the Omicron strain, and the emergence
of the original strain of the new crown and the Delta variant has not been monitored.
The so-called "white lung" is the imaging manifestation of severe pneumonia, that is, when patients with severe pneumonia take CT and chest radiograph, the lungs will appear white due to the decrease in light transmission, just reflecting the severity of pneumonia, "no matter what pathogen, as long as it causes severe pneumonia, there may be 'white lung'"
.
of the original strain of the new crown and the Delta variant has not been monitored.
The so-called "white lung" is the imaging manifestation of severe pneumonia, that is, when patients with severe pneumonia take CT and chest radiograph, the lungs will appear white due to the decrease in light transmission, just reflecting the severity of pneumonia, "no matter what pathogen, as long as it causes severe pneumonia, there may be 'white lung'"
.
——Some netizens believe that vaccination will lead to adverse reactions and an increase in "white lung", is there any basis for this?
Zhang Wenhong said that a special controlled study has been done on this issue, and the results are obvious: according to the data in Shanghai in the first half of this year, after vaccination, the overall proportion of severe disease can be reduced by nearly 80%, "so we believe that vaccines have an effect on reducing the occurrence of 'white lung'"
.
.
——Once "white lung" appears, how to treat it clinically?
Zhang Wenhong said that the treatment of "white lung" is similar to other viral pneumonia, the first thing to do is to give respiratory support, especially for patients with respiratory failure, to give mechanical ventilation support to maintain oxygen supply in the body
.
On this basis, anticoagulant therapy, anti-inflammatory therapy, antiviral therapy, nutritional support and co-infection control are also very important, "to enable patients to survive the critical severe period and smoothly enter the recovery stage"
.
.
On this basis, anticoagulant therapy, anti-inflammatory therapy, antiviral therapy, nutritional support and co-infection control are also very important, "to enable patients to survive the critical severe period and smoothly enter the recovery stage"
.
Zhang Wenhong particularly emphasized that the success rate of treatment after the occurrence of severe pneumonia is lower than that of ordinary pneumonia and mild cases, so special attention should be paid to the "golden 72 hours" of treatment, that is, vulnerable people infected with the new crown and closely monitored within 72 hours after the onset of symptoms, oxygen therapy, symptomatic and nutritional support therapy, antiviral treatment, etc.
in the nearest community medical center or nearby hospital.
If there is a tendency to severe disease, anti-inflammatory therapy such as glucocorticoids should be used in time, try to prevent the aggravation of the disease, and go to the hospital for further examination
in time.
If severe manifestations such as "white lung" are found, optimal treatment
needs to be carried out within 24 hours.
in the nearest community medical center or nearby hospital.
If there is a tendency to severe disease, anti-inflammatory therapy such as glucocorticoids should be used in time, try to prevent the aggravation of the disease, and go to the hospital for further examination
in time.
If severe manifestations such as "white lung" are found, optimal treatment
needs to be carried out within 24 hours.
——Approaching the Spring Festival, various places are about to usher in large-scale population movements, how to protect vulnerable people in the face of the possible peak of severe illness?
Zhang Wenhong said that on the one hand, it is necessary to carry out continuous monitoring of vulnerable groups, and once problems occur, timely prevent the occurrence and aggravation of pneumonia; On the other hand, it is necessary to step up the expansion of medical resources to ensure that vulnerable people can receive timely treatment
.
.
"At present, the spread of the epidemic in 'small places' is not as rapid as in large cities, but the duration of transmission is relatively long
.
With the return of people during the Spring Festival, it may cause a wave of imported peaks in the local area, which needs to be treated in different categories: some of them are areas where the infection rate is already relatively high, and the impact is relatively small; However, if it is an area with a very low infection rate, the impact will be greater
.
For areas where the infection rate is not yet high, it is necessary to minimize large-scale crowd gatherings
.
Zhang Wenhong said
.
.
With the return of people during the Spring Festival, it may cause a wave of imported peaks in the local area, which needs to be treated in different categories: some of them are areas where the infection rate is already relatively high, and the impact is relatively small; However, if it is an area with a very low infection rate, the impact will be greater
.
For areas where the infection rate is not yet high, it is necessary to minimize large-scale crowd gatherings
.
Zhang Wenhong said
.
Finally, Zhang Wenhong suggested that we should do a good job in popularizing science, encourage people to do a good job of personal protection in the process of returning to their hometowns, and make personal efforts for the "peak pressure", so as to reduce the pressure
of treatment caused by the "peak of severe disease".
"People who have already been infected may not have much impact
when they return home.
If you have not been infected, you should do a good job of protection, try to avoid new infections caused by your own infection and aggravate the local epidemic peak
.
Therefore, everyone should wear masks during the trip, preferably N95 masks; If the elderly in the family have not been infected, we must also strictly wear masks
when we visit.
”
of treatment caused by the "peak of severe disease".
"People who have already been infected may not have much impact
when they return home.
If you have not been infected, you should do a good job of protection, try to avoid new infections caused by your own infection and aggravate the local epidemic peak
.
Therefore, everyone should wear masks during the trip, preferably N95 masks; If the elderly in the family have not been infected, we must also strictly wear masks
when we visit.
”
