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When will we be able to return to normal production and life? The National Health Commission made clear and heartfelt words
4, the fourth dose of vaccine is coming, should it be given? How to fight?
2 million people have the latest research, nearly 7% have the sequelae of the new crown.
.
.
.
Nature: More than 100,000 people have the latest study, nearly half of the new crown patients have "long new crown" symptoms.
.
.
.
com/journals/jama/fullarticle/2797443https://doi.
org/10.
1038/s41467-022-33415-5
Written by | Alaska Po Editor | Alaska Po
Recently, at the new round of press conference of the joint prevention and control mechanism of the State Council, in response to the reporter's question: "Now the virus spreads rapidly, but the infected people are mainly mild and asymptomatic, the virus is so light, why can't it 'coexist' with the virus, why do you still spend a lot of strength to adhere to 'dynamic zero'?" When will we be able to return to normal production and life? Liang Wannian, head of the expert group of the National Health Commission's leading group for epidemic response and handling, and Mi Feng, spokesperson Mi Feng, and Wu Zunyou made a clear response
.
Let us first abandon all personal emotions, take a neutral attitude, and carefully understand these answers
from the perspective of individuals, families, and countries.
Liang Wannian's response was quite emotional, and the words revealed his true feelings
.
He responded that the fundamental principle of our country in handling all affairs is "people first and life first", and it is our consistent style not to abandon or give up anyone, which can be seen
from the evacuation of overseas Chinese and the safe return of our citizens.
A country, a government, especially a large country with more than 1.
4 billion people, formulating a policy is not a mistake, let alone a child's play, and decisions must be carefully investigated and fully evaluated at home and abroad before they dare to make decisions
.
Is it responsible to make decisions easily in a few words? A hard landing of the epidemic is something that no one can afford
.
It is said that the current new crown virus is "mild and small cold", which is a feeling in the country, because there has been basically no large-scale infection in the country, and the people are well
protected.
In the past three years, there have been more than 300 local epidemics caused by overseas imports, these epidemics have been well controlled, practice has proved that the general policy of "dynamic clearance" is scientific, the effect is significant, is in line with China's actual situation, now who dares to stand up and guarantee that changing another policy can do better than "dynamic zero"?
Based on the current understanding of the Omicron variant, especially the direction of its mutation, the understanding of the harmful changes after mutation, including the understanding of this disease, there is no ability to completely eliminate the virus, nor the ability to ensure that there will not be a case or sporadic case, some of its long-term sequelae are also related research at home and abroad, we know these better than anyone, comparing it to a "small cold, flu", too irrational
.
If we have the ability and conditions to achieve "dynamic zeroing", why not insist on it? Wouldn't it be safer to wait until the time is right to make some changes? Everyone sees only lying flat abroad, but do they have a second option?
Liang Wannian: Omicron's excess mortality rate is high, who can guarantee it?Subsequently, Liang Wannian introduced the excess mortality rate
of the new crown virus.
He explained that there are two different perspectives to measure the harm of the epidemic, and the internationally common public health perspective is from the perspective of the group, using indicators such as mortality and excess mortality to measure, rather than the case fatality rate and individual perspective
.
For the Omicron variant, its case fatality rate is indeed decreasing compared with previous variants and the original strain, but because of its rapid transmission, more insidious transmission, and the gradual enhancement of immune escape, the overall incidence is high, which means that there will be a large number of infections
in the population.
The larger the number of infected people multiplied by the individual case fatality rate, the number of deaths will be relatively large, the group mortality rate will be higher than influenza, and not lower than the original strain and other variants, it can be seen that its harm to humans has not decreased significantly, which is an important indicator
for the World Health Organization and various countries to judge its harmfulness.
In addition, excess mortality means that after the emergence of this disease, it will not only affect the severe illness and death of patients infected with this disease, but also may lead to a run on medical resources, which will affect the demand for other normal medical services, which may lead to unnecessary deaths
under normal conditions.
Scientifically, measuring this additional death due to the impact of the pandemic is called "excess death"
.
The calculation is based on how many more deaths this year have died in this country or region compared with the total number of deaths in this country or region last year or the previous three years, and if there are no other explainable factors, it is attributed to excess deaths
caused by the epidemic.
Judging from the current situation, the excess death caused by the new crown pneumonia epidemic, whether it is the original strain or the previous variant, especially the Omicron variant, is still relatively high, and it has been studied to be more than 100 per 100,000, so high, who can bear it?
Finally, he said that in the past three years, the impact of epidemic prevention and control on the economy and society can be seen by everyone, bringing some inconvenience, which is also the main reason why some people have emotional fluctuations and constantly attack the epidemic prevention policy, so we must resolutely rectify the code layer by layer, and the fundamental point of all contradictions is also layer by layer! ! ! It is imperative to care for the people affected by the epidemic, effectively protect their lives and medical needs, and rectify some nucleic acid testing institutions so that they cannot become an obstacle
.
4, the fourth dose of vaccine is coming, should it be given? How to fight?
When it comes to when we can return to normal production and life, we have to mention the vaccination rate
.
With the global spread of large-scale infections driven by Omicron and its new mutant subtype BF.
4, the effectiveness of the original new crown vaccine has declined
to varying degrees.
A clinical trial published in The Lancet showed that after receiving two doses of the Johnson & Johnson adenovirus vector vaccine and one dose of the Pfizer vaccine as a booster shot, the effectiveness of the vaccine decreased to 8.
8% after 25 weeks; Even after three doses of Pfizer's mRNA vaccine, after 10 weeks, the effectiveness of the vaccine was still not high, reducing to 45.
7%.
When dealing with the original strain of the virus, the effectiveness rate of one dose of mRNA vaccine is as high as 90%.
Today's coronavirus vaccine has changed from preventing infection to preventing hospitalization, severe disease and death
.
Many of the new infections at this stage are already vaccinated or previously infected
.
From the mortality data in the fifth wave of the epidemic in Hong Kong, it can be seen that the average mortality rate corresponding to 0~3 doses of vaccine is 3.
04%, 1.
03%, 0.
17% and 0.
04%, respectively, of which the mortality rate of two and three doses of Sinovac vaccine is 0.
35% and 0.
06%, respectively, and the mortality rate of two and three doses of Forbidden mRNA vaccine are respectively 0.
05％、0.
03％
。
From the perspective of infection rate, the infection rate of unvaccinated people is as high as 30.
9%, the infection rate of two doses of vaccine is still more than 20%, and the infection rate of three doses of vaccine has dropped to less than 10%, of which the infection rate corresponding to three doses of forbidden mRNA vaccine is 4.
0％
。
In this context, more and more countries have begun to plan or launch the fourth dose of the new crown vaccine, including Japan, Italy, the United Kingdom, Israel, Singapore, Denmark and Chile
.
With BA.
5 gaining an overwhelming predominance in Israel, Israeli experts say the possibility of including a fifth dose of the vaccine for the elderly and immunocompromised should be considered.
But not to mention the fourth dose, at present, the three-shot vaccination rate of China's vaccine is not high, and the natural infection rate is not high, especially in the
elderly group.
Vaccination of Shanghai citizens (from China Newsweek)
According to Beijing Daily, as of August 10, the full vaccination rate of the new crown vaccine for the elderly in China was 85.
6%, and the booster vaccination rate was 67.
8%, lower than the United States (92.
1%, 70.
7%) and Germany (91.
2%, 85.
9%) and Japan (92.
4%, 90.
3%)
.
Once the epidemic breaks out on a large scale again, those who have not been vaccinated or who have underlying medical conditions will still face a higher risk of
severe disease or death.
Older people are at high risk of infection and are more likely to become severely ill
.
From the current point of view, the vaccination rate of the domestic elderly vaccine booster is far from enough
.
Jin Dongyan, a professor at the School of Biomedical Sciences at the University of Hong Kong and an expert in virology, said: "At present, vaccination is still the most effective and cost-effective way to fight the new crown virus, and when the domestic three-dose vaccination rate reaches more than 90%, the possibility of policy adjustment will be greater
.
”
The question is, in the face of all the crowd, should the fourth injection be hit?
The so-called fourth dose of the new crown vaccine, don't think too high-end, it has no special meaning, it is a booster shot
for the pipeline production of the new variant that is currently circulating.
Epidemiologist Zeng Guang has said in public that with the emergence of new strains, the vaccine production line will produce targeted vaccines, and the possibility of
people needing a third, fourth, or even fifth booster shot is not ruled out.
Undoubtedly, a fourth shot will greatly prevent the possibility of infection with the new variant and greatly reduce the probability
of hospitalization, severe disease and death.
However, a fact that cannot be ignored is that no matter which new crown vaccine, no matter how many injections it takes, the immunity generated in the human body will decay over time, and in the future, we may need to repeat and periodically vaccinate
the new crown vaccine.
However, many experts believe that considering the cost and benefits of vaccination, no matter what dosage form and technical route, there is no need to promote the general population to be vaccinated
for the time being.
2 million people have the latest research, nearly 7% have the sequelae of the new crown.
.
.
.
Nature: More than 100,000 people have the latest study, nearly half of the new crown patients have "long new crown" symptoms.
.
.
.
Long before the National Health Commission answered "when to return to normal production and life", a blockbuster study published abroad in JAMA on October 10, 2022 Estimated Global Proportions of Individuals With Persistent Fatigue, Cognitive, and Respiratory Symptom Clusters Following Symptomatic COVID-19 in 2020 and 2021 shocked the world and academia!
The article said that as of October 10, 2022, 620 million people worldwide have been infected with the new coronavirus, and its long-term health conditions, especially sequelae, have become the most concerned issues, which is the research focus of the research
team.
The WHO-led collaboration of medical scientists worldwide included self-reported follow-up of 1.
2 million people diagnosed with COVID-19 in 22 countries
.
The study defined the long-term sequelae of the new crown (Long COVID-19) as having symptoms after 3 months of suffering from the new crown and lasting at least 2 months
.
Sadly and shockingly, the study found that at least 1 in 3 self-reported long-term sequelae symptom clusters accounted for 6.
2% of 3 months after symptomatic SARS-CoV-2 infection .
Of these, 3.
7% had persistent breathing problems, 3.
2% had persistent fatigue with physical pain or emotional abnormalities, and 2.
2% had abnormal
cognitive levels.
By 12 months of illness, 0.
9% of patients still had long-term sequelae
.
At the same time, the study also found that the proportion of long-term sequelae was higher among hospitalized patients with COVID-19, reaching 27.
5% (hospitalized patients) at 3 months versus 5.
7% (non-hospitalized patients); 11.
1% at 12 months (inpatients) vs.
0.
7% (non-hospitalized); The long-term sequelae of ICU patients were more serious, reaching 43.
1% at 3 months; 20.
5%
at 12 months.
This study shocked Western countries, but also shocked domestic scholars, a number of experts from the Chinese Academy of Medical Sciences said that it is absurd to equate Omicron with influenza and small colds.
Just two days later, on October 12, Nature also published a blockbuster study of "long new crown" symptoms, Outcomes among confirmed cases and a matched comparison group in the Long-COVID in Scotland study
。
The researchers conducted a long-term follow-up survey of 33,281 confirmed new crown infections and 62,957 people who had never been infected with new crowns for 6-18 months, and the survey found that among all new crown infections, 1,856 were (about 6%) There was no recovery at all (all symptoms persisted), and 13,350 people (42%) recovered
only partially from symptoms.
The results showed that among the 26 symptoms of infection, 24 symptoms related to poor quality of life and impaired daily activities may become persistent symptoms
of the new crown.
Among the 21,525 people who developed persistent symptoms after symptomatic infection, fatigue, headache, muscle pain and weakness were the most common, and these symptoms are also common
in uninfected people.
Therefore, after adjusting the relevant factors, only the characteristics of the strongest correlation of long new crown symptoms such as dyspnea, palpitations, chest pain and confusion were studied.
The team ultimately concluded that 6 to 18 months after symptomatic coronavirus infection, adults were more likely to experience a variety of symptoms, poorer quality of life, and widespread impairment of daily activities, which could not be explained
by confusion.
People with severe infection are more likely to develop sequelae of the new crown, which is less observed in asymptomatic infection, and pre-infection vaccination may be protective against
the new crown.
The heavy research of JAMA and Nature has cast a shadow on the global new crown epidemic for a while, and this is only a few months of research, and the symptoms of the new crown in three, five, and ten years later?
Who can predict what will happen in the future?
Link to paper: https://jamanetwork.com/journals/jama/fullarticle/2797443https://doi.
org/10.
1038/s41467-022-33415-5
Written by | Alaska Po Editor | Alaska Po
