Zhang Wenhong, a Chinese virologist and chief physician of the Shanghai Infectious Diseases Hospital, recently gave an interview to Chinese media in which he shared his opinion on the development of the coronavirus disease in Shanghai.
Since the beginning of April 2022, Shanghai has seen a peak incidence of 27,000 cases per day, and now it has gradually decreased to about 20,000 per day, the number Rt = about 1.0, according to Chinese media. In particular, Pudong, where the epidemic was most severe, led the way in reducing the effective reproduction number Rt to below 1.
Although the epidemic still has a high risk of resurgence, the good news is that the number of social cases outside the control zone is gradually decreasing, and full negative social screening has been carried out in some administrative areas. The subsequent social cleansing work is still very difficult and requires full attention. Especially as the number of cases increases, the problem of treating vulnerable populations begins to arise.
Prior to the COVID-19 epidemic, these patients with severe multi-organ complications and long-term care were typically treated in primary care or nursing facilities. During an outbreak, these patients will be concentrated in designated hospitals.
After the epidemic of the new variant of the coronavirus, Omicron in Shanghai found a significant difference from the earlier epidemic in Wuhan, when the death rate from new coronary pneumonia was the highest - more than 5%. Today, even if mortality from major diseases is taken into account, overall mortality in Shanghai remains at 0.0178% (87/488,000), of which the proportion of deaths from severe pneumonia caused by new coronary pneumonia is very low. Currently, the death rate of elderly patients and patients with comorbidities has the greatest impact on the mortality rate, which is the biggest challenge facing the current treatment in Shanghai.
During the epidemic period of the new corona variant of Omicron, the treatment of patients with new coronopositive underlying diseases or other acute diseases will cause a strain on medical resources. Clearly, positive patients must be admitted to designated hospitals for COVID-19, placing high demands on designated hospitals – not only to treat the symptoms of new crowns, but also to ensure uniform treatment of the various departments of the underlying disease.
Based on this, given the characteristics of multiple and severe underlying disease in elderly patients, the requirements for the treatment of multidisciplinary critically ill patients are very high. Shanghai gathered more than 360 intensive care medical experts with rich experience in clinical diagnosis and treatment in the city, as well as experts supported by other provinces and cities, to form 9 intensive care teams located in 8 city hospitals. new crown heavy, critical and new crown.
For positive patients with severe underlying diseases, centralized management and complex treatment are implemented. In order to improve the specialized treatment capacity of designated hospitals for COVID-19, the head hospital of the designated city hospital has also established a hospital multidisciplinary specialty treatment team and established a team of 53 city experts with rich clinical experience. specialty experience 15. Using the consultation platform system developed for emergency care, Conducting multidisciplinary collaborative rounds and consultations for critically ill patients in designated municipal hospitals, conducting treatment with one person and one strategy, adjusting treatment plans in a timely manner, and do everything possible to save lives seriously ill patients.
Strong medical support is more required in specialized district level hospitals. Rescue resources should gradually descend to the grassroots level, increase the ability of the grassroots to treat new corona patients, and achieve full medical resource coverage.
Academician Ning Guang from Ruijin Hospital led a team to connect with hospitals at all levels in Huangpu District. The Zhongshan Hospital Intensive Care Medical Team went to the front line to treat the community to fully improve the capabilities of primary care, implement the full coverage of medical resources, and improve the treatment effect for the elderly and vulnerable groups.
All in all, the future against the Omicron epidemic is a long and protracted people's war. The aim has always been to spare the elderly and vulnerable populations from the significant risks associated with a pandemic.