Can we relax epidemic control at this stage? What are the consequences? Dialogue with authoritative experts

According to a case recently reported by Beijing, Zhu, a newly infected person in Fengtai District, knew that he had a travel history in medium- and high-risk areas of the epidemic. He still illegally entered the Xinfadi Market by hiding in the back seat of the cab and having someone else drive for him, and then went in and out of restaurants, convenience stores and other places in the market.
During the National Day holiday, people traveled and gathered more, and many people relaxed their vigilance in epidemic prevention and control.

Is it time to relax epidemic control? How to correctly view the current domestic epidemic prevention and control situation? Science and Technology Daily interviewed Wang Guiqiang, a member of the National COVID-19 Medical Treatment Expert Group and Director of the Infectious Diseases Department of Peking University First Hospital.

Reporter: Recently, most of the domestic patients with new coronavirus pneumonia are asymptomatic. What is the reason?

Wang Guiqiang: First, the virulence of the Omicron strain of the novel coronavirus has decreased, its morbidity has decreased, the invasion of the lower respiratory tract has decreased significantly, and the number of asymptomatic infections has increased. Second, the number of people vaccinated has gradually increased, and the symptoms of reinfection after vaccination are often alleviated, especially the incidence of severe and critical illness has decreased significantly. The Omicron epidemic in Hong Kong has also strongly demonstrated the protective effect of the vaccine. In this epidemic, the mortality rate of the people who received the new crown vaccine was 0.03%, while the mortality rate of the people who did not receive the new crown vaccine was 3.04%. The data of the elderly are more telling. The mortality rate of the elderly over 80 years old who were not vaccinated was 16.48%, the mortality rate of those who completed one shot of vaccination was 7.08%, the mortality rate of those who completed two shots of vaccination was 3.81%, and the mortality rate of those who completed the third shot of booster immunization was 1.20%.

At present, judging from the domestic epidemic situation, a large number of COVID-19 patients are asymptomatic. If the infected do not take the initiative to do nucleic acid testing, they cannot be discovered because they do not have any symptoms. However, from the perspective of infectious disease prevention and control, asymptomatic or latent infections should be taken more seriously, because asymptomatic infections are the main source of infection. If they are not discovered in time, the epidemic will spread rapidly and cannot be controlled.

Reporter: Many people are discussing the possibility of relaxing epidemic control requirements. What would happen if epidemic control requirements were relaxed at this stage?

Wang Guiqiang: The pathogenicity of the Omicron strain BA.5 has weakened, but its infectiousness has increased. If it is not actively controlled, it will lead to a large-scale epidemic. A large-scale epidemic will inevitably lead to the death of high-risk groups. Although the pathogenicity of the Omicron strain has decreased, if the base of the sick population is large, the number of deaths will also rise.

It is particularly important to note that if epidemic control is relaxed, the elderly will be the first to be affected. In the Omicron epidemic in Hong Kong, it can be seen that the mortality rate of the elderly over 60 years old increased 252 times compared with the 18 to 30-year-old population. As of the end of 2021, the number of elderly people aged 60 and above in the country reached 267 million, accounting for 18.9% of the total population. Vaccination can effectively reduce the mortality rate of elderly patients, but from the current data, there is still a gap in the vaccination rate of the elderly aged 60 and above in my country, especially the elderly aged 80 and above.

There are two prerequisites for the current relaxation: First, vaccination should be done well to minimize the mortality rate, especially for the elderly and those with underlying diseases. Second, stratified diagnosis and treatment should be done well, because once the relaxation is done, a large-scale epidemic will occur, and a large number of patients will flock to hospitals, causing a run on medical resources and an increase in secondary disasters. Therefore, it is important to do a good job in stratified management of patients, such as who stays at home, who goes to the hospital, and who is treated in the community. Corresponding plans should also be made at the community and home levels, such as ensuring the accessibility of drugs and the convenience of testing.

Reporter: Many people say that contracting COVID-19 is similar to catching a cold and that you can just rest at home. What is the truth?

Wang Guiqiang: At this stage, the symptoms of COVID-19 infection are indeed very mild, and many patients are asymptomatic. However, we cannot ignore that the infected are always the main source of infection. COVID-19 infection in young people may not cause much harm to their bodies, but it can be transmitted to the elderly at home, especially those who have not been fully vaccinated. The infection of the new coronavirus in them will increase the mortality rate.

Reporter: What is the correct attitude towards epidemic prevention that the public should adopt at this stage?

Wang Guiqiang: During the National Day holiday, many people traveled and had dinner together, which increased the pressure of population gathering and mobility. During this period, we still need to pay attention to personal protection.

In crowded and relatively closed environments, be sure to wear a mask, pay attention to hand hygiene, and maintain social distance. Wearing a mask is very important. On the one hand, it can prevent yourself from being infected. On the other hand, if you are infected, even if you have no symptoms or the symptoms are mild, you can effectively prevent the further spread of the virus by wearing a mask. If you have symptoms such as fever, fatigue, etc., go to the fever clinic in time for medical treatment.

(Source: WeChat official account of Science and Technology Daily, reporter Dai Xiaopei)