Academician Zhong Nanshan talks about scientific prevention and control of new coronavirus pneumonia

Source: Medical Network

Since the outbreak of pneumonia infected by the new coronavirus (2019-nCoV), the country has joined forces and joined forces to form a city, starting an epidemic-stricken battle without gunpowder. Zhong Nanshan, academician of the Chinese Academy of Engineering and leader of the scientific research team for the joint prevention and control of pneumonia epidemic of new coronavirus infection, said in an exclusive interview with Xinhua News Agency on the 2nd that he should have a scientific understanding of the 2019-nCoV pneumonia epidemic, and carry out scientific and effective Prevent and control and avoid unnecessary panic.

Research basically supports virus originating from bats

Coronavirus (CoV) is a type of enveloped, single-stranded RNA virus that is widely spread in humans, other mammals, and birds, and can cause diseases such as the respiratory, intestinal, liver, and nervous systems. Seven CoVs are currently known to cause human disease, four of which are CoV-229E, -OC43, -NL63, and -HKU1, which are generally prevalent in the population and usually cause common cold symptoms. The other three SARS-CoV and MERS-CoV, including the 2019-nCoV, are severely harmful and can cause severe pneumonia and even death.

According to reports, some research results published for 2019-nCoV have some reference significance for epidemic prevention and control. Epidemiological studies have shown that the median age of 2019-nCoV-infected pneumonia patients is 59 years, 56% are male, and the average incubation period for viral infection is 5.2 days (95% confidence interval is 4.1 to 7.0), and 95% of the distribution points are 12.5 days. The average virality was 2.2. Fever is still a typical symptom of 2019-nCoV infected patients. Although asymptomatic infections have also been reported, it is not the main body. For current prevention and control, it is still necessary to focus on the majority. The analysis of the 2019-nCoV genome shows that it has 79.5% similarity with SARS-CoV and 96% similarity with bat-derived CoV, basically supporting 2019-nCoV from bats, but whether there is an intermediate host currently Research is needed. 2019-nCoV, like SARS-CoV, enters human cells through the ACE2 receptor, and the receptor binding domains of the two have a high similarity. Studies have also found that SARS-CoV-specific monoclonal antibody CR3022 can effectively bind to the 2019-nCoV receptor binding domain to neutralize virus infection, which also provides ideas for the development of antibody drugs.

Zhong Nanshan introduced that the virus damages the body in two main ways. One is the direct damage caused by the virus' damage to the body's cells; the other is the indirect immune damage caused by the damaged cell tissue. Once the immune response produced by itself is too strong, it may lead to more serious body damage, leading to serious illness.

At least 7 small molecule drugs are in different clinical research stages

Zhong Nanshan introduced that, so far, 2019-nCoV has not targeted specific effects. Some case-reported therapeutic drugs still need more clinical practice to prove their effectiveness. There are at least 7 small-molecule drugs targeting viral RNA polymerase or protease, including the above CR3022 antibody drugs, which are in different clinical research stages; research and development of related vaccines is also underway, but it takes time to reach clinical application.

"However, we have learned from the successful experience of SARS treatment, and have established some effective treatment programs. At the same time, the application of multiple life support methods has ensured the success rate of patients. We use high-throughput oxygen-assisted, non-invasive in critically ill patients. Mask ventilation, small tidal volume lung protective ventilation, extracorporeal membrane oxygenation (ECMO) and other adjuvant treatments have achieved good results. With the in-depth understanding of the disease and the accumulation of experience in diagnosis and treatment, the National Health and Medical Commission has repeatedly organized experts The diagnosis and treatment plan was revised, and the "New Coronavirus Infected Pneumonia Diagnosis and Treatment Plan (Trial Version 4)" has been formed, which effectively guided the nationwide diagnosis and treatment of 2019-nCoV pneumonia. "Zhong Nanshan said.

The most effective method is still "early detection and early isolation"

"At present, the epidemic situation in the country is still on the rise, but we judge that there should not be a national outbreak, but it may only be a partial outbreak." Zhong Nanshan said that in the face of the 2019-nCoV pneumonia outbreak, the most primitive and effective method is still "Early detection and early isolation."

"To this end, our government and relevant departments have adopted a number of national measures: extended holidays, traffic control, temperature detection and inspection in public places, active publicity of less gathering, personal protection knowledge, etc., and the improvement of national public safety awareness has also ensured relevant The measures were successfully implemented. "Zhong Nanshan said:" These measures effectively blocked the source of infection and greatly reduced the second and third generation infections. We judge that the epidemic situation is expected to peak in the next 10 days to about two weeks, but we still need to strengthen prevention and control. We must not relax our vigilance. We would like to express our special thanks to Wuhan, a heroic city, for their important sacrifices and contributions. "

Problems and Challenges in Epidemic Prevention and Control

At the same time, Zhong Nanshan believes that the current epidemic prevention and control work also faces many problems and challenges.

"First of all, the epidemic was partially concentrated and medical resources were scarce. At present, the government and relevant departments have learned from the successful experience of Beijing Xiaotangshan Hospital during SARS and newly built Vulcan Mountain Hospital and Lei Shenshan Hospital in Wuhan. A total of 2,300 beds will be placed. Greatly alleviate the problem of patient treatment; in terms of medical personnel, a number of teams of medical experts have been organized to support Wuhan; in terms of medical supplies, the government and social forces need to work together to ensure the distribution of front-line materials.

"Second, we need to do a good job of shunting patients to reduce the pressure on designated hospitals. The time is alternated between winter and spring and the climate is changeable. Common respiratory pathogens such as influenza virus are also in the epidemic season, and patients cannot be accurately judged by clinical manifestations in the early stages of the disease. Whether it is the 2019-nCoV infection or other common respiratory virus infections depends on the diagnosis of pathogens. However, the diagnosis of pathogens in primary hospitals is insufficient, resulting in the inability to shunt patients, which makes fever patients concentrated in a limited number of designated hospitals without shunting As a result, related hospitals are facing tremendous pressure, which also seriously affects patient treatment and epidemic prevention and control. Therefore, it is urgent to improve the ability of primary-level hospitals to screen and diagnose pathogens, realize diversion and treatment of patients, and reduce the pressure of epidemic prevention and control.

"Thirdly, we need to do a good job in preventing and controlling hospital sensations. Patients with high outbreaks, such as in Wuhan and other places, have surged, and relative medical resources are short, which can easily lead to hospital sensations and threaten the safety of medical staff and the public. Process management needs to be optimized to effectively protect front-line hospitals. The hospital senses prevention and control facilities, equipment and related materials. "

"It takes one mind to overcome difficulties"

Zhong Nanshan believes that scientific research needs to be accelerated to provide support for epidemic prevention and control. He believes that at present there is less understanding of 2019-nCoV and its infection characteristics. At present, national, provincial, municipal and social levels have launched special research funds for tackling the 2019-nCoV pneumonia epidemic, and urgently need to accelerate scientific research work for clinical Provide support for rescue and epidemic prevention and control.

"17 years ago, SARS lasted for nearly 6 months. Now our country has made great progress in the prevention and control of major infectious diseases. We are confident to control the 2019-nCoV pneumonia epidemic more effectively and recover as soon as possible. Normal social order. This requires the efforts of our front-line medical staff, the efforts of our scientific researchers, the efforts of our patients, and the efforts of our people. At the same time, it is necessary for all countries to strengthen cooperation and work together to cope with difficulties and overcome difficulties. " Zhong Nanshan said.