This article comes from WeChat public number: CC Weekly (ID: cancer-weekly) , author: Zhang Jiao (MD Anderson cancer Center tenured professor), the original title: “American scholars predicted: The turning point of Wuhan pneumonia may be dragged to late February? 》
WHO finally put down another boot: Announcing Wuhan 2019-nCoV pneumonia as a global public health emergency. As soon as the news came out, the whole country was distressed. Undoubtedly, this decision of WHO will have a huge negative impact on China’s economy and national psychology.
However, the pain is painful, and the past is irretrievable. And more importantly, What will happen tomorrow? What should we do? Faced with a critical situation with tens of thousands of cases, where is the inflection point for the development and change of the epidemic?
On January 22, I proposed in Phoenix News’s public account “CC Weekly”:
The peak of the disease will be after the 15th of the first month.
This is a forecast and basic research based on the peak of the Spring Festival and the incubation period of the virus for nearly 14 days. Due to the rapid changes in the diagnosed data and the epidemic situation of the patients at the time, everything is changing, and the inflection point of Wuhan pneumonia cannot be accurately predicted.
One or two factors determine the next step of the epidemic
The turning point of this virus infection depends on two factors:
1. Does the virus have powerful third and fourth generation infectivity?
Although there are slight differences in different research data, the current data show that the virus has strong second-generation infectivity, with an infection index between 2 and 5. (MRC Center for Global Infectious Disease Analysis) , similar to SARS. Therefore, if effective measures are not taken, an outbreak cannot be avoided. In the early stages of the disease, the number of new patients doubled every seven days (NEJM Jan. 2020), to this day (number of cases 10,000) , its growth rate has exceeded SARS. If it is not stopped, the consequences will be disastrous.
Three generations of transmission have occurred, including in Germany and the United States. What is not clear is whether the three-generation infectious index and the severity of the disease will be significantly reduced?
2. The degree of disease prevention and control by society, family and individuals determines the direction of the next turning point?
In a way, this turning point is in the hands of everyone. In other words, when we are in the epidemic area, we personally accurately control the epidemic prevention, control, sanitary disposal, whether to walk with illness, whether to comply with the isolation requirements, whether we can isolate ourselves, and isolate the virus source. Both determine the intensity and power of the virus infection.
Harvard researchers believe in an article that some coronaviruses have also been found in the stool of some people. At this time, you can’t urinate anywhere, and if necessary, you must maintain the sanitary condition of the toilet.
According to the World Health Organization, to protect yourself, you should take the same measures as any virus: avoid close contact with infected people and wash your hands frequentlyAnd practice good cough etiquette: This means covering your mouth and coughing into your elbows, not toward others.
In a way, we ourselves determine when the inflection point of this epidemic will come and when it will end.
Two or two outcomes: Will the inflection point of new cases be delayed until the end of March?
Based on all the data and information I know, I think there are two endings to the epidemic:
1: If the three-generation infectious index is low and the severity of the disease is reduced, coupled with the concerted efforts of the people across the country to isolate, prevent, and prevent most of the transmission routes, the highest point of new cases will appear inflection point in mid-late February.
2: If the three-generation infectious index and the level of disease remain high, coupled with factors such as the return of employees to work in the market in early February, the disease will break out at the end of February and may spread across the globe. In the end, the inflection point of the new cases will be delayed until the end of March if nothing unexpected happens. If so, the actual number of people infected will exceed one million, or even higher. Of course, the counted number will be much lower than this number.
Three, the possibility of infection and transmission of Wuhan pneumonia cannot be ruled out for pets and other animals
I want to emphasize the following five points:
1. Don’t panic or take it lightly
At the moment, there is no vaccine (Dr. Fauci, director of the NIH Institute of Infectious Diseases, estimates that it will take at least one year to complete the vaccine trial study) And effective antiviral drugs, we cannot control the virus threeGeneration infectious and pathogenic. However, we can control ourselves, and everyone has its own position. This critical period of infection, climbing, going out, gathering less, washing your hands and wearing a mask. This is not only about personal safety, but also the key to global disease control! Is the most effective way to save money. For individuals, the relationship between zero and 100% is either infected or uninfected.
2. How to cooperate with infectious disease experts from various countries to become a decisive factor in the epidemic in terms of drugs and vaccines
Analysis of the human genome map has confirmed that the DNA genetic differences between races are very small. The differences between people and races and races are mostly the result of gene expression and modification, not the DNA genetics. It is impossible to make a biological weapon specifically for another race, but other races are spared. At most the susceptibility is different. Imagine that even viruses from animals can be passed on to humans. Therefore, please abandon the so-called “conspiracy” theory and make full use of the current international cooperation channels opened by the WHO. Everyone should work together to make plans and contribute money to reverse the global health emergency of the global village. Nowadays, humans live in a global village. Taking the record of China Airlines as an example, there will be 4 billion travellers in 2019. The world has become smaller and smaller.
While Wuhan has flown to the United States in the past two months, there have been 8,000 people and 23,000 to Japan. 2019-nCoV has spread to more than 20 countries and regions.
At present, infectious disease physicians from developed countries such as the United States and Germany have basically arrived in China. Chinese researchers need to use this opportunity to establish a new international cooperation mechanism in vaccines, drug screening, epidemic prevention models, Comprehensive cooperation in such areas as early warning and the establishment of an effective mechanism.
In the past, we thought that “SARS virus will still appear, but the SARS epidemic is no longer possible.” But reality slaps us.
3. Work hard for the best ending, but prepare for the worst possible
As early as mid-January, I publicly stated that “to control infectious diseases, medically, we must prevent them before they occur. Blood stains in hospitals must be treated as HIV-positive first. Since Wuhan virus infection cannot “Transferring people” must first be “person-to-person” in handling, otherwise it will be too late. This is medical knowledge around the world. “In reality, we do the opposite.
We don’t know much about 2019-nCoV. The key links such as the source of infection, the route of transmission, and the ability to spread for multiple generations need further observation. Therefore, we must take early warning of the possibility of high transmission index in the three generations of 2019-nCoV, strictly control large-scale transmission sources (such as Hubei) , limit In early February, migrant workers returned to the city to implement hygiene practices in every household, every person, and mobilize the whole people. Control of infectious diseases depends on mass movements. In fact, this was a battle without gunpowder. The biggest advance in human medicine is controlling infectious diseases. This is a matter of life and death. In history, the example of a germ killing a village is not without.
4. The deaths and consequences of Wuhan pneumonia and influenza viruses cannot be compared.
Recently, some people have suggested that the flu kills thousands in the United States every year and tens of thousands of lives in China. Therefore, there are currently 10,000 cases of infection in 2019-nCoV, and the death of two hundred people is a piece of cake. . Do n’t forget, the genes of flu viruses are relatively stable and regular, and we have vaccines that can cause thousands of deaths every year without additional isolation and precautions. (case fatality rate is about 0.1%) .
If a new virus, all of our humans have no immunity, and a 3% mortality rate (Lancet Jan 2020’s current prediction of the virus ) , assuming that 10% of Chinese people are infected, and 1.4 billion Chinese, there will be more than 4 million deaths. The resulting social unrest and economic losses will be a huge disaster. That’s why WHO and other countries around the world are so anxious about this issue.
5. The possibility of infection and transmission of Wuhan pneumonia cannot be ruled out for pets and other animals
There may be many unknown possibilities for us to really determine the next variables. Recently, some people have emphasized that pets and other animals will not infect and spread 2019-nCoV. In the absence of evidence, no infection can be ruled out. There are currently no reports of pets getting sick from 2019-nCoV. But several coronaviruses have been found to infect animals and in some cases make them sick. Therefore, the U.S. Centers for Disease Control and Prevention recommends avoiding contact with pets and wearing a mask if you are sick. Researchers reported in the 2003 issue of Nature that cats could be infected with the SARS virus and spread it to other cats in the same cage, but they showed no symptoms.
In fact, WHO specifically emphasized in its statement that if other animals are found (including pets) , please Notify WHO immediately. Because there may be another way to spread it.
We all live in the same global village and now face the same enemy. Learn to self-discipline, learn to cooperate, and learn to analyze and act scientifically.
China, hold on!
This article comes from WeChat public account: CC Weekly (ID: cancer-weekly) , author: Zhang Jiao (MD Anderson cancer Center tenured professor)