This article comes from WeChat public account: CC Forum (ID: ccjt2014) , Speaker: Wenhong Zhang, Director of Department of Infectious Diseases, Huashan Hospital Affiliated to Fudan University, and leader of Shanghai Medical Treatment Expert Team
SARS mortality is 10%, influenza pneumonia is 9%, and influenza is short for “influenza.”
Many people are wondering, since it is a “cold”, how can flu spread as soon as it comes, and it can even become a deadly threat, causing some patients to pay the price of their lives?
Doctor Zhang Wenhong said: Flu is not a cold! Just like a tiger is never a cat!
The mortality rate of influenza pneumonia is 9%, and the mortality rate of SARS is 10%. Then why are you not afraid of influenza, so afraid of SARS? Because you know nothing about SARS and you are afraid, you are afraid of SARS.
Every responsible doctor sees the source of his anxiety when he sees a doctor.
If we look back a century ago, 1918, this is a picture of a ward taken in Europe. I do n’t know how my colleague worked here a hundred years ago, and died around the world How many people are affected by the flu? From 50 million to 100 million, the current statistics are at least 50 million.
So do you know the total number of humans in the world right after the end of World War I in 1918? It was 1.8 billion. When 50 million of the 1.8 billion people on this planet died of a disease, and when the disease came, we knew nothing about it, so you can imagine the kind of fear at the time How is it.
We have spent so much time all over the world, and now we have caught this culprit. What is the culprit? It’s the flu virus. You see in the upper left corner of this photo is capturing a killer flu virus. A group of doctors and scientists, we call ourselves a hunter, we are called a virus hunter. What I’m looking for is something small and invisible, but it kills you every day.
We are all chasing, one is chasing ideals, the other is chasing reality. Who do you say is happy? Who is anxious?
A hundred years ago, when 50 million people died, many people were blaming me. Have you caught up? You must be asking what happened in Wuhan today, did you catch up? I am very proud to tell you here that Chinese scientists have basically been chasing this matter for just over a week.
I’m talking about one thing a hundred years ago, but everyone has misunderstood it, so today you went to the hospital to have flu, and then someone actually died because of the flu. How could the flu die? Well, what I’m talking about today is that a cold can die, everyone thinks so, right?
The full name of the flu is influenza. Are the influenza and the cold a family? Then I ask you, are cats and tigers a family? Many people think for a long time, it seems like a family! Because they all belong to one family, feline, right? Cats and tigers are a family, which means that they are close in gene pronunciation, so although there are differences between cats and tigers, they are still a family. However, influenza and colds are not a family at all. If I tell you that influenza is a tiger, what do you say is a cold? I tell you, a cold is not even a rabbit, it may be a small reptile, it may be a fly. It’s so far away, but they have the same name. Who can understand this?
A hundred years ago, the flu was called flu influenza in the world. The name came to China. How can we translate it? Isn’t it just a fever? Is it burning very high? Isn’t that just a cold? Many people have a fever, many people have a cold, isn’t it just influenza? The name was settled, and after it was settled, this misunderstanding continued for a hundred years. So, if someone went to the hospital with a fever today and died, they still spent so much money. To whom do you say this hate should be vented? Doctor, it must be a doctor! I told you what the flu is today, and you understand.
When SARS came in 2003, you didn’t think we could fight back. What was the mortality rate? 10%. Why are many people seriously ill? There is a problem here. When a new virus comes to the world, you have no resistance to it. What do you rely on? Rely on our immunity. When a new virus arrives in our body, our immunity will not rise quickly, because all our cells have no memory of this new thing, so at this time we have very serious with it The fight, this fight is natural immunity, that is, all our white blood cells start to attack, and when we don’t know what it is, we throw some bombs in and blow them up everywhere.
There is a lot of inflammation in our lungs. However, if we had a viral infection or a vaccine today, we would know it. The next time the virus comes to you, the cells with memory in our body will throw out a lot of missiles and give it to Kill it, so this is the only difference.
For an unknown virus, when influenza came to this world a hundred years ago, 50 million people were killed by the flu.Because the world has no resistance to it, this is the first. Second, public health does n’t know how to isolate it, so SARS did n’t do it all in 2003? why? Because we used a very good isolation situation to control it.
Flu and cold are completely two diseases. One may be very, very severe. This is influenza. It is a special virus. This virus may cause extremely serious clinical manifestations, which is pneumonia. Severe pneumonia may die.
So how many people in China get flu every year? This value is January 2019 data from the Chinese Centers for Disease Control and Prevention. What is the annual influenza data we report to the Chinese Centers for Disease Control and Prevention? Less than one million, more than 800,000. More than 800,000 miles are light and heavy, and the heavy account for more than 10%. What will happen to the heavy patient? What do you think is the most serious disease and the highest mortality virus infection? People in Beijing know that it is SARS, and the SARS incident has passed.
The number of SARS infections worldwide in 2003 was 8,422, with 916 deaths and a mortality rate of 10%. Remember, SARS has a 10% mortality rate. 10% of patients with influenza are severe. What is heavy? Influenza pneumonia causes 30% of influenza pneumonia to be admitted to the intensive care unit. What is the mortality rate?
The death rate from influenza pneumonia is 9%. Today I tell you that the mortality rate of influenza pneumonia is 9%, and the mortality rate of SARS is only 10%. Then why are you not afraid of influenza? So scared of SARS? Because you know nothing about SARS, you are afraid, so you are afraid.
In 2017, all Beijing residents had actually seen a WeChat account because this was a narrative report of a case of severe influenza death. We deeply deplore the death of the patient. But, you know, in the emergency room, in our infected room, we face countless patients like this every day, all of them are the heaviest, all in my ward.
The departure of each patient is a huge blow to the family. So, when I am treating patients today, what is our only wish and harvest? We want to be able to reap the lives that may be lost. This is what I want most. But talking too much is useless. What kind of spirit do we want? In fact, in the medical consultation, we need the spirit of a craftsman. The current medical consultation is different from the previous medical consultation. IWe need to know very accurately what virus we are searching for, and then treat the virus with appropriate antiviral treatments in order to save the patient.
Back to 2013, many people in Shanghai suddenly suffered from pneumonia. My colleague took the specimen and took it for a test. It is an unknown virus. You do n’t know what the virus is. It took us more than a month for the new infectious disease laboratory of Fudan University to identify the virus.
You have no way to imagine that it was bird flu. Why is it called bird flu? It is because it only infects chickens and ducks. So how did it infect people today? Everyone remember that when we eat chicken and duck at home, we all know that chickens can get chicken fever, right? There is a virus in chicken plague that only infects chickens and ducks and does not infect humans. Therefore, as long as the word poultry is added to all viruses, it will infect chickens and ducks and will not reach people. If it arrives, what barrier does it cross?
It crosses the boundary between one species of virus. This boundary is called the species boundary. Once the species boundary is crossed, chicken viruses can infect humans.
You can see that I was interviewed by CCTV here, but most of the time, I look like this.
This is a huge victory for China after ten years of SARS. After a short period of time, our Fudan University scientists identified the virus and asked the Chinese CDC scientists to make it clear that it is bird flu. And after knowing it, formulating a plan, bird flu quickly passed away, because I knew where it came from. Once you know where it came from, give it its nest and it’s gone. This is the first point. Second, the patient survived as soon as the infected person was treated with the flu virus. Therefore, 2013 is the biggest victory for China after SARS, and it is a great review of our health system.
However, do you think why people still get H7N9 bird flu today? Because the number of people found to be infected with this bird flu is limitedYes, that is to say, a girl who is sick may infect her husband or her mother, but among the patients I have seen, most of them are infected to their family members. No more than 10%. Most of the 10% infected her mother, but did not infect her husband, so at that moment, I had doubts about love!
When you are close to a very close relationship, close care, including things he vomits, things he pulls out, and you are likely to be infected when you care for him close, generally The degree of contact can’t be infected. Therefore, its spread is called limited person-to-person transmission, and it is a very limited person-to-person transmission. For this reason, our flu has not changed its name so far. It is also called H7N9 bird flu, not flu. Then why do you say the other thing is the flu, this is not the flu?
If we go back in time to 1918, a hundred years ago, there was hell on earth, this is a hell on earth, with 50 million deaths.
This is the situation of medical workers in Europe at the time. So what’s your problem?
Before 1918, it seemed that so many things had never happened in human society. After the British Industrial Revolution, Western medicine has developed a lot. Where did the virus come from? Did it suddenly fall from the sky someday? no! So everyone is looking for it. Why are we doctors also a virus hunterWhat about hands? In 2013, we came out as a scientist, and I must mention him here, Taubenberger.
He thought of some ideas. He said it was so cold in Alaska. In the frozen soil there, among the people who died of the flu at that time, maybe the virus could be found in the remains of the dead body frozen there? We knew that the virus that was frozen there could be found, but he was really found.
When they started digging there in the summer, after he found it, he analyzed all the gene sequences and found out where the 1918 flu came from. What is the current technology? You can recover all the gene sequences, then find the trace of the virus, find where it came from, the popularity of H1N1, and figure it out today. This is the first point.
Second, all human influenza viruses today come from birds, but are n’t birds avian flu? In constant contact and life with human society, some viruses have mutated. This mutation allows it to live in humans for a long time. What is this bird flu called? It’s called seasonal flu.
So, everyone is facing a very successful virus that has evolved in the biological world. This successful virus, we call it seasonal flu, and it changes every year. What does it mean?
From this day on, the lives of everyone here have never been so quiet and good. There must be someone maintaining such a quiet and good life. For example, ourPLA soldiers are in the frontier, for example, there is us.
I tell you that this flu virus changes every year. From now on, in our world, when you look at some beautiful things, when you look at the underwater world, when you look at the sky, in fact, The virus is watching with you, so the risk of infection is always there. Then you must be thinking, what level is China today?
In our hospital, if this virus has ever appeared in the world, I will basically find it for you within a few hours, so you will see that I have so many weapons, and a sequence will come out to tell you What virus. Now it is an unknown virus. We found the virus and shattered it, and shattered it in to restore all the sequences.
This machine is a deep sequencing machine. The second-generation sequencing machine restores all the sequences, and then the big data starts to stitch. After stitching,Everyone sees a lot of things, one by one. This is a database of records. This data will tell you what virus it is.
Like this patient, when I came to my ward in 2013, I did n’t know what virus he got. When all the known virus tests were negative, we recovered all the sequences at this time. You see that the sequence is H7N9, what should I do if it is H7N9?
I should send him to the negative pressure ward immediately, and then I started to look like this again, and you can’t see me again, I rushed in and started to treat this patient, of course, we were successfully treated in the end. Why do you say that you can save success? Because I know what virus it is. Here, I once again declare that the early diagnosis of the influenza virus is extremely important. If the time is delayed, the patient’s life will be gone. If the treatment is successful one day earlier, we will have one more day. Why do you say that the flu virus is the virus that we humans have been able to treat so far, that is to say that we now have drugs to deal with.
He was very grateful at the end. When he came out, he gave a plaque. I usually do n’t hang such a plaque, but his plaque is still hanging on my ward. He wrote a sentence on it. He said, I am just a hurry in your work, and you are a turning point in my life. He said this sentence, and immediately made us feel that our work is extremely fulfilling.
The ability of doctors is very limited. The things our doctors can do are very limited. We ca n’t treat every patient successfully.Who depends on health? Health is totally on your own! Like influenza, SARS, and corona virus, these are all preventable. So how do you prevent it?
So, let me tell you a few points, and everyone will know. The biggest point is that one hundred years ago, when everyone knew that this was a spreading disease, they wore masks. That is to say, if an outbreak occurs in this city, the masks you go out are very important. The most important thing for the flu is to wash your hands. Wash your hands often to keep you healthy. Wash your hands for all respiratory infections.
I told you before, when you are sitting in this theater, the flu virus must be watching with you, but in most cases you are in contact with your hands, of course, air droplets will also spread, but When someone coughs, what do you put your face over? is not it? It can get on your hands and your clothes, so when you eat, wipe your mouth and runny nose, you start to get infected.
So when the host said they wanted to shake hands with me, I refused. I said I wouldn’t shake hands with you. What is the propaganda in the United States now?
Punch punches when meeting people (Chinese people do not shake hands) ; the last thing I need to remind everyone is the vaccine, the vaccine is very critical However, it is not mandatory. Many people have opinions on the vaccine. However, I tell you that human beings can go to this day, do you know what the average life expectancy of humans is now? The average life expectancy of the people of Shanghai is 84 years.
The largest health contribution in human society, the first is a vaccine, and the second is clean drinking water. These two are the main reasons for greatly increasing human life expectancy, and nothing else.
There are two types of vaccines, one is a mandatory type I vaccine, and the other is a type II vaccine. Influenza is a type II vaccine because it cannot prevent 100%, it can only prevent 60%. Why do you say scientists So bad? Not 100%? Because flu changes every day, and it changes every year, so the probability of my prevention is 60%, just for 60%, do you vaccinate? If you don’t get vaccinated, the first move is cero or one hudred.
So who should be vaccinated in particular?Children, the elderly, low immunity, obesity … Once obese people develop pneumonia, the mortality rate is much higher than that of non-obese people, so we should focus on vaccination.
Finally, I would like to tell you that there is flu every year. We just don’t know when the next global outbreak will happen. The virus mutates every day, and when that mutation comes out, it is a brand new time. We know that a big outbreak is coming. Therefore, the World Health Organization is making predictions every day, but every prediction is wrong. He predicts that next year will come, and next year will not come. When the bird flu came in 2013, they thought it was flu, and they didn’t.
So, let us give a word from a famous flu expert. He said that we only heard the ticking of the clock, but we never knew what time it was. That’s it. We know it will come, but we don’t know when it will come. The incident is uncertain, but the preventive measures are very certain. I hope everyone is healthy and thank you all.
Mr. Zhang Wenhong’s interactive Q & A at CC Forum on January 18, 2020
Note: The lecture time of CC Forum & People’s Advocacy Class is January 18, 2020, and the venue is Beijing. On the day of the speech, Director Zhang Wenhong flew back to Shanghai to work and continued his struggle.
This article comes from WeChat public account: CC Forum (ID: ccjt2014) , Speaker: Wenhong Zhang, Director of Department of Infectious Diseases, Huashan Hospital Affiliated to Fudan University, and leader of Shanghai Medical Treatment Expert Team