Article is from WeChat public account: CC Weekly (ID: cancer-weekly) , author: Zhang Jiao (MD Anderson cancer Center tenured professor)
New coronavirus infection is about to spread globally?
Please let scientific research take a step!
Since the recognition of “people-to-people” on January 20, the closure of Wuhan on the 23rd, and the WHO ’s announcement of a global public health emergency on the 30th, there were nearly 15,000 new cases and the death toll in Hubei on the 12th Up to 242 people, the infection and spread of the new coronavirus covid-19 has affected the hearts of hundreds of millions of people, and it has aroused global attention!
The frontline medical staff in China is so devoted to their lives that they can sing and cry, which has moved the land of China! And the “foreign mountains and rivers, the wind and the moon are the same day; the neighborly Japan, which means no clothes, and with the same clothes”, this time of generous donations and unity, let us appreciate the warmth of the same global village!
However, just as the epidemic situation outside Hubei gradually eased and the number of new cases and deaths in Hubei entered the peak platform period, Japan ’s Minister of Health, Labour and Welfare Kato Katsuyuki said at a press conference on the 15th that the epidemic situation “has changed” Pneumonia has actually begun to spread in Japan.
To date, of the 413 confirmed cases in Japan so far, 355 are Diamond Princess and 58 are domestic. (Japanese newPneumonia real-time query website: http://t.cn/A6hIFi52) . Based on approximately 3,000 Diamond Princess visitors, the infection rate exceeded 10%! Moreover, Japan has obvious signs of community infection, and many patients have neither visited China nor directly contacted people who have recently visited China.
At the same time, patient deaths are beginning to occur in the Philippines, Japan and France.
February 13th, The United States CDC warned that “this virus will probably not disappear in this season, and it may last a whole year or even until next year. I think it will sooner or later be based in the United States and based on the community Spread. “ During the same period, the US Department of Defense warned the military system to prepare for global spread. For a while, everything was in the East and the West!
However, the more urgent the need, the more the guidance and implementation of scientific research is needed, and global cooperation becomes very important. Therefore, the development of new drugs and vaccines is urgent, but far water cannot save near fire. At this juncture, the countries with the highest risk of overseas epidemics need to be identified early. What is the pressure of prevention and control? Where is the breaking point? When does it happen? How to deal with the world and China?
Infectious diseases are a global problem. If China controls it, other countries around the world will start to spread. The epidemic is only a move from one country to another. There is no substantial change. Countries in the world will still be in the current state of traffic interruption. . In terms of prevention and control of global infectious diseases, China should not only be absent, but also bear its own responsibility.
On February 17th, the WHO Epidemic and Infectious Diseases Expert Group has launched investigation and research in China. This is a good opportunity for international cooperation, and we hope to make full use of it! At the same time, China is also given the opportunity to receive support and learning in this disease control, but more importantly, it can fully summarize the clinical treatment experience in the current anti-epidemic, and the gains and losses in clinical application of drug trials. Virus experts have conducted comprehensive exchanges, so that the epidemic situation in China can be resolved as soon as possible, and at the same time, experience can be taken as soon as possible.Share it with epidemic prevention experts around the world, especially our neighbor Japan.
How do we work with countries around the world to prevent new coronary pneumonia?
1. China is at the forefront of the epidemic, including Japan, Singapore, and the United States. Most of them are imported pneumonia.
Even in the hardest hit area of Japan, imported pneumonia is the main cause. First-line doctors and researchers in China have treated thousands of patients with new coronary pneumonia, and first-line medical staff and virologists in China have published more than 50 papers on world-class magazines on new coronary pneumonia. Coupled with the government’s front-line mobilization capabilities, and its performance in major epidemic areas such as the isolation and management of tens of millions of large cities, it can serve as a comprehensive and effective reference for medical personnel in countries in the event of an outbreak.
Tokyo, Japan and Wuhan are similar. This time’s effective isolation, management, experience in medical treatment, lack of medical treatment, and effective achievements are direct examples that can be used for reference in the field.
2. COVID-19 The fatal severity of third-generation and above infections: it has been confirmed that it has the ability to transmit three and four generations of infection, and the possibility of global spread Already mentioned on the agenda.
But will the severity of the disease in these offspring be significantly reduced? What is the proportion of severe cases? In provinces and cities outside Hubei, China, the case fatality rate of COVID-19 is slightly over 0.5%. (Similar to previous severe case fatality rates) . And Hubei is as high as 3% (the first NEJM JanThe 2020 report is a 15% fatality rate for hospitalized patients) . In addition to the exhaustion of medical resources and other factors, whether the second- and third-generation infections have significantly reduced the severity of the disease (fatality 6 times?) < / span>? If the pathogenicity of the multi-generation transmission is similar to that of the flu, then it is only necessary to take measures to isolate patients and strengthen personal hygiene habits without stopping work, closing the city, and closing the community.
Research and analysis of the epidemiological analysis of more than 60,000 cases in China. It is crucial to guide China and the world’s anti-virus operations and economic recovery!
3. The infection rate of Japan Diamond Cruises is so high (nearly 10%), indicating that the virus is potentially infectious, especially in asymptomatic patients Contagious.
Analyzing these unique and closely related community transmission routes will help determine whether the virus has other modes of transmission in addition to direct direct contact, such as long-distance air, food, and physiological / life fecal infections. This information is essential to further control the infection!
The most important thing is that in China and internationally, especially those with the closest transportation links to China’s main ports, emergency plans should be prepared, including ensuring the supply chain of medicines, personal protective equipment, and hospital supplies Security, and the human resources necessary to respond to a global outbreak of this size.
4. China should step up its efforts to organize scientific researchers to analyze the viral gene maps of new cases and their pathogenicity, and to explore the degree of viral gene mutations and their Pathogenicity.
Understand and predict the development of disease at the molecular level, and provide the most direct evidence for the development of drugs and vaccines. Expansion of autopsy identification, analysis of virus pathogenicity and patient death, which will significantly improve the method for rescue of critically ill patientsValidation and strengthening to further reduce mortality.
According to the above research results, scientifically remove some of the unnecessary isolation measures that are currently unnecessary, and gradually restore the hospital’s diagnosis and treatment of other major diseases, including cardiovascular disease and cancer. Planned and step-by-step restoration of industrial and agricultural production. In each region and in urban and rural areas, scientific and rational formulation of prevention and control measures suitable for the region will reduce unnecessary panic and economic losses.
These are actually excellent ways to prevent and control pneumonia outside of experience. These are not only China’s urgent needs and valuable academic wealth, but also important results for the prevention and treatment of pneumonia that can be shared with other countries.
5. The help of Japanese society to China’s epidemic has warmed the hearts of the Chinese people.
This move shows a new Japanese image beyond the description of the media for more than ten years. For the first time, thanks to the Japanese government and the public have appeared in the media and official media. Although the media speculates that Japan is helping China this time, in addition to the good side of folk civilization, there are also concerns about whether the Olympic Games will be affected. Helping China is helping itself. But now the world is worried about Japan. As recipients, we should do our best to help Japan through the difficulties while helping ourselves.
At present, in addition to the private voluntary donations to Japan for masks and other materials, the government should establish an information channel on disease control in China and Japan as soon as possible, and update the latest information on various treatments, protections, and drugs as soon as possible. shared. At a certain time, after the Chinese epidemic is under control, an experienced ambulance team can be established to go to Japan to exchange front-line treatment experience.
6. China should establish a global, coordinated and coordinated cooperation mechanism and response method.
In this global epidemic prevention and control, China should seize the opportunity to establish a global coordinated cooperation mechanism and response method. And it is an effective response to the next pandemic except this time. This requires Chinese disease control scientists to find Chinese methods and models in the effective detection system and global response system in this cooperation.
Why do I propose the inflection point theory and CT diagnosis and treatment standards in mid-late February?
As the saying goes, knowing oneself and knowing oneself will never end in battle! The virus sounds scary, but as long as we figure out what it doesMechanism and way of transmission, we can live together with the virus without affecting each other. In fact, some modified viruses have completely removed their disease-causing genes and made it truly “human-to-human”. Humans can also use the “good” genes for treating diseases, such as anti-cancer genes. The virus is transferred to cancer patients, so-called cancer gene therapy.
In 1990, I came to the No. 1 MD Anderson Cancer Center in the United States. For gene therapy, new one-time-infected retroviruses and adenoviruses carrying anti-cancer genes were recombined in the laboratory. He obtained a doctorate degree and participated in the gene therapy of the first human clinical patient, and obtained several patents. We have been doing research and development in this area for more than ten years. Therefore, I hope that the public can treat the virus and its possible diseases objectively.
According to the characteristics of virus infection, the prediction of human epidemics, and the principles of prevention and control of infectious diseases, as early as mid-January, in order to prevent microinvasion, I publicly appealed that the new type of coronavirus should be treated as “human to human”. After the city was closed in Wuhan, I was on the Fenghuang website and CC Weekly ’s “alert” virus. The real climb of the virus should be the 15th day of the first month. Afterwards. ”Then, in response to the urgent needs of frontline doctors in China, I once again explained the necessity and limits of the clinical diagnosis of new coronary pneumonia using chest CT in Fenghuang.com, the New York Times, and the CC Weekly WeChat account. < / p>
In late January, based on the information at the time, I predicted that humans ’active intervention and prevention and control measures determined the specific time of the” inflection point “of the disease, and proposed two possibilities:
1. Good possibility: the inflection point of new cases and deaths across the country occurred in mid-to-late February.
2. Possibility of a bad situation: the country broke out at the end of February and spread across the world. The “inflection point” will be postponed to the end of March.
Most of my forward-looking judgments have been confirmed.
The enemy now, let scientific research take a step! Not just to publish papers, but to save sentient beings!
Article from WeChat public account: CC Weekly (ID: cancer-weekly) author: Zhang Jiao (MD Anderson cancer Center tenured professor)