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Hits:Updated:2022-11-18 08:11:27【Print】
Under the joint prevention and control mechanism of The State Council, the Circular on Further optimizing COVID-19 prevention and control measures in a scientific and precise manner was released on Thursday. So what is the background to the announcement? How do we understand these 20 optimization measures, and how do we implement them? Talk in Focus invited relevant people to give a detailed explanation. On November 11, the joint prevention and control mechanism of The State Council released 20 measures to further optimize the prevention and control work, including quarantine and transport, nucleic acid testing, personnel flow, medical services, vaccination, service support enterprises and campuses, and the relocation of stranded personnel. 
He Qinghua, first Inspector of the Department of Infectious Disease Prevention and Control of the National CDC: "Since the outbreak of the epidemic, we have continued to follow up the development of the global epidemic situation, the virus mutation and its epidemiological characteristics, combined with the assessment of the implementation of the ninth edition of the prevention and control program, through repeated in-depth research and demonstration by experts, proposed 20 optimized policy measures and measures. "The optimized prevention and control policies and measures can effectively address the bottlenecks and difficulties in the handling of the epidemic in various regions, such as insufficient isolation resources, insufficient sampling and testing capacity. Limited resources should be allocated to people and areas at high risk of transmission."
 At present, the novel coronavirus continues to mutate, the global epidemic is still in epidemic status, and new outbreaks continue to emerge in China. China has a large population, a large number of vulnerable people, uneven regional development, and insufficient medical resources. In some regions, the epidemic is still on a certain scale. Due to virus mutation and winter and spring weather factors, the scope and scale of the epidemic may further expand, and the prevention and control situation remains grim. The introduction of the 20 measures to optimize the prevention and control work does not mean to relax the epidemic prevention and control, still less lie down, but to further improve the scientific and precise prevention and control, is a specific practice of scientific and precise prevention and control.  He Qinghua, first grade Inspector, Department of Infectious Disease Prevention and Control, National CDC: "The 20 optimization measures do not mean relaxing the overall strategy of 'preventing import from outside and preventing rebound from inside', nor does the general policy of 'dynamic zeroing' change. Instead, they require higher standards, stricter standards, more precise, scientific, more rapid and effective prevention and control measures, and control the epidemic within the minimum range at the minimum cost and in the shortest time. We should minimize the impact of the epidemic on economic and social development and protect people's lives and health to the greatest extent possible." 
The 20 optimization measures are more scientific and precise, which are highlighted in the adjustment of management measures for people involved in the epidemic.
According to the optimization measures, the management measures for close contacts should be changed from "7+3" to "5+3", that is, from "7 days of centralized isolation and 3 days of home health monitoring" to "5 days of centralized isolation and 3 days of home isolation". Expert introduction, this is based on the results of scientific research. The study found that the maximum incubation period of the Omicron variant has been shortened to about eight days, and the possibility of detection of positive within five days is very high.
 Wang Liping, a researcher with the Communication and Prevention Division of the Chinese Center for Disease Control and Prevention, said, "According to our pilot evaluation study in 31 provinces, for close contact tracing, the incidence of positive exposure reached 94.5% within five days after the last exposure, and nearly 99.7% within seven days. Therefore, 7 days of centralized isolation was adjusted to 5 days of centralized isolation and 3 days of home isolation, and 3 days of home isolation was used to contain subsequent risks. This adjustment can save nearly 30 percent of centralized isolation resources. It can manage risks while reducing the occupation of centralized and isolated resources." 
For the close contact, that is, the secondary close contact personnel, the twenty optimization measures clearly require no decision.
Wang Liping, a researcher from the Communication and Prevention Division of the Chinese Center for Disease Control and Prevention, said, "We found that in the evaluation process of the pilot for more than a month, after the judgment of the close contact, the subsequent positive rate is very low, is 3.1 per 100,000, that is, 100,000 people, there may be three people positive, so the efficiency is relatively low. As long as limited epidemic prevention resources and timely detection and control of close contacts are implemented, it is more likely that the detection rate of secondary close contacts will be reduced. Therefore, it is the lesser of two evils.
High risk area spillover refers to the person who leaves the risk area before determining the high risk area. According to the evaluation results of the pilot, the risk of the spill in the high-risk area is low, so the control measures have been adjusted accordingly. The "7-day centralized quarantine" for the spill in the high-risk area has been adjusted to "7-day home quarantine", during which the code management is assigned and no one is allowed to go out.
Wang Liping, A researcher from the Communication and Prevention Division of China CDC, said, "If A high-risk area is designated in A, the personnel in the high-risk area should be sealed off. However, for the high-risk personnel who flow to B before the high-risk area is designated in A, they should be quarantined at home for 7 days after being tracked down at B."
Reporter: "When does this seven-day home quarantine start?"
Wang Liping, Researcher of the Communication and Prevention Division of China CDC: "According to the ninth version of the prevention and control plan, the control period of the overflow personnel in the high-risk area is calculated from the time when they leave the high-risk area, that is, the time when they leave place A. If the control period of place B has exceeded in the process of screening, in principle, there is no need to carry out quarantine control anymore."
In the ninth edition of the prevention and control plan, the risk is divided into three types: high, medium and low. In the twenty optimization measures, the decision of medium risk area was cancelled.
Wang Liping, a researcher with the Communication and Prevention Division of the China Center for Disease Control and Prevention, said, "We found that some areas of the medium-risk area are very inaccurate and very large. After the whole intermediate risk division, positive is also 3 in 100,000, the risk is actually very low. In order to minimize the number of controlled areas and personnel, the designation of medium-risk areas was cancelled."
For high-risk areas, the optimization measures narrowed the delineation scope to generally be defined by units and buildings, stressing that it should not be expanded at will. No new infections were found in the high-risk area for five consecutive days, and the risk was reduced to a low-risk area. High risk areas that meet the conditions for unsealing should be unsealed in time.
 Wang Liping, Researcher of the Communication and Prevention Division of China CDC: "To make such an adjustment is to delineate the risk area in a scientific and accurate way as far as possible, to avoid large-scale control of people's travel. This optimization actually puts forward higher requirements for professional technology of work. It is not a relaxation, but requires more accurate research and judgment of flow and risk areas, which can not only control the risks that need to be controlled, but also implement measures, such as high risk areas. Community control must be in place, and containment is absolutely impossible. Measures to be implemented should be implemented, and adjustments should be made, so as to coordinate epidemic prevention and control with economic and social development as much as possible."  What will nucleic acids do in the future? The optimization measures once again emphasized the principle of nucleic acid testing: in areas without epidemic outbreaks, nucleic acid testing should be carried out for high-risk positions and key personnel in strict accordance with the scope determined in the ninth edition of the prevention and control plan, and the scope of nucleic acid testing should not be expanded. Generally, nucleic acid testing of all personnel is not carried out according to administrative region, but only when the source of infection and transmission chain are unclear, and the community transmission time is long and the epidemic situation is unclear.  Wang Liping, Researcher of the Communication and Prevention Division of China CDC: "Once the local epidemic occurs, when to carry out regional nucleic acid testing is also clearly proposed in the ninth edition of prevention and control plan. When the epidemic occurs, based on the flow investigation and determination, it is clear that the transmission chain is clear and there is no community transmission. At this time, there is no need to carry out nucleic acid testing for all personnel in the region. Nucleic acid testing should be carried out according to the flow investigation, and rapid outbreak management should be carried out. The core of the whole strategy is to conduct comprehensive risk assessment through regional nucleic acid detection based on fast flow modulation. Article 6 of the 20-point optimization measures specifically emphasizes that areas without epidemic outbreaks should strictly follow the scope determined by the ninth version of the prevention and control plan, and nucleic acid testing should be carried out for high-risk positions and key personnel, and the scope of nucleic acid testing should not be expanded. These two requirements are completely consistent." 
In terms of preventing foreign imports, the optimization measures have also been adjusted accordingly, such as canceling the circuit breaker mechanism for inbound flights; Reduce the number of negative nucleic acid certificates from 2 to 1 within 48 hours before boarding. It is clear that the Ct value of nucleic acid detection is <35; "7 days of centralized quarantine +3 days of home health monitoring" is adjusted to "5 days of centralized quarantine +3 days of home quarantine", with code management and no going out during the period.
Wang Liping, a researcher from the Communication and Prevention Division of China CDC: "The situation of the international epidemic, the situation of the virus mutation, and the data from the evaluation of the control measures for entry personnel are more about the overall coordination of China's epidemic prevention and control with international exchanges and the facilitation of personnel exchanges. From these perspectives, the control and control of entry personnel and nucleic acid testing have been optimized and adjusted in the 20 optimization measures. The incubation period of the virus is shortened, and the five-plus-three risk is still manageable, because those three days are also home quarantined."
The 20-point measures to optimize prevention and control also set out detailed regulations on the construction of medical resources, guarantee of life services, epidemic prevention and control in key units, vaccination, drug storage, and evacuation of stranded personnel. Experts pointed out that the 20 measures to optimize prevention and control are the optimization and improvement of the ninth version of the prevention and control program. For those not mentioned in the 20 measures, it is still necessary to strictly follow the ninth version of the prevention and control program.
Wang Liping, Researcher of the Communication and Prevention Division of China CDC: "For example, the time and space accompanying is actually explained in the ninth edition of the prevention and control program. He is an exposed person in the pestilence site. For this type of person, it is not mentioned in the Article 20, and the ninth edition of the prevention and control program is still implemented. Requirements for home quarantine and home health monitoring are being ramped up everywhere."
Experts stress again that no matter what kind of control method, the control time is calculated from the time of the last exposure of personnel.
Wang Liping, a researcher from the Communication and Prevention Division of China CDC, said, "For the time of control, the starting time should be based on the time judged to be the last exposure, rather than the time traced to the close contact, which is clear in the ninth version of the prevention and control program."
The COVID-19 epidemic is a big test, which requires strategic focus and scientific and precise prevention and control work. Only by fully, accurately and comprehensively implementing the decisions and arrangements of the CPC Central Committee and ensuring that the 20 optimization measures are fully implemented can we win the test. In this regard, we need to oppose irresponsible attitudes that cannot be implemented properly and lead to increased risks of prevention and control. At the same time, we need to oppose and overcome formalism and bureaucracy, and put an end to the practice of adding layers to layers and applying a one-size-fits-all approach.
National Bureau for Disease Control and Prevention of infectious disease prevention and control Department of a inspector He Qinghua: "Currently from the central to the local has established the regulation layer by layer work class, daily dispatch timely to solve the problem of the masses to respond to the concerns of the masses, as far as possible to prevent and put an end to 'one size fits all' and layer by layer, affecting the production and life of the masses, affecting economic and social development."
To meet these challenges, we need to fully, accurately and comprehensively implement the decisions and arrangements of the CPC Central Committee and ensure that the 20 optimization measures are fully implemented. To protect people's lives and health, and minimize the impact of the epidemic on economic and social development. This has raised higher requirements for the epidemic prevention and control work, and requires all local governments and departments to strengthen their responsibility, strengthen their ability to fight against the epidemic, safeguard the soil and fulfill their duties, go to the grassroots and the front lines of the epidemic prevention and control work, strengthen ideological guidance and psychological counseling, and resolutely win the battle against the epidemic on a regular basis.
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