Expert: Transmission within 15 seconds is completely possible. Wang Guiqiang, director of the Department of Infectious Diseases, Peking University First Hospital, said in an interview with Xinhua News Agency that the virus is generally highly contagious, and transmission within 15 seconds is completely possible of. If there is no protection and the amount of local virus is very high, it does not depend on how long it takes. In a word, the droplets may arrive and you will be infected.
Not to mention 15 seconds, 2 seconds can also cause infection, so protection is important .
Wang Guiqiang is the director of the Department of Infectious Diseases of the First Hospital of Peking University and the chairman of the Infectious Diseases Branch of the Chinese Medical Association. During the new crown pneumonia epidemic, he was a national medical expert and was assigned by the National Health Commission to guide the treatment of critically ill patients in Anhui and other places. He also participated in the revision of the fifth version of the new crown pneumonia diagnosis and treatment program and represented the expert group. State Council press conference on joint prevention and control mechanism.
Infection within 15 seconds of exposure indicates that neo-coronary pneumonia is particularly contagious? Why do mild patients die suddenly? Why are "false negatives" frequent in nucleic acid testing? On these issues, a reporter from Xinhua News Agency interviewed Director Wang Guiqiang on February 10 and come to understand it together!
Question: The recent example of 15-second exposure caused infection with the new crown virus, does it indicate that new crown pneumonia is particularly contagious?
Wang Guiqiang: Generally speaking, the virus is relatively contagious. It is completely possible for 15 seconds to cause transmission. If there is no protection and the amount of local virus is very high, it does not depend on how long it takes. In a word, the droplets may arrive and you will be infected. Not to mention 15 seconds, 2 seconds can also cause infection, so protection is important.
Q: What is aerosol transmission and what are the specific conditions?
Wang Guiqiang: Visually speaking, aerosol is equivalent to the sunlight. You can see the small dust floating in the room, which is the feeling. Therefore, aerosol transmission is a very important mode of transmission in respiratory infectious diseases. However, there are certain conditions for aerosol transmission, which is not to say that all places where aerosol is transmitted.
The size of the environment is important, and the density of the virus per unit volume is decisive. For example, if the virus floats in the atmosphere and the outdoor environment, the probability of infection is extremely low, so we emphasize that these places generally do not cause infection in the outdoor and on the street. If in a small environment, such as the laboratory space where animal experiments are cultivated, including the space where nucleic acid testing is now performed, aerosols may float in the air, and poor protection may cause transmission.
In certain work environments, air circulation can also create transmission risks. For example, the office is not ventilated. Several people have worked in it. Although this office is no longer used and no one is there, there may still be aerosols. After entering, it may be infected without protection.
The environment inside the elevator is also high risk. In this case, it is recommended that you take good precautions. We always recommend wearing a mask in a small, unventilated area, which is itself a protective measure against aerosol transmission. Currently, this measure is effective for aerosol protection.
Q: Why are some patients critically ill, while others can heal at home?
Wang Guiqiang: The same virus infected patients, some are light, some are ordinary, and some are heavy, which is closely related to the individual's immune status. At present, patients with a higher mortality rate of new coronary pneumonia are mainly the elderly and those with underlying diseases. The reason is that the elderly are less resistant and the immune status is not so good; patients with underlying disease may worsen the underlying disease during the infection of new coronary pneumonia. For example, patients with chronic bronchitis and viral infections will develop secondary bacterial infections, and their condition will easily deteriorate.
Q: Why did someone with mild illness suddenly die?
Wang Guiqiang: Immunity is a double-edged sword. When the body's immune activation attempts to remove foreign pathogenic microorganisms, it will cause the body's own damage. If the amount of virus is large and the immunity is strong, there will be a more severe local struggle, which will cause local inflammation and cell damage, which is the so-called inflammatory factor storm. At this time, the condition may worsen. Therefore, sometimes the stronger the immunity, the more severe the disease and the faster the progress.
We mentioned in the diagnosis and treatment plan that there are conditions to do cytokine testing. If there is an obvious inflammatory factor storm and a large number of inflammatory factors are released, do not let it have an overly strong response. Drugs such as hormones and gamma globulin can be used to solve the inflammatory factor storm, or reduce inflammatory factors through blood purification and plasma exchange. . An inflammatory response after infection is inevitable. This is a normal immune process, but an excessively strong immune response will cause greater harm to the body. We hope to have some control and some suppression.
Q: What is the significance of building a "square cabin hospital" in Wuhan?
Wang Guiqiang: "Fangcai Hospital" is a very good means in the current emergency situation, mainly used for the centralized treatment of light confirmed cases. These patients do not need to be treated systematically in large hospitals and general hospitals, saving their beds for people who may become heavier, which can further reduce the mortality rate; at the same time, it can also solve the problem of lightly diagnosed cases requiring isolation and care. Some light cases may be converted into ordinary or even heavy ones. In the "square cabin hospital", it is helpful to promptly identify these patients and transfer them to the hospital in time, so it is also equivalent to a transfer station. At this stage, the "square cabin hospital" is of great significance, and has achieved the purpose of isolating patients, timely screening patients, and performing triage.
Q: What should we do in the face of a suspected case?
Wang Guiqiang: All suspected cases should be quarantined and treated at designated medical institutions. The diagnosis and treatment plan is written like this. I hope everyone will implement them. If this is not done, it will be responsible for causing the spread. Pay special attention to people from Hubei, because there is indeed a risk of transmission. This is not discrimination. From the perspective of infectious disease control, special attention must be paid to this group.
Q: Why do “false negatives” occur frequently in nucleic acid testing?
Wang Guiqiang: The first factor is the sensitivity of the detection technology, which is the detection technology itself. The first is whether the specificity and sensitivity of the detection method are good enough; the second is whether the operation process is very standardized and the specimen collection is also very knowledgeable. Therefore, in the fifth edition of the diagnosis and treatment plan, we proposed to change to a nasopharyngeal swab, which was originally just a throat swab. At present, from the perspective of infectious diseases of the respiratory tract, the detection rate of nasopharyngeal swabs is higher, including the first and second stream, which are mainly detected by nasopharyngeal swabs.
The second factor is the disease itself. Coronary pneumonia is an infectious disease of the respiratory tract. Most of the virus enters the body through the respiratory tract, so the amount of virus in the upper respiratory tract may be relatively large. After the disease progresses to a certain degree, it mainly infects the lungs, and a large number of viruses reproduce and release in the lungs, causing lung inflammation. At this time, the amount of virus in the upper respiratory tract may be less, because the respiratory mucosa itself has a certain immune state, natural immunity works, and the upper respiratory tract test may be negative. At this time, the detection rate of the lower respiratory tract specimen must be high. However, when you have just gotten sick, the lower respiratory tract may not be detected. You must wait for pneumonia, cough, and sputum, and its positive rate must be high. This is determined by the characteristics of the disease itself.
Question: What are the practical needs of the grassroots in terms of diagnosis and treatment technology?
Wang Guiqiang: Nucleic acid diagnosis is now widely used, and the supply of kits is sufficient. At the grassroots level, objectively speaking, the PCR polymerase chain reaction technology still has bottlenecks. It requires a PCR laboratory and a certain level of protection. Therefore, at the grassroots level, development may be difficult. Some patients at the grassroots level cannot perform effective nucleic acid screening, which may affect the diagnosis and treatment of the disease. Simple and easy rapid diagnosis technology is a top priority, and the Ministry of Science and Technology has set up a project to promote this work.
Q: How is the current development of antiviral drugs? Are there any specific drugs?
Wang Guiqiang: At present, there are no data on these drugs, and the case report can't draw conclusions. It can only be said that they see better signs, including Redecive and Cleeve. The fifth edition of the diagnosis and treatment plan still says that there are no exact antiviral treatment drugs at present. The drugs that can be applied are interferon spray and clitoris. There are still many drugs under study, such as Abidol, these are being researched and explored. There is no conclusion yet.
Q: How will the peak of the return trip affect the epidemic?
Wang Guiqiang: There may be a small fluctuation in the epidemic at the peak of the return trip. Some cases are not well screened. He may have been infected and become a hidden source of infection, but this part of the population is small. Although there may be a change in the epidemic situation after the peak of the return trip, or it may fluctuate or increase, if the prevention and control is not relaxed, the epidemic peak will not occur.
Q: After you return to work, what issues should you pay attention to when eating?
Wang Guiqiang: No one can say that takeaway is 100% safe, but overall the probability of causing disease transmission is very low. However, special attention should also be paid. It is recommended not to take it out at home when taking out food. Wear a mask and go outside to take it out. Throw the packaging directly into the trash can and do not bring it back to the room. After entering the house, wash your hands, then take the meals inside, and then wash your hands and eat.
Try to keep your distance when you eat, and do n’t want a group of people to eat and chat in the house. It's best to eat your own, don't talk, and finish eating quickly. Because you must take off your mask when eating, be sure to keep a distance of more than one meter.
Q: When will the inflection point of the epidemic arrive?
Wang Guiqiang: The turning point of the epidemic needs to be viewed from two aspects. On the one hand, whether the patient mobility in Wuhan and Hubei is well controlled is the first. On the other hand, patients in other provinces are not effectively diagnosed and isolated in time. If both are well done, I think we will soon see the so-called inflection point. At present, the overall incidence has a downward trend, and the increase is not so great, but it cannot be said that the inflection point has come. It can be said that this is a good phenomenon, indicating that prevention and control efforts in various places are increasing.
Question: How to understand the significance of medical personnel from all over the country helping Hubei?
Wang Guiqiang: It is incumbent on doctors to rush on the front line in the face of the epidemic. There is no reason to shirk it, especially for infection doctors. I would like to take this opportunity to express my gratitude to my colleagues in the National Infectious Diseases Department, and hope that you will protect yourself. (Source: Xinhua News Agency)
(Article source: China Business News)
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