Zhong Nanshan: Optimistically speaking, we can return to the pre-epidemic state in the first half of next year

At present, my country's epidemic prevention and control is facing new situations and new tasks. On December 9, Zhong Nanshan, winner of the Medal of the Republic and academician of the Chinese Academy of Engineering, and two members of his team - Li Yimin, secretary of the Party Committee and chief physician of the Department of Critical Care Medicine of the First Affiliated Hospital of Guangzhou Medical University, and Professor Yang Zifeng, deputy director of the Guangzhou Institute of Respiratory Health, were interviewed by reporters in Guangzhou.

During the interview, Zhong Nanshan answered hot topics such as the pathogenicity and evolutionary trends of the virus, the safety and effectiveness of vaccination, the sequelae of the new crown, and when the peak of infection will come.

Zhong Nanshan said that the current prevention focus should shift from preventing infection to preventing severe illness, and strengthening COVID-19 vaccination is the key next step. According to the team's model calculation, it is expected that the peak of the first wave of infection in Guangzhou may arrive in mid-to-early January to mid-February next year, and enter a stable stage in mid-to-early March. It is optimistically estimated that life can return to the pre-epidemic state in the first half of next year .

The following are nine judgments made by Zhong Nanshan and his team experts in an interview.

1. 99% of infections are not severe

Zhong Nanshan said that looking back at the three years of the COVID-19 outbreak, before the emergence of the Omicron strain, the cumulative number of COVID-19 infections in my country was about 100,000, with a case fatality rate (number of deaths/confirmed cases) of 4.65%. After Omicron entered China, especially since September, through analysis of relevant data from major cities such as Guangzhou and Chengdu, it was found that the current severe illness rate is less than 1% and the case fatality rate is less than 0.1%, which shows that the pathogenicity of Omicron has significantly decreased.

"After being infected with Omicron, 99% of cases are not severe." Zhong Nanshan said that most people can get better within 5-7 days. "Don't be afraid of getting the new coronavirus, and don't discriminate against those infected."

2. Asymptomatic infection is not a disease

Are asymptomatic people considered to be sick? Zhong Nanshan believes that "from a medical point of view, if there are no symptoms of an acute infectious disease, it should not be considered a disease." In addition, he believes that in the future, the new coronavirus infection may be defined as a new coronavirus upper respiratory tract infection.

3. The probability of the virus evolving to a weaker virulence is high

Zhong Nanshan said that he had discussed with pathogen experts, and they believed that the future evolution trend of the new coronavirus would most likely weaken its virulence. "No one said it would definitely weaken, but we must follow the most general rules to think about problems and make decisions." He added that taking the XBB.1 subtype variant strain currently prevalent in Singapore as an example, it is more contagious but less pathogenic, and its mortality rate is 62% of that of ordinary seasonal influenza.

4. Omicron rarely causes pneumonia, and severe cases are not life-threatening

Li Yimin said that in this round of Guangzhou epidemic, the proportion of critically ill patients truly caused by the new coronavirus is not high, and it is mainly manifested in the aggravation of underlying diseases. Pneumonia caused by Omicron infection is currently very rare.

Li Yimin said that severe cases of COVID-19 refer to those who need oxygen or intensive observation, which is different from the common understanding of "seriously ill" or even "critically ill". "Severe and critical cases may be life-threatening, but we will take active measures to reduce the risk of patients turning from ordinary or severe cases to critical cases."

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5. Domestic vaccines are no different from imported vaccines in preventing severe illness

Zhong Nanshan said that except for those who have undergone organ transplant surgery and suffer from severe rheumatism, heart failure, tumors and other diseases, even the elderly with underlying diseases in a stable period can be vaccinated.

Zhong Nanshan believes that compared with imported vaccines, although domestic vaccines are slightly less effective in preventing infection, they have fewer side effects and better safety. Moreover, studies have shown that after three doses of vaccines, the effectiveness of preventing severe illness is similar, both in terms of laboratory indicators and real-world data. "For the elderly, the most important thing is not to get seriously ill. Vaccination, especially full vaccination (including booster shots), has a good protective effect on preventing severe illness in the elderly."

6. Aftereffects are more of a subjective feeling

Zhong Nanshan said that in medicine, there is a strict definition of sequelae, which refers to the lifelong damage caused by the disease. For example, even if polio is cured, there will be polio. Now some so-called sequelae of COVID-19 are more of a subjective feeling, such as general fatigue and brain fog, which are mainly caused by mental and psychological effects. He pointed out, "We can't call it a sequelae. So far, we have not seen any cases of COVID-19 causing long-term organ dysfunction that is particularly obvious."

7. It is expected that life will return to pre-epidemic conditions in the first half of next year

Yang Zifeng, a member of Zhong Nanshan's team, said that based on the characteristics of the Omicron variant and the current status of vaccination in my country, and with reference to the situation in Hong Kong and Japan, the peak of infection in Guangzhou may arrive in mid-to-early January to mid-February next year. "As we take a series of non-drug intervention and pressure peak measures, it is expected to enter a stable stage in mid-to-early March."

"Someone just asked me, when can we return to the state before 2019? My opinion is that it will be in the first half of next year, after March. I can't guarantee it, but judging from the trend, it should be around this time," said Zhong Nanshan.

8. Don’t believe there will be a mass death toll

Some people have previously estimated that hundreds of thousands of people may have died nationwide based on the death rate of the Hong Kong epidemic. Zhong Nanshan believes that this assumption is inappropriate and "I don't believe this will happen."

Zhong Nanshan analyzed that when the epidemic broke out in Hong Kong this year, the full vaccination rate of people over 60 years old was no more than 20%, but now the vaccination situation in the mainland is much better than that in Hong Kong May ago. As of December 8, the booster vaccination rate for people over 60 years old has reached 68.86%, "although it is still not enough, it is much better than that in Hong Kong at that time."

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9. Repeated infection is unlikely to occur for a period of time

Academician Zhong Nanshan and his team conducted a study on 158 local patients infected with the Delta strain and 679 imported patients admitted to Guangzhou Medical University in 2021. The study showed that patients infected with the new coronavirus who had recovered from the virus had no risk of infection and their clinical symptoms did not worsen, so they did not need to be hospitalized.

Zhong Nanshan introduced that the research in Qatar showed that after being infected with Omicron, 78% of people will not be infected with Omicron again for a considerable period of time, regardless of whether they have symptoms or not. At the same time, a study conducted in Denmark with a sample size of tens of thousands of people showed that as long as people have been infected with Omicron once, 98% of people can avoid being infected with Omicron a second time. "In this sense, getting Omicron is equivalent to getting a vaccine," Zhong Nanshan emphasized, "Of course, this does not encourage everyone to get infected with Omicron."

Source: Nan Fang Daily, Nan Fang + Client

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