Zhang Boli: Western medicine believes that infected people are asymptomatic, but traditional Chinese medicine believes that...

According to Shangguan News, the reporter asked: This round of epidemic has been going on for a while. What analysis do experts have on the path and characteristics of the virus transmission? Although the number of infected people is still high recently, they are basically found in isolation and control. Can you analyze it?

Sun Xiaodong, deputy director of the Shanghai Municipal Center for Disease Control and Prevention, introduced that as of now, the results of viral gene sequencing of the Municipal Center for Disease Control and Prevention show that the vast majority of the new coronaviruses that have caused this round of local epidemics are Omicron ba.2 and ba.2.2 types. The occurrence and development of this wave of epidemics are also completely in line with the characteristics of the Omicron variant that humans have mastered. This is also basically consistent with the characteristics of the epidemics caused by the Omicron variant in other regions at home and abroad.

1. Fast transmission speed: This is closely related to the short incubation period of infection caused by the Omicron variant, with an average incubation period of 3-4 days. If it is not discovered, it can be transmitted 2-3 generations within a week, especially in the early stages. The epidemic in Shanghai began at the end of February, and by mid-March, the cumulative number of cases exceeded 1,000, which took about half a month; but by late March, the cumulative number of cases exceeded 10,000, which increased tenfold, and it only took about 10 days; by early April, the cumulative number of cases exceeded 100,000, which increased tenfold again, and it only took about 10 days; that is to say, in the early stages of this round of epidemic, the epidemic was increasing at a geometric rate, and it took a very short time. As of April 24, the cumulative number had exceeded 500,000.

2. Strong transmission ability: Domestic and foreign studies have shown that the transmission ability of the Omicron variant is greater than that of influenza and other previous variants of the new coronavirus. Without protective measures, one person can infect an average of 9.5 people. This typical feature is present in the clustered epidemics that have occurred in some densely populated workplaces in the city where people are likely to gather.

3. Strong concealment: In particular, the proportion of asymptomatic infections is high. In the epidemic in this city, the proportion of asymptomatic infections has reached about 90%. Taking the data released in the past 10 days as an example, the high is 93% and the low is 85%. Even for symptomatic cases, the symptoms are relatively mild, mainly runny nose, sneezing, sore throat, etc. Patients often mistakenly think that this is a common cold or seasonal flu, and fail to seek medical treatment in time. This will also greatly reduce the number of cases that medical institutions can detect in time in the early stages of the epidemic, and even the epidemic will be discovered after a long time, which is easy to cause hidden transmission.

In summary, it is precisely because of the characteristics of the Omicron variant itself that in the early stages of this round of epidemic, when we discovered positive infections, the epidemic had actually spread covertly within a certain range, and then further spread rapidly through wholesale markets, vegetable markets, collective units and other places where people gathered, until it further caused widespread transmission in the community in a relatively short period of time, leading to the current epidemic situation.

At the press conference, Sun Xiaodong introduced that although the epidemic is currently running at a high level, it has shown a certain downward trend. Judging from the figures announced today, the absolute number has dropped by more than 2,000 compared with yesterday, and the proportion has basically reached about 13%. This is also the largest decline since the epidemic began to show a downward trend recently. Moreover, more than 90% of the positive infections were found during the lockdown and in centralized isolation points. However, the epidemic is still at a certain high level and is in a fluctuating state.

At present, the epidemic situation in Shanghai remains severe and complicated. In this round of epidemic prevention and control, Shanghai insists on combining traditional Chinese and Western medicine, and using both Chinese and Western medicine, giving full play to the unique advantages of traditional Chinese medicine in fighting the new crown pneumonia epidemic.

How is the effect of traditional Chinese medicine in treating patients? How can we better treat elderly infected patients and improve the ability to treat severe and critical patients? The reporter interviewed Zhang Boli, an academician of the Chinese Academy of Engineering and honorary president of Tianjin University of Traditional Chinese Medicine in Shanghai.

Traditional Chinese medicine intervention has good efficacy in asymptomatic and mildly infected patients

"From the perspective of traditional Chinese medicine, the core etiology and pathogenesis of the Omicron variant have not changed significantly compared with previous strains, and it still belongs to the category of 'epidemic' diseases in traditional Chinese medicine." Zhang Boli analyzed that the cause of the Omicron variant is the plague, and the symptoms of the infected people in Shanghai are dampness, toxins and wind-heat. The large number of asymptomatic infections and the high proportion are the obvious characteristics of this round of epidemic in Shanghai. On the one hand, this is related to the characteristics of the Omicron variant itself, its toxicity is relatively weakened, and the clinical symptoms are relatively mild; on the other hand, it is related to my country's timely screening, early detection of infections and widespread vaccination of new coronavirus vaccines.

"For asymptomatic infections, Western medicine believes that they are asymptomatic, while traditional Chinese medicine believes that they have symptoms." Zhang Boli analyzed that, for example, some asymptomatic infections may have symptoms of traditional Chinese medicine such as fatigue, greasy tongue coating, and abdominal distension. According to the principles of the "Diagnosis and Treatment Plan for New Coronavirus Pneumonia (Trial Ninth Edition)", "three prescriptions and three medicines" are used, plus the agreed prescriptions and medicines formulated by Shanghai for treatment. From the previous use, after the use of traditional Chinese medicine intervention for asymptomatic and mild infections, it has shown good efficacy in preventing the progression of the disease and accelerating the conversion of nucleic acid test results to negative.

Try to prevent the progression of infection in elderly people

"At present, 30% of hospitalized cases are elderly people over 60 years old. Most of the elderly suffer from underlying diseases, including hypertension, diabetes, coronary heart disease, advanced tumors, etc." Zhang Boli said that underlying diseases combined with new coronary pneumonia will lead to serious illness, which can easily turn into severe or critical illness, and requires special attention.

"The first principle of treating elderly infected people is to take both new and old diseases into consideration." Zhang Boli believes that it is not difficult to treat COVID-19 alone, but it is more difficult to treat when it is mixed with unstable underlying diseases. Therefore, while treating COVID-19, more attention should be paid to the treatment of underlying diseases.

"The second principle is to 'strengthen the body's resistance and eliminate the evil'." Zhang Boli analyzed that the elderly often have underlying diseases such as insufficient vital energy, organ deficiency, and poor blood circulation. After being infected with the new coronavirus, their conditions are prone to rapidly worsen and they need focused treatment.

During treatment, emphasis should be placed on "strengthening the body's health" and protecting "positive energy", using methods such as invigorating qi and activating blood circulation, invigorating qi and nourishing yin, etc.; in eliminating evil, emphasis should be placed on "clearing" and "unblocking", and prescriptions such as clearing heat and detoxifying, activating blood circulation and removing blood stasis can be used.

"The third principle is to move the treatment threshold forward, treat the symptoms first, and cut off the disease." Zhang Boli believes that it is a process for the infected to develop symptoms, which requires early intervention. For example, in clinical practice, although some elderly infected people seem to be ordinary, when they have symptoms such as persistent fever, confusion, sticky phlegm that is difficult to cough up, and unabsorbed pulmonary exudate, they should seize the time to treat.

Improve the ability to treat severe and critically ill patients

Currently, the number of severe and critical cases in Shanghai has begun to increase, and the treatment capacity of traditional Chinese medicine has also increased accordingly.

Zhang Boli introduced that Shanghai has organized famous Shanghai Chinese medicine practitioners and Qiyan scholars with rich experience in infectious disease treatment to form a multidisciplinary Chinese medicine expert group together with the national Chinese medicine expert group. They hold consultations and discussions on critical cases in designated hospitals in the city and districts at a fixed time every night, and fully participate in joint ward rounds and consultations by city-level Chinese and Western medicine experts.

"When treating severe and critical patients, the first thing to emphasize is multidisciplinary cooperation." Zhang Boli believes that disciplines such as critical care medicine, respiratory medicine, nutritional support, nursing, and traditional Chinese medicine should play their respective advantages, work together, and combine Chinese and Western medicine to control the disease, reverse the condition, and reduce the mortality rate.

Zhang Boli analyzed that Chinese medicine adopts a dialectical approach and targeted treatment strategies for the most dangerous factors of each case at the moment based on factors such as the underlying disease. Specifically, it is "early" and "accurate". Early detection, early warning, early research and judgment, and early intervention; adopt targeted and precise treatment, and treat with the method of "one person, one policy, one person, one prescription, one prescription per day". In terms of specific treatment, it is necessary to be "fast" and sometimes "stable". Patiently observe the changes in symptoms, and it is good to be stable without aggravation. Sometimes it is also necessary to "support". In case of Yang Qi exhaustion, large doses of ginseng and aconite should be used to restore Yang and rescue the adverse.

(Source: Daily Economic News, The Paper)