The diagnosis and treatment plan for COVID-19 has been revised! Mild cases will be managed in centralized isolation

Notice on Issuing the Diagnosis and Treatment Plan for Novel Coronavirus Pneumonia (Trial Ninth Edition)

National Health Commission Medical Letter [2022] No. 71

To the Health Commissions and Administration Bureaus of Traditional Chinese Medicine of all provinces, autonomous regions, municipalities directly under the Central Government and the Xinjiang Production and Construction Corps:

At present, the novel coronavirus pneumonia epidemic is still spreading around the world. The Omicron strain has replaced the Delta strain as the main epidemic strain. The clinical manifestations of patients with novel coronavirus pneumonia present new characteristics. New drugs for the treatment of novel coronavirus pneumonia have been launched one after another, and treatment experience and treatment methods have been further enriched. In order to further scientifically and standardizedly carry out the diagnosis and treatment of novel coronavirus pneumonia, we organized experts to revise the relevant contents of the "Diagnosis and Treatment Plan for Novel Coronavirus Pneumonia (Trial Eighth Edition Revised Version)" and formed the "Diagnosis and Treatment Plan for Novel Coronavirus Pneumonia (Trial Ninth Edition)". It is now issued to you for reference.

Appendix: Diagnosis and Treatment Plan for Novel Coronavirus Pneumonia (Trial Version 9)

General Office of the National Health Commission

Office of the State Administration of Traditional Chinese Medicine

March 14, 2022

The Diagnosis and Treatment Plan for Novel Coronavirus Pneumonia (Trial Version 9) has been adjusted as follows:

① Optimize case detection and reporting procedures;

② Classify and treat cases, determine isolation management and treatment sites based on their condition, implement centralized isolation management for mild cases, and centralized treatment for common, severe, critical cases and patients with high risk factors for severe illness in designated hospitals;

③ Further standardize antiviral treatment and include two specific anti-new coronavirus drugs approved by the National Medical Products Administration in the diagnosis and treatment plan;

④The content of TCM treatment was revised and improved;

⑤ Adjust the isolation management and discharge standards to speed up the isolation and discharge process of patients;

⑥ Adjust the precautions for lifting isolation management and discharge from hospital, and change "continue isolation management and health status monitoring for 14 days after discharge from hospital" to "continue home health monitoring for 7 days after lifting isolation management or discharge from hospital."

Key points for revision of the Diagnosis and Treatment Plan for Novel Coronavirus Pneumonia (Trial Ninth Edition)

In order to further improve the medical treatment of COVID-19 and effectively improve the level of standardized and homogeneous diagnosis and treatment, the National Health Commission and the State Administration of Traditional Chinese Medicine organized experts to revise the "Diagnosis and Treatment Plan for Novel Coronavirus Pneumonia (Trial Eighth Edition Revised Version)" and formed the "Diagnosis and Treatment Plan for Novel Coronavirus Pneumonia (Trial Ninth Edition)", which was issued to all localities for reference and implementation. The new version of the diagnosis and treatment plan was formed on the basis of careful study of the transmission characteristics and case characteristics of Delta, Omicron and other mutant strains, and in-depth analysis of relevant research results. The key revisions are as follows:

First, optimize the case discovery and reporting procedures. On the basis of nucleic acid testing, add antigen testing as a supplement to further improve the ability to detect cases early. At the same time, improve the efficiency of diagnosis or exclusion of suspected cases, and require suspected cases or those with positive antigen test results to immediately undergo nucleic acid testing or be transferred in a closed loop to qualified superior medical institutions for nucleic acid testing. Those with positive nucleic acid test results will be placed under centralized isolation management or sent to designated hospitals for treatment, and direct online reporting will be carried out in accordance with regulations.

Second, cases are classified and treated. Based on the opinions from various places that "the patients with the Omicron variant are mainly asymptomatic and mild cases, most of whom do not need much treatment, and admitting all of them to designated hospitals will occupy a large amount of medical resources", the case classification and treatment measures have been further improved:

1. Mild cases shall be managed in centralized isolation. Relevant centralized isolation sites cannot simultaneously isolate inbound personnel, close contacts and other groups. During the isolation management period, symptomatic treatment and condition monitoring should be carried out. If the condition worsens, the patient should be transferred to a designated hospital for treatment.

2. Ordinary, severe, critical cases and cases with severe high-risk factors should be treated in designated hospitals. Severe and critical cases should be admitted to the ICU for treatment as early as possible. Patients with high-risk factors and a tendency to severe illness should also be admitted to the ICU for treatment.

The third is to further standardize antiviral treatment. Two specific anti-new coronavirus drugs approved by the National Medical Products Administration will be included in the diagnosis and treatment plan, namely: PF-07321332/ritonavir tablets (Paxlovid) and domestically produced monoclonal antibodies (ambavir monoclonal antibody/romisvir monoclonal antibody injection).

Fourth, the content of TCM treatment has been revised and improved. In combination with the clinical treatment experience of various regions, the application of TCM non-drug therapy has been strengthened, and acupuncture treatment content has been added; in combination with the characteristics of pediatric patients, relevant content on TCM treatment for children has been added.

Fifth, adjust the standards for lifting isolation management and discharge, as well as the precautions for lifting isolation management and discharge. Domestic studies have shown that when the nucleic acid Ct value of infected people in the recovery period is ≥35, the virus cannot be isolated from the sample, and close contacts are not found to be infected. Accordingly, the new version of the diagnosis and treatment plan will modify the "two consecutive negative nucleic acid tests of respiratory specimens (with at least 24 hours between sampling times)" in the standards for lifting isolation management and discharge to "two consecutive new coronavirus nucleic acid tests N gene and ORF gene Ct values ​​≥35 (fluorescent quantitative PCR method, the limit value is 40, and the sampling time is at least 24 hours apart), or two consecutive new coronavirus nucleic acid tests are negative (fluorescent quantitative PCR method, the limit value is less than 35, and the sampling time is at least 24 hours apart)". "Continue 14 days of isolation management and health status monitoring after discharge" was modified to "continue 7 days of home health monitoring after lifting isolation management or discharge."

Source: Xinhua News Agency, Healthy China