Since the outbreak of pneumonia infected with the new coronavirus (2019-nCoV), the whole country has worked together and started a battle without smoke. Zhong Nanshan, a member of the Chinese Academy of Engineering and head of the scientific research and control team of the new coronavirus infection outbreak of pneumonia, said in an exclusive interview with Xinhua News Agency on Tuesday that there should be a scientific understanding of the 2019-nCoV pneumonia outbreak, scientific and effective prevention and control, and avoid unnecessary panic.
Studying the basic support virus originating in bats, the presence of intermediate hosts is still needed.
Coronavirus (Coronavirus, CoV) is a type of positive single-stranded RNA virus with endomes, widespread in humans, other mammals and birds, and can cause diseases such as respiratory, intestinal, liver and nervous system. There are currently seven types of CoV known to cause human diseases, four of which are CoV-229E, -OC43, -NL63 and -HKU1, which are prevalent in the population and usually cause common cold symptoms. Three other SARS-CoV, MERS-CoV, including this 2019-nCoV, are seriously harmful and can lead to severe pneumonia or even death.
According to reports, the current 2019-nCoV has published some research results, the epidemic prevention and control has a certain reference significance. Epidemiological studies show that the median age of 2019-nCoV infection is 59 years, 56% male, and the average incubation period for viral infectionis is 5.2 days (95% confidence interval is 4.1 to 7.0), and 95% distribution point is 12.5 days. The average viral propagation force is 2.2. Fever is still a typical symptom of 2019-nCoV infection patients, although there are no reports of symptoms of infection, but not the main body, in terms of current prevention and control still need to focus on most. Analysis of the 2019-nCoV genome shows that it is 79.5% similar to SARS-CoV, and 96% similar to bat source CoV, which basically supports the 2019-nCoV from bats, but the presence of intermediate hosts is still needed. 2019-nCoV, like SARS-CoV, enters human cells through ACE2 receptors, and the receptor binding domains of the two are highly similar. The study also found that SARS-CoV-specific monoclonal antibody CR3022 can effectively bind to the 2019-nCoV receptor binding domain to neutralize viral infection, which also provides ideas for the development of antibody drugs.
Zhong Nanshan introduced that the damage of the virus to the body has two main aspects, one is the direct damage caused by the virus destroying the body’s cells, and the other is the indirect immune damage caused by the damaged cell tissue. Once the autogenuated immune response is too strong, it can lead to more severe damage to the body, leading to serious diseases.
At least 7 small molecule drugs are at different stages of clinical research
Zhong Nanshan introduced, so far 2019-nCoV has not targeted special drugs. Some case-reported therapeutic drugs still need more clinical practice to prove results. There are at least 7 small molecular drugs for viral RNA polymerases or proteases, including the above-mentioned CR3022 antibody drugs, at different stages of clinical study;
“However, we have learned from the successful experience of SARS treatment, has established some effective treatment programs, while the application of a variety of life support means to ensure the success rate of patients. We used high-throughput oxygen aid, non-invasive mask ventilation, low-tide gas-weight lung protective ventilation, in vitro membrane pulmonary oxygenation (ECMO) and other auxiliary treatment in critically ill patients have achieved good results. With the in-depth understanding of the disease and the accumulation of medical experience, the National Health and Reform Commission has organized experts to revise the diagnosis and treatment program, has now formed a “new coronavirus infection pneumonia diagnosis and treatment program (trial fourth edition)”, effectively guide the country’s 2019-nCoV pneumonia diagnosis and treatment work. Zhong Nanshan said.
The most effective way is still to “early detection, early isolation”
“The outbreak is still on the rise across the country, but we don’t judge that there should be a national outbreak, but probably only a localized outbreak.” Zhong Nanshan said that in the face of the 2019-nCoV pneumonia outbreak, the most primitive and effective method is still “early detection, early isolation.”
“To this end, our government and related departments have taken a number of national initiatives: extended holidays, traffic control, temperature detection in public places, active lying less gathering, personal protection knowledge, and the improvement of national public safety awareness also ensurethed the smooth implementation of the relevant initiatives. Zhong Nanshan said: “These measures effectively block the source of infection, greatly reduce the second and third generation of infection, we judge that the outbreak is expected to peak in the next 10 days to two weeks or so, but we still need to strengthen prevention and control, not to relax vigilance.” In particular, I would like to express my gratitude to Wuhan, a heroic city, for its important sacrifices and contributions. “
Epidemic prevention and control face problems and challenges
At the same time, Zhong Nanshan believes that the current epidemic prevention and control work is also facing many problems and challenges.
“First of all, the outbreak is locally concentrated and medical resources are scarce. At present, the government and related departments draw on the successful experience of Beijing Xiaotangshan Hospital during SARS, in Wuhan fire rapid new Fire Shenshan Hospital and Leishenshan Hospital, a total of 2,300 beds, when completed will greatly alleviate the problem of patient treatment; In the area of medical supplies, the government and social forces need to work together to ensure the distribution of supplies on the front line of the epidemic.
“Second, it is still needed to do a good job of patient diversion, to reduce the pressure of fixed-point hospitals. When the winter and spring alternate, climate change, common respiratory pathogens such as influenza virus esmotic season is also in the epidemic season, and early disease through clinical performance can not accurately distinguish whether the patient is 2019-nCoV infection or other common respiratory virus infection, need to rely on pathogen diagnosis. However, the lack of diagnostic power of pathogens in primary hospitals, resulting in the inability to divert patients, so that fever patients without diversion in the case of concentration in a limited number of fixed-point hospitals, resulting in the relevant hospitals are facing great pressure, but also seriously affected patient treatment and epidemic prevention and control. Therefore, it is urgent to improve the detection and diagnosis capacity of pathogens in primary hospitals, to achieve patient diversion treatment, and to reduce the pressure of epidemic prevention and control.
“Third, we need to do a good job in hospital sense of prevention and control. The high incidence of the epidemic, such as Wuhan and other places, the surge of patients, relative shortage of medical resources, it is very easy to lead to hospital feelings, threatening the safety of medical personnel and the masses. It is necessary to optimize the process management and ensure the rationing of first-line hospital sensing prevention and control facilities, equipment and related materials. “
“It takes one heart and one heart to overcome the difficulties”
Zhong Nanshan believes that scientific research should be accelerated to provide support for epidemic prevention and control. He believes that the current 2019-nCoV and its infection characteristics of less understanding, the current national, provincial, municipal and social forces at all levels have started a special research fund for the 2019-nCoV pneumonia outbreak, the urgent need to speed up scientific research work for clinical treatment and epidemic prevention and control to provide support.
“The SARS 17 years ago lasted nearly six months, and now our country has made great progress in the prevention and control of major infectious diseases, we are confident that we can more effectively control the 2019-nCoV pneumonia outbreak and restore normal social order as soon as possible.” This requires the efforts of our first-line medical personnel, the efforts of our scientific researchers, the efforts of our patients, the efforts of our people, and the need for countries to strengthen cooperation, work together to deal with, and solve difficulties with one heart. Zhong Nanshan said.