Taking SARS data as a reference, at what stage has the epidemic reached?

In 1960, the year of Gengzi. The nationwide food shortage caused by the ever-expanding drought has allowed the Chinese to start a new year in a famine.

In 2020, it will be another year of Gengzi Rat, and it will be a new crisis. In a panic, the Chinese ushered in another Spring Festival, which is bound to be often mentioned.

During the Spring Festival this year, the search for “pneumonia” and “Wuhan” surpassed “Spring Festival” and “New Year’s Day”, becoming the two key words of Chinese memory about the 2020 Lunar New Year.

The huge search volume stems from the rising number of outbreaks. The latest data show that as of 24:00 on January 25, 1945 cases were confirmed nationwide, a total of 56 deaths, and 21,556 people are still under medical observation.

Increasing with confirmed case data is widespread anxiety and panic, bitterness and anxiety. But we all know that we can really “share the hard times” by referring to known epidemic samples and doing things more calmly.

We have compared the information of the new coronavirus pneumonia and the SARS information 17 years ago. We hope to use this as a reference to help us take a more objective look at what kind of development stage is the epidemic now? As ordinary individuals, what can we do in this epidemic?

Referring to SARS 17 years ago, at what stage is the prevention and treatment of new coronavirus pneumonia?

On January 24, Pulitzer Prize winner and policy analyst Laurie Garrett said in an interview with the media: “At this time 17 years ago, I was reporting the SARS epidemic that killed 774 infected people and affected 37 countries. So, on December 12, 2019, when I read about congestive lung infections in the Wuhan seafood market, there was a striking similarity. “

The many similarities in the cause, pathogenesis, and transmission link did make people suddenly associate this “worry out of mouth” Wuhan’s new coronavirus pneumonia with SARS in 2003.

Along this line of thought, we have organized the timeline for the development of SARS. From the time of the first case to the end of the disease, we have found some factors that affect the transmission and can provide some references for truly understanding the epidemic.

But from the beginning of the study, we realized that the epidemic situation we face today is much faster than SARS.

From the number of cumulative cases, the rate of development of SARS has been relatively flat: the number of confirmed cases rose to 218 in the two months after the first reported case, and the number of confirmed cases in four months exceeded 1,000.

And this time, 25 days after the first publicly confirmed case was reported, the number of confirmed cases had exceeded one thousand, and then quickly approached two thousand.

If we take a closer look at the SARS development cycle, we will find that the key word for advancing transmission is “population movement”, and the node that promotes the increase in the number of confirmed diagnoses is “completion of viral gene sequencing”.

During the SARS period, the number of people diagnosed for the first time rose sharply in early February. New Year’s Eve in 2003 is January 31, and the beginning of February coincides with the end of the Spring Festival. From February 5th to 10th, Guangdong has more than 50 new cases per day. The following wave of repatriation during the Spring Festival brought another large-scale population movement, and the number of confirmed cases increased further.

Immediately after, Beijing received the first imported SARS case on March 6. SARS started with Beijing as a transit point and began to flow from the heart of China to other places.

In contrast, this new type of coronavirus pneumonia, compared with SARS, has promoted the conditions for “population”: the Spring Festival Transport in 2020 is earlier than in previous years.

In addition, Wuhan, where the epidemic originated, is itself one of the country’s largest transportation hubs, with spreading links extending in all directions.

Both of these are amplifiers of “population”, which directly led to the rapid spread of the virus across the country. What followed was growing panic.

It is a little comforting that the speed of the pathogen identification study was nearly three months faster than that of 2003.

On December 30, the Wuhan Health and Medical Commission issued the “Urgent Notice on Doing a Good Job in the Treatment of Unknown Cause of Pneumonia”, saying that some medical institutions have seen patients with unknown cause of pneumonia. As of January 7, experts from the Centers for Disease Control and Prevention had isolated the new coronavirus, and had completed the detection of pathogenic nucleic acids on January 10. It was only in mid-April 2003 that a scientific institution completed the sequencing of the entire genome of the coronavirus.

Identifying the pathogen can not only be used for clinical screening, designing PCR detection reagents, but also important for subsequent treatment programs and epidemic prevention and control. So in the follow-up news, we can also read from time to time some news that makes people “slightly relieved.”

Accompanied by clinical screening ability is a higher diagnosis rate.

Therefore, even though the new type of coronavirus pneumonia itself may not be as terrible as SARS, but because of the population flow amplifier we mentioned earlier, earlier diagnosis capabilities and faster information transmission conditions, coupled with the virus’s stronger transmission The outbreak (or the number of people diagnosed) is more rapid than 17 years ago.

Regardless of the government or the individual, the preparation time for this sudden outbreak has been shortened, and the panic has become more urgent.

Hurrying to battle is a great test for any city and people in it.

Hubei is difficult now, but it is still difficult

Because of SARS experience, we take it for granted that this should be a battle that can be concluded quickly and smoothly.

Wuhan City, or Hubei Province, which is in the center of the vortex, has not performed satisfactorily this time, so we will not repeat it here. Looking back on accountability does not solve the problem. What’s more important is that there must be sufficient vigilance and presupposition for the next degree of difficulty, and corresponding plans and preparations.

According to the compilation of the existing public information, we think that there are two outstanding difficulties. Even if it has been mentioned repeatedly by the media, it cannot be overemphasized.

First, the experience of Beijing during the SARS period can be translated, but the implementation of the city will vary depending on the city.

Looking back at SARS 17 years ago, the overall prevention and control effect appeared in May. We noticed that from April to May, emergency policies and measures mainly include three aspects:

The whole nation mobilized to fight against SARS, and the epidemic was fully disclosed to the public;

Regulation of public places, transportation and group activities:

Identify designated hospitals to focus on treating SARS-infected patients.

It can be seen that the effective emergency policies and measures summarized from the atypical pneumonia mentioned above have all been implemented in the course of fighting the new coronavirus pneumonia. Although everyone thinks that the action is too late, it is too far ahead of SARS and it should have a better effect.

The biggest variable is that this time the key city is not Beijing, but Wuhan and other cities in Hubei. The three elements of urban success against SRAS summarized by the media before are: individual citizens, institutional systems and medical experts.

In other words, in addition to supporting the medical experts with the power of the country, what needs to be implemented is the individual consciousness and responsibility of each citizen, as well as the detailed system and execution of the hair-this is the Wuhan and The real difficulties facing Hubei now.

Second, there is more than one Wuhan in Hubei, and the prevention and control of its surrounding cities should not be underestimated.

The figure below is a piece of data that you should have seen many times in the past few days: the main outflow of Wuhan during the Spring Festival. Obviously, due to Wuhan’s leading position in Hubei Province, at the beginning of the Spring Festival, the most populated cities were around Wuhan and other cities in Hubei Province. The top 14 cities with the most popular cities came from Hubei. , Jingzhou, Xianning …

However, under the condition of continuous spread of disease, until January 23, Hubei Province for the first time disclosed the details of cases in cities other than Wuhan.

According to the latest data released by the official website of the Hubei Provincial Health and Health Committee, as of 24:00 on January 25, 2020, 618 cases were confirmed in Wuhan, 55 cases were diagnosed in Xiaogan, 122 cases were diagnosed in Huanggang, 33 cases were diagnosed in Jingzhou … Only 12 cases.

Judging from the public information reported by the media, due to the rush, these cities are not only unprepared for medical supplies including inspections and medical equipment, but are also stretched for emergency systems and capabilities.

Just in the past few days, we have seen the difficulties of these cities from various media reports and social platforms, especially the medical staff and suspected patients standing at the center of the epidemic. Judging from the SARS experience, all regions can help out. In addition to the material gap, it may also need a management system, mobilization capabilities and implementation details …

Of course, now that Hubei has used the coercive method to “close the province”, it is necessary for us to use data to interpret this. If in the current situation, Wuhan City and even Hubei Province are still free to go in and out, then the crowd of people returning after the holiday will more quickly bring the virus to a large number of cities, mainly Shenzhen, Shanghai, Guangzhou, and Beijing.

However, the side effects brought about by the closure of the city are also obvious, such as inconvenient supplies, blocked travel of medical staff, and panic …

What can we do as ordinary people

In the end, we are now struggling with coronavirus at a tremendous effort and price. Although we have experienced SARS and MERS (Middle East Respiratory Syndrome) in the 21st century, when the new coronavirus arrived, we still couldn’t solve the problem easily and quickly.

However, from our existing data, there are two points that should be optimistic.

The first is the ability to mobilize the entire society.

Compared with SARS 17 years ago, the frequency, speed, and scope of the current crowd movement have expanded, and it seems that virus control seems more difficult.

But 17 years ago there were no smartphones, no social media, no big data, no artificial intelligence, and no such fast and dense transportation and logistics network. These new infrastructures can support faster material deployment and information transmission in the epidemic prevention and control work, respond to virus infection, and can also have faster distributed centralized control and more accurate individual protection. “.

Secondly, although the epidemic situation is very serious, the virus is not beyond the “viciousness” beyond imagination.

Coronavirus is a positive-stranded single-stranded RNA virus with an outer membrane. Because it has a corona-like protrusion under the electron microscope, it is called a coronavirus. 10% of colds in daily life are caused by coronaviruses and their symptoms are mild, so they are often ignored. However, the coronavirus has relatively strong vitality and can leave the host to remain in the air for a period of time, so the infectivity will be so high.

Su Yiren, a Taiwan-based virus expert who has participated in the fight against SARS, said that the higher the infectivity, the lower the lethality of the virus.

This is exactly the status quo. From the actual situation, the transmission speed and range of Wuhan’s new coronavirus are greater than SARS, but the mortality rate is currently less than 3%, which is much lower than 10% of SARS.

The editor of the international medical journal The Lancet spoke on social platforms to remind the media that the virus is escalating the event by calling the virus a “killer virus” + “fueling panic.” In fact, the virus is moderate / certainly infectious and relatively low pathogenicity. It is absolutely unnecessary to “cultivate” panic in overly exaggerated language.

However, Su Yiren also said that it is still in the early stages of the outbreak and it is impossible to accurately determine the transmission rate and infection rate. The following is a very important observation period.

This is the message we want to convey. While preventing excessive pessimism, never be blindly optimistic.

After all, the fortification has just begun.

As ordinary people, whether in Hubei or elsewhere, we play a very important role in this fight. Here we must continue to emphasize: not letting ourselves be infected is the greatest contribution of our ordinary people; everyone is safe, everyone can be safe.

Finally, we again present this self-diagnosis guide, which integrates reports from Wuhan Union Medical College, National Health Committee, and World Health Organization (WHO), hoping to help everyone, protect themselves and their families and avoid unnecessary panic .

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