Author: Chairman Rabbit Source: tuzhuxi (ID: chairman rabbit)
In combination with the current situation around (coordinate Beijing), talk about the problems encountered in epidemic prevention and control.
1. After the number of infected people increases, the motivation of people to do nucleic acid is greatly reduced. First, the probability of positive mixed tube is greatly improved, and the treatment of positive mixed tube varies from community to community: some households are closed, and some units are closed for different periods of time. It can last up to a week. Most people don’t want to enter this state. Second, it is believed that nucleic acid is a transmission event, and the positive probability is also increased. People are very afraid of masculine gender, mainly because they are afraid to go to the shelter;
2. The shelter is very delicate. From the perspective of humanization, the shelter should certainly not be built too badly, but in addition to the financial perspective, from a more “hidden” perspective, the shelter should not be built too “well” – of course, different people have different standard definitions of “good”. If the shelter is comfortable and convenient in extreme situations – even close to the experience of home isolation (and considering that many ordinary people also have poor living conditions), people will not be so afraid to go to the shelter. Therefore, under the current policies and strategies, the shelter has an implicit function of “deterrence”: it must provide reverse incentives, which makes people afraid to go to the shelter, based on which to restrict their own behavior and reduce infection. Therefore, shelter and home isolation must be two logics. Shelter mode is conducive to reducing transmission, and home isolation will increase transmission;
3. Therefore, people are afraid of the combination of positive and household sealing units as well as the infection of positive transit shelters, but only one situation can trigger these two events, that is, making nucleic acid. So people’s willingness to do nucleic acid declined;
4. This is a classic dilemma for the public health supervision of dynamic clearing. If there is no high-frequency and extensive nucleic acid, cases cannot be found in time, and they cannot be transported and isolated as soon as possible, resulting in community outbreaks; High frequency and extensive nucleic acid itself will lead to transmission events, which is the cause of community outbreaks. In a word, we found that once the infection cases reached a certain threshold, the means of screening nucleic acids in a large area would be difficult to use. On the contrary, it will increase various costs;
5. Concerns about control and shelter make people unwilling to do nucleic acid. If they can do less, they can do less. After the case reached a certain threshold, the public health supervision also considered that nucleic acid was risky and costly, and considered the convenience of the public, so it chose to give up the mandatory requirement for all nucleic acids;
6. However, in order to adhere to the current policies and strategies and avoid the spread of infection, visitors are required to show nucleic acid negative results (such as 48 hour nucleic acid) in general public places and public transportation, which forces people to do nucleic acid. People also fall into the dilemma of choice;
7. The final result is still to do as little as possible, or as little as possible. A family chooses a person who has to go out to do nucleic acid, while others do less. But as long as there is one person who does nucleic acid, there will be mixed yang and infectious wind. But in order to work and live, people can only bear such risks;
8. In addition, when the infection cases reach a certain level, in order to avoid cross infection, reduce mixed positive tube, and facilitate local control, the nucleic acid points in the community will be evacuated and only those in the community will be retained, which makes people spend a lot of time making nucleic acids in their own communities;
9. As a result, people who travel for their families (such as going to work) need to continue to do nucleic acid. They will spend a lot of time doing nucleic acid in the community, but it can make other families unnecessary and avoid social aspects as much as possible;
10. There are fewer people making nucleic acids, less population mobility and overall silence, which will inevitably lead to a result that the number of confirmed cases we have observed decreases. It should be mentioned here that there are two factors causing the reduction: one is the result of observation dimension: as long as the residents do not have all nucleic acids, we cannot understand the real infection situation. The epidemic may occur in the community, but it may not occur, but as long as we do not do nucleic acids, we cannot judge; The other is the real reduction: because the population mobility is significantly reduced, the scenario and probability of people infected with the virus will naturally become smaller (R0 becomes smaller), so the spread of the epidemic will indeed become smaller. However, this is based on the premise that population mobility is reduced, and the direct result of this is to increase the economic and social costs;
11. Therefore, without all staff detection and long-term static management (not necessarily absolute, but relative), we will naturally see that the number of cases has decreased and the epidemic situation has been controlled. At this time, there is hope of opening up again;
12. The so-called liberalization means returning to work and production. It’s time to go to work and go to school. However, it can be predicted that the nucleic acid negative requirements in public places will still exist, and all regions will require 48~72 hours of testing. In addition, we only talk about the population in the same city. For example, as long as cross regions are involved, there is a requirement of two inspections in three days. In a word, there are many scenarios of forced nucleic acid. As long as the society moves forward, the spread increases and the number of people detected increases, then the epidemic will come back (reflected in: the number of confirmed cases we observe will increase again). The results of the epidemic are: static management again;
13. It can be seen that there will be repeated cycles. You can control it as soon as you collect it, and it will explode as soon as you release it. In this cycle, it is naturally difficult for society to return to normal order. It is now in winter and the Spring Festival is coming. The Spring Festival is the most important event of population mobility in China. With the existing conditions, it must be hoped that the Spring Festival will last until the Spring Festival, when the spring is warm and the flowers bloom, so that there will be no large-scale outbreak of respiratory infectious diseases and medical runs caused by population mobility and cold seasons. As long as the current static management is carried out, this goal can be achieved, but it will certainly have a negative impact on the economic and social order;
14. However, it is not difficult to see that the Ninth Edition makes sense to use nucleic acid as the epidemic prevention infrastructure: nucleic acid is the “radar”, “eye”, “nose” and “sense” to find the epidemic, and the “radar” is turned off if there is no high-frequency nucleic acid for all staff; If you turn off the “radar”, you will not be able to find the epidemic situation/cases in the society in time, and if you cannot find the epidemic situation/cases in time, you will not be able to achieve “dynamic reset” in the society under the premise of “four early”; In fact, if we can’t do “four early”, we can’t do precise prevention and control, and we often have to passively deal with the epidemic that has lurked in the community or even broke out. As a result, the relationship between epidemic prevention and control and economic life cannot be well balanced, and it is not easy to minimize the economic and social costs;
15. Speaking of this, it can be seen that the current system relies most on high-frequency and large-scale nucleic acid detection. In retrospect, in the early days of the epidemic, China’s nucleic acid detection capability was admired by the world and was our magic weapon in fighting against the epidemic. However, nucleic acid detection relies on timely detection of the epidemic situation and response at the earliest time. It should be a classic public health prevention means (rather than personal medical means). A close reading of the Ninth Edition also shows that nucleic acid testing runs through the entire prevention and control program and is our most effective epidemic prevention infrastructure;
16. The current problems of epidemic prevention and control in China are actually the problems of nucleic acid detection infrastructure: in practice, professionalism, accuracy and reliability have declined. After industrialization, there are still some illegal operations with many factors, which will not be discussed here one by one. It is conceivable that if the “radar” goes wrong, the epidemic prevention and control will go wrong. As originally written in this article, when the epidemic reaches the threshold, nucleic acid detection itself will provide the epidemic transmission scenario; Large scale dependence on mixed management also greatly increases the proportion of mixed positive after the outbreak of the epidemic in the community. At this time, taking preventive and control measures will also cause inconvenience to residents’ work and life. For the purpose of precise prevention and control, increasing the convenience of residents, choosing to reduce the national/compulsory nucleic acid is equivalent to blaming the problem on the basic infrastructure for epidemic prevention and control – the “radar” for detecting the epidemic. When the “radar” is turned off, it is a headache healer and foot pain healer. As a result, accurate prevention and control is more difficult to achieve. This is the root of the problem;
17. As a “radar”, the function of nucleic acid detection is to detect and prevent, and ultimately cannot replace vaccination. Nucleic acid has won us valuable time. When SARS COV-2 virus gradually weakens, we must seize the time gained through the huge nucleic acid infrastructure to vaccinate the whole population. Only by improving the vaccination rate of key populations can we increase our society’s ability to fight against COVID-19-Omicron, increase our choices, and finally let us win the great struggle against COVID-19-Omicron.