Infectious Diseases Department Is The Outpost And The Fortress Of National Epidemic Prevention And Control System

With Zheng Xin's wechat, it was on March 4. In the early days, she was busy with the treatment of new coronal pneumonia patients in the ward, and had no time to be interviewed. After completing the isolation work in the ward, she put herself into the international anti epidemic work. During the appointment period of more than one month, she occasionally sent some pictures and pictures of her work feelings or working scenes to share the "history" of the team.

Zheng Xin is the director of infectious diseases department of Union Medical College Affiliated to Tongji Medical College of Huazhong University of science and technology, member of infectious diseases branch of Chinese Medical Association and chairman of infectious diseases branch of Hubei Medical Association. On December 31, 2019, she led her team to start running the fever clinic.

After the ward was closed, neither she nor her team had time to stop. Through the video of the new epidemic situation in Poland, Spain and her colleagues, she shared the experience of rapid spread of pneumonia in the United States, Brazil and other countries.

Recently, the 21st century economic report started a dialogue with Zheng Xin.

Zheng Xin. Information map

21st century: the whole anti epidemic war in Wuhan has now completed its phased tasks. What are your suggestions for the development of infectious Science in China in the context of the impact of the epidemic on the public health system?

Zheng Xin: in the traditional sense, the infectious diseases department of the general hospital mainly treats non respiratory infectious diseases, so there is no negative pressure ward, which does not have the conditions for the treatment of respiratory infectious diseases, and does not accept such patients. Previously encountered respiratory infectious diseases, patients are transferred to infectious disease specialist hospital. Under the impact of the epidemic situation, infectious disease specialist hospitals do not have such a large capacity to treat patients. General hospitals have medical strength, and ward hardware needs to be further improved to better deal with public health emergencies.

As the clinical front line of infectious disease prevention and control, infectious diseases department is indispensable to the whole infectious disease prevention and control system. Many infectious disease prevention and control work may not produce direct economic benefits, but the contribution of infectious diseases department to reduce the social and economic losses caused by infectious diseases is irreplaceable by any discipline. To invest more in the construction of infectious diseases department and improve the treatment of infectious disease prevention and control personnel working in the high-risk front line, it also needs more support from the health management department, and even a large amount of capital investment.

21st century: how to construct infectious diseases discipline after the epidemic situation is over?

Zheng Xin: in the future, it is very important to make the infectious diseases department of general hospitals bigger and stronger. The infectious diseases department is the outpost of discovering new infectious diseases and the strong fortress of the national epidemic prevention and control system. In addition to dealing with infection related diseases, one of the most important functions is to undertake public health work. For the future construction of infectious disease discipline, specifically, we should build infectious disease ward that meets the standard, enhance the ability of infectious disease discipline to find new pathogens, increase the corresponding equipment and personnel selection and retention, build infection intensive care unit, and form the rotation system of other specialist doctors to the infectious disease department, so that we can be prepared for the epidemic situation in the future.

In order to cultivate infectious disease doctors, we need to accumulate common clinical experience and form the soft power of keen insight, which needs long-term training. Secondly, it is very important to keep pace with the detection technology of unknown pathogens. In addition, the Department of infectious diseases should strengthen basic and clinical research. In addition to clinical manifestations, the understanding of disease mechanism is more important.

The fever clinic played a great role, but the space was obviously insufficient. In the future, a standard fever clinic with enough space should be set up, that is, patients' payment, pharmacy, detection, observation, isolation ward and other "one-stop" equipment are complete. After patients come in, all things can be done in it, which can not only facilitate patients, but also reduce the potential risks of patients flowing in hospitals.

After the epidemic situation is over, I believe that the country will definitely build a strong system to combat the epidemic, including the way of "combining medical treatment with prevention" and "combining peacetime and wartime". We are looking forward to the development and construction of infectious diseases in the future. At present, Xiehe Hospital is also planning to strengthen the construction of infectious diseases department.

21st century: now, the epidemic situation Bureau of Wuhan is facing a good situation, but some cured patients have recovered. What do you think of this phenomenon? How to defend?

Zheng Xin: at present, due to various factors, nucleic acid detection cannot be 100% accurate. So is it true that individual patients turned negative before detection? Is this conversion positive? Does nucleic acid conversion mean relapse or delay? Is it infectious? These need further research, combined with epidemiological data, clinical manifestations of comprehensive judgment. For example, although some patients with nucleic acid recovery, but the lung lesions in patients with no progress or improvement, there are no clinical symptoms, this is not terrible. With the improvement of the disease, their own immunity is enhanced, and eventually the virus will be eliminated. As for whether it is still infectious, the problem is complex and needs to be studied in depth. However, generally speaking, because the current detection method is to directly detect whether there are some fragments of new coronavirus nucleic acid in the sample, rather than isolating and culturing the virus, the positive results can only indicate the presence of viral nucleic acid in the sample, and can not indicate that there must be a complete virus, let alone infectious. Therefore, to simplify the complex problem: for some patients with nucleic acid recovery can do a good job of isolation, also do not need to panic.

21st century: how to prevent asymptomatic infections worldwide?

Zheng Xin: new coronavirus can show asymptomatic infection, which is the difficulty of global prevention and control, and another manifestation of virus strangeness. At present, asymptomatic infected people should pay more attention to people under 60 years old. Whether a person has clinical manifestations after infection depends on the game between virus and human immunity. He may be infected with a low nucleic acid load if he is not likely to show a strong immune load. To prevent asymptomatic infection, the main thing is to prevent the infection to the elderly susceptible population, especially the elderly with cardiovascular and diabetes mellitus and patients receiving various immunosuppressive treatment, which are high-risk groups of new coronary pneumonia. At present, the best means of protection is still to wear masks and wash hands frequently, so as to make our immunity stronger and reduce the chance of virus invading human body.

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