The first anniversary of the outbreak: Why did I warn of the major progress of the epidemic five times in a year?
The Gengzi Year is about to end on February 1 of the Gregorian calendar, and China has ushered in the annual Spring Festival and Spring Festival.When more than XNUMX million people worldwide were diagnosed with the new crown, more than two million died.
People are asking: Will 2021 be better than 2020? In mid-to-late January 2020, I was invited to give a lecture in Geneva, Switzerland.The Wuhan epidemic affects the hearts of millions of people.
On the plane to Geneva, I reminded the Chinese people to "be careful of person-to-person transmission."On the flight from Geneva to Dubai, I again expressed concern that the epidemic might worsen.
Since then, in 2020, I have expressed my concerns about the epidemic and put forward many warnings and suggestions through Phoenix.com (Cancer Intelligence Bureau), CC Intelligence Bureau, NY Times, Weibo and other media.
Early warning cannot rule out human-to-human transmission: In the early days, people thought that the new crown would not be transmitted from person to person. On January 2020, 1, I wrote an article on the Phoenix Network (Tumor Intelligence Bureau), calling, "Since the infection "cannot be ruled out from person to person", the treatment must first be "person to person", otherwise it will be too late."
At that time, Wuhan's nucleic acid detection reagents were severely insufficient and false negative problems, and severely ill patients in Wuhan urgently needed rapid diagnosis and timely isolation and treatment.In response to a request from a clinical doctor in Wuhan through my Weibo, as a foreign scholar, I scientifically and systematically analyzed the advantages, disadvantages and complementarities of nucleic acid detection and CT imaging diagnosis, and called for "CT as a diagnosis of new pneumonia. Standards brook no delay".
The article was reprinted by major media at home and abroad, including NY Times.Thanks to everyone's efforts, this suggestion has been adopted and the fifth edition of the National New Coronary Diagnosis and Treatment Plan has been revised.
Early warning of the second wave of epidemics in China's autumn and winter seasons: After the Wuhan epidemic has achieved decisive results, in the face of the paralyzed mentality of the people that "the epidemic will be in China in the first half and abroad in the second half", I was on Phoenix.com for the 2020th time on May 5, 5. (Tumor Intelligence Agency) called for "... The first half of China's fight against the epidemic has just ended, and it is now halftime. It is still unknown whether the second half will be more tragic! This is definitely not the time to celebrate.
How to deal with the second wave of epidemic depends on the power of science and technology..."
Early warning of China's immunization gap:
At the end of last year, when the vaccine was approved in European and American countries and began to be vaccinated, I once again called on (Phoenix Cancer Information Bureau) on January 2021, 1 to "be vigilant: How can China respond to the "immunity gap" in large-scale vaccination of European and American vaccines?"
In the past year, I have been following the latest COVID-19 literature and epidemic developments around the world every day, combining my 30 years of immunization, gene transformation and clinical expertise to make judgments, and telling everyone in a language that ordinary people can understand .
Although every time I predict the epidemic, I receive criticisms such as "sensational". I really hope that my prediction is wrong and that worry is unnecessary.Unfortunately, these worries are all expressed by me.
Early warning: China, where herd immunity is lagging behind, will usher in the third wave of epidemics around the end of this year?
The purpose of our early warning is to enable everyone and relevant decision-making departments to study countermeasures and prepare early on the premise of having more comprehensive information.
As the epidemic situation in Europe and the United States is rushing to the darkest moment, my current predictions and concerns for 2021 are:
1. In the second half of 2021, western developed countries will achieve herd immunity through vaccination and natural infections that have already formed.The new crown will turn into a "large flu" with a significantly lower case fatality rate in these countries. Life and work will be fully banned, and the economy will recover.
2. China, after the intermission, is currently experiencing the second wave of epidemics.In the second half of this year, when Western countries reopen their economies in the autumn, it is also the time when the epidemic in China is severe.China, where herd immunity is lagging behind, will usher in the third wave of the epidemic around the end of 2021.
3. The herd immunity of the global village will not be formed in one or two years, and the new coronavirus will spread and mutate in the population for a long time, becoming a "large flu" with a high incidence every year.Annual or every few years vaccination of high-risk groups will become a reality that has to be accepted.Not only that, recent clinical studies in Wuhan and the United Kingdom have found that a small number of COVID-19 patients have a series of chronic sequelae of multiple organs after recovering from the acute infection period. The diagnosis and treatment of sequelae of COVID-19 will become a unique discipline.
Photo/Los Angeles, USA has turned the Dodge Stadium into a vaccination venue. The picture shows the long queue for testing on January 1.The number of people vaccinated daily in the United States has reached 4 million
8 million people in the United States will be vaccinated by the end of August?Vaccination and virus mutation: who is faster?Whether the vaccine is effective will be known in March
Fortunately, due to the advancement of the two 95% effective Pfizer/BioTech and Moderna's mRNA vaccination, the number of inoculations per day in the United States has exceeded 130 million doses, and currently 7-8% of the population has been vaccinated. At the end of January, Johnson and Johnson announced their adenovirus vector DNA New crown saplingThe results of a randomized clinical study of phase three (only one injection) showed that the overall effective rate was 66%.
The Phase III clinical study of Novavax's new crown protein vaccine was also announced last week, with an overall effective rate of 89%, of which the effective rate against non-variant strains was 95%, the UK variant strain was 85.6%, but the South American variant strain was reduced to 60% (After removing AIDS patients).If approved, only ordinary refrigerators are required for storage of these two vaccines.And, the output will soon reach hundreds of millions of doses.
Picture: January 1, a temporary tent set up outside a hospital in Pretoria, South Africa to treat infected patients
It is expected that with the increase in the production of various vaccines and the approval of new vaccines, the daily vaccination in the United States will rapidly rise to between 8 million and 50 million.By the end of the summer at the end of August, the vaccination rate of nearly 60-1.7% of the population (about 2 million people, 50 doses/person) is no longer a luxury (the annual influenza vaccination rate in the United States is also about 60-30%. The acceptance rate of the new crown vaccine should be higher than that of the flu vaccine), coupled with the actual natural infection rate of more than 1% by then (more than 70 million people, including asymptomatic, mildly ill people who have not been tested, and the number of confirmed nucleic acids is conservative It is possible to achieve herd immunity of about XNUMX% of the overall immunity achieved by triple calculation).
This will drastically reduce the number of critically ill patients, COVID-19 will become a real "large flu", and social and economic recovery can become a reality.In the past week, the epidemic in the United States and some European countries began to ease.Among them, the number of new cases per day in the United States dropped from the highest peak of 30 at the beginning of January to 1 at the end of January.The number of deaths per day has dropped from 15 at the peak to more than 19.However, the invasion of mutant viruses has increased the number of uncertainties in the epidemic.Fortunately, so far, the mutation problem of COVID-XNUMX is that only a small part of the genes have been mutated, which will not completely change the efficacy of the overall vaccine (including mRNA, inactivated vaccines, etc.), but this is a dynamic process.
Picture: On January 1, an Israeli medical worker vaccinated a woman with the Covid-14 vaccine at the Kupat Holim Clalit Clinic in Jerusalem
Recently, the mutant strain in South Africa has raised concerns about the weakening of the vaccine's effectiveness.
Among them, the most complete data comes from the Novarax vaccine released recently.Its effective rate has dropped from 95% for non-mutant strains to 60% for South American mutant strains.
From the point of view of the immune function acquired by natural infection, Manaus, Brazil, experienced the first wave of large-scale natural infections last year and is considered to be possible to achieve "Herd immunityRecently, another wave of severe epidemics has appeared in the region, suggesting two possibilities: 1. The immune protection of natural infections may only last for about half a year; 2. The immunity of natural infections has a significantly reduced effect on mutant strains.
The CDC in the United States warned that the British variant may become the main disease in the United States in March; and the South African variant will also appear in the United States in the near future.In view of this complicated situation, Moderna, Pfizer/Biotech and Novarax have all announced recently that they have begun to develop vaccine boosters against mutant viruses in case of unexpected events.Due to the advantages of mRNA technology, changing the mRNA series for mutation is like changing a bullet in a ready-made gun (rather than changing the whole bullet, let alone changing the gun).
According to the person in charge of Moderna, they can complete the design in about 6 weeks.The US FDA also stated that because the basic structure of the vaccine has been verified by phase III clinical studies for its safety and reliability, the revised mRNA vaccine only needs to be carried out in a phase 400/1 study of about 2 people, based on the titer and safety of the antibody. As an indicator, it can meet the listing requirements.It is expected that these clinical studies will be launched in the first half of 2021.
Although the mutated virus may become a major epidemic strain in Europe and America in the first half of this year, thereby increasing the number of infections and deaths, as long as the vaccine is still effective, the final outcome will be controllable.
Therefore, while the mutation of the virus has not changed from quantitative to qualitative, the more people are vaccinated faster, the quantitative and qualitative changes of virus mutation will slow down and decrease.Israel was vaccinated with nearly 50% of the population's mRNA vaccine in a month and a half, ranking first in the world.
Although most people have not completed the second vaccination of the vaccine, the country’s daily new cases seem to have declined from the peak period.Although the efficacy of the vaccine has achieved initial results, the invasion of the mutant strain has increased the infectivity.The effect of the final vaccine will not be known until the end of March.
Photo/At the end of January, workers waiting to be vaccinated against the new coronavirus in a Beijing medical center.Large-scale vaccination is being carried out in China. According to news on January 1, China has received 31 million doses
At the end of August, the number of domestic vaccinations may reach about 8 million, which is several times short of the minimum ratio required for 2% herd immunity?What should we do?
The Spring Festival is approaching, and the call to "stay for the New Year" this year has become a national policy.
China's extensive social distancing has successfully controlled the spread of the epidemic in several large cities.This is undoubtedly the effective method so far.This feat allowed the Chinese people to spend a year in peace.
However, how long this effective method can last is a question worth considering.According to reports, an asymptomatic patient in northern China has infected 102 other people; there are also reports of some patients who have been negative for many times and then turned positive; suggesting the difficulty of case tracking, the difficulty of social isolation, and the manpower, material resources and resources required. financial resources.
In addition, many "nucleic acid-positive" people and objects may be residues after infection and do not have the ability to re-infect.As the global epidemic spreads, these "residues" will become more and more common, and will inevitably lead to the dilemma of all.
Photo/An exhibition held in Wuhan to commemorate the city's struggle against the new crown virus.Although China is currently very strict and effective in controlling the epidemic, when the case exceeds a certain limit, it will start to be unable to do so and the situation may get out of control.
According to the current mutation situation and the general laws of viruses, mutations tend to increase infectivity.When these mutations spread, the method of "surrounding, chasing and intercepting" may become outweigh the gains.
Facing the European and American societies that are about to fully open up, more than 90% of Chinese people who have no immunity will make China's fight against the epidemic likely to face the embarrassing situation of losing the other.These dynamic changes of the epidemic situation in the world and China all point in the same direction, and it is urgent to speed up vaccination!
At present, in China, given the limited vaccine effectiveness, yield and variety, priority should be given to vaccinating high-risk groups and regions. In important political, economic and cultural centers, a vaccine seat belt with an inoculation rate of more than 95% is the most effective. To reduce spread.And, immediately start the development of a new vaccine against the mutant virus.This is an issue that must be put on the agenda immediately.Moreover, in terms of technology, China should strive to have more exchanges and cooperation with international advanced technologies and exchange what is needed.
Photo/Wuhan Hankou Station, passengers are taking a train.In order to prevent the spread of the epidemic, it is a national policy to promote local Chinese New Year.
The global vaccine gap reaches 50 billion doses?How does society treat more than 200 million patients with new coronary sequelae? Will 2021 be better than 2020?
Although we have a vaccine this year, we do not have enough.Moreover, the virus is changing, and we have to change too.In terms of quantity, even if we use all the vaccines this year, there will only be an output value of about 30 to 50 billion doses (15 billion to 25 billion people are vaccinated). There is still a huge and impossible gap between the 75 billion people in the global village.This will allow the new crown virus to keep its base and continue to mutate, waiting for opportunities to counterattack.
In addition, scholars from the University of Leicester recently studied the 48 patients admitted to the hospital for the first wave of COVID-19 in the UK and found that nearly 30% of the patients were readmitted within 5 months, and 12% eventually died.
Although the number of severely ill patients admitted to the hospital accounts for only a small number of COVID-19 infections (about ten percent), the chronic multi-organ damage caused by COVID-19 among these people has attracted the attention of the medical community.
Based on the infection of 1 million people on the planet, more than 1 million people need emergency hospitalization. In addition to the more than two million people who have died, several million people may have serious sequelae.
The epidemic will eventually get better.However, based on the current statistics, in the first month of 2021 alone, nearly 2 million new coronavirus infections and 45 deaths were reported globally, and the epidemic situation is still getting worse, especially in developing countries without vaccinations. And facing the invasion of mutant strains.Judging from the number of COVID-19 infections and deaths, 2021 will far exceed 2020 million infections and 8 million deaths worldwide in 4.
Some scholars predict that the total death toll may be close to 5 million.Last year, the reality and data of epidemic prevention and control in developed countries made us very disappointed.And this year, in some poor countries and regions, the actual number of infections and deaths may never be known.We all hope that tomorrow will be better!But, unfortunately, this will not happen tomorrow in 2021.On the contrary, the peak of the epidemic will fall in 2021!
Last week, I was invited to give lectures in Geneva, Switzerland; the difference is that my class became a Zoom online class, and this annual international conference had to be held online.
After these hardships, those words that usually seem "tall" have infused new practical meanings in the Gengzi Year: survival, freedom, responsibility, action, mind, science, collaboration...
As for each of us, what we feel most deeply is "endurance" and "consequence"... This is not the first time a global infectious disease outbreak, and it will not be the last.
In 2020, God will let mankind understand the "global village" and the heart of awe more deeply! 2021, when hope is ahead, let us hold the handle again!
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