The world's first accurate depiction of the complete Delta transmission chain

2021-09-15: [Original Article Link].

At 0-24 on September 14, 31 provinces (autonomous regions and municipalities directly under the Central Government) and the Xinjiang Production and Construction Corps reported 73 new confirmed cases. Among them, 23 cases were imported from abroad (13 in Yunnan, 4 in Guangdong, 2 in Shanghai, 1 in Tianjin, 1 in Zhejiang, 1 in Fujian, and 1 in Henan), including 4 cases from asymptomatic infection to confirmed cases (1 in Tianjin, 1 in Zhejiang, 1 in Fujian, 1 in Guangdong); 50 local cases (all in Fujian, among them, there were 33 cases in Putian City, 12 cases in Xiamen City, and 5 cases in Quanzhou City), including 9 cases from asymptomatic infection to confirmed cases (all in Fujian). No new deaths. 1 new suspected case, which is an imported case from abroad (in Shanghai). On the same day, 46 cases were cured and discharged, and 1011 people were relieved of medical observation. The severe cases were the same as the previous day. There are 596 confirmed cases imported from abroad (including 4 severe cases) and 1 suspected case. A total of 8701 confirmed cases, a total of 8105 cured and discharged cases, no deaths. As Sep 14th 24 according to the 31 provinces, autonomous regions and municipalities directly under the central government and the public finance bureau of Xinjiang Production and Construction Corps report existing confirmed 837 cases (severe cases of 4 cases), A total of 89940 cured and discharged cases, a total of 4636 deaths, a total of 95413 confirmed cases, and 1 suspected case. Accumulatively tracked 1175662 close contacts, still under medical observation of 15205 close contacts. 31 provinces (autonomous regions and municipalities directly under the Central Government) and the Xinjiang Production and Construction Corps reported 16 new cases of asymptomatic infection, including 15 cases imported from abroad and 1 case locally (in Xiamen, Fujian); 13 cases were converted to confirmed cases on the same day (4 imported from abroad); 18 cases were released from medical observation on the same day (13 cases imported from abroad); 386 cases of asymptomatic infection still under medical observation (360 cases imported from abroad). A total of 28309 confirmed cases have been reported from Hong Kong, Macao and Taiwan. Among them, there were 12148 cases in the Hong Kong Special Administrative Region (11854 cases discharged, 213 deaths), 63 cases in the Macao Special Administrative Region (63 cases discharged), and 16098 cases in Taiwan (13742 cases discharged, 839 deaths). Xiamen a hospital nucleic acid detected more than 200 positive? According to the CCTV news client on September 14th news, the reporter from Fujian Xiamen Tong'an District police learned that online hot transmission of Xiamen third hospital nucleic acid detected more than 200 positive rumors, at noon that day, the police had traced the netizens who posted this information in the WeChat group. The other party admitted the mistake and had refuted the rumors in their WeChat circle of friends. In the follow-up, the police will deal with it in accordance with relevant regulations. In addition, according to the official Weibo of Xiamen Public Security Bureau @ Xiamen police online report, Xiamen police investigated and dealt with an illegal person who spread epidemic-related rumors in accordance with the law, and the person has been administratively detained. The specific notification is as follows ↓ On September 14, the false information that "the third hospital tested positive for more than 200" was circulated on the Internet, which aroused public concern and caused adverse social impact. On the same day, the Tongan Public Security Branch of Xiamen Public Security Bureau summoned Ji Mouyi (male, 33 years old, Tongan) who was suspected of publishing the false information to the police station for investigation. After investigation, Ji intended to hear the relevant news from others. Without verification, he used his sister Ji's mobile phone to publish "Now The report comes out, the third hospital tested positive for more than 200" messages, which were later forwarded by many people, causing the spread of false information. At present, due to Fictitious facts disrupting public order, according to the provisions of Article 25 (1) of the "Public Security Administration Punishment Law of the People's Republic of China", The Tongan Public Security Bureau has detained Ji in accordance with the law. The police reminded that the general public should pay attention to the official release of information when they understand the dynamics of the epidemic, do not spread false information, do not believe in rumors, do not spread rumors. What kind of communication chain does the local epidemic in Fujian? On September 12, Xiamen City reported the first case of Wu Moumou, a close contact of the confirmed case in Putian. At present, there are 33 confirmed cases in Wu's factory, all of which are close contacts of Wu's same factory and belong to the same transmission chain. In the birthplace of the local epidemic in Fujian, Xianyou County of Putian City has formed two transmission chains of the shop School and Xiesheng shoe factory. Putou Primary School in Fengting Town, Xianyou County was the first place to find cases in the epidemic. From Putian Health Commission published the case details can be seen as 14th 0, the laying head Primary School of the outbreak, has led to the 18 pupils infection. Xiesheng Shoe Factory located in Fengting Town is another concentrated communication point. According to the details of the cases released by the Putian Municipal Health Commission, 8 of the 36 new cases of infection on September 11 were employees of the shoe factory; 28 cases were newly infected on September 12, there were 12 cases for employees of the shoe factory. According to Quanzhou official disclosure as Sep 14th 24 Quanzhou Cumulative Report of confirmed cases in 7 cases, they are Putian outbreak associated with 4 cases are the shoe factory employees. Because of these two transmission chains, the epidemic has been spread by Putian to Quanzhou and Xiamen. Experts from the working group sent by the National Health Commission to Fujian studied and judged that as long as various measures and links are implemented, the scale of the epidemic is expected to be controlled before the National Day holiday. The picture shows that on September 14th, the staff is carrying out environmental killing in Fenyang Village, Xianyou County, Fujian Province. (Zhang Bin photo) Where did people from Putian, Fujian go? According to the report, 38-year-old Lin Moujie, on August 4th, took Xiamen Airlines Flight 852 from Singapore from Xiamen Airport, 14 days later, on August 19, the centralized isolation point in Xianyou County continued to be isolated (three nucleic acid tests were negative), and then home health monitoring was implemented on August 26. On September 10, the test was positive. Lin Moujie's 12-year-old Lin Moumou went to a primary school in Fengting Town, Xianyou County and tested positive for nucleic acid on September 10. This means that the epidemic transmission chain may start after Lin's home isolation on August 26. Baidu migration map, data statistics from August 26th to September 11th So since August 26th, where have people from Putian City gone? According to the statistics of Baidu's migration map from August 26 to September 11, the reporter found that during this period, the population of Putian City moved frequently, and most of the population flowing from Putian flowed in Fujian Province. Among them, Fuzhou, Quanzhou, Xiamen, Zhangzhou, Ningde and other places are the main places for the population of Putian City. In addition, Guangzhou, Shenzhen, Nanchang, etc. also had a continuous population inflow in Putian City during this period. How many more infected people will be detected? According to preliminary research by experts, the source of the epidemic is suspected to be an infectious chain caused by Singaporean inbound personnel Lin Moujie, and the virus gene is a Delta strain. This time, the cunning "Delta" not only has a long incubation period, but also spreads fast and is highly contagious. Just 4 days Fujian Local confirmed cases it has broken through the hundreds of cases. From September 14th, Xianyou County launched the second round of nucleic acid testing for all staff, and Putian City, Xiamen City and Hui'an County of Quanzhou City also launched all-member nucleic acid testing. Wu Haiduan, the county magistrate of Xianyou County, said that experts have judged that it is necessary to go through more than three rounds of nucleic acid testing and then judge according to the results. The current situation is relatively severe. With the expansion of the range of nucleic acid detection and the full promotion of flow tracing, more infected people are expected to be detected in Fujian. The first in the world! Zhong Nanshan and other teams accurately depict the complete transmission chain of Delta variants The team of Professor Tang Xiaoping and Li Feng from the Eighth Hospital Affiliated to Guangzhou Medical University, and the team of Academician Zhong Nanshan and Professor Chen Ruchong of Guangzhou Respiratory Health Research Institute, the First Affiliated Hospital of Guangzhou Medical University, for Delta variation strains cause the "5 · 21 the Covid pneumonia outbreak", in combination with epidemiological and virus genome sequencing technology for the first time on a global scale accurate depiction of the Delta mutant dissemination of full chains, combined with clinical resources, the clinical characteristics and viral dynamics of the cases in the epidemic were described in multiple directions. Recently, the research results were published in the international authoritative journal "The Lancet" Journal of Electronic Clinical Medicine. According to previous epidemiological investigation and viral nucleic acid gene sequencing "5 · 21 the Covid pneumonia outbreak" for Delta variation strains cause, with a clear chain. For the first time, the study tracked and fully reported the clear chain of transmission of this outbreak. In the beginning of the 75-year-old woman accidentally exposed infection and close family contact or dinner and infected another 3. The researchers observed that the transmission of the virus in the epidemic was mainly through direct and indirect close contact, of which 30.8% of the infected were transmitted through meals, followed by family contact (30.13%), community communication (18.59%), and other routes of transmission including work and social contact (19.87%). At the same time, the researchers included the "5 · 21" epidemic in a cohort of patients infected with the wild strain of the new coronavirus in the 2020 COVID-19 epidemic, the clinical characteristics and viral dynamics of the "5 · 21" epidemic cases were analyzed in multiple directions, and the characteristics of Delta variants were summarized, and the risk factors for severe illness were sought. The researchers found that the Delta variant had a short incubation period and a rapid spread, with a median incubation period of only 4.7 days, which was significantly shorter than that of the wild strain (6.3 days). Further subgroup analysis showed that in the non-severe Group, the latency of the virus (4.0 days) was significantly shorter in the non-severe group than in the wild strain (6.0 days). The Delta variant can spread 4 generations in 10 days, of which the fastest intergenerational transmission does not exceed 24 hours. Compared with the wild strain, the viral load of the Delta variant was significantly higher (the median CT value is 34.0, the latter is 20.6, the higher the viral load), the time of nucleic acid conversion of Delta mutant strains was also significantly longer than that of wild strains. The researchers also found that infection with the Delta variant was a risk factor for predicting critical illness. The risk of critical illness was 1.45 times higher in the Delta mutant group than in the wild strain group among elderly patients aged 60 years and older; moreover, the development of infected Delta mutant strains is 2.98 times faster than that of infected wild strains. Researchers believe that this study revealed that the Delta variant has the characteristics of short incubation period, fast transmission speed, high viral load, long nucleic acid conversion time, and easier development into critical illness. Therefore, it is very important to quickly track, isolate and detect virus infected persons in time, implement timely control of key places and implement nucleic acid screening for all staff in local areas under special circumstances. The practice of quickly discovering the source of infection and cutting off the route of transmission provides the "Guangzhou experience" for the prevention and control of the Delta variant of the Covid virus ". New guidelines released! Concerning the full nucleic acid detection In order to effectively respond to the possible epidemic caused by the Delta variant of the new coronavirus, and to further enhance the ability of the organization and implementation of nucleic acid testing, the National Health Commission organized experts to combine the preliminary work practice, the "Guidelines for the Implementation of the New Coronavirus Nucleic Acid Testing Organization" was revised to form the "Guidelines for the Implementation of the New Coronavirus Nucleic Acid Testing Organization (Second Edition)". Which clearly: It is necessary to actively respond to the new coronary pneumonia epidemic, quickly and efficiently control the epidemic, standardize the work process of nucleic acid testing organization, sampling, testing, reporting, etc., coordinate the deployment of nucleic acid testing resources, and improve the quality of nucleic acid testing. 5 million of the population within the city, should be completed within 2 days full nucleic acid detection task, if necessary by the people's governments of provinces, autonomous regions and municipalities, the) within the overall security. 5 million over population in cities should be completed in 3 days full nucleic acid detection task, if necessary, may apply for the support of the whole nation. Relevant nucleic acid detection strategy: in the early stage of the epidemic, at least 3 rounds of nucleic acid testing should be carried out when the source of the risk is unknown, comprehensive research and judgment of nucleic acid test results to determine the subsequent detection range and frequency. In principle, the isolation and nearly 3-wheel nucleic acid detection there have been cases of the neighborhood or the community a daily check, within 14 days there have been cases in recent 3 rounds of nucleic acid detection no cases have been in the neighborhood or the community every other day for a check, within fourteen (14) days not cases of every 5 days check. Relevant sampling methods: according to the control measures taken by the target population has taken measures to determine the sampling method, isolation points and other key groups should be single inspection, closed community (closed to the home) 1 household and 1 tube, other regions take 5 mixed 1 or 10 mixed 1 to carry out testing according to the actual situation. For nucleic acid detection laboratory reserves and guarantee: 5 million of the population of city must reserve 2 shall be available for nucleic acid detection support teams use of laboratory or reconstruction of the region; 5 million over population in city, there should be a reserve of 5 laboratories or reconfigurable areas that can be used by the nucleic acid detection support team. Each lab or reconstruction of the region should, at the very least, can accommodate 5 testing team (each team day amount by 10,000 tube) and reserve related testing equipment, reagents and consumables. Source: Sichuan CDC China

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