Xinhua News Agency, Beijing, November 21st Question: how to carry out nucleic acid testing in various places? How to classify and manage high and low risk areas? —— Focus on the new documents of the State Council joint defense and joint control mechanism

Xinhua News Agency reporters Dong Ruifeng, Peng Yunjia and Gu Tiancheng

After the introduction of Article 20 optimization measures, the Comprehensive Group of the State Council Joint Prevention and Control Mechanism released four documents on 21st, namely, Implementation Measures for Nucleic Acid Detection in COVID-19 Epidemic Prevention and Control, Delineation and Control Plan of COVID-19 Epidemic Risk Area, Medical Observation Guide for Home Isolation of COVID-19 Epidemic, and Home Health Monitoring Guide for COVID-19 Epidemic, to further guide all localities and departments to do a good job in epidemic prevention and control.

How to carry out nucleic acid detection in different regions? What are the demarcation standards and control schemes for high and low risk areas? What are the self-management requirements for home isolation medical observation? Who needs home health monitoring? The above documents give answers to these questions one by one.

How to carry out nucleic acid detection? Early detection and early disposal

Early detection is one of the keys to deal with the epidemic in time. The Measures for the Implementation of Nucleic Acid Detection for Epidemic Prevention and Control in COVID-19 provides guidance for epidemic monitoring in all localities in terms of normalization monitoring and regional nucleic acid detection.

In terms of normalization monitoring, this method requires key institutions and places to monitor the symptoms of relevant personnel under normalization, and can organize nucleic acid sampling according to local prevention and control needs. After 1 case or more local epidemic occurs within the jurisdiction, the whole staff should be organized to complete the nucleic acid detection in time, and then the nucleic acid detection can be carried out according to the detection results and the spread risk of the epidemic, according to the sampling ratio of at least 20% per day or the detection requirements of the jurisdiction.

At the same time, medical institutions carry out nucleic acid testing for all patients with fever, unexplained pneumonia and severe acute respiratory infection in hospitalized patients, all newly admitted patients and their accompanying staff.

In terms of regional nucleic acid detection, this method requires that in the process of epidemic disposal, on the basis of epidemiological investigation, comprehensive judgment should be made according to the population size in the epidemic area, whether the source of infection is clear, whether there is a risk of community transmission and whether the transmission chain is clear, and the scope, frequency and order of the detection population should be determined according to the risk size and the principle of classification.

According to this method, after the outbreak in provincial capital cities and cities with a population of more than 10 million, it is found that the transmission chain is unclear, there are many risk sites and risk personnel, and the risk personnel are highly mobile. When there is a risk of spread of the epidemic, all the people in the epidemic area will be tested once a day. After three consecutive nucleic acid tests without social infection, all the people will be tested once every three days. If there is no social infection, all the people can stop the nucleic acid testing.

How to manage different risk areas? Implement classified management measures

Twentieth optimization measures will adjust the risk area from "high, medium and low" to "high and low". What are the criteria for delineating different risk areas? What prevention and control measures need to be taken respectively?

According to the Delineation and Control Plan of Epidemic Risk Zones in COVID-19, once a local epidemic occurs, the counties (cities, districts and banners) where the cases and asymptomatic infected people are located should be accurately divided into high-risk zones and low-risk zones as soon as possible, and all forces should be coordinated to implement classified management measures.

The plan makes it clear that, in principle, the areas where infected people live, as well as workplaces and activities with frequent activities and high risk of epidemic spread are classified as high-risk areas. High-risk areas shall be sealed and controlled, during which "stay at home and provide on-site service". If new infected persons are found during the containment period, the local joint prevention and control mechanism will organize risk judgment, and the containment time of the original containment area can be extended in whole or in part according to the requirements of "one area, one policy".

The plan made it clear that no new infections were found in the high-risk area for five consecutive days, and all the people in the risk area were negative after completing a round of nucleic acid screening on the fifth day, which was reduced to a low-risk area. High-risk areas that meet the conditions for unsealing should be unsealed in time.

Other areas of counties (cities, districts and banners) where high-risk areas are located are designated as low-risk areas. Implement "personal protection and avoid aggregation" and leave the city with a negative nucleic acid test certificate within 48 hours. In addition, after all high-risk areas are lifted, counties (cities, districts and banners) will implement normalized prevention and control measures.

According to the plan, in the process of epidemic disposal, if individual cases and asymptomatic infected people have low transmission risk to the residence, work place and activity area, close contacts have been controlled in time, and there is no risk of community transmission after judgment, the risk area may not be designated; Counties (cities, districts and banners) that have not experienced local epidemics should earnestly implement various measures for the prevention and control of normalized epidemics, and there is no need to delimit risk areas.

How to do home isolation? Period assignment management

Who needs home isolation medical observation? What are the self-management requirements of home isolation medical observers?

The "Guidelines for Medical Observation of Home Isolation of COVID-19 Epidemic" clearly states that the management targets include special people among close contacts, close contacts and entry personnel after lifting centralized isolation, spillover personnel in high-risk areas and other personnel who cannot be subjected to centralized isolation medical observation after professional evaluation.

According to the guideline, medical observers in home isolation should take temperature measurement and self-health monitoring once a day in the morning and once a night, and report the monitoring results to the community medical observation management personnel. During the period of home isolation, the code management is assigned, and the home isolation personnel strictly do not go out and refuse all visits. For those who really need to go out for medical treatment, they can go out only after being approved by the local community medical observation and management personnel, and arrange a special car to do personal protection and implement closed-loop management.

Among them, non-single residents, their daily life and meals are limited to the isolation room as far as possible, and other people do not enter the isolation room. You don’t need to wear a mask when you are in the isolation room, and you should wear a mask when you leave the isolation room. Try to reduce contact with other family members, keep a distance of more than 1 meter when contacting, and wear medical surgical masks regularly.

According to the guideline, medical observers in home isolation should cooperate with the staff to complete nucleic acid detection, antigen self-test and report the results according to the relevant prevention and control requirements.

How to do home health monitoring? Don’t go out unless necessary

Who needs home health monitoring? What management requirements do home health monitors have?

The Guidelines for Home Health Monitoring of Epidemic in COVID-19 clearly states that it is applicable to employees in high-risk posts who have finished closed-loop operations, people discharged from hospitals (cabins) infected with COVID-19, and other people who need home health monitoring after professional evaluation.

According to the guideline, the personnel who implement home health monitoring should measure their body temperature once a day in the morning and evening, do a good job in symptom monitoring, and truthfully report to the community (village). During the period of home health monitoring, I should strictly implement not going out unless necessary, and do personal protection when going out under special circumstances such as medical treatment, and wear N95/KN95 particulate matter protective mask regularly to avoid taking public transportation. At the same time, it is necessary to cooperate with the completion of nucleic acid detection according to the prevention and control requirements.