Red Star News:

The NHC has released the ninth version of the COVID-19 diagnosis and treatment guidelines, making important adjustments in the management of people with mild COVID-19 infections and the cycle threshold value of a nucleic acid test. What are the reasons for the adjustments? Does it mean that prevention and control measures have been relaxed? Is it necessary for all localities to continue to implement strict prevention and control measures?

Jiao Yahui:

Thanks for your questions. First, I would like to make it clear that revisions to China's COVID-19 diagnosis and treatment guidelines do not mean relaxed prevention and control measures. All localities should continue to carry out COVID-19 prevention and control work with caution constantly. The revisions are based on our country's anti-epidemic experience over the past two years, especially the observation and research of clinical cases infected with the Delta and Omicron variants. The main adjustments involve the detection and reporting of cases and the adding of antigen testing to form the "antigen test plus nucleic acid test" tactic. In addition, we proposed classified treatment. We have also made adjustments to antiviral treatment, TCM treatment, criteria for being released from isolation and discharged from hospitals, and management following discharge. The adjustments are made in accordance with General Secretary Xi Jinping's important instructions to make the COVID-19 response more scientific and targeted, and achieve maximum effect in prevention and control with minimum cost.

I would like to give a detailed explanation on changes to the admission of cases. In terms of classified treatment, people with mild COVID-19 infections will be placed at centralized isolation facilities rather than in designated hospitals, according to the latest version of the guidelines. Mild, severe, and critical cases, as well as cases with other high risks, will be admitted to designated hospitals. In other words, asymptomatic and mild cases will be placed in centralized isolation. Here I want to clarify that centralized isolation facilities for asymptomatic and mild cases must be strictly separated from those designated for close contacts and overseas travelers because mild and asymptomatic cases have positive nucleic acid test results, while close contracts usually have negative nucleic acid test results, so isolation facilities for them must be strictly separated. 

In response to the pandemic, some regions use special isolation facilities, such as Shandong province and Jilin province, where temporary treatment centers have been built. That doesn't mean that people with mild COVID-19 infections and asymptomatic cases placed in centralized isolation will go uncared. The revised guidelines require that the centralized isolation facilities where these cases are treated should also be staffed with medical personnel. What are the duties of those medical personnel? On the one hand, they should provide therapies to the mild cases, such as cases with symptoms of nasal obstruction, a cough, and fever. On the other hand, they should monitor the patients' conditions. Based on our practice, about 95 percent of patients in the latest outbreak are asymptomatic or only show mild symptoms. Although there are fewer treatment and intervention measures for them, it does not mean that we will leave them unattended. If their condition worsens, they will be timely transferred to designated hospitals for further treatment. 

The other thing that people are concerned about is the CT (cycle threshold) value — part of the discharge criteria. In the ninth version of the diagnosis and treatment plan, we proposed that patients can be discharged from hospitals or centralized isolation when their two consecutive CT values are both 35 or above with at least 24 hours between the two tests and that the COVID-19 symptoms relieved, with some hospitalization-required symptoms gone. The adjustment is also based on our practical research. Research showed that the live virus cannot be isolated from samples of convalescent patients whose CT value is 35 and above, meaning that these patients are no longer infectious. Therefore, such patients can be discharged from hospitals and return home. These adjustments have been made to improve the utilization efficiency of medical resources. For one thing, we can concentrate in-need cases in hospitals to ensure effective medical treatment. For another, it also leaves us more medical resources to provide normal medical services for the public. The adjustment has fully embodied implementing the principle of putting the people and their lives first.  

As for post-discharge management, we changed the previous 14-day isolation into seven-day health monitoring at home. Thus, the adjustments made to the latest diagnosis and treatment plan does not mean the pandemic prevention and control policies have been relaxed. Instead, they are more scientific, precise, and targeted. Thank you.