专家：预计明年1月，新冠将回归乙类传染病管理

生命时报2022-12-19

《生命时报》第1666期头版受访专家：北京大学首钢医院感染性疾病科主任、主任医师张丹北京大学法学院教授、卫生法学专家孙东东武汉大学公共卫生学院教授谭晓东本报记者张健卞磊2022年接近尾声，随着疫情防控措施的持续优化，全国各地复工复产也按下“加速键”。例如，北京市经济技术开发区百强企业复工复产率达100%；重庆市重大项目累计复工率达99.5%；广州市、深圳市等多地自...

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Comment（9）

herb
·2022-12-19
專nimagebi
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轩辕小伞
·2022-12-19
政策隨意性太強，經濟活動毫無預見性
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3
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谷歌屮国广东论一许
·2022-12-19
應該在家庭教育儲備檢查抗原體與新冠傳染病管理數據庫庫。。。。？。？？？？@@%%%
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nomi
·2022-12-19
別嘈踏馬了
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王勇_4337
·2022-12-19
應該是明天出版的報紙吧，今天就先登出來了！
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2
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看股票的布朗熊
·2022-12-19
真把老百姓當耗材了
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- 哥的韭菜:
  不是耗材吗？
  2022-12-19
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sammas
·2022-12-19
說話動動腦子啊。特殊崗位確實需要輕症在可能的條件下繼續服務，比如醫護。但是對於非特殊崗位，最好的做法是控制傳染速度，讓感染曲線平滑，不要硬着陸這政策搞的，一腳油門、一腳剎車。打的全是無準備之仗
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- skyteeth:
  就这么极端你能怎么样
  2022-12-19
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- 陈文红:
  666
  2022-12-19
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- tunu:
  加油
  2022-12-19
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Skysmile
·2022-12-19
**
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灰太狼1234
·2022-12-19
所以入境還隔離麼
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 磊2022年接近尾声，随着疫情防控措施的持续优化，全国各地复工复产也按下“加速键”。例如，北京市经济技术开发区百强企业复工复产率达100%；重庆市重大项目累计复工率达99.5%；广州市、深圳市等多地自12月份起发放多轮消费券，期待重拾城市烟火气。但同时，各地的新冠感染者也处于快速增长期。绝大多数感染者在经历几天休息和康复后，很快就回到岗位工作，继续拥抱新生活。也有部分行业、企业推进复工复产面临困难，不少企业因为出现大量阳性感染者，业务经营一片愁云惨雾；外卖、快递等服务行业因为感染风险高，高薪却难求一人，城市服务遭受重创；有的学校，更是因一两个学生出现抗原阳性，整个线下教学说停就停，学生学业耽误拖延……面对当前现状，多位专家对《生命时报》表示，总躲着新冠不是办法。如今奥密克戎毒株的危害性已大大降低，感染者一般一周左右就能转阴，我们只有将新冠像流感一样管理，才能真正助力各行各业安全有序恢复动力，让所有人尽快回到正常的工作生活状态。阳性成常态，新冠降级管理更合理近段时间，北京市新冠阳性感染者明显增加，疫情快速扩散蔓延的趋势仍然存在。大量无症状感染者或轻型病例居家康复，一些行业也因有阳性病例、核酸检测“十混一”阳性、顾客稀少等问题，一度陷入半停摆状态。例如，西单明珠商场12月7日恢复营业后，客流寥寥无几，全楼商家平均到岗率不足20%，最后不得不缩短营业时间，暂停部分楼层营业。湖南省某市一高三班级，因一名学生阳性，全班暂停线下教学，回家自我隔离。“冬季本就是呼吸道疾病高发季节，目前，新冠感染者大量增加已不可避免，北京、上海等大城市已接近感染高峰，二三线城市和农村地区可能还会持续增加一段时间才能到达感染高峰。”北京大学首钢医院感染性疾病科主任、主任医师张丹说，随着越来越多阳性病例出现，奥密克戎已经开始大规模流行，疫情防控和医疗卫生的重心就要从防控传染转移到治疗上来。北京大学法学院教授、卫生法学专家孙东东表示，到12月14日，“新十条”落地实施已整整一周时间。按病毒代谢规律，大约在12月21日以后，北京感染数量可能会有所减少。随着越来越多的民众对病毒有了“亲身体会”，对奥密克戎的认识也越来越准确，囤药和医疗挤兑现象会随之逐渐缓解。但目前确实存在部分用人单位对感染问题反应过度、自行加码的情况，也存在部分员工由于害怕感染而不愿复工的现象，这阻碍了大家回归正常生活。从现实情况来看，我们应科学认识奥密克戎变异株，虽然感染后个体差异较大，每个人症状轻重有所不同，但基本都是上呼吸道感染，不会带来肺部损伤。因此，我们应该按季节性流感来对待它，将新冠降类管理提上日程。武汉大学公共卫生学院教授谭晓东也表示，政策会有一个过渡期，预计明年1月，新冠将回归乙类传染病管理。未来，奥密克戎的管理要向流感等其他冬季传染病管理看齐。总因为个别人阳性，导致全体、乃至全社会正常运行受影响，这与民众所期望的社会活力及政策优化目的是相悖的。无症状、轻症人群应该返岗目前，普通中青年患者感染奥密克戎后，多为无症状或轻症，病程一般为5~7天，接种过新冠疫苗并完成加强免疫的人群，病程更短、病情更轻。按照国务院联防联控机制综合组印发的《新冠病毒感染者居家治疗指南》标准，居家治疗人员症状明显好转或无明显症状，自测抗原阴性且连续两次核酸检测Ct值大于等于35（两次检测间隔大于24小时），可结束居家治疗，恢复正常生活和外出。然而，现阶段由于核酸检测力量不足，很多社区已经做不到上门核酸检测服务，有的社区直接参考两次抗原阴性即可解除居家隔离。“无症状感染者居家并没有实际意义。”张丹说，从防范传染病的角度来说，为切断传播途径，阳性感染者应该居家到两次核酸检测为阴性为止，但前提是，新冠病毒在有限范围内传播。而随着阳性人群增多，根据国外传播的数据规律，明年1月左右，我国人群感染率大约会增加到60%~70%，明年3月左右，可能会达到90%。可以说，过段时间几乎人人都“阳过”。如果阳性感染者都居家管理，社会可能会在很长一段时间里陷入瘫痪，所以必须考虑备选方案，维持全社会生产生活。在诸多行业人力短缺的情况下，应允许无症状感染者和轻型病例回到岗位，这也是不少机构已开始实施的方案。例如，为应对激增的就医需求，不少医疗机构不得不让无症状和轻症的医护人员恢复工作。香港特区政府的做法是，可根据新冠症状的严重程度来判断人群是否可复工：1.重症患者要住院治疗。重症指的是新冠核酸阳性之后，出现了发热、干咳、乏力、咽痛、味觉嗅觉减退、鼻塞、流涕、结膜炎、肌痛、腹泻等10类新冠肺炎相关症状，影像学上又确诊为肺炎的。2.轻症患者缓解后可复工。可居家治疗的轻型病例，经过服药、适当休息，症状缓解后，在不影响体力的情况下，就可以复工。3.无症状感染者可正常上班。如果没有典型的新冠症状，或只是轻微的乏力、头疼，不影响工作的，可以正常上班。不过，需要根据个人从事的工作强度和身体耐受程度进行区分。例如，从事重体力劳动的人，即使是无症状感染者，出现不能胜任工作的情况，也应改为轻体力劳动或休息。保护好重点人群，关注医疗资源薄弱地区孙东东认为，若想全面推动复工复产，各地必须认真贯彻落实《传染病防治法》，理顺“二十条”“新十条”等防疫政策，坚持“预防为主，防治结合、分类管理、依靠科学、依靠群众”的传染病防治工作方针。首先，复工复产复学的前提和基础是，坚持落实好出台的一系列政策措施、指南，对重点人群积极对症治疗，尽可能防止合并细菌感染、诱发身体重要器官损害等。其次，目前新冠肺炎是乙类传染病按照甲类管理，建议将新冠降为乙类管理，同时将由奥密克戎引发的单纯上呼吸道感染，降为丙类管理，流感也是丙类。另外，在复工复产已是人民群众迫切需要的当下，尤其临近春节，健康码及各地实施的各类码应尽快取消，因为它已失去了流行病学调查的意义。特别是当前健康码和核酸检测的规定还存在矛盾之处。例如，乘坐公共交通工具及前往公园等公共场所已不再查验健康码和核酸阴性证明，多地餐馆堂食、单位上班等又需持核酸阴性证明，但社区核酸检测点已逐渐撤出，社会核酸点检测结果又迟迟不出，导致很多人耽误上班、就餐不便等。当然，取消健康码并不意味着可以完全放松警惕，对于一些特殊机构，如养老院、精神病院等，还是有必要严格管理，进行核酸查验。再次，个人和企事业单位机构等应担起相应的责任。孙东东强调，对抗新冠，最关键的是“依靠群众”。无症状感染者、轻症患者和感染后康复人群复工后，应佩戴好N95口罩、做好手卫生。同时，单位机构应“程式化”地加强职场环境卫生管理，减少气溶胶传播风险，定期对场所消毒、通风，并采取适当措施增强人员免疫力。例如，企业要提倡员工在上班间隙活动身体，做工间操等；学校可鼓励学生在课间多进行户外活动。大家要坚持科学防疫，只有在不躲新冠、不怕新冠、正确认识疫情的基础上，对形势做出理智判断，众志成城，才能共克时艰。谭晓东呼吁：“不能只把目光集中在大城市，二三线城市和农村地区医疗资源相对薄弱，儿童、老人、孕产妇等脆弱人群更加庞大。目前，北上广等一线城市快达到或已经达到感染高峰，二三线城市和农村地区正处于感染数量上升期，还有一到两周的窗口期，这是我们最重要的时刻！”一是要把ICU、重症救治等资源准备好。近日，国务院应对新型冠状病毒肺炎疫情联防联控机制综合组研究制定的《依托县域医共体提升农村地区新冠肺炎医疗保障能力工作方案》也明确提出，要做好农村地区新冠肺炎医疗服务工作，保障高龄合并基础疾病等重症风险较高的感染者及时救治，在农村地区，以县域医共体为载体，提升县级医院重症救治能力，发挥乡镇卫生院和村卫生室健康监测作用，最大可能降低重症率、病亡率。二是要加强健康教育。政府相关部门、大众媒体，应通过广泛的宣传教育，引导社会科学正确认识奥密克戎，指导个人做好健康管理，包括家庭环境的科学消杀、通风，日常的营养均衡和科学运动。目前多数人在出现症状后，只需要居家治疗，一定要先以观察为主，不要乱用药、滥用药，否则会带来更多危害。另外，当前应优先确保医院患者、养老院老人等重点人群的用药需求，希望大家不要盲目抢购和囤药，这会导致真正需要药物的人购药困难。三是尽快接种加强针。医务工作者、老人、孕产妇、儿童等要首先接种第四针。12月13日，国务院应联防联控机制综合组发布了《新冠病毒疫苗第二剂次加强免疫接种实施方案》，提出感染高风险人群、60岁以上老年人群、具有较严重基础性疾病人群和免疫力低下人群中开展第二剂次加强免疫接种。最近两周是接种加强针的黄金时间，也是有效降低重症率、病死率的有效手段，相关人群要尽快接种，优先推荐序贯加强免疫（加强针与之前两针所用疫苗种类不同）。","kind":null,"is_publish_news":true,"is_publish_highlight":true,"is_publish_live":false,"is_publish_wemedia":null,"editions":null,"column":"","sentiment":"0","news_tag":"","news_rank":0,"symbols":[],"gpt_button":1},"commentList":[{"id":623295824,"gmtCreate":1671430419970,"gmtModify":1676538535288,"author":{"id":"3527546903021838","authorId":"3527546903021838","name":"herb","avatar":"https://static.tigerbbs.com/7a8a764def14157ddf52a6db9ac906fe","vip":1,"crmLevel":1,"crmLevelSwitch":0,"idStr":"3527546903021838","authorIdStr":"3527546903021838"},"htmlText":"專nimagebi","listText":"專nimagebi","text":"專nimagebi","images":[],"top":1,"highlighted":1,"essential":1,"paper":1,"likeSize":0,"commentSize":0,"repostSize":0,"link":"https://ttm.financial/post/623295824","repostId":1128906209,"repostType":2,"isVote":1,"likeStatus":false,"favoriteStatus":false,"reportStatus":false,"tweetType":1,"langContent":"CN"},{"id":623207427,"gmtCreate":1671425946670,"gmtModify":1676538534754,"author":{"id":"3564978165288885","authorId":"3564978165288885","name":"轩辕小伞","avatar":"https://static.laohu8.com/default-avatar.jpg","vip":1,"crmLevel":6,"crmLevelSwitch":0,"idStr":"3564978165288885","authorIdStr":"3564978165288885"},"htmlText":"政策隨意性太強，經濟活動毫無預見性","listText":"政策隨意性太強，經濟活動毫無預見性","text":"政策隨意性太強，經濟活動毫無預見性","images":[],"top":1,"highlighted":1,"essential":1,"paper":1,"likeSize":3,"commentSize":0,"repostSize":0,"link":"https://ttm.financial/post/623207427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