SCIO briefing on progress of Central Guidance Team in Hubei to organize and guide epidemic control and medical rescue
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E-mail China.org.cn, February 29, 2020
Xinhua News Agency:
Official data shows that there are still a large number of severe cases of novel coronavirus infection in Hubei province, especially in Wuhan. What measures have been taken to treat severe patients so that the mortality rate is reduced? Thank you.
Ma Xiaowei:
Compared with SARS, the new coronavirus spreads faster. Most infected people show mild symptoms, while a small number of people are in a critical condition, with the heart and other organs affected. Among the fatalities, most people have serious underlying diseases, including heart disease, terminal cancer and kidney failure. There are also some young patients whose diseases developed rapidly, hence increasing the difficulty of treatment. Although the medical community lacks knowledge about the treatment of the disease, as well as the mechanism of its development and outcome, the viral damage to the body is consistent with the known pathophysiological process. Enhancing medical treatment and improving the quality of basic medical care are always the essential requirement for us.
In order to reduce the mortality rate and increase the recovery rate, we have adopted the strategy of "pooling together patients, experts and resources for centralized treatment." In Wuhan, we identified more than 10 designated hospitals with over 9,000 beds for the treatment of severe and critically ill patients. Around 13,000 high-level medical personnel from more than 90 national and provincial medical teams have been dispatched to these hospitals. They closely cooperate with local medical workers, and continue to make new progress in the treatment of severely ill patients.
To sum up, we have made efforts in the following three aspects. First, we try to make the treatment more targeted. By carrying out study on pathological anatomy, we have identified which organs suffer great damage and to what extent. In this way, we have made clear the main direction of clinical treatment and come up with corresponding treatment methods. We continue to optimize the previous treatment schemes and reach an expert consensus on treating severely ill patients. Second, we need to figure out more creative ways of treatment. It's very important to identify critically ill patients at an early stage. We need to focus on the principal contradiction during clinical treatment, such as solving the problem of tracheal obstruction, and adopt treatment methods and devices in a creative way. We have to seize the best time for treatment, choose the best treatment method, and even determine the optimal dosage of the medications. This time, anesthetists are a mainstay in intensive care units. They have formed a special team to carry out tracheal intubation and provide ventilator support for patients in a timely manner. It's very important to adopt this means at an early stage to save the lives of patients. This is also what we have learned from the treatment process of the severely ill. Third, we need to take a holistic approach to the treatment. We will give full play to the role of high-level experts working together, attach importance to their close communication and collaboration, and enhance the exchange of experience among them.
We should ensure the "four combinations" in the fight against the COVID-19. First, we should combine preclinical medicine with clinical practice. We will further conduct research on etiology, morbid anatomy and immunology in order to provide theoretical support and clinical evidence to improve the effectiveness of clinical treatment.
Second, we should combine frontline medical treatment with backup multidisciplinary consultation and technical support. During the early stage of the epidemic outbreak, the rear area supported the frontline work mainly by strengthening the available medical force, and allocating sufficient medical supplies and equipment. At present, however, the priority for the rear area is moving to provide multidisciplinary technical and academic support, with consultations held daily between frontline and rear-area doctors to make the very best treatment plan for severe cases.
Third, we should combine treatment with nursing. We have witnessed patients suffering severe respiratory disease in a critical condition, as well as the treatment and care they received in the ICU. All these cases show the significance of basic nursing. Therefore, we should establish unified nursing procedures, standards and assessment at the wards for severely-ill patients, with an aim of attending to all.
Fourth, we should combine treatment with outstanding management. We have adopted a model of overall takeover, with assisting medical staff from the same hospital taking charge of one specific department. On that basis, we have also established a joint medical affairs department, nursing department and nosocomial infection control department; set up joint expert groups consisting of experts at the national, provincial and municipal level; and constantly improved procedures and unified standards. Meanwhile, we have arranged inspections and mobile medical services by expert groups covering other hospitals in Wuhan. By doing so, we have brought all the severe and even critical cases in the epicenter city into unified management.
Based on previously accumulated experience, we have released the sixth edition of the COVID-19 diagnosis and treatment scheme. Up to now, we have cured more than 78,000 patients. Over 36,000 patients have been discharged from hospital after recovery. On that basis, we should provide the Chinese approach to the treatment of severe COVID-19 cases, which applies the Chinese standards and reflects the Chinese level of health service provision. With continued progress made in clinical treatment of the disease, our medical staff will accumulate more experience and strengthen their confidence to fight on the frontline against the epidemic.
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