SCIO briefing on progress of Central Guidance Team in organizing and guiding epidemic control and medical rescue

The State Council Information Office held a press conference on March 31 in Wuhan, inviting members of the Central Guidance Team to brief the media about the progress of its work in epidemic control and medical rescue. April 2, 2020

Shou Xiaoli:

Good afternoon, everyone. Welcome to the press conference held by the State Council Information Office in Wuhan, Hubei province. Today, we have invited Mr. Ma Xiaowei, a member of the Central Guidance Team, and minister of the National Health Commission (NHC); Mr. Yu Xuejun, a member of the Central Guidance Team, and vice-minister of the NHC; Mr. Chang Jile, director of the Bureau of Disease Prevention and Control, NHC; Ms. Jiao Yahui, deputy director of the Bureau of Medical Administration, NHC; and Mr. Luo Huiming, chief physician of the Chinese Center for Disease Control and Prevention (CDC). They will introduce the progress being made by the Central Guidance Team in organizing and guiding work related to epidemic control and medical rescue. Later, they will answer your questions. 

First, I'll give the floor to Mr. Ma Xiaowei.

Ma Xiaowei:

Good afternoon, friends from the media. Since the COVID-19 outbreak, the CPC Central Committee with Comrade Xi Jinping at its core has consistently put people's safety and health first. General Secretary Xi Jinping has been personally deploying, commanding and leading the battle against COVID-19. Since Jan. 27, the Central Guidance Team has been stationed in Wuhan and effectively guiding, organizing and promoting the work related to epidemic prevention and control in Hubei province. We have taken a two-pronged approach to focus on both treatment and community-level prevention to contain infections, treat the infected and control the variables. With much effort, we have essentially cut off domestic transmission across the whole nation with Wuhan as the main battlefield, which means we have achieved a milestone in epidemic control.

With patient treatment as the top priority, the Central Guidance Team has made special deployments on dispatching medical team, increasing available hospital beds, treating severe and mild patients, applying traditional Chinese medicine (TCM), monitoring and managing recovered and discharged patients, and preventing hospital-acquired infections. We have worked from two aspects: management and treatment. We have overcome one difficulty after another and conducted much research. To date, more than 63,000 patients in Hubei province have now recovered, with a recovery rate of over 93%.

With regards to hospital management, we have organized more than 42,600 medical workers from NHC's subordinated and administered hospitals, hospitals of provinces across the country and hospitals of the PLA to form over 340 medical teams. They took equipment and supplies to assist Hubei province. Among them were more than 15,000 specialists in intensive care, respiratory medicine, circulatory medicine and anesthesiology. 10 provinces sent 20% of their intensive care specialists.

The Central Guidance Team carried out sophisticated coordination and dispatch work, matching medical treatment capacity with the treatment tasks and degree of difficulty. The team made resolute decisions to build Fangcang shelter hospitals and designated hospitals; accelerated the revamp of existing hospitals; and expanded medical resources via various channels. Due to these actions, the health system was able to withstand the shock of the rapidly increasing amount of cases at the peak of the outbreak. We adopted a model that directed national medical teams to take over whole wards, while provincial, regional and local-level medical staff took charge of specific departments. Also, joint medical affairs offices, nursing departments and hospital infection control offices were established, and joint expert teams were formed at the national, provincial and municipal levels. We implemented five systems: the daily assessment of patients; discussions and group consultations about difficult diseases; regular visits to patients; holistic nursing; and discussions about cases resulting in death . We revised our diagnosis and treatment guidelines seven times, revised the guidelines for severe cases three times, and standardized treatment plans.

In terms of clinical treatment, we made efforts to make it more targeted, creative and holistic, and achieved "five combinations." The first was a combination of basic medicine with clinical practice. We adopted targeted treatments based on damage to organs shown by pathological anatomy. We grasped major problems in clinical practice, paying special attention to the early stages of the illness; identifying severe cases;. adopting invasive mechanical ventilation and oxygen supplies; providing supporting treatment; and using anticoagulants. We implemented multiple organ protection, and ensured that we treated the disease in the early stages and in a targeted way. 

Second, we combined frontline treatment with rear support, giving play to the advantages of rear resources, using information technology to conduct remote multidisciplinary consultations, and providing comprehensive guidance on treatment timing, means and dosage.

Third, we combined medical treatment and nursing. We placed a premium on basic nursing, critical nursing, specific nursing and psychological nursing to find changes in patient conditions as soon as possible. We paid special attention to details and took good care of the patients. 

Fourth, we combined medical treatment and management. We established a management system of joint diagnosis and treatment and an efficient operation mechanism, providing a reliable institutional guarantee for treatment. 

Fifth, we combined traditional Chinese medicine (TCM) and Western medicine, involving TCM in the whole process of prevention, diagnosis and treatment and recovery. Meanwhile, we paid attention to the treatment of mild cases, and reduced the viral load to prevent mild cases from progressing into severe cases. We also rigorously implemented measures preventing and controlling hospital infection. None of our 40,000 assisting medical staff contracted the disease, which is most comforting of all.

In terms of epidemic control, the Central Guidance Team in Hubei has precisely identified changes in different phases of the epidemic situation, and adjusted its priorities and response measures accordingly. It dispatched nearly 1,000 top public healthcare workers, community healthcare personnel and testing staff from across the country to Hubei, forming 36 epidemic prevention teams and working alongside the local disease control personnel. Vice Premier Sun Chunlan personally promoted wide-ranging investigations in all subdistricts and communities across Wuhan city, identifying more than 6,000 confirmed or suspected COVID-19 cases. All of these have been admitted to hospitals, effectively preventing the spread of the disease in communities, and playing a decisive role in containing it. 

With an emphasis on nucleic acid testing, we have managed to increase the detection capacity from 300 to 35,000 people a day, and the interval for obtaining test results has been shortened from six days to 4-6 hours. We have endeavored to ensure that testing covers all those necessary, and that all cases are tested the same day. With all residential communities and villages adopting closed-off management, we have carried out work there on environmental improvement, disinfection and popularizing knowledge of epidemic prevention and control measures. Based on extensive practices, the disease control staff have revised the prevention and control plans six times, and summarized distinctive Chinese experiences as follows. We have focused on epidemic prevention in communities and fever clinics, and carried out face-to-face epidemiological surveys. We have ensured each case is "reported through the online direct reporting system within two hours and tested within 12 hours," and "conducted an epidemiological survey for each patient within 24 hours." We have emphasized the prevention and control work in key areas and locations, and for key populations. We have implemented the early detection, reporting, quarantine and medical treatment measures. Focusing on the four categories of personnel – confirmed and suspected COVID-19 cases, people with fever, and those in close contact with coronavirus infections – we have admitted them to hospitals, provided medical treatment, and tested and quarantined them as necessary. We have implemented a responsibility system for community control, distributed epidemic protection supplies to disadvantaged groups, and ensured our investigation, control, supervision, publicity and education work progresses smoothly in communities while showing our concern and love for residents. We are unswervingly carrying out the above requirements, and gradually seizing the initiative in epidemic prevention and control.

At present, as the epidemic spreads rapidly overseas, we are focused on guarding against imported COVID-19 cases and a rebound in domestic cases according to the requirements of the CPC Central Committee. We will carry out the epidemic prevention and control work at home with caution, and implement targeted measures to ensure that every household and individual adheres to them. We will continue to put medical treatment first. There are nearly 1,500 infections at present in Hubei, with severely and critically ill patients accounting for one third, which renders treatment very difficult. The medical team will spare no effort in carrying out its treatment work. As long as there is a glimmer of hope, we will do our best to save every life. We will take targeted measures to effectively respond to imported infections and improve the prevention and control strategy along the whole route from overseas to the country, and to each home. We will investigate every imported case and conduct treatment immediately. As the COVID-19 situation continues to improve in the country, we will not allow our hard-won results to reverse.

Finally, I would like to say that in the magnificent fight against COVID-19, large numbers of medical workers clad in white rushed to the frontlines. Their organization and management capability, professional qualifications as well as medical ethics have been thoroughly tested. It has been proven that they are a group of personnel with solid political faith, excellent capabilities and noble medical ethics, whom the Party and the people can fully rely on. During the medics' return, the Party and the people showed their appreciation to all of them, and having worked in Hubei, they deeply felt the sincere gratitude of the people there. Under the strong leadership of the CPC Central Committee, all staff working within the national health system will make unremitting efforts in the epidemic prevention and control work to achieve an ultimate and great victory against COVID-19. Thank you.

Shou Xiaoli:

Thank you, Mr. Ma. Now we will take questions. Today, we will still be doing this via video link. Please identify your media organization before asking questions.

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