sharon sanders
Editor-in-Chief & President
Hidden transmission, urban spread, 143 confirmed cases, a difficult time for Xi'an epidemic
At 09:48 on December 22, 2021
The local epidemic keeps moving.
As of 24:00 on the 21st, there were 143 confirmed cases in Xi'an in this round of the epidemic, which have spilled to Beijing, Dongguan, Yan'an, and Xianyang.
From December 18th to 20th, for three consecutive days, the number of new diagnoses in Xi'an doubled every day-10 cases, 21 cases, and 42 cases. On the 21st, the number of new diagnoses continued to increase-52 cases.
Liu Feng, director of the Shaanxi Provincial Center for Disease Control and Prevention, believes that concealed transmission has occurred in Xi'an, forming a certain scale of community transmission.
There have been 90 “closed areas” in Xi’an where positive cases have been reported, and 16 million nucleic acid tests have been completed. Even so, the epidemic still shows no signs of bottoming out, and it has entered the peak of case reporting.
Behind the rapidly increasing number of confirmed diagnoses is the exhaustion and chaos of the ancient city of Xi'an during the two years of preparing for the new crown.
Starting on the 20th, the local health code "YiMatong" in Xi'an was in trouble. Millions of people showed that the page could not be opened, so they could not show the nucleic acid test report on the Yimatong page.
Because of the failure of the One-Code Communication, serious congestion occurred in front of the high-speed toll station where the nucleic acid report was required to be checked. The buses and subways that also need to check nucleic acid reports have to be manually registered ID cards. In the cold wind, there are long queues at subway bus stations.
In addition, the company was unable to provide nucleic acid test reports because the employees' one-code-pass codes could not be opened, and required employees to raise their hands and swear that they had done nucleic acid.
At the press conference that day, Liu Jun, director of the Xi'an Big Data Bureau, responded to the one-code-to-pass failure, saying: "The number of visits per second has reached more than 10 times the previous peak, causing network congestion" and advised the general public to " It is not necessary to expand or brighten the code".
After the trilogy of epidemic, nucleic acid, and isolation, the secondary disaster of the epidemic has also begun.
The Beijing News interviewed a video interview with Ms. Dai, a late-stage uremia patient who had not been dialysis for four days due to lockdown. According to the plan, Ms. Dai needs dialysis three times a week. If there is no regular dialysis, various metabolic wastes will accumulate in the body more and more, which will eventually lead to multiple organ failures.
At 8:00, Jianwen also contacted a patient with uremia in Beilin District. Because the designated dialysis hospital closed the clinic and could not get the "Certificate of Medical Treatment" issued by the community, it took a day to finally confirm the hospital for dialysis tomorrow. However, this A resident also mentioned that he had 5 dialysis in two weeks, and he didn’t know where the next hospital would be.
In the chaos, this ancient city in the Central Plains suffered its second round of local epidemics in the past six months, which was also the most serious.
What happened at the airport?
Although there are many suspicious points and confusing aspects of this epidemic, it is certain that the source of infection was an overseas flight PK854-at least 6 confirmed cases were found among the 180 passengers on this flight.
Xiang, the first local case detected in the Xi'an epidemic, was a member of the Jincheng Hotel special class in the isolation hotel for foreign personnel. He carried out the elimination of the rooms of passengers with positive nucleic acid tests on December 5th and 8th.
The Shaanxi Provincial Center for Disease Control and Prevention performed whole-genome sequencing on 36 positive specimens from Xi'an, all of which were highly homologous to the imported cases in PK854 that entered the country on December 4.
The genetic sequencing results of the spilled Dongguan-associated epidemic also pointed to this international flight. The first two asymptomatic infections found in Dongguan took flight CZ3226 from Xi’an to Shenzhen on December 4th. Currently, Dongguan has reported 23 confirmed cases.
There is also a key flow of information. The infection case from the Family Hospital of Chang'an University stayed at the airport T3 terminal, check-in counter, and parking lot on the afternoon of December 4, during which time Flight PK854 landed. Apart from this, there is no other suspicious whereabouts.
At present, the infected persons on at least two transmission chains are related to Xianyang International Airport on the outskirts of Xi'an.
"The doubt must be the airport. The airport hasn't been clarified until now. From December 4 to today, I don't know what happened at the airport." Shantou University virologist Chang Rongshan believes that the airport may have been infected.
This scene reminds people of the Nanjing epidemic this summer. It was also spread by airports in important provincial capitals. The transportation hub superimposed on the summer tourist peak, bringing the epidemic to 15 provinces across the country.
In the Nanjing epidemic, due to the inadequate protection of cleaners, cross-infection of domestic and foreign flights caused by cross-infection of domestic and foreign flights, airport leaders were dismissed and sanctioned, which sounded the alarm for national airport prevention and control.
Li Tong, the chief physician of the Department of Respiratory and Infectious Diseases of Beijing You’an Hospital, once believed that, with the lessons learned from Nanjing, the airport should have noticed the problems in the sharing of overseas and domestic flights, from the distribution of venues, passenger isolation, and cleaning. Form a single closed loop.
However, it is still unclear what happened at Xianyang International Airport in Xi'an, and how the virus was transmitted from the suburban airport to the city center; Xi'an has not announced whether the environmental samples at the airport are positive; and no new confirmed cases have been found at the airport.
So far, the Xi'an epidemic has spilled over three provinces and four cities-Xianyang International Airport, located on the outskirts of Xi'an, not only undertakes shipping tasks in Xi'an, Xianyang, Yan'an and other places, but is also a transportation hub in the northwestern region.
Lost 8 days
Generally speaking, the week after the infection occurs is the most critical time period for epidemic prevention and control.
Early detection, starting from chasing the infected person, and discovering close contacts, sub-close contacts, and key groups through precise flow adjustments, and managing them well, is the core of a race against the virus to achieve precise prevention and control.
But now it seems that Xi'an's prevention and control has not kept up with the speed of the virus spread, and it is more like a "fire fighting" with hindsight.
The international flight identified as the source of infection by genetic sequencing entered Xi'an on December 4, but it was not until the 9th that Xi'an reported the first local case, Xiang Mou, a member of the Jincheng Hotel special class in the isolation hotel for foreigners.
I found out that I could not do it early, and on the other side, the flow did not keep up.
"So far, the circulation between December 4 and December 9 is blank." Chang Rongshan analyzed the eight-point health news.
After the first local case appeared on December 9, Xi'an did not respond quickly either. It went back to the inbound flight on December 4 and controlled the airport. A public health expert told Jianwen at 8 o'clock that he had passed by Xi'an Xianyang Airport on the 11th. At that time, the airport did not take any special anti-epidemic measures.
On December 12, another unrelated chain of transmission appeared. During routine inspections of personnel in key industries, Mr. Guo had an abnormal nucleic acid in the outpatient clinic of Qujiang Ziniu, and the diagnosis was confirmed the next day. Judging from the published information, Guo's rented place is separated from the eight hospitals where the confirmed cases are treated in isolation only by a wall.
It is not clear how the two propagation chains intersect, which should have attracted enough attention. Because even if there is only one case, but not knowing where it came from, it is a huge risk.
Under the circumstances that the source and transmission chain are not clear, and precise prevention and control cannot be achieved, Xi'an did not immediately initiate large-scale nucleic acid testing, but only carried out nucleic acid testing in some regions and key populations.
Looking back now, in the three days from December 9th to December 12th, the Delta strain, which has a strong spreading power, high viral load, and fast spreading speed, has the opportunity to further spread in the community.
And if from the 4th, 8 days have passed to the 12th, "according to the transmission speed of Delta, at least 3 to 4 generations have been transmitted."
After the 12th, Xi'an began to conduct multiple rounds of large-scale nucleic acid testing in key areas; after the 15th, Xi’an, based on research and judgment, carried out expanded-scale nucleic acid testing in Yanta District, Qujiang New District, Economic Development District, Beilin District and other areas.
Xi'an, Northwestern Polytechnical University's second full-staff nucleic acid test
Image source: People's Vision
However, the epidemic is still progressing, especially on December 15, when the transmission chain of Chang'an University surfaced. The source of this transmission chain is also unclear, and the transmission chain continues to extend. So far, there have been three dissemination chains with no intersection.
On December 18, when the epidemic was still not under control and continued to spread, Xi'an initiated nucleic acid testing for all employees in the city.
The virus spreads in the urban area
Among the three existing transmission chains in Xi’an, the epidemics in designated quarantine hotels and the Qujiang Ziniu clinic have not yet spread, while the transmission chain in the family hospital of Chang’an University has been further fermented through the Four Seasons Restaurant, with the most associated infections.
On December 14, 3 people in the Family Hospital of Chang'an University were tested positive and all of them were subsequently diagnosed. One of the infected persons drove with his family to the airport to send his grandson abroad on December 4, the day the plane of the source of infection entered Xi'an.
According to the Beijing Youth Daily, at least 34 cases of infection have been linked to the transmission chain of Chang'an University, and at least 11 staff and 2 students in the university have been infected. The epidemic also affected employees of Four Seasons Restaurant and cases in Yan'an.
Among all the urban areas, the largest number of confirmed cases is Yanta District, which is the most prosperous and densely populated district in Xi'an. The headquarters of Chang'an University is located in this district.
The university that became the focus of the epidemic is located on the West Second Ring Road of Xi'an. It is a few large shopping malls, a variety of specialty snacks, script kills, and escape rooms.
This time, the virus arrived in the urban area from the suburban airport. The current report shows that the confirmed cases are almost concentrated in the six districts of Xi'an. The virus has spread in the core urban area of this city with a population of tens of millions. .
Whether there is an intersection between the three transmission chains is still unknown. During this period, the virus also spread rapidly in the community.
From December 18th to 20th, for three consecutive days, the number of new diagnoses in Xi'an doubled every day-10, 21, and 42; by the 21st, the number of newly diagnosed cases in a single day was as high as 52.
According to the details of the latest confirmed cases released by Xi’an: Many infected people are no longer in the chain of transmission of Chang'an University. They were positive during active nucleic acid sampling. They are not closely connected or key populations that have been controlled and isolated. It means that the transmission chain will continue to extend.
Several interviewed experts told Badian Jianwen that "widespread community transmission" has occurred in the main urban area of Xi'an.
The virus broke the prevention and missed the golden period, and Shaanxi, which has always been guarding against the dead, had to continue to increase its weight. At present, the province has closed a total of 453 risk points for management and control, and closed more than 1,300 related places. The second round of nucleic acid testing for all employees is in progress.
In view of the fact that the area where positive cases are currently detected is getting larger and larger, this will be a huge test for Xi'an, a large city with a population of more than 10 million, especially the main urban area with a high population density. "The population base is large and the coverage of nucleic acid inspections is large. Not enough, only one round of testing. At least five rounds of nucleic acid are needed to figure out the scale of the infection." Chang Rongshan said.
Another epidemiologist is also worried, "If there is no increased testing, a larger number is still to come. This kind of widespread community spread, the cost of social censorship is too great."
zhttps://k.sina.com.cn/article_6914257879_19c1f33d7020017rmo.html?from=news
At 09:48 on December 22, 2021
The local epidemic keeps moving.
As of 24:00 on the 21st, there were 143 confirmed cases in Xi'an in this round of the epidemic, which have spilled to Beijing, Dongguan, Yan'an, and Xianyang.
From December 18th to 20th, for three consecutive days, the number of new diagnoses in Xi'an doubled every day-10 cases, 21 cases, and 42 cases. On the 21st, the number of new diagnoses continued to increase-52 cases.
Liu Feng, director of the Shaanxi Provincial Center for Disease Control and Prevention, believes that concealed transmission has occurred in Xi'an, forming a certain scale of community transmission.
There have been 90 “closed areas” in Xi’an where positive cases have been reported, and 16 million nucleic acid tests have been completed. Even so, the epidemic still shows no signs of bottoming out, and it has entered the peak of case reporting.
Behind the rapidly increasing number of confirmed diagnoses is the exhaustion and chaos of the ancient city of Xi'an during the two years of preparing for the new crown.
Starting on the 20th, the local health code "YiMatong" in Xi'an was in trouble. Millions of people showed that the page could not be opened, so they could not show the nucleic acid test report on the Yimatong page.
Because of the failure of the One-Code Communication, serious congestion occurred in front of the high-speed toll station where the nucleic acid report was required to be checked. The buses and subways that also need to check nucleic acid reports have to be manually registered ID cards. In the cold wind, there are long queues at subway bus stations.
In addition, the company was unable to provide nucleic acid test reports because the employees' one-code-pass codes could not be opened, and required employees to raise their hands and swear that they had done nucleic acid.
At the press conference that day, Liu Jun, director of the Xi'an Big Data Bureau, responded to the one-code-to-pass failure, saying: "The number of visits per second has reached more than 10 times the previous peak, causing network congestion" and advised the general public to " It is not necessary to expand or brighten the code".
After the trilogy of epidemic, nucleic acid, and isolation, the secondary disaster of the epidemic has also begun.
The Beijing News interviewed a video interview with Ms. Dai, a late-stage uremia patient who had not been dialysis for four days due to lockdown. According to the plan, Ms. Dai needs dialysis three times a week. If there is no regular dialysis, various metabolic wastes will accumulate in the body more and more, which will eventually lead to multiple organ failures.
At 8:00, Jianwen also contacted a patient with uremia in Beilin District. Because the designated dialysis hospital closed the clinic and could not get the "Certificate of Medical Treatment" issued by the community, it took a day to finally confirm the hospital for dialysis tomorrow. However, this A resident also mentioned that he had 5 dialysis in two weeks, and he didn’t know where the next hospital would be.
In the chaos, this ancient city in the Central Plains suffered its second round of local epidemics in the past six months, which was also the most serious.
What happened at the airport?
Although there are many suspicious points and confusing aspects of this epidemic, it is certain that the source of infection was an overseas flight PK854-at least 6 confirmed cases were found among the 180 passengers on this flight.
Xiang, the first local case detected in the Xi'an epidemic, was a member of the Jincheng Hotel special class in the isolation hotel for foreign personnel. He carried out the elimination of the rooms of passengers with positive nucleic acid tests on December 5th and 8th.
The Shaanxi Provincial Center for Disease Control and Prevention performed whole-genome sequencing on 36 positive specimens from Xi'an, all of which were highly homologous to the imported cases in PK854 that entered the country on December 4.
The genetic sequencing results of the spilled Dongguan-associated epidemic also pointed to this international flight. The first two asymptomatic infections found in Dongguan took flight CZ3226 from Xi’an to Shenzhen on December 4th. Currently, Dongguan has reported 23 confirmed cases.
There is also a key flow of information. The infection case from the Family Hospital of Chang'an University stayed at the airport T3 terminal, check-in counter, and parking lot on the afternoon of December 4, during which time Flight PK854 landed. Apart from this, there is no other suspicious whereabouts.
At present, the infected persons on at least two transmission chains are related to Xianyang International Airport on the outskirts of Xi'an.
"The doubt must be the airport. The airport hasn't been clarified until now. From December 4 to today, I don't know what happened at the airport." Shantou University virologist Chang Rongshan believes that the airport may have been infected.
This scene reminds people of the Nanjing epidemic this summer. It was also spread by airports in important provincial capitals. The transportation hub superimposed on the summer tourist peak, bringing the epidemic to 15 provinces across the country.
In the Nanjing epidemic, due to the inadequate protection of cleaners, cross-infection of domestic and foreign flights caused by cross-infection of domestic and foreign flights, airport leaders were dismissed and sanctioned, which sounded the alarm for national airport prevention and control.
Li Tong, the chief physician of the Department of Respiratory and Infectious Diseases of Beijing You’an Hospital, once believed that, with the lessons learned from Nanjing, the airport should have noticed the problems in the sharing of overseas and domestic flights, from the distribution of venues, passenger isolation, and cleaning. Form a single closed loop.
However, it is still unclear what happened at Xianyang International Airport in Xi'an, and how the virus was transmitted from the suburban airport to the city center; Xi'an has not announced whether the environmental samples at the airport are positive; and no new confirmed cases have been found at the airport.
So far, the Xi'an epidemic has spilled over three provinces and four cities-Xianyang International Airport, located on the outskirts of Xi'an, not only undertakes shipping tasks in Xi'an, Xianyang, Yan'an and other places, but is also a transportation hub in the northwestern region.
Lost 8 days
Generally speaking, the week after the infection occurs is the most critical time period for epidemic prevention and control.
Early detection, starting from chasing the infected person, and discovering close contacts, sub-close contacts, and key groups through precise flow adjustments, and managing them well, is the core of a race against the virus to achieve precise prevention and control.
But now it seems that Xi'an's prevention and control has not kept up with the speed of the virus spread, and it is more like a "fire fighting" with hindsight.
The international flight identified as the source of infection by genetic sequencing entered Xi'an on December 4, but it was not until the 9th that Xi'an reported the first local case, Xiang Mou, a member of the Jincheng Hotel special class in the isolation hotel for foreigners.
I found out that I could not do it early, and on the other side, the flow did not keep up.
"So far, the circulation between December 4 and December 9 is blank." Chang Rongshan analyzed the eight-point health news.
After the first local case appeared on December 9, Xi'an did not respond quickly either. It went back to the inbound flight on December 4 and controlled the airport. A public health expert told Jianwen at 8 o'clock that he had passed by Xi'an Xianyang Airport on the 11th. At that time, the airport did not take any special anti-epidemic measures.
On December 12, another unrelated chain of transmission appeared. During routine inspections of personnel in key industries, Mr. Guo had an abnormal nucleic acid in the outpatient clinic of Qujiang Ziniu, and the diagnosis was confirmed the next day. Judging from the published information, Guo's rented place is separated from the eight hospitals where the confirmed cases are treated in isolation only by a wall.
It is not clear how the two propagation chains intersect, which should have attracted enough attention. Because even if there is only one case, but not knowing where it came from, it is a huge risk.
Under the circumstances that the source and transmission chain are not clear, and precise prevention and control cannot be achieved, Xi'an did not immediately initiate large-scale nucleic acid testing, but only carried out nucleic acid testing in some regions and key populations.
Looking back now, in the three days from December 9th to December 12th, the Delta strain, which has a strong spreading power, high viral load, and fast spreading speed, has the opportunity to further spread in the community.
And if from the 4th, 8 days have passed to the 12th, "according to the transmission speed of Delta, at least 3 to 4 generations have been transmitted."
After the 12th, Xi'an began to conduct multiple rounds of large-scale nucleic acid testing in key areas; after the 15th, Xi’an, based on research and judgment, carried out expanded-scale nucleic acid testing in Yanta District, Qujiang New District, Economic Development District, Beilin District and other areas.
Xi'an, Northwestern Polytechnical University's second full-staff nucleic acid test
Image source: People's Vision
However, the epidemic is still progressing, especially on December 15, when the transmission chain of Chang'an University surfaced. The source of this transmission chain is also unclear, and the transmission chain continues to extend. So far, there have been three dissemination chains with no intersection.
On December 18, when the epidemic was still not under control and continued to spread, Xi'an initiated nucleic acid testing for all employees in the city.
The virus spreads in the urban area
Among the three existing transmission chains in Xi’an, the epidemics in designated quarantine hotels and the Qujiang Ziniu clinic have not yet spread, while the transmission chain in the family hospital of Chang’an University has been further fermented through the Four Seasons Restaurant, with the most associated infections.
On December 14, 3 people in the Family Hospital of Chang'an University were tested positive and all of them were subsequently diagnosed. One of the infected persons drove with his family to the airport to send his grandson abroad on December 4, the day the plane of the source of infection entered Xi'an.
According to the Beijing Youth Daily, at least 34 cases of infection have been linked to the transmission chain of Chang'an University, and at least 11 staff and 2 students in the university have been infected. The epidemic also affected employees of Four Seasons Restaurant and cases in Yan'an.
Among all the urban areas, the largest number of confirmed cases is Yanta District, which is the most prosperous and densely populated district in Xi'an. The headquarters of Chang'an University is located in this district.
The university that became the focus of the epidemic is located on the West Second Ring Road of Xi'an. It is a few large shopping malls, a variety of specialty snacks, script kills, and escape rooms.
This time, the virus arrived in the urban area from the suburban airport. The current report shows that the confirmed cases are almost concentrated in the six districts of Xi'an. The virus has spread in the core urban area of this city with a population of tens of millions. .
Whether there is an intersection between the three transmission chains is still unknown. During this period, the virus also spread rapidly in the community.
From December 18th to 20th, for three consecutive days, the number of new diagnoses in Xi'an doubled every day-10, 21, and 42; by the 21st, the number of newly diagnosed cases in a single day was as high as 52.
According to the details of the latest confirmed cases released by Xi’an: Many infected people are no longer in the chain of transmission of Chang'an University. They were positive during active nucleic acid sampling. They are not closely connected or key populations that have been controlled and isolated. It means that the transmission chain will continue to extend.
Several interviewed experts told Badian Jianwen that "widespread community transmission" has occurred in the main urban area of Xi'an.
The virus broke the prevention and missed the golden period, and Shaanxi, which has always been guarding against the dead, had to continue to increase its weight. At present, the province has closed a total of 453 risk points for management and control, and closed more than 1,300 related places. The second round of nucleic acid testing for all employees is in progress.
In view of the fact that the area where positive cases are currently detected is getting larger and larger, this will be a huge test for Xi'an, a large city with a population of more than 10 million, especially the main urban area with a high population density. "The population base is large and the coverage of nucleic acid inspections is large. Not enough, only one round of testing. At least five rounds of nucleic acid are needed to figure out the scale of the infection." Chang Rongshan said.
Another epidemiologist is also worried, "If there is no increased testing, a larger number is still to come. This kind of widespread community spread, the cost of social censorship is too great."
zhttps://k.sina.com.cn/article_6914257879_19c1f33d7020017rmo.html?from=news
