All medical institutions should receive nucleic acid positive patients, how to ensure the elderly to see a doctor... Authoritative release!

Under the joint prevention and control mechanism of The State Council, a press conference was held on the afternoon of December 9 to introduce the medical service guarantee of integrated Chinese and Western medicine.

There are nearly 10 beds for every 100,000 people in China

At present, the total number of ICU beds in China is 138,100, of which 106,500 are in tertiary medical institutions. The number of intensive care beds is close to 10 for every 100,000 people. There are 80,500 physicians in intensive care units, 106,000 in "transferable ICU" units, 220,000 intensive care nurses, and 177,700 "transferable ICU" nurses.

Level III hospitals are required to have 4 percent of their total ICU beds

Level III hospitals are required to have 4 percent of their total ICU beds. In addition, for each specialized ICU, expansion, transformation and construction should be carried out according to the standards of comprehensive ICU. In addition, 4% of the total number of beds in the convertible ICU can be transformed into intensive ICU resources within 24 hours when needed, ensuring that the integrated ICU and convertible ICU can reach 8% of the total number of hospital beds. In addition, there are a number of specialized ICU beds as an important supplement. Once the beds are ready, doctors and nurses need to prepare the medical force. In addition to the medical staff in comprehensive ICU, medical staff in other specialized ICU, especially medical staff in internal medicine, emergency department, pediatrics and other related professionals, should be trained in comprehensive ICU knowledge and skills, so as to ensure that they can be quickly added to the intensive care medical team when needed. According to the current bed-doctor ratio and bed-nurse ratio, an additional 20 to 30 percent of the medical force will be expanded to supplement the severe illness force. All this expansion and renovation work is required to be completed by the end of December.

All secondary and above hospitals should open fever clinics

All secondary and above hospitals should set up fever clinics, which should be set up and opened as often as possible. In addition, grassroots medical and health institutions with sufficient conditions should also open fever clinics or consultation rooms, which should be equipped with sufficient strength.

Upgrade makeshift hospitals into designated Asian hospitals

Makeshift hospitals should be upgraded and transformed into designated sub-hospitals on a city-level basis and in accordance with the size of the city's population. The so-called Asia designated hospital means that on the basis of makeshift hospitals, it should be equipped with certain therapeutic functions, and the monitoring beds should be transformed according to the proportion of 10% of their beds.

It is recommended to follow the hierarchical diagnosis and treatment procedure

· Now is winter, which is the season of high incidence of respiratory diseases. Patients with fever should try their best to treat them at home if they have commonly used medicines at home. If the community health service center near your home has a fever clinic or fever clinic, try to go to the community center for treatment.

· To seek treatment in secondary or above hospitals, patients in general outpatient clinics are required to make an appointment for diagnosis and treatment or present a 48-hour negative nucleic acid test certificate during pre-examination and triage. Of course, if it is positive for nucleic acid, the hospital is also required not to reject the diagnosis and treatment, the hospital general outpatient treatment area should be divided into positive nucleic acid treatment area and negative nucleic acid treatment area. After the nucleic acid test results are presented, the patient shall enter the corresponding diagnosis and treatment area for medical services according to the results.

 With regard to emergency care, it has been stressed that the results of nucleic acid tests cannot be used as a prerequisite for admission. If there is a negative nucleic acid proof directly go to the emergency room to receive appropriate medical services. If there is no corresponding negative nucleic acid certificate, the emergency department is required to enter the buffer zone without affecting or delaying the medical emergency services. Antigen or nucleic acid testing should be performed at the same time as emergency services are provided.

· For patients attending fever clinics, antigen testing is required as soon as possible. After antigen detection, most of the corresponding prescriptions are issued according to the condition of the disease. After the patients take the medicine, it is suggested that they can return home as soon as possible for home treatment.

· For the hospitalization procedure, all patients should undergo nucleic acid detection before admission, and the detection frequency should be adjusted according to the situation after admission, and antigen detection or nucleic acid detection should be cross-selected.

How to guarantee the elderly to see a doctor?

At present, cities and counties have basically established the medical association organization model, which lays a very important foundation for the health monitoring of the elderly.

One is to build a grid layout in cities and counties. In each grid, at least one medical consortium is formed. Through the grid layout of the medical consortium, to ensure that all the elderly can be fully covered by the grid medical consortium, are included in the scope of management.

Second, the elderly should be graded health monitoring. First of all, the grassroots should carry out a survey on the health status of the elderly, and use the assessment scale to grade the basic health status of the elderly. According to the health risk level, it is divided into three levels, which are marked with red, yellow and green colors. Red and yellow are the elderly with relatively high risk. Special management should be carried out, and the community should conduct daily health monitoring and provide corresponding guidance and services.

Third, secondary and above hospitals in the CIS, especially the lead hospitals, should give full play to the role of technical guidance, human assistance and remote guidance, send personnel to provide on-site guidance, remote guidance and touring guidance, strengthen the support and technical support for the health monitoring of the elderly at the grass-roots level, and make quick treatment and judgment on the health risks of the elderly found at the grass-roots level. Provide technical support.

In addition, lead hospitals, especially tertiary hospitals, are required to establish a green channel and rapid referral mechanism. For the elderly, once their condition changes, they are not required to be referred step by step. Instead, they can directly go to a hospital with high medical level to receive corresponding diagnosis and treatment services through the green channel opened by tertiary hospitals.

All medical institutions have to accept nucleic acid positive patients

Nucleic acid positive and negative areas should be set up in both inpatient and outpatient areas, including emergency areas, including in inpatient wards. According to the conditions of the hospital, if there is a separate building, a separate building can be used as the admission area for nucleic acid positive patients. If there is no independent building, it is also required to set aside a corresponding room in each floor or each ward as a ward for nucleic acid positive patients. Hospitals are required to pay special attention to those over 65 years of age with severe underlying diseases, especially those who have not completed full immunization. Once positive nucleic acid is found, patients should pay attention to increasing the frequency of observation, and be transferred to an independent isolation ward to strengthen medical treatment services.

Next, all the medical institutions should accept nucleic acid positive patients. You don't have to worry that the hospital will not accept patients because you are positive for nucleic acid, which is not allowed. All medical institutions treat patients according to their conditions and complaints, and patients also choose medical institutions according to the needs of their conditions. All medical institutions are not allowed to discriminate between negative and positive nucleic acids to receive medical treatment, and receive medical treatment solely for medical needs.

Patients with fever can directly go to the fever clinic of medical institutions

From now on, all fever patients who want to go to the fever clinic of medical institutions do not need to contact the neighborhood committee or the street or the community for assistance. They can go to the fever clinic of medical institutions directly by themselves, and they do not need to take 120 ambulances. We advocate that people go directly to the fever clinic of medical institutions for point-to-point treatment, and use public transportation as little as possible to reduce the risk of transmission during the process.

Medical institutions are required to first set up a fever clinic in a relatively independent area, and it is no longer required to set up three areas and two channels in the fever clinic, but the ventilation conditions should be increased. Hospitals are required to increase the number of fever rooms as much as possible, and to carry out corresponding training for all medical staff in the hospital's internal medicine department, to ensure that these personnel can be adjusted to the fever clinic for treatment at any time as needed.

The closure and suspension of some fever clinics were requested to be corrected. For places with serious problems, a letter of supervision was issued, asking them to rectify the problems immediately, and the National Health Commission will immediately send a supervision team to all places for supervision and inspection. If the problem is serious, a national notice of criticism should be issued. If there is a lack of accountability, it is also suggested that local authorities should be held accountable and accountable.

The point of nucleic acid sampling can not be removed at will to meet the needs of the public

In the process of optimizing and adjusting epidemic prevention and control measures, local governments should not arbitrarily remove nucleic acid sampling sites, and should keep the layout and scale of existing nucleic acid sampling sites unchanged for a period of time to meet the needs of those who are willing to be tested. In the future, we will continue to optimize and adjust the layout of nucleic acid sampling sites and related requirements according to the measures.

What kind of positive infected person can stay at home? How is it administered? What conditions require a referral?

Asymptomatic infected persons without serious underlying diseases and mild infected persons can stay at home. Those with stable underlying diseases and no serious insufficiency of heart, lung, brain, kidney and other important organs requiring hospitalization can also be quarantined at home for observation.

At present, more than 90% of the infected people in the branch of Omicron are asymptomatic and mild. Asymptomatic infected people do not need treatment. Mild infected people have some mild symptoms, such as mild cough, moderate fever or throat discomfort, which can be dealt with according to the symptoms. Now we often for these light infected people, there are some mild symptoms, do not affect the work, life, sleep, in fact, there is no need to use drugs. There is no need to take antipyretics when the body temperature is below 38.5℃. Of course, if it is high fever above 38.5℃, you can use antipyretic medicine or Chinese patent medicine of clearing heat and detoxification.

At the same time, such infected people with basic diseases at home should also adhere to the original basic disease medication. For those over 65 years old with serious underlying diseases, such as tumors, chronic respiratory diseases, cardiovascular and cerebrovascular diseases, chronic kidney diseases, autoimmune diseases, and some immunosuppressed infections, and who have not completed the whole course of vaccination, surveillance and close attention should be strengthened. If the underlying disease is relatively stable, but high fever does not go away, the body temperature continues to be above 38.5℃, rapid breathing rate, chest shortness of breath and other symptoms, should be timely to the designated hospital for treatment. If the above basic diseases are unstable, such as acute cardiovascular and cerebrovascular diseases, or related tumor diseases requiring regular radiotherapy and chemotherapy, acute exacerbation of chronic respiratory diseases, many infected people need emergency surgery, and the third pregnancy is about to give birth to a baby, it is recommended to go to the general hospital for treatment in these cases, because the general hospital has a complete set of departments. Medical consultations can be made according to the specialty and condition of the disease.

Asymptomatic infected patients and mild ordinary patients were mainly treated with traditional Chinese medicine

Giving full play to the unique advantages of traditional Chinese medicine in preventing disease and treating symptoms according to syndrome differentiation, seven versions of TCM diagnosis and treatment protocols have been introduced and incorporated into the national program in light of the new changes in the virus and the new characteristics of the infected population. Asymptomatic and mild ordinary patients are mainly treated with TCM, and severe and critical patients are treated with integrated Chinese and Western medicine, and TCM medical institutions are encouraged to set up COVID-19 rehabilitation clinics. Traditional Chinese medicine intervention was carried out for key groups such as close contacts. The WHO held an expert eva luation meeting on the treatment of COVID-19 with traditional Chinese medicine, and the meeting report clearly affirmed the effectiveness and safety of traditional Chinese medicine in the treatment of COVID-19.

If you are infected with COVID-19, under what conditions should you take traditional Chinese medicine? How to choose Chinese Medicine?

First, for mild and ordinary types, if the first time to use traditional Chinese medicine treatment, when the symptoms of discomfort, start the medication, can not only improve the symptoms, especially the Omicronon variant, can improve fever, sore throat, body joint pain, fatigue and these symptoms, but also shorten the time. At the same time, the conversion to severe and critical illness has been greatly reduced.

Second, for severe and critically ill patients, TCM and western medicine should be combined to give play to their respective advantages. Traditional Chinese medicine plays a very good role in improving fever, promoting inflammatory absorption and improving gastrointestinal function, and has a very good value for the success rate of rescue.

Thirdly, the key population varies from the southeast to the northwest. According to the local climate and people's physical characteristics, the intervention for the key population such as the contact personnel may be the intervention of traditional Chinese medicine with the same origin of medicine and food, or the intervention of traditional Chinese medicine without drugs. We have promoted the forward movement of the threshold and achieved good results. For example, the number of people diagnosed with asymptomatic infection has been reduced through intervention.

Fourth, under the condition of the patients with rehabilitation needs, speak "Chai defence after" in traditional Chinese medicine, by the way of Chinese traditional medicine, acupuncture, massage, and traditional techniques, improve lung function, improve symptoms such as fatigue, at the same time for the soothing mood, enhanced physique, enhance immunity, etc, also play a very good role.

In general, all the Chinese patent medicine with the effect of dispelling wind and clearing heat, dampness and detoxification, clearing distemper and Xuanlung is very good for the present Omicronon. Not limited to the drugs in the Version 9 protocol. According to the principle of "three reasons for measures" in traditional Chinese medicine, the medicines used to treat colds are different in different regions, different populations and different seasons. The range of Chinese patent medicine is very wide. However, if the disease worsens, the NHC has issued guidelines for home treatment of COVID-19 patients. In the guidelines, if the disease worsens, patients should go to the hospital for diagnosis and treatment in time.