Notice on doing a good job in providing dynamic services to key groups of people affected by COVID-19 and "moving the gateway forward"

Notice on doing a good job in providing dynamic services to key groups in the new crown epidemic and "moving the gate forward"

Joint Prevention and Control Mechanism Zongfa [2023] No. 4

Provinces , the joint prevention and control mechanism of autonomous regions, municipalities directly under the Central Government and the Xinjiang Production and Construction Corps, and the member units of the joint prevention and control mechanism of the State Council:

In order to give full play to the comprehensive management of grassroots organizations and the professional service role of grassroots medical and health institutions, adhere to the principle of "early detection" , early identification, early intervention, early referral" to prevent and reduce the occurrence of severe COVID-19 infection, ensure the smooth and orderly "peak transition" of epidemic prevention and control, and now provide dynamic services for key groups and "move forward" at the current stage The work notice is as follows:

1. Build a strong defense line for grassroots health care

The joint prevention and control mechanisms at all levels must strengthen overall planning and coordination, increase organizational dispatch, implement financial guarantees, and smooth health care. Supply channels, organize centralized procurement, ensure that grassroots medical and health institutions are fully equipped with personnel, drugs, and equipment, and essential drugs and equipment go directly to village clinics and community health service stations. It is necessary to care for grassroots medical staff and other front-line personnel in epidemic prevention and control, and ensure the on-duty rate of grassroots medical staff and the order of basic diagnosis and treatment services through scientific arrangements for shift rotation, temporary recruitment, organizing second- and third-level hospitals to dispatch, and mutual aid and support. Primary medical and health institutions must be equipped with sufficient Chinese patent medicines, antipyretics, cough medicines and antigen detection kits for the symptomatic treatment of new coronavirus infection in accordance with the standard of serving a population of 15-20, ensuring that the available quantity of the institution is always maintained for more than 2 weeks. . Based on actual conditions, various localities will timely distribute small molecule drugs for the treatment of new coronavirus infection to primary medical and health institutions to ensure that primary medical and health institutions can carry out community medical treatment under the guidance of superior hospitals. Strengthen the construction of fever clinics and equip relevant facilities and equipment in accordance with standards. In larger residential areas or villages and public facilities, it is necessary to set up mobile service points to facilitate residents to obtain medical and health services nearby.

2. Strengthen the guarantee guarantee linkage for key groups

Counties should strengthen grassroots manpower organization and dispatch, strengthen the responsibilities of street and township governments, give full play to the role of grid management, organize and mobilize villagers committees and their public officials ***Health committees, social organizations, community workers, volunteers, etc., take streets and towns as units to identify the elderly over 65 years old, pregnant women, children, disabled people, etc. Key groups such as people should contact the service guarantee team. The number of people participating in the work of the insurance team should match the number of key groups contacted for services, and each team should designate at least one medical staff to provide professional guidance. All localities must distribute "health packages" to groups at high risk of severe illness, such as the elderly and patients with underlying diseases, and children in need, including a certain amount of antipyretics, cough medicines, cold medicines, antigen detection reagents, masks, disinfection supplies, etc. Special attention should be paid to empty-nest elderly people and elderly people who only live with their disabled children, and to strengthen daily contact.

3. Actively provide dynamic services to key groups

Give full play to the role of family doctors in contacting the masses and proactively providing services, using cloud services, phone calls, WeChat, videos and other non-contact methods or door-to-door follow-up visits, etc. Face-to-face service mode, implement health services for key groups marked with red, yellow and green signs, and achieve "six implementations in place": clarify the implementation of each community grid guarantee team in streets and towns as a unit; complete the survey and classification of three types of key groups and establish a platform Accounts have been implemented in place; the 24-hour consultation phone number of the institution and family doctors has been informed to key groups or families; implementation has been implemented through various methods to contact key groups with yellow and red marks no less than 2 and 3 times a week respectively; dynamics Understand the basic diseases and health status of key groups with red signs and implement them in place; provide timely guidance and treatment when key groups are infected with the new coronavirus or have aggravated basic diseases, provide immediate guidance and referral for those infected with red signs, and strengthen treatment for those infected with yellow signs Guidance on symptomatic medication, daily health monitoring, and timely referral for medical treatment if symptoms continue to worsen or if it is assessed that it is not suitable to stay at home.

4. Expand oxygen inhalation and blood oxygen monitoring services

All localities should equip primary medical and health institutions and elderly care institutions with an appropriate number of oxygen bags, oxygen bottles, oxygen concentrators and other equipment. Ensure that oxygen therapy or oxygen filling services can be provided in a timely manner to outpatients, home treatment patients and elderly people in nursing homes. Increase the number of finger-clip pulse oximeters and ensure that each community health service center and township health center is equipped with at least 20 or more, and each community health service station and village clinic are equipped with at least 2 or more, so as to provide timely services to patients undergoing treatment and hospitalization. Carry out blood oxygen saturation monitoring. It is necessary to equip each family doctor team, key population insurance team, nursing home, and welfare institution with a certain number of oximeter to meet the needs of patrol monitoring, visit monitoring, and on-site monitoring. All localities should actively organize the distribution of oximeter to key groups over 65 years old who are at risk of severe COVID-19 infection and have limited mobility, and provide guidance on self-testing of blood oxygen saturation at home.

5. Give full play to the therapeutic effect of traditional Chinese medicine

Adhere to the integration of traditional Chinese and Western medicine and the simultaneous use of traditional Chinese medicine, and accelerate the deployment and use of traditional Chinese medicine such as "three medicines and three prescriptions" in primary medical and health institutions. All localities should organize research and determine a batch of traditional Chinese medicine agreement prescriptions suitable for the treatment of patients with new coronavirus infection based on local actual conditions and medication habits, and classify and propose traditional Chinese medicine treatment plans for common symptoms of new coronavirus infection, adapting measures to local conditions, and treating based on syndrome differentiation. Grasp the principles of "early" and "fast", let traditional Chinese medicine intervene as early as possible in the early stage of new coronavirus infection, and promptly prevent mild patients from developing into severe and critical diseases.

6. Vigorously expand pre-hospital emergency transport capacity

The county should establish a special transfer class for severe patients, expand 120 transport capacity and telephone seats, implement road traffic guarantees, and ensure first aid The phone can be dialed 24 hours a day, a car is dispatched, and the response time is no significant delay compared with normal times. Strengthen the deployment of ambulances in township hospitals and community health service centers to ensure that each institution has at least one ambulance and accepts 120 unified dispatch. County governments should urge streets and towns to implement local responsibilities, set up dedicated personnel and posts, organize and guide enterprises, institutions, social organizations, and volunteers’ personal vehicles in the jurisdiction, establish non-emergency transport fleets, and publish 24-hour hotlines to ensure the transport needs of ordinary patients. .

7. Timely referral of persons at risk of severe illness

For infected persons who are elderly and have underlying diseases and are at higher risk of severe illness, once they are infected, they must be promptly transferred to a hospital with diagnostic and treatment capabilities. Superior hospital. For critically ill patients who are first diagnosed at the grassroots level, it is necessary to quickly and accurately identify them, provide oxygen in a timely manner according to the actual situation, take active rescue measures, try to keep the patient's vital signs stable, and make timely referrals accompanied by medical staff. All types of medical and health institutions at all levels should designate dedicated personnel to be responsible for referral connections, simplify the referral process for severely ill patients, establish and unblock green channels for the referral of severely ill patients, improve the green channel for medical referrals for the elderly in nursing homes, and improve referral efficiency.

8. Strengthen the training of all grassroots medical staff

All localities should formulate training plans for grassroots medical staff, and carry out various trainings such as online, offline, and leading hospitals to teach. . Make full use of national, provincial, municipal and other relevant training resources to actively develop training courses that meet local needs. Strengthen spot checks and strict training and assessment to ensure the effectiveness of training, so that grassroots medical staff can master the grading and classification service methods for key new coronavirus groups, observation of infection symptoms, home management and treatment of infected people, traditional Chinese medicine treatment and rehabilitation diagnosis and treatment, and hypoxemia in a short period of time. Early detection, evaluation and consultation methods for dyspnea, use of finger oximeter, important referral indications, and indications and correct use of small molecule drugs, etc.

9. Strengthen the support of the leading hospitals of the medical consortium to the grassroots level

According to the principle of zoning and coverage, the leading hospitals of urban medical groups and county medical consortiums must establish respiratory departments, A technical guidance group composed of chief physicians from the Department of Intensive Care, Pediatrics, Traditional Chinese Medicine and other departments carried out tour guidance to primary medical and health institutions, and trained and standardized the use of small molecule drugs and traditional Chinese medicine "three medicines and three prescriptions" to help improve the ability of grassroots hospitals to prevent severe illness. Strengthen the overall coordination and deployment of health human resources within the medical consortium, and solve the problem of insufficient manpower in grassroots medical and health institutions through methods such as down-site inspections, personnel dispatching, and the establishment of remote medical collaboration networks.

Urban tertiary hospitals should provide counterpart support to county-level hospitals, improve county-level hospitals' ability to treat severe COVID-19 infections, and accept severe patients transferred from county-level hospitals.

10. Strengthen health education in urban and rural communities

Implement the territorial responsibilities of streets and towns, give full play to the role of village committees, volunteers, etc., and target the key groups registered in the early stage through text message reminders, Various methods such as issuing "awareness cards" and rural radio broadcasts are used to let the public know the basic knowledge of new coronavirus infection, medical treatment procedures, and the 24-hour consultation hotline of village cadres and local grassroots medical and health institutions. Widely distribute simple and easy operation guidelines for early identification of severe illness and home treatment guidelines to guide people to seek medical treatment in medical and health institutions in a timely manner when they are at risk of severe illness.

11. Real-time grasp of work dynamics

All localities must improve the epidemic response in towns, streets, rural communities and monitoring mechanisms for the operation and services of primary medical and health institutions, and dynamically grasp the development of local epidemics, The reception status of fever clinics in primary medical and health institutions, the reserve and use of medicines and equipment, the infection and attrition of medical staff, the service status of key groups, etc., and real-time dispatch to places with problems or lagging work in the province. Strengthen data statistical analysis to help grassroots solve difficulties encountered in work in a timely manner. Make full use of information technology to improve work efficiency, reduce the burden on grassroots, and promptly report dynamic data and information needed by the country, provinces, and cities.

12. Strengthen the implementation of responsibilities and supervision and assessment

The joint prevention and control mechanisms in various regions must strengthen organizational leadership, consolidate responsibilities at all levels, clarify departmental responsibilities and division of tasks, and ensure working conditions. The provincial level should strengthen the supervision of the implementation of work and the implementation of responsibilities at the city and county levels, establish work ledgers, formulate task lists, problem lists, and responsibility lists to ensure that everything is managed and everything is in place, and that things are not done overnight. It is necessary to link the current status and results of dynamic services for key groups at the grassroots level and strengthening the "health protection and prevention of severe illness" with the assessment, fund allocation, and priority evaluation of relevant key tasks, so as to effectively play the role of assessment and incentive guidance. .

Integrated Team of the Joint Prevention and Control Mechanism of the State Council

January 3, 2023_