Can the trend of getting out of the epidemic be reversed (the trend of the epidemic)

Recently, Rao Yi, president of Capital Medical University, published an article entitled "Don't be brave above, let alone below: representatives of both sides of the epidemic should seek truth from facts" on WeChat official account "Rao Yi Science", beginning with the media report that "we are about to get out of this epidemic, and this trend will not be reversed", saying that "the COVID-19 epidemic is completely different from known viruses"; No one in the world can tell the direction of the epidemic.

Rao Yi's critical remarks came from Zhang Wenhong, director of the Infectious Diseases Department of Huashan Hospital affiliated to Fudan University, National Center for Infectious Diseases. The different opinions of two scholars in the industry have attracted a lot of attention, and also led to the question of "whether the pathogenicity of the late mutant can be predicted".

This is not the only problem that needs to be clarified. According to the reporter of the National Business Daily, previously, the controversial topics raised by Rao Yi included "Asymptomatic infection and mild illness of Omicron account for more than 99.5% of the total number of infected people, which is too optimistic", "COVID-19 vaccine can prevent severe illness, but it can't prevent infection" and "The death toll caused by Omicron is higher than that caused by Delta".

Image source: "Rao Yi Science" WeChat official account screenshot

Core controversy: Can the trend of "getting out of the epidemic" be reversed and the pathogenicity of mutant strains be predicted?

Back to 202 1, 1 1, when Omicron was first discovered, its spread and pathogenicity were still unknown. Zhong Nanshan said in a public speech that month, "This mutant is very new. Although molecular genetic testing has found many changes in its receptor binding site, how harmful it is, how fast it spreads, whether it will make the disease worse, and whether it is necessary to develop a vaccine for it, we must judge it according to the situation. It is still too early to draw conclusions. "

Over the past year, people have found that the global epidemic has changed a lot because of the appearance of Omicron. According to the Health Times, Zhang Wenhong's statement that "it is a foregone conclusion that we will get out of this epidemic soon, and this trend will not be reversed" comes from a speech at the Sino-US high-level forum on clinical microbiology and infectious diseases.

Take the flu as an example. Zhang Wenhong thinks that human beings will never control infectious diseases by destroying a species, but will keep a certain steady state with infectious diseases with the vaccination and widespread infection of human beings. This is the situation that COVID-19 will face.

He pointed out that at present, various studies show that the number of COVID-19 strains has been greatly reduced after vaccination. At present, only the Omicron strain has won, and it is difficult for this family to produce strains that spread faster.

Data Map Image Source: Picture Network -40 1695570

At present, it is difficult to get a complete description of the live broadcast on the internet, but this view is common among experts who speak. For example, Jin Dongyan, a professor at the School of Medicine of the Hong Kong University, said in an interview in the first half of the year that the survival of the fittest will also occur between COVID-19, and the strains with stronger and stronger infectivity will survive and the strains with weaker infectivity will be eliminated. In addition, according to the laws of nature, the infectivity and pathogenicity of the virus are inversely proportional, and the stronger the infectivity, the lower the pathogenicity.

These views attracted Rao Yi's opposition. On February 3rd, 65438, Rao Yi Science published a document to correct Jin Dongyan's "statement inconsistent with scientific facts", holding that the pathogenicity of Omicron was lower than that of the previous strain, but the pathogenicity of COVID-19 did not weaken from the original strain to DeltaVOC. COVID-19 can not only mutate in the direction of stronger pathogenicity, but also evolve in the direction of enhancing immune escape ability. The recent Delta/Omicron recombinant strain, such as XBC, is likely to have both immune escape ability and strong pathogenicity.

In other words, although the appearance and prevalence of COVID-19 strain Omicron followed the law of enhanced transmission and weakened pathogenicity, it may not be the whole epidemic situation in COVID-19. In the first half of this year, virologist Chang Rongshan once said that it is possible for COVID-19 to evolve into a subspecies with high pathogenicity and high infectivity, but the probability is relatively low.

Or because of this, Rao Yi made it clear in an interview with a reporter from China News Service in June+February, 5438 that "the pathogenicity of the virus strain cannot be predicted in the future".

More Controversy: Is Omicron really a self-limiting disease? Does it cause less or more deaths than Delta?

It's not the first time that Rao Yi objected to COVID-19's related viewpoints. During this period, other researchers also raised objections. 65438+February 3rd ~ 65438+February 6th. The two articles exchanged between Rao Yi Science and Jin Dongyan are the objections of a front-line researcher in COVID-19 to the statement of Jin Dongyan 18. Its main viewpoints include "asymptomatic infection and mild disease of Omicron account for more than 99.5% of the total infected people, which is too optimistic", "COVID-19 vaccine can prevent severe disease, but it can't prevent infection" and "the death toll caused by Omicron is higher than that of Delta". The following are the views of both sides compiled by various journalists:

Source: Rao Yi Science WeChat official account, Phoenix. "Cancer Intelligence Bureau" was drawn by reporter Liu.

Some * * * knowledge: The death of Omicron still exists and is increasing, and the awareness of protection cannot be relaxed with "jokes"

With the optimization and adjustment of epidemic prevention policies, China's epidemic prevention work has entered the "second half" at present, and the focus of work has shifted from avoiding infection to avoiding serious transfer. In the context of the high number of infected people in COVID-19, the reporter of China Business Daily found that although experts' arguments on specific topics have not stopped, their views are not completely opposite. On the contrary, some people achieve the same goal through different routes, and provide the public with the guidance of "health first responsibility" through constant and accurate expression. But this also requires the public to polish their eyes and see the ins and outs of these conclusions.

For example, on February 22, 65438, the word "Jin Dongyan: the global COVID-19 epidemic is coming to an end" was searched again, but the search for related reports found that its complete expression was "I guess, as long as there are no new varieties with super immunity or super pathogenicity, the global COVID-19 epidemic is coming to an end". These preconditions are the basis of argument, but they are easily weakened or even disappeared in communication.

In addition, whether scholars argue or all kinds of popular science, the most important thing is to fall into practice and sort out what needs serious discussion. For example, based on real-world data, how harmful is Omicron's COVID-19? Is it time to relax the protection of people? How should vaccination be carried out in COVID-19? What was the cause of COVID-19's death? Apart from the vulnerable groups, what alarm bells have been sounded by the case of COVID-19's death? Some of these issues are still under debate, but the main line has never changed. One of them is to promote vaccination in COVID-19.

Immunologist Zhou in "Is it getting weaker?" We observed that the pathogenicity of the current mainstream virus strain Omicron was weaker than that of the previous mainstream virus strain in COVID-19. Scientists have also deciphered some biological mechanisms behind this phenomenon. However, the death toll caused by Omicron is still high, and the health harm caused by Omicron is not "weak" at all. In different areas, the trend and severity of the epidemic are not consistent, and the most critical factor lies in the immune basis of the population.

In the future, all kinds of arguments about COVID-19 will not disappear. Both the public and experts should stick to a scientific attitude and not be too focused on emotional arguments. What is more important is to acquire * * * protection knowledge; While actively coping with COVID-19 infection, the public should avoid being blindly optimistic induced by various "jokes" and not go from one extreme to the other.

References:

1, Rao Yi: What do you think of the three-year epidemic? s？ id = 175 1926807273 1 15982。 Spider & for = PC

2. Zhang Wenhong: Getting rid of the epidemic is a foregone conclusion. We should focus on protecting the vulnerable groups this winter. id = 175252799942 1 106607。 Spider & for = PC

3. Discussion: Professor Jin Dongyan's statement of HKU and the facts of COVID-19 S/XU5AFD1UNOHJ5NRZCOHI _ G.

4. Jin Dongyan and Rao Yi discuss scientifically: Does Omicron have sequelae? Is it different from flu? c/s/v 002 xoyv 3n 3c tqke 8 ickjb 64s 0-6079 sa 2 q 2 ov-xy rap 45 I

5. Does Omicron really need to worry? -Discuss with Professor Jin Dongyan again S/VLD0S6yufkqsrjn0zqc1MW

6. Tao Siliang: Now, please have mercy. s/8pVCTplu6LhBU8tRYs2O-g

7. Is COVID-19 getting weaker? s/AYluJy 1DzLhPPreN6JTxeQ