[Just just stepped down, 611 was revised before two o'clock]

The main types of new coronavirus mutations

1,voi:

Compared with early reference strains, voi should meet the possibility of changes in viral phenotype, or changes in amino acid mutations caused or potentially caused changes in viral phenotype; 2 virus mutations caused community transmission, or spread in multiple regions or countries.

At present, the variant strains that meet the definition of voi announced by who mainly include the following types

2,voc:

The main characteristics of voc include 1. Enhanced transmission ability or harmful changes in epidemic characteristics; 2. Enhanced pathogenicity or clinical manifestations are becoming more serious, or the effectiveness of public health, social measures or existing diagnosis, vaccines, and treatment methods is reduced.

As of May 11, 2021, the following 4 variants identified by who belong to voc are:

It is worth noting that on June 16, who announced a new coronavirus variant called lambda (c.37). This variant has been discovered in 29 countries and is reported to originate in South America and is reported to be in Peru for the first time. Based on current data, the infectiousness and ability to resist vaccines in this virus variant may be stronger, and who    has divided it from the voi class to the voc class.

1.Prevalence and characteristics of delta mutant strain:

Judging from the popularity trend of the delta mutant strain (b.1.617.2) in India, after February, as time goes by, the delta mutant strain gradually became the main popular strain in India. The high transmission power of delta has become the culprit for the large-scale outbreak in India.

The delta variant has been widely spread in 80 countries around the world, with significantly enhanced transmission power and more likely to occur after infection.

According to information released by gisaid, the variant is 50% more contagious than the alpha variant found in the UK.

A large-scale study on the Lancet on the 14th showed that compared with infection with the alpha mutant strain, patients with the delta mutant strain have twice the risk of hospitalization, and the delta mutant strain has a stronger transmission ability and can also lead to more serious diseases.

The delta variant causes 50-150 new cases every day in France, accounting for 2%-4% of the new cases.

On June 18, local time, the Public Health Department of England issued a report stating that since June 11, the number of cases infected with the delta variant has increased by 33,630. According to the latest sequencing and genotyping data, 99% of confirmed cases in the UK have been infected with the delta variant in the past week.

"India Today" TV reported on the 15th that the new coronavirus variant delta, first discovered in India, has further evolved into "delta", which shows resistance to the "antibody cocktail therapy" that India is promoting.

Based on existing evidence, on June 18, who chief scientist Dr. Swaminathan said at a regular press conference: Among the currently discovered variant strains, the delta variant strain (b.1.617.2) first discovered in India has increased its transmission and is becoming the main variant strain spreading worldwide.

2. Clinical characteristics of delta variant strain:

According to reports from India, the delta variant can cause hearing impairment, gastrointestinal diseases and thrombosis.

India reported 8 patients with thrombosis complications due to infection with the delta variant. The severity of blood clots caused gangrene and two patients had to amputate the limbs. It was also reported that after infection with the delta variant, clots formed in the intestinal blood vessels, resulting in intestinal gangrene.

Are delta variants more likely to cause thrombosis?

In this regard, Professor Hu Bijie raised his own questions and thoughts based on his experience in treating patients with **** in China: If we test d-dimer and other related indicators in the early stage and actively intervene, can we avoid or reduce adverse consequences such as amputation caused by thrombosis?

Professor Hu believes that it is still unclear whether the delta variant is more likely to cause thrombosis, and more clinical data and research are needed to further confirm it.

03

The effect of the new crown vaccine on mutant strains

1. Coronavirus vaccine classification:

Existing evidence shows that vaccination with the new coronavirus vaccine can effectively prevent the incidence of morbidity and reduce the severity and mortality rate after infection. However, there are reports of breakthrough infection cases after vaccination at home and abroad. Possible reasons for breakthrough infection include: the injection time is too long and the antibody titer is declining; virus mutations, affecting the effect of some vaccines (such as mRNA vaccine); differences in individual immunity status, etc.

2. Can vaccines resist mutant strains?

A growing number of data suggest that most vaccines can stimulate the body to produce sufficient immunity to maintain substantial effectiveness against most mutant strains.

3. Will viral mutation affect the efficiency of vaccines?

Theoretically, the impact of viral mutation on mRNA vaccines may be greater. The main vaccination in my country at this stage is inactivated vaccines. Research shows that my country's inactivated vaccines still have protective effects on alpha, beta, and gamma mutant strains, and also on delta mutant strains.

The expansion of the hospital's business and scale have led to the increase in the number of PC terminals that the hospital information department needs to maintain year by year. However, due to the limited allocation of human resources, many hospital information departments have encountered human and technical bottlenecks in PC terminal operation and maintenance.

Terminal operation and maintenance is just a microcosm of the hospital's IT operation and maintenance work. Some information department personnel compare the problems encountered in IT operation and maintenance work to "three longs and one shorts", that is, clinical users describe the time for a terminal failure through telephone and other means, and the time for the IT operation and maintenance engineer to digest and understand the cause of the failure is long, and spend a long time on the fault site to get rid of the fault site; however, the time for realizing the problem solving is very short.

Today, with the booming development of Internet medical care and telemedicine, medical services are gradually crossing the boundaries of time and space. The traditional hospital IT operation and maintenance methods are no longer able to adapt to the needs of business development. In order to release the increasingly heavy operation and maintenance pressure, the IT operation and maintenance change of the hospital information department is imperative.?

Insufficient manpower, low efficiency

Taking terminal operation and maintenance as an example, the new Intel VPro platform is such a solution that meets the actual needs of the hospital information department. On the one hand, it can provide PC terminals with enterprise-level PC performance and hardware-enhanced security functions. Through advanced threat detection in the operating system, application and data protection for operating systems and virtual machines, as well as underlying operating systems for hardware and firmware, it realizes "full-stack computer protection" and fundamentally reduces the probability of PC failure; on the other hand, it provides the hospital information department with remote manageability of IT operation and maintenance, helping IT operation and maintenance engineers to use cloud-based remote repair functions to restore terminal devices to a good state anytime and anywhere, thereby simplifying the complexity of hospital terminal operation and maintenance management, reducing security risks and potential risks, and achieving "double-out of the results with half the effort".

According to reports, since it was launched more than ten years ago, Intel VPro platform technology has become the standard configuration for commercial PCs. Based on this technology platform, it can also help hospital information departments solve the operation and maintenance problems of three categories of PC terminals, allowing them to "liberate" from the increasingly heavy operation and maintenance tasks.

First, help the hospital information department quickly repair network or hardware failures of in-band/out-band PC terminals.

With the help of the active management technology provided by the new Intel VPro platform and the terminal management system, the hospital information department can view and manage all PC terminal devices in-band/out-band in-band in hospital. As long as these PC devices are connected to the power supply and network, even if they are not turned on, blue screen or system crash, IT engineers can use remote control to repair the problem equipment without leaving the station, and can even use their own computer to reinstall the remote computer's operating system.

At present, "single-body multi-campus" is becoming one of the development models that public hospitals in my country are generally exploring. The new Intel VPro platform provides a powerful weapon for the efficient management and maintenance of PC terminals under the background of multi-campus. Even if the operation and maintenance personnel are not increased, the hospital information department can easily and quickly remotely manage and repair PC terminals in branch hospitals. In addition, for some special places of the hospital, such as fever clinics and PC equipment repair in isolation areas, the introduction of the new Intel VPro platform can significantly shorten the medical business stagnation caused by terminal failure, reduce hospital infection risk, and improve the patient's medical experience.

Secondly, help the hospital information department to uniformly upgrade and maintain PC terminals, fix vulnerabilities and file distribution.

Under the pressure of huge number of visits, the various departments of the hospital are busy and cannot upgrade and maintain PC terminals during the day. In the past, many hospital information departments could only choose to work at night, turn on the shutdown equipment one by one and upgrade the patches, which took a lot of time and energy, and also needed to communicate with each department to complete the work smoothly. Now, with the help of the new Intel VPro platform, IT operation and maintenance personnel can boot the PC terminals of the hospital in a unified manner, and then through the patch management function, the patches that need to be upgraded will be set on the server side. Finally, just click on the upgrade to complete the system upgrade of all devices at the same time.

During the epidemic, cloud desktop has become a priority option for hospital IT departments to fight the epidemic with its outstanding advantages in rapid deployment and remote operation and maintenance. The new Intel vpro platform not only provides excellent performance and stability guarantees for cloud desktops, but also further helps cloud desktops achieve contactless operation and maintenance. This is because the new Intel vpro platform can help IT operation and maintenance personnel quickly diagnose whether cloud desktop failures are related to hardware, and repair and maintain the virtual layer.

Third, help hospital information departments to conduct effective IT asset statistics and management.

In the hospital's huge network environment, if you rely on manual statistics to manage it, it will not only take time and effort, but also often have problems of data lag and inaccurateness. With the help of the new Intel VPro platform and terminal management software, the information department can provide hospital managers with clear, intuitive, complete and reliable asset reports. Except for a very small number of PC devices that have not been powered on, the rest of the equipment can be included in the statistical scope. Once the assets change, the system will provide timely feedback, which is conducive to the information department's "family capital", reduce the waste of idle assets, and promote the virtuous cycle of hospital operations.

Although some hospitals have gradually outsourced terminal and printer operation and maintenance in areas with better economic conditions, the full use of the features of the new Intel vpro platform mentioned above requires the hospital information department to deeply understand and fully utilize it.

The hospital's IT operation and maintenance work covers all-round. In addition to PC terminals, it also includes desktops, applications, peripherals, networks, security, etc. How can the hospital's IT operation and maintenance service level be improved as a whole?

In the "Hospital Information Center Exchange Group" under Hit Expert Network, the heads of hospital information departments who participated in this topic discussion generally believe that to solve the dilemma of "repaying hard work" in hospital IT operation and maintenance, we must not only "take measures", that is, to introduce remote management platforms, cloud desktops and other applications based on the actual situation of the hospital, or introduce new business models such as operation and maintenance outsourcing. More importantly, "change the concept", that is, to establish a "user-oriented" service concept and promote the development of IT operation and maintenance services to refined management.

Liu Xinping, director of the Information Management Office of Hebei Provincial People's Hospital, believes in the article "How to improve the satisfaction of the information department in the hospital?", believes that the improvement of the satisfaction of the information department is closely related to whether it can provide warm services, and a large part of this is IT operation and maintenance services. Therefore, she advocates: when facing certain recurring and complex problems, engineers should change from the past work habit of trying to remotely serve to solve problems as much as possible to arrive at the site as soon as possible, communicate fully with medical staff, and narrow the distance between information and clinical practice.

"On-site service remote operation and maintenance should be the normal work of the hospital's IT operation and maintenance for a long time in the future." An information department head summarized several types of problems that suggested to be solved at the site as soon as possible: problems that occur repeatedly and try remote guidance but cannot be solved; problems that the operator cannot operate, and cannot explain things clearly and are more anxious (such as older doctors); IT problems in special areas of hospitals that are prone to disputes, etc. "Remote operation and maintenance value is to improve efficiency, and when you arrive at the site as soon as possible, you express your empathy and service attitude towards users."

Manpower, efficiency, and satisfaction are three lingering keywords that are lingering in the field of IT operation and maintenance in hospitals. Liu Xinping believes that the dilemma of IT operation and maintenance is often caused by the inequality of information technology between the information department and the clinical department, which is a very test of the "communication" and "scheduling" capabilities of the information department: it is necessary to quickly grasp the real situation of user failures and accurately judge which method to use to achieve the best results. "This requires us to carefully experience, analyze, and properly solve."

In addition, Liu Xinping also believes that one of the important responsibilities of the information department is to promote the digital transformation of the entire hospital through publicity. The information department can carry out relevant training on daily information technology knowledge, IT basic problem solving, network security, etc., to improve the "information quality" of the entire hospital staff and try to narrow the gap caused by this information asymmetry.

Another person in charge of the information department believes that the reason why the hospital's IT operation and maintenance is hard and tiring is that "the information department personnel are busy dealing with current problems, and do not use their brains to analyze the causes, carry out rectification, and reduce the recurrence of duplicate problems." Operation and maintenance work should focus on fault replication and root cause analysis, especially periodic failures. IT operation and maintenance engineers should also master some data analysis methods and tools, mine data on daily operation and maintenance, extract key problems and common problems, and solve them in batches, and reduce the failure rate. "The purpose of hospital IT operation and maintenance is not to efficiently handle many faults, but to effectively improve the continuity and stability of software and hardware operation, and ensure the stable operation of hospital business. At the same time, this is also the key performance indicators and ultimate purpose of the hospital information department."
Chapter completed!