This is the first time since the outbreak of the new coronavirus epidemic, the world's top journals have gathered Chinese and foreign scholars to scientifically and systematically introduce China's successful experience in fighting the epidemic in the form of a "special issue".

December 2, 2021 is a rare "complete symmetry day" in history, and it is also called "the symmetry day of love" by many netizens. On such a day full of blessings, the world-renowned comprehensive medical journal "The British Medical Journal" (BMJ) quietly launched a "gift" to global anti-epidemic workers: experts in the field of public health in China and abroad jointly released a special issue called "china's      response   to                                                                                                                                                                                               

It is reported that this is the first time since the outbreak of the new coronavirus epidemic, the world's top journals have gathered Chinese and foreign scholars to scientifically and systematically introduce China's successful experience in fighting the epidemic in the form of a "special issue".

"For a long time, the epidemic in China has attracted widespread attention from people all over the world. China's population accounts for 19% of the world, but as of now, the number of new coronavirus infections in China accounts for only 0.05% of the world." said the executive editor-in-chief of the bmj, Dr. Kamran, abbasi. "We hope that this special issue can reflect China's 'first-hand' experience in fighting the epidemic and provide important guidance to other countries."

So what information does this special issue convey? From the perspective of public health, what experience can we summarize in fighting the epidemic. To this end, two leading experts of the "medical community" exclusively connected to the special issue - Professor Li Liming, director of the Center for Public Health and Major Epidemic Prevention and Control Strategy of Peking University, and Tang Jinling, senior clinical research editor of the bmj and professor of epidemiology at the Shenzhen University of Technology, Chinese Academy of Sciences, told us the story behind this special issue

"After the outbreak of the new crown epidemic, both domestically and internationally, there have always been different voices and perceptions of the anti-epidemic measures taken by our country. Therefore, we have always hoped to organize experts to discuss from a professional perspective: what measures can effectively prevent and control this epidemic under the national conditions of China." Professor Li Liming said.

In December last year, Professor Tang Jinling, senior clinical research editor of the BMJ, communicated with Professor Li Liming, and suggested that they join hands with Chinese scholars to make a special issue of the anti-epidemic to introduce China's anti-epidemic experience to the world. The two of them coincided and soon received widespread support from domestic experts in the field of public health. In order to prepare for this special issue, Professor Li Liming took the lead and convened experts from the School of Disease Control and Prevention, Public Health and Health Administrative Officials from the School of Disease Control and Prevention, Public Health, and held a closed-door meeting in Suzhou. Everyone talked freely about our practical experience and practical issues in the fight against the epidemic.

"Based on the results of the seminar, we formed about 25 prevention and control strategies worthy of research in the prevention and control of the new crown epidemic. Afterwards, we organized relevant domestic experts to conduct multiple rounds of discussion with the experts from the bmj editorial department, including Professor Tang Jinling, and selected 11 relatively mature topics with certain evidence support. We invited corresponding experts to write reports for these 11 topics. Finally, after strict magazine review, 10 articles were selected to enter this special issue. It can be said that the entire publication process is carried out completely according to the scientific and objective procedures published by international magazines." Professor Li Liming introduced.

These 10 essential articles that were finally "concentrated" gave systematic and comprehensive answers to the focus of China's anti-epidemic issues that have attracted much attention from the world:

First, in the early stages of the outbreak, how my country can quickly and continuously curb the spread of the virus through traditional public health measures and strong social mobilization;

Secondly, high-tech technologies such as virus isolation and sequence sharing provide possibilities for the development of testing reagents and vaccines, greatly assisting and improving the efficiency of traditional public health measures such as discovering sources of infection and protecting susceptible populations;

Third, the special issue discusses my country's current vaccine strategies and the problems and challenges it faces in detail.

In addition, the special issue also scientifically demonstrated and elaborated on some "keywords" of prevention and control during this epidemic, such as asymptomatic infections, 14-day isolation, cold chain transmission, epidemiological models, etc., and discussed the "Wuhan" experience in the management of critically ill patients.

Looking back at the history of human infectious diseases, the most similar to this new crown epidemic. The most recent super-large epidemic is the "Spanish flu" incident around 1918. This global disaster a hundred years ago once caused about 500 million infections and 25 million to 40 million deaths (the world population was about 1.7 billion at that time), and its global average mortality rate was about 2.5%-5%.

Similar to the Spanish flu, the new coronavirus this time is extremely pathogenic and highly contagious. However, today's new coronavirus epidemic prevention and control faces greater challenges: the global population mobility has been greatly enhanced, and the spread of diseases is much faster than a hundred years ago. From this point of view, the Spanish flu at that time may be far less severe than today's new coronavirus epidemic. This can be said to be an infectious disease event that has happened once in a few hundred years in human history.

As the first country to report the epidemic, our country has taken rapid and decisive measures in such an important and urgent situation, and achieved "zero" local cases less than half a year after the outbreak of the epidemic and there were no special drugs and vaccines.

"From my professional perspective and the perspective of medical infectious diseases, this is really a 'feat' in human history, an important event that rewrites the history of human beings in response to infectious diseases, and a milestone event that has been recorded in history." Professor Jinling Tang emphasized.

Nowadays, looking back at China's most important experience in the control of this epidemic and the point mentioned most in the special issue is that under the leadership of a strong government, our country has firmly implemented common sense, traditional public health measures, namely non-pharmaceutical interventions, such as isolation, washing hands, disinfection, wearing masks, maintaining social distance, and canceling public activities.

How important are these traditional hygiene measures? Taking wearing masks as an example, "wearing masks" for the whole nation can effectively reduce the spread of the disease. A meta-analysis shows that wearing masks alone can reduce the risk of infection by 85% [2]. A global study from 190 countries shows that the joint application of multiple public health measures can increase the disease control rate by 11%-60% compared to the application of only a single public health measure [3].

An earlier article published in the Lancet once predicted that if my country does not block the spread of the virus in time and does not lock down the city in time, the number of people suffering from the epidemic in April 2020 will likely reach a peak of 30,000 in one day, far higher than the 1,967 cases that actually occurred on February 2. It can be said that public health measures after Wuhan lockdown successfully reduced the number of people on peak days by nearly 93%, curbing the pandemic two months ahead of schedule, and making a huge contribution to global epidemic prevention and control [4].

Professor Jinling Tang sighed: "In the future, when humans face such a strong and highly infectious disease again, we must believe that even if there is no vaccine or special medicine, as long as we use public health measures and some modern technologies, we can quickly eliminate this disease. I think this is the greatest revelation to mankind."

So, how to do traditional health measures? The most important point is to do a good job in health education and social mobilization. "We often say that health education is the best 'vaccine'. We must let the people realize that these traditional measures can play an active role." Professor Li Liming said.

However, not all countries can strictly abide by and implement these common sense of public health and provide good health education:

"For example, everyone knows that the US disease control system and scientific research capabilities are significantly higher than our country, but this time their epidemic prevention and control has not been successful. Now there are more than 80 million confirmed cases and more than 700,000 deaths. Why? One of the important reasons is that it has not insisted on implementing traditional public health measures, such as wearing masks, which is a very profound lesson. Some countries, such as the UK, insist on herd immunity and blindly emphasize vaccination. However, vaccination can only protect susceptible groups, and cannot identify and detect the source of infection in the early stage, nor can it cut off the transmission route."

Now, with the emergence of the new coronavirus vaccine, global epidemic prevention and control has entered the second important stage. Unfortunately, this new coronavirus vaccine is by no means a "life-saving straw" for epidemic prevention and control.

Professor Li Liming has a rational judgment on this: From a scientific point of view, it is already a thing worthy of "happiness" for us to develop a new coronavirus vaccine.

"The new coronavirus is an RNA virus, a single-stranded, very unstable pathogen. Many RNA viruses, such as HIV and Sars virus, do not have vaccines. The effectiveness of the new coronavirus vaccine is not absolutely 100%, but it can actively protect susceptible people, reduce the risk of disease, and reduce the chance of death. Moreover, after vaccination, not only humoral immunity will occur, but also cellular immunity, and even immune memories can appear to resist some new pathogens."

Obviously, vaccines alone cannot control the epidemic 100%, and new mutant strains are still emerging. If vaccines are compared to a "wall" that has not completely blocked the virus, then what will the remaining "wall" rely on? It can only rely on public health measures.

"It is certain that before the epidemic is completely eliminated, traditional public health measures cannot be relaxed, nor should they be relaxed." Professor Tang Jinling said, "We have seen that many countries have begun to relax their vigilance on epidemic prevention and control, gradually reducing the application and emphasis of traditional public health measures. For example, Israel's comprehensive vaccination rate is close to 80%, but the high vaccination rate has failed to prevent the epidemic. The severe illness and mortality rates caused by breakthrough infection are still rising, which is closely related to the relaxation of traditional public health measures."

After the outbreak of the epidemic in early 2020, virologists, clinical scientists, and epidemiologists quickly entered the epidemic site, conducted investigations, found the situation, found the cause, and then reported to decision makers. However, they each saw different aspects of the same problem. In the view of Professor Tang Jinling, the biggest inspiration of this epidemic to the public health community is that the prevention and control of diseases cannot be separated from the group view of medicine, which is also a unique feature of the public health discipline.

Nowadays, the disciplines are becoming more and more detailed. Everyone is looking at the micro level, from organs to cells to molecules. The group view is a systematic view, a holistic view, and a global view. This epidemic is an important practice of the group view, and it fully reflects the important characteristics of the group view of public health: my country has carried out social group measures such as "lockdown", national mobilization, tracking close contacts, etc., to carry out research on the source of infection, transmission pathways, incubation periods, incidences, and mortality among the population to understand the development stages and trends of the epidemic in the group.

It can be said that without a holistic concept, group perspective, and group strategy, we will not be able to deal with the prevention and control of infectious diseases at the group level.

So, in an era when the epidemic is still raging, where will the discipline of public health go? It is true that the country's investment in public health and disease prevention has increased day by day, but the entire discipline still has many questions worth exploring in terms of research direction, infrastructure construction, talent training, etc.

However, what is certain is that after the outbreak of the new crown epidemic, everyone's positioning of public health has become clearer.

"Public health is not only a technical team that protects public health and prevents diseases, but also a team that protects national security and maintains social stability. The quality of disease control and public health work will directly affect the country's economic and social development, and will also change the international relations and political landscape.

Therefore, public health issues must not be regarded as a small matter. It is a concept of a major, big health, and big health, which plays a crucial role in the entire society. We can see that many countries have experienced economic shutdowns due to a small virus. Through the practice of epidemic prevention and control in our country, it has been proved that public health issues should be dominated by the government. Only by the attention of the Party and the government and scientific leadership can such effective disease control results be achieved." Professor Li Liming said.

According to US media reports, there are currently more than 20 cases of Omickron strain infection in at least 12 states in the United States. The age, vaccination status and travel history of these patients vary. American infectious disease expert Fauci pointed out that the Omickron strain has undoubtedly been community-transmitted in the United States.

From 0:00 to 24:00 on December 4, 31 provinces (autonomous regions, municipalities) and the Xinjiang Production and Construction Corps reported 59 new confirmed cases. Among them, 42 local cases (30 in Inner Mongolia, all in Hulunbuir City; 10 in Heilongjiang, all in Harbin City; and 2 in Yunnan, all in Dehong Dai and Jingpo Autonomous Prefecture). There were no new deaths and no new suspected cases.

According to the Manzhouli Daily, in the case of Zhao Hui, deputy director of the Public Security Bureau of Zhalai Nuoer District, and Su Weidong, vice chairman of the Manzhouli Federation of Trade Unions, had problems such as lack of awareness of the overall situation, poor performance of duties, and slow work responsibilities, the Manzhouli Municipal Party Committee studied and decided to dismiss the two of them.
Chapter completed!