Is chloroquine phosphate effective？ Zhong Nanshan responds to hot issues in treatment and testing.

　　At 16: 00 on February 18th, the Information Office of the People’s Government of Guangdong Province held a press conference in Guangzhou to inform the situation of epidemic prevention and control in COVID-19, focusing on the new progress in scientific and technological research on epidemic prevention and control.

　　Zhong Nanshan, director of the National Center for Clinical Medicine of Respiratory Diseases and academician of China Academy of Engineering, said that about 85% of critically ill patients can obviously improve their symptoms if they have good clinical life support and nutritional support, and the remaining 15% of critically ill patients need further treatment. After seven or eight days of treatment, the virus content in some critically ill patients is greatly reduced. "At present, there are not many critically ill patients discharged from the hospital, but after good treatment, about 50% of critically ill patients are transferred from ICU to general wards. Overall, the treatment effect of critically ill patients at this stage is good. "

　　Is chloroquine phosphate effective?

　　Jiang Shanping, director of the Department of Respiratory Medicine of Sun Yat-sen Memorial Hospital of Sun Yat-sen University, revealed at the press conference that chloroquine phosphate is an old antimalarial drug that has been on the market for many years, and its safety in treatment of a wide range of people is controllable. Chloroquine phosphate has been included in the new diagnosis and treatment guidelines, expanding the scope of clinical application.

　　According to whether chloroquine phosphate is a specific drug or not, Zhong Nanshan judged that chloroquine phosphate is not a specific drug, but it has therapeutic effect and little side effect, which is worth studying and discussing.

　　He explained that in the face of sudden new viruses, human beings often practice before scientific research and cross the river by feeling the stones. Some old drugs used before can be applied to this disease in terms of mechanism and so on.

　　He suggested that chloroquine phosphate is an old drug, and there is not much side effect in short-term use. At the same time, it has been used in Beijing You ‘an Hospital and Guangdong. Compared with other drugs, the fever symptoms and virus disappear about one day earlier, and the side effects are not great, with diarrhea and a few tinnitus, but the tinnitus will disappear after stopping the drug.

　　Does the effectiveness of nucleic acid detection decrease?

　　Does the "false negative" problem of virus nucleic acid detection mean that the effectiveness of nucleic acid detection is declining?

　　Zhong Nanshan believes that nucleic acid testing should be more accurate if it is done regularly.

　　"Some people say that the accuracy rate is 30% to 50%. If so, it is really confusing."

　　He said that the vast majority of nucleic acid testing samples are taken from the nose and pharynx, and the method is correct, and sampling is equally important.

　　He called for confidence in the results of nucleic acid testing. If the medical staff samples correctly, the results of nucleic acid detection will definitely be accurate.

　　What is the significance of autopsy for treatment?

　　The autopsy of the first and second cases of COVID-19’s death in China was recently completed in Wuhan Jinyintan Hospital, and COVID-19 pathology was successfully obtained. What does this mean for the treatment of COVID-19 patients?

　　"The autopsy of the deceased patient is very important." Zhong Nanshan believes that 17 years ago, SARS also conducted anatomical research on the remains of patients, only to find out the damage of the whole body organs, especially the pathological changes of the lung itself.

　　"We have done a lung transplant for a COVID-19 patient and got very good treatment."

　　He said that from the perspective of lung transplantation, COVID-19 patients’ lungs are different from those of SARS, with alveoli and inflammation, and there are a lot of mucus at the same time, which causes asthma. This is very similar to COVID-19’s clinical observation.

　　He reminded that special attention should be paid to the patient’s airway patency in clinical treatment.

　　Is plasma therapy safe and effective?

　　Regarding whether plasma therapy is safe and effective for COVID-19, Zhong Nanshan revealed that rehabilitative plasma was first used in the H5N1 epidemic in 2005, and the viremia miraculously disappeared. Although there is only one case, it is also attached great importance internationally. In the 2009 H1N1 epidemic, colleagues in Hong Kong made plasma treatment for the recovered patients.

　　"This gives us great inspiration!" He said that in Wuhan Institute of Biological Governance, 10 cases have been treated, of which 6 cases have viremia. After plasma treatment, viremia disappeared in two or three days, and the patient’s clinical situation improved. This treatment is promising, effective and safe.

　　He said that plasma therapy will also be adopted in Guangdong. Due to organ failure in critically ill patients, plasma therapy has little effect, but plasma therapy in convalescent patients has obvious effect in the clinical situation of severe treatment, which is safer and more effective.

　　prevention and control

　　Two problems must be solved.

　　Zhong Nanshan said that at present, 80% of COVID-19 patients in China are in Wuhan, and more than 90% of the dead patients are also in Wuhan. It seems that Wuhan has not stopped human-to-human transmission, and two problems are very urgent.

　　"One is how to separate normal people from patients, and the other is to separate Covid-19 from influenza virus."

　　He said that these two problems are very urgent, and the problem of the transmission of Wuhan people will not stop until these two problems are solved.

　　Zhong Nanshan said that how to effectively prevent nosocomial infection is a very important issue.

　　"There are more than 1,700 medical staff infected nationwide, many of which occurred in hospitals in Wuhan. In the early days of epidemic prevention and control, hospitals became one of the main places for cross-infection. "

　　In addition, it is extremely important to keep the sewer unblocked. Zhong Nanshan said that a team had found Covid-19 in feces before. Covid-19 does not necessarily transmit infection through the digestive tract, but because pollutants in sewers are dried up, and then spread through air and aerosols, and people inhale them to cause infection. This is the most reasonable explanation.

　　This group/reporter Liu Yilong Meng Yaxu