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The Canadian journal of cardiology, v.36 no.6, 2020년, pp.915 - 930
Peng, Fujun (Center for Systems Medicine, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and Peking Union Medical College) , Tu, Lei (Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology) , Yang, Yongshi (Department of Allergy and Clinical Immunology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, National Clinical Research Center for Immunologic Diseases) , Hu, Peng (Department of Respiratory Medicine, Second Medical Center and National Clinical Research Center for Geriatric Diseases, Medical College of the People’s Liberation Army, Chinese People’s Liberation Army General Hospital) , Wang, Runsheng (Department of Respiratory Medicine, Second Medical Center and National Clinical Research Center for Geriatric Diseases, Medical College of the People’s Liberation Army, Chinese People’s Liberation Ar) , Hu, Qinyong , Cao, Feng , Jiang, Taijiao , Sun, Jinlyu , Xu, Guogang , Chang, Christopher
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Abstract With more than 1,800,000 cases and 110,000 deaths globally, COVID-19 is one of worst infectious disease outbreaks in history. This paper provides a critical review of the available evidence regarding the lessons learned from the Chinese experience with COVID-19 prevention and management. T...
Résumé Avec plus de 1 800 000 cas et 110 000 décès dans le monde, la COVID-19 est l'une des pires éclosions de maladies infectieuses de l'histoire. Ce document présente un examen critique des constats disponibles concernant les leçons tirées de l'expérience chinoise en matière de prévention et de gestion de la COVID-19. Les mesures qui ont conduit à la quasi-disparition des nouveaux cas en Chine comprenaient le séquençage rapide du virus pour établir des trousses de tests, ce qui a permis de suivre les personnes infectées à l'intérieur et à l'extérieur de Wuhan. En outre, des mesures agressives de quarantaine ont consisté à isoler complètement Wuhan, puis la province de Hubei et le reste du pays, ainsi qu'à fermer toutes les écoles et les entreprises non essentielles. D'autres mesures ont été prises, notamment la construction rapide de deux nouveaux hôpitaux et la création d'hôpitaux provisoires de type « Fangcang ». En l'absence de vaccin, la gestion de la COVID-19 a compris des antiviraux, de l'oxygène à haut débit, de la ventilation mécanique, des corticostéroïdes, de l'hydroxychloroquine, du tocilizumab, des interférons, des immunoglobulines en intraveineuses et des perfusions de plasma de patients convalescents. Ces mesures ne semblent avoir apporté qu'un succès modéré. Bien que certaines mesures aient été soutenues par des données descriptives modestes, leur efficacité n'est pas encore évidente, en attendant de meilleurs essais cliniques contrôlés. En fin de compte, c'est l'application de mesures de quarantaine drastiques qui a permis d'arrêter la propagation du SARS-CoV-2. Plus la mise en œuvre est précoce, moins il est probable que les limites des ressources soient atteintes. Les facteurs les plus critiques pour stopper une pandémie sont l’identification précoce des personnes infectées, des porteurs et des contacts et la mise en œuvre rapide de mesures de quarantaine grâce à une stratégie organisée, proactive et unifiée au niveau national. Tout retard entraîne une augmentation significative du nombre de décès.
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