There is no clear evidence of imaging examination and a lack of strong nucleic acid examination results. It is difficult to prove that a fever patient with Yunhe’s history of traveling is a patient with novel coronavirus pneumonia.

It is even more difficult to prove that it is not only difficult in medicine, but also in actual operation.

As the current "high-risk group", all travelers with Yunhe's history of traveling need to undergo quarantine and medical observation at their location. After quarantine for 14 days without any health problems or symptoms, they also need to undergo home isolation of different lengths according to the "level of attention" of different regions.

Changning's local policies are currently relatively strict, requiring all personnel with a history of Wuhan to undergo at least two 14-day quarantine observations. The body temperature is reported every day. If you feel uncomfortable, you must immediately send it to a designated hospital for further examination. The patient developed symptoms on the third day of quarantine, so he was sent to Zhongfu Hospital.

"The patient said he had never been to the seafood market and had never had contact with the confirmed personnel before. He drove to Changning two days before the lockdown." Mei Ying roughly explained the patient's condition and then said, "After coming to Changning, the patient began to undergo quarantine, and developed fever and cough on the third day of quarantine. According to the principle of proximity, he was sent to our Zhongfu Hospital."

"The Center for Disease Control and Prevention and the streets have specially sent staff to disinfect the patient's living area. The entire building where the patient lives is currently in a closed and controlled state." Mei Ying's voice sounded a little worried, "If this patient is indeed infected with the new coronavirus, then we have to vacate the entire hospitalization department immediately - we have to use 215 beds to treat patients. I don't know if we can take all the patients in this building."

"There is no reason to send everyone in the entire building to the hospital, right?" Sun Lien was a little stunned when he heard this. Because Yunhe's medical resources were tight, most patients with fever had to be isolated at home. The purpose of this is to prevent possible gathering of fever clinics and large-scale in-hospital transmission before the diagnosis ability is kept up.

Like many other hospitals, Zhongfu Hospital only retains a few separate wards for clean treatment or isolation. Overall, their inpatient departments are still mainly multi-person wards. Such multi-person wards cannot meet the requirements of isolation observation - before PCR accuracy is improved, no one can guarantee that one or two patients who are really infected with the new coronavirus will not be hidden among the patients admitted to the observation.

If there is indeed a carrier of the new coronavirus among the people in centralized isolation, the entire ward and even the entire floor may have in-hospital infection. This design has a big problem from the beginning.

"It must not be done like this." Mei Ying was also worried about this issue. But the reality is that the Changning Municipal Health Commission arranged this way. "The isolation point needs to be transformed, and medical personnel must be dispatched to garrison. There must be someone to ensure the daily life of the quarantined people... The allocation and coordination of these things take time. But the problem is... there is no time now."

So, after talking about the topic, I returned to that fundamental issue - first of all, I must determine whether this patient is a new coronavirus infection.

Sun Lien was a little worried. If someone was in Changning, even if someone was in Ningyuan, he would know everything after rushing over and taking a look. However, if the status bar does not directly see the person, it would be useless, and imaging examinations are not available for the time being...

When people are worried, they will lose their hair. Sun Lien now has a deep understanding of this - he feels a little itchy on his head, and scratches it with his hands, which leads to a lot of black hair.

It felt like I had just gone to get my hair cut, but I was in a hurry to go out so I didn't wash my hair. Sun Lien shook his hair stuck to his hands and said to the phone, "Did you send me the detailed information on WeChat? Have you checked the patient's peripheral blood lymphocytes?"

Judging from Sun Lien's experience in North Five Districts over the past few days, patients who have reached the severe stage will start to experience inflammatory storms. The inflammatory storms will appear sooner or later, but they will definitely come in the end.

The two key indicators to determine the beginning of an inflammatory storm are Sun Lien who has been staring at the total number of interleukin-6 and peripheral blood lymphocytes that he has emphasized. Once the level of interleukin-6 increases and the total number of peripheral blood lymphocytes begins to decline, the patient is likely to be developing towards the direction of an inflammatory storm.

"The total number of peripheral blood lymphocytes has been checked. It is now around 0.7. When I was just admitted to the hospital yesterday, it was 0.9." Mei Ying heard a sound of flipping through papers. After a few seconds, she said, "The value was abnormal today, but it has not reached the critical value yet."

"It would be strange if his condition is critical." Sun Lien thought for a while and asked, "How much c-reactive protein is there? Are you coughing and sputum?"

"27, I have a cough but a dry cough. The inflammation index increased slightly yesterday compared to the previous year." Mei Ying sighed, "This is also because I am in a hurry to seek medical treatment. If there is no examination, the gods can't handle it..."

"I personally recommend that it is best to treat the patient according to the standards of the confirmed patient and start evacuating the patient immediately." Sun Lien said seriously, "This symptom is indeed very similar. Without imaging evidence or a positive nucleic acid at one time, I suggest that he should be treated as a highly suspected patient. After evacuating the hospitalized patient as soon as possible, the patient's chest CT examination will be immediately improved. His entry and exit will be accurately managed, and the bedside b-ultrasound will be available to judge the pulmonary edema."

Mei Ying's voice immediately became serious. She stopped Sun Lien's explanation like a cannon, and then muttered, "Wait, I'll remember it."

The national guidelines currently published are relatively "rough", and they are more of a directional and framework document. They list some knowledge about this new disease during this period and many experts' treatment suggestions for this disease. This can certainly provide some reference for front-line clinicians, but it is impossible to completely refer to the guidelines for treatment.

When Sun Lien received patients with pneumonia caused by the novel coronavirus at the Comprehensive Diagnosis Center, he kept emphasizing that "a thousand people and a thousand steps" is also because of this. As a new virus, the symptoms shown by the infected people of the novel coronavirus vary greatly. From ards caused by the virus infecting the lungs, to electrolyte disorders caused by the severe diarrhea, from systemic organ damage caused by hypoxemia, to viral myocarditis caused by the virus infecting the heart through blood... not to mention inflammation storms and other unknown injuries. More than 50 patients Sun Lien had seen in the fifth district of Lien can show him so many reasons for "ineffective rescue of patients" and he doesn't know how many symptoms he can't see.

Of course, these contents will not be put into the guide - it is as meaningless as a difficult track guide for F1 racers to write "The left pedal is the brake, and the right pedal is the accelerator".

As long as the position and angle of each corner is stated, the racers will figure out where to accelerate, where to brake, where to use the offensive route, and where to maintain the tire. If they don’t even understand these things, they can really consider changing careers and doing something else.

But the prerequisite for completely letting go with the guide is that this guide is sufficiently detailed.

If fighting the new coronavirus is a track, the current guide shows at most one or two corners. At the same time, the track is full of thick fog that will reduce visibility to 10 meters.

Racing in such a place... will kill people.
Chapter completed!