中国全科医学 ›› 2022, Vol. 25 ›› Issue (11): 1383-1386.DOI: 10.12114/j.issn.1007-9572.2022.0098

所属专题: 新型冠状病毒肺炎最新文章合集

• COVID-19疫情防控研究 • 上一篇    下一篇

城中村新型冠状病毒肺炎疫情发生特点及其基层医疗卫生机构的防控策略分析研究

张冬莹1,2, 姚弥3,4, 刘曼玲5, 郭发刚6, 吴江7, 王宝记8, 肖宝军9, 徐静7, 赖艳梅8, 郑劲平2,*   

  1. 1999078 澳门特别行政区,澳门科技大学医学院
    2510120 广东省广州市,广州医科大学附属第一医院/广州呼吸健康研究院/国家呼吸系统疾病临床医学研究中心
    3100191 北京市,北京大学医学部全科医学学系
    4B15 2TT伯明翰,英国伯明翰大学应用卫生研究院
    5710021 陕西省西安市,西安医学院全科医学研究所
    6724103 陕西省汉中市,留坝县玉皇庙镇中心卫生院全科医学科/医务管理科
    7710043 陕西省西安市,新城区韩森寨社区卫生服务中心
    8710000 陕西省西安市,国际港务区新合社区卫生服务中心
    9710002 陕西省西安市,莲湖区北院西大街社区卫生服务中心
  • 收稿日期:2022-01-26 修回日期:2022-02-21 出版日期:2022-04-15 发布日期:2022-03-28
  • 通讯作者: 郑劲平
  • 基金资助:
    国家重点研发计划(2021YFF0604000)

Analysis and Research on the Characteristics of COVID-19 Epidemic in Urban Village and Its Prevention and Control Strategies in Primary Care Institutions

ZHANG Dongying12YAO Mi34LIU Manling5GUO Fagang6WU Jiang7WANG Baoji8XIAO Baojun9XU Jing7LAI Yanmei8ZHENG Jinping2*   

  1. 1.Faculty of MedicineMacau University of Science and TechnologyMacau 999078China

    2.First Affiliated Hospital of Guangzhou Medical University / Guangzhou Institute of Respiratory Health / National Clinical Research Center for Respiratory DiseaseGuangzhou 510120China

    3.Department of General PracticePeking University Health Science CenterBeijing 100191China

    4.Institute of Applied Health ResearchUniversity of BirminghamBirmingham B15 2TTUK

    5.Institute of General MedicineXi 'an Medical CollegeXi 'an 710021China

    6.General Medicine and Medical Affairs DepartmentLiuba County Yuhuangmiao Town Central HospitalHanzhong 724103China

    7.Han Sen Village Community Health Service CenterXincheng DistrictXi 'an 710043China

    8.Xinhe Community Health Service Center of International Port DistrictXi 'an 710000China

    9.Community Health Service CenterWest StreetNorth YuanLianhu DistrictXi 'an 710002China

    *Corresponding authorZHENG JinpingChief physicianProfessorDoctoral supervisorE-mail18928868238@163.com

  • Received:2022-01-26 Revised:2022-02-21 Published:2022-04-15 Online:2022-03-28

摘要: 背景一段时间以来,全国多地城中村暴发聚集性新型冠状病毒肺炎疫情引发关注。城中村内道路错综,人口密集且人员结构复杂、跨区域流动频繁,给疫情防控工作带来挑战。目的城中村因其空间环境、人口结构特征、跨区域流动的特点且居民就医行为特点更容易发生传染病的区域性暴发,了解我国城中村新型冠状病毒肺炎疫情发生特点及其基层医疗卫生机构对在此类区域开展新型冠状病毒肺炎疫情防控工作的现状和存在的困难,为应对常态化防控、社会面动态清零的基层防控工作及应对未来传染病发生的防控提供借鉴。方法通过舆情分析、文献检索、城中村基层疫情防控人员和疫情防控专家在线访谈等方法,总结城中村疫情发生及防控现状,分析存在的薄弱环节和重要漏洞。结果基于相关资料共提炼出6个关注点:(1)摸底排查量大面宽,是城中村疫情防控工作的重点和难点;(2)没有严格闭环管理,病毒携带者未被及时管控,存在疫情传播扩散风险;(3)基层医疗卫生机构院感防控工作不到位,院感发生风险大;(4)属地管理原则在排查密切接触者环节存在漏洞,对于生活与工作场所不在同一行政区域的密切接触者,只排查其生活场所容易导致工作场所的次密切接触者可能存在被感染风险未被及时排查而扩散疫情;(5)超负荷工作成常态,凸显基层医疗卫生机构人力缺口大;(6)疫情防控常态化期间,居民麻痹大意,公共场所不戴口罩、人群聚集现象屡见不鲜,健康教育仍需深入并强调居民为自身健康第一责任人。结论基层医疗卫生机构工作者在城中村新型冠状病毒肺炎疫情防控中承担着社区健康管理、门诊诊疗、公共卫生服务、健康教育、新冠疫苗接种、隔离酒店驻守、联防联控等工作,发挥着重要作用。建议增设发热哨点诊所,早发现早隔离,避免疫情进一步扩散,征用出租屋满足隔离医学观察需求,加强基层医疗卫生机构院感防控,开通绿色救助通道,保障特殊群体就医,组织志愿者增援基层医疗卫生机构,健康教育强调居民是保持自身健康第一责任人,提高个人新型冠状病毒肺炎防控风险意识。

关键词: 新型冠状病毒肺炎, 城中村, 基层医疗卫生, 防控现状, 策略建议

Abstract: Background

For a period of time, the outbreak of the COVID-19 outbreak in many urban villages in our country had caused concern. The dense and complex population structure of urban villages, with their inter-regional mobility, posed a challenge to the prevention and control of the epidemic.

Objective

Urban village areasare more prone to regional outbreaks of infectious diseases because of their spatial environment, demographic characteristics, cross-regional mobility and the characteristics of residents' medical treatment behavior. The purpose of this study was tounderstand the characteristics of the COVID-19 epidemic situation in urban villages and the current situation and difficulties of primary care institutions in carrying out COVID-19 epidemic prevention and control measures, in order to provide references for primary care institutions to deal with normalized prevention and control, social dynamic clearing work and future infectious disease prevention and control.

Methods

By using public opinion analysis, literature retrieval, online interviews with epidemic prevention and control personnel and experts in urban village, the epidemic situation, prevention and control status of urban village were summarized, and the existing weak links and important loopholes were analyzed.

Results

Based on the relevant information, a total of six points of concern were extracted: (1) The number of mapping and screening objects was large, which was the focus and difficulty of epidemic prevention and control work in urban villages. (2) There was not strict closed-loop management lead to virus carriers who were not timely controlled, which caused a risk of spreading the epidemic. (3) The prevention and control of nosocomial infection in primary care institutions was not in place. (4) There were loopholes in the inspection of close contacts in the principle of territorial management; close contacts who did not live and work in the same administrative area but only screened in their living places, which may lead to the spread of the epidemic in workplaces where secondary close contacts may be at risk of infection were not screened in a timely manner. (5) Overload had become the norm, highlighting the large gap in primary health care manpower. (6) During the normalization of epidemic prevention and control, residents were paralyzed and careless, and the phenomenon of not wearing masks in public places and crowd gathering was common. Health education still needs to be strengthened and emphasized that residents were the first responsible for their own health.

Conclusion

Primary care providers played an important role in the prevention and control of COVID-19 in urban village by undertaking community management, outpatient treatment, public health services, health education, vaccination, quarantine hotel stationing, joint prevention and control, etc. It was recommended that additional fever sentinel clinics be set up for early detection and isolation to avoid further spread of the epidemic, rental houses be requisitioned to meet the demand for isolated medical observation, primary care institutions be strengthened for hospitalization and prevention, green relief channels be opened to protect special groups from medical treatment, volunteers be organized to reinforce primary care institutions, and health education emphasized that residents were the first to be responsible for maintaining their own health and raised personal awareness of the risk of COVID-19 prevention and control.

Key words: COVID-19, Urban villages, Primary health care, Disease prevention and control, Strategy suggestion

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