The Shoe Has Finally Dropped: Facing Everything with Equanimity
The "Ten New Measures" released today mean that the shift in our country's pandemic-control policy is essentially complete.After three years of fighting the epidemic, we have been comparatively lucky: our building door was temporarily locked down only one night, and that happened while we were completely unaware. The lockdown came at eight or nine in the evening and was lifted by seven the next morning; during that time we had no need to go out anyway. Other buildings and units in the compound were locked down for several days, but it never reached us. I know many people whose lockdowns lasted far longer than ours.Still, we have tasted the bitterness of people's hardship as fully as everyone else. The economic slump has affected nearly everyone, and the epidemic-control measures have kept us from returning home to visit relatives for a long time. There are plenty of people far less resilient than we are, and some have unfortunately passed away. Now that at last we see the hope of society restarting, my heart has suddenly lightened considerably.The road ahead will still be muddy, and some of our fellow citizens will meet misfortune; we can only pray that the number of those who suffer is as small as possible. Data released today by Wuhan Jinyintan Hospital shows that, among the infected in Hubei Province in this wave, about 90% were asymptomatic or mildly ill, about 4.45% showed pulmonary inflammatory changes (generally mild and resolvable within a week), and about 0.5% were severe or critical. This figure is the most representative of our national average among the data recently released by various places. The earlier figures from Guangzhou were not representative, because that wave's infected were mainly the able-bodied migrant workers of Haizhu District; they were generally young, so a low proportion of critical illness was only natural. Any data from Guangzhou and Shenzhen—cities with a very high proportion of young people—cannot represent China's average.The 0.5% critical-illness rate reported by Jinyintan Hospital is a bit high. In Singapore, the critical rate was 0.3% for first-time infections and 0.2% for reinfections. This suggests we still need to improve vaccination coverage, or need better vaccines (even imported ones) to protect the population. A critical rate just 0.2% higher means, for our huge population, many additional deaths—because 0.2% of 100 million is 200,000, and of one billion is 2 million. When medical resources are strained, the case-fatality rate among critical patients is very high.In the period ahead, the actual number of infected people will grow exponentially—at first roughly doubling every week, and later perhaps doubling every two or three days. A Japanese study shows that when the number of infected reaches a certain level, social-distancing measures no longer slow the epidemic's growth. So once enough people in our society are infected, the number of cases will surge regardless of whether we keep our distance.Medical crunches are not yet obvious, but when new cases number in the millions per day, the crunch will appear and the death rate among critical patients will rise. This is the final window; those who should be vaccinated should seize this chance to get vaccinated and protect themselves. Many of us—myself included—received our third dose more than a year ago, and our antibody levels have dropped considerably. It is time for the country to consider opening up a fourth booster shot, so as to lower the proportion of critical illness as much as possible.Omicron may soon evolve within our own borders into a less lethal new variant that becomes the dominant strain in China. After all, our population base is huge; once infection rates surge, the emergence of new variants is no surprise. Of course, a more lethal variant could also evolve, because the genetic drift of viral populations is uncertain and does not necessarily move toward weaker virulence. But when a more lethal new variant appears, it will surely be detected quickly, and more effective controls will then be available to contain it, so there is little to worry about.If Omicron evolves a less lethal new variant, our mainland case-fatality rate may be lower than Taiwan's. Taiwan's case-fatality rate is currently close to but slightly below one per thousand of its total population, while Hong Kong's exceeds one per thousand. Hong Kong's higher rate is related to the fact that the dominant strain when Hong Kong opened up was more lethal than the dominant strain when Taiwan opened up.Because Omicron mainly enters human cells through the angiotensin-converting enzyme 2 (ACE2) receptor on cell surfaces, people with hypertension, heart disease, kidney disease, obesity, and long-term smokers easily become high-risk groups. In addition, immunocompromised tumor patients, immunodeficient patients, and COPD patients are also prone to becoming high-risk.The proportion of pneumonia caused by Omicron is not high, but its harm to blood vessels and the nervous system is considerable. So at-risk groups should strengthen personal protection: get vaccinated, wear masks and goggles, wash hands often, ventilate frequently, and try not to get infected. Although 65% of deaths occur among people over 60, 35% occur among those under 60. Hong Kong data show children have a mortality rate of about one in ten thousand, though far lower than adults. So young people cannot let their guard down either; while getting vaccinated, they should also maintain good routines and diet and exercise moderately to boost immunity. The best exercise for protecting the heart is push-ups; research data show doing 40 push-ups a day can extend life by ten years.Omicron's aftereffects are also related to this. The international reports I have seen on Omicron's long-term effects resemble stroke sequelae in many ways—depression, brain fog, memory decline, and fatigue—which are also common in stroke patients. The first deaths reported in Beijing's current wave basically all had concurrent sequelae of cerebral infarction or cerebral hemorrhage.So everyone should shed the stereotype created by the name "COVID pneumonia"; stop thinking the lung is the only dangerous site. Heart patients, diabetics, the obese, those with blood pressure above 130 (note: 130, not 140), and those with a family history of hypertension should all keep regular routines; overexertion raises the risk of critical illness. Those who need antihypertensive medication should remember to take it.For the great majority of people in basically good health, Omicron's harm is small. I myself am prepared: if I am infected, I will not rely on medication but will deal with it entirely through my own immunity. I'll drink plenty of boiled water and then sleep under the covers to sweat out the fever. If the fever exceeds 38°C and those methods fail, I'll use ice packs for physical cooling. This is a self-limited disease; as long as we manage the symptoms properly and don't develop pneumonia, we can leave the rest to our immune system.After the pandemic-control policy opens up, while taking personal precautions, we should return to normal life. The meaning of life lies in life itself; if we castrate part of daily life away, we will miss many of life's joys. Long-term loss of life's pleasures saps the will and drains vitality. So, after taking necessary precautions, return to normal life! Don't dwell on Omicron.I would like to close this article with Haizi's poem "Facing the Sea, with Spring Blossoms": "From tomorrow on, I will be a happy man; grooming horses, chopping wood, and traveling the world."