Vaccination is the key to immunization planning, and it is also a sharp weapon for China to deal with a series of infectious diseases such as COVID-19.

　　According to the "Immunization Agenda 2030" announced by 26 institutions including the World Health Organization (WHO), the goal is to achieve 90% coverage of basic vaccines for children and adolescents by 2030, and to reduce the number of children who have not been vaccinated at all by half. The "Healthy China 2030" Planning Outline clearly stated that "the expanded national immunization program should be continued, and the vaccination rate of school-age children in the national immunization program should be maintained at a high level".

　　At present, 14 kinds of vaccines under China’s immunization program can prevent 15 kinds of infectious diseases, including hepatitis A, meningitis and rubella, and the coverage population is mainly children aged 0 to 6. However, there are still four kinds of vaccines recommended by WHO that are internationally recognized as cost-effective and have not been included in China’s immunization program.

　　What is the urgency and cost-effectiveness of these four vaccines for patients? How to set relevant evaluation standards? On the occasion of "World Immunization Week", CBN interviewed a number of clinical and immunization planning experts and gave their answers.

　　The dilemma of high price of PCV vaccine

　　The vaccines recommended by WHO but not included in China’s immunization program mainly include Hib vaccine (Haemophilus influenzae type B vaccine), HPV vaccine (human papillomavirus vaccine), PCV vaccine (streptococcus pneumoniae conjugate vaccine) and RV vaccine (rotavirus vaccine).

　　"Streptococcus pneumoniae (SPN) is the main pathogen of community-acquired pneumonia and invasive infection among children in China." Zeng Mei, chief physician of the Pediatric Hospital affiliated to Fudan University, said that according to multi-center research, nearly 80% of patients with invasive pneumococcal diseases are children under 5 years old. "It is urgent to vaccinate this population with streptococcus pneumoniae vaccine."

　　As a pediatric clinician, Zeng Mei has been concerned about the impact of Streptococcus pneumoniae on children and the related immunization planning process for many years. For example, a multi-center clinical study covering 1138 cases of invasive Streptococcus pneumoniae in children from 2012 to 2017 showed that the mortality rate of these invasive Streptococcus pneumoniae diseases was as high as 16.2%, and the proportions of meningitis, bacteremia and bacteremia caused by these diseases were 22.9%, 9.1% and 7.8 respectively.

　　In terms of vaccine supply, at present, there are two kinds of PCV13-valent vaccines available in China. Among them, imported vaccines are suitable for infants aged 6 weeks to 15 months, and domestic vaccines are suitable for infants and children aged 6 weeks to 5 years. PPV23(23-valent pneumococcal polysaccharide vaccine) is used for people over 2 years old who are infected with SPN and have an increased risk of IPD (invasive pneumococcal disease).

　　"In China, there are obvious regional differences in deaths caused by Streptococcus pneumoniae, and about 49% of deaths caused by Streptococcus pneumoniae occurred in the western region. In terms of mortality, the mortality rate in the western region is 17 per 100,000, which is about twice as high as that in other regions. " Wang Weibing, director and professor of the Department of Epidemiology, School of Public Health, Fudan University, said that the vaccination rate of PCV13 vaccine in Shanghai has reached almost 50% in recent years, and the risk of pneumonia can be reduced by about 82% after vaccination, but the vaccination rate in the western region is less than 1%.

　　Wang Weibing further said that from the perspective of economic burden, the price of PCV vaccine in most countries covered by Gavi (Global Alliance for Vaccine Immunization) is about US$ 3.3 per dose. The price of imported PCV13 vaccine in China is about 700 yuan per dose, which still has a certain gap. "The current price also leads to the vaccine not being cost-effective in health economics." .

　　It is necessary to comprehensively consider many factors such as disease, vaccine, vaccination ability and so on when vaccines are included in the immunization program. Wang Weibing told reporters that on the one hand, epidemiological evidence such as the disease burden of influenza and pneumococcal diseases in China is still insufficient. Because pneumonia, influenza and other respiratory diseases usually have similar symptoms, there are many kinds of pathogens that can cause the same disease, which makes it difficult to estimate the disease burden of vaccine-preventable diseases, and it is difficult to observe the effect after vaccination.

　　On the other hand, from the point of view of vaccine supply, because PCV vaccine contains many serotypes, the production process is complex and there are certain technical barriers, which leads to the vaccine supply can not meet the needs of being included in the national immunization plan. However, with the joining of Chinese manufacturers who independently research and develop PCV vaccine, it is believed that the current situation of insufficient supply will be expected to be improved.

　　Significance of free HPV vaccination

　　Since the first government-led HPV vaccine free vaccination project was launched in Erdos city three years ago, at present, Guangdong, Hainan, Jiangxi, Fujian, Tibet and Chongqing provinces have also started or announced that they will launch a global HPV vaccine free vaccination program.

　　According to other data, there are six kinds of HPV vaccines listed in the world, including two bivalent HPV vaccines independently developed by China (one from Wan Tai and one from watson biological). As of March 2023, 126 countries and regions have included HPV vaccine in the immunization program.

　　"In terms of HPV vaccination, people’s acceptance and participation enthusiasm are higher than expected. These explorations may provide important reference for the inclusion of HPV vaccine in national immunization planning decisions." Zhang Jun, deputy dean of the School of Public Health of Xiamen University and deputy director of the National Infectious Disease Diagnostic Reagents and Vaccine Engineering Technology Research Center of Xiamen University, said in an interview.

　　In Zhang Jun’s view, there is no doubt about the health damage caused by HPV infection in China. With the large and stable supply of high-quality domestic HPV vaccines and widely recognized by the public, the independent control of vaccine research and development and the long-term sustainability of supply have become a fact. "At present, HPV vaccines have not been included in the national immunization plan, and the main difficulty lies in the high cost and price of vaccines and the uncertainty of public acceptance."

　　Judging from the bidding price of Jiangsu Province’s previous procurement, the bivalent HPV vaccine in watson biological was 246 yuan/piece, and the bivalent HPV vaccine in Wan Tai was 329 yuan/piece, and three shots were inoculated in the whole process. In addition, the average price of HPV tetravalent vaccine ranges from 800 to 900 yuan per dose, and the total price of three doses of HPV nine-valent vaccine is about 4,000 yuan.

　　"Because the research and development cycle of HPV vaccine is generally more than 10 years, it requires high production facilities and quality control. In order to maintain a virtuous circle of market demand-R&D investment, the pricing of products should not be too low within several years of listing; This may put greater pressure on the country’s budget. " Zhang Jun analyzed the reporter.

　　Du Heng, senior project officer of the Beijing Representative Office of Bill and Melinda Gates Foundation, believes that enterprises will make production capacity layout and arrangement according to market demand, and naturally leave production capacity to the high-priced vaccine market and people with higher payment capacity. The key population that should be vaccinated with HPV vaccine first, that is, girls aged 9-15, can guide the production behavior of enterprises through strengthening the national immunization program and large-scale procurement.

　　Zhang Jun suggested that, on the one hand, a more flexible medical insurance payment mechanism could be considered. For example, formulate affordable medical insurance payment standards, where the expenses within the standards are reimbursed by medical insurance/finance, and the expenses beyond the standards are paid by individuals.

　　On the other hand, on the basis of bidding and purchasing with quantity, considering increasing the time factor, relatively high prices are allowed in the first few years, so that enterprises can recover their costs as soon as possible and obtain reasonable income, maintain their enthusiasm for innovation, and quickly switch to cost pricing or market competition after a certain number of years and more diversified manufacturers, so as to ensure the sustainability of immunization planning policies.

　　Implement a scientific and accurate evaluation standard path

　　Professor Tang Shenglan, co-director of the Global Health Research Center of Duke University in Kunshan and head of the Innovation Laboratory of Vaccine Delivery Research, told the reporter that there have been many mature research results on the key decision-making research and the selection of vaccine varieties for introducing immunization programs for new vaccines in the world, which generally involve three types of indicators.

　　The first category is indicators related to disease prevalence and burden. "For example, malaria is highly prevalent and has a high disease burden in many African countries, so it is necessary to include malaria vaccines in the immunization programs of these countries. However, malaria has been effectively controlled in China. In 2021, WHO awarded China the certification for eliminating malaria. Obviously, malaria vaccine will not be considered in the expansion of immunization programs in China. " Tang Shenglan said.

　　The second kind of indicators mainly focus on the vaccine itself, including its effectiveness, safety, quality, supply capacity and health and economic benefits.

　　The third category of indicators involves financial resources, manpower and material resources. Tang Shenglan analyzed in detail for the reporter. Financial resources mainly refer to whether China’s health financing mechanism can support the expansion decision. Generally speaking, if the budget is abundant this year, it will vigorously expand vaccination, and if the budget is tight next year, it will reduce vaccination coverage (the baby born next year will not be able to enjoy the plan). This obviously violates the principle of fairness. Manpower, every time a new vaccine is added to the immunization program, it means that the workload of vaccination increases and the number of possible vaccine adverse reactions increases; Correspondingly, the inoculation technology of new vaccines needs training, and the results of disease surveillance also need to be reported. Material resources include whether the vaccine distribution has cold chain conditions, whether the monitoring system can "expand" synchronously, and whether the media and grassroots science popularization have enough resources for public science popularization.

　　In the next step, what specific measures and adjustments should be made in immunization planning in various places?

　　Tang Shenglan suggested that, first of all, from the national level, a scientific and dynamic adjustment mechanism of immunization program catalogue can be gradually established, and based on this mechanism, the adjustment plan of national immunization program in the next 5-10 years can be defined, and the market can be shaped through this plan. At the same time, guided by health and fairness, taking into account the local disease burden, financial level and residents’ ability to pay, we will explore and support the gradual inclusion of more cost-effective vaccines in the national immunization plan in different regions, batches and steps, and include high-risk groups such as teenagers, the elderly, chronically ill patients and medical workers in the vaccination scope, so as to accelerate the realization of life-cycle vaccination.

　　Secondly, it is to improve the sustainable financing mechanism of vaccines, which can establish the clear expectations of relevant enterprises for the market. "Practice in some places shows that medical insurance reimbursement or moderate subsidies can effectively incite individuals to share and improve the vaccination rate without significantly increasing the financial burden." For example, Tang Shenglan, Qinhuai District of Nanjing, for example, paid about 670,000 yuan to buy varicella vaccine through finance in 2019, accounting for only 1.10% of the basic public health service expenses in the district, but it increased the coverage rate of the first vaccination by 10 percentage points.

　　Thirdly, improve the research and development of key vaccines through policy guidance. These policy guidance can include: optimizing vaccine review and approval standards, accelerating industrial transformation and upgrading, supporting joint vaccine research and development and production, and leaving room for optimizing immunization strategies; Support the domestic substitution of key vaccines to ensure a stable and sufficient supply of vaccines included in the immunization program.

　　Finally, Tang Shenglan suggested that we can learn from some innovative international procurement mechanisms to balance the risks and benefits of enterprises while adjusting vaccine prices.

　　"For example, in the bidding process in the UK, manufacturers are allowed to give different quotations according to different purchase quantities (often the larger the purchase quantity, the lower the price), so that economies of scale can be effectively utilized and the risks of manufacturers can be reduced. The Canadian government will require provinces or regions to estimate their demand before awarding the contract to manufacturers, and require provinces or regions to purchase at least 75% of their estimated amount, thus forming a quantitative guarantee for manufacturers. " Tang Shenglan said that China can fully learn from the experience of developed countries, start with regional pilot projects, and explore a better procurement model. While reducing the price of non-immunization vaccines, it also enhances the R&D enthusiasm of enterprises and achieves the goal of multi-win.

　　CCTV News:During the Ming and Qing Dynasties, the maritime industry flourished, and colored gems and jade from various countries entered China with merchant ships. In the jewelry category exhibition being exhibited in Changsha Museum, about 300 pieces of collected treasures show the beauty of the blending of Chinese and Western cultures.

　　With the continuous development of navigation and trade, China is rich in precious stones and stored in by going up one flight of stairs. Jewelry inlay technology developed rapidly in the Ming and Qing Dynasties. This Ming Dynasty’s "gold inlaid with precious silk and five phoenix crowns" is very rich in decorative elements, including the flower shape of peony, dragons, phoenixes, butterflies and other forms of decoration, using a variety of complex techniques such as tired silk and hammering.

　　The continuous export of China’s artworks has also made westerners know and understand China culture. These two French cosmetic boxes, dating from about 1920, are rich in China elements in design.

　　Bronze decoration embodies the cultural characteristics of Shang and Zhou Dynasties.

　　At the special exhibition of Shang and Zhou cultural relics on display in Tianjin Museum, more than 150 pieces (sets) of Oracle bones, bronzes and other cultural relics provide important clues for studying the origin of Chinese civilization.

　　The typical animal face pattern in Shang bronzes is the reorganization and deformation of many animals based on people’s imagination. All kinds of animal-faced tripod in the exhibition reflect the reverence and worship of nature by the ancestors of Shang and Zhou Dynasties.

　　Cicada pattern is also a common animal pattern decoration on bronzes, which means it is high in food and dew, clean and valuable. This cicada-patterned tripod in the late Shang Dynasty has a complicated craft, which embodies the exquisite skills of ancient craftsmen.

　　Zhaoji civilization sees the origin of Chinese characters from cultural relics

　　Through this special exhibition, we can learn about the history and culture of that period from the Oracle bones and bronzes with inscriptions.

　　The word "China" combined together first appeared on the bronze ware "He Zun" more than 3,000 years ago. In fact, the earliest Chinese characters "Zhong" and "Guo" can also be found in Oracle Bone Inscriptions in Shang Dynasty.

　　Oracle Bone Inscriptions can not only reflect the political and military situation at that time, but also reflect the ecological environment at that time. From the Oracle inscriptions carved on this piece of Oracle bones, we can see that the Central Plains at that time had traces of elephant survival and reproduction.

　　In Shang dynasty, people not only carved words on Oracle bones, but also wrote on wooden slips and silks with brush. Although it is no longer possible to see the Shang dynasty classics written with a brush, the inscriptions on bronzes basically retain the form of brush writing. In the inscription of Xin Ding, the father of the Shang Dynasty, we can intuitively see the trace of the writing of the word "father" with a brush.

On April 16th, BYD personalized brand equation Leopard Technology Tide SUV Titanium 3 was officially launched, with a total of five versions, with a surprise price of 133,800 yuan, and a financial discount policy of up to 5,500 yuan and five super-value car purchase rights.

"One abnormal titanium gives birth to everything", Equation Leopard Titanium 3 creates the trend aesthetics with science and technology. With its unique "one machine, three cabins" trend configuration, "E+2C" intelligent three-piece suite and "iCT" safety three-piece suite, it has the super-value value of surpassing technology, space and configuration, and at the same time, it further realizes the "scientific and technological trend products, which are shared by the whole people". Titanium 3 will work with all users to open a new chapter in urban travel and create a new era of high-tech products.

Titanium 3 configuration is full, technology is full, value is full, sincerity is full

Inspired by "Star Wars Aesthetics", Titanium 3 has created a new category of "science and technology fad" and led a brand-new "science and technology fad" with its unique technology of "one machine and three cabins". "One Machine" refers to the intelligent vehicle-mounted unmanned aerial vehicle system of Lingyuan jointly developed by BYD and DJI, which can easily achieve a good shot with one button.

"No.3 cabin" refers to the electric front cabin, ecological cockpit and convenient rear cabin. The electric front cabin is equipped with the only electric opening and closing function at the same level and a large volume of 151L; Eco-cockpit includes multifunctional smart island, ergonomic chair, custom buttons, 15.6-inch central control screen, dual-temperature air conditioner, cold and warm refrigerator, Divale audio, 6kW high-power external discharge, one-button down of the rear seat, and official customized air mattress, which can easily lie flat and change into a big bed room every second; 28L’s convenient rear schoolbag is stylish in appearance and dry in content, which can meet the daily personalized storage needs of more yuan and more flexibility.

The "iCT" safety three-piece set makes the safety technology configuration full, including iTAC intelligent torque control system, extremely fast vehicle response and one-button drift mode; CTB vehicle safety structure, which is resistant to extrusion, folding and collision, makes every trip feel at ease; TSC high-speed tire burst stability control system, assisted by 140km/h high-speed tire burst control, allows users not to panic when they are in danger. Let every time you drive actively and passively, it is safe, and the safety guard will accompany you all the time.

The "E+2C" intelligent three-piece set makes the intelligent technology configuration full, including the intelligent EVO+ platform, which has a product performance of 1 super and 3 strong, and its unique iATS intelligent all-terrain recognition system can automatically identify road conditions such as grass/sand/mud/snow, and automatically switch driving modes, so that users’ travel scenes can be opened infinitely; High efficiency, shortening the charging time of users at low temperature by 40% and the charging time of 30-80%SOC at room temperature by 18min；; Strong handling, titanium 3 is equipped with a million-class suspension, and the front two-ball joint McPherson rear five-bar linkage brings users the ultimate driving feeling; Strong performance, 20000 rpm motor, 100 km acceleration of 4.9 s; Eye of God C high-order intelligent driving assistance system can easily realize high-speed navigation assistance, intelligent parking and active obstacle avoidance; Active preview+Yunqi -C intelligent damping body control system can realize intelligent preview of road conditions and intelligent damping control, and bring users a driving experience with light sensitive cornering, smooth handling, stable body posture and strong road adaptability. Let the platform drive intelligently, and intelligent technology is always online.

Titanium 3 surprise listing, rights and interests in place, 0 yuan can also buy.

Titanium 3 successfully set off a "tide wind" and brought three surprises. First of all, it has brought a very competitive price of 133,800 Pro version of 501KM rear-drive intelligent driving, 139,800 Max version of 501KM rear-drive intelligent driving, 153,800 Max version of 501KM four-wheel drive intelligent driving, 163,800 Ultra version of 501KM four-wheel drive intelligent driving, and 193,800 UAV version of 501KM four-wheel drive intelligent driving, which will be delivered as soon as it goes on the market, with excellent price and the whole people can close their eyes.

Secondly, Titanium 3 also brought a financial discount policy of up to 5,500 yuan, and provided multiple financial schemes of "0 down payment, 0 interest and 0 monthly payment" for selection. "0 down payment", up to 5 years long loan; "0 interest", starting from 50% down payment, 24 installments with 0 interest; "Payment in 0 months", with 50% down payment and 50% final payment, and payment in 0 months at least for one year.

Finally, it sent out four great car purchase rights! Replacement subsidy of up to 6000 yuan; 7kW charging piles are delivered free of charge, and the first owner enjoys the rights and interests of charging pile basic installation service within two years from the date of self-delivery; Smart internet services, including lifelong OTA upgrade, online navigation, free car traffic for 2 years and 5G every month, etc. After-sales service, the whole vehicle repair of non-operating vehicles for 6 years or 150 thousand kilometers, the lifetime warranty of the "three power" system, etc.

Titanium 3 has launched two major reform plans, which are often used for renovation.

Titanium 3 breaks the traditional doll model of the car and provides the world’s first front face modular dressing system, so that titanium 3 truly has a variety of titanium and Vientiane forms. At the release site, the "Titanium 3 Face Change Plan" was officially released, and a variety of front face plans will be put on the official store of Equation Leopard one after another. You can make an appointment with one click, and the national Equation Leopard store can make a face change.

Titanium 3 has brought 12 joint tide reform schemes in conjunction with a number of tide reform brands. This time, the SUPER 3 version of the tide reform plan will be added, and it will also be put on the official mall simultaneously. In addition, Equation Leopard announced the launch of the "Titanium 3 Tide Reform Co-creation Competition" on April 23, and Equation Leopard official will invest a million bonus pools to help users realize their dreams of tide reform! This competition has set up a number of tracks, such as national track and professional track, so you can pay attention to the official information of the follow-up equation leopard.

High-tech products are shared by the whole people. Equation Leopard Titanium 3 is officially listed.

Text/Zhang Xinmeng

It took only one year for the industry’s TOP3 threshold to soar from 200 billion to 300 billion.

In 2016, China’s real estate turnover increased by nearly 30%. What is this concept? "The automobile industry grew by 9%, e-commerce by 20%, and express delivery by 50%. The only thing that exceeded the real estate growth rate in China was express delivery. However, the express base is too small, which is nothing compared with real estate. " Chen Jinsong, chairman of World Bank, made a comparison in the recent Midtown Alliance Forum, which made the 10 trillion real estate plate more specific.

The TOP20 threshold increased by 81% year-on-year

Real estate rivers and lakes, a year of melee, Evergrande surpassed Vanke with sales of 373.15 billion, becoming the first real estate enterprise. Vanke and Country Garden ranked second and third with 363.3 billion and 309.03 billion respectively. Time went back to a year ago, when the leaders were Vanke, Evergrande and Greenland, and the record of the top three remained at 200 billion+.

Sales amount of China real estate enterprises in 2016 TOP20

According to Kerry data, the threshold of TOP20 housing enterprises has increased from 35.8 billion yuan to 64.67 billion yuan, a substantial increase of 81% year-on-year. The total sales of TOP20 increased from 2012.28 billion yuan to 2967.32 billion yuan. The threshold for entering the top 100 has also increased from 10.38 billion yuan to 15.68 billion yuan, up 51% year-on-year.

In terms of sales area, the entry threshold of TOP100 housing enterprises has also improved, from 900,000 square meters in 2015 to 1.29 million square meters, up 43% year-on-year. The biggest increase was the TOP50 threshold, which increased from 1.63 million cubic meters in 15 years to 2.38 million cubic meters, up 46% year-on-year.

According to the data of the National Bureau of Statistics, from January to November 2016, the national sales of commercial housing reached 10,250.3 billion yuan, a year-on-year increase of 37.5%. According to the forecast of the growth rate in the first 11 months, the national commercial housing sales will exceed 11 trillion yuan in 2016.

According to the growth rate of commercial housing sales in the first 11 months, in 2016, the total sales concentration of the top 200 real estate enterprises has exceeded 50%, accounting for half of the real estate market in China. It is expected that the concentration of housing enterprises will further increase in the future, and the situation of "strong and strong" will be further intensified.

Billion clubs expanded to 12.

In the TOP20 list, there are four new housing enterprises, namely Xincheng Holding, Shoukai, Xuhui and Luneng.

The market development momentum is strong, and its significance to medium-sized housing enterprises may exceed that of giants such as Vanke. As Peng Kong, the helm of Xuhui Beijing, who just broke 10 billion yuan, said in an interview with Netease Real Estate, "At least Xuhui Beijing is a 10 billion-dollar organization, just like an Olympic champion. It is not won every day, but there is an essential difference between winning and not winning." Team combat capability may be able to reach a higher level with the experience of scale.

Country Garden, the "King of Suburbs", jumped from the seventh place to the third place, and its annual performance increased by 121%, reaching the threshold of 300 billion yuan, successfully achieving the screaming goal of the group. Earlier, Mo Bin, president of Country Garden Group, talked about this year’s performance and admitted that the market played a great role. It is worth mentioning that in the land market, Country Garden is even more fruitful. In the whole year, 74,461,800 cubic meters of land was added, which not only ranked first among 30 typical housing enterprises, but also set the largest land acquisition area in Country Garden over the years, with an increase of 95% compared with 2015.

In addition to the established 700 billion housing enterprises, in 2016, Sunac, Huaxia Happiness, Greentown, China Resources and Jindi also entered the threshold of 100 billion for the first time, and the number of 100 billion clubs expanded to 12. Excluding the factors of rising house prices, mergers and acquisitions have become a booster for these housing enterprises to rapidly increase their scale. In particular, Sunac’s acquisition in the industry has provided it with a large number of low-cost saleable values. Take Sunac’s acquisition of seven projects of Lemon International in 2016 as an example, with a total price of 4.394 billion yuan and an average unit price of only 2,751 yuan. More importantly, Sunac successfully completed the layout of all first-tier cities with this acquisition.

With its strong expansion, Evergrande finally realized its "One Brother Dream". The data shows that from the listing of Evergrande in 2009 to 2016, the compound annual growth rate of sales is as high as 43.6%, the compound annual growth rate of turnover is also 69%, and the average core net profit rate is about 10.45%. Just as the industry generally believes that 2017 is the year of real estate adjustment, Evergrande announced on January 2 that the expected sales from 2017 to 2019 are about 450 billion yuan, 500 billion yuan and 550 billion yuan respectively.

Wanda, which has been committed to de-real estate, fell from the fourth place in the rankings to the tenth place. During the annual period of the industry, the sales amount of Wanda actually showed negative growth, down by 41.24 billion yuan. At the beginning of 2015, Wang Jianlin announced that the real estate sales target would be lowered by 40%, from 164.08 billion yuan in 2015 to 100 billion yuan. Previously, Wang Jianlin had repeatedly stated that by the end of 2016, Wanda would no longer be a real estate enterprise. In the process of transformation, traditional real estate investment and sales will inevitably be squeezed.

TOP10 local housing enterprises in Beijing account for six seats.

In the first eleven months of this year, the total supply of new commercial housing in four first-tier cities in the north, Guangzhou and Shenzhen reached 28.15 million square meters. It decreased by 22% year-on-year, of which the supply of commercial housing in Beijing was 6.38 million square meters, with a turnover of 12.56 million square meters, up by 14% year-on-year. Although the supply of housing in first-tier cities has declined, house prices have risen rapidly. Taking Beijing as an example, the sales of TOP10 housing enterprises have all exceeded 10 billion.

Beijing sales amount TOP10 housing enterprises

According to the ranking of sales amount of Kerui real estate enterprises, the total sales amount of TOP10 real estate enterprises in Beijing market in 2016 was 216.9 billion yuan. Among them, the first one ranked seventeenth in the country, occupying the first place in the Beijing market in terms of sales amount and sales area.

In the first sales share of 65.41 billion yuan, the Beijing market accounted for 52.5%, reaching 34.364 billion yuan. The old state-owned enterprises that have been deeply involved in Beijing for 36 years, at the brand launch conference in 2015, the first figures announced were 29 projects that were on sale and about to enter the market. In the Beijing market, where land is scarce, the "big landlord" first put forward the strategy of "urban revitalization officer" and turned his attention to shed reform, old community reform and other fields.

In the Beijing market in 2016, Sunac was the biggest dark horse. The annual sales performance reached 26.993 billion yuan, 17.192 billion yuan higher than the previous year, and jumped from the eighth place in 2015 to the second place.

In fact, Sunac won the sales crown in Beijing in 2013, and its performance at that time was 12 billion, which was basically close to the sales of the tenth financial street this year. However, with the rapid development of its projects, the prolonged digestion cycle of high-end projects and the tight policies, Sunac’s performance in the Beijing market was average in 2014 and 2015, and even its performance fell below 10 billion in 2014. With the loose policy, Dinghao’s market performance is extremely outstanding, and the "No.1 Hospital" products laid out by Sunac have finally ushered in spring.

In 2016, the real estate industry experienced an upward-downward curve, and the indicators of sales, investment and start-up showed an anticlimactic trend. With the continuous tightening of policies, many executives of real estate enterprises have made it clear that the market in 2017 is definitely not as good as that in 2016, and the market target will be lowered.

This article comes from WeChat WeChat official account:Gu San Gu Si (ID: GH _ A68D56C34119), Author: Gu Yuan, the first picture from: vision china.

There are not so many things in this world, but there are always some people who create various theories to create various problems. Medical impossible trinity is such a stupid theory.

There is a Mundell impossible trinity in financial theory. It is said that the financial system can only choose two of the three: free capital flow, exchange rate stability and monetary policy independence, and it is impossible to have all three, otherwise it will lead to financial collapse. In this financial theory, there is actually a premise, and that is legal tender.

Someone made up another theory with this theory, which is called impossible trinity’s theory of medical system. Cheap, efficient and good service. You can’t have both, otherwise it will lead to collapse.

At first glance, does this theory make sense? It seems to make sense.

Let me discuss the common views of this theory first. For example, the United States has chosen high efficiency and good service, which leads to extremely high medical costs. It’s so expensive that ordinary families can go bankrupt by getting a rabies vaccine and calling an ambulance. The United States is efficient and has good service, but it is expensive.

Many people praise American medical care and find it particularly humanized. Doctors and nurses are patient and smiling because they choose high efficiency and good service. Since efficiency and good service are satisfied in impossible trinity, the cost can never be cheap.

American nuclear magnetic resonance imaging costs $1,100, appendicitis surgery costs about $15,000, and hospitalization costs $5,000 a day. A federal survey in 2012 found that the average cost per ambulance ride was $224.(about 1485 yuan)To $2204(about 14610 RMB)Between

For another example, Commonwealth countries and Europe choose cheap and good service, and as a result, it is difficult to see a doctor and queue up to death. Make an appointment with a dentist for one month, an ophthalmologist for seven months, and a B-ultrasound for three months. As long as it’s not a dying disease that needs emergency treatment, you have to queue up slowly. In the case of limited medical resources, low price and good service are required, and the result is extremely low efficiency.

Similarly, the medical systems in impossible trinity, the Commonwealth and Europe chose cheap and good service. The reason is simple. Good service requires doctors to listen patiently to every patient and give them time to talk. It takes at least half an hour to see a patient like this. Every doctor can see 16 patients in an eight-hour working day.

The limited number of doctors leads to the limited number of patients you can see every day, so you need to queue up in advance to make an appointment. As long as it’s not a dying disease, it’s not unusual to wait for three to five months before it’s your turn. The Canadian documentary "You are Dead" is about the problem of long queues in the medical systems of Commonwealth countries.

Choice determines efficiency, which is the case in all Commonwealth and European countries. The inefficiency of medical system is everywhere. In order to prevent patients from waiting too long, there is even a law that 90% of patients should be treated by a specialist within 13 weeks, and the rest must be treated within 26 weeks. The waiting time for surgery should not exceed 18 months.

China, with its large population and tight per capita expenses, chose cheap and efficient.The price is high-intensity work of doctors, high turnover of beds and high turnover of outpatient clinics, so that everyone can see a doctor.

Because of the large population and limited medical resources, and I hope everyone can see a doctor, we can only choose cheap and efficient. Choosing cheap and efficient means that it is normal to see a person for three minutes and ask two sentences to diagnose the disease.

If you register in the public top three, you shouldn’t queue up. Doctors need to serve smiles and have patience to listen. Is it possible? How many patients are there in a big hospital a day? Really want to engage in patient service, every patient has to talk about his illness for half an hour, and the efficiency is simply not allowed.

It is also the best hospital in China and America. The Mayo Clinic has 15 times as many medical staff as Concord, but only half the number of patients. 15 times the number of medical staff and 1/2 of the number of patients, which means that the efficiency of Concord is 30 times that of Mayo Clinic.

The outpatient fee of Mayo Clinic started at $500, but after the outpatient fee increased in Beijing, it was 50 Qian Qi.

Do you think Concord is tired enough? In fact, compared with Beijing Children’s Hospital, Concord is already relaxed. The average daily attendance of Beijing Children’s Hospital in winter is 12,000, with a peak of 16,000. In other words, 360,000 people will be treated every month in winter.

But now the first-and second-level hospitals and community clinics can basically be on call. Except for some top hospitals, most tertiary hospitals can also go to the hospital on the same day, see a doctor on the same day, and get the results within the same day or a few days. If this is all difficult to see a doctor, it is hard to imagine that Canada, where the average waiting time for emergency treatment is six to eight hours, and Britain and the United States, where appointments are made for several months.

It is difficult to see a doctor in people’s mouth now. In fact, it is difficult to find the top three famous experts in the region.It is actually not difficult to find the top three directors in the region to see a doctor, because many hospitals are not limited to the number, and they will finish reading it on the same day. Patients are crowded into the top three, which also causes a structural shortage of hospital bed resources. Judging from the number of inpatients undertaken by hospitals at all levels, the trend is very obvious. Low-level hospitals are getting empty, but high-level hospitals are getting crowded.

The beds in the top three are overcrowded. Let’s take a look at the first-and second-level hospitals and community hospitals below. Except for the old people who prescribe drugs for chronic hypertension for a long time, they are basically empty. Why? Because patients simply don’t believe that they can cure the disease.

Ok, is there a problem with the above discussion? Is it the actual situation?The reality discussed above is true, but the theory is wrong.What’s wrong with that?

The first big mistake: the definition of inefficiency, free and high quality in the Commonwealth system is wrong

If you don’t talk about other countries, say Britain. In Britain, the annual per capita absolute medical cost is 3327 pounds.($4,356). However, in recent years, the average life expectancy in Britain has remained basically unchanged, while in other countries, it has improved significantly. For example, in Singapore, the average life expectancy is 82.7 years, and medical expenditure only accounts for 4.3% of GDP.

Health care in the UK has increased from 21 in 2014.(A total of 56 countries participated in the ranking)It fell to 35 places in 2015, down 14 places, and currently lags behind Chile, Algeria and the Czech Republic. This change means that it has fallen to the bottom half of the Bloomberg list, and it is now behind Mexico, which is equivalent to Slovakia and Peru. The NHS is notorious for frequent accidents, insufficient supply and low efficiency.

It can be seen that the medical system of the Commonwealth system is expensive, poor in quality and inefficient. Medical impossible trinity theory,Mistreating welfare medical care as free medical care and giving him a cheap label is actually just medical care implemented by taxation.The cost is very high,Per capita expenditure is close to half that of the United States.

Secondly, medical impossible trinity theory.Completely ignoring people’s needs, and actually treating queuing for medical treatment as a good service.It takes months to see a doctor. Is this called service? Is there only one dimension of good attitude as the standard of medical service quality?

I won’t see a doctor. I’m not a doctor. If you are sick, you can spend 10 thousand yuan to find me. I will accompany you with a smile all day. Is it called service? Helping patients to solve their pain is the first dimension of medical service quality, and even seeing a doctor in time can’t be done. How can this be called good service?

The second big mistake: the definition of the most special American medical care in the world is wrong.

Impossible trinity Theory defines the United States as expensive, good in service and efficient.

Consumers are pursuing cost performance when they consume any commodity.

If you spend 30 yuan to press a foot in a street foot bath shop, you won’t pursue a luxurious hall and beautiful welcome. As long as you press it comfortably, you will say that the service is really good because of its high cost performance. On the contrary, you spend 500 yuan to press a foot in a high-end club. If a stingy man brings you tea and water, you will turn around and leave, because you will calculate your input-output ratio, and you spend more money in the hope of enjoying better service.

That ambulance will cost 1200 dollars for a trip. Is this called service? Just like if you order a fast food, you get 1000 yuan RMB. Who will say that this is good service? I can’t afford to get sick. You told me that this service is efficient and good? What kind of dog theory is this?

Let’s look at what is efficient.Whether efficiency only refers to speed depends on the result.Barefoot doctors in China used to see a doctor very quickly. Most patients came to prescribe some anti-inflammatory drugs and painkillers and sent them away. There was no inspection equipment, so the speed was certainly fast.

Efficiency depends on what the result is. What is an important criterion for the quality of medical services? It is the index of life expectancy and the calculation of input cost. Americans spend an average of tens of thousands of dollars a year on medical care, but the average life expectancy of Americans is the lowest in developed countries, and it often drops in some years. What kind of efficiency and good service is this?　

The third mistake: take medical service for granted as a pot of rice.

According to impossible trinity’s definition, a good doctor’s service attitude means a good service. Hurry up and see that a doctor is called efficient and a low fee means cheap. He also made a big mistake. He ignored people’s different needs.

Does the catering market exist in impossible trinity? If you have a big dining hall that everyone must go to, there will be impossible trinity:

Ma Yun came to dinner and ate the dishes of migrant workers, which is called poor service.

It is not expensive for middle-class people to eat, but they have to queue up, which is called inefficiency.

When the poor go to eat, they find that the price is more expensive than the roadside stalls. This is called the price is not cheap.

But didn’t the multi-level catering market completely solve this problem? Isn’t it cheap, efficient and good service for everyone to eat in a place that suits them?You mix all the people at all levels of consumption. Isn’t this an artificial contradiction?As a result, no one is satisfied. Is this the inevitable impossible trinity of the medical market?

More market-oriented medical care is that the needs of the poor will also be met, and it will be efficient and cheap.

India, which we despise, will show the world a model of medical marketization in 20 or 30 years. Private hospitals in India have innovated ophthalmic cataract surgery. One doctor performed cataract surgery for five or six patients at the same time. The doctor only did the key parts, while the rest were all operated by nurses. Low cost, low charge, high efficiency and good effect.

There is a private hospital in India that needs only $1,200 for heart surgery, which is a few tenths of the price of such surgery in the United States, but the level of surgery has surpassed that of ordinary hospitals in the United States. Just because other fields in India have not developed and people’s consumption power is insufficient, the results of medical marketization in India are not eye-catching.

The fourth mistake: misjudgment of China medical care.

If we just compare the United States, Commonwealth countries and China, my point is,Compared with medical care in these countries, medical care in China is efficient, good in service and cheap.

The per capita medical expenditure in China is about 10,000 yuan, but the average life expectancy in China is close to that in the United States. That is to say, it is close to that in the United States at one sixth of the medical expenses of Americans. Isn’t this efficient? When Chinese is ill, he can see a doctor at any time. Even if he goes to see an expert, he doesn’t have to wait for months. As long as you go to the queue, even if you buy a number from a scalper, you can always see him.

If you have to wait a month to meet experts in Beijing, how can 700 thousand people go to Beijing every day? In other words, you can quickly see experts who are equal to the severity of the disease, which is good service. Because the first dimension of medical service is not a good attitude, but that the other party can solve your problems.

Then it’s cheaper, the total expenditure is less, and of course it’s cheaper. The total expenditure of Chinese is lower than that of the United States or the United Kingdom. Once again, this is a comparison, and the bar is fine.

Then why? There’s actually only one reason,The degree of marketization of medical care in China is higher than that in Europe and America.

Nani, what are you talking about? It’s acceptable to say that all medical services in Britain are public, while hospitals and insurance companies in the United States are mainly private, while hospitals in China are mainly public. What makes you conclude that medical services in China are more market-oriented?

The world is often so strange, and the name is easy to deceive people. American hospitals are playing a private name, as if they were the product of marketization. Is this true? No, you have to look at the essence through the phenomenon. What is medical marketization? To put it more popularly, it isHospitals and doctors aim at making money, and the process of making money is less interfered.The less intervention, the higher the degree of marketization.

Do you think hospitals and doctors in China aim at making money? Of course it is. Because hospitals in China are not like public hospitals in Britain, which are fully funded, but hospitals in China have very little financial allocation.The main income of the hospital comes from the fees paid by patients.

Zhu Hongbiao, inspector of the Department of Physical Reform of the National Health and Wellness Commission, said that the direct subsidies from all levels of finance to public hospitals nationwide increased from 84.9 billion yuan in 2010 to 270.5 billion yuan in 2018. There are 50,000 public hospitals and health centers, with an average allocation of more than 5 million a year. Even the money for buying equipment is not enough, let alone paying salaries.

Therefore, hospitals in Britain do not aim at making money. They are the same as civil servants, and they are fully funded units. They do not need to cater to the needs of consumers, so they have a fixed source of income.

What is the difference between a fully funded hospital and a hospital that relies on patients to pay for medical treatment? The difference is,If you want to earn money, you must cater to consumers.Otherwise, consumers will not come to see you.

Although public hospitals are subject to various controls,But doctors in China have the motivation to improve their medical skills and to form a good reputation in the local society.Because skills and reputation can be exchanged for money, which can make more consumers come here.

Why can so many doctors operate for more than ten hours from day to night? What are they for? Because medical skills need practice, contact with various cases and repeated operations. Such doctors will become scarce resources, and thus get higher income.

If doctors are managed according to the civil service system, why should doctors improve their medical level? Why are you working so hard? Can’t you see fewer patients? Can’t you do a few less operations? Don’t I get the same salary? Under real public ownership, doctors have no incentive to improve efficiency.

Therefore, for a long time, doctors in public hospitals in China have been working hard, because efforts will have results, and efforts can increase income. At present, the level of treatment and operation of doctors in China is not inferior to that of developed countries, and even leads the world in many fields. The treatment level is high and the fees are not high, which is called good service.

It’s just that Dr. China’s income is limited, so he can’t raise the operation fee, so he can replace it with a red envelope, but he can’t raise the outpatient fee, so he can replace it with drug commission and inspection commission. Of course, these methods are not good, but they still constitute an incentive for doctors, and finally they have not blocked the way for doctors to make money.

Therefore, China hospitals have the motivation to continuously expand their scale, increase equipment and wards, and doctors have the motivation to continuously improve their level. Because they can make money, although they are restricted, they still have access.

At present, the scale of well-known top-three hospitals in various places is often very large, and some of them have operating income as high as several billion yuan. Is this entirely funded by the government? No. It is brought by the rush of consumers. There are always endless queues at the entrance of the top three hospitals, and the bustling crowds come to the door on their own initiative, and they vote with banknotes.

Many people say that private hospitals in China are terrible, and there is nothing wrong. Except ophthalmology and dentistry, other private medical services are really not so good, and they are full of fraud and low quality. Why is this? Because the marketization of public hospitals is not low. If it was a fully funded unit, the doctor would have finished running.

This makes it more difficult for private hospitals and public hospitals to compete. Many doctors don’t want to leave the public to go private for the simple reason.There are many public patients, and consumers have voted with their feet to prove that public hospitals in China can partially satisfy consumers.

Going back to American medical care, American medical care is completely private. Why is it so expensive? American medical care is subject to a lot of government control. Although it is nominally private, it must be handled according to various government regulations, which is called insufficient marketization. Give a few examples and you will understand.

Private hospitals in the United States need to apply to the government to increase beds. Is this called marketization?

Doctors in the United States need to apply to the government for interstate practice. Is this called marketization?

The number of doctors in the United States is controlled by doctors’ unions, and the supply quantity is artificially controlled. Is this called marketization?

The profit rate of medical insurance companies in the United States is set by the government. Is this called marketization?

How many restrictions are there like this? There are hundreds of them, and it takes tens of thousands of words to make them clear, so I won’t expand them here.

Then I’ll tell you again, even if all the medical enterprises in China are private enterprises now, it can’t be called marketization. Because in today’s China, the government-run medical insurance is dominant, and the government becomes the consumer of medical care, and he sets the rules. Even if you are a private medical service, your customers are also the government.

Under the current medical insurance control means, private medical care will also become an inefficient service organization, because it no longer serves consumers, but caters to and obeys the rules of government-run medical insurance.

It doesn’t matter whether the medical institution is public or private. What matters is whether it is market-oriented enough. As long as there are more market-oriented factors, so that consumers can choose with their feet and medical service providers can only make money by satisfying consumers, then medical care can be cheap, good and efficient.

The so-called medical impossible trinity theory is a stupid theory, and it is an argument for the specialization of medical services. In fact, medical care and eating are the same thing, both of which are service industries. How should medical care be done?Would you be satisfied with running a public canteen now?

This article comes from WeChat WeChat official account:Gu San Gu Si (ID: GH _ A68D56C34119), author: Gu Yuan

　　Li dongzeng

　　editorial comment/note

　　Recently, a case of bubonic plague was confirmed in Wulate Zhongqi, Bayannaoer City, Inner Mongolia Autonomous Region. Subsequently, Inner Mongolia Autonomous Region announced that three plague foci had been discovered, and close contacts had been observed in isolation at home. This is the second case of plague in Inner Mongolia since last November. Because there have been many plagues in human history, many people turn pale at the sight of them. In fact, today, through effective preventive isolation measures and treatment, plague has long been less terrible. In this issue, we will introduce the spread characteristics and prevention methods of this disease in detail.

　　one

　　The infectivity of different plague is high or low.

　　There are three common types of plague, namely bubonic plague, pneumonic plague and septicemic plague. Plague is usually transmitted from animals to people through rat fleas biting the skin. After a rat flea carrying Yersinia pestis bites a person, Yersinia pestis invades the body from the skin and first reaches the nearest lymph node, causing inflammation of the lymph node, which leads to high fever and swollen lymph nodes. The swollen lymph nodes can be felt from pigeon eggs to the size of eggs, which is bubonic plague.

　　If patients with bubonic plague are not treated in time, swollen lymph nodes may fester and rupture. These pus are also contagious and may be infected if they are touched. Yersinia pestis may also spread to the blood and lungs, becoming septicemic plague and pneumonic plague.

　　Pneumonic plague developed from bubonic plague is called secondary pneumonic plague, and patients with pneumonic plague will have severe pneumonia. There is Yersinia pestis in the respiratory secretions of patients with pneumonic plague, which is highly contagious. Others will be infected after inhalation. People who inhale Yersinia pestis from the respiratory tract can directly suffer from pneumonic plague, which is called primary pneumonic plague. Whether it is primary pneumonic plague or secondary pneumonic plague, the manifestations are similar, and they all have the ability of respiratory transmission. Plague spread from person to person is mainly pneumonic plague.

　　Bubonic plague is the most common, but the risk is lower than pneumonic plague, and it is generally not contagious. However, patients with pneumonic plague are highly contagious, and the mortality rate is relatively high if they are not treated in time.

　　When Yersinia pestis spreads into the blood from lymph nodes or lungs, it may become septicemic plague. Septic plague is rare, but it is the most dangerous and has a high mortality rate. If the patient is not rescued in time, he may die within 1 to 3 days after onset. Septic plague appears ecchymosis because of bleeding under the skin, and the skin is purple-black. Therefore, it was called "Black Death" after the outbreak of plague in medieval Europe.

　　2

　　There is little chance of infection without entering the epidemic focus.

　　The main sources of infection of plague are rats and other rodents, and in China, it is mainly Rattus and Marmota. Other animals such as rabbits, foxes, wolves, camels and some domestic animals such as cats, dogs and sheep can also become sources of infection. The spread of plague among animals is mainly due to being bitten by rats and fleas.

　　Plague itself is spread among animals. There are 12 types of plague natural foci in China, distributed in 19 provinces, and animals in these natural foci may carry Yersinia pestis. Under normal circumstances, plague will not infect humans, but some people are at risk of being infected because of their professional needs or because of travel and exploration. Therefore, the staff in pastoral areas are often high-risk people infected with plague. People who enter pastoral areas are most likely to be bitten by rat fleas in the lower limbs, so the most common symptom of bubonic plague is swelling and pain of inguinal lymph nodes. There are also some people who enter the plague natural focus because of hunting or traveling, and they are also at risk of infection after contacting animals. If you strip animals suffering from plague, you may be infected by rat flea bites, or you may be infected by skin wounds touching the blood and body fluids of sick animals. Plague infected by stripping animals is more common in axillary and cervical lymph nodes of upper limbs.

　　If ordinary people do not enter the natural focus of plague, there is little chance of being infected with plague, and rats in urban areas usually do not carry Yersinia pestis. If you plan to travel to the plague natural focus, you must know the local plague situation in advance, try to keep a distance from wild animals, and don’t get in touch with the woodchuck when you see it. When entering the grassland, try to wear long trousers and gloves, avoid being bitten by rats and fleas, don’t sit and roll on the grassland, don’t picnic and camp on the grassland, and try to reduce the risk of infection.

　　three

　　Symptoms and treatment after plague infection

　　People infected with plague have different symptoms according to different types. The common characteristics of plague patients are rapid onset, repeated high fever, chills, shortness of breath, rapid heartbeat and severe headache. The symptoms of bubonic plague are mainly swelling and pain of lymph nodes, mainly groin, armpit and neck, which are generally unilateral swelling and pain. Patients dare not move easily when the pain is severe. The bubonic plague may be misdiagnosed as other causes of lymph node swelling and pain, such as acute lymphadenitis, lymphadenopathy caused by filariasis, tuberculosis of lymph nodes, etc., but other diseases with lymphadenopathy usually start slowly and develop less rapidly than bubonic plague.

　　Pneumonic plague is characterized by severe chest pain, cough, expectoration, hemoptysis, dyspnea and wheezing. Pneumonic plague is easily misdiagnosed as common bacterial pneumonia or viral pneumonia, so it needs to be distinguished from other pulmonary infection diseases, including lobar pneumonia, pneumonia secondary to influenza, novel coronavirus and so on.

　　Septic plague can be characterized by high fever, no increase in body temperature, unconsciousness, confusion and even coma, extensive bleeding, ecchymosis, cyanosis and necrosis of the skin, and some patients’ bodies are purple and black after death. Septic plague is easily misdiagnosed as coma and shock caused by other reasons, such as hemorrhagic fever with renal syndrome, septicemia caused by epidemic cerebrospinal meningitis, epidemic Japanese encephalitis spread by mosquito bites, shock caused by staphylococcus aureus or streptococcus infection, etc.

　　After people are infected with plague, the disease can be effectively controlled through timely drug treatment. At present, the treatment of plague is mainly antibacterial treatment, supplemented by symptomatic support treatment. Antibacterial treatment refers to the use of antibiotics to sterilize. Streptomycin is the most effective antibiotic against Yersinia pestis, especially in the treatment of pneumonic plague, mainly by intramuscular injection, which can be injected continuously for 10 days. Gentamicin can also be used in the case of human infection with plague. Tetracycline has bacteriostatic effect, which is effective for mild patients. It can be taken orally or used together with other antibiotics. Sulfonamides are widely used in the treatment and prevention of plague. Sulfonamides are the earliest synthetic antibacterial drugs, which have good curative effect on plague, and they are easy to use, stable in nature and low in price. Symptomatic support therapy refers to helping patients recover as soon as possible by means of antipyretic analgesia, anti-shock, respiratory support and nutritional support.

　　four

　　What should I do if I find a mouse at home?

　　Domestic hamsters and rabbits usually don’t have access to wild animals, and animals don’t naturally carry infectious diseases. Without the source of infection, they won’t be infected, so there is no need to worry about domestic hamsters and rabbits catching plague. However, rats, rabbits and other animals do have a lot of bacteria in their mouths. After being bitten, it is necessary to disinfect the wound in time to avoid bacterial infection. If the wound shows signs of infection such as redness, swelling, pain and skin color change, you need to seek medical attention in time.

　　Families find that rats need to be scientifically killed. The first is to clean up the dead corners and garbage in time to reduce the living space of rats. Secondly, try to block all the passages that mice may enter and leave the room, such as air-conditioning pipe holes and sewer holes, so that mice have nowhere to hide and can’t enter the room. Around houses, corridors and other areas, compliant rat traps, rat boards and rat poison can be placed in places where rats are infested, and eye-catching signs should be made at the same time to prevent others, especially children, from accidentally contacting rat poison.

　　Don’t put snacks in the house at will. The food and all kinds of food in the house should be stored out of the reach of mice. If conditions permit, community managers should invite professional rodent control companies to carry out rodent control in a unified way to improve efficiency. If you find dead rats at home, don’t touch them with your bare hands to avoid being bitten by rats and fleas. You can wear long trousers, masks and gloves, collect the dead rats in sealed plastic bags, and contact the community property management department to dispose of the dead animals.

　　Plague prevention includes bubonic plague prevention and pneumonic plague prevention. The bubonic plague is mainly caused by the bites of rats and fleas on animals, so the prevention of bubonic plague by ordinary people is mainly to avoid contact with animals in the natural focus of plague, and to prevent rats and fleas. If you must enter the epidemic area, you can wear long trousers, boots and gloves, and try not to expose your skin to avoid being bitten by rats and fleas.

　　During the tour, everyone should try not to touch wild animals, including wild animal carcasses. Don’t buy wild animals. If you find dead animals on the roadside, you should report them to the local health and disease control departments in time.

　　If you are just traveling, you can do these preventive measures well, and you don’t need to use drugs in advance to prevent it. If you are bitten by rat fleas in areas with plague, or have close contact with patients with pneumonic plague without protection, you can use tetracycline, doxycycline, sulfanilamide and other drugs to prevent it. (Author: Deputy Chief Physician, Department 2, Infection Center, Beijing You ‘an Hospital)

Beijing Zhengban Fa [2005] No.59

The people’s governments of the districts and counties, the commissions, offices and bureaus of the municipal government, and the municipal institutions:

　　"Beijing highly pathogenic avian influenza emergency plan" has been approved by the municipal government and is hereby issued to you, please implement it carefully.

　　November 22nd, 2005

Emergency plan for highly pathogenic avian influenza in Beijing

(Revised in 2005)

catalogue

　1 General rules

　　1.1 Purpose of compilation

　　1.2 Compilation basis

　　1.3 Scope of application

　　1.4 working principles

　　1.5 epidemic situation confirmation

　　1.6 epidemic classification

2 Organization and responsibilities

　　2.1 emergency command organization

　　2.2 Daily management organization

　　2.3 Expert Advisory Group

　　2.4 Emergency handling institutions

　　2.5 Responsibilities of District and County Governments

3 Early warning and reporting

　　3.1 Early warning level

　　3.2 Early warning release

　　3.3 Early warning response

　　3.4 epidemic situation report　

　4 emergency response

　　4.1 the principle of emergency response

　　4.2 Graded response

　　4.3 Basic emergency

　　4.4 Expand emergency response

　　4.5 Emergency response in areas without epidemic situation

　　4.6 Safety Protection of Emergency Handling Personnel

　　4.7 Termination of emergency response

　5 after-treatment

　　5.1 Late evaluation

　　5.2 Reward

　　5.3 Responsibility

　　5.4 Disaster compensation

　　5.5 Pensions and subsidies

　　5.6 Resume production

　　5.7 Social assistance

　6. Guarantee of emergency response

　　6.1 Technical Support of Command System

　　6.2 Communication Guarantee

　　6.3 Emergency resources and equipment support

　　6.4 Technical Reserve and Guarantee

　7 Training, exercises and publicity and education

　　7.1 Training

　　7.2 exercise

　　7.3 publicity and education

　8 supplementary provisions

　　8.1 Definitions and descriptions of noun terms and abbreviations

　　8.2 Plan Management and Update

　　8.3 Plan Interpretation Department

　　8.4 implementation time of the plan

　　1 General rules

　　1.1 Purpose of compilation

　　Through the preparation and implementation of this plan, we will earnestly strengthen the basic work of emergency treatment of highly pathogenic avian influenza, build a long-term management and emergency treatment mechanism that combines prevention and extermination, realize systematic prevention, scientific decision-making, intelligent command and overall security, ensure that administrative and technical resources can be mobilized in time when a highly pathogenic avian influenza epidemic occurs, and take strict measures to effectively control and exterminate the epidemic, so as to minimize the losses caused by the epidemic.

　　1.2 Compilation basis

　　This plan is formulated in accordance with People’s Republic of China (PRC) Animal Epidemic Prevention Law, People’s Republic of China (PRC) Entry-Exit Animal and Plant Quarantine Law, Emergency Regulations on Major Animal Epidemic, National Emergency Plan for Sudden Major Animal Epidemic, National Emergency Plan for Highly Pathogenic Avian Influenza, Measures for Beijing to Implement People’s Republic of China (PRC) Animal Epidemic Prevention Law, Beijing Overall Emergency Plan for Public Emergencies and related regulations.

　　1.3 Scope of application

　　This plan is applicable to the emergency treatment of highly pathogenic avian influenza epidemic that has caused or may cause serious losses in poultry production and serious damage to public health.

　　The management object of this plan is the poultry and its products produced, slaughtered, transported, stored, imported and sold in this city, the poultry used for viewing, performing arts, competitions, scientific research and teaching, diagnosis and treatment, and wild poultry such as migratory birds.

　　1.4 working principles

　　1.4.1 Territorial management

　　Governments at all levels shall uniformly lead and direct the emergency handling of highly pathogenic avian influenza epidemic; Territorial management shall be implemented for emergency handling of epidemic situation; Governments at all levels are responsible for extinguishing the epidemic situation of highly pathogenic avian influenza within their respective administrative areas, and all relevant departments shall, in accordance with the provisions of the plan, do a good job in emergency handling of the epidemic situation within their respective functions and duties. According to the scope, nature and degree of harm of highly pathogenic avian influenza epidemic, the epidemic situation shall be managed at different levels.

　　1.4.2 Rapid response

　　Governments at all levels shall, in accordance with relevant laws and regulations, establish and improve the emergency system, emergency response mechanism and emergency handling procedures for highly pathogenic avian influenza epidemic, and improve the emergency handling capacity for highly pathogenic avian influenza epidemic; When a highly pathogenic avian influenza epidemic occurs, governments at all levels should respond quickly and take decisive measures to control and extinguish the epidemic in time.

　　1.4.3 Prevention first.

　　Carry out the policy of putting prevention first, implement various prevention and control measures, do a good job in emergency reserve of personnel, technology, materials and equipment, and carry out technical training and emergency drills on a regular basis as needed; Carry out epidemic monitoring, early warning and forecasting, and timely analyze and warn all kinds of situations that may lead to highly pathogenic avian influenza epidemic, so as to achieve early detection, quick action and strict handling.

　　1.4.4 Scientific control

　　Implement scientific prevention and control, further establish and popularize scientific immunization and disinfection procedures, strengthen epidemiological research, standardize the operating procedures of epidemic prevention and quarantine, and realize scientific and standardized prevention and control work.

　　1.4.5 Group prevention and control

　　Strengthen the propaganda of epidemic prevention knowledge, popularize the epidemic prevention knowledge of highly pathogenic avian influenza, popularize immunization, diagnosis and disinfection techniques, improve the epidemic prevention awareness and self-protection awareness of animal breeding practitioners and the general public, and enhance the awareness of the whole society to prevent highly pathogenic avian influenza; The emergency treatment of highly pathogenic avian influenza epidemic situation depends on the masses, the whole people’s epidemic prevention, and mobilization of various resources to achieve mass prevention and control.

　　1.5 epidemic situation confirmation

　　1.5.1 After receiving the epidemic report, the supervising agency for animal epidemic prevention immediately dispatched two or more epidemic prevention personnel with relevant qualifications to the site for clinical diagnosis and put forward preliminary diagnosis opinions.

　　1.5.2 In case of suspected highly pathogenic avian influenza epidemic, timely collect disease materials and send them to the Municipal Veterinary Laboratory for serological detection (waterfowl cannot use agar diffusion test). If the diagnosis is positive, it can be confirmed as a suspected case of highly pathogenic avian influenza.

　　1.5.3 Suspected cases must be sent to the laboratory designated by the animal husbandry and veterinary administrative department of the State Council for virus isolation and identification for final diagnosis.

　　1.6 epidemic classification

　　According to the nature, harm degree and scope of highly pathogenic avian influenza epidemic, the epidemic situation of highly pathogenic avian influenza is divided into four levels: particularly serious (Grade I), major (Grade II), large (Grade III) and general (Grade IV).

　　1.6.1 particularly serious and highly pathogenic avian influenza epidemic situation (Grade I)

　　Within 21 days, there were more than 4 districts and counties with epidemic situation; Or the number of epidemic spots is more than 10; Or there are more than 4 townships or more than 3 contiguous townships in one district and county; Or in several districts and counties, there are multiple trends, and some people are infected, which continues to spread in a large area.

　　1.6.2 Major highly pathogenic avian influenza epidemic (Grade II)

　　Within 21 days, there were 2 to 3 districts and counties with epidemic situation; Or there are 4 to 9 epidemic spots in one district and county; Or an epidemic occurred in two townships.

　　1.6.3 Large and highly pathogenic avian influenza epidemic (Grade III)

　　Within 21 days, there are two or three epidemic spots in one district and county.

　　1.6.4 General epidemic situation of highly pathogenic avian influenza (Grade IV)

　　Occurred in a township and an epidemic spot.

　　2 Organization and responsibilities

　　2.1 emergency command organization

　　2.1.1 Municipal Command for the Prevention and Control of Major Animal Diseases (emergency headquarters) shall lead, organize and coordinate the emergency treatment of highly pathogenic avian influenza in the city.

　　Responsibilities of the Municipal Command for the Prevention and Control of Major Animal Diseases (emergency headquarters):

　　(1) Implement the Law of People’s Republic of China (PRC) on Animal Epidemic Prevention and the Measures of Beijing for Implementing the Law of People’s Republic of China (PRC) on Animal Epidemic Prevention and other laws and regulations;

　　(2) Organizing the formulation and revision of the Emergency Plan for Highly Pathogenic Avian Influenza in Beijing;

　　(3) To lead, organize and implement the prevention and control of highly pathogenic avian influenza in this Municipality, and formulate working procedures for the prevention and control of highly pathogenic avian influenza;

　　(4) to guide the prevention and treatment of highly pathogenic avian influenza in districts and counties.

　　2.1.2 The commander-in-chief of the Municipal Command for the Prevention and Control of Major Animal Diseases (emergency headquarters) is the deputy mayor in charge, and the deputy commander-in-chief is the deputy secretary-general in charge of the municipal government and the director and deputy director in charge of the Municipal Agriculture Bureau. He is responsible for the unified leadership and unified command of the emergency treatment of highly pathogenic avian influenza epidemic and makes major decisions to deal with the highly pathogenic avian influenza epidemic.

　　2.1.3 member units and responsibilities of the municipal headquarters for the prevention and control of major animal diseases (emergency headquarters).

　　Municipal Bureau of Agriculture: (1) Responsible for organizing and coordinating relevant departments to do a good job in the prevention and control of highly pathogenic avian influenza; (2) To undertake the work functions of the Office of the Municipal Command for the Prevention and Control of Major Animal Diseases (emergency headquarters), and organize and carry out the work of epidemic monitoring, immunization, culling, disinfection, disease diagnosis and reporting, epidemiological investigation and focus tracking in a unified way; (3) Put forward the technical scheme for epidemic control and extermination; (4) Delineate epidemic spots, epidemic areas and threatened areas, put forward blockade suggestions to the municipal government and participate in the organization and implementation; (5) Supervise and guide the culling of poultry in epidemic areas, carry out harmless treatment of poultry carcasses and poultry products according to the prescribed standards, disinfect and treat pollutants in epidemic areas, and disinfect breeding sites and surrounding environment; (6) Organize emergency immunization of related animals in the threatened area; (7) Monitoring related animals and animal products in the threatened area; (8) Organize the establishment of emergency epidemic prevention materials storage, and reserve enough vaccines, diagnostic reagents, disinfection drugs, machines and tools, equipment, protective articles, blockade facilities and harmless treatment facilities; (9) To be responsible for the training of the emergency response reserve team; (10) to participate in the propaganda work of epidemic spots, epidemic areas and surrounding people.

　　Municipal Agriculture Committee: responsible for studying and putting forward policy suggestions for the development of agricultural industry.

　　Propaganda Department of the Municipal Party Committee: responsible for coordinating and organizing the news propaganda work of highly pathogenic avian influenza and popularizing relevant scientific prevention and control knowledge.

　　Municipal government supervision room: responsible for supervising the prevention and control of highly pathogenic avian influenza in all districts and counties and relevant departments.

　　Legislative Affairs Office of the municipal government: responsible for organizing the formulation of policies, regulations and compulsory measures for the prevention and control of highly pathogenic avian influenza.

　　Municipal Information Office: responsible for the construction of information network for the prevention and control of highly pathogenic avian influenza, do a good job in network maintenance and ensure the safety and smoothness of the network.

　　Municipal organization: responsible for the implementation of the staffing of major animal disease prevention and control institutions.

　　Foreign Affairs Office of the Municipal Government: responsible for the review and coordination of foreign-related matters concerning the prevention and control of highly pathogenic avian influenza in this Municipality, and handling matters related to foreign embassies in China, overseas news agencies in Beijing, overseas personnel in Beijing, Hong Kong and Macao Beijing offices and personnel.

　　Municipal Health Bureau: responsible for prevention, medical observation and human epidemic monitoring of high-risk groups, and strengthening contact and information communication with animal epidemic prevention departments.

　　Municipal Development and Reform Commission: responsible for making plans and arrangements for infrastructure construction related to epidemic prevention and control.

　　Municipal Finance Bureau: responsible for ensuring the funds needed for emergency treatment of epidemic diseases such as immunization, monitoring, disinfection, culling and harmless treatment, and strengthening supervision over the use of funds.

　　Beijing Entry-Exit Inspection and Quarantine Bureau: Strengthen the quarantine of inbound and outbound animals, animal products and other quarantine objects to prevent the spread of epidemic diseases.

　　Municipal Public Security Bureau: responsible for assisting relevant departments to do a good job in blockade and forced culling of epidemic areas, and to do a good job in security and social security management of epidemic areas.

　　Municipal Administration for Industry and Commerce: It is responsible for closing the poultry and poultry products trading market in epidemic areas and cracking down on the illegal operation of poultry and poultry products in the market.

　　City Urban Management and Law Enforcement Bureau: responsible for cracking down on the illegal operation of poultry and poultry products outside the bazaar according to law.

　　Municipal Transportation Commission: Cooperate with epidemic prevention and control, and be responsible for giving priority to the dispatch of emergency epidemic prevention materials.

　　Municipal Science and Technology Commission: responsible for strengthening the research on early warning and forecasting of epidemic situation and prevention and control technology.

　　Municipal Bureau of Commerce: responsible for strengthening market monitoring and management of reserved poultry products, organizing market regulation and maintaining market stability.

　　Municipal Management Committee: responsible for coordinating the relevant units to do a good job in the collection and harmless treatment of kitchen waste.

　　Municipal Forestry Bureau: It is responsible for cracking down on illegal hunting and management of wild birds, closely monitoring the health status of wild birds, and immediately notifying the local supervising agencies for animal epidemic prevention when any abnormality is found, and assisting the animal husbandry and veterinary departments in monitoring relevant diseases.

　　Municipal Water Affairs Bureau: responsible for the observation of aquatic wild birds in water source protection areas and surrounding areas, and immediately notify the local supervising agencies for animal epidemic prevention when any abnormality is found, and assist the animal husbandry and veterinary departments to do a good job in disease monitoring.

　　Municipal Bureau of Landscape Architecture: responsible for coordinating the immunization of birds in parks under the guidance of animal quarantine departments and health and epidemic prevention departments at the county level, closely monitoring their health conditions, immediately notifying the local supervising agencies for animal epidemic prevention when finding any abnormality, and cooperating with the animal husbandry and veterinary departments to do a good job in monitoring the epidemic situation.

　　Municipal Bureau of Quality and Technical Supervision: responsible for strengthening the supervision of poultry products production and processing enterprises.

　　Logistics Department of Beijing Garrison: responsible for the prevention and control of epidemic diseases in its subordinate units, actively cooperating with the prevention and control of epidemic diseases in the station, and timely reporting epidemic information.

　　Municipal Local Taxation Bureau: It is responsible for regulating and controlling the taxation of poultry farms (households) affected by the disaster, and promoting them to resume production as soon as possible.

　　Civil Affairs Bureau: responsible for providing life assistance to poultry farm personnel and poultry farmers who have difficulties in living due to disasters, and properly arranging the basic life of the affected people.

　　Municipal Tourism Bureau: responsible for cooperating with the Municipal Agriculture Bureau to carry out epidemic prevention supervision and management of hotels and restaurants.

　　Beijing Railway Bureau: Ensure the transportation of emergency personnel dealing with highly pathogenic avian influenza, emergency materials and relevant samples such as prevention and control drugs and instruments, and ensure safety and speed; Cooperate with the supervising agencies for animal epidemic prevention to do a good job in quarantine supervision of poultry and their products transported by rail.

　　Civil Aviation North China Regional Administration: organize and coordinate relevant units to do a good job in air transportation support for emergency personnel dealing with highly pathogenic avian influenza epidemic situation, emergency materials such as prevention and control drugs and equipment, and related samples; Supervise the relevant units to cooperate with the supervising agencies for animal epidemic prevention to do a good job in quarantine supervision of poultry and their products transported by air, and cooperate with the inspection and quarantine departments to do a good job in inspection and quarantine of inbound and outbound poultry and their products.

　　Beijing Ershang Group Co., Ltd.: Responsible for the reserve of national and municipal commodities and ensuring the quality of the reserved commodities.

　　Beijing Dafa Animal Products Company: responsible for the animal epidemic prevention work of this enterprise.

　　Beijing Huadu Group Co., Ltd.: Responsible for the animal epidemic prevention work of this enterprise.

　　Beijing Sanyuan Group Co., Ltd.: Responsible for the animal epidemic prevention work of this enterprise.

　　2.2 Daily management organization

　　The municipal headquarters for the prevention and control of major animal diseases (emergency headquarters) has an office as a daily office. The office is located in the Municipal Agriculture Bureau. The office of the Municipal Command for the Prevention and Control of Major Animal Diseases (emergency headquarters) is equipped with a command site and corresponding facilities and equipment as a command platform when a major animal epidemic occurs, and it is interconnected with the command platform of the Municipal Emergency Committee.

　　The functions of the Municipal Command for the Prevention and Control of Major Animal Diseases (emergency headquarters) Office for the prevention and control of highly pathogenic avian influenza are as follows:

　　(1) Responsible for organizing the implementation of the decision of the Municipal Emergency Committee and the Municipal Command for the Prevention and Control of Major Animal Diseases (emergency headquarters), mobilizing the reserve team for emergency treatment of highly pathogenic avian influenza epidemic, coordinating the member units of the Municipal Command for the Prevention and Control of Major Animal Diseases (emergency headquarters), and contacting the municipal expert advisory group.

　　(2) Responsible for organizing the drafting and revision of the Emergency Plan for Highly Pathogenic Avian Influenza in Beijing, organizing emergency drills for highly pathogenic avian influenza incidents, and organizing publicity, education and training for the prevention and treatment of highly pathogenic avian influenza.

　　(3) Responsible for the collection, analysis and reporting of highly pathogenic avian influenza information at home and abroad.

　　(4) responsible for organizing the investigation of hidden dangers of highly pathogenic avian influenza in the city.

　　(5) Responsible for issuing blue and yellow warning information, and put forward suggestions on issuing orange and red warning information to the office of the Municipal Emergency Committee.

　　(6) responsible for the construction of the city’s highly pathogenic avian influenza emergency command system and the management of emergency resources.

　　(7) coordinate and deal with the problems encountered in the prevention and treatment of highly pathogenic avian influenza.

　　2.3 Expert Advisory Group

　　City headquarters for the prevention and control of major animal diseases (emergency headquarters, a major animal disease) hired experts to form a highly pathogenic avian influenza expert advisory group.

　　Main responsibilities:

　　(1) to put forward suggestions on technical measures to deal with the corresponding level of highly pathogenic avian influenza epidemic;

　　(2) Make suggestions on emergency preparedness for highly pathogenic avian influenza epidemic;

　　(3) to participate in the formulation or revision of emergency plans and disposal technical schemes for highly pathogenic avian influenza;

　　(4) to provide technical guidance and training for emergency treatment of highly pathogenic avian influenza epidemic;

　　(5) Put forward suggestions on termination and post-evaluation of emergency response to highly pathogenic avian influenza epidemic;

　　(6) To undertake other tasks assigned by the Municipal Command for the Prevention and Control of Major Animal Diseases (emergency headquarters) and the Office.

　　2.4 Emergency handling institutions

　　2.4.1 Field headquarters

　　The on-site headquarters is responsible for organizing the implementation of the decision of the Municipal Emergency Committee and the Municipal Command for the Prevention and Control of Major Animal Diseases (emergency headquarters), and coordinating and mobilizing the member units of the Municipal Command for the Prevention and Control of Major Animal Diseases (emergency headquarters) to jointly carry out the emergency treatment of highly pathogenic avian influenza epidemic.

　　2.4.2 Reserve Team for Emergency Treatment of Highly Pathogenic Avian Influenza

　　Key personnel in animal husbandry and veterinary administration, animal epidemic prevention supervision, health and epidemic prevention, public security and other aspects are drawn from relevant departments and units of the city and county to form an emergency response reserve team, and epidemic situation handling, public security blockade, emergency immunization and health and epidemic prevention teams are set up separately, and each team is composed of corresponding professionals. Its main duties are to blockade the epidemic areas, cull susceptible poultry in the epidemic areas, strictly disinfect the epidemic areas and do a good job in personnel protection according to the requirements of emergency command agencies for major animal epidemics at all levels and the specific scope of designated epidemic areas and threatened areas.

　　2.5 Responsibilities of District and County Governments

　　The district and county governments shall take overall responsibility for the prevention and control of highly pathogenic avian influenza within their respective jurisdictions. According to the contents of this plan, formulate the planning, monitoring plan and emergency plan for the prevention and control of highly pathogenic avian influenza in this area; Establish an emergency command system and daily offices for major animal epidemics in districts and counties, uniformly lead and direct the emergency handling of highly pathogenic avian influenza epidemic within their respective administrative areas, make decisions on handling highly pathogenic avian influenza epidemic within their respective administrative areas, and decide on measures to be taken.

　　3 Early warning and reporting

　　3.1 Early warning level

　　According to the possible harm degree, development and urgency of highly pathogenic avian influenza epidemic, it is divided into four warning levels from low to high: general (level IV), severe (level III), severe (level II) and particularly severe (level I), which are indicated by blue, yellow, orange and red in turn.

　　Blue Warning: Outbreaks of highly pathogenic avian influenza with neighboring countries or other provinces, autonomous regions and municipalities (except Inner Mongolia Autonomous Region, Liaoning Province, Shandong Province, Henan Province, Shanxi Province, Hebei Province and Tianjin City).

　　Yellow warning: The outbreak of highly pathogenic avian influenza in Inner Mongolia Autonomous Region, Liaoning Province, Shandong Province, Henan Province and Shanxi Province has a tendency to spread to this city.

　　Orange warning: Highly pathogenic avian influenza has broken out in Hebei Province and Tianjin, and it has a tendency to spread to this city.

　　Red warning: A suspected case of highly pathogenic avian influenza occurred in this city, or a suspected case of human infection with highly pathogenic avian influenza appeared.

　　3.2 Early warning release

　　3.2.1 According to the monitoring information provided by the supervising agency for animal epidemic prevention and the epidemic dynamics of highly pathogenic avian influenza at home and abroad, the office of the municipal headquarters for the prevention and control of major animal epidemics (emergency headquarters) analyzes the harm degree and development trend according to the occurrence, development law and characteristics of highly pathogenic avian influenza epidemic, puts forward corresponding early warning suggestions, and releases them after being approved by the municipal headquarters for the prevention and control of major animal epidemics (emergency headquarters) and the municipal emergency committee.

　　3.2.2 After confirming the early warning information that may cause highly pathogenic avian influenza epidemic, the Municipal Command for Prevention and Control of Major Animal Diseases (emergency headquarters) shall deploy in time according to the formulated plan, and promptly notify all relevant departments and units to take action to prevent the occurrence and spread of highly pathogenic avian influenza epidemic.

　　3.2.3 In accordance with the relevant provisions on the release and confidentiality of the epidemic situation, early warning of highly pathogenic avian influenza with different levels shall be released and cancelled. General and heavier level of early warning, by the municipal headquarters for the prevention and control of major animal diseases (emergency headquarters) organization issued and announced the cancellation. Serious and especially serious warning information needs to be reported to the main leaders of the city for approval, and the office of the Municipal Emergency Committee is responsible for organizing the release and announcement of cancellation.

　　3.3 Early warning response

　　3.3.1 Blue Early Warning Response

　　Pay close attention to the development trend of epidemic situation in neighboring countries or relevant provinces, autonomous regions and municipalities. Strengthen the reserve of epidemic prevention materials such as vaccines and disinfectants. Strengthen the monitoring of immune effect. Strengthen the observation and monitoring of transit migratory birds. It is forbidden to import birds and their products from countries and regions in epidemic areas announced by the Ministry of Agriculture and the General Administration of Quality Supervision, Inspection and Quarantine, and strengthen the quarantine of imported birds and their products in non-epidemic areas. After the epidemic situation in neighboring countries or relevant provinces, autonomous regions and municipalities is controlled, the blue warning will be cancelled.

　　3.3.2 Yellow Early Warning Response

　　On the basis of implementing the blue warning response measures, all poultry farms (households) should adopt closed feeding methods to strictly control the flow of people and logistics. Expand the monitoring scope of poultry immune effect, and timely supplement the poultry farms (households) with low immune titer. Thoroughly disinfect the internal and external environment of poultry farms (households). In addition to the live birds from the breeding bases outside Beijing designated by this Municipality entering Beijing according to the relevant procedures, other live birds from other places will be stopped from entering Beijing. Suspend the city’s live poultry trading activities, suspend the release of pigeons and temporarily close the bird trading market. Strictly inspect and quarantine poultry and products entering Beijing through roads, railways, civil aviation and other channels according to law. Combine neighboring provinces and cities to carry out compulsory immunization of poultry within 5 kilometers from both sides of the administrative boundary of this Municipality, and establish a "firewall" for the prevention and control of highly pathogenic avian influenza in this Municipality; Carry out dragnet inspection, strengthen the monitoring of the immune effect of poultry within 5 kilometers from both sides of the administrative boundary of this Municipality, and make up for the exemption in time when problems are found. All members of the emergency command organization for major animal diseases strengthen information communication and jointly strengthen various prevention and control measures. After the epidemic situation in relevant provinces, autonomous regions and municipalities is effectively controlled, the yellow warning will be cancelled.

　　3.3.3 Orange Early Warning Response

　　On the basis of implementing the yellow early warning response measures, stop foreign poultry and their products from entering Beijing. When necessary, purchase poultry within 3 kilometers of the border between this city and the epidemic area. Strengthen joint prevention and control with Hebei Province and Tianjin City, and establish an information notification mechanism to ensure timely and effective communication of information. After the epidemic situation in Hebei Province and Tianjin City was effectively controlled, the orange warning was cancelled.

　　3.3.4 Red Warning Response

　　On the basis of implementing the orange early warning and response measures, the relevant departments closed the area where suspected cases occurred, and implemented measures such as culling and compulsory immunization for poultry in this area and surrounding areas. Isolate people suspected of being infected with highly pathogenic avian influenza and their close contacts. The Municipal Agriculture Bureau and the Municipal Health Bureau strengthen information communication and jointly strengthen various prevention and control measures. If suspected cases are excluded, cancel the red warning; If the epidemic situation is confirmed, enter the emergency response procedure.

　　3.4 epidemic situation report

　　Any unit or individual has the right to report the epidemic situation of highly pathogenic avian influenza and its hidden dangers to governments at all levels and relevant departments, and to report the departments, units and individuals that fail to perform or fail to perform the duties of emergency handling of highly pathogenic avian influenza epidemic in accordance with regulations to higher government departments.

　　3.4.1 Responsibility Reporting Unit and Responsibility Reporting Person

　　(1) Responsibility reporting unit

　　a。 Units related to poultry breeding and management, production and management of poultry products, various animal clinics and other related units;

　　b。 Relevant scientific research units and institutions;

　　c。 Supervising agencies for animal epidemic prevention under local governments at or above the county level;

　　d。 Other relevant departments and units.

　　(2) Responsible reporter

　　Personnel who raise and manage poultry and produce and manage poultry products; Staff of various animal clinics; Relevant staff of scientific research units and colleges; Personnel of supervising agencies for animal epidemic prevention at all levels performing their duties; Other relevant personnel.

　　3.4.2 Report Form

　　The supervising agencies for animal epidemic prevention at all levels shall report the epidemic situation of highly pathogenic avian influenza according to the relevant provisions of the state; Other responsible reporting units and individuals report by telephone or in writing.

　　3.4.3 Time limit and procedures for reporting

　　When a suspected highly pathogenic avian influenza epidemic situation is found, it must be reported to the district and county supervising agencies for animal epidemic prevention immediately. After receiving the report, the county supervising agencies for animal epidemic prevention shall immediately rush to the scene for clinical diagnosis. If necessary, please ask the municipal supervising agencies for animal epidemic prevention to send people to assist in the diagnosis. After it is identified as a suspicious epidemic situation, it shall report the epidemic situation to the municipal supervising agencies for animal epidemic prevention step by step within 2 hours, and also report it to the county emergency headquarters for major animal epidemics. The municipal supervising agency for animal epidemic prevention shall, within 1 hour after receiving the report, report to the office of the municipal headquarters for the prevention and control of major animal diseases (emergency headquarters) and the municipal veterinary administrative department. The office of the municipal headquarters for the prevention and control of major animal diseases (emergency headquarters) and the municipal veterinary administrative department shall report to the municipal government (Municipal Emergency Committee) and the Ministry of Agriculture respectively within 1 hour after receiving the report.

　　If it is identified as a suspicious epidemic situation, it shall immediately collect sick materials and send them to the laboratory of the Municipal Veterinary Laboratory for preliminary diagnosis; Confirmed as a suspected case of highly pathogenic avian influenza, sent to the National Avian Influenza Reference Laboratory for diagnosis.

　　3.4.4 Report content

　　(1) the time and place of the epidemic;

　　(2) species and quantity of infected or suspected infected animals, number of animals in the same group, immunity, number of deaths, clinical symptoms, pathological changes and diagnosis;

　　(3) Epidemiology and focus tracking;

　　(4) Control measures taken;

　　(5) the unit, person in charge, reporter and contact information of the epidemic situation report.

　　4 emergency response

　　4.1 the principle of emergency response

　　When a highly pathogenic avian influenza epidemic occurs, the municipal, district, county and township governments and their relevant departments make emergency response according to the principle of graded response. At the same time, it is necessary to follow the objective law of the occurrence and development of highly pathogenic avian influenza epidemic, and adjust the response level in time in combination with the actual situation and the needs of prevention and control work. Pay attention to the analysis of the development trend of highly pathogenic avian influenza epidemic situation, and upgrade the response level in time for the epidemic situation with expanding situation and influence; For the epidemic with limited scope and no further spread, the response level should be reduced accordingly. The emergency treatment of highly pathogenic avian influenza epidemic should adopt the methods of investigation, treatment and verification to effectively control the development of the epidemic.

　　Districts and counties where highly pathogenic avian influenza epidemic has not occurred should organize personnel, materials and other emergency preparations, take necessary preventive and control measures to prevent highly pathogenic avian influenza epidemic from occurring within their respective administrative areas, obey the unified command of the Municipal Command for the Prevention and Control of Major Animal Diseases (emergency headquarters), and support the emergency treatment at the place where highly pathogenic avian influenza epidemic has occurred.

　　4.2 Graded response

　　4.2.1 Emergency response to particularly serious and highly pathogenic avian influenza epidemic (Grade I)

　　By the office of the Municipal Command for the Prevention and Control of Major Animal Diseases (emergency headquarters), suggestions are made to the Municipal Command for the Prevention and Control of Major Animal Diseases (emergency headquarters) and the Office of the Municipal Emergency Committee, and the emergency plan is launched after being approved by the main leaders of the municipal party committee and the municipal government. The mayor is responsible for emergency command; The deputy mayor in charge should rush to the scene, and set up an on-site headquarters composed of the municipal headquarters for the prevention and control of major animal diseases (emergency headquarters) and the local district and county governments. The mayor is the commander in chief, responsible for participating in the formulation of plans, guiding, coordinating and urging relevant departments to carry out their work; The commander-in-chief of the Municipal Command for the Prevention and Control of Major Animal Diseases (emergency headquarters) and the relevant leaders of the local districts and counties shall be the executive commander-in-chief, responsible for the specific command and disposal of the epidemic.

　　When a particularly serious and highly pathogenic avian influenza epidemic occurs, the municipal government or district/county government shall issue a blockade decision according to law. The public security department and the armed police force blocked the epidemic areas and set up temporary checkpoints. The city stopped all poultry and its products from entering and leaving Beijing and closed all live poultry trading markets. If someone is infected with highly pathogenic avian influenza, the health department should treat the infected person in isolation and observe the people in contact with him in isolation. By the epidemic emergency response reserve team, poultry within a radius of 3 kilometers with the epidemic as the center will be culled, and poultry products will be treated harmlessly; The supervising agencies for animal epidemic prevention shall organize the implementation of compulsory immunization for poultry within 5 kilometers outside the epidemic area; Strictly disinfect the internal and external environment of all poultry farms (households) and strictly control the flow of people and logistics.

　　4.2.2 Emergency Response to Major Highly Pathogenic Avian Influenza Epidemic (Level II)

　　The municipal headquarters for the prevention and control of major animal diseases (emergency headquarters) is responsible for starting the emergency plan. The deputy mayor in charge is responsible for emergency command, and the deputy secretary-general in charge assists the deputy mayor in his work. The director and deputy director of the Municipal Bureau of Agriculture should rush to the scene and set up an on-site headquarters composed of the municipal headquarters for the prevention and control of major animal diseases (emergency headquarters) and the district and county governments. The deputy mayor in charge is the chief commander, responsible for participating in the formulation of the plan and coordinating the work of relevant departments; The director of the Municipal Bureau of Agriculture, the deputy director in charge and the relevant responsible comrades of the districts and counties shall be the executive chief commander, responsible for the specific command and disposal of the incident.

　　When a major highly pathogenic avian influenza epidemic occurs, the municipal government or district/county government shall issue a blockade decision according to law. The public security department and the armed police force blocked the epidemic areas and set up temporary checkpoints. The poultry within a radius of 3 kilometers centered on the epidemic spot shall be culled by the emergency response reserve team; Birds within 5 kilometers outside the epidemic area shall be given compulsory immunization by the supervising agencies for animal epidemic prevention; Strictly disinfect the internal and external environment of all poultry farms (households) and strictly control the flow of people and logistics.

　　4.2.3 Emergency response to a large and highly pathogenic avian influenza epidemic (Grade III)

　　The office of the Municipal Command for the Prevention and Control of Major Animal Diseases (emergency headquarters) is responsible for starting the emergency plan and taking full command. When necessary, the person in charge of the office of the Municipal Agriculture Bureau or the Municipal Command for the Prevention and Control of Major Animal Diseases (emergency headquarters) was present to participate in the formulation of the plan and coordinate the work of relevant departments.

　　When a large highly pathogenic avian influenza epidemic occurs, the local district and county governments shall issue a blockade decision according to law. The public security department and the armed police force blocked the epidemic areas and set up temporary checkpoints. The poultry within a radius of 3 kilometers centered on the epidemic spot shall be culled by the emergency response reserve team; Poultry within 5 km outside the epidemic area shall be given compulsory immunization by the supervising agency for animal epidemic prevention. Strictly disinfect the internal and external environment of all poultry farms (households) and strictly control the flow of people and logistics.

　　4.2.4 Emergency Response of General Highly Pathogenic Avian Influenza Epidemic (Grade IV)

　　The emergency headquarters of major animal diseases in the epidemic areas and counties shall be responsible for starting the emergency plan and handling it with full authority. When necessary, the office of the Municipal Command for the Prevention and Control of Major Animal Diseases (emergency headquarters) sent technicians to the site to give guidance and support.

　　When a general highly pathogenic avian influenza epidemic occurs, the local district and county governments shall issue a blockade decision according to law. The public security department and the armed police force blocked the epidemic areas and set up temporary checkpoints. The poultry within a radius of 3 kilometers centered on the epidemic spot shall be culled by the emergency response reserve team; Birds within 5 kilometers outside the epidemic area shall be given compulsory immunization by the supervising agencies for animal epidemic prevention; Strictly disinfect the internal and external environment of all poultry farms (households) and strictly control the flow of people and logistics.

　　4.3 Basic emergency

　　Under the unified leadership and command of governments at all levels and close cooperation with relevant departments, emergency treatment of highly pathogenic avian influenza epidemic situation will be carried out.

　　(1) according to the needs of highly pathogenic avian influenza epidemic, mobilize all kinds of personnel, materials, transportation and related facilities and equipment to carry out emergency treatment.

　　(2) Issue a blockade order to blockade the epidemic areas. If the blockade of epidemic areas exceeds the area under its jurisdiction, and the blockade of epidemic areas leads to the interruption of trunk traffic, it shall be reported to the government at the next higher level for approval and release the blockade decision according to regulations.

　　(3) Organize supervising agencies for animal epidemic prevention to investigate and deal with the epidemic situation of highly pathogenic avian influenza; Delineate epidemic spots, epidemic areas and threatened areas, and propose and implement targeted prevention and control measures; According to the provisions of the collection of disease materials, sent to the city veterinary laboratory for testing, such as confirmed as suspected cases, sent to the National Avian Influenza Reference Laboratory for diagnosis.

　　(4) Organize emergency preparedness teams to temporarily requisition houses, places and vehicles, take emergency measures such as culling infected animals and related animals, sealing public drinking water sources contaminated by highly pathogenic avian influenza pathogens, and organize emergency immunization as needed.

　　(5) Take measures to restrict or stop the trade of poultry and poultry products according to the epidemic level.

　　(6) Organize public security, transportation and other departments to set up temporary animal epidemic prevention supervision and inspection stations at traffic stations according to law to inspect and disinfect vehicles.

　　(7) Organize township governments, sub-district offices, neighborhood committees and village committees to carry out mass prevention and control.

　　(8) Organize relevant departments to ensure the supply of commodities, stabilize prices, severely crack down on illegal and criminal activities such as spreading rumors and spreading rumors, making and selling fake goods and disturbing social order, and maintain social stability.

　　(9) Responsible for the supervision and inspection of emergency handling.

　　(10) In accordance with the provisions of the state, timely carry out training on relevant technical standards and norms.

　　(11) to carry out targeted publicity and education on epidemic prevention knowledge of highly pathogenic avian influenza, and improve people’s awareness of prevention and control and self-protection ability.

　　(12) Organize experts to comprehensively evaluate the handling of highly pathogenic avian influenza epidemic situation, including the epidemic situation, on-site investigation, tracking of epidemic sources, and measures such as poultry culling, harmless treatment, disinfection and emergency immunization.

　　(13) do a good job in information collection, reporting and analysis of highly pathogenic avian influenza epidemic.

　　4.4 Expand emergency response

　　(1) When an epidemic situation of highly pathogenic avian influenza involving foreign countries occurs, the Foreign Affairs Office of the municipal government, the Municipal Publicity Office and other relevant departments should send people to participate in the work of the on-site headquarters according to the needs of emergency handling and the division of responsibilities, and be responsible for undertaking related matters.

　　(2) With the existing emergency resources and manpower in this city, it is difficult to implement effective disposal, and it is necessary for the state or other provinces and cities to provide assistance and support. The Municipal Emergency Committee should immediately report the situation to the CPC Central Committee and the State Council, request the CPC Central Committee and the State Council to directly direct or authorize Beijing to direct, coordinate and mobilize the emergency resources of the central state units in Beijing, the Beijing Military Region, the Beijing Armed Police Corps and other aspects to participate in the handling of the epidemic.

　　4.5 Emergency response in areas without epidemic situation

　　According to the epidemic nature, characteristics, occurrence area and development trend of highly pathogenic avian influenza epidemic area, analyze the possibility and degree of being affected in this area, and focus on the following work:

　　(1) Keep close contact with the epidemic area and obtain relevant information in time.

　　(2) Organize the preparation of personnel and materials needed for emergency treatment in this administrative area.

　　(3) to carry out monitoring and prevention and control of highly pathogenic avian influenza in breeding, transportation, slaughter and circulation to prevent the introduction, occurrence and spread of highly pathogenic avian influenza.

　　(4) to carry out epidemic prevention knowledge propaganda of highly pathogenic avian influenza, and improve public protection ability and awareness.

　　(5) do a good job in quarantine supervision of highway, railway, aviation and water transportation according to regulations.

　　4.6 Safety Protection of Emergency Handling Personnel

　　It is necessary to ensure the safety of personnel involved in the emergency response to the epidemic. Emergency personnel should take special protective measures, such as wearing protective clothing, inoculating corresponding vaccines, and conducting serological tests regularly.

　　4.7 Termination of emergency response

　　The termination of the emergency response of highly pathogenic avian influenza epidemic situation must meet the following conditions: after all poultry and their products in the epidemic area are treated according to regulations, there are no new cases of the epidemic in at least one longest incubation period.

　　Especially serious and highly pathogenic avian influenza epidemic situation shall be evaluated by relevant experts organized by the municipal animal husbandry and veterinary administrative department, and suggestions for terminating emergency response shall be put forward, submitted to the municipal government for approval, and reported to the Ministry of Agriculture.

　　The larger and generally highly pathogenic avian influenza epidemic situation shall be evaluated by the county animal husbandry and veterinary administrative department to organize relevant experts to control the epidemic situation, put forward suggestions to terminate the emergency response, report to the county government for approval, and report to the municipal headquarters for the prevention and control of major animal epidemics (emergency headquarters) and the municipal emergency committee office.

　　5 after-treatment

　　5.1 Late evaluation

　　After the highly pathogenic avian influenza epidemic is extinguished, the emergency command institutions of major animal diseases at all levels shall organize relevant personnel to evaluate the handling of the epidemic. The contents of the assessment should include: the basic situation of the epidemic, the process of the epidemic, the results of field investigation and laboratory testing; Analysis and conclusion of the main causes of the epidemic; The process of handling the epidemic situation, the preventive measures taken and their effects; The problems and difficulties in the emergency process, as well as the reasons for the outbreak of this epidemic, the problems and difficulties in prevention and control work, etc., put forward improvement suggestions and countermeasures.

　　The assessment report shall be submitted to the government at the corresponding level (emergency committee) within 20 days, and a copy shall be sent to the emergency command organization of major animal diseases at the next higher level.

　　5.2 Reward

　　The municipal or district/county government shall commend the advanced collectives and individuals who have contributed to the emergency treatment of highly pathogenic avian influenza epidemic; Those who died heroically in the emergency treatment of highly pathogenic avian influenza epidemic situation shall be regarded as martyrs according to relevant regulations.

　　5.3 Responsibility

　　In the process of prevention, reporting, investigation, control and treatment of highly pathogenic avian influenza epidemic, there are dereliction of duty, dereliction of duty and other violations of law and discipline, and the responsibility of the parties concerned shall be investigated according to relevant laws and regulations.

　　5.4 Disaster compensation

　　In accordance with the relevant provisions of this Municipality on the management of special funds for compulsory animal culling compensation, the amount and grade standards shall be determined, and compensation shall be made according to the procedures. The object of compensation is the units and individuals whose poultry or property have suffered losses in order to put out the epidemic or prevent its spread.

　　5.5 Pensions and subsidies

　　Governments at all levels should organize relevant departments to give corresponding subsidies and pensions to those who are sick, disabled or killed due to their participation in emergency response work in accordance with relevant state regulations.

　　5.6 Resume production

　　After the highly pathogenic avian influenza epidemic is extinguished, restrictive measures such as blockade restrictions and circulation control will be cancelled. According to the characteristics of highly pathogenic avian influenza epidemic situation, the epidemic spots and epidemic areas should be continuously monitored, and animals can be reintroduced to resume poultry production if they meet the requirements.

　　5.7 Social assistance

　　After the outbreak of highly pathogenic avian influenza, the competent civil affairs departments at all levels should do a good job in the reception, distribution and use of relief materials and funds provided by all sectors of society to the epidemic areas in accordance with the People’s Republic of China (PRC) Public Welfare Donation Law, the Interim Measures for the Administration of Disaster Relief Donation and relevant state policies.

　　6. Guarantee of emergency response to epidemic situation

　　After the outbreak of highly pathogenic avian influenza, governments at all levels should actively coordinate with veterinary, health, finance, transportation, public security, industry and commerce, urban management, quality and technical supervision, forestry and other departments to do a good job in emergency support for epidemic handling.

　　6.1 Technical Support of Command System

　　6.1.1 The Office of the Municipal Command for the Prevention and Control of Major Animal Diseases (emergency headquarters) shall improve the technical support system for emergency command to meet the command requirements for handling the highly pathogenic avian influenza epidemic. It mainly includes: wired communication system, wireless command and dispatch system, information reporting system, basic geographic information system, analysis and decision support system, video conference system, mobile command system, etc.

　　6.1.2 The Office of the Municipal Command for the Prevention and Control of Major Animal Diseases (emergency headquarters) and all districts and counties shall gradually establish and improve the basic information database of emergency command. The basic information database of emergency command includes epidemic monitoring and early warning database, emergency plan database based on spatial location, emergency decision-making consulting expert database, and auxiliary decision-making knowledge database, etc. It should be maintained and updated in time to ensure the quality of data and provide support for emergency command, analysis and decision-making of highly pathogenic avian influenza.

　　6.2 Communication Guarantee

　　Under the leadership of the Municipal Emergency Committee Office and the cooperation of the Municipal Information Office and the Municipal Communications Administration, a four-level network transmission system covering cities, districts, counties, streets (towns) and communities (villages) will be formed through various telecom operators in this city, Beijing wired government private network and wireless government private network, and a stable and reliable emergency communication system with multi-routing, wire and wireless will be established. When the communication trunk line is interrupted or the existing network is blind, the communication means such as satellite and microwave are used to ensure the contact between the office of the Municipal Emergency Committee and the municipal headquarters for the prevention and control of major animal diseases (emergency headquarters) and the on-site headquarters.

　　6.3 Emergency resources and equipment support

　　6.3.1 The emergency team ensures that the municipal, district and county governments should establish a reserve team for emergency treatment of highly pathogenic avian influenza epidemic, and specifically implement culling, disinfection and harmless treatment. The reserve team consists of personnel from veterinary, health, public security, industry and commerce, armed police, military and other departments, and is relatively fixed.

　　6.3.2 Transportation Guarantee The transportation department should give priority to the dispatch of emergency epidemic prevention materials.

　　6.3.3 The health department of medical and health security is responsible for carrying out human monitoring of highly pathogenic avian influenza and doing a good job in prevention and security. Veterinary administrative departments and health departments at all levels should inform each other of the epidemic situation in a timely manner and work together.

　　6.3.4 Public security departments and armed police forces should assist in the blockade and forced culling of epidemic areas, and do a good job in the security and social security management of epidemic areas.

　　6.3.5 Material Guarantee Governments at all levels shall, according to the principle of graded storage, establish emergency epidemic prevention material storage, and store enough medicines, vaccines, diagnostic reagents, instruments, protective equipment, transportation and communication tools.

　　Reserve materials should be planned reasonably according to the poultry breeding quantity and disease control. Mainly includes: (1) highly pathogenic avian influenza inactivated vaccine; (2) diagnostic reagents; (3) Disinfecting drugs, including stable chlorine dioxide, peracetic acid, chlorine disinfectant, caustic soda, potassium permanganate, etc. (4) disinfection equipment, including high-pressure sterilizers, portable disinfection machines and tools, disinfection containers, etc.; (5) Protective articles, including breathable jumpsuits, latex gloves, ordinary white coats, hats, masks, waterproof shoes, safety goggles, etc. (6) Means of transport, including closed transport vehicles, trucks and special vehicles for on-site diagnosis and disinfection; (7) Sealing appliances, including high-strength environmentally-friendly sealed plastic bags and plastic sheets; (8) Communication tools, including car phones and walkie-talkies; (9) Other articles, including towels, flashlights and disposable 2ml syringes.

　　6.3.6 Funding guarantee

　　The financial departments of the municipal, district and county governments should arrange emergency funds for sudden major animal diseases in the general expenditure budget, use government reserve funds when necessary, and gradually increase the proportion of funds extraction according to the needs of urban public safety management.

　　After the outbreak of highly pathogenic avian influenza, first, adjust the internal structure of departmental budget according to the actual situation, cut departmental expenditure budget, and concentrate financial resources to deal with the epidemic; Second, with the approval of the government, the emergency special reserve fund was launched. In accordance with the principle of "emergency handling", simplify the work link, and complete the relevant procedures within 1 working day for the funding approved by the municipal government to ensure the smooth progress of the emergency handling of highly pathogenic avian influenza epidemic.

　　The funds required for immunization, emergency epidemic prevention materials reserve and epidemic monitoring every year shall be guaranteed by the governments at all levels, and the specific subsidy standards and management measures shall be jointly formulated by the agricultural department and the financial department. In the event of a highly pathogenic avian influenza epidemic, there is a gap between the actual capital demand and the budget arrangement, and the financial departments at all levels should add it to ensure the expenditure needs.

　　The financial departments at all levels should strengthen the management and supervision of the use of epidemic prevention funds while ensuring that the epidemic prevention funds are in place in time and in full.

　　6.4 Technical Reserve and Guarantee

　　Establish an expert Committee on highly pathogenic avian influenza. The expert committee is composed of technical officials, animal disease prevention experts, epidemiologists, health and epidemic prevention experts, wildlife experts, animal welfare experts, economic experts, risk assessment experts, legal experts, etc. It is responsible for consulting the strategies and methods of disease prevention and control, and participating in the planning, formulation and implementation of prevention and control technical schemes.

　　7 Training, exercises and publicity and education

　　7.1 Training Governments at all levels should organize systematic training for members of the reserve team for handling highly pathogenic avian influenza epidemic. The contents include: (1) knowledge of prevention, control and eradication of highly pathogenic avian influenza, including knowledge and skills of immunization, epidemiological investigation, diagnosis, collection and inspection of sick materials, disinfection, isolation, blockade, quarantine, culling and harmless treatment; (2) animal epidemic prevention laws and regulations; (3) Personal protection knowledge; (4) Common sense of public security and environmental protection; (5) Work coordination and cooperation with relevant requirements.

　　7.2 Exercise When there is no highly pathogenic avian influenza epidemic, the emergency headquarters of major animal diseases at the city, district and county levels should organize drills in a planned way every year to ensure the emergency response capability of the emergency response reserve team.

　　7.3 Publicity and Education Governments at all levels should organize relevant departments to widely spread the emergency knowledge of highly pathogenic avian influenza epidemic to the public through radio, film and television, newspapers, manuals and other forms, publicize the popular science knowledge of highly pathogenic avian influenza epidemic prevention, and guide the masses to treat the highly pathogenic avian influenza epidemic in a scientific way. It is necessary to give full play to the role of relevant social groups in popularizing animal epidemic prevention knowledge and popular science knowledge.

　　8 supplementary provisions

　　8.1 Definitions and descriptions of noun terms and abbreviations

　　Epidemic spot: the place where sick poultry are located. Generally refers to the poultry farm (household) where sick poultry are located or other relevant slaughter and business units.

　　Epidemic area: refers to the area with the epidemic spot as the center and within a radius of 3 kilometers. When dividing epidemic areas, we should pay attention to the local breeding environment, natural barriers (such as rivers and mountains) and traffic and other factors.

　　Threatened area: refers to the area within 5 kilometers outside the epidemic area.

　　In the expression of relevant quantities in this plan, "above" includes the number, and "below" does not include the number.

　　8.2 Plan Management and Update

　　This plan is formulated by the office of the Municipal Command for the Prevention and Control of Major Animal Diseases (emergency headquarters), organized by the office of the Municipal Emergency Committee, reported to the Municipal Emergency Committee for the record, and approved, issued and implemented by the municipal government. The plan should be reviewed regularly, and revised in time according to the situation changes of highly pathogenic avian influenza epidemic and the problems found in the implementation. The emergency plan for highly pathogenic avian influenza formulated by all districts and counties and their relevant departments shall be reported to the Municipal Command for the Prevention and Control of Major Animal Diseases (emergency headquarters) for the record.

　　8.3 Plan Interpretation Department

　　This plan shall be interpreted by the Municipal Command for the Prevention and Control of Major Animal Diseases (emergency headquarters).

　　8.4 implementation time of the plan

　　This plan shall be implemented as of the date of issuance, and the Notice of Beijing Municipal Bureau of Agriculture on Printing and Distributing the Emergency Plan for Highly Pathogenic Avian Influenza in Beijing (Jing Nong Zi [2004] No.2) shall be abolished at the same time.

　　China is the hometown of tea. Chinese has discovered and used tea for thousands of years, and many people like drinking tea very much. However, there is news on the Internet recently that drinking tea is bad for the heart and may even lead to heart disease. Is it true?/You don’t say.

　　In fact, drinking tea is not bad for the heart, and it may even be beneficial — — This should start with the special ingredients in tea. Tea is usually rich in flavonoid antioxidants, such as tea polyphenols and catechins, which give tea an attractive fragrance. In addition, tea also contains a lot of caffeine. In the process of making tea, some of these substances will dissolve into the tea. Therefore, tea is actually a drink containing a variety of plant antioxidants and caffeine.

　　Tea is rich in antioxidant substances such as tea polyphenols, which can scavenge human free radicals and have certain benefits to health. Judging from a large number of current studies, drinking tea is good for the heart and cardiovascular system — — It may significantly reduce the risk of heart disease and stroke by reducing low-density lipoprotein cholesterol ("bad cholesterol").

　　A study in Journal of American Heart Association took six years to analyze the relationship between the change of high density lipoprotein cholesterol (HDL-C) level in the blood of more than 80,000 Chinese and drinking tea. The results show that the HDL-C level of people who insist on drinking tea for a long time decreases more slowly, and the risk of cardiovascular diseases decreases by 8%, which is beneficial to cardiovascular health.

　　China’s "Food and Health-Scientific Evidence and Consensus" summarizes and analyzes the research on tea and health, and thinks that drinking tea can reduce the risk of diabetes, stroke and cardiovascular diseases. Therefore, it can be considered that drinking tea is not only harmless to the heart, but also beneficial.

　　However, because tea contains caffeine, some people drink too much tea, which will lead to discomfort such as palpitations, so some people worry that drinking tea is not good for the heart. In fact, this is a normal phenomenon, which is called "tea drunk" by the people. As long as you drink it in moderation, there will be no problem.

　　At present, the international research on caffeine is relatively sufficient, and authoritative health institutions believe that moderate drinking of coffee and caffeine will not cause damage to the heart. For example, the American Heart Association, the European Heart Association, the Australian National Institute of Health and Medical Research and other institutions believe that healthy adults drinking coffee in moderation (1 to 2 cups a day, about 200 milligrams of caffeine) will not increase the risk of heart disease and cardiovascular disease.

　　Compared with coffee, there is much less caffeine in tea. The caffeine content in a cup of tea is usually only 40 to 80 mg, which is less than half that of an equivalent cup of coffee. Therefore, it is no problem to drink 3 to 4 cups of light tea, such as white tea and green tea every day; For some strong tea, such as black tea, the caffeine content will be more, but drinking 2 cups will not be a problem. Of course, if your heart and head are really uncomfortable after drinking tea, try not to drink or drink less.

　　According to the data of China Cardiovascular Disease Report 2017, the number of cardiovascular patients in China has reached 290 million, and cardiovascular deaths account for 40% of the deaths of residents, which is higher than tumors and other diseases, ranking first; Moreover, the morbidity and mortality are still on the rise. From the current research, maybe drinking some tea every day can also reduce the risk of cardiovascular disease, which is beneficial to the body.

　　It is worth noting that many people may drink tea in the wrong way. How can drinking tea be beneficial to health?

　　First, don’t drink too much tea or drink too much tea. Drinking a lot of tea, in addition to too much and too strong caffeine intake, tannic acid in tea may also affect the absorption of iron, which is not good for health — — It is recommended not to drink more than 4 cups of tea every day. Second, drinking tea every day is best arranged in the afternoon, not too late, so as not to affect sleep. What needs special reminder is that you should try to stay away from sugary tea drinks. At present, there is no evidence that sugary tea drinks also have cardiovascular protection. Therefore, tea drinks should not be used instead of drinking tea, let alone deliberately drinking tea drinks to protect cardiovascular health.

　　(The author is Ruan Guangfeng, Director of Science and Technology Department of Food Nutrition and Information Exchange Center)

　　Original title: Why are there many industrial and commercial halls in Chongwai area?

　　The traffic location is convenient for businessmen.

　　According to the Records of Place Names in Chongwen District, there are 154 halls in Old Chongwen District. Although some of them are called fellow country halls, they are actually industry or industrial and commercial halls. There are not many halls that really serve the literati who came to Beijing to take the exam. There are only two halls, Jizhou Trial Hall and Zunhua Trial Hall, which are called trial halls, which are different from other halls.

Linfen Guild Hall, located in Ximaochang Street, is more than 400 years old, and was jointly built by five elements merchants in Linfen, Shanxi.

　　Historically, Shanxi businessmen and Shandong businessmen once dominated Beijing’s economy. Lu ‘an Guild Hall, which was once located in the south of Guangqumen Inner Street Road (now around Anhua Building), was built by Shanxi merchants who engaged in copper, iron, tin and carbon. In the old days, the hardware industry regarded the old gentleman in Taishang as the industry god, so there was an old gentleman hall dedicated to the old gentleman in Taishang in the guild hall. According to historical data, Lu ‘an Guild Hall appeared in the Ming Dynasty, and it grew from small to large, becoming one of the great guilds in Beijing. The "Monument" in the hall in 1920 said: "There was a Shenlu Temple in the old Lu County Hall, and the room outside the courtyard was the tomb of Lu people. For example, offering sacrifices to the meeting, raising the life and stopping the coffin, to the managers of the three gangs of copper, iron and tobacco bags for the county people. " Lu ‘an Guild Hall has the Laojun Temple and the altar for offering sacrifices to the furnace god, because the hardware industry can’t do without smelting furnace, so it is natural to offer sacrifices to the furnace god in the Guild Hall, and the old place name of the Guild Hall was called the furnace holy temple.

　　Shanxi Linfen Guild Hall was established by Shanxi merchants, and Shanxi pigment merchants also built another pigment guild hall in Qingyun Hutong. Pigment is not a concept in the old days, it includes many building materials and daily necessities, and it is a big industry. According to the data of Beijing’s economic history, "the cover of the paint shop is a flower stick, which is more than a foot long. Generally, it is painted in five colors: red, yellow, black, green and blue, decorated with golden flowers and painted with golden paths". This kind of flower stick, also known as the Five Flower Stick, is said to be specially designed to beat the emperor who fainted, and Emperor Yangdi was killed by the Five Flower Stick. Later, the five-flower stick became the symbol of the paint shop. "This kind of cover is always hung, not if other shops hang it early and later, it is intended to be the monarch of Yongzhen."

　　The pigment shop also sells all kinds of waxes, such as Jingyang Yellow Wax and Sichuan White Wax. In the years when there was no electric light, wax was mostly used for urban residents’ lighting, and wax was still a sacrificial object. When they got married, they were called "wedding night", and some scholars "read by candlelight at night", and candles were wax.

　　Linxiang Guild Hall, located in the eastern city of Chongwai, is also related to Shanxi merchants. It was established by Xiangling merchants in Linfen.

　　Cixi Guild Hall was established by a clothing merchant in Cixi, Zhejiang. Garment shops are shops that process, customize and sell garments. In 1923, there were 84 garment shops in Beijing. Shanxi cloth merchants built Jinyi Guild Hall in Xiaojiang Hutong, which was also called "Cloth Guild Hall" because it was built by cloth merchants among Shanxi merchants. According to "Atlas of China Cultural Relics", by the time of the Republic of China, Jinyi Guild Hall was no longer used as a cloth business meeting, but as a place for people from Yicheng, Shanxi Province to reunite in Beijing, and also provided free living services for people who went to Beijing temporarily. In 2011, Jinyi Hall became a part of Liu Laogen Hall.

　　In addition, Fujian paper merchants built Yanshao Guild Hall in Chongwai, while Yuanning Guild Hall was funded by Jiangsu silk merchants.

　　There are many historical reasons for "worshipping foreign countries" industries and industrial and commercial halls. Since the Ming Dynasty, the Grand Canal was cut in two due to the construction of the outer city. "The soil is getting higher and higher, and the boat can’t reach it." The pier of Jishuitan can’t be used anymore, and the terminal pier of the Grand Canal was changed under the Datong Bridge in Dongbianmen, not far from Chongwenmen. In addition to water transport vessels, there are many merchant ships at Datong Bridge Wharf. Merchants often unload ships here. Besides building warehouses and warehouses in Chongwai, they also build industrial and commercial halls. They live in the halls to facilitate business.

　　Since the Ming Dynasty, Chongwenmen has been a very important tax gate. At the end of Qing Dynasty, Prince Su once supervised Chongwenmen’s tax gate. He honored the collected taxes to "Lafayette" and became Cixi’s "rouge money" for her to squander at will. It is said that many of Beijing’s "official residences" were built by her with uncountable rouge money, and she profited a lot from them, which shows that the amount of tariffs and taxes in Chongwenmen is large. After paying taxes, most businessmen live in Chongwai area nearby. They don’t live in chicken feather shops, but prefer private residences. Of course, the most convenient place is the clubhouse built by peers. As a result, it is normal that there are many industrial and commercial and trade halls in Chongwai area.

　　In addition, Chongwai area is the hometown of handicraft industry in history, and all kinds of products have become the source of goods for merchants from all walks of life. Vendors from all over the world bargain and discuss business here. Merchants will build some halls in Chongwai nearby. Although some halls are nominally literati test halls, the imperial examination is held once every three years, and people in the industrial and commercial circles mainly live in them on weekdays. It is natural that there are many industrial and commercial halls in Chongwai Hall.

　　Handicraft developed and business prospered.

　　There are many industrial and commercial halls in Chongwai area, which has a lot to do with the development of handicrafts here. Since the Ming and Qing Dynasties, in addition to many small weaving factories, hosiery factories, hemp rope factories and towel factories, handicrafts such as paper, silk, paper and flower, filigree inlay, cloisonne, ivory carving and feeder have been worshiped abroad, especially around Huashi Street, where they have grown and developed, leaving an unforgettable page.

　　In the 1920s, Beijing Practical Guide made statistics on handicraft workshops and shops in Chongwai area. For example, there are 9 Cui Hua Bureau (making glass jadeite); There are 18 paper flower shops, most of which are in the flower market. There are 13 hemp rope shops, 14 hemp shops and 4 official hemp shops. Chongwenmen was the gate of liquor import and export in history. There was a great demand for wine baskets in that year, and there were as many as 13 shops buying and selling wine baskets in Chongwai area. Interestingly, the shops that buy and sell shoulder poles are also concentrated in the flower market area, with 8 shops. There are 6 feeder shops, and all the mirrors in Beijing are laid in four flower markets, totaling 11.

　　In 2008, Donghuashi Street also made statistics on the shops and workshops in Donghuashi Street in the 1940s, and made the brand "Flower Market Store Directory". There are more than 300 shops recorded in the store directory, mainly Donghuashi Street, excluding Xihuashi Street and the surrounding hutongs, among which there are four paper flower velvet flower shops, and the velvet silk flower Trade Association is also in this street, with one feeder, one silk cutter, one inlay and one enamel shop (workshop) each.

　　The flower market is famous for its flowers, but the flowers here are not flowers, but velvet flowers, silk flower flowers and paper flowers, which are called "Beijing flowers". "Jinghua" was once an indispensable ornament for Beijingers, especially decades ago, middle-aged and elderly women wore bright red velvet flowers on their heads during the Chinese New Year holiday, which was very festive from a distance. Flowers bloom for a short time in the north, and there are seasonal restrictions. People who love beauty decorate the environment with silk flower and put silk flower in a vase to make the room full of spring scenery. As for paper flowers, wreaths are mainly made, and all kinds of flowers have their own uses. The "Jinghua" industry was once very prosperous. According to the "Overview of Industry and Commerce in Beiping", in old Beijing, "there are more than 1,000 flower growers in various markets and homes."

　　The "Jinghua" workshop in the flower market generally does not do all the work, but has a clear division of labor. Some specialize in flowers, some in pistils, some in leaves, and some people or workshops assemble them into finished flowers. "Every morning, thousands of people gather in the flower market to display their products in the market". In addition to retail, larger stalls and "Flower Village" run wholesale and sell "Jinghua" to all parts of the country. In the development of "Jinghua", large-scale merchants, such as flower shops and flower villages, appeared to specialize in the sale of "Jinghua".

　　The technical content of making "Jinghua" is not high. Assembling flowers, stamens and branches is called "saving live". Adults and children can do it, which has solved many people’s employment. In addition to being used as headgear and decorating life, "Jinghua" merchants also provide services for opera artists and act as "outfits". Famous artists such as "Hua Er Liu", "Hua Er Gong" and "Hua Er Jin" have emerged in Beijing Flower Industry. Hemp rope is an indispensable material for Beijing gardeners, so there are many hemp shops in Donghua Market alone. Later, plastic flowers appeared on the stage, and velvet flowers and silk flower plummeted. Coupled with changes in folk customs, not many people wore velvet flowers. "Jinghua" basically doesn’t exist, except for those who make wreaths, and even "Jingyi silk flower Sales Department" has disappeared.

　　In addition to the flower industry, there are many handicrafts in Chongwai that are unique in Beijing, such as filigree mosaic, which is very famous. Filament inlay is a traditional handicraft in China. It processes gold and silver into filaments, shapes them by pushing, pinching and weaving, and engraves patterns on the gold and silver filaments, and then inlays them with beautiful pearls, jade and precious stones. The products inlaid with filigree can be roughly divided into three categories, one is jewelry, the other is display and decoration, and the other is to decorate filigree with some daily necessities. Nowadays, filigree mosaic has become a national intangible cultural heritage.

　　The feeder is also an ancient industry. The grape feeder made in the famous "Grape Factory" is as shiny and shiny as a real grape. The grape feeder is inherited by the "Chang sisters" who originally lived in the flower market. They are Mongolians. In order to keep this craft secret, the Chang sisters never marry. Their deeds are often seen in newspapers. Scholar Deng Tuo once wrote: "The two generations of the Chang family kept the cold, and a hundred years passed down. The purple color of the grapes damages the beauty, and the old dreams are like smoke! "

　　There are many kinds of feeders in old Beijing, except grapes, peaches, fruits, pears, flowers, animals and people can be confused. The feeder takes glass as the main material, and the handicrafts made are colorful, ingenious, lifelike, exquisite, crystal clear and lovely, and are loved by people. In 1964, the feeder company built a building near Longtan Lake, and more than 800 people were engaged in feeder production. Prior to this, feeder artists were all based on families or workshops, distributed in Huashi Street and surrounding alleys, which should be the birthplace of old Beijing feeders in Huashi area.

　　Cloisonne, also known as inlaid enamel, is a kind of ware made of fine copper wire woven into various patterns on a copper tire, and then the enamel glaze is mainly blue and filled in the patterns. Cloisonne craft has a history of 600-700 years in China, and it is called "Cloisonne" because of its high development, exquisite technology and various varieties during the Jingtai period in the Ming Dynasty. Before the Japanese invaders invaded China, cloisonne products in Beijing sold very well, and most of them were exported to Europe, America and Japan, and the Japanese secretly copied them. At the time of its prosperity, there were nearly 100 cloisonne workshops with more than 2,700 employees. Dexingcheng, the second lane in Chongwai, and Da Rui Hall in Tea Hutong are among them. In 1923, there were 15 "Jingtai enamel shops" in Beijing, specializing in cloisonne products. In 1950, Beijing Enamel Factory was built in the south of the Temple of Heaven, and the road next to the factory was named Jingtai Road.

　　Chongwai is known as the hometown of handicrafts and the birthplace of many handicrafts in Beijing. The "Hundred Workshops" established a few years ago confirmed the prosperity of Chongwai handicrafts. Before 1990, there were glassware factories, feeder products factories, art red light factories, craft woodcarving factories, jade factories, theatrical outfitting factories, etc. Many handicraft factories gathered in the same area, which explained the origin of industrial and commercial halls in Chongwai area from the side. (Zhang Shuanglin)

　　In order to ensure that critically ill patients can receive timely priority treatment, the reporter learned from the Beijing Municipal Hospital Administration that from May 1, 2019, 20 Beijing-owned hospitals providing emergency services will uniformly implement emergency pre-examination and triage ("emergency classification").

　　According to the former Ministry of Health’s Guide to the Construction and Management of Emergency Department (Trial) (Wei Yi Zheng Fa [2009] No.50) and the national health industry standard "Standardized Process of Hospital Emergency Department" (WS/T390-2012), it is clearly put forward that "emergency departments should formulate and strictly implement triage procedures and triage principles": patients should be divided into "endangered, critical, emergency and non-emergency" 1.

　　Level 1 patients are in critical condition and may be life-threatening at any time, and immediately enter the resuscitation room or rescue room for rescue. Such as cardiac arrest, shock, definite myocardial infarction, status epilepticus, body temperature > 41℃, systolic blood pressure < 70mmHg, blood sugar < 3.33mmol/L, etc.

　　Grade 2 patients are critically ill or rapidly deteriorating and life-threatening, and enter the rescue room for treatment within 10 minutes. Such as severe dyspnea, lethargy, acute stroke, ECG suggesting acute myocardial infarction, active or severe blood loss, etc.

　　Grade 3 patients are in an urgent condition and have potential life threats, and priority is given to diagnosis and treatment before grade 4 non-emergency patients. Such as acute asthma, foreign body inhalation, dysphagia, persistent vomiting, chest and abdominal pain, mild and moderate trauma, mild and moderate bleeding, etc.

　　Grade 4 patients are non-emergency, and the degree of illness is average. According to the guidelines, the waiting time is longer. Such as mild pain without dangerous features, minor abrasions without suture, follow-up visit of patients in stable recovery period, and only issuing medical certificates.

　　How to achieve scientific classification and give consideration to fairness and safety? According to reports, first of all, the emergency departments of all hospitals have arranged experienced personnel to engage in emergency pre-examination and triage, and organized all medical staff related to emergency to conduct special training for all staff; Secondly, the most important basis for grading is the collection of patients’ vital signs by professional instruments, including heart rate, blood pressure, blood oxygen saturation, etc., and the medical staff will combine the patient’s medical history, symptoms and signs to make the final scientific grading and subordinate to the specialty; Third, professionals monitor the condition of patients in the waiting area. For Grade 3 and Grade 4 patients, when waiting in the waiting area, there will be specialized medical personnel to patrol regularly to dynamically evaluate the condition and potential risks of the patients waiting for treatment, and they can be graded again according to the latest evaluation to ensure the safety of patients. If the patient has sudden discomfort, please inform the medical staff in time so as to take corresponding medical care measures in time.

　　20 municipal hospitals providing emergency services:

　　1. Beijing Friendship Hospital affiliated to Capital Medical University

　　2. Beijing Tongren Hospital affiliated to Capital Medical University

　　3. Beijing Chaoyang Hospital affiliated to Capital Medical University

　　4. beijing jishuitan hospital

　　5. Beijing Tiantan Hospital affiliated to Capital Medical University

　　6. Beijing anzhen hospital affiliated to Capital Medical University.

　　7. Beijing Millennium Monument Hospital affiliated to Capital Medical University

　　8. xuanwu hospital of Capital Medical University

　　9. Tsinghua Chang Gung Memorial Hospital.

　　10. Beijing Hospital of Traditional Chinese Medicine affiliated to Capital Medical University

　　11. Beijing Children’s Hospital affiliated to Capital Medical University

　　12. Children’s Hospital Affiliated to Capital Institute of Pediatrics

　　13. Beijing Maternity Hospital affiliated to Capital Medical University

　　14. Beijing Chest Hospital affiliated to Capital Medical University

　　15. Beijing Stomatological Hospital affiliated to Capital Medical University

　　16. Beijing You ‘an Hospital affiliated to Capital Medical University

　　17. beijing ditan hospital affiliated to Capital Medical University.

　　18. Beijing Anding Hospital affiliated to Capital Medical University

　　19. Beijing huilongguan hospital

　　20. Beijing Geriatric Hospital