How can a nucleic acid test company run by loan and some people queue for a few hours. How to avoid excessive testing?

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Normalization of nucleic acid detection has been promoted for a while

Its influence on ordinary people's daily life

The burden on fiscal expenditure and

The challenge to the nucleic acid detection industry has been revealed

Beginning at the end of May, Henan has successively launched the province's normalized nucleic acid testing. "In principle, every 48 hours" in the province completes at least one nucleic acid testing, otherwise it will be popcorn or yellow code, and it will not enter public places and take public transportation.

Although the "battery life" cycle is 48 hours, due to the slow results, the interval between local residents for two nucleic acid detection is far shorter than this time. Xu Wenjun, who works in Zhengzhou, originally worked at 10 am. Now he wants to do nucleic acid at 7:30 in the morning and do it again the next afternoon. "It takes at least an hour to do nucleic acids every day." From June 5th, Zhengzhou has not appeared in the new crown local cases for nearly 10 days.

On June 9, at the press conference organized by the joint prevention and control mechanism of the State Council, He Qinghua, a first -level inspector of the National Health and Health Commission's CDC, pointed out that "there is no epidemic and no risk input (region). A normal state. "

Normalization of nucleic acid detection has been promoted for a while. It has the impact on the daily life of ordinary people, the burden on fiscal expenditure, and the challenge to the nucleic acid detection industry, which has been revealed.

Even if normalized nucleic acid testing is carried out, the epidemic is not as easy to discover and control as it wants. As of June 6, in addition to individual areas, many regions in Beijing have achieved more than 7 days of society. Beginning this day, Beijing resumed dignitaries and demanded the time limit of nucleic acid negative proof from 48 hours to 72 hours. But just three days later, Beijing reproduced the clustered epidemic: 00:00 on June 9th to the present, the cumulative report of more than 200 infected people in the gathered epidemic involved in the heavenly supermarket bar.

On June 11, residents participated in nucleic acid testing at a nucleic acid testing point at Balizhuang Street, Chaoyang District, Beijing. Picture/Xinhua

Out of the clinic, work, cut wheat, first light up the nucleic acid

After being "sullen" two months later, from June 1, Shanghai has resumed work and re -production, and the Shanghai International Varicose Center where vascular surgery Zhang Qiang is located has also begun to take over.

"But now there are new problems." The next day, he said when he shared the resumption of work on social media that the soreness was arranged for an hour team on June 1st. Find other places to measure acid.

He said that if the nucleic acid report is not uploaded in time, the doctor's work will be affected, especially when encountering an urgent consultation. Patients should also prepare for a 48 -hour nucleic acid negative certificate to see the doctor. Many patients lined up for two or three hours to do nucleic acid the day before. Another problem is that if the hospital has been treated for a long time, the nucleic acid will expire. What should I do if the patient goes home to take a bus and the subway? He lamented that the detection of nucleic acid detection may have a great impact on resumption.

According to Shanghai's requirements, from June 1, entering public places with clear epidemic prevention and public transportation personnel must hold 72 hours of kernel acidic acid test negative proof. Even if you do n’t go out, according to the latest regulations on June 10, before July 31 this year, you are required to perform at least 1 nucleic acid testing per week. Essence

Nucleic acid testing began to invade public daily life. On the day of the Dragon Boat Festival on June 3, Xu Wenjun did not need to go to work. The original voice could be "rest for a day", but because he went to the supermarket to shop in the afternoon. Many people have also encountered the following scenes: make an appointment with friends to enter a restaurant, because they forget to be blocked in time for nucleic acids; they come to the park with great interest, and the results of the failure nucleic acid will once again defeat the public.

Recently, a video circulating on the Internet shows that a villager in a place in Henan rushed back to his hometown. When he was ready to start harvesting wheat, the village secretary suddenly ran over. Essence The person in charge of the relevant departments of the Ministry of Agriculture and Rural Affairs subsequently said in an interview with the media that he had paid attention to the situation that the video reflected and asked the relevant provinces to carefully check it. What are the problems to solve?

On May 31, Siping City, Jilin Province also released the "strictest" nucleic acid order in history. At 6:00 to 17:00 on June 2nd, the local urban residents' nucleic acid testing was launched in the local area. If you have not participated in nucleic acid testing personnel twice, Siping City will detain its administrative detention for 10 days, fined 500 yuan, and includes the personnel in the list of dishonesty personnel.

As part of the normalization strategy of nucleic acid detection, many cities are undergoing a "15 -minute nucleic acid circle". But in practice, it is not so simple to build a nucleic acid circle.

After experiencing normalized nucleic acids on the first day of chaos, on June 2, the person in charge of the Shanghai epidemic prevention and control nucleic acid screening apologized to the citizens, saying that a series of measures should be taken next to Service time and so on. But the situation has not improved completely. A Shanghai citizen said on June 8 that the nucleic acid sampling time of non -working hours is still very long, about an hour.

The citizen told China News Weekly that he made an appointment to go to the outpatient consultation of the Cancer Hospital of Fudan University on the morning of the day. Because he took 48 hours of nucleic acid, he went to the nuclear acid at 11 am on June 6. However, the results of nucleic acids did not come out until the afternoon of June 8th, which caused him to fail to be admitted to the hospital that morning. He could only re -make an appointment and make nucleic acid. On the one side is the 100 billion market, on the other hand, the cash flow loss

In the early stages of the new crown epidemic, the third -party medical inspection laboratory industry ushered in its high light moment. Testing a sample, which has been charged up to 200 yuan. In 2020, the industry leader Jinyu medicine increased by 56.5 % and 275.24 % over the previous year on the two financial indicators of operating income and net profit. In 2021, the above two indicators still had 44.88 % and 47.03 % compared with the same period, respectively. increase. The revenue and net profit of Huada Gen in 2020 increased by 200 % and 656 % year -on -year, respectively.

Nowadays, although the detection price of nucleic acid decreases again, the market size is not small because of the huge amount of detection. According to the calculation of Pacific Securities, it is assumed that the large -scale nucleic acid test is 10: 1 mixed inspection. The mixed detection unit price is 3.4 yuan/person, and an average of 8 per person per month per person. The market size reached 15.4 billion yuan, and 92.2 billion yuan in half a year.

However, in the industry, third -party testing agencies entering the market tell the other side of the story. For many enterprises, there is not much profit space for nucleic acid testing business now, or even losses; because the government's repayment cycle is slow, the theoretical 100 billion market revenue is still like "water in the water". According to industry analysts, it is difficult to calculate how much each person's single inspection and mixed inspections are charged separately, which is the profit and loss point for third -party testing companies to carry out the business. In addition, facilities such as sampling kiosks to buy, personnel wages, and large amounts of nucleic acid detection will cause the company to conduct different costs of nucleic acid detection.

A number of industry people told China News Weekly that taking Shanghai's nucleic acid testing agency as an example, since the epidemic occurred in these two or three months, the local nucleic acid test was launched in the local area. However, there are still many companies that have not received the payment, and some have to rely on loans or other business income to operate.

Judging from the financial report of the listed company participating in nucleic acid testing, many companies have risen the amount of accounts receivable in the past two years. Taking the head enterprise Jinyu Medicine as an example, as of the end of 2021, the accounts receivable of Jinyu Medical's book reached 4.665 billion yuan, an increase of 73.15 % year -on -year. Among them, the account receivable period within one year was 4.6 billion yuan, accounting for 95.7 %. Similarly, Lan Wei Medicine also mentioned in the 2021 annual report that the company's account receivables increased by 54 % year -on -year, mainly due to the rapid growth of the reporting business, and the long period of large screening nucleic acid detection business.

In the new year, the situation is even more severe. In the first quarter of 2022, the net operating cash flow of Jinyu Medicine was 090 million yuan, a decrease of 96 % from the end of 2021. Another leading company Di'an diagnosed the operating cash flow directly from the positive turn, from 2021, from 2021 The net inflow at the end of the year was 1.318 billion yuan, which became a net outflow of 973 million yuan.

Qian Mingdong is an industrial investor in the field of in vitro. He told "China News Weekly" that in the early stages of the new crown epidemic, among the earliest batch of companies that joined the new crown nucleic acid testing business, some of the high -end testing projects originally represented by molecular diagnosis were carried out. The assembly line type test project was later launched by some companies.

Wu Sen is the founder of a medical inspection company. Its company originally provided tumor gene testing services. After the new crown epidemic, in order to maintain the company's operation, he used the new crown nucleic acid detection business. He told "China News Weekly" that the new crown testing has high requirements for cash flow, and it is even more so after entering normalized testing, and now this business has basically not made money.

The same challenge is also a medical institution. The leaders of a second -level hospital in a local city at a prefecture -level city in Henan introduced to China News Weekly. Since June 4, the local nucleic acid test has also been launched. Three -party testing company. However, fund settlement is not timely.

Prior to the normalized nucleic acid detection, in March and April this year, eight rounds of large -scale nucleic acid tests had been launched. These were free nucleic acid testing and the municipal government shall bear the corresponding costs. However, as the main local testing agency, the hospital needs to pay for testing agents, protective clothing, masks and other consumables, which has spent millions of yuan, but now, the government has not settled. According to the provisions of the purchase volume, consumables such as reagents need to pay accounts within 30 days. The leaders of the aforementioned hospital also emphasized that the Municipal Health and Health Commission has been actively coordinating. Recently, the municipal government has reported to the municipal government. The hospital should soon receive a funds.

On May 23, in Guangzhou, Guangdong, normalized nucleic acid testing was carried out in many places in the urban area. Figure/People's Vision

How to do normalize?

After Beijing entered the normalized nucleic acid test, the testing agency had a lot of work. A staff member of the Beijing Municipal Health Commission introduced that the nucleic acid detection point is basically district management. Generally, the streets and communities in various districts and communities will set up how many nucleic acid detection points are set up in accordance with the surrounding residents and buildings. The health committee reported. According to the Beijing Daily reported on June 1, the testing agency considers that its own ability to detect volume has become more and more cautious about opening new nucleic acid detection points, and it is easy to lead to less detection points in some areas. Wu Sen said that after the normalization, the average daily sample volume received by the current day is nearly half less than half of the staff, because considering that the demand for the detection of the new crown nucleic acid may be maintained for a period of time, especially in Beijing, such as ten million levels such as Beijing, such as 10 million levels in Beijing The big city of population, so the company will not reduce the sampling point for the time being. However, the ideas of each company are different, and the cash flow has different abilities.

New crown testing is normalized to test the operation and management capabilities of the company. After normalization, people are becoming more and more sensitive to the time for detecting the results. Many local governments require that the testing agencies should strive for reports within 6 hours. However, it is not easy to do this.

A third -party nucleic acid testing enterprise managers in Shanghai have talked that when the residents were screened in the past, the sampling points and the number of inspections were relatively fixed, and the large -scale samples were sent away to the laboratory at a certain time point. However, normalized nucleic acid detection is different from large sieves. Residents choose time testing. There are some periodic periodic periods, and sometimes no one is empty, which reduces the efficiency of sample collection, transfer and inspection.

Qian Mingdong analyzed that some nucleic acid testing laboratories spent a lot of recruitment and training cost expansion experiments in the early days. Nowadays, due to the unstable sample samples of the new crown, large screening will occur from time to time, and it is difficult for enterprises to always equip personnel in accordance with the highest peak business volume. The solution is more inclined to deal with the peak from the three classes that are changed from two classes to radical. But even so, the public will complain that the results are slow.

It is necessary to save costs and maintain survival in the case of micro -profit, but also add progress according to the requirements. Under the seams, some nucleic acid testing agencies have to "take risks". Qian Mingdong said that there may be inferior coins to expel good coins in the industry. According to his understanding, the daily detection capacity of nucleic acid testing agencies is 50,000 to 60,000 pipes, but in a certain total nucleic acid, the government requires it to complete the sample samples of about 200,000. Detection of illegal methods of mixed inspections. This is also recently the illegal operation of some nucleic acid testing agencies.

At present, the nucleic acid testing industry is in strict supervision. According to the data provided by Li Ang, deputy director of the Beijing Municipal Health and Health Commission, in Beijing, in Beijing, in the past two weeks, the urban health department has carried out 622 secondary supervision and inspections on the third -party testing laboratory. The State Council's Epidemic Control and Control Comprehensive Group also proposed six aspects of supervision on June 1, including the qualification management of strict testing institutions and personnel, the collection and preservation and transfer management of samples, and strengthening the daily supervision and management of nucleic acid detection agencies, strengthening, and strengthening the nucleic acid detection agency, and strengthening the nucleic acid testing agency. Supervision of nucleic acid detection agencies under emergency state.

In the recently announced flight inspection of the medical insurance fund announced by the National Medical Insurance Administration and other departments, the recruitment of new crown virus nucleic acid and antigen testing costs in violation of regulations also included in the scope of inspection. Pharmaceutical strategic marketing expert Shi Lichen said in an interview with the media that the feet test added nucleic acid and antigen testing in some reason for some regions to pay nucleic acids or antigen tests with medical insurance funds. In addition, nucleic acid detection chaos should also be within the scope of being investigated. In some places, nucleic acid testing has formed interest groups.

In Qian Mingdong's opinion, fiscal expenditure may not be the biggest challenge in the normalization of nucleic acids. What's more difficult is that because of the impact and impact on offline business activities, neither merchants and consumers are unwilling to cooperate with participating in sampling and checking nucleic acids.

At the grassroots level, normalized nucleic acid testing has affected the development of the normal work of health institutions. According to media reports, in some grass -roots health service centers in Zhengzhou, due to insufficient personnel, all staff need to sample, and the basic business is almost paralyzed. A community health service center undertakes the sampling work of about 30 nuclear acid sample pavilions nearby. Each pavilion dispatched at least two staff members, and sent nearly 60 or seventy people a day, accounting for nearly half of the community health service center.

"I think the normalization of nucleic acids has reached a balance, and now all parties are exploring. Everyone wants the real 'normalization'." An industry person said that if you do not solve the payment problem as soon as possible, there are not many enterprises that can Carry the debt and continue to support nucleic acid testing.

Policies have been changing. As an example, the previous industry person in Shanghai as an example. According to the latest news on June 11, free normalized testing will be extended to July 31st. After that, what will this business be like, whether people are willing to test it at their own expense. It is unknown how to arrange and dispose of the recruiting personnel and the sampling kiosk purchased.

Wu Sen admits that the operation of the company's nucleic acid testing is very difficult now, and his company has already started loan. Because of the risk of policy changes, he could not plan the company how long to conduct testing tasks. He said, it may be when it is unable to do.

Checking nucleic acids should not be the norm

From the perspective of health economics, many public health experts have stated that compared with the economic losses caused by large -scale and long -term control, using normal nucleic acid detection to achieve early discovery and early action is more cost -effective in the medium and long term. Strategy. However, as Zhao Hong, a professor of China University of Political Science and Law, wrote recently, the economic cost of all -level nucleic acid consumption can be seen by the naked eye. However, how governments at all levels pay this expenditure have rarely expressed their explanation, and it is unknown whether it meets the budget requirements. Frequent nucleic acid testing and counterfeiting incidents, heavy negatives caused by ordinary individuals, and high law enforcement costs paid by the government to promote normalized nucleic acids, etc., all have caused us to think: how to scientifically determine the frequency of detection and scope of screening, not to cause nucleic acid Detecting the waste of resources due to normalization, and the effect is slightly excessive?

From the end of May, Zhengzhou City, which started normalized testing, was added in the week from May 30th to June 5th, with a total of 1 newly confirmed cases and 3 asymptomatic infections. In the same period, a total of new in Henan provinces added a total of new provinces. There are 3 cases of local diagnosis and 8 asymptomatic infected. From June 5th to the present, there are no new infections in Henan.

He Qinghua, a first -level inspector of the National Health and Health Commission's Disease Control Bureau, pointed out that low -risk areas, low -risk people, and long -term home groups are not necessary to perform frequent nucleic acid testing. The focus of nucleic acid detection should be placed in high -risk groups and staff of high -risk positions. And areas with outbreaks.

How to understand the risk of a regional more specifically? The group leader of the Shenzhen Epidemic Prevention and Control Public Health Expert, Lu Hongzhou, Dean of the Third People's Hospital of Shenzhen, said in an interview with China News Weekly that high -risk groups, including medical staff, isolation hotel staff, and the cold chain industry practitioners , Shipping industry, port and customs staff, should adhere to high frequency regular screening. However, for ordinary people, there is no need to perform normalized nucleic acid testing on a large scale.

Nucleic acid detection positive results are still the gold standard of diagnosis. However, at the same time, Jin Dongyan, a professor at the School of Biomedicine at the University of Hong Kong, believes that compared to nucleic acid testing of social life and economy, low -cost and convenient antigen testing should be more important. He analyzed that normalized nucleic acid testing is basically mixed. Unlike the early epidemic of Wuhan epidemic, the virus content of Omikon infection is low, and most of them are asymptomatic infections. After dilution of mixed examinations, the number of missed inspections will increase. Although the sensitivity of the antigen detection is lower than the nucleic acid detection, it is also better than the sensitivity of this mixed test.

Jin Dongyan said that if a person is a new crown infection, as long as the antigen is used for 5 days to 7 days, positive results will definitely occur. If the results are negative, the infection can be excluded. Antigen detection also appears "false positive". In this case, the first -test -positive person can do a nucleic acid detection again and can also be excluded.

According to the latest guidelines from the US Centers for Disease Prevention and Control, the test of the new coronal virus is divided into three types, diagnostic testing, antigen detection, and public health monitoring testing. For different detection purposes, different detection methods are used, such as mixed inspections can be used in screening detection; antigen detection is used for new coronary virus screening in gathered places such as nursing homes, dormitories, and shelters. In this case, in this case , Quickly detect and take results. However, the results of the antigen detection require further confirmation of professional public health and medical personnel.

Jin Dongyan suggested that the frequency of antigen detection should also be determined according to the risk of epidemic conditions. For some key and high -risk groups, such as medical groups, they can be tested every day and the cost can be acceptable. In addition, some people can conduct antigen tests randomly, and use statistical methods to judge social infection. For example, through regular random checks, you can understand the risk of the epidemic in the community where they are located; or randomly draw a thousandth of households in the community for testing, which can also calculate the virus infection rate. From February, Hong Kong has randomly draw 10,000 people from 18 administrative communities every day for antigen testing. As a result, its results can reflect the basic situation of virus infections in the community.

In cities where sporadic infections occur, citizens can continue to test antigen for a period of time until there is no risk.

Some provinces in China have relaxed the requirements for nucleic acid detection. On June 2nd, Jiangxi Province first proposed that personnel between low -risk areas and counties (cities, districts) without local epidemics can flow freely and orderly, no longer check nucleic acid detection negative proof, and no nucleic acid targets are not implemented; June will not be implemented. On the 7th, Zhejiang and Gansu also introduced prevention and control measures similar to mobile personnel. Jiang Qingwu, a professor at the School of Public Health of Fudan University, believes that, in the case of high proportion of people with asymptomatic infections in various places today, it is necessary to consider more scientific and effective nucleic acid testing strategies and a series of anti -epidemic measures, and should not be tested.

(At the request of the interviewees, Xu Wenjun, Qian Mingdong, and Wu Sen in the text were pseudonym.)

Send 2022.6.20 Total Issue 1048 "China News Weekly"

Magazine title: How to do normalize the detection of new coronary nucleic acid?

Reporter: [email protected])

Edit: Du Wei

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