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面對新型冠狀病毒：已知與未知
08:07來自不認真說事兒
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中英文稿
[As of the morning February 27, 2020, there were at least 82,000 confirmed cases worldwide of the coronavirus and 2,810 deaths from it. TED invited Dr. David Heymann to share the latest findings about the outbreak.]
[ 截止 2020 年 2 月 27 日， 全球新冠肺炎確診 82000 多例， 其中死亡病例為 2810 個。TED 邀請了大衛 · 赫曼醫生分享 對於本次病毒爆發的最新發現 ]
[What happens if you get infected with the coronavirus?]
[ 如果你感染了新冠病毒， 症狀是什麼？]
This looks like a very mild disease, like a common cold, in the majority of people. There are certain people who get infected and have very serious illness; among them are health workers. It's a very serious infection in them, as they get a higher dose than normal people, and at the same time, they have no immunity. So in the general population, it's likely that the dose of virus that you receive when you are infected is much less than the dose that a health worker would receive, health workers having more serious infections. So your infection would be less serious, hopefully. So that leaves the elderly and those with comorbidities to really be the ones that we have to make sure are taken care of in hospitals.
大多數人的症狀顯得輕微， 就像普通的感冒。但有一些感染者， 會表現出非常嚴重的症狀， 這些人中包括醫護人員。對他們來說， 這種感染非常嚴重， 因為他們接觸的病毒量 比起普通人要高得多， 與此同時， 他們沒有足夠的免疫力。在普通人群中， 大致上你受感染時接觸的病毒量 遠低於一位醫護人員 所接觸到的病毒量， 許多醫護人員會遇到 更嚴重的感染。所以普通人若被感染， 也不會特別嚴重，但願如此。剩下的就是老人和患有併發症的人， 他們是我們必須確保 得到醫院治療的人。
[Who are the people who should be most concerned about this?]
[ 哪些人特別需要重視這個病毒？]
Well, the most concerned are people who are, first of all, in developing countries and who don't have access to good medical care and may not have access at all to a hospital, should an epidemic occur in their country. Those people would be at great risk, especially the elderly. Elderly in all populations are at risk, but especially those who can't get to oxygen. In industrialized countries, it's the very elderly who have comorbidities, who have diabetes, who have other diseases, who are at risk. The general population doesn't appear to be at great risk.
最應該重視此事的人， 首先是那些處於發展中國家， 缺少優質醫療資源， 甚至可能無法前往醫院的人。當流行病毒波及他們的國家時， 他們需要特別注意。那些人，特別是其中的老年人， 將面臨高風險。所有人口中的老年人都面臨風險， 尤其是那些無法得到氧氣供應的人。在工業化國家， 那些有併發症、 糖尿病和其他疾病的老年人 都面臨風險。現在看來， 普通人群則風險不大。
[What pre-existing medical conditions put people at higher risk?]
[ 有哪些既存病症會使人們 面臨更高的感染風險？]
First of all, pulmonary disease existing as a comorbidity is also important. In general, the elderly are at greater risk, especially those over 70, because their immune systems are not as effective as they might have once been, and they are more susceptible to infections. In addition, in some instances in China, there's been a coinfection with influenza and at the same time, there have been some bacterial superinfections on the pneumonias that are occurring.
首先， 已患有肺病併發症的人 要引起重視。總體來說， 老年人患病風險是最高的, 特別是 70 歲以上的老人， 因為他們的免疫系統 不如年輕時那樣強健， 所以他們更容易受到感染。而且，在中國的一些病例 存在新冠和流感的共同感染， 與此同時， 還有肺炎上的 細菌重複感染。
[Where can we find up-to-date information?]
[ 我們能從哪裡獲得最新信息？]
The Center for Disease Control in Atlanta keeps track and has updates on a regular basis on its website. Also, the World Health Organization in Geneva, which is coordinating many of the activities going on internationally, also has a website with daily updates. It's our responsibility to get that information as individuals, so we understand and can make sure that we can contribute in our own way to prevention of major spread.
亞特蘭大的 疾病控制與預防中心（CDC） 會在它的網站上定期更新 追蹤到的疫情信息。位於日內瓦的世界衛生組織 正在協調全球同時開展的 許多行動， 也會在自己的網站上 每日更新。我們每個人都有責任 去獲取那些信息， 以便了解 並確知如何各盡所能 阻擋疫情的大範圍傳播。
[You led the global response to the SARS outbreak in 2003. How does this outbreak compare?]
[ 在 2003 年，全球抗擊 SARS 病毒的行動由你領導， 相對而言，如何評價 這次的疫情爆發？]
That's the same problem with all new infections. This is an infection that's coming to humans who have never been exposed to this virus before. They don't have any antibody protection, and it's not clear whether their immune system can handle this virus or not. This is a virus that usually finds itself in bats or in other animals, and all of a sudden, it's in humans. And humans just don't have experience with this virus. But gradually, we are beginning to learn a lot, as we did with SARS. And you know, there are certainly a larger number of deaths than there were with SARS. But when you divide that by a denominator of persons who are infected, there are many, many more persons infected than there were with SARS. The case fatality ratio, that is the ratio of deaths to the numbers of cases in SARS, was about 10 percent. With the current coronavirus, COVID-19, it is two percent or probably less. So it's a much less virulent virus, but it's still a virus that causes mortality, and that's what we don't want entering human populations.
所有的新型感染的問題都一樣。人類之前從未 暴露於這種病毒之中。人類沒有任何抗體的保護， 現在還無法確定 人體本身的免疫系統 是否可以抵抗這個病毒。這種病毒一開始 傳播於蝙蝠或其他動物之間， 突然，它出現在了人類中。人類對它沒有任何處理經驗。但漸漸的，我們開始整理出頭緒， 就像當時面對 SARS 病毒一樣。大家也知道，這個病毒的死亡人數 超過了 SARS 病毒。但是若用死亡人數 除以所有感染的人數—— 新冠感染人數也比 感染 SARS 病毒的人多—— 對比死亡率， 即死亡人數和確診人數的比例， 就 SARS 而言， 是 10% 左右。對於新冠病毒（COVID-19）來說， 現在的死亡率低於 2%。所以它是一種毒性偏低的病毒， 但仍是一種可致命的病毒， 我們非常不希望它進入人群中。
[Have we responded adequately at border crossings, such as airports?]
[ 我們在國家邊境做出的措施 還算及時妥當嗎？]
It's clearly understood that airports or any land borders cannot prevent a disease from entering. People in the incubation period can cross that border, can enter countries and can then infect others when they become sick. So borders are not a means of preventing infections from entering a country by checking temperatures. Borders are important because you can provide to people arriving from areas that might be at risk of having had infection, provide them with an understanding, either a printed understanding or a verbal understanding, of what the signs and symptoms are of this infection, and what they should do if they feel that they might be infected.
我們現在很清楚的認識到， 機場和其他的陸地邊境 並不能阻止病毒的入侵。處於潛伏期的病患 仍可以出入邊境， 出入國境， 並在病發後傳染他人。因此，若僅通過檢測體溫 防止病毒進入一個國家， 邊境限制並不算是一種防疫機制。邊境非常重要， 因為可以為那些 來自病毒高風險地區的人們 提供書面或是口頭的訊息， 讓他們了解感染病毒後 會產生哪些症狀， 若他們感覺自己可能被感染後， 可以採取什麼措施。
[What's the timeline for a vaccine?]
[ 現在疫苗研發的時間線是怎麼樣的？]
Vaccines are under development right now, there's a lot of research going on. That research requires first that the vaccine be developed, then that it be studied for safety and effectiveness in animals, who are challenged with the virus after they are vaccinated, and then it must go into human studies. The animal studies have not yet begun, but will soon begin for certain vaccines. And it's thought that by the end of the year, or early next year, there may be some candidate vaccines that can then be studied for licensing by regulatory agencies. So we're talking about at least a year until there's vaccine available that can be used in many populations.
目前相關疫苗正在研發當中， 很多研究正在進行。目標首先是研發出一種疫苗， 再是觀察研究疫苗在動物 身上的安全性和效力， 讓動物接種疫苗後 再接觸病毒， 然後必須進行人體研究。現在，動物試驗還未開始， 但馬上就會有幾株疫苗 開始進行試驗。我們期望在今年年底 或明年年初 完成針對一些備選疫苗的研究 並取得監管部門派發的使用許可證。現在可預計的是 至少需要一年的時間 才能研發出可被多人群接種的疫苗。
[What questions about the outbreak are still unanswered?]
[ 哪些有關疫情的疑問仍有待回答？]
It's clear we know how it transmits, we don't know how easily it transmits in humans, in communities or in unenclosed areas. We know, for example, that in the enclosed area of a cruise ship, it spread very easily. We need to better understand how it will spread once it gets into more open areas where people are exposed to people who might be sick.
現在我們清楚病毒的傳播途徑， 但我們還不知道病毒在人群中、 在社區中或是在未封閉環境中 有多容易傳播。我們知道的是， 在一個相對封閉的環境中， 比如說遊輪上，病毒傳播得非常快。我們需要更好的理解 病毒在更開放空間中是如何傳播的, 特別是當人們接觸到 可能感染的患者時。
[What about the global response could be improved?]
[ 全球對於病毒的應對有 哪些可以改進的地方？]
A major problem in the world today is that we look at outbreaks in developing countries as something that we need to go and stop. So when there's an outbreak of Ebola, we think "How can we go and stop this outbreak in the country?" We don't think about "How can we help that country strengthen its capacity, so that it can detect and respond to infections?" So we haven't invested enough in helping countries develop their core capacity in public health. What we've done is invested in many mechanisms globally, which can provide support to other countries to go and help stop outbreaks. But we want to see a world where every country can do its best to stop its own outbreaks.
當今世界上一個很嚴重的問題 在於，當我們關注 在發展中國家的病毒爆發時， 我們會想到要去當地消滅病毒。當伊波拉病毒爆發時， 我們想的是， 「我們如何在那裡阻止病毒的傳播？」 而不是 「我們如何幫助那個國家 提高整體醫療水平， 以有效檢測和應對感染?」 所以在幫助其他國家 提高公共醫療水平方面， 我們並沒有進行足夠的投資。我們所做的是 投資全球的許多應對機制， 從而為其他國家提供幫助， 阻止病毒的傳播。但我們更希望看到的是 所有國家 能儘自己最大的努力 來阻止病毒的爆發。
[Will we see more emerging disease outbreaks in the future?]
[ 在未來我們是否會經歷 更多的疫情爆發？]
Today, there are over seven billion people. And when those people come into the world, they demand more food, they demand a whole series of things and they live closer together. In fact, we're an urban world, where people live in urban areas. And at the same time, we're growing more animals, and those animals are contributing food to humans as well. So what we see is that that animal-human interface is becoming closer and closer together. And this intensive agriculture of animals and this intensive increase in human populations living together on the same planet is really a melting pot where outbreaks can occur and do occur. We will eventually have more and more of these outbreaks. So an emerging infection today is just a warning of what will happen in the future. We have to make sure that that technical collaboration in the world is there to work together to make sure that we can understand these outbreaks when they occur and rapidly provide the information necessary to control them.
今天，地球上有超過 70 億人口。人口增長帶來的是 對食物 和生活用品日益增長的需求， 而且在生活中， 人們彼此的距離會越來越近。現在的世界，是城市化的世界， 大多數人住在城市地域。與此同時，我們也飼養 越來越多的牲畜， 這些牲畜是人類的食物來源。我們發現， 動物和人類的交界 也在變得越來越近。畜禽集約農業 以及極速上升的人口 在同一個星球上共存， 這種大熔爐式的生活方式 讓疫情爆發成為了可能。這樣的疫情爆發還會越來越多。當今的疫情為未來將會發生什麼 敲響了警鐘。我們必須確保 世界範圍內的 技術合作 在病毒爆發時能夠幫助我們 了解疫情的發展， 並迅速提供必要的信息 進行有效防控。
[Is the worst behind us?]
[ 最糟的時候已經過去了嗎？]
I can't predict with accuracy. So all I can say is that we must all be prepared for the worst-case scenario. And at the same time, learn how we can protect ourselves and protect others should we become a part of that epidemic.
我無法準確回答這個問題。我能說的是，我們必須 為最壞情況做好準備。與此同時， 若我們被捲入這場疫情中， 要學會如何保護自己和他人。
[To learn more, visit: Centers for Disease Control and Prevention World Health Organization]
[ 了解更多，請訪問：疾病控制與預防中心官方網站， 國際衛生組織官方網站 ]
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