來源：國是直通車
急需各國加大響應力度
針對當前備受國際關注的歐洲抗擊新冠肺炎疫情進展以及不同國家採取的防疫策略，世界衛生組織歐洲區域辦事處高威脅性病原體團隊負責人理察·皮博迪博士（Dr. Richard Pebody）當地時間16日獨家接受中新社國是直通車記者專訪表示，不存在一種適合所有國家的防疫模式，每個國家應該做的是實施最適合其自身情況的措施。針對德國較低的病死率，他特別提醒，除義大利外的其它歐洲國家疫情發展還處在較為早期的階段。「這部分國家也許會在接下來數日或數周經歷死亡病例增多。」
世衛組織總幹事譚德塞本月13日指出，歐洲現在已經成為大流行疫情的中心，報告的病例和死亡人數超過了除中國以外世界其他地區的總和。世衛組織歐洲區域辦事處截至歐洲中部時間16日23時的數據顯示，歐洲國家累計確診人數已達63268人，死亡2755人。
位於丹麥哥本哈根的世衛組織歐洲區域辦事處負責歐洲地區50個國家。皮博迪當天遠程接受了中新社國是直通車記者專訪。
皮博迪核心觀點如下：
防疫不存在「適合所有腳的鞋子」，各國只能因地制宜
德國病死率低可能因其疫情處在早期，需要密切關注接下來數日到數周發展
當前急需各國加大響應力度、檢測力度、減緩傳播的力度
每個人做出自己的貢獻同樣重要
談中國派專家組赴義大利：事實證據和已經取得的經驗教訓將幫助我們戰勝這場大流行病和未來的大流行病
採訪實錄（中英文對照）如下：
國是直通車：世衛組織日前宣布將新冠肺炎疫情定性為大流行，這一定性是否會對歐盟及其成員國對新冠肺炎暴發的應對產生影響？
答：將新冠肺炎COVID-19疫情定性為「大流行」並未改變世衛組織給各國和個體的相關建議。這一定性提供的只是一種程度更強的提醒，敦促各方採取必須採取的行動。
國是直通車：在2月26日於羅馬舉行的世衛、歐盟和義大利三方會議期間，歐盟委員會衛生與食品安全事務委員斯泰拉·基裡亞基季斯曾表示「我們已要求歐盟成員國重新評估其應對大流行病的預案以及從診斷、化驗到追蹤接觸者在內的整體醫療能力，並將評估情況和實施計劃上報歐盟」。從世衛組織的角度來看，歐盟成員國目前更新它們各自的大流行病預案的情況如何？
答：世衛組織持續地與所有國家保持合作，幫助它們維持和提示各自的國家大流行病預案。
世衛組織歐洲區域辦事處派出的技術團隊已被部署至義大利、亞塞拜然、烏克蘭、黑山和亞美尼亞等國。我們正持續以遠程或現場的方式為它們提供著有針對性的協助，具體採取何種形式取決於目前條件下的旅行通達性。世衛組織已編制了內容豐富、涉及防疫工作所有領域的技術指南。我們正在支持每一個國家制定防疫技術方案，並在一個強有力的全國性策略框架下落實最迫切的行動內容。
世衛組織歐洲區域辦事處同時也在響應新冠肺炎（COVID-19）疫情的各個層面與歐盟和歐盟疾控中心（ECDC）開展著緊密的合作。
位於哥本哈根的世衛組織歐洲區域辦事處。圖據WHO/Europe
國是直通車：世衛組織在歐盟國家應對疫情方面有無推薦的「最佳實踐」或者最佳模式？還是說每個國家都不一樣？
答：不存在一種「適合所有腳的鞋子」式的模式。每個國家的衛生體系都不相同，它們的人口結構也各不相同——因此，每個國家是根據它們的本國情況以及疫情在它們的國家和地區所處的階段去決定採取何種行動。每個國家應該做的是，實施最適合其自身情況的措施，這些措施是與當地情況相結合的。
國是直通車：德國的新冠肺炎死亡率與義大利比起來相當的低。甚至與法國和西班牙相比，德國也是非常低的。您如何解讀這一差異？這是反映歐盟各國公共衛生應急能力的落差，還是說由於上面提到的防疫模式之別所致？（註：德國疾病防控機構羅伯特·科赫研究所數據顯示，截至當地時間3月16日15時，德國共確診6012例新冠病毒肺炎感染病例，其中死亡病例13例。據此計算，死亡率為0.2%。而義大利的死亡率達到7.3%，全球平均死亡率為3.7%。）
答：為了戰勝這種新型病毒，現在急需各國加大對病毒威脅的響應力度，加大檢測力度，也加大減緩病毒傳播的力度，以拯救人們的性命。在當前的階段，每個個體也參與到這一抗擊疫情的努力中，作出自己的貢獻也非常關鍵。特別是，我們鼓勵公眾遵循所在國家的衛生部門的指南，並且為他人提供幫助。
世衛組織同時提醒人們要警惕對流行病學數據的解讀，這其中包括不同國家之間的病死率（case fatality rate）差異。具體到COVID-19新冠肺炎，那些因為感染這種病而去世的病人平均是在兩到三周前被感染的。義大利的疫情暴發和發展要比歐洲其它地方開始得更早，因此出現了更多的病人來到上述的關鍵周期，這時他們要麼治癒出院，要麼不幸離世。其它歐洲國家疫情發展所處的還是一個早期階段。這部分國家也許會在接下來數日或數周經歷死亡病例增多。
同時，病死率也可能受到病例年齡分布影響——70歲以上的感染者死亡率最高。在大流行病的早期階段，出現有更多處於工作年齡的成年人被感染也是可能的。這是因為大流行病還沒有從他們身上傳播到老年人群，後者的病死率更高。
最後，對疑似病例檢測的覆蓋程度也將影響病死率數字。不同國家的檢測體系決定了它們發現確診病例的能力不盡相同。如果不是所有感染者都被發現並確診（特別是排除了輕症患者）的話，這就會影響到病死率。
國是直通車：中國已向義大利派出一隊抗疫醫療專家組，幫助當地抗擊疫情。歐洲是否能夠、或者應該從中國抗疫中學習任何經驗？如果有的話是什麼？
答：這是一種新的病毒，且形勢正在快速演變發展。世衛組織專家和其它各方都正在爭分奪秒地搜集、整理和傳播針對這種病毒的研究成果和抗擊疫情前線的信息，這是為了讓我們對這種病毒了解得更充分，也持續地改進每個國家作出的響應。事實證據和已經取得的經驗教訓將幫助我們戰勝這場大流行病和未來的大流行病。
Q: Which impact will WHO's announcement have on the EU and its member states fighting against the coronavirus outbreak?
A: Calling COVID-19 a pandemic does not change WHO’s advice to countries and individuals. What it does do is provide a stark reminder for implementing needed actions.
Q: During the last meeting in Rome on 26 February 2020, the EU Commissioner Kyriakides has told that "we have requested Member States to review their pandemic plans as well as health care capacities, including capacity for diagnosing, laboratory testing and procedures for contact tracing. All Member States need to inform us about their preparedness plans and how they propose to implement them"
From WHO's perspective, how well have the EU member states updated their plans so far?
WHO works continually with all countries to maintain and improve their national preparedness plans.
A: WHO/Europe technical missions have also been deployed to Italy, Azerbaijan, Ukraine, Montenegro, Armenia. We are continuing to provide tailored assistance remotely or on-site depending on the possibility of travelling in the current context. WHO has developed an abundance of technical guidance in all areas of work: we are supporting each and every country to develop technical plans and implement priority actions in the framework of a strong nationwide strategy.
WHO/Europe also works closely with the European Union and the European Centre for Disease Control on all aspects of the COVID-19 response.
Q: Does WHO have any recommendation on which model would be the best for most countries in the EU to follow or it just varies from country to country?
A: There is no one-size-fits-all approach. Every health system is different, the demographics are different so each country takes action according to their national context and the stage the outbreak has reached in their area. Every country should decide to implement the most appropriate measures adapted to the local contexts.
Q: The coronavirus death rate in Germany is quite low so far compared to the rate in Italy. And even compared to the death rate in France or Spain, the rate in Germany is still very low. How do you interpret this difference? Does it reflect a gap of public health capabilities among the member states? Or is it because of the difference in approach as mentioned above?
A: To fight this new virus, there is now a great need for countries to scale up response to treat, detect and reduce transmission to save people’s lives. At this stage it is also critical that everybody join the efforts and do their part. In particular, we encourage citizens to follow guidance from health authorities and reach out to support others.
WHO also urges caution in interpreting epidemiological numbers, including differences in the case fatality rates between countries. In the case of COVID-19, patients who pass away from the disease were infected 2-3 weeks previously on average. The outbreak in Italy has been evolving for longer than other places in Europe and therefore more patients will have completed their final outcome and either been discharged or sadly passed away. Other European countries, who are earlier in the epidemic, may well begin to experience deaths in the coming days and weeks. The case fatality rate can also be affected by the age profile of cases; deaths usually occur in the elderly (>70 years).
In the early stages of the epidemic it is possible that more cases occur among working age adults before the epidemic spreads to older populations, where the case fatality is higher. Lastly, the sensitivity of case detection will make a difference, and national surveillance systems may vary in their ability to detect cases. If not all cases, particularly excluding the milder cases, are being detected then this will affect the case fatality ratio.
Q: China has sent an anti-epidemic expert team to Italy to help fight COVID-19. Could or should Europe learn anything from China? If so, what is it?
A: This is a new virus and a rapidly evolving situation. WHO experts and others are working around the clock to collect, compile and disseminate research findings and information from the field, to learn more about the virus and continuously improve each country’s response. Evidence and lessons learned will help us beat this and future pandemics.
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