What we do (and don't) know about the coronavirus | David Heymann

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2020-03-05・ 7753    355


Visit http://TED.com to get our entire library of TED Talks, transcripts, translations, personalized talk recommendations and more. What happens if you get infected with the coronavirus? Who's most at risk? How can you protect yourself? Public health expert David Heymann, who led the global response to the SARS outbreak in 2003, shares the latest findings about COVID-19 and what the future may hold. Recorded February 27, 2020 The TED Talks channel features the best talks and performances from the TED Conference, where the world's leading thinkers and doers give the talk of their lives in 18 minutes (or less). Look for talks on Technology, Entertainment and Design -- plus science, business, global issues, the arts and more. You're welcome to link to or embed these videos, forward them to others and share these ideas with people you know. For more information on using TED for commercial purposes (e.g. employee learning, in a film or online course), submit a Media Request here: http://media-requests.TED.com Follow TED on Twitter: http://twitter.com/TEDTalks Like TED on Facebook: http://facebook.com/TED Subscribe to our channel: http://youtube.com/TED

Instruction

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00:12
[As of the morning February 27, 2020,
00:14
there were at least 82,000 confirmed cases worldwide of the coronavirus
00:17
and 2,810 deaths from it.
00:19
TED invited Dr. David Heymann to share the latest findings about the outbreak.]
00:22
[What happens if you get infected with the coronavirus?]
00:25
This looks like a very mild disease, like a common cold,
00:28
in the majority of people.
00:30
There are certain people who get infected and have very serious illness;
00:34
among them are health workers.
00:36
It's a very serious infection in them,
00:38
as they get a higher dose than normal people,
00:40
and at the same time, they have no immunity.
00:42
So in the general population,
00:46
it's likely that the dose of virus that you receive when you are infected
00:51
is much less than the dose that a health worker would receive,
00:54
health workers having more serious infections.
00:56
So your infection would be less serious, hopefully.
00:59
So that leaves the elderly and those with comorbidities
01:03
to really be the ones that we have to make sure
01:05
are taken care of in hospitals.
01:07
[Who are the people who should be most concerned about this?]
01:12
Well, the most concerned are people
01:14
who are, first of all, in developing countries
01:17
and who don't have access to good medical care
01:20
and may not have access at all to a hospital,
01:23
should an epidemic occur in their country.
01:26
Those people would be at great risk,
01:28
especially the elderly.
01:29
Elderly in all populations are at risk,
01:32
but especially those who can't get to oxygen.
01:35
In industrialized countries,
01:36
it's the very elderly who have comorbidities,
01:39
who have diabetes, who have other diseases,
01:41
who are at risk.
01:42
The general population doesn't appear to be at great risk.
01:45
[What pre-existing medical conditions put people at higher risk?]
01:50
First of all,
01:51
pulmonary disease existing as a comorbidity is also important.
01:55
In general, the elderly are at greater risk,
01:57
especially those over 70,
01:59
because their immune systems are not as effective
02:02
as they might have once been,
02:04
and they are more susceptible to infections.
02:07
In addition, in some instances in China,
02:10
there's been a coinfection with influenza
02:14
and at the same time,
02:15
there have been some bacterial superinfections
02:17
on the pneumonias that are occurring.
02:19
[Where can we find up-to-date information?]
02:22
The Center for Disease Control in Atlanta keeps track
02:25
and has updates on a regular basis on its website.
02:29
Also, the World Health Organization in Geneva,
02:31
which is coordinating many of the activities
02:34
going on internationally,
02:35
also has a website with daily updates.
02:37
It's our responsibility to get that information as individuals,
02:41
so we understand
02:42
and can make sure that we can contribute in our own way
02:45
to prevention of major spread.
02:48
[You led the global response to the SARS outbreak in 2003.
02:50
How does this outbreak compare?]
02:52
That's the same problem with all new infections.
02:54
This is an infection that's coming to humans
02:57
who have never been exposed to this virus before.
03:00
They don't have any antibody protection,
03:02
and it's not clear whether their immune system
03:05
can handle this virus or not.
03:07
This is a virus that usually finds itself in bats or in other animals,
03:11
and all of a sudden, it's in humans.
03:13
And humans just don't have experience with this virus.
03:17
But gradually,
03:18
we are beginning to learn a lot, as we did with SARS.
03:21
And you know, there are certainly a larger number of deaths
03:24
than there were with SARS.
03:26
But when you divide that by a denominator of persons who are infected,
03:30
there are many, many more persons infected than there were with SARS.
03:34
The case fatality ratio,
03:36
that is the ratio of deaths to the numbers of cases in SARS,
03:40
was about 10 percent.
03:42
With the current coronavirus, COVID-19,
03:45
it is two percent or probably less.
03:48
So it's a much less virulent virus,
03:51
but it's still a virus that causes mortality,
03:53
and that's what we don't want entering human populations.
03:56
[Have we responded adequately at border crossings, such as airports?]
04:00
It's clearly understood that airports or any land borders
04:04
cannot prevent a disease from entering.
04:06
People in the incubation period can cross that border,
04:09
can enter countries
04:11
and can then infect others when they become sick.
04:14
So borders are not a means of preventing infections from entering a country
04:20
by checking temperatures.
04:22
Borders are important because you can provide to people arriving
04:26
from areas that might be at risk of having had infection,
04:29
provide them with an understanding,
04:31
either a printed understanding or a verbal understanding,
04:34
of what the signs and symptoms are of this infection,
04:37
and what they should do if they feel that they might be infected.
04:41
[What's the timeline for a vaccine?]
04:44
Vaccines are under development right now,
04:46
there's a lot of research going on.
04:48
That research requires first that the vaccine be developed,
04:52
then that it be studied for safety and effectiveness in animals,
04:57
who are challenged with the virus after they are vaccinated,
05:00
and then it must go into human studies.
05:03
The animal studies have not yet begun,
05:05
but will soon begin for certain vaccines.
05:07
And it's thought that by the end of the year,
05:10
or early next year,
05:11
there may be some candidate vaccines
05:13
that can then be studied for licensing by regulatory agencies.
05:18
So we're talking about at least a year until there's vaccine available
05:22
that can be used in many populations.
05:25
[What questions about the outbreak are still unanswered?]
05:29
It's clear we know how it transmits,
05:31
we don't know how easily it transmits in humans,
05:33
in communities or in unenclosed areas.
05:38
We know, for example,
05:39
that in the enclosed area of a cruise ship, it spread very easily.
05:43
We need to better understand
05:45
how it will spread once it gets into more open areas
05:49
where people are exposed to people who might be sick.
05:52
[What about the global response could be improved?]
05:56
A major problem in the world today is that we look at outbreaks
06:00
in developing countries
06:01
as something that we need to go and stop.
06:04
So when there's an outbreak of Ebola,
06:06
we think "How can we go and stop this outbreak in the country?"
06:09
We don't think about "How can we help that country
06:13
strengthen its capacity,
06:15
so that it can detect and respond to infections?"
06:18
So we haven't invested enough
06:21
in helping countries develop their core capacity in public health.
06:25
What we've done is invested in many mechanisms globally,
06:29
which can provide support to other countries
06:32
to go and help stop outbreaks.
06:34
But we want to see a world where every country
06:36
can do its best to stop its own outbreaks.
06:38
[Will we see more emerging disease outbreaks in the future?]
06:41
Today, there are over seven billion people.
06:43
And when those people come into the world,
06:46
they demand more food,
06:47
they demand a whole series of things
06:49
and they live closer together.
06:50
In fact, we're an urban world, where people live in urban areas.
06:54
And at the same time, we're growing more animals,
06:57
and those animals are contributing food to humans as well.
07:01
So what we see
07:02
is that that animal-human interface is becoming closer and closer together.
07:07
And this intensive agriculture of animals
07:11
and this intensive increase in human populations
07:14
living together on the same planet
07:16
is really a melting pot where outbreaks can occur and do occur.
07:21
We will eventually have more and more of these outbreaks.
07:24
So an emerging infection today is just a warning
07:28
of what will happen in the future.
07:30
We have to make sure
07:31
that that technical collaboration in the world
07:34
is there to work together
07:36
to make sure that we can understand these outbreaks when they occur
07:40
and rapidly provide the information necessary to control them.
07:44
[Is the worst behind us?]
07:46
I can't predict with accuracy.
07:48
So all I can say is that we must all be prepared
07:51
for the worst-case scenario.
07:52
And at the same time,
07:54
learn how we can protect ourselves and protect others
07:57
should we become a part of that epidemic.
08:00
[To learn more, visit: Centers for Disease Control and Prevention
08:03
World Health Organization]
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