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

Prevoditelj: Mira Lenžer Newbould Recezent: Sanda L

[As of the morning February 27, 2020,

[Do jutra 27. veljače 2020.

there were at least 82,000 confirmed cases worldwide of the coronavirus

potvrđeno je bar 82 000 slučajeva koronavirusa

diljem svijeta, od čega 2 810 smrtnih.

and 2,810 deaths from it.

TED je pozvao Dr. Davida Heymanna da podijeli najnovija saznanja o bolesti.]

TED invited Dr. David Heymann to share the latest findings about the outbreak.]

[What happens if you get infected with the coronavirus?]

[Što se događa ako se zarazimo koronavirusom?]

This looks like a very mild disease, like a common cold,

Izgleda kao blaga bolest, najobičnija prehlada

in the majority of people.

kod većine ljudi.

There are certain people who get infected and have very serious illness;

Kod određenih se ljudi nakon zaraze razvija ozbiljna bolest,

among them are health workers.

uglavnom kod zdravstvenih djelatnika.

It's a very serious infection in them,

Kod njih se javlja ozbiljna infekcija

jer su izloženiji višoj dozi od običnih ljudi,

as they get a higher dose than normal people,

and at the same time, they have no immunity.

a istovremeno nemaju imunitet.

So in the general population,

Stoga je u općoj javnosti

it's likely that the dose of virus that you receive when you are infected

doza virusa koju primite kad se zarazite vjerojatno

is much less than the dose that a health worker would receive,

mnogo niža od one koju bi primio zdravstveni djelatnik,

health workers having more serious infections.

s obzirom na to da je infekcija kod njega puno ozbiljnija.

So your infection would be less serious, hopefully.

Stoga bi, nadajmo se, i vaša infekcija bila blaža.

So that leaves the elderly and those with comorbidities

To znači da su starije osobe te one s kroničnim oboljenjima

to really be the ones that we have to make sure

zapravo te za koje moramo osigurati

are taken care of in hospitals.

da budu zbrinute u bolnicama.

[Who are the people who should be most concerned about this?]

[Koga bi sve ovo trebalo najviše zabrinjavati?]

Well, the most concerned are people

Pa, najviše se to odnosi na ljude

who are, first of all, in developing countries

koji su, prije svega, u zemljama u razvoju

and who don't have access to good medical care

te nemaju pristup kvalitetnoj liječničkoj skrbi,

and may not have access at all to a hospital,

a možda ni bolnici,

should an epidemic occur in their country.

u slučaju izbijanja epidemije u zemlji.

Those people would be at great risk,

Oni bi bili izloženi velikom riziku,

especially the elderly.

osobito osobe starije dobi.

Elderly in all populations are at risk,

Stariji su posvuda ugroženi,

but especially those who can't get to oxygen.

no osobito oni koji nemaju pristup kisiku.

In industrialized countries,

U razvijenim zemljama,

it's the very elderly who have comorbidities,

upravo su starije osobe koje imaju istovremeno više bolesti,

who have diabetes, who have other diseases,

dijabetes i druge bolesti,

who are at risk.

one najugroženije.

The general population doesn't appear to be at great risk.

Opća javnost, čini se, nije izložena velikom riziku.

[What pre-existing medical conditions put people at higher risk?]

[Koje postojeće zdravstveno stanje može dodatno povećati ugroženost?]

First of all,

Prije svega,

pulmonary disease existing as a comorbidity is also important.

vrlo je važno ako uz ostale bolesti postoji i plućna bolest.

In general, the elderly are at greater risk,

Općenito su ugroženije starije osobe,

especially those over 70,

osobito one starije od 70 godina,

because their immune systems are not as effective

jer njihov imunološki sustav nije učinkovit

as they might have once been,

kao nekad

and they are more susceptible to infections.

te su podložnije infekcijama.

In addition, in some instances in China,

Osim toga, u nekim slučajevima u Kini,

there's been a coinfection with influenza

oboljeli su se zarazili i gripom,

and at the same time,

a istovremeno je došlo

there have been some bacterial superinfections

i do superinfekcija bakterijama

on the pneumonias that are occurring.

kod upala pluća.

[Where can we find up-to-date information?]

[Gdje možemo pronaći ažurne informacije?]

The Center for Disease Control in Atlanta keeps track

Centar za nadzor bolesti u Atlanti prati stanje

and has updates on a regular basis on its website.

i redovito ažurira svoje web stranice.

Also, the World Health Organization in Geneva,

Svjetska zdravstvena organizacija u Ženevi,

which is coordinating many of the activities

koja koordinira brojne aktivnosti

going on internationally,

na međunarodnoj razini,

also has a website with daily updates.

dnevno ažurira svoju web stranicu.

It's our responsibility to get that information as individuals,

Naša je odgovornost da te informacije i potražimo,

so we understand

kako bismo razumjeli

and can make sure that we can contribute in our own way

i na svoj način pridonijeli

to prevention of major spread.

sprečavanju daljnjeg širenja zaraze.

[You led the global response to the SARS outbreak in 2003.

[Predvodili ste globalni odgovor na epidemiju SARS-a 2003.

How does this outbreak compare?]

Po čemu se ove epidemije razlikuju?]

That's the same problem with all new infections.

Sa svim je novim infekcijama isti problem.

This is an infection that's coming to humans

Radi se o infekciji koja se prenosi na čovjeka

who have never been exposed to this virus before.

koji nikad nije bio izložen tom virusu.

They don't have any antibody protection,

Nema zaštitna antitijela

and it's not clear whether their immune system

i nije jasno može li njegov imunološki sustav

can handle this virus or not.

podnijeti taj virus ili ne.

This is a virus that usually finds itself in bats or in other animals,

Takav se virus obično nalazi kod šišmiša i drugih životinja,

and all of a sudden, it's in humans.

a sad se odjednom javio kod ljudi.

And humans just don't have experience with this virus.

A ljudi jednostavno s tim virusom nemaju iskustva.

But gradually,

No, postupno

we are beginning to learn a lot, as we did with SARS.

o njemu saznajemo sve više, kao što smo i o SARS-u.

And you know, there are certainly a larger number of deaths

I sigurno je više smrtnih slučajeva

than there were with SARS.

u odnosu na SARS.

But when you divide that by a denominator of persons who are infected,

No kad ih podijelimo s djeliteljem, tj. brojem zaraženih,

there are many, many more persons infected than there were with SARS.

znatno je više zaraženih nego li je to bio slučaj kod SARS-a.

The case fatality ratio,

Stopa smrtnosti,

that is the ratio of deaths to the numbers of cases in SARS,

odnosno omjer smrtnih slučajeva u odnosu na broj zaraženih SARS-om,

was about 10 percent.

iznosila je oko 10 posto.

With the current coronavirus, COVID-19,

Kod trenutačnog koronavirusa COVID-19,

it is two percent or probably less.

ta stopa iznosi 2 posto ili manje.

So it's a much less virulent virus,

Dakle radi se o manje zaraznom virusu,

but it's still a virus that causes mortality,

no ipak je to virus koji je smrtonosan

and that's what we don't want entering human populations.

te stoga ne želimo da prodre među ljude.

[Have we responded adequately at border crossings, such as airports?]

[Jesmo li ispravno reagirali na granicama, npr. u zračnim lukama?]

It's clearly understood that airports or any land borders

Jasno je da zračne luke i bilo kakve kopnene granice

cannot prevent a disease from entering.

ne mogu spriječiti prodiranje bolesti.

People in the incubation period can cross that border,

Svi zaraženi mogu, u razdoblju inkubacije, prijeći granicu,

can enter countries

ući u državu

and can then infect others when they become sick.

i zaraziti ostale jednom kad se razbole.

So borders are not a means of preventing infections from entering a country

Stoga granice nisu način kojim se prodor bolesti u zemlju

by checking temperatures.

sprečava provjerom temperature.

Borders are important because you can provide to people arriving

Granice jesu važne jer ljudima koji dolaze

from areas that might be at risk of having had infection,

iz ugroženih i zaraženih područja

provide them with an understanding,

mogu pružiti informacije,

either a printed understanding or a verbal understanding,

bilo napismeno ili usmeno,

of what the signs and symptoms are of this infection,

o tome koji su simptomi ove bolesti,

and what they should do if they feel that they might be infected.

te što trebaju poduzeti ako misle da su zaraženi.

[What's the timeline for a vaccine?]

[Kada možemo očekivati cjepivo?]

Vaccines are under development right now,

Na cjepivima se trenutačno radi,

there's a lot of research going on.

u tijeku je niz istraživanja.

That research requires first that the vaccine be developed,

U sklopu istraživanja, prije svega, cjepivo treba razviti,

then that it be studied for safety and effectiveness in animals,

zatim proučiti i ispitati njegovu sigurnost i učinkovitost na životinjama

who are challenged with the virus after they are vaccinated,

koje se virusu izlažu nakon cijepljenja,

and then it must go into human studies.

a tek na kraju ispituje se na ljudima.

The animal studies have not yet begun,

Testiranje na životinjama još nije počelo,

but will soon begin for certain vaccines.

ali uskoro hoće, za određena cjepiva.

And it's thought that by the end of the year,

Smatra se da ćemo do kraja godine

or early next year,

ili početkom sljedeće godine

there may be some candidate vaccines

imati na raspolaganju neka moguća cjepiva

that can then be studied for licensing by regulatory agencies.

koja regulatorne agencije potom mogu ispitati prije licenciranja.

So we're talking about at least a year until there's vaccine available

Dakle, proći će najmanje godina dana prije no što bude dostupno cjepivo

that can be used in many populations.

koje se može koristiti kod većine stanovništva.

[What questions about the outbreak are still unanswered?]

[Na koja pitanja još nemamo odgovor?]

It's clear we know how it transmits,

Sada je jasno kako se prenosi,

we don't know how easily it transmits in humans,

ne znamo još koliko se lako prenosi kod ljudi,

in communities or in unenclosed areas.

u zajednicama ili na otvorenom.

We know, for example,

Znamo, primjerice,

that in the enclosed area of a cruise ship, it spread very easily.

da se u zatvorenim prostorijama kruzera prenosi vrlo lako.

We need to better understand

Moramo bolje razumjeti

how it will spread once it gets into more open areas

kako će se zaraza širiti kad stigne na otvoreni prostor,

where people are exposed to people who might be sick.

gdje su ljudi izloženi mogućim zaraženim osobama.

[What about the global response could be improved?]

[Što možemo poboljšati kod globalnog odgovora?]

A major problem in the world today is that we look at outbreaks

Danas je glavni problem u svijetu to što gledamo na nove epidemije

in developing countries

u zemljama u razvoju

as something that we need to go and stop.

kao nešto što treba zaustaviti.

So when there's an outbreak of Ebola,

Pa kad dođe do izbijanja ebole,

we think "How can we go and stop this outbreak in the country?"

pitamo se kako možemo zaustaviti epidemiju u toj zemlji,

We don't think about "How can we help that country

a ne kako bismo toj zemlji mogli pomoći

strengthen its capacity,

da ojača svoje kapacitete

so that it can detect and respond to infections?"

te time bude u stanju otkriti bolesti i promptno reagirati.

So we haven't invested enough

Dakle, nismo dovoljno uložili

in helping countries develop their core capacity in public health.

u pomoć zemljama da razviju svoje ključne kapacitete u javnom zdravstvu.

What we've done is invested in many mechanisms globally,

Mi smo jedino uložili u brojne globalne mehanizme

which can provide support to other countries

koji mogu biti podrška drugim zemljama

to go and help stop outbreaks.

koje pomažu u suzbijanju epidemija.

But we want to see a world where every country

No, težimo svijetu u kojem svaka zemlja

can do its best to stop its own outbreaks.

može poduzeti sve da zaustavi svoje epidemije.

[Will we see more emerging disease outbreaks in the future?]

[Čeka li nas ubuduće sve više novih epidemija?]

Today, there are over seven billion people.

Danas brojimo više od 7 milijardi ljudi.

And when those people come into the world,

A kad ti ljudi dođu na svijet,

they demand more food,

zahtijevaju više hrane,

they demand a whole series of things

zahtijevaju cijeli niz stvari

and they live closer together.

i žive bliže jedni drugima.

In fact, we're an urban world, where people live in urban areas.

Mi smo urbani svijet, gdje ljudi žive u urbanim sredinama.

And at the same time, we're growing more animals,

A istovremeno uzgajamo više životinja,

and those animals are contributing food to humans as well.

a te životinje ljudima pridonose u smislu hrane.

So what we see

Dakle možemo vidjeti

is that that animal-human interface is becoming closer and closer together.

da su životinje i ljudi sve uže povezani.

And this intensive agriculture of animals

A taj intenzivni poljoprivredni uzgoj životinja

and this intensive increase in human populations

te intenzivni porast ljudskog stanovništva

living together on the same planet

koji koegzistiraju na istom planetu

is really a melting pot where outbreaks can occur and do occur.

doista su kotao u kojem mogu izbiti i izbijaju nove epidemije.

We will eventually have more and more of these outbreaks.

S vremenom će tih epidemija biti sve više.

So an emerging infection today is just a warning

Stoga je današnja infekcija samo upozorenje

of what will happen in the future.

onoga što tek predstoji.

We have to make sure

Moramo se pobrinuti

that that technical collaboration in the world

da tehnička suradnja u svijetu

is there to work together

osigura da radimo zajedno,

to make sure that we can understand these outbreaks when they occur

da budemo sigurni da razumijemo epidemije kad se pojave

and rapidly provide the information necessary to control them.

te da brzo osiguramo informacije potrebne da ih obuzdamo.

[Is the worst behind us?]

[Je li najgore iza nas?]

I can't predict with accuracy.

Ne mogu točno predvidjeti.

So all I can say is that we must all be prepared

Sve što mogu reći jest da svi moramo biti spremni

for the worst-case scenario.

na najgori mogući scenarij.

And at the same time,

A istovremeno,

learn how we can protect ourselves and protect others

moramo naučiti kako zaštititi sebe i druge

should we become a part of that epidemic.

u slučaju da se i mi zarazimo.

[To learn more, visit: Centers for Disease Control and Prevention

[Saznajte više, posjetite: Centri za nadzor i sprečavanje bolesti

World Health Organization]

Svjetska zdravstvena organizacija]