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

Prevodilac: Milenka Okuka Lektor: Ivana Korom

[As of the morning February 27, 2020,

[Do ponedeljka 27. februara 2020.

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

širom sveta je potvrđeno bar 82 000 slučajeva virusa korona

and 2,810 deaths from it.

sa 2 810 smrtnih ishoda.

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

TED je pozvao Dr Dejvida Hejmana da podeli poslednja otkrića o epidemiji.]

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

[Šta se desi, ako se zarazite virusom korona?]

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

Čini se kao veoma blaga bolest, poput obične prehlade

in the majority of people.

za većinu ljudi.

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

Neki ljudi se zaraze i krajnje ozbiljno se razbole;

among them are health workers.

među njima su zdravstveni radnici.

It's a very serious infection in them,

Za njih je to veoma ozbiljna infekcija

as they get a higher dose than normal people,

jer dobiju jače doze od normalnih ljudi,

and at the same time, they have no immunity.

a istovremeno nemaju imunitet.

So in the general population,

Dakle, kod opšte javnosti,

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

verovatnije je da će doza virusa koju dobiju kada se zaraze

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

da bude mnogo manja od doze koju bi dobio zdravstveni radnik,

health workers having more serious infections.

zdravstveni radnici imaju daleko ozbijnije infekcije.

So your infection would be less serious, hopefully.

Dakle, vaša infekcija bi bila manje ozbiljna, nadamo se.

So that leaves the elderly and those with comorbidities

Tako da ostaju stari ljudi i oni sa pratećim oboljenjima

to really be the ones that we have to make sure

koji zaista jesu oni za koje moramo da se postaramo

are taken care of in hospitals.

da budu zbrinuti u bolnicama.

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

[Ko su ljudi koji bi trebalo da budu najzabrinutiji zbog ovoga?]

Well, the most concerned are people

Najviše zabrinutosti bi trebalo da bude za ljude

who are, first of all, in developing countries

koji žive, pre svega, u zemljama u razvoju,

and who don't have access to good medical care

a koji nemaju pristup dobroj medicinskoj nezi

and may not have access at all to a hospital,

i možda uopšte nemaju pristup bolnicama,

should an epidemic occur in their country.

ukoliko dođe do epidemije u njihovoj državi.

Those people would be at great risk,

Ovi ljudi bi bili pod velikim rizikom,

especially the elderly.

naročito stariji.

Elderly in all populations are at risk,

Stariji u svim populacijama su pod rizikom,

but especially those who can't get to oxygen.

a naročito oni koji nemaju pristup inhalatoru.

In industrialized countries,

U industrijalizovanim državama,

it's the very elderly who have comorbidities,

baš oni stariji koji imaju prateće bolesti,

who have diabetes, who have other diseases,

koji imaju dijabetes, koji imaju druga oboljenja

who are at risk.

su pod rizikom.

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

Opšta populacije se ne čini da je pod velikim rizikom.

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

[Koje postojeće medicinsko stanje dovodi ljude u veću opasnost?]

First of all,

Pre svega,

pulmonary disease existing as a comorbidity is also important.

važno je ako neko već ima plućnu bolest.

In general, the elderly are at greater risk,

Uopšteno, stariji su pod većim rizikom,

especially those over 70,

naročito stariji od 70 godina

because their immune systems are not as effective

jer njihov imunitet više nije delotvoran

as they might have once been,

kao što je možda nekad bio,

and they are more susceptible to infections.

te su podložniji infekcijama.

In addition, in some instances in China,

Uz to, u nekim slučajevima u Kini,

there's been a coinfection with influenza

došlo je do dodatne zaraze influencom

and at the same time,

i istovremeno,

there have been some bacterial superinfections

došlo je do bakterijskih superinfekcija

on the pneumonias that are occurring.

kod već postojećih upala pluća.

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

[Gde možemo da pronađemo aktuelne informacije?]

The Center for Disease Control in Atlanta keeps track

Centar za kontrolu bolesti u Atlanti prati situaciju

and has updates on a regular basis on its website.

i redovno ažuriraju svoj sajt.

Also, the World Health Organization in Geneva,

I Svetska zdravstvena organizacija u Ženevi,

which is coordinating many of the activities

koja koordiniše mnoge aktivnosti

going on internationally,

na međunarodnom nivou,

also has a website with daily updates.

takođe ima sajt sa dnevnim ažuriranjima.

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

Naša je odgovornost da prenosimo informacije kao pojedinci

so we understand

kako bismo razumeli

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

i postarali se na svoj način da doprinesemo

to prevention of major spread.

prevenciji većeg širenja.

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

[Predvodili ste globalnu reakciju na epidemiju SARS-a 2013.

How does this outbreak compare?]

Uporedite ove dve epidemije.]

That's the same problem with all new infections.

Isti je problem sa svim novim infekcijama.

This is an infection that's coming to humans

Radi se o infekciji koja se prenosi na ljude

who have never been exposed to this virus before.

koji nikad pre nisu bili izloženi ovom virusu.

They don't have any antibody protection,

Nemaju nikakva zaštitna antitela

and it's not clear whether their immune system

i nije jasno da li njihov imunitet

can handle this virus or not.

može da podnese virus ili ne.

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

Radi se o virusu koji se obično nalazi u šišmišima ili drugim životinjma,

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

a iznenada ga zatičemo kod ljudi.

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

A ljudi nemaju iskustvo sa ovim virusom.

But gradually,

Međutim, vremenom,

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

počinjemo da učimo mnogo, kao što smo i sa SARS-om.

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

I znate, zasigurno ima više smrti

than there were with SARS.

nego što je bio slučaj sa SARS-om.

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

Međutim, kada to podelite sa imeniocem, osobama koje su zaražene,

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

ima mnogo, mnogo više zaraženih osoba nego što je bio slučaj sa SARS-om.

The case fatality ratio,

Stopa smrtnosti,

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

ovo je stopa smrtnosti u odnosu na broj slučajeva SARS-a,

was about 10 percent.

bila je oko 10 procenata.

With the current coronavirus, COVID-19,

U slučaju trenutnog virusa korona, COVID-19

it is two percent or probably less.

je dva procenta ili čak i manja.

So it's a much less virulent virus,

Dakle, manje je zarazan virus,

but it's still a virus that causes mortality,

ali je i dalje virus sa smrtnim ishodima,

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

a to ne želimo da uđe u ljudsku populaciju.

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

[Da li smo odreagovali pravilno u slučaju graničnih prelaza, poput aerodroma?]

It's clearly understood that airports or any land borders

Jasno je da aerodromi ili bilo koji granični prelazi na tlu

cannot prevent a disease from entering.

ne mogu da spreče ulazak bolesti.

People in the incubation period can cross that border,

Ljudi u periodu inkubacije mogu da pređu tu granicu,

can enter countries

mogu da uđu u države

and can then infect others when they become sick.

i potom kad se razbole mogu da zaraze druge.

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

Granice nisu sredstva za sprečavanje infekcija od ulaska u državu

by checking temperatures.

proverom telesne temperature.

Borders are important because you can provide to people arriving

Granice su važne jer možete da obezbedite ljudima koji dolaze

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

iz oblasti u kojima je veći rizik od dobijanja infekcije,

provide them with an understanding,

možete da im pružite razumevanje

either a printed understanding or a verbal understanding,

bilo odštampano razumevanje ili verbalno razumevanje

of what the signs and symptoms are of this infection,

o znacima i simptomima ove infekcije,

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

kao i šta da rade, ukoliko osete da bi mogli da budu zaraženi.

[What's the timeline for a vaccine?]

[Kada možemo da očekujemo vakcinu?]

Vaccines are under development right now,

Trenutno se radi na vakcinama,

there's a lot of research going on.

mnoga istraživanja su u toku.

That research requires first that the vaccine be developed,

Prvo je potrebno istraživanje kako bi se razvila vakcina,

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

potom se ona, radi bezbednosti i efikasnosti, izučava na životinjama

who are challenged with the virus after they are vaccinated,

koje su izložene virusu nakon vakcinacije,

and then it must go into human studies.

a potom mora da prođe testiranja na ljudima.

The animal studies have not yet begun,

Testiranja na životinjama još nisu počela,

but will soon begin for certain vaccines.

ali hoće uskoro za određene vakcine.

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

I veruje se da će do kraja godine

or early next year,

ili početkom sledeće,

there may be some candidate vaccines

možda postojati neki kandidati za vakcinu

that can then be studied for licensing by regulatory agencies.

koje će potom regulatorne agencije izučavati radi licenciranja.

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

Dakle, govorimo da je potrebno najmanje godinu dana dok budemo imali vakcinu

that can be used in many populations.

koja može da se koristi kod većinske populacije.

[What questions about the outbreak are still unanswered?]

[Na koja pitanja u vezi sa epidemijom i dalje nemamo odgovore?]

It's clear we know how it transmits,

Jasno je da znamo kako se prenosi,

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

ne znamo koliko se lako prenosi kod ljudi,

in communities or in unenclosed areas.

u zajednicama ili na otvorenom prostoru.

We know, for example,

Znamo, na primer,

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

da se u zatvorenom prostoru kruzera veoma lako širila.

We need to better understand

Moramo bolje da razumemo

how it will spread once it gets into more open areas

kako će da se širi kada stigne na otvoreniji prostor

where people are exposed to people who might be sick.

gde su ljudi izloženi onima koji bi mogli da budu bolesni.

[What about the global response could be improved?]

[Kako bi globalna reakcija mogla da se popravi?]

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

Veliki problem današnjeg sveta je što posmatramo epidemije

in developing countries

u zemljama u razvoju

as something that we need to go and stop.

kao nešto što moramo da odemo tamo i zaustavimo.

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?"

razmišljamo: „Kako da odemo i zaustavimo epidemiju u toj državi?”

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

Ne razmišljamo: „Kako da pomognemo toj državi

strengthen its capacity,

da ojača svoje kapacitete

so that it can detect and respond to infections?"

kako bi mogla da prepozna i odgovori na infekcije?”

So we haven't invested enough

Dakle, nismo dovoljno uložili

in helping countries develop their core capacity in public health.

da pomognemo državama da razviju ključne kapacitete u javnom zdravstvu.

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

Uložili smo u razne globalne mehanizme

which can provide support to other countries

koji mogu da pruže podršku drugim državama

to go and help stop outbreaks.

kako bismo pošli i zaustavili epidemije.

But we want to see a world where every country

Međutim, želimo da vidimo svet u kom svaka država

can do its best to stop its own outbreaks.

može da da sve od sebe da zaustavi epidemije.

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

[Hoćemo li videti sve više epidemija u budućnosti?]

Today, there are over seven billion people.

Trenutno postoji preko sedam milijardi ljudi

And when those people come into the world,

A kada ti ljudi dođu na svet,

they demand more food,

zahtevaju više hrane,

they demand a whole series of things

zahtevaju čitav niz stvari

and they live closer together.

i žive sve zbijenije.

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

Zapravo, mi smo urbani svet, u kom ljudi žive u urbanim prostorima.

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

Istovremeno, uzgajamo sve više životinja,

and those animals are contributing food to humans as well.

a te životinje takođe doprinose hranjenju ljudi.

So what we see

Dakle, vidimo

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

da je sve jača i jača spona između životinja i ljudi.

And this intensive agriculture of animals

A ovaj intenzivni poljoprivredni uzgoj životinja

and this intensive increase in human populations

i intenzivni rast ljudske populacije

living together on the same planet

koji žive zajedno na istoj planeti

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

je uistinu presek u kome može da dođe i dolazi do epidemija.

We will eventually have more and more of these outbreaks.

Vremenom ćemo da imamo sve više sličnih epidemija.

So an emerging infection today is just a warning

Pa je trenutna infekcija samo upozorenje

of what will happen in the future.

za ono što sledi u budućnosti.

We have to make sure

Moramo da se postaramo

that that technical collaboration in the world

da je tehnička saradnja u svetu

is there to work together

tu da radi zajedno

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

kako bismo se postarali da razumemo ove epidemije kad se dese

and rapidly provide the information necessary to control them.

i da brzo pružimo nužne informacije kako bismo ih kontrolisali.

[Is the worst behind us?]

[Da li je najgore prošlo?]

I can't predict with accuracy.

Ne mogu tačno da predvidim.

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

Sve što mogu da kažem je da moramo da budemo spremni

for the worst-case scenario.

za najgori mogući scenario.

And at the same time,

I da istovremeno

learn how we can protect ourselves and protect others

naučimo kako da zaštitimo sebe i druge,

should we become a part of that epidemic.

ukoliko postanemo deo epidemije.

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

[Da saznate više, posetite sajtove: Centra za kontrolu i sprečavanje bolesti

World Health Organization]

i Svetske zdravstvene organizacije]