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

翻译人员: Cissy Yun 校对人员: Yolanda Zhang

[As of the morning February 27, 2020,

[ 截止 2020 年 2 月 27 日，

全球新冠肺炎确诊 82000 多例，

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

其中死亡病例为 2810 个。

and 2,810 deaths from it.

TED 邀请了大卫 · 赫曼医生分享 对于本次病毒爆发的最新发现 ]

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

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

[ 如果你感染了新冠病毒， 症状是什么？]

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

大多数人的症状显得轻微，

in the majority of people.

就像普通的感冒。

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

但有一些感染者， 会表现出非常严重的症状，

among them are health workers.

这些人中包括医护人员。

It's a very serious infection in them,

对他们来说， 这种感染非常严重，

因为他们接触的病毒量 比起普通人要高得多，

as they get a higher dose than normal people,

and at the same time, they have no immunity.

与此同时， 他们没有足够的免疫力。

So in the general population,

在普通人群中，

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

大致上你受感染时接触的病毒量

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

远低于一位医护人员 所接触到的病毒量，

health workers having more serious infections.

许多医护人员会遇到 更严重的感染。

So your infection would be less serious, hopefully.

所以普通人若被感染， 也不会特别严重，但愿如此。

So that leaves the elderly and those with comorbidities

剩下的就是老人和患有并发症的人，

to really be the ones that we have to make sure

他们是我们必须确保

are taken care of in hospitals.

得到医院治疗的人。

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

[ 哪些人特别需要重视这个病毒？]

Well, the most concerned are people

最应该重视此事的人，

who are, first of all, in developing countries

首先是那些处于发展中国家，

and who don't have access to good medical care

缺少优质医疗资源，

and may not have access at all to a hospital,

甚至可能无法前往医院的人。

should an epidemic occur in their country.

当流行病毒波及他们的国家时， 他们需要特别注意。

Those people would be at great risk,

那些人，特别是其中的老年人，

将面临高风险。

especially the elderly.

Elderly in all populations are at risk,

所有人口中的老年人都面临风险，

but especially those who can't get to oxygen.

尤其是那些无法得到氧气供应的人。

In industrialized countries,

在工业化国家，

it's the very elderly who have comorbidities,

那些有并发症、

who have diabetes, who have other diseases,

糖尿病和其他疾病的老年人

who are at risk.

都面临风险。

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

现在看来， 普通人群则风险不大。

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

[ 有哪些既存病症会使人们 面临更高的感染风险？]

First of all,

首先，

pulmonary disease existing as a comorbidity is also important.

已患有肺病并发症的人 要引起重视。

In general, the elderly are at greater risk,

总体来说， 老年人患病风险是最高的,

especially those over 70,

特别是 70 岁以上的老人，

because their immune systems are not as effective

因为他们的免疫系统

as they might have once been,

不如年轻时那样强健，

and they are more susceptible to infections.

所以他们更容易受到感染。

In addition, in some instances in China,

而且，在中国的一些病例

there's been a coinfection with influenza

存在新冠和流感的共同感染，

and at the same time,

与此同时，

there have been some bacterial superinfections

还有肺炎上的

on the pneumonias that are occurring.

细菌重复感染。

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

[ 我们能从哪里获得最新信息？]

The Center for Disease Control in Atlanta keeps track

亚特兰大的 疾病控制与预防中心（CDC）

and has updates on a regular basis on its website.

会在它的网站上定期更新 追踪到的疫情信息。

Also, the World Health Organization in Geneva,

位于日内瓦的世界卫生组织

which is coordinating many of the activities

正在协调全球同时开展的

going on internationally,

许多行动，

also has a website with daily updates.

也会在自己的网站上 每日更新。

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

我们每个人都有责任 去获取那些信息，

so we understand

以便了解

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

并确知如何各尽所能

to prevention of major spread.

阻挡疫情的大范围传播。

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

[ 在 2003 年，全球抗击 SARS 病毒的行动由你领导，

How does this outbreak compare?]

相对而言，如何评价 这次的疫情爆发？]

That's the same problem with all new infections.

所有的新型感染的问题都一样。

This is an infection that's coming to humans

人类之前从未

who have never been exposed to this virus before.

暴露于这种病毒之中。

They don't have any antibody protection,

人类没有任何抗体的保护，

and it's not clear whether their immune system

现在还无法确定 人体本身的免疫系统

can handle this virus or not.

是否可以抵抗这个病毒。

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

这种病毒一开始 传播于蝙蝠或其他动物之间，

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

突然，它出现在了人类中。

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

人类对它没有任何处理经验。

But gradually,

但渐渐的，我们开始整理出头绪，

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

就像当时面对 SARS 病毒一样。

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

大家也知道，这个病毒的死亡人数

than there were with SARS.

超过了 SARS 病毒。

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

但是若用死亡人数 除以所有感染的人数——

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

新冠感染人数也比 感染 SARS 病毒的人多——

The case fatality ratio,

对比死亡率，

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

即死亡人数和确诊人数的比例， 就 SARS 而言，

was about 10 percent.

是 10% 左右。

With the current coronavirus, COVID-19,

对于新冠病毒（COVID-19）来说，

it is two percent or probably less.

现在的死亡率低于 2%。

So it's a much less virulent virus,

所以它是一种毒性偏低的病毒，

but it's still a virus that causes mortality,

但仍是一种可致命的病毒，

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

我们非常不希望它进入人群中。

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

[ 我们在国家边境做出的措施 还算及时妥当吗？]

It's clearly understood that airports or any land borders

我们现在很清楚的认识到， 机场和其他的陆地边境

cannot prevent a disease from entering.

并不能阻止病毒的入侵。

People in the incubation period can cross that border,

处于潜伏期的病患 仍可以出入边境，

can enter countries

出入国境，

and can then infect others when they become sick.

并在病发后传染他人。

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

因此，若仅通过检测体温 防止病毒进入一个国家，

by checking temperatures.

边境限制并不算是一种防疫机制。

Borders are important because you can provide to people arriving

边境非常重要， 因为可以为那些

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

来自病毒高风险地区的人们

provide them with an understanding,

提供书面或是口头的讯息，

either a printed understanding or a verbal understanding,

让他们了解感染病毒后

of what the signs and symptoms are of this infection,

会产生哪些症状，

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

若他们感觉自己可能被感染后， 可以采取什么措施。

[What's the timeline for a vaccine?]

[ 现在疫苗研发的时间线是怎么样的？]

Vaccines are under development right now,

目前相关疫苗正在研发当中，

there's a lot of research going on.

很多研究正在进行。

That research requires first that the vaccine be developed,

目标首先是研发出一种疫苗，

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

再是观察研究疫苗在动物 身上的安全性和效力，

who are challenged with the virus after they are vaccinated,

让动物接种疫苗后 再接触病毒，

and then it must go into human studies.

然后必须进行人体研究。

The animal studies have not yet begun,

现在，动物试验还未开始，

but will soon begin for certain vaccines.

但马上就会有几株疫苗 开始进行试验。

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

我们期望在今年年底

or early next year,

或明年年初

there may be some candidate vaccines

完成针对一些备选疫苗的研究

that can then be studied for licensing by regulatory agencies.

并取得监管部门派发的使用许可证。

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

现在可预计的是 至少需要一年的时间

that can be used in many populations.

才能研发出可被多人群接种的疫苗。

[What questions about the outbreak are still unanswered?]

[ 哪些有关疫情的疑问仍有待回答？]

It's clear we know how it transmits,

现在我们清楚病毒的传播途径，

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

但我们还不知道病毒在人群中、

in communities or in unenclosed areas.

在社区中或是在未封闭环境中 有多容易传播。

We know, for example,

我们知道的是，

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

在一个相对封闭的环境中， 比如说游轮上，病毒传播得非常快。

We need to better understand

我们需要更好的理解

how it will spread once it gets into more open areas

病毒在更开放空间中是如何传播的,

where people are exposed to people who might be sick.

特别是当人们接触到 可能感染的患者时。

[What about the global response could be improved?]

[ 全球对于病毒的应对有 哪些可以改进的地方？]

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

当今世界上一个很严重的问题 在于，当我们关注

in developing countries

在发展中国家的病毒爆发时，

as something that we need to go and stop.

我们会想到要去当地消灭病毒。

So when there's an outbreak of Ebola,

当埃博拉病毒爆发时，

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

我们想的是， “我们如何在那里阻止病毒的传播？”

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

而不是 “我们如何帮助那个国家

strengthen its capacity,

提高整体医疗水平，

so that it can detect and respond to infections?"

以有效检测和应对感染?”

So we haven't invested enough

所以在帮助其他国家

in helping countries develop their core capacity in public health.

提高公共医疗水平方面， 我们并没有进行足够的投资。

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

我们所做的是 投资全球的许多应对机制，

which can provide support to other countries

从而为其他国家提供帮助，

to go and help stop outbreaks.

阻止病毒的传播。

But we want to see a world where every country

但我们更希望看到的是 所有国家

can do its best to stop its own outbreaks.

能尽自己最大的努力 来阻止病毒的爆发。

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

[ 在未来我们是否会经历 更多的疫情爆发？]

Today, there are over seven billion people.

今天，地球上有超过 70 亿人口。

And when those people come into the world,

人口增长带来的是

对食物

they demand more food,

和生活用品日益增长的需求，

they demand a whole series of things

而且在生活中， 人们彼此的距离会越来越近。

and they live closer together.

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

现在的世界，是城市化的世界， 大多数人住在城市地域。

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

与此同时，我们也饲养 越来越多的牲畜，

and those animals are contributing food to humans as well.

这些牲畜是人类的食物来源。

So what we see

我们发现，

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

动物和人类的交界 也在变得越来越近。

And this intensive agriculture of animals

畜禽集约农业

and this intensive increase in human populations

以及极速上升的人口

living together on the same planet

在同一个星球上共存，

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

这种大熔炉式的生活方式 让疫情爆发成为了可能。

We will eventually have more and more of these outbreaks.

这样的疫情爆发还会越来越多。

So an emerging infection today is just a warning

当今的疫情为未来将会发生什么

of what will happen in the future.

敲响了警钟。

We have to make sure

我们必须确保

that that technical collaboration in the world

世界范围内的

is there to work together

技术合作

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

在病毒爆发时能够帮助我们 了解疫情的发展，

and rapidly provide the information necessary to control them.

并迅速提供必要的信息 进行有效防控。

[Is the worst behind us?]

[ 最糟的时候已经过去了吗？]

I can't predict with accuracy.

我无法准确回答这个问题。

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

我能说的是，我们必须

for the worst-case scenario.

为最坏情况做好准备。

And at the same time,

与此同时，

learn how we can protect ourselves and protect others

若我们被卷入这场疫情中，

should we become a part of that epidemic.

要学会如何保护自己和他人。

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

[ 了解更多，请访问： 疾病控制与预防中心官方网站，

World Health Organization]

国际卫生组织官方网站 ]