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

譯者: Lilian Chiu 審譯者: Amanda Chu

[As of the morning February 27, 2020,

〔截至 2020 年 2 月 27 日早上，

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

全世界至少有 82,000 個 冠狀病毒確診個案，

and 2,810 deaths from it.

造成 2,810 人死亡。

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

TED 邀請大衛海曼醫生來分享 此次疾病爆發的最新發現。〕

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

〔感染到冠狀病毒會如何？〕

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

這種疾病症狀輕微，像感冒一樣，

in the majority of people.

對大部分人是如此。

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

某些人受到感染之後會病得很嚴重，

其中不乏醫療工作者。

among them are health workers.

It's a very serious infection in them,

他們受感染的情況很嚴重 因為他們接觸的病毒量比一般人高，

as they get a higher dose than normal people,

and at the same time, they have no immunity.

同時，他們也沒有免疫力。

So in the general population,

對一般大眾來說，

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

你受到感染時所接收到的病毒量

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

遠比醫療工作者接收到的要少很多，

health workers having more serious infections.

醫療工作者的感染情況會嚴重許多。

So your infection would be less serious, hopefully.

你們若被感染也不會 那麼嚴重，但願如此。

So that leaves the elderly and those with comorbidities

所以，就剩下老年人及有共病症者

to really be the ones that we have to make sure

是我們一定得要送到醫院

are taken care of in hospitals.

去接收照護的人。

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

〔哪些人最應該擔心此疾病？〕

Well, the most concerned are people

最應該留意的人，

who are, first of all, in developing countries

首先，是開發中國家當中，

and who don't have access to good medical care

無法取得良好醫療照護，

and may not have access at all to a hospital,

也可能完全進不了醫院的人，

should an epidemic occur in their country.

萬一疫情在他們的國家 流行就要特別注意。

Those people would be at great risk,

那些人的風險最高， 特別是老年人。

especially the elderly.

Elderly in all populations are at risk,

各地的老年人都有風險，

but especially those who can't get to oxygen.

但特別危險的是 無法取得氧氣的老年人。

In industrialized countries,

在工業化國家，

it's the very elderly who have comorbidities,

就是那些有共病症的老人，

who have diabetes, who have other diseases,

患有糖尿病或其他疾病的老人

who are at risk.

風險最高。

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

一般大眾似乎沒有很高的風險。

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

〔哪些既有的病症會讓風險變高？〕

First of all,

首先，

pulmonary disease existing as a comorbidity is also important.

如果共病症是既有的 肺部疾病，那就很重要。

In general, the elderly are at greater risk,

一般來說，老年人的風險較高，

especially those over 70,

特別是七十歲以上的老年人，

because their immune systems are not as effective

因為他們的免疫系統

as they might have once been,

沒有以前那麼有效，

and they are more susceptible to infections.

且他們比較容易被感染。

In addition, in some instances in China,

此外，在中國的一些案例中，

there's been a coinfection with influenza

還有發生感冒的共同感染，

and at the same time,

而同時，還有一些 肺炎的細菌性重複感染發生。

there have been some bacterial superinfections

on the pneumonias that are occurring.

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

〔在哪裡可以找到最新資訊？〕

The Center for Disease Control in Atlanta keeps track

位在亞特蘭大的疾病控制與預防中心

and has updates on a regular basis on its website.

會持續了解並在其網站上 提供最新資訊。

Also, the World Health Organization in Geneva,

此外，日內瓦的世界衛生組織

which is coordinating many of the activities

負責協調許多國際性的活動，

going on internationally,

also has a website with daily updates.

其網站也會每日更新資訊。

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

每一個人都有責任 去了解那些資訊，

so we understand

這樣我們才能有所了解， 並確保能用自己的方式盡一份力，

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

to prevention of major spread.

來預防大規模散播。

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

〔2003 年，全球對 SARS 爆發的應變是由你領導。

How does this outbreak compare?]

這次爆發相較如何？〕

That's the same problem with all new infections.

所有的新型感染問題都一樣，

This is an infection that's coming to humans

就是以前從來沒有接觸過 這種病毒的人類受到感染，

who have never been exposed to this virus before.

They don't have any antibody protection,

他們沒有抗體的保護，

and it's not clear whether their immune system

且並不清楚他們的免疫系統 能否處理這種病毒。

can handle this virus or not.

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

通常是蝙蝠或其他動物 才會感染這種病毒，

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

突然間，人類也感染了。

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

而人類對這種病毒完全沒有經驗。

But gradually,

但就像 SARS 一樣， 我們會開始漸漸越學越多。

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

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

死亡人數雖然比 SARS 多。

than there were with SARS.

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

但如果除以感染的人數，

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

這種病毒的感染人數 也比 SARS 多出非常多。

The case fatality ratio,

病案死亡率，

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

也就是得到 SARS 案例中的死亡率

was about 10 percent.

大約是 10%。

With the current coronavirus, COVID-19,

至於目前的冠狀病毒，COVID-19，

it is two percent or probably less.

只有 2% 或甚至更低。

So it's a much less virulent virus,

所以它的致命程度低很多，

but it's still a virus that causes mortality,

但它仍然是會致死的病毒，

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

我們人類並不歡迎會致死的病毒。

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

〔我們在邊境通路（如機場） 所做出的因應措施妥當嗎？〕

It's clearly understood that airports or any land borders

我們很清楚知道， 機場或任何地面邊境

cannot prevent a disease from entering.

都無法預防疾病進入。

People in the incubation period can cross that border,

潛伏期的人能通過邊境，進入各國。

can enter countries

and can then infect others when they become sick.

當他們發病之後就可能感染他人。

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

所以，邊境並不是用量體溫

來預防感染進入國家的手段。

by checking temperatures.

Borders are important because you can provide to people arriving

邊境很重要，

因為它能針對從高感染 風險地區入境的人，

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

provide them with an understanding,

提供他們資訊讓他們了解，

either a printed understanding or a verbal understanding,

不論是書面或口頭的資訊，

of what the signs and symptoms are of this infection,

讓他們了解這種感染的徵兆和症狀，

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

以及當他們覺得自己 可能受到感染時該怎麼做。

[What's the timeline for a vaccine?]

〔疫苗的時間表是怎麼樣的？〕

Vaccines are under development right now,

目前正在開發疫苗，

there's a lot of research going on.

有很多研究正在進行。

That research requires first that the vaccine be developed,

研究的步驟是要先開發出疫苗來，

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

接著再研究疫苗在動物 身上的安全性和效力，

who are challenged with the virus after they are vaccinated,

這是藉由讓動物施打疫苗後， 讓牠們接觸病毒。

and then it must go into human studies.

再接著，才是人體研究。

The animal studies have not yet begun,

動物研究尚未開始，

but will soon begin for certain vaccines.

但某些疫苗很快 就會開始進行動物研究。

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

一般認為在今年年底或明年年初，

or early next year,

可能會有一些候選疫苗，

there may be some candidate vaccines

that can then be studied for licensing by regulatory agencies.

接著管理機關會再研究 是否可發許可證給這些疫苗。

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

所以要有足以應付 龐大人口需求的疫苗數量，

that can be used in many populations.

至少要一年的時間。

[What questions about the outbreak are still unanswered?]

〔關於這次爆發， 有什麼尚未解答的問題？〕

It's clear we know how it transmits,

很顯然，我們知道它如何傳播，

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

我們不知道它在 人類之間、在社區中，

in communities or in unenclosed areas.

或在開放空間的傳播有多容易。

We know, for example,

比如，各位知道，

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

在郵輪的密閉空間裡， 它就非常容易傳播。

We need to better understand

我們需要進一步了解，

how it will spread once it gets into more open areas

當病毒進入更開放的 空間中會如何傳播，

where people are exposed to people who might be sick.

因為在這類空間我們會 接觸到可能生病的人。

[What about the global response could be improved?]

〔全球的因應措施 有什麼可以改進的地方？〕

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

現今世界的主要問題是，

我們認為在開發中國家爆發的疫情

in developing countries

as something that we need to go and stop.

是我們必須要去阻止的。

So when there's an outbreak of Ebola,

所以，當伊波拉爆發時，

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

我們會想「我們要如何 去那個國家阻止疫情？」

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

我們想的不是「我們 要如何協助那個國家

strengthen its capacity,

強化它的能力，

so that it can detect and respond to infections?"

讓該國能夠偵測出感染 並採取因應措施。」

So we haven't invested enough

所以，我們還沒有做足夠的投資

in helping countries develop their core capacity in public health.

來協助其他國家發展 它們的公共衛生核心能力。

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

我們目前已經做的是 投資在許多全球機制上，

which can provide support to other countries

這些機制能支援其他國家

to go and help stop outbreaks.

去協助阻止疫情爆發。

But we want to see a world where every country

但我們希望的世界，

是每個國家都能盡力 去阻止自己國內的疫情。

can do its best to stop its own outbreaks.

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

〔在未來還會出現更多 疾病疫情爆發嗎？〕

Today, there are over seven billion people.

現今世界上有超過七十億人。

And when those people come into the world,

這些人在世上

需要更多食物、

they demand more food,

they demand a whole series of things

更多各式必需品，

且他們住得更靠近。

and they live closer together.

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

事實上這是個都市世界， 人類住在都市地區。

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

同時，我們養的動物也更多，

and those animals are contributing food to humans as well.

而那些動物也供人類食用。

So what we see

所以，我們看到 動物和人類之間的介面

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

變得越來越靠近。

And this intensive agriculture of animals

而這種密集的畜牧業

and this intensive increase in human populations

以及暴增的人口

living together on the same planet

共同生存於地球上，

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

其實正是讓疾病爆發的融爐， 疾病也確實因此爆發。

We will eventually have more and more of these outbreaks.

最終，這類的疫情會越來越多。

So an emerging infection today is just a warning

所以，現今出現的感染 只是一種警訊，

of what will happen in the future.

警告未來可能發生什麼。

We have to make sure

我們必須要確保世界上的技術合作

that that technical collaboration in the world

is there to work together

是要能夠同心協力

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

確保疫情爆發時，我們能即刻了解，

and rapidly provide the information necessary to control them.

並且快速提供控制疫情的必要資訊。

[Is the worst behind us?]

〔最糟的已經過去了嗎？〕

I can't predict with accuracy.

這我無法準確預測。

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

我只能說，我們都必須 做最壞的打算。

for the worst-case scenario.

And at the same time,

同時，

learn how we can protect ourselves and protect others

萬一我們身陷疫情中時，

學會如何保護自己和保護他人。

should we become a part of that epidemic.

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

〔若要了解更多，請前往： 世界衛生組織疾病管制與預防中心〕

World Health Organization]