可以摘口罩了吗?新冠肺炎会流感化吗?全球拐点到了吗?钟南山最新判断!


现在可以摘口罩了吗?无症状感染者有传染性吗?动物之间会传染病毒吗?全球疫情的拐点会在何时到来?4月12日,中国工程院院士、呼吸病学专家钟南山接受了人民日报客户端的专访,给出了最新判断。


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现在还不是摘口罩的时候

现在还不是摘口罩的时候。现在国内外情况悬殊,中国由于采取了非常果断的措施,现在已步入疫情第二阶段,而其他一些主要国家还处在大暴发的第一阶段,且仍在向上攀升。这意味着人传人的几率非常高,确诊病例增加非常快。


After China took decisive measures, the epidemic in the country has now entered its second phase, said Zhong Nanshan, China's renowned respiratory expert, Academician of Chinese Academy of Engineering, in an interview with People's Daily.


However, he noted that some countries are still in the first phase of the outbreak and the situation continues to escalate, which also means there is a high possibility of human-to-human transmission with rapidly growing numbers of confirmed cases.


戴口罩仍是很重要的自我防护手段,现在就提出不戴为时过早。不过,在疫情不严重的地区,人少的地方或空旷场所,倒不见得必须戴。

"It's not time to take off the masks, which is still an important measure for self-protection," he said.

武汉过关了,但还有下一关

武汉解封了,我也很高兴。疫情暴发时,中央果断出手,对武汉城市交通进行管控,其他地方采取群防群治措施,是非常成功的,在疫情防控史上,这也称得上是一个壮举。


接下来仍然面临两个考验。一个是如何边防控、边复工,另外一个是“外防输入”关。现在国外还处在疫情暴发高峰,一些跟国外交流密切的中国沿海大城市很容易被卷进去又出现部分疫情,还需要通过各种防控举措过关。


Zhong noted that China now faces two major tests, the first being how to gradually resume production while maintaining prevention and control work, and the other is fending off risks of imported infections.


图源:人民日报客户端采访视频

境外输入造成中国疫情二次暴发可能性小


境外输入病例不断出现,会不会造成社区传播,引发我国疫情二次暴发?


这实际上是两个问题,一是外来输入病例有没有传播,二是会不会在传播过程中暴发。境外输入病例传播的危险性肯定存在,特别是核酸检测阳性或已出现感染症状的病例,传染性比较强,会造成病毒传播。


会不会造成疫情的暴发?估计可能性比较小。我国的群防群控一直下沉到社区,社区居民都有很强的自我防护意识,比如戴口罩、与人交往保持距离等,一旦有人出现发烧等症状,也能够快速报告或接受诊断,进而隔离。总体看,社区的传播危险性肯定存在,但中国出现疫情第二波大暴发的几率很小。

The risk of community transmission caused by imported cases certainly exists, but the possibility of outbreaks is relatively small, and given the enhanced public awareness of self-protection, a second wave of outbreak in China is unlikely, Zhong said.


"China's prevention and work has been deployed at communities. Residents now have a strong sense of self-protection. Once there are people with fevers, they can be rapidly reported, diagnosed and isolated," Zhong said, noting that the risks of community transmission definitely exist, but the chances of a second wave are very small.

谈全球疫情拐点为时尚早


从全球看,原来疫情的“震中”在欧洲,特别是西班牙和意大利,现在还包括德国、法国、英国。当前问题最大的是美国,最近这一周每天是以一两万例的速度在增加。所以,现在看拐点还早。


到不到拐点,要看政府能不能出手进行强力的干预。其他国家有很多不可测的因素,所以现在让我预测全球拐点,就比预测中国的难得多。照目前这个形势发展下去,恐怕还需要两周。

It's too early to talk about an inflection point in the global coronavirus pandemic, and the biggest problem is the US, given its rapid growth in case numbers of 10,000 to 20,000 per day this week, Zhong said on Sunday, noting that there are unpredictable factors in projecting this point now, and it might take two more weeks to start making that projection.

中国无症状感染者比例不会很大

无症状感染者不会凭空产生,通常会出现在两个群体:一是在疫情相对严重的地区,暂时还没有表现出症状、但可能已经被感染的人。另一个是确诊病例的密切接触者。他们占的比例还是比较少的。


无症状感染者也有两个概念,一类是开始没有症状,但后来会逐渐发展到有症状,这类是肯定有传染性的。另一类是最近我们发现的,在相当长的观察过程中始终没有症状,但核酸检测阳性。这类的传染性,我们正在研究。但根据新冠病毒的特性,一旦出现症状,传染性就比较强,所以将他们作为一组人进行隔离观察,这样的战略是对的。


China does not have a large proportion of asymptomatic patients, and most recovered COVID-19 patients will not infect others, Zhong said .


Asymptomatic patients usually exist in two groups: people from areas where the virus is rife who have not yet shown symptoms after being infected; and those who have had close contact with confirmed cases, said Zhong.


He stressed that the proportion of those patients is relatively small.


Some asymptomatic patients may show an onset of symptoms later, said Zhong, noting that this group of patients are infectious.


Zhong said he and his team are researching the infectiousness of the second group of virus carriers, noting that based on the virus' particularity, once symptoms show, this group of people possess a strong ability to infect.


The second group of people are now being put under quarantine and observation.


图源:人民日报客户端采访视频


复阳患者大多不传染

所谓的“复阳”,大多数应是核酸的片段而不是病毒本身。需要注意两种情况,第一种是患者本人是不是复发,假如患者产生很强的抗体,一般不会再感染。至于复阳患者会不会传染给别人,则需要具体分析。一般来说核酸片段没有传染性。一些学者曾经对复阳患者的咽拭子及分泌物进行培养,没有培养出病毒。

还有一种很少的情况,病人原本就有很多基础病,只不过症状改善了,并没有完全康复,这些病人不能排除有传染性。


总体而言,复阳患者带不带传染性,我个人不是太担心。


Zhong also said concerns that recovered patients may be infectious do not worry him.


"The so-called 'recovered patients who test positive again' mainly refer to the fact that they tested positive again for nucleic fragments, not that they were invaded again by the virus," Zhong said.


He said attention must be paid to whether the virus invades recovered patients again. If patients already develop strong antibodies inside them, normally they won't become infectious.


Normally, the virus's nucleic fragments are not infectious, said Zhong, noting that scholars cultivated throat swabs from recovered patients and found no virus in them, according to Zhong.


In rare situations, patients who already have underlying diseases only see an improvement in their symptoms but do not recover completely. Zhong said this group of patients are, in fact, infectious.


新冠肺炎流感化尚无充足证据

新冠肺炎会不会像流感(flu)一样长期存在?


这是一派的观点。到现在来看,还没有充足证据。除非病毒传播出现这样的规律:它的传染力仍然较强,但病死率(case fatality rate)越来越低,在这种情况下,有长期存在的可能。我们现在需要进行一个长期的观察,掌握充分的数据、案例,才能够得出类似这样的看法。在现在的情况下,我不认为这种预测会是现实。


图源:人民日报客户端采访视频


动物间传播现在下结论太早


狗、猫、老虎等一些动物核酸检测(nucleic acid testing)阳性(positive),究竟是污染造成的,还是感染的,有待观察。有些动物身上原本就带有一些病毒,不一定有症状,也不一定会传染。


现在就认为这些动物身上的新冠病毒既能传染人,又能传染动物,而且都能致病,结论下得太早了,一般来说我不会那么看。


还没有特效药,但发现一些有效药


我们现在试验的一些药物,比如氯喹,实验结果肯定是有效的,我们正在总结,可能很快要发表出来。还有一些中药,比如连花清瘟,我们不仅做了离体实验,还在P3实验室(即生物安全防护三级实验室,编者注)发现,它抗病毒作用不强,但抗炎症方面表现突出,有关实验结果不久之后也会发表。


此外还有中药血必净,它的主要成分包括红花、丹参、赤芍等,用于活血化瘀,对重症病人的治疗初步看也是有效的,我们现在也在总结。

There are no specific medicines for coronavirus, although some have turned out to be effective in treating it.


Zhong said his team is testing the effectiveness of medicines such as chloroquine and traditional Chinese medicine (TCM) formulae such as Lianhuaqingwen and Xuebijing, which have been proved to be effective in treating critically ill patients.


疫苗不会很快上市


真正终结疫情,疫苗挺重要的,现在各国都在以最快的速度研发。但我不认为疫苗三四个月时间就能做出来。


把全部希望放在疫苗上,其他方法一概不管,是消极的。而且疫苗出来后,也不可能一下就非常完善,易感人群可打,但没必要全部人群人人都打。


Zhong believed that a vaccine will not be available in the near future and placing all hopes on a vaccine while disregarding other methods is a negative approach.


"I don't think the vaccine will be available in three or four months," he said. "After the vaccine comes out, you can't expect it to be perfect. Highly infective people can get vaccinated, but it is not necessary for everyone to be vaccinated," he said.


此外,根据抗击“非典”的经验,去掉中间宿主,也能阻断疫情的传播。目前,我们还不知道新冠病毒的传播链是怎么样的,搞清楚之后切断也很重要。


He also noted that it is important to identify the intermediate host of the coronavirus.


"Based on our experience of fighting SARS, removing the intermediate host can also curb the epidemic. At present, we do not know the whole chain of how the novel coronavirus spreads. It is also important to cut the intermediate host off after figuring it out," he said.


群体免疫是最消极的做法


对待疫情最为消极的做法就是所谓的群体免疫,这是一百多年前的思路了,那时人类没有什么办法,只能任由病毒感染,感染后活下来的人自然获得抗体。现在再用这种方法应对新冠病毒我不赞同。在过去一百多年里,人类取得很大进步,有很多办法预防,不需要再用自然免疫、群体免疫。

Regarding the "herd immunity" approach, Zhong said this is the most passive way of fighting the epidemic.


"This idea goes back a hundred years when humans had no choice but to let the virus infect them so that those who survived it naturally obtained antibodies. Now, there are many precautionary methods and there is no need to adopt 'herd immunity,'" he said.


中国抗疫最值得分享的经验是执行力


中国战“疫”主要采取了两大措施:一是对暴发地区进行封堵,阻断传播;二是基层群防群治,也就是联防联控。现在防控的核心也是两个,第一是保持距离,第二是戴口罩。


所以,最可分享的经验是执行力。很多国家的医疗水平、技术实力比我国高得多,之所以在疫情面前措手不及,就是因为没有思想准备,也没有果断采取相应措施,导致不少一线医务人员感染,而这道防线一旦垮掉,会很容易失控。


Zhong believes the experience most worthy of sharing in China's success over coronavirus is its strong enforcement ability, especially in locking down the worst-affected areas to block the spread and popularizing precautionary measures among individuals.


"Some countries are more advanced than China in terms of medical treatment and technical strength. However, they were not well prepared and did not take immediate measures, which led to the infection of frontline medical staff. When this defense broke down, things quickly went out of control," he said.


综合来源:人民日报、环球时报、中国日报双语新闻

本文部分内容转载自:中国日报双语新闻,已获授权

 
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