How China’s Coronavirus Is Spreading—and How to Stop It
Studies are building toward a tentative clinical profile of the outbreak.
BY ANNIE SPARROW | JANUARY 26, 2020, 3:37 PM
in Foreign Policy
https://foreignpolicy.com/2020/01/26/20 ... l-profile/
The coronavirus is a physically large virus—in relative terms, at just 125 nanometers with a surface of spike projections, too big to survive or stay suspended in the air for hours or travel more than a few feet. Like influenza, this coronavirus spreads through both direct and indirect contact. Direct contact occurs through the physical transfer of the microorganism among friends and family through close contact with oral secretions. Indirect contact results when an infected person coughs or sneezes, spreading coronavirus droplets on nearby surfaces, including knobs, bedrails, and smartphones.
Even trickier than treatment is detecting the virus. In quarantined Wuhan, dozens of fever clinics are singling out anyone with a fever of 99.1 degrees Fahrenheit or above—the cardinal sign for 98 percent of pneumonia cases—and then interviewing them about possible exposure to the coronavirus. In theory, this sounds reasonable.
In practice, it is the screening from hell. Early symptoms of fever and cough are clinically indistinguishable from the usual winter suspects, such as influenza, while fever is an undifferentiated sign, common to hundreds of noninfective diseases from allergies to arthritis.
总结一下要点:传播途径类似流感和普通感冒病毒,空气传播效率很低,但可以在物件表面存活几个小时。传播途径主要是接触,所以手和物体表面(尤其是手机表面!)的消毒比较重要,反而口罩之类并没有那么重要。One puzzling aspect so far is the thankful lack of child victims... Few children have yet been reported with coronavirus symptoms. That does not mean that no children have been infected. A similar pattern of benign disease in children, with increasing severity and mortality with age, was seen in SARS and MERS.
仅依赖发烧来 screen 病毒携带者效率低下。体温是非常难分辨的症状。总之就是不要有发烧就跑到医院里去诊断,很容易交叉感染。实际上如有呼吸道感染的症状,留在家里自我隔离一段时期,是相对来说最安全的做法。
儿童几乎没有症状,没有危险。但是有可能携带病毒。这方面类似于很多其他病毒,例如 chicken pox。
---------
CDC 的网站上有比较全面的数据以及传播地图,尤其是美国的感染案例会更新的比较及时,有问题可以看看他们的 Q&A:
https://www.cdc.gov/coronavirus/2019-nCoV/summary.html
目前各国的案例都可以直接 trace 到近距离接触,不需要疑神疑鬼,更不需要跑到机场去抗议入境旅客和航班。(我不知道教育程度要高到什么程度才能避免这种神经病的思路和行为。)Imported cases of 2019-nCoV infection in people have been detected in the U.S. While person-to-person spread among close contacts has been detected with this virus, at this time this virus is NOT currently spreading in the community in the United States.
---------
英国医学期刊 The Lancet 是最早发表 2019-nCOV 临床论文的期刊,他们开放了一个网页,免费分享中国医生写的临床描述论文和传染科专家的综述。这上面的文章专业性比较强,都是原始数据。
https://www.thelancet.com/coronavirus
网页上最新发表的是香港公共卫生研究人员做的模拟病毒传播的数据模型。(我现在就扔下话,如果香港没了,公共卫生水平会倒退不知多少年。中国医学研究水平再高,大众和外面谁都看不见有个屁用。)
---------Results: In our baseline scenario, we estimated that the basic reproductive number for 2019-nCoV was 2·68
(95% CrI 2·47–2·86) and that 75 815 individuals (95% CrI 37 304–130 330) have been infected in Wuhan as of
Jan 25, 2020. The epidemic doubling time was 6·4 days (95% CrI 5·8–7·1). We estimated that in the baseline
scenario, Chongqing, Beijing, Shanghai, Guangzhou, and Shenzhen had imported 461 (95% CrI 227–805),
113 (57–193), 98 (49–168), 111 (56–191), and 80 (40–139) infections from Wuhan, respectively. If the transmissibility
of 2019-nCoV were similar everywhere domestically and over time, we inferred that epidemics are already
growing exponentially in multiple major cities of China with a lag time behind the Wuhan outbreak of about
1–2 weeks.
我查了一下今天的最新数据,中国大陆以外的地区目前已经发现140例感染,这些感染中无人死亡。这说明 2019-nCoV 感染的死亡率,可能是病毒变异到现在的状态,远低于 SARS (15-20%) 和 MERS (~35%)。
对于 2019-nCoV 警惕但不要惊慌是最稳妥的个人应付手段。其他措施只能交给本地公共卫生。
这次病毒爆发的最大祸害,很可能不是 2019-nCoV 本身,而是它的副作用。为什么呢?目前已经可以看出灾区的医疗系统不堪压力而接近崩溃或者已经崩溃,一线临床医疗人员因为自己被感染而减少数量。所以,其他疾病的病人,原本可以得到医治,这时失去应有的医治照顾,从而恶化或死掉,我估计数量会远超过死于 2019-nCoV 的人数。
一星期之前也不知是那个宣传机构的头头拍脑袋想出的主意,在媒体上大肆宣传美国流感死亡人数。只要用脚趾头想想都能明白,influenza 只限于美国流传吗?实际上,在中国,今年因为 2019-nCoV 而死于 influenza 的人恐怕远远多于往年。当然,没有数据就什么都证明不了。