我们距离疫情结束究竟还有多远？
字幕摘录
| 时间 | 英文 | 中文 |
|---|---|---|
| 0:04 | All right. | 好吧,我们走。 |
| 0:04 | Hello, everybody. | 哈罗,大家好。 |
| 0:06 | Good morning from New Haven and a good evening to those of you guys | 早晨从纽黑文 和一个美好的夜晚 给那些家伙 |
| 0:10 | joining us from Beijing and in China. | 从北京和中国加入我们 |
| 0:13 | I'm very excited to have everybody join us. | 很高兴大家加入我们 |
| 0:16 | My name is | 我的名字是 |
| 0:17 | Devin Lau. | 刘德文. |
| 0:17 | I'm the Assistant Director of Yale Center Beijing and we have here with us today | 我是耶鲁中心北京的助理主任 今天我们在这里 |
| 0:22 | Dr. Saad Omer. | 萨德·奥马尔博士 |
| 0:23 | I'm very excited to have today's talk. | 今天的谈话我非常兴奋 |
展开字幕全文（546 条）
| 序号 | 英文 | 中文 |
|---|---|---|
| 1 | All right. | 好吧,我们走。 |
| 2 | Hello, everybody. | 哈罗,大家好。 |
| 3 | Good morning from New Haven and a good evening to those of you guys | 早晨从纽黑文 和一个美好的夜晚 给那些家伙 |
| 4 | joining us from Beijing and in China. | 从北京和中国加入我们 |
| 5 | I'm very excited to have everybody join us. | 很高兴大家加入我们 |
| 6 | My name is | 我的名字是 |
| 7 | Devin Lau. | 刘德文. |
| 8 | I'm the Assistant Director of Yale Center Beijing and we have here with us today | 我是耶鲁中心北京的助理主任 今天我们在这里 |
| 9 | Dr. Saad Omer. | 萨德·奥马尔博士 |
| 10 | I'm very excited to have today's talk. | 今天的谈话我非常兴奋 |
| 11 | Of course, the reason we're doing this talk | 当然,我们谈这个的原因 |
| 12 | on Zoom is, of course, because of COVID and, you know, we've been doing these online Zoom talks now | 当然,因为COVID 我们一直在做这些在线演讲 |
| 13 | for over two years now and so it's very good to sort of take a step back and be able to reflect | 两年多来 所以最好退一步 思考一下 |
| 14 | on why it is that we're doing these Zoom talks and so that's what we're doing today. | 我们为什么要做这些Zoom的演讲 所以这就是我们今天要做的 |
| 15 | For those of you guys that are joining us for the first time, Yale Center Beijing is Yale's | 你们这些第一次加入我们的人 北京耶鲁中心是耶鲁的 |
| 16 | only university-wide center where we host Yale professors and thought leaders from around the | 只有全大学中心 我们接待耶鲁的教授和思想领袖 |
| 17 | world on subjects across the disciplines. | 世界的学科。 |
| 18 | You know, everything from economics to science to | 从经济学到科学 |
| 19 | art to music and today we're very lucky to have Dr. Saad Omer join us. | 艺术到音乐,今天我们非常幸运 有萨阿德·奥马尔博士加入我们。 |
| 20 | He is the inaugural director | 他是首任导演 |
| 21 | of the Yale Institute for Global Health and he's also a professor of medicine infectious diseases | 耶鲁全球卫生研究所的教授 他也是医学传染病教授 |
| 22 | at the Yale School of Medicine and the Susan Dwight Bliss Professor of Epidemiology of Microbial | 耶鲁医学院和苏珊·德怀特·布利斯微生物流行病学教授 |
| 23 | Diseases at the Yale School of Public Health. | 耶鲁大学公共卫生学院的疾病. |
| 24 | Dr. Omer has conducted studies in the U.S. as | 奥梅尔博士在美国从事研究 |
| 25 | well as multiple countries across South America, Africa, Asia, and Australia. | 以及南美洲、非洲、亚洲和澳大利亚的多个国家。 |
| 26 | His research portfolio | 他的研究组合 |
| 27 | includes epidemiology of respiratory viruses such as influenza and of course most recently COVID-19. | 包括流感等呼吸道病毒的流行病学,当然还有最近的COVID-19。 |
| 28 | He's done clinical trials to estimate efficacy of maternal and infant influenza polio measles | 他做了临床试验 估计母子流感脊髓灰质炎麻疹的疗效 |
| 29 | and pneumococcal vaccines as well as trials to evaluate drug regimens to reduce mother-to-child | 和肺炎球菌疫苗以及评估药物治疗方法以减少母子感染的试验 |
| 30 | HIV. | 艾滋病毒。 |
| 31 | So a very broad portfolio here. | 因此,一个非常广泛的组合在这里。 |
| 32 | His work has included public health preparedness strategies | 他的工作包括公共卫生准备战略 |
| 33 | to effectively respond to large emerging and reemerging infectious disease outbreaks | 有效应对新出现的和重新出现的大型传染病爆发 |
| 34 | and it has been cited in global and country-specific policy recommendations, | 并已在全球和具体国家的政策建议中援引, |
| 35 | informed clinical practice and health legislation in several countries, and of course been cited | 若干国家知情的临床实践和卫生立法,当然也有人引用 |
| 36 | in popular media. | 在大众传媒。 |
| 37 | He is a graduate of Johns Hopkins and he's published over 400 papers in | 他是约翰·霍普金斯的毕业生 他发表了400多篇论文 |
| 38 | peer-reviewed journals and mentored over 100 junior faculty, clinical and research postdoctoral | 同行评审期刊,并指导100多名初级教师、临床和研究博士后课程 |
| 39 | fellows and PhD and graduate students. | 研究员、博士和研究生。 |
| 40 | And today a very timely discussion for me personally because | 今天我个人非常及时的讨论 因为 |
| 41 | I actually just caught COVID over the weekend and so you know I was actually quite strangely | 其实我周末刚抓到COVID 所以你知道我其实很奇怪 |
| 42 | excited to have this talk with you and glad to do so over Zoom instead of in person. | 很高兴能和你谈这个 很高兴通过Zoom而不是亲自来 |
| 43 | So I guess | 所以我觉得 |
| 44 | you know I remember last seeing you about two years ago when COVID first broke out and that | 你知道,我记得最后一次见到你大约 两年前,当COVID第一次爆发, |
| 45 | was back in early 2020 and Yale had put on a panel with yourself and you know Stan and Albert Ko | 在2020年初,耶鲁 和你自己放在一个面板上 你知道斯坦和阿尔伯特·柯 |
| 46 | who actually gave a talk here at Yale Center Beijing in person right before COVID broke out | 他其实是在北京耶鲁中心亲自演讲的 就在COVID爆发之前 |
| 47 | in probably September or October and he said you know we should get ready for a global outbreak | 可能九月或十月 他说你知道我们应该做好全球爆发的准备 |
| 48 | of a new emerging disease that we've never seen before and we had no idea at that time how | 我们以前从未见过的新型疾病 我们当时完全不知道 |
| 49 | prophetic his words would be because within a couple months that's exactly what happened | 预言他的话会是 因为几个月后 事情就是这样 |
| 50 | and so here we are two years later and we're still you know in the midst of a pandemic | 两年后,我们仍处在大流行中 |
| 51 | and so I want to start with just sort of laying the groundwork here and just saying you know | 所以我想从打基础开始 说你知道 |
| 52 | in two years what have we learned? | 两年后我们学到了什么? |
| 53 | Where are we now exactly? | 我们现在究竟在哪里? |
| 54 | What are sort of you know just | 什么样的你知道 |
| 55 | the general sense of where we are in this global pandemic and how are we doing so far? | 对我们在这一全球流行病中所处的位置的总体认识,以及我们迄今是如何做到的? |
| 56 | A few things we have learned. | 我们学到了一些东西。 |
| 57 | The first thing we have learned is about the virus. | 我们了解的第一件事是病毒。 |
| 58 | We know a lot | 我们知道很多 |
| 59 | about the virus about the disease than we did before at the beginning and that has taken | 关于病毒的疾病 比我们之前的开始, 并且已经采取了 |
| 60 | a global effort and a truly global effort. | 全球努力和真正的全球努力。 |
| 61 | For example I know that many countries | 例如,我知道许多国家 |
| 62 | like the US and Europe benefited from the data that was shared by scientists in China earlier on | 如美国和欧洲从中国科学家先前分享的数据中获益。 |
| 63 | about the clinical features. | 关于临床特征。 |
| 64 | Obviously these data evolve and we have had sort of sometimes | 显然这些数据在演化,我们有时有 |
| 65 | the initial findings get adjusted as more people get infected more science comes out but the early | 随着更多的人被感染 科学的出现 但早期 |
| 66 | insights were extremely helpful and a lot of them have stood the test of time and so that was | 洞察力非常有帮助,其中许多人经受住了时间的考验,因此 |
| 67 | helpful. | 帮助。 |
| 68 | Sharing of the genome earlier on publicly and openly in the sense that you know through | 更早公开分享基因组 意思是你知道通过 |
| 69 | sort of open science fora helped scientists develop vaccines earlier on irrespective of the | 某种开放的科学论坛 帮助科学家开发疫苗 更早,无论 |
| 70 | form to target you know spike protein and all of that stuff so that has been helpful. | 以你为对象,你懂螺旋蛋白 和所有的东西,所以这是有用的。 |
| 71 | The other | 另一个 |
| 72 | lessons we have learned that there is a role for both non-pharmaceutical and vaccine related | 我们学到的教训是,非药品和疫苗都有作用。 |
| 73 | interventions in controlling the outbreak. | 干预控制疫情。 |
| 74 | A further lesson is that any sustainable control | 另一个教训是,任何可持续的控制 |
| 75 | of the outbreak requires vaccines to be a part of the strategy but the vaccine strategy needs | 疫苗是战略的一部分 但疫苗战略需要 |
| 76 | to be adjusted based on the data's data because each new variant has had its own | 根据数据数据进行调整,因为每个新变体都有自己的 |
| 77 | quirks and we'd be happy to go into the details into that. | 我们很乐意深入了解细节 |
| 78 | The other lesson we learned is that | 我们学到的另一个教训是: |
| 79 | having technology is not sufficient. | 拥有技术是不够的。 |
| 80 | We need to work on people actually taking the vaccines | 我们需要对实际服用疫苗的人进行研究 |
| 81 | for example compliance and the human behavior related factors. | 例如遵守和人类行为相关因素。 |
| 82 | So these are a few big picture | 所以这是几个大局 |
| 83 | lessons but the last lesson that I kept for it, the lesson that I kept for the end of this list | 教训,但我为它保留的最后教训, 教训,我为本列表的结尾保留 |
| 84 | is the fact that because vulnerabilities anywhere in the world | 因为世界上任何地方的脆弱 |
| 85 | impact everyone. | 影响每个人。 |
| 86 | So emergence of new variants you know if you leave people unprotected and new | 所以,新变种的出现,你知道 如果你离开人们无保护 和新的 |
| 87 | variants come up it impacts everyone and we know that Omicron is more infectious than the other | 变体会影响每个人 我们知道Omicron比其他的更传染 |
| 88 | although on a per infection basis it causes less mortality but if more people get infected | 虽然每一次感染的死亡率都较低,但如果感染的人数更多的话 |
| 89 | means that even if it's per infection lower mortality we have a public health problem | 这意味着即使每一次感染 死亡率降低 我们有一个公共卫生问题 |
| 90 | and so that means that no one is safe until everyone is safe and focusing on global | 因此,这意味着,除非每个人都安全,并注重全球安全,否则没有人是安全的。 |
| 91 | vaccine access is in everyone's interest. | 获得疫苗符合每个人的利益。 |
| 92 | So these are a few big picture lessons. | 因此,这些是几个大的经验。 |
| 93 | Great so there's a lot we can delve into there. | 好极了,我们可以深入调查 |
| 94 | 你说你知道Omicron似乎 | |
| 95 | per infection less deadly but of course it's more infectious. | 每一次感染的死亡率都较低 但当然更传染性 |
| 96 | Could you just maybe | 你能只是也许 |
| 97 | so that we're all on the same page walk us through sort of what the sort of evolution of the variants | 所以,我们都在同一页 带我们走过什么类型的 进化的变体 |
| 98 | has been like so far? | 到现在为止都这样吗? |
| 99 | Obviously when we first started we knew nothing about the disease at all | 很明显,我们刚开始的时候 我们根本不知道这个病 |
| 100 | and it seems like now you know in some parts of the world you know like in say large cities in | 现在似乎你知道 在世界一些地方,你知道 比如说,大城市在 |
| 101 | Europe and you know people don't even seem to care anymore. | 欧洲和你知道人们 似乎不再关心了。 |
| 102 | So sort of what has been the evolution of | 如此之类的进化 |
| 103 | the different variants and how has it changed over time? | 不同的变体 和它是如何变化的? |
| 104 | Yeah so as the original virus was | 对,原来是病毒 |
| 105 | identified in Wuhan and reported in Wuhan the evidence the current state of evidence points to | 在武汉发现的证据 和在武汉报告的证据 |
| 106 | a zoonotic transmission meaning it's a bad virus through an intermediate host going to humans. | 动物传播意味着它是一个坏病毒 通过中间宿主去人类。 |
| 107 | There are a lot of sort of related bad viruses etc and there's even more evidence more recently | 有很多相关的坏病毒 并且最近有更多的证据 |
| 108 | that supports that line of thinking and so when the virus evolved it had certain characteristics. | 所以当病毒演化时 它具有某些特征 |
| 109 | One of the initial interesting things was that asymptomatic people were able to | 最初有趣的是,无症状的人能够 |
| 110 | transmit the virus and there was some you know initial confusion in all countries. | 病毒的传播, 有一些你知道最初的混乱 在所有国家。 |
| 111 | About that | 关于那个 |
| 112 | point it took us a couple of months to clarify that asymptomatic transmission was a significant | 我们花了几个月的时间 来澄清无症状的传播 |
| 113 | mode of transmission. | 传输模式。 |
| 114 | People sort of transmitting before developing symptoms so that was the sort | 人们在出现症状前就传播了 就是这样 |
| 115 | to go back in time a little bit. | 回到过去一点。 |
| 116 | Then we had you know through the spring summer northern hemisphere | 然后,我们让你知道 通过春季夏季北半球 |
| 117 | spring summer whenever I say spring summer my Australian and South African colleagues point to | 春夏,每当我说春夏, 澳大利亚和南非同事指 |
| 118 | the round nature of the globe and that all seasons don't happen in the same months but | 地球的圆形性质 所有季节不会在同一个月发生 |
| 119 | the northern hemisphere spring summer 2020 saw the emergence of the original virus. | 北半球的2020年春夏 出现了原始病毒 |
| 120 | That was infectious it was more infectious than influenza but slightly less infectious than SARS | 传染性比流感强,但感染性比非典略低 |
| 121 | 1. | 一、导 言 |
| 122 | The original SARS that happened in 2003 that you know China is well aware of and other countries | 最初发生在2003年的SARS,你知道中国对其他国家很了解 |
| 123 | in Southeast Asia were able to successfully control and the rest of the world was able to | 东南亚成功控制了世界其他地方 |
| 124 | eventually but it was slightly in that vicinity but not hugely infectious. | 最终,但它在那个附近略微,但并没有巨大的传染性。 |
| 125 | Then what happened was | 然后发生的事是 |
| 126 | we had the emergence of a new variant alpha that was first identified in the UK. | 我们发现一个新的变体α 最早是在英国发现的 |
| 127 | The reason I'm | 是因为我 |
| 128 | saying is that identified is once sort of a virus spreads after the original one and sometimes it's | 说: 识别是曾经一种病毒 传播在原病毒之后,有时它 |
| 129 | not even clear with the original virus but here we have sort of evidence that points to | 但这里有证据表明 |
| 130 | sort of an emergency instead of a finite geographic area. | 这是一种紧急情况,而不是有限的地理区域。 |
| 131 | It's hard to say where the | 很难说在哪里 |
| 132 | variant emerged but it's just that you go by where it was reported. | 变体出现,但只是你走它被报道的地方。 |
| 133 | So the initial reporting | 所以,初始报告 |
| 134 | of the alpha the so-called alpha variant what happened in the UK where it was found that it | 所谓的α变体 在英国发生的事情 在那里发现它 |
| 135 | was more transmittable but equally on the per case basis equally severe or actually slightly | 较易传染,但按个案计算同样严重或实际轻微 |
| 136 | severe in terms of hospitalization rates etc. | 在住院率方面非常严重。 |
| 137 | But not hugely more severe but substantially | 但不是更严重,而是实质性的 |
| 138 | you know so that caused that was associated with the late 2020 early 2021 wave which was | 这和2020年末的2021年初的浪潮有关 |
| 139 | pretty substantial. | 相当实质性 |
| 140 | Then came a couple of other variants one in you know beta and sort of in | 之后出现了几个其他的变体之一 你知道β和排序在 |
| 141 | Lao etc. | 老挝等. |
| 142 | So there are a couple of variants that came in South Africa were identified in South | 所以南非有几种变种 在南方被发现 |
| 143 | Africa and Brazil etc. | 非洲和巴西等。 |
| 144 | That raised alarm but didn't go too far. | 这引起了警醒 但没走得太远 |
| 145 | The next big variant | 下一个大变体 |
| 146 | of concern that impacted everyone was delta because it was not only more infectious but also | 影响每个人的关切是三角洲,因为它不仅更具有感染性,而且还包括: |
| 147 | more severe substantially more severe than alpha. | 比阿尔法严重得多 |
| 148 | And around November late November it was reported | 大约11月下旬报道 |
| 149 | more broadly it was it emerged earlier on was the so-called omicron variant which is a variant | 更广义地说,它早先出现过 所谓的微缩变体是一种变体 |
| 150 | which it was fairly clear that it was identified in as being more infectious but more infectious | 很明显,它被确认为 感染性较强但感染性较强 |
| 151 | in the sense that it is evading not by inherently more infectious. | 也就是说,它不是从本质上来说更具有传染性的。 |
| 152 | So delta was inherently more | 因此,三角洲本质上是更多的 |
| 153 | infectious than alpha. | 感染性比α。 |
| 154 | Omicron now we know is slightly more inherently infectious than delta | 我们现在知道 与三角洲相比 其内在传染性略强 |
| 155 | but it is it evades unlike delta it evades immunity both not just vaccine related immunity | 但与三角洲不同的是它逃避了豁免 不仅仅是疫苗豁免 |
| 156 | but also infection related immunity. | 但还有与感染有关的豁免。 |
| 157 | So it successfully so there is this perception that | 所以,它成功 所以有这种感觉, |
| 158 | infection related immunity is somehow permanent etc. | 与感染有关的免疫力是永久性的,等等。 |
| 159 | No that's not the case. | 不,不是这样的。 |
| 160 | In the face of omicron you know I would roughly consider it equivalent to one and a half | 在Omicron面前,你知道我大概会认为它相当于一个半 |
| 161 | dose of a vaccine and this is a very rough way of describing it. | 疫苗的剂量, 这是一个非常粗糙的方式描述它。 |
| 162 | So slightly better than a single | 感觉好过一个 |
| 163 | dose but not by much etc. | 剂量,但不是很多等。 |
| 164 | So this is so omicron spread like wildfire and countries that had even | 因此,这是如此的微粒扩散 像野火和那些甚至有 |
| 165 | successfully controlled the virus against you know but their now well practiced policies | 成功控制了病毒,但现在他们的政策 |
| 166 | against other variants were faced with a much much bigger challenge in the face of omicron. | 面对其他变种 面对更大的挑战 |
| 167 | So that's in a nutshell about the history of important variants. | 简言之,这就是关于重要变体的历史。 |
| 168 | Very interesting. | 非常有趣,你觉得呢? |
| 169 | So if we kind of take a step back and understand the evolution of the specific | 所以如果我们退一步 了解具体的进化 |
| 170 | virus over time if we were to compare it to other viruses and other epidemics and pandemics that | 如果我们把它与其他病毒、其他流行病和流行病相比较 |
| 171 | we've seen in history is this a normal sort of course of evolution for a virus to go through? | 我们从史上看到的 病毒的进化过程是正常的吗? |
| 172 | Is this something that we've seen before of normal being you know how often do you have a | 这是以前我们见过的 正常的,你知道 你有多经常有一个 |
| 173 | global pandemic but you know is there a point of comparison that we can have with with say | 但是你知道,我们可以用这个来比较 |
| 174 | you know a cold or a flu? | 你知道感冒还是感冒? |
| 175 | That's a really good question. | 这是一个非常好的问题。 |
| 176 | Well it's normal for a pandemic to give you surprises let's put it that way. | 给大家惊喜是正常的 我们这么说吧 |
| 177 | So it is normal for us to not know a lot about it initially and then learn slowly about it but it | 所以,我们通常不 了解它很多 首先,然后慢慢地学习它,但它 |
| 178 | still continues to give surprises. | 仍然继续给人惊喜。 |
| 179 | I think when we look back in terms of what we as the global | 我想,当我们回顾 我们作为全球 |
| 180 | community global scientific and medical and public health community could have done better | 全球科学和医疗及公共卫生界本来可以做得更好 |
| 181 | one thing is that we could have learned more from seasonal coronavirus spread. | 有一件事是,我们可以学到更多的 从季节性冕病毒传播。 |
| 182 | So they are seen you | 他们看见你了 |
| 183 | know I'm sure people or a lot of people may be familiar that there are seasonal coronaviruses | 我敢肯定,人们或很多人可能 熟悉有季节性冕病毒 |
| 184 | that spread every year. | 这每年传播。 |
| 185 | They may have entered in the human population the decades or centuries | 他们可能已经进入人类 数十年来或数世纪 |
| 186 | ago but they continue to circulate with some frequency. | 但他们继续频繁地流通 |
| 187 | For influenza we learn from seasonal | 对于流感,我们从季节性学习 |
| 188 | influenza in preparation for pandemic influenza you know as you know that you know you may know | 防范大流行性流感的流感 你知道,你知道 你可能知道 |
| 189 | that that threat hasn't gone away of influenza pandemic. | 那个威胁并没有消失 流感大流行。 |
| 190 | So that is so in that sense you know | 所以从这个意义上讲,你知道 |
| 191 | coming back to your question surprises are to be expected you know that's the paradox of pandemics. | 回到你的问题的惊喜是预期的 你知道这是传染病的悖论 |
| 192 | Having said that we you know if there is a silver lining in a way is that we didn't get | 说我们知道 如果有一条光明线 从某种意义上说 就是我们没有得到 |
| 193 | the level of infectivity of omicron or severity of delta as the first variant. | omicron的感染程度或三角洲的严重性是第一个变体。 |
| 194 | So that gave us | 所以,这给了我们 |
| 195 | gave us a little bit of a lead time to prepare for vaccines and so on so forth and there's no | 给了我们一些准备疫苗的准备时间,没有 |
| 196 | that's one thing. | 这是一件事。 |
| 197 | The other thing is it's not surprised but it's at the lower end of the | 另一件事是,它并不惊讶,但它的下端 |
| 198 | expectation of how quickly the protection against infection remember protection against severe | 期望预防感染的防护能多快地记住防止严重感染 |
| 199 | disease still holds up reasonably well although with omicron we need to have sort of additional | 病情还维持得比较好 虽然有眼线 我们需要一些额外的 |
| 200 | boosters etc. | 助动器等. |
| 201 | There was some justification against during delta as well but with omicron we should | 在三角洲期间也有一些理由反对,但是,用微粒,我们应该 |
| 202 | specifically have a strategy for for boosting especially high-risk populations but the fact | 特别有促进高危人群的战略,但事实上, |
| 203 | that it is not it is lasting the immune the the immune memory is lasting less than we had hoped | 它不是长久的免疫力 免疫力的记忆力比我们希望的要少 |
| 204 | for that's that's part of the surprise. | 因为这是惊喜的一部分 |
| 205 | Having said that again it's just to clarify even against | 再说一遍,只是澄清一下,甚至反对 |
| 206 | omicron the mortality and the severe outcomes have been overwhelmingly in unvaccinated and then | 在未接种疫苗的情况下,死亡率和严重后果占绝大多数,然后 |
| 207 | unboosted populations. | 未经鼓励的人口。 |
| 208 | So that data continue to support that doesn't mean that we should not | 因此,数据继续支持 这并不意味着我们不应该 |
| 209 | continue to focus on sort of better and better protection but just to just to clarify. | 继续注重更好和更好的保护,但只是为了澄清。 |
| 210 | Yes | 对 |
| 211 | we've seen from public health in the last years that it's very important to have very clear | 过去几年我们从公共卫生方面看到 说清楚很重要 |
| 212 | messaging here. | 给您留言 |
| 213 | So you've mentioned the seasonality of you know other diseases like the cold or | 所以,你提到了季节性 你知道其他疾病,如寒冷或 |
| 214 | influenza and that was a question that came up with some people also is this it doesn't seem like | 流感是有人问到的一个问题 也不是 |
| 215 | their seasonality with with covid at least from what we've experienced we've had waves but it | 他们的季节性 至少从我们所经历的来看 我们有过波浪 |
| 216 | like you know you know summer winter you know northern or southern makes a big difference | 就像你知道的夏天冬天 你知道北方或南方会有很大的不同 |
| 217 | in terms of having this disease is this sort of unique to this disease or is it perhaps because | 就患上这种疾病而言,这种疾病是这种疾病特有的,或是因为 |
| 218 | we're we're at the very forefront of dealing with disease you know what are the possible | 我们处在对付疾病的最前沿 你知道什么是可能的 |
| 219 | explanations for I guess first of all is the observation true that there is no seasonality | 我首先要解释的是 没有季节性的观察 |
| 220 | in covid and then what are some of the possibilities for for why that might be? | 为何如此呢? |
| 221 | That's again a good question. | 问又曰. |
| 222 | So think of it as tides and waves. | 所以把它当作潮汐和波浪 |
| 223 | ┮Τ waves | |
| 224 | go up and down and then there is a tide that goes up and down. | 上下游,然后有 涨落的潮流。 |
| 225 | So seasonality think of it as a wave | 所以,季节性把它当作一个波 |
| 226 | as a tide and waves are you're going up and down based on measures and based on immunity | 作为潮汐和波浪,你正在上下 依据措施和豁免 |
| 227 | both through infection and vaccination and so here's what has happened. | 不管是通过感染还是接种, 事情是这样的。 |
| 228 | So we have | 所以我们有 |
| 229 | known even from the first year by the end of the first year that there is a strong seasonal | 即使从第一年开始,到第一年结束时,人们都知道,季节性强势。 |
| 230 | vector or strong seasonal force for this virus that supports transmission of this virus both | 这种病毒的传播媒介或强大的季节性力量 |
| 231 | for environment people are indoors but also other factors like humidity or lack thereof and sort of | 人类在室内,但也存在其他因素,如湿度或缺乏湿度,以及诸如此类因素。 |
| 232 | things even somewhat temperature etc may impact the transmission of this virus although the | 温度会影响病毒的传播 |
| 233 | evidence for latter is emerging but we have observed these waves that are pretty pronounced | 但是我们看到这些波浪非常明显 |
| 234 | or these sort of tides that are seasonal. | 或这些季节性的潮汐。 |
| 235 | That doesn't mean that that inherent advantage for | 这并不意味着那内在优势 |
| 236 | transmission during again northern hemisphere falls winter is that doesn't mean that it doesn't | 北半球冬天再次传播 并不意味着它不会 |
| 237 | happen in other seasons and this what you alluded to is correct happens because they're so in the | 发生在其他赛季 你提到的事情是正确的 因为它们是如此的 |
| 238 | beginning of a pandemic there is transmission there's so many people unprotected that even | 传染病的开始 传播 这么多的人没有保护 甚至连... |
| 239 | outside that most conducive season there are other waves as well. | 在那个最有利的季节之外 还有其他的海浪 |
| 240 | So these are waves and then the | 这些是波浪 然后是 |
| 241 | underlying tide goes up and down because of the inherent advantage in those seasons. | 由于这些季节的固有优势,基本潮流上下行. |
| 242 | So we have | 所以我们有 |
| 243 | seen that before in the so-called you may you know a lot of you may be familiar with the H1N1 | 之前在所谓的"H1N1"中 你可能认识很多人 |
| 244 | flu that happened in 2009 and 2010. | 2009年和2010年发生的流感。 |
| 245 | We saw again an increased transmission during winter but we | 我们又看到冬天的传播量增加,但我们 |
| 246 | also saw at a lower level but still waves in the summer. | 夏日中也能看到低级的波浪 |
| 247 | So that's the kind of thing we expect | 这就是我们期望的 |
| 248 | until it settles down and each country will have a slightly different pattern based on their | 直到它安定下来 每个国家将有一个 略有不同的模式 根据其 |
| 249 | personality and their interaction and big events like the you know the Chinese New Year etc. | 性格以及他们的互动和重大事件 比如你知道的中国新年等等 |
| 250 | is a | 是一个 |
| 251 | big gathering in China. | 在中国的大型集会。 |
| 252 | In other countries it's Christmas, Eid and those kinds of things so | 在其他国家是圣诞节,节日之类的事情 |
| 253 | sometimes they impact as well but essentially when the virus is new it has additional waves etc. | 有时它们也会影响,但基本上当病毒是新病毒时,它会有更多的波浪等等。 |
| 254 | and | 和 |
| 255 | as it becomes endemic a seasonal pattern so it may not be let's say in the U.S. | 因为它成为地方性的季节性图案 所以也许不能说在美国 |
| 256 | I expect | и稱 |
| 257 | like four or five years from now the peak seasons to be from December to February but that hasn't | 譬如四五年以后 十二月到二月的高峰季节 |
| 258 | settled yet. | 已经解决了 |
| 259 | There may be an early fall wave etc. | 可能出现早落波等. |
| 260 | in the U.S. but that will happen in like four, | 在美国,但那会发生 像四, |
| 261 | five, three, four years at least. | 至少5、3、4年时间 |
| 262 | We will continue to be hit by these smaller waves | 我们将继续受到这些小浪的冲击 |
| 263 | smaller in relative sense. | 相对意义上较小。 |
| 264 | So coming back to sort of countries in Asia etc. | 所以回到亚洲的一些国家。 |
| 265 | the influenza pattern | 流感模式 |
| 266 | is different by country based on various as I said social factors as well as actual weather | 正如我所说的,各国因各种社会因素和实际天气而异 |
| 267 | related factors but there will be a pattern a more predictable pattern that the virus will settle | 病毒会解决的规律 |
| 268 | into in a few years. | 几年后开始 |
| 269 | That's what we expect. | 这就是我们期望的。 |
| 270 | That's very interesting so it seems then that | 这很有趣 所以看起来 |
| 271 | we're heading into a pattern of sort of COVID becoming more and more like | 我们正在进入一种模式 COVID越来越像 |
| 272 | {\fn黑体\fs22\bord1\shad0\3aHBE\4aH00\fscx67\fscy66\2cHFFFFFF\3cH808080}我们期待季节性流感或季节性感冒 {\fn黑体\fs22\bord1\shad0\3aHBE\4aH00\fscx67\fscy66\2cHFFFFFF\3cH808080}这似乎 | |
| 273 | bear out throughout history that that's sort of what happens with pandemics. | 在整个历史中证明, 传染病就是如此。 |
| 274 | Is that correct? | 是吗? |
| 275 | Yeah and if it may so in certain places the seasonal even seasonal viruses have | 是啊,如果它可能在某些地方是这样 季节性的病毒甚至季节性的病毒 |
| 276 | you know more than one peak but there is it does become a more predictable pattern | 你知道不止一个峰 但是它确实变成了更可预测的模式 |
| 277 | so it depends on the country as I said where what that what that pattern is somewhat | 所以它取决于国家,就像我所说的 哪里是什么模式有点 |
| 278 | and based on various factors but it does settle into that pattern. | 并且基于各种因素,但它确实符合这种模式。 |
| 279 | Very interesting and so I think I guess with that then there's a lot of questions right because | 很有趣,所以我想我猜 这样的话,有很多问题是正确的。 |
| 280 | what we've observed is the first couple waves obviously the mortality was very high compared | 我们所观察到的,是第一对夫妇波 很明显,死亡率是很高的比较 |
| 281 | to where Omicron is and things like that. | 到Omicron的地方 和类似的东西。 |
| 282 | So is that also sort of typical and is that just because | 这是否也是典型的? |
| 283 | of quote-unquote herd immunity like the that the variants seem to be a little less deadly over time | 类似变体在一段时间里 似乎不那么致命 |
| 284 | um what are some of the possible explanations for what's going on? | 嗯,什么是一些可能的解释 发生了什么事? |
| 285 | Yeah so a little bit of a nuance there so the way viruses these kinds of respiratory viruses evolve | 是啊,有点细微的细微 在那里,所以病毒的方式 这些呼吸道病毒进化 |
| 286 | is that for a virus to spread it has to be either inherently more infectious than the previous variant | 病毒的传播 要么是内在的传染性比前一个变体强 |
| 287 | to out out compete or better at evading immunity natural as well as vaccine related depending on | 外出竞争或更好地逃避自然免疫力和疫苗,取决于 |
| 288 | what is the source of immunity in a population so that is more sort of more and more in the | 人口中的豁免来源是什么,因此,这种豁免越来越多。 |
| 289 | direction of you know more infectivity generally or out competing other existing variants or | 通常你知道更多的感染性 或与其它现有变体竞争 |
| 290 | immunity against those variants but unless a virus kills so many of its hosts that it reduces the | 除非病毒杀死了如此多的宿主 从而减少病毒的传播 |
| 291 | diminishes its ability to propagate so let's say if a virus was killing 30 percent of hosts | 减低了传播能力 所以说病毒是否杀死了30%的宿主 |
| 292 | god forbid you know it's you know these kinds of crazy viruses are out there | 天晓得这些疯狂的病毒就在外面 |
| 293 | so we have unless it's it's it does that then the severity part is kind of not random but it can go | 因此,我们有,除非是它这样做, 那么严重部分 有点不是随机的,但它可以去 |
| 294 | be the the next variant could be more severe or less severe so it is not necessary that the virus | 接下来的变体可能更严重或更不严重 所以病毒没有必要 |
| 295 | will directly evolve into a less severe per case basis so as you build immunity | 随着豁免的建立,每个案例将直接演变为不那么严重的情况。 |
| 296 | and if there is less evasion of the virus there may be an equilibrium that fewer people are getting | 如果病毒的逃逸程度降低的话 就会有平衡 |
| 297 | it and new variants are not emerging as frequently or are emerging at a predictable level but if you | 它和新变种的出现并不那么频繁,或者在可预见的水平上出现,但是如果你 |
| 298 | at the the severity it could be less severe or more severe so so that's a not so reassuring news | 严重性可能更轻 或更严重 所以这是一个不那么令人安心的消息 |
| 299 | that we may have a virus for the infectivity of omicron but severity of delta so the the waves or | 我们可能感染了一种病毒 但是三角洲的严重性 所以波浪或者 |
| 300 | the you know they their peak may be higher over you know or the relationship between cases and | 你知道他们的峰值可能比你知道的要高 或者案件和案件之间的关系 |
| 301 | hospitalization may be less more pessimistic etc so hopefully we'll settle into a pattern that | 住院可能不那么悲观了... ...所以希望我们定下来 |
| 302 | there's enough immunity through infection and vaccination where the possibility of the total | 通过感染和接种疫苗,有足够的免疫力,其中可能包括: |
| 303 | number of cases will not be as high the peaks will not be as high so therefore even if the | 案件数量不会这么高 因此即使 |
| 304 | uh we should be okay at a population level but that's the whole but but but that does | 嗯,我们应该在人口水平上是好的 但这是整体,但这样做 |
| 305 | remain so i'm not going to hide the concern about variants that are more infectious but also a | 所以,我不会隐藏 担心的变种 更传染性,但也有一个 |
| 306 | little bit more severe i see um and is there usually a correlation between severity and | 更严重一点 我看到了 嗯 通常情况下 严重程度和 |
| 307 | um that's what i'm saying yeah no unfortunately no unless a virus kills a huge amount of its | 嗯,这就是我的意思 是的,是的,不 不幸不 除非一个病毒杀死了它的大量 |
| 308 | like huge not just amount proportion of its host and which this virus is not doing the reason why | 就像巨大的 不只是数量的比例 宿主 而这个病毒并没有做的原因 |
| 309 | it's causing havoc is that it sits in that you know unfortunate quote unquote sweet spot where | 它造成了破坏 因为它坐在那里 你知道不幸的引文 |
| 310 | it's propagating it's not killing most of the people thankfully uh but then so there's a this | 它在宣传 它不会杀死大多数人 感激不尽,但是... |
| 311 | ability to propagate right and and from the virus's perspective that's evolutionarily | 从病毒的角度讲,这是进化的 |
| 312 | like what its peak functionality is right yeah no again so there is uh so i that's a simple | 就像它最高峰的功能是正确的,是的,是的,没有了 所以有,所以有,所以我是一个简单的 |
| 313 | that's why i'm trying to stay away from that intentionally formulation that the more infectious | 这就是为什么我试图远离 故意的配方 越传染性 |
| 314 | virus is less severe no that's uh that's a more you know there's more to it than sure than so | 病毒不是那么严重... ...呃... |
| 315 | infectivity goes up either through natural infectivity or evasion of the pandemic evasion | 感染率通过自然感染或逃避大流行病而上升 |
| 316 | of the the immunity uh through vaccination or um infection but severity can go up or down | 通过接种疫苗或感染,但严重程度可以上升或下降 |
| 317 | i see um well a lot of the questions that are coming in you know not surprisingly is uh when | 我看得很清楚 有很多问题要问进去 你知道 毫不奇怪是什么时候 |
| 318 | is this pandemic gonna end um how what how do we even where do we even begin in terms of benchmarks | 这场大流行会结束吗? 我们从哪开始呢? |
| 319 | for for how do we know what the end looks like well so here's the thing this will we do know | 我们怎么知道结局是怎样的 |
| 320 | that this will become endemic for the foreseeable future and because of the fact that gradually | 这在可预见的未来将变得很普遍,因为事实上, |
| 321 | either through vaccination or a mix of vaccination and infection enough people at a given time will | 要么通过接种疫苗,要么通过混合接种疫苗和感染,在一定时间内有足够的人 |
| 322 | have protection that the number of cases the number of peaks will not be as high so that's | 保护案件数量 峰值不会那么高 |
| 323 | how it will settle into a pattern in the next few years i can't tell you it will happen this year | 接下来几年会怎样发展成一种模式 我不能告诉你今年会怎样 |
| 324 | uh this fall or winter i can't tell you it will happen next one but i can on average tell you | 这个秋天或冬天 我无法告诉你 接下来会发生什么 但我可以平均告诉你 |
| 325 | that's in a few years it will settle into a pattern and it will be a situation where it is | 几年后它就会变成一种模式 并且会变成这样 |
| 326 | that people like myself are worrying about it on a daily basis but people like you or most of you | 像我这样的人每天都在担心 但像你这样的人或你们大多数人 |
| 327 | will not have to worry about it on a daily basis obviously what your actions are likely to be is | 日复一日地不必担心你的行为 |
| 328 | to get and we are looking at at least an annual booster for for most people most adults even | 我们每年至少要为大多数成年人提供助推器 |
| 329 | moderate to high risk adults that's what we are looking at so i think we should be mentally | 中度至高度风险的成年人,我们所看到的, 所以我认为我们应该是精神上的 |
| 330 | prepared for this this wasn't a given last year it has but the data applying to that kind of | 去年不是为这个准备的,而是数据 应用到这种类型的 |
| 331 | a situation but that's not the end of the world like sort of getting a shot which is increasingly | 情况不是世界末日 就像拍到的镜头 越来越 |
| 332 | we know that all vaccines that have come out you know the data from the chinese vaccines as well as | 我们知道所有疫苗都出来了 你知道中国疫苗的数据 |
| 333 | the u.s and european vaccines have been very reassuring in terms of safety although there | 欧、欧疫苗安全性很强 |
| 334 | are differences between the number of doses that may and we may end up requiring but that's normal | 可能和我们最终需要的剂量数量之间的差异,但这是正常的 |
| 335 | for all all sides of vaccines so so annual boosters is not you know too cost too higher | 所以每年的助推器不会太高 |
| 336 | cost to pay for sort of sustained protection so that's what it's looking like so it's not going | 花很多钱来支付持续保护费 所以看起来是这样 所以不会去 |
| 337 | to go with the you know over the big celebration in the sense that one fine morning we find out | 和大家一起庆祝盛大的庆典 也就是说一个美好的早晨 |
| 338 | gone it will diminish in its ability to impact daily life unfortunately it may still continue | 它将削弱它影响日常生活的能力 不幸的是它可能仍在继续 |
| 339 | to cause mobility and mortality death and disease but not at the numbers that halt daily life | 导致流动和死亡的死亡和疾病,但不包括停止日常生活的人数; |
| 340 | and but but that would mean that you know people like myself will have to continue to fight this | 但这意味着你认识像我这样的人 必须继续反抗 |
| 341 | uh to get it further under control but it it it we may we are likely to get to an | 嗯,让它进一步控制 但是它,它,我们可能得到一个 |
| 342 | equilibrium that does not impacting daily life not because people stop thinking about it and | 没有影响日常生活的平衡 不是因为人们不再思考 |
| 343 | but because it's at levels especially death and hospitalization is at levels | 但因为它处于死亡和住院的水平 |
| 344 | which do not concern people in governments etc and just to clarify that seems to be with pandemics | 并澄清这似乎与流行病有关 |
| 345 | we've had in the in the past in history that also seems to be the pattern where it's not that these | 过去我们有过的历史 似乎也是一种模式 而不是这些 |
| 346 | diseases are no longer around it's just that they're no longer around to the point where it's | 病症已经不在身边了 只是他们已经不在身边了 |
| 347 | it's affecting our daily lives exactly so you mentioned that the most likely need for | 它影响着我们的日常生活 所以你提到最可能需要 |
| 348 | annual boosters and so it would be at least in the u.s. it would be similar to us getting a flu | 一年一度的助推器,所以至少在U.s. 它和我们感冒相似 |
| 349 | shot every year i have observed that in some in some countries there the the flu shot is not | 我注意到,在一些国家里,流感的发作不是 |
| 350 | something that's given um for various reasons um you know so i think it should be i think it should | 有些东西,因为各种原因... ...所以我觉得应该... ... |
| 351 | be uh that's that's a different especially for at least for some populations at least for the very | 嗯,这是不同的, 尤其对于一些人口来说, 至少对于最 |
| 352 | young and the very old i think and the pregnant women i think that should be because that helps | 年轻和非常年老的我 和孕妇 我认为,那应该是因为 |
| 353 | prepare for actually a flu pandemic as well if people are used to getting that it protects them | 如果人们习惯接受流感的防疫, |
| 354 | against seasonal vaccine etc but we will have to this is one of the things that will be the cost | 对抗季节性疫苗等,但我们必须这样做,这是代价之一。 |
| 355 | of going back to normalcy is to build an adult vaccination system of boosters at least for the | 恢复正常状态是建立成人免疫系统,至少为 |
| 356 | next few years for boosters of you know against covid-19 sorry i didn't mean to interrupt no no | 接下来的几年里,你对科维德 -19的助推器很了解... 对不起,我不是故意打断... |
| 357 | that's that's this is great um because the next question then is you mentioned at risk populations | 就是这样,这是伟大的,嗯 因为下一个问题 是,你提到 在风险人群 |
| 358 | and i i remember actually uh in the beginning of the pandemic you know with the first uh wave | 我记得,实际上,呃... 在流行的开始... ...你知道的第一场... |
| 359 | and the first variants that children seemed to be uh pretty much okay and that they wouldn't | 和第一个变体, 孩子们看起来是呃 几乎很好,他们不会 |
| 360 | really be at risk of of getting um covid at first um and or at least have symptoms of it | 一开始真有被迷恋的风险 或至少有症状 |
| 361 | and it seems that over time that children have become more and more susceptible i guess | 看来随着时间的推移 孩子们变得越来越容易受感染 |
| 362 | um to covid uh is that observation true and what is the difference between you know the earlier | 科维德的观察是真实的, 和什么是区别 你了解之前 |
| 363 | um you know children and being able to get covid versus now and and uh you know especially because | 嗯,你知道孩子 并且能够得到 covid现在和呃你知道,特别是因为 |
| 364 | we have a lot of parents on on the zoom you know should they be worried so here's the thing so | 我们有很多父母在缩放上 你知道如果他们担心 所以事情是这样的 |
| 365 | very early on from very early reports uh from uh wuhan and china and other parts of china | 从很早的报告来看 呃 武汉 瓷器和瓷器的其他部分 |
| 366 | uh it became that was again an important piece of data that the world learned that there was | 这再次成为了一个重要的数据 全世界得知有 |
| 367 | a huge uh age differential uh and this is again one of those things initially everyone including | 年龄差别很大 这也是其中之一 最初每个人包括 |
| 368 | the scientists who reported reported with caution saying that it could be uh that uh there are | 报告时小心翼翼的科学家说 可能是 呃... |
| 369 | and other risk factors comorbidities and not just age etc but it became fairly clear very quickly | 以及其他危险因素的杂乱无章 不只是年龄等等 但很快就变得相当清楚了 |
| 370 | based on subsequent data in china and in the rest of the world that it was age was a huge factor | 根据后来中国和世界其他地方的数据 年龄是巨大的因素 |
| 371 | and so having said that it was never uh as data became available that uh that covid is less severe | 所以说,它从来没有 呃,随着数据 得到,呃,科维德不是那么严重 |
| 372 | in young children or children than older people but it was still more severe than other normal | 在幼儿或儿童中比老年人严重,但仍比其他正常情况严重。 |
| 373 | respiratory infections so so it's a matter of comparison it says so those of you well you know | 呼吸道感染,所以这是个比较问题 上面写着: |
| 374 | in toke economics it's a matter of counterfactual uh it's a matter of your comparison group so if | 经济学中,这是反事实问题,呃,这是你比较组的问题,所以如果 |
| 375 | you're comparing children to older people and that's been true from the beginning uh they get | 你们把孩子和老人比起来 从一开始就是真的了 |
| 376 | impacted less especially in it was unclear in terms of acquisition but it was certainly true | 影响较小,因为它在购置方面不明确,但确实如此。 |
| 377 | based on once they get it what is their uh sort of what is the that is their outcome disease outcome | 根据一旦他们得到,什么是他们的... ...什么是他们的结果是疾病的结果。 |
| 378 | and so so based on those data we can be fairly confident uh and say that um this is a | 所以根据这些数据 我们可以相当自信地说,嗯,这是一个 |
| 379 | a situation where um children get impacted less in terms of severe disease uh compared to older | 儿童在严重疾病方面受到的影响比老人少 |
| 380 | people but if you compare it to other respiratory infection it is more severe in children when it | 人,但如果你比较它 与其他呼吸道感染 更严重的儿童,当它 |
| 381 | comes to covid-19 but for some of the subsequent variants especially delta and omicron that | 但对于后来的一些变体 特别是三角洲和燕尾酒 |
| 382 | severity has has been a little bit more ramped up and the one of the reasons why the proportion | 严重性稍有加剧, 原因之一 |
| 383 | of children in being admitted in other countries has gone up as one of the reasons I described | 作为我所描述的原因之一,被其他国家接纳的儿童人数有所增加。 |
| 384 | the other reasons as well is because as you have protected the elderly through vaccination | 其他原因也是因为您通过接种疫苗保护了老年人 |
| 385 | and uh through unfortunately infections uh uh you are um that contrast has gone down a little bit | 很不幸的感染了... ...呃... ...你这个反差有点小 |
| 386 | so so these this is the nuance that we are looking at so I guess then the next question | 所以这是我们所看到的细微差别 所以我猜下一个问题 |
| 387 | is sort of what looking at omicron specifically because that's the variant that we're dealing | 某种程度上是什么 看微量 具体地说,因为 这就是我们处理的变体 |
| 388 | with now um what what do we know in terms of um incubation period and how long we're contagious | 现在,嗯,我们知道什么 在嗯孵化期 和多久我们感染 |
| 389 | for and um you know those basic stats has that changed over time with the different variants | 和嗯,你知道这些基本数据 已经随着时间的变化 不同的变体 |
| 390 | um and of course the science is is continually evolving as well yeah so there are few things | 嗯,当然,科学也在不断演变。 是啊,所以没有什么事情 |
| 391 | uh that have changed first of all our ability to so again you need a higher number of cases | 首先改变我们的能力,你需要更多的案子 |
| 392 | to get more certain evidence uh etc one of the things that became clear in 2020 not right away | 以获得更多的证据,呃... . |
| 393 | was the importance of super spreader events uh in a sense that in dense situations and populations | 是超级传播事件的重要性... 一种在密集的形势和人群中 |
| 394 | both because of social factors because there's certain kinds of things where you know for example | 都因为社会因素 因为你知道某些事情 |
| 395 | when there's a lot of speaking and and loud talking going on there's a lot of ventilation | 当有很多说话和 大声说话, 有很多通风 |
| 396 | but also because of host factors as well that some people have higher viral loads | 但也因为宿主因素 一些人的病毒含量较高 |
| 397 | compared to others potentially uh the average transmission is uh the the average transmission | 相对于其他可能 额 平均传输额 额 平均传输额 |
| 398 | is only looking at the surface of it uh that that that looks at a huge distribution of uh the | 只是看着它的表面,呃,那 看着巨大的分布,呃... |
| 399 | and then it's eventually translates in practice to a few people transmitting a lot of infection so | 最终在实践上翻译为少数传播大量感染的人 |
| 400 | the importance of super spreader events so that's become more clear the other thing is that we know | 超级传播者事件的重要性 所以更清楚的是 另一件事是 我们知道 |
| 401 | that with omicron uh the the time from infection uh to developing uh to testing positive is shorter | 从感染到发育到检测阳性的时间更短 |
| 402 | um so it used to be four five days now it's three three four days uh with omicron uh we know that | 嗯,所以它曾经是四五天 现在它是三三四天 呃,与微缩,我们知道 |
| 403 | uh the uh the viral loads go down quickly and the things are cleared quickly if you're vaccinated | 嗯,呃,病毒的负荷 迅速下降, 东西清理得很快 如果你接种了疫苗 |
| 404 | compared to unvaccinated uh so so we know that the other thing is that a lot of countries based on | 和未接种疫苗相比 所以我们知道另一个问题是 很多国家基于 |
| 405 | a balance between uh policy uh and you know between the ability of the workforce to go back | 平衡政策,嗯,你知道 劳动力的能力回去 |
| 406 | to work versus uh keeping people safe shortened their quarantine requirements so the uk did | 工作与保障人们的安全 缩短了他们的隔离要求 因此,uk做了 |
| 407 | that in the u.s and instead of i was um you know i'm on the record to say that for countries based | 在U. S. 和代替我 嗯,你知道我 在记录上说, 对于国家 |
| 408 | on their circumstances it's okay to do that unless you know provided they do testing rapid | 在他们的情况下,可以这样做 除非你知道,如果他们做测试 快速 |
| 409 | testing um to get out after beyond five days unfortunately in the u.s the recommendations is | 5天后离开 不幸的建议是 |
| 410 | is wishy-washy about five days and beyond uh in terms of testing so but i do recommend that if | 5天左右 超过测试时间 但我建议如果 |
| 411 | people uh get infected uh and they're isolated or um you know uh and and so therefore they want to | 人们被感染了 他们被隔离或被隔离了 所以他们想 |
| 412 | want to do that after five days you test to get out of isolation but it depends on public health | 5天之后你想要做这个测试 摆脱隔离,但这取决于公共卫生 |
| 413 | policy of a region because there are considerations about what is the population density and what are | 由于考虑到人口密度和人口密度是多少,所以一个区域的政策是多少。 |
| 414 | the implications and all of that stuff but you know where there is a policy of allowing early | 影响和所有的东西 但你知道哪里有 允许早期 |
| 415 | end of isolation it doesn't make sense to do it without testing | 隔绝的结束 没有测试就毫无意义 |
| 416 | between five and ten days nine after nine ten days it's you know in those situations | 在五到十天之间 九天之后 |
| 417 | with the policy is to have shorter isolation periods people can you know you don't need to | 政策是缩短隔离时间 人们可以知道你不需要 |
| 418 | test beyond nine days and this is rapid test and just to give you an idea just to clarify why i'm | 测试超过9天,这是快速测试 并且只是给你一个想法 只是澄清为什么我 |
| 419 | saying rapid tests or antigen test in for this specific purpose is that pcr tests are pretty | 说快速测试或抗原测试 用于这个特定目的 是pcr测试是漂亮的 |
| 420 | solid and they are the gold standard for therapeutic reasons but for public health reasons | 坚固,由于治疗原因和公共卫生原因,它们都是金本位 |
| 421 | a rapid test tells you whether you are infectious or not pcr continues to be and understandably | 快速测试告诉你,你是否感染性 或Pcr继续是和可以理解的 |
| 422 | continues to be positive beyond when you are infectious but you still have the infection | 感染后继续呈阳性 但你仍然感染 |
| 423 | yourself so there are two different things you know isolation is associated with your ability | 所以有两种不同的东西 你知道孤立与你的能力有关 |
| 424 | to infect others rather than you just you having the disease so pcr is telling you whether you have | 所以Pcr告诉你你有没有 |
| 425 | virus and a rapid test antigen test is telling you whether you're transmitting or not so these are | 病毒和快速检测抗原测试 告诉你你是否在传播这些 |
| 426 | the differences between the tests right and and i think that's a very important distinction to make | 测试的区别是正确的 我认为这是一个非常重要的区别 |
| 427 | that i think is not necessarily out there so just again to clarify there are two types of tests | 我觉得这不一定 所以只是再次澄清 有两种测试 |
| 428 | there's the rapid test which tells you whether you are capable of infecting other people | 有快速测试 告诉你你是否能够感染其他人 |
| 429 | and then there's the pcr test which tells you whether the virus is inside you but that does | 然后有Pcr测试 告诉你病毒是否在你体内 但确实如此 |
| 430 | mean that you are necessarily going to infect other people is that correct yes and you continue | 也就是说你必定会感染别人 是没错 你继续 |
| 431 | to so so for there you you look at the overall population level recommendations and what is the | 因此,在这里,你看看总体的人口水平建议是什么? |
| 432 | probability of you infecting others and so and so forth and the other thing is it's a bit of a | 你感染其他人的概率等等 另一件事是有点 |
| 433 | misnomer in countries like china pcr testing has been made pretty rapid by reducing the turnaround | 在瓷器测试等国家中,通过降低翻转率,错误的异构体变得相当迅速。 |
| 434 | time but so so but but you know that's the general terminology that is | 时间,但如此,但你知道 这是一般术语是 |
| 435 | just to clarify let's go behind the science a little bit so what are the | 只是澄清一下,让我们去后面 科学一点点,什么是 |
| 436 | differences between the two tests what exactly are we looking at so so without going into too | 我们到底在看什么,所以不用再谈 |
| 437 | much detail so rapid antigen tests sort of rapid tests look at your i'm trying to i'm struggling | 很多细节 如此快速的抗原测试 那种快速的测试 看你的 我正在努力挣扎 |
| 438 | without sort of keeping it general versus um you know uh while providing into this mini-grid yeah | 没有那种保持它的一般 与嗯,你知道的,呃... ...同时提供 在这个小网 |
| 439 | yeah so so rapid tests uh you know in practice uh have uh or have uh usually work better if there | 是啊,那么快速的测试... 你知道在实践... ...呃有呃或有呃通常工作更好的,如果那里 |
| 440 | is a replicating virus uh and pcr can work with even remnants of a virus that's the practical | 是一种复制病毒,呃,Pcr可以工作 甚至与病毒的残留 这是实际 |
| 441 | thing uh and so uh it's rapid tests are not culture but de facto uh they work when there is | 快速测试不是文化,而是事实上的,呃,如果有的话。 |
| 442 | more virus uh and so therefore if you have more virus and your virus is replicating you're more | 所以如果你有更多的病毒 你的病毒在复制... ... |
| 443 | infectious um and so that's why we use it as a sort of a rough marker of infectivity as well | 因此我们把它作为感染的粗略标记 |
| 444 | as sort of you being positive and pcr is more sensitive in that sense that it even | 那种你积极和 Pcr 更敏感 从这个意义上说,它甚至 |
| 445 | detects remnants of a virus i see i see um and you mentioned viral caseload so is is the general | 检测病毒残留物 我看到了 你提到病毒量 将军也是 |
| 446 | data right now pointing to five days being sort of a big drop off in terms of viral load yeah so | 现在的数据显示 5天的病毒载荷 有点大 |
| 447 | five days but i think there is uh still in the population of two eight nine days uh so so therefore | 5天,但我认为,呃... ... 仍然有2 8,9天的人口... |
| 448 | uh i thought it was better if countries were going to have reduced isolation was not to do | 呃,我认为,如果各国能减少孤立,那更好。 |
| 449 | that without testing there's still significant uh proportion of people who are infectious | 没有检测,仍有相当比例的感染者 |
| 450 | and there are data uh from for example nba the national basketball association uh studies uh i | 有数据 呃 例如Nba 国家篮球协会 呃研究 |
| 451 | don't know if you guys know that in the u.s the nba was very at the forefront of collaborating with | 不知道你们知道吗? 因为NBA很在行 |
| 452 | you know some from yale uh on these studies to look at uh you know how things happen uh you know | 你从耶鲁那里知道一些... ...关于这些研究... ...看看... |
| 453 | how this is transmitted what is the value of tests and how you know how long people are infectious | 测试的价值是什么? 你如何知道人们感染的时间 |
| 454 | and that kind of stuff right um so then with um and and that's regardless of whether they still | 那种东西,嗯,然后与嗯, 而不管他们是否仍然 |
| 455 | have symptoms or not um so so if you get infected you know after five days regardless of whether you | 所以如果你感染了 5天后就知道了 不论你是否 |
| 456 | have a cough or whatever that may be so that's a that's a good question is there a direct | 咳嗽什么的,这是个好问题,是直接的 |
| 457 | correlation between viral load and symptoms not not a perfect correlation or not because your | 病毒负荷和症状之间的关联 并不是完美的关联 也不是因为你 |
| 458 | symptoms are often how your body is responding not what the virus directly is doing so it's the so | 症状往往是你的身体如何反应 而不是病毒的直接反应 |
| 459 | obviously your body responds to the virus uh but your you know people respond differently to the | 显然你的身体对病毒有反应 但你知道人们对病毒的反应不同 |
| 460 | virus etc in terms of ending isolation currently cdc that sort of has a somewhat mixed message on | 在结束隔离方面,目前cdc 有一种有点混杂的信息 |
| 461 | after five days um the u.s cdc also talks about improving symptoms uh if your symptoms are not | 五天后... . . |
| 462 | improving then you should probably stay in uh isolation uh you should continue to stay in | 那你应该保持隔离 你应该继续留在 |
| 463 | isolation and so you know because it may be even though the the the correlation is imperfect it's | 孤立,所以你知道,因为它可能 纵使关联是不完美的,它是 |
| 464 | not non-existent uh so it's a bit of a nuanced uh picture there but but it's not so if you have | 并非不存在,呃,所以它有点细微的 额,在那里,但如果你有 |
| 465 | symptoms especially if they're improving or not getting worse at five days it's it's probably | 特别是如果5天后病情好转或没有恶化 可能是 |
| 466 | your body responding to it not the not necessarily that you're infectious meaning your ability to | 你的身体对它的反应 不一定是感染 意味着你的能力 |
| 467 | infect others very interesting um so then we've talked a little bit about the immediate symptoms | 感染其他人非常有趣,所以我们谈了一下眼前的症状 |
| 468 | but of course one of the things that people have talked about a lot and are worried about are the | 当然,人们已经谈论了很多 和担心的事情之一 是 |
| 469 | long long long covid right long-term effects of covid do we have any more clarity in terms of | 我们是否更清楚地了解 |
| 470 | what causes some people to have long-term effects and what doesn't and i guess also just what are | 是什么导致一些人有 长期的影响,什么没有,我猜也是什么 |
| 471 | the long-term effects potentially well look this is a virus uh that is quote-unquote considered a | 长期影响 可能很好看 这是一个病毒 嗯 引文未引用 |
| 472 | respiratory virus but it impacts the whole body it's a pretty use especially amongst the | 呼吸道病毒会影响整个身体 尤其是在其中 |
| 473 | vaccinated it's a pretty substantial body blow so it's not your uh usual influenza seasonal | 注射疫苗是相当严重的身体打击 所以这不是你通常的流感季节性 |
| 474 | influenza virus that's absolutely not um the the case and so it impacts multiple systems your | 流感病毒绝对不是这个病例 所以它会影响你的多个系统 |
| 475 | neurological system your cardiac system and because of some of the uh sort of the secondary | 神经系统,你的心脏系统 和由于一些呃类的二级 |
| 476 | effects for example you have clots uh in your blood vessels so they go everywhere so so all | 比如说,你的血管里有血块 所以到处都是 所以... |
| 477 | sorts of uh things are impacted by by this even in the acute disease uh after certain viruses | 某些病毒后 即使是急性疾病 也会受到这种病毒的影响 |
| 478 | there are syndromes that are you know this is not new that some viruses cause long-term sequelae | 有些病毒引起长期后遗症 |
| 479 | uh etc uh but this virus because of the fact that it's been so widespread uh because nobody | 嗯,等等,但是这个病毒 因为它是如此广泛... ... |
| 480 | had immunity to start with especially before vaccination uh you know we've had seen uh long | 在接种疫苗之前有免疫力... 你知道我们见过... 很久了 |
| 481 | covid in pretty substantial uh numbers if not proportion not everyone gets long covid and we are | 以相当多的数字计算,如果不是比例的话, 每个人都会很长的时间,我们是 |
| 482 | we meaning the scientific community is still in the process of first of all we know that it happens | 我们的意思是科学界仍然在进行中 首先我们知道它发生 |
| 483 | so so long covid is is real obviously there's substantial evidence that it happens at what | 这么长时间的渴望是真实的 显然有确凿的证据表明 它发生在什么 |
| 484 | proportions and what are the risk factors we're still studying that because remember that you'll | 比例和什么是风险因素 我们仍在研究 因为记住你会 |
| 485 | have to have some period passed long covid to have to follow up and it's a it's a pandemic where we | 必须经过一段时间才能继续追踪 这是一种流行性疾病 |
| 486 | are you know it's the second third year there's a third year of the pandemic um etc so uh and | 你知道这是第二年的第三年 有第三年的流行 嗯... |
| 487 | so people are coming up with cardiovascular neurological and some of the other uh syndromes | 所以人们会出现心血管神经综合征 和一些其他的 uh综合征 |
| 488 | that that get clustered and and so so one clarity would be that you know obviously people even without | 被组合在一起,所以一个清晰的,是 你显然认识的人,即使没有 |
| 489 | covid people will some people as you we all age um will develop something so how much above the | covid的人会有些人,像你一样年老... ... |
| 490 | baseline is not long covid versus what they would have developed already will take a little bit of | 基线并不长 相对于它们已经开发了多少 |
| 491 | time to quantify the magnitude we know that it has happened we know at a crude level it is happening | 时间来量化我们知道它已经发生的程度 我们知道它正在发生 |
| 492 | at a higher level than people would be expected to develop some of these things but how high | 在比人们期望的更高层次上 开发一些这些东西,但有多高 |
| 493 | in what risk group what is the role of vaccines early data indicate that vaccine subsequent | 早期数据表明疫苗的作用是什么? |
| 494 | dose if you develop long covid a subsequent dose can very early data suggests improve your symptoms | 剂量,如果你发展出长吻合 后续剂量可以非常早期的数据表明 改善你的症状 |
| 495 | um is it true for all vaccines is it true for all symptoms you know these are the things that people | 嗯,这是真的 对于所有疫苗 是真的,对于所有症状 你知道这些东西 人们 |
| 496 | keep people like myself employed because there's so much to to study um that you know we that's | 雇用像我这样的人 因为有很多事要做 你知道我们 |
| 497 | unfortunately um we don't have all the answers right now have we been able to at all sort of | 很遗憾,我们没有 全部的答案 现在,我们已经能够 在所有种类 |
| 498 | point to certain at risk factors um you know either for just severity of covid or long covid | 指某些危险因素,嗯... ...你知道,或者只是 严重covid或长covid |
| 499 | i mean obviously there's old age and and and immunocompromised but you know even with you | 我的意思是,显然有老年 和免疫妥协,但你知道,即使与你 |
| 500 | mentioned the nba right there are certain players that seems to to do worse than others and as a | 提到Nba 右 有一些玩家 似乎做的比别人更糟糕 并作为一个 |
| 501 | the nba is i'm guessing you know relatively young and healthy and and such yeah no so first of all | 我猜你知道的相对年轻 健康 如此之多 |
| 502 | that's been a humbling experience uh that even sort of people uh who are at the peak of their | 这段经历令人发指 甚至有些人... 处于他们的顶峰 |
| 503 | physical performance uh physical ability can get it but what but what is the you know are they | 身体表现 呃 身体能力是可以得到的 但你知道的是什么 |
| 504 | getting it at lower numbers certainly they're not the indications are they're not getting at | 以较低的数字得到它,当然他们不是 迹象是他们没有得到得到 |
| 505 | higher numbers uh compared to the rest of the population but are they getting it at lower | 比其他人口要多 但他们得到的更低 |
| 506 | numbers how low that is being determined right now because there are other sort of uh downstream | 因为下游还有其它种类的 |
| 507 | things that are being clarified even now uh and and so we we will figure this it's not something | 事情被澄清,即使现在,呃, 所以我们会认为这是不是什么 |
| 508 | that is unknowable uh we have learned a lot about this virus uh and in fact we have learned about | 我们学到了很多关于这个病毒的知识 事实上我们知道 |
| 509 | other viruses through a lot of the investment that has gone into this you know studying this virus | 其他病毒通过很多投资 已经进入这一点,你知道研究这个病毒。 |
| 510 | but but that clarification uh will come in terms of the magnitude what is the different reduced or | 但是,这个澄清... ...呃... ...从大小上来看... |
| 511 | increased risk by underlying uh you know and how uh you know underlying factors and how much it is | 风险增加,因为... 你知道... 你知道... |
| 512 | different on top of the you're just likelihood of getting disease so we know that the likelihood | 在你生病的可能性之外 我们才知道可能性 |
| 513 | of getting covid itself is highly differential by your uh comorbidity status you know not just | 自我迷恋 高度差异 与你的... 共性状态 |
| 514 | uh you know uh things like you know cancer etc but also chronic kidney disease obesity | 嗯,你知道,嗯... 事情,你了解癌症... ... ...... |
| 515 | etc and all of that stuff and obviously age is the biggest factor so so it will take some time | 和所有的东西,显然年龄 是最大的因素 所以它需要一些时间 |
| 516 | to tease that out it will be teased out because there are enough scientific incentives and | 取笑它会被取笑 因为有足够的科学激励 |
| 517 | actually do that uh but but we don't have a sort of a reasonably clear picture of this | 实际上,呃,但我们没有 一种合理的清晰的图片 |
| 518 | where we could say this is this level of risk is attributed to this and and so on and so forth | 我们可以说这是这种风险水平 归结于这个等等 |
| 519 | great um so i think we have a lot of more clarity now than than we began with um obviously | 所以,我认为我们现在有很多 比我们开始,嗯显然 |
| 520 | um i guess sort of as a last uh sort of question um so what what do we know in terms of the science | 嗯,我想是作为最后一个问题... ...嗯... ... |
| 521 | in terms of uh what should we still be doing um and uh what what do we need to make sure we're | 嗯,我们应该做什么,嗯,嗯,我们需要什么来确保我们 |
| 522 | we're on top of and sort of just what is the clear public health messaging that we need to get across | 我们正站在上面,而且有点 只是什么是明确的公共卫生信息 我们需要通过 |
| 523 | yeah no first of all uh uh it's you know in our communities individually as well | 是啊,不是的 首先,呃... ...你知道在我们的社区 也单独 |
| 524 | for a while we'll have to have a first of all vaccines are the mainstay of control | 有一阵子,我们首先要用疫苗 来控制 |
| 525 | how many doses uh what schedules uh boosters etc boosters are likely to be there animal | 多少剂量... 什么时间表... ... |
| 526 | boosters for the next few years at least um and so we need to focus on that and we need | 今后几年的助推器至少是 嗯 所以我们需要专注于这一点 我们需要 |
| 527 | make sure that our loved ones especially those at higher risks are vaccinated the the second thing | 确保我们的爱人,特别是那些风险较高的人 接种第二针 |
| 528 | is uh we are in this together so everyone around the world needs to get vaccinated | 我们在一起 所以全世界每个人都需要接种疫苗 |
| 529 | and gets needs to get vaccinated with the full schedule whatever the full schedule is | 并需要接种疫苗 完整的时间表是 |
| 530 | for each vaccine uh the third thing is while vaccines are a cornerstone of pandemic control | 第三件事是疫苗是控制大流行的基石 |
| 531 | for covid-19 uh vaccines it's the more appropriate strategy is a vaccine plus strategy | 更合适的策略是疫苗加战略 |
| 532 | and it depends on what's going on in the community how much transmission is there what are the risk | 这取决于社区里发生什么 传播的多少 风险是什么 |
| 533 | factors etc so it can range from masking to uh all sorts of other things uh you know ventilation and | 诸如此类的因素,这样它可以从蒙面到... 各种其他东西... |
| 534 | other stuff and and non-pharmaceutical measures but but we're just pretty clear it's that at | 其他东西和非药物措施 但我们很清楚 |
| 535 | least in the short run in the long run we may be able to almost exclusively rely to on vaccines | 从长远来看,从短期来看,我们也许能够几乎完全依靠疫苗。 |
| 536 | but we need to focus on that the last thing is uh the global public health community needs to | 但是我们需要集中关注最后一件事 也就是全球公共卫生界需要 |
| 537 | evolve uh with the changing data with the changing uh variants etc and and focus on | 随着数据的变化 和变化的 uh 变体等并专注于 |
| 538 | what needs to be done at under the current circumstances great uh thank you so much | 在目前情况下需要做什么 非常感谢 |
| 539 | dr saram we've learned a lot from you and thank you for spending the time to clarify | 沙兰博士 我们已经从你那里学到了很多 感谢你花时间澄清 |
| 540 | so many of these questions um of course this is an ongoing situation that continues to develop | 如此众多的问题 当然,这是一个持续的情况 继续发展 |
| 541 | and so uh i'm sure that questions will continue to come in but thank you so much for for providing | 所以,我敢肯定,问题会继续 进来,但非常感谢你提供 |
| 542 | the answers that you have so far um per tradition i'm going to ask everybody to turn on their webcam | 我要求大家打开他们的网络摄像头 |
| 543 | so we can take a group picture um to celebrate our our gathering of sorts and i'm also going | 这样我们就可以拍张合影 庆祝我们的聚会 我也要去 |
| 544 | to unmute everybody so that everybody has the chance to thank you um personally um thank you | 揭开每个人的胸怀 让每个人都有机会感谢你 亲自谢谢你 |
| 545 | you again dr amir and um hopefully we won't need to see you too soon thank you thank you | 你又来了 Amir博士 希望我们不用太快见你了 谢谢 |
| 546 | thank you doctor thank you thank you thank you thank you thank you thank you so much | 医生,谢谢,谢谢,谢谢,谢谢,非常感谢 |
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