SARS和流感相比新冠肺炎当前人数和死亡率 (新冠肺炎讲座5）

SARS和流感相比新冠肺炎当前人数和死亡率

Current Numbers & Mortality Rate vs SARS and Influenza (coronavirus lecture 5)

Welcome to another MedCram update on the coronavirus for January 29, 2020. And overnight, what we’ve been looking at is the number of deaths reported has gone from 106 to 132, and the number of confirmed cases has gone to 5974, that’s about a 32% increase of the number of confirmed cases overnight.

欢迎参加2020年1月29日关于冠状病毒的MedCram的另一个讲座。一夜之间，我们一直在观察报告的死亡人数已从106增至132，确诊病例数已达5974，一夜之间确诊病例数增加了32％。

Now, I want to make sure that we put this in perspective because it’s easy to kind of get lost in this. There is a little bit of a probably a misunderstanding in terms of how accurate these numbers are. If anything, these numbers are probably underrepresented, and that could be a good thing or it could be a bad thing. And I say that with a little bit of trepidation in terms of being misunderstood, but if you’re looking here, you’re going to see that there is a ratio. Okay, if you look at the number of deaths to the number of confirmed cases, you’re going to get a general mortality rate of about 2.3 percent here on this particular day, versus the most recent data that we have is about the same at 2.2%.

现在，我想确保我们正确地看待这一点，因为很容易在其中迷失方向。关于这些数字的准确性，可能存在一些误解。如果有的话，这些数字可能不足，那就是一件好事，也可能是一件坏事。我说这是有点被误解的恐惧，但是如果您在这里看，就会发现这是一个比率。好吧，如果您查看死亡人数与确诊病例数的对比，那么您在这一天的总体死亡率将达到2.3％，而我们得到的最新数据大致相同2.2％。

Here’s the thing: both the numerator here and the denominator need to be confirmed by testing to confirm that this is specifically from the 2019 coronavirus, and it’s possible that we were undercounting in these areas. In fact, I think everybody agrees that we were undercounting here. There are probably more deaths than a hundred thirty-two, and there are probably more than 5974 confirmed cases.

事情是这里的：这里的分子和分母都需要通过测试来确认，以确认这是2019年的冠状病毒特别产生的，而且我们在这些领域可能被低估了。实际上，我认为每个人都同意我们在这里少算了。死亡人数可能超过一百二十二，而且确诊病例可能超过5974。

The question is, where are we missing it? A death is a pretty obvious thing. It’s hard to miss. The only question about whether or not it’s from this virus or another particular virus. But it’s really possible, and if you think about it, there could be cases out there of coronavirus that are completely missed. And there is an asymptomatic individual who maybe just got a little bit of a cold, and they may be completely asymptomatic, which means that this number may be far larger, could be 50,000, in which case this mortality rate is going to be much, much lower than is being reported here. So keep that in mind. That’s a possibility.

问题是，我们在哪里错过它？死亡是一件很明显的事情。很难错过。关于它是否来自此病毒还是其他特定病毒的唯一问题。但这确实是有可能的，如果您考虑一下，可能会完全遗漏冠状病毒。有一个无症状的人可能只是感冒了一点，而他们可能是完全无症状的，这意味着这个数字可能更大，可能是50,000，在这种情况下，这个死亡率将会很高，比这里所报告的要低得多。所以记住这一点。这是可能的。

Furthermore, if you’ve looked at some of our other videos, and specifically why the coronavirus can kill, and how it kills, we talked a lot about ARDS. Obviously, not everybody that gets coronavirus goes into ARDS, which is acute respiratory distress syndrome. In fact, of all of these cases, there’s only a fraction that end up in the hospital, and of those there’s only a fraction that need to go to the ICU, and there there’s a fraction that get ARDS, and some of those end up death.

此外，如果您看了其他一些视频，特别是为什么冠状病毒可以杀死以及如何杀死冠状病毒，我们还谈到了ARDS。显然，并非所有人都感染冠状病毒，这是急性呼吸窘迫综合征。实际上，在所有这些情况中，只有一小部分最终会进入医院，而其中只有一小部分需要去ICU，还有一小部分会获得ARDS，其中一些最终会死亡。

I think in the most recent Lancet article, of those that ended up in the hospital that were confirmed to be cases, the mortality there was about 15%. So that doesn’t mean that, 15 percent of people who get coronavirus infections are going to die. It just means those that are sick enough that end up in the hospital, they may go on to get ARDS, 15% of those, at least in the Lancet article, passed away.

我认为在《柳叶刀》杂志的最新文章中，那些最终入院的确诊病例中，那里的死亡率约为15％。因此，这并不意味着15％的冠状病毒感染者会死亡。这只是意味着那些病得很重的人最终进入医院，他们可能会继续获得ARDS，至少在《柳叶刀》的文章中，有15％的人去世了。

Okay, and so to put this in perspective, let’s look at SARS. Now SARS as you may recall was another variant of coronavirus. It was a different mutation, and it had come from bats, and total over about a year or two period of time, the number of deaths in that was 774, and the total number of infections was 8,098 confirmed cases. That was for SARS in 2002. So you can see here when we’re looking at the numbers already for coronavirus. These numbers are getting up there fairly quickly, and we’re only just a number of weeks into this epidemic.

好的，这样看来，让我们看一下SARS。您可能还记得，SARS是冠状病毒的另一种变异。这是一个不同的突变，它来自蝙蝠，总共大约需要一两年的时间，其中死亡人数为774，感染总数为8098例确诊病例。那是2002年的SARS。因此，当我们查看已经存在的冠状病毒数量时，您可以在这里看到。这些数字很快就到了那里，而我们距离这种流行病只有几个星期了。

Okay. So what are they doing about this? Well famously you may know that China is actually working on building a 1000-bed hospital in about 10 days, and it’s actually quite interesting to look at. I will post in the description below a link of a live webcam that you can look at on YouTube as they are actually building this hospital. And just a few days ago, it was a big field of the dirt, and now they’ve already poured the concrete slab, and they believe that on Monday morning, they’ll be admitting their first patients that hospital. So that’s quite remarkable.

好的。那么他们在做什么呢？众所周知，您可能知道中国实际上正在大约10天之内建立起拥有1000张病床的医院，而且看起来真的很有趣。我将在下面的说明中发布一个实时网络摄像头的链接，您可以在他们实际建立医院的同时在YouTube上查看它们。就在几天前，那是一块大土，现在他们已经倒了混凝土板，他们相信星期一星期一，他们将让第一批患者住院。因此，这非常了不起。

But we want to get into some other numbers about what’s going on outside of China, and what about this person-to-person transmission because we’ve got some updates there as well.

但是我们想了解中国以外发生的事情以及人与人之间的传播情况，因为我们那里也有一些更新。

So as it stands right now in the United States, there are about five confirmed cases; two of them in Southern California. By the way, there is a little side note to this that we had talked about: 240 people are being transported back. These are diplomats, and there is a chartered plane that is traveling back from China that is going to land in Anchorage, and then was scheduled to fly down to Ontario International Airport in Southern California, where they would be screened that has slightly changed, and that is going to March Air Force Reserve, which was March Air Force Base that is in Riverside County.

因此，就目前美国而言，大约有五宗确诊病例。其中两个在南加州。顺便说一句，我们刚才谈到的这一点还有一点说明：240人正在被运送回去。这些是外交官，有一架从中国回国的包机，将在安克雷奇降落，然后预定飞往南加州的安大略国际机场，在那里将对其进行检查，但略有改变，并且那就是去三月空军预备队，那是河滨县的三月空军基地。

That has been a last-minute change, but probably a better choice from a political standpoint because these people are going to be monitored at an air force base that was turned into our air force reserve base as opposed to a fully functional civilian airport.

这是最后一刻的变化，但从政治角度来看可能是一个更好的选择，因为将在一个空军基地对其进行监视，这些空军基地已变成我们的空军后备基地，而不是一个功能齐全的民用机场。

Now something that is concerning is the recent story in Germany. And this is a story where a woman from China who was asymptomatic and visited in Germany was not symptomatic until apparently she flew back on the plane to China, and it was only after that that the man who had never traveled to China was found and confirmed to have the coronavirus.

现在令人关注的是德国最近的故事。这是一个故事，其中一个没有症状并在德国拜访过的中国妇女直到在她飞回中国的飞机上之前都没有症状，直到后来发现并确认从未曾去过中国的那个男人。感染冠状病毒。

That is a concern for a couple of reasons. Number one: it’s the first evidence that we have outside of China of human-to-human transmission. Number two: it seems as though this transmission occurred when the woman was asymptomatic.

这有两个原因。第一个：这是我们在中国以外存在人与人之间传播的第一个证据。第二点：这种传播似乎是在女性无症状的时候发生的。

Fortunately, we can say this at this point that none of the deaths involved with coronavirus have occurred outside of China at this point. And if you look at the number of cases that are being reported, including the United States, there are about 73 confirmed cases outside of China as of January 29. And in all of those cases, there have been no deaths.

幸运的是，在这一点上我们可以说目前在中国以外没有发生任何与冠状病毒有关的死亡。而且，如果您查看包括美国在内的报告病例数，那么截至1月29日，在中国境外大约有73例确诊病例。在所有这些病例中，没有死亡。

So this sort of goes along with the possibility that we may be underestimating the denominator in the mortality rate, and that that denominator is possibly far larger than we know and therefore would be a bad thing of course in terms of the number of people who might be infected. But as more and more people are infected, and the number of deaths stay the same, the mortality rate goes down.

因此，这种可能性伴随着我们可能低估了死亡率的分母，而且该分母可能比我们所知道的要大得多，因此，对于可能被感染。但是，随着越来越多的人被感染，死亡人数保持不变，死亡率下降。

Something to think about, and also something to put in perspective, as we talked about. The number of people to date that have died as a result of coronavirus is 132. That is in contradistinction to, let’s just look at, the regular flu.

正如我们所讨论的，需要考虑的东西，以及可以透视的东西。迄今为止，死于冠状病毒的人数为132。这与普通流感是矛盾的。

In California, which is where I practice medicine, and specifically we’re having a real issue right now with the H1N1 flu from 2009. I’ve seen a number of those patients on ventilators in ARDS here in the last couple of weeks where I work. And California State Public Health Department put out that the number of deaths from the flu this year in the state of California have doubled from the previous year, and we are already up to 149 deaths. So just the number of deaths from the regular flu in California is more than the number of deaths worldwide for coronavirus. If of course, you believe what they’re telling you in China, but just again to put this in perspective.

在我从事医学工作的加利福尼亚州，尤其是2009年以来的H1N1流感，现在正面临一个真正的问题。最近几周，我在ARDS的呼吸机上见到了许多此类患者，工作。加利福尼亚州公共卫生部门指出，今年加利福尼亚州因流感造成的死亡人数比去年增加了一倍，而我们已经有149人死亡。因此，仅加利福尼亚州因常规流感造成的死亡人数就超过了全世界冠状病毒的死亡人数。

So thank you for joining us for this update. More updates as they come. Hopefully better news as we go, and hopefully we start to see a slowdown of the number of reported cases and also the number of reported deaths, of course. Thank you for joining us!

因此，感谢您加入我们进行此更新。随着更多更新。希望我们能取得更好的消息，当然，也希望我们开始看到报告的病例数量和报告的死亡人数有所下降。感谢您加入我们！