意大利感染，新冠病毒传播性，COVID-19症状
Infections in Italy, Transmissibility, COVID-19 Symptoms (Lecture 24)
Welcome to another MedCram lecture. We’re talking about SARS-2- COV, or covid-19. This update is for February 24, 2020. A lot has happened over the weekend, and we’ve got a lot of stuff to talk about, not the least of which is Italy and South Korea.
欢迎参加另一个MedCram讲座。我们在谈论SARS-2-COV或covid-19。此更新是2020年2月24日的。周末发生了很多事情，我们有很多事情要谈，尤其是意大利和韩国。
But before I get to that, I just want to go over where I think MedCram fits into this whole thing, because there’s a lot of news sources out there. You can read a lot of things on the internet about a lot of aspects of the coronavirus, and what I think the niche that MedCram serves, and we will continue to do this, is to take the medical aspect of this and try to explain it as best as we can because I think that’s our wheelhouse.
但是在开始之前，我只想回顾一下我认为MedCram可以适合整个过程的地方，因为那里有很多新闻来源。您可以在互联网上阅读有关冠状病毒许多方面的很多东西，我认为MedCram服务的领域是什么，我们将继续这样做，是从医学方面着手并尝试对其进行解释尽我们所能，因为我认为那是我们的操舵室。
Where did this coronavirus come from? What are the true numbers? What are the political, ideological aspects of it? We try to stay away from that; kind of stick to the medical information that’s coming out, and try to explain it to you as best as possible.
这种冠状病毒是从哪里来的？什么是真实数字？它的政治，意识形态方面是什么？我们试图远离这一点；坚持要发布的医疗信息，并尽力向您解释。
So with that being said, here’s the map from the Johns Hopkins site. We can see here that the total confirmed cases are increasing although not as fast as they were. Total deaths are also increasing, but not as fast as they were. Totally recovered seem also to be kind of leveling off.
话虽如此，这是约翰霍普金斯网站的地图。我们在这里可以看到，确诊病例的总数正在增加，尽管没有以前那么快。总死亡人数也在增加，但没有以前那么快。完全康复似乎也趋于平稳。
There is a site here in the link where it was a Lancet article, and I want to go to that to show you what they are doing over there at the Lancet. They have a number of articles. They also have their own graphs where they compared the WHO, the Chinese CDC, and the Johns Hopkins University site.
链接上有一个网站，上面是《柳叶刀》的文章，我想去那里向您展示他们在柳叶刀那边的所作所为。他们有很多文章。他们还拥有自己的图表，在其中比较了WHO，中国疾病预防控制中心和约翰霍普金斯大学网站。
But one of the things I want you to look at is this related hub. And that is the covid-19 resource center. That’s at the bottom. This is where you can get updates on interesting articles that are published across the Lancet platform. The Lancet, of course, being a very reputable medical journal. The other place that I wanted you to look was this site from Nucleus Wealth. They have a lot of different graphs on this site, and we will leave a link in the description below.
但是，我想让您看的一件事就是这个相关的中心。那就是covid-19资源中心。那是底部。在这里，您可以获取有关在Lancet平台上发布的有趣文章的更新。当然，《柳叶刀》是一本非常有名的医学杂志。我希望您看到的另一个地方是Nucleus Wealth的此站点。他们在这个网站上有很多不同的图表，我们将在下面的描述中保留一个链接。
They’ve got, for instance, some graphs that I haven’t seen before, where it shows here the change in cases based on the season. So the winter countries obviously are having an increase, whereas the summer countries are not of course. There may be some confounders here because a lot of the countries that are having in increase happened to be next to China, and of course, they’re in the northern hemisphere, and so they’re currently in winter, but you can see here a number of the different graphs.
例如，他们有一些我从未见过的图表，其中显示了根据季节而变化的情况。因此，冬季国家显然在增加，而夏季国家当然没有。这里可能会有一些混杂因素，因为许多增长最快的国家恰好位于中国旁边，当然，它们位于北半球，所以目前处于冬季，但是您可以在这里看到许多不同的图。
We’ve got the doubling time, which I had not seen before, and then one of the graphs that I thought was really interesting was total deaths, of course. But then this issue that’s been brought up all throughout the last month or so, which is the mortality rate using lag periods. And so what they did on this graph is that if you were to delay 4 days, what does mortality look like it is doing in the rest of China? Delay of 8 days delay, of 12 days, you can see they’re all kind of leveling out here as time goes along, just below 1% for the mortality or the case fatality rate.
我们有了倍增的时间，这是我之前从未见过的，然后我认为非常有趣的图表之一就是总死亡人数。但是，这个问题在过去一个月左右的时间里都出现了，这就是使用滞后期的死亡率。因此，他们在这张图表上所做的是，如果您推迟4天，死亡率在中国其他地区的情况如何？延迟8天，延迟12天，您会发现随着时间的流逝，它们都在逐步趋于平稳，死亡率或病死率仅低于1％。
However, in Hubei Province, doing the same kind of analysis, you can see that we’re coming up with a different mortality rate if you look at these numbers based on this. If you looked at the World, excluding China and Iran, the mortality rate using different lag periods, you can see we’re back to around two to three percent. And of course, there’s more analysis, and just like any good site, they give their data sources. So I thought this was a good site to add to your armamentarium for those of you who are liking to look at the covid-19 statistics.
但是，在湖北省进行同样的分析，如果您以此为依据，则可以得出不同的死亡率。如果您查看世界（不包括中国和伊朗）使用不同滞后期的死亡率，您会发现我们回到了百分之二到三。当然，还有更多的分析，就像任何一个好的网站一样，他们提供自己的数据源。因此，我认为对于那些希望查看covid-19统计信息的人来说，这是一个添加您的军备库的好网站。
Of course, our favorite one that we always go to is the WorldOmeter, which gives us the updated coronavirus cases: deaths, recovered, and active cases, closed cases. Another reason why I like to use this site is because if you scroll down below all of the country-specific data, you will see an update, and this is very helpful.
当然，我们一直喜欢的最喜欢的设备是WorldOmeter，它为我们提供了最新的冠状病毒病例：死亡，康复，活动病例，结案。我喜欢使用此站点的另一个原因是，如果您向下滚动到所有特定于国家/地区的数据，就会看到更新，这对您很有帮助。
So let’s go through this. Of course, the Italy outbreak being the biggest over the weekend. There are 78 new cases as of today, and one new death in Italy. This was a woman being treated for cancer. There are four new cases in Bergamo, two new cases in Venice, and a 70-year-old male in Valtellina, and a couple in Turin who visited their child at the Regina Margarita Hospital yesterday. Those are all new cases.
因此，让我们来看一下。当然，周末意大利爆发的疫情最大。截止到今天，有78例新病例，意大利有1例新死亡。这是一名正在接受癌症治疗的妇女。贝加莫有4例新病例，威尼斯有2例新病例，瓦尔泰利纳（Valtellina）有70岁的男性，都灵的一对夫妇昨天在里贾纳玛格丽塔医院看望了孩子。这些都是新情况。
We’ve got 114 cases in Lombardy, 25 cases in Veneto, and you can see the other ones trailing up, at least 26 patients are in critical condition in the intensive care units. And if you look at that number 26, and divide it by the number of cases that are there, which is quite substantial. It is coming out to a little bit more than we would expect to see in the intensive care unit.
伦巴第大区有114例，威尼托大区有25例，您会看到其他人紧随其后，重症监护病房中至少有26名病情危重。如果您查看该数字26，并将其除以那里的案例数，那将是非常可观的。它比我们在重症监护室看到的要多得多。
We have 11 towns, 50,000 people placed in lockdown, and we have the armed forces and the police forces that have been mobilized to form an insurmountable health belt, as they call it, and they’re going to be sentencing people if they break that roadblock to up to three months in prison, so they’re very serious.
我们有11个城镇，有50,000人被封锁，我们已经动员了武装部队和警察部队，形成了他们所说的不可逾越的医疗腰带，如果他们打破了这种腰带，他们将被判刑。最多可坐牢三个月，所以他们非常认真。
One of the things that’s been interesting to see is how different countries deal with this issue, and some of the quotes as well. There is a Walter Ricciadi of the WHO, adding that within two weeks, we will know if we are facing an epidemic, and that we should avoid crowded places over the next two weeks. So what they have done is their movie theaters are closed, more than 40 football matches have been postponed. There are games. There are fashion shows. All of which have been canceled.
有趣的事情之一是不同国家如何处理此问题，以及一些引号。世卫组织的一位瓦尔特·里恰迪（Walter Ricciadi）补充说，在两周之内，我们将知道我们是否面临流行病，并且在接下来的两周中，我们应该避免拥挤的地方。因此，他们所做的就是关闭电影院，推迟了40多次足球比赛。有游戏。有时装秀。所有这些都已被取消。
If we look down here to South Korea, and this is as of February 23rd. 166 new cases, 4 new deaths in South Korea, and they have risen the alert level to maximum, and you can see what the cases have done. The total cases from 31 to 58, now up to 602, and the numbers are still rolling in at this point.
如果我们在这里看韩国，这是从2月23日开始的。韩国有166例新病例，有4例新死亡，它们使警报等级提高到了最高水平，您可以看到这些案件的结果。案件总数从31增至58，目前已达602，而这一数字仍在增加。
I want to talk to you about this JAMA article. That was published on the 21st of February. Now, the issue has been containing this virus, and one of the ways to contain the virus is to be able to screen for it using symptoms. This disconcerting article showing a presumed asymptomatic carrier transmission of covid-19, which is the disease caused by the SARS-2-COV virus.
我想和您谈谈这篇JAMA文章。该书于2月21日发布。现在，问题一直在包含这种病毒，并且包含这种病毒的一种方法是能够使用症状进行筛查。该令人不安的文章显示了covid-19的无症状载体传播，该传播是由SARS-2-COV病毒引起的疾病。
What they did is they looked at a familial cluster of about five patients, with fever and respiratory symptoms, who were admitted to The Fifth People’s Hospital of Anyang, China, and one asymptomatic family member. Then here’s the key, and it showed that this asymptomatic carrier, a 20-old woman, was living with, and had close proximity to, five relatives. And they visited another hospitalized relative, and you can see this in the figure. There was no report of covid-19 at the hospital.
他们所做的是，他们检查了大约五名有发热和呼吸道症状的患者的家族，这些患者被送往中国安阳市第五人民医院，并且是一名无症状的家庭成员。然后，这是关键，它表明，这名无症状的携带者是一名20岁妇女，与五个亲戚同住并与之亲密接触。他们拜访了另一位住院的亲戚，您可以在图中看到这一点。医院没有covid-19的报告。
This number one patient was isolated and observed, and as of February 11, she had no elevated temperature, no self-reported fever, no GI symptoms, or respiratory symptoms, including cough or sore throat. And on January 26, she was positive on testing for real-time polymerase Chain Reaction or RT- PCR.
隔离并观察了这名第一名患者，截至2月11日，她没有升高的温度，没有自我报告的发热，没有胃肠道症状或呼吸道症状，包括咳嗽或喉咙痛。在1月26日，她对实时聚合酶链反应或RT-PCR的检测很满意。
She then once again tested negative thereafter. Despite this, 2 patients, two through six, developed covid-19, the disease. 4 were women in ages from forty to fifty-Seven, and none of the patients had visited Wuhan. In other words, they believe that they got it through her.
然后，她此后再次测试阴性。尽管如此，仍有2例（从2到6例）患上了covid-19病。 4名年龄在40至57岁之间的女性，没有患者去过武汉。换句话说，他们相信他们是通过她得到的。
They did develop fever and respiratory symptoms between January 23rd and January 26. They were admitted to the hospital on the same day. All of them had RT-PCR tests for covid-19 within one day. When they looked at these patients sympathetically, they had ground glass opacities, which is the finding on chest CT, and they all had reduced lymphocyte count, which is compatible with covid-19.
他们在1月23日至1月26日之间确实出现了发烧和呼吸道症状。他们于当天入院。他们都在一天之内进行了针对covid-19的RT-PCR测试。当他们同情地看待这些患者时，他们有磨砂玻璃混浊，这是在胸部CT上发现的，而且他们的淋巴细胞总数都减少了，这与covid-19兼容。
So, their analysis says that on the previous study reported an asymptomatic 10-year-old boy with covid-19 infection, but he had abnormalities on his chest CT. If the findings in this report of presumed transmission by an asymptomatic carrier are replicated, the prevention of covid-19 infection would prove challenging. The mechanism by which asymptomatic carriers could acquire and transmit the coronavirus that causes covid-19 requires further study.
因此，他们的分析表明，在先前的研究中，一名无症状的10岁男孩患有covid-19感染，但他的胸部CT异常。如果该报告中假定无症状携带者传播的发现得以重复，那么预防covid-19感染将具有挑战性。无症状携带者获得并传播导致covid-19的冠状病毒的机制需要进一步研究。
So it’s looking as though it’s going to be difficult just based on fever symptoms and self quarantining to be able to prevent this from spreading based on this article. Now, we don’t know exactly how often asymptomatic people are carrying this virus and able to spread it, but we do know that it is possible based on this article at least.
因此，基于本文的发烧症状和自我隔离，看起来似乎很困难，才能防止这种情况蔓延。现在，我们不知道无症状的人经常携带这种病毒并能够传播这种病毒，但是我们确实知道，至少根据本文而言，这是有可能的。
One of the things that we’re going to be talking about coming up in future updates as we mentioned before is we’re going to talk about the molecular biology of this new SARS-2, covid virus. I haven’t seen much out there in terms of describing what actually happens.
正如我们之前提到的，我们将要讨论的将来更新中的一件事是，我们将讨论这种新的SARS-2 covid病毒的分子生物学。关于描述实际发生的事情，我还没有看到太多。
I’m used to having these videos made for people in the medical field, people who have an understanding of biology, people understand what DNA is, and RNA, and polypeptides, and things of that nature, but I realized that we have probably a lot of people out there that don’t really understand the molecular biology of the cell, and what DNA polymerase is, and RNA polymerase, and what Transfer RNA is, and what’s the difference between translation and codons and transcription. So I’m going to put a link in the description below of a nice YouTube video that describes a little bit about that.
我习惯于为医疗领域的人们，对生物学有了解的人们，了解DNA是什么，RNA，多肽以及类似性质的东西制作这些视频，但我意识到我们可能许多人并不真正了解细胞的分子生物学，什么是DNA聚合酶，RNA聚合酶，什么是RNA转移，以及翻译，密码子和转录之间的区别。因此，我将在下面的一段不错的YouTube视频的描述中添加一个链接，其中描述了一些相关内容。
Of course. I’m not going to be leaving you out in the cold, so I will do a little bit of description, and I will upload a video on a primer for understanding the terminology that we’re going to use, because what I’d like to do is go through and really step by step show you what happens when the SARS-2-COV virus infects one of your cells, and exactly how does that work? And how is that different from the other viruses that were used to, including HIV, so we will be helping out with that understanding. Thank you for joining us.
当然。我不会冷落你，所以我会做一些描述，并且我将在入门影片上载一个视频，以了解我们将要使用的术语，因为我会我想做的就是一步一步真正地向您展示SARS-2-COV病毒感染您的一个细胞时会发生什么，以及它是如何工作的？这与以前的其他病毒（包括HIV）有何不同，因此我们将帮助您加深了解。感谢您加入我们。
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