疫苗的发展，意大利的应对措施和死亡率趋势
Vaccine Developments, Italy’s Response, and Mortality Rate Trend (Lecture 25)
Welcome to another MedCram lecture on the SARS-COV-2 virus, causing the covid-19 disease. This update is for the 25th of February 2020, and we’re going to talk about Italy and China, and then vaccines. This is going to be kind of interesting when we get into that.
欢迎来到MedCram关于SARS-COV-2病毒引起covid-19疾病的另一场讲座。此更新将于2020年2月25日发布，我们将先讨论意大利和中国，然后再讨论疫苗。当我们开始讨论时，这将很有趣。
And again, here are the numbers that they are reporting. So I’m simply reporting what they are reporting, and we’ve hit 80,000 proper. Total deaths at almost 2700; total recovered 27,000; and so we’re up to a differential there of 10 times. I remember when that was almost on par. In fact when it was even less than the number of total deaths. So whereas total deaths have leveled off, we still have an increasing amount of total recovered, which is always a good thing.
再次，这是他们报告的数字。因此，我只是报告他们所报告的内容，而我们已经达到了80,000。总死亡人数接近2700；总共追回了27,000；因此，我们最多可以相差10倍。我记得当时差不多可以做到这一点。实际上，当时的死亡人数甚至少于总死亡人数。因此，尽管总死亡人数趋于平稳，但我们的总康复人数仍在增加，这始终是一件好事。
Let’s look at the Nucleus Wealth site, which I’ve found to have some interesting graphs that are unique to it. I’m going to scroll all the way down here to the bottom, where they talk about the mortality rate, or the case fatality rate. And as we’ve talked about, there is a bit of a delay in measuring what the total cases are right now compared to what the total deaths are right now. There’s been a question about whether or not you should delay the mortality accounts and look back 4 days, 8 days, or 12 days, depending on how long it takes somebody in average to die from the onset.
让我们看一下Nucleus Wealth网站，我发现其中有一些非常有趣的图表。我将一直滚动到最下面，他们谈论死亡率或病死率。正如我们已经谈到的那样，与目前的总死亡人数相比，在衡量目前的总病例数方面存在一些延迟。有一个问题是您是否应该推迟死亡率报告并回溯4天，8天或12天，具体取决于某人从死亡到死亡的平均时间。
In looking at those, it’s interesting that if you look at all of the cases outside of Wuhan in the rest of China, you can see here that if you look at a full 12 days out, that the mortality rate, or case fatality rate, reaches around the same asymptotes as if you look at eight days versus if you look at four days, and that’s just under 1%.
在查看这些数据时，有趣的是，如果您查看中国其他地区武汉市以外的所有病例，那么您可以看到，如果您整整看了整整12天，死亡率或病死率，达到相同的渐近线，就好像您看了八天还是看了四天一样，大约不到1％。
If you look at Hubei province, which is where Wuhan is, and you do the same sort of analysis, it all settles out again, but not at just below 1%, but just below 5%. This kind of makes sense if you think about the fact that inside Hubei, where most of the cases were, their healthcare industry is going to be more overwhelmed, and therefore perhaps having a higher case fatality rate. So you can take a look at this site, we will put the link to it in the description below.
如果您查看湖北省（位于武汉的地方），并且进行相同的分析，则所有结果都会再次稳定下来，但不会低于1％，而是会低于5％。如果您考虑到这样一个事实，那就是事实，即在湖北省（大多数情况下），他们的医疗保健行业将更加不堪重负，因此病死率可能会更高。因此，您可以看一下这个站点，我们将在下面的描述中添加指向该站点的链接。
If we go over to the WorldOmeter, as we have done in the past, you can see similar numbers here, where I like to look at the active cases and the close cases. Of the closed cases that we have, 91% of recovered and been discharged and 9% death.
如果像过去一样转到WorldOmeter，您可以在此处看到类似的数字，我希望在其中查看活动案例和结束案例。在我们已结案的病例中，91％的康复出院，9％的死亡。
If we look further down, we come to the latest updates for February 25th. We can see here that there’s one new death in South Korea, another death on the Diamond Princess, two new cases in Italy, and 60 new cases in South Korea.
如果进一步往下看，我们将提供2月25日的最新更新。我们在这里可以看到，在韩国有1例新死亡，在《钻石公主》上又有1例死亡，在意大利有2例新病例，在韩国有60例新病例。
Possibly, some good news here in South Korea is that the 60 new cases that were seen today in South Korea is a sharp decline in new cases compared to 161. And so this may be that there might be a cluster. In fact, that’s what they’re saying that there are two clusters, and that has to do with this church where they had met, and this may be the reason for the spreading, and this accounts for over 50% of the cases within South Korea.
在韩国，可能有一个好消息是，今天在韩国看到的60例新病例与161例相比，新病例急剧下降。因此，这可能是一个集群。实际上，这就是他们说的有两个集群，这与他们相遇的教堂有关，这可能是传播的原因，占南方地区案例的50％以上韩国。
Let’s go over to another site. This is by Reuters, title Battle Against Coronavirus Turns to Italy; Wall Street Falls on Pandemic Fears, Over 1,000 point loss on the Dow Jones on the 24th. A couple of interesting things here. It kind of contrasts what they did in China and what’s going on in Italy. Of course in China, things seem to be not rising as fast, and in Italy, things seem to be climbing pretty rapidly.
让我们转到另一个站点。路透社报道，标题为“与冠状病毒的战斗转向意大利”。华尔街因大流行而忧虑，24日道琼斯指数下跌超过1,000点。这里有一些有趣的事情。这与他们在中国的所作所为以及意大利的现状形成了鲜明的对比。当然，在中国，事情似乎并没有以那么快的速度增长，而在意大利，事情似乎在迅速地攀升。
And so they talked here about China putting cities in lockdown. Italian authorities are also doing similar things, sealing off the worst-affected towns, closing schools, halting the carnival in Venice. What they say here, interestingly, this is from Reuters, “China’s actions, especially in Wuhan, the epicenter of the outbreak, probably prevented hundreds of thousands of cases,” said the head of the WHO delegation in China Bruce Aylward, “the rest of the world to learn from the lesson of acting fast.”
因此，他们在这里谈论了中国将城市封锁的问题。意大利当局也在做类似的事情，封锁受灾最严重的城镇，关闭学校，停止威尼斯狂欢节。他们在这里说的很有趣，这是来自路透社的，“中国的行动，特别是在疫情的爆发地武汉，可能阻止了数十万病例，”世卫组织驻中国代表团团长布鲁斯·艾尔沃德说。世界上的人可以从快速行动的教训中学习。”
They’re at a point now, where the number of cure people coming out of the hospital each day is more than the sick going in. He said, “the surge of cases outside of mainland China triggered sharp falls in global markets, specifically in Italy, as investors fled to safe havens.” And they talk about the European equities markets.
现在到了一个关键时刻，每天从医院出来的治愈人数超过了病入院的人数。他说：“中国大陆以外病例的激增引发了全球市场的急剧下降，尤其是在意大利，因为投资者逃往避风港。”他们谈论了欧洲股票市场。
He goes on to talk about the epidemic in China, Peking between January 23rd and February 2nd, and they say, has been declining since Dr. Mike Ryan, the head of the WHO Emergencies Program told reporters. It is still possible to contain the virus, and that it might appear each year like the flu, quote “the virus may settle down into an endemic pattern of transmission into a seasonal pattern of transmission, or it could accelerate into a full-blown global pandemic, “he said, in Geneva on Monday. And at this point, it’s not possible to say which of these realities is going to happen. Goes on to talk about how the Trump Administration is requesting a billion dollars to deal with the coronavirus.
他继续谈论中国在北京1月23日至2月2日之间的流行病，他们说，自从WHO紧急情况计划负责人Mike Ryan博士告诉记者以来，这种流行病一直在下降。仍然有可能包含这种病毒，而且这种病毒可能每年像流感一样出现，并引用“该病毒可能会以一种流行的传播方式定居为一种流行的传播形式，或者以季节性传播的形式传播，或者可能会加速发展成一个成熟的全球性传播媒介。大流行，”他说，星期一在日内瓦。在这一点上，尚无法确定将发生哪些现实。继续讨论特朗普政府如何要求10亿美元用于治疗冠状病毒。
Now, specifically, what it is that’s going on in China. We’ve got China’s National Health Commission said that while the rapid rise has been halted, the situation was still grim. He said over 3,000 medical staff have become infected, most in Hubei Province, surrounding Wuhan, probably due to the lack of protective gear and fatigue.
现在，具体地说，这就是中国正在发生的事情。中国国家卫生委员会表示，尽管这种迅速增长的趋势已经停止，但形势仍然严峻。他说，已经有3000多名医务人员被感染，其中大部分是在湖北省武汉市附近，这可能是由于缺乏防护装备和疲劳所致。
And we talked about the fact that the case fatality rate in Wuhan was higher than it is in the rest of China. We also talked previously about the fact that there was no protective gear, but we also talked about the need for sleep and the ability to sleep and get rest. And of course, if there are a number of professional colleagues of yours who are infected and quarantined, that’s going to increase the load on you, that’s going to make you more fatigued, and hence we see videos of health care providers in China collapsing, and we hear a number of these physicians are actually succumbing to the virus.
我们谈到了武汉市的病死率高于中国其他地区的事实。前面我们也谈到了没有防护装备的事实，但是我们也谈到了睡眠的需求以及睡眠和休息的能力。当然，如果您的许多专业同事被感染和隔离，那将增加您的负担，这会使您更加疲劳，因此，我们看到中国的医疗服务提供者的视频正在崩溃，而且我们听说许多这样的医生实际上都死于该病毒。
So at this point excluding Wubei, mainland China reported 11 new cases, that’s the lowest since they started actually taking figures on January 20th. Overall, China reported 409 new cases on the mainland, down from 648 a day earlier. There was a measure of relief, it says, for the world’s second-largest economy. More than 20 province-level jurisdictions, including Beijing and Shanghai, here we go, reported zero new infections.
因此，在目前不包括无北市的情况下，中国大陆报告了11例新病例，这是自1月20日开始实际记录以来的最低水平。总体而言，中国大陆报告有409例新病例，低于一天前的648例。它说，这是世界第二大经济体的缓解措施。我们来的包括北京和上海在内的20多个省级辖区报告了零新感染。
Whereas what’s going on outside of China? Well, things are taking off. We’ve got 29 countries and territories with a death toll of about two dozen, according to the Reuters tally. South Korea, 231 new cases, making its total to 833. We see a couple of new countries that have come to the table here: Kuwait, Bahrain, Oman and Afghanistan. They are believed to be cases that have been to Iran in the past.
而中国境外发生了什么？好吧，事情正在起飞。据路透社统计，我们有29个国家和地区的死亡人数大约为二十。韩国有231例新病例，总数达到833例。我们在这里看到了几个新国家：科威特，巴林，阿曼和阿富汗。人们认为它们是过去曾到伊朗的案件。
So a lot of things going on. It’s almost like A Tale of Two Cities. It seems as though China has had a huge hit, but things may be on the verge of something different, potentially. We’ll have to see, and then we have Italy and South Korea, which are taking off.
因此发生了很多事情。这几乎就像两个城市的故事。中国似乎遭受了巨大的打击，但事情可能即将发生变化。我们得先看看，然后是意大利和韩国，它们正在起飞。
I want to talk briefly about another interesting article. This is in the Wall Street Journal. We will put a copy of this link as well on the description below. This fascinating article, which you would probably need to have a login to read. It talks about this drug maker Moderna Incorporated, which has shipped its first batch of its rapidly developed coronavirus vaccine to US government researchers, who will launch the first human tests of whether the experimental shot could help suppress the epidemic originating in China.
我想简短地谈谈另一篇有趣的文章。这在《华尔街日报》上。我们还将在下面的描述中放置此链接的副本。这篇引人入胜的文章，您可能需要登录后才能阅读。它谈论的是该药物制造商摩登那公司（Moderna Incorporated），该公司已将其第一批快速开发的冠状病毒疫苗运送给美国政府研究人员，后者将启动人类首次实验，以证明该实验疫苗能否帮助抑制源自中国的流行病。
Now, why is this experimental? Well, I encourage you to actually watch the video that is on this site, and you’ll see what I’m talking about. But very briefly let me explain to you what it is that’s going on there.
现在，为什么要进行实验？好吧，我鼓励您实际观看此站点上的视频，您会明白我在说什么。但请允许我简单地向您解释这是怎么回事。
Okay, so normally what happens is a virus. Here’s the virus goes in and infects a cell, and what happens is these proteins go on the surface of the cell when this virus infects the cell. These proteins here are very important because they tell the body that this is an infected cell, or that this, for instance, is a virus, and what they normally do is they will normally take the virus, and they will inactivate it or kill it, and they will inject it in, and what will happen here is that these proteins will induce an antibody response in the body that allows the body to have many of these antibodies already ready to fight.
好的，所以通常发生的是病毒。这是病毒进入并感染细胞的过程，当这种病毒感染细胞时，发生的是这些蛋白质进入细胞表面。这些蛋白质在这里非常重要，因为它们告诉人体这是被感染的细胞，或者例如是病毒，它们通常做的是通常会吸收病毒，然后将其灭活或杀死它。 ，然后将它们注射进去，这将发生在这些蛋白质中，它们会在体内诱导抗体反应，从而使人体中许多已经准备好对抗的抗体。
So this is the normal situation up here. And the problem is it takes many months to create this type of model where you can inject these proteins into the body so that you can have these antibodies form against these proteins. What they’re planning on doing, from what I’m getting from this article, is something completely different in terms of a vaccine. What they’re really doing here is they’re having a cell, and because they have the genome of this virus, they’re able to inject in this case the RNA somehow into the body, and this RNA will then go into the cells, which will tell the cells to produce the antigens, which will then cause the antibodies to form against it.
所以这是正常情况。问题是创建这种类型的模型需要花费数月的时间，您可以在其中将这些蛋白质注射到体内，从而使这些抗体形成针对这些蛋白质的抗体。从我从本文中学到的内容来看，他们计划做的事情与疫苗完全不同。他们在这里真正在做的是拥有细胞，并且因为它们具有这种病毒的基因组，因此在这种情况下，他们能够以某种方式将RNA注入人体，然后该RNA进入细胞，它将告诉细胞产生抗原，然后将导致针对它的抗体形成。
So in other words, instead of having the virus, or the lab produce these antigens to inject into the human so that the human can make antibodies, what they’re instead doing is isolating the genomic sequences themselves, having them tell your own cells to produce these antigens, and then these antigens are going to cause antibodies to be formed, and that is how they can do this much faster, because they don’t have to go through all the sequences of having this be done. In other words, making this, they can have your cells make the vaccine for you, and then have you self immunize against the virus.
因此，换句话说，不是让病毒或实验室产生这些抗原以注入人体内，从而使人可以制造抗体，他们要做的就是自己分离基因组序列，让它们告诉自己的细胞产生这些抗原，然后这些抗原将导致抗体形成，这就是它们可以更快地完成此过程的原因，因为它们不必经历完成此过程的所有过程。换句话说，这样做可以使您的细胞为您制造疫苗，然后让您针对该病毒进行自我免疫。
And it seems as though this really hasn’t been done before, and so according to that Wall Street Journal article, it looks as though they’re going to be starting clinical trials in April. And so that would be 3 months from the time that they learned about the genome to the point where they can actually get a vaccine for human clinical trials. Now, this is a new technology, and for some people, this may sound really cool; for others, it maybe, well, what are the side effects of this?
似乎以前确实没有做过，因此根据《华尔街日报》的文章，似乎他们将在四月份开始临床试验。从他们了解基因组到可以实际获得用于人类临床试验的疫苗的时间大约需要3个月。现在，这是一项新技术，对于某些人来说，这听起来真的很酷。对于其他人，也许这有什么副作用？
What’s going to happen when you’re starting to put DNA or RNA instructions, messenger RNA in most cases, in this case, into your cells and tell them to make proteins that are foreign to your body to cause an immune response. Almost sounds like an autoimmune condition. So it’s going to be interesting to see what happens and what are the side effects of this.
当您开始将DNA或RNA指令，大多数情况下的信使RNA放入细胞中，并告诉它们制造对您的身体异物以引起免疫反应的蛋白质时，会发生什么。几乎听起来像是自身免疫病。因此，看到发生了什么以及其副作用是什么会很有趣。
To get a better understanding of this, you’re going to need to know about molecular biology, and as it just so happens, we have a video that’s a primer on molecular biology, because what we’re about to do is get into the details of the coronavirus life cycle, and what it actually does in the cell, and how it’s different from other viruses. Thanks for joining us!
为了更好地理解这一点，您将需要了解分子生物学，而就在这种情况下，我们有一段视频是分子生物学的入门书，因为我们要做的是进入冠状病毒生命周期的详细信息，它在细胞中的实际作用，以及与其他病毒的区别。感谢您加入我们！
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