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特朗普想嘗試群體免疫,先從年輕人下手?

Sy Mukherjee
2020-10-19

靠群體免疫抗擊疫情的想法是對(duì)傳染病科學(xué)的誤解。

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多條報(bào)道稱,特朗普政府為應(yīng)對(duì)疫情,越來(lái)越接受“群體免疫”策略。但科學(xué)家和公共衛(wèi)生專家相當(dāng)不安,因?yàn)槿后w免疫策略備受爭(zhēng)議,而且到底能否有效應(yīng)對(duì)疫情以及隨之而來(lái)的倫理問題,都很缺乏證據(jù)。

世界衛(wèi)生組織總干事譚德塞公開抨擊了靠群體免疫抗擊疫情的想法,聲稱該思路的根源是對(duì)傳染病科學(xué)的誤解。

什么是群體免疫?

簡(jiǎn)單來(lái)說(shuō),群體免疫理論認(rèn)為,如果有足夠多的人產(chǎn)生抗體或?qū)Σ≡w免疫,就能夠保護(hù)更容易受感染的人。只要免疫人群達(dá)到足夠規(guī)模,就容易控制病毒傳播。

問題在于群體免疫需要很長(zhǎng)時(shí)間,而且要十分謹(jǐn)慎,不能像錘子釘釘一樣對(duì)付新冠病毒之類的新病原體,畢竟人類新冠病毒的研究還在進(jìn)行中。看看現(xiàn)成的例子吧,瑞典采用了群體免疫策略,結(jié)果慘不忍睹。

“要實(shí)現(xiàn)群體免疫,關(guān)鍵在于保護(hù)人們免受病毒侵害,而不是任由人們暴露在病毒中。”世界衛(wèi)生組織的泰德羅斯在上周的虛擬會(huì)議上說(shuō)。“公共衛(wèi)生史上從未將群體免疫作為應(yīng)對(duì)疫情的策略,更不用說(shuō)應(yīng)對(duì)大規(guī)模疫情。”他補(bǔ)充說(shuō),這么做很“不道德”。

要實(shí)現(xiàn)群體免疫,首先要有大量人群受感染。“具體規(guī)模因病而異。疾病傳染性越強(qiáng),對(duì)該病免疫以阻止傳播的人口比例就要越高。”梅奧診所表示。“舉個(gè)例子,麻疹是傳染性很強(qiáng)的疾病。據(jù)估計(jì),必須有94%的人口免疫才能阻斷傳播鏈。”

證據(jù)已經(jīng)顯示,新冠病毒傳染性極強(qiáng),也就是說(shuō)要達(dá)到群體免疫需要更高比例的人口獲得免疫。

為何美國(guó)要考慮群體免疫

據(jù)報(bào)道,特朗普政府開始考慮讓新冠病毒在年輕人中擴(kuò)散,最終實(shí)現(xiàn)群體免疫。年輕人的癥狀一般沒有高風(fēng)險(xiǎn)人群高。報(bào)道稱,一群科學(xué)家聯(lián)名支持,認(rèn)為這是恢復(fù)經(jīng)濟(jì)發(fā)展和社會(huì)開放的手段,引起了白宮的注意。

大多數(shù)支持者并未公開。不過特朗普的高級(jí)科學(xué)顧問斯科特?阿特拉斯博士是主要支持者之一。支持該策略的其他醫(yī)生和流行病學(xué)專家觀點(diǎn)基本上都被科學(xué)界駁斥,被駁斥的觀點(diǎn)當(dāng)中包括群體免疫只需10%到20%的人群受感染。

批評(píng)人士稱,面臨全球100多年來(lái)最嚴(yán)重的疫情,采取如此試驗(yàn)可能導(dǎo)致數(shù)百萬(wàn)人死亡。當(dāng)前證據(jù),例如瑞典的案例似乎足以證明。隨意接觸新冠病毒與接種真正安全的疫苗并不是一回事,很可能只會(huì)引發(fā)更多的混亂和痛苦。(財(cái)富中文網(wǎng))

譯者:馮豐

審校:夏林

多條報(bào)道稱,特朗普政府為應(yīng)對(duì)疫情,越來(lái)越接受“群體免疫”策略。但科學(xué)家和公共衛(wèi)生專家相當(dāng)不安,因?yàn)槿后w免疫策略備受爭(zhēng)議,而且到底能否有效應(yīng)對(duì)疫情以及隨之而來(lái)的倫理問題,都很缺乏證據(jù)。

世界衛(wèi)生組織總干事譚德塞公開抨擊了靠群體免疫抗擊疫情的想法,聲稱該思路的根源是對(duì)傳染病科學(xué)的誤解。

什么是群體免疫?

簡(jiǎn)單來(lái)說(shuō),群體免疫理論認(rèn)為,如果有足夠多的人產(chǎn)生抗體或?qū)Σ≡w免疫,就能夠保護(hù)更容易受感染的人。只要免疫人群達(dá)到足夠規(guī)模,就容易控制病毒傳播。

問題在于群體免疫需要很長(zhǎng)時(shí)間,而且要十分謹(jǐn)慎,不能像錘子釘釘一樣對(duì)付新冠病毒之類的新病原體,畢竟人類新冠病毒的研究還在進(jìn)行中。看看現(xiàn)成的例子吧,瑞典采用了群體免疫策略,結(jié)果慘不忍睹。

“要實(shí)現(xiàn)群體免疫,關(guān)鍵在于保護(hù)人們免受病毒侵害,而不是任由人們暴露在病毒中。”世界衛(wèi)生組織的泰德羅斯在上周的虛擬會(huì)議上說(shuō)。“公共衛(wèi)生史上從未將群體免疫作為應(yīng)對(duì)疫情的策略,更不用說(shuō)應(yīng)對(duì)大規(guī)模疫情。”他補(bǔ)充說(shuō),這么做很“不道德”。

要實(shí)現(xiàn)群體免疫,首先要有大量人群受感染。“具體規(guī)模因病而異。疾病傳染性越強(qiáng),對(duì)該病免疫以阻止傳播的人口比例就要越高。”梅奧診所表示。“舉個(gè)例子,麻疹是傳染性很強(qiáng)的疾病。據(jù)估計(jì),必須有94%的人口免疫才能阻斷傳播鏈。”

證據(jù)已經(jīng)顯示,新冠病毒傳染性極強(qiáng),也就是說(shuō)要達(dá)到群體免疫需要更高比例的人口獲得免疫。

為何美國(guó)要考慮群體免疫

據(jù)報(bào)道,特朗普政府開始考慮讓新冠病毒在年輕人中擴(kuò)散,最終實(shí)現(xiàn)群體免疫。年輕人的癥狀一般沒有高風(fēng)險(xiǎn)人群高。報(bào)道稱,一群科學(xué)家聯(lián)名支持,認(rèn)為這是恢復(fù)經(jīng)濟(jì)發(fā)展和社會(huì)開放的手段,引起了白宮的注意。

大多數(shù)支持者并未公開。不過特朗普的高級(jí)科學(xué)顧問斯科特?阿特拉斯博士是主要支持者之一。支持該策略的其他醫(yī)生和流行病學(xué)專家觀點(diǎn)基本上都被科學(xué)界駁斥,被駁斥的觀點(diǎn)當(dāng)中包括群體免疫只需10%到20%的人群受感染。

批評(píng)人士稱,面臨全球100多年來(lái)最嚴(yán)重的疫情,采取如此試驗(yàn)可能導(dǎo)致數(shù)百萬(wàn)人死亡。當(dāng)前證據(jù),例如瑞典的案例似乎足以證明。隨意接觸新冠病毒與接種真正安全的疫苗并不是一回事,很可能只會(huì)引發(fā)更多的混亂和痛苦。(財(cái)富中文網(wǎng))

譯者:馮豐

審校:夏林

The Trump administration is increasingly embracing a strategy of "herd immunity" to grapple with the COVID-19 pandemic, according to multiple reports. But the controversial strategy has scientists and public health experts on edge given the limited proof that it would work for this specific outbreak and the ethical concerns which accompany it.

Tedros Adhanom Ghebreyesus, director-general of the World Health Organization (WHO), has openly lambasted the idea of using herd immunity to fight a pandemic, asserting that it's driven by a misunderstanding of the science of infectious diseases.

What is herd immunity?

To put it simply, herd immunity is the scientific theory that if enough of a population builds antibodies or gains immunity against a pathogen, they can protect those who are more vulnerable to infection. With enough immune people, the spread of a virus becomes much more containable.

The trouble is that herd immunity is a process that takes time and caution. It can't be used as a hammer against a new pathogen like the coronavirus which we're still trying to understand. Just ask Sweden, which employed a herd immunity strategy and saw disastrous results.

“Herd immunity is achieved by protecting people from a virus, not by exposing them to it,” the WHO's Tedros said in a virtual town hall last week. “Never in the history of public health has herd immunity been used as a strategy for responding to an outbreak, let alone a pandemic," adding that it would be "unethical" to rely on this strategy.

Achieving herd immunity would require a massive proportion of the population to become infected. "It varies from disease to disease. The more contagious a disease is, the greater the proportion of the population that needs to be immune to the disease to stop its spread," according to the Mayo Clinic. "For example, the measles is a highly contagious illness. It's estimated that 94% of the population must be immune to interrupt the chain of transmission."

COVID has proven quite transmissible and contagious, suggesting that herd immunity would require a higher threshold of mass immunity.

Why the U.S. is considering the herd immunity approach

The Trump administration is reportedly open to the idea of letting coronavirus run amok among younger people, who generally don't become as sick as higher-risk populations, in order to achieve herd immunity. A group of scientists endorsed the idea as a means to reopening the economy and society at large and caught the White House's attention, according to the reports.

Most of the signatories to that declaration have not been made public. But Dr. Scott Atlas, a senior scientific advisor to President Trump, is one of its major proponents. Other doctors and epidemiologists who have signed on to the declaration espouse views that are largely rejected by the scientific community, including the notion that herd immunity would only require 10% to 20% of the population to be infected.

The results of such an experiment in the midst of a pandemic the likes of which the world hasn't seen in more than 100 years could result in millions of deaths, according to critics. Current evidence, such as what's already been seen in Sweden, appears to support that thesis. And willful exposure to the coronavirus wouldn't resemble an actual, safe vaccine; it could very well just breed more chaos and suffering.

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