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专访WHO专家:德国死亡率为什么这么低?

  来演:国事纵贯车

  针对以后备受国内存眷的欧洲抗击新冠肺炎疫情停顿以及差别国度采纳的防疫战略,天下卫生构造欧洲地区处事处高要挟性病原体团队担任人理查德·皮博迪博士(Dr。 Richard Pebody)外地工夫16日独家承受中新社国事纵贯车记者专访透露表现,不存在一种合适一切国度的防疫形式,每一个国度该当做的是施行最合适其本身状况的办法。针对德国较低的病死率,他出格提示,除意大利外的别的欧洲国度疫情开展还处在较为晚期的阶段。“这局部国度大概会在接上去很多天或数周阅历出生病例增加。”

  世卫构造总做事谭德塞本月13日指出,欧洲如今曾经成为大盛行疫情的中间,陈述的病例和出生人数超越了除中国之外天下其余地域的总和。世卫构造欧洲地区处事处停止欧洲中部工夫16日23时的数据表现,欧洲国度累计确诊人数已达63268人,出生2755人。

  位于丹麦哥本哈根的世卫构造欧洲地区处事处担任欧洲地域50个国度。皮博迪当天近程承受了中新社国事纵贯车记者专访。

  皮博迪中心观念以下:

  防疫不存在“合适一切脚的鞋子”,列国只能量体裁衣

  德国病死率低能够因其疫情处在晚期,需求亲密存眷接上去很多天到数周开展

  以后急需列国加大呼应力度、检测力度、缓解传达的力度

  每一个人做出本人的奉献异样紧张

  谈中国派专家组赴意大利:现实证据和曾经获得的经历经验将协助咱们打败这场大盛行病和将来的大盛行病

  采访实录(中英文比较)以下:

  国事纵贯车:世卫构造日前颁布发表将新冠肺炎疫情定性为大盛行,这必定性能否会对欧盟及其成员国对新冠肺炎爆发的应答发生影响?

  答:将新冠肺炎COVID-19疫情定性为“大盛行”并未改动世卫构造给列国和集体的相干倡议。这必定性供给的只是一种水平更强的提示,鞭策各方采纳必需采纳的举动。

  国事纵贯车:在2月26日于罗马进行的世卫、欧盟和意大利三方集会时期,欧盟委员会卫生与食物平安事件委员斯泰拉·基里亚基季斯曾透露表现“咱们已请求欧盟成员国从头评价其应答大盛行病的预案以及从诊断、化验到追踪打仗者在内的全体医疗才能,并将评价状况和施行方案上报欧盟”。从世卫构造的角度来看,欧盟成员国今朝更新它们各自的大盛行病预案的状况若何?

  答:世卫构造继续地与一切国度坚持协作,协助它们保持和提醒各自的国度大盛行病预案。

  世卫构造欧洲地区处事处派出的技能团队已被安排至意大利、阿塞拜疆、乌克兰、黑山和亚美尼亚等国。咱们正继续以近程或现场的体式格局为它们供给着有针对性的帮忙,详细采纳何种方式取决于今朝前提下的游览灵通性。世卫构造已体例了内容丰厚、触及防疫任务一切范畴的技能指南。咱们正在撑持每个国度订定防疫技能计划,并在一个强无力的天下性战略框架着落实最火急的举动内容。

  世卫构造欧洲地区处事处同时也在呼应新冠肺炎(COVID-19)疫情的各个层面与欧盟和欧盟疾控中间(ECDC)展开着严密的协作。

位于哥本哈根的世卫组织欧洲区域办事处。图据WHO/Europe位于哥本哈根的世卫构造欧洲地区处事处。图据WHO/Europe

  国事纵贯车:世卫构造在欧友邦家应答疫情方面有没有引荐的“最好理论”或许最好形式?仍是说每一个国度都纷歧样?

  答:不存在一种“合适一切脚的鞋子”式的形式。每一个国度的卫生系统都不相反,它们的生齿构造也各不相反——因而,每一个国度是依据它们的外国状况以及疫情在它们的国度和地域所处的阶段去决议采纳何种举动。每一个国度该当做的是,施行最合适其本身状况的办法,这些办法是与外地状况相分离的。

  国事纵贯车:德国的新冠肺炎出生率与意大利比起来相称的低。乃至与法国和西班牙比拟,德国也黑白常低的。您若何解读这一差别?这是反应欧盟列国大众卫生应急才能的落差,仍是说因为下面提到的防疫形式之别而至?(注:德国疾病防控机构罗伯特·科赫研讨所数据表现,停止外地工夫3月16日15时,德国共确诊6012例新冠病毒肺炎传染病例,此中出生病例13例。据此较量争论,出生率为0.2%。而意大利的出生率到达7.3%,全世界均匀出生率为3.7%。)

  答:为了打败这类新型病毒,如今急需列国加大对病毒要挟的呼应力度,加大检测力度,也加大缓解病毒传达的力度,以解救人们的人命。在以后的阶段,每一个集体也到场到这一抗击疫情的积极中,作出本人的奉献也十分关头。出格是,咱们鼓舞大众遵照地点国度的卫生部分的指南,而且为别人供给协助。

  世卫构造同时提示人们要警觉对盛行病学数据的解读,这此中包含差别国度之间的病死率(case fatality rate)差别。详细到COVID-19新冠肺炎,那些由于传染这类病而逝世的病人均匀是在两到三周前被传染的。意大利的疫情爆发和开展要比欧洲别的中央开端得更早,因而呈现了更多的病人离开上述的关头周期,这时候他们要末治愈入院,要末可怜离世。别的欧洲国度疫情开展所处的仍是一个晚期阶段。这局部国度大概会在接上去很多天或数周阅历出生病例增加。

  同时,病死率也能够遭到病例春秋散布影响——70岁以上的传染者出生率最高。在大盛行病的晚期阶段,呈现有更多处于任务春秋的成年人被传染也是能够的。这是由于大盛行病尚未从他们身上传达到暮年人群,后者的病死率更高。

  最初,对疑似病例检测的掩盖水平也将影响病死率数字。差别国度的检测系统决议了它们发明确诊病例的才能不尽相反。假如不是一切传染者都被发明并确诊(出格是扫除了轻症患者)的话,这就会影响到病死率。

  国事纵贯车:中国已向意大利派出一队抗疫医疗专家组,协助外地抗击疫情。欧洲能否可以、或许该当从中国抗疫中进修任何经历?假如有的话是甚么?

  答:这是一种新的病毒,且情势正在疾速演化开展。世卫构造专家和别的各方都正在分秒必争地汇集、收拾整顿和传达针对这类病毒的研讨效果和抗击疫情火线的信息,这是为了让咱们对这类病毒理解得更充沛,也继续地改良每一个国度作出的呼应。现实证据和曾经获得的经历经验将协助咱们打败这场大盛行病和将来的大盛行病。

  Q: Which impact will WHO‘s announcement have on the EU and its member states fighting against the coronavirus outbreak?

  A: Calling COVID-19 a pandemic does not change WHO’s advice to countries and individuals。 What it does do is provide a stark reminder for implementing needed actions。

  Q: During the last meeting in Rome on 26 February 2020, the EU Co妹妹issioner Kyriakides has told that “we have requested Member States to review their pandemic plans as well as health care capacities, including capacity for diagnosing, laboratory testing and procedures for contact tracing。 All Member States need to inform us about their preparedness plans and how they propose to implement them”

  From WHO‘s perspective, how well have the EU member states updated their plans so far?

  WHO works continually with all countries to maintain and improve their national preparedness plans。 

  A: WHO/Europe technical missions have also been deployed to Italy, Azerbaijan, Ukraine, Montenegro, Armenia。 We are continuing to provide tailored assistance remotely or on-site depending on the possibility of travelling in the current context。 WHO has developed an abundance of technical guidance in all areas of work: we are supporting each and every country to develop technical plans and implement priority actions in the framework of a strong nationwide strategy。

  WHO/Europe also works closely with the European Union and the European Centre for Disease Control on all aspects of the COVID-19 response。

  Q:  Does WHO have any reco妹妹endation on which model would be the best for most countries in the EU to follow or it just varies from country to country?

  A: There is no one-size-fits-all approach。 Every health system is different, the demographics are different so each country takes action according to their national context and the stage the outbreak has reached in their area。 Every country should decide to implement the most appropriate measures adapted to the local contexts。

  Q: The coronavirus death rate in Germany is quite low so far compared to the rate in Italy。 And even compared to the death rate in France or Spain, the rate in Germany is still very low。 How do you interpret this difference? Does it reflect a gap of public health capabilities among the member states? Or is it because of the difference in approach as mentioned above?

  A: To fight this new virus, there is now a great need for countries to scale up response to treat, detect and reduce transmission to save people’s lives。 At this stage it is also critical that everybody join the efforts and do their part。 In particular, we encourage citizens to follow guidance from health authorities and reach out to support others。

  WHO also urges caution in interpreting epidemiological numbers, including differences in the case fatality rates between countries。 In the case of COVID-19, patients who pass away from the disease were infected 2-3 weeks previously on average。 The outbreak in Italy has been evolving for longer than other places in Europe and therefore more patients will have completed their final outcome and either been discharged or sadly passed away。 Other European countries, who are earlier in the epidemic, may well begin to experience deaths in the coming days and weeks。 The case fatality rate can also be affected by the age profile of cases; deaths usually occur in the elderly (>70 years)。

  In the early stages of the epidemic it is possible that more cases occur among working age adults before the epidemic spreads to older populations, where the case fatality is higher。 Lastly, the sensitivity of case detection will make a difference, and national surveillance systems may vary in their ability to detect cases。 If not all cases, particularly excluding the milder cases, are being detected then this will affect the case fatality ratio。

  Q: China has sent an anti-epidemic expert team to Italy to help fight COVID-19。 Could or should Europe learn anything from China? If so, what is it?

  A: This is a new virus and a rapidly evolving situation。 WHO experts and others are working around the clock to collect, compile and disseminate research findings and information from the field, to learn more about the virus and continuously improve each country’s response。 Evidence and lessons learned will help us beat this and future pandemics。

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