科学美国人60秒 COVID 克服大流行的推动力（在线收听）

The Push to Move Past the Pandemic: COVID Quickly

COVID 克服大流行的推动力

Tanya Lewis: Hi, and welcome to COVID, Quickly, a Scientific American podcast series.

Josh Fischman: This is your fast-track update on the COVID pandemic. We bring you up to speed on the science behind the most urgent questions about the virus and the disease. We demystify the research and help you understand what it really means.

Tanya Lewis：您好，欢迎收看美国科学播客系列《COVID, Quickly》。

Josh Fischman：这是您对 COVID 大流行的快速更新。 我们让您快速了解有关病毒和疾病的最紧迫问题背后的科学。 我们揭开研究的神秘面纱，并帮助您了解它的真正含义。

Lewis: I’m Tanya Lewis.

Fischman: I’m Josh Fischman.

刘易斯：我是坦尼娅·刘易斯。

菲施曼：我是乔什·菲施曼。

Lewis: And we’re Scientific American’s senior health editors.

Today, we’ll explain the new official methods to determine if you’re in a pandemic safe zone or danger area…

刘易斯：我们是《科学美国人》的高级健康编辑。

今天，我们将解释新的官方方法来确定您是否处于流行病安全区或危险区……

Fischman: Then we’ll discuss what other pandemics looked like when they were ending—and whether this one, at long last, is heading down a similar path.

Fischman：然后我们将讨论其他流行病结束时的样子——以及这次流行病是否最终会走上类似的道路。

Lewis: The map of the U.S. shifted last week. Or at least the map of COVID danger did. Suddenly a lot of hazardous regions were deemed safer. What happened, Josh? Did COVID disappear?

刘易斯：上周美国的地图发生了变化。 或者至少 COVID 危险地图确实如此。 突然间，许多危险区域被认为更安全。 发生了什么事，乔什？ 新冠病毒消失了吗？

Fischman: It was a weird moment, Tanya. And no, COVID hasn’t gone away. But last Friday morning people looked at an official Centers for Disease Control map showing much of the nation was in high risk areas. And the next day that map showed about 60 percent of the US was really at low or medium risk. And people in those areas didn’t need to wear a mask.

Fischman：这是一个奇怪的时刻，Tanya。 不，COVID并没有消失。 但上周五早上，人们查看了疾病控制中心的官方地图，显示该国大部分地区处于高风险地区。 第二天，这张地图显示，美国大约 60% 的地区确实处于低风险或中等风险。 这些地区的人们不需要戴口罩。

What happened was three things. One, now we have more tools to keep people safer, such as vaccinations and new antiviral drugs. Two, we are seeing fewer infections as we slide down from the scary Omicron wave. (Though about 2,000 Americans are still dying every day, and none of us should tolerate that level of death.)

发生了三件事。 一，现在我们有更多的工具来保证人们的安全，比如疫苗和新的抗病毒药物。 第二，随着我们从可怕的 Omicron 浪潮中滑落，我们看到的感染减少了。

And three, because of the first two, the CDC decided to recalculate how it measured COVID risk. That’s what changed the map.

In the old scheme, the agency used only case counts in a particular county. 100 cases or more per 100,000 meant high risk of virus transmission, and the CDC said people in those places should wear masks.

第三，由于前两个原因，CDC 决定重新计算其衡量 COVID 风险的方式。 这就是改变地图的原因。

在旧计划中，该机构仅使用特定县的病例数。 每 10 万人中有 100 例或更多病例意味着病毒传播的高风险，疾病预防控制中心表示，这些地方的人们应该戴口罩。

The new scheme shifts the calculation to measures of severe disease. It emphasizes the number of new hospital admissions and how much of a hospital is filled with existing COVID patients. And it still includes case counts. But it ups the levels for high risk to 200 for every 100,000 people.

The agency has a tracker where you can check whether your community is at low, medium or high risk.

新方案将计算转移到严重疾病的测量上。 它强调了新入院的人数以及医院中有多少现有的 COVID 患者。 它仍然包括病例数。 但它将高风险水平提高到每 100,000 人 200 人。

该机构有一个跟踪器，您可以在其中检查您的社区是否处于低、中或高风险。

Public health experts generally applauded the move. People can usually deal with mild illness. But getting sick enough for an emergency trip to the hospital is what everyone wants to avoid. Also we need to stop overwhelming the health care system with COVID patients.

Case counts rise ahead of hospitalizations, so keeping them in the mix provides communities with early warnings.

公共卫生专家普遍对此举表示赞赏。 人们通常可以应对轻微的疾病。 但是，每个人都想避免病得足以紧急去医院。 此外，我们需要停止让 COVID 患者压倒医疗保健系统。

病例数在住院之前就上升了，因此将它们混合在一起可以为社区提供早期预警。

If a community rises to high risk, the new guidelines explain how to dial up protection measures, says Katelyn Jetelina, an epidemiologist at the University of Texas Health Science Center in Houston. Masks should go back on, and people should stay out of buildings with poor ventilation, and there should be a push for more vaccinations and booster shots. When the warning indicators drop, measures can be dialed back down.

休斯顿德克萨斯大学健康科学中心的流行病学家凯特琳·杰特琳娜 (Katelyn Jetelina) 说，如果一个社区出现高风险，新指南将解释如何加强保护措施。 应该重新戴上口罩，人们应该远离通风不良的建筑物，应该推动更多的疫苗接种和加强注射。 当警告指标下降时，可以调回措施。

However, Jetelina is unhappy about the 200 cases allowed before a community moves to high risk. With people getting long COVID, and only about a quarter of children aged 5 through 11 fully vaccinated, she thinks this level of transmission is still unsafe.

And if more people go without masks, with even a moderate transmission rate in their area, it endangers people with weakened immune systems.

然而，Jetelina 对在社区转移到高风险之前允许的 200 例病例感到不满。 随着人们感染新冠病毒的时间越来越长，并且只有大约四分之一的 5 到 11 岁的儿童完全接种了疫苗，她认为这种传播水平仍然不安全。

如果更多人不戴口罩，即使他们所在地区的传播率中等，也会危及免疫系统较弱的人。

But the US wants to push towards pre-pandemic normal, and government policies are following that line. This week the White House announced a series of plans for getting there while COVID stays around. There will be “test and treat” facilities at local pharmacies and community centers, where people can get rapid tests and antiviral medications.

但美国希望推动大流行前的常态，而政府的政策也在遵循这条路线。 本周，白宫宣布了一系列计划，以便在 COVID 流行期间到达那里。 当地药店和社区中心将设有“检测和治疗”设施，人们可以在那里获得快速检测和抗病毒药物。

The government wants to step up surveillance for new waves with expanded wastewater testing sites – virus surges can be spotted this way. It also plans to look more aggressively for new variants, with more genetic testing facilities.

政府希望通过扩大废水检测站点来加强对新浪潮的监测——通过这种方式可以发现病毒激增。 它还计划更积极地寻找新的变种，配备更多的基因检测设施。

J: What’s up to each of us, it now seems, is how to respond when one of these early warning flags goes up. And they will: the virus is now a part of our world. Will we dial up protections such as masks and boosters to stop the spread?

That’s clearly the response that government policymakers are banking on. And people did that early in the pandemic. But going back to more restricted lives may not sit well with Americans today.

J：现在看来，我们每个人都需要在这些预警信号之一升起时如何应对。 他们会的：病毒现在是我们世界的一部分。 我们会拨打口罩和助推器等防护措施来阻止传播吗？

这显然是政府决策者所指望的回应。 人们在大流行初期就这样做了。 但回到更受限制的生活可能并不适合今天的美国人。

Fischman: Speaking of getting back to normal, you interviewed some historians about how pandemics end. What can we learn from previous pandemics about the end game for COVID?

Lewis: It’s a fascinating question. I talked to John Barry, the historian and author of “The Great Influenza: The story of the deadliest pandemic in history.” The book is an exhaustively reported history of the 1918 influenza, which is believed to have killed at least 50 million people worldwide, and nearly 700,000 in the U.S. alone.

Fischman：谈到恢复正常，您采访了一些历史学家，了解大流行是如何结束的。 我们可以从以前的流行病中学到什么关于 COVID 的最终游戏？

刘易斯：这是一个有趣的问题。 我与历史学家、《大流感：历史上最致命的流行病的故事》一书的作者约翰·巴里进行了交谈。 这本书详尽地报道了 1918 年流感的历史，据信该流感已导致全球至少 5000 万人死亡，仅在美国就有近 700,000 人死亡。

I asked Barry how he would define the end of a pandemic, and he said, basically, the point at which people stop paying attention to it. That seems to be happening already in many places. There is also a scientific component to it—when the virus is causing less severe disease, and when there is ready access to vaccines and therapeutics.

我问巴里，他将如何定义大流行的结束，他说，基本上，是人们停止关注它的那一点。 这似乎已经在很多地方发生了。 它还有一个科学组成部分——当病毒引起不太严重的疾病时，以及当疫苗和治疗方法可用时。

For COVID, we’re almost at that point, Barry says, but we don’t yet have widespread availability of treatments like Pfizer’s antiviral, Paxlovid. Ultimately, though, the end of a pandemic is more of a human decision than a biological one. “We’ve clearly wearied as a society,” Barry told me. But there’s a danger in dropping all precautions too early.

Barry 说，对于 COVID，我们几乎到了那个地步，但我们还没有像辉瑞公司的抗病毒药物 Paxlovid 这样的广泛可用的治疗方法。 但最终，大流行的结束更多是人类的决定，而不是生物学的决定。 “作为一个社会，我们显然已经厌倦了，”巴里告诉我。 但过早放弃所有预防措施存在危险。

Most histories of the 1918 pandemic describe it as having three waves: in the spring of 1918, the fall of 1918, and the winter and spring of 1919, finally subsiding in the summer of that year. But in fact, a new flu variant emerged in 1920 that caused a fourth wave that was in some places worse than previous waves, Barry says.

1918 年大流行的大多数历史都将其描述为三波：1918 年春季、1918 年秋季和 1919 年冬春季，最后在当年夏季消退。 但事实上，1920 年出现了一种新的流感变种，它引发了第四波，在某些地方比前一波更严重，巴里说。

Most of the U.S. put in place restrictions during the second wave, and some did for the third. But by the fourth peak in 1920, no cities imposed restrictions. Americans had moved on.

Eventually the disease became milder, in part because most people had some immunity to it from infection, but also because it lost the ability to infect cells in the lungs. There is no law of nature that says a virus has to evolve to be less virulent, Barry says. But over time, our immune systems exerted pressure on the virus to make it harder to infect the lungs—similar to what we are seeing with the Omicron variant.

美国大部分地区在第二波期间实施了限制，有些在第三波期间实施了限制。 但到了 1920 年的第四个高峰，没有城市施加限制。 美国人继续前进。

最终，这种疾病变得更温和了，部分原因是大多数人对它有一定的免疫力，但也因为它失去了感染肺部细胞的能力。 巴里说，没有自然法则规定病毒必须进化为毒性较低。 但随着时间的推移，我们的免疫系统对病毒施加压力，使其更难感染肺部——类似于我们在 Omicron 变体中看到的情况。

Right now, Barry is optimistic. COVID cases have fallen dramatically, and most people have some immunity from vaccination, infection, or both. But that doesn’t mean every variant will be mild. There were severe upticks in the flu death toll well after the 1918 pandemic, such as in 1928. Viral evolution is random, so we shouldn’t let down our guard just yet, Barry says.

Ultimately, it won’t be the VIRUS that decides when this pandemic is over. It will be US.

现在，巴里很乐观。 COVID 病例急剧下降，大多数人对疫苗接种、感染或两者都有一定的免疫力。 但这并不意味着每个变体都是温和的。 巴里说，在 1918 年大流行之后很久，例如 1928 年，流感死亡人数急剧上升。病毒进化是随机的，所以我们现在不应该放松警惕。

最终，决定这场大流行何时结束的不会是病毒。 这将是美国。

Lewis: Now you’re up to speed. Thanks for joining us. Our show is edited by the inimitable Jeff DelViscio.

刘易斯：现在你已经跟上进度了。 感谢您加入我们。 我们的节目由无与伦比的 Jeff DelViscio 编辑。

Fischman: Come back in two weeks for the next episode of COVID, Quickly! And check out SciAm.com for updated and in-depth COVID news.

Fischman：请在两周后回来观看 COVID 的下一集，并查看 SciAm.com 以获取最新和深入的 COVID 新闻。