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新冠疫情远未结束,未来数月将非常难熬

新冠疫情远未结束,未来数月将非常难熬

Michelle Cortez, 彭博社 2021年10月07日
全球尚有数十亿人没有接种新冠疫苗,而且目前消灭这种病毒的可能性微乎其微。

对于那些希望在未来三到六个月里就能够看到新冠疫情结束的人们来说,科学家们有一个坏消息:战疫尚未成功,需要做好长期抗疫的准备。

新冠疫情的反扑将导致学校被迫关闭,课程暂停。接种过新冠疫苗的疗养院居民仍然会面临新一轮感染。在医院再次不堪重负之际,上班族也将权衡是否需要继续居家办公。

专家们一致认为,在新冠疫情结束之前,几乎每个人不是感染过新冠病毒,就是接种了新冠疫苗,或是两者兼有之。少数运气不好的人可能会不止一次感染新冠病毒。在全人类感染新冠病毒之前,由于传播出现的新型变异毒株和全球疫苗接种举措之间的赛跑不会结束。

迈克尔·奥斯特霍尔姆是位于明尼阿波利斯的明尼苏达大学(University of Minnesota)传染病研究和政策中心(Center for Infectious Disease Research and Policy)的主任,也是美国总统乔·拜登的新冠疫情顾问,他说:“我看到全球各地的病例持续激增,然后下降,很可能是急剧下降,不过我认为很可能在今年秋冬两季会再次大幅攀升。”

全球尚有数十亿人没有接种新冠疫苗,而且目前消灭这种病毒的可能性微乎其微。那么,随着经济重新开放,预计在未来几个月里,学校、公共交通及工作场所会出现更多的新增病例。即使免疫比例上升,但还是会有人很容易感染新冠病毒:新生儿、无法或不愿意接种新冠疫苗的人,以及那些接种过新冠疫苗但因为疫苗的保护力下降而遭遇突破性感染的人。

未来的几个月将会举步维艰。有抗药性的变异毒株出现将是一个关键的危险因素,当然我们也还面临着其他危险。在接下来的几个月里,彭博社(Bloomberg)将继续探讨新冠疫情对经济和市场、制药业、旅游业等的长期影响。

奥斯特霍尔姆称:“至少在未来几年里,随着我们研发出更多的新冠疫苗,我们仍然会面临跌宕起伏。疫苗会起效。但我们将面临挑战:跌宕起伏的差距会有多大?没有人知道。但我可以告诉你,新冠病毒就像一场森林大火,人类好比是木材,在所有木材烧尽之前,这场火灾不会消停。”

新冠疫情VS其他流行病

位于丹麦的罗斯基勒大学(Roskilde University)的流行病学家兼人口健康科学教授隆娜·西蒙森是这方面的专家,她指出,在过去130年间,发生过5次有据可查的流行病,这为新冠疫情的未来发展提供了一些启示。

她还表示,虽然时间最长的全球流感持续了五年之久,不过一般平均周期是两到三年,出现二至四轮的感染。新冠疫情已经成为最严重的流行病之一,在这种疫情爆发将近两年之际,世界正处于第三轮感染中,而且还看不到尽头。

被称为SARS-CoV-2的新型冠状病毒可能不会遵循过去流行病的发展模式。毕竟,这是一种潜在传染性更强的新型病原体。1918年西班牙发生大流感,而截至目前新冠疫情的死亡人数已经超470万人,致死率是自那以后流行病致死率的两倍多。

新冠疫情在爆发之初十分迅猛,不过新冠疫苗的接种率也相对较高,然而美国、英国、俄罗斯和以色列等国家的病例数量还是不断创下新高。接种新冠疫苗能够有效降低重症率和死亡率,但感染激增意味着病毒正在感染青少年和其他仍未接种新冠疫苗的人群,导致这些群体的重症率上升。

新冠疫苗接种率较低的马来西亚、墨西哥、伊朗和澳大利亚等国,由于德尔塔变种毒株的出现,正在面临迄今最大规模的疫情爆发。随着德尔塔变种毒株在多国肆虐,很可能会出现另一种新型变异毒株。

根据西蒙森的说法,经验表明,人们通常认为随着时间的推移,病毒的致病性会减弱,从而不会完全消灭所有宿主,不过这种想法并不正确。她表示,虽然新型变异毒株的致病性并不一定会更严重,不过“在新冠疫情期间,由于新冠病毒正在不断适应新的宿主,实际上其致死率可能会更高。”

在新冠疫情爆发前期,人们有充分理由希望接种新冠疫苗可以提供长期保护,就像小时候接种预防脊髓灰质炎等疾病的疫苗一样。

冠状病毒具有“校对”机制,能够修复病毒复制过程中产生的先天性错误,降低病毒传播时出现变异的可能性。

然而,全球的新冠肺炎病例不计其数,因此无论如何都会存在突变。

世界卫生组织流感参考与研究合作中心(WHO Collaborating Center for Reference and Research on Influenza)的主任坎塔·苏巴拉奥在位于墨尔本的彼得·多尔蒂感染与免疫研究所(Peter Doherty Institute for Infection and Immunity)工作,他说:“由于全球疫情蔓延,我们极有可能会被感染,所以冠状病毒的校对机制也不会起什么作用。”

因此,随着病毒的不断进化,我们可能得像预防流感一样,需要定期接种疫苗才可以有效应对新冠病毒。

一些研究人员表示,新冠病毒可能对第一代新冠疫苗完全具有抗药性。来自日本的一项(尚未发表或经同行评议)研究表明,全球疫情监测数据库显示,德尔塔变种毒株存在潜在的危险病毒突变。目前,关于德尔塔变种毒株对新冠疫苗具有耐药性或会引发更高致死率的报告,尚未经过严格的审查。

西蒙森称:“我们希望这种情况不会发生,太可怕了,一旦发生就得从头再来。”

未来几个月的情况更为严峻,很可能会出现另外一种流感病毒或冠状病毒,不止动物会被感染,人类也不能幸免。

苏巴拉奥指出:“只要动物体内存在冠状病毒,未来就仍然有可能出现另外一种人畜共患病的冠状病毒。当下情况就是如此,应对这种病毒的同时可能会有另外一种病毒出现。”

新冠疫情如何结束?

显而易见,这场新冠疫情不会在六个月后结束。专家们普遍认为,只有大多数人(约占全球人口的90%到95%)通过新冠疫苗接种或由于感染而获得了一定程度的免疫力,当前的疫情才可以得到控制。

他们指出,控制新冠疫情的关键应该在于新冠疫苗的接种。

西蒙森认为:“如果不接种新冠疫苗,人们只能坐以待毙,因为新冠病毒会在今年秋冬两季广泛传播,到时几乎每个人都会被感染。”

彭博社追踪疫苗接种情况的数据显示,全球的新冠疫苗接种数量已经超过56.6亿剂。然而欧盟(European Union)、北美和中国等地区的广泛接种,掩盖了其他地区接种不足的情况。大多数非洲国家的新冠疫苗数量只够不到5%的人口接种两剂新冠疫苗。印度则仅能够满足26%左右的人口接种新冠疫苗。

牛津大学(Oxford University)的医学史副教授埃丽卡·查特斯是关于新冠疫情如何结束项目的协调员,她认为,新冠疫情在不同地区,结束的时间也会不同,就像爆发之时也各不相同。她还补充道,各国政府将不得不做出决定,可以在多大程度下容忍与新冠病毒共存。

采取的应对措施千差万别。虽然一些国家力求实现新冠肺炎病例清零,但全球不太可能完全根除新冠病毒。

丹麦和新加坡等国已经设法把新冠疫情维持在相对可控的范围,已经正在向着限制措施较少的后疫情时代迈进。美国和英国等其他国家,尽管感染人数不断创新高,但仍然在逐步开放。与此同时,中国和新西兰等地则承诺继续保持高度警惕,努力实现本土病例清零。因此,这几个国家地区很可能是最后一批摆脱新冠疫情影响的地方。

“新冠疫情结束的过程不会一成不变。”查特斯指出,疫情“不仅是一种生物现象,但也是一种政治社会现象。”

“即使现在我们有不同的应对措施。”

不过很可能会混乱不堪,在未来几年里留下持久影响。在结束之前,我们大多数人还是要做好准备,努力应对新冠疫情。

奥斯特霍尔姆还说:“我们必须保持警惕,谨慎对待新冠疫情。倘若有任何人认为我们会在未来几天或几个月内就能够解决新冠疫情,那就大错特错了。”(财富中文网)

译者:三叠瀑

对于那些希望在未来三到六个月里就能够看到新冠疫情结束的人们来说,科学家们有一个坏消息:战疫尚未成功,需要做好长期抗疫的准备。

新冠疫情的反扑将导致学校被迫关闭,课程暂停。接种过新冠疫苗的疗养院居民仍然会面临新一轮感染。在医院再次不堪重负之际,上班族也将权衡是否需要继续居家办公。

专家们一致认为,在新冠疫情结束之前,几乎每个人不是感染过新冠病毒,就是接种了新冠疫苗,或是两者兼有之。少数运气不好的人可能会不止一次感染新冠病毒。在全人类感染新冠病毒之前,由于传播出现的新型变异毒株和全球疫苗接种举措之间的赛跑不会结束。

迈克尔·奥斯特霍尔姆是位于明尼阿波利斯的明尼苏达大学(University of Minnesota)传染病研究和政策中心(Center for Infectious Disease Research and Policy)的主任,也是美国总统乔·拜登的新冠疫情顾问,他说:“我看到全球各地的病例持续激增,然后下降,很可能是急剧下降,不过我认为很可能在今年秋冬两季会再次大幅攀升。”

全球尚有数十亿人没有接种新冠疫苗,而且目前消灭这种病毒的可能性微乎其微。那么,随着经济重新开放,预计在未来几个月里,学校、公共交通及工作场所会出现更多的新增病例。即使免疫比例上升,但还是会有人很容易感染新冠病毒:新生儿、无法或不愿意接种新冠疫苗的人,以及那些接种过新冠疫苗但因为疫苗的保护力下降而遭遇突破性感染的人。

未来的几个月将会举步维艰。有抗药性的变异毒株出现将是一个关键的危险因素,当然我们也还面临着其他危险。在接下来的几个月里,彭博社(Bloomberg)将继续探讨新冠疫情对经济和市场、制药业、旅游业等的长期影响。

奥斯特霍尔姆称:“至少在未来几年里,随着我们研发出更多的新冠疫苗,我们仍然会面临跌宕起伏。疫苗会起效。但我们将面临挑战:跌宕起伏的差距会有多大?没有人知道。但我可以告诉你,新冠病毒就像一场森林大火,人类好比是木材,在所有木材烧尽之前,这场火灾不会消停。”

新冠疫情VS其他流行病

位于丹麦的罗斯基勒大学(Roskilde University)的流行病学家兼人口健康科学教授隆娜·西蒙森是这方面的专家,她指出,在过去130年间,发生过5次有据可查的流行病,这为新冠疫情的未来发展提供了一些启示。

她还表示,虽然时间最长的全球流感持续了五年之久,不过一般平均周期是两到三年,出现二至四轮的感染。新冠疫情已经成为最严重的流行病之一,在这种疫情爆发将近两年之际,世界正处于第三轮感染中,而且还看不到尽头。

被称为SARS-CoV-2的新型冠状病毒可能不会遵循过去流行病的发展模式。毕竟,这是一种潜在传染性更强的新型病原体。1918年西班牙发生大流感,而截至目前新冠疫情的死亡人数已经超470万人,致死率是自那以后流行病致死率的两倍多。

新冠疫情在爆发之初十分迅猛,不过新冠疫苗的接种率也相对较高,然而美国、英国、俄罗斯和以色列等国家的病例数量还是不断创下新高。接种新冠疫苗能够有效降低重症率和死亡率,但感染激增意味着病毒正在感染青少年和其他仍未接种新冠疫苗的人群,导致这些群体的重症率上升。

新冠疫苗接种率较低的马来西亚、墨西哥、伊朗和澳大利亚等国,由于德尔塔变种毒株的出现,正在面临迄今最大规模的疫情爆发。随着德尔塔变种毒株在多国肆虐,很可能会出现另一种新型变异毒株。

根据西蒙森的说法,经验表明,人们通常认为随着时间的推移,病毒的致病性会减弱,从而不会完全消灭所有宿主,不过这种想法并不正确。她表示,虽然新型变异毒株的致病性并不一定会更严重,不过“在新冠疫情期间,由于新冠病毒正在不断适应新的宿主,实际上其致死率可能会更高。”

在新冠疫情爆发前期,人们有充分理由希望接种新冠疫苗可以提供长期保护,就像小时候接种预防脊髓灰质炎等疾病的疫苗一样。

冠状病毒具有“校对”机制,能够修复病毒复制过程中产生的先天性错误,降低病毒传播时出现变异的可能性。

然而,全球的新冠肺炎病例不计其数,因此无论如何都会存在突变。

世界卫生组织流感参考与研究合作中心(WHO Collaborating Center for Reference and Research on Influenza)的主任坎塔·苏巴拉奥在位于墨尔本的彼得·多尔蒂感染与免疫研究所(Peter Doherty Institute for Infection and Immunity)工作,他说:“由于全球疫情蔓延,我们极有可能会被感染,所以冠状病毒的校对机制也不会起什么作用。”

因此,随着病毒的不断进化,我们可能得像预防流感一样,需要定期接种疫苗才可以有效应对新冠病毒。

一些研究人员表示,新冠病毒可能对第一代新冠疫苗完全具有抗药性。来自日本的一项(尚未发表或经同行评议)研究表明,全球疫情监测数据库显示,德尔塔变种毒株存在潜在的危险病毒突变。目前,关于德尔塔变种毒株对新冠疫苗具有耐药性或会引发更高致死率的报告,尚未经过严格的审查。

西蒙森称:“我们希望这种情况不会发生,太可怕了,一旦发生就得从头再来。”

未来几个月的情况更为严峻,很可能会出现另外一种流感病毒或冠状病毒,不止动物会被感染,人类也不能幸免。

苏巴拉奥指出:“只要动物体内存在冠状病毒,未来就仍然有可能出现另外一种人畜共患病的冠状病毒。当下情况就是如此,应对这种病毒的同时可能会有另外一种病毒出现。”

新冠疫情如何结束?

显而易见,这场新冠疫情不会在六个月后结束。专家们普遍认为,只有大多数人(约占全球人口的90%到95%)通过新冠疫苗接种或由于感染而获得了一定程度的免疫力,当前的疫情才可以得到控制。

他们指出,控制新冠疫情的关键应该在于新冠疫苗的接种。

西蒙森认为:“如果不接种新冠疫苗,人们只能坐以待毙,因为新冠病毒会在今年秋冬两季广泛传播,到时几乎每个人都会被感染。”

彭博社追踪疫苗接种情况的数据显示,全球的新冠疫苗接种数量已经超过56.6亿剂。然而欧盟(European Union)、北美和中国等地区的广泛接种,掩盖了其他地区接种不足的情况。大多数非洲国家的新冠疫苗数量只够不到5%的人口接种两剂新冠疫苗。印度则仅能够满足26%左右的人口接种新冠疫苗。

牛津大学(Oxford University)的医学史副教授埃丽卡·查特斯是关于新冠疫情如何结束项目的协调员,她认为,新冠疫情在不同地区,结束的时间也会不同,就像爆发之时也各不相同。她还补充道,各国政府将不得不做出决定,可以在多大程度下容忍与新冠病毒共存。

采取的应对措施千差万别。虽然一些国家力求实现新冠肺炎病例清零,但全球不太可能完全根除新冠病毒。

丹麦和新加坡等国已经设法把新冠疫情维持在相对可控的范围,已经正在向着限制措施较少的后疫情时代迈进。美国和英国等其他国家,尽管感染人数不断创新高,但仍然在逐步开放。与此同时,中国和新西兰等地则承诺继续保持高度警惕,努力实现本土病例清零。因此,这几个国家地区很可能是最后一批摆脱新冠疫情影响的地方。

“新冠疫情结束的过程不会一成不变。”查特斯指出,疫情“不仅是一种生物现象,但也是一种政治社会现象。”

“即使现在我们有不同的应对措施。”

不过很可能会混乱不堪,在未来几年里留下持久影响。在结束之前,我们大多数人还是要做好准备,努力应对新冠疫情。

奥斯特霍尔姆还说:“我们必须保持警惕,谨慎对待新冠疫情。倘若有任何人认为我们会在未来几天或几个月内就能够解决新冠疫情,那就大错特错了。”(财富中文网)

译者:三叠瀑

For anyone hoping to see light at the end of the COVID-19 tunnel over the next three to six months, scientists have some bad news: Brace for more of what we’ve already been through.

Outbreaks will close schools and cancel classes. Vaccinated nursing home residents will face renewed fears of infection. Workers will weigh the danger of returning to the office as hospitals are overwhelmed, once again.

Almost everyone will be either infected or vaccinated before the pandemic ends, experts agree. Maybe both. An unlucky few will contract the virus more than once. The race between the waves of transmission that lead to new variants and the battle to get the globe inoculated won’t be over until the coronavirus has touched all of us.

“I see these continued surges occurring throughout the world,” said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota in Minneapolis, and an adviser to U.S. President Joe Biden. “Then it will drop, potentially somewhat precipitously,” he said. “And then I think we very easily could see another surge in the fall and winter” of this year, he added.

With billions of people around the world yet to be vaccinated and little chance now of eliminating the virus, we can expect more outbreaks in classrooms, on public transport and in workplaces over the coming months, as economies push ahead with reopening. Even as immunization rates rise, there will always be people who are vulnerable to the virus: Newborn babies, people who can’t or won’t get inoculated, and those who get vaccinated but suffer breakthrough infections as their protection levels ebb.

The next few months will be rough. One key danger is if a vaccine-resistant variant develops, although it is not the only risk ahead. In the coming months, Bloomberg will explore the pandemic’s long-term impact on economies and markets, the pharmaceutical industry, travel and more.

“We’re going to see hills and valleys, at least for the next several years as we get more vaccine out. That’s going to help. But the challenge is going to be: How big will the hills and valleys be, in terms of their distance?” Osterholm said. “We don’t know. But I can just tell you, this is a coronavirus forest fire that will not stop until it finds all the human wood that it can burn.”

COVID Compared to Other Pandemics

The five well-documented influenza pandemics of the past 130 years offer some blueprint for how COVID might play out, according to Lone Simonsen, an epidemiologist and professor of population health sciences at Roskilde University in Denmark. She is an expert on the ebb and flow of such events.

While the longest global flu outbreak lasted five years, they mostly consisted of two to four waves of infection over an average of two or three years, she said. COVID is already shaping up to be among the more severe pandemics, as its second year concludes with the world in the middle of a third wave—and no end in sight.

It’s possible that the virus known as SARS-CoV-2 won’t follow the path set by the pandemics of the past. After all, it is a different, novel and potentially more transmissible pathogen. And with a death toll of more than 4.7 million people so far, it’s already more than twice as deadly as any outbreak since the 1918 Spanish flu.

Despite brutal initial waves and relatively high vaccination rates, countries including the U.S., U.K., Russia and Israel are flirting with record numbers of cases. Immunization is helping to moderate incidences of severe cases and deaths, but surging infections mean the virus is reaching the young and others who remain unvaccinated, leading to rising rates of serious disease in those groups.

Nations where vaccination has been sparse—including Malaysia, Mexico, Iran and Australia—are in the midst of their biggest outbreaks yet, fueled by the contagious delta strain. With the virus still spreading out of control in vast swathes of the planet, another novel variant could quite feasibly emerge.

History shows the commonly held belief that viruses automatically get milder over time—to avoid completely wiping out their host population—is wrong, according to Simonsen. Although new mutations aren’t always more severe than their predecessors, “pandemics can in fact get more deadly during the pandemic period, as the virus is adapting to its new host,” she said.

Early in the COVID outbreak, there was good reason to hope that vaccines would provide long-term protection, much like childhood shots that stop diseases such as polio.

Coronaviruses have a “proof-reading” mechanism that fixes the in-born errors caused when the virus replicates, reducing the likelihood of variants emerging when the virus is transmitted from one person to another.

The number of global cases has been so vast, however, that mutations are occurring anyway.

“With the pandemic, we have this enormous force of infection,” said Kanta Subbarao, director of the WHO Collaborating Center for Reference and Research on Influenza at the Peter Doherty Institute for Infection and Immunity in Melbourne. “That has counterbalanced the ability of the virus to proof-read.”

As a result, COVID could be like the flu, requiring regular vaccine top-ups to remain effective as the virus evolves.

Some researchers say SARS-CoV-2 is poised to become completely resistant to the first generation of vaccines. A study from Japan, which has yet to be published or peer-reviewed, suggests that potentially dangerous mutations in the delta variant are already being picked up in a global database used to track such developments. Reports of current strains breaking through vaccinations or triggering higher fatality rates have not held up to rigorous scrutiny thus far.

“This is a scenario we hope won’t happen,” Simonsen said. “My God, we would have to do it all again.”

Other even grimmer possibilities for the coming months include the emergence of a novel influenza virus or another coronavirus making the leap from animals into humans.

“As long as there are animal reservoirs of coronavirus there is still the possibility that another zoonotic coronavirus could emerge in the future,” Subbarao said. “There is that in the background, the risk of still dealing with this one when another one emerges.”

How Will COVID End?

What seems clear is that the pandemic will not be over in six months. Experts generally agree that the current outbreak will be tamed once most people—perhaps 90% to 95% of the global population—have a degree of immunity thanks to immunization or previous infection.

The key element should be vaccination, they say.

“Without vaccination, one is like a sitting duck, because the virus will spread widely and find most everybody this autumn and winter,” said Simonsen.

More than 5.66 billion doses of vaccine have been administered around the world, according to Bloomberg’s vaccine tracker. But the success of rollouts in some regions, such as the European Union, North America and China, masks the failure in others. Most countries in Africa have only given enough vaccine to cover less than 5% of their populations with a two-dose shot. India has administered enough to cover only about 26%.

The pandemic will end at different times in different places, just as previous outbreaks have, said Erica Charters, associate professor of the history of medicine at Oxford University and the coordinator of a project on how epidemics end. Governments will have to decide how much of the disease they are comfortable living with, she said.

Approaches vary. While some countries are still shooting for zero COVID cases, the world is unlikely to eradicate the virus completely.

Nations like Denmark and Singapore, which have managed to keep cases relatively contained, are already moving toward a post-pandemic future with fewer safety restrictions. Others, such as the U.S. and U.K., are opening up even as infection numbers near records. Meanwhile, China, Hong Kong and New Zealand have vowed to keep vigilantly working to eliminate the virus locally. As a result, they are likely to be among the last places to leave behind the disruption wrought by walling out the pandemic.

“The end process is not going to be uniform,” Charters said. The pandemic “is a biological phenomenon, but it’s also a political and social phenomenon.”

“Even now we have different approaches to it.”

It’s likely to be messy, leaving a lasting legacy for years to come. Until then, most of us will need to brace for many more months in the pandemic’s grip.

“We have to approach it with our eyes wide open and with a great deal of humility,” Osterholm said. “Anybody that thinks we're going to be over this in the next few days or a few months is sorely mistaken.”

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