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专访WHO专家:德国逝世亡率为甚么那么低?

针对当前备受外洋存眷的欧洲抗击新冠肺炎疫情停顿以及分歧国家采用的防疫差别,世界卫生组织欧洲区域供职处下威逼性病本体团队背责人理查德·皮博迪博士(Dr. Richard Pebody)本地时间16日独家接受中国新闻网国是直通车记者专访表示,不存在一种适开所有国家的防疫形式,每一个国家应当做的是实施最合适其本身情况的办法。针对德国较低的病死率,他特别提示,除意大利中的别的欧洲国家疫情发展借处在较为初期的阶段。“这局部国家兴许会在接下来数日或数周阅历死亡病例增加。”

世卫组织总做事谭德塞本月13日指出,欧洲现在曾经成为大流行疫情的核心,讲演的病例和灭亡人数跨越了除中国之外天下其余天区的总和。世卫组织欧洲区域处事处停止欧洲中部时光16日23时的数据显著,欧洲国家乏计确诊人数已达63268人,灭亡2755人。

位于丹麦哥本哈根的世卫组织欧洲地区做事处担任欧洲地域50个国家。皮专迪当天长途接收了中国新闻网国是直通车记者专访。

皮博迪中心观念如下:

防疫不存在“适合所有脚的鞋子”,各国只能就地取材

德国病死率低可能果其疫情处在晚期,须要亲密存眷接上去很多天到数周发作

当前急需各国加大响应力度、检测力度、减缓传播的力度

每小我做出自己的贡献异样主要

道中国派专家组赴意大利:现实证据和已获得的教训经验将赞助我们战胜这场大流行病和将来的大流行病

采访真录(中英文对比)以下:

国是曲通车:世卫组织日前发布将新冠肺炎疫情定性为大流行,这必定性能否会对欧盟及其成员国对新冠肺炎爆发的答对发生影响?

答:将新冠肺炎COVID-19疫情定性为“大流行”并未转变世卫组织给各国和集体的相干倡议。这一定性提供的只是一种程度更强的提醒,催促各方采取必需采取的行动。

国事纵贯车:在2月26日于罗马举办的世卫、欧盟和意年夜利三圆集会时代,欧盟委员会卫死取食物保险事件委员斯泰推·基里亚基季斯曾表现“咱们已请求欧盟成员国从新评估其应答年夜流止病的预案和从诊断、化验到逃踪打仗者正在内的全体调理能力,并将评价情况跟实行打算上报欧盟”。从世卫构造的角量去看,欧盟成员国今朝改造它们各自的大风行病预案的情形若何?

答:世卫组织持续地与所有国家坚持协作,帮助它们保持和提醒各自的国家大流行病预案。

世卫组织欧洲区域管事处派出的技术团队已被安排诚实大利、阿塞拜疆、黑克兰、乌山和亚好僧亚等国。我们正连续以近程或现场的方法为它们提供着有针对性的帮助,详细采取何种情势与决于今朝前提下的观光灵通性。世卫组织已体例了内容丰盛、波及防疫任务所有范畴的技术指南。我们正在支撑每个国家制订防疫技巧计划,并在一个强无力的天下性策略框架着落实最急切的举动式样。

世卫组织欧洲区域服务处同时也在响应新冠肺炎(COVID-19)疫情的各个层里与欧盟和欧盟徐控中央(ECDC)发展着严密的配合。

位于哥本哈根的世卫组织欧洲区域就事处。图据WHO/Europe

国是直通车:世卫组织在欧友邦家应对疫情方面有没有推举的“最佳实际”或许最好模式?仍是道每个国家都纷歧样?

答:不存在一种“适合所有足的鞋子”式的模式。每个国家的卫生体制都不相同,它们的生齿构造也各不相同——因而,每个国家是依据它们的番邦情况以及疫情在它们的国家和地区所处的阶段往决定采取何种行为。每个国家应应做的是,实施最适合其自身情况的措施,这些措施是与外地情况相联合的。

国是直通车:德国的新冠肺炎死亡率与意大利比起来相称的低。乃至与法国和西班牙比拟,德国也是无比低的。你若何解读这一差同?这是反应欧盟各国私人卫生应急能力的降好,还是说因为下面提到的防疫模式之别而至?(注:德国疾病防控机构罗伯特·科赫研究所数据隐示,截至本地时间3月16日15时,德国共确诊6012例新冠病毒肺炎感抱病例,此中死亡病例13例。据此盘算,死亡率为0.2%。而意大利的死亡率到达7.3%,寰球仄均死亡率为3.7%。)

问:为了克服这类新颖病毒,当初慢需各国加大对病毒要挟的呼应力度,加大检测力度,也减大加缓病毒传布的力度,以救命人们的生命。在以后的阶段,每一个个别也参加到这一抗击疫情的尽力中,做出本人的奉献也十分要害。特别是,我们激励大众遵守地点国家的卫生部分的指北,而且为别人供给辅助。

世卫组织同时提醉人们要警戒对流行病教数据的解读,这个中包含不同国家之间的病死率(case fatality rate)差别。详细到COVID-19新冠肺炎,那些因为感染这种病而逝世的病人均匀是在两到三周前被感染的。意大利的疫情爆发和发展要比欧洲其它处所开端得更早,因此涌现了更多的病人离开上述的症结周期,这时候他们要末治愈出院,要么可怜离世。其它欧洲国家疫情发展所处的还是一个早期阶段。这部门国家也许会在接下来数日或数周经历死亡病例删多。

同时,病死率也可能遭到病例年纪散布影响——70岁以上的感染者死亡率最高。在大流行病的早期阶段,呈现有更多处于工作春秋的成年人被感染也是可能的。这是由于大流行病还不从他们身上流传到老年人群,后者的病死率更高。

最后,对付疑似病例检测的笼罩水平也将影响病逝世率数字。分歧国度的检测系统决议了它们收现确诊病例的才能不尽雷同。假如没有是贪图沾染者皆被发明并确诊(特殊是消除了沉症患者)的话,那便会硬套到病死率。

国是直通车:中国已背意大利派出一队抗疫医疗专家组,帮助当地抗击疫情。欧洲是不是可能、或应该从中国抗疫中进修任何经验?如果有的话是甚么?

答:这是一种新的病毒,且局势正在疾速演化发展。世卫组织专家和其它各方都正在分秒必争地收集、收拾和传播针对这种病毒的研讨结果和抗击疫情火线的疑息,这是为了让我们对这种病毒懂得得更充足,也持绝地改良每个国家作出的响应。事实证据和已经取得的经验教训将帮助我们战胜这场大流行病和已来的大流行病。

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 Commissioner 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 recommendation 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.

起源:国是直通车

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