流行病学家克努特•维特科夫斯基|我们可以再次敞开心扉,忘记一切

2020年6月2日09:29:10流行病学家克努特•维特科夫斯基|我们可以再次敞开心扉,忘记一切已关闭评论 434 17375字阅读57分55秒
摘要

世界各地的政府都表示,他们正在遵循”科学”原则,采取严厉措施阻止病毒的传播。但是围绕新型冠状病毒肺炎的科学研究却遭到了激烈的争论。许多专家严重怀疑这些措施的有效性,并认为我们对新型冠状病毒肺炎组织的过度恐惧是没有道理的。

流行病学家克努特•维特科夫斯基|我们可以再次敞开心扉,忘记一切Epidemiologist Knut WittkowskiCovid-19 is Not Dangerous'Unless You Have Age-related Severe Comorbidities'

流行病学家 Knut Wittkowski:除非你患有与年龄相关的严重共病,否则新型冠状病毒肺炎并不危险

Governments around the world say they are following'The Science'with their draconian measures to stem the spread of the virus.But the science around Covid-19 is bitterly contested.Many experts have serious doubts about the effectiveness of the measures,and argue that our outsized fears of Covid-19 are not justified.

世界各地的政府都表示,他们正在遵循"科学"原则,采取严厉措施阻止病毒的传播。但是围绕新型冠状病毒肺炎的科学研究却遭到了激烈的争论。许多专家严重怀疑这些措施的有效性,并认为我们对新型冠状病毒肺炎组织的过度恐惧是没有道理的。

Knut Wittkowski is one such expert who has long argued for a change of course.For 20 years,Wittkowski was the head of Biostatistics,Epidemiology,and Research Design at The Rockefeller University's Center for Clinical and Translational Science.spiked spoke to him to find out more about the pandemic.

克努特维特科夫斯基(Knut Wittkowski)就是这样一位专家,他长期以来一直主张改变航向。20年来,Wittkowski 一直是洛克菲勒大学临床与转化科学期刊研究中心生物统计学、流行病学和研究设计部门的负责人。Spiked 和他谈了谈,想了解更多关于流行病的情况。

Epidemiologist Knut Wittkowski Covid 19 Is Not Dangerous'unless You Have Age Related Severe Comorbidities'

除非你患有与年龄相关的严重共病,否则流行病学家 Knut Wittkowski Covid 19并不危险

spikedIs Covid-19 dangerous?

Covid-19危险吗?

Knut WittkowskiNo,unless you have age-related severe comorbidities.So if you are in a nursing home because you cannot live by yourself anymore,then getting infected is dangerous.

克努特·维特科夫斯基:不,除非你有与年龄相关的严重并发症。因此,如果你在疗养院,因为你不能自己生活了,那么感染是危险的。

We had the other extreme in Switzerland,which was hit pretty hard.There was one child that died.People believed that this child was born in 2011.In fact,it was born in 1911,and that was the only child that died.It was a mere coding error.Somebody with the age 108 was coded as aged eight.

我们在瑞士遇到了另一个极端,受到了相当严重的打击。有一个孩子死了。人们认为这个孩子出生于2011年。事实上,它出生于1911年,那是唯一一个死去的孩子。这仅仅是一个编码错误。一个108岁的人被编号为8岁。

spikedHow far along is the epidemic?

疫情发展到什么程度了?

WittkowskiIt is over in China.It is over in South Korea.It is substantially down in most of Europe and down a bit everywhere,even in the UK.The UK and Belarus are latecomers,so you do not see exactly what you are seeing in continental Europe.But everywhere in Europe,the number of cases is substantially declining.

Wittkowski:在中国已经结束了。在韩国,一切都结束了。欧洲大部分地区的通胀率大幅下降,其它地区(甚至包括英国)的通胀率也略有下降。英国和白俄罗斯是后来者,所以你看不到欧洲大陆的确切情况。但在欧洲各地,病例数量正在大幅下降。

spikedHave our interventions made much of an impact?

spiked:我们的干预是否产生了很大的影响?

WittkowskiWhen the whole thing started,there was one reason given for the lockdown and that was to prevent hospitals from becoming overloaded.There is no indication that hospitals could ever have become overloaded,irrespective of what we did.So we could open up again,and forget the whole thing.

Wittkowski:当整个事情开始的时候,为了防止医院超负荷运转,我们给出了一个封锁的理由。没有任何迹象表明,不管我们做了什么,医院可能已经超负荷了。这样我们就可以重新开始,忘记这一切。

I hope the intervention did not have too much of an impact because it most likely made the situation worse.The intervention was to'flatten the curve'.That means that there would be the same number of cases but spread out over a longer period of time,because otherwise the hospitals would not have enough capacity.

我希望干预措施没有产生太大的影响,因为它很可能使情况变得更糟。干预的目的是"平缓曲线"。这意味着病例的数量将保持不变,但分散的时间会更长,因为否则医院将没有足够的容量。

Now,as we know,children and young adults do not end up in hospitals.It is only those who are both elderly and have comorbidities that do.Therefore you have to protect the elderly and the nursing homes.

现在,我们知道,儿童和年轻人不会住进医院。只有那些同时患有并发症的老年人才会这样做。因此,你必须保护老人和疗养院。

The ideal approach would be to simply shut the door of the nursing homes and keep the personnel and the elderly locked in for a certain amount of time,and pay the staff overtime to stay there for 24 hours per day.

理想的做法是简单地关闭疗养院的大门,让工作人员和老年人锁在里面一段时间,并支付工作人员每天24小时的加班费。

How long can you do that for?For three weeks,that is possible.For 18 months,it is not.The flattening of the curve,the prolongation of the epidemic,makes it more difficult to protect the elderly,who are at risk.More of the elderly people become infected,and we have more deaths.

你能做多久?三个星期内,这是可能的。18个月以来,情况并非如此。曲线的平缓,流行病的延长,使得保护处于危险中的老年人变得更加困难。越来越多的老年人被感染,我们有更多的死亡。

spikedWhat are the dangers of lockdown?

spiked:禁闭有什么危险?

WittkowskiFirstly,we have the direct consequencessuicides,domestic violence and other social consequences leading to death.And then we have people who are too scared to go to the hospitals for other problems like strokes or heart attacks.So people stay away from hospitals because of the Covid fear.And then they die.

Wittkowski:首先,我们有直接的后果:自杀,家庭暴力和其他导致死亡的社会后果。还有一些人因为害怕去医院治疗其他问题,比如中风或心脏病。因此,人们远离医院是因为考维德人的恐惧。然后他们就死了。

spikedWere hospitals likely to be overrun?

spiked:医院有可能被占领吗?

WittkowskiGermany had 8,000 deaths in a population of 85million.They had 20,000 to 30,000 hospitalisations.In Germany,that is nothing.It does not even show up as a blip in the hospital statistics.In Britain,the highest hospital utilisation was about 60 per cent,if I am not mistaken.

Wittkowski:德国在8500万人口中有8000人死亡。他们有20,00030,000个住院病例。在德国,这算不了什么。在医院的统计数据中,它甚至都没有出现过。如果我没记错的话,英国医院的最高使用率约为60%

In New York City,it was a bit higher.The Javits Congress Center was turned into a field hospital with 3,000 beds.It treated just 1,000 patients in all.The Navy ship sent to New York by President Trump had 179 patients but it was sent back because it was not needed.

在纽约,这个数字要高一些。贾维茨会议中心变成了一个拥有3000张床位的野战医院。它总共只治疗了1000名患者。特朗普总统派往纽约的这艘海军军舰有179名病人,但因为没有必要而被送回。

New York is the epicenter of the epidemic in the United States,and even here at the epicenter,hospital utilisation was only up a bit.Nothing dramatic.Nothing out of the ordinary.That is what happens during the flu season.People have the flu,and then there are more patients in the hospitals than there otherwise would be.

纽约是美国疫情的中心,即使在这里的中心,医院的利用率也只上升了一点点。没什么特别的。没什么不寻常的。这就是流感季节发生的事情。人们得了流感,然后医院里的病人就比平时多了。

spikedAre we on the way to reaching herd immunity?

spiked:我们正在达到群体免疫的程度吗?

WittkowskiAll the studies that have been done have shown that we already have at least 25 per cent of the population who are immune.That gives us a nice cushion.If 25 per cent of the population are already immune,we are very quickly getting to the 50 per cent that we need to have what is called herd immunity.

Wittkowski:所有已经完成的研究都表明,我们已经至少有25%的人口免疫。这给了我们一个很好的缓冲。如果25%的人口已经具有免疫力,那么我们很快就会达到所谓的群体免疫力所需的50%

We will actually get a bit higher than that.So we have flattened what otherwise would have been a peak,and if we now let it run,even if the number of cases would increase a bit,it would not get as high as it was,because we already have enough immune people in the population.So it is not going to spread as fast as it could have spread in the beginning.

我们实际上会得到一个比这更高的数值。所以我们已经把原本会达到的峰值压平了,如果我们现在让它继续下去,即使病例数量会有所增加,它也不会达到原来的高度,因为我们人口中已经有了足够多的免疫者。所以它不会像一开始传播得那么快。

spikedShould we worry about a second spike?

spiked:我们应该担心第二个尖峰吗?

WittkowskiThis is an invention to justify a policy that politicians are afraid of reversing.

Wittkowski:这是一个为政客们害怕扭转的政策辩护的发明。

spikedShould people practice social distancing?

spiked:人们应该保持社会距离吗?

WittkowskiNo.

Wittkowski:不。

spikedWhy not?

spiked:为什么不呢?

WittkowskiWhy?What is the justification for that?People need to ask the government for an explanation.The government is restricting freedom.You do not have to ask me for justification.There is no justification.It is the government that has to justify what it is doing.Sorry,but that is how it is.

Wittkowski:为什么?这样做的理由是什么?人们需要向政府要求解释。政府在限制自由。你不需要向我寻求正当理由。没有正当理由。政府必须为自己的所作所为辩护。对不起,但事实就是如此。

spikedHow did we get this so wrong?

spiked:我们怎么会把这件事弄得这么糟?

WittkowskiGovernments did not have an open discussion,including economists,biologists and epidemiologists,to hear different voices.In Britain,it was the voice of one person–Neil Ferguson–who has a history of coming up with projections that are a bit odd.

Wittkowski:各国政府没有进行公开讨论,包括经济学家、生物学家和流行病学家,听取不同的声音。在英国,这是一个人的声音——尼尔·弗格森——他曾经提出过一些有点奇怪的预测。

The government did not convene a meeting with people who have different ideas,different projections,to discuss his projection.If it had done that,it could have seen where the fundamental flaw was in the so-called models used by Neil Ferguson.His paper was published eventually,in medRxiv.The assumption was that one per cent of all people who became infected would die.There is no justification anywhere for that.

政府没有召集有不同想法、不同预测的人开会讨论他的预测。如果他们这样做了,就会发现尼尔弗格森(Neil Ferguson)使用的所谓模型存在根本缺陷。他的论文最终发表在 medRxiv 上。当时的假设是,所有被感染的人中有百分之一会死亡。这是没有任何正当理由的。

Let us say the epidemic runs with a basic reproduction rate of around two.Eventually 80 per cent of the population will be immune,because they have been infected at some point in time.Eighty per cent of the British population would be something like 50million.One per cent of them dying is 500,000.That is where Ferguson's number came from.

我们假设这种流行病的基本生殖率约为2。最终,80%的人口将获得免疫,因为他们曾在某个时间点受到感染。英国人口的百分之八十大约是5000万。其中1%的死亡人数是50万。这就是弗格森号码的来源。

But we knew from the very beginning that neither in Wuhan nor in South Korea did one per cent of all people infected die.South Korea has 60million people.It is about the same size as the UK.How many deaths were in South Korea?Did they shut down?No.The South Korean government was extremely proud to have resisted pressure to drop the very basic concepts of democracy.

但我们从一开始就知道,无论是在武汉还是在韩国,都没有百分之一的感染者死亡。韩国有6000万人口。它的面积与英国大致相当。韩国有多少人死亡?他们关门了吗?没有。韩国政府极为自豪地顶住了压力,拒绝放弃最基本的民主概念。

The epidemic in South Korea was over by March,the number of cases was down by 13 March.In Wuhan they also did not shut down the economy.Wuhan had restricted travel out of the city.

韩国的疫情在3月份结束,313日病例数量下降。在武汉,他们也没有关闭经济。武汉已经限制出城旅行。

They stopped train services and blocked the roads.They did not restrict anything social within the city until very late.We have seen,then,in Wuhan and South Korea,if you do not do anything,the epidemic is over in three weeks.

他们停止了火车服务,封锁了道路。直到很晚的时候,他们才限制城市里的任何社交活动。我们已经看到,在武汉和韩国,如果你不采取任何行动,这种流行病将在三周内结束。

Knowing that the epidemic would be over in three weeks,and the number of people dying would be minor,just like a normal flu,the governments started shutting down in mid-March.

由于知道疫情将在三周内结束,而且死亡人数将很少,就像普通的流感一样,政府从三月中旬开始关闭。

Why?Because somebody pulled it out of his head that one per cent of all infected would die.One could argue that maybe one per cent of all cases would die.But one per cent of all people infected does not make any sense.And we had that evidence by mid-March.

为什么?因为有人把它从他的脑袋里拔出来,百分之一的感染者会死亡。有人可能会说,所有病例中可能有百分之一会死亡。但在所有感染者中,有1%的人说不通。我们在三月中旬得到了证据。

spikedJust to clarify,cases are different from people infected?

spiked:只是为了澄清,病例和感染者是不同的吗?

WittkowskiCases means people who have symptoms that are serious enough for them to go to a hospital or get treated.Most people have no symptoms at all.But waking up with a sore throat one day is not a case.A case means that someone showed up in a hospital.

Wittkowski:病例指的是那些症状严重到需要去医院或接受治疗的人。大多数人没有任何症状。但是有一天因为喉咙痛醒来却不是这样。一个病例意味着有人出现在医院。

spikedThe UK government was also heavily influenced by the situation in Italy.Why did that go so wrong?

spiked:英国政府也深受意大利局势的影响。为什么事情会变得如此糟糕?

WittkowskiWhat we saw in Italy was that the virus was hitting those who were both old and had comorbidities,so lots of people died.But the median age of those who died in Italy was around 81 years.It is not that children or working people were dying.

Wittkowski:我们在意大利看到的是,病毒正在侵袭那些既老又有并存病的人,所以很多人死亡。但在意大利死亡的人的平均年龄在81岁左右。这并不是说儿童或劳动人民正在死去。

It was the elderly in nursing homes–not even the elderly living by themselves mostly.We saw lots of deaths and that scared people.But then,Italy did an illogical thing.It closed schools so that the schoolchildren were isolated and did not get infected and did not become immune.

是疗养院里的老人——甚至大部分都不是独自生活的老人。我们看到很多人死去,这让人们感到害怕。但后来,意大利做了一件不合逻辑的事情。它关闭了学校,使学童得到隔离,没有受到感染,也没有免疫。

Instead,the virus spread almost exclusively among the old,causing more deaths and a higher utilisation of hospitals.And that is mind-boggling.

相反,这种病毒几乎只在老年人中传播,造成更多的死亡和更多的医院利用率。这是令人难以置信的。

Very early on,we knew from China and we knew from South Korea that this is an epidemic that runs its course,and there was nothing special about it.But when it hit Italy,we stopped thinking about it as an age-stratified problem,and instead lumped everyone all together.

很早的时候,我们从中国和韩国了解到,这是一种流行病,它的发展是有规律的,没有什么特别之处。但当它袭击意大利时,我们不再把它看作是一个按年龄分层的问题,而是把所有人都归为一类。

The idea that if we did not shut down the schools the hospitals would have been overwhelmed does not make any sense.I frankly still cannot fully understand how our governments can be so stupid.

如果我们不关闭学校,医院就会不堪重负,这种想法是毫无意义的。坦率地说,我仍然不能完全理解我们的政府为什么会如此愚蠢。

spikedGovernments say they are following the science.Is that really true?

spiked:政府说他们在跟踪科学,这是真的吗?

WittkowskiThey have the scientists on their side that depend on government funding.One scientist in Germany just got$500million from the government,because he always says what the government wants to hear.

Wittkowski:他们有依靠政府资助的科学家。德国的一位科学家刚从政府那里得到了5亿美元,因为他总是说政府想听的话。

Scientists are in a very strange situation.They now depend on government funding,which is a trend that has developed over the past 40 years.Before that,when you were a professor at a university,you had your salary and you had your freedom.

科学家们正处于一种非常奇怪的境地。他们现在依靠政府资助,这是一个在过去40年中发展起来的趋势。在那之前,当你还是一个大学教授的时候,你有你的薪水,你有你的自由。

Now,the university gives you a desk and access to the library.And then you have to ask for government money and write grant applications.If you are known to criticise the government,what does that do to your chance of getting funded?It creates a huge conflict of interest.The people who are speaking out in Germany and Switzerland are all independent of government money because they are retired.

现在,大学给了你一张桌子和进入图书馆的通道。然后,你必须向政府申请资金,并提交拨款申请。如果你以批评政府而闻名,那么这对你获得资助的机会有什么影响呢?这造成了巨大的利益冲突。在德国和瑞士发表意见的人都是独立于政府资金的,因为他们都已经退休了。

spikedDid the Swedish scientists get it right?

spiked:瑞典科学家的理论正确吗?

WittkowskiSweden did the right thing.And they had to take a lot of heat for it.Now compare Sweden and the UK.The only difference is that Sweden did fine.They did have a problem.They had a relatively high number of deaths among the nursing homes.

Wittkowski:瑞典做了正确的事情。他们不得不承受巨大的压力。现在比较一下瑞典和英国。唯一的区别是瑞典做得很好。他们确实有问题。在疗养院中,他们的死亡人数相对较高。

They decided to keep society open and they forgot to close nursing homes.Remarkably,the politicians acknowledged that it was a mistake to extend that open concept to nursing homes.The nursing homes should have been isolated to protect the elderly who are at high risk.But I think the Swedish government is doing well to even acknowledge that mistake.

他们决定保持社会的开放,却忘了关闭疗养院。值得注意的是,政治家们承认,将这种开放的概念推广到疗养院是一个错误。疗养院应该被隔离起来,以保护高危老人。但是我认为瑞典政府在承认这个错误方面做得很好。

The first death in the United States was in a nursing home in Seattle.And that was by the end of February.So everybody knew that we were expecting the same thing that we had seen in Italy–an epidemic that hits the elderly.

美国第一例死亡病例发生在西雅图的一家疗养院。那是在二月底。所以每个人都知道我们期待着和在意大利看到的一样的事情——一种侵袭老年人的流行病。

But until just this week in New York State,the government told the nursing homes that if they did not take in patients from hospitals,they would lose their funding.So they would have to import the virus from the hospitals.

但是直到本周在纽约州,政府告诉疗养院,如果他们不从医院接收病人,他们就会失去资金。所以他们必须从医院进口病毒。

One third of all deaths in New York State were in nursing homes.One could have prevented 20,000 deaths in the United States by just isolating the nursing homes.After three or four weeks,they could have reopened and everybody would be happy.

在纽约州,三分之一的死亡病例是在疗养院。在美国,仅仅隔离疗养院就可以避免20000人的死亡。三四个星期之后,他们就可以重新开张,每个人都会很高兴。

That would have been a reasonable strategy.But shutting down schools,driving the economy against the wall–there was no reason for it.The only reason that this nonsense now goes on and on,and people are inventing things like this'second wave',which is going to force us to change society and never live again,is that the politicians are afraid of admitting an error.

这是一个合理的策略。但是关闭学校,使经济陷入困境——没有理由这样做。这种无稽之谈现在还在继续,人们正在发明类似第二次浪潮的东西,这将迫使我们改变社会,再也不能生存,唯一的原因是政客们害怕承认错误。

spikedIs this easier to see in hindsight?

spiked:事后诸葛亮是不是更容易看出来?

WittkowskiWhat I am talking about is not hindsight.The epidemics in Wuhan and South Korea were over in mid-March.In March,I submitted a paper to medRxiv,summarising all of that.At least towards the end of March,the data was there,and everybody who wanted to learn from it could.

Wittkowski:我说的不是事后诸葛亮。武汉和韩国的疫情在三月中旬结束。今年3月,我向 medRxiv 提交了一篇论文,总结了所有这些。至少在3月底,数据还在那里,每个想从中学习的人都可以。

On 17 April,Robert Redfield,director of the Centers for Disease Control and Prevention,presented data at the coronavirus presidential briefing at the White House.And there was one plot that he presented.And I looked at it and asked why people were not jumping to their feet.

417日,疾病控制和预防中心主任罗伯特·雷德菲尔德在白宫举行的冠状病毒总统简报会上提交了数据。他展示了一个情节。我看着它,问人们为什么不跳起来。

Why were people not understanding what they were looking at?The plot was the data from the ILINet.For 15 years,hospitals have counted every person who shows up with an influenza-like illness–fever,coughing,whatever.There were three spikes in the 2019-2020 flu season.

为什么人们不理解他们在看什么?图表是来自 ILINet 的数据。15年来,医院一直在统计每一个出现流感样疾病的人——发烧、咳嗽等等。在2019-2020年流感季节有三个峰值。

The first was in late December–influenza B.The next was in late January–an influenza A epidemic.And then there was one that had a peak in hospital visits around 8 March–Covid-19.

第一次发生在12月下旬——乙型流感。第二次是在一月下旬——甲型流感的流行。然后有一个在38日左右到医院就诊的新型冠状病毒肺炎达到了顶峰。

For the peak to happen on that day,those patients have to go through a seven-day incubation period and then have symptoms.But they do not go to the hospital with the first symptoms.If it gets worse over three days,only then do they go to a hospital.

为了在那一天达到高峰,这些患者必须经历7天的疾病潜伏期,然后出现症状。但是他们不会带着最初的症状去医院。如果病情在三天内恶化,只有到那时他们才去医院。

Four weeks later,on 8 April,the number of new infections was already down.In time for Easter,our governments should have acknowledged they were overly cautious.People would have accepted that.Two weeks'shutdown would not have been the end of the world.

四周后,也就是48日,新感染的人数已经下降。在复活节到来之际,我们的政府应该承认他们过于谨慎了。人们会接受这一点。政府停摆两周并不意味着世界末日。

We would not have what we have now–30million people unemployed in the United States,for example.Companies do not go bankrupt over a two-week period.Two months is a very different story.If you have to pay rent for two months for a restaurant in New York with no income,you will go bankrupt.

我们不会有现在这样的情况——例如,美国有3千万人失业。公司不会在两周内破产。两个月就完全不同了。如果你在纽约一家没有收入的餐馆要付两个月的租金,你就会破产。

We see unemployment,we see bankruptcies,we see a lot of money wasted for economic-rescue packages–trillions of dollars in the United States.We see more deaths and illness than we would otherwise have had.

我们看到失业,我们看到破产,我们看到许多钱被浪费在经济救助计划上——美国有数万亿美元。我们看到了更多的死亡和疾病。

And it is going on and on and on,just because governments are afraid of admitting an error.They are trying to find excuses.They say they have to do things slowly,and that they have'avoided 500,000 deaths'in the UK.But that was an absurd number that had no justification.

这样的事情一直在发生,就因为政府害怕承认错误。他们试图寻找借口。他们说他们必须慢慢来,他们已经在英国避免了50万人的死亡。但这是一个荒谬的数字,没有任何理由。

The person presenting it pretended it was based on a model.It was not a model.It was the number of one per cent of all people infected dying.And nobody was questioning it.And that is the basic problem.

展示它的人假装它是基于一个模型。它不是一个模型。这是百分之一的感染者死亡的数字。没有人怀疑这一点。这就是最基本的问题。

spikedPeople will say that the interventions in South Korea–like contact tracing–were more effective.

spiked:人们会说,韩国的干预措施——比如追踪接触者——更有效。

WittkowskiHow many orders of magnitude,take us from 500,000 to 256,the number of deaths in South Korea?To have that kind of effect you would have to put everybody in the UK into a negative pressure room.It is totally unrealistic to even consider a reduction from 500,000 to 256.

Wittkowski:韩国死亡人数,从50万到256,有多少个数量级?要达到这种效果,你必须把英国的每个人都放到一个负压室里。甚至考虑从50万减少到256都是完全不现实的。

»Source

转自:

https://eraoflight.com/2020/06/01/epidemiologist-knut-wittkowski-we-could-open-up-again-and-forget-the-whole-thing/

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  • 本文由 发表于 2020年6月2日09:29:10
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