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严重急性呼吸综合征(SARS)、中东呼吸综合征(MERS)和新型冠状病毒(COVID-19)疫情,最新和最大的全球健康威胁:我们从中吸取了哪些教训?

The SARS, MERS and novel coronavirus (COVID-19) epidemics, the newest and biggest global health threats: what lessons have we learned?

机构信息

Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, Fort Worth, TX, USA.

Department of Statistics, Begum Rokeya University, Rangpur, Bangladesh.

出版信息

Int J Epidemiol. 2020 Jun 1;49(3):717-726. doi: 10.1093/ije/dyaa033.

Abstract

OBJECTIVES

To provide an overview of the three major deadly coronaviruses and identify areas for improvement of future preparedness plans, as well as provide a critical assessment of the risk factors and actionable items for stopping their spread, utilizing lessons learned from the first two deadly coronavirus outbreaks, as well as initial reports from the current novel coronavirus (COVID-19) epidemic in Wuhan, China.

METHODS

Utilizing the Centers for Disease Control and Prevention (CDC, USA) website, and a comprehensive review of PubMed literature, we obtained information regarding clinical signs and symptoms, treatment and diagnosis, transmission methods, protection methods and risk factors for Middle East respiratory syndrome (MERS), severe acute respiratory syndrome (SARS) and COVID-19. Comparisons between the viruses were made.

RESULTS

Inadequate risk assessment regarding the urgency of the situation, and limited reporting on the virus within China has, in part, led to the rapid spread of COVID-19 throughout mainland China and into proximal and distant countries. Compared with SARS and MERS, COVID-19 has spread more rapidly, due in part to increased globalization and the focus of the epidemic. Wuhan, China is a large hub connecting the North, South, East and West of China via railways and a major international airport. The availability of connecting flights, the timing of the outbreak during the Chinese (Lunar) New Year, and the massive rail transit hub located in Wuhan has enabled the virus to perforate throughout China, and eventually, globally.

CONCLUSIONS

We conclude that we did not learn from the two prior epidemics of coronavirus and were ill-prepared to deal with the challenges the COVID-19 epidemic has posed. Future research should attempt to address the uses and implications of internet of things (IoT) technologies for mapping the spread of infection.

摘要

目的

概述三种主要致命冠状病毒,并确定改进未来防范计划的领域,同时利用前两次致命冠状病毒爆发以及中国武汉当前新型冠状病毒(COVID-19)疫情的初步报告,对传播风险因素和可采取措施进行批判性评估。

方法

利用美国疾病控制与预防中心(CDC)网站和全面审查 PubMed 文献,我们获取了有关中东呼吸综合征(MERS)、严重急性呼吸综合征(SARS)和 COVID-19 的临床体征和症状、治疗和诊断、传播方式、防护方法和风险因素的信息。对这些病毒进行了比较。

结果

对情况的紧迫性的风险评估不足,以及中国境内对该病毒的报告有限,部分导致 COVID-19 在中国大陆迅速传播,并传播到邻近和遥远的国家。与 SARS 和 MERS 相比,COVID-19 的传播速度更快,部分原因是全球化程度提高和疫情焦点的变化。中国武汉是一个大型枢纽,通过铁路连接中国的北部、南部、东部和西部,也是一个主要的国际机场。有转机航班,疫情发生在中国(农历)新年期间,以及位于武汉的大型铁路交通枢纽,使得病毒在中国境内迅速传播,最终在全球范围内传播。

结论

我们的结论是,我们没有从前两次冠状病毒流行中吸取教训,也没有做好应对 COVID-19 流行带来的挑战的准备。未来的研究应该尝试解决物联网(IoT)技术在感染传播映射中的用途和影响。

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