Preventive Medicine and Epidemiology Department, Hospital Clínic-Universitat de Barcelona-ISGlobal, Barcelona, Spain.
Curr Allergy Asthma Rep. 2021 Apr 28;21(4):29. doi: 10.1007/s11882-021-01007-w.
The ongoing COVID-19 pandemic is a matter of great concern worldwide. After the first wave, several countries, notably in the European Union, are suffering a very rapid increase in the number of cases in the pandemic second wave. Health systems are under stress; hospital beds and ICU beds are increasingly occupied by COVID-19 patients, and hospitals are struggling to keep their normal operations. We review some basic epidemiological data of this new disease, regarding its appearance, reproductive rate, ways of transmission, number of cases, death rate, usefulness of diagnostic tests, basic treatment options, and prevention and control strategies, including vaccines.
The basic control strategy falls into two well established categories: active attack (control) or organized defense (mitigation). The control strategy relies on classic testing, tracing, and tracking possible cases of COVID-19. Those actions draw from classical epidemiology: to actively find and detect cases, isolate if positive for 10 days and treat when needed. At the same time, the search for close contacts, test them when needed and quarantine and monitor for 10 to 14 days in order to break chains of transmission. The mitigation strategy include basic measures to protect people at increased risk of severe illness, like social distancing, wearing a mask when social distancing is not possible, avoiding crowds, avoiding indoor crowded spaces, increase ventilation indoors and washing or sanitizing hands often. They include also targeted restrictions in people's mobility, and lock-downs, widely used during the first wave in order to spare the health system, become overwhelmed and increasingly used in Europe once more in the current strong second wave. Waiting for effective and safe vaccines and treatments, stopping the ongoing COVID-19 transmission is our only defense wall. We do not know yet which strategy or strategies worked best. We all must work as a team to give an adequate response to this pandemic. We have just one world and one health. Nobody will be safe until everybody is safe.
目前的 COVID-19 大流行是全世界关注的焦点。第一波疫情过后,一些国家,尤其是欧盟国家,正在经历第二波疫情病例的快速增长。医疗系统面临压力;新冠患者占用了越来越多的病床和 ICU 床位,医院难以维持正常运转。我们回顾了一些关于这种新疾病的基本流行病学数据,包括其发病、繁殖率、传播途径、发病数量、死亡率、诊断检测的有效性、基本治疗方法以及防控策略,包括疫苗。
基本防控策略分为两种:积极攻击(控制)或有组织防御(缓解)。控制策略依赖于经典的检测、追踪和识别新冠病例。这些措施来源于经典的流行病学:主动发现和检测病例,对阳性病例进行 10 天隔离,并在需要时进行治疗。同时,寻找密切接触者,根据需要对他们进行检测,并对他们进行 10-14 天的隔离和监测,以打破传播链。缓解策略包括保护高风险人群的基本措施,如保持社交距离、在无法保持社交距离时佩戴口罩、避免人群、避免室内拥挤场所、增加室内通风和经常洗手或消毒。这些措施还包括对人们的流动性进行有针对性的限制,以及封锁,封锁在第一波疫情期间被广泛使用,目的是为了避免医疗系统不堪重负,在当前第二波疫情中,封锁在欧洲再次被广泛使用。在等待有效和安全的疫苗和治疗方法的同时,阻止当前的 COVID-19 传播是我们唯一的防御手段。我们还不知道哪种策略或策略效果最好。我们都必须作为一个团队,对这场大流行做出适当的反应。我们只有一个世界,只有一个健康。除非每个人都安全,否则没有人会安全。