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新型冠状病毒肺炎疫情的流行病学特征:超出预期的传播。

The Epidemiologic Aspects of COVID-19 Outbreak: Spreading Beyond Expectations.

机构信息

Research Center for Immunodeficiencies, Tehran University of Medical Sciences, Tehran, Iran.

Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran.

出版信息

Adv Exp Med Biol. 2021;1318:61-79. doi: 10.1007/978-3-030-63761-3_4.

Abstract

The coronavirus disease 2019 (COVID-19) outbreak started in late 2019 in Wuhan, Hubei Province of China, and quickly spread to the surrounding regions and neighboring countries. A novel coronavirus, the so-called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was found to be responsible for this outbreak potentially originating from pangolins. In China, the outbreak lasted for 1 month until it seemed to be controlled after affecting over 81,000 individuals and causing deaths in over 4200 patients. Subsequently, and after affecting over 118,000 individuals and causing over 4200 deaths, the condition was officially announced as a pandemic by the World Health Organization (WHO). In the meantime, the epidemic curve took a downtrend in China, the original epicenter of the pandemic, but started to rise in other countries with a steep slope. Among over 215 affected countries, the USA, European countries (Italy, Germany, Spain, France, the UK), Iran, and South Korea had the highest frequencies in the matters of infected patients and deaths. Importantly, different countries took different policies when encountered with an outbreak, especially in the matter of accuracy of the report and timing of the action. A part of the delays in reporting was expected, including the lag in the chain of reporting, the shortcomings of tests, missed patients, and inadequate testing facilities. However, there were also political and nontechnical reasons that caused the reporting to be inaccurate. Surveillance seems to be less of a reason for the observed in poor management, and it mostly originated from human decision-making failures and political issues. Besides, the culture of populations and their trust in their governments played an important role on how they reacted to the COVID-19 pandemic and acquired policies. Finally, the characteristics of the world today indicate the danger of probable upcoming outbreaks, and policymakers should utilize the existing opportunities, particularly the advancements in technology and media, to prevent or adequately manage them.

摘要

2019 年底,新型冠状病毒病(COVID-19)疫情在中国湖北省武汉市爆发,并迅速蔓延至周边地区和邻国。一种新型冠状病毒,即所谓的严重急性呼吸综合征冠状病毒 2(SARS-CoV-2),被认为是此次疫情的罪魁祸首,其可能来源于穿山甲。在中国,疫情持续了 1 个月,在影响了超过 81000 人并导致 4200 多名患者死亡后,似乎得到了控制。随后,在影响了超过 118000 人并导致超过 4200 人死亡后,世界卫生组织(WHO)正式宣布该情况为大流行。与此同时,疫情曲线在中国这个大流行的最初震中呈下降趋势,但在其他国家却呈陡峭上升趋势。在超过 215 个受影响的国家中,美国、欧洲国家(意大利、德国、西班牙、法国、英国)、伊朗和韩国在感染患者和死亡人数方面频率最高。重要的是,不同国家在遇到疫情时采取了不同的政策,尤其是在报告的准确性和行动的及时性方面。报告的延迟在一定程度上是可以预料的,包括报告链的滞后、检测的不足、漏诊和检测设施不足等。然而,也有政治和非技术原因导致报告不准确。监测似乎不是管理不善的主要原因,它主要源于人为决策失误和政治问题。此外,人口的文化和对政府的信任在他们对 COVID-19 大流行的反应和获得政策方面发挥了重要作用。最后,当今世界的特点表明,可能即将爆发的疫情存在危险,政策制定者应该利用现有的机会,特别是技术和媒体的进步,来预防或妥善管理这些疫情。

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