THE NEW YORK TIMES
THE MORNING

By David Leonhardtand

Good morning. Many experts expect Covid caseloads to rise soon. Here are four steps to protect people.
許多專家預期新的病例數很快將會攀升,在此有四個步驟,可以保護民眾。
Minimizing the toll 減至最低的傷亡
The BA.2 subvariant — an even more contagious version of Omicron — has already caused Covid-19 cases to rise across much of Europe. In the U.S., caseloads have held steady over the past week, ending two months of sharp declines, and many experts expect increases soon.
新冠Omicron 變種病毒的「BA.2」亞型變異株(sub-variant)更具傳染性-在歐洲造成Covid-19新病例的上升。在美國的病例數,上星期還保持平平,但已終止了兩個月急劇下降的新病例,許多專家預估近期內會大量增加。
Today’s newsletter looks at four promising strategies for minimizing Covid’s toll in the coming months.
今天的新聞簡報將檢視四種有效的策略,以將Covid的傷亡,在未來的數月中減至最低。
1. More boosters 更多加強針的接種
Dr. Aaron Richterman, an infectious-disease specialist in Philadelphia, regularly sees patients who have been vaccinated against Covid but have not received a booster shot. Some are not aware they are eligible for a booster. Others have heard about boosters but are not interested. “I just feel like I don’t need it,” one patient — an older man — recently told Richterman.
在費城的一位傳染病專科醫生Aaron Richterman經常看到一些病人,接種二劑疫苗而沒打加強針,有些人不知道他們符合第三針接種資格,有些人聽說可以打加強針,但是沒有興趣,另外有一位年長的病人最近告訴Richterman,他感覺不需要接種。
That attitude is common. Almost one-quarter of U.S. adults have been vaccinated but have not received a booster shot, according to Kaiser Family Foundation surveys. (Any American who was vaccinated more than six months ago is eligible.)
持有這種態度的人,非常普遍,大約有1/4美國成人只接種了兩劑,而沒有打加強針,依據凱澤家族基金會(Kaiser Family Foundation)的調查指出。(任何美國人接種疫苗超過了6個月,都符合施打加強針的資格)
These vaccinated-but-unboosted Americans are clearly open to receiving a Covid shot. And many would benefit significantly from getting boosted. Without a booster, immunity tends to wane. With a booster, people are even more protected than they were shortly after receiving a second shot, data shows.
沒有打加強針的美國人,隨時都可接種,對於許多施打過加強針的民眾,抵抗病毒會有很大的助益,而沒有施打者,他們的免疫力將會隨時間而下降。資料顯示,打過加強針的民眾,比剛接種過第2劑疫苗者,還更具保護力。
Consider the numbers from California, which publishes detailed data by vaccination status. For every million boosted Californians, fewer than two have been hospitalized with Covid at any given time recently:
思考一下加州最近公佈接種疫苗者詳細資料的數據,每百萬加州民眾,接種過加強針者,因新冠重症住院者不到兩人。
“I remain most worried about lack of booster uptake among the elderly and the immunocompromised,” Jennifer Nuzzo, a Johns Hopkins University epidemiologist, told me.
約翰斯霍普金斯大學流行病學家Jennifer Nuzzo告訴作者,她非常擔心年長者和免疫力有缺陷的民眾,沒有接種加強針。
Many Americans still have not gotten this message, though. What might help? A prominent public-service campaign, focused specifically on booster shots rather than vaccination, could. So could encouragement from politically conservative voices. Fewer than 30 percent of Republican adults have received a booster; many Republicans have not received even a first shot.
許多美國民眾沒有接收到上述的訊息,如何協助他們呢?有一個知名的公共服務活動,就是專門聚焦在加強針重要性的推廣,如此可以透過共和黨保守派的聲音,鼓勵民眾施打加強針,目前有不到30%共和黨黨員接種了加強針,然而更有許多共和黨員,連第一劑疫苗都沒有接種。
“The most powerful weapon we have, by far, is vaccination,” Richterman told me, “and that includes first doses, second doses and third doses.”
傳染病專科醫生Richterman告訴作者,目前最強而有力的武器,就是接種疫苗,包括第一劑、第二劑和第三劑。
What about fourth doses (that is, second booster shots)? The Biden administration will soon begin offering them to anybody 50 or older. The evidence suggests that these shots may offer additional protection but that they are less important than first booster shots, as Katelyn Jetelina, an epidemiologist, has explained in her newsletter.
有關第四劑(也就是第二劑的加強針)要如何作為呢?拜登政府很快將會提供給50歲以上年長者施打,證據顯示所提供的保護力,沒有第一劑加強針來得重要,這位流行病學家Katelyn Jetelina在她的新聞簡報中有解釋原因。
2. The immunocompromised 免疫缺陷者
For a small percentage of Americans, vaccination is impossible or ineffective. This group includes people who are receiving cancer treatments and those who have received certain organ transplants.
對於正在接受癌症治療和器官移植的少部分美國人,無法接種疫苗,即使施打疫苗也是無效的。
Fortunately, a drug now exists that may help many of them. It is an injection called Evusheld, developed by AstraZeneca with help from government funding. It appears to provide months of protection, and the Biden administration has ordered enough doses to treat 850,000 people.
值得慶幸的是,現在有一種注射的藥物,稱為Evusheld-是由政府出資,阿斯特捷利康(AstraZeneca)所研發,有助於上述的這些病人。該藥物能提供數月的保護力,拜登政府已訂購足夠的藥劑,可醫治85萬人次。
But about 80 percent of the available doses are sitting unused, in warehouses, pharmacies and hospitals, my colleagues Amanda Morris and Sheryl Gay Stolberg have reported. Among the reasons: Many patients are unaware of Evusheld’s existence. Some doctors are uncertain about who qualifies. Some hospitals are refusing to dispense it to eligible patients, saving it for people who they think might benefit more from it.
作者同事Amanda Morris和 Sheryl Gay Stolberg報導指出,大約80%可用的這些藥物,存放在倉儲、藥局和醫院,目前仍有很多的病人,尚不知有此Evusheld藥物的存在,有些醫生也不確定何種病人,符合規定可以施打,有些醫院拒絕開此藥,給合格的病人,醫院認為要保留這些藥物給更需要的病人。
“The biggest problem is that there is absolutely no guidance or prioritization or any rollout in place at all,” Dr. Dorry Segev of N.Y.U. Langone Health told The Times. “It’s been a mess.”
紐約大學Langone 醫藥學院醫生Dorry Segev,告訴紐約時報:目前最大的問題在於沒有指引、沒有優先順序和首次發行計畫,搞得一團混亂。
Biden administration officials have been working with state officials, hospitals, doctors and patient advocates to clear up the uncertainty. They have a long way to go.
拜登政府官員正在和州政府官員、醫院、醫生和病人代表會商,排除各種不確定性,但目前仍有很多的工作要克服。
3. Post-infection treatments 染病後治療
A knowledge gap is also hampering the distribution of Paxlovid — a post-infection treatment from Pfizer that seems to sharply reduce the chances a Covid illness will become severe. It is most effective when prescribed shortly after symptoms begin, but many Americans do not know it exists.
有一個知識鴻溝,阻礙了Paxlovid的配發運用-由輝瑞(Pfizer)研發的染病後服用的藥物,能免於新冠病毒,成為重症,當有徵狀出現後,服用該藥物非常有效,但是有很多美國民眾並不知道有此藥物的存在。
The good news is that Paxlovid has become more widely available in recent weeks. If you are in a high-risk group and get infected with Covid, you should immediately talk with a doctor. (Here’s an explainer.)
好消息指出Paxlovid藥物,在最近的幾星期中,已大量使用了,假如你是新冠高風險族群或是感染者,你應該立刻和你的醫生好好討論。
One thing to keep in mind: The government has so far authorized Paxlovid only for high-risk people, like those 65 and older or those with serious underlying medical conditions. I know that many Americans, especially liberal Democrats, are nervous about their own Covid risk and may be tempted to seek out Paxlovid.
請謹記在心:目前政府已授權有高風險的民眾、65歲以上的年長者和有共病的民眾,可以使用Paxlovid藥物,作者瞭解許多美國民眾,尤其是自由派民主黨人士,擔心新冠病毒感染風險,很想要尋求並獲得Paxlovid藥物。
But the risk of developing severe Covid for most people who are boosted remains very low, as the chart above shows. And the current supply of Paxlovid is not large enough to treat anywhere near everybody who gets infected, especially if cases rise. “Our supply is fragile,” Dr. Scott Dryden-Peterson of Brigham and Women’s Hospital in Boston told Bloomberg News.
只要打過加強針的民眾,罹患新冠重症的風險是很低的,如上述的圖表所示,目前對染病者,所提供的Paxlovid藥物治療,還不夠全面,尤其是當新病例升高的時候,波士頓布萊根婦女醫院(Brigham and Women’s Hospital)Scott Dryden-Peterson醫生,告訴彭博新聞社,Paxlovid藥物治療的供應系統,是非常脆弱的。
If many younger, otherwise healthy people rush to get a Paxlovid prescription, they may effectively be taking doses from vulnerable people.
假如年輕人或是健康的民眾,一窩蜂前去領取Paxlovid藥物處方,對於真正染病需要民眾會有很大的影響。
4. Masks 口罩
Broad mask mandates have not done much to prevent Omicron’s spread. Too many people wear low-quality masks or take them off at times, and Omicron is so contagious that it takes advantage of these gaps.
廣泛強制戴口罩,防止Omicron病毒擴散的要求,執行的並不徹底,太多人戴上不合格的口罩,或是經常拿下口罩,讓容易傳染的Omicron病毒有機可乘。
But masks can still help reduce Covid’s spread: 口罩有助於降低新冠的擴散
• They are especially helpful in hospitals and nursing homes, where high-quality masks can be required and where many people are vulnerable.
口罩在醫院和養老院,是非常有幫助的,而且高品質的口罩是必需具備的,因為在那裏的民眾,是很容易感染新冠病毒。
• Masks also make sense for people who have returned to work or school five to 10 days after a Covid infection, Dr. Shira Doron of Tufts Medical Center says.
塔芙茨醫療中心(Tufts Medical Center)醫生Shira Doron表示,新冠感染民眾經過5~10天的隔離,返回職場或是學校,戴上口罩是非常合理的。
• Anybody who is personally anxious about Covid, for any reason, can wear a mask, too, Dr. Tom Frieden, a former C.D.C. director, notes. A high-quality mask will protect the wearer even if others nearby are maskless.
任何人不管任何理由,擔憂新冠病毒,都可以自行戴上口罩,疾管預防中心前主任Tom Frieden醫生指出,高品質的口罩可以保護戴口罩的民眾,即使身邊有人沒有戴口罩的話。
The bottom line 最重要的事實
All four of these steps have small costs and large benefits.
所有這四種步驟,可以以最低的代價,而獲取最大的利益。
They avoid contributing to the pandemic’s continuing crisis of isolation and disruption, like closing classrooms and keeping children home from school for weeks on end. And they can save lives. Covid’s official death toll in the U.S. has already exceeded 975,000. But given the availability of vaccine shots and other treatments, the vast majority of deaths are now avoidable.
這些可以避免造成新冠病毒繼續隔離和中斷的危機,諸如停課,讓學童在家無法上學連續好幾個星期。同時也可以拯救生命,美國死於新冠病毒的官方人數已超過了97萬5000人,鑒於有疫苗接種而不施打和其它的治療方式,這重大的死亡人數,原本是可以避免的。

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