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关于冠状病毒的一些认识和思考

热度 2已有 109 次阅读2020-4-29 10:46 |个人分类:时事随笔|系统分类:热点杂谈 | 宽屏 请点击显示宽屏,再点击恢复窄屏 | 动漫全图 如只见部分动漫,请点击显示全图,再点击恢复窄图

关于冠状病毒的一些认识和思考
文/春雨秋风

最近一段时间,阅读了有关SARS-Co-2病毒和COVID-19感染的资料。也认真对比一般流感,以及2009年甲型H1N1 流感的资料,有以下几点认识。
1,传染性
Covid-19病毒感染的传染性强,对R0值的估计在3.3-3.8,明显高于普通流感的R01.2-1.9,也高于甲型流感的1.4-1.6,(R02.2-3.1 最高估算值)。这也是这次Covid-19全球爆发性大流行的根本原因。
2,死亡率和年纪分布
Covid-19 感染发病,死亡率的估算,由于地区,医疗,人群年纪构成等等因素,从2%到5%不等。死亡者平均年纪,多伦多市平均超过80岁;意大利平均超过80岁。德国病理学家波尔舍对44例病毒感染死亡者的解剖结论是“他没有发现一例死亡病例是仅仅因为感染SARS-CoV-2而去世。通过尸体解剖,他和他的团队认为是患者既往患有的多种疾病和SARS-CoV-2感染共同引起了死亡”。德国卫生部门的统计数据显示,德国因COVID-19死亡的绝大部分死者为老年人。
相比H1N1感染死亡的年纪分布“其中80%因甲型流感或甲型流感引起的心血管病而死亡的人在65岁以下,65%的死亡病例是在18岁至64岁之间”,Covid-19对中青年的感染致死率是只低而不高。初步阅读的印象,Covid-19感染的死亡率对于65岁以下的人,或者近似普通流感。
3,Covid-19 感染的早期常见体征
发烧,干咳,全身酸痛,头痛,失去嗅觉和味觉,腹泻,红眼(结膜炎),脚趾发痒水泡,或者脚趾红肿等。
3,治疗
首先明确,目前并不存在任何一种据有明确抗病毒作用的神药!从社会心理学角度,这种神药似乎据有划时代意义。但从人类发展的自然规律而言,因为Covid-19不过是违反人类道德和文明意识的,推动自然淘汰的启动因子,对社会有效构成只有积极作用,所以这种药物的真实价值有待商榷。
在病毒株致病性,病毒载量,这两个不可控因素相同的情况下,感染者对病毒的反应并不相同。反应越重(高烧为主要体征),病情越重,预后也越差。从高烧的机制而言,似乎对病毒过度免疫反应是导致病情严重,预后不佳的原因之一。因此应该考虑在感染早期,严格控制发烧,及时对症治疗,尽量改善任何身体不适的情况等等,或者是决定病毒感染转归的重要因素。
到目前为止,Covid-19导致病毒性肺炎,肺失去呼吸功能而造成死亡还是公认的致死主要原因。肺泡充填,塌陷,肺不张,肺栓塞,肺实变等是肺失去功能的常见原因。因此强调感染者无论如何痛苦,必须坚持自主呼吸,坚持活动,坚持呼吸功能的锻炼,主动咳嗽等等,或许有着挽救生命的重要意义。
总结
1,正确认识Covid-19,这种病毒是一个传染性很强,对高龄人有着巨大生命威胁的流行病。但对中青年的生命威胁程度不如H1N1病毒,对社会生产力损失不构成威胁。
2,因为Covid-19的强传染性,避免集群性爆发,挤兑和冲击医疗资源和医疗保障系统,保证社会医疗的正常秩序有着重要意义。
3,机体对病毒的免疫反应低下,过度免疫反应都可能是导致病情严重的重要原因。早期控制发烧,减轻不适症状有着重要的治疗意义。
4,感染者注意保持肺功能,坚持自主呼吸,坚持活动,坚持呼吸功能得锻炼对预后转归有积极的影响。
5,疫情期间,保证营养,休息,睡眠,争取以最好得精神和身体状态面对可能的情况。
6,必须强调,因为Covid-19 感染没有有效治疗办法,除非出现明显呼吸困难,尽可能不要去医院。在家隔离休息,控制发烧,坚持呼吸锻炼是实际可行的办法,如果能在专科医生的指导下在家治疗康复,实为首选。
简单说:
1,对绝大多数人就是流感。
2,吃好睡好,得了感染也容易好。
3,一旦感染,一定要控制发烧退热。
4,感染了,无论气管喉咙多疼,也必须主动深呼吸锻炼,坚持活动,不能躺着,这是救命。

明天太阳还会升起,我们依然可见春天。
以下数种现象具有特殊意义
1,无论性别,年纪,感染机会相似。
2,肥胖者,糖尿病者,感染后容易变成重症,需要住院,死亡率明显高。
3,同样感染,女性症轻,男性症重,女性预后更好。
4,与通常想法完全相反。吸烟者感染后轻症多。与吸烟者相比,不吸烟者转化为重症,需要住院治疗,是吸烟者的四五倍。具体原因不详。

疫苗不会一蹴而就,抗病毒神药更如天方夜谭,我们应该做好与病毒共存的心理和生活准备。冷静,平静,心里有数,正确应对。生活还是要积极地继续!

2020,04,17

understanding the coronavirus

By Han Luheng

Recently, through reading research and clinical data regarding the  Covid-19 virus and virus infection. and carefully compared the general influenza and the 2009 H1N1 influenza data, there are the following points of understanding.

1, infectious
The Covid-19 virus is highly infectious, with an estimated R0 value of 3.3-3.8, which is significantly higher than R01.2-1.9 for common influenza and 1.4-1.6 for influenza A (the highest estimate for R02.2-3.1 value). This is also the root cause of the global outbreak of Covid-19.

2. Mortality and age distribution
Covid-19 infection morbidity and mortality estimates vary from 2% to 5% due to factors such as region, medical treatment, and age of the population. The average age of the deceased is over 80 years old in Toronto;  over 80 years old in Itly. German pathologist Polscher ’s anatomical conclusions on 44 deaths from viral infections were: “He did not find a death case just because of SARS-CoV-2 infection. Through autopsy, he and his team believe that the patient was the past Various diseases and SARS-CoV-2 infection have caused death together. " Statistics from the German Ministry of Health show that the vast majority of German deaths due to COVID-19 are elderly.

Compared with the age distribution of H1N1 infection deaths, “80% of people who died of cardiovascular disease caused by influenza A or influenza A are under 65 years old, and 65% of deaths are between 18 and 64 years old”, The mortality rate of Covid-19 infection among young and middle-aged people is only low but not high. According to the preliminary reading, the mortality rate of Covid-19 infection is for people under the age of 65, or similar to a serious flu.

3. Early common signs of Covid-19 infection
Fever, dry cough, body aches, headaches, loss of sense of smell and taste, diarrhea, red eyes (conjunctivitis), itchy blisters on the toes, or red and swollen toes.

3. Treatment
First of all, it is clear that at present there is no magic drug with a clear antiviral effect! From the perspective of social psychology, this magic medicine seems to have epoch-making significance. However, from the perspective of the natural laws of human development, Covid-19 is just a violation of human morality and civilized consciousness. The starting factor for promoting natural elimination has only a positive effect on the effective composition of society, so the true value of this drug is open to question.

If don't consider pathogenicity of the virus strain, viral load,  these two uncontrollable factors, still, the response of the infected individuas to the virus are not the same. The heavier  reaction (high fever is the main sign) which is from the infection, and it wouldbe the more severe development of the disease , and would be much worsen  prognosis. From the mechanism of high fever, it seems that excessive immune response to the virus is one of the reasons leading to serious illness and poor prognosis. Therefore, it should be considered in the early stages of infection, strict control of fever, timely symptomatic treatment, try to improve any physical discomfort, etc., that can be an important factor in determining the outcome of viral infection.

So far, Covid-19 has caused viral pneumonia, and the death of the lungs due to loss of respiratory function is still a recognized major cause of death. Alveolar filling, collapse, atelectasis, pulmonary embolism, and lung consolidation are common causes of lung loss. Therefore, it must be emphasized that the infected person must persist in spontaneous breathing, activity, exercise of breathing function, active coughing, etc., regardless of the pain, which may have the important meaning of saving lives.

Conclusion
1. Recognize Covid-19 correctly. This virus is a highly contagious epidemic that threatens the lives of elderly people. However, the life threat to young and middle-aged people is not as great as the H1N1 virus, and it does not pose a threat to social productivity loss.

2. Because of the strong contagious nature of Covid-19, it is of great significance to avoid cluster outbreaks, run and impact medical resources and medical care systems, and ensure the normal order of the society.

3. The body's immune response to the virus is low, and excessive immune response may be an important cause of serious illness. Early control of fever and relief of discomfort have important therapeutic significance.

4. Infected persons pay attention to maintaining lung function, insisting on spontaneous breathing, insisting on activity, and exercising on breathing function have a positive effect on prognosis.

5. During the pandemic, ensure nutrition, rest and sleep, and strive to face the possible situation with the best mental and physical state.

6. It must be emphasized, that because there is no effective treatment for Covid-19 infection, unless obvious breathing difficulties occur, try not to go to the hospital if possible. Isolating and resting at home, controlling fever, and insisting on breathing exercises are practical and feasible methods. If you can treat and recover at home under the guidance of a specialist, it is the first choice.
simply say:

1. For most people, it is a serious flu.
2. Eat well, sleep well, and get infected easily.
3. Once infected, be sure to control fever and fever.
4. Infected, no matter how much the trachea and throat hurt, you must actively take a deep breathing exercise and stay active. You can't lie down. This is lifesaving.

The following phenomena have special significance
1. Regardless of gender, age, and chance of infection are similar.
2. The obese and diabetic patients are prone to become severe after infection, requiring hospitalization, and the mortality rate is significantly higher.
3. The same infection, mild female disease, severe male disease, female prognosis is better.
4. It is completely contrary to the usual idea. Smokers have more mild symptoms after infection. Compared with smokers, non-smokers become severe and require hospitalization, which is four or five times that of smokers. The specific reason is unknown.

The vaccine will not be achieved overnight. Antiviral magic medicine is more like a fantasy. We should be prepared to coexist with the virus and prepare for life. Be calm, calm, know what you are doing, and respond correctly. Life still has to continue active
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回复 追求永生 2020-5-30 08:46
谢谢黄兄谆谆善诱的解释和非常有实践意义的建议。

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