which is responsible for a global pandemic. Thus far the main country affected has been

就是目前全球大爆發的新冠肺炎元兇，剛開始主要在中國流傳，

China, but it has spread to a number of other countries around the world to a varying degree.

但現在已經擴散到世界上其他國家，嚴重程度不一，

The virus was initially referred to as the 2019-nCoV, or the 2019 novel coronavirus and

這種病毒剛開始被稱為 2019 新型冠狀病毒，簡稱 2019 新冠病毒，

was informally called “Wuhan coronavirus”. The World Health Organization named the disease

另一個非正式稱呼是「新冠病毒」，世界衛生組織將這個疾病稱作 COVID-19，

COVID-19 because it doesn't refer to a geographical location, an animal, a person or group of

因為這個名稱不代表任何地理位置、人名、或一群人，

people - all of which can lead to stigma. They also wanted to make it pronounceable

否則會造成汙名化爭議，世衛組織也想讓這個名稱好念、又跟新冠肺炎有關 (字母與數字分別代表冠狀、病毒、疾病、與 2019 年)，

and related to the disease - not an easy task! The virus was officially named SARS CoV-2,

要達成這些條件可不簡單。新冠病毒的官方名稱為 SARS CoV-2，

or severe acute respiratory syndrome coronavirus 2, because it's genetically very similar

也就是「嚴重急性呼吸系統綜合症冠狀病毒 2 型」，因為這種病毒整體上很類似

to the SARS coronavirus which was responsible for…well the Severe Acute Respiratory Syndrome,

造成嚴重急性呼吸系統綜合症─的 SARS 冠狀病毒，

or SARS, outbreak in 2002. So SARS-CoV-2 causes COVID-19.

SARS 疫情在 2002 年爆發，後來 SARS 冠狀病毒 2 型變異成 2019 年新型冠狀病毒，

Now, coronaviruses that circulate among humans are typically benign, and they cause about

現今感染冠狀病毒的症狀通常都是良性的，

a quarter of all common cold illnesses. But occasionally, coronaviruses that circulate

佔普通感冒症狀的四分之一，但有時冠狀病毒在動物體內時發生突變，

in an animal reservoir mutate just enough to where they're able to start infecting

若有機會接觸到人類，就會感染人體並致病，

and causing disease in humans, if they're given an opportunity. In 2002 SARS was a coronavirus

2002 年的 SARS 病毒也是冠狀病毒，

that hopped over from bats to civets, which is a cat-like mammal; and then over to humans.

從蝙蝠傳染到麝貓─ 一種長得像貓的哺乳動物，再傳染給人類。

And in 2012, there was MERS, which was a coronavirus that hopped over from bats to camels a few

2012 年又有 MERS 冠狀病毒，這種病毒在幾十年前從蝙蝠傳染到駱駝，

decades ago and then circulated among camels for quite some time before infecting humans.

在駱駝之間流傳了一陣子就開始感染人類。

COVID-19 most likely also started with bats, but this time the intermediate host was probably

這次的 2019 年新型冠狀病毒最初極有可能也在蝙蝠體內，但中間宿主可能是穿山甲─

a pangolin, an animal that looks like a cross between an anteater and an armadillo. That's

一種看起來像介於食蟻獸與犰狳的動物，

based on the fact that scientists identified a coronavirus in pangolins that's a 96%

根據科學家研究，指出穿山甲裡的冠狀病毒跟 SARS 冠狀病毒 2 型的基因相似度高達百分之 96，

genetic match to SARS-CoV-2. Sadly, pangolins are heavily trafficked around the planet,

令人難過的是，全世界各地都有非法販售穿山甲，

largely because people believe that their scales have healing properties. Because they're

主要是因為人們認為穿山甲的鱗片有療效，

moved around the world rather than left in the wild, there are ample opportunities for

也因為牠們被帶到世界各地，無法在野外生活，

a coronavirus to go from a pangolin to a human.

冠狀病毒有很大的機會是從穿山甲跑到人類體內。

As of February 11, 2020, there have been 43,103 cases of COVID-19 and 1,018 deaths, with a

截至 2020 年二月十一日，已經有 43103 個確診病例，其中 1018 例死亡，

fatality rate of 2.4%, according to WHO. The vast majority of cases and deaths have occurred

根據世衛組織統計，致死率為百分之 2.4，大部分的確診與死亡個案發生在中國，

in China. For a little perspective, the 2002 SARS outbreak resulted in 8,098 cases and 774 deaths,

跟別的傳染病比較：2002 的 SARS 爆發導致 8098 個確診與 774 例死亡個案，

so the fatality rate was around 9.6%. And the 2012 MERS outbreak results in 2,494 cases

致死率大約是百分之 9.6；2012 年的 MERS 有 2494 例確診與 858 例死亡，

and 858 deaths, bringing the fatality rate to 34%. Finally, for the 2014 Ebola outbreak,

死亡率百分之 34，最後是 2014 的伊波拉病毒疫情，雖然不是冠狀病度造成的疾病，

which was not due to a coronavirus, there were 28,639 cases and 11,316 deaths. The fatality

但有 28639 例確診與 11316 例死亡，

rate was a whooping 40%!

致死率高達百分之 40！

At a microscopic level, coronaviruses are single strand positive sense RNA viruses with

若以微觀的角度來看，冠狀病毒屬於正鏈單股核糖核酸病毒，

protein spikes on their surface that look a bit like a crown under a microscope. In

表面帶有蛋白刺突，在顯微鏡下看起來像皇冠，

fact, “corona” is latin for crown. Besides looking majestic, these spikes allow the virus

其實 "corona" 在拉丁語的意思就是皇冠，除了看起來有威嚴，

to invade cells lining the respiratory tract and lungs. After binding, the coronavirus

這些刺突能幫助病毒黏附與入侵呼吸道與肺部的細胞，

enters and takes over the cellular machinery to make more and more copies of itself so

和細胞受體結合後，冠狀病毒進入細胞，控制其運作機制，以製造更多病毒複製體，

it can spread to the surrounding cells and get into the mucus.

散播至周圍細胞，最終進入黏液內，

Sometimes the infection is mild, and some people don't develop any symptoms at all.

有些人的感染症狀很輕微，甚至有人根本不會有症狀，

For others, they can develop symptoms that can range from mild symptoms like fever, cough,

但有些人可能會有輕微病徵，例如發燒、咳嗽、

and shortness of breath, all the way to serious problems like pneumonia. Severe lung damage

呼吸急促，甚至嚴重一點會造成肺炎，若肺部嚴重受損或受感染，

can cause acute respiratory distress syndrome, or ARDS, which occurs when the lung inflammation

會導致急性呼吸窘迫症候群 (ARDS)，

is so severe that fluid builds up around and within the lungs. The severe infection can

這是因為肺部嚴重感染，液體開始在肺部周圍和內部堆積，

cause septic shock, which happens when the blood pressure falls dramatically and the

可能造成血壓急速降低、器官缺氧，引發敗血性休克，

body's organs are starved for oxygen. ARDS and shock are the main cause of death for

ARDS 與休克是新冠病毒肺炎患者的兩大主要死因，

people with the infection, and this is more likely to occur in those over the age of 60,

發生在超過六十歲以上、

smokers, and people with previous medical conditions like hypertension.

癮君子、與之前就有生病的人─例如高血壓患者─可能性最大，

In addition to causing disease, coronaviruses can spread quickly. Usually the virus spreads

新冠病毒不僅會致病，散播速度也非常快，

when people cough or sneeze, and tiny droplets containing the virus are released. These droplets

通常新冠病毒是在人類咳嗽或打噴嚏的時候藉由飛沫小水滴傳播，

can land on another person's mouth, nose, or eyes, and that allows the virus to enter

小水滴可能會降落在人類嘴巴、鼻子、眼睛，就會感染另一個人。

a new person. Virus can also be found in a person's stool, and in rare situations coronavirus

在感染者坐過的板凳也能找到新冠病毒，

has been transmitted from one apartment to another within a residential building. This

極端情況下，新冠病毒也能在同一棟公寓的住房之間散播，

was seen in the 2002 SARS epidemic. At that time, faulty plumbing allowed virus-containing

這在 2002 年 SARS 疫情期間就有發生過。當時某些建築物內的配管系統設計不當，

fecal matter originating from one person's apartment to drift from drainage pipes back

使得一間住戶含有病毒的排泄物藉著排水管流到

up into fixtures like sinks and toilets within other apartments in the same building. This

同棟大樓另一個住戶的裝置，例如水槽和馬桶，

created a terrible smell and allowed the virus-containing droplets to deposit on bathroom surfaces,

不僅味道難聞，也讓病毒水滴沉積在浴室表面，

ultimately causing people in those apartments to get ill. Something similar may have happened

最後那些住戶的鄰居也因此得病。

with COVID-19, and this is being actively investigated.

現在新冠疫情中可能有發生類似的事情，官方也在積極調查中。

Once a person is infected, symptoms develop an average of 5 days later. This is called

人類一旦感染新冠病毒，症狀平均會在五天後開始出現，

the incubation period. However the incubation period varies from person to person, and in

這段無症狀的時間稱為潛伏期，然而潛伏期長短因人而異，

some studies, the incubation period lasted as long as 24 days! Now there's debate about

有些研究指出新冠病毒的潛伏期可能長達 24 天！

whether or not asymptomatic people can spread the disease, because these people typically

現在有人在討論無症狀者是否也有傳染力，

have low levels of circulating virus. But even if they do, asymptomatic transmission

因為這些人體內的病毒含量通常較低，就算帶有病毒，

likely plays a minor role in the overall epidemic. Viruses are given a reproductive number or

無症狀感染者的傳染程度在整個疫情來看也不會太嚴重。

R-naught based on how quickly they spread, and person to person transmission has been

科學家會根據病毒的傳播速度估計病毒的 R0 值、或稱傳染數，

confirmed both in and outside of China. An R naught of 1 means that an infected person

而在中國國內外都證實出現冠狀病毒人傳人。再生數 1 代表受感染的人會傳染給另一個人，

passes it on to 1 new person, an R-naught of 2 means that 1 person spreads it to 2 new

2 代表一人傳染兩人，

people, and so forth. If the R naught is below 1, the infection peters out, if it's 1 it

以此類推。如果 R0 值小於 1，代表傳染人數會持續減少，

stays steady, and if it's above 1, then it continues to spread. The current estimate

若等於 1，人數維持穩定，若大於 1，則病毒會持續擴散，

for the SARS-CoV-2 R naught is between 2 and 2.5. Of course that's an average, with some

目前科學家估計SARS 冠狀病毒 2 型的傳染基數介於 2 和 2.5，當然這只是平均值，

spreading the disease less, and others - called superspreaders - spreading the disease at

有時新冠病毒不會傳染給這麼多人，但有些人─稱為超級傳染者─ 散播病毒的速度高出許多，

a much much higher rate. The exact cause of these superspreaders is unclear, perhaps they

超級傳染者的出現原因尚不清楚，

are just in contact with more folks, perhaps their bodies naturally shed more virus, or

也許他們只是接觸比較多人，或他們的體質本來就容易讓病毒流出、

perhaps there's some other reason altogether.

或者還有其他原因。

To confirm the diagnosis, there should be a real time polymerase chain reaction or rt-PCR

若要篩檢病毒，需要有即時聚合酶連鎖反應，簡稱 rt-PCR 測試，

tests, a quick test used in many labs and hospitals that can detect very small amounts

這是一種用在許多實驗室與醫院的快篩，

of viral RNA.

非常少量的核醣核酸病毒也能測出。

Treatment is focused on supportive care - providing fluids, oxygen, and ventilatory support for

目前新冠肺炎主要使用支持治療：提供輸液、氧氣，對重症患者給予呼吸器輔助，

really ill people. There's also some early data showing that three medications are highly

先前研究數據顯示在實驗室環境下

effective against SARS-CoV-2 in the laboratory setting. These medications are chloroquine,

有三種療法對抗擊新冠病毒非常有效：治療瘧疾的「奎寧」、

an anti-malarial drug; ritonavir, an anti-HIV medication; and remdesivir, an antiviral drug

治愛滋病的「利托那韋」、以及瑞德西韋，一種先前用在伊波拉病毒的抗病毒藥物，

previously used against Ebola. Remdesivir was given to the first US patient with COVID-19

美國第一例新冠肺炎病患在發病第 11 天時，病情持續惡化，

on day 11 of his illness as he was clinically worsening, and he began to improve the very

使用瑞德西韋後的隔天即開始改善，

next day. Large scale clinical trials using remdesivir are already underway in China.

中國已開始著手進行大規模的瑞德西韋臨床試驗。

Unfortunately there's no vaccine currently available to protect against COVID-19. At

不幸的是，目前新冠病毒肺炎的疫苗仍未問世，

best, it looks like a vaccine will be many months away. So the goal is to avoid human

最快還要幾個月，所以現在應盡可能避免人傳人，

to human transmission, starting with isolating people with COVID-19. Coronaviruses don't

首先要隔離新冠肺炎病患，

usually spread over long distances in the air, but they can travel roughly 3 feet or

新型冠狀病毒通常無法在空氣中長距離擴散，

1 meter from one person to another on tiny droplets of saliva, which are produced when

但病患咳嗽或打噴嚏時，

someone's coughing or sneezing. In addition, some strains of coronavirus can survive on

病毒可以藉由飛沫擴散約一公尺左右。除此之外，有些種類的冠狀病毒

surfaces for over a day. With that in mind, if you're a healthy person living in a non-outbreak

可以在物體表面上生存超過一天。從這點來看，如果你身體健康、也不是住在疫區，

area, the recommendation is to avoid travel to disease outbreak areas, generally stay

最好的方法是避免到疫情爆發的地區，

away from crowded places, and stay at least 6 feet or 2 meters away from anyone with symptoms.

盡量別到人多的地方，跟有症狀的人要保持兩公尺以上的安全距離，

Wearing a surgical mask is not recommended because the general risk of getting COVID-19

然而手術口罩並不推薦，因為在這些情況下，感染新型冠狀病毒的風險並不高，

in these settings is so low. As always, careful hand washing is key and it should be done

所以還是那一句老話，仔細洗手才是關鍵，而且洗手的時候要用肥皂

with soap or alcohol-based hand sanitizers and scrubbing. Also, avoid touching your eyes,

或酒精洗手液，

nose, and mouth—this is the area, known as your T-zone is a common entry point for

此外不要碰你的眼睛、鼻子和嘴巴，這三個地方稱為臉部 T 區，

viruses into the body.

常常是病毒進入人體的管道。

For healthcare workers who are around people with COVID-19, the recommendation is to apply

若你是常待在新冠肺炎患者身邊的醫護人員，

droplet and contact precautions. That includes wearing personal protective equipment like

最好採用飛沫與接觸防護措施，包括個人保護裝置，

a clean, dry surgical mask, gloves, long-sleeved gowns, and eye protection like goggles or

例如乾淨乾燥的手術口罩、手套、長袖手術衣、眼鏡防護物，像是護目鏡或是護面罩。

a face shield. When performing a procedure that generates aerosol, like tracheal intubation,

如果進行會產生飛沫微粒的手術或治療，像是氣管插管、

bronchoscopy, CPR, or noninvasive ventilation, it's important to wear a N95 respirator.

支氣管鏡檢、心肺復甦、或植入非侵入性呼吸器，務必要帶 N95 口罩，

This prevents 95% of the small particles, like respiratory droplets, from passing through.

這樣可以阻擋百分之 95 的飛沫等微粒進入體內。

To recap, the SARS-CoV-2 virus causes a respiratory disease called COVID-19. The virus probably

現在來稍微複習一下：SARS 冠狀病毒 2 型會引發一種稱為「新型冠狀肺炎」的呼吸道疾病，

originated from bats, then went to pangolins as an intermediate host, and finally to humans.

這種病毒最初可能來自蝙蝠，後來以穿山甲當作中間宿主，最後開始感染人類。

The virus travels in respiratory droplets and enters the body via the mouth, nose, or

它藉由飛沫傳播，從嘴巴、鼻子或眼睛進入人類體內，

eyes. Once inside the body, it replicates in the respiratory system, causing symptoms

一旦進去了，新冠病毒會在呼吸系統內複製，

like fever, cough, and shortness of breath. Some people might develop more dangerous complications

導致發燒、咳嗽、與呼吸急促，有些人可能會有更危險的併發症：

like pneumonia, ARDS, and shock. Treatments are focused on supportive care, but certain

像是肺炎、急性呼吸窘迫症候群、和休克。治療方法主要為支持治療，

medications like Remdesivir are currently in clinical trials. In the meantime, the best

雖然目前有在針對瑞德西韋等某些藥物進行臨床試驗。

strategy is prevention -- this includes careful hand washing, avoiding traveling to disease

不過預防仍然勝於治療，防疫方法包括確實洗手、

outbreak areas and crowded places when possible, avoiding touching your T-zone, and if you're

避免到疫區旅遊，若可以的話，也盡量不去人多的地方、不要摸臉部的 T 區部位，

a healthcare worker to use personal protective equipment.

醫護人員則要使用個人防護裝備。