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  • welcome to another MedCram coronavirus update let's take a look at the numbers

    歡迎收看最新一期冠狀病毒的消息。 我們先來看一下數據。

  • since the updated criteria for the diagnosis has gone to just a lung scan

    由於最新的確診標準加入了肺部掃描及臨床診斷,

  • and a clinical history consistent with coronavirus 64,000 436 total deaths 1383

    確診64436人,死亡1383人,

  • total recovered is six thousand eight hundred eighty six about five times the

    而康復人數是死亡人數的5倍,有6886人。

  • total deaths is the total recovered let's take a look at the world of meter

    再看一下其他國家的數據,

  • and we can see here total cases outside of China have kind of remained constant

    中國以外感染人數維持上升,

  • because there hasn't been that redefinition causing a slew of new cases

    這是因為他們沒有像中國一樣修改診斷方式

  • let's take a look at see what's going on inside China or total cases overall if

    我們再看一下中國內部的情況

  • we look down here at new cases there's been a dramatic drop in the number of

    新增病例數,這個位置可以看到一個顯著的下降

  • new cases probably because there was a number of cases that were reclassified

    因為很多病例被重新分類。

  • we'll have to watch this and see how things go now remember what we're

    這方面有待後續關注。

  • talking about these total cases is based on the number of people presenting to

    請留意我們正在談論的這些數字只是基於就醫的人數

  • hospitals that can get work done on them based on some reports that we've been

    從某些報導中,

  • seeing especially out in New York Times there's been a crackdown and a rounding

    特別是從紐約時報,我們可以得知

  • up of people and holding them in quarantine and not getting the medical

    中國政府采取封城,和集中隔離的措施,仍有人沒有得到所需治療,

  • treatment that they need some people of course too scared to go and not wanting

    有些人太過害怕而沒有去醫院,諱疾忌醫,

  • to get treatment and so it's unclear exactly how many people are not being

    因此,我們還不清楚到底有多少感染的人仍未被發現。

  • counted here but it's apparent that this is still being under counted in terms of

    而死亡總人數是明顯被低估的。

  • total deaths there has been a jump and that doesn't seem to be cooling off

    單日死亡個案有下降的趨勢,

  • anytime soon unfortunately

    但不幸地,這不代表拐點已經出現。

  • for the same reason why the total number of cases may be underestimated the total

    由於同樣的原因,總确診人數

  • deaths may be underestimated as well on the worldA meter latest updates for

    和總死亡人數可能都被低估了。

  • February 14 we see that there's a report from Hebei province for yesterday that

    據2月14日,湖北省發布的疫情報告

  • there was four thousand eight hundred and twenty three new cases including

    新增病例4823人,

  • three thousand and ninety five that were clinically diagnosed we can see here

    包括3095例臨床确診

  • that the testing was just kind of under estimating those chronically a hundred

    我們可以看到,DNA測試長期低估感染人數

  • and sixteen new deaths and eight clinically diagnosed so we can see that

    新增死亡116例,確診8例。

  • the clinical diagnosis addition to the count is greatly influencing the number

    臨床确診人數的增加,大大影響了新增病例數目,

  • of new cases whereas it's not affecting the number of deaths as much total human

    卻沒有影響總死亡人數

  • of cases we can see here that five thousand three hundred and eighty four

    15384人臨床确診

  • were clinically diagnosed we talked about that what's interesting here is

    有趣的是

  • that thirty six thousand are currently hospitalized that's an incredible amount

    住院人數達36000人之多,

  • of people that are hospitalized and you can see here that seventy three percent

    其中73%

  • so the vast majority of them are in mild condition whereas eight thousand are in

    即大部分人癥狀較輕,8000人情況嚴重

  • serious condition and about four point six percent are in critical condition

    約4.6%屬於危殆

  • there's a number of people that are undergoing medical observation because

    有很多人正在接受醫學觀察,

  • of either their contact or other symptoms that they may have two new

    這些人要麼是密切接觸者,要麼是有相關癥狀的。

  • cases in Japan one of them being a surgeon at a hospital who developed a

    日本新增2個病例,其中一人是醫院外科醫生,他出現發熱癥狀,

  • fever and in still continue to work as usual and saw patients for three days so

    仍繼續接診病人達三日之久。

  • that's probably gonna have to be followed up on as well okay I want to

    此事有待跟進。

  • discuss three things today I want to talk about the New England Journal of

    我今日想討論三件事:

  • Medicine article that actually we referenced back at the end of January

    一是我們1月底曾引述過的來自新英格蘭醫學雜誌的一篇論文;

  • want to talk about cell phones in China and I also want to talk just briefly

    二是中國的手機;

  • about sleep and circadian rhythms and some more reading so first of all let's

    第三,我想略微談一下睡眠與生物鐘的關係。

  • talk about the New England Journal of Medicine so there was this article that

    首先是,關於新英格蘭醫學雜誌上的那篇論文

  • was published in the New England Journal talking about a visitor from Wuhan China

    文中講述一個來自中國武漢的訪客,去德國參加一個商務會議。

  • who visited in Germany for a business meeting and it was reported in the New

    據新英格蘭醫學雜誌所述,

  • England Journal of Medicine that this woman who came over was asymptomatic and

    這個女士當時沒有新冠肺炎的癥狀,

  • when she flew back to China she developed symptoms of fever and the

    她坐飛機回中國後,才出現發熱和新冠肺炎的癥狀,

  • symptoms of the corona virus had later tested positive and when they test heard

    爾後被确診。

  • her friends that were at the business meeting in Germany they had already

    與她同在德國開會的朋友做病毒測試時,

  • become sick and then got better and they tested

    已經發病并好轉,被确診

  • positive for coronavirus and it was touted at that time that this was

    當時就有消息稱

  • evidence that coronavirus could be spread even though the patients were

    那是新冠肺炎無癥狀傳播(隱形傳播)的證據

  • asymptomatic well as it turns out there's been a correction on this new in

    後來在新英格蘭醫學雜誌上又做了更正

  • Journal of Medicine case and we'll post a link in the description what they

    我們將在備註欄加上一個連結

  • found out was that before they printed they had not actually reached out to

    他們在付印前知道了這個情況,

  • this index case from China and discussed with her if she actually had symptoms

    他們至今仍未找出中國的原發病例,再看這個案例,如果該女士實際有病癥,

  • they reported that she was asymptomatic but in reality she actually was

    而報告說她是無癥狀,但事實上她是有癥狀的

  • symptomatic in fact she was taking medications to suppress a fever and was

    她吃藥控制發熱的癥狀,并且只有很輕微的病癥

  • having very mild symptoms but was having them nevertheless so what does this mean

    癥狀輕微也是有癥狀,這是什麼意思呢?

  • does this mean that coronavirus does not shed when the patient is asymptomatic no

    難道說患者沒有癥狀,新冠肺炎就會自我去除嗎?

  • there's still people that believe that and they may be correct all it means is

    仍有人堅持認為他們是正確的

  • that you can't use this New England Journal of Medicine case to support that

    我覺得不能用新英格蘭醫學雜誌這個案例來支持該理論

  • theory so I think that's an important distinction that needs to be made and it

    我認為有個界定需要釐清,

  • tells us that we've got to be careful in this world of rapid information that we

    而且這件事告訴我們,在資訊科技發達的時代,我們必須謹慎。

  • get it right before we spread the information because spreading false

    傳播資訊前要確保資訊正確

  • information can have consequences the other thing I want to mention with cell

    因為不實資訊會造成不良後果。第二,我想談一個手機的運用,

  • phones we will link to a article also in The New York Times about what they are

    關於這點,我們也會備註一條連結,

  • doing right now in China in terms of cell phone use of course in China they

    紐約時報上的一篇相關文章,

  • have three cell phone providers that are run by the government and wherever you

    中國有三家公營電信服務供應商

  • go of course that phone is GPS right so if you go to any particular province

    GPS定位正確的情況下,你去過哪個特定的省份

  • it's gonna keep track of that on the phone well what they've currently worked

    可以在手提電話上實時追蹤,操作方法是

  • out through these phone companies is if you text a particular number to them it

    電信公司輸入某個電話號碼

  • will show on the phone right in front of you exactly which provinces in China you

    就可以顯示出,在過去2個禮拜至一個月內,

  • have been in in the last two weeks one month however they want to do it and

    該用戶曾經到過中國的哪些省份。

  • they just list it and so what's going on now is people are coming in to various

    有一份列出了地點的清單。目前的情況是

  • places to various checkpoints the customs agents the military personnel

    從各地來,去往各地的人,經過檢查點時,維持秩序的海關關員或者軍人

  • who are enforcing these banned are actually asking people as they come

    會對他們進行核查,要求民眾在官方手帳上輸入自己的手機號碼,

  • off to text on their phone exactly this number and up there will pop where they

    然後手帳上就會彈出這些人過去一個月曾經到過的地點,

  • have been in the last month or so and of course if Luhan is on there or specific

    如果上面有武漢或者某些特定的省份,

  • province that Wuhan is in pops up there in some cases not letting them go and

    他們就不會被放行,

  • they're redirecting them so I thought I'd make you aware of that the last

    會被勸返。

  • thing I want to talk about real quickly is circadian rhythms now there's been a

    最後我想很快地講一下生物鐘。

  • lot of questions and what I'm really trying to do is balance how much we talk

    問題很多,但我儘量做個平衡,

  • about the virus and how much we talked about sleep and this is the reason why

    病毒和睡眠我都想討論一下

  • I'm really gung-ho here about sleep number one is according to the studies

    我為什麼要談睡眠呢?

  • that we've talked about in our last updates you can prevent getting the cold

    原因一,據我們上一集所談的研究表明,

  • with sleeping appropriately up to five times imagine if I could tell you that

    適當的睡眠能有效防止感冒達5倍之多。試想一下,

  • if you took this pill you could reduce the chances of you

    如果我跟你說,你只要這麼做,感染冠狀病毒的機率,

  • getting the corona virus by 80% that would be an amazing way of curtailing

    可以減少8成。這個方法有效的話,

  • the arnott's or the spread factor of corona virus and that's what we're

    我想用它來說服別人不要吃餅乾,或者用來遏止冠狀病毒的傳播。

  • seeing not necessarily the corona virus but in

    我們覺得對睡眠并不能預防冠狀病毒,

  • Rhino virus and so I think this is actually significant enough in a

    預防鼻病毒還差不多。

  • discussion of what we can do practically so in that vein of things there's been a

    這個討論很詳細地說明了我們應該怎麼做。

  • lot of comments specifically about some things that I wanted to talk about shift

    有很多評論都是關於我接下來要講的:

  • workers circadian rhythm lights and insomnia first of all shift workers I

    輪班工作者,生物鐘,光與睡眠障礙。首先是辦班工作者

  • know there's a lot of health care workers that work night shift so that's

    我知道很多醫務工作者要上夜班

  • like going in at 7 p.m. and getting home at 7 a.m. or 6 p.m. to 6 a.m. etc here's

    晚上七點到班,翌日早上七點回到家;或者是晚上六點到翌日早上六點,等等

  • the key about shift workers if you're gonna do shift work it's better to

    對輪班工作者來說,最好是長期做固定的輪班工作,

  • always do shift work and not go back between day and night that's number one

    而不要回復日作夜休模式,這是第一

  • so stay at same shifts the reason why this is important is because of the

    維持固定的輪班很重要,

  • second thing we're going to talk about and that is your circadian rhythm if you

    這涉及到我們將在第二點討論的生物鐘

  • don't do that you confuse your body circadian rhythm

    因為不這樣做的話,生物鐘就要紊亂

  • number two is make sure that your nights are days and that your days are nights

    第二點是確保夜即日,日即夜

  • in other words if you're going to be up at night make sure that it is bright

    換句話說,如果你晚上不睡覺,

  • where you work at night it's also very helpful sometimes to take naps when

    就要確保你工作的環境里的燈光是明亮的,有時,小息是很有用的,

  • you're working if your job allows for that even a 15 to 20

    如果你的工作情況允許的話,

  • Neb can be very restful number three if you're a shift worker and you get home

    即便只有15-20分鐘的小息也能令人感到放鬆

  • make sure you go to sleep right away as soon as you get home don't go out

    回家後馬上睡覺,不要外出購物

  • shopping don't do the kids laundry don't go work outside go to sleep and make

    不要洗小孩衣物,不要帶工作回家,單純睡覺,

  • sure that the room is dark to make sure that the curtains are sealed make sure

    還要确保房間是黑暗的,窗簾拉好,

  • the window is sealed you are working different shift from what the rest of

    窗戶關好,你的上班模式跟別人不一樣

  • the world is doing but you still need your sleep

    但你也需要睡覺

  • and so what you need to do is get your circadian rhythm on a completely

    你所要做的就是讓你自身的生物鐘形成完全不一樣的循環

  • different cycle and that way you're gonna get your sleep the problem occurs

    那樣你便可以有足夠的睡眠

  • is when you want to be one way on the weekends and the other way during the

    而睡眠問題只會出現在換班前,不用上班的週末

  • week that doesn't work so number four continue your routine on the weekend I'm

    所以,在週末也要堅持這种作息。

  • gonna put a link into the American Academy of Sleep Medicine website that

    以下有一條網站連結,美國睡眠醫學學會

  • gives very very good tips on not only shift workers but people who have other

    針對輪班工作者以及其他有睡眠障礙的人士,

  • issues with their sleep so the other thing I want to talk about affects all

    作了一些建議。

  • of us is circadian rhythm and light so there's two cycles that have to be in

    另外我想談一下影響睡眠的其他因素:生物鐘和光。

  • perfect harmony in your body for you to get the great night's sleep number one

    兩者在人體內必須協調,人才能有良好的睡眠。

  • is the homeostatic and this is just a funny word that tells you basically as

    一是穩態,這個詞很有趣,

  • you are awake more and more and more you start to become increasingly more and

    它告訴你,醒的時間越長,就會感覺昏昏欲睡;

  • more and more sleepy as you sleep more and more you start to become more and

    而睡得越久,越會感覺精力充沛。

  • more and more rested it's just like eating and hunger the more you eat the

    這就好比進食及飢餓,吃得多就不覺得餓

  • less hungry you are the longer you go without eating the more hungry you are

    禁食越久就越餓

  • and that's pretty easy to understand but there is a bedtime that we have and

    這很容易理解。但我們有睡覺的時候,

  • there's a wake time that we have and so the other one is circadian and this is

    和清醒的時候。二是生物鐘。

  • what happens when you go on a jet plane and go to a different time zone and you

    當你坐飛機到一個不同時區的地方時,

  • get off there's a certain circadian rhythm that occurs and when both of

    下機後會有時差。

  • these are combined together the perfect thing happens is you are asleep until

    當以上兩者結合時,最完美的情況是,你會一覺睡到清晨,

  • the morning and then you wake up and then you are awake until the evening and

    然後醒著一直到晚上

  • then you go to sleep and what makes you go to sleep all of a sudden which makes

    然後你又可以繼續睡覺。

  • you get tired around ten o'clock normally or 11 o'clock normally is the

    是什麼令你在9-10點鐘就突然想睡覺呢?

  • combination of the drive to go to sleep and the drive to stay awake finally goes

    來自以上兩者的結合,

  • away and both of those combined for you to go to sleep the

    是驅使你睡覺和醒來的動力

  • is that the circadian rhythm can be shifted either to the left advanced or

    但問題是,生物鐘的節奏是可以改變的。

  • to the right delayed and what is it that can shift

    既可以提前,也可以延遲。是什麼改變了生物鐘節奏呢?

  • circadian rhythm it's light and this is the thing that is the bane of our

    答案是光——我們人類的生存之源。

  • existence as people who look at electronic equipment whether it's coming

    當人們看著電子光源時,

  • from a TV screen a cell phone whether it's coming from the lights in our house

    無論是來息電視螢幕,手機,還是房屋里的燈光

  • all of those things at that time of the night when we should be going to bed

    在晚上我們需要上床睡覺時,所有這些光

  • especially blue light is going to delay your circadian rhythm so that you become

    會延遲生物鐘,尤其是藍光。

  • tired later and later and later and so what happens is you stay up later and

    人會越來越晚睡,然後早上越來越遲才起床。

  • later and later and you don't feel tired until later and later and later but you

    然後直到很晚才覺得累,

  • still have to get up in the morning to beat the traffic to get into work which

    但是還要一早起床出發,以避免交通擁堵,

  • starts at 8:00 or 9:00 or whatever it starts and so that squeezes the amount

    準時在8點或9點趕到上班地點。

  • of time that you have to go to bed and to get the sleep so by eliminating light

    所以,既要消除晚上的

  • at night the light that causes this delay in your circadian rhythm is

    那些會延遲生物鐘節奏的光,

  • particularly from blue light but bright light exposure at the beginning of your

    尤其是藍光,還要在一日之始,將自己暴露在明光下