Due to the relief of the new coronavirus pneumonia epidemic, countries such as Europe and the United States have begun to unblock them one after another, but the number of infections is expected to rise again after unblocking. Professor Liang Zhuowei, Dean of the Faculty of Medicine of the University of Hong Kong, a member of the China-WHO Joint Expert Investigation Team, a member of the Hospital Authority, and a public health medical expert, received a video interview with the “Mirror News” on 26 June, and Dr. Zhou Bozhan, the host and Consultant of the “Mirror”, said on the global situation of the new coronavirus pneumonia epidemic that the SAR government's containment strategy against the epidemic is effective and well done, but the people of Hong Kong must not relax in the prevention of the epidemic and let the hard-won results fall short.

Professor Liang Zhuowei and Dr. Zhou Bozhan

Zhou Bozhan: Welcome everyone to watch "Mirror News". The new coronavirus pneumonia ravages the world. The number of infections worldwide is now close to 10 million, and the death toll has reached 500,000. Everyone is very concerned about the development of the epidemic. Today I am very happy to invite the "expert among experts", that is, the authority. Professor Liang Zhuowei is Dean of the Faculty of Medicine of the University of Hong Kong, an epidemiologist, the SAR government, the country, and World Health Organization have invited him to serve as a Consultant on the epidemic, so his remarks are authoritative. The new coronavirus pneumonia virus is the most poisonous virus in human history. It has the longest survival time on the surface of plastic and stainless steel, and can survive for up to two years on the surface of refrigerated plastic bags. It is very easy to be infected and can be spread through droplets, air, and blood. After being touched, it can enter the body through the eyes, mouth and nose. Not immediately attacking the body at first, this is the most "slick". The virus can be carried around by super spreaders. The first thing that new coronavirus pneumonia hurts is the human lungs (so called new coronavirus pneumonia). Eyes and kidneys may also be directly fatal due to virus attack. In contrast, the latest confirmed number of people in Hong Kong exceeds 1,100, but the death rate is only 0.5%, which is far lower than the 5% death rate in the United States.

There is no specific medicine for new coronavirus pneumonia. The vaccine has entered clinical trials. We hope that with the coming of summer, the new coronavirus pneumonia virus can die as easily as other viruses. Now after the summer solstice, the epidemic situation is still serious all over the world. There are 37,000 new confirmed cases in the United States in the northern hemisphere. Gabriel, would you please tell us what virus is this?

See the true chapter in autumn and winter

Liang Zhuowei: New coronavirus pneumonia is not the most virulent and spreading disease in history. The 1918-1919 pandemic (H1N1) is the new virus that has affected most people and countries so far. Anyone who pays attention to the news knows that no matter where problems occur in the world, the world will be profoundly affected. But what is more difficult to grasp is the obvious differences in the handling methods of different localities and governments: East Asia, South Asia, Europe, North America, and South America have very different handling methods. Especially in recent months the difference has been greater. Now the epidemic in Hong Kong has subsided, but don't take it lightly and be complacent, because the true chapter is only seen in autumn and winter. The world's epidemic situation is still climbing to its peak. The most severely affected countries in the United States, South America, South Asia, Africa, and Europe rebounded again because Europe proposed to restart economic activities when the first wave of the epidemic slowed down, and the number of infections rose again. It is foreseeable that the whole world has not been able to do a good job of disease control in the first wave. I hope that countries in the world can ease the situation as soon as the Hong Kong epidemic.

The world's epidemic situation is still climbing to a peak. The most severely affected countries in the United States, South America, South Asia, Africa, and Europe have rebounded again.

Where did the virus come from

Zhou Bozhan: I just mentioned the current situation of the epidemic. From 1918-1919, the number of infections reached 500 million, and the death toll was 50 million. Today's new crown pneumonia epidemic has not yet seen its end.

Where did the virus come from?

The South China Seafood Market in Wuhan, which is said to be the source of the virus, also refers to bats. It also refers to the 2019 seasonal influenza in the United States that has caused a large number of human infections. It also refers to the first confirmed patient in Italy in the first confirmed country in Europe. Imported from Japan, the new crown virus has been detected in water samples from northern Italian cities in early December 2019. It is also said that more than 1,000 confirmed cases in the UK were imported from Europe.

The epidemic situation in the world is still climbing to a peak. The United States, South America, South Asia, Africa and Europe have rebounded again.

Where did the virus come from

Zhou Bozhan: I just mentioned the current situation of the epidemic. In 1918-1919, the number of infections reached 500 million, and the number of deaths was 50 million. Today's new crown pneumonia epidemic has not yet seen its end. Where did the virus come from? The source of the virus is said to be the South China Seafood Market in Wuhan, and it is also said that it originated from bats. It is also pointed out that the seasonal flu in the United States in 2019 has caused a large number of human infections. It is also said that the first confirmed patient in Italy, the first confirmed country in Europe, was imported from Hawaii or Japan. The new crown virus has been detected in water samples of northern Italian cities in early December 2019. It is also said that more than 1,000 confirmed cases in the UK were imported from Europe. Do you think the new coronavirus pneumonia virus is transmitted from wild animals to humans, or is it a human-made germ warfare?

Liang Zhuowei: This is still a big question mark. We use mathematical and statistical models to analyze many gene sequencing data. The results obtained by top experts around the world do not seem to show that the new coronavirus pneumonia virus is man-made. Many people have realized that many types of mammals naturally carry coronaviruses. Bats do not directly transmit the virus to humans, and there must be an "intermediate animal or host" in it to transmit the virus to humans. The SARS epidemic originated in the Guangdong Wildlife Trading Market. Civet cats are only the intermediate host of SARS disease, while bats are the host. Middle East Respiratory Syndrome is transmitted by camels. Recently, the University of Hong Kong published a paper on pangolins smuggled from Southeast Asia intercepted in Guangdong and Guangxi, and found that the similarity to the new coronavirus is about 90%, which clearly shows that pangolins are potential intermediate hosts of the new coronavirus. But how is it transmitted from bats to humans? It is still unknown. The new coronavirus was first discovered in environmental samples from Wuhan South China Seafood Market, and recently the new coronavirus was discovered again in environmental samples from Beijing Xinfadi Agricultural Products Wholesale Market. It is believed that these environments may not be the original explosion point, but only evolved into the place where cluster infections occur. Because it is difficult for the vegetable market to avoid the introduction of viruses, it is easy to cause transmission. In the early days, we and the National Centers for Disease Control and Prevention (CDC) published the first epidemiological research report at the end of January. The first five cases in the South China seafood market were not the point of an outbreak, and the source of the outbreak has not yet been found.

Zhou Bozhan: Beijing Xinfadi Wholesale Market has detected the new coronavirus from the cutting boards of imported salmon. It is said that the virus came from Europe. What do you think?

Liang Zhuowei: It is difficult to conclude because I don't have first-hand information. In addition, it is very likely to cause cross-infection in such a large market. Because even if a certain place, a certain type of food, or the cutting boards of certain employees' stalls, food, or oneself carry the virus, it cannot be said to be the source. When we do epidemiology, we must sample and generalize, and try to be as unbiased as possible. So it depends on whether the number of plates is sufficient, and it depends on scientific data analysis. Therefore, it is hard to say that the virus from salmon came from Europe. I personally think that only by collecting more evidence and collecting more data on people and environmental samples can we make a conclusion.

Zhou Bozhan: It seems that this place has broken out again, and that place has broken out again. Could it be that there is no Ground Zero or Patient Zero, but it is actually multiple outbreaks?

Liang Zhuowei: It is possible in several places, but the chance is not great. Unless the host or animal makes the move from animal to human at the same time, this does not happen often. It may happen in the same city or village, but it is difficult to happen in different countries at the same time. Therefore, we need to find history to prevent the next time there is a way to skip the human and animal gap.

While protecting people's health, we must also focus on the economy

Zhou Bozhan: We talked about the current situation, the past, and what will happen in the future? I once listened to your lecture and talked about the pull of the three forces, which is very profound. The epidemic not only affects the health of citizens, but also affects the economy and people's livelihood. The blockade order has even caused a great psychological impact on people. Now as the epidemic eases and the gathering restrictions are relaxed, many citizens are beginning to come out. How do you think the three forces should be balanced to relax future measures?

Liang Zhuowei: You mentioned a three-sided tug of war. I use tug of war as an analogy. Because the tension of tug-of-war is very high, tug-of-war consumes a lot of strength, and occasionally loses inadvertently. The most interesting thing about tug-of-war is that the two to three are evenly matched. The mystery of our fight against the epidemic lies in this. We must not only protect people's health, but also prevent the medical system from collapsing. Protecting health is the biggest responsibility of the Health Protection Center, and this is the first force. We have seen the world economy step into recession. The economic recession is not only a decrease in citizens' income, but also a lack of employment. Underemployment is a big problem, and it affects young people even more. For this reason, we must pay equal attention to the economy and employment. Because of employment and economic problems, it will also affect the health of citizens.

The economy and employment must be equally concerned, because employment and economic issues will also affect the health of the people.

Zhou Bozhan: I have seen an analysis report by a British economist that the blockade will make the economy sink and cause more people to become poorer. Poverty will also affect people’s health and even their lives, which will cause more deaths than open measures.

Liang Zhuowei: This is not surprising, it depends on the balance of many parties. The new coronavirus epidemic has made the global economy "exacerbated". Fortunately, Hong Kong has sufficient fiscal reserves to help the people "bail out". But some places have fallen into more severe recessions.

Zhou Bozhan: Please talk about the "Buddha immunization" measures in Britain and Sweden.

Liang Zhuowei: The death rate of new coronavirus pneumonia in Sweden is several times higher than that of neighboring countries. Because Sweden has not implemented blockade measures like the neighboring countries Finland, Norway, and Denmark, they hope that more young people with no health risks will be infected first, so that the whole society will gradually realize "herd immunity". This is actually dangerous.

Zhou Bozhan: Regarding the policy of abandoning the treatment of the elderly and the weak in the United States, some people use the theory of "evolution" to explain this move-survival of the fittest, what do you think?

Liang Zhuowei: Looking back at the evolutionary theory of social sciences in the twentieth century, the two world wars fought against each other. If people do not learn from history, but instead use the new coronavirus pneumonia pandemic to integrate into the evolutionary theory of social sciences, this is against morality and ethics, and this should not be done by any government. Because the elderly are susceptible to infection by the new coronavirus and have a high mortality rate. They have toiled all their lives, letting their descendants today enjoy a peaceful life. They have made great contributions, but today they may have lost the ability to protect themselves. It is absolutely inevitable for national leaders to "think" and "do" to give up the treatment of the elderly and the weak.

Social conventions require citizens to cooperate

Zhou Bozhan: The first force is to protect the health of the people. The second force is to focus on the economy. Tell me about the third kind?

Liang Zhuowei: No matter what system it exercises, any country must obtain the approval and acquiescence of the citizens of the society in order to achieve politics go well, people are happy. Regarding any public health measures introduced by the government, whether it is a gathering order, customs closure, or testing, if the local people do not support and approve of it, and resist implementation, the government will not be able to implement it. The social contract between the government and the people is not a form of signing a contract. It is a form of acquiescence and acceptance, so the government must be careful about what measures the local people are willing to accept and cooperate. Another indicator is the group's mental health. Students have not been able to attend classes for many years because of the new crown epidemic. They must know that school is not just a place to impart knowledge, it is also a place to train students to build a social life. Therefore, even if teachers teach knowledge online, they cannot cultivate students' social life. Similarly, going to work is also a social life. Because of the continuation of the new coronavirus pneumonia epidemic, nursing homes for the elderly are not allowed to visit. This brings trauma to the elders and their families, and the suffering in them is not worth talking to outsiders.

Zhou Bozhan: Generally speaking, the first force is to protect the health of the people, the second force is to focus on the economy, and the third force is the social convention. I believe that the Chinese people are willing to cooperate with the government to implement it, but the culture of foreign countries is completely different. Foreigners advocating freedom. Half a year has passed this year, and there is still no sign of relaxation.

How to protect

Liang Zhuowei: Some people now say that half of the people in the world must have the ability to protect if the epidemic is to subside. How to have the ability to protect can be divided into two aspects: first, vaccines and herd immunity both produce antibodies for protection; second, the development of new coronavirus vaccines. I am confident that the disease will be developed, but as for what can be prevented whether the virus can create lifelong immunity is still unknown. Because not all vaccines in the world can be immunized for life, for example, BCG vaccination can produce resistance to tuberculosis after injection of BCG, but the prevention effect against primary infection of tuberculosis is not good, so BCG vaccination is the best The main effect is to avoid serious complications such as tuberculous meningitis. Some vaccines, such as flu and tetanus injections, also need to be vaccinated regularly. The third is whether the global production can supply 7-8 billion people, if the higher prices get it, it is against the principle of fairness, especially now that the black human rights issue has become a problem in the United States, Europe, and even the world. In addition to the principle of fairness, we have to predict whether there will be so many people going to give injections to the general public. The annual seasonal flu vaccine in Hong Kong is a very large event. How to provide enough vaccines for 7.5 million people under safe conditions? There are 60,000 doctors and nurses in Hong Kong, that is, one person has to vaccinate 100 citizens. It involves a huge number of people, so how to do the equipment and process will be a big challenge.

Liang Zhuowei: Some people now say that half of the people in the world must have the ability to protect if the epidemic is to subside. How to have the protective ability can be divided into two aspects: first, vaccines and herd immunity both produce antibodies to play a protective role; second, the development of new coronavirus vaccines. I am confident that the disease will be developed, but as to what virus can be prevented, whether it can create lifelong immunity is still unknown. Because not all vaccines in the world can be immunized for life, such as BCG vaccination (BCG). After injection of BCG vaccine, resistance to tuberculosis can be produced, but the preventive effect on primary infection of tuberculosis is not good. Therefore, the main effect of BCG vaccination is to avoid serious complications such as tuberculous meningitis. Some vaccines, such as flu and tetanus injections, also need to be vaccinated regularly. The third is whether the global production capacity can supply 7-8 billion people. If the higher price gets it, it is against the principle of fairness. Especially now that the black human rights issue has become an issue of the United States, Europe, and even the whole world. In addition to the principle of fairness, we have to predict whether there will be so many people going to give injections to the general public. The annual seasonal flu vaccine in Hong Kong is a very large event. How to provide enough vaccines for 7.5 million people under safe conditions. There are 60,000 doctors and nurses in Hong Kong, that is, one person has to vaccinate 100 citizens. This involves huge manpower, so how to do the equipment and process will be a big challenge.

Whether the new coronavirus vaccine can create life-long immunity in the future is still unknown.

Zhou Bozhan: It sounds like an impossible thing that vaccination for 7 billion people. Are we still unable to see the "tail"?

Liang Zhuowei: The "tail" will come. It is expected that more vaccines will be available in the market next summer. Now there are still a few months before next year, that is, more people will be infected and immune. But Hong Kong people should not be complacent. Although we did a good job in the first wave of the epidemic, relatively speaking, that is, the entire population has no immune antibodies. Compared with New York and London, one in eight people has antibodies, and our risk of contracting the epidemic will be higher high.

Wash hands frequently and gather less

Zhou Bozhan: Before the development of a vaccine, if people don't want to be infected, should they wear masks, blindfolds, go out and party less? Please give people "tips".

Liang Zhuowei: Hong Kong people have been close to all people wearing masks since the beginning of February. Wearing a mask is a must, but not a panacea. There were several clusters of confirmed cases in Hong Kong in February and March. Recently, the infected persons in Lek Yuen Village and Lei Muk Shue Village also showed the emergence of invisible transmission chains, so citizens should not take it lightly. Although the SAR government has further relaxed the restrictions on gatherings, everyone must be vigilant, especially hand hygiene is very important. Wash your hands frequently, bring your own alcohol handrub, and do not touch your eyes, nose and mouth with your hands to avoid virus infection. In addition, I hope everyone will only gather with individual families during this period, so that you can protect yourself and others. Even if people are unfortunately infected, they will not be widely involved. The summer vacation is approaching, and many Hong Kong citizens think of other places to relax, but the world is still implementing "customs closure" measures. However, it is believed that as the epidemic eases, the "closure" measures will be gradually relaxed. I think there is nothing wrong with having official duties. If you want to go out to play, you must take adequate measures. It is safer to take a long-term perspective.

The SAR government has further relaxed the restrictions on gatherings, but everyone must also be vigilant.

Zhou Bozhan: Finally, what is your message to the public?

Liang Zhuowei: I hope all citizens can bite their teeth and cross together. This is not only a difficulty for Hong Kong, but also a difficulty for the whole world. The new coronavirus is unprecedented in a century. So everyone must work hard to prevent and fight the epidemic. I wish everyone mind and body peaceful, healthy!

I hope everyone will not relax before the vaccine is developed.

(Reproduced from "Mirror News")