拐点到了吗？中药有效吗？为什么下水道这么重要？钟南山发声了！
“峰值”不等于“拐点”
2月17日下午，广州医科大学附属第一医院副院长张挪富带领广东医疗队，在武汉协和医院西院区通过网络平台与中国工程院院士钟南山进行视频会诊。
期间，钟南山介绍，其团队建立的数学模型将国家强有力干预措施和春节后务工人员返程高峰两个变量纳入考量，这两个变量将改变疾病的自然发展规律。根据该模型预计，2月中下旬全国病例数将达到峰值，但并不意味着达到峰值后马上下降。
“目前是否已经达到峰值还不确定，还需要再观察几天。” 钟南山说，峰值不等于“拐点”，疫情还有可能随着务工人员返程再次出现新的高峰。
不过他补充，主要大中城市都采取了强有力的措施做好出入人员的检查，因此返程带来新的疫情高峰的可能性不大。
The possibility of a spike in new coronavirus cases caused by people returning to big cities after the extended Spring Festival holiday is unlikely, said Chinese respiratory expert Zhong Nanshan on Monday.
Zhong said that strong measures taken in major large and medium-sized cities are effective in epidemic prevention and control.
According to a mathematical model built by Zhong’s team, the outbreak is expected to reach its peak in mid-late February, but that doesn't mean an immediate fall afterwards. "It is uncertain if the outbreak has reached its peak, we need a few more days of observation," said Zhong.
18日，广东省人民政府新闻办公室召开疫情防控新闻发布会，钟南山院士出席，针对新冠肺炎的治疗、疫情防控等问题进行了回答。
保持下水道通畅极为重要
钟南山在会上两次提醒，防范新冠肺炎，保持下水道通畅极为重要！
Zhong warned the public to keep their waste pipes unobstructed as the novel coronavirus may spread through drainage systems.
此前，包括钟南山的团队在内的两个团队已经在粪便里发现新冠病毒，引发人们对于粪口传播的担忧。
Two separate research groups, one of which was led by Zhong, announced last week they had isolated novel coronavirus strains from samples of infected patients' feces, triggering suspicion of fecal-oral transmission.
但钟南山表示，新冠病毒并不一定通过消化道传播感染，而是因为下水道中污染物干了，又通过空气、气溶胶传播，人们吸入造成感染。这是最合理的解释。
"If a waste pipe is blocked, the contaminated air, or the aerosol carrying the novel coronavirus, may cause infection," Zhong said. "I don't think the virus was ingested but inhaled by people," he said, adding that hospitals should also pay attention to drainage pipes.
前不久，香港有一栋楼宇，上下楼层住户相继确诊新冠肺炎，引发关注。钟南山说，要吸取2003年SARS期间香港淘大花园的教训，当时一个小区就有300多人感染。
He said a similar case happened in 2003, when over 300 people were infected with SARS in a Hong Kong residential community due to the defective design of its sewage system that caused the spread of the virus.
武汉还没有停止人传人
钟南山表示，全国确诊病例已出现下降趋势，但武汉仍是关键，现在全国80%新冠肺炎患者在武汉，95%以上死亡患者也在武汉或周围，因为武汉还没有停止人传人。
Eighty percent of COVID-19 patients and 95 percent of the deaths are in Wuhan, Zhong said, noting that Wuhan is still the key to the battle against the epidemic, as the confirmed cases outside Hubei province have been declining.
Zhong also said person-to-person transmission of the novel coronavirus is still happening in Wuhan, the epicenter of the epidemic.
现在迫切需要解决两个问题，一是正常人和患者分开，二是新冠肺炎病人和流感病人分开。如果混在一起，用了很大的人力财力，这个问题仍然不能解决。
He stressed the importance for Wuhan to distinguish health people from infected patients, and also to distinguish COVID-19 infection from common flu. "Virus transmission between people is unlikely to be halted if these different groups remain together," Zhong said.
血浆治疗对重症患者有效
针对康复病人血浆治疗方法(plasma therapy)，钟南山表示，现在数据太少，还显示不出统计学的意义。在武汉现在做了10例，6例经过用药以后，两三天病毒血症消失了，病人临床情况有些改善。
钟南山表示，到目前为止，血浆治疗是比较老的办法，我认为是一个很有效的方法，特别是对重症病人。垂危的病人就差一些，因为他不单纯是病毒感染。
The renowned Chinese respiratory scientist also added that plasma therapy is a stable and safe method that has so far been found effective in treating the novel coronavirus patients, especially for those in severe condition.
Ten coronavirus patients in Wuhan have received the treatment so far, six of whom have shown signs of their symptoms easing.
肯定中药作用
钟南山表示，就西药来说，在实验室发现的细胞水平对新型冠状病毒有效，真正进入人体有个过程，有相当多的西药体外有效，进到人体没效。
但中药不太一样，一些药在临床已经很常用。如果这些中药真的显示了减少病毒进入细胞或减少炎症，这样就能够给中药使用提供依据和线索。一旦有证据，中药是可以放心用的。特别是针对一些早中期患者。
"For Western medicine, there is a process before it works in human body even with proven effectiveness in lab," said Zhong. "Quite a few Western drugs are found to be effective in vitro, but not in the human body."
The case is different with TCM (Traditional Chinese medicine). Some TCMs have already been commonly used in clinic. Further tests in lab and animals can provide evidence and clues for their use.
"Once there is evidence, TCM can be used securely, especially for those early and mid-term patients," said Zhong.
磷酸氯喹还够不上特效药，但值得探讨
钟南山介绍，磷酸氯喹(Chloroquine phosphate)还够不上特效药，但是它是非常值得探讨的药。面对新的东西，往往实践先于科研，摸着石头过河。已有的比利时、美国的研究表明，磷酸氯喹对冠状病毒是有效的，这次是真正用在人体。磷酸氯喹是老药。短期使用来看，没有太大的副作用。相当一部分患者，能够在一段时间内使得病毒转为阴性。和其他药物对比，发热症状消失，副作用不是很大。个别会出现腹泻，很个别会出现耳鸣，停药后就会停止。目前正在开展较大（范围）的临床观察，要进行用药和不用药的比较。
Zhong told reporters work and research are speeding up on medicines to treat this new virus and a drug called Chloroquine phosphate has shown good clinical efficacy.
"Chloroquine is not really a kind of medicine with a special effect, but it is worthy of study," Zhong said.
尸体解剖目前非常重要
钟南山表示，17年前的SARS，也是通过尸体解剖（post-mortem examinations）了解除了肺部之外，全身脏器受损的影响情况。通过尸体解剖，这次新冠肺炎患者肺部的表现，和SARS有点不一样，没有严重纤维化，肺泡还存在，但是炎症很厉害，还有大量的粘液，非常黏，这将导致病人的通气不通顺。解剖可以帮助我们认识病人的特点，在帮助他们通气上改变一些方式。
据报道，2月16日凌晨3时许，在国家法律政策允许下，并在征得患者家属同意后，全国第1例新冠肺炎逝世患者的遗体解剖工作在武汉金银潭医院完成，并成功拿到新冠肺炎病理。在同一日18点45分，全国第2例新冠肺炎逝世患者的遗体解剖工作也在金银潭医院顺利完成，这两具解剖病理目前已被送检。
由解剖获得的新冠肺炎病理，对于探索新冠肺炎患者临床的病理改变、疾病机制等有重大帮助，并能从根本上寻找新冠肺炎的致病性、致死性，给未来临床治疗危重症患者提供依据。
The dissections of the bodies of the first and second patients who died of the novel coronavirus in China were completed at Wuhan Jinyintan Hospital last Sunday. The move was made subject to the national laws and policies and came after their families granted permission. By obtaining their pathological organs, further studies can be made and aid clinical treatment.
综合来源：央视新闻 中国日报 CGTN 人民日报 中国日报双语新闻
