美国新冠病例数量再次增长,达到自去年冬季晚些时候以来的最高水平。
随着高度变异的新型新冠变异株“Pirola”BA.2.86引起所有人的关注,再加上呼吸道病毒高发季节即将来临,现在是否应该开始恢复戴口罩?
许多专家认为,自从2020年新冠病毒开始广泛传播以来,在任何时候戴口罩都是可取的,尽管这种观点在政治上并不受欢迎也不好玩。虽然并非在所有情况下都需要戴口罩(比如户外),但尤其是在某些情况下,你绝对有必要戴上口罩。
美国公共卫生协会(American Public Health Association)执行主任乔治·本杰明博士对《财富》杂志表示:“戴口罩依旧是降低感染新冠风险的有效工具。
如果有人面临高风险,计划参加有大量人聚集的室内活动,或者身边人的健康状况导致他们面临较高风险,在当前新冠病例增多的时期,这些人戴口罩获得的好处最大。”
约翰斯·霍普金斯卫生安全中心(Johns Hopkins Center for Health Security)传染病专家和高级学者阿梅什·阿达尔佳对《财富》杂志表示,新冠重症风险较高的人群“在人员密集的室内环境下应该始终考虑配戴口罩”。
他表示:“如果人们的症状符合新冠的表现,在计划与重症风险更高的人会面时,也应该保持警惕。”他还表示,这条建议“始终适用,而不是只适用于现在的情况”。
要不要戴口罩?听听专家们怎么说
斯图尔特·雷博士认同本杰明的观点。他是约翰斯·霍普金斯大学医学系数据完整性与分析专业的医学副主任。
他表示,在戴口罩这个问题上,需要考虑许多因素,包括:
• 社区传播:新冠在你所在地区的流行情况如何?向本地和/或州公共卫生部了解具体情况。如果本地的新冠疫情处于中等或较高水平,戴口罩或许是好主意。
• 个人免疫力:对新冠的抗体免疫力,即防止感染的能力,通常会在三至六个月后减弱。问题是免疫力并非万无一失。对于所有其他流行变异株,并非所有新冠毒株都能让人体获得相同程度的保护力。而且也无法保证新出现的变异株会按照我们习惯的规则流行。如果你在过去几个月内未接种加强针疫苗,也没有被感染,最好戴上口罩。
• 你的日程安排:你是否要参加大规模活动,例如不能因病缺席的演示?你是否计划参加婚礼、会议或音乐会等大型活动?你是否计划前往购物中心、电影院或机场等人员密集的场所?你是否计划与高风险家庭成员见面?如果以上问题的答案是肯定的,你最好在活动前和/或活动期间戴上口罩,以保护自己和/或其他人。
• 你的风险程度:是否有糖尿病、肥胖症、高龄或免疫状况等因素,会导致你因新冠住院或死亡的风险更高?如果答案是肯定的,你应该更谨慎地戴上口罩。
雷表示:“对我而言,在乘坐公共交通和人员高度密集的场合配戴口罩,是简单和明智的决定。”
另外一个应该戴口罩的场合是医院。安大略省圭尔夫大学(University of Guelph)生物学教授瑞恩·格里高利对《财富》杂志表示,在医疗环境中永远不应该取消配戴口罩的强制规定。自从世界卫生组织(WHO)停止用新希腊字母命名新冠变异株以来,他一直在用“街道名称”命名高度流行的变异株。
他还建议进一步推广呼吸机和空气过滤设备,保持良好通风和避免大量人群聚集,无论你遭遇任何变异株,无论新冠病毒出现任何不可思议的新变化,这些减缓措施都能发挥作用。
学会明智地与病毒共存
多年来,公共卫生官员一直强调人类社会需要学会与新冠病毒共存。但纽约理工学院(New York Institute of Technology)阿肯色州琼斯伯勒分校的助理研究主任和副教授、著名新冠病毒变异株跟踪研究员拉吉·拉吉纳拉亚纳对《财富》杂志表示,要求人们与病毒共存,应该发布指导原则,告诉人们根据社区传播水平确定什么时候戴口罩。
拉吉纳拉亚纳表示:“我们没有前瞻性的非药理学方法。我们总是在被动响应。”
可惜,美国疾病预防控制中心(U.S. Centers for Disease Control and Prevention)不再提供说明社区传播程度的地图。(不过这份地图一直不准确,它代表的是一个地区的医院床位可用性,并不能体现病毒活动状况。)虽然该部门确实提供了一份地图,显示美国各地新冠检测呈阳性的比例,但由于近期新冠检测数量处于史上最低水平,因此这些数字可能并不真实。(这意味着实际情况可能更加糟糕。)
截至周二,这份地图显示在美国10个地区中,有7个地区的阳性率达到10%至14.9%,这些地区以黄色表示。在美国中南部地区,包括德克萨斯州,情况更严重,检测阳性率高达15%至19%,这些地区以橘色表示。美国东南部地两个地区的阳性率水平可以接受,只有5%至9.9%,以绿色表示。需要说明的是,世界卫生组织在2020年首轮封锁之后,曾建议社区的检测阳性率为5%或更低时,才可以考虑重新开放。
拉吉纳拉亚纳表示,在室内依旧应该戴口罩,尤其是医院、机场、飞机和其他公共交通工具内。
近期的一项研究发现,受试者接触低水平或中等水平的病毒量时,其先前感染、接种疫苗或者这两者同时(即“混合”免疫力)带来的免疫力能够有效预防感染新冠,但在接触大量病毒时,免疫力变得无效(该项研究中,囚犯与患新冠的狱友生活在同一间牢房,导致其持续接触病毒)。格里高利指出,研究结果凸显出戴口罩的效果,甚至对接种过疫苗的人群依旧有效。
他说道:“重要的是减少吸入体内的病毒数量。”虽然理想情况下应该选择与面部贴合并且高品质的口罩,但“即使不完美的口罩也有价值”。
长新冠的威胁
专家表示,个人在决定是否配戴口罩时,应该将长新冠的持续威胁考虑在内。与普遍的观点不同,即使你首次感染新冠时没有出现症状,现在依旧有可能无法幸免。此外,不止在经历重症之后会患上长新冠,轻症过后患长新冠的可能性同样存在。
最近的研究显示,我们需要牢记与病毒后疾病有关的几个事实:
• 本月《自然医学》(Nature Medicine)杂志上发表的一篇论文证实,长新冠可能持续至少两年。
• 研究显示,感染新冠期间住院治疗的患者,在两年内死亡和住院的风险依旧“明显升高”。
• 研究人员发现,对于感染新冠期间未住院治疗的患者,在感染新冠后六个月死亡的风险,在统计上依旧明显较高。住院的风险在约一年半内依旧升高。
• 《英国医学杂志开放版》(BMJ Open)6月发表的一篇论文显示,长新冠比一些晚期癌症更容易令患者感到疲劳。
• 研究发现,长新冠患者出现的功能性损伤,比中风患者更严重,与帕金森患者的遭遇类似。
• 研究人员还发现,第4阶段肺癌患者的生活质量,普遍高于长新冠患者。
个人戴口罩是否有帮助?
有专家指出,戴口罩始终是一种集体干预措施,而不是个人干预措施。雷表示,无论其他人如何选择,只要口罩品质优良,例如紧密贴合的N-95口罩,单向配戴依旧能“大幅降低”感染新冠的风险。(有缝隙的外科手术口罩,可从两侧吸入空气,这种口罩并不是并且永远不是理想选择。)
雷的另外一条建议:即使周围的人对戴口罩持不同立场,也要保持冷静。他建议:“与不想戴口罩的其他人发生冲突,并不能降低风险。”这种冲突很难通过讨论分出胜负,除此之外,“随着双方情绪高涨,这种情况可能持续很长时间或者增加接触病毒的风险”。如果相互争吵的人中有人感染了新冠,那么在争吵过程中可能会有更多病毒被释放到空气当中。(财富中文网)
翻译:刘进龙
审校:汪皓
美国新冠病例数量再次增长,达到自去年冬季晚些时候以来的最高水平。
随着高度变异的新型新冠变异株“Pirola”BA.2.86引起所有人的关注,再加上呼吸道病毒高发季节即将来临,现在是否应该开始恢复戴口罩?
许多专家认为,自从2020年新冠病毒开始广泛传播以来,在任何时候戴口罩都是可取的,尽管这种观点在政治上并不受欢迎也不好玩。虽然并非在所有情况下都需要戴口罩(比如户外),但尤其是在某些情况下,你绝对有必要戴上口罩。
美国公共卫生协会(American Public Health Association)执行主任乔治·本杰明博士对《财富》杂志表示:“戴口罩依旧是降低感染新冠风险的有效工具。
如果有人面临高风险,计划参加有大量人聚集的室内活动,或者身边人的健康状况导致他们面临较高风险,在当前新冠病例增多的时期,这些人戴口罩获得的好处最大。”
约翰斯·霍普金斯卫生安全中心(Johns Hopkins Center for Health Security)传染病专家和高级学者阿梅什·阿达尔佳对《财富》杂志表示,新冠重症风险较高的人群“在人员密集的室内环境下应该始终考虑配戴口罩”。
他表示:“如果人们的症状符合新冠的表现,在计划与重症风险更高的人会面时,也应该保持警惕。”他还表示,这条建议“始终适用,而不是只适用于现在的情况”。
要不要戴口罩?听听专家们怎么说
斯图尔特·雷博士认同本杰明的观点。他是约翰斯·霍普金斯大学医学系数据完整性与分析专业的医学副主任。
他表示,在戴口罩这个问题上,需要考虑许多因素,包括:
• 社区传播:新冠在你所在地区的流行情况如何?向本地和/或州公共卫生部了解具体情况。如果本地的新冠疫情处于中等或较高水平,戴口罩或许是好主意。
• 个人免疫力:对新冠的抗体免疫力,即防止感染的能力,通常会在三至六个月后减弱。问题是免疫力并非万无一失。对于所有其他流行变异株,并非所有新冠毒株都能让人体获得相同程度的保护力。而且也无法保证新出现的变异株会按照我们习惯的规则流行。如果你在过去几个月内未接种加强针疫苗,也没有被感染,最好戴上口罩。
• 你的日程安排:你是否要参加大规模活动,例如不能因病缺席的演示?你是否计划参加婚礼、会议或音乐会等大型活动?你是否计划前往购物中心、电影院或机场等人员密集的场所?你是否计划与高风险家庭成员见面?如果以上问题的答案是肯定的,你最好在活动前和/或活动期间戴上口罩,以保护自己和/或其他人。
• 你的风险程度:是否有糖尿病、肥胖症、高龄或免疫状况等因素,会导致你因新冠住院或死亡的风险更高?如果答案是肯定的,你应该更谨慎地戴上口罩。
雷表示:“对我而言,在乘坐公共交通和人员高度密集的场合配戴口罩,是简单和明智的决定。”
另外一个应该戴口罩的场合是医院。安大略省圭尔夫大学(University of Guelph)生物学教授瑞恩·格里高利对《财富》杂志表示,在医疗环境中永远不应该取消配戴口罩的强制规定。自从世界卫生组织(WHO)停止用新希腊字母命名新冠变异株以来,他一直在用“街道名称”命名高度流行的变异株。
他还建议进一步推广呼吸机和空气过滤设备,保持良好通风和避免大量人群聚集,无论你遭遇任何变异株,无论新冠病毒出现任何不可思议的新变化,这些减缓措施都能发挥作用。
学会明智地与病毒共存
多年来,公共卫生官员一直强调人类社会需要学会与新冠病毒共存。但纽约理工学院(New York Institute of Technology)阿肯色州琼斯伯勒分校的助理研究主任和副教授、著名新冠病毒变异株跟踪研究员拉吉·拉吉纳拉亚纳对《财富》杂志表示,要求人们与病毒共存,应该发布指导原则,告诉人们根据社区传播水平确定什么时候戴口罩。
拉吉纳拉亚纳表示:“我们没有前瞻性的非药理学方法。我们总是在被动响应。”
可惜,美国疾病预防控制中心(U.S. Centers for Disease Control and Prevention)不再提供说明社区传播程度的地图。(不过这份地图一直不准确,它代表的是一个地区的医院床位可用性,并不能体现病毒活动状况。)虽然该部门确实提供了一份地图,显示美国各地新冠检测呈阳性的比例,但由于近期新冠检测数量处于史上最低水平,因此这些数字可能并不真实。(这意味着实际情况可能更加糟糕。)
截至周二,这份地图显示在美国10个地区中,有7个地区的阳性率达到10%至14.9%,这些地区以黄色表示。在美国中南部地区,包括德克萨斯州,情况更严重,检测阳性率高达15%至19%,这些地区以橘色表示。美国东南部地两个地区的阳性率水平可以接受,只有5%至9.9%,以绿色表示。需要说明的是,世界卫生组织在2020年首轮封锁之后,曾建议社区的检测阳性率为5%或更低时,才可以考虑重新开放。
拉吉纳拉亚纳表示,在室内依旧应该戴口罩,尤其是医院、机场、飞机和其他公共交通工具内。
近期的一项研究发现,受试者接触低水平或中等水平的病毒量时,其先前感染、接种疫苗或者这两者同时(即“混合”免疫力)带来的免疫力能够有效预防感染新冠,但在接触大量病毒时,免疫力变得无效(该项研究中,囚犯与患新冠的狱友生活在同一间牢房,导致其持续接触病毒)。格里高利指出,研究结果凸显出戴口罩的效果,甚至对接种过疫苗的人群依旧有效。
他说道:“重要的是减少吸入体内的病毒数量。”虽然理想情况下应该选择与面部贴合并且高品质的口罩,但“即使不完美的口罩也有价值”。
长新冠的威胁
专家表示,个人在决定是否配戴口罩时,应该将长新冠的持续威胁考虑在内。与普遍的观点不同,即使你首次感染新冠时没有出现症状,现在依旧有可能无法幸免。此外,不止在经历重症之后会患上长新冠,轻症过后患长新冠的可能性同样存在。
最近的研究显示,我们需要牢记与病毒后疾病有关的几个事实:
• 本月《自然医学》(Nature Medicine)杂志上发表的一篇论文证实,长新冠可能持续至少两年。
• 研究显示,感染新冠期间住院治疗的患者,在两年内死亡和住院的风险依旧“明显升高”。
• 研究人员发现,对于感染新冠期间未住院治疗的患者,在感染新冠后六个月死亡的风险,在统计上依旧明显较高。住院的风险在约一年半内依旧升高。
• 《英国医学杂志开放版》(BMJ Open)6月发表的一篇论文显示,长新冠比一些晚期癌症更容易令患者感到疲劳。
• 研究发现,长新冠患者出现的功能性损伤,比中风患者更严重,与帕金森患者的遭遇类似。
• 研究人员还发现,第4阶段肺癌患者的生活质量,普遍高于长新冠患者。
个人戴口罩是否有帮助?
有专家指出,戴口罩始终是一种集体干预措施,而不是个人干预措施。雷表示,无论其他人如何选择,只要口罩品质优良,例如紧密贴合的N-95口罩,单向配戴依旧能“大幅降低”感染新冠的风险。(有缝隙的外科手术口罩,可从两侧吸入空气,这种口罩并不是并且永远不是理想选择。)
雷的另外一条建议:即使周围的人对戴口罩持不同立场,也要保持冷静。他建议:“与不想戴口罩的其他人发生冲突,并不能降低风险。”这种冲突很难通过讨论分出胜负,除此之外,“随着双方情绪高涨,这种情况可能持续很长时间或者增加接触病毒的风险”。如果相互争吵的人中有人感染了新冠,那么在争吵过程中可能会有更多病毒被释放到空气当中。(财富中文网)
翻译:刘进龙
审校:汪皓
U.S. COVID cases are once again at a high plateau, climbing to heights not seen since late last winter.
With all eyes on the new, highly mutated COVID variant “Pirola” BA.2.86 and respiratory virus season on its way, is it time to start masking again?
Though not always en vogue politically or much fun, it was never not time to mask, many experts contend—not since COVID began circulating widely in 2020, anyway. And while masking might not be necessary in all situations (think: outdoors), it can certainly still behoove you—especially in some circumstances.
“Masking remains an effective tool to reduce your risk” of catching COVID, Dr. Georges Benjamin, executive director of the American Public Health Association, tells Fortune.
“People who are at high risk, are planning to be indoors in crowds, or who are around people whose health conditions put them at risk would benefit most from mask-wearing during this period of COVID uptick.”
Those at high risk of severe outcomes from COVID “should always consider masking in crowded indoor settings,” Dr. Amesh Adalja, an infectious disease specialist and senior scholar at the Johns Hopkins Center for Health Security, tells Fortune.
“People should also be vigilant if they have symptoms consistent with COVID if they are planning to be in the presence of those at higher risk for severe disease,” he says, adding that such advice applies “all the time, not just now.”
To mask or not to mask? What the experts say
Dr. Stuart Ray agrees with Benjamin. He’s vice chair of medicine for data integrity and analytics at Johns Hopkins’ Department of Medicine.
When it comes to masking, there are multiple factors to consider, he says, including:
• Community transmission: How prevalent is COVID in your area? Check with your local and/or state public health department. If local levels are moderate or high, masking may be a good idea.
• Your immunity: Antibody immunity to COVID, which can prevent infection, tends to wane after three to six months. The trouble is, immunity is never bulletproof. Not all COVID strains confer the same degree of protection against all other circulating variants. And there’s no guarantee that up-and-coming variants will play by the rules we’re used to. If you’ve not been boosted or infected in the last few months, you may want to mask up.
• Your schedule: Do you have big events coming up, like a presentation that you can’t afford to be sick for? Are you planning to attend large events, like a wedding, conference, or concert? Do you intend to visit crowded places, like a mall, movie theater, or airport? Are you planning to meet with high-risk family members? If so, you might want to mask ahead of such events and/or during them—for your protection, and/or for the protection of others.
• Your risk level: Are there factors—like diabetes, obesity, advanced age, or immune status—that put you at higher risk of hospitalization or death from COVID? If so, you’ll likely want to “err” on the side of caution and mask up.
“For me, wearing a mask on mass transit and in very crowded spaces is easy and wise,” Ray says.
Another place where it makes a lot of sense to mask up: hospitals. Masking mandates in medical settings should have never been dropped, Ryan Gregory, a biology professor at the University of Guelph in Ontario, tells Fortune. He’s been assigning “street names” to high-flying variants since the WHO stopped assigning new Greek letters to them.
More broadly, he recommends respirators, air filtration devices, good ventilation, and avoiding large crowds—all mitigation measures that work regardless of the variant(s) you’re encountering and any weird new curveballs the virus throws our way.
‘Learning to live’ with the virus—wisely
For years, public health officials have said society would need to “learn to live” with COVID. But doing so should have included guidelines on when to mask, based on levels of community transmission, Raj Rajnarayanan, assistant dean of research and associate professor at the New York Institute of Technology campus in Jonesboro, Ark., and a top COVID-variant tracker, tells Fortune.
“We don’t have proactive non-pharmacological approaches,” Rajnarayanan says. “We’re always reactive.”
Unfortunately, the U.S. Centers for Disease Control and Prevention no longer offers a map illustrating levels of community spread. (The map was inaccurate for a while anyway, reflecting hospital bed availability in an area instead of viral activity.) And while the agency does offer a map that shows the percent of COVID tests returning positive by U.S. region, those numbers are likely to be skewed by near all-time low levels of testing. (Read: Things may appear worse than they actually are.)
Still, as of Tuesday, that map showed seven of 10 U.S. regions with a percent positivity rate of 10% to 14.9%, a category shaded yellow. The U.S. south-central region, including Texas, was worse off, with a 15% to 19.% percent test positivity rate, shaded orange. Two regions in the U.S. Northeast had more acceptable levels of percent positivity, from 5% to 9.9% and shaded green. For context, the World Health Organization initially recommended a test positivity rate of 5% or lower for communities wishing to reopen after the first lockdowns of 2020.
People should still mask indoors, Rajnarayanan says—especially in hospitals, at airports, and on planes and other modes of mass transit.
A recent study found that immunity from prior infection, vaccination, or both (known as “hybrid” immunity) was effective in preventing COVID when subjects were exposed to low or moderate doses of the virus—but not when they were intensely exposed (in this case, prisoners who lived with cellmates who had COVID, resulting in constant exposure). The findings highlight the utility of masking, even for the vaccinated, Gregory points out.
“It’s important to reduce the amount of virus inhaled,” he says. While masks should ideally be snug-fitting and high quality, “even imperfect masking would be worthwhile.”
The threat of long COVID
Personal decisions on whether or not to mask should take into account the continuing threat of long COVID, experts say. Contrary to popular belief, it’s still possible to develop the condition—even if you didn’t the first time you got COVID. What’s more, it’s possible to develop long COVID after a mild case of the virus—not just with severe cases.
A few facts to keep in mind about the post-viral illness, according to recent research:
• Long COVID can linger for at least two years, a study published this month in Nature Medicine confirmed.
• For those hospitalized during their COVID illness, the risk of death and hospitalization remains “significantly elevated” for two years, according to the study.
• For those who weren’t hospitalized during their COVID illness, the risk of death after COVID remained statistically significant for six months, researchers found. The risk of hospitalization remained elevated for about a year and a half.
• Long COVID can be more fatiguing than some late-stage cancers, according to a study published in June in BMJ Open.
• Functional impairment among long COVID patients is worse than that experienced by those who’ve had a stroke, and is similar to that experienced by patients with Parkinson’s disease, the study found.
• What’s more, quality of life was generally better in stage 4 lung cancer patients than in long COVID patients, researchers found.
Does solo-masking help?
Some experts point out that masking was always meant to be a group intervention, not a single-person one. Still, one-way masking “substantially reduces risk” of contracting COVID, Ray says, regardless of what others are doing—as long as your mask is high quality, like an N-95that it fits snugly. (Surgical masks with gaps that let air in from the sides are not, and were never, ideal.)
Another tip from Ray: Keep your cool, even if you’re surrounded by those whose opinions on masking differ. “Clashing with others who don’t wish to mask doesn’t tend to reduce risk,” he advises. Aside from the fact that people are rarely won over by arguments, such a situation could “prolong or intensify exposures, if tempers run high.” A yelling match could actually lead to greater volumes of the virus being expelled, if those yelling have COVID.