地球，人間煉獄：疫情、戰爭、窮困 (274期)：
Two testing experts explain the latest data on how well the assays perform
SCIENTIFICAMERICAN.COM
How Accurate Are Rapid COVID Tests?
What worries you at this stage of the COVID-19 pandemic?
As we switch to a COVID-19 prevention model where individuals are responsible for taking care of themselves, I’m not 100% convinced we've gotten all of the information out. People don’t necessarily realize they’re at high risk for getting a bad case of COVID-19.
Those at obvious high-risk—older individuals, the immunocompromised, the unvaccinated—know. But as protection from our vaccines weaken, there are a lot of people who are at high risk for COVID-19 and other conditions because they have illnesses like heart disease, high blood pressure or diabetes. These may be well-controlled in your day-to-day life, but they still make you more vulnerable for severe COVID-19.
Can I quit wearing a mask?
Until coronavirus transmission is much lower, we need to keep masks on in places like trains, planes and buses.
Japan uses the three C’s to remind people where risk of COVID-19 is highest: closed spaces (places with limited ventilation); crowds; and close contact settings. These are the places where masks offer the best benefit and individuals should decide whether or not to use a mask based on their risk and the current amount of COVID-19 in the community.
Immunocompromised folks may want to keep wearing masks in most of these settings until COVID-19 rates are very low, whereas healthy, vaccinated people may want to forgo a mask. In a setting where masks aren’t required anymore, it’s important to choose a really protective mask (like a close-fitting KN95, KF94 or N95 mask) to provide the best protection. When cases are really high in an area, indoor mask mandates provide the best protection and can help save lives. On the other hand, when we get to a point where there’s almost no COVID-19 circulating, there’s no reason to be wearing masks unless you’re at very high risk.
What mask should I use in the future?
Choose the mask based on the situation and your risk factors. For instance, if you're a low-risk individual going to an event where everybody's wearing masks, people don't need to all be in N95s. Even a well-fitting fabric mask will offer some protection; a poorly fitting surgical mask probably isn’t any better. That said, a tight-fitting mask, like a well-fitted surgical mask with adjusted straps, such as KN95s and KF94s, would be a real step up. A fitted N95 mask is best.
How often should I be washing or sanitizing my hands?
For colds that are spread on surfaces, washing your hands is critical; for other colds, you're only going to pick them up from coughs and sneezes in the air. But you're not going to know what type of cold someone has when you're around them. Any time I switch settings or change buildings, I like to wash my hands. For example, when I go from work to home, I’m touching a lot of stuff along the way, so I wash my hands when I get home. Also make sure to wash your hands before preparing food, eating and after using the washroom.
“Everyone needs to be vaccinated for COVID-19 and it’s wise to keep up with boosters as well.”
大流行響起，流感幾乎消失了。我應該打流感疫苗嗎？
我不認為如果我們要求每個人都戴口罩，就可以徹底結束流感。但在正常年份，數以萬計的美國人死於流感。我們傾向於低估流感和其他呼吸道病毒，因為當我們年輕健康時，它們看起來就像是嚴重的、令人討厭的感冒。但它們可能會危及某些人的生命，包括兒童甚至一些健康的成年人。流感疫苗有助於預防住院、肺炎甚至死亡等不良後果。儘管如此，您不應該依賴疫苗作為您唯一的保護層。生病時，您還需要洗手並待在家裡。如果您是高風險人群，請確保您可以使用達菲等藥物。
在接下來的幾個月裡，老年人和/或免疫功能低下的人應該如何應對？
高危人群可能需要採取更多預防措施，因為其他人不再戴口罩來幫助保護他們。例如，在與其他人在一起的封閉空間中，風險最高的人可能需要同時佩戴 N95 和麵罩，以保護他們的眼睛免受大的 COVID-19 飛沫的傷害。如果無法與未戴口罩的人保持 6 英尺的距離，風險最高的人也可能需要完全避開人群，即使是在外面也是如此。由於疫苗對這一群體沒有那麼有效，因此請務必遵守疫苗接種建議並註意 COVID-19 的情況。您的醫生應該能夠說出新的建議是否適用於您。
在這一點上，為什麼還要接種 COVID-19 疫苗呢？
每個人都需要接種 COVID-19 疫苗，並且跟上助推器也是明智之舉。未接種疫苗的人死於 COVID-19 的可能性是接種疫苗的人的 10 倍。目前關於不戴口罩和“恢復正常”是安全的建議適用於接種疫苗的人。即使是健康的未接種疫苗的人在感染 COVID-19 後也面臨著不良後果的高風險。這些疫苗的接種劑量幾乎比其他任何疫苗都多，接種疫苗的人表現很好。我們沒有看到人們死亡或出現與疫苗有關的醫療問題。另一方面，未接種疫苗的 COVID-19 感染已導致數十萬美國人死亡，並導致數百萬例長期 COVID、中風、心髒病發作、腎衰竭、心力衰竭、肺損傷、血栓……這個名單還在繼續。 .
During the pandemic, the flu all but disappeared. Should I bother with a flu vaccine?
I didn't think that if we asked everybody to wear a mask, it would completely end influenza. But in a normal year, tens of thousands of Americans die of influenza. We tend to underappreciate influenza and other respiratory viruses, because when we’re young and healthy, they just seem like bad, nuisance colds. But they can be life-threatening for some people, including kids and even some healthy adults. The flu vaccine is helpful in preventing bad outcomes like hospitalization, pneumonia and even death. Still, you shouldn’t rely on the vaccine to be your only layer of protection. You also need to wash your hands and stay home when you’re sick. And if you’re high-risk, make sure you have access to medications like Tamiflu.
How should people who are older and/or immunocompromised navigate the next few months?
High-risk individuals may need to take more precautions because others are no longer wearing masks to help shield them. For instance, in closed spaces with other people, the highest-risk individuals may need to wear both an N95 and face shield to protect their eyes from large COVID-19 droplets. Highest-risk people probably also need to avoid crowds altogether, even outside, if they can’t keep 6 feet of distance from the unmasked. Because vaccines aren’t as effective for this group, make sure to keep up with vaccination recommendations and pay attention to the COVID-19 situation. Your physician should be able to say whether new recommendations apply to you.
At this point, why bother getting vaccinated against COVID-19?
Everyone needs to be vaccinated for COVID-19 and it’s wise to keep up with boosters as well. Individuals who are unvaccinated are 10 times more likely to die of COVID-19 than the vaccinated. The current recommendations that it’s safe to be unmasked and "get back to normal" is meant for vaccinated people. Even healthy unvaccinated people are at high risk of a bad outcome after having COVID-19. More doses of these vaccines have been given than almost any other vaccine and vaccinated people are doing beautifully. We are not seeing people die or have medical problems related to the vaccine. Unvaccinated COVID-19 infection, on the other hand, has killed hundreds of thousands of Americans and caused millions of cases of long COVID, strokes, heart attacks, kidney failure, heart failure, lung damage, blood clots… the list goes on and on.
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