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為什么非洲的新冠肺炎死亡病例這么少,?這是一個(gè)謎,!

Amiah Taylor
2022-03-28

從整體上來(lái)說(shuō),,新冠肺炎疫情給非洲帶來(lái)的影響相對(duì)較小。

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盡管悲觀(guān)主義者預(yù)測(cè)新型冠狀病毒將讓非洲大陸陷入癱瘓,,但似乎在更富裕、醫(yī)療設(shè)備更完善的國(guó)家,,其死亡人數(shù)更多,。從整體上來(lái)說(shuō),新冠肺炎疫情給非洲帶來(lái)的影響相對(duì)較小,。

來(lái)自Statista的數(shù)據(jù)顯示,,自2020年首次出現(xiàn)新冠肺炎死亡病例以來(lái),截至今年3月13日,,歐洲死于新冠肺炎的人數(shù)已經(jīng)高達(dá)1883711人,,具體到法國(guó),有140600人死于新冠肺炎,。世界銀行(World Bank)的數(shù)據(jù)表明,,截至2018年,法國(guó)每10000人中有6.5名醫(yī)生,,而截至2019年,,塞拉利昂每10000人中僅有1.4名醫(yī)生、護(hù)士和助產(chǎn)士,。相比于塞拉利昂這樣的非洲國(guó)家,,法國(guó)的醫(yī)療專(zhuān)業(yè)人員數(shù)量是其數(shù)量的四倍多,但實(shí)際情況是:法國(guó)死于新冠肺炎的人數(shù)比塞拉利昂高出99%以上,。據(jù)路透社(Reuters)報(bào)道,,塞拉利昂僅報(bào)告了125例與冠狀病毒相關(guān)的死亡病例。

據(jù)《紐約時(shí)報(bào)》(New York Times)報(bào)道,,自新冠肺炎疫情開(kāi)始以來(lái),,在塞拉利昂的卡馬奎,其新冠肺炎應(yīng)急中心僅記錄了11例病例,,沒(méi)有死亡病例,。

而且,不僅僅是在塞拉利昂,。據(jù)路透社報(bào)道,,自新冠肺炎疫情開(kāi)始以來(lái),加納共報(bào)告了1445例死亡病例。非洲一些國(guó)家報(bào)告的與冠狀病毒相關(guān)的死亡病例人數(shù)甚至沒(méi)有達(dá)到四位數(shù),,例如坦桑尼亞自新冠肺炎疫情開(kāi)始以來(lái)報(bào)告了800例與新冠肺炎相關(guān)的死亡病例,,多哥報(bào)告了272例與冠狀病毒相關(guān)的死亡病例。有一點(diǎn)可以肯定的是,,非洲各個(gè)國(guó)家的新冠肺炎死亡率如此之低并不是因?yàn)楫?dāng)?shù)厝艘呙缃臃N的覆蓋率高,。在烏干達(dá),、贊比亞等許多非洲國(guó)家,,疫苗分配不平等現(xiàn)象持續(xù)存在。比如,,利比里亞已經(jīng)接種了約120萬(wàn)劑新冠疫苗,,這相當(dāng)于該國(guó)約有12.2%的人接種了疫苗,但該國(guó)報(bào)告的新冠肺炎死亡病例人數(shù)僅為294例,。另一方面,,據(jù)報(bào)道稱(chēng),在像葡萄牙這樣的歐洲國(guó)家,,其民眾已經(jīng)接種了超過(guò)2200萬(wàn)劑次新冠疫苗,,接種率超過(guò)92%,但該國(guó)報(bào)告的新冠肺炎死亡病例人數(shù)卻仍然有21342例,。

兩相對(duì)比,,這種差異十分明顯,于是許多人都想知道:為什么新冠肺炎疫情在非洲國(guó)家的影響更???

難道是因?yàn)榉侵薜男鹿诜窝姿劳霾±龥](méi)有被記錄在案?

世界銀行等搜集數(shù)據(jù)資料的機(jī)構(gòu)紛紛懷疑信息來(lái)源的可靠性,,畢竟新型冠狀病毒的檢測(cè)比較稀缺且大多數(shù)新冠肺炎患者無(wú)法就醫(yī)導(dǎo)致最后在家中死亡,,所以說(shuō)非洲的新冠肺炎死亡率被嚴(yán)重低估了。根據(jù)SARS-CoV-2專(zhuān)家,、約翰斯·霍普金斯大學(xué)(Johns Hopkins University)分子微生物學(xué)和免疫學(xué)系(Molecular Microbiology & Immunology Department)的副主任安迪·佩科斯博士的說(shuō)法,,盡管在某些非洲國(guó)家,例如肯尼亞和津巴布韋,,可能在充分檢測(cè)新型冠狀病毒方面存在問(wèn)題,,但缺乏病例記錄可能不是導(dǎo)致報(bào)告的新冠肺炎病例數(shù)量較少的主要原因。

佩科斯告訴《財(cái)富》雜志:“我認(rèn)為很明顯的是,,SARS-CoV-2已經(jīng)多次進(jìn)入非洲國(guó)家,,但在某些情況下,它并沒(méi)有導(dǎo)致像我們?cè)谄渌胤娇吹降哪菢右?guī)模性爆發(fā),,包括像南美洲這樣與非洲部分地區(qū)位于同一經(jīng)線(xiàn)上的地方,。”

佩科斯更相信:“非洲國(guó)家對(duì)傳染病所作的監(jiān)測(cè)也很足夠,因?yàn)樗麄兡軌虬l(fā)現(xiàn)新冠肺炎導(dǎo)致的嚴(yán)重病例和死亡病例,?!彼哉f(shuō),在非洲國(guó)家,,死于冠狀病毒感染的患者人數(shù)較少的現(xiàn)象可能是由于其他原因,。

如果非洲國(guó)家沒(méi)有少報(bào)新冠肺炎死亡病例,那么這種差異是怎么造成的,?

一些科學(xué)家和研究人員認(rèn)為,,由于“交叉反應(yīng)性抗體”的存在,像塞拉利昂這樣長(zhǎng)期暴露于埃博拉病毒和拉沙熱病毒的非洲公民具有更高的復(fù)原率,。根據(jù)同行評(píng)審和開(kāi)放獲取的病毒學(xué)雜志《Viruses》,,比如,2021年的一項(xiàng)研究顯示,,塞拉利昂的埃博拉和拉沙熱幸存者的血液樣本對(duì)季節(jié)性冠狀病毒的抗體高于美國(guó)獻(xiàn)血者,,從而產(chǎn)生了交叉保護(hù)性免疫。

佩科斯了解交叉保護(hù)性免疫的論點(diǎn),,但他認(rèn)為這一論點(diǎn)缺乏證據(jù)難以讓人信服,。

佩科斯告訴《財(cái)富》雜志:“關(guān)于為什么我們?cè)谝恍┓侵迖?guó)家沒(méi)有看到大量的新冠肺炎病例,有很多理論,。我經(jīng)常聽(tīng)到一種理論,,說(shuō)某種先前存在的免疫力會(huì)抑制SARS-CoV-2感染帶來(lái)的影響,但我還沒(méi)有看到任何強(qiáng)有力且令人信服的數(shù)據(jù)來(lái)支持這一理論,?!?/p>

佩科斯認(rèn)為,拉沙熱和埃博拉病毒沒(méi)有造成足夠多的病例,,所以說(shuō)形成群體免疫力來(lái)對(duì)抗新型冠狀病毒也就無(wú)從談起,,也就是說(shuō)這與非洲的新冠肺炎病例數(shù)量少無(wú)關(guān)。他認(rèn)為,,瘧疾的分布范圍足夠廣泛,,可以形成群體免疫力,但還沒(méi)有找到瘧疾與新冠肺炎病例數(shù)量較少之間的密切聯(lián)系,。

佩科斯告訴《財(cái)富》雜志:“此外,,一些對(duì)非洲國(guó)家抗體水平的研究并未發(fā)現(xiàn)先前存在的SARS-CoV-2抗體的強(qiáng)烈信號(hào),可能是與抗體無(wú)關(guān)的部分免疫反應(yīng)起了作用——也許是T細(xì)胞反應(yīng)等細(xì)胞免疫反應(yīng)起了作用,?!保ㄘ?cái)富中文網(wǎng))

譯者:ZHY

盡管悲觀(guān)主義者預(yù)測(cè)新型冠狀病毒將讓非洲大陸陷入癱瘓,但似乎在更富裕,、醫(yī)療設(shè)備更完善的國(guó)家,,其死亡人數(shù)更多,。從整體上來(lái)說(shuō),新冠肺炎疫情給非洲帶來(lái)的影響相對(duì)較小,。

來(lái)自Statista的數(shù)據(jù)顯示,,自2020年首次出現(xiàn)新冠肺炎死亡病例以來(lái),截至今年3月13日,,歐洲死于新冠肺炎的人數(shù)已經(jīng)高達(dá)1883711人,,具體到法國(guó),有140600人死于新冠肺炎,。世界銀行(World Bank)的數(shù)據(jù)表明,,截至2018年,法國(guó)每10000人中有6.5名醫(yī)生,,而截至2019年,,塞拉利昂每10000人中僅有1.4名醫(yī)生,、護(hù)士和助產(chǎn)士,。相比于塞拉利昂這樣的非洲國(guó)家,,法國(guó)的醫(yī)療專(zhuān)業(yè)人員數(shù)量是其數(shù)量的四倍多,,但實(shí)際情況是:法國(guó)死于新冠肺炎的人數(shù)比塞拉利昂高出99%以上,。據(jù)路透社(Reuters)報(bào)道,,塞拉利昂僅報(bào)告了125例與冠狀病毒相關(guān)的死亡病例,。

據(jù)《紐約時(shí)報(bào)》(New York Times)報(bào)道,,自新冠肺炎疫情開(kāi)始以來(lái),在塞拉利昂的卡馬奎,,其新冠肺炎應(yīng)急中心僅記錄了11例病例,,沒(méi)有死亡病例,。

而且,,不僅僅是在塞拉利昂,。據(jù)路透社報(bào)道,自新冠肺炎疫情開(kāi)始以來(lái),,加納共報(bào)告了1445例死亡病例。非洲一些國(guó)家報(bào)告的與冠狀病毒相關(guān)的死亡病例人數(shù)甚至沒(méi)有達(dá)到四位數(shù),,例如坦桑尼亞自新冠肺炎疫情開(kāi)始以來(lái)報(bào)告了800例與新冠肺炎相關(guān)的死亡病例,,多哥報(bào)告了272例與冠狀病毒相關(guān)的死亡病例,。有一點(diǎn)可以肯定的是,非洲各個(gè)國(guó)家的新冠肺炎死亡率如此之低并不是因?yàn)楫?dāng)?shù)厝艘呙缃臃N的覆蓋率高,。在烏干達(dá)、贊比亞等許多非洲國(guó)家,,疫苗分配不平等現(xiàn)象持續(xù)存在,。比如,,利比里亞已經(jīng)接種了約120萬(wàn)劑新冠疫苗,,這相當(dāng)于該國(guó)約有12.2%的人接種了疫苗,但該國(guó)報(bào)告的新冠肺炎死亡病例人數(shù)僅為294例,。另一方面,據(jù)報(bào)道稱(chēng),,在像葡萄牙這樣的歐洲國(guó)家,,其民眾已經(jīng)接種了超過(guò)2200萬(wàn)劑次新冠疫苗,,接種率超過(guò)92%,,但該國(guó)報(bào)告的新冠肺炎死亡病例人數(shù)卻仍然有21342例,。

兩相對(duì)比,這種差異十分明顯,,于是許多人都想知道:為什么新冠肺炎疫情在非洲國(guó)家的影響更小,?

難道是因?yàn)榉侵薜男鹿诜窝姿劳霾±龥](méi)有被記錄在案?

世界銀行等搜集數(shù)據(jù)資料的機(jī)構(gòu)紛紛懷疑信息來(lái)源的可靠性,,畢竟新型冠狀病毒的檢測(cè)比較稀缺且大多數(shù)新冠肺炎患者無(wú)法就醫(yī)導(dǎo)致最后在家中死亡,所以說(shuō)非洲的新冠肺炎死亡率被嚴(yán)重低估了,。根據(jù)SARS-CoV-2專(zhuān)家,、約翰斯·霍普金斯大學(xué)(Johns Hopkins University)分子微生物學(xué)和免疫學(xué)系(Molecular Microbiology & Immunology Department)的副主任安迪·佩科斯博士的說(shuō)法,,盡管在某些非洲國(guó)家,,例如肯尼亞和津巴布韋,可能在充分檢測(cè)新型冠狀病毒方面存在問(wèn)題,,但缺乏病例記錄可能不是導(dǎo)致報(bào)告的新冠肺炎病例數(shù)量較少的主要原因。

佩科斯告訴《財(cái)富》雜志:“我認(rèn)為很明顯的是,,SARS-CoV-2已經(jīng)多次進(jìn)入非洲國(guó)家,,但在某些情況下,,它并沒(méi)有導(dǎo)致像我們?cè)谄渌胤娇吹降哪菢右?guī)模性爆發(fā),,包括像南美洲這樣與非洲部分地區(qū)位于同一經(jīng)線(xiàn)上的地方,?!?/p>

佩科斯更相信:“非洲國(guó)家對(duì)傳染病所作的監(jiān)測(cè)也很足夠,因?yàn)樗麄兡軌虬l(fā)現(xiàn)新冠肺炎導(dǎo)致的嚴(yán)重病例和死亡病例,?!彼哉f(shuō),在非洲國(guó)家,,死于冠狀病毒感染的患者人數(shù)較少的現(xiàn)象可能是由于其他原因,。

如果非洲國(guó)家沒(méi)有少報(bào)新冠肺炎死亡病例,那么這種差異是怎么造成的,?

一些科學(xué)家和研究人員認(rèn)為,,由于“交叉反應(yīng)性抗體”的存在,像塞拉利昂這樣長(zhǎng)期暴露于埃博拉病毒和拉沙熱病毒的非洲公民具有更高的復(fù)原率,。根據(jù)同行評(píng)審和開(kāi)放獲取的病毒學(xué)雜志《Viruses》,,比如,2021年的一項(xiàng)研究顯示,,塞拉利昂的埃博拉和拉沙熱幸存者的血液樣本對(duì)季節(jié)性冠狀病毒的抗體高于美國(guó)獻(xiàn)血者,,從而產(chǎn)生了交叉保護(hù)性免疫,。

佩科斯了解交叉保護(hù)性免疫的論點(diǎn),,但他認(rèn)為這一論點(diǎn)缺乏證據(jù)難以讓人信服,。

佩科斯告訴《財(cái)富》雜志:“關(guān)于為什么我們?cè)谝恍┓侵迖?guó)家沒(méi)有看到大量的新冠肺炎病例,,有很多理論,。我經(jīng)常聽(tīng)到一種理論,,說(shuō)某種先前存在的免疫力會(huì)抑制SARS-CoV-2感染帶來(lái)的影響,但我還沒(méi)有看到任何強(qiáng)有力且令人信服的數(shù)據(jù)來(lái)支持這一理論,?!?/p>

佩科斯認(rèn)為,,拉沙熱和埃博拉病毒沒(méi)有造成足夠多的病例,,所以說(shuō)形成群體免疫力來(lái)對(duì)抗新型冠狀病毒也就無(wú)從談起,,也就是說(shuō)這與非洲的新冠肺炎病例數(shù)量少無(wú)關(guān)。他認(rèn)為,,瘧疾的分布范圍足夠廣泛,,可以形成群體免疫力,,但還沒(méi)有找到瘧疾與新冠肺炎病例數(shù)量較少之間的密切聯(lián)系,。

佩科斯告訴《財(cái)富》雜志:“此外,,一些對(duì)非洲國(guó)家抗體水平的研究并未發(fā)現(xiàn)先前存在的SARS-CoV-2抗體的強(qiáng)烈信號(hào),可能是與抗體無(wú)關(guān)的部分免疫反應(yīng)起了作用——也許是T細(xì)胞反應(yīng)等細(xì)胞免疫反應(yīng)起了作用,?!保ㄘ?cái)富中文網(wǎng))

譯者:ZHY

Despite pessimistic projections that the coronavirus would cripple the African continent, it seems that wealthier and more well-equipped countries have higher death tolls and that the effect of COVID in Africa was comparatively minimal.

Since the first recorded death in 2020, a whopping 1,883,711 people have died from COVID in Europe as of Mar. 13, according to Statista. In France specifically, 140,600 people have died from COVID, according to Statista. As of 2018 there were 6.5 doctors per 10,000 people in France, according to The World Bank. And even with over four times as many health professionals as an African country like Sierra Leone—there are 1.4 doctors, nurses and midwives per 10,000 people in the country as of 2019—over 99% more people died from the coronavirus in France than Sierra Leone. In Sierra Leone only 125 coronavirus-related deaths have been reported according to Reuters.

And in Kamakwie, Sierra Leone in particular, the district’s COVID response center has registered a mere 11 cases since the beginning of the pandemic and no deaths, as reported by The New York Times.

And it’s not just Sierra Leone that has a low death toll. Ghana has reported 1,445 deaths since the pandemic started, according to Reuters. Some countries in Africa are reporting coronavirus-related deaths that don’t even reach the four-figure mark, like Tanzania which has reported 800 COVID-related deaths since the start of the pandemic, and Togo which has reported 272 total coronavirus-related deaths. And one thing is for certain, the low COVID mortality rates in various African countries are not owed to incredibly widespread vaccine access. Vaccine inequity is an ongoing issue in many African countries like Uganda, Zambia, and more. Liberia, for example, has administered about 1.2 million doses of the COVID vaccine which would amount to about 12.2% of the country being vaccinated and yet has only reported 294 total coronavirus-related deaths. On the other hand, a European country like Portugal has administered over 22 million doses of the COVID vaccine and is reportedly over 92% vaccinated, but still has reported 21,342 total coronavirus-related deaths.

As a result of this inescapable discrepancy, many are wondering: how are African countries faring better than other parts of the world?

Are African COVID deaths just not being recorded?

Some sources like WorldBank have asserted suspicions that African COVID death rates are heavily underreported given the scarcity of COVID tests and the fact that most coronavirus-related deaths occur at home. While it’s worth acknowledging that there may be issues with adequate testing for COVID-19 in some African countries, like Kenya and Zimbabwe for example, a lack of case recording is likely not the culprit behind the fewer numbers of COVID-19 cases being reported, according to Dr. Andy Pekosz, a SARS-CoV-2 expert and the Vice Chair of the Molecular Microbiology & Immunology Department at Johns Hopkins University.

“I think it's quite clear that SARS-CoV-2 has been introduced into African countries on numerous occasions but in some cases, it's not lead to outbreaks that are anywhere close to the scale we have seen elsewhere, including places like South America that lie on the same longitudinal lines as parts of Africa,” Pekosz told Fortune.

Pekosz is more convinced that there is “certainly good enough monitoring of infectious diseases to have detected severe cases and deaths resulting from COVID-19,” and that the lack of coronavirus-related deaths in African countries is owed to something else.

If African COVID deaths aren't underreported, where is the discrepancy coming from?

Because of “cross-reactive antibodies,” some scientists and researchers think that African countries that were exposed to Ebola and Lassa fever, such as Sierra Leone, have citizens with higher rates of resilience. For example, in a 2021 study, the blood samples of survivors of Ebola and Lassa fever in Sierra Leone had higher antibodies to seasonal coronaviruses than American blood donors, resulting in cross-protective immunity, according to Viruses, a peer-reviewed, open access journal of virology.

Pekosz is aware of the cross-protective immunity argument but struggles to believe it wholeheartedly because of a lack of evidence.

“There are a lot of theories about why we don’t see lots of COVID-19 in some African countries. The theory that there is some preexisting immunity that is dampening the effects of SARS-CoV-2 infection is one I hear often, but I have not seen any strong convincing data to support this,” Pekosz told Fortune.

Pekosz believes that Lassa Fever and Ebola have not caused enough cases to generate immunity from COVID and therefore can’t be correlated to low case numbers in Africa. He believes that malaria has wide enough distribution to explain immunity, but has not been able to find a strong link to malaria and reduced COVID cases.

“Furthermore, some studies of antibody levels in African countries haven’t shown a strong signal of preexisting antibodies to SARS-CoV-2,” Pekosz told Fortune. “It may be that parts of the immune response not related to antibodies could be contributing–perhaps cellular immune responses like T cell responses.”

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