[啲中文幾好喎!]我是秦始皇。我沒有死,我吃了長生不老藥。我在陝西有3000噸黃金和300萬秦兵被封印,現在只需要198元就能解封。只要你打錢給我,待我解封之日,我就收你當乾兒子,立你為太子!
TLDR:關維鵬都叫Teddy Robin啦!可能我係 陳大文 David Webb TM Chan 呢?唔得咩?
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告個急先:Ivan已被炒,已成失業人士。未訂嘅記得訂Patreon,積小成多呀。訂咗嘅可以考慮加碼(https://bityl.co/4Y0h)。 一星期至少出返六篇文.月頭訂最抵!月費80
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1. David Webb啲中文幾好喎.牛頓隔離在家發明(其實係發現)咗微積分,萬有引力定律,三大力學定律,仲有光學理論。David Webb都唔差,啲中文學到咁好!
2. 正經,除咗微信女,亦有冒啲咩股壇名嘴。我唔少朋友都有畀人冒(我就冇,證明真係冇人識,不過焉知非福)。但佢地又好醒架喎,例如佢會放張(舉例)胡孟青嘅相,然後只稱自己係「青姐」。
3. 咁,可能我真係叫「David Webb」呢,有乜唔得?Jason Bourne真名都叫David Webb 啦(我是鐵粉)!可能我係 陳大文 David Webb TM Chan 呢?唔得咩?關維鵬都叫Teddy Robin啦,周鵬都叫薩頂頂啦,型英師靚正,網名嚟之嘛。你見啲非洲球員,又莫扎特又波歷克(*)又柏天尼又查斯古特都係咁
4. 咁本身,有冇問題呢?我…….都唔知。我有冇impersonate other?冇喎又好似。咁我改自己個別名做胡孟青 畢菲特都唔得?況且,我都冇話自己係 胡孟青 畢菲特,我話我係「青姐」,「畢翁」之嘛。「個名你註冊咗咩?」
5. 至於相,一樣之嘛,我貼張相咋喎,我冇話嗰個係我喎。我見好多網友啲頭像都係侵侵啦,唔見有人拉喎。
6. 認真,雖然好似話唔應該Blame the victim(**)。但即係,咁都信嘅,照計十居其九嘅人心中都覺得抵撚死。雖然未必敢講出嚟,陣間又畀人話Blame the victim,虛偽嘅社會。
7. 但當然另一問題係:你心諗,咁白痴都有人信?就真係有的。況且成本唔係好高(***)。正如尼日利亞啲 email 某某將軍有幾億但就係爭幾百蚊解封唔到咁,有咁白痴得咁白痴。係特別的,都有人解過:就係確保釣到啲最白痴嘅人。因你有啲白痴唔晒,未閹乾淨未變晒喪屍嘅,陣間覆咗佢,問得幾問你又唔落搭,佢就浪費時間。
8. 所以重覆一次:個策略一定係有咁白痴整到咁白痴,確保稍為正常嘅人都唔會信。因為啲False Positive (未計啲玩嘢嘅人)都好花時間的。
(*)擺明off topic,絶對主觀,但在我心中,波歷克係近廿年甚至半世紀最有個人能力亦最有影響力嘅德國球員。你見岡比亞都有個波歷克(!),佛得角有兩個波歷克(!!),總唔見有個塞拉利昂拿姆或者茅利塔利亞馬圖斯(不過,魯爾/萊奧/話烏 個仔就叫Mateo,就真係name after 馬圖斯)
(**)你可以留意下講呢句嘢嘅人係照樣做的,佢地嘅意思係:唔好Blame啲佢覺得唔應該Blame 嘅victim
(***)不過而家啲微信女群組都幾落本,佢平時都好多嘢寫,又要寫下CoinBase呀,美國通脹呀,字節跳動呀。得閒又要醒兩隻真係升嘅畀你(雖然可能係騰訊之類)。都要啲時間同知識的。搵食唔易。
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2021比別人知得多。subscribe now。Ivan Patreon,港美市場評點,專題號外,每日一圖,好文推介。每星期6篇,月費80,半年已1400人訂!(https://bityl.co/4Y0h)。 年費仲有85折
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同時也有10000部Youtube影片,追蹤數超過2,910的網紅コバにゃんチャンネル,也在其Youtube影片中提到,...
false positive意思 在 Eric's English Lounge Facebook 的最佳貼文
[時事英文] 死亡率(mortality rate)*、壓平曲線(flattening the curve)、活動限制 (lockdown):如何理解這些術語?
Language goes beyond a sealed system governed by a rigid set of rules. To fully understand the meaning of a word, one must look further than connotation and denotation, and also take context into consideration. In this case, one needs to examine the social, political, economic, and even statistical contexts of the terms.
語言並非只是受嚴密規則所約束的封閉系統。為了充分理解一個單詞的意涵,我們不僅要瞭解其本義與引申義,同時還要考慮整個語境。在此一情況下,應要考察社會、政治、經濟甚至統計上的語境。
Does “confirmed cases,” for example, mean the same thing in every country before and during the coronavirus outbreak? What about “lockdowns”? Does it mean that the government is advising people to stay home or is someone nailing your door shut? Some food for thought when reading about the coronavirus outbreak.
例如,在冠狀病毒爆發前以及爆發期間,「確診病例」在各國是否具有相同的含義?那麼,封鎖呢?這是否意味著政府正建議人們留在家中,抑或有人正把你家大門釘上?以上是在閱讀疫情的相關資訊時所引人深思的一些事情。
*同學好心的補充說明:「mortality rate」通常指的是死亡率,而「fatality rate」則是(因罹患某疾病)致死率。兩者都是重要的死亡指標,但計算公式不相同。
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《紐約時報》報導:
Making sense of the coronavirus pandemic requires getting up to speed on semantics as much as epidemiology. Government officials and health care professionals toss off mentions of mortality rates, flattening the curve and lockdowns, assuming that we know what they mean. But the terms mean different things from country to country, state to state, even city to city and person to person. Officials use the same phrases about mass testing, caseloads and deaths to describe very different situations. That makes it hard to give clear answers to vital questions: How bad are things? Where are they headed?
1. make sense of… 理解……
2. get up to speed on 了解最新情況;跟上進度
3. toss off 輕而易舉地處理*
弄懂新型冠狀病毒大流行,既需要了解流行病學的最新情況,也需要在語義學上跟上形勢。「死亡率」、「壓平曲線」和「活動限制」等說法從政府官員和公共衛生專業人士的嘴裡脫口而出,他們假設大家都知道這些詞的意思。但對不同的國家、不同的州,甚至不同的城市和個人來說,這些術語有著不同的含義。 官員們使用「大規模檢測」、「病例數」和「死亡病例數」等相同的措辭,來描繪非常不同的情況。這令一些重要的問題難以得到明確的回答:情況有多糟糕?正在向什麼方向發展?
toss off: https://www.merriam-webster.com/dictionary/toss%20off
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People search for insight by comparing their countries to those that are further along in the epidemic. But if the terms are misleading or used in differing ways, the comparisons are flawed. Also, the statistics and vocabulary offer a false sense of precision while in reality, the information we have shows only a fraction of what’s going on. “The new cases or deaths each day are given as exact numbers, and we’re trained to take that at face value,” said Mark N. Lurie, an epidemiologist at Brown University’s School of Public Health. “But those are far from exact, they’re deeply flawed, and their meaning varies from place to place and from time period to time period.”
4. be further along in 在……上走得更深遠
5. at face value 根據外表;從表面上看
人們將自己的國家與那些經歷了疫情更多階段的國家進行比較,以求了解情況。但是,如果這些詞語使人產生誤解,或在使用方式上存在差異的話,這種比較就是錯誤的。此外,這些統計數據和詞彙給人以精準的假象,而現實是,我們所掌握的信息僅代表冰山一角。「每天的新增病例數或死亡人數都是以精準數字的形式通報的,我們被訓練成只看這些表面數字。」布朗大學公共衛生學院流行病學家馬克・盧裡說。「但這些數字遠非精準,而且有嚴重缺陷,它們的含義因不同的時間和地點而不同。」
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I. Confirmed Cases 確診病例
Countries vary wildly in testing for the virus and how they report the numbers, and experts say most infections are going undetected. So the publicized national tallies are rough, incomplete pictures that may not be all that comparable. And that’s if countries are forthcoming about their data.
6. vary wildly in 在……上有極大的差異*
7. publicize 公布;宣傳
8. national tallies 國家的統計數據
9. incomplete pictures 不完整的狀況
10. forthcoming 樂於幫助的
各國在病毒檢測以及通報數字的方式上有很大差異,而且專家們說,大多數感染都沒有被發現。因此,各國公布的只是粗略的數據,這些並不完整的描繪也許沒有多少可比性。這還是在假設各國願意提供數據的情況下。
wildly: https://bit.ly/2wkgPjo
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Officials in the United States say that China, which has reported more than 82,000 infections, has understated its epidemic. Until this week, the Chinese government excluded those patients who tested positive for the virus but had no symptoms. China also doesn’t say how many tests it has conducted, and doubts have been raised about whether it has tested extensively in Xinjiang, the province where it holds hundreds of thousands of Muslims in indoctrination camps. The Covid Tracking Project, run by The Atlantic, has tried to compile all the numbers in the United States and reports more than 1.2 million tests so far, over 3,600 per million people.
11. understate 未如實陳述;避重就輕地說
12. exclude 把……排除在外
13. indoctrination camps 再教育營
14. run by 由……經營
中國通報的累計確診病例超過8萬2千例,美國官員說,中國淡化了國內的疫情。直到本週前,中國政府一直把病毒檢測呈陽性但沒有癥狀的感染者不納入確診病例。中國也未公開接受檢測的人數,而且外界已對中國是否在新疆進行了大規模檢測表示懷疑,中國在那裡把數十萬穆斯林關進了拘禁營。《大西洋月刊》的新冠肺炎追蹤計劃試圖匯總美國的所有數據,它統計到的數字是,美國迄今為止進行了逾120萬例檢測,平均每百萬人超過3600例。
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II. Widespread Testing 大規模檢測
It matters not only how many people are tested, but also when, and who they are. Once again, countries differ, shaping what the numbers mean. A few countries, like South Korea, Australia and Singapore, got serious about mass testing early on. They used the information to do ambitious contact-tracing — finding and testing those who had recently been near infected people, even if they had no symptoms.
15. it matters 重要的是
16. not only……, but also…… 不僅……,而且……
17. get serious about 認真對待某事
18. early on 在早期
重要的不只是多少人做了檢測,檢測時間和檢測對象也很重要。各國在檢測時間和對象上也有不同,這讓數字的含義也有所不同。韓國、澳洲和新加坡等少數國家很早就開始認真地進行大規模檢測。他們利用這些信息嚴格追蹤接觸者,也就是找到並檢測那些親密接觸者,即使他們沒有癥狀。
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But most nations with large numbers of cases have done less testing, waited longer to do it in bulk, and made little attempt at contact tracing. They find themselves playing catch-up with the virus, ramping up testing after their outbreaks had already mushroomed. They detect more cases, but by then it’s hard to tell how much of that growth is the expanding epidemic and how much is expanding surveillance. Unable to meet the demand, they often limit testing to the sickest patients and health workers.
19. in bulk 大量
20. make little attempt 幾乎未做嘗試
21. ramp up 增加*
22. mushroom (v.) 迅速增長;迅速發展*
23. meet the demand 滿足需求
24. limit……to 將……限制在……
但大多數存在大量確診病例的國家進行的檢測數量都比較少,都是等了更長時間後才開始進行大規模檢測,而且對追蹤接觸者的工作幾乎未做嘗試。這些國家發現自己在拚命追趕病毒的傳播,在疫情迅速蔓延後才加大了檢測力度。這些國家都檢測到了更多的病例,但此時已很難判斷新增病例中有多少是疫情不斷擴大的結果,有多少是擴大疫情監測的結果。由於無法滿足檢測需求,這些國家通常只能對病情最嚴重的患者以及衛生工作者做檢測。
ramp up: https://www.collinsdictionary.com/dictionary/english/ramp-up
mushroom: https://www.ldoceonline.com/dictionary/mushroom
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III. Fatality Rates 致死率
It has been stated time and again: Italy and Spain have high mortality rates among coronavirus patients, Germany’s is low, and China’s is somewhere between. It may not be that simple. Counting the dead is as flawed and inconsistent as counting the infected. Recent reports say that mortuaries in Wuhan, China, where the disease was first discovered, have ordered thousands more urns than usual, suggesting a much higher death toll than the city’s official count, 2,535. The outbreaks in Wuhan, and parts of Italy and Spain, overwhelmed hospitals, forcing many sick people to ride it out at home. No one knows how many people have recovered or died without ever being tested. And if only the sickest patients are tested, then the number of infections will appear smaller and the percentage who die will seem higher.
25. time and again 屢次;一再
26. as flawed and inconsistent as 像……一樣存在缺陷與不一致
27. mortuary 停屍間(太平間)
28. urn 骨灰罈
29. suggest 暗示*
30. death toll 死亡人數
31. to ride it out 安然渡過(難關)*
一個反覆提及的說法是:義大利和西班牙的新冠病毒肺炎患者死亡率高,德國的低,中國的居中。情況也許並不那麼簡單。統計死亡人數和統計感染人數一樣存在缺陷和不一致的地方。最近有報導稱,武漢的殯儀館訂購的骨灰盒數比該市官方統計的2535例死亡高出好幾千,表明死亡人數遠高於官方公布的數字。新冠病毒最早就是在這座城市發現的。武漢以及義大利和西班牙部分地區的疫情使醫院不堪重負,許多患者被迫在家中渡過難關。沒人知道究竟有多少人在從未做檢測的情況下康復或死亡。如果只對病情最嚴重的患者做檢測的話,感染人數看上去會更低,而死亡率看起來將更高。
suggest: https://www.oxfordlearnersdictionaries.com/definition/english/suggest
ride sth out: https://bit.ly/2Rd6Tj6
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IV. The Peak 疫情高峰
Officials often talk about when the epidemic peaks or plateaus — when a country “flattens the curve.” But they rarely specify, the peak of what? And how can we be sure we’re past it? When an outbreak is growing unchecked, more people become infected and more die each day than the day before. On a graph, the curve showing the daily count of new cases has gone from rising sharply to moving sideways — the curve has flattened — and even begun to move downward. That is one corner being turned: The rate of the spread of the virus has slowed down. It takes longer to turn another: the rate of people dying.
32. from rising sharply to moving sideways 從急劇上升到橫向移動
33. turn the corner 好轉;度過難關*
官員們經常提疫情何時達到高峰或進入平台期,也就是一個國家「壓平曲線」的時候。但他們很少具體說明是什麼達到了高峰,以及我們怎麼能確定高峰已過?當疫情不受控制地發展時,每天的感染和死亡人數都比前一天多。曲線圖上顯示的每天新增病例數從急劇上升變得趨於平緩——曲線已被壓平——甚至開始下降。這是一個轉折點:病毒的傳播速度已經放緩。度過死亡人數的轉折點則需要更長的時間。
turn the corner: https://www.merriam-webster.com/dictionary/turn%20the%20corner
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But even when those curves flatten, the epidemic still has not “peaked” by another crucial measure: the number of active cases. That figure continues to rise until the number of patients who either die or recover each day is larger than the number of new infections. To ease the staggering load on health care systems, the active cases curve must also flatten and then fall.
34. peak (v.) 使……達到頂峰
35. either……or…… 不是……就是……
36. staggering 沉重的;巨大的
但是,即使這些曲線已趨於平緩,疫情的另一個重要衡量指標——現存確診病例數——仍未達到「峰值」。在每天的死亡或康復患者人數超過新增感染人數之前,這個數字還將繼續上升。為緩解衛生系統的沉重負擔,現存確診病例數的曲線也必須先趨平,然後下降。
peak: https://www.oxfordlearnersdictionaries.com/definition/english/peak_2
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V. Lockdowns 封鎖(活動限制)
More than two billion people, including most Americans, are living under something usually called a lockdown. But there is no set definition of that word — or related terms like stay-at-home mandates and social distancing — so the details differ from place to place. The biggest differences may be in enforcement. Some places, like those in the United States with lockdowns, mostly rely on people to follow the rules without coercion. But Italy and others have deployed soldiers to ensure compliance, and French police have fined hundreds of thousands of people for violating restrictions. China, in addition to using security forces, mobilized an army of volunteers, ratcheting up social pressure to obey.
37. set definition 固定的定義
38. enforcement 實施;執行
39. rely on 仰賴;依靠
40. deploy 部署
41. compliance 服從
42. fine 處……以罰款(或罰金)
43. in addition to 除了……之外
44. mobilize 動員
45. ratchet sth up/down 逐步增加/減少
全球有20多億人,包括大多數美國人正生活在一般被稱為「活動限制」的狀態下。但這個詞沒有固定的定義,其他的相關說法,比如政府的「待在家裡」和「保持社交距離」令也沒有明確的定義,所以各地的具體做法也不一樣。最大的不同可能在執行方面。有些地方,比如美國有限制令的地方,主要依靠人們自覺遵守,而非強制。但義大利等國為確保限制令的落實而動用了軍隊,法國警方還對數已十萬計的違反禁令者處以罰款。中國除了使用安全部隊外,還動員了一支志願者大軍來加大服從封鎖隔離措施的社會壓力。
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Italy’s experience shows the looseness of the term. It has gone through several phases of restrictions, applying them to more people, making them stricter and increasing enforcement. A few weeks ago, a person could travel around Italy for a valid work or family reason. Now, people are fined for nonessential walking too far from their homes. But each stage was widely called by the same name: lockdown.
46. looseness 鬆散
47. valid 確鑿的;合理的;有根據的;讓人信服的
義大利的經歷表明了這個詞語解釋上的自由。義大利的封鎖令經歷了幾個階段,適用範圍擴大到越來越多的人,封鎖及其執行也變得越來越嚴格。幾週前,人們還可以因為正當的工作或家庭原因在義大利旅行。現在,人們會因不必要的離家太遠的走動而被罰款。但禁令的每個階段用的都是同一個泛泛的名稱:活動限制。
《紐約時報》完整報導:https://nyti.ms/2XcCUeT
圖片出處:https://fxn.ws/34gwSeH
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時事英文大全:http://bit.ly/2WtAqop
如何使用「時事英文」:https://bit.ly/3a9rr38
#疫情英文
false positive意思 在 賴叔閱事 Facebook 的最讚貼文
恐慌嘅時候,更需要睇清楚啲。
肥人知道呢篇文真係寫得遲,本來我乜都唔想寫,依家見到個勢係全世界順水推舟圍堵中共就更加唔想寫,但係姣婆係好難守寡既,尤其是呢排成日俾班極度恐慌既人trigger… 我決定代肥控制員寫,因為我呢邊收視率高過佢。
好,開波!
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“We had better learn to doubt our inflated fears before they destroy us. Valid fear have their place; they cue us to danger. False and overdrawn fears only cause hardship. Even concerns about real dangers, when blown out of proportion, do demonstrable harm.” – Barry Glassner, American sociologist, author of The Culture of Fear.
網絡世界千奇百趣,好多網上既意見同評論,如果同傳媒製造既輿論結合(不論有心定無意),係會對社會有非常深切既影響。例如以前有政權會向群眾灌輸恐懼,挑起群眾之間既仇恨,或令群眾不知所措,進而控制群眾。呢種手法,不論以前納粹德國、現存或者已覆亡既共產國家、甚至自命民主自由既開放社會如美國都有出現。當政者及其黨羽,就係利用群眾既錯誤認知,以感性因素去扭曲大家既認知同決策能力,咁就可以達到佢地既政治目的啦。咩政治目的?好多種既,下至失敗政府要掩飾施政失誤,上至衝出國際統治全世界都有。
所以唔好話咁樣係「誇張」、「陰謀論」、同「乜都拉埋政治來講」呀,因為人類歷史就係充滿呢種叫 fearmongering既手段-用有目的地散播同誇大一樣不愉快既事情既手法,去引起大家既恐懼來控制群眾。現今世界,庸碌無能之輩當政比比皆是,唔識控制群眾既情緒,點樣遮掩政府既無能同做錯事既後果?不過肥人今次唔講法律,我學下一般既KOL咁「跨界別評論」先,所以呢篇文我講生物醫學,particularly 係將近來我係周遭聽聽埋埋既恐慌言論歸納一齊,逐點解釋。
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首先,等肥人我同大家重溫一下近來有關武漢肺炎既新聞標題:
信報報導「河南超長潛伏期病例疑94天確診」
HK01就話「逾5000疫廈元朗區最多 衛生署拒回應真偽」
Business Focus既報導就恐怖啦,話「肺炎突變新冠腦炎? 北京醫院首證病毒能侵襲中樞神經系統 感染肺炎併發腦炎北京醫院:患者意識曾陷入混亂」
CCTVB報導「私家醫生可收患者呼吸道樣本交政府陳肇始稱可及早減低傳播」
仲有零零星星報導例如:
「伊朗新冠肺炎疫情增至145死55歲國會議員不治」
「伊朗新型冠狀肺炎疫情失控,再有一位高級官員病逝。」
「【新冠肺炎・伊朗】數名官員先後染病身亡 23國會議員確診」
「新型冠狀病毒南韓確診個案累計增至逾7千宗死亡人數維持在44人。」
「【新冠肺炎.最新疫情】意大利確診個案逾萬 美國突破千宗」
上面堆報導實在睇到好多人好恐慌,尤其是本來對科學/病毒/醫療/疾病無咩認知既人,呢兩個月睇新聞就好似睇恐怖熱線咁。於是搞到好多心理質素差,表面受過教育既人墮入恐慌之中。
然後,我聽到身邊好多人竭斯底理咁驚叫:
「個肺花!個肺花!個肺花!個肺花呀!」
「呢個唔係流感呀!唔好再錯誤同流感比較啦!」
「潛伏期變長呀!無病徵既隱形病人都會傳染人架!」
(隔離果個choke到,咳兩聲)「我以後唔同你坐埋一齊呀!我唔想死呀!」
「如果唔係香港人衛生意識好,堅持戴口罩,香港一早淪陷啦!依家已經無新病例!你睇鬼佬幾污糟!又唔戴口罩,病又話唔使入醫院,返屋企休息,依家美國同意大利都爆發啦!」
「呢D廢老唔戴口罩,鬼唔望佢地中招死全家!政府應該強制人戴口罩!」
以上說話我全部聽過人講,最後一句我最撚火滾,你自己恐慌就好啦,咒人死仲要政府好 draconian 咁立法同執法?俾個民主自由既國會你仲可以普選,你都會選班人渣出來,然後大比數通過立法強制抽血抽組織,強制所有人有無問題都要戴口罩,仲可能要將人tag完再限制人出入自由。1984呀!
我日日做mon post狗睇網上既post,好多share出來又會令人恐懼既post,大部份都係有好多空間令人胡思亂想,如果你對科學尤其是 research methods, medical science, microbiology, virology等等唔認識的話,你鐵定會誤讀誤解再誤判… oh wait,睇返上面「利用群眾既錯誤認知,以感性因素去扭曲大家既認知同決策能力」,BINGO! 咁就搞掂你啦。為咩事要搞掂你?唔講啦,因為你會用陰毛論、陳雲信徒、唔好乜都政治化來駁我。
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依家太多post講呢個新型冠狀病毒,例如Facebook有個印度人既 Infographics on Covid-19,好詳盡,但咁又點呢?大家對病毒以致肺炎、流感、醫療系統等等都毫無認識,講到咁深入你地都會誤解或者一頭霧水。咁樣樣,好多人因為無足夠既basic knowledge,又先入為主咁因為自己既恐慌情緒相信左錯既資訊,要同佢地「解毒」,就好似同藍絲講咩叫法治一樣困難,真係太監洞房無撚用。
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好,依家開始【法網肥人講病毒】!
1. 眾所鳩知,武漢肺炎係由新型既冠狀病毒 Covid-19引起。Covid-19係冠狀病毒科 Coronaviridae裡面其中一種,佢係屬於 positive-sense, singled stranded RNA virus (正鏈單股核醣核酸病毒) 。RNA病毒有好高突變率,因為病毒既RNA polymerases缺乏 DNA polymerase 既proofreading能力,所以佢地好難有 nearly identical既 sequence。仲有一點好重要,病毒同病菌唔同,病毒係需要靠 host cell (宿主細胞)先可以生存,離開 host cell 佢地不能複製,不能運作,只有死路一條。所以一開始就話新病毒同SARS個sequence有幾多幾多 percent 相似,我即刻叮左一下,然後好多人傳話新病毒點點點可以生存好耐,我更加叮多兩下…. 邊個放呢D料出來既?
2. 另外,呢隻病毒並非 retrovirus (逆轉錄病毒, class VI single-stranded RNA-Reverse Transcriptase),唔會將自己既RNA用 reverse transcriptase (逆轉錄酶)塞入host cell既基因裡面,然後適時復發。咩係retrovirus呢? 例如會引起 T Cell Leukemia 既 Human T-cell lymphotropic virus type 1 (HTLV-1),或者引起愛滋病既 Human Immunodeficiency Virus (HIV)。呢個病毒,亦唔係好似肝病毒科乙型肝炎咁,唔係 retrovirus 但會有reverse transcriptase去將 viral genome incorporate 入host cell,所以就算不幸中左,都唔會話咩病者會成世帶住個病。所以我每一次聽到人講「就算中左都一世帶病呀」就會好抆,冠狀病毒變愛滋,黐L線!
3. 冠狀病毒既結構好簡單:一個 viral envelope,外面有protein spike,裡面有RNA,that’s it。佢地個replication mechanism (複製機制) 就係病毒接觸host cell後進入 host cell,然後係host cell個細胞核nucleus裡面複製。複製完之後就由host cell cytoplasm (細胞質)裡面製造既 necleocapsid (核蛋白衣) 加埋細胞核既 endoplasmic reticulum (內質網) 既phospholipid membrane (磷脂層)包住病毒RNA,經由host cell 既Golgi apparatus (高氏體)帶出host cell 繼續傳染人。呢個複製過程,當然會破壞甚至殺死 host cell啦。咁知道呢點有咩用?Phospholipid membrane係lipid bilayer (脂質雙分子層),lipid bilayer係怕番梘soap既!咁勤D用番梘洗手就得啦,使撚用甲醇咩屌你,你嫌命長?
4. 有人話:「咁基因突變都得架嘛!個病毒咪做到所有野囉!」喔,係咩?如果咁簡單,呢個世界既大學就唔需要有生物系,而且達爾文應該無人理。首先,病毒點解會有基因變異?簡單講就係 replication 之中,有polymerases 抄錯條 sequence,例如本來係 ATCG 既,抄成 ATTG,跟住無 proofread 就掉出去。又有一種變異,就好似屬於Orthomyxoviridae 既influenza A virus咁,裡面有八條 RNA segments,可以係 replication既時候洗牌。呢種 replication 既錯誤或者洗牌,積埋積埋,小則變成 genetic drift/antigenic drift,大則變成 genetic shift/antigenic shift。前者可能將某一個半個 surface protein 結構變左少少,整體來講人體免疫系統仲認得出,變異後既病毒殺傷力有限。後者可能將原有病毒變成新既 subtype,大部份人既免疫系統都認唔出而死傷無數。假設,新既冠狀病毒係由舊有冠狀病毒(包括 SARS)天然 antigenic shift 變出來既,咁點可能係短短兩三個月再次 antigenic shift 呢?如果基因突變去到呢個地步,肯定顛覆生物學界既認知。但好多本來就無讀過生物既人會唔認同,佢地會搏命咁話基因變異點能夠預測!肥人話你知,唔係預測,而係不符合現實同暫時無人能夠推翻既理論。如果新病毒可以係短時間內變成 retrovirus,可以無任何條件下生存好耐,隨意改變 latent period潛伏期,隨意改變傳染力同殺傷力的話,科學家應該點 classify 佢呢?簡單講,長頸鹿頸長先叫做長頸鹿,如果長頸鹿變成 Mike Tyson 條頸咁短,咁我地應該叫佢做 Mike Tyson 定長頸鹿?如果新冠狀病毒有 HTLV-1既retrovirus能力,有hepatitis B 既 reverse transcriptase,有 flu A 可以 shuffle RNA 既能力,又有 HIV 既超長 latent period,你會叫佢做 coronavirus 定 super virus?
5. 講基因變異,要一個變異既病毒基因可以流傳,病毒本身必須要不斷繁衍,宿主傳宿主咁一代傳一代,病毒先可以續存。呢個就係進化論,survival of the fittest。古代有好多生物不能續存,就係因為被環境淘汰,例如有理論認為三葉蟲因為蛻變機制 (instar and molting) 有問題,結果難以生存,最後被大自然淘汰。如果病毒勁到咩人都可以一野就殺死佢的話,佢點傳播?宿主死左,無人帶佢地去傳染其他人嘛!病毒唔係病菌,可以係環境種生存好耐,病毒只要離開宿主好快就會死,就算有飛沫帶住,我地環境中既太陽紫外光、oxidizing agents、濕度與氣溫等等會令佢地好快收皮。病毒唔係倪匡衛斯理《藍血人》裡面隻「獲殼依毒間」,可以變成游離電波周圍飄。大家明白進化論,就會明白病毒學101既常識,從而 debunk 左一個不斷流傳既流言:「隻病毒好勁,好多人死架,傳播得又快!」傳播得快,不等如勁,而太勁既病毒,難以傳播。係呢度,傳播得快,同隻病毒之間並無關係。病毒殺傷力勁,傳播範圍就會窄,傳播速度都會慢;病毒殺傷力一般如普通流感的話,傳播範圍先會闊,傳播速度先會快。如果新聞瘋狂報導好多人死就等如勁,咁非洲同中東都有好多基督徒男女老幼被人大規模屠殺,你會唔會覺得信耶穌係死路一條?
6. 又有人話:「呢隻病毒唔同流感呀!唔好再同流感比啦!呢隻病毒會死人架!呢隻病毒無藥醫架!」首先,除左冠狀病毒同流感病毒,仲有 Respiratory Synctical Virus (人類呼吸道合胞病毒) 同 Rhinovirus (鼻病毒) 都會引起呼吸道感染疾病,隻隻都係病毒,病毒一向未必有有效既藥物醫治,隻隻都會死人。你地以為流感有得醫?用 Tamiflu 都未必得架,而且有可能有嚴重副作用。咁冠狀病毒同流感病毒有咩唔同? 有人話death rate高,無vaccine,latent period又長又短,病人無病徵,但呢堆因素唔係用來分別病毒勁唔勁囉。Death rate 高低由咩決定,點計?Vaccine有咩用,target 咩?latent period 點解會長短不一?有無病徵同嚴重性有咩關係,係咪好似異形咁,你怕有人無病徵但會 sudden death?你地睇得太多 WhatsApp D人無啦啦訓低既片段啦,你又知人地係武漢肺炎死?New England Journal of Medicine 有篇叫 First Case of 2019 Novel Coronavirus in the United States既文,提到美國華盛頓州有個病人1月19日入廠,20日確診,一直都係 supportive care,直到染病第11日,即係入廠第7日,醫生先用 IV 俾 remdesivir (瑞德西韋),然後佢就退燒,其他症狀都消失或者減輕。咁又點解會係無得醫?大家記住remdesivir (瑞德西韋),遲下會再講。
7. 仲有,我最憎既「個肺花!個肺花!個肺花!個肺花呀!」呢句,我想同講呢句既人講,肺花,係因為照 X-ray 既時候個肺有 consolidation/infiltration,呢個問題唔單止係肺炎,肺癆甚至cancer都會肺花。你怕咩肺花?流感去到嚴重的話,都可能肺花,因為你有 pulmonary consolidation or infiltration。肺花係因為你個肺 filled with liquid, exudate, pus 甚至 blood from hemorrhage。理性少少,冷靜D,肺花講一次就得,repeat 幾次無幫助。
8. 孤勿論點,呢隻病毒都只係一隻呼吸道感染既病毒,一隻真病毒,一隻同流感一樣會令人病,亦會令人死既病毒,只係流感令人鼻塞,但一樣有機會令人肺炎。呢個新病毒佢所有既威力都係傳媒、WhatsApp片段、社交媒體既報導俾佢,就好似有D 人,你聽佢大名如雷灌耳,一見到真人原來係柒碌又無料到一樣(我懷疑我自己都係咁)。其實有無人真正去了解上面我所講既野?無人話你聽你可以當呢隻病毒無到,話之佢死,但係一開始就進入恐慌狀態,咁你係咪俾人耍緊呢?
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講完上面既病毒既基本知識,不如講多少少基本病毒檢測既知識。好,依家開始【法網肥人化身肥控制員】!
外面成日有人話:「哎呀,個病人21日後先確診呀!」「哎呀,佢隻狗弱陽性呀!」「哎呀,本來係陰性依家係陽性呀!」「哎呀,南韓同意大利爆發,突然好多人確診呀!」Now TV 更報導「鑽石公主號在日確診香港人 康復回港後再檢測呈陽性」
究竟,呢堆確診數字信唔信得過?我意思唔係話邊個國家信唔信得過,而係呢個 test method 同個 protocol 信唔信得過,會唔會有 uncertainty 或者error? 一開始,我地可以睇下 Journal of the American Medical Association 3月9日既文章,Diagnostic Testing for the Novel Coronavirus,裡面有講到 false positive/false negative 既問題,仲有病毒測試既regulation,測試既 guideline等等。文中有提到,開初發展出來既病毒測試有 false negative,顯示出呢個測試既設計應該係有問題。另外,FDA,CDC與美國各州政府之間都有分歧,州政府當然想為居民檢驗啦,但因為個測試係新開發,有大量問題同 uncertainy,所以FDA “made clear that laboratories were encouraged to develop tests but could not use them for clinical diagnosis without FDA’s “approval, clearance, or authorization during an emergency declaration.” 咁 what does that means? 如果你讀 law 的話,我expect你可以 read between the lines。
講返個測試,檢驗新病毒一般都係會用 RT-PCR (Reverse transcriptase-polymerase chain reaction 逆轉錄聚合酶鏈式反應)。好多人,包括肥人好多行家與同事甚至客仔,一聽到咩DNA測試,就以為呢個 test 無L敵啦,一定準確啦。Oh Sorry,no! 撇除所有「中國的會爆炸」同「中國有咩係真」呢兩個因素,一個test既結果是否可信係建基於樣本收集同檢驗方法,無論你係美國,意大利,南韓,日本定中國,樣本收集同檢驗方法先係 main point!
檢驗呼吸道感染疾病,你地話收集咩樣本好呀?Saliva? Sputum? Nasopharyngeal aspirate (NPA)? Bronchial lavage? 如果係上呼吸道病毒,咁 NPA都足夠既,sputum 都可以,但saliva 就應該要reject。但有時呢類既樣本都未必有足夠既病毒樣本去驗,病毒深入氣管去到肺氣泡(alveoli),樣本可能要係bronchial lavage先夠做。仲有,收集樣本既手法,部位,儲存方式,收集時間與檢驗時間既差距,樣樣都會影響結果。支棉花棒「了」得唔好,你或者都會無 result。
好啦,到講 RT-PCR啦。RT-PCR係需要 medical scientist 去砌一段 primer 出來開始做test。為左檢驗結果既可靠性,scientist通常會係新病毒入面抽一段比較穩定既 RNA segment 出來做 primer。可惜,有好多情況下,RT-PCR會俾個錯既答案你。
第一,primer 既設計好影響結果,上面都話段 primer 要係抽病毒一段比較穩定既 RNA segment 出來做,咁如果你抽錯左呢?第二,樣本既 DNA/RNA sequence 既integrity好差,甩頭甩骨咁,結果就會受影響。即係上面所講既樣本收集出現問題呀!第三,樣本純度低,或者份量少,又即係上面所講既樣本收集出現問題呀!咁個 tech 或者 scientist 要係咁加 PCR cycle去 amplify 個 sample,咁 amplify 出來既樣本就有好大機會係 false positive,呢點會影響所謂確診既可信度,亦係咁肥人我見到漁護處話瑞士花園個阿婆患者隻狗呈現弱陽性反應,我當下笑 L97 左出來。大佬呀,你是咪無足夠 sample 就鳩 amplify,然後個 result 根本有問題你都聽長官意志,鳩簽個名話係弱陽性呀?陽就陽,陰就陰。Result 唔 significant 或者 inconclusive,你出咩報告jack? Invalid 啦!仲有呀,病毒係 host specific 架,會傳染人既病毒,又點會無啦啦傳染狗? 眾所鳩知冠狀病毒係靠人類細胞上既 ACE2 (Angiotensin-converting enzyme 2,血管收縮素轉化酶2)來進入人體細胞啦,狗 ACE2既同人既一樣?
寫下寫下,喂,原來未寫數據演繹同政策問題,太長啦,下次再續!
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