
English: 
welcome to another MedCram lecture
total confirmed cases is 73,000
approximately total deaths is 1873 total
recovered is 12,000 887 and that ratio
of total recovered to total deaths has
been increasing if we go to the world
ammeter website we look at the total
cases that have been diagnosed again
here we see that big jump on February
12th because of the expansion of the
diagnostic criteria and leveling off
once again as we saw total deaths
however continued to increase although
there seems to be some leveling off if
we look again at more case statistics we
can get that broken down and we've been
looking at these carefully the number of
daily new cases seem to be leveling off
worldwide however if we look at new
cases outside of China they seem to be

Chinese: 
欢迎收看新一期的MedCram讲座
总确诊病例为73,000
总死亡人数1873，恢复人数是12887，
恢复和死亡数的比值在增加。
我们看一下Worldometer网站，确诊病例总数
可以看到二月十二的巨大上涨
是因为诊断标准变化，之后趋于稳定。
总死亡数
继续增加，但似乎趋于平稳。
这里有更多病例数据统计和分析，
我们仔细跟进这些数据，
每日新病例趋于稳定
但中国大陆以外的病例似乎在加速

Chinese: 
2月15-17的77%的新病例都来自钻石公主号的邮轮
我们稍后详细讨论。
在NPR网站上发布了一篇采访笔录
采访对象是Carl Bergstrom，华盛顿
大学生物学教授
他提到比起病毒，
传播更快的是伪科学谣言。
这些谣言涉及感染人数，传播方式
以及病毒的来源。
也讨论了谣言的可能来源。
我们下面放一个该文章的链接。
继续看这篇文章
这是来自明尼苏达大学
传染疾病研究与政策中心，讨论
过去24小时内的新闻，其中一件事

English: 
accelerating
we'll have more on that in a little bit
there was an interesting article that
was published on the website of NPR was
a transcript of a interview that was
done with Carl Bergstrom who's a
professor of biology at the University
of Washington who talks about something
that's spreading even faster than the
virus and that's false information it's
an interesting discussion about
misinformation about how many are
infected how it's spreading and the
source of how this virus came about and
it discusses the different motives for
why there might be misinformation about
this I think it's an interesting read
and we'll include a link in the
description below so given that let's go
ahead and take a look at this article
which is out of the University of
Minnesota and the Center for infectious
disease research and policy and it talks
about a lot of things that have happened
in last 24 hours one of the big things

Chinese: 
是一份来自中国CDC的报告
当然在中国有些事情受管控
但看下他们的研究报告
这项研究回顾了72,000例患者病历，
其中44,000个是实验室确诊病例
16,000起疑似病例
10,000是新的临床诊断病例
并且还有900例无症状患者
这里显示的是轻度，重度和
危重症的比例，这也肯定了我们
一开始的观察，
就是大约80％病症都为轻度，
绝大部分患者年龄在30到79岁之间。
疾病中14％是重症，其中约5％是危重症。

English: 
that's come out is a report from
basically the Chinese version of the CDC
and of course many things in China are
controlled by the government but it's
interesting to look to see what they are
reporting this is a study that came out
that looked at 72,000 patient records of
which 44,000 were lab confirmed cases
and 16,000 were suspected cases and over
10,000 were part of the newly expanded
clinical criteria for the corona virus
and there was almost 900 asymptomatic
cases so what they're showing here is
what proportion are mild severe and
critical and it kind of confirms what we
had been seeing in the beginning which
was that about 80% of the cases that
were diagnosed were mild and the vast
majority of these cases were in people
aged 30 to 79 so what did they see about
14 percent of these illnesses were
severe and about 5% of them were

Chinese: 
我们一直在讨论如果
能比较特定时间点的死亡人数和
确诊病例数。这是我和许多同仁关心的问题
因为患者可能确诊得很早，但是需要一段时间
才会因病毒去世
所以需要回顾多远才能得出准确的病死率。
做完了分析，他们观察了整体的
病死率，分析出来约为2.3％，
就像我们猜想的，有很多流感并发病毒性肺炎
研究中包括1023例死亡，
大多数患者年龄大于六十岁，
或者患有基础疾病。
在JAMA上发表的一项研究
表明许多医疗工作者

English: 
critical and then here's the interesting
part because we always discussed if you
could compare the number of deaths at a
particular point in time with the number
of confirmed cases at a particular point
in time and that was a concern for many
including myself because patients can be
diagnosed very early but it takes quite
a while for them
to die obviously from the virus and so
how far back did you need to go to have
a case fatality rates well when they
looked at these after it was said and
done they looked at the overall case
fatality rate and it turns out to be in
their analysis about 2.3 percent and
just as we suspected what we seen a lot
of viral pneumonia cases with influenza
there was one thousand twenty three
deaths included in the study
most of these were people who were aged
older than sixty and those who had
underlying medical conditions now there
was a study that was published in JAMA
that showed that a number of health care
workers at the very beginning of this

English: 
outbreak were infected a lot of them
those who call me Lee this confirmed
that about 1,700 health care workers
were infected in the outbreak and five
of them fatally one of those of course
was dr. Lee who was at the early portion
of the epidemic and actually warned a
number of his colleagues about this and
was reprimanded of course by the Chinese
government the events that marked the
severe acute respiratory syndrome or
SARS and the Middle East respiratory
syndrome coronavirus MERS Co V were
sometimes associated with super spreader
events and it didn't seem like there was
any evidence of that
occurring in this particular outbreak
the other big news is that there seems
to be and they're looking at a decline
in the number of cases that are
diagnosed in China now this may be
because of the quarantine and if they
release that quarantine we may see that
shoot up again it's also of course as
you have more and more people in fact
that it's more difficult for the virus
to infect more people because it can't
infect someone that's already infected

Chinese: 
从疫情一开始被感染，
证实大约有1,700名医护人员
在疫情中被感染，有五名
去世，他们其中之一是李医生。在疫情早期
流行时，提醒他身边的同事人数，
但并没有被政府重视。
之前的SARS 和
中东呼吸综合征冠状病毒(MERS-CoV)
有时会出现超级传播者
但似乎没有任何证据表明这次
疫情发生这种情况。
另一大新闻是，
中国的新病例数似乎在下降
这可能是因为隔离的效果，如果他们
解除隔离，可能会看到数据再次上涨
当病毒感染到一定数量时会有个瓶颈，
因为它无法感染已经感染的人

Chinese: 
WHO现在建议各方参考这个报告，关注事态进展。
另一个值得关注的新闻是关于
钻石公主游轮在横滨港被隔离
自2月3日起。截止昨天又新增了99例
确诊阳性的患者，总数增加到454，
美国国务院已经撤离了超过
300名美国人
和他们一起乘坐钻石公主的家人。
在他们下船和到达美国机场之间
官员们了解到其中十四名乘客
对Covid-19检测阳性，
这些人仍然上了飞机，被隔离到一个专门
区域，文章提到根据标准流程进行隔离。

English: 
so the w-h-o is asking people to take
this with a grain of salt and see how
things go the other interesting story in
all of this is what is going on on the
diamond Princess cruise ship which has
been quarantined in the Yokohama port
since February 3rd and as of yesterday
there was another 99 more people on this
cruise ship that had tested positive
raising the total to 454 and so the US
State Department had evacuated more than
300 US citizens
and their family members who had been on
the diamond princess interestingly
between when they got off the ship and
when they got to the airport the US
officials had learned that about
fourteen passengers who have been tested
turned positive for kovat 19 which is
the illness that is produced by the
virus and these people were still put on
the plane but put into a specialized
part of the aircraft and it says here
isolated according to standard protocol

English: 
these people argue to arrive at Travis
Air Force Base or the Joint Base in San
Antonio Texas there has also been a lot
of talk about where did this corona
virus actually come from and there is a
preprint
publication that means that this has not
been peer reviewed and this was made
available by an international group of
virologist some of them out of Southern
California at Scripps who looked at
their analysis of the genome of this
corona virus and they described as it
says here it's notable features and
scenarios that likely led to its
evolution they proposed two scenarios
natural selection in a host animal
before the virus jumped to humans or
natural selection in humans following
transmission from animals to people and
if we look at this article as you can
see here it comes out of Scripps
research in La Jolla California and also
the University of Edinburgh in the UK as
well as New York Sydney Australia New
Orleans and Germantown Maryland talks

Chinese: 
这些人到特拉维斯空军基地或
德州圣安东尼奥联合基地。另一个大家讨论的话题就是
新冠病毒起源于哪里。一个未出版的文章
（意味着还没有经过同行审查），
由一组国际病毒学家发表，其中一些人来自南加州
他们对病毒基因组进行分析
描述了一些特征性的功能
以及提出了它进化变异的两种可能场景：
在病毒感染人类以前，中间宿主内发生自然选择；
或者是从动物传人之后发生自然选择。
如果我们看这篇文章来自
加州拉荷亚的斯克里普斯研究中心，英国爱丁堡大学，
以及纽约、悉尼、澳大利亚、新
奥尔良和马里兰州。文章讨论

English: 
about the different possible origins of
this SARS cub - which is the name of the
virus in this they talk about the
binding sites of the SARS cuff - genome
specifically to the human ace to
receptor and in their discussion you can
see the breakdown of these sites where
they analyzed it and the mutations and
contact residues of the SARS cub to
spike protein and the conclusion that
they come to is interesting they say
that it is improbable that the SARS cuff
to emerge through a laboratory
manipulation of existing SARS related
coronavirus they go on further to say
that either this thing mutated before it
when in humans or after it went in
humans and they talked more about the
adaptation to humans finally in their
conclude
they say that it's currently impossible
to prove or disprove the other theories
of its origin and whether or not further
data will help resolve this issue and so

Chinese: 
SARS-Cov-2的可能不同起源
他们在讨论SARS-Cov-2病毒基因组的结合位点，
专门针对人类ACE2受体（血管紧张素II），在他们的讨论中，
可以看到这些网站的分析，分析了它的突变，
以及SARS-Cov-2刺突蛋白。
他们得出结论是
SARS-Cov-2不太可能
是通过实验室改造SARS出现的疾病
他们继续讲到，病毒亦或是在进入人体之前
或之后产生的变异。
最终得出结论
他们说目前不可能证明或反驳其他起源论，
也不确定更多数据是否有助于解决此问题，因此

Chinese: 
我们将在此处链接到这篇文章。
下面几期视频更新中讨论
该病毒究竟如何感染细胞
以及它如何复制自己
将涉及分子生物学知识
有兴趣的人我建议收看之前的视频
讲解新冠病毒如何通过
细胞因子风暴、病毒性肺炎和ARDS致死。感谢收看

English: 
we'll put a link in here to this article
as well some of the things that we'll be
talking about in upcoming updates is
exactly how does this virus infect cells
and how does it replicate and reproduce
we'll get into a little bit of molecular
biology also for those are interested I
will refer you to our video with the
link provided on how the corona virus
actually kills somebody through the
cytokine storm and the viral pneumonia
is an A RDS thanks for joining us
