Offline: COVID-19 is not a pandemic.
Offline: COVID-19 is not a pandemic.
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DOI：
10.1016/s0140-6736(20)32000-6
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发表时间：
2020-09-26
期刊：
影响因子：
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通讯作者：
Horton R
中科院分区：
文献类型：
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作者：
Horton R
随着全球死于COVID-19的人数接近100万，我们必须面对这样一个事实，即我们正在采取一种过于狭隘的方法来管理这种新型冠状病毒的爆发。我们认为这场危机的原因是一种传染病。我们所有的干预措施都侧重于切断病毒传播途径，从而控制病原体的传播。指导各国政府的“科学”主要是由流行病建模者和传染病专家推动的，他们可以理解地用几个世纪以来的瘟疫术语来描述目前的卫生紧急情况。但到目前为止，我们所了解到的情况告诉我们，COVID-19的故事并不那么简单。两类疾病在特定人群中相互作用-严重急性呼吸系统综合征冠状病毒2型（SARS-CoV-2）感染和一系列非传染性疾病。根据我们社会中根深蒂固的不平等模式，这些情况集中在社会群体中。这些疾病在社会和经济不平等的背景下聚集在一起，加剧了每种疾病的不利影响。COVID-19并非大流行病。这是一种流行病。我们所面临的威胁的流行病性质意味着，如果我们要保护我们社区的健康，就需要采取更细致入微的办法。
As the world approaches 1 million deaths from COVID-19, we must confront the fact that we are taking a far too narrow approach to managing this outbreak of a new coronavirus. We have viewed the cause of this crisis as an infectious disease. All of our interventions have focused on cutting lines of viral transmission, thereby controlling the spread of the pathogen. The “science” that has guided governments has been driven mostly by epidemic modellers and infectious disease specialists, who understandably frame the present health emergency in centuries-old terms of plague. But what we have learned so far tells us that the story of COVID-19 is not so simple. Two categories of disease are interacting within specific populations—infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and an array of non-communicable diseases (NCDs). These conditions are clustering within social groups according to patterns of inequality deeply embedded in our societies. The aggregation of these diseases on a background of social and economic disparity exacerbates the adverse effects of each separate disease. COVID-19 is not a pandemic. It is a syndemic. The syndemic nature of the threat we face means that a more nuanced approach is needed if we are to protect the health of our communities.