- 作者列表："Valeras AS
:In previous President's Columns (Valeras, 2019a, 2019b), the properties of complexity and complex adaptive systems have been discussed, in terms of the value of continual and iterative change, in order to nudge a system to emerge differently, rather than maintain the status quo. COVID-19 is not a nudge; it is a tidal wave. Engaging with and understanding complexity science allows us to examine the internal rules of our health care system and recognize our own role as agents that can systematically and deliberately disrupt the status quo. The intertwined and interdependent complex relationships that exist in health care between persons, business, academia, and government buffer the system from rapid and drastic change. COVID-19, however, swiftly disrupted many of the rules keeping the system in its previous state. Some would describe this sudden and dramatic systems change as a Black Swan. This column will examine the role of the Black Swan, as it relates to this pandemic. The Black Swan is a term coined in the 2nd century by Roman poet Juvenal's description of something being rara avis in terries nigroque simillima cygno, Latin for "a bird as rare as the black swan" (Taleb, 2007, p. xxxi). At this time, reference to a black swan was meant as a statement of impossibility, because all historical records of swans had been white. In 1697, Dutch explorers discovered black swans living in the wild in Western Australia (Taleb, 2007, p. xxi), and the black swan became a metaphor for events that come as a surprise, have major implications, and can often be understood only with the benefit of hindsight. This theory of the black swan was further articulated by Nassim Nicholas Taleb in his books Fooled by Randomness (Taleb, 2001) and The Black Swan (Taleb, 2007). (PsycInfo Database Record (c) 2020 APA, all rights reserved).
: 在前任总统的专栏 (Valeras，2019a，2019b) 中，讨论了复杂性和复杂适应系统的性质，即连续和迭代变化的值，为了推动一个系统以不同的方式出现，而不是维持现状。新型冠状病毒肺炎不是一种推动，而是一种浪潮。参与和理解复杂性科学使我们能够检查我们的医疗保健系统的内部规则，并认识到我们自己作为能够系统地故意破坏现状的代理的角色。医疗保健中存在的人、企业、学术界和政府之间相互交织和相互依存的复杂关系缓冲了系统的快速和剧烈变化。然而，新型冠状病毒肺炎迅速扰乱了许多规则，使系统保持以前的状态。有些人会把这种突然而戏剧性的系统变化描述为黑天鹅。本专栏将研究黑天鹅的作用，因为它与这一流行病有关。《黑天鹅》是第2 世纪罗马诗人朱维纳尔在类似cygno的terries nigroque中描述rara avis的术语，拉丁文表示 “像黑天鹅一样罕见的鸟” (Taleb，2007，p. xxxi)。此时，提到黑天鹅的意思是说不可能，因为所有关于天鹅的历史记录都是白色的。1697 年，荷兰探险家在西澳大利亚发现了生活在野外的黑天鹅 (Taleb，2007，p. xxi)，而黑天鹅成为一个隐喻的事件来作为一个惊喜，有重大的含义，往往可以理解只有事后的好处。纳西姆 · 尼古拉斯 · 塔勒布在《被随机性愚弄》 (Taleb，2001) 和《黑天鹅》 (Taleb，2007) 中进一步阐明了黑天鹅的这一理论。(PsycInfo数据库记录 (c) 2020 APA，保留所有权利)。
METHODS::Since mid-December of 2019, coronavirus disease 2019 (COVID-19) infection has been spreading from Wuhan, China. The confirmed COVID-19 patients in South Korea are those who came from or visited China. As secondary transmissions have occurred and the speed of transmission is accelerating, there are rising concerns about community infections. The 54-year old male is the third patient diagnosed with COVID-19 infection in Korea. He is a worker for a clothing business and had mild respiratory symptoms and intermittent fever in the beginning of hospitalization, and pneumonia symptoms on chest computerized tomography scan on day 6 of admission. This patient caused one case of secondary transmission and three cases of tertiary transmission. Hereby, we report the clinical findings of the index patient who was the first to cause tertiary transmission outside China. Interestingly, after lopinavir/ritonavir (Kaletra, AbbVie) was administered, β-coronavirus viral loads significantly decreased and no or little coronavirus titers were observed.
METHODS::In December 2019, a novel coronavirus (2019-nCoV) caused an outbreak in Wuhan, China, and soon spread to other parts of the world. It was believed that 2019-nCoV was transmitted through respiratory tract and then induced pneumonia, thus molecular diagnosis based on oral swabs was used for confirmation of this disease. Likewise, patient will be released upon two times of negative detection from oral swabs. However, many coronaviruses can also be transmitted through oral-fecal route by infecting intestines. Whether 2019-nCoV infected patients also carry virus in other organs like intestine need to be tested. We conducted investigation on patients in a local hospital who were infected with this virus. We found the presence of 2019-nCoV in anal swabs and blood as well, and more anal swab positives than oral swab positives in a later stage of infection, suggesting shedding and thereby transmitted through oral-fecal route. We also showed serology test can improve detection positive rate thus should be used in future epidemiology. Our report provides a cautionary warning that 2019-nCoV may be shed through multiple routes.
METHODS::There is a current worldwide outbreak of a new type of coronavirus (2019-nCoV), which originated from Wuhan in China and has now spread to 17 other countries. Governments are under increased pressure to stop the outbreak spiraling into a global health emergency. At this stage, preparedness, transparency, and sharing of information are crucial to risk assessments and beginning outbreak control activities. This information should include reports from outbreak sites and from laboratories supporting the investigation. This paper aggregates and consolidates the virology, epidemiology, clinical management strategies from both English and Chinese literature, official news channels, and other official government documents. In addition, by fitting the number of infections with a single-term exponential model, we report that the infection is spreading at an exponential rate, with a doubling period of 1.8 days.