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On March 12, British Prime Minister Johnson announced the measures to respond to the Coronary Virus epidemic.On the 13th, the British government's chief scientific consultant Varanis explained that the policy of British resistance was to cause 60%of the population infection to obtain group immunity.
Subsequently, this anti -epidemic policy was criticized by the United Kingdom and the world.Those who are light say that group immunity is a lie; the most important thing is that this is irresponsible to the people, and even the violations and crimes of citizens' lives.
Under the wave of critical criticism, on March 15, the British Health Minister Han Cock said that the group's immune policy is not a government policy or goal, and its goal is to fight viruses and protect vulnerable groups.He said that the British government will announce new anti -epidemic measures, and elderly people over 70 years of age may be asked to be separated at home for four months.
It is unknown whether this statement can appease the British people and the people of the world, but the point is that if you can formulate anti -epidemic policies based on the medical level, economic strength, cultural customs, political systems, religious beliefs and historical accumulation of a country,There is a choice that connects Rome, rather than only Huashan.
In fact, more than one country has adopted similar approach to Britain.On March 15th, French Education Minister Brown Kai said that (our epidemic prevention) strategy was not to prevent virus spread at the beginning, but to delay the spread of the epidemic.In the end, people will infected this virus to form lsquo; most immune to rsquo; and the virus itself disappears.
There are actually two questions about the problem. One is whether the group's immunity is rational and effective, and the other is whether people criticize the policy of group immunity, whether they fully understand this policy.
Herd Immunity (Herd Immunity or Community Immunity) refers to that when there are enough people to cause pathological pathogens, such as 2019 coronary viruses, after immune, other unmnological individuals are also protected and not infected.There are two ways to obtain group immunity. One is artificial immunity, and the other is natural immunity.
Artificial immunity includes serum (passive immunity) of injection vaccine (active immunity) and rehabilitation.At present, both of them are difficult to implement. The former is because the vaccine has not been developed, and the latter is because the serum of the recovery is difficult to confirm the immune effect and safety, especially the safety is difficult to guarantee. Therefore, there are some hidden dangers.Patients perform sympathetic use (compilation: Compassionate use, referring to the use of new drugs for intensive patients who can no longer be delayed).
Therefore, the realization of immunity to the crown disease group has fallen into natural immunity, that is, let people naturally infection and disease, and get the immunity to the virus after healing.If there are more people who have obtained immunity through natural immunity, Britain's calculation is more than 60%of people, and it can become an effective natural barrier and protective wall, thereby preventing the popularity of crown diseases and disappearing them.
The basis for immune theory of coronary group
There are more theories and basis for this approach.First, when a large number of individuals in the group are immune or susceptible to individuals in infectious diseases, the infectious chain of infection of those infectious diseases spreading between individuals will be interrupted. Without the infectious chain, the epidemic will be unsustainable.
In addition, another theory of immunity is that the immunity obtained from natural diseases is more immunity than artificial immunity. This is the theory of immunity.For example, when you have suffered from influenza in your childhood, you will be greatly protected when you experience the same type of influenza in the future without suffering from flu.Even different types of influenza will be protected. If the symptoms are mild during illness, they can recover quickly.
Another scientific basis for implementing group immune policies is that many of the crown virus infection is hidden, and many of them are mild and difficult to prevent; even many people turn positive after cure and are contagious.Therefore, it is difficult for everyone to find every person in the world but also mild symptoms through medical methods.In this case, it is an effective way to obtain group immunity after natural illness.
Of course, there is another reason for the implementation of group immunity. At present, there is no development of vaccines, and the immunity can only be obtained by the disease of primary infection.It is at this point that some people think that Britain's approach is to disregard the safety of citizens.In addition, there is a reason for people to suspect that group immune theory, that is, whether crown disease will be like flu. Most people can obtain strong immunity after natural illness, and ensure that most people do not die.
This is actually an ethical issue.If it is an plague, the mortality rate of people after illness is very high, with 30%to 60%. If it is not taken in isolation and sealing the city, people will naturally die after the illness.The defensive wall cannot talk about group epidemic prevention.Moreover, the result of allowing most people to suffer from plague is death. This is obviously a great violation of human life ethics, and even anti -humans. It is taken for granted by criticism and opposition.
However, Britain's biggest ethical consideration for group immunity to crown disease is that according to the scientific research and analysis of the current situation, this disease is only higher than the mortality rate of influenza, which is more serious than the flu. The average evaluation is 1%of the disease mortality rate;Moreover, more than 80%of human beings must not have symptoms or mildness after the virus is infected. Therefore, the results or consequences are acceptable, and people can obtain immunity, so group immunity can be established.
However, the stance that critics insist on is to make a cost -effective assessment of people's lives and formulate anti -epidemic policies based on this, which is immoral.In fact, this has involved the second question, how to comprehensively evaluate British group immunity.
Group immunity is not to give up the treatment of patients.Under the limited medical resources, rescue of the crisis is still the rescue of mild cases. This seems to be another tram ethics, moral choices, and utilitarian choices.The choice of Britain happens to be utilitarian and uses medical resources on a few severe people.This choice is also a refutation to the so -called survival of the critics.Britain did not eliminate critical patients, but instead used limited medical resources to rescue them.
Secondly, group immunity does not push everyone to natural illnesses, but only after weighing the advantages and disadvantages, it is believed that measures such as Fengcheng are basically unavailable, and the spread of coronary virus is not available.The prevention of easy -to -prone people is to be separated at home for the elderly over 70 years old for four months.At the same time, the British government's prevention measures are also separated from the home of patients with symptomatic patients to achieve effective internal family prevention and control, while protecting the elderly and susceptible people.Moreover, as long as one person in the family is infected, all family members must be isolated at home to achieve internal family prevention and control.Of course, these measures are also an effective way to prevent the spread of crown disease.
In addition, only the key prevention and treatment of the susceptible population can be used in addition to the use of steel on the blade, which can also reduce social costs and economic losses. This is also the content that must be considered.Some of the costs of resistance are obviously hidden and will not be mentioned by people. For example, after the city and the prohibition of all normal life, production and entertainment, the hospital stops the usual diagnosis and treatment.The patients with nephrotoxenosis, pregnant women who need to give birth, acute injured, etc., their treatment will be delayed or even stagnated, that is, at the cost of their health and life.How big is this price, few people are counting; it is possible that the number of deaths of these people is equivalent to the number of deaths of crown diseases, which may even exceed.Who will consider and resolve this price?
Uncertainty of group immunity
The only or biggest disadvantage of group immunity is uncertainty.As proposed by the British Institute of Immunization, we do not know the mechanism of coronary virus on the human immune system, and we are not sure how it should be applied in the actual situation.Can the virus have continuous antibodies in the infected person?we do not know.
However, there are at least a little clear about this problemReal answer.First, the recovery of crown disease will definitely obtain immunity, and antibodies with therapeutic effects in the body, such as IgG (immunoglobulin G), otherwise China will not propose a clinical diagnosis and treatment plan for the recovery period of new crown pneumonia, andThe dose of this plasma therapy is 200 ml to 500 ml.
Secondly, a research on Ganges monkeys in China shows that the monkey can recover for the monkey's active infection with coronary virus. The neutral antibody produced in its body is equivalent to the neutralized antibody of the rehabilitation patient.If monkeys develop neutralized antibodies early after the first infection, no re -infection will occur.These situations at least show that the healing of people after natural infection can obtain immunity. As for the size or strength of immunity, it needs to be confirmed.
Of course, if you cannot get strong immunity after natural illness, you may fail to immune to the group of crown diseases.However, if you can get immunity or get more powerful than influenza?This is just like the treatment of all diseases in the treatment of all diseases.In addition, group immunity is conducting scientific demonstrations. With a lot of protection strategies, if the strategy proposed after the protection of the susceptible population, the possibility of success is higher than the possibility of failure. Why not try it?This is more reasonable than that of 1%of hope in clinical 1%hopes.
What's more, it is difficult for Britain and other countries to be able to implement a comprehensive sealed city and prohibit all life and production activities like China.Group immunity is right and wrong, effective or ineffective, and should be tested for time and practice.Of course, the key is the time point of the British to adjust the immune policy of the group at any time.
The author is a Beijing scholar
