7月29日晚，中央广播电视总台中国国际电视台（CGTN）“全球疫情会诊室”网络直播节目再次举办中国与南美国家专场交流，邀请来自中国香港的两名抗疫专家与来自巴西和阿根廷的同行分享抗疫经验。南美国家目前仍然是疫情的重灾区。根据美国约翰斯•霍普金斯大学的数据，截至7月30日，巴西累计新冠肺炎确诊病例超过255万，死亡人数超过9万，居全球第二位；阿根廷累计新冠肺炎确诊病例17.9万，死亡超过3000例。In the latest episodes of CGTN's live stream program "COVID-19 Frontline" held on Wednesday, July 29, CGTN invited doctors from Argentina, Brazil, and China to exchange their views on dealing with the new norm in cities around the world as the global COVID-19 cases have passed 16.5 million with over 656,000 deaths.香港医务行政学院院长刘少怀在节目中介绍，香港大部分新冠肺炎病例都是轻型患者，但目前疫情已经进入了第三波。第一波疫情是春节期间来自大陆的输入病例，当时政府很快采取了边境控制措施，及时控制了疫情。第二波疫情主要来自英国、美国、加拿大、澳大利亚等国家，主要是留学生和回港工作的人带回来的输入病例，这两个人群的整体健康水平较好，平均病程是15天左右。目前香港正在经历的是第三波疫情，和前两波疫情不太一样，主要是社区传播，大部分确诊的都是有基础疾病的老年人，患者的病程长达几周甚至几个月，且容易出现更加严重的并发症。截至7月29日，香港累计报告确诊病例3002例，死亡22例。阿根廷传染病学会会长奥马尔•苏德（Omar Sued）问道，新冠病毒除了会对患者造成肺部损伤之外，是否还会造成长期的神经系统或免疫系统损伤？前香港大学深圳医院呼吸与危重症学科主任、现伦敦皇家自由医院呼吸与重症监护医学顾问许建名回答说，在救治新冠肺炎重症病例的时候，他们确实观察到一些病人会出现神经功能损伤，这是他们没有预料到的，但这不一定与新冠病毒有直接关系。有些患者会出现脑炎、脑部微小血管损伤等情况，有些还有脑卒中的风险。目前他们还遇到十几例出现神经麻痹的病例，他认为这大概率是插管时间过长造成的。除了这些，比较常见的并发症还是心脑血管损伤、心肌衰竭、肺部损伤等，都是在救治病人的过程中需要长期注意的情况。The long term health effects of COVID-19 infectionDr. Omar Sued, president of Argentinean Infectious Diseases Society, asked about the long term health effects of COVID-19 infection.Dr. Liu Shao-haei, president of Hong Kong College of Health Service Executives, answered that most of the cases in Hong Kong are mild, and longer-term follow-up is needed. There has been a third wave of COVID-19 in Hong Kong, which is very different from the first and second waves. The first wave was imported cases from the Chinese mainland before the Chinese New Year. The second wave of the epidemic came from western countries, such as The United Kingdom, The United States, Canada, and Australia. Most patients during the second wave were overseas students or migrant workers who returned to Hong Kong. Now there's a third wave of community transmission, and most of the confirmed patients are in vulnerable populations, including elderly people and people with bacterial myocarditis. They can stay sick for up to a month and a half. To date, 22 out of 3,000 confirmed cases in Hong Kong have been fatal.Dr. Christopher Hui, the consultant of Royal Free Hospital and the Royal Brompton & Harefield NHS Foundation Trust (Lung Division) in London, added that some critically ill patients do have neurological damage. Several patients have developed nerve damage, which is related to prolonged intubation and intensive care management. Cardiovascular and cerebrovascular injury, heart failure also needs to be considered in managing these patients. "I do think COVID-19 patients need to be followed up regularly for the long-term. We are starting data collection from these patients as soon as they are discharged from hospital to assure that they have very good access to health care," Dr. Hui said.苏德医生说，在拉美国家，ICU床位是很有限的，很多病人在重症病房住了三十多天，检测结果显示仍然携带病毒，因而没有转出ICU，他想了解如何更高效地使用ICU床位。刘少怀医生向他介绍了香港的经验。他说，首先，需要卫生管理部门制定ICU转入和转出的标准，这一点非常重要，因为它不仅涉及科学管理问题，还涉及资源的调度和分配。第二，要有一个集中的医疗资源管理系统。他介绍，香港是公共医院系统在统一负责管理所有的隔离场所，这个系统掌握香港所有确诊病例的数据库，符合转出ICU标准或出院标准的病人，视具体情况，要么转到普通病房继续接受治疗，要么转到专门的康复机构进行康复，要么回家进行自我康复，有专门的部门对这些病人做医学追踪观察，还有针对这些病人提供的专业热线服务。 他补充说，这种对病人进行分级管理的经验来自大陆，方舱医院的设置就是为了使医疗资源得到高效利用，香港的会展中心也改造成了方舱医院，南美可以复制这一经验。CGTN主持人邹韵在北京演播室主持“全球疫情会诊室”The challenge of Lacking ICU bedsDr. Omar also said there are not many ICU beds in Latin America, and many patients have been in the ICU for more than 40 days. So he wondered how can ICU be used effectively?Dr. Liu said that Hong Kong also faces a similar challenge, but it's the health authorities who need to formulate discharge standards. The data on COVID-19 patients needs to be collected. Discharged patients can stay in rehabilitation facilities or recover at home with help from a professional nurse. They also need to wear a mask and self check their temperature.In Hong Kong, the hospitalized patients in stable condition will be transferred to "step-down wards" to ease the pressure on ICU beds. In the Chinese mainland, temporary hospitals were built to accept patients for the time being. But critically ill patients need to be admitted to the ICU. Discharge criteria should be established, and hospitals can't be run the way they used to be.巴西里约热内卢联邦大学的感染科医生玛塔•卡瓦尔坎蒂（Marta G.Cavalcanti）说，核酸检测是找出病人的最有效的办法，但是拉美很多国家都属于低收入国家，很难负担得起大范围进行核酸检测的费用，她想知道如何在成本有限的情况下高效地利用核酸检测发现病人。刘医生回答说，首先要说服政府和卫生部门做好前期的防控措施，因为如果不能在早期控制疫情传播，后期需要的检测费用会高出许多。另外，虽然香港是一个人口密集城市，也没有要求全部居民都做核酸检测，而是重点对高风险人群进行检测，具体包括几类人群：一是养老院里的老年人；二是出租车司机；三是生鲜市场的工作人员；四是餐饮行业的工作人员。他还指出，核酸检测能够增强人们的信心，因为如果在类似生鲜市场这样的地方发现病毒，整个城市都会恐慌，而政府需要解决市民的心理恐慌问题。Marta G. Cavalcanti, the infectious diseases specialist from Brazil, said testing is very important, but it is not realistic to detect most of the population. So she wondered whether the detection capacity needs to be increased? And how to detect asymptomatic patients?Dr. Christopher Hui said the RT-PCR test, a nuclear-derived method, is mainly used in China and Europe. Antibody testing is problematic, but it's improving because there are more data samples now. Another problem is that current commercially available kits were drawn on a very limited number of patients, such as patients in intensive care. So the sensitivity of these kits is low. Therefore, the tests should be done repeatedly to break the chain of transmission.Dr. Liu also added that health code could also help prevent the spread of COVID-19. But Hong Kong is a small city with a dense population of 7 million, it hasn't adopted the health code system. But it uses epidemiology criteria FTOCC (Fever, Travel, Occupation, Contact, Clustering). Also, Dr. Liu said Hong Kong is a dynamic city that won't be locked down. It is important to collect samples for early detection and diagnosis.本场节目进行了一个小时，中国专家还回答了南美同行在出院病人的康复治疗、“复阳”病例出现的原因、抗体检测的准确性、南美国家城市和乡村的疫情分布差异等方面的问题。巴西和阿根廷的医生表示，中国同行在节目里分享的很多经验都为他们提供了很好的思路，他们深表感谢。全球疫情会诊室: 中国与墨西哥医学专家探讨新冠肺炎治疗策略
“全球疫情会诊室”：中国专家与赞比亚、加拿大、比利时同行分享公共防疫经验