我的中原大學廖文忠學長(益鼎公司前董事長)，敘述其母集團中鼎公司SARS因應傑出經驗，值得借鏡:
我是中鼎退休主管，2003年中鼎員工在華航自香港飛台北的班機上，在不知情的情況下，感染SARS，造成台灣
的SARS風暴。
的SARS風暴。
我們的員工及眷屬，曾經被民眾避之唯恐不及。慘痛教訓，15年過去，記憶猶深。
SARS造成台灣47人死亡。而我們中鼎員工卻奇跡式的，除染煞的同仁全部康復，也沒有增加任何一個病例。
事後我們做了很澈底的SARS危機及風險管理的檢討。結論是，最有效的策略就是現在各國在實行的「決戰境外」。
我們是7000人的全球化集團，海內外有30幾家分支機構。人員來往頻繁，只要有病徵，立刻隔離觀察七天。這種隔離觀察，就是「決戰境外」概念的延伸。
另外，我們的危機處理火速澈底。早上要求有狀況的幾位（記得是6位）同仁去台大醫院檢查，傍晚就決定大樓2000員工停班三天全面消毒。而且住院同仁周邊的100多人停班7天觀察。
我們的不幸，是台灣第一批感染SARS的病例，卻幸運的得到台灣最頂尖醫療團隊的照護。
在病因不明，沒有前例下，我們嚴格的遵守醫療團的要求，渡過了最危險的三個月，最後，不但染病的員工，全部奇跡式的完全康復，其他員工也安然無恙。
我個人的感受是，其間決無僥倖，與醫療團隊充分配合，嚴格的團體紀律是關鍵。
其間很多細節就不在此贅述！
EYE ON THE NEWS
January 29, 2020
A Threat to Humanity
Viral epidemics, like coronavirus, represent a danger far more real than climate change.January 29, 2020
Health Care
The Social Order
Over the past century, as globalization accelerated, viral epidemics have become a serious threat to humanity. In 1918, the Spanish flu killed about 50 million people around the world. The average age of victims was 20, and many died within a day. A comparable flu struck Mexico in 2009, infecting at least 1 million victims. This time, the average victim age was 40. Such flus or pneumonias, different from ordinary seasonal flus, kill the young rather than the elderly. Youth lack natural immunity because of their limited exposure to viruses.
These epidemics are becoming recurrent, too, and emerging more quickly. They’re especially prevalent in China, which has experienced remarkable growth since the turn of the century. In 2003, a pneumonia epidemic, SARS, infected thousands in China before reaching Canada and the United States. At the time, the SARS story paralyzed media, but even today, we don’t know how many people succumbed to the virus, because Chinese authorities hid the evidence.
Now China’s latest epidemic, the coronavirus, is causing anxiety worldwide while remaining largely a mystery. Coronavirus typically spreads between animals and humans, the illness leaping from one to the other, mutating and becoming deadlier as it evolves. The latest mutation originated somewhere in China’s Wuhan region, home to vast chicken and pig farms, where dubious hygienic conditions prevail amid a large population. But now the virus has traveled, as did previous epidemics. The Spanish Flu, for example, likely started on a U.S. chicken farm and then traveled by ship. It took one infected sailor, going from port to port, to create a global pandemic. But the risk is even greater today, with airline traffic making the globalization of a virus almost immediate.
When a new virus emerges, it takes months to create a vaccine for treatment. In the interim, only time and isolation can manage infection rates. Nor is there any remedy other than medicines that ease symptoms. The highly respected French epidemiologist Robert Sebag told me that, judging from past experience, it’s conceivable that up to 15 percent of those who contract the Wuhan virus could die. Chinese officials, though conceding that the virus is highly contagious (and more so than SARS), maintain that the more likely figure is 3.5 percent. This is, of course, largely guesswork for the time being. The only effective measure against the virus at this point is to isolate the sick to control contagion. But the source remains unknown, making management difficult; and not enough Chinese doctors exist—and not all are competent—to contain an illness spreading from city markets to the countryside.
Chinese Communism worsens the problem. According to Communist Party logic, all is well, and news that reflects poorly on the government must be suppressed. Any negative development, from a train accident to an epidemic, is harmful to the Party’s glorious and progressive image. Dissimulation is the norm throughout the land. In 2003, for example, China denied the SARS epidemic; once the virus had spread beyond its borders, Beijing’s admission came too late to do any good.
This time, China is taking an aggressive approach, isolating a province of 40 million people. It’s still too late, though: the epidemic required a quicker response to a smaller area, but local authorities delayed action in favor of silence. As a result, since the epidemic began—the start date remains unknown—several million travelers have entered and left Wuhan. Now coronavirus has spread throughout China, as well as France, Canada, and the United States. At this point, isolation is likely impossible, and even the Chinese government will have difficulty detaining 40 million people. For now, the coronavirus will have to run its course, and when it subsides, it will take months to determine how many succumbed to the illness.
Such epidemics will occur again—perhaps as soon as next year. Establishing better sanitation standards on Chinese farms could improve prevention. The Communist Party must also change its culture by rewarding, rather than punishing, those who raise alarm. An early quarantine, even if it proved groundless, would be better than one that is late and useless.
An effective vaccine protocol isn’t beyond reach. Current flu vaccines protect against about 20 percent of cases, depending on the seasonal mutation. It would be possible to create and store vaccines over a larger spectrum, on the order of 80 percent, but this would require massive investment in research and production. The University of Minnesota’s Michael Osterholm, an expert in fighting the flu virus, believes that scientists should equate battling deadly epidemics with the Manhattan Project—this time, to save lives. Indeed, considering the number of avoidable deaths, such a project would be economically viable. But people have short memories. The flu has been around as long as humanity; it ravaged ancient Greece. Yet it goes forgotten from one year to the next.
Another problem: we confuse seasonal flu with special viral strains that kill younger people in huge numbers. No one wishes for it, but only a global epidemic of extreme gravity could launch the necessary research and change political behavior. We don’t know if the Wuhan virus will spark such a change. The threat, in any case, is more serious and more immediate than global warming—but will a real threat arouse less fear than a theoretical one?
新英格蘭醫學期刊
蔡秀男──和 A Nan Tsai 。
NEJM最新論文（1/29）出爐了！竟然，掀開了天大的秘密與醜聞！
中國武漢肺炎最初傳染425個案例流行病學大公開！
中國武漢肺炎隱匿疫情的戰犯們，自證己罪/呈堂證供都在這裡，看來有人要倒大楣了！
作者群裡有幾位身兼中國中央及省市地方疾病管制單位？
1. 原來，早在2019/12月中，你們自己人可能就知道會「人傳人」？！
2. 原來，你們早就知道多數案例已跟華南海鮮市場無關！？
3. 可惡，2020/1月中，還騙人「不會人傳人」？「有限人傳人」？ 「可防可控」？
4. 直到1/20 才被外省人北京鍾南山院士揭發武漢肺炎「會人傳人」！害全球華人2020農曆年都不用過年了！
5. 作者群裡有幾位身兼中國中央及地方疾病管制單位？ 竟然還隱匿疫情到1月底？只顧著寫論文？是誰說「感控任務完成前，不應把精力放在論文發表上...」？
6. 你們到底做了什麼防疫作為？應注意能注意而有注意？坐視人群傳染觀察研究數據而不救人？
7. 到底，寫論文投稿重要？還是公共衛生防疫救人重要？是誰說「要把人民群眾生命放在第一位」？
8.公共衛生倫理與學術倫理，都需要被嚴格檢視！除了違反倫理，難道沒有違反中國傳染病防治相關法規？
9. 尊重生命是普世價值，面對武漢肺炎世紀疫災千萬難民，到底根本原因系統因素是什麼？ 全方位危機處理怎麼辦？
10. 到底，誰說「緩報」、「瞞報」、「漏報」導致疫情擴散要嚴懲？
習大大，李克強，你們不該震怒嗎，不該撤查法辦嗎？
「Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus–Infected Pneumonia
List of authors.
Qun Li, M.Med., Xuhua Guan, Ph.D., Peng Wu, Ph.D., Xiaoye Wang, M.P.H., et al.
Qun Li, M.Med., Xuhua Guan, Ph.D., Peng Wu, Ph.D., Xiaoye Wang, M.P.H., et al.
January 29, 2020
DOI: 10.1056/NEJMoa2001316
DOI: 10.1056/NEJMoa2001316
Abstract
BACKGROUND
The initial cases of novel coronavirus (2019-nCoV)–infected pneumonia (NCIP) occurred in Wuhan, Hubei Province, China, in December 2019 and January 2020. We analyzed data on the first 425 confirmed cases in Wuhan to determine the epidemiologic characteristics of NCIP.
METHODS
We collected information on demographic characteristics, exposure history, and illness timelines of laboratory-confirmed cases of NCIP that had been reported by January 22, 2020. We described characteristics of the cases and estimated the key epidemiologic time-delay distributions. In the early period of exponential growth, we estimated the epidemic doubling time and the basic reproductive number.
RESULTS
Among the first 425 patients with confirmed NCIP, the median age was 59 years and 56% were male. The majority of cases (55%) with onset before January 1, 2020, were linked to the Huanan Seafood Wholesale Market, as compared with 8.6% of the subsequent cases. The mean incubation period was 5.2 days (95% confidence interval [CI], 4.1 to 7.0), with the 95th percentile of the distribution at 12.5 days. In its early stages, the epidemic doubled in size every 7.4 days. With a mean serial interval of 7.5 days (95% CI, 5.3 to 19), the basic reproductive number was estimated to be 2.2 (95% CI, 1.4 to 3.9).
CONCLUSIONS
On the basis of this information, there is evidence that human-to-human transmission has occurred among close contacts since the middle of December 2019. Considerable efforts to reduce transmission will be required to control outbreaks if similar dynamics apply elsewhere. Measures to prevent or reduce transmission should be implemented in populations at risk. (Funded by the Ministry of Science and Technology of China and others.)」
DW Euromaxx 人像/人頭縮時
Happy 69th birthday, Phil Collins! 🎉🎊🎈 The British musician kicked off his career in the 1970s as the lead singer and drummer of the rock band Genesis, and later enjoyed a successful career as a solo artist with hits like "In the Air Tonight" and "Another Day in Paradise." What's your favorite Phil Collins song?
---- 內有歌文
......robin may
3 days ago
She calls out to the man on the street
"Sir, can you help me?
It's cold and I've nowhere to sleep
Is there somewhere you can tell me?"
Happy 69th birthday, Phil Collins! 🎉🎊🎈 The British musician kicked off his career in the 1970s as the lead singer and drummer of the rock band Genesis, and later enjoyed a successful career as a solo artist with hits like "In the Air Tonight" and "Another Day in Paradise." What's your favorite Phil Collins song?
---- 內有歌文
......robin may
3 days ago
She calls out to the man on the street
"Sir, can you help me?
It's cold and I've nowhere to sleep
Is there somewhere you can tell me?"
He walks on, doesn't look back
He pretends he can't hear her
He starts to whistle as he crosses the street
She's embarrassed to be there
He pretends he can't hear her
He starts to whistle as he crosses the street
She's embarrassed to be there
Oh, think twice, it's just another day for
For you and me in paradise
Oh, think twice, it's just another day
For you, you and me in paradise
Just think about it
For you and me in paradise
Oh, think twice, it's just another day
For you, you and me in paradise
Just think about it
She calls out to the man on the street
He can see she's been cryin'
She's got blisters on the soles of her feet
She can't walk but she's tryin'...
He can see she's been cryin'
She's got blisters on the soles of her feet
She can't walk but she's tryin'...
讀之落淚⋯
進入疫區現場
有助於了解與評估
疫情的可能發展
有助於了解與評估
疫情的可能發展
卡繆的《大瘟疫》
則以虛構的疫區封城
深入討論
人性、理性、道德、宗教
與 「真實」
則以虛構的疫區封城
深入討論
人性、理性、道德、宗教
與 「真實」
因虛構而益見真實
這是藝術與文學的本質
想像不是空穴來風
透過想像
好的小說家
才得以探討真實
這是藝術與文學的本質
想像不是空穴來風
透過想像
好的小說家
才得以探討真實
真實必須蘊涵普遍性
但實際發生的現場
則是藝術心霊與手法的素材
則是藝術心霊與手法的素材
在這疫病開始蔓延
未來佈滿不確定性的時刻
譲我們先回到現場
融入罹病的愛、恐懼與悲悽⋯
未來佈滿不確定性的時刻
譲我們先回到現場
融入罹病的愛、恐懼與悲悽⋯
阿南 2020-1-30
————————-
在人間：媽媽走了
/倩倩口述
在人間：媽媽走了
/倩倩口述
（編按：联系上倩倩是腊月二十九。当天上午10点，武汉因新型冠状病毒肺炎封了城。她很焦急，她母亲和父亲被隔离在不同的医院，母亲严重，父亲轻微。哥哥也确诊了，但医院不接收，自己在一个酒店房间隔离。她担心虚弱的妈妈在病房里缺少照料。
除夕夜里，我们又聊了一次，她的情绪明朗了些。早些时候妈妈告诉她，在隔离病房里找到了护工。她奔波一天，帮爸爸买到了免疫球蛋白。她一路飞驰，从买药的汉口奔回了家。那天夜里12点，武汉要锁江。
大年初一中午，她发来微信，告知了妈妈去世的消息。她哭着喊“我没有妈妈了，我没有妈妈了，我该怎么办”。
江城冬日阴冷，时常飘雨。农历新年第一天，倩倩四处奔波，送别母亲。疫情给了这个家庭突然的重击。最内疚的是她父亲。因为担心妻子肺部的小结节，1月中旬，他让她动了个手术。随后她在医院感染新型冠状病毒。
短短几个日夜，疫情陡然严峻，喧闹的武汉逐渐停转。截至1月28日的官方统计数据显示，湖北已有100个人感染去世。
以下是倩倩的口述）
——————
一、
一、
妈妈走了。一切都太不真实了。
大年初一早上，爸爸打电话让我给他送药。我拿了10瓶免疫球蛋白出门，想分别给爸妈送一些。
我把药放在隔离楼大厅的一个地方，走远。爸爸来取走了药，临走时，喊了一句“妈妈可能不行了”。我很震惊。后来他发短信来，说十几分钟前医院打来电话，告知妈妈器官衰竭了，正在抢救。我很着急，想联系妈妈的护士，但一直联系不上。
我又给爸爸发短信，安慰他“哪里衰竭，不会的，肯定可以抢救回来。妈妈那么坚强，我们要相信她”。
他回复：“不会了，现在抢救只是走形式”。
我向爸爸要了告诉他消息的电话号码，打过去，对方一直暗示，妈妈要不行了。我只能哭着求他，“我什么都可以不要，多少钱都不在乎，求你用最好的药、最好的设备救救妈妈，我不能没有妈妈啊”。
没几分钟，电话又响了。医生很郑重地介绍了身份。我就知道，完了。医生说已经通知了殡仪馆，一会就要把妈妈的尸体拉走。我求医生等等我，我马上就到。他答应了，但让我不能靠近妈妈。
第一次跟医院打电话后，我给哥哥打了个电话，故作轻松，像往常一样打听他的进展。哥哥早上5点就去医院排队做检查，这是第三天去了。哥哥说得要两点半才能看得上医生。我忍住没跟他说抢救的事。哥哥最爱妈妈了。
接了医院的第二通电话后，我哭了几分钟，又想了几分钟，觉得这件事哥哥应该知道。何况我自己也懵了，不知道怎么处理，我怕自己扛不住。
我打给哥哥，问他，“你要不要来妈妈这边”。他问怎么了，排了一上午队，他怕现在走就白排了。
我一个字一个字告诉他，“哥哥你要冷静，绝对不能冲动。我们没妈妈了。”哥哥被吓到了，他不相信。我不说话了。我张不了嘴，一开口我就会哭。一瞬间，哥哥崩溃了，哭得很惨。他从没哭成这样过。我也想哭，但哥哥已经这样了，我就不敢哭了。我一直安抚他。
我们想去看妈妈最后一眼。一路上，嫂子和爸爸一直给我打电话，让我们不要去，太危险了。但我们不能不去。
我先到了医院，手脚发着抖。过了会儿，哥哥也到了。他只戴了口罩，踉踉跄跄冲去病房，我抓都抓不住。妈妈还有体温。哥哥趴在妈妈胸口抽噎，大喊“还有心跳，医生，还有心跳啊”。医生过来看了下监视器，上面是两个0。病房里还有三个阿姨，她们都在抹眼泪。妈妈的桌子上摆着这么多天来我们送来的饭，好像一动都没动过。
哥哥哭得喘不过气。那是感染科病房，我担心他的安全，只能使劲拉他出去。
医生不愿意跟我们多说什么。他给了我们一张死亡证明，上面写着直接死亡原因是“呼吸衰竭”，因“新型冠状病毒感染”引起。他说有问题回头再来找医院，现在要先把人送去殡仪馆。
我们只能走了，在楼下一个空旷的停车场等着。天开始下雨。半小时后，有人推着一个尸袋出来。确认是妈妈后，我们跟着来到了太平间。我和哥哥一直在门口跪着磕头。那个地方没消过毒，我担心哥哥，只能又拉着他走了。
殡仪馆随后打来电话。我哀求他们，一定要等我们。我们一路加速，二十分钟就赶到了。他们递过来一份遗体处理承诺书，上面写着“逝者疑似或患重症肺炎死亡”。
殡仪馆的人不允许我们再进去，让我们签了字就直接走。他也在抱怨，说那里已经都是人了，情况比我们想的严重很多。
几辆车停在那。我们确认了运妈妈的车，跪下，向着车子磕头。旁边还有三四个男人，也跪着哭。
车子开走了，我一直追在后面跑。它越开越快，我实在追不上，停了下来，站在那儿，气喘呼呼。天很冷，我感觉很无助，很绝望。
哥哥哭得收不住。我平复了心情，特别冷静地跟他说，走，我们现在要赶紧把爸爸的药送过去。我一直在和他说，我们剩下的人一定要活得更好，不能再失去任何一个人了。
二、
一月中旬，爸爸担心妈妈的身体，把她叫回来动了手术。妈妈之前在外地陪外婆。没想到术后感染了病毒，但医院没对她做什么特殊护理。我们很着急。
去找爸爸的半个小时车程里，我一直和哥哥说，你可以在我这哭，但不能对爸爸和嫂子哭。你也不能钻牛角尖，你说自责的话，爸爸会更自责。我们所有人都没错，我们都是为了妈妈的身体才让她做手术的。新闻之前没报，我们完全不知道这个传染会这么严重。
爸爸下来了，离我们远远的，不说话。我猜他一开口就会哭，会崩溃。哥哥一直喊，爸爸你把口罩摘下我看看。爸爸没搭理。
我们把东西放在桌子上，走远了，爸爸才来拿东西，拿了就走。妈妈确诊后，他一直不让我靠近他。我们俩见面，要隔开20米。我走近一步，他就退后一步。他会很凶地喊我走。如果我不走，他就着急，急起来他会吼，让我赶紧滚。我一直很黏爸爸，他以前从不这么对我。
爸爸也很爱妈妈。17号做完手术后，妈妈每天都很痛苦，日日夜夜睡不好觉，爸爸贴身照顾她，每天也几乎没怎么睡。
1月21日，我和哥哥开了很久的车去看外婆，刚到不久，就接到电话，说妈妈疑似感染了新型冠状病毒。我们很吃惊，妈妈的医院不在汉口，我们一家也没去过华南海鲜市场。
我们又赶紧开了两百公里车，回了武汉。但爸爸很强硬，不让我们去找他们。那天下午，他们就从住院部三人间转移到了一个单人间。22号确诊了，中午，医生说要转到金银潭医院。但过了三个小时，我再找他，他就说转不了了，金银潭那边满了。我当时就特别慌。医生安慰我，说这家医院也会有全国的专家来支援。
我还是很着急，很想去找他们。当时有一种心情，想一定要看到爸爸妈妈，确定他们在那里。因为我不知道到底发生了什么，我们就一天不在，事情怎么就成了现在这样。想到隔离就看不到妈妈了，我很害怕，怕会不会以后再也看不见了。
我求护士，能不能让我走近一点，隔着玻璃看一眼。护士挺好心，她一直提醒我不能进去，不能待久了，要做好防护。我隔着玻璃门看到了我爸，他当时就很生气，用手势比划，让我赶紧走。妈妈的床靠墙，我看不清她。护士把她扶起来，她特别虚弱地跟我招了招手。
我一直哭，爸爸一直赶我。我只能走了，哭着嘱咐他们好好的，好好吃东西，好好看病。
后来我们才知道，爸爸当时没有确诊，他是自己主动要去陪护妈妈的。这段时间，我们每天都面临很残忍的选择。如果爸爸当时没有被感染，让不让爸爸去照顾妈妈？这怎么选。妈妈刚做完手术，爸爸不去照顾，她可能就没有办法上厕所，没办法吃饭。妈妈被隔离后，这家医院规定不能收外卖了，也不提供伙食。让哥哥送饭他会有感染的风险，不送，妈妈又会饿肚子，送还是不送？
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