科学美国人60秒 第二次加强针，下一波带口罩和明智风险决策（在线收听）

Tanya Lewis: Hi, and welcome to COVID, Quickly, a Scientific American podcast series.

Josh Fischman: This is your fast-track update on the COVID pandemic. We bring you up to speed on the science behind the most urgent questions about the virus and the disease. We demystify the research and help you understand what it really means.

Tanya Lewis：您好，欢迎收看美国科学播客系列《COVID, Quickly》。

Josh Fischman：这是您对 COVID 大流行的快速更新。 我们让您快速了解有关病毒和疾病的最紧迫问题背后的科学。 我们揭开研究的神秘面纱，并帮助您了解它的真正含义。

Lewis: I’m Tanya Lewis.

Fischman: I’m Josh Fischman.

刘易斯：我是坦尼娅·刘易斯。

菲施曼：我是乔什·菲施曼。

Lewis: And we’re Scientific American’s senior health editors. Today, we’ll talk about the plan for a second vaccine booster shot…

刘易斯：我们是《科学美国人》的高级健康编辑。 今天，我们将讨论第二次疫苗加强注射的计划……

Fischman: The prospects of a new COVID wave and whether people will put on masks to stop it …

Fischman：新一轮 COVID 浪潮的前景以及人们是否会戴上口罩来阻止它……

Lewis: And how to think about COVID risk when it comes to everyday activities.

刘易斯：以及在日常活动中如何考虑 COVID 风险。

Fischman: This week the FDA authorized a second booster shot, on top of the one given last year. That would be four shots total for me, Tanya. Why this new one?

Fischman：本周 FDA 批准了第二次加强注射，在去年给予的基础上。 坦尼娅，对我来说一共是四枪。 为什么是这个新的？

Lewis: It happened sooner than I expected, Josh, although the scientific community had been debating whether additional booster shots were needed for some time. Normally, the FDA holds a meeting of its advisory committee before deciding whether to authorize vaccines or boosters, but that didn’t happen this time.

刘易斯：它发生得比我预期的要早，乔希，尽管科学界一直在争论是否需要额外的助推剂有一段时间了。 通常情况下，FDA 在决定是否批准疫苗或加强剂之前会召开其咨询委员会会议，但这次没有发生这种情况。

The move makes boosters available to adults age 50 and older, and anyone 12 and older who is immunocompromised, four months after their first booster shot. For people who had two shots and a booster, this would be their fourth shot. For some immunocompromised folks, this would be their fifth shot.

此举使 50 岁及以上的成年人以及任何 12 岁及以上免疫功能低下的人在第一次加强注射后四个月都可以使用加强剂。 对于有两针疫苗和一针加强针的人来说，这将是他们的第四针。 对于一些免疫功能低下的人来说，这将是他们的第五针。

Fischman: That’s a bunch of jabs. Why does the FDA think we need this new one?

Fischman：那是一堆刺拳。 为什么 FDA 认为我们需要这个新的？

Lewis: It was based on some evidence that immune protection against severe disease wanes over time in these groups. A recent CDC report found that protection against hospitalization waned from 91 percent to 78 percent four months after a third dose.

刘易斯：这是基于一些证据表明，这些群体对严重疾病的免疫保护会随着时间的推移而减弱。 CDC 最近的一份报告发现，在第三次给药四个月后，对住院的保护从 91% 下降到 78%。

But some experts are not convinced a second booster shot will significantly improve immunity. It may top up antibodies for a few months, but at a certain point with additional shots, we may see diminishing returns.

For those who haven’t gotten their first booster yet, that is important to do. And if you’re older or higher risk, you might want to consider getting a second booster after four months to top up your protection.

但一些专家不相信第二次加强注射会显着提高免疫力。 它可能会在几个月内补充抗体，但在某个时间点加上额外的注射，我们可能会看到收益递减。

对于那些还没有获得第一针加强针的人来说，这很重要。 如果您年龄较大或风险较高，您可能需要考虑在四个月后获得第二次加强针以补充您的保护。

Lewis: It seems like many people have ditched their masks, and health officials are allowing it. But if a new COVID surge comes, Josh, will people put them on again?

刘易斯：似乎很多人都放弃了口罩，卫生官员也允许这样做。 但是，如果出现新的 COVID 激增，乔希，人们会再次戴上它们吗？

Fischman: That’s a really important question, because some kind of surge is coming, and we know masks stop infections. The effectiveness of a good mask like an N95 is beyond dispute, as you’ve pointed out, Tanya.

Fischman：这是一个非常重要的问题，因为某种激增即将到来，而且我们知道口罩可以阻止感染。 正如您所指出的，Tanya，像 N95 这样的好口罩的有效性是无可争议的。

And we will face more COVID. Infections and hospitalizations have started to rise in Europe. The new BA.2 variant is becoming more common there and in the U.S. And, like Europe, we’ve cut back on masks and on restrictions. So we’re likely to see something, a spike, a surge, or whatever you want to call it. It’s not clear how big it will be.

我们将面临更多的新冠病毒。 欧洲的感染和住院人数开始上升。 新的 BA.2 变体在那里和美国变得越来越普遍。而且，像欧洲一样，我们减少了口罩和限制。 所以我们可能会看到一些东西，一个尖峰，一个激增，或者任何你想称之为的东西。 目前尚不清楚它将有多大。

But if it gets above a certain level, we should put masks back on,?according to the CDC. If cases and hospitalizations per 100,000 people in your area jump up—by 20 hospitalizations in a week, if you’re starting from a low level of cases—then put on a mask when you’re indoors with other people.

但如果超过一定水平，我们应该重新戴上口罩，?根据 CDC 的说法。 如果您所在地区每 100,000 人中的病例数和住院人数猛增（如果您的病例数从低水平开始，则每周增加 20 次住院），那么当您与其他人在室内时，请戴上口罩。

Lewis: But masks aren’t just health aids. During the pandemic they’ve become political symbols. Some people are really pro-mask and others are adamantly opposed to them.

刘易斯：但口罩不仅仅是健康辅助工具。 在大流行期间，它们已成为政治象征。 有些人真的很支持口罩，而另一些人则坚决反对。

Fischman: Exactly. So how’s that going to play out in the future? I asked an expert on mask attitudes, Emily Mendenhall, a medical anthropologist at Georgetown University. She just published a book called UNMASKED, based on research in communities in Iowa and in California.

费施曼：没错。 那么这将如何在未来发挥作用？ 我询问了戴口罩态度方面的专家，乔治城大学的医学人类学家艾米莉·门登霍尔。根据爱荷华州和加利福尼亚州的社区研究，她刚刚出版了一本书，名为 UNMASKED。

Emily’s talked with us about masks on an earlier episode. She says anti-mask feelings stem partly from perceptions of low disease risk. People would unmask if they weren’t worried about themselves. Maybe they were younger and didn’t think the disease would make them sick. And partly it was political. People said they didn’t want governments dictating their behavior. They had legitimate worries about business closures and their ability to make a living. But it was also about making a public show of defiance. Masks got caught up in all that.

艾米丽在前一集中与我们讨论了口罩。 她说，反口罩的感觉部分源于对疾病风险低的看法。 如果他们不担心自己，人们就会揭开口罩。 也许他们更年轻，并不认为这种疾病会让他们生病。 部分原因是政治性的。 人们说他们不希望政府支配他们的行为。 他们对企业倒闭和谋生能力有合理的担忧。 但这也是为了公开展示反抗。 口罩被卷入了这一切。

Pro-mask feelings came from an idea that we faced a collective risk. In the street, Emily says, people would talk about the need to work together and protect one another. And obviously they also felt they were in danger as individuals, and they trusted government guidelines.

支持口罩的感觉来自于我们面临集体风险的想法。 艾米丽说，在街上，人们会谈论合作和相互保护的必要性。 显然，他们也觉得自己作为个人处于危险之中，他们相信政府的指导方针。

As the pandemic has worn on, these collective worries have faded in many places. And mask-wearing has faded with them. Without actual rules such as mandates, people in those areas are unlikely to put masks back on.

随着大流行的蔓延，这些集体担忧在许多地方已经消退。 戴口罩也随着他们褪色。 如果没有授权等实际规则，这些地区的人们不太可能重新戴上口罩。

But Emily says there’s another group we overlook: the “sometime maskers.” That’s about 1 in 3 people in her research. They’re all political moderates. Sometimes government does a good job, they say, and sometimes not. Sometimes the media is trustable, other times not so much. And sometimes they wear a mask. There are huge swaths of Americans who would put on a mask if they were around someone with a weak immune system, or someone older, or at risk in some way.

但艾米丽说我们忽略了另一个群体：“有时掩饰者”。 在她的研究中，大约有三分之一的人。 他们都是政治温和派。 他们说，有时政府做得很好，有时则不然。 有时媒体是值得信赖的，有时则不然。 有时他们戴着口罩。 如果周围有免疫系统较弱的人，或者年龄较大的人，或者在某种程度上处于危险之中，有大量的美国人会戴上口罩。

So the focus should be on sometime maskers. That’s who’s willing to listen to mask promotion if COVID starts to peak in their communities. It’s a sizeable group, Emily says. They could be a part of making mask-wearing seem normal, especially in times of danger, and making it normal is key.

因此，有时应将重点放在掩蔽者上。 如果 COVID 开始在他们的社区中达到顶峰，那就是愿意听口罩促销的人。 艾米丽说，这是一个相当大的群体。 它们可能是让戴口罩看起来很正常的一部分，尤其是在危险的时候，而让它变得正常是关键。

Emily still thinks mandates are important, but she understands there’s a lot of resistance. If these sometimes-maskers put on N95s, they could start a whole surge of protection.

艾米丽仍然认为授权很重要，但她知道有很多阻力。 如果这些有时戴上口罩的人戴上 N95，他们可能会开始全面保护。

Fischman: Clearly people are growing tired of restrictions as we head into Pandemic Year Three. Many are eager to get back to doing things they enjoy again. Is there a smart way to evaluate any risks as we venture out more often?

Fischman：随着我们进入大流行第三年，人们显然越来越厌倦了限制。 许多人渴望重新做他们喜欢的事情。 当我们更频繁地冒险时，是否有一种聪明的方法来评估任何风险？

Lewis: We’re definitely getting to the point, Josh, where people are tired of wearing masks, social distancing, and avoiding the people and places they enjoy. But the virus hasn’t gone away, and it isn’t likely to anytime soon. There will always be some level of risk, but as with everything in life, we have to find ways to balance risks with benefits.

刘易斯：乔希，我们肯定要说到点子上了，人们厌倦了戴口罩、保持社交距离以及避开他们喜欢的人和地方。 但病毒并没有消失，而且不太可能很快消失。 总会有一定程度的风险，但就像生活中的一切一样，我们必须找到平衡风险与收益的方法。

One of our freelancers, Sri De-va-bhak-tuni, is working on a story for us about this. He asked a number of experts in epidemiology, risk assessment, and related fields how they make their own decisions about COVID risk.

我们的一位自由职业者 Sri De-va-bhak-tuni 正在为我们撰写一个关于此的故事。 他询问了一些流行病学、风险评估和相关领域的专家，他们如何自行决定 COVID 风险。

We can think about risk in three different ways, they said: there’s personal risk, which is the risk of you or people in your household contracting COVID; there’s community risk, which is the likelihood of encountering someone with COVID in your local community; and there’s exposure risk, which accounts for the chances of getting COVID from a particular setting based on things like airflow and the behavior of other people.

他们说，我们可以从三种不同的方式考虑风险：存在个人风险，即您或您家中的人感染 COVID 的风险； 存在社区风险，即在您当地社区遇到感染 COVID 的人的可能性； 并且存在暴露风险，这说明了根据气流和其他人的行为等因素从特定环境中感染 COVID 的机会。

Katelyn Jetelina, an epidemiologist at the University of Texas, Houston, says that age is the biggest personal risk factor, followed by having certain comorbidities or being immunocompromised. She estimates that vaccinated and boosted people in their 60s have a 10 times higher likelihood of dying from a severe breakthrough case than 18- to 49-year-olds. People who are at higher risk should talk with their doctor about what risks are reasonable. There may be some activities that are safe if you take precautions such as wearing an N95 mask, for example.

德克萨斯大学休斯顿分校的流行病学家凯特琳·杰特琳娜 (Katelyn Jetelina) 表示，年龄是最大的个人风险因素，其次是患有某些合并症或免疫功能低下。 她估计，与 18 至 49 岁的人相比，60 多岁接种疫苗和加强免疫的人死于严重突破性病例的可能性要高 10 倍。 风险较高的人应该与他们的医生讨论哪些风险是合理的。 如果您采取预防措施，例如戴上 N95 口罩，可能有些活动是安全的。

Then there’s community risk – in other words, the risk that the person next to you has COVID. There’s not one metric that perfectly captures this risk, but you can look at things like daily cases per 100,000 residents. Jetelina considers a figure below 50 cases per 100,000 to be lower risk, and she might feel comfortable removing her mask indoors. Others use a lower threshold of 10 cases per 100,000. But since not everyone who has COVID is getting tested, a better measure may be the test positivity rate. Anything above 5 percent is considered high risk.

然后是社区风险——换句话说，就是你旁边的人感染新冠病毒的风险。 没有一个指标可以完美地捕捉到这种风险，但您可以查看每 100,000 名居民的每日病例数。 Jetelina 认为每 100,000 人中低于 50 例的数字风险较低，她可能会觉得在室内摘下口罩很舒服。 其他人则使用每 100,000 例 10 例的较低阈值。 但由于并非所有感染 COVID 的人都接受检测，因此更好的衡量标准可能是检测阳性率。 任何高于 5% 的都被视为高风险。

Fischman: What about different settings, like bars or movie theaters or a local park? Where you are affects risk, doesn’t it?

Fischman：不同的环境怎么样，比如酒吧、电影院或当地公园？ 你在哪里会影响风险，不是吗？

Lewis: That’s right. Exposure risk is a spectrum—some settings are safer than others. Depending on your personal and community risk levels, you might be more or less comfortable doing things in certain settings.

刘易斯：没错。 暴露风险是一个范围——一些环境比其他环境更安全。 根据您的个人和社区风险水平，您可能会或多或少地在某些环境下做事。

Gyms, for example, are probably one of the highest risk places, because people are exercising and expelling more aerosols, which spread the virus, says Linsey Marr, a professor of civil and environmental engineering at Virginia Tech and an expert on airborne transmission of viruses. Bars are risky too, because they may be crowded and have lots of people talking loudly. But museums and movie theaters might be safer because they tend to have higher ceilings, so there’s more air dilution, and fewer people are talking.

例如，健身房可能是风险最高的地方之一，因为人们正在锻炼和排出更多传播病毒的气溶胶，弗吉尼亚理工大学土木与环境工程教授、病毒空气传播专家林赛马尔说 . 酒吧也有风险，因为它们可能很拥挤，而且有很多人大声说话。 但博物馆和电影院可能更安全，因为它们往往有更高的天花板，所以空气稀释更多，说话的人更少。

If you do go to a bar or restaurant and you want to protect yourself, experts say you can wear a mask and remove it briefly to take sips or bites, without increasing the risk too much. And N95s protect you pretty well, if they’re well-fitted to your face.

如果您确实去酒吧或餐厅并且想保护自己，专家说您可以戴上口罩并短暂摘下以啜饮或咬一口，而不会增加太多风险。 如果 N95 贴合您的脸部，则可以很好地保护您。

At the end of the day, you have to decide how to balance these risks with the benefits of doing the things that make life worth living.

归根结底，您必须决定如何平衡这些风险和做让生活有价值的事情的好处。

Lewis: Now you’re up to speed. Thanks for joining us. Our show is edited by Jeff DelViscio.

Fischman: Come back in two weeks for the next episode of COVID, Quickly! And check out SciAm.com for updated and in-depth COVID news.

刘易斯：现在你已经跟上进度了。感谢您加入我们。我们的节目由Jeff DelViscio编辑。

Fischman：请在两周后回来观看 COVID 的下一集，快点！查看 SciAm.com 以获取最新和深入的 COVID 新闻。