關於 who influenza ，我們在網路上蒐集到這些相關的討論、資訊與評價

在貼文的約莫三個小時前
英國公布對於大眾 #第三劑 的最新建議

也是面對病毒活躍的秋冬季，比較危險的族群如以下，被建議施打：

1️⃣. 安養院的病人
2️⃣. #所有50歲以上 的成年人
3️⃣. #前線醫療衛生工作人員
4️⃣. 16至49歲且有潛在 #新冠重症風險者
5️⃣. #免疫抑制 病人(器官移植、癌症治療、HIV)的成年家庭成員

比較亮眼的是抓了50歲以上的分水嶺
跟之前疫苗抗體反應研究抓的分水嶺是一樣的

這也許是我們要參考的
疫苗覆蓋大家也知道，光是一劑就是這麼不容易的事
何況到第三劑

保護好容易重症者即可，讓醫療能量不要垮
才能減少疫情再起時因為醫療支持不夠造成的額外死亡率

當然也希望第三劑續航力比第二劑更久
(在WHO網頁上輝瑞、莫德納、高端的第三劑抗體都比第二劑高)

--
這裡也談一下，WHO宣布 #群體免疫 (Herd Immunity)之日不會來
雖然這是講疫苗戰略的調整
但是對一般人意義就是全球開放之日應該不會來了?

會有今天有太多原因
像是疫苗產能不足，病毒變異，全球防疫與接種步伐不一致...

我想也許是疫情後新常態也有個譜了

也許我們這個世代口罩會拿不下來了
社交習慣也會有很大的改變 (法式擁抱消失中...)
不然就是大量依賴篩檢、疫苗護照或抗體證明來出席群聚活動
沒打疫苗或抗體不足者恐怕會社交有些困難

在疫苗覆蓋不夠的國家，如果還期望清零
就會靠高度入境篩檢與隔離檢疫

疫苗覆蓋高的國家，認為社區可以承受一定風險
就可以來考 #期末考
減少或甚至取消已經打疫苗的入境者的入境隔離天數
並且取代的是規定入境一定期間內的高頻率篩檢，例如韓國
也不是讓入境者那麼方便的

所以篩檢工具在入境普篩+社區廣篩需求下
低成本+大量生產是未來趨勢，不然會吃跨很多國家的預算

因應要減少這些高接種率帶來的壓力
(總不能每年都小巨蛋接種吧?)
會不會未來研發流感與新冠合併的ABC疫苗 (Influenza A+B & Corona virus)來一石兩鳥?

這是未來可能在別的國家看到的變化
很多國家都比我們跑在前面考期末考
這個疾病不會有根除的一天
只是看怎麼與我們在最低重症率的前提下共存了

變種病毒可以抵抗疫苖
今年7月底的研究顯示，攬打lambda變種病毒可以對抗免疫力。研究人員利用全球分享所有流感數據倡議Global Initiative on Sharing All Influenza Data的數據庫進行研究。研究結論是RSYLTPGD246-253N突變令到攬打變種病毒可以克制人類對抗病毒免疫力。這份研究報告還未得到其他同行科學家審閱，即是未得到科學界最終確認。我認為這份報告明確地顯示攬打變種病毒令疫苖無效。如果疫苖真的無效，這是人類文明浩劫。

【國立臺灣大學 109學年度畢業典禮 校長致詞】
Opening Remarks, National Taiwan University Commencement 2021
President Dr. Chung-Ming Kuan

.
各位師長同仁，各位畢業同學以及家長們，歡迎大家參加 109 學年度的線上畢業典禮。

去年新冠疫情初起，學校雖仍舉辦實體的畢業典禮，但規模大為縮小，許多師生和家長均以無法參加典禮為憾。今年初臺灣的疫情持續穩定，大家原本期待今年畢業典禮能按照往年方式辦理。不料五月時疫情急轉直下，臺北市疫情警戒程度提高，我們於是推遲畢業典禮，並改以線上方式進行。這也是臺大首次以線上方式舉辦畢業典禮。

隨著疫情發展，線上活動如今已成為生活中的新常態。我們雖逐漸習慣線上教學，線上會議，線上交流，線上購物訂餐等，但連期待了四年的畢業典禮也只能在線上參加，許多同學與家長們難免失望。為此，學務處與許多同學攜手，精心策劃了今天這場特殊的線上畢業典禮，希望能讓大家留下不一樣，但仍美好的記憶。

因為新冠疫情，有些同學會抱怨：這樣大的疫情怎麼就正好被我們在畢業時碰上了？也有些同學則樂觀的想，一旦有了疫苗，疫情得到控制，世界最終還是會回到以前的軌道，大家仍可以過著平穩安定的日子。

然而這個世界從不曾平靜。今年畢業的同學多數出生於1999 年，那正是規模達 7.3 的 921 大地震發生的那一年。時隔四年，亞洲（包括臺灣）爆發了罕見的急性呼吸道感染病 SARS。不過五年之後，源自美國的金融海嘯席捲全球，影響全世界經濟數年之久。2009 更是不平靜的一年，臺灣出現莫拉克風災，造成慘重傷亡；全球則爆發了 H1N1 流感大流行，數十萬人因此死亡。這些當時都曾被認為是數十年（甚至百年）一遇的重大災難。

回顧二十多年來的這些事件（這還僅僅是一部份與臺灣相關的事件），我們就會發現：巨大的天災人禍，過去曾頻繁出現，未來應該也不會少見。

當然，新冠疫情的影響範圍遠超過 SARS 與 H1N1 流感，對世界的衝擊則更大於金融海嘯。近代能與這次疫情相比的是一百年前 (1918-1920) 的全球流感大流行；據後來估計，當時全世界人口三分之一染疫，約有五千萬人因此不幸喪生。

那次流感爆發時正值第一次世界大戰末期，對當時的德軍主力造成嚴重打擊。而後疫情時代，戰敗的德國被列強宰割，奧匈帝國及奧圖曼帝國亦隨之瓦解，徹底改變了舊的國際秩序，也為後來的世局（從歐陸，到中東和亞洲）埋下許多不安定的種子。

這次新冠疫情並未伴隨著世界大戰，但出現在國際強權針鋒相對，世界產業供應鏈重整的關鍵時刻；後疫情時代因此充滿不確定性。而重組後的國際政經秩序，我不知道那會是一個「美好或不美好的新世界」*，但它就是大家必須面對的世界。那裡將充滿挑戰和機會，如何善用所學回應挑戰，如何從機會中脫穎而出，都是大家新的功課。這些功課沒有標準答案，你們必須自己解答，自己審閱答案。

我也希望利用這個機會提醒同學們，對於正在醫療前線奮戰的眾多醫護人員，其中包括了許多學校師長與大家的學長姐們，我們一定要心存感念。當疫情大浪襲來時，他們勇往直前，力挽狂瀾，不僅保護病人，也捍衛著臺灣社會。他們是真正的英雄。只要大家共同努力，疫情終會過去，我們一定會贏得抗疫的最後勝利。

最後，我謹代表所有老師和行政主管，向所有畢業同學們表達最深切的祝福，也恭喜辛苦多年的家長們。敬祝大家未來一切順利，身體健康
最後我還想講幾句話。我記得我看過一篇外國人寫的文章，他說他在臺灣多年，注意到臺灣有個很奇怪的習慣，朋友分手時都常常會說：「要小心哦」。我看到這篇文章的時候，也突然心有所感；多年來我媽媽每次看到我出門時會跟我講這句話，而後來我跟自己的小孩，也會講這樣的話。所以在畢業典禮這個時刻，我敬祝大家未來一切順利，身體健康，大家都要小心哦！

2021.6.26

*「美好新世界」(Brave New World) due to A. Huxley

.
==============================

.
When the COVID-19 pandemic began last year, NTU was still able to hold graduation ceremonies in person but on a much smaller scale and with the absence of many faculty members, students, and parents. Earlier this year, we were hoping to gather for a traditional commencement. But the sudden outbreak in May had forced Taipei City to raise its epidemic alert level. So we postponed the Commencement and made the decision to hold the ceremony virtually. This is the first virtual Commencement in NTU history.

To our faculty, new graduates, and parents, welcome to the National Taiwan University’s Commencement celebration for the Class of 2021.

As the pandemic unfolds, digital is the new normal. While we gradually adapt to online learning, virtual meetings, social media, online shopping, and food delivery, it is inescapably disappointing for many students and parents to have to celebrate the achievements of our graduates this way after anticipating this event for four years. And because of this, the Office of Student Affairs has teamed up with the graduates to ensure that this unique virtual Commencement is a moment that everyone will remember fondly in the future.

Some of you may ask, "why does this happen just when we are graduation?" And some of you may think optimistically that once the vaccines are available and the pandemic is contained, the world will be back to normal, and that we will all live peacefully.

But the world has never been peaceful. Most of the graduates this year were born in 1999, when the magnitude 7.3 earthquake happened on September 21. Four years after, SARS broke out in Asia, including Taiwan. Within another 5 years, the financial crisis, originated in the United States, affected global economies for years. In 2009, Typhoon Morakot landed and caused severe casualties in Taiwan; the H1N1 flu pandemic took hundreds of thousands of lives. These disasters were, at the time, seen as rare catastrophes that would only take place once every few decades, or even centuries.

Looking back to the past 20 years, we’d notice that, even just in Taiwan, catastrophes have never been in short supply. And they will probably never be in the future either.

Of course, the effect of COVID is far beyond SARS and H1N1, and its impact is greater than the financial crises. What came close was the Spanish flu that took place a century ago (1918-1920), when, according to estimation, one-third of the global population was infected and about 50 million people died.

The influenza pandemic outbreak took place at the end of WWI and hit the German military especially hard. And after the pandemic, Germany was forced to cede its territories to the great powers. What followed was the fall of the Austro-Hungarian and the Ottoman Empires. The series of events reset the international order and formed the settings for many conflicts in the years to come.

While COVID did not break out during a world war, it came at a critical time when great powers bicker and the global supply chains face a reform. The post-pandemic ear is therefore full of uncertainty. I don’t know whether it’d be a "Brave New World"* once the international political and economic orders are reshuffled. But it will be a world we have to live in. There will be many challenges and opportunities, and it will be our new task to utilize what we have learned to tackle challenges and grasp opportunities. Unlike any standardize
d test, you will have to answer and grade the answers yourselves.

I also want to use this opportunity to remind the graduates, that we must have appreciation and gratitude for the healthcare workers who are on the frontlines fighting. Many of them are our faculty members and alums. When the waves of the pandemic hit, they stood up to save lives and protect Taiwan’s society. They are true heroes. As long as we work together, we will weather the crisis and win this battle.

Finally, on behalf of the faculty and management, I send you our deepest best wishes. And congratulations to the parents and families who have supported the graduates for years. I wish you success and good health.

One final thing, I remember reading an article by a foreign writer who said he had lived in Taiwan for years and had noticed that Taiwanese people have a strange habit of saying "be careful" when they part ways. When I read the article, this resonates with me from the heart. For years, my mother would say the same thing whenever I am leaving the house. Now I say the same thing to my children, too. So at this Commencement ceremony, I wish everyone great success in the future, good health, and "be careful."

2021.6.26

*「美好新世界」(Brave New World) due to A. Huxley

.
詳見：
https://www.facebook.com/NTUCommencement/posts/2718144868475937

.
#臺灣大學 #畢業典禮 #NTUCommencement2021 #校長致詞

肺炎鏈球菌疫苗 － 謝彥丰普通科醫生＠FindDoc.com

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（一）13價肺炎鏈球菌疫苗打一次就夠嗎？ 00:06

（二）「13價肺炎球菌結合疫苗」和「23價肺炎球菌多醣疫苗」有什麼分別？ 01:10

（三）流感引起併發症肺炎，是否接種流感疫苗後就不需要接種肺炎球菌疫苗？01:48

（四）接種肺炎疫苗後會否有副作用？ 02:44

(本短片作健康教育之用，並不可取代任何醫療診斷或治療。治療成效因人而異，如有疑問，請向專業醫療人士諮詢。)

參考資料：
1.Department of Health. (2011). Faqs on pneumococcal infection and pneumococcal vaccines. Retrieved from. https://www.chp.gov.hk/files/pdf/faqs_on_pneumoccocal_infection_and_pneumoccocal_vaccines_chi.pdf
2.Department of Health. (2020). Frequently Asked Questions on Pneumococcal Vaccination. Retrieved from. https://www.chp.gov.hk/tc/features/100770.html
3. Department of Health. (2020). Frequently Asked Questions on Pneumococcal Vaccination. Retrieved from. https://www.chp.gov.hk/tc/features/100770.html
4. World Health Organization.(2019 Feb). Position paper on pneumococcal conjugate vaccines (PCV). Retrieved from https://apps.who.int/iris/bitstream/handle/10665/310968/WER9408.pdf?ua=1
5. World Health Organization.(2019 Feb). Position paper on pneumococcal conjugate vaccines (PCV). Retrieved from https://apps.who.int/iris/bitstream/handle/10665/310968/WER9408.pdf?ua=1
6. World Health Organization.(2008, 17 October). 23-valent pneumococcal polysaccharide vaccine WHO position paper. Retrieved from Weekly Epidemiological Record. No.42, 2008, pp. 373-584）
7. Department of Health. (2020, 24 April). Seasonal Influenza. Retrieved from. https://www.chp.gov.hk/en/healthtopics/content/24/29.html
8. Department of Health. (2020). Frequently Asked Questions on Pneumococcal Vaccination. Retrieved from. https://www.chp.gov.hk/tc/features/100770.html
9. Katrin S. Kohl, S. Michael Marcy, Michael Blum, Marcy Connell Jones, Ron Dagan, John Hansen, David Nalin, Edward Rothstein, the Brighton Collaboration Fever Working Group. (2004,1 August). Fever after Immunization: Current Concepts and Improved Future Scientific Understanding. Retrieved from Clinical Infectious Diseases, Volume 39, Issue 3, 1 August 2004, Pages 389–394




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所以flatten the curve 展平曲线 真的有效吗？



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