關於 public health concern中文 ，我們在網路上蒐集到這些相關的討論、資訊與評價

【生死教育研討會第一講】
講題 Title：「無言老師」給我們的生死課 Life and Death Education from the “Silent Teachers”
講者 Speaker：伍桂麟先生 Mr Pasu Ng
主持 Moderator：鍾一諾教授 Prof Roger Chung

日期 Date：15th May, 2021 (Sat)
時間 Time：3:00-4:30pm
地點 Venue：沙田澤祥街12號香港中文大學鄭裕彤樓地下演講廳1B (LT1B)
Lecture Theatre 1B, Level 1, Cheng Yu Tung Building, The Chinese University of Hong Kong, 12 Chak Cheung Street, Shatin, N.T.

講座內容 Synopsis:
由中大公共衞生及基層醫療學院主辦的公眾「生死教育」四講系列的第一講，邀請到中大「無言老師」遺體捐贈計劃的推手兼醫學院解剖室經理，資深遺體防腐師及遺體修復師的伍桂麟先生與大家分享「無言老師」計劃，除解說遺體捐贈背後的意義與理念外，亦回顧並展望相關遺體處理的發展與人道理念。
We are honoured to have Mr Pasu Ng, the champion behind the CUHK "Silent Teacher" Body Donation Programme and dissecting laboratory manager of the Faculty of Medicine, to be our speaker in the first public seminar of the four-lecture series on life and death education, organized by the School of Public Health and Primary Care, CUHK. A veteran embalmer and restorative artist, Pasu will share with us the concepts and values behind body donation, as well as reviewing and projecting the development of and the humanitarian concern behind "remains processing."

報名 Register NOW: https://cloud.itsc.cuhk.edu.hk/mycuform/view.php?id=1039880

名額有限，先到先得。
Seats are limited and first come, first served.

生死教育 X 伍桂麟

今早為Asian Medical Students Association Hong Kong (AMSAHK)的新一屆執行委員會就職典禮作致詞分享嘉賓，題目為「疫情中的健康不公平」。
感謝他們的熱情款待以及為整段致詞拍了影片。以下我附上致詞的英文原稿：

It's been my honor to be invited to give the closing remarks for the Inauguration Ceremony for the incoming executive committee of the Asian Medical Students' Association Hong Kong (AMSAHK) this morning. A video has been taken for the remarks I made regarding health inequalities during the COVID-19 pandemic (big thanks to the student who withstood the soreness of her arm for holding the camera up for 15 minutes straight), and here's the transcript of the main body of the speech that goes with this video:

//The coronavirus disease 2019 (COVID-19) pandemic, caused by the SARS-CoV-2 virus, continues to be rampant around the world since early 2020, resulting in more than 55 million cases and 1.3 million deaths worldwide as of today. (So no! It’s not a hoax for those conspiracy theorists out there!) A higher rate of incidence and deaths, as well as worse health-related quality of life have been widely observed in the socially disadvantaged groups, including people of lower socioeconomic position, older persons, migrants, ethnic minority and communities of color, etc. While epidemiologists and scientists around the world are dedicated in gathering scientific evidence on the specific causes and determinants of the health inequalities observed in different countries and regions, we can apply the Social Determinants of Health Conceptual Framework developed by the World Health Organization team led by the eminent Prof Sir Michael Marmot, world’s leading social epidemiologist, to understand and delineate these social determinants of health inequalities related to the COVID-19 pandemic.

According to this framework, social determinants of health can be largely categorized into two types – 1) the lower stream, intermediary determinants, and 2) the upper stream, structural and macro-environmental determinants. For the COVID-19 pandemic, we realized that the lower stream factors may include material circumstances, such as people’s living and working conditions. For instance, the nature of the occupations of these people of lower socioeconomic position tends to require them to travel outside to work, i.e., they cannot work from home, which is a luxury for people who can afford to do it. This lack of choice in the location of occupation may expose them to greater risk of infection through more transportation and interactions with strangers. We have also seen infection clusters among crowded places like elderly homes, public housing estates, and boarding houses for foreign domestic helpers. Moreover, these socially disadvantaged people tend to have lower financial and social capital – it can be observed that they were more likely to be deprived of personal protective equipment like face masks and hand sanitizers, especially during the earlier days of the pandemic. On the other hand, the upper stream, structural determinants of health may include policies related to public health, education, macroeconomics, social protection and welfare, as well as our governance… and last, but not least, our culture and values. If the socioeconomic and political contexts are not favorable to the socially disadvantaged, their health and well-being will be disproportionately affected by the pandemic. Therefore, if we, as a society, espouse to address and reduce the problem of health inequalities, social determinants of health cannot be overlooked in devising and designing any public health-related strategies, measures and policies.

Although a higher rate of incidence and deaths have been widely observed in the socially disadvantaged groups, especially in countries with severe COVID-19 outbreaks, this phenomenon seems to be less discussed and less covered by media in Hong Kong, where the disease incidence is relatively low when compared with other countries around the world. Before the resurgence of local cases in early July, local spread of COVID-19 was sporadic and most cases were imported. In the earlier days of the pandemic, most cases were primarily imported by travelers and return-students studying overseas, leading to a minor surge between mid-March and mid-April of 874 new cases. Most of these cases during Spring were people who could afford to travel and study abroad, and thus tended to be more well-off. Therefore, some would say the expected social gradient in health impact did not seem to exist in Hong Kong, but may I remind you that, it is only the case when we focus on COVID-19-specific incidence and mortality alone. But can we really deduce from this that COVID-19-related health inequality does not exist in Hong Kong? According to the Social Determinants of Health Framework mentioned earlier, the obvious answer is “No, of course not.” And here’s why…

In addition to the direct disease burden, the COVID-19 outbreak and its associated containment measures (such as economic lockdown, mandatory social distancing, and change of work arrangements) could have unequal wider socioeconomic impacts on the general population, especially in regions with pervasive existing social inequalities. Given the limited resources and capacity of the socioeconomically disadvantaged to respond to emergency and adverse events, their general health and well-being are likely to be unduly and inordinately affected by the abrupt changes in their daily economic and social conditions, like job loss and insecurity, brought about by the COVID-19 outbreak and the corresponding containment and mitigation measures of which the main purpose was supposedly disease prevention and health protection at the first place. As such, focusing only on COVID-19 incidence or mortality as the outcomes of concern to address health inequalities may leave out important aspects of life that contributes significantly to people’s health. Recently, my research team and I collaborated with Sir Michael Marmot in a Hong Kong study, and found that the poor people in Hong Kong fared worse in every aspects of life than their richer counterparts in terms of economic activity, personal protective equipment, personal hygiene practice, as well as well-being and health after the COVID-19 outbreak. We also found that part of the observed health inequality can be attributed to the pandemic and its related containment measures via people’s concerns over their own and their families’ livelihood and economic activity. In other words, health inequalities were contributed by the pandemic even in a city where incidence is relatively low through other social determinants of health that directly concerned the livelihood and economic activity of the people. So in this study, we confirmed that focusing only on the incident and death cases as the outcomes of concern to address health inequalities is like a story half-told, and would severely truncate and distort the reality.

Truth be told, health inequality does not only appear after the pandemic outbreak of COVID-19, it is a pre-existing condition in countries and regions around the world, including Hong Kong. My research over the years have consistently shown that people in lower socioeconomic position tend to have worse physical and mental health status. Nevertheless, precisely because health inequality is nothing new, there are always voices in our society trying to dismiss the problem, arguing that it is only natural to have wealth inequality in any capitalistic society. However, in reckoning with health inequalities, we need to go beyond just figuring out the disparities or differences in health status between the poor and the rich, and we need to raise an ethically relevant question: are these inequalities, disparities and differences remediable? Can they be fixed? Can we do something about them? If they are remediable, and we can do something about them but we haven’t, then we’d say these inequalities are ultimately unjust and unfair. In other words, a society that prides itself in pursuing justice must, and I say must, strive to address and reduce these unfair health inequalities. Borrowing the words from famed sociologist Judith Butler, “the virus alone does not discriminate,” but “social and economic inequality will make sure that it does.” With COVID-19, we learn that it is not only the individuals who are sick, but our society. And it’s time we do something about it.

Thank you very much!//

Please join me in congratulating the incoming executive committee of AMSAHK and giving them the best wishes for their future endeavor!

Roger Chung, PhD
Assistant Professor, CUHK JC School of Public Health and Primary Care, @CUHK Medicine, The Chinese University of Hong Kong 香港中文大學 - CUHK
Associate Director, CUHK Institute of Health Equity

【重磅！世衛組織宣布疫情是「國際突發公共衛生事件」】

就在剛剛，世界衛生組織 WHO 就就在剛剛，世界衛生組織針對新型冠狀病毒疫情（2019-nCoV）召開了緊急委員會會議，宣布：

此次疫情被列為 " 國際關註的突發公共衛生事件 "（Public Health Emergency of International Concern，即PHEIC）——世界衛生組織傳染病應急機制中的最高等級。

世衛組織表示不是因為對中國沒有信心，而是擔心疫情發展到其他無力應對的國家。

同時，譚德塞還宣布了 7 條建議：

1． 不建議對中國實施旅行和貿易限制，任何措施都應當以證據為基礎；

2． 支持和保護醫療系統相對脆弱的國家；

3． 加速科研和疫苗相關研究；

4． 共同對抗謠言和不實信息；

5． 各國積極尋找預防、治療和阻止進一步傳播的計劃；

6． 各國積極與 WHO 分享信息；

7． 所有國家共同努力，共同對抗病毒。

世界衛生組織突發衛生項目主任瑞恩在 1 月 29 日向中國一線醫護工作者致敬：在歡慶春節的日子裏離開家人，去幫助另一個省份的同行，在一個目前沒有治療方法和疫苗的病毒前進行一線工作，再次證明了其勇氣和專業精神。

世衛組織對中國「新型冠狀病毒肺炎」極為關註

在此之前，世界衛生組織曾在日內瓦時間 2020 年 1 月 22 日 12:00 及 23 日 12:00，就中國發生的新型冠狀病毒（2019-nCoV）疫情召開了兩次會議。

北京時間 2020 年 1 月 24 日淩晨，委員會發布聲明，新型冠狀病毒肺炎疫情不構成 " 國際關註的突發公共衛生事件 "。

1 月 26 日、1 月 27 日，世衛組織在新型冠狀病毒每日疫情報告中說，中國面臨的疫情風險級別為 " 非常高 "，而疫情對地區和全球構成的風險級別為 " 高 "。

其中，世衛組織在 26 日報告的腳註中指出，該組織在 23 日、24 日、25 日發布的幾份報告中，錯誤地將新型冠狀病毒疫情對全球構成的風險總結為中等。

雖然世衛組織調整了新型冠狀病毒的危險程度，但仍沒有宣布疫情構成 " 國際關註的突發公共衛生事件 "

1 月 29 日，在世衛組織的記者會上，總幹事譚德塞表示自己之所以重新召集突發事件委員會成員來討論，是因為當下新冠病毒感染的肺炎疫情存有 " 進一步全球傳播的可能 "。他說：

" 在中國以外的 3 個國家，德國、日本和越南都已出現人傳人的現象 "。

而就在北京時間 1 月 31 日淩晨 3 點多，世衛組織宣布決定：

新型冠狀病毒肺炎疫情

構成 PHEIC

從擔心疫情到心系經濟

從謠言四起，到如今塵埃落定

這幾日，世衛組織的 " 一舉一動 " 都牽動著不少中國人的心，與此同時，也有很多謠言搞得大家夥人心惶惶。

比如——今天還沒等人家世衛組織開會就率先傳播 "WHO 不認為新型冠狀病毒是突發公共衛生事件 " 的尼日利亞先鋒報（Vanguard）和國內某留學自媒體大號 ...

以及在此之前的——

" 一旦被列為疫區國，將為期三年"

" 如果被列為 PHEIC

會讓中國經濟全盤崩潰、倒退 20 年"

首先我們需要弄清楚 " 疫區 " 和 " 國際關註的突發公共衛生事件 " 之間的區別。

" 疫區 " 在 WHO 裏叫 Affected Area，國際公共衛生緊急事件叫 PHEIC，這是兩個不同的概念，而世衛組織開會是討論中國需不需要被納入 PHEIC。

根據世界衛生組織剛剛的回應，我們被列為 PHEIC；

其次，被列為 PHEIC，不僅沒有我們想象得那麽可怕，而且也沒有強制 3 年一說。

根據《國際衛生條例（2005）》（International Health Regulations, IHR）的定義，PHEIC 是指：

按特殊程序確定的不尋常公共衛生事件，即通過疾病的國際傳播對其他國家構成公共衛生風險，並有可能需要采取協調一致的國際應對措施。

根據《國際衛生條例（2005）》，如果被確定為 PHEIC，世界衛生組織會發布一個臨時建議，主要是針對人員、行李、貨物、集裝箱、交通工具、物品和郵包等

國際衛生條例（2005）中文版鏈接：

http://www.aqsiq.gov.cn/xxgk_13386/xxgkztfl/zcfg/201210/t20121017_274705.htm

雖然肯定會對疫情國有所影響，如貿易、經濟、旅遊等，但並非一刀切地中斷所有貿易和國際旅行。

一般而言，根據疫情的發展，世衛宣布 PHEIC 後隨時可以撤銷及修改，並且在 3 個月後自動失效，但可以根據實際情況修改或延續三個月。

事實上， 在 2005 年世衛組織設立國際關註的突發公共衛生事件（PHEIC）機制後，迄今為止，共宣布過 5 次。

分別是：

2009 年 H1N1 流感病毒

2014 年野生型脊髓灰質炎病毒

2014 年西非埃博拉病

2016 年巴西寨卡病毒

2018-2020 年剛果（金）埃博拉疫情

而這一次，是第六次。