保持社交距離對新型冠狀病毒（COVID-19）傳播的影響

Effectiveness of Social Distancing to Prevent COVID-19 Transmission

周孟樵(Meng-Chiao Chou) ； 鍾錦鈿(Chin -Tien Chung) ； 邱婷芳(Tin-Fang Chu) ； 張詠森(Yung-Sen Chang) ； 鄭志堅(Chih-Chien Cheng)

《北市醫學雜誌》 預刊文章 Pp. 1-11

https://doi.org/10.6200/TCMJ.202010/PP.0030

摘要

新冠肺炎病毒的傳播力與存活能力在不同的環境及物質表面有所差異，進而造成的感染後果也有所不同。新型冠狀病毒可以通過直接方式傳播（人對人近距離的飛沫和氣溶膠傳播），也可以通過間接接觸傳播（受污染的物體和空中懸浮氣溶膠傳播）。同時，個人防護設備（Personal Protective Equipment, PPE）也可能是傳播感染的來源。而新型冠狀病毒在人與人之間的傳播主要是在患者咳嗽，打噴嚏，甚至是談話或唱歌時通過呼吸道飛沫發生的。飛沫通常不能穿過六英尺的距離，並且在空氣中停留的時間有限。保持社交距離，亦稱採取社交距離，是阻止傳染病傳播或降低其傳播速度的感染控制措施，目的為減少感染者和未感染者之間的接觸，藉此使疾病的傳播、致病率和死亡率可以降低。當傳染病可通過飛沫接觸（咳嗽或噴嚏）、包括性接觸在內的直接身體接觸、間接身體接觸（觸摸帶有大量病毒的分泌物再觸摸身體黏膜）或空氣傳染來傳播時，保持社交距離是有效的感染控制措施。本文藉由最新的文獻收集整理數據來檢視新型冠狀病毒傳播及存活能力，並比較各國社交距離相關規範。結果顯示我國社交距離相關政策與主要國家、國際組織規定相仿，而文獻回顧則顯示新型冠狀病毒於各種環境的穩定性與存活力不同，受到不同表面材質、溫度、絕對與相對溼度等因素影響，最長可至數天。而社交距離政策搭配社交活動規範則在多國研究中均顯示有助於疫情減緩，並且對於已感染者的死亡率也有幫助。然而在特定情況下現有的社交距離可能無法完全防範病毒，因此該情況下更長的社交距離政策是需要考慮的，但此措施在實行上會有困難，尤其當病毒株不斷變異時，很多情況會影響疫情的發展。然而保持社交距離是有效及必要的防疫措施之一，這一點是無庸置疑的。除了此規範之外，有系統的搭配各項防疫措施，控制源頭並阻斷傳播非常重要，包括佩戴口罩，做好個人防護及勤洗手消毒。

關鍵字

新型冠狀病毒肺炎 ； 社交距離 ； 病毒傳染力 ； 病毒存活時間

並列摘要

The transmissibility and stability of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) differ on different surfaces and environments and results in different infection outcomes. The spread of SARS-CoV-2 occurs via direct (person-to-person droplet and aerosol transmission in a short distance) and indirect (contaminated surfaces or floating aerosols) transmission. Moreover, personal protective equipment (PPE) can be a source of transmission. SARS-CoV-2 mainly spreads via airway droplets in direct person-to-person transmission when the patient coughs, sneezes, talks, or sings. However, droplets usually cannot reach beyond 6 feet and stay in the air for a limited time. Keeping a social distance could prevent the spread of the virus by reducing contact between the infected people and the non-infected, thereby reducing the infection and the mortality rate. Keeping a social distance is an effective way to minimize the spread of the disease while the infectious diseases spread via droplets (coughing or sneezing), body contact including sexual contact, indirect body contact (touching the contaminated surfaces and then touching the body mucus membrane), or airborne transmission. In this article, we reviewed recent papers and collected abstracted data to review the transmissibility and stability of SARS-CoV-2 and compared social distancing regulations of different countries and organizations. The results revealed that the stability of SARS-CoV-2 differs upon the various surfaces, humidity, and temperature, with the longest sustains a few days. Studies from several countries have shown that social distancing with restrictions on social events could slow down the disease outbreak and reduce the mortality rate. However, under certain circumstances, ordinary social distancing policies may not be sufficient to prevent the spread of SARS-CoV-2, which makes a longer social distance and broader regulations on social events an option to be considered. Nevertheless, such policies would be hard to enforce, which is particularly important given that SARS-CoV-2 itself is evolving, adding uncertainty to the battle against Covid-19. In sum, keeping a social distance is undoubtedly an efficient and necessary approach to contain the spread of the disease. Other than these regulations, it is equally important to systematically collocate the actions with various protecting measurements systematically and control and block the transmission sources by wearing PPE, performing personal protection, and washing and sanitizing hands frequently.

並列關鍵字

COVID-19 ； social distance ； SARS-CoV-2 ； stability ； infectivity ； transmission