最近，新型冠状病毒在美国出现社区传播，华人社区有各种担忧，讨论和传言。 为此， 平权会的徐佶翮（Frank Xu）理事写信给圣地亚哥郡卫生署的公共卫生官Wooten博士， 咨询美国国家疾控中心（CDC）以及郡卫生署既上次会面后是否有新的对策。Wooten博士感谢徐理事的来信， 并对咨询的问题以书面的形式一一做了详尽的回答。也欢迎华人社区向平权会反应最新问题，平权会会尽力寻求官方渠道的答复。以下是这次的问答部分：
徐：关于加州大学戴维斯分校医学中心最新确诊的病例，公众觉得CDC动作太慢，没有及时测试新型冠状病毒。CDC何时能更改标准甄别哪类患者可以进行新型冠状病毒测试，您是否有任何更新？公众认为应该听从医生的建议尽早检测，而不用考虑旅行记录和接触史。如果您的部门可以帮助推动这一变化，我们将不胜感激。
Dr. Wooten：徐先生，对于您问题的第一部分，我没有答案。正如您将在以下回答中会看到的，我们的公共卫生实验室现在能够进行新型冠状病毒测试。但即使在本地检测，每个检测也要花费时间。目前，所有检测均需经我们本地的流行病学部门和CDC讨论后进行。我们的流程分为识别，隔离和报告。医生在对患者进行检查后，如果发现患者有发烧和呼吸道症状（咳嗽和呼吸困难），应隔离患者， 并让病人戴上口罩，然后致电我们的卫生部门进行咨询。如果卫生部门与CDC讨论后确定要进行检测，医生必须与我们的卫生部门合作以收集样本并将其运送到我们的实验室，我们会对样本进行处理。在我们流行病学部门和CDC指导下调查旅行历史非常重要，是确定一个人是否需要测试的必要步骤。对于疑似病例和检测， CDC有专门的专业指导文件, 以供 医护人员参考。 根据最新的信息，这些指导文件会随时更新。该信息可在CDC网站上找到：https：//www.cdc.gov/coronavirus/2019-nCoV/hcp/clinical-criteria.html。由于信息随时变化，建议您每天访问该网站。
徐：CDC何时会授权本地卫生机构检测新冠状病毒？这样可以加快检测速度，并避免在当地社区爆发疫情。
Dr. Wooten：好消息：我们郡公共卫生实验室经过CDC的批准，从这星期三（平权会注：2月26日）下午就开始可以进行检测。关于我们公共卫生实验室的这项新任务的新闻报道（星期四）已经发布。请参考 https://www.countynewscenter.com/county-public-health-lab-now-able-to-test-for-new-coronavirus/
徐：检测新型冠状病毒的最准确方法是什么？
Dr. Wooten：如上！ 目前只有一种方法可以确诊新型冠状病毒。 简称PCR， 就是聚合酶链式反应；它是分子生物学中广泛使用的一种方法。
徐：我们卫生机构正在考虑关闭学校的预案吗？如果是，在什么情况下会发生？
Dr. Wooten：如果在圣地亚哥郡发生社区传播，则社会隔离是将要采用的几种策略之一。停课是社会隔离的一种类型。这在疫情爆发时， 会在CDC指导下进行。
徐：你们将如何通知公众贮备口罩，洗手液等抗疫物品？
Dr. Wooten：目前，我们不建议公众使用口罩。CDC，州，圣地亚哥郡或其他地方司法管辖区均不建议健康者戴口罩。 经常洗手很重要–最好用肥皂和水清洗，如果没有肥皂和水，请使用洗手液。 我们所有的公共通讯，网站和教育资料中都包括了预防措施宣传。您可以在我们的网站www.coronavirus-sd.com 上找到此信息。
徐：有传言说中国武汉不是冠状病毒的源头，我认为这很荒唐。关于疫情的源头， 如果你知道有进一步的消息或科学研究给我们分享，这也会对我们社区有帮助。
Dr. Wooten：不幸的是，谣言会不断流传。这种新的冠状病毒是在湖北省武汉市首次出现。有了这个新毒株后，现在冠状病毒有七种：四株与普通感冒有关；一种是中东呼吸综合征（MERS），与骆驼有关；一种是与蝙蝠有关的严重急性呼吸系统综合征（SARS）；还有就是这种新的冠状病毒。对这种新型病毒的研究正在进行中，一旦有新的发现， 就会公布。下面这篇文章表明，这种新病毒与2003/04年的非典病毒在遗传上有关联。它与蝙蝠有关，就像SARS一样，这就是为什么病毒的名字是SARS-CoV-2。《2019新型冠状病毒的起源与进化》：https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa112/5721420
以下为英文邮件原文：
Mr. Xu,
Thank you for your email. The following are my responses in red:
1, Regarding the latest confirmed case in UC Davis Medical Center, the public concerns that CDC is too slow to test for Coronavirus. Do you have any update about when CDC would change the standard for which category of patient can be tested for Coronavirus? The general public believe it should be as early as the doctor recommends for one instead of having to wait for the travel history at this moment. If your department could help push for that change, that would also be very appreciated.
RESPONSE: Mr. Xu, I do not have an answer for the first segment of your question.
- As you will see in Questions #2 and #3, our PH Laboratory is now able to perform coronavirus testing.
- Every tests takes time, even when it is performed locally.
- At this time, all tests are conducted in consultation with our local Epidemiology program and the Centers for Disease Control and Prevention (CDC).
- Our process is to Identify, Isolate, andReport at the time that the patient is seen.
- Upon examining a patient and he/she finds that the patient has a fever and respiratory symptoms (cough and difficulty breathing), the provider should isolate the patient and mask them, then call our local health department for consultation.
- If upon consultation with CDC, it is determined that tests should be ordered, the provider MUST work with our health department to collect and deliver specimens to our lab and we process specimens, accordingly.
- Obtaining a travel history is a VERY important and a necessary step to determine if a person is tested or not; again this is done in consultation with our local Epidemiology Program and the CDC.
- There are guidance documents that are periodically updated, based on the latest information available, for health care personnel regarding management of a “patient under investigation,” or PUI, and testing. This info is available on the CDC website: https://www.cdc.gov/coronavirus/2019-nCoV/hcp/clinical-criteria.html.
- As information is readily changing, I would suggest you visit the website daily.
2, When will CDC authorize the local agencies to test for Coronavirus? That will speed up the test and avoid outbreak in local communities.
RESPONSE: Great news:
- Our County Public Health Laboratory was approved by the CDC to conduct testing this past Wednesday afternoon.
- A news story was being issued (Thursday) about this new capability of our Public Health Laboratory.
- https://www.countynewscenter.com/county-public-health-lab-now-able-to-test-for-new-coronavirus/
3, What’s the most accurate way to test patients for Coronavirus?
RESPONSE: See above!
- There is only one process currently being used to test for the novel coronavirus.
- The test is the PCR or Polymerase chain reaction; it is a method widely used in molecular biology.
4. Is it in the agenda that local health agencies are considering closing schools? If yes, in what condition it would happen?
RESPONSE: If community- associated spread occurs in San Diego County, social distancing is one of several strategies that will be utilized.
- School closure is one type of social distancing.
- This would be done based on guidance from the CDC and in the face of a pandemic.
5. How would the public be informed about stockpiling of masks, hand sanitizer, etc?
RESPONSE: At this time we are not recommending the use of masks for the general public.
- The CDC, State, nor San Diego County or other local jurisdictions ARE NOTrecommending masks for well people.
- To wash one’s hands – soap and water is best, with hand sanitizer used if soap and water is NOT available.
- Preventive measures are included in all of our public communications, website, and educational materials.
- This information can be found on our webpage at www.coronavirus-sd.com
6. Rumors are spreading that Wuhan, China is not the original of the Coronavirus, which I believe makes no sense. If there is an insight information or scientific study to confirm where the outbreak starts, that will help us too. But this one is of the lowest priority comparing the prior five questions.
RESPONSE: Unfortunately, rumors will happen and continue. For this new coronavirus, “Ground Zero” is Wuhan City, Hubei Province where cases first started. With this new strain, there are now seven (7) coronavirus strains: four are associated with the common cold; one is the Middle East Respiratory Syndrome or MERS, associated with camels; one is Severe Acute Respiratory Syndrome or SARS, associated with bats; and the novel coronavirus (see below).
- Research on this novel virus is ongoing and being made available, as it is published.
*) This article suggests that the new virus is genetically linked to the SARS virus outbreak, from 2003/04.
*) It is linked to bats, like SARS, which is why the name of the virus is SARS-CoV-2.
*) Origin and Evolution of the 2019 Novel Coronavirus: https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa112/5721420