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A survey of New Yorkers last week found that one in five city residents carried antibodies to the new coronavirus — and in that, Gov. Andrew M. Cuomo saw good news. 在上周，纽约进行了一项调查，发现五分之一的城市居民携带了针对新冠状病毒的抗体，州长安德鲁·库莫（Andrew M. Cuomo）对此欣喜不已。 If so many had been infected and survived, he reasoned, the virus may be far less deadly than previously thought. But many scientists took a darker view, seeing instead a vast pool of people who are still very vulnerable to infection. 他认为，如果有这么多的感染者幸存下来，那么这种病毒的致命性可能比以前想象的要少得多。但是，许多科学家依旧悲观地看到了一副相反的景象：一大群人仍然很容易受到感染。 Like the leaders of many states, Mr. Cuomo has been hoping that the results of large-scale antibody testing may guide decisions about when and how to reopen the economy and reintegrate society. 像许多州的领导人一样，库莫一直希望大规模抗体检测能够为何时以及如何重新开放经济和恢复社会秩序提供指导。 Few scientists ever imagined that these tests would become an instrument of public policy — and many are uncomfortable with the idea. Antibody tests, which show who has been infected, are often inaccurate, recent research suggests, and it is not clear whether a positive result actually signals immunity to the coronavirus. 很少有科学家想到这些测试有朝一日会成为政策的工具，许多人也对此做法存疑。最近的研究也表明，用来排查被感染人群的抗体测试通常是不准确的，而阳性结果是否能够代表对冠状病毒的免疫也有待考究。
▲Celebrity eatery Nello has put on masks for their teddy bear installation during the coronavirus pandemic shut down on April 26, in New York City. On Friday, the World Health Organization warned against relying on these tests for policy decisions. While countries such as Italy have even floated the idea of "immunity passports" for people who test positive, W.H.O. officials noted that it is not known to what extent people carrying antibodies are immune to the virus. 周五世界卫生组织就曾发出警告不要依靠这些测试来制定政策。尽管意大利等国家已经开始为阳性测试者提供“免税护照”，世卫组织官员仍然表示抗体携带者对病毒免疫的程度依旧不明确。 (The W.H.O. on Saturday backed off an earlier assertion that people with antibodies may not be immune at all.) （世界卫生组织周六驳回了先前的说法——即带有抗体的人可能根本没有免疫力。） But widespread testing has started nonetheless, and important decisions are likely to flow from the results. The National Institutes of Health, the Centers for Disease Control and Prevention and virtually every university with an epidemiology department has begun antibody surveys in communities across the United States. 尽管如此，抗体检测已经广泛开展起来，其结果也可能成为一些重要决策的依据。美国国立卫生研究院，疾病控制与预防中心以及几乎每个设有流行病学系的大学都已开始在美国各地进行抗体检测。 "It seems like all of a sudden, everybody just decided that antibody tests are going to give them some grand answer," said Dr. Michael Osterholm, an infectious diseases expert at the University of Minnesota. 明尼苏达大学（University of Minnesota）的传染病专家迈克尔·奥斯特霍尔姆（Michael Osterholm）博士说：“突然之间，似乎每个人都认为抗体检测将为他们提供重要的参照。” The goal of most of these projects is to get a handle on the size and nature of the epidemic here, rather than to guide decisions about reopening the economy. But now scientists are racing to fine-tune the tests and to learn more about what having antibodies actually means, both for the patient and for the community. 这些项目大多是为了掌握该流行病的规模和性质，而不是指导有关重新开放经济的决定。然而，科学家们现在正在竞相微调测试，弄清楚抗体对于患者和整个社会来说到底意味着什么。 Many questions raised by these initiatives have no easy answers: When will we achieve "herd immunity"? How quickly does the virus spread? How long does immunity last and how strong is it? 我们何时才能实现“群体免疫”？病毒传播速度有多快？免疫能持续多长时间，程度有多大？抗体检测带来的许多问题都很难回答。 "This is a very difficult problem, and the solutions are not going to be easy," said Natalie Dean, a biostatistician at the University of Florida. "Normal is not on the horizon yet." “这是一个非常困难的处境，寻求解决方案也不容易。” 佛罗里达大学的生物统计学家纳塔莉·迪恩说，“恢复正常还不太可能。” The results in New York State offer an early glimpse of the promise and pitfalls of widespread antibody testing. 纽约州的结果似乎预示着抗体检测带来的希望和隐患。
▲A man wearing a protective mask jumps rope in the financial district of lower Manhattan in New York City, on April 26. Public health officials tested 3,000 residents at grocery stores and big-box retailers throughout the state. In New York City, about 21 percent of participants were found to carry coronavirus antibodies. 公共卫生官系统在全州的杂货店和大型零售商中对3,000名居民进行了测试。结果发现，在纽约市大约21％的测试者携带冠状病毒抗体。 The rate was about 17 percent on Long Island, nearly 12 percent in Westchester County and Rockland County, and less than 4 percent in the rest of the state. 其中，长岛的抗体携带者约占17％，韦斯切斯特县和罗克兰县约占12％，其他州的抗体携带者占比不到4％。 New York's survey was reasonably well designed and the results largely credible, experts said. But unlike Mr. Cuomo, few saw happy news in the numbers. 专家们认为在纽约进行的检测设计合理，结果基本可信。但是，与州长库莫不同的是，对此感到欣喜的人寥寥无几。 "I just don't see any way to put a silver lining on any of these results," said Carl Bergstrom, an infectious diseases expert at the University of Washington in Seattle. "I think that the efforts to spin it that way are irresponsible." “我几乎不能从这些结果中看到一线希望。” 西雅图华盛顿大学传染病学专家卡尔·伯格斯特罗姆说，“如此大费周章地粉饰真相是不负责任的。” If one in five residents in hard-hit New York City has been exposed to the virus, he and others said, then four in five are still vulnerable — and that underscores how far we are from the pandemic's end. 他和其他专家都认为，如果病毒肆虐的纽约市有五分之一的居民受到这种病毒的感染，那么其他的五分之也很容易受到感染，这凸显了我们离这次大流行的终点还有多远。 New York's results suggested a death rate of between 0.5 and 1 percent, figures some conservative commentators have argued are too low to justify statewide lockdowns. 纽约的检测结果表明，冠状病毒的死亡率在0.5％至1％之间，这一数字在一些保守的评论员看来太低，不足以证明全州范围内的封锁的合理性。 Public health experts like Dr. Bergstrom took the opposite view. "If the mortality rate is 1 percent, we're looking at 2 million deaths, which is unprecedented in our nation's history and unimaginable," he said. 伯格斯特罗姆博士（瑞典生物化学家）等公共卫生专家持相反的观点。他说：“如果死亡率为1％，那我们将看到200万人死亡，这在我们的民族历史上是前所未有的，也是不可想象的。” "Anyone talking about the death rate as 'only 1 percent and so we should not worry about it' has an extraordinarily callous view." “所有人都认为死亡率只有百分之一，因此我们不同担心。这太冷酷无情了。” The New York survey confirms what experts have long believed: that because of the lack of tests, the state has undercounted the true number of infections by about a factor of 10. 纽约的调查证实了专家们长期以来的推测：由于缺乏检测，该州将实际少算了十倍的感染人数。 Reopening society with such a huge vulnerable population, and without careful consideration, could be disastrous, allowing the virus to sweep through the country, Dr. Bergstrom and others said. 伯格斯特罗姆博士和其他专家认为，不经仔细考虑就在有着如此多的易感人群的情况下重新开放社会，可能会造成灾难性的后果，使得病毒席卷全国。 Another lesson from the survey: New York is far from attaining "herd immunity" — a proportion of the community immune to the virus that is so large that the pathogen cannot maintain a toehold. 这项调查带来的另一个教训是：纽约远没有实现“群体免疫”（整个社区中有大量的免疫人群，以致病原体无法立足。） For that to happen, experts have estimated that 60 to 70 percent of the population would need to be immune. Even then, the coronavirus would continue to spread, just at a slower rate. 要达到那个程度，专家估计需要有60％至70％的免疫人群。即使那样，冠状病毒也仍将继续传播，只是速度较慢。 "Honestly, from an ethical vantage point, herd immunity in the absence of a vaccine is not something we should be aiming to achieve," said Maimuna Majumder, a computational epidemiologist at Harvard Medical School. 哈佛医学院的计算流行病学家Maimuna Majumder表示：“坦白地说，从伦理的角度出发，在没有疫苗的情况下达到群体免疫不是我们应该追求的目标。 To get there, "that's a lot of sick people — and a lot of deaths," she added. 她补充说：“那会意味着大量的病人，大量的死亡。”
▲Supporters of a group called "Open Texas" rally to re-open Texas businesses, schools and religious services shut down by restrictions, as they gather in a park outside City Hall in Frisco, on April 25. While these results should not be used to make public health decisions, they can be useful for estimating the size and nature of the epidemic, said Bill Hanage, an epidemiologist at the Harvard T.H. Chan School of Public Health. 哈佛大学陈曾熙公共卫生学院流行病学专家比尔·汉纳格（Bill Hanage）表示，尽管这些结果不应该被用做公共卫生决策的依据，但它们对于估算该流行病的规模和性质很有帮助。 Antibody surveys can also identify high-risk groups, Dr. Dean of the University of Florida pointed out: "I think that's very important for policy, understanding who are these groups that we need to focus on and work to protect." 佛罗里达大学的Dean博士指出，抗体检测还可以识别高危人群。“我认为这对于政策的制定非常重要，有助于我们了解哪些人群需要我们的关注和保护。” The shortcomings of antibody testing were on vivid display in two other recent surveys, one in Santa Clara County and the other in Los Angeles County. 抗体检测的缺点在其他两项最近的调查中得到了生动体现，一项在圣塔克拉拉县，另一项在洛杉矶县。 Both drew sharp criticism from scientists, who said the tests had a rate of false positives too high to be used in places the virus has left largely untouched and therefore may have few true positives. 这两个调查都引起了科学家的严厉批评，他们说测试的假阳性率太高，无法在病毒基本未受感染的地方使用，在这些地方可能没有真正的阳性。 Scientists have also repeatedly cautioned that the presence of antibodies does not signify protection from the virus. Some preliminary evidence suggests, for example, that people who are asymptomatic might not produce enough antibodies to prevent a second infection. 科学家们也一再警告说，抗体的存在并不意味着对病毒的免疫。例如，一些初步证据表明，没有症状的人群也可能无法产生足够的抗体来预防第二次感染。 To be sure about what quantity of antibodies are needed in the blood, researchers need further tests, both to measure the exact amount — which the majority of rapid tests available do not provide — as well as more detailed analyses of the antibodies' strength. The answers will take weeks to months. 为了确定血液中需要多少抗体，研究人员需要进一步测试，以得到确切的数量（大多数快速测试无法提供的数量），以及对抗体强度进行更详细的分析。这将需要数周到数月的时间。 "We're kind of heavily leaning on these tests when they're not perfect," said Saskia Popescu, an epidemiologist at George Mason University in Fairfax, Va. 弗吉尼亚州费尔法克斯的乔治·梅森大学的流行病学家萨斯基亚·波佩斯库（Saskia Popescu）说：“当这些检测还不够完善时，我们就已经非常依赖它们了。” "And we still have a lot of people susceptible, so it's a dangerous thing to heavily rely on them right now." “而且我们中仍然有很多易感人群，因此过多地依靠抗体检测是一件危险的事情。” Dr. Osterholm said an antibody survey, because it provides "historical data" on who was infected, is like a smoke alarm that gives out a report once a month. 奥斯特霍尔姆博士说，抗体检测就像烟雾报警器一样，每月发出一次报告。它提供了有关感染者的“历史数据”， "It doesn't work very well if you have a fire right now," he said. 他说：“但是如果现在就着火了，那就报警器就没什么用了。” Diagnostic tests for the virus offer a better snapshot of the current picture, he added, and states should focus on acquiring accurate diagnostic tests that can provide timely data on the rise or fall in the number of infections. 他补充说，对病毒的诊断检测可以更好地反映当前情况，各州应将重点放在获取准确的诊断结果上，及时地提供有关感染数量上升或下降的数据。 "That should be the data we use to judge opening or not opening" the economy, Dr. Osterholm said. 奥斯特霍尔姆博士说：“这才是我们用来判断经济重新开放与否的依据。” “这是【外刊阅读者】发出的第1篇文章” |
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