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A BETTER WAY TO TEST
更好的檢測方式
By Dr. Ashish K. Jha
文/阿施施·K·杰哈醫生
Imagine spitting on a special strip of paper every morning
想象一下，每天早上往一張特殊的紙條上吐點唾沫，
and being told two minutes later whether you were positive for COVID-19.
兩分鐘后就能告知你你的新冠肺炎檢測是否呈陽性。
If everyone in the U.S. did this daily,
如果所有美國人都能每天堅持這樣檢測，
we would dramatically drop our transmission rates and bring the pandemic under control.
我們就能大幅降低國內的新冠傳播率，控制住這場大流行。
Schools and businesses could reopen with the peace of mind that infectious individuals had been identified.
學校和企業就可以放心地復產復工復學，因為被感染者都會被識別出來。
Michael Mina of the Harvard School of Public Health has been a major proponent of this idea,
哈佛大學公共衛生學院的邁克爾·米納一直都在推動這一理念，
and has pushed the idea of a test that costs as little as $1,
而他推動的檢測辦法成本低至1美元，
which the government could mass-produce and provide free of charge to every one.
政府可以批量生產并免費提供給所有人。
In fact, these technologies exist today.
事實上，這些技術已經面世了。
Antigen tests are significantly cheaper and faster than the RT-PCR tests
RT-PCR檢測是美國目前最核心的檢測方式，但其地位已經不保。
that are at the heart of America's current testing infrastructure, which is collapsing.
抗原檢測比RT-PCR檢測便宜得多，速度也快得多。
As coronavirus cases surge around the country,
全國各地的新冠病毒病例都在激增，
laboratories are facing crippling shortages of key supplies and growing backlogs of samples.
實驗室檢測用的關鍵物資已經嚴重短缺，樣本積壓日益嚴重。
In many states, it can take 10 to 15 days to get test results—
許多州檢測結果等待時間都長達10~15天——
rendering these tests useless as a tool to prevent transmission and bring the pandemic under control.
如此一來，檢測便對預防傳播和控制大流行毫無用處。
For most people, the peak period of infectiousness lasts about a week.
就大多數人而言，感染最嚴重的階段將持續時間為一周左右。
And in the middle of this testing collapse,
就在檢測工作面臨崩潰之際，
cities and towns are preparing to return millions of children to school this fall with neither the intention nor the capability to test them.
各大城鎮卻已經開始準備在今秋開學期將數百萬兒童送回學校，盡管學校即沒有打算，也沒有能力為孩子們提供檢測。
At this critical moment in our nation's fight against COVID-19,
我們國家的抗疫工作已經進入關鍵時刻，
it is time to radically rethink our approach to testing.
我們也是時候重新審視我們的檢測方式了。
The way forward is not a perfect test, but one offering rapid results.
我們的出路并不是沒有缺陷的檢測方式，而是能夠快速給出結果的檢測方式。
Over the past months, much of the conversation around testing has focused on accuracy.
過去幾個月，圍繞檢測的大部分討論都集中在了檢測的準確性上。
Tests have been touted for their high sensitivity,
有些檢測因高靈敏度備受吹捧，
and the FDA requires diagnostic tests to correctly identify 95% of positive cases.
FDA也要求檢測準確率達到95%。
The intuition behind this is clear:
這一要求背后的邏輯很明顯：
we want a test that won't miss positive cases and send infected individuals back into the world to spread the virus.
我們想要的是一種不會遺漏陽性病例，將已經感染的人送回人群中繼續擴散病毒的檢測方法。
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