atepeq/tico19 huggingface dataset:
First, these data are preliminary, and the analysis was limited by missing data related to the health department reporting burden associated with rapidly rising case counts and delays in completion of information requiring medical chart review; these findings might change as additional data become available.
首先，这些数据是初步的，并且分析受到缺失数据的限制，这是由于病例数的迅速增加造成的卫生部门上报负担以及需要病历审查造成的信息填写延迟；随着更多数据的获得，这些结果可能会发生改变。
Information on underlying conditions was only available for 7,162 (5.8%) of 122,653 cases reported to CDC.
在向 CDC 报告的 122,653 起病例中，仅有 7,162 名 (5.8%) 可获得有关基础疾病的信息。
It cannot be assumed that those with missing information are similar to those with data on either hospitalizations or underlying health conditions.
不能假定缺失信息的患者与具备住院或基础疾病数据的患者相似。
Second, these data are subject to bias in outcome ascertainment because of short follow-up time.
其次，由于随访时间短，这些数据在结局确定方面存在偏倚。
Some outcomes might be underestimated, and long-term outcomes cannot be assessed in this analysis.
某些结局可能会被低估，而长期结局无法在这项分析中进行评估。
Third, because of the limited availability of testing in many jurisdictions during this period, this analysis is likely biased toward more severe cases, and findings might change as testing becomes more widespread.
再次，由于在此期间许多辖区实验室检测的可用性有限，这项分析可能偏向更严重的病例，随着实验室检测变得更加普遍，分析结果可能会发生变化。
Fourth, because of the descriptive nature of these data, attack rates among persons with and without underlying health conditions could not be compared, and thus the risk difference of severe disease with COVID-19 between these groups could not be estimated.
第四，由于这些数据为描述性，无法比较具有和不具有基础疾病的人群之间的发病率，因此无法估算两组患者之间 COVID-19 重症的风险差异。
Fifth, no conclusions could be drawn about underlying conditions that were not included in the case report form or about different conditions that were reported in a single, umbrella category.
第五，关于未包含在病例报告表中的基础疾病或在单个总括类别中报告的不同疾病，无法得出结论。
For example, asthma and COPD were included in a chronic lung disease category.
例如，哮喘和 COPD 被包括在慢性肺病类别中。
Finally, for some underlying health conditions and risk factors, including neurologic disorders, chronic liver disease, being a current smoker, and pregnancy, few severe outcomes were reported; therefore, conclusions cannot be drawn about the risk for severe COVID-19 among persons in these groups.
最后，对于一些基础疾病和危险因素，包括神经系统疾病、慢性肝病、当前吸烟者和妊娠，几乎没有严重后果的报道；因此，无法得出关于这些人群中重症 COVID-19 风险的结论。
Persons in the United States with underlying health conditions appear to be at higher risk for more severe COVID-19, consistent with findings from other countries.
与其他国家的研究结果一致，美国具有基础疾病的人群中发生更严重 COVID-19 的风险似乎更高。
Persons with underlying health conditions who have symptoms of COVID-19, including fever, cough, or shortness of breath, should immediately contact their health care provider.
存在基础疾病并出现发热、咳嗽或气促等 COVID-19 症状的患者应立即联系医务人员。
These persons should take steps to protect themselves from COVID-19, through washing their hands; cleaning and disinfecting high-touch surfaces; and social distancing, including staying at home, avoiding crowds, gatherings, and travel, and avoiding contact with persons who are ill.
这些人应该采取措施来保护自己免受 COVID-19 感染，包括洗手；清洁和消毒经常接触的表面；以及保持社交距离，包括居家，避免集会、聚集和旅行，以及避免与生病的人接触。
Maintaining at least a 30-day supply of medication, a 2-week supply of food and other necessities, and knowledge of COVID-19 symptoms are recommended for those with underlying health conditions.
对于具有基础疾病的患者，建议维持至少 30 天的药品储备、2 周的食物和其他必需品储备以及了解 COVID-19 的症状。
All persons should take steps to protect themselves from COVID-19 and to protect others.
所有人都应该采取措施来保护自己免受 COVID-19 感染并保护他人。
All persons who are ill should stay home, except to get medical care; should not go to work; and should stay away from others.
所有生病的人都应该留在家中，除非需要获取医疗诊治；不应该上班；并应与他人保持距离。
This is especially important for those who work with persons with underlying conditions or who otherwise are at high risk for severe outcomes from COVID-19.
对于那些与存在基础疾病者或 COVID-19 导致严重后果的风险较高者一起工作的人而言，这尤其重要。
Community mitigation strategies, which aim to slow the spread of COVID-19, are important to protect all persons from COVID-19, especially persons with underlying health conditions and other persons at risk for severe COVID-19–associated disease (https://www.cdc.gov/coronavirus/2019-ncov/downloads/community-mitigation-strategy.pdf).
旨在减缓 COVID-19 传播的社区缓解策略对于保护所有人免受 COVID-19 感染至关重要，特别是对于存在基础疾病者以及其他重度 COVID-19 相关疾病高危个体 (https://www.cdc.gov/coronavirus/2019-ncov/downloads/community-mitigation-strategy.pdf)。
What is already known about this topic?
关于此主题的已知信息是什么？
Published reports from China and Italy suggest that risk factors for severe COVID-19 disease include underlying health conditions, but data describing underlying health conditions among U.S. COVID-19 patients have not yet been reported.
来自中国和意大利的已发表报告表明，重症 COVID-19 的危险因素包括基础疾病，但尚未报告过描述美国 COVID-19 患者中基础疾病的数据。
What is added by this report?
该报告增加了什么内容？
Based on preliminary U.S. data, persons with underlying health conditions such as diabetes mellitus, chronic lung disease, and cardiovascular disease, appear to be at higher risk for severe COVID-19–associated disease than persons without these conditions.
根据美国的初步数据，存在糖尿病、慢性肺病和心血管病等基础疾病的患者罹患重度 COVID-19 相关疾病的风险似乎比没有这些基础疾病的患者更高。
What are the implications for public health practice?
对公共卫生实践有何影响？
Strategies to protect all persons and especially those with underlying health conditions, including social distancing and handwashing, should be implemented by all communities and all persons to help slow the spread of COVID-19.
所有社区和所有人都应实施保护所有人的策略，尤其是那些存在基础疾病者，包括保持社交距离和洗手，以帮助减缓 COVID-19 的传播。
Emergence of a Novel Coronavirus (COVID-19): Protocol for Extending Surveillance Used by the Royal College of General Practitioners Research and Surveillance Centre and Public Health England
新型冠状病毒 (COVID-19) 的出现：英国皇家全科医师学会研究及监测中心与英格兰公共卫生部使用的扩展监测方案
The Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) and Public Health England (PHE) have successfully worked together on the surveillance of influenza and other infectious diseases for over 50 years, including three previous pandemics.
英国皇家全科医师学会 (RCGP) 研究及监测中心 (RSC) 与英格兰公共卫生部 (PHE) 在过去 50 年来成功合作进行了流感和其他传染性疾病的监测，其中包括之前的三次大流行。
With the emergence of the international outbreak of the coronavirus infection (COVID-19), a UK national approach to containment has been established to test people suspected of exposure to COVID-19.
随着冠状病毒感染 (COVID-19) 在全球爆发，英国建立了全国性控制措施以监测疑似暴露于 COVID-19 的人群。
At the same time and separately, the RCGP RSC’s surveillance has been extended to monitor the temporal and geographical distribution of COVID-19 infection in the community as well as assess the effectiveness of the containment strategy.
与此同时，RCGP RSC 单独进行的监测已经扩展到监控 COVID-19 社区感染的时间和地域分布以及评估控制策略的有效性。
The aims of this study are to surveil COVID-19 in both asymptomatic populations and ambulatory cases with respiratory infections, ascertain both the rate and pattern of COVID-19 spread, and assess the effectiveness of the containment policy.
这项研究的目的是对无症状人群以及存在呼吸道感染的门诊病例进行 COVID-19 监测，确定 COVID-19 传播的速度和模式，并评估控制政策的有效性。
The RCGP RSC, a network of over 500 general practices in England, extract pseudonymized data weekly.
RCGP RSC 是由英格兰 500 多家全科诊所组成的网络，每周一次提取匿名化数据。
This extended surveillance comprises of five components: (1) Recording in medical records of anyone suspected to have or who has been exposed to COVID-19.
这种扩展监测包括五个部分：(1) 在疑似患有或曾经接触过 COVID-19 的任何人的医疗记录中进行记录。
Computerized medical records suppliers have within a week of request created new codes to support this.
计算机化病历供应商已在要求的一周内创建出新编码以支持此项工作。
(2) Extension of current virological surveillance and testing people with influenza-like illness or lower respiratory tract infections (LRTI)—with the caveat that people suspected to have or who have been exposed to COVID-19 should be referred to the national containment pathway and not seen in primary care.
(2) 扩展当前的病毒学监测，对患有流感样疾病或下呼吸道感染 (LRTI) 的患者进行检测，告诫疑似患有或曾经接触过 COVID-19 者应该进入国家控制通道，而不是在基层医疗机构就诊。
(3) Serology sample collection across all age groups.
(3) 在所有年龄段进行血清学样本采集。
This will be an extra blood sample taken from people who are attending their general practice for a scheduled blood test.
将从前往全科诊所进行常规血液检查者那里获取额外的血液样本。
The 100 general practices currently undertaking annual influenza virology surveillance will be involved in the extended virological and serological surveillance.
目前正在进行年度流感病毒学监测的 100 家全科诊所将参与扩展的病毒学和血清学监测。
(4) Collecting convalescent serum samples.
(4) 采集康复期血清样本。
We have the opportunity to escalate the data extraction to twice weekly if needed.
如果需要，我们有机会将数据提取升级到每周两次。
Swabs and sera will be analyzed in PHE reference laboratories.
拭子和血清将在 PHE 参考实验室中进行分析。
General practice clinical system providers have introduced an emergency new set of clinical codes to support COVID-19 surveillance.
全科诊所临床系统提供商已经引入了一套全新的紧急事件临床编码以支持 COVID-19 监测。
Additionally, practices participating in current virology surveillance are now taking samples for COVID-19 surveillance from low-risk patients presenting with LRTIs.
此外，参与当前病毒学监测的诊所现在正在从表现为 LRTI 的低危患者中采集样本进行 COVID-19 监测。
Within the first 2 weeks of setup of this surveillance, we have identified 3 cases: 1 through the new coding system, the other 2 through the extended virology sampling.
在进行这种监测的前 2 周内，我们发现了 3 个病例：1 个是通过新的编码系统，另外 2 个是通过扩展的病毒学采样。
We have rapidly converted the established national RCGP RSC influenza surveillance system into one that can test the effectiveness of the COVID-19 containment policy.
我们已经迅速将既有的全国性 RCGP RSC 流感监测系统转换为能够检测 COVID-19 控制政策有效性的系统。
The extended surveillance has already seen the use of new codes with 3 cases reported.
扩展的监测已经使用了新编码并报告了 3 个病例。
Rapid sharing of this protocol should enable scientific critique and shared learning.
快速共享此方案应该能够实现科学评判和共享学习。
The Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) is a network of general practices (GPs) with a nationally representative population that provides pseudonymized data for weekly surveillance of infectious diseases.
英国皇家全科医师学会 (RCGP) 研究及监测中心 (RSC) 是一个具有全国代表性人群的全科诊所 (GP) 网络，它每周一次提供匿名化数据用于传染性疾病监测。
The disease surveillance program is commissioned by Public Health England (PHE) and covers 37 infectious diseases, including influenza.
该疾病监测计划是由英格兰公共卫生部 (PHE) 委托进行的，涵盖了包括流感在内的 37 种传染性疾病。
The RCGP RSC and PHE have an established collaboration of over 50 years in influenza and respiratory disease surveillance and are now in their 53rd season of surveillance and analysis.
RCGP RSC 和 PHE 在流感和呼吸道疾病监测方面已经建立了 50 多年的合作关系，目前正处于第 53 个监测和分析季节。
The RCGP RSC extracts pseudonymized data from a nationally representative sample of over 500 urban and nonurban GPs each week covering a population of over 4 million.
RCGP RSC 每周从覆盖超过 400 万人口的 500 多个城市和非城市 GP 的全国代表性样本中提取匿名化数据。
Data from these practices are reported online in a weekly return, which includes monitoring weekly rates of influenza-like illness (ILI) and other communicable and respiratory diseases in England.
来自这些诊所的数据每周一次在线报告，其中包括监测英格兰的流感样疾病 (ILI) 以及其他传染病和呼吸道疾病的每周发生率。
We also produce an annual report.
我们还会编制年度报告。
The RCGP RSC data set includes all coded data and all prescribed items including vaccine exposure.
RCGP RSC 数据集包括所有编码数据和所有处方项目，包括疫苗暴露。
The RCGP RSC conducts virology surveillance each influenza season, with 100 GPs participating in the 2019-2020 season (Figure 1).
RCGP RSC 在每个流感季节进行病毒学监测，在 2019-2020 年监测季有 100 家 GP 参与（图 1）。
These virology sampling practices are also recruited to be nationally representative (Figure 1).
这些病毒学采样诊所也被招募为全国性代表（图 1）。
GPs take nasopharyngeal swabs from persons showing acute respiratory illness within 7 days of the onset of symptoms.
GP 在出现症状后 7 天内从表现为急性呼吸系统疾病的患者处采集鼻咽拭子。
Nasopharyngeal swabs are taken from children younger than 5 years showing symptoms of acute bronchitis or bronchiolitis.
对表现为急性支气管炎或细支气管炎症状的 5 岁以下儿童采集鼻咽拭子。
Additionally, nasopharyngeal samples are taken from anyone 5 years and older showing acute onset of ILI and respiratory synctial virus.
此外，还从表现为 ILI 和呼吸道合胞病毒急性发作的 5 岁及以上人群中采集鼻咽样本。
Swabs are tested at the PHE Respiratory Virus Unit for influenza to monitor positivity rates and circulating strains, as well as for measuring vaccine effectiveness.
在 PHE 呼吸道病毒部门对拭子进行流感检测，用于监测阳性率和传播毒株，以及测量疫苗的有效性。
The RCGP RSC successfully conducted a pilot collecting serological samples from adults and linking them to a patient’s medical records during the 2018-2019 influenza season.
RCGP RSC 成功进行了一项试点工作，在 2018-2019 年流感季节采集成年人的血清样本并将其与患者的病历相关联。
This pilot was in collaboration with the PHE Seroepidemiology Unit and added to the residual blood samples submitted to PHE by National Health Service (NHS) laboratories.
这项试点工作是与 PHE 血清流行病学部门合作，作为英国国家医疗服务体系 (NHS) 实验室将剩余血样提交给 PHE 的补充。
Serology can provide important information about background population immunity, and sentinel networks can provide a mechanism for systematic data collection and linkage to medical records and health outcomes.
血清学可以提供有关背景人群免疫力的重要信息，并且预警网络可以提供一种系统的数据收集机制以及与病历和健康结局的联系。
The serology pilot has demonstrated the ability of the network to collect serology samples in adults.
血清学试点工作已经证明了该网络采集成年人血清学样本的能力。
With the COVID-19 outbreak, PHE and RCGP RSC have adapted existing influenza surveillance to monitor the spread of COVID-19 in the community, and this protocol sets out the basis for that collaboration.
随着 COVID-19 的爆发，PHE 和 RCGP RSC 调整了现有的流感监测措施以便监测 COVID-19 的社区扩散，本方案为这种合作奠定了基础。
The primary national strategy for COVID-19 infection is containment, with patients who are at high risk managed via the telephone help system NHS111 and the PHE health protection teams, but the RCGP RSC surveillance is entirely separate.
国家针对 COVID-19 感染的主要策略是控制，通过电话帮助系统 NHS111 和 PHE 健康保护团队管理高危患者，但 RCGP RSC 的监测是完全独立的。
The RCGP RSC, by extending its established work, will provide virological and serological surveillance to monitor the temporal and geographical distribution of COVID-19 infection in the community, and assess the effectiveness of the containment strategy.
RCGP RSC 将通过扩展其既定工作提供病毒学和血清学监测，用于监控 COVID-19 社区感染的时间和地域分布以及评估控制策略的有效性。
We would not be working in isolation on this research.
我们不会孤身从事这项研究。
We will share the protocol with UK colleagues and the I-MOVE consortium who have recently obtained EU Horizon 2020 funding from the stream “Advancing knowledge for the clinical and public health response to the novel coronavirus epidemic”.
我们会将该方案与英国的同事以及 I-MOVE 联盟共享，后者最近因为“提高对新型冠状病毒疫情的临床和公共卫生响应的知识”获得了欧盟“地平线 2020”项目的资助。
It is anticipated that great efficiencies in project management will result through this collaboration than that obtained from countries acting alone.
与单独采取行动的国家相比，预计通过这种合作将会获得更高的项目管理效率。
The aim of this study is to identify whether there is undetected community transmission of COVID-19, estimate population susceptibility, and monitor the temporal and geographical distribution of COVID-19 infection in the community.
这项研究旨在确定是否存在未检测到的 COVID-19 社区传播，估计人群的易感性，并监测社会中 COVID-19 感染的时间和地域分布。
The objectives of this study are as follows:
这项研究的目的如下：
To monitor the burden of suspected COVID-19 activity in the community through primary care surveillance and clinical coding of possible COVID-19 cases referred into the containment pathway
通过基层医疗监测以及转诊至控制通道的可能 COVID-19 病例的临床编码来监测社区中疑似 COVID-19 活动的负担
To provide virological evidence on the presence and extent of undetected community transmission of COVID-19 and monitor positivity rates among individuals presenting ILI or acute respiratory tract infections to primary care
提供关于未检测到的 COVID-19 社区传播的存在和程度的病毒学证据，并监测前往基层医疗机构就诊的 ILI 或急性呼吸道感染患者中的阳性率
To estimate baseline susceptibility to COVID-19 in the community and estimate both symptomatic and asymptomatic exposure rates in the population through seroprevalence monitoring
估计社区人群对 COVID-19 的基线易感性，并通过血清阳性率监测估计人群的有症状和无症状暴露率
To pilot implementation of a scheme for collection of convalescent sera with antibody profiles among recovered cases of COVID-19 discharged to the community
试行一项计划，在出院的已康复 COVID-19 病例中采集具有抗体谱的康复期血清
We intend to capture the following.
我们打算采集以下信息。
Clinical workload related to reports of COVID-19 using the codes created to flag cases, those being assessed and where the infection is located are excluded (Figures 2-​-44)
使用创建用于标记病例的编码进行 COVID-19 报告相关的临床工作量，正在接受评估的病例以及已经确定感染的地点排除在外（图 2-​-44）
Foreign countries visited in the last 28 days
最近 28 天内访问过的其他国家
Existing codes that may have utility (Tables 1-​-3).3).
可能具有实用性的已有编码（表 1--3).3）。
Many GPs and primary care teams may not realize that important relevant data can be coded.
许多 GP 和基层医疗团队可能没有意识到可以对重要的相关数据进行编码。
There is also the potential during any pandemic to monitor the effectiveness of any transmission control measures.
在任何疫情期间都有可能监测任何传播控制措施的有效性。
Reliable coding of letters and test results that will show an infection has become either confirmed or excluded
可以显示感染已确诊或被排除的可靠字母编码和检测结果
The methods will follow the approach used in the current influenza surveillance system and recent serology study, and includes five components: (1) primary care clinical surveillance; (2) virological surveillance; (3) population serological surveillance; (4) convalescent sera in cases; and (5) data curation.
这些方法将遵循在当前流感监测系统和近期血清学研究中使用的方法，包括五个组成部分：(1) 基层医疗临床监测；(2) 病毒学监测；(3) 人群血清学监测；(4) 病例的康复期血清；以及 (5) 数据管护。
The NHS uses the Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT) system of coding, which is normally only updated twice annually.
NHS 使用临床医学系统术语 (SNOMED CT) 编码系统，通常每年仅更新两次。
There was added complexity as some computerized medical record (CMR) suppliers use the Read coding systems (Read clinical terms version 3 – CTv3), which is no longer updated.
由于某些计算机化病历 (CMR) 供应商使用已经不再更新的读取编码系统 (Read clinical terms version 3 – CTv3)，因此增加了复杂性。
Additionally, there were no clinical codes to record COVID-19 in early February 2020.
此外，在 2020 年 2 月上旬还没有用于记录 COVID-19 的临床编码。
Therefore, the two main GP system suppliers added the five terms shown in Table 4 as system-wide local codes.
因此，两个主要 GP 系统供应商添加了表 4 所示的五个术语，作为系统范围内的本地编码。
A UK emergency release of SNOMED CT concepts for COVID-19 was also subsequently made available across all CMR systems (Table 4).
随后，也在所有 CMR 系统中提供了英国针对 COVID-19 的 SNOMED CT 概念的紧急版本（表 4）。
The intention is that these will eventually be mapped to the new SNOMED CT concepts as they become available, allowing recording of relevant data (Multimedia Appendix 1).
目的是在它们可用时最终映射到新的 SNOMED CT 概念，从而允许记录相关数据（多媒体附录 1）。
The key requirements for this release were the ability to code (Table 4) a case of COVID-19, exposure to risk of infection (travel to an area where there may be a higher risk), contact with anyone infected with COVID-19, a report that a person had been tested for COVID-19, and that the disease had been excluded (likely a negative test).
此版本的关键要求包括：编码（表 4）COVID-19 病例的能力，暴露于感染的风险（到可能存在较高风险区域的旅行史），与 COVID-19 感染者的接触，COVID-19 检测报告，以及疾病已被排除（例如阴性检测结果）。
In addition, practices are now able to code any foreign travel undertaken, including the ability to record visits to multiple countries (implemented February 8, 2020).
此外，诊所现在能够对任何国外旅行史进行编码，包括记录多个国家旅行史的能力（自 2020 年 2 月 8 日起实施）。
Figures 2-​-44 show the EMIS web implementation.
图 2-44 显示了 EMIS Web 实施方案。
Currently, virology samples for influenza surveillance are accompanied by a standard request form.
目前，用于流感监测的病毒学样本附有标准申请单。
For COVID-19, we will create a new request form that will record:
对于 COVID-19，我们将创建一个新的申请单，其中将记录：
Date of onset of symptoms
症状发作日期
Diagnosis of any of the following:
以下任何一项诊断：
Acute bronchitis/bronchiolitis in those younger than five years
五岁以下儿童的急性支气管炎/细支气管炎
Lower respiratory tract infection (LRTI)
下呼吸道感染 (LRTI)
History of fever (Y/N); measured (Y/N); if yes, level
发热史（是/否）；已测量（是/否）; 如果是，则记录体温
Shortness of breath (Y/N), if measured: oxygen saturation and respiratory rate
气促（是/否），如果已测量：血氧饱和度和呼吸频率
Recent travel (Y/N); if yes, countries visited in last 14 days
近期旅行史（是/否）；如果是，最近 14 天内到访的国家
Contact with a named person with confirmed COVID-19 (Y/N) with a free text comment about the level of certainty
与已确诊 COVID-19 患者的接触史（是/否），并提供有关确定性水平的自由文字注释
These codes will be grouped ontologically into “definite”, “probable”, “possible”, and “not a case” using our standard approach to grouping codes (Table 5), which has been used previously across disease areas.
使用我们以前用于各疾病领域的标准分组编码方法（表 5），将这些编码在本体上分为“确定的病例”、“很可能的病例”、“可能的病例”和“不是病例”。
The RCGP RSC definition for ILI is shown in Multimedia Appendix 2.
RCGP RSC 对 ILI 的定义见多媒体附录 2。
Public Presentation of Data Using an Observatory and Dashboards
使用天文台和仪表板公开展示数据
We will develop an observatory to present data nationally and a dashboard for feedback to practices about their data quality and collection of virology and serology samples.
我们将建立一个天文台，用于在全国范围内展示数据，并建立一个仪表板，用于向诊所反馈有关其数据质量以及病毒学和血清学样本采集的信息。
This is based on coding described in Table 4.
这基于表 4 中描述的编码。
Definite case will be presented on our dashboard as “cases” of COVID-19.
在我们的仪表板上，确定的病例将显示为 COVID-19 “病例”。
Possible cases will be presented as “Under investigation” (investigating).
可能的病例将显示为“正在调查”（调查中）。
“Not a case” will be presented as “Excluded”.
“不是病例”将显示为“已排除”。
Online data has been established within the initial few weeks in the COVID-19 Observatory (Figure 5), indicating the overall number of patients and rate per 10,000 patients of cases confirmed or under investigation, as well as where the virus is excluded.
已经在创建 COVID-19 天文台的最初几周内建立了在线数据（图 5），表明已确诊或正在调查的病例总数和每 10,000 名患者的比率，以及已排除该病毒的地点。
We have the option to move to twice weekly surveillance reports with a scope to change this to daily reporting.
我们可以选择每周两次提交监测报告，并且可以将其更改为每日报告。
We will continue virology sampling from our sentinel practices, rather than discontinuing as seasonal influenza declines.
我们将持续从预警诊所进行病毒学采样，而不是随着季节性流感的减少而终止。
Additionally, we will recruit more surveillance practices.
此外，我们将招募更多的监测诊所。
The RCGP RSC virology practices will aim to undertake 200-300 nasopharyngeal swabs per week across the RCGP RSC sentinel network, collecting specimens across all age bands.
RCGP RSC 病毒学监测诊所的目标是每周在 RCGP RSC 预警网络中进行 200-300 次鼻咽拭子采集，从而采集各个年龄段的标本。
In addition to the inclusion criteria for influenza virology surveillance (ILI, acute bronchitis/bronchiolitis), participating practices will take nasopharyngeal swab samples from any people showing acute symptoms of LRTI if the onset of symptoms is within 7 days.
除了流感病毒学监测的纳入标准（ILI、急性支气管炎/细支气管炎）之外，如果在 7 天内出现 LRTI 急性症状，参与诊所还将从任何出现症状的患者中采集鼻咽拭子样本。
RCGP RSC research officers and practice liaison staff will manage practices to achieve a total national sample of 200-300 swabs per week.
RCGP RSC 研究人员和诊所联络人员将管理相关诊所，以实现每周 200-300 个拭子的全国样本总数。
This could be increased if PHE modelers require more samples.
如果 PHE 建模人员需要更多样本，此数量可能会增加。
Samples from each practice would be spread across the following age groups: &lt; 5 years, 5-17 years, 18-64 years, and 65 years and older
每个诊所的样本采集将分布在以下年龄段：&lt;5 岁、5-17 岁、18-64 岁和 65 岁及以上
Samples (swabs or serum) collected will be sent via prepaid envelopes addressed to the appropriate PHE laboratory for analysis.
采集的样本（拭子或血清）将通过预付信封发送到适当的 PHE 实验室进行分析。
All samples collected will be tested for the presence of influenza and COVID-19.
将对采集的所有样本进行流感和 COVID-19 检测。
Additionally, PHE will retrospectively test any influenza virology samples collected between early and mid-February 2020 for COVID-19.
此外，PHE 还将对 2020 年 2 月上旬至中旬期间采集的所有 COVID-19 流感病毒学样本进行回顾性检测。
Practices will still follow the PHE protocol for COVID-19 with respect to people at risk of infection who should be signposted down the containment pathway, rather than physically attend their practice.
诊所将继续遵循 PHE 制定的 COVID-19 方案，有感染风险者应转诊至控制通道，而不是亲自前往诊所就诊。
Direct testing of those who attend surgery remains permitted, but we have also rolled out self-swabbing at home.
仍然允许对前往诊室的患者进行直接检测，但我们也已经推出家庭自我拭子采集。
Summary of processes are detailed in Multimedia Appendix 3.
流程总结详见多媒体附录 3。
Everyone with an ILI or a respiratory illness who contacts a GP (eg, phones for an appointment) should be asked specifically about recent travel to China and other countries flagged in current PHE advice, or if they have had contact with other people with COVID-19.
对于每个与 GP 联系（例如，电话预约）并且患有 ILI 或呼吸道疾病的个人，都应该具体询问他们最近前往中国以及 PHE 建议中标记的其他国家的旅行史，或者他们是否与其他 COVID-19 患者有过接触。
If these screening enquiries are positive, the patient would be advised to not come to the practice but instead to follow the PHE flow sheet.
如果这些筛查询问得到了肯定的答复，则建议患者不要前往诊所，而是应该遵循 PHE 流程图。
This can be by a reception or clinician staff, depending on individual practice protocol.
这可以由接待人员或临床工作人员决定，具体取决于个体诊所规程。
These calls should be coded into the GP CMR system and can be reported as part of the RCGP RSC weekly return.
这些电话应编码至 GP CMR 系统，并可以作为 RCGP RSC 每周回报的一部分进行报告。
We have developed training material to support this coding (Multimedia Appendix 4).
我们已经开发出支持该编码的培训材料（多媒体附录 4）。
These include prompt cards for:
这些包括以下提示卡：
Practice reception or triage staff: for coding of any patients calling the practice with symptoms of acute respiratory infection with a history of travel to important areas based on PHE advice
诊所接待或分诊人员：根据 PHE 建议，对所有致电诊所并存在急性呼吸道感染症状以及重要地区旅行史的患者进行编码
Administrative staff or clinicians who code: to encourage consistent coding of results for any suspected cases, including coding of negative results for exclusion
负责编码的行政人员或临床医生：鼓励对任何疑似病例进行一致的结果编码，包括对阴性结果进行排除编码
Practices participating in virology surveillance will opportunistically collect blood samples from patients coming into the practice for a routine blood test.
参加病毒学监测的诊所将适时从前往诊所进行常规血液检查的患者那里采集血样。
Patients who attend their practice for a routine blood test will be asked to provide an additional sample for serology.
前往诊所进行常规血液检查的患者将被要求提供额外的血清学样本。
We have conducted initial searches within the RCGP RSC database to look at the number of full blood count (FBC) results and overall rates in adults and children (Figures 6-​-9).9).
我们已经在 RCGP RSC 数据库中进行了初步检索，以查看成人和儿童的全血细胞计数 (FBC) 结果的数量和总体比率（图 6--9).9）。
An FBC is one of the most common tests performed, and we hope this will give an approximate indication of overall numbers of blood tests performed.
FBC 是最常进行的检测项目之一，我们希望这能大致显示出进行血液检测的总数。
The sampling rate, per 100,000 patients was highest for children 15-17 years of age and 60 year or older in adults, with the lowest rates in children 0-4 years of age and 18-29 years of age in adults (Figures 6-​-99).
每 10 万名患者的采样率在 15-17 岁的儿童以及 60 岁或以上成人中最高，而在 0-4 岁的儿童以及 18-29 岁的成人中最低（图 6--99）。
We will provide 1000 serology baseline samples across all ages that reflect the varying rates of attendance by age.
我们将提供 1000 个不同年龄段的血清学基线样本，用于反映各年龄段到场率的差异。
Additionally, we will test if we can obtain these all from virology practices to enhance the yield.
此外，我们将测试能否从病毒学监测诊所中获得所有这些信息以提高产出。
A good geographical spread is important, so PHE can advise on areas where serology will most usefully be collected.
合理的地域分布非常重要，因此 PHE 可以对采集血清学样本最有用的区域提供建议。
This will be followed by 800 samples monthly.
随后每月将提供 800 个样本。
The sample will be stratified with 200 specimens for prepandemic survey (100 for monthly) in the following age groups: &lt; 5 years, 5-17 years, 18-64 years, and 65 years or older.
样本将按照以下年龄组对用于疫情前调查（每月 100 个）的 200 个样本进行分层：&lt;5 岁、5-17 岁、18-64 岁和 65 岁或以上。
The younger patients, in many practices younger than 14 years, and in nearly all for children younger than 8 years will require pediatric serology surveillance.
在许多诊所中，年龄小于 14 岁的年轻患者以及几乎所有 8 岁以下的儿童都需要进行儿科血清学监测。
We will develop a new request form for practices to capture recent travel and exposure to COVID-19.
我们将为诊所开发新的申请表，以记录近期旅行史和 COVID-19 暴露情况。
We will pilot a scheme for collecting convalescent serology from people with confirmed cases and who have had an acute virology sample at the time of their infection.
我们将试行一项计划，从已确诊病例以及在感染时已获得急性病毒学样本的患者中采集康复期血清学样本。
This is to identify a carrier state in patients who have recovered from the virus but may continue shedding the virus.
这是为了确定已经康复但可能继续释放病毒的患者的携带者状态。
If there are a small number of cases, this may assist in developing a test kit for patients to take to their own GP and explore its acceptability to patients.
如果病例数量很少，这可能有助于为患者开发一套检测试剂盒，以带给他们自己的 GP 并探讨其对患者的可接受性。
If there are a large number of COVID-19 cases nationally, convalescent samples could be collected from RCGP RSC practices where there are confirmed cases, with the ability to link to the full medical record.
如果在全国范围内有大量 COVID-19 病例，则可以从已确诊病例并具有与完整病历关联能力的 RCGP RSC 诊所中采集康复期样本。
This process may include checking pseudonymized NHS numbers for positive individuals at RCGP RSC practices, checking current PHE guidance regarding considerations of infectiousness for confirmed cases, and offering the patient an appointment following the previously mentioned process.
该过程可能包括核对 RCGP RSC 诊所内阳性个体的匿名化 NHS 编号，核对有关已确诊病例传染性考虑因素的现行 PHE 指南，以及按照上述流程为患者提供预约。
This needs to be carefully coordinated nationally across the network and may require PHE to ensure individuals are not contacted by multiple agencies.
这需要在整个网络内进行周密地全国性协调，并可能要求 PHE 确保不会由多个机构联系个人。
RCGP RSC could provide a useful structure to channel the initial contact once PHE has made a request.
一旦 PHE 发出申请，RCGP RSC 即可提供一种有用的结构来引导初始联系人。
The RCGP RSC practices participating in the annual influenza virology surveillance have started sampling from patients showing symptoms of a LRTI.
参与年度流感病毒学监测的 RCGP RSC 诊所已经开始从存在 LRTI 症状的患者中取样。
All samples received are being tested for influenza and COVID-19.
收到的所有样本正在进行流感和 COVID-19 检测。
The RCGP RSC will explore ways to collect convalescent samples from any patients tested positive for COVID-19 through the extension of the virological surveillance.
RCGP RSC 将探索通过扩大病毒学监测从任何 COVID-19 检测结果呈阳性的患者中采集康复期样本的方法。
From the start, we will be carefully curating data to ensure that it can be used for future studies.
从一开始，我们就将仔细整理数据以确保可用于将来的研究。
Our clinical data will be linked to virology.
我们的临床数据将与病毒学样本相关联。
We will curate our data using the Findable, Accessible, Interoperable, Reusable principles.
我们将使用“可查找、可访问、可共同操作、可重新使用”的原则来整理数据。
To facilitate this our data set is listed with Health Data Research UK and the European Health Data Evidence Network.
为此，我们的数据集已在“英国健康数据研究中心”和“欧洲健康数据证据网络”中列出。
The statistical methodology is in support of a policy approach to widespread disease outbreak, where so-called nonpharmaceutical interventions (NPIs) are used to respond to an emerging pandemic to produce disease suppression.
统计方法学支持针对广泛疾病爆发的政策方法，其中使用所谓的非药物干预措施 (NPI) 应对新出现的疫情以产生疾病抑制效果。
This policy aims to reduce contact rates in the population and thereby reduce transmission of the virus.
该政策旨在降低人群中的接触率，从而减少病毒的传播。
To implement this the UK government has recently articulated the desire to implement population self-isolation measures.
为了实现这一目标，英国政府最近明确表达了实施人群自我隔离措施的要求。
By targeting the reproduction number (R) (the average number of secondary cases each case generates) and aiming to reduce the R to below 1, the policy seeks to reduce case numbers to low levels or (as seen in previous outbreaks with severe acute respiratory syndrome and Ebola) to eliminate human-to-human transmission.
通过针对再生数 (R) （每个病例产生的二代病例的平均数量）并将 R 降低至 1 以下，该政策试图将病例数量降至较低水平或（如先前的严重急性呼吸系统综合征和埃博拉病毒爆发）消除人传人现象。
As the experience from the 2009 H1N1 pandemic has shown, NPIs can be a crucial component of pandemic mitigation.
2009 年 H1N1 疫情的经验已经证明，NPI 可能是缓解疫情的重要组成部分。
Key to the focus of our study will be the estimation of peak cases in the population and continual monitoring by data collection and modelling the potential growth and emergence of subsequent peaks in new cases as social distancing measures are relaxed.
我们研究重点的关键将是估计人口中的峰值病例，通过数据采集进行持续监测，并对随着扩大社交距离措施的放松而可能出现的病例增长和后续高峰进行建模。
There has already been publication of important disease epidemiological measures concerning the outbreak of COVID-19 in mainland China.
关于中国大陆 COVID-19 爆发的重要疾病流行病学措施已经出版。
A further fundamental measure in pandemic dynamics is the length of time from infection to when a person is infectious to others and the mean duration of infectiousness.
疫情动态的另一个基本指标是从一个人发生感染到传染给其他人的时间长度以及平均传染性持续时间。
These factors, if estimated accurately, will give good predictions for the likely length of the pandemic, the final number of infected cases.
如果能够准确估算这些因素，将对疫情可能持续的时间以及最终的感染病例数量给出合理的预测。
We intend to apply approximate Bayesian inference (ABC) to (possibly spatially heterogeneous) Susceptible-Exposed- Infectious-Removed (SEIR) stochastic epidemic models.
我们打算将近似贝叶斯推断 (ABC) 应用于（可能在空间上存在异质性）“易感-暴露-传染-移出” (SEIR) 随机疫情模型。
Such techniques are highly parallelizable and have been successfully applied to many fields including disease transmission modelling.
此类技术是高度可并行的，并且已经成功地应用于许多领域，包括疾病传播建模。
They are particularly suited to situations where likelihood functions are absent and where more traditional approaches such as Markov chain Monte Carlo are impractical.
它们特别适合于缺少似然函数且不适合使用诸如马尔可夫链蒙特卡洛等更传统方法的情况。
Such an approach has been demonstrated to work effectively on the ASPREN surveillance data, a network of sentinel GPs and nurse practitioners who report deidentified information on ILIs and other conditions, where issues such as missing data and the need to model the observation process itself has been successfully addressed.
事实证明，这种方法可以有效地处理 ASPREN 监测数据，这是一个由预警 GP 和执业护士组成的网络，负责报告关于 ILI 和其他疾病的匿名信息，在这些情况下，诸如缺失数据等问题以及对观察过程本身进行建模的需求已经被成功解决。
Furthermore, peaks in new cases have been estimated by distributional methods.
此外，已经通过分布方法估计了新发病例的高峰。
Estimates of the parameters of the SEIR model are tractable on large data sets because of parallelizability, and these methods have been implemented in several R libraries; we intend to use the libraries ABSEIR (deposited on GitHub: https://tinyurl.com/vqu35cj) and abctools (https://tinyurl.com/tfjavz4) to estimate epidemic measures on a weekly basis.
由于可并行性，SEIR 模型参数的估计在大型数据集上易于处理，并且这些方法已经应用于多个 R 库；我们打算使用 ABSEIR 库（存储于 GitHub：https://tinyurl.com/vqu35cj）和 abctools 库 (https://tinyurl.com/tfjavz4) 每周估算一次疫情指标。
Since we are fitting an SIR-epidemic model in the ABC routine, we anticipate that our results will be robust against weekly case data containing relatively small counts.
由于我们在 ABC 例程中拟合了 SIR 疫情模型，因此我们预期分析结果对于包含相对较少数量的每周病例数据将是可靠的。
For example, see for the ABC methodology applied to the Tristan da Cunha common cold data from 1967, where counts of I (number of infectious cases) and R (number of recovered cases) are in the tens at most.
例如，ABC 方法已经应用于特里斯坦-达库尼亚群岛 1967 年以来的普通感冒数据，其中 I（感染病例数）和 R（恢复病例数）的计数最多为几十。
Finally, in addition to the above methodology we will employ the Kaplan-Meier method with two outcomes (death and recovery) to estimate the case fatality ratio.
最后，除了上述方法学之外，我们还将采用具有两种结局（死亡和恢复）的 Kaplan-Meier 方法来估计病死率。
This approach is independent of the ABC methodology and will allow comparisons between estimates from the two modelling approaches to judge robustness of results.
该方法独立于 ABC 方法学，将允许比较两种建模方法的估计值以判断结果的稳健性。
RCGP RSC’s surveillance with PHE is defined as Health Protection under Regulation 3 of The Health Service (Control of Patient Information) Regulations 2002.
RCGP RSC 与 PHE 的监测在 2002 年《卫生服务（患者信息控制）条例》第 3 条中被定义为“健康保护”。
This has been confirmed by PHE’s Caldicott Guardian’s Office.
PHE 的卡尔迪科特监护人办公室已经证实了这一点。
We do not see any increased risk to practices or practitioners taking part in this surveillance.
我们认为参与此项监测计划对诊所或从业者没有增加任何风险。
Infection prevention and control advice will follow extant national guidance.
感染预防和控制建议将遵循现有的国家指南。
Any cases identified will be managed according to the PHE/NHS guidance in force at the time, including advice for identified contacts.
发现的所有病例都将根据当时有效的 PHE/NHS 指南进行管理，包括对已确定的密切接触者提供的建议。
However, our training will include reminders about safe handling of specimens and revision of infection control measures anticipated to be high in our practices.
但是，我们的培训将包括预计在诊所中常用的有关标本安全处理以及感染控制措施修订的提醒。
It is a key part of Regulation 12 about safe care and treatment, periodically inspected by the Care Quality Commission.
这是关于安全护理和治疗的“12 号法规”的关键部分，由医疗质量委员会定期检查。
Travel History and Clinical Descriptors of the COVID-19 Infections
旅行史以及 COVID-19 感染的临床描述
The RCGP RSC practices have been advised on the clinical coding that has been made available for COVID-19 across all CMR systems.
已经对 RCGP RSC 诊所提出了有关所有 CMR 系统中可用于 COVID-19 的临床编码的建议。
This includes information on coding of clinical descriptors (Table 4) and any recent travel history.
这包括有关临床描述符编码（表 4）和任何近期旅行史的信息。
Establishment of Extended Virology Sampling
建立扩展病毒学采样
The RCGP RSC practices participating in the annual influenza virology surveillance have started sampling from patients showing symptoms of LRTI.
参与年度流感病毒学监测的 RCGP RSC 诊所已经开始从存在 LRTI 症状的患者中取样。
This has led to initial early identification of background spread in low-risk patients.
这导致开始早期发现低危患者的背景扩散。
As of March 7, 2020, the surveillance system has detected 2 cases of COVID-19 in low-risk patients with no history of travel through extended virological sampling.
截至 2020 年 3 月 7 日，监测系统已经通过扩展病毒学采样在没有旅行史的低危患者中检测到 2 名 COVID-19 病例。
This protocol describes how we have adapted a national influenza surveillance system to monitor community spread of an unexpected infection of COVID-19.
该方案描述了我们如何调整全国性流感监测系统以监控意外 COVID-19 感染的社区扩散。
We have rapidly created and incorporated new codes to allow data recording, and are collecting data to monitor the effectiveness of containment strategies.
我们已经快速创建并合并了新的编码以允许进行数据记录，并正在收集数据以监控控制策略的有效性。
Through this surveillance, we intend to find out more about the epidemiology of COVID-19 in ambulatory care.
通过这种监测，我们打算找到更多门诊医疗中的 COVID-19 流行病学信息。
In particular, its rate of spread, both temporal and geographical.
具体而言，是疫情扩散速度，包括时间和地域方面。
Our testing of low-risk patients will also inform whether the containment strategy that is based on virology testing of high-risk patients and their contacts plus self-isolation is effective.
我们对低危患者的检测还将了解基于对高危患者及其接触者进行病毒学检测外加自我隔离的控制策略是否有效。
Containment should slow the spread, and there may be benefits in the management of spread from intense surveillance.
控制措施应该会减慢疫情扩散速度，严格监测可能有利于控制疫情扩散。
However, there may come a point at which the virus spreads more widely into the population, as has happened in Italy.
但是，就像在意大利发生过的那样，可能会达到一个病毒更广泛传播到人群中的时间点。
Surveillance of low-risk patients should inform when we reach this tipping point and when infection rates start to remit.
低危患者的监测应该能够告知我们何时达到这个临界点以及感染率何时开始降低。
The epidemiology of COVID-19 remains emergent.
COVID-19 的流行病学仍然处于发展初期。
The registration-based nature of UK primary care means that we will be able to create a complete picture of the cumulative incidence and duration.
英国基层医疗的登记制度意味着我们将能够对累积发病率和持续时间进行全面了解。
The surveillance system should be able to identify areas where COVID-19 spread is taking place that might be suitable for trials of antiviral therapy.
监测系统应该能够确定正在发生 COVID-19 传播的区域，这些区域可能适合进行抗病毒治疗试验。
We could also follow up on the effectiveness or any adverse reactions to these medicines or vaccinations.
我们还可以跟踪这些药物或疫苗接种的有效性或任何不良反应。
Finally, early detection of a confirmed COVID-19 case has exemplified the rapid implementation of this enhanced surveillance in the national network.
最后，一名确诊 COVID-19 病例的早期检测已经证明在全国性网络中快速实施这种增强监测方案的价值。
Safety of practices is our primary concern.
诊所的安全性是我们首要考虑的问题。
The RCGP RSC has operated for over 50 years and has been involved in collecting samples to monitor disease and vaccine effectiveness through the Hong Kong flu pandemic of 1968/69, the Russian flu of 1977/78, and the 2009 Swine flu pandemic.
RCGP RSC 已经运行了 50 多年，并且在 1968/69 年的香港流感疫情、1977/78 年的俄罗斯流感疫情以及 2009 年的猪流感疫情期间参与了样本采集以监测疾病和疫苗有效性。
We are not aware of any increased risk to practice staff or other patients from involvement in surveillance.
我们不知道参与监测的诊所工作人员或其他患者的风险是否会增加。
Pandemic preparedness is part of the role of the RCGP RSC.
疫情防范是 RCGP RSC 职能的一部分。
It is plausible that enhanced coding of information from contacts with the practices in RCGP RSC will reduce the likelihood of people who may be suspected COVID-19 cases being brought to the surgery inadvertently.
对从与 RCGP RSC 诊所的联系人获得的信息进行增强编码似乎有望减少可能为疑似 COVID-19 病例的患者被误带入诊室的可能性。
Where cases are detected unexpectedly, it is probably helpful for that patient, their contacts, and the practice to know.
在意外发现病例的情况下，对患者、其密切接触者和诊所可能会有所帮助。
The impact on practices has been to close for a day, if a case is found, for deep cleaning and then reopen.
对诊所的影响是，如果发现病例，需要关闭一天，在进行深度消毒后重新开放。
The principal limitations of our system are the number of data points.
我们系统的主要限制是数据点的数量。
We are collecting serology and virology data from 100 sites, which covers a small group of the population.
我们正在从覆盖一小部分人口的 100 个研究中心采集血清学和病毒学数据。
This has been satisfactory for monitoring influenza, but we are not certain if this is a sufficiently large sample for the COVID-19 outbreak.
这对于流感监控而言已经令人满意，但我们不确定这些样本的数量是否足够用于监测 COVID-19 爆发。
Our sites (surveillance practices) are currently fixed, and it could be helpful to be able to rapidly onboard practices in regions where there are more cases.
我们的研究中心（监测诊所）目前是固定的，能够在具有更多病例的地区迅速启用更多诊所可能会有所帮助。
Currently, we will be reporting weekly.
目前，我们将每周报告一次。
Our existing system can be enhanced to twice weekly, but maybe daily or hourly data should be our current approach.
我们现有的系统可以提高到每周两次，但也许每天或每小时数据应该成为我们当前的方法。
Opportunistic sampling for serology in children younger than 10 years might be limited due to the overall reduced rate of blood tests in children.
由于儿童的总体血液检测率较低，10 岁以下儿童的血清学采样机会可能会受到限制。
The extended surveillance using the RCGP RSC-PHE network for the emergent COVID-19 outbreak has been established rapidly.
已经快速建立了使用 RCGP RSC-PHE 网络对处于发展初期的 COVID-19 爆发进行扩展监测的方案。
The model of getting the appropriate informatics to enable capture of the required data has already been a success, with data recording starting the week the codes were created.
获取适当信息以支持采集必需数据的模型已经取得成功，从创建编码的那一周开始记录数据。
In addition, modifying the existing surveillance system to collect population data in a parallel way has also been effective.
此外，修改现有监测系统以并行方式采集人口数据也很有效。
However, we are at present unsure as to whether the scale of this surveillance provides sufficient data to drive local containment strategies or if reporting infrequently meets the need of our information age.
但是，我们目前尚不确定这种监测规模能否提供足够的数据来推动当地控制策略，或者较低频率的报告是否符合我们信息时代的需要。
Updating the diagnostic criteria of COVID-19 “suspected case” and “confirmed case” is necessary
有必要更新 COVID-19 “疑似病例”和“确诊病例”的诊断标准
On 6 February 2020, our team had published a rapid advice guideline for diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infection, and this guideline provided our experience and make well reference for fighting against this pandemic worldwide.
2020 年 2 月 6 日，我们团队发布了《2019 新型冠状病毒 (2019-nCoV) 感染的诊断和治疗快速建议指南》，我们通过该指南为全球应对疫情提供了经验和借鉴。
However, the coronavirus disease 2019 (COVID-19) is a new disease, our awareness and knowledge are gradually increasing based on the ongoing research findings and clinical practice experience; hence, the strategies of diagnosis and treatment are also continually updated.
然而，2019 冠状病毒疾病 (COVID-19) 是一种新型疾病，基于正在进行的研究成果和临床实践经验，我们对该疾病的认知在逐步提高；因此，诊断和治疗策略也在不断更新。
In this letter, we answered one comment on our guideline and provided the newest diagnostic criteria of “suspected case” and “confirmed case” according to the latest Diagnosis and Treatment Guidelines for COVID-19 (seventh version) that issued by the National Health Committee of the People’s Republic of China.
在本函中，我们回应了关于上述指南的一条意见，并根据中华人民共和国国家卫生健康委员会发布的最新《COVID-19 诊疗方案（第七版）》，提供了最新的“疑似病例”和“确诊病例”诊断标准。
In December 2019, the 2019 novel coronavirus (2019-nCoV) has caused an outbreak, which is now officially named as the coronavirus disease 2019 (COVID-19) and the virus has been named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
2019 年 12 月，2019 新型冠状病毒 (2019-nCoV) 爆发，目前，该疾病已被正式命名为 2019 冠状病毒疾病 (COVID-19)，该病毒曾被命名为严重急性呼吸综合征 2 型冠状病毒 (SARS-CoV-2)。
On 11 March 2020, WHO characterized COVID-19 as a pandemic.
2020 年 3 月 11 日，WHO（世界卫生组织）将 COVID-19 列为全球性大流行病。
In order to fight against the SARS-CoV-2 infection, our team has developed a rapid advice guideline and that has been published online in Military Medical Research on 06 February 2020.
为对抗 SARS-CoV-2 感染，我们的团队制定了快速建议指南，并于 2020 年 2 月 06 日将该指南在线发布到《军事医学研究》杂志上。
It has attracted a great attention since published.
自发布以来，它引起了广泛的关注。
Note however that COVID-19 is a new disease, our awareness and knowledge is gradually increasing based on the ongoing research findings and clinical practice experience; hence, the strategies of diagnosis and treatment are also continually updated.
但请注意，COVID-19 是一种新型疾病，基于正在进行的研究成果和临床实践经验，我们对该疾病的认知在逐步提高；因此，诊断和治疗策略也在不断更新。
For instance the Diagnosis and Treatment Guidelines for COVID-19 issued by the National Health Committee of the People’s Republic of China (http://www.nhc.gov.cn/), among 16 January 2020 to 3 March 2020, has issued a total of seven editions with some contexts being substantively changed.
例如，中华人民共和国国家卫生健康委员会 (http://www.nhc.gov.cn/) 在 2020 年 1 月 16 日至 2020 年 3 月 3 日期间共发布了 7 版《COVID-19 诊疗方案》，其中部分内容已经发生了实质性的变化。
Now our guideline received a comment by Zhou et al., they introduced a simple scoring proposal based on their clinical experience.
现在，我们的指南收到了 Zhou 等人的意见，他们根据自己的临床经验提出了一种简单的评分方案。
Their work added new evidence for our guideline and also make valuable reference for this pandemic worldwide.
他们的工作为我们的指南提供了新的证据，也为这个全球性大流行病提供了有价值的参考。
We endorse their significant work and express our thanks.
我们认可他们所做的这一重要工作并表示感谢。
However, their work also needs update according to the latest Diagnosis and Treatment Guidelines for COVID-19 (Trial seventh version) and recently studies.
不过，他们的提案也需要根据最新的《COVID-19 诊疗方案（试行第七版）》以及最近的研究进行更新。
According to the seventh edition (3 March 2020), to confirm the suspected case needs to combine any one item of epidemiological history features with two items of clinical manifestations to make a comprehensive analysis, or needs to meet three items of clinical manifestations if without clear epidemiological history:
根据第七版（2020 年 3 月 3 日），疑似病例的确诊需要将一项流行病学史特征与两项临床表现相结合以进行综合分析，如果没有明确的流行病学史，则需要满足三项临床表现：
Epidemiological history: (1) a history of travel or residence in Wuhan city and surrounding areas, or other communities where COVID-19 cases had been reported in the last 14 days before symptom onset; (2) a history of contact with SARS-CoV-2 infectious cases (with positive nucleic acid test); (3) a history of contacting with patients with fever or respiratory symptoms from Wuhan city and surrounding areas, or other communities where COVID-19 had been reported in the last 14 days before symptom onset; (4) a history of contacting with cluster of confirmed cases (≥ 2 cases with fever and/or respiratory symptoms occurred within 2 weeks in small areas, such as home, office, class of school, etc).
流行病学史：(1) 在症状出现前 14 天内曾在武汉市及周边地区或其他报告有 COVID-19 病例的社区有旅行或居住史；(2) 与 SARS-CoV-2 感染病例（核酸检测呈阳性）有接触史；(3) 在症状出现前 14 天内曾与来自武汉市及周边地区或其他报告有 COVID-19 的社区的发热或呼吸道症状患者有接触史；(4) 与聚集性确诊病例（在症状出现前 2 周内，于小范围内接触 ≥ 2 例发热和/或呼吸道症状患者，如家中、办公室、学校班级等）有接触史。
Clinical manifestations: (1) fever and/ or respiratory symptoms; (2) with imaging features of COVID-19 infection; (3) total white blood cell counts showing normal, decreased, or reduced lymphocyte count in the early onset stage.
临床表现：(1) 发热和/或呼吸道症状；(2) 具有 COVID-19 感染的影像学特征；(3) 发病早期白细胞总数正常或减少，淋巴细胞计数减少。
Diagnosing the confirmed case should base on suspected case with any one item of pathogenic or serological evidence as following: (1) real-time PCR test positive for SARS-CoV-2; (2) viral whole genome sequencing showing high homogeneity to the known novel coronaviruses; (3) positive for the specific IgM antibody and IgG antibody to SARS-CoV-2 in serum test; or a change of the SARS-CoV-2-specific IgG antibody from negative to positive, or titer rising ≥4 times in the recovery phase above that in the acute phase.
对确诊病例的诊断应以疑似病例为依据，并有下列任何一项病原学或血清学证据：(1) SARS-CoV-2 的实时 PCR 检测呈阳性；(2) 病毒全基因组测序显示与已知的新型冠状病毒高度同源；(3) 血清试验中针对 SARS-CoV-2 的特异性 IgM 抗体和 IgG 抗体呈阳性；或 SARS-CoV-2 特异性 IgG 抗体由阴性变为阳性，或在恢复期中滴度上升 ≥4 倍，高于急性期。
We can see that the real-time PCR test for nucleic acid in respiratory tract or blood samples was added to the second (18 January 2020) and third (22 January 2020) editions.
我们可以看到，第二版（2020 年 1 月 18 日）和第三版（2020 年 1 月 22 日）增加了呼吸道或血液标本中的实时 PCR 核酸检测。
The pathogenic detection of blood sample was added to the fourth (27 January 2020) and fifth (8 February 2020) editions; and then the serological evidence was added to the seventh edition.
第四版（2020 年 1 月 27 日）和第五版（2020 年 2 月 8 日）增加了血液标本病原学检测；之后第七版增加了血清学证据。
These modifications based on the researchers continued work that to search for an optimal nucleic acid detection kit for rapid diagnosis, as well as the samples from respiratory tract including blood sampling, which increased the availability of different specimens, and supported bringing the specific antibody positive result into the confirmed criteria.
这些修改基于研究人员为实现快速诊断而研究最佳核酸检测试剂盒的持续工作，以及包括采血在内的呼吸道标本，这增加了不同标本的可用性，并为将特异性抗体的阳性结果纳入确诊标准提供了证据。
Besides, there are more and more evidence that remind us to caution with the atypical symptomatic and asymptomatic patients.
此外，越来越多的证据提醒我们注意非典型症状和无症状患者。
Hence, the flow chart of Zhou et al. should be updated, as they classified the person without clinical symptoms as “low risk”.
因此，应更新 Zhou 等人的流程图，因为他们将没有临床症状的人员归类为“低风险”。
The score system also needs to be verified in further clinical practice and studies.
另外，评分系统还需要在进一步的临床实践和研究中得到验证。
To conclude, we hope more direct evidence coming up and call for readers to provide their comments.
最后，我们希望出现更多直接的证据，并呼吁读者提出意见。