Ask an expert: Q & A with Dr. Tom Frieden

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Tom Frieden, a former director of the Center for Disease Control in Atlanta as well as a former Commissioner of Health for New York City, was interviewed about coronavirus yesterday by reporter Helen Branswell. Branswell, who used to work for the Canadian Press, now writes for统计，在线新闻每日专门研究健康，医学和药物研究。我坐在那个视频会上。简而言之，这是弗里登的一些评论。

卫生当局现在应该做什么？

“Use the time to prepare for the next wave of the virus. Like Wayne Gretzky used to say, skate toward where the puck is去，不是现在的位置。这将意味着更广泛地测试，隔离所有受感染的人，积极地追踪他们的所有接触，并进行14天的隔离。”

If these things are executed properly, Frieden suggested we may be able to “box in” or contain the virus to small clusters and avoid re-imposing the strict physical distancing measures we are living with today. That said, when we re-emerge, the future will look different from the past.

“您会在公共场所看到很多洗手液；我们仍然必须弄清楚该如何处理电梯。”弗里登说。“将不再有握手，面对面的商务会议将更少。工作日或工作时间可能不得不交错，以减少聚集的人数。”

When will the world be ready to re-open?

弗里登说：“疫苗仍然至少一年远，因此该病毒仍将在这里。”要保持“小火煮”，必须发生三件事：1）死亡人数必须降低；2）必须保护卫生保健工作者；3）公共卫生系统必须能够测试，隔离，追踪和隔离感染者。

“Right now in the United States, we aren’t moving fast enough to get the test capacity up,” said Frieden. “In terms of contact tracing, that army of people is just beginning to get organized. Seven thousand people have already died in my city of New York.”

What percentage of COVID-19 transmission is resulting from people who don’t have any symptoms (asymptomatic) or people before they show any symptoms (pre-symptomatic)?

“Information on this is emerging. Some of the best information we have is coming from the Diamond Princess cruise ship. Initially, between 40% and 50% of the people who had the virus didn’t have any symptoms.那真是令人震惊。但是随着时间的流逝，大多数人出现症状，只有大约18％的人出现了neverto have symptoms. Spread could be either from the pre-symptomatic or the asymptomatic person. There is one well-done study from Singapore which estimates 6.4% of their transmission came from people who did not show any symptoms.”

How are the serology tests working?

“有针对该病毒的测试，还测试了称为血清学的抗体，这是一种血液检查。市场上有许多血清学测试，其中许多是垃圾。我们不知道有很多。我们不知道每个被病毒感染的人是否会开发抗体，尽管它看起来如此。我们不知道抗体是否可以防止未来的感染，这是一个至关重要的问题。从理论上讲，如果蚂蚁体具有保护性，该人将拥有“摆脱无监狱卡”，并且可以返回正常活动并帮助做出回应。”

What is your opinion on wearing cloth masks?

The Center for Disease Control has recommended that healthy people wear cloth masks whenever they go out but the World Health Organization has not.

“The CDC recommendation was thoughtful and reasonable. It is a judgment call. The reasoning is as follows. In a place with lots of spread, some people will be pre-symptomatic or asymptomatic and therefore potentially spreading the virus. We do know if people who have the virus wear a home-made mask, they are less likely to give it to others. There are some “buts” here. You don’t want to be taking supply away from healthcare workers. You don’t want to be touching your face more because you are sweaty. And you want to make sure it doesn’t give you false confidence to go out because if you are ill, stay home.”

有一线希望吗？

“For all the terrible death and economic depression we are in, in fact, we are seeing some silver linings. We are seeing a future where despite conflicts among (and within) countries, we are all connected and that we can work together. That there is interest in global solidarity. It matters to us if the nursing home residents are safe, if the prisoners are safe, if the homeless are safe. This is the time to build our public health entities to keep us safer from other conditions beside coronavirus that are needlessly causing illness and disability. So I remain optimistic we will come out of this stronger.”

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