
English: 
welcome to another MedCram update let's
talk about California and testing but
before we do let's just review total
confirm eighty 2164 total deaths 2800 oh
one total recovered thirty two thousand
eight hundred and ninety seven we see
more of a continuation of what we've
been seeing in the past let's go to the
world ometer we gonna talk a little bit
about testing today and also the
positivity rate and UK they have well
over seven thousand tests of which only
thirteen are positive and that's a very
low positivity rate of course in Italy
where they actually have an outbreak
they've done over nine thousand tests of
which only four hundred and seventy are
positive it's about a five percent
positivity rate in France two point two
positivity rate in Austria 321 tests of

Chinese: 
欢迎观看新一期MedCram，今天我们聊聊
加利福尼亚和（新冠肺炎）检测，但是
在我这之前，让我们来回顾一下总数疫情数字：
82,164例确诊，2,801例死亡
32,897例治愈，此外
如此前一段时间一样，疫情仍在持续。
这是实时全球数据，今天我们将谈谈病毒检测
以及检测呈阳性的比例，英国进行了超过七千例测试
其中仅有十三例阳性，显然这一比例很低
病毒已在意大利爆发，而他们已经进行了九千例测试
其中仅有470例阳性，阳性占比约5%
法国阳性比例2.2%，奥地利进行测试321例

English: 
which two are positive and then in the
United States notice we've only done
four hundred and forty five concluded
tests of which fourteen are positive and
that's around three point one positivity
rate these tests are not as sensitive as
you may think that you're going to be
surprised that the sensitivity on these
tests are only around seventy percent
and so it is possible to have a negative
test and to still be infected with the
corona virus we see that there are so
far 334 new cases and one death in South
Korea and the number of confirmed cases
expected to jump in the coming days as
health authorities have started testing
more than two hundred and ten thousand
members of this church and Daegu if we
look at the numbers coming out of China
and the rest of the world in terms of
the total deaths that seems to be
leveling off and if we look at the
number of daily new cases outside of
China that has hit its highest amounts

Chinese: 
其中两例阳性，注意美国的情况
我们只做了445例检测，其中14例阳性
阳性的比例大概是3.1%，这些检测
并不像人们想象的那样灵敏，你可能会感到很惊讶
这些检测的灵敏度大约只有70%，因此即使检测呈阴性
患者可能已经感染，我们还注意到
韩国有334个新增病例
随着卫生部门逐渐对大邱一个教会中的两万一千名教徒开始检测
在未来几天，确诊数字会猛增
就中国和其他地区公布的数字而言
总死亡人数似乎已经趋于平稳，如果我们
看一下中国以外的每日新增病例，确诊人数

English: 
ever on February 26 with daily cases of
569 I want to go to a local site
Eyewitness News
here in Southern California a new case
that has been detected in Northern
California in a resident who has not
traveled overseas
couple things that I want you to be
aware of this patient is a resident of
Solano County turns out that Solano
County is the home to Travis Air Force
Base where Americans returning from
overseas were quarantined the patient
was transferred back on February 19th so
that was about a week ago from
undisclosed hospital to UC Davis health
and that is the hospital in Sacramento
for the University of California Davis
patient had already been intubated was
on a ventilator and was given droplet
precautions orders because of an
undiagnosed and suspected viral
condition so there are other viruses
that can do this now at the time it

Chinese: 
在二月26日达到前所未有的569例，再来看看
南加州当地的Eyewitness News新闻网，当地一位居民
确诊了新冠肺炎，而该病患
并未出国旅行，我想说明几点
该病患是Solano县居民，而
Solano县是Travis空军基地，从海外
返回美国的居民在这里隔离，大约一周以前的2月19号
该病患从南加州某家医院转院至加州大学戴维斯医院
这家在萨克拉门托的医院隶属于加州大学戴维斯分校
病人入院的时候已经接受插管，上了呼吸机
考虑到这可能是新冠疑似病例，医院也采取了防疫措施
当然，也有可能是其他细菌引起的病症

English: 
seems as though UC Davis had asked the
CDC for testing but this was not done at
the time and if you go to the CDC
website it tells you what their
requirements are for testing although
they do put a disclaimer that they will
look at a case-by-case basis but
essentially unless you traveled to Wuhan
or that part of China they weren't
really going to be doing that kind of
testing so it's unclear how eventually
UC Davis was able to get CDC to test
this patient but they did and eventually
on Sunday the CDC ordered the Cova 19
testing of the patient at that time the
patient was put into airborne
precautions what does this mean it means
that anybody going into that room had to
have an n95 mask and had to go into
contact isolation precautions that means
they would have to wear a gown gloves
they may even have to wear I wear
protection if they were not able to do
that then they would have to go under

Chinese: 
尽管医院当时请求CDC进行新馆病毒测试，但是
并没有进行检测，你可以去CDC官网看一下
进行检测要满足一些要求，尽管
他们声明中表示会具体问题具体分析，但是
除非到过武汉或者中国其他地区，否则疑似患者
不会得到新冠的检测，因此不知道戴维斯医院最终
如何说服了CDC，并且在周日进行了新冠检测
当时，现场采取了“空气传播”级别的防疫措施
也就是说所有出入人员
佩戴n95口罩，并且实施阻断接触的措施
也就是说身着防护服、佩戴手套、甚至护目镜
如果没有这些防护用具，他们必须

Chinese: 
佩戴防护面罩，也就是一个能通风的口罩
知道星期三，CDC才最终
确认了呈病毒阳性，部分医护
也因此开始进行居家隔离，监测体温，观察是否出现症状
关键在于，这名病患
没有去过疫区，官方表示
尚不了解患者如何感染，这个病例
可能是新冠病毒的社区传播，而这可能是
新冠在美国首次出现社区传播，也有可能
病人接触过病毒携带者
当然这就有问题了，任何
有发烧、病毒感染症状以及呼吸困难的人
都有可能是潜在新冠病毒携带者，由此可见

English: 
something called poppers where they
basically go in with a mask that was
vented from Sunday to Wednesday it took
for the CDC to confirm finally that the
patient's test was positive the small
number of employees were to go home and
monitor their temperature for any kind
of fever or things of that nature
and the key here is to recognize
apparently this patient had no travel to
that part of the world they go on to say
here at this time the patient's exposure
is unknown it's possible that this could
be an instance of
they call community spread of kovat 19
which would be the first time that this
has happened in United States
it's also possible however they said
that the patient may have been exposed
to a returned traveler who was infected
of course this brings up the issue of
anybody that comes when with fever or
signs and symptoms of a viral illness
and shortness of breath could be
potentially a carrier of this novel
coronavirus and that's why it's really

Chinese: 
那些收治这些患者的医院，需要配备足够的个人防护设备
而不能出现防护设备短缺，因此
医院要有足够的获取防护设备的能力，这很重要
谁都不愿意去到医院，结果发现医护工作者
没有足够的保护，否则
医护可能会把病毒传染给医院里每个人，因此
不要为了自用，拿医院的口罩和防护设备
不过由此也产生了一个大问题，我们如何
进行病毒检测，如何快速的确诊
显而易见，这次这个病例中
他们周三得出阳性的结果，周日
提出的检测，在我看来
这个情况不太好，尤其是

English: 
important to have lots of personal
protective equipment at hospitals where
they belong instead of running out at
hospital so it's really important that
hospitals have the ability to acquire
personal protective equipment because
you don't want to show up to a hospital
where the employees there or the doctors
or the nurses don't have the adequate
amount of protection so that they don't
pass the virus on to anybody else that
might show up at that hospital so please
do not take masks and protective
equipment from hospitals for your own
use but this really brings up a big
issue and that is how do you test people
for coronavirus how do you know quickly
whether or not this person that's coming
in has this virus obviously if we see
here in this case it took them from
Wednesday when they actually got the
causative test all the way from Sunday
when they first order the tests you can
see that that's not the optimal
situation especially when we add to the
situation that this test is not really

Chinese: 
这个检测灵敏度并不很高，也就是说
如果结果阴性患者仍有可能感染，因此加强研究很重要
《科学日报》刚发表的这篇文章正是如此
这篇名为“CT 是新冠诊断的最佳依据”的文章发表在“Radiology”
我在下面放个链接，大致内容是这样的
他们在中国观测了超过一千名患者，并且
进行了逆转录聚合酶链，也就是rt-pcr
具体而言，在以这种方式RNA，然后
和CT结果进行对比，这还有一个
关于这篇论文的新闻，题目是“CT是新冠诊断的最佳依据”
新闻表示，中国的研究发现：胸部CT检测

English: 
that sensitive meaning that if you have
a negative test you can absolutely rule
it out so enter a study that I think is
going to be important and that is this
science Daily News article which talks
about this article that was just
published in radiology called CT
provides the best diagnosis for kovat
19:00 I will put a link to it in the
description below basically what they
did is in China they looked at over a
thousand patients and they did this
reverse transcriptase polymerase chain
reaction which is what rt-pcr stands for
this is where you look for the actual
RNA of the patients and compared it to
the classical findings that they see on
CT scan here's another news item of the
same article so title as CT provides
best diagnosis for kovat 19 and it says
the study from China shows that chest CT
demonstrates better sensitivity than

Chinese: 
比通过验血寻找pcr要更准确
记得上个月，疫情正在蔓延的时候
他们修改了新冠肺炎的诊断标准，因此
就有了这篇发表在“Radiology”中的文章，以及里面提到的一千个病例
连接在下面，请大家自取
对于诊断新冠而言,CT由于实验室检测
中国武汉的情况也对此给予了验证，因此
如果想要进行隔离、防止病毒传播
尽早确诊就非常重要了，还记得
我们之前谈到，41%的感染者
是在医院中被感染的，并且
其中大部分是医护工作者，根据中国政府最新发布的指导意见，
新冠确诊必须进行

English: 
this blood test looking for the actual
pcr of the virus
remember that halfway through the
epidemic last month they changed the
criteria in the definition for the
diagnosis of kovat 19 so you can see
here in a study of more than a thousand
patients that was published in the
journal article radiology which we link
to so you can look at it for yourself
chest CT actually outperformed lab
testing in the diagnosis of 2019 novel
coronavirus and this was looked at in
Wuhan China so it's important to
understand that you have to make an
early diagnosis of kovat 19 if you're
going to isolate and you're going to
prevent the spread of that disease as we
talked about earlier in a early jam
article 41 percent of patients who
contracted Co vyd 19 did so in the
hospital and the majority of those 41
percent were healthcare workers
according to the latest guidelines by
the Chinese government the diagnosis
must be confirmed by reverse

Chinese: 
转录酶聚合酶链反应
，也就是在这里说的基因测序
但是，咽拭子在初次检测中
呈阳性比例为30%至60%，这样的低准确率
意味着很多病人检测为阴性，而且
这些人会被漏掉，他们如果继续进出医院
可能会感染其他人，尤其是
医院工作人员，使得他们必须停止工作、进行隔离
所以他们认为，对于疾病治疗和防控而言
早期诊断很重要，而相比于rt-pcr（基因检测）
胸部CT成像可能更加可靠，实用，快速
特别是在疫区
为什么有这样的结论，我们来看一下
从1月6日到2月6日，有超过一千名患者

English: 
transcriptase polymerase chain reaction
or the gene sequencing they say here
however that those throat samples are
only about 30 to 60 percent positive at
initial presentation having a low
sensitivity implies that there's going
to be a lot of people who will be
negative initially and you're gonna miss
those people those people are going to
come through into your hospital and
potentially infect other people
specifically people who are there to
help and causing them to be taken out of
work and put into isolation most likely
and so they say here that early
diagnosis of copán 19 is crucial for the
disease treatment and control compared
to rt-pcr that is the genetic testing
they say here that chest CT imaging may
be a more reliable practical and rapid
method to diagnose and assess kovat 19
especially in the epidemic area so why
did they think that well let's take a
look and see this
there was over a thousand patients who
underwent both CT chest and rt-pcr tests

Chinese: 
进行了CT胸部检查和rt-pcr检查
总共有601名pcr阳性患者
888名CT阳性患者
由此，他们问道
敏感度是多少，特异性是多少
，准确性是多少
他们发现，根据临床症状、CT影响以及CT的动态变化
在pcr阴性、CT阳性患者中
81%被重新划分为高度疑似或者病毒携带者
其中，CT动态变化是说，患者病情持续加重
他们还发现，有些开始检测阴性的患者
在后续检测中会呈阳性
这也就确认了CT的结果

English: 
from January 6 to February 6 and what
they did was they looked at all of those
people who had a positive PCR and there
was about six hundred and one of those
and everybody that had a positive CT
scan and there was eight hundred and
eighty eight of those and then they
asked the question well what's the
sensitivity what's the specificity and
what's the accuracy and what they found
was that about eighty one percent of
patients with a negative rt-pcr
but a positive CT scan were reclassified
as highly likely or probable cases with
kovat 19 based on the comprehensive
analysis of clinical symptoms typical CT
manifestations and dynamic CT follow-ups
what they mean by that they were getting
worse and they were consistent they also
found in a lot of these that the initial
tests may have been negative but that
follow-up tests turned positive
confirming in a lot of these cases the
original CT findings let's review those

Chinese: 
我们回顾一下，59%的患者
pcr检测阳性，88%的患者
CT扫描呈阳性，他们表示
敏感性
当然名感性越高越好，因为
敏感度高意味着如果检测为阴性
，你实际上可以确认未感染
对于，rt-pcr阳性患者CT检测敏感度为97%
在rt-pcr阴性的患者
75%CT检测阳性，而这之中48%得人高度疑似
因此可能的情况，CT扫描可能是
快速检测新冠病毒的方法
但问题是，要在如何通过CT确诊
确认CT扫描有效是好事，关键在于应该在CT上寻找什么特征

English: 
results the results showed that 59
percent of these patients that they
tested had PCR results that were
positive eighty eight percent had
positive CT scans they said that the
sensitivity and this is something that
you want to be very very high in this
situation because something that is very
sensitive means that if it is negative
you can practically rule it out and as
it turned out that sensitivity of chest
CT was 97% based on positive rt-pcr
results in patients with negative rt-pcr
results seventy-five percent of those
patients had positive CT findings and of
those forty eight percent were highly
likely cases so what we're seeing here
is that CT scans may be the way to get a
quick screening of whether or not your
patient with fever is likely to have
kovat 19:00 but the question is what are
the findings on CT it's good enough to
know that you should get a CT but what
is it that you should be looking for I'm

Chinese: 
我会链接一篇文章，里面介绍了
新冠患者CT特征，以及今天的结论
视频是在发布前一天做的
因为我还在icu照看病人
所以做视频要等到每天工作结束后
因为，医护工作者一直守在前线，我们要时刻准备
准备感谢您的参与

English: 
going to link in the description below
a youtube video describes the findings
on CT scan of known cases of copán night
and that concludes our update for today
realize that many of these videos are
made the evening before they get
released because I still am working in
the intensive care unit seeing patients
every single day and so this is
something that I do at the end of the
day because we as healthcare providers
are on the front line and we have to be
prepared thanks for joining us
