zh-cn	一、考察组 
en-us	I. The Mission 

zh-cn	(一）目标和目的 
en-us	Goal and Objectives  

zh-cn	联合考察组的总体目标是迅速就中国及国际社会如何进一步应对新冠肺炎(COVID-19)疫情提供信息，并为尚未受疫情影响的国家和地区如何做好应对准备提出意见。 
en-us	The overall goal of the Joint Mission was to rapidly inform national (China) and international planning on next steps in the response to the ongoing outbreak of the novel coronavirus disease (COVID-191) and on next steps in readiness and preparedness for geographic areas not yet affected. 

zh-cn	联合考察组的主要目的如下： 
en-us	The major objectives of the Joint Mission were as follows: 

zh-cn	进一步了解中国新冠肺炎疫情形势和釆取的各项防控措施所取得的效果； 
en-us	To enhance understanding of the evolving COVID-19 outbreak in China and the nature and impact of ongoing containment measures; 

zh-cn	与各国分享受新冠肺炎疫情影响国家或存在输入风险国家为应对疫情进行的准备及防控经验； 
en-us	To share knowledge on COVID-19 response and preparedness measures being implemented in countries affected by or at risk of importations of COVID-19; 

zh-cn	为中国和其它国家遏制新冠肺炎疫情、调整应对措施等提出建议； 
en-us	To generate recommendations for adjusting COVID-19 containment and response measures in China and internationally; and 

zh-cn	针对疫情防控相关的知识、应对及防范工具等关键局限领域，确定下一步工作和研发的合作优先事项。 
en-us	To establish priorities for a collaborative programme of work, research and development to address critical gaps in knowledge and response and readiness tools and activities. 

zh-cn	(二）成员组成和工作方法 
en-us	Members & Method of Work  

zh-cn	联合考察组由来自中国、德国、日本、韩国、尼日利亚、俄罗斯、新加坡、美国和世界卫生组织的25名中外专家组成。
en-us	The Joint Mission consisted of 25 national and international experts from China, Germany, Japan, Korea, Nigeria, Russia, Singapore, the United States of America and the World Health Organization (WHO). 

zh-cn	联合考察组外方组长为世界卫生组织的布鲁斯•艾尔沃德（Bruce Aylward)博士，中方组长为梁万年博士。
en-us	The Joint Mission was headed by Dr Bruce Aylward of WHO and Dr Wannian Liang of the People's Republic of China. 

zh-cn	联合考察组成员及其所属机构名单见附件1。
en-us	The full list of members and their affiliations is available in Annex A.

zh-cn	此次联合考察组于2020年2月16日至24日在华开展考察调研，为期9天。
en-us	The Joint Mission was implemented over a 9-day period from 16-24 February 2020. 

zh-cn	工作日程详见附件2。 
en-us	The schedule of work is available in Annex B. 

zh-cn	联合考察组首先在中国国家卫生健康委与中国国务院应对新型冠状病毒感染的肺炎疫情联防联控工作机制的牵头和参与的主要部门负责同志举行了座谈会，各部门全面、详细地介绍了疫情防控工作情况。
en-us	The Joint Mission began with a detailed workshop with representatives of all of the principal ministries that are leading and/or contributing to the response in China through the National Prevention and Control Task Force. 

zh-cn	之后，联合考察组与国家卫生健康委和中国疾病预防控制中心（中国CDC)等负责疫情应对管理、实施和评估的国家级机构召开了一系列更加深入的技术交流会议。
en-us	A series of in-depth meetings were then conducted with national level institutions responsible for the management, implementation and evaluation of the response, particularly the National Health Commission and the China Centers for Disease Control and Prevention (China CDC). 

zh-cn	为实地了解国家应对策略的现场实施情况及效果，经双方协商一致，联合考察组对北京、四川（成都）、广东（广州、深圳）和湖北（武汉）等省市进行了实地考察和调研。
en-us	To gain first-hand knowledge on the field level implementation and impact of the national and local response strategy, under a range of epidemiologic and provincial contexts, visits were conducted to Beijing Municipality and the provinces of Sichuan (Chengdu), Guangdong (Guangzhou, Shenzhen) and Hubei (Wuhan). 

zh-cn	考察地点包括街道、社区中心、社区卫生服务中心、县/区级医院、新冠肺炎定点医院、交通枢纽（航空、铁路、公路）、农贸市场、药品及个人防护物资储备仓库、研究机构、省级卫生健康委和省市级疾控中心等。
en-us	The field visits included community centers and health clinics, country/district hospitals, COVID-19 designated hospitals, transportations hubs (air, rail, road), a wet market, pharmaceutical and personal protective equipment (PPE) stocks warehouses, research institutions, provincial health commissions, and local Centers for Disease Control (provincial and prefecture). 

zh-cn	期间，联合考察组与省、市政府领导、应急响应团队、资深科学家、一线临床医务人员和公共卫生人员及社区工作者、社区街道行政人员等进行了详细讨论和交流。
en-us	During these visits, the team had detailed discussion and consultations with Provincial Governors, municipal Mayors, their emergency operations teams, senior scientists, frontline clinical, public health and community workers, and community neighbourhood administrators. 

zh-cn	考察结束后，联合考察组专家进行了内部讨论，归纳考察发现和结论，提出下一步应对建议。 
en-us	The Joint Mission concluded with working sessions to consolidate findings, generate conclusions and propose suggested actions. 

zh-cn	为实现工作目标，联合考察组尤其重视以下重要问题：新冠肺炎疾病自然史及严重程度、病毒在不同情形下的传播动力学特点、以及目前在高风险地区（发生社区传播地区）、中风险地区（出现聚集性病例地区）和低风险地区（仅有散发病例或无病例地区）所釆取的防控措施的效果等。 
en-us	To achieve its goal, the Joint Mission gave particular focus to addressing key questions related to the natural history and severity of COVID-19, the transmission dynamics of the COVID-19 virus in different settings, and the impact of ongoing response measures in areas of high (community level), moderate (clusters) and low (sporadic cases or no cases) transmission. 

zh-cn	本报告的内容以联合考察组对中央和地方政府报告的梳理、与国家级和地方级专家对防控措施的讨论、以及现场考察的所见所闻为基础。
en-us	The findings in this report are based on the Joint Mission's review of national and local governmental reports, discussions on control and prevention measures with national and local experts and response teams, and observations made and insights gained during site visits. 

zh-cn	图表制作釆用了现场考察中收集的信息和数据并经过相关机构同意。
en-us	The figures have been produced using information and data collected during site visits and with the agreement of the relevant groups. 

zh-cn	本报告中任何巳在杂志中公开发表的信息，均有参考文献备查。 
en-us	References are available for any information in this report that has already been published in journals. 

zh-cn	联合考察报告于2020年2月28日提交，3月11日更新。 
en-us	The final report of the Joint Mission was submitted on 28 February and updated 11 March. 

zh-cn	二、主要发现 
en-us	Major findings  

zh-cn	主要发现分为六个方面：病毒，疫情暴发，传播动力学，疾病进程和严重性，中国的应对措施，以及知识局限。
en-us	The major findings are described in six sections: the virus, the outbreak, transmission dynamics, disease progression and severity, the China response and knowledge gaps. 

zh-cn	更多详细的技术发现请见附件3。 
en-us	More detailed descriptions of technical findings are provided in Annex C. 

zh-cn	(一')病毒 
en-us	The virus 

zh-cn	2019年12月30日，从武汉金银潭医院不明原因肺炎(2002-2003年SARS暴发之后制定的一种监测定义）患者中釆集了3份支气管肺泡灌洗液样本。
en-us	On 30 December 2019, three bronchoalveolar lavage samples were collected from a patient with pneumonia of unknown etiology 一 a surveillance definition established following the SARS outbreak of 2002-2003 一 in Wuhan Jinyintan Hospital. 

zh-cn	对样本进行泛β-冠状病毒实时荧光定量RT-PCR检测后，结果显示冠状病毒核酸阳性。
en-us	Real-time PCR (RT-PCR) assays on these samples were positive for pan-Betacoronavirus. 

zh-cn	利用Illumina 二代测序和nanopore三代测序技术，获得了病毒的全基因组序列。
en-us	Using Illumina and nanopore sequencing, the whole genome sequences of the virus were acquired. 

zh-cn	生物信息学分析表明，新型冠状病毒（nCoV-19)具有冠状病毒家族的典型特征，属于β-冠状病毒。
en-us	Bioinformatic analyses indicated that the virus had features typical of the coronavirus family and belonged to the Betacoronavirus 2B lineage. 

zh-cn	对nCoV-19的全基因组序列和巳有的其他β-冠状病毒的全基因组序列进行一致性比对后显示，该病毒与蝙蝠携带的SARS样冠状病毒RaTG13株全基因组亲缘关系最近，同源性为96%。 
en-us	Alignment of the full-length genome sequence of the COVID-19 virus and other available genomes of Betacoronavirus showed the closest relationship was with the bat SARS-like coronavirus strain BatCov RaTG13, identity 96%. 

zh-cn	利用人呼吸道上皮细胞、Vero E6、Huh-7等不同细胞系进行了病毒分离。
en-us	Virus isolation was conducted with various cell lines, such as human airway epithelial cells, Vero E6, and Huh-7. 

zh-cn	接种后96小时观察到细胞病变效应(CPE)。
en-us	Cytopathic effects (CPE) were observed 96 hours after inoculation. 

zh-cn	负染后在透射电子显微镜（TEM)下能观察到典型的冠状颗粒。
en-us	Typical crown-like particles were observed under transmission electron microscope (TEM) with negative staining. 

zh-cn	从恢复期患者中釆集的血清可以完全中和分离病毒的细胞感染性。
en-us	The cellular infectivity of the isolated viruses could be completely neutralized by the sera collected from convalescent patients. 

zh-cn	转人ACE2基因小鼠和恒河猴经鼻感染该病毒后，可诱发多灶性肺炎伴间质增生。
en-us	Transgenic human ACE2 mice and Rhesus monkey intranasally challenged by this virus isolate induced multifocal pneumonia with interstitial hyperplasia. 

zh-cn	随后可在受试动物的肺和肠道组织中检测并分离出该新型冠状病毒。 
en-us	The COVID-19 virus was subsequently detected and isolated in the lung and intestinal tissues of the challenged animals. 

zh-cn	对2019年12月底至2020年2月中旬在不同地点釆集的患者标本中分离出的104株COVID-19病毒株，进行了全基因组测序分析，结果显示它们具有99.9%的同源性，无明显基因突变（图1)。 
en-us	Whole genome sequencing analysis of 104 strains of the COVID-19 virus isolated from patients in different localities with symptom onset between the end of December 2019 and mid-February 2020 showed 99.9% homology, without significant mutation (Figure 1). 

zh-cn	对武汉市一名50岁男性患者的肺、肝和心脏等尸检标本的组织学检查显示，弥漫性肺泡损伤伴细胞纤维粘液样渗出。
en-us	Post-mortem samples from a 50-year old male patient from Wuhan were taken from the lung, liver, and heart. Histological examination showed bilateral diffuse alveolar damage with cellular fibromyxoid exudates. 

zh-cn	肺部显示有肺细胞剥脱和透明膜形成，提示有急性呼吸窘迫综合征（ARDS)。
en-us	The lung showed evident desquamation of pneumocytes and hyaline membrane formation, indicating acute respiratory distress syndrome (ARDS). 

zh-cn	肺组织也显示细胞纤维粘液样渗出、肺细胞剥脱和肺水肿。
en-us	Lung tissue also displayed cellular and fibromyxoid exudation, desquamation of pneumocytes and pulmonary oedema. 

zh-cn	双肺均可见以淋巴细胞为主的单个核细胞间质炎性浸润。
en-us	Interstitial mononuclear inflammatory infiltrates, dominated by lymphocytes, were seen in both lungs. 

zh-cn	肺泡内可见以大细胞核、双染颗粒的细胞质和核仁突出为特征的非典型肺细胞膨胀的多核合胞细胞，提示病毒导致的细胞病变。
en-us	Multinucleated syncytial cells with atypical enlarged pneumocytes characterized by large nuclei, amphophilic granular cytoplasm, and prominent nucleoli were identified in the intra- alveolar spaces, showing viral cytopathic-like changes. 

zh-cn	未见明显的核内或胞浆内病毒包涵体。 
en-us	No obvious intranuclear or intracytoplasmic viral inclusions were identified. 

zh-cn	(二）疫情暴发 
en-us	The outbreak  

zh-cn	截至2月20日，中国全国累计报告新冠肺炎病例75465例。
en-us	As of 20 February 2020, a cumulative total of 75,465 COVID-19 cases were reported in China. 

zh-cn	该病例数据是通过国家卫健委和省卫健委之间的全国报告系统（NRS)进行上报的。
en-us	Reported cases are based on the National Reporting System (NRS) between the  National and Provincial Health Commissions. 

zh-cn	该NRS报告系统每天发布新确诊病例、死亡病例、疑似病例和密切接触者的人数。
en-us	The NRS issues daily reports of newly recorded confirmed cases, deaths, suspected cases, and contacts. 

zh-cn	各省在凌晨3点报告前一天的病例数。 
en-us	A daily report is provided by each province at 0300hr in which they report cases from the previous day. 

zh-cn	图2和图3的流行曲线是利用全国法定传染病报告系统(IDIS)数据生成的。该系统要求每个新冠肺炎病例诊断后，负责医生要通过该系统进行网络直报。
en-us	The epidemic curves presented in Figures 2 and 3 are generated using China's National Infectious Disease Information System (IDIS), which requires each COVID-19 case to be reported electronically by the responsible doctor as soon as a case has been diagnosed. 

zh-cn	病例的信息也在该系统里实时更新。
en-us	It includes cases that are reported as asymptomatic and data are updated in real time. 

zh-cn	病例个案信息每天24点后下载用于分析。
en-us	Individual case reporting forms are downloaded after 2400hr daily. 

zh-cn	图2显示了武汉、湖北（除武汉以外）、全国（除湖北以外）以及全中国病例发病时间流行曲线。 
en-us	Epidemiologic curves for Wuhan, Hubei (outside of Wuhan), China (outside Hubei) and China by symptom onset are provided in Figure 2. 

zh-cn	图3为实验室确诊病例按发病日期和报告日期绘制的曲线图，截止日期分别为2月5日、12日和20日。
en-us	Figure 3 presents epidemic curves of laboratory-confirmed cases, by symptom onset and separately by date of report, at 5, 12, and 20 February 2020. 

zh-cn	图2和图3 显示了病例数在1月10日至22日期间迅速增加，1月23日至27日报告病例达到高峰并趋于平缓，此后保持了稳步下降的趋势，只有2月1日例外出现高峰。
en-us	Figures 2 and 3 illustrate that the epidemic rapidly grew from 10-22 January, reported cases peaked and plateaued between 23 January and 27 January, and have been steadily declining since then, apart from the spike that was reported on 1 February 

zh-cn	（举例：在武汉一家大型综合医院，发热门诊就诊人数从1月下旬高峰期的500人/天降至2月中旬平均50人/天） 
en-us	(note: at a major hospital in Wuhan, fever clinic patients fell from a peak of 500/day in late January to average 50/day since mid-February). 

zh-cn	根据上述流行曲线、巳发表文献以及本次湖北武汉、广东(深圳和广州）、四川（成都）和北京的现场考察，考察组得到以下流行病学考察结果： 
en-us	Based on these epidemic curves, the published literature, and our on-site visits in Wuhan (Hubei), Guangdong (Shenzhen and Guangzhou), Sichuan (Chengdu), and Beijing, the Joint Mission team has made the following epidemiological observations: 

zh-cn	人口学特征 
en-us	Demographic characteristics  

zh-cn	截至2月20日，在报告的55，924例实验室确诊病例中，年龄中位数为51岁（年龄范围2天-100岁；四分位间距39-63岁），大多数病例（77.8%)介于30-69岁之间。
en-us	Among 55,924 laboratory confirmed cases reported as of 20 February 2020, the median age is 51 years (range 2 days-100 years old; IQR 39-63 years old) with the majority of cases (77.8%) aged between 30-69 years. 

zh-cn	其中，51.1%为男性，来自湖北的病例占77%，农民或体力劳动者占21.6%。 
en-us	Among reported cases, 51.1% are male, 77.0% are from Hubei and 21.6% are farmers or laborers by occupation. 

zh-cn	动物溯源 
en-us	Zoonotic origins  

zh-cn	新冠肺炎病毒是一种动物源性病毒。
en-us	COVID-19 is a zoonotic virus. 

zh-cn	目前的全基因组基因序列系统进化分析结果显不，蝙蝠似乎是该病毒的宿主，但中间宿主尚未查明。
en-us	From phylogenetics analyses undertaken with available full genome sequences, bats appear to be the reservoir of COVID-19 virus, but the intermediate host(s) has not yet been identified. 

zh-cn	而中国巳经在此次疫情动物溯源的三个重要领域开展工作：对武汉2019年12月发病病例开展早期调查；
en-us	However, three important areas of work are already underway in China to inform our understanding of the zoonotic origin of this outbreak. These include early investigations of cases with symptom onset in Wuhan throughout December 2019,

zh-cn	对华南海鲜批发市场及其他市场进行环境釆样；
en-us	environmental sampling from the Huanan Wholesale Seafood Market and other area markets,

zh-cn	对华南海鲜批发市场售卖的野生动物的来源和种类以及市场关闭后这些动物的去向开展详细调查。 
en-us	  and the collection of detailed records on the source and type of wildlife species sold at the Huanan market and the destination of those animals after the market was closed. 

zh-cn	传播途径 
en-us	Routes of transmission  

zh-cn	新冠肺炎在无防护下通过飞沫和密切接触在感染者和被感染者之间发生传播。
en-us	COVID-19 is transmitted via droplets and fomites during close unprotected contact between an infector and infectee. 

zh-cn	尚无新冠肺炎空气传播的报告，且根据现有证据，也不认为空气传播是主要传播方式。
en-us	Airborne spread has not been reported for COVID-19 and it is not believed to be a major driver of transmission based on available evidence; 

zh-cn	但在医疗机构中或可存在因医疗操作产生气溶胶而发生空气传播的可能。
en-us	however, it can be envisaged if certain aerosol-generating procedures are conducted in health care facilities.

zh-cn	粪便排毒巳在一些患者中得到证实，少数病例粪便中还发现了活病毒
en-us	Fecal shedding has been demonstrated from some patients, and viable virus has been identified in a limited number of case reports.

zh-cn	但根据现有证据，粪-口传播似乎并不是新冠肺炎传播的主要传播方式，其在新冠肺炎病毒传播中的地位和作用仍待明确。
en-us	However, the fecal-oral route does not appear to be a driver of COVID-19 transmission; its role and significance for COVID-19 remains to be determined.

zh-cn	排毒相关内容详见“技术发现”（附件3)。 
en-us	Viral shedding is discussed in the Technical Findings (Annex C). 

zh-cn	家庭传播 
en-us	Household transmission  

zh-cn	在中国，新冠肺炎的人际传播主要在家庭中发生。
en-us	In China, human-to-human transmission of the COVID-19 virus is largely occurring in families. 

zh-cn	联合考察组从聚集性病例调查和一些家庭传播案例研究中获得了一些省份家庭成员间持续传播的详细信息。
en-us	The Joint Mission received detailed information from the investigation of clusters and some household transmission studies, which are ongoing in a number of Provinces. 

zh-cn	广东和四川省报告的344起聚集性病例中共涉及1308例病例（两省总病例数为1836例），其中大多数（78%-85%)聚集性病例发生在家庭成员中。
en-us	Among 344 clusters involving 1308 cases (out of a total 1836 cases reported) in Guangdong Province and Sichuan Province, most clusters (78%-85%) have occurred in families. 

zh-cn	家庭成员内传播的研究正在进行中，但广东的初步研究结果估计家庭成员二代续发率约为3-10%。 
en-us	Household transmission studies are currently underway, but preliminary studies ongoing in Guangdong estimate the secondary attack rate in households ranges from 3-10%. 

zh-cn	密切接触者追踪 
en-us	Contact Tracing  

zh-cn	中国釆取了坚决果断的措施对新冠肺炎病例和密切接触者进行确认和追踪。
en-us	China has a policy of meticulous case and contact identification for COVID-19. 

zh-cn	例如，武汉有超过1800个流行病学调查小组，每组至少5人，每天对成千上万的密切接触者进行追踪。
en-us	For example, in Wuhan more than 1800 teams of epidemiologists, with a minimum of 5 people/team, are tracing tens of thousands of contacts a day. 

zh-cn	正是通过艰苦卓绝的工作，使得确认的密切接触者中绝大多数都被追踪到并完成了医学观察。
en-us	Contact follow up is painstaking, with a high percentage of identified close contacts completing medical observation. 

zh-cn	1%-5%的密切接触者后来被实验室诊断为新冠肺炎病例。
en-us	Between 1% and 5% of contacts were subsequently laboratory confirmed cases of COVID-19, depending on location. 

zh-cn	例如： 截至2月17日，在深圳市2842名巳确认的密切接触者中，巳追踪到2842人（100%)，其中2240人（79%)结束了医学观察。
en-us	For example: As of 17 February, in Shenzhen City, among 2842 identified close contacts, 2842 (100%) were traced and 2240 (79%) have completed medical observation. 

zh-cn	在密切接触者中，88人（3.1%)后来被确认感染了新型冠状病毒。  
en-us	Among the close contacts, 88 (3.1%) were found to be infected with COVID-19. 

zh-cn	截至2月17日，在四川省25493名巳确认的密切接触者中，巳追踪到25347人（99%)，其中23178人（91%)结束了医学观察。
en-us	As of 17 February, in Sichuan Province, among 25493 identified close contacts,  25347 (99%) were traced and 23178 (91%) have completed medical observation. 

zh-cn	在密切接触者中，0.9%的人后来被确认感染了新型冠状病毒。  
en-us	Among the close contacts, 0.9% were found to be infected with COVID-19. 

zh-cn	截至2月20日，在广东省9939名巳确认的密切接触者中，巳追踪到9939人（100%)，其中7765人（78%)结束了医学观察。
en-us	As of 20 February, in Guangdong Province, among 9939 identified close contacts, 9939 (100%) were traced and 7765 (78%) have completed medical observation. 

zh-cn	在密切接触者中，479人（4.8%)后来被确认感染了新型冠状病毒。 
en-us	Among the close contacts, 479 (4.8%) were found to be infected with COVID-19. 

zh-cn	在发热门诊和常规流感样病例（ILI)和严重急性呼吸道感染（SARI)监测中进行检测 
en-us	Testing at fever clinics and from routine ILI/SARI surveillance  

zh-cn	联合考察组系统询问了在中国常规呼吸道疾病监测系统中针对新冠肺炎进行检测的情况，包括对流感样病例（ILI)和严重急性呼吸道感染（SARI)监测样本进行RT-PCR检测，以及对发热门诊患者进行检测的结果，以了解新冠肺炎是否存在社区传播且未被发现的情况
en-us	The Joint Mission systematically enquired about testing for COVID-19 from routine respiratory disease surveillance systems to explore if COVID-19 is circulating more broadly and undetected in the community in China. These systems could include RT-PCR testing of COVID-19 virus in influenza-like-illness (ILI) and severe acute respiratory infection (SARI) surveillance systems, as well as testing of results among all visitors to fever clinics. 

zh-cn	武汉对2019年11月和12月以及2020年1月前2周的 ILI标本进行了新冠肺炎检测（每周20个）后发现，2019年的样本未见阳性结果，1月第一周有1个成人标本为阳性，1月第二周有3个成人标本为阳性；所有儿童标本新冠肺炎检测均为阴性，有些为流感阳性。
en-us	In Wuhan, COVID-19 testing of ILI samples (20 per week) in November and December 2019 and in the first two weeks of January 2020 found no positive results in the 2019 samples, 1 adult positive in the first week of January, and 3 adults positive in the second week of January; all children tested were negative for COVID-19 although a number were positive for influenza. 

zh-cn	在广东，1月1日至14日期间，在15000多例ILI或SARI标本中，只有一例新冠病毒检测阳性。
en-us	In Guangdong, from 1-14 January, only 1 of more than 15000 ILI/SARI samples tested positive for the COVID-19 virus. 

zh-cn	在北京的一家医院，从2019年1月28日至2020年2月13日收集的1910份标本中没有发现一例阳性。
en-us	In one hospital in Beijing, there were no COVID-19 positive samples among 1910 collected from 28 January 2019 to 13 February 2020. 

zh-cn	在深圳的一家医院，40例ILI样本中也无新冠病毒检测阳性。 
en-us	In a hospital in Shenzhen, 0/40 ILI samples were positive for COVID-19. 

zh-cn	广东省发热门诊新冠病毒检测阳性率随时间的推移有所下降，1月30日为0.47%，2月16日降至0.02%。
en-us	Within the fever clinics in Guangdong, the percentage of samples that tested positive for the COVID-19 virus has decreased over time from a peak of 0.47% positive on 30 January to  0.02% on 16 February. 

zh-cn	总体而言，广东省约32万次发热门诊筛查检测中，新冠病毒检测阳性率仅为0.14%。 
en-us	Overall in Guangdong, 0.14% of approximately 320,000 fever clinic screenings were positive for COVID-19. 

zh-cn	易感性 
en-us	Susceptibility  

zh-cn	由于新冠肺炎病毒是一种新发现的病原体，人群普遍缺乏免疫力。
en-us	As COVID-19 is a newly identified pathogen, there is no known pre-existing immunity in humans. 

zh-cn	根据目前在中国观察到的流行病学特征，几乎人人易感，尽管可能存在易感性增加的危险因素，但还需要进一步研究，明确感染后是否具有免疫力。 
en-us	Based on the epidemiologic characteristics observed so far in China, everyone is assumed to be susceptible, although there may be risk factors increasing susceptibility to infection. This requires further study, as well as to know whether there is neutralising immunity after infection. 

zh-cn	(三）传播动力学 
en-us	The transmission dynamics  

zh-cn	根据图2和3以及根据我们在国家和省/市级的联合考察的观察结果，总结和解释了新冠肺炎迄今为止的传播动力学。
en-us	Inferring from Figures 2 and 3, and based on our observations at the national and provincial/municipal levels during the Joint Mission, we summarize and interpret the transmission dynamics of COVID-19 thus far. 

zh-cn	任何疫情暴发的传播动力学本质上都是与具体情境有关，了解这点很重要。
en-us	It is important to note that transmission dynamics of any outbreak are inherently contextual. 

zh-cn	对于新冠肺炎，我们分析了在流行增长期到控制措施实施后的时间段内观察到的四种主要的传播模式，并突出了对儿童传播的了解，如下所示： 
en-us	For COVID-19, we observe four major types of transmission dynamics during the epidemic growth phase and in the post-control period, and highlight what is known about transmission in children, as follows: 

zh-cn	武汉传播模式 
en-us	Transmission in Wuhan  

zh-cn	在武汉发现的早期病例被认为是通过动物传染到人的途径感染，因为许多人报告有华南海鲜批发市场暴露史。
en-us	Early cases identified in Wuhan are believed to be have acquired infection from a zoonotic source as many reported visiting or working in the Huanan Wholesale Seafood Market. 

zh-cn	截至2月25日，尚未查明动物来源。 
en-us	As of 25 February, an animal source has not yet been identified. 

zh-cn	在疫情早期的某个时点，部分病例间产生了人际传播，导致随后在一系列控制措施实施前发生了社区暴发并首先在武汉扩散开，再随着大规模人口流动，从武汉进一步辐射到湖北省和中国其他大部分地区，从而解释了高达2-2.5的传播系数（R0值）。 
en-us	At some point early in the outbreak, some cases generated human-to-human transmission chains that seeded the subsequent community outbreak prior to the implementation of the comprehensive control measures that were rolled out in Wuhan. The dynamics likely approximated mass action and radiated from Wuhan to other parts of Hubei province and China, which explains a relatively high R0 of 2-2.5. 

zh-cn	自2020年1月23日起在武汉及周边城市釆取的严格管控措施有效地阻止了感染者向全国其他地区的进一步输出。 
en-us	The cordon sanitaire around Wuhan and neighboring municipalities imposed since 23 January 2020 has effectively prevented further exportation of infected individuals to the rest of the country. 

zh-cn	湖北除武汉以外的传播模式 
en-us	Transmission in Hubei, other than Wuhan  

zh-cn	在紧邻武汉的地区（孝感、黄冈、荆州和鄂州），传播程度低于武汉。
en-us	In the prefectures immediately adjoining Wuhan (Xiaogan, Huanggang, Jingzhou and Ezhou), transmission is less intense. 

zh-cn	对于该省其他地区，由于交通管制后与武汉的交通联系不紧密，且人流不畅，其动力学与全国其他地区的动力学更为接近。
en-us	For other prefectures, due to fewer transport links and human mobility flows with Wuhan, the dynamics are more closely aligned with those observed in the other areas of the country. 

zh-cn	在湖北省内，一系列控制措施（包括控制社交距离）降低了社区传播，从而减少发病。 
en-us	Within Hubei, the implementation of control measures (including social distancing) has reduced the community force of infection, resulting in the progressively lower incident reported case counts. 

zh-cn	中国除湖北以外的传播模式 
en-us	Transmission in China outside of Hubei  

zh-cn	由于武汉的交通枢纽地位和春节期间的人口流动（春运），感染者迅速流向全国各地，尤其是集中在与武汉交通往来最为密切的城市。
en-us	Given Wuhan's transport hub status and population movement during the Chinese New Year (chunyun), infected individuals quickly spread throughout the country, and were particularly concentrated in cities with the highest volume of traffic with Wuhan. 

zh-cn	其中一些输入病例在目的地城市导致了有限的人际传播。 
en-us	Some of these imported seeds generated limited human-to-human transmission chains at their destination. 

zh-cn	根据武汉/湖北的经验，实施的一系列综合防控措施，包括早发现病例、追踪密切接触者、隔离和管理以及尽可能地增大社交距离，在全国范围内阻断了病毒传播。
en-us	Given the Wuhan/Hubei experience, a comprehensive set of interventions, including aggressive case and contact identification, isolation and management and extreme social distancing, have been implemented to interrupt the chains of transmission nationwide. 

zh-cn	到目前为止，绝大多数病例是来自武汉或湖北或与之有直接联系。
en-us	To date, most of the recorded cases were imported from or had direct links to Wuhan/Hubei. 

zh-cn	社区传播非常有限。
en-us	Community transmission has been very limited. 

zh-cn	如前所述，大多数本地病例都来自于聚集性病例，其中大部分发生在家庭中。 
en-us	Most locally generated cases have been clustered, the majority of which have occurred in households, as summarized above. 

zh-cn	综上，病毒输入一个地区后，如不加干预，会很容易引起当地发生聚集性病例，进而导致相对较高的R0（2-2.5)，但如釆取严格隔离和增大社交距离的控制措施，可以有效减少发病。 
en-us	Of note, the highly clustered nature of local transmission may explain a relatively high R0(2¬2.5) in the absence of interventions and low confirmed case counts with intense quarantine and social distancing measures. 

zh-cn	特殊场所 
en-us	Special settings  

zh-cn	我们注意到医疗机构、监狱和其他封闭场所也发生了疫情。
en-us	We note that instances of transmission have occurred within health care settings prisons and other closed settings. 

zh-cn	但是，目前还不清楚这些场所和人群在传播中的作用。
en-us	At the present time, it is not clear what role these settings and groups play in transmission. 

zh-cn	但它们似乎并不是疫情扩散的主要驱动因素。
en-us	However, they do not appear to be major drivers of the overall epidemic dynamics. 

zh-cn	具体地说： 
en-us	Specifically, we note: 

zh-cn	医疗机构医务人员感染——联合考察组讨论了所考察的所有地点的院感情况。
en-us	Transmission in health care settings and among health care workers (HCW) - The Joint Mission discussed nosocomial infection in all locations visited during the Mission. 

zh-cn	截至2020年2月20日，全国476家医院报告了2055起医务人员感染新冠肺炎实验室确诊病例，大多数（88%)来自湖北。 
en-us	As of 20 February 2020, there were 2,055 COVID-19 laboratory-confirmed cases reported among HCW from 476 hospitals across China. The majority of HCW cases (88%) were reported from Hubei. 

zh-cn	值得注意的是，中国巳从湖北以外地区派遣逾4万多名医务人员驰援武汉。
en-us	Remarkably, more than 40,000 HCW have been deployed from other areas of China to support the response in Wuhan. 

zh-cn	尽管存在散在的少数医院暴发（例如，武汉一家医院有15名医务人员感染），但医疗机构医务人员感染并不是新冠肺炎在中国的主要传播特征。
en-us	Notwithstanding discrete and limited instances of nosocomial outbreaks (e.g. a nosocomial outbreak involving 15 HCW in Wuhan), transmission within health care settings and amongst health care workers does not appear to be a major transmission feature of COVID-19 in China. 

zh-cn	联合考察组获悉，大多数医务人员感染是发生在武汉疫情暴发早期，当时应对这种新疾病的物资和经验较为缺乏。
en-us	The Joint Mission learned that, among the HCW infections, most were identified early in the outbreak in Wuhan when supplies and experience with the new disease was lower. 

zh-cn	此外，流调显示，许多医务人员病例可能是在家庭内而非医院感染的。
en-us	Additionally, investigations among HCW suggest that many may have been infected within the household rather than in a health care setting. 

zh-cn	湖北以外地区的医务人员感染很少见（246例，全国医务人员感染总数2055例）
en-us	Outside of Hubei, health care worker infections have been less frequent (i.e. 246 of the total 2055 HCW cases). 

zh-cn	流调显示大多数医务人员感染病例有家庭确诊病例暴露史。 
en-us	When exposure was investigated in these limited cases, the exposure for most was reported to have been traced back to a confirmed case in a household. 

zh-cn	联合考察组还注意到，中国一直非常重视医务人员的感染预防。
en-us	The Joint Team noted that attention to the prevention of infection in health care workers is of paramount importance in China. 

zh-cn	医务人员监测数据显示，疫情早期感染风险最高，这些信息巳经用于修订完善政策，提高医务人员感染防护。 
en-us	Surveillance among health care workers identified factors early in the outbreak that placed HCW at higher risk of infection, and this information has been used to modify policies to improve protection of HCW. 

zh-cn	封闭场所疫情一一据报告，以下场所发生了新冠肺炎传播：监狱（中国湖北、山东、浙江）、医院（如前所述）等。
en-us	Transmission in closed settings - There have been reports of COVID-19 transmission in prisons (Hubei, Shandong, and Zhejiang, China), hospitals (as above) and in a long¬term living facility. 

zh-cn	人们在这些环境中的密切接触和潜在的环境污染是传播的重要因素。
en-us	The close proximity and contact among people in these settings and the potential for environmental contamination are important factors, which could amplify transmission. 

zh-cn	在这些场所中的传播情况仍需进一步研究。 
en-us	Transmission in these settings warrants further study. 

zh-cn	儿童 
en-us	Children 

zh-cn	数据表明18岁及以下人群的罹患率相对较低（占所有报告病例的2.4%)。
en-us	Data on individuals aged 18 years old and under suggest that there is a relatively low attack rate in this age group (2.4% of all reported cases). 

zh-cn	在武汉，对2019年11月、12月和2020年1月前两周的流感样病例进行检测，未发现有儿童新冠病毒检测呈阳性。
en-us	Within Wuhan, among testing of ILI samples, no children were positive in November and December of 2019 and in the first two weeks of January 2020. 

zh-cn	根据现有数据，在没有血清学研究结果的情况下，无法确定儿童感染状况以及儿童在传播中所起的作用，无法回答儿童是否较不易感或他们的临床表现是否不同(即通常轻症）等问题。
en-us	From available data, and in the absence of results from serologic studies, it is not possible to determine the extent of infection among children, what role children play in transmission, whether children are less susceptible or if they present differently clinically (i.e. generally milder presentations). 

zh-cn	联合考察组获悉，儿童病例多是通过追踪成人病例家庭密切接触者的时候发现的。
en-us	The Joint Mission learned that infected children have largely been identified through contact tracing in households of adults. 

zh-cn	值得注意的是，接受联合考察组访谈的人未发现有儿童传染成人的情况。 
en-us	Of note, people interviewed by the Joint Mission Team could not recall episodes in which transmission occurred from a child to an adult. 

zh-cn	症状、体征、疾病进程和严重程度 
en-us	The signs, symptoms, disease progression and severity  

zh-cn	新冠肺炎的症状是非特异性的，从无症状到重症肺炎和死亡不等。
en-us	Symptoms of COVID-19 are non-specific and the disease presentation can range from no symptoms (asymptomatic) to severe pneumonia and death. 

zh-cn	截至2020年2月20日55924例实验室确诊病例中，典型症状和体征包括发热（87.9%)、干咳（67.7%)、乏力(38.1%)、咳痰(33.4%)、气短(18.6%)、咽痛(13.9%)、头痛（13.6%)、肌痛或关节痛（14.8%)、寒战（11.4%)、恶心或呕吐（5.0%)、鼻塞（4.8%)、腹泻（3.7%)、咯血（0.9%)和结膜充血（0.8%)。  
en-us	As of 20 February 2020 and based on 55924 laboratory confirmed cases, typical signs and symptoms include: fever (87.9%), dry cough (67.7%), fatigue (38.1%), sputum production (33.4%), shortness of breath (18.6%), sore throat (13.9%), headache (13.6%), myalgia or arthralgia (14.8%), chills (11.4%), nausea or vomiting (5.0%), nasal congestion (4.8%), diarrhea (3.7%), and hemoptysis (0.9%), and conjunctival congestion (0.8%). 

zh-cn	新冠肺炎患者通常在感染后平均5-6天（平均潜伏期5-6天，范围1-14天）出现轻度呼吸道症状和发热等症状。  
en-us	People with COVID-19 generally develop signs and symptoms, including mild respiratory symptoms and fever, on an average of 5-6 days after infection (mean incubation period 5-6 days, range 1-14 days). 

zh-cn	多数感染新冠肺炎病毒的患者为轻症并可痊愈。
en-us	Most people infected with COVID-19 virus have mild disease and recover. 

zh-cn	约80%的实验室确诊病例为轻症和普通型，包括无肺炎或肺炎患者，13.8%的患者为重症，存在呼吸困难、呼吸频率>=30次/分钟、血氧饱和度593%、动脉血氧分压/吸入氧浓度比<300和/或24-48小时内肺部浸润>50%, 6.1%的患者为危重型（呼吸衰竭、脓毒性休克和/或多器官功能障碍/衰竭）。
en-us	Approximately 80% of laboratory confirmed patients have had mild to moderate disease, which includes non-pneumonia and pneumonia cases, 13.8% have severe disease (dyspnea, respiratory frequency >30/minute, blood oxygen saturation <93%, PaO2/FiO2 ratio <300, and/or lung infiltrates >50% of the lung field within 24-48 hours) and 6.1% are critical (respiratory failure, septic shock, and/or multiple organ dysfunction/failure). 

zh-cn	巳有无症状感染的报告，但多数在报告时无症状的病例随后会出现症状。
en-us	Asymptomatic infection has been reported, but the majority of the relatively rare cases who are asymptomatic on the date of identification/report went on to develop disease. 

zh-cn	真正的无症状感染者的比例尚不明确，但相对较罕见，也不是传播的主要驱动因素。 
en-us	The proportion of truly asymptomatic infections is unclear but appears to be relatively rare and does not appear to be a major driver of transmission. 

zh-cn	重症和死亡高危人群为年龄60岁以上，以及患有高血压、糖尿病、心血管疾病、慢性呼吸道疾病和癌症等基础性疾病者。
en-us	Individuals at highest risk for severe disease and death include people aged over 60 years and those with underlying conditions such as hypertension, diabetes, cardiovascular disease, chronic respiratory disease and cancer. 

zh-cn	儿童病例似乎很少且病情较轻，19岁以下病例约占总报告病例的2.4%。
en-us	Disease in children appears to be relatively rare and mild with approximately 2.4% of the total reported cases reported amongst individuals aged under 19 years. 

zh-cn	极少数19岁以下病例发展为重症(2.5%)或危重症（0.2%)。 
en-us	A very small proportion of those aged under 19 years have developed severe (2.5%) or critical disease (0.2%). 

zh-cn	截至2月20日，55924例实验室确诊病例中有2114例死亡（粗病死率[CFR]为3.8%)
en-us	As of 20 February, 2114 of the 55,924 laboratory confirmed cases have died (crude fatality ratio [CFR2] 3.8%) 

zh-cn	(注：其中包含部分由临床诊断病例转成的确诊病例）。
en-us	(note: at least some of whom were identified using a case definition that included pulmonary disease).

zh-cn	粗病死率因地区和传播强度而异（武汉5.8%，中国其他地区0.7%)。
en-us	The overall CFR varies by location and intensity of transmission (i.e. 5.8% in Wuhan vs. 0.7% in other areas in China). 

zh-cn	在中国，疫情暴发早期的粗病死率较高（1月1日至10日间发病的病例，粗病死率为17.3%);随着时间推移，2月1日之后发病病例的粗病死率降至0.7%(图4)。
en-us	In China, the overall CFR was higher in the early stages of the outbreak (17.3% for cases with symptom onset from 1¬10 January) and has reduced over time to 0.7% for patients with symptom onset after 1 February (Figure 4). 

zh-cn	联合考察组注意到医疗服务水平在疫情进展过程中发生了变化. 
en-us	The Joint Mission noted that the standard of care has evolved over the course of the outbreak. 

zh-cn	病死率随年龄增长而增加，80岁以上者病死率最高(21.9%)。
en-us	Mortality increases with age, with the highest mortality among people over 80 years of age (CFR 21.9%). 

zh-cn	男性病死率高于女性（分别为4.7%和2.8%)。
en-us	The CFR is higher among males compared to females (4.7% vs. 2.8%). 

zh-cn	退休人员在各职业人群中病死率最高，为8.9%。无合并症的患者病死率为1.
en-us	By occupation, patients who reported being retirees had the highest CFR at 8.9%. 

zh-cn	4%，有合并症的患者病死率显著增高（合并心血管疾病患者为13.2%，糖尿病为9.2%，高血压为8.4%，慢性呼吸道疾病为8.0%，癌症为7.6%)。 
en-us	While patients who reported no comorbid conditions had a CFR of 1.4%, patients with comorbid conditions had much higher rates: 13.2% for those with cardiovascular disease, 9.2% for diabetes, 8.4% for hypertension, 8.0% for chronic respiratory disease, and 7.6% for cancer. 

zh-cn	疾病进程数据来自数量有限的报告住院病例（图5)。
en-us	Data on the progression of disease is available from a limited number of reported hospitalized cases (Figure 5). 

zh-cn	根据现有数据，从全国来看，从发病到实验室确诊的中位时间从2020年1月初的12天(8-18天)缩短到2月初的3天（1-7天）。
en-us	Based on available information, the median time from symptom onset to laboratory confirmation nationally decreased from 12 days (range 8-18 days) in early January to 3 days (1-7) by early February 2020, 

zh-cn	在武汉，则分别为15天（10-21天）和5天（3-9天）。
en-us	and in Wuhan from 15 days (10-21) to 5 days (3-9), respectively.

zh-cn	这有助于更早地发现、隔离和治疗病例，以及确认、追踪密切接触者。 
en-us	This has allowed for earlier case and contact identification, isolation and treatment. 

zh-cn	根据可用的初步数据，从发病到临床痊愈的中位时间，轻症约为2周，重症或危重症约为3-6周。
en-us	Using available preliminary data, the median time from onset to clinical recovery for mild cases is approximately 2 weeks and is 3-6 weeks for patients with severe or critical disease. 

zh-cn	初步数据表明，从起病到进展为出现缺氧等重症的时间为1周。
en-us	Preliminary data suggests that the time period from onset to the development of severe disease, including hypoxia, is 1 week. 

zh-cn	死亡患者中，发病到死亡的时间范围为2-8周。 
en-us	Among patients who have died, the time from symptom onset to outcome ranges from 2-8 weeks. 

zh-cn	巳康复患者数量不断增加，截至2月20日，巳有18264人（24%)痊愈。
en-us	An increasing number of patients have recovered; as of 20 February, 18264 (24%) reported cases have recovered. 

zh-cn	令人鼓舞的是，广东省疾病预防控制中心2月20日的一份报告显示，在广东省发现的125例重症病例中，33例（26.4%)巳痊愈并出院，58例（46.4%)转为轻/中度病例。
en-us	Encouragingly, a report on 20 February from the Guangdong CDC suggests that of 125 severe cases identified in Guangdong, 33 (26.4%) have recovered and been released from hospital, and 58 (46.4%) had improved and were reclassified as having mild/moderate disease (i.e. + milder pneumonia). 

zh-cn	在迄今报告的重症病例中，13.4%死亡。
en-us	Among severe cases reported to date, 13.4% have died. 

zh-cn	更早发现病例和接触者，就可以更早进行治疗。 
en-us	Early identification of cases and contacts allows for earlier treatment. 

zh-cn	(五）中国的应对措施 
en-us	The China response  

zh-cn	武汉新冠疫情发生后，党中央国务院高度重视，立即启动国家应急响应
en-us	Upon the detection of a cluster of pneumonia cases of unknown etiology in Wuhan, the CPC Central Committee and the State Council launched the national emergency response. 

zh-cn	成立中央应对疫情工作领导小组和国务院联防联控机制
en-us	A Central Leadership Group for Epidemic Response and the Joint Prevention and Control Mechanism of the State Council were established. 

zh-cn	习近平主席亲自指挥、亲自部署防控工作，明确要求防控新冠病毒疫情是当前各级政府的首要任务
en-us	General Secretary Xi Jinping personally directed and deployed the prevention and control work and requested that the prevention and control of the COVID-19 outbreak be the top priority of government at all levels.

zh-cn	李克强总理任中央应对疫情工作领导小组组长，统筹协调各相关部门和全国各省（区、市）各项防控工作，并第一时间亲赴武汉现场考察指导
en-us	Prime Minister Li Keqiang headed the Central Leading Group for Epidemic Response and went to Wuhan to inspect and coordinate the prevention and control work of relevant departments and provinces (autonomous regions and municipalities) across the country. 

zh-cn	孙春兰副总理驻武汉前线指挥部亲自领导和协调一线防控工作。 
en-us	Vice Premier Sun Chunlan, who has been working on the frontlines in Wuhan, has led and coordinated the frontline prevention and control of the outbreak. 

zh-cn	全国防控工作由前期在武汉等湖北重点地区快速上升到当前全国疫情的全面控制，主要经历了三个阶段，两个重要事件可以作为三阶段的分期标志：
en-us	The prevention and control measures have been implemented rapidly, from the early stages in Wuhan and other key areas of Hubei, to the current overall national epidemic. It has been undertaken in three main phases, with two important events defining those phases. 

zh-cn	一是2020年1月20日新冠肺炎纳入法定报告乙类传染病和国境卫生检疫传染病，标志着由前期的局部防控进入到依法全面釆取各项控制措施的转变；
en-us	First, COVID-19 was included in the statutory report of Class B infectious diseases and border health quarantine infectious diseases on 20 January 2020, which marked the transition from the initial partial control approach to the comprehensive adoption of various control measures in accordance with the law.

zh-cn	二是2020年2月8日国务院下发《关于切实加强疫情科学防控有序做好企业复工复产工作的通知》，标志着中国防控工作进入疫情防控与全面恢复社会经济正常运行统筹兼顾阶段。 
en-us	The second event was the State Council's issuing, on 8 February 2020, of The Notice on Orderly Resuming Production and Resuming Production in Enterprises, which indicated that China's national epidemic control work had entered a stage of overall epidemic prevention and control together with the restoration of normal social and economic operations. 

zh-cn	第一阶段，围绕武汉等湖北省重点地区防输出、全国其它地区防输入的防控目的，以控制传染源，阻断传播，预防扩散为主要策略
en-us	The first stage. During the early stage of the outbreak, the main strategy focused on preventing the exportation of cases from Wuhan and other priority areas of Hubei Province, and preventing the importation of cases by other provinces; the overall aim was to control the source of infection, block transmission and prevent further spread. 

zh-cn	釆取启动响应和多部门联防联控
en-us	The response mechanism was initiated with multi-sectoral involvement in joint prevention and control measures. 

zh-cn	关闭市场，确定病原体
en-us	Wet markets were closed, and efforts were made to identify the zoonotic source. 

zh-cn	1月3日向世卫组织通报疫情，1月10日分享了毒株全基因组序列研发检测试剂盒
en-us	Information on the epidemic was notified to WHO on 3 January, and whole genome sequences of the COVID-19 virus were shared with WHO on 10 January. 

zh-cn	制定下发诊疗、监测、流调、密切接触者管理和实验室检测方案，开展监测与流行病学调查
en-us	Protocols for COVID-19 diagnosis and treatment, surveillance, epidemiological investigation, management of close contacts, and laboratory testing were formulated, and relevant surveillance activities and epidemiological investigations conducted. 

zh-cn	严格野生动物和活禽市场监管等防控措施。 
en-us	wildlife and live poultry markets were placed under strict supervision and control measures. 

zh-cn	第二阶段，围绕降低流行强度，缓疫削峰的防控目的
en-us	The second stage. During the second stage of the outbreak, the main strategy was to reduce the intensity of the epidemic and to slow down the increase in cases. 

zh-cn	在武汉等湖北省重点地区以积极救治，减少死亡，外防输出为主要策略
en-us	In Wuhan and other priority areas of Hubei Province, the focus was on actively treating patients, reducing deaths, and preventing exportations. 

zh-cn	在全国其他地区以外防输入，内防扩散，群防群控为主要策略
en-us	In other provinces, the focus was on preventing importations, curbing the spread of the disease and implementing joint prevention and control measures. 

zh-cn	在全国关闭了野生动物市场，隔离了野生动物繁育养殖设施；
en-us	Nationally, wildlife markets were closed and wildlife captive-breeding facilities were cordoned off. 

zh-cn	1月20日将新冠肺炎纳入法定报告乙类传染病和国境卫生检疫传染病，实行体温监测和健康申报制度，釆取依法监测与交通场站检疫；
en-us	On 20 January, COVID-19 was included in the notifiable report of Class B infectious diseases and border health quarantine infectious diseases, with temperature checks, health care declarations, and quarantine against COVID-19 instituted at transportation depots in accordance with the law.

zh-cn	1月23日武汉实行严格限制交通的措施；
en-us	 On 23 January, Wuhan implemented strict traffic restrictions. 

zh-cn	完善诊疗和防控技术方案，强化病例隔离救治。 
en-us	The protocols for diagnosis, treatment and epidemic prevention and control were improved; case isolation and treatment were strengthened. 

zh-cn	全面落实“四早”、“四集中”，确保应治尽治，对密接和重点地区人员隔离医学观察；
en-us	Measures were taken to ensure that all cases were treated, and close contacts were isolated and put under medical observation. 

zh-cn	实施延长春节假期、交通管制、控制运能的措施，减少人员流动，取消人群聚集性活动；
en-us	Other measures implemented included the extension of the Spring Festival holiday, traffic controls, and the control of transportation capacity to reduce the movement of people; mass gathering activities were also cancelled. 

zh-cn	动态发布疫情和防控信息
en-us	Information about the epidemic and prevention and control measures was regularly released. 

zh-cn	加强公众风险沟通和健康宣教；
en-us	Public risk communications and health education were strengthened;

zh-cn	统筹调配医疗物资，新建医院，启用储备床位和征用相应场所，确保应收尽收；
en-us	allocation of medical supplies was coordinated, new hospitals were built, reserve beds were used and relevant premises were repurposed to ensure that all cases could be treated; 

zh-cn	生活物资保供稳价，维护社会平稳运行等综合性防控措施。 
en-us	efforts were made to maintain a stable supply of commodities and their prices to ensure the smooth operation of society. 

zh-cn	第三阶段，围绕减少聚集性疫情，彻底控制疾病流行，统筹兼顾疫情防控与经济社会可持续发展的目的，全国范围内以统一指挥，分类指导，科学循证，精准施策为主要策略
en-us	The third stage of the outbreak focused on reducing clusters of cases, thoroughly controlling the epidemic, and striking a balance between epidemic prevention and control, sustainable economic and social development, the unified command, standardized guidance, and scientific evidence-based policy implementation.

zh-cn	其中，在武汉等湖北省重点地区突出“救治”和“阻断”，强调继续做实做细上一阶段“应检尽检、应收尽收、应治尽治”等各项措施。
en-us	 For Wuhan and other priority areas of Hubei Province, the focus was on patient treatment and the interruption of transmission, with an emphasis on concrete steps to fully implement relevant measures for the testing, admitting and treating of all patients. 

zh-cn	釆取以风险为导向的地域差异化防控措施
en-us	A risk-based prevention and control approach was adopted with differentiated prevention and control measures for different regions of the country and provinces. 

zh-cn	强化流行病学调查、病例管理和高危场所聚集性疫情防控。 
en-us	Relevant measures were strengthened in the areas of epidemiological investigation, case management and epidemic prevention in high-risk public places. 

zh-cn	应用大数据和人工智能等新技术加强密切接触者和重点人群管理；
en-us	New technologies were applied such as the use of big data and artificial intelligence (AI) to strengthen contact tracing and the management of priority populations. 

zh-cn	出台“医保支付、异地结算、财政兜底”的医保政策；
en-us	Relevant health insurance policies were promulgated on "health insurance payment, off-site settlement, and financial compensation". 

zh-cn	全国对口支援武汉等湖北省重点地区，迅速遏制疾病流行；
en-us	All provinces provided support to Wuhan and priority areas in Hubei Province in an effort to quickly curb the spread of the disease and provide timely clinical treatment. 

zh-cn	完善开学前准备工作，分类分批有序复工复产
en-us	Pre-school preparation was improved, and work resumed in phases and batches. 

zh-cn	开展“点对点、一站式”务工人员返岗健康和保障服务
en-us	Health and welfare services were provided to returning workers in a targeted and ‘one-stop' manner. 

zh-cn	全面恢复社会正常运行；
en-us	Normal social operations are being restored in a stepwise fashion; 

zh-cn	普及防病知识，提高公众健康素养和技能；
en-us	knowledge about disease prevention is being popularized to improve public health literacy and skills;

zh-cn	全面开展检测、药物、疫苗、疾病谱、溯源等应急科研攻关。 
en-us	and a comprehensive program of emergency scientific research is being carried out to develop diagnostics, therapeutics and vaccines, delineate the spectrum of the disease, and identify the source of the virus. 

zh-cn	(六）现有知识局限 
en-us	Knowledge gaps  

zh-cn	自从新冠肺炎疫情暴发以来，通过现场调查和中国开展的研究，人们对该病毒和疾病有了更好的了解。
en-us	Since the start of the COVID-19 outbreak, there have been extensive attempts to better understand the virus and the disease in China. 

zh-cn	在如此短的时间内能获得关于一种新病毒如此多的知识令人瞩目。
en-us	It is remarkable how much knowledge about a new virus has been gained in such a short time. 

zh-cn	然而，与所有新疾病一样，疫情发生至今仅7周，关键的知识局限仍然存在。
en-us	However, as with all new diseases, and only 7 weeks after this outbreak began, key knowledge gaps remain. 

zh-cn	附件4总结了若干未知的关键领域，包括传染源、病毒的致病机理和毒性、传染性、感染和疾病进展的风险因素、监测、诊断、重症和危重病人的临床管理以及预防和控制措施的有效性。
en-us	Annex D summarizes the key unknowns in a number of areas including the source of infection, pathogenesis and virulence of the virus, transmissibility, risk factors for infection and disease progression, surveillance, diagnostics, clinical management of severe and critically ill patients, and the effectiveness of prevention and control measures. 

zh-cn	及时填补这些知识局限对于完善和加强控制策略至关重要。 
en-us	The timely filling of these knowledge gaps is imperative to enhance control strategies. 

zh-cn	三、评估 
en-us	III. Assessment  

zh-cn	联合考察组根据考察组在中国的工作情况和全球应对新冠肺炎的了解得出4个主要结论
en-us	The Joint Mission drew four major conclusions from its work in China and four major conclusions from its knowledge of the broader global response to COVID-19. 

zh-cn	从5个主要方面对全球和中国正在釆取的应对措施提出建议。 
en-us	Recommendations are offered in five major areas to inform the ongoing response globally and in China. 

zh-cn	(一）中国的应对措施及下一步工作 
en-us	The China Response & Next Steps  

zh-cn	1.面对这种前所未知的病毒，中国釆取了历史上最勇敢、最灵活、最积极的防控措施。
en-us	in the face of a previously unknown virus, china has rolled out perhaps the most ambitious, agile and aggressive disease containment effort in history. 

zh-cn	疫情之初，基于围堵策略的防控措施是在全国范围广泛开展体温检测、佩戴口罩与洗手消毒等。
en-us	The strategy that underpinned this containment effort was initially a national approach that promoted universal temperature monitoring, masking, and hand washing. 

zh-cn	随着疫情的发展和对疾病认识的深化，釆取了更加科学、基于风险评估的防控措施，各省、县甚至社区根据各自特点、机构能力以及新型冠状病毒传播情况，釆取了更有针对性的防控措施。 
en-us	However, as the outbreak evolved, and knowledge was gained, a science and risk-based approach was taken to tailor implementation. specific containment measures were adjusted to the provincial, county and even community context, the capacity of the setting, and the nature of novel coronavirus transmission there. 

zh-cn	在防控策略基本原则保持不变的基础上，根据对新型冠状病毒、新冠肺炎以及防控措施的新认识，不断完善具体措施，尽可能迅速地遏制病毒传播。
en-us	While the fundamental principles of this strategy have been consistent since its launch, there has been constant refinement of specific aspects to incorporate new knowledge on the novel coronavirus, the COVID-19 disease, and COVID-19 containment, as rapidly as that knowledge has emerged. 

zh-cn	中国科学家和公共卫生专家迅速分离了致病病毒，建立了诊断方法，确定了传播途径和潜伏期等关键传播参数，为中国防控策略的制定提供了重要的证据基础，为应急响应赢得了宝贵的时间。 
en-us	The remarkable speed with which Chinese scientists and public health experts isolated the causative virus, established diagnostic tools, and determined key transmission parameters, such as the route of spread and incubation period, provided the vital evidence base for China's strategy, gaining invaluable time for the response. 

zh-cn	令人瞩目的是，在所考察的每一个机构都能够强有力地落实防控措施；
en-us	As striking, has been the uncompromising rigor of strategy application that proved to be a hallmark in every setting and context where it was examined. 

zh-cn	不折不扣提升关键措施效果，例如不断提高病例检测、隔离及早期治疗的速度；
en-us	There has also been a relentless focus on improving key performance indicators, for example constantly enhancing the speed of case detection, isolation and early treatment.

zh-cn	积极利用前沿科技促进防控措施的创新，比如将常规医疗和教学工作转移到在线医疗平台、使用5G平台支持农村地区的防控工作。 
en-us	The implementation of these containment measures has been supported and enabled by the innovative and aggressive use of cutting edge technologies, from shifting to online medical platforms for routine care and schooling, to the use of 5G platforms to support rural response operations. 

zh-cn	2.面对共同威胁时，中国人民凝聚共识团结行动，才使防控措施得以全面有效的实施。
en-us	Achieving China's exceptional coverage with and adherence to these containment measures has only been possible due to the deep commitment of the Chinese people to collective action in the face of this common threat. 

zh-cn	每个省、每个城市在社区层面都团结一致，帮助和支持脆弱人群及社区。
en-us	At a community level this is reflected in the remarkable solidarity of provinces and cities in support of the most vulnerable populations and communities. 

zh-cn	尽管本地区也同样发生了疫情，但各省市仍不断地向湖北省和武汉市派遣了数以万计的医务人员，并支援了大量宝贵的个人防护用品。 
en-us	Despite ongoing outbreaks in their own areas, Governors and Mayors have continued to send thousands of health care workers and tons of vital PPE supplies into Hubei province and Wuhan city. 

zh-cn	在个人层面，面对此次疫情中国人民表现出极大的勇气和信念。
en-us	At the individual level, the Chinese people have reacted to this outbreak with courage and conviction. 

zh-cn	他们接受并坚持了最严厉的遏制措施——无论是暂停公众集会、长达月余的“居家”，还是禁止旅行。
en-us	They have accepted and adhered to the starkest of containment measures 一 whether the suspension of public gatherings, the month-long ‘stay at home' advisories or prohibitions on travel. 

zh-cn	在中国各地为期9天的实地考察中，考察组与社区工作人员、一线医务人员、顶级的科学家以及省长和市长进行了坦诚的交流，他们表现出的真诚和奉献精神深深地感动了联合考察组所有成员。 
en-us	Throughout an intensive 9-days of site visits across China, in frank discussions from the level of local community mobilizers and frontline health care providers to top scientists, Governors and Mayors, the Joint Mission was struck by the sincerity and dedication that each brings to this COVID-19 response. 

zh-cn	3.中国釆取的果敢措施有效遏制了这一新的呼吸道病原体的迅速蔓延，改变了疫情快速扩散流行的危险进程。
en-us	China's bold approach to contain the rapid spread of this new respiratory pathogen has changed the course of a rapidly escalating and deadly epidemic. 

zh-cn	一个特别令人信服的统计数字是，在先遣组工作的第一天，中国报告了2478例新增确诊病例，而两周后考察任务的最后一天，中国报告了409例新增确诊病例。
en-us	A particularly compelling statistic is that on the first day of the advance team's work there were 2478 newly confirmed cases of COVID-19 reported in China. Two weeks later, on the final day of this Mission, China reported 409 newly confirmed cases. 

zh-cn	这充分表明全国范围内新冠肺炎疫情下降是令人信服的。 
en-us	This decline in COVID-19 cases across China is real. 

zh-cn	另外有几组数据也支持这一结论，包括发热门诊就诊人数的急剧下降、治愈患者出院后空出的床位可用于收治新患者、以及因病人数量减少以至于临床实验难以招募足够的新病人等。
en-us	Several sources of data support this conclusion, including the steep decline in fever clinic visits, the opening up of treatment beds as cured patients are discharged, and the challenges to recruiting new patients for clinical trials. 

zh-cn	联合考察组对各省的粗发病率进行了比较，估计中国釆取的政府主导的全社会防控措施成功避免或至少预防了全国范围内数十万病例的发生。
en-us	Based on a comparison of crude attack rates across provinces, the Joint Mission estimates that this truly all-of- Government and all-of-society approach that has been taken in China has averted or at least delayed hundreds of thousands of COVID-19 cases in the country. 

zh-cn	中国新冠肺炎疫情的下降显著地保护了国际安全，构建起了防止疾病国际传播强有力的第一道防线。
en-us	By extension, the reduction that has been achieved in the force of COVID-19 infection in China has also played a significant role in protecting the global community and creating a stronger first line of defense against international spread. 

zh-cn	然而，中国和中国人民为遏制疫情的暴发付出了巨大的生命和物质代价。 
en-us	Containing this outbreak, however, has come at great cost and sacrifice by China and its people, in both human and material terms. 

zh-cn	在充分肯定中国防控工作成绩的同时，也发现在公共卫生应急反应能力领域还有进一步提升的空间 
en-us	While the scale and impact of China's COVID-19 operation has been remarkable, it has also highlighted areas for improvement in public health emergency response capacity. 

zh-cn	包括消除阻碍及时开展早期预警和快速应对；短时间内大幅扩容隔离和救治能力；优化医疗机构一线医务人员防护；加强关键优先的科研领域协同合作；促进与国际社会共享关键数据等。 
en-us	These include overcoming any obstacles to act immediately on early alerts, to massively scale-up capacity for isolation and care, to optimize the protection of frontline health care workers in all settings, to enhance collaborative action on priority gaps in knowledge and tools, and to more clearly communicate key data and developments internationally. 

zh-cn	4.中国在努力遏制疫情传播的同时，正在逐步恢复经济、教育和社会等各部门的日常服务和生产活动。
en-us	China is already, and rightfully, working to bolster its economy, reopen its schools and return to a more normal semblance of its society, even as it works to contain the remaining chains of COVID-19 transmission. 

zh-cn	中国也正在釆取基于科学、风险研判和分层分级的防控策略，以便限制性策略解除时，能迅速应对和处置再次出现的新发病例或聚集性疫情。 
en-us	Appropriately, a science-based, risk- informed and phased approach is being taken, with a clear recognition and readiness of the need to immediately react to any new COVID-19 cases or clusters as key elements of the containment strategy are lifted. 

zh-cn	尽管病例数在下降，考察组所到的省、市和社区都正在加速扩大对救治床位和公共卫生能力的投入，而且有必要持续加大投入力度。
en-us	Despite the declining case numbers, across China every province, city and community visited is urgently escalating their investments in acute care beds and public health capacity. It is crucial that this continues. 

zh-cn	目前全国各地仍有5万名患者在接受治疗。
en-us	Fifty thousand infected COVID-19 patient are still under treatment, across the country. 

zh-cn	考察组了解到中国在这次危机中迅速积累的知识、经验和能力。
en-us	However, the Joint Mission has come to understand the substantial knowledge, experience and capacities that China has rapidly built during this crisis. 

zh-cn	因此，联合考察组赞同中国对当前形势的判断，并认为随着认知、经验和能力的提高，中国釆取针对性强的可持续的应对策略，如病例的迅速发现，关键防控措施的快速启动，高层领导直接领导以及社区层面的广泛参与，中国绝大部分省市能够很快的处置任何再发新冠肺炎病例。 
en-us	Consequently, it endorses China's working assumption that in most provinces and municipalities it should soon be possible to manage a resurgence in COVID-19 cases, using even more tailored and sustainable approaches that are anchored in very rapid case detection, instant activation of key containment activities, direct oversight by top leadership, and broad community engagement. 

zh-cn	中国正在努力恢复正常的社会和经济活动，世界各国必须正确认识并积极回应这一事实，即中国新冠肺炎疫情风险正在快速改变和不断降低。
en-us	As China works to resume a more normal level of societal and economic activity, it is essential that the world recognizes and reacts positively to the rapidly changing, and decreasing, risk of COVID-19 in the country. 

zh-cn	中国需要迅速恢复与世界的正常联系，其生产力和经济的恢复对中国自身和世界都至关重要。
en-us	China's rapid return to full connectivity with the world, and to full productivity and economic output, is vital to China and to the world. 

zh-cn	世界各国都迫切需要了解和利用中国在应对新冠肺炎疫情方面的经验，充分认识到其为全球应对行动带来的实际贡献。
en-us	The world urgently needs access to China's experience in responding to COVID- 19, as well as the material goods it brings to the global response. 

zh-cn	随着中国境外新冠疫情形势的不断升级，目前更为紧迫的是，所有国家都应立即并且不断重新评估任何超出《国际卫生条例》新冠病毒应急委员会向各国提出的与中国相关的旅行和/或贸易限制。 
en-us	It is even more urgent now, with escalating COVID-19 outbreaks outside of China, to constantly reassess any restrictions on travel and/or trade to China that go beyond the recommendations of the IHR Emergency Committee on COVID-19. 

zh-cn	(二）全球应对措施及下一步工作 
en-us	The Global Response & Next Steps 

zh-cn	1.新型冠状病毒是一种新出现的病原体，传染性强、传播速度快，在任何环境下都会对公共卫生问题及经济社会影响。
en-us	The COVID-19 virus is a new pathogen that is highly contagious, can spread quickly, and must be considered capable of causing enormous health, economic and societal impacts in any setting. 

zh-cn	它既不是SARS,也不是流感，仅根据已知的这两种病原体来构建对病毒的认识并制定防控措施存在风险，尚不足以阻止传播、减少疾病、挽救生命。 
en-us	It is not SARS and it is not influenza. Building scenarios and strategies only on the basis of well-known pathogens risks failing to exploit all possible measures to slow transmission of the COVID-19 virus, reduce disease and save lives. 

zh-cn	新型冠状病毒具备独有特征。
en-us	It is a new virus with its own characteristics. 

zh-cn	例如，与流感相比，其在儿童中的传播活跃度有限，其临床表现也与SARS不尽相同。
en-us	For example, COVID-19 transmission in children appears to be limited compared with influenza, while the clinical picture differs from SARS. 

zh-cn	虽然上述结论仅基于有限数据，但在中国各地不同环境条件下，通过严格釆取综合性非药物性干预措施阻断人传人巳经发挥了作用，并取得了效果。
en-us	Such differences, while based on limited data, may be playing a role in the apparent efficacy of rigorously applied non-pharmaceutical, public health measures to interrupt chains of human-to- human transmission in a range of settings in China. 

zh-cn	新型冠状病毒极强的传播力、导致高危人群死亡的不确定性、以及对社会经济秩序破坏力，是人类冠状病毒中非比寻常的。
en-us	The COVID-19 virus is unique among human coronaviruses in its combination of high transmissibility, substantial fatal outcomes in some high-risk groups, and ability to cause huge societal and economic disruption. 

zh-cn	如果要应对，必须假定全球人口均是易感人群。
en-us	For planning purposes, it must be assumed that the global population is susceptible to this virus. 

zh-cn	此外，目前还不清楚新型冠状病毒的动物来源，因此巳发生疫情的地区必须考虑病毒复发的风险。 
en-us	As the animal origin of the COVID-19 virus is unknown at present, the risk of reintroduction into previously infected areas must be constantly considered. 

zh-cn	随着对病毒认识的不断深入，我们应像中国那样具有较强的灵活性，能够迅速调整应对措施和方案。
en-us	The novel nature, and our continuously evolving understanding, of this coronavirus demands a tremendous agility in our capacity to rapidly adapt and change our readiness and response planning as has been done continually in China. 

zh-cn	这对于一个拥有14亿人口的国家来说是一项非凡的成就。 
en-us	This is an extraordinary feat for a country of 1.4 billion people. 

zh-cn	中国釆取了坚定有力的综合性非药物性干预措施，非常有效地切断病毒传播途径，为全球应对新冠肺炎提供了重要经验。
en-us	China's uncompromising and rigorous use of non-pharmaceutical measures to contain transmission of the COVID-19 virus in multiple settings provides vital lessons for the global response. 

zh-cn	尽管湖北其他地区已经发生了社区传播，其他有输入病例的省份也多有家庭聚集性疫情，但中国釆取的这些独特且史无前例的措施彻底扭转了湖北和其他地区不断升级的疫情形势。 
en-us	This rather unique and unprecedented public health response in china reversed the escalating cases in both Hubei, where there has been widespread community transmission, and in the importation provinces, where family clusters appear to have driven the outbreak. 

zh-cn	虽然中国各地暴发疫情的时间相对接近，但中国从北到南，从大城市到偏远地区，不同环境和场所的传播特点各不相同。
en-us	Although the timing of the outbreak in China has been relatively similar across the country, transmission chains were established in a wide diversity of settings, from mega¬cities in the north and south of the country, to remote communities. 

zh-cn	然而，中国迅速调整防控措施表明，不同情况下都有可能成功实施防控措施。 
en-us	However, the rapid adaptation and tailoring of China's strategy demonstrated that containment can be adapted and successfully operationalized in a wide range of settings. 

zh-cn	中国的经验证明，确定新冠病毒后，积极的准备措施和快速应对十分有效。在地方开展全面风险评估，利用差异化的风险控制策略，管理无病例、散发病例、聚集性病例乃至社区传播等不同类型地区也取得了明显成效。
en-us	China's experience strongly supports the efficacy and effectiveness of anchoring COVID- 19 readiness and rapid response plans in a thorough assessment of local risks and of utilizing a differentiated risk-based containment strategy to manage the outbreak in areas with no cases vs. sporadic cases vs. clusters of cases vs. community-level transmission. 

zh-cn	这种策略对于确保控制措施落实的可持续性，尽量减少对社会经济影响都至关重要。 
en-us	Such a strategy is essential for ensuring a sustainable approach while minimizing the socio-economic impact. 

zh-cn	国际社会无论在思想上，还是行动上都还尚未准备好去组织实施已经被中国证明了的唯一能够阻断或最大程度降低新冠病毒传播的措施
en-us	Much of the global community is not yet ready, in mindset and materially, to implement the measures that have been employed to contain COVID-19 in China. 

zh-cn	这些措施包括：开展积极主动监测，迅速发现并立即诊断、隔离病例，严格追踪并隔离密切接触者，引导民众理解并接受上述措施。 
en-us	These are the only measures that are currently proven to interrupt or minimize transmission chains in humans. Fundamental to these measures is extremely proactive surveillance to immediately detect cases, very rapid diagnosis and immediate case isolation, rigorous tracking and quarantine of close contacts, and an exceptionally high degree of population understanding and acceptance of these measures. 

zh-cn	贯彻落实上述举措并确保其实施效果，不仅需要高层迅速做出决策，公共卫生体系全面启动，还需要整个社会充分参与。
en-us	Achieving the high quality of implementation needed to be successful with such measures requires an unusual and unprecedented speed of decision-making by top leaders, operational thoroughness by public health systems, and engagement of society. 

zh-cn	新型冠状病毒如果不受控制地持续在社区传播，可能造成重大风险和严重损害，而釆取综合性非药物性干预措施能够为研制疫苗及验证治疗方法争取到数周和数月时间。
en-us	Given the damage that can be caused by uncontrolled, community-level transmission of this virus, such an approach is warranted to save lives and to gain the weeks and months needed for the testing of therapeutics and vaccine development. 

zh-cn	此外，目前中国以外的新发病例大都出现在中高收入国家，这些国家均承诺严格釆取“非药物性干预措施”减缓传播，这对于建立其保护卫生体系及应对能力较差的低收入国家的第二道防线至关重要。 
en-us	Furthermore, as the majority of new cases outside of China are currently occurring in high and middle- income countries, a rigorous commitment to slowing transmission in such settings with non-pharmaceutical measures is vital to achieving a second line of defense to protect low income countries that have weaker health systems and coping capacities. 

zh-cn	通过全面实施这些措施而获得的时间——即使只有几天或几周——在最终减少新冠肺炎致病和死亡方面都十分宝贵。
en-us	The time that can be gained through the full application of these measures 一 even if just days or weeks 一 can be invaluable in ultimately reducing COVID-19 illness and deaths. 

zh-cn	中国在发现病毒后短短7周内，开展的科学研究在知识、方法和工具等方面都取得了巨大的进步。 
en-us	This is apparent in the huge increase in knowledge, approaches and even tools that has taken place in just the 7 weeks since this virus was discovered through the rapid scientific work that has been done in China. 

zh-cn	4.必须充分利用通过实施遏制新冠肺炎措施所争取的时间，更加有效地提高全球应对疫情能力，尽快推出能够遏制病毒传播的具体工具。 
en-us	The time gained by rigorously applying COVID-19 containment measures must be used more effectively to urgently enhance global readiness and rapidly develop the specific tools that are needed to ultimately stop this virus. 

zh-cn	新型冠状病毒正以惊人的速度蔓延，新冠肺炎在任何环境中暴发都将导致非常严重的后果。
en-us	COVID-19 is spreading with astonishing speed; COVID-19 outbreaks in any setting have very serious consequences; 

zh-cn	巳有证据充分显示，综合性非药物性干预措施在某些情况下可以减少甚至阻断传播。
en-us	and there is now strong evidence that non-pharmaceutical interventions can reduce and even interrupt transmission.

zh-cn	然而，全球和各国的应对方案往往对非药物性干预措施态度模糊。
en-us	Concerningly, global and national preparedness planning is often ambivalent about such interventions. 

zh-cn	为减少新冠肺炎发病和死亡，短期内釆取的应对方案就是积极釆取非药物性干预措施
en-us	However, to reduce COVID-19 illness and death, near-term readiness planning must embrace the large-scale implementation of high-quality, non-pharmaceutical public health measures. 

zh-cn	而充分落实这些措施就需要：快速发现并隔离病例，严格实施密切接触者追踪、医学观察和隔离，以及相关人群和社区的直接参与。 
en-us	These measures must fully incorporate immediate case detection and isolation, rigorous close contact tracing and monitoring/quarantine, and direct population/community engagement. 

zh-cn	中国及全球各国都在开展大量新冠肺炎研究，相关科研项目和产品研发工作也正在进行，这值得鼓励和支持。
en-us	A huge array of COVID-19 studies, scientific research projects and product R&D efforts are ongoing in China and globally. This is essential and to be encouraged and supported. 

zh-cn	但是，大量的研究项目需要优化，否则将有可能消耗研究者的精力和资源，而优化能够将研究成果时间表缩短宝贵的几周或几个月。
en-us	However, such a large number of projects and products needs to be prioritized. Without prioritizing, this risks compromising the concentration of attention and resources and collaboration required to cut timelines by precious weeks and months. 

zh-cn	新冠肺炎防控的紧迫形势要求必须优先开展诊断，治疗和疫苗领域的研究工作。 
en-us	While progress has been made, the urgency of the COVID-19 situation supports an even more ruthless prioritization of research in the areas of diagnostics, therapeutics and vaccines. 

zh-cn	同样，关于新型冠状病毒的起源、疾病自然史以及病毒传播动力学方面的研究选题巳经很多。
en-us	Similarly, there is a long list of proposed studies on the origins of COVID-19, the natural history of the disease, and the virus's transmission dynamics. 

zh-cn	然而，政策决策者很难在处置疫情和挽救生命的紧迫性与众多研究中取得适当的平衡。
en-us	However, the urgency of responding to cases and saving lives makes it difficult for policy makers to consider and act on such comprehensive lists. This can be addressed by balancing studies with the immediate public health and clinical needs of the response. 

zh-cn	因此，应当优先选择保障与关键知识局限性相关的研究项目，而弥补这样的知识差距可以迅速对处置疫情产生很大的直接影响。
en-us	Studies can be prioritized in terms of the largest knowledge gaps that can be most rapidly addressed to have greatest immediate impact on response operations and patient management. 

zh-cn	建议优先开展家庭、机构和社区内聚集性传播危险因素研究，基于巳有的呼吸系统疾病监测系统的人群新冠肺炎抽样监测，不同年龄人群血清流行病学调查，临床病例系列分析以及聚集性病例调查等。 
en-us	This suggests prioritizing studies to identify risk factors for transmission in households, institutions and the community; convenience sampling for this virus in the population using existing surveillance systems; age-stratified sero-epidemiologic surveys; the analysis of clinical case series; and cluster investigations. 

zh-cn	四、主要建议 
en-us	Major Recommendations 

zh-cn	(一）对中国的建议 
en-us	For China 

zh-cn	考虑经济活动恢复、旅行限制逐渐解除、学校重新开学带来新出现病例和聚集性病例的风险，应继续维持基于各地风险评估的程度适当的应急管理方案; 
en-us	Maintain an appropriate level of emergency management protocols, depending on the assessed risk in each area and recognizing the real risk of new cases and clusters of COVID-19 as economic activity resumes, movement restrictions are lifted, and schools reopen; 

zh-cn	密切监测，分阶段有序解除限制措施，先复工和返程、然后复学，直至最终取消其他限制措施； 
en-us	Carefully monitor the phased lifting of the current restrictions on movement and public gatherings, beginning with the return of workers and migrant labor, followed by the eventual reopening of schools and lifting other measures; 

zh-cn	进一步加强应急管理机制建设，协调公共卫生部门(如疾病预防控制中心)、医疗机构和社区联动机制，持续保持警惕，随时遏制疫情反弹； 
en-us	Further strengthen the readiness of emergency management mechanisms, public health institutions (e.g. CDCs), medical facilities, and community engagement mechanisms to ensure sustained capacity to immediately launch containment activities in response to any resurgence in cases; 

zh-cn	重点开展应急响应和风险管理决策相关研究，识别家庭、机构、医院和社区传播的危险因素，不同年龄人群血清流行病学调查，尽快在武汉开展新冠肺炎动物疫源综合性调查
en-us	Prioritize research that rapidly informs response and risk management decisions, particularly household and health care facility studies, age-stratified sero- epidemiologic surveys and rigorous investigation of the animal-human interface; 

zh-cn	开展集中研究项目，快速确定最有效的诊断和血清学检测方法，测试现有抗病毒药物和各类疫苗载体，中国应该参与多国试验项目； 
en-us	establish a centralized research program to fast-track the most promising rapid diagnostics and serologic assays, the testing of potential antivirals and vaccine candidates, and Chinese engagement in selected multi-country trials; and 

zh-cn	中国作为对新冠肺炎了解最多的国家，应持续系统的实时分享流行病学资料和临床结果与经验，帮助全球共同应对新冠肺炎疫情。 
en-us	As the country with the greatest knowledge on COVID-19, further enhance the systematic and real-time sharing of epidemiologic data, clinical results and experience to inform the global response. 

zh-cn	对有输入性新冠肺炎病例及/或新冠肺炎疫情暴发国家的建议 
en-us	For countries with imported cases and/or outbreaks of COVID-19 

zh-cn	立即启动最高级别国家应急处置方案，确保各级政府和全社会釆取所有必要的非药物性干预措施，阻断疫情传 
en-us	Immediately activate the highest level of national Response Management protocols to ensure the all-of-government and all-of-society approach needed to contain COVID-19 with non-pharmaceutical public health measures; 

zh-cn	优先进行彻底的病例筛查和检测，耐心细致做好接触者追踪调查，严格隔离密切接触者； 
en-us	Prioritize active, exhaustive case finding and immediate testing and isolation, painstaking contact tracing and rigorous quarantine of close contacts; 

zh-cn	大力开展疫情防治宣传，让公众充分认识到新冠肺炎疫情的严重性，并发挥公众力量，阻止疫情传播； 
en-us	Fully educate the general public on the seriousness of COVID-19 and their role in preventing its spread; 

zh-cn	制定多部门联合情景规划并模拟演练，根据需要釆取更严格的措施阻断传播链(例如暂停大型集会和关闭学校和工作场所)。 
en-us	Conduct multi-sector scenario planning and simulations for the deployment of even more stringent measures to interrupt transmission chains as needed (e.g. the suspension of large-scale gatherings and the closure of schools and workplaces). 

zh-cn	(三）对尚未受疫情影响国家的建议 
en-us	For uninfected countries 

zh-cn	做好随时启动最高级别应急响应机制的准备，动员各级政府和全社会共同应对可能暴发的新冠肺炎疫情； 
en-us	Prepare to immediately activate the highest level of emergency response mechanisms to trigger the all-of-government and all-of society approach that is essential for early containment of a COVID-19 outbreak; 

zh-cn	根据对釆用非药物性干预措施阻断新冠肺炎传播有效性最新认识，迅速调整国家应急处置方案
en-us	Rapidly test national preparedness plans in light of new knowledge on the effectiveness of non-pharmaceutical measures against COVID-19; 

zh-cn	将新冠肺炎快速检测、大规模病例隔离和呼吸机设备等救治能力、严格追踪和管理接触者纳入国家应急处置方案和能力建设当中； 
en-us	incorporate rapid detection, largescale case isolation and respiratory support capacities, and rigorous contact tracing and management in national COVID-19 readiness and response plans and capacities; 

zh-cn	立即加强对新冠肺炎的监测，快速检测对阻断传播至关重要
en-us	Immediately enhance surveillance for COVID-19 as rapid detection is crucial to containing spread; 

zh-cn	考虑对所有非典型的肺炎症状患者进行新冠肺炎病毒检测，并将新冠肺炎病毒检测纳入现有流感监测系统； 
en-us	consider testing all patients with atypical pneumonia for the COVID-19 virus, and adding testing for the virus to existing influenza surveillance systems; 

zh-cn	立即在所有医疗机构门急诊和发热门诊实施最为严格的防控措施，这些是新冠肺炎病例最有可能输入的区域； 
en-us	Begin now to enforce rigorous application of infection prevention and control measures in all healthcare facilities, especially in emergency departments and outpatient clinics, as this is where COVID-19 will enter the health system; and 

zh-cn	迅速评估公众对新冠肺炎的认知，并据此立即调整  
en-us	Rapidly assess the general population's understanding of COVID-19, adjust national health promotion materials and activities accordingly, and engage clinical champions to communicate with the media. 

zh-cn	(四）对公众的建议 
en-us	For the public 

zh-cn	认识到新冠肺炎是一种全新出现的令人关注的传染性疾病，但只要釆取正确的应对措施，疫情暴发就可以得到控制，患者大都能够康复； 
en-us	Recognize that COVID-19 is a new and concerning disease, but that outbreaks can managed with the right response and that the vast majority of infected people will recover; 

zh-cn	立即釆取并落实最为严格的预防措施，勤洗手，打喷嚏或咳嗽时掩住口鼻； 
en-us	Begin now to adopt and rigorously practice the most important preventive measures for COVID-19 by frequent hand washing and always covering your mouth and nose when sneezing or coughing; 

zh-cn	时时关注新冠肺炎及其体征和症状（如发热、干咳)的最新信息，各国会根据疫情发展不断调整应对策略； 
en-us	Continually update yourself on COVID-19 and its signs and symptoms (i.e. fever and dry cough), because the strategies and response activities will constantly improve as new information on this disease is accumulating every day; and 

zh-cn	人人做好准备，通过各种方式积极参与到疫情防控中来，严格保持“社交距离”，努力帮助老年人等高危人群。 
en-us	Be prepared to actively support a response to COVID-19 in a variety of ways, including the adoption of more stringent ‘social distancing' practices and helping the high-risk elderly population. 

zh-cn	(五）对国际社会的建议 
en-us	For the international community 

zh-cn	认识到各国之间真正的团结与合作对于解决新冠肺炎的共同威胁至关重要并落实这一原则； 
en-us	Recognize that true solidarity and collaboration is essential between nations to tackle the common threat that COVID-19 represents and operationalize this principle; 

zh-cn	根据《国际卫生条例》的要求迅速共享信息，包括输入病例的详细信息，促进各国追踪接触者并告知防控措施； 
en-us	Rapidly share information as required under the International Health Regulations (IHR) including detailed information about imported cases to facilitate contact tracing and inform containment measures that span countries; 

zh-cn	识别新冠肺炎感染的国家疫情快速变化的风险特征，持续监测疫情暴发趋势和控制能力，重新评估严重干扰国际旅行和贸易的其他卫生措施。  
en-us	Recognize the rapidly changing risk profile of COVID-19 affected countries and continually monitor outbreak trends and control capacities to reassess any ‘additional health measures' that significantly interfere with international travel and trade. 

zh-cn	附件3 详细的技术调查结果 
en-us	Detailed Technical Findings 

zh-cn	应急处置、病例和密切接触者管理、风险沟通与社区防控 
en-us	Response management, case and contact management, risk communication and community engagement  

zh-cn	中国应急体系基于现有的应急预案，在国家、省、市、县/区四级自上而下，迅速响应。 
en-us	The response structures in China were rapidly put in place according to existing emergency plans and aligned from the top to the bottom.This was replicated at the four levels of government (national provincial, prefecture and county/district). 

zh-cn	(一）组织结构与响应机制 
en-us	Organizational structure and response mechanism  

zh-cn	启动国家级响应:宣布新冠肺炎暴发之后，立即启动了国务院联防联控机制，下设综合组、疫情防控组、医疗救治组、科研攻关组、宣传组、外事组、医疗物资保障组、生活物资保障组、社会稳定组等9个工作组。
en-us	Response activation at the national level: COVID-19 prevention and control mechanisms were initiated immediately after the outbreak was declared and nine working groups were set up to coordinate the response: a) Coordination b) Epidemic prevention and control c) Medical treatment d) Research e) Public communication f) Foreign affairs g) Medical material support h) Life maintenance supplies and i) Social stability. 

zh-cn	各工作组组长由正部级领导担任，制、修订应急处置相关法律法规，指导应急处置工作。 
en-us	Each working group has a ministerial level leader. Emergency response laws and regulations for the emergency response to public health emergencies, prevention and control of infectious diseases have been developed or updated to guide the response. 

zh-cn	启动省级响应:每个省都建立了与国家类似的联防联控机制，国家、省、市、县/区和社区等多级联动。
en-us	Response activation in provinces: Each province set up a similar structure to manage the outbreak. The response is organized at the levels of national, provincial, prefecture, county/district and the community. 

zh-cn	截至1月29日，中国各省均启动突发公共卫生事件一级响应。 
en-us	By 29 January, all provinces across China had launched the highest level of response for major public health emergencies. 

zh-cn	(二）应对策略 
en-us	Response Strategy  

zh-cn	中国政府制定了明确的战略和目标，在整个响应体系内进行贯彻实施。
en-us	A clear strategy was developed, and goals were well articulated and communicated across the entire response architecture. 

zh-cn	并在应对过程中，根据全国不同地区疫情形势和各地区特点，迅速进行适应和调整。 
en-us	This strategy was rapidly adapted and adjusted to the outbreak, both in terms of the epidemiological situation over time and in different parts of the country. 

zh-cn	根据疫情形势将各地分为四类地区： 
en-us	The epidemiological situation has been used to define location into four areas: 

zh-cn	无病例地区的防控原则是“严防输入”。
en-us	In areas without cases, the strategy in these areas is to "strictly prevent introduction". 

zh-cn	包括交通枢纽隔离检疫，体温监测，加强预检分诊，启用发热门诊，确保经济社会正常运转。 
en-us	This includes quarantine arrangements in transportation hubs, monitoring for temperature changes, strengthening of triage arrangements, use of fever clinics, and ensuring normal economic and social operations. 

zh-cn	出现散发病例地区的防控原则是“减少输入、阻断传播，提供适当治疗”。 
en-us	In areas with sporadic cases, the strategy is focused on "reducing importation, stopping transmission and providing appropriate treatment". 

zh-cn	出现社区聚集性病例地区的防控原则是“阻断传播，严防输出，加强治疗”。 
en-us	In areas with community clusters, the strategy is focussed on "stopping transmission, preventing exportation, and strengthening treatment". 

zh-cn	发生社区传播地区实施最严格的防控措施，禁止人员流入、流出，全面加强公共卫生和医疗救治措施。 
en-us	In areas with community transmission, the strictest prevention and control strategies are being implemented, the entry and exit of people from these areas has been stopped and public health and medical treatment measures are comprehensively strengthened. 

zh-cn	(三）中国实施的主要防控措施 
en-us	Main control measures implemented in China 

zh-cn	中国实施的主要控制措施如图6A至6D所示，分别代表国家、省级和市级的应对措施。 
en-us	The main control measures implemented in China are as follows and are illustrated in Figures 6A-6D, representing the national level response and examples of the response at the Provincial and municipal levels: 

zh-cn	监测与报告：1月20日，新冠肺炎被纳入法定报告传染病，发布诊断、监测和报告的方案。 
en-us	Monitoring and reporting: COVID-19 was included in the statutory reporting of infectious diseases on 20 January and plans were formulated to strengthen diagnosis, monitoring, and reporting. 

zh-cn	加强口岸检疫:海关启动全国口岸突发公共卫生事件应急预案，重新启动出入境健康申报卡制度，严格开展出入境旅客体温监测。 
en-us	Strengthening ports of entry and quarantine: The Customs Department launched the emergency plan for public health emergencies at ports across the country and restarted the health declaration card system for entry and exit into cities as well as strict monitoring of the temperature of entry and exit passengers. 

zh-cn	加强治疗:对重症和危重症患者实施“四集中”原则：集中患者、集中专家、集中资源、集中救治。
en-us	Treatment: For severe or critical patients, the principle of "Four Concentrations" was implemented: i.e. concentrating patients, medical experts, resources and treatment into special centres. 

zh-cn	各市县对相关医院进行改造，增加定点医院数量，派遣医务人员，成立专家组进行会诊，将重症患者的死亡率降到最低。
en-us	All cities and districts transformed relevant hospitals, increased the number of designated hospitals, dispatched medical staff, and set up expert groups for consultation, so as to minimise mortality of severe patients. 

zh-cn	调动全国各地的医疗资源，支持救治武汉的患者。 
en-us	Medical resources from all over China have been mobilized to support the medical treatment of patients in Wuhan. 

zh-cn	流行病学调查与密切接触者管理:对确诊病例、聚集性病例和密切接触者开展详细流行病学调查，查明传染染源，并实施密切接触者追踪等有针对性的防控措施。 
en-us	Epidemiological investigation and close contact management: Strong epidemiological investigations are being carried out for cases, clusters, and contacts to identify the source of infection and implement targeted control measures, such as contact tracing. 

zh-cn	减少公共活动，增加社交距离：国家层面：国务院延长2020年春节假期，全国各地取消或暂停体育赛事、影剧院等各项活动，全国各地推迟开学，企事业单位错开复工时间。
en-us	Social distancing: At the national level, the State Council extended the Spring Festival holiday in 2020, all parts of the country actively cancelled or suspended activities like sport events, cinema, theatre, and schools and colleges in all parts of the country postponed re¬opening after the holiday. Enterprises and institutions have staggered their return to work. 

zh-cn	交通部门在高速公路服务区及车站出入口设置数万个卫生检疫站。
en-us	Transportation Departments setup thousands of health and quarantine stations in national service areas, and in entrances and exits for passengers at stations. 

zh-cn	湖北省釆取了最严格的交通管控措施，如暂停城市公共交通，包括地铁、轮渡和长途客运。
en-us	Hubei Province adopted the most stringent traffic control measures, such as suspension of urban public transport, including subway, ferry and long-distance passenger transport. 

zh-cn	所有人在公共场合都必须戴口罩，遵守居家规定。
en-us	Every citizen has to wear a mask in public. Home support mechanisms were established. 

zh-cn	以上措施大大减少了公共活动。 
en-us	As a consequence of all of these measures, public life is very reduced. 

zh-cn	资金与物资保障:医保支付救治费用，稳定医疗物资供应和价格，减轻群众个人负担，为受影响群众提供个人防护用品和基本生活物资。 
en-us	Funding and material support: Payment of health insurance was taken over by the state, as well as the work to improve accessibility and affordability of medical materials, provide personal protection materials, and ensure basic living materials for affected people. 

zh-cn	应急物资保障：政府号召恢复生产，组织巳开工重点企业扩大产能，支持地方企业扩大进口，利用跨境电商平台和企业助力医疗物资进口，提升物资保障能力。 
en-us	Emergency material support: The government restored production and expanded production capacity, organized key enterprises that have already started to exceed current production capacity, supported local enterprises to expand imports, and used cross-border e-commerce platforms and enterprises to help import medical materials and improve the ability to guarantee supplies. 

zh-cn	(四）风险沟通（信息发布、公众和媒体沟通） 
en-us	Risk communications (information release, public and media communications)  

zh-cn	开展国际及区域间合作、信息共享：从1月3日起，每天向世界卫生组织通报疫情信息。
en-us	International and interregional cooperation and information sharing: From 3 January 2020, information on COVID-19 cases has been reported to WHO daily. 

zh-cn	1月7日确认病原体后，第一时间与世界卫生组织和国际社会共享了全部基因序列。 
en-us	Full genome sequences of the new virus were shared with WHO and the international community immediately after the pathogen was identified on 7 January. 

zh-cn	1月13—14日，港澳台地区专家组赴武汉实地考察。
en-us	From 13 to 14 January, a group of technical experts from Hong Kong SAR, Macao SAR and Taiwan, China visited Wuhan. 

zh-cn	1月20—21日，世界卫生组织专家组应邀赴武汉实地考察。
en-us	From 20-21 January, a World Health Organization team visited Wuhan. 

zh-cn	1月21日，公布新型冠状病毒核酸检测引物和探针序列。 
en-us	A set of nucleic acid primers and probes for PCR detection for COVID-19 was released on 21 January. 

zh-cn	每日更新信息:国家卫生健康委员会每天公布疫情信息并举行新闻发布会。
en-us	Daily updates: The National Health Commission announces the epidemic situation every day and holds daily press conferences to respond to emerging issues. 

zh-cn	政府经常性邀请专家分享新冠肺炎相关科学知识，回应公众关切。 
en-us	The government also frequently invites experts to share scientific knowledge on COVID-19 and to address public concerns. 

zh-cn	心理疏导:向患者和公众提供心理疏导服务。
en-us	psychological care: This is provided to patients and the public. 

zh-cn	各级政府、非政府组织和社会各界编写紧急心理危机干预指导原则和公众心理自助与疏导辅导指南
en-us	Governments at all levels, NGOs and all sectors of society developed guidelines for emergency psychological crisis intervention and guidelines for public psychological self-support and counselling. 

zh-cn	开设心理健康服务热线。 
en-us	A hotline for mental health services has been established for the public. 

zh-cn	信息平台：中国利用信息技术、大数据和人工智能等手段，做好新冠肺炎疫情应对准备工作。
en-us	IT platform: China has capitalized on the use of technology, big data and AI for COVID-19 preparedness, readiness and response. 

zh-cn	发布权威可靠的信息和诊疗指南、提供在线诊疗服务、提供网络教学工具，开发并在全国范围使用远程办公工具。
en-us	Authoritative and reliable information, medical guidance, access to online services, provision of educational tools and remote work tools have been developed in and used across China. 

zh-cn	这些服务提高了医疗卫生资源的可及性，减少信息误报，最大限度减少虚假信息的影响。 
en-us	These services have increased accessibility to health services, reduced misinformation and minimized the impact of fake news. 

zh-cn	(五）社会动员与社区参与 
en-us	Social mobilization and community engagement  

zh-cn	动员社会组织（社区工作站和卫生服务中心）参与疫情防控工作。
en-us	Civil society organizations (community centers and public health centers) have been mobilized to support prevention and response activities. 

zh-cn	大多数社区能落实防控措施，全面配合和落实居民自我隔离和市民遵守管理措施的监督工作。
en-us	The community has largely accepted the prevention and control measures and is fully participating in the management of self-isolation and enhancement of public compliance. 

zh-cn	组织社区志愿者，为居民自我隔离提供支持，帮助居家隔离的群众解决实际生活困难。
en-us	Community volunteers are organized to support self-isolation and help isolated residents at home to solve practical life difficulties. 

zh-cn	实施以家庭为基础的管理措施，限制人口流动。
en-us	Measures were taken to limit the movement of the population through home- based support. 

zh-cn	目前，湖北以外，全国巳有30个省对来自武汉的500多万人口进行了登记管理。 
en-us	Up to now, outside of Hubei, 30 provinces have registered and managed more than 5 million people coming from Wuhan. 

zh-cn	二、临床病例处置与感染控制  
en-us	Clinical case management and infection prevention and control  

zh-cn	新冠肺炎的主要体征和症状包括发热、干咳、乏力、咳痰、气短、肌痛或关节痛、咽痛和头痛。
en-us	The main signs and symptoms of COVID-19 include fever, dry cough, fatigue, sputum production, shortness of breath, myalgia or arthralgia, sore throat, and headache. 

zh-cn	一小部分患者(5%)报告恶心或呕吐。
en-us	Nausea or vomiting has been reported in a small percentage of patients (5%). 

zh-cn	2月14日，中国疾病预防控制中心介绍了44672例实验室确诊病例的临床特征、结果、实验室和影像学检查结果。
en-us	On 14 February, China CDC described the clinical features, outcomes, laboratory and radiologic findings of 44 672 laboratory-confirmed cases. 

zh-cn	其中只有965名患者(2.2%)年龄在20岁以下，该年龄段只有1人死亡(0.1%)。
en-us	Only 965 (2.2%) were under 20 years of age and there is just one recorded death (0.1%) in this age group. 

zh-cn	大部分患者(77.8%)年龄在30至69岁之间。
en-us	Most patients (77.8%) were aged 30 to 69 years. 

zh-cn	80岁以上患者的病死率为14.8%。
en-us	Patients aged over 80 years had a CFR of 14.8%. 

zh-cn	心血管疾病、糖尿病、慢性呼吸道疾病、高血压和癌症患者的病死率最高。 
en-us	The CFR was highest in those with comorbidities including cardiovascular, diabetes, chronic respiratory disease, hypertension and cancer. 

zh-cn	与H1N1不同的是，孕妇成为重症患者的风险似乎并不高。
en-us	As opposed to Influenza A(H1N1)pdm09, pregnant women do not appear to be at higher risk of severe disease. 

zh-cn	在对147名孕妇(64名确诊，82名疑似，1名无症状)的调查中，8%的孕妇属于重症，1%的孕妇为危重症。 
en-us	In an investigation of 147 pregnant women (64 confirmed, 82 suspected and 1 asymptomatic), 8% had severe disease and 1% were critical. 

zh-cn	重症患者的定义为静息时气促>=30次呼吸/分钟)或氧饱和度<=93%或动脉血氧分压（PaO2)/吸氧浓度（FiO2)< 300mmHg，
en-us	Severe cases are defined as tachypnoea (>=30 breaths/ min) or oxygen saturation <=93% at rest, or PaO2/FIO2 <300 mmHg. 

zh-cn	危重患者的定义为呼吸衰竭，需要机械通气、休克或其他器官衰竭，需要重症监护治疗。
en-us	Critical cases are defined as respiratory failure requiring mechanical ventilation, shock or other organ failure that requires intensive care. 

zh-cn	其中大约四分之一的重症和危重症患者需要机械通气，剩余75%的仅需要氧气支持。 
en-us	About a quarter of severe and critical cases require mechanical ventilation while the remaining 75% require only oxygen supplementation. 

zh-cn	中国实行早发现、早隔离、早诊断、早治疗的“四早”防疫工作原则。
en-us	China has a principle of early identification, early isolation, early diagnosis and early treatment. 

zh-cn	尽早识别疑似病例对防控工作至关重要，可在机构、社区、交通场站(机场、火车站)、特别是医院的入口进行体温筛查和问询。
en-us	Early identification of suspect cases is critical to containment efforts and occurs via a process of temperature screening and questioning at entrances to many institutions, communities, travel venues (airports, train stations) and hospitals. 

zh-cn	SARS暴发以来，不少医院设有发热门诊。
en-us	Many hospitals have fever clinics that were established and maintained since the SARS outbreak. 

zh-cn	根据早期的病例定义，进行实验室检测的疑似病例需要有与湖北或其他确诊病例的流行病学暴露史。
en-us	In China, laboratory tests were originally requested according to the case definitions, which included an epidemiological link to Hubei or other confirmed cases. 

zh-cn	然而，最近实行的临床诊疗方案，允许临床医生以较低的怀疑指数进行测试。 
en-us	However, more recently, a more liberal clinical testing regimen allows clinicians to test with a low index of suspicion. 

zh-cn	疑似病例在常压单人间隔离，戴外科口罩(用于源头控制)。
en-us	Suspect cases are isolated in normal pressure single rooms, wear a surgical mask (for source control). 

zh-cn	工作人员须戴帽子、护目镜、N95口罩、防护服及手套(一次性)。
en-us	Staff in China wear a cap, eye protection, n95 masks, gown and gloves (single use only). 

zh-cn	在武汉，大多数疑似病例需集中在常压隔离病房。
en-us	In Wuhan it is necessary for most suspects to be cohorted in a normal pressure isolation ward. 

zh-cn	工作人员持续穿着个人防护用品，只在离开病房时更换。 
en-us	Staff wear PPE continuously, changing it only when they leave the ward. 

zh-cn	PCR检测当天出结果。
en-us	PcR test results are returned the same day. 

zh-cn	如果呈阳性，患者将被送往定点医院(一些城市釆用负压救护车转运)。
en-us	If positive, patients are transported to designated hospitals (including negative pressure ambulances in some cities). 

zh-cn	所有检测结果呈阳性的患者都被收治，包括轻症和无症状感染者。
en-us	All patients, including the mild and asymptomatic, with a positive test are admitted. 

zh-cn	每个地区/县至少战略性的指定一家定点医院，名单向社会公开。
en-us	The designated hospitals are known and are strategically placed with at least one per district/county. 

zh-cn	阳性病例按性别分室居住。
en-us	Positive cases are cohorted by gender. 

zh-cn	阴性患者根据临床需要进行管理。
en-us	Negative tested patients are managed based on clinical needs. 

zh-cn	所有患者都进行了呼吸道病毒多重PCR核酸检测以确定其他诊断。
en-us	All patients are evaluated with a respiratory multiplex to look for other diagnoses. 

zh-cn	此法可以提高新冠肺炎检测阴性患者排除新冠肺炎感染的可靠性。 
en-us	This can add to the reassurance that a negative COVID-19 test reflects a lack of infection with COVID-19. 

zh-cn	武汉市共有45家定点医院，其中6家收治危重患者，39家收治重症患者和年龄大于65岁以上患者。
en-us	In Wuhan, there are 45 designated hospitals, 6 of which are designated for critical patients, and 39 for severe patients and/or any patients >65 years old. 

zh-cn	另外还有10家由体育馆和展览中心改建的临时医院，专门收治轻症患者。
en-us	There are an additional 10 temporary hospitals reconstructed from gymnasium and exhibition centers, which are for mild patients. 

zh-cn	在武汉釆取的其他快速床位扩增措施包括新建2所临时医院，拥有2600张床位，以及许多临时征用医院，以增加床位容量。
en-us	Other surge measures undertaken in Wuhan include two new temporary hospitals with 2600 beds, plus many makeshift hospitals to increase bed capacity. 

zh-cn	武汉的床位容量巳增加到5万张。 
en-us	Bed capacity within Wuhan has increased to >50,000. 

zh-cn	按照国家卫健委发布的新冠肺炎诊疗方案(第六版)治疗患者。
en-us	Patients are treated according to the National clinical guidelines (edition 6) released by the China National Health Commission (NHC). 

zh-cn	目前，尚无经过证实的特异性抗病毒或免疫调节药物可改善预后。
en-us	There are no specific antiviral or immune modulating agents proven (or recommended) to improve outcomes. 

zh-cn	所有患者均接受常规脉搏血氧饱和度监测。
en-us	All patients are monitored by regular pulse oximetry. 

zh-cn	诊疗方案内容包括按临床严重程度(轻症、普通型、重症和危重型)釆取支持治疗，以及试验性治疗如磷酸氯喹、洛匹那韦/利托那韦、α干扰素、利巴韦林、阿比多尔等。
en-us	The guidelines include supportive care by clinical category (mild, moderate, severe and critical), as well as the role of investigational treatments such as chloroquine, phosphate, lopinavir/ritonavir, alpha interferon, ribavirin, arbidol. 

zh-cn	对危重患者应用插管/无创通气和ECMO可以提高其生存率。
en-us	The application of intubation/invasive ventilation and ECMO in critically ill patients can improve survival. 

zh-cn	联合考察组成员在一家医院了解到，4例患者使用ECMO，其中1例死亡，3例病情似乎有所好转。
en-us	The Joint Mission Team was told of ECMO use in four patients at one hospital with one death and three who appeared to be improving. 

zh-cn	显然，ECMO非常消耗医疗资源，卫生系统需要仔细权衡利弊。
en-us	Clearly, though ECMO is very resource consumptive, any health system would need to carefully weigh the benefits. 

zh-cn	目前广泛使用中药治疗，对其疗效必须进行充分评估。 
en-us	There is widespread use of Traditional Chinese Medicines (TCM), for which the affects must be fully evaluated. 

zh-cn	新冠肺炎患者不允许探视。
en-us	Patients with COVID-19 are not permitted visitors. 

zh-cn	工作人员穿戴连体工作服、面罩、护目镜、手套，仅在离开病房时脱下防护用品。 
en-us	Staff use coveralls, masks, eye cover, and gloves, removing PPE only when they leave the ward. 

zh-cn	患者在临床康复后出院标准包括无发热>3天、症状消失且影像学表现明显改善，间隔24小时分别釆样进行两次 PCR核酸检测均为阴性。
en-us	Patients are discharged after clinical recovery (afebrile >3 days, resolution of symptoms and radiologic improvement) and 2 negative PCR tests taken 24 hours apart. 

zh-cn	出院患者应尽量减少与家人和社会的接触并佩戴口罩。
en-us	Upon discharge, they are asked to minimise family and social contact and to wear a mask. 

zh-cn	新药临床试验结果有望在几周内发布，为治疗带来更多的可能。 
en-us	There are expectations of clinical trial results within a matter of weeks, which will see further opportunities for treatment. 

zh-cn	中国针对养老院专门制定了养老院新冠肺炎防护指南，防止新冠肺炎传入养老院。 
en-us	There are guidelines for elderly care specifically targeting prevention in individuals and introduction of COVID-19 to nursing homes. 

zh-cn	通过电视会议在全国开展大范围培训，指导实践及使用个人防护用品。
en-us	Training programmes by video conference nationally are scaled up to inform staff of best practice and to ensure PPE usage. 

zh-cn	专家组专家负责传播知识和提供本地的经验。 
en-us	Clinical champions are created to disperse knowledge and provide local expertise. 

zh-cn	其他正常医疗活动由医院划分区域开展，如医疗机构设置分为清洁/污染区域等。 
en-us	Maintenance of usual healthcare activities is maintained by hospital zoning (e.g. clean/contaminated sections of the healthcare facility). 

zh-cn	三、实验室检验、诊断与病毒学 
en-us	Laboratory, diagnostics and virology  

zh-cn	1月7日，首次从临床样本中分离获得新冠肺炎病毒。
en-us	The virus found to cause COVID-19 was initially isolated from a clinical sample on 7 January. 

zh-cn	值得注意的是，在确定病毒病原后的1-2周内，即开发并部署了一系列可靠敏感的诊断工具。
en-us	It is notable that within weeks following the identification of the virus, a series of reliable and sensitive diagnostic tools were developed and deployed. 

zh-cn	1月16日，第一批新冠肺炎实时荧光RT-PCR试剂发往湖北。
en-us	On 16 January, the first RT- PCR assays for COVID-19 were distributed to Hubei. 

zh-cn	1月19日实时荧光 RT-PCR试剂盒发往中国大陆所有省份，且提供给香港特别行政区和澳门特别行政区。
en-us	Real-time PCR kits were distributed to all the provinces on 19 January and were provided to Hong Kong SAR and Macao SAR on 21 January. 

zh-cn	中国于1月12日与世界卫生组织和国际社会共享了病毒全基因组序列，PCR引物和探针的信息
en-us	Information regarding viral sequences and PCR primers and probes was shared with WHO and the international community by China CDC on 12 January 2020. 

zh-cn	为了促进相关的产品开发和新病毒研究，将新冠肺炎病毒序列信息上传到GISAID数据库。 
en-us	To facilitate product development and research on the new virus, COVID-19 virus sequences were uploaded to the GISAID Database by China. 

zh-cn	截至2月23日，国家药品监督管理局共审批10个种类的新冠肺炎检测试剂盒，包括6个RT-PCR试剂盒，1个恒温扩增芯片法核酸检测试剂、1个测序产品和2个胶体金抗体检测试剂盒。
en-us	By 23 February, there were 10 kits for detection of COVID-19 approved in China by the NMPA, including 6 RT-PCR kits, 1 isothermal amplification kit, 1 virus sequencing product and 2 colloidal gold antibody detection kits. 

zh-cn	其他一些检测试剂也巳进入应急审批程序。
en-us	Several other tests are entered in the emergency approval procedure. 

zh-cn	现有至少6家本土 PCR检测试剂盒生产商，每周可生产并发放多达165万人份的检测试剂。 
en-us	Currently, there are at least 6 local producers of PCR test kits approved by NMPA. Overall, producers have the capacity to produce and distribute as many as 1,650,000 tests/week. 

zh-cn	同时釆集上呼吸道（鼻咽部和咽部）和下呼吸道（深咳痰液、呼吸道吸出物和支气管肺泡灌洗）样本进行新冠病毒 PCR检测。 
en-us	Specimens from both the upper respiratory tract (URT; nasopharyngeal and oropharyngeal) and lower respiratory tract (LRT; expectorated sputum, endotracheal aspirate, or bronchoalveolar lavage) are collected for COVID-19 testing by PCR. 

zh-cn	呼吸道、粪便及血液样本中巳检出新冠肺炎病毒。
en-us	COVID-19 virus has been detected in respiratory, fecal and blood specimens. 

zh-cn	根据广州疾控中心原始数据，截至2月20日，新冠病毒可在症状出现前1-2日在上呼吸道首次检测到，在普通型患者中可持续7-12日，在重症患者中持续时间达2周。
en-us	According to preliminary data from Guangzhou CDC as of 20 February, virus can initially be detected in upper respiratory samples 1-2 days prior to symptom onset and persist for 7-12 days in moderate cases and up to 2 weeks in severe cases. 

zh-cn	约有30%的普通型患者在症状出现后第5日起，直至4-5周可在粪便中检测到病毒RNA。
en-us	Viral RNA has been detected in feces in up to 30% of patients from day 5 following onset of symptoms and has been noted for up to 4-5 weeks in moderate cases. 

zh-cn	然而，尚不清楚是否与病毒的传染性存在关联。
en-us	However, it is not clear whether this correlates with the presence of infectious virus. 

zh-cn	同时，一些患者的粪便中也培养出活病毒，但其在粪-口传播中的作用尚不甚明确。 
en-us	While live virus has been cultured from stool in some cases, the role of fecal-oral transmission is not yet well understood. 

zh-cn	临床样本通过人呼吸道上皮细胞、Vero E6和Huh-7细胞系分离出新冠病毒。 
en-us	COVID-19 has been isolated from the clinical specimens using human airway epithelial cells, Vero E6 and Huh-7 cell lines. 

zh-cn	血清学诊断试剂正处于快速开发中，但尚未广泛应用。
en-us	Serological diagnostics are rapidly being developed but are not yet widely used. 

zh-cn	联合考察组成员在中国疾病预防控制中心和广州再生医学与健康广东实验室会见了当地的研究团队
en-us	Joint Mission members met with local research teams at the China CDC, Guangzhou Regenerative Medicine and Health Guangdong Laboratory. 

zh-cn	当地的研究团队向联合考察组报告了免疫组化及化学发光法的新冠病毒IgM、 IgG和IgM+IgG快速检测研究进展。
en-us	The teams reported on the development of tests for IgM, IgG and IgM+IgG using rapid test platforms utilizing chemiluminiscence. 

zh-cn	ELISA检测试剂正在开发中。 
en-us	ELISA assays are also under development. 

zh-cn	四、研发 
en-us	Research & Development  

zh-cn	中国政府启动了病毒基因组学、抗病毒药物、中药、临床试验、疫苗、诊断和动物模型等一系列重大应急研究项目。
en-us	The government of China has initiated a series of major emergency research programs on virus genomics, antivirals, traditional Chinese medicines, clinical trials, vaccines, diagnostics and animal models. 

zh-cn	研究涵盖基础研究和人体试验研究。
en-us	Research includes fundamental basic research and human subjects research. 

zh-cn	就本报告的目的而言，研究仅限于涉及伦理审查委员会批准并知情同意的研究。
en-us	For the purpose of this report, human studies are limited to those involving IRB approval and informed consent. 

zh-cn	其他类型的受试者调查放在本报告的流行病学部分。
en-us	Other forms of human subjects investigations are included in the sections on epidemiology in this report. 

zh-cn	在疫情暴发的背景下进行的重点明确、结果可期的研究，通过确定预防、诊断和治疗疾病的最有效方法，有可能挽救许多生命。 
en-us	Well-focused, robust research conducted in the setting of an outbreak has the potential of saving many lives by identifying the most effective ways to prevent, diagnose and treat disease. 

zh-cn	由于新冠病毒与蝙蝠SARS样冠状病毒和穿山甲SARS 样冠状病毒的基因组同源性分别为96%和86%-92%，因此蝙蝠很可能是COVID-19的动物源头。
en-us	Since the COVID-19 virus has a genome identity of 96% to a bat SARS-like coronavirus and 86%-92% to a pangolin SARS-like coronavirus, an animal source for COVID-19 is highly likely. 

zh-cn	从武汉华南海鲜市场釆集的大量RT-PCR阳性环境样本证实了这一点。 
en-us	This was corroborated by the high number of RT-PCR positive environmental samples taken from the Huanan Seafood Market in Wuhan. 

zh-cn	至少有8种直接检测COVID-19核酸的试剂盒和2种胶体金抗体检测试剂盒在中国获得了国家药品监督管理局(NMPA)的批准。
en-us	At least 8 nucleic acid-based methods for direct detection of COVID-19 and two colloidal gold antibody detection kits have been approved in China by the NMPA. 

zh-cn	其他一些检测试剂盒也即将获批。
en-us	Several other tests are close to approval. 

zh-cn	重要的是要比较这些巳批准的试剂盒和未来的血清学方法的敏感性和特异性。
en-us	It will be important to compare the sensitivities and specificities of these and future serologic tests. 

zh-cn	如果可以将快速和准确的检测方法整合至目前市面上可及的多重呼吸道病毒检测中，将对开发目前在现场环境中表现较好的快速准确床边检测方法尤其有益。
en-us	Development of rapid and accurate point-of-care tests which perform well in field settings are especially useful if the test can be incorporated into presently commercially available multiplex respiratory virus panels. 

zh-cn	这将极大改善感染病人的早期识别与隔离，并扩大密切接触者的识别。
en-us	This would markedly improve early detection and isolation of infected patients and, by extension, identification of contacts. 

zh-cn	快速IgM和IgG抗体检测对促进早期诊断同样重要。
en-us	Rapid IgM and IgG antibody testing are also important ways to facilitate early diagnosis. 

zh-cn	标准血清学检测可用于血清学调查背景下的回顾性诊断，有助于更好的了解COVID-19感染的全疾病谱。 
en-us	Standard serologic testing can be used for retrospective diagnoses in the context of serosurveys that help better understand the full spectrum of COVID-19 infection. 

zh-cn	目前多种老药新用的药物和试验性药物巳经被鉴定出来。
en-us	A variety of repurposed drugs and investigational drugs have been identified. 

zh-cn	通过筛选国家药品监督管理局（NMPA)批准的药物名录及其他化学库也发现了多种新型药剂。
en-us	Screening NMPA approved drug libraries and other chemical libraries have identified novel agents. 

zh-cn	数以百计的临床实验包括瑞德西韦、磷酸氯喹、法匹拉韦、恢复期血浆、中医药以及其他干预措施等正在实施或者在计划中。
en-us	Hundreds of clinical trials involving remdesivir, chloroquine, favipiravir, chloroquine, convalescent plasma, TCM and other interventions are planned or underway. 

zh-cn	快速完成这些研究中最重要的部分对于确定真正有效的治疗方法至关重要。
en-us	Rapid completion of the most important of these studies is critical to identifying truly effective therapies. 

zh-cn	然而，研究的评价工作需要有充足的人力、随机、对照试验以及符合实际的、科学的操作标准以及适当的患者分层。
en-us	However, evaluation of investigational agents requires adequately powered, randomized, controlled trials with realistic eligibility criteria and appropriate stratification of patients. 

zh-cn	中国与其他地区开展相应的合作研究同样重要。 
en-us	It is important for there to be a degree of coordination between those conducting studies within and beyond China. 

zh-cn	开发安全有效的呼吸道病毒疫苗是防治该病的重要手段。
en-us	The development of a safe and effective vaccine for this highly communicable respiratory virus is an important epidemic control measure. 

zh-cn	重组蛋白、mRNA、DNA、灭活全病毒和重组腺病毒疫苗目前正在研制中，一些疫苗巳进入动物实验阶段。
en-us	Recombinant protein, mRNA, DNA, inactivated whole virus and recombinant adenovirus vaccines are being developed and some are now entering animal studies. 

zh-cn	鉴于以往曾有灭活全病毒麻疹疫苗导致疾病严重效应以及SARS样冠状病毒疫苗在动物实验的类似报道，疫苗的安全性是冠状病毒感染研究的首要考虑。
en-us	Vaccine safety is of prime concern in the area of coronavirus infection in view of the past experience of disease enhancement by inactivated whole virus measles vaccine and similar reports in animal experiments with SARS coronavirus vaccines. 

zh-cn	这些候选疫苗快速进入适当的临床试验也尤为重要。 
en-us	It will be important that these vaccine candidates rapidly move into appropriate clinical trials. 

zh-cn	研究病毒传播途径、发病机制、抗病毒治疗、疫苗和免疫应答的理想动物模型尚未找到。
en-us	The ideal animal model for studying routes of virus transmission, pathogenesis, antiviral therapy, vaccine and immune responses has yet to be found. 

zh-cn	转人ACE2基因小鼠模型和恒河猴模型巳在实验室中得到应用。
en-us	The ACE2 transgenic mouse model and Macaca Rhesus model are already used in research laboratories. 

zh-cn	系统地阐述哪些动物模型能够更加准确地模拟人类感染尤为重要。 
en-us	Systematically addressing which models can accurately mimic human infection is required. 

zh-cn	口罩、手部卫生用品和其他个人防护用品在全球的需求量激增。
en-us	There is a global rush for masks, hand hygiene products and other personal protective equipment. 

zh-cn	口罩、手卫生和减少公共活动等非药物措施需进一步研究量化其作用。 
en-us	The relative importance of non-pharmaceutical control measures including masks, hand hygiene, and social distancing require further research to quantify their impact. 

zh-cn	COVID-19在家庭内传播有不同的传播模式。
en-us	There are distinct patterns of intra-familial transmission of COVID-19. 

zh-cn	目前尚不清楚是否有遗传因素在内的宿主因素影响易感性或疾病进程。
en-us	It is unclear whether or not there are host factors, including genetic factors, that influence susceptibility or disease course. 

zh-cn	COVID-19有多种临床病程，对病程的精确描述难以实现。
en-us	COVID-19 has a varied clinical course and a precise description of that course is not available. 

zh-cn	此外，COVID-19的长期后果尚不清楚。
en-us	In addition, the long-term consequences of COVID-19 are unknown. 

zh-cn	对确诊时登记的COVID-19患者（与适当的对照组）进行观察性队列研究将有助于提供关于COVID-19临床、病毒学及免疫学特征的深入信息。
en-us	An observational cohort study of patients with COVID-19 enrolled from the time of diagnosis (with appropriate controls) could provide in-depth information about clinical, virologic and immunologic characteristics of COVID-19. 

zh-cn	表1总结了优先研究领域的直接目标和长期目标。 
en-us	Table 1 summarizes priority research areas with immediate to longer term goals. 

zh-cn	附件4 现有知识局限 
en-us	Knowledge Gaps 

zh-cn	现有知识局限和防控策略关键问题包括： 
en-us	Knowledge gaps and key questions to be answered to guide control strategies include: 

zh-cn	一、传染源 
en-us	Source of infection 

zh-cn	病毒的动物来源和天然宿主 
en-us	Animal origin and natural reservoir of the virus 

zh-cn	初始阶段的动物到人的感染过程 
en-us	Human-animal interface of the original event 

zh-cn	早期暴露史不详的病例 
en-us	Early cases whose exposure could not be identified 

zh-cn	二、致病机理与病毒毒力 
en-us	The pathogenesis and virulence evolution of the virus 

zh-cn	三、传播动力学 
en-us	Transmission dynamics 

zh-cn	传播模式 
en-us	Modes of Transmission:  

zh-cn	非医疗卫生环境中的气溶胶传播作用 
en-us	 Role of aerosol transmission in non-health care settings 

zh-cn	粪-口传播的作用 
en-us	Role of fecal-oral transmission 

zh-cn	疾病不同临床进程的不同类型标本的排毒情况（上、下呼吸道，唾液，粪便，尿液） 
en-us	Viral shedding in various periods of the clinical course in different biological samples (i.e. upper and lower respiratory tract, saliva, faeces, urine)  

zh-cn	发病前和无症状感染者 
en-us	Before symptom onset and among asymptomatic cases  

zh-cn	(2）症状期 
en-us	 During the symptomatic period  

zh-cn	(3）发病后/临床恢复期 
en-us	After the symptomatic period / during clinical recovery 

zh-cn	四、感染风险因素 
en-us	Risk factors for infection 

zh-cn	行为与社会经济学危险因素 
en-us	Behavioral and socio-economic risk factors for infection in 

zh-cn	(1)家庭/机构 
en-us	Households / institutions  

zh-cn	(2）社区 
en-us	the Community 

zh-cn	无症状感染的危险因素 
en-us	Risk factors for asymptomatic infection 

zh-cn	院内感染的危险因素 
en-us	Risk factors for nosocomial infection  

zh-cn	医务人员之间 
en-us	among health care workers

zh-cn	患者之间 
en-us	 among patients 

zh-cn	五、监测与监控 
en-us	Surveillance and monitoring 

zh-cn	利用现有监测系统监控社区传播 
en-us	Monitoring community transmission through existing  

zh-cn	流感样病例监测系统 
en-us	ILI surveillance

zh-cn	严重急性呼吸道感染病例监测系统 
en-us	SARI surveillance 

zh-cn	暴发趋势与干预动态 
en-us	The outbreak trend and intervention dynamics  

zh-cn	流行各阶段的基本传播系数 
en-us	Basic reproduction numbers in various stages of the epidemic 

zh-cn	流行与季节性的关联 
en-us	The epidemic's relation to seasonality 

zh-cn	六、实验室检测与诊断 
en-us	Laboratory and diagnostics 

zh-cn	不同核酸试剂盒（PCR、NAATs和快速检测）、抗体和抗原检测方法的敏感性与特异性 
en-us	Sensitivity and specificity of different nucleic acid (PCR, NAATs and rapid tests), antibody and antigen tests 

zh-cn	感染后抗体滴度变化与保护期限 
en-us	Post-infection antibody titers and the duration of protection 

zh-cn	人群血清阳性水平 
en-us	Sero-prevalence among 

zh-cn	医务人员 
en-us	Health care workers 

zh-cn	—般人群 
en-us	General population 

zh-cn	儿童 
en-us	Children 

zh-cn	七、重症与危重症患者临床管理 
en-us	Clinical management of severe and critically ill patients 

zh-cn	体现体外膜肺氧合机（ECMO)在危重患者管理中的价值 
en-us	Value of ECMO in the management of critically ill patients 

zh-cn	机械通气在危重患者管理中的最佳实践 
en-us	Best practice using mechanical ventilation in the management of critically ill patients 

zh-cn	重新评估类固醇在重症与危重症患者治疗中的作用 
en-us	Re-evaluation of the role of steroids in the management of severe and critically ill patients 

zh-cn	发现有效临床管理和疾病结果的相关因素 
en-us	Identification of factors associated with successful clinical management and outcome 

zh-cn	确定中医药（TCM)的效用 
en-us	Determination of the effectiveness of Traditional Chinese Medicines (TCM) 

zh-cn	替代治疗方案的有效性（免疫球蛋白，康复者血浆等) 
en-us	Determination the effectiveness of additional investigational treatment options (e.g. intravenous immunoglobulin/IVIg, convalescent plasma) 

zh-cn	八、防控措施 
en-us	Prevention and control measures 

zh-cn	为循证防控策略决策与调整提供信息的关键流行病学指标 
en-us	Key epidemic indicators that inform evidence-based control strategy decision making and adjustments 

zh-cn	各种医疗环境中感染预防与控制（IPC)措施的有效性 
en-us	Effectiveness of infection prevention and control (IPC) measures in various health care settings 

zh-cn	出入境筛查的有效性 
en-us	Effectiveness of entry and exit screening 

zh-cn	公共卫生控制措施的有效性及其社会经济学影响 
en-us	Effectiveness of the public health control measures and their socio-economic impact  

zh-cn	附件5 操作和技术建议 
en-us	C. Operational & Technical Recommendations 

zh-cn	一、操作/规划建议 
en-us	Operational/ programmatic recommondations

zh-cn	根据疫情的不同阶段重新评估风险和能力，在不同阶段釆取不同的措施，评估应对的不同阶段，在应对与社会发展之间取得平衡 
en-us	Reassess risk and capacities based on different stages of the outbreak; approve different measures during the different phases of the response; assess different stages of the response; reach a balance between response and social development 

zh-cn	(二）在政府强有力的领导下，建立及时、科学、有效、灵活的多部门联防联控机制 
en-us	Initiate a timely scientific evidence based, efficient and flexible joint multi-sectoral mechanism, which is driven by strong government leadership 

zh-cn	二、技术建议 
en-us	Technical recommendations 

zh-cn	(一）流行病学和传播 
en-us	Epidemiology and transmission 

zh-cn	通过现有的呼吸道疾病监测系统，包括ILI、SARI 或肺炎监测系统，在全国范围内继续加强监测 
en-us	Continue enhanced surveillance across the country through existing respiratory disease systems, including ILI, SARI or pneumonia surveillance systems 

zh-cn	优先开展早期调查，包括家庭传播特征研究、儿童等不同年龄人群血清流行病学调查、病例对照研究、聚集性病例调查和医务人员血清学研究 
en-us	Prioritize early investigations, including household transmission studies, age- stratified sero-epidemiologic surveys including children, case-control studies, cluster investigations, and serologic studies in health care workers 

zh-cn	(二）严重程度 
en-us	Severity 

zh-cn	继续进行病例管理、疾病进程以及不同临床结局相关因素的信息共孚 
en-us	Continue to share information on patient management, disease progression and factors leading to severe disease and favorable outcomes 

zh-cn	分析研究与疾病严重程度相关的可能因素，包括： 
en-us	Review and analyze the possible factors associated with the disease severity, which may include:  

zh-cn	(1)研究疾病自然史，更为深入地认识轻度，重度和致命患者的疾病进程 
en-us	natural history studies to better understand disease progression in mild, severe and fatal patients  

zh-cn	(2) 根据病例诊疗病案信息，回顾弱势群体，例如有基础性疾病的人群，老年人，孕妇和儿童等的严重程度，制定合适的诊疗护理标准 
en-us	medical chart reviews about disease severity among vulnerable groups, (e.g. those with underlying conditions, older age groups, pregnant women and children) to develop appropriate standards of care  

zh-cn	评估早发现、早治疗等产生积极结果的因素 
en-us	evaluation of factors leading to favorable outcomes (e.g. early identification and care) 

zh-cn	(三）临床诊疗与感染防控 
en-us	Clinical care and infection prevention and control 

zh-cn	疑似患者（未釆样检测）应单间隔离。可将检测结果阳性的病例安排在一个房间。 
en-us	Suspect patients who have not yet been tested should be isolated in single normal pressure rooms; cohorting of positive cases is acceptable 

zh-cn	医生和所有医务人员需要对新冠肺炎保持高度警惕 
en-us	Physicians and all health care workers need to maintain a high level of clinical alert for COVID-19 

zh-cn	对于受影响的国家，根据当地专家人数和规模，开展标准化临床照护及IPC培训 
en-us	For affected countries, standardize training for clinical care and IPC and scale with the development of local (e.g. district level) experts 

zh-cn	同时开展其他病毒病原体检测，以确保支持新冠肺炎检测阴性结果 
en-us	Ensure concurrent testing for other viral pathogens to support a negative COVID-19 test 

zh-cn	确保疫情期间维持常规和基本医疗服务 
en-us	Ensure maintenance of usual and essential services during the outbreak 

zh-cn	确保落实老年人等最弱势群体预防感染的流程 
en-us	Ensure processes are in place for infection prevention among the most vulnerable, including the elderly 

zh-cn	确保做好提供临床治疗和满足院内感染防控需求的准备 
en-us	Ensure readiness to provide clinical care and to meet IPC needs, including: 

zh-cn	提前准备呼吸支持，例如脉搏血氧仪，氧气和适当的侵入性支持 
en-us	anticipated respiratory support requirements (e.g. pulse oximeters, oxygen, and invasive support where appropriate) 

zh-cn	修订新冠肺炎的国家临床照护和院内感染防控指南 
en-us	national guidelines for clinical care and IPC, revised for COVID-19 

zh-cn	在全国开展标准化培训，统一对疾病的认识，及医务人员使用个人防护装备 
en-us	nationally standardised trainings for disease understanding and PPE use for HCWs 

zh-cn	社区参与 
en-us	community engagement 

zh-cn	储备个人防护装备和药物 
en-us	PPE and Medication stockpiles 

zh-cn	制定早期发现应对方案，包括预检分诊，体温筛查，设置等待区（包括分诊、脉搏血氧测定） 
en-us	early identification protocols; triage, temperature screening, holding bays (triage, including pulse oximetry) 

zh-cn	制定诊疗方案，包括设置定点医院和患者转运 
en-us	treatment protocols including designated facilities, patient transportation 

zh-cn	制定国家指南，加强流感和肺炎球菌疫苗接种 
en-us	enhanced uptake of influenza and pneumococcal vaccine according to national guidelines 

zh-cn	开展实验室检测 
en-us	laboratory testing 

zh-cn	组建快速反应小组 
en-us	rapid response teams 

zh-cn	(四）实验室检验与病毒学 
en-us	Laboratory and virology 

zh-cn	继续对不同时间和地点分离的病毒进行全基因组分析，掌握病毒进化特点。 
en-us	Continue to perform whole genome analysis of COVID-19 viruses isolated from different times and places, to evaluate virus evolution 

zh-cn	釆用新冠肺炎患者活体或尸检标本，或受感染的动物模型进行致病机理研究。 
en-us	Conduct pathogenesis studies using biopsy/post-mortem specimens of COVID-19 patients or infected animal models 

zh-cn	评估现有的PCR诊断试剂盒。 
en-us	Evaluate available nucleic acid PCR diagnostics 

zh-cn	快速开发和评估快速/定量血清学诊断方法。 
en-us	Rapidly develop and evaluate rapid/point-of-care diagnostics and serologic assays 

zh-cn	开展深入研究，解释新冠肺炎康复患者粪便中检测出新冠肺炎核酸阳性的意义。 
en-us	Conduct further study to interpret the result of positive COVID-19 RNA detection in feces in patients recovering from COVID-19 

zh-cn	加强国际合作，重视生物安全和信息共享，深入认识新型冠状病毒，做好病毒溯源。 
en-us	Enhance international cooperation, especially in terms of biosafety and information sharing for increased understanding of the COVID-19 virus and traceability of the virus 

zh-cn	考虑釆用多重检测方法监测促炎细胞因子水平，预测“细胞因子风暴”的出现。 
en-us	Consider monitoring proinflammatory cytokines via multiplex assays to predict the development of “cytokine storm” 

zh-cn	(五）研究与开发 
en-us	Research and development 

zh-cn	应进一步加大力度寻找病毒天然宿主和任何可能的中间宿主的动物，以防止出现任何新的疫源地或疫情复发。 
en-us	Additional effort should be made to find the animal source, including the natural reservoir and any intermediate amplification host, to prevent any new epidemic foci or resurgence of similar epidemics 

zh-cn	应建立统一的实验室检测标准和可用于评估的生物储存库，以完成对现有和未来的新冠肺炎诊断方法的一致性评估。 
en-us	Efforts should be made to consistently evaluate existing and future diagnostic tests for detection of COVID-19 using a harmonized set of standards for laboratory tests and a biorepository that can be used for evaluating these tests 

zh-cn	应考虑在中国建立集中的研究项目以统筹并确保最有希望的研究（疫苗、治疗、发病机制）得到充分的支持并具有研究优先权。为减少现场临床人员的研究性工作量，参与此项目的科研人员应在临床研究现场工作。 
en-us	Consider the establishment of a centralized research program in China to oversee that portfolio and ensure the most promising research (vaccines, treatments, pathogenesis) are adequately supported and studied first; program staff dedicated to the clinical research would work at the clinical research site(s) to decrease the research workload of the clinicians at the site 

zh-cn	应考虑将中国一个或多个地区纳入巳开展或将要开展的多中心全球性试验计划，中方研究人员应该积极参与此类国际试验。 
en-us	Consider including one or more sites within China in the ongoing and future multi¬center, international trials; Chinese investigators should be actively engaged in international trials 

zh-cn	应继续开发其他动物模型，并尽力确保动物模型高度模拟人类感染和病毒传播模式。 
en-us	Continue to develop additional animal models, making every effort to ensure these mimic human infection and virus transmission as closely as possible 

zh-cn	应开展个人防护装备（PPE)阻断新冠肺炎传播的有效性研究。 
en-us	Conduct studies to determine which of the commonly used forms of PPE are most effective in controlling the spread of COVID-19 