A Coronavirus Death in Early February Was ‘Probably the Tip of an Iceberg’

“冰山一角”:加州补报死亡病例,改写美国疫情时间线

纽约时报双语版-“冰山一角”:加州补报死亡病例,改写美国疫情时间线

早在今年1月,甚至在联邦政府2月2日开始限制来自中国的旅行之前,新冠病毒就已经在加州湾区传播了。
Jim Wilson/The New York Times

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SAN FRANCISCO — Weeks before there was evidence that the coronavirus was spreading in U.S. communities, a 57-year-old woman developed flulike symptoms and abruptly died in her San Jose kitchen, triggering a search for what had killed her. Flu tests were negative. The coroner was baffled. It appeared that the woman had suffered a massive heart attack.

旧金山——在有证据表明新冠病毒在美国存在社区传播几周前,一名57岁的女性出现了类似流感的症状,后来她在位于圣何塞家中的厨房里突然死去,有关部门对其死因展开了调查。她的流感检测结果是阴性。验尸官百思不得其解。她看上去像是出现了一次严重的心脏病发作。

But tissue samples from the woman, who died on Feb. 6, have now shown that she was infected with the coronavirus — a startling discovery that has rewritten the timeline of the virus’ early spread in the United States and suggests that the optimistic assumptions that drove federal policies over the early weeks of the outbreak were misplaced.

但现在,这名2月6日去世的女子的组织样本显示,她感染了新冠病毒——这一令人震惊的发现改写了该病毒在美国早期传播的时间线,表明在疫情暴发的最初几周里决定了联邦政策的乐观假设是不准确的。

The unexpected new finding makes clear that the virus was circulating in the Bay Area of California as early as January, even before the federal government began restricting travel from China on Feb. 2. It also raises new questions about where else the virus might have been spreading undetected.

这一出乎意料的新发现清楚地表明,这种病毒最早在1月,在联邦政府于2月2日开始限制来自中国的旅行之前,已在加州湾区传播。这也引发了还有哪些地方有疫情却未被发现的疑问。

With little local testing throughout February — in part because of botched testing kits from the Centers for Disease Control and Prevention, along with strict guidelines that limited who could get tested — officials were not aware of the virus transmitting locally in the country until Feb. 26, in Solano County, California.

在2月,由于疾控中心的检测试剂盒质量不佳,加之检测标准定得太高等原因,当地几乎没有开展检测,所以加州索拉诺县的官员并没有意识到病毒已经到了美国。

Previous cases had involved people who had traveled to China, where the outbreak began, or who had been exposed to someone who was sick. But the Feb. 26 case in Solano County was of unexplained origin. Similar cases of community transmission were quickly identified in nearby Santa Clara County, which includes San Jose, as well as in Washington state and Oregon.

此前的感染者都有在疫情暴发地中国的旅行史,或者与患者有过接触。但2月26日索拉诺县的病例的感染源不明。在附近的圣克拉拉县(包括圣何塞)以及华盛顿州和俄勒冈州,很快也发现了类似的社区传播病例。

The new test results made public late Tuesday show that even this timeline failed to reveal how long the virus had been circulating. The woman in San Jose had not recently traveled outside the country, the authorities said, and yet she died a full 20 days before the earliest recorded case of community transmission. Another previously unconnected death in Santa Clara County, on Feb. 17, has also now been linked to the coronavirus.

周二晚些时候公布的新检测结果显示,即使是这条时间线也没能揭示出这种病毒已经传播了多长时间。当局表示,圣何塞的这名女性最近没有出国旅行,但她的死亡却比最早记录到的社区传播病例早了整整20天。2月17日,在圣克拉拉县的另一例此前被认为无关的死亡,现在也确定跟新冠病毒有关。

“Each one of those deaths is probably the tip of an iceberg of unknown size,” Dr. Sara Cody, Santa Clara County’s medical officer, said in an interview.

圣克拉拉县的卫生主管萨拉·科迪(Sara Cody)博士在接受采访时说:“这些死亡,每一例可能都只是冰山的一角。”

纽约时报双语版-“冰山一角”:加州补报死亡病例,改写美国疫情时间线

今年2月,圣塔克拉拉县的卫生主管萨拉·科迪博士。她在本周表示,若是知道2月份就有人死于新冠病毒感染,她会更早发布居家令。
Anda Chu/Bay Area News Group, via Associated Press

Gov. Gavin Newsom of California said on Wednesday that there could be “subsequent announcements” as investigations across the state further examine the early origins of the virus. He said investigators are looking at coroner and autopsy reports going back to December in some counties.

加州州长加文·纽瑟姆(Gavin Newsom)周三表示,随着在全州范围内进一步就该病毒的最早起源展开调查,可能还会有“进一步的消息宣布”。他说,调查人员正在查看一些县去年12月的验尸官和尸检报告。

The earliest case discovered this week, friends and family members said, was of a woman who worked at a Silicon Valley semiconductor manufacturing company with offices worldwide, including in Wuhan, China, the city where the outbreak began.

据朋友和家人说,本周发现的这名最早的女性病患在硅谷一家半导体制造公司工作,公司在世界各地设有办事处,包括在最早暴发疫情的中国武汉。

A longtime friend said that on Feb. 2, the woman had complained of flulike symptoms. Four days later, he said, she was working from home, still feeling under the weather. Her daughter came home and found her collapsed at the breakfast bar in her kitchen, according to the friend, who asked not to be identified because he did not want the woman’s identity to be disclosed.

她的一位老朋友说,她在2月2日抱怨自己出现了类似流感的症状。他说,四天后,她还在家里工作,身体仍然感到不适。据这位友人表示,她女儿回家后发现她倒在了厨房的早餐吧台前。为了保护感染者的身份,这位友人要求匿名。

Family members said they initially had wondered if she had been suffering from COVID-19, the disease caused by the coronavirus. Her work as a company auditor for her firm, they said, brought her into contact with employees from all over the world and involved frequent travel.

她的家人说,他们一开始就怀疑她是否感染了冠状病毒引起的COVID-19。他们说,她在公司担任审计师,因此会接触到来自世界各地的员工,并且经常出差。

Across the country, doctors and public health officials have reported earlier cases of serious illnesses and deaths that preceded official diagnoses of the coronavirus. Only now are some of them being examined, and the new findings in Santa Clara County — suggesting that these suspicious earlier cases were instances of community transmission — shed light on the understated public health response to the widening outbreak.

全国范围内,在官方确诊的冠状病毒病例之前,医生和公共卫生官员就已报告了重症和死亡病例。其中一些病例直到现在才得到检测,而圣克拉拉县的新发现表明,这些可疑的早期病例是社区传播的实例,显示出公共卫生应对措施在不断扩大的疫情面前是不足的。

Had there been earlier proof that the virus had already found a foothold in the United States, experts said, public health officials would have had more urgency to ramp up testing, prepare hospitals and assemble protective gear that might have prevented infections among health care workers and others.

专家们说,如果有更早的证据表明这种病毒已经登陆美国,公共卫生官员就会更迫切地加强检测,为医院做好准备,并且调配防护装备,防止医护人员和其他人感染。

Instead, the focus in February was on quarantining thousands of travelers who were returning from China in the hope that infections could be identified, isolated and contained.

然而2月的工作重点是对数千名从中国归来的旅客进行隔离,希望能够发现、隔离和控制感染。

“What in the end was that really going to accomplish if it was already here?” said Dr. Amesh Adalja, an infectious disease specialist and senior scholar at Johns Hopkins Center for Health Security.

“如果已经在这里了,那么这样做又有什么意义呢?”传染病专家、约翰·霍普金斯健康安全中心(Johns Hopkins Center for Health Security)高级学者阿迈什·阿达尔贾(Amesh Adalja)博士说。

纽约时报双语版-“冰山一角”:加州补报死亡病例,改写美国疫情时间线

加州奥克兰一个针对一线急救人员的免下车新冠病毒快速检测站。
Jim Wilson/The New York Times

It is unclear how the virus reached the people in these earliest deaths. In January, health officials identified a series of people who had traveled from China and then tested positive for the virus, but those cases were largely contained. At the time, President Donald Trump said he did not think the virus would become a pandemic and declared that public health authorities “have it totally under control.”

目前还不清楚最早的死亡者是如何感染这种病毒的。今年1月,卫生官员确认了一系列来自中国的病毒检测呈阳性者,但这些病例基本得到了控制。当时,唐纳德·特朗普总统表示,他不认为这种病毒会成为大流行病,并宣布公共卫生当局“完全控制住了它”。

Federal health officials initially limited testing largely to those who had traveled from Wuhan, then expanded it to people coming from mainland China. Trump ordered travel restrictions, including health screenings for U.S. residents returning from mainland China, that began on Feb. 2.

联邦卫生官员最初主要将检测范围限制在来自武汉的人身上,然后将检测范围扩大到来自中国大陆的人。特朗普下达了旅行限制令,包括自2月2日开始,对从中国大陆返回的美国居民进行健康检查。

By Feb. 26, Trump claimed that the limited number of cases in the country “within a couple of days is going to be down to close to zero. That’s a pretty good job we’ve done.”

到2月26日,特朗普声称,美国有限的病例数量“在几天内将减少到接近于零。我们的工作做得相当棒”。

That was the same day community transmission began to emerge, first in California, then in the Portland, Oregon, area, and near Seattle.

就在同一天,社区传播开始出现,首先在加州,然后是波特兰、俄勒冈地区,以及西雅图附近。

Cody led the effort to issue the nation’s first stay-at-home orders on March 16. But she said she would have issued them even earlier had she known about the February deaths.

3月16日,科迪率先发布了美国首个居家令。但她说,如果知道2月份的死亡事件,她可能会更早发布这样的命令。

“I think if we had had widespread testing earlier and if we had been able to document the level of transmission in the county, if we had understood then that people were already dying, we probably would have acted earlier than we did,” Cody said. She said officials had been hearing about a lot of people who were ill but did not meet the criteria for testing.

“我认为,如果我们能够更早地进行广泛检测,如果我们能够追踪记录县内的传播水平,如果我们当时就知道已经有人死亡,我们可能会比现在更早采取行动,”科迪说。她说,官员们听说很多人都生病了,但他们没有达到检测标准。

“It was just sort of this understanding that the testing capacity at the CDC was very, very, very limited,” she said. When doctors would call them with suspicious cases, she said, county health authorities would have to explain that the cases did not qualify for testing.

“只是因为我们认为疾控中心的检测能力非常非常非常有限,”她说。如果有可疑病例,医生会打电话给他们,县卫生当局会解释说,这些病例不符合检测条件。

“It got increasingly uncomfortable, right?” she said. “It didn’t make any sense. How are you going to detect community transmission if you’re only testing people with a travel history? Well you’re not.”

“越来越让人不安,对不对?”她说。“这完全说不通。如果你只检测有旅行记录的人,那要怎么检测出社区传播?于是,就没测出来。”

纽约时报双语版-“冰山一角”:加州补报死亡病例,改写美国疫情时间线

圣何塞一处关闭的游乐场。根据最新发现,这座城市早在2月初就有一名女性死于新冠病毒。
Jim Wilson/The New York Times