美国疫情未过各州却已开放公共卫生专家表示担忧

美国疫情影响了美国大部分人群的生活，但是否就要忽视新型冠状病毒的影响?近日美国各州开放问题，引起了社会各界的讨论。公共卫生专家说许多州开放得太早，不能保证安全美国东部时间20207年5月9日上午星期六周末

美国疫情影响了美国大部分人群的生活，但是否就要忽视新型冠状病毒的影响?近日美国各州开放问题，引起了社会各界的讨论。

公共卫生专家说许多州开放得太早，不能保证安全

美国东部时间20207年5月9日上午

星期六周末版

从星期五起，你可以去德州的晒黑沙龙。在印第安纳州，礼拜堂被允许开放，不设出席人数上限。宾夕法尼亚州等地采取了更加谨慎的做法，只是根据新型冠状病毒病例的数量，开始放宽一些县的限制。

到周一，至少31个州将在7周的限制后部分重新开放。这些举措正值特朗普总统推动国家恢复工作之际，尽管公共卫生专家警告说，美国疫情恢复工作美国各州开放还为时过早。

亚特兰大埃默里大学罗林斯公共卫生学院全球卫生和流行病学助理教授鲍勃·贝德纳奇克说：“我们从日本北海道岛上学到的早期教训，真的，我们从那里学到了教训，他们在控制疫情的初始阶段方面做得非常好。”。

由于这一成功，对该岛的许多限制被取消。但在第二波感染中，病例和死亡人数激增。26天后，岛上又被封锁了。

他说：“这是我们现在关心的问题。

贝德纳奇克正在密切关注乔治亚州公共卫生部的数据。两周来，国家允许许多企业开业，其中包括理发或修指甲等密切接触的活动。贝德纳奇克说，他所看到的数字显示，该州的病例数没有持续下降。

“我们在控制早期的指数增长方面做得相当好，”他说但在我们许多人看来，我们确实还没有达到顶峰，也还没有从山顶的背面下来。”

佐治亚州并不孤单

本周，约翰霍普金斯健康安全中心(Johns Hopkins Center for Health Security)的首席学者凯特琳里弗斯(Caitlin Rivers)对美国众议院拨款小组委员会表示，没有一个州符合重新开放所需的所有标准。

该中心为各州制定了放宽限制前的参考标准，但并非所有州都采用了这些标准。该标准包括14天的病例减少、接触痕迹的能力、能够安全护理患者的医疗系统(包括为医护人员提供足够的防护装备)和足够的快速诊断测试。

里弗斯对小组委员会说：“我很清楚，我们正处于这场斗争的关键时刻。”我们冒着沾沾自喜的风险，接受每天2000名美国人的可预防死亡。我们冒着沾沾自喜的风险，承认我们的卫生保健工作者没有他们安全工作所需的东西。我们冒着沾沾自喜的风险认识到，如果不继续保持警惕，我们将再次创造条件，使我们成为世界上受影响最严重的国家。”

事实上，来自约翰霍普金斯大学的数据显示，一些州的COVID-19病例呈上升趋势。与此同时，华盛顿大学健康计量与评估研究所的新模型称，到8月4日，将有近13.5万人死于COVID-19。这是上一个模式的两倍多，并考虑到了放宽限制。截至周六上午，美国已有77000多人死亡。

加州等一些州正在采取所谓的“婴儿步骤”重新开放：允许在花店等一些不重要的商店进行路边接送，并开放一些户外娱乐活动。加文·纽森(Gavin Newsom)州长让各县决定是否按照他的命令放宽限制。

其他州正在跃升。例如，乔治亚州的居民可以纹身。

亚特兰大地铁地区德卡布县卫生局局长桑德拉·伊丽莎白·福特博士说：“仅仅开放该州并不意味着每个人都能像2月份那样四处走动。”我们的信息必须是一致的：有一个新的常态。当我们开放的时候，我们就不能像以前那样开放了。”

乔治亚州州长布莱恩·肯普的行政命令取代了所有的地方法规。所以福特说她的团队唯一能做的就是传达他们自己的建议。该县正在分发口罩和洗手液给那些自己可能买不到的人。

福特说：“我们试图谈论公平的重返社会，因为这不仅仅是为了开放该州，而且我们希望以公平的方式开放该州。”确保每小时工作的员工，例如，必须报告工作并且可能一直报告工作的员工，仍然有待测试的选项，有适当防护服的选项，以及在需要时被隔离的机会。”

系统性问题

在德卡尔布县，人们讲大约90种语言和方言。而且，大多数是非裔美国人。数据显示，黑人和棕色社区受到COVID-19的影响不成比例。福特说，这是因为在获得医疗保健方面长期存在的差距。

她说：“这是一个事件，但导致有色人种(冠状病毒感染)过多的问题是系统性的。”因此，如果我们不利用这一流行病，试图改变一些系统性问题，那将是一种浪费。”

该县已按邮政编码列出了病例，并正在重灾区加大检测力度。它还提供有关精神卫生服务、家庭虐待或工资保护计划资源的信息。与此同时，该县正努力提高接触痕迹的能力。

得克萨斯州达拉斯县成立了一个由传染病专家、流行病学家和其他科学家组成的团队，使当地的决策以科学为基础。

给县居民的信息是：

达拉斯县卫生和公共服务局局长Philip Huang说：“仅仅因为你能做点什么，并不意味着你应该做。”。

地方领导只能提建议。德州重新开放的第二阶段始于上周五，此前州长阿博特(Greg Abbott)发布行政命令，扩大可以再次欢迎客户的业务类型。现在，居民不仅可以去电影院或商场，只要商家按照行政命令限制顾客数量，还可以使用日光浴床或在沙龙理发。

“我不能违背州长的命令。因此，当我们可以在某些领域提供额外的澄清和指导时，我们正努力做到这一点我们正试图根据我们在这里看到的情况，为我们自己的当地社区提出这些建议。”

官员们希望看到的是，在这些企业开业前，案件数量将减少两周。他们在黄县没有看到这种情况，相反，在过去的一周里，案件实际上有所上升。

“德州有些地区可能没有病例。我们有5000多个。“所以这里的情况有点不同，”黄说我们要做的是利用这个专家委员会来根据科学做出真正的建议。所以我们说，“尽管你可以，但以下是专家们推荐的理发方法。”

现在，公共卫生专家建议你不要这样做。

附上原文，以供参考，拒绝转载，侵权必删：

Public Health Experts Say Many States Are Opening Too Soon To Do So Safely

May 9, 20207:00 AM ET

Heard on Weekend Edition Saturday

As of Friday in Texas, you can go to a tanning salon. In Indiana, houses of worship are being allowed to open with no cap on attendance. Places like Pennsylvania are taking a more cautious approach, only starting to ease restrictions in some counties based on the number of COVID-19 cases.

By Monday, at least 31 states will have partially reopened after seven weeks of restrictions. The moves come as President Trump pushes for the country to get back to work despite public health experts warning that it's too soon.

"The early lesson that was learned, really, we learned from the island of Hokkaido in Japan, where they did a really good job of controlling the initial phase of the outbreak," said Bob Bednarczyk, assistant professor of global health and epidemiology at the Rollins School of Public Health at Emory University in Atlanta.

Because of that success, many of the restrictions on the island were lifted. But cases and deaths surged in a second wave of infections. Twenty-six days later, the island was back on lockdown.

"That's the concern that we have right now," he said.

Bednarczyk is closely following the data from Georgia's Department of Public Health. For two weeks now, the state has allowed a lot of businesses to open, businesses that include close-contact activities like a haircut or a manicure. And Bednarczyk said the numbers he's looking at show the state hasn't had a sustained decrease in cases.

"We've done a pretty good job in controlling that exponential growth that we saw early on," he said. "But the way that it looks to many of us is that we really haven't reached that peak and we're not coming down the backside of the peak yet."

Georgia is not alone

This week, Caitlin Rivers, a leading scholar at Johns Hopkins Center for Health Security told a U.S. House Appropriations subcommittee that none of the states meet all the criteria needed to start reopening.

The center laid out the criteria for states to reference before they ease restrictions, but not all states adopted them. The criteria includes a 14-day decline in cases, the ability to contact trace, a health system that can safely care for patients including enough protective gear for health care workers, and enough rapid diagnostic testing.

"It's clear to me that we are in a critical moment of this fight," Rivers told the subcommittee. "We risk complacency in accepting the preventable deaths of 2,000 Americans each day. We risk complacency in accepting that our health care workers do not have what they need to do their jobs safely. And we risk complacency in recognizing that without continued vigilance, we will again create the conditions that led to us being the worst-affected country in the world."

In fact, data from Johns Hopkins University shows that cases of COVID-19 in a number of states are on the rise. Meanwhile, the University of Washington's Institute for Health Metrics and Evaluation's new model says that nearly 135,000 people will have died from COVID-19 by Aug. 4. That's more than double the last model and takes into consideration the easing of restrictions. As of Saturday morning, more than 77,000 people have died in the United States.

Some states like California are taking so-called baby steps to reopen: allowing curbside pickup at some nonessential shops like florists and the opening of some outdoor recreation. Gov. Gavin Newsom left it up to counties to decide whether to ease the restrictions in accordance with his order.

Other states are leaping. For instance, in Georgia residents can get a tattoo.

"Simply opening up the state doesn't mean that everyone gets to walk around like they did back in February," said Dr. Sandra Elizabeth Ford, the district health director for Dekalb County in the Atlanta metro area. "Our messaging has got to be consistent: that there is a new normal. And while we're open, we won't be able to be open the way we were open before."

Georgia Gov. Brian Kemp's executive orders supersede all local rules. So the only thing Ford said her team can do is communicate their own recommendations. The county is distributing masks and hand sanitizer to people who might not be able to get it for themselves.

"We're trying to talk about equitable reentry because it's not just about opening up the state, but we want to open up the state in a way that is equitable," Ford said. "Make sure that folks who have hourly jobs, for example, that must report to work and have probably reported to work the whole time, are still provided options to be tested, options to have appropriate protective wear and opportunity, if needed, to be quarantined off site."

Systemic problems

In Dekalb County, people speak some 90 languages and dialects. Also, it's majority African American. Data show that black and brown communities have been disproportionately impacted by COVID-19. Ford said that's because of long-standing disparities in access to health care.

"This is an event, but the issues that contribute to the overabundance [of coronavirus infections] in people of color is systemic," she said. "And so for us to not take advantage of this pandemic and try to change some systemic issues would be a waste."

The county has mapped out cases by ZIP code and is ramping up testing in hard-hit areas. It's also providing information about resources for mental health services, domestic abuse or the Paycheck Protection Program. Meanwhile the county is working to ramp up its ability to contact trace.

Dallas County in Texas has stood up a team of infectious disease experts, epidemiologists and others scientists so that local decisions are based on science.

The message to county residents:

"Just because you can do something, doesn't mean you should," said Philip Huang, director of Dallas County Health and Human Services.

Local leaders can only make recommendations. The second phase of Texas' reopening began on Friday after Gov. Greg Abbott issued an executive order expanding the types of businesses that can welcome customers again. Now, not only can residents go to a movie theater or a mall, as long as the businesses limit the number of customers according to the executive order, but they can also use a tanning bed or get their hair cut at a salon.

"I can't contradict the governor's orders. So when there are areas where we can provide additional clarification and sort of guidance, then that's what we're trying to do," Huang said. "We're trying to make these recommendations for our own local community based on what we're seeing here."

What the officials want to see is two weeks of decreases in cases before these businesses open up. They have not seen that in Huang's county;, instead, cases actually went up in the past week.

"There are some areas of Texas that might have no cases. We've got more than 5,000. So things are a little different here," Huang said. "What we're trying to do is use this expert committee to really make recommendations based on the science. So we say, 'Even though you can, here's what the experts recommend in terms of going to get that haircut.' "

Right now, public health experts recommend that you don't.

Source of articles：https://www.npr.org/

Author：Weekend Edition Saturday

希望美国民众不要轻视美国疫情的严重性，不要认为新型冠状病毒如同流感一般，更不要赞同美国各州开放这一行为，大家还应尽量隔离在家。