關於 chain reaction中文 ，我們在網路上蒐集到這些相關的討論、資訊與評價

新冠肺炎疫情發展至今，全球遍地開花，且變異株持續發展，只要稍不留意，便會讓疫情一波未平一波又起。用「星星之火足以燎原」來比喻眼前現況，一點也不為過。而提升篩檢率，以掌握疫源與黑數，以利全面防堵，是各界防疫之共識。除可至醫院進行檢驗外，目前亦有居家快篩之選項，雖試劑仍存在誤判機率，但準確度仍有一定水平，自行居家檢驗可減少群聚風險，還可發揮降低醫療機構能量負載之作用，不失為當前自行初步篩檢的良好方案

目前新冠病毒的檢驗方法有三種，分別是抗原檢測、抗體檢測及PCR核酸檢測。全球實驗室診斷主要以PCR核酸檢測為主，以下即提供各檢驗資訊

➤抗原檢測(居家快篩)
目前各大篩檢站所使用的即為抗原快篩，能在10-20分鐘內，是從呼吸道中採集檢體，檢驗是否含有病毒的抗原
◉優點：檢驗時間短，可快速獲得結果
◉缺點：準確率較PCR檢測低，未發病者可能不容易被發現，可能出現偽陽性、偽陰性等情況

➤抗體檢測(快篩試劑)
透過血液偵測血清內的抗體，檢測時間比較短，適用於感染14天以上者，可判斷是否曾經感染過，但潛伏期、感染前期測不到，無法即時做感染管制，且無法判斷是曾經感染還是正在感染，適合用於事後疫調，以釐清感染範圍，或判定感染者是否具抵抗力等用途。主要以檢疫場所施行為主
◉優點：藉以找出曾感染或接受疫苗注射者，以推測體內是否具有抗體
◉缺點：需在感染後期才能驗出，也可能會有偽陰性情況產生

➤PCR核酸檢測(Reverse transcriptase polymerase chain reaction，簡稱 RT-PCR)
為當前全球作為診斷染疫與否的檢測標準，可檢測出檢體中是否含有新冠病毒的遺傳物質
◉優點：準確度高，病毒量低也可檢驗出
◉缺點：耗時、成本高，且需要在生物安全第二級以上的實驗室，並透過專業設備及人員執行

中央流行疫情指揮中心宣布採用抗原快篩試劑，民眾能自行購買後居家自行檢測。目前核准的抗原快篩試劑廠牌其準確度高達80%~95%。雖然準確度較PCR略低，但以基礎防疫檢測已足夠，一旦出現陽性經通報，醫院將進行更精密專業的檢測與處理。而抗原快篩原理是以單株抗體偵測病毒蛋白，僅需15-20分鐘即可快速偵測病毒

根據桃園市小兒科家醫科診所李柏鋒醫師指出，若無症狀且未踏足高風險區域者，不需立刻進行快篩。但若出現症狀且有相關接觸史，就有進行檢測之必要；若無接觸史卻出現症狀，則可先考慮使用居家快篩，或是預約前往診所進行自費快篩。以下即彙整出「居家快篩5要點」，積極防疫不心急，共同守護顧家園！

❶落實前置作業
測試前務必洗淨雙手，再用酒精消毒，將檢測套組所有內容分別攤開在桌上。並確實檢查試劑的有效期限。事先備妥計時器，以掌握在最佳時間進行檢測結果判讀，需超過15分鐘但短於30分鐘內為準，過猶不及皆視為無效

❷詳細閱讀說明
使用居家快篩試劑前，務必詳閱使用說明書，並依步驟說明正確進行採檢及操作，以利提升檢測準確度。若有不了解，也可配合官方教學影片進行操作

❸採陰持續戒備
採檢後若依照說明書示例，判斷採檢結果是「陰性」，試劑會顯示1條線，僅代表採檢當下收集的檢體沒有偵測到病毒，但不能代表完全安全無虞。務必將用過的家用快篩試劑及試劑棒用塑膠袋密封好，以一般垃圾處理

❹採陽主動呈報
若採檢結果為「陽性」，試劑會顯示2條線，即表示可能染疫或出現誤判，當下不需驚慌，冷靜觀察身體情況，並將快篩試劑及試劑棒用塑膠袋密封好，主動連繫當地衛生局或撥打1922防疫專線，依照指示進行後續安排

❺檢後謹慎行事
快篩結果呈陰性者
應持續遵循疾病管制署防疫規範，做好個人防護，維持謹慎健康管理及體況觀察

快篩結果呈陽性者
主動聯繫當地衛生局或撥打1922防疫專線，聽從專業人員指示，若前往採檢院所，務必戴好口罩，切勿搭乘大眾運輸，並將使用過的居家快篩試劑及試劑棒用塑膠袋密封包好，交付給採檢院所人員，依防疫人員指示進行後續事宜

#快篩哪裡買
為響應防疫政策，提供民眾便利居家自行檢測，四大超商、藥妝店及電信通路，陸續開始販售「COVID-19家用快篩試劑」，在家即能自行檢測，可減少外出染疫之風險

▶️7-11（福爾威創、羅氏）
現場購買

▶️全家（福爾威創、羅氏）
到店使用FamiPort事務機台預購並結帳，預購後最快可隔日到店領取，以上2款皆限量販售，售完為止

▶️萊爾富（福爾威創）
現場購買，每店限量100盒

▶️OK MART（羅氏）
門市OK Line群組預購，預計7/9開始領取

▶️康是美（福爾威創、羅氏）
已開始販售

▶️屈臣氏（福爾威創、羅氏）
已開始販售

▶️POYA寶雅（福爾威創）
已開始販售，全台限定33家門市，每人限購一盒，每間門市限量30盒，並可搭配POYA Pay所有優惠使用

▶️全聯福利中心（福爾威創、羅氏）
已開始販售，台北市共109家有藥商許可執照門市

▶️遠傳電信（福爾威創）
已開始販售，全台超過600家擁有藥商許可執照的遠傳門市直接購買

#快篩停看聽
⚠️若已明顯出現COVID-19相關症狀，就不宜再使用COVID-19家用快篩試劑，此時應儘速聯繫相關防疫單位，佩戴醫用口罩並前往指定醫療院所就醫，切勿搭乘大眾運輸工具前往

⚠️居家快篩試劑屬於醫療器材，需在合法藥局、藥妝店、醫材行或指定通路購買。食藥署規定，居家快篩試劑並未准許於網路上販售，不管是正品或仿冒品，依法可開罰3萬元以上，100萬元以下之罰鍰

⚠️快篩高誤判機率者有二，1是無症狀感染者，其敏感度只有40~60%；2是Ct值太高也不易快篩出來，每家廠商的快篩數據不同，大部分是「Ct值大於30」不利使用抗原快篩

Ct值英文全名為「cycle threshold（CT）value」，中文又可稱為「循環數閥值」，這是新冠肺炎病毒基因在實驗室中，透過病毒核酸檢測（PCR）之後所測出來的數值。長庚大學新興病毒感染研究中心主任施信如指出，新冠病毒非常微小，僅約流感病毒的10分之1，想要監測病毒RNA的濃度，就必須透過PCR多次複製特定基因，放大觀測。每將病毒放大1次就是1單位的Ct值，也就是2的次方倍（以Ct值18為例，就是指2的18次方）。如果確診者體內病毒RNA濃度很高，進行PCR檢測時，只要複製幾次就能觀測到病毒，此時Ct值數值相對較低，顯示傳染力較高。相較之下，許多確診者感染時間較久，體內病毒濃度相當低，在做PCR檢測時，就必須重複複製好多次，才能觀測到病毒RNA濃度，這個時候Ct值數值就較高了，卻也代表傳染力低。一般來說，確診者出現症狀時，Ct值低於28，顯示剛被傳染，體內病毒濃度較高。在染疫14至20天後，Ct值逐漸變高，如果到了30以上，傳染力相當低。指揮中心指出，凡Ct值大於34，就符合解除隔離的規範，可讓患者盡快出院

#凱鈞話重點
#居家快篩5要點

「Epidemiologic and Clinical Characteristics of Novel Coronavirus Infections Involving 13 Patients Outside Wuhan, China(2020/02/07)+中文摘要轉譯」


➥中文摘要轉譯：
截至2/4日，北京報告13例，大多為年輕健康人。症狀輕微且無人死亡。與過去報導一致，健康人感染後預後較佳。
註：初期流行病學易有偏誤，不可推估大流行時狀況。(財團法人國家衛生研究院-郭書辰醫師整理)


➥In December 2019, cases of pneumonia appeared in Wuhan, China. The etiology of these infections was a novel coronavirus (2019-nCoV),1,2 possibly connected to zoonotic or environmental exposure from the seafood market in Wuhan. Human-to-human transmission has accounted for most of the infections, including among health care workers.3,4 The virus has spread to different parts of China and at least 26 other countries.1 A high number of men have been infected, and the reported mortality rate has been approximately 2%, which is lower than that reported from other coronavirus epidemics including severe acute respiratory syndrome (SARS; mortality rate, >40% in patients aged >60 years)5 and Middle East respiratory syndrome (MERS; mortality rate, 30%).6 However, little is known about the clinical manifestations of 2019-nCoV in healthy populations or cases outside Wuhan. We report early clinical features of 13 patients with confirmed 2019-nCoV infection admitted to hospitals in Beijing.


「Methods」
Data were obtained from 3 hospitals in Beijing, China (Beijing Tsinghua Changgung Hospital, School of Medicine, Tsinghua University [8 patients], Beijing Anzhen Hospital, Capital Medical University [4 patients], and College of Respiratory and Critical Care Medicine, Chinese PLA General Hospital [1 patient]). Patients were hospitalized from January 16, 2020, to January 29, 2020, with final follow-up for this report on February 4, 2020. Patients with possible 2019-nCoV were admitted and quarantined, and throat swab samples were collected and sent to the Chinese Center for Disease Control and Prevention for detection of 2019-nCoV using a quantitative polymerase chain reaction assay.3 Chest radiography or computed tomography was performed. Data were obtained as part of standard care. Patients were transferred to a specialized hospital after diagnosis. This study was approved by the ethics commissions of the 3 hospitals, with a waiver of informed consent.


「Results」
The median age of the patients was 34 years (25th-75th percentile, 34-48 years); 2 patients were children (aged 2 years and 15 years), and 10 (77%) were male. Twelve patients either visited Wuhan, including a family (parents and son), or had family members (grandparents of the 2-year-old child) who visited Wuhan after the onset of the 2019-nCoV epidemic (mean stay, 2.5 days). One patient did not have any known contact with Wuhan.


Twelve patients reported fever (mean, 1.6 days) before hospitalization. Symptoms included cough (46.3%), upper airway congestion (61.5%), myalgia (23.1%), and headache (23.1%) (Table). No patient required respiratory support before being transferred to the specialty hospital after a mean of 2 days. The youngest patient (aged 2 years) had intermittent fever for 1 week and persistent cough for 13 days before 2019-nCoV diagnosis. Levels of inflammatory markers such as C-reactive protein were elevated, and numbers of lymphocytes were marginally elevated (Table).


Four patients had chest radiographs and 9 had computed tomography. Five images did not demonstrate any consolidation or scarring. One chest radiograph demonstrated scattered opacities in the left lower lung; in 6 patients, ground glass opacity was observed in the right or both lungs (Figure). As of February 4, 2020, all the patients recovered, but 12 were still being quarantined in the hospital.


➥Author: De Chang, Minggui Lin, Lai Wei, et al.

➥Link: (JAMA) https://jamanetwork.com/journals/jama/fullarticle/2761043


衛生福利部
疾病管制署 - 1922防疫達人
疾病管制署
國家衛生研究院-論壇
#2019COVID19Academic

「Epidemiologic and Clinical Characteristics of Novel Coronavirus Infections Involving 13 Patients Outside Wuhan, China(2020/02/07)+中文摘要轉譯」


➥中文摘要轉譯：
截至2/4日，北京報告13例，大多為年輕健康人。症狀輕微且無人死亡。與過去報導一致，健康人感染後預後較佳。
註：初期流行病學易有偏誤，不可推估大流行時狀況。(財團法人國家衛生研究院-郭書辰醫師整理)


➥In December 2019, cases of pneumonia appeared in Wuhan, China. The etiology of these infections was a novel coronavirus (2019-nCoV),1,2 possibly connected to zoonotic or environmental exposure from the seafood market in Wuhan. Human-to-human transmission has accounted for most of the infections, including among health care workers.3,4 The virus has spread to different parts of China and at least 26 other countries.1 A high number of men have been infected, and the reported mortality rate has been approximately 2%, which is lower than that reported from other coronavirus epidemics including severe acute respiratory syndrome (SARS; mortality rate, >40% in patients aged >60 years)5 and Middle East respiratory syndrome (MERS; mortality rate, 30%).6 However, little is known about the clinical manifestations of 2019-nCoV in healthy populations or cases outside Wuhan. We report early clinical features of 13 patients with confirmed 2019-nCoV infection admitted to hospitals in Beijing.


「Methods」
Data were obtained from 3 hospitals in Beijing, China (Beijing Tsinghua Changgung Hospital, School of Medicine, Tsinghua University [8 patients], Beijing Anzhen Hospital, Capital Medical University [4 patients], and College of Respiratory and Critical Care Medicine, Chinese PLA General Hospital [1 patient]). Patients were hospitalized from January 16, 2020, to January 29, 2020, with final follow-up for this report on February 4, 2020. Patients with possible 2019-nCoV were admitted and quarantined, and throat swab samples were collected and sent to the Chinese Center for Disease Control and Prevention for detection of 2019-nCoV using a quantitative polymerase chain reaction assay.3 Chest radiography or computed tomography was performed. Data were obtained as part of standard care. Patients were transferred to a specialized hospital after diagnosis. This study was approved by the ethics commissions of the 3 hospitals, with a waiver of informed consent.


「Results」
The median age of the patients was 34 years (25th-75th percentile, 34-48 years); 2 patients were children (aged 2 years and 15 years), and 10 (77%) were male. Twelve patients either visited Wuhan, including a family (parents and son), or had family members (grandparents of the 2-year-old child) who visited Wuhan after the onset of the 2019-nCoV epidemic (mean stay, 2.5 days). One patient did not have any known contact with Wuhan.


Twelve patients reported fever (mean, 1.6 days) before hospitalization. Symptoms included cough (46.3%), upper airway congestion (61.5%), myalgia (23.1%), and headache (23.1%) (Table). No patient required respiratory support before being transferred to the specialty hospital after a mean of 2 days. The youngest patient (aged 2 years) had intermittent fever for 1 week and persistent cough for 13 days before 2019-nCoV diagnosis. Levels of inflammatory markers such as C-reactive protein were elevated, and numbers of lymphocytes were marginally elevated (Table).


Four patients had chest radiographs and 9 had computed tomography. Five images did not demonstrate any consolidation or scarring. One chest radiograph demonstrated scattered opacities in the left lower lung; in 6 patients, ground glass opacity was observed in the right or both lungs (Figure). As of February 4, 2020, all the patients recovered, but 12 were still being quarantined in the hospital.


➥Author: De Chang, Minggui Lin, Lai Wei, et al.

➥Link: (JAMA) https://jamanetwork.com/journals/jama/fullarticle/2761043


衛生福利部
疾病管制署 - 1922防疫達人
疾病管制署
國家衛生研究院-論壇
#2019COVID19Academic