生物与医学2020medrxiv.org
污水中的 SARS-CoV-2 滴度高于确诊病例的预期值
SARS-CoV-2 titers in wastewater are higher than expected from confirmed cases
入门 · 约 30 分钟读完前置知识：流行病学基础、PCR 检测原理
导读
这篇预印本研究通过检测马萨诸塞州废水中的 SARS-CoV-2 病毒 RNA 滴度，发现其水平远高于按确诊病例数推算的预期值，提示实际感染人数可能远超官方统计。作者认为废水监测可作为疫情规模的早期预警工具。
HN 关注点：论文暗示实际感染规模远大于确诊病例，且作者与相关检测公司 Biobot Analytics 有利益关联，引发 HN 读者对结果可靠性和利益冲突的讨论。
后来怎么样
这篇预印本推动了废水流行病学的快速兴起，Biobot Analytics 等公司将其商业化，美国 CDC 后来建立了全国废水监测系统(NWSS)，废水监测成为疫情追踪的常规手段。
HN 评论精选
这几条评论里：支持 1 质疑 1 补充 1 亲历 1
质疑HN 社区缺乏评估专业预印本的能力，容易滋生错误信息
我认为 HN 不适合讨论这类进展极快、结果高度出人意料的专业预印本。社区里很少有人能真正评估其中的信息，导致大量无意义的猜测和错误信息。尽管我在生物学领域工作了 20 年，我也不会相信自己对这个预印本的解读。我唯一信任的是愿意用自己声誉背书的专业领域专家，而目前公开场合只有 Twitter 上存在这样的讨论。
epistasis查看英文原文
I don't think that HN is a good venue for discussion of specialized preprints that have highly surprising results, in topics that are moving extremely quickly. Too few people in this community are able to evaluate the information contained, which leads to lots of pointless speculation, and lots of misinformation. Despite working in biology for 20 years, I would not trust any of my own interpretations of this pre-print. The only people who I would trust are named specialists in this field, that are willing to stake bits of their reputation on what they say. The only venue where that is happening in the public is on Twitter.
支持检测能力不足导致确诊病例远低于实际感染，符合预期
这是意料之中。即使检测水平高、感染率低的地区也会漏掉一些病例。在马萨诸塞州，30% 的检测呈阳性，实际感染数是确诊病例的数倍并不奇怪。但情况应该比 2 月好多了——当时估计实际病例是确诊的 100 倍以上。
Symmetry查看英文原文
Well, yes. Even areas of the world with high levels of testing and low levels of infection are going to be missing some cases. Here in MA where a full 30% of tests are coming back positive[1] it would be surprising if actual infections weren't a multiple of confirmed cases. But things are probably much better than they were in February where estimates of the ration are that we were factor of 100 or more behind actual cases. [1]https://i.redd.it/ajxsj8jxyur41.png
亲历亲历者讲述早期无法检测、疑似感染的经历，印证漏检规模
我住在马萨诸塞州，2 月 26 日病得很重，之后又得了严重的感冒。我妻子是医生，她查了 CDC 网站后认为不是新冠。之后她还从洛根机场飞去洛杉矶度周末，我还去新罕布什尔滑了两次雪、参加了两场社交活动。整个 3 月我出现了从未有过的症状，但根本约不上检测，症状持续了 4 周才消失。我是不是感染过？不知道，但如果感染了，最可能是从 2 月中旬就不舒服的妻子和孩子那里传来的。
gwbas1c查看英文原文
I live in MA and got very sick on Feb 26, then had a horrible cold. My wife is a doctor, and she thought I just had one of the many things going around. I asked her if it was COVID-19 and she looked at the CDC's web site and said she didn't think so. Then a week later she flew out of Logan to spend a weekend in LA. I also went skiing in New Hampshire twice, and went to two networking events! Throughout March I had symptoms that I never had in my life... I couldn't get a test! The symptoms went away after 4 weeks. Did I have it? I have no idea, but if I got it, it most likely came from her or my kids, who all felt kinda wonky in mid February. My wife had a very bad headache two weeks before I got sick.
补充指出论文作者与检测公司存在利益关联，提醒读者注意
论文包含利益冲突声明：MM 和 NG 是 Biobot Analytics 的联合创始人，EJA 是其顾问，NE 和 CD 是其员工，这些作者都持有公司股份。有评论称 Biobot 是 YC 孵化的公司，他们三周前在 HN 上发过 Covid 相关页面，2018 年也曾因用废水检测阿片类药物危机上过新闻。
floatingatoll查看英文原文
The paper includes a disclaimer: > MM and NG are cofounders of Biobot Analytics. EJA is advisor to Biobot. NE and CD are employees at Biobot. All these authors hold shares in the company. Another comment suggests that Biobot is YC. As far as I can tell, Biobot has never posted a Launch HN, but they did post a Covid page 3 weeks ago: https://news.ycombinator.com/item?id=22627746 They were in the news in 2018 for testing wastewater to measure the opioid crisis, but I can't find any HN discussions about any link or story that I can find myself, or from their list of media posts. https://www.biobot.io/media Among those links are a video interview / product demo (Cheddar) and a podcast interview (Latina Founders).
相关资源
从这篇论文所有 HN 讨论帖的全部评论里整理出来的链接。
历次讨论
- 2020Hacker News 讨论帖172 分 · 266 评
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