It is breathtaking to consider how the response to pandemic viral pathogens has been transformed over the past century by greater knowledge of fundamental biology and technological innovations including PCR and next-generation sequencing. In striking contrast to the current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, the pathogen responsible for the 1918 influenza pandemic was not identified until years after the outbreak (1). The definitive text in 1927 described influenza as “an epidemiologic conception” likely caused by the bacterium Haemophilus influenzae (2). Six decades later, HIV-1 was discovered within a few years of the first report of AIDS, although it took another decade before HIV-1 RNA detection methods were sensitive enough to correlate viral load during clinical latency with rate of progression to AIDS (3). Four decades later, the genomic sequence of SARS-CoV-2 was publicly available on the internet within weeks of the unexplained outbreak of fatal pneumonia that is now known as COVID-19 (4⇓–6). This critical information enabled academic researchers, vaccine manufacturers, diagnostic laboratories, and some governments to spring into action. In the midst of COVID-19 lockdown, despite collapse of reagent supply chains, independent investigators around the world shared expertise and reagents in order to establish desperately needed local screening programs for SARS-CoV-2. A paper by Yang et al. in PNAS describes the analysis of viral load data from one local screening program (7), the results of which have important implications for efforts to control the spread of SARS-CoV-2 and for understanding the pathogenesis of SARS-CoV-2 infection.

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当地筛查 SARS-CoV-2 的经验教训 [微生物学]

通过对基础生物学和技术创新（包括 PCR 和下一代测序）的更多了解，在过去的一个世纪里，对大流行病毒病原体的反应发生了怎样的转变，令人叹为观止。与当前的严重急性呼吸系统综合症冠状病毒 2 (SARS-CoV-2) 大流行形成鲜明对比的是，导致 1918 年流感大流行的病原体直到爆发多年后才被确定 ( 1 )。1927 年的权威文本将流感描述为可能由流感嗜血杆菌引起的“流行病学概念” （2）。六年后，在第一次报告艾滋病的几年内发现了 HIV-1，尽管又过了十年，HIV-1 RNA 检测方法才足够敏感，能够将临床潜伏期的病毒载量与进展为 AIDS 的速度相关联（3）。四个十年后，SARS-COV-2的基因组序列是在互联网上公开提供致命的肺炎的原因不明的爆发是现在被称为COVID-19（数周内4 ⇓ - 6）。这一关键信息使学术研究人员、疫苗制造商、诊断实验室和一些政府能够立即采取行动。在 COVID-19 封锁期间，尽管试剂供应链崩溃，但世界各地的独立调查人员仍共享专业知识和试剂，以建立急需的 SARS-CoV-2 本地筛查计划。杨等人的论文。在 PNAS 中描述了对来自一个本地筛选程序的病毒载量数据的分析 ( 7 )，其结果对控制 SARS-CoV-2 传播的努力和了解 SARS-CoV-2 感染的发病机制具有重要意义。