CDC COVID-19 Emergency Response Team.
MMWR Morb Mortal Wkly Rep. 2022 Aug 19;71(33):1057-1064. doi: 10.15585/mmwr.mm7133e1.
As SARS-CoV-2, the virus that causes COVID-19, continues to circulate globally, high levels of vaccine- and infection-induced immunity and the availability of effective treatments and prevention tools have substantially reduced the risk for medically significant COVID-19 illness (severe acute illness and post-COVID-19 conditions) and associated hospitalization and death (1). These circumstances now allow public health efforts to minimize the individual and societal health impacts of COVID-19 by focusing on sustainable measures to further reduce medically significant illness as well as to minimize strain on the health care system, while reducing barriers to social, educational, and economic activity (2). Individual risk for medically significant COVID-19 depends on a person's risk for exposure to SARS-CoV-2 and their risk for developing severe illness if infected (3). Exposure risk can be mitigated through nonpharmaceutical interventions, including improving ventilation, use of masks or respirators indoors, and testing (4). The risk for medically significant illness increases with age, disability status, and underlying medical conditions but is considerably reduced by immunity derived from vaccination, previous infection, or both, as well as timely access to effective biomedical prevention measures and treatments (3,5). CDC's public health recommendations change in response to evolving science, the availability of biomedical and public health tools, and changes in context, such as levels of immunity in the population and currently circulating variants. CDC recommends a strategic approach to minimizing the impact of COVID-19 on health and society that relies on vaccination and therapeutics to prevent severe illness; use of multicomponent prevention measures where feasible; and particular emphasis on protecting persons at high risk for severe illness. Efforts to expand access to vaccination and therapeutics, including the use of preexposure prophylaxis for persons who are immunocompromised, antiviral agents, and therapeutic monoclonal antibodies, should be intensified to reduce the risk for medically significant illness and death. Efforts to protect persons at high risk for severe illness must ensure that all persons have access to information to understand their individual risk, as well as efficient and equitable access to vaccination, therapeutics, testing, and other prevention measures. Current priorities for preventing medically significant illness should focus on ensuring that persons 1) understand their risk, 2) take steps to protect themselves and others through vaccines, therapeutics, and nonpharmaceutical interventions when needed, 3) receive testing and wear masks if they have been exposed, and 4) receive testing if they are symptomatic, and isolate for ≥5 days if they are infected.
随着导致 COVID-19 的 SARS-CoV-2 病毒在全球持续传播,高水平的疫苗和感染诱导的免疫以及有效的治疗和预防工具已大大降低了患有重大医学意义的 COVID-19 疾病(严重急性疾病和 COVID-19 后疾病)以及相关住院和死亡的风险 (1)。这些情况现在使公共卫生工作能够通过采取可持续措施来进一步减少具有重大医学意义的疾病,同时减轻医疗保健系统的负担,从而最大程度地减少 COVID-19 对个人和社会健康的影响,同时减少对社会、教育和经济活动的障碍 (2)。个人患具有重大医学意义的 COVID-19 的风险取决于个人接触 SARS-CoV-2 的风险以及如果感染后发生严重疾病的风险 (3)。通过非药物干预措施可以减轻接触风险,包括改善通风、在室内使用口罩或呼吸器以及检测 (4)。如果感染,患病风险会随着年龄、残疾状况和潜在医疗条件的增加而增加,但通过接种疫苗、既往感染或两者兼而有之获得的免疫力以及及时获得有效的生物医学预防措施和治疗可以大大降低患病风险 (3,5)。CDC 的公共卫生建议会根据不断发展的科学、生物医学和公共卫生工具的可用性以及环境变化(如人群中的免疫水平和当前流行的变异)而变化。CDC 建议采取一种战略方法来最大限度地降低 COVID-19 对健康和社会的影响,该方法依赖于疫苗接种和治疗来预防严重疾病;在可行的情况下使用多组分预防措施;并特别强调保护患严重疾病风险高的人。应加强努力扩大疫苗接种和治疗的获取途径,包括为免疫功能低下者使用暴露前预防、抗病毒药物和治疗性单克隆抗体,以降低患具有重大医学意义的疾病和死亡的风险。保护患严重疾病风险高的人的工作必须确保所有个人都能获得信息以了解其个人风险,以及能够高效且公平地获得疫苗、治疗、检测和其他预防措施。当前预防具有重大医学意义的疾病的重点应放在确保个人 1)了解自己的风险,2)在需要时通过疫苗、治疗和非药物干预措施来保护自己和他人,3)如果接触过病毒,则接受检测并佩戴口罩,以及 4)如果出现症状,则接受检测,并在感染后隔离至少 5 天。