在 COVID-19 成為全球大流行 (pandemic) 的傳染病後,如何有效篩檢確診病患,一度成為討論的熱點。
疫情爆發初期,國內有些縣市首長主張要普篩(全面篩檢),找出隱藏的新冠肺炎病例,不過,疫情指揮中心說明,全面用聚合?連鎖反應 (polymerase chain reaction, PCR) 檢驗來為全民普篩,將耗費近七百億元公帑和醫療資源,不符合效益。
根據衛福部長陳時中的說法,用準確度高的 PCR 方式對全國 2300 萬人普篩,平均一人 3000 元,總額將高達 690 億元。以當時的盛行率萬分之 18,即使不用人人普篩,以看似健康的人口1800 萬人計算,也需要花費 540 億元,才能找出當中的 3 萬 2577 人無症狀感染者,其中還有 1797 人屬於「偽陽性」,即使沒有得病,還是得將他們隔離、再檢測,才能恢復正常生活。
Photo/GRAPHIC courtesy of Bookman l 圖片:書林
雖然也可以用價格較低(200 元/人)的快篩做篩檢,但此舉也需花費約 46 億元,且準確度偏低,偽陰和偽陽性機率更高。
(新冠肺炎)「普篩/全面篩檢」的英文是 widespread coronavirus testing 或 community-wide screening/testing。「快篩」是 rapid testing。篩檢中,可能出現「偽陰性」(false negative) 有患病,但篩不出來,和「偽陽性」(false positive)沒患病,卻篩檢出來。
在醫學檢測上「陰性」(negative) 代表沒有(病或病毒),「陽性」 (positive) 代表有(病或病毒),避免患病與否造成污名化,因此用比較中性 (neutral) 的詞彙來稱呼。至於驗孕 (pregnancy test),「陰性」代表未懷孕,「陽性」代表懷孕。
Photo/GRAPHIC courtesy of Bookman l 圖片:書林
「盛行率」的英文是 prevalence rate,即患病率,在流行病學中指特定時間內總人口中罹患該病的人口所占比例。在新冠肺炎的篩檢中,「咽喉拭子」是目前國內主流採用的方式,「咽喉拭子」英文是 throat swab,就是以棉棒擦拭咽喉部位,取得上皮細胞,並置入病毒收集瓶。如果是採集鼻咽部位,就叫「鼻咽拭子」(nasal swab)。
另外,「靈敏度」(sensitivity) 與「特異度」(specificity) 也是醫學檢測時所使用的術語,用以衡量該檢測的準確度。特異度是不帶原者 (non-carrier) 中採檢陰性的比例,而靈敏度則是帶原者 (carrier) 中採檢陽性的比例,靈敏度、特異度越高,代表準確度越高。
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www.bookman.com.tw
蘇正隆 — 台灣翻譯學學會前理事長、師大翻譯研究所兼任副教授; 編著《英語的對與錯》,《世紀病毒:必讀防疫英文知識與詞彙》...等
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