TED演讲新冠肺炎为什么全球大爆发如何为下次疫情爆发做准备文档格式.docx

1、t patient care or taking care of individual people. My specialty is looking at populations and health systems, what happens when diseases move on the large level. If were ranking sources of global health expertise on a scale of one to 10, one is some random person ranting on Facebook and 10 is the W

2、orld Health Organization, Id say you can probably put me at like a seven or an eight. So keep that in mind as I talk to you.我从事全球卫生工作 大约有 20 年了， 我的特定技术专长是卫生系统以及当卫生系统遭到严重冲击时 会发生什么。我也一直在 全球卫生相关的新闻业工作， 我为报纸和网络媒体 撰写过不少 关于全球卫生和生物安全的文章， 在几年前也我也出版过一本书， 这本书讲述了我们星球 所面临的主要全球卫生威胁。我支持并领导了 许多流行病相关的工作 从评估埃博拉治疗中心

3、到研究医疗机构中肺结核的传播机制， 再到禽流感的准备工作。我是国际卫生专业的硕士。我不是医生，也不是护士。我的专长 不是照顾病患，或照顾个体。我的专长 是研究总体人口、卫生系统， 并研究当疾病大规模传播时 会发生什么。如果我们把 关于全球卫生的知识来源 用 1 到 10 来形容其专业度， 1 是随意一个在 Facebook 上肆意怒吼的人， 10 是世界卫生组织（WHO）， 我会说你大概能把我放在 7 或 8 的位置上。接下来我进行演讲的时候， 请你记住这一点。Ill start with the basics here, because I think thats gotten lost i

4、n some of the media noise around COVID-19. So, COVID-19 is a coronavirus. Coronaviruses are a specific subset of virus, and they have some unique characteristics as viruses. They use RNA instead of DNA as their genetic material, and theyre covered in spikes on the surface of the virus. They use thos

5、e spikes to invade cells. Those spikes are the corona in coronavirus. COVID-19 is known as a novel coronavirus because, until December, wed only heard of six coronaviruses. COVID-19 is the seventh. Its new to us. It just had its gene sequencing, it just got its name. Thats why its novel.我先从最基础的开始， 因

6、为我觉得这在许多嘈杂的 关于 COVID-19 的媒体报道中被遗漏了。所以，COVID-19 是一种冠状病毒（Coronavirus）。冠状病毒是病毒的一个特定子集， 它们具有某些特定的病毒特征 它们使用 RNA 而非 DNA 作为它们的遗传物质， 它们的外表面被棘突包围， 并以此来入侵细胞。这些棘突使得冠状病毒 看起来像皇冠。COVID-19 被认为是一种 新型冠状病毒， 因为在 12 月之前， 我们只知道 6 种冠状病毒。COVID-19 是第 7 种。对我们来说是新的。它们刚经历了基因测序， 才有了自己的名字。这也就是为何它们是“新型的”。If you remember SARS, Se

7、vere Acute Respiratory Syndrome, or MERS, Middle Eastern Respiratory Syndrome, those were coronaviruses. And theyre both called respiratory syndromes, because thats what coronaviruses do - they go for your lungs. They dont make you puke, they dont make you bleed from the eyeballs, they dont make you

8、 hemorrhage. They head for your lungs.如果你记得非典， 重症急性呼吸综合征（SARS）， 或是 MERS 病毒， 中东呼吸综合征（MERS）， 这些都是由冠状病毒引发的。而且它们都被称作为 呼吸综合征， 是因为这是冠状病毒的特长 它们专攻肺部。它们不会让你呕吐 或是让你从眼睛里流血， 它们也不会让你大出血。而是直奔你的肺部。COVID-19 is no different. It causes a range of respiratory symptoms that go from stuff like a dry cough and a fever al

9、l the way out to fatal viral pneumonia. And that range of symptoms is one of the reasons its actually been so hard to track this outbreak. Plenty of people get COVID-19 but so gently, their symptoms are so mild, they dont even go to a health care provider. They dont register in the system. Children,

10、 in particular, have it very easy with COVID-19, which is something we should all be grateful for.COVID-19 也一样。它能引发一系列呼吸道症状， 从干咳、发烧等一系列症状， 到致命的病毒性肺炎。如此广泛的症状 也就是为何如此难以追踪 疾病爆发的原因之一。不少人感染了 COVID-19 ， 但是非常轻度的感染。他们的症状如此轻微， 甚至不用去医疗机构， 也不用将自己上报到系统中。尤其是孩子， 能够非常轻易地抵抗 COVID-19。这是我们所有人 都应该感到庆幸的一个事实。口译网Coronavi

11、ruses are zoonotic, which means that they transmit from animals to people. Some coronaviruses, like COVID-19, also transmit person to person. The person-to-person ones travel faster and travel farther, just like COVID-19. Zoonotic illnesses are really hard to get rid of, because they have an animal

12、reservoir. One example is avian influenza, where we can abolish it in farmed animals, in turkeys, in ducks, but it keeps coming back every year because its brought to us by wild birds. You dont hear a lot about it because avian influenza doesnt transmit person-to-person, but we have outbreaks in pou

13、ltry farms every year all over the world. COVID-19 most likely skipped from animals into people at a wild animal market in Wuhan, China.冠状病毒是动物源性病毒， 这意味着 它们能从动物传播至人类。有些冠状病毒，例如 COVID-19 也能通过人与人传播。人人传播的方式 感染得更快且范围更广， 就像 COVID-19 。动物源性疾病真的很难摆脱， 因为它们有着 一个很大的动物储备。一个例子就是禽流感， 我们可以在农场动物 比如火鸡和鸭子中消灭它， 但它依旧每年都

14、会发生， 因为禽流感能通过野鸟传播到人。你不常听到人们谈及它， 因为禽流感不会人人传播， 但其实世界范围的家禽农场 每年都会出现禽流感的大爆发。COVID-19 很可能就是 在中国武汉的野生动物市场中 从动物身上转移到了人。Now for the less basic parts. This is not the last major outbreak were ever going to see. Theres going to be more outbreaks, and theres going to be more epidemics. Thats not a maybe. Thats

15、 a given. And its a result of the way that we, as human beings, are interacting with our planet. Human choices are driving us into a position where were going to see more outbreaks. Part of that is about climate change and the way a warming climate makes the world more hospitable to viruses and bact

16、eria. But its also about the way were pushing into the last wild spaces on our planet.现在说点不是那么基础的东西。这不是我们人类历史上能看到的 最后一场重大疾病爆发。往后将会有更多的爆发， 更多的流行病。这不是概率事件，而是既定事实。这是我们作为人类， 与地球互动方式的结果。人类的选择把我们推入一个 未来会看到更多流行病爆发的境地。其中一部分，是气候变化， 变暖的气候让世界对病毒和细菌 变得更加生存环境友好。但这也与我们逼近地球上 最后的野外空间的方式有关。When we burn and plow the

17、Amazon rain forest so that we can have cheap land for ranching, when the last of the African bush gets converted to farms, when wild animals in China are hunted to extinction, human beings come into contact with wildlife populations that theyve never come into contact with before, and those populati

18、ons have new kinds of diseases: bacteria, viruses, stuff were not ready for. Bats, in particular, have a knack for hosting illnesses that can infect people, but theyre not the only animals that do it. So as long as we keep making our remote places less remote, the outbreaks are going to keep coming.

19、kouyi.org当我们在亚马逊雨林的土地上 焚烧并耕种， 我们以此希望 低成本经营牧场， 当最后一片非洲丛林 被转化为农场， 当中国的野生动物被猎杀到几近灭绝， 人们与不同野生动物种群 开始了前所未有的联系， 之后那些野生动物种群 可携带各种新的疾病：细菌、病毒， 我们毫无准备的东西。尤其是蝙蝠，有一种本事：它们能作为 可以传染给人的疾病的宿主， 不过不仅蝙蝠有这种能力。所以只要我们继续逼近 偏远的地方， 流行病的爆发将会一直持续。We cant stop the outbreaks with quarantine or travel restrictions. Thats everybod

20、ys first impulse: Lets stop the people from moving. Lets stop this outbreak from happening. But the fact is, its really hard to get a good quarantine in place. Its really hard to set up travel restrictions. Even the countries that have made serious investments in public health, like the US and South

21、 Korea, cant get that kind of restriction in place fast enough to actually stop an outbreak instantly. Theres logistical reasons for that, and theres medical reasons. If you look at COVID-19 right now, it seems like it could have a period where youre infected and show no symptoms thats as long as 24

22、 days. So people are walking around with this virus showing no signs. Theyre not going to get quarantined. Nobody knows they need quarantining.我们无法用隔离或旅行限制 来停止疾病大爆发。这是每个人的第一反应：“我们要禁止人口流动， 我们要阻止这场疫情的发生。” 但实际上， 真的很难做到有效适当的隔离， 也真的很难做到设置旅行限制。即使是在公共卫生领域 投入足够预算的国家， 像是美国和韩国， 都无法快速做到 那样有效的限制隔离 以即刻阻止这场疫情的爆发。

23、这其中有物流原因， 也有医学原因。如果你现在看看 COVID-19， 看起来会有一段时间 你已经被感染但没有任何症状 能长达 24 天。所以人们携带着这个病毒 走来走去，没有任何征兆。他们不会被隔离， 也没人知道他们自己需要被隔离。Theres also some real costs to quarantine and to travel restrictions. Humans are social animals, and they resist when you try to hold them into place and when you try to separate them.

24、 We saw in the Ebola outbreak that as soon as you put a quarantine in place, people start trying to evade it. Individual patients, if they know theres a strict quarantine protocol, may not go for health care, because theyre afraid of the medical system or they cant afford care and they dont want to

25、be separated from their family and friends. Politicians, government officials, when they know that theyre going to get quarantined if they talk about outbreaks and cases, may conceal real information for fear of triggering a quarantine protocol. And, of course, these kinds of evasions and dishonesty

26、 are exactly what makes it so difficult to track a disease outbreak. We can get better at quarantines and travel restrictions, and we should, but theyre not our only option, and theyre not our best option for dealing with these situations.kouyi.org隔离和旅行限制也有 一些真实代价。人类是一种社交动物， 当你尝试把他们限定在一个地方， 尝试把他们分隔开

27、来， 他们会反抗。在埃博拉的时候，我们看到 只要你开始实行隔离， 人们就会开始尝试逃离。个别病人，如果知道有一个 严格的隔离处理流程的存在， 可能就不会选择去看病， 因为他们害怕这样的医疗流程， 或他们担心自己经济上无法承担， 而且，他们不想要 与自己的家人和朋友分开。政客和政府官员， 当他们知道自己将会被隔离， 如果他们谈及疫情和病例， 可能会隐藏真实信息， 从而避免触发隔离处理流程。当然，正是这些回避的态度 与不诚实的手段 让疫情控制变得如此困难。通过隔离和旅行限制， 我们能好得更快，我们也应该这么做， 但是这不是唯二的方法， 也不是我们应对这些疾病爆发的 最佳选择。The real wa

28、y for the long haul to make outbreaks less serious is to build the global health system to support core health care functions in every country in the world so that all countries, even poor ones, are able to rapidly identify and treat new infectious diseases as they emerge. Chinas taken a lot of crit

29、icism for its response to COVID-19. But the fact is, what if COVID-19 had emerged in Chad, which has three and a half doctors for every hundred thousand people? What if it had emerged in the Democratic Republic of the Congo, which just released its last Ebola patient from treatment? The truth is, countries like this dont have the