我們的領導人現在可以做什麼 | 蓋茨筆記
原創 Bill Gates 比爾蓋茨 昨天
There’s no question the United States missed the opportunity to get ahead of the novel coronavirus. But the window for making important decisions hasn’t closed. The choices we and our leaders make now will have an enormous impact on how soon case numbers start to go down, how long the economy remains shut down and how many Americans will have to bury a loved one because of covid-19.
毫無疑問，美國錯失了遏制新冠病毒蔓延的最佳時機。但做出重要決定的時間窗口尚未關閉。我們和我們的領導人現在所做的決定，將極大地影響病例數多快開始下降、經濟停擺持續多久，以及多少美國人會因新冠肺炎失去至親。
Our foundation has been working to slow the outbreak for several months. To date, we’ve invested $105 million in efforts to create new therapeutics, expand access to testing, and limit the virus’s impact here in Seattle.
我們的基金會幾個月來一直致力於減緩疫情發展。截至目前，我們已經投入1.05億美元，用於開發新的治療方案、提高檢測的可及性和在西雅圖限制病毒傳播的影響。
As a result of this work, I’ve spoken with experts and leaders in Washington and across the country. It’s become clear to me that we must take three steps.
由於這些工作，我得以與華盛頓和全國的專家和領導人進行溝通。我很清楚，現在我們必須採取三個行動。
First, we need a consistent nationwide approach to shutting down. Despite urging from public health experts, some states and counties haven’t shut down completely. In some states, beaches are still open; in others, restaurants still serve sit-down meals.
首先，我們需要採取全國統一的閉關措施。儘管公共衛生專家極力敦促，一些州縣還是沒有完全關閉。在一些州，海灘仍舊開放；而在另一些州，餐館仍然提供堂食服務。
This is a recipe for disaster. Because people can travel freely across state lines, so can the virus. The country’s leaders need to be clear: Shutdown anywhere means shutdown everywhere. Until the case numbers start to go down across America — which could take 10 weeks or more — no one can continue business as usual or relax the shutdown. Any confusion about this point will only extend the economic pain, raise the odds that the virus will return, and cause more deaths.
這樣做後患無窮。由於人們可以自由地穿越州界，病毒也同樣可以。這個國家的領導人需要明確：閉關意味著關閉所有公共場所。沒人能繼續照常活動或放鬆閉關管控，直到全美病例數開始下降，而這將需要10周甚至更長的時間。做不到這一點會延長經濟陣痛、增加疫情回彈的可能性，以及導致更多的死亡。
Second, the federal government needs to step up on testing. Far more tests should be made available. We should also aggregate the results so we can quickly identify potential volunteers for clinical trials and know with confidence when it’s time to return to normal. There are good examples to follow: New York state recently expanded its capacity to up to more than 25,000 tests per day.
其次，聯邦政府需要加強檢測。人們應該獲得更多的檢測機會。我們還應彙總測試結果，以便快速甄別出可以進行臨床試驗的志願者，並且明確何時才能恢復正常。我們可以效仿一些不錯的例子：紐約州最近將其檢測能力提高到每天2.5萬次以上。
There’s also been some progress on more efficient testing methods, such as the self-swab developed by the Seattle Coronavirus Assessment Network, which allows patients to take a sample themselves without possibly exposing a health worker. I hope this and other innovations in testing are scaled up across the country soon.
我們在開發更高效的檢測方式上也取得了一些進展，例如由“西雅圖冠狀病毒評估網絡”開發的自檢拭子，病人可以在沒有醫務人員在場的情況下自行採樣。我希望這項技術和其他檢測方面的創新可以儘快在全國大規模推廣。
Even so, demand for tests will probably exceed the supply for some time, and right now, there’s little rhyme or reason to who gets the few that are available. As a result, we don’t have a good handle on how many cases there are or where the virus is likely headed next, and it will be hard to know if it rebounds later. And because of the backlog of samples, it can take seven days for results to arrive when we need them within 24 hours.
即便如此，檢測在一定時間內可能供不應求，而眼下誰應該獲得這些稀缺的檢測資源也沒有規矩可循。正因如此，我們並沒有完全掌握到底有多少病例，或者病毒接下來會蔓延到哪裡，也很難知道疫情之後是否會反彈。此外，由於檢測樣本的積壓，我們需要在24小時內就得到的結果，可能會花費七天才能得到。
This is why the country needs clear priorities for who is tested. First on the list should be people in essential roles such as health-care workers and first responders, followed by highly symptomatic people who are most at risk of becoming seriously ill and those who are likely to have been exposed.
這就是為什麼這個國家需要明確哪些人有檢測的優先權。在這個名單上，首先應該是那些重要崗位上的人，例如醫護工作者和急救人員，其次是症狀明顯並有可能發展成重症的人，以及可能已經發生病毒暴露的人。
The same goes for masks and ventilators. Forcing 50 governors to compete for lifesaving equipment — and hospitals to pay exorbitant prices for it — only makes matters worse.
對於口罩和呼吸機同樣如此。讓50個州長被迫爭搶救命的設備，並讓醫院為此支付高昂的價格，這隻會讓情況變得更糟。
Finally, we need a data-based approach to developing treatments and a vaccine. Scientists are working full speed on both; in the meantime, leaders can help by not stoking rumors or panic buying. Long before the drug hydroxychloroquine was approved as an emergency treatment for covid-19, people started hoarding it, making it hard to find for lupus patients who need it to survive.
最後，我們需要一個基於數據的方法來開發治療方案和疫苗。科學家正在這兩方面全速攻關。與此同時，領導人不要煽動謠言或引發恐慌性搶購。早在羥氯喹被批准用於新冠肺炎緊急治療之前，人們就開始搶購，這讓狼瘡患者很難找到賴以生存的藥物。
We should stick with the process that works: Run rapid trials involving various candidates and inform the public when the results are in. Once we have a safe and effective treatment, we’ll need to ensure that the first doses go to the people who need them most.
我們應該堅定貫徹有效的流程：例如對多種候選藥物進行快速試驗，並在得到結果的第一時間告知公眾。一旦我們有了安全、有效的治療方案，就要確保最先給最需要的人使用。
To bring the disease to an end, we’ll need a safe and effective vaccine. If we do everything right, we could have one in less than 18 months — about the fastest a vaccine has ever been developed. But creating a vaccine is only half the battle. To protect Americans and people around the world, we’ll need to manufacture billions of doses.
為了消滅這種疾病，我們需要安全有效的疫苗。如果我們每件事都做對了，我們就能在18個月內得到它——這將是有史以來最快被開發出來的疫苗。然而，開發疫苗只是戰役的一半。為了保護美國和全世界的人，我們將需要生產數十億劑疫苗。
Without a vaccine, developing countries are at even greater risk than wealthy ones, because it’s even harder for them to do physical distancing and shutdowns. The further down the income ladder people live, the more important it is that they go to work every day just to feed their family.
如果沒有疫苗，發展中國家會比富裕國家面臨更高風險，因為它們更難實施社交隔離和閉關措施。處於收入階梯越底端的人，越需要靠每天工作來養家餬口。
If they live in the poorest parts of sub-Saharan Africa or India, staying home simply isn’t an option. Even if they do stay home, they can’t just wall themselves off from their neighbors; in slums, the houses are packed together so closely that there’s no way to keep your distance. All the work that rich countries are doing now to develop vaccines will save lives in those places, too.
如果他們生活在撒哈拉以南非洲或印度最貧困的地區，呆在家裡根本就不是個辦法。即便呆在家裡，他們也無法將自己與鄰居隔離開來：在貧民窟，房屋彼此捱得太緊，以至於人們很難與其他人保持距離。富裕國家正在開發疫苗，這些工作也將幫助在貧困地區挽救生命。
We can get a head start on manufacturing all of the doses we’ll need now by building the facilities where these vaccines will be made. Because many of the top candidates are made using unique equipment, we’ll have to build facilities for each of them, knowing that some won’t get used. Private companies can’t take that kind of risk, but the federal government can. It’s a great sign that the administration made deals this week with at least two companies to prepare for vaccine manufacturing. I hope more deals will follow.
我們現在就可以從建設疫苗生產場所開始行動。因為最佳候選疫苗中有許多需要特殊生產設備，我們必須為每一種分別建設生產設施，雖然我們知道有些可能不會被用到。私營企業無法承擔這樣的風險，但聯邦政府可以。政府本週與至少兩家公司簽訂了協議，為疫苗生產做準備，這是一個很好的跡象。我希望之後會有更多這樣的合作。
In 2015, I urged world leaders in a TED talk to prepare for a pandemic the same way they prepare for war — by running simulations to find the cracks in the system. As we’ve seen this year, we have a long way to go. But I still believe that if we make the right decisions now, informed by science, data and the experience of medical professionals, we can save lives and get the country back to work.
2015年，我在一次TED演講中呼籲世界領導人做好應對全球大流行病的準備，就像他們為戰爭做準備那樣，通過模擬演練發現系統裡的漏洞。正如我們今年所看到的，我們還有很長的路要走。但我仍舊相信，如果我們能在科學、數據和醫療專家經驗的指導下做出正確的決定，我們就能挽救生命，並且讓整個國家恢復正常運轉。
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