4 epidemics that almost happened (but didn't) - George Zaidan

翻译人员: Zhihao Hou 校对人员: Jacky He

Ebola is one of the deadliest viruses we know of.

埃博拉病毒是我们所了解 最致命的病毒之一。

If left untreated, it kills about half of those it infects.

如果不进行治疗， 一半受感染的人将死亡。

It can spread through pretty much every fluid your body makes,

它可以通过你身体产生的 几乎所有液体进行传播，

including blood and sweat.

包括血液和汗液。

Even the dead can transmit the disease, often doing so at their own funerals.

即使是死人也会传染疾病， 这经常在死者的葬礼上发生。

On December 26th, 2013, a two-year-old boy in southern Guinea got sick.

2013 年 12 月 26 日，几内亚 南部一名两岁男童患病。

Just two days later, he died.

仅仅过了两天，他就离开了人世。

It took local doctors working with the international community

当地医生和国际团队经过 4 个月的合作，

four months to discover that Ebola was to blame,

才发现这是埃博拉病毒所导致的，

largely because it had never before been detected outside of Central Africa.

很大程度上是因为其从来没有在 中非之外的地方被发现过。

In those four months, Ebola gained a head start that would prove devastating.

在之后的 4 个月里，埃博拉病毒开始 迅速蔓延，逐渐转为毁灭性的。

The outbreak lasted two years

大爆发持续了两年，

and mushroomed into the largest Ebola epidemic in recorded history.

并迅速成为有史以来规模最大的埃博拉疫情。

More than 28,000 people contracted the disease and over 11,000 died.

超过 28,000 人感染了病毒， 死者超过了 11,000 人。

In 2013, Guinea had no formal emergency response system,

在 2013 年，几内亚并没有正式的 应急体系来应对埃博拉病毒，

few trained contact tracers, and no rapid tests,

很少有经训练的疾控人员， 也没有快速测试，

border screenings, or licensed vaccine for Ebola.

边境筛查，或获得许可的疫苗。

After that epidemic, Guinea,

在疫情过后，

with the support of the US and other international partners,

几内亚在美国和国际伙伴的帮助下，

completely overhauled their epidemic response system.

对他们的流行病应急系统 进行了彻底的变革。

And in January 2021, that system faced its first real test.

在 2021 年 1 月，这个系统迎来了它的第一次考验。

It started when a nurse in southern Guinea developed a headache, vomiting, and fever.

在几内亚南部，一个护士出现了 头痛、呕吐和发烧的症状。

A few days later, she died.

几天之后，她因病去世，

As dictated by traditional burial practices,

按照传统的葬礼的习俗，

her family prepared her body for the funeral.

她的家人准备她的遗体进行安葬。

Within a week, the nurse’s husband and other family members

在一周之内，她的丈夫和其他 家庭成员也出现了类似的症状。

started experiencing symptoms.

Health officials suspected Ebola much quicker than in 2013 and ordered tests.

卫生官员比 2013 年更迅速地 怀疑埃博拉病毒，并进行了检测。

They came back positive,

检测结果为阳性，

and Guinea activated its epidemic alert system the next day.

第二天，几内亚启动了流行病警报系统，

Then, lots of things happened very quickly.

之后，各方反应非常迅速。

Guinea’s National Agency for Health Security

几内亚国家卫生安全局 启动了 38 个区级应急行动中心，

activated 38 district-level emergency operations centers,

as well as a national one.

以及一个国家应急行动中心。

Teams of epidemiologists and contact tracers began the painstaking job

流行病学家和疾控团队 开始了艰苦的工作，

of figuring out exactly who was exposed and when,

找出谁在什么地方接触病毒；

generating a list of 23 initial contacts that quickly grew to over 1,100.

他们列出了一份含有 23 人 一级接触者的名单；这很快增至 1,100 人。

Advanced rapid testing capacity spun up in the city where the outbreak started.

最先爆发疫情的城市 迅速设立了快速检测体系。

At Guinea’s borders with Liberia and Cote d’Ivoire,

在几内亚、利比里亚和 科特迪瓦的边境，

public health workers screened more than 2 million travelers.

公共卫生工作者筛查了 超过 2 百万位旅行者。

A large-scale vaccination campaign was started.

一次大规模的疫苗接种项目展开；

And, finally, more than 900 community mobilizers

最终，超过 900 名社区志愿者 给人们发出疫情警报，

alerted people of the outbreak

and suggested alternative burial practices that were acceptable to the community

并建议采用其他被大众接受的 埋葬方式来处置死者，

and reduced the risk of spreading Ebola.

这种做法减少了 埃博拉病毒的传播风险。

Thanks to all these measures,

得益于这些措施，

the 2021 outbreak ended just four months after it began.

2021 年的大爆发在 仅仅 4 个月后就结束了。

Only 23 people contracted Ebola; only 12 died.

仅有 23 人感染了埃博拉病毒， 其中仅 12 人死亡。

That's less than 1% of the deaths in the prior outbreak.

这还不到之前大爆发的百分之一。

The 2021 outbreak cost $100 million to control—

用来控制 2021 年大爆发的 花销是一亿美金，

which sounds like a lot but pales in comparison

这听起来很多，但与 前一次埃博拉疫情中

全球 530 亿美元的 经济损失相形见绌。

to the global economic cost of the previous outbreak:

$53 billion.

530 亿美元！

So should every country just copy Guinea’s approach?

那么，是不是所有国家 都应该效仿几内亚的方法呢？

Not exactly.

并不是。

It is always important to respond to an outbreak quickly,

迅速应对流行病大爆发总是很重要的，

so an early warning system is essential.

早期预警系统也是不可或缺的。

But beyond that, a successful response can look very different

但除此之外，一个成功的反应 因不同疾病或者不同国家而各不相同。

for different diseases in different countries.

For example, Brazil quenched an outbreak of yellow fever,

例如，巴西迅速消灭了 通过蚊子传播的黄热病爆发，

which is spread by mosquitoes,

primarily by mounting a massive vaccination campaign.

这主要是通过大规模的 疫苗接种实现的。

That strategy worked well for Brazil

这种方法对巴西很有效，

because it’s one of the major global producers of the yellow fever vaccine,

因为巴西是世界上 黄热病疫苗的生产大国，

and its population was accustomed to regular, routine vaccinations.

而且巴西民众已经 习惯于定期的常规疫苗接种。

But for many diseases, you don't even need a mass vaccination program.

但是对付很多疾病 并不需要大规模的疫苗接种。

In August of 2021, a truck driver tested positive for cholera in Burkina Faso.

2021 年 8 月，一名卡车司机在 布基纳法索检测出霍乱阳性，

Health care workers alerted the government that same day

卫生工作人员在当天就对政府发出了警告，

and contact tracing began immediately.

并且开始追踪接触者。

Cholera is caused by a bacterium,

霍乱是由细菌引起的，

so Burkina Faso gave antibiotics to those exposed or potentially exposed.

因此，布基纳法索为那些接触 或可能接触的人提供了抗生素。

This extremely fast response stopped the outbreak

这种极其迅速的反应在几个星期内 阻止了疫情的爆发。

just a few weeks after it started.

Cholera often rears its head in West Africa—

霍乱经常出现在在西非，

in 2021, there were over 100,000 cases and more than 3,700 deaths.

在 2021 年，有超过 100,000 例 霍乱，超过3,700人死亡。

Because Burkina Faso was so well prepared, they had zero deaths that year.

但是因为布基纳法索准备充分， 其在当年没有死亡病例。

Zero.

一个也没有！

In Chiang Mai, Thailand, health officials piloted

在泰国清迈，

a community-owned, community-driven outbreak alert system

卫生官员试行了一个社区自建 并由社区驱动的疫情警报系统，

to monitor animal health—

来监控动物的健康。

that’s important because some animal outbreaks have the potential

这很重要，因为一些动物疫情 可能会转变为人类疫情爆发。

to spill over and become human outbreaks.

Villagers used an app to alert health authorities about outbreaks in animals.

村民们使用应用程序 给卫生局上报动物疫情的信息，

Over the course of 16 months, 36 animal outbreaks were identified.

在 16 个月内，发现了 36 起动物疫情。

For any outbreak response system to be effective,

为了保证任何疫情应对系统的有效性，

it needs to be trusted, valued, and ultimately used by communities.

它需要被大家信任、重视、 并最终在社区中使用。

That means reaching people where they are, in the language they speak,

这意味着用当地的语言接触那里的居民，

and aware of the culture, beliefs, and practices with which they live.

并了解他们的文化、 信仰和他们的生活习惯。

Perhaps most importantly, we can't expect to do nothing for years

最重要的大概是， 我们不能消极怠工，

在疫情到来时才进入状态。

and then just swing into action when an outbreak occurs.

One of the best ways to save lives is to invest in lasting health infrastructure,

拯救生命的最佳方式之一 是对于卫生基础设施的持久投资，

365 days a year, for everyone,

一年 365 天，对每个人的投入，

especially the most vulnerable among us.

特别是我们当中易感染的人。