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

譯者: 麗玲 辛 審譯者: Helen Chang

Ebola is one of the deadliest viruses we know of.

伊波拉病毒是我們所知 最致命的病毒之一。

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

如果不加以治療， 大約一半的感染者會身亡。

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

病毒會透過幾乎所有 身體產生的液體傳播，

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.

即使死者也可以傳播這種疾病， 通常是在他們的葬禮上傳播。

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

2013 年 12 月 26 日， 幾內亞南部一名兩歲男童患病。

Just two days later, he died.

僅僅兩天后，他就去世了。

It took local doctors working with the international community

當地醫生與國際社會合作四個月後

four months to discover that Ebola was to blame,

才發現罪魁禍首是伊波拉病毒，

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

這主要是因為此前從未 在中非以外地區發現過這種病毒。

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

在那四個月裡，伊波拉取得先機， 後來證實這是毀滅性的原因。

The outbreak lasted two years

疫情持續了兩年，

and mushroomed into the largest Ebola epidemic in recorded history.

迅速發展成有記錄以來 規模最大的伊波拉疫情。

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

逾二萬八千人感染， 超過一萬一千人死亡。

In 2013, Guinea had no formal emergency response system,

2013 年，幾內亞並沒有 正式的緊急應變系統，

few trained contact tracers, and no rapid tests,

受訓的接觸者追踪人員很少， 也沒有快速檢測方式、

border screenings, or licensed vaccine for Ebola.

邊境檢疫或批准的伊波拉疫苗。

After that epidemic, Guinea,

在那次疫情之後，幾內亞

with the support of the US and other international partners,

在美國和其他國際夥伴的支持下，

completely overhauled their epidemic response system.

徹底改革了他們的疫情應變系統。

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

2021 年 1 月，該系統第一次 面臨真正的考驗。

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

首先是幾內亞南部的一名護士 出現頭痛、嘔吐和發燒。

A few days later, she died.

幾天后，她過世。

As dictated by traditional burial practices,

按照傳統的葬禮習俗，

her family prepared her body for the funeral.

家人為了葬禮整理遺體。

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

一週內，護士的丈夫和其他家庭成員

started experiencing symptoms.

開始出現症狀。

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

比起 2013 年，衛生官員很快懷疑 是伊波拉病毒，並下令進行檢測。

They came back positive,

結果呈陽性，

and Guinea activated its epidemic alert system the next day.

幾內亞隔天就啟動疫情警報系統。

Then, lots of things happened very quickly.

然後，事情進展得很快。

Guinea’s National Agency for Health Security

幾內亞的國家衛生安全局啟動了

activated 38 district-level emergency operations centers,

38 個地區級緊急應變中心，

as well as a national one.

以及一個國家級緊急應變中心。

Teams of epidemiologists and contact tracers began the painstaking job

流行病學家和接觸者追踪人員 開始了一項艱鉅的工作，

of figuring out exactly who was exposed and when,

準確地確定誰在何時接觸過病毒，

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

並列出 23 名初始接觸者的名單， 該名單很快增加到一千一百多人。

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

有疫情的城市迅速建立了 先進的快速檢測能力。

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

在幾內亞與利比里亞 和科特迪瓦的邊界，

public health workers screened more than 2 million travelers.

公共衛生工作者對超過 二百萬旅客進行了篩查。

A large-scale vaccination campaign was started.

大規模的疫苗接種計畫開始。

And, finally, more than 900 community mobilizers

最後，超過九百名社區動員者

alerted people of the outbreak

提醒人們注意疫情，

and suggested alternative burial practices that were acceptable to the community

並建議民眾採用 可接受的替代埋葬方式，

and reduced the risk of spreading Ebola.

降低傳播伊波拉病毒的風險。

Thanks to all these measures,

由於以上這些措施，

the 2021 outbreak ended just four months after it began.

2021 年的疫情 短短四個月就結束了。

Only 23 people contracted Ebola; only 12 died.

只有 23 人感染了伊波拉病毒； 只有 12 人死亡。

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

這還不到上一次爆發時 死亡人數的 1%。

The 2021 outbreak cost $100 million to control—

2021 年的疫情控制成本 為一億美元——

which sounds like a lot but pales in comparison

聽起來很多，但與上一次疫情相比，

to the global economic cost of the previous outbreak:

全球經濟成本 530 億美元， 就相形見絀了。

$53 billion.

So should every country just copy Guinea’s approach?

每個國家都應該效仿幾內亞的做法嗎？

Not exactly.

不盡然。

It is always important to respond to an outbreak quickly,

快速應對疫情很重要，

so an early warning system is essential.

因此預警系統必不可少。

But beyond that, a successful response can look very different

但除此之外，不同國家對不同疾病，

for different diseases in different countries.

有效的應對措施可能很不一樣。

For example, Brazil quenched an outbreak of yellow fever,

例如，為了遏制 由蚊子傳播的黃熱病疫情，

which is spread by mosquitoes,

primarily by mounting a massive vaccination campaign.

巴西主要進行大規模疫苗接種計畫。

That strategy worked well for Brazil

該策略對巴西很有效，

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

因為它是全球主要的 黃熱病疫苗生產國之一，

and its population was accustomed to regular, routine vaccinations.

而且其人口習慣於定期接種疫苗。

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

但許多疾病甚至不需要 大規模的疫苗接種計劃。

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

2021 年 8 月，一名卡車司機 在布基納法索檢測霍亂呈陽性。

Health care workers alerted the government that same day

衛生保健工作者在同一天 向政府發出警報，

and contact tracing began immediately.

並立即開始追踪接觸者。

Cholera is caused by a bacterium,

霍亂是由細菌引起的，

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

因此佈基納法索提供抗生素 給接觸者或可能接觸霍亂的人。

This extremely fast response stopped the outbreak

這樣極其快速的反應 在疫情開始幾週後就阻止了疫情。

just a few weeks after it started.

Cholera often rears its head in West Africa—

霍亂經常在西非現身——

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

2021 年，霍亂病例逾十萬例， 死亡人數超過三千七百人。

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

由於布基納法索準備充分， 那一年的死亡人數為零。

Zero.

零。

In Chiang Mai, Thailand, health officials piloted

在泰國清邁，衛生官員試行了

a community-owned, community-driven outbreak alert system

一個社區主導、驅動的疫情警報系統

to monitor animal health—

來監測動物健康狀況——

that’s important because some animal outbreaks have the potential

這很重要，因為有些動物疫情可能蔓延 並演變成人類疫情。

to spill over and become human outbreaks.

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

村民們使用一款應用程序 向衛生當局通報動物疫情。

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

在 16 個月期間， 確認了 36 起動物疫情。

For any outbreak response system to be effective,

任何疫情應對系統想要有效，

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

都需要得到社區的 信任、重視並且使用。

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

這意味著在當地， 用他們的語言與人們溝通，

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

了解當地生活文化、信仰和習俗。

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

也許最重要的是， 我們不能指望多年無為而治，

and then just swing into action when an outbreak occurs.

在疫情爆發時才立即採取行動。

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

挽救生命的最佳方法之一 是投資永續的衛生基礎設施，

365 days a year, for everyone,

每年 365 天，保護每個人，

especially the most vulnerable among us.

尤其是我們之中最脆弱的人。