请双击下面的英文字幕来播放视频。
翻译人员: Wang-Ju Tsai
校对人员: Min WANG
00:17
When I was a kid,
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当我还是小孩时,
00:19
the disaster we worried about most
was a nuclear war.
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我们最担心的灾害是核战争。
00:23
That's why we had a barrel like this
down in our basement,
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所以我们在地下室有个这样的筒子,
00:27
filled with cans of food and water.
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装满了罐头食物和水。
00:30
When the nuclear attack came,
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当核战争爆发时,
00:31
we were supposed to go downstairs,
hunker down, and eat out of that barrel.
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我们就要躲到地下室去,
蹲低身子并靠那个筒子维生。
00:37
Today the greatest risk
of global catastrophe
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今天的全球灾难最大的危险
00:41
doesn't look like this.
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看起来已不像这样了。
00:44
Instead, it looks like this.
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事实上,会像这样。
00:48
If anything kills over 10 million people
in the next few decades,
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如果有什么东西在未来几十年里
可以杀掉上千万人,
00:53
it's most likely to be
a highly infectious virus
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那比较有可能是个高度传染的病毒,
00:57
rather than a war.
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而不是战争。
00:59
Not missiles, but microbes.
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不是导弹,而是微生物。
01:03
Now, part of the reason for this is that
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部分的理由是因为
01:05
we've invested a huge amount
in nuclear deterrents.
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我们在核威慑上投注了很大的
精力和金钱。
01:10
But we've actually invested very little
in a system to stop an epidemic.
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但是我们在防止疫情的
系统上却投资很少。
01:16
We're not ready for the next epidemic.
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我们还没有准备好预防
下一场大疫情的发生。
让我们看看埃博拉病毒。
01:20
Let's look at Ebola.
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01:21
I'm sure all of you read about it
in the newspaper,
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我相信大家在报纸上
都有读到这样的新闻,
01:25
lots of tough challenges.
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充满了许多艰难的挑战。
01:27
I followed it carefully
through the case analysis tools
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用我们追踪消灭脊髓灰质炎(小儿麻痹)的
案例分析工具,
01:30
we use to track polio eradication.
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我仔细地追踪这病毒的发展。
01:35
And as you look at what went on,
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随着疫情的发展我们可以看到,
01:37
the problem wasn't that there was a system
that didn't work well enough,
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问题不在于我们没有一套
可以使用的系统,
01:42
the problem was that we
didn't have a system at all.
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而是我们根本没有任何系统。
01:46
In fact, there's some pretty obvious
key missing pieces.
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事实上我们可以看到有几个
很明显的不足。
01:51
We didn't have a group of epidemiologists
ready to go, who would have gone,
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我们找不到一群准备好了的流行病学家,
01:55
seen what the disease was,
seen how far it had spread.
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能去疫区看看病理和病情发展。
01:59
The case reports came in on paper.
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病例都是由纸上报道传来的。
02:02
It was very delayed
before they were put online
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信息传上线时已经很晚了,
02:04
and they were extremely inaccurate.
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此外还很不准确。
02:07
We didn't have a medical team ready to go.
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我们也找不到训练有素的医护小组。
02:09
We didn't have a way of preparing people.
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我们没有一套让人们严阵以待的方法。
02:12
Now, Médecins Sans Frontières
did a great job orchestrating volunteers.
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目前,“无国界医生”
在动员志愿者上做了很大的贡献。
02:17
But even so, we were far slower
than we should have been
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但即使如此,我们调动数千名
工作者到疫区的速度
02:20
getting the thousands of workers
into these countries.
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还是十分差强人意的。
02:24
And a large epidemic would require us
to have hundreds of thousands of workers.
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大的疫情会需要我们动员
数十万的人员,
02:32
There was no one there
to look at treatment approaches.
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但我们没有任何人在研究治疗的方向。
02:37
No one to look at the diagnostics.
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也没有人在看诊断的方法。
02:38
No one to figure out
what tools should be used.
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没有人在想该用什么工具。
02:42
As an example, we could have
taken the blood of survivors,
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举个例子来说,
我们也许可以抽取生还者的血液,
02:45
processed it, and put that plasma
back in people to protect them.
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处理过后,再将血浆注入
人体内来保护没得病的人。
02:51
But that was never tried.
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但是这个方法从来没有试过,
02:53
So there was a lot that was missing.
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所以有很多事都还没来得及做。
02:55
And these things
are really a global failure.
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而这的确是全球性的失败。
03:00
The WHO is funded to monitor epidemics,
but not to do these things I talked about.
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世界卫生组织的目的是来监视流行病,
而不是来做我刚讲的事。
但是在电影中演的剧情又是另一回事。
03:07
Now, in the movies it's quite different.
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03:09
There's a group of handsome
epidemiologists ready to go,
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有一群很英俊的流行病学家准备就绪,
03:14
they move in, they save the day,
but that's just pure Hollywood.
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他们到了疫区拯救了大家,
但这是纯好莱坞的剧情。
03:22
The failure to prepare
could allow the next epidemic
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我们的准备不足 ,
可能会导致下一场疫情,
03:25
to be dramatically
more devastating than Ebola
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比埃博拉病毒的危害更严重。
03:30
Let's look at the progression
of Ebola over this year.
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让我们看看埃博拉病毒在
过去一年中的发展。
03:36
About 10,000 people died,
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大约死了一万人,
03:39
and nearly all were in the three
West African countries.
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所有的死者都在西非的三个国家里。
03:43
There's three reasons why
it didn't spread more.
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之所以没有扩散的原因有三个。
03:46
The first is that there was a lot
of heroic work by the health workers.
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第一个是卫生工作人员作的
很多英雄事迹。
03:50
They found the people and they
prevented more infections.
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他们找到很多病人
并防止了更多人得病。
03:54
The second is the nature of the virus.
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第二个是病毒的特性,
03:56
Ebola does not spread through the air.
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埃博拉病毒不是靠空气传染的。
03:59
And by the time you're contagious,
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等到你有足够的传染力时,
04:01
most people are so sick
that they're bedridden.
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大部分的人已经病得卧床不起了。
04:06
Third, it didn't get
into many urban areas.
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第三个是因为病毒没有传到都会区。
04:10
And that was just luck.
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这纯粹是运气好。
04:12
If it had gotten into a lot
more urban areas,
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如果病毒传到了都会区,
04:14
the case numbers
would have been much larger.
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那么死亡的人数绝对不止于此。
04:17
So next time, we might not be so lucky.
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所以下一次我们可能不会这么幸运了。
04:21
You can have a virus where people
feel well enough while they're infectious
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有的病毒可能让你毫无察觉,
但当感染病毒的人乘飞机或者去逛商场,
04:26
that they get on a plane
or they go to a market.
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他们其实已经具有一定的传染力了。
04:29
The source of the virus could be
a natural epidemic like Ebola,
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此外病毒的来源可以是
天然的,像埃博拉病毒,
04:32
or it could be bioterrorism.
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或是由生物恐怖攻击产生的。
04:34
So there are things that would literally
make things a thousand times worse.
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所以可以让疫情惨上千倍的
病毒是存在的。
04:39
In fact, let's look at a model
of a virus spread through the air,
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事实上,让我们来看看一个病毒
由空气传染的模型,
04:45
like the Spanish Flu back in 1918.
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像1918年的西班牙流感。
04:49
So here's what would happen:
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疫情有可能像这样发展:
04:51
It would spread throughout the world
very, very quickly.
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病毒会以很快的速度向全世界蔓延。
04:55
And you can see over 30 million people
died from that epidemic.
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你可以看到全球有三千万人
死于这个疾病。
05:00
So this is a serious problem.
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这就是个很严重的问题。
05:02
We should be concerned.
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我们绝不应该忽视。
05:04
But in fact, we can build
a really good response system.
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但事实上我们可以建立
一个很好的反应系统。
05:08
We have the benefits of all the science
and technology that we talk about here.
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我们可以利用所有发展至今的科技和科学。
05:13
We've got cell phones
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我们可以用手机
05:14
to get information from the public
and get information out to them.
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来收集信息和发布信息。
05:18
We have satellite maps where we can see
where people are and where they're moving.
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我们有卫星地图可以看到
人们在哪里和往哪移动。
05:22
We have advances in biology
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我们在生物学上也有进展,
05:24
that should dramatically change
the turnaround time to look at a pathogen
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这可以大幅缩短我们找到病原的时间,
05:28
and be able to make drugs and vaccines
that fit for that pathogen.
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并可以在很短的时间里找出解药和疫苗。
05:33
So we can have tools,
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所以我们是有工具的,
05:34
but those tools need to be put
into an overall global health system.
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但这些工具必须统合在
一个全球健康系统下。
05:39
And we need preparedness.
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此外我们必须处在准备好的状态。
05:41
The best lessons, I think,
on how to get prepared
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而我们如何做好准备,
05:44
are again, what we do for war.
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最好的例子还是来自于备战。
05:46
For soldiers, we have full-time,
waiting to go.
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对军人来说,他们是随时随地
都准备好要投入战争的。
05:51
We have reserves that can scale
us up to large numbers.
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我们还有预备军人,
能使备战人口大量增加。
05:54
NATO has a mobile unit
that can deploy very rapidly.
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北约组织有个机动小组,
可以很快地行动起来。
05:58
NATO does a lot of war games
to check, are people well trained?
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北约组织有很多战争游戏可以测试
人员是否已训练有素?
06:01
Do they understand
about fuel and logistics
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他们是否了解燃油,补给
06:03
and the same radio frequencies?
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和相同的收音机频率?
06:06
So they are absolutely ready to go.
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是的话,那么他们就已准备好了。
06:08
So those are the kinds of things
we need to deal with an epidemic.
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这些就是面对疫情时我们该准备的事。
06:13
What are the key pieces?
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关键的项目有哪些?
06:15
First, we need strong health systems
in poor countries.
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第一,在贫穷的国家里
必须有发达的卫生系统。
06:20
That's where mothers
can give birth safely,
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母亲们可以安全地生小孩,
06:23
kids can get all their vaccines.
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小孩们可以接种疫苗。
06:25
But, also where we'll see
the outbreak very early on.
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我们也可以在很早的阶段
侦查到疫情的爆发。
06:30
We need a medical reserve corps:
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我们需要后备的医疗部队:
06:31
lots of people who've got
the training and background
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还有很多训练有素的专业人员,
06:34
who are ready to go, with the expertise.
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随时准备好能带着他们专长到疫区。
06:37
And then we need to pair those
medical people with the military.
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我们可以用军队来配合医护人员,
06:42
taking advantage of the military's ability
to move fast, do logistics
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利用军队移动迅速的特性,
06:46
and secure areas.
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来进行后勤运输和维持安全。
06:48
We need to do simulations,
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我们也需要进行一些情境模拟,
06:51
germ games, not war games,
so that we see where the holes are.
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不是进行战争游戏而是进行病菌游戏 ,
看看防卫漏洞在哪。
06:55
The last time a germ game
was done in the United States
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上一次的病菌游戏是在美国进行的,
06:58
was back in 2001,
and it didn't go so well.
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那是在2001年了, 进行得也不是很顺利。
07:02
So far the score is germs: 1, people: 0.
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目前病菌得一分人类零分。
07:07
Finally, we need lots of advanced R&D
in areas of vaccines and diagnostics.
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最后我们在疫苗和病理学上
还需要很多的研发工作。
07:13
There are some big breakthroughs,
like the Adeno-associated virus,
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在某些方面例如腺相关病毒上,
我们已经有了相当的突破,
07:17
that could work very, very quickly.
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这可以在很短的时间内生效。
07:21
Now I don't have an exact budget
for what this would cost,
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我目前没有明确的预算
这到底需要多少钱,
07:24
but I'm quite sure it's very modest
compared to the potential harm.
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但是我确信跟损失比起来是比较便宜的。
07:29
The World Bank estimates that
if we have a worldwide flu epidemic,
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根据世界银行的估算,
如果我们有流感的疫情暴发,
07:33
global wealth will go down
by over three trillion dollars
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全球经济会损失三万多亿美元。
07:37
and we'd have millions
and millions of deaths.
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我们还会可能有千百万人员的死亡。
07:41
These investments
offer significant benefits
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跟仅仅只是准备好比起来,
07:44
beyond just being ready for the epidemic.
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这些额外的投资会带来显著的益处。
07:46
The primary healthcare, the R&D,
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基础的卫生保健,研发,
07:48
those things would reduce
global health equity
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可以促进全球健康的平衡发展,
07:51
and make the world more just
as well as more safe.
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让这个世界更健康更安全。
07:55
So I think this should absolutely
be a priority.
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所以我觉得这非常重要重要。刻不容缓。
07:59
There's no need to panic.
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不需要惊慌。
08:00
We don't have to hoard cans of spaghetti
or go down into the basement.
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我们不需要囤积面罐头
或是躲到地下室去,
08:05
But we need to get going,
because time is not on our side.
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但是我们必须急起直追,因为时间有限。
08:09
In fact, if there's one positive thing
that can come out of the Ebola epidemic,
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事实上,要说这场埃博拉病毒的疫情
带来了什么正面影响的话,
08:15
it's that it can serve as an early
warning, a wake-up call, to get ready.
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那就是提早响起了警报,
让我们觉醒并做好准备。
08:21
If we start now, we can be ready
for the next epidemic.
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我们如果即刻开始准备,那么在
下一场疫情来临前我们是可以准备好的。
08:26
Thank you.
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谢谢大家。
08:28
(Applause)
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(掌声)
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