A COVID-19 "exit" strategy to end lockdown and reopen the economy | Uri Alon

翻译人员: psjmz mz 校对人员: Wanting Zhong

Chris Anderson: So our first speaker gave a TED Talk at TEDGlobal

克里斯·安德森： 我们的第一位演讲者

大概七年前在 TEDGlobal 上 做过一次 TED 演讲。

I think seven years ago.

His name is Professor Uri Alon,

他就是尤里 · 阿隆（Uri Alon）教授，

at the Weizmann Institute of Science.

来自以色列魏茨曼科学研究所。

Now, he and his colleagues there have come up with a powerful idea

他和他的同事想出了 一个绝佳的主意

that addresses this key question:

去解决这个关键问题：

How on earth do we get back to work

我们究竟应该如何复工

without creating a second surge of the infection?

才不会造成疫情的再次爆发？

Uri Alon, welcome to TED.

尤里 · 阿隆，欢迎来到 TED。

Uri Alon: Thank you. Nice to be here again.

尤里 · 阿隆： 谢谢，很高兴再次来到这里。

CA: It's great to see you again.

克里斯：再次见到你我也很高兴。

So, I guess the key to your idea

我猜你的想法的关键在于

is this obsession with the reproduction number R, R-naught.

对传染数 R0 的关注。

If that number is less than one,

如果 R0 低于1，

就意味着一个典型感染者 能感染的人数小于 1，

then fewer than one person is infected by a typical person,

and eventually, the epidemic fades away.

最终，疫情将渐渐消失。

People are worried that as we come back to work,

大家担心如果返工的话，

R will shoot up above one again.

R0 将再次飙升到 1 以上。

You have a suggestion for how we might avoid that.

你有一个关于 如何避免这种情况发生的建议。

What is that suggestion?

这个建议是什么？

UA: Exactly.

尤里：没错。

So, we are suggesting a strategy

我们提出的这个策略

that's based on a weak spot based on the biology of the virus,

是基于病毒的生物学弱点，

which is a cycle of work and lockdown.

即周期性的返工与隔离。

It exploits the vulnerability of the virus in that, when a person gets infected,

它利用了病毒的弱点： 那就是当一个人被感染时，

they're not infectious for about three days.

他有大约三天的时间 是 “无害” 的。

也就是说在最初的三天里， 你不会传染其他人，

So you don't infect others for the first three days,

and after another two days, on average, you get symptoms.

一般来说，再过两天， 你就会出现发病症状。

So we're proposing a strategy which is four days of work

所以我们提出了一个工作四天，

and then 10 days of lockdown,

然后隔离十天的策略，

and the next two weeks, again: four days of work, 10 days of lockdown.

然后在接下来的两周重复这个周期： 工作四天，隔离十天。

And that way, if a person gets infected at work,

用这种方法，如果一个人 在工作的时候被感染，

they reach their peak infectiousness during lockdown, and that way,

他的传染性会在隔离期达到最高峰，

they avoid infecting many others.

这样就可以避免感染很多其他人。

This restricts the viral transmission.

这个措施限制了病毒的传播。

Also, just working four days out of two weeks

并且，每两周工作四天

restricts the amount of time the virus gets to see many other people,

也限制了病毒 接触很多其他人的时间，

and that's a very powerful effect.

这能起到很大的抗疫作用。

So everybody works on the same four days,

每个人选择在同样的四天上班，

kids go to school on the same four days,

孩子也在相同的四天时间去上学，

with all the measures of social distancing and masks, etc,

外加所有的社交距离 和口罩等防护措施，

and then there's a lockdown period.

然后进入一个隔离期。

CA: So if you take the worst-case scenario,

克里斯：那么假设一下最坏的情况：

where you come to work on a Monday morning at the start of your four days,

你在“工作四日”开始的 周一早上去工作，

and you're infected on the subway, say, on the way to work,

然后在上班的路上， 在地铁上被感染了，

the theory here is that even by the end of that four days,

根据这个理论， 就算工作到第四天结束，

you're not really starting to infect your coworkers?

你也不会开始传染你的同事吗？

UA: That's correct.

尤里：对的。

So you're infected on the subway,

假设你在地铁被感染，

那么在最初的三天里， 你还处于潜伏期，

and so for the first three days or so, you're in your latent period,

you don't infect your coworkers,

不会感染你的同事，

you reach your peak infectiousness at home,

当你的传染性达到顶峰时， 你已经在家里，

there will be secondary infections at home,

这时会在家里发生二次传染，

and people with symptoms can self-quarantine,

而出现症状的人可以自我隔离，

and over the long run, you have a reproduction number less than one,

长期来看，R0 将小于 1，

so the epidemic, if you continue these cycles,

因此如果一直继续这个周期，

will go away.

疫情最终将会消失。

CA: I mean, is it frustrating

克里斯：这么说可能有点悲观，

at the thought that people are going to say,

但人们可能会想，

“等等——我不想感染我的家人，

"Wait -- I don't want to infect people at home,

我宁愿感染我的同事。”

I'd rather infect people at work than at home."

该怎么回应这种想法？

What's the response to that?

尤里：当然，肯定的。

那么我们要想想别的方案会怎样。

UA: Yes, absolutely.

So we have to consider the alternatives.

如果你重启了经济， 并出现了第二波疫情，

If you open up the economy and there's a second wave,

you'll get all those infections anyway during the lockdown that happens,

那么在隔离期间， 所有这些人还是会被感染，

along with the devastating effects on the economy, etc.

且对经济有毁灭性打击。

And so, in the long run,

所以，就长远来看，

if you do a cyclic strategy like this

如果执行这样的周期策略

but with a reproduction number that's less than one,

但让病毒感染数小于 1，

you avoid, at least with these mathematical models and considerations,

至少根据数学模型和预测， 我们可以避免第二波疫情，

the much larger number of infections you'd get if there's a second wave.

以及第二波疫情带来的 更大规模的感染。

CA: Right. You're serving the needs of your family by -- sorry, go on.

克里斯：没错，这样也是为了家人—— 抱歉，请继续。

UA: Even people who are infected don't infect everyone at home.

尤里：即便是受感染的人 也不会感染家中所有人。

The attack rates are 10 to 30 percent, according to several studies.

根据多项研究，这种疾病的小范围 短期发病率在 10% 到 30% 之间。

CA: Right.

克里斯：对的。

But the hope is that you're serving the needs of your family

不过采用了这个策略的话，

by engaging in a strategy where very few of your fellow workers

你的同事中会传染病毒的人 其实是非常少的，

are going to be infectious anyway,

希望这个策略能帮你照顾到家人。

so that's the plan, but um --

是这样打算的，但是——

UA: That's right.

尤里：没错。

CA: Tell me this, though -- because four days out of 14,

克里斯：不过我想问—— 因为十四天里只工作四天，

someone's going to say, "Well, great idea,

有人会说，“这个主意倒是不错，

但那意味着，经济会损失

but that implies, like, a 70 percent loss of productivity

70% 的生产率，

in the economy,

so that can't possibly work."

所以这可能不太可行。”

I think you think that the productivity loss

我感觉你会认为生产率的损失

need not be anything like that much.

其实并不会那么严重。

UA: That's right,

尤里：没错。

and of course, most people don't work weekends,

当然，大部分人周末都不工作，

so it's four days out of the 10 work days in the two weeks,

所以是在两周的 十个工作日里的四天，

and once you have a predictable schedule

并且一旦你有了固定的

四天工作日程，

of four days at work,

you can work longer hours,

你就可以工作更长的时间，

you can design shifts and get higher productivity

你可以设计轮班，合理分配优先级，

by prioritizing in those four days

通过这样在这四天中达到

much more than 40 percent of the workdays.

远高于十个工作日中 40% 的效率。

CA: Yes, so talk through how that could work.

克里斯：能否讲一讲具体如何操作？

I mean, let's imagine, first of all, manufacturing,

我们可以想象一下， 首先比如制造业，

目前处于关闭状态。

which is currently shut down.

Is the implication here that a manufacturer could set up

这是否意味着一个制造商可以安排

two, possibly even three, shifts of four days,

两个、甚至三个为期四天的轮班，

maybe 35 hours or something of work over those four days

可能在这四天里一共工作 35 个小时左右，

and still get a lot of productivity,

仍然能保持很高的生产效率。

basically, having the lines almost running continuously that way?

基本上就是通过这种办法 让生产线保持连续运转？

UA: Exactly.

尤里：没错。

So this is a staggered version of this idea,

你说的是这个想法的交错版本：

where you take the population, divide it into two groups or three groups.

把所有的人分成两组或者三组。

Let's say one group works four days and then 10 days of lockdown.

比方说一组人工作四天， 然后隔离十天。

Then the other group kicks in.

然后由另外一组接上。

This idea was proposed by colleagues at Bar-Ilan University.

这个想法是巴依兰大学的同行提出的。

Then you get an added benefit that during workdays there's less density.

同时还有个额外好处， 就是工作日时人员密度更低。

If there's two groups,

如果有两个组，

there's half the density and less transmission.

人员密度就只有一半， 病毒传播的可能性也就更低。

And you can keep production lines working almost continuously like that

使用这种交错的方法， 你就可以让生产线

基本保持连续运转。

using this staggered idea.

CA: And applying it to thinking about offices coming back --

克里斯：再考虑一下办公室复工——

I mean, it seems to me that, as we've already seen,

就像大家已经看到的，

there's a lot of productivity that can happen when you're at home,

在家的工作效率也可以很高。

so you could picture on this idea of people doing one set of things

所以可以想象一下， 人们在回公司上班的四天里

during the four days when they're, say, back at the office,

可以做某些事情，

doing the exposure to each other, sparking off each other,

相互接触、彼此启发，

the discussions, the brainstorming, all that good stuff,

做些诸如讨论、头脑风暴 这样有益的事情。

while at home, they're then doing all the things

而在家时，他们接着做

that we've been doing the last few weeks,

过去几周所做的事情，

kind of working solo.

类似独立办公。

How much have you thought about how that,

你对此有什么想法？

whether it's possible, effectively, to divide work into different types

是否可能有效地 把工作分成不同的类型，

and actually use a strategy like this

并通过这样的策略，

来保持几乎 100%， 甚至更高的工作效率呢？

to maintain almost full or even better productivity?

UA: I agree -- for many sectors, people work at home very effectively,

尤里：我同意——对于很多行业， 人们可以非常高效地居家办公，

and we've heard from several industries

我们还听到有几个行业说，

that productivity actually went up during lockdown

隔离期间人们居家办公，

and people working at home.

工作效率反而提升了。

So if you have a schedule, a [cyclic exit strategy]

如果你有日程表， 并且采用周期式复工策略，

you can restrict the amount,

就可以很有效地限制

or you can plan the work where you need to be together

或者合理规划

需要一起在场完成的工作，

in a very effective way

with avoiding a lot of time lost,

来避免浪费大量时间，

if the person's work can be more effective at home

让人们在家和在公司时

and more effective at work and get high productivity.

都能更高效地工作， 提升工作效率。

I should say that some sectors really need to adjust,

应该说，有些行业的工作模式 确实需要调整，

like hotels, tourism, dining.

比如酒店、旅游、餐饮。

In several industries, this will require more thought and adjusting.

对于有的行业，人们需要 进行更多的思考和调整。

But other industries are almost built for ideas like this.

但其他行业几乎天生 就适合这样的工作方式。

Maybe it's even something you can consider after the epidemic,

或许甚至在疫情后也可以考虑沿用，

because productivity can be at least as high.

因为他们可以保持 至少是同样水准的工作效率。

CA: I mean, I read this and I started thinking about our own organization, TED,

克里斯：了解这个之后， 我开始思考我们自己的组织，TED，

and how, in many ways, you could argue that could work really well.

在很多方面，你都有理由认为 这种方法会很有效。

I mean, for one thing,

我意思是，首先，

there's this question about extroverts and introverts.

这是一个关于外向者 和内向者的问题。

Some introverts, if they were honest,

一些内向者，如果说实话，

might say that this pandemic has been manna from heaven for them.

他们会说这次疫情 对他们可谓是天降甘露。

They've found work less stressful.

他们发现工作压力不那么大了，

They've been able to focus and so forth.

也更能够集中注意力，等等。

With this sort of four days on, four days off type strategy,

有了这种四天现场办公、 四天居家的策略，

perhaps you can imagine a work world

也许你会认为这样的职场

that's optimized for both introverts and extroverts?

对外向者和内向者都很有利？

UA: Absolutely.

尤里：的确如此。

I mean, I feel it also.

我也有同感。

Me and my partner, with different personalities,

我和我的伴侣性格不同，

we both teach in universities,

我们都在大学教书。

and teaching through this

以这种方式教学

has [helped me] become productive in certain ways.

让我在某些方面变得更有效率。

So I agree completely,

所以我完全同意，

and I think harnessing the creativity of people at workplaces,

我认为要想在工作场所 发挥人们的创造力，

we're only at the beginning of what these kinds of mixtures can offer.

这种混合工作方式的优势 还只是初现端倪。

CA: But for people who are on the front line,

克里斯：但对于一线工作者，

again, if you're delivering goods and so forth

比如快递员们，

and you can't do that virtually,

他们无法在线办公，

is there any thought about

你有没有思考过

how a four days on and then isolation strategy,

如果这些人采用 工作四天后隔离的策略，

how that off time could be used

他们该如何利用非工作时间

to nonetheless contribute to that person's work

来帮助提升自己的工作能力，

through some form of training?

比如说参加某种形式的培训？

Or is it more just that people would work very intensely during four days,

还是说人们更多只是 在四天里高强度地工作，

and maybe people still aren't quite earning their full pay in this scenario,

也许在这种情况下， 他们仍然没法拿到全额工资，

but it's better than complete lockdown,

但这总好过彻底关门，

and it's better than going back to work and seeing another surge?

也好过回到工作岗位， 结果让疫情再次爆发？

UA: That's right.

尤里：是的。

So on a society level,

在社会层面上，

it's better than opening up and seeing another surge,

这的确要好过完全解禁后 让疫情再次爆发，

which would require complete lockdown.

导致彻底关门。

For people like hospital shifts,

对于在医院轮班的人来说，

some hospitals adopted this kind of program

有些医院采用了这样的规划，

so we can protect shifts and avoid mixing.

这样就可以保护值班人员， 也能避免人员混杂。

It also creates a lot of simplicity and clarity.

同时问题也被大大简化了，

So you understand when you're working,

你很清楚什么时候上班，

and you have some confidence because this is based on scientific modeling

对这种安排也更有信心， 因为其有效性

about the effectiveness of this plan.

是基于科学模拟的。

It's also equitable in the sense that everybody gets to go to work,

另外，这个策略也是公平的， 因为大家都可以去上班，

not only certain sectors,

而不仅仅是特定行业，

it's transparent, etc.

它也是透明的，等等。

[Cross talk]

[ 两人同时发言 ]

CA: And this is something that is best implemented

克里斯：这些措施最好是

by individual companies?

以公司为单位单独执行吗？

Or is it actually much better implemented a city at a time

还是说最好以城市甚至国家为单位

or even a nation at a time?

依次执行？

UA: We think it can work [in levels].

尤里：我们认为都是可以的。

So at certain companies, it's very natural to adopt,

比如说某些公司、医院、学校

可以很自然地采取这个措施。

or at hospitals, schools, etc.

It can also work at the level of a town or a region,

这个策略也可以在一个城镇 或一个地区的层面进行实施，

and then we would advise trying it out for something like a month,

我们会建议试行一个月左右，

seeing whether cases rise.

看看病例是否会上升。

In that case, you can dial down the number of workdays.

如果病例增加了， 你可以减少连续工作的天数。

Or, if cases are declining quickly, you can add workdays

或者如果病例数快速下降， 你可以增加工作的天数，

and therefore adapt to the climate and the location where a person is.

因此，人们可以根据当地的气候 和地理位置来调整。

So it's quite adaptable.

所以这是很灵活的。

CA: But by aligning work schedules with schools, for example,

克里斯：不过假如根据学校安排 同步匹配工作日程，

that suddenly allows parents to go back to work

父母就可以在小孩上学的日子

on the days that their kids are at school, and you'd have to try --

重返工作岗位了， 那样就要试试——

UA: Absolutely.

尤里：当然。

CA: I mean, is the best instantiation of this

克里斯：最好的方法是不是这样：

that countries literally divide households

国家将家庭进行分组，

into different A and B categories, or something like that,

比如说划分成 A 组和 B 组之类的，

so that that kind of alignment could happen?

这样就能进行这种 上班和上学的匹配调整了？

UA: Exactly.

尤里：没错。

So you can align different households, Group A and Group B,

你可以安排不同的家庭， 比如 A 组和 B 组，

and then the children go to school, the parents go to work

让孩子们去上学，

同时父母也去上班，

in a synchronized way,

and the other group, let's say, the alternating weeks.

而另一组则在另一周上学上班， 两组交替进行。

A certain amount of people need to work all the time.

有些人需要一直工作。

Maybe teachers are, like, essential workers and need to work throughout.

比如说老师和其它必需工种， 需要一直上班。

Just like during lockdown situations,

就像在隔离期间那样，

a certain fraction of the population still works throughout.

有一部分人群仍然要一直上班。

But a region that does this should be protected, in a sense,

但在某种程度上， 这样做的地区应该能得到防护，

because it has a replication number of less than one,

因为它的传染数 R0 小于 1，

so imported infections also can't spread very much.

所以输入性感染也不会大幅扩散。

CA: And here is the aforementioned David Biello. David.

克里斯：这位是前面提到的 大卫 · 比耶洛（David Biello）。

大卫，交给你。

David Biello: Yes. Hello, everybody.

大卫 · 比耶洛：大家好。

Uri, as you can imagine, there are lot of questions

尤里，你可以想象， 观众们提了很多问题。

from the audience,

and we have a first one

我们的第一个问题是

kind of about those workers who have been marked as essential.

关于那些一线工作者的。

你能否谈谈这将如何影响 医疗人员和其他

Can you comment on how this would impact the health care professionals and others

who may not have time or the flexibility to quarantine

可能没法按你说的方法

in the way you suggest.

进行弹性隔离的人？

UA: That's great.

尤里：好问题。

我想说，一线工作者，

I want to say that there's essential workers,

还有低收入人群， 他们无法一直按要求隔离，

there's people with low income, that just can't adhere to lockdown

because they have to make a living.

因为他们必须谋生。

And studies show that mobility [among] people in the low-income sectors

研究发现，低收入人群

在隔离期间流动性反而更大了。

is larger during lockdown.

And also, in developing countries, people just have to go out of the house.

而且在发展中国家， 人们必须要走出家门。

You can't enforce lockdown.

你没法强制他们呆在家。

So this four-10 kind of strategy can actually make lockdown easier to bear

所以这个 4-10 天的策略 其实能让需要在这期间谋生的人

for people who can still make a living during those days,

更容易忍受隔离，

or at least make their own choices

或者至少可以让他们选择

about what fraction to work and what fraction to stay in lockdown.

什么时候去工作， 什么时候保持隔离。

Some countries can't get R less than one even with lockdown,

有些国家甚至在隔离期间 也没法让传染数降到 1 以下，

because of this adherence problem, because of informal sectors, etc.

因为很难让人们一直隔离， 比如非正式部门，等等。

We believe that a four-10 cycle might make it easier to do lockdown

我们相信一个 4-10 天的周期策略 可以让隔离更容易执行，

and maybe get our infection level less than one.

也许还能让我们的感染数 降到 1 以下。

That affects billions of people in the world.

这会影响全球数十亿人。

I hope I answered your question.

我希望我解答了你的问题。

DB: I think so,

大卫：是的，

and we have another question, I believe,

我们还有另一个问题。

if that can be queued up,

看下屏幕会不会显示。

which is:

这个问题就是：

Any chance you can do the math

你有做过计算，

and quantify the increased risk of this four-10 cycle?

量化过这个 4-10 天周期策略 所增加的风险吗？

UA: So the increased risk, we're saying in our scientific paper,

尤里：关于增加的风险， 我们在学术论文里提到了，

we did all the sensitivity analyses, etc,

我们做了所有的敏感性分析，

and the question is, it's comparing increased risk comparing to what?

问题是，增加的风险是跟什么比较？

So, to the economy ...

对经济来说……

It's possible there will be a second wave.

有可能会有第二波疫情。

I mean, I hope there won't be, but it certainly is possible,

我希望不会这样， 但这显然是可能的，

and in that case, it's clear that a second wave and another lockdown

在那种情况下， 第二波疫情和隔离

will have worse consequences on health

显然会比 4-10 天周期策略

than a cycle of four-10.

给健康带来更严重的后果。

And so it's really a question of what you're comparing to.

所以这其实是一个 跟谁比较的问题。

DB: Sure.

大卫：的确。

Well, thank you so much for sharing this idea, Uri.

谢谢分享你的观点，尤里。

CA: Indeed.

克里斯：的确。

David, stay on.

大卫，先别下线。

But just before you go:

在我们结束之前：

Have any governments expressed interest in exploring this?

你认为有没有政府 对此表示有兴趣呢？

Do you see people considering actually implementing this

有人考虑在国家政策层面

as national policy?

实施这个策略吗？

UA: Yes, we're in touch with several European countries

尤里：是的，我们正在联系欧洲和

and countries in South America and Israel, of course.

南美的一些国家，当然还有以色列。

Austria has adopted a similar program for their school system,

奥地利已经在他们的 学校系统中采用了类似的安排——

which is five school days every two weeks.

就是每两周上五天学，

And several companies and hospitals, etc.

还有几个公司和医院，等等。

And so we're very interested to see how this will play out.

我们非常有兴趣观望 事情的后续发展。

CA: Well, I love the basic start point

克里斯：我喜欢这个

of starting by looking at the enemy's weakness.

抓住敌人弱点的基本出发点。

And you've got this four-day period

还有这个四天的、

where it's not necessarily that dangerous after an infection,

受到感染后也不一定 那么危险的窗口期——

假如在这期间你还能 想办法上班的话。

if you could figure out a way to work then.

I assume that testing would actually enhance this idea as well a lot, right?

我觉得检测也能 巩固这个策略的效果，对吧？

To test people before they come back --

在人们复工前检测——

尤里：这个不是基于检测的。

UA: It's not predicated on testing.

You don't have to have testing for this idea,

实施这个策略不需要检测，

so that can apply to regions without a lot of testing.

所以可以应用于 没有大量检测的地区。

If you do have testing, it could help you use testing in a more effective way

如果你有能力进行检测， 它可以帮助你更加有效地利用检测，

就是把检测集中在 结束了十天隔离期，

by concentrating testing on people at the end of their 10 lockdown days,

快要返工的人群上；

just as they're about to go to work;

这可以让每一次检测

that could make each test more impactful

都能更有效地降低传染数 R0。

in terms of reducing their reproduction number.

CA: Indeed, instead of having to test the whole population

克里斯：确实，与其每隔三到四天

every three or four days,

就检测所有人，

it's just once every two weeks.

这个策略只需要每两周检测一次。

That's a much more imaginable goal.

这是个更容易理解的目标。

UA: Sure.

尤里：当然。

CA: Yeah.

克里斯：好的。

Well, Uri Alon, thank you so much for spending this time.

尤里 · 阿隆， 非常感谢你参与我们的对话。