The secret weapon against pandemics | Georges C. Benjamin

翻译人员: Jiasi Hao 校对人员: Yolanda Zhang

David Biello: It's now my great honor and privilege

戴维 · 比耶洛（David Biello）： 接下来，我非常荣幸

to introduce Dr. Georges Benjamin,

为大家介绍乔治斯 · 本杰明博士 （Dr. Georges Benjamin）。

who's the executive director of the American Public Health Association,

他是美国公共卫生常务理事，

who has a long and distinguished career,

作为医学专家以及 公共卫生领域专家，

both as a medical professional and as a public health professional.

他有着多年丰富而卓越的职业生涯，

Please give a warm welcome to Dr. Georges Benjamin.

请热烈欢迎， 乔治斯 · 本杰明博士。

Georges Benjamin: Hey, David, how are you?

乔治斯 · 本杰明（Georges Benjamin）: 嗨，戴维，最近如何？

DB: I am good, how are you, Dr. Benjamin?

DB：我很好，您呢？

GB: I'm here. (Laughs)

GB：至少还能毫发无损的坐在这里。 （笑声）

DB: Hanging in there. Good.

DB：一切安好吗？ 听上去不错。

GB: Hanging in.

GB：没错，还算坚持得住。

DB: We know that the theme of the moment is reopening, I would say.

DB：我们知道当前的 一大主题是复学复工复产。

We just heard one possibility for that,

我们只听到了这一种可能性，

but obviously,

但显然，

a lot of countries have already reopened in one form or another,

很多国家已经利用这样 或那样的形式重新开放了，

and I believe, as of today,

而且我相信，截至今日，

all 50 states here in the US have reopened in one form or another.

美国所有 50 个州 也已经在不同形式下重开了。

How do we do that smartly, how do we do that safely?

但我们能如何做到 明智且安全的重新开放？

GB: Yeah, we really do need to reopen safely and carefully,

GB：没错，我们确实需要 安全小心的重开。

and it means that we have not got to forget these public health measures

而这意味着我们还未忘记

that really brought down the curve to begin with.

能帮助拉平曲线的公共卫生措施。

And that means thing such as

这意味着

covering up your nose and mouth when you cough or sneeze,

诸如咳嗽或打喷嚏时遮挡抠鼻、

wearing a mask, washing your hands,

戴口罩、洗手、

physically distancing yourself to the extent possible from others.

还有尽量与他人保持距离等措施。

Thinking about everything we do,

想想我们所做的所有事情——

you know, before we go to work in the morning,

在早晨去上班前，

while we're at work.

或者在工作时。

And being as careful as many of us have been

在过去的 2 个月，

in the last two months,

我们很多人都在 尽可能保持谨慎，

as we go into the next three months,

在接下来的 3 个月中依旧如此，

because this thing is not over.

因为这事儿还没结束。

DB: Right.

DB：没错。

There is the chance of more waves, as Uri [Alon] mentioned.

就如乌里 · 艾隆（Uri Alon）所说， 可能未来还会出现几波。

It seems like it's kind of incumbent on all of us then

看起来我们所有人似乎都有义务

to take public health as kind of a second job.

需要将公共卫生 作为我们的第二份工作。

Is that right?

是这样吗？

GB: You know, I've been arguing a lot

GB：我一直在重申：

that now that everybody really knows what public health is,

现在每个人都知道了 什么是公共卫生，

that everybody should always recognize that their second job is public health,

每个人应该总能意识到 他们的第二份工作是公共卫生，

whether you're picking up the garbage or working in a grocery store,

不论你是保洁员， 还是在杂货店工作，

or you are a bus driver,

或者是公交车司机，

or you're, you know, like me, doing public health,

或者像我， 在公共卫生领域的

a physician or a nurse,

一名医生或是护士，

everybody needs to put the public health mantle

每个人都需要将公共卫生

into what they do each and every day.

融入他们每天都在做的事情中。

DB: What do you think --

DB：你认为——

So we're all public health professionals now,

鉴于我们现在都是 公共卫生领域的一员了，

what do you think the new normal we might expect,

你认为在国家重新开放之时，

as countries reopen?

我们可能预期的新常态是什么？

What is that going to look like,

这看起来会是怎么样，

or what do you hope that looks like, as a public health professional?

或是你作为一个公共卫生领域专家， 希望这看起来会是如何？

GB: If I could wave a magic wand,

GB：如果我有一根魔法棒，

I would clearly recognize

我会很清晰的意识到

that people are going to be doing a lot more of the public health things,

人们将会做更多与公共卫生 相关的事情，

in terms of handwashing

例如洗手，

and thinking about what they do around safety when they go out in public.

并且思考他们身处公共场合时， 怎么做才能确保安全。

You know, it was not too long ago

就在不久之前，

when you got in your car and you didn't put your seat belt on.

你上车还不会主动系上安全带。

Today we do it,

而如今我们都是这么做的，

and we don't think anything about it.

而且完全是下意识的。

Most of us don't smoke,

我们大部分人不抽烟，

because we know that that's bad for us.

因为我们知道抽烟对人体有害。

Most of us look both ways before we cross a street.

我们大部分人在过马路时 会左右观察路况。

Most of us, you know,

我们大部分人

do things in our house, that are -- fix trip hazards.

会修缮房屋，消除危险隐患。

So as we go forward with this outbreak,

所以随着这场 全球大流行病爆发的推进，

I'm hoping that people will pay a lot more attention

我希望人们能更加注意

to things that can cause us to get an infection.

有可能导致我们被感染的事物，

So you know, cleaning things, disinfecting things.

例如要注意清洗和消毒。

More importantly, not coming to work if you're sick.

更重要的是， 如果你生病了就别去上班。

I'm hoping that employers will put in paid sick leave for everybody,

我希望雇主能为每个员工 提供带薪病假，

so people can stay home.

让生病的人可以安心在家休息。

Yeah, it’s an additional cost,

没错，这里有附带成本，

but I can tell you that we've now learned

但我要告诉你， 我们现在已经学到了教训——

that the cost of not doing something like that

如果我们不那么做，

is billions and billions and billions of dollars.

最终的代价就是 奥多支付数十亿美元。

Paid sick leave is pretty cheap when you do that.

带薪病假其实是 一个相对节约成本的方式。

DB: Yeah, we are, I think, envious in the United States

DB：是的，我认为美国所有人

of all the countries that perhaps have

都非常羡慕比我们国家

a more all-encompassing health care system than we do.

有着更加全面的医疗体系的国家。

Would you agree that masks are kind of the symbol

有一种说法，口罩多少已经成为了

of adopting that "public health professional as a second job" mindset?

采取“公共卫生作为第二职业” 观念模式的象征，你同意吗？

GB: Well, you know, it's funny.

GB：这很有趣。

Our colleagues in Asia have had a mask --

我们在亚洲的同事就有口罩——

wearing masks as a culture for many, many years.

多年来，戴口罩一直是一种文化。

And you know, we've always kind of chuckled at that.

我们总是对此嗤之以鼻。

When I went overseas,

当我在海外，

I would always kind of chuckle when I saw people wearing masks.

看到戴口罩的人，我总会暗笑。

And of course, when this first started,

当然，最开始的时候，

you know, we only promoted masks for people that were infected

我们说口罩仅适用于 那些被感染的人，

or of course, health care workers,

或是那些暴露在高风险环境下的

who we thought were in a higher-risk environment.

医疗工作者。

But I think that wearing masks

但我认为，戴口罩

is probably going to be part of our culture.

可能会成为我们文化的一部分。

We've already seen it probably will not be part of our beach culture,

我们已经发现这可能不会成为 我们沙滩文化的一部分，

although it probably should be for now.

尽管现在或许应该如此。

But I do think that we're going to see more and more people wearing masks

但我确实认为在不同场景下，

in a variety of settings.

我们会看到越来越多的人戴口罩。

And I think that makes sense.

我觉得这很合乎逻辑。

DB: Yeah, wear your mask to show that you care about others.

DB：是的，通过戴口罩的方式 来表达你对他人的关心。

And that you have this, kind of, public health spirit.

之后你就有了一种 公共卫生精神。

So speaking of Asia,

那么谈到亚洲，

who has done well?

哪些国家做得比较好？

Looking around the world, you've been doing this for a while

放眼全球， 你已经在这个部门从业很久，

and communicated with your peers,

并且和同事们交流不少。

who has done well

哪些国家做得还不错？

and what can we learn from those good examples?

有什么经验值得我们借鉴？

GB: Yeah, South Korea in many ways is the role model.

GB：韩国在很多方面能成为榜样。

You know, China actually, at the end of the day,

中国，从后续的成果上说，

did reasonably well.

实际上做得也还不错。

But the secret to all of those countries

但发病率和死亡率

that have had less morbidity and mortality than we have,

都比我们低的那些国家的秘诀就是，

is they did lots of testing very early on,

他们在非常初期的时候 就做了大规模的检测，

they did contact tracing and isolation and quarantine,

他们做了很多接触史追踪、 分离和隔离，

which by the way, is the bedrock of public health practice.

顺便一提，这些其实都是 公共卫生实践的基石。

They did it early, they did a lot of it,

他们很早就开始实施大规模检测了，

and by the way, even though they're reopening their society,

而且即使他们马上要重启经济，

and they're beginning to see episodic surges,

并且会开始时不时 看到病例的激增，

they then go back to those basic public health practices

他们也会再次采用 那些基础的公共卫生实践——

of testing, isolation, contact tracing

测试、隔离、接触史追踪，

and transparency to the public when they can,

以及在可能的情况下， 向大众公开透明。

because it's important for the public to understand how many cases there are,

因为对大众来说，

了解病例的总数及分布 是至关重要的，

where the disease is,

if you're going to get compliance from the public.

如果你想要大众遵从你的管制。

DB: So testing, contact tracing and isolation.

DB：所以测试、接触史追踪， 还有隔离。

That doesn't seem like rocket science, to use that old cliché.

使用这些传统方法 看起来十分简单，可以理解，

Why has that been hard for some countries to implement?

那为什么在有些国家， 要实行这些措施是如此困难？

What's holding us back,

是什么在阻碍我们？

is it electronic medical records,

是电子医疗记录吗？

is it some fancy doodad,

或者一些花里胡哨的东西吗？

or is it just maybe overconfidence,

还是可能基于其过去 100 年 在公共卫生领域的成功，

based on maybe the public health successes of the last 100 years?

所造成的过度自信？

GB: You know, we are very much a pill society.

GB：我们很像是一个“药丸社会”。

We think there's a pill for everything.

我们总认为有一种药丸 可以治愈一切。

If we can't give you a pill for it,

如果我们没办法给你开药，

then we can give you surgery and fix it.

那我们可以进行手术， 帮你解决问题。

You know, prevention works.

但是，预防起着很大的作用。

And we have totally underinvested in prevention.

可我们完全没有在预防上 投入必需的资金，

We've totally underinvested in a strong, robust

建立一个成熟且强大的 公共卫生体系，

public health system.

我们的投资完全不够。

If you look at the fact that in the America today,

如果你看看如今的美国，

you can very easily know

你很容易就会发现

what's coming off the shelf of a grocery store,

杂货店什么东西卖得最快，

Amazon knows everything there is to know about you,

亚马逊知道关于你的一切，

but your doctor does not have the same tools.

但你的医生却没有类似的工具。

At three o'clock in the morning,

比如在早上 3 点，

it's still very difficult to get a hold of your electrocardiogram,

很难即时获得你的心电图，

or your medical record, or your list of allergies

或是医疗记录、过敏原清单——

if you can't tell the practitioner what you have.

如果你无法告诉医生 你有什么问题。

And we just haven't invested in robust systems.

而我们就是迟迟没有 投资于一个成熟稳健的医疗系统。

One of the interesting things about this outbreak

这场疫情大爆发中， 其中一件有趣的事

is that it has created an environment

就是大爆发创造了一个环境——

in which we're now dependent on telemedicine,

我们如今依赖的远程医疗。

which has been around for several years,

这个领域 其实已经出现了好几年了，

but we weren't quite into it.

但我们之前对此并不是很感兴趣。

But now, it's probably going to be the new standard.

但现在，这却可能成为一种新标准。

DB: But it also seems --

DB：但这看起来似乎也——

So, obviously,

所以显然，

those countries with an incredibly robust health care system,

那些有着非常成熟的 医疗保健体系的国家及地区，

like Taiwan, have done well,

例如台湾，他们做得不错，

but it seems like even countries that perhaps would be considered

但即使是那些被认为可能

to have a less robust health care system, like a Ghana in Africa,

没有如此成熟的医疗保健体系的国家， 例如非洲的加纳，

have actually done well.

他们实际上也做得不错。

What has been the, I guess, the secret sauce

这类国家的秘诀

for those kinds of countries?

又是什么呢？

GB: Yeah, it's still pretty early in some of their exposures,

GB：他们对疫情的暴露 还处于相对早期阶段，

and hopefully, they might not have a wave that comes later,

希望他们之后不用 再经历另一波病毒侵袭，

that's still a possibility,

尽管这依旧很有可能发生。

but at the end of the day,

但总的来说，我认为，

I think, to the extent you have done good, sound public health practices,

你只需要实行良好且健全的 公共卫生措施。

all of the countries that have done well

所有做得不错的国家

have implemented that.

都已经实行了这些。

Now we're a big country, we're a complex country.

我们是一个庞大而复杂的国家。

And yes, we didn't get the testing right to begin with.

而且没错，我们在一开始 就没有做好测试这项工作。

But we should not repeat the mistakes that we had over the last three months,

但我们不应该 重复过去三个月的错误，

because we've still got several months to go.

因为我们眼前还有好几个月。

And now that we know what we did wrong,

既然现在我们知道 自己之前做错了什么，

I'm encouraging us to do it right the next time.

我希望大家下一次能做好。

DB: That seems smart.

DB：很明智的建议。

GB: And the next time is tomorrow.

GB：我说的下次就是明天。

DB: That's right.

DB：没错。

It's already started.

已经开始了。

I mean, it almost seems to me,

我的感觉就是，

if I can use this metaphor,

如果我能用这个比喻的话，

that some of these countries

那就是有些国家

already had the, kind of, antibodies in their system,

在他们的体系中， 已经有了类似“抗体”的东西，

because they had experience with maybe Ebola or the first SARS.

因为他们或许有着对抗 埃博拉或是非典（SARS）的经验。

Is that the key, previous exposure

在应对公共卫生危机之时，

to these kind of public health crises?

过往的经验是关键所在吗？

GB: Well, this is a very different virus.

GB：这是一个非常不同的病毒。

And while there may be some early evidence

尽管有些初期证据可能表明

that MERS and SARS one,

针对中东呼吸综合征（MERS）和 SARS，

we may have some early protection from that,

我们或许需要一些早期保护。

there's some early, early studies looking at that,

也有一些十分早期的研究，

that's not the solution.

而这不是解决方案。

The secret sauce here is good, solid public health practice.

这里的秘诀是 成熟稳健的公共卫生实践。

That's the secret sauce here.

这才是秘诀。

We should not be looking for anything, any mysticism,

我们不应该找寻任何别的东西， 期待任何神秘论，

or anyone to come save us with a special pill.

或是某个人给我们提供 神奇药丸，拯救我们。

This is all about good, solid public health practice,

这完全关乎于 成熟稳健的公共卫生实践，

because, by the way, look,

因为——顺便说一句——

this one was a bad one,

这是一场非常糟糕的 全球流行病大爆发，

but it's not the last one.

但这肯定不是最后一场。

And so we need to prepare for the next really big one.

所以我们要为下一场 真正的疾病大爆发做准备。

We think this one was bad,

我们认为这场疫情很糟糕，

imagine what would have happened had Ebola been aerosolized,

想象一下如果埃博拉病毒 或是 MERS 病毒被雾化，

or MERS had been aerosolized.

什么会发生？

You know, pick a TV movie.

选一个电影。

Even though this was a bad one,

即使这场疫情很糟糕，

we still dodged a really, really bad one this time.

但我们仍旧躲避过了 这次极其糟糕的情况。

DB: Yeah, Middle East Respiratory Syndrome is no joke,

DB：没错，MERS 不是开玩笑的，

and we should be thankful that it doesn't spread more easily,

我们应该感恩， 这种病毒不像 SARS-CoV 这样

like SARS-CoV.

容易传播。

Is this, though --

不过，可以说，

So all these diseases are zoonotic,

所有这些疾病都是人畜共患的，

that means they jumped to us from the animals that are out there.

也就是说，那些病毒从动物身上 传播到了人类身上。

Obviously, humanity is kind of encroaching on nature

显然，人类向来在侵占自然——

in an ever more, kind of, urgent way,

不管是气候变化，还是滥砍滥伐——

whether that's climate change or going into the forests, what have you.

如今更是以前所未有的速度发生着。

Is this just the new normal,

这会是我们的新常态吗？

like, we should expect pandemics every so often?

我们应该预期全球大流行病 未来会发生得如此频繁吗？

GB: Well, they do come periodically,

GB：它们确实会阶段性发生。

so this is not, you know, the first pandemic, right?

这不是我们经历的第一场 全球大流行病了，对吧？

We've had several,

我们经历过几次，

100 years ago, the 1918 influenza,

100 年前的 1918 大流感，

SARS was a significant infection,

SARS 也是一个很严重的感染，

even though it didn't get this bad, SARS one.

即使 SARS 在当时 没有造成太严重的后果。

And we had the avian flu,

我们有过禽流感，

which was a challenge,

曾经也是一场挑战，

and the swine flu.

还有甲型流感、

We had Zika.

寨卡病毒。

So no, we've had several new disease outbreaks.

所以并不是什么新常态，我们已经 经历过几场新疾病的爆发。

These emerging diseases happen a lot,

这些新的疫情会通过多种方式

and in many ways,

频繁发生。

we've been fortunate

迄今为止，我们一直非常幸运，

that we have been able to identify them early

还有能力在早期

and contain them.

鉴别并控制这些疫情的传播。

But we're now in an environment

但我们现在正处于

where people can, by the way, make some of these things up.

人造病毒的威胁之中。

Now, this one did not happen, as best we can tell, it's not man-made.

但这并未发生，据我们所知， 这场疫情并不是人为的，

It did not probably come out of a leak in the lab.

不是实验室病毒泄露导致的。

But we know that, when I was in school,

不过至少在我读书期间，

to grow a bug, you had to be pretty sophisticated.

想要创造这样一种病毒， 你必须得相当老练。

That's not the case today.

今天疫情的起源而非如此。

And we need to protect ourselves from both naturally occurring infections

但我们依旧要在身处 自然感染以及人造病毒的夹击之时，

and from those that are created by humans.

学会自我保护。

DB: Plus we have other, kind of, threat multipliers,

DB：外加我们还有诸如气候变化的

like climate change,

放大效应，

that make pandemics like this that much worse.

这会让全球大流行病 变得更难以控制。

GB: You know, I was saying climate change was the greatest threat human survival

GB：我曾说过

气候变化是人类生存的最大威胁。

before this one.

But this is rivaling climate change.

但这种疫情的威胁 与气候变化相当。

But let me tell you,

不过我想说，

the big challenge we have now

我们现在面临的一个主要挑战

is that we have a pandemic,

就是我们尚未能控制的

which we have still not contained,

全球大流行病。

as we enter hurricane season,

当我们进入飓风季节，

and we have climate change,

外加因为气候变化，

which is exacerbating the ferocity of the hurricanes that we're having.

这加剧了飓风的破坏力。

So, you know, we're in for an interesting summer.

所以，我们将迎来 一个情况复杂的夏季。

DB: And here's Chris with, I think, a question from our audience.

DB：克里斯上线了， 他应该为我们带来了一个观众的问题。

Chris Anderson: Many questions, actually.

克里斯 · 安德森（Chris Anderson）： 其实有很多问题。

People are very interested in what you're saying, Georges.

人们对您的话很感兴趣，乔治斯。

Here we go, here's the first one from Jim Young:

那么第一个问题来自吉姆 · 杨：

“我们该如何处理 那些不相信情况严重性的人？”

"How do we deal with people who don't believe this is serious?"

GB: You know, you just have to continue to communicate the truth to folks.

GB：你只能继续和他们交流真相。

One of the things about this particular disease

关于这一特定疾病的 一个真相就是，

is that it does not spare anyone.

就是它不会放过任何人。

It does not recognize political parties,

它不分政党，

it does not recognize geography,

不分地理位置，

and we had lots of people, particularly in rural communities,

尤其在偏远的社区， 之前很多人还没看到病毒的影响，

that were not seeing it, because it had not yet come to them,

因为病毒还没影响到那些地方，

and they didn't believe it was real.

所以他们并不相信其真实性。

And now many of those communities are being ravaged by this disease.

现在很多那些社区 正被这个疾病侵袭。

And so we just have to --

所以我们只要——

You know, it's not appropriate to say "I told you so."

如果只是说“我早说过了” 可能不是很合适。

It is appropriate to say, "Look, now that you see it,

我们更应该说：“你看， 现在你看到病毒影响了，

come on board and help us resolve these problems."

加入我们，帮助我们 解决这些问题吧”，才更合适。

But this is something that's going to be around for a while.

但这种情况将会持续一段时间。

And if it becomes endemic,

如果这成为地方性疾病，

meaning that it occurs all the time at some low level,

意味着它将在低层面持续发生，

everyone is going to have this experience.

最终每个人都无法幸免。

CA: Thank you.

CA：谢谢。

Here is one from Robert Perkowitz.

还有一个来自 罗伯特 · 珀科维茨的问题：

"We seem to have been ignoring and underfunding public health,

“我们似乎一直都忽视了公共卫生的问题， 并且没有投入足够的资金，

and we were unprepared for this virus."

所以我们未能为该病毒 做足准备。”

Look if the question is going to pop up there,

这个问题应该会出现在屏幕上，

稍等一下。

I think it should, by some magic.

"What should our priorities be now

“我们现在的优先事项是什么？

to prepare for the next public health crisis?"

如何更好的为下次的 公共健康危机做好充分的准备？”

GB: Well, we now need to make sure that we've put in the funding,

GB：我们现在需要确保

resources, training, staffing on the table.

就投入的资金、资源、 训练和人员展开充分的讨论。

And by the way, our next public health crisis

顺便一提，我们下一次 面临的公共卫生危机

is not 10 years from now, it's not 20 years from now,

不是 10 年之后， 更不是 20 年之后，

it's the potential co-occurrence

这是潜在的流感并发，

of influenza, which we know is going to happen this fall,

所以我们知道它将于今年秋天发生，

because it comes every year,

因为流感季节每年都会发生，

with either continued COVID or a spike in COVID.

不论是持续伴随着新冠病毒， 或是出现新冠病毒的峰值。

And we're going to have a disease process

我们都将经历一个

which presents very much the same,

几乎相同的疾病传播过程，

and we're going to have to differentiate COVID from influenza.

而我们将不得不区分 新冠病毒和流感。

Because we have a vaccine for influenza,

因为我们有预防流感的疫苗，

we don't yet have a vaccine for COVID.

但还没有针对新冠病毒的疫苗。

We hope to have one in about a year.

我们希望在未来一年左右 能研发出新冠病毒疫苗。

But that still remains to be seen.

但这还得看情况。

DB: So get your flu shots.

DB：所以大家去接种流感疫苗吧。

CA: Yeah.

CA：是啊。

Indeed, in fact, David Collins asked exactly that question.

没错，事实上， 戴维 · 柯林斯问了同样的问题。

"What is the likelihood of a vaccine before the next wave?"

“在下一波疫情来袭之前， 我们能获得疫苗的可能性有多大？”

GB: Well you know, the fastest vaccine that we've ever developed was measles,

GB：事实上，人类史上 研发速度最快的是寻麻疹疫苗，

and that took four years.

花了 4 年时间。

Now, a lot of things are different, right?

如今，很多事情 都大有不同了对吧？

We have started on a SARS-one vaccine.

我们已经开始了 SARS 疫苗的研发，

So it had gone to a lot of animal trials,

这需要通过一系列的动物试验，

it had gone to some very, very early human trials.

需要通过一些非常非常早期的 人体临床试验。

As you know, we just got some announcement

大家可能已经知道， 我们刚从最新的通告中得知，

that at least it does seem to work in monkeys, in rhesus monkeys,

说它至少对恒河猴起作用，

and there's some evidence that at least it may be efficacious and safe

也有一些证据 表明至少在极少数人中，

in a very, very small number of people.

这可能是有效且安全的。

When I say very, very small number of people,

我说的极少数人，

handful of people.

就是很少很少的人……

So now it's got to go to phase two and phase three trials.

所以现在该疫苗的研发将会进入 第二和第三阶段试验。

So, yeah, [David] held up two hands,

所以没错， 戴维举起了两只手，

so yeah, yeah, it's a small number of people.

没错，就是这样， 只有很少的一些人。

What that tells you is either that those folks were very lucky,

这意味着 要么那些人非常幸运，

or it works.

要么就是 这个疫苗的确有效。

And we won't know until we put this into the arms of thousands of people.

而在将其进行广泛接种之前， 我们不得而知。

CA: Here's an important question from a TED Fellow.

CA：还有一个很重要的 来自 TED 会员的问题：

"How do we actually train people about what public health means?

“我们如何才能准确训练人员 认清公共卫生到底意味着什么？

尤其在人们不相信

Especially in the context of folks

who don't believe they have a responsibility to 'the public?'"

自己对 ‘公众’ 也肩负责任的情景下？”

GB: Well, you know, I remind folks

GB：我通常提醒人们

that when public health does its best job,

当公共卫生发挥最大作用时，

nothing happens.

什么都不会发生。

And of course, when nothing happens, we don't get credit for it.

当然，如果大家都安然无恙， 我们的贡献就根本无人知晓。

So the reason that everyone in this country

所以，这个国家每个人

does not have to get up every morning and boil their own water

早上起来不用烧水喝，

is because of public health.

是因为公共卫生。

The reason that, if you get into a car accident,

如果你被卷入一场车祸，

you know, get into an automobile collision,

汽车相撞，

and you wear your seat belt, and you have airbags,

你系着安全带， 车里有安全气囊，

and you're not killed from that automobile collision,

那么你幸存于这场车祸的原因

is because of public health.

也是因为公共卫生。

The reason that the air is safe to breathe,

你能安全的呼吸空气，

the food is safe to eat,

安全的进食，

is because of public health.

都是因为公共卫生。

The reason that your kids are not in clothing that ignites

你孩子身上的衣服不会着火，

is because we have fire-retardant clothing.

是因为制衣时 我们采用了防火材料，

And that is a requirement.

而且这是一个制衣要求。

The reason that you don't trip walking down the stairs

你走楼梯的时候不会被绊倒，

is because we've actually looked at how to build the stair

是因为我们已经研究过 如何设计楼梯，

so that people don't trip when they go up or down it.

能防止人们在上下台阶时 不被绊倒。

That's actually a public health intervention.

这实际也是 一种公共卫生的干预。

So the built environment,

所以已建立的环境、

medicines, all those kinds of things,

医药等等各种东西，

vaccines, those are all public health,

包括疫苗， 它们都属于公共卫生的范畴，

and that's why public health is there,

而这也是为何我们说 公共卫生无处不在，

and you may not believe that it's that important,

你可能不会相信它们很重要，

but we couldn't live without it.

但没有它，我们无法生存。

CA: Maybe one day we can all envision a health care system in America

CA：或许有一天我们所有人 都能构想出一个美国的医疗保健系统，

that actually has some incentives

在公共卫生方面

that point towards public health.

确实有着一些激励机制。

That would be very nice.

这会很好。

David, I've got to just keep going with some of these questions, if it's OK,

戴维，如果可以的话， 我得继续问接下来的问题，

因为大家的问题 正源源不断的进来。

because they're pouring in.

There's one here from Jacqueline Ashby.

这个问题来自杰奎琳 · 阿什比，

Important question for every parent.

是个对每位家长都很重要的问题：

"What are your recommendations about sending children back to school?"

“对于把孩子们送回学校， 您有些什么建议？”

GB: Yeah, I'm struggling with this one, I've got three grandkids.

GB：是的，我也在苦思这个问题， 我有 3 个孙辈小孩。

And the good news is that my grandkids are more technically proficient than I am,

好消息是我的孙辈们 比我更精通技术，

and right now are getting their lessons remotely.

所以他们现在正远程上课。

I think it's going to be a challenge

我认为把孩子送回学校

as we think about sending kids back to school.

在目前看来会是一个挑战。

We're going to really need to know how infectious kids are

我们真的需要明确 孩子的感染力有多强，

and how well they do when they get infected.

他们被感染时的状态如何。

Now, right now, it seems,

现在看来，

except for a very small number of children who get a very rare disease,

除了很少一些 患有罕见疾病的孩子们，

that they tolerate this disease very well.

大部分儿童似乎 对于该疾病的耐受性很好。

But the central question is,

但核心问题在于，

how many of these germs will these kids bring back to you

那些孩子将会带回多少病菌

and to grandma and grandpa.

给你，还有祖父和祖母。

So that's going to be important.

这个问题很关键。

And you know, trying to tell an eight-year-old

而且尝试告诉一个 8 岁的孩子

not to interact with their friends,

不要和他们的朋友互动，

is a real challenge.

算是一个挑战。

By the way, trying to tell a 17-year-old not to interact with their friends

话说，尝试告诉一个 17 岁的青少年 不要和朋友互动，

is going to be a real challenge.

绝对是个真正的挑战。

So, we've got to properly educate these kids,

所以我们需要正确教育孩子，

we've got to figure out how we stagger their schedules.

需要弄清如何错开他们的时间表。

Uri's idea for the workforce

乌里针对工作场所的想法

might be an interesting concept for schools,

可能对学校政策提供 一些有趣的参考——

because the idea is to try to decompress the number of kids in the classroom.

因为想法本身其实就旨在 减少在教室中孩子的数量。

By the way, if you get smaller class size, you get better education, anyway.

班级人数变少，同时， 教育质量还能有所提高。

So, we've got to have enough teachers, though.

不过我们得有足够的师资，

So that may be the rate limiting step.

在这点上我们可能会 面临一些问题。

CA: Alright, last question here for now from [Steven] Petranek.

CA：好的，最后一个问题， 来自史蒂文 · 彼得兰克。

Masks. Advice on masks --

是口罩，关于口罩的建议。

I switched that off, here we go.

哦，我不小心把字幕关了，好了。

Advice on masks seems to have shifted.

针对口罩的建议似乎发生了变化。

"Would most Americans who live and work in cities

“在城市中工作生活的美国人，

be better off wearing masks

戴口罩大部分会受益于戴口罩吗？

to also help reduce the air pollution particles

也会同时帮助他们 减少每天吸入的

they encounter every day?"

空气污染颗粒吗？”

GB: It may help some, absolutely.

GB：在一定程度上绝对会有帮助。

But let me tell you what I would prefer we stopped doing:

但我想说的是 不建议大家去做的事：

燃烧化石燃料，

burning fossil fuels.

And doing all those terrible things

还有做那些会让我们破坏气候的

that we are doing to destroy our climate.

糟糕的事情。

You know, everyone's talking about the fact

所有人都在谈论一个事实——

that we've had this amazing reduction

因为我们没有在开车，

in CO2 because we're not driving cars.

所以我们极大减少了二氧化碳排放。

I've got to tell you,

我得告诉你，

that is the best evidence that climate change is man-made.

这是“人为因素造成了 气候变化”的最佳证据。

All those climate change skeptics

所有那些气候变化论怀疑者，

who don't think climate change is man-made,

不认为气候变化 是人为因素造成的人，

we have just had a worldwide demonstration

我们刚在世界范围内 亲眼目睹了一场演示——

on what people do to create climate change.

人类如何创造了气候变化。

And so what we need to do is stop

所以我们需要做的

and move to a green economy.

就是停下脚步， 转向绿色经济。

DB: Here, here.

DB：说得太好了。

CA: Thank you so much for those,

CA：非常感谢您的回答，

I'll dip back in at the end with maybe a couple more.

我在最后可能还会带着几个问题 再次参与你们的讨论。

再次感谢。

Thank you for this.

DB: So we're waving the flag for masks.

DB：所以我们正在号召口罩的使用。

But also, one of the things

但与此同时，有一种情势

that has become clear from this

也由此变得更加清晰了——

is that COVID-19 is not the great leveler that maybe some had hoped it was.

即新冠病毒所呈现的并非是 有些人所认为的人人平等的局面。

Some communities are experiencing much worse,

有些社区正面临着

比其他社区要糟糕得多的情况。

significantly worse outcomes than others.

Why is that?

为什么呢？

GB: We're talking principally about the African American

GB：我们所说的主要是非裔美国人

and Latino communities

和拉丁裔社区，

that seem to be disproportionately impacted if they get the disease.

一旦感染了这个疾病， 他们似乎会遭受不成比例的巨大影响。

And it's because of exposure, primarily.

这主要是因为暴露程度。

Those populations have more public-facing jobs.

他们中更高比例的人 在从事面向公众的工作，

So, you know, bus drivers,

例如公交司机、

grocery clerks,

杂货店店员，

working in long-term care facilities,

很多人在长期护理机构、

nursing homes,

疗养院、

in meatpacking facilities, chicken farms.

肉类包装工厂， 养鸡场等场所工作。

So that's why they're much more -- going to be exposed to the disease.

这也就是为何他们 更可能遭受疾病侵袭。

Susceptibility.

还有易感性，

Lots of chronic disease.

以及许多慢性疾病。

So we know that particularly African Americans

尤其是非裔美国人，

have disproportionate amounts of diabetes, heart disease,

很多人都患有糖尿病、心脏病、

lung disease,

肺部疾病，

and because of those chronic diseases,

因为这些慢行疾病，

we found early on that that virus

我们在早期就发现，

is more detrimental to those populations that have those diseases.

病毒针对这类人群更为致命。

And so that's the big issue here.

所以这是一个大问题。

That is what's causing those differentiations

这就是造成这些差异的原因。

and it's really a challenge,

这的确是一个挑战，

because in many ways,

因为在许多方面，

those are many of the people

他们中的很多人

that we have decided are essential employees

是我们的政策所认为的 关键岗位的员工，

and have to go to work.

必须坚持上班。

DB: That's right.

DB：没错。

So what is, in your view, the public health intervention

那么在您看来，

to protect these essential workers,

怎样的公共卫生干预 可以保护这些关键岗位的员工，

if you have ideas on that front?

如果您在这方面有任何想法的话？

GB: I absolutely do.

GB：肯定的。

We started this by a testing strategy based on symptoms.

我们从基于症状的检测策略开始。

And now that we have enough tests,

现在我们已经进行了 足够的检测，

we need to make sure that not only people get those tests for clinical reasons,

我们不仅需要确保

那些临床需求和出现症状的人 能获得检测，

and people who have symptoms,

but also begin to prioritize people who are public-facing,

也需要开始优先考虑

面向供众的关键岗位工作者。

who are essential workers.

So, certainly people working in nursing homes, hospitals, etc.,

例如在疗养院和医院的工作人员，

but bus drivers, security guards,

还有公交车司机、保安、

grocery store clerks.

杂货店员工，等等。

They need to be tested,

他们需要被检测，

and they need to have testing with the periodicity

而且需要定期被检测，

that will secure them, their families,

这能为他们和他们的家庭 提供一定的保障，

and give everyone the trust

让所有人相信

that they're not going to be infected

他们不会被感染，

and we're not going to infect them.

并且我们不会让他们被感染。

People who work in meatpacking plants,

拿在肉类包装加工厂的工人

as an example.

举个例子。

And we've seen the real tragedy

我们已经看到了，

of what's going on in the meatpacking plants,

肉类包装厂的情况相当严峻，

because they are working in an environment where they're shoulder to shoulder.

因为他们的工作环境 是人群密集的，大家肩并肩站着。

There are some other things they need to do

围绕着在生产线上 如何保持一定的物理距离，

in terms of figuring out how to give them physical distancing on the assembly line,

有很多重要的事情

需要考虑。

that's going to be important.

But again, Uri's idea is not a bad idea

但我要再次重申， 乌里的想法对于这个国家的情况

for this nation to consider,

也是适用的，

for many of those industries to think about.

值得很多类似行业参考。

DB: Yeah, we have to make sure that these truly are folks

DB：是的，我们必须确保 这些人被视为关键岗位工作者，

who are treated as essential workers, not sacrificial workers, it seems to me.

而非可牺牲的工人。 我是这么认为的。

And obviously, this is not just confined to the US.

而且显然，这不仅限于美国。

GB: Oh, absolutely.

GB：哦，绝对的。

We're seeing these disparities not just in the United States,

我们不仅在美国看到了这些差异，

but in other countries as well.

其他国家也是。

And they have a lot to do with race and class

他们有大量的相关工作要做—— 关于种族和阶级，

and the types of jobs that you do,

你的工作类别，

the occupations that you do.

还有你的职业。

And quite frankly,

而且老实说，

we should have thought about this when we saw the first data

在第一次看到中国公开的数据时，

that showed that in China

我们本就应该想到这些：

people with chronic diseases were much more at risk

患有慢性疾病的人 处于更大的风险之中，

and had worse health outcomes.

并有着更严重的健康后果。

We would have sped up our actions right away,

我们本能立即加快我们的行动，

because, look, that's happened with every new disease

毕竟这是每个新疾病进入一个国家

that's come into the country.

都会发生的情况。

DB: So it seems like a lot of this goes back to that potential --

DB：好像又回到了刚才的话题——

it's not an oxymoron,

这不是一种矛盾说辞，

public health is everybody's job,

公共卫生真的是每个人的工作，

and we need to adopt that.

我们需要积极采用这种方法。

What does, in your view,

在您看来，

a robust public health infrastructure look like?

一个健全的公共卫生 基础设施看起来是怎样的？

What would that look like?

能为我们展望一下吗？

GB: Well, you know,

GB：应该说，

anytime a new health threat enters our community,

不论何时，一种新的公共健康威胁 进入我们社区，

we ought to be able to rapidly identify it,

我们都应该能快速鉴别

contain it,

并控制它，

and if we can mitigate it, for sure, and eliminate it if possible,

而且要尽量削弱它的威胁， 甚至彻底消灭它，

and then put in all the protective measures

并且实行我们之前所有的

that we had before.

保护措施。

这就意味着，我们需要有

So that means having a well-staffed,

一个有良好人员配备且训练有素的 政府公共卫生机构，

well-trained governmental public health entity,

just like we have for police, fire, EMS.

就如同我们的警察、消防 和邮政特快专递（EMS）系统一样。

It means that they've got to be well-paid,

这意味着这些人需要有 良好的薪资水平，

it means that they've got to be well-resourced.

意味着他们需要有充足的资源。

You know, we still have some of our contact tracers

我们仍旧有一些联系追踪人员

out there using pen and pads.

在用笔和小本子在进行记录，

And sending things to Excel Spreadsheets.

之后转换成 Excel 表格。

No, we need the same kind of robust technology

这样不行，我们需要 同样健全的技术支持，

that the folks at, you know,

那种任何在线零售商

any of the online retailers are using, whether it's Amazon, etc.

都在使用的科技， 例如亚马逊之类的。

We're still looking at data that's two years in the rear

我们还在用两年前的数据

to make data-driven decisions.

做着数据驱动的决策。

We need to be able to make immediate decisions.

我们需要能够做出即时决策。

By the way, Taiwan,

顺便一提，

you mentioned them earlier,

你之前提及了台湾，

I remember being in Taiwan

我记得之前在台湾的时候，

watching data come from infectious diseases, real time,

看到过感染性疾病的实时数据

from their electronic medical record system.

从他们的电子医疗记录系统 自动录入更新。

So, you know, we can do this, the technology exists.

所以我们可以做到的， 这样的科技已经存在了。

DB: Imagine that.

DB：想象一下，

Wow, real time health information,

实时卫生信息，

what a difference that would make.

这能做出多大的改变啊。

Do you think that technology can help us here,

所以您认为科技 在这个领域能帮助我们，

whether that's the Google-Apple collaboration or whatever else?

不论是谷歌和苹果的合作， 还是以其他的方式？

GB: Technology can help us,

GB：科技可以帮助我们，

but it's not going to replace us.

但不会替代我们。

We're nowhere near where we can sit back

坐在一边，让我们的 虚拟人物为我们工作——

and have our electronic avatar do our work for us.

我们离这样的未来还很远。

But the technology can outstrip our work.

但是科技可以超前于我们的工作，

It can give us situational awareness.

可以帮助我们了解现实情况；

It can give us real time information.

提供我们实时数据；

It allows us to send information from point A to point B

让我们能够进行数据传送

for data analysis.

和数据分析；

It allows us to do second thinking,

让我们能够进行二次思考，

so we're doing all this modeling,

所以我们在做 所有这些建模的工作；

it allows others to check our numbers right away.

他人也能够立即检查我们的数据，

So it could speed up research.

所以这的确可以加速我们的研究。

But we have to invest in it,

但是我们需要投资于科技，

and we have to continue it,

而且我们需要不断投资，

because obsolescence is always the evil part of technology.

因为过时的科技有害无利。

DB: And it looks like Chris is back with more questions.

DB：看起来克里斯 带着更多问题回来了。

CA: Yeah, I guess we're getting close to the end,

CA：是的，时间快要到了，

but the questions keep coming in.

但我们还在不断收到新的问题。

There's one here from Neelay Bhatt.

有一个来自尼莱 · 巴特的问题：

"What role do you see parks, trails and open space play

“您认为公园、步道和开放空间 在协助实现更大的公共卫生目标方面

in assisting larger public health goals?"

能扮演什么角色？”

GB: You know, green space is absolutely essential,

GB：绿色空间绝对很重要，

and the ability to get out and walk and exercise,

能够出门走路和运动，

having sidewalks, so that you can have communities that are walkable,

有街边步道让你能够 在社区自由行走、骑行，

bikeable and green for utilization of all ages,

这是适合各个年龄段的 环保健身方法，

it's good for our mental health, it's good for our physical health.

有利于我们的心理和身体健康。

And I always tell folks, you know,

我时常说，

it's a great place to go when someone's gotten on your last nerve.

当有人不知所措时， 这是一个理想的去处。

CA: Indeed.

CA：确实。

Here we have one anonymous question.

我们还有一个匿名问题——

Where possible don't go anonymous,

请尽量不要匿名——

because we're all friends here when all said and done.

因为这里所有人都是我们的朋友。

Probably someone ... Anyway.

可能有人……无所谓了。

Let's see, but it's a good question.

让我们看看， 这倒是个很好的问题。

"There are many who are highly suspicious of what the real experts are saying.

“很多人高度怀疑专家说的话。

What have you found to be effective in helping the highly suspicious

你知道怎样能有效帮助 那些持高度怀疑态度的人

be less suspicious and more trusting?"

变得不那么多疑，而是更加信任？”

GB: Tell the truth.

GB：传递真相。

If you make a mistake, acknowledge it and correct it right away.

如果你犯了错，承认自己的错误， 并马上纠正过来。

Be consistent.

说话要前后一致。

And don't say stupid stuff.

不要说蠢话。

And far too often that happens.

这种事太常见了。

And you know, one of the interesting things,

有意思的是，

we've already been through this with the mask discussion.

我们已经针对口罩进行了讨论。

You know, traditional wisdom was that we only had people wear the mask

从传统的角度来说， 只有具有传染性的人

if they were infectious,

才需要戴口罩，

or you're in a health care environment

或者你是医护人员，

where there was a high risk of getting the disease.

需要在高风险环境下工作。

And then we said,

之后我们说，

no, it's OK for everybody to wear a mask.

不，每个人都可以戴口罩。

And that's because we learned eventually,

因为我们最后了解到，

and became much more believable,

也更加确信，

in the science that we had asymptomatic spreading.

有科学研究证实了 无症状传播的说法。

But we did not communicate it very well.

但我们并没有进行很好的沟通。

We said, oh, no, no, we're changing our minds,

在我们告诉人们不要戴口罩后，

everybody can wear a mask,

我们说：“哦不，不， 我们改变主意了。

after telling people not to wear a mask.

每个人都可以戴口罩。”

And then we didn't spend enough time explaining to people why.

之后我们没有花足够的时间 为大众解释原因，

So we lost trust.

所以我们失去了人们的信任。

So we need to do a better job of that.

所以在这方面，我们需要做得更好。

And then our leaders

还有，我们的各位领导人，

need to be very careful what they say when you have a bullhorn.

当你手持话筒， 你需要非常小心。

And by the way, I've made mistakes,

我也犯过错误，

I've said things on TV that were just wrong,

我在电视上也说过错话，

because I was wrong.

因为我当时的理解是错误的。

And I've tried very hard to try to correct those

但我努力尝试尽快

as quickly as I can.

改正那些错误。

All of us do that,

我们所有人都犯错，

but you have to be strong enough

但你需要足够坚韧，

and have a strong enough personality to say when you're wrong

有一个坚强的个性 去承认你的错误，

and then correct it.

并改正它。

Because at the end of the day, once you've lost trust,

因为到头来，一旦你失去了信任，

you've lost everything.

你就已经失去了一切。

CA: Well if I might say so,

CA：也许我能这么说，

just the way in which you're communicating right now,

您刚才沟通的方式

I mean, to me, that is a means of communication

对我来说， 是一种能够产生信任的

that engenders trust.

沟通方式。

I don't know what magic sauce you have going there,

我不知道您有什么小诀窍，

but it's very, very compelling listening to you.

但听您所分享的这些， 非常扣人心弦。

Thank you so much for this.

非常感谢。

David, do you have any other last cues?

戴维，你还有什么要说的吗？

GB: I've made lots of mistakes.

GB：我犯过很多错误。

DB: Yeah, no, but it really has been a real pleasure

DB：好的，不， 能有您加入我们今天的这场对话

to have you join us, and thank you for that.

真的是我们的荣幸，谢谢。

Just one final question if I may.

如果可以，我还有最后一个问题。

You've been doing this for a while,

您在这行已经干很久了，

what gives you hope looking forward?

是什么让您怀揣希望继续前行？

GB: You know, let me tell you something.

GB：我想说，

The one thing that gives me hope

一件给我带来希望的事是，

is when I see people taking care of their friends and family members.

我看到了人们悉心照顾 他们的朋友和家人的场景。

I mean, drive-by birthday parties.

比如“驱车经过”的生日聚会，

I saw that on the news today.

我今天刚在新闻上看到这件事。

People who are calling their friends.

人们在打电话给他们的朋友们。

I've heard from people that I haven't talked to in years,

我接到了好几年没联系的 朋友的电话，

他们只是打来问候我：

who are just calling me to say,

“我好久没和你联系了， 你还好吗？”

"I haven't talked to you for a long time. Are you OK?"

So do more of that.

所以多联系联系你的朋友吧。

And the trust we've had in one another,

我们所拥有的对彼此的信任，

and the love we've shown, it's just been absolutely amazing,

我们之间所表达的爱， 简直太不可思议了，

所以这给我带来了希望。

so that gives me hope.

DB: Humanity for the win in the end.

DB：以人性为本，我们终将取胜。

GB: Yeah.

GB：没错。

DB: Well, thank you so much, Dr. Benjamin,

DB：非常感谢本杰明博士的参与，

for joining us and for sharing your wisdom.

并与我们分享您的智慧。

GB: Glad to be here.

GB：很高兴能参与这场对话。

CA: Yes, thank you.

CA：是的，谢谢您。

GB: You guys be safe.

GB：请你们保重。

Your families be safe.

你们的家人也保重。

DB: Thank you, you too.

DB：谢谢，您也是。