How the pandemic will shape the near future | Bill Gates

1,848,966 views ・ 2020-07-06

TED


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00:00
Chris Anderson: Welcome, Bill Gates.
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翻译人员: Grace Yang 校对人员: Yolanda Zhang
克里斯·安德森(Chris Anderson): 欢迎,比尔·盖茨!
00:02
Bill Gates: Thank you.
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比尔·盖茨:谢谢。
00:04
CA: Alright. It's great to have you here, Bill.
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克里斯:好的, 欢迎你加入这场谈话,比尔。
00:06
You know, we had a TED conversation about three months ago
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大概三个月之前,
我们有过一次 关于新冠病毒的对话。
00:09
about this pandemic,
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00:10
and back then, I think fewer than -- I think that was the end of March --
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大概是三月底吧,
00:14
back then, fewer than 1,000 people in the US had died
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当时在美国只有不到 1000 人 因为感染而死亡,
00:16
and fewer than 20,000 worldwide.
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而全球的死亡人数还不到 2 万。
00:19
I mean, the numbers now are, like, 128,000 dead in the US
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然而现在,死亡人数 已经达到了 12 万 8 千人,
00:24
and more than half a million worldwide,
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全球死亡人数超过了 50 万,
00:27
in three months.
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只用了
00:28
In three months.
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短短三个月。
00:30
What is your diagnosis of what is possible for the rest of this year?
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你对下半年的疫情有什么判断呢?
00:34
You look at a lot of models.
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你了解了很多预测模型,
00:37
What do you think best- and worst-case scenarios might be?
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你觉得最坏和最好的情况是什么呢?
00:43
BG: Well, the range of scenarios, sadly, is quite large,
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比尔: 其实有非常多的可能性,
00:46
including that, as we get into the fall,
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比如到了秋季的时候,
00:51
we could have death rates that rival the worst of what we had
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死亡率可能会比四月份
00:56
in the April time period.
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最严重的时候还要高。
00:58
If you get a lot of young people infected,
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如果有许多年轻人感染了,
01:00
eventually, they will infect old people again,
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最终他们就会再把 病毒传染给老年人,
01:03
and so you'll get into the nursing homes,
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所以在养老院里,
01:06
the homeless shelters,
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和流浪汉的收容所里,
01:08
the places where we've had a lot of our deaths.
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死亡人数就会大大增加。
01:11
The innovation track, which probably we'll touch on --
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在科技创新方面,
01:15
diagnostics, therapeutics, vaccines --
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包括诊断、治疗、疫苗等,
01:17
there's good progress there,
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都有了很大的进展,
01:20
but nothing that would fundamentally alter the fact
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但是这并不能改变一个事实,
01:24
that this fall in the United States could be quite bad,
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那就是这个秋季美国的 疫情可能会很严重,
01:28
and that's worse than I would have expected a month ago,
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并且比我上个月预测的还要严重。
01:32
the degree to which we're back at high mobility,
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因为我们逐步复工,
01:35
not wearing masks,
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人们不戴口罩,
01:37
and now the virus actually has gotten into a lot of cities
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所以新冠病毒正在许多城市蔓延,
01:42
that it hadn't been in before in a significant way,
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而这种传播速度是前所未有的,
01:47
so it's going to be a challenge.
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所以这将是一个挑战。
01:50
There's no case where we get much below the current death rate,
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让死亡率降低到
01:54
which is about 500 deaths a day,
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每天 500 人以下是不太可能的。
01:57
but there's a significant risk we'd go back up
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但是二次爆发的几率却很大,
02:01
to the even 2,000 a day that we had before,
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死亡率甚至会攀升到 一天 2000 人,
02:06
because we don't have the distancing,
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这都是因为我们 没有保持社交距离,
02:09
the behavior change,
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没有像四五月份的时候那样
02:11
to the degree that we had in April and May.
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居家隔离。
02:15
And we know this virus is somewhat seasonal,
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并且我们知道,这个病毒 在一定程度上是季节性的,
02:19
so that the force of infection,
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所以包括温度、湿度、 更多的室内活动等影响,
02:21
both through temperature, humidity, more time indoors,
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会导致感染率
02:25
will be worse as we get into the fall.
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在秋季有所增长。
02:28
CA: So there are scenarios where in the US,
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克里斯:所以如果 按照这个增长速度
02:30
like, if you extrapolate those numbers forward,
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推断美国的疫情情况,
02:32
we end up with, what,
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到最后,
02:33
more than a quarter of a million deaths, perchance,
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如果我们没有控制好,
02:36
even this year if we're not careful,
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仅在今年就会有 超过 25 万人死亡。
02:39
and worldwide, I guess the death toll could, by the end of the year,
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而到了今年年底,
02:42
be well into the millions, with an "s."
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全球会有超过百万人死亡。
02:45
Is there evidence that the hotter temperatures of the summer
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有没有证据表明高温
02:49
actually have been helping us?
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其实会帮助我们抑制病毒?
02:53
BG: They're not absolutely sure,
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比尔:这个我们还不能确定,
02:54
but certainly, the IHME model definitely wanted to use the season,
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但是健康指标和评估研究所(IHME) 确实曾尝试用环境因素,
03:01
including temperature and humidity,
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像温度和湿度,
03:03
to try and explain why May wasn't worse than it was.
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来解释为什么五月的疫情 并没有之前那么严重。
03:08
And so as we came out and the mobility numbers got higher,
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当我们开始出行,
03:14
the models expected more infections and deaths to come out of that,
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这个模型显示, 感染和死亡人数也会增加。
03:20
and the model kept wanting to say,
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并且这个模型 也一直希望能够表明,
03:22
"But I need to use this seasonality
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是否能够用季节性来解释,
03:28
to match why May wasn't worse,
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为什么五月份没有那么严重,
03:30
why June wasn't worse than it was."
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为什么六月份 并没有之前那么严重。
03:34
And we see in the Southern Hemisphere,
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并且我们也观察到,在南半球,
03:39
you know, Brazil,
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像巴西,
03:41
which is the opposite season,
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那里目前是冬季,
03:43
now all of South America is having a huge epidemic.
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现在所有的南美洲国家 都已经有了大规模的传染。
03:48
South Africa is having a very fast-growing epidemic.
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病毒也在南非迅速传播。
03:53
Fortunately, Australia and New Zealand,
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幸运的是,澳大利亚和新西兰
03:55
the last countries in the Southern Hemisphere,
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是仅有的几个 没有很多确诊人数的
03:57
are at really tiny case counts,
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南半球国家。
03:59
and so although they have to keep knocking it down,
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即使他们在很努力地防疫,
04:03
they're talking about, "Oh, we have 10 cases,
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也仍然会说, “我们又确诊了 10 例,
04:05
that's a big deal, let's go get rid of that."
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这可不是个小数目, 我们得严格防控。”
04:09
So they're one of these amazing countries that got the numbers so low
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所以他们才成为了能把确诊人数 降到最低的那几个国家。
04:14
that test, quarantine and trace
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这些测试、隔离和追踪
04:18
is working to get them, keep them at very near zero.
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都能帮助他们 把感染人数降到接近 0。
04:23
CA: Aided perhaps a bit by being easier to isolate
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克里斯: 更方便的隔离促使
04:26
and by less density, less population density.
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和更低的人口密度 可能会帮助他们控制疫情。
04:29
But nonetheless, smart policies down there.
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当然还有明智的政策。
04:32
BG: Yeah, everything is so exponential
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比尔:是的, 所有数字都在飞快增长,
04:33
that a little bit of good work goes a long way.
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一点点努力都会有很大的帮助。
04:36
It's not a linear game.
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这不是一个简单的局面。
04:38
You know, contact tracing, if you have the number of cases we have in the US,
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拿美国的确诊人数来说,
04:43
it's super important to do,
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追踪接触者是尤其重要的,
04:45
but it won't get you back down to zero.
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但这并不会直接把感染率降到 0,
04:48
It'll help you be down,
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只是会把确诊人数降低一点,
04:49
but it's too overwhelming.
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但目前确诊人数实在是太多了。
04:53
CA: OK, so in May and June in the US,
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克里斯:在五六月份的时候,
04:56
the numbers were slightly better than some of the models predicted,
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美国的确诊人数 比预估的要好一些,
04:59
and it's hypothesized that that might be partly because of the warmer weather.
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这有可能是因为天气转暖。
你会把我们现在所看到的局面
05:03
Now we're seeing, really, would you describe it
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05:05
as really quite alarming upticks in case rates in the US?
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当作一个爆发的预警吗?
05:11
BG: That's right, it's --
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比尔:是的,
05:13
In, say, the New York area,
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比如像纽约地区,
05:17
the cases continue to go down somewhat,
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确诊人数在持续下降。
05:20
but in other parts of the country,
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但是在其他地方,
05:22
primarily the South right now,
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比如美国南部,
05:26
you have increases that are offsetting that,
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确诊人数在持续增加。
05:28
and you have testing-positive rates in young people
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并且年轻人的确诊率
05:32
that are actually higher than what we saw even in some of the tougher areas.
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甚至要比一些疫情 严重的地区还要高。
05:38
And so, clearly, younger people have come out of mobility
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很明显,年轻人开始外出活动,
05:42
more than older people have increased their mobility,
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并且比老年人外出频率要高,
05:46
so the age structure is right now very young,
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所以现在感染的 主要人群是年轻人。
05:51
but because of multigenerational households,
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但是有的家里有不同年龄的人,
05:54
people work in nursing care homes,
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有人在养老院工作,
05:56
unfortunately, that will work its way back,
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不幸的是, 这些人都很容易被感染。
06:00
both the time lag and the transmission,
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而这样就会
06:03
back up into the elderly,
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导致很多老年人确诊。
06:04
will start to push the death rate back up,
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所以死亡率就会开始增长。
06:07
which, it is down --
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而现在的死亡率已经
06:10
way down from 2,000 to around 500 right now.
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从每天 2000 人 降低到差不多 500 人了。
06:15
CA: And is that partly because there's a three-week lag
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克里斯:这是不是因为 在确诊人数和死亡人数中
06:18
between case numbers and fatality numbers?
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有三个星期的时间差?
06:21
And also, perhaps, partly because
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也有可能是因为
06:24
there have been some effective interventions,
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一些有效的防护
06:26
and we're actually seeing the possibility
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让死亡率
06:29
that the overall fatality rate is actually falling a bit
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下降了一点点,
06:32
now that we've gained some extra knowledge?
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并且我们对病毒了解更多了?
06:34
BG: Yeah, certainly your fatality rate is always lower
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比尔:是的,如果医院 没有超负荷运转的话,
06:38
when you're not overloaded.
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死亡率一定会低一些。
06:40
And so Italy, when they were overloaded,
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当意大利的医院超负荷的时候,
06:43
Spain, even New York at the start,
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还有西班牙, 甚至是纽约初期的时候,
06:46
certainly China,
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还有中国,
06:48
there you weren't even able to provide the basics,
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医院甚至都不能提供 基本的医疗设施,
06:53
the oxygen and things.
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像氧气等等。
06:56
A study that our foundation funded in the UK
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我们在英国的基金会发现,
07:00
found the only thing other than remdesivir
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除了瑞德西韦,
07:03
that is a proven therapeutic,
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唯一被证明有一定疗效的
07:06
which is the dexamethasone,
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就是地塞米松,
07:08
that for serious patients,
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而且是给重症病人用的。
07:11
is about a 20 percent death reduction,
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这个药会减少大概 百分之二十的死亡率。
07:15
and there's still quite a pipeline of those things.
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所以这些药物的需求也很大。
07:20
You know, hydroxychloroquine never established positive data,
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现在没有数据证明 羟化氯喹有效,
07:23
so that's pretty much done.
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所以这个试验基本上 就不会再进行了。
07:26
There's still a few trials ongoing,
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现在还有少数几个实验在进行。
07:28
but the list of things being tried,
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但是所有我们尝试过的东西,
07:31
including, eventually, the monoclonal antibodies,
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包括单克隆抗体,
07:35
we will have some additional tools for the fall.
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我们在秋季的时候 将会有更多的手段。
07:39
And so when you talk about death rates,
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所以说到死亡率,
07:42
the good news is, some innovation we already have,
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好消息是我们已经 取得了一定的进展,
07:46
and we'll have more, even in the fall.
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并且在秋季的时候 会有更多进展,
07:49
We should start to have monoclonal antibodies,
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到时候我们应该 会有单克隆抗体,
07:53
which is the single therapeutic that I'm most excited about.
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这是我最期待的疗法。
07:57
CA: I'll actually ask you to tell me a bit more about that in one sec,
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克里斯:其实我想让你 再详细地说说
08:01
but just putting the pieces together on death rates:
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关于死亡率的问题。
08:03
so in a well-functioning health system,
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在一个正常运转的医疗系统里,
08:05
so take the US when places aren't overcrowded,
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像是在美国,如果 没有那么多人的话,
08:09
what do you think
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现在的死亡率大概会是
08:11
the current fatality numbers are, approximately, going forward,
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全部确诊人数的 1%?
08:14
like as a percentage of total cases?
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你是怎么想的?
08:17
Are we below one percent, perhaps?
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会低于百分之一吗?
08:20
BG: If you found every case, yes,
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比尔:如果你把每一个 病例都统计上,是的。
08:23
you're well below one percent.
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死亡率会低于 1%。
08:26
People argue, you know, 0.4, 0.5.
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有的人会说 0.4%,0.5%。
08:31
By the time you bring in the never symptomatics,
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当你把无症状感染者 也计入考量的话,
08:34
it probably is below 0.5,
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死亡率就会低于 0.5%,
08:37
and that's good news.
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这是个好消息。
08:38
This disease could have been a five-percent disease.
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新冠病毒本可能是一个 死亡率 5% 的病毒。
08:43
The transmission dynamics of this disease
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这个病毒的传播性
08:47
are more difficult than even the experts predicted.
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比许多专家预料的还要强。
08:54
The amount of presymptomatic and never symptomatic spread
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无症状和轻度症状感染者 也会传染很多人,
08:58
and the fact that it's not coughing,
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因为他们不咳嗽,
09:01
where you would kind of notice, "Hey, I'm coughing" --
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完全没有任何预兆,
09:03
most respiratory diseases make you cough.
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但许多的呼吸道疾病 都有咳嗽的症状。
09:06
This one, in its early stages, it's not coughing,
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在潜伏期, 新冠感染者是不会咳嗽的,
09:09
it's singing, laughing, talking,
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还能正常唱歌、大笑、说话。
09:13
actually, still, particularly for the super-spreaders,
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尤其是这些超级传染者,
09:16
people with very high viral loads,
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携带很多病毒的人,
09:17
causes that spread,
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造成的传播
09:18
and that's pretty novel,
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这是比较惊人的。
09:21
and so even the experts have to say, "Wow, this caught us by surprise."
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所以专家们也不得不承认。 “哇,这是我们没有预料到的。”
09:25
The amount of asymptomatic spread
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因为无症状感染者的高传播率
09:27
and the fact that there's not a coughing element
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和没有咳嗽等症状,
09:30
is not a major piece like the flu or TB.
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所以这和普通流感 或者肺结核并不太一样。
09:33
CA: Yeah, that is devilish cunning by the virus.
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克里斯:是的,这就是 新冠病毒的狡猾之处。
09:36
I mean, how much is that nonsymptomatic transmission
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我想知道无症状感染者的传播率
09:41
as a percentage of total transmission?
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占总传播率的多少呢?
09:43
I've heard numbers it could be as much as half of all transmissions
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我听说仅仅轻症状感染者
09:46
are basically presymptomatic.
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就占了一半的传播率。
09:49
BG: Yeah, if you count presymptomatics,
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比尔:是的,如果你考虑 轻症状和无症状感染者,
09:52
then most of the studies show that's like at 40 percent,
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那么大部分的研究都会表明,
09:57
and we also have never symptomatics.
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他们的传染率大概占 百分之四十左右。
10:00
The amount of virus you get in your upper respiratory area
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在上呼吸道的病毒
10:04
is somewhat disconnected.
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跟下呼吸道是没有关联的。
10:05
Some people will have a lot here and very little in their lungs,
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有些人的上呼吸道感染很严重, 但肺部却不太受影响。
10:08
and what you get in your lungs causes the really bad symptoms --
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而在肺部里的病毒会 让你感到非常的不适,
10:13
and other organs, but mostly the lungs --
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其他器官也会,但主要是肺部。
10:16
and so that's when you seek treatment.
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所以你就会去医院寻求治疗。
10:19
And so the worst case in terms of spreading
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传染方面最坏的情形,
10:21
is somebody who's got a lot in the upper respiratory tract
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就是那些 上呼吸道感染较重的人,
10:24
but almost none in their lungs,
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但是肺部基本上没有感染,
10:26
so they're not care-seeking.
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所以他们就不会去医院。
10:29
CA: Right.
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克里斯:是的。
10:31
And so if you add in the never symptomatic
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如果把所有的无症状感染者
10:34
to the presymptomatic,
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都计入轻症状感染者里,
10:36
do you get above 50 percent of the transmission
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会有超过 50% 的传染率
10:38
is actually from nonsymptomatic people?
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来自无症状感染者吗?
10:41
BG: Yeah, transmission is harder to measure.
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比尔:是的,传染率其实更难评估。
10:45
You know, we see certain hotspots and things,
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我们已经看到一些爆发地,
10:48
but that's a huge question with the vaccine:
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所以对疫苗还有很大的疑问:
10:51
Will it, besides avoiding you getting sick,
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除了自己做好防护,
10:55
which is what the trial will test,
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实验要证明的就是
10:57
will it also stop you from being a transmitter?
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疫苗会不会防止你传染给别人?
11:01
CA: So that vaccine,
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克里斯:这个疫苗
11:02
it's such an important question, let's come on to that.
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是一个很关键问题, 我们还会深入聊一下。
但是在这之前,
11:05
But before we go there,
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在过去的几个月里,
11:06
any other surprises in the last couple months
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有没有任何其他的发现,
11:08
that we've learned about this virus
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11:10
that really impact how we should respond to it?
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需要我们对新冠病毒 采取不同的措施?
11:14
BG: We're still not able to characterize who the super-spreaders are
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比尔:我们还不能确定 谁是这些超级传染者,
11:19
in terms of what that profile is,
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像是具体的个人信息之类的,
11:21
and we may never.
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有可能我们永远都不能确定,
11:23
That may just be quite random.
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因为这个人可能是任何人。
11:25
If you could identify them,
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如果你能找到他们,
11:28
they're responsible for the majority of transmission,
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他们就是主要的传染病携带者。
11:30
a few people who have very high viral loads.
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而只有少数人会携带 这样致命的病毒。
11:33
But sadly, we haven't figured that out.
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但是遗憾的是,我们无法找到他们。
11:38
This mode of transmission,
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如果你们在一个房间里,
11:40
if you're in a room and nobody talks,
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没有人说话,
11:42
there's way less transmission.
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传染率就会大大降低。
11:45
That's partly why, although planes can transmit,
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这就是为什么,虽然 在飞机上可以传染病毒,
11:48
it's less than you would expect just in terms of time proximity measures,
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但被传染的概率比你想象的要小。
11:53
because unlike, say, a choir or a restaurant,
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因为这不像合唱团或者餐厅,
11:57
you're not exhaling in loud talking
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你不会在说话的时候大口喘息,
12:03
quite as much as in other indoor environments.
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就像很多室内环境一样。
12:05
CA: Hmm.
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克里斯:嗯。
12:07
What do you think about the ethics of someone who would go on a plane
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你怎么看待不戴口罩
12:10
and refuse to wear a mask?
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坐飞机的人?
12:11
BG: If they own the plane, that would be fine.
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比尔:如果飞机是他们家的, 那就没有任何问题。
12:15
If there's other people on the plane,
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如果飞机上有别人,
12:18
that would be endangering those other people.
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这就是对别人的健康不负责任了。
12:21
CA: Early on in the pandemic,
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克里斯:在疫情的前期,
12:22
the WHO did not advise that people wear masks.
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世卫组织并没有建议人们戴口罩,
12:27
They were worried about taking them away from frontline medical providers.
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他们担心在一线工作的 医护人员会没有口罩用。
12:33
In retrospect, was that a terrible mistake that they made?
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现在看来,这是不是 一个巨大的错误?
12:38
BG: Yes.
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比尔:是的。
12:40
All the experts feel bad that the value of masks --
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所有的专家都对此感到难过,
12:46
which ties back somewhat to the asymptomatics;
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而这与无症状感染者有关。
12:49
if people were very symptomatic,
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如果人们表现出强烈的症状,
12:52
like an Ebola,
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像是埃博拉,
12:55
then you know it and you isolate,
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你就会知道自己生病了, 并且主动自我隔离,
12:59
and so you don't have a need for a masklike thing.
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那么你就不会戴口罩外出了。
13:03
The value of masks,
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而对于口罩的重要性,
13:05
the fact that the medical masks was a different supply chain
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所谓医用口罩和普通口罩
13:09
than the normal masks,
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有不同的生产链,
13:12
the fact you could scale up the normal masks so well,
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或者我们能把普通的 口罩进行大规模生产,
13:14
the fact that it would stop that presymptomatic,
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又或者口罩能防止轻症状感染者
13:18
never symptomatic transmission,
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和无症状感染者的传播,
13:20
it's a mistake.
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这些都是错的。
13:22
But it's not a conspiracy.
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但是这不是一个阴谋论。
13:25
It's something that, we now know more.
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只是我们现在更了解这个病毒了。
13:29
And even now, our error bars on the benefit of masks
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甚至现在,我们在 口罩的好处上所犯的错误
13:32
are higher than we'd like to admit,
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也比我们愿意承认的要高,
13:33
but it's a significant benefit.
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但这确实是一个显著的好处。
13:36
CA: Alright, I'm going to come in with some questions
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克里斯:好的,我想问几个
13:39
from the community.
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观众提出的问题。
13:42
Let's pull them up there.
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我们一起来看看。
13:44
Jim Pitofsky, "Do you think reopening efforts in the US have been premature,
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吉姆·皮托夫斯基问: “你觉得现在复工是不是为时过早,
13:50
and if so, how far should the US go to responsibly confront this pandemic?"
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如果是的,美国应该 继续抗疫到什么阶段?”
13:57
BG: Well, the question of how you make trade-offs
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比尔:问题在于利弊之间的平衡。
14:01
between the benefits, say, of going to school
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其中有一些好处,比如开学。
14:05
versus the risk of people getting sick because they go to school,
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但是风险就是人们可能 会因为上学而受到感染。
14:10
those are very tough questions
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这些问题都是很难决策的。
14:13
that I don't think any single person can say,
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并且我认为没有人可以说,
14:20
"I will tell you how to make all these trade-offs."
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“我知道怎样权衡利弊。”
14:24
The understanding of where you have transmission,
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要了解疫情传播在哪里发生,
14:28
and the fact that young people do get infected
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以及年轻人确实会被感染,
14:31
and are part of the multigenerational transmission chain,
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而且他们是多代传播链的一部分,
14:35
we should get that out.
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我们应该把这个弄清楚。
14:37
If you just look at the health aspect,
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如果只是从医疗方面看,
14:40
we have opened up too liberally.
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我们确实复工太早了。
14:43
Now, opening up in terms of mental health
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但是在精神上的“复工”,
14:47
and seeking normal health things like vaccines or other care,
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接受正常医疗救治,像是疫苗,
14:54
there are benefits.
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是有好处的。
14:56
I think some of our opening up has created more risk than benefit.
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我觉得一部分复工是弊大于利的。
15:02
Opening the bars up as quickly as they did,
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这么快让酒吧恢复营业,
15:05
you know, is that critical for mental health?
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对心理健康有那么重要吗?
15:07
Maybe not.
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也许没有。
15:09
So I don't think we've been as tasteful about opening up
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所以我觉得复工并没有 我们想象的那么美好。
15:13
as I'm sure, as we study it,
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并且我确信,随着我们 对病毒的深入了解,
15:19
that we'll realize some things we shouldn't have opened up as fast.
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就会发现我们不应该这么快复工。
15:25
But then you have something like school,
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但是像学校等地方,
15:27
where even sitting here today,
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甚至今天,
15:30
the exact plan, say, for inner-city schools for the fall,
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一些内城区的学校,
15:35
I wouldn't have a black-and-white view
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我对这样利弊的权衡
15:38
on the relative trade-offs involved there.
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也不是非黑即白的。
15:44
There are huge benefits to letting those kids go to school,
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让孩子们重新回到学校 上学是一件极大的好事。
15:50
and how do you weigh the risk?
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但是其中的风险呢?
15:53
If you're in a city without many cases,
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如果是在一个 确诊人数没那么多的地方,
15:57
I would say probably the benefit is there.
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我认为在那利是大于弊的。
16:01
Now that means that you could get surprised.
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你们也可能会感到惊讶——
16:03
The cases could show up, and then you'd have to change that,
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确诊病例如果持续增加的话, 学校可能会重新关闭,
16:06
which is not easy.
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要做到这一点并不容易。
16:08
But I think around the US,
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不过我认为在整个美国,
16:10
there will be places where that won't be a good trade-off.
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肯定会有一些地方 是不值得冒这个风险的。
16:15
So almost any dimension of inequity,
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对于任何一个不平等的方面,
16:18
this disease has made worse:
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这场病毒都更加恶化了这个情况:
16:22
job type, internet connection,
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行业种类、是否有互联网、
16:27
ability of your school to do online learning.
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学校上网课的能力。
16:31
White-collar workers,
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对于白领们,
16:33
people are embarrassed to admit it,
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人们很不情愿承认,
16:35
some of them are more productive
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其中的一些人在家里
16:37
and enjoying the flexibility that the at-home thing has created,
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就是会更有效率些, 并且能享受更加自由的时间。
16:42
and that feels terrible
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当你知道很多人还在挣扎,
16:44
when you know lots of people are suffering in many ways,
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他们的孩子们没法回去上学,
16:49
including their kids not going to school.
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这种感觉也的确很糟糕。
16:52
CA: Indeed. Let's have the next question.
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2015
克里斯:确实。让我们 看看下一个问题。
16:54
[Nathalie Munyampenda] "For us in Rwanda,
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1991
[ 娜塔丽·明尼潘达 ] “在卢旺达,
16:56
early policy interventions have made the difference.
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早期的政府干预是很有效的。
你建议美国政府 现在采取哪些措施呢?”
16:59
At this point, what policy interventions do you suggest for the US now?"
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17:03
Bill, I dream of the day where you are appointed
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比尔,我梦想着有一天你能
17:05
the coronavirus czar
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成为抗疫的领导者,
17:07
with authority to actually speak to the public.
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有能力说服大众。
17:10
What would you do?
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2006
你会怎么做?
17:13
BG: Well, the innovation tools
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比尔:这些科技创新
17:18
are where I and the foundation probably has the most expertise.
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就是我跟基金会最擅长的地方。
17:23
Clearly, some of the policies on opening up have been too generous,
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很明显,一部分 复工的政策过于急躁了,
17:27
but I think everybody
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但是我认为大家
17:31
could engage in that.
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可以一起努力。
17:36
We need leadership
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我们需要领导力。
17:37
in terms of admitting that we've still got a huge problem here
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并且能承认我们还有 许多问题需要去解决,
17:43
and not turning that into almost a political thing
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3924
而不是把它变成一个政治问题。
17:47
of, "Oh, isn't it brilliant what we did?"
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4757
“我们做得真好,不是吗?”
17:51
No, it's not brilliant,
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不,我们做得不好。
17:53
but there's many people, including the experts --
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但是还有很多事情是很多人,
17:58
there's a lot they didn't understand,
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包括专家们既然没搞清楚的。
18:00
and everybody wishes a week earlier whatever action they took,
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大家都希望要是能早一点 实施这个计划就好了,
18:05
they'd taken that a week earlier.
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比如早一个星期。
18:08
The innovation tools,
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这些科技创新,
18:09
that's where the foundation's work
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就是基金会在研究的,
18:15
on antibodies, vaccines,
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抗生素、疫苗等等。
18:19
we have deep expertise,
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我们有深厚的专业知识,
18:20
and it's outside of the private sector,
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并且这都是私营部门所没有的,
18:23
and so we have kind of a neutral ability to work with all the governments
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所以我们可以 以中立的态度和政府
18:28
and the companies to pick.
337
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以及目标公司合作。
18:30
Particularly when you're doing break-even products,
338
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特别是如果你是非赢利机构,
18:32
which one should get the resources?
339
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谁应该拿到资源?
18:34
There's no market signal for that.
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没有市场信息能指明这一点。
18:38
Experts have to say, "OK, this antibody deserves the manufacturing.
341
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专家们说:“好吧, 这个抗生素可以批量生产。
18:42
This vaccine deserves the manufacturing,"
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这个疫苗可以批量生产。”
18:45
because we have very limited manufacturing for both of those things,
343
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因为我们很难 同时生产这两个东西,
18:50
and it'll be cross-company, which never happens in the normal case,
344
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而且是跨公司生产的, 这是以前从未出现过的情况,
18:53
where one company invents it
345
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比如一个公司发明了疫苗,
18:55
and then you're using the manufacturing plants of many companies
346
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之后许多公司将效果最好的疫苗
18:59
to get maximum scale of the best choice.
347
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以最大规模投入生产。
19:03
So I would be coordinating those things,
348
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所以我可能会重点协调这些事项。
19:06
but we need a leader who keeps us up to date,
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5031
但是我们需要 一个对民众开诚布公的领导者,
能够实事求是,
19:11
is realistic
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2712
19:14
and shows us the right behavior,
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2185
以身作则,
19:16
as well as driving the innovation track.
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2289
并且推动创新。
19:20
CA: I mean, you have to yourself be a master diplomat
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2533
克里斯:在谈论这些话题的时候,
19:22
in how you talk about this stuff.
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你必须能够服众。
19:24
So I appreciate, almost, the discomfort here.
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我真的很佩服你。
19:26
But I mean, you talk regularly with Anthony Fauci,
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3123
但是当你跟安东尼·福奇谈话的时候,
19:29
who is a wise voice on this by most people's opinion.
357
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5091
许多人都认为福奇是个很聪明的人。
19:34
But to what extent is he just hamstrung?
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2043
但是有哪些事是他也无能为力的,
19:36
He's not allowed to play the full role
359
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3318
在这种情况下
19:40
that he could play in this circumstance.
360
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2358
他无法履行全部职责的?
19:43
BG: Dr. Fauci has emerged where he was allowed to have some airtime,
361
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5411
比尔:福奇博士在他力所能及的时候 都会尽可能发表一些意见。
19:48
and even though he was stating things that are realistic,
362
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4008
即使他说的事情都很现实,
19:52
his prestige has stuck.
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2172
他的威望已经根深蒂固。
19:54
He can speak out in that way.
364
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1818
他可以按照他的方式来说话。
19:56
Typically, the CDC would be the primary voice here.
365
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5773
通常情况下,疾控中心 应该是主要的发声机构。
20:02
It's not absolutely necessary,
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1962
这并不是绝对的,
20:04
but in previous health crises,
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2576
但是在以前的流行病爆发期间,
20:07
you let the experts inside the CDC
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1207519
2864
疾控中心里的专家
20:10
be that voice.
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1367
起到了主要的领导作用。
20:11
They're trained to do these things,
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1943
他们的专业就是这个。
20:13
and so it is a bit unusual here how much we've had to rely on Fauci
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所以当我们说我们能不能依靠福奇, 而不是疾控中心,
20:19
as opposed to the CDC.
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1811
是有点奇怪的。
20:21
It should be Fauci, who's a brilliant researcher,
373
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3851
福奇是个非常棒的研究人员。
20:25
so experienced, particularly in vaccines.
374
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特别是在疫苗方面,他很有经验。
20:28
In some ways, he has become, taking the broad advice
375
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4270
有时候他会听取别人的意见,
20:33
that's the epidemiology advice
376
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3665
关于传染病学的意见,
20:36
and explaining it in the right way,
377
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2651
并且解释得很清楚。
20:39
where he'll admit,
378
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1160
他会承认,
20:40
"OK, we may have a rebound here,
379
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3415
“我们可能会有二次爆发,
20:44
and this is why we need to behave that way."
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3175
这就是为什么我们要这么做。”
20:47
But it's fantastic that his voice has been allowed to come through.
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5933
他的建议能被说出来是一件好事。
20:53
CA: Sometimes.
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1429
克里斯:有时候吧。
20:55
Let's have the next question.
383
1255270
1963
让我们来看看下一个问题。
21:01
Nina Gregory, "How are you and your foundation
384
1261150
2652
妮娜·格雷戈里问, “如果新冠疫苗研发成功了,
21:03
addressing the ethical questions about which countries get the vaccine first,
385
1263826
4490
你和你的基金会将如何解决 哪些国家优先得到疫苗等
21:08
assuming you find one?"
386
1268340
1677
伦理问题?“
21:10
And maybe, Bill, use this as a moment
387
1270041
2009
比尔,正好可以借这个机会
21:12
to just talk about where the quest for the vaccine is
388
1272050
3968
跟我们说说疫苗实验 进行到哪个阶段了,
21:16
and what are just some of the key things we should all be thinking about
389
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3435
以及我们在关注新闻时,
21:19
as we track the news on this.
390
1279501
1792
我们应该想到哪些问题。
21:22
BG: There's three vaccines that are,
391
1282072
4332
比尔:目前有三种疫苗,
如果的确有效的话, 那就是最早的几个了:
21:26
if they work, are the earliest:
392
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1616
21:28
the Moderna, which unfortunately, won't scale very easily,
393
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6190
Moderna,很遗憾的是, 大规模生产比较困难。
21:34
so if that works, it'll be mostly a US-targeted thing;
394
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3950
如果能做到的话, 大概率美国会是其主要市场。
21:38
then you have the AstraZeneca, which comes from Oxford;
395
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2574
然后还有牛津的 阿斯利康(AstraZeneca),
21:41
and the Johnson and Johnson.
396
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1332
最后是强生。
21:42
Those are the three early ones.
397
1302938
1687
这是最早的几个疫苗。
21:44
And we have animal data
398
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3500
我们还有动物实验的数据,
21:48
that looks potentially good but not definitive,
399
1308173
6241
虽然看起来很好,但还不能 百分百确定是否可靠。
21:54
particularly will it work in the elderly,
400
1314438
2112
尤其是对老年人有没有效;
21:56
and we'll have human data over the next several months.
401
1316574
3202
在接下来的几个月里 我们也会有人体实验数据。
21:59
Those three will be gated by the safety and efficacy trial.
402
1319800
5763
这三个疫苗都会通过 安全性和药效试验。
22:05
That is, we'll be able to manufacture those,
403
1325587
2079
虽然不能百分百满足我们的需求,
22:07
although not as much as we want.
404
1327690
2587
但是我们也会尽量大规模生产。
22:10
We'll be able to manufacture those before the end of the year.
405
1330301
2921
今年年底之前, 我们就可以大规模生产了。
无论第三阶段是否能成功,
22:13
Whether the Phase 3 will succeed
406
1333246
1792
22:15
and whether it'll complete before the end of the year,
407
1335062
2970
无论今年年底能不能完成实验,
22:18
I wouldn't be that optimistic about.
408
1338056
3648
我都不抱太大希望。
22:21
Phase 3 is where you need to really look at all the safety profile
409
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4592
在第三阶段会测试安全性
22:26
and efficacy,
410
1346344
1166
和药效,
22:27
but those will get started.
411
1347534
1530
这些实验也会逐渐开始。
22:29
And then there's four or five vaccines that use different approaches
412
1349088
4694
之后三到四个月,
可能会有四到五个 不同种类的疫苗出现:
22:33
that are maybe three or four months behind that:
413
1353806
2655
22:36
Novavax, Sanofi, Merck.
414
1356485
4361
诺瓦瓦克斯(Novavax), 赛诺菲(Sanofi),默克(Merck)。
22:40
And so we're funding factory capacity for a lot of these --
415
1360870
6245
我们为很多这类疫苗 都投入了资金以支持大规模生产——
22:47
some complex negotiations are taking place right now on this --
416
1367139
6280
目前还在进行一些复杂的讨论——
22:53
to get factories that will be dedicated to the poorer countries,
417
1373443
5293
为了让这些工厂为贫穷的国家生产,
22:58
what's called low- and middle-income.
418
1378760
2544
也就是所谓的中低收入国家的国家。
23:01
And the very scalable constructs
419
1381328
2662
那些能大规模生产的工厂,
23:04
that include AstraZeneca and Johnson and Johnson,
420
1384014
4633
像是阿斯利康和强生,
23:08
we'll focus on those,
421
1388671
1283
我们会关注
23:09
the ones that are inexpensive
422
1389978
1496
那些低成本的疫苗,
23:11
and you can build a single factory to make 600 million doses.
423
1391498
3802
这样一个工厂 可以生产 6 亿支疫苗。
23:15
So a number of the vaccine constructs
424
1395324
4432
疫苗的大批量生产
23:19
are potential.
425
1399780
1398
是可行的,
23:21
I don't see anything before the end of the year.
426
1401202
4016
但是我觉得在今年年底 还不太可能实现。
23:25
That's really the best case,
427
1405242
1946
这已经是最好的情况了,
23:27
and it's down to a few constructs now,
428
1407212
3519
现在只有几个疫苗在实验中,
23:30
which, typically, you have high failure rates.
429
1410755
4410
通常失败率会很高。
23:36
CA: Bill, is it the case
430
1416300
1196
克里斯:比尔,
23:37
that if you and your foundation weren't in the picture here
431
1417520
2984
如果你和你的基金会 并没有参与其中,
23:40
that market dynamics would likely lead to a situation
432
1420528
2986
市场形势会不会因此而改变?
23:43
where, as soon as a promising vaccine candidate emerged,
433
1423538
3853
比如,一旦有效的疫苗 可以投入生产,
23:47
the richer countries would basically snap up, gobble up
434
1427415
2760
富有的国家就会蜂拥而至,
23:50
all available initial supply --
435
1430199
2769
抢夺最初的少量产品——
23:52
it just takes a while to manufacture these,
436
1432992
2064
毕竟疫苗生产也需要时间。
23:55
and there would be nothing for the poorer countries --
437
1435080
3956
那么那些贫穷的国家就没有疫苗了。
23:59
but that what, effectively, you're doing
438
1439060
2501
但是你现在
24:01
by giving manufacturing guarantees and capability
439
1441585
3327
为很多候选疫苗
24:04
to some of these candidates,
440
1444936
1901
保证了工厂的产量,
24:06
you're making it possible that at least some of the early vaccine units
441
1446861
6493
你也在想办法让那些贫穷的国家
24:13
will go to poorer countries?
442
1453378
2357
能够分到一些疫苗,
24:15
Is that correct?
443
1455759
1248
是这样吧?
24:17
BG: Well, it's not just us, but yes,
444
1457031
1866
比尔:并不只有我们,不过没错。
24:18
we're in the central role there,
445
1458921
2573
我们处在中心的位置,
24:21
along with a group we created called CEPI, Coalition for Epidemic Preparedness,
446
1461518
6738
和另外一个组织合作建立了CEPI, 即联合流行病预备中心,
24:28
and the European leaders agree with this.
447
1468280
3967
欧洲的领导者们也表示了赞同。
24:32
Now we have the expertise to look at each of the constructs
448
1472271
3028
现在有专家去一一查看每一个疫苗,
24:35
and say, "OK, where is there a factory in the world
449
1475323
2473
然后评估,“在哪有能力生产
24:37
that has capacity that can build that?
450
1477820
1865
这样的疫苗的工厂呢?”
24:39
Which one should we put the early money into?
451
1479709
2636
我们该怎么分配这笔初始资金?
24:42
What should the milestones be
452
1482369
1471
我们可以把钱投资到其他地方的
24:43
where we'll shift the money over to a different one?"
453
1483864
3242
时间点是什么?”
24:47
Because the kind of private sector people
454
1487130
4179
私营部门里
24:51
who really understand that stuff,
455
1491333
2638
这方面的一些专家
24:53
some of them work for us,
456
1493995
1734
也在为我们工作。
24:55
and we're a trusted party on these things,
457
1495753
3916
我们在疫苗方面是有一定权威的,
24:59
we get to coordinate a lot of it, particularly that manufacturing piece.
458
1499693
5340
有能力协调资源和生产。
25:05
Usually, you'd expect the US to think of this as a global problem
459
1505374
5103
通常情况下,美国会 把这当作一个国际问题,
25:10
and be involved.
460
1510501
1168
并且参与其中。
25:11
So far, no activity on that front has taken place.
461
1511693
6016
不过目前为止, 政府对此还没有任何举动。
25:17
I am talking to people in the Congress and the Administration
462
1517733
4353
我在跟国会和行政部的人讨论,
25:22
about when the next relief bill comes along
463
1522110
3362
等下一波救助金发放的时候,
25:25
that maybe one percent of that could go for the tools
464
1525496
4773
是不是可以用这笔钱中的百分之一
25:30
to help the entire world.
465
1530293
1930
来帮助全世界。
25:32
And so it's possible,
466
1532247
2870
这是有可能的。
25:35
but it's unfortunate,
467
1535141
1831
但是很遗憾,
25:36
and the vacuum here,
468
1536996
3200
这个方案还不成熟,
25:40
the world is not that used to,
469
1540220
1468
世界还没有就此达成共识。
25:41
and a lot of people are stepping in, including our foundation,
470
1541712
4497
很多人都在参与, 包括我们的基金会,
25:46
to try and have a strategy,
471
1546233
2506
尝试找到一种新的策略,
25:48
including for the poorer countries,
472
1548763
2103
包括针对贫穷国家的策略,
25:50
who will suffer a high percentage of the deaths and negative effects,
473
1550890
6082
这些国家的死亡率 和受到的冲击程度比较高,
25:56
including their health systems being overwhelmed.
474
1556996
3233
它们的医疗系统都在超负荷运转。
26:00
Most of the deaths will be in developing countries,
475
1560253
2581
除了在欧洲和美国 有这么高的死亡率,
26:02
despite the huge deaths we've seen in Europe and the US.
476
1562858
3716
大部分的死亡病例 都出现在发展中国家。
26:07
CA: I mean, I wish I could be a fly on the wall
477
1567193
2263
克里斯:我希望自己能够
26:09
and hearing you and Melinda talk about this,
478
1569480
2289
偷听你和梅琳达是怎么说的。
26:11
because of all of the ethical ... "crimes," let's say,
479
1571793
5465
因为这些领导人知道的更多,
26:17
executed by leaders who should know better,
480
1577282
3824
而他们犯下的“罪行”, 就这么说吧,
26:21
I mean, it's one thing to not model mask-wearing,
481
1581130
4280
当我们有一个共同的敌人的时候,
26:25
but to not play a role in helping the world
482
1585434
6221
不戴口罩
26:31
when faced with a common enemy,
483
1591679
1831
就是抛弃了整个世界。
26:33
respond as one humanity,
484
1593534
1976
我们应该一起抗疫,
26:35
and instead ...
485
1595534
1226
而不是
26:38
you know, catalyze a really unseemly scramble between nations
486
1598040
4777
在不同国家之间挑起冲突,
26:42
to fight for vaccines, for example.
487
1602841
2459
比如哄抢疫苗。
26:45
That just seems -- surely, history is going to judge that harshly.
488
1605324
5855
当然,历史会证明一切,
26:51
That is just sickening.
489
1611203
3119
这简直让人忍无可忍。
26:54
Isn't it? Am I missing something?
490
1614798
1998
对吧?我没漏掉什么吧?
26:56
BG: Well, it's not quite as black-and-white as that.
491
1616820
5357
比尔:事情并不是这么简单的。
27:02
The US has put more money out
492
1622201
2632
到现在为止, 美国比任何一个国家
27:04
to fund the basic research on these vaccines
493
1624857
3433
都投入了更多的资金
27:08
than any country by far,
494
1628314
2644
来研究疫苗。
27:10
and that research is not restricted.
495
1630982
2679
而这个研究并不是限制性的。
27:13
There's not, like, some royalty that says, "Hey, if you take our money,
496
1633685
3629
这并不是说, “如果你拿了我们的钱,
27:17
you have to pay the US a royalty."
497
1637338
2072
你就得给美国付使用费。”
27:19
They do, to the degree they fund research,
498
1639434
2925
他们确实给基金会投入了很多钱,
27:22
it's for everybody.
499
1642383
1184
但是为了所有人的利益。
27:23
To the degree they fund factories, it's just for the US.
500
1643591
2686
但是目前他们之投资了美国的工厂。
27:26
The thing that makes this tough is that in every other global health problem,
501
1646301
4501
让这个问题变得棘手的是, 在所有其他全球卫生问题上,
27:30
the US totally leads smallpox eradication,
502
1650826
3087
美国在根除天花方面完全领先,
27:33
the US is totally the leader on polio eradication,
503
1653937
4832
在根除脊髓灰质炎方面也一样, 有着关键的合作伙伴:
27:38
with key partners -- CDC, WHO, Rotary, UNICEF, our foundation.
504
1658793
6098
疾控中心、世卫组织、扶轮社、 联合国儿童基金会,以及我们的基金会。
27:44
So the world -- and on HIV,
505
1664915
3159
那么在艾滋病方面, 在布什总统的领导下,
27:48
under President Bush's leadership, but it was very bipartisan,
506
1668098
4770
通过两党的携手合作, 我们启动了令人难以置信的
27:52
this thing called PEPFAR was unbelievable.
507
1672892
2993
总统防治艾滋病 紧急救援计划(PEPFAR),
27:55
That has saved tens of millions of lives.
508
1675909
2709
拯救了上千万条生命。
27:58
And so it's that the world always expected the US
509
1678642
4272
所以整个世界都在期盼着美国
28:02
to at least be at the head of the table,
510
1682938
2003
至少能在资金和方法上做领头羊。
28:04
financially, strategy, OK, how do you get these factories for the world,
511
1684965
5732
像是如何让这些工厂为全世界运作,
28:10
even if it's just to avoid the infection coming back to the US
512
1690721
3979
或只是防止美国输入性感染,
28:14
or to have the global economy working,
513
1694724
1872
或者是让全球经济运转起来。
28:16
which is good for US jobs
514
1696620
1990
能有海外的需求
28:18
to have demand outside the US.
515
1698634
3332
对于美国的工人们来说是好事。
28:21
And so the world is kind of --
516
1701990
1880
所以现在全世界
28:23
you know, there's all this uncertainty about which thing will work,
517
1703894
3182
对到底哪些方法有效, 依然没有明确的答案。
28:27
and there's this, "OK, who's in charge here?"
518
1707100
3913
于是都很好奇, “究竟是谁在领导这一切?”
28:31
And so the worst thing, the withdrawal from WHO,
519
1711037
4454
最差的状况就是 我们退出了世卫组织,
28:35
that is a difficulty that hopefully will get remedied
520
1715515
6773
而我希望能够在某处程度上
28:42
at some point,
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1583
撤回这个决定。
28:43
because we need that coordination
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3001
因为我们需要和世卫组织
28:46
through WHO.
523
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1511
一起协调合作。
28:49
CA: Let's take another question.
524
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2378
克里斯:一起来看看下一个问题。
28:55
Ali Kashani, "Are there any particularly successful models
525
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3176
阿里-卡沙尼问道: “有没有一些手段
28:58
of handling the pandemic that you have seen around the world?"
526
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3012
能有效处理这个全球危机?”
29:03
BG: Well, it's fascinating that, besides early action,
527
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4488
比尔:除了及早行动,
29:08
there are definitely things where you take people who have tested positive
528
1748052
3602
我们还可以监测这些 核酸检测阳性患者的
29:11
and you monitor their pulse ox,
529
1751678
3380
血氧饱和度,
29:15
which is the oxygen saturation level in their blood,
530
1755082
3161
就是血液里的氧气含量。
29:18
which is a very cheap detector,
531
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1596
只需要一个非常廉价的检测仪,
29:19
and then you know to get them to the hospitals fairly early.
532
1759887
3438
然后尽早把他们转入就近的医院。
29:23
Weirdly, patients don't know things are about to get severe.
533
1763349
6895
奇怪的是,病人们并不知道 自己的病情要恶化了,
29:30
It's an interesting physiological reason that I won't get into.
534
1770268
4263
这涉及到了有些有趣的病理学知识, 但我不打算深入介绍。
29:34
And so Germany has quite a low case fatality rate
535
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5022
德国的死亡率是比较低的,
29:39
that they've done through that type of monitoring.
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2946
而他们就是这样监视病人的。
29:42
And then, of course, once you get into facilities,
537
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2959
当然,当你去到这些地方的时候,
29:45
we've learned that the ventilator, actually, although extremely well-meaning,
538
1785554
5143
你就会了解到,即使这些 呼吸机是非常有帮助的,
29:50
was actually overused and used in the wrong mode
539
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4346
但在前期却被过度使用了,
29:55
in those early days.
540
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1244
而且使用不当。
29:56
So the health -- the doctors are way smarter about treatment today.
541
1796359
6558
所以当前,医生们的 治疗手段都是非常先进的。
30:02
Most of that, I would say, is global.
542
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2352
大部分策略都是全球适用的。
30:05
Using this pulse ox as an early indicator,
543
1805317
2270
用血氧饱和度 作为前期监测的指标,
30:07
that'll probably catch on broadly,
544
1807611
1680
这样就可以大范围掌握病情。
30:09
but Germany was a pioneer there.
545
1809315
2627
但是在这一点上, 德国是第一个做到的。
30:11
And now, of course, dexamethasone -- fortunately, it's cheap, it's oral,
546
1811966
6106
当然,地塞米松 也很便宜,是口服的,
30:18
we can ramp up manufacture.
547
1818096
1656
所以我们可以大量生产,
30:19
That'll go global as well.
548
1819776
2951
并推广到全世界。
30:25
CA: Bill, I want to ask you something about
549
1825061
3789
比尔,我很想知道,
30:28
what it's been like for you personally through this whole process.
550
1828874
3155
当你自己经历 这些事情的时候是什么感受。
因为,很奇怪的是, 如果有人接触过你,
30:32
Because, weirdly, even though your passion and good intent on this topic
551
1832053
6017
30:38
seems completely bloody obvious to anyone who has spent a moment with you,
552
1838094
5610
就会知道你对公共健康研究的 热情和善心,
30:43
there are these crazy conspiracy theories out there about you.
553
1843728
4043
但是还是有一些人在传播 非常夸张的阴谋论。
30:47
I just checked in with a company called Zignal
554
1847795
2874
我刚刚和一个 监管社交媒体的公司
30:50
that monitors social media spaces.
555
1850693
2389
Zignal 交流过。
30:53
They say that, to date, I think on Facebook alone,
556
1853106
4179
他们说,我觉得仅仅是在脸书上,
30:57
more than four million posts have taken place
557
1857309
4174
就有超过 400 万的帖子,
31:01
that associate you with some kind of conspiracy theory around the virus.
558
1861507
5202
是关于你和新冠病毒阴谋论的。
31:07
I read that there was a poll that more than 40 percent of Republicans
559
1867133
5961
我看到一个投票显示, 百分之四十的共和党
31:13
believe that the vaccine that you would roll out
560
1873118
3807
觉得你们推出的疫苗
31:16
would somehow plant a microchip in people to track their location.
561
1876949
4996
将会在人们的身体里植入 芯片来追踪他们的位置。
31:21
I mean, I can't even believe that poll number.
562
1881969
4502
我想说,这个数字简直难以置信。
31:27
And then some people are taking this seriously enough,
563
1887376
3073
有的人对此十分认同,
31:30
and some of them have even been recirculated on "Fox News" and so forth,
564
1890473
4675
有的人在福克斯新闻上 不断提到这个话题,
31:35
some people are taking this seriously enough
565
1895172
2257
也有的人对此深信不疑,
31:37
to make really quite horrible threats and so forth.
566
1897453
4253
甚至把它当成一种威胁。
31:41
You seem to do a good job sort of shrugging this off,
567
1901730
3774
你好像总是对此一笑了之,
31:45
but really, like, who else has ever been in this position?
568
1905528
3414
不过说真的, 又有谁经历过这些呢?
31:48
How are you managing this?
569
1908966
2105
你是怎么做到的?
31:51
What on earth world are we in
570
1911095
2987
现在是什么世道,
31:54
that this kind of misinformation can be out there?
571
1914106
2372
竟然让这种流言到处散播?
31:56
What can we do to help correct it?
572
1916502
1751
我们该怎么做才能改变这种风气?
31:59
BG: I'm not sure.
573
1919856
3245
比尔:我也不知道。
32:04
And it's a new thing
574
1924539
2392
阴谋论
32:08
that there's conspiracy theories.
575
1928380
3023
是一个比较新的东西。
32:11
I mean, Microsoft had its share of controversy,
576
1931427
2490
我是说,微软也有这种言论,
32:13
but at least that related to the real world, you know?
577
1933941
2933
但是这至少是跟 现实生活相关的,对吧?
32:16
Did Windows crash more than it should?
578
1936898
3637
Windows 系统崩溃得 是不是太频繁了?
32:20
We definitely had antitrust problems.
579
1940559
1840
我们肯定面临着 一些反垄断的问题,
32:22
But at least I knew what that was.
580
1942423
2879
但是至少我知道这是什么。
32:25
When this emerged, I have to say,
581
1945326
1916
当这种情况发生,我得说,
32:27
my instinct was to joke about it.
582
1947266
4177
我的直觉就是, 开个玩笑就过去了。
32:31
People have said that's really inappropriate,
583
1951467
2386
有人认为这么说不太好,
32:33
because this is a very serious thing.
584
1953877
2777
因为这是一件很严肃的事情,
32:37
It is going to make people less willing to take a vaccine.
585
1957270
4865
会导致人们对接种疫苗更加抗拒。
32:42
And, of course, once we have that vaccine,
586
1962159
2953
当然,当我们有了疫苗,
32:45
it'll be like masks,
587
1965136
1772
就像口罩一样,
32:46
where getting lots of people,
588
1966932
2661
就会有很多人去接种,
32:49
particularly when it's a transmission-blocking vaccine,
589
1969617
3349
特别是可以阻止传染的疫苗,
32:52
there's this huge community benefit
590
1972990
2583
这个巨大的群体福利
32:55
to widespread adoption of that vaccine.
591
1975597
5314
会驱使人们大量的接种疫苗。
33:00
So I am caught a little bit,
592
1980935
3283
所以我有一点不确定
33:04
unsure of what to say or do,
593
1984242
2458
自己该说什么,或者做什么。
33:06
because the conspiracy piece is a new thing for me,
594
1986724
3460
因为对我来说, 阴谋论是一个新事物。
33:11
and what do you say
595
1991287
3566
所以对于一个 我太不相信的东西,
33:14
that doesn't give credence to the thing?
596
1994877
4503
我能说什么呢?
33:19
The fact that a "Fox News" commentator, Laura Ingraham,
597
1999404
5051
事实上福克斯新闻的解说员 劳拉-英格拉姆(Laura Ingraham)
33:24
was saying this stuff about me microchipping people,
598
2004479
2462
说过这个植入芯片的事情,
33:26
that survey isn't that surprising because that's what they heard
599
2006965
3701
这个调查结果 并不是很出乎意料,
因为这就是人们在电视上听到的,
33:30
on the TV.
600
2010690
2195
33:33
It's wild.
601
2013418
1985
是毫无根据的。
33:35
And people are clearly seeking simpler explanations
602
2015427
3293
人们通常只会去寻求 一个简单的解释,
33:38
than going and studying virology.
603
2018744
2968
而不是去仔细研究病理学知识。
33:43
CA: I mean,
604
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1723
克里斯:我想说,
33:45
TED is nonpolitical,
605
2025126
1425
TED 的政治立场是中立的。
33:46
but we believe in the truth.
606
2026575
2737
但是我们相信真理。
33:49
I would say this:
607
2029336
2722
我想说:
33:52
Laura Ingraham, you owe Bill Gates an apology and a retraction.
608
2032082
4092
劳拉·英格拉姆,你欠比尔·盖茨 一个道歉,并且应该撤回你的言论。
33:56
You do.
609
2036198
1168
你应该跟他道歉。
33:57
And anyone who's watching this
610
2037390
1558
在观看这个视频的人,
33:58
who thinks for a minute that this man is involved in some kind of conspiracy,
611
2038972
4790
如果你认为这个人 跟某个阴谋论有关,
34:03
you want your head examined.
612
2043786
1335
你需要好好反省一下,
34:05
You are crazy.
613
2045145
1238
这种想法简直不可理喻。
34:06
Enough of us know Bill over many years
614
2046407
2589
我们很多人都认识比尔很多年了,
34:09
and have seen the passion and engagement in this to know
615
2049020
3760
并且也见证了他对 公共卫生保护的决心。
34:12
that you are crazy.
616
2052804
1564
我们可以告诉你, 你的想法很疯狂。
34:14
So get over it,
617
2054392
1172
别再执迷不悟了,
34:15
and let's look at the actual problem of solving this pandemic.
618
2055588
3705
去专注于抗击病毒 过程中的一些困难吧。
34:19
Honestly.
619
2059317
1460
老实说,
34:20
If anyone in the chat here has a suggestion,
620
2060801
2155
如果观众中的任何人
34:22
a positive suggestion for how you can,
621
2062980
2595
在摆脱阴谋论方面
34:25
how do you get rid of conspiracies,
622
2065599
1851
有任何积极的建议,
34:27
because they feed on each other.
623
2067474
1804
因为这背后有一个连锁效应。
34:29
Now, "Oh, well I would say that, because I'm part of the conspiracy,"
624
2069302
3889
你会有“哦,我这么说是因为 我就是这个阴谋论中的一部分。”
34:33
or whatever.
625
2073215
1190
或者之类的想法。
34:34
Like, how do we get back to a world
626
2074429
2853
我们如何才能回到一个
34:39
where information can be trusted?
627
2079080
1673
信息可靠的世界呢?
34:40
We have to do better on it.
628
2080777
1898
我们需要做得更好。
34:42
Are there any other questions out there from the community?
629
2082699
2794
我们还有别的问题吧?
34:50
Aria Bendix from New York City:
630
2090912
1513
来自纽约的 阿里·班迪克斯问:
34:52
"What are your personal recommendations for those who want to reduce
631
2092449
3382
“你对那些想在 疫情越来越严重的地方
34:55
their risk of infection amid an uptick in cases?"
632
2095855
3305
保护自己的人有什么建议?”
35:00
BG: Well, it's great if you have a job
633
2100369
2775
比尔:如果你 有一份工作,那很好。
你可以呆在家里, 通过网上会议工作,
35:03
that you can stay at your house and do it through digital meetings,
634
2103168
7008
35:10
and even some of your social activities,
635
2110200
4291
甚至一些社交活动 也可以在网上进行。
35:14
you know, I do video calls with lots of friends.
636
2114515
3759
我会跟很多朋友通视频电话。
35:18
I have friends in Europe that, who knows when I'll see them,
637
2118298
3017
我有一些在欧洲的朋友, 谁知道我什么时候才能见到他们,
35:21
but we schedule regular calls to talk.
638
2121339
4853
但我们还是会时常打电话。
35:26
If you stay fairly isolated,
639
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4933
如果你把自己隔离起来的话,
35:31
you don't run much risk,
640
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3517
感染的几率并不是很大。
35:35
and it's when you're getting together with lots of other people,
641
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5854
但是如果你跟很多人 聚在一起的时候,
35:40
either through work or socialization,
642
2140962
1814
无论是同事还是朋友,
35:42
that drives that risk,
643
2142800
2823
感染的几率就会高很多,
35:45
and particularly in these communities where you have increased cases,
644
2145647
6116
特别是在这些疫情高发的地方。
35:51
even though it's not going to be mandated,
645
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2677
即使政府不会强制隔离你,
35:54
hopefully, the mobility numbers will show people responding
646
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4042
希望出行的人数也会少一点,
35:58
and minimizing those kind of out-of-the-house contacts.
647
2158554
6543
并且尽量减少 在外与人接触的机会。
36:05
CA: Bill, I wonder if I could just ask you
648
2165121
2012
克里斯:比尔, 我还想问问你
36:07
just a little bit about philanthropy.
649
2167157
1779
关于慈善的事情。
36:08
Obviously, your foundation has played a huge role in this,
650
2168960
3366
很明显,你的基金会 在这其中起到了巨大的作用。
36:12
but philanthropy more generally.
651
2172350
3409
但是说到整个慈善领域,
36:15
You know, you've started this Giving Pledge movement,
652
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3427
你发起了这个“赠予誓言”活动。
36:19
recruited all these billionaires
653
2179234
2695
将这些保证会在去世前
36:21
who have pledged to give away half their net worth
654
2181953
5061
把自己一半的财产 捐赠出去的亿万富翁
36:27
before or after their death.
655
2187038
2304
聚集起来。
36:29
But it's really hard to do.
656
2189366
1335
但这是很难做到的,
36:30
It's really hard to give away that much money.
657
2190725
2317
一下子捐出去那么多钱 是很难做到的。
36:33
You yourself, I think,
658
2193066
1186
我觉得,你自己
36:34
since The Giving Pledge was started --
659
2194276
2015
从“赠予誓言”活动开始的时候——
36:36
what? 10 years ago or something, I'm not sure when --
660
2196315
3320
大概十年之前吧, 我也记不太清了——
36:39
but your own net worth, I think, has doubled since that period
661
2199659
3418
你的身价从那时候就翻了一倍,
36:43
despite being the world's leading philanthropist.
662
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3478
尽管你还是世界上 最主要的慈善家之一。
36:46
Is it just fundamentally hard to give away money effectively
663
2206981
5483
把这些钱有效地捐出去
36:52
to make the world better?
664
2212488
2456
来改变这个世界,是不是很难?
36:54
Or should the world's donors,
665
2214968
4027
还是说,这些捐赠者,
36:59
and especially the world's really rich donors,
666
2219019
2202
尤其是这些非常富裕的捐献者们,
37:01
start to almost commit to a schedule,
667
2221245
2221
开始形成了一个捐赠的习惯,
37:03
like, "Here's a percentage of my net worth each year
668
2223490
3782
好比说,“这是我 每年身价的百分之几。
37:07
that, as I get older,
669
2227296
1368
当我慢慢老了,
37:08
maybe that goes up.
670
2228688
1737
捐赠的钱款有可能增加。
37:10
If I'm to take this seriously,
671
2230449
2398
如果我认真做这件事的话,
37:12
I have to give away -- somehow, I've got to find a way
672
2232871
2646
我得找到一个
能有效实现目标的方法。”
37:15
of doing that effectively."
673
2235541
1376
37:16
Is that an unfair and crazy question?
674
2236941
2379
这个问题听起来合理吗?
37:19
BG: Well, it'd be great to up the rate,
675
2239344
3389
比尔:多捐赠当然是件好事。
37:22
and our goal, both as the Gates Foundation or through The Giving Pledge,
676
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5393
贝茨基金会和“赠予誓言”的目的都是
37:28
is to help people find causes they connect to.
677
2248174
3333
去帮助人们找到自己的目标。
37:31
People give through passion.
678
2251531
2916
人们都有助人为乐的善心
37:34
Yes, numbers are important,
679
2254471
1945
是的,钱款很重要,
37:36
but there's so many causes out there.
680
2256440
2683
但是有那么多人需要帮助。
37:39
The way you're going to pick is you see somebody who's sick,
681
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3347
当你看到有个人生病了, 你可以去帮助他。
37:42
you see somebody who's not getting social services.
682
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3002
或是有个人没有得到社会帮助, 你可以去帮助他。
37:45
You see something that helps reduce racism.
683
2265544
2863
或者你看到一个能减少 种族歧视的事物,
37:48
And you're very passionate, and so you give to that.
684
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3118
你非常热心, 就会全身心投入进去。
37:51
And, of course,
685
2271573
1201
当然,
37:52
some philanthropic gifts won't work out.
686
2272798
2100
有的慈善家的贡献 并不会解决问题。
37:54
We do need to up the ambition level of philanthropists.
687
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5558
我们确实需要把慈善家的 目标设高一些。
38:00
Now, collaborative philanthropy
688
2280504
1583
通过 TED 的“大胆项目”
38:02
that you're helping to facilitate through Audacious,
689
2282111
4068
组织起来的合作性慈善,
38:06
there's four or five other groups that are getting philanthropists together,
690
2286203
3609
还有另外四到五个慈善家组织,
38:09
that is fantastic,
691
2289836
1195
这些都是非常棒的实践。
38:11
because then they learn from each other,
692
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3152
他们可以彼此学习,
38:14
they get confidence from each other,
693
2294231
2148
通过彼此来树立自信。
38:16
they feel like, "Hey, I put in x, and the four other people put money in,
694
2296403
4566
他们就会觉得,“每个组织, 包括我自己,都投入了一部分资金,
38:20
so I'm getting more impact,"
695
2300993
3384
这样我的影响力也会随之提升,”
38:24
and hopefully, it can be made fun for them even when they find out,
696
2304401
4427
即使他们发现其中 一项捐献的效果并不是太好,
38:28
OK, that particular gift didn't work out that well,
697
2308852
2428
我也希望他们能觉得开心,
38:31
but let's keep going.
698
2311304
2878
而且想要继续合作下去。
38:34
So philanthropy, yes,
699
2314206
1996
所以慈善事业,是的,
38:36
I would like to see the rate go up,
700
2316226
2671
我想让捐款率上升。
38:38
and people who do get going,
701
2318921
3081
而捐献者也可以
38:42
it is fun,
702
2322026
1190
乐在其中,
38:43
it's fulfilling,
703
2323240
2151
很有成就感。
38:45
you pick which of the family members are partnered in doing it.
704
2325415
4108
你可以和家人一起做。
38:49
In my case, Melinda and I love doing this stuff together,
705
2329547
3239
比如我,梅琳达和我 非常喜欢一起做这些事情,
38:52
learning together.
706
2332810
1167
一起学习。
38:54
Some families, it will even involve the kids in the activities.
707
2334001
4815
在一些家庭里,孩子们 甚至也会参与进来。
38:58
Sometimes the kids are pushing.
708
2338840
1739
有时候孩子们也可以推动进展。
39:00
When you have lots of money,
709
2340603
2823
当你有很多钱的时候,
39:03
you still think of a million dollars as a lot of money,
710
2343450
3433
你仍然会觉得一百万是很多钱。
39:06
but if you have billions,
711
2346907
1862
但是如果你有几十亿,
39:08
you should be giving hundreds of millions.
712
2348793
2132
你可能就会捐出上亿的财富。
39:10
So it's kind of charming that, in terms of your personal expenditure,
713
2350949
4272
有趣的是,就你个人支出来说,
39:15
you stay at the level you were at before.
714
2355245
2019
你本身的财富地位 并没有什么改变,
39:17
That's societally quite appropriate.
715
2357288
2686
对社会地位也没什么影响。
39:19
But on your giving, you need to scale up
716
2359998
3173
但是当你捐赠的时候, 你需要放大规模,
39:23
or else it will be your will,
717
2363195
5560
要不然就成了你自己的心愿。
39:28
and you won't get to shape it and enjoy it quite that same way.
718
2368779
4229
那样你所带来的影响和 个人体验也会不太一样。
39:33
And so without --
719
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1221
所以不是——
39:34
we don't want to mandate it,
720
2374277
1778
我们不想强制要求,
39:36
but yes, both you and I want to inspire philanthropists
721
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4840
但是的确, 我们都想启发慈善家们
39:40
to see that passion, to see those opportunities
722
2380943
3539
去发现这些梦想, 发现这些机会,
39:44
significantly faster than in the past,
723
2384506
3349
而且要以比以往更快的速度。
39:47
because whether it's race or disease, or all the other social ills,
724
2387879
4871
无论是因为种族、疾病, 还是其他的社会问题,
39:52
the innovation of what philanthropy can go to and do quickly
725
2392774
4506
慈善事业的创新 都可以发展得很快,
39:57
that, if it works, government can come in behind it and scale it up,
726
2397304
3241
如果效果不错,政府 也很可能会介入,并扩大规模。
40:00
God knows we need solutions,
727
2400569
2184
上帝知道我们需要解决办法,
40:02
we need that kind of hope and progress
728
2402777
3335
我们需要这种希望和过程,
40:06
that expectations are high
729
2406136
4386
我们对此的期望很高,
40:10
that will solve very tough problems.
730
2410546
2744
希望许多难题可以得到解决。
40:13
CA: I mean, most philanthropists, even the best of them,
731
2413956
3562
克里斯:大部分的慈善家, 甚至是最有名望的那几位,
40:17
find it hard to give away more than about a percent of their net worth every year,
732
2417542
4268
也会觉得每年把身价的 百分之一捐出去很难。
40:21
and yet the world's richest often have access
733
2421834
4038
而世界上最富裕的几个人
40:25
to great investment opportunities.
734
2425896
1662
也和政府的投资项目有联系。
40:27
Many of them are gaining wealth at seven to 10 percent plus per year.
735
2427582
3906
他们其中的很多人每年的 财富增长速度达到了百分之七到十。
40:31
Isn't it the case that to have a real chance
736
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2225
是不是可以这样说,
40:33
of giving away half your fortune,
737
2433761
1726
要想把一半的财产捐出去,
40:35
at some point you have to plan to give away five, six, seven, eight,
738
2435511
4070
你将来可能迟早得每年
捐出你的净资产的 百分五到百分之十?
40:39
10 percent of your net worth annually?
739
2439605
2480
40:42
And that is, isn't that the logic of what should be happening?
740
2442109
4859
这样理解没错吧?
40:46
BG: Yeah, there are people like Chuck Feeney,
741
2446992
2391
比尔:是的,有些人, 像恰克 · 弗里尼( Chuck Feeney),
40:49
who set a good example and gave away all of his money.
742
2449407
7000
把所有的财产都捐了出去, 而且给我们做了一个好榜样。
40:56
Even Melinda and I are talking about, should we up the rate that we give at?
743
2456431
5400
就连我和梅琳达也讨论过这个事情, 我们是不是也应该捐多一点?
41:01
As you say, we've been very lucky on the investment side
744
2461855
4032
就像你说的,我们很幸运,
41:05
through a variety of things.
745
2465911
1398
可以投资不同的领域。
41:07
Tech fortunes in general have done well,
746
2467333
4336
总体而言, 科技行业的财富很表现不错,
41:11
even this year,
747
2471693
1871
即便是在今年,
41:13
which is one of those great contrasts
748
2473588
5330
在这个特殊时期,
41:18
in what's going on in the world.
749
2478942
2449
和其他行业形成了鲜明对比。
41:21
And I do think there's an expectation that we should speed up,
750
2481415
4677
我的确认为我们应该 加快这一进程,
41:26
and there's a reason to speed up,
751
2486116
2890
我们也有理由这么做,
41:29
and government is going to miss a lot of needs.
752
2489030
3656
而政府则会错过很多机会。
41:32
Yes, there's tons of government money out there,
753
2492710
2912
是的,政府有很多很多钱,
41:35
but helping it be spent well,
754
2495646
1712
但是帮助他们花在对的地方,
41:37
helping find places it's not stepping up,
755
2497382
3344
帮忙他们找到那些 需求还没有被满足的地方。
41:40
and if people are willing to give to the developing world,
756
2500750
4822
如果人们愿意为发展中国家捐款,
41:45
they don't have governments
757
2505596
1448
而他们的政府无法提供
41:47
that can print checks for 15 percent of GDP,
758
2507068
4619
相当于本国 GDP 的 15% 的资金,
41:51
and so the suffering there broadly, just the economic stuff alone,
759
2511711
4169
那么所带来的负面影响, 仅仅从经济情况来看——
41:55
put aside the pandemic,
760
2515904
2505
撇开大流行疫情不谈——
41:58
is tragic.
761
2518433
1337
也是很糟糕的。
41:59
It's about a five-year setback
762
2519794
2886
这些国家在发展的道路上
42:02
in terms of these countries moving forward,
763
2522704
2604
相当于要经历五年的衰退,
42:05
and in a few cases, it's tough enough that the very stability of the country
764
2525332
4333
在一些情况下,其严重程度
甚至会导致一些国家 连维持自身的稳定都成了问题。
42:09
is in question.
765
2529689
1778
42:12
CA: Well, Bill,
766
2532249
1159
克里斯:那么比尔,
42:13
I'm in awe of what you and Melinda have done.
767
2533432
5453
我对你和梅琳达 所做的一切表示敬意——
42:18
You walk this narrow path
768
2538909
3456
你走上的一条少有人走的路,
42:22
of trying to juggle so many different things,
769
2542389
4498
去尝试不同的东西,
42:26
and the amount of time that you dedicate to the betterment of the world at large,
770
2546911
5783
你为了改变世界而付出的时间,
42:32
and definitely the amount of money
771
2552718
1704
当然还有财富,
42:34
and the amount of passion you put into it --
772
2554446
2074
以及你对此付出的一腔热忱——
42:36
I mean, it's pretty awesome,
773
2556544
1408
真的太了不起了。
42:37
and I'm really grateful to you for spending this time with us now.
774
2557976
4361
非常感谢你抽出时间来 参与这场对话。
42:42
Thank you so much,
775
2562361
1635
非常感谢。
42:44
and honestly, the rest of this year,
776
2564020
1740
我相信,下半年,
42:45
your skills and resources are going to be needed more than ever,
777
2565784
3117
这个世界会比以往任何时候 都更需要你的能力和资源。
42:48
so good luck.
778
2568925
1176
祝你好运。
42:50
BG: Well, thanks.
779
2570669
1164
比尔:谢谢你。
42:51
It's fun work and I'm optimistic, so thanks, Chris.
780
2571857
2788
我很热爱我的工作,对未来也很乐观。 谢谢你,克里斯。
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