Jennifer B. Nuzzo: 3 ways to prepare society for the next pandemic | TED

譯者: Lilian Chiu 審譯者: Helen Chang

So I'm an infectious disease epidemiologist,

我是傳染病流行病學家，

and it used to be the case that when I would tell people that,

在以前，當我這麼告訴別人時，

they would ask me if it had something to do with the skin.

他們會問：這工作和皮膚有關嗎？

(Laughter)

（笑聲）

But thanks to COVID-19, most people have now heard of epidemiologists.

但，因為新冠肺炎，現在 大家都聽過流行病學家了。

So these days, when I tell people what I do,

這段期間，當我告訴別人我的職業，

the questions I get asked most frequently are more like:

我最常被問到的問題多半是：

When does this end?

這何時才會結束？

When do things go back to how they were?

什麼時候一切才能回到原本的樣子？

I get it.

我懂。

I am very eager to stop worrying about COVID-19.

我非常想要停止擔心新冠肺炎。

But these questions seem to be imbued with a hope

但這些問題似乎帶著一種希望，

that when we get to the other side of all this,

當我們渡過這一切，到達另一頭時，

our prepandemic lives are just going to be waiting for us.

我們疫情前的生活就會等著我們。

Now this pandemic will end.

這疫情會結束。

But it won't be possible just to go back to how it was in 2019.

但不可能再回到過去的生活，

回到 2019 年。

Now that may sound bleak, but I assure you, it doesn't have to be.

聽起來可能很無望，

但我保證不一定要如此。

Let me tell you a story that's been giving me some hope.

讓我分享一個帶給我 一些希望的故事。

Feeling better about this.

它讓我對這一切的感覺變好。

Baltimore 1904.

1904 年在巴爾的摩，

A lit cigarette was left in the basement

一根未熄滅的香菸被留在一棟六層樓

of the six-story Hurst building.

赫斯特建築的地下室。

Within a half an hour, the fire grew to an out-of-control conflagration.

半小時之內，火勢變為失控的大火。

Local firefighters were quickly overwhelmed,

當地的消防員很快就招架不住了，

so crews came in from neighboring cities.

所以鄰近城市的隊員也來支援。

But when they arrived, they couldn't hook up their hoses

但他們抵達時，

卻無法把水管接上去。

因為在 1904 年，

because in 1904

there were over 600 variations of hose couplings

美國的消防栓上就有超過

六百種不同的水管連結頭。

on hydrants in the United States.

The fire destroyed more than 1,500 buildings,

大火毀滅了一千五百棟大樓，

2,500 businesses.

兩千五百間公司。

And when it was finally extinguished,

火勢終於被撲滅時，

the burnt district, as it was called, spanned more than 80 blocks.

所謂被燒毀的區域，

橫跨八十個街區。

Fortunately, just a few people died,

幸運的是，只有幾個人死亡。

but that was probably a function of luck

但那可能只是運氣好，

due to the fact that the fire broke out in a business district

因為火勢的起點是在商業區，

that was uninhabited on the weekends.

在週末時沒有人煙。

The story of the Great Baltimore Fire of 1904 is important for a few reasons.

1904 年巴爾的摩大火的故事 之所以很重要，有幾個理由。

To this day, it is one of the largest urban conflagrations in US history.

至今，它仍然是美國史上 最重大的都市大火之一。

And in today’s money,

換算成現今的貨幣，

the toll of this one event is upwards of three billion dollars.

單單這一個事件的損失 就上看三十億美金。

But the Great Fire is remarkable not just for its tolls

但這場大火的驚人之處 不只是它造成的損失，

but for what happened afterwards.

還有事後發生的事情。

Witnessing the devastation that was caused by a single unattended cigarette

見識到一根香菸的疏忽 能造成多大的破壞，

prompted massive change

促成巴爾的摩及美國 其他地方大大改變了

in how Baltimore and the rest of the country

protect itself against urban fires.

預防都市大火的保護措施。

We saw changes in three major areas.

我們可以看到三個面向的改變。

First, we began using data to make buildings safer

第一，

我們開始用資料

讓大樓更安全，並改善 我們因應火災的方式。

and to improve the way we respond to fires.

Governments passed ordinances

政府通過法令，

that became the basis of the first building codes:

為最早的建築規範奠定基礎：

standards that inform the design and construction of buildings

這些規範是大樓設計 與建造的相關標準，

to make them more resistant to fire

旨在讓大樓更能防火， 保護大樓中的人。

and to protect the people that occupy them.

We installed fire alarms so that we could detect and pinpoint fires in buildings

我們安裝了火災警報器， 讓我們能在火災一發生時

就偵測鎖它發生在大樓中的何處，

as soon as they occur

and alert people of the need to evacuate.

警告需要撤離的人。

And we created national standards for firefighting equipment

我們也針對消防設備 建立了國家標準，

so that crews coming out of state could hook up their hoses.

讓其他州來支援的隊員 能裝上他們的水管。

The second area of change is that we created a culture of fire safety.

第二個改變的面向是 我們創造了火災安全的文化。

We regularly test fire alarms and fire hydrants,

我們經常會測試 火災警報器和消防栓，

and we educate people about the risk of fires,

我們也會教育大眾關於火災的風險、

how to prevent them and what to do when one occurs.

如何預防火災， 及發生火災時要怎麼辦。

You remember "stop, drop and roll" fire drills in schools?

各位還記得學校火災演習的 「停止、倒下、翻滾」？

These exercises prime us to act when the alarms go off.

這些練習讓我們能為警報 響起的那一刻做準備。

Even if there's no noticeable sign of fire,

即使沒有明顯的火災徵兆，

we know we're supposed to get out of the building

我們也知道我們應該離開大樓， 直到被通知安全了可以回去了。

until someone tells us it's safe to go back.

第三個改變的面向是 我們建立起了火災防線。

The third area of change was that we built up our fire defenses.

Communities across the country created and staffed fire departments

全國各地的社區

都設立了消防局並安排人員進駐，

so that they'd be ready to respond in emergencies.

準備好因應緊急狀況。

And because we don't know when the next fire is going to occur,

因為我們不知道 下一次火災何時會發生，

we operate our fire defenses 24 hours a day, every day,

我們的火災防線是每天 二十四小時運作的，

and we don't get rid of our fire defenses

且我們不會因為幾年都沒有 發生火災就放棄火災防線。

just because we haven't had a fire for a couple of years.

Data, drills and defense.

資料、演習，和防線。

The collective impact of changes implemented in the US since 1904

1904 年起在美國實施這些改變

所帶來的整體影響

has meant that we no longer have the same number of great urban fires

意味著都市大火 發生的次數已經不再像

that were so frequent in the 19th and early 20th centuries.

十九世紀和二十世紀初那麼頻繁了。

Now I first came to Baltimore 17 years ago,

我在十七年前初次來到巴爾的摩，

actually when the city was gearing up

當時該市正在準備紀念 大火一的百週年。

to commemorate the 100th anniversary of the Great Fire.

I came to study infectious disease outbreaks,

我去研究傳染病爆發，

and even then, well before COVID-19,

就連那時，遠在新冠肺炎之前，

it was abundantly clear that the risk of our experiencing

也非常清楚我們遭遇危險疫情的風險

a dangerous pandemic

was high and increasing.

很高且不斷上升。

By the year 2000,

到了 2000 年，

the number of emerging infectious disease outbreaks that was occurring

新興傳染病爆發的次數

是 1940 年代的四倍之多。

was four times greater than in the 1940s.

And in the last 17 years, we have witnessed a string of events

在過去十七年間， 我們見識到一連串的事件，

that have each exposed vulnerabilities in how we respond to infectious diseases

每一件都曝露出我們 在因應傳染病上的弱點，

and have challenged us in ways that should have made us really worried

這些事件挑戰我們的方式， 應該要讓我們相當憂心

how we'd fare when the big one hit.

當大爆發到來的時候該怎麼辦。

I first heard about COVID December 2019.

2019 年十二月 我初次聽到新冠肺炎。

I was on vacation with my family,

我和家人在渡假，

and in a few weeks we would learn

幾週之後我們就發現 這種病毒很容易在人之間傳播。

that the virus was spreading easily between people.

As an epidemiologist, that's when the alarms went off.

身為傳染病流行病學家， 那就是警報響起的時刻。

At that point, most of my work had been focused on other countries,

那時，我的工作主要都以國外為主，

helping places develop the tools they needed

協助一些地方開發他們需要的工具，

to stop the spread of new diseases.

阻止新疾病的傳播。

But it was becoming clear the US was not taking the steps it needed

但越來越明顯，美國 並沒有採取必要的步驟

to protect us from the unfolding pandemic.

來保護我們，對抗發展中的疫情。

On February 5, 2020,

2020 年二月五日，

I testified before Congress about the US experience of COVID,

我在國會面前針對 美國的新冠肺炎狀況作證，

and I said that just closing travel to China

我說，

只是禁止前往中國

was not going to be sufficient,

是不夠的，我們迫切 需要加強我們的防禦。

that we urgently needed to bolster our defenses.

We had a lot of reasons to be worried.

我們有很多該擔心的理由。

Due to budget cuts,

因為預算被刪減，

there were 250,000 fewer public health workers in the US

美國的公共衛生工作者人數比我們

所需要的少了二十五萬名。

than we needed.

Our hospitals weren’t ready for a surge of patients,

我們的醫院沒有準備好 迎接大量湧入的病人，

and the outbreak in China was causing disruptions

而中國疫情爆發

造成全球個人保護設備 和藥物的供應中斷。

in global supplies of personal protective equipment and medicines.

But our leaders didn't heed those alarms.

但我們的領導人並不在意那些警訊。

While other countries, like South Korea, snapped into action

當其他國家，如南韓， 馬上採取行動，

developing COVID tests and contact tracing programs,

開發新冠肺炎檢測及接觸追蹤方案，

the US remained in denial.

美國還在否認。

Instead of telling us how to protect ourselves,

沒有告訴我們要如何保護自己，

our political leaders tried to assure us we had nothing to worry about.

我們的政治領導人反而試著 向我們保證沒什麼好擔心的。

Over the last year, I've worked

去年，我和約翰霍普金斯 新冠病毒資源中心合作，

with the Johns Hopkins Coronavirus Resource Center,

分析重要的新冠肺炎資料， 並向世界各地的政府收集資訊。

analyzing key COVID data

and gathering information from governments around the world.

在疫情期間，絕大多數的時間， 我們對於新冠肺炎在美國

And for much of the pandemic, we have had an inconsistent picture

of how much of a crisis COVID has been here in the US

是多大的危機， 以及誰受到的影響最大，

and who has been most affected

一直沒有很一致的共識，

because states collect and report COVID data in inconsistent ways.

因為各州收集和回報新冠肺炎 資料的方式並不一致。

Still today states report testing data, vaccine data, COVID demographic data

至今，各州回報測試資料、

疫苗資料、新冠肺炎 人口統計資料的方式仍不同。

differently.

Having nonstandard data, unstandardized data,

沒有標準的資料，

都是未標準化的資料，且正值疫情，

in the midst of a pandemic

is like not being able to hook up your hoses to the hydrants

就如同你的國家被大火肆虐時 卻無法把你的水管

when your country is burning down.

接到消防栓上。

Today, our culture of safety around infectious diseases is in shambles.

現今，針對傳染病， 我們的安全文化很不穩固。

We finally have vaccines, lifesaving tools to end the pandemic.

我們終於有了疫苗，

可以終結疫情的救命工具。

And too many of us won’t take them.

卻有太多人不願接種。

If we thought about pandemics the way we thought about fires,

若我們用看待火災的方式看待疫情，

what we would do would be to try to learn as much as possible

我們會做的就是在新冠肺炎疫情期間

盡可能去學習了解我們的弱點，

about our vulnerabilities during COVID

and work to ensure we are never again left so unprotected.

並努力確保我們永不再 陷入如此沒有保護的情況。

We would commit to action in three areas.

我們會致力投入三個面向的行動：

Data, drills and defense.

資料、演習、防禦。

First, we would develop systems to ensure we have the data we need

首先，我們會開發系統

確保我們能得到必要的資料，

to know when and where there's danger and how best to protect ourselves.

才能知道何時何地有危險發生， 以及保護自己的最佳方式。

The next time there's a concerning outbreak in the world,

下次世界上再爆發 讓人擔心的疫情時，

we wouldn't just wait until people get sick enough

我們就不會只是等著，直到 病得很嚴重才去醫院做檢測。

to go to the hospital to test them.

We would go out and start looking for infections

我們會走出去，開始尋找感染， 才能盡早偵測到它們。

so that we could detect them as early as possible.

And every case we find, we would investigate it,

我們會去調查我們找到的 每個案例，這樣才能快速了解

so that we could quickly learn

what specific places and activities are most likely to get people sick

哪些地方和活動 最有可能會讓人生病，

instead of just saying, "Stay home, if you can, for two years."

而不只是說：「如果能的話， 兩年都盡量留在家。」

And we would develop national data standards,

我們會發展出全國的資料標準，

so that data from New Jersey

這樣，新澤西的資料就能和 俄克拉荷馬的資料做有意義的比較。

could be meaningfully compared to data from Oklahoma.

The second area of action would be to start building a culture of safety

第二個面向的行動

會是開始建立安全文化，

that empowers us as individuals and businesses

讓我們每個人、每間企業， 以及每個社區組織

and community organizations to protect ourselves and others.

能夠保護自己和他人。

We would work to ensure that everyone had access to in-home tests

我們會努力確保人人 都能取得家用檢測，

so that we could know if it's safe to go to work or to see family.

這樣我們才知道去上班 或去看家人是不是安全的。

We would teach people about the threat, how to protect themselves

我們會教導人民威脅是什麼、

如何保護自己，

and how not to spread it to others.

以及如何不要傳染給別人。

But this education would be mostly a reminder

但這種教育主要的功能是提醒，

because we would be practicing these skills

因為我們會在下次疫情之前

well in advance of the next pandemic.

就事先練習過這些技巧。

We would use every flu season as a drill.

我們會把每次流感季用來做演習。

Long before COVID-19, Taiwan began staging mass vaccination exercises

早在新冠肺炎之前，

台灣在每個流感季就開始 施行大眾疫苗接種演練。

every flu season.

They did this to boost vaccination rates in the most vulnerable,

他們這麼做是要提升 最弱勢者的接種率，

but also to practice how they would do it in a pandemic,

同時也是演練在疫情期間要怎麼做，

so that well in advance of a crisis,

這樣，在危機發生之前人民就能知道

people would know where and how they would get a vaccine.

在哪裡、如何接種疫苗。

Now, at a time when the country is incredibly divided,

在國家相當分化的時期，

I know it may seem impossible

我知道，我們似乎不可能

that we could build this culture of safety around infectious diseases that we need.

針對傳染病建立這種 我們需要的安全文化。

But I have spent the last year and a half talking to all sorts of people

但我這一年半的時間 和各式各樣的人談過，

with a range of views on these issues,

從各種觀點來看這些議題，

from top leaders to QAnon believers.

從頂層領導人 到相信匿名者 Q 的人。

And I assure you, we all want to protect ourselves and our families.

而我可以向各位保證，

我們全都想要保護自己和家人。

But we need to build trust.

但我們需要建立信任。

And we can't do that

但如果我們要等到下次危機時 才和彼此談，是不可能辦到的。

if we wait until the next crisis to talk to each other.

The third area where we'd take action

我們採取行動的第三個面向，

is to build our defenses against infectious diseases.

是建立防禦，對抗傳染病。

Instead of a skeletal public health infrastructure

我們有的不是會隨著每次危機

起落的簡單公共衛生基礎設施，

that waxes and wanes with every crisis,

we would maintain, for good,

我們會永遠保有

a large cadre of highly skilled public health professionals

一個具有高度技能的 公共衛生專業骨幹團隊，

who work day in and day out

他們會日復一日地努力 讓我們的社區更健康、安全，

to make our communities healthier and safer

and be ready to respond in an emergency.

並且準備好因應緊急狀況。

We'd reduce our structural vulnerabilities to infectious diseases,

我們可以針對傳染病 來改善建築上的弱點，

starting with our buildings,

從我們的大樓著手，

updating our building codes and ventilation systems

更新我們的建築規範和通風系統，

so that we could be assured

讓我們可以確定這些空間 不會造成超級傳播。

that these spaces will not result in super spreading.

And we would implement economic defenses:

我們可以實施經濟防禦：

policies that provide financial and social support to people

制訂政策來提供財務和社會支援

給因為生病而得待在家的人，

who need to stay home because they're sick

or a loved one is sick or they need to quarantine

或愛人生病的人，或需要隔離的人，

so they don't have to choose between following public health guidance

他們就不需要在遵守公共衛生指南

and earning a paycheck.

和賺薪水之間做抉擇。

Data, drills and defense.

資料、演習，和防禦。

If we acted

如果我們以這三種方式採取行動，

in these three ways,

we'd have a much better shot of keeping the next pandemic threat

我們就會更有機會把 下次疫情流行威脅維持在

to a manageable outbreak

可以掌控的爆發，

instead of a blazing inferno that engulfs entire cities and countries.

而不是吞沒整個城市和國家的 燃燒煉獄。

When people ask me

當別人問我，

when the pandemic is going to end,

疫情什麼時候會結束，

I don't think they're also wondering when the next one is going to occur.

我不認為他們也在思考 下一波疫情何時會發生。

They are, understandably, focused on getting past this threat.

可以理解，他們的焦點 是在撐過這次威脅。

They want to know for how much longer do we have to hold our breath

他們想要知道， 我們還得要摒息多久，

until the flames of the pandemic die down.

疫情的火焰才會熄滅。

But conflagrations don't end just because one was put out.

但不會因為撲滅一場大火， 從此就不再有大火。

The frequency and severity of fires changes when changes are made.

當我們做出改變時， 火災的頻率和嚴重度也會改變。

The same is true for pandemics.

疫情也是如此。

So when people ask me when are things going to go back to how they were,

所以，當別人問我，

一切何時會回到從前，

I have to say: hopefully never.

我得說：希望永遠不會。

Thank you.

謝謝。

(Applause)

（掌聲）

Helen Walters: Thank you. Thank you so much. Thank you.

海倫·華特斯：謝謝你。 非常謝謝你。謝謝你。

So you talked about trust in that --

所以，你談到了信任——

and we've seen the vaccine rate, when it's available,

我們也見識到了可取得 疫苗之後的接種率，

it's really shockingly low,

低得驚人，

and much of that is really related to trust,

很大的一個原因就是信任，

trust in the systems, trust in society.

對體制的信任，對社會的信任。

What are ways that you think that we can do a better job as a society

你認為我們這個社會 要如何才能做得更好，

to convince people that vaccines are safe and people should take them?

來說服人民疫苗是安全的， 應該要去接種？

Jennifer B. Nuzzo: I think, first of all, don’t give up on people.

講者：我想，首先，別放棄人。

我見過人的改變。

I have seen people change.

And you have to come at your conversations with people

你得和大家對談，

from a place of empathy.

從同理的角度切入。

Try to understand why, right?

試著去了解為什麼。

We don't do enough of that,

這方面我們做的不夠，沒去了解 大家為什麼會有那樣的感受，

trying to understand why people feel that way,

and engage with them, hear them.

和他們互動，聆聽他們。

I have found that just simply giving space to people,

我發現，光是給大家空間，

to allow them to talk about their anxieties and their concerns

讓他們談談他們的焦慮和憂慮，

and having the conversation

和他們交談，

takes it from a culture war to just a conversation between human beings.

把談話從文化戰爭

轉變成 人與人之間的談話。

And we've lost that ability,

我們失去了那種能力，

and part of the pandemic has taken that ability from us

疫情有部分已經

奪走了我們的那種能力， 因為我們的機會很少。

because we've had few opportunities.

But we really do have to talk to each other

但我們真的需要和彼此談談，

and have the hard conversations,

進行困難的談話，

and just recognize that we're all walking through this world

承認我們大家活在這個世界上都一樣

trying to get the same things, trying to do the same thing.

在試圖取得同樣的東西， 試圖做同樣的事。

HW: Well, thank you for everything that you’re doing, Jennifer.

海：感謝你所做的一切，珍妮佛。

JBN: Thank you.

珍：謝謝你。

(Applause)

（掌聲）