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

譯者: C Cheng 審譯者: Amanda Chu

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

克里斯·安德森：TEDGlobal 上 發表的第一個 TED 演講

I think seven years ago.

大概是七年前的事了。

His name is Professor Uri Alon,

講者的名字是烏里·阿隆教授，

at the Weizmann Institute of Science.

來自魏茨曼科學研究所。

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

如今他和同事提出了 一個強有力的想法，

that addresses this key question:

來應付這一關鍵問題：

How on earth do we get back to work

我們到底該如何重回工作崗位

without creating a second surge of the infection?

而不造成第二次感染激增？

Uri Alon, welcome to TED.

烏里·阿隆，歡迎來到 TED。

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

烏里·阿隆：謝謝。 很高興再次來到這裡。

CA: It's great to see you again.

克：能再次見到您太好了。

So, I guess the key to your idea

你們這個想法的關鍵

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

圍繞著再生數 R，或是說 R0。

If that number is less than one,

如果這個數字小於 1，

那麼被一個典型病例 傳染的人數就會少於一人，

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

and eventually, the epidemic fades away.

最終，這個傳染病就會逐漸消失。

People are worried that as we come back to work,

人們擔心復工之後，

R will shoot up above one again.

R 值會再次飆升到 1 以上。

You have a suggestion for how we might avoid that.

對於如何避免這個問題， 你提出了一個建議。

What is that suggestion?

這個建議是什麼？

UA: Exactly.

烏：是的。

So, we are suggesting a strategy

我們所建議的這個策略

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

建立在病毒生物特性上的一個弱點。

which is a cycle of work and lockdown.

做法就是讓復工與封鎖交替循環，

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

利用的是病毒脆弱的環節，

也就是人被感染之後，

they're not infectious for about three days.

他們大約在三天內不具備傳染性。

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

所以在最初的三天裡， 你不會傳染其他人。

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

一般而言，再過兩天，你會出現症狀。

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

所以我們提出的建議是工作四天，

and then 10 days of lockdown,

然後封鎖十天。

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

下兩個星期同樣工作四天、封鎖十天。

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

這樣的話，如果有人在工作時被感染，

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

他們的傳染性會在封鎖期達到高峰，

they avoid infecting many others.

避免傳染給更多人。

This restricts the viral transmission.

這就限制了病毒傳播。

Also, just working four days out of two weeks

兩週裡只工作四天

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

也限制了病毒跟其他人接觸的時間。

這個效果是非常強大的。

and that's a very powerful effect.

So everybody works on the same four days,

所以每人都在相同的四天裡上班，

kids go to school on the same four days,

孩子在這四天去學校，

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

同時有社交距離、戴口罩等配套措施，

and then there's a lockdown period.

之後便是封鎖期。

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

克：如果以最壞的情況為例，

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

星期一是你四天上班時間的第一天，

早晨在上班途中，你在地鐵上被感染，

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

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

根據這個理論，在四天結束時，

you're not really starting to infect your coworkers?

你還沒有真的開始傳染給你的同事？

UA: That's correct.

烏：沒錯。

So you're infected on the subway,

你在地鐵上被感染，

在最初三天左右的時間裡， 你處於潛伏期，

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

you don't infect your coworkers,

你不會傳染給你的同事，

you reach your peak infectiousness at home,

在家不上班的期間， 你的傳染性才會達到高峰。

there will be secondary infections at home,

家裡會發生繼發傳染，

and people with symptoms can self-quarantine,

有症狀的人可以自我隔離，

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

長期下來，再生數就會小於 1。

so the epidemic, if you continue these cycles,

因此，如果這個循環持續下去，

will go away.

這個流行病就會消失。

CA: I mean, is it frustrating

克：這個會不會讓人有挫折感？

at the thought that people are going to say,

當你考慮到有人會說：

「欸，我可不想傳染給我的家人。

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

我寧願傳染我在工作中 遇到的人，而不是家人。」

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

What's the response to that?

對此該如何應對？

烏：是的，一點沒錯。

UA: Yes, absolutely.

我們必須考慮替代方案。

So we have to consider the alternatives.

如果開放經濟活動時 發生了第二波疫情，

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

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

那麼在接下來的封鎖期內， 所有這些傳染反正都要發生。

along with the devastating effects on the economy, etc.

隨之而來的， 是對經濟的毀滅性影響等。

And so, in the long run,

所以，長期而言，

if you do a cyclic strategy like this

如果你採用一個像這樣的循環策略，

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

但同時讓再生數小於 1，

那麼，至少根據這個數學模式和考量，

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

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

如果第二波疫情來臨， 你可以避免大量人員感染。

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

克：是的，你照顧到 家庭的需求……抱歉，請繼續。

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

烏：即使是被感染者 也不會感染家裡的每個人。

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

根據好幾項研究， 感染率是 10% 至 30%。

CA: Right.

克：對。

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

但期望的是你能透過參與 這個策略來滿足家人的需要，

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

這個策略就是要讓你的同事中

are going to be infectious anyway,

很少人具有傳染性。

so that's the plan, but um --

這個計劃就是這樣，但是……

UA: That's right.

烏：沒錯。

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

克：不過，你說說看， 如果十四天中只工作四天，

有人會說：「好主意。

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

但也意味著生產力會削減 70%，

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

影響經濟，

in the economy,

so that can't possibly work."

所以是不可行的。」

I think you think that the productivity loss

我想你認為生產力的損失

不一定要這麼大。

need not be anything like that much.

UA: That's right,

烏：沒錯。

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

當然了，大部分人週末不工作，

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

所以兩週有十個工作天， 其中四天要工作。

and once you have a predictable schedule

而且一旦有了固定的

of four days at work,

四天的工作日程表，

you can work longer hours,

你就可以工作更長的時間。

you can design shifts and get higher productivity

你可以做輪班計畫， 安排這四天中的優先工作，

by prioritizing in those four days

讓縮短為 40% 的工作時間，

much more than 40 percent of the workdays.

獲得更高的生產力。

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

克：是的，聊一聊這該如何運作吧。

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

讓我們來想像一下，首先是製造業，

which is currently shut down.

當前停產。

Is the implication here that a manufacturer could set up

這個是否意味著

製造商可以在四天中安排 兩班制或三班制的輪班制度，

two, possibly even three, shifts of four days,

maybe 35 hours or something of work over those four days

四天中，每班大約工作 35 個小時，

and still get a lot of productivity,

還是可以有很大產出，

basically, having the lines almost running continuously that way?

基本上，就是讓生產線持續運轉？

UA: Exactly.

烏：正是如此。

So this is a staggered version of this idea,

這是加上人員交替的版本。

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

即把人分為兩組或者三組。

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

一組工作四天，然後封鎖十天，

Then the other group kicks in.

第一組下班後，再換第二組上班。

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

這個主意是我在 巴伊蘭大學的同事提出來的。

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

這還有個額外的好處， 就是工作日中人員密度較低。

If there's two groups,

如果有兩個組，

there's half the density and less transmission.

密度就會減少一半，傳播也會減少。

And you can keep production lines working almost continuously like that

而使用這樣交錯的方式，

using this staggered idea.

生產線也可以持續運轉。

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

克：如果運用到 辦公型工作復工的狀況，

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

我覺得我們已經看到

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

在家工作也可有很好的生產力。

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

所以你可以這樣設想，

人們在回到辦公室的這四天

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

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

做一些需要交流互動、 互相啟發的事情，

the discussions, the brainstorming, all that good stuff,

像是各種討論、集思廣益等等。

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

而在家的時候，

他們則從事那些在過去幾個星期中 我們都在做的事，

that we've been doing the last few weeks,

kind of working solo.

就是獨自工作。

你是否考慮過，

How much have you thought about how that,

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

是否可能將每個人的工作清楚地分類，

and actually use a strategy like this

並且確實採用與此類似的策略

to maintain almost full or even better productivity?

來維持原有，甚至更高的生產力。

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

烏：我同意。在許多領域裡， 人們可以非常有效地在家工作。

and we've heard from several industries

我們從一些產業了解到：

that productivity actually went up during lockdown

封鎖期間，員工在家辦公，

and people working at home.

生產力反而提高了。

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

所以，如果你有一個時間表， 一個循環策略，

you can restrict the amount,

你可以限制工作量，

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

或者對那些需要共同完成的工作

in a very effective way

進行非常有效安排，

with avoiding a lot of time lost,

同時避免許多時間上的浪費。

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

前提是在家時和在辦公室 都能更有效地辦公，

and more effective at work and get high productivity.

讓產值更高，

I should say that some sectors really need to adjust,

我應該說某些行業確實需要進行調整，

like hotels, tourism, dining.

比如旅館業、旅遊業、餐飲業。

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

應用在某些產業時， 這個方法需要更多的思考和調整，

但對有些產業而言， 簡直就像量身訂做。

But other industries are almost built for ideas like this.

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

甚至在疫情過後，仍可考慮拿來運用，

because productivity can be at least as high.

生產力至少可以保持在同等水平。

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

克：我讀了這個， 開始思考我們自己的組織 TED，

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

從很多方面來看，你可以說 這個策略可以有很好的效果。

I mean, for one thing,

我的意思是，首先，

這裡有一個關於外向型人 和內向型人的問題。

there's this question about extroverts and introverts.

Some introverts, if they were honest,

如果他們誠實的話，一些內向的人

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

會說這場疫情對他們來說 是一個意外幫助。

They've found work less stressful.

他們感到工作壓力減輕了，

They've been able to focus and so forth.

他們可以集中精力在工作上等等。

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

透過這種四天工作制的策略，

perhaps you can imagine a work world

我們或許可以設想一個 對外向型和內向型來說

that's optimized for both introverts and extroverts?

都是最佳化的工作環境？

UA: Absolutely.

烏：完全同意。

I mean, I feel it also.

我是說，我也有同感。

Me and my partner, with different personalities,

我和我的搭檔性格不同，

we both teach in universities,

我們都在大學任教。

and teaching through this

透過這個方式教書

has [helped me] become productive in certain ways.

使我在某些方面變得更加富有成效。

So I agree completely,

所以，我完全同意。

and I think harnessing the creativity of people at workplaces,

我認為，就利用人們 在工作崗位上的創造力而言，

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

我們只是剛剛開始探索 這些組合所能提供的可能性。

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

克：但是對那些 在第一線工作的人來說，

again, if you're delivering goods and so forth

比如說投遞貨物之類的工作，

and you can't do that virtually,

不可能在網路上完成。

is there any thought about

是否考慮過，

how a four days on and then isolation strategy,

該如何透過這種 工作和隔離交替的策略，

how that off time could be used

還能將不工作的時間加以利用，

to nonetheless contribute to that person's work

透過某種形式的培訓 來為這些人的工作加值？

through some form of training?

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

或者，是否可以這樣說：

人們高強度地工作四天，

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

但是，在這種情景中， 可能仍然無法掙到全額工資。

but it's better than complete lockdown,

但這總比完全封鎖強，

也強過因復工而出現的疫情激增？

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

烏：正確。

UA: That's right.

所以，在社會層面上，

So on a society level,

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

這個要比開放後而出現另一波激增好。

which would require complete lockdown.

因為這將導致全面封鎖。

For people like hospital shifts,

對於那些在醫院輪班的人來說，

some hospitals adopted this kind of program

有些醫院採用了此類計劃，

so we can protect shifts and avoid mixing.

輪班的人可以獲得保護 並避免人員混雜。

而且，它還非常簡單明瞭。

It also creates a lot of simplicity and clarity.

So you understand when you're working,

你知道你該何時工作。

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

你還會對這個計劃的 有效性抱有一定信心，

about the effectiveness of this plan.

因為它是以科學模型為基礎的。

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

這個計劃還很公平合理， 因為每個人都可以出來工作，

not only certain sectors,

而不僅僅是某個行業的人員。

it's transparent, etc.

它還有公開透明等優點。

[Cross talk]

【串話】

CA: And this is something that is best implemented

克：這個方案最好由各個公司來執行，

by individual companies?

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

還是說，其實由城市，甚至全國

or even a nation at a time?

同時執行會更好呢？

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

烏：我們認為這可以 在不同範圍上發揮作用。

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

在某些公司裡， 採用這個方案是很自然的。

or at hospitals, schools, etc.

或者醫院，學校之類也是。

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

它也可以在城鎮 或行政區的範圍發揮作用。

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

我們建議試行一個月左右，

seeing whether cases rise.

看看病例是否增加。

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

如果增加的話，可以減少工作日。

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

如果病例迅速下降的話， 可以增加工作日。

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

由此根據當地的具體情況來進行調整。

So it's quite adaptable.

所以它的適應性很強。

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

克：比如，將工作日和上學日重疊，

父母突然間可以

that suddenly allows parents to go back to work

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

在孩子上學的日子重返工作崗位。 而且必須要試行……

UA: Absolutely.

烏：是的。

CA: I mean, is the best instantiation of this

克：最好的方式

that countries literally divide households

是否是讓各國將每種不同的家庭

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

分成 A、B 兩類，或類似的作法，

so that that kind of alignment could happen?

以便做到前面所說的重疊？

UA: Exactly.

烏：完全正確。

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

所以將不同的家庭 分別歸類為 A 組和 B 組，

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

然後孩子上學、家長上班，

in a synchronized way,

同步進行。

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

下週則由另一組輪替。

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

一部分人的工作不能間斷。

比如教師是必要工作人員， 必須連續工作。

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

Just like during lockdown situations,

就像在封鎖期間，

a certain fraction of the population still works throughout.

有一部分人都照常工作。

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

但施行這個方法的地區應該受到保護，

because it has a replication number of less than one,

因為它的再生數小於 1，

如此，境外移入感染也無法廣泛傳播。

so imported infections also can't spread very much.

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

克：這是我跟你提到過的 戴維·比耶洛。戴維。

David Biello: Yes. Hello, everybody.

戴維·比耶洛：大家好。

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

烏里， 你可以想像得到

觀眾提出了許多問題。

from the audience,

and we have a first one

第一個問題是關於那些 從事必要工作的人員。

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

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

你是否可以評論一下這個會給 醫護人員和其他人帶來什麼影響嗎？

who may not have time or the flexibility to quarantine

這些人或許沒有時間或者靈活性

來按照你所推薦的方式進行隔離。

in the way you suggest.

UA: That's great.

烏：好的。

我想說的是， 除了從事必要工作的人員，

I want to say that there's essential workers,

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

還有低收入者。 他們無法服從封鎖的規定，

because they have to make a living.

因為他們要維持生計。

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

有研究顯示低收入產業中 人員外出活動頻率

is larger during lockdown.

在封鎖期間增加了。

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

並且在發展中國家，人們不得不出門。

You can't enforce lockdown.

你不可能實施封鎖。

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

所以這個四工十封的策略 其實使封鎖更容易承受。

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

在這些日子裡， 人們仍然可以維持生計。

or at least make their own choices

或者至少他們可以選擇

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

哪些人工作，哪些人封鎖。

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

即使實施了封鎖，有些國家 也無法使 R 值降到 1 以下，

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

因為有服從封鎖規定的問題， 以及邊緣產業等因素。

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

我們相信這個四工十封的循環制度 或許可以讓封鎖更容易執行。

and maybe get our infection level less than one.

並使再生數減到 1 以下。

That affects billions of people in the world.

這將影響到全世界數十億人口。

I hope I answered your question.

我希望我回答了你的問題。

DB: I think so,

戴：我覺得有。

and we have another question, I believe,

我們還有另一個問題，

if that can be queued up,

如果時間還允許的話，

which is:

問題是：

Any chance you can do the math

你能否做一些計算

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

來量化這個四工十封制 可能增加的風險？

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

烏：增加的風險性 在我們的科學論文裡是這樣說的：

we did all the sensitivity analyses, etc,

我們做了所有敏感性分析等相關分析。

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

問題是，增加的風險 是跟什麼做比較？

So, to the economy ...

對於經濟而言……

It's possible there will be a second wave.

有可能出現第二波疫情。

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

我希望沒有，但是確實有這種可能。

那樣的話，很顯然， 第二波疫情和另一個封鎖期

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

will have worse consequences on health

將給健康造成

比這個四工十封循環更為慘重的後果。

than a cycle of four-10.

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

所以這其實是一個與何相比較的問題。

DB: Sure.

戴：是的。

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

烏里，非常感謝你 與我們分享你的觀點。

CA: Indeed.

克：確實。

David, stay on.

戴維，請留在線上。

But just before you go:

在你走之前我有另一個問題：

Have any governments expressed interest in exploring this?

是否已經有政府對探討 這個策略表示了興趣呢？

Do you see people considering actually implementing this

你是否看到有人考慮將它 作為全國性的政策來實施呢？

as national policy?

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

烏：是的，我們和一些 歐洲國家保持聯繫，

and countries in South America and Israel, of course.

此外還有南美的國家， 當然還有以色列。

Austria has adopted a similar program for their school system,

奧地利已經在學校體系裡 採用了類似的計劃，

which is five school days every two weeks.

他們是每兩個星期上學五天。

And several companies and hospitals, etc.

還有一些公司、醫院等等。

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

我們非常想了解這些措施的表現如何。

CA: Well, I love the basic start point

克：我很喜歡將敵人的弱點 當作出發點的想法。

of starting by looking at the enemy's weakness.

And you've got this four-day period

在這四天期間，

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

即使受到感染，也並不一定那麼危險，

if you could figure out a way to work then.

只要能找到執行的方法。

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

我想這個方法配合檢測 會有很大的幫助，對吧？

To test people before they come back --

在復工前，對人們進行檢測……

UA: It's not predicated on testing.

烏：這個方法不一定要配合檢測。

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

你不需要檢測來實施這個想法。

所以它可以用於不具備 大量檢測能力的地區。

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

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

如果要檢測的話，這個方法 可以讓你更有效運用檢測的資源。

即是將檢測集中在十天封鎖期結束，

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

也就是人們準備上班之前。

just as they're about to go to work;

就降低再生數而言，

that could make each test more impactful

這樣會讓每次檢測更有影響力。

in terms of reducing their reproduction number.

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

克：的確。與其每隔三四天 就進行一次全民測試，

every three or four days,

it's just once every two weeks.

不如每兩個星期檢測一次。

That's a much more imaginable goal.

那是一個更可行的目標。

UA: Sure.

烏：是的。

CA: Yeah.

克：好的。

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

烏里·阿隆，非常感謝您撥冗參與。