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中国也许有效控制了疫情,但代价惨重
China May Be Beating the Coronavirus, at a Painful Cost

来源:纽约时报    2020-03-10 01:18



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        BEIJING — As the new coronavirus races around the world, tanking markets, cutting off global travel and suspending school for hundreds of millions of children, governments are desperate for ways to contain it.        北京——随着新冠病毒在世界各地肆虐,股市遭受重创,全球旅行中断,数亿学童无法上学,各国政府都在迫切寻求控制病毒的方法。
        China, the place where it first appeared, says it has the answers.        中国,病毒的始发地,说他们有答案。
        To the surprise of some, the country that concealed and mismanaged the initial outbreak appears to be bringing it under control, at least by its own official figures. The number of new cases reported has fallen dramatically in recent days even as infections are surging in other countries. The World Health Organization has praised Beijing’s response.        出乎一些人意料的是,这个在疫情初期存在瞒报和应对不当的国家,似乎控制住了疫情,至少从官方数据看来如此。最近几天,即使其他国家的新增病例激增,中国的新增感染病例显著下降。世界卫生组织赞扬中国应对疫情的努力。
        Officials reported only 99 new cases on Saturday, down from around 2,000 a day just weeks ago, and for the second day in a row, none were detected in Hubei Province outside of its capital, Wuhan, the center of the outbreak.        中国官方宣布周六新增确诊99例,而这一数据在两三周前约为每天2000例。而且,除了疫情中心武汉之外,湖北省其他地区已经连续两天无新增确诊病例。
        China says the trend proves that its containment measures — which include a lockdown on nearly 60 million people in Hubei and strict quarantine and travel restrictions for hundreds of millions of citizens and foreigners — are working. And it has begun trying to promote its efforts as successful in propaganda at home and abroad.        中国称这一趋势证明了其控制手段——包括封锁湖北境内近6000万人,并对数亿民众和外国人实施严格隔离和旅行限制——是有效的。它已经开始在国内外的政治宣传中宣扬这些举措取得了成功。
        The rest of the world, much of it fearfully confronting its first cases, has taken note. But there is also concern that China’s numbers may be flawed and incomplete. The real test will be whether the virus flares again when children return to classrooms and workers to factories, and commuters start taking buses and subways.        世界其他地方,大多数还正战战兢兢地面对首批感染病例,它们也注意到了这一点。但是对于中国的数据是否有误、是否完整,大家也心存疑虑。真正的考验在于,当学生返校、工人复工、上班人群重新乘坐公交和地铁时,病毒是否会卷土重来。
        China’s blunt force strategy poses deeper questions for other countries. Its campaign has come at great cost to people’s livelihoods and personal liberties. Even countries that could copy China still have to ask whether the cure is worse than the disease.        中国生硬的防御措施,还对其他国家提出了更深层次的问题。中国应对疫情的努力,是以民众生计和个人自由为代价的。即使对于那些可以重复中国模式的国家来说,也不得不考量,这种治疗手段是否比疾病本身更糟糕。
        “I think they did an amazing job of knocking the virus down,” said Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. “But I don’t know if it’s sustainable. What have the Chinese really accomplished? Have they really contained the virus? Or have they just suppressed it?”        “我认为在击溃病毒方面他们做了很了不起的工作。”明尼苏达大学传染病研究和政策中心主任迈克尔·T·奥斯特霍尔姆(Michael T. Osterholm)说,“但我对其可持续性感到怀疑。中国人到底取得了怎样的成就?他们是控制住了病毒?还是仅仅压制了它?”
        Elsewhere, Italy, South Korea and Iran are struggling to control the spread of the virus. In the United States, where there are now more than 400 confirmed cases, the government has been criticized for fumbling its rollout of test kits and allowing the virus to spread in vulnerable communities like a nursing home in Seattle. The outbreak now threatens global growth and is intensifying a backlash against immigration and globalization.        其他地方,如意大利、韩国和伊朗,正在艰难地遏制病毒传播。美国目前已有超过400例确诊病例,而因为试剂盒问题以及放任病毒在西雅图疗养院这样的高危人群中传播,政府饱受批评。当前,疫情已经危及全球经济增长,并正在助长移民和全球化方面的倒车。
        Countries studying China’s approach would need to consider how it has upended nearly every corner of Chinese society.        向中国学习的国家需要考虑到,中国社会的每个角落都被掀了个底朝天。
        The economy has ground to a near standstill, and many small businesses say they may soon run out of cash. Patients with critical illnesses are struggling to find timely care, and some have died. Hundreds of millions of people have been placed in some form of isolation. As of Friday, about 827,000 people remained under quarantine in Beijing, according to the state-run China Daily newspaper.        中国的经济几近陷入停顿,众多小企业表示,资金链可能很快无以为继。危重的病人很难及时就医,一些人甚至病故。数亿人曾处于不同形式的隔离中。据官方媒体《中国日报》称,截止周五,北京仍有82.7万人被隔离。
        “I have been worried about all the focus on just controlling the virus,” said Dr. Jennifer Nuzzo, a senior scholar at the Johns Hopkins Center for Health Security. She recommended a more measured response, such as that taken by the governments in Hong Kong and Singapore. Officials there enacted targeted quarantines but did not shut down workplaces altogether, allowing their respective economies to continue operating while so far successfully containing the virus.        “对于大家将全部注意力放在控制病毒上,我感到担忧。”约翰·霍普金斯大学健康保障中心的高级学者詹妮弗·努佐博士(Dr. Jennifer Nuzzo)说。她建议借鉴香港和新加坡那种更为谨慎的做法。那里的政府制定了有针对性的隔离措施,但没有完全关闭工作场所,经济因此得以继续运转,而病毒到目前为止也成功被遏制。
        “We have to take a broad view of the impact on society,” Dr. Nuzzo said, “and do a better accounting for the social tolls of these measures that is not just focused on the numbers.”        “我们必须更全面地看待社会影响,”努佐博士说,“要仔细计算这些方法的社会成本,而不能仅仅锁定疫情数字。”
        For China, the numbers are key.        对中国来说,数字是关键。
        The number of cases reported on Saturday was a substantial decline from two and a half weeks ago, when China was recording around 2,000 new infections and as many as 100 deaths a day. Twenty-eight new deaths were reported on Saturday, all in Hubei.        相比于两周半前每天约2000例确诊和多达100例死亡,中国在周六报告的数据大大降低。周六死亡28例,均来自湖北。
        By comparison, Italy reported 49 deaths from the virus on Friday.        相比之下,意大利在周五报告了49例死亡。
        Outside of Wuhan, the spread has effectively stopped, according to the official figures. All but one of the 99 new cases reported on Saturday were in Wuhan or were people who had traveled to China from abroad.        根据官方数字,武汉以外地区的传播已被有效阻止。周六报告的99例新增病例中,除了一人之外,其他都在武汉或从境外输入。
        The World Health Organization says China’s containment measures may have saved hundreds of thousands of people from infection. Its efforts show that uncontrolled spread of the virus “is not a one-way street,” Dr. Tedros Adhanom Ghebreyesus, the group’s director general, said on Thursday.        世界卫生组织说,中国的控制手段也许让数十万人免受感染。中国的努力显示,病毒的不可控传播“不是一条单行道”,世卫组织的总干事谭德塞周四说道。
        “This epidemic can be pushed back,” Dr. Tedros said, “but only with a collective, coordinated and comprehensive approach that engages the entire machinery of government.”        “这种传染病是可以能够被打败的,”谭德塞博士说,“但只能有赖于整个政府机器集中、协调一致而全面广泛的行动。”
        W.H.O. experts sent to China have also highlighted clinics that could diagnose hundreds of cases a day with CT scans and laboratory tests, and the mass isolation centers in stadiums in Wuhan that separated people who had mild infections from their families.        被派往中国的世卫专家还指出,当地医院每天可以通过CT扫描和试剂盒确诊数百人,武汉的一些体育馆被用作大型隔离中心,将轻症患者与家人分开。
        “There’s no question that China’s bold approach to the rapid spread of this new respiratory pathogen has changed the course of what was a rapidly escalating and continues to be a deadly epidemic,” Dr. Bruce Aylward, the leader of the W.H.O. team that visited China, told reporters in Beijing late last month.        “毫无疑问,针对这种快速传播的新型呼吸道病原体,中国的大胆举措改变了这场急速升级并仍将是一场致命疫情的走势。”世卫组织访华专家组组长布鲁斯·艾尔沃德博士(Dr. Bruce Aylward)上个月在北京告诉记者。
        The numbers suggest that aggressive quarantine measures, when fully enforced, could choke the spread of the virus, said Dr. William Schaffner, an infectious disease specialist at Vanderbilt University.        数据显示,激进的隔离措施,如果能执行彻底,可以扼制病毒的传播,范德比尔特大学(Vanderbilt University)的传染病专家威廉·舍夫纳博士(Dr. William Schaffner)说。
        “This is the largest public health experiment in the history of humankind,” Dr. Schaffner said. “They can’t turn it off, but they did turn it down. And it did provide the rest of the world with some extra time.”        “这是人类史上最大的公共卫生实验,”舍夫纳博士说,“他们无法将疫情灭掉,但确实在让它受到了控制。而且这一实验也的确为世界其他地区赢得了更多时间。”
        Still, the total number of infections in China, at more than 80,000, is staggering. And there are reasons to doubt the official figures.        然而,中国的总感染人数已超过8万,这是一个相当骇人的数字。而且我们有理由对官方数据存疑。
        In the early days of the outbreak, a shortage of test kits and hospital beds meant that many were not able to get tested. Many mild infections are likely going undetected. The government has changed how it counts cases several times in recent weeks, prompting large fluctuations in the reported figures, though experts say such adjustments are not unusual.        在疫情暴发的初期,试剂盒与病床短缺致使很多人做不上检测。很多轻症感染者可能没有被发现。在最近几周内,中国政府好几次改变病例统计方法,导致报告数据出现大幅度波动。但专家表示,这样的调整并不罕见。
        Medical experts say that there have been few signs that the government has aggressively tested for the coronavirus outside of medical facilities in Hubei. Until they broaden the scope of testing, experts say, it will be impossible to determine the true extent of the epidemic because those who have mild infections might not see a doctor.        医学专家说,几乎没有迹象表明政府在湖北的医疗机构以外进行了积极的冠状病毒检测。专家说,除非扩大检测范围,否则无法确定疫情的真实程度,因为那些轻度感染者可能不会去看医生。
        “At the moment we are focused on the tip of the iceberg,” said David Hui, the director of the Stanley Ho Center for Emerging Infectious Diseases at the Chinese University of Hong Kong.        香港中文大学何鸿燊防治传染病研究中心(Stanley Ho Center for Emerging Infectious Diseases)主任许树昌说:“目前,我们关注到的是冰山一角。”
        The ruling Communist Party hails the slowdown of the outbreak as a sign of the superiority of its authoritarian, top-down political system that gives officials nearly unchecked power. But its heavy-handed measures are testing the patience of its citizens, many of whom think such a clampdown could have been avoided if officials had not first hid the scale of the outbreak and silenced whistle-blowers.        执政的共产党将疫情速度放缓歌颂为威权主义及自上而下的政治体系优越性的一个标志,该制度赋予官员几乎不受限制的权力。但它的高压措施正在考验民众的耐心,其中许多人认为,如果官员们没有首先掩盖疫情暴发规模并使吹哨人噤声,那么这种强制措施本可以避免。
        The impact of the restrictions has been felt most acutely in Hubei, where 56 million people have been effectively penned in since January. For more than five weeks, the typically bustling hub of universities, commerce and transportation has been transformed into a collection of ghost towns as the virus has ravaged communities, ensnared entire families and infected thousands of medical workers.        限制的影响在湖北感受最为明显,自1月份以来,湖北已实质封锁了5600万人。五个多星期以来,随着病毒肆虐社区、许多人家举家遭难、成千上万的医务人员感染,往日繁华的大学、商业和交通枢纽变成了一个个鬼城。
        China’s experience combating the virus has also highlighted the risk of family transmission if hospitals run out of beds and testing kits, as they did in Wuhan, where for weeks, many who were sick were sent home and infected their relatives.        中国抗击病毒的经验也凸显出,如果医院床位和检测试剂盒短缺,就会出现家庭感染的风险,就像武汉那样,数周之内,许多生病的人被送回家并感染了亲属。
        Roadblocks have sealed off cities, public transportation has been shut down and private cars have been mostly banned from the roads. In Wuhan, restrictions on individual movement have been stepped up in recent weeks, with residents now mostly barred from leaving their homes.        路障将城市封锁,公共交通停运,私家车大部分禁止上路。在武汉,最近几周加大了对个人行动的限制,现在大多数居民被禁止离家。
        Among residents in Hubei, there are signs that anger and frustration are mounting. Chinese social media sites are flooded with posts from residents saying they have lost their jobs because of the extended lockdown, making it difficult to make payments on mortgages and loans. Others have described food shortages in their communities.        在湖北民众当中,有迹象表明,愤怒和沮丧情绪正在加剧。中国社交媒体网站上充斥着居民的帖子,说他们由于封锁太久而失去了工作,难以偿还抵押贷款。还有人则描述了他们所在社区的食物短缺情况。
        On Thursday, in a rare public rebuke of the government, disgruntled people in a residential community in Wuhan heckled high-level officials as they walked through the neighborhood on an inspection.        周四出现了对政府的罕见指责,在武汉一个小区,不满的居民在高官走访社区时大声抗议。
        “Fake! Everything is fake!” shouted one resident at the delegation, which included Sun Chunlan, a vice premier leading the central government’s response to the outbreak.        “假的!全是假的!”一位居民向代表团大喊,代表团中包括领导中央政府应对疫情的副总理孙春兰。
        The state-run People’s Daily newspaper later said that the accusations were aimed at local neighborhood officials who had “faked” delivery of vegetables and meat to residents. Ms. Sun ordered an immediate investigation into the issue.        官方媒体《人民日报》随后表示,这些指控是针对那些向居民运送菜肉时“作假”的当地社区官员。孙春兰下令立即对此事进行调查。
        Wang Zhonglin, the party secretary of Wuhan, announced plans on Friday to teach the city’s residents to be grateful to the party, a move that was quickly met with derision and anger on Chinese social media.        武汉市委书记王忠林周五宣布要在广大市民中开展感恩教育,此举很快在中国社交媒体上引起了嘲讽和愤怒。
        Relationships are also fraying as families are forced to live for extended periods in confined spaces. Guo Jing, a feminist activist in Wuhan, said she and other volunteers had fielded a number of requests for help from residents reporting physical abuse by their family members at home.        由于被迫长期居住在受限的空间内,家庭关系也越来越紧张。武汉的女权主义者郭晶(音)说,她和其他志愿者已经接到了许多居民寻求帮助的报告,说她们在家中受到家人的身体虐待。
        “Under these circumstances, it’s really difficult for them to find help during the epidemic,” said Ms. Guo. “It’s so difficult to leave the house.”        “在这种情况下,疫情期间她们很难求助,”郭晶说。“出家门都是很难。”
        Fang Fang, a writer who has been keeping a widely read — and often-censored — online journal of life in Wuhan, said that the lockdown was exacting a psychological toll on residents.        作家方方的武汉日记被广泛阅读——并经常被删,她说这次封锁对居民造成了心理伤害。
        “Ordinary people have no source of income and lack a sense of certainty even about when they’ll be able to go out,” she wrote in a recent entry. “When you can’t feel the ground or you lose control over a situation, it’s easy to lose the most basic sense of security.”        “普通百姓的经济来源无着,也没有确定感,即哪天可以出门,”她在最近的一篇日记中写道。“在自己抓摸不着,无法掌控的情况下,会导致最基本的安全感丧失。”
        Outside of Hubei, China wants to fire up its economy, but local officials are also under immense pressure to take no risks in order to reduce the number of infections. Even as provinces have lowered their alert levels for the virus, many companies are choosing to err on the side of caution. Some have even faked electricity consumption rates in order to hit stringent back-to-work targets, according to a recent report by Caixin, an influential Chinese magazine.        在湖北以外,中国希望刺激经济,但地方官员也承受着巨大的压力,为了减少感染人数不愿承担风险。即使各省下调了对该病毒的响应级别,许多公司还是选择谨慎行事。根据在中国有影响力的杂志《财新》的最新报道,一些地方甚至伪造了用电量,以达到严格的返工目标。
        Some experts are increasingly wondering if China’s lockdown will become pointless the more widespread the virus becomes. Given the global spread of the virus and the difficulty of spotting mild cases, they say, it is unlikely that it will ever be completely eliminated — even in China.        一些专家越来越怀疑,随着病毒的传播越来越广泛,中国的封锁是否会变得毫无意义。他们说,鉴于该病毒在全球范围内的传播,以及发现轻症病例的难度,即使在中国也不大可能将其彻底消除。
        “I do think the declining case numbers likely mean that all these incredible measures that have been taken are probably having an effect,” said Marc Lipsitch, an epidemiologist at the Harvard T.H. Chan School of Public Health. “But I don’t think zero is zero.”        “我确实认为病例数的下降可能意味着,已采取的所有这些令人难以置信的措施可能正在产生效果,”哈佛大学陈曾熙公共卫生学院(Harvard T.H. Chan School of Public Health)流行病学教授马克·利普西奇(Marc Lipsitch)说。“但我不认为零等于完全没有。”
                
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