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Tracking the Coronavirus: How Crowded Asian Cities Tackled an Epidemic

来源:纽约时报    2020-03-18 06:03

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        SINGAPORE — Two hours. That’s all the time medical teams in Singapore are given to uncover the first details of how patients contracted the coronavirus and which people they might infect.        新加坡——两小时。新加坡医疗队只有这点时间,去找到患者如何感染冠状病毒的最初细节,以及可能感染了哪些人。
        Did they travel abroad? Do they have a link to one of the five clusters of contagion identified across the city-state? Did they cough on someone in the street? Who are their friends and family, their drinking buddies and partners in prayer?        他们出国过吗?他们和这个城市国家发现的五个传染集群中的一个有联系吗?他们在街上对人咳嗽了吗?他们的朋友和家人都有谁,他们的酒友和教友呢?
        As Western nations struggle with the wildfire spread of the coronavirus, Singapore’s strategy, of moving rapidly to track down and test suspected cases, provides a model for keeping the epidemic at bay, even if it can’t completely stamp out infections.        在西方国家与野火般蔓延的冠状病毒作斗争之际,新加坡迅速采取行动追踪和检测疑似病例的策略,为控制疫情提供了一种模式,即便这不能完全消灭传染。
        With detailed detective work, the government’s contact tracers found, among others, a group of avid singers who warbled and expelled respiratory droplets together, spreading the virus to their families and then to a gym and a church — forming the largest concentration of cases in Singapore.        通过详细的侦测工作,政府接触追踪者查到了一群热情的歌手,他们放声高唱,排出飞沫,将病毒传播给家人,然后又传播到一座体育馆和一座教堂——这两处形成了新加坡病例最集中的地方。
        “We want to stay one or two steps ahead of the virus,” said Vernon Lee, the director of the communicable diseases division at Singapore’s Ministry of Health. “If you chase the virus, you will always be behind the curve.”“我们希望能领先病毒一两步,”新加坡卫生部传染病司司长弗农·李(Vernon Lee)说。“如果只是在病毒后面追,就会永远落后于趋势。”        
        And the vigilant monitoring systems in Singapore, Taiwan and Hong Kong were built over years, after their failures to stop another dangerous outbreak — SARS — 17 years ago. The United States disbanded its pandemic response unit in 2018.        新加坡、台湾和香港的预警系统是17年前未能阻止危险的SARS疫情之后,用多年时间建立起来的。美国在2018年解散了其流行病应对部门。
        There is also the question of how replicable this model from smaller Asian centers is in large Western countries where people might chafe at the harnessing of C.C.T.V. cameras or immigration records for the health of the nation. Disease control infringes on individual liberties, and places like Singapore, where chewing gum was once banned, are more willing to accept government orders.        还有一个问题是,这种较小的亚洲中心的模式,多大程度上能复制到较大的西方国家,利用公共摄像头或移民记录来维护国家健康,可能会引起那里的人的不满。疾病控制侵犯了个人自由,而像新加坡这样曾经禁止嚼口香糖的地方,人们更愿意接受政府的命令。
        “Maybe it’s because of our Asian context, but our community is sort of primed for this,” said Lalitha Kurupatham, the deputy director of the communicable diseases division in Singapore. “We will keep fighting, because isolation and quarantine work.”        “也许是因为我们的亚洲背景,但我们的社区已经为此做好了准备,”新加坡传染病部门的副主任拉莉塔·库鲁帕塔姆(Lalitha Kurupatham)说。“我们会继续战斗,因为隔离和检疫是有效果的。”
        Rich and orderly, Singapore has spent years building a public health system that includes designated clinics for epidemics and official messaging urging the public to wash their hands or sneeze into tissues during flu season. The Infectious Diseases Act gives the city-state wide latitude in prioritizing the common good over privacy concerns.        新加坡富裕而有序,多年来一直在建设其公共卫生系统,其中包括指定的流行病诊所,官方信息会敦促公众在流感季节洗手或打喷嚏时用纸巾。《传染病法》赋予城邦政府更多的权限,可以优先考虑公共利益而不是隐私问题。
        “During peacetime, we plan for epidemics like this,” Ms. Kurupatham said.        “在和平时期,我们就已经为应对这样的流行病做计划,”库鲁帕塔姆说。
        As the leader of Singapore’s contact tracing program, she has been working 16-hour days for two months, and her depiction of a war against disease is a function of its vulnerability to contagion. A tiny red dot on a world map, Singapore is a densely populated island where every flight is international.        作为新加坡接触者追踪项目的负责人,她已经连续两个月每天工作16个小时,她将此描述为一场与疾病的战争,是源于这里对传染病的易感性。新加坡是世界地图上的一个小红点,是一个人口稠密的岛屿,所有航班都是国际航班。
        In the early days of the outbreak, Singapore was highly susceptible to a large population of mainland Chinese people arriving during the Lunar New Year holiday.        在疫情暴发的最初几天,新加坡很容易受到春节期间前来的大量中国大陆人的冲击。
        The dozens of confirmed cases in Singapore in January reflect widespread and freely available testing. Many were mild cases that would otherwise have gone undiagnosed. Nevertheless Singapore was sprinting to stem the possibility of runaway local transmission.        今年1月在新加坡发现的数十例确诊病例显示了免费的检测得以广泛进行。许多都是轻症病例,本来可能不会被诊断出来。尽管如此,新加坡仍在努力预防本地传播的失控。
        “Until Italy, Korea and Iran happened, Singapore was the worst outside China,” said Linfa Wang, the director of the emerging infectious diseases program at the Duke-National University of Singapore Medical School. “Why didn’t we feel that way? Because the government is very transparent and because that number means we are so effective in tracing and isolating every case.”        “在意大利、韩国和伊朗之前,新加坡曾是中国以外情况最糟的国家,”新加坡杜克-国立大学医学院(Duke-National University of Singapore Medical School)新兴传染病项目主任王林发说。“为什么我们没有那种感觉呢?因为政府是非常透明的,因为这个数字意味着我们在追踪和隔离每个病例方面非常有效率。”
        For all the panic erupting elsewhere, most Singaporeans do not wear masks out, because the government has told them it’s not needed for their safety. Most schools are still running, albeit with staggered lunchtimes to avoid big crowds. There is plenty of toilet paper.        尽管其他地方也暴发了恐慌,但大多数新加坡人都不戴口罩,因为政府告诉他们,无需为了安全而戴口罩。大多数学校仍在上课,不过为了避免聚集,午餐时间错开了。卫生纸供应充足。
        As of Tuesday evening, Singapore had 266 confirmed cases. Only a fraction are mysteries, unlinked to recent foreign travel or previously identified local clusters, which include churches and a private dinner.        截至周二晚间,新加坡有266例确诊病例。只有一小部分显得很神秘,与近期国外旅行或之前确定的教堂和一次私人晚宴等当地聚会无关。
        Nearly 115 patients have been discharged from the hospital. Singapore has recorded no deaths from the coronavirus.        近115名患者已经出院。新加坡没有死于冠状病毒的记录。
        When rumors of a mysterious respiratory virus began circulating in China at the beginning of the year, Singapore moved quickly. It was one of the first countries to ban all travelers from mainland China, starting in late January. Thermal scanners measured the temperatures of all who came into the country.        今年年初,当有关神秘的呼吸道病毒的传闻开始在中国传播时,新加坡迅速采取了行动。从1月底开始,该国是第一批禁止所有大陆游客入境的国家之一。机场对所有入境人员使用热扫描仪测量体温。
        In a nation of 5.7 million residents, Singapore rapidly developed the capacity to test more than 2,000 people a day for the coronavirus. In Washington State, one of the hardest hit places in the United States, public labs are aiming to process 400 samples a day.        拥有570万人口的新加坡迅速发展了每天对2000多人进行冠状病毒检测的能力。在美国受灾最严重的地区之一华盛顿州,公共实验室计划每天处理400个样本。
        Testing is free in Singapore, as is medical treatment for all locals. Singapore has 140 contact tracers outlining each patient’s case history, along with the police and security services doing the shoe-leather work.        在新加坡,检测是免费的,所有本国人的医疗也是免费的。新加坡有140个接触追踪者,负责列出所有病人的病例史,警察和安全部门也做些跑腿工作。
        After weeks of investigation and the use of a new antibody test that can detect people who have recovered, health officials were able to tie two church clusters of 33 people to a Lunar New Year dinner attended by members of both congregations. The people who transmitted the disease between the two churches had never shown serious symptoms.        经过数周的调查,以及启用一种可以检测出康复者的新抗体测试,卫生官员成功地将两个拥有33人的教会团体同一场春节晚宴联系起来,两个团体都有人参加那次晚宴。在两个教会之间传播这种疾病的人始终没有表现出严重的症状。
        Close contacts of patients are put into mandatory quarantine to stop further contagion. Nearly 5,000 have been isolated. Those who dodge quarantine orders can face criminal charges.        与患者有密切接触的人会被实施强制隔离,以防止进一步的传染。近5000人被隔离。逃避隔离命令的人可能面临刑事指控。
        All pneumonia patients in Singapore are tested for coronavirus. So are people who are seriously ill. Positive cases have been identified at the airport, at government clinics and, most frequently, through contact tracing.        新加坡所有的肺炎病人均进行了冠状病毒检测。重症患者也是如此。在机场、政府诊所以及通过对接触的追踪均发现了阳性病例,其中大部分是追踪找到的。
        Singapore’s epidemic regimen was shaped by the 2003 SARS outbreak, when 33 people died out of 238 confirmed cases. As in Hong Kong, medical workers were among the casualties in Singapore.
        “The most important thing is that Hong Kong people have deep memories of the SARS outbreak,” said Kwok Ka-ki, a lawmaker in Hong Kong who is also a doctor. “Every citizen did their part, including wearing masks and washing their hands and taking necessary precautions, such as avoiding crowded places and gatherings.”        “香港人对SARS暴发有着深刻的记忆,这是最重要的,”身为香港议员同时也是医生的郭家麒(Kwok Ka-ki)说。“每个公民都尽其所能,包括戴口罩、洗手并采取必要的预防措施,例如避免拥挤的地方和聚会。
        The Hong Kong government eventually caught up to the public’s caution. Borders were tightened. Civil servants were ordered to work from home, prompting more companies to follow suit. Schools were closed in January, until at least the end of April.        香港政府最终听从了公众的警告。加强边界管制。公务员被命令在家工作,促使更多公司效仿。学校在1月关闭,至少要关到4月底。
        Taiwan acted even faster. Like Hong Kong and Singapore, Taiwan was linked by direct flights to Wuhan, the Chinese city where the virus is believed to have originated. Taiwan’s national health command center, which was set up after SARS killed 37 people, began ordering screenings of passengers from Wuhan in late December even before Beijing admitted that the coronavirus was spreading between humans.        台湾的行动更快。像香港和新加坡一样,台湾与武汉之间有直飞航班相连,而武汉被认为是该病毒的起源地。台湾国家卫生指挥中心是在SARS造成37人死亡后成立的,在北京承认冠状病毒在人与人之间传播之前,该中心在12月下旬已经开始命令排查来自武汉的乘客。
        “Having learned our lesson before from SARS, as soon as the outbreak began, we adopted a whole-of-government approach,” said Joseph Wu, Taiwan’s foreign minister.        台湾外交部长吴钊燮说:“我们从SARS中吸取了教训,疫情一暴发,我们就采取了全政府参与的方针。”
        By the end of January, Taiwan had suspended flights from China, despite the World Health Organization’s advising against it. The government also embraced big data, integrating its national health insurance database with its immigration and customs information to trace potential cases, said Jason Wang, the director of the Center for Policy, Outcomes and Prevention at Stanford University. When coronavirus cases were discovered on the Diamond Princess cruise ship after a stop in Taiwan, text messages were sent to every mobile phone on the island, listing each restaurant, tourist site and destination that the ship’s passengers had visited during their shore leave.        到1月底,尽管世卫组织提出反对,台湾仍暂停了从中国出发的航班。斯坦福大学政策成果与预防中心主任王智弘(Jason Wang)说,政府还充分利用了大数据,将国家健康保险数据与移民和海关信息整合在一起,以追踪潜在病例。曾在台湾停靠的钻石公主号邮轮上发现冠状病毒病例时,台湾岛上的每部手机都收到了短信,其中列出了船上乘客在离岸期间曾去过的每一个餐馆、旅游景点和目的地。
        As of Tuesday, Taiwan had recorded 77 cases of the coronavirus, although critics worry that testing is not widespread enough. Students returned to school in late February.        截至周二,台湾记录了77例冠状病毒病例,然而批评者担心检测还不够广泛。2月下旬,学生返校。
        With new waves of the virus surging across the world, public health officials in the three locales are gearing up for a longer fight.        随着病毒在世界各地掀起浪潮,这三个地区的公共卫生官员正在加紧准备应对长期斗争。
        On Tuesday, the government of Hong Kong, where only 157 cases have been confirmed, announced a mandatory 14-day quarantine for all travelers from abroad beginning later this week.        在仅有157例病例的香港,政府周二宣布从本周晚些时候开始对所有来自国外的旅行者进行为期14天的强制性隔离。
        Taiwan will require self-quarantine for arrivals from 20 countries and three American states.        台湾将要求来自20个国家和美国三个州的入境者必须进行自我隔离。
        Prime Minister Lee Hsien Loong of Singapore warned last week that the country’s caseload would increase sharply. Singapore announced 23 new coronavirus patients on Tuesday, the highest single-day tally, with 17 imported cases.        新加坡总理李显龙上周警告说,新加坡的病例数量将急剧增加。新加坡在周二宣布了23名新增冠状病毒患者,这是单日最高记录,其中17例为输入性病例。
        The city-state has restricted its borders further. Arrivals from Southeast Asia and parts of Europe must now undergo a 14-day self-quarantine.        这个城市国家对边界实施了进一步限制。来自东南亚和欧洲部分地区的入境者现在必须进行为期14天的自我隔离。
        “The world is only as good as the weakest link,” said Dr. Lee, the head of Singapore’s communicable diseases division. “Diseases do not respect borders.”

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