to introduce Dr. Georges Benjamin,

大衛 · 比爾羅（大）： 我很榮幸向大家介紹

who's the executive director of the American Public Health Association,

喬治 · 本傑明博士，

who has a long and distinguished career,

他是美國公共衛生協會的執行董事，

both as a medical professional and as a public health professional.

在醫療和公衛這兩個職業領域中

Please give a warm welcome to Dr. Georges Benjamin.

都有很長的經歷和卓越的職涯。

Georges Benjamin: Hey, David, how are you?

請歡迎喬治 · 本傑明博士。

DB: I am good, how are you, Dr. Benjamin?

喬治 · 本傑明（喬）： 嘿，大衛，你好嗎？

GB: I'm here. (Laughs)

大：我很好。本傑明博士你好嗎？

DB: Hanging in there. Good.

喬：我還在。（笑聲）

GB: Hanging in.

大：要撐住。很好。

DB: We know that the theme of the moment is reopening, I would say.

喬：在撐著。

We just heard one possibility for that,

大：我們知道目前的關注焦點 是重新開放，至少我會這麼說。

but obviously,

我們剛剛才聽到了可能會。

a lot of countries have already reopened in one form or another,

但很顯然，

and I believe, as of today,

很多國家已經以某種 形式開始開放了，

all 50 states here in the US have reopened in one form or another.

且我相信，目前為止，

How do we do that smartly, how do we do that safely?

美國這裡的五十州 都以某種形式開放了。

GB: Yeah, we really do need to reopen safely and carefully,

我們要如何以明智、 安全的方式做好重新開放？

and it means that we have not got to forget these public health measures

喬：我們確實需要以明智、 安全的方式來重新開放，

that really brought down the curve to begin with.

那就表示，首先我們不能忘記

And that means thing such as

把疫情曲線拉下來的那些公衛措施。

covering up your nose and mouth when you cough or sneeze,

那些措施包括像是

wearing a mask, washing your hands,

在咳嗽或打噴嚏時要遮住口鼻，

physically distancing yourself to the extent possible from others.

戴口罩、洗手、

Thinking about everything we do,

和他人盡可能保持實體距離。

you know, before we go to work in the morning,

想想看我們所做的一切，

while we're at work.

早上我們出門工作之前所做的，

And being as careful as many of us have been

在職場做的。

in the last two months,

而且我們要一直十分小心

as we go into the next three months,

跟過去兩個月很多人一樣，

because this thing is not over.

在接下來的三個月也要延續，

DB: Right.

因為這疫情尚未結束。

There is the chance of more waves, as Uri [Alon] mentioned.

大：是的。

It seems like it's kind of incumbent on all of us then

有可能像烏里（艾隆）提到的， 會有更多波疫情。

to take public health as kind of a second job.

看起來，我們所有人都有責任

Is that right?

要把公衛當作另一份工作。

GB: You know, I've been arguing a lot

對嗎？

that now that everybody really knows what public health is,

喬：我時常主張，

that everybody should always recognize that their second job is public health,

現在大家都真確知道公衛是什麼了，

whether you're picking up the garbage or working in a grocery store,

那麼大家也應該持續將公衛 視為他們的另一份工作，

or you are a bus driver,

不論你是收垃圾的人、 在雜貨店工作的人、

or you're, you know, like me, doing public health,

或者公車司機，

a physician or a nurse,

或者像我一樣， 從事公衛方面的工作，

everybody needs to put the public health mantle

比如醫生或護士，

into what they do each and every day.

大家都應該把公衛

DB: What do you think --

融入到他們的日常生活當中。

So we're all public health professionals now,

大：就你看來——

what do you think the new normal we might expect,

所以我們大家都是公衛專業人士，

as countries reopen?

就你看來，當國家重新開放，

What is that going to look like,

我們要預期什麼樣的新常態？

or what do you hope that looks like, as a public health professional?

那會是怎樣的情況？

GB: If I could wave a magic wand,

或者，身為公衛專業人士， 你希望是怎樣的情況？

I would clearly recognize

喬：如果我能揮一揮魔杖，

that people are going to be doing a lot more of the public health things,

我會清楚認知

in terms of handwashing

大家會做更多公衛的事，

and thinking about what they do around safety when they go out in public.

比如洗手

You know, it was not too long ago

和思考在公共場所時 要怎麼做才安全。

when you got in your car and you didn't put your seat belt on.

不久前，

Today we do it,

你進到車內， 還沒有繫上安全帶的習慣。

and we don't think anything about it.

現今大家都會繫，

Most of us don't smoke,

且完全不假思索。

because we know that that's bad for us.

我們大部分人不抽菸

Most of us look both ways before we cross a street.

是因為我們知道抽菸對我們不好。

Most of us, you know,

我們大部分人在過馬路時 會先看左右兩邊。

do things in our house, that are -- fix trip hazards.

我們大部分人

So as we go forward with this outbreak,

在我們的房子裡 會做防止摔倒的措施。

I'm hoping that people will pay a lot more attention

當我們在這疫情向前邁進時，

to things that can cause us to get an infection.

我希望大家會更加注意

So you know, cleaning things, disinfecting things.

可能會讓我們受到感染的事物。

More importantly, not coming to work if you're sick.

所以，東西要清洗、要消毒。

I'm hoping that employers will put in paid sick leave for everybody,

更重要的是，如果生病就不要去工作。

so people can stay home.

我希望僱主會提供所有人帶薪的病假，

Yeah, it's an additional cost,

大家才能夠待在家裡。

but I can tell you that we've now learned

是的，那是額外的成本，

that the cost of not doing something like that

但我可以告訴各位， 我們現在已經學到

is billions and billions and billions of dollars.

不這麼做的成本更高，

Paid sick leave is pretty cheap when you do that.

是數十億，數十億，數十億美金。

DB: Yeah, we are, I think, envious in the United States

相較之下有薪的病假就便宜多了。

of all the countries that perhaps have

大：我想，在美國，我們很羨慕

a more all-encompassing health care system than we do.

所有那些健康照護系統

Would you agree that masks are kind of the symbol

比我們更完整、全面的國家。

of adopting that "public health professional as a second job" mindset?

你是否認同，戴口罩就是象徵了

GB: Well, you know, it's funny.

「視公衛職業為另一份工作」的心態？

Our colleagues in Asia have had a mask --

喬：這很有趣。

wearing masks as a culture for many, many years.

我們在亞洲的同事有口罩——

And you know, we've always kind of chuckled at that.

戴口罩是種多年的文化。

When I went overseas,

我們一直竊笑這件事。

I would always kind of chuckle when I saw people wearing masks.

當我到海外，

And of course, when this first started,

當我看到有人戴口罩，我總會竊笑。

you know, we only promoted masks for people that were infected

當然，這次疫情剛開始時，

or of course, health care workers,

我們呼籲的是，需要 戴口罩的是被感染的人，

who we thought were in a higher-risk environment.

當然還有健康照護工作者，

But I think that wearing masks

因為我們認為他們 身處在高風險環境中。

is probably going to be part of our culture.

但我認為，戴口罩

We've already seen it probably will not be part of our beach culture,

很可能會變成我們文化的一部分。

although it probably should be for now.

我們已經看到，它可能無法 成為我們海灘文化的一部分，

But I do think that we're going to see more and more people wearing masks

雖然現在應該要這麼做。

in a variety of settings.

但我確實認為，我們會在各種地方

And I think that makes sense.

看到更多人戴口罩。

DB: Yeah, wear your mask to show that you care about others.

我認為這是合理的。

And that you have this, kind of, public health spirit.

大：是的，戴口罩表示你關心其他人，

So speaking of Asia,

且你具有公衛的精神。

who has done well?

說到亞洲，

Looking around the world, you've been doing this for a while

哪個國家做得很好？

and communicated with your peers,

你已經觀察全世界

who has done well

並和你的同儕交流好一陣子了，

and what can we learn from those good examples?

哪個國家做得好？

GB: Yeah, South Korea in many ways is the role model.

我們能從這些好典範身上學到什麼？

You know, China actually, at the end of the day,

喬：在許多層面上，南韓是個典範。

did reasonably well.

其實到頭來，中國也做得很好。

But the secret to all of those countries

但所有這些發病率和死亡率

that have had less morbidity and mortality than we have,

比我們低的國家，都有個秘密，

is they did lots of testing very early on,

就是他們很早就做很多的檢測，

they did contact tracing and isolation and quarantine,

它們做接觸者追蹤、隔離、檢疫，

which by the way, is the bedrock of public health practice.

順道一提，這些都是公衛實做的基礎。

They did it early, they did a lot of it,

它們很早就做，且做了很多；

and by the way, even though they're reopening their society,

順道一提，雖然它們正在重新開放，

and they're beginning to see episodic surges,

且開始出現突如其來的激增，

they then go back to those basic public health practices

接又會回到基本的公衛實做：

of testing, isolation, contact tracing

檢測、隔離、接觸者追蹤，

and transparency to the public when they can,

以及在可能的範圍內 盡可能做到對大眾公開資訊，

because it's important for the public to understand how many cases there are,

因為很重要的是要讓大眾知道

where the disease is,

有多少確診案例、在哪裡，

if you're going to get compliance from the public.

這樣才能得到大眾的配合。

DB: So testing, contact tracing and isolation.

大：所以，檢測、 接觸者追蹤，以及隔離，

That doesn't seem like rocket science, to use that old cliché.

那些老方法都不需要複雜的技術。

Why has that been hard for some countries to implement?

為什麼有些國家卻很難實施？

What's holding us back,

是什麼在扯我們的後腿？

is it electronic medical records,

是電子醫療記錄？

is it some fancy doodad,

是某種新奇的小玩意兒？

or is it just maybe overconfidence,

或者只是也許因為過去 一百年來在公衛上的成果

based on maybe the public health successes of the last 100 years?

造成我們過於自信了？

GB: You know, we are very much a pill society.

喬：要知道，我們 可說是個藥丸社會。

We think there's a pill for everything.

我們認為什麼都有藥丸可以治。

If we can't give you a pill for it,

遇到藥丸無法解決的，

then we can give you surgery and fix it.

就用手術來搞定。

You know, prevention works.

預防性工作，

And we have totally underinvested in prevention.

我們在預防性工作上 所做的投資完全不足。

We've totally underinvested in a strong, robust

我們根本沒做足夠的投資，

public health system.

去建個強大、穩固的公衛系統。

If you look at the fact that in the America today,

看看現今在美國社會的真實情況，

you can very easily know

你非常容易就能知道

what's coming off the shelf of a grocery store,

雜貨店有什麼現貨，

Amazon knows everything there is to know about you,

亞馬遜知道你的各種資訊，

but your doctor does not have the same tools.

但你的醫生卻沒有同樣的工具。

At three o'clock in the morning,

凌晨三點時

it's still very difficult to get a hold of your electrocardiogram,

仍舊很難取得你的心電圖、

or your medical record, or your list of allergies

醫療記錄，或過敏清單，

if you can't tell the practitioner what you have.

若無法告訴醫生你有什麼，就會如此。

And we just haven't invested in robust systems.

我們沒投資建造穩固的系統。

One of the interesting things about this outbreak

關於這次疫情，很有趣的一點是

is that it has created an environment

它創造出了一種環境，

in which we're now dependent on telemedicine,

現在這環境得要仰賴視訊醫療，

which has been around for several years,

視訊醫療已經存在許多年了，

but we weren't quite into it.

但我們過去不怎麼用。

But now, it's probably going to be the new standard.

但現在它可能會變成新的標準。

DB: But it also seems --

大：但，還似乎——

So, obviously,

很顯然，

those countries with an incredibly robust health care system,

健康照護系統超級穩固的那些國家，

like Taiwan, have done well,

比如台灣就做得很好，

but it seems like even countries that perhaps would be considered

但，似乎就連健康照護系統 被認為沒那麼穩固的國家，

to have a less robust health care system, like a Ghana in Africa,

比如非洲的迦納，

have actually done well.

防疫也做得很好。

What has been the, I guess, the secret sauce

那些國家的秘方是什麼？

for those kinds of countries?

喬：它們的接觸狀況還在很初期，

GB: Yeah, it's still pretty early in some of their exposures,

希望他們之後不會有一波疫情，

and hopefully, they might not have a wave that comes later,

仍然有可能。

that's still a possibility,

但到頭來，

but at the end of the day,

就執行好、做完善公衛實做來說，

I think, to the extent you have done good, sound public health practices,

所有疫情控制很好的國家

all of the countries that have done well

都做到了。

have implemented that.

我們是個大國，是很複雜的國家。

Now we're a big country, we're a complex country.

是的，一開始我們沒做好檢測。

And yes, we didn't get the testing right to begin with.

但我們不應該再重犯 我們過去三個月犯過的錯誤，

But we should not repeat the mistakes that we had over the last three months,

因為我們還要再熬幾個月。

because we've still got several months to go.

現在我們已經知道做錯了，

And now that we know what we did wrong,

我想鼓勵大家，下次要做對。

I'm encouraging us to do it right the next time.

大：那很明智。

DB: That seems smart.

喬：下次就是明天。

GB: And the next time is tomorrow.

大：沒錯。

DB: That's right.

已經開始了。

It's already started.

在我看來，

I mean, it almost seems to me,

讓我這樣比喻，

if I can use this metaphor,

一些國家的系統已經有了抗體，

that some of these countries

因為它們經歷過像是 伊波拉或第一波的 SARS。

already had the, kind of, antibodies in their system,

過去接觸過這類公衛危機，

because they had experience with maybe Ebola or the first SARS.

是否是個關鍵因子？

Is that the key, previous exposure

喬：這次的病毒很不一樣。

to these kind of public health crises?

雖然有些早期的證據顯示

GB: Well, this is a very different virus.

對 MERS 和 SARS 冠狀病毒，

And while there may be some early evidence

我們或有一些早期的防護，

that MERS and SARS one,

有些早先的研究探討這些，

we may have some early protection from that,

那並不是解決方案。

there's some early, early studies looking at that,

這裡的關鍵秘方在於 優良、實在的公衛實做，

that's not the solution.

那才是關鍵秘方所在。

The secret sauce here is good, solid public health practice.

我們不該想去尋找什麼很玄的東西，

That's the secret sauce here.

或期待有種特別藥丸能拯救我們。

We should not be looking for anything, any mysticism,

重點在於實實在在地實做公衛，

or anyone to come save us with a special pill.

因為，順道一提，

This is all about good, solid public health practice,

這次是個險峻的大流行，

because, by the way, look,

但它不會是最後一次大流行。

this one was a bad one,

我們得要為下次大流行做好準備。

but it's not the last one.

我們認為這次很慘，

And so we need to prepare for the next really big one.

想像如果換成是 伊波拉能透過空氣傳染，

We think this one was bad,

或 MERS 能透過空氣傳染。

imagine what would have happened had Ebola been aerosolized,

看看電視上的電影就知道了。

or MERS had been aerosolized.

雖然這次的狀況很慘，

You know, pick a TV movie.

我們這次仍然是躲過了 非常糟糕的慘狀。

Even though this was a bad one,

大：是的，MERS 可不是開玩笑的，

we still dodged a really, really bad one this time.

謝天謝地它沒有像 SARS 冠狀病毒

DB: Yeah, Middle East Respiratory Syndrome is no joke,

那麼容易傳染。

and we should be thankful that it doesn't spread more easily,

不過，這是——

like SARS-CoV.

這些疾病都是人畜共患病，

Is this, though --

它們從動物身上跳到我們身上， 而那些動物外頭有的是。

So all these diseases are zoonotic,

很顯然，人類正在以一種

that means they jumped to us from the animals that are out there.

前所未有的急迫方式侵佔大自然，

Obviously, humanity is kind of encroaching on nature

不論是氣候變遷或侵入森林。

in an ever more, kind of, urgent way,

這是否只是個新常態，

whether that's climate change or going into the forests, what have you.

我們應該預期 將來常會有疾病大流行嗎？

Is this just the new normal,

喬：的確定期會出現大流行，

like, we should expect pandemics every so often?

所以這次並非第一次大流行。

GB: Well, they do come periodically,

我們遇過好幾次，

so this is not, you know, the first pandemic, right?

一百年前，1918 年的流感，

We've had several,

SARS 是很嚴重的感染，

100 years ago, the 1918 influenza,

雖然 SARS 冠狀病毒沒有到這麼慘。

SARS was a significant infection,

我們也有過禽流感，

even though it didn't get this bad, SARS one.

那是個困難的挑戰，

And we had the avian flu,

還有豬流感。

which was a challenge,

我們過過茲卡病毒。

and the swine flu.

我們已經經歷過數次新疾病大流行。

We had Zika.

這些新出現的疾病常常發生，