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  • David Biello: It's now my great honor and privilege

    譯者: Crystal Tsang 審譯者: Helen Chang

  • 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,

  • So no, we've had several new disease outbreaks.

    在許多層面上,

  • These emerging diseases happen a lot,

    我們一直很幸運,

  • and in many ways,

    因為我們能及早辨識它們,

  • we've been fortunate

    將它們控制住。

  • that we have been able to identify them early

    但現在我們身處新環境,

  • and contain them.

    在這環境裡,人可以造出這些病毒。

  • But we're now in an environment

    這次不是,

  • where people can, by the way, make some of these things up.

    我們目前的最佳判斷是 這次病毒並非人造的。

  • Now, this one did not happen, as best we can tell, it's not man-made.

    病毒並不像是從實驗室流出來的。

  • It did not probably come out of a leak in the lab.

    但在我讀書時,我們就已知道,

  • But we know that, when I was in school,

    培養病菌/病毒非常地複雜。

  • to grow a bug, you had to be pretty sophisticated.

    現今的狀況並非如此。

  • That's not the case today.

    我們必須要保護我們自己, 對抗天然產生的感染,