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  • so I appreciate that.

    所以我很感激。

  • Let me move forward to my second point, and, uh, I was really honored yesterday to have an incredible guest on the show and this guest.

    讓我繼續說說我的第二點,呃,昨天我真的很榮幸能在節目中請到一位不可思議的嘉賓,這位嘉賓。

  • His name is Professor David Miles.

    他的名字是大衛-邁爾斯教授。

  • He is a professor at Imperial College, London.

    他是倫敦帝國學院的教授。

  • He's a former member of Bank of England's Monetary Policy Committee right now.

    他現在是英格蘭銀行貨幣政策委員會的前成員。

  • Look, I spent 20 years in finance.

    聽著,我在金融界呆了20年。

  • Monetary policy is how governments choose short term interest rates, and it basically controls the economy.

    貨幣政策是政府選擇短期利率的方式,它基本控制了經濟。

  • It's one of the most powerful positions in government.

    這是政府中最有權力的職位之一。

  • Some would argue in America.

    有人會認為,在美國。

  • It's the decision that Fed makes its more powerful than what the president can decide.

    這是美聯儲做出的決定其比總統能決定的更有力。

  • So this man is high ranking.

    所以這個人的地位很高。

  • He's also former chief economist for Morgan Stanley and Merrill Lynch Alright, former member of the Financial Services Authority, which polices all the bankers here.

    他也是摩根士丹利和美林的前首席經濟學家 好吧,金融服務管理局的前成員,該局負責監管這裡所有的銀行家。

  • And I sat down with Professor David Miles yesterday and we had a discussion, and the professor said this quote, uh, the three month locked down earlier this year came at an extremely high price relative to the health benefits, and he went on to say that in another extremely costly locked down, um, he believes that the benefits may not exceed the costs we want went on further and we concluded that we cannot survive past 30 days and he briefly said this and I'm gonna play a video of him shortly if this lock down last for any longer than 30 days and honestly, I think he was being generous a 30 days.

    而我昨天和大衛-邁爾斯教授坐在一起,我們進行了討論,教授說,這句話,呃,今年早些時候的三個月鎖定,相對於醫療福利來說,價格極高,他接著說,在另一個代價極高的鎖定,嗯。他認為利益可能不會超過我們想要的成本,我們進一步得出結論,我們不能生存過去30天,他簡短地說了這一點,我會很快播放他的視頻,如果這種鎖定持續超過30天,說實話,我認為他是慷慨的30天。

  • I think he really wanted to Same or like two weeks, he said.

    我想他真的想相同或像兩個星期,他說。

  • Literally.

    從字面上看

  • We won't survive and he's not talking about surviving the disease.

    我們活不下去了,他也不是說要活下來。

  • He's talking about surviving as as a people.

    他說的是作為一個民族的生存。

  • We will no longer have the money to even pay for basic services.

    我們連基本服務的錢都沒有了。

  • We will no longer have the funds to keep this country going.

    我們將不再有資金來維持這個國家的運轉。

  • We won't be even to pay for our health services.

    我們甚至不會為我們的醫療服務買單。

  • This is how dire these decisions are being made and that's why I want to go in deeper on this.

    這就是這些決定的可怕之處,這也是我想深入瞭解的原因。

  • But he also made a really interesting point and he talked about something called quality and this is something that's not being talked about and we need to talk about it right now.

    但他也提出了一個非常有趣的觀點,他談到了一種叫做品質的東西,這是一個沒有被談論的東西,我們現在需要談論它。

  • It's called the quality adjusted life year quality and this is the measure that the NHS actually uses to evaluate whether a procedure needs to take place on a patient in the National Health Service, and this is how it works.

    它叫做品質調整生命年品質,這是NHS實際上用來評估是否需要在國家醫療服務中對病人進行手術的措施,這是如何工作的。

  • They look at a patient, and they look at a procedure.

    他們看的是病人,看的是手術。

  • If the procedure can increase the patient's lifespan by one year, then they agreed to do that procedure on Lee.

    如果這個手術能讓患者的壽命增加一年,那麼他們就同意給李先生做這個手術。

  • If it costs £30,000 or less, let me repeat that.

    如果花費3萬英鎊或更少,讓我再重複一遍。

  • Say, there's a cancer surgery that they're about to do or a cancer treatment.

    比如說,他們要做一個癌症手術,或者癌症治療。

  • If it costs more than £30,000 and it doesn't extend their life by more than one year, they say, No, we're not going to do the procedure now.

    如果花費超過3萬英鎊,而且不能延長他們一年以上的壽命,他們就會說,不,我們現在不做這個手術。

  • You might say, Well, that's really callous.

    你可能會說,嗯,那真是太無情了。

  • They should do anything to save their life.

    他們應該做任何事情來挽救自己的生命。

  • But what if that procedure costs £3 million or £300 million or £3 billion?

    但如果這個程序需要300萬英鎊或3億英鎊或30億英鎊呢?

  • At some point?

    在某些時候?

  • It's not cost effective to have that procedure for everyone.

    為每個人做這種手術是不划算的。

  • And the professor went on to say, Brian, our our health budget would be 98% of GDP if we spent every dollar to save every life.

    教授接著說,布萊恩,我們的衛生預算將佔GDP的98%,如果我們花每一塊錢去拯救每一個生命。

  • So at some point we have to make a decision on these decisions were made every every day in our lives, the speed limit is that I think 70 MPH in Britain because that's the optimal limit to make sure transportation moves and we minimize the loss of life.

    是以,在某些時候,我們必須做出決定這些決定是在我們生活中的每一天,速度限制是,我認為70英里/小時在英國,因為這是最佳的限制,以確保運輸移動,我們最大限度地減少生命損失。

  • If we wanted to eliminate the loss of life, we would make the speed limit five miles an hour, so we would all go so slow there would be no traffic accidents.

    如果我們想消除生命的損失,我們就會把時速限制為五英里,這樣我們都會走得很慢,就不會發生交通事故。

  • So every day we make decisions that are somewhere in between optimizing for loss of life and the economic benefits.

    所以,每天我們做出的決策,都是介於生命損失和經濟效益的優化之間。

  • And he went deeper on this quality adjusted life here.

    而他在這裡對這個品質調整的生活進行了更深入的探討。

  • And he said that if you save someone from Cove in there, usually in their eighties, he said, on on a maximum scale, they had 10 years of expected life left.

    他說,如果你把一個人從庫夫那裡救出來,通常是80多歲,他說,在最大的規模上,他們還有10年的預期壽命。

  • It's probably more like five, he said.

    他說,可能更像是五個。

  • If you multiply that times 30,000 when you save a life, ITT's if you want to quantify it, it's £300,000 to save that life.

    如果你救人的時候乘以3萬,ITT的如果你想量化的話,救人的費用是30萬英鎊。

  • And, uh, Professor Miles went in and said, If you look at that £300,000 figure and you multiply it by the potential 1000 people that are gonna die per day, according to some of these models or even two or 3000.

    而且,呃,邁爾斯教授走了進來,說, 如果你看看那30萬英鎊的數字 你乘以潛在的1000人 這是要去死的每一天, 根據這些模型的一些 甚至兩個或3000。

  • When you compare that to the £1.8 billion of loss to the economy every single day, you start to really see a clear cost benefit analysis, and you start to really understand that eliminating the virus.

    當你把它與每天18億英鎊的經濟損失相比較時,你開始真正看到一個清晰的成本效益分析,你開始真正明白,消除病毒。

  • If you try to do that, we will not survive because we cannot afford to look at it that way again.

    如果你想這麼做,我們就活不下去了,因為我們不能再這麼看了。

  • We need to think about control versus elimination on.

    我們需要思考控制與淘汰上。

  • We need to find a way toe live with this virus.

    我們需要找到一種方法來與這種病毒共存。

  • There is no way to eliminate it.

    沒有辦法消除它。

  • But right now our government has sold you an agenda that this is the way to eliminate this virus and we are literally crushing our economy.

    但現在我們的政府已經向你推銷了一個議程,這是消除這種病毒的方法,我們實際上是在粉碎我們的經濟。

  • Our future are lively hoods on the back of trying to save a small portion of lives that, when you quantify it, does not justify the loss from this lock down.

    我們的未來都是活潑的油煙機,在努力挽救一小部分生命的背後,當你把它量化後,並不能證明這種鎖定的損失。

  • I can't put it any clearly and again.

    我說不清楚,又說不清楚。

  • Every loss of life needs to be minimized.

    每一個生命的損失都需要被降到最低。

  • But this is a disproportionate response to the virus, and it couldn't be made any clear than by this quality score.

    但這是對病毒的一種不相稱的反應,通過這個品質分數再清楚不過了。

  • And here's a short video of me talking to Professor Miles about this concept and again he is very clear on the cost benefit analysis on this is the conversation no one's having.

    這是一個簡短的視頻,我和邁爾斯教授談論這個概念,他再次非常清楚地對這個成本效益分析是沒有人的對話。

  • We need to talk about it because it's a really reason why we shouldn't be locked down right now.

    我們需要談論它,因為這是一個真正的理由,為什麼我們現在不應該被鎖定。

  • Here is Professor Miles.

    這是邁爾斯教授。

  • If I was maybe just to generalize some of the assumptions you made about that model, I think you said if you save a life roughly 10 years of life, you might save for that person times the 30,000.

    如果我也許只是籠統地說說你對那個模型的一些假設,我想你說如果你救了一個人大概10年的生命,你可能為這個人救了3萬倍。

  • I guess that's £300,000 you would potentially save with each life.

    我想這是30萬英鎊,你會潛在地節省每一個生命。

  • Is that a rough idea?

    這是一個粗略的想法嗎?

  • Um, yes, in a way.

    嗯,是的,在某種程度上。

  • In a way, that's right.

    從某種程度上說,這是對的。

  • So, I mean, if you looked at the average age off people who tragically have died with co vid, it's somewhere in the sort of low eighties.

    所以,我的意思是,如果你看了平均年齡 關閉的人誰不幸已經死了co vid, 它的地方在排序低80多歲。

  • Um, if you asked what was the life expectancy off people off that typical age, the best.

    嗯,如果你問什麼是預期壽命 關閉的人關閉的典型年齡,最好的。

  • Probably.

    也許吧

  • It was about 10 years, probably actually a little bit less, given that most of the people who died at that age with Cove it had related health problems.

    大概是10年,其實可能更短一點,因為那個年齡段死於科沃它的人大部分都有相關的健康問題。

  • And so if you then said, Well, okay, suppose you apply that national health service rule.

    所以,如果你接著說,好吧,假設你適用那個國家衛生服務規則。

  • How many resources using the NHS rule.

    多少資源使用NHS規則。

  • Would you want to apply to saving on average, those kind of lives?

    你想申請平均節省,那些生命嗎?

  • And the answer would be, as you say, you know, three or £400,000.

    答案是,如你所說,你知道,三四十萬英鎊。

  • Now I stress again, this looks like a very macabre thing to do.

    現在我再次強調,這看起來是一件非常可怕的事情。

  • It looks like the kind of thing a kind of heartless economists would do.

    這看起來像是一種無情的經濟學家會做的事情。

  • Attaching money, values, alights, saved.

    附上錢,值,阿萊克斯,存。

  • But the reality is that that's how decisions are made in public health systems in pretty much every country in the world and in other areas where governments have to make rules.

    但現實情況是,世界上幾乎所有國家的公共衛生系統都是這樣決策的,在其他政府必須制定規則的領域也是如此。

  • How fast can people drive on our roads, for example?

    比如說,在我們的道路上,人們可以開多快?

  • So it was simply applying that kind of rule, and I think had that analysis said, well, it was a close run thing, whether the lock down for three months was sensible or not, I think it would be much more open minded about it.

    所以,它只是簡單地運用了這樣的規則,我想如果這樣分析說,好吧,這是一個近距離跑的事情,無論鎖定三個月是否合理,我想它都會更開放地對待它。

  • But I think as it turned out, the numbers suggested that the costs were so much higher down the £30,000 per quality rule would have justified that.

    但我認為,結果,數字表明,成本是如此之高下來,每個品質規則3萬英鎊將證明這一點。

  • It seemed to me you'd have to go way beyond that National health service rule to have justified restrictions, blanket restrictions kept in place for as long as we did back in the spring, into the summer here in the UK Yeah, I think you're right.

    在我看來,你必須走得更遠 超越了國家衛生服務規則 有正當的限制, 籠統的限制保持在地方 因為我們做了這麼久 早在春天,到夏天 在英國這裡 是的,我想你是對的。

  • Because I think the maximum death was back in April.

    因為我想最大的死亡是在4月份的時候。

  • I think it was 1200 or 1242 and one day.

    我想應該是1200或1242和一天。

  • So if you took that number of 300,000, which is probably being generous for 10 years of life and you do the math compared to the GDP loss per day, which I heard now is about 1.8 billion in GDP loss per day on lock down, maybe I'm off, but it looks to be orders of magnitude cost benefit analysis.

    所以,如果你把這個30萬的數字,可能對10年的生命來說是很慷慨的,你算算和每天的GDP損失相比,我現在聽說每天鎖定的GDP損失大約是18億,也許我說的不對,但看起來是數量級的成本效益分析。

  • And I know this is kind of a macabre topic, but like you said, we make these decisions every day in our policy.

    我知道這是個可怕的話題,但就像你說的,我們每天都會在政策中做出這些決定。

  • And like you said, the speed limits the NHS.

    就像你說的,限速的NHS。

  • So it's something we have to face at some point, like you said in an extended locked down and say this actually just doesn't make sense.

    所以這是我們在某些時候必須要面對的問題,就像你說的在擴大鎖定,說這個其實就是沒有意義的。

  • And if we continue, this will quite literally just bankrupt the nation.

    如果我們繼續下去,這將相當字面上只是破產的國家。

  • Well, I think I think you know, continuing toe have blanket lockdowns switched on for a few months, then maybe off from Sorsogon scripts them back on, um is so costly that my guess is that that would not pass any sensible cost benefit analysis again to stress, you know, that's not the current government strategy.

    我想我認為,你知道,繼續有全面的鎖定開關幾個月,然後也許從Sorsogon腳本他們回來,嗯是如此昂貴,我的猜測是,這不會通過任何明智的成本效益分析再次強調,你知道,這不是目前的政府戰略。

  • You know, we're told that this is going to be a four week locked down.

    你知道,我們被告知,這將是一個四星期的鎖定。

  • Hopefully will succeed in bringing the infection rates down very rapidly.

    希望能成功地將感染率迅速降低。

  • Take off the table.

    從桌子上拿下來。

  • Much of the risk of hospitals being I'm overwhelmed on that.

    醫院的很多風險是我在這上面不知所措。

  • That might well be a sensible strategy, I think what wouldn't be, though, is if we kept getting back into this situation.

    這或許是一個明智的策略,不過我想,如果我們一直陷入這種境地,那就不是了。

  • You know, two months on, one month off, two months on, one month off, I think that would be pretty disastrous.

    你知道,兩個月的時間,一個月的時間,兩個月的時間,一個月的時間,我想這將是非常災難性的。

so I appreciate that.

所以我很感激。

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A2 初級 中文 生命 教授 鎖定 手術 損失 邁爾斯

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    林宜悉 發佈於 2020 年 11 月 16 日
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