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  • When I was a kid, the disaster we worried about most was a nuclear war.

    在我小時候,最讓我們感到擔憂的是一場核戰災難。

  • That's why we had a barrel like this down in our basement, filled with cans of food, and water.

    那就是我們在地下室放個像這樣的桶子的原因,裝滿罐頭食物及水。

  • When the nuclear attack came, we were supposed to go downstairs, hunker down, and eat out of that barrel.

    如果發生核子攻擊,我們就要躲到地下室,蹲下,吃桶裡的食物。

  • Today the greatest risk of global catastrophe doesn't look like this.

    但是今天全球最大的災難風險不是這個。

  • Instead, it looks like this.

    而是看似像這樣的東西。

  • If anything kills over 10 million people in the next few decades, it's most likely to be a highly infectious virus rather than a war.

    如果在未來數十年有任何東西能殺死一千多萬人,那極可能是具高度傳染性的病毒,而非一場戰爭。

  • Not missiles, but microbes.

    不是各樣的飛彈,而是微生物。

  • Now, part of the reason for this is that we've invested a huge amount in nuclear deterrence.

    那麼,造成這種情況的部分原因是,我們投進了大把鈔票在核威懾上。

  • But we've actually invested very little in a system to stop an epidemic.

    卻極少投資在防止流行病的系統上。

  • We're not ready for the next epidemic.

    我們還沒準備好對抗下一場流行病。

  • Let's look at Ebola.

    來看一下伊波拉。

  • I'm sure all of you read about it in the newspaper, lots of tough challenges.

    我敢肯定你們都在報上讀過相關消息,很多艱難的挑戰。

  • I followed it carefully through the case analysis tools we use to track polio eradication.

    我透過我們追蹤根除小兒麻痺症的個案分析工具,仔細追蹤伊波拉的情況。

  • And as you look at what went on, the problem wasn't that there was a system that didn't work well enough, the problem was that we didn't have a system at all.

    你看看當時的情況,問題不在系統沒有發揮足夠的作用,問題在於我們根本就沒有系統。

  • In fact, there's some pretty obvious key missing pieces.

    事實上,是有一些相當明顯的重大缺失。

  • We didn't have a group of epidemiologists ready to go, who would have gone, seen what the disease was, see how far it had spread.

    我們沒有一組流行病學家待命,他們本該到發病當地,察看這種疾病,察看這種疾病蔓延的情況。

  • The case reports came in on paper.

    個案報告以書寫形式發表。

  • It was very delayed before they were put online and they were extremely inaccurate.

    但是耽擱許久後才放上網路,而且內容還極不正確。

  • We didn't have a medical team ready to go.

    我們沒有醫療團隊待命。

  • We didn't have a way of preparing people.

    我們沒有替隊員預備部署的方法。

  • Now, Médecins Sans Frontières did a great job orchestrating volunteers.

    現在無國界醫生在動員志工上表現極好。

  • But even so, we were far slower than we should have been getting the thousands of workers into these countries.

    但是即便如此,我們仍然慢太多了,我們本來應該能動員數千名人員進入這些國家的。

  • And a large epidemic would require us to have hundreds of, thousands of workers.

    而一場大型的流行病需要我們數千名人員待命。

  • There was no one there to look at treatment approaches.

    沒有人在那裡研究治療方法。

  • No one to look at the diagnostics.

    沒有人研究診斷學。

  • No one to figure out what tools should be used.

    沒有人去搞清楚到底要用什麼工具。

  • As an example, we could have taken the blood of survivors, processed it, and put that plasma back in people to protect them.

    舉個例,我們本來可以取倖存者的血液,處理一下,把那個血漿打回人類身上來保護他們。

  • But that was never tried.

    但是那個方法從沒有人試過。

  • So there was a lot that was missing.

    所以還有很多的事情沒有處理。

  • And these things are really a global failure.

    而這些事真的是全球層面的失敗。

  • The W.H.O. is funded to monitor epidemics, but not to do these things I talked about.

    世界衛生組織是受資助去監控流行病,但是沒有做到我剛剛談及的那幾件事。

  • Now, in the movies, it's quite different.

    但是電影可不是這麼演的。

  • There's a group of handsome epidemiologists ready to go, they move in, they save the day, but that's just pure Hollywood.

    有一群好帥的流行病學家隨時待命,他們進入災區,轉危為安, 但那只是好萊塢罷了。

  • The failure to prepare could allow the next epidemic to be dramatically more devastating than Ebola.

    無法未雨綢繆可能會讓下一場疫情比伊波拉更具破壞力。

  • Let's look at the progression of Ebola over this year.

    來看一下今年伊波拉的進展。

  • About 10,000 people died, and nearly all were in the three West African countries.

    大約一萬人死亡,而且死亡人口幾乎集中在這三個西非國家。

  • There's three reasons why it didn't spread more.

    有三個原因讓它沒有蔓延到更遠的地方。

  • The first is that there was a lot of heroic work by the health workers.

    第一是衛生人員做了很多英勇事蹟。

  • They found the people and they prevented more infections.

    他們找出患病的人,而且防止更多感染。

  • The second is the nature of the virus.

    第二是這個病毒的天性。

  • Ebola does not spread through the air.

    伊波拉不會透過空氣傳播。

  • And by the time you're contagious, most people are so sick that they're bedridden.

    當你被傳染時,大部分患者都已嚴重到臥病在床。

  • Third, it didn't get into many urban areas.

    第三,它沒有傳到許多城市地區。

  • And that was just luck.

    這僅是運氣好。

  • If it had gotten into a lot more urban areas, the case numbers would have been much larger.

    如果它傳到更多城市地區,病例數可能會大幅提高。

  • So next time, we might not be so lucky.

    所以下次, 我們可能就沒這麼幸運了。

  • You can have a virus where people feel well enough while they're infectious that they get on a plane or they go to a market.

    你可能帶有一種病毒, 而其他人的身體沒有出現毛病,病毒卻具感染性的,他們還可以登機或去市場。

  • The source of the virus could be a natural epidemic like Ebola, or it could be bioterrorism.

    病毒的來源可能是天然疫源如伊波拉,也可能是生化恐怖主義。

  • So there are things that would literally make things a thousand times worse.

    所以的確有東西會讓情況糟一千倍。

  • In fact, let's look at a model of a virus spread through the air, like the Spanish Flu back in 1918.

    事實上,讓我們來看一下經空氣傳播的病毒傳染模式,就像 1918 年發生的西班牙型流感。

  • So here's what would happen: It would spread throughout the world very, very quickly.

    所以情況可能是這樣:它可能極快速地傳遍世界。

  • And you can see there's over 30 million people died from that epidemic.

    你們可以看到超過三千萬人死於那次疫情。

  • So this is a serious problem.

    所以這是很嚴重的問題。

  • We should be concerned.

    我們應當掛慮。

  • But in fact, we can build a really good response system.

    但事實上,我們可以建立良好的應變系統。

  • We have the benefits of all the science and technology that we talk about here.

    我們有這裡談到的科學與技術優勢。

  • We've got cell phones to get information from the public and get information out to them.

    我們有手機,可以從民眾得到資訊,也可以傳播資訊給民眾。

  • We have satellite maps where we can see where people are and where they're moving.

    我們有衛星圖能看到民眾聚集在哪裡又移動到哪裡。

  • We have advances in biology that should dramatically change the turnaround time to look at a pathogen and be able to make drugs and vaccines that fit for that pathogen.

    我們的生物學蓬勃發展,應能大幅提升從尋找病原體到製造治療藥物及疫苗所需的處理時間。

  • So we can have tools, but those tools need to be put into an overall global health system.

    所以我們有工具,但是這些工具需要讓全球衛生系統都運用到。

  • And we need preparedness.

    而且我們要未雨綢繆。

  • The best lessons, I think, on how to get prepared are again, what we do for war.

    我想,如何未雨綢繆的最佳範例就是我們如何備戰。

  • For soldiers, we have full-time, waiting to go.

    在軍員方面,我們的職業軍人隨時待命。

  • We have reserves that can scale us up to large numbers.

    而後備軍人也能大量擴充動員。

  • NATO has a mobile unit that can deploy very rapidly.

    北約還有個機動組能快速遣兵,

  • NATO does a lot of war games to check, are people well-trained?

    北約做過很多軍事演習以查驗大家是否訓練有素?

  • Do they understand about fuel and logistics and the same radio frequencies?

    他們是否了解燃料及後勤,是否在同一無線頻率上?

  • So they are absolutely ready to go.

    如此一來他們完全準備待命。

  • So those are the kinds of things we need to deal with an epidemic.

    這些就是我們對抗流行病需要做的事。

  • What are the key pieces?

    有哪些主要部分?

  • First, is [that] we need strong health systems in poor countries.

    第一,在貧窮國家我們需要完善的醫療系統。

  • That's where mothers can give birth safely, kids can get all their vaccines.

    在那裡母親能安全生產,小孩能注射疫苗。

  • But, also where we'll see the outbreak very early on.

    但是,那些地方也是我們能早早發現疫情爆發的地方。

  • We need a medical reserve corps: lots of people who've got the training and background who are ready to go, with the expertise.

    我們需要醫療後備部隊:很多受過訓練且具備相關背景的人能隨時待命,還有專門知識技能。

  • And then we need to pair those medical people with the military.

    然後我們需要讓醫療人員與軍方搭配。

  • Taking advantage of the military's ability to move fast, do logistics, and secure areas.

    利用軍方的能力快速行動、做後勤及採取安全措施保護當地。

  • We need to do simulations, germ games, not war games, so that we see where the holes are.

    我們需要模擬演練,做微生物演習,而非軍事演習,那樣才能發現漏洞所在。

  • The last time a germ game was done in the United States was back in 2001, and it didn't go so well.

    美國最後一次微生物演習於 2001 年舉行,而且還不太成功。

  • So far the score is germs: 1, people: 0.

    到目前為止比數是微生物 1 分, 人類 0 分。

  • Finally, we need lots of advanced R&D in areas of vaccines and diagnostics.

    最後,我們就疫苗及診斷方面需要很多先進的研發。

  • There are some big breakthroughs, like the Adeno-associated virus, that could work very, very quickly.

    也有一些重大的突破,例如腺相關病毒,能產生非常、非常快的成效。

  • Now I don't have an exact budget for what this would cost, but I'm quite sure it's very modest compared to the potential harm.

    我對這個要花多少錢並沒有明確的預算,但我還蠻確定與潛在危害相比這應該不算多。

  • The World Bank estimates that if we have a worldwide flu epidemic, global wealth will go down by over three trillion dollars and we'd have millions and millions of deaths.

    世界銀行估計,如果來一場全球流感疫情,全球財富將會減少三兆多美元,而且還會有數不清的死亡病例。

  • These investments offer significant benefits beyond just being ready for the epidemic.

    這些投資提供的顯著效益不僅在於充分預備對抗流感疫情。

  • The primary health care, the R&D, those things would reduce global health equity and make the world more just as well as more safe.

    還有基礎衛生醫療與研發,這些事都可能縮小全球健康公平性的差距,讓這個世界更公平更安全。

  • So I think this should absolutely be a priority.

    所以我認為這絕對是該優先考慮的事情。

  • There's no need to panic.

    我們絕不需要恐慌。

  • We don't have to hoard cans of spaghetti or go down into the basement.

    不需要囤積義大利麵罐頭或躲到地下室去。

  • But we need to get going, because time is not on our side.

    但是我們需要開始行動,因為時間並不站在我們這邊。

  • In fact, if there's one positive thing that can come out of the Ebola epidemic, it's that it can serve as an early warning, a wake-up call, to get ready.

    事實上,如果要說伊波拉疫情帶給我們什麼正面的事情,那就是它是早期警告,一個警鐘,要我們準備好。

  • If we start now, we can be ready for the next epidemic.

    如果我們現在就開始, 必定能夠準備好對抗下一場疫情。

  • Thank you.

    謝謝。

When I was a kid, the disaster we worried about most was a nuclear war.

在我小時候,最讓我們感到擔憂的是一場核戰災難。

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B1 中級 中文 美國腔 TED 伊波拉 疫情 全球 病毒 流行病

【TED】比爾蓋茲五年前預言:下一波爆發的世界疫情,我們準備好了嗎? (Bill Gates: The next outbreak? We’re not ready)

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    Jeng-Lan Lee 發佈於 2020 年 04 月 23 日
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