本轮上海疫情累计感染近50万例，死亡87例！曾预言大流行病的盖茨最新演讲：新冠可能会是最后的大流行病！（附视频&演讲稿）
高位波动，上海新增阳性感染者数量依然较多。
4月23日，上海新增本土阳性患者“1401+19657”，重型患者160例，危重型患者19例，本土死亡病例39例。本轮疫情以来，本市共有死亡病例87例，其中男性48例、女性39例，平均年龄81.10岁，最大101岁 。
截至目前，上海本土阳性感染者已累计接近50万例，已累计排查到在沪“密接”超过45万人。累计本土确诊38809例，治愈出院14592例，在院治疗24130例，死亡87例。据健康时报消息，曾经驰援武汉的“重症八仙”，现已有三位专家奔赴上海进行支援。真的希望上海这一轮疫情能够早点结束，人们能够回归正常的生活。
近日，曾经成功预言新冠肺炎全球大爆发的比尔盖茨在TED大会发表了他的最新演讲，他说：“如果我们采取正确措施”，新冠肺炎可能是最后一次大流行。
“公元六年，一场大火摧毁了罗马。为了应对此次火灾，奥古斯都大帝做了一件在帝国历史上从未做过的事：他创建了一个永久性的消防员团队。奥古斯都意识到，个人无法保护自己免受火灾的威胁，我们需要社区的帮助。一幢房子若不幸着火，就会给他人的房子带来风险。在这几年，我们人类见证的就如一场可怖的全球性‘火灾’。新冠疫情已导致数百万人死亡并破坏了经济，我们不希望再重蹈覆辙。”
↓↓↓ 上下滑动，查看演讲稿 ↓↓↓
In the year 6 CE, a fire devastated Rome.
In response, Emperor Augustus did something that had never been done before in the history of the Empire.
He created a permanent team of firefighters who used buckets just like this one.
Augustus understood that individuals alone can't protect themselves from fires.
They need help from the community.
When one person's house is on fire, that creates a risk for everyone else's homes.
And so what we've had these last few years is like a horrific global fire.
The COVID pandemic has killed millions and upended economies, and we want to stop that from happening again.
COVID, it's hard to overstate how awful it's been.
It's increased the health inequities between the rich and the poor.
Survival depended partly on your income, your race, the neighborhood you lived in.
And so we should seize this opportunity to create a world where everyone has a chance to live a healthy and productive life.
Also a life free from the fear of the next COVID-19.
When I was on this stage in 2015, I was one of many people who said we weren't ready and we needed to get ready.
We didn't.
The speech actually was watched by a lot of people.
But 90 percent of the views were after it was too late.
So now I hope the need is clear.
And of course, we've learned a lot.
During this pandemic, a lot of things worked well, a lot of things didn't work well.
And so we have all that knowledge to build a prevention system.
COVID-19 can be the last pandemic if we take the right steps.
So how, what are these steps? Well, let's go back and look at what the Romans did.
Think about how, over time, we've gotten good at preventing big fires.
Fire prevention is kind of this pervasive thing.
It's well funded.
It's well understood.
If an alarm went off right now, everyone here would know we're supposed to calmly gather, go out and wait instructions.
We'd know that help would be on the way because we have lots of trained firefighters who practice.
The United States alone has 370,000 full-time firefighters, even more than I guessed that number would be.
We also have access to water.
The United States, for example, has almost nine million fire hydrants.
And so that type of investment, that type of practice, that type of system is what we need to stop pandemics.
Now, often in movies, we'll have pandemics.
And I'm always impressed with what takes place.
Let's look at an example of this rapid response.
[Motaba River Valley, Zaire] (Helicopter rotors whirring) Well, that's quite impressive.
We don't need the music, but otherwise we saw exactly what should happen.
An outbreak’s detected.
Very quickly, literally within days, doctors are dispatched.
They have a helicopter to get into exactly ground zero.
They go in there, and they’ve got the right tools.
And this is what should happen when an outbreak is spotted.
But we don't have that team, we don't have those resources.
And if an outbreak took place in a low-income country, it could be literally months before we started to orchestrate those resources.
So despite what you see in movies, there is no group of experts standing by to prevent this disaster.
So we have to create a new team.
I believe we should create what I call the GERM team.
Germ stands for Global Epidemic Response and Mobilization.
This group is full-time.
Their only priority is pandemic prevention.
It's made up of a diverse set of specialists with a lot of different realms of expertise: epidemiologists, data scientists, logistics experts.
And it's not just scientific and medical knowledge.
They also have to have communication and diplomacy skills.
The cost of this team is significant.
It's over a billion a year to support the 3,000 people who would be on this team.
And its mission is to stop outbreaks before they become pandemics.
The work would be coordinated by the WHO.
They'd be present in many locations around the world, stationed in public health agencies.
They'd work closely with the national teams, depending on the income level.
They'd have more in the lower-income countries.
You know, for example, we could have GERM members say an epidemiologist, working out of the Africa CDC office in Abuja.
And a very important thing is that like firefighters, a GERM team would do drills.
When you want to have quick response, when you want to make sure you have all the pieces there and you can move very quickly, practice is key.
That's how you make sure everyone knows what to do.
Now, this team, there could be periods where there's no risky outbreak and they can keep their skills strong by working on some of the other infectious diseases, but that would be a second priority.
They would work with countries to strengthen their health systems.
The health systems are the front line.
You need to know if, say, a lot of people show up with a new kind of cough, that’s when GERM needs to look into it and say, is this an outbreak? Is there a new pathogen here? What is the sequence of that? And so for all of this, the first 100 days are key.
Viruses spread exponentially.
And so if you get in there when the infection rate is fairly small, you can actually stop the spread.
You know, in this epidemic, if we'd been able to stop it within 100 days, we would have saved over 98 percent of the lives.
Now, we did have countries that did a good job.
Australia is an example.
They orchestrated diagnostic capacity.
They came up with distancing policies and quarantine policies.
And so their overall death rate per capita will be well less than a 10th of other countries.
But we did not, as a world, contain it.
And that's what we have to do next time.
When COVID struck, we were almost like Rome before they had fire buckets and firefighters.
We didn't have the people, the systems or the tools we need.
Now, with the right investments, we can have a whole new generation of tools, better diagnostics, therapeutics and vaccines.
A good example in the diagnostic area is this little machine, this is called the Lumira.
We can have these all over the world that can test for any number of diseases.
It’s a 10th as expensive as PCR, it’s absolutely as accurate, and it’s simple.
So it can be used anywhere.
We need other R&D investments.
One that I'm very excited about is the idea of a drug that you inhale that blocks you from getting infected.
It can be pathogen-independent and trigger your immune system so that you'll be protected.
A lot of the tools, the diagnostic tools and those infection-blocking tools are important because they can be staged in advance.
Now, we also need vaccines, but we want to stop the outbreak before we have to do a global vaccination campaign.
And so vaccines can play a couple of different roles, but not the primary role.
We have to invest in more than just that.
When we look at vaccines, they were the miracle of this epidemic.
They saved millions of lives, but they can be far better.
We need to invent easier-to-deliver vaccines that are just a patch you put on your arm or something that you inhale.
We need vaccines that actually block infections.
In this case, there were lots of breakthrough infections.
We need vaccines that are broad spectrum, so they work against most of the emerging variants, which we did not have this time.
And we also need factories that are standing by so we can build enough vaccines for the entire world within six months and achieve far better equity.
The vaccines can also do something that would be super helpful, which is to help us eradicate entire families of viruses.
Innovative new vaccines used properly could get rid of the flu family, the coronavirus family.
And there's a huge burden of those, even in non-pandemic years, and if we get rid of it, it can never cause a pandemic.
So I'm talking about investments in three broad areas: Disease monitoring, that's GERM.
The R and D tools that are far better.
And finally, and the most expensive, is improved health systems.
This won't be cheap, but it'll save lives.
And even it'll save money in the long run.
It's like an insurance policy.
The cost to prevent the next pandemic will be tens of billions of dollars.
But let's compare that to what we just went through.
The IMF estimates that COVID has cost nearly 14 trillion dollars.
And so we need to spend billions in order to save trillions.
And here's the best part of this.
Even when we're not having an outbreak, these investments like the Lumira, those new vaccines, they will make people healthier.
They'll shrink the gap, the health equity gap, which is gigantic, between rich and poor countries.
For example, we can detect more HIV cases and do a better job of treatment.
We can reduce deaths from malaria.
We can get more people high-quality care.
And so this is not just a downer about how to stop things from getting worse, but also a chance to make things better.
If we take the right steps, we can make COVID-19 the last pandemic, and we can build a healthier, more equitable world for everyone.
Thank you.
Helen Walters: Thank you so much.
I have a few follow-up questions and one is really about the formal status of GERM.
So you mentioned this would cost a billion dollars, you mentioned it comes through the WHO, but exactly who's running this, how does this work, how do we make this happen? BG: Well, GERM does not exist.
It's a proposal I'm putting forward that hopefully over the next year, while the pain of the pandemic is still clear in people's minds, will get a global consensus.
The rich-world governments will have to step up like they do with all the aid things and come up with that money.
The way the personnel systems works, so that it's under WHO, but a really top-notch team, there will be a lot of debate about how to do that well.
So, you know, I'm putting it forward and hopefully within the next year we'll get that consensus.
HW: Who do you need to pick that up next? BG: Well, it's really the rich-world governments.
The WHO has this big yearly meeting, the World Health Assembly, and at some point somebody will put forward a resolution and we'll see if the extra resources can be put in for that.
After World War II, we did a lot.
You know, we created the United Nations, we talked a lot about war.
So I'd be stunned, although, you know, so far the action has been less than I would have expected, I'd be stunned if we don't go forward with something pretty close to what I'm laying out there.
HW: This has been pretty personal for you.
You know, the anti-vaxxers are out there, they are loud, and this has become personal.
I just wanted to ask, like, how are you managing that? BG: Well, it's kind of weird.
Now, our foundation, the Gates Foundation, is very involved in vaccines, the invention of new vaccines, funding vaccines.
And we're very proud that through joint efforts like GAVI, that saved tens of millions of lives.
So it's somewhat ironic to have somebody turn around and say, no, you know, we're using vaccines to kill people or to make money or, you know, we started the pandemic, even some strange things like, that I somehow want to track, you know, the location of individuals because I'm so deeply desirous to know where everybody is.
I'm not sure what I'm going to do with that information.
You know, does this turn into something where, you know, there's constantly crazy people showing up? Who knows? But, you know, hopefully, as the pandemic calms down, people are more rational about, hey, vaccines are a miracle and there's a lot more we can do.
HW: So the future is in our hands in the present.
Bill Gates, thank you so much for being here.
BG: Thank you.
在公元六年， 一场大火摧毁了罗马。
来应对此次火灾， 皇帝奥古斯做了一件 在帝国历史上从未做过的事：他创建了一个永久性的消防员团队， 用着像这样的水桶。
奥古斯意识到，个人无法保护自己免受火灾的威胁， 我们需要社区的帮助。
一幢房子若不幸着火， 就会给他人的房子带来风险。
在这几年，我们人类见证的就如一场可怖的全球火灾。
新冠疫情已导致数百万人死亡并破坏了经济， 我们不希望再重蹈覆辙。
新冠肺炎的可怕程度怎么说都不过分。
它加剧了富人和穷人之间的健康不平等。
你的幸存几率和你的收入、种族 和居住地紧紧相关。
我们应该抓住这个机会 来创造一个世界 让每一个人都有机会 活的健康、充实。
在2015年的TED大会上， 我还有很多人都说 面对疫情我们毫无准备，而我们需要迅速行动起来。
我们并没有。
很多人看了那个演讲。
但90%的观看量都发生在为时已晚之后。
现在我希望这种必要性是显然易见的。
当然，我们掌握了不少新知识。
在这场大流行病中， 一些措施都很有效，而其他则不管用。
我们得利用我们的知识储备来建立一个预防系统。
若我们走对下一步棋，COVID-19可成为最后一场大流行病， 所以怎么才能做到？让我们看看罗马人当时怎么做的。
想想，随着时间的推移，人们变得善于预防大火灾。
防火是一件很普遍的事情。
它有着充足的预算资金。
它被人熟知并理解。
如果火警现在响了， 所有在场观众都知道 我们应经条有序的走向安全出口，在外面等待指令。
我们清楚救援马上会到， 因为我们有很多训练有素的消防员。
单单在美国，我们有超过37万专职消防员， 这个数字比我想象的还要多。
我们很容易获得大量的水。
在美国，差不多有九百万个消防栓。
高投入资金，大量训练， 完善的系统，是我们来对抗大流行病的必要条件。
在电影中，时常有大流行病的桥段。
电影中发生的一切让我印象深刻。
让我们看一个片段其中的迅速反应。
[莫他巴河谷，扎伊尔] (直升飞机旋翼声) 影片中值得赞赏。
背景音乐的确是有些过火， 但这个片段展示了在现实生活中本该发生的事。
疫情开始爆发， 很快，在几天之内， 医生们迅速部署。
直升机带领医生直达疫情中心。
他们带着对的工具抵达。
一旦发现疫情，这是人们应该采取一系列措施。
但我们现在没有这种团队，没有这种资源。
若疫情爆发于低收入国家， 我们需要要数月 仅开始整理资源。
与你在电影中看到的不同， 现今我们没有一个专家小组随时待命来预防这场灾难。
所以我们必须建立一个新团队。
我认为我们需要建立一个GERM团队。
GERM是全球流行病应对和动员的缩写。
它是一个全职小组。
他们唯一的重点职责是预防大流行病。
GERM由来自广泛领域的专家组成 流行病学家、数据科学家、 物流专家。
他们不仅仅有科学或医学知识， 他们还具有沟通和外交能力。
运行GERM团队花费不小。
每年将要约10亿美元 来支撑3000位团队成员。
它的任务是阻止疫情演变成大流行病。
这项工作将由世卫组织协调。
GERM将身处世界各地， 在公共卫生机构工作。
他们会和当地国家的团队紧密合作， 当然这也要看当地的收入情况。
在低收入国家中，分配的人手会更多。
举个例子，我们可以让GERM成员 一位流行病学家在非洲疾病预防控制中心驻阿布贾办公室工作。
与消防员相似， GERM团队会经常进行演习。
你若想要及时的反应， 万事俱备， 快速行动，那练习是必不可少的。
这样才能确保每个人都知道该怎么做。
这支队伍，可能会面对一段时间没有危险疫情爆发， 那他们可以 治理其他传染病帮助团队保持技能， 但那会是他们的第二责任。
GERM将帮助各国加强其卫生系统。
卫生系统是就是前线。
你若想知道， 如果一群人带着一种奇怪的新咳嗽出现在健康诊所， 这时GERM就需研究并判断，这是一场会蔓延的疫情吗？这里有新的病原体吗? 它的序列是什么？对于这一切行动，前100天将是关键。
病毒以指数方式传播。
所以如果能在感染率很小时开始控制， 你实际上可以阻止传播。
在这场流行病中， 若我们可以在前100天阻止传播， 我们可以拯救98%的生命。
我们确实有一些国家做得很好。
比如说澳大利亚。
他们协调了诊断能力。
他们制定了保持距离和隔离政策。
因此，他们的人均总死亡率 远低于其他国家的十分之一。
但就整个世界来讲，我们并没有成功控制病毒。
这是我们在下一次必须做到的。
当新冠来临，我们就像 还未具备水桶和消防员的罗马。
我们没有急需的人，系统和工具。
如果我们做出正确的投资 我们将拥有一系列更成熟的工具， 更有效的诊断、治疗和疫苗。
举个诊断方面的例子， 这个小小的机器叫做Lumira。
可以在世界任何地方检测多种疾病。
与PCR测试相比成本只有其十分之一， 结果一样准确，而且用起来十分方便。
几乎可以在任何地方使用。
我们需要其他研发投资。
有一个让我十分激动的想法是一种可被吸入的药物 保护你免受传染。
它可以不依赖于病原体，并触发你的免疫系统 保护你。
许多工具，诊断工具 和那些阻断感染工具十分重要， 因为它们可以被提前部署。
我们也需要疫苗。
但我们更希望在需要进行全球疫苗行动之前 阻止疫情的爆发 疫苗可以扮演几个不同的角色， 但它并不是主角。
我们要投资的不止这些。
当我们看到疫苗在这场流行病中发挥了奇迹般的作用。
它们拯救了百万生命，但它还可以不断进步。
我们需要投资研发更容易提供的疫苗 如手臂贴片或鼻腔喷雾。
我们需要可以阻断感染的疫苗。
如今，我们看到了不少接种疫苗后的感染。
我们需要广谱疫苗， 它们会与大多数新出现的变异相对抗， 我们现在还没有这种疫苗。
同时，我们需要工厂待命， 这样才可以为全世界人民生产足够疫苗， 这要在六个月内完成， 达到真正意义上的公平。
疫苗还可以做一些非常有用的事情， 比如说完全消除整个病毒家族。
正确使用创新的新疫苗可以消除流感家族， 或是冠状病毒家族。
这些病毒是我们巨大的负担， 在没有大流行的年代也是这样， 如果我们可以清除它们，将在不会引起一场大流行病。
我在谈论三个广泛领域的投资: 疾病监测， 就是GERM。
更好的研发工具。
还有其中花费最高的，提升我们的卫生系统。
这些不会很便宜，它们将拯救生命。
并从长远角度来看，它还会省钱。
就像是一个保险政策。
来预防下一次大流行病我们要花费几十亿美元。
但是让我们把它和我们刚刚经历的疫情做个比较。
国际货币基金组织(IMF)估计，新冠肺炎已经造成近14万亿美元损失。
为了节省这数万亿美元，我们必须要花这数十亿美元。
最好的部分是。
在没有疫情时，对类似Lumira工具的投资， 新型疫苗， 会让人们更健康。
他们会缩小贫富之间的健康差距， 现今在贫困和富有国家之间，健康差距是一个巨大鸿沟。
例如，我们可以发现更多艾滋病毒病例，并更好地进行治疗。
我们可以减少疟疾造成的死亡。
我们可以为更多的人提供高质量的医疗服务。
所以这并不是 只能阻止坏情况发酵的灰心事， 而是一个让世界变更好的机会。
若我们走对棋， 我们可以让COVID-19成为最后的大流行病， 我们也可以为所有人建造一个更健康，更公平的世界。
谢谢。
海伦·沃特斯：非常感谢你。
我有几个想跟进的问题， 其中一个是关于GERM的现状。
你提到了这将花费10亿美元， 你也提到了这需要通过世卫组织来实现， 但究竟谁来经营，工作将如何进行， 我们如何实现这一目标？盖茨：目前来说，GERM并不存在。
这是我提出的一个建议，希望在未来的一年里， 当新冠的痛苦还很清晰的在我们脑海里， 将会获得一个全球共识。
强国的政府，将不得不采取行动， 就像他们做出的援助那样并拿出这笔钱。
人事运作方面，在世卫的领导下， 这是一个真正的一流团队， 关于如何做好这一点，将会有很多辩论。
我现在提出这个想法， 并希望在明年我们会达到这个共识。
沃特斯：接下来需要谁来接这个项目？盖茨：嗯，说实在，应该是是富裕国家的政府。
世卫组织每年都有这样的大型会议。世界卫生大会， 在这个时候会有人提出一个建议， 我们将看看能否为此投入额外的资源。
第二次世界大战后，我们做了很多。
你知道，我们创建了联合国。我们谈了很多关于战争的问题。
所以我会感到震惊， 因为目前的行动比我预期的要少。
如果我们不以非常接近我刚描述的方式前进， 我会感到震惊。
沃特斯：这个话题与你紧密相关。
你知道，反疫苗主义者十分活跃， 这已经变成了私人恩怨。
我想问的是，你是如何处理这个问题的？盖茨：说来奇怪。
现在，我们的基金会，即盖茨基金会， 在疫苗方面有很大的投入。
我们感到非常自豪的是，通过像全球疫苗和免疫联盟的共同努力， 拯救了数以千万计的生命。
因此，有人转过头来说我们利用疫苗来杀人 或者是为了赚钱，是很讽刺的。
或者说是我们引发了大流行病。
甚至一些奇怪的事情，比如我想通过疫苗追踪 你的个人定位 因为我是如此深切地渴望想知道每个人在哪里。
我不确定我将如何处理这些信息。
这是否会形成 不断有疯狂的人在我面前出现？谁知道呢？但是希望随着大流行病的平静下来， 人们会更加理性地看待， 疫苗是一个奇迹，而且我们还可以做很多事情。
沃特斯:所以未来在我们手中。
比尔·盖茨，非常感谢你来到这里。
盖茨：谢谢你。
Bill Gates appeared at the TED conference last week toting a curious wooden bucket. It was a replica of the pails used by the first firefighting brigades in 6th century Rome. The prop symbolized a key pillar in the 66-year old billionaire philanthropist’s latest idea for preventing future pandemics.
Speaking to a packed auditorium at the elite ideas conferenceheld in Vancouver, Canada, Gates proposed creating a standby pandemic prevention unit, not unlike the Romans did when they organized the first permanent fire brigade (calledcohortes vigilumor colloquially, sparteolifor “little bucket fellows”) after a devastating fire engulfed their city.
Gates’s vision would establish a permanent pandemic watch unit, with representatives in key cities around the world, who would parachute to any locale to contain health outbreaks before they spread. The name of the proposed for group: “Global Epidemic Response and Mobilization” or GERM.
Gates elaborates on its structure in his new book, “How to Prevent the Next Pandemic.”
My back-of-the-napkin estimate is that GERM would need about 3,000 full-time employees. Their skills should run the gamut: epidemiology, genetics, drug and vaccine development, data systems, diplomacy, rapid response, logistics, computer modeling, and communications. GERM should be managed by the World Health Organization, the only group that can give it global credibility, and it should have a diverse workforce, with a decentralized staff working in many places in the world.
When not dealing with a live crisis, GERM could conduct pandemic preparedness drills, as firefighters do, or work with countries to strengthen their health systems, he explained.
Prevention has been a regular talking point for Gates since he first spoke about how ill-prepared the world was for a pandemicat TED in 2015. “I was one of many people who said we weren’t ready and we needed to get ready. We didn’t,” he said.
“The speech actually was watched by a lot of people, but 90% of the viewers were after it was too late,” he said at TED last week.
“When covid first struck, we were almost like Rome before they had fire buckets and firefighters…Now, with the right investments, we can have a whole new generation of tools in diagnostics, therapeutics and vaccines,” Gates said, holding up handheld rapid covid testing device calledLumiraDxthat his foundation supports, as an example.
“The cost of this team is significant—over a billion dollars a year,” Gates acknowledged. But he reasoned that the expense of funding GERM, along with investments in research and vaccine development, is akin to buying an insurance policy against future health catastrophes. “The cost to prevent the next pandemic will be tens of millions of dollars, but let’s compare that to what we just went through.”
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