“惊人失败”顶尖医学杂志打破208年传统首次评论政治（中英文对照）
【编者按】10月8日，世界上最负盛名的医学杂志之一 ——《新英格兰医学杂志》打破传统，在其208年历史上首次发表政治评论，抨击川普政府对新冠病毒处置不力。
这篇署名为“所有编辑”的社论称：政府不依靠专业人士，反而求助于那些掩盖真相、助力弥天大谎的无知的“意见领袖”和江湖骗子。
“这次失败令人震惊。”
杂志的主编埃里克·鲁宾博士说，“很明显，我们不是一个政治组织，但几乎每周在我们的编辑会上大家都会大光其火：他们怎么可以在这种时候说出那种话呢？”
在新英格兰医学杂志发表这篇社论之前，《科学美国人》(Scientific American)杂志也发表了类似的社论。该杂志在其175年的历史上首次表明支持拜登。
延伸阅读：
编辑：新约客
死于领导力真空
BY | 全体编辑
编译：新约客
Covid-19 has created a crisis throughout the world. This crisis has produced a test of leadership. With no good options to combat a novel pathogen, countries were forced to make hard choices about how to respond. Here in the United States, our leaders have failed that test. They have taken a crisis and turned it into a tragedy.
新冠病毒在全世界造成了一场危机。这场危机，对领导力提出了考验。对付一种新的病原体，没有好的选择，只有各国在应对时所作出的，艰难的选择。在美国，我们的领导人没有通过这一考验。他们把一场危机变成了一场悲剧。
The magnitude of this failure is astonishing. According to the Johns Hopkins Center for Systems Science and Engineering,1 the United States leads the world in Covid-19 cases and in deaths due to the disease, far exceeding the numbers in much larger countries, such as China. The death rate in this country is more than double that of Canada, exceeds that of Japan, a country with a vulnerable and elderly population, by a factor of almost 50, and even dwarfs the rates in lower-middle-income countries, such as Vietnam, by a factor of almost 2000. Covid-19 is an overwhelming challenge, and many factors contribute to its severity. But the one we can control is how we behave. And in the United States we have consistently behaved poorly.
这次失败令人震惊。据约翰·霍普金斯系统科学与工程中心(Johns Hopkins Center for Systems Science and Engineering)的数据，美国新冠病例和因新冠死亡人数方面在全世界居于首位，远远超过中国等更大国家的数字。美国的死亡率是加拿大的两倍多，比人口脆弱和老龄的日本高出近50倍，甚至比越南等中低收入国家都相形见绌，高出近2000倍。新冠病毒是一个压倒性的挑战，诸多因素导致其严重性。但我们可以控制我们的行为。在美国，我们一直表现得很差。
We know that we could have done better. China, faced with the first outbreak, chose strict quarantine and isolation after an initial delay. These measures were severe but effective, essentially eliminating transmission at the point where the outbreak began and reducing the death rate to a reported 3 per million, as compared with more than 500 per million in the United States. Countries that had far more exchange with China, such as Singapore and South Korea, began intensive testing early, along with aggressive contact tracing and appropriate isolation, and have had relatively small outbreaks. And New Zealand has used these same measures, together with its geographic advantages, to come close to eliminating the disease, something that has allowed that country to limit the time of closure and to largely reopen society to a prepandemic level. In general, not only have many democracies done better than the United States, but they have also outperformed us by orders of magnitude.
我们知道，我们本可以做得更好。中国面对第一次爆发的疫情，在最初的拖延之后，选择了严格的检疫和隔离。这些措施虽然严厉，但很有效，基本上在疫情爆发之初就杜绝了传播，并将死亡率降低到据报告的百万分之三，而美国，则是每百万人中有500。与中国交流多得多的国家，如新加坡和韩国，很早就开始了密集的检测，同时进行积极的接触者追踪和适当隔离，疫情相对较小。而新西兰也采取了同样的措施，加上其地理优势，接近消灭了这种疾病，该国控制了封闭时间，社会基本重新开放到流行前水平。总的来说，很多民主国家不仅做得比美国好，而且比我们好了好几个数量级。
Why has the United States handled this pandemic so badly? We have failed at almost every step. We had ample warning, but when the disease first arrived, we were incapable of testing effectively and couldn’t provide even the most basic personal protective equipment to health care workers and the general public. And we continue to be way behind the curve in testing. While the absolute numbers of tests have increased substantially, the more useful metric is the number of tests performed per infected person, a rate that puts us far down the international list, below such places as Kazakhstan, Zimbabwe, and Ethiopia, countries that cannot boast the biomedical infrastructure or the manufacturing capacity that we have.2 Moreover, a lack of emphasis on developing capacity has meant that U.S. test results are often long delayed, rendering the results useless for disease control.
为什么美国对这场疫情的处理如此糟糕?几乎每一步，我们都失败了。我们有充分的预警，但当疾病第一次到达时，我们却无法进行有效的检测，甚至无法为医护人员和公众提供最基本的个人防护设备。而在检测方面，我们仍然远远落后于形势。虽然检测的绝对数量大幅增加，但更有用的度量标准是检测数量与感染者的比率，我们的比率在国际名单上远远落在后面，低于哈萨克斯坦、津巴布韦和埃塞俄比亚等国，这些国家无法像我们一样拥有生物医学基础设施或生产能力。更有甚者，由于缺乏对发展能力的重视，美国的检测结果经常被长期拖延，以至于检测结果对疾病控制毫无用处。
Although we tend to focus on technology, most of the interventions that have large effects are not complicated. The United States instituted quarantine and isolation measures late and inconsistently, often without any effort to enforce them, after the disease had spread substantially in many communities. Our rules on social distancing have in many places been lackadaisical at best, with loosening of restrictions long before adequate disease control had been achieved. And in much of the country, people simply don’t wear masks, largely because our leaders have stated outright that masks are political tools rather than effective infection control measures. The government has appropriately invested heavily in vaccine development, but its rhetoric has politicized the development process and led to growing public distrust.
虽然我们倾向于关注技术，但大多数可产生显著效果的干预并不复杂。在疾病已在许多社区大量蔓延之后，美国才迟迟开始实施宽严不一的检疫隔离措施，而且，往往没有采取任何措施加以落实。在许多地方，我们关于社交距离的规定充其量也只是漫不经心的，在疾病得到充分控制之前就早早放松了限制。美国很多地方的人们根本就不戴口罩，这很大程度要归因于我们的领导人明确声称口罩只是政治工具，而不是有效的感染控制措施。政府正确地在疫苗开发上投入了大量资金，但却让言论使开发过程政治化，导致公众的不信任日益加深。
The United States came into this crisis with enormous advantages. Along with tremendous manufacturing capacity, we have a biomedical research system that is the envy of the world. We have enormous expertise in public health, health policy, and basic biology and have consistently been able to turn that expertise into new therapies and preventive measures. And much of that national expertise resides in government institutions. Yet our leaders have largely chosen to ignore and even denigrate experts.
美国是带着巨大的优势进入这场危机的。除了巨大的生产能力，我们还拥有一个举世羡慕的生物医学研究体系。我们在公共卫生、卫生政策和基础生物学方面拥有大量的专业力量，并且一直能够将这些专业知识转化为新的疗法和预防措施。这些国家专业力量大多蕴藏于政府机构之中，然而，我们的领导人却极大地选择了无视甚至诋毁专家。
The response of our nation’s leaders has been consistently inadequate. The federal government has largely abandoned disease control to the states. Governors have varied in their responses, not so much by party as by competence. But whatever their competence, governors do not have the tools that Washington controls. Instead of using those tools, the federal government has undermined them. The Centers for Disease Control and Prevention, which was the world’s leading disease response organization, has been eviscerated and has suffered dramatic testing and policy failures. The National Institutes of Health have played a key role in vaccine development but have been excluded from much crucial government decision making. And the Food and Drug Administration has been shamefully politicized, appearing to respond to pressure from the administration rather than scientific evidence. Our current leaders have undercut trust in science and in government, causing damage that will certainly outlast them. Instead of relying on expertise, the administration has turned to uninformed “opinion leaders” and charlatans who obscure the truth and facilitate the promulgation of outright lies.
我们国家领导人的反应一直不够充分。联邦政府已经在很大程度上放弃了疾病控制的工作，全盘交给各州。州长们的反应各不相同，与其说是党派不同，不如说是能力不同。但无论他们的能力如何，州长们都没有华盛顿控制的工具。可是，联邦政府不但没有使用这些工具，反而破坏了它们。美国疾病控制与预防中心(Centers for Disease Control and Prevention，简称CDC)曾经是世界领先的疾病应对组织，现在却被掏空，遭遇了严重的检测和政策上的失败。美国国立卫生研究院（National Institutes of Health，简称NIH）在疫苗研发方面发挥了关键作用，但却被排除在许多关键的政府决策之外。食品和药物管理局（Food and Drug Administration，简称FDA）更是被可耻地政治化了，似乎是为了应对来自政府的压力而不是科学依据。我们的现任领导人削弱了人们对科学和政府的信任，造成的损害肯定会比他们更长久。政府不依靠专业人士，反而求助于那些掩盖真相、助力弥天大谎的无知的“意见领袖”和江湖骗子。
Let’s be clear about the cost of not taking even simple measures. An outbreak that has disproportionately affected communities of color has exacerbated the tensions associated with inequality. Many of our children are missing school at critical times in their social and intellectual development. The hard work of health care professionals, who have put their lives on the line, has not been used wisely. Our current leadership takes pride in the economy, but while most of the world has opened up to some extent, the United States still suffers from disease rates that have prevented many businesses from reopening, with a resultant loss of hundreds of billions of dollars and millions of jobs. And more than 200,000 Americans have died. Some deaths from Covid-19 were unavoidable. But, although it is impossible to project the precise number of additional American lives lost because of weak and inappropriate government policies, it is at least in the tens of thousands in a pandemic that has already killed more Americans than any conflict since World War II.
让我们明确如此不采取哪怕是简单措施的代价：一场疫情，对有色人种社区造成了不成比例的影响，加剧了与不平等相关的紧张局势。许多儿童在社交和智力发展的关键时期缺课。冒着生命危险的医护人员的辛勤工作却无法得到明智的利用。我们的现任领导人以经济为傲，而美国却在世界上大多数国家均已在某种程度上开放的时候，仍然饱受疾病困扰，许多企业无法重新开工，数千亿美元和数百万个就业机会损失。而且，超过20万美国人死亡。新冠病毒造成的死亡有一些是不可避免的。但是，虽然不可能推算出由于羸弱不当的政府政策而导致的美国人额外死亡的确切数字，但至少数以万计，而这场疫情，已经夺走了比二战以来的任何一场冲突都多的美国人生命。
Anyone else who recklessly squandered lives and money in this way would be suffering legal consequences. Our leaders have largely claimed immunity for their actions. But this election gives us the power to render judgment. Reasonable people will certainly disagree about the many political positions taken by candidates. But truth is neither liberal nor conservative. When it comes to the response to the largest public health crisis of our time, our current political leaders have demonstrated that they are dangerously incompetent. We should not abet them and enable the deaths of thousands more Americans by allowing them to keep their jobs.
其他任何人，如果这样肆意糟蹋生命和金钱，都必将承受法律的后果，而我们的领导人，却声称他们的行为可以享有豁免。但这次选举赋予了我们做出判断的权力。理性的人肯定会对候选人采取的许多政治立场产生分歧。但真理，既不是自由派，也不是保守派。在应对我们这个时代最大的公共卫生危机之际，我们当前的政治领导人已经显示出，他们是危险的不称职者。我们不能再纵容他们，为了要保住他们自己的位子，导致成千上万的美国人死亡。
原文链接：
https://www.nejm.org/doi/full/10.1056/NEJMe2029812?query=nejmyxqy
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