硬核示范神预见，比尔盖茨关于大传染病的一次TED演讲

小白老师说：2015年，比尔盖茨曾在TED做过一个题为“The next outbreak? We're not ready” 的演讲，翻译过来就是“距下次疫情爆发，人类还毫无准备”。是的，早在五年前，这位世界前首富就提醒我们，大型传染病可能带来灭绝性的袭击，而人类尚未建立一个良好的应对机制。他认为人类不能坐等大流行病的到来，而应该立刻行动，防患未然。

他在演讲中这样讲道：

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

下一次我们可能不会这么幸运了。有的病毒可能让你毫无察觉， 但当感染病毒的人乘飞机或者去逛商场， 他们其实已经具有一定的传染力了。

TED Talk

五年前的演讲，神奇地预见了今天新型冠状病毒传播的场景。

比尔盖茨的这个演讲仅八分钟，却对病毒疫情防御非常有前瞻性，他建议：

1. “We need strong health systems in poor countries. ”

第一，要在落后的国家建立强大的卫生体系。

果然，世界卫生组织把新型冠状病毒肺炎列入国际突发公共卫生事件的原因，也正是“担心这种病毒有可能传播到卫生系统较弱、应对准备不足的国家。”

2. “We need medical reserve crops, and pair these medical people with the military.”

第二，我们需要后备医疗部队，要让医护人员和军队并肩作战。

3.  “We need to do simulations, like germ games.”

第三，我们要做疫情模拟，比如开展“病毒游戏”这样的实战演练。

点击这里观看精彩演讲：▼

以下是演讲全文，英文来自TED官网，中文为小白老师翻译。

When I was a kid, the disaster we worried about most was a nuclear war. That's why we had a barrel like this down in our basement, filled with cans of food and water. When the nuclear attack came, we were supposed to go downstairs, hunker down, and eat out of that barrel.

我小时候，我们最担心的灾难是核战争。这就是为什么家家户户地下室有一个这样的大桶，里面装满了罐头食品和水。当核攻击来临时，人们躲到地下室，下蹲低头，吃桶里的储备。

Today the greatest risk of global catastrophe doesn't look like this. Instead, it looks like this. 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. Not missiles, but microbes. Now, part of the reason for this is that we've invested a huge amount in nuclear deterrents. But we've actually invested very little in a system to stop an epidemic. We're not ready for the next epidemic.

今天的全球最大的灾难看起来已经不是这样的了。事实上，也会像这样。如果有什么东西在未来几十年里可以杀掉上千万人，那比较有可能是个高度传染的病毒，而不是战争。也不是导弹，而是微生物。部分原因是人类在核威慑上投入了大量精力和资金，可在防止疫情的体系建设上却投资甚少。我们还没有准备好预防下一场大疫情的发生。

Let's look at Ebola. I'm sure all of you read about it in the newspaper, lots of tough challenges. I followed it carefully through the case analysis tools we use to track polio eradication. 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. In fact, there's some pretty obvious key missing pieces.

让我们看看埃博拉病毒。我相信大家在报纸上都看过有关疫情的报道，其间充满了艰辛的挑战。我用我们跟踪消灭脊髓灰质炎的案例分析工具来深入追踪了埃博拉疫情，我仔细地追踪了病毒的传播。但随着追踪的深入，我们发现，问题不在于人类没有高效的应对机制，而是人类根本没有任何应对机制。事实上，我们还有一些显而易见的关键功能的缺失。

We didn't have a group of epidemiologists ready to go, who would have gone, seen what the disease was, seen how far it had spread. The case reports came in on paper. It was very delayed before they were put online and they were extremely inaccurate. We didn't have a medical team ready to go. We didn't have a way of preparing people.

我们没有准备充足的流行病学家，能去疫区看病理和病情发展。病例都是从报纸上看来的。各种消息等传到网上，就已经严重滞后了，而且还不准确。我们没有训练有素的医护团队，我们也没有行之有效的办法能让人们严阵以待。

Now, Médecins Sans Frontières did a great job orchestrating volunteers. But even so, we were far slower than we should have been getting the thousands of workers into these countries.

目前，“无国界医生”在动员志愿者上做了很大的贡献。即便如此，我们调动大量工作人员支援疫区的速度还是非常缓慢。

And a large epidemic would require us to have hundreds of thousands of workers. There was no one there to look at treatment approaches. No one to look at the diagnostics. No one to figure out what tools should be used. As an example, we could have taken the blood of survivors, processed it, and put that plasma back in people to protect them. But that was never tried.

大的疫情会需要我们动员数以十万计的工作人员，但没有任何人在研究治疗的方向，也没有人在研究诊断的方法，没有人在思考该用什么工具。举个例子，也许我们可以抽取幸存者的血液，经过处理，再将血浆注入人体内来保护未感染者。但是这个方法从来没有试过。

So there was a lot that was missing. And these things are really a global failure. The WHO is funded to monitor epidemics, but not to do these things I talked about. Now, in the movies it's quite different. There's a group of handsome epidemiologists ready to go, they move in, they save the day, but that's just pure Hollywood.

所以有很多该做的事都还没做。而这的确是全球性的失败。世卫组织的功能是观测流行病，而不是做我刚才讲的这些事。但是在电影里，上演的剧情却跟现实截然不同——总有一群英俊的流行病学家整装待发，义无反顾奔赴疫区，拯救了无数生命。可惜，这只是纯好莱坞式的理想剧情。

The failure to prepare could allow the next epidemic to be dramatically more devastating than Ebola Let's look at the progression of Ebola over this year. About 10,000 people died, and nearly all were in the three West African countries. There's three reasons why it didn't spread more.

人类的准备不足 ，可能让我们会面临下一场疫情大流行，比埃博拉更严重。回顾埃博拉病毒在过去一年的传播，有一万人左右丧生，几乎所有的死者都集中在西非的三个国家。之所以没有扩散到更大范围，有三个原因。

The first is that there was a lot of heroic work by the health workers. They found the people and they prevented more infections. The second is the nature of the virus. Ebola does not spread through the air. And by the time you're contagious, most people are so sick that they're bedridden. Third, it didn't get into many urban areas. And that was just luck. If it had gotten into a lot more urban areas, the case numbers would have been much larger.

第一个是医护工作人员的英雄之举。他们找出很多病人，并防止了更多人染病。第二个是病毒的特性，埃博拉病毒不是靠空气传播的。等到你有足够的传染力时，大部分人已经病得卧床不起了。第三个是因为病毒没有传到城市。这纯粹是运气好。如果病毒传到了城市，那么死亡人数绝对不止这些。

So next time, we might not be so lucky. 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. The source of the virus could be a natural epidemic like Ebola, or it could be bioterrorism. So there are things that would literally make things a thousand times worse.

所以下一次我们可能不会这么幸运了。有些病毒可能让人毫无症状，但病毒感染者乘飞机或者逛商场时，他们其实已经具有一定的传染力了。此外病毒的可以是源于大自然的，像埃博拉病毒，也可能由生物恐怖攻击而产生的。总之，能让疫情比埃博拉惨上几千倍的病毒也是存在的。

In fact, let's look at a model of a virus spread through the air, like the Spanish Flu back in 1918. So here's what would happen: It would spread throughout the world very, very quickly. And you can see over 30 million people died from that epidemic. So this is a serious problem. We should be concerned.

事实上，让我们来看看一个病毒由空气传染的模型，比如1918年的西班牙流感。未来可能会发生：病毒快速蔓延至全世界，你可以看到全球三千万人死于这个疾病。这是严重的问题，我们应该重视它。

But in fact, we can build a really good response system. We have the benefits of all the science and technology that we talk about here. We've got cell phones to get information from the public and get information out to them. We have satellite maps where we can see where people are and where they're moving. 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. So we can have tools, but those tools need to be put into an overall global health system. And we need preparedness.

但事实上我们可以建立一个很好的反应机制。我们可以利用现有的科学技术。我们可以利用手机收集信息、发布信息。我们有卫星地图，可以看到人们在哪里、往哪移动。我们在生物学上也取得了很大进步，这可以大幅缩短我们找到病原的时间，并在短时间内开发出解药和疫苗。所以我们是有工具的，但这些工具必须整合在一个全球健康系统之下。此外，这个体系必须时刻待命。

The best lessons, I think, on how to get prepared are again, what we do for war. For soldiers, we have full-time, waiting to go. We have reserves that can scale us up to large numbers.

应对未来疫情的最好的办法，就是要像准备迎接战争一样严阵以待。军人是随时随地待命的。我们还有预备役军人，能使备战人数大大增加。

NATO has a mobile unit that can deploy very rapidly. NATO does a lot of war games to check, are people well trained? Do they understand about fuel and logistics and the same radio frequencies? So they are absolutely ready to go. So those are the kinds of things we need to deal with an epidemic.

北约有个能够快速行动的机动小组。北约还组织大量的战争游戏，用来测试相关人员是否训练有素，比如他们是否了解燃油、补给、相同的无线电频段，如果是的话，那么他们就已做好充分准备了。这些，也是面对疫情时我们同样需要面对的事。

What are the key pieces? First, we need strong health systems in poor countries. That's where mothers can give birth safely, kids can get all their vaccines. But, also where we'll see the outbreak very early on.

关键的环节有哪些？第一，在贫穷的国家，必须有发达的卫生系统，要让母亲们可以安全地分娩，要让小孩子可以接种疫苗。我们也可以在很早的阶段就侦查到疫情爆发的苗头。

We need a medical reserve corps: lots of people who've got the training and background who are ready to go, with the expertise. And then we need to pair those medical people with the military. taking advantage of the military's ability to move fast, do logistics and secure areas.

我们需要有后备医疗部队：要有大批训练有素的专业人士，随时准备好能带着他们专长驰援疫区。我们可以用军队来配合医护人员，利用军队移动迅速的特点，来保障后勤运输、维持安全。

We need to do simulations, germ games, not war games, so that we see where the holes are. The last time a germ game was done in the United States was back in 2001, and it didn't go so well. So far the score is germs: 1, people: 0.

我们还需要开展疫情演练。我们需要的不是“战争游戏”，而是“病菌游戏” ，看看防卫漏洞在哪。上一次的“病菌游戏”是在美国进行的，那已经是2001年的事了， 开展得也不是很顺利。到目前为止，病毒和人类之战，病毒得一分，人类是零分。

Finally, we need lots of advanced R&D in areas of vaccines and diagnostics. There are some big breakthroughs, like the Adeno-associated virus, that could work very, very quickly.

最后，我们在疫苗和病理学上还有很多的研发工作可做。我们已经取得了重大突破，比如腺相关病毒，这些研究可以很快投入应用。

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. 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.

我还没有精确预算这些到底需要多少钱，但是我确信，跟人类可能遭受的损失比起来，一定是比较便宜的。根据世界银行的估算，如有流感疫情爆发，全球经济会损失三万多亿美元，另外还会可能有数以千百万人的死亡。

These investments offer significant benefits beyond just being ready for the epidemic. The primary healthcare, the R&D, those things would reduce global health equity and make the world more just as well as more safe.

这些投资不仅能让我们为下一次大传染病做好准备，而且还会带来明显的社会效益。基础医保、医药研发，这些都可以促进全球健康平衡发展，让这个世界更健康更安全。

So I think this should absolutely be a priority. There's no need to panic. We don't have to hoard cans of spaghetti or go down into the basement. But we need to get going, because time is not on our side.

所以我觉得这是当务之急，刻不容缓。但我们没有必要惊慌。我们该做的，不是囤上罐头食品或是躲到地下室；我们该做的，是奋起直追，因为时间有限。

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

说到底，如果说这场埃博拉疫情带来了什么正面影响的话，那就是提早拉响了警报，提醒人类觉醒并做好准备。我们如果立即投入准备，那么在下一场疫情来临前，我们还是可以准备好的。

Thank you.

谢谢大家。

点下方文章学习更多：▼

点击阅读原文参加写作冲刺课▼  

       喜欢就点个“在看”吧~↘