• 04月26日 星期五

「经济学人」20200208期:Meet the new boss|来见见新老板

All governments will struggle. Some will struggle more than others

全球都在抗击疫情。有些国家需要做的更多。

TO SEE WHAT is to come look to Lombardy, the affluent Italian region at the heart of the covid-19 outbreak in Europe. Its hospitals provide world-class health care. Until last week they thought they would cope with the disease—then waves of people began turning up with pneumonia. Having run out of ventilators and oxygen, exhausted staff at some hospitals are being forced to leave untreated patients to die.

看一看意大利伦巴第地区如今的疫情现状吧,这个富裕的地区成为了欧洲疫情的中心。伦巴第地区的医疗水平处于世界领先水平。直到上周前,该地区的领导人还错认为他们可以很好地应对新冠肺炎疫情,随即该地区突增大量新冠肺炎确诊病例。由于缺乏呼吸机,筋疲力尽的医护人员只能眼睁睁看着患者得不到治疗而死亡。

The pandemic, as the World Health Organization (who) officially declared it this week, is spreading fast, with almost 45,000 cases and nearly 1,500 deaths in 112 countries outside China. Epidemiologists reckon Italy is one or two weeks ahead of places like Spain, France, America and Britain. Less-connected countries, such as Egypt and India, are further behind, but not much.

根据本周WHO官方数据表明,全球新冠肺炎疫情发展迅速,除中国外,112个国家和地区累计确诊45000例,累计死亡人数近1500例。流行病学专家预测, 只要1到2周,西班牙、法国、美国和英国的疫情就会发展成如今的意大利一样。而那些和意大利联系不紧密的国家,比如埃及和印度,疫情爆发的时间可能会稍晚点,但也不会太久。

Few of today’s political leaders have ever faced anything like a pandemic and its economic fallout—though some are evoking the financial crisis of 2007-09 (see next leader). As they belatedly realize that health systems will buckle and deaths mount, leaders are at last coming to terms with the fact that they will have to weather the storm. Three factors will determine how they cope: their attitude to uncertainty; the structure and competence of their health systems; and, above all, whether they are trusted.

全球疫情大爆发和经济衰落对于当今各国的领导人来说是一场少有的挑战,尽管他们中部分人应对过08年的金融危机。当医疗系统开始崩溃,死亡人数急剧增加时,这些领导人终于开始认识到这场疫情的严重性,采取措施应对疫情。三个因素决定这些领导人应对新冠疫情的效果:他们对待不确定性的态度,卫生健康治理体系和治理能力,最重要的是,这些领导人是否值得被继续信任。

The uncertainty has many sources. One is that sars-cov-2 and the disease it causes, covid-19, are not fully understood (see Briefing). Another is over the status of the pandemic. In each region or country it tends to proliferate rapidly undetected. By the time testing detects cases in one place it will be spreading in many others, as it was in Italy, Iran and South Korea. By the time governments shut schools and ban crowds they may be too late.

不确定性来自很多方面。首先就是我们没有彻底搞明白新冠病毒的起因和原理。还有就是新冠肺炎的传播速度。在每一个国家和地区都传播的很快。一旦在某地发现,它会迅速传播到其他地方,意大利、伊朗和韩国就是这种情况。而此时政府再去关闭学校和禁止公众聚集性活动就为时太晚。

China’s solution, endorsed by the WHO, was to impose a brutal quarantine, bolstered by mass-testing and contact tracing. That came at a high human and economic cost, but new infections have dwindled. Yet uncertainty persists even in China, because nobody knows if a second wave of infections will rise up as the quarantine eases.

世界卫生组织称赞说,中国通过大规模的检测和密切接触者追踪手段,有效的控制住了疫情,值得全球借鉴。中国政府投入大量人力物力防控疫情,最终取得了卓越的成效。当前中国要重点防范由于隔离放松带来的疫情“二次爆发”的风险。

In democracies leaders have to judge if people will tolerate China’s harsh regime of isolation and surveillance. Italy’s lockdown is largely self-policed and does not heavily infringe people’s rights. But if it proves leakier than China’s, it may be almost as expensive and a lot less effective (see International section).

西方国家的领导人必须要审视年轻人们是否可以严格遵守中国式隔离措施。意大利采取了大规模自我隔离措施,但如果没有像中国那样严格执行隔离政策,那么意大利只会付出巨大代价而收效甚微。

Efficacy also depends on the structure and competence of health-care systems. There is immense scope for mixed messages and inconsistent instructions about testing and when to stay isolated at home. Every health system will be overwhelmed. Places where people receive very little health care, including refugee camps and slums, will be the most vulnerable. But even the best-resourced hospitals in rich countries will struggle.

疫情防控效果取决于一个国家的卫生健康治理体系和治理能力。现在有大量混乱的疫情相关信息、前后不一致的新冠病毒测试效果和模糊的隔离政策。每一个国家的卫生系统都不堪重负。那些处于发展中国家身处贫民窟的人们因为得不到及时的救治而处于危险之中。就算是在发达国家,那些有着最好医疗资源的医院也在疫情压力下几临崩溃。

Universal systems like Britain’s National Health Service should find it easier to mobilize resources and adapt rules and practices than fragmented, private ones that have to worry about who pays whom and who is liable for what (see Britain section). The United States, despite its wealth and the excellence of its medical science, faces hurdles. Its private system is optimized for fee-paying treatments. America’s 28m uninsured people, 11m illegal immigrants and an unknown number without sick pay all have reasons to avoid testing or isolation. Red tape and cuts have fatally delayed adequate testing (see United States section).

有着全民医疗服务制度的英国相对于那些需要担心医疗费用由谁承担的私人医疗体系来说,更容易调动资源,根据实际情况调整规则来应对疫情。美国虽然有着巨大的财富和卓越的医疗水平,但依旧面临很多问题。美国的医疗体系是为那些付费病人服务的。而全美有2800万人没有医保,有1100万非法移民以及不计其数人没有带薪病假,这些人都会因为上述原因逃避检测或者隔离。而美国政府的官僚主义和开支裁减也会减缓疫情检测的速度。

Uncertainty will be a drag on the third factor—trust. Trust gives leaders license to take difficult decisions about quarantines and social-distancing, including school closures. In Iran the government, which has long been unpopular, is widely suspected of covering up deaths and cases. That is one reason rebellious clerics could refuse to shut shrines, even though they spread infection (see Middle East & Africa section).

不确定性会导致第三个方面-信任。各国领导人只有在得到公众信任后才能做出诸如大规模隔离、社会疏离,甚至是关闭学校等艰难的决定。伊朗的强硬派神职人员拒绝关闭库姆,尽管这座圣城是新冠肺炎严重感染地区。

Nothing stokes rumor and fear more than the suspicion that politicians are hiding the truth. When they downplay the threat in a misguided attempt to avoid panic, they end up sowing confusion and costing lives. Yet leaders have struggled to come to terms with the pandemic and how to talk about it. President Donald Trump, in particular, has veered from unfounded optimism to attacking his foes. This week he announced a 30-day ban on most travel from Europe that will do little to slow a disease which is already circulating in America. As people witness the death of friends and relatives, he will find that the pandemic cannot be palmed off as a conspiracy by foreigners, Democrats and CNN.

没有什么比对各国领导人正在掩盖疫情真相这件事情更能引发谣言和公众恐惧的。各国领导人为了避免民众的恐慌,试图轻描淡写新冠肺炎带来的威胁,但最终会以造成社会动荡和牺牲人民群众的生命为代价。然后各国领导人并不能正视新冠肺炎疫情,也不知道该如何应对它。特别是美国总统特朗普,开始从他那对待疫情毫无根据的“乐观”态度转向攻击他的敌人们。本周,特朗普政府宣布一项对除英国外所有欧洲国家实施的30天旅行禁令,这对减缓已经在美国爆发的疫情毫无帮助。当越来越多的美国人民见证亲友的死亡时,特朗普会发现他不能把这场疫情甩锅到外国政府、民主党人和CNN身上。

What should politicians do? Each country must strike its own balance between the benefits of tracking the disease and the invasion of privacy, but South Korea and China show the power of big data and mass-testing as a way of identifying cases and limiting their spread. Governments also need to anticipate the pandemic, because actions to slow its spread, such as banning crowds, are more effective if they are early.

那么各国政府应该怎么做呢?每一个国家都必须在追踪病患和侵犯公民隐私权之间找到平衡,中韩采用大数据技术和大规模测试来追踪病患,限制疫情进一步传播。各国政府甚至可以通过预测疫情发展趋势来实施防疫措施,像禁止公众聚集这类的措施越早实行,对防范疫情进一步传播非常有效。

The best example of how to respond is Singapore, which has had many fewer cases than expected. Thanks to an efficient bureaucracy in a single small territory, world-class universal health care and the well-learned lesson of SARS, an epidemic of a related virus in 2003, Singapore acted early. It has been able to make difficult trade-offs with public consent because its message has been consistent, science-based and trusted.

新加坡政府的防疫措施值得被表扬,该国的累计感染人数比预期的要少很多。新加坡在早期就采取了有效的防疫措施,这得益于其领土面积小、有着世界领先的医疗健康系统和从2003年非典防治中学习到的经验。新加坡的防疫措施之所以取得公众支持,得益于其持续、科学和真实的信息发布。

In the West covid-19 is a challenge to the generation of politicians who have taken power since the financial crisis. Many of them decry globalization and experts. They thrive on division and conflict. In some ways the pandemic will play to their agenda. Countries may follow America and turn inward and close their borders. In so far as shortages crimp the world economy, industries may pull back from globalization—though they would gain more protection by diversifying their supply chains.

新冠肺炎疫情对于自2008年上台的这一代西方国家领导人来说是一个巨大的挑战。这一代领导人大多数反对全球化。他们煽动分裂和冲突。某种程度上来说,新冠疫情可能会被他们政治化。以美国为首的部分国家可能会转向国内,关闭国境。因为疫情可能会造成全球经济短缺,部分工业企业可能会退出全球化,尽管他们中的大多数受益于全球化下的多元化供应链体系。

Yet the pandemic also puts doctors, scientists and policy experts once again at the heart of government. Pandemics are quintessentially global affairs. Countries need to work together on treatment protocols, therapeutics and, it is hoped, a vaccine. Worried voters may well have less of an appetite for the theatrical wrestling match of partisan politics. They need their governments to deal with the real problems they are facing—which is what politics should have been about all along.

新冠疫情让医生、科学家和政策专家们再次站到政府舞台中央。疫情防控是一件典型的全球事务。各国政府需要在治疗方案、治疗方法和疫苗开发方面共同努力。选民们对党派斗争并没有什么兴趣。他们需要的是政府实实在在来解决他们所面临的问题,这也是一直以来政治本该有的面貌。

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