流行病：如何预防流感大爆发（2020）

Sir, this one is expected H1N1.
先生 这应该是H1N1
So fast?
这么快？
There has been an alarming rise in the swine flu
今年在印度 猪流感 或是说H1N1病例数量
or H1N1 cases in India this year.
急剧增加 令人担忧
The situation is turning rather serious with the fatalities increasing by the day.
随着死亡人数逐日增加 情况也变得相当严重
The North Indian State of Rajasthan has been worst hit by the H1N1 virus.
印度北部的拉贾斯坦邦 遭遇了最严重的H1N1病毒袭击
（迪内什维杰医生是胸腔内科医生）
（正在与拉贾斯坦邦日渐增长的 流感病例数量战斗）
-Negative. It's negative. -But, look.
-阴性 是阴性 -但是 听我说
The shadow is still here.
阴影依然还在
And there are some light ones here.
这里还有亮一些的
Let us see how you feel without oxygen.
让我们看看没有氧气你是什么感觉
Should we continue with Tamiflu?
继续用达菲吗？
It's day six today, right? Give it for one more day.
今天已经是第六天了 对吧？ 再试一天吧
Tamiflu, stop after seven days.
达菲 满七天后停药
We will stop it tomorrow.
明天就停用
（桑拓巴杜拉布吉纪念医院 是拉贾斯坦邦首府斋浦尔）
（最大的私立医院）
Swine flu is a very rapidly progressing disease. Very rapidly.
猪流感发病非常迅速
In just a few days, it can affect both of the lungs,
只需要几天就能影响两侧肺部
and it is a life-threatening disease.
能够威胁生命
Common flu.
一般的流感
All patients came with throat pain, sneezing, fever, body ache.
病人的症状是喉咙痛、打喷嚏 发烧和身体疼痛
But a patient who has nausea, vomiting, along with breathlessness,
但如果症状是恶心呕吐 还伴随呼吸急促
and he says "troublesome cough,"
还有“烦人的咳嗽”
always think "swine flu."
十有八♥九♥就是得了“猪流感”
Always think swine flu.
十有八♥九♥就是这种情况
（印度官方所称的“猪流感” 指的是一种季节性流感毒株）
（而在其他地方 指的是H1N1）
Breathe normally.
正常呼吸
If it's not diagnosed properly at an early stage,
如果在早期阶段未能正确诊断
it is difficult to treat.
就会很难治疗
（妮莎德维在被诊断出有流感之后）
（从斋浦尔32公里之外的 乔穆镇的小医院转院过来）
The problem is, when she came here, she had 60%-70% saturation.
问题在于她来的时候 饱和度已经是60%-70%了
If she had been on the road, she would've died.
如果她上了路 是会死的
That is the fact.
这就是事实
We will shift to the ICU. Then treatment will start.
我们会转进重症监护室 然后开始治疗
The later they come, the more laborious it gets to breathe,
来得越晚 呼吸就越困难
and it becomes a matter of life or death.
就会变得生死攸关
（越南高禄县）
Biggest challenge with flu
面对流感时的最大挑战
is not being lulled into acceptance of seasonal flu
就是不要麻痹大意
as all we have to worry about.
觉得只需担心季节性流感
Because every once in a while, there is a variant of flu that emerges
因为每隔一段时间 就会出现能够威胁到…
that poses an existential threat to us as a species.
人类物种生存的新流感变种
We go back to 1918...
我们回到1918年
and, you know, that flu profoundly impacted this Earth.
那次流感爆发深刻影响了这个星球
It emerged at the very end of World War I.
病毒最初出现于一战的末期
Soldiers returning home from battle helped spread the virus around the world.
从战场归家的士兵 把病毒散播到了全世界
We ended up seeing a global event very rapidly,
我们最终看到了 一场传播迅速的全球疫情
even at a time when population movements were a fraction of what they are today.
尽管那时的人口流动 和现今相比都不值一提
Far more people died in the 18-month period of that flu
在为期18个月的疫情期间
than died in all of World War I and World War II.
死于流感的人数超过了 两次世界大战的死亡总人数
Somewhere in the order of 50 to 100 million deaths.
大约是五千万到一亿人
In 1918, there were 1.8 billion people on the planet Earth.
在1918年 全球人口数量是18亿
Today, there are 7.8 billion people.
而现今 这个数字是78亿
If a similar virus emerged today, the result would be not 50 to 100,
如果现在出现类似的病毒 那结果就不是五千万到一亿了
but hundreds of millions of people that would likely die.
而是可能会死亡数亿人
And it's a guarantee that another version
而这种致命流感的另一个版本
of that killer flu will reappear.
是肯定会出现的
We don't know when,
我们不知会是何时
but we should always presume it can be... soon.
但我们应该要假设 这可能会很快
When it comes to a pandemic, there are many unknowns.
谈及流行病时 有太多未知因素
It's about the societal disruption.
这关系到社会混乱
The thing that will immediately be threatened
立即就会被威胁到的
is continuity of health services.
就是卫生服务的连续性
But also, you'll have severe issues with normal infrastructure operating.
此外 普通基础设施的运营 也会面临严重问题
Electricity is dependent on power plants
电力要依靠发电厂
and power plants are dependent on a work force.
而发电厂要依靠劳动力
That work force becomes ill, then you have huge vulnerabilities.
当劳动力病倒时 就会出现巨大的漏洞
What are urban areas going to do
如果食物供应遭遇…
after a couple of weeks of disruptive impact on food supplies?
数周的破坏性影响 城市区域将会如何？
You'll not only have people dying from an influenza virus,
到时人们不止会死于流感病毒
they'll be dying from what are preventable deaths today.
也会死于一些如今可预防的死因
It will leave its mark.
病毒会留下印迹
That's why I do what I do.
所以我才会做这份工作
If we catch it early enough, we may be able to save millions of lives.
如果能及时截获病毒 我们或许能拯救数百万的生命
But it's an uphill battle
但这是艰苦的斗争
because there are so many opportunities for emergence,
因为病毒出现的机会太多
and our resources for early detection are limited.
而我们用于早期侦测的资源很有限
（第三章 答案就在年轻与大胆中）
All right, good morning, everybody.
好了 各位早上好
We'll go ahead and get started with roll call.
我们开始进行点名
As always, one person from each facility can just state that they are on.
一如既往 每家机构可以有一个人 来说明他们的情况
（美国纽约州纽约市）
We started this weekly system-wide seasonal flu activation call
我们开始和系统内所有医院
with all hospitals that we have across the system,
进行全系统季节性流感电♥话♥会议
and the whole purpose of it is really, as we progress with seasonal flu,
会议目的就是在处理季节性流感时
they let us know any impact that they're having.
让他们告知我们所受到的影响
Influenza activity is categorized as widespread.
流感活动被归类为广泛传播类型
This is the actual first week
据报 本周是
that widespread activity has been reported.
疫情广泛传播的第一周
Last year's flu season
去年的流感季
was one of the worst that we've had in decades.
是数十年来最糟糕的情况之一
A record-breaking number of hospitalizations and deaths.
住院和死亡人数都创了新高
Bellevue, any changes to your current status?
贝尔维尤 目前状态有变化吗？
No changes from the current status.
目前状态无变化
Great. Thank you. Coney Island, any changes?
很好 谢谢?科尼艾兰 有变化吗？
No changes.
没有变化
Great. Thank you.
很好 谢谢
We started seeing impacts to staffing. We started seeing impacts to flu supplies.
我们开始看到人员配备受到影响 开始看到流感物资受到影响
There were shortages of Tamiflu,
达菲出现缺货
so much so that folks were coming back to the emergency department
以致于有人回到急诊科
asking for their children to be admitted, because they couldn't get this medication.
请求收治他们的孩子 因为他们买♥♥不到药
-Queens, any changes? -No changes.
-皇后区 有变化吗？ -没有变化
Thank you.
谢谢
So we activated an emergency operation center
所以我们激活了一个紧急运营中心
to really get a bird's-eye view of what's happening system-wide
来鸟瞰全系统的情况
and where we can provide the resources and expertise that's needed.
搞清楚能向哪里提供 所需的资源和专业技术
And Woodhull, any changes?
伍德哈尔 有变化吗？
Yes. We have four patients on droplet precautions as of Monday
是的 截止至周一 我们有四位病人 采取了飞沫传染防护措施
and seven positive flu tests.
有七人被检测出流感阳性
All right. Excellent. Well, thank you all so much for joining.
好的 非常好 多谢各位参会
We appreciate it and we will see you next week.
非常感谢 我们下周见
Take care, everybody.
各位保重
Part of emergency management is, you know,
应急管理也就意味着
you're not just at the facilities, but just for me also worldwide.
不止要处理设施内的事务 我还要处理全球事务
Sometimes when I wake up in the morning and I see 20 different emails,
有时早上起来后 我会看到20封不同的邮件
not just internally but also externally,
不止有内部的 也有外部的
I'm getting alerts of what's happening. I just try to stay on top of it.
我会收到新情况的警报 我只是试图保持掌控
I'm gonna pull up her info so that...
我会调出她的信息 从而…
On any given day, it's meetings back-to-back.
每一天都是连续不断在开会
First, thank you all so much for meeting with us,
首先 感谢各位和我们见面
and then obviously, for this collaboration...
显然 为了这次合作…
I typically start, you know, 8:30 or so...
我通常差不多从八点半开始
If this was a real world event, what are some crisis standards...
如果这是真实事件 那么一些危机标准…
...and then go on for the duration of the day.
然后就工作一整天
You wanna call the Department of Health.
你要联♥系♥卫♥生♥部♥
They will walk you through the case definition and they will...
他们会向你介绍诊断标准
This isn't Atlanta. Anyone email back from CDC yet?
这不是亚特兰大 疾控中心回复邮件了吗？
This is Syra.
我是赛拉
A good chunk of my work is actually done at night,
我很大部分的工作 实际是在晚上完成的
so it's not surprising at all
所以如果你在晚上11或12点
if you get an email from me, like, 11:00, 12:00 at night.
收到我的邮件 这也不足为奇
-Thank you so much. -Thank you for coming.