为什么美国医护人员的口罩快耗尽了?
为什么美国医护人员的口罩快耗尽了?这个世界上最富有的国家怎么会看到自己陷入如此不幸且可以避免的境地?得到足够的防护器材将需要多长时间，如果现在还有这种可能的话?
I’ve spent the last few days digging into these questions, because the shortages of protective gear, particularly face masks, has struck me as one of the more disturbing absurdities in America’s response to this pandemic.
过去几天里，我一直在探究这些问题，因为防护器材的短缺，尤其是口罩的短缺，让我觉得这是美国应对新型冠状病毒疫情的众多荒谬之处当中最令人不安的一个。
Yes, it would have been nice to have had early, widespread testing for the coronavirus, the strategy South Korea used to contain its outbreak. It would be amazing if we can avoid running out of ventilators and hospital space, the catastrophe that has befallen parts of Italy. But neither matters much — in fact, no significant intervention is possible — if health care workers cannot even come into contact with coronavirus patients without getting sick themselves.
是的，如果尽早对新冠病毒做广泛检测的话，本来可以更好，韩国将疫情遏制住用的就是这个策略。如果我们能避免呼吸机和医院床位不够用的状况，本会令人欣慰，医院爆满是意大利部分地区正在发生的灾难。但是，如果医护人员根本不能在保护自己不生病的情况下接触新冠病毒感染者，上述问题就都不重要了，确切地说，在这种情况下，不可能对患者采取多少干预措施。
That’s where cheap, disposable face masks, eye protection, gloves and gowns come in. That we failed to procure enough safety gear for medical workers — not to mention for sick people and for the public, as some health experts might have recommended if masks were not in such low supply — seems astoundingly negligent.
这就是便宜的一次性口罩、护目镜、手套和防护服起作用的地方。我们没有为医护人员采购足够多的安全装备似乎是个惊人的疏忽，更不用说像一些卫生专家可能会建议的那样，如果口罩供应不是这么少的话，本应让患者和公众都戴上口罩。
What a small, shameful way for a strong nation to falter: For want of a 75-cent face mask, the kingdom was lost.
这么小的事情搞垮一个强大的国家让人多丢脸呀：因为缺少75美分一个的口罩，一个国家完蛋了。
I am sorry to say that digging into the mask shortage does little to assuage one’s sense of outrage. The answer to why we’re running out of protective gear involves a very American set of capitalist pathologies — the rise and inevitable lure of low-cost overseas manufacturing, and a strategic failure, at the national level and in the health care industry, to consider seriously the cascading vulnerabilities that flowed from the incentives to reduce costs.
我很遗憾地说，探究口罩短缺的问题丝毫不能平息人们的愤怒。我们为什么缺少防护器材这个问题，答案涉及一组非常美国的资本主义病态——海外低成本制造的兴起及其不可避免的吸引力，以及没有从国家层面和医疗卫生行业的角度认真考虑降低成本的动机所带来的一连串脆弱性的战略失败。
Perhaps the only way to address the shortfall now is to recognize that the market is broken, and to have the government step in to immediately spur global and domestic production. President Trump, bizarrely, has so far resisted ordering companies to produce more supplies and equipment. In the case of masks, manufacturers say they are moving mountains to ramp up production, and some large companies are donating millions of masks from their own reserves.
也许现在解决这种短缺的唯一方法是认识到市场已经崩溃，需要政府介入，立刻鼓励全球和国内生产这些东西。奇怪的是，特朗普总统迄今一直拒绝下令企业生产更多的器材和设备。就口罩而言，制造商们说，他们正在竭尽全力提高产量，一些大公司从自己的储备中捐献出来数百万个口罩。
But given the vast global need for masks — in the United States alone, fighting the coronavirus will consume 3.5 billion face masks, according to an estimate by the Department of Health and Human Services — corporate generosity will fall short. People in the mask business say it will take a few months, at a minimum, to significantly expand production.
但考虑到全球对口罩的巨大需求——据美国卫生与公众服务部(Department of Health and Human Services)估计，仅美国一个国家，在抗击新冠病毒的战斗中将消耗35亿个口罩——企业的慷慨不足以满足需求。口罩行业的人士说，至少需要几个月的时间才能显著扩大生产规模。
“We are at full capacity today, and increased production by building another factory or extending further will take anywhere between three to four months,” said Guillaume Laverdure, the chief operating officer of Medicom, a Canadian company that makes masks and other protective equipment in factories around the world.
“我们现在已经满负荷运转，通过再建一座工厂或进一步扩大产能来提高产量，将需要三到四个月的时间，”加拿大麦迪康(Medicom)的首席运营官纪尧姆·拉弗杜尔(Guillaume Laverdure)说，麦迪康在世界各地有生产口罩和其他防护器材的工厂。
And though some nontraditional manufacturers like T-shirt factories and other apparel makers have announced plans to rush-produce masks, it’s unclear that they will be able to meet required safety standards or shift over production in time to answer demand.
虽然一些非传统生产商，比如T恤衫工厂和其他服装生产商等，已经宣布了加急生产口罩的计划，但目前还不清楚它们能否达到所要求的安全标准，或能否及时转移生产以满足需求。
Few in the protective equipment industry are surprised by the shortages, because they’ve been predicted for years. In 2005, the George W. Bush administration called for the coordination of domestic production and stockpiling of protective gear in preparation for pandemic influenza. In 2006, Congress approved funds to add protective gear to a national strategic stockpile — among other things, the stockpile collected 52 million surgical face masks and 104 million N95 respirator masks.
在防护装备行业，很少有人对这种短缺感到惊讶，因为相关预测已经存在数年时间了。2005年，乔治·W·布什(George W. Bush)政府曾呼吁协调防护装备的国内生产和储备能力，以应对大流行性流感。2006年，美国国会批准了国家战略储备增购防护装备的资金，增加的库存中除其他装备外，还有5200万个医用口罩和1.04亿个N95口罩。
But about 100 million masks in the stockpile were deployed in 2009 in the fight against the H1N1 flu pandemic, and the government never bothered to replace them. This month, Alex Azar, secretary of health and human services, testified that there are only about 40 million masks in the stockpile — around 1 percent of the projected national need.
但2009年抗击H1N1流感大流行用掉了大约一亿个口罩的库存，而政府从未考虑过补充它们。本月，美国卫生与公众服务部部长亚历克斯·阿扎尔(Alex Azar)在国会作证说，库存中只有大约4000万个口罩，约为全国预计需求的1%。
As the coronavirus began to spread early this year, a global shortage of protective equipment began to look inevitable. But by then it was too late for the American government to do much about the problem. Two decades ago, most hospital protective gear was made domestically. But like much of the rest of the apparel and consumer products business, face mask manufacturing has since shifted nearly entirely overseas. “China is a producer of 80 percent of masks worldwide,” Laverdure said.
随着今年早些时候新型冠状病毒开始传播，防护装备的全球短缺问题看来不可避免。但美国政府在这个时候为解决短缺问题采取行动为时已晚。20年前，大多数医院用的防护装备都是美国国内生产的。但与服装和消费者产品等许多其他行业一样，口罩的生产已几乎全部转移到了海外。“中国生产全球80%的口罩，”拉弗杜尔说。
Hospitals began to run out of masks for the same reason that supermarkets ran out of toilet paper — because their “just-in-time” supply chains, which call for holding as little inventory as possible to meet demand, are built to optimize efficiency, not resiliency.
医院里口罩开始缺货的原因与超市里卫生纸缺货的原因一样，都是因为它们的“准时制”(just-in-time)供应链优化的是效率，而非韧性。这种做法要求用尽可能少的库存来满足需求。
“You’re talking about a commodity item,” said Michael J. Alkire, president of Premier, a company that purchases medical supplies for hospitals and health systems. In the supply chain, he said, “by definition, there’s not going to be a lot of redundancy, because everyone wants the low cost.”
“你说的是一种大宗商品，”为医院和卫生系统采购医疗用品的公司Premier的总裁迈克尔·J·阿尔凯尔(Michael J. Alkire)说。他说，这种商品的供应链“按照定义，不会有多少冗余，因为人们要的是低成本”。
In January, the brittle supply chain began to crack under pressure. To deal with its own outbreak, China began to restrict exports of protective equipment. Then other countries did as well — Germany, France and India took steps to stop exports of medical equipment. That left American hospitals to seek more and more masks from fewer and fewer producers.
今年1月，这个脆弱的供应链在压力下开始断裂。为了应对本国的疫情，中国开始限制防护装备出口。随后，其他国家也跟着这样做——德国、法国和印度都采取了停止医疗设备出口的措施。这使得美国的医院不得不从越来越少的生产商那里寻找越来越多的口罩。
People in the industry assured me they would prepare better next time. “We are laserlike focused to ensure that our health care systems are never in this scenario again,” Alkire told me. “There will be a lot more domestic manufacturing of these products going forward.”
业内人士向我保证，他们下次会准备得更好。“我们正在专心致志地确保我们的卫生保健系统不再出现这种情况，”阿尔凯尔对我说。“未来将有更多的此类产品在国内生产。”
I don’t doubt it — but that we did not plan, as a nation, for this entirely predictable shortage makes me wonder what other inevitable pothole is lurking out there for all to trip over. Getting enough protective gear was among the cheapest, most effective things we could have done to slow down the pandemic. That we failed on such an obvious thing reveals an alarming national incapacity to imagine and prepare for the worst.
我并不怀疑这点，但作为一个国家，我们没有计划应对这种完全可以预见的短缺，这让我想知道，前面的路上还有什么其他不可避免的坑洼会把所有的人绊倒。储备足够的防护装备是我们减缓新冠病毒大流行本来可以采取的最便宜、最有效的措施之一。我们在如此显而易见的事情上的失败，暴露了这个国家在做最坏的打算方面的骇人的无能。
We will get enough masks in time for the next disaster. But wouldn’t it be nice, for once, if we prepared for trouble before it hit us in the face?
我们会弄到足够多的口罩来应对下一次灾难。但如果我们能在危机出现之前就做好准备的话，那不是更好吗?
