听力课堂TED音频栏目主要包括TED演讲的音频MP3及中英双语文稿,供各位英语爱好者学习使用。本文主要内容为演讲MP3+双语文稿:对话比尔盖茨——这场疫情将如何影响未来?,希望你会喜欢!
【演讲者及介绍】Bill Gates
作为一个充满热情的技术迷,Bill Gates在引导微软成就举世瞩目的成功的同时也改变了世界。现在,他重操旧业,通过他的全球慈善事业努力减少各地的不平等。
【演讲主题】这场疫情将如何影响不远的未来
How the pandemic will shape the near future
【中英文字幕】
翻译者Grace Yang 校对者 Yolanda Zhang
[01:27.97]Chris Anderson: Welcome, Bill Gates. |克里斯·安德森(Chris Anderson): 欢迎,比尔·盖茨!
[01:30.70]Bill Gates: Thank you. |比尔·盖茨:谢谢。
[01:32.17]CA: Alright. It's great to have you here, Bill. |克里斯:好的, 欢迎你加入这场谈话,比尔。
[01:34.81]You know, we had a TED conversation about three months ago about this pandemic, and back then, fewer than 1,000 people in the US had died and fewer than 20,000 worldwide.| 大概三个月之前, 我们有过一次关于新冠病毒的对话。当时在美国只有不到1000人因为感染而死亡, 而全球的死亡人数还不到2万。
[01:44.97]I mean, the numbers now are, like, 128,000 dead in the US and more than half a million worldwide, in three months. |然而现在,死亡人数已经达到了12万8千人, 全球死亡人数超过了50万, 只用了短短三个月。
[01:52.91]What is your diagnosis of what is possible for the rest of this year? You look at a lot of models. What do you think best- and worst-case scenarios might be? |你对下半年的疫情有什么判断呢? 你了解了很多预测模型, 你觉得最坏和最好的情况是什么呢?
[02:04.95]BG: Well, the range of scenarios, sadly, is quite large, including that, as we get into the fall, we could have death rates that rival the worst of what we had in the April time period.| 比尔: 其实有非常多的可能性, 比如到了秋季的时候, 死亡率可能会比四月份最严重的时候还要高。
[02:18.94]If you get a lot of young people infected, eventually, they will infect old people again, and so you'll get into the nursing homes, the homeless shelters, the places where we've had a lot of our deaths. | 如果有许多年轻人感染了, 最终他们就会再把病毒传染给老年人, 所以在养老院里, 和流浪汉的收容所里, 死亡人数就会大大增加。
[02:32.15]The innovation track, which probably we'll touch on -- diagnostics, therapeutics, vaccines -- there's good progress there, but nothing that would fundamentally alter the fact that this fall in the United States could be quite bad, |在科技创新方面, 包括诊断、治疗、疫苗等, 都有了很大的进展, 但是这并不能改变一个事实, 那就是这个秋季美国的疫情可能会很严重,
[02:48.44]and that's worse than I would have expected a month ago, the degree to which we're back at high mobility, not wearing masks, and now the virus actually has gotten into a lot of cities that it hadn't been in before in a significant way, |并且比我上个月预测的还要严重。 因为我们逐步复工, 人们不戴口罩, 所以新冠病毒正在许多城市蔓延, 而这种传播速度是前所未有的,
[03:07.13]so it's going to be a challenge. | 所以这将是一个挑战。
[03:10.31]There's no case where we get much below the current death rate, which is about 500 deaths a day, but there's a significant risk we'd go back up to the even 2,000 a day that we had before, because we don't have the distancing, the behavior change, to the degree that we had in April and May. |让死亡率降低到每天500人以下是不太可能的。 但是二次爆发的几率却很大, 死亡率甚至会攀升到一天2000人, 这都是因为我们没有保持社交距离, 没有像四五月份的时候那样居家隔离。
[03:33.81]And we know this virus is somewhat seasonal, so that the force of infection, both through temperature, humidity, more time indoors, will be worse as we get into the fall. |并且我们知道,这个病毒在一定程度上是季节性的, 所以包括温度、湿度、 更多的室内活动等影响, 会导致感染率在秋季有所增长。
[03:46.21]CA: So there are scenarios where in the US, like, if you extrapolate those numbers forward, we end up with, what, more than a quarter of a million deaths, perchance, even this year if we're not careful, |克里斯:所以如果按照这个增长速度推断美国的疫情情况, 到最后, 如果我们没有控制好, 仅在今年就会有超过25万人死亡。
[03:56.44]and worldwide, I guess the death toll could, by the end of the year, be well into the millions, with an "s." | 而到了今年年底, 全球会有超过百万人死亡。
[04:03.14]Is there evidence that the hotter temperatures of the summer actually have been helping us? |有没有证据表明高温其实会帮助我们抑制病毒?
[04:10.38]BG: They're not absolutely sure, but certainly, the IHME model definitely wanted to use the season, including temperature and humidity, to try and explain why May wasn't worse than it was. |比尔:这个我们还不能确定, 但是健康指标和评估研究所(IHME) 确实曾尝试用环境因素, 像温度和湿度, 来解释为什么五月的疫情并没有之前那么严重。
[04:25.38]And so as we came out and the mobility numbers got higher, the models expected more infections and deaths to come out of that, "|当我们开始出行, 这个模型显示, 感染和死亡人数也会增加。
[04:36.35]And we see in the Southern Hemisphere, you know, Brazil, which is the opposite season, now all of South America is having a huge epidemic. South Africa is having a very fast-growing epidemic. |并且我们也观察到,在南半球, 像巴西, 那里目前是冬季, 现在所有的南美洲国家都已经有了大规模的传染。 病毒也在南非迅速传播。
[04:54.10]Fortunately, Australia and New Zealand, the last countries in the Southern Hemisphere, are at really tiny case counts, and so although they have to keep knocking it down, they're talking about, "Oh, we have 10 cases, that's a big deal, let's go get rid of that." |幸运的是,澳大利亚和新西兰是仅有的几个没有很多确诊人数的南半球国家。 即使他们在很努力地防疫, 也仍然会说, “我们又确诊了10例, 这可不是个小数目, 我们得严格防控。”
[05:09.15]So they're one of these amazing countries that got the numbers so low that test, quarantine and trace is working to get them, keep them at very near zero. |所以他们才成为了能把确诊人数降到最低的那几个国家。 这些测试、隔离和追踪 都能帮助他们把感染人数降到接近 0。
[05:22.58]CA: Aided perhaps a bit by being easier to isolate and by less density, less population density. But nonetheless, smart policies down there. |克里斯: 更方便的隔离促使和更低的人口密度可能会帮助他们控制疫情。 当然还有明智的政策。
[05:31.49]BG: Yeah, everything is so exponential that a little bit of good work goes a long way. It's not a linear game. |比尔:是的, 所有数字都在飞快增长, 一点点努力都会有很大的帮助。 这不是一个简单的局面。
[05:38.71]You know, contact tracing, if you have the number of cases we have in the US, it's super important to do, but it won't get you back down to zero. |拿美国的确诊人数来说, 追踪接触者是尤其重要的, 但这并不会直接把感染率降到 0。
[05:47.82]It'll help you be down, but it's too overwhelming. |只是会把确诊人数降低一点, 但目前确诊人数实在是太多了。
[05:52.63]CA: OK, so in May and June in the US, the numbers were slightly better than some of the models predicted, and it's hypothesized that that might be partly because of the warmer weather. |克里斯:在五六月份的时候, 美国的确诊人数 比预估的要好一些, 这有可能是因为天气转暖。
[06:02.37]Now we're seeing, really, would you describe it as really quite alarming upticks in case rates in the US? |你会把我们现在所看到的局面当作一个爆发的预警吗?
[06:11.20]BG: That's right, it's -- In, say, the New York area, the cases continue to go down somewhat, but in other parts of the country, primarily the South right now, you have increases that are offsetting that, and you have testing-positive rates in young people that are actually higher than what we saw even in some of the tougher areas. |比尔:是的, 比如像纽约地区, 确诊人数在持续下降。但是在其他地方, 比如美国南部, 确诊人数在持续增加。 并且年轻人的确诊率甚至要比一些疫情严重的地区还要高。
[06:37.13]And so, clearly, younger people have come out of mobility more than older people have increased their mobility, so the age structure is right now very young, but because of multigenerational households, people work in nursing care homes, |很明显,年轻人开始外出活动, 并且比老年人外出频率要高, 所以现在感染的主要人群是年轻人。 但是有的家里有不同年龄的人, 有人在养老院工作,
[06:55.70]unfortunately, that will work its way back, both the time lag and the transmission, back up into the elderly, will start to push the death rate back up, which, it is down -- way down from 2,000 to around 500 right now. |不幸的是, 这些人都很容易被感染。 而这样就会导致很多老年人确诊。 所以死亡率就会开始增长。 而现在的死亡率已经从每天2000人降低到差不多500人了。
[07:13.33]CA: And is that partly because there's a three-week lag between case numbers and fatality numbers? |克里斯:这是不是因为在确诊人数和死亡人数中有三个星期的时间差?
[07:19.25]And also, perhaps, partly because there have been some effective interventions, and we're actually seeing the possibility that the overall fatality rate is actually falling a bit now that we've gained some extra knowledge? |也有可能是因为一些有效的防护让死亡率下降了一点点, 并且我们对病毒了解更多了?
[07:32.01]BG: Yeah, certainly your fatality rate is always lower when you're not overloaded. And so Italy, when they were overloaded, Spain, even New York at the start, certainly China, there you weren't even able to provide the basics, the oxygen and things. |比尔:是的,如果医院没有超负荷运转的话, 死亡率一定会低一些。 当意大利的医院超负荷的时候, 还有西班牙, 甚至是纽约初期的时候, 还有中国, 医院甚至都不能提供基本的医疗设施, 像氧气等等。
[07:52.49]A study that our foundation funded in the UK found the only thing other than remdesivir that is a proven therapeutic, which is the dexamethasone, that for serious patients, is about a 20 percent death reduction, and there's still quite a pipeline of those things. | 我们在英国的基金会发现, 除了瑞德西韦, 唯一被证明有一定疗效的就是地塞米松, 而且是给重症病人用的。 这个药会减少大概百分之二十的死亡率。 所以这些药物的需求也很大。
[08:14.83]You know, hydroxychloroquine never established positive data, so that's pretty much done. There's still a few trials ongoing. |现在没有数据证明羟化氯喹有效, 所以这个试验基本上就不会再进行了。 现在还有少数几个实验在进行。
[08:22.87]And so when you talk about death rates, the good news is, some innovation we already have, and we'll have more, even in the fall. We should start to have monoclonal antibodies, which is the single therapeutic that I'm most excited about. | 所以说到死亡率, 好消息是我们已经取得了一定的进展, 并且在秋季的时候会有更多进展, 到时候我们应该会有单克隆抗体, 这是我最期待的疗法。
[08:41.01]CA: Just putting the pieces together on death rates: so in a well-functioning health system, so take the US when places aren't overcrowded, what do you think the current fatality numbers are, approximately, going forward, like as a percentage of total cases? Are we below one percent, perhaps? |克里斯:其实我想让你再详细地说说关于死亡率的问题。 在一个正常运转的医疗系统里, 像是在美国,如果没有那么多人的话, 现在的死亡率大概会是全部确诊人数的1%? 你是怎么想的? 会低于百分之一吗?
[09:00.44]BG: If you found every case, yes, you're well below one percent. People argue, you know, 0.4, 0.5. By the time you bring in the never symptomatics, it probably is below 0.5, and that's good news. |比尔:如果你把每一个 病例都统计上,是的。 死亡率会低于1%。 有的人会说 0.4%,0.5%。 当你把无症状感染者也计入考量的话, 死亡率就会低于0.5%, 这是个好消息。
[09:17.82]This disease could have been a five-percent disease. The transmission dynamics of this disease are more difficult than even the experts predicted. |新冠病毒本可能是一个 死亡率5%的病毒。 这个病毒的传播性比许多专家预料的还要强。
[09:31.44]The amount of presymptomatic and never symptomatic spread and the fact that it's not coughing, where you would kind of notice, "Hey, I'm coughing" -- most respiratory diseases make you cough. |无症状和轻度症状感染者也会传染很多人, 因为他们不咳嗽, 完全没有任何预兆, 但许多的呼吸道疾病都有咳嗽的症状。
[09:43.70]This one, in its early stages, it's not coughing, it's singing, laughing, talking, actually, still, particularly for the super-spreaders, people with very high viral loads, causes that spread, and that's pretty novel, and so even the experts have to say, "Wow, this caught us by surprise." |在潜伏期, 新冠感染者是不会咳嗽的, 还能正常唱歌、大笑、说话。 尤其是这些超级传染者, 携带很多病毒的人, 造成的传播这是比较惊人的。 所以专家们也不得不承认。 “哇,这是我们没有预料到的。”
[10:02.70]The amount of asymptomatic spread and the fact that there's not a coughing element is not a major piece like the flu or TB. |因为无症状感染者的高传播率和没有咳嗽等症状, 所以这和普通流感或者肺结核并不太一样。
[10:10.57]CA: Yeah, that is devilish cunning by the virus. |克里斯:是的,这就是新冠病毒的狡猾之处。
[10:14.19]I mean, how much is that nonsymptomatic transmission as a percentage of total transmission? I've heard numbers it could be as much as half of all transmissions are basically presymptomatic. | 我想知道无症状感染者的传播率占总传播率的多少呢? 我听说仅仅轻症状感染者就占了一半的传播率。
[10:26.71]BG: Yeah, if you count presymptomatics, then most of the studies show that's like at 40 percent, and we also have never symptomatics. The amount of virus you get in your upper respiratory area is somewhat disconnected. |比尔:是的,如果你考虑轻症状和无症状感染者, 那么大部分的研究都会表明, 他们的传染率大概占百分之四十左右。 在上呼吸道的病毒跟下呼吸道是没有关联的。
[10:41.63]Some people will have a lot here and very little in their lungs, and what you get in your lungs causes the really bad symptoms -- and other organs, but mostly the lungs -- and so that's when you seek treatment. |有些人的上呼吸道感染很严重, 但肺部却不太受影响。 而在肺部里的病毒会让你感到非常的不适, 其他器官也会,但主要是肺部。 所以你就会去医院寻求治疗。
[10:54.71]And so the worst case in terms of spreading is somebody who's got a lot in the upper respiratory tract but almost none in their lungs, so they're not care-seeking. |传染方面最坏的情形, 就是那些上呼吸道感染较重的人, 但是肺部基本上没有感染, 所以他们就不会去医院。
[11:05.45]CA: Right. And so if you add in the never symptomatic to the presymptomatic, do you get above 50 percent of the transmission is actually from nonsymptomatic people? |克里斯:是的。 如果把所有的无症状感染者都计入轻症状感染者里, 会有超过50%的传染率来自无症状感染者吗?
[11:16.52]BG: Yeah, transmission is harder to measure. You know, we see certain hotspots and things, but that's a huge question with the vaccine: Will it, besides avoiding you getting sick, which is what the trial will test, will it also stop you from being a transmitter? |比尔:是的,传染率其实更难评估。 我们已经看到一些爆发地, 所以对疫苗还有很大的疑问: 除了自己做好防护, 实验要证明的就是疫苗会不会防止你传染给别人?
[11:35.99]CA: And maybe, Bill, use this as a moment to just talk about where the quest for the vaccine is and what are just some of the key things we should all be thinking about as we track the news on this. |克里斯:比尔,正好可以借这个机会跟我们说说疫苗实验进行到哪个阶段了, 以及我们在关注新闻时, 我们应该想到哪些问题。
[11:47.65]BG: There's three vaccines that are, if they work, are the earliest: the Moderna; then you have the AstraZeneca, which comes from Oxford; and the Johnson and Johnson. |比尔:目前有三种疫苗, 如果的确有效的话, 那就是最早的几个了: Moderna,然后还有牛津的阿斯利康(AstraZeneca), 最后是强生。
[11:59.84]Those are the three early ones. And we have animal data that looks potentially good but not definitive, particularly will it work in the elderly, and we'll have human data over the next several months.|这是最早的几个疫苗。 我们还有动物实验的数据, 虽然看起来很好,但还不能百分百确定是否可靠。 尤其是对老年人有没有效; 在接下来的几个月里我们也会有人体实验数据。
[12:14.51]Those three will be gated by the safety and efficacy trial. That is, we'll be able to manufacture those, although not as much as we want. We'll be able to manufacture those before the end of the year. |这三个疫苗都会通过安全性和药效试验。 虽然不能百分百满足我们的需求, 但是我们也会尽量大规模生产。 今年年底之前, 我们就可以大规模生产了。
[12:27.40]Whether the Phase 3 will succeed and whether it'll complete before the end of the year, I wouldn't be that optimistic about. Phase 3 is where you need to really look at all the safety profile and efficacy, but those will get started. | 无论第三阶段是否能成功, 无论今年年底能不能完成实验, 我都不抱太大希望。 在第三阶段会测试安全性和药效, 这些实验也会逐渐开始。
[12:43.11]And then there's four or five vaccines that use different approaches that are maybe three or four months behind that: Novavax, Sanofi, Merck. And so we're funding factory capacity for a lot of these -- some complex negotiations are taking place right now on this -- to get factories that will be dedicated to the poorer countries, what's called low- and middle-income. |之后三到四个月, 可能会有四到五个不同种类的疫苗出现: 诺瓦瓦克斯(Novavax), 赛诺菲(Sanofi),默克(Merck)。 我们为很多这类疫苗都投入了资金以支持大规模生产—— 目前还在进行一些复杂的讨论—— 为了让这些工厂为贫穷的国家生产, 也就是所谓的中低收入国家的国家。
[13:13.09]And the very scalable constructs that include AstraZeneca and Johnson and Johnson, we'll focus on those, the ones that are inexpensive and you can build a single factory to make 600 million doses. | 那些能大规模生产的工厂, 像是阿斯利康和强生, 我们会关注那些低成本的疫苗, 这样一个工厂可以生产6亿支疫苗。
[13:27.19]So a number of the vaccine constructs are potential. I don't see anything before the end of the year. That's really the best case. |疫苗的大批量生产是可行的, 但是我觉得在今年年底还不太可能实现。 这已经是最好的情况了。
[13:38.92]CA: Bill, is it the case that if you and your foundation weren't in the picture here that market dynamics would likely lead to a situation where, as soon as a promising vaccine candidate emerged, the richer countries would basically snap up, gobble up all available initial supply, |克里斯:比尔, 如果你和你的基金会并没有参与其中, 市场形势会不会因此而改变? 比如,一旦有效的疫苗可以投入生产, 富有的国家就会蜂拥而至, 抢夺最初的少量产品
[13:55.99]but that what, effectively, you're doing by giving manufacturing guarantees and capability to some of these candidates, you're making it possible that at least some of the early vaccine units will go to poorer countries? Is that correct? |但是你现在为很多候选疫苗保证了工厂的产量, 你也在想办法让那些贫穷的国家能够分到一些疫苗, 是这样吧?
[14:11.82]BG: Well, it's not just us, but yes, we're in the central role there, along with a group we created called CEPI, Coalition for Epidemic Preparedness, and the European leaders agree with this. |比尔:并不只有我们,不过没错。 我们处在中心的位置, 和另外一个组织合作建立了CEPI, 即联合流行病预备中心, 欧洲的领导者们也表示了赞同。
[14:27.10]Now we have the expertise to look at each of the constructs and say, "OK, where is there a factory in the world that has capacity that can build that? Which one should we put the early money into? What should the milestones be where we'll shift the money over to a different one?" |现在有专家去一一查看每一个疫苗, 然后评估,“在哪有能力生产 这样的疫苗的工厂呢?” 我们该怎么分配这笔初始资金? 我们可以把钱投资到其他地方的时间点是什么?”
[14:41.97]Because the kind of private sector people who really understand that stuff, some of them work for us, and we're a trusted party on these things, we get to coordinate a lot of it, particularly that manufacturing piece. | 私营部门里这方面的一些专家也在为我们工作。 我们在疫苗方面是有一定权威的, 有能力协调资源和生产。
[14:59.32]Usually, you'd expect the US to think of this as a global problem and be involved. So far, no activity on that front has taken place. |通常情况下,美国会把这当作一个国际问题, 并且参与其中。 不过目前为止, 政府对此还没有任何举动。
[15:11.31]I am talking to people in the Congress and the Administration about when the next relief bill comes along that maybe one percent of that could go for the tools to help the entire world. |我在跟国会和行政部的人讨论, 等下一波救助金发放的时候, 是不是可以用这笔钱中的百分之一来帮助全世界。
[15:26.29]And so it's possible, but it's unfortunate, and the vacuum here, the world is not that used to, and a lot of people are stepping in, including our foundation, to try and have a strategy, including for the poorer countries, who will suffer a high percentage of the deaths and negative effects, including their health systems being overwhelmed. |这是有可能的。 但是很遗憾, 这个方案还不成熟, 世界还没有就此达成共识。 很多人都在参与, 包括我们的基金会, 尝试找到一种新的策略, 包括针对贫穷国家的策略, 这些国家的死亡率和受到的冲击程度比较高, 它们的医疗系统都在超负荷运转。
[15:52.62]Most of the deaths will be in developing countries, despite the huge deaths we've seen in Europe and the US. |除了在欧洲和美国有这么高的死亡率, 大部分的死亡病例都出现在发展中国家。
[15:59.14]CA: I mean, I wish I could be a fly on the wall and hearing you and Melinda talk about this, because of all of the ethical ... "crimes," let's say, executed by leaders who should know better, |克里斯:我希望自己能够偷听你和梅琳达是怎么说的。 因为这些领导人知道的更多, 而他们犯下的“罪行”,
[16:13.26]I mean, it's one thing to not model mask-wearing, but to not play a role in helping the world when faced with a common enemy, respond as one humanity, and instead ... you know, catalyze a really unseemly scramble between nations to fight for vaccines, for example. |就这么说吧, 当我们有一个共同的敌人的时候, 不戴口罩就是抛弃了整个世界。 我们应该一起抗疫, 而不是在不同国家之间挑起冲突, 比如哄抢疫苗。
[16:37.28]That just seems -- surely, history is going to judge that harshly. That is just sickening. Isn't it? Am I missing something? |当然,历史会证明一切, 这简直让人忍无可忍。 对吧?我没漏掉什么吧?
[16:48.65]BG: Well, it's not quite as black-and-white as that. The US has put more money out to fund the basic research on these vaccines than any country by far, and that research is not restricted. |比尔:事情并不是这么简单的。 到现在为止, 美国比任何一个国家都投入了更多的资金 来研究疫苗。 而这个研究并不是限制性的。
[17:04.99]There's not, like, some royalty that says, "Hey, if you take our money, you have to pay the US a royalty." They do, to the degree they fund research, it's for everybody. To the degree they fund factories, it's just for the US. |这并不是说, “如果你拿了我们的钱, 你就得给美国付使用费。” 他们确实给基金会投入了很多钱, 但是为了所有人的利益。 但是目前他们只投资了美国的工厂。
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