为什么大流行病不断出现?

2月26日Bloomberg（彭博社）播出了一个短片：Why Do Pandemics Keep Happening? 该片从文化和社会角度进行了深入分析，认为大流行病不断出现的原因或许是畜牧业工业化、气候变化和城市化。视频下方是中英文对照文本，由医学英语角听写并翻译。

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The disease has already claimed more victims than Legionnaires’ disease and toxic shock syndrome combined.

这种疾病夺去了更多受害者的生命，超过军团病和中毒性休克综合征的总和。

This is the deadliest outbreak of Ebola on record. There are a lot of experts around the world who do not yet know how contagious this is, how deadly this new virus is.

这是有记录以来最致命的埃博拉疫情。世界上有很多专家还不知道这种病的传染性有多强，这种新病毒有多致命。

Here in the U.S. Panic is increasing around the world about the pandemic. As the disease spreads to North America, the consequences are multiplying.

这里是美国。全世界对大流行的恐慌正在加剧。随着疾病蔓延到北美，影响加剧。

The World Health Organization has declared a swine flu pandemic.

世界卫生组织已经宣布爆发猪流感疫情。

Is the world ready for the coronavirus?

世界做好准备应对冠状病毒了吗？

Cholera, bubonic plague, smallpox, and influenza, are some of the most deadly diseases in human history. And when they spread across regions of the world, an epidemic becomes a pandemic and it can result in more deaths than wars and natural disasters.

霍乱、黑死病、天花和流感，是一些人类历史上最致命的疾病。当它们扩散到世界各地时，传染病成为大疫情，会带来比战争和自然灾害更多的死亡。

A good example of that is the 1918-1919 influenza pandemic, which took place just as the First World War was ending. Some historians believe that up to 100 million people died. In other words, many more people than died in the war itself.

一个典型的例子就是1918-1919年的流感大爆发，发生在第一次世界大战结束的时候。一些历史学家认为有多达1亿人死亡。换句话说，比死于战争本身的人还多。

And when a newly identified coronavirus emerged in China in late 2019, governments reacted like they had in the past: with quarantines and travel bans, while researchers raced to create a vaccine.

当新型冠状病毒于2019年底在中国出现时，政府的反应和过去一样：实施隔离和旅行禁令，研究人员竞相研制疫苗。

We tend to think about managing an epidemic episode like this in terms of public health or science. But in fact, what I would argue is at the root of many of the issues here are sort of social, cultural, political issues, practices, how people live, working environments, how people travel, why they live in cities.

我们倾向于从公共卫生或科学的角度来考虑如何应对这样的流行病。但事实上，我认为这里很多问题的根源是社会、文化和政治问题，是人类实践、人们如何生活、工作环境、人们如何旅行、为什么他们住在城市里。

In 1980 some predicted that science would overcome epidemics. That was the year the World Health Organization declared one of the biggest killers in human history was eradicated: smallpox. In its 3,000-year existence, this one disease killed an estimated 300 million people worldwide. The global vaccination program had prevailed and many virologists at the time were declaring an end to infectious diseases.

在1980年，有人预言科学将战胜流行病。那一年世界卫生组织宣布，人类历史上最大的杀手之一天花被根除。在天花存在的3,000年里，估计全世界有3亿人死于这种疾病。全球疫苗接种计划取得了成功，当时许多病毒学家都在宣告传染病的终结。

That’s a sort of shining example, right, of a great optimism that human societies could actually put an end to disease. At the time that smallpox was being eradicated was precisely the time that other emerging infectious diseases like Ebola were coming onto the scene.

这是一个过于乐观主义的经典例子，认为人类社会实际上可以终结疾病。天花被根除的时候，正是埃博拉等其它新传染病出现的时候。

Smallpox is still the only human disease to be eradicated. And more have been popping up, making the jump from animals to humans.

天花仍然是唯一被根除的人类疾病。越来越多的传染病出现了，从动物传到人类。

When people started to settle and cities developed about 10,000 years ago, our relationship with animals also changed and spillovers took place. Like smallpox, measles, tuberculosis, influenza, et cetera, originated in animal populations. And obviously, that was a very big change from hunter-gatherers where there wasn’t a possibility of diseases to be sustained in large populations.

大约一万年前，人类开始定居，城市开始发展，我们与动物的关系也发生了变化，并且产生了溢出效应。天花、麻疹、肺结核、流感等疾病发源于动物种群。显然，这和狩猎采集时期相比有很大的变化，那时不可能有疾病在大的种群中持续。

Diseases that are able to live between species like SARS, make it nearly impossible to eradicate. And that’s why the plague, which exists in rodents and killed between 75 to 200 million people in Eurasia, still exists to this day.

像SARS这样可以跨物种存在的疾病，几乎不可能根除。所以来自啮齿动物、在欧亚大陆导致7500万到2亿人死亡的鼠疫，至今仍然存在。

Ebola, MERS, SARS, rise a very complicated interspecies relations. And they exist in reservoirs in the wild. And those diseases are very difficult for us to tackle.

埃博拉、MERS、SARS，带来了一种非常复杂的物种间关系。它们存在于野外的水库中。对于人类来说，这些疾病十分棘手。

Wild animals are just a small piece of the puzzle. The last century saw an industrialization of livestock, making a perfect intermediary for diseases. And in 2009 we saw the H1N1 influenza virus make the jump from pigs to people.

野生动物只是其中的一小部分。上个世纪见证了畜牧业的工业化，为疾病提供了完美的媒介。2009年，我们看到H1N1流感病毒从猪传染给人。

The world is now at the start of the 2009 influenza pandemic.

世界现在正处于2009年流感大流行的开端。

The U.S. Centers for Disease Control and Prevention estimated that as many as 575,000 people died from H1N1 during the first year the virus circulated.

美国疾病控制和预防中心估计，在病毒传播的第一年有多达57.5万人死于H1N1。

So when you mass-produce animals and you have an outbreak, it’s very easy for the disease to move very rapidly through the animal populations.

所以当人们大规模饲养动物时，一旦疫情爆发，疾病很容易在动物种群中迅速传播。

And then linked all of these is bigger environmental issues: climate change – means that diseases that could exist in some areas are moving into other areas. We’re seeing mosquito-borne diseases move into areas where it wasn’t posing a problem.

与此相关的是更大的环境问题：气候变化——这意味着可能存在于某些地区的疾病正在向其他地区转移。我们看到蚊子传播的疾病转移到没有造成问题的地区。

According to the WHO, a global temperature increases of 2 to 3ºC would increase the number of people who are at risk of malaria by around 3-5%, or several hundred million. Malaria already killed 405,000 people in 2018.

根据世界卫生组织的说法，全球气温上升2到3摄氏度将使患疟疾的人数增加约3-5%，那就是几亿人。疟疾在2018年已经造成40万5千人死亡。

And linked to all of this is urbanization. Millions of people, living side by side, allowing diseases to spread rapidly.

与此相关的还有城市化。成千上万的人密集的生活在一起，疾病得以迅速传播。

There are sort of environmental reasons why diseases happen in certain places. But I think that the fact that you’ve got mass cities, the fact you’ve got a lot of people moving certainly helps in the spread of disease.

疾病在某些地方发生有环境方面的原因。但我认为，城市人口众多，大量的人口流动无疑有助于疾病的传播。

And that’s why how governments respond is more crucial than ever. Critics of the coronavirus travel bans say that it only exacerbates the outbreak: shortages become more common, people suffering from non-coronavirus related illnesses have difficulty making it to hospitals, and many flee before the measures are implemented. There isn’t sufficient data that shows travel bans actually do anything to stop the spread.

所以政府如何应对比以往任何时候都更加重要。对冠状病毒旅行禁令持批评态度的人士说，它只会加剧疫情的爆发：物资短缺变得更加普遍，患有非冠状病毒相关疾病的人很难去医院，许多人在采取措施之前就逃离了。没有足够的数据显示，旅行禁令实际上能够阻止疫情的蔓延。

It’s interesting that as this coronavirus outbreak is happening, we’ve got an H5N1 outbreak in a poultry farm in China, we’ve got H1N1 in Taiwan. There are many other diseases around and they could pose problems. We’ve had African swine fever decimating pig population. 300million pigs have died.

值得关注的是，随着这种冠状病毒的爆发，中国的一个家禽养殖场爆发了H5N1禽流感，台湾爆发了H1N1病毒。还有许多其他疾病可能会造成问题。非洲猪瘟导致大量猪死亡。3亿头猪死了。

So I think there’s an issue about what diseases gets focused on, why it gets focused on, what the politics of that is.

所以我认为有一个问题是疾病需要关注的重点是什么，为什么要关注，其中有什么政治规则。

What’s clear is in order to tackle infectious diseases, a more integrated approach that considers all of the variables is needed.

显然，要应对传染病，需要一种考虑所有变量的更综合的方法。

Over the last 10, 15 years has been a move towards one health, which is an integrated health that essentially tries to put human health and animal health together to say that actually we can’t deal with human health unless we integrate and think about what’s happening in animal populations.

在过去的10到15年里，我们朝着一个健康的方向前进，这是一种综合的健康，本质上是把人类健康和动物健康放在一起，以说明除非综合考虑动物种群中正在发生的事情，否则我们实际上不能解决人类健康问题。

I think we need to go further. A much more integrated approach that draws on insights about how human behavior determines disease dynamics. Unless we understand these cultural social processes, I think we’re not going to be in a very strong position in the future to tackle outbreaks.

我认为我们需要更进一步。这是一种更综合的方法，是基于对人类行为如何决定疾病动态的研究。除非我们了解这些文化和社会进程，否则我认为我们将来不会在应对疫情方面处于非常有利的地位。

Understanding that new outbreaks are a complex issue that depends on more than just vaccines and sanitation – that they’re interwoven in the way we live and consume, is perhaps the first step in tackling pandemics.

理解新的疫情是一个复杂的问题，它不仅取决于疫苗和卫生设施，更与我们的生活和消费方式交织，这也许是应对流行病的第一步。