FlyTitle: The pandemic

The struggle to save lives and the economy is likely to present agonising choices

救命也要救经济,这将带来十分痛苦的抉择

经济学人双语版-停摆 Closed

PLANET EARTH is shutting down. In the struggle to get a grip on covid-19, one country after another is demanding that its citizens shun society. As that sends economies reeling, desperate governments are trying to tide over companies and consumers by handing out trillions of dollars in aid and loan guarantees. Nobody can be sure how well these rescues will work.

我们这个星球正在停摆。为防控新冠肺炎,一个接一个的国家要求国民减少社会接触。这令经济陷入困境,心急火燎的政府正试图通过发放数万亿美元的援助和贷款担保来帮助企业和消费者渡过难关。这些挽救措施效果会如何谁也说不准。

But there is worse. Troubling new findings suggest that stopping the pandemic might require repeated shutdowns. And yet it is also now clear that such a strategy would condemn the world economy to grave—perhaps intolerable—harm. Some very hard choices lie ahead.

然而还有更糟糕的事。令人不安的新研究结果表明,要终止这场全球大流行可能需要反复地停摆。而现在可以明确的一点是,这种抗疫策略将导致世界经济遭受严重的,也许是无法承受的损害。等着大家的是一些非常艰难的抉择。

Barely 12 weeks after the first reports of people mysteriously falling ill in Wuhan, in central China, the world is beginning to grasp the pandemic’s true human and economic toll. As of March 18th SARS-CoV-2, the virus behind covid-19, had registered 134,000 infections outside China in 155 countries and territories. In just seven days that is an increase of almost 90,000 cases and 43 countries and territories. The real number of cases is thought to be at least an order of magnitude greater.

中国中部城市武汉首次报告出现不明原因病例后仅仅12周,全世界就开始见识到这场大流行病对人类和经济的真正冲击。截至3月18日,新冠病毒已在中国以外的155个国家和地区造成了13.4万例感染病例。短短七天之内,新增病例接近9万例,受感染的国家和地区增加了43个。实际感染人数被认为至少是确诊病例的十倍。

Spooked, governments are rushing to impose controls that would have been unimaginable only a few weeks ago. Scores of countries, including many in Africa and Latin America, have barred travellers from places where the virus is rife. Times Square is deserted, the City of London is dark and in France, Italy and Spain cafés, bars and restaurants have bolted their doors. Everywhere empty stadiums echo to absent crowds.

一片惊惶之中,各国政府纷纷紧急实施就在几周前还难以想象的防控手段。包括许多非洲和拉美国家在内的众多国家都禁止来自疫情严重地区的旅客入境。纽约时代广场空无一人,伦敦金融城一片黑暗,法国、意大利和西班牙的咖啡馆、酒吧和餐馆大门紧闭。各地体育场馆空空荡荡,人潮不再。

It has become clear that the economy is taking a much worse battering than analysts had expected. Data for January and February show that industrial output in China, which had been forecast to fall by 3% compared with a year earlier, was down by 13.5%. Retail sales were not 4% lower, but 20.5%. Fixed-asset investment, which measures the spending on such things as machinery and infrastructure, declined by 24%, six times more than predicted. That has sent economic forecasters the world over scurrying to revise down their predictions. Faced with the most brutal recession in living memory, governments are setting out rescue packages on a scale that exceeds even the financial crisis of 2007-09.

已经清楚的是,经济遭受的打击比分析师们预期的要严重得多。原本预计中国1月和2月的工业产值会较去年同期下降3%,但实际下降了13.5%;零售额降幅不是预期的4%,而是20.5%。衡量机械和基础设施等方面支出的固定资产投资下降了24%,是预期的六倍。世界各地的经济预测机构因而纷纷下调之前的预测。面对人们记忆中最残酷的经济衰退,各国政府正在制定规模甚至超过2007至2009年金融危机时的救助方案。

This is the backdrop for fundamental choices about how to manage the disease. Using an epidemiological model, a group from Imperial College in London last week set out a framework to help policymakers think about what lies ahead. It is bleak.

这就是人们要对控制疫情做出根本性的抉择所面临的现实。上周,伦敦帝国理工学院的一个研究小组运用流行病学模型建立了一个框架,帮助政策制定者思考未来局面。结果显示形势很严峻。

One approach is mitigation, “flattening the curve” to make the pandemic less intense by, say, isolating cases and quarantining infected households. The other is to suppress it with a broader range of measures, including shutting in everybody, other than those who cannot work from home, and closing schools and universities. Mitigation curbs the pandemic, suppression aims to stop it in its tracks.

一种方法是减缓疫情,例如通过隔离患者和受感染家庭,“压平曲线”,减轻疫情严重程度。另一种方法是用更广泛的措施来压制疫情,包括要求所有人居家不出(不能在家工作的人除外),并关闭各类学校。减缓措施意在抑制疫情,而压制措施则是要彻底阻断扼杀它。

The modellers found that, were the virus left to spread, it would cause around 2.2m deaths in America and 500,000 in Britain by the end of summer. In advanced economies, they concluded, three months of curve-flattening, including two-week quarantines of infected households, would at best prevent only about half of these. Moreover, peak demand for intensive care would still be eight times the surge capacity of Britain’s National Health Service, leading to many more deaths that the model did not attempt to compute. If that pattern holds in other parts of Europe, even its best-resourced health systems, including Germany’s, would be overwhelmed.

建模人员发现,如果任由病毒传播,到夏季末,美国将约有220万人死于该病毒,英国为50万。他们推断,在发达经济体中,实施三个月的减缓措施(包括隔离被感染家庭两周)最多只能令预计死亡人数减少约一半。此外,疫情高峰期对重症监护服务的需求仍将是英国国家医疗服务体系(NHS)应急服务能力的八倍多,这会使死亡人数大大增加,而模型尚未计入这一部分。如果欧洲其他地区也按这种模式发展,即使是资源最充裕的卫生系统(包括德国的)也将不堪重负。

No wonder governments are opting for the more stringent controls needed to suppress the pandemic. Suppression has the advantage that it has worked in China. On March 18th Italy added 4,207 new cases whereas Wuhan counted none at all. China has recorded a total of just over 80,000 cases in a population of 1.4bn people. For comparison, the Imperial group estimated that the virus left to itself would infect more than 80% of the population in Britain and America.

难怪各国政府正选择采取更严格的控制措施来压制疫情。压制措施的优势是它在中国已见成效。3月18日,意大利新增4207个病例,而武汉的统计显示零新增。中国有14亿人口,确诊病例略超过8万。相比之下,帝国理工学院的研究小组估计,如果放任病毒传播,英美将有80%以上的人口感染。

But that is why suppression has a sting in its tail. By keeping infection rates relatively low, it leaves many people susceptible to the virus. And since covid-19 is now so widespread, within countries and around the world, the Imperial model suggests that epidemics would return within a few weeks of the restrictions being lifted. To avoid this, countries must suppress the disease each time it resurfaces, spending at least half their time in lockdown. This on-off cycle must be repeated until either the disease has worked through the population or there is a vaccine which could be months away, if one works at all.

但正因为如此,压制措施的麻烦在后头。把感染率保持在相对较低的水平,也就意味着很多人仍然有感染病毒的危险。而帝国理工的模型显示,由于疾病如今在国家内部和全球各地广泛传播,只要限制措施一取消,几周之内本地疫情就会复发。为了避免这种情况,各国必须在每次疫情复发时都压制它,至少一半时间都处于封城封国状态。这种不断“开/关”的模式必须重复施行,直至病毒冲击过全体人口或者可能在几个月之后有了疫苗——如果它真的有效的话。

This is just a model, and models are just educated guesses based on the best evidence. Hence the importance of watching China to see if life there can return to normal without the disease breaking out again. The hope is that teams of epidemiologists can test on a massive scale so as to catch new cases early, trace their contacts and quarantine them without turning society upside down. Perhaps they will be helped by new drugs, such as a Japanese antiviral compound which China last week said was promising.

这只是一个模型,模型只是基于最佳证据的合理推测。所以,重要的是观察中国的情况,看生活恢复正常后疫情能否不再复发。希望在于,各个流行病学家团队可进行大规模检测,以便及早发现新病例,追踪接触史并隔离相关人员,同时不会令社会秩序大乱。也许新药物会有帮助,例如中国上周表示日本的一款抗病毒药物显示出较好的前景。

But this is just a hope, and hope is not a policy. The bitter truth is that mitigation costs too many lives and suppression may be economically unsustainable. After a few iterations governments might not have the capacity to carry businesses and consumers. Ordinary people might not tolerate the upheaval. The cost of repeated isolation, measured by mental well-being and the long-term health of the rest of the population, might not justify it.

但这只是希望,而希望不是政策。严酷的事实是,减缓措施会夺去太多性命,而压制措施则可能导致经济挺不下去。经过几轮反复,政府可能再也无力负担企业和消费者。普通人可能忍受不了这种动荡。如果考虑到整体人群的心理健康和长期健康,反复隔离的代价可能使得这种措施站不住脚。

In the real world there are trade-offs between the two strategies, though governments can make both more efficient. South Korea, China and Italy have shown that this starts with mass-testing. The more clearly you can identify who has the disease, the less you must depend upon indiscriminate restrictions. Tests for antibodies to the virus, picking up who has been infected and recovered, are needed to supplement today’s which are only valid just before and during the illness. That will let immune people go about their business in the knowledge that they cannot be a source of further infections.

在现实世界中,在两种策略间会有平衡折中,但政府可以让两者都变得更高效。从韩国、中国和意大利的经验来看,这可以从大规模排查开始。越能清楚识别染病者,就越不必实施全面的无差异限制。现在的检测只能发现发病前和发病中的人,除此之外还需要推广病毒抗体检测以找出被感染过而已康复的人。这将让已获得免疫力的人群知道自己不会再成为感染源,从而可以自由开展常规活动。

A second line of attack is to use technology to administer quarantines and social distancing. China is using apps to certify who is clear of the disease and who is not. Both it and South Korea are using big data and social media to trace infections, alert people to hotspots and round up contacts. South Korea changed the law to allow the state to gain access to medical records and share them without a warrant. In normal times many democracies might find that too intrusive. Times are not normal.

第二条进攻路线是运用技术来管理隔离和保持社交距离。中国正在运用手机应用来认证需要隔离管理的人群。中国和韩国都在利用大数据和社交媒体追踪病例,提醒人们避开病例聚集爆发地,以及追踪隔离密切接触者。韩国修订了法律,政府无须申请搜查令就能调阅及共享患者病历。在正常时期,许多民主国家可能会认为这种做法过于侵扰隐私。但如今是非常时期。

Last, governments should invest in health care, even if their efforts take months to bear fruit and may never be needed. They should increase the surge capacity of intensive care. Countries like Britain and America are desperately short of beds, specialists and ventilators. They should define the best treatment protocols, develop vaccines and test new therapeutic drugs. All this would make mitigation less lethal and suppression cheaper.

最后,政府应加大医疗投资,即便这样的努力需要几个月才能显现成果,甚至有些可能永远派不上用场。政府应提升重症监护的应急服务能力。英美等国紧缺床位、专科医师和呼吸机。政府还应制订最佳治疗方案,研发疫苗并测试新药。这一切将减少减缓措施中的死亡人数,降低压制措施付出的代价。

Be under no illusions. Such measures might still not prevent the pandemic from extracting a heavy toll. Today governments seem to be committed to suppression, whatever the cost. But if the disease is not conquered quickly, they will edge towards mitigation, even if that will result in many more deaths. Understandably, just now that is not a trade-off any government is willing to contemplate. They may soon have no choice. ■

但别抱幻想。这些措施可能仍然无法阻止这场全球大流行病带来惨重的损失。目前,各国政府似乎都在拼命压制疫情。但假如无法速战速决,它们将渐渐转向减缓措施,即便这将导致更多人死亡。可以理解的是,眼下任何政府都不愿意考虑这种妥协。但它们可能很快就别无选择了。