FlyTitle: The world after covid-19

The coronavirus will hasten three big medical breakthroughs. That is just a start.

新冠病毒将加速三大医学突破。这只是个开端。【新冠报道】

经济学人双语版-比尔·盖茨谈备战未来大流行病 Bill Gates on how to fight future pandemics

WHEN HISTORIANS write the book on the covid-19 pandemic, what we’ve lived through so far will probably take up only the first third or so. The bulk of the story will be what happens next.

当历史学家著书记录这场全球新冠肺炎疫情时,我们迄今已经历的可能只会占前三分之一左右的篇幅,故事的主体将是接下来发生的事情。

In most of Europe, East Asia and North America the peak of the pandemic will probably have passed by the end of this month. In a few weeks’ time, many hope, things will return to the way they were in December. Unfortunately, that won’t happen.

在欧洲、东亚和北美的大部分地区,疫情高峰可能会在本月底过去。许多人希望,再过几周,一切就能恢复到去年12月时的状态。不幸的是,情况不会如此。

I believe that humanity will beat this pandemic, but only when most of the population is vaccinated. Until then, life will not return to normal. Even if governments lift shelter-in-place orders and businesses reopen their doors, humans have a natural aversion to exposing themselves to disease. Airports won’t have large crowds. Sports will be played in basically empty stadiums. And the world economy will be depressed because demand will stay low and people will spend more conservatively.

我相信人类终将战胜这场流行病,但要等到全球大多数人都接种了疫苗之时。在那之前生活不会恢复正常。即使政府取消居家隔离令,企业复工,人们也会自然而然地减少外出活动以避免感染。机场不会再人潮涌动。体育比赛会在基本上没有观众的体育场内进行。世界经济会陷入萧条,因为需求将持续低迷,人们的消费也将变得更保守。

As the pandemic slows in developed nations, it will accelerate in developing ones. Their experience, however, will be worse. In poorer countries, where fewer jobs can be done remotely, distancing measures won’t work as well. The virus will spread quickly, and health systems won’t be able to care for the infected. Covid-19 overwhelmed cities like New York, but the data suggest that even a single Manhattan hospital has more intensive-care beds than most African countries. Millions could die.

疫情在发达国家缓解之时,在发展中国家将加速扩散。后者的境遇会更糟糕。在更不富裕的国家,可以远程完成的工作较少,保持社交距离的措施也就不容易发挥作用。病毒将迅速传播,而医疗系统将无法照料受感染者。疫情令纽约等城市难以招架,但数据显示,仅仅曼哈顿一间医院里的重症监护病床就比大多数非洲国家全国都要多。数以百万计的人可能死去。

Wealthy nations can help, for example, by making sure critical supplies don’t just go to the highest bidder. But people in rich and poor places alike will be safe only once we have an effective medical solution for this virus, which means a vaccine.

富裕国家可以施以援手,例如确保重要物资并非只能价高者得。但无论是在贫穷还是富裕的国家,只有在针对新冠病毒的有效的医疗解决方案出现后,人们才是安全的。这个方案就是疫苗。

Over the next year, medical researchers will be among the most important people in the world. Fortunately, even before this pandemic, they were making giant leaps in vaccinology. Conventional vaccines teach your body to recognise the shape of a pathogen, usually by introducing a dead or weakened form of the virus. But there’s also a new kind of immunisation that doesn’t require researchers to spend time growing large volumes of pathogens. These mRNA vaccines use genetic code to give your cells instructions for how to mount an immune response. They can probably be produced faster than traditional vaccines.

接下来的一年里,医学研究人员将是世界上最举足轻重的人群之一。幸运的是,在这次疫情发生之前,他们就已在疫苗学上取得了巨大飞跃。常规疫苗通常是通过向人体接种经灭活或减毒的病毒,引导人体识别病原体。但还有一种新的免疫接种方法,不需要研究人员花时间培养大量病原体。这些mRNA疫苗利用遗传密码指导人体细胞启动免疫反应。相比传统疫苗,它们的生产速度很可能更快。

My hope is that, by the second half of 2021, facilities around the world will be manufacturing a vaccine. If that’s the case, it will be a history-making achievement: the fastest humankind has ever gone from recognising a new disease to immunising against it.

我希望,到2021年下半年世界各地的疫苗企业都能开始生产新冠病毒疫苗。真能做到的话,那将是个历史性成就:人类以最快的速度完成了对一种新疾病从识别到免疫的工作。

Apart from this progress in vaccines, two other big medical breakthroughs will emerge from the pandemic. One will be in the field of diagnostics. The next time a novel virus crops up, people will probably be able to test for it at home in the same way they test for pregnancy. Instead of peeing on a stick, though, they’ll swab their nostrils. Researchers could have such a test ready within a few months of identifying a new disease.

除了疫苗研制方面的进步外,新冠疫情还将带来另外两大医学突破。其一是在诊断领域。下次出现新型病毒时,人们也许就能在家自行测试,像验孕一样——只不过不是用测试棒验尿,而是做鼻拭子检测。研究人员可以在发现新疾病后的几个月里准备好推出这种测试。

The third breakthrough will be in antiviral drugs. These have been an underinvested branch of science. We haven’t been as effective at developing drugs to fight viruses as we have those to fight bacteria. But that will change. Researchers will develop large, diverse libraries of antivirals, which they’ll be able to scan through and quickly find effective treatments for novel viruses.

第三个突破将是在抗病毒药物研发上。对这个科研领域的投入一直不足。我们在研发抗病毒药物上的效率向来低于抗菌药物。但这将改变。研究人员将建成各种大型抗病毒化合物库,方便迅速筛选并找到能有效治疗新型病毒的方法。

All three technologies will prepare us for the next pandemic by allowing us to intervene early, when the number of cases is still very low. But the underlying research will also assist us in fighting existing infectious diseases—and even help advance cures for cancer. (Scientists have long thought mRNA vaccines could lead to an eventual cancer vaccine. Until covid-19, though, there wasn’t much research into how they could be produced en masse at even somewhat affordable prices.)

这三方面的技术能让我们在病例数量还很低的时候及早干预,从而为应对下一次大流行病做好准备。而相关的基础研究也将有助我们对抗现有的传染性疾病,甚至有助于推进癌症治疗。(科学家们一直认为,mRNA疫苗研发最终会带来癌症疫苗。不过,直到新冠肺炎爆发前,并没有多少研究在探讨如何能以还算负担得起的价格大批量生产这类疫苗。)

Our progress won’t be in science alone. It will also be in our ability to make sure everyone benefits from that science. In the years after 2021, I think we’ll learn from the years after 1945. With the end of the second world war, leaders built international institutions like the UN to prevent more conflicts. After covid-19, leaders will prepare institutions to prevent the next pandemic.

进展不会仅限于科学领域。我们还将能更好地确保每个人都从科研成果中获益。我认为,在2021年后,大家会借鉴1945年后的行动。当时随着第二次世界大战结束,各国领导人建立了联合国等国际机构以防止更多冲突发生。新冠疫情过后,领导人将筹建机构来防范下一次大流行病。

These will be a mix of national, regional and global organisations. I expect they will participate in regular “germ games” in the same way as armed forces take part in war games. These will keep us ready for the next time a novel virus jumps from bats or birds to humans. They will also prepare us should a bad actor create an infectious disease in a home-made lab and try to weaponise it. By practising for a pandemic, the world will also be defending itself against an act of bioterrorism.

这些机构将包含国家、区域和全球性组织。我估计它们会像军队参加作战演习一样定期参加“抗病菌演习”。这将让人们准备好迎战下一次来自蝙蝠或鸟类的新型病毒,还能帮助人们防备危险分子在家里自制传染病并用作生化武器。通过大流行病演习,世界也在加强对生物恐怖主义行动的防御。

Keep it global

保持全球协调行动

I hope wealthy nations include poorer ones in these preparations, especially by devoting more foreign aid to building up their primary health-care systems. Even the most self-interested person—or isolationist government—should agree with this by now. This pandemic has shown us that viruses don’t obey border laws and that we are all connected biologically by a network of microscopic germs, whether we like it or not. If a novel virus appears in a poor country, we want its doctors to have the ability to spot it and contain it as soon as possible.

我希望富裕国家在做这些准备工作时能携手较贫穷国家,尤其是提供更多外国援助来帮助它们建立基础医疗保健系统。事到如今,即便是最自私的人或最奉行孤立主义的政府也该认同这一点。这场大流行病让人们明白,病毒无视国界,而无论我们喜欢与否,从生物学来说,我们所有人都被一张肉眼看不见的微生物网络连接在一起。假如一种新病毒出现在某个贫穷国家,我们希望那里的医生能尽快发现并遏制它。

None of this is inevitable. History doesn’t follow a set course. People choose which direction to take, and may make the wrong turn. The years after 2021 may resemble the years after 1945. But the best analogy for today might be November 10th 1942. Britain had just won its first land victory of the war, and Winston Churchill declared in a speech: “This is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning.”■

这些都不是必然的。历史并不会按指定的路线发展。人们选择前行的方向,也有可能走上弯路。2021年之后的日子可能与1945年后的岁月类似。而此时此刻也许最像1942年11月10日。当时英国在二战中刚刚赢得第一次地面战役胜利,丘吉尔发表演讲说:“这不是结束,甚至不是结束的开始。但这可能是开始的结束。”

比尔·盖茨是微软的联合创始人,也是比尔及梅琳达·盖茨基金会的联席主席。本文为本刊《新冠肺炎之后的世界》系列文章之一。全部系列可参见 Economist.com/coronavirus