en-us	Not a day passes without us being bombarded by the rapidly evolving medical literature and media on the hitherto unknown COVID-19.
zh-cn	我们每天都被大量关于至今未知的新冠病毒的医学文献和媒体报道狂轰滥炸

en-us	 Rightfully so, as we now have an outbreak with more than 100,000 cases confirmed globally. 
zh-cn	理应如此，毕竟我们面对的是一场全球确诊病例突破10万的疫情。 

en-us	Yet, I cannot help but wonder how the general public is dealing with such an onslaught of information, if I, as a trained physician, epidemiologist and a global public health practitioner, find it too much to take in and digest.
zh-cn	但是，我不禁想到，我作为一名训练有素的医生、流行病学家和全球公共卫生从业人员，尚且感到有太多东西难以吸收和消化

en-us	 How do we expect a lay person to sift through it all, separate the chaff from the grain, avoid fear mongering - No, you do not get COVID-19 if you receive a package from China, or eat in a Chinese restaurant - and stick with the most relevant information and the essentials for behavioral change? 
zh-cn	公众又怎能应付如此猛烈的信息冲击，我们又怎能期望外行人士对这些信息进行筛选甄别，去伪存真，以防产生恐惧心理（比如收到寄自中国的包裹或者到中国餐馆吃饭是不会感染新冠肺炎的），把握住最相关的信息和行为改变的要领呢？

en-us	This is ultimately what counts the most:, arming people with the right messaging and instructions for compliance with the science-based best practice. 
zh-cn	归根结底，最重要的是：为民众提供正确的消息和指示，以使其遵循科学的最佳做法。

en-us	With local community transmission in about 20 countries across several regions of the globe, we must ask ourselves could we have done better? 
zh-cn	随着病毒在全球多个地区数十个国家的当地社区中传播，我们必须扪心自问我们是否本可以做得更好？ 

en-us	To answer that question, let us rewind a bit to early January, and skip what caused the outbreak. 
zh-cn	为了回答这个问题，让我们倒退到1月初，跳过引发疫情的原因。

en-us	Human ecology is increasingly overlapping with animal ecology – think of the clearance of the Amazon for farming and livestock, or of the felling of Kalimantan forest tapestry for palm oil production. 
zh-cn	人类生态学与动物生态学之间的相互重叠越来越多，比如破坏亚马逊雨林用于发展农牧业，或者砍伐加里曼丹森林植被用于生产棕榈油。

en-us	Zoonoses are bound to emerge with more frequency as rapid environmental and climatic changes occur, and as we human beings encroach upon the territoriality of animals, including those that are vectors of zoonotic diseases. 
zh-cn	随着环境和气候的迅速变化，随着我们人类侵占野生动物（包括作为人畜共患疾病中间宿主的野生动物）的栖息地，人畜共患疾病必然会以更高的频率出现。

en-us	And we do trap, handle and consume many of those animals, often with total disregard for basic food hygiene. 
zh-cn	而且我们的确还捕猎、屠宰和食用很多野生动物，往往把基本的食品卫生置之脑后。 

en-us	Once the genie is out of the bottle, which actually may have been a few weeks prior to the first reported cases, what mattered most was quickly figuring out the properties and genomic makeup of the underlying virus, not only to kickstart the process of developing a vaccine and drugs, but also to acquire the much-needed information on its transmission dynamics. 
zh-cn	魔鬼一旦被从瓶子里放出来，可能实际上就在报告首批病例之前的几周里，最重要的是快速弄清楚潜在病毒的特性和基因组成，不仅是为了启动疫苗和药物的研发过程，也是为了获得有关病毒传播动态的急需信息。

en-us	My aim here is to focus on the latter. 
zh-cn	我写本文的目的在于后者。 

en-us	By now we have all heard of the basic reproduction number, R0 - R naught, or R zero, as it is called; that is, the number of new cases that one case could generate in a usually susceptible, non-immune population. 
zh-cn	迄今为止，我们都听说过基本再生数值，就是一个病例可能在通常易感染、无免疫力人群中产生的新病例数。

en-us	We all know that if its value is bigger than one (R0 >1) we have transmission, meaning that one infected person will transmit the disease to more than one person. 
zh-cn	我们都知道，如果基本再生数值大于1，就出现传播，就是说一个感染者会把疾病传播给一个人以上。

en-us	For COVID-19, the reproduction number, or R0, is estimated to be around 2.2 (higher than seasonal influenza).
zh-cn	就新冠肺炎而言，据估计其基本再生数值约为2.2（高于季节性流感）。

en-us	 For public health interventions to prevent and contain the transmission, the value itself is less important than understanding and acting on the four components which all together help us estimate its value. 
zh-cn	对于预防和遏制疾病传播的公共卫生干预措施来说，基本再生数值本身并不重要，重要的是了解并针对我们用于评估基本再生数值的四个元素采取措施。

en-us	First is the duration (D) of the infectivity – not of the disease itself – but of the COVID-19 illness, from one sick individual to an otherwise healthy individual. 
zh-cn	第一是传染期，新冠肺炎从一个患病个体传染给另一个健康个体的持续时间。

en-us	This is all the more important if infectivity begins before the end of the incubation period, that is before the patient becomes symptomatic, as it appears to be the case for COVID-19. 
zh-cn	如果感染性开始于潜伏期结束之前，也就是在患者出现症状之前开始，这点就显得特别重要，新冠肺炎显然就是这种情况。 

en-us	The second component is the opportunity (O) to transmit the virus to another person. 
zh-cn	第二个元素是将病毒传播给另一个人的机会

en-us	This depends very much on the social interactions of the infected person with their family, community, workplace, or school; 
zh-cn	这在很大程度上取决于被感染者与其家庭、社区、工作场所或学校之间的社交互动

en-us	while in transit by air, sea, or land; or in any other mass gathering (soccer match, pilgrimage, rock concert, to name a few) while being infected and contagious. 
zh-cn	在乘坐飞机、海上或陆上交通工具时；或在任何其他聚集性活动（比如足球赛、朝圣、摇滚音乐会等）中被感染和传染他人。

en-us	If the person remains totally isolated by virtue of being very sick or hospitalized the (O) would have a value of zero, meaning no onward transmission! This would apply to only a few of the infected. 
zh-cn	如果此人因病重或住院被完全隔离，传播机会值则为零，意思是不会继续传播！这仅适用于少数感染者。 

en-us	The third component is the transmissibility (T) of the virus. 
zh-cn	第三个元素是病毒的传播性

en-us	Assuming there is an opportunity to transmit, the transmission dynamics of the virus and the nature of interpersonal contact must be considered. 
zh-cn	假设有传播的机会，必须考虑病毒的传播动态和人际接触的性质。

en-us	Respiratory viruses hop from one individual to another through airborne droplets emitted by coughing or sneezing;
zh-cn	呼吸道病毒由咳嗽或打喷嚏产生的飞沫通过空气从一个人传播到另一个人；

en-us	 or via contaminated objects (such as faucets, handrails, doorknobs, or poles on buses). 
zh-cn	或者通过受到污染的物体（例如水龙头、扶手、门把手或公交车上的扶杆）。

en-us	The likelihood of effective transmission depends on the nature of the contact as well as on ambient parameters such as air pressure, humidity, and temperature, affecting how long the droplet remains suspended in the air and how far it travels. 
zh-cn	有效传输的可能性取决于接触的性质以及环境参数，比如气压、湿度和温度，这些因素影响飞沫在空气中悬浮的时间和传播的距离。 

en-us	The nature of interpersonal contact is key to transmissibility. 
zh-cn	人际交往的性质是传播性的关键。

en-us	I belong to a culture where we greet each other warmly, not only with a handshake, but also with a hug and kisses on the cheek. 
zh-cn	在我所属的文化中，我们彼此打招呼时不仅握手，还拥抱和亲吻面颊。

en-us	I have also lived in a culture where people keep their distance from each other when they meet, greeting each other by bringing their hands together in front of their chest, with a gentle bow. 
zh-cn	我也曾在另一种文化中生活过：人们见面时彼此保持距离，把双手放在胸前微微鞠躬相互问候。

en-us	One does not have to be a rocket scientist to guess which type of greeting would be, all other things being equal, more prone to transmission! 
zh-cn	在所有其他条件相同的情况下，不必非得成为专家就能猜到哪种问候方式更容易传播！ 

en-us	The final component in the rate of transmission is the susceptibility (S) of the individual exposed to the virus. 
zh-cn	决定传播速度的最后一个元素是个人暴露于病毒的感染性。

en-us	Are they an infant, a child, a pregnant woman, or an elderly person? 
zh-cn	是婴儿、幼儿、孕妇还是老人？

en-us	Do they have an existing health problem or a compromised immune system, or have they already had the viral infection and became immune as a result? 
zh-cn	是否存在健康问题或免疫系统受损，还是已经被病毒感染因而具有了免疫力？ 

en-us	There are two take-home messages from this short synopsis of epidemiology. 
zh-cn	这个简短的流行病学概述包含有两个主要信息。

en-us	First, without a vaccine or cure, we have no control over the duration (D) of infectivity –which still is the case with COVID-19. 
zh-cn	第一，在没有疫苗或药物的情况下，我们无法控制传染期，新冠肺炎目前仍是这种情况。

en-us	We have only limited control of the opportunity (O) for transmission given the ability of the virus to transmit before symptoms appear, undermining the effectiveness of case isolation. 
zh-cn	鉴于病毒在症状出现之前就具有传染性，因此我们对传播机会的控制有限，这就削弱了隔离病例的有效性。

en-us	But there remains a lot that we could do to minimize the opportunity (O), transmissibility (T) and susceptibility (S). 
zh-cn	但是，我们仍然可以做很多事情来把传播机会、传播性和感染性降到最低。

en-us	Finding the Index (or first) case and rapidly tracking and isolating their contacts are key to stopping the fire before it spreads. This requires serious preparedness. 
zh-cn	找到零号病人（首例病例）并迅速追踪并隔离其接触者是阻止疫情蔓延的关键，这需要认真的准备。 

en-us	Unfortunately, most countries (based on the 2019 Global Health Security Index scores) do not appear to have the needed surveillance, case detection and diagnostic capacities to stop public health threats such COVID-19 before it spreads. 
zh-cn	不幸的是，大多数国家（根据2019年全球卫生安全指数得分）似乎不具备必要的监视、病例检测和诊断能力，无法在新冠肺炎等公共卫生威胁扩散之前阻止其传播。

en-us	The report says no country is fully prepared for epidemics and pandemics, and most countries in Sub-Saharan Africa are least prepared. 
zh-cn	该报告说，没有一个国家为流行病和大流行做好了充分准备，撒哈拉以南非洲的大多数国家的准备程度最低。

en-us	These health systems need major investment in training, laboratory capabilities and case management of the infected in properly equipped healthcare settings. 
zh-cn	这些卫生系统需要在培训、实验室能力以及装备完善的医疗设施里对感染者的病例管理方面大量投入资金。

en-us	Strengthening the preparedness and response capacity of any country is strengthening the capacity of all countries. 
zh-cn	加强任何一个国家的应急准备和响应能力，就是加强所有国家的能力。 

en-us	The second take-home message is that public health messaging can have a real impact in terms of changing attitudes and behaviors. 
zh-cn	第二个主要信息是，公共卫生信息传播可以在改变态度和行为方面真正产生影响。

en-us	We all know that we need to wash our hands frequently and wear a mask if we are around others while infected. 
zh-cn	我们都知道，如果周围有人被感染，我们就需要经常洗手和戴口罩。

en-us	Equipping people with the essential information for behavioral change in times of a pandemic can instill a sense of communal responsibility for the global common good. 
zh-cn	在大流行期间让民众掌握必要的信息，改变行为方式，有助于灌输对于全球共同利益的共同责任感。 

en-us	Key behaviors include conscientious reporting and testing when the viral infection is suspected, voluntary social distancing and limiting unnecessary travel – with the added carbon footprint co-benefits, if I may add. 
zh-cn	关键的行为包括：在怀疑被病毒感染时自觉报告和测试，自愿保持社交距离和限制不必要的出行（这还能减少碳足迹）。

en-us	We must also be grateful to overloaded and exhausted health workers grappling with surging caseloads by ensuring that we do not use their services unnecessarily, so they can focus on the symptomatic and severe cases , the very young, pregnant women, the elderly, and those with existing pre- conditions who remain the most vulnerable. 
zh-cn	我们还必须尽量减少自身不必要的医疗服务，以使因病例激增而超负荷工作已精疲力尽的医务人员能够专注于有症状和严重的病例、婴幼儿、孕妇、老年人以及那些患有基础疾病的人，他们仍是最脆弱的群体。

en-us	All these require strong to-the-point public health messages on the four key components outlined above!
zh-cn	所有这些都需要在上述四个关键方面提供强有力而直截了当的公共卫生信息！

en-us	Artificial intelligence and mobile applications could potentially be harnessed for live monitoring of these four parameters to ease the burdens of surveillance, case detection, isolation, social distancing, and forecasting where efforts should be directed. 
zh-cn	可以利用人工智能和移动应用程序对这四个参数进行实时监视，以减轻病例监测、发现、隔离、社交距离和预测等重点领域的负担。 

en-us	A final word. Like all animate beings, viruses want to live and reproduce.
zh-cn	最后一点，像所有生物一样，病毒也要生存和繁殖

en-us	 They mutate and evolve to increase their virulence, odds of transmissibility and survival. 
zh-cn	病毒通过变异和进化以增加致病性、传播性和生存几率。

en-us	At present, COVID-19 appears to have a similar or higher rate of reproduction (R0) compared to other coronaviruses such as SARS and MERS, but it appears to be less fatal, at least for now.
zh-cn	目前，与非典和中东呼吸综合征等其他冠状病毒相比，新冠病毒的基本再生数值好像相似或更高，但致死率似乎较低，至少目前如此。

en-us	COVID-19 could become a seasonal occurrence like influenza, or in the worst scenario, a true pandemic.
zh-cn	新冠肺炎可能会成为像流感一样的季节性流行病，或者在最坏的情况下变成真正的大流行。

en-us	But Spring is around the corner in the northern hemisphere, and the rising temperatures and humidity are bound to affect the transmission dynamics, most likely for the better. 
zh-cn	但是在北半球春天即将来临，气温和湿度的上升势必会影响其传播动态，最有可能逐渐向好。

en-us	Regardless, it is time for the global community to become truly global.
zh-cn	无论如何，现在是国际社会真正推进全球化的时候了。

en-us	We are all weakly prepared for pandemics if any country is weak . 
zh-cn	面对大流行，任何一个国家准备不足，就意味着我们大家准备不足。

en-us	That is why we have international health regulations for countries to comply with, and why we help those whose means are insufficient to do so. 
zh-cn	这就是为什么我们要求各国遵守国际卫生规定，也就是为什么我们要对那些财力不足的国家出手相助。

en-us	We all are in the same boat and live under the same sky. 
zh-cn	我们都在同一条船上，生活在同一片天空下。

en-us	Animals and humans!
zh-cn	动物和人类！