比尔·盖茨：美国错失了遏制病毒蔓延的最佳时机 但时间窗口尚未关闭

There’s no question the United States missed the OPPOrtunity to get ahead of the novel coronavirus. But the window for making important decisions hasn’t closed. The choices we and our leaders make now will have an enormous impact on how soon case numbers start to go down, how long the economy remains shut down and how many Americans will have to bury a loved one because of covid-19.

Our foundation has been working to slow the outbreak for several months. To date, we’ve invested $105 million in efforts to create new therapeutics, expand access to testing, and limit the virus’s impact here in Seattle.

我们的基金会几个月来一直致力于减缓疫情发展。截至目前，我们已经投入1.05亿美元，用于开发新的治疗方案、提高检测的可及性和在西雅图限制病毒传播的影响。

As a result of this work, I’ve spoken with experts and leaders in Washington and across the country. It’s become clear to me that we must take three steps.

由于这些工作，我得以与华盛顿和全国的专家和领导人进行沟通。我很清楚，现在我们必须采取三个行动。

First, we need a consistent nationwide approach to shutting down. Despite urging from public health experts, some states and counties haven’t shut down completely. In some states, beaches are still open; in others, restaurants still serve sit-down meals.

首先，我们需要采取全国统一的闭关措施。尽管公共卫生专家极力敦促，一些州县还是没有完全关闭。在一些州，海滩仍旧开放；而在另一些州，餐馆仍然提供堂食服务。

This is a recipe for disaster. Because people can travel freely across state lines, so can the virus. The country’s leaders need to be clear: Shutdown anywhere means shutdown everywhere. Until the case numbers start to go down across America — which could take 10 weeks or more — no one can continue business as usual or relax the shutdown. Any confusion about this point will only extend the economic pain, raise the odds that the virus will return, and cause more deaths.

这是做后患无穷。由于人们可以自由地穿越州界，病毒也同样可以。这个国家的领导人需要明确：闭关意味着关闭所有公共场所。没人能继续照常活动或放松闭关管控，直到全美病例数开始下降，而这将需要10周甚至更长的时间。做不到这一点会延长经济阵痛、增加疫情回弹的可能性，以及导致更多的死亡。

Second, the federal government needs to step up on testing. Far more tests should be made available. We should also aggregate the results so we can quickly identify potential volunteers for clinical trials and know with confidence when it’s time to return to normal. There are good examples to follow: New York state recently expanded its capacity to up to more than 25,000 tests per day.

其次，联邦政府需要加强检测。人们应该获得更多的检测机会。我们还应汇总测试结果，以便快速甄别出可以进行临床试验的志愿者，并且明确何时才能恢复正常。我们可以效仿一些不错的例子：纽约州最近将其检测能力提高到每天2.5万次以上。

There’s also been some progress on more efficient testing methods, such as the self-swab developed by the Seattle Coronavirus Assessment Network, which allows patients to take a sample themselves without possibly exposing a health worker. I hope this and other innovations in testing are scaled up across the country soon.

我们在开发更高效的检测方式上也取得了一些进展，例如由“西雅图冠状病毒评估网络”开发的自检拭子，病人可以在没有医务人员在场的情况下自行采样。我希望这项技术和其他检测方面的创新可以尽快在全国大规模推广。

Even so, demand for tests will probably exceed the supply for some time, and right now, there’s little rhyme or reason to who gets the few that are available. As a result, we don’t have a good handle on how many cases there are or where the virus is likely headed next, and it will be hard to know if it rebounds later. And because of the backlog of samples, it can take seven days for results to arrive when we need them within 24 hours.

即便如此，检测在一定时间内可能供不应求，而眼下谁应该获得这些稀缺的检测资源也没有规矩可循。正因如此，我们并没有完全掌握到底有多少病例，或者病毒接下来会蔓延到哪里，也很难知道疫情之后是否会反弹。此外，由于检测样本的积压，我们需要在24小时内就得到的结果，可能会花费七天才能得到。

This is why the country needs clear priorities for who is tested. First on the list should be people in essential roles such as health-care workers and first responders, followed by highly symptomatic people who are most at risk of becoming seriously ill and those who are likely to have been exposed.

这就是为什么这个国家需要明确哪些人有检测的优先权。在这个名单上，首先应该是那些重要岗位上的人，例如医护工作者和急救人员，其次是症状明显并有可能发展成重症的人，以及可能已经发生病毒暴露的人。

The same goes for masks and ventilators. Forcing 50 governors to compete for lifesaving equipment — and hospitals to pay exorbitant prices for it — only makes matters worse.

对于口罩和呼吸机同样如此。让50个州长被迫争抢救命的设备，并让医院为此支付高昂的价格，这只会让情况变得更糟。

Finally, we need a data-based approach to developing treatments and a vaccine. Scientists are working full speed on both; in the meantime, leaders can help by not stoking rumors or panic buying. Long before the drug hydroxychloroquine was approved as an emergency treatment for covid-19, people started hoarding it, making it hard to find for lupus patients who need it to survive.

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