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(CNN)Less than a month ago, India''s future looked dire.

(CNN)不到一个月前,印度的未来看起来还很危急。



Experts predicted that the country could expect millions of coronavirus cases. Doctors warned that India needed to prepare for an onslaught of cases that could cripple the country''s ill-equipped health system. Onlookers worried that the virus could spread like wildfire through India''s slums, where residents live in cramped quarters and basic sanitation often isn''t available.

专家预测,该国可能会出现数百万例冠状病毒病例。医生们警告说,印度需要做好准备,以应对可能使该国装备不良的医疗系统瘫痪的大量病例。旁观者担心这种病毒会像野火一样蔓延到印度的贫民窟,那里的居民居住在狭小的地方,基本的卫生设施也常常无法提供。

But so far, the world''s second-most populous country appears to have avoided the worst.

但到目前为止,这个世界第二人口大国似乎避免了最糟糕的情况。

As of Tuesday, India had reported 31,360 coronavirus cases and 1,008 deaths, or about 0.76 deaths per million. Compare that to the United States, where the number of deaths per million is more than 175.

截至周二,印度报告了31360例冠状病毒病例和1008例死亡,约为百万分之0.76。与美国相比,美国每百万人的死亡人数超过175人。



How swift were Modi''s decisions?

莫迪的决定有多快?

On March 24, Modi announced that the country was going into a three-week lockdown.

3月24日,莫迪宣布该国将进入为期三周的封锁期。

The scale of it was unprecedented. India has a population of 1.3 billion, and the only country with a bigger population -- China -- had imposed citywide lockdowns, but never a nationwide one.

封锁规模空前。印度有13亿人口,唯一一个人口更多的国家——中国——实施了全市范围的封锁,但从未实施全国范围的封锁。

It was a high-stakes decision. Going into lockdown meant millions of daily-wage workers would be deprived of an income. But not imposing a lockdown risked overwhelming India''s health care system. One model estimated that without social distancing measures, about 150 million people in India would be infected by June. On Friday, India''s top pandemic official said that the country would have had more than 100,000 cases by now if it weren''t for the lockdown.

这是一个高风险的决定。进入停工期意味着数以百万计的日薪工人将被剥夺收入。但如果不实行封锁,印度的医疗体系将面临无法承受的风险。一个模型估计,如果不采取社会疏远措施,到6月份,印度约会有1.5亿人将受到感染。上周五,印度最高流行病官员说,如果没有封锁,到目前为止印度可能已经有超过10万例病例。

India moved into lockdown relatively quickly -- it was announced when the country had reported 519 coronavirus cases.

印度相对较快地进入了封锁状态——该国报告了519例冠状病毒病例后宣布了这一决定。

By comparison, Italy waited until it had more than 9,200 coronavirus cases before it went into a nationwide lockdown, while the United Kingdom had about 6,700.

相比之下,意大利等到有9200多个冠状病毒病例后才进入全国范围的封锁,而英国则是大约6700个病例。

Following the lockdown, thousands of migrant workers attempted to leave India''s major cities after the restrictions left them without jobs. That prompted fears that the migrants could spread the virus, with some officials in the Indian state of Uttar Pradesh even spraying returning workers with disinfectant -- an ineffective approach to controlling coronavirus.

封锁之后,数千名移民工人试图离开印度的主要城市,因为这些限制使他们失去了工作。这引发了人们对移民可能传播病毒的担忧,印度北方邦的一些官员甚至向返回的工人喷洒消毒剂——这是控制冠状病毒的无效方法。

Around a week after the lockdown began, two people had died from coronavirus in Mumbai''s densely packed slums. Following the second death, several of the man''s family members had been tested and placed under home quarantine, and the block of 300 homes and 90 shops that make up his neighborhood have been sealed off.

在封锁开始一周后,孟买拥挤的贫民窟里有两人死于冠状病毒。第二次死亡后,这名男子的几名家属接受了检测,并接受了家庭隔离,构成他居住区的300户人家和90家商店也被封锁。

By the time the lockdown was imposed, India had already taken other measures.

在实施封锁时,印度也已经采取了其他措施。

On March 11, India suspended all tourist visas, and announced that all travelers who had been in the most-affected areas of the world in the past few weeks would be quarantined for at least 14 days. From March 22, all international commercial flights were banned from landing in India and all passenger train services in the country were suspended.

3月11日,印度暂停了所有的旅游签证,并宣布,过去几周来去过世界上受影响最严重地区的所有游客将被隔离至少14天。从3月22日起,印度禁止所有国际商业航班降落,印度所有客运列车服务暂停。

The United States, by comparison, has restricted foreigners traveling from China, Iran, and certain European countries, but there is no blanket ban on foreigners entering the country.

相比之下,美国限制了来自中国、伊朗和某些欧洲国家的外国人入境,但没有全面禁止外国人入境。

What if the numbers aren''t right?

数字会不会是不正确的?

As with every country, our understanding of the outbreak is only as good as the numbers we have available. And that depends on testing.

和每个国家一样,我们对疫情的了解只能取决于我们有的数字。而数字取决于检测量。

According to India''s Health Ministry, the country has conducted more than 625,000 tests as of Sunday -- more than South Korea, which has been praised for its approach to testing.

据印度卫生部统计,截至周日,该国已经进行了超过62.5万次检测,超过了因大量检测而受到赞扬的韩国。

When public health experts are assessing how aggressively a country is testing, they don''t look at the total numbers alone -- instead, they often look at the country''s test positivity rate. If a large proportion of the tests are coming back positive, that suggests that only the most serious cases -- such as those in hospital -- are being tested.

当公共卫生专家评估一个国家的检测力度时,他们并不是只看总数,而是经常看这个国家的检测阳性率。如果很大一部分的检测结果呈阳性,那就意味着只有最严重的病例——比如住院的病例——才能接受检测。

According to Mike Ryan, the executive director of the WHO''s Health Emergencies Programs, a good benchmark is to have at least 10 negative cases for every positive one.
据世卫组织紧急卫生方案执行主任迈克·瑞安说,一个好的基准是,每一个阳性病例至少伴随10个阴性病例。

Around 4% of India''s tests are positive, according to data from India''s Health Ministry -- well below that benchmark. It''s also a significantly lower rate than the US, where the rate is about 17%, according to data from Johns Hopkins University (JHU). It''s also lower than the UK, where the rate is around 21%, based on government data.

印度卫生部的数据显示,印度约4%的检测结果为阳性,远远低于这一基准。根据约翰霍普金斯大学的数据,这一比例也明显低于美国,美国的比例约为17%。根据政府数据,这一比例也低于英国,英国的比例约为21%。

Another useful measure is the proportion of cases that are fatal. In India, about 3% of cases have died, compared with more than 13% in Italy, the UK and France, according to JHU. That suggests that India is testing people besides those with the most serious symptoms.

另一个有用的指标是致命病例的比例。在印度,约3%的病例已经死亡,而在意大利、英国和法国,这一比例超过了13%。这表明,除了那些有最严重症状的人之外,印度还在测试其他人。



For now, there''s no indication of either. However, there is a growing body of evidence that Covid-10 causes symptoms far beyond influenza-like symptoms.

目前,还没有这种迹象。然而,越来越多的证据表明Covid-19引起的症状远远超过流感样症状。

Could more people be dying than we know?

死亡的人是否比我们知道的多?

Even when India isn''t facing a pandemic, only about 22% of all registered deaths are medically certified. That means that, in the majority of deaths, the official cause of death has not been certified by a doctor.

即使在印度没有面临大流行病的时候,也只有22%的登记死亡病例得到了医学证明。这意味着,在大多数死者中,官方死因并没有得到医生的证实。

And there''s already evidence that some deaths may be flying under the radar. A resident doctor at one of the main government hospitals in Mumbai said last week that when dead bodies were brought into the hospital, they didn''t test them for coronavirus, even if they suspected that was how patients died.

而且已经有证据表明,一些人的死亡可能根本没有被注意。孟买一家主要政府医院的住院医生上周说,当死尸被带进医院时,他们没有对尸体进行冠状病毒检测,即使他们怀疑病人就是因此死亡的。

"If the personal history shows that the person came in contact with someone who tested positive for the virus, we dispose of the body in the same way that we would for Covid-positive patients," said the doctor, who asked not to be named as they were not authorized to speak to media.

这位不愿透露姓名的医生说:“如果个人病史显示此人与病毒检测呈阳性的人接触,我们处理尸体的方式与处理新冠阳性患者的方式相同。”。

But, experts say, at this stage, it doesn''t look like there is a huge flood of coronavirus deaths.

但是,专家说,在现阶段,冠状病毒造成的死亡似乎并不多。

"Even if we are not testing enough and are not discovering enough, there are not enough bodies being piled up in hospitals or in ICUs or in mortuaries ... to suggest we are in the midst of something really dramatic at this stage," said Saran.

“即使我们没有进行足够的检测,也没有足够的去了解,但我们也没有那么多的尸体被堆在医院、ICU或太平间里。。。“这表明我们正处于一个非常戏剧性的阶段,”萨拉说。

Even so, the true count of Covid-19 deaths will only come much later, when we are able to compare statistics from this year with past years, said CCDEP''s Laxminarayan.

即便如此,Covid-19的真正死亡人数也只有在很久以后才会统计出,届时我们才能将今年和过去几年的统计数据进行比较,疾病动力学、经济与政策中心(CCDEP)的拉斯米纳雷安说。

When did coronavirus take hold?

冠状病毒什么时候开始流行的?

India''s swift policy measures only tell part of the story. Even before India''s lockdown, coronavirus was present in the country, the country had reported some coronavirus cases, but not many.

印度迅速的政策措施只是整个疫情的一部分。早在印度封锁之前,该国就已经出现了冠状病毒,该国当时就已经报告了一些冠状病毒病例,但数量并不多。

On January 30, India reported its first case -- a student who had been studying at Wuhan University in China.

1月30日,印度报告了第一例病例——一名在中国武汉大学学习的学生。

It was around the same time that the UK, France, and Italy also reported their first cases, although their coronavirus outbreaks followed dramatically different trajectories. All three countries now have well over 100,000 coronavirus cases.

大约在同一时间,英国、法国和意大利也报告了他们的第一例病例,尽管他们的冠状病毒爆发遵循截然不同的轨迹。这三个国家现在都有超过10万例冠状病毒病例。

Experts still aren''t sure why the virus would have shown a different pattern of spread in India.

专家们仍然不确定为什么这种病毒会在印度表现出不同的传播模式。

One possible reason, said Reddy, is that coronavirus may thrive in colder conditions, meaning that it might not spread so efficiently in India, where temperatures are often more than 30 degrees Celsius (96.8 degrees Farenheit).

雷迪说,一个可能的原因是冠状病毒可能适合在较冷的条件下繁殖,这意味着它可能不会在印度传播得如此迅速,那里的温度通常超过30摄氏度(96.8华氏度)。

But scientific evidence so far contradicts this idea. The World Health Organization says the evidence so far shows the virus can be transmitted in all areas, including those with hot and humid weather. The US''s National Academy of Sciences committee said the data is mixed on whether coronavirus spreads as easily in warm weather as it does in cold weather.

但迄今为止的科学证据与这一观点相悖。世界卫生组织说,迄今为止的证据显示,病毒可以在所有地区传播,包括那些炎热潮湿的天气。美国国家科学院委员会表示,有关冠状病毒在温暖天气中是否像在寒冷天气中一样容易传播的数据好坏参半。

Another possibility, Reddy said, is that India''s population may be less susceptible due to the country''s policy of universal Bacillus Calmette-Guerin (BCG) vaccination. BCG -- which was developed to fight tuberculosis -- is being studied in clinical trials around the world as a possible way to fight the novel coronavirus.

雷迪说,另一种可能性是,由于印度实行卡介苗(BCG)普及接种政策,印度人口可能不易受感染。卡介苗(BCG)是为抗击结核病而研制的,目前正在世界各地进行临床试验,作为对抗新型冠状病毒的一种可能途径。



The determining factor will likely be what restrictions are still in place when the lockdown lifts. As Reddy put it: "It''s not as though tomorrow we declare victory and then we get back to normal."

决定因素可能是在解除封锁时仍保留哪些限制。正如雷迪所说:“并不是说明天我们宣布胜利,然后我们就能恢复正常。”

Experts say that social distancing will need to be maintained, although some states with fewer cases may be able to ease restrictions. Uttar Pradesh -- India''s most populous state with 200 million residents -- has extended a ban on public gatherings until the end of June.

专家说,社交距离需要保持,尽管一些州的案件较少,可能能够放宽限制。印度人口最多、拥有2亿居民的北方邦已经将禁止公众集会的禁令延长至6月底。

Laxminarayan warned that if social distancing and hygiene measures "are not taken seriously, we will have a serious issue that the health system is not equipped to handle."

拉斯米纳雷安警告说,如果“不认真对待社交距离和卫生措施,我们将面临卫生系统无法处理的严重问题”

One thing that won''t work in India is an age-specific lockdown, where elderly stay inside and the young are allowed to go back to work. Around the world, the elderly have been at a higher risk of dying from coronavirus -- in the US, 80% of deaths have been those ages 65 or older.

有一件事在印度是行不通的,那就是针对年龄的封锁,指让老人呆在家里,年轻人可以回去工作。在全世界,老年人死于冠状病毒的风险更高——在美国,80%的死亡是65岁或65岁以上的人。

India has a relatively young population -- 44% of the population are 24 or younger, compared with 23% in Italy and 29% in China, according to data from the CIA World Factbook. But many Indians live in a three-generation household, meaning that there is significant contact between younger and older generations, said University of Cambridge mathematician Ronojoy Adhikari, who modeled India''s outbreak.

中情局世界概况的数据显示,印度人口相对年轻——44%的人口年龄在24岁或24岁以下,而意大利为23%,中国为29%。但为印度的疫情建模的剑桥大学数学家Ronojoy Adhikari说,许多印度人生活在一个三代家庭中,这意味着年轻一代和年长一代之间有着紧密接触。

"This makes the elderly in India particularly vulnerable, as they are far more likely to catch the infection from the second and third generations, on whom the infection will, statistically speaking, only have mild effects," he said.

他说:“这使得印度的老年人特别脆弱,因为他们更容易被第二代或第三代人感染,而从统计学上讲,感染对年轻代的影响只是轻微的。”

Even if India does manage to avoid the worst of the virus this time around, there''s plenty to be done. The government needs to be working to support the country''s informal workforce, who are "underwriting the cost of the lockdown," as Saran puts it. The government needs to strengthen the public health system to prepare for a possible return and resurgence in the winter, said Reddy.

即使印度这次成功地避免了病毒最严重影响,也依然还有很多事情要做。政府需要努力支持该国的非正规劳动力,正如萨兰所说,他们正在“承担封锁的成本”。雷迪说,政府需要加强公共卫生系统,为病毒可能在冬季的卷土重来做好准备。

"This is not a one month challenge, this is going to be a 12-month challenge," said Saran. "I think this is a good 18-month examination of how we respond as people, communities, countries, states."

“这不是一个月的挑战,而是一个12个月的挑战,”萨兰说我认为这是对我们作为人民、社区、国家和州如何应对疫情的一次为期18个月的良好检查。”