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这个国家实行全球最严防疫措施,明确提出要“消灭病毒”

这个国家实行全球最严防疫措施,明确提出要“消灭病毒”

MATTHEW BROCKETT, 彭博社 2020-04-22
这个南太平洋国家是唯一一个明确致力于消灭病毒的西方国家。

当历史学家们评价每个国家如何应对新冠疫情的时候,新西兰肯定会引起他们的关注。

这个南太平洋国家是唯一一个明确致力于消灭病毒的西方国家。早在未出现死亡病例之前,新西兰就实行了全球最严的封锁措施,对感染者进行隔离,以防止新冠疫情失控。

早期迹象显示这些措施颇有成效。新增确诊病例已经降至数周最低,死亡病例为11人,是死亡人数最少的发达国家之一。新西兰总理杰辛达·阿德恩在周一决定从下周开始部分放松隔离措施。目前,新西兰政府要求除了必要工作者以外,所有人全部居家隔离。

上周四,阿德恩在惠灵顿告诉记者:“我们有机会做到其他国家做不到的事情,彻底消灭病毒。”但她警告不要太快放松限制。

对于岛国新西兰提出的消灭病毒这个远大目标,也不乏批评的声音。有人认为这个目标并不现实,而且新西兰经济将为此付出毁灭性的代价。即使新西兰成功地消灭了病毒,它还必须继续长期关闭与其他多数国家的边境,以防止输入病例。而这将给新西兰的创汇大户旅游业带来灭顶之灾。

奥塔哥大学(University of Otago)公共卫生系教授、来自惠灵顿的迈克尔·贝克表示,新西兰防疫措施的核心是被多数西方国家领导者忽视的一个科学事实,那就是病毒通常有5至6天的潜伏期,是流感的两倍。贝克是新西兰政府新冠病毒技术顾问组成员。

他说:“这意味着如果有人感染病毒,只要迅速将他们隔离,并把密切接触者集中隔离,就能阻断病毒的传播链。我们无法这样应对流感,因为等找到密切接触者时已经太迟了,他们又传染了其他人。”

他说,大部分国家都像对待流感一样处理新冠病毒,试图减缓疫情的进展,而不是将病毒彻底消灭。英美等国在发现确诊病例令他们难以应付之后,选择了缓解和抑制的做法。

调整策略

新西兰最初也采取了这种做法。在疫情初期,阿德恩表示要拉平病毒传播的曲线,以确保医疗系统足以应对疫情。

但在3月23日,她彻底改变了策略,宣布从两天后开始执行为期四周的全国隔离措施。她表示,模拟结果显示,如果不采取隔离措施,“新西兰会有数万人死亡。”

工厂关闭,学校停课,只有超市、街角便利店和药店可以继续营业。当时新西兰只有102例确诊病例,而且没有死亡病例。而多数国家在死亡率大幅攀升之后才开始采取这种措施。英国同样在3月23日宣布全国封城,但当时其国内已经有6,650例确诊病例,共335人死亡。

退出策略

新西兰的防疫措施背后的理论是早期施行严格的限制措施,以阻断病原体传播,最终确定一个具体的退出策略。虽然这样做可能会在初期带来更严重的经济冲击,但经济将很快恢复元气。缓解或抑制等替代措施可能要求居家隔离几个月,反而延长了经济阵痛的时间。

新西兰的策略需要具备大面积检测和密切接触者跟踪能力。统计数据显示,这种策略取得了成效。虽然新西兰的总确诊病例增加到1,409例,但却避免了欧洲和美国出现的指数级增长。新西兰在上周五仅公布了8例新增确诊病例,为四周来的最低增幅。

新西兰共有500万居民,与爱尔兰的人口数量相当,但爱尔兰的确诊病例超过13,000例,死亡近500人。虽然新西兰的11例死亡病例与东南亚国家新加坡的10例相当,但新加坡低收入外国工人居住的集体宿舍可能导致感染病例飙升。

新西兰与邻国澳大利亚的对比则更加复杂。澳大利亚已经公布确诊病例6,468例,死亡病例增加到63例。但澳大利亚的感染率为每百万人254例,低于新西兰的每百万人292例。

澳大利亚的防疫措施

澳大利亚并没有像新西兰一样采取严格的限制措施,但是也获得了一定防疫成果。澳大利亚允许更多行业继续运营,例如建筑业等,消费者依旧可以理发或者买外卖,这些措施为许多低收入工人保住了饭碗。

堪培拉医院(Canberra Hospital)的传染病科医生彼得·柯利格侬是澳大利亚政府聘请的疫情顾问。他表示:“澳大利亚没有采取新西兰的极端措施,但却取得了更好的结果。”

柯利格侬质疑新西兰消灭病毒的策略的现实性。

他说:“事实是病毒无处不在,它遍布在世界各地。即使你在短期内能取得成功,但长期内怎么办?隔离六个月?两年?最终病毒一定会再次输入。”

现在令人担心的是无症状感染现象。有人可能没有任何症状,但却会传播病毒,这种现象给抑制疫情蔓延带来了更大的挑战。

“虚幻”情境

澳大利亚首席医学官布伦丹·墨菲在4月14日对新西兰议会委员会表示,消灭病毒是一个“虚幻”情境。

他说:“我们采取了非常极端的抑制策略。显然我们希望可以消灭病毒,(但)我们高度质疑这种状态能够维持多久,因为你们需要采取极其严格的边境防控措施。”

不过贝克认为,尽量消灭病毒是有好处的,而且有证据显示这个目标是可以实现的,比如中国似乎已经成功控制住了武汉的疫情,并且阻止了境内的大范围传播。

他认为,包括澳大利亚在内的更多国家应该采取消灭病毒的策略,并最终与中国、新加坡、韩国等国家形成一个“东半球集团”,在集团内实现自由出行。

贝克说:“这或许有点乐观,但至少我们有退出策略和方案。与欧洲和北美在可以预见的未来可能陷入的混乱相比,这种情境似乎更有吸引力。”(财富中文网)

译者:Biz

当历史学家们评价每个国家如何应对新冠疫情的时候,新西兰肯定会引起他们的关注。

这个南太平洋国家是唯一一个明确致力于消灭病毒的西方国家。早在未出现死亡病例之前,新西兰就实行了全球最严的封锁措施,对感染者进行隔离,以防止新冠疫情失控。

早期迹象显示这些措施颇有成效。新增确诊病例已经降至数周最低,死亡病例为11人,是死亡人数最少的发达国家之一。新西兰总理杰辛达·阿德恩在周一决定从下周开始部分放松隔离措施。目前,新西兰政府要求除了必要工作者以外,所有人全部居家隔离。

上周四,阿德恩在惠灵顿告诉记者:“我们有机会做到其他国家做不到的事情,彻底消灭病毒。”但她警告不要太快放松限制。

对于岛国新西兰提出的消灭病毒这个远大目标,也不乏批评的声音。有人认为这个目标并不现实,而且新西兰经济将为此付出毁灭性的代价。即使新西兰成功地消灭了病毒,它还必须继续长期关闭与其他多数国家的边境,以防止输入病例。而这将给新西兰的创汇大户旅游业带来灭顶之灾。

奥塔哥大学(University of Otago)公共卫生系教授、来自惠灵顿的迈克尔·贝克表示,新西兰防疫措施的核心是被多数西方国家领导者忽视的一个科学事实,那就是病毒通常有5至6天的潜伏期,是流感的两倍。贝克是新西兰政府新冠病毒技术顾问组成员。

他说:“这意味着如果有人感染病毒,只要迅速将他们隔离,并把密切接触者集中隔离,就能阻断病毒的传播链。我们无法这样应对流感,因为等找到密切接触者时已经太迟了,他们又传染了其他人。”

他说,大部分国家都像对待流感一样处理新冠病毒,试图减缓疫情的进展,而不是将病毒彻底消灭。英美等国在发现确诊病例令他们难以应付之后,选择了缓解和抑制的做法。

调整策略

新西兰最初也采取了这种做法。在疫情初期,阿德恩表示要拉平病毒传播的曲线,以确保医疗系统足以应对疫情。

但在3月23日,她彻底改变了策略,宣布从两天后开始执行为期四周的全国隔离措施。她表示,模拟结果显示,如果不采取隔离措施,“新西兰会有数万人死亡。”

工厂关闭,学校停课,只有超市、街角便利店和药店可以继续营业。当时新西兰只有102例确诊病例,而且没有死亡病例。而多数国家在死亡率大幅攀升之后才开始采取这种措施。英国同样在3月23日宣布全国封城,但当时其国内已经有6,650例确诊病例,共335人死亡。

退出策略

新西兰的防疫措施背后的理论是早期施行严格的限制措施,以阻断病原体传播,最终确定一个具体的退出策略。虽然这样做可能会在初期带来更严重的经济冲击,但经济将很快恢复元气。缓解或抑制等替代措施可能要求居家隔离几个月,反而延长了经济阵痛的时间。

新西兰的策略需要具备大面积检测和密切接触者跟踪能力。统计数据显示,这种策略取得了成效。虽然新西兰的总确诊病例增加到1,409例,但却避免了欧洲和美国出现的指数级增长。新西兰在上周五仅公布了8例新增确诊病例,为四周来的最低增幅。

新西兰共有500万居民,与爱尔兰的人口数量相当,但爱尔兰的确诊病例超过13,000例,死亡近500人。虽然新西兰的11例死亡病例与东南亚国家新加坡的10例相当,但新加坡低收入外国工人居住的集体宿舍可能导致感染病例飙升。

新西兰与邻国澳大利亚的对比则更加复杂。澳大利亚已经公布确诊病例6,468例,死亡病例增加到63例。但澳大利亚的感染率为每百万人254例,低于新西兰的每百万人292例。

澳大利亚的防疫措施

澳大利亚并没有像新西兰一样采取严格的限制措施,但是也获得了一定防疫成果。澳大利亚允许更多行业继续运营,例如建筑业等,消费者依旧可以理发或者买外卖,这些措施为许多低收入工人保住了饭碗。

堪培拉医院(Canberra Hospital)的传染病科医生彼得·柯利格侬是澳大利亚政府聘请的疫情顾问。他表示:“澳大利亚没有采取新西兰的极端措施,但却取得了更好的结果。”

柯利格侬质疑新西兰消灭病毒的策略的现实性。

他说:“事实是病毒无处不在,它遍布在世界各地。即使你在短期内能取得成功,但长期内怎么办?隔离六个月?两年?最终病毒一定会再次输入。”

现在令人担心的是无症状感染现象。有人可能没有任何症状,但却会传播病毒,这种现象给抑制疫情蔓延带来了更大的挑战。

“虚幻”情境

澳大利亚首席医学官布伦丹·墨菲在4月14日对新西兰议会委员会表示,消灭病毒是一个“虚幻”情境。

他说:“我们采取了非常极端的抑制策略。显然我们希望可以消灭病毒,(但)我们高度质疑这种状态能够维持多久,因为你们需要采取极其严格的边境防控措施。”

不过贝克认为,尽量消灭病毒是有好处的,而且有证据显示这个目标是可以实现的,比如中国似乎已经成功控制住了武汉的疫情,并且阻止了境内的大范围传播。

他认为,包括澳大利亚在内的更多国家应该采取消灭病毒的策略,并最终与中国、新加坡、韩国等国家形成一个“东半球集团”,在集团内实现自由出行。

贝克说:“这或许有点乐观,但至少我们有退出策略和方案。与欧洲和北美在可以预见的未来可能陷入的混乱相比,这种情境似乎更有吸引力。”(财富中文网)

译者:Biz

When historians assess how countries approached the coronavirus pandemic, New Zealand is sure to stand out.

The South Pacific nation is alone among its western peers in explicitly attempting to eradicate the virus. It adopted one of the strictest lockdowns in the world before a single death was reported, and has isolated infections to keep the disease from spreading out of control.

The early signs are promising. The rate of new infections has dwindled to the lowest in weeks, and the death toll -- at 11 -- is one of the lowest among developed nations. The prime minister, Jacinda Ardern, decided on Monday to start easing some quarantine measures that requires everyone but essential workers to stay at home.

“We have the opportunity to do something no other country has achieved -- elimination of the virus,” Ardern told reporters last Thursday in Wellington, as she cautioned against relaxing restrictions too quickly.

The island nation’s lofty goal of elimination is not without critics, who say it’s unrealistic and comes at a devastating economic cost. Even if New Zealand succeeds, its borders will have to remain closed to much of the world for a considerable period to keep the virus out. That will decimate the tourism industry, its largest source of foreign exchange earnings.

Central to New Zealand’s approach is a scientific fact that most western leaders appear to have ignored, according to Michael Baker, a professor at the University of Otago’s Department of Public Health in Wellington who sits on the government’s Covid-19 Technical Advisory Group. That is that the virus usually has an incubation period of five to six days, twice as long as influenza.

“That means that when someone gets sick, if you isolate them quickly and round up their contacts, you can quarantine those people and interrupt that chain of transmission,” said Baker. “With influenza you can’t really do that because by the time you’ve found their contacts it’s too late, they’ve infected other people.”

And yet most countries treated Covid-19 as if it were influenza, he said, trying to slow its advance rather than eradicate it. Nations including the U.K. and the U.S. opted for such mitigation and suppression efforts after they found themselves overwhelmed by cases.

Changing Tactics

New Zealand’s initial response took that approach too. In the early stages of the outbreak, Ardern spoke of “flattening the curve” of the virus’s spread to ensure the health system could cope.

That all changed on March 23, when she announced a four-week nationwide lockdown would commence two days later, saying modeling showed that without the measures “tens of thousands of New Zealanders could die.”

Industries were shuttered, schools were closed, and the only shops allowed to stay open were supermarkets, some corner stores and pharmacies. At that stage, New Zealand had only 102 cases and no deaths. Most countries resorted to such measures only after fatalities soared. When the U.K. announced its lockdown, also on March 23, it had 6,650 Covid-19 cases and 335 people had already died.

Exit Strategy

The theory is that imposing tough restrictions early halts the spread of the pathogen and eventually allows an exit strategy to crystallize. The economic hit may be worse upfront, but activity can resume sooner. The alternatives of mitigation or suppression may require restrictions to stay in place for many months, prolonging the economic pain.

New Zealand’s strategy, which requires extensive testing and contact-tracing capabilities, is supported by the statistics. While total cases have risen to 1,409, it has avoided the exponential growth seen in Europe and the U.S. Just eight new infections were reported last Friday, the lowest number in four weeks.

The island nation, with 5 million residents, has a similar population to Ireland, which has seen more than 13,000 infections and almost 500 deaths. And while New Zealand’s 11 fatalities compare with 10 in Singapore, that Southeast Asian country is now struggling with a wave of infections from dormitories housing low-wage foreign workers.

A comparison with neighboring Australia is more complicated. Australia has far more cases, at 6,468, and deaths have climbed to 63. But the infection rate comes out to 254 per million people, less than New Zealand’s 292 per million.

Australia’s Approach

Australia’s results have come despite less stringent restrictions. It has allowed more industries to continue operating, such as construction, and consumers can still get a haircut or buy a takeaway meal, keeping many workers on lower incomes employed.

“Australia is doing better than New Zealand without going to that extreme,” said Peter Collignon, an infectious diseases physician at Canberra Hospital who advises the Australian government.

Collignon questions whether New Zealand’s eradication strategy is realistic.

“The reality is this virus is everywhere, it’s all around the world,” he said. “So even if you’re successful for a short period of time, how long do you do this for? Six months? Two years? Invariably, you’re going to get the virus re-introduced.”

One concern is the phenomenon of asymptomatic transmission. The possibility that people can pass along the disease even though they show no symptoms underscores the challenge of containing the pandemic.

‘Nirvana’ Scenario

Brendan Murphy, Australia’s chief medical officer, told a New Zealand parliamentary committee April 14 that eradicating the virus is a “nirvana” scenario.

“We are pursuing a very aggressive suppression strategy,” he said. “Obviously we would like to achieve elimination (but) we’re pretty doubtful that could be maintained for the long-term given the incredible border measures you would need to have.”

For Baker, there are benefits in trying to eliminate the virus, as well as evidence it can be done -- China, for example, appears to have succeeded in stopping the Wuhan epidemic and preventing wider transmission within its borders.

He believes more countries, including Australia, could yet adopt elimination strategies and eventually form an “eastern hemisphere bloc” with nations like China, Singapore and South Korea within which travel will be possible.

“Maybe it’s a bit optimistic, but at least we have an exit strategy and a plan,” Baker said. “That seems a lot more appealing than the mess that Europe and North America are going to be in for the foreseeable future.”

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