專家稱武漢「封城」規模史無前例
中國將武漢~~一座人口超過1100萬的城市——封鎖的舉措,是在運用一種有幾百年歷史的公共衛生手段來防止傳染病的傳播~~這一次是由一種冠狀病毒導致的神秘呼吸道疾感染疾病。
專家表示,此次封城相當於孤立了一個比紐約市還大的重要城市交通樞紐,規模之大令人震驚,這是史無前例的。
「這是一項不可思議的工作,」密西根大學醫學史教授霍華德·馬克爾(Howard Markel)博士說,他還說,他從未聽說過將隔離這麼多人作為疾病預防措施。
儘管如此,「還是會有人出去,」他說。「會有漏洞。」
為保護公共健康而限制上千萬人的流動,中國此舉是在訴諸於一種有著漫長而複雜的歷史、充滿了社會、政治和倫理問題的折衷之法。
亞利桑那州立大學(Arizona State University)公共衛生法律與政策中心(Center for Public Health Law and Policy)主任小詹姆斯·G·霍奇(James G. Hodge Jr.)表示,封閉城市幾乎肯定會導致侵犯人權,而且在美國顯然是違反憲法的。
「這很容易適得其反,」他說,並且這些限制措施可能會阻止健康人群逃離城市,使他們面臨更大的感染風險。「總的來說,這是一種有風險的做法。」
該病毒於去年12月底首次出現,已造成至少17人死亡,500多人患病。為遏制病毒的蔓延,中國政府表示將從週四開始取消從武漢出發的飛機和火車,並暫停城內的公車、地鐵和渡輪。
隔離人員和貨物以阻止疾病傳播的做法至少可以追溯到14世紀,當時鼠疫流行,船隻到達威尼斯時需要先在海上停泊40天。根據美國疾病控制與預防中心(Centers for Disease Control and Prevention)的說法,英語中的「檢疫隔離」(quarantine)一詞就由這段隔離期而來~~它源自義大利語的quaranta giorni,意思是40天。
霍奇說,如果隔離措施只是選擇性地隔離那些已經感染或疑似感染的人,這可能是有效的。武漢的反應遠不止於此,而是建立了「警戒線」式的邊界。
「檢疫隔離本來應該是『你不能離開自己的家,不能去上學、工作或者做禮拜』,」他說。但中國當局「在這座城市周圍划了一條線,說『不許進來,也不許出去』。這樣做顯然是過度的反應」。
近年來,各國政府也曾採取其他大規模措施來防止傳染病的傳播。
2014年9月,擁有約700萬人口的塞拉利昂宣布,「所有人」都應在室內待上三天,與此同時,7000支醫療組和社區工作人員挨家挨戶尋找隱藏的伊波拉患者。
那一年早些時候,利比裡亞官員對蒙羅維亞的西點進行了伊波拉檢疫隔離,那是一個面積很大的貧民窟,有6萬至12萬人擠在棚屋裡。專家說,這個命令導致了民眾與士兵的傷亡衝突,並可能助長了疾病的傳播,迫使人們聚集在一起接受基本的人道主義援助。
在2003年SARS爆發期間,加拿大衛生官員要求安大略省任何有呼吸道感染癥狀的人在家裡待幾天,因為他們擔心這種疾病會在復活節週末期間傳播。
在北京,當時至少有4000名接觸過該病毒的居民被隔離,300名與感染者有過接觸的大學生被隔離在一座軍營內两週。
歷史學家指出,隔離通常針對的是邊緣人群。
曾寫過有關檢疫隔離史文章的義大利研究人員尤金尼亞·托諾斯蒂(Eugenia Tognotti)說,14世紀鼠疫流行期間,歐洲各城邦在道路和出入口設置了武裝警衛,以阻止商人、痲瘋病患者和猶太人等少數群體進入。
她還寫道,19世紀30年代,歐洲爆發了一波霍亂疫情,那不勒斯限制妓女和乞丐的流動,因為他們被認為是霍亂的傳播者。
馬克爾說,1892年俄羅斯猶太人把斑疹傷寒帶到了曼哈頓下東區。然而,被集中起來並隔離在布朗克斯附近島嶼上的不僅是受感染的人,還有他們的鄰居,以及在街上和他們打招呼的人。
「這是檢疫隔離的陰暗面~~它被誤用為一種社會工具,而不是對一種醫療手段的科學應用,」馬克爾說。
翻譯:晉其角
專家稱武漢「封城」規模史無前例
Scale of China's Wuhan Shutdown Is Believed to Be Without Precedent
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In closing off Wuhan, a city of more than 11 million people, China is deploying a centuries-old public health tactic to prevent the spread of infectious disease — this time, a mysterious respiratory infection caused by a coronavirus.
中國將武漢~~一座人口超過1100萬的城市~~封鎖的舉措,是在運用一種有幾百年歷史的公共衛生手段來防止傳染病的傳播~~這一次是由一種冠狀病毒導致的神秘呼吸道疾感染疾病。
Experts said the stunning scale of the shutdown, isolating a major urban transit hub larger than New York City, was without precedent.
專家表示,此次封城相當於孤立了一個比紐約市還大的重要城市交通樞紐,規模之大令人震驚,這是史無前例的。
"It's an unbelievable undertaking," said Dr. Howard Markel, a professor of the history of medicine at the University of Michigan, adding that he had never heard of so many people being cordoned off as a disease-prevention measure.
「這是一項不可思議的工作,」密西根大學醫學史教授霍華德·馬克爾(Howard Markel)博士說,他還說,他從未聽說過將隔離這麼多人作為疾病預防措施。
Still, "people are going to get out," he said. "It's going to be leaky."
儘管如此,「還是會有人出去,」他說。「會有漏洞。」
By limiting the movements of millions of people in an attempt to protect public health, China is engaging in a balancing act with a long and complicated history fraught with social, political and ethical concerns.
為保護公共健康而限制上千萬人的流動,中國此舉是在訴諸於一種有著漫長而複雜的歷史、充滿了社會、政治和倫理問題的折衷之法。
James G. Hodge Jr., director of the Center for Public Health Law and Policy at Arizona State University, said the shutdown would almost certainly lead to human rights violations and would be patently unconstitutional in the United States.
亞利桑那州立大學(Arizona State University)公共衛生法律與政策中心(Center for Public Health Law and Policy)主任小詹姆斯·G·霍奇(James G. Hodge Jr.)表示,封閉城市幾乎肯定會導致侵犯人權,而且在美國顯然是違反憲法的。
"It could very easily backfire," he said, adding that the restrictions could prevent healthy people from fleeing the city, perhaps exposing them to greater risk of infection. "In general, this is risky business."
「這很容易適得其反,」他說,並且這些限制措施可能會阻止健康人群逃離城市,使他們面臨更大的感染風險。「總的來說,這是一種有風險的做法。」
To combat the spread of the virus, which first appeared at the end of December and has killed at least 17 people and sickened more than 500, the Chinese government said it would cancel planes and trains leaving Wuhan beginning Thursday, and suspend buses, subways and ferries within it.
該病毒於去年12月底首次出現,已造成至少17人死亡,500多人患病。為遏制病毒的蔓延,中國政府表示將從週四開始取消從武漢出發的飛機和火車,並暫停城內的公車、地鐵和渡輪。
The practice of isolating people and goods to halt the spread of disease dates at least to the 14th century, when ships arriving in Venice during the plague epidemic were required to anchor off the coast for 40 days. The isolation period gave rise to the term quarantine, from the Italian quaranta giorni, meaning 40 days, according to the Centers for Disease Control and Prevention.
隔離人員和貨物以阻止疾病傳播的做法至少可以追溯到14世紀,當時鼠疫流行,船隻到達威尼斯時需要先在海上停泊40天。根據美國疾病控制與預防中心(Centers for Disease Control and Prevention)的說法,英語中的「檢疫隔離」(quarantine)一詞就由這段隔離期而來~~它源自義大利語的quaranta giorni,意思是40天。
Professor Hodge said quarantines could be effective if they selectively isolate only those who have been infected or are suspected of infection. The response in Wuhan, with the establishment of a "cordon sanitaire"-type boundary, goes much further than that.
霍奇說,如果隔離措施只是選擇性地隔離那些已經感染或疑似感染的人,這可能是有效的。武漢的反應遠不止於此,而是建立了「警戒線」式的邊界。
"Quarantine would be saying 'You can't leave your own home, can't go to school, work or church,'" he said. But the Chinese authorities "have drawn a line around this city and said, 'No one in and no one out.' That type of thing is obviously an excessive response."
「檢疫隔離本來應該是『你不能離開自己的家,不能去上學、工作或者做禮拜』,」他說。但中國當局「在這座城市周圍划了一條線,說『不許進來,也不許出去』。這樣做顯然是過度的反應」。
In recent years, governments have imposed other large-scale measures to prevent the spread of infectious diseases.
近年來,各國政府也曾採取其他大規模措施來防止傳染病的傳播。
Sierra Leone, a country of about seven million people, said "everybody" was expected to stay indoors for three days in September 2014, as 7,000 teams of health and community workers went door to door to find hidden Ebola patients.
2014年9月,擁有約700萬人口的塞拉利昂宣布,「所有人」都應在室內待上三天,與此同時,7000支醫療組和社區工作人員挨家挨戶尋找隱藏的伊波拉患者。
Earlier that year, Liberian officials placed West Point, a sprawling slum in Monrovia where 60,000 to 120,000 people were crammed into shacks, under an Ebola quarantine. The order led to deadly clashes with soldiers and may have helped to spread the disease, experts said, forcing people to crowd together for basic humanitarian aid.
那一年早些時候,利比裡亞官員對蒙羅維亞的西點進行了伊波拉檢疫隔離,那是一個面積很大的貧民窟,有6萬至12萬人擠在棚屋裡。專家說,這個命令導致了民眾與士兵的傷亡衝突,並可能助長了疾病的傳播,迫使人們聚集在一起接受基本的人道主義援助。
During the SARS outbreak of 2003, Canadian health officials asked anyone in Ontario who had even one symptom of the respiratory infection to stay home for a few days out of fear that the disease might spread during the Easter holiday weekend.
在2003年SARS爆發期間,加拿大衛生官員要求安大略省任何有呼吸道感染癥狀的人在家裡待幾天,因為他們擔心這種疾病會在復活節週末期間傳播。
In Beijing, at least 4,000 residents who had been exposed to the virus were kept in isolation, and 300 college students who had had contact with infected people were sequestered in a military camp for two weeks.
在北京,當時至少有4000名接觸過該病毒的居民被隔離,300名與感染者有過接觸的大學生被隔離在一座軍營內两週。
Historians have noted that quarantines have often targeted marginalized populations.
歷史學家指出,隔離通常針對的是邊緣人群。
During the plague epidemic of the 14th century, European city-states posted armed guards on roads and access points to keep out merchants, people with leprosy and minority groups such as Jews, according to Eugenia Tognotti, a researcher in Italy who has written on the history of quarantine.
曾寫過有關檢疫隔離史文章的義大利研究人員尤金尼亞·托諾斯蒂(Eugenia Tognotti)說,14世紀鼠疫流行期間,歐洲各城邦在道路和出入口設置了武裝警衛,以阻止商人、痲瘋病患者和猶太人等少數群體進入。
And during a wave of cholera outbreaks in Europe in the 1830s, Naples restricted the movement of prostitutes and beggars, who were thought to be carriers of the contagion, she wrote.
她還寫道,19世紀30年代,歐洲爆發了一波霍亂疫情,那不勒斯限制妓女和乞丐的流動,因為他們被認為是霍亂的傳播者。
Russian Jews brought typhus fever into the Lower East Side of Manhattan in 1892, Dr. Markel said. It was not only infected people who were rounded up and quarantined on an island off the Bronx, however, but also their neighbors and others whom they had simply greeted on the street.
馬克爾說,1892年俄羅斯猶太人把斑疹傷寒帶到了曼哈頓下東區。然而,被集中起來並隔離在布朗克斯附近島嶼上的不僅是受感染的人,還有他們的鄰居,以及在街上和他們打招呼的人。
"That's the darker side of quarantine — its misuse as a social tool rather than its scientific use as a medical tool," Dr. Markel said.
「這是檢疫隔離的陰暗面~~它被誤用為一種社會工具,而不是對一種醫療手段的科學應用,」馬克爾說。
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