关于戴口罩 —— 译介

许个愿。
楼主 若啬  发布于 2020-04-05 12:38:12 +0800 CST  
浏览到一篇戴不戴口罩的文章。想及之前有关口罩的种种,……

复制英文原文以免自己错译错解。未检查译文,请读到者自动更正好make sense。
楼主 若啬  发布于 2020-04-05 12:43:39 +0800 CST  
The CDC now recommends everyone use cloth masks in public
There’s evidence that everyone should use masks in certain public settings. But there’s also a shortage of masks for health care workers.
By German [email protected]@vox.com Apr 3, 2020, 6:25pm EDT
疾病控制中心现在建议在公共空间人人用布口罩
有证据显示在一定的公共情景人人应该用口罩。但医护工作者也有口罩短缺问题。
作者:German [email protected]@vox.com
2020年4月3日,美东时间傍晚6点25分

President Donald Trump said Friday the CDC is advising that every person in the US wear a cloth mask or face covering in certain public settings to combat the coronavirus pandemic.
总统唐纳德创破星期五说,疾病控制中心建议在美国在一定的公共场合,每个人戴布口罩或面罩以对抗新冠病毒大流行。

Masks should be worn by all except infants “in public settings where other social distancing measures are difficult to maintain,” such as grocery stores and pharmacies, CDC guidance reads. Masks are especially recommended in areas where Covid-19, the disease caused by the SARS-CoV-2 coronavirus, has shown significant spread from person to person.
“在社交距离难以维持的公共场合”, 如杂货店和急诊,除了婴儿所有人都应该戴口罩,疾病控制中心的指南写道。在新冠肺炎,这种由SARS-CoV-2新冠病毒引起的疾病已经出现显著的人与人之间传播的地方,尤其建议戴口罩。

The new guidance is a big shift for the federal government, which previously declined, through the Centers for Disease Control and Prevention and surgeon general, to recommend that most of the public wear a mask. Authorities previously only recommended masks for those who are sick and people, such as health care workers, who frequently interact with the sick.
这建议大部分市民戴口罩的新指南对于联邦政府来说是一个巨大的转变,因为之前它被政府通过疾病控制及预防中心(CDC)和卫生部门官员(surgeon general)所否决了。先前权威部门只建议病人和那些频繁与病人接触的医护人员戴口罩。

The White House’s recommendation, based on new guidance from the CDC, only calls for people to use cloth masks, including homemade variants. The guidance is voluntary — and Trump immediately added at a press conference Friday that he would not be complying: “You can do it. You don’t have to do it. I’m choosing not to do it.”
白宫的建议是基于来自疾病控制中心的新指南,而且只呼吁人们戴布口罩,包括在家里自己制作的替代物。这指南是自愿性的 —— 进而,创破在星期五的一个发布会上立即说他不会照做:“你可以那么做,你不是必须去做。我选择不去做。”

The recommendation does not mean you should go out and buy a traditional medical mask. Since there’s a shortage of personal protective equipment (PPE), including masks, for doctors and nurses, experts recommend that people don’t use the limited supply of medical masks, like surgical masks and N95 respirators, for themselves and instead leave those for health care workers.
这个建议不意味着你应该出去买传统的医用口罩。因为存在医生和护士所用个人防护用品(PPE)的短缺,包括口罩,专家建议人们不要自己用供应受限的医用口罩,如手术口罩和N95呼吸保护口罩,要把它们留给医护人员。
楼主 若啬  发布于 2020-04-05 12:45:40 +0800 CST  
While the evidence is limited, research suggests that more mask use by the greater public could help stop the spread of Covid-19. Some studies in households and colleges “show a benefit of masks,” Raina MacIntyre, head of the Biosecurity Program at the University of New South Wales in Sydney, Australia, told me, “so it would be plausible that they would also protect in lower-intensity transmission settings such as in the general community.”
同时,建议大众更多使用口罩帮助阻止新冠肺炎传播的研究证据也是有限的。澳大利亚新南威尔士大学的生物安全计划负责人Raina MacIntyre告诉我,一些在家居和学校环境里的研究显示戴口罩是有效的,所以,“认为口罩在较低人口密度传播场合如一般社区也具有保护作用是合理的。”

The PPE shortage makes this evidence a bit harder to act on. If doctors and nurses can’t get medical masks, that’s very bad news for all of us: We need as many health care workers as possible to stay healthy so they can treat and save people who are sick, not just with Covid-19 but with other illnesses too.
PPE短缺使得这研究证据被试用有点儿难。如果医生和护士们得不到医用口罩,对我们所有人来说都是个坏消息:我们需要尽可能多的医务工作者保持健康,那样他们才能去治疗和拯救病人,不只新冠肺炎患者,还有其他疾病患者。

“I am worried that telling people to wear masks will strain already weak supplies that are needed by doctors and nurses,” Jennifer Nuzzo, an epidemiologist at Johns Hopkins University, previously told me, before the federal government’s updated guidance. “If we are able to fix that supply chain, I’d feel less worried about this. But some of the shortages initially were due to members of public and medical staff raiding medical offices’ and hospitals’ supplies for home use.”
约翰霍普金斯大学流行病学家Jennifer Nuzzo在联邦政府更新指南之前对我说,“我担心告诉人们戴口罩会恶化已经不足的医生和护士的医疗供给,如果我们能修补好供货链,我就会少些担心。但是起初的一些短缺是由于市民和医护人员把医疗机构和医院的供给做家庭使用。”

Experts also worry masks can give people an exaggerated sense of security. Masks don’t make you invincible, and they absolutely can’t replace good hygiene — Wash your hands! Don’t touch your face! — and social distancing. Even in Asian countries where widespread mask use is common, good hygiene and social distancing have been necessary to combat Covid-19. Epidemiological models also suggest coronavirus cases will rise if social distancing measures are relaxed, potentially causing hundreds of thousands, if not millions, of deaths in the US alone.
专家们也担心口罩会给人们一种夸大的安全感。口罩不能使你百病不侵,它们绝对不能代替好的卫生习惯 —— 洗手!不要碰你的脸!—— 和社交距离。即使在大众普遍都戴口罩的亚洲国家,好的卫生习惯和社交距离对抵抗新冠肺炎也是必须。流行病学模型也提示如果社交距离要求放松,新冠病例将会增加,潜在地,单在美国就会引起如果不是数百万也是数十万的死亡。
楼主 若啬  发布于 2020-04-05 12:47:16 +0800 CST  
Still, masks do appear to help. It’s straightforward: Coronavirus appears to mostly spread when germ-containing droplets make it into a person’s mouth, nose, or eyes. If you have a physical barrier in front of your mouth and nose, that’s simply less likely to happen.
不过,口罩似乎确实有帮助。简单说:新冠病毒似乎主要是通过含菌毒的飞沫进入人的口,鼻,或双眼。如果你有个物理屏障在你的口鼻前,简单地说,传播发生的可能性就小。

But the best protection masks offer may be protection from the wearer. While the evidence is thin on how much masks protect the wearer from coronavirus — since it’s unclear if the virus spreads much through airborne droplets — it’s true that the masks stop people from spreading their own droplets: When you breathe, talk, laugh, sigh, yawn, sneeze, or cough in public, you’re less likely to get droplets on a checkout machine, dining table, or anywhere else if you have a mask on. That could stop people, even those who are asymptomatic, from spreading infection.
但是,口罩提供的最好的保护可能是来自戴口罩人的保护。同时,戴口罩对预防新冠病毒到底有多大保护作用的证据是稀少的 —— 因为病毒通过空气飞沫散播的程度尚不清楚 —— 口罩确实阻止了戴口罩者自己的飞沫传播:当你在公共场合呼吸,说话,笑,叹气,打哈欠,打喷嚏,或咳嗽时,如果你戴个口罩,你不太可能让飞沫落在收银机,餐桌,或其他地方。这能够阻止人们,甚至那些无症状的感染者,传播病毒。

That’s especially important for Covid-19, since at least some spread happens when people are asymptomatic, when they have few symptoms, or before they develop symptoms. Universal mask use could stop these asymptomatic carriers — many of whom might not even know they’re sick — from inadvertently infecting other people.
对新冠肺炎而言,那是特别重要的,因为至少有些传播是在人们没有症状,几乎没症状,或他们出现症状前发生的。普通的口罩使用能阻止这些无症状的携带者 —— 其中许多人甚至不知道自己病了 ——无意中传染病毒给其他人。

The CDC guidance stated that masks are primarily meant to prevent the spread of disease from the wearer to others.
疾病控制中心的指南说,口罩主要是阻止戴口罩的人把疾病传播给其他人。

Some members of the general public would also benefit more. People who know they’re sick or interacting with someone who’s sick were already advised to use a mask. People who frequently interact with others as part of their jobs, like a first responder or a grocery store clerk, are more likely to get good use out of masks too. The logic is similar to why masks are so important for health care workers: Masks are most useful during prolonged, close interactions involving potentially sick people.
公众中的某些人会获益更多。病人或与病人接触的人已经被建议戴口罩。工作时要频繁与人打交道的人,如接待员或杂货店店员更可能从正确使用口罩中获得保护。逻辑与为什么口罩对医护人员很重要相似。口罩在与潜在病人长期密切接触时是最有用的。
楼主 若啬  发布于 2020-04-05 12:48:06 +0800 CST  
With the new guidance, the federal government is trying to walk a line between acknowledging the evidence for public mask use — as well as many people’s desires to take more action to combat the coronavirus — and avoiding further strain on available PPE supplies. So it’s limited its call to just cloth masks (which can be made at home) for now. The CDC also notes that “cloth face coverings should not be placed on young children under age 2, anyone who has trouble breathing, or is unconscious, incapacitated or otherwise unable to remove the mask without assistance.”
按照新指南,联邦政府正试图在承认公众应用口罩的证据——以及很多人想更积极地抵抗新冠病毒 —— 与避免进一步加剧PPE供应紧张之间找到一个出路。所以,它是一个有限制的(戴口罩)指南,它只是呼吁现在戴布口罩(家里就可以做)。疾病控制中心(CDC)也特别指出,“布面罩不能用于:2岁以下的小孩,呼吸困难的人,昏迷者,没有协助无法戴或摘掉面罩者。”

But for almost every American, that means the official guidance is to now wear some sort of cloth on the face while in public.
但是对几乎每一个美国人,那意味着,这个正式的指南是让他们在公共场合戴某种布在脸上。

There’s some research in favor of everyone wearing masks
有些研究倾向于每个人都戴口罩。

Here’s the gist of the evidence on public mask use: Masks don’t offer full protection — but some protection is better than none.
这就是公众戴口罩的证据要点:口罩不能提供完全的保护 —— 但是,有些保护好于没有保护。

Masks can’t replace all the other approaches needed to fight the coronavirus, like washing your hands, not touching your face, and social distancing. But when paired with all these other tactics — and when used correctly, which may not be as easy as you think — masks offer an extra layer of protection.
口罩不能取代对抗新冠病毒需要采取的其他方式,像洗手,不要碰你的脸,和社交距离。但是,当与其他战术相配合 —— 同时被正确使用,这可能没你以为的那么容易 —— 口罩会提供一层额外的保护。

The quality of the research on this topic is weak, with a lot of small, underpowered studies. “There’s not this overwhelming body of evidence that says that’s exactly what we should be doing right now,” Saskia Popescu, an epidemiologist focused on hospital preparedness, told me. “That’s why there hasn’t been an earlier push from public health agencies.”
对口罩问题进行的调研,研究质量不高,是不少小型,缺乏说服力的研究。 “没有压倒性的研究证据准确地说明,我们现在应该怎么做。”重点研究医院准备的流行病学家Saskia Popescu告诉我。“那就是为什么公共健康机构没有早些督促戴口罩。”

But the studies that do exist generally favor more people wearing masks.
但是,确实存在些支持更多让戴口罩的研究。

A 2008 systematic review, published in BMJ, found medical masks halted the spread of respiratory viruses from likely infected patients. In particular, studies on the 2003 outbreak of SARS — a cousin to the coronavirus that causes Covid-19 — found that masks alone were 68 percent effective at preventing the virus. By comparison, washing hands more than 10 times a day was 55 percent effective. A combination of measures — hand-washing, masks, gloves, and gowns — was 91 percent effective.
发表在BMJ(英国医学杂志)的一篇2008年的系统性回顾,发现医用口罩中止了来自很可能已感染病人的呼吸病毒的传播。特别是对于引起新冠肺炎的新冠病毒的表亲2003年暴发的SARS的研究,发现单单口罩预防病毒的有效性达68%。作为对比,一天洗不止10次手的有效性是55%。 一种联合的度量 ——洗手,戴口罩,戴手套,和穿防护服 —— 有效性是91%。
楼主 若啬  发布于 2020-04-05 12:49:07 +0800 CST  
A 2015 review, also published in BMJ, looked at mask use among people in community settings, specifically households and colleges. Some studies produced unclear results, but the findings overall indicated that wearing a mask protected people from infections compared to not wearing a mask, especially when paired with hand-washing. A big issue was adherence; people were often bad at actually wearing masks, which, unsurprisingly, diminished their effectiveness. But if masks were used early and consistently, the authors concluded, they seemed to work.
同样也发表于BMJ的一个2015年的回溯,考察了社区环境里戴口罩的人,特别是家和学院的环境。 一些研究的结果不明确,但是总体发现指明,与不戴口罩相比,戴口罩保护人们免予感染,尤其是配合洗手时。但顺带一个大问题;实际上人在感觉不好时才戴口罩,毫不意外地,这削弱了戴口罩的有效性。但是,假如能一早一直地用口罩,作者下结论说,口罩似乎是有用的。

Other studies have produced similar results, typically finding at least some protective value from masks as long as they’re used consistently and properly.
其他一些研究产生了相似的结果,典型的发现是,只要口罩被一贯地正确地使用了,至少有些保护价值。

There are some risks. If people start feeling like masks make them invulnerable and begin acting recklessly — ignoring social distancing or failing to wash their hands — that could actually make wearing masks worse than not wearing them. But if people take all the other precautions and add masks to their repertoire, as other countries’ experiences suggest people can do, then masks seem to help.
口罩也有一些风险。如果人们开始觉得口罩让他们百病不侵并鲁莽行事 —— 忽视社交距离或不洗手 —— 那确实会造成戴口罩不如不戴口罩的后果。 但是,假如人们遵行所有的预防措施再加上口罩,正如其他国家的经验建议人们去做的,那么口罩似乎是有帮助的。

There’s no good research on how masks affect people’s behaviors. “It could be good. It could be bad,” Popescu said. “But either way, we need to have that knowledge.”
还没有关于口罩怎样影响人们行为的好的研究。“它可能好,也可能坏,”Popescu说。“但无论哪种方式,我们都需要去获得相关知识。”

There’s also a risk of improper use actually exposing people to more illness. If people don’t put on the masks correctly, they won’t be as protective (though some barrier is likely better than none). If people touch the front of their masks and then touch other parts of their face, they can infect themselves with droplets their mask caught. If people reuse masks, they can breathe in virus-containing droplets from the masks while putting them on or taking them off.
不适当的使用口罩也有置人们于更多疾病的风险。如果人们没有正确地戴口罩,口罩将不会起到应有的保护作用(尽管有保护屏障很可能比没有更好)。如果人们碰触他们口罩的前面,然后碰触他们脸的其他部分,他们就可能用他们的口罩捕捉到的飞沫使他们自己感染。如果人们重复使用口罩,在戴口罩或摘口罩时,他们能吸入包含有病毒的飞沫。

The results also vary depending on the type of mask. One kind of mask that’s been talked about a lot lately is the N95 respirator, which is a more complex, expensive mask meant to fit more tightly on the face. N95 respirators in theory outperform surgical masks (which are the more traditional, looser-fitting medical masks), but they’re genuinely difficult to fit and use properly — to the point that a 2016 review in CMAJ couldn’t find a difference among health care workers using N95 respirators versus surgical masks for respiratory infection, likely due to poor fitting. Given how difficult these are to use, and the extra layer of protection they can provide, experts argue these masks should, above all, be saved for health care workers.
结果也随口罩类型而改变。近来被谈论得很多的一种口罩是N95防护口罩,一种更复杂,更贵的口罩意味着它与面部贴合得更紧密。N95防护口罩理论上比手术口罩(一种更传统,更宽松的医用口罩)防护效果更好,但实情是它们不易被恰当地贴合和使用——2006年发表在CMAJ上的一个回顾研究指出,就预防呼吸感染来说,没有发现医护人员使用的N95 防护口罩与手术口罩之间有差别,很可能是由于口罩与面部间的不良密合。考虑到这些口罩的使用之难,和它们提供的额外保护层,专家主张这些口罩应该首先留给医护人员。
楼主 若啬  发布于 2020-04-05 12:49:46 +0800 CST  
Cloth masks, meanwhile, are much less effective than the modern alternatives, as a 2015 study in BMJ found. And they can be extra risky, since they can trap and hold virus-containing droplets that wearers can then breathe in. But they still, in general, offer more protection than no mask at all, several studies concluded.
与此同时,布口罩和它的现代替代物相比效果要差得多,正如2015年BMJ上一个研究的发现。而且它们可能是额外冒险的,因为它们可能困住能被戴口罩的人吸入的含病毒的飞沫。然而几个研究的结论是,总体而言,与完全不戴口罩相比它们仍然提供了更多保护。

Experts at the CDC also offered some advice for proper mask use, which differs somewhat depending on the type of mask: Wash your hands before and after taking off a mask — before to avoid getting anything on your face and mask, and after to get rid of anything that was on your mask. Don’t fidget with your mask while it’s on. If possible, throw away disposable masks after using them. And if you can’t throw a mask away, make sure to thoroughly disinfect it with ultraviolet light sterilizers — not something most people have around. Or, if using a cloth product, soap and water or laundering works.
CDC的专家们也提供了些正确戴口罩的忠告,忠告因口罩类型而有所不同:在摘口罩之前和之后洗手 —— 之前洗手以避免沾染任何东西到你的脸上和口罩上, 而之后是摆脱掉任何从你口罩上沾来的东西。戴着口罩时不要因你的口罩而烦躁。如果可能,立即扔掉使用过的一次性口罩。如果你不能扔掉一个口罩,要保证用紫外线杀菌灯将它彻底消毒 —— 而不是用多数人常用的灯。或者,如果使用布口罩,肥皂和水或者洗涤就好。

Based on the evidence, masks appear to help both the wearer and other people. The latter is particularly important for the coronavirus, since the disease can spread from those with few to no symptoms. So whether it’s for selfish or altruistic reasons, there could be a benefit to everyone, even the asymptomatic, wearing masks — as is standard and recommended by public officials in many Asian countries (including Taiwan and South Korea, both of which seem to have done a better job containing Covid-19 than the US).
基于研究证据,口罩似乎有助于戴口罩者和其他人这两者。就新冠病毒而言,对后者特别重要,因为这疾病能从那些轻微到无症状者处传播来。所以,不管戴口罩的理由是自私还是利他,戴口罩对每个人,甚至无症状者都有益处 —— 正如在许多亚洲国家(包括台湾和南韩,两国似乎在防止Covid-19扩散上都比美国做得好),它是准则并被公共健康官员所推荐。

George Gao, director general of the Chinese Center for Disease Control and Prevention, said as much in an interview with Science magazine:
中国疾病控制和预防中心主任(director general)乔治高在接受科学杂志采访时说:

The big mistake in the US and Europe, in my opinion, is that people aren’t wearing masks. This virus is transmitted by droplets and close contact. Droplets play a very important role — you’ve got to wear a mask, because when you speak, there are always droplets coming out of your mouth. Many people have asymptomatic or presymptomatic infections. If they are wearing face masks, it can prevent droplets that carry the virus from escaping and infecting others.
在我看来,美国和欧洲的大错误就是人们不戴口罩。这种病毒是通过飞沫和密切接触传播的。飞沫起很重要的作用 —— 你必须戴口罩,因为在你说话时,总有飞沫从你嘴里出来。 很多人是无症状或前症状感染者。如果他们戴着口罩, 口罩能防止携带病毒的飞沫逃脱并感染其他人。
楼主 若啬  发布于 2020-04-05 12:51:06 +0800 CST  
But part of persuading people to wear masks in these countries was simply more people wearing masks in public, removing the stigma that only sick people wear masks and making masks more socially acceptable. That’s an argument for everyone wearing a cloth mask now — and medical masks once supply shortages are fixed — when we go out. Not only could that help protect ourselves and those around us, it might help instill a healthier norm for the rest of society too.
但是在这些国家说服人们戴口罩的部分方式简单地就是更多人在公共场所戴口罩,消除了病人才戴口罩的印鉴,使戴口罩更被社会所接受。所以,一种主张就是,我们出去时,现在我们戴布口罩,待供应短缺解决后我们戴医用口罩。这不仅可能有助于保护我们自己和周围人,也可能有助于在整个社会形成一种更健康的规范。

Masks aren’t a cure-all — and doctors and nurses need them more
口罩不是万灵药 —— 而且医生和护士更需要它们。

The federal government, particularly through the CDC, had for months rejected calls for the general public to wear masks. Before the government announced its updated guidance, I tried to find out why — and the CDC didn’t seem like it was budging on the issue anytime soon.
疫情出现后的数月,联邦政府有意地通过CDC驳回公众戴口罩的呼吁。在政府宣布它的新指南之前,我曾试图找出原因 —— 而CDC似乎不想在近期讨论这一问题。

Why shouldn’t the public use masks if they provide some protection? “CDC does not recommend that people who are well wear a face mask to protect themselves from respiratory illnesses, including Covid-19,” CDC spokesperson Arleen Porcell responded. Okay, but why? “The science says that surgical masks won’t stop the wearer from inhaling small airborne particles, which can cause infection. Nor do these masks form a snug seal around the face.” Sure, masks don’t stop everything, but isn’t some protection better than none? I got no response after that.
如果口罩能提供某些保护为什么公众不应该用口罩呢?“CDC不建议健康的人戴口罩保护他们自己防止呼吸疾病,包括Covid-19,”CDC发言人Arleen Porcell回答。好,但为什么呢?“科学表明手术口罩不能阻止戴口罩者吸入会引起感染的小气态颗粒。这些口罩也不会与脸部形成紧密的贴合。”是,口罩不会阻止疫情,但是,有所保护不是比没有保护好吗?我没得到对这问题的回复。

Since then, however, the federal government has shifted course — now recommending at least a cloth mask for every American in public when social distancing measures are difficult to maintain.
然后,从那时起,联邦政府转换了方向 —— 现在建议当公共场合的社交距离尺度难以维持时,每个美国人都至少戴个布口罩。

That comes after the federal government’s messaging backfired: As health care workers have clamored for masks, it’s become harder to tell the public that masks wouldn’t benefit everyone else. By obfuscating and failing to fully explain the issue, experts told me, officials have likely sown distrust toward their guidance — and the public has rushed to buy masks anyway.
这发生在联邦政府得到的消息事与愿违后:当医护人员一直为口罩大声疾呼,对公众说口罩对其他人没什么益处变得越来越难。专家告诉我,由于混淆和无法充分地解释这问题,官员们很可能已经产生了对他们指南的怀疑 —— 而无论如何公众已经赶紧去买口罩了。

I can’t explain the motives behind the federal government’s original stance and shift. But based on my conversations with other experts and officials, it seems many people are afraid of saying anything that could exacerbate the PPE shortage for health care workers or get members of the general public to think — incorrectly — that they could ease on social distancing if they just wear a mask.
我无法解释联邦政府起初的立场和转变背后的动机。但是基于我与其他专家和官员的交谈,似乎很多人都害怕说任何可能加剧医护人员PPE短缺的话,或者使公众错误地以为,只要他们戴上口罩他们就能放宽社交距离。

“I fear that if we tell everyone they should go out and buy masks, it will not only contribute to the PPE shortage,” Meyer, an infectious disease expert at Yale University, told me, “but it will give a false sense of a ‘quick fix’ for protection, whereas people still need to be practicing social distancing strategies that are much more effective, though perhaps socially, psychologically, [and] logistically challenging.”
“我担心如果我们告诉每个人他们应该出去买口罩,则不仅仅会加剧PPE短缺,”耶鲁大学传染病专家Meyer告诉我,“而且会给公众一个‘迅速解决’防护问题的错觉,反之,人们仍然需要践行更加有效的社交距离策略,尽管可能有社会,心理,和逻辑上的挑战性。”

So as tough as social distancing can feel, it’s, unfortunately, a requirement for now that just won’t be supplanted by masks.
所以,尽管人们感到社交距离粗暴强硬,不幸地,就目前而言,它是一个无法被戴口罩所取代的要求。
楼主 若啬  发布于 2020-04-05 12:52:43 +0800 CST  
The PPE shortage is a real problem too. There are reports of doctors, nurses, and other health care workers using bandanas and scarves for masks and trash bags for gowns. Hospitals are considering do-not-resuscitate orders for dying Covid-19 patients out of fear that such intensive, close-up procedures could get doctors and nurses without PPE infected with the virus. The CDC, acknowledging the shortage, previously recommended homemade masks for health care workers when no other options are available.
PPE短缺也是一个现实的问题。有医生,护士,和其他保健人员用头巾和围巾当口罩用垃圾袋做防护服的报告。出于害怕这样强烈近距离的抢救程序会造成没有PPE的医生和护士的病毒感染,医院正考虑不给濒死的新冠肺炎患者做复苏抢救。CDC承认这短缺,先前建议保健人员在没有其他选择时使用家庭制作的口罩。

Different levels of government are racing to fix the PPE shortage, which is driven by both high demand as the coronavirus spreads and a lack of supply as countries, hospitals, and individuals hoard what they can find. Experts say the shortage reflects poor government preparedness for a pandemic, given that disease outbreak simulations repeatedly found PPE problems in the past.
当国家,医院,和个人纷纷囤积他们所能找到的(资源)时,各级政府都在想法尽快解决由新冠病毒暴发产生的高需求及缺乏供给导致的PPE短缺。专家说,考虑到过去的疾病暴发模拟中反复地发现PEE问题,这短缺反映出政府部门糟糕的疫病大流行准备。

Whatever the cause, the shortage for health care workers is bad news for all of us.
无论原因是怎样的,医护人员的短缺对我们所有人都是坏消息。
楼主 若啬  发布于 2020-04-05 12:54:26 +0800 CST  
As coronavirus has spread, experts have talked up “flattening the curve.” The idea is to spread out the number of coronavirus cases — through social distancing, testing, contact tracing, and other protective measures — to avoid overwhelming the health care system. Here’s what that looks like in chart form:
随着新冠病毒的传播,专家们谈论所谓“扁平化曲线。”想法就是通过社交距离,检测,反溯接触路径,和其它保护性手段 —— 避免健康医疗系统被压垮。这里就是以图标方式展示这扁平化曲线的样子。



The PPE shortage could make it harder to flatten the curve of new cases if doctors and nurses get sick. But the line representing health care system capacity also isn’t a constant. If we develop more capacity, it can handle more cases at once. If capacity falls — if doctors and nurses get sick because of a lack of protective equipment, or refuse to work without conditions that can ensure their safety — even a flatter curve will be hard for the system to handle.
PPE短缺如果造成医生护士感染会使得扁平化新病例曲线更难。但是表示健康医疗系统能力的线也不是一个常数。如果我们提高系统能力,它就能同时处理更多病例。 如果能力降低 —— 假如医护人员因缺乏防护而被感染,或者因条件不能确保他们的安全而拒绝工作 —— 甚至一个扁平些的曲线医疗系统也很难去处理。

That’s why experts, even those who acknowledge that the public would benefit from using masks, say that doctors and nurses should get priority: This isn’t just about keeping people on the front lines safe; it’s about keeping all of us safe.
那就是为什么专家们,甚至那些承认公众将因用口罩而获益的专家们,说医生和护士应该有优先权:这不仅仅是保持前线人员的安全;它是关于我们所有人的安全。

So until the shortage is fixed, experts say that people should not compete with our health care workers for mask supplies. If you do have masks, consider donating them to hospitals and clinics (though most will only accept unopened packages). There’s also a new group, Project N95, trying to connect PPE suppliers and health care workers.
所以,直到短缺问题被解决,专家们说,人们不应该与医护人员竞争口罩补给。如果你有口罩,考虑把它们捐献给医院和诊所(尽管最可能的情况是只未开包装的会被接受)。有一个新群体,N95项目,正努力把PPE供应商与医护人员联系到一起。

Policymakers could also take steps to fix the shortage: sending out strategic reserves, funding more production, and, in President Trump’s case, using the Defense Production Act to better prioritize PPE for hard-hit states in the short term and mandating more production in the medium and long term. And individual companies could shift their production lines to produce more PPE, like some clothing and pillow companies are doing.
政策制定者也会采取步骤解决短缺问题:分派战略储备,寻找更多产品,以特朗普总统的情况,使用国防产品,行动起来在短期内更好地优化疫情严重州的PPE,在中长期调用更多产品。个别公司能够转换他们的生产线生产更多PPE,像一些制衣和枕头公司正在做的。

For now, the federal government recommends cloth masks for the general public, echoing what other organizations had previously suggested. A “road map” on dealing with coronavirus by the conservative-leaning American Enterprise Institute, for instance, made a similar recommendation: “Personal protective equipment should continue to be reserved for health care workers until supplies are sufficient for them and abundant. For this reason, right now members of the general public should opt to wear nonmedical fabric face masks when going out in public.”
现在,联邦政府建议公众用布口罩,回应其他组织先前所给的建议。例如,保守倾向的美国企业研究所的一个关于处理新冠病毒的“路线图”给出了相似的推荐:“个人保护性装备应该继续保留给医护人员,直到给他们的供给是充足的并有富裕。 因为这个原因,当下,公众去公共场所时,应该选择戴非医用纤维面罩。”

Again, the research suggests cloth masks aren’t as effective as medical masks, but they offer some protection. If you want to make your own, people are increasingly offering tips for how to do so on social media.
再一次,研究提示布口罩不像医用口罩那么有效,但是它们仍提供一些保护。如果你要自己给自己做口罩,人们在社交媒体上正越来越多地提供怎么做口罩的小窍门。

楼主 若啬  发布于 2020-04-05 12:57:17 +0800 CST  
1、这篇文令我更看到人的共性。

2、今天本地一个电视频道做是否戴口罩的投票,有人发来链接,并要求选“戴”。我没做选择。觉得只是浪费网络资源。

3、因译这文,关了收音机。但晚饭后家人又说看见多少多少例,注意防护之类。拍发了好几张照片好让家人安心点儿。

……
楼主 若啬  发布于 2020-04-05 13:08:59 +0800 CST  
荒人之歌 - 王晰
(电视剧《将夜I》插曲)
作词:猫腻
作曲:王铮亮

天亦凉 地亦凉 苍鹰不敢望北荒
热海落 热海涨 热海之畔猎雪狼
雪狼逐 雪狼亡 握刀寻鹿终日忙
何处生 何处死 何处能将白骨葬
岷山雄 岷山壮 岷山才是真故乡
踏过茫茫雪 终日南望
踩破万里霜 不再南望
踏过茫茫雪 终日南望
踩破万里霜 不再南望
我先去 你再来
我先战 你再来
我先死 你再来
归途踏上
我已去 你快来
我已战 你快来
我已死 你快来
我已死 你快来
踏过茫茫雪 终日南望
踩破万里霜 不再南望
踏过茫茫雪 终日南望
踩破万里霜 不再南望
楼主 若啬  发布于 2020-04-05 13:24:21 +0800 CST  

之前存的接收捐赠的图片。
楼主 若啬  发布于 2020-04-06 04:11:44 +0800 CST  


上文的配图。
楼主 若啬  发布于 2020-04-06 04:13:45 +0800 CST  

Shoppers wear masks at the Silver Lake Farmer’s Market during the outbreak of the coronavirus disease (COVID-19) in Los Angeles, California, U.S., April 4, 2020. Kyle Grillot/Reuters
今天看见的图。
楼主 若啬  发布于 2020-04-06 04:19:59 +0800 CST  
Trump warns of 'very deadly period' of COVID-19 deaths, likening it to fatalities during world wars
'It's going to be a difficult week for the American people,' Vice President Mike Pence said
Bloomberg News
Jordan Fabian and Justin Sink
April 4, 2020
7:45 PM EDT
Last Updated
April 5, 2020
12:39 PM EDT
特朗普警告新冠肺炎致死的‘非常致命时期’,用世界大战时的死亡作比
‘对美国人将是艰难的一周,’副总统麦克潘斯说
彭博新闻(Bloomberg News)
乔丹法比安(Jord Fabian)和贾斯汀星克(Justin Sink)
2020年4月4日,美东时间7:45 PM
最后更新 2020年4月5日 12:39 PM

U.S. President Donald Trump warned that deaths from the coronavirus in the U.S. will escalate over the next one to two weeks, and could be on par with the number of fatalities seen in world wars.
美国总统唐纳德特朗普提醒人们紧接着的1到2周新冠病毒造成的死亡将会升级,而且可能会与世界大战中的死亡人数相当。

“There’s going to be a very, very deadly period, unfortunately,” Trump told reporters at the White House on Saturday.
The president said that as the number of deaths peak, “I really believe we probably have never seen anything like these kind of numbers, maybe during the war — a world war. A World War I or II or something.”
Trump didn’t give any estimates of how many will die in the coming weeks. Earlier this week, Trump administration officials said as many as 200,000 Americans could die from the virus, less than if the government hadn’t taken aggressive mitigation steps.
“不幸的是,将会有一个非常非常致命的时期,”星期六在白宫,特朗普对记者们说。
当总统说到死亡病例峰值时他说,“我真的相信我们可能从来没有见到过这种死亡数字,也许战争时期 —— 世界性战争。一战或二战或之类的战争。”
特朗普没有估计在未来一周会有多少人死亡。本周早些时候,特朗普政府官员说多达20万美国人可能死于病毒,少于如果政府还没有实施积极缓解疫情的步骤。

A general view of tents of an emergency field hospital set by Samaritan’s Purse staff in East Meadow in Central park during the outbreak of the coronavirus disease (COVID-19) in New York City, U.S., April 4, 2020. Jeenah Moon/Reuters
一个紧急战地医院帐篷的概观,为应对新冠肺炎爆发,该医院由Samaritan’s Purse医院的员工搭设在纽约中央公园的东侧草地上。
2020年4月4日。吉娜穆恩/路透社

Governors and state health officials have raised alarm about a lack of ventilators in some areas, saying shortages will likely lead to deaths among victims who are critically ill. The soaring rate of infections is straining hospitals — especially in New York — that are struggling to care for infected patients and obtain desperately needed supplies.
州长和州卫生官员已经就某些地区缺乏呼吸机发出警报,说短缺很可能造成感染者中危重患者的死亡。飙升的感染率正让医院应接不暇 —— 特别是纽约州 —— 挣扎于抢救感染病人的同时还要设法获得急需的医护用品。

Trump told reporters his administration is working to lose as few lives as possible and is distributing ventilators to states that need them the most.
特朗普告诉记者,他的政府正致力于减少生命损失,同时正在把呼吸机送往最需要的州。

Administration officials raised concern about increasing deaths in cities, including New York, Detroit and Chicago. They said they’re also closely watching an upswing in cases in New Jersey, Pennsylvania, Colorado, Connecticut, Rhode Island and the District of Columbia.
政府官员对纽约,底特律和芝加哥这些城市里不断增加的死亡人数表示关心。他们说他们也在密切关注新泽西,宾夕法尼亚,科罗拉多,肯塔基,罗德岛和哥伦比亚特区病例的上升。

“This is the moment to do everything you can” by following guidelines on social distancing and avoiding crowds, said White House virus task-force coordinator Deborah Birx.
She said guidelines encouraging social distancing are working, and that new cases in some areas will start going down. An increase in deaths in the next week will be a result of people who were infected several weeks ago, she said.
“As much as much as you go up, you have to come down the other side because coming down is a reflection of the cases that were coming in before,” Birx said.

“这是一个尽你所能的时刻”,按照指南保持社交距离并避免聚堆,白宫抗病毒工作组协调官黛博拉伯克斯(Deborah Birx)说。
她说指南倡导的社交距离在起作用,在有些地区新病例数将开始下降。在未来一周增多的死亡是由于前面几周被感染的人,她说到。
“攀升到无法攀升时,必然从另一边跌下来,因为下降是之前出现的病例的一种反映,” 伯克斯说。

Vice President Mike Pence told Americans not to be discouraged by deaths in the weeks ahead.
“It’s going to be a difficult week for the American people,” Pence said.
副总统麦克潘斯告诉美国人不要因未来几周将出现的死亡而气馁。
“对美国人来说下周将是艰难的一周,”潘斯说。

Projections made public last weekend about the number of people who may die from the virus helped persuade Trump to back away from his desire to ease social distancing guidelines by Easter Sunday, April 12. Trump extended them until April 30, despite the damage those tactics have done to the U.S. economy.
上周末向公众做的关于死于病毒感染人数的预测帮助说服特朗普放弃了他在复活节星期日,四月十二日,放松社交距离指南的念头。特朗普把它们延长到了四月三十日,尽管那些策略已经损害了美国经济。

©2020 Bloomberg L.P.
楼主 若啬  发布于 2020-04-06 09:09:18 +0800 CST  

楼主 若啬  发布于 2020-04-06 09:51:09 +0800 CST  

An I.C.U. Nurse’s Coronavirus Diary
I’ve started to refer to the time before this as peace time. Because this feels like a war.
By Simone Hannah-Clark
Ms. Hannah-Clark is a nurse in an intensive care unit in New York City.
April 3, 2020
Eleni Kalorkoti

I’m awake before my alarm goes off. I make coffee, wash my face and put deodorant on twice. The deodorant is never enough to stop the sweat and smell, but I try. My husband and kids are still asleep. I try to eat. My stomach turns as I imagine what today will bring, though of course I know. It’s always variations on the same theme: Critically ill patients who all have been given the same diagnosis, Covid-19.

I’ve started to refer to the time before this as peace time. Because this feels like a war. I grudgingly respect our enemy’s tenacity. Unseen, ruthless, random.

I am one of the many thousands of nurses who work in intensive care units in New York. We are not handmaidens or angels. We are professionals in our own right. We turn treatment plans into action. We question when things don’t make sense or aren’t going to work. We find solutions that work for our patients. Nurses assess and observe, question and console. We stand between the patient and the enemy. We are the front line.

Subway or Lyft? I ponder this before every shift. I don’t feel safe taking the subway. It’s too eerily quiet now. So Lyft it is. I pick up my work buddy on the way. We discuss our enemy, our talk inflected with dark humor and good-natured digs at colleagues. “If I end up here,” I say as we arrive at the I.C.U., “promise me you won’t let Chad see me naked?”

We arrive at work and are both assigned to the Covid I.C.U. We are always here now. This is the first Covid I.C.U. opened in our hospital. We feel a sense of ownership.

We have a quick huddle to confer about patients: who’s the sickest, who’s about to “crash,” whose family has been calling and needs an update. We assess what supplies are low. We don N95 masks. We wear them all day now.

I don’t have a specific patient assignment yet. I’m the “float” nurse, doing a range of things. My first task is to help with post-mortem care on a Covid patient we just lost. We had watched her slowly die over the past few days. We did everything we could. It’s just me and a nursing colleague in the room.

It’s a grim affair. We wrap the patient’s body securely, stroking her brow and wishing her well on her next journey. My colleague removes her jewelry carefully; we know her daughter will want it. I have to collect her belongings because security isn’t allowed to come into the room. It moves me to see her wallet, her planner, her toiletries. Only a week ago she was a person with a future, with plans, with cherry-flavored lip balm.

I spend the next few hours helping to figure out how to double our I.C.U. capacity. How will we fit two beds, two ventilators, two monitors in each room? Where will we get more monitors? Do we have enough ventilators? One of my doctors jokes about the feng shui of the room. It’s all wrong, I say.

We get three Covid admissions back-to-back. A nursing colleague and I each add a gown, double our gloves and put a face shield over our N95 masks. This is our personal protective equipment, or P.P.E.

We begin a familiar and elaborate choreographic sequence. We move one of the recently admitted patients from a stretcher to an I.C.U. bed. We strip him and while I do a full body assessment, my colleague hooks him up to the cardiac monitor and gets a set of vital signs. We place a urinary catheter and two intravenous lines.

We wash the patient and check his skin for wounds. We pad his heels and lower back with foam adhesives to prevent painful pressure areas forming while he is bed-bound. We place an oral gastric tube so he can receive nutrition while he is intubated and on a ventilator.

Nursing colleagues outside the room set up our IV pumps with long extension tubing, so that we can manage our drips without donning our P.P.E. It is amazing what kinds of hacks we’ve devised to stay safe.

Finally, it is time to doff our P.P.E. We carefully clean our face shields and place them in a paper bag for reuse. An hour has passed. We are both sweating, our faces striped with marks from our N95s. The same worry haunts me every day now: Was I careful enough when I removed my P.P.E.? It’s the only mask and shield I have for the rest of the day. Did I wash my hands well enough, for long enough?

Next, I check in with the doctors to discuss the treatment plan, changes and additions. I call the pharmacy to check on a medication. I need a piece of equipment I can’t find; our nursing assistant reads my mind and finds it without my having to ask.

I start some documentation while one of our nurse practitioners dons her P.P.E. and goes in to place an arterial line — a special catheter that helps us monitor blood pressure and arterial blood gases, so we can know how well a patient is breathing. I discuss the results with our attending I.C.U. doctor. I need to go back in the room to change the ventilator settings.



I’m still there an hour and a half after our shift change. I want to go home but it’s hard to leave. There is so much still to do. We always have to remind one another that nursing is a 24-hour profession. We hand off to our night nurses.

I remove my shoe covers and bleach my shoes. I change and bag up dirty scrubs to wash at home. My work buddy and I share a car home. We don’t talk much. I stare outside at the Brooklyn Bridge, at our beautiful city, and wonder how the patient in Bed 8 is doing, and if we will ever get back to peace time.

I walk into my apartment backward, leaving my shoes at the door, spraying Lysol behind me, headed for the shower. The kids are asleep. My husband gives me a smile but knows we won’t greet each other till I’m scrubbed, head to toe. Even then we keep our distance, sleeping in separate rooms.

Sometimes the day doesn’t go this smoothly because the patients are crashing, or we are short-staffed. But we do some version of this with every patient, over and over, day after day. They keep coming. And they are sick. Some of them die. Some are old, some are young.

Looking after these patients is a team effort. We are all scared and heartbroken. But we have our triumphs: A patient improves and can be moved out of the I.C.U.; we come up with an idea that saves time and preserves our precious P.P.E.

The teamwork right now is inspiring. I.C.U. nurses are tough; we fight for our patients; we have one another’s backs. Doctors may be the architects of what happens in the hospital. But we are the builders. And so we build, even amid chaos and disintegration. We build, even as a silent enemy attempts to undo everything we’ve done. We build and we build, shift after shift, as fast — and as best — as we can.

Simone Hannah-Clark is a nurse in an intensive care unit in New York City.
——————————————
这是一个ICU护士的新冠病毒日记。有兴趣想读就读下,不读也可以想象。大概比较象武汉各地医疗队到来之前。
楼主 若啬  发布于 2020-04-06 09:58:03 +0800 CST  
继续关于口罩 ——
在上星期五傍晚,美国在白宫CDC给出了新指南之后
今天上午,加拿大在首都渥太华也就口罩给出了变化的版本
——————————————————
The COVID-19 advice around masks has changed. Here’s a simplified version of Canada’s new recommendation
By Ilya BanaresStaff Reporter
Mon., April 6, 2020

Homemade Mask | 家里做的口罩

The message from the federal government surrounding masks has changed.

At a press conference Monday morning, Dr. Theresa Tam, Chief Public Health Officer of Canada, said that wearing a “non-medical mask, even if you have no symptoms, is an additional measure that you can take to protect others around you.”

This is especially important in situations where you may not be able to practice physical distancing, such as at a grocery store or on public transit. “A non-medical mask can reduce the chance of your respiratory droplets coming into contact with others or land on surfaces,” Tam noted.

Although wearing a non-medical mask “has not been proven to protect the person wearing it,” Tam added, “it is an additional way that you can protect others.”

If I’m not a health professional, what should I do?
If you’re going out in public, the Public Health Agency of Canada recommends you wear a non-medical mask. This is intended to help the people around you — not necessarily yourself. However, just because you’re wearing a mask does not mean you can ignore previous warnings — “you must continue to practice physical distancing and good hygiene, frequent handwashing, and regularly disinfect high-touch surfaces,” Tam said.

Should I wear an N95 mask if I’m not a health professional?
No. An N95 mask is critically important for frontline workers in the medical field, and they need to be readily available to them. “I want to emphasize that it’s extremely important that we keep the supply of medical masks where it is needed. Health-care workers need medical masks,” Tam said.

What kind should I wear for everyday use?
As long as the mask is not medical-grade, it should be fine. For the most part, this means wearing homemade masks, such as bandanas or scarves, according to the U.S. Centers for Disease Control and Prevention.

What’s the difference between these masks?
An N95 mask is a face covering intended specifically for health-care workers who come into close contact with COVID-19 patients, as it protects the wearer from germs in the air. Another type of mask does not do this.
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就偷懒不译了。觉得有兴趣的人看懂是没困难的。
楼主 若啬  发布于 2020-04-07 08:25:43 +0800 CST  

楼主:若啬

字数:60142

发表时间:2020-04-05 20:38:12 +0800 CST

更新时间:2020-05-27 03:42:39 +0800 CST

评论数:382条评论

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