日本似乎在进行一场抗疫“赌博”,好运还会继续吗
TOKYO — Japan had only a few dozen confirmed coronavirus infections when the 30-something nurse with a slight sore throat boarded a bus to Osaka, the country’s third-largest city, to attend a Valentine’s weekend performance by pop bands at a music club.
东京——当这名喉咙有点痛的30多岁的护士坐大巴前往日本第三大城市大阪,去一家音乐俱乐部看一个流行乐队的情人节周末表演时,日本确诊的新型冠状病毒肺炎病例只有几十例。
Less than two weeks later, she tested positive for the virus, and the authorities swiftly alerted others who had been at the club. As more infections soon emerged from three other music venues in the city, officials tested concertgoers and their close contacts, and urged others to stay home. All told, 106 cases were linked to the clubs, and nine people are still hospitalized.
不到两周后,她的病毒检测结果出来了,呈阳性,当局迅速通知了那天在俱乐部的其他人。随着大阪另外三个音乐场所很快出现了更多感染病例,官员给去过音乐会的观众及其密切接触者做了病毒检测,并敦促其他人留在家中。总共有106个感染病例与这些俱乐部有关,其中有九人仍在住院治疗。
But less than a month after the nurse tested positive, the governor of Osaka declared the outbreak over.
但是,在该护士确诊感染病毒不到一个月后,大阪府知事宣布疫情结束了。
周三的大阪人来人往。
Ever since the first coronavirus case was confirmed in Japan in mid-January, health officials have reassured the public that they have moved quickly to prevent the virus from raging out of control. At the same time, though, Japan has puzzled epidemiologists as it has avoided the grim situations in places like Italy and New York without draconian restrictions on movement, economically devastating lockdowns or even widespread testing.
自从1月中旬日本出现了首例确诊病例以来,卫生官员们一直向公众保证,他们已迅速采取了防止病毒失控的行动。不过,与此同时,日本也一直令流行病学家们不解,它没有严格限制人员流动,也没有采取给经济造成毁灭性打击的封锁措施,甚至没有做广泛的病毒检测,却避开了意大利和纽约等地的严峻局面。
The puzzle may be about to gain some clarity. On Thursday, Katsunobu Kato, Japan’s health minister, said he had informed Prime Minister Shinzo Abe that there was evidence that Japan was now at a high risk of rampant infection.
这个不解之谜可能会得到部分澄清。周四,日本厚生劳动大臣加藤胜信说,他已告知首相安倍晋三,有证据表明,日本目前有很高的感染失控风险。
On Wednesday night, just a day after Japan and the International Olympic Committee agreed to delay the Tokyo Summer Games for a year because of the coronavirus pandemic, the governor of Tokyo, Yuriko Koike, warned citizens that the sprawling city of close to 14 million people was in a “critical phase before a possible infection explosion.”
周三晚,东京都知事小池百合子警告市民,这座人口近1400万的庞大城市正处于“可能的感染暴发前的关键阶段”。就在前一天,由于新冠病毒大流行,日本与国际奥委会同意将东京夏季奥运会推迟一年。
Cases in Tokyo spiked this week, setting records for four days running — including an announcement of 47 cases on Thursday — as travelers returned from overseas. The limited testing for the virus has raised fears that many more are going undetected.
东京本周的病例数激增,连续四天创下记录——包括周四公布的47例,其中一些是海外归来的旅行者输入的。有限的病毒检测让人们担心还有更多的感染者没被查出来。
Ms. Koike implored the people of Tokyo to work from home, avoid unnecessary outings and stay inside over the weekend. On Thursday, governors from four neighboring prefectures also requested that residents refrain over the weekend from going outside for anything other than urgent needs.
小池百合子恳求东京人在家工作,避免不必要的外出,周末呆在家里。周四,东京周边四个县的知事也要求民众这个周末不外出,除非有紧急需要。
“If we go without doing anything now,” Ms. Koike said, “the situation will worsen. I ask for everyone’s cooperation.”
小池百合子说,“如果我们现在什么都不做的话,情况会变得更糟。我请求大家的合作。”
The public so far has not taken such warnings seriously. Although schools have been closed for a month and the government has requested that large sports and cultural events be canceled or delayed, the rest of life has returned to normal. People have been riding crowded subways, congregating in parks to view the cherry blossoms, shopping, drinking and dining, comforted by Japan’s relatively low number of confirmed coronavirus cases and deaths.
到目前为止,日本公众还没有认真对待这些警告。虽然学校已经停课一个月,政府要求取消或推迟大型体育和文化活动,但生活的其他方面仍正常运行。人们一直乘坐拥挤的地铁,聚集在公园里赏樱、购物,去酒吧和餐馆。日本确诊的新冠病毒病例和死亡人数相对较低,这让人们感到宽慰。
Even at one of the Osaka clubs where the outbreak occurred earlier this month, a group of 40 young women attended a performance by a boy band on Wednesday, jumping and waving their hands in a small, unventilated space for close to two hours.
甚至有40名年轻女性周三在大阪一家俱乐部观看一个男子乐队的表演,这家俱乐部本月早些时候曾暴发过病毒感染。她们在一个狭小、不通风的空间里跳上跳下,挥舞着双手,这场表演持续了近两个小时。
As other parts of the world fall into a spiral of infections, hospital overflows and deaths, Japan, a country of almost 127 million people, has reported only 1,300 cases and 45 deaths, with one of the slowest-progressing death rates in the world despite its aging population.
在世界其他地方陷入感染人数猛增、医院人满为患、死亡人数越来越多的恶性循环的时候,日本这个有近1.27亿人口的国家却只报告了1300例病例和45例死亡,尽管日本人口老龄化严重,但仍是世界上新冠病毒病死率最低的国家之一。
“It’s either they did something right,” said Dr. Peter Rabinowitz, co-director of the University of Washington MetaCenter for Pandemic Preparedness and Global Health Security, “or they didn’t, and we just don’t know about it yet.”
“要么是他们做对了什么,要么是没有,我们只是还不知道而已,”华盛顿大学大流行病防备和全球卫生安全中心(University of Washington MetaCenter for Pandemic Preparedness and Global Health Security)的联席主任彼得·拉比诺维茨(Peter Rabinowitz)博士说。
As Japan has seemed to pull off a feat of infection containment, it has presented an intriguing contrast to other countries in Asia, where the pandemic began. It has not deployed modern surveillance technology like a growing number of countries, including Singapore. Nor did it adopt the kind of wholesale testing that helped South Korea isolate and treat people before they could spread the disease.
随着日本似乎成功地控制了感染,它与亚洲其他国家形成的对比引发了人们好奇。日本没有像包括新加坡在内的越来越多的国家那样使用现代化的监控技术,也没有进行大规模的病毒检测,大规模的检测帮韩国在感染者进一步传播病毒之前,将他们隔离、治疗。
While South Korea, with a population less than half the size of Japan’s, has conducted tests on close to 365,000 people, Japan has tested only about 25,000. Japan now has the capacity to conduct about 7,500 tests a day, but its daily average is closer to 1,200 or 1,300.
虽然韩国人口不到日本的一半,但已检测了近36.5万人,而日本只检测了约2.5万人。日本现在有每天做约7500个检测的能力,但其日均检测量在1200或1300左右。
Dr. Tomoya Saito, director of the department of health crisis management at the National Institute of Public Health, said the limited testing was intentional. Those who are tested are referred by doctors, usually after patients have had fevers and other symptoms for two to four days. Japan’s current policy is to admit anyone who tests positive to a hospital, so officials want to avoid draining health care resources with less severe cases.
国立保健医疗科学院(National Institute of Public health)健康危机管理研究部部长斋藤智也(Tomoya Saito)博士说,有限的检测是有意的。接受检测的人都是医生送来的,通常是在患者出现发烧和其他症状两到四天后。日本目前的政策是接收所有检测结果呈阳性的人入院,因此官员们不想让非重症患者入院,以避免耗费医疗资源。
Dr. Saito said that part of Japan’s seeming resistance to infection may result from measures common in the culture, including frequent hand-washing and bowing instead of shaking hands. People are also much more likely to wear masks on trains and in public spaces. “It’s a kind of social distancing,” Dr. Saito said.
斋藤智也说,日本看似对感染有抵抗力,部分原因可能来自日本文化中常见的做法,包括勤洗手,见面鞠躬而非握手。人们也更有可能在乘坐公共交通工具以及在公共场所时戴口罩。“这是保持社交距离的一种,”斋藤智也说。
But Jeffrey Shaman, an epidemiologist at Columbia University, said Japan’s approach was a “gamble.”
哥伦比亚大学(Columbia University)流行病学家杰弗里·萨曼(Jeffrey Shaman)说,日本的做法是一种“赌博”。
“The risk is that things may be brewing underneath the surface that you don’t recognize until it’s also a little bit too late,” Dr. Shaman said.
“风险在于,事情可能正在表象之下酝酿,等你意识到它时,也有点太迟了,”萨曼说。
In Osaka, a report prepared for the health ministry this month projected that by early April, the city could have close to 3,400 infections, 227 of them serious. “It’s possible that provision of medical treatment to seriously ill patients may become difficult,” the report said.
大阪本月为厚生劳动省准备的一份报告预计,到4月初,该市可能有近3400例感染病例,其中227例病情严重。“为重症患者提供医疗服务可能会变得困难,”报告说。
On Wednesday, Osaka’s governor, Hirofumi Yoshimura, said he was working to secure an additional 600 beds in hospital isolation wards that could accommodate patients with the most severe infections.
周三,大阪府知事吉村洋文说,他正在与医院一起努力增加600张隔离病房床位,以容纳重症患者。
Dr. Masaya Yamato, chief of infectious diseases at Rinku General Medical Center in Osaka, said the region was moving toward a model where coronavirus patients with mild symptoms could stay at home in order to save hospital beds for the seriously ill.
大阪临空综合医疗中心(Rinku General Medical Center)的传染病中心长倭正也(Masaya Yamato)博士说,该地区正在转向另一种做法,让症状较轻的新冠病毒患者在家中隔离,以便将床位留给重症患者。
In Tokyo, there are only 100 beds designated to handle those with serious infectious diseases. On Wednesday, the city government pledged to secure 600 more.
东京目前只有100张病床是专门用来治疗新冠病毒重症患者的。东京都政府周三承诺,争取再留出600张病床。
The request by Tokyo’s governor to stay inside this weekend, Dr. Yamato said, may be too weak to defer a crisis.
倭正也说,东京都知事要求人们本周末不外出,但这个要求可能太弱,无法推迟危机的到来。
“It’s better that Prime Minister Abe decisively declare a lockdown in Tokyo,” Dr. Yamato said. “The economic impact should not be a top priority. Tokyo should lock down for two to three weeks. Otherwise, Tokyo’s medical system could collapse.”
“安倍晋三首相果断地宣布在东京采取限制行动的措施会更好,”倭正也说。“经济影响不应该是最重要的考虑。东京应该采取两到三周的封闭措施。否则,东京的医疗系统可能会崩溃。”
Mr. Abe’s administration has appointed a task force to determine whether he should declare a state of emergency, a measure that he said was unnecessary earlier this month.
安倍晋三的政府已经任命了一个工作组,来决定是否由他宣布国家进入紧急状态。安倍晋三在本月早些时候曾说,没有必要这么做。
For now, the public is largely unmoved. Although some grocery store shelves in Tokyo were cleared out on Wednesday night after the governor’s request, it was business as usual on Thursday.
目前,日本公众基本上无动于衷。尽管东京一些超市在东京都知事周三晚上的宣布后被抢购一空,但周四一切如常。
Near Shinbashi Station in central Tokyo, men in black suits sat elbow to elbow at a counter in a restaurant offering a fried noodle lunch special for 500 yen, about $4.50. A long line formed outside a McDonald’s, and smokers crowded a small pen near the station entrance.
在东京市中心新桥站附近,身穿黑色西装的男士们正一个挨着一个地坐在一家餐馆的柜台前,这家餐馆正在供应一种特价炒面午餐,售价500日元。麦当劳外面排着长队,吸烟者挤在车站入口附近的一个小围栏里。
In Shinjuku Gyoen park in western Tokyo, where cherry blossoms were near peak bloom, a sign at the entrance informed visitors that, as part of antivirus efforts, picnic blankets and alcohol were banned. Security guards with megaphones wandered through groups of people who were taking photos with the flowers, warning them to wash their hands.
在位于东京西部的新宿御苑,樱花正在接近盛开期,公园入口处的一个标牌告诉游客,作为防病毒措施的一部分,院内禁止野餐和饮酒。手持扩音器的保安人员在与花拍照的人群中走来走去,警告他们勤洗手。
At a store not far from the park, Kazuhisa Haraguchi, 36, stood in a long line for a chance to buy a limited-edition pair of Nike Air Max sneakers.
公园附近的一家商店外排着一条长队,36岁的原口和久(Kazuhisa Haraguchi,音)是排队者之一,他希望能买到一双限量版的耐克Air Max运动鞋。
Mr. Haraguchi said that he was worried about how the virus was spreading in the United States and Europe, but that he wasn’t too concerned about the situation in Japan.
原口和久说,他对新冠病毒在美国和欧洲的传播情况感到担忧,但他并不太担心日本的情况。
“It’s scary, but it doesn’t seem like there’s much of it here right now,” he said. “If I die, at least I’ll die with my sneakers.”
“那些地方很可怕,但目前这里似乎没有多少感染病例,”他说。“如果我死的话,至少我将穿着我的球鞋去死。”