日本多地进入紧急状态,但是否为时已晚?
TOKYO — For months, Japan has confounded the world by reporting a relatively low rate of coronavirus infections without imposing the kind of stringent measures used by other nations.
东京——几个月来,日本并没有采取其他国家那样的严格措施,但通报的新型冠状病毒感染病例却相对较低,这一直让世界感到困惑。
Now, as its largest cities experience a worrisome rise in cases, medical experts are wondering whether a state of emergency declared on Tuesday has come just in time to avoid calamity, or is too little, too late.
现在,随着该国最大城市的病例数出现令人担忧的上升,医学专家们想知道,周二宣布的紧急状态对避免灾难是否来得正是时候,还是远远不够且为时已晚。
日本首相安倍晋三周一宣布日本大部分地区进入紧急状态几小时后,东京歌舞伎町地区。
Prime Minister Shinzo Abe, in announcing that the declaration would apply to Japan’s biggest population centers for the next month, painted an optimistic picture. By asking citizens to significantly reduce human-to-human contact, he said, “the expansion of infections can be turned to a decline in two weeks.”
日本首相安倍晋三宣布的紧急状态适用于日本最大的几个人口中心,将为期一个月,但他同时也描述了一个乐观前景。他说,通过要求民众显著减少人与人之间的接触,“感染人数的增长可以在两周内转为减少。”
But some experts said the state of emergency amounted to a tacit admission that the approach the country had stood by for months was no longer working, as Japan reached 3,906 confirmed cases on Tuesday, exactly double the number a week earlier.
但一些专家说,宣布紧急状态相当于默认了日本几个月来一直采取的应对措施并未奏效。日本的确诊病例周二达到了3906例,正好是一周前的一倍。
“Japan has been screwing up,” said Kenji Shibuya, director of the Institute for Population Health at King’s College London. The confirmed cases, he said, are “just the tip of the iceberg,” adding that a surge of patients could cause Tokyo’s health care system to collapse.
“日本搞得一塌糊涂,”伦敦国王学院(King’s College London)人口健康研究所所长涉谷健司(Kenji Shibuya)说。他表示,确诊病例“只是冰山一角”,还说,患者人数激增可能会导致东京的医疗系统崩溃。
Although Japan is now taking its virus fight a step further, the emergency move has limits of its own. The declaration will depend largely on voluntary compliance, and Mr. Abe emphasized that it was not a lockdown, and that public transit would continue. Prefectural governors can only request that people work from home and avoid going out.
尽管日本现已在抗击病毒上迈进了一步,但紧急状态本身也有局限性,它在很大程度上取决于公众的自愿遵守。安倍晋三强调,这不是活动限制,公共交通将继续运行。都府县的知事们也只能要求人们在家工作,避免外出。
A day earlier, Mr. Abe announced that the country would increase its testing capacity for the virus to 20,000 a day. So far, however, Japan has rarely conducted even half of the 7,500 tests it now has the ability to perform each day.
安倍晋三曾在一天前宣布,日本将把新冠病毒的检测能力提高到每天2万例。但到目前为止,日本的检测量甚至很少达到其现有能力——每天7500例的一半。
Experts who have been advising the government are divided over whether Japan — which has still not reported the sort of explosive rise in cases seen in places like Italy and the United States — is at a crisis point.
为政府提供咨询的专家们在日本是否进入了危机阶段的问题上存在分歧。日本尚未通报过意大利和美国等地出现的那种呈爆炸性增长的病例数。
In a statement posted on Twitter over the weekend, Hitoshi Oshitani, a professor of virology at Tohoku University in northeastern Japan and a government adviser, wrote that “the risk of infection is very low if people continue ordinary living, unless they go to hot spots.” Those places are defined by the government as the “3 Cs” — closed spaces where crowds meet in close proximity.
日本东北大学病毒学教授押谷仁(Hitoshi Oshitani)也是政府顾问,他上周末在Twitter上发的声明中写道,“如果人们继续按照正常方式生活,感染的风险非常低,除非他们去热点地区。”政府对热点地区的定义是,人群近距离聚集的密闭空间。
In Tokyo, by most measures the world’s largest city, cases have doubled in the last five days to more than 1,000. Now, some government advisers are warning of a perilous new phase.
按照大多数标准衡量,东京是世界上最大的城市,东京的确诊病例在过去五天里翻了一番,达到了1000多例。一些政府顾问现在警告,将出现一个危险的新阶段。
“It’s possible that Tokyo has entered a period of explosive and exponential growth,” Hiroshi Nishiura, an epidemiology professor at Hokkaido University in northern Japan and a member of an expert panel advising Japan’s government, told the newspaper Nikkei last week. “It’s necessary to issue a stronger restriction on going out than” telling people to exercise self-restraint, Professor Nishiura said.
“东京有可能已经进入了一个爆炸式的指数增长阶段,”日本北海道大学流行病学教授西浦博(Hiroshi Nishiura)上周对《日本经济新闻》(Nikkei)说,他也是为日本政府提供咨询的专家组成员。西浦博说,“有必要发布更有力的外出限制措施”,而不只是叫人们自我克制。
However, a law enacted last month under which Mr. Abe declared the state of emergency does not give him the power to issue stay-at-home orders or force businesses to close, as other hard-hit countries have done. Mr. Abe can ask prefectural governors to shut schools and order building owners to contribute facilities for medical use, but the authorities cannot take punitive action against anyone who disregards suggestions to stay inside or to work remotely.
不过,安倍晋三宣布紧急状态所依据的法律是议会上个月通过的,这项法律并没有赋予他颁布“禁足令”或强迫商店关门的权力,像其他受病毒影响严重的国家所做的那样。安倍晋三可以要求地方官员关闭学校,命令建筑物业主贡献医用物资,但当局不能对任何无视不要出门或远程工作建议的人采取惩罚性措施。
Mikiko Eto, principal of the Hatto Nursery School in Tokyo, said she hoped that parents would comply with the soft directives. Until last week, most of the 150 children who regularly attend were still showing up every morning.
东京Hatto幼儿园园长卫藤干子(Mikiko Eto)说,她希望家长们能遵守这些非硬性命令。直到上周,通常在这家幼儿园上学的150名儿童中仍有大多数每天早上照常来园。
Despite daily temperature checks and frequent disinfection of toys and tables, staff members worry about contracting the coronavirus, Ms. Eto said. “Many parents come and go,” she noted, “which makes us feel stressed and nervous.”
卫藤干子说,尽管每天都查体温,而且经常对玩具和桌面进行消毒,但工作人员仍担心感染新冠病毒。她说,“很多父母进进出出,让我们有压力和忧虑感。”
On Monday, with confirmed cases in Tokyo spiking, Ms. Eto sent an email to parents asking them to keep their children at home. About a third of the children did not come that day, she said. The prime minister said on Tuesday that day care centers would not be forced to close because some parents might still need care for their children.
随着东京的确诊病例周一出现激增,卫藤干子给家长们发了一封电子邮件,要求他们将孩子留在家里。她说,那天大约有三分之一的孩子没有来园。日本首相周二说,不会强迫幼儿园关门,因为一些家长可能仍需要有人照顾孩子。
The state of emergency covers seven prefectures with about 56.1 million people; Japan’s total population is just under 127 million. Across Tokyo and other large cities, including Kobe, Osaka and Yokohama, citizens and businesses will have to decide how to respond to the declaration.
紧急状态措施涵盖7个都府县,人口约为5610万;日本的全国人口略低于1.27亿。东京以及神户、大阪、横滨等其他大城市的老百姓和企业,需要自行决定如何响应措施。
Health officials in Japan, until now, have reassured the public that they have kept the virus in check by closing schools, urging the cancellation of large sports and cultural events, and warning people to avoid crowds in enclosed, unventilated spaces, such as in karaoke bars or nightclubs.
到目前为止,日本卫生官员一直向公众保证,通过关闭学校,敦促取消大型体育和文化活动,以及警告人们避免去卡拉OK或夜总会等封闭、不通风的人群聚集场所等措施,病毒已得到了控制。
In contrast to other countries, such as Germany and South Korea, that have had some success in controlling the virus, Japan has refrained from testing widely.
与在控制新冠病毒上取得了一定成功的国家(如德国和韩国)不同,日本没有对病毒进行广泛的检测。
Until last week, public health officials argued that rules requiring the hospitalization of everyone who tested positive risked overwhelming the health care system with mildly sick patients. The government has since changed that rule, and Mr. Abe said that it had secured 10,000 hotel rooms in Tokyo and 3,000 in the Kansai region, which includes Osaka, where patients with mild symptoms could recover. Up to 800 patients can also stay in an Olympic building in Tokyo.
直到上周,日本的公共卫生官员给出的理由是,要求所有病毒检测呈阳性的人住院治疗的规定,会导致医疗系统因为收治症状轻微的患者而不堪重负。政府已经改变了这条规定,安倍晋三说,政府已在东京获得了一万个酒店房间,在大阪所在的关西地区获得了3000个酒店房间,可作为轻症患者隔离康复的地方。东京的一座为奥运会准备的大楼也可容纳800多名患者。
In and around the capital, clusters of infections have begun to emerge. There have been outbreaks linked to several Tokyo hospitals, including a university center where 18 residents were infected after attending a dinner party, and another in eastern Tokyo where at least 146 have been infected and 16 have died.
聚集性感染已开始在首都东京及周边地区出现。其中几起与东京的几家医院有关,包括一个大学医学中心,那里的18名临床实习医生参加了一个晚餐聚会后感染了病毒,另一起聚集性感染发生在东京东部,那里至少146人感染病毒,其中16人已经死亡。
For the last two weekends in a row, Tokyo’s governor, Yuriko Koike, has asked residents to stay inside for all but the most essential needs. She has encouraged people to telecommute and to avoid going out in the evenings during the week.
东京都知事小池百合子已连续两个周末要求居民不要出门,除非有完全必要的原因。她鼓励人们远程办公,避免在工作日的晚上外出活动。
Crowds have thinned in popular nightlife spots and shopping districts, but commuters have been more resistant. According to a survey by the Ministry of Land, Infrastructure, Transport and Tourism, just over one in eight respondents said they had worked from home as a preventive measure against the coronavirus.
在受欢迎的夜生活场所和购物中心,人群已变得稀少,但上下班往返的人并未减少多少。日本国土交通省的一项调查显示,只有略高于八分之一的受访者说,为了预防感染,他们在家中工作。
On Tuesday morning, before the emergency declaration went into effect, throngs of commuters wearing masks crowded platforms at the Shinjuku and Shibuya train stations, two of Tokyo’s largest.
在周二上午宣布的紧急状态生效之前,新宿站和涩谷站这两个东京最大的火车站站台上挤满了戴着口罩的通勤者。
With Japan still recording a relatively low number of deaths — fewer than 100 so far — some say they do not see a need to avoid all contact with others.
由于日本的死亡人数仍相对较低,目前不到100例,一些人说,他们认为没有必要避免与他人的所有接触。
If packed trains were a problem, said Takuji Okubo, North Asia director of the Economist Corporate Network, “I think we would have seen a nightmare story in Japan” already.
经济学人企业网络组织(Economist Corporate Network)北亚区主管大久保琢史(Takuji Okubo)说,如果拥挤的火车有问题的话,“我认为我们会在日本(已经)看到了一个噩梦般的情况。”
Mr. Okubo, who said he was more concerned about the potential damage to the economy — Mr. Abe also announced a stimulus package worth nearly $1 trillion — added that he saw little risk of infection from shopping in department stores or eating in restaurants.
大久保琢史说,他更担心的是可能给经济带来的损害——安倍晋三也宣布了一项近一万亿美元的刺激方案。大久保琢史还说,他认为在百货商店购物或在餐馆吃饭不会有多少感染的风险。
Some experts express worry that the Japanese government has focused too narrowly in its warnings about where infections can spread. Many of the newest cases cannot be traced to a specific source of transmission, which means public health officials do not know what conditions led to those infections.
一些专家担心,日本政府关于病毒可能在什么地方传播的警告过于狭窄。许多最新的感染病例无法追溯到特定的传播源,这意味着公共卫生官员不知道是什么情况导致了这些感染。
With undetected cases multiplying, there is also a concern among medical experts that Japan’s hospital capacity could quickly be overwhelmed. According to the Japanese Society of Intensive Care Medicine, Japan has five intensive care beds per 100,000 people, compared with close to 30 in Germany and 12 in Italy.
随着未检测到的感染病例不断增加,医学专家们也担心,日本医院的容纳能力可能很快就会不堪重负。据日本集中治疗医学会的数据,日本平均每10万人有5张重症监护病床,而德国和意大利的这一数字分别为近30张和12张。
“For most countries, it’s not ‘are they going to dodge the bullet?,’” said Dr. Keiji Fukuda, director of the School of Public Health at the University of Hong Kong. “It’s just ‘when is it going to come?’ This is true for Japan, too.”
“对大多数国家来说,问题不是‘能否躲过这一劫’,”香港大学公共卫生学院院长福田敬二博士说。“问题是‘什么时候来’,日本也是如此。”
And while the Japanese are more likely to wear masks in public, the recent spike in Tokyo suggests that the face coverings cannot provide total protection.
尽管日本人更愿意在公共场合戴口罩,但东京最近的感染病例激增表明,只靠戴口罩并不能提供全部的保护。
“Even in a place where lots of people wear masks,” said Dr. Peter Rabinowitz, co-director of the University of Washington MetaCenter for Pandemic Preparedness and Global Health Security, “that is probably not enough by itself if there is not social distancing on top of the masks.”
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,“即使在很多人都戴口罩的地方,如果只戴口罩,不保持社交距离的话,可能还不够。”
As Japan’s outlook has deteriorated, some have adjusted. Masataka Morita, general manager of the public relations department at Hitachi, the electronics giant, said he had juggled Skype meetings from home while helping to care for his three sons.
随着日本疫情前景的恶化,有些人已经在做调整。电子巨头日立公司的公关部总经理森田正孝(Masataka Morita)说,他已在家通过Skype主持会议,同时还要帮忙照顾三个儿子。
He can no longer visit his father, who has been in the hospital for a noncoronavirus illness for the last four months. When he took one of his sons to visit his mother last weekend, they decided to forgo their usual trip to a sushi restaurant.
他不能再去医院看望父亲,他的父亲在新冠病毒暴发前已因病住院四个月了。上周末,他带着一个儿子去看望他的母亲时,他们决定放弃去寿司店吃饭的通常做法。
Last week, he noted, he visited his office for about two hours. With the state of emergency though, he said he would refrain from doing so again.
他指出,上周他在自己的的办公室里总共只呆了大约两小时。但他说,宣布了紧急状态后,他不会再去办公室。