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This is what cities
in the world's most populous country
look like during this new coronavirus outbreak.
Millions of people in China
have been ordered to stay indoors
or banned from traveling
in an attempt to stop the disease from spreading.
But from the city of Wuhan,
where the first patient came from,
coronavirus infections have spread
to several continents.
So, why is it so hard to contain these outbreaks?
And, are we ready for the next one?
This strain of the coronavirus
is believed to have spread
from animals to humans,
and then from humans to humans
by droplets from sneezing or coughing.
The World Health Organization says
that, so far, it has a low mortality rate.
The flu, for example, kills thousands of people every year.
But this coronavirus strain is new,
and it is infectious, which is why
it's being taken so seriously.
As of February 2020, about 60 million people,
more than the entire population of Spain,
are being quarantined in their homes in China.
It's a massive feat. But some fear
that isolating that many people together could backfire.
- First of all, you can't wall off a germ.
Simply impossible.
- Lawrence Gostin is a professor
of Global Health Law at Georgetown University
and a director at the World Health Organization's Center
on Global Health Law.
- Can you imagine if you were forced
to be congregated in with 50 million people
in a hot zone of contagion, how you would feel?
You'd feel you're a guinea pig.
You would feel panicky.
You would worry about getting food,
water, essential medicines,
that you couldn't get to a hospital,
and you were walled off from the world.
- Professor Gostin worries
about a breakdown in public trust.
If the public doesn't trust the solutions
being offered by officials,
then they aren't solutions at all.
For example, in the West African Ebola outbreak,
many people stopped reporting
when they were getting sick.
They didn't trust the foreign health workers
who were cordoning patients off from the rest of society,
especially since many were dying in quarantine.
And so the outbreak continued to spread.
Many people were infected and more died.
But even if there is full cooperation
between officials and the population at risk,
it's hard to contain an outbreak like the coronavirus.
- We're less safe because we're globally interconnected
in a way that we've never ever been before.
- In 1950, 750 million people
lived in urban areas globally.
Today, that number is more than 4 billion.
People are living closer together,
many in overcrowded areas, making it easier
for disease to spread from human to human.
And our modern transport infrastructure
means a virus that would have been geographically
contained in the past can now get from one side
of the globe to another in just a few hours.
In 2003, another coronavirus epidemic called SARS
spread from China.
- There's actually four times greater
international travel by Chinese citizens
now than there was during SARS.
- But transport technology
is generally a good thing,
and people will keep moving to urban areas.
What's more, viruses are always mutating into new strains.
So, in reality we can't avoid outbreaks.
We just need to get better at dealing with them.
- We tend to lurch from complacency
to panic and overreaction.
And so, when we're in a major outbreak,
like we are now with the coronavirus,
we tend to react and overreact
and try to just catch up and respond.
But then, as soon as things calm down,
we withdraw funding, we withdraw planning,
we withdraw preparedness.
So, isn't it a much, much better way
to prepare for an epidemic
and to prevent it and detect it early?
- So, if the solution
is to be proactive rather than reactive,
what can we do?
Until a vaccine is discovered
for this strain of the coronavirus,
you can protect yourself and others
by covering your mouth
when coughing or sneezing,
washing your hands frequently,
and, if you develop symptoms,
avoiding contact with others
until you're cleared by a doctor.
That's what you can do.
But governments need to do more,
and they need to do it together.
There's no real way to force a government
to work with global health organizations
if it doesn't want to.
For example, during the SARS epidemic,
Chinese officials hid the extent of the outbreak
from both the Chinese public and the world.
That led to many more people being infected.
This time around, lessons seem to have been learned.
China informed the World Health Organization
and its own citizens of this new coronavirus
relatively quickly.
It also sequenced the virus's genome
and shared that information
with scientists around the world,
who have begun working on trying to find a vaccine.
- We used to not have effective vaccines.
We didn't have effective antiviral medications.
Now, we can rapidly develop those.
So, yes, we are very much less safe,
but we have the technical capacity to be safer.
- But the problem with any defense,
is that it's only as strong as its weakest link.
And we live in a world where access to healthcare
and healthy environments is not equal.
- If you asked any thoughtful epidemiologist,
"What is the single greatest predictor
of a human being's health?"
He would say, "The postal code."
Where you live matters. And it's not just
the differences in health systems
and public health infrastructure
between high-income and low- and middle-income countries.
There are also vast inequities within countries
for those who are living in well-heeled neighborhoods
and those that are living in squalor.
This is simply immoral, unjust.
- That's a problem,
even in the world's richest country
where many people avoid going to the doctor
because of how expensive American healthcare can be.
That's tragic enough by itself.
But in an epidemic, it might be disastrous.
If we're going to be proactive in our fight
against these outbreaks,
improving healthcare quality for everyone
might be the best strategy we've got.
- Health equality matters,
and it matters a lot - not just for the individual,
not just for the community, not only for the country,
but for the globe.
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Why It's So Hard To Contain The Coronavirus And Other Outbreaks

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Annie Huang 2020 年 3 月 16 日 に公開

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