美國疾控中心 埃博拉患者或將增至140萬
Yet another set of ominous projections about the Ebola epidemic in West Africa was released Tuesday, in a report from the Centers for Disease Control and Prevention that gave worst- and best-case estimates for Liberia and Sierra Leone based on computer modeling.
本週二，美國疾病控制與預防中心（Centers for Disease Control and Prevention，簡稱CDC）發佈了一份報告，對西非的埃博拉疫情做出了不樂觀的預測。該報告使用計算機建模，針對利比里亞和塞拉利昂的疫情，進行了最壞和最好情況的估計。
In the worst-case scenario, the two countries could have a total of 21,000 cases of Ebola by Sept. 30 and 1.4 million cases by Jan. 20 if the disease keeps spreading without effective methods to contain it. These figures take into account the fact that many cases go undetected, and estimate that there are actually 2.5 times as many as reported.
在最壞的情況下，到9月30日，這兩個國家可能共有2.1萬宗埃博拉病例，如果病情不斷蔓延，缺乏有效的方法來遏制它，那麼到明年1月20日，會增至140萬宗。CDC考慮到很多病例都沒有被發現，估計實際病例可能是統計數據的2.5倍，據此得出了以上預測。In the best-case model, the epidemic in both countries would be “almost ended” by Jan. 20, the report said. Success would require conducting safe funerals at which no one touches the bodies, and treating 70 percent of patients in settings that reduce the risk of transmission. The report said the proportion of patients now in such settings was about 18 percent in Liberia and 40 percent in Sierra Leone.
報告稱，在最好的情況下，到1月20日，這兩個國家的疫情“幾乎會結束”。要實現這一點，就需要安全地開展喪葬，在這個過程中不讓任何人觸及屍體，並且需要在可以降低傳染風險的環境中，治療70%的患者。該報告表示，目前處在這種環境中的患者，在利比里亞只有約爲18%，塞拉利昂約爲40%。
The caseload projections are based on data from August, but Dr. Thomas R. Frieden, the C.D.C. director, said the situation appeared to have improved since then because more aid had begun to reach the region.
該報告根據8月的數據，做出了疫情猖獗的預測，但CDC主任托馬斯·R·弗雷登(Thomas R. Frieden)博士表示，8月之後，隨着更多的援助逐漸抵達了該地區，疫情似乎有所改善。“My gut feeling is, the actions we’re taking now are going to make that worst-case scenario not come to pass,” Dr. Frieden said in a telephone interview. “But it’s important to understand that it could happen.”
“我的直覺是，鑑於我們目前採取的行動，最壞的情況不會應驗，”弗裏登博士在接受電話採訪時說。“但重要的是要明白，那是有可能發生的。”Outside experts said the modeling figures were in line with estimates by others in the field.
外界專家稱，CDC的建模數目與該領域其他人的預測相吻合。“It’s a nice job,” said Ira Longini, a professor of biostatistics at the University of Florida who has also done computer modeling of the epidemic. “It summarizes the extent of the problem and what has to happen to deal with it.”
“這份報告很不錯，”佛羅里達大學生物統計學教授艾拉·朗吉尼(Ira Longini)說，他也對這次疫情進行了計算機建模。“它總結了問題的嚴重程度，以及要應對它，必須開展哪些工作。”Bryan Lewis, an epidemiologist at the Virginia Bioinformatics Institute at Virginia Tech, agreed that the estimates were reasonable, perhaps even a bit low compared with those generated by other models. He said that if some of the latest data from the World Health Organization is plugged into the C.D.C. model, “the very large numbers of estimated cases are, unfortunately, even larger.”
布萊恩·劉易斯(Bryan Lewis)是一名流行病學家，供職於弗吉尼亞理工大學(Virginia Tech)弗吉尼亞生物信息學研究所(Virginia Bioinformatics Institute)，他認爲這些估計是合理的，相對於其他模型得出的估計數目而言，甚至有點偏低。他說，如果CDC的模型使用世界衛生組織（World Health Organization，簡稱WHO）的一些最新數據，那麼“很不幸，這些已經非常大的病例估計數目，甚至就會變得更大”。The current official case count is 5,843, including 2,803 deaths, according to the W.H.O.
WHO目前的官方數據顯示，病例數目已達5843例，其中包括已經死亡的2803例。The C.D.C. estimates omit Guinea, which has been hit hard, because the epidemic struck in waves that could not be modeled.
CDC沒有對幾內亞的猖獗疫情進行估計，因爲在該國，埃博拉是一波一波來襲的，研究者無法對此建模。The W.H.O. published its own revised estimates of the outbreak on Monday, predicting more than 20,000 cases by Nov. 2 if control does not improve. That figure is more conservative than the one from the C.D.C., but the W.H.O. report also noted that many cases were unreported and said that without effective help, the three most affected countries would soon be reporting thousands of cases and deaths per week. It said its projections were similar to those from the C.D.C.
本週一，WHO修訂了自己的估計數字，稱如果疫情控制狀況沒有得到改善，那麼到11月2日，病例數目將超過2萬例。這個數字比CDC的預計保守，但WHO的報告還指出，很多病例都未經報告，如果缺乏行之有效的幫助，疫情最嚴重的三個國家很快就會報告每週數千人的死亡數目。WHO說，自己的預測與CDC的很相似。The W.H.O. report also raised, for the first time, the possibility that the disease would not be stopped but could become endemic in West Africa, meaning that it could become a constant presence there.
WHO的報告還首次指出，這種疾病不會消失，而是可能會成爲西非的地方病，這意味着，埃博拉可能在那裏成爲一種常見病。President Obama’s promise last week to send 3,000 military personnel to Liberia and to build 17 hospitals there, each with 100 beds, was part of the solution, Dr. Frieden said. But it was not clear when those hospitals would be ready, or who would staff them.
上週，奧巴馬總統承諾，將派遣3000名軍事人員到利比里亞，搭建17家醫院，每家提供100張牀位；弗雷登博士說，這是整個解決方案的一部分。不過目前還不清楚，這些醫院將在何時準備好，以及由誰來提供醫療服務。Dr. Frieden said the Defense Department had already delivered parts of a 25-bed unit that would soon be set up to treat health workers who become infected, a safety measure he said was important to help encourage health professionals to volunteer. He said that more aid groups were also arriving in the region to set up treatment centers, and that a “surge” of help would “break the back of the epidemic.”
弗雷登博士說，國防部已經提供了一些材料，用來搭建一個25個牀位的病房，以便治療那些感染了埃博拉的醫療人員，搭建工作將很快完成。他說，這是一個很重要的安全措施，有益於鼓勵醫務人員擔當志願者。他說，還有更多援助團正在抵達該地區，以搭建治療中心，而且“一大波”援助將會“很好控制住埃博拉疫情”。Dr. Jack Chow, a professor of global health at Carnegie Mellon University and a former W.H.O. official, said, “The surge only becomes realized when those beds are up and operating and the workers are delivering care.”
卡內基梅隆大學(Carnegie Mellon University)全球衛生教授周啓康博士(Dr. Jack Chow)曾是WHO官員，他說，“只有當這些牀位都建好，投入使用，而且有人提供醫療服務時，這一大波援助才能變成現實。”He added, “If even the medium case comes to pass, with, say, 700,000 cases by January, the epidemic will quickly overwhelm the capabilities that the U.S. plans to send.”
他還說，“就算只是出現了預測的中間情況，比如1月時，病例數目達到70萬例，那麼疫情也將迅速壓垮美國計劃提供的援助。”The W.H.O. reported that a new center had just opened in Monrovia, the Liberian capital, with 120 beds for treatment and 30 for triage. Patients were already lined up at the door.
WHO的報告稱，一家新的治療中心剛剛在利比里亞首都蒙羅維亞開業，它擁有120張治療牀位，還有30張牀位用於分診。患者已經在門口一字排開。The report from the C.D.C. acknowledged that case counts were rising faster than hospital beds could be provided. It said that in the meantime, different types of treatment would be used, based in homes or community centers, with relatives and others being given protective gear to help prevent the disease from spreading.
CDC報告承認，和可以提供的牀位數目相比，病例數目的增長速度更快。該組織表示，在此期間，可以採用不同類型的治療方式，讓患者在家中或社區中心裏，接受親戚和其他人的護理。護理者將獲得保護設備，以防止疾病蔓延。The United States government is also sending 400,000 kits containing gloves and disinfectant to Liberia to help families take care of patients at home.
美國政府還將運送40萬份手套和消毒劑到利比里亞，以幫助患者的家人在家中護理他們。At least one aid group in Liberia is already shifting its focus to teaching people about home care and providing materials to help because there are not enough hospital beds for the sick. Ken Isaacs, a vice president of the group, Samaritan’s Purse, said, “I believe inevitably this is going to move into people’s houses, and the notion of home-based care has to play a more prominent role.”
在利比里亞，由於沒有足夠的牀位供患者住院，至少有一個援助組織已經轉移工作重心，開始側重於教導人們如何開展家庭護理，並提供相應的物資。該組織名爲撒瑪利亞救援會(Samaritan's Purse)，其副主席肯·艾薩克斯(Ken Isaacs)說，“我認爲護理工作將在家庭中開展，這一點不可避免，而家庭護理這個概念可以發揮更加突出的作用。”
