让美国再次免疫

让美国再次免疫

——这个国家很多的力量源泉已经付之东流

 

作者：Thomas Friedman (The New York Times) May 5,2020

见习翻译：夏大愚

 

如果拜登先生，在与特朗普先生正在进行的总统竞选中，需要一句口号，我会向他推荐这个：“让美国再次免疫”。

我们正在与疫情战斗，来保卫我们的生命，拯救我们的生活。这时候我们发现，这个战斗所需要的所有的力量源泉，在这个国家都被我们自己破坏了。我们破坏了了我们的认知，破坏了我们的环境，破坏了经济和社会管理，破坏了公共和个人卫生的防疫体系。疫情打了我们的脸，暴露了这些问题。而且，情况还在变得更糟。

种瓜得瓜，种豆得豆。很多年来我们装聋作哑，于是我们得到了这样一个免疫功能失调的国家，这是如此公平和符合逻辑。我们嘲笑科学和读书，任凭政党政治搞垮我们的专业公务员队伍，把严肃的政治搞成一出闹剧。甚至于在这种装聋作哑和明知故犯中，美国人养成了可怕的饮食习惯，把我们当中超过40%的人吃成了肥仔。

在田纳西州的奥斯汀，一名公园管理员正在进他的职责，向游客们解释需要保持社交距离。可是一个游客将这名管理员扔进了河里。多少年来我们装聋作哑，造成的这种愚昧和无知，难道还不足够可怕吗？

沃伦·巴菲特说过一句话，当潮水退去，你会看见谁在裸泳。现在我们举头四望，发现是我们自己光着屁股。事实上，我们美国在确诊人数和死亡人数两个方面领导了世界。

在我老家明尼苏达，有一个75岁的退休老太太，她叫Gloria Jackson, 她向《华盛顿邮报》的记者抱怨说：“在我年轻的时候，我们美国在所有方面，堪称这个世界的楷模。但是现在呢？我们自私，虚弱而又难缠，别的国家都为我们感到脸红。这个国家已经脱轨了，没有了领导力，也不再团结，每个美国人都在为此蒙受巨大损失。”

这些年来，很多原因造成了这个国家患上了社会综合免疫系统失调症。其中最要命的，是共和党政府把病情的恶化推上了快车道。特朗普总统本来就是社会免疫失调症的产物，他上任后投桃报李，狠狠踩下加重病情的油门。

在疫情的绝望中，人们最需要的是科学的拯救。但是我们选出的总统先生，只管每天张开大嘴，狂喷各种谎言和谬论，而且将所有他不喜欢的消息称为“假新闻”。特朗普先生对破坏我们的认知免疫力“贡献”太大了，以至于我们已经分不清什么是真实，什么是谎言，什么是科学，什么是幻想小说。

在我们最需要国际合作的时候，特朗普总统搞垮了我们所有的联盟。在我们最需要社会信任，合作抗疫的时候，特朗普总统却在跳动群众斗群众。他把民众分成两派，拉一派，打一派。他让选民站起来反对他们的州长，因为这符合他的竞选策略。我们没法团结在一起，如何能够战胜疫情？

特朗普总统一上台，就一脚踢飞了他的前任奥巴马总统费尽力气搞出来的全民可负担医疗法案。特朗普先生甚至不屑于考虑一下一个替代的办法。其结果是疫情来了，我们没有医疗保险。就连那些上第一线与病毒搏斗的医护人员，也需要担心，万一自己被传染上，是不是有人会救治他们？

特朗普总统对于敢于反对的他的意见的官员，也采取一脚踢开的策略。其结果是当疫情在全世界泛滥，负责为保卫美国提供早期预警的国土安全部和国家情报办公室里，坐的都是不知所措的临时工。所以我们面对危局无动于衷，坐失良机。国家疾控中心的人同样不敢举手，提出反对意见，只能看着总统先生任意胡来。

那么我们怎样才能有效的对抗这次的病毒呢？目前已知的有三个有效的途径。首先是爆发的前几个星期最为重要，必须要尽可能的减缓疫情的流行。然后需要一个可持续的计划，救助病患，一直等到老天爷，或者人工的疫苗，让我们集体免疫。瑞典在这方面就做出了榜样，他们局部封锁了社区，保护住最脆弱的人群，然后让最健康的人经受考验，逐步接受自然形成的群体免疫。

另外一个看起来有效的办法就是中国人干的，他们的国家机器全力开动，凶狠的封城，阻挡住要回去工作的人潮，强迫公民带口罩，保持距离。进行大规模的检测，建立隔离区，把病患关起来，直到疫情过去，或者疫苗出现。我们看起来是要以一种相对民主的方式学习中国人的做法，但是干的全都乱了套。各个州各自为战，是否有效只能凭运气了。奥巴马总统的卫生部长 Dr. Vivek Murthy告诉我，我们即便没办法像强悍的中国政府一样工作，能够做到他们的10%也是好的。不幸的是，我们也没能做到。这位博士刚刚非常及时的出版了他充满智慧的新书：《让我们一起在孤独中治愈》。

这位博士补充说，针对不同风险的人群采取不同级别的封城是行之有效的办法。但是这一切取决于大范围的快速检测，并且要将结果立即应用于分析和预测疫情的传播。但是跟特朗普总统吹嘘的情况不一样，我们的检测远远跟不上形势。最糟糕的是，检查自己有没有被感染，成为了每个公民自己的职责，然后他们的联系人也一样。

“时间就是一切，失去时间等于失去很多生命。”我们已经失去了太多时间。

我们现在面临的最大威胁是社区传染。设想一下，一对夫妻带着三个孩子，大人要去上班，小孩要去上学，怎么能够保证不带病毒回家？这位博士建议学习中国的做法，政府租用空置的旅馆酒店，将病患集中隔离，并且雇佣失业者，在专家指导下追踪和照顾患病者。为了能够让更多的人尽快去复工，避免失业带来的忧郁与绝望，我们迫切需要联邦以更加民主的方式，效仿中国的做法。

但是特朗普总统拒绝了这样一套通过联邦和社会合作来对抗疫情的方案。因为这样自打嘴巴的做法会让他受到支持者的反对，在政治上等于自杀。他能做的只有继续耍开两片嘴皮子，大谈什么“大自然母亲”，继续糊弄和恐吓他的支持者。他从当房地产开发商时就是这么干的，他的那些同党也已经习惯于给他不停的擦屁股。

可惜谈论大自然母亲并不管用。大自然就是冷冰冰的化学、生物学、物理学公式。我们不能拿她老人家练手，是她一直拿我们练手。我们不能对她发火，是她一直要对我们发火。她把瘟疫、飓风、洪水、干旱、热浪，种种灾难，不断扔在我们头上，就是想让那些基因不能适应的家伙们去死。

这就是全部的事实。如果我们自己无所作为，很多人就要提早回到造物主的怀抱。

（原文附后）

Make America Immune Again

Many sources of the nation’s strength have eroded.

If Joe Biden is looking for a bumper sticker for his campaign against Donald Trump, I’d suggest this one: “Make America Immune Again.”

This pandemic has both exposed and exacerbated the fact that over the last 20 years we as a country have weakened so many sources of our strength. We’ve simultaneously eroded our cognitive, ecological, economic, social, governance, public health and personal health immune systems — all the sources of resilience we need to get through this pandemic with the least damage to lives and livelihoods.

All these immune deficiencies are the logical outcome of how we’ve let ourselves go as a country, how we’ve let ourselves be dumb-as-we-wanna-be for so many years — devaluing science and reading, bashing public servants for political sport, turning politics into entertainment, not to mention adopting horrible eating habits that have left 40 percent of Americans obese.

Dumb-as-we-wanna-be is epitomized by the guy in Austin, Texas, who last week shoved a “park ranger into the water while the ranger was explaining to a crowd the need for social distancing,” as CNN reported.

Warren Buffett was right: When the tide goes out you see who’s swimming naked. And now it’s us. We are still exceptional, but now it’s in the fact that we lead the world in total coronavirus cases and deaths from Covid-19.

“We were the leading country in everything when I was young,” Gloria Jackson, a 75-year-old retiree from my home state, Minnesota, told The Washington Post. “And what are we now? We’re mean. We’re selfish. We’re stubborn and sometimes even incompetent. … It seems like some of these other countries almost feel sorry for us. … We can’t get out of our own way. … There’s no leadership and no solidarity, so everybody’s doing whatever they want … which means everyone who’s vulnerable is losing big.”

This erosion of our collective societal immunity has been fed by many sources over the years, but none more than a Republican Party that has simply jumped the tracks. Donald Trump’s election was a byproduct of our lost immunity, but his leadership has now become a giant accelerant of it.

At a time when we desperately need to be guided by the best science, Trump’s daily fire hose of lies, and his denunciations of anything he doesn’t like as “fake news,” has contributed mightily to the loss of our “cognitive immunity” — our ability to sort out truth from lies and science from science fiction.

At a time when we need a globally coordinated response to a pandemic, Trump has wrecked every alliance we have.

At a time when we need high social trust in order to have a coordinated response at home, Trump’s political strategy of dividing us and playing everything both ways — even telling people both to rise up against their governors and to lock down according to his guidelines — is the opposite of the “all in this together” approach we need to win this battle.

At a time when access to affordable health care is extra-important — when frontline workers need to know that if they go to work and fall ill, they will have some safety net to protect them — Trump has been trying to destroy the Affordable Care Act enacted by President Barack Obama without even thinking through an alternative.

At a time when we’ve never more needed our early warning systems to be operating at peak potential, the four top jobs at the Department of Homeland Security and the Office of the Director of National Intelligence “have all been filled with temporary acting officials for literally every day that Covid-19 has been on the world stage,” Garrett Graff recently noted in Politico.

And Trump’s vindictiveness toward any career public servant who challenges his narrative has surely contributed to the weak response from the Centers for Disease Control and Prevention. Experts are afraid to raise their hands to contradict the president.

What would it take to make ourselves collectively more immune to Covid-19? It starts with the understanding that the only thing these weeks of lockdown have done is slow the spread of the virus. We still need a sustainable plan for saving lives and livelihoods until we get herd immunity, naturally or from a vaccine. There are three basic approaches.

One is the Swedish approach of partial lockdown, protecting the most vulnerable and gradually allowing the healthiest to acquire the infection, recover and build herd immunity naturally.

The other is the Chinese strategy: strict lockdown followed by back-to-work flows, accompanied by masks, social distancing and the full use of China’s state surveillance systems to test, trace and quarantine any carriers of the virus to keep it contained until a vaccine can provide herd immunity.

We seem to be opting for a more democratic version of the China model — but in a totally haphazard, every-state-for-itself manner.

What are our prospects of success?, I asked Dr. Vivek Murthy, Obama’s surgeon general, who has just published a thoughtful and timely book, “Together: The Healing Power of Human Connection in a Sometimes Lonely World.”

“Even if we can’t be as aggressive as China in terms of surveillance and testing, the truth is, we are at best only 10 percent of the way there. Simply put, we are behind,” said Murthy.

Yes, a strategy of gradually lifting lockdowns based on different risk categories can make sense, he added, but only if every state has in place widely available testing that generates rapid results — results that are efficiently turned over to teams empowered to immediately trace and then quarantine the infected or the most vulnerable, in big towns and small, to block any further spread of Covid-19.

“Speed is everything,” said Murthy. “Time lost equals lives lost.”

The number of tests we are doing — which Trump is always boasting about — is irrelevant unless you can reliably and quickly get a test when and where you need it, and the results can be converted into efficient tracing of others who might be infected.

“By that measure we are falling far short,” said Murthy. “It is your ability to find an infected person through testing — and then all their contacts — that matters most.”

That’s because the biggest challenge we face in America today is “community spread,” explained Murthy. “Consider a diabetic parent living in a small home with three children who need to go back to school and the other parent needs to go back to work. How do we open up safely and prevent them from bringing the disease home? Practically speaking, how do we actually protect the vulnerable?”

Murthy suggests the federal government do a version of what China did: rent empty hotels to provide quarantine options to the most vulnerable or those infected and hire some of the massive numbers of unemployed workers to become part of tracing teams in every state under the lead of public health experts.

In sum, if we are going to save the most lives while getting the most people back to work to prevent an epidemic of unemployment, depression and despair, it is going to require a federally coordinated, democratic version of the China strategy.

But Trump resists that kind of science-based, nationally coordinated approach, because it serves him politically to urge his supporters to resist his own administration’s health guidelines.

Trump seems to think he can bluster, bluff and talk out of both sides of his mouth with Mother Nature — the way he did in real estate and has done on so many issues as president, when his party could always cover for him.

But it doesn’t work that way with Mother Nature. She is not a contestant on “The Apprentice.” She is just chemistry, biology and physics. We’re the contestants on her show. We don’t get to fire her. She gets to fire us.

She throws viruses, hurricanes, floods, droughts, heat waves and pandemics at us to sort out who’s the fittest. And the ones who survive have one thing, and one thing only, in common: They are the most adaptive at generating the chemistry, biology and physics needed to meet the challenge.

That’s all that matters. All those who can’t, get fired or, rather, are returned to the manufacturer.