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内容：Morgan Hu编辑：Yong Wechat ID: NativeStudy / Weibo: http://weibo.com/u/3476904471 ----------------------------------下划线-------------------------------------------- Part I: Speaker Creating A Post Pandemic World Paddy Hirsch&Cardiff Garcia, May 2020
Source:NPR https://www.npr.org/2020/05/01/849232762/creating-a-post-pandemic-world [Rephrase 1, 09:43] Part II：Speed
'Unity, Faith, Discipline, Tolerance and Respect Can Bring Peace and Prosperity' MOEEZ BIN HAMID, MAY 4, 2020
[Time 2] Kamel Ghribi is one of North Africa's most successful and prominent businessmen, with a long and prestigious career in the petrochemicals sector. Since his first major role as vice-president of Olympic Petroleum Corporation in New York, at the youthful age of 29, he contemporaneously held the position of president of Olympic Management in Italy until he became president of Olympic Energy. Since 2005, he has devoted his time to his new company, Swiss-based GK Investment Holding Group. GK Investment Holding Group specializes in developing new business opportunities, largely in Africa and the Middle East, with a special emphasis on healthcare.
In recent years, he has been deeply concerned by the course of events in the Middle East and Africa: “In particular, I was disturbed by how the lack of understanding between certain nations was so deep rooted which seem almost impossible to overcome.” Referring to discussions of these matters with influential friends in political, industrial and cultural circles, he states, “What started as informal chats among friends soon developed into using my influence in the field of business and translating it into diplomacy.”
Ghribi has always been a patriotic Tunisian. Recently while talking about Tunisia’s former president Beji Caid Essebsi, who died in July 2019 at the age of 92, he reflected on the current state of the nation. [225 words]
[Time 3] “The best way to honour his memory is to continue to uphold our delicate constitution and forge onwards with democracy, no matter how hard. We cannot move forward by destroying one another. We need to seek consensus.”
Speaking of the economy, Ghribi said, “There is no magic wand that will solve Tunisia’s economic challenge with a simple wave. The situation in Tunisia is complex. Tunisia is still in the process of economic reform and liberalisation. Although we have been historically blessed with a diverse market orientated economy, we faced many challenges following the 2011 changes, which slowed our economy and increased unemployment, particularly among the youth.”
Here too the role of political stability and consensus-building was paramount: “The government can do much to boost current economic conditions but must first address the issue of stability and security in the country if it is to encourage both domestic and foreign investors back.”
“The Tunisian economy has always been highly dependent on tourism. However, stability is difficult to guarantee if your neighbours are in civil war or fighting one form of terrorism or another. Long-term plans are difficult to make under precarious circumstances.”
To build this stability, cooperation was necessary on an international scale as well. “Short-term solutions need to be supported by our partners in the EU who can not only help us to stabilize the area as a whole by helping us to combat terrorism but also provide financial support to the government in the form of reduced borrowing costs on loans that can give Tunisia access to new markets and help open the domestic market to foreign investors,” said Ghribi. [283 words]
[Time 4] He called for the diversification of the Tunisian economy, through both private and public measures.
“Tunisia must broaden its tax base and that means that its economy must diversify. I am not an advocate of everything being privatized, however, some parts of our economy need to be if we are to sustain growth and create employment. We must also create more opportunities for the educated members of the population to help build Tunisia into the country that it can become because a dissatisfied and disillusioned educated population is dangerous for any country.”
He further stated, “The deep sense of antipathy and disillusionment felt by many concerning the current state of affairs was very likely to result in violent consequences for the Middle East.”
“For example, I was very troubled and saddened to hear that young Tunisians were joining ISIS, a force of destruction, not hope, and one that is inconsistent with any religion. ISIS must be defeated and wiped out but that won’t happen unless we try to understand the desperation that drove so many young people from many countries to join such a malignant force. Unless we address the root causes of such movements, they will arise again and again.”
Ghribi is convinced that in order to be turned away from such ideologies, people need not merely employment, but meaningful employment that will allow them to live more meaningful lives.
“The lack of jobs is a major source of the problem but there were many educated people who joined ISIS, too. I think we must look beyond menial work but also at meaningful work. Employment must not only provide income but add to the purpose of life,” he said. [290 words]
[Time 5] Ghribi has put forward a positive and optimistic vision of Tunisia's possibilities for social and economic development.
“Why can’t Tunisia become a centre for renewable energy and innovative housing models? Rwanda is making itself a centre of innovation for East Africa. What country is better suited than Tunisia to do the same in North Africa,” he said.
In recent months, via his role as vice-chairman of the board of Gruppo Ospedaliero San Donato, Italy's largest private healthcare supplier, Ghribi has been at the very forefront of the fight against the COVID-19 virus in Lombardy, one of the worst affected areas. Here too, he has witnessed first-hand how his belief in the need for cooperation between the public and private spheres and not just between nations, has been put into practice.
“COVID-19 concerns humanity as a whole,” he says. “No nation has been spared, and humanity as a whole must unite and face the situation as one if we are to defeat this invisible enemy. We must open our metaphorical borders even though our physical ones are being closed.”
He pointed out that the distinction in healthcare between rich and poor nations was being broken down here: “For too long now wealthy, developed nations have paid lip service to the difficulties faced in the less wealthy developing nations,” while sheltering behind advanced medical systems, but "COVID-19 is an invisible and unwelcome guest that respects no boundary and has swiftly and relentlessly smashed through all barriers, manmade or otherwise”. [259 words]
[Time 6] Stating that “cooperation between nations is absolutely necessary if we are to effectively combat the virus” he went on to highlight Gruppo San Donato’s success in Lombardy, where although making up only 13 per cent of the health system it nonetheless treated 18 per cent of COVID-19 patients during the emergency. “Such figures demonstrate just how efficient the private sector can be in terms of responsiveness when properly integrated into the public system,” he said, while emphasising the need for governments to support and utilize private healthcare systems.
Looking both backwards and forwards, Ghribi says: “I firmly believe that the greater cooperation and dialogue we were successful in establishing at the highest level in the late 90s, helped to define the ideal framework for the rebuilding of impoverished economies and fractured societies. That is to say, dialogue and cultural awareness are key to the foundation of stable social and political systems in the Middle East and Africa. Only through the principles of unity, faith, discipline, tolerance and respect will we finally gain peace and prosperity in all nations.” [186 words] Source: Entrepreneur https://www.entrepreneur.com/article/350124 Part III: Obstacle
A Plan to Safely Reopen the U.S. Despite Inadequate Testing RANU S. DHILLON , ABRAAR KARAN , DAVID BEIER , ANDREW SULLIVAN , GERARDO CHOWELL , DIEGO CHOWELL AND DEVABHAKTUNI SRIKRISHNA, MAY 1, 2020
[Paraphrase 7] For regions shut down due to Covid-19 to safely begin to reopen, we need ways to keep R — the average number of additional people infected by each infected person — under one, the threshold below which epidemics contract and ultimately die out. Among the proposals for how we can do this in the United States, one calls for frequent population-wide testing to identify and isolate those who are infected. Others suggest that the country will be hard-pressed to get through this without either prolonging lockdowns or intermittently reinstating them whenever infections rise until we have enough testing and contact tracing to control the spread or enough people become immune through infection or vaccination. The former requires testing on a scale that, barring a breakthrough, will not be possible anytime soon. The latter would inflict ongoing social and economic damage with the specter of lockdowns constantly looming over us.
We suggest another way that is perhaps both more achievable in the near term and sustainable over the long term. It is based on our belief that given the expected limited levels of testing that will be available for the next several months, we may not be able to detect and isolate enough infected people to keep R below one without lockdowns even with strong contact tracing.
Once cases are declining for multiple weeks, though, we could begin easing social distancing if we can implement population-wide social protections that, combined with more modest increases in testing and tracing, could be sufficient for keeping R below one. Social protections are ways to protect against transmission, including asymptomatic and presymptomatic spread, that still allow people to work and resume some normal activities. Our plan involves two measures:
- Mass producing and then widely distributing masks that are more protective than those that are now typically being worn by the general population.
- Ensuring rigorous implementation of physical distancing and hygiene in workplaces, public areas, high-risk settings (e.g., homeless shelters), and homes.
While many reopening plans call for versions of these measures, we are calling for governments, employers, and the population at large to be bolder, more systematic, and more innovative in maximizing these approaches. In the absence of adequate testing, strong social protection is the only other lever we have to blunt transmission enough that lockdowns could potentially be relaxed without needing to be quickly reimposed.
Ultimately, social protection may neither need to be as effective as social distancing nor require testing and tracing to be perfect. The key is for their combined effect to be good enough to keep R below one. This could be more achievable than it seems. From an analysis we conducted (not yet peer reviewed), if social protection were 50% effective, we would keep R below one by isolating 40% of symptomatic infected individuals within a day of the onset of symptoms.
Invisible Spread One of the key reasons why current levels of testing, tracing, and isolation are not enough to stop Covid-19 is its “invisible” transmission. Between 25% and 80% of infected people have no symptoms, or only mild ones, yet still infect others, some possibly contributing to “superspreading” events. Even patients who develop serious illness may be most infectious either one or two days before their symptoms start or on the day that their symptoms appear. Almost half of all transmission may happen during this presymptomatic period when people — and those around them — don’t know they are transmitting.
The White House projects that five to 10 people need to be tested to find one infected person; others suggest that number is 50 to 100 people. At current levels of infection, testing widely enough to stop enough asymptomatic and presymptomatic transmission would likely require millions of tests per day — more than the roughly 200,000 a day done now or the 450,000 a day expected by the fall. Contact tracing can find some of these invisible transmission chains, but no matter how many tracers are hired or what digital tools are used, it can only help to the extent that testing is available to identify cases whose contacts need to be traced, isolated, and also tested.
Social Protection Strategies Many states have recently gotten R just below one by buttressing testing with lockdowns. As states gradually reopen, we need measures that mimic the protective benefits of lockdowns without their destructive downsides.
High-filtration masks. Though Covid-19 can spread through surfaces and contact, it seems to mainly transmit through the air. If we block this respiratory transmission, we should be able to control the virus. High-filtration surgical masks that are easier to wear than N95 masks can help achieve this goal. They could be just as important to stopping Covid-19 as any diagnostic or treatment.
The cloth masks that people are now using vary widely in how well they block infection but typically stop less than 50% of viral particles with many closer to 20% or less. High-filtration surgical and N95 masks used by health workers more reliably impede transmission. Right now, these are rightly prioritized for health workers. What is more, N95 masks are difficult to wear for long periods of time even for those used to them.
While not as protective, high-filtration surgical masks are generally more effective than cloth masks and more wearable than N95s. A new study suggests that combining cotton with other widely available materials, such as silk, chiffon, or flannel, could achieve levels of filtration similar to these masks.
An existing high-filtration surgical mask or a new design — ideally one that is reusable — that strikes the right balance between protection and comfort should be rapidly mass manufactured and distributed to the general population. As was done for ventilators, we need to use the Defense Production Act to mass produce and widely distribute these masks.
While this sounds ambitious, it may be easier and faster to do than establishing adequate testing. And, though there is a concern that wearing masks may prompt people to be less careful in other ways, we have not seen any data to support this notion. In fact, similar reservations were raised about whether seatbelts would cause careless driving, which studies have shown to be untrue.
Physical distancing The Centers for Disease Control and Prevention (CDC) needs to develop clear guidelines and regulations for maintaining safe distancing in public that local health departments can use to help businesses implement and then monitor for compliance. Even once lockdowns are relaxed, we need to keep large public gatherings on hold. Public areas need to be choreographed to ensure spacing — for instance, by limiting the number of passengers in a subway car or customers in a business at any one time. Workplaces similarly need to be reorganized to minimize crowding — by staggering shifts, limiting in-person meetings, spacing out seating arrangements, resorting to telework as much as possible, and so on. Restaurants and retail stores need to actively plan and manage the spacing of customers, provide hand sanitizing facilities, and ensure appropriate ventilation to prevent viral particles from lingering in the air. [1178 words]
[The Rest] Hygiene. While masks and distancing address respiratory transmission, fomite spread — spreading a disease through surfaces — needs to also be blocked by routinely disinfecting highly frequented areas and making hand sanitizing ubiquitous in public spaces. While preventing people from picking up virus this way, we also need to other strategies to nudge them into not touching their face and mouth. In a study observing medical students, subjects touched their face 23 times per hour. While changing these behaviors is difficult, it’s not impossible. For example, wearing rubber or other reusable gloves when grocery shopping may make people less likely to touch their face. Other creative, scalable, and possibly simple ideas could go a long way.
Home isolation. People with symptoms, confirmed infection, or identified as a contact of an infected person need to be isolated until they are clearly not infectious. If isolating at home — where household members are up to 20 times more likely to get infected than other contacts — people need to be truly isolated. They should not share bathrooms, beds, or living spaces with others and should wear masks and wash hands before passing through common areas. People for whom this is not practical — for example, those living in crowded housing or with people who are at high-risk — need to be given the option to isolate in hotels, dorms, or other repurposed venues free of charge.
While people seem willing to adopt protective practices at home when someone is symptomatic, it may be unrealistic to expect people to do so when family members could unknowingly be asymptomatically or presymptomatically infectious. Scenarios may arise where guarding against this invisible spread by wearing masks and practicing social distancing within households might become important for controlling the epidemic, especially as people return to work. However, such intrusive measures would have to be weighed carefully against their extreme social cost. The number of people living in a household would likely be an important factor in navigating such situations. For community housing scenarios — like nursing homes and homeless shelters, where large numbers of people get infected very quickly — the need for protective measures is clearer.
As states look to reopen, we need to establish a multilayered, social-protection strategy that, combined with more achievable levels of testing and tracing, could keep R below one. Doing so will also require cultivating public buy-in without regressive punitive enforcement while supporting disadvantaged communities to adopt these approaches. We need to move quickly to create and widely implement such a strategy within the coming weeks, not months. [429 words] Source:Harvard Business Review https://hbr.org/2020/05/a-plan-to-safely-reopen-the-u-s-despite-inadequate-testing
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发表于 2020-5-5 22:23:39
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