病亡率、压平曲线、疫情高峰：如何正确理解这些术语？                

来源：  NYT双语阅读

Making sense of the coronavirus pandemic requires getting up to speed on semantics as much as epidemiology.

弄懂新型冠状病毒大流行，既需要了解流行病学的最新情况，也需要在语义学上跟上形势。

Government officials and health care professionals toss off mentions of mortality rates, flattening the curve and lockdowns, assuming that we know what they mean. But the terms mean different things from country to country, state to state, even city to city and person to person.

“病亡率”、“压平曲线”和“活动限制”等说法从政府官员和公共卫生专业人士的嘴里脱口而出，他们假设大家都知道这些词的意思。但对不同的国家、不同的州，甚至不同的城市和个人来说，这些术语有着不同的含义。

Officials use the same phrases about mass testing, caseloads and deaths to describe very different situations. That makes it hard to give clear answers to vital questions: How bad are things? Where are they headed?

官员们使用“大规模检测”、“病例数”和“死亡病例数”等相同的措辞，来描绘非常不同的情况。这令一些重要的问题难以得到明确的回答：情况有多糟糕？正在向什么方向发展？

People search for insight by comparing their countries to those that are further along in the epidemic. But if the terms are misleading or used in differing ways, the comparisons are flawed. Also, the statistics and vocabulary offer a false sense of precision while in reality, the information we have shows only a fraction of what’s going on.

人们将自己的国家与那些经历了疫情更多阶段的国家进行比较，以求了解情况。但是，如果这些词语使人产生误解，或在使用方式上存在差异的话，这种比较就是错误的。此外，这些统计数据和词汇给人以精准的假象，而现实是，我们所掌握的信息仅代表冰山一角。

“The new cases or deaths each day are given as exact numbers, and we’re trained to take that at face value,” said Mark N. Lurie, an epidemiologist at Brown University’s School of Public Health. “But those are far from exact, they’re deeply flawed, and their meaning varies from place to place and from time period to time period.”

“每天的新增病例数或死亡人数都是以精准数字的形式通报的，我们被训练成只看这些表面数字，”布朗大学(Brown University)公共卫生学院流行病学家马克·N·卢里(Mark N. Lurie)说。“但这些数字远非精准，而且有严重缺陷，它们的含义因不同的时间和地点而不同。”

‘Confirmed Cases’

确诊病例

The United States recently hit an attention-getting milestone, passing China as the country with the most reported infections. But there is deep uncertainty about whether there really are more American cases, and about how well the figures reflect reality.

美国前不久超过中国成为通报的感染病例数最多的国家，这是一个引人注目的里程碑。但对于美国是否真的有更多病例，以及这些数字在多大程度上反映了真实情况等方面，仍存在很大的不确定性。

Countries vary wildly in testing for the virus and how they report the numbers, and experts say most infections are going undetected. So the publicized national tallies are rough, incomplete pictures that may not be all that comparable.

各国在病毒检测以及通报数字的方式上有很大差异，而且专家们说，大多数感染都没有被发现。因此，各国公布的只是粗略的数据，这些并不完整的描绘也许没有多少可比性。

And that’s if countries are forthcoming about their data.

这还是在假设各国愿意提供数据的情况下。

Officials in the United States say that China, which has reported more than 82,000 infections, has understated its epidemic. Until this week, the Chinese government excluded those patients who tested positive for the virus but had no symptoms.

中国通报的累计确诊病例超过8.2万例，美国官员说，中国淡化了本国的疫情。直到本周前，中国政府一直把病毒检测呈阳性但没有症状的感染者不纳入确诊病例。

China also doesn’t say how many tests it has conducted, and doubts have been raised about whether it has tested extensively in Xinjiang, the province where it holds hundreds of thousands of Muslims in indoctrination camps.

中国也未公开接受检测的人数，而且外界对中国是否在新疆进行了大规模检测表示怀疑，中国在那里把数十万穆斯林关进了拘禁营。

Few countries have done aggressive testing. And of course, the more testing there is, the more cases are found.

很少有国家进行大规模的检测。当然，检测的人数越多，发现的感染病例就越多。

Japan, with relatively few confirmed cases, has conducted only about 500 tests for every million people, raising fears that the virus might be spreading undetected. Similar concerns have been aired in Britain, whose testing rate — more than 2,400 people per million so far — is low by Western European standards, and includes relatively few health workers.

在确诊病例相对较少的日本，每百万人中只做了大约500例检测，让人担心病毒可能在隐性传播。英国也有类似的担忧，它的检测率按西欧的标准来看是很低的，到目前为止，每百万人中有2400余人接受检测，而且其中的卫生工作者相对较少。

In contrast, South Korea has tested more than 8,000 people per million, and Norway about 17,000.

相比之下，韩国每百万人当中有逾8000人做了检测，挪威的这个数字约为1.7万人。

In the United States, state and local authorities collect figures from public and private labs, but they can be like apples and oranges: Some labs report the number of tests conducted, some report how many people were tested, and some report only positive test results.

在美国，州政府和地方当局从公立和私营实验室收集数据，但这些数据可能截然不同：一些实验室报告做了多少例检测，一些则报告有多少人接受了检测，而另一些只报告阳性检测结果。

The Covid Tracking Project, run by The Atlantic, has tried to compile all the numbers in the United States and reports more than 1.2 million tests so far, over 3,600 per million people.

《大西洋月刊》(The Atlantic)的新冠病毒肺炎跟踪计划(Covid Tracking Project)试图汇总美国的所有数据，它统计到的数字是，美国迄今为止进行了逾120万例检测，平均每百万人超过3600例。

‘Widespread Testing’

大规模检测

President Trump has boasted that more people have been tested in the United States than any other country, though on a per-capita basis, many developed countries have done more.

特朗普总统曾吹嘘，美国接受病毒检测的人数超过其他国家，但在人均基础上，许多发达国家的检测数字都超过了美国。

But it matters not only how many people are tested, but also when, and who they are. Once again, countries differ, shaping what the numbers mean.

但重要的不只是多少人做了检测，检测时间和检测对象也很重要。各国在检测时间和对象上也有不同，这让数字的含义也有所不同。

A few countries, like South Korea, Australia and Singapore, got serious about mass testing early on. They used the information to do ambitious contact-tracing — finding and testing those who had recently been near infected people, even if they had no symptoms.

韩国、澳大利亚和新加坡等少数国家很早就开始认真地进行大规模检测。他们利用这些信息严格追踪接触者，也就是找到并检测那些亲密接触者，即使他们没有症状。

That provided a pretty full picture of the outbreak while the numbers were still manageable, and made it possible to slow it down.

在感染人数仍在可控范围内时，这种做法为疫情提供了一个相当全面的描绘，让减缓疫情成为可能。

Though it did not act on the same scale as those countries, Germany did more testing and contact-tracing in the early going than most of Europe.

尽管德国没有采取与韩国和新加坡相同规模的行动，但德国在早期做了比大多数欧洲国家都多的病毒检测和追踪工作。

But most nations with large numbers of cases have done less testing, waited longer to do it in bulk, and made little attempt at contact tracing. They find themselves playing catch-up with the virus, ramping up testing after their outbreaks had already mushroomed.

但大多数存在大量确诊病例的国家进行的检测数量都比较少，都是等了更长时间后才开始进行大规模检测，而且对追踪接触者的工作几乎未做尝试。这些国家发现自己在拼命追赶病毒的传播，在疫情迅速蔓延后才加大了检测力度。

They detect more cases, but by then it’s hard to tell how much of that growth is the expanding epidemic and how much is expanding surveillance. Unable to meet the demand, they often limit testing to the sickest patients and health workers.

这些国家都检测到了更多的病例，但此时已很难判断新增病例中有多少是疫情不断扩大的结果，有多少是扩大疫情监测的结果。由于无法满足检测需求，这些国家通常只能对病情最严重的患者以及卫生工作者做检测。

A prime example is the United States, where about 90 percent of the tests so far were done in just the last two weeks. Doctors, patients and state and local officials report that there still isn’t enough testing available, and ailing people are routinely told that they are not sick enough to warrant a test.

美国是一个典型的例子。它大约90%的检测是在过去两周完成的。医生、病人、州和地方官员都报告说，检测试剂盒仍不够用，患者经常得到的说法是，他们的病情还没有严重到做检测的程度。

‘Fatality Rates’

病亡率

It has been stated time and again: Italy and Spain have high mortality rates among coronavirus patients, Germany’s is low, and China’s is somewhere between.

一个反复提及的说法是：意大利和西班牙的新冠病毒肺炎患者病亡率高，德国的低，中国的居中。

It may not be that simple. Counting the dead is as flawed and inconsistent as counting the infected.

情况也许并不那么简单。统计死亡人数和统计感染人数一样存在缺陷和不一致的地方。

Recent reports say that mortuaries in Wuhan, China, where the disease was first discovered, have ordered thousands more urns than usual, suggesting a much higher death toll than the city’s official count, 2,535.

最近有报道称，武汉的殡仪馆订购的骨灰盒数比该市官方统计的2535例死亡高出好几千，表明死亡人数远高于官方公布的数字。新冠病毒最早就是在这座城市发现的。

The outbreaks in Wuhan, and parts of Italy and Spain, overwhelmed hospitals, forcing many sick people to ride it out at home. No one knows how many people have recovered or died without ever being tested.

武汉以及意大利和西班牙部分地区的疫情使医院不堪重负，许多患者被迫在家中渡过难关。没人知道究竟有多少人在从未做检测的情况下康复或病亡。

Italy and France have reported death tolls that generally included only those who died in hospitals. In Germany, even some of those patients are excluded, because post-mortem testing for the virus is not standard in hospitals.

意大利和法国报告的死亡人数一般只包括那些死在医院的人。德国甚至将部分在医院死亡的患者也排除在外，因为死后进行检测不是医院的标准做法。

And if only the sickest patients are tested, then the number of infections will appear smaller and the percentage who die will seem higher.

如果只对病情最严重的患者做检测的话，感染人数看上去会更低，而死亡的比例看起来将更高。

Germany’s low apparent fatality rate — about 1 percent of those infected — may stem partly from its broader testing of those who are healthy or who have mild to no symptoms, and its narrower testing of the dead.

德国的病亡率（约占感染者的1%）看起来较低，部分原因可能是将健康的或症状轻微或无症状者包括进来的大规模检测，以及对死者做检测的范围相当有限。

‘The Peak’

疫情高峰

Officials often talk about when the epidemic peaks or plateaus — when a country “flattens the curve.” But they rarely specify, the peak of what? And how can we be sure we’re past it?

官员们经常提疫情何时达到高峰或进入平台期，也就是一个国家“压平曲线”的时候。但他们很少具体说明是什么达到了高峰，以及我们怎么能确定高峰已过？

When an outbreak is growing unchecked, more people become infected and more die each day than the day before. Italy went from reporting a few hundred newly detected infections per day in early March to more than 6,500 on March 21.

当疫情不受控制地发展时，每天的感染和死亡人数都比前一天多。3月初，意大利每天报告的新增确诊病例只有几百例，而3月21日一天的新确诊病例就超过6500例。

That acceleration cannot continue indefinitely, and more important, Italy has strengthened social distancing, apparently slowing transmission of the virus. Since March 21, new confirmed infections have varied between about 4,000 and 6,000 daily. Despite the problems with the available figures, and the dangers of drawing conclusions based on just a few days, it seems clear after almost two weeks that Italy has passed a turning point.

这种加速传播不可能无限期地持续下去，更重要的是，意大利已经加强了保持社交距离的做法，这似乎减缓了病毒的传播。自3月21日以来，每天新增确诊病例一直在4000至6000例之间徘徊。尽管现有数据存在种种问题，而且仅凭几天的数据就做结论也有危险，但近两周的数据显示，意大利似乎已经度过了一个转折点。

On a graph, the curve showing the daily count of new cases has gone from rising sharply to moving sideways — the curve has flattened — and even begun to move downward.

曲线图上显示的每天新增病例数从急剧上升变得趋于平缓——曲线已被压平——甚至开始出现下行。

That is one corner being turned: The rate of the spread of the virus has slowed down. It takes longer to turn another: the rate of people dying. But that, too, appears to have leveled off in Italy, fluctuating around 800 a day in the last week.

这是一个转折点：病毒的传播速度已经放缓。度过死亡人数的转折点则需要更长的时间。不过，意大利的死亡人数似乎也在趋于平缓，上周每日的死亡人数徘徊在800左右。

But even when those curves flatten, the epidemic still has not “peaked” by another crucial measure: the number of active cases. That figure continues to rise until the number of patients who either die or recover each day is larger than the number of new infections.

但是，即使这些曲线已趋于平缓，疫情的另一个重要衡量指标——现存确诊病例数——仍未达到“峰值”。在每天的死亡或康复患者人数超过新增感染人数之前，这个数字还将继续上升。

To ease the staggering load on health care systems, the active cases curve must also flatten and then fall.

为缓解卫生系统的沉重负担，现存确诊病例数的曲线也必须先趋平，然后下降。

‘Lockdowns’

活动限制

More than two billion people, including most Americans, are living under something usually called a lockdown. But there is no set definition of that word — or related terms like stay-at-home mandates and social distancing — so the details differ from place to place.

全球有20多亿人，包括大多数美国人正生活在一般被称为“活动限制”的状态下。但这个词没有固定的定义，其他的相关说法，比如政府的“呆在家里”和“保持社交距离”令也没有明确的定义，所以各地的具体做法也不一样。

The lockdowns have varying exceptions for certain lines of work, personal circumstances or exercise. Some allow gatherings of up to ten people, or five, or forbid groups of any size; some exempt funerals, others do not.

各地的封锁措施，对于某些工种、个人情况或锻炼有不同的例外。有些地方允许最多10人或最多5人的聚会，有些地方则禁止所有聚会。有些地方对葬礼有例外，有些地方则没有。

The biggest differences may be in enforcement. Some places, like those in the United States with lockdowns, mostly rely on people to follow the rules without coercion.

最大的不同可能在执行方面。有些地方，比如美国有限制令的地方，主要依靠人们自觉遵守，而非强制。

But Italy and others have deployed soldiers to ensure compliance, and French police have fined hundreds of thousands of people for violating restrictions. China, in addition to using security forces, mobilized an army of volunteers, ratcheting up social pressure to obey.

但意大利等国为确保限制令的落实而动用了军队，法国警方还对数已十万计的违反禁令者处以罚款。中国除了使用安全部队外，还动员了一支志愿者大军来加大服从封锁隔离措施的社会压力。

And on Wednesday, President Rodrigo Duterte of the Philippines threatened to have lockdown violators shot.

周三，菲律宾总统罗德里戈·杜特地(Rodrigo Duterte)威胁要击毙违反封锁隔离措施的人。

Italy’s experience shows the looseness of the term. It has gone through several phases of restrictions, applying them to more people, making them stricter and increasing enforcement.

意大利的经历表明了这个词语解释上的自由。意大利的封锁令经历了几个阶段，适用范围扩大到越来越多的人，封锁及其执行也变得越来越严格。

A few weeks ago, a person could travel around Italy for a valid work or family reason. Now, people are fined for nonessential walking too far from their homes.

几周前，人们还可以因为正当的工作或家庭原因在意大利旅行。现在，人们会因不必要的离家太远的走动而被罚款。

But each stage was widely called by the same name: lockdown.

但禁令的每个阶段用的都是同一个泛泛的名称：活动限制。

作者：Richard Pérez-Peña

翻译：Cindy Hao