中国防疫困境：“清零”难持续，开放恐致病例灾难性激增As Officials Ease Restrictions, China Faces New Pandemic RisksBENJAMIN MUELLER, 艾莎2022年12月2日 周二，北京的医护人员，那里每天的新冠感染人数达到了大流行病开始以来的最高值。 KEVIN FRAYER/GETTY IMAGESAs one country after another succumbed to outbreaks this year, China kept the coronavirus at bay, buying valuable time to prepare for the inevitable: a variant of the virus so shifty and contagious that China, too, would struggle to contain it. 今年，随着一个又一个国家相继屈服于疫情，中国仍控制着新冠病毒，赢得了宝贵的时间来应对不可避免的灾难：病毒的变异株变得极为狡猾、传染性极强，以至于中国也将难以控制它。 But rather than laying the groundwork for that scenario, China stepped up its commitment to “zero Covid,” deploying snap lockdowns and contact tracing. 但中国没有为这种情况奠定基础，而是加强了对“清零”的承诺，部署了快速封锁和接触者追踪。 In the meantime, daily vaccinations fell to record lows. Critical-care beds remained in short supply, even as workers built testing booths and isolation facilities. Research on homegrown mRNA vaccines failed to keep up with the fast-mutating virus. 与此同时，每日疫苗接种量降至历史最低水平。尽管工作人员建造了检测室和隔离设施，重症监护床位仍然短缺。国产mRNA疫苗的研究未能跟上快速变异的病毒。 Now, the costs of that approach are piling up, putting China in a bind from which there appears to be no easy escape, scientists said in interviews. 科学家们在接受采访时表示，如今，这种做法的代价正在不断增加，使中国陷入似乎无法轻易摆脱的困境。 Even as new Covid cases have reached all-time highs, residents have taken to the streets to protest lockdowns that have ground daily life to a halt in many cities. Alarmed, officials have begun easing restrictions. 尽管新冠病例达到历史新高，但居民们走上街头，抗议导致许多城市日常生活陷于停顿的封锁。震惊的官员开始放松限制。 Researchers worry that China may struggle to reopen the country and relieve the strain on its economy without risking a tide of deaths. Such a catastrophic surge could pose a significant threat to the political leadership. 研究人员担心，中国可能很难在不出现死亡潮风险的情况下重新开放，缓解经济压力。这种灾难性的激增可能对政治领导人构成重大威胁。。 “We often pretend that China has a choice in terms of ‘zero Covid’ versus opening up,” said Dr. Siddharth Sridhar, a virologist at the University of Hong Kong. “There never was a choice. The simple fact is that China is not ready for a wave on that scale.” “我们经常假装中国可以在‘清零’和开放之间做出选择，”香港大学病毒学家斯达斯·斯达尔博士说：“从来没有过选择。一个简单的事实是，中国还没有准备好迎接这种规模的浪潮。” Nothing has set back China’s preparations as extensively as its difficulty in vaccinating older people. Two-thirds of people ages 80 and older are vaccinated, but only 40 percent have received a booster dose, a critical shortcoming because Chinese-made vaccines offer weaker protection than the Pfizer-BioNTech and Moderna vaccines. 为老年人接种疫苗的困难是中国准备工作中最严重的阻碍。在80岁及以上的人群中，有三分之二的人接种了疫苗，但只有40%的人接种了强化针，这是一个严重的缺陷，因为中国生产的疫苗比辉瑞和莫德纳疫苗提供的保护作用更弱。 In a study during Hong Kong’s Omicron surge, two doses of China’s main domestic vaccine, Sinovac, were only 58 percent effective against severe Covid or death in people ages 80 and older. Two Pfizer-BioNTech doses, by contrast, were 87 percent effective in the same group. An earlier study in Brazil similarly found that two Sinovac doses were only 61 percent effective in preventing Covid deaths. 在香港奥密克戎病毒激增期间的一项研究中，中国主要国产疫苗科兴的两剂疫苗对80岁及以上人群的新冠重症或死亡的有效性只有58%。相比之下，两剂辉瑞疫苗对同一群体的有效性为87%。巴西的一项早期研究也发现，两剂科兴疫苗在预防新冠死亡方面的有效性只有61%。 本周在上海，警察监视抗议者对新冠限制的示威。 THE NEW YORK TIMESThose results have cemented an impression among scientists that the Chinese shots, which rely on killed viruses to prompt an immune response, are effectively a three-dose, rather than a two-dose, vaccine. 这些结果在科学家中巩固了一种印象，即中国的灭活疫苗是三针有效，而不是两针。 Making matters more difficult, China’s last major vaccination push was in the spring, an interval of eight months or more since the last dose for many recipients. 更加困难的是，中国上一次大规模的疫苗接种是在春季，对于许多接种者来说，距离上一次接种间隔了八个月或更长时间。 That could put a dent in their immune defenses. A study in Malaysia found that while the Pfizer-BioNTech vaccine elicited relatively steady protection against intensive-care admissions three to five months later, the effectiveness of the Sinovac vaccine against intensive-care admissions fell to 29 percent from 56 percent over that period. 这会削弱他们的免疫防御系统。马来西亚的一项研究发现，虽然辉瑞疫苗在三到五个月后对重症监护住院产生了相对稳定的保护作用，但科兴疫苗在同一时期对重症监护住院的有效性从56%下降到29%。 The Chinese vaccines stack up relatively well against the world’s other non-mRNA Covid shots, said Dr. Paul Hunter, an infectious disease specialist at the University of East Anglia in England. But reopening the country so long after the last vaccination campaign could be damaging. 英国东安格利亚大学传染病专家保罗·亨特博士说，与世界上其他非mRNA的新冠疫苗相比，中国疫苗的表现相对较好。但是在上次疫苗接种运动结束这么久之后重新开放国家可能是有害的。 “I think that’s more of an issue than the quality” of China’s vaccines, Dr. Hunter said. 亨特说，“我认为这是一个比（中国疫苗的）质量更大的问题”。 The vaccination gaps in China’s older population are all the more glaring because the country has achieved relatively strong coverage overall. Nearly 90 percent of the population has received a primary vaccine series, generally comprising two doses of Sinovac or Sinopharm, another Chinese-made shot. 由于中国已经实现了相对较高的总体覆盖率，中国老年人口的疫苗接种差距更加明显。近90%的人口已经接种了最初的疫苗，通常包括两剂科兴或国药控股的疫苗，后者是另一种中国制造的疫苗。 The disparity results in part from an outdated theory that so long as younger and more active Chinese were immunized, the country could establish a sort of herd immunity and protect older people, said Andy Chen, a Shanghai-based analyst at Trivium, a consulting firm. 咨询公司Trivium驻上海的分析师安迪·陈（音）说，造成这种差异的部分原因是一种过时的理论，即只要更年轻、更活跃的中国人接种疫苗，国家就可以建立一种群体免疫，保护老年人。 Older people in China often avoid health risks, Mr. Chen said, and so the chances of even minor vaccine side effects may have seemed threatening to many. China’s reluctance to provide data on the efficacy and side effects of its vaccines created a vacuum in which those worries flourished, other experts said. Misinformation about side effects spread on Chinese social media. 安迪·陈说，中国的老年人通常会避免健康风险，因此，对许多人来说，即使是轻微的疫苗副作用，也可能是一种威胁。其他专家说，中国不愿提供疫苗功效和副作用的数据，这造成了一个真空，使这些担忧变得更加严重。有关副作用的错误信息在中国社交媒体上大量传播。 And while health officials have encouraged older adults with chronic illnesses to get shots, vaccinators are often reluctant to administer them without access to the medical histories of more vulnerable recipients. 尽管卫生官员鼓励患有慢性疾病的老年人接种疫苗，但疫苗接种人员往往不愿意在没有获得更脆弱接种者病史的情况下接种疫苗。 The “zero Covid” strategy only complicated the vaccination drive. By limiting infections, it saved lives but also eroded many older people’s sense of urgency about the need for a shot. “清零”战略只会使疫苗接种复杂化。限制感染措施挽救了生命，但也削弱了许多老年人对于注射疫苗的紧迫感。 3月，在香港的一个疫苗接种点发放口罩。 DALE DE LA REY/AGENCE FRANCE-PRESSE — GETTY IMAGESAn emphasis on swabbing throats instead of administering shots drew further attention from the vaccination campaign. In the aftermath of a springtime surge, China erected tens of thousands of testing booths in cities like Shanghai and Beijing and built huge facilities to isolate millions. The vaccination rate stagnated. 强调核酸检测而不是注射疫苗的做法进一步分散了人们对疫苗接种的关注。在春季疫情暴发后，中国在上海和北京等城市设立了数以万计的检测点，并建造了巨大的设施来隔离数百万人。疫苗接种率停滞不前。 “There is always a shortage of staff members in the health care system,” said Xi Chen, an associate professor of public health at Yale University. “People told me at the time they were told to focus on mass testing.” “医疗系统的工作人员总是短缺，”耶鲁大学公共卫生副教授陈曦（音）说，“人们当时告诉我，他们被告知要专注于大规模检测。” China said this week that it would renew efforts to vaccinate its oldest citizens, announcing measures to use mobile vaccination stations, bring shots into nursing homes and go door-to-door to reach the most vulnerable, according to a statement from the country’s National Health Commission. 根据中国国家卫生健康委员会的一份声明，中国本周表示，将继续努力为最年长的公民接种疫苗，宣布采取措施，使用流动疫苗接种站，将疫苗送到养老院，走访上门。 But some experts, like Yanzhong Huang, a global health specialist and a senior fellow at the Council on Foreign Relations, expressed skepticism that the move was much more than lip service. 但一些专家，比如全球卫生专家、外交关系委员会高级研究员黄严忠怀疑此举只是口惠而实不至。 “It is about tinkering with the current approach,” he said. “But that approach fundamentally doesn’t make any sense from a public health policy perspective anymore.” “这是对当前方法的修补，”他说。“但从公共卫生政策的角度来看，这种做法从根本上已经没有任何意义了。” The authorities did not provide a detailed plan for the new efforts and stopped short of mandating vaccinations. As powerful as the country’s leadership is, forcing older people to get shots is seen as a potential overreach, experts said, bringing with it the risk of a public backlash. 在与卫生官员举行的新闻发布会上，当局没有提供新举措的详细计划，也没有强制要求接种疫苗。专家们表示，尽管领导层掌握着巨大的权力，但强迫老年人接种疫苗被视为一种潜在的越权行为，可能会引发公众的反感。 “From a local government official’s perspective, if even just one person dies from the adverse effects of vaccines, that’s blood on your hands,” said Mr. Chen, the Trivium analyst. “It’s really hard to recover from that.” “从地方政府官员的角度来看，即使只有一个人死于疫苗的不良影响，那也是你手上的血债，”Trivium的分析师安迪·陈说。“真的很难从中恢复。” If cases keep climbing, gaps in vaccine coverage could pile more pressure on hospitals that may also need to confront a winter cold and flu season. China has fewer intensive care beds per capita than many other Asian countries. 如果病例继续攀升，疫苗覆盖率的差距可能会给医院带来更大的压力，这些医院可能还需要应对冬季感冒和流感季节。中国的人均重症监护床位少于许多其他亚洲国家。 The country once dealt with shortages of doctors and nurses, especially in rural areas, by moving health workers from one province to another when the virus flared up. A nationwide torrent of Omicron infections would make that impossible. 中共曾在疫情暴发时将卫生工作者从一个省份转移到另一个省份，以应对医生和护士短缺的问题，特别是在农村地区。如果奥密克戎病毒在全国范围内泛滥，那样做就不可能了。 A study from Shanghai’s Fudan University in May warned of a “tsunami” of Covid cases and roughly 1.6 million deaths if China abandoned its “zero Covid” policy. China has since acquired more options for antiviral treatments. But its hospital capacity is limited enough that a sudden lifting of “zero Covid” restrictions would still create a health crisis, said Ben Cowling, a professor of epidemiology at the University of Hong Kong. 上海复旦大学今年5月的一项研究警告称，如果中国放弃“清零”政策，将出现一场新冠病例的“海啸”，约160万人死亡。自那以后，中国获得了更多抗病毒治疗的选择。但香港大学流行病学教授本·考林表示，中国的医院能力非常有限，突然取消“清零”限制仍然会造成健康危机。 上个月，在西南部城市重庆，一家方舱医院正在施工。AGENCE FRANCE-PRESSE — GETTY IMAGESGiven the inevitability that cases will surge whenever China reopens, Yang Yang, an associate professor of biostatistics at the University of Florida, said that efforts “to prepare the medical system” were a priority. Already there are some signs that the leadership is shifting focus from building quarantine facilities to fortifying its best hospitals, he added. 佛罗里达大学生物统计学副教授杨洋（音）表示，鉴于中国一旦重新开放，病例将不可避免地激增，“为医疗系统做好准备”是当务之急。他还说，已经有一些迹象表明，领导层正在将重点从建设隔离设施转移到巩固其最好的医院。 China’s floundering retreat from the emergency phase of the pandemic contrasts with the exits made by places like New Zealand and Taiwan. There, lockdowns brought breathing room while the population was being vaccinated; when the measures were lifted, deaths surged, but to levels far lower than in countries like the United States. 中国笨拙地退出大流行紧急阶段，与新西兰和台湾等地的退出形成鲜明对比。后者用封锁争取了喘息之机，让人口有时间接种疫苗；随着防疫措施的解除，死亡上升了，但上升幅度远不像美国这样的国家那么大。 China’s strategy so far has limited Covid deaths, too, scientists said, but without also mapping an exit from restrictions. 科学家表示，中国的策略到目前为止也限制了新冠死亡规模，但没能规划出一个退出封锁措施的途径。 “Restrictions and lockdowns can help buy time to get crucial public health measures in place and save lives, but they are not an exit strategy by themselves,” said Jeremy Farrar, the director of Wellcome, a global health foundation. “限制和封锁只能用来争取时间，以便让关键公共卫生措施就位，拯救生命，但是他们没有自己的退出策略，”全球卫生基金会惠康的总监杰瑞米·法拉说。 China, which has spurned the Pfizer and Moderna vaccines, appears to be leaning on hopes for locally made mRNA alternatives. Government scientists have been running a head-to-head trial of more than a dozen new vaccine candidates, including some mRNA doses, experts said. 至今没有接受辉瑞和莫德纳疫苗的中国似乎把希望寄托在本国生产的mRNA替代品上。专家说，政府的科学家正在同时测试十多种新疫苗，其中包括一些mRNA疫苗。 Public data is sparse, but Indonesia recently authorized China’s mRNA shot, and some vaccine makers appear to be moving closer to seeking authorization from Chinese officials. 公开数据十分稀少，不过印度尼西亚近日批准了中国的mRNA疫苗，其中一些疫苗生产商在获得中国官方批准方面似乎走在前面。 “The formulation of getting an mRNA vaccine correct might have taken a few shots on goal, but early data suggests it’s heading in the right direction,” said James Bellush, a medical science expert at RTW Investments in New York. “在mRNA研制上可能做了一些失败的尝试，但初步数据显示正走在正确的方向，”纽约RTW投资公司医疗科学专家詹姆斯·贝尔拉什说。 China’s top leadership has signaled a recognition that its blanket approach to controlling the virus is taking an increasingly large economic and social toll, calling for measures to adjust what has been a “one-size-fits-all” approach. In recent days, several cities have loosened some of their harshest restrictions following a wave of mass protests. 中国最高领导层释放的信号显示，他们看到为了控制病毒而采取的全面措施正在造成越来越大的经济和社会损耗，并呼吁对“一刀切”的方式做出调整。近日经过一波大规模抗议后，有多座城市放松了最严厉的限制措施。 But there still seemed to be some debate about whether backing down from Covid restrictions was the right approach. In the northeastern city of Jinzhou, in China’s Liaoning province, officials said that they had already begun to loosen some measures but still pushed back on deserting the “zero Covid” strategy. 但是，是否应该放弃新冠防疫限制，似乎还存在争论。在东北省份辽宁的锦州市，官员们表示已经开始放松一些措施，但仍然抵制彻底放弃“清零”政策。 “There’s no need for us to abandon our defenses when we can reach zero, avoiding large-scale infections,” officials said. 他们说，“我们没有必要在可以清零、可以不形成大面积感染的情况下放弃防守。” David Pierson对本文有报道贡献。 Benjamin Mueller是一名健康与科学记者。此前他常驻伦敦，负责报道新冠疫情，他还曾报道纽约警察。欢迎在Twitter上关注他：@benjmueller。 Alexandra Stevenson是时报上海分社社长。欢迎在Twitter和Facebook上关注她。 翻译：纽约时报中文网 点击查看本文英文版。 相关报道中国严苛防疫措施给经济带来沉重代价2022年11月30日 中国多地爆发反封控大规模抗议2022年11月28日 那些第一次上街的中国年轻抗议者2022年11月30日 北京罕见政治抗议凸显焦虑和矛盾2022年11月29日 中国抗议者面临的阻碍与前景2022年12月1日 最受欢迎中国共产党正在失去民心 习近平“加冕”后，抗议浪潮挑战其威权统治 习近平的新难题：如何悼念江泽民？ 习近平打破了中共建立的社会契约 扒下习近平“皇帝的新衣” 全国多地抗议后，中国释放调整“清零”政策信号 中国防疫困境：“清零”难持续，开放恐致病例灾难性激增 中共前最高领导人江泽民去世，享年96岁 中国抗议者面临的阻碍与前景 广州城中村民众抗议封控，接连两日与警方发生冲突 国际 中国 商业与经济 镜头 科技 科学 健康 教育 文化 风尚 旅游 房地产 观点与评论 免费下载 纽约时报中文网 iOS 和 Android App 点击下载iOS App点击下载Android App点击下载Android APK © 2022 The New York Times Company.