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A grim calculus


英文部分选自经济学人 20200404 期 Leaders 版块

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A grim calculus


The Covid-19 presents stark choices between life, death and the economy


The trade-offs required by the pandemic will get even harder


Imagine having two critically ill patients but just one ventilator. That is the choice which could confront hospital staff in New York, Paris and London in the coming weeks, just as it has in Lombardy and Madrid. Triage demands agonising decisions . Medics have to say who will be treated and who must go without: who might live and who will probably die.


注:triage:患者鉴别分类 / 伤病员鉴别分类 / 治疗类选法,即根据紧迫性和救活的可能性等决定哪些人优先治疗的方法。

The pandemic that is raging across the world heaps one such miserable choice upon another. Should medical resources go to covid-19 patients or those suffering from other diseases? Some unemployment and bankruptcy is a price worth paying, but how much? If extreme social distancing fails to stop the disease, how long should it persist?

疫情肆虐全球,这样的痛苦抉择也将接踵而至。医疗资源应该提供给新冠肺炎患者还是其他疾病患者 ? 一些员工失业以及企业破产是值得付出的代价,但要付出多少?如果极端的社交隔离都不能阻止这种疾病,那它还会持续多久 ?

The governor of New York, Andrew Cuomo, has declared that “We’re not going to put a dollar figure on human life.” It was meant as a rallying-cry from a courageous man whose state is overwhelmed. Yet by brushing trade-offs aside, Mr Cuomo was in fact advocating a choice—one that does not begin to reckon with the litany of consequences among his wider community. It sounds hard-hearted but a dollar figure on life, or at least some way of thinking systematically, is precisely what leaders will need if they are to see their way through the harrowing months to come. As in that hospital ward, trade-offs are unavoidable.

纽约州州长安德鲁·科莫 (Andrew Cuomo) 宣称,“我们不会用金钱来衡量人的生命。”这不过是这位勇敢的人发出的口号,而纽约州已然不堪重负。然而置取舍于不顾,科莫先生实际上是在支持另一种选择——这种选择并没有考虑他所处的更大群体会面临的一系列后果。这听起来很无情,但如果领导者们想要熬过接下来痛苦的几个月,他们需要的正是这种以金钱衡量生命的观念,或者至少是一种系统化的思维方式。就像在医院病房里一样,取舍是不可避免的。

Their complexity is growing as more countries are stricken by covid-19. In the week to April 1st the tally of reported cases doubled: it is now nearing 1m. America has logged well over 200,000 cases and has seen 55% more deaths than China. On March 30th President Donald Trump warned of “three weeks like we’ve never seen before”. The strain on America’s health system may not peak for some weeks. The presidential task-force has predicted that the pandemic will cost at least 100,000-240,000 American lives.

随着更多国家遭受新冠肺炎的侵袭,权衡取舍变得越来越复杂。4 月 1 日前的一周内报告病例数翻了一番:现在已经接近 100 万人。美国记录的病例数已经远远超过 20 万,而且死亡人数比中国多 55%。美国总统唐纳德·特朗普 3 月 30 日警告称,“未来三周的情况将是我们前所未见的”。美国医疗系统所面临的负担在几周内可能还不会达到顶峰。总统的工作小组(即白宫冠状病毒应对工作组)预测,这场疫情大流行将至少夺去 10 万至 24 万美国人的生命。

Just now the effort to fight the virus seems all-consuming. India declared a 21-day lockdown starting on March 24th. Having insisted that it was all but immune to a covid-19 outbreak, Russia has ordered a severe lockdown, with the threat of seven years’ prison for gross violations of the quarantine. Some 250m Americans have been told to stay at home. Each country is striking a different trade-off—and not all of them make sense.

目前,这场抗击病毒的斗争似乎是费时费力的。印度宣布从 3 月 24 日起实行为期 21 天的封锁。俄罗斯之前坚称新冠肺炎爆发对其几乎没有任何影响,但如今也下达了严格的封锁令,并威胁要对那些严重违反隔离禁令的人判处 7 年监禁。大约 2.5 亿美国人被告知呆在家里。每个国家都在进行不同的权衡取舍,但不是所有的权衡取舍都是合理的。

In India the Modi government decided that its priority was speed. Perhaps as a result it has fatally bungled the shutdown. It did not think about migrant workers who have streamed out of the cities, spreading the disease among themselves and carrying it back to their villages (see article 2). In addition, the lockdown will be harder to pull off than in rich countries, because the state’s capacity is more limited. India is aiming to slow its epidemic, delaying cases to when new treatments are available and its health-care system is better prepared. But hundreds of millions of Indians have few or no savings to fall back on and the state cannot afford to support them month after month. India has a young population, which may help. But it also has crowded slums where distancing and handwashing are hard. If the lockdown cannot be sustained, the disease will start to spread again.


Russia’s trade-off is different. Clear, trusted communications have helped ensure that people comply with health measures in countries like Singapore and Taiwan. But Vladimir Putin has been preoccupied with extending his rule and using covid-19 in his propaganda campaign against the West. Now that the virus has struck, he is more concerned with minimising political damage and suppressing information than leading his country out of a crisis. That trade-off suits Mr Putin, but not his people.

俄罗斯的取舍则不同。清晰可信的沟通有助于确保新加坡和中国 TW 的民众践行卫生措施。然而,普京总统一直专注于扩大自己的政治影响,并且利用疫情进行对抗西方的政治宣传。现在病毒已经侵入,他更关心如何最大化减少政治损害和封锁信息,而不是带领国家走出危机。这种权衡方式适合普京个人,但并不适合他的人民。

America is different, too. Like India, it has shut down its economy, but it is spending heavily to help save businesses from bankruptcy and to support the income of workers who are being laid off in devastating numbers .


For two weeks Mr Trump speculated that the cure might be worse than the “problem itself”. Putting a dollar figure on life shows he was wrong. Shutting the economy will cause huge economic damage. Models suggest that letting covid-19 burn through the population would do less, but lead to perhaps 1m extra deaths. You can make a full accounting, using the age-adjusted official value of each life saved. This suggests that attempting to mitigate the disease is worth $60,000 to each American household. Some see Mr Trump’s formulation itself as mistaken. But that is a comforting delusion. There really is a trade-off, and for America today the cost of a shutdown is far outweighed by the lives saved. However, America is fortunate to be rich. If India’s lockdown fails to stop the spread of the disease its choice will, tragically, point the other way.

两周来,特朗普一直认为这种应对方法可能比“问题本身”更糟糕。把生命用金钱加以衡量就能发现他的错误。诚然,封锁经济将会造成巨大损失——数据模型显示,任由新冠肺炎在人群中爆发带来的经济损失更小,但是可能导致额外的 100 万人死亡。你可以用每个被挽救的生命经年龄调整后的官方价值做一次全面的核算。核算结果是,疫情缓解对每个美国家庭来说意味着 6 万美元的收益。一些人认为特朗普的应对之策有误,这种想法不过是一种安慰人心的错觉。政策的制定的确是一种权衡,而且对今天的美国来说,拯救生命的意义远远超过了停产的代价。然而,幸运的是,美国的财力雄厚。不幸的是,如果印度封锁经济不能够阻止疾病的传播,它的这种选择将指向另一个方向。

注:Age adjustment:In epidemiology and demography, age adjustment, also called age standardization, is a technique used to allow populations to be compared when the age profiles of the populations are quite different.


Wherever you look, covid-19 throws up a miasma of such trade-offs. When Florida and New York take different approaches, that favours innovation and programmes matched to local preferences. But it also risks the mistakes of one state spilling over into others (see Lexington). When China shuts its borders to foreigners almost completely, it stops imported infections but it also hobbles foreign businesses. A huge effort to make and distribute covid-19 vaccines will save lives, but it may affect programmes that protect children against measles and polio.

无论你看向哪个国家,新冠肺炎都营造了一种需要取舍的不良氛围。佛罗里达州和纽约州的应对方案迥然不同,这有利于创新和制定出因地制宜的方案。但它也带来了风险,一个州的错误可能会波及其他州(见莱克星顿)。此处省略 ......,努力研发和分发新冠疫苗将挽救生命,但这可能会影响到儿童麻疹和脊髓灰质炎的免疫项目。

How should you think about these trade-offs? The first principle is to be systematic. The $60,000 benefit to American households, as in all cost-of-life calculations, is not real cash but an accounting measure that helps compare very different things such as lives, jobs and contending moral and social values in a complex society. The bigger the crisis, the more important such measurements are. When one child is stuck down a well the desire to help without limits will prevail—and so it should. But in a war or a pandemic, leaders cannot escape the fact that every course of action will impose vast social and economic costs. To be responsible, you have to stack each against the other.

你应该如何看待这些权衡利弊之说?第一条原则是系统评价。和所有对生命价值几何的计量一样,美国每户家庭 6 万美元的收益,并不是实实在在的钞票,而是一种会计计量。它权衡了一个复杂的社会中的各种因素,比如生活、工作、不同的道德价值和社会价值观。危机越大,这种衡量就越重要。一个孩子困于井里时,人们会不惜一切代价地施救——理应如此。但在一场战争或一场流行病中,领导人无法逃避这样一个事实,即每一项行动都将带来巨大的社会和经济代价。要想负责任,你就得有所取舍。

注 :

stack (something) against (someone or something)

1. Literally, to build and lean a pile of something against something.

Investigators found that someone had stacked large crates against the emergency exit, blocking everyone's egress once the fire broke out.

2. To manipulate some situation or circumstances to make it harder for someone or something to succeed. Typically "the deck," "the cards," or "the odds" is used between "stack" and "against." Often used in passive constructions.

The Olympic committed is facing criminal charges for stacking the odds against athletes from particular countries.

Of course, simply by virtue of his being the boss's son, Jeremy has stacked the cards against the rest of us for an early promotion.

These big corporations stack the deck against any small business that might stand in their way by hiring huge, high-level legal firms to drown them in litigation.

Hard-headed is not hard-hearted


A second principle is to help those on the losing side of sensible trade-offs. Workers sacked in forced shutdowns deserve extra help; children who no longer get meals at schools need to be given food. Likewise, society must help the young after the pandemic has abated. Although the disease threatens them less severely, most of the burden will fall on them, both today and in the future, as countries pay off their extra borrowing.


A third principle is that countries must adapt. The balance of costs and benefits will change as the pandemic unfolds. Lockdowns buy time, an invaluable commodity. When they are lifted, covid-19 will spread again among people who are still susceptible. But societies can prepare in a way that they never did for the first wave, by equipping health systems with more beds, ventilators and staff. They can study new ways to treat the disease and recruit an army of testing and tracing teams to snuff out new clusters. All that lowers the cost of opening up the economy.


注:Snuff out: to snuff out something such as a disagreement means to stop it, usually in a forceful or sudden way.

Perhaps, though, no new treatments will be found and test-and-trace will fail. By the summer, economies will have suffered double-digit drops in quarterly GDP. People will have endured months indoors, hurting both social cohesion and their mental health. Year-long lockdowns would cost America and the euro zone a third or so of GDP. Markets would tumble and investments be delayed. The capacity of the economy would wither as innovation stalled and skills decayed. Eventually, even if many people are dying, the cost of distancing could outweigh the benefits. That is a side to the trade-offs that nobody is yet ready to admit.

但是,也许最终并没有新的治疗方法,测试追踪的方法也会失效。步入夏季之前,全球经济体季度 GDP 将会遭受两位数锐减。那时,人们也已经忍受了长达数月的封闭生活,这不仅会对社会凝聚力造成伤害,也会给人们的心理健康带来打击。一整年的封锁会让美国和欧元区损失三分之一左右的 GDP。股市会暴跌,投资活动也会延迟。随着创新停滞和人们技能的退化,经济产能也会萎缩。最终,即使很多人会生命垂危,隔离的代价仍会大于所带来的成效。而取舍权衡中的这一点,大家都没有准备好去承认。





Rex,男,口译研究生,立志成为同传 经学钢粉



Neil, 男,外贸民工,经济学人铁粉





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