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| The infections in Dadi Village, a corn farming community tucked between verdant hills in China’s remote southwest, started in early December when a handful of young people returned from jobs in big cities. | 种植玉米的大地村位于中国西南部的青翠山峦之间，12月初这里开始出现新冠感染病例，当时有一些在大城市工作的年轻人回乡。 |
| The nearest hospital was an hour away, and few could afford the $7 bus fare there. The village clinic is not equipped with oxygen tanks or even an oximeter to detect if someone’s blood is dangerously deprived of oxygen. It quickly ran out of its stockpile of five boxes of fever medicine, so officials told sick residents to stay home and drink lots of water. | 最近的医院有一个小时的路程，很少有人能负担得起50元左右的汽车票。村卫生室没有配备氧气罐，甚至没有血氧仪来检测一个人的血液中是否严重缺氧。五盒退烧药库存很快就用完了，因此村干部告诉生病的村民呆在家里多喝水。 |
| For three years, the villagers had avoided the worst of the coronavirus pandemic. But late last year, Covid infections surged across China, forcing the government to abandon its stringent, yet ultimately futile, policy of mass lockdowns. It was only a matter of time before the virus wound its way out of the cities and arrived in poorer rural areas like Dadi, in Guizhou Province, with the barest of medical care. | 三年来，村民们避免了最严重的新冠病毒大流行。但去年年底，新冠感染在中国各地激增，迫使政府放弃其严格但最终徒劳的大规模封锁政策。病毒从城市蔓延开来，到达贵州省大地村这样医疗条件恶劣的贫困农村地区，只是个时间问题。 |
| China is bracing for an onslaught of infections in its fragile countryside as millions of migrant workers crowd onto trains and buses to leave factory towns, construction sites and cities, to return to their rural homes for the Lunar New Year holiday. The travel period, which begins Saturday and lasts 40 days, is expected to overwhelm the rural health care system only weeks after hospitals in wealthy cities like Beijing and Shanghai were buckled by the outbreak. | 随着数以百万计的外来务工者涌上火车和长途汽车离开工业城市、建筑工地和城市，返乡过年，中国正在准备迎接脆弱的农村地区的感染冲击。从上周六开始、持续40天的旅行期预计将使农村医疗保健系统不堪重负，仅数周前，北京和上海等富裕城市的医院因疫情暴发而瘫痪。 |
| “What we are most worried about is that after three years, everyone … can finally go home for the new year to visit relatives,” Jiao Yahui, an official with China’s National Health Commission, told state media. With the populous countryside’s limited medical resources, she said, “how to deal with the peak of infection in vast rural areas has become a huge challenge.” | “我们最担心的是，三年后，大家……终于可以回家过年探亲了，”中国国家卫生健康委员会官员焦亚辉告诉官方媒体。她说，农村人口庞大，但人均医疗资源有限，“如何应对广大农村地区的感染高峰，成为巨大的挑战。” |
| In Dadi, the local clinic is little more than a converted cottage with four rooms and a closet. At best, it can offer intravenous drips, but for no more than five or six people at a time. No one from the county government told the village to prepare for an outbreak, Gao Hong, a village official, said by phone. | 在大地村，本地卫生所是一座经过改建的平房，有四个房间和一个储藏室。它至多可以打吊瓶，但一次不超过五六个人。村干部高宏在电话中说，县政府没有人通知村里要为疫情暴发做好准备。 |
| Because cases in Dadi have so far been mild, Mr. Gao said, villagers were most in need of fever-reducing and cough medicines, but even those have been hard to come by. “We are too remote to get any medicine purchased online delivered,” he said. | 高宏表示，由于大地村的病例到目前为止都是轻症，村民们最需要的是退烧药和止咳药，但即使是这些药也很难买到。“像我们这么偏根本寄不过来，网上也买不到，”他说。 |
| Despite the lack of reliable government data, there are signs that Covid is already being transmitted freely in the countryside, particularly in places with large numbers of returning migrants like central Henan Province. | 尽管缺乏可靠的政府数据，但有迹象表明，新冠病毒已经在农村肆意传播，尤其是在像中部省份河南这样有大量返乡农民工的地方。 |
| Long lines of people have been forming outside village clinics there, according to state media. Such clinics and local community health centers are meant to serve as the first line of defense in a triage system and preventing overcrowding at county hospitals, which are often the closest places rural residents can be treated for serious medical conditions. | 据官方媒体报道，河南的村卫生所外已经排起了长队。这些诊所和地方社区卫生中心旨在作为分流系统的第一道防线，防止县医院过度拥挤，而县医院往往是农村居民患重病时距离最近的去处。 |
| One such county hospital in Henan was so inundated with patients from the surrounding countryside that it had to ration fever-reducing medicine to patients registering a body temperature of 101.3 degrees or higher. Officials at another county hospital in central Anhui Province said they had received so many patients that the facility would soon run out of critical care beds and ventilators. | 河南一家县级医院挤满了来自周边农村的患者，以至于它不得不向体温达到或超过38.5摄氏度的患者定量配给退烧药。另一家位于中部省份安徽的县医院的负责人说，他们收治的病人太多，重症监护病床和呼吸机很快就要不够用了。 |
| China’s countryside is less densely populated than its cities, which could mean the virus will spread less quickly. But Omicron variants have proven so infectious that population density may not make a difference, especially as friends and families gather to celebrate the Lunar New Year. Rural areas are also home to a disproportionate number of older adults, because so many younger people have left for the cities to seek better job opportunities. | 中国农村人口密度低于城市，这可能意味着病毒传播速度较慢。但事实证明，奥密克戎变种的传染性如此之强，以至于人口密度可能不会产生什么影响，尤其是在朋友和家人聚在一起庆祝春节的时候。由于许多年轻人前往城市寻找更好的工作机会，农村地区也居住着大量老年人口。 |
| The rate of vaccination in the rural areas is unclear. Nationwide, older adults have lower booster rates in general. The government tried in 2021 to ramp up inoculations but encountered resistance among residents skeptical of the safety of the vaccines, state media reported. | 农村地区的疫苗接种率尚不清楚。在全国范围内，老年人的免疫接种率普遍较低。据官方媒体报道，政府曾在2021年尝试加大疫苗接种力度，但遭到居民的抵制，他们对疫苗的安全性持怀疑态度。 |
| “When people move around, we are very likely going to see a surge of cases in the countryside, but the health care system does not have the capacity to withstand the rapid increase of demand,” said Yanzhong Huang, a senior fellow for global health at the Council on Foreign Relations. | “当人们四处流动时，我们很可能会看到农村病例激增，但医疗保健系统没有能力承受快速增长的需求，”对外关系委员会全球卫生高级研究员黄严忠说。 |
| Other countries such as India have already experienced the devastating consequences of a runaway outbreak in rural areas with underdeveloped health care. What later became known as the Delta variant tore through the Indian countryside in early 2021, leaving bodies floating in the Ganges and villagers clamoring for what little supplies of oxygen were available. | 在印度等国，卫生保健不发达的农村地区已经经历了失控疫情的破坏性后果。2021年初，后来被称为德尔塔的变种席卷了印度乡村，恒河中漂浮着尸体，村民们强烈要求获得氧气瓶，但供应难以满足需求。 |
| In China, few things highlight the inequities between urban and rural life as starkly as medical care. Despite ongoing health reforms, access to everything from ventilators to fever medicine remains scant for the 500 million people who live in the countryside. Staffing in rural health facilities is also woefully low. There are 1.3 million physicians and 1.8 million nurses in rural China — roughly less than half as many per 1,000 people as there are in the cities, government statistics show. | 在中国，城乡生活水平的差距在医疗上可能体现得最为突出。尽管医疗改革正在进行，但生活在农村的5亿人口仍面临从呼吸机到退烧药等各种用品的短缺。农村卫生机构的人员配备也少得可怜。政府数据显示，中国农村有130万名医师和180万名护士——每千人口医护数量还不及城市的一半。 |
| Rural communities are largely served by grassroots health workers who have only minimal medical training — less than 1 percent hold university degrees, and just over half have graduated from vocational high schools. They’re often called upon only when needed. | 在农村社区提供服务的基本都是只受过最低程度医疗培训的基层医务人员，拥有大学学历的人不到1%，毕业于职业高中的人刚过半数。他们通常只在有需要的时候上岗。 |
| “Village doctor is only a side job. The doctors need to farm as well,” said Hunter Ge, a migrant worker describing the level of care in Maxiaoji, his village of about 700 people in Henan that’s been hit with a massive virus outbreak. | “乡村医生只是副业。医生也得务农，”农民工亨特·葛这样描述他所在村庄马小集的医疗水平，这个约有700人口的河南村庄发生了大规模疫情。 |
| Mr. Ge said village doctors couldn’t be relied upon for treating major illnesses but were often the only local source of medicine. | 亨特·葛说，不能指望乡村医生医治严重疾病，但他们往往是当地唯一的药品供应者。 |
| “They are quite nice,” said Mr. Ge, who works at a factory. “You can call a village doctor at midnight, if needed.” | “他们人都很好，”在工厂打工的亨特·葛说。“如果需要，半夜给乡村医生打电话都可以。” |
| Village health workers can provide basic services such as vaccinating babies and treating minor ailments. But experts say it’s unrealistic to expect them to know how to effectively treat Covid. Their lack of training makes them risk-averse, increasing the odds they’ll send people to a hospital and exacerbate overcrowding. | 农村医务人员可以提供基本服务，例如为婴儿接种疫苗，治疗小病小痛。但专家表示，指望他们懂得如何有效治疗新冠是不现实的。由于缺乏培训，他们不敢冒险，导致他们宁愿把病人送到医院，这加剧了医院的负担。 |
| “What you ideally want is for people with less severe conditions to stay away from the higher-tier hospitals,” said Sean Sylvia, an assistant professor of health policy at the University of North Carolina who has studied rural China. “And if you’re relying on village doctors to appropriately triage patients, there’s a big question as to whether they can do that.” | “理想情况下，病情不太严重的患者不应该去级别更高的医院就诊，”北卡罗来纳大学研究中国乡村问题的卫生政策助教肖恩·西尔维亚说。“但如果要靠乡村医生对病人进行适当的分类，他们能否做到这一点都是个大问题。” |
| The government is scrambling to address the looming crisis with social distancing restrictions, vaccination campaigns and pledges to improve the supply of drugs. | 政府忙于通过限制社交距离、开展疫苗接种活动和承诺改善药品供应情况来应对迫在眉睫的危机。 |
| In southwestern Sichuan Province, officials recently ordered villages to restrict gatherings at weddings, banquets and mahjong parlors. And southern Yunnan Province is urging returning migrants to stay away from crowds and older people. | 在西南省份四川，官员最近要求限制婚礼、宴会和麻将馆等场所的人员聚集。南方的云南省则敦促返乡务工人员远离人群和老年群体。 |
| As recently as last month, the National Health Commission called on health workers in the countryside to expedite efforts to fully vaccinate rural residents, particularly older adults. In the southern island of Hainan, teams of Communist Party cadres, doctors and nurses are going door to door to vaccinate villagers. | 就在上个月，国家卫健委才呼吁乡村医务人员加快为农村居民，特别是老年人口全面接种疫苗。在南方的海南岛，一批批党员干部、医生和护士正在挨家挨户为村民打疫苗。 |
| The shortage of cough and fever medicines has been widespread, a result of the explosion of infections and stockpiling by residents. But those drugs only relieve symptoms. Antiviral treatments such as Pfizer’s Paxlovid, which can reduce the risk of hospitalization and death, are far more expensive and scarcer, even in cities where health care services are better, let alone the countryside. | 由于感染激增和居民囤药，止咳和退烧药普遍短缺。但这些药只能缓解症状。辉瑞的奈玛特韦片/利托那韦片(Paxlovid)等抗病毒药物能降低住院和死亡风险，但价格更贵也更加稀缺，在医疗条件更好的城市尚且如此，更不用说农村。 |
| The State Council, China’s cabinet, issued a directive last week calling on local authorities and Communist Party cadres to marshal resources to blunt the outbreak by, among other things, ensuring medical supplies, bolstering critical care and prioritizing older adults. The cabinet called for grassroots health workers to distribute health kits packed with fever and cough medicine, rapid antigen tests and masks to vulnerable groups. | 中国国务院上周发出通知，要求地方当局和党员干部统筹资源，通过保障医疗物资供应、提升重症救治水平以及优先照顾老年群体等措施遏制疫情。国务院要求基层卫生人员为脆弱群体发放健康包，里面有退烧和止咳药、快速抗原检测试剂和口罩。 |
| Public health experts say the last-minute efforts underscore how ill-prepared the country was for the U-turn in Covid strategy. | 公共卫生专家表示，这样的临时抱佛脚凸显出中国对于新冠防疫政策急转弯的准备有多么不足。 |
| “The bottom line is that these measures should have been rolled out prior to the policy pivot,” Mr. Huang of the Council on Foreign Relations said of the State Council’s directive. | “归根结底，这些措施本应在政策转向之前推出，”外交关系协会的黄严忠在谈到国务院的指示时表示。 |
| “Many of the problems we are seeing in rural China are fundamentally problems in China’s health care reform, and you cannot expect to fix them in such a short period of time,” he said. “In short, they won’t be effective in significantly mitigating the harmful effects of the unbridled spread of Covid-19 in the countryside.” | “中国农村存在的许多问题都是中国医疗改革的根本性问题，不能指望在短时间内就得到解决，”他说。“简而言之，这些措施不能有效地显著缓解新冠病毒在农村大肆传播所带来的有害影响。” |
| Mr. Gao, the official in Dadi, said donors and nongovernmental groups recently delivered medicine to his village, offering relief for the community’s 760 residents. He estimates that 300 migrants will return to Dadi in the coming weeks and fuel infections, which currently stand at over 150. Even if the medicine runs out, most will try to ride out the illness at home. | 大地村官员高宏表示，捐赠者和非政府组织最近向他的村庄运送了药品，为村里的760名居民提供救济。他估计，未来几周将有300名农民工返回大地村并加剧感染情况，目前的感染人数已超过150人。即使药用完了，大多数人也会在家中设法扛过去。 |
| “This is not a rich village, it’s quite poor, actually,” Mr. Gao said. “It’s not realistic for villagers to spend 50 yuan to take a bus and buy medicine in the county. Even if they did take a bus, there’s no guarantee they’d get medicine because of the extreme scarcity.” | “这个村本身就不富裕，属于一个贫困村了吧，”高宏说。“来回（一趟）村民（要）花50块钱，为了买点药，买药就算是坐车去都不一定能买到，这个药特别匮乏。” |
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