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Also, most of the reports collected at the time of the pandemic referred to deaths taking place during the major wave of Autumn-Winter.
此外，疫情期间收集的死亡报告大多发生在秋冬季最严重的那波疫情期间。
Influenza mortality before and after that wave may have been ignored or reported under other causes of death, such as pneumonia.
而疫情爆发前后的死亡率可能会被忽略，或者被报告称肺炎等其他原因的死亡。
All in all, considering all these instances of under-reporting, Johnson and Mueller placed their estimate in a range from 50 up to 100 million dead.
总而言之，考虑到所有这些漏报事件，约翰逊和穆勒估计的死亡人数在5000万至1亿之间。
Let's stop for a second to consider that. 100 million dead.
咱们停下来思考一下。1亿人是什么概念。
The entire population of the US at that time was just 108 million.
当时美国的总人口只有1.08亿。
The whole of Latin America only had 57 million inhabitants.
整个拉丁美洲只有5700万居民。
Sometimes numbers may not be enough to represent the sheer scale of a tragedy, so think about it this way:
有时候数字可能无法让你感受到一场悲剧的规模，你可以这样想：
in a matter of few months, one USA or two Latin Americas had been completely wiped out by a microscopic being which had likely originated in the bowels of a duck.
在几个月的时间里，一个美国或者说两个拉丁美洲被一种很可能起源于鸭子内脏的微生物完全消灭了。
In all honesty, the more we researched the death toll, the more we found conflicting accounts, ranging from the top count of 100 million, down to the no less tragic 18 million.
坦白说，我们对死亡人数研究得越多，就会发现更多矛盾的说法，从最高的1亿人，到同样令人悲痛的1800万人。
We will likely never know how many people did not get to see their next year because of the Great killer of 1918 and 1919.
我们可能永远都不会知道究竟有多少人因为1918年和1919年的“大杀手”而没能看到自己的下一年。
In our grim research we also came across an even bleaker notion: how many victims didn't even get to see their first day of life.
在我们的研究中，我们还发现了更令人沮丧的一点：有多少受害者甚至没能看到自己出生的第一天。
In other words: the impact of the Great Influenza on unborn children.
换句话说：就是疫情对未出生的婴儿的影响。
Dr Bloom-Feshbach of Mount Sinai School of Medicine, New York, and her team have examined the relationship between influenza and birth rates during the Great pandemic in the US, Denmark, Sweden, and Norway.
纽约西奈山医学院的布卢姆-费什巴赫博士和她的团队研究了疫情期间，在美国、丹麦、瑞典和挪威，疫情和出生率之间的关系。
The analysis showed a decline in birth rates for all examined populations in spring of 1919.
分析显示，1919年春季，所有接受调查的人口出生率都有所下降。
This decline represented a 15% drop below baseline levels recorded before the pandemic.
这一下降比疫情前记录的基线水平下降了15%。
This 'natality depression' reached its maximum levels about 6 months after the pandemic peak of the previous autumn.
这种“生育抑郁症”在去年秋季疫情高峰后大约6个月达到了最高水平。
This suggested that the decline in birth could be attributed to a surge in first trimester miscarriages, which affected about 10% of all women who were pregnant at the peak of the pandemic.
这表明出生率的下降可能归因于早期流产的激增，在疫情高峰期怀孕的所有妇女中有约10%的人受到了影响。
The conclusion of Bloom-Feshbach and team is that the virus was directly responsible for the miscarriages.
布鲁姆-费什巴赫和他的团队得出的结论是：病毒是导致流产的直接原因。
And the 10% incidence rate may have been an underestimation.
10%的发病率可能被低估了。
As they point out, a 1919 report of 1350 pregnant women with influenza, showed how more than a quarter of them had miscarried.
他们指出，1919年的一份报告显示，1350名患流感的孕妇中有超过四分之一的人流产。
The concept of so many babies not even being born is hard to accept.
这么多的婴儿甚至没有出生，让人难以接受。
But the same study revealed another finding, which shows that regardless of the disaster, our species is always capable of bouncing back up.
但同一项研究还揭示了另一项发现：无论发生什么灾难，人类总能恢复过来。
The dip in birth rates in spring of 1919 was followed by 'a compensatory natality increase in late autumn 1919 and early spring 1920, when natality significantly exceeded the expected rates.'
在1919年春季出生率下降之后，“1919年深秋和1920年初春的出生率出现了补偿性上升，当时的出生率明显超过了预期。”
The resurgence of births confirmed that fertility was not permanently impacted.
出生率的回升证实了一点：生育率并没有受到永久性影响。
Humanity could slowly rebuild itself, lick the wounds inflicted by the double tragedy of the Great War and the Great Pandemic, and slowly return to normal.
人类可以慢慢重建自己，舔一舔一战和疫情这两个双重悲剧造成的伤口，然后慢慢恢复正常。
Return to a daily life, and a historical period that was going to be devoid of war, famine and disease, at least according to some leaders … a period which turned out to be only a 20-year truce.
回归正常生活，那是一个没有战争、饥荒和疾病的历史时期，至少有一些领导人这么说过：……那段时期只是一个20年的休战期。
But that's another story. Could It Happen Today?
不过那就是另外一个故事了。今天会发生吗?
Back in 2004, a team at the Harvard School of Public Health had modelled the transmissibility patterns of the 1918 virus, more precisely they calculated its reproductive number, 'R', in relation to its serial interval, 'v'.
早在2004年，哈佛大学公共卫生学院的一个团队就建立了1918年病毒传播模式的模型，他们更精确地计算了病毒的繁殖数量R与序列间隔v之间的关系。
The 'R' number tells how many secondary patients are produced by each primary patient.
“R”表示每个原发患者产生的继发患者的数量。
The 'v' value is the average time – expressed in days - between a primary and secondary case.
“v”是主要病例和次要病例之间的平均时间(按天算)。
The team evaluated that the 1918 virus had an 'R0' value of 2 to 4.
研究小组评价说，1918年流感病毒的“R0”值为2~4。
In lay terms: an infected patient could infect four more patients in less than a day.
说白了就是，一个被感染的病人可以在不到一天的时间里感染4个病人。
This may sound like a high rate of contagion, however the researchers pointed out that this was not that high, in relation to other influenza subtypes.
听起来像是传染率很高的样子，但研究人员表示，与其他流感亚型相比，这个数字并不是很高。
In their estimation, a similar pandemic could be prevented by vaccinating or administering antiviral prophylaxis to 50–75% of the population.
据他们估计，通过对50-75%的人口接种疫苗或进行抗病毒预防，可以预防类似的大流行。
Sounds easy, right?
听起来挺简单的，对吧？
Well, this depends on how well prepared a national health system is, when it comes to facing such emergencies.
嗯，这取决于国家卫生系统在面对这类紧急情况时准备得有多充分。
Stockpiles of vaccines and antivirals may or may not be enough – or these drugs may not be available at all, still progressing through the early stages of a clinical trial.
疫苗和抗病毒药物的储备可能够，也可能不够，或者可能这些药物仍处于临床试验的早期阶段，根本无法获得。
There is the added problem that flu viruses may be transmitted before the onset of defining signs and symptoms.
还有一个问题，流感病毒可能在明确的症状和体征出现之前就已经在传播了。
In other words: people infect each other even before they appear to be sick.
换句话说，人们甚至在生病之前就已经感染了对方。
So, what is left to do?
那么，我们还能做什么呢？
I will quote directly from the clinical paper: "This implies that measures that generally reduce contacts between persons, regardless of infection status,
我直接引用临床论文里的话：“这意味着，在国家生产出足够的疫苗和抗病毒药物之前，无论感染状况如何，
may be our most powerful protection against a pandemic until adequate vaccine and antiviral medicines can be produced, at which point mass-vaccination and prophylaxis may be more effective than targeted approaches."
减少人与人之间接触可能是我们对抗疫情最有力的保护措施，届时大规模的疫苗接种和预防可能比有针对性的治疗方法更为有效。”
