新冠疫情调查的第六份报告对英国政府在疫情期间保护养老院等机构人员的方式提出了严厉批评。
The sixth report of the Covid inquiry is highly critical of the way the government tried to protect people in care settings in the UK.
疫情开始时，约有50万人居住在养老院，另有100万人在家中接受护理。调查称，保护他们的行动来得太迟，造成了毁灭性的后果。
Around 500,000 people were living in care homes at the start of the pandemic – with another million receiving care in their own homes. The inquiry said action to protect them came too late, causing devastating consequences.
2020年3月至2022年7月期间，养老院记录在案的涉及新冠的死亡病例超过4.3万例。以下是这份287页报告的主要发现。
There were more than 43,000 recorded deaths involving Covid in care homes between March 2020 and July 2022. Here are the key findings of the 287-page report.
疫情开始时，时任英格兰卫生大臣马特·汉考克称，英国政府在养老院周围设立了“保护圈”。但调查称事实并非如此，列举了一系列失职。调查表示，养老护理领域似乎“被放在了次要位置”。
At the start of the pandemic, the then-health secretary in England, Matt Hancock, said the UK government had placed "a protective ring" around care homes. But the inquiry says this was not the case, listing a catalogue of failings. It says the care sector appeared to be "something of an afterthought".
个人防护装备（PPE）短缺，导致工作人员不得不采取临时权宜之计，包括使用垃圾袋、音乐节防水雨衣和油漆工工作服。
A lack of personal protective equipment (PPE) meant staff had to resort to makeshift workarounds, including bin bags, festival waterproof ponchos and painters' overalls.
报告还批评了将可能感染新冠的医院患者转移到养老院以腾出床位的做法。鉴于需要为新冠患者腾出床位，这一决定可以理解。
The report is also critical of the way hospital patients who may be infected with Covid were moved to care homes to make space for others. The decision was understandable given the need to free up beds for Covid patients.
但由于缺乏足够的检测，将这些人与他人隔离开来至关重要，以防他们被感染。
But, without sufficient testing, it was important to keep these people separate and isolate them from others in case they were infected.
2020年3月，英格兰、威尔士和北爱尔兰的官方指南并未要求这样做。报告称，这是一个重大疏忽。
Official guidance in March 2020 in England, Wales and Northern Ireland did not request this. That, the report says, was a significant oversight.
疫情开始时，社会护理领域的高空缺率和人员流动率意味着劳动力“脆弱且缺乏韧性”。调查称，这削弱了该领域应对疫情的能力。
When the pandemic started, high levels of staff vacancies and turnover in the social care sector meant that the workforce was "fragile and lacking resilience". This undermined the ability of the sector to respond to the pandemic, the inquiry says.
例如，养老院往往严重依赖在多家不同养老院工作的机构人员。但为了降低感染传播风险，不希望员工进入多家养老院的做法，导致人员短缺问题更加严重。
For example, care homes tend to rely heavily on agency staff who work in a variety of different homes. But a desire not to have staff going into multiple homes, to reduce the risk of infection transmission, meant staff shortages got even worse.
在财务方面，护理服务提供方同样举步维艰，因为使用服务的人数减少了。
Financially, care providers struggled too, as the number of people using services dropped.
对于一个依赖零工合同的行业而言，缺乏财政支持来帮助护理人员在担心可能被感染时留在家中不上班。
And for a sector that uses zero-hours contracts, there was a lack of financial support to help care staff stay off work if there was concern they might be infected.
由于体系的碎片化性质，应对工作也受到了影响，成千上万家不同的提供方和服务由地方议会监管。这意味着该行业比国民医疗服务体系（NHS）更远离政府。调查指出，疫情暴露并加剧了这些现有的弱点。
The response also suffered because of the fragmented nature of the system, with thousands of different providers and services overseen by councils. It meant the sector was more distant from government than the NHS. The pandemic, the inquiry said, exposed and exacerbated these existing weaknesses.
报告明确指出，作为感染控制一部分而采取的限制探视预防措施走得太远了。
The report is clear that precautionary steps taken to restrict visiting, as part of infection control, went too far.
报告承认，在疫情初期几乎别无选择，只能实施探视禁令，并称这在当时是合理的。但随着疫情发展，限制措施的利弊平衡也发生了变化。
It acknowledges there was little choice to introduce bans on visitors at the start of the pandemic, saying that was rational. But as the pandemic progressed, so did the balance between the benefits and harms of restrictions.
探视极其重要，它让亲人能够协助居民做从个人护理到维护心理健康的一切事情。
Visits are extremely important, allowing loved ones to help residents with everything from personal care to maintaining their mental health.
英国四个构成国随后开始放宽指导建议，但许多养老院未能落实执行，探视仍然受到严格限制。调查指出，这导致居民的健康和福祉显著下降。
The four UK nations then started to relax their guidance, but many care homes failed to implement this and visiting remained heavily restricted. This, says the inquiry, resulted in a significant decline in the health and wellbeing of residents.
心肺复苏术（CPR），包括胸外按压，如果一个人的心脏停止跳动，可以挽救生命。
CPR (Cardiopulmonary Resuscitation), including chest compressions, can be life-saving if a person's heart has stopped beating.
但医生有时会选择不对某人实施复苏——个人也可以提前自行选择不复苏——例如，如果个人极度虚弱或患有限制寿命的疾病。
But doctors can sometimes opt not to resuscitate people - as can individuals themselves in advance - for example, if the individual is extremely frail or has a life-limiting illness.
这应当以个体为基础进行决定，使用统一的“不予复苏”指令（DNACPR）被视为非法。
This should be done on an individual basis and the use of blanket do not resuscitate orders (DNACPR) is considered unlawful.
调查称，听到了全科医生对养老院居民强制实施统一DNACPR指令的证据。
The inquiry says it heard evidence of GPs imposing blanket DNACPRs on care home residents.
并指出记录显示，此类指令的数量急剧增加——在疫情前九个月，指令数量从16,800份跃升至26,500份。
And it pointed to records showing a sharp increase in orders being put in place – they jumped from 16,800 to 26,500 in the first nine months of the pandemic.
这一担忧与早前护理质量委员会（Care Quality Commission）的一项调查结果相呼应，该调查发现存在不可接受且不恰当的“不予心肺复苏”指令被实施的证据。
This concern mirrors an earlier Care Quality Commission investigation which found evidence of unacceptable and inappropriate DNACPRs being put in place.
调查指出，对养老院工作人员的影响巨大，严重损害了他们的心理健康和福祉。
The impact on staff working in care homes was huge, affecting their mental health and wellbeing, the inquiry said.
一些工作人员搬进了他们工作的养老院，试图保护住户免受感染。威尔士一位养老院老板描述说，疫情初期有39名员工搬进养老院居住了两周。
Some moved into the care homes where they worked, in an attempt to protect residents from infection. One care home owner in Wales described how 39 staff moved in for a fortnight at the start of the pandemic.
目睹如此多住户离世，给工作人员带来了巨大的压力，他们往往不得不同时为多人提供临终关怀。例如，一家养老院在三周内失去了半数住户。工作人员向调查组讲述了他们遭受的深重痛苦。
Seeing so many residents die placed an enormous strain on workers, who often had to provide end-of-life care to multiple people at the same time. One care home, for example, lost half of its residents over the course of three weeks. Staff told the inquiry of the deep distress they suffered.
“员工们坐在视频通话中陪伴家属，向亲人告别。那太可怕了……员工们和住户一起哭泣，因为对他们来说实在太令人心碎了，”一名工作人员说。
"Staff were sitting on video calls with families, saying their last goodbye to loved ones. That was horrendous… staff were crying with the residents, because it was just so emotional for them," one said.