演講MP3+雙語文稿:我們?nèi)绾螌瓜乱环N致命病毒？-哈佛遺傳學(xué)教授

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【演講人】PardisSabeti

【演講主題】《我們?nèi)绾螌瓜乱环N致命病毒？》

【中英文字幕】

翻譯者Yi-Fan Yu校正者Tim Lan

00:05

You may never have heard of Kenema, Sierra Leone or Arua, Nigeria. But I know them as two of the most extraordinary places on earth.

你們可能從未聽說過 塞拉利昂的凱內(nèi)馬，或者是尼日利亞的阿魯阿。但我認為它們是 世界上最棒的兩個地方。

00:14

In hospitals there, there's a community of nurses, physicians and scientists that have been quietly battling one of the deadliest threats to humanity for years: Lassa virus. Lassa virus is a lot like Ebola. It can cause a severe fever and can often be fatal. But these individuals, they risk their lives every day to protect the individuals in their communities, and by doing so, protect us all.

在那里的醫(yī)院，有一個由護士、 外科醫(yī)生和科學(xué)家組成的社區(qū)，多年來一直在默默對抗人類最致命的威脅之一——拉薩病毒。拉薩病毒十分像埃博拉病毒。它可以導(dǎo)致嚴重的發(fā)熱癥狀， 而且往往是致命的。但是這些人每天都冒著生命危險來保護社區(qū)中的每個成員，與此同時，也保護著我們所有人。

00:41

But one of the most extraordinary things I learned about them on one of my first visits out there many years ago was that they start each morning -- these challenging, extraordinary days on the front lines -- by singing. They gather together, and they show their joy. They show their spirit. And over the years, from year after year as I've visited them and they've visited me, I get to gather with them and I sing and we write and we love it, because it reminds us that we're not just there to pursue science together; we're bonded through a shared humanity.

我從他們身上學(xué)到的最棒的一點，就是在很多年前 我第一次去拜訪的時候，那些充滿挑戰(zhàn)、在前線奮斗的日子里，他們每天早上都是這樣開始的——唱歌。他們聚集在一起， 盡情展現(xiàn)他們的愉悅。他們展現(xiàn)著一種精神。許多年過去了，當(dāng)我們年復(fù)一年彼此相互拜訪的時候，我都可以跟他們聚在一起唱歌，而且我們會把這些記錄下來， 我們很愛這樣做，因為它了提醒我們， 我們不只是要一起探尋科學(xué)真理，還有一條人性的紐帶將我們緊密相連。

01:13

And that of course, as you can imagine, becomes extremely important, even essential, as things begin to change. And that changed a great deal in March of 2014, when the Ebola outbreak was declared in Guinea. This is the first outbreak in West Africa, near the border of Sierra Leone and Liberia. And it was frightening, frightening for us all. We had actually suspected for some time that Lassa and Ebola were more widespread than thought, and we thought it could one day come to Kenema.

而且你們可以想象，當(dāng)周遭發(fā)生變化時，這種聯(lián)系就變得極其重要， 甚至是不可或缺的。2014年的3月，巨變發(fā)生了。埃博拉疫情在幾內(nèi)亞爆發(fā)。這是在西非地區(qū)的第一次疫情爆發(fā)，發(fā)生在塞拉利昂和利比亞的交界處。情況非?？膳?，我們每個人都震驚了。事實上，我們甚至一度懷疑拉薩和埃博拉疫情的散布范圍 比我們想象中更廣，而且我們擔(dān)心某天它會傳播到凱內(nèi)馬。

01:44

And so members of my team immediately went out and joined Dr. Humarr Khan and his team there, and we set up diagnostics to be able to have sensitive molecular tests to pick up Ebola if it came across the border and into Sierra Leone. We'd already set up this kind of capacity for Lassa virus, we knew how to do it, the team is outstanding. We just had to give them the tools and place to survey for Ebola.

于是我的團隊成員立即出發(fā)，趕到那里并加入了 胡馬爾·汗醫(yī)生和他的團隊，我們搭建好了診斷設(shè)備， 來做一些敏感的分子測試，當(dāng)埃博拉病毒跨越塞拉利昂邊境時，我們就可以探測得到。我們早已為拉薩病毒 設(shè)置了這種規(guī)模的設(shè)備，我們知道如何去應(yīng)對，這個團隊極其出色。我們只需要給他們設(shè)備和場地， 讓他們?nèi)パ芯堪２├?/p>

02:05

And unfortunately, that day came. On May 23, 2014, a woman checked into the maternity ward at the hospital, and the team ran those important molecular tests and they identified the first confirmed case of Ebola in Sierra Leone. This was an exceptional work that was done. They were able to diagnose the case immediately, to safely treat the patient and to begin to do contact tracing to follow what was going on. It could've stopped something. But by the time that day came, the outbreak had already been breeding for months. With hundreds of cases, it had already eclipsed all previous outbreaks. And it came into Sierra Leone not as that singular case, but as a tidal wave.

很不幸的是，那一天來臨了。2014年5月23日，一位女子 住進了醫(yī)院里的產(chǎn)房，我們團隊就進行了那些重要的分子測試，并確診了塞拉利昂的 第一例埃博拉病例。這其實是非常了不起的。他們可以在第一時間診斷出病情，安全地診治病人，并且開始追蹤接觸者， 跟進病情的擴散情況。它本可以阻止些什么的。但是當(dāng)那天來臨的時候，疫情的爆發(fā)已經(jīng)醞釀了好幾個月了。發(fā)現(xiàn)了成百個病例之后， 它讓所有之前的疫情爆發(fā)都相形見絀。而且病毒不是由那個單一病例 攻進塞拉利昂的，這是一個巨大的沖擊波。

02:46

We had to work with the international community, with the Ministry of Health, with Kenema, to begin to deal with the cases, as the next week brought 31, then 92, then 147 cases -- all coming to Kenema, one of the only places in Sierra Leone that could deal with this.

我們得跟國際社會緊密合作， 跟衛(wèi)生部，跟凱內(nèi)馬當(dāng)?shù)兀?共同應(yīng)對這些病例。 接下來的一周來了31個病人， 然后是92個，后來漲到147個——全部都涌到凱內(nèi)馬來， 因為這是塞拉利昂 能夠應(yīng)對疫情的少數(shù)幾個地方之一。

03:01

And we worked around the clock trying to do everything we could, trying to help the individuals, trying to get attention, but we also did one other simple thing. From that specimen that we take from a patient's blood to detect Ebola, we can discard it, obviously. The other thing we can do is, actually, put in a chemical and deactivate it, so just place it into a box and ship it across the ocean, and that's what we did. We sent it to Boston, where my team works. And we also worked around the clock doing shift work, day after day, and we quickly generated 99 genomes of the Ebola virus. This is the blueprint -- the genome of a virus is the blueprint. We all have one. It says everything that makes up us, and it tells us so much information.

我們?nèi)找篃o休，拼盡全力地工作，希望去幫助每一個患者， 希望獲得大家的關(guān)注，但我們同時也做了另外一件簡單的事。為了探測埃博拉病毒， 我們從病人血液中提取了樣品，我們當(dāng)然可以直接丟掉它們。但是事實上，我們能做的另一件事， 是在樣品中加化學(xué)藥品使其失活，然后把它封存在盒子里， 把它運過大洋。而這正是我們所做的。我們把樣品發(fā)到了波士頓， 我的團隊工作的地方，我們同樣日夜無休，每天都在輪班工作，于是我們很快地整理出了 埃博拉病毒的99個基因組。這就是一份藍圖——病毒的基因組就是一份藍圖。我們?nèi)祟惿砩弦灿小Ｋ斒隽藰?gòu)成我們身體的一切，告訴我們非常多的信息。

03:42

The results of this kind of work are simple and they're powerful. We could actually take these 99 different viruses, look at them and compare them, and we could see, actually, compared to three genomes that had been previously published from Guinea, we could show that the outbreak emerged in Guinea months before, once into the human population, and from there had been transmitting from human to human. Now, that's incredibly important when you're trying to figure out how to intervene, but the important thing is contact tracing. We also could see that as the virus was moving between humans, it was mutating. And each of those mutations are so important, because the diagnostics, the vaccines, the therapies that we're using, are all based on that genome sequence, fundamentally -- that's what drives it. And so global health experts would need to respond, would have to develop, to recalibrate everything that they were doing.

這些工作的結(jié)果很簡單，但也很強大。我們可以拿這99個不同的病毒變異，觀察并且比較它們，我們可以清晰地看到，相比于幾內(nèi)亞方面發(fā)布的三個基因組，我們可以發(fā)現(xiàn)，病情在幾個月前 就已經(jīng)開始在幾內(nèi)亞傳播，一旦闖進了人群中，就會通過人與人之間的接觸快速傳遞。這個信息其實至關(guān)重要，尤其當(dāng)你在研究如何阻礙 病毒傳播的時刻。但是最重要的事情是接觸者追蹤。我們也可以看到 病毒在人與人之間傳播的時候，它也在不斷變異。每一種變異都無比重要，因為所有的診斷、疫苗，還有我們用的治療方式，基本全都是基于那種特定的基因組序列，這才是導(dǎo)致疫情傳播的根源。于是全球的健康專家要快速應(yīng)對，要改進研究方法，要把自己所做的一切都進行調(diào)整。

04:33

But the way that science works, the position I was in at that point is, I had the data, and I could have worked in a silo for many, many months, analyzed the data carefully, slowly, submitted the paper for publication, gone through a few back-and-forths, and then finally when the paper came out, might release that data. That's the way the status quo works.

但是就當(dāng)時我所處的位置來看， 科學(xué)研究的方法是我拿到了數(shù)據(jù)，我可能要關(guān)在實驗室里研究好幾個月，細致謹慎地分析那些數(shù)據(jù)，寫好論文投出去，再進行反復(fù)修改，最后論文公之于眾，那些數(shù)據(jù)才能公開。這就是當(dāng)時科學(xué)研究的現(xiàn)狀。

04:51

Well, that was not going to work at this point, right? We had friends on the front lines and to us it was just obvious that what we needed is help, lots of help. So the first thing we did is, as soon as the sequences came off the machines, we published it to the web. We just released it to the whole world and said, "Help us." And help came.

好吧，在那個特定時候這種方法 肯定不管用，對吧？我們有些朋友在抗病前線工作，顯然對于我們來說 最需要的就是外界幫助，很多的幫助。所以我們所做的第一件事，基因測序結(jié)果從機器上一出來，我們就立即在網(wǎng)上發(fā)布了這些數(shù)據(jù)。我們向全世界公開， 然后說：“幫幫我們！”于是幫助接踵而至。

05:09

Before we knew it, we were being contacted from people all over, surprised to see the data out there and released. Some of the greatest viral trackers in the world were suddenly part of our community. We were working together in this virtual way, sharing, regular calls, communications, trying to follow the virus minute by minute, to see ways that we could stop it.

我們還沒反應(yīng)過來，全世界就有一大群人主動跟我們聯(lián)系，他們驚喜地看到這些數(shù)據(jù)在網(wǎng)上公開了。世界上一些最出色的病毒追蹤者突然就變成了我們團隊的一員了！我們用這種虛擬的方式共同合作，我們共享信息，經(jīng)常互通電話， 一直保持聯(lián)系，希望能夠分秒跟蹤病毒的擴散情況，然后找到遏制它的辦法。

05:31

And there are so many ways that we can form communities like that. Everybody, particularly when the outbreak started to expand globally, was reaching out to learn, to participate, to engage. Everybody wants to play a part. The amount of human capacity out there is just amazing, and the Internet connects us all. And could you imagine that instead of being frightened of each other, that we all just said, "Let's do this. Let's work together, and let's make this happen."

其實我們?nèi)粢M建這樣的團體 有很多種方式。每個人，尤其是當(dāng)疫情 在世界范圍爆發(fā)時，都在不斷獲取信息， 都在參與、投入進來。每個人都想做一些貢獻。世界上所有人的力量真的是太神奇了，而因特網(wǎng)將我們聯(lián)系在一起。你們可以想象嗎？ 我們不再害怕與他人交流，我們所有人都說，“開工吧。讓我們齊心協(xié)力，我們一定做得到！”

05:57

But the problem is that the data that all of us are using, Googling on the web, is just too limited to do what we need to do. And so many opportunities get missed when that happens. So in the early part of the epidemic from Kenema, we'd had 106 clinical records from patients, and we once again made that publicly available to the world. And in our own lab, we could show that you could take those 106 records, we could train computers to predict the prognosis for Ebola patients to near 100 percent accuracy. And we made an app that could release that, to make that available to health-care workers in the field.

但是問題就是， 我們所有人所用到的數(shù)據(jù)，在谷歌上搜到的數(shù)據(jù)， 遠不能滿足我們工作的需求。當(dāng)這種情況發(fā)生時， 我們就會錯失很多機會。所以在凱內(nèi)馬的疫情爆發(fā)初期，我們有106份病人的臨床記錄，我們再一次把這些都公之于眾。在我們自己的實驗室里， 你拿給我們那106份記錄，我們就可以讓電腦來預(yù)測 接下來的埃博拉患者，而且準確度接近100%。我們還做了個應(yīng)用程序， 專門發(fā)布這些預(yù)測，讓全世界健康領(lǐng)域的工作者 都能獲得這些信息。

06:29

But 106 is just not enough to make it powerful, to validate it. So we were waiting for more data to release that. and the data has still not come. We are still waiting, tweaking away, in silos rather than working together. And this just -- we can't accept that. Right? You, all of you, cannot accept that. It's our lives on the line. And in fact, actually, many lives were lost, many health-care workers, including beloved colleagues of mine, five colleagues: Mbalu Fonnie, Alex Moigboi, Dr. Humarr Khan, Alice Kovoma and Mohamed Fullah. These are just five of many health-care workers at Kenema and beyond that died while the world waited and while we all worked, quietly and separately.

但是106份報告遠遠不夠，還無法讓這種方法產(chǎn)生實效。所以我們在等待更多的臨床報告， 才能發(fā)布那個軟件，而這些報告一直沒有來。我們還在等待，還在不斷修正軟件，窩在實驗室里而不是跟大家合作。這個真是……我們完全不能接受。對吧？你們，你們所有人都不能接受?，F(xiàn)在正是命懸一線的時候。然而事實上，很多的人犧牲了， 很多工作在醫(yī)療領(lǐng)域的人們，包括我所敬愛的同事們，有五個同事： 姆巴魯·馮尼、艾力克斯·穆比、胡馬爾·汗醫(yī)生、艾麗絲·科沃瑪， 還有穆罕默德·富勒。這只是千千萬萬醫(yī)療衛(wèi)生工作者中的五人，他們在凱內(nèi)馬還有其他地方犧牲，而世界卻一直在等待， 我們一直在埋頭工作，人與人都是獨立的、毫無交流的。

07:15

See, Ebola, like all threats to humanity, it's fueled by mistrust and distraction and division. When we build barriers amongst ourselves and we fight amongst ourselves, the virus thrives. But unlike all threats to humanity, Ebola is one where we're actually all the same. We're all in this fight together. Ebola on one person's doorstep could soon be on ours. And so in this place with the same vulnerabilities, the same strengths, the same fears, the same hopes, I hope that we work together with joy.

埃博拉病毒，就像其他種種對人類的威脅，都會因人與人之間的不信任、 分散與隔閡而愈演愈烈。當(dāng)我們互相建起隔障，互相爭斗的時候，病毒的氣焰就更囂張了。但是埃博拉又不像其它的威脅，因為這一次，我們成為了一家人。我們都在同一條戰(zhàn)線。一個人患上了埃博拉， 我們可能就會是下一個。于是我們生活在世上， 有著共同的弱點，共同的優(yōu)勢，共同的恐懼，共同的希望，我衷心希望我們能夠 帶著喜悅一起工作。

07:46

A graduate student of mine was reading a book about Sierra Leone, and she discovered that the word "Kenema," the hospital that we work at and the city where we work in Sierra Leone, is named after the Mende word for "clear like a river, translucent and open to the public gaze." That was really profound for us, because without knowing it, we'd always felt that in order to honor the individuals in Kenema where we worked, we had to work openly, we had to share and we had to work together. And we have to do that. We all have to demand that of ourselves and others -- to be open to each other when an outbreak happens, to fight in this fight together. Because this is not the first outbreak of Ebola, it will not be the last, and there are many other microbes out there that are lying in wait, like Lassa virus and others. And the next time this happens, it could happen in a city of millions, it could start there. It could be something that's transmitted through the air. It could even be disseminated intentionally. And I know that that is frightening, I understand that, but I know also, and this experience shows us, that we have the technology and we have the capacity to win this thing, to win this and have the upper hand over viruses. But we can only do it if we do it together and we do it with joy.

我的一個已經(jīng)畢業(yè)的學(xué)生 讀到了一本關(guān)于塞拉利昂的書，她發(fā)現(xiàn)“凱內(nèi)馬”這個詞，我們在塞拉利昂工作時 那個城市、那所醫(yī)院的名字，在當(dāng)?shù)氐拈T得語中意思是“像河流一樣透明、澄凈，并且所有人的目光都能觸及”。這對我們有著非常深遠的意義，我們自己并沒意識到， 但我們一直都覺得為了向凱內(nèi)馬，我們奮斗過的地方的 所有人致敬，我們必須開放合作， 我們必須共享信息，我們必須攜手共進。我們必須這樣做。所有人都應(yīng)該這樣要求自己和他人——當(dāng)災(zāi)難爆發(fā)時，我們都應(yīng)該互相敞開心扉，一起進行這場戰(zhàn)斗。因為這不是埃博拉疫情的第一次爆發(fā)，也不會是最后一次，世上還有許多其它的微生物 一直潛伏在我們身邊，就像拉薩病毒還有其它的生物。下次當(dāng)災(zāi)難發(fā)生的時候，可能會在一個百萬人口級別的城市， 可能就會在那里爆發(fā)。病毒可能會通過空氣傳播。病毒甚至可能會被人故意散播出去。我知道這很嚇人，我能理解，但是我也知道，這次經(jīng)歷告訴我們，我們有足夠的科技和能力，來打贏這場仗，不僅打贏這場仗， 而且對所有的病毒都能道高一丈。但是只有當(dāng)我們精誠合作時我們才能做到，而且我們要心懷喜悅。

08:59

So for Dr. Khan and for all of those who sacrificed their lives on the front lines in this fight with us always, let us be in this fight with them always. And let us not let the world be defined by the destruction wrought by one virus, but illuminated by billions of hearts and minds working in unity.

所以對于汗醫(yī)生， 還有犧牲在抗病前線的所有人， 永遠與我們并肩作戰(zhàn)的人， 讓我們也永遠與他們一起戰(zhàn)斗。 我們的世界不應(yīng)被 一個病毒所造成的破壞而定義， 我們要讓數(shù)十億顆心靈 團結(jié)合作的光輝灑遍大地。

09:18

Thank you.

謝謝大家。

09:19

(Applause)