What we do (and don't) know about the coronavirus | David Heymann

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2020-03-05・ 7753    355


Visit http://TED.com to get our entire library of TED Talks, transcripts, translations, personalized talk recommendations and more. What happens if you get infected with the coronavirus? Who's most at risk? How can you protect yourself? Public health expert David Heymann, who led the global response to the SARS outbreak in 2003, shares the latest findings about COVID-19 and what the future may hold. Recorded February 27, 2020 The TED Talks channel features the best talks and performances from the TED Conference, where the world's leading thinkers and doers give the talk of their lives in 18 minutes (or less). Look for talks on Technology, Entertainment and Design -- plus science, business, global issues, the arts and more. You're welcome to link to or embed these videos, forward them to others and share these ideas with people you know. For more information on using TED for commercial purposes (e.g. employee learning, in a film or online course), submit a Media Request here: http://media-requests.TED.com Follow TED on Twitter: http://twitter.com/TEDTalks Like TED on Facebook: http://facebook.com/TED Subscribe to our channel: http://youtube.com/TED

Instruction

Double-click on the English captions to play the video from there.

翻訳: Kazunori Akashi 校正: Yasushi Aoki
00:12
[As of the morning February 27, 2020,
[2020年2月27日 午前の時点で
00:14
there were at least 82,000 confirmed cases worldwide of the coronavirus
新型コロナウイルスの確認されている感染者は 世界で8万2千人以上—
00:17
and 2,810 deaths from it.
死者は2,810人である
00:19
TED invited Dr. David Heymann to share the latest findings about the outbreak.]
アウトブレイクの最新情報を聞くため TEDはデヴィッド・ヘイマン博士を招いた]
00:22
[What happens if you get infected with the coronavirus?]
[新型コロナウイルスに感染したら どうなりますか?]
00:25
This looks like a very mild disease, like a common cold,
患者の大部分では 普通のかぜのように
00:28
in the majority of people.
軽い病気に見えます
00:30
There are certain people who get infected and have very serious illness;
ただ 感染した場合に 重症化する人がいます
00:34
among them are health workers.
例えば医療従事者です
00:36
It's a very serious infection in them,
一般の人よりも 大量のウイルスに接触し
00:38
as they get a higher dose than normal people,
免疫がないため
00:40
and at the same time, they have no immunity.
症状が深刻なものになります
00:42
So in the general population,
一般の人の場合
00:46
it's likely that the dose of virus that you receive when you are infected
感染する時に接触する ウイルスの量は
00:51
is much less than the dose that a health worker would receive,
医療従事者が接触する量より ずっと少ないでしょう
00:54
health workers having more serious infections.
だから医療従事者は 重症化しやすいのです
00:56
So your infection would be less serious, hopefully.
それに比べると 一般の人は 軽症になりやすいと思います
00:59
So that leaves the elderly and those with comorbidities
一方 高齢者や 基礎疾患がある人の場合は
01:03
to really be the ones that we have to make sure
医療機関で治療を受けることが
01:05
are taken care of in hospitals.
不可欠です
01:07
[Who are the people who should be most concerned about this?]
[もっとも懸念されるのは どのような人々でしょうか?]
01:12
Well, the most concerned are people
一番心配されるのは
01:14
who are, first of all, in developing countries
開発途上国の人々
01:17
and who don't have access to good medical care
質の高い医療が 受けられない人や
01:20
and may not have access at all to a hospital,
医者にまったく かかれない人がいるところで
01:23
should an epidemic occur in their country.
感染が広がった場合です
01:26
Those people would be at great risk,
そういった人々 とりわけ高齢者は
01:28
especially the elderly.
非常に危険です
01:29
Elderly in all populations are at risk,
どの集団でも 高齢者はリスクが高いですが
01:32
but especially those who can't get to oxygen.
中でも酸素を入手できない人は 特に危険です
01:35
In industrialized countries,
先進国の場合
01:36
it's the very elderly who have comorbidities,
基礎疾患がある高齢者—
01:39
who have diabetes, who have other diseases,
糖尿病やその他の 疾患がある人は
01:41
who are at risk.
危険があります
01:42
The general population doesn't appear to be at great risk.
ただ一般の人の多くには 大きな危険はなさそうです
01:45
[What pre-existing medical conditions put people at higher risk?]
[どんな持病があると リスクは高まりますか?]
01:50
First of all,
何よりまず
01:51
pulmonary disease existing as a comorbidity is also important.
呼吸器疾患を既に持っている人
01:55
In general, the elderly are at greater risk,
また 一般的に高齢者 中でも70歳以上の方は
01:57
especially those over 70,
危険性が高まります
01:59
because their immune systems are not as effective
高齢者は 若い頃に比べて
02:02
as they might have once been,
免疫系が衰えていて
02:04
and they are more susceptible to infections.
感染症にかかりやすく なるからです
02:07
In addition, in some instances in China,
さらに中国では
02:10
there's been a coinfection with influenza
インフルエンザを併発した例や
02:14
and at the same time,
肺炎を発症した上に
02:15
there have been some bacterial superinfections
細菌重複感染を起こした事例も
02:17
on the pneumonias that are occurring.
報告されています
02:19
[Where can we find up-to-date information?]
[最新の情報は どこで手に入りますか?]
02:22
The Center for Disease Control in Atlanta keeps track
アトランタの 疾病予防管理センター(CDC)は
02:25
and has updates on a regular basis on its website.
常に状況を把握し ウェブサイトで 定期的に情報を更新しています
02:29
Also, the World Health Organization in Geneva,
またジュネーブの 世界保健機関(WHO)は
02:31
which is coordinating many of the activities
世界各国の様々な活動の
02:34
going on internationally,
調整をしていますが
02:35
also has a website with daily updates.
こちらもウェブサイトを 毎日更新しています
02:37
It's our responsibility to get that information as individuals,
これらの情報を一人ひとりが入手し
02:41
so we understand
よく理解し
02:42
and can make sure that we can contribute in our own way
自分なりに貢献できるようになって
02:45
to prevention of major spread.
大規模な感染拡大を防ぐのは みんなの責務です
02:48
[You led the global response to the SARS outbreak in 2003.
[あなたは2003年に世界的な SARS対応を指揮しました
02:50
How does this outbreak compare?]
その時と比較して どうでしょう?]
02:52
That's the same problem with all new infections.
ここでも まったく新しい感染症に 共通する問題があります
02:54
This is an infection that's coming to humans
これは人類が初めて接触する
02:57
who have never been exposed to this virus before.
ウイルスによる感染症です
03:00
They don't have any antibody protection,
人間には抗体による守りがなく
03:02
and it's not clear whether their immune system
このウイルスに 免疫システムが 対応できるかどうかも
03:05
can handle this virus or not.
定かではありません
03:07
This is a virus that usually finds itself in bats or in other animals,
このウイルスは通常 コウモリなどの動物を宿主にしていますが
03:11
and all of a sudden, it's in humans.
急に人間に感染するようになりました
03:13
And humans just don't have experience with this virus.
だから人間には このウイルスに 感染した経験がないのです
でもSARSの時と同様
03:17
But gradually,
03:18
we are beginning to learn a lot, as we did with SARS.
次第に多くの情報が 集まりつつあります
03:21
And you know, there are certainly a larger number of deaths
確かに死亡者数はSARSよりも
03:24
than there were with SARS.
多くなっていますが
03:26
But when you divide that by a denominator of persons who are infected,
感染者数を分母とする 死亡者数の割合を考えると
03:30
there are many, many more persons infected than there were with SARS.
感染者数がSARSに比べて かなり多いので
03:34
The case fatality ratio,
SARSでは致死率—
03:36
that is the ratio of deaths to the numbers of cases in SARS,
つまり感染者数に対する 死亡者数の割合は
03:40
was about 10 percent.
およそ10%でしたが
03:42
With the current coronavirus, COVID-19,
今回のコロナウイルス感染症 COVID-19では
03:45
it is two percent or probably less.
2%か たぶんそれを下回ります
03:48
So it's a much less virulent virus,
ですから 毒性は だいぶ低いと言えますが
03:51
but it's still a virus that causes mortality,
それでも死につながるウイルスなので
03:53
and that's what we don't want entering human populations.
人の集団には 侵入させたくはありません
03:56
[Have we responded adequately at border crossings, such as airports?]
[空港などの国境での検疫は 適切に行われているでしょうか?]
04:00
It's clearly understood that airports or any land borders
はっきりしているのは 空港も国境も
病気の侵入は 止められないということです
04:04
cannot prevent a disease from entering.
04:06
People in the incubation period can cross that border,
潜伏期間中の感染者は 国境を超えて
04:09
can enter countries
入国できますし
04:11
and can then infect others when they become sick.
その後 症状が出れば 他の人が感染します
04:14
So borders are not a means of preventing infections from entering a country
ですから国境で 体温をチェックしても
国内への感染症の侵入を防ぐ 手段にはなりません
04:20
by checking temperatures.
04:22
Borders are important because you can provide to people arriving
国境の重要性は
感染の危険度が 高いと思われる地域から来た人々に
04:26
from areas that might be at risk of having had infection,
04:29
provide them with an understanding,
この感染症の徴候や症状
04:31
either a printed understanding or a verbal understanding,
感染したと思った時に 何をすべきかといった知識を
04:34
of what the signs and symptoms are of this infection,
文書や口頭で
04:37
and what they should do if they feel that they might be infected.
提供できるという点にあります
04:41
[What's the timeline for a vaccine?]
[ワクチンはいつできるのでしょう?]
04:44
Vaccines are under development right now,
ワクチンは現在 開発中で
04:46
there's a lot of research going on.
盛んに研究が進められています
04:48
That research requires first that the vaccine be developed,
研究に必要な手順として まずワクチンを作り
04:52
then that it be studied for safety and effectiveness in animals,
次に動物を使って 安全性と効果を調べます
04:57
who are challenged with the virus after they are vaccinated,
動物にワクチンを接種して ウイルスに感染させるのです
05:00
and then it must go into human studies.
その後 臨床試験が必要です
05:03
The animal studies have not yet begun,
動物実験は まだ始まっていませんが
05:05
but will soon begin for certain vaccines.
いくつかのワクチンで もうすぐ始まるでしょう
05:07
And it's thought that by the end of the year,
そして 今年中か来年初頭には
05:10
or early next year,
候補となるワクチンが
05:11
there may be some candidate vaccines
いくつか完成して
05:13
that can then be studied for licensing by regulatory agencies.
規制当局が承認審査を することになるでしょう
05:18
So we're talking about at least a year until there's vaccine available
つまり 一般に利用できる ワクチンが完成するまでには
05:22
that can be used in many populations.
最低1年はかかる ということです
05:25
[What questions about the outbreak are still unanswered?]
[今回のアウトブレイクで まだわかっていない点は?]
05:29
It's clear we know how it transmits,
ウイルスがどう感染するかは 判明していますが
05:31
we don't know how easily it transmits in humans,
よくわかっていないのは
05:33
in communities or in unenclosed areas.
人同士や地域内、開放空間で どの程度 感染するかです
05:38
We know, for example,
たとえばクルーズ船のような 閉鎖空間では
05:39
that in the enclosed area of a cruise ship, it spread very easily.
感染がかなり広がりやすいことが わかっています
05:43
We need to better understand
知る必要があるのは
05:45
how it will spread once it gets into more open areas
もっと開けた場所での 感染者との接触で
05:49
where people are exposed to people who might be sick.
感染がどう広がるのか という点です
05:52
[What about the global response could be improved?]
[世界的な対応について 改善すべき点は?]
05:56
A major problem in the world today is that we look at outbreaks
現在 世界的に見て大きな問題は 開発途上国でのアウトブレイクを
06:00
in developing countries
先進国の私たちが行って 止めなければならないものと
06:01
as something that we need to go and stop.
捉えていることです
06:04
So when there's an outbreak of Ebola,
だから エボラ出血熱が流行すると
06:06
we think "How can we go and stop this outbreak in the country?"
「この国のアウトブレイクを 私たちがどう止めるか」とは考えても
06:09
We don't think about "How can we help that country
「感染を検出し 対応できる 能力を高められるように
06:13
strengthen its capacity,
この国をどう支援するか?」とは 考えないのです
06:15
so that it can detect and respond to infections?"
06:18
So we haven't invested enough
これまで私たちは 公衆衛生の基本的な能力を
06:21
in helping countries develop their core capacity in public health.
各国が高めていくことに 十分に力を注いできませんでした
06:25
What we've done is invested in many mechanisms globally,
出動してアウトブレイクを止める という形で
06:29
which can provide support to other countries
他国に支援を提供するための 世界的な仕組みに
06:32
to go and help stop outbreaks.
力を入れてきたわけですが
06:34
But we want to see a world where every country
私たちが望むのは 世界中のどの国でも
06:36
can do its best to stop its own outbreaks.
自国でアウトブレイクの阻止に 取り組めることです
06:38
[Will we see more emerging disease outbreaks in the future?]
[将来 新たなアウトブレイクは 起こるでしょうか?]
06:41
Today, there are over seven billion people.
現在 世界人口は 70億人を超えています
06:43
And when those people come into the world,
人が増えれば
食料や いろいろなものが 必要になり
06:46
they demand more food,
06:47
they demand a whole series of things
06:49
and they live closer together.
みんな密集して生活します
06:50
In fact, we're an urban world, where people live in urban areas.
実際 世界では都市化が進み 多くの人が都市に住んでいます
06:54
And at the same time, we're growing more animals,
同時に 家畜がより多く飼育され
06:57
and those animals are contributing food to humans as well.
人間の食料になります
07:01
So what we see
ですから 現在
07:02
is that that animal-human interface is becoming closer and closer together.
家畜と人間の距離が どんどん近づいています
07:07
And this intensive agriculture of animals
畜産の集約化が進み
07:11
and this intensive increase in human populations
地球上で 一緒に住む人口が
07:14
living together on the same planet
激増している今の状態は
07:16
is really a melting pot where outbreaks can occur and do occur.
アウトブレイクが起こりうる そして実際に起こる温床になります
07:21
We will eventually have more and more of these outbreaks.
ゆくゆくは アウトブレイクが どんどん増加するでしょう
07:24
So an emerging infection today is just a warning
今 出現している感染症は 将来 起こることへの
07:28
of what will happen in the future.
警告にすぎません
07:30
We have to make sure
私たちに必要なのは
07:31
that that technical collaboration in the world
世界が力を合わせ
07:34
is there to work together
アウトブレイクの発生時に 事態が理解でき
07:36
to make sure that we can understand these outbreaks when they occur
コントロールするのに必要な情報を 迅速に提供できるよう
07:40
and rapidly provide the information necessary to control them.
技術面での世界的連携を 確かなものにすることです
07:44
[Is the worst behind us?]
[最悪の状況は過ぎたのでしょうか?]
07:46
I can't predict with accuracy.
正確な予測はできません
07:48
So all I can say is that we must all be prepared
だから 少なくとも 誰もが最悪の事態に備える
07:51
for the worst-case scenario.
必要があると思います
07:52
And at the same time,
合わせて
07:54
learn how we can protect ourselves and protect others
この病気にかからないよう 自分自身や他の人の身を守る方法を
07:57
should we become a part of that epidemic.
学んでおく必要があります
08:00
[To learn more, visit: Centers for Disease Control and Prevention
[詳しくは 疾病予防管理センター(CDC)や 世界保健機関(WHO)の
08:03
World Health Organization]
ウェブサイトをご覧ください]
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