How we'll fight the next deadly virus | Pardis Sabeti

Translator: Špela Lipovšek Reviewer: Nika Kotnik

You may never have heard of Kenema, Sierra Leone

Verjetno še niste slišali za Kenemo, Sierra Leone

or Arua, Nigeria.

ali Aruo, Nigerija.

But I know them as two of the most extraordinary places on earth.

Jaz jih poznam kot dva izmed najbolj izjemnih krajev na svetu.

In hospitals there, there's a community of nurses, physicians and scientists

Tam so v bolnišnicah skupnosti sester, zdravnikov in znanstvenikov,

that have been quietly battling

ki se potihem borijo

one of the deadliest threats to humanity for years:

z eno od najsmrtonosnejših groženj človeštvu:

Lassa virus.

Virus Lassa.

Lassa virus is a lot like Ebola.

Virus Lassa je podoben kot Ebola.

It can cause a severe fever and can often be fatal.

Lahko povzroča resno vročino in je pogosto smrtna.

But these individuals, they risk their lives every day

Ampak ti posamezniki vsak dan tvegajo svoja življenja,

to protect the individuals in their communities,

da zaščitijo posameznike v njihovi skupnosti

and by doing so, protect us all.

in s tem ščitijo vse nas.

But one of the most extraordinary things I learned about them

Ena izmed najbolj izjemnih stvari, ki sem se jih naučila

on one of my first visits out there many years ago

na enem izmed mojih prvih obiskov mnogo let nazaj

was that they start each morning --

je bilo to, da vsako jutro

these challenging, extraordinary days on the front lines -- by singing.

v teh težavnih in izrednih dneh v prvi bojni vrsti, začnejo s petjem.

They gather together, and they show their joy.

Zberejo se skupaj in pokažejo svojo radost.

They show their spirit.

Pokažejo svojo voljo.

And over the years,

V vseh letih

from year after year as I've visited them and they've visited me,

odkar sem jih obiskovala in so oni obiskovali mene,

I get to gather with them and I sing

sem lahko pela z njimi

and we write and we love it,

pisali smo in uživali,

because it reminds us that we're not just there to pursue science together;

ker nas je to spomnilo, da nismo tu samo, da skupaj izvajamo znanost;

we're bonded through a shared humanity.

povezani smo skupaj kot človeštvo.

And that of course, as you can imagine, becomes extremely important,

To seveda, kot si lahko predstavljate, postane izjemno pomembno,

even essential, as things begin to change.

skorajda ključno, ko se stvari začnejo spreminjati.

And that changed a great deal in March of 2014,

To se je zelo spremenilo marca 2014,

when the Ebola outbreak was declared in Guinea.

ko je bil oznanjen izbruh Ebole v Gvineji.

This is the first outbreak in West Africa,

To je bil prvi izbruh v zahodni Afriki

near the border of Sierra Leone and Liberia.

blizu meje s Sierro Leone in Liberijo,

And it was frightening, frightening for us all.

Bilo je strašljivo, strašljivo za vse nas.

We had actually suspected for some time

Nekaj časa smo sumili,

that Lassa and Ebola were more widespread than thought,

da sta Lassa in Ebola bolj razširjeni, kot smo mislili

and we thought it could one day come to Kenema.

in da bosta nekega dne prišla do Keneme.

And so members of my team immediately went out

Zato smo s člani moje ekipe nemudoma šli ven,

and joined Dr. Humarr Khan and his team there,

se pridružili zdravniku Humarr Khanu in ekipi,

and we set up diagnostics to be able to have sensitive molecular tests

tam smo postavili diagnostiko za senzitivne molekularne teste

to pick up Ebola if it came across the border

da bi našli Ebolo, če bi prišla čez mejo

and into Sierra Leone.

v Sierro Leone.

We'd already set up this kind of capacity for Lassa virus,

Že prej smo postavili takšno podobno postajo za virus Lassa,

we knew how to do it,

vedeli smo kako,

the team is outstanding.

ekipa je neverjetna.

We just had to give them the tools and place to survey for Ebola.

Morali smo jim samo predati orodja in kraj za preverjanje Ebole.

And unfortunately, that day came.

Na žalost je ta dan prišel.

On May 23, 2014, a woman checked into the maternity ward at the hospital,

23. maja 2014 je ženska prišla v porodnišnico,

and the team ran those important molecular tests

ekipa je naredila vse te pomembne molekularne teste

and they identified the first confirmed case of Ebola in Sierra Leone.

in odkrila prvi potrjen primer Ebole v Sierra Leone.

This was an exceptional work that was done.

To je bilo izjemno delo.

They were able to diagnose the case immediately,

Tako so lahko nemudoma diagnosticirali primer,

to safely treat the patient

da so lahko varno zdravili pacientko

and to begin to do contact tracing to follow what was going on.

in začeli iskati njene kontakte, da so ugotovili kaj se dogaja.

It could've stopped something.

Lahko bi s tem nekaj ustavili.

But by the time that day came,

A do tega dne

the outbreak had already been breeding for months.

je izbruh že nekaj mesecev tlel.

With hundreds of cases, it had already eclipsed all previous outbreaks.

S stotinami primerov, je takoj zasenčil vse prejšnje izbruhe.

And it came into Sierra Leone not as that singular case,

V Sierro Leone ni prišel kot osamljen primer,

but as a tidal wave.

ampak kot plimski val.

We had to work with the international community,

Morali smo sodelovati z mednarodno skupnostjo,

with the Ministry of Health, with Kenema, to begin to deal with the cases,

z Ministrstvom za zdravje, s Kenemo, da smo lahko začeli delati,

as the next week brought 31,

naslednji teden je prinesel 31,

then 92, then 147 cases -- all coming to Kenema,

potem 92 in nato 147 primerov, vsi v Kenemi,

one of the only places in Sierra Leone that could deal with this.

edini kraj v Sierri Leone, ki se je s tem lahko spoprijel.

And we worked around the clock trying to do everything we could,

Delali smo dneve in noči, storili smo vse kar smo lahko,

trying to help the individuals, trying to get attention,

pomagali smo posameznikom, poskusili pridobiti pozornost,

but we also did one other simple thing.

smo pa naredili še preprostejšo stvar.

From that specimen that we take from a patient's blood to detect Ebola,

Vzorec, ki ga vzamemo iz pacientove krvi, da odkrijemo Ebolo,

we can discard it, obviously.

lahko seveda zavržemo.

The other thing we can do is, actually, put in a chemical and deactivate it,

Lahko pa ga damo v kemikalijo in ga deaktiviramo,

so just place it into a box and ship it across the ocean,

torej ga damo v škatlo in pošljemo čez ocean.

and that's what we did.

In to smo storili.

We sent it to Boston, where my team works.

Poslali smo ga v Boston, kjer je moja ekipa.

And we also worked around the clock doing shift work, day after day,

Tudi tam smo delali dneve in noči v izmenah, dan za dnem.

and we quickly generated 99 genomes of the Ebola virus.

Kmalu smo ustvarili 99 genomov virusa Ebola.

This is the blueprint -- the genome of a virus is the blueprint.

To je načrt - genom virusa je načrt.

We all have one.

Vsak ima svojega.

It says everything that makes up us,

Pove vse, kar nas naredi nas

and it tells us so much information.

in nam pove ogromno informacij.

The results of this kind of work are simple and they're powerful.

Rezultati takšnega dela so preprosti in mogočni.

We could actually take these 99 different viruses,

Lahko bi pravzaprav vzeli teh 99 različnih virusov,

look at them and compare them,

jih pregledali in primerjali,

and we could see, actually, compared to three genomes

lahko bi ugotovili, da so v primerjavi s tremi genomi,

that had been previously published from Guinea,

ki so jih pred tem objavili v Gvineji,

we could show that the outbreak emerged in Guinea months before,

lahko bi dokazali, da se je izbruh v Gvineji začel že mesece prej,

once into the human population,

enkrat se je virus naselil v človeka

and from there had been transmitting from human to human.

in se od takrat naprej širi s človeka na človeka.

Now, that's incredibly important

To je zelo pomembno

when you're trying to figure out how to intervene,

ko poskušaš ugotoviti, kako posredovati,

but the important thing is contact tracing.

ampak pomembna stvar je iskanje kontaktov.

We also could see that as the virus was moving between humans,

Lahko smo tudi videli, da je virus s tem, ko se je premikal med ljudmi

it was mutating.

tudi mutiral.

And each of those mutations are so important,

Vsaka od teh mutacij je pomembna,

because the diagnostics, the vaccines,

ker diagnostični postopki, cepiva,

the therapies that we're using,

in terapije, ki jih uporabljamo

are all based on that genome sequence, fundamentally --

temeljijo na tisti sekvenci genoma, ki je ključna -

that's what drives it.

to je tisto, kar ga žene.

And so global health experts would need to respond,

Zato se morajo globalno-zdravstveni izvedenci odzvati,

would have to develop,

razviti in preračunati vse, kar počnejo.

to recalibrate everything that they were doing.

But the way that science works, the position I was in at that point

Znanost deluje tako: Jaz sem bila na poziciji,

is, I had the data,

imela sem podatke

and I could have worked in a silo for many, many months,

lahko bi delala v kleti več mesecev

analyzed the data carefully, slowly,

in jih pazljivo ter počasi analizirala,

submitted the paper for publication, gone through a few back-and-forths,

poslala članek za objavo

and then finally when the paper came out, might release that data.

in bi potem, ko bi bil objavljen, morda objavila vse podatke.

That's the way the status quo works.

Tako trenutno vse deluje.

Well, that was not going to work at this point, right?

Ampak to ne bi delovalo, kajne?

We had friends on the front lines

Imeli smo prijatelje v središču boja

and to us it was just obvious that what we needed is help,

in nam je bilo očitno, da potrebujemo pomoč,

lots of help.

veliko pomoči.

So the first thing we did is,

Prva stvari, ki smo jo naredili

as soon as the sequences came off the machines,

takoj, ko so se iz strojev pojavile sekvence,

we published it to the web.

smo jih objavili na internetu.

We just released it to the whole world and said, "Help us."

Pokazali smo jih celotnem svetu in rekli: "Pomagajte nam."

And help came.

In pomoč je prišla.

Before we knew it,

Preden smo se zavedli,

we were being contacted from people all over,

so nam pisali ljudje iz celotnega sveta,

surprised to see the data out there and released.

presenečeni nad objavo podatkov.

Some of the greatest viral trackers in the world

Nekateri izmed najboljših virusnih sledilcev

were suddenly part of our community.

so bili nenadoma del naše skupnosti.

We were working together in this virtual way,

Na virtualen način smo delali skupaj,

sharing, regular calls, communications,

delili podatke, se klicali in pogovarjali,

trying to follow the virus minute by minute,

poskušali slediti virusu vsako minuto,

to see ways that we could stop it.

da bi našli načine, kako ga zaustaviti.

And there are so many ways that we can form communities like that.

Obstaja mnogo načinov, s katerimi lahko oblikujemo takšne skupnosti.

Everybody, particularly when the outbreak started to expand globally,

Vsak, še sploh, ko se je izbruh virusa začel širiti v svet,

was reaching out to learn, to participate, to engage.

se je želel učiti, sodelovati in vključiti.

Everybody wants to play a part.

Vsak je želel biti del tega.

The amount of human capacity out there is just amazing,

Količina človeške kapacitete je bila enostavno neverjetna.

and the Internet connects us all.

Internet nas je vse povezal.

And could you imagine that instead of being frightened of each other,

Lahko si predstavljate, da smo namesto, da bi se bali drug drugega,

that we all just said, "Let's do this.

samo rekli: "Naredimo to.

Let's work together, and let's make this happen."

Sodelujmo in omogočimo to."

But the problem is that the data that all of us are using,

Ampak problem je v tem, da so podatki, ki jih uporabljamo,

Googling on the web, is just too limited to do what we need to do.

z brskanjem po internetu, preveč omejeni, da bi iz njih naredili kar moramo.

And so many opportunities get missed when that happens.

S tem zamudimo zelo veliko priložnosti.

So in the early part of the epidemic from Kenema,

Na začetku epidemije v Kenemi

we'd had 106 clinical records from patients,

smo imeli 106 kliničnih zapisov pacientov,

and we once again made that publicly available to the world.

ki smo jih javno objavili.

And in our own lab, we could show that you could take those 106 records,

V našem lastnem laboratoriju smo ugotovili, da lahko s temi 106. zapisi

we could train computers to predict the prognosis for Ebola patients

računalnike pripravimo do tega, da napovejo prognozo Ebole

to near 100 percent accuracy.

s skoraj 100% natančnostjo.

And we made an app that could release that,

Naredili smo aplikacijo, ki bi to naredila

to make that available to health-care workers in the field.

in jo želeli narediti dosegljivo vsem zdravstvenim delavcem.

But 106 is just not enough to make it powerful,

Ampak 106 še ni dovolj, da bi bila aplikacija zanesljiva,

to validate it.

da bi jo lahko potrdili.

So we were waiting for more data to release that.

Zato smo čakali na še več podatkov, preden bi objavili aplikacijo,

and the data has still not come.

ampak podatki niso prišli.

We are still waiting, tweaking away,

Še vedno čakamo in optimiziramo

in silos rather than working together.

v naši kleti, namesto, da bi delali skupaj.

And this just -- we can't accept that.

Tega ne moremo sprejeti.

Right? You, all of you, cannot accept that.

Imam prav? Vsi vi tega ne smete sprejeti.

It's our lives on the line.

Naša življenja visijo na nitki.

And in fact, actually,

Dejstvo je,

many lives were lost, many health-care workers,

da je bilo izgubljeno veliko življenj, veliko zdravstvenih delavcev,

including beloved colleagues of mine,

vključno z mojimi sodelavci,

five colleagues: Mbalu Fonnie, Alex Moigboi,

bilo jih je pet: Mbalu Fonnie, Alex Moigboi,

Dr. Humarr Khan, Alice Kovoma and Mohamed Fullah.

doktor Humarr Khan, Alice Kovoma in Mohamed Fullah.

These are just five of many health-care workers

To je samo pet od ogromnega števila zdravstvenih delavcev

at Kenema and beyond

v Kenemi in drugje,

that died while the world waited and while we all worked,

ki so umrli ko je svet čakal in medtem ko smo mi vsi delali,

quietly and separately.

tiho in ločeno.

See, Ebola, like all threats to humanity,

Ebola, kot vse grožnje človeštvu,

it's fueled by mistrust and distraction and division.

je virus, ki se hrani z nezaupanjem, motnjami in deljenjem.

When we build barriers amongst ourselves and we fight amongst ourselves,

Ko zgradimo meje med nami in se borimo med seboj,

the virus thrives.

virus uspeva.

But unlike all threats to humanity,

V nasprotju z ostalimi grožnjami

Ebola is one where we're actually all the same.

je Ebola edina, kjer smo dejansko vsi enaki.

We're all in this fight together.

V tem boju smo vsi skupaj.

Ebola on one person's doorstep could soon be on ours.

Ebola na sosedovem pragu, je kmalu lahko tudi na vašem.

And so in this place with the same vulnerabilities,

Zato v tem prostoru z enakimi občutljivostmi,

the same strengths, the same fears, the same hopes,

močmi, strahovi in upi,

I hope that we work together with joy.

upam, da lahko delujemo skupaj z veseljem.

A graduate student of mine was reading a book about Sierra Leone,

Ena izmed mojih študentk je brala knjigo o Sierri Leone

and she discovered that the word "Kenema,"

in ugotovila, da je beseda "Kenema",

the hospital that we work at and the city where we work in Sierra Leone,

bolnišnica in mesto v kateri delamo v Sierri Leone,

is named after the Mende word for "clear like a river, translucent

poimenovana po Mende besedi, ki pomeni "čista kot reka, prosojna

and open to the public gaze."

odprta očem javnosti.

That was really profound for us,

To je bilo osupljivo za nas,

because without knowing it, we'd always felt

ker smo se brez zavedanja vedno čutili,

that in order to honor the individuals in Kenema where we worked,

da moramo v skladu s tem, da častimo posameznike v Kenemi,

we had to work openly, we had to share and we had to work together.

delovati odprto, moramo vse deliti in moramo skupaj sodelovati.

And we have to do that.

To moramo storiti.

We all have to demand that of ourselves and others --

To moramo zahtevati zase in za druge.

to be open to each other when an outbreak happens,

Ko se zgodi izbruh, moramo biti odprti drug do drugega,

to fight in this fight together.

da lahko to bitko bijemo skupaj.

Because this is not the first outbreak of Ebola,

To ni prvi izbruh Ebole

it will not be the last,

in tudi ne bo zadnji.

and there are many other microbes out there that are lying in wait,

Zunaj je mnogo drugih mikrobov, ki počivajo in čakajo,

like Lassa virus and others.

tako kot Lassa in ostali.

And the next time this happens,

Naslednjič, ko se to zgodi,

it could happen in a city of millions, it could start there.

lahko se zgodi v milijonskem mestu, lahko se začne tukaj.

It could be something that's transmitted through the air.

Lahko je nekaj, kar se prenaša po zraku.

It could even be disseminated intentionally.

Lahko se celo raznaša namenoma.

And I know that that is frightening, I understand that,

Vem, da je to strašljivo, razumem vas,

but I know also, and this experience shows us,

ampak vedite, da nas ta izkušnja uči,

that we have the technology and we have the capacity

da imamo tehnologijo in kapacitete,

to win this thing,

da to premagamo,

to win this and have the upper hand over viruses.

da zmagamo in imamo prednost pred virusi.

But we can only do it if we do it together

Ampak to lahko naredimo le, če delujemo skupaj

and we do it with joy.

in to delamo z veseljem.

So for Dr. Khan

Zato bo doktor Khan

and for all of those who sacrificed their lives on the front lines

in vsi tisti, ki so žrtvovali svoja življenja v prvih bojnih črtah,

in this fight with us always,

vedno v boju z nami

let us be in this fight with them always.

in bodimo tudi mi z njimi.

And let us not let the world be defined

Naj ne bo naš svet definiran

by the destruction wrought by one virus,

z uničenjem, ki ga povzroči en virus,

but illuminated by billions of hearts and minds

ampak osvetljen z milijardami src in glav,

working in unity.

ki delujejo skupaj.

Thank you.

Hvala.

(Applause)

(Aplavz.)