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

翻译人员: Hancheng Li 校对人员: Yinchun Rui

You may never have heard of Kenema, Sierra Leone

你们可能从未听说过 塞拉利昂的凯内马，

or Arua, Nigeria.

或者是尼日利亚的阿鲁阿。

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

但我认为它们是 世界上最棒的两个地方。

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

在那里的医院，有一个由护士、 外科医生和科学家组成的社区，

that have been quietly battling

多年来一直在默默对抗

one of the deadliest threats to humanity for years:

人类最致命的威胁之一——

Lassa virus.

拉萨病毒。

Lassa virus is a lot like Ebola.

拉萨病毒十分像埃博拉病毒。

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

它可以导致严重的发热症状， 而且往往是致命的。

But these individuals, they risk their lives every day

但是这些人每天都冒着生命危险

来保护社区中的每个成员，

to protect the individuals in their communities,

and by doing so, protect us all.

与此同时，也保护着我们所有人。

But one of the most extraordinary things I learned about them

我从他们身上学到的最棒的一点，

就是在很多年前 我第一次去拜访的时候，

on one of my first visits out there many years ago

was that they start each morning --

那些充满挑战、在前线奋斗的日子里，

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

他们每天早上都是这样开始的——唱歌。

They gather together, and they show their joy.

他们聚集在一起， 尽情展现他们的愉悦。

They show their spirit.

他们展现着一种精神。

And over the years,

许多年过去了，

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

当我们年复一年彼此相互拜访的时候，

I get to gather with them and I sing

我都可以跟他们聚在一起唱歌，

and we write and we love it,

而且我们会把这些记录下来， 我们很爱这样做，

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

因为它了提醒我们， 我们不只是要一起探寻科学真理，

we're bonded through a shared humanity.

还有一条人性的纽带将我们紧密相连。

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

而且你们可以想象，当周遭发生变化时，

even essential, as things begin to change.

这种联系就变得极其重要， 甚至是不可或缺的。

And that changed a great deal in March of 2014,

2014年的3月，巨变发生了。

when the Ebola outbreak was declared in Guinea.

埃博拉疫情在几内亚爆发。

This is the first outbreak in West Africa,

这是在西非地区的第一次疫情爆发，

near the border of Sierra Leone and Liberia.

发生在塞拉利昂和利比亚的交界处。

And it was frightening, frightening for us all.

情况非常可怕，我们每个人都震惊了。

We had actually suspected for some time

事实上，我们甚至一度怀疑

that Lassa and Ebola were more widespread than thought,

拉萨和埃博拉疫情的散布范围 比我们想象中更广，

and we thought it could one day come to Kenema.

而且我们担心某天它会传播到凯内马。

And so members of my team immediately went out

于是我的团队成员立即出发，

and joined Dr. Humarr Khan and his team there,

赶到那里并加入了 胡马尔·汗医生和他的团队，

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

我们搭建好了诊断设备， 来做一些敏感的分子测试，

to pick up Ebola if it came across the border

当埃博拉病毒跨越塞拉利昂边境时，

and into Sierra Leone.

我们就可以探测得到。

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

我们早已为拉萨病毒 设置了这种规模的设备，

we knew how to do it,

我们知道如何去应对，

the team is outstanding.

这个团队极其出色。

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

我们只需要给他们设备和场地， 让他们去研究埃博拉。

And unfortunately, that day came.

很不幸的是，那一天来临了。

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

2014年5月23日，一位女子 住进了医院里的产房，

and the team ran those important molecular tests

我们团队就进行了那些重要的分子测试，

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

并确诊了塞拉利昂的 第一例埃博拉病例。

This was an exceptional work that was done.

这其实是非常了不起的。

They were able to diagnose the case immediately,

他们可以在第一时间诊断出病情，

to safely treat the patient

安全地诊治病人，

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

并且开始追踪接触者， 跟进病情的扩散情况。

It could've stopped something.

它本可以阻止些什么的。

But by the time that day came,

但是当那天来临的时候，

the outbreak had already been breeding for months.

疫情的爆发已经酝酿了好几个月了。

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

发现了成百个病例之后， 它让所有之前的疫情爆发都相形见绌。

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

而且病毒不是由那个单一病例 攻进塞拉利昂的，

but as a tidal wave.

这是一个巨大的冲击波。

We had to work with the international community,

我们得跟国际社会紧密合作，

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

跟卫生部，跟凯内马当地， 共同应对这些病例。

as the next week brought 31,

接下来的一周来了31个病人，

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

然后是92个，后来涨到147个—— 全部都涌到凯内马来，

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

因为这是塞拉利昂 能够应对疫情的少数几个地方之一。

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

我们日夜无休，拼尽全力地工作，

希望去帮助每一个患者， 希望获得大家的关注，

trying to help the individuals, trying to get attention,

但我们同时也做了另外一件简单的事。

but we also did one other simple thing.

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

为了探测埃博拉病毒， 我们从病人血液中提取了样品，

we can discard it, obviously.

我们当然可以直接丢掉它们。

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

但是事实上，我们能做的另一件事， 是在样品中加化学药品使其失活，

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

然后把它封存在盒子里， 把它运过大洋。

and that's what we did.

而这正是我们所做的。

我们把样品发到了波士顿， 我的团队工作的地方，

We sent it to Boston, where my team works.

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

我们同样日夜无休，每天都在轮班工作，

and we quickly generated 99 genomes of the Ebola virus.

于是我们很快地整理出了 埃博拉病毒的99个基因组。

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

这就是一份蓝图—— 病毒的基因组就是一份蓝图。

We all have one.

我们人类身上也有。

It says everything that makes up us,

它详述了构成我们身体的一切，

and it tells us so much information.

告诉我们非常多的信息。

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

这些工作的结果很简单，但也很强大。

We could actually take these 99 different viruses,

我们可以拿这99个不同的病毒变异，

look at them and compare them,

观察并且比较它们，

and we could see, actually, compared to three genomes

我们可以清晰地看到，相比于

that had been previously published from Guinea,

几内亚方面发布的三个基因组，

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

我们可以发现，病情在几个月前 就已经开始在几内亚传播，

once into the human population,

一旦闯进了人群中，

and from there had been transmitting from human to human.

就会通过人与人之间的接触快速传递。

Now, that's incredibly important

这个信息其实至关重要，

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

尤其当你在研究如何阻碍 病毒传播的时刻。

but the important thing is contact tracing.

但是最重要的事情是接触者追踪。

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

我们也可以看到 病毒在人与人之间传播的时候，

it was mutating.

它也在不断变异。

And each of those mutations are so important,

每一种变异都无比重要，

because the diagnostics, the vaccines,

因为所有的诊断、疫苗，

the therapies that we're using,

还有我们用的治疗方式，

are all based on that genome sequence, fundamentally --

基本全都是基于那种特定的基因组序列，

that's what drives it.

这才是导致疫情传播的根源。

And so global health experts would need to respond,

于是全球的健康专家要快速应对，

would have to develop,

要改进研究方法，

to recalibrate everything that they were doing.

要把自己所做的一切都进行调整。

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

但是就当时我所处的位置来看， 科学研究的方法是

我拿到了数据，

is, I had the data,

我可能要关在实验室里研究好几个月，

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

细致谨慎地分析那些数据，

analyzed the data carefully, slowly,

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

写好论文投出去，再进行反复修改，

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

最后论文公之于众，那些数据才能公开。

That's the way the status quo works.

这就是当时科学研究的现状。

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

好吧，在那个特定时候这种方法 肯定不管用，对吧？

We had friends on the front lines

我们有些朋友在抗病前线工作，

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

显然对于我们来说 最需要的就是外界帮助，

lots of help.

很多的帮助。

So the first thing we did is,

所以我们所做的第一件事，

as soon as the sequences came off the machines,

基因测序结果从机器上一出来，

我们就立即在网上发布了这些数据。

we published it to the web.

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

我们向全世界公开， 然后说：“帮帮我们！”

And help came.

于是帮助接踵而至。

Before we knew it,

我们还没反应过来，

we were being contacted from people all over,

全世界就有一大群人主动跟我们联系，

surprised to see the data out there and released.

他们惊喜地看到这些数据在网上公开了。

Some of the greatest viral trackers in the world

世界上一些最出色的病毒追踪者

were suddenly part of our community.

突然就变成了我们团队的一员了！

We were working together in this virtual way,

我们用这种虚拟的方式共同合作，

sharing, regular calls, communications,

我们共享信息，经常互通电话， 一直保持联系，

trying to follow the virus minute by minute,

希望能够分秒跟踪病毒的扩散情况，

to see ways that we could stop it.

然后找到遏制它的办法。

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

其实我们若要组建这样的团体 有很多种方式。

Everybody, particularly when the outbreak started to expand globally,

每个人，尤其是当疫情 在世界范围爆发时，

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

都在不断获取信息， 都在参与、投入进来。

Everybody wants to play a part.

每个人都想做一些贡献。

The amount of human capacity out there is just amazing,

世界上所有人的力量真的是太神奇了，

and the Internet connects us all.

而因特网将我们联系在一起。

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

你们可以想象吗？ 我们不再害怕与他人交流，

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

我们所有人都说，“开工吧。

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

让我们齐心协力，我们一定做得到！”

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

但是问题就是， 我们所有人所用到的数据，

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

在谷歌上搜到的数据， 远不能满足我们工作的需求。

And so many opportunities get missed when that happens.

当这种情况发生时， 我们就会错失很多机会。

So in the early part of the epidemic from Kenema,

所以在凯内马的疫情爆发初期，

we'd had 106 clinical records from patients,

我们有106份病人的临床记录，

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

我们再一次把这些都公之于众。

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

在我们自己的实验室里， 你拿给我们那106份记录，

we could train computers to predict the prognosis for Ebola patients

我们就可以让电脑来预测 接下来的埃博拉患者，

to near 100 percent accuracy.

而且准确度接近100%。

And we made an app that could release that,

我们还做了个应用程序， 专门发布这些预测，

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

让全世界健康领域的工作者 都能获得这些信息。

But 106 is just not enough to make it powerful,

但是106份报告远远不够，

to validate it.

还无法让这种方法产生实效。

So we were waiting for more data to release that.

所以我们在等待更多的临床报告， 才能发布那个软件，

and the data has still not come.

而这些报告一直没有来。

We are still waiting, tweaking away,

我们还在等待，还在不断修正软件，

in silos rather than working together.

窝在实验室里而不是跟大家合作。

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

这个真是……我们完全不能接受。

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

对吧？你们，你们所有人都不能接受。

现在正是命悬一线的时候。

It's our lives on the line.

And in fact, actually,

然而事实上，

many lives were lost, many health-care workers,

很多的人牺牲了， 很多工作在医疗领域的人们，

including beloved colleagues of mine,

包括我所敬爱的同事们，

five colleagues: Mbalu Fonnie, Alex Moigboi,

有五个同事： 姆巴鲁·冯尼、艾力克斯·穆比、

Dr. Humarr Khan, Alice Kovoma and Mohamed Fullah.

胡马尔·汗医生、艾丽丝·科沃玛， 还有穆罕默德·富勒。

These are just five of many health-care workers

这只是千千万万医疗卫生工作者中的五人，

at Kenema and beyond

他们在凯内马还有其他地方牺牲，

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

而世界却一直在等待， 我们一直在埋头工作，

quietly and separately.

人与人都是独立的、毫无交流的。

See, Ebola, like all threats to humanity,

埃博拉病毒，就像其他种种对人类的威胁，

it's fueled by mistrust and distraction and division.

都会因人与人之间的不信任、 分散与隔阂而愈演愈烈。

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

当我们互相建起隔障，互相争斗的时候，

the virus thrives.

病毒的气焰就更嚣张了。

But unlike all threats to humanity,

但是埃博拉又不像其它的威胁，

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

因为这一次，我们成为了一家人。

We're all in this fight together.

我们都在同一条战线。

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

一个人患上了埃博拉， 我们可能就会是下一个。

And so in this place with the same vulnerabilities,

于是我们生活在世上， 有着共同的弱点，共同的优势，

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

共同的恐惧，共同的希望，

I hope that we work together with joy.

我衷心希望我们能够 带着喜悦一起工作。

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

我的一个已经毕业的学生 读到了一本关于塞拉利昂的书，

and she discovered that the word "Kenema,"

她发现“凯内马”这个词，

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

我们在塞拉利昂工作时 那个城市、那所医院的名字，

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

在当地的门得语中意思是 “像河流一样透明、澄净，

and open to the public gaze."

并且所有人的目光都能触及”。

That was really profound for us,

这对我们有着非常深远的意义，

我们自己并没意识到， 但我们一直都觉得

because without knowing it, we'd always felt

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

为了向凯内马，我们奋斗过的地方的 所有人致敬，

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

我们必须开放合作， 我们必须共享信息，我们必须携手共进。

And we have to do that.

我们必须这样做。

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

所有人都应该这样要求自己和他人——

to be open to each other when an outbreak happens,

当灾难爆发时，我们都应该互相敞开心扉，

to fight in this fight together.

一起进行这场战斗。

Because this is not the first outbreak of Ebola,

因为这不是埃博拉疫情的第一次爆发，

it will not be the last,

也不会是最后一次，

世上还有许多其它的微生物 一直潜伏在我们身边，

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

like Lassa virus and others.

就像拉萨病毒还有其它的生物。

And the next time this happens,

下次当灾难发生的时候，

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

可能会在一个百万人口级别的城市， 可能就会在那里爆发。

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

病毒可能会通过空气传播。

病毒甚至可能会被人故意散播出去。

It could even be disseminated intentionally.

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

我知道这很吓人，我能理解，

but I know also, and this experience shows us,

但是我也知道，这次经历告诉我们，

that we have the technology and we have the capacity

我们有足够的科技和能力，

to win this thing,

来打赢这场仗，

to win this and have the upper hand over viruses.

不仅打赢这场仗， 而且对所有的病毒都能道高一丈。

But we can only do it if we do it together

但是只有当我们精诚合作时我们才能做到，

and we do it with joy.

而且我们要心怀喜悦。

So for Dr. Khan

所以对于汗医生，

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

还有牺牲在抗病前线的所有人，

in this fight with us always,

永远与我们并肩作战的人，

let us be in this fight with them always.

让我们也永远与他们一起战斗。

And let us not let the world be defined

我们的世界不应被

by the destruction wrought by one virus,

一个病毒所造成的破坏而定义，

but illuminated by billions of hearts and minds

我们要让数十亿颗心灵 团结合作的光辉洒遍大地。

working in unity.

Thank you.

谢谢大家。

(Applause)

（掌声）