How COVID-19 human challenge trials work -- and why I volunteered | Sophie Rose

47,989 views ・ 2020-12-01

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翻译人员: Yong Xu 校对人员: psjmz mz
[ 本演讲录制于 2020 年 10 月 26 日。
00:13
[Recorded on October 26, 2020.
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00:14
COVID-19 vaccine development
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新冠疫苗研发进展
以及围绕 人体受控感染试验的道德思考
00:16
and ethical considerations around human challenge trials
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依然在不断发展变化中。]
00:18
are constantly evolving.]
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00:20
In April 2020,
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2020 年 4 月,
00:21
I made what many perceive as a risky decision.
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我做出了很多人认为是 非常冒险的决定。
00:25
I volunteered to be deliberately infected with COVID-19.
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我自愿故意感染新冠。
00:29
This infection would be part of what is called a human challenge trial,
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这种感染是所谓的人体受控感染试验 (亦称人体挑战试验)的一部分——
00:32
where young, healthy people are given a vaccine
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健康的年轻人接受了疫苗注射,
00:35
and are deliberately exposed to the virus that causes COVID-19.
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并被故意暴露在 导致新冠的病毒中。
00:39
These trials help researchers figure out more quickly
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这些试验有助于 研究人员更快地确定
00:42
if a vaccine is working.
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疫苗是否有效。
00:45
I think this research is crucial,
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我认为这项研究很重要,
00:47
because today, I'm going to speak to you for six minutes.
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因为今天, 我会进行六分钟的演讲。
00:50
In that time,
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在这段时间内,
00:51
roughly 1,250 people will be confirmed infected with COVID-19.
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将有大约 1250 人 确认感染了新冠。
00:56
Twenty-one people will die.
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21 人将死去。
00:59
And then this pattern will repeat hour after hour and day by day,
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然后这种模式会一小时 接一小时,一天接一天地重复,
01:03
until we're able to vaccinate most of the eight billion people
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直到我们能够为受这场全球危机 影响的 80 亿人中的大多数
01:06
affected by this global crisis.
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接种疫苗。
01:09
Scientists have been working around the clock
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科学家们夜以继日地努力工作,
01:11
to make those vaccines a reality.
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希望这些疫苗能够尽快问世。
01:14
But what should we do when the human cost of waiting for those vaccines
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但是,当等待这些疫苗期间的 逝去的生命与日俱增时,
01:17
is rising by the day?
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我们该怎么办?
01:19
This is where human challenge trials come in.
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这就是人体受控感染试验 派上用场的地方。
01:22
They're different from the traditional phase three vaccine trials
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它们不同于现在正在进行的
01:25
taking place now,
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传统的疫苗三期临床试验,
01:26
where people are given a vaccine or placebo
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即给人们注射疫苗或安慰剂,
01:28
and asked to go about their everyday lives.
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并要求他们继续他们的日常生活。
01:31
Here, researchers have to wait to see how many people in each group
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这里,研究人员 要等着观察每一组中
01:35
become infected.
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有多少人被感染。
01:37
Until enough of them get sick,
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在没有足够多的人患病之前,
01:38
we don't have enough data to know whether a vaccine is working.
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我们没有足够的数据 确认疫苗是否有效。
01:42
Finding an effective vaccine with this method
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用这种方法找到有效的疫苗
01:44
can take months or sometimes years,
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可能需要数月甚至数年时间,
01:47
and it requires thousands of volunteers.
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而且需要成千上万的志愿者。
01:50
A challenge trial works faster
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人体受控感染试验的速度更快,
01:52
because researchers control exposure,
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因为研究人员可以控制 (与病毒的)接触,
01:54
instead of waiting for people to get sick.
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而不是等待人们生病。
01:56
So instead of a year,
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因此,相比要等上一年,
01:58
we could know in as little as a month
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我们只需一个月就能知道
02:00
whether a vaccine seems effective.
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疫苗是否有效。
02:02
Instead of thousands of volunteers,
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相比招募数千名志愿者,
02:04
a challenge trial relies on just 50 to 100.
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受控感染试验仅需 50 到 100 人,
02:08
Because we know for certain
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因为我们确切地知道
02:09
when people are exposed and develop disease,
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人们什么时候接触病毒并患病,
02:12
these trials also allow us to gather data
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这些试验还使我们能够收集
02:14
about the early stages of infection and our immune response.
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有关感染早期阶段 和我们的免疫反应的数据。
02:18
This data is impossible to gather in any other way,
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这些数据是不可能 以任何其他方式收集的,
02:21
especially for people who become infected but never show symptoms.
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特别是对于那些感染了, 但从未出现症状的人。
02:26
This knowledge is important for designing policies
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这些知识在设计 限制新冠传播的策略时
02:28
that limit COVID-19 transmission.
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非常重要。
02:31
The time saved translates into precious months' head start
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节省的时间可以 转化为提前几个月的
02:34
on manufacturing,
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宝贵的生产启动时间,
02:36
getting us more working COVID-19 vaccines faster.
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使我们可以更快地生产 更多的新冠疫苗。
02:39
These trials are useful --
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这些试验非常有用,
02:41
even though recent phase three results sound encouraging.
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尽管最近三期临床结果 听起来很令人鼓舞。
02:44
The arrival of the first vaccine is going to be a monumental breakthrough.
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第一种疫苗的问世 将是个巨大的突破。
02:49
It just isn't quite the fairytale ending we're all hoping for.
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这并不是我们所期待的 童话般的结局。
02:53
We're going to need multiple vaccines,
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我们需要多种疫苗,
02:55
because we just don't have the infrastructure needed
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因为我们还没有 所需的基础设施
02:57
to immunize all eight billion people on the planet with just one kind.
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用一种疫苗为地球上 80 亿人提供免疫。
03:01
Each type of vaccine requires its own special process and equipment
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每种疫苗都需要 特殊工艺和设备
03:05
to make, store and deliver it.
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来制造、储存和运送。
03:08
If we had multiple working COVID-19 vaccines,
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如果我们有多种有效的新冠疫苗,
03:11
we could make use of all of our equipment at the same time.
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就可以同时使用所有设备进行生产。
03:15
Some of the leading candidates need to be kept extremely cold
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一些领先的候选疫苗 在被交付给人们之前
03:18
before they are delivered to people.
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需要在极低的温度保存。
03:20
This can be really hard,
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做到这一点很难,
03:21
especially in countries where there isn't reliable electricity
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尤其是在那些没有可靠电力
03:25
or a secure method to store them.
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或安全储存方法的国家。
03:27
Scientists have been using human challenge trials
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科学家们进行 人体受控感染试验
03:29
for hundreds of years.
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已有数百年的历史。
03:31
They've sped up the development of vaccines against typhoid and cholera,
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这些试验加快了 伤寒和霍乱疫苗的研发,
03:35
and they've helped us better understand how immunity develops
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并帮助我们更好地 了解了人体对流感、
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to things like the flu, malaria and dengue.
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疟疾和登革热等疾病的 免疫力是如何发展的。
03:41
We've even used them for other types of coronavirus before.
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我们以前甚至用这种方法 对付过其他类型的冠状病毒。
03:46
There's been a lot of debate
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关于受控感染试验 是否风险太大
03:48
about whether challenge trials are too risky.
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一直存在很多争论。
03:51
I happen to think that those risks are worth taking.
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我倒是认为,这些风险值得冒。
03:54
A challenge trial would only recruit young and healthy participants --
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受控感染试验只招募 年轻、健康,
03:58
think between the ages of 20 and 29.
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且年龄在 20 岁 到 29 岁之间的受试者。
04:01
Fewer than one percent of people in that age-group
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在这个年龄组中, 只有不到 1% 的人
04:04
need to be taken to hospital after becoming infected with COVID-19.
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在感染新冠后需要住院治疗。
04:08
So it would likely be even lower in a challenge trial,
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因此,在受控感染试验中, 这个数值可能会更低,
04:11
because researchers check to make sure
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因为研究人员会检查参与者,
04:12
that participants have no preexisting conditions.
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以确定其是否存在现有疾病。
04:16
The risk of a young healthy person dying of COVID-19
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健康的年轻人死于 新冠的风险约为
04:19
is around five thousandths of a percent.
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一个百分点的千分之五 (十万分之五)。
04:22
That means for every 100,000 20-year-olds who become infected with COVID-19,
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这意味着每 10 万名 感染新冠的 20 岁人群中,
04:27
about five die.
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大约会有 5 人死亡。
04:30
If I were to give birth in the United States,
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如果我要在美国生孩子,
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my risk of dying would be higher than that.
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我的死亡风险比这更高。
04:36
Or you could choose to think about it this way.
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或者你可以选择这样想。
04:39
If my little sister needed a kidney,
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如果我妹妹需要一个肾,
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I wouldn't hesitate for a moment before I offered her mine.
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我会毫不犹豫地把我的肾给她。
04:44
And if I can take on that risk to benefit a loved one,
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如果我能承担这种风险, 使亲人受益,
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it makes sense to allow people to take on a similar risk
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那么让人们承担类似的风险,
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to speed up the development of a vaccine
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加快疫苗的研制就是有意义的,
04:53
that would benefit not just their loved ones,
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这不仅能造福亲人,
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but everyone around them as well.
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也造福了身边的每一个人。
04:58
There's a lot we still don't know,
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还有很多我们未知的信息,
05:00
especially about the long-term effects of COVID-19 infection.
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尤其是关于新冠感染的长期影响。
05:04
I volunteered despite that uncertainty
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尽管存在不确定性, 我还是自愿参加了,
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because like many of you, I feel frustrated
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因为和你们中的许多人一样,
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knowing that hundreds of thousands of people are dying.
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了解到成千上万的人正在死去, 让我感到很沮丧。
05:11
And that's without mentioning the millions more who are struggling
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更不用说还有 数以百万计的人在挣扎,
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as measures to stop the spread take a toll on their physical,
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防疫措施对他们的身体、
05:18
emotional and mental well-being.
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情感和心理健康都造成了伤害。
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It turns out I'm not alone in feeling this way.
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事实证明,有类似感受的 不只我一个人。
05:24
Since May, over 39,000 people from across the world
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自 5 月以来, 世界各地有 39000 多人
05:27
have volunteered to participate in potential COVID-19 challenge trials
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通过我协助成立的非营利组织 “早一天(1Day Sooner)”
05:31
through a nonprofit I helped found called 1Day Sooner.
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自愿报名参与可能的 新冠受控感染试验。
05:34
We advocate for challenge trial participants
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我们鼓励人们参与试验,
05:37
and have been encouraging stakeholders to begin preparing for these trials.
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并鼓励利益相关方 开始为这些试验做准备。
05:41
As early as May,
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早在 5 月,
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when challenge trials were still being considered
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当人们仍在考虑受控感染试验
05:45
for their role in the fight against COVID-19,
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在对抗新冠上面的作用时,
05:48
the World Health Organization cited 1Day Sooner
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世界卫生组织就开始以“早一天”
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as an example of the kind of public engagement needed
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作为进行受控感染试验所需的
05:53
to run a challenge trial.
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公众参与的例子。
05:55
In mid-October,
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10 月中旬,
05:56
the UK government formally announced their intention
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英国政府正式宣布,
05:59
to conduct a challenge trial at the beginning of 2021.
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打算在 2021 年初 进行受控感染试验。
06:03
It is clear that the COVID-19 pandemic is a global crisis.
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显然,新冠大流行 是一场全球性危机。
06:07
It has inspired record-shattering innovation,
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它激发了破纪录的创新,
06:10
and it has highlighted the heroic acts of many frontline workers,
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也凸显了许多 一线工作人员的英勇行为,
06:13
but is has also taken a catastrophic toll.
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但也造成了灾难性的损失。
06:16
The arrival of each new vaccine brings us one step closer to rebuilding.
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每一种新疫苗的到来都使我们 离重建又近了一步。
06:20
But the true global solution
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但真正的全球解决方案在于,
06:23
lies in those vaccines being in the hands of people all over the world.
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这些疫苗应掌握在 全世界人民手中。
06:26
Challenge trials could be a part of that solution.
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受控感染试验可以是 解决方案的一部分。
06:30
Thank you.
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非常感谢。
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