Yesterday I joined Devi Sridhar on Twitter to answer questions about the COVID-19 pandemic. We tackled everything from the breakthroughs we still need to the origins of the COVID virus to whether the world will be ready next time. Devi joined me from Scotland, where she works as a professor and department chair at the University of Edinburgh Medical School. She’s also the founding director of the Global Health Governance Programme, which does great work improving health systems for people all around the world.
You can read our full conversation below.
昨天(译注:1月11日),我与德维·斯里达尔一同在Twitter上回答了关于新冠大流行的问题。我们从仍需解决的突破,谈到新冠病毒的起源,再谈到世界是否将为下一次大流行做好准备。德维在苏格兰与我对话,她在那里担任爱丁堡大学医学院教授兼系主任。她也是全球健康治理项目的创始主任,该项目为世界各地的人民改善卫生系统做出了巨大贡献。
你可以在下面阅读我们的完整对话。
To kick-off the conversation with @BillGates, what scientific or tech breakthrough would make the biggest difference now to ending the COVID pandemic?
— Prof. Devi Sridhar 🌈 (@devisridhar) January 11, 2022
与比尔·盖茨对话的第一个问题,现在什么科学或技术突破将最有助于结束新冠大流行?
——德维·斯里达尔教授(以下以“斯里达尔”指代),2022年1月11日
The vaccines we have prevent severe disease and death very well but they are missing two key things.
First they still allow infections ("breakthrough") and the duration appears to be limited.
We need vaccines that prevent re-infection and have many years of duration.#
— Bill Gates (@BillGates) January 11, 2022
我们现有的疫苗很好地预防了严重疾病和死亡,但它们缺少两个关键的东西。
其一,接种疫苗后可能仍会被感染(“突破性感染”);
其二,疫苗的保护时间有限。
我们需要能够防止再次感染、并且保护时间可持续多年的疫苗。
——比尔·盖茨(以下以“盖茨”指代),2022年1月11日
Agree 100%- next gen vaccines with sterilising immunity. 2nd question: What are the current challenges in reaching global vaccination access? What are the obstacles?
— Prof. Devi Sridhar 🌈 (@devisridhar) January 11, 2022
斯里达尔:完全同意——具有消除性免疫功能(译注:指接种疫苗的人不会再感染他人)的下一代疫苗。
第二个问题:目前实现全球疫苗接种面临着哪些挑战?有哪些障碍?
During 2021 the supply of vaccines was limited and they mostly went to wealthy countries. Now we have a lot of supply overall and the problems are logistics and demand. The health systems in developing countries are a limiting factor.
— Bill Gates (@BillGates) January 11, 2022
盖茨:在2021年,疫苗的供应是有限的,大多流向富裕国家。现在我们总体上供应充足,问题是物流和需求。发展中国家的卫生系统是一个限制因素。
mRna vaccines still can't meet all the demand so figuring out who gets what is complicated.#
— Bill Gates (@BillGates) January 11, 2022
盖茨:mRNA疫苗仍不能满足所有需求,所以弄清楚“谁得到什么”是很复杂的。
There's been a lot of discussion on responsibility of pharma companies like Pfizer/Moderna for access. What is the role of these companies in ensuring pricing and availability esp in low and middle income contexts?
— Prof. Devi Sridhar 🌈 (@devisridhar) January 11, 2022
斯里达尔:针对辉瑞/莫德纳等制药公司在疫苗可及性上的责任,已经有了很多讨论。这些公司在确保定价和可及性方面(尤其对于中低收入国家而言)扮演着怎样的角色?
When we have adequate supply then tiered pricing is used where the rich countries pay a lot more than middle income and low income pay the least which is funded by @gavi. When supply is limited rich countries have to not outbid the others so governments are key to this. #
— Bill Gates (@BillGates) January 11, 2022
盖茨:当供应充足时,我们会采用分级定价机制,即富裕国家支付的费用比中等收入国家多得多,而低收入国家可依托全球疫苗免疫联盟(Gavi)的资助支付最少的费用。而当供应有限时,富国必须避免出价高于其他国家,因此,政府才是(确保定价的)关键。
Looking back on 2020/21 (and given you warned of a respiratory pandemic for years before), what do you think is the biggest mistake most countries (with resources) made in responding?
— Prof. Devi Sridhar 🌈 (@devisridhar) January 11, 2022
斯里达尔:回顾2020/21年(鉴于您在几年前就警告过呼吸道大流行的发生),您认为大多数(有资源的)国家在应对大流行时所犯的最大错误是什么?
A few countries like Australia moved fast to diagnose cases at scale and isolate people who were infected. They were able to limit deaths dramatically. Once the numbers get large in a country it is too late. So the first few months made a lot of difference.
— Bill Gates (@BillGates) January 11, 2022
盖茨:澳大利亚等少数国家迅速采取行动,大规模地诊断病例,并隔离感染者。他们能够很大程度地控制死亡人数。一旦一个国家的死亡病例数过多,再采取行动就太晚了。所以最初几个月(采取的应对方式)产生的结果差别巨大。
Also some countries did a better job of reducing mobility, using masks and protecting the elderly.
We weren't prepared - no practice in advance.#
— Bill Gates (@BillGates) January 11, 2022
盖茨:此外,一些国家在减少人口流动、佩戴口罩和保护老年人方面做得更好。
我们没有准备好——事先没有演习过。
Do you think the world will come together to get ready for the next one? I hope so but I am not sure.#
— Bill Gates (@BillGates) January 11, 2022
盖茨:您认为世界会团结起来为下一次大流行做准备吗?我希望如此,但我并不确定。
I'm optimistic about the '100 day challenge'- the idea of sequencing a new genome to developing diagnostics, therapeutics and effective vaccines- and getting them out to people. But requires leadership, planning & foresight. Now is the window to prepare.#
— Prof. Devi Sridhar 🌈 (@devisridhar) January 11, 2022
斯里达尔:我对“百日挑战”持乐观态度——“百日挑战”的概念,即对一个新的基因组进行测序,从而开发出诊断方法、治疗方法和有效的疫苗,并将其提供给人群。但这需要领导力、规划和远见。现在到了做准备的时候了。
One major problem has been online misinformation on Facebook & other platforms around vaccines, masks and other interventions- how do we deal with this challenge? When expertise is neglected and conspiracy theories are spread as if they are truth?
— Prof. Devi Sridhar 🌈 (@devisridhar) January 11, 2022
斯里达尔:一个主要问题是在脸书和其他平台上围绕疫苗、口罩和其他干预措施的错误信息——我们如何应对这一挑战?当专业知识被忽视,阴谋论却像真理一样被传播的时候?
Trusted authorities like @WHO and @CDCgov need more resources to see the pandemic early (surveillance) and to communicate better. Social media got behind on trying to get factual information out - there will be a lot of debate about how to do better on that...
— Bill Gates (@BillGates) January 11, 2022
盖茨:像世界卫生组织和美国疾控中心这样值得信赖的官方机构需要更多的资源,以尽早发现大流行(监测),并更好地进行沟通。社交媒体在尝试澄清真相,以正视听方面落后了——关于如何在这方面做得更好,将会有很多争论......
People like you and I and Tony Fauci have been subject to a lot of misinformation. I didn't expect that. Some of it like me putting chips in arms doesn't make sense to me - why would I want to do that?#
— Bill Gates (@BillGates) January 11, 2022
盖茨:像您、我以及托尼·福奇这样的人遭受虚假信息的攻击。我没想到会这样。其中一些假消息,比如我利用疫苗在人的手臂里植入芯片,对我来说没有意义——我为什么要那样做?
I'd make a joke but would cause a storm😆. Turning to the Gates Foundation's mission, what do you see as the biggest challenges to development in poor countries now? Have we gone backwards on girls' education & the child survival revolution?
— Prof. Devi Sridhar 🌈 (@devisridhar) January 11, 2022
斯里达尔:一句笑话也会引发一场暴风雨。谈到盖茨基金会的使命,您认为目前贫困国家发展中面临的最大挑战是什么?我们在女童教育和儿童生存革命上是否出现了倒退?
From 2000 to the start of the pandemic we made strong progress on health and other goals. The pandemic is a huge setback - including rich countries not focusing on the needs of developing countries as much. I hope we can reverse that.
— Bill Gates (@BillGates) January 11, 2022
盖茨:从2000年到大流行开始,我们在卫生和其他目标方面取得了巨大进展。这场大流行对世界而言,是一个巨大的挫折——包括对发展中国家需求没那么重视的富裕国家。我希望我们能够扭转这一局面。
I am optimistic about polio eradication - we are close. Malaria, HIV, Nutrition, will take a lot longer but better tools are coming. Education also needs innovation - it is behind where global health is particularly for girls.#
— Bill Gates (@BillGates) January 11, 2022
盖茨:我对根除脊髓灰质炎持乐观态度——我们已经接近这一目标。疟疾、艾滋病、营养不良,(根除这些疾病)将需要更长的时间,但更好的工具正在出现。教育也需要创新——它落后于全球健康的发展,特别是对女童而言。
So tough question: where do you think SARS-CoV-2 came from? What data do you want to see? And is this information important to preventing future spillovers & pandemics?
— Prof. Devi Sridhar 🌈 (@devisridhar) January 11, 2022
斯里达尔:所以棘手的问题是:您认为新冠病毒来自于哪里?您希望看到哪些数据?这些信息对于预防由新冠疫情带来的新影响和未来的大流行病重要吗?
The data is pretty strong that it came from another species which is true for most pandemics. People will continue to speculate on this and we should make sure labs are careful. There will be future outbreaks coming from other species so we need to invest in being ready. #
— Bill Gates (@BillGates) January 11, 2022
盖茨:数据相当有力的证实了新冠病毒来自于另一个种类,大多数大流行病都是如此。人们将继续对此进行猜测,(正因此)我们应该确保实验室数据是严谨的。未来还会有来自其他种类病毒的疫情暴发,所以我们需要预先投入,以做好准备。
Final question- what everyone wants to know -> how and when will the pandemic be over? Does omicron show that we can ‘live with COVID’? Or are other dangerous variants around the corner in 2022?
— Prof. Devi Sridhar 🌈 (@devisridhar) January 11, 2022
斯里达尔:最后一个问题,也是每个人都想知道的问题:大流行将如何以及何时结束?奥密克戎是否表明我们可以“与新冠共存”?或者,2022年是否会有其他危险的变体出现?
As countries experience their Omicron wave health systems will be challenged. Most of the severe cases will be unvaccinated people. Once Omicron goes through a country then the rest of the year should see far fewer cases so Covid can be treated more like seasonal flu.
— Bill Gates (@BillGates) January 11, 2022
盖茨:随着奥密克戎在多个国家暴发,卫生系统将受到挑战。大多数重症病例将会是未接种疫苗的人。一旦奥密克戎在一个国家全面暴发,那么今年剩下的时间,(该国)病例应该会大幅减少,这样的话,新冠肺炎就可以像季节性流感一样应对。
A more transmissive variant is not likely but we have been surprised a lot during this pandemic. Omicron will create a lot of immunity at least for the next year. @trvrb tracks the genetics really well. We may have to take yearly shots for Covid for some time.
— Bill Gates (@BillGates) January 11, 2022
盖茨:(奥密克戎之后)不太可能出现传染性更强的变种病毒,但我们在这次大流行中见到了太多意外。至少在未来一年里,奥密克戎会产生大量的免疫病例。Trevor Bedford(病毒进化学家)很好地追踪了病毒的遗传基因。在一段时间内,我们可能不得不每年接种一次新冠疫苗。
.@DrTedros has started the conversation about how we avoid the next pandemic which is important. I appreciate your work on this. We can do a lot better next time!!#
— Bill Gates (@BillGates) January 11, 2022
盖茨:谭德塞博士已经开启了新对话,讨论我们如何避免下一次大流行,这很重要。我很赞赏您在这方面的工作。下次我们可以做得更好!!
We definitely can. Thanks for your time & insights & let's continue the good fight to improve health & well-being for those living across the world.💪We're all interconnected & in this together.
— Prof. Devi Sridhar 🌈 (@devisridhar) January 11, 2022
斯里达尔:我们一定可以做得更好。感谢您的时间和见解,让我们继续为改善全世界人民的健康和福祉而奋斗。💪我们同舟共济,一起应对公共卫生挑战。
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