字幕列表 影片播放 自動翻譯 列印所有字幕 列印翻譯字幕 列印英文字幕 This is a chart of Covid-19 cases in the UK. 這是英國的Covid-19病例圖。 In April, the UK's rate of new cases climbed so high that it was second only to the US. 4月，英國的新增病例率攀升至僅次於美國。 Around that time, researchers at Oxford University who were developing a Covid-19 vaccine 大約在那個時候，牛津大學的研究人員，他們正在開發一種Covid-19疫苗 had started planning to do a large-scale test of the vaccine in the UK. 已開始計劃在英國進行大規模的疫苗測試。 But by July, new Covid-19 cases in the country had fallen. 但到了7月，國內新發的科維德-19病例有所下降。 It was good news -- but it also meant the UK was no longer a good place to test a vaccine. 這是一個好消息--但這也意味著英國不再是一個測試疫苗的好地方。 And that's because of a crucial part of the process of testing any new vaccine: 而這是因為在測試任何新疫苗的過程中，有一個至關重要的環節。 What's called the Phase III human trials. 所謂的三期人體試驗。 Before we can end the coronavirus pandemic, a vaccine developer will have to give tens 在我們結束冠狀病毒大流行之前，一個疫苗開發商將不得不給數十種 of thousands of participants either the vaccine or a placebo. 數千名參與者的疫苗或安慰劑。 And then... we wait, for months, or possibly years, 然後... ... 我們等待，幾個月，或可能幾年。 to see how many of each group eventually gets Covid-19, 來看看每組最終有多少人得到科維德-19。 while the participants go about their lives; which, right now, 而參與者卻在忙碌著自己的生活；這，就是現在。 probably means they are living under Covid-19 restrictions, 可能意味著他們生活在Covid-19的限制之下。 like wearing masks and staying at home. 喜歡戴口罩，呆在家裡。 But until enough of those participants get sick, there won't be enough data 但在足夠多的參與者生病之前，不會有足夠的數據。 on whether the vaccine is working. 關於疫苗是否有效。 And in the meantime, thousands of people are dying of covid-19 every day. 而與此同時，每天都有成千上萬的人死於covid-19。 That's why, some people are starting to advocate a different, more controversial model: 所以，有人開始提倡另一種更有爭議的模式。 Instead of waiting for the coronavirus to eventually infect some of these people.... 與其等著冠狀病毒最終感染其中一些人......。 What if we gave a group of willing volunteers the virus on purpose? 如果我們故意給一群自願者提供病毒呢？ “I'm a young guy, I'm 23 years old, I'm relatively healthy.” "我是個年輕人，我今年23歲，我比較健康。" “I have no pre-existing health conditions. "我沒有任何原有的健康狀況。 I have no children, no dependents.” 我沒有孩子，沒有依靠。" “It's really important that we do everything we can to speed up research and development.” "我們盡一切可能加快研發速度，這真的很重要。" It's 2016, and this man is about to drink a test tube of the bacteria that causes typhoid. 現在是2016年，這個人要喝下一管引起傷寒的細菌的試管。 He's one of about 100 participants who deliberately infected themselves with it 他是大約100名參與者中的一員，他們故意讓自己感染了這種病毒 to test a new vaccine in the UK. 以在英國測試一種新疫苗。 “In March 2016 I downed a shot of typhoid.” "2016年3月，我打下了一針傷寒針。" Daina was another participant. 達伊娜是另一個參與者。 She was a PhD student, who needed the money, but she also liked the idea of it. 她是個博士生，需要錢，但她也喜歡這個想法。 “It was like, you know, I'm helping to make this disease less deadly.” "就好像，你知道，我在幫助讓這種疾病不那麼致命。" This kind of study is called a human challenge trial. 這種研究稱為人類挑戰試驗。 And in the case of the typhoid vaccine, researchers told the New York Times 而在傷寒疫苗的案例中，研究人員告訴《紐約時報》。 that doing the challenge trial saved them three or four years. 說做挑戰試驗為他們節省了三四年的時間。 To put that in context, it helps to look at the bigger picture of how a vaccine normally gets developed. 要想了解這一點，從更大的角度來看疫苗通常是如何被開發出來的，是有幫助的。 The first step in the process is to test a vaccine in a lab on either human cells, or on animals, 這個過程的第一步是在實驗室裡對人類細胞或動物進行疫苗測試。 just to see if it causes any harm. 只是想看看它是否會造成任何傷害。 This is called the preclinical phase. 這就是所謂的臨床前階段。 If it passes that test, it enters human trials. 如果它通過了這個測試，就進入了人體試驗。 This is the longest and most important part. 這是最漫長也是最重要的部分。 If it passes human trials, the vaccine gets licensed by regulators, 如果通過人體試驗，疫苗就會得到監管部門的許可。 and can be manufactured and distributed to the public. 並可以製造和向公眾分發。 Human trials typically have 3 phases, each one testing a larger and larger group of people. 人體試驗一般有3個階段，每個階段測試的人群越來越多。 Phase 1 involves a very small group of people, maybe 50, and mainly tests if the vaccine is safe. 第一階段涉及的人群非常少，大概50人，主要是測試疫苗是否安全。 Phase 2 usually involves a few hundred participants. 第二階段通常有幾百人參加。 This is where we start learning if the vaccine actually works. 這就是我們開始瞭解疫苗是否真的有效的地方。 And then there's the final test: the Phase 3 trial. 然後是最後的測試：3期試驗。 It's expensive, it takes time, it requires tens of thousands of volunteers, and it involves 這是昂貴的，它需要時間，它需要數以萬計的志願者，它涉及到 as broad a cross-section of participants as possible. 儘可能廣泛的跨部門參與者； The entire process of developing a vaccine usually takes around ten years. 整個疫苗的研發過程通常需要十年左右的時間。 But many Covid-19 vaccine developers are racing to compress this entire process into about 但許多Covid-19疫苗的研發人員正在競相將這一整個過程壓縮到大約 a year and a half. 一年半的時間。 One way they're doing this is to overlap the different phases, 他們的一個方法是將不同的階段重疊起來。 conducting several different trials at once. 同時進行幾個不同的試驗； Or, to ramp up the manufacturing of a vaccine 或者，加大疫苗的製造力度。 while it's still being tested, so that if it works, it can be distributed right away. 趁著還在測試中，如果能用，就可以馬上分發。 As of the making of this video, 截止到這段視頻的製作。 there were 166 Covid-19 vaccines in various stages of development. 有166種Covid-19疫苗處於不同的開發階段。 24 vaccine candidates are already in the human trial phase. 24種候選疫苗已經進入人體試驗階段。 And 5 of them are already in Phase III. 而其中5家已經進入第三階段。 For these leading candidates, a human challenge trial could save weeks, or months, 對於這些領先的候選人來說，人類挑戰試驗可以節省數週，或者數月的時間。 by augmenting a Phase III trial that isn't getting data fast enough. 通過增強一個沒有足夠快獲得數據的三期試驗。 And for any of these candidates in pre-clinical phases, 而對於這些處於臨床前階段的候選者來說。 a challenge study, followed by a larger-scale safety study for the vaccine, 挑戰性研究，然後進行更大規模的疫苗安全研究。 could replace a Phase III trial altogether. 可以完全取代三期試驗。 A challenge trial that successfully shrinks down this timeline could save thousands of lives. 一個挑戰試驗，如果能成功縮減這條時間線，可以挽救成千上萬的生命。 And so far, a grassroots movement has recruited more than 30,000 volunteers, from over 100 countries, 而到目前為止，一場草根運動已經招募了3萬多名志願者，來自100多個國家。 who said they would participate in a challenge trial for covid-19 if it happens. 誰說他們會參加covid-19的挑戰試驗，如果它發生。 “My moral values say that I kind of have an obligation to do what I can to help.” "我的道德觀認為，我有義務盡我所能去幫助別人。" “I see it as very similar to other acts of public service, like trying to fight climate change, "我認為這與其他公共服務行為非常相似，比如努力應對氣候變化。 and disastrous events that are forthcoming that are the consequences of a lack of care.” 和即將發生的災難性事件，這些都是缺乏關愛的後果"。 “It's affecting, literally, pretty much every person globally. "它影響到了，簡直是影響到了全球幾乎每一個人。 I feel like I need to do something to help.” 我覺得我需要做一些事情來幫助你。" Here's the problem. Human challenge studies have been used before 這就是問題所在。人類挑戰研究之前已經被使用 for cholera, typhoid, malaria, influenza and the common cold. 霍亂、傷寒、瘧疾、流感和普通感冒。 But there's a big, important difference that sets covid-19 apart. 但covid-19有一個很大的重要區別，就是與眾不同。 “For each of those conditions, we do have effective treatments so that we know, "對於每一種情況，我們都有有效的治療方法，所以我們知道。 to my knowledge, no one has ever actually ever died in those studies.” 據我所知，沒有人真正在這些研究中死去。" Peter Smith is one of the world's leading epidemiologists, and he was one of the first 彼得-史密斯是世界上著名的流行病學家之一，他是最早的。 to advocate for the possibility of human challenge trials, in March of this year. 以倡導人體挑戰試驗的可能性，今年3月。 He says, because there's no covid-19 treatment, it limits who could participate in a challenge study. 他說，因為沒有covid-19治療，它限制了誰可以參加挑戰研究。 “The challenge trial would necessarily be done in people "質疑審判必然會在人 who were at very low risk of serious disease." 誰的嚴重疾病風險非常低"。 In other words, unlike in a typical Phase III trial, where you'd recruit the widest range of people possible, 換句話說，與典型的III期試驗不同，在那裡你會招募儘可能廣泛的人群。 a Covid-19 challenge trial would produce data on a much narrower group of young, healthy people. Covid-19挑戰性試驗將產生關於範圍更窄的年輕、健康人群的數據。 And we don't know if a vaccine that works for that group would work for everyone. 而且我們不知道對該群體有效的疫苗是否會對所有人有效。 But the immediate goal is not to get a single Covid-19 vaccine that offers perfect protection. 但眼前的目標並不是要得到一種能提供完美保護的科威德-19疫苗。 In the US, to be deemed sufficiently effective, a vaccine just has to work 50% better than 在美國，要想被認為是足夠有效的疫苗，疫苗的效果必須比普通疫苗好50%。 not being vaccinated. 不接種疫苗； An imperfect vaccine could still slow the spread of the virus. 一個不完美的疫苗仍然可以減緩病毒的傳播。 The bigger issue with a covid-19 challenge study 更大的問題是covid-19的挑戰研究 is that there's no way to guarantee that it's actually safe for participants. 是沒有辦法保證它對參與者的實際安全。 On one hand, the risk of hospitalization for young people is relatively low. 一方面，年輕人住院的風險相對較低。 And a study of the outbreak in New York City suggests the risk of death for young people 而紐約市的一項疫情研究表明，年輕人的死亡風險很大 is as low as 0.01 percent. 是低至0.01%。 And advocates for Covid-19 challenge trials say that's a level of risk we already accept 而Covid-19挑戰試驗的倡導者說，這是我們已經接受的風險水準了 in similar situations. 在類似情況下，。 They point out it's even lower than the risk of fatality from donating a kidney. 他們指出，這甚至比捐獻腎臟的死亡風險還要低。 But any risk of harm or death at all would still set it way apart from any other challenge study. 但任何傷害或死亡的風險在所有仍然會設置它的方式與任何其他挑戰研究。 And the long-term risks of Covid-19 for those who recover are still almost entirely unknown. 而科維德-19對康復者的長期風險仍幾乎完全未知。 We emailed nearly all of the institutions who were reachable who are currently developing 我們給幾乎所有能夠聯繫到的、目前正在開發的機構都發了郵件。 a vaccine, to see whether they would consider human challenge trials. 疫苗，看他們是否會考慮進行人體挑戰試驗。 And none would go on the record saying they are considering it. 而沒有一個人願意去公開說他們正在考慮。 But we know at least one is seriously considering it. 但我們知道至少有一個人在認真考慮。 Developers of the Oxford University vaccine said that they hope to do challenge trials 牛津大學疫苗的研發人員表示，他們希望能做挑戰實驗 by the end of the year. 到今年年底，。 In 2016, the World Health Organization's stance on challenge studies was that 2016年，世界衛生組織對挑戰研究的態度是：1． "it would not be ethical or safe” to use them for a disease that is “virulent,” and has "將它們用於治療 "毒性 "很強的疾病是不道德的，也是不安全的"。 no “existing therapies” to treat it. 沒有 "現有療法 "來治療它。 But in May of this year, they released new guidelines, saying that they could theoretically 但在今年5月，他們發佈了新的指導方針，稱理論上可以。 be considered if there was confidence that “the potential benefits of SARS-CoV-2 challenge studies 如果對 "SARS-CoV-2挑戰研究的潛在效益 "有信心，則可考慮進行以下研究 outweigh the risks.” 勝過風險。" If challenge studies do reduce the time it takes to get a vaccine, those benefits are clear. 如果挑戰研究確實能縮短接種疫苗的時間，這些好處是顯而易見的。 If the current leading candidates have quick, successful Phase III trials, we may never 如果目前領先的候選藥物能夠快速、成功地進行III期試驗，那麼我們可能永遠不會 need to do a challenge trial for Covid-19 at all. 根本不需要對Covid-19進行挑戰試驗。 But if we do, it'll only be possible because there are people out there willing to take on this risk. 但如果我們這樣做，那就只有可能了，因為外面有人願意承擔這個風險。 “It's worth it to me to save the lives of a countless number of people. "能挽救無數人的生命，我覺得很值得。 “I'm happy to take that small risk to myself… and make things better for a lot of people.” "我很樂意為自己冒這個小風險... ...讓很多人的生活變得更好。" “Feeling like I was doing nothing, and just feeling miserable and demoralized, "感覺自己什麼都沒做，只覺得很痛苦，很喪氣。 to being like, OK, I have something I can do here.” 要像，OK，我有東西 我可以在這裡做。" “I'm a lot less at risk than my parents and grandparents are, "我比我的父母和爺爺奶奶少了很多風險。 And my moral imperative tells me I have to do it.” 而我的道德要求告訴我，我必須這麼做。"