“不可接受”:中国隐瞒新冠肺炎数据

Maria Van Kerkhove领导世界卫生组织在新发疾病方面的工作。本周，由于最近披露了武汉此前未发布的有关Covid-19起源的信息，她在《科学》杂志上发表了一篇尖锐的社论，她说:“三周前，世界卫生组织(世卫组织)获悉，中国科学家拥有2020年1月收集的武汉病毒样本数据，这些数据本应立即与全球研究界共享，而不是三年后。缺乏数据披露是不可原谅的。”强大的语言。那么她指的是什么数据，我们应该如何回应呢?

玛丽亚:这是在武汉海鲜市场收集的数据。可用的数据包含分子证据。在那个市场上确实有动物出售。这是有嫌疑的，但没有得到证实。但同时，在市场上出售的一些动物对SARS冠状病毒感染很敏感。这意味着存在潜在的中间宿主。对于像我这样的科学家和世界各地的公共卫生专业人员来说，这是一个非常重要的发现，因为这些病毒有时会通过另一种可能出现在市场上的动物传播。我们称这些中间宿主为感染人类之前的宿主。因此，这些数据提供了更多的线索，表明在那个市场上存在中间宿主。这是新的信息。

克里斯:这些数据是如何被发现的，在此期间又在哪里呢?

玛丽亚:嗯，这些数据是由中国疾病预防控制中心生成的，并提交给GISAID，这是一个存储序列信息和数据的平台，我们称之为元数据。这是关于样本收集日期的补充数据，这些样本来自哪里，只是提交给GISAID的更多信息，这是中国一个小组所做研究的一部分，该小组去年夏天发表了一份关于样本的预印本。所以这些数据是存在的，这些样本的样本收集日期是2020年1月。因此，作为一个全球社区，我们面临的挑战是，这些信息已经存在了三年多。我们需要分享这些信息，以便进行分析。这才是最重要的。这才是真正的关键。也许你没听我说话是因为我觉得我已经直言不讳太久了，因为这不是游戏。这是为了了解这场已造成至少700万人死亡、扰乱了我们每一个人的生活、改变了未来的大流行——我们必须了解它是如何开始的。像这样的数据是非常重要的，因为通过了解这些信息，我们采取措施来减轻，防止这种情况再次发生，因为不幸的是，这种情况会再次发生。

到目前为止，世界卫生组织已经进行了一项分析，早在2020/21年，人们就认为是什么引发了这场大流行。当时世卫组织要求提供样本，中国拒绝提供，现在仍然拒绝提供。这也属于同样的心态吗?在这里，从源头获取信息被证明是非常具有挑战性的。如果是，为什么?

玛丽亚:你指的是国际科学家和中国科学家在2021年1月至2月进行的一项任务，目的是了解火星的起源。这是一个专门研究SARS冠状病毒2起源的任务。他们在2021年3月发表了一份报告，概述了他们能够确定的内容。在那份报告中，有一些研究建议需要进行。它包括市场上的样本追踪动物，做血清学，通过在市场上工作的人在动物身上的抗体来寻找过去感染的证据。任何疾病爆发的开始都是极具挑战性的。你一开始主要关注的是五个问题。这是什么?它是如何传播的?感染的程度如何? How far has it spread already? What disease does it cause and what do we do? And at the time, the cat was out of the bag so to speak; the virus was already spreading. And so a lot of the efforts early on were on putting out that fire, stopping human to human transmission, reducing the morbidity and mortality because we were seeing huge increases in deaths and hospitals were being overwhelmed. But in addition to that, there's always work that's done at that initial source or what you think is the initial source. We knew the market played a really important amplification role because most of the cases were associated with that market. So the market was closed, the market was disinfected. That was the right thing to do. But what also happens at that time is samples would be collected. Those samples were collected, we knew that was happening. That's where some of the early sequences were identified, as well as some of the early sequences from the patients. And the question is, what happened to that information? Were there studies that actually traced the animals that we now know were sold? Were these wildlife, were these domestic species? Was this legal trade or illegal trade? And that's not a blame question, it's just getting to these answers. Because we can't come away with this pandemic and say, we need better surveillance, we need better reporting. We need to actually know the exact drivers of this. Where did they come from in terms of the trade routes? What were the animal species that were there, the conditions by which they were raised, the conditions by which they were sold so that we could do better, we could prevent this from happening again. So a lot of those early days, that early work, I believe more was done. There's incredible scientific knowledge in China that this work maybe was done. And that's what we're questioning. We keep questioning has this work been done? And if so, that data needs to be shared immediately.

然而，世界卫生组织却因为一开始几乎照本宣科而受到批评。人们说，“当调查进行的时候，你让一出木偶戏上演了，因为人们在一个舞台管理的方式下从一个地方迅速到另一个地方。我们需要这些样本和数据，我们能否看到中国各地的污水样本或血液样本，以评估疫情的蔓延情况?”这些样品还没有提供。人们确实想知道，还有什么东西是可以和应该分享的。为什么中国如此拒绝让世界卫生组织这样的组织获得这一信息，以帮助预防下一次大流行?

玛丽亚:是的，我认为这是在改写历史。因为你知道我们在公开场合说过什么，我们对中国说过什么，我们对所有成员国说过什么，我们在闭门会议上说过什么，我们对已知病例的信息提出了过多的要求，包括感染程度、病例定义、正在进行的检测、从人类、动物身上收集的样本，以及从任何可能的地方收集的样本。这些都是反复要求的。作为世卫组织，很多人认为我们可以空降到任何我们想要的国家，走进前门，说给我们样本。我们没有能力亲自去各个国家收集样本，然后带着这些样本走出去。你知道，人们在电影中看到的那种贴着生物危害标签的行李箱——这是不可能发生的。听着，我和你们所有人一样对为什么我们不能获得这种机会感到沮丧。我们通过各种渠道开展工作，科学渠道、技术渠道、外交渠道。再次强调，这不是游戏。我们不是在这里玩，然后说，你知道吗? It would be nice to have access to this information. We need access to this information so that we can do better the next time.

Chris -国际上让人们感到非常沮丧的一件事是，中国在这一领域已经形成了，因为即使是在20年前，当第一次SARS出现时，他们也做了类似的事情。有证据表明这是流传的。我们认为，中国在告诉世界其他国家之前，可能已经知道它在传播了六个月。然后它逃出了中国的边界，有成千上万的病例。有将近一千人因此死亡。人们批评中国说，你需要更加透明。20年后的今天，历史正在重演。现在我们回到了我们在这里开始讨论的问题，为什么会有这种沉默来更加开放?为什么不分享这些数据，除非像一些人声称的那样，有什么要隐瞒的?

玛丽亚:我的意思是这不是健康问题。我认为这与你问的其他问题有关。分享的动机是什么?更重要的是，分享的阻碍因素是什么?现在，我们的重点是中国，但我们在报道来自许多国家的信息方面确实面临挑战。在过去的几年里，特别是去年，我们爆发了其他病原体的疫情。我们面临着从各国获取信息的挑战。这是我们必须面对的问题和挑战，我们必须研究激励因素和抑制因素。我可以跟你们谈谈为什么分享这些信息很重要，为什么世界需要保持警惕，为什么我们需要更快地采取行动，为什么预防某些事情发生比试图控制它并在它开始传播时结束它要好得多。我可以和你们谈谈财政影响，花100万美元或10亿美元用于流行病防范，比我们现在花在应对和2019冠状病毒病经济影响上的数万亿美元要好得多。 I can talk to you about governance. I could talk to you about responsibility and accountability. What I can't do is force countries to adhere to this. I do think this is why something like a pandemic accord is so important. It's a promise that we will do better, that governments will do better, that everybody has a responsibility and a collective responsibility to do better. Because forget these borders that we have within our countries. These viruses, these pathogens don't respect borders. We live in a completely interconnected world where a virus that passes from an animal to a human or passes - let's say it was a breach in biosafety or biosecurity - into humans. Once it's efficiently transmitting within humans, it can go from one part of the world to the completely opposite part of the world in 24 to 48 hours. That's why everything that we've done for Covid 19 in terms of surveillance, sequencing, improved diagnostics, sharing of information, better data management systems, better analytics, has to be maintained. Because if we dismantle these systems and say, oh, we'll just scale them up for the next time, we're living in a fantasy world. This will happen again. But we have not addressed, and we have not moved forward on this issue of transparency and sharing. And frankly, I'm very concerned that we're almost in a worse situation than we were before this pandemic began. And that is because of the politicisation. That is because no one wants to find that next pandemic virus. No one wants to be blamed for this. But collectively, as a species, we all need to be working together on this.