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这个国家很小,但新冠病毒的检测水平比美国还先进

这个国家很小,但新冠病毒的检测水平比美国还先进

Vivienne Walt 2020年03月31日
该国的一家生物制药公司发挥了很大作用。

新型冠状病毒在世界范围内疯狂肆虐的这两个月里,包括美国在内,大多数国家都选择只对那些出现了明显症状的人进行病毒检测,并告诉其他人,如果他们怀疑自己感染了冠状病毒,就去自我隔离。基于这种方法,自去年12月该病毒首次出现于中国武汉以来,已经有80万人的病毒检测结果呈阳性,其中美国就有超过16万人。

如果展开随机检测的话,当局能了解到什么呢?或许,在冰岛这个小国家能找到些线索。到目前为止,该国已经对11727人进行了检测——约占其36.4万总人口的3.2%。之所以能够如此,部分也是因为该国备受赞誉的生物制药公司deCODE Genetics在这场危机中提供了帮助。

冰岛雷克雅未克市中心议会大厦附近的一条购物街。该国针对新型冠状病毒的检测比例尤为突出。图片来源:SPENCER PLATT—GETTY IMAGES

自3月14日起,加利福尼亚生物科技巨头安进公司(Amgen)的子公司deCODE就开始为全体冰岛公民提供免费的冠状病毒检测。无论身体健康还是出现病症,冰岛人只要在网上填写一份表格即可参加检测。本月,DeCODE将与冰岛公共卫生部门展开合作。自2月初以来,公共卫生部门一直在对高危和感染人群进行冠状病毒筛查,而筛查开始数周之后,冰岛才出现首个检测结果呈阳性的病例。

科学家们表示,通过对健康和感染人群的筛查,冰岛政府和deCODE公司已经收集了一份相当精确的新型冠状病毒图谱。筛查结果很能引人深思。上周三,在雷克雅未克的办公室里接受《财富》杂志的电话采访时,deCODE公司创始人兼首席执行官卡里·斯蒂芬森表示:“对高危易感人群的筛查结果显示,这种病毒在社区内的传播范围比我们想象的要大得多。”截至上周四, 已有737人的病毒检测结果呈阳性,约占冰岛全国总检测人数的6.3%。有15人住院治疗,其中2人已经进了重症监护室。其余确诊病患——有很多人都未出现症状——已被勒令进行自我隔离。

斯蒂芬森说,该公司的最终目标是对冰岛三分之一的人口进行检测——其比例相当于美国对约1.15亿人进行检测。他补充说,本周deCODE公司的病毒检测速度有所放缓,因为他们正忙于补充棉签的库存,这几天就会开始提速。斯蒂芬森解释说,检测是为了追踪每一个病例:“假设某社区约有3000人感染了病毒,那么为了在一段时间内控制住疫情,我们就得进行更多的筛查,找到被感染的人,把他们隔离起来。”

随机检测的意义

DeCODE公司的做法与美国及欧洲大多数国家的做法形成了鲜明对比。在欧洲,只有那些表现出明显感染迹象的人才会接受冠状病毒检测。在周日的新闻发布会上,美国副总统迈克·彭斯说:“如果你没有出现症状,就不需要做病毒检测。”美国疾病控制与预防中心也给出了类似的建议,“不必给所有人做检测。大多数人都只出现了轻微的症状,待在家里就能自己康复。”

现年70岁的斯蒂芬森曾是哈佛大学的一名神经学教授。1996年,他回到冰岛创办了自己的公司。他认为,政府没有足够的数据来追踪冠状病毒的起源,所以才不知道如何控制住疫情的传播。

他说,在开始做随即检测之前,“他们对病毒在社会上传播的方式和原因都完全没有概念。事情就是这么简单。”

斯蒂芬森表示,冰岛政府2月份开始提供检测时,就估计那些在寒假期间从阿尔卑斯山滑雪旅行归来的游客中会有人感染上病毒,因为当时意大利和法国的阿尔卑斯山地区已经爆发了疫情。公共卫生部门也确实发现了受感染的游客。但从英国返回冰岛的人群中也发现了一组感染病例,还有从美国返回的一例:这些感染者体内的冠状病毒都经过了变异。斯蒂芬森说:“截至昨天,我们已经获得了大约380种病毒的序列。”该公司计划在本周以公共数据库的形式对外公布关于变异病毒的数据。

在围绕自我隔离的激烈辩论中,冰岛保持着令人惊奇的冷静。该国没有下达封锁法令,只是敦促人们尽可能地呆在家里。各小学也依然照常上课。

相比于强调自我隔离,该国更加重视检测。冰岛前总理大卫·京勒伊格松周二时在英国《旁观者》(The Spectator)周刊上发表了一篇文章,表示:“所有国家都应该听从世界卫生组织的建议,并以冰岛为榜样,‘检测、检测、再检测’。”他说,该国的检测策略“在全世界范围内几乎是独一无二的”。

当然,冰岛人口稀少,所以做检测要比其它大多数国家都容易得多,甚至比韩国容易。拥有5000万人口的韩国之所以能迅速控制住冠状病毒的传播,很大程度上要归功于政府积极的检测和隔离策略。在一封电子邮件中,冰岛卫生部的工作人员告诉《财富》杂志,该国参与检测人口占总人口的比例远远高于韩国,“从而对病毒的状态产生了有价值的见解。”

DeCODE公司——和冰岛这个国家——在分析其关于冠状病毒的发现方面都处于极其罕见的地位,或许还有可能发现一些人更容易感染、生病的原因。这对科学家来说非常有价值,因为他们正在竞相研究治疗方法和疫苗,试图避免冠状病毒未来再度爆发。

自24年前成立以来,DeCODE公司已经绘制了冰岛一半以上人口的DNA图谱。斯蒂芬森说:“我们可以从另一半人口中推断出数据。我们正处于合理的有利位置,可以开始探索这种病毒的易感性是否在某种程度上是由基因决定的。”目前,科学家们正在把DeCODE数据库中的DNA图谱与冰岛冠状病毒随机检测的结果进行对比,或许将成为新的可能。

斯蒂芬森说:“我们正在研究,试图生成一组重叠的数据。我不认为还有其它地方有这样的数据。”(财富中文网)

译者:殷圆圆

新型冠状病毒在世界范围内疯狂肆虐的这两个月里,包括美国在内,大多数国家都选择只对那些出现了明显症状的人进行病毒检测,并告诉其他人,如果他们怀疑自己感染了冠状病毒,就去自我隔离。基于这种方法,自去年12月该病毒首次出现于中国武汉以来,已经有80万人的病毒检测结果呈阳性,其中美国就有超过16万人。

如果展开随机检测的话,当局能了解到什么呢?或许,在冰岛这个小国家能找到些线索。到目前为止,该国已经对11727人进行了检测——约占其36.4万总人口的3.2%。之所以能够如此,部分也是因为该国备受赞誉的生物制药公司deCODE Genetics在这场危机中提供了帮助。

自3月14日起,加利福尼亚生物科技巨头安进公司(Amgen)的子公司deCODE就开始为全体冰岛公民提供免费的冠状病毒检测。无论身体健康还是出现病症,冰岛人只要在网上填写一份表格即可参加检测。本月,DeCODE将与冰岛公共卫生部门展开合作。自2月初以来,公共卫生部门一直在对高危和感染人群进行冠状病毒筛查,而筛查开始数周之后,冰岛才出现首个检测结果呈阳性的病例。

科学家们表示,通过对健康和感染人群的筛查,冰岛政府和deCODE公司已经收集了一份相当精确的新型冠状病毒图谱。筛查结果很能引人深思。上周三,在雷克雅未克的办公室里接受《财富》杂志的电话采访时,deCODE公司创始人兼首席执行官卡里·斯蒂芬森表示:“对高危易感人群的筛查结果显示,这种病毒在社区内的传播范围比我们想象的要大得多。”截至上周四, 已有737人的病毒检测结果呈阳性,约占冰岛全国总检测人数的6.3%。有15人住院治疗,其中2人已经进了重症监护室。其余确诊病患——有很多人都未出现症状——已被勒令进行自我隔离。

斯蒂芬森说,该公司的最终目标是对冰岛三分之一的人口进行检测——其比例相当于美国对约1.15亿人进行检测。他补充说,本周deCODE公司的病毒检测速度有所放缓,因为他们正忙于补充棉签的库存,这几天就会开始提速。斯蒂芬森解释说,检测是为了追踪每一个病例:“假设某社区约有3000人感染了病毒,那么为了在一段时间内控制住疫情,我们就得进行更多的筛查,找到被感染的人,把他们隔离起来。”

随机检测的意义

DeCODE公司的做法与美国及欧洲大多数国家的做法形成了鲜明对比。在欧洲,只有那些表现出明显感染迹象的人才会接受冠状病毒检测。在周日的新闻发布会上,美国副总统迈克·彭斯说:“如果你没有出现症状,就不需要做病毒检测。”美国疾病控制与预防中心也给出了类似的建议,“不必给所有人做检测。大多数人都只出现了轻微的症状,待在家里就能自己康复。”

现年70岁的斯蒂芬森曾是哈佛大学的一名神经学教授。1996年,他回到冰岛创办了自己的公司。他认为,政府没有足够的数据来追踪冠状病毒的起源,所以才不知道如何控制住疫情的传播。

他说,在开始做随即检测之前,“他们对病毒在社会上传播的方式和原因都完全没有概念。事情就是这么简单。”

斯蒂芬森表示,冰岛政府2月份开始提供检测时,就估计那些在寒假期间从阿尔卑斯山滑雪旅行归来的游客中会有人感染上病毒,因为当时意大利和法国的阿尔卑斯山地区已经爆发了疫情。公共卫生部门也确实发现了受感染的游客。但从英国返回冰岛的人群中也发现了一组感染病例,还有从美国返回的一例:这些感染者体内的冠状病毒都经过了变异。斯蒂芬森说:“截至昨天,我们已经获得了大约380种病毒的序列。”该公司计划在本周以公共数据库的形式对外公布关于变异病毒的数据。

在围绕自我隔离的激烈辩论中,冰岛保持着令人惊奇的冷静。该国没有下达封锁法令,只是敦促人们尽可能地呆在家里。各小学也依然照常上课。

相比于强调自我隔离,该国更加重视检测。冰岛前总理大卫·京勒伊格松周二时在英国《旁观者》(The Spectator)周刊上发表了一篇文章,表示:“所有国家都应该听从世界卫生组织的建议,并以冰岛为榜样,‘检测、检测、再检测’。”他说,该国的检测策略“在全世界范围内几乎是独一无二的”。

当然,冰岛人口稀少,所以做检测要比其它大多数国家都容易得多,甚至比韩国容易。拥有5000万人口的韩国之所以能迅速控制住冠状病毒的传播,很大程度上要归功于政府积极的检测和隔离策略。在一封电子邮件中,冰岛卫生部的工作人员告诉《财富》杂志,该国参与检测人口占总人口的比例远远高于韩国,“从而对病毒的状态产生了有价值的见解。”

DeCODE公司——和冰岛这个国家——在分析其关于冠状病毒的发现方面都处于极其罕见的地位,或许还有可能发现一些人更容易感染、生病的原因。这对科学家来说非常有价值,因为他们正在竞相研究治疗方法和疫苗,试图避免冠状病毒未来再度爆发。

自24年前成立以来,DeCODE公司已经绘制了冰岛一半以上人口的DNA图谱。斯蒂芬森说:“我们可以从另一半人口中推断出数据。我们正处于合理的有利位置,可以开始探索这种病毒的易感性是否在某种程度上是由基因决定的。”目前,科学家们正在把DeCODE数据库中的DNA图谱与冰岛冠状病毒随机检测的结果进行对比,或许将成为新的可能。

斯蒂芬森说:“我们正在研究,试图生成一组重叠的数据。我不认为还有其它地方有这样的数据。”(财富中文网)

译者:殷圆圆

In the two months since COVID-19 began its rampage across the world, most countries, including the U.S., have opted to test only those people with active symptoms, telling others to self-isolate if they suspect they are infected with the coronavirus. Based on that approach, more than 480,000 people have tested positive for the virus since it first appeared in Wuhan, China, last December, including more than 68,500 in the U.S.

But what might authorities learn if people were tested randomly instead? Some early clues may be found in the tiny country of Iceland. So far, the country has tested 11,727 people—about 3.2% of its population of 364,000. It has done so in part by enlisting the country’s prized biopharma company deCODE Genetics to help tackle the crisis.

Since March 14 deCODE, a subsidiary of the California biotech giant Amgen, has offered a free coronavirus test to any Icelander, sick or healthy, who simply fills out an online form. DeCODE joined forces this month with Iceland’s public health authorities, which had been screening high-risk or sick people for the coronavirus since early February, weeks before even the first Icelander tested positive for the virus.

By screening healthy as well as sick people, say scientists, Iceland and deCODE have assembled a far more accurate picture of COVID-19. And the results are sobering. “The virus had a much, much wider spread in the community than we would have assumed, based on the screening of high-risk people,” deCODE’s founder and CEO Kári Stefánsson told Fortune by phone from his office in Reykjavík on Wednesday. As of Thursday, 737 have tested positive, or roughly 6.3% of all people tested in the country. Of those, 15 are in hospitals, two of them in intensive care. The rest—many of whom are asymptomatic—have been ordered to self-quarantine.

Stefánsson says the company aims in the end to test about one-third of Iceland’s population—the equivalent of the U.S. testing about 115 million people. He adds that deCODE’s testing has slowed down this week, as the company scrambles to restock its supply of cotton swabs, but will ramp up again within days. “Let’s assume about 3,000 people in the community are infected,” Stefánsson says. The idea, he explains, is to track every case. “To contain the infection for some period of time, we need to screen more, find those individuals, and quarantine them.”

The value of random testing

DeCODE’s model stands in sharp contrast to that of the U.S. and most countries in Europe, where only those who show clear signs of infection have been tested for the coronavirus. “If you don’t have symptoms, you don’t need a test,” Vice President Mike Pence said in a press conference on Sunday. Similar advice comes from the Centers for Disease Control and Prevention, whose website notes, “[N]ot everyone needs to be tested. Most people have mild illness and are able to recover at home.”

Stefánsson, 70, who was a professor of neurology at Harvard University before returning to his homeland to launch his company in 1996, rejects that strategy. He believes it leaves governments unable to understand how to control the spread of the coronavirus, since they have too little data to track its origins.

Until they do random testing, he says, “they do not have the faintest idea of how and why it is spreading in the society,” he says. “It is as simple as that.”

Stefánsson says that when Iceland began testing people in February, it expected to find infections among those who had returned from skiing trips to the Alps during the winter vacation, because an outbreak was then beginning in Italy and France’s Alpine region. Indeed, public health authorities did find infected vacationers. But Iceland also found a cluster of infections among people who had returned from England, as well as one from the U.S.—each of which presented with a separate mutation of the coronavirus. “As of yesterday, we have sequences for about 380 viruses,” Stefánsson says. The company plans to release the data on those mutations in the form of public databases this week.

Amid the fraught debate over self-quarantining, Iceland has remained curiously calm. It has no lockdown laws in place, simply urging people to remain at home if possible. Elementary schools remain open.

Rather than stress self-distancing above all, the focus has been on testing. “All countries should listen to the World Health Organization and follow the example of Iceland when it comes to the mantra ‘Test, test, test,’” former Prime Minister David Gunnlaugsson wrote in Britain’s The Spectator on Tuesday. He called the country’s testing strategy “virtually unparalleled anywhere in the world.”

Of course, Iceland’s minuscule population makes it far easier to test there than in most other countries—including even South Korea, where the swift control of the coronavirus among its 50 million people is credited in large part to the government’s aggressive testing and quarantine strategy. In an email, Iceland’s Health Ministry tells Fortune the country has tested a far higher proportion of its population than South Korea has, “yielding valuable insights into the behavior of the virus.”

DeCODE—and Iceland in general—is in an exceedingly rare position in its ability to analyze its findings on the coronavirus, and perhaps detect what makes some people more susceptible to infection and illness. That could be hugely valuable for scientists as they race to develop treatments and vaccines, and try to stave off any future coronavirus outbreak.

Since launching 24 years ago, deCODE has mapped the DNA of more than half the population of Iceland, “and we can infer data from the other half,” Stefánsson says. “We are in a reasonably good position to begin to explore if the susceptibility to the infection is in part genetically dictated,” he says. As scientists compare the DNA in deCODE’s data banks with the results of Iceland’s random coronavirus testing, the possibilities might begin to emerge.

“We are working on that, trying to generate a set of overlapping data,” Stefánsson says. “I don’t think there is another place where there is data like this.”

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