流行病：如何预防流感大爆发（2020）

（美国加州旧金山）
（莎拉艾维斯 分布式生物首席科学家）
So, while we were giving the lab tour,
我们带人参观实验室的时候
I looked down at my phone and noticed that that email had come in.
我看了一下手♥机♥ 发现收到了邮件
（杰克格兰维尔 分布式生物 共同创始人 首席科学官）
We're opening the Gates email.
我们要打开盖茨基金会的邮件了
No matter what, uh...
无论如何
if we don't get it...
如果我们没拿到拨款
If we don't get it... The possibilities are we don't get it
如果我们没拿到拨款 拿不到的可能性也还是有的
or we get it but it's different than what we thought or--
也可能拿到了 却和我们想的不一样
-I think we should just open the email. -All right, let's just do it.
-我想我们还是把邮件打开吧 -好的 来吧
Tear off the Band-Aid. Let's see.
长痛不如短痛 来吧
"Grand Challenges universal vaccine developments full proposal...
“通用疫苗开♥发♥大挑战完整建议书…
congratulate you on being selected to move forward.
祝贺你被选中继续开♥发♥
This is a very competitive process.
这是个竞争非常激烈的过程
We're excited to work with you more closely on your project.
我们很愿意就你的项目 与你进行更紧密的合作
Program officer and program fully funded."
提供项目官员和全额项目资金”
I've been waiting nine years for this.
我等这一刻已经等了九年了
We heard back, and...
我们收到了回音
-it's yes. -
是“同意”
Let's do a Champagne toast.
我们来干一杯香槟
-I'll tell everybody. -Yeah, sure.
-我来告诉大家 -好的 没问题
Are you happy? Happy.
你开心吗？开心
Yeah, I am happy. I'm fucking stoked.
-这是好消息 -是的 我很开心
We've won the grant,
我们赢得了拨款
and that gives me the optimism
让我觉得很乐观
to be able to move forward without worrying about funding.
能够继续前进而不用担心资金
To our piggies.
-致我们的猪猪 -耶 好兴奋
To the piggies.
致猪猪们
Right now, I feel confident, but a little antsy.
目前 我感觉很有信心 但也有点焦虑
We need to finish the job
我们得要完成工作
with the latest test of our flu vaccine and our pigs in Guatemala.
借助我们最近的流感疫苗测试 和我们在危地马拉的猪
Cheers.
干杯
片名：流行病
（第一章 付出代价）
（美国俄克拉荷马州沃里卡）
Take another deep breath.
再深呼吸一次
And again.
再来一次
So the swab can tell us if it's the flu.
取样能让我们判断这是不是流感
It's pretty accurate but it can... You know, we can miss a couple of cases.
挺准确的 但也还是会… 我们也可能会搞错几个病例
（霍莉戈拉克医生 内科医师兼员工主管）
They said that you'd been tested last week or that you'd been sick last week.
他们说你上周做过检查 还是你上周一直生病？
-But it came back negative... -Right.
-但结果是阴性 -对
As the flu season kind of wears on,
流感季依然在持续
we're busier and we're having sicker patients.
我们变得更忙 遇到的病人病情也更严重
We get tired and we're really looking forward
我们变得疲惫劳累
to the end of flu season.
真的希望流感季赶紧结束
While I was working, the chills hit...
我在工作的时候着了凉
and I started feeling worse and then the coughing hit.
我开始感觉不舒服 接着就开始咳嗽
And then we did the flu swab and it was negative.
然后我们做了流感检查 结果是阴性
So I'm like, "I'm fine. I'll just wear a mask." And I kept working.
我想：“我没事 我戴口罩吧” 然后继续工作
That was on a Monday afternoon.
那是周一下午
Draw labs and get an IV and we'll run his urine...
抽血取样 打点滴 我们会检查他的尿样
My shift was Monday through Thursday morning.
我的班次是从周一到周四早晨
So I knew this was early on. I have to just push.
所以我知道离下班还早 我得要坚持
He'll probably get a chest X-ray, too.
他可能还得做个胸透
I decided...
我决定…
Tuesday afternoon that I would test myself again,
周二下午的时候 再给自己做个检查
and I was positive for the flu.
结果我得了流感
It shocks me every time I get the flu how much it hurts.
得了流感后的痛苦 每次都能震惊我
The muscle aches and joint pain
肌肉痛和关节痛
and the bad headache and just coughing and feeling so tired,
糟糕的头痛 还有咳嗽 感觉非常疲劳
but still feeling too miserable to even sleep.
但却又难受得睡不着觉
I get the flu shot because I want to protect myself as much as possible,
我接种了流感疫苗 因为我想尽可能保护自己
but with the flu shot, it's not 100%.
但流感疫苗也不是100%有效
I tell my patients that they need good rest and they need to eat healthy.
我告诉我的病人 得要好好休息 健康饮食
"You need to make sure you're balancing your life. Don't work too much."
“你一定得要平衡好你的生活 不要工作太久”
And I think that I just don't follow my own advice.
我想我自己却没有听从这些建议
I don't get enough sleep, and I'm very stressed in my position.
我睡眠不足 而这份工作的压力很大
It does put me at a place where I'm at risk for having more illness.
这的确让我有患上更多疾病的风险
Probably, I'm putting myself at risk for having a heart attack and stroke
我可能会得上心脏病 中风
and high blood pressure,
还有高血压
but that's the nature of the job.
但这份工作就是这样
（印度拉贾斯坦邦斋浦尔）
There has been a rise in swine flu cases across India this winter season,
今年冬季 印度各地的 猪流感病例数都在上升
and Rajasthan is where the impact has been felt the most.
而拉贾斯坦邦是情况最严重的地方
Are you seeing an increase in patients this year?
今年病人数上涨了吗？
Definitely. There is a huge increase.
毫无疑问 非常大的涨幅
Authorities say that the sharpest spike in swine flu cases was seen last week.
当局称上周猪流感病例激增最为明显
The numbers are staggering.
数字触目惊心
Over 9,000 people are affected,
有九千多人被感染
which means that once it reaches that level again,
这也意味着 一旦数字再次达到那个水平
the spread will be that much faster.
扩散速度也会快得多
So are enough measures being taken to restrict the spread of this disease?
为限制这种疾病的扩散 政♥府♥有没有采取足够的措施？
（阿努普里亚阿格加瓦尔 住院医师）
So shift number five. There's an empty bed.
转到五号♥ 那是空床位
-Don't cough so loudly. -What else should I do?
-别咳得这么大声 -那我能怎么办？
-Cough normally. -
正常咳嗽
If you cough so loudly, it will hurt you.
如果你咳得太响 会伤到自己的
I am hurting.
我已经伤了
（迪内什维杰医生 纪念医院胸腔内科医生）
We have learned that every year
我们已经知道
these two months are the most hectic.
每年中这两个月是最忙的
We don't even see our own families.
我们连自己的家人都见不到
No lunch or anything. There was no time.
也没有午餐 根本没时间
But being a doctor is a passion.
但做医生是一种热情
I can work day and night.
我日夜都在工作
Patients who are very, very sick, obviously it's very difficult.
病人病情严重 这显然非常困难
What if the patient does not make it?
要是病人挺不住怎么办？
You follow that patient from day one,
你从看到病人到达急诊室起
when you see that patient arriving in the Emergency.
就会一直跟随着病人
Majority of the doctors get very attached to their patients,
大部分医生都会与他们的病人 建立起很紧密的关系
and every time we lose a patient, it really hurts.
而我们每次失去一位病人都会很痛苦
（拉杰库马尔 流感病人）
When Rajkumar came to us, he was very, very sick.
拉杰库马尔到我们这里时 病情已经非常严重了
Take an X-ray for me now and send it to OPD.
现在帮我拍张X光 然后送去门诊
When Rajkumar arrived at the hospital, he could hardly breathe.
拉杰库马尔到达医院的时候 几乎都不能呼吸了
He was completely deteriorating.
他已经完全恶化了
When I attended to him, he was extremely hypoxic.
等我来处理他的时候 他已经极端缺氧了
Hypoxia means there is a lack of oxygen in your body.
组织缺氧意思是你的身体里缺少氧气
His oxygen saturation was around 30-35%.
他的氧气饱和度大约是30-35%
We had to intubate him immediately and put him on a ventilator.
我们必须立即给他插管 接上呼吸机
He was kept unconscious through sedation.
通过镇静让他保持昏迷状态
There is a lot of stress, whether he'll make it or not.
不管他挺不挺得住 压力都很大
Although deep inside, they're very worried,
虽然在内心深处 家属都非常担心
the family has full trust in us.
但他们还是完全信任我们
His children are getting married on the 9th and 10th of March.
他的孩子们要在3月9日和10日结婚
But his health is more important now.
但他的健康更重要
If he gets well, it's fine, or else we will try to postpone the wedding.
如果他恢复了 那就没问题 如果没有 我们就会推迟婚礼
Let's see.
再说吧
Get his X-ray sent to me in OPD.
把他的X光片送来门诊给我
We have to prone him at two o'clock, okay?
我们必须在两点钟让他俯卧 好吗？
Proning is a way of placing the patient.
俯卧是放置病人的一种方式
If the patient is not getting sufficient oxygen from the ventilator
如果病人平躺时无法从呼吸机
when lying on his back, then we place him on his stomach,
获得足够氧气 那我们就把他翻过来
so that even his lower lung will open up with the pressure.
这样他的下肺也能在压力作用下张开
If after proning, his saturation is not improved,
如果俯卧之后 他的饱和度也没有改善
then it means his mortality is almost confirmed.
那就意味着他基本上死定了
（第二章 登月计划）
（美国纽约州纽约市）
Being a Muslim, it shapes my daily life.
作为穆♥斯♥林♥ 我的日常生活都以此为基础
（赛拉医生 特殊病原体项目高级总监）
With our busy schedule these days,
我们的日程这么繁忙
it's hard to attend various programs, events or prayers,
我很难有机会去参加各种项目 活动或祷告
but I always try to make the time to go.
但我一直试图抽时间去参加
-Thank you. -You're welcome.
-谢谢 -不客气
Will everyone please come in close?