知名美国制药公司是如何成为病毒“超级传播者”的
来源/作者:纽约时报
2020-04-15 02:01:13
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CODY OLOUGHLIN FOR THE NEW YORK TIMES
BOSTON On the first Monday in March, Michel Vounatsos, chief executive of the drug company Biogen, appeared in good spirits. The companys new Alzheimers drug was showing promise after years of setbacks. Revenues had never been higher.
波士顿3月的第一个周一,制药公司百健(Biogen)的首席执行官冯纳玺(Michel Vounatsos)看上去特别有精神。公司治疗阿尔茨海默症的新药在经历了多年挫折后显露出了希望。公司的收入从来没有这么高过。
Onstage at an elite health care conference in Boston, Mr. Vounatsos touted the drugs remarkable journey. Asked if the coronavirus that was ravaging China would disrupt supply chains and upend the companys big plans, Mr. Vounatsos said no.
冯纳玺在波士顿一个医药精英会议的主席台上大赞特赞该药的非凡历程。有人问他,当时正肆虐中国的新型冠状病毒是否会扰乱供应链、颠覆公司的宏伟计划时,冯纳玺说不会。
So far, so good, he said.
到目前为止,一切都好,他说。
But even as he spoke, the virus was already silently spreading among Biogens senior executives, who did not know they had been infected days earlier at the companys annual leadership meeting.
但就在他说这番话的时候,新冠病毒已在百健高管中悄悄传播,这些人不知道他们已在几天前公司召开的领导力年度会议上感染了病毒。
Biogen employees, most feeling healthy, boarded planes full of passengers. They drove home to their families. And they carried the virus to at least six states, the District of Columbia and three countries, outstripping the ability of local public health officials to trace the spread.
会后,这些百健员工大多数并无不适,他们登上了满载乘客的飞机。他们开车回到家中。病毒就这样被带到美国的至少六个州和哥伦比亚特区,还传到了其他三个国家,范围之广超出了当地公共卫生官员追踪病毒传播的能力。
The Biogen meeting was one of the earliest examples in the U.S. of what epidemiologists call superspreading events of Covid-19, where a small gathering of people leads to a huge number of infections. Unlike the most infamous clusters of cases stemming from a nursing home outside Seattle or a 40th birthday party in Connecticut, the Biogen cluster happened at a meeting of top health care professionals whose job it was to fight disease, not spread it.
百健的那次会议是被流行病学家称为美国新冠病毒肺炎超级传播事件的最早例子之一。超级传播事件指的是一小群人的聚集导致了一场大规模的感染,包括西雅图附近的一家专业护理设施内出现的聚集性病例,以及与康涅狄格州的一个40岁生日派对有关的感染,但与这两起声名狼藉的超级传播事件不同的是,百健的聚集性感染发生在一个顶级医疗专业人士的会议上,这些人的工作应该是抗击病毒,而不是传播疾病。
The smartest people in health care and drug development and they were completely oblivious to the biggest thing that was about to shatter their world, said John Carroll, editor of Endpoints News, which covers the biotech industry.
他们是医疗保健和药物开发领域最聪明的人,他们对即将打破他们世界的最大事件完全没有意识,报道生物技术行业的专业媒体端点新闻(Endpoints News)的编辑约翰卡罗尔(John Carroll)说。
The official count of those sickened 99, including employees and their contacts, according to the Massachusetts Department of Public Health includes only those who live in that state. The true number across the United States is certainly higher. The first two cases in Indiana were Biogen executives. So was the first known case in Tennessee, and six of the earliest cases in North Carolina.
据马萨诸塞州公共卫生部的官方数字,百健的聚集性感染导致99人患病,包括员工和他们的接触者,但这个数字只包括该州居民。美国各地与百健有关的实际病例数肯定更高。印第安纳州的头两例感染都发生在百健高管身上。田纳西州的首例已知感染者以及北卡罗来纳州最早的6名感染者都是百健高管。
All the people outside Massachusetts that The New York Times has connected to the cluster have recovered. But its impossible to say for certain whether anyone became gravely ill or died from the spread out of the conference.
《纽约时报》在马萨诸塞州以外找到的与百健聚集性感染有关联的所有人都已康复。但目前还不能确定,是否有人因此患上重症或已经死亡。
In hindsight, many people have criticized Biogens decision to continue with its leadership meeting in late February, which was attended by vice presidents from European countries already hit by the virus. Others in the industry fault Biogen for being too tight-lipped about the outbreak.
事后,许多人批评百健没有做出取消2月下旬的领导力会议的决定,与会者包括来自已经受到病毒打击的欧洲国家的公司副总裁。业内人士则指责百健对疫情守口如瓶。
At least two of the companys senior executives have tested positive. Citing privacy concerns, the company has declined to name them, even as other chief executives in biotech have disclosed their positive tests.
百健至少有两名高管后来病毒检测结果呈阳性。公司以担心隐私为由,拒绝透露这些人的姓名,尽管其他生物科技公司的首席执行官们已经披露了自己的阳性检测结果。
Responding to questions from The New York Times, Mr. Vounatsos refused to say even whether he had been tested for Covid-19.
冯纳玺在回答时报的提问时,甚至拒绝透露自己是否做过新冠病毒检测。
He is completely focused on employee safety, supplying medicines to patients, and leading the company, said a Biogen spokesman, David Caouette. This takes precedence over his personal health status.
他把全部精力都放在员工安全、为病人提供药物,以及领导公司上,百健发言人戴维考埃特(David Caouette)说。这些工作比他的个人健康状况更重要。
The company has defended its handling of the leadership meeting and its aftermath, saying it made the best decisions it could with the information available at the time.
百健为公司召开领导力会议以及后续的处理进行了辩护,称公司根据当时可获得的信息做了最好的决定。
For a company whose mission is to save lives, it was very difficult to see our colleagues and community directly affected by this disease, Mr. Vounatsos said in his first public comments about what happened at Biogen. We would never have knowingly put anyone at risk.
对一家以拯救生命为己任的公司来说,看到我们的同事和社区受到这种疾病的直接影响,令人非常难受,冯纳玺在就百健发生的事情首次发表公开评论时说。我们绝不会故意让任何人的健康受到威胁。
Founded in 1978 and based near Boston, Biogen helped pioneer the biotechnology industry, specializing in multiple sclerosis drugs. The company is best known now for its work on a promising treatment for Alzheimers.
百健是生物技术行业的先驱,公司成立于1978年,总部设在波士顿附近,曾专门从事多发性硬化症药物的研发。公司在治疗阿尔茨海默症方面取得的大有希望的进展,是其目前最为人所知的工作。
Its experimental drug was seen as a potential holy grail until the company announced about a year ago that the drug appeared to be a failure in large-scale trials. Patients were devastated. The companys stock nose-dived.
百健的这个实验药物曾被视为一个潜在的圣杯直到大约一年前,公司宣布,该药物似乎在大规模临床试验中失败了。这让阿尔茨海默症患者极为失望。公司的股票暴跌。
But last fall, in a stunning reversal, Biogen announced that further analysis of the data suggested the drug actually worked at higher doses. Mr. Vounatsos said the company planned to seek approval from the Food and Drug Administration as soon as possible. The stock soared; the company pulled in record annual revenues of about $14.4 billion.
但在去年秋天的一个惊人逆转中,百健宣布,对数据的进一步分析表明,该药物在更高剂量下实际上是有效的。冯纳玺当时说,公司打算尽快获得美国食品和药物管理局(简称FDA)的批准。公司的股价随之飙升,年收入达到创记录的约144亿美元。
By the time of Biogens annual leadership meeting on Feb. 26 and 27, spirits were high. So was the pressure to deliver.
2月26日和27日召开百健年度领导力会议时,公司上下情绪高涨,但在履行诺言上也面临着很大的压力。
Although some other companies canceled international meetings around that time, Biogen never discussed doing so. The outbreak was raging in China but had not yet been declared a worldwide pandemic. As of Feb. 21, the Friday before the meeting, the United States had only 30 confirmed cases, according to data compiled by The Times. Biogen executives in Germany, Switzerland and Italy where there were just 20 known cases packed their bags.
尽管一些其他的公司取消了那前后的一些国际会议,但百健从未讨论过这样做。尽管疫情已在中国蔓延,但尚未被宣布为全球大流行病。据时报收集的数据,截至2月21日,即会议召开前的那个周五,美国只有30例确诊病例。百健在德国、瑞士和意大利(当时意大利只有20例已知病例)的高管收拾行装登上了飞机。
On the first night, about 175 executives gathered for a buffet dinner and cocktails at the Marriott Long Wharf overlooking Boston Harbor. Colleagues who hadnt seen each other in a year shook hands and vied for face time with bosses. Europeans gave customary kisses on both cheeks.
会议第一天的晚上,大约175名高管在俯瞰波士顿港的龙码头万豪酒店(Marriott Long Wharf)参加了自助晚餐和鸡尾酒聚会。已一年没见面的同事们互相握手,争着与上司见面。欧洲人则按照习惯互相亲吻两颊。
在百健领导力年度会议的第一天晚上,175名高管聚集在波士顿的龙码头万豪酒店共享自助晚餐和鸡尾酒。CODY OLOUGHLIN FOR THE NEW YORK TIMES
Its unfortunately the perfect breeding ground for a virus, said one former vice president, who spoke on condition of anonymity because of his ties to Biogen.
不幸的是,这些做法为病毒传播提供了完美的温床,一名前副总裁说。该人仍与百健有联系,因此要求不具名。
Two days later, the senior executives returned to their offices. One drove to a manufacturing center in North Carolina. Others flew back to Europe.
两天后,这些高管们回到了各自的办公室。其中一人开车回到了位于北卡罗来纳州的一个制造中心。其他人飞回了欧洲。
Peter Bergethon, the head of digital and quantitative medicine at Biogen, went home to his wife, an infectious-disease doctor.
百健的数字与定量医学主管彼得伯杰桑(Peter Bergethon)回到妻子身边,她是一名传染病医生。
A Biogen vice president in the Alzheimers franchise and her husband attended a party the following Saturday night at a friends home in Princeton, N.J., with about 45 other people.
百健公司负责阿尔茨海默病研究的副总裁和她的丈夫在会后的周六晚去了新泽西州的普林斯顿,参加了在一个朋友家举行的大约45人的聚会。
They celebrated a holiday in the Greek Orthodox calendar, the end of the Carnival season, with special sweets and traditional dances that involved holding hands in a circle. Although celebrations in Greece had been canceled, the party in New Jersey went forward, since White House officials had just pronounced the virus in the United States to be under control.
聚会是为了庆祝希腊东正教的一个节日,人们用特别的糖果和手拉手围成一圈跳传统舞的方式庆祝了狂欢节的结束。尽管希腊国内的庆祝活动已被取消,但新泽西州的这个派对照常举行,因为白宫官员刚刚宣布了美国疫情可控。
That night, Allana Taranto, a photographer who covered the leadership meeting for Biogen, celebrated her 42nd birthday with her boyfriend and another couple.
那天晚上,在百健领导力会议上担任摄影师的阿拉娜塔兰托(Allana Taranto)与男友和另一对夫妇一起庆祝了自己42岁的生日。
Over that weekend, though, some people in the company had already started feeling sick.
不过,公司里的一些人已经在那个周末开始感到不舒服。
Jie Li, a 37-year-old biostatistician who worked on the Alzheimers drug team, had chills, a cough and aches. She was too junior to attend the companys leadership conference, but her boss went, and showed up at the office afterward.
曾在阿尔茨海默氏症药物研究小组工作的37岁的生物统计员黎洁(音)出现了受寒、咳嗽和身体酸痛的症状。她的职位还没高到参加公司领导力会议的层次,但她的上司去了,并在会后到过办公室。
On March 2, the following Monday, the companys chief medical officer sent an email informing everyone who attended the leadership meeting that some people had fallen ill and telling them to contact a health care provider if they felt sick.
3月2日,也就是会后的第一个周一,公司的首席医学官给所有人发了一封电子邮件,告诉他们,参加领导力会议的有些人病了,并告诉他们如果感到不适,要与医疗服务部门联系。
We moved quickly, Mr. Caouette said.
我们迅速采取了行动,考埃特说。
Still, that same day, the companys four top executives attended a huge health care conference hosted by the investment firm Cowen. At another Marriott in Boston, they held meetings in hotel rooms with potential investors. Another attendee who met some of the same investors said he heard that members of the Biogen team looked sick.
然而,就在同一天,百健的四名高管参加了由投资公司考恩(Cowen)主办的一个涉及医疗保健行业的大会。百健高管在波士顿的另一家万豪酒店房间里与潜在的投资者举行了会议。见过这些投资者的另一位与会者说,他听说百健团队的成员中有人看上去有病态。
At the conference, concern about the coronavirus mounted as word spread that some companies, including Vertex and Seattle Genetics, had canceled their appearances. By Tuesday, the second day of the conference, many attendees had stopped shaking hands.
包括弗特克斯(Vertex)和西雅图遗传学公司(Seattle Genetics)在内的几家公司决定退出会议,随着消息的传开,会上人们对新冠病毒的担忧也在增长。到会议的第二天,也就是周,许多与会者已不再与他人握手。
Later, investors were informed that two of the four Biogen executives at the conference tested positive for the virus.
后来,投资者被告知,参加会议的四名百健高管中两人病毒检测呈阳性。
In defense of his companys decision to attend the event, Mr. Vounatsos said, When we learned a number of our colleagues were ill, we did not know the cause was Covid-19.
冯纳玺为公司参加投资者会议的决定做辩护说,得知一些同事生病时,我们并不知道他们感染了新冠病毒。
That Tuesday, Biogen contacted the Massachusetts Department of Public Health and reported that about 50 employees in the Boston area and overseas had flulike symptoms. Biogen employees began showing up at the emergency room of Massachusetts General Hospital, demanding tests. They were told their cases didnt satisfy the testing criteria at the time, since none had traveled to a hot spot or had known exposure to someone who had tested positive for Covid-19.
就在那个周二,百健与马萨诸塞州公共卫生部联系,将大约有50名波士顿地区和海外的员工出现了类似流感症状的情况通报给了后者。百健员工开始出现在马萨诸塞州总医院(Massachusetts General Hospital)的急诊室,要求做新冠病毒检测。他们被告知,他们不符合当时的检测标准,因为没去过热点地区,也没有接触过新冠病毒检测呈阳性的人。
The next day, confirmation of the worst arrived. Two Biogen executives who had returned home to Germany and Switzerland, where tests were more widely available, had tested positive.
最坏的情况在接下来的那天得到了证实。百健的两名高管回到德国和瑞士后,病毒检测结果呈阳性,德国和瑞士的病毒检测范围要大得多。
On Thursday, the company held a call with its staff and shared the news. All office-based employees were directed to work from home.
周四,百健与员工举行了电话会议,把这个消息告诉了他们。所有在办公室上班的员工都被要求在家工作。
Yet on that same day, a Biogen executive visited the Washington office of Pharmaceutical Research and Manufacturers of America, or PhRMA, the industrys top lobbying group. Soon after, that executive tested positive, prompting the group to close its headquarters for deep cleaning.
然而,就在同一天,百健的一名高管拜访了美国药物研究机构和制药厂商协会(Pharmaceutical Research and Manufacturers of America)的华盛顿办公室,该协会是药品行业的主要游说机构。不久后,这名百健高管的病毒检测结果呈阳性,导致协会关闭总部,对办公室进行消杀。
The next few weeks turned into a blur of Biogen employees leaving casseroles on one anothers doorsteps and trading news about who had fallen ill.
接下来的几周在百健员工的记忆里已变得有些模糊不清,人们只记得把炖好的菜饭送到一些人的家门口,以及相互交换谁中招的消息。
Dr. Bergethon infected his wife, the infectious-disease specialist. While their symptoms were manageable, the scariest part was the uncertainty, Dr. Bergethon recalled recently at a virtual event hosted by the University of Rochester.
伯杰桑把病毒传染给了身为传染病专家的妻子。尽管他们的症状都不太严重,但最可怕的是这个病的不确定性,伯杰桑在罗切斯特大学(University of Rochester)最近举办的一个网上活动中回忆道。
We didnt know we were going to recover, he said. We didnt know what was coming next.
我们不知道我们会不会痊愈,他说。我们不知道病情下一步会怎么发展。
Ms. Taranto, the photographer who had been at Biogens leadership conference, unknowingly gave the illness to a friend at her birthday dinner. She had felt healthy at the time.
曾在百健领导力会议上担任摄影师的塔兰托,在庆祝生日与朋友一起吃饭时,无意中把病毒传染给了朋友。她当时并无症状。
Of the four dozen people who attended the party in New Jersey, at least 15 later tested positive, according to public health authorities.
据公共卫生当局称,参加了新泽西州那个派对的40多人中,至少有15人后来病毒检测呈阳性。
A Biogen executive, Chris Baumgartner, became the first Covid case in Tennessee. I was patient zero, he wrote on Facebook. He added: Imagine having to confront a virus so feared, it now has the entire world on the brink of mass hysteria.
百健高管克里斯鲍姆加特纳(Chris Baumgartner)成了田纳西州的第一个新冠病毒病例。我是零号病人,他在Facebook上写道。他还说:想象一下不得不面对这样一种如此令人恐惧的病毒吧,它已让整个世界处于群体性歇斯底里的边缘。
The earliest cases in Indiana and North Carolina were tied to the company. One Biogen employee even carried the virus back to China.
印第安纳州和北卡罗来纳州最早的病例都与百健有关。百健的一名员工甚至把病毒带回了中国。
After falling ill with flu-like symptoms, Ms. Li called an ambulance and was given a coronavirus test, according to a public health official in Belmont, the upscale Boston suburb where she lived. But before she received the results, she booked a flight to Beijing, boarding a plane with her husband and son, leaving behind their house, a white BMW and other trappings of the life they had built in the United States over 15 years.
据黎洁居住的波士顿郊区高档社区贝尔蒙特的一位公共卫生官员说,黎洁在出现了类似流感的症状后,叫了一辆救护车,并做了新冠病毒检测。但在收到检测结果前,她订了飞往北京的机票,与丈夫和儿子一起登上了飞机,把他们的房子、一辆白色宝马车,以及他们在美国生活了15年积累起来的其他一些东西留在了美国。
They must have been desperate, said Dr. William Q. Meeker, a statistics professor at Iowa State University who had worked closely with Ms. Lis husband, Yili Hong, also a statistician. The couple worried most about their 2-year-old, who would be far from relatives if they both fell ill, according to a former graduate school classmate.
他们一定很绝望,艾奥瓦州立大学(Iowa State University)统计学教授威廉Q米克尔(William Q. Meeker)博士说,米克尔曾与黎洁的丈夫洪义理(音)有密切的工作关系。据他们以前的一名研究生院同学说,这对夫妇最担心的是他们两岁大的孩子,如果他们都生病的话,孩子在附近没有亲戚能照顾他。
百健的生物统计员黎洁(音)在收到自己的新冠病毒检测结果之前,登上了飞往北京的飞机。她离开美国几周后,一封来自当地卫生部门的信仍然贴在她家的门上。CODY OLOUGHLIN FOR THE NEW YORK TIMES
Ms. Li took medicine to conceal her symptoms, and revealed her health condition to flight attendants on board the flight, Air China and Beijing disease control officials said last month.
中国国际航空公司和北京疾控中心的官员上个月说,黎洁服用药物掩盖了自己的症状,在飞机上才把自己的健康状况告诉了空乘人员。
After she landed in China, authorities placed her under investigation for obstructing the prevention of infectious diseases, a crime that reportedly carries a sentence of up to seven years in prison.
抵达中国后,当局以涉嫌妨害传染病防治的罪名对她立案调查,该罪据称最高可判七年徒刑。
In Beijing, the couple suffered from high fevers and lung infections and were hospitalized, Dr. Meeker said. He recently received an email from Mr. Hong that said they were recuperating, but that their lives will be different in the future.
米克尔说,这对夫妇到北京后都出现了高烧和肺部感染的症状,被送往医院。他最近收到洪义理一封电子邮件,说他们正在康复中,但他们的生活将来会不一样。
It appears that all of Biogens employees who fell ill have recovered. Aside from Ms. Li, who was fired, all have returned to work, Mr. Caouette said.
百健所有患病的员工似乎都已康复。考埃特说,除了被解雇的黎洁,其他人已重返工作岗位。
Biogen has since joined the fight against the virus. The company donated $10 million to expand access to testing and to provide emergency food and protective gear for hospital workers.
百健也在那之后加入到抗击新冠病毒的战斗中来。公司捐赠了1000万美元,用于扩大病毒检测范围和为医院工作人员提供紧急食品和防护器材。
Company officials said its struggle against the pandemic is just beginning: Biogen, for instance, has also entered into talks with Vir Technology about manufacturing a potential treatment for Covid-19, another pharmaceutical holy grail that could make untold amounts of money.
公司的高层表示,它与大流行病的斗争才刚刚开始,并举例指出:百健正在与维尔生物科技公司(Vir Technology)谈判,讨论制造一种治疗新冠病毒疾病的潜在药物的事情。治疗新冠病毒疾病的药物也是人们都在努力追求的圣杯,能实现这个目标的公司将能挣到一笔大钱。
Serge Kovaleski、Jeffrey E. Singer和Susan Beachy自纽约对本文有贡献。Austin Ramzy自香港对本文有贡献。
本文作者Kim Barker是一名企业记者,专注于长期项目和叙事写作。在2014年加入时报之前,她曾是ProPublica的记者,还曾担任《芝加哥论坛报》南亚分社社长。