Bill Gates has been warning about a pandemic since 2015. His posts on GatesNotes and a column on The New York Times repeatedly warned that the world is not ready for a pandemic. He has spoken on various platforms about how it's the next world war, but a virus that we should really be worried about.
Then somewhere in mid-December, in the Chinese city of Wuhan, in a wet animal market, a zootonic virus made its way into humans and in the last over three months have affected 300,000 people with over 13,000 deaths.
He recently held an AMA with Reddit users and spoke at length about what we know and understand about the pandemic. We've curated some of his answers for you. For the full 31 questions, visit GatesNotes.
Redditor’s question: What about the current crisis worries you the most? What gives you the most hope?
My answer: The current phase has a lot of the cases in rich countries. With the right actions including the testing and social distancing (which I call “shut down”) within 2-3 months the rich countries should have avoided high levels of infection. I worry about all the economic damage but even worse will be how this will affect the developing countries who cannot do the social distancing the same way as rich countries and whose hospital capacity is much lower.
Is there any chance that the 18 month timeline for development of a vaccine can be shortened, and by how much?
This is a great question. There are over 6 different efforts going on to make a vaccine. Some use a new approach called RNA which is unproven. We will have to build lots of manufacturing for the different approaches knowing that some of them will not work. We will need literally billions of vaccines to protect the world. Vaccines require testing to make sure they are safe and effective. Some vaccines like the flu don’t for the elderly.
The first vaccines we get will go to health care workers and critical workers. This could happen before 18 months if everything goes well but we and Dr. Fauci and others are being careful not to promise this when we are not sure. The work is going at full speed.
I’d also like to ask the same thing, but with regards to the timeline for an effective treatment.
A therapeutic could be available well before a vaccine. Ideally this would reduce the number of people who need intensive care including respirators. The Foundation has organized a Therapeutics Accelerator to look at all the most promising ideas and bring all the capabilities of industry into play. So I am hopeful something will come out of this. It could be an anti-viral or antibodies or something else.
One idea that is being explored is using the blood (plasma) from people who are recovered. This may have antibodies to protect people. If it works it would be the fastest way to protect health care workers and patients who have severe disease.
In your opinion, after this pandemic comes to a close, however long that may be, what should be the first step we as a global community take so that we are better prepared for the next pandemic?
The TED talk I did in 2015 talked about this. We need to have the ability to scale up diagnostics, drugs and vaccines very rapidly. The technologies exist to do this well if the right investments are made. Countries can work together on this. We did create CEPI = Coalition for Epidemic Preparedness Innovation which did some work on vaccines but that needs to be funded at higher level to have the standby manufacturing capacity for the world.
Thoughts on chloroquine/hydroxychloroquine?
There are a lot of therapeutic drugs being examined. This is one of many but it is not proven. If it works we will need to make sure the finite supplies are held for the patients who need it most. We have a study going on to figure this out. We also have a screening effort to look at all the ideas for Therapeutics because the number being proposed is very large and only the most promising should be tried in patients. China was testing some things but now they have so few cases that that testing needs to move to other locations.
When will this all end?
To bring it to small numbers globally we need a vaccine. Many rich countries will be able to keep the number of cases small (including the US) if they do the right things but developing countries will find it very difficult to stop the spread so a vaccine is critical. A group called GAVI helps buy vaccines for developing countries and they will play a key role once we have a vaccine being made in volume.