"Let's look at a model of a virus spread through the air, like the Spanish Flu back in 1918. So here's what would happen: It would spread throughout the world very, very quickly. And you can see over 30 million people died from that epidemic. So this is a serious problem. We should be concerned."

By Ian Horswill


Posted on April 2, 2020

In a 2015 Ted Talk, which is gaining a lot of viewers of late, Microsoft co-founder and former CEO Bill Gates delivered a speech entitled “The next outbreak? We’re not ready”.

“When I was a kid, the disaster we worried about most was a nuclear war. That’s why we had a barrel like this down in our basement, filled with cans of food and water. When the nuclear attack came, we were supposed to go downstairs, hunker down, and eat out of that barrel,” Bill Gates said.

“Today the greatest risk of global catastrophe doesn’t look like this. Instead, it looks like this. If anything kills over 10 million people in the next few decades, it’s most likely to be a highly infectious virus rather than a war. Not missiles, but microbes. Now, part of the reason for this is that we’ve invested a huge amount in nuclear deterrents. But we’ve actually invested very little in a system to stop an epidemic. We’re not ready for the next epidemic.”

According to World Health Organisation Director-General Tedros Adhanom Ghebreyesus, the coronavirus pandemic will reach one million infections within days.

“In the next few days we will reach one million confirmed cases and 50,000 deaths worldwide,” Tedros said.

The US (884), Spain (864) and the UK (563) reported their highest number of COVID-19 deaths in a single day since the start of the coronavirus pandemic.

“Let’s look at Ebola,” Bill Gates said at the Ted Talk in 2015.

“I’m sure all of you read about it in the newspaper, lots of tough challenges. I followed it carefully through the case analysis tools we use to track polio eradication. And as you look at what went on, the problem wasn’t that there was a system that didn’t work well enough, the problem was that we didn’t have a system at all. In fact, there’s some pretty obvious key missing pieces.

“We didn’t have a group of epidemiologists ready to go, who would have gone, seen what the disease was, seen how far it had spread. The case reports came in on paper. It was very delayed before they were put online and they were extremely inaccurate. We didn’t have a medical team ready to go. We didn’t have a way of preparing people. Now, Médecins Sans Frontières did a great job orchestrating volunteers. But even so, we were far slower than we should have been getting the thousands of workers into these countries. And a large epidemic would require us to have hundreds of thousands of workers. There was no one there to look at treatment approaches. No one to look at the diagnostics. No one to figure out what tools should be used. As an example, we could have taken the blood of survivors, processed it, and put that plasma back in people to protect them. But that was never tried.

“So there was a lot that was missing. And these things are really a global failure. The WHO is funded to monitor epidemics, but not to do these things I talked about. Now, in the movies it’s quite different. There’s a group of handsome epidemiologists ready to go, they move in, they save the day, but that’s just pure Hollywood.

“The failure to prepare could allow the next epidemic to be dramatically more devastating than Ebola Let’s look at the progression of Ebola over this year. About 10,000 people died, and nearly all were in the three West African countries. There’s three reasons why it didn’t spread more. The first is that there was a lot of heroic work by the health workers. They found the people and they prevented more infections. The second is the nature of the virus. Ebola does not spread through the air. And by the time you’re contagious, most people are so sick that they’re bedridden. Third, it didn’t get into many urban areas. And that was just luck. If it had gotten into a lot more urban areas, the case numbers would have been much larger,” continued Bill Gates.

Bill Gates, Melinda Gates

“So next time, we might not be so lucky. You can have a virus where people feel well enough while they’re infectious that they get on a plane or they go to a market. The source of the virus could be a natural epidemic like Ebola, or it could be bioterrorism. So there are things that would literally make things a thousand times worse,” Bill Gates said.

“In fact, let’s look at a model of a virus spread through the air, like the Spanish Flu back in 1918. So here’s what would happen: It would spread throughout the world very, very quickly. And you can see over 30 million people died from that epidemic. So this is a serious problem. We should be concerned.

“But in fact, we can build a really good response system. We have the benefits of all the science and technology that we talk about here. We’ve got cell phones to get information from the public and get information out to them. We have satellite maps where we can see where people are and where they’re moving. We have advances in biology that should dramatically change the turnaround time to look at a pathogen and be able to make drugs and vaccines that fit for that pathogen. So we can have tools, but those tools need to be put into an overall global health system. And we need preparedness.

“The best lessons, I think, on how to get prepared are again, what we do for war. For soldiers, we have full-time, waiting to go. We have reserves that can scale us up to large numbers. NATO has a mobile unit that can deploy very rapidly. NATO does a lot of war games to check, are people well trained? Do they understand about fuel and logistics and the same radio frequencies? So they are absolutely ready to go. So those are the kinds of things we need to deal with an epidemic.

“What are the key pieces? First, we need strong health systems in poor countries. That’s where mothers can give birth safely, kids can get all their vaccines. But, also where we’ll see the outbreak very early on. We need a medical reserve corps: lots of people who’ve got the training and background who are ready to go, with the expertise. And then we need to pair those medical people with the military. taking advantage of the military’s ability to move fast, do logistics and secure areas. We need to do simulations, germ games, not war games, so that we see where the holes are. The last time a germ game was done in the United States was back in 2001, and it didn’t go so well. So far the score is germs: 1, people: 0. Finally, we need lots of advanced R&D in areas of vaccines and diagnostics. There are some big breakthroughs, like the Adeno-associated virus, that could work very, very quickly.”

US President Donald Trump has admitted the government’s emergency stockpile of protective equipment is nearly exhausted because of the extraordinary demands of the coronavirus pandemic.

Donald Trump, impach, acquittal

“We’ve asked states where they have large manufacturers of different types of equipment to use those local factories, those local plants and have it made directly, ship it right into the hospitals,” Trump said.

“We’re shipping things right in. We have, as you know, almost 10,000 ventilators which we need for flexibility. It’s sounds like a lot but it’s not.”

The Federal Emergency Management Agency had shipped or delivered 11.6 million N95 respirators, 26 million surgical masks, 5.2 million face shields, 4.3 million surgical gowns, 22 million gloves, and 8,100 ventilators, the White House said on 28 March.

The US 24 hours earlier predicted that between 100,000 and 240,000 people will die because of COVID-19.

The Bill & Melinda Gates Foundation pledged US$100 million to fighting coronavirus, as part of a broader offensive against the disease.

The Bill & Melinda Gates Foundation is also reportedly exploring the idea of supplying at-home testing kits for the novel coronavirus in Seattle, the initial epicentre of the US outbreak that has spread throughout the country. It also launched a US$125 million COVID-19 Therapeutics Accelerator and gave US$5 million to help public health agencies in the Seattle area enhance their capacity to detect the virus.

In an opinion article in The Washington Post on Wednesday Bill Gates said the coronavirus could be contained if three measures were implemented: A nationwide shutdown, increased testing (with healthcare workers at the front of the queue), and a “a data-based approach to developing treatments and a vaccine.

“Despite urging from public health experts, some states and counties haven’t shut down completely. In some states, beaches are still open; in others, restaurants still serve sit-down meals,” Bill Gates wrote.

“This is a recipe for disaster. Because people can travel freely across state lines, so can the virus. The country’s leaders need to be clear: Shutdown anywhere means shutdown everywhere.”