Bill Gates analysis There is no doubt that the United States missed the opportunity to be one step ahead of the new coronavius. But the space for important decisions has not been closed.
The choices we and our leaders make now will have a huge impact on how quickly the case numbers start to decline, how long the economy will remain closed, and how many Americans will have to bury a man. their dear, because of covid-19. Through my work with the Gates Foundation, I have spoken with experts and leaders in Washington and around the country.
It is clear to me that we need to take three steps. First, we need a sustainable nationwide approach to isolation. Despite calls from public health experts, some states and counties have not been fully closed. In some states, the beaches are still open; in others, restaurants still serve food on tables.
This is a recipe for disaster. Because people can travel freely across state lines, so can the virus. Country leaders need to be clear: closing everywhere means closing everywhere. Until case numbers start to fall across America – which can take 10 weeks or more – no one can do business as usual, or ease isolation measures.
Any confusion about this point will only prolong the economic pain, increase the chances of the virus returning and cause more deaths. Second, the federal government needs to step up testing. Many more tests need to be made available.
We also need to collect the results so that we can quickly identify potential volunteers for clinical trials, and be sure when it’s time to return to normal. There are good examples to follow: New York State recently expanded its capacity to more than 20,000 tests per day.
Progress has also been made on more effective testing methods, such as self-buffering developed by Seattle’s Coronavirus Evaluation Network, which allows patients to take a sample themselves without exposing a health worker. I hope this and other innovations in testing will spread around the country soon. Even so, the demand for tests will probably outstrip supply for some time, and right now, it’s not clear who makes those few tests available.
As a result, we do not have a clear idea of how many cases there are, or where the virus is likely to go, and it will be difficult to know if it returns later. And because of sampling lag, it can take up to seven days for the results to arrive, when we need them within 24 hours.
That is why the country needs clear priorities for who has been tested. First on the list should be people in essential roles such as health care workers and first responders, followed by sympathetic people who are most at risk of becoming seriously ill and those likely to be exposed. The same is true for masks and respirators. Forcing 50 governors to bid for rescue equipment – and hospitals paying salty prices for them – only makes things worse.
Finally, we need a data-driven approach to developing medical treatments and a vaccine. Scientists are working fast on both; in the meantime, leaders can help by avoiding gossip or panic buying. Long before hydroxy-chloroquine was approved as an emergency treatment for covid-19, people began to keep it at home, making it harder for lupus patients to find it.
And they have to survive. We must adhere to the process that works: Perform rapid testing of treatments and vaccines that involve different candidates and inform the public when the results arrive. Once we have a safe and effective treatment, we will need to make sure that the first doses go to the people who need them most. To end the disease, we will need a safe and effective vaccine.
If we do everything right, we can have one in less than 18 months – the fastest time a vaccine has ever been developed. But creating a vaccine is only half the battle. To protect Americans and people around the world, we will need to produce billions of doses. (Without the vaccine, developing countries are at greater risk than rich ones because it is even harder for them to enforce physical distances and isolation.) We can start now by building the plants where these vaccines will be produced.
Because many of the top candidates are made using unique equipment, we will need to build facilities foreach of them, knowing that some will not be used. Private companies may not take this kind of risk, but the federal government can. It is a great sign that the administration has reached an agreement this week with at least two companies to prepare for vaccine production.
I hope more agreements will follow. In 2015, I called on world leaders in a TED talk to prepare for a pandemic, in the same way they prepared for war – by conducting simulations to find cracks in the system. As we’ve seen this year, we still have a long way to go. But I still believe that if we make the right decisions now, informed by science, data, and the experience of medical professionals, we can save lives and get the country back to work.