Bill Gates says COVID-19 could be once-in-a-century pathogen

"In the past week, COVID-19 has started to behave a lot like the once-in-a-century pathogen we've been worried about," Gates said. "I hope it's not that bad, but we should assume that it will be until we know otherwise."

He said in the article that in any crisis, leaders have two equally important responsibilities -- solve the immediate problem and keep it from happening again. "The COVID-19 pandemic is an excellent case in point."

"The world needs to save lives now while also improving the way we respond to outbreaks in general. The first point is more pressing, but the second has crucial long-term consequences," he said.

The article gave two reasons that COVID-19 is such a threat. First, it can kill healthy adults in addition to elderly people with existing health problems. The data so far suggest that the virus has a case fatality risk around 1 percent; this rate would make it several times more severe than typical seasonal influenza.
Second, COVID-19 is transmitted quite efficiently. The average infected person spreads the disease to two or three others -- an exponential rate of increase. COVID-19 will be much harder to contain than Middle East Respiratory Syndrome or Severe Acute Respiratory Syndrome.

National, state, and local governments and public health agencies can take steps over the next few weeks to slow the spread of the virus, Gates said.
He called on donor governments to help low- and middle-income countries (LMICs) in addition to helping their own citizens respond. "By helping African and South Asian countries get ready now, we can save lives and slow the global circulation of the virus."

Gates said the world also needs to accelerate work on treatments and vaccines for COVID-19.
Scientists sequenced the genome of the virus and developed several promising vaccine candidates in a matter of days, and the Coalition for Epidemic Preparedness Innovations is already preparing up to eight promising vaccine candidates for clinical trials, he said.

"If some of these vaccines prove safe and effective in animal models, they could be ready for larger-scale trials as early as June," he added.
Drug discovery can also be accelerated by drawing on libraries of compounds that have already been tested for safety and by applying new screening techniques, including machine learning, to identify antivirals that could be ready for large-scale clinical trials within weeks, he said.

"All these steps would help address the current crisis. But we also need to make larger systemic changes so we can respond more efficiently and effectively when the next epidemic arrives," he said.

Those include helping LMICs strengthen their primary health care systems and investing in disease surveillance.

"In addition, we need to build a system that can develop safe, effective vaccines and antivirals, get them approved, and deliver billions of doses within a few months after the discovery of a fast-moving pathogen," Gates said.

"That's a tough challenge that presents technical, diplomatic, and budgetary obstacles, as well as demanding partnership between the public and private sectors. But all these obstacles can be overcome," he added.
According to Gates, the scale of investment required to solve the problem should be billions of dollars for anti-pandemic efforts. "Given the economic pain that an epidemic can impose -- we're already seeing how COVID-19 can disrupt supply chains and stock markets, not to mention people's lives -- it will be a bargain."

"These are the actions that leaders should be taking now. There is no time to waste," Gates said.