Microsoft founder Bill Gates has been speaking about a coming pandemic for 5 years now. He believes we need a vaccine to put all this behind us.
As we move further and further along in our battle with COVID-19, a lot of the discussion has naturally turned to what our exit strategy will be. While we may think that this will be a simple matter, where we just start to open things up again as the threat plays out and diminishes, there are those such as Microsoft’s Bill Gates who sees a lot longer road ahead of us than many may think.
There are not one but two beasts that we are currently fighting, the virus one and the economic one, and if we’re going to survive this mess, we need to be looking closely at both, not just being content to just look at the increasing number of cases and deaths that pile up each day and allow our fear to prevent us from the honest appraisal of the risks and benefits to prolonging this extreme response that we have chosen.
We already have a good idea of the economic costs of this, and no one is even pretending that the costs of this won’t be very high. The variable here is the risk, and this risk is not only a factor in initiating our lockdowns, it will continue to be as we move away from the apex that is now predicted to be days away.
How many deaths that we would have faced if not for these measures has become a moot point now, because all but a handful of states have stay at home orders in place now. Many are calling for the remaining states to do the same, but these states aren’t very populous and should the outbreak actually become a concern in these areas, it will show itself pretty clearly and we can deal with the issue if it ever becomes one worth dealing with.
In the meantime, it is at least helpful to our understanding of the matter that we do have areas in the U.S. and elsewhere who have not chosen these drastic measures, to serve as a reference point if nothing else, because we will be in a position where we’re going to need to re-assess things soon and the more knowledge we have, the better. If some states survive this without going down that road, and come out of it all right, then all the better, as this will provide us a higher level of confidence as we get to the point where we will want or even need to wrap this up.
It is very important to know what difference the extreme measures that we are taking would make, because we are going to have to untie people eventually, and we especially need to make sure that the beast that we are feeding, the economic one, does not become a far bigger problem than the virus ever was. This really is all about balance, whether we wish it to be or not. It really is all about doing what is best for the people’s welfare, ensuring that we don’t do a lot more harm than what is to be avoided.
This is at best a difficult task, but cannot be made without keeping an eye on the costs, because that’s the only way we can know when to stop. The perspective that we need here is that these actions are and must be reserved for crises of great magnitude, and whenever we decide that this one no longer is of that magnitude, that’s the time we need to consider pulling back.
There are always wars to fight in the world of infectious diseases, and we’d have to lock everyone away all of the time to prevent deaths from them, and even doing this would not eliminate them all. This is why we do need to rely on the past for a sense of proportion, why comparisons to influenza for instance remain very relevant even if you are of the belief that this outbreak will be far worse. How much worse still would matter, and of the same or even a lesser threat would matter even more.
This Virus is Likely Much More Widespread than Just the Known Infections
We honestly do not know how widespread this outbreak has become, although if we are looking to build models that can be relied upon or even have a chance to produce reliable data, we need to start by making sure that we are at least trying to account for how quickly this is spreading, or not. You can’t tell much from testing a half of a percentage of the population, and we especially do not want to think that the third of a million cases we’ve found so far is a number even close to the real number on any given day.
It’s hard to imagine how the real number would not be in the tens of millions already, from what we have seen from this tiny sample of the population testing. There isn’t any way that the infection rate could be the 19% that we’ve seen so far, but on the other hand it’s a lot higher than the 1/10 of a percent that this 336,000 represents.
The number of cases that we’re discovering really isn’t that significant therefore, as if there are 10 million people or more in the U.S. that has been infected already, which is on the low end of things, going to a million or two million or however far we measure is still going to capture only a portion of this.
The death count, on the other hand, is very real and is not a number that is subject to debate, and even though we’re counting people who die of anything while infected with this virus, this is not only the number to watch, it’s the only one to watch.
If we did want to look at the number of infections versus the number of tests, the infection rate, we should be looking at how this rate may change as we do more testing, where the infection rate going up would be of grave concern, and seeing this rate go down would be consistent in a diminution of the outbreak.
It’s the deaths that we are really concerned about though, or should be. As we gather more data, the latest model has honed in more on what we may expect in the United States, where we’ve gone from millions of deaths not so long ago, to millions if we didn’t take these measures, to the less than 100,000 that this new model is predicting.
We finally get a chance to see this unfold in real time, day by day, and the path to 96,000 has at least been dented a bit by its forecasting almost 400 deaths more than occurred on April 5. However, this model also gets revised daily and what they have done to accommodate this is to increase the peak further, to where it is now 3,130 10 days from now.
It’s nice to see that they are continuing to refine this, and although we’re not sure how we get a day with considerably less deaths than predicted and this leads to this considerably more later, but these 10 days will come and go soon enough and time will end up telling the real story here.
It is fabulous to have this data as a reference point finally though, so we can see the situation, and these predictions, stand alongside the data as it comes in each day and provide a much better feel as to where we are headed during this crucial time. These predictions at least look much more reasonable than past ones, even though there still is a lot of guesswork involved.
While these recent guesses may still be too high, mostly due to things looking like they may be starting to level off, and we aren’t seeing the daily escalations that the model is, going from where we were Sunday to tripling that number over 10 days, this will all be decided soon enough.
Alongside all these deaths so far and the ones yet to come sits the concerns of the welfare of the survivors. We have paid a huge price economically so far, and economically here means more than people’s wealth being diminished or our seeing our collective financial welfare taking such a big hit, as the economic impact of this reaches all the way to the bottom, with the number of people in the United States who do not have enough to eat taking a big hit along with everything else.
As we move forward, we have to keep an eye on both the health impact of this virus and its economic impact, and once we reach the apex, we will be seeing the health risks go down while the economic cost continues to rise. We will need a plan here, and a good one, to not take a bad situation and make it worse, or perhaps a lot worse if we are not careful.
We should know that this lockdown is not something that we could afford to sustain indefinitely, or even for much longer. We cannot just think that the government can hold the country on its back for very long, as even their heroic efforts thus far does not even come close to evening the score.
Seeking the Right Balance is Critical as We Move Forward
We will have to find the right balance. Talk of keeping this going for a much longer period has been with us for a while, but now Bill Gates is suggesting that we will need to constrain ourselves for as long as it may take to get a vaccine, which is thought to be a full year away.
Gates actually believes that we can do better than this roughly 100k model that is out there now, but still thinks that we need to keep this up to some degree for a long while yet. He admits to being afraid of a second wave, and that’s only natural because this is what countries like China and South Korea have grappled with as things dramatically improved, but this is an area what we absolutely require a balanced approach.
We can certainly not afford to just choose to seek prevention over risk, as once again, we need to look at what we gain from restriction and compare it to the costs of it, to make any kind of informed decision. The only sensible way to do this is to seek to return to normal as quickly as possible without actually causing a second wave of deaths that could not be controlled, and only intervene if and when problems do arise that need addressing.
Since Gates believes that we will need to wait for a vaccine to put all this behind us, this would require that this outbreak not be well controlled otherwise, and it’s hard to even imagine how anyone could know this. The latest model has U.S. deaths declining to near zero in 3 months, and near zero is hardly not well controlled or in need of anything.
Some may believe that this virus will be a seasonal thing, even though these viruses tend not to persist for very long at all. This is at best speculation, and given that is the case, the advice should have been that we may need to revisit this at some point in the future as needed, not that this will happen and we will need a vaccine.
Even if we do get another outbreak of this next winter, this does not mean that it will be anywhere close to the magnitude of this one. People speak of the need for enough of us to become infected to develop herd immunity, but when this is all over, a much higher percentage of our herd may have this than we think.
We need to realize that there is nothing special about this virus that should have us treating it with grave concern if its numbers are no longer even comparable to normal annual outbreaks such as influenza. Should COVID-20 come to town, next year’s model, we will be more ready this time, but do need to judge its risk by its own merits and not just some guesses that are made this far in advance. We can deal with such things as they merit.
Not a lot of people are breathing all that easier with this one yet, and this is a difficult process when we are inundated with constant bad news, but things have really taken a turn for the better already and it’s even predicted now that the U.S. is not that far behind.
Beyond that point, we do need to start rebuilding all that we have torn down, and getting people back to work provided we can do so without re-escalating this tragedy is what we need to be focusing on. It’s not too early to start working out how this will all happen.