Thank You Bill Gates

Bill Gates, who warned us–The Next Outbreak, We’re not ready–is getting ready for a vaccine, in fact for seven of them.

Business Insider: Gates said he was picking the top seven vaccine candidates and building manufacturing capacity for them. “Even though we’ll end up picking at most two of them, we’re going to fund factories for all seven, just so that we don’t waste time in serially saying, ‘OK, which vaccine works?’ and then building the factory,” he said.

Gates said that simultaneously testing and building manufacturing capacity is essential to the quick development of a vaccine, which Gates thinks could take about 18 months.

…”It’ll be a few billion dollars we’ll waste on manufacturing for the constructs that don’t get picked because something else is better,” Gates said in the clip. “But a few billion in this, the situation we’re in, where there’s trillions of dollars … being lost economically, it is worth it.”

This is exactly the type of planning and spending on attacking the virus that governments should be doing.

See also my post, A Solution if We Act.

Comments

Ah, but can Mr. Gates get regulatory permission to actually distribute any drugs for use when the time comes?

Yes.

Seriously. Of all the problems, this isn't one.

Like Alex, I think the FDA is normally too restrictive. That is not going to be a problem for vaccine candidates.

Counter-example: development of a replacement test in the U.S. was held back by the FDA because certain activities (e.g., sample gathering) could only be done at a "certified lab"

Governments range from the Trump administration on up.
Companies range from Theranos on down.
Glad that the BMGF is near the top of the range for nonprofits.

Or not, the free market seems to be working fine here. I love the reaction from state capacity libertarianism to a an example of a non-market failure private enterprise success story "we need more government in that market cuz can't have state capacity without a state". Libertarianism has come a long way I see.

If you're of a certain age, your father told you stories of Henry Kaiser and liberty ships.

I guess if you're younger you might think it's impossible or a fairy tale?

And that is really sad. We stopped doing things because we started believing there impossible.

Came here to say this. A private citizen does a great thing, and all Alex can do is complain that government didn't do it first.

Stop posting "I'm surprised a libertarian would say this." This guy is a pure statist, and he shows it very plainly just about every day.

Do you understand what you're saying?

It becomes an ideology when you demand that only one sector should ever be in play. For socialists that is government. For arch capitalists that is business.

I think in an international emergency a sane person says all hands on deck.

Not an ideologue.

Are people with small hands helpful?

Keep hate alive.

Exactly!

What could be more hated than the 94% income tax rate on the .01%? Paraphrasing an earlier president, “…in this time of grave national danger, when all excess income should go to win the war (beat the virus)…Profits must be taxed to the utmost limit consistent with continued production. This means all business profits-not only in making munitions (medical supplies), but in making or selling anything else.

Not all of us enjoy political snark, and your snarky disdain for what you presume are my political views is off the mark.

Have a nice life.

It’s tough to fight sark on the Internet.

Gates has consistently called for a nationwide 10 week shutdown. He doesn't think state-by-state shutdowns work at all because viruses don't care about state lines. He's right. You know he's right.

Except they won't stop at 10 weeks.

On April Fool's Day, Anthony Fauci said we could “relax social distancing” once there’s “no new cases, no deaths,” but the real turning point won’t come until there’s a vaccine.

So 18 months then. Controlled flight into terrain.

Even countries like Singapore and South Korea are looking at data, and making decisions based on data. They will stop when the data supports stopping - basing decisions on anything else is pure idiocy during a pandemic.

Unless you believe in presidentially promised miracles.

Wuhan has plans to stop at 11 weeks, basically.

A truly data-supported approach looks at all types of data. If this drags on forever, no country in the world will have the luxury of wholly ignoring economic data.

In most countries lockdown enforcement will cease—perhaps chaotically—on other than purely medical criteria. Consider that a prediction. Developing countries especially will have no choice.

Lockdown overreach might even discredit the very idea, and lead to a disastrous under-reaction if the next pandemic is a smallpox-in-the-New-World existential threat.

Wuhan is not exactly poised to go back to its absolute lockdown, but this is reporting from yesterday. "Residents of Wuhan have been warned to stay indoors and strengthen protection measures, a few days before travel restrictions on the city at the centre of the pandemic are scheduled to be lifted.

The city’s top official urged vigilance as authorities sought to ward off a second wave of infection from incoming travellers, while also easing some of its stringent containment measures." https://www.theguardian.com/world/2020/apr/03/coronavirus-wuhan-residents-told-to-stay-inside-and-be-vigilant

And data is being collected in, and shared by, a number of places. America seems a bit of an outlier in many ways, but there is little question that information is being collected by several countries, such as South Korea or Germany, where the health care system is yet to be overwhelmed, and where the necessary abilities and infrastructure allow for the continued development and deployment of better and larger testing regimes.

And at least in Italy, Spain, and France, no one is concerned at lockdown overreach, since they actually worry that their lockdowns are not tight enough. The French will be deploying something 160,000 police (and possibly further military manpower) on their roads to prevent Easter travel, for example.

Sadly, the U.S. is likely going to be an example of what happens when an effective lockdown is not used early enough, making what happened in Italy, Spain, and France seem a better case scenario.

...that information is being collected by several countries, such as South Korea or Germany, where the health care system is yet to be overwhelmed,...

You think they will be overwhelmed some time in the future?

<blockquoteSadly, the U.S. is likely going to be an example of what happens when an effective lockdown is not used early enough, making what happened in Italy, Spain, and France seem a better case scenario.

Out of the U.S., Italy, Spain, and France, what country do you think is going to have the lowest COVID-19 fatality rate per million population? Which do you think is going to have the highest?

This virus is 6 months old. Till now, the South Koreans are keeping an adequate lid on the pandemic, in likely part due to retaining a higher degree of readiness regarding North Korea and the threat of biological warfare.

And who knows who will have the lowest fatality rate per million? Effective treatment regimes or vaccines are not yet available, but as soon as they are, one assumes that it is unlikely that any nation affected after that time point will have anywhere near the fatality rate per million of the U.S., Italy, Spain, and France.

The amount we simply don't know is much greater than the amount we do know.

Prior you’ve been pushing this NBC war theory for weeks.

Singapore? Taiwan?

Are they also?

Taiwan has been ready for war with the PRC longer than the vast majority of commenters here have been alive. That readiness along with an assumed American commitment to Taiwan's defense is the reason that Taiwan is not part of the PRC. North Korea is a greater immediate and rogue threat to South Korea than the PRC to Taiwan, but it seems reasonable enough to believe that Taiwan is considerably better equipped for NBC war than any former Warsaw Pact member today. Singapore is a tiny and exceptionally well run city state that never had any real participation in realistic Cold War scenarios.

State lines are irrelevant, but so are federal lines.

I call for density by density shut down. We shut down dense places in phase two. Shut mass transit, ER rooms, concerts, government meetings, class rooms. The are the high spreaders, the ones that make the curve peak sharply. Then let herd immunity build up at a slower rate, make the virus follow the circuitous route. In four weeks, after testing rates are up, start to reopen certain mass venues when antibody rates are 15%.

My plan is ex post.

It is a plan for an experiment already done. I know my plan works because NYC is already clobbered, game over. The entire city is built around mass gatherings.

By the way, my plan says that rural areas that are sparse and slow need not lock down. These areas will get the virus about as fast now as after herd immunity takes hold. Some idsize cities can wait two or three weeks before starting lock downs. They will get the virus from phase one travelers anyway, but if their native economy has a slow R then there is no need to rush the lock downs.

We are all getting this virus. The optimizing problem is not to overwhelm the hospitals. That problem differs according to the local rate of mass gatherings, which varies. Some factories can operate without mass congestion and proper precautions. They need only reduce their rate of infection to that of a seasonal flu.

How do I know this? I watched NYC the last week and NYC told us about everything we need to know and it is making the data very solid, we know how to minimize the race to herd immunity.

And the answer for pandemic buffs for all time: to learn the immunity spread, watch NYC, they gonna go through it first and establish all the constants you need with at least two weeks delay. Number one rule of epidemiology.

Except those 'constants' are not constant but in fact context dependent as you point out yourself. So how does watching NYC burn really help in tailoring reaction elsewhere?

Especially since NYC is about the same as Milan, Madrid, or Strabourg. The only difference seems to be that now a virus is wreaking its eminently predictable havoc among another population, it is getting more difficult to pretend that it won't happen wherever someone is.

The virus cares nothing about what we think.

"By the way, my plan says that rural areas that are sparse and slow need not lock down."

We have a vacation home in a rural county in northern Michigan that has one stoplight and no reported cases adjoining two other counties with one case each. BUT under non-lockdown conditions, they would certainly get hit. Vacationers would resume flowing in from the Detroit, Chicago and other urban areas to the south. And a sparsely populated county doesn't mean people do not congregate. They do -- in the same relatively small number of bars, restaurants, and grocery stores (not to mention churches). And it goes without saying that they don't have a lot of ICU beds in the area. It's not just hypothetical this is happening just a few counties over.

Of course rural areas will be infected... and often worse, per capita, than urban areas. They all go to the same supermarket and push the same carts, get coffee at the same mini-mart, go to the same church and sing in each other's faces (refusing to believe that could possibly be a bad thing).

All it takes sometimes is one event, given how virulent this virus is. See:

https://www.cnn.com/2020/04/02/us/albany-georgia-coronavirus/index.html

This all happened because of one or two funerals ......

...they all go to the same supermarket and push the same carts, get coffee at the same mini-mart, go to the same church and sing in each other's faces (refusing to believe that could possibly be a bad thing).

You know, those hit hardest hit (by far) in Michigan are not rural religious white 'yokels', but rather black city-dwellers some of whom apparently believed a rumor that social distancing wasn't needed because melanin protected them against the virus.

Still want to point and laugh? Or would pointing and laughing at 'dumb' church-going black Detroiters be actual bigotry as opposed to pointing and laughing at 'dumb' church-going rural whites (which, of course, is de rigueur).

in the current viral pandemic/political climate
the minute the president calls for a nationwide lockdown the obvious problem will be enforcing the lockdown.
the newyorktimes.com and cnn.com will immediately make this another wedge issue/confrontation.
its better to let the governors institute lockdowns even if some of them
are too slow because enforcement of lockdowns will mostly have to be done by the individual states.

"This is exactly the type of planning and spending on attacking the virus that governments should be doing."

Except the government was busy spending a couple trillion keeping the economy on life support because we didn't consider other ways to mitigate other than throw millions of people forcibly from their jobs.

But hey, if he can get a vaccine, great. Meanwhile, can we stop pretending it's essential to shut down Wyoming when the NYC airports are open and people are spreading Covid-19 on the crowded NYC subways or by coughing on bus drivers?

I kind of wish his planning had included privately stockpiling a few billion N95 masks, back when they cost a buck apiece.

Hindsight is great.

Because the idea of a pandemic has been kicking around for a while. Even buying those masks in as late as 8 weeks ago would have been extremely helpful. Notice that 'late,' since there was nothing early about making preparations for Covid19 starting in February. Beginning of January, maybe.

IDK, strategic stockpiles are more of a CDC task than a private charity task.

I'm not even sure if charities are allowed to stockpile. Don't they have minimum spend percentages each year? Or is that just foundations?

But for him of all people, it wasn't hindsight. His 2015 TED Talk on pandemics is now famous. And his whole post-Microsoft second act has been about public health.

The efforts from Bill Gates are appreciated and much needed but governments have already been at work on this problem and deserve our thanks too.

For US efforts, NIAID under NIH, Walter Reed. US Army Medical Research, and the University of Pittsburgh are all at various stages with their vaccine research. The University of Queensland in Australia, Imperial College London in the UK, the University of Saskatchewan in Canada, the Government of Canada, the Chinese CDC, and the University of Hong Kong round out the rest of government funded efforts that is publicly disclosed.

https://en.wikipedia.org/wiki/COVID-19_vaccine

The ones in Phase 1 trial are mRNA-12 from US NIAID and Ad5-nCov from CanSino Biologics from Tianjin, China.

https://en.wikipedia.org/wiki/COVID-19_drug_development#Phase_I_trials

Are they also building factories in parallel for all their candidates?

Of course not, the Chinese are certainly completely incapable of the sort of high tech work that the U.S. is such a world leader in. Most definitely including building any facilities at the level of technology and speed which the U.S. can. And the Germans are simply too interested in efficacy to actually start doing anything but planning how to adapt/create facilities to manufacture vaccines, in similar fashion to how they have adapted/created facilities for manufacturing a variety of tests, in large enough numbers to have already start antibody testing of 100,000 people in the worst hit area, with the hope that even the preliminary results will allow policy to be guided by data.

Gallows humor doesn't help much, but it is still better than screaming in frustration at stupidity. Gates is making a contribution, but in the scale of things, it is only large on the level of an individual, not a modern functioning state, regardless of political model.

I imagine building a factory is the easy part and getting a working vaccine to be the hard part.

In all fairness, spreading your bets is not a bad strategy, as building such facilities involves significant lead times.

Because America is slow at manufacturing. The Chinese can pop out new factories as fast as that Wuhan hospital. America can't even make masks or toilet paper fast enough.

A cynic, of the variety that would never be attracted to a place like MR, might just wonder if Gates is spending his money in China, South Korea, Japan, Germany, Switzerland, as one assumes that all five countries have the necessary combination of technical ability and infrastructure to reward his strategy.

Or maybe Gates reads MR, and is counting on the sort of American gungho spirit prised by Tyler in a time that seems extremely remote in the light of recent events.

Betting the covid trials futures. He is buying dosages in the predicted concentration before the trials are finished. Allow us all the same opportunity, get the online covid futures market up and runing.

Isn't this the precise opposite of using efficient market mechanisms to solve problems? Gates is seemingly wasting money/resources far beyond the profligate level of waste so many decry regarding government inefficiency. It is good that vaccines being developed in Germany or China can also be manufactured in the U.S., considering that it appears that America First policies may end up meaning America alone.

Spreading your bets when developing a new medicine by randomly trying candidates is very common in R&D, it's called the "shotgun approach". The only difference here is the simultaneous factory building, which is rare.

Just yesterday the Kraft Family, which owns the New England Patriots, sent the Patriots plane to bring 1M N95 masks from China. The federal government, of course, has plenty of planes, but it didn't use any of them to retrieve masks. That same government spent trillions of dollars recently, but couldn't find a few billion to spend on accelerating the mass manufacture of a vaccine. So, centralized government has plenty of resources, i.e., it collects plenty of taxes; it just can't always deploy resources effectively. No central entity can be perfect or have perfect knowledge of everything. When resources are dispersed, we increase the chances that someone will plug the inevitable gaps left by the central government. Thank goodness we have a lot of wealthy, private philanthropists in this country that can fill that role.

State capacity as a concept is too narrow. Civil society capacity is what matters.

Plenty of governments around the world know how to buy masks and do. You just elected morons to run yours.

"Civil society capacity is what matters."

You mean the one that is collapsing without trillions printed by Uncle Sam? Civil capacity doesn't exist when your society failed its middle and working classes.

"but it didn't use any of them to retrieve masks"

Because of course the Chinese are going to allow American military cargo aircraft to fly into China. Just like we would let Chinese military cargo planes to fly into Dulles.

Prior thinks all of our planes are military aircraft...?

Huh?

Not to be a jerk here, but there is some history of Chinese-manufactured N95 masks not meeting US standards.

"This is exactly the type of planning and spending on attacking the virus that governments should be doing."

This is usually referred to as "wasteful government spending" by our usual political thinking. It's usually followed by a charade on the Hill where a pol grandstands before C-SPAN cameras with a "so let me get this straight, you spent millions to build a factory before you had a working vaccine? And you did this for the other six failed vaccines too?"

Just name the factories after the politicians appropriating the money. The late Sen. Robert Byrd was a master at it.

https://en.wikipedia.org/wiki/List_of_places_named_after_Robert_Byrd

Don't spoil the fairy tale. And never look behind the curtains for the motive. Leave that up to the professional public choice economists - they know precisely where to tell everyone else to look.

It's time for the baby-boomer generation to face the inevitability of their death and that the world will go on without them.

The American baby boom generation, though more generally, American society. What is starting to occur in the U.S. is a pandemic, not a made for TV miniseries with a happy end. A lot of people are not going to enjoy learning that fact.

The Italians are mourning their dead, as they have done for thousands of years following the results of a deadly contagious disease. Exceedingly few there expect to live forever, and few believe in Silicon Valley dreams of life extension.

Tell Boomers they can watch all the "I Love Lucy" reruns they want in hell. It might work.

This odd notion that it is 'only the old people' seems to never die. Obesity is also a large (ha-ha) risk factor and we all know the US is full of young fatties.

Trump's performance: 8>
Captain Bolsonaro's performance: 8======>

Nothing can infect the strong leadership and the brave people of Brazil. When you show cowardice to the virus, you are not a man and but a sad goat accepting sickness and death.

He understands his county better than you. Brazil is in far more danger and risks far more lives by shutting down for 2 months than a few hundred thousand flu deaths with an average age of 80.

Trump is not covering his nose, in an example of do what they say, not what I do, that the Captain (and Tenille too?) could never match.

USA number 1!

18 months until a vaccine, even with the help of the very worthy Bill Gates?

In Thailand, the workers are saying, "We will not die from Covid 19, we will die from hunger."

I hope the shutdowns work, although they have not in Hong Kong. We will still have a naive population and a novel cold virus in two weeks, four weeks or 10 weeks.

There is no exit strategy from shutdowns. They are a dead end.

Good luck everybody.

"There is no exit strategy from shutdowns."

Wuhan seems to have exited from their shutdown.

https://www.foxbusiness.com/lifestyle/wuhan-reopen-coronavirus

There is a link above from the Guardian suggesting that Wuhan is not exactly exiting quite yet, and will be shutdown in a heartbeat if there are any problems.

Think of Wuhan as a lab experiment, being run by precisely the same people who shut it down completely over 11 weeks.

Yes, they are releasing the grip slowly and prepared to retighten. No country in the west has even attempted a lockdown system like the one in Wuhan.

There’s a real danger that the West screws this up so badly we get an 18 month long economic collapse AND the virus burns through the entire population since our lockdowns were ineffective anyways.

>There is no exit strategy from shutdowns. They are a dead end.

This is why we should have quarantined the hot spots early on (i.e., stricter rule over a narrow geographic reach). The rest of the country could provide succor for NYC, Seattle, etc. for months or years.

"This is exactly the type of planning and spending on attacking the virus that governments should be doing." My how I laughed. Have you ever met a government? Specifically, have you met US fedgov?

This is a problem just made for an intelligent, sane plutocrat with a desire to do good. Well done, Mr Gates.

This is very, very good of Bill Gates. But our government is capable enough of far more on the order of 1000s of times more. And all of you know that, even if you think the government is evil or something. But we need to beat this thing somehow- and yeah there is going to be a lot of costs. Sorry- this thing sucks and if you live here you and me are going to pay a cost to deal with it.

Fauci said the other day they are preparing for scaling up production of the NIH supported vaccine just in case it works. The company will start producing it even before it’s approved. Not the same as 7 vaccine candidates but they’re doing it for their federally supported clinical trial.

How about this. Find a place near a decent remote airport somewhere in the Midwest, so it has reasonable access from both coasts. Maybe pick an army base (see below)
Build a (I am picking a number without much expertise) 10,000 bed hospital facility and equip it for COVID 19 patients (whatever that looks like-I do not know).
Build local housing, (or if an army base, use existing barracks).
During the pandemic, pay medical staff very, very high amounts to incent them to sign up for 6 month gigs there (or 3 months, or whatever the market is).
Us a couple of grounded planes and flight crews to stand by to bring passengers who need to go to the big facility.
Use this as an overload hospital for wherever you get overload. Let's say NYC/NJ will be using 80% of the beds now. Come 2 months from now, when they are well past their peak, maybe Miami or Dallas will need the excess beds.

When done, this becomes a pandemic research center and will still have facilities to say, treat weird infectious diseases that show up (it is where Ebola 2.0 patient #1 gets sent), not in DC (for those suspicious of another federal program controlled in DC). You will not need to pay medical people more to be there, because doing your epidemiology training at "Omaha Central" will be a badge of honor, like playing your college football at Alabama or getting your engineering degree at Georgia Tech.

Gates would be more credible if he and his own family had gotten vaccinated over the years instead of refusing that.

I completely agree, if Bill Gates and his family are vaccinated then that enhances his credibility. Of course, there's no evidence that they haven't been. And every claim that the Gates family is unvaccinated hasn't provided any proof.

So perhaps a more relevant consideration is that you would be more credible if you didn't post things that have been debunked.

has only suffered from a constricted arse. why expect him to be vaccinated - his whole skin looks like falling apart - an area of whiteness.

Turns out there are some public goods billionaire philanthropists can supply and government can't.

Compare and contrast. Regarding German exceptionalism: Ms. Merkel has communicated clearly, calmly and regularly throughout the crisis, as she imposed ever-stricter social distancing measures on the country.

Good on the Gates and the Gates Foundation! This seems like a great idea for a big foundation to step in aggressively, in a way that would be hard for the private sector or government I think.

Pace Alex, I do think this would be a very hard thing for a government to do politically: We're going to build 7 factories, knowing full well that between 5 and 7 will end up useless.

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