Bill Gates talks COVID cases after Omicron, lack of pandemic preparation, and those ‘chips in arms’

Bill Gates. (GeekWire File Photo)In a new discussion about the COVID-19 pandemic, Bill Gates said Tuesday that we should expect to see “far fewer cases” of COVID-19 after the Omicron variant and that the virus can be treated more like the seasonal flu the rest of the year.

Gates, the co-founder of Microsoft and co-chair of the Bill & Melinda Gates Foundation in Seattle, took part in a Twitter Q&A on Tuesday with Devi Sridhar, professor and chair of Global Health at the University of Edinburgh and director of the Global Health Governance Programme.

Devi Sridhar. (Twitter Photo)

Among the highlights of the 45-minute conversation, Gates said that COVID vaccines are missing two key things: the ability to prevent breakthrough cases and the ability to last for much longer.

He also said a more transmissive variant after Omicron is not likely, “but we have been surprised a lot during this pandemic.” He added that “Omicron will create a lot of immunity at least for the next year” and that “we may have to take yearly shots for COVID for some time.”

Gates also touched on some of the familiar themes that have come up over the nearly two years that he has been a leading voice on the global and U.S. response to the pandemic, including mistakes that were made, access to vaccines, and the conspiracy theory around whether his interest in vaccines had to do with putting microchips in people.

Gates said he didn’t expect himself and infectious disease expert Dr. Anthony Fauci, to be the subjects of such mininformation campaigns.

“Some of it like me putting chips in arms doesn’t make sense to me,” Gates said to Sridhar. “Why would I want to do that?”

See the full conversation in this thread on Twitter or in the transcript below:

Through my foundation work I’m very lucky to have the opportunity to talk to—and learn from—experts in many different fields. Many of my conversations recently have been about the omicron variant and how to prevent the next pandemic. https://t.co/jYR0KjX4Cx— Bill Gates (@BillGates) January 11, 2022

Devi Sridhar: What scientific or tech breakthrough would make the biggest difference now to ending the COVID pandemic?

Bill Gates: The vaccines we have prevent severe disease and death very well but they are missing two key things.

First they still allow infections (“breakthrough”) and the duration appears to be limited.

We need vaccines that prevent re-infection and have many years of duration.

DS: Agree 100% — next gen vaccines with sterilising immunity. 2nd question: What are the current challenges in reaching global vaccination access? What are the obstacles?

BG: During 2021 the supply of vaccines was limited and they mostly went to wealthy countries. Now we have a lot of supply overall and the problems are logistics and demand. The health systems in developing countries are a limiting factor.

mRna vaccines still can’t meet all the demand so figuring out who gets what is complicated.

DS: There’s been a lot of discussion on responsibility of pharma companies like Pfizer/Moderna for access. What is the role of these companies in ensuring pricing and availability esp in low and middle income contexts?

BG: When we have adequate supply then tiered pricing is used where the rich countries pay a lot more than middle income and low income pay the least which is funded by @gavi. When supply is limited rich countries have to not outbid the others so governments are key to this.

DS: Looking back on 2020/21 (and given you warned of a respiratory pandemic for years before), what do you think is the biggest mistake most countries (with resources) made in responding?

BG: A few countries like Australia moved fast to diagnose cases at scale and isolate people who were infected. They were able to limit deaths dramatically. Once the numbers get large in a country it is too late. So the first few months made a lot of difference.

Also some countries did a better job of reducing mobility, using masks and protecting the elderly.

We weren’t prepared — no practice in advance.

Do you think the world will come together to get ready for the next one? I hope so but I am not sure.

DS: One major problem has been online misinformation on Facebook & other platforms around vaccines, masks and other interventions — how do we deal with this challenge? When expertise is neglected and conspiracy theories are spread as if they are truth?

BG: Trusted authorities like @WHO and @CDCgov need more resources to see the pandemic early (surveillance) and to communicate better. Social media got behind on trying to get factual information out — there will be a lot of debate about how to do better on that…

People like you and I and Tony Fauci have been subject to a lot of misinformation. I didn’t expect that. Some of it like me putting chips in arms doesn’t make sense to me — why would I want to do that?

DS: I’d make a joke but would cause a storm. Turning to the Gates Foundation’s mission, what do you see as the biggest challenges to development in poor countries now? Have we gone backwards on girls’ education & the child survival revolution?

BG: From 2000 to the start of the pandemic we made strong progress on health and other goals. The pandemic is a huge setback – including rich countries not focusing on the needs of developing countries as much. I hope we can reverse that.

I am optimistic about polio eradication — we are close. Malaria, HIV, Nutrition, will take a lot longer but better tools are coming. Education also needs innovation — it is behind where global health is particularly for girls.

DS: So tough question: where do you think SARS-CoV-2 came from? What data do you want to see? And is this information important to preventing future spillovers & pandemics?

BG: The data is pretty strong that it came from another species which is true for most pandemics. People will continue to speculate on this and we should make sure labs are careful. There will be future outbreaks coming from other species so we need to invest in being ready.

DS: Final question — what everyone wants to know — how and when will the pandemic be over? Does omicron show that we can ‘live with COVID’? Or are other dangerous variants around the corner in 2022?

BG: As countries experience their Omicron wave health systems will be challenged. Most of the severe cases will be unvaccinated people. Once Omicron goes through a country then the rest of the year should see far fewer cases so Covid can be treated more like seasonal flu.

A more transmissive variant is not likely but we have been surprised a lot during this pandemic. Omicron will create a lot of immunity at least for the next year. @trvrb tracks the genetics really well. We may have to take yearly shots for Covid for some time.

.@DrTedros has started the conversation about how we avoid the next pandemic which is important. I appreciate your work on this. We can do a lot better next time!!

DS: We definitely can. Thanks for your time & insights & let’s continue the good fight to improve health & well-being for those living across the world. We’re all interconnected & in this together.

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