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From Gates to Osterholm: The coronavirus was actually expected

Bill Gates
REUTERS/Arnd Wiegmann
Bill Gates in April 2018: "There is one area, though, where the world isn’t making much progress, and that’s pandemic preparedness. This should concern us all, because if history has taught us anything, it’s that there will be another deadly global pandemic."

At a White House press conference last week, the president noted that the novel coronavirus had “snuck up on us.”

China might be the only country that could say it “snuck up” on them, since the virus was born there. And yet the SARS outbreak in 2003 was living proof of how the intimate mixing of wild and domesticated animals with humans in so-called “wet markets” was a pandemic virus incubator. But China ignored the warning and only briefly shut them down.

The truth is, the novel coronavirus snuck up on no one. And it wasn’t fringy conspiracy theory bloggers who were sounding the pandemic alarm. It was some of the best and brightest people on the planet, including Bill Gates. The self-described “super-optimist” said this in April 2018:

There is one area, though, where the world isn’t making much progress, and that’s pandemic preparedness. This should concern us all, because if history has taught us anything, it’s that there will be another deadly global pandemic.

We can’t predict when. But given the continual emergence of new pathogens, the increasing risk of a bioterror attack, and how connected our world is through air travel, there is a significant probability of a large and lethal, modern-day pandemic occurring in our lifetimes.

And he said this:

In the real world, though, the health infrastructure we have for normal times breaks down very rapidly during major infectious disease outbreaks. This is especially true in poor countries. But even in the U.S., our response to a pandemic or widespread bioterror attack would be insufficient.

‘More than likely … an unknown pathogen’

Then Gates said this:

However, the next threat may not be a flu at all. More than likely, it will be an unknown pathogen that we see for the first time during an outbreak, as was the case with SARS, MERS, and other recently-discovered infectious diseases. [SARS and MERS are both coronaviruses]

At the Munich Security Conference last year, I asked world leaders to imagine that somewhere in the world, there is a weapon that exists – or that could emerge – that is capable of killing millions of people, bringing economies to a standstill, and casting nations into chaos.

If you had listened to that April 2018 lecture and thought, “That Gates guy is a little bit of an alarmist,” then you might have also dismissed an October 2019 event hosted by the Johns Hopkins Center for Health Security as kind of a Star Trek convention for public and international health braniacs.

It was titled “Event 201” and began with the modeling of a fictional novel coronavirus they named Coronavirus Associated Pulmonary Syndrome (CAPS). Their fictional CAPS started in pigs in South America, but once it crossed over into humans it behaved like COVID in every other respect — quickly moving around the globe, overwhelming health care systems, tanking financial markets and businesses, causing unprecedented social upheaval, and paralyzing the business and government systems required to deal with the pandemic. (For the exercise, their model predicted 65 million deaths globally, and since COVID’s arrival Event 201 representatives have been busy pointing out that that number should not be extrapolated to COVID, as it used different inputs.)

Fifteen prominent, knowledgeable individuals from global business, government, and public health were part of a panel that spent the rest of the conference discussing private-public partnerships that might mitigate the worst outcomes of the projected pandemic. They came up with seven recommendations, put their crystal balls back in their briefcases, and went home. And the band played on.

Larry Brilliant’s 2006 TED Talk

Going back further, in 2006, epidemiologist Larry Brilliant won the TED Prize for his development of an early detection system that would crawl the web, global news, and social media to detect the earliest sign of an infectious outbreak. After beginning his TED talk by discussing global efforts to eradicate smallpox, he moved on to the likelihood of a bird flu. Having previously surveyed a number of the top epidemiologists in the world, he summarized their answers:

Ninety percent said they thought there’d be a pandemic within your children or your grandchildren’s lifetime. And they thought that if there was a pandemic, a billion people would get sick. As many as 165 million people would die. There would be a global recession and depression as our just-in-time inventory system and the tight rubber band of globalization broke, and the cost to our economy of one to three trillion dollars would be far worse for everyone than merely 100 million people dying, because so many more people would lose their job and their health care benefits, that the consequences are almost unthinkable. And it’s getting worse, because travel is getting so much better.

Fortunately, those predictions were much closer on COVID’s economic impact than on its mortality, but 14 years after Brilliant’s TED Talk, viruses continue to do their thing: replicate and mutate. You can think of an RNA virus like the coronavirus as the world’s tiniest slot machine, perpetually rolling over its genetic slots, hoping to hit a “winner” — a new mutation that creates a virus that is easily passed (infective) and unrecognized (‘novel’, so no one has immunity). From a virus’ standpoint, it just needs to replicate and move on to the next unwitting victim; it doesn’t need to kill anyone, but it will.

Within a few weeks of Event 201, one lucky coronavirus hit it big in China’s Hubei province, and it’s been following the script ever since. All of this was foretold. If this COVID virus “snuck up on us,” it was because we ignored the prophetic voices of some of our smartest advisers, including Dr. Michael Osterholm at the University of Minnesota’s Center for Infectious Disease Research and Policy. Osterholm is an international expert on influenza preparedness — and the lack thereof, even as our awareness and expectation of a coming pandemic rises. In a recent interview, he made his point with alliteration, noting we often “elect to neglect it.”

The lesson we learn from history is that we are often unable to learn from history.

Dr. Craig Bowron is a Twin Cities internist and writer.

Comments (17)

  1. Submitted by Sheila Kihne on 03/27/2020 - 10:24 am.

    Can you also put out what Osterholm has said yesterday in his podcast?

    That’s there’s NO DATA showing limiting crowd sizes, of closing schools does anything to change numbers??

    Post it for your readers. Truly unbiased dialog that needs to happen right now!

    Lastly, MN journalists have a duty to refute the poppycock numbers that Walz put out this week of “74,000 dying” in Minnesota. Can anyone find the model and raw data that was derived from? The latest projections show 80,000 total dying in the US– that’s the same number as the 2017-2018 flu season.

    http://www.healthdata.org/sites/default/files/files/research_articles/2020/covid_paper_MEDRXIV-2020-043752v1-Murray.pdf

    • Submitted by Robert Ahles on 03/27/2020 - 01:21 pm.

      Many Trump supporters are much like Trump. Their opinions are little influenced by reality. They continue to believe whatever seems to make them feel better about themselves. Trump’s childish behavior, his infidelity, his lies, his treatment of allies, his flip-flopping, his lack of accomplishment and inconsistencies matter not a whit. Their blind allegiance to a single political leader is not patriotism or American, it is the characteristic of a Sheeple. They will defend him regardless of what happens, come hell or high water or the coronavirus.

    • Submitted by Dave Wahlstedt on 03/27/2020 - 01:30 pm.

      Instead of waiting for MinnPost or Dr. Bowron to post the Osterholm podcast you mention, can you do it, please? I am interested based on your comment and have been searching for about 15 min, but I find him on everyone else’s podcast (especially Joe Rogan’s) and every other date other than the 26th, but not his own podcast, and not the 26th.

    • Submitted by Dave Wahlstedt on 03/27/2020 - 01:56 pm.

      And as I listen to him in other places, my guess is he was saying that the total number of cases won’t change, not that we can’t “flatten the curve” and reduce the total number of deaths as a result. Your comment implies there is no point to limiting crowd sizes, closing schools, etc., but I doubt that is what he is saying. If he really is saying that, I’d like to hear it.

    • Submitted by Pat Terry on 03/27/2020 - 04:00 pm.

      I don’t know what podcast to which you are referring, but based on what I have seen from Osterholm elsewhere, I expect that you are misrepresenting what he said.

    • Submitted by Craig Bowron on 03/27/2020 - 09:56 pm.

      Do you mean his March 24th podcast? http://www.cidrap.umn.edu/covid-19/podcasts-webinars/episode-1-how-we-got-here

      Gov. Walz said in his March 25th FB broadcast that his modeling projections are made in partnership with the MN Dept of Health and the University of MN. One minute in. https://www.facebook.com/KARE11/videos/256611328708223/

    • Submitted by Paul Udstrand on 03/28/2020 - 12:29 pm.

      Osterholm has NOT said this. It’s possible that someone has misinterpreted something Osterholm said, specially if the interpreter is somewhat scientifically illiterate. If by “numbers” you mean those who end up ultimately infected, it’s true that the measure being taken might not change the final number of infections. What we’re doing here though CAN spread that infection RATE out so that our health care system isn’t hit with thousands of patient all in one month or so. Osterholm probably explained that somewhere, but he wasn’t saying that the measure he’s been advocating for decades will have no effect in managing the pandemic.

    • Submitted by Paul Udstrand on 03/28/2020 - 12:39 pm.

      Sheila,

      These model are based extremely complex statistical calculations that very few people would be able to understand if they could look at the “numbers” themselves. These models and studies hare being published every week but they’re published in peer reviewed scientific journals behind relatively expensive paywalls. You won’t find these documents in a newspaper, website, or magazine, and even you could, you wouldn’t be able to make heads or tails our it. There are for instance no “raw” numbers because these are projections based on infection rates extrapolated from current cases compared to data drawn from other regions and scenarios.

      This isn’t a debate game, you can’t go shopping for models that support your “argument”.

    • Submitted by David Silverman on 03/29/2020 - 07:09 am.

      http://www.cidrap.umn.edu/covid-19/podcasts-webinars/episode-1-how-we-got-here
      Osterholm podcast on March 24
      [my transcript]

      “… certain events likely have very little impact on whether or not the virus spreads, and one of them, which is counterintuitive to most people, are crowds.” [the virus really spreads within small, intimate groups – my summation – DS]
      ––––––––-
      https://www.rev.com/blog/transcripts/joe-rogan-michael-osterholm-podcast-transcript-infectious-disease-expert-talks-coronavirus
      But from Joe Rogan interview on March 10:

      “You know, today you have an underlying health problem and you’re particularly over age 50, 55 I’d say avoid big crowds if you can, and that’s going to be really important…”

      My take on this, is that in the big picture, if you do not have strict social distancing and isolation, then it won’t matter if people congregate in large crowds or in small intimate groups – the virus will spread the same. But if there were strict social distancing, you would not have the small groups either, and that would make a difference.

      However if you’re not going to have strict social distancing, at least people at high risk should avoid large crowds. Even though the virus would spread the same for the population as a whole, at least high-risk people would be somewhat more protected. Hmm… I’m not sure I understand the reasoning behind this: does that mean that high-risk people are more likely catch the virus in large crowds than in small groups? It sounds like, from the March 24 podcast, that the virus is spread more in small groups than in crowds, in which case it would be better to avoid small groups than large crowds.

      Another factor to consider is that Osterholm gave the Rogan interview on March 10th, and made the podcast on March 24th, during which time he had privy to new data. It would be nice to interview him again, and get the explanation of this apparent contradiction.

  2. Submitted by William Hunter Duncan on 03/28/2020 - 09:02 am.

    I was one of those fringe bloggers, and I have known something like this was coming since I read Laurie Garrett’s NYT Bestseller “The Coming Plague” in 1995.

    If you have read any Jared Diamond, Joseph Tainter, or William Catton, then you know Covid 19 (SARS, MERS) was inevitable based on an economic model that, like all empires before it, believes in eternal growth. Such societies believe ecological rules are less important than economic ones, and so abuse the ecosystems they are dependent on until the system can no longer sustain what has been built.

    Viruses are part of the biosphere’s management system. Economics is merely a thing built out of ecology. In this sense, a virus is simply a check of the earth that no thing be out of balance. It is not merely about being prepared, it is about building an economy that respects ecology and is consciously defined by it, so that such viruses need not rise.

    Every empire before this one we call loosely, neoliberal globalization, has collapsed, and viruses have been a factor in every one. The question now is, do we use this crisis to not merely prepare for the next virus, or do we redefine the economy to be more local fundamentally, and healthier for people, families, communities, pollinators, the land and waters?

    • Submitted by Craig Bowron on 03/31/2020 - 09:08 pm.

      Unfortunately, I haven’t read Diamond, Tainter or Catton. But I’ve read (and believed) a lot of Wendell Berry, and so your comments resonate with me and Wendell–who wrote the following:

      “The ruling ideas of our present national or international economy are competition, consumption, globalism, corporate profitability, mechanical efficiency, technological change, upward mobility—and in all of them there is the implication of acceptable violence against the land and the people. We, on the contrary, must think again of reverence, humility, affection, familiarity, neighborliness, cooperation, thrift, appropriateness, local loyalty. These terms return to us the best of our heritage. They bring us home.” P. 64 Our Only World

  3. Submitted by BK Anderson on 03/29/2020 - 11:07 am.

    What can one say about a supposedly advanced nation that pours a trillion dollars a year down the rat-hole of wasteful militarism (as “national defense”), yet concludes that it should scrimp on (a hundred times-cheaper) pandemic preparedness? That concludes nuclear war with Russia, North Korea and (bomb-free) Iran is more likely than the rise of a new strain of deadly virus? That (repeatedly!) ignores medical advice and expertise?

    As for our (rather egotistical) “conservative” friends who think they can “prove” the nation’s epidemiologists “wrong” via their studious use of the Google, this is what we can expect from a movement that concluded that untutored laymen could hunt around on the internet and conclusively prove NASA’s climate scientists were “wrong” on global warming as well.

    Of course, the Obama admin had at least attempted to put pandemic preparedness on the federal radar screen after Ebola (and the Repub party’s cynical and use of that scare to win another election). But the Grand Incompetent and his crackpots wiped even those rudimentary processes out upon his “election”, because….Obama!

    • Submitted by Craig Bowron on 03/31/2020 - 09:29 pm.

      You must not be a big fan of Space Force, which ironically launched another $1.4 billion satellite into space last Thursday. Spent early and thoughtfully, that amount of money could have saved some lives.

      Osterholm has long described pandemic readiness as a matter of national defense, and COVID only tempers that point.

  4. Submitted by Paul Udstrand on 03/30/2020 - 09:10 am.

    Yes, pandemics have indeed been expected AND planned for for over a decade. Many millions of dollars were spent on planning and training, and thousands of public health officials and scientists all over the country have been prepared for this for many years.

    The problem is that ALL of THAT planning always assumed that the federal government would stand up like it always has. Without national coordination and federal direction and intervention even localized disasters can overwhelm State, city, and county agencies. THAT national response still hasn’t materialized.

    Trump has had three years to re-make the government into his own bankrupt prone image and he’s been quite successful. Thousands of competent and experienced professionals throughout the government have either been fired or resigned because of political interference and facile loyalty demands that had nothing to do with their missions.

    Hundreds of positions are still not filled, or filled with interim appointees. And most of the agencies are working with 2nd, 3rd, or even 5th appointed heads. We’re no longer looking the “b” team, we’ve moved on the “D” and “E” teams. Trump’s only job qualification is those who demonstrate sufficient loyalty to himself, and adoration of his “leadership”. EVERYONE who’s supposed to working on this has constantly look over their shoulders because if they dare do their jobs they do so at the risk of pissing Trump off somehow, or contradicting some stupid thing that he just said.

    We remain in a pattern of reaction rather than pro-action, and we’re a month or two behind where should have been on almost any measure from protective gear to testing and respirators.

    If Trump or someone in the White House had bothered to read the 100 page plan that was written to address a crises like this, they would have anticipated the respirator shortage two months ago, and we’d have new respirators rolling out of production today. Instead we’re waiting for auto companies who’ve never built respirators to re-tool because pushing that manufacturing out to car companies has been a political decision… Trump wants to say he put auto workers back on the job. And so it goes.

    It’s impossible to overestimate the damage done by a buffoon in the White House who doesn’t know the difference between managing a “portfolio” and running a government. The fact that Trump is a lousy portfolio manager at that just makes it all the more tragic. We have exactly the wrong people in exactly the right place to screw this up on a monumental scale.

  5. Submitted by Ron Quido on 03/31/2020 - 10:23 pm.

    Much of federal planning is after-the-fact to address a possible recurrence. Lots of federal grants went to decontamination response in the wake of the anthrax and chemical weapons scare of post 9/11.

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