In an increasingly complex world, how can any of us have enough information to make educated decisions?
Yesterday I joined Devi Sridhar on Twitter to answer questions about the COVID-19 pandemic. We tackled everything from the breakthroughs we still need to the origins of the COVID virus to whether the world will be ready next time. Devi joined me from Scotland, where she works as a professor and department chair at the University of Edinburgh Medical School. She’s also the founding director of the Global Health Governance Programme, which does great work improving health systems for people all around the world.
You can read our full conversation below.
To kick-off the conversation with @BillGates, what scientific or tech breakthrough would make the biggest difference now to ending the COVID pandemic?
— Prof. Devi Sridhar 🌈 (@devisridhar) January 11, 2022
The vaccines we have prevent severe disease and death very well but they are missing two key things.
— Bill Gates (@BillGates) January 11, 2022
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.#
Agree 100%- next gen vaccines with sterilising immunity. 2nd question: What are the current challenges in reaching global vaccination access? What are the obstacles?
— Prof. Devi Sridhar 🌈 (@devisridhar) January 11, 2022
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.
— Bill Gates (@BillGates) January 11, 2022
mRna vaccines still can't meet all the demand so figuring out who gets what is complicated.#
— Bill Gates (@BillGates) January 11, 2022
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?
— Prof. Devi Sridhar 🌈 (@devisridhar) January 11, 2022
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. #
— Bill Gates (@BillGates) January 11, 2022
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?
— Prof. Devi Sridhar 🌈 (@devisridhar) January 11, 2022
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.
— Bill Gates (@BillGates) January 11, 2022
Also some countries did a better job of reducing mobility, using masks and protecting the elderly.
— Bill Gates (@BillGates) January 11, 2022
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.#
— Bill Gates (@BillGates) January 11, 2022
I'm optimistic about the '100 day challenge'- the idea of sequencing a new genome to developing diagnostics, therapeutics and effective vaccines- and getting them out to people. But requires leadership, planning & foresight. Now is the window to prepare.#
— Prof. Devi Sridhar 🌈 (@devisridhar) January 11, 2022
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?
— Prof. Devi Sridhar 🌈 (@devisridhar) January 11, 2022
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...
— Bill Gates (@BillGates) January 11, 2022
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?#
— Bill Gates (@BillGates) January 11, 2022
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?
— Prof. Devi Sridhar 🌈 (@devisridhar) January 11, 2022
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.
— Bill Gates (@BillGates) January 11, 2022
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.#
— Bill Gates (@BillGates) January 11, 2022
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?
— Prof. Devi Sridhar 🌈 (@devisridhar) January 11, 2022
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. #
— Bill Gates (@BillGates) January 11, 2022
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?
— Prof. Devi Sridhar 🌈 (@devisridhar) January 11, 2022
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.
— Bill Gates (@BillGates) January 11, 2022
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.
— Bill Gates (@BillGates) January 11, 2022
.@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!!#
— Bill Gates (@BillGates) January 11, 2022
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.
— Prof. Devi Sridhar 🌈 (@devisridhar) January 11, 2022
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