Log out
My profile and settings
My bookmarks
Comment history
Please complete your account verification. Resend verification email.
today
This verification token has expired.
today
Your email address has been verified. Update my profile.
today
Your account has been deactivated. Sign in to re-activate your account.
today
View all newsletters in the newsletter archive
today
You are now unsubscribed from receiving emails.
today
Sorry, we were unable to unsubscribe you at this time.
today
0
0
Back to profile
Comment Items
You have not left any comments yet.
title
you replied to a comment:
name
description
Saved Posts
You haven’t bookmarked any posts yet.

Melinda and I were thrilled that President Carter found time in his busy schedule to stop by our foundation’s annual employee meeting earlier this year.

read post
Become a Gates Notes Insider
Sign up
Log out
Personal Information
Title
Mr
Mrs
Ms
Miss
Mx
Dr
Cancel
Save
This email is already registered
Cancel
Save
Please verify email address. Click verification link sent to this email address or resend verification email.
Cancel
Save
Email and Notification Settings
Send me updates from Bill Gates
You must provide an email
On
Off
Send me Gates Notes survey emails
On
Off
Send me the weekly Top of Mind newsletter
On
Off
Email me comment notifications
On
Off
On-screen comment notifications
On
Off
Interests
Select interests to personalize your profile and experience on Gates Notes.
Saving Lives
Energy Innovation
Improving Education
Alzheimer's
Philanthropy
Book Reviews
About Bill Gates
Account Deactivation
Click the link below to begin the account deactivation process.
If you would like to permanently delete your Gates Notes account and remove it’s content, please send us a request here.

Let's Get Ready

A better response to the next pandemic

The H1N1 flu wasn’t nearly as bad as predicted, but not because of the effectiveness of the steps taken to contain it.

|
0

The H1N1 flu strain got a lot of attention in 2009. Most of the headlines made it sound dangerous. Early in the epidemic we thought that a very high percentage of infected people were getting sick, and it was quite scary.

But the real story isn’t how bad H1N1 was. The real story is that we are lucky it wasn’t worse because we were almost completely unprepared for it.

When an epidemic breaks out, there are four steps to try to contain it. The first is to gather data about the disease—where it is and how it is spreading. Second is to limit the movement of people from place to place—with quarantine a last option. Once a disease is widespread this is very hard to do. Third is to have drugs of some type that reduce how much someone infects others and that reduces the severity of the sickness. Fourth is to make a vaccine that is effective against the disease and give it to anyone who is at risk.

We did a reasonable job of gathering data, partly due to the capacity that had been set up to track avian flu. But for all the other steps, we didn’t manage to do anything that would have stopped a serious epidemic. In other words, the modest death toll from this flu epidemic is entirely because we were lucky.

Hopefully this outbreak will serve as a wakeup call to get us to invest in better capabilities, because more epidemics will come in the decades ahead and there is no guarantee we will be lucky next time. The 1918 flu killed more than 50 million people. Nothing other than bioterrorism could kill that many people again, and most of the things we need to do to reduce the impact of an epidemic will also reduce the impact of bioterrorism.

The ability to make a vaccine quickly and manufacture it in huge quantities is a critical part of a response to an epidemic. You need to get production going in less than a month instead of more than five months, which is what it took in this case. You also need to be able to make vaccine at a rate ten times faster than what was achieved.

Most flu vaccines today are made by injecting parts of the virus into chicken eggs, which is a laborious process. Given the approved approaches, the vaccine industry did a great job getting the vaccine out as quickly as it did. (Ironically, now that the disease is proving to be relatively mild, a lot of the vaccines they hurried to make will not be bought.) This is one place where innovation can make a big difference.

There are new manufacturing approaches that reduce the lead time and increase the production rate, but government rules don’t allow the vaccine companies to use them yet because of safety concerns. Although governments are right to be conservative about vaccine safety, they have to find a way to help the vaccine industry incorporate these new approaches and expand its capacity in the next few years before the next epidemic comes along.