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Bill Gates answered COVID-19 questions Wednesday during a Reddit AMA. (Twitter Photo / Bill Gates)

Microsoft co-founder Bill Gates, a leading philanthropist on global public health, offered predictions and advice for coping with the COVID-19 pandemic Wednesday during a Reddit AMA. He urged everyone who can stay home to do so, calling social distancing, “the only model that is known to work.” Gates also urged governments to organize their testing efforts to prevent a prolonged outbreak.

“The testing in the U.S. is not organized yet,” Gates said. “In the next few weeks, I hope the Government fixes this by having a website you can go to to find out about home testing and kiosks. Things are a bit confused on this right now.”

Gates has been forecasting a global pandemic like this for years.

The Microsoft co-founder on multiple occasions over the past decade talked about the potential for something like the novel coronavirus that has infected nearly 200,000 worldwide and killed almost 8,000. His TED Talk from 2015 titled “The next outbreak? We’re not ready” is being shared widely online, given the impact of COVID-19 around the world.

Despite being unprepared, Gates said that facilities that are closed due to the virus could re-open in 6-10 weeks if widespread social distancing and testing are implemented.

The Bill and Melinda Gates Foundation has committed up to $100 million to support the global COVID-19 response. The nonprofit is providing an additional $5 million to help Washington state officials deal with the crisis.

The Gates Foundation’s head of global health, Dr. Trevor Mundel, and Gates’ chief scientific adviser, Dr. Niranjan Bose, also participated in the AMA.

Continue reading for highlights from Gates’ responses to questions submitted by Reddit users.

How long will this go on?

Gates: This will vary a lot by country. China is seeing very few cases now because their testing and “shut down” was very effective. If a country does a good job with testing and “shut down” then within 6-10 weeks they should see very few cases and be able to open back up.

What about the current crisis worries you the most? What gives you the most hope?

Gates: The current phase has a lot of the cases in rich countries. With the right actions including the testing and social distancing (which I call “shut down”) within 2-3 months the rich countries should have avoided high levels of infection. I worry about all the economic damage but even worse will be how this will affect the developing countries who cannot do the social distancing the same way as rich countries and whose hospital capacity is much lower.

Should there be a national shelter in place order? Why or why not?

Gates: Most people can shelter in their home but for people who that doesn’t work there should be a place for them to go. We are working on seeing if we can send test kits to people at home so they don’t have to go out and so the tests get to the people who are the priority. The U.S. still is not organized on testing.

Is there any chance that the 18-month timeline for development of a vaccine can be shortened, and by how much?

Gates: This is a great question. There are over 6 different efforts going on to make a vaccine. Some use a new approach called RNA which is unproven. We will have to build lots of manufacturing for the different approaches knowing that some of them will not work. We will need literally billions of vaccines to protect the world. Vaccines require testing to make sure they are safe and effective. Some vaccines like the flu don’t for the elderly.

The first vaccines we get will go to health care workers and critical workers. This could happen before 18 months if everything goes well but we and Fauci and others are being careful not to promise this when we are not sure. The work is going at full speed.

I’d also like to ask the same thing, but with regards to the timeline for an effective treatment.

Gates: A therapeutic could be available well before a vaccine. Ideally this would reduce the number of people who need intensive care including respirators. The Foundation has organized a Therapeutics Accelerator to look at all the most promising ideas and bring all the capabilities of industry into play. So I am hopeful something will come out of this. It could be an anti-viral or antibodies or something else.

One idea that is being explored is using the blood (plasma) from people who are recovered. This may have antibodies to protect people. If it works it would be the fastest way to protect health care workers and patients who have severe disease.

I live in Seattle, like you, and it feels like our testing has not increased. Our number of confirmed cases are starting to lag behind other states. What do you think gives? Effective social distancing or lack of testing?

Gates: The testing in the U.S. is not organized yet. In the next few weeks, I hope the Government fixes this by having a website you can go to to find out about home testing and kiosks. Things are a bit confused on this right now. In Seattle the U of W is providing thousands of tests per day but no one is connected to a national tracking system.

Whenever there is a positive test it should be seen to understand where the disease is and whether we need to strengthen the social distancing. South Korea did a great job on this including digital contact tracing.

Can you provide any estimates for how much of the world’s population might become infected?

Gates: This will vary a lot by country. Taiwan, Hong Kong and Singapore acted quickly and will have very few cases. Even China will stay at a low level of their population (less than .01%) so far. Thailand is another exemplar. Unfortunately in poorer countries doing social distancing is much harder. People live in close proximity and need to work to get their food so there could be countries where the virus will spread broadly.

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