Monday, February 20, 2017

FORBES: Bill Gates Warns Of Epidemic That Will Kill Over 30 Million People

Bill Gates Warns Of Epidemic That Will Kill Over 30 Million People

Bill Gates is a smart guy, who knows something about global health. So when he gives a grave warning about a potential catastrophe, it's a good idea to listen. Yesterday, at the Munich Security Conference in Germany, the man who tops the FORBES richest person in the world list and is Co-Chair of the Bill and Melinda Gates Foundation said:
Whether it occurs by a quirk of nature or at the hand of a terrorist, epidemiologists say a fast-moving airborne pathogen could kill more than 30 million people in less than a year. And they say there is a reasonable probability the world will experience such an outbreak in the next 10 to 15 years.
Notice that this was at a security conference and not a health meeting. Therefore, he could have focused on some other issue such as nuclear weapons or climate change. But Gates chose to focus on infectious disease threats (whether starting naturally or used as a bio-terrorist weapon) for good reason. Our society is in need of a good wake-up call and slap in the face.
Our society is woefully under-prepared for a bad pandemic. This was obvious in 2009 when I and Shawn Brown, PhD, Director of Public Health Applications at the Pittsburgh Supercomputing Center (PSC), were embedded in the Department of Health and Human Services (HHS) to use our computational models to help with the national response to the H1N1 influenza pandemic. People in HHS were working very hard each day to mobilize the national response. However, the external resistance that they encountered was troubling. Many external parties put their own individual or business interests in front of national security and were reluctant to share information. Some of the general public questioned whether the pandemic existed and even raised a number of conspiracy theories. Fortunately, the virus was not as harmful as initially thought and the world was spared real disaster. Was the H1N1 pandemic a wake-up call for society? Not really.
Maybe a slower progressing epidemic that resulted in more deaths and disability would do the trick? After the H1N1 pandemic ran its course, more attention focused on the continuing epidemics of methicillin-resistant Staphylococcus aureus (MRSA) and other antibiotic-resistant bacteria. The Centers for Disease Control and Prevention (CDC), with efforts led by John Jernigan, MD, MS and Rachel Slayton, PhD, and other public health agencies have been working to combat the MRSA epidemic with health care facilities and researchers such as our RHEA (Regional Healthcare Analyst) computational modeling team that includes Susan Huang, MD, MPH of the University of California-Irvine, Sarah Bartsch, MPH of the Johns Hopkins Bloomberg School of Public Health (JHSPH), Dr. Brown, Kim Wong, PhD of the University of Pittsburgh Center for Simulation and Modeling, and Loren Miller, MD and Jamie McKinnell, MD of UCLA. Has the MRSA epidemic, which is still continuing, prompted all the major changes in infection control and antibiotic development necessary to combat a pandemic? Again, no. While some advances have been made, lack of resources for infection control practice and research remains a challenge, antibiotic overuse has continued, and relatively few antibiotics are under development. As I have stated previously, this continues to be a crisis as our society may eventually run out of antibiotics that work against bacteria.
Surely then an epidemic in which the pathogen is highly and rapidly fatal would spur people to more action. Well, it did result in a new version of the song "Do They Know It's Christmas?"..but, to sound like a broken record, no, it did not deliver the needed kick in the behind. The 2014-2016 Ebola outbreaks in West Africa involved a virus that killed around half the people it infected. Seemingly suddenly, Ebola jumped into the headlines (even though it had been around for years) when the number of deaths in Liberia, Sierra Leone, and Guinea surged, raising concerns that the pathogen may spread elsewhere, including the U.S. Suddenly, people were saying, "quick, we need a vaccine" without giving the world much lead time to deliver and prepare accordingly as stated in our Lancet piece. I recall during the Paul G Allen Family Foundation Ebola Innovation Summit seeing many people around the room who had not even heard of Ebola a year prior, saying that we needed to eliminate this disease, naively underestimating the effort required to do so. As I tried to explain to a founder of a major at the meeting, creating a successful website is not the same as combating an infectious disease. Fortunately for the rest of the world, the Ebola epidemic eventually subsided without any vaccines or new technologies. As Gates mentioned during his Munich speech, "we would be wise to consider the social and economic turmoil that might ensue if something like Ebola made its way into urban centers."
How much did the activity around the Ebola outbreaks change the world? The refrain: not nearly enough. As David Peters, MD, DrPH, Chair of International Health at JHSPH explains in the following video, many major systems problems in West Africa contributing to the Ebola epidemic still remain and could easily lead to future epidemics:

Indeed, many health systems around the world remain broken. For example, our HERMES Logistics computational modeling team, coordinated by Leila Haidari, MPH and working with Raja Rao at the Bill and Melinda Gates Foundation, has found that numerous countries have major problems in their vaccine supply chains that could benefit from significant re-design. Even if the proper technology such as vaccines and medications are available during an epidemic, effective and efficient supply chains and health systems would be necessary to get them to where they need to go. Progress has occurred with vaccine supply chains but not as much in other types of supply chains and other aspects of health systems. As before, the Ebola outbreaks resulted in some changes but not nearly enough.

A chilling warning that tens of millions of people could be killed by bio-terrorism was delivered at the Munich security conference by the world’s richest man, Bill Gates
Gates, who has spent much of the last 20 years funding a global health campaign, said: “We ignore the link between health security and international security at our peril.”
Gates, the co-founder of Microsoft who has spent billions in a philanthropic drive to improve health worldwide, said: “The next epidemic could originate on the computer screen of a terrorist intent on using genetic engineering to create a synthetic version of the smallpox virus ... or a super contagious and deadly strain of the flu.”
US and UK intelligence agencies have said that Islamic State has been trying to develop biological weapons at its bases in Syria and Iraq. However, they have played down the threat, saying that the terrorists would need people with the necessary skills, good laboratories and a relatively calm environment free from the confusion and chaos of conflict zones.
Yet other security specialists say the threat from bio-terrorism has become more realistic over the past decade, particularly the past five years, with changes in molecular biology that make development of biological weapons more accessible.
Gates, making his first appearance at the Munich security conference on Saturday, said: “Whether it occurs by a quirk of nature or at the hand of a terrorist, epidemiologists say a fast-moving airborne pathogen could kill more than 30 million people in less than a year. And they say there is a reasonable probability the world will experience such an outbreak in the next 10 to 15 years.”
He added: “It’s hard to get your mind around a catastrophe of that scale, but it happened not that long ago. In 1918, a particularly virulent and deadly strain of flu killed between 50 million and 100 million people.

“You might be wondering how real these doomsday scenarios really are. The fact that a deadly global pandemic has not occurred in recent history shouldn’t be mistaken for evidence that a deadly pandemic will not occur in the future. And even if the next pandemic isn’t on the scale of the 1918 flu, we would be wise to consider the social and economic turmoil that might ensue if something like ebola made its way into urban centres.”
Gates said advances in biotechnology, new vaccines and drugs could help prevent epidemics spreading out of control. “Most of the things we need to do to protect against a naturally occurring pandemic are the same things we must prepare for an intentional biological attack,” he said.
“Getting ready for a global pandemic is every bit as important as nuclear deterrence and avoiding a climate catastrophe. Innovation, cooperation and careful planning can dramatically mitigate the risks presented by each of these threats.”
The international community, Gates told the conference, needed to prepare for epidemics the way the military prepared for war: “This includes germ games and other preparedness exercises so we can better understand how diseases will spread, how people will respond in a panic and how to deal with things like overloaded highways and communications systems.”
The Bill and Melinda Gates Foundation published an Ipsos Mori poll saying that 71% of Britons aged between 16 and 75 are more concerned about the spread of infectious diseases such as Ebola or Zika than war with other nations. Just over two-thirds said they were concerned about war, while 83% said violent terrorist attacks were their main concern.