Bill Gates answered 4 critical questions from people worried about the coronavirus

Bill Gates is one of the most important human beings on the planet right now. His place is history is already ensured as the co-founder of Microsoft and increasingly through the humanitarian work his wife and he do through the Bill and Melinda Gates Foundation. And while Gates is not a doctor, immunologist or actively working in the scientific field related to the coronavirus, he has spent a considerable amount of time and money helping to combat the threat of viral outbreaks.

Over the past several decades, Gates has expanded his areas of expertise far beyond computers and technology in general. And one topic that has greatly concerned him has been viral outbreaks. In 2015, Gates gave an essential TED Talk about what the next pandemic was likely to look like and what we should do to prevent and address future outbreaks. Unfortunately, it seems like no one in the current administration, or other leaders from around the world for that matter, was paying close enough attention.

This week, Gates took part in a Reddit "Ask Me Anything" aka AMA session with readers. The topic was: "I'm Bill Gates, co-chair of the Bill & Melinda Gates Foundation. AMA about COVID-19." It was a real public service, as Gates is one of the most trusted independent voices in the world and rarely speaks without a true, informed voice. Reddit readers voted on his questions and answers and these are what they considered the four most important answers during his AMA.



Before we get to the actual questions and answers, Gates himself took to Twitter to share perhaps the most important piece of scientific information out there:


REDDIT: As an educator, what is something I can do for my students, especially for my low-income students who don't have access to technology during this time? I have tried to send reassuring emails (including cat pictures), but I worry about the educational impact, as well as the long-term impact to my students' well being.

GATES: It is a huge problem that schools will likely be shut down for the next few months. I am impressed by the creative approaches that many teachers are coming up with to teach remotely. (If you are a teacher reading this, thank you for the work you're doing.) But I know that not everyone is set up to teach remotely. There are a lot of good online resources out there, including Khan Academy, CommonLit, Illustrative Mathematics, Zearn, and Scholastic. Comcast and other internet connectivity providers are doing special program to help with access. Microsoft and others are working on getting machines out but the supply chain is quite constrained. Unfortunately low-income students will be hurt more by the situation than others so we need to help any way we can.

***


Secretary Alex Azar and Bill Gates HHS Photo Christopher Smith


REDDIT: Bill, I read the Imperial College COVID-19 Response Team report as well as this explanation in a historical context. Essentially, it says that by doing nothing, 4 million Americans die. Through the mitigation strategy - i.e. social distancing and "flattening the curve" - it says that 1.1-2 million Americans will die. However, it also says that the suppression strategy, or "shutting everything down for 18 months" - will lead to only a few thousand people dying. Do you agree with these numbers, and if so, is there any excuse for not immediately issuing a shelter in place order for the entire country?

GATES: Fortunately it appears the parameters used in that model were too negative. The experience in China is the most critical data we have. They did their "shut down" and were able to reduce the number of cases. They are testing widely so they see rebounds immediately and so far there have not been a lot. They avoided widespread infection. The Imperial model does not match this experience. Models are only as good as the assumptions put into them. People are working on models that match what we are seeing more closely and they will become a key tool. A group called Institute for Disease Modeling that I fund is one of the groups working with others on this.

***



REDDIT: Covid-19 testing standards seem grossly unfair in favor of the rich and famous. Testing is happening for people like professional sports players, even those without any symptoms at all. I'm not talking about health care workers or people in essential jobs- I'm talking about actors, actresses, sports players and so on. On the flip side, the guidance from Kaiser in WA is that you must have a fever of 101.5 and either serious shortness of breath or a bad cough, and even then testing results take 5 days or more. How is it that even with something like covid-19 testing, which the government is supposed to manage, the rich and famous are getting special treatment? Is there a big stash of tests that are reserved for "people that matter"? Isn't it hypocritical for everyone else to be told they need to look out for the common good and avoid demanding too much of the health care system, meanwhile the rich and famous get whatever they want, when they want it?

GATES: We need to democratize and scale the testing system by having a CDC website that people go to and enter their situation. Priority situations should get tested within 24 hours. This is very possible since many countries have done it. Health care workers for example should have priority. Elderly people should have priority. We will be able to catch up on the testing demand within a few weeks of getting the system in place. Without the system we don't know what is missing - swabs, reagents etc..

***

REDDIT: Hi Mr. Gates, In your opinion, after this pandemic comes to a close, however long that may be, what should be the first step we as a global community take so that we are better prepared for the next pandemic?

GATES: The TED talk I did in 2015 talked about this. We need to have the ability to scale up diagnostics, drugs and vaccines very rapidly. The technologies exist to do this well if the right investments are made. Countries can work together on this. We did create CEPI = Coalition for Epidemic Preparedness Innovation which did some work on vaccines but that needs to be funded at higher level to have the standby manufacturing capacity for the world.

Watch Gates' full TED talk below:


Photo by NeONBRAND on Unsplash

I'll never forget the exhilaration I felt as I headed into the city on July 3, 2018. My pink hair was styled. I wore it up in a high ponytail, though I left two tendrils down. Two tendrils which framed my face. My makeup was done. I wore shadow on my eyes and blush on my cheeks, blush which gave me color. Which brought my pale complexion to life. And my confidence grew each time my heels clacked against the concrete.

My confidence grew with each and every step.

Why? Because I was a strong woman. A city woman. A woman headed to interview for her dream job.

I nailed the interview. Before I boarded the bus back home, I had an offer letter in my inbox. I was a news writer, with a salary and benefits, but a strange thing happened 13 months later. I quit said job in an instant. On a whim. I walked down Fifth Avenue and never looked back. And while there were a few reasons why I quit that warm, summer day: I was a new(ish) mom. A second-time mom, and I missed my children. Spending an hour with them each day just wasn't enough. My daughter was struggling in school. She needed oversight. Guidance. She needed my help. And my commute was rough. I couldn't cover the exorbitant cost of childcare. The real reason I quit was because my mental health was failing.


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Photo by NeONBRAND on Unsplash

I'll never forget the exhilaration I felt as I headed into the city on July 3, 2018. My pink hair was styled. I wore it up in a high ponytail, though I left two tendrils down. Two tendrils which framed my face. My makeup was done. I wore shadow on my eyes and blush on my cheeks, blush which gave me color. Which brought my pale complexion to life. And my confidence grew each time my heels clacked against the concrete.

My confidence grew with each and every step.

Why? Because I was a strong woman. A city woman. A woman headed to interview for her dream job.

I nailed the interview. Before I boarded the bus back home, I had an offer letter in my inbox. I was a news writer, with a salary and benefits, but a strange thing happened 13 months later. I quit said job in an instant. On a whim. I walked down Fifth Avenue and never looked back. And while there were a few reasons why I quit that warm, summer day: I was a new(ish) mom. A second-time mom, and I missed my children. Spending an hour with them each day just wasn't enough. My daughter was struggling in school. She needed oversight. Guidance. She needed my help. And my commute was rough. I couldn't cover the exorbitant cost of childcare. The real reason I quit was because my mental health was failing.


Keep Reading Show less
True

Each year, an estimated 1.8 million people in the United States are affected by cancer — most commonly cancers of the breast, lung, prostate, and blood cancers such as leukemia. While not everyone overcomes the disease, thanks to science, more people are surviving — and for longer — than ever before in history.

We asked three people whose lives have been impacted by cancer to share their stories – how their lives were changed by the disease, and how they're using that experience to change the future of cancer treatments with the hope that ultimately, in the fight against cancer, science will win. Here's what they had to say.

Celine Ryan, 55, engineer database programmer and mother of five from Detroit, MI

Photo courtesy of Celine Ryan

In September 2013, Celine Ryan woke up from a colonoscopy to some traumatic news. Her gastroenterologist showed her a picture of the cancerous mass they found during the procedure.

Ryan and her husband, Patrick, had scheduled a colonoscopy after discovering some unusual bleeding, so the suspicion she could have cancer was already there. Neither of them, however, were quite prepared for the results to be positive -- or for the treatment to begin so soon. Just two days after learning the news, Ryan had surgery to remove the tumor, part of her bladder, and 17 cancerous lymph nodes. Chemotherapy and radiation soon followed.

Ryan's treatment was rigorous – but in December 2014, she got the devastating news that the cancer, once confined to her colon, had spread to her lungs. Her prognosis, they said, was likely terminal.

But rather than give up hope, Ryan sought support from online research, fellow cancer patients and survivors, and her medical team. When she brought up immunotherapy to her oncologist, he quickly agreed it was the best course of action. Ryan's cancer, like a majority of colon and pancreatic cancers, had been caused by a defect on the gene KRAS, which can result in a very aggressive cancer that is virtually "undruggable." According to the medical literature, the relatively smooth protein structure of the KRAS gene meant that designing inhibitors to bind to surface grooves and treat the cancer has been historically difficult. Through her support systems, Ryan discovered an experimental immunotherapy trial at the National Institutes of Health (NIH) in Bethesda, MD., and called them immediately to see if she was eligible. After months of trying to determine whether she was a suitable candidate for the experimental treatment, Ryan was finally accepted.

The treatment, known as tumor-infiltrating lymphocyte therapy, or TIL, is a testament to how far modern science has evolved. With this therapy, doctors remove a tumor and harvest special immune cells that are found naturally in the tumor. Doctors then grow the cells in a lab over the next several weeks with a protein that promotes rapid TIL growth – and once the cells number into the billions, they are infused back into the patient's body to fight the cancer. On April 1, 2015, Ryan had her tumor removed at the NIH. Two months later, she went inpatient for four weeks to have the team "wash out" her immune system with chemotherapy and infuse the cells – all 148 billion of them – back into her body.

Six weeks after the infusion, Ryan and Patrick went back for a follow-up appointment – and the news they got was stunning: Not only had no new tumors developed, but the six existing tumors in her lungs had shrunk significantly. Less than a year after her cell infusion, in April 2016, the doctors told Ryan news that would have been impossible just a decade earlier: Thanks to the cell infusion, Ryan was now considered NED – no evaluable disease. Her body was cancer-free.

Ryan is still NED today and continuing annual follow-up appointments at the NIH, experiencing things she never dreamed she'd be able to live to see, such as her children's high school and college graduations. She's also donating her blood and cells to the NIH to help them research other potential cancer treatments. "It was an honor to do so," Ryan said of her experience. "I'm just thrilled, and I hope my experience can help a lot more people."

Patrice Lee, PhD, VP of Pharmacology, Toxicology and Exploratory Development at Pfizer

Photo courtesy of Patrice Lee

Patrice Lee got into scientific research in an unconventional way – through the late ocean explorer Jacques Cousteau.

Lee never met Cousteau but her dreams of working with him one day led her to pursue a career in science. Initially, Lee completed an undergraduate degree in marine biology; eventually, her interests changed and she decided to get a dual doctoral degree in physiology and toxicology at Duke University. She now works at Pfizer's R&D site in Boulder, CO (formerly Array BioPharma), leading a group of scientists who determine the safety and efficacy of new oncology drugs.

"Scientists focused on drug discovery and development in the pharmaceutical industry are deeply committed to inventing new therapies to meet unmet needs," Lee says, describing her field of work. "We're driven to achieve new medicines and vaccines as quickly as possible without sacrificing safety."

Among the drugs Lee has helped develop during her career, including cancer therapies, she says around a dozen are currently in development, while nine have received FDA approval — an incredible accomplishment as many scientists spend their careers without seeing their drug make it to market. Lee's team is particularly interested in therapies for brain metastases — something that Lee says is a largely unmet need in cancer research, and something her team is working on from a variety of angles. "Now that we've had rapid success with mRNA vaccine technology, we hope to explore what the future holds when applying this technology to cancers," Lee says.

But while evaluating potential cancer therapies is a professional passion of Lee's, it's also a mission that's deeply personal. "I'm also a breast cancer survivor," she says. "So I've been on the other side of things and have participated in a clinical trial."

However, seeing how melanoma therapies that she helped develop have affected other real-life cancer patients, she says, has been a highlight of her career. "We had one therapy that was approved for patients with BRAF-mutant metastatic melanoma," Lee recalls. "Our team in Boulder was graced by a visit from a patient that had benefited from these drugs that we developed. It was a very special moment for the entire team."

None of these therapies would be available, Lee says without rigorous science behind it: "Facts come from good science. Facts will drive the development of new drugs, and that's what will help patients."

Chiuying "Cynthia" Kuk (they/them) MS, 34, third-year medical student at Michigan State University College of Human Medicine

Photo courtesy of Cynthia Kuk

Cynthia Kuk was just 10 years old when they had a conversation that would change their life forever.

"My mother, who worked as a translator for the government at the time, had been diagnosed with breast cancer, and after her chemotherapy treatments she would get really sick," Kuk, who uses they/them pronouns, recalls. "When I asked my dad why mom was puking so much, he said it was because of the medicine she was taking that would help her get better."

Kuk's response was immediate: "That's so stupid! Why would a medicine make you feel worse instead of better? When I'm older, I want to create medicine that won't make people sick like that."

Nine years later, Kuk traveled from their native Hong Kong to the United States to do exactly that. Kuk enrolled in a small, liberal arts college for their Bachelor's degree, and then four years later started a PhD program in cancer research. Although Kuk's mother was in remission from her cancer at the time, Kuk's goal was the same as it had been as a 10-year-old watching her suffer through chemotherapy: to design a better cancer treatment, and change the landscape of cancer research forever.

Since then, Kuk's mission has changed slightly.

"My mom's cancer relapsed in 2008, and she ended up passing away about five years after that," Kuk says. "After my mom died, I started having this sense of urgency. Cancer research is such that you work for twenty years, and at the end of it you might have a fancy medication that could help people, but I wanted to help people now." With their mother still at the forefront of their mind, Kuk decided to quit their PhD program and enter medical school.

Now, Kuk plans to pursue a career in emergency medicine – not only because they are drawn to the excitement of the emergency room, but because the ER is a place where the most marginalized people tend to seek care.

"I have a special interest in the LGBTQ+ population, as I identify as queer and nonbinary," says Kuk. "A lot of people in this community and other marginalized communities access care through the ER and also tend to avoid medical care since there is a history of mistreatment and judgement from healthcare workers. How you carry yourself as a doctor, your compassion, that can make a huge difference in someone's care."

In addition to making a difference in the lives of LGBTQ+ patients, Kuk wants to make a difference in the lives of patients with cancer as well, like their mother had.

"We've diagnosed patients in the Emergency Department with cancer before," Kuk says. "I can't make cancer good news but how you deliver bad news and the compassion you show could make a world of difference to that patient and their family."

During their training, Kuk advocates for patients by delivering compassionate and inclusive care, whether they happen to have cancer or not. In addition to emphasizing their patient's pronouns and chosen names, they ask for inclusive social and sexual histories as well as using gender neutral language. In doing this, they hope to make medicine as a whole more accessible for people who have been historically pushed aside.

"I'm just one person, and I can't force everyone to respect you, if you're marginalized," Kuk says. "But I do want to push for a culture where people appreciate others who are different from them."