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Gates Package, p.15 · gates:exh:00011
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PANDEMIC I - THE FIRST MODERN PANDEMIC
phones are reasonably close to each other.) The idea is that if someone tests positive then their phone can send
a message to the other phones and their owners can get tested. If most people voluntarily installed this kind of
application, it would probably help some. One limitation is that you don't necessarily have to be in the same place
at the same time to infect someone--you can leave the virus behind on a surface. This system would miss this kind
of transmission.
I think most countries will use the approach that Germany is using, which requires interviewing everyone who
tests positive and using a database to make sure there is follow-up with all the contacts. The pattern of infections is
studied to see where the risk is highest and policy might need to change.
In Germany, if someone is tested and confirmed positive, the doctor is legally required to inform the local
government health office. The doctor must provide all personal data--name, address, phone number--so that the
health office can contact the person and ensure they isolate themselves.
Then the local health office begins the process of contact tracing. They interview the infected person, find out how
to contact all the people he or she has met in the past couple of weeks, and contact those people to ask them to selfisolate and get a test.
This approach relies on the infected person to report their contacts accurately, and also depends on the ability of
the health authorities to follow up with everyone. The normal health service staff can't possibly do all this work
even if the case numbers are fairly low. Every health system will have to figure out how to staff up so that this work
is done in a timely fashion. Everyone who does the work would have to be properly trained and required to keep all
the information private. Researchers would be asked to study the database to find patterns of infection, again with
privacy safeguards in place.
OPENING UP
Most developed countries will be moving into the second phase of the epidemic in the next two months. In one
sense, it is easy to describe this next phase. It is semi-normal. People can go out, but not as often, and not to
crowded places. Picture restaurants that only seat people at every other table, and airplanes where every middle seat
is empty. Schools are open, but you can't fill a stadium with 70,000 people. People are working some and spending
some of their earnings, but not as much as they were before the pandemic. In short, times are abnormal but not as
abnormal as during the first phase.
The rules about what is allowed should change gradually so that we can see if the contact level is starting to increase
the number of infections. Countries will be able to learn from other countries that have strong testing systems in
place to inform them when problems come up.
One example of gradual reopening is Microsoft China, which has roughly 6,200 employees. So far about half are
now coming in to work. They are continuing to provide support to employees who want to work at home. They
insist people with symptoms stay home. They require masks and provide hand sanitizer and do more intensive