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Gates Package, p.1083 · gates:exh:00493
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Early in the pandemic, scientists needed to know what they were dealing with. To find out, they
turned to genetic sequencing, the technology that sped up vaccine development (by quickly
revealing the genetic code of the COVID virus) and made it possible to detect and monitor
variants as they spread around the world.
It's no accident that the first COVID variants were not discovered in the United States.
The reason has little to do with where variants were emerging, and a lot to do with which
countries were prepared to look for variants: The U.S. didn't put enough money and time into
gathering virus samples and getting them sequenced. (The lab capacity existed--it just wasn't
used.) . Compared with other countries, the U.S. was flying blind.
Fortunately, several countries in Africa--most especially South Africa and Nigeria--
were better prepared, having spent years building up a robust network of sequencing labs. The
original intent was to help with diseases like malaria that affect the continent disproportionately,
but when COVID came along, these labs were ready to pivot; having been nurtured for years,
they were able to produce more results, and faster, than their counterparts in the United States.
South Africa's labs were the first to discover the Beta variant of COVID, as well as the
subsequent Omicron variant.
Similarly, as I wrote in Chapter 3, computer modeling has helped us learn a lot about this
pandemic, and it needs to be an even bigger part of our pandemic-prevention efforts. But the
notion of using computer modeling to understand infectious diseases did not emerge suddenly
with COVID.
The Institute for Health Metrics and Evaluation--whose computer models were widely
cited by the White House and reporters during the pandemic--was created in 2007 to give the
world insight into causes of death in poor countries. Imperial College London established its