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Gates Package, p.1173 · gates:exh:00571
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na Bot to help recovered COVID patients donate plasma for
PANDEMIC I - THE FIRST MODERN PANDEMIC
Innovation to beat the enemy
During World War II, an amazing amount of innovation, including radar, reliable torpedoes, and code-breaking,
helped end the war faster. This will be the same with the pandemic. I break the innovation into five categories:
treatments, vaccines, testing, contact tracing, and policies for opening up. Without some advances in each of these
areas, we cannot return to business as usual or stop the virus. Below, I go through each area in some detail.
TREATMENTS
Every week, you will be reading about new treatment ideas that are being tried out, but most of them will fail.
Still, I am optimistic that some of these treatments will meaningfully reduce the disease burden. Some will be easier
to deliver in rich countries than developing countries, and some will take time to scale. A number of these could be
available by the summer or fall.
If in the spring of 2021 people are going to big public events--like a game or concert in a stadium--it will be
because we have a miraculous treatment that made people feel confident about going out again. It's hard to know
precisely what the threshold is, but I suspect it is something like 95 percent; that is, we need a treatment that is 95
percent effective in order for people to feel safe in big public gatherings. Although it is possible that a combination
of treatments will have over 95 percent effectiveness, it's not likely, so we can't count on it. If our best treatments
reduce the deaths by less than 95 percent, then we will still need a vaccine before we can go back to normal.
One potential treatment that doesn't fit the normal definition of a drug involves collecting blood from patients who
have recovered from COVID, making sure it's free of the coronavirus and other infections, and giving the plasma
to people who are sick. The leading companies in this area are working together to get a standard protocol to see
if this works. They will have to measure each patient to see how strong their antibodies are. A variant of this
approach is to take the plasma and concentrate it into a compound called hyperimmune globulin, which is much
easier and faster to give a patient than unconcentrated plasma. The foundation is supporting a consortium of most
of the leading companies that work in this area to accelerate the evaluation and, if the procedure works, be ready
to scale it up. These companies have developed a Plasma Bot to help recovered COVID patients donate plasma for
this effort.
Another type of potential treatment involves identifying the antibodies produced by the human immune system
that are most effective against the novel coronavirus. Once those antibodies have been found, they can be
manufactured and used as a treatment or as a way to prevent the disease (in which case it is known as passive
immunization). This antibody approach also has a good chance of working, although it's unclear how many doses
can be made. It depends on how much antibody material is needed per dose; in 2021, manufacturers may be able
to make as few as 100,000 treatments or many millions. The lead times for manufacturing are about seven months
in the best case. Our grantees are working to compare the different antibodies and make sure the best ones get
access to the limited manufacturing capacity.