Gates Package — page 1150

Page 71, para 3: the term "brain-tickling" is here used for the second time, and I don't recall that this jocular usage is explained so that regular folks will understand. Actually, the olfactory nerve is a projection of the brain, and physically close to it, so "brain-tickling" comes close to being true. Page 74, para 3. See comments above about not over-praising the role of disease modeling compared with on the ground epi and science studies. Big data from computer models don't replace common sense. Studies in the past have shown that model predictions do no better than the old fashioned "Delphi method". Chapter 4. Page 80, para 3. Nobody ever says this, but it is worth saying. "If only" we could convince people to use NPIs and standard PH interventions known for over a century (isolation of cases and contacts, masks, social distancing, disbanding crowding situations, etc.), we could STOP ALL PANDEMICS in their tracks. The problem isn't that we don't have the tools, it's that we aren't able to arrive at consensus about using them. If COVID was 100% fatal instead of 1% fatal, we would have been able to stop it completely using stringent PH measures even before we had vaccines. It's worth remembering this because vaccines should be viewed as the second line of defense, not the first. When native societies first encountered Westerners and their diseases in the 1700s and 1800s, they instinctively understood isolation of the sick and self-isolation of the well to prevent getting sick, even without any concept of infection. Common sense, not rocket science. Page 82, top few lines. While there is general agreement about this point, going back to 1918, it's worth remembering that all these data (on cities with better PH policies faring better in pandemics) are based on unscientific ecologic studies. It all makes sense, and more public health is always a good thing, but we don't have hard science to back this up. Page 85, top of para 2. The figure of 100 million school students falling behind, is that number correct? Off the top of my head there are only something in the range of 65 million total kids (18 and under) in the US, so how can 100 million be falling behind? Page 91, para 3: should perhaps have more discussion of both cell phone data and the privacy issues we have in the US, here and/or elsewhere (and see above comment), and also with contact tracing Page 92: more on contact tracing, see above. Page 93: The introduction of the concept of super-spreaders could be defined fleshed out here. It us hugely important because the combination of crowds + super-spreaders leads to super-transmission, and probably accounts directly and indirectly for a large percentage of total cases and rapidity and completeness of spread. The public should know that super-spreaders are of little greater risk to most of us than other infected people in the home and work environments, at least when we use good PH practices, but when we go into crowded bars, etc., during times of community transmission, the chance that there will be one or more super-spreaders not only increases, but their ability to infect many v. just a few increases as well. Linear spread becomes logarithmic spread when these folks go into crowded places. And they don't know who they are, nor does anyone else. Why is no one studying the biology of super-spreaders?