Gates Package — page 8

one in Seattle done with the PANDEMIC I - THE FIRST MODERN PANDEMIC The ability to do testing well explains a lot of the variation. It is impossible to defeat an enemy we cannot see. So testing is critical to getting the disease under control and beginning to reopen the economy. So far, developing countries like India and Nigeria account for a small portion of the reported global infections. One of the priorities for our foundation has been to help ramp up the testing in these countries so they know their situation. With luck, some factors that we don't understand yet, like how weather might affect the virus's spread, will prevent large-scale infection in these countries. However, our assumption should be that the disease dynamics are the same as in other countries. Even though their populations are disproportionately young--which would tend to mean fewer deaths from COVID--this advantage is almost certainly offset by the fact that many low-income people's immune systems are weakened by conditions like malnutrition or HIV. And the less developed a country's economy is, the harder it is to make the behavior changes that reduce the virus's reproduction rate. If you live in an urban slum and do informal work to earn enough to feed your family every day, you won't find it easy to avoid contact with other people. Also, the health systems in these countries have far less capacity, so even providing oxygen treatment to everyone who needs it will be difficult. Tragically, it is possible that the total deaths in developing countries will be far higher than in developed countries. What we need to learn Our knowledge of the disease will help us with tools and policies. There are a number of key things we still don't understand. A number of studies are being done to answer these questions, including one in Seattle done with the University of Washington. The global collaboration on these issues is impressive, and we should know a lot more by the summer. − IS THE DISEASE SEASONAL OR WEATHER DEPENDENT? Almost all respiratory viruses (a group that includes COVID) are seasonal. This would mean there are fewer infections in the summer, which might lull us into complacency when the fall comes. This is a matter of degree. Because we see coronavirus spreading in Australia and other places in the Southern hemisphere, where the seasons are the opposite of ours, we already know the virus is not as seasonal as influenza is. − HOW MANY PEOPLE WHO NEVER GET SYMPTOMS HAVE ENOUGH OF THE VIRUS TO INFECT OTHERS? WHAT ABOUT PEOPLE WHO ARE RECOVERED AND HAVE SOME RESIDUAL VIRUS--HOW INFECTIOUS ARE THEY? Computer models show that if there are a lot of people who are asymptomatic but infectious, it is much harder to open up without a resurgence in cases. There is a lot of disagreement about how much infection comes from these sources, but we do know that many people with the virus don't report symptoms, and some portion of those might end up transmitting it. − WHY DO YOUNG PEOPLE HAVE A LOWER RISK OF BECOMING SERIOUSLY ILL WHEN THEY GET INFECTED? Understanding the dynamics here will help us weigh the risks of opening schools. It is a complicated subject because even if young people don't get sick as often, they might still spread the disease to others.