Gates Package — page 949

through a city--most importantly, they needed to know how many people actually got sick, not just how many were tested. And in an emergency outbreak, city officials would need to quickly identify the lion's share of people who might be sick, get them tested, and inform them about their results. But there was no systematic way to do any of those things. Eventually, in June 2018, a few of the people who were driving this conversation met with me at my office outside Seattle to explain the problem as they saw it. They outlined a threeyear project they called the Seattle Flu Study--a prototype for a citywide effort that could transform the way respiratory viruses were detected, monitored, and controlled--and asked whether I would fund it. Here's how it would work. Beginning that fall, as the flu season ramped up, volunteers throughout the Seattle area would be asked to answer a few questions about their health. If they'd had at least two symptoms of a respiratory problem in the past seven days, they would be asked to submit a sample that would be tested for a range of respiratory diseases. (Despite the name of the project, it wouldn't be limited to flu--the tests would actually cover twenty-six different pathogens.) Some people would give samples at kiosks set up in SeaTac Airport, the University of Washington campus, homeless shelters, and a few workplaces around town, but most of the samples would come from local hospitals that had already collected them from patients for other reasons. This is a common practice in medical research: When you get tested at a hospital, the results help the doctor decide how to treat you, but the mucus from your nasal swab might be saved for later. Researchers can then use that sample, after certain private data about you has been removed, to test for other pathogens and understand what's happening throughout the community. Just by being sick, you're contributing to science.