Gates Package — page 953

fund it through the Brotman Baty Institute, a research partnership between Fred Hutch, the University of Washington, and Seattle Children's. The team quickly got to work on the infrastructure they had envisioned. They created a system to develop and prove a new diagnostic test, process and share the results, and perform quality checks to make sure all the work was valid. In the second year, they added a way to let participants take their own samples at home and return them in the mail. With this innovation, the Seattle Flu Study became the first medical study anywhere with a soup-to-nuts process that let people order a kit online, have it delivered to their home, ship it back to the lab, and receive a result. This was pioneering work and a point of pride for the team, but none of us had any idea just how crucial it was about to become. In 2018 and 2019, the Seattle Flu Study tested more than 11,000 cases of flu and sequenced more than 2,300 influenza genomes--about one sixth of all flu genomes sequenced anywhere in the world in that time. They were able to show that flu in Seattle wasn't one homogenous outbreak, but actually a series of overlapping outbreaks of different flu strains. Then, in the first few weeks of 2020, everything changed. Nearly overnight, influenza was no longer the virus we needed to worry about the most. The scientists who had spent countless hours planning and creating the flu study were now thinking about nothing but COVID. By February, they had developed their own COVID test--once the virus was sequenced, this was an easy task for a diagnostician--and began running it on a few hundred samples that they had gathered for the flu study. Within two days, they had found a positive case, a sample submitted to the study by a local hospital that had treated a patient for flulike symptoms.