Microsoft co-founder Bill Gates said the coronavirus is starting to behave like the “once-in-a-century pathogen we’ve been worried about.” Comparing the ongoing coronovirus outbreak to influenza pandemic of 1957, which killed an estimated 66,000 people in the U.S., Gates said the COVID-19′s current predicted fatality rate is higher .
“I hope it’s not that bad, but we should assume it will be until we know otherwise,” Gates wrote in an article published Friday in The New England Journal of Medicine.
According to Gates, COVID-19 poses a serious threat to the world because it’s far more deadly and contagious than many other deadly viruses.
“First, it can kill healthy adults in addition to elderly people with existing health problems,” he wrote. “Second, Covid-19 is transmitted quite efficiently. The average infected person spreads the disease to two or three others — an exponential rate of increase.”
There are two reasons that Covid-19 is such a threat. First, it can kill healthy adults in addition to elderly people with existing health problems. The data so far suggest that the virus has a case fatality risk around 1%; this rate would make it many times more severe than typical seasonal influenza, putting it somewhere between the 1957 influenza pandemic (0.6%) and the 1918 influenza pandemic (2%).
Second, Covid-19 is transmitted quite efficiently. The average infected person spreads the disease to two or three others — an exponential rate of increase. There is also strong evidence that it can be transmitted by people who are just mildly ill or even presymptomatic.3 That means Covid-19 will be much harder to contain than the Middle East respiratory syndrome or severe acute respiratory syndrome (SARS), which were spread much less efficiently and only by symptomatic people. In fact, Covid-19 has already caused 10 times as many cases as SARS in a quarter of the time.
National, state, and local governments and public health agencies can take steps over the next few weeks to slow the virus’s spread. For example, in addition to helping their own citizens respond, donor governments can help low- and middle-income countries (LMICs) prepare for this pandemic.4 Many LMIC health systems are already stretched thin, and a pathogen like the coronavirus can quickly overwhelm them. And poorer countries have little political or economic leverage, given wealthier countries’ natural desire to put their own people first.
By helping African and South Asian countries get ready now, we can save lives and slow the global circulation of the virus. (A substantial portion of the commitment Melinda and I recently made to help kickstart the global response to Covid-19 — which could total up to $100 million — is focused on LMICs.)