For many, the coronavirus pandemic seemed to come out of nowhere, an unexpected crisis that we couldn’t have been prepared for. But some people have actually been warning of a global pandemic—and the fact that we are largely unprepared to handle one—for years. Along with epidemiologists and even the director for medical and biodefense preparedness at the National Security Council, Bill Gates has been saying for a decade that the world was woefully underprepared for an inevitable pandemic. Here are some warnings we could have paid more attention to:

2010

Writing on his blog in January 2010, Gates brought up the H1N1 outbreak that garnered media attention the prior year. Most of the coverage made it sound dangerous, he wrote, “but the real story isn’t how bad H1N1 was. The real story is that we are lucky it wasn’t worse because we were almost completely unprepared for it.” He also referred to that outbreak as a “wake-up call” to invest in better capabilities to track and manage a deadly epidemic, “because more epidemics will come in the decades ahead and there is no guarantee we will be lucky next time.”

2015

At the annual TED conference in Vancouver, Gates gave a TED Talk bluntly titled “The Next Outbreak? We’re Not Ready.” This talk was given in the midst of the Ebola epidemic, but Gates was already looking ahead to the next deadly illness. “If anything kills over 10 million people in the next few decades, it’s most likely to be a highly infectious virus rather than a war,” he said. Not preparing now would mean the next epidemic could be more devastating than Ebola. “You can have a virus where people feel well enough while they’re infectious that they get on a plane or they go to a market,” he said then, aptly predicting an element that makes COVID-19 so dangerous.

2016

In an interview with the BBC, Gates said he crosses his fingers all the time that “some epidemic like a big flu doesn’t come along in the next 10 years” because of how vulnerable the world was (and is). The Ebola and Zika crises both, he noted, showed that the global systems for responding to emergencies were not strong enough.

2017

Speaking at the Munich Security Conference, an annual conference on international security policy, Gates started his speech by saying that he was there because “our worlds are more tightly linked than most people realize,” and that means health security and international security are connected. He noted that epidemiologists have said a fast-moving airborne pathogen could kill more than 30 million people in less than a year, and could occur in the next 10 to 15 years. “I view the threat of deadly pandemics right up there with nuclear war and climate change.” he said. “Getting ready for a global pandemic is every bit as important as nuclear deterrence and avoiding a climate catastrophe.”

2018

Giving the Massachusetts Medical Society’s annual Shattuck Lecture in April 2018, Gates noted that while life has kept getting better for most of the world, “There is one area, though, where the world isn’t making much progress, and that’s pandemic preparedness.” This should concern us, he said, “because if history has taught us anything, it’s that there will be another deadly global pandemic.”

The 2014 Ebola outbreak was a wakeup call, he added; the world was too slow to respond then, so it’s important to have a coordinated global approach at the ready. “The world needs to prepare for pandemics the way the military prepares for war,” he told the medical society. In an interview with Stat around the same time, he reiterated his concern and noted that he brought it up to President Trump. (In May 2018, Trump dissolved the pandemic office at the White House.)