Should a deadly pandemic comparable to the 1918 influenza outbreak reach the US in the relatively near future, the US government would be powerless to stop it. And in all likelihood, hundreds of thousands – if not, millions – of Americans will die. That’s the message from a Washington Post interview with Microsoft founder Bill Gates, which touched on many of the same subjects from a talk he gave Friday before the Massachusetts Medical Society.

Bill Gates says the U.S. government is falling short in preparing the nation and the world for the “significant probability of a large and lethal modern-day pandemic occurring in our lifetimes.”

Gates discussed his efforts to convince the Trump administration to set aside more funding for the Centers for Disease Control and Prevention and to prioritize the creation of a national response plan that would govern how resources are deployed during a pandemic or biological weapons attack.

During the interview, the billionaire who appears to have gotten such a touch eccentric in his gray years, confirmed that he had raised the issue of pandemic preparedness with President Trump, and that he tried to convince the president that he has a chance to lead on the issue of global health security.

According to Gates, Trump told him to raise these issues with officials at the Health and Human Services Department, the National Institutes of Health and the Food and Drug Administration. Gates said he also met with HR McMaster, who was ousted as National Security Advisor last month, and he hopes to meet with McMaster’s successor John Bolton. He is probably the only one.

That said, Gates may have a point: Even this winter’s flu season – the worst in years – overwhelmed hospitals, some of which were forced to pitch tents outside the facilities and deploy other emergency accommodations.

Gates, whose Gates Foundation focuses on public health initiative, has shifted his focus in recent years to international pandemic awareness and preparation. To be sure, he’s not the only one who believes the developed world is dangerously ill-prepared to beat back such a threat.

Gates and his wife, Melinda, have repeatedly warned that a pandemic is the greatest immediate threat to humanity. Experts say the risk is high, because new pathogens are constantly emerging and the world is so interconnected. Many experts agree that the United States remains underprepared for a pandemic or a bioterrorism threat. The government’s sprawling bureaucracy, they say, is not nimble enough to deal with mutations that suddenly turn an influenza virus into a particularly virulent strain, as the 1918 influenza did in killing an estimated 50 million to 100 million people worldwide. Even this winter’s harsh seasonal flu was enough to overwhelm some hospitals, forcing them to pitch tents outside emergency rooms to cope with the crush of patients. If a highly contagious and lethal airborne pathogen like the 1918 influenza were to take hold today, nearly 33 million people worldwide would die in just six months, Gates noted in his prepared remarks, citing a simulation done by the Institute for Disease Modeling, a research organization in Bellevue, Wash.

So what should the US do according to Gates: the nation needs to prioritize the development of better vaccines – including a “universal” flu vaccine – and other treatments as well as new diagnostic capabilities to help doctors detect and identify a pandemic before it has the opportunity to spread, according to the Microsoft founder.

In those remarks, Gates highlighted scientific and technical advances in the development of better vaccines, drugs and diagnostics that he said could revolutionize how we prepare for and treat infectious diseases moving forward. He praised last year’s formation of a new global coalition, known as CEPI, to create new vaccines for emerging infectious diseases. He also announced a $12 million Grand Challenge in partnership with the family of Google Inc. co-founder Larry Page to accelerate the development of a universal flu vaccine. But vaccines, he noted, take time to research, deploy and generate protective immunity. “So we need to invest in other approaches, like antiviral drugs and antibody therapies that can be stockpiled or rapidly manufactured to stop the spread of pandemic diseases or treat people who have been exposed,” he said in his speech. Among the advances in these areas are a new influenza antiviral recently approved in Japan that Gates said “stops the virus in its tracks” by inhibiting an enzyme it needs to multiply; research on antibodies that could protect against a pandemic strain of a virus; and a diagnostic test that harnesses the powerful genetic-engineering technology known as CRISPR and has the field-use potential to check a patient’s blood, saliva or urine for evidence of multiple pathogens. That test could, for example, identify whether someone is infected with Zika or dengue virus, which have similar symptoms.

But even the most cutting-edge remedies are useless without a plan to deploy them, something Gates says the Trump administration recognizes.

Trump and senior administration officials have affirmed the importance of controlling infectious disease outbreaks. But the Centers for Disease Control and Prevention is facing a loss of emergency funding provided in the wake of the 2014 Ebola epidemic and has begun to dramatically downsize its epidemic-prevention activities in 39 out of 49 countries where disease risks are greatest. Congress provided additional funding in last month’s spending bill. But it also directed the administration to come up with a comprehensive plan to strengthen global health security at home and abroad. “This could be an important first step if the White House and Congress use the opportunity to articulate and embrace a leadership role for the U.S.,” Gates said in the speech. No other country, he noted, has the depth of scientific or technical expertise that the United States possesses, drawing on the resources of institutions such as NIH, CDC and the Biomedical Advanced Research and Development Authority, as well as the Defense Department’s Defense Advanced Research Projects Agency.

While Gates’s sense of urgency is admirable, other experts on the likelihood of a global pandemic emerging in the relatively near future make Gates look like a Walt Disney-level optimist.

“We know that it is coming, but we have no way of stopping it,” said WHO infectious disease specialist Dr. Sylvie Brand.

If you haven’t already, now would probably be as good a time as any to invest in some surgical masks. Unless of course Elon Musk is correct with his own doomsday prediction, and sentient, AI-capable killer robots have already bought out the entire inventory.

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