
Bill Gates slams 'shocking' U.S. response to Covid-19 pandemic - prawn
https://www.statnews.com/2020/09/14/bill-gates-slams-mismanaged-u-s-response-to-covid-19-pandemic/
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baryphonic
I appreciate a lot of Gates' statements here, since they are substantive and
not just posturing. The issue is that the US medical system is rotten to the
core. There are hundreds of thousands of wonderful individual practitioners
and even thousands of excellent teams, but the system as a whole is broken.

His idea that no one should be paid for a test result if it takes more than 24
hours to result is not bad, but the existing system is not set up for it.
Decades of regulation of all aspects of the US medical system, from billing
codes even to electronic health records, would prevent that kind of change
from being adopted overnight. If we adopted this change, you'd very likely see
almost no one running any COVID tests at all - the risk and infrastructure
investment would be too high, for too little payout. (Recouping the cost of
lab tests is generally hard as is, since the costs of running a medical lab
are almost entirely fixed, both in terms of labor and capital. Routine
maintenance must be performed, the lab must have a certain contingent on duty
to handle stat tests, etc.)

I'm not sure the US system can be improved unless we have some practitioners
who want to make a clean break from the existing regime, and they get some
cover from the government to actually innovate. I'm not holding my breath.

~~~
PragmaticPulp
> If we adopted this change, you'd very likely see almost no one running any
> COVID tests at all

This is especially true for providers who aren't running the tests in-house.
If your doctor takes a test and sends it out to an external lab like LabCorp,
who is responsible if the complete process takes more than 24 hours?

In reality, your doctor would simply stop testing for Coronavirus and instead
refer you to a LabCorp collection center, where they could keep you waiting in
line until they had enough testing capacity to take your sample and start the
24-hour clock. Everyone loses.

Not to mention all of effort required to retool billing and accounting systems
to account for time-based costing. This alone would drive the cost of testing
upward by huge amounts. Or more realistically, providers would simply not
offer tests unless patients paid in cash to avoid this mess.

This is a great example of how regulation can end up making the situation
worse, despite good intentions.

~~~
scsilver
Im currently in grand teton national park and need to get a test before seeing
my parents. This area that has 5+ million visitors a summer has about 3 covid
tedting sites in an 2-3 hour drive. The main hospital needs a referal to give
you s test. Any referals from out of the area will have their tests sent to
another site, results are expected in 5-7 buisness days. When asked how much
it would cost, they said they have no idea, they will bill the insurance. We
have decided not to take this test and wait till we are in a major city and
get the 15 minute test. Naturally, they have plenty of open appointments to
administer the test. Our healthcare is completely broken. These national parks
are intersections of people from all over the US and one of the most important
places to have rapid testing and its just completely unavailable.

~~~
lumberingjack
Imagine a virus so bad you got to get tested in order to know if you have it
or not. You made the choice to go to the park nobody forced you to go there
you're going to have to sacrifice some stuff if you want to be 100% safe but
trust me buddy CDC websites says 003% that anything is going to happen

~~~
scsilver
Thankfully, I'm a young and healthy adult and wish to do my part to continue
living my life while doing due diligence to protect more susceptible people
around me. And if you want to look at it in a fiscally conservative way,
prevention of spread is cheaper than treating those it may have spread to.

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bransonf
I don’t know when this interview was, but I’m surprised to see no mention of
sputum testing as a replacement for Nasopharyngeal RT-PCR.

I don’t know the precise number, but probably at least a dozen of these spit
tests have been developed at Universities and approved by the FDA for
emergency use. Some even use the LAMP protocol as opposed to RT-PCR, which
saves on time and reagents.

Another thing I always think of is how we didn’t adopt the contact tracing
protocol that Google and Apple developed. Obviously it was a trust issue, and
maybe some logistical shortcomings, but contact tracing as we’ve implemented
it is largely ineffectual in reducing spread. The serial interval in young
people is likely less than the time it takes to get back a test, and certainly
shorter than the time it takes to get a test and complete a contact tracing
interview.

The US response to Covid is obviously a polarizing issue, but we’re all wrong
to assume that we couldn’t have done better.

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itsthecourier
At this moment of history he is standing up and saying things government don't
want to hear. I really respect the patriotism and courage of Gates.

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mensetmanusman
If the US had done nothing, many models predicted over 2 million deaths by
now.

We have had 200k, so a 90% reduction.

Hopefully there is a vaccine soon

~~~
youngNed
> many models predicted over 2 million deaths by now

citation needed.

Here are many models that we can backcheck:
[https://projects.fivethirtyeight.com/covid-
forecasts/](https://projects.fivethirtyeight.com/covid-forecasts/)

~~~
jjcon
> without action by the government and individuals to slow the spread of
> coronavirus and suppress new cases, 2.2 million people in the United States
> could die

[https://www.nytimes.com/2020/03/16/us/coronavirus-
fatality-r...](https://www.nytimes.com/2020/03/16/us/coronavirus-fatality-
rate-white-house.html)

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peer2pay
Whenever I read such extreme action verbs as "slam", "bash" etc. in a
headline, I have to assume the underlying article is a populist piece of
garbage.

~~~
lumberingjack
this whole place is turned into Reddit man there's people up top in this
comment section complaining that there's not enough testing while they're
frolicking around the countryside. Complaining that they want free testing.
Imagine a virus so bad you have to get tested to know if you have it or not

~~~
EForEndeavour
What do you mean when you say this place has "turned into reddit"? Are you
referring to the generally lower standard of comment quality there? If so,
that's ironic.

Imagine a virus so unpredictable that you might take anywhere from 0 to 14
days to become infectious, and you could end up anyhwere from unknowingly and
asymptomatically shedding the virus to dead from it. Imagine that.

------
eternalban
Here's is an interesting article on the relationship between Bill Gates and
the media recently published by CJR:

Journalism’s Gates keepers: [https://www.cjr.org/criticism/gates-foundation-
journalism-fu...](https://www.cjr.org/criticism/gates-foundation-journalism-
funding.php)

If you are wondering why someone like Michael Levitt [1] doesn't get wall to
wall coverage by media (including outfits like RT) [as an 'expert voice on
pandemic response'], the above article has a few clues.

[1]: He's just one example. There are many others.

[https://twitter.com/mlevitt_np2013?lang=en](https://twitter.com/mlevitt_np2013?lang=en)

[https://en.wikipedia.org/wiki/Michael_Levitt](https://en.wikipedia.org/wiki/Michael_Levitt)

\-- p.s. relevant pull quote asking the timely question --

 _During the pandemic, news outlets have widely looked to Bill Gates as a
public health expert on covid—even though Gates has no medical training and is
not a public official. PolitiFact and USA Today (run by the Poynter Institute
and Gannett, respectively—both of which have received funds from the Gates
Foundation) have even used their fact-checking platforms to defend Gates from
“false conspiracy theories” and “misinformation,” like the idea that the
foundation has financial investments in companies developing covid vaccines
and therapies. In fact, the foundation’s website and most recent tax forms
clearly show investments in such companies, including Gilead and CureVac._

~~~
zamfi
Michael Levitt, though almost certainly a smart guy, has not had the best
track record, making predictions both accurate and not. Also, predictions
alone are...not that useful? From your Wikipedia article:

> In March, the Los Angeles Times reported that Levitt correctly forecasted in
> February that the COVID-19 pandemic in China would soon peak and that China
> would end up with around 80,000 cases and 3,250 deaths from COVID-19.[41]
> However, it has been noted that Levitt actually made a number of
> predictions, including incorrect forecasts, in February about China's
> COVID-19 trajectory[42], including one on February 7, 2020 claiming that "by
> 14-Feb. we will have reached 95% of the eventual death count of 928".[43]
> Levitt also has stated his belief that achieving natural herd immunity to
> the virus is possible[44] and has spoken against lockdown orders.[45]

> Levitt also wrongly predicted that Israel would suffer no more than 10
> COVID-19 deaths[46]. On July 25, 2020, Levitt predicted that COVID-19 in the
> United States would be over "in 4 weeks with total reported deaths below
> 170,000".[47] However, this prediction about the reported death count also
> ended up being wrong as the number of reported deaths from COVID-19 in the
> United States exceeded 170,000 on August 16, 2020, only 3 weeks after
> Levitt's prediction.[48]

Sounds like he does get some coverage. As for why it’s not wall-to-wall? Maybe
his predictions have been wrong too many times?

~~~
eternalban
Don't focus on one guy. He is just one example. There is a pattern of a whole
range of individuals with very credible credentials that are entirely ignored.

Track records don't seem to matter. The famous Imperial College model was by a
worker with a rather alarming track record. How is the track record of Bill
and Melinda Gates foundation, btw? Or the unqualified man currently serving as
head of WHO? His C.V. is alarming enough.

So side arguments aside, the question remains as to why Bill Gates, are
granted such a global megaphone. The article from Columbia Review of
Journalism tells us why that may be the case.

I find it entirely irrational and unreasonable that decisions that will affect
the entirety of humanity today, and will definitively alter the course of
human development are to be made by individuals such as Bill Gates, and that
other input by far more qualified individuals is entirely ignored, if not
blackwashed.

It not unreasonable to seek a second opinion even for relatively minor health
matters. And here we are talking about metaphorical open heart surgery on the
very nature of society: how we are governed, how we interact, and how we make
collective decisions.

There has never been a more timely moment to ASK QUESTIONS.

