
The next outbreak? We're not ready. Ted talk by Bill Gates (2015) - axelfontaine
https://www.ted.com/talks/bill_gates_the_next_outbreak_we_re_not_ready
======
dang
[https://news.ycombinator.com/item?id=22575745](https://news.ycombinator.com/item?id=22575745)

~~~
melling
It’s 10 days old and has far fewer comments

By marking it as a duplicate, you just killed this new thread.

~~~
dang
The criterion we use is: did the previous post get significant attention? 87
points and 36 comments is way over that threshold.

When a discussion is particularly good, we sometimes override that. This one
seems pretty generic to me, though, especially in light of how many
coronavirus threads HN has been seeing. I'm not sure there's even a single
comment below that is reacting to more than what's in the title: "outbreak",
"not ready", and "Bill Gates".

~~~
nouveaux
I'd argue that this post is more relevant than 10 days ago and should receive
an exemption.

10 days ago, the number of cases were small and there was no lock down. Many
people did not consider Corvid-19's real impact. Now that most of the country
is taking it seriously, it is more top of mind.

10 days ago, Corvid-19 posts were barely considered here on HN. Now many are
generating serious discussions.

Please reconsider marking this as a dupe.

~~~
dang
We've also had 10 days worth of massive coronavirus discussion. The issue is
the quality (and specificity) of this thread relative to the others.

------
merpnderp
No one paid attention. After the H1N1 crisis, the US burned through its
reserves of N95 masks and other pandemic supplies, and never refilled them.

We aren't even learning now, even after it was obvious Italy needed to lock
down more, the US still wasn't taking it seriously. I listened last night to
my city council argue that it was still no big deal. Two members, a doctor and
scientist said we needed to shut down the city, and everyone else arguing it
would destroy small businesses and it wasn't that big a deal to anyone but the
elderly.

We just don't learn.

~~~
chrisco255
20-50 year olds with no pre-existing conditions are at low risk. The policy of
shutting down the economy indefinitely is frightening on its own and we'll be
dealing with the steep repercussions of that for many years. This is not
sustainable.

~~~
enumjorge
So do we treat anyone outside the group of 20-50 year old with no preexisting
conditions as acceptable collateral damage to keeping the economy afloat?

~~~
Klinky
It's almost as if some people think human's purpose is to sustain an economy,
rather than the other way around.

Economies and markets are a tool used by human's to achieve goals(ideally
better quality of life), they are not the goal itself.

~~~
jjeaff
It seems like you are making their point for them.

If an economy's purpose is to sustain humans, then letting it crash and burn
puts those humans at risk.

It's a balancing act. We just can't forget that too much economic destruction
will cost lives as well.

~~~
Klinky
It is a balancing act, but we need to watch out that we're not letting the
economy run the show based on things like overinflated valuations and
speculation, which at the first sign of trouble, implode on themselves at
almost a 50% loss.

How much actual value(quality of life) is really being generated here? How
much of it is hype, bandwagons, and charades? How sustainable is it and what
safety nets are available when the bottom falls out? During this time you also
think about how many people are telecommuting effectively right now, and how
much downtown economies and real estate relies on everyone getting in their
car, or on a bus/train going downtown each morning, and then the knock on
effects this has on the environment.

A lot of people don't want to hear pessimism or realism, they want to see
growth, growth and growth. Growth at all other costs can still result in the
side effect of quality of life improvements, but unlimited economic growth has
not been sustainable, and we've had quite a few boom and bust cycles the last
2 decades now. If you're designing the economy to continually boom & bust,
it's hard not to expect eventual economic destruction. It's not a matter of
"not letting it happen", it's a matter of that's how it's been designed. It's
what it does.

------
0xff00ffee
This feels like a giant game of "I can't wait to say 'I told you so!'" by many
different factions. The HeadInTheSand GOP, the Apocalyptic Left, the panicked
middle (/r/coronavirus). Everyone except health professionals.

Competitive Schadenfreude.

~~~
emilsedgh
While we are in the middle of an apocalypse, you're name calling the people
who predicted it.

I sincerely hope that one of the side effects of this crisis would be more
acceptance towards science.

~~~
0xff00ffee
I name-called the "health professionals"? Help me out: what do they like to be
called?

------
DanSmooth
Perhaps also of interest, his recent AMA on Reddit:
[https://www.reddit.com/r/Coronavirus/comments/fksnbf/im_bill...](https://www.reddit.com/r/Coronavirus/comments/fksnbf/im_bill_gates_cochair_of_the_bill_melinda_gates/)

------
ryndbfsrw
I try to imagine the counter-scenario where leaders had done the correct thing
but because they did the right thing and a spread never occurred we
collectively boot them out of office because nothing bad happened and
criticize them for 'overreacting' when that is exactly what is needed for a
pandemic.

I am sympathetic to why nothing changed and no one listened. good risk
management shows up as nothing bad happening. Heroes who avert disaster don’t
get statues.

~~~
siwatanejo
This is why good security professionals are never promoted: if they do their
job well, nobody notices.

~~~
nojvek
Or may be they do because they say “look competitor X just got pwned and is
bleeding customers which are coming to us”.

------
jimbob45
Would things have been different if it had started in a country other than
China? Politics aside, starting in the most populous and most trafficked
country on Earth seems like the worst-case scenario.

~~~
beager
Population density is a factor to be sure, but the government response was a
bigger factor in failing to contain it in my opinion.

The CCP’s culture of fear and retribution pushed municipal officials to
suppress reports of a novel outbreak, and pushed authorities to retaliate
against medical professionals sounding the alarm.

A culture of transparency and non-retribution may have enabled China to
contain this, and could have provided earlier warnings to the world to prepare
for an epidemic or pandemic that might not have even happened.

~~~
bcrosby95
A handful of countries were able to prevent an epidemic in their own country
because they responded quickly. The vast majority of them ignored the virus
and claimed it wouldn't come here, and changed their tune only when it was too
late.

China gave a perfectly fine head start as evidenced by countries that were
able to contain it. Everyone else just wasted the head start, and I see no
evidence that they wouldn't have wasted it even if China gave them a longer
one.

~~~
wpasc
The first US case was diagnosed on Jan 19 2020. The US-China border was closed
on Feb 2. Screening procedures followed later on. It is up for debate whether
or not screening procedures would have started earlier if the border had
closed earlier. BUT, to say there is no evidence at all that a longer head
start would have helped countries is a very dubious claim.

------
jliptzin
It’s because we have really been in the midst of a stupidity epidemic for at
least the last 5 years and our debt has finally come due.

~~~
Enginerrrd
For only the last 5 years?! We started approaching our current level of
polarization and infighting over wedge issues during the 90's, and have
steadily gotten worse. Both sides are hopelessly deadlocked and so convinced
they're right as to completely disparage and dehumanize half of the
population. They're more interested in fighting the other side than they are
moving forward in any way if it involves giving the other side a victory, no
matter how small. If that's not the stupidity that got us into this mess, I
don't know what is.

~~~
throwaway894345
By my estimation, most elite media, academia, and other epistemological
institutions retained a strong sense of professional integrity prior to ~2012.
They certainly had their biases, but they took some care to veil them. This
change felt pretty distinct and abrupt to me; before the sort of overt
partisanship was widespread among the general population, but these elite
institutions were generally seen as above the fray. Afterward, we saw a steep
trend toward tabloidism that climaxed early last year with the Covington
Catholic affair (for the unfamiliar, the media doctored a video of some
students to make them appear to be frothing racists to the effect that they
were mobbed online and received threats of death and violence even from
celebrities) but which has remained in a lesser but still heightened state
ever since.

------
dustingetz
"Sufficiently Powerful Optimization Of Any Known Target Destroys All Value"

From the Moral Mazes blog series featured on HN a couple months ago
[https://thezvi.wordpress.com/2019/12/31/does-big-business-
ha...](https://thezvi.wordpress.com/2019/12/31/does-big-business-hate-your-
family/) ; the first segment is
[https://thezvi.wordpress.com/2019/12/28/moloch-hasnt-
won/](https://thezvi.wordpress.com/2019/12/28/moloch-hasnt-won/)

------
throwaway894345
I really hope we (the US) conducts a thorough and credible investigation as to
who is responsible for this failure to prepare for this crisis. I have minimal
faith in government or regulatory agencies, but I thought the CDC was one of
the few government agencies that had its shit together. Apparently they
couldn't even be bothered to keep a reasonably stocked reserve of masks and
ventilators--things that we knew we would need in the event of a respiratory
disease outbreak which we were looking pretty probable following SARS and
MURS. Never mind planning to secure and ramp up critical supply chains. I'm
sure there's lots of blame to be laid at the feet of congress and various
administrations, but these things seem to be squarely in the purview of the
CDC and certainly aren't line items on the congressional appropriations bill.

I want criminal charges pressed against bureaucrats and politicians tarred and
feathered not so much because I'm pissed that their negligence has killed /
will kill thousands but so that future politicians and agency heads will take
this shit seriously in the future. If there aren't sufficient legal avenues
for holding politicians and bureaucrats accountable, then we need to create
some.

~~~
kiba
_I really hope we (the US) conducts a thorough and credible investigation as
to who is responsible for this failure to prepare for this crisis._

I don't see how blaming x and y will fix anything but boot out the current
bureaucrats. The next time a pandemic happens, the guys who remembered
anything in living memory are already dead or retired.

Worse, punishing people when they don't understand or making honest mistakes
are going to lead to hiding of their mistakes or incentive not to understand
anything.

 _but I thought the CDC was one of the few government agencies that had its
shit together. Apparently they couldn 't even be bothered to keep a reasonably
stocked reserve of masks and ventilators_

It's hard to keep a reserve of masks and ventilators when the higher ups don't
think your mission is particularly important and you don't have a budget.
Ventilators and masks costs money to store, maintain, and test.

The better solution is to prioritize pandemic preparation and war game
pandemic scenario, and conduct an honest investigation to prepare for the
future, rather than punish people.

~~~
throwaway894345
We have accountability for every other executive. Why do top brass at CDC get
to plead ignorance?

Maybe to your point the CDC or Congress really is just one guy working out of
his Atlanta garage and it is too much to ask of him to maintain a stockpile of
basic supplies for the most likely disaster scenario (you know, those
respiratory disease outbreaks that we've seen 3 of in the last 2 decades). If
this is what the investigation finds and this guy really did everything he
could with the budget he had, then let's name and shame the politicians who
gave him that budget.

Like I previously mentioned, I don't doubt that congress didn't give the CDC a
stellar budget, but I have a hard time believing that they spent their
resources on better things than masks and ventilators (no, not based on
hindsight, but based on the pattern of respiratory disease outbreaks) and that
they couldn't even afford to plan to secure supply chains. That's like one
analyst's job for several months.

But again, maybe I'm wrong and the fault lies squarely with Congress or one or
several administrations--those politicians still deserve to be tarred and
feathered (again, accountability is a real thing). In any case, _we won 't
know without an investigation_.

> conduct an honest investigation to prepare for the future, rather than
> punish people.

Nope. "Accountability" is preparing for the future. Without it those in charge
will just ignore those best laid plans because they're too expensive and
there's no cost to ignoring them. If you drive drunk and kill someone, you go
to jail. If you are in charge of a federal agency and you don't do your basic
due diligence and your glaring fuck-up kills thousands of people, we shouldn't
laugh it off.

------
RyanShook
Really thankful that Bill Gates is focusing his attention on coronavirus at
this time. I think he will likely be called one of the many heroes in this
epidemic.

------
tbergeron
Seems he was ready after all. Look up Event201 and ID2020.

~~~
melling
I found this:

[http://www.centerforhealthsecurity.org/event201/](http://www.centerforhealthsecurity.org/event201/)

~~~
cbhl
It appears they updated that page to explicitly state that the tabletop
exercise was not meant to be a prediction, but simply to highlight challenges
in responding in a pandemic.

~~~
melling
Here’s an exercise:

There’s an epidemic in the China with a population of 1.3 billion, the second
largest economy. They lock down Wuhan on Jan 23rd to try and contain it from
spreading to the rest of China.

On Jan 30th with 7818 infected, the WHO declares Global Health Emergency. It’s
a now threat beyond China.

What do you do?

Things to consider:

\- There are 100,000 global flights a day.

\- China is rushing to build 2 hospitals in 10 days

\- It appears to be highly contagious

~~~
MagnumOpus
Interestingly, the more severe response of "check or cancel all flights to
China" would not have worked, because by January 21th, the virus started
community transmission in Germany and Italy.

But stocking up the mask and respirator and PPE reserve immediately would not
have gone amiss, nor would fever checks at airports, public buildings etc.

~~~
melling
There was also community spread in the United States on Jan 21st. Patient Zero
arrived before any lockdown.

[https://www.bloomberg.com/news/features/2020-03-09/how-
coron...](https://www.bloomberg.com/news/features/2020-03-09/how-coronavirus-
spread-from-patient-zero-in-seattle)

------
zaptheimpaler
The asian countries by and large did better because they don't view every
decision through a narrow economic lens. They simply understand that the
health of their population is the ground upon which everything else is built.

US/West has been taken over by paperclip maximizers, thats all. The landlords
want to maximize paperclips, so no rent relief for small businesses. The
politicians see this and decide shutting down would be catastrophic, instead
of questioning the premise.

Like it is literally inconceivable to me how retarded modern capitalism is.
You need a 5-6 week shutdown on businesses, so force rent to be waived for
that period. Thats most of the fixed cost, and the employees being on
leavetakes care of the variable cost. The businesses don't go bankrupt,
everyone just takes a 6 week vacation and comes back like nothing happened.
You need ICUs/equipment - take over hotels and make it happen. Instead, they
are worried about getting congress approval to pass a bill to pay the hotel
owners leasing costs during a global emergency. In the face of a million
deaths, the paperclip maximizers can only see all the lost paperclips.

------
tehjoker
Bill Gates, the giving pledge guy, is somehow richer than before he took the
pledge. His organization is also mysteriously involved in encouraging the
women of developing nations to get IUDs under a Malthusian theory that
mysteriously benefits the people of rich nations over poor nations.

This guy may be talking to health experts, but he's not someone we should be
taking advice from. He represents the right wing of international development
aid.

[https://www.dailywire.com/news/whos-racists-bill-gates-
spend...](https://www.dailywire.com/news/whos-racists-bill-gates-
spending-18-million-paul-bois)

~~~
pinkfoot
> get IUDs under a Malthusian theory

3 new people per second.

Out of curiosity, which developing nation problems get easier with _more_
people?

Mankind's time of easy answers is behind us.

------
DarkCoder
i highly doubt that. its all about microchip implemenation

------
glofish
yeah, he was not ready even after telling us about how we are not ready

~~~
melling
The warning was for us...5 years ago.

~~~
3fe9a03ccd14ca5
Warnings are cheap and easy. Lots of people warning about all kinds of things
all of the time.

Where is the technology? Where is the solution? Where is the execution on the
warning?

