The next outbreak? We're not ready. Ted talk by Bill Gates (2015) - <AUTHOR> https://www.ted.com/talks/bill_gates_the_next_outbreak_we_re_not_ready <comment><USER2> [https://news.ycombinator.com/item?id=22575745](https://news.ycombinator.com/item?id=22575745)

<comment><USER3> It's 10 days old and has far fewer comments

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

<comment><USER2> 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".

<comment><USER4> 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.

<comment><USER2> 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.

</comment></comment></comment></comment></comment><comment><USER5> 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.

<comment><USER6> 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.

<comment><USER7> 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?

<comment><USER8> 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.

<comment><USER9> 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.

<comment><USER8> 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.

</comment></comment></comment></comment></comment></comment><comment><USER10> 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.

<comment><USER11> 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.

<comment><USER10> I name-called the "health professionals"? Help me out: what do they like to be called?

</comment></comment></comment><comment><USER12> 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/)

</comment><comment><USER13> 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.

<comment><USER14> This is why good security professionals are never promoted: if they do their job well, nobody notices.

<comment><USER15> Or may be they do because they say "look competitor X just got pwned and is bleeding customers which are coming to us".

</comment></comment></comment><comment><USER16> 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.

<comment><USER17> 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.

<comment><USER18> 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.

<comment><USER19> 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.

</comment></comment></comment></comment><comment><USER20> 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.

<comment><USER21> 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.

<comment><USER22> 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.

</comment></comment></comment><comment><USER23> "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/)

</comment><comment><USER22> 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.

<comment><USER24> _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.

<comment><USER22> 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.

</comment></comment></comment><comment><USER25> 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.

</comment><comment><USER26> Seems he was ready after all. Look up Event201 and ID2020.

<comment><USER3> I found this:

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

<comment><USER27> 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.

<comment><USER3> 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

<comment><USER28> 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.

<comment><USER3> 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)

</comment></comment></comment></comment></comment></comment><comment><USER29> 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.

</comment><comment><USER30> 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)

<comment><USER31> > 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.

</comment></comment><comment><USER32> i highly doubt that. its all about microchip implemenation

</comment><comment><USER33> yeah, he was not ready even after telling us about how we are not ready

<comment><USER3> The warning was for us...5 years ago.

<comment><USER34> 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?</comment></comment></comment>


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