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Bill Gates Says 9 Months Is Best Scenario for COVID-19 Vaccine Development

Bill Gates shared his thoughts on the straightforward — yet daunting — task of developing a viable COVID-19 vaccine at unprecedented scale.

Co-Founder of Microsoft Bill Gates wrote a blog post to clarify his thoughts on the viability of vaccine development — in which he gave a low-end vaccine development estimate of 9 months — and the eventual end of the age of the COVID-19 pandemic.

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Bill Gates shares thoughts on vaccine timeline, end of COVID-19

Bill Gates outlines his binary answer to the question about when the COVID-19 pandemic will end, a historical eventuality that turns on either a near-perfect drug treatment or the vaccination of nearly every human on Earth against the novel coronavirus.

In his blog post, he laments that a direct treatment for COVID-19 won't happen soon. "We'd need a miracle treatment," with at least 95% effectivity to halt the advance of the outbreak, wrote Gates. "Most drug candidates right now are nowhere near that powerful. They could save a lot of lives, but they aren't enough to get us back to normal."

This leaves all our hopes resting, according to Gates, on a vaccine.

Gates stresses the need to create broad immunity across the entire species before we can expect a "return to normal." To get there, we'll need a safe and effective vaccine. And not just a sample — to innoculate the entire human race, we'll need to disperse billions of doses to every corner of the world, and it will have to happen in a flash.

Gates readily admits the daunting nature of this task, and adds that his foundation — the COVID-19 Therapeutics Accelerator — is the biggest funder of vaccine development and testing globally, said Gates. But, he adds in the deceptively-calm tone of nature's ultimatum: "I know it'll get done. There's simply no alternative."

He added that while he agrees with the possibility of an 18-month COVID-19 vaccine timeline estimated by Dr. Anthony Fauci — director of the National Institute of Allergies and Infectious Diseases (NIAID) — Gates thinks "it could be as little as 9 months or as long as two years."

Of course, there's no guarantee it will happen this fast — there is a system to developing vaccines. But with global financial support, Gates believes we can speed up some processes in ways we couldn't before.

New England Journal of Medicine
All vaccines must pass through a process of vetting for safety and effectiveness. Source: Gates Notes / New England Journal of Medicine

Search for COVID-19 vaccine will be unconventional

In the past, the necessary steps to finding a viable vaccine were taken to address essential questions and unknown factors. This is a way of managing financial risk entailed in creating an expensive vaccine. There are many failed candidates, which is generally why numerous companies don't immediately invest in developing a vaccine — in anticipation of the one that works.

However, with COVID-19, financing development isn't the problem. Governments around the world, in addition to several organizations (like Gates', and another he points to called Coalition for Epidemic Preparedness Innovations) have committed to putting the ultimate cost of the vaccine as their number one priority. This widespread support allows scientists to work on several stages of vaccine development at once, saving precious time in the fight against the COVID-19 pandemic.

UPDATE April 30, 7:00 PM EDT: Vaccine safety, efficacy, and development

The high-end estimation to develop the COVID-19 vaccine — 18 months — is a very long time, but Gates reiterates that this would still be the fastest scientists have created a vaccine. "Development [of vaccines] usually takes around five years," wrote Gates. This is because viable vaccines first require animal tests. Once we've seen that animals can take it, then human trials may begin, wrote Gates.

On the way to a viable vaccine, Gates stresses safety and efficacy as the two most important goals. Safety is as we know it: some minor side-effects (like some injection site pain, or a mild fever) is acceptable, but inoculating the entire human race with something that makes them sick would be the quickest way to avoid Gates' best-case scenario.

Efficacy is also common-sense: we want a vaccine that works perfectly, 100% of the time, but many don't. Gates cited this year's flu vaccine, which is only roughly 45% effective.

UPDATE April 30, 7:30 PM EDT: The three phases of vaccine testing

To test both efficacy and safety, ever vaccine must pass three phases of intensive trials:

Phase one is for safety. A small collective of healthy volunteers is given the vaccine candidate. Doctors vary dosage to induce the strongest possible immune response to the lowest effective dose, while mitigating side effects.

Once the formula is nailed down, the vaccine moves on to phase two, which tests how well the vaccine works in humans who receive it. But it's on a scale of hundreds, instead of a small collective, of varying age and health.

If the third phase is the biggest scale-up, it's also the one that takes the longest. Testing the vaccine on thousands of people, the effects are seen in what's known as "natural disease conditions;" wherein the target recipients of the vaccine are likely people already at-risk for infection by the active disease. After administering the vaccine candidate, all that's left is to wait, and see if the newly-vaccinated get better, or don't.

Once a vaccine passes all three phases, factories shoot up to manufacture it en masse, and it's submitted to the WHO and several government agencies for final approval. The graphic above shows a comparative analysis of the fastest-yet developed vaccine versus Dr. Fauci's vaccine timeline estimation.

While a great number of vaccine candidates undergo testing, the world anxiously waits, hoping to persevere in the face of this most unprecedented COVID-19 pandemic.

This is a developing review of Bill Gates' thoughts on the search for a vaccine to the COVID-19 pandemic, so be sure to return here for more updates.

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