https://www.ted.com/talks/bill_gates_how_we_must_respond_to_the_covid_19_pandemic

Philanthropist and Microsoft cofounder Bill Gates offers insights into the COVID-19 pandemic, discussing why testing and self-isolation are essential, which medical advancements show promise and what it will take for the world to endure this crisis. (This virtual conversation is part of the TED Connects series, hosted by head of TED Chris Anderson and current affairs curator Whitney Pennington Rodgers.)

“When we sent data to the FDA this weekend, showing that just an individual by themselves swapping out to the tip of their nose, they're able -- the accuracy of that test is essentially the same as having a health care worker do it. That helps a lot. We still have to do other things, but that means that you don't have to change protective equipment. You just hand the patient that swab, they do it, put it in a test tube and, if the capacity's right, within 24 hours you should get that result back."

For more on the self-swab technology, see this White House press briefing from March 23, 2020 (here).

""The herd immunity is meaningless until you infect over half the population, and so you can peak -- you'll overload your medical system. So your case fatality rate, instead of being one percent, will be like three to four percent."

Herd immunity refers to community-level immunity, due to widespread vaccination or infection with recovery. As of March 2020, herd immunity has not been widely considered a viable strategy for the novel coronavirus pandemic (see here, here and here).

"And that gave us some experience. In fact, that flu study actually was the first time coronavirus was found in the community, because the government was still saying you only test people coming from China. But we ran into people who had coronavirus who weren't, hadn't been travelers. So that was like an early warning sign, even though the regulation said you weren't supposed to even look at that."

According to this series of tweets (here), data from the Seattle Flu Study was used to sequence the genome of SARS-CoV-2.

"... those swabs are very easy to manufacture. The one where you had to jam it into the throat, mid-turbinate, that was getting into short supply."

For more on the timeline of swab production, see this article from NPR (here).

"And so, the Gates Foundation and Wellcome Trust, with support from Mastercard and now others, rated this therapeutic accelerator, to really triage out -- you have hundreds of people showing up and saying try this, try that. We look at lab essays, animal models. And so we understand which things should be prioritized for these very quick human trials that need to be done all over the world. So the coordination on that is very complex globally. But I think, you know, out of the top 20 or so candidates, probably three or four of them will work out, you know, at different stages of the disease, to reduce the respiratory distress."

The Gates Foundation shared the following: “We are focusing initial efforts on large libraries of drug compounds that have safety data and clinical data in some other indication. The ReFRAME library, held by Calibr at Scripps Research, is the first, which contains about 14,000 different compounds that could be repurposed if they show any hits in assays being done at academic research laboratories. We are also working with more than a dozen pharmaceutical companies to access their proprietary compound libraries to add to the mix."

"We can make billions of tests within two or three weeks. We can figure out which antiviral drugs, within two or three weeks, and we can make a vaccine. If we're really ready, probably in six months. Using these new platforms, probably the RNA vaccines."

According to the Gates Foundation, these figures are an estimate of a possible production capacity and are contingent on the safety and efficacy of the mRNA construct, as well as the available manufacturing capacity.