A Virtual Debate Between John Norris and Bill Gates Over What Are the Real Current and Future Risks of COVID-19 and Its Variants and Over How Best to Manage Them (Round 2)
For months, a global debate has been rising in volume. It is now raging between and among health policy and risk-management experts worldwide.
The debate's threshold topics raised by "change advocates" are four:
First, how could the world have made such a health and economic mess in managing the "COVID-19 and Its Variants Pandemic?"
Second, some experts believe it would have been possible to avoid many of the deaths, and much of the other physical, mental, psychological, social, and economic harms, from COVID-19 and its variants by using a better management approach.
Third, how did we not know that using the outdated and failed "top-down approach" of 100 years ago was unacceptable and would only lead to the disasters we see today?
Fourth, what can we do immediately, using a "bottom-up approach," to right the ship, prevent further harm, and learn from our experience? And then, a fourth question is raised: assuming the past year's program was seriously flawed, what can we immediately do to create far better infectious disease management programs, including better strategies, methods, and models—both for now and for the future.
As you can imagine, there are many points of view within this debate. Bill Gates, one of the wealthiest men in the world, has the most prominent health policy voice in the world right now.
However, John Norris, a former FDA leader and Harvard health policy and management faculty member, is a lesser-known health policy and risk-management expert who largely disagrees with Gates' positions on many critical aspects of the debate. Although, in fairness, Norris does agree with Gates on some points.
And Norris acknowledges that Gates was sometimes shooting at a moving target that he was sure he could hit, but he did not. So here is this virtual and hypothetical debate, set forth in 10 separate Rounds of five Gates' Points of View each, just like it would be if this were a heavy weight boxing match. We base the on facts and reasonable assumptions.
It uses Gates' oral or written public statements or reasonable inferences from those statements to set the table with his POINTS. Then Norris, with the help of his COVID-19 and its variants-related Safely2Prosperity LLC and TestProcessOversight LLC Teammates, makes a COUNTER-POINT of one type or another to each of Gates' POINTS. Watch them fight it out, virtually. It is not always a one-way fight. Bill gives as well as he gets. Plus, in some rounds, they have a draw, or they even agree. The battle is fairly called. Let us know what you think at firstname.lastname@example.org.
The Debate Continues – Questions 6 thru 10 — Key Points and Counter-Points
6. Bill: We are seeing the same variant mutations over and over again.
John: Wrong - There is Great Variety Among Variants — There are currently four COVID-19 variants of concern and six COVID-19 variants of interest circulating around the world. There are many more variants that are not of concern. With great certainty we will have many more variants (and perhaps variants of variants) arise over the next 5-year planning horizon. None necessarily will they be dangerous or more dangerous than existing variants. But the way in which extremely dangerous variants (up to 40% more contagious) are spreading around the world, there is legitimate concern that variants of those variants might be even more deadly or otherwise harmful. Please also see my response to questions seven and nine below.
7. Bill: A booster shot to more fully protect against COVID-19 variants (and variants of variants) will likely be available, soon.
John: Right — Strong Assumption — Booster Shots Are Likely to Add Great Value — Pfizer and Moderna are both working on a vaccine booster shot to help protect against dangerous COVID-19 variants (maybe even variants of variants) that have emerged since the start of the Pandemic. Right now, there are no vaccine boosters authorized by the Food and Drug Administration (FDA). So far, all three vaccines authorized by FDA for use in the U.S. have been found to be effective against COVID-19 and the variants of concern, to the extent that they largely prevent serious illness and hospitalization. The Delta variant (SARS-CoV-2 that originated in India) has been found to decrease the efficacy of the three vaccines authorized by FDA by more than 30%, and possibly as much as 40%. This is a very significant deuteriation in effectiveness. The media and the government both seem to have completely missed this point, and neither Pfizer nor Moderna are working to educate the public on it. It is no wonder, then that the public is ignorant of these facts. On the other hand, 60% efficacy against key variants right out of the box is a good thing. Hard to tell what is likely to come next. Boosters in study probably will just create another step forward on the road to safety. But a booster shot that after seven months re-establishes immunity for another seven months plus fully protects Americans and our world-neighbors from all the then known variants would be extremely valuable. This third level of success, a fully capable booster, is possible, even though not likely. Step two seems to be highly likely.
8. Bill: We could soon see COVID-19 variants that can evade existing vaccines altogether.
John: Right — Strong Assumption — Variants, and Perhaps, Soon, Variants of Variants, Are an Increasing Danger — Currently, all COVID-19 variants of concern are suspectable to a significant degree to the three vaccines currently authorized in the U.S. The Delta variant from India (possibly, for a while as many as 1M new cases per day) has been shown to decrease the efficacy of the Pfizer and Modera vaccine by up to 40%. This development is genuinely concerning. In various studies around the world, the Delta variant has been shown to be up to 40% more contagious overall than the original SARS-CoV-2 virus strain. Therefore, it is likely to be some 40% more lethal and otherwise seriously harmful. This situation already is an extremely critical matter. And it is likely to get far worse before it gets better. On the other hand, Bill is also correct in his strong assumption that a booster will, at least for the short term, begin to address this. It is the still next round of variants of the variants that even more concern us.
9. Bill: The best way to stop new variants is to stop the transmission of COVID-19 Worldwide.
John: Right — The Wider and More Voluminous the Spread of Viruses the More Variants (and Variants of Variants) that Arise — Viruses survive by continuous mutation (producing variants) so to make the virus: (1) stronger (more virulent), (2) more effective (more able to invade a human cell), and (3) more able to reproduce rapidly. Therefore, viruses might become ever more deadly and otherwise harmful in one way or another). I believe that if we are able to achieve worldwide herd immunity (i.e., 70% of the world population getting vaccinated), along with putting far more and far more effective COVID-19 (and variants) risk management practices in place we could be able to bring this pandemic to an end. It now is largely a war against more deadly variants and the possibility of even more deadly variants of variants. The more one loses the war, as the world has done over the past year, the more variants, and variants of variants one gets. This makes it harder and harder to win the war unless one dramatically changes programs, including strategies, methods, and models, worldwide. All four components are essential. Governments and others who feel it is over while India is "burning to the ground" are blind on these points. Finally, the chances of ever getting to 70% having vaccination induced immunity during the same seven months period, and/or immune from having had the disease during the same seven-month period, are very bleak. So dramatically new programs, strategies, and methods, as well as models, are the best path to stopping new variants from growing exponentially and spreading around the world. This would of course include helping poorer countries like India to embrace and fully execute the same set of new programs, strategies, methods, and models. We are all in one battle. It is only a matter of time before India's battle becomes the U.S.'s battle. Pay now or pay 10x more later. We have a choice.
10. Bill: New variants of COVID-19 are more contagious but less lethal than the original SARS-CoV-2 strain.
John: Wrong — The Delta Variant in India is More Deadly in Possibly Two Ways — There are currently four COVID-19 "variants of concern" circulating around the world: (1) The Alpha variant, which was first identified in Great Britain, (2) the Beta variant, first identified in South Africa, (3) the Gamma variant, first identified in Brazil, and (4) the Delta variant, first identified in India. The variants of concern were found to be significantly more contagious and therefore could be far more lethal ad otherwise harmful. There are six CoVID-19 "variants of interest": (1) The Epsilon variant first identified in the U.S., (2) the Zeta variant first identified in Brazil, (3) the ETA variant first identified in Nigeria and now already found in multiple countries, (4) the THETA variant first identified in the Philippines, (5) the IOTA variant first identified in the U.S., and (6) the KAPPA variant first identified in India. The variants of interest can cause community transmission or multiple clusters or have been detected in multiple countries. There is little question that some of the new variants are both more contagious (and therefore could be more lethal), and more lethal in another sense.
*Bill Gates is a well-known business leader and COVID-19 (and its variants) thought-leader/policy-leader. Bill has publicly spoken or often published his evolving thoughts on the risks associated with COVID-19 (and its variants) and on how to best manage them.
*John Norris is a lesser-known former FDA leader, Harvard faculty member, business leader, and a SARS-CoV-2 (COVID-19) thought-leader/policy-leader. John, too, has often published his evolving thoughts on the risks associated with COVID-19 (and variants) and on how to best manage them. In addition, John has formed three companies to better address and begin to resolve the risks:
1. Safely2Prosperity LLC ("S2P"; a company that has designed, verified, and built tailor-made thoughtful and comprehensive "COVID-19 and Its Variants Safety Software Programs");
2. TestProcessOversight LLC ("TPO"; a company that has designed, verified, and built software to improve the physical utility of infectious disease testing significantly); and
3. VaccinationPassportValidation LLC ("VPV"; a company that has designed, verified, and built software geared toward significantly improving the reliability of vaccination passports. These passports are known to be widely counterfeited).
Each company addresses a different aspect of the thoughtful and comprehensive risk-management "COVID-19 Safety Program" that John and his Teammates have designed. They will tailor-make this Safety Program for each CEO and Chairman who has brought (or is bringing) their workers or teachers back to work. Others are beginning to follow their lead. Soon, there should be real competition in this space, which John welcomes.
*This paper should NOT be viewed as an attempt by David to slay The Giant. Rather, it should be considered a call for different understandings and processing of the facts and reasonable assumptions. The goal: so, we might reach new and better conclusions AND thereby invent and adopt far better COVID-19 (and increasingly its variants) risk-management and problem-solving Safety Programs.
The goal of these new programs: to better address and begin to prevent, mitigate, and solve this infectious disease pandemic (COVID-19 and variants), lingering pandemics (the Flu and HIV, for example), and likely future pandemics. In fairness, old ways did make significant dents in polio, TB, and smallpox, although these diseases are to an extent making their way back. It is clear, too, though, that the old ways coupled with closing many economies for a year created much (by far, too much) avoidable harm.
Doing things the "old top-down way" mainly led to the needless closing of many economies worldwide for a year. (Many countries followed the United States failed lead.)
This self-destruction was mainly avoidable. If instead CEOs had immediately and more broadly put in place at high-risk closed-in work facilities comprehensive "COVID-19 and Its Variants Safety Programs" (including, but not limited to highly organized and managed, high-grade testing and vaccinating), businesses and federal, state, and local governments could have saved trillions of dollars. Instead, it seems that no significant leader seriously looked for better strategies and methods. And they ignored those that John and others frequently brought to their attention. These government and business leaders should have looked deeper before wasting trillions of dollars on a largely ineffective old and outdated "top-down" prevention, mitigation, and management approaches.
This failure to fully evaluate alternative, more thoughtful, and more comprehensive programs will make a good case study at Harvard Business School and Harvard School of Public Health someday. So why did our leaders like lemmings jump off this cliff, one after another, faster and faster, when there were far better alternatives?
It will be a shame if soon, and in the future, America, and the parts of the world that largely follow America's lead, together, do not learn much from the past year's many errors and successes. Immediately and quickly doing more of the right things and fewer of the wrong things is essential to preventing human deaths and other harms (including people's physical, mental, emotional, social, and economic devastation), and in preventing country-wide financial crashes, both now and in the future.
Lockdowns, themselves, kill and otherwise harm people. Unfortunately, there was little thought given to this fact. Because they are primarily unneeded, they should be used only as last resorts where "COVID-19 and Its Variants Safety Programs" are impractical, which is likely few. TODAY, a CEO who failed to support their company's or school system's "Fire Safety Program" would be fired. The same movement is underway in the infectious disease safety program arena. CEO firings will especially happen where CEOs order company workers and teachers back to work without a "COVID-19 and Its Variants Safety Program" in place or at least well underway toward being put in place.