Bill Gates can see how the Covid pandemic becomes manageable by next summer — and his roadmap is surprisingly simple.
On Wednesday, the billionaire philanthropist and Microsoft co-founder listed the two key steps that he thinks will help conquer Covid, in an interview at the Bloomberg New Economy Forum. According to Gates, the path forward looks like this: Continue to vaccinate the rest of the world, and use up-and-coming antiviral drugs to prevent severe disease and death.
For Gates, ending the pandemic doesn't mean eradicating Covid completely. Rather, he told Sky News in April, "we'll be able to bring it down to very small numbers by the end of 2022."
That target remains realistic, given advancements in vaccines and antiviral drugs, he said on Wednesday. For starters, "the vaccines are very good news," Gates said. In the United States, 69% of the population is currently fully vaccinated against Covid, according to the Centers for Disease Control and Prevention.
In lower-income countries, access and demand for vaccines are both low. Only 4.7% of people in low-income countries have received at least one dose of a Covid vaccine, according to research firm Our World in Data.
Gates' prediction: Access could improve by next year, as "supply constraints will be largely solved." Demand, however, could be trickier to encourage — especially in places "where the epidemic hasn't been as visible," like sub-Saharan African countries, he said.
Doubling down on education and combating misinformation could raise vaccination rates in those parts of the world, according to the World Health Organization.
As for the antiviral drugs, Gates called them "pretty impressive," despite the fact that none of them have been approved by the U.S. Food and Drug Administration yet. The drugs, if approved, could drastically lower the number of people hospitalized and severely ill from Covid.
Drugmakers Merck and Pfizer both submitted data to the FDA for their antiviral Covid pills, called molnupiravir and Paxlovid, respectively. If approved, treatments could be available in the U.S. by the end of the year. Earlier this month, Britain approved molnupiravir, becoming the world's first country to do so.
You could take these drugs as soon as you test positive, Gates noted. And while consumer pricing is still unknown, they're certainly easier to administer than intravenous treatments like remdesivir, and can be reformulated into less expensive versions for low-income countries.
Data on the antiviral pills looks promising. In Merck's clinical trials, unvaccinated patients with mild or moderate cases of Covid who took molnupiravir within five days of developing symptoms had about a 50% reduction in hospitalization and death rates, compared to those who received a placebo pill.
In Pfizer's trials, Paxlovid and ritonavir reduced the risk of hospitalization or death in high-risk patients by 89%.
Between vaccines and antiviral drugs, Gates said, the rates of severe disease and death from Covid "ought to be coming down pretty dramatically" by this upcoming summer. But, he warned, that timeline could easily be thrown off by the emergence of a new, more dangerous Covid variant between now and then.
"Right now, the evidence is that [a new variant is] not that likely," Gates said. "But it can never be ruled out."