SINGAPORE - Through a combination of natural immunity, vaccine immunity and new oral treatments, the death and disease rates for Covid-19 are coming down dramatically - and by the summer of 2022, should be on a par with, or even lower than, the average levels of seasonal flu, said Mr Bill Gates on Thursday (Nov 18).
Once this happens, it is likely that economic activity will resume fully, notwithstanding some remaining hot spots, said Mr Gates, the co-chair of the Bill & Melinda Gates Foundation, at the Bloomberg New Economy Forum in Singapore.
Responding to moderator and Bloomberg editor-in-chief John Micklethwait's question on countries' different approaches to the Covid-19 pandemic, he said that any country that was able to do what China did - which was to spot the disease early and lock down its borders - is "blessed".
But there are consequences to such extreme measures, he said.
"That means they have very little natural immunity, and so they have to drive their vaccination coverage up dramatically before they drop that wall that has allowed them to (stop infected people) from coming in.
"Maintaining that wall is very hard. And many countries decide that, between vaccination rates (going up) and antivirals, the benefits of allowing people to go in and out of the country mean it's fine to open up."
Observing the lack of mask wearing during a reception at the recent COP26 climate talks in Glasgow, Mr Gates said Britain is at the other end of the spectrum, "where they said, 'hey let's act like it's the flu', and they're paying the price of that".
Weeks away from the onset of winter, Covid-19 infection and hospitalisation rates in Britain, which opened up aggressively, are now six times higher than other major European nations.
On whether the world was lucky that Covid-19 vaccines were developed so quickly, Mr Gates said there are three major types of vaccines to take note of: mRNA vaccines which were "not that ready" as recently as five years ago; viral vector vaccines, such as AstraZeneca's, which were available some eight years ago through efforts mainly to do with HIV and Ebola; and China's inactivated vaccines that countries have been able to produce for decades.
"(The inactivated vaccines) are not quite as good, but they work and can be made at scale. So yes, it helped that the mRNA was there, but it wouldn't have been the end of the world if we didn't have that.
"And next time, we're really going to have some good vaccines where we won't have breakthrough cases, like with the measles vaccine."
Acknowledging the difficulty of getting countries to invest in pandemic preparedness, he said governments must understand that not doing so will have serious repercussions.
"We (need to) keep reminding people that Covid-19 cost trillions and killed millions, that this is going to be the best insurance policy that anybody ever talked about compared with defence budgets, or fire departments, or big corporations."
But a key challenge has been misinformation about the side effects and political motives behind vaccines, he added - something which has been made harder by people's mistrust in their politicians.
He said: "Statistically, we didn't do as well as I would have expected. The politicisation of taking vaccines and helping to protect other people, you could almost see that as a step backwards. I hope vaccine acceptance for other diseases like measles is not reduced because of this.
"A lot of people jumped in and took the vaccines, but a meaningful minority in most countries were led down a path of believing that not only were there rare side effects, but also that the vaccine wasn't properly tested or was part of some evil conspiracy."
Responding to Mr Micklethwait's point that even in Singapore where the Government has done a good job in controlling the pandemic, there remain 60,000 people who refused to be vaccinated, Mr Gates quipped that resisters should be caned: "You would have thought they had a lash for these people."
Recalling the foundation's work on polio before the pandemic, Mr Gates said that while it was able to get around 85 per cent of children vaccinated, those efforts were also hindered by rumours from anti-vaxxers.
The foundation had to get political and religious leaders to show that they were willing to give the vaccines to their children. Today, wild polio is mainly limited to Pakistan and Afghanistan, he said.
"So if you stick with it and talk to the right people, you can succeed in the case of this pandemic. We want people to get vaccinated rapidly so that we stop those transmission chains (from getting) to the elderly."