How to reopen the economy of the United States will depend on the capacity to test for and detect new cases of the coronavirus, according to Bill Gates.
Despite warning from health experts, several US states plan to relax social distancing and stay-at-home restrictions on May 1.
The total number of coronavirus cases in the United States is about to hit one million. The virus killed over 54,000 Americans.
In an interview with CNN's Fareed Zakaria Sunday, Gates stressed that just because some areas that are reopening have had relatively small outbreaks does not mean they are free from risks.
Gates, the Microsoft (MSFT) founder whose foundation studied pandemics for years, warned such areas about exponential growth.
"If they open up, they can go back into exponential (coronavirus infection) growth and compete with New York on that basis," Gates said.
He noted that parts of the US that reopen and allow people to move again could spread infections in other areas of the country. This situation may slow the recovery from the pandemic.
Successful reopenings
Successful reopenings will happen in stages and require critical thinking, Gates says about how to reopen the economy.
He emphasized the importance of the guidance based on recommendations from health experts and economists, such as the World Health Organization (WHO).
The country must identify elements of society that are most essential to get back to work. These sectors should also implement safety measures when they reopen. Diagnostic testing and contact tracing must take place to determine the impact of easing restrictions on the spread of the virus.
"What we don't know is, (if) we go slightly back to normal, which activities create the risk of a rebound?" Gates said.
"We need to put in place a very dense testing regime so you would detect that rebound going back into exponential growth very quickly and not wait for the ICUs to fill up and there to be a lot of deaths. If you see the hot spot, you kind of understand the activities causing that," he added.
Continuous testing
The country needs to conduct millions of diagnostic tests each week before lifting restrictions.
According to Gates, the US can have between 400,000 and 500,000 tests per day, with new testing machines and methods. However, Gates added that's "just barely enough for really doing the tracking."
Dr. Anthony Fauci, a member of the White House coronavirus task force, announced on Saturday that the US is holding around 1.5 million to 2 million COVID-19 tests per week. The figures may double within the next several weeks. To date, the country has only held about four million coronavirus tests.
"The key thing about the US, though, this focus on the number of tests understates the cacophony and mistakes we made in the testing system," said Gates. These include testing shortages, inequality in who can access testing, and test results taking longer than 24 hours to reach patients.
Gates recommends a staged reopening of various parts of the economy. He admitted "we're a little naive about how to prioritize these activities."
According to Gates, states must prioritize "high value" segments of the economy such as schools, manufacturing and construction. However, authorities should lay out how to operate those things with masks and social distancing.
Meanwhile, communities should continue to trace the effects of reopening schools and businesses on infection rates.
"The inequality has gotten greater in education, so if we can figure out how to do K through 12 in the fall, that would be good," Gates said. "I even think if we're creative about it and things have gone well, we'll be able to do college."
