A mysterious virus in China is a reminder that the world isn’t ready for a pandemic. Bill Gates says we should prepare for a deadly outbreak as we do for war.

It started with a few cases of what seemed like pneumonia.

Chinese authorities reported on December 31 that 41 people in Wuhan, the most populous city in central China, were afflicted with a pneumonia-like illness. The likely source of the outbreak was the local Huanan seafood market, which sells live animals. The market closed a day after the outbreak was reported.

By January 7, Chinese authorities had determined that the illness was a new type of coronavirus: a large family of viruses that typically affect the respiratory tract.

The first death was reported a few days later; local officials announced the second on Thursday.

The virus has now spread to Thailand and Japan. A 61-year-old female tourist in Thailand was diagnosed on Tuesday. She’d recently spent time in Wuhan but said she did not visited the now-shuttered seafood market. The woman did visit another local market with live animals, though.

Japan’s health ministry reported Wednesday that a man in his 30s has the virus as well. That patient recently came back from a trip to China, where he did not visit any seafood markets, according to the ministry.

“It is possible that the patient had close contact with an unknown patient with lung inflammation while in China,” the ministry said in a statement.

The World Health Organization has said there’s no clear evidence that the virus can be transmitted between humans – most likely it just passes from animals to people. But the two cases outside of China have called that into question.

On Friday, the Centers for Disease Control and Prevention announced that three US airports – New York’s John F. Kennedy International Airport, San Francisco International Airport, and Los Angeles International Airport – will begin screening passengers for the virus.

If the virus were to somehow morph into a pandemic (a far cry from the situation right now), the world wouldn’t be remotely prepared, according to Bill Gates.

“In the case of biological threats, that sense of urgency is lacking,” Gates said in a 2018 presentation hosted by the New England Journal of Medicine. “The world needs to prepare for pandemics in the same serious way it prepares for war.”

The virus belongs to the same family as SARS, the source of a fatal epidemic in China

Some of the patients who contracted the new virus reported symptoms such fever, chills, headaches, and sore throat. A few had difficulty breathing.

Coronaviruses can lead to illnesses like the common cold, pneumonia, and severe acute respiratory syndrome (SARS), a potentially fatal illness that hasn’t been reported anywhere since 2004.

A viral outbreak of SARS that started in China in November 2002 resulted in 8,000 cases and 774 deaths by July 2003. The outbreak spread to dozens of countries in North America, South America, Europe, and Asia. Recent research suggests that it may have spread to humans from horseshoe bats.

Though Chinese officials don’t expect the new coronavirus to spread from human to human, they have quarantined patients and closely observed anyone who has been in close contact with them.

Airports in Hong Kong, Singapore, Thailand, and South Korea are also closely screening passengers for fever. Hundreds of millions of people are expected to travel throughout China later this month for the Lunar New Year.

Gates thinks a pandemic could kill 30 million people in less than a year

Gates considers a deadly pandemic to be one of the world’s three biggest threats, next to climate change and nuclear war.

He has repeatedly warned about what might happen if the world were struck by a pandemic virus like the Spanish flu of 1918, which killed 50 million people. A similar scenario today might kill more than 30 million people in less than a year, Gates said in his presentation.

The statistic comes from the Institute for Disease Modeling, which predicts that the world will experience such an outbreak in the next 10 to 15 years. One possible source of the virus could be animals such as birds, chicken, or pigs.

Gates at a New York Times event in 2019.

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Gates at a New York Times event in 2019.
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Mike Cohen/Getty Images for The New York Times

“More than 60% of human disease, particularly related to infections, are coming from animals,” Victor Dzau, the president of the National Academy of Medicine, told Insider. “The fact that animals are not living in the forest but we are domesticating them … putting them in crowded conditions close to humans, that’s really a very big factor.”

Animal-borne diseases can morph to jump to humans and spread between people, especially among travelers or in dense urban areas. Rising global temperatures also heighten the risk of mosquito-borne diseases.

Gates thinks more vaccines could help us prepare

People participate in an emergency exercise on prevention and control of H7N9 bird flu virus organized by the local government in Hebi, Henan province, China, June 17, 2017.

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People participate in an emergency exercise on prevention and control of H7N9 bird flu virus organized by the local government in Hebi, Henan province, China, June 17, 2017.
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China Stringer Network/Reuters

Though the world is armed with antiviral drugs and antibiotics, Gates has said, new vaccines would likely be necessary to address and prevent future epidemics. That’s because strange pathogens emerge all the time, finding new ways to mutate or jump from their host to other species.

In a 2017 op-ed for Business Insider, Gates wrote that the process of creating a vaccine takes too long – about 10 years for development and licensing. He estimated that = process would need to be reduced to 90 days or less to prevent deaths from an airborne pathogen.

Gates also said countries should routinely monitor their populations for signs of an outbreak. Once a new virus strikes, the countries could then share that information with the rest of the world, in addition to coordinating with military and medical professionals to control the spread of the virus.

“The irony is that the cost of ensuring adequate pandemic preparedness worldwide is estimated at $3.4 billion a year – yet the projected annual loss from a pandemic could run as high as $570 billion,” Gates wrote. “Even if the next pandemic isn’t on the scale of the 1918 flu, we would be wise to consider the social and economic turmoil.”