Subtitles section Play video Print subtitles Our next guest is one of the richest and most generous men in the world. Please welcome Bill Gates. Hi, Bill. Hi. First of all, thank you for doing this. And how is the family? How are you? Well, I think everybody's lives have been completely upended by this social isolation that we're doing to get the disease numbers way, way down. So it's disconcerting. You know, a lot of online school, a lot of teams meetings. A completely different routine. Yeah. So my question is, you warned everybody about this in a TED Talk in 2015. You predicted this would happen. And so I'm sure you're very prepared, because you knew this was going to happen. Do you feel like you prepared for this? I mean, even though this probably surprised you beyond what you expected? Well, the goal of the 2015 talk and the detailed article in the New England Journal of Medicine was so that the government would do the work to be ready for the next epidemic. And that would have meant that we would have had diagnostics very quickly, drugs very quickly, and even a vaccine, all of those things dramatically faster than what we're going through here. Over the last five years, the Foundation and others did make investments in things like a coalition called CEPI that will help get the vaccine out faster than would have otherwise been the case. But only about 5% of what should have been done to get ready for this-- because this is even, you know, worse than war. And yet the amount that was put into it, the amount we practiced and had the ability to make these tools, virtually nothing was done. And so are you saying-- and I don't want to get political about this. Obviously this administration is blaming the last administration saying they didn't have anything. Did anyone listen to you? Was there something and then it was then-- like then everybody abandoned it? Or what happened, exactly? Well, it's hard to know how much to spend on something that you can't really compute the probability in any particular year that it's going to come. You know, fire, war, earthquakes. And so government, you know, they look and they see, we had epidemics like the Ebola epidemic in Africa that should have gotten us ready. Then we had Zika. But a respiratory pandemic that's very widespread, really, we haven't seen anything like this for the 100 years. And I actually thought that the anniversary of 1918 would, you know, galvanize people as well. So a few things were done. Some countries, even without that preparing in advance, have acted in a way that made sure that very few of their citizens die and they don't have to shut down their economy. You know, now all the countries that have widespread infection, like the United States, we need to learn from each other about how you not only flatten the numbers but to get them down. And then, you know, with luck, in early June, if the whole country does a better job of shutting down and we get privatization of the testing that's going on, what policies should we have? Because until we get almost everybody vaccinated globally, we still won't be fully back to normal. We want to go, you know, and manufacture and do construction and go to school. But there will be things like big public events where the risk will outweigh the risk of a disease rebound. So you just said June, but we aren't going to have any vaccines for probably a year. So how-- I mean, I can't even imagine going out to a crowded restaurant or anything in June or July if we don't have vaccines. How do you see us acclimating back into a normal life when we don't have the cure for this? Well, your point is a very good one, which is, even if we're doing the right things, where we've fixed the testing problems, we're making sure people are strict about quarantine, we're doing really good contact tracing, and so the government is able to encourage some type of activities to resume. Even so, the populace has been thinking about this infectious disease enough that people will be reluctant even if they say, OK, it's fine to send your kids to school. I hope we have enough proof that everybody will feel like they go along with that. If you want to reopen a factory, do enough workers show up that you can really engage in that activity? Some things, like restaurants, will probably have more spacing, and the demand will be reduced because of what we've all gone through here. But we need to start getting things back to normal. They won't be back to normal until we either have that phenomenal vaccine or a therapeutic that's like over 95% effective. And so we have to assume that's going to be almost 18 months from now. But I mean, you and Melinda-- first of all, that's why I call you the most generous, and I should include Melinda in this, too. You're both extremely generous. You donated $100 million to fight this as soon as this started. In February, I think, you donated the money. So that 100 million is going to go towards, obviously, trying to find a vaccine, but also this therapeutic that you're talking about that will be like a temporary fix? That's right. The Foundation does far more in terms of infectious disease work than any group in the world. And so we've re-prioritized, and everybody and all our grantees now, prioritized this coronavirus work. So, you know, even polio eradication, we're not able to work on that, or new drugs for HIV. But that skill set is very applicable to helping pick which drugs should go into trials and which vaccines we should build factories for so that, if one proves safe and efficacious, we can make billions of doses. So our whole thing is upended. We're giving money to up the testing capacity, because in developing countries where they can't do these quarantines, that's where, sadly, the vast majority of the deaths are likely to take place. Yeah. All right, we're going to take a break. We'll be right back after this. So I still don't-- I mean, I can't wrap my head around, if we don't really have a cure for it-- like, you know, I'm obviously doing my show from my house. And as a lot of other people, you know, that have shows are able to do. But I can't imagine having an audience all kind of sitting next to each other and that being-- because also isn't it possible that it comes back in the fall? Well, we don't know how seasonal it is. So that would actually be good news, that is that the force of infection went down in the summer. That would make this thing of getting the case numbers way down so we start opening up. That would actually make it easier. But you're right, then we'd have to pay attention to it coming back. But there are ways of doing it that China is showing, that South Korea is showing, that the risk of infection is very, very low. So you might be back in your studio because the way the workers engage with each other and the amount they can be tested to make sure nobody's infectious will be very different from what we have today. You may or may not have the audience. I would guess that will take a lot longer than going back to the studio for the filming itself. You know, speaking of that, I mean, there's no cars on the road, very few planes. I mean, it's obviously affecting the economy in a bad way. But the planet is benefiting from this. And I know that's been important, the environmental issue, for you. I mean, they just said the air in Los Angeles is cleaner than it's ever been in the history of, I mean, ever. That's amazing. Yeah, I wish that all our jobs could be done from home as well as your job and my job, you know? But for people who are in restaurants or factories or construction or cleaning, you know, they are looking at their livelihood going away. And so, sadly, like many bad things, those who are in the toughest circumstances are going to bear most of the pain. And so we really want to get into this semi-normal phase as soon as we can. And then the vaccine is the thing that will change things. And that's why, you know, really figuring out, how do we make sure it's safe? Because when you give it to seven billion healthy people, that's super important. So the challenge we put to scientists at the Foundation and many, many places who are working night and day on this is very high. And although the best case is actually shorter than 18 months, we don't want to create a lot of expectations. Because we really aren't quite sure. So people like Fauci and myself are giving that as kind of the likely date. It could be better. It could be worse. So 18 months. And the economy is already, as you mentioned-- I mean it's heartbreaking what's happening to people out there that were already living paycheck to paycheck and now don't know when they're going to get paid again. And, you know, it's a strain on unemployment. Everyone's-- you know, it's an issue for everyone. So how does the economy bounce back from something like this? Do you do you have faith that it will? Or how long do you think it's going to take? Well, it won't go back to normal in some very rapid fashion. Because not only do we have, you know, these factories shut down and all these activities have ceased, even as we start them back up people will still be a bit leery about going out. And they will have seen their investments and their job security greatly reduced. So the ebb-- the strong economy we had will take several years before that comes back. The good thing about the economy is that eventually it will come back. The medical price that will be paid by countries all over the world, you know, that's a lot of deaths that we'll simply never be able to reverse that at all. Then here's a question that I don't know if you can answer. But, you know, I was talking to Pink, who of course, had COVID-19, and her three-year-old baby, who is now two days fever free, so he's getting better. And she's feeling much better. But she's super healthy and yet she gets it. You know, in the beginning it was only older people that were vulnerable or people with pre-existing conditions. And then it's, you know, babies and people that are healthy. And then, you know, she gets it and she's in the same house with her husband and her daughter and they don't get it. So how is it so-- and she never had fever. She didn't have the same symptoms that everybody-- she never once had fever. So it's all over the place. How is this happening to really healthy people? Yeah, we have a surveillance network that we've started here in Seattle that will get expanded to other locations-- we're helping other countries do the same thing-- to really understand what's going on with different age ranges and professions. You know, some communities, blacks are getting the disease, severe disease, in higher percentages. That's not well understood. This is different than flu, where young people do get the flu quite a bit, although they don't die of it here. The level of infection in young people is quite a bit younger. The death rates are different than the infection rates. Those are even more tilted towards the elderly and comorbidities, except for some health workers, who seem to get such a strong exposure that that alone makes it potentially fatal for them. So this deep understanding of, are young people part of the infection chain, that will help inform things like resuming school. Because, you know, it'd be great if the kids who have essentially lost three months of the school year, if we can get them back and help them catch up. I have a little question if I may ask? Please ask. Can you get different doses of COVID? In other words-- because you mentioned with people like health care workers getting a full dose as opposed to a micro dose, I guess. And do you think that's the reason that the disease is presenting symptoms in different ways? Yeah, the initial exposure and the inoculum will make a difference. Because it's a race between the virus duplicating itself and the immune system saying, OK, what is this? Is this something I should go and attack? And so like when a health care worker goes to intubate somebody, they can get quite an exposure. One of the things our Foundation has done-- it used to be that when you would take a test, you had to have a health care worker do that and stick a swab up to the back of your throat. And that would expose the health care worker. They'd have to wear protective equipment. Now what we've shown is that if you just give the patient the swab and have them just put it up at the tip of their nose, that the accuracy is every bit as good as having that health care worker. And so it means that you don't need protective equipment. You can actually send a test to somebody's home, and this is just-- we've just convinced the FDA recently. And so this idea of a home test that, even before you go to a medical center where you might infect people, so that's called the self swab and that's catching on. But yeah, the exposure level. We see this with measles and other respiratory diseases, that the degree of exposure makes a big difference. Which is why some young, healthy doctors, stunningly, got sick very quickly and unfortunately died. Right. Wow. Well, thanks again for everything you're doing. All right. You're a good guy. We'll be back. We're back with Bill Gates. So let's end on a positive note. What gives you hope and what should we look at as hopeful in this situation? Well, I feel very confident that this time we won't ignore the potential for the next epidemic. That this is such a dramatic thing that, you know, has reshaped our lives and the economy and created so many tragedies, we will get ready. And the work we do there will have benefits to other infectious diseases as well. I also think we have great examples of heroics where people are stepping up, where communities are coming together to solve these problems. And so although it's very bad news and almost a kind of worst-case scenario, the ingenuity of people, the compassion of people, you know, the amount they're giving of their time and money, I think, you know, hopefully this will renew our sense that we're kind of in this together. You know, in our communities and our country and in the world. Because, you know, until we stop this disease everywhere, we'll always be at risk of it coming back to the United States. Yeah, I agree with you with it giving all of us a sense of-- I mean, some people have always had compassion. But I think a lot of people now are getting that. And one last question. What do you look forward to the most when all this is over? What do you miss and what are you going to do first when this is over? Well, there are things that were high priorities, like stopping HIV infection and getting polio eradicated, that sadly, even though we're able to repurpose all that expertise to go after this epidemic, for those things, this is a big setback. So I'll be thrilled when, you know, the other work can resume. That we go back and say, OK, how much did polio spread back during this? Or how much were these discovery programs interrupted? You know, I think everybody is going to be super excited to have their worries of four months ago being the ones that are top their minds once again. Yep. Well, you're a great guy, and say hello to Melinda, and thank you so much. And I'll see you soon. All right. Thanks, Ellen. Thanks, Bill. To see what else Bill has to say, check out his blog, Gate's Notes. Go to our website for more information. Hi, I'm Andy. 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A2 TheEllenShow people infection disease economy exposure Bill Gates on Finding a Vaccine for COVID-19, the Economy, and Returning to ‘Normal Life’ 6 1 林宜悉 posted on 2020/04/15 More Share Save Report Video vocabulary