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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Ah, [BLEEP]!
God [BLEEP]!
