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.
Ellen asked me to remind you to subscribe to her channel
so you can see more awesome videos,
like videos of me getting scared or saying embarrassing things.
Like ball peen hammer.
And also some videos of Ellen and other celebrities,
if you're into that sort of thing.
Ah, [BLEEP]!
God [BLEEP]!