Bill Gates on Fighting Coronavirus | The Daily Social Distancing Show

by birtanpublished on June 30, 2020

Bill Gates, welcome to The Daily
Social Distancing Show

(chuckles):
It's great to be on

Let's, uh, jump straight
into the first question

that everybody
would want me to ask

You delivered a TED Talk

where you predicted pretty much
what is happening now

Now, thanks
to the world we live in,

that has spouted a bunch
of conspiracy theories,

everything from
"Bill Gates invented this virus

to prove himself right,"
or "He knew it was gonna happen,

and that's why he said it"

Was that Ted Talk
about this virus,

or was that a hypothetical
that has now come true?

Well, I didn't know specifically
that it'd be coronavirus

and that it would hit
in late 2019

But the goal of the talk
was to encourage governments

to make the investments
so we could respond very quickly

and keep the case numbers
very, very low

And so sadly,
this is not a case where,

you know, I feel like,
"Hey, I told you so,"

-Mm-hmm -uh it,
because we didn't use that time,

when it was clear
as the biggest threat

to kill millions of people,

to have the diagnostics
standing by,

to be ready to ramp up a
a vaccine factory

A few things were done,
uh, of some countries

Our foundation funded some work

that will help
with the vaccines now,

will help with the diagnostics

But, uh, you know,

well, most of what
was called for,

particularly in a New England
Journal of Medicine article

I did that went
into way more specifics

than I could
in a short TED Talk,

uh, those things
didn't get done,

and so that's why
it's taking us a long time

to get our act together, uh,
faced with this threat

Here's a question I have, um,
as an individual

How is it that you
as a nongovernment

knew this information and knew
that it needed to be act on

acted on, and governments
and organizations

that are specifically tasked
with protecting people

from this very thing

either didn't have
the information or ignored it?

What-what do you think
happened there?

Because I know you interact
with governments

You talk to organizations
like the CDC, like the WHO

What went wrong?

Well, there are lots
of individuals,

uh, who were as worried
as I was

You know, people like Dr Fauci,

who'd been through
various epidemics

And, so, when we had Ebola,

Zika, SARS, MERS,

we were lucky that they didn't
transmit very easily

They weren't, uh,
these respiratory viruses

where somebody
who's not very symptomatic

and is still walking around
can spread the disease,

in some cases
to literally dozens of people

So the respiratory transmission,

particularly because
world travel is so intense,

that's where I show
the simulation in that speech

and say,
"This keeps me up at night,

uh, more than even war,"

which is no small thing

And yet,
in terms of being systematic

about, okay,
let's run a simulation

and see how would we reach out
to the private sector

for tests or ventilators

and, uh, what kind of quarantine
would we do?

You know, as we enter into this,

we haven't practiced at all

And so you can see it's,
you know,

every state is being forced to
figure things out on their own,

-and, uh, it's very ad hoc
-Mm-hmm

It's not like when a war comes

and we've done,
you know, 20 simulations

of various types of threats

and we've made sure
that the training,

communications, logistics,

all those pieces fall into place
very rapidly

You are
in an interesting position

where, in many ways,
you are an expert on this topic

because of the work
that you now do in philanthropy

You know, your goal has been
to eradicate malaria

across the globe,
focusing in Africa

You work
with infectious disease

You work with experts in
and around infectious disease

When you look at the coronavirus
as it stands now

It's happened
Leaders acted late

But what do you think
needs to be done going forward?

You wrote an interesting op-ed
about this,

but what do you think we need
to do from the ground up?

From the people to the leaders
to the private sector?

Well, the main tools
we have right now

are the behavioral change,

the social distancing,

which, uh, often means staying
at home most of the time,

and the testing capacity
to identify

who in particular
needs to get isolated

and then testing their contacts

to make sure
that we can catch it so early

that a lot of people
who get sick

don't infect anyone else

Now, you know, so,
our foundation is engaged

in projecting, uh,
what's going to go on,

the modeling

Uh, our partner IHME

is, you know, telling each state
what they should think about

in terms of ventilators
and capacity

Further on out,
the work we're doing now

to find a therapeutic,
a drug to reduce the disease,

to cut the deaths down,
you know,

we're hopeful, uh,
that even in six months,

some of those
will have been approved

Uh, but the ultimate solution,

the only thing
that really lets us

go back completely to normal

and feel good
about sitting in a stadium

with lots of other people
is to create a vaccine

and not just take care
of our country

but take that vaccine out

to the global population

and, uh, so that we have
vast immunity

and this thing, no matter what,

isn't going to spread
in large numbers

You have a unique vantage point

in that
you have been communicating

with various governments
around the world

in and around
their COVID-19 response,

um, what they plan to do

and what they-they haven't done
thus far

Which countries do you think
we should be looking to

for models that work,
and can we apply those models

to a larger country
like the United States?

So, you know,
many people say Italy and Korea,

yes, have their numbers,

but they can't necessarily
be applied to America

Is that true or not?

Or is there a model
that does seem to work

and should be followed
for everybody?

Well, countries
have differences

You know, uh, South Korea

did get
a medium-sized infection,

but then they used testing,

enforced quarantine,
contact tracing

and really bent the curve,

uh, even though it looked
pretty scary there for a while

The epidemic
in the United States

is more widespread, uh,
than it ever got in South Korea

So we're like the part of China,
uh, Hubei province,

where a lot of the cases
were in one city, Wuhan

And the US and China
are different

You know,
the lockdowns that we do

won't be as strictly enforced,

but they are very,
very important

The way we do contact tracing

won't be as, uh, invasive

and so won't be
quite as perfect

But it is very good news
that China,

uh, although they're maintaining
a lot of measures,

they are not seeing a rebound

They're not seeing cases
coming back

even though they are sending
people back to the factories,

sending people back to schools

And, you know,
so, thank goodness,

if we're seeing
a big rebound there,

uh, the idea
you could keep it under control

once you have
a large number of cases,

like the US does
and many countries in Europe,

then it, you know,
would seem almost impossible

So it can be done

You know, China ended up

with 01%
of their population infected

You know, our goal is to stay
so it's only a few percent

so at least the medical penalty,
uh, isn't gigantic

even though the economic penalty
will be very large

When-when you look
at that balance

between the economic penalty
and, um, the human penalty,

there are some who have argued
that the economic penalty

will, over time,
equal the human penalty

Now, you are one
of the few people in the world

where you actually have
enough money

to tell us about whether or not
an economy shifting

in this way or another way
is going to cause mass deaths

But how do you think
we should be looking at this?

Because, yes,
there is an economy,

and, yes, there is human life,

but where do you think
the truth lies?

Well, the, uh

There isn't a choice
where you get to say to people,

"Don't pay attention
to this epidemic"

Uh, you know, most people,

uh, they have older relatives

You know, they're worried
about getting sick

Uh, the idea of a normal economy

is not there as a choice

You know, about 80% of people

are going to change
their activities

If you get the other 20%

to go along with that
nationwide,

then the disease numbers come

will flatten,
hopefully in the next month,

and start to go down,

hopefully in the month
after that

And then
when they've gone down a lot,

then, in a tasteful way,

using prioritized testing,

you can start
to reopen a lot of things,

like schools and work

Probably not sports events,

because the chance of mass
spread there is-is quite large

-Mm-hmm -And so
to get back economically,

uh, taking the pain
extremely now

and telling, you know,
those who wouldn't,

uh, curb their activities,

"No, you must go along
with the rest of society

"and not associate in a way

that we have exponential
increase in these cases,"

uh, you know,
that is the right thing,

even though
it's extremely painful

It's-it's unheard of

And, you know,
there are particular businesses

that, uh, it's catastrophic for

-Mm-hmm
-That's the only way you get

so you can feel like you can say
to the entire population–

ideally in the early summer,
if things go well–

yes, now please do resume,

and we are through testing,

making sure that it won't, uh,

spread in some-some very,
very big way

So people will need
the confidence

that the system is working

and smart people
are making decisions,

and overoptimistic statements
actually work against that

What do you think most people
are missing right now?

Because everyone has an opinion

You know, everyone from my mom

to my friends to people online–

everyone has an opinion
on coronavirus,

because we have
very few centralized sources

that people trust

But what do you think people
are missing about this virus

and this moment and what we need
to be doing as people?

Because we know the basics–
wash your hands,

stay at home,
stay away from other people,

um, try to, you know,
maintain a world

where people are moving
as little as possible–

but-but what do you think
we're missing

that-that people
might make a mistake

and-and exacerbate
what we're going through now?

Well, I– The thing
that needs to get fixed

in the next few weeks is to
prioritize our testing capacity,

which is going up,

but making sure the right people
are being tested

Uh, that will guide us,

uh, in-in a very deep way

And who are–
who are the right people?

Uh, if you're symptomatic

or somebody you've been
in close contact with

tested positive, you know,

those are the broad categories

Of course,
in the front of the line,

you have health workers
or essential workers

who have to go, you know,
keep the food supply,

the medical system, water,

electricity, uh, Internet,

keep those things running,
uh, for the people

who are-are mostly at home

But that doesn't use up
that higher percentage

of the testing capacity

We have a lot of people
without symptoms

who are just kind of worried,

and there we need
to show them that,

until our capacity
goes up a lot,

uh, they are going
to have to wait

The worst thing we have is that,

if-if it takes you longer than
24 hours to get the test result,

then you don't know–

You haven't been told
during the very key period

where you're most infectious

to take extreme measures

And so we've got to get, uh,
not just the numbers up–

that-that confuses people–

it's the speed of the results

South Korea was giving those
results in less than 24 hours

So if we have tests that are
ramping up around the world,

we're gonna see the numbers
going up

Now, some have said that number

and the mortality rate
or fatality rate

can be deceptive
because there are so many

who aren't getting tested
and are recovering

And so we don't really know
how dangerous

or-or how fatal
this disease actually is

What is– what is needed
in the realm of testing?

Like-like,
what I'm trying to say is,

I understand that you want to
get as many tests as possible,

but-but once we've tested as
many people as we have tested,

what are we trying
to get to as an end goal?

Well, for, um,

rich countries that do
the right policies,

you should be able
to, uh, plateau

and get the cases down
with less than a few percent

of the population infected

Uh, China, South Korea,

uh, you know,
they are countries

that absolutely
have achieved that,

and that means
that your total deaths,

-uh, is actually not-not
gigantic -Mm-hmm

Now, in developing countries,

the ability to do lots
of testing,

uh, to have the patients who
have severe respiratory distress

get treatment, uh,
and do this social isolation,

for developing countries,
it's far harder

And so, you know, there,

will these measures
actually stop it

from getting to a large part
of the population,

places like India, Nigeria?

You know, I was talking to,
uh, President Ramaphosa today,

who's not only president
of South Africa,

he's the head
of the African Union

And he's a very strong voice,

encouraging the countries there

to act quickly

when the number of cases,
uh, is still fairly low,

uh, which is true throughout
Sub-Saharan Africa right now

When you look
at where we are now,

the one thing that we can't deny

is everybody has dealt
with the coronavirus

on a different timeline

You know?
Not just across the globe

I mean,
even within the United States

You have states
like Georgia and Florida

that have just implemented
stay-at-home orders

You have many other states
that haven't done it at all

Is this going to fundamentally
undermine the efforts

of other states
and other countries

that have shut themselves down?

Because if the numbers dip
in one country

and another country hasn't had
the same amount of, um,

shutdowns
or people self-quarantining–

for instance, if people
from Brazil travel after this

or if people from, uh–
whether it's Belarus or Hungary

or any other country
where a leader

hasn't taken it seriously,

will that not undermine
the effort completely?

Is-is there a point
to doing this

when everybody isn't doing it?

Well, sadly,

at some level of wealth,

there will be countries that,
no matter how hard they try,

they will have
a widespread epidemic

And so, again,

sadly, the richer countries
that do contain the epidemic

will not allow people
from those countries

to come in, you know,
unless they are quarantined

or tested
or-or proved they're immune

Uh, and so this is gonna stop
people going across borders

very dramatically
these next few years

till we get
to that full vaccination

Within the United States
is different,

because we're not gonna
partition the country

Uh, and so, therefore,
we are all in it together

We can't do what we're gonna do
with foreign nationals,

which is reduce
the numbers a lot

and have very strict screening
there

We're not gonna have
at every state border,

you know,
some complex quarantine center

Uh, and-and
so the whole country needs–

Even when you have
small numbers,

because those can exponentiate
to big numbers so quickly

You know, the doubling time
is, like, three days

when you're still behaving,

uh, in the pre-epidemic way

Uh, so, you know,
each country,

uh, you know,
has to get the entire populace,

even some who-who, uh,

initially resisted,

-maybe for very good reasons,
-Mm-hmm

because the economic effect
on them, uh, is-is strong

So this is powerful medicine

But if you take a big dose of it
earlier,

you-you don't have to take it
for nearly as long

You were one of the first people
to come out

and, um, donate a large chunk
of money

to fighting coronavirus

or helping medical workers get
the equipment they need

I remember the last I read,

it was yourself
and your wife Melinda

who had pledged
over $100 million

It seems, though,
that money isn't able

to fix this problem

It seems like governments around
the world are trying everything

they can, but it doesn't seem
like it can be fixed

What are you hoping to achieve
in this moment in time?

Well, you If we get
the right testing capacity,

you can change
by literally millions, uh,

the number who are infected

And governments will eventually

come up with lots
of money for these things,

but they don't know
where to direct it,

they can't move as quickly

And so because, you know,
our foundation has

such deep expertise
in infectious diseases,

we've thought
about the epidemic

We did fund some things, uh,

to be more prepared,
like a-a vaccine effort

Uh, our early money
can accelerate things

So, for example, there's

Uh, of all
the vaccine constructs,

the seven most promising
of those,

even though we'll end up picking
at most two of them,

we're going to fund factories
for all seven

And just so
that we don't waste time

in serially saying,

-Oh, wow
-"Okay, which vaccine works?"

and then building the factory

Because to get
to the best case, uh,

that people like myself
and Dr Fauci are saying

is about 18 months,

we need to do safety
and efficacy

and build manufacturing

Uh, and they're different
for the different constructs

And so we'll abandon

You know, it'll be
a few billion dollars

we'll waste on manufacturing

for the constructs
that don't get picked

because something else
is better

But a few billion in this

the-the situation
where we're in,

where there's trillions
of dollars–

that's a thousand times more–
uh, trillions of dollars

being lost economically,

it is worth it

In normal government
procurement processes,

and understanding
which are the right seven,

you know, in a few months,
those may kick in

But our foundation, you know,
we can get that bootstrapped

and get it going, uh,

and, you know, save months
because every month counts

You know,
things can reopen if thing

if-if if we do
the right things, in the summer,

but it won't be
completely normal

You'll still be very worried

You know, we may decide
masks are important,

although right now, they're in
short supply for health workers,

so people should not, uh,
go and-and hoard those

But the capacity
of that can be brought up

So it may be something that,
like China today,

everybody who's walking around
is wearing one of those

-So we'll have a lot
of unusual measures -Mm-hmm

until we get
the world vaccinated

You know, seven billion people–

-that's a tall order
-Mm-hmm

But it is
it is where we need to get to,

uh, despite a lot of things
in between now and then,

to minimize the damage

You predicted this pandemic
almost to a T

And maybe it was
because we were dealing

with other things at the time,

we didn't really pay
that much attention

Is there anything else
you want to warn us about now

-that-that we should be
looking forward to? -(laughs)

Is there anything else
that keeps you up at night?

Well, this is
a naturally-caused epidemic,

and as bad as it is,

it looks, if you have
reasonable treatment,

to have a one percent fatality

There could be epidemics
that are worse than that,

including ones
that aren't naturally-caused

that are a form
of bioterrorism

But I do One thing
I feel good about is

this is such a big, uh, change,
to the world

that this time,
it won't be like Ebola,

which was just there in
West Africa or Central Africa

This time, the tens of billions

to have the diagnostics
standing by,

the vaccine manufacturing
standing by–

this time we will, uh,

get ready for the next epidemic

Well, I hope your words are
prophetic once again

Thank you so much for your time

Um, good luck
in all of your work

and, um, stay healthy out there
We need you

Hey, thanks, Trevor

Hopefully, we'll be playing
tennis again soon

You bet
Looking forward to it

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