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  • 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]!

Our next guest is one of the richest and most generous

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