Bill Gates: I am still a determined optimist

Home Health Bill Gates: I am still a determined optimist
Bill Gates responds to quarantine policy at home office Source: Gates FoundationBill Gates responds to quarantine policy at home office Source: Gates Foundation

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Source: Gates Foundation

Local On March 24th, Bill Gates was on the TED Connects program to answer questions related to new coronary pneumonia. During the one-hour live broadcast, Gates shared information and insights on topics such as the development of effective diagnostic tools and vaccines, the need for international cooperation to fight the epidemic, and how the Gates Foundation can help respond to the epidemic.

The following is the text of this interview.

  CHRIS ANDERSON: Five years ago, you stood on the podium of TED and issued a frightening warning that the world would sooner or later face a crisis of a pandemic. The people watching this speech are now shuddering. This is exactly what we are going through. What exactly happened? Did people listen to this warning?

  Bill Gates: Basically not. You know, Zika, Ebola, SARS and the Middle East Respiratory Syndrome have not spread to many countries, but I used to hope that these diseases can remind us that in a world where people move frequently, the destructive power of the epidemic is huge. So the talk at the time was to say, hey, we are not ready for the next pandemic. But in fact, due to scientific progress, if we invest resources to fight the epidemic, we can be ready.

  CHRIS ANDERSON: Last month you said that this might be a pandemic that people worry about every 100 years. Do you still think so?

  Bill Gates: It’s scary to say, but the mortality rate of the new crown virus is not high. If it were a smallpox-like illness, 30% would die. So, although this (new crown pneumonia) is scary, in fact, most people can survive the new crown pneumonia. Although it is more contagious than Middle East Respiratory Syndrome or SARS, it is not as deadly as them. However, the price we paid to overcome it was unprecedented.

Compared with other severe infectious diseases, the mortality rate of new coronary pneumonia is not high. Source: BloombergCompared with other severe infectious diseases, the mortality rate of new coronary pneumonia is not high. Source: Bloomberg,

it is spreading globally. This is a characteristic of respiratory infectious diseases. This is the biggest fear. How many people will eventually die? If we can do the right thing, it will not be a huge number, and the situation like the 1918 pandemic may not repeat itself, and we should be able to do better.

  CHRIS ANDERSON: When did you start to understand that unless we take action, this will be a truly deadly pandemic?

  Bill Gates: Compared with other severe infectious diseases, the mortality rate of new coronary pneumonia is not considered Gao Tuyuan: Bloomberg: In January, everyone began to discuss “people-to-people”. The alarm bell sounded, everything that happened was in line with this very scary pattern, and it was difficult to contain. On January 23, China began to adopt very strict isolation measures.

The good news is that as a result of these actions, China has significantly reduced its infection rate. We should all start in January with work on testing, treatment and vaccines. Faced with this new infectious and deadly new respiratory virus, we should deal with it methodically and calmly.

  CHRIS ANDERSON: So what did we do? The work that happened last month is hard for me to understand. I mean, what exactly are we doing in the United States and many other countries? Did you call around late January and early February and ask, “What happened? The epidemic cannot be ignored, what are we doing?” What happened behind the scenes during that time?

  Bill Gates: You will look forward to the government Ability to invest in key initiatives. Our foundation has committed $ 100 million to launch the “(New Crown Pneumonia) Treatment Accelerator”. I think we should have done more before this outbreak.

I think the most important thing to discuss today is that our ability in the field of testing is still lacking, and we cannot guarantee that the most needed people get the testing they deserve. For example, some symptomatic health workers cannot be tested, so they don’t know if they should go to work; some asymptomatic people are tested. I think testing should be planned. It must be prioritized and very, very urgent.

The second thing is isolation. As far as the United States is concerned, some areas are doing well, but some areas are far behind. Isolation measures are a formidable challenge both for individuals and for the economy. But the sooner you take strict quarantine measures, the sooner you can release quarantine and return to normal.

  CHRIS ANDERSON: Some people are of the opinion that all tests should be cancelled now because the epidemic has spread. Testing will bring people together, leading to a greater risk of infection. So we should focus only on treatment and isolation strategies. You should disagree with this view and feel that testing is still absolutely necessary and necessary.

  Bill Gates: Large-scale testing and isolation should be implemented together. If you are a medical worker, you want to stay and do your job. If your job is to ensure a continuous supply of electricity, water and food, you also want to continue your job. So testing can tell you if you need isolation and make sure you are not the source of the infection. Therefore, testing is critical. South Korea has conducted large-scale tests, and every country should learn from them. At the same time, it is necessary to cooperate with the implementation of the isolation strategy. Our goal is to keep the proportion of infected people at a very low level. Only 0.01% of the population in China is diagnosed with new coronary pneumonia. If these measures are not done well, there will be a large number of infected people, which will cause a huge burden on the medical system.

  CHRIS ANDERSON: One question about the isolation strategy is how long will it last? Many people worry that defeating the epidemic through isolation will cost the economy too much. We have to stay at home for 3-6 months, or even a year, and not work as usual. The United States and many other countries are discussing that this may not be the right strategy, and we cannot let the economy collapse. We should quarantine for another two weeks to get people back. Even if this means that many people will get infected, it will eventually form herd immunity. This may be the right way.

  What’s your opinion on this? Is it possible to find a compromise? What isolation strategy will finally get us back on track?

  Bill Gates: There is really no compromise. It’s hard to tell people, “Hey, go on to the restaurant. Buy a new house. Don’t worry about those who died because of the epidemic, we hope you continue to spend money.” Perhaps some politicians will think that GDP growth is really important. But when the epidemic threatens people’s parents or the elderly around them and knows that walking around will exacerbate the spread of the epidemic, it is difficult for people to continue doing what they need to do. I don’t know of any rich country that would choose to do this.

In fact, if you insist on a herd immunity strategy for a few years and enough people are infected, you will indeed get the so-called herd immunity. However, unless more than half of the population is infected, herd immunity is meaningless. But if you do that, it will not only overload your medical system, but it will also cause a fatality rate of 3% or 4% instead of 1%.

Source: The network isfacing the new crown pneumonia epidemic. Unless there is an effective vaccine, herd immunization strategies will be difficult to work. Photo source: Network

So if someone says we can get the best of both worlds, it is very irresponsible. What we have to do is to completely “retreat” in 6-10 weeks, and if everything goes well, you can get back on track.

  推特CHRIS ANDERSON: Bill, here 推特‘s a question 推特I asked on 推特Twitter . What would you do if you came to be president of the United States for a month? What are the two or three things you want to do most?

  Bill Gates: It is clear that we have no choice but to maintain isolation for a period of time. According to China, it is about six weeks. Therefore, we must be prepared and strictly implemented while conducting tests and evaluating the actual situation every week.

If the quarantine strategy is implemented well, you will see significant changes in the data in about 20 days.

It’s not easy. We need a clear message. The impact of the epidemic on the economy was severe. In our lifetime, there have been no incidents with such a bad economic impact. However, the economy can recover, and people cannot come back to life. Therefore, in order to minimize disease and death, we must bear huge economic losses.

  WHITNEY PENNINGTON RODGERS: Are there any tools available for countries that cannot implement social isolation and do not have a sound health system? How should they deal with the virus?

  Bill Gates: If developed countries really do their job, by the summer, they will be like China or some other responsive countries do now. But in developing countries, especially in the southern hemisphere, seasonal factors can be unfavorable and, as you said, there are no conditions for social isolation. People need to go out to buy food every day, they need to make money, and people living in slums are close to each other, which makes social isolation difficult to implement. I think the lower the income level, the more difficult it is to implement social isolation.

Therefore, we should accelerate the development of vaccines. The vaccine will eventually be developed, and the person in charge said that it will take 18 months and there are many such studies in progress. I had a lot of discussions with Seth Berkley (CEO of Gavi, the Global Alliance for Vaccines and Immunization). They can share many front-line jobs related to vaccines because they play an important role in the outbreak.

We want to make sure that low-income countries have very low-cost tests, and we need effective therapies to prevent 5% of people from going to the ventilator, because even if they have the equipment, they lack a professional. They don’t have enough beds and treatment capacity. Fortunately, rich countries have these and can test relevant therapies and fund vaccine development for the world, so as to minimize the damage to the developing countries.

  CHRIS ANDERSON: You mentioned therapy. Are there any promising therapies?

  Bill Gates: There are many clinical trials in progress. Some frequently mentioned therapies, such as ribecvir, hydroxychloroquine, azithromycin, etc., although it is uncertain when the results will come out, there are already some positive data. Radixivir requires a 5-day intravenous infusion and is difficult to manufacture, and people are working on ways to improve it. Hydroxychloroquine also appears to be effective in early treatment.

Mastercard There are also a large number of compounds, including antibodies and antiviral drugs. The Gates Foundation and the Wellcome Foundation, , and other partners have co-founded the “(New Crown Pneumonia) Treatment Accelerator” to accelerate the development of effective therapies. Many people are suggesting “try this, try that.” We use laboratory reports, animal models, and other results to assess which therapies should be prioritized for rapid clinical trials worldwide.

Carrying out such collaboration at the global level is very complicated, but I think that there may be 3 to 4 of the top 20 or so drug candidates that can effectively reduce respiratory distress at different stages of the disease.

  CHRIS ANDERSON: How important is cooperation between countries around the world now? I mean, viruses are a common enemy facing humanity. It does not know that it has crossed national borders, nor does it know people’s race or religion. It only knows that there are people here, it can start the spreading program, and then it can be famous, everything is fine.

But I am scared to see some countries trying to blame each other, and xenophobia is very harmful. What do you think? Do you see signs of cooperation?

  Bill Gates: I see that the restored country can help other countries, which is great. It would be great if we overcome the epidemic by summer, and we can help other countries.

Vaccine projects are underway all over the world. These projects should be evaluated against a very neutral criterion, which one is the best for all humanity. We must ensure that the production capacity is not only sufficient for rich countries, but also that mass production can be carried out at a very low cost to meet the needs of the entire world. Gavi’s mission is to make vaccination available to everyone. You can see that it is doing very well in science and data sharing, and you can see that this amazing collaboration is happening.

Unfortunately, whenever an outbreak occurs, that xenophobic, “away from me” mood is amplified. We must avoid this situation. On the one hand, we have to be physically isolated. On the other hand, we need to help each other more. Some community groups are pooling resources to ensure that everyone has access to food and the medical services they need. Some are working for people living in nursing homes. Help from older people.

Our generous care for others should not stop because of our physical isolation.

  WHITNEY PENNINGTON RODGERS: Many people want to know what your foundation does, including the distribution of test tools, the production of protective gear, masks and other tools that can help health workers.

  Bill Gates: We invested $ 100 million early on to support testing, treatment and vaccine development. Our specialty is not manufacturing masks, respirators and protective clothing. But the good news is that others are contributing to these areas, including 3D printing and open source technologies.

One of our key points is the self-test tool, which no one has done before. People think it doesn’t work. But we are pretty sure it will succeed. This means a lot to the world.

We have a lot of cooperation with the government and the private sector, and in some ways we are a bit like a bridge. We work with the heads of pharmaceutical companies and testing companies, and we also support vaccine development-especially new RNA vaccines, which we have been supporting through the CEPI (Epidemic Prevention Innovation Alliance).

CEPI was founded at the Davos Forum in 2017. Source: CEPICEPI was established at the Davos Forum in 2017. Source: CEPI

Our expertise is to inspire the best resources in the private sector to truly participate in these medical tools. We can donate funds immediately. In contrast, even in this case, the government still needs to follow some standard processes and take the time to understand who has unique capabilities in which areas. As a result, a long-term agency can play a role at this time to support the development of new vaccines.

It’s really amazing. When we talk to partners in the private sector, they are very willing to help. This is the unique role we can play as a foundation.

  WHITNEY PENNINGTON RODGERS: Everyone wants to know your opinion. Are we moving in the right direction?

  Bill Gates: The pandemic is very, very scary, but it doesn’t get the attention it deserves. If we do the right thing, we can cope better. Science can be used by us. The fact that we can prepare for the next pandemic is obvious. Yes, this will cost tens of billions of dollars, but it will not be bottomless. Compared to economic losses, this is a worthwhile investment.

I remember when I gave a TED speech in 2015, I said that a pandemic could cost us $ 4 trillion. When I was preparing to speak, I thought, wow, this is a big number. Is it really that big? I went to check some data and it was really that big. This pandemic will indeed cause such huge losses to the economy.

So, in the short term, we will experience more pain and difficulties, and people will have to help each other. And I am still a determined optimist. Whether it is climate change, the ecological crisis, or infectious diseases like malaria, tuberculosis, or even cancer, we can meet the challenge through cooperation and innovation. Yes, I am very optimistic.

I love my job because I see the progress we have made in all these areas of disease. Now we must focus on the new crown pneumonia epidemic. Unfortunately, it may affect the progress of polio work and make the situation worse. But we are working to help developing countries respond to the epidemic with a disease control system built to eradicate polio.

My thoughts on this epidemic are that although the situation is severe, I believe that this epidemic will make us tightly united. We will finally overcome the epidemic and prepare for the next pandemic.

  CHRIS ANDERSON: Do you think we can survive this difficult time? I know you are an optimist by nature and believe that science can help us find a way out. But will important leaders listen to scientists? Can we survive it? Do you believe that after a few months, when we look back, will we say “we have escaped”?

  Bill Gates: We are not sure that even rich countries may not be able to get out of the situation in 6-10 weeks. But I think it is possible. When we get the test data, we will see more clearly, and it will become more and more clear. Rich countries will eventually get out of trouble, and developing countries will pay a heavy price for it. But we will not give up anyone, we will eventually get the vaccine, and Gavi will make sure everyone is protected by the vaccine.

Two to three years from now, the world will pay a heavy price for this. But the next time we see the pathogen, we will be able to perform billions of tests in two to three weeks, and we will figure out which antiviral drugs are effective in two to three weeks and then put them into mass production. If we are really prepared, we may be able to make vaccines using new technology platforms within six months, and most likely RNA vaccines.

Therefore, after this epidemic, many innovations will be funded, and I hope to be very generous. Three years later, when we look back, we will say, “That epidemic is so terrible. There are so many heroes worth remembering. And we have learned our lessons. With the great kindness of science and watchfulness, the world ’s largest The degree has reduced the harm caused by the epidemic, and can prevent the same situation from happening again. ”

   CHRIS ANDERSON: This is also my own most optimistic assumption, that the world can realize: first, we must unite in the face of some challenges; Second, science is really important. Science can help us understand germs, make vaccines, sequence genes, develop treatments, and build models. It was a miracle to me.

So, are we focusing more on scientists now? I believe you have heard that there is an amazing analogy about climate change. Scientists say, “There is a terrible enemy here. If we do nothing, it will take millions of lives. It will ruin our planet. For God’s sake, act now, politician Do something! “Politicians would say,” No, we need GDP growth. We need to win elections! “They did nothing. Do you think the outbreak will change the way politicians think and their overall emphasis on science. Is this too much?

  Bill Gates: The outbreak has largely delayed the urgent innovation agenda for climate change. I made a lot of time before studying climate issues. But I have to say that this has changed in the past few months. Until the epidemic is over, new crown pneumonia will dominate. As a result, some issues that continue to affect climate change will not receive the same attention.

After all this, we will find that scientific innovation and global collaboration should be our common solution to the two problems of infectious diseases and climate change. So, I do n’t think this epidemic is a huge setback for climate issues. In fact, I think it is a useful guideline. “Come on, scientists, where do you see the imminence of the disaster? Let us Make sure this doesn’t happen. ”

  CHRIS ANDERSON: Thousands of people are watching this conversation. Many of them live alone and some are very scared. It may even be that someone is infected with the virus, is suffering from symptoms or has begun to recover.

  What advice can you give them? What can people do as individuals to help each other?

  Bill Gates: There is a lot of space for creativity. The school is closed and children are forced to take classes online, but the school system does not provide good support for this. Do you have any way to coach them? Can you organize a donation event so that the food bank can provide services in difficult places? The United States has a tradition of philanthropy. Although there are some things that the government needs to do, most people can contribute to help each other relieve pain, break isolation, and reduce harm.