全球确诊突破100万例!崔娃连线专访比尔·盖茨:美国的情况更像湖北!(附视频&对话稿)
英语演讲视频,第一时间观看
截至美国东部时间2日16时(北京时间3日4时),全球新冠肺炎确诊病例达1002159例,死亡病例为51485例。数据还显示,美国新冠肺炎确诊病例升至236339例,是目前确诊病例最多的国家,其死亡病例为达到了5648例。
崔娃连线专访了比尔·盖茨,聊到各国的做法不同,美国是否应该效仿意大利或韩国。盖茨说美国的情况更像湖北,但又做不到中国严格的隔离和接触者追踪,所以美国只能努力把感染比例维持在几个百分点(中国0.01%)。还说直到疫苗研发出来之前,即使几个月后复工开学,也无法恢复以前的生活,大规模赛事仍会中断。现在不鼓励戴口罩,主要是因为医护人员缺口罩,等美国口罩的供应跟上了,也许大家也会像中国一样上街戴口罩。说的都挺实在的。最后崔娃还主动说要一起打网球。
中文精简版
Bill Gates, welcome to The Daily Social Distancing Show.
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 U.S. 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 U.S. 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?
- 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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