美国确诊超75万例！艾伦秀专访比尔·盖茨：新冠疫情比战争更严重！（附视频&对话稿）

据美国约翰斯霍普金斯大学发布的全球新冠肺炎数聚实时统计现实，过去24小时，美国新增确诊病例28888例，新增死亡人数1797例，全美累计已经超过75万例，四万人数累计超过4万例。疫情形势仍然不容乐观！

近日，比尔·盖茨（Bill Gates）接受了艾伦秀（The Ellen DeGeneres Show）采访，在节目中他谈及2015年的TED演讲中对流行性疾病的预测，以及目前的新冠疫情。盖茨表示，“因为这次的疫情比战争更严重，我们所投入的资金，实践的数量和目前具备的能力，都远远不能应对。”

盖茨称，过去五年，（比尔及梅琳达·盖茨）基金会和各方建立了流行病防范创新联盟（CEPI），在提高疫苗的快速研发能力方面进行投资，但是我们的目标进度也只有5%。 

他表示，真正意义上的恢复到正轨，还是要有显著疗效的疫苗，或者有超过95%治疗效果的疗法。我们的猜测是需要18个月的时间。盖茨认为，即使工厂复工，社会活动恢复，人们对于外出还会非常谨慎，同时，人们的投资缩水，工作无法得到保障也让经济恢复到疫情爆发前的强劲水平需要几年时间。

好在经济最终会恢复，医疗支出也会由国家负担，但是在疫情中病亡的人我们却再也无法挽回。此前，比尔·盖茨在接受金融时报采访时表示，这是他这一生遇到的最严重的经济危机，可能比1873年大萧条还要严重。

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? 

盖茨：你好。

盖茨：嗯，我觉得为了尽快控制疫情而实施的社交隔离让所有人的生活都收到了极大的影响。还是挺让人焦虑的。你知道的，要在线上课，公司会议也是线上完成，完全不符合常规。

盖茨：2015年的那场TED演讲，以及我发表在《新英格兰医学期刊》上那篇文章的目的是希望各国政府能做好准备应对下一场大流行病，包括快速诊断，快速找到对症药物，快速研发疫苗等方面的能力，需要比现在我们所看到的进展还要更快。过去五年，（比尔及梅琳达·盖茨）基金会和各方建立了流行病防范创新联盟（CEPI），在提高疫苗的快速研发能力方面进行投资，但是我们的目标进度也只有5%，因为这次的疫情比战争更严重，我们所投入的资金，实践的数量和目前具备的能力，都远远不能应对。

盖茨：对于一件几率无法预估，也不知道何时发生的事情，我们很难知晓需要投入多少资金应对，比如火灾，战争，地震，所以政府需要评估，比如我们之前有非洲爆发的埃博拉疫情，这应当让我们有所准备，还有寨卡病毒，但是呼吸系统流行病的流行范围更广，过去100年都没有如此严重的疫情，实际上，我甚至觉得1918年（流感的百年）纪念能刺激到大家有所行动。不过我们还是做了一些事情，比如有些国家，即使在没有提前准备的情况下，通过迅速行动，确保了最小数量的国民病亡，而不必将整个经济停下来。现在，疫情已经蔓延至全世界，包括美国，我们需要相互学习，尽快让感染人数到达顶峰，并且逐步减少。如果我们幸运的话，如果整个国家在封城方面做得很好，如果（疫苗）测试工作能有序进行，可能6月初（情况就能好转）。到那时我们需要什么样的政策？因为除非世界上几乎所有人都接受疫苗注射，我们的生活还是不能完全回到之前的正常状态，我们需要制造业恢复，建筑业恢复，复学等等，但是大型的公共活动还是可能让疫情反弹。

盖茨：你说的很有道理，即使我们采取正确的方法，比如解决疫苗测试的种种问题，所有人都能坚持社交隔离，流行病学调查面面俱到，政府可以在这种条件下鼓励某些活动的恢复，但是即使如此，大众脑中还是会有对于病毒传染性的担忧，不愿意（按照政府的鼓励）去做，比如政府说孩子可以复学了，但是大家可能不想让孩子回到学校。我们希望能有让大家都感觉安心的证据表明，这些活动是没有传染风险的，因为如果你想让工厂重新开张，是不是有足够多的个人会到岗？饭店重新营业，可能需要提倡食客拉大距离，你肯定会看到需求的减少，因为大家经历了这么多事情。说了这么多，我们还是需要让生活逐步恢复正常，但是真正意义上的恢复到正轨，还是要有显著疗效的疫苗，或者有超过95%治疗效果的疗法。我们的猜测是需要18个月的时间。

盖茨：基金会在传染病方面的研究，要比世界上任何一个组织做得都多得多，我们重新规划了工作重点，包括受赠人在内的所有人目前都专注于新冠病毒的研究，根除脊髓灰质炎和艾滋病新药的研究也都暂停了，但是那些项目的基本工作原理都适用于选择用于测试的治疗药物，选择需要投入生产的疫苗，接下来如果哪些被证明是安全且有效，我们可以实现几十亿支剂量的生产。我们的所有工作都做了极大的调整，在提高测试能力方面投入资金，因为在有些发展中国家，我们所建议的隔离是不可能实现的，不幸的是，这些地方也是病亡数字最高的。

盖茨：嗯，我们不知道这种传染病受季节性的影响有多大，但这对大家而言可能是好消息，因为如果夏天传染性没那么强，感染人数就会有超级大幅的下降，有助于我们解除隔离，当然你说的也对，我们还要防范疫情再次来袭，不过根据中国和韩国的情况，这种可能性很低。你或许可以回到演播室录制节目，因为对于工作人员的互动会有建议，并且可能所有人都会接受病毒检测，情况会与现在有很大不同。演播室可能有，也可能没有观众，但是我认为引入观众可能还要等更长时间。

盖茨：我希望所有人，比如你和我，都能在家工作，但是那些在饭店，工厂，建筑工地，或者从事清洁工作的人，这场疫情夺走了他们的生计，不幸的是，很多经济状况不佳的人恰恰是受这次疫情影响最大的人，所以，我们非常希望尽快恢复一种“半正常”的社会状态，然后疫苗可以帮助所有人恢复真正意义上的正常生活，这也是为什么我们要非常努力地保证疫苗的安全性，因为会有70亿人接受疫苗注射，基金会的科学家们和很多在其他地方的工作人员，都面临着非常大的挑战，最好的情况是在18个月内完成研制，但是我们不想因此引发过多期待，因为我们确实不能确定，正如福西和我自己说的，这只是我们估计的可能的时间，可能提前，也可能延后。

盖茨：肯定不会很快地恢复正常，因为即使工厂复工，社会活动恢复，人们对于外出还会非常谨慎，同时，人们的投资缩水，工作无法得到保障也让经济恢复到疫情爆发前的强劲水平需要几年时间。好在经济最终会恢复，医疗支出也会由国家负担，但是在疫情中病亡的人我们却再也无法挽回。

盖茨：我们在西雅图有一个监测网络，未来会拓展到其他地方，我们也在帮助其他国家，了解不同年龄段，职业，社区受影响的情况，比如我们还不是特别了解为什么黑人社区的重症比例更高，新冠疫情和流感不同，很多年轻人也得流感，而死亡率不高，年轻人感染新冠病毒的更高，但是病亡率和感染率不是一个概念，年长者或者有其他基础性疾病的人群死亡率更高，例外的是医务人员，因为他们曝露在高浓度，而因此更致命的病毒环境下。我们对于年轻人作为感染链一部分可能染病的深刻理解，对于包括复学在内的一些事情都会有参考，因为如果能让失去三个月学习时间的学生们回到学校，赶回学习进度，将是非常不错的一件事情。

盖茨：请讲。

盖茨：是的，最初的接触和感染量会导致症状的差别，因为这是病毒自我复制和免疫系统判断反应之间的速度竞赛。免疫系统会问，这是什么，我应该对它发起攻击吗？当医务人员给病人做插管的时候，他们就可能接触到大量的病毒。我们基金会所做的一个工作就是，之前如果你去做检测，必须得由一名医护人员操作，把一根拭子插入你的咽喉深处，这样医护人员就有感染病毒的风险，因此他们必须穿着防护服。现在我们做的是把拭子给病人，由他们自己采样，这种检测方式和之前由医护人员所做检测一样准确。也就是说，你不需要防护装备，你可以把检测材料直接寄到需要检测的人员家里。我们最近刚刚才说服美国食品药品管理局接纳这一居家检测办法，你可以在居家检测后再去医疗中心，从而避免感染他人。这就是我们所说的自测拭子，正在推广应用。是的，关于病毒接触量，我们看到像麻疹和其它一些呼吸系统疾病，不同的病毒接触量导致的症状差别很大。有些年轻且健康的医生感染后病情急速恶化，不幸去世，令人震惊，这就是原因所在。

盖茨：现在我充满信心的是下一次流行病爆发的潜在可能不会再被人们忽视。这场突发的疫情重塑了我们的生活，改变了经济，导致了众多的悲剧，下一次我们将做好准备，而其他的传染性疾病也将从我们这次所做的工作中受益。我还看到很多英勇的行为涌现出来，人们挺身而出，社区团结，大家一起去解决问题。尽管疫情并不是什么好消息，甚至可以说是最糟糕的情况，人类表现出了非凡的聪明才智和同情心，为抗击疫情，人们贡献了时间和金钱，希望通过这次疫情大家能够意识到我们是一个命运共同体，因为无论是对于社区，国家还是整个世界而言，如果我们不能在世界所有地方都结束这次疫情，新冠病毒就还有在美国再次爆发的可能。

盖茨：有一些事情需要优先考虑，比如阻断艾滋病感染和彻底消除脊髓灰质炎，可悲的是，当我们将这些专业力量都用于抗击新冠疫情的时候，原本需要优先考虑的事情会收到巨大影响，如果这些工作都能恢复正常，我会非常高兴。我会想知道，在我们没有做脊髓灰质炎项目期间，这种病的传播是否再次扩大？项目受到了多大程度的干扰？我相信所有人届时都会因为可以继续从事四个月之前放下的项目而感到兴奋不已。

盖茨：谢谢你，艾伦。

中文部分编译来自新浪科技。