How the pandemic will shape the near future Bill Gates

Chris Anderson: Welcome, Bill Gates.

Bill Gates: Thank you.

CA: Alright. It’s great
to have you here, Bill.

You know, we had a TED conversation
about three months ago

about this pandemic,

and back then, I think fewer than –
I think that was the end of March –

back then, fewer than
1,000 people in the US had died

and fewer than 20,000 worldwide.

I mean, the numbers now are,
like, 128,000 dead in the US

and more than half a million worldwide,

in three months.

In three months.

What is your diagnosis of what is possible
for the rest of this year?

You look at a lot of models.

What do you think best-
and worst-case scenarios might be?

BG: Well, the range of scenarios,
sadly, is quite large,

including that, as we get into the fall,

we could have death rates
that rival the worst of what we had

in the April time period.

If you get a lot of young people infected,

eventually, they will infect
old people again,

and so you’ll get into the nursing homes,

the homeless shelters,

the places where we’ve had
a lot of our deaths.

The innovation track,
which probably we’ll touch on –

diagnostics, therapeutics, vaccines –

there’s good progress there,

but nothing that would
fundamentally alter the fact

that this fall in the United States
could be quite bad,

and that’s worse than
I would have expected a month ago,

the degree to which we’re back
at high mobility,

not wearing masks,

and now the virus actually
has gotten into a lot of cities

that it hadn’t been in before
in a significant way,

so it’s going to be a challenge.

There’s no case where we get
much below the current death rate,

which is about 500 deaths a day,

but there’s a significant risk
we’d go back up

to the even 2,000 a day
that we had before,

because we don’t have the distancing,

the behavior change,

to the degree that we had
in April and May.

And we know this virus
is somewhat seasonal,

so that the force of infection,

both through temperature, humidity,
more time indoors,

will be worse as we get into the fall.

CA: So there are scenarios
where in the US,

like, if you extrapolate
those numbers forward,

we end up with, what,

more than a quarter of a million
deaths, perchance,

even this year if we’re not careful,

and worldwide, I guess the death toll
could, by the end of the year,

be well into the millions, with an “s.”

Is there evidence that the hotter
temperatures of the summer

actually have been helping us?

BG: They’re not absolutely sure,

but certainly, the IHME model
definitely wanted to use the season,

including temperature and humidity,

to try and explain
why May wasn’t worse than it was.

And so as we came out
and the mobility numbers got higher,

the models expected more infections
and deaths to come out of that,

and the model kept wanting to say,

“But I need to use this seasonality

to match why May wasn’t worse,

why June wasn’t worse than it was.”

And we see in the Southern Hemisphere,

you know, Brazil,

which is the opposite season,

now all of South America
is having a huge epidemic.

South Africa is having
a very fast-growing epidemic.

Fortunately, Australia and New Zealand,

the last countries
in the Southern Hemisphere,

are at really tiny case counts,

and so although they have
to keep knocking it down,

they’re talking about,
“Oh, we have 10 cases,

that’s a big deal,
let’s go get rid of that.”

So they’re one of these amazing countries
that got the numbers so low

that test, quarantine and trace

is working to get them,
keep them at very near zero.

CA: Aided perhaps a bit
by being easier to isolate

and by less density,
less population density.

But nonetheless,
smart policies down there.

BG: Yeah, everything is so exponential

that a little bit of good work
goes a long way.

It’s not a linear game.

You know, contact tracing, if you have
the number of cases we have in the US,

it’s super important to do,

but it won’t get you back down to zero.

It’ll help you be down,

but it’s too overwhelming.

CA: OK, so in May and June in the US,

the numbers were slightly better
than some of the models predicted,

and it’s hypothesized that that might be
partly because of the warmer weather.

Now we’re seeing, really,
would you describe it

as really quite alarming upticks
in case rates in the US?

BG: That’s right, it’s –

In, say, the New York area,

the cases continue to go down somewhat,

but in other parts of the country,

primarily the South right now,

you have increases
that are offsetting that,

and you have testing-positive
rates in young people

that are actually higher than what we saw
even in some of the tougher areas.

And so, clearly, younger people
have come out of mobility

more than older people
have increased their mobility,

so the age structure
is right now very young,

but because of
multigenerational households,

people work in nursing care homes,

unfortunately, that will
work its way back,

both the time lag and the transmission,

back up into the elderly,

will start to push the death rate back up,

which, it is down –

way down from 2,000
to around 500 right now.

CA: And is that partly because
there’s a three-week lag

between case numbers and fatality numbers?

And also, perhaps, partly because

there have been
some effective interventions,

and we’re actually seeing the possibility

that the overall fatality rate
is actually falling a bit

now that we’ve gained
some extra knowledge?

BG: Yeah, certainly
your fatality rate is always lower

when you’re not overloaded.

And so Italy, when they were overloaded,

Spain, even New York at the start,

certainly China,

there you weren’t even able
to provide the basics,

the oxygen and things.

A study that our foundation
funded in the UK

found the only thing
other than remdesivir

that is a proven therapeutic,

which is the dexamethasone,

that for serious patients,

is about a 20 percent death reduction,

and there’s still quite
a pipeline of those things.

You know, hydroxychloroquine
never established positive data,

so that’s pretty much done.

There’s still a few trials ongoing,

but the list of things being tried,

including, eventually,
the monoclonal antibodies,

we will have some additional
tools for the fall.

And so when you talk about death rates,

the good news is,
some innovation we already have,

and we’ll have more, even in the fall.

We should start to have
monoclonal antibodies,

which is the single therapeutic
that I’m most excited about.

CA: I’ll actually ask you to tell me
a bit more about that in one sec,

but just putting the pieces
together on death rates:

so in a well-functioning health system,

so take the US when places
aren’t overcrowded,

what do you think

the current fatality numbers are,
approximately, going forward,

like as a percentage of total cases?

Are we below one percent, perhaps?

BG: If you found every case, yes,

you’re well below one percent.

People argue, you know, 0.4, 0.5.

By the time you bring in
the never symptomatics,

it probably is below 0.5,

and that’s good news.

This disease could have been
a five-percent disease.

The transmission dynamics of this disease

are more difficult
than even the experts predicted.

The amount of presymptomatic
and never symptomatic spread

and the fact that it’s not coughing,

where you would kind of notice,
“Hey, I’m coughing” –

most respiratory diseases make you cough.

This one, in its early stages,
it’s not coughing,

it’s singing, laughing, talking,

actually, still, particularly
for the super-spreaders,

people with very high viral loads,

causes that spread,

and that’s pretty novel,

and so even the experts have to say,
“Wow, this caught us by surprise.”

The amount of asymptomatic spread

and the fact that there’s not
a coughing element

is not a major piece like the flu or TB.

CA: Yeah, that is
devilish cunning by the virus.

I mean, how much is
that nonsymptomatic transmission

as a percentage of total transmission?

I’ve heard numbers it could be
as much as half of all transmissions

are basically presymptomatic.

BG: Yeah, if you count presymptomatics,

then most of the studies show
that’s like at 40 percent,

and we also have never symptomatics.

The amount of virus you get
in your upper respiratory area

is somewhat disconnected.

Some people will have a lot here
and very little in their lungs,

and what you get in your lungs
causes the really bad symptoms –

and other organs, but mostly the lungs –

and so that’s when you seek treatment.

And so the worst case
in terms of spreading

is somebody who’s got a lot
in the upper respiratory tract

but almost none in their lungs,

so they’re not care-seeking.

CA: Right.

And so if you add in the never symptomatic

to the presymptomatic,

do you get above 50 percent
of the transmission

is actually from nonsymptomatic people?

BG: Yeah, transmission
is harder to measure.

You know, we see certain
hotspots and things,

but that’s a huge question
with the vaccine:

Will it, besides avoiding
you getting sick,

which is what the trial will test,

will it also stop you
from being a transmitter?

CA: So that vaccine,

it’s such an important question,
let’s come on to that.

But before we go there,

any other surprises
in the last couple months

that we’ve learned about this virus

that really impact how
we should respond to it?

BG: We’re still not able to characterize
who the super-spreaders are

in terms of what that profile is,

and we may never.

That may just be quite random.

If you could identify them,

they’re responsible
for the majority of transmission,

a few people who have
very high viral loads.

But sadly, we haven’t figured that out.

This mode of transmission,

if you’re in a room and nobody talks,

there’s way less transmission.

That’s partly why,
although planes can transmit,

it’s less than you would expect
just in terms of time proximity measures,

because unlike, say,
a choir or a restaurant,

you’re not exhaling in loud talking

quite as much as in other
indoor environments.

CA: Hmm.

What do you think about the ethics
of someone who would go on a plane

and refuse to wear a mask?

BG: If they own the plane,
that would be fine.

If there’s other people on the plane,

that would be endangering
those other people.

CA: Early on in the pandemic,

the WHO did not advise
that people wear masks.

They were worried about taking them away
from frontline medical providers.

In retrospect, was that
a terrible mistake that they made?

BG: Yes.

All the experts feel bad
that the value of masks –

which ties back somewhat
to the asymptomatics;

if people were very symptomatic,

like an Ebola,

then you know it and you isolate,

and so you don’t have
a need for a masklike thing.

The value of masks,

the fact that the medical masks
was a different supply chain

than the normal masks,

the fact you could scale up
the normal masks so well,

the fact that it would stop
that presymptomatic,

never symptomatic transmission,

it’s a mistake.

But it’s not a conspiracy.

It’s something that, we now know more.

And even now, our error bars
on the benefit of masks

are higher than we’d like to admit,

but it’s a significant benefit.

CA: Alright, I’m going to come in
with some questions

from the community.

Let’s pull them up there.

Jim Pitofsky, “Do you think reopening
efforts in the US have been premature,

and if so, how far should the US go
to responsibly confront this pandemic?”

BG: Well, the question
of how you make trade-offs

between the benefits, say,
of going to school

versus the risk of people getting sick
because they go to school,

those are very tough questions

that I don’t think
any single person can say,

“I will tell you how to make
all these trade-offs.”

The understanding
of where you have transmission,

and the fact that young people
do get infected

and are part of the multigenerational
transmission chain,

we should get that out.

If you just look at the health aspect,

we have opened up too liberally.

Now, opening up in terms of mental health

and seeking normal health things
like vaccines or other care,

there are benefits.

I think some of our opening up
has created more risk than benefit.

Opening the bars up
as quickly as they did,

you know, is that critical
for mental health?

Maybe not.

So I don’t think we’ve been
as tasteful about opening up

as I’m sure, as we study it,

that we’ll realize some things
we shouldn’t have opened up as fast.

But then you have something like school,

where even sitting here today,

the exact plan, say,
for inner-city schools for the fall,

I wouldn’t have a black-and-white view

on the relative trade-offs involved there.

There are huge benefits
to letting those kids go to school,

and how do you weigh the risk?

If you’re in a city without many cases,

I would say probably the benefit is there.

Now that means that
you could get surprised.

The cases could show up,
and then you’d have to change that,

which is not easy.

But I think around the US,

there will be places
where that won’t be a good trade-off.

So almost any dimension of inequity,

this disease has made worse:

job type, internet connection,

ability of your school
to do online learning.

White-collar workers,

people are embarrassed to admit it,

some of them are more productive

and enjoying the flexibility
that the at-home thing has created,

and that feels terrible

when you know lots of people
are suffering in many ways,

including their kids not going to school.

CA: Indeed. Let’s have the next question.

[Nathalie Munyampenda] “For us in Rwanda,

early policy interventions
have made the difference.

At this point, what policy interventions
do you suggest for the US now?”

Bill, I dream of the day
where you are appointed

the coronavirus czar

with authority to actually
speak to the public.

What would you do?

BG: Well, the innovation tools

are where I and the foundation
probably has the most expertise.

Clearly, some of the policies
on opening up have been too generous,

but I think everybody

could engage in that.

We need leadership

in terms of admitting
that we’ve still got a huge problem here

and not turning that
into almost a political thing

of, “Oh, isn’t it brilliant what we did?”

No, it’s not brilliant,

but there’s many people,
including the experts –

there’s a lot
they didn’t understand,

and everybody wishes a week earlier
whatever action they took,

they’d taken that a week earlier.

The innovation tools,

that’s where the foundation’s work

on antibodies, vaccines,

we have deep expertise,

and it’s outside of the private sector,

and so we have kind of a neutral ability
to work with all the governments

and the companies to pick.

Particularly when you’re doing
break-even products,

which one should get the resources?

There’s no market signal for that.

Experts have to say, “OK,
this antibody deserves the manufacturing.

This vaccine deserves the manufacturing,”

because we have very limited
manufacturing for both of those things,

and it’ll be cross-company,
which never happens in the normal case,

where one company invents it

and then you’re using
the manufacturing plants of many companies

to get maximum scale of the best choice.

So I would be coordinating those things,

but we need a leader
who keeps us up to date,

is realistic

and shows us the right behavior,

as well as driving the innovation track.

CA: I mean, you have
to yourself be a master diplomat

in how you talk about this stuff.

So I appreciate, almost,
the discomfort here.

But I mean, you talk regularly
with Anthony Fauci,

who is a wise voice on this
by most people’s opinion.

But to what extent is he just hamstrung?

He’s not allowed to play the full role

that he could play in this circumstance.

BG: Dr. Fauci has emerged
where he was allowed to have some airtime,

and even though he was stating
things that are realistic,

his prestige has stuck.

He can speak out in that way.

Typically, the CDC would be
the primary voice here.

It’s not absolutely necessary,

but in previous health crises,

you let the experts inside the CDC

be that voice.

They’re trained to do these things,

and so it is a bit unusual here
how much we’ve had to rely on Fauci

as opposed to the CDC.

It should be Fauci,
who’s a brilliant researcher,

so experienced, particularly in vaccines.

In some ways, he has become,
taking the broad advice

that’s the epidemiology advice

and explaining it in the right way,

where he’ll admit,

“OK, we may have a rebound here,

and this is why we need
to behave that way.”

But it’s fantastic that his voice
has been allowed to come through.

CA: Sometimes.

Let’s have the next question.

Nina Gregory, “How are you
and your foundation

addressing the ethical questions about
which countries get the vaccine first,

assuming you find one?”

And maybe, Bill, use this as a moment

to just talk about where
the quest for the vaccine is

and what are just some of the key things
we should all be thinking about

as we track the news on this.

BG: There’s three vaccines that are,

if they work, are the earliest:

the Moderna, which unfortunately,
won’t scale very easily,

so if that works, it’ll be mostly
a US-targeted thing;

then you have the AstraZeneca,
which comes from Oxford;

and the Johnson and Johnson.

Those are the three early ones.

And we have animal data

that looks potentially good
but not definitive,

particularly will it work in the elderly,

and we’ll have human data
over the next several months.

Those three will be gated by
the safety and efficacy trial.

That is, we’ll be able
to manufacture those,

although not as much as we want.

We’ll be able to manufacture those
before the end of the year.

Whether the Phase 3 will succeed

and whether it’ll complete
before the end of the year,

I wouldn’t be that optimistic about.

Phase 3 is where you need
to really look at all the safety profile

and efficacy,

but those will get started.

And then there’s four or five vaccines
that use different approaches

that are maybe three
or four months behind that:

Novavax, Sanofi, Merck.

And so we’re funding factory capacity
for a lot of these –

some complex negotiations
are taking place right now on this –

to get factories that will be dedicated
to the poorer countries,

what’s called low- and middle-income.

And the very scalable constructs

that include AstraZeneca
and Johnson and Johnson,

we’ll focus on those,

the ones that are inexpensive

and you can build a single factory
to make 600 million doses.

So a number of the vaccine constructs

are potential.

I don’t see anything
before the end of the year.

That’s really the best case,

and it’s down to a few constructs now,

which, typically, you have
high failure rates.

CA: Bill, is it the case

that if you and your foundation
weren’t in the picture here

that market dynamics would likely
lead to a situation

where, as soon as a promising
vaccine candidate emerged,

the richer countries
would basically snap up, gobble up

all available initial supply –

it just takes a while
to manufacture these,

and there would be nothing
for the poorer countries –

but that what, effectively, you’re doing

by giving manufacturing
guarantees and capability

to some of these candidates,

you’re making it possible that
at least some of the early vaccine units

will go to poorer countries?

Is that correct?

BG: Well, it’s not just us, but yes,

we’re in the central role there,

along with a group we created called CEPI,
Coalition for Epidemic Preparedness,

and the European leaders agree with this.

Now we have the expertise
to look at each of the constructs

and say, “OK, where is there
a factory in the world

that has capacity that can build that?

Which one should we put
the early money into?

What should the milestones be

where we’ll shift the money
over to a different one?”

Because the kind of private sector people

who really understand that stuff,

some of them work for us,

and we’re a trusted party on these things,

we get to coordinate a lot of it,
particularly that manufacturing piece.

Usually, you’d expect the US
to think of this as a global problem

and be involved.

So far, no activity
on that front has taken place.

I am talking to people in the Congress
and the Administration

about when the next
relief bill comes along

that maybe one percent of that
could go for the tools

to help the entire world.

And so it’s possible,

but it’s unfortunate,

and the vacuum here,

the world is not that used to,

and a lot of people are stepping in,
including our foundation,

to try and have a strategy,

including for the poorer countries,

who will suffer a high percentage
of the deaths and negative effects,

including their health systems
being overwhelmed.

Most of the deaths will be
in developing countries,

despite the huge deaths we’ve seen
in Europe and the US.

CA: I mean, I wish
I could be a fly on the wall

and hearing you and Melinda
talk about this,

because of all of the ethical …
“crimes,” let’s say,

executed by leaders
who should know better,

I mean, it’s one thing
to not model mask-wearing,

but to not play a role
in helping the world

when faced with a common enemy,

respond as one humanity,

and instead …

you know, catalyze a really unseemly
scramble between nations

to fight for vaccines, for example.

That just seems – surely, history
is going to judge that harshly.

That is just sickening.

Isn’t it? Am I missing something?

BG: Well, it’s not quite
as black-and-white as that.

The US has put more money out

to fund the basic research
on these vaccines

than any country by far,

and that research is not restricted.

There’s not, like, some royalty
that says, “Hey, if you take our money,

you have to pay the US a royalty.”

They do, to the degree they fund research,

it’s for everybody.

To the degree they fund factories,
it’s just for the US.

The thing that makes this tough is that
in every other global health problem,

the US totally leads smallpox eradication,

the US is totally the leader
on polio eradication,

with key partners – CDC, WHO,
Rotary, UNICEF, our foundation.

So the world – and on HIV,

under President Bush’s leadership,
but it was very bipartisan,

this thing called PEPFAR was unbelievable.

That has saved tens of millions of lives.

And so it’s that the world
always expected the US

to at least be at the head of the table,

financially, strategy, OK, how do you
get these factories for the world,

even if it’s just to avoid the infection
coming back to the US

or to have the global economy working,

which is good for US jobs

to have demand outside the US.

And so the world is kind of –

you know, there’s all this uncertainty
about which thing will work,

and there’s this,
“OK, who’s in charge here?”

And so the worst thing,
the withdrawal from WHO,

that is a difficulty
that hopefully will get remedied

at some point,

because we need that coordination

through WHO.

CA: Let’s take another question.

Ali Kashani, “Are there any
particularly successful models

of handling the pandemic
that you have seen around the world?”

BG: Well, it’s fascinating that,
besides early action,

there are definitely things where
you take people who have tested positive

and you monitor their pulse ox,

which is the oxygen saturation
level in their blood,

which is a very cheap detector,

and then you know to get them
to the hospitals fairly early.

Weirdly, patients don’t know
things are about to get severe.

It’s an interesting physiological reason
that I won’t get into.

And so Germany has
quite a low case fatality rate

that they’ve done through
that type of monitoring.

And then, of course,
once you get into facilities,

we’ve learned that the ventilator,
actually, although extremely well-meaning,

was actually overused
and used in the wrong mode

in those early days.

So the health – the doctors
are way smarter about treatment today.

Most of that, I would say, is global.

Using this pulse ox as an early indicator,

that’ll probably catch on broadly,

but Germany was a pioneer there.

And now, of course, dexamethasone –
fortunately, it’s cheap, it’s oral,

we can ramp up manufacture.

That’ll go global as well.

CA: Bill, I want to ask you
something about

what it’s been like for you personally
through this whole process.

Because, weirdly, even though
your passion and good intent on this topic

seems completely bloody obvious to anyone
who has spent a moment with you,

there are these crazy conspiracy theories
out there about you.

I just checked in
with a company called Zignal

that monitors social media spaces.

They say that, to date,
I think on Facebook alone,

more than four million posts
have taken place

that associate you with some kind
of conspiracy theory around the virus.

I read that there was a poll
that more than 40 percent of Republicans

believe that the vaccine
that you would roll out

would somehow plant a microchip
in people to track their location.

I mean, I can’t even believe
that poll number.

And then some people
are taking this seriously enough,

and some of them have even been
recirculated on “Fox News” and so forth,

some people are taking this
seriously enough

to make really quite horrible
threats and so forth.

You seem to do a good job
sort of shrugging this off,

but really, like, who else
has ever been in this position?

How are you managing this?

What on earth world are we in

that this kind of misinformation
can be out there?

What can we do to help correct it?

BG: I’m not sure.

And it’s a new thing

that there’s conspiracy theories.

I mean, Microsoft had
its share of controversy,

but at least that related
to the real world, you know?

Did Windows crash more than it should?

We definitely had antitrust problems.

But at least I knew what that was.

When this emerged, I have to say,

my instinct was to joke about it.

People have said
that’s really inappropriate,

because this is a very serious thing.

It is going to make people
less willing to take a vaccine.

And, of course, once we have that vaccine,

it’ll be like masks,

where getting lots of people,

particularly when it’s
a transmission-blocking vaccine,

there’s this huge community benefit

to widespread adoption of that vaccine.

So I am caught a little bit,

unsure of what to say or do,

because the conspiracy piece
is a new thing for me,

and what do you say

that doesn’t give credence to the thing?

The fact that a “Fox News”
commentator, Laura Ingraham,

was saying this stuff
about me microchipping people,

that survey isn’t that surprising
because that’s what they heard

on the TV.

It’s wild.

And people are clearly seeking
simpler explanations

than going and studying virology.

CA: I mean,

TED is nonpolitical,

but we believe in the truth.

I would say this:

Laura Ingraham, you owe Bill Gates
an apology and a retraction.

You do.

And anyone who’s watching this

who thinks for a minute that this man
is involved in some kind of conspiracy,

you want your head examined.

You are crazy.

Enough of us know Bill over many years

and have seen the passion
and engagement in this to know

that you are crazy.

So get over it,

and let’s look at the actual problem
of solving this pandemic.

Honestly.

If anyone in the chat here
has a suggestion,

a positive suggestion for how you can,

how do you get rid of conspiracies,

because they feed on each other.

Now, “Oh, well I would say that,
because I’m part of the conspiracy,”

or whatever.

Like, how do we get back to a world

where information can be trusted?

We have to do better on it.

Are there any other questions
out there from the community?

Aria Bendix from New York City:

“What are your personal recommendations
for those who want to reduce

their risk of infection
amid an uptick in cases?”

BG: Well, it’s great if you have a job

that you can stay at your house
and do it through digital meetings,

and even some of your social activities,

you know, I do video calls
with lots of friends.

I have friends in Europe that,
who knows when I’ll see them,

but we schedule regular calls to talk.

If you stay fairly isolated,

you don’t run much risk,

and it’s when you’re getting together
with lots of other people,

either through work or socialization,

that drives that risk,

and particularly in these communities
where you have increased cases,

even though it’s not going to be mandated,

hopefully, the mobility numbers
will show people responding

and minimizing those kind of
out-of-the-house contacts.

CA: Bill, I wonder if I could just ask you

just a little bit about philanthropy.

Obviously, your foundation
has played a huge role in this,

but philanthropy more generally.

You know, you’ve started
this Giving Pledge movement,

recruited all these billionaires

who have pledged to give away
half their net worth

before or after their death.

But it’s really hard to do.

It’s really hard to give away
that much money.

You yourself, I think,

since The Giving Pledge was started –

what? 10 years ago or something,
I’m not sure when –

but your own net worth, I think,
has doubled since that period

despite being the world’s
leading philanthropist.

Is it just fundamentally hard
to give away money effectively

to make the world better?

Or should the world’s donors,

and especially the world’s
really rich donors,

start to almost commit to a schedule,

like, “Here’s a percentage
of my net worth each year

that, as I get older,

maybe that goes up.

If I’m to take this seriously,

I have to give away – somehow,
I’ve got to find a way

of doing that effectively.”

Is that an unfair and crazy question?

BG: Well, it’d be great to up the rate,

and our goal, both as the Gates Foundation
or through The Giving Pledge,

is to help people find causes
they connect to.

People give through passion.

Yes, numbers are important,

but there’s so many causes out there.

The way you’re going to pick
is you see somebody who’s sick,

you see somebody who’s not
getting social services.

You see something
that helps reduce racism.

And you’re very passionate,
and so you give to that.

And, of course,

some philanthropic gifts won’t work out.

We do need to up the ambition level
of philanthropists.

Now, collaborative philanthropy

that you’re helping to facilitate
through Audacious,

there’s four or five other groups
that are getting philanthropists together,

that is fantastic,

because then they learn from each other,

they get confidence from each other,

they feel like, “Hey, I put in x,
and the four other people put money in,

so I’m getting more impact,”

and hopefully, it can be made fun for them
even when they find out,

OK, that particular gift
didn’t work out that well,

but let’s keep going.

So philanthropy, yes,

I would like to see the rate go up,

and people who do get going,

it is fun,

it’s fulfilling,

you pick which of the family members
are partnered in doing it.

In my case, Melinda and I
love doing this stuff together,

learning together.

Some families, it will even
involve the kids in the activities.

Sometimes the kids are pushing.

When you have lots of money,

you still think of a million dollars
as a lot of money,

but if you have billions,

you should be giving hundreds of millions.

So it’s kind of charming that,
in terms of your personal expenditure,

you stay at the level you were at before.

That’s societally quite appropriate.

But on your giving, you need to scale up

or else it will be your will,

and you won’t get to shape it
and enjoy it quite that same way.

And so without –

we don’t want to mandate it,

but yes, both you and I
want to inspire philanthropists

to see that passion,
to see those opportunities

significantly faster than in the past,

because whether it’s race or disease,
or all the other social ills,

the innovation of what philanthropy
can go to and do quickly

that, if it works, government
can come in behind it and scale it up,

God knows we need solutions,

we need that kind of hope and progress

that expectations are high

that will solve very tough problems.

CA: I mean, most philanthropists,
even the best of them,

find it hard to give away more than about
a percent of their net worth every year,

and yet the world’s richest
often have access

to great investment opportunities.

Many of them are gaining wealth
at seven to 10 percent plus per year.

Isn’t it the case that
to have a real chance

of giving away half your fortune,

at some point you have to plan
to give away five, six, seven, eight,

10 percent of your net worth annually?

And that is, isn’t that the logic
of what should be happening?

BG: Yeah, there are people
like Chuck Feeney,

who set a good example
and gave away all of his money.

Even Melinda and I are talking about,
should we up the rate that we give at?

As you say, we’ve been very lucky
on the investment side

through a variety of things.

Tech fortunes in general have done well,

even this year,

which is one of those great contrasts

in what’s going on in the world.

And I do think there’s an expectation
that we should speed up,

and there’s a reason to speed up,

and government is going
to miss a lot of needs.

Yes, there’s tons of government
money out there,

but helping it be spent well,

helping find places it’s not stepping up,

and if people are willing to give
to the developing world,

they don’t have governments

that can print checks
for 15 percent of GDP,

and so the suffering there broadly,
just the economic stuff alone,

put aside the pandemic,

is tragic.

It’s about a five-year setback

in terms of these countries
moving forward,

and in a few cases, it’s tough enough
that the very stability of the country

is in question.

CA: Well, Bill,

I’m in awe of what
you and Melinda have done.

You walk this narrow path

of trying to juggle
so many different things,

and the amount of time that you dedicate
to the betterment of the world at large,

and definitely the amount of money

and the amount
of passion you put into it –

I mean, it’s pretty awesome,

and I’m really grateful to you
for spending this time with us now.

Thank you so much,

and honestly, the rest of this year,

your skills and resources
are going to be needed more than ever,

so good luck.

BG: Well, thanks.

It’s fun work and I’m optimistic,
so thanks, Chris.

克里斯·安德森:欢迎,比尔·盖茨。

比尔盖茨:谢谢。

CA:好的。
比尔,你能来真是太好了。

你知道,大约三个月前,我们就这场流行病进行了一次 TED 对话

,那时,我认为不到——
我认为那是三月底

——当时,
美国死亡人数不到 1000 人,

而且更少 全球超过 20,000 人。

我的意思是,现在的数字是
,在三个月内,美国有 128,000 人死亡,

全球死亡人数超过 50 万

三个月内。

您对今年余下时间可能发生的事情的诊断是什么

你看了很多模型。

你认为最好
和最坏的情况可能是什么?

BG:嗯,遗憾的是,情景的范围
相当大,

包括当我们进入秋季时,

我们的死亡率可能会与四月期间
最糟糕的情况相媲美

如果你感染了很多年轻人,

最终,他们会
再次感染老年人

,所以你会进入疗养院

、无家可归者收容所,

以及我们死亡人数众多的地方。

创新轨道
,我们可能会谈到——

诊断、治疗、疫苗——

那里取得了很好的进展,

但没有什么
能从根本上改变

美国今年秋天
可能非常糟糕的事实

,这比我更糟糕
一个月前就可以预料

到,我们恢复
到高流动性的程度,

不戴口罩

,现在病毒实际上
已经以重要的方式进入了许多

以前从未进入过的城市,

所以它是 将是一个挑战。

没有任何情况下我们
的死亡率远低于目前的死亡率,

即每天大约 500 人死亡,

但是我们有很大的
风险会回到以前

的每天 2000
人,

因为我们没有 疏远

,行为改变,

达到我们
在四月和五月的程度。

而且我们知道这种病毒
在某种程度上是季节性的,

因此随着我们进入秋季

,通过温度、湿度和
更多的室内时间感染的力量

将会变得更糟。

CA:所以
在美国

,如果你将
这些数字向前推算

,我们最终会

得到超过 100 万的
死亡人数,

甚至今年,如果我们不小心的话,可能会

在全球范围内死亡 ,我猜到
今年年底,死亡人数

可能会达到数百万,并带有“s”。

是否有证据表明
夏天的高温

确实对我们有所帮助?

BG:他们并不完全确定,

但可以肯定的是,IHME 模型
肯定想利用这个季节,

包括温度和湿度,

来尝试解释
为什么五月没有比现在更糟。

因此,当我们出来
并且流动性数字变得更高时

,模型预计会出现更多的感染
和死亡,

并且模型一直想说,

“但我需要利用这个季节性

来匹配为什么五月没有更糟 ,

为什么六月没有比现在更糟。”

我们在南半球看到,

你知道,巴西,

这是相反的季节,

现在整个南美洲
都在发生巨大的流行病。

南非
的流行病发展非常迅速。

幸运的是,

南半球最后一个国家澳大利亚和新西兰的

病例数非常少

,因此尽管他们
不得不继续减少病例数,但

他们正在谈论,
“哦,我们有 10 个病例,

这是一个大病例 交易,
让我们摆脱它。”

因此,它们是这些令人惊叹的国家之一,这些国家
的数字如此之低

,以至于测试、隔离和追踪

正在努力获取它们,
并将它们保持在非常接近于零的水平。

CA:也许
通过更容易隔离

和更低的密度,
更少的人口密度有所帮助。

但尽管如此,还是
有明智的政策。

BG:是的,一切都是指数级的

,一点点好的工作
都会有很长的路要走。

这不是线性游戏。

你知道,接触者追踪,如果你
有我们在美国的病例数量,

这是非常重要的,

但它不会让你回到零。

它会帮助你沮丧,

但它太压倒了。

CA:好的,所以在美国,5 月和 6 月

的数字略好
于一些模型的预测

,据推测,这可能
部分是因为天气变暖。

现在我们看到,真的,
你会把它描述

为美国病例率真的非常惊人的
上升吗?

BG: 没错,它是

——比如说,在纽约地区

,病例继续有所下降,

但在该国其他地区,

主要是现在的南方,

你的
增长抵消了这一点

,你有
年轻人

的检测阳性率实际上比我们
在一些更艰难的地区看到的还要高。

因此,很明显,
年轻人摆脱流动性


老年人增加流动性更多,

所以现在的年龄结构
非常年轻,

但是由于
多代家庭,

人们在养老院工作,

不幸的是,这将
起作用 回到

过去,时间滞后和传播,

回到老年人,

将开始推动死亡率回升

,它正在下降——


现在的 2,000 下降到 500 左右。

CA:部分原因是因为

病例数和死亡数之间存在三周的滞后?

而且,也许,部分原因是


一些有效的干预措施,

而且我们实际上

看到了总体
死亡率实际上正在下降的可能性,

因为我们已经获得了
一些额外的知识?

BG: 是的,当你没有超负荷时,
你的死亡率当然会更低

所以意大利,当他们超载的时候,

西班牙,甚至一开始的纽约,

当然还有中国,

在那里你甚至
无法提供基本

的东西,氧气和其他东西。

我们的基金会
在英国资助的一项研究

发现,
除了瑞德西韦之外

,唯一一种经过验证的治疗

方法是地塞米松

,对于严重的患者,

它可以减少大约 20% 的死亡率,

而且这些东西还有很长
的路要走。

你知道,羟氯喹
从来没有建立过积极的数据,

所以这已经完成了。

仍有一些试验正在进行,

但正在尝试的东西清单,

包括最终
的单克隆抗体,

我们将在秋季推出一些额外的
工具。

所以当你谈到死亡率时

,好消息是,
我们已经有了一些创新,

而且我们还会有更多,甚至在秋天。

我们应该开始有
单克隆抗体,


是我最兴奋的单一疗法。

CA:我实际上会要求你
在一秒钟内告诉我更多关于这一点的信息,

但只是把
死亡率放在一起:

所以在一个运作良好的卫生系统中,

所以在地方没有过度拥挤的情况下选择美国

认为目前的死亡人数大约是

多少,例如占总病例的百分比?

也许我们低于百分之一?

BG:如果你发现每一个案例,是的,

你的比例远低于百分之一。

人们争论,你知道,0.4,0.5。

到您
引入从未出现过的症状时,

它可能低于 0.5

,这是个好消息。

这种疾病可能是
百分之五的疾病。

这种疾病的传播动力学

甚至比专家预测的还要困难。

症状前
和从未出现症状的传播量

以及它不咳嗽的事实

,你会注意到,
“嘿,我在咳嗽”——

大多数呼吸道疾病都会让你咳嗽。

这个,在它的早期阶段,
它不是咳嗽,

它是唱歌、大笑、说话,

实际上,仍然如此,特别是
对于超级传播者,

病毒载量非常高的人,

导致传播

,这很新颖

,所以即使是 专家不得不说,
“哇,这让我们大吃一惊。”

无症状传播的数量


没有咳嗽因素

的事实并不像流感或结核病那样是主要因素。

CA:是的,那
是病毒的狡猾。

我的意思是
,无症状传播

占总传播的百分比是多少?

我听说可能有
多达一半的

传播基本上是症状前的。

BG:是的,如果你算上症状前的症状,

那么大多数研究表明
这大约是 40%,

而且我们也从未出现过症状。

您在上呼吸道区域感染的病毒

量多少有些脱节。

有些人在这里会有很多东西,
而他们的肺里却很少,

而你在肺部得到的东西
会导致非常糟糕的症状——

以及其他器官,但主要是肺部

——所以这就是你寻求治疗的时候。

因此
,就传播而言,

最糟糕的情况
是上呼吸道感染很多

但肺部几乎没有感染的人,

所以他们没有就医。

CA:对。

因此,如果您将无症状者添加

到症状前,

您是否得到超过 50%

传播实际上来自无症状者?

BG:是的,
传输更难测量。

您知道,我们看到了某些
热点和事物,

但这是疫苗的一个大
问题:

除了避免
您生病

(试验将要测试的内容)之外,

它还会阻止
您成为传播者吗?

CA:所以疫苗,

这是一个非常重要的问题,
让我们来谈谈。

但是在我们去那里之前,

在过去的几个月里

,我们了解到这种病毒

是否真的会影响
我们应该如何应对它?

BG:我们仍然无法

根据个人资料来描述谁是超级传播者

,我们可能永远也不会。

这可能只是非常随机的。

如果你能识别出他们,

他们
是大部分传播的罪魁祸首,

少数人的
病毒载量非常高。

但遗憾的是,我们还没有弄清楚这一点。

这种传播方式,

如果你在一个房间里,没有人说话,

那么传播就会少很多。

这就是为什么,
虽然飞机可以传播,

但就时间接近度而言,它比您预期的要
少,

因为与
合唱团或餐厅不同,

您在大声说话时呼气的次数

不像在其他
室内环境中那样多 .

CA:嗯。

您如何
看待乘坐飞机

并拒绝戴口罩的人的道德规范?

BG:如果他们拥有这架飞机,
那很好。

如果飞机上有其他人,

那将危及
其他人。

CA:在大流行初期

,世界卫生组织没有
建议人们戴口罩。

他们担心把他们
从一线医疗提供者那里带走。

回想起来,这
是他们犯的一个可怕的错误吗?

BG:是的。

所有专家都
对口罩的价值感到难过——

这在某种程度上
与无症状者有关;

如果人们非常有症状,

比如埃博拉病毒,

那么你就知道它并隔离

,所以
你不需要像口罩一样的东西。

口罩的价值

,医用口罩

与普通口罩的供应链不同,普通

口罩可以很好地扩大规模

,它可以阻止
症状前的

传播,从没有症状的传播,

这是一个错误。

但这不是阴谋。

就是这样,我们现在知道的更多了。

即使是现在,我们
对口罩好处的误差线

也比我们想承认的要高,

但这是一个显着的好处。

CA:好的,我将向社区
提出一些问题

让我们把它们拉上去。

吉姆·皮托夫斯基(Jim Pitofsky),“您认为
美国的重新开放努力是否为时过早

,如果是,美国应该走多远
才能负责任地应对这一流行病?”

BG:嗯,
你如何在上学

的好处

与人们因为上学而生病的风险之间做出权衡的问题

这些都是非常棘手的问题

,我认为
任何人都没有 可以说,

“我会告诉你如何做出
所有这些权衡。”

了解
您在哪里传播,

以及年轻人
确实被感染

并且是多代
传播链的一部分这一事实,

我们应该把它弄清楚。

如果你只看健康方面,

我们已经开放得太自由了。

现在,在心理健康方面开放

并寻求
疫苗或其他护理等正常健康的东西

,是有好处的。

我认为我们的一些
开放带来的风险大于收益。 你知道

,像他们一样快地打开酒吧

,这
对心理健康至关重要吗?

也许不会。

所以我不认为我们
在开放方面有品位,

因为我确信,当我们研究它时

,我们会意识到一些
我们不应该这么快开放的事情。

但是你有像学校这样的东西

,即使今天坐在这里

,确切的计划,
比如说,秋季的市中心学校,

我不会对那里涉及的相对权衡有非黑即白的看法

让这些孩子上学有巨大的好处

,你如何权衡风险?

如果你在一个没有很多病例的城市,

我会说可能有好处。

现在这意味着
你可能会感到惊讶。

案件可能会出现,
然后你必须改变它,

这并不容易。

但我认为在美国各地,

会有一些
地方不能很好地权衡取舍。

因此,几乎任何方面的不平等,

这种疾病都会变得更糟:

工作类型、互联网连接、

学校进行在线学习的能力。

白领,

人们不好意思承认这一点,

他们中的一些人更有效率

,享受
在家创造的灵活性,

当你知道很多人
在很多方面都在受苦时,这感觉很糟糕,

包括他们的孩子 不去上学。

CA:确实。 让我们来回答下一个问题。

[Nathalie Munyampenda] “对我们卢旺达来说,

早期的政策干预
起到了重要作用。

在这一点上,
你现在建议美国采取哪些政策干预?”

比尔,我梦想有
一天你被任命

为冠状病毒沙皇

,有权实际
向公众讲话。

你会怎么做?

BG:嗯,创新工具

是我和基金会
最擅长的领域。

显然,一些
开放政策过于慷慨,

但我认为每个人都

可以参与。

我们需要领导

力来
承认我们在这里仍然存在一个巨大的问题,

而不是将其
变成几乎是政治上的

事情,“哦,我们所做的事情不是很棒吗?”

不,这不是很出色,

但是有很多人,
包括专家——

有很多
他们不明白

,每个人都希望提前一周
采取任何行动,

他们早在一周前就采取了。

创新工具,

这是基金会

在抗体、疫苗方面的工作,

我们拥有深厚的专业知识,

而且它不属于私营部门

,因此我们具有
与所有政府

和公司合作的中立能力。

特别是当你在做
盈亏平衡的产品时,

哪一个应该得到资源?

没有市场信号。

专家不得不说,“好吧,
这种抗体值得制造。

这种疫苗值得制造,”

因为我们
对这两种东西的制造非常有限,

而且它会是跨公司的,
这在正常情况下永远不会发生,

一家公司发明了它

,然后您使用
许多公司的制造工厂

来获得最佳选择的最大规模。

所以我会协调这些事情,

但我们需要一位
让我们跟上时代

、现实

并向我们展示正确行为

以及推动创新轨道的领导者。

CA:我的意思是,

在谈论这些事情时,你必须成为一名外交大师。

所以我很欣赏
这里的不适。

但我的意思是,你经常
与安东尼·福奇交谈,

在大多数人看来,他是一个明智的声音

但他在多大程度上只是腿筋?

在这种情况下,他不能发挥他可以发挥的全部作用。

BG:福奇博士出现
在他被允许有一些广播时间的地方

,尽管他说的
是现实的事情,但

他的声望已经停滞不前。

他可以这样说出来。

通常,CDC 将是
这里的主要声音。

这不是绝对必要的,

但在以前的健康危机中,

你让 CDC 内的专家

成为那个声音。

他们受过训练来做这些事情

,所以在这里
我们不得不依赖福奇

而不是疾病预防控制中心有点不寻常。

应该是福奇,
他是一位出色的研究人员

,经验丰富,尤其是在疫苗方面。

在某些方面,他已经
接受了广泛的建议

,即流行病学建议

并以正确的方式解释它

,他会承认,

“好吧,我们可能会在这里反弹

,这就是为什么我们需要
那样做 。”

但他的
声音被允许通过真是太棒了。

CA:有时。

让我们来回答下一个问题。

Nina Gregory,“假设你找到了疫苗,你
和你的基金会如何

解决关于
哪些国家首先接种疫苗的伦理问题

?”

也许,比尔,利用这个机会

来谈谈
对疫苗的追求在哪里,

以及我们在跟踪这方面的新闻时都应该考虑的一些关键事情。

BG:有三种疫苗,

如果它们有效的话,是最早的

:Moderna,不幸的是,它
不会很容易扩大规模,

所以如果有效,它将主要
针对美国。

然后你有来自牛津的阿斯利康;

和强生公司。

这就是早期的三个。

我们的动物数据

看起来可能不错,
但不确定,

特别是它是否适用于老年人

,我们将
在接下来的几个月内获得人类数据。

这三者将
通过安全性和有效性试验进行控制。

也就是说,我们将
能够制造这些,

尽管没有我们想要的那么多。

我们将能够
在今年年底之前生产这些产品。

第三阶段是否会成功

,是否会
在年底前完成,

我不会那么乐观。

第 3 阶段是您
需要真正了解所有安全性

和有效性的阶段,

但这些都将开始。

然后有四到五种
使用不同方法

的疫苗可能
比这晚了三到四个月:

Novavax、赛诺菲、默克。

因此,我们正在
为其中的许多工厂产能提供资金——

一些复杂的谈判
正在就此展开

——让工厂专门
用于较贫穷的国家,也

就是所谓的低收入和中等收入国家。

包括阿斯利康(AstraZeneca)
和强生(Johnson and Johnson)在内的可扩展性非常强的结构,

我们将专注于

那些价格低廉的结构

,您可以建立一个工厂
来生产 6 亿剂。

因此,许多疫苗结构

是有潜力的。 在年底之前

我什么都看不到

这确实是最好的情况

,现在可以归结为一些结构

,通常情况下,您的
故障率很高。

CA:比尔

,如果你和你的
基金会不在这幅画

中,市场动态可能会
导致这样一种

情况,即一旦出现有希望的
候选疫苗,

较富裕的国家
基本上会抢购,狼吞虎咽。 增加

所有可用的初始供应——制造

这些只需要一段
时间,

对于较贫穷的国家来说没有任何

东西——但是,实际上,你

通过向其中一些候选人提供制造
保证和能力所做的事情

你 是否有可能
至少一些早期的疫苗单位

将流向较贫穷的国家?

那是对的吗?

BG:嗯,不只是我们,但是,是的,

我们在那里发挥核心作用,

与我们创建的一个名为 CEPI 的小组一起,
流行病防范联盟

,欧洲领导人同意这一点。

现在我们有专业知识
来查看每个结构

并说,“好吧,
世界上哪里有工厂

有能力建造它

?我们应该
把早期的钱投到哪一个?

里程碑应该

在哪里? 我们会把
钱转到另一个地方吗?”

因为真正了解这些东西的那种私营部门的

人,

他们中的一些人为我们工作,

而且我们在这些事情上是值得信赖的一方,

我们可以协调很多事情,
尤其是制造环节。

通常,您会期望
美国将此视为一个全球性问题

并参与其中。

到目前为止,还没有
在这方面开展任何活动。

我正在与国会
和政府的人们

讨论下一个
救济法案何时出台

,也许其中的百分之一
可以

用于帮助整个世界的工具。

所以这是可能的,

但很不幸

,这里的真空

,世界已经不是以前那样了

,很多人正在介入,
包括我们的基金会,

试图制定一个战略,

包括针对较贫穷国家的战略,

谁会 遭受高比例
的死亡和负面影响,

包括他们的卫生
系统不堪重负。

尽管我们在欧洲和美国看到了大量死亡病例,但大多数死亡病例将发生在发展中国家

CA:我的意思是,我希望
我能成为墙上的苍蝇

,听到你和梅琳达
谈论这件事,

因为所有道德……
“罪行”,比如说,


应该更了解的领导人执行,

我的意思是 ,
不戴口罩是一回事,

而是

在面对共同的敌人时不扮演帮助世界的角色,

作为一个人类做出回应

,而是……

你知道,催化国家之间真正不合时宜的
争夺

战 以疫苗为例。

这似乎——当然,
历史会严厉地评判这一点。

这简直令人作呕。

不是吗? 我错过了什么吗?

BG:嗯,它
不像那样黑白分明。

迄今为止,美国

在这些疫苗的基础研究上投入

的资金比任何国家都多,

而且这项研究不受限制。

没有,比如,一些皇室成员
会说,“嘿,如果你拿了我们的钱,

你就必须向美国支付版税。”

他们这样做,就他们资助研究的程度而言,

这是为每个人准备的。

就他们为工厂提供资金的程度而言,
这只是为了美国。

让这件事变得艰难的是,
在所有其他全球健康问题上

,美国完全领导根除天花

,美国完全是
根除脊髓灰质炎的领导者,

与关键合作伙伴——疾病预防控制中心、世卫组织、
扶轮社、联合国儿童基金会和我们的基金会一起。

所以这个世界——在艾滋病毒方面,

在布什总统的领导下,
但它是两党合作的,

这个叫做 PEPFAR 的东西令人难以置信。

这挽救了数以千万计的生命。

所以世界
总是期望

美国至少在财务上、战略上处于领先地位

,好吧,你如何
为世界获得这些工厂,

即使只是为了避免
感染回到美国

或者让全球经济运转起来,

这有利于美国的工作

在美国以外有需求。

所以这个世界有点——

你知道,关于哪件事情会奏效的所有这些不确定性

,就是这样,
“好吧,谁在这里负责?”

所以最糟糕的事情
是退出世卫组织,

这是一个
希望

在某个时候得到纠正的困难,

因为我们需要

通过世卫组织进行协调。

CA:让我们再问一个问题。

Ali Kashani,“您在世界各地看到过哪些
特别成功

的应对流行病
的模式?”

BG:嗯,令人着迷的是,
除了早期行动之外,

肯定有一些事情是
你让检测呈阳性

的人监测他们的脉搏,

这是他们血液中的氧饱和度
水平,

这是一个非常便宜的检测器,

然后 你知道要早点把他们
送到医院。

奇怪的是,病人不知道
事情会变得很严重。

这是一个有趣的生理原因
,我不会进入。

所以德国的
病死率很低

,他们通过
这种监测完成了。

然后,当然,
一旦您进入设施,

我们就了解到,
实际上,呼吸机虽然非常好意,

但实际上在早期被
过度使用并以错误的方式使用

所以健康——今天的医生
在治疗方面要聪明得多。

我想说,其中大部分是全球性的。

使用这种脉搏牛作为早期指标,

这可能会广泛流行,

但德国是那里的先驱。

现在,当然,地塞米松——
幸运的是,它很便宜,是口服的,

我们可以增加生产。

这也将走向全球。

CA:比尔,我想问你
一些

关于你个人
在整个过程中的感受。

因为,奇怪的是,即使
你对这个话题的热情和良好的意图

对于任何
与你共度过片刻的人来说都是非常明显的,

但仍有这些
关于你的疯狂阴谋论。

我刚刚
联系了一家名为 Zignal 的公司,该公司

监控社交媒体空间。

他们说,迄今为止,
我认为仅在 Facebook 上,

就有超过 400 万个帖子

将你与某种
围绕病毒的阴谋论联系起来。

我读到有一项民意调查
显示,超过 40% 的共和党人

认为,你将推出的疫苗

会以某种方式在人们体内植入一个微芯片
来跟踪他们的位置。

我的意思是,我什至无法相信
这个投票数字。

然后有些人
对此足够认真,

其中一些甚至
在“福克斯新闻”等上重新传播,

有些人
认真到

足以做出非常可怕的
威胁等等。

你似乎做得很好,
有点耸耸肩,

但真的,像,还有谁
曾担任过这个职位?

你是如何管理这个的?

我们到底是什么世界

,这种错误信息
可能存在?

我们能做些什么来帮助纠正它?

BG:我不确定。

有阴谋论是一件新鲜事。

我的意思是,微软
也有争议,

但至少
与现实世界有关,你知道吗?

Windows 崩溃的次数是否超出了应有的程度?

我们肯定有反垄断问题。

但至少我知道那是什么。

当这种情况出现时,我不得不说,

我的直觉是拿它开玩笑。

人家说
这很不合适,

因为这是一件很严肃的事情。

这将使人们
不太愿意接种疫苗。

当然,一旦我们有了这种疫苗,

它就会像口罩

一样吸引很多人,

特别是当它是
一种阻止传播的疫苗时

,广泛采用这种疫苗会给社区带来巨大的

好处。

所以我有点被抓住了,

不知道该说什么或做什么,

因为阴谋片
对我来说是新事物

,你

说什么不相信这件事?

事实上,“福克斯新闻”
评论员劳拉·英格拉汉姆(Laura Ingraham)

说我给人们植入微芯片,

这项调查并不令人惊讶,
因为这是他们

在电视上听到的。

这是野生的。

人们显然在寻求比研究病毒学
更简单的解释

CA:我的意思是,

TED 是非政治性的,

但我们相信真理。

我会这样说:

劳拉·英格拉汉姆,你欠比尔·盖茨
一个道歉和撤回。

你做。

任何在看这个的

人,如果有片刻认为这个
人参与了某种阴谋,

你需要检查一下你的脑袋。

你疯了。

多年来,我们中足够多的人认识比尔,

并且看到了对此的热情
和参与,

知道你疯了。

所以克服它

,让我们看看
解决这一流行病的实际问题。

诚实地。

如果这里聊天中的任何人
有一个建议,

一个积极的建议,关于你

如何做,你如何摆脱阴谋,

因为他们互相依赖。

现在,“哦,我会这么说,
因为我是阴谋的一部分,”

或其他什么。

比如,我们如何回到一个

信息可以信任的世界?

我们必须在这方面做得更好。 社区

还有其他问题
吗?

来自纽约市的 Aria Bendix:


对于那些希望

在病例增加的情况下降低感染风险的人,您有什么个人建议?”

BG:嗯,如果你有一份工作

,你可以呆在家里
,通过数字会议

甚至你的一些社交活动来完成,

那就太好了,你知道,我
和很多朋友进行视频通话。

我在欧洲有朋友,
谁知道我什么时候能见到他们,

但我们会安排定期电话交谈。

如果你保持相当孤立,

你就不会冒太大风险,

而当你

通过工作或社交与许多其他人聚在一起时

,就会增加这种风险

,尤其是在这些
病例增加的社区,

即使不会强制执行,但

希望流动性数据
能够显示人们的反应

并最大限度地减少
这种户外接触。

CA:比尔,我想知道我能不能问

你一些关于慈善事业的问题。

显然,您的基金会
在这方面发挥了巨大的作用,

但更普遍的是慈善事业。

你知道,你发起了
这场捐赠誓言运动,

招募了

所有承诺在死前或死后捐出
一半净资产的亿万富翁

但这真的很难做到。

真的很难捐出
这么多钱。

你自己,我想,

自从“捐赠誓言”开始以来——

什么? 10 年前或什么时候,
我不确定什么时候——

但我认为,尽管你是世界领先的慈善家,但你自己的净资产
自那个时期以来已经翻了一番

有效地捐钱

让世界变得更美好从根本上来说很难吗?

或者世界上的捐赠者

,尤其是世界上
真正富有的捐赠者,是否应该

开始几乎承诺一个时间表,

例如,“这
是我每年净资产

的百分比,随着我年龄的增长,

可能会上升。

如果我 为了认真对待这件事,

我必须放弃——不知何故,
我必须找到一种

有效地做到这一点的方法。”

这是一个不公平和疯狂的问题吗?

BG:嗯,提高利率会很好

,我们的目标,无论是作为盖茨基金会
还是通过捐赠誓言,

都是帮助人们找到
他们联系的原因。

人们通过热情给予。

是的,数字很重要,

但那里有很多原因。

你要选择的方式
是你看到有人生病,

你看到有人没有
得到社会服务。

你看到
一些有助于减少种族主义的东西。

你非常热情
,所以你为此付出。

而且,当然,

一些慈善礼物是行不通的。

我们确实需要提高慈善家的抱负水平

现在

,你正在
通过 Audacious 帮助促进合作慈善事业,

还有四五个其他
团体正在将慈善家聚集在一起,

这太棒了,

因为他们互相学习,

互相信任,

他们觉得,” 嘿,我投了 x
,其他四个人投了钱,

所以我的影响力更大了,

”希望
即使他们发现,

好吧,那个特别的礼物
没有用,也能取笑他们 很好,

但让我们继续前进。

所以慈善事业,是的,

我希望看到比率上升,

而那些开始行动的人,

很有趣,

很充实,

你可以选择哪个家庭
成员合作去做。

就我而言,梅琳达和我
喜欢一起做这些事情,

一起学习。

有些家庭,它甚至
会让孩子参与活动。

有时孩子们在推。

当你有很多钱时,

你仍然认为一百万美元
是很多钱,

但如果你有几十亿,

你应该给几亿。

因此
,就您的个人支出而言,

您保持在以前的水平,这有点迷人。

这在社会上是非常合适的。

但是在您的捐赠方面,您需要扩大规模,

否则它将成为您的意愿

,您将无法以
同样的方式塑造和享受它。

所以没有 -

我们不想强制它,

但是是的,你和我
都想激励

慈善家看到这种激情
,看到这些机会

比过去快得多,

因为无论是种族还是疾病,
或者所有 其他的社会弊病,

慈善事业的创新
可以去并迅速

做到,如果有效,政府
可以介入并扩大规模,

上帝知道我们需要解决方案,

我们需要期望的那种希望和进步

,将解决非常棘手的问题。

CA:我的意思是,大多数慈善家,
即使是最优秀的慈善家,也

很难每年捐出超过
1% 的净资产

,但世界上最富有的人
往往能够

获得巨大的投资机会。

他们中的许多人正
以每年 7% 到 10% 以上的速度获得财富。

是不是
真的有

机会捐出你一半的财富,

在某个时候你必须计划
每年捐出

你净资产的 5%、6%、7%、8%、10%?

也就是说,这不
就是应该发生的事情的逻辑吗?

BG:是的,有
像查克·菲尼这样的人,

他树立了一个很好的榜样
,把他所有的钱都捐了出去。

甚至梅琳达和我都在谈论,
我们应该提高我们付出的速度吗?

正如你所说,我们
在投资方面非常幸运,

经历了各种各样的事情。

总体而言,即使在今年,科技股也表现不错,

这是世界上

正在发生的事情的巨大反差之一。

而且我确实
认为我们应该加快速度,

并且有理由加快速度

,政府
将错过很多需求。

是的,那里有大量的政府
资金,

但帮助它花得好,

帮助找到它没有加紧的地方

,如果人们愿意
为发展中国家捐款,

他们没有

政府可以打印
15% 的支票 国内生产总值

,因此,除了大流行之外,仅经济方面的痛苦,就广泛
而言

是悲惨的。

就这些国家的前进而言,这大约是五年的挫折

在少数情况下,这已经足够艰难,
以至于该国的稳定性

受到质疑。

CA:嗯,比尔,

我对
你和梅琳达的所作所为感到敬畏。

你走在这条狭窄的道路

上,试图兼顾
这么多不同的事情

,你
为改善整个世界

所付出的时间,当然还有

你投入的金钱和热情——

我的意思是 ,太棒了

,我真的很感谢你
现在和我们一起度过这段时间。

非常感谢

,老实说,今年剩下的时间里,

你的技能和资源
将比以往任何时候都更需要

,祝你好运。

BG:好的,谢谢。

这是有趣的工作,我很乐观,
所以谢谢,克里斯。