Monday, Nov 16, 2020 • 43min
EP 1: What will the world look like after COVID-19?
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Ever since the pandemic started, we’ve heard the same refrain: we need to get back to normal. But what does “normal” even mean after such a history-changing event? Bill and Rashida discuss how COVID-19 will forever change our workplaces, our schools, and even our social lives. They also get real with NIAID director Dr. Anthony Fauci about what we can expect in the months ahead.
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Speakers
(3)
Bill Gates
Rashida Jones
Anthony Fauci
Transcript
Verified
Rashida Jones
00:00
Hi, I'm
Rashida Jones
and I consider myself a pretty rational person most of the time. And I really try not to be an alarmist, but I have to say that I've become increasingly worried about the state of the world and about the future. And every day to me it seems to be getting a little worse.Share
Bill Gates
00:17
Hi, I'm
Bill Gates
, and I actually think things will be all right.Share
Rashida Jones
00:22
You do?
Share
Bill Gates
00:23
I do. But I'm an optimist.
Share
Rashida Jones
00:26
Yeah, I don't think I am. But let's talk.
Share
00:32
[Talk - Khalid]
Share
Rashida Jones
00:34
So, today we're going to talk about the big question around
Covid
. In this country alone, we've seen a quarter of a million deaths and the infection rates are still spiking.Share
Bill Gates
00:53
You know, these are big numbers. If we get a vaccine soon enough, then you know, maybe we'll have less than a doubling in the total number of deaths. I have to say the economic damage is worse than I expected. And even once we get done, we're going to have a lot of ketchup on schooling and mental health.
Share
Rashida Jones
01:16
But there is some room for hope, right? Vaccines have gone to trial faster than ever before.
Share
Bill Gates
01:23
That's the only very positive thing that we can look forward to, is the likelihood of many of these vaccines working is actually pretty high.
Share
Rashida Jones
01:36
So that leads me to the big question. And I've heard you answer so many questions on
Covid
and you've helped me to sort of understand the science of it and what it 's going to take us to get out of this. So, recently we've been hearing a lot about this potentially effective vaccine that might be available soon. So it feels like the right time to talk about what life might look like after Covid
.Share
01:60
For those of us who are lucky enough to survive this, and if we haven't lost loved ones or the place we work, we can start to imagine and hope for a time when this horrible pandemic is over. So, let me ask you,
Bill
, when we get the vaccine and everybody's taking it and things go back to normal, what is the first thing you're going to do?Share
Bill Gates
02:19
You know, there's some people that it would be so nice to see, you know? We do a lot of our foundation work with
Bono
and he's always very affectionate and energetic. And there s some people who on video just aren't as... the emotional connection isn't as strong.Share
Rashida Jones
02:37
You're gonna go hug Bono, that's the first thing you're gonna do.
Share
Bill Gates
02:39
Absolutely, he's gonna be surprised.
Share
Rashida Jones
02:42
What is life gonna be like after
Covid
? Do you think that there's any possibility that we will be like East Asian countries and wear masks when we feel sick or when there's, you know, there's a particular threat? Is there any version of that?Share
Bill Gates
02:58
I don't know. In
Japan
, you know, when you ride the subway, people wear masks. But of course, they're crowded together in Japan,
has a thing about cleanliness. I don't know if that will spread. It was certainly easier to tell Asians to wear masks than it was to tell Americans or Europeans.Share
Rashida Jones
03:17
We just have no precedents.
Share
Bill Gates
03:19
Well, except when we're robbing a bank or something.
Share
Rashida Jones
03:22
What? Do you want to tell me about your past?
Share
Bill Gates
03:24
No, no. Just in the movies, it looks like. And it's nice, people don't recognize me quite as much when I'm wearing a mask.
Share
Rashida Jones
03:32
Yeah, well, that is one of the benefits. So what do you think in terms of like meetings on Zoom, and, you know, people are educating at home. I, for one, don't want to get in my car and go across town for a meeting to meeting and I hope that I can continue to do that online. But do you think any of these things will stick?
Share
Bill Gates
03:50
I think just like World War II brought women into the workforce and a lot of that stayed, this idea "do I need to go there physically", we're now allowed to ask that. If a salesperson is going to a customer, if they said, "oh, I just want to stay at home today, so I'll be on your screen", you would have thought: "hey, they don't really care about connecting with me".
Share
04:17
And so, for the first time, the idea of learning or having a doctor's appointment, or a sales call where it's just screen-based with something like Zoom or,
Microsoft
makes Teams, which competes with Zoom, but anyway - great competition- and I think that will change dramatically.Share
04:47
I think people will go to the office less. You can even share offices with a company that has its employees coming in on different days than your employees are coming in. So even the whole idea of the downtown and traffic and where you can live or designing your house to make it great to be able to-
Share
Rashida Jones
05:08
You think all of that will change because of what's happening right now?
Share
Bill Gates
05:11
Yes, and pretty dramatically. And of course, the software was kind of clunky when this all started. But now people are using it so much, people will be surprised by how quickly will innovate with the software.
Share
Rashida Jones
05:25
So, I believe that human connection is important. I mean, obviously there're some things we can sacrifice, there're some things we don't. I don't feel comfortable going to restaurants and movies yet. When do you think will be normal again, where we don't feel scared to sit at a restaurant or it feels actually relaxing to go to a movie?
Share
Bill Gates
05:45
There's a phase where we're going to have the numbers be super low in
the United States
, but it will still be out in other parts of the world, so you could get a resurgence. And I think a lot of people will remain quite conservative in their behavior, particularly if they associate with older people whose risk of being very sick is quite high. If we get it, so it's eliminated from the entire globe.Share
06:17
Then people are going to start to give you a hard time. Hey
Rashida
, we're here at the restaurant, you know, not yet down here, but if it's still out in the world, you know, even the countries that have very little virus are mostly still being very careful about public events, because it could get into their country.Share
Rashida Jones
06:40
Well, I think we can't continue to have this conversation without talking to an incredibly knowledgeable person. This is a person who if you had to guess if he or I had been on the cover of In Style magazine, I would bet all of my Bitcoin that you would guess wrong. But they made the right choice, because Dr.
Anthony Fauci
is responsible for 2020's most important fashion trend, I think, which is masks. So we have Dr. Fauci
with us here today.Share
Anthony Fauci
07:11
Hi Rashida, hi
Bill
.Share
Bill Gates
07:11
Hey
Tony
, how are you?Share
Anthony Fauci
07:13
I'm very well, I know
Bill
well, yes.Share
Bill Gates
07:15
I can't believe how busy you are,
Tony,
you seem to be everywhere. How are you dealing with it?Share
Anthony Fauci
07:21
It's not easy
Bill
, really. It's just so many things going on that you have to do, and it's just they overlap with each other, it's kind of stressful. But you know, as you and I have discussed in the past, you kind of just dig deep, suck it up and do itShare
Rashida Jones
07:37
Bill
and I've been talking about life getting back to normal, and it feels hard to imagine right now, but can we expect any breakthroughs in testing or treatments?Share
Anthony Fauci
07:48
We have good therapies for people with advanced disease, you know, not spectacular, but good enough to prevent deaths and to diminish the time in the hospital. What we don't have a lot of is something you can give to someone early in the course of infection to prevent them from getting to the hospital.
Share
08:07
This is important not only, for example, in
the United States
and in the developed world, also in the developing world where you don't have the hospital capabilities of taking care of somebody who gets seriously ill. So if you could prevent them from getting into the hospital by treating them early, I think they might be a game changer.Share
Rashida Jones
08:29
And is that something that is being developed?
Share
Anthony Fauci
08:31
Oh yes, very actively right now, there are multiple clinical trials in hospitalized patients, in patients as out patients, in nursing homes. And even a very interesting study in families, in which one member of the family is infected, and you give it to all the members to see if you can prevent what we call household spread.
Share
Rashida Jones
08:53
Is there a universe in which that is so readily available that until we get the vaccine where everybody's kind of taking that if they have exposure?
Share
Anthony Fauci
09:03
Well, that's not gonna happen. That's not gonna happen because a from a pure expense standpoint that's going to be very difficult. But also the quantity of it that would be available for the widespread use is also problematic.
Share
Rashida Jones
09:18
Right. And what about the people who don't get sick, who hopefully don't get sick? I mean, what is this winter going to look like? You know, once weather becomes an issue, what kind of precautions are we going to need to take?
Share
Anthony Fauci
09:31
Well, I think we're going to have to double down on the things that we've been talking about all along, the universal use of masks, physical distancing, avoiding crowds, doing things if possible. I know it's tougher in the winter, but if possible in an outdoor setting versus an indoor setting, and washing your hands frequently.
Share
09:50
I'm actually concerned as we enter the cooler months of the fall and the colder months of the winter, because our baseline of daily infections is indicative of a good degree of community spread that's already here existing.
Share
10:06
So you go into the winter, you would like to have as low a level of infection as possible so that you're starting off in a problematic situation at least without having your hand tied behind your back.
Share
Rashida Jones
10:20
So there 's got to be a magic number. I know that you were talking about
Vermont
has a very low infection transmission rate right now, that kind of thing. Going into like a cold Vermont
winter, is the goal to keep that rate or to have the growth slow?Share
Anthony Fauci
10:36
Well, if you have a low test positivity is what they refer to, namely the number test you do what percent are positive, when you get an intermittent infection, which you inevitably will, it's going to be no place is going to be zero infections during the winter, there will be infections.
Share
10:54
If you have a low level of infection in the community. And when you get these little blips, you can contain them much more easily by identification isolation and contact tracing. When you have such a high level of community spread, it becomes very difficult to do that.
Share
Rashida Jones
11:12
Right, okay. So you said identification, isolation and contact tracing. Okay. And this is just something I kind of want to know for myself. But do you think it's worth getting the flu shot? How does the flu play into this season?
Share
Anthony Fauci
11:26
Well, it's more than worth getting it, it's essential to get the flu shot. I mean, everyone six months of age or older should get the flu shot this year.
Share
Bill Gates
11:35
Yeah, I totally agree with that, I just got mine. People will look back and if this is a very low flu season, you know, give us a hard time. But the cost of the flu shot is so low that we've got to drive compliance as high as ever, even though it might be a very mild flu season.
Share
Anthony Fauci
11:53
Absolutely, absolutely,
Bill
is totally correct. The one of the things that I'm concerned of is our Australian colleagues in the Southern Hemisphere. They had their winter from April to the end of August, and they did well by wearing masks and doing the things that we're speaking of.Share
12:12
And by doing that, not only did they bring the level of
Covid
down, but they had almost a non-existent flu season, because the things that prevent COVID-19
prevent flu. What you don't want is people to say: oh, therefore I don't need to get vaccinated. No, you want to do both.Share
Rashida Jones
12:31
So what do you think is important about the public's trust in a vaccine, once we have a vaccine in terms of distribution?
Share
Anthony Fauci
12:40
Yeah, we're not in a good place there,
Rashida,
because there is a baseline level of anti-vaccination in the country that goes back before COVID-19
and relates to the measles, mumps, rubella and those types of attitudes about which are not based on science, that are just based on falsified data.Share
13:04
So we have a task on our hands. We have got to reach out in a very strong way to the community, to be transparent with them. And when I say reach out, I mean engage the community with people that the community trusts. This is particularly true of the minority populations because of the historical understanding of the mistrust that African Americans and to some extent Latinxs have about the federal government.
Share
13:33
It dates back to historic shameful things that have happened, but they are very skeptical about getting vaccinated. So, you know, you have a scientific task of developing a safe and effective vaccine, and you have a PR task of making sure people understand why it's important for them and their families to get vaccinated.
Share
Bill Gates
13:55
I think the positive thing is if you get 30 or 40% of the population that's willing, and then the rest of the population sees that those people didn't have side effects, that in fact they will come along and we'll get up to the high percentage, probably over 70%, that we'd eventually like to vaccinate to have transmission exponentially decline instead of go up.
Share
14:21
Are you worried about the fact that the military has been pulled into this delivery process and people perceiving that in a strange way,
Tony
?Share
Anthony Fauci
14:31
Yeah
, Bill
, I think you make a good point. I've heard that, multiple times, that people don't fully appreciate what the military is doing in this. And it's really simple. It's a logistic challenge to get supply chain, particularly when you need a cold chain. Some of the vaccines require very stringent requirements for temperature control, very, very low temperatures.Share
14:58
So when this process called Operation Warp Speed came about, it had two elements to it. One scientific, which is led by a former head of a pharmaceutical company who makes vaccines
, Moncef Slaoui,
used to be with GlaxoSmithKline
.Share
15:14
And then because this is a collaborative effort with the Department Of Defense, the Department Of Defense came in and got us their chief logistics supply chain person, who has great experience and talent and moving things from place to place, tanks and planes and things like that.
Share
15:32
So he's gotten involved in helping out in the supply chain and the availability. The military is not going to be making the vaccine, they're not going to be administering the vaccine. Yet when people hear military, they immediately think it's another conspiracy when in fact it's not.
Share
Rashida Jones
15:48
It's just about efficiency and getting it to as many people as possible.
Share
Anthony Fauci
15:52
That's exactly what it is.
Share
Rashida Jones
15:53
So let's play this out. So I get an alert on my phone, "a vaccine has been approved". What happens? Talk us through the process.
Share
Anthony Fauci
16:02
Well, if a vaccine is approved to be safe and effective, then you have to have the availability of the doses, 'cause you're not gonna... there are 330 approximately million people in the country. So, most of the vaccines are prime and boost. One of them is just a single dose, but most of them are prime boost.
Share
Rashida Jones
16:21
Prime and boost, that's two doses?
Share
Anthony Fauci
16:23
Two doses. So you're going to need two doses. So you need around 700 million doses, approximately. So, you're not going to get 700 million doses the day that the vaccine has been shown to be safe and effective. So what happens is that there have been groups that have actually been tested with making what's called prioritization of who should get it in the 1st, 2nd, 3rd, 4th and 5th.
Share
Rashida Jones
16:50
What's... who are they? Who gets it first?
Share
Anthony Fauci
16:53
Yeah, it hasn't been officially determined yet. Usually healthcare providers, those who put themselves in harm's way of taking care of people. Then there are those who have underlying conditions, the elderly with underlying conditions, particularly, that we know lead to an adverse outcome.
Share
17:12
Then people who are essential workers in society to make society work well, and then you have older people who may not have underlying conditions but just are risky because they're elderly. Then you get students, and then you get everybody else. So there's five layers. That isn't a definitive one yet, they haven't fully decided. But if they do it the way they've done it in the past, that's the way it will be.
Share
Bill Gates
17:36
But the thing I'm not seen yet. I can imagine having a website that you would go to, and you would enter in the various data, and it would give you sort of a priority code tell you: okay, there's a drive through site five miles away that you should go on a particular day.
Share
17:55
Until we get that website to kind of register the data and give people feedback about their priority, to me it's pretty vague how the recruitment is going to go on. I would think CDC would put up that website fairly soon.
Share
Anthony Fauci
18:13
Yeah, I hope so,
Bill
. I mean, you make a very good point. Theoretically. It all sounds great until you say how are you going to make it happen?Share
Bill Gates
18:20
Yeah, even with the diagnostic we made a strong pitch to the CDC that they should have a website, and that therefore only the, you know, inner city communities would get equal access, and you wouldn't ever overload the test provider so that you were taking more than 24 hours to get the results back, because you were using prioritization anyway. I'm a little worried that that may never happen or won't happen this year.
Share
Rashida Jones
18:49
I'm also concerned that people would be... if they're fearful about a vaccine, they'd be fearful to just give up their information to then be in line for a vaccine. Because I think there has to be some sort of like proof positive where somebody takes it, a group of people take it and then in taking it, they survive, and they're safer and they're healthier, and that's going to encourage other people which might make the whole process longer, right?
Share
Bill Gates
19:11
I think there are 30% who get that it's not just beneficial to yourself, it's beneficial to everyone around you. We won't know how good of a transmission block or the vaccine is for a while, but we'll have a sense, and you know we're hopeful that along with protecting you from getting sick, that it reduces the number of superspreaders, and reduces the transmission quite a bit.
Share
19:35
There are some vaccines for other diseases that are fantastic at blocking transmission. For this one, we're going to be learning even for a few months after we get the vaccine out exactly how strong that characteristic is. Some of the vaccines may be better at that than others. Which, that'll be confusing.
Share
Rashida Jones
19:57
So, one is gonna win? Like, one person's gonna- No. Okay.
Share
Anthony Fauci
20:01
No, no, no, no. In fact, the plan is that we have more than one winners. The reason you want to get so many companies in is because you can't think provincially only about us. This is a global pandemic, you know?
Share
20:17
And this
Bill
has been one of the great exposés of that, and I've followed him in that and learned by his example about that, that we really have a responsibility to the global community. We, not only the United States,
but all of the countries that are wealthy countries, to get as many players in as possible, so that you could actually get enough vaccine for anyone and everyone who needs it.Share
20:41
If you only have one winner there, they're not gonna make it. I want to see four winners. Five winners. There are eleven vaccines in advanced trial now, five of them are already in phase three trial in
the United States
. And the other thing that I think we alluded to just a few moments ago is that there may be one vaccine that seems to work better in the elderly than in the young, and one may work better in children than it works in the elderly.Share
21:05
So when you learn that, and it will take some time to learn that, then you might have, you know, more of a selective distribution depending upon the demographic group.
Share
Bill Gates
21:15
One thing I wanted to ask
Dr. Fauci
is, once we get the US, I mean, assume a vaccine gets approved, which you and I are quite hopeful for early next year, and assume we get pretty broad vaccination in the US and the numbers go down a lot.Share
21:31
If we have the disease elsewhere in the world, you know, it's not clear to me we can go back and do big sports events or open up the bars, because you know like
Australia
or South Korea,
the risk of reinfection will be looming out there. And so as long as it's in the world, I'm not sure we'll be completely back to normal.Share
Anthony Fauci
21:55
I totally agree. I mean, but I think it even gets more complicated than that. Because if you have a vaccine, you know, that's 99% effective and 99% of the people take it, then you're in really good shape. But that is not gonna happen,
Rashida
, I can assure you, that's not gonna happen. So if you get 75% effective and 69% of the people take the vaccine, you still have a lot of infection that has the capability of spreading.Share
22:23
And as
Bill
said that means that what we're gonna likely be, and that's what people ask me the question all the time, when are we going to actually get back to normal? Well, I don't think it's gonna be for a while, but I think we're going to get closer and closer to normal, namely a combination of the protective effect of the vaccine and a moderate degree of public health measures.Share
22:48
I don't mean lockdown. I mean you wear a mask when you're in a crowded situation, you maybe have theaters or sports events that you don't fill it too full capacity but you at least have Spectators. That 's a big difference than essentially shutting everything down.
Share
Rashida Jones
23:04
Right. Now, I know you guys agree on a lot of things about this, and you've talked about this a lot. Is there anything you disagree on when it comes to?
Share
Bill Gates
23:12
I don't think so.
Share
Rashida Jones
23:16
Philosophically? Anything else?
Share
Bill Gates
23:17
No, we're both very enthused that the antibodies might reduce the death rate. You know, in the next few months we'll learn a lot more about that. We're both enthused about how the vaccine companies have stepped up.
Share
23:31
You know, it's amazing, and the
US
actually, in that area has been the leader in funding the research, which will be a benefit to the entire world. You know, so it seems weird in a very tough time, but I think we're both along with the seriousness of the precautionary measures. We're both trying to deliver a bit of a hopeful message about the tools that are coming along.Share
Rashida Jones
23:56
Dr. Fauci
, I know you're a very busy man. I'm so happy that you gave us some time today. What's the kind of final word, as we approach vaccine, as people try to live life. Can you just give us the couple of things that the general public need to abide by to make for a safer quicker recovery?Share
Anthony Fauci
24:17
Yeah, it gets it gets back to what I said early o, and I repeated it so much,
Rashida,
that sometimes I think people get bored with.Share
Rashida Jones
24:26
You have to know it's not boring, you gotta keep doing it.
Share
Anthony Fauci
24:29
You've really, you know, you absolutely got to do things that sounds so simple that people think that maybe not relevant. But wearing a mask, keeping a distance, avoiding crowds, being outdoors as much as you possibly can, weather permitted, and washing your hands.
Share
24:46
We have seen what happens when you don't do that by the very unfortunate experiences that have become very public now in
the United States
. So, I mean, that's proof positive. The other message that I like to give to people, because one of the things we're dealing with, is a degree of essentially fatigue that people have about going through this.Share
25:09
You know, we've been, it's amazing. You know, it's almost like a distortion of time,
Rashida
. I mean, I want to tell people: don't give up. This is going to end. Science is going to help us with the vaccine and therapy, and if we pay attention to the public health measures, we can gain control of it. The thing you don't want to happen is that people said, I've done this so long. I'm tired of it, the heck with it. I'm just gonna go out there and do what I want to do. That would only make this be more prolonged than it would end it, right?Share
Rashida Jones
25:43
This is not gonna end organically, it's up to us.
Share
Anthony Fauci
25:47
It's not going to spontaneously go away. I think that's what we need to understand. It's not gonna spontaneously go away.
Share
Rashida Jones
25:53
So wash your hands, wear masks, stay away from crowds, believe in science and stay at the course, right.
Share
Speaker 5
26:02
Exactly.
Share
Rashida Jones
26:03
Thank you so much.
Dr. Fauci
, it's a pleasure to talk to you today.Share
Bill Gates
26:07
Great to talk to you,
Tony
.Share
Anthony Fauci
26:09
Thank you,
Bill
, it 's great to be with you. Bill
and I, we do this without the microphones. Every couple of weeks we touch bases and compare notes and learn from each other. So it's great to see you Bill
. And thanks Rashida
, appreciate it.Share
Bill Gates
26:22
You bet.
Share
Rashida Jones
26:23
Thank you.
Share
26:27
Wow. It really was nice to hear directly from
Dr. Fauci
. I always feel like he is so direct, and he has all the information. He's so humble about pivoting when he needs to and he gets new information and he shares it with the American public. Is it weird for you to see him kind of hit this international stage?Share
Bill Gates
26:46
Absolutely. You know, if somebody said: hey, there's a guy that you hang out with, who is going to be a rock star. He might have been the last person I would name, but he stepped up!
Share
Rashida Jones
27:00
Yes. So how important is he in this process?
Share
Bill Gates
27:03
Well, he's very important because people want sanity.
Share
Rashida Jones
27:07
I just wanted to ask. Personally, how has your life changed during this lockdown, and you take precautions? Are you careful not to get it? Like, what are your parameters right now?
Share
Bill Gates
27:18
Well, I haven't been to the foundation office or on a business trip since early March and most of my time would have been going on business trips, doing a lot of conferences about the various diseases and raising money for helping the developing countries and sitting in the office together with colleagues. And so my life has changed utterly. I'm kind of embarrassed to admit there's parts that I kind of like.
Share
Rashida Jones
27:48
What do you like about it?
Share
Bill Gates
27:49
Well, it's a simpler schedule. You know, if I do drive somewhere, there's no traffic. Business trips, even though I'm one of these macho people who says, okay, I'll get on the plane and go see those guys, that is disruptive to your being thoughtful, getting reading done, you know, your sleep gets disrupted.
Share
Rashida Jones
28:10
Have you read more since I've read more since lockdown?
Share
Bill Gates
28:14
I've read more, mostly what I've read is about
Covid
. My general goof off reading hasn't gone up as much. You know, I've been lucky I've got more time with kids who are in college. I didn't expect to be at home.Share
Rashida Jones
28:28
So their home right, right?
Share
Bill Gates
28:29
Now one in medical school and one in college are off away from home.
Share
Rashida Jones
28:35
Does it feel normal or no? There's got to be-
Share
Bill Gates
28:36
No, it's very abnormal. And I hadn't realized the uncertainty ways on young people who are trying to make their plans, trying to build up their friends. They want to have a sense, and the fact that they could be sent home at any minute is just tricky.
Share
Rashida Jones
28:55
Yeah. I feel like there 's a value system that has emerged that I didn't even know I had around
Covid
and how cautious I am, and I feel like I've heard this from a lot of friends and people being like "well, that person doesn't have the same standards as I do in terms of, you know, masks and washing hands and sitting outside".Share
29:14
Have any of your friendships been thrown into doubt because of your relationship with how to protect yourself from
Covid
and heir values around?Share
Bill Gates
29:23
Well, you're definitely right that given an excuse to really be isolated, some people, wow, they are hardcore! And so I have to say to myself, what, should I be as hardcore? Say, I mean, I know people who won't even let the take out person, you know, open the door, they have to put it on the porch and uh, okay!
Share
Rashida Jones
29:45
Can we still be friends?
Share
Bill Gates
29:46
Well, no, it just means, you know, there's a spectrum. One thing that's tricky is, when the kids have friends, how much do you interrogate you know the friends about what have you been doing the last twelve days and, okay, you were with your parents, what have your parents, been doing the last twelve days?
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30:04
It's almost like invading their privacy to say, oh, well, are you as virtuous as we are? If not, we're not going to let you come over.
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Rashida Jones
30:13
Its a giant test of trust, really.
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Bill Gates
30:15
That's right. Building, okay, what is that small group that you've chosen to be without wearing a mask and fairly close, which is mostly family, right?
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Rashida Jones
30:26
But you have science on your side. So it's not like you're making kind of wild, illogical assumptions of how to keep this virus out of your life. You're you're following data driven information that you've been given, right?
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Bill Gates
30:37
Yeah, absolutely. I mean, we didn't know how important masks were.
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Rashida Jones
30:40
RIght.
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Bill Gates
30:41
Now, it s kind of mindblowing, and the idea that somebody's resisting wearing a mask, yhat is such a weird thing to me.
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Rashida Jones
30:49
Me too.
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Bill Gates
30:49
I mean, what are these, like, nudists? I mean, you know? What? We ask you to wear pants and, you know, no Americans says - or very few Americans - says that's like some terrible thing.
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Rashida Jones
31:03
Right. If you want to get back to normal life anytime sooner, wear a mask, or don't wear a mask and stay at home. But like to ask for both things, it feels like you just want things to be better, and they're not. So you kind of have to just deal with what it is.
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Bill Gates
31:17
Yeah, the mask helps you open up more things.
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Rashida Jones
31:21
Why was there ever a time when we thought masks were not effective? That's what I don't understand. Masks just seem inherently effective to me.
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Bill Gates
31:28
We think of respiratory diseases as coughing diseases, so the flu is spread by people who are coughing. So our model of respiratory diseases is heavily influenced by the common cold and the flu. And these unbelievable viral loads that you see with
Coronavirus
don't occur with most of the other respiratory viruses.Share
31:56
So the idea, a superspreader is spreading at a level it's almost like measles, which is the most transmissible disease we've ever seen, a superspreader can go into a room, you know, spend an hour there and in fact a high percentage of people in the room, that's like measles. And yet most people who get sick can go into that room and infect no one.
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32:22
So our model of flu with coughing turned out to be wrong. With flu you have symptoms before you start infecting other people. And so it's a much easier disease to say "okay, that person goes and isolates themselves". So the mask, at first we thought the simple masks didn't work. We were wrong about that.
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32:48
The complex masks we thought we had short supplies, so we needed them for the medical workers. So the N-95 mask, actually there was quite a bit of awareness, but for the healthcare workers. The idea that a simple mask for the masses, including people who are spreading without knowing it, that that would make such a big difference. The evidence started to accumulate in April and May.
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33:14
And you know, now it's overwhelmingly clear that the upside is gigantic. The modeling group, one of the ones that the foundation funds to me, she actually shows a projection that if everybody wore masks, how many deaths we would avoid, you know, and it's over 100,000 deaths.
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Rashida Jones
33:36
Yeah, I wanted to ask you about school, and what does it look like? What's the best case scenario? Because to me that feels like the easiest place to get back to normal is to send kids to school, and it seems so essential. How do we get from before vaccines are approved? Is there a way that kids get to go back to school?
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Bill Gates
33:60
I certainly believe that for younger kids where online is just difficult, if you're young, paying attention just to that screen is very hard. So I hope in lots of cities in the US in the first half of next year we can have at least K-8 in session, that educational deficits were building up, particularly of lower income kids and lower income families is just disastrous.
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34:31
You know? Yes, I think you should have less bars open and less restaurants open if that's what it takes to allocate your social mixing to education as opposed to those other activities.
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Rashida Jones
34:46
Feels like the right place to mitigate the risk because the upside is so much higher than going to a bar.
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Bill Gates
34:52
And you know, if some teachers aren't comfortable because they're older, you know, you can move some of the high school teachers down to help out with K-8 and move Some of the K-8 teachers up.
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35:04
Now, the public school systems didn't have much warning for the spring or even this fall. But you know, I really hope that we set our priorities so that that K-8 can resume in most of the country.
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Rashida Jones
35:20
Now, do you think that the need for human connection, like, where do you think that lies in the list of priorities? Obviously, we're talking about some baseline survival stuff, but I don't know about you, but I've been to a lot of Zoom cocktail hours. Sorry, not
Microsoft
Teams, cocktail hours. Have you had to do any online cocktail hours, socializing? 'Cause it's not the same.Share
Bill Gates
35:44
I've done visits with friends where we drink wine.
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Rashida Jones
35:48
On the internet?
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Bill Gates
35:48
Yeah, absolutely. Now, my European friends are a little weird, because somebody has to drink wine in the morning.
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Rashida Jones
35:54
They're probably fine that, though. It's Europe.
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Bill Gates
35:56
I don't know, that might just be colored water that they're drinking. I can't test it.
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Rashida Jones
36:02
But it's no substitute, right? I mean, it's great that it's possible with technology, but it's no real substitute from getting a hug or making eye contact or picking up on kind of, you know, conversation and banter and rhythms with people. Being in the same room means something, doesn't it?
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Bill Gates
36:20
Yeah. I think we may get the amount of kind of social contact you get from your work, may go down, and see your desire to get more social contact in your community, with your friends, at night. You know, that might go up, because particularly if we're doing a lot of remote work, than our desire to socialize our energy, to socialize after we stopped working, will be quite a good greater. So you could shift the balance there somewhat.
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Rashida Jones
36:50
Wow, that's the
Bill Gates
optimistic hot take on post-Covid
, is that we will socialize more with people in our communities, and we will socialize less and make work sort of a lesser priority than our family and friends. I love that if that actually happens.Share
Bill Gates
37:06
Yeah, so you can see that in your local communit, yoor bedroom community, the restaurants and the entertainment could thrive, whereas in the downtown, you know, maybe less so.
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Rashida Jones
37:17
How is that the fallout of this moment?
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Bill Gates
37:19
Well, you have something in the cities that are very successful, just take Seattle and
San Francisco
the cost of living and the downtown is such that teachers, policemen, they can't live there even though that's where they come in and do their work.Share
37:38
And even for the person who's well paid, they're spending an insane amount of their money on their rent, and so it's a windfall to the urban real estate owners, you know, who are already quite rich. And you have these insane commute times if you want to buy an affordable house. I do think that that holds back our country, that some cities are too successful and some cities are not successful enough.
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38:08
And so the idea that you can live further away if you're only going in half the time, the number of cars on the freeway when you do go in as half as many, and you might be even willing to have a longer commute.
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38:23
And so the idea that you could get a cheaper house, a bigger house and kind of feel a sense of community with a smaller set of people, you know, the 5000 people are so in your nearby community, and that is more engaging than, you know, when you're in the downtown, and it's just overwhelming how many people are all crowded in down there.
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Rashida Jones
38:47
People like that though,
Bill
. They like to be crowded in together. This is what I'm realizing. I don't feel that way, but other people do like to go to extremely crowded places that are loud.Share
Bill Gates
38:58
If you're raising a kid and you want them to be able to get out to a park and walk over to their friend's house. I don't know that the downtown is the best bar place for that. But I can have my bar out in my satellite community, and you'll run into more people you know.
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Rashida Jones
39:19
I love this vision of the future, don't get me wrong. I'm just pointing out the fact that people do go out of their way to be in very crowded places. I'm not sure it's because it's crowded or it's new or whatever.
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39:29
But this being said, so if we talk about the next pandemic, okay? Let's say this wonderful kind of utopian version happens, where people kind of sober up and realize that their smaller communities are of the utmost importance and then they can go to work less, and they can work from home. Inevitably we're going to have another pandemic, right?
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Bill Gates
39:50
Yeah. Hopefully, with luck, it could be twenty years from now. But we have to assume that it could be three years from now.
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Rashida Jones
39:59
So if people are already set up in this way, do you think that the next one that comes will have less of a destructive impact?
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Bill Gates
40:09
The main reason it will have less destructive impact is we will have practiced, we would have done, you know, disease games like war games and almost every country will respond like
South Korea
or Australia
did. Where you're very quickly testing people and quarantine people and our tools for testing will be way better now. We won't be this stupid the second time around, yes?Share
Rashida Jones
40:37
We hope!
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Bill Gates
40:38
People like myself warned, you know, back in 2015. But when you see trillions of dollars, you know, mental health and education, all these awful things happening, countries will get the experts, they'll get them the fairly modest resources, tens of billions, nothing like a military budget that you need to have these tools invented and standing by.
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41:04
And so the next natural epidemic, even though it might have a higher fatality, I think we'll deal with it quite well because this time it hit us over the head so hard, it's obvious that those prescriptions from 2015, they will happen.
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Rashida Jones
41:18
I hope that you're right, I really do. But in my pessimistic mind, I still worry about this American identity and this need for autonomy, and the autonomy is always at odds with the greater good of this country. I hope I'm wrong, though. I hope you're right. I hope we're better prepared.
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Bill Gates
41:36
We wear seatbelts.
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Rashida Jones
41:39
We didn't have the internet when when people decided to wear seatbelts.
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Bill Gates
41:43
Well, you know, I think death, death is a pretty clear thing to people. The next time around, people will respond more quickly. No, we do learn, even though when you're right in the middle of the crisis, it seems a bit insane.
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Rashida Jones
42:02
I'm gonna trust you on this one.
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Bill Gates
42:03
Absolutely, please. It's definitely lasted long enough to try our patients and you know, people have latched onto over simplistic explanations or they've just gotten tired of distancing the way that they should, and so it's asking a lot of people but it will make a big difference and help is on the way in terms of the vaccine.
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42:31
Getting that out there, particularly if we explain what we know about the vaccine, and I'm hopeful that next year, as the year goes on, we'll get closer to normal.
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Rashida Jones
42:44
I can't wait to move to my satellite city with all my friends and family.
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Bill Gates
42:48
It's gonna be cool.
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Rashida Jones
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