On March 24th, local time, Bill Gates appeared on TED Connects to answer questions about COVID-19.

The following is the textual content of this interview.

CHRIS ANDERSON：Five years ago, you stood on the podium of TED and issued a frightening warning that the world would sooner or later face the crisis of a pandemic. Now people who watch this speech shudder. This is exactly what we are going through. What on earth happened? Did people heed this warning or not?

BILL GATES：Almost nothing. You know, Zika, Ebola, SARS and MERS did not spread to many countries, but I had hoped that these diseases would remind us that in a world where people move frequently, the destructive power of the epidemic is huge. So, the speech was to say, hey, we're not ready for the next pandemic. But in fact, due to the progress of science, if we invest resources to fight the epidemic, we can be prepared.

CHRIS ANDERSON：Last month you said this might be what people were worried about.An once-in-a-century pandemic. Do you still think so?

BILL GATES: that's terrible to say, but novel coronavirus's case fatality rate is not high.. If it were a smallpox-like disease, 30% of people would die. So, although this (COVID-19) is terrible, in fact, most people can survive even if they get COVID-19. Although it is more contagious than Middle East respiratory syndrome or SARS, it is not as deadly as they are.However, the price we pay to defeat it is unprecedented.

It is spreading all over the world. This is the characteristic of respiratory infectious disease. That's the biggest fear. How many people will eventually die? If we can do the right thing, it won't be a huge number, and things like the 1918 pandemic may not happen again, and we should be able to do better.

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

BILL GATES：In January, people began to talk about "human to human". The alarm sounded, and everything that happened was in line with this very terrible pattern, and it was hard to contain it. On January 23, China began to adopt very strict quarantine measures.

The very good news is that as a result of these actions, China has significantly reduced the infection rate. We should all start working on testing, treatment and vaccines in January. In the face of this new type of respiratory virus, which is highly contagious and deadly, we should deal with it methodically and calmly.

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

BILL GATES：You would expect the government to invest in key initiatives. Our foundation committed $100 million to launch. "(COVID-19) treatment Accelerator". I think we should have done more before this outbreak.

I think the most important thing to discuss today is that our capacity in the field of testing is still lacking to ensure that the people who need it the most get the tests they deserve. For example, some symptomatic health workers cannot be tested and do not know whether they should go to work, while some asymptomatic people are tested. I think the testing should be planned. It must be given priority and is very, very urgent.

The second thing is isolation. In the case of the United States alone, some areas are doing well, but others are still far from being able to do so. Quarantine measures are a daunting challenge for both individuals and the economy. But the sooner you take strict quarantine measures, the sooner you can release the quarantine and return to normal.

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

BILL GATESLarge-scale testing and isolation should be implemented together.If you are a medical worker, you want to stay and do your job. If your job is to ensure a continuous supply of electricity, water and food, you also want to continue your work. So, testing will let you know if you need to be quarantined and make sure you are not the source of infection. Therefore, testing is very critical. South Korea has carried out large-scale tests, and every country should learn from them. At the same time, it is necessary to cooperate with the implementation of the isolation strategy. Our goal is to keep the proportion of infected people at a very low level. Less than 0.01 per cent of China's population is diagnosed with COVID-19. If these measures are not taken properly, there will be a large number of infected people, thus placing a huge burden on the health care system.

CHRIS ANDERSON：One question about the quarantine strategy is how long will it last? Many people worry that fighting the epidemic through isolation is bound to bring down the economy, which is too expensive. We have to stay at home for 3-6 months, or even a year, and can't work as well as we used to. The United States and many other countries are discussing that this may not be the right strategy, and we cannot let the economy collapse. We should quarantine people for another two weeks and get people back, even if it means a lot of people will get infected, but eventually there will be mass immunity, which may be the right way to do it.

What do you think of this? Is it possible to find a compromise? What kind of isolation strategy will eventually get us back on track?

BILL GATES：There is really no compromise. It's hard to say to people, "Hey, keep going to the restaurant." To buy a new house. Never mind those who died as a result of the epidemic, we want you to keep spending. Maybe some politicians will think that GDP growth is really important. But when the spread of the epidemic threatens people's parents or the elderly around them, and knowing that moving around will exacerbate the spread of the epidemic, it is difficult to get people to continue to do what needs to be done. I don't know which rich country would choose to do so.

In fact, if you adhere to the group immunization strategy and infect enough people within a few years, you will indeed get the so-called group immunity. But,Group immunity is meaningless unless it infects more than half of the population. But if so, it will not only overload your health care system, but also increase the case fatality rate to 3% or 4% instead of 1%.

Therefore, it would be very irresponsible to say that we can have the best of both worlds. What we need to do is to completely "shut down" in 6-10 weeks, and if all goes well, you can get back on track.

CHRIS ANDERSON：Bill, here is a question I asked on Twitter. If you were president of the United States for a month, what would you do? What are the two or three things you most want to do?

BILL GATES：What is more clear is that we have no choice but to adopt isolation, and we must continue to isolate for a period of time. According to the situation in China, it is about six weeks. Therefore, we must be prepared and strictly implemented, and at the same time carry out tests and weekly assessments according to the actual situation.

If you can implement the isolation strategy well, you will see a significant change in the data in about 20 days.

It's not easy. We need a clear message. The impact of this epidemic on the economy is very serious. There has never been an event in our lifetime that has such a bad impact on the economy. But,The economy can recover, but people cannot come back from the dead. Therefore, in order to minimize disease and death, we must bear huge economic losses.

WHITNEY PENNINGTON RODGERS：Are there any tools available for countries that are unable to enforce social segregation and do not have a sound health care system? How should they deal with the virus?

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

Therefore, we should speed up the development of vaccines. The vaccine will eventually be developed, and officials say it will take 18 months, and there are many such studies under way. Me and Seth Berkley BerkeleyGlobal Alliance for Vaccines and Immunization (Gavi)CEO) there is a lot of discussion. They can share a lot of vaccine-related front-line work because they play an important role in the epidemic.

We need to make sure that low-income countries have very low-cost tests, and we need effective treatments to prevent 5% of people from going on ventilators, because even if they have equipment, they lack professionals. They do not have enough beds and treatment capacity.Fortunately, rich countries have these, which can test related treatments and fund vaccine research and development for the world, thereby minimizing the damage caused by the epidemic to developing countries.

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

BILL GATES：There are many clinical trials going on. Some oft-mentioned treatments, such as redaciclovir, hydroxychloroquine and azithromycin, are not sure when the results will come out, but there are some positive data. Redcivir takes five days of intravenous infusion and is difficult to manufacture, and people are studying how to improve it. Hydroxychloroquine also seems to be effective in early treatment.

There are also a large number of compounds, including antibodies and antiviral drugs.The Gates Foundation, Wellcome Foundation, MasterCard and other partners have jointly created "(COVID-19) Therapy AcceleratorTo accelerate the development of effective treatments. A lot of people are saying, "try this, try that." "We use laboratory reports, animal models and other results to assess which treatments should be given priority in rapidly developing clinical trials around the world.

Such collaboration at the global level is very complex, but I think three or four of the top 20 or so drug candidates may be effective in reducing respiratory distress at different stages of the disease.

CHRIS ANDERSON：How important is the cooperation among all countries in the world now? I mean, the virus is the common enemy facing mankind. It does not know that it has crossed national boundaries, nor does it know people's race or religion. It only knows that there is someone here, it can start the communication program, and then it will be famous and everything will be all right.

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

BILL GATES：I see that recovered countries can help other countries, which is great. If we beat the epidemic by the summer, that would be great. We can help other countries.

Vaccine programs are being carried out all over the world, and these projects should be assessed by a very neutral standard, that is, which is the most helpful to all mankind.It is necessary to ensure that there is not only enough capacity to supply rich countries, but also to mass produce at very low cost to meet the needs of the whole world.The purpose of Gavi is to make everyone vaccinated. You can see that it is doing very well in science and data sharing, and you can see that this amazing collaboration is happening.

Unfortunately, the feeling of exclusion and "stay away from me" is magnified every time the disease breaks out. We must avoid this situation. On the one hand, we have to be physically isolated, and on the other hand, we need to help each other more, and some community groups are concentrating resources to ensure that everyone has access to food and the medical services they need. some people are providing help to the elderly living in nursing homes.

Our generous love for others should not stop because of physical isolation from each other.

WHITNEY PENNINGTON RODGERS：Many people want to know about the work done by your foundation, including the distribution of testing tools, the production of protective equipment, masks and other tools that can help health workers.

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

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

We have a lot of cooperation with the government and the private sector, and in some ways we are a bit of a bridge. We work with the heads of pharmaceutical and testing companies, and also support vaccine development-- especially the new RNA vaccine, which we have adopted.CEPI(innovative Alliance for epidemic Preparedness)I've always supported.

Our expertise is the best resources that motivate the private sector to really participate in these areas of medical tools.We can donate money immediately, by contrast, even in this case, the government still needs to follow some standard procedures and take the time to understand who has unique capabilities in which area. As a result, an organization that has been committed to this for a long time can play a role at this time in supporting the development of new vaccines.

This is really amazing. When we communicate with private sector partners, they are more than willing to lend a helping hand. This is the unique role we can play as a foundation.

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

BILL GATES：Pandemics are very, very frightening but do not receive the attention they deserve. If we do the right thing, we can deal with it better. Science can be used by us. In fact,It is obvious that we can prepare for the next pandemic. Yes, it will cost tens of billions of dollars, but it will not be a bottomless pit. Compared with economic losses, this is a worthwhile investment.

I remember when I gave a TED speech in 2015, I said that an influenza pandemic could cost 4 trillion dollars. When I was about to give a speech, I thought, wow, that's a big number. Is it really that big? I went to check some data, and it's really that big. It is true that this pandemic will cause so much damage to the economy.

So, in the short term, we will experience more pain and difficulties, and people will have to help each other.And I am still a staunch optimist. Whether it's climate change, ecological crises, infectious diseases such as malaria, tuberculosis, or even cancer, we can meet the challenges through cooperation and innovation.Yes, I am very optimistic about this.

I love my job because I see the progress we have made in all these diseases. Now we must focus on the COVID-19 epidemic. Unfortunately, it may affect the progress of polio work and make the situation worse. But we are using the disease control system built to eradicate polio to help developing countries respond well to this epidemic.

My thinking about this epidemic is that although the situation is serious, I believe it will bring us together. We will eventually overcome the epidemic and prepare for the next pandemic.

CHRIS ANDERSON：Do you think we can get through this? I know you are a born optimist and believe that science can help us find a way out. But will important leaders listen to scientists? Are we gonna make it? Do you believe that in a few months' time, when we look back, we will say, "We dodged a bullet"?

BILL GATES：We are not sure that even rich countries will not be able to get out of trouble in six to 10 weeks. But I think it's possible. When we get the test data, we will see more clearly, and it will become more and more clear. Rich countries will eventually get out of trouble, while developing countries will pay a heavy price. But we will not give up on anyone, we will eventually get the vaccine, and Gavi will ensure that everyone is protected by the vaccine.

Two to three years from now, the whole world will pay a heavy price for this. But the next time we see a pathogen, we will be able to do billions of tests in two to three weeks, and we will figure out which antivirals are effective and put them into mass production in two to three weeks. If we are really ready, we may still be able to use the new technology platform to produce a vaccine within six months, and it is likely to be a RNA vaccine.

Therefore, after this epidemic, a lot of innovation will be funded, which I hope will be very generous. Three years later, when we look back, we will say, "that epidemic was terrible." There are so many heroes worth remembering. And we've learned our lesson.With great science and the goodwill of watching and helping each other, the world has minimized the damage caused by the epidemic and can prevent the same situation from happening again. "

CHRIS ANDERSON: this is also my own most optimistic vision, that is, the world can realize: first, we must unite in the face of some challenges; second, science is really important, science can help us understand germs, make vaccines, sequence genes, develop therapies, build models. It's a miracle to me.

So, will we pay more attention to scientists now? I'm sure you've heard that there is an amazing analogy about climate change. The scientists said, "there is a terrible enemy coming. If we do nothing, it will take millions of lives. It will destroy our planet. For God's sake, let's do it, politicians. Do something! Politicians will say, "No, we need GDP growth. We need to win the election! "they did not take action. Do you think this epidemic will change the way politicians think and how much they attach importance to science as a whole? Is that too much to ask?

BILL GATES：The outbreak has largely delayed the emergency innovation agenda for climate change. I have set aside a lot of time to study climate problems. But I have to say that all that has changed in the past few months. Before the end of the epidemic, COVID-19 will occupy a dominant position. As a result, some issues that are continuing to affect climate change will not receive the same attention.

After all this, we will find thatScientific innovation and global collaboration should be our common solutions to the problems of infectious diseases and climate change.So, I don't think this epidemic is a huge setback for climate. In fact, I think it's a useful guide. "come on, scientists, where do you see the impending disaster?" Let's make sure this doesn't happen. "

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

What advice can you give them? As individuals, what can people do to help each other now?

BILL GATES：There is a lot of room for creativity. Schools are closed and children are forced to attend classes online, but the school system does not provide good support. Is there anything you can do to tutor them? Can you organize donation activities to allow food banks to provide services in places where there are difficulties? The United States has a tradition of charity.Although there are some things that need to be done by the government, there are most things that everyone can contribute to help each other ease the pain, break the isolation, and reduce the harm.

This is an unprecedented era, and people's creativity should be stimulated while abiding by the policy of isolation.