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  • Derek: So how did it feel to make this prediction and then

  • have the world essentially not listen and not prepare?

  • Bill Gates: Well there's no good feeling that comes on something like this saying i told you so

  • If anything kills over 10 million people

  • in the next few decades, it's most likely to be a highly

  • infectious virus rather than a war.

  • You know I just think back and could I have been more persuasive?

  • We've actually invested very little in a system to stop an epidemic.

  • We're not ready for the next epidemic.

  • Derek: How did you make such a prescient prediction?

  • How did you know this was going to happen?

  • BG: Well there's a number of respiratory viruses

  • and from time to time one will come along that's very transmissive and causes some level of fatalities.

  • Respiratory diseases are very scary

  • because you're still walking around on a plane, a bus when you're infectious

  • unlike some other diseases like ebola where you're mostly

  • in a hospital bed by the time the viral load

  • infects other people.

  • Derek: Hey, so recently i got the chance to interview

  • Bill Gates when his foundation's annual letter came out

  • I'll link to it in the description and we talked about lots of things including

  • conspiracy theories and misinformation but about the pandemic i wanted to know

  • if so many people could see this coming and the costs of prevention were

  • relatively small then why wasn't more done about it?

  • BG: Well there's some risks like earthquakes where we see small earthquakes all the time.

  • Or you know the history of war or fire or

  • hurricanes so you don't forget.

  • These pandemics only come along so irregularly

  • that being lulled into a sense of security where it probably won't be a

  • problem in the next few years, why should we put money into that?

  • You don't buy the insurance policy, basically.

  • This one will help us understand it needs to be a priority.

  • Derek: I feel like humans have an issue though with fighting the last battle

  • potentially, so if we focus on pandemics now and there

  • isn't one say for another hundred years

  • What is the next disaster? What is the one that we're not prepared for?

  • BG: Well I'd point out two:

  • One is climate change.

  • Every year that would be a death toll

  • even greater than we've had in this pandemic.

  • Also, related to pandemics is something people don't like to talk about much

  • which is bioterrorism, that somebody who wants to cause damage could

  • engineer a virus and so that means the cost

  • the chance of running into this is more than just the naturally cost

  • epidemics like the current one.

  • Derek: It feels to me like

  • there's something similar about pandemics and you know climate change or

  • like asteroid impact, which is that you know they're not very

  • tangible but you could do a little bit.

  • I don't know it seems like humans are not

  • very good at those sorts of problems.

  • BG: Well my favorite writer, Vaclav Smil, you know wrote about all the potential

  • kinds of disasters like you know the risk of an asteroid, the risk of a

  • you know yellowstone-like eruption and in fact he showed that pandemics

  • were significantly the biggest thing other than a

  • human-caused nuclear war that we needed to be more prepared for

  • Derek: So what changes do we put in place to be readier for the next one and

  • is it possible that covid-19 could be the last global pandemic?

  • BG: Well certainly there will be more pandemics. The ways that humans interact with other

  • species, these viruses are coming across a species barrier whether it's from bats

  • or monkeys or

  • Derek: but you don't think we could increase our preparedness to such a level that

  • it never sort of becomes this global issue?

  • BG: We could increase our preparedness so we never have a death toll

  • uh anywhere near what we have today.

  • You know pandemics can be worse in terms of

  • the fatalities. Smallpox was a over 30 per cent fatality. You know so a little

  • bit we were lucky that the fatality here is not

  • not super high but we can nip it in the bud it'll still

  • get to a lot of countries but the number of deaths you know

  • uh with the right system should be a tenth of what we we've seen here.

  • Derek: And the systems that you want to put in place so this

  • sort of so you can nip it in the bud or so what are the key elements

  • that we didn't have that we should have going forward?

  • BG: I would divide it into two sections:

  • There's the field based activity and the R&D activity.

  • In R&D we need to mature mRNA so we can make it even faster and have

  • factories all over the world,

  • have it be cheap and thermal stable.

  • There's a lot that can go into therapeutics including antibodies.

  • On diagnostics having the ability to give

  • 10 million PCR tests a day.

  • Then in terms of the field we need

  • a lot of diagnostic machines all over the world.

  • We need a team of epidemiologists. So the investments are about equal between

  • R&D and the the field-based group and information that should beconstantly flowing.

  • Derek: You know I feel like there's a meta-issue

  • that is kind of above all of these issues which is you know

  • the way that people connect with reality and figure out what's true and

  • what's not and you know what information to believe.

  • I've got to say that you know as i was growing up and coming into this

  • information age it seemed like the Internet and all these tools were going

  • to make the correct information so much more

  • easy to access and bring us into a more fact-based world.

  • Instead it doesn't look as though it's bringing us there.

  • I wonder if you shared a similar vision for

  • you know what the Internet might do for all of us and

  • i don't know if you have any thoughts about the current state of it you know

  • how do we deal with this?

  • BG: Well the internet has done something fantastic

  • which is if you want to learn you know the people who watch you are

  • you know getting an opportunity to understand

  • science and what's going on and that just wasn't there

  • uh and so for a lot of people they're so much more informed.

  • I mean I have friends who ask me about these variants where I'm just stunned at

  • how up to date they are with the latest information so

  • for people who want to learn facts this is a golden age.

  • You know we focus on the negative part with some of these conspiracy theories

  • and anti-factual things and so because social media is so new

  • figuring out how you curb that, you know labeling it restrict

  • the speed of spread of things that are titillating but false.

  • We are missing some good ideas to you know not have this kind of scary

  • phenomena that in the case of anti-vaccine things may

  • slow down how quickly we get lots of people

  • uh to take the vaccine and therefore extend the epidemic and

  • and cost us in in tens of thousands of lives.

  • Derek: It feels like you're running up against you know kind of that

  • great American principle of free speech, right? I think it's a great point

  • that you bring up that you know in the past the problem was kind of scarcity

  • getting access to this sort of information and now it's sort of a

  • problem of too much and figuring out which is the good stuff and which is not.

  • BG: Well there are certainly clear things like you know saying

  • completely false things about you know vaccines but there is kind of a gray

  • area in the middle that figuring out what the rules are and

  • who should be the one looking and interpreting those rules

  • Wow, we are missing that today. You know can you get a group of experts

  • that are weighing in on these things you don't really want the profit motive involved

  • But you want

  • you know expertise and capacity and so you know a few years from now i hope

  • we're more sophisticated on what or how that line should be drawn

  • Derek: you know a while back on my second channel I made a video called

  • Be Hated, which was kind of about my thoughts about pushing back against

  • misinformation, that we should see anything that is wrong in the world

  • and we should do our best to fight it so you should not be liked by everyone

  • because there are some people out there with bad ideas and you should be pushing

  • back against them. That was essentially my thought but since then I

  • feel like my views have softened a little

  • and now I think of our pushing back against misinformation a little bit like

  • an immune system. Obviously it's a problem if your immune system is weak if

  • it doesn't respond to anything but it's also a problem if your immune

  • system is too strong. You know during the 1918 flu pandemic

  • there's a really interesting distribution of deaths where the young

  • and old were more likely to die obviously

  • because they have weak immune systems but also people in the sort of 25 to 35

  • year-old range because their immune systems were just so strong

  • they were overactive and that ended up resulting in mortality

  • so I feel like there's a sweet spot in terms of how much we push back against

  • misinformation. You know you'll never see me make a

  • video about flat earthers because i just don't see

  • the point. You know making that video only kind of

  • reconfirms their world view and there's not really any minds to move

  • there so that's kind of how I'm conceptualizing

  • misinformation these days, a bit like we have to be a targeted immune system.

  • So i wanted to push Bill a bit further

  • on this idea and I brought up a tweet that I had seen doing the rounds on

  • twitter that basically said that the Oxford vaccine development, they

  • were going to open source that vaccine until

  • the Bill and Melinda Gates Foundation got involved and said

  • no you must partner exclusively with a big pharma company AstraZeneca

  • and so obviously it seems to the people on twitter that something nefarious was

  • going on there, but I wanted to know from Bill what was the real story

  • BG: Well the making a safe vaccine

  • is more complicated than say making a jet engine

  • and people are very picky about vaccines in fact you could ruin the

  • reputation of vaccines if you're making them in factories

  • where the quality control at every stage is not exquisite.

  • and you know any mistake you know you can have that factory shut down

  • literally for months at a time when its output is needed to

  • save millions of lives. So vaccine factories are not

  • something that you just you know you know like open source code that you

  • can take and you know mess around with and so the the limitations on

  • how many vaccines are being made, that's based on how many great

  • capable vaccine manufacturers there are in the world and we've made sure that

  • the AstraZeneca's being made in these big indian factories and there's no

  • royalty for that, no charge at all. Now we've had to fund

  • that, the Gates Foundation. These are companies we've been working

  • on their factory quality for over a decade

  • so that there was spare capacity to make inexpensive vaccines

  • so Oxford University is is wonderful, but they're not capable of doing a phase

  • three trial and they they don't have factories

  • We did tell Oxford that they needed to seek somebody

  • with expertise and AstraZeneca came in and we didn't

  • control that agreement but they came in and said hey they want to do it on a

  • non-profit basis and I'm impressed with how they put

  • their best people on it and helped out. You know the pharma companies who

  • didn't get involved nobody's criticizing them. So you know

  • you feel sorry for the ones that are really

  • miraculously helping make these vaccines.

  • These are the very good reasons that I suspect exist but

  • that that's where I feel like social media just doesn't get the nuance

  • and you know it pains me to see the world like that.

  • And you know even to see you, Bill, you know be the target of some of these

  • conspiracy theories

  • It seems to not bother you but you know it kind of bothers me as a guy who wants

  • you know everyone to live in the same kind of reality and you know I see

  • you out there doing great things and I think that you know that should be

  • commended as opposed to what you get.

  • I'm not in a position to complain much you know I have a lot of things that you know

  • make me extremely lucky and you know I hope these conspiracy

  • theories go away and I don't know what what it'll mean

  • for the future.

  • Derek: How do you feel about the vaccine roll-out so far?

  • BG: Well we you know we need the supply,

  • we need the logistics and we need the demand

  • and there are huge challenges in each of those.

  • I'm hopeful that Johnson and Johnson in the next month will get approved because

  • that's a single dose vaccine, very cheap highly scalable so

  • AstraZenica, Johnson and Johnson and a few months later Novovax.

  • Most of the developing world, those are the vaccines that will be going to them

  • and so we put billions into trying to make that happen and

  • you know in a few months hopefully it'll come together.

Derek: So how did it feel to make this prediction and then

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I Asked Bill Gates What's The Next Crisis?

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    nanako.kamiya posted on 2021/04/12
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