ビル・ゲイツとのコロナウイルス（COVID-19）談義 (Corona Virus (COVID-19) discussion with Bill Gates)

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- Hi, everyone, welcome
to the Khan Academy Daily Homeroom, Sal Khan here.
Thanks for joining us, we have a pretty exciting show
I guess today.
For those of you all that this is the first time
you're joining, the whole idea is in this time
of school closures, we at Khan Academy, we're trying
to make sure that you have the resources needed
to keep learning, that you know how to use those resources,
and, that we have ways to stay connected in times
of these closures.
And that's why we're doing this webinars
and why we're doing these live streams.
I do wanna highlight as I always do in the seminar,
in these live streams.
Khan Academy is a not for profit with a mission
of providing a free world class education
for anyone anywhere.
And we we're running in a little bit
of a deficit even before, this whole crisis struck
but now we're seeing our traffic is three acts
of what it normally is,
and so any support is super valuable.
I wanna give a special thanks to several corporations
that have stepped up in the last few weeks in record time,
Bank of America followed by AT&T, google.org, and Novartis.
And many of you have also helped donate
to help close our gap.
And with that, I wanna make sure we have
as much time as possible for our guest today,
I'll introduce someone who is known for many many things,
including one of being one of the longtime supporters
of Khan Academy, we have Bill Gates here today.
And, I encourage everyone, whether you're watching
on YouTube, or Facebook or any other platform,
post questions on the message boards,
we have team members who will surface questions
and I can ask bill those questions over
the course of our conversation.
So Bill, great to see you, maybe a good place
to start is, how is the situation affecting you personally?
How's the social distancing?
And where are you spending most of your time?
- Well, I think everyone's lives
are almost completely upended.
The normal, things I do, talking about Polio eradication,
going into meetings at the foundation, traveling
to meet with scientists.
That's all gone, when I wake up in the morning
and I think was this a nightmare?
Are we really in this almost different world?
Where Coronavirus is the top priority, we've got
to get this thing under control.
I'm doing lots of online meetings,
I use Microsoft Teams for those things.
I don't get to see many people beyond my family in person.
So it's a, huge adjustment and yet there's so much
to be done, It's like I'm not not busy.
- And where are you spending most of your time?
Is that around the virus work?
- Yes, that's, the our foundation works
on infectious diseases, we are the biggest funder
of vaccine work, we understand, how to make vaccines
in volume, we do the disease modeling.
And so, the skills that we have,
understanding private sector, being able to work
with governments, what regulatory things should
be maintained for safety, and which ones,
because we've got to move so fast, Should you go around?
and talking to leaders, talking to Tony Fauci,
About Okay, how do we make sure the public is seeing this
in the right way.
We explain, why it takes so long for a vaccine,
which is such a key thing to.. until we have that,
We can open up a bit but
we won't go back completely to normal.
And so we're orchestrating, all of our partners around,
getting the testing right, getting the drugs right,
and getting a vaccine which will will bring us
to the end of this.
- Yeah, now we're gonna talk more about that.
And actually, the first question I wanna surface
is from Facebook, Abid Sheikh,
and I think it's front of mind for a lot of us.
He writes Hello, since you predicted about
a similar outbreak in the 2015, Ted Talk,
how did you react to the news about the Covid 19 pandemic?
And that he's referring to a famously for
anyone who doesn't know, Bill made a talk in 2015,
that essentially was very prescient
of the situation we're in now.
- Yeah, and I wrote a New England Journal
of Medicine article that really went through
the specific things, like high speed diagnostics
and vaccine platforms that we needed to fund.
This is certainly a case where being able to say,
I told you so is not at all gratifying,
because this is a horrific disaster and in my lifetime,
whether it's health or economics or just uncertainty
for people, there's nothing like this.
And the goal there, was to get governments to step up,
so that you could easily make a new RNA vaccine
or you'd have, the testing capacity very, very rapidly.
I'm sure that because this is so widespread
that next time we will have made those investments,
but it's unfortunate that, very little got done in
our foundation, Wellcome Trust,
a few others did fund work along these lines,
but not enough.
And, you know, so here, here we are.
- And give us a sense of where we are right now.
And we could talk a little bit about maybe
what could or should have happened, but where are we now?
What's your analysis, how bad is the situation
in the US rest of world, how close are we to peak?
How's it's gonna play out over the next few weeks or months?
- Yeah so, the concept of exponential growth,
is not that intuitive to people,
but when you have this human
to human transmissible respiratory virus,
it creates exponential growth, that is each case leads
to, say two or more cases, and so, if we haven't changed
our behavior, there's no doubt the majority of people would
be infected, and you'd get this huge overload
of the medical system, and literally millions of deaths.
The reactions, whenever you're gonna stop something
that's exponential, the sooner you act,
the better because then you can act in a way that
you don't overload your hospital systems.
And you can treat the cases very, very well.
Testing is key to know where's the spread,
and to inform people that they need
to really isolate themselves, the tests
the PCR test can actually see the virus before
you're symptomatic, before you would
be transmitting to people.
And so, if we had had the testing right prioritized,
that would help with this, with the social isolation,
by the end of the month with any luck, we'll start
to see the curve level off.
And then another month, the number of cases would come down.
And you could get to a point where,
because you are targeting the testing
and giving quick results, that will do start
to open up in a way like China has where kids do go
to school, people go back to their jobs,
it's not normal that they don't do sports events
or big gatherings, that will wait until the vaccine
but we'd like, if things go well,
and the numbers will drive it. we'd like to see
thatability to open up somewhat by ideally early summer.
- And as we are all seeing evidence
that the social distancing is working that
we are on track to peak, in the next few weeks
and then, get to maybe a more a better state by the end
of, I guess would be by the end of May.
- Well, China had in Hebei Province, over 80,000 cases
and so that's the model where they intervened
in a very dramatic way,
they enforced their quarantine very strongly.
They did their contact tracing, they used the testing,
people would get testing results very quickly,
and it was the right people.
They are now, able to open up.
South Korea had reasonable number of cases,
but they did the testing did the tracing,
and so now they are in the situation where,
they've definitely bent the curve.
There are a few countries like Taiwan
who did all the right things and never allowed
the large numbers to develop.
That unfortunately for most countries,
we can't go back and change the fact we missed
that early opportunity, but they, there are communities
where we are starting to see the numbers peak
because of that social isolation, so that's the first step
is that peak, but you don't open up until
they're in absolute, way below,
like a factor of five below where they are today.
- Wow, and just from us, I don't know from either economic
or a scientific point of view,
why do we see this disparity in testing,
or even the types of tests?
In the US right now, even if you're kind of lucky enough
to get a test, so to speak, it could still take several days
to get a result, while you know, I heard stories
in Taiwan three months ago, you get your results
before you leave the airport?
- Yeah, the very sensitive test is
the Polymerase Chain Reaction PCR, where you make
the primer specifically for this virus.
It's an amazing test and there's a lot
of machines out there, in commercial labs, academic centers,
public health labs, that we were slow
to get them all going, even today,
we're not completely taken advantage of that.
If you make sure you're testing healthcare workers,
you don't let the queue to get very long,
you're testing contacts and people who test positive,
that really is guiding individual behavior
and the abroad behavior.
And so that in the US, we actually have more
of those machines per capita than South Korea
or anyone else.
So, it should be possible.
There isn't a set of criteria though, that stops somebody
who's not symptomatic from say, getting in the queue
and testing themselves every day
just 'cause they're worried, versus that healthcare worker.
And so, we do need to bring a sense of prioritization
and not let these queues mean, it's taking too long
to get the results back.
- Are you hopeful that that's going to change over
the next couple of weeks?
- Yes, well, there's a lot of discussion about it,
the notion of okay,
does the federal level really jump into that?
Which agency, has the right expertise to be able to do that?
And so, that I think is likely
to improve in the weeks ahead.
- And your prediction of hitting a peak
in the country in a few weeks,
one question I've been curious about it,
places like California I know in Seattle and Washington,
we've been in some form of stay at home policy,
stay in place policy, lockdown policy
for about three weeks now, and the quarantine time
is typically two weeks, why aren't we seeing
the peak cases sooner, why is it taking so much time?
- Well, there's the league of, once you do the shutdown,
you need to go, at least maybe two infection periods before
you'd really expect to see things going down.
Also, we weren't doing enough testing, and so,
now we're seeing, a higher percentage
of what's actually out there.
And, but the actual the numbers for California
and Washington are very hopeful,
the New York numbers continue to go up.
We have cities with explosive growth, like Detroit,
New Orleans, but the there are early signs,
that our, our changes have made a difference.
Our lockdown is not as extreme as what they did in China,
but it should be enough in the places
where there's strong adherence, to get to that peak.
And so I'd say, we'll see in some locals
in the next few weeks, we'll see that, but for the country,
at best, it would be the end of the month.
- And what's your sense of why New York
has had such a tough situation?
They're in a lockdown situation now,
is it just the nature of the density of people
or is there something else going on there?
- Well, the international travel into New York
is more than anywhere else, the density is more
than anywhere else,and these things, there's some degree
of bad luck, when you're dealing with the exponential
just a few cases here at the front
of the exponential can drive a big separation
between place A in place B.
And, the governor, there is stepping up
and getting the models to help him understand
what's going on, enforcing
their lockdown in a pretty serious way.
So hopefully, the deaths are another lagging indicator,
because those are people
who were infected 18 to 20 days earlier.
But, we really hope that New York peaks
because they are, near the breaking point
for their medical system.
- And you're one of the world's experts
and you've worked with many of the world's experts
on things like vaccines, obviously, there's a lot
of talk about a vaccine,
I have a question here from Facebook, Siam Kumar asks,
he's calling you Billy, that's a little informal.(laughs)
any insight into how long this vaccine will take time
to come to market?
And actually I'll add a second question to science question,
how long, and also how effective will it be?
I know the the influenza vaccine
is famously not 100% effective,
and it depends from year to year.
- That is so important, here we only have one strain
of the corona virus, so we don't have the same shifting
we see in flu, so that makes it an easier target.
The foundation works with the greatest funder
of vaccine work, so of the a hundred
or so efforts out there, there are about four
that use a new approach DNA RNA, which they're getting
that going, if that works, if it's safe and efficacious,
including in old people which is super important here,
those will be done, the first, then we have four others
that are more conventional techniques, but the risk
of them not working is lower.
So we were funding, the manufacturing capacity
and the safety and efficacy of all eight
of these very much at full speed, because government's,
in a few months, their money will really start to flow,
but they're a little bit slower,
and they don't really understand
which of these organizations have which capabilities.
You saw the Madonna, which is an RNA vaccine,
actually go into phase one safety trials last month,
so they were the first to get to that milestone.
We need to back all the eight leading candidates
because some won't be safe, some won't be effective.
We're saying to people, it's likely about 18 months
because of the scale issues.
In the best case yes, things could be done before then,
in the worst case, it would take longer.
This is super important because until
we have an efficacious vaccine, that the entire world
has had the benefit of, we will not go completely back
to normal that is large gatherings, even if
we've kept the cases under control, schools are open,
people are going back to their jobs, the large gatherings
they risk benefit ratio could is not strong enough,
because you could get a super spreading
and in a bit of a rebound there.
And, you know, so people will be fearful,
people won't be behaving like they were, before this.
And so, getting that vaccine for the world is critical.
And, the world doesn't have a (murmurs) of monitoring,
so we're trying to step up and say, Okay, let's fix this
for the entire world, individual countries will try get
the supplies allocated to them,
but only by having 7 billion doses,
do you really solve the problem?
- And we have this question from Maya
which Bergman on Facebook, I think everyone is wondering,
about just life until we have a vaccine.
And I'll add a little bit to it, which is, this world
you're describing, even in a good scenario, we might be able
to normalize and places in like the United States
and maybe June, but it's not even full normalization,
the vaccines is 18 months away, as we go back into the fall,
it might pick back up with the seasonality maybe,
what are the economic implications,
because as you talked about large gatherings,
sporting events, concerts, but even,
I can imagine people's behavior,
restaurants won't normalize for a very long time,
how do you see this playing out economically?
- Well, this will be the biggest shrinkage of GDP
in any of our lifetimes.
And there will be businesses like restaurants
or tourism, things that will be dramatically affected,
and so yes, the opening up, most jobs and school,
like in China, should be able to resume,
in rich countries, that do the right things by this summer,
by them we ought to have an additional type of testing,
which is a lateral flow, rapid diagnostic test
that is very quick, we ought to have, large numbers
of those, so that, broadly, we don't have
to triage quite as much, in terms of that testing capacity.
There will be types of activities that people will
be conservative about, even if the authorities,
if the model say that those risks are low, most people will,
It'll take a while to get back into the,
let's go take a vacation, let's buy a new house, tight mode.
So the economy, will be less vibrant in lots of sectors,
and so this idea of, how much government help can there be,
does that eventually cause huge inflation?
We are in unchartered territory, in terms
of how we minimize that, the economy will come back,
once you get the vaccine out there
and people mindset returns, so eventually
the economy will be bigger than it was before
we got into this, but the shrinkage
we're seeing in these few months,
is completely unprecedented,
and, they're human lives behind that.
- And there's a ton of questions that have come through
on various social media, from Facebook, Kandy, Westin,
Burcombe, Facebook Greg Ram, a lot of people are asking,
Kimberly Bizarre, why aren't we having just
a really hardcore sheltering place nationwide?
And I'll add that question, maybe make it global,
how do people balance, I've heard the argument
that the economic harm could could cause a lot
of deaths too and you could imagine in places like India,
I've been monitoring some of the news there of folks who,
with the shutdown, they have no livelihood,
and they don't know how they're gonna get food,
so that's happening even in the US,
so how do you weigh those tensions, and what do you see
as the dynamics that's keeping us
from a really serious shutdown versus some
of the more scattershot things that have been put in place?
- Well, whenever you do shutdowns, you always wish
you did them a bit earlier, and we should do this nationwide
because we're not gonna partition
the country into separate blocks.
So, we need to get going on that.
Your point about developing countries
is a very important one because, people live in slums
where they're close to each other,
they have to get food every day.
In rich countries we'll be able to maintain food,
electricity, sewage, garbage, through, several month period,
there will be incredible hardships,
but there won't be shortage of food,
we shouldn't see civil unrest coming out of this.
In the developing countries, you're just not going
to reduce social contacts as much, and so the likelihood
that you can, really bend that curve and get
to a small number of cases, it may not may not
be possible in developing countries.
And so that I'm very worried about the developing countries,
their health capacity is much less, the total number
of cases say in Africa, India today is not gigantic,
but we are starting to see it grow, and so in the end,
it looks likely there'll be more damage both in terms
of deaths and economic damage in developing countries
than in the rich countries.
- And there's a lot of questions that have come in on,
hopefully, I (murmurs) dystopian reality
that we're finding ourselves in,
but what you've articulated is in some ways,
is a hopeful scenario where we are able to shut down,
we are able to surface in the summer,
do you see this flaring back up in the fall?
And what do you think just life's gonna
be like for the next 18 months?
I guess it's just going to be at this weird new normal.
- Well, the next two months, hopefully we get
that cases down, and have we're so good at that point,
a quick turnaround, testing, contact tracing, testing,
that we have been, and some ongoing measures like,
no big public gathering, spacing, will must be part
of that we don't know, we're trying to do the experiments
to see how much that reduces transmission.
China is using that but, they're also using
temperature tests, we'll see how effective that is.
We don't know how seasonal this virus is.
If it is seasonal, then we'll start to see the benefit
of that reduced force of infection
in the Northern Hemisphere over the next few months.
Sadly that would mean the southern hemisphere would
be going into the strong season.
Right now the assumption is, that it's not very seasonal,
just because that's kind of the worst case assumption.
And these measures can help us even if it's not seasonal,
if it is seasonal, as you say, yes, our vigilance will have
that might be relaxed a tiny bit in the summer,
we'll have to go back up in the fall.
- And a question from Greg Roman on Facebook,
how will humanity change as a result of this?
- Well, I never lived through anything that's dramatic.
Did the the depression changed humanity,
World War Two changed humanity, the 2008 recession
to some degree change things, this is much bigger than
that 2000 anything, or anything that I've ever experienced,
And so it's hard to predict.
I mean, simple things like will people
take less business trips, will people be afraid
of foreign travel, I am concerned will this drive
us together within the country and across countries
to solve a global problem like this or will it have a say,
okay, you know, we just need to hunker down and, and just,
isolate at various tribal or national type levels.
I see the cooperation of scientists globally,
enabled by these Digital Connections is thought phenomenal.
We did the genetics on this virus very quickly,
that was very informative the testing and understanding
and many countries got going very quickly,
we are very much in unchartered territory
and so the fact that I saw this as a risk doesn't mean
that I understand the broad deep facts, many of which are,
sadly, scary and potentially negative.
- Yeah, and in that kind of goes to this question,
it's actually a more personal question from YouTube,
Marco Neto saying, hello, Sal and Bill?
As a team who is trying to make a difference,
what are your tips on maintaining a focused environment,
staying productive and prioritize
during this hectic and uncertain time?
I'd love I think a lot of people would love to hear,
how are you coping with the stress of everyone's trying
to say socially distance
but you're trying to help the world?
- Well, I think it's a great time.
Mostly digitally to talk to your friends understanding
the stress and uncertainty it's causing for them.
Thank God the internet, looks to have the resilience,
that it's a tool for us to constantly see what's going on,
have these collaborations, the foundation meetings
are always virtual so I'm learning about the rooms
that people have in their house
and their cats jumping up on their desk.
It is a chance, where you can learn a lot, thank goodness,
the online tools, Khan Academy in the lead there,
there's amazing materials,
how do you develop that discipline?
What is your day look like,
when you're not able to go out as much?
This is there's some tough adjustment,
ideally people would get a rhythm of Okay,
I'm online doing serious stuff.
I'm watching videos to relax, entertain myself,
I'm going, these are some friends
that I regularly connect up with digitally.
I do think in the next couple of weeks,
although they'll be immense tension, will fall into
a pattern, and there's no reason that learning at least
for those who have access, shouldn't go on or even
to some degree intensify,
the fact that some students don't have access even here
in the United States,
and some districts are therefore saying,
maybe they shouldn't do anything,
that is gonna create disparities,
that you and I have talked about
in the fall, how do we help get students who've lost
the entire three months?
How do we encourage them and really allow them
to regain that material, I mean, losing three months
of learning, there's a huge cost about it's hard to put
a dollar number on it, but no matter what grade you're in,
it's a very huge setback.
- Yeah, and one last question, maybe I'll throw it to,
there's we talked about a likely scenario,
it's I'm almost afraid to think about a worst case scenario,
there's possibilities I mean, I am curious, do you think
we might have shutdowns again, in the fall type of scenario,
but also I'd love to finish up on,
Is there a silver lining to this?
Is there something, that you're hopeful of,
that might come out of it?
Yeah, some people say you should never waste a good crisis,
how are you thinking about that?
- Well, part of the reason our foundation has been funding,
these new diagnostic tools and vaccine platforms is that,
they're useful, not just for the pandemic threat,
but also for diseases like Tuberculosis, HIV, Malaria,
that we've got and so, we've been funding these things
for over a decade and they do look promising both
for coronavirus and those other things.
I will say that, the the thing that we didn't act on,
five years ago when the danger was clear'
this time, governments will act on it,
we will get the right tools in place
and it's the resources of society
are dramatically dramatically less than we spend say
on the military to be prepared prepared
for that eventuality.
Hopefully some families are drawn closer together,
the idea of volunteering to help our people,
giving philanthropically, we're all in this together,
even time of a global basis, and so, this, the rest
of your life you will think of this event,
and how you responded to it, as a defining thing and,
I'm seen many people rise to the occasion
to help out others, or to use their skills
to try and bring this to an end.
- Thank you so much, We could obviously talk for hours,
I'm sure many people would love to hear there's,
we could tell there's just so much more that
we could learn especially about the virus.
But thank you so much, bill for joining us,
this was a real treat.
- Yeah, great to talk to you Sal, thanks.
- Thank you, so thank you everyone
for joining this livestream, I think
we all learned a lot today, I hope that we can have
a future live streams where we can, as I've talked about
in previous versions, talk about whether it's the pandemic,
talking about how do we keep learning,
how do we deal with kids at home,
who might have trouble staying focused, but regardless,
thanks for joining as Bill just mentioned,
the silver lining behind all of this is that is,
this is a bit of a shared experience for all of humanity,
and as stressful as it is, the more
that we can stay connected, I think the more
it will help all of us get through this.
So I will see you on Monday.