Five years ago, Microsoft co-founder Bill Gates gave a TED Talk about global pandemics, warning that the world was not ready to take one on.

Now, in the midst of such an outbreak, he has been thinking about how to make up for lost time. Gates has invested in coronavirus research as well as global health more broadly. [Note: Gates is co-chair of the Bill & Melinda Gates Foundation, an NPR funder. The Gates Foundation funds the work of the Institute for Health Metrics and Evaluation, which produced a coronavirus model that predicts the U.S. death toll through early August.]

In a conversation with NPR's Ari Shapiro, Gates gives the U.S. response high marks for social distancing efforts but low marks for testing.

If you were tomorrow appointed the COVID-19 czar in the U.S., what steps would you take immediately?

It's pretty simple to say there should be a government website that you enter your symptoms, your profession, and it gives you a rating in terms of this very finite testing capacity we have to make sure that you always get results within 24 hours, that health care workers are getting those results very quickly, that it's not random based on where you are in the country or your relationship to the hospital. Rather, we're using that as the indicator of where we need to intensify distancing or where we can back off.

How confident are you the U.S. will take a responsible, evidence-based approach to returning to normal?

What I'm saying, what Dr. [Anthony] Fauci is saying, what some other experts are saying, there's a great deal of consistency. We're not sure yet which activities should be resumed, because until we get a vaccine that almost everybody's had, the risk of a rebound will be there. ... As we follow the numbers into May and see if we can get them down to a very low level, then in parallel, this debate about which things have benefits to society and can be formatted so the infection risk is very low, which things should we resume? I do think manufacturing, construction, a lot of things we'll do, but large public gatherings may have to await until we have that vaccine.

After this crisis subsides, what do you think the world needs to do to make sure that we're more prepared for the next one?

Imagine that the diagnostics had been available in a month and the therapeutics in four months and the vaccine in less than a year. When you have something that grows exponentially, the speed of those responses makes all the difference. A few countries really jumped on the testing, prioritized it properly, and they are not going to suffer nearly the deaths or the economic loss that most other countries will go through. We should make sure that we have those platforms ready to go. And the science is such that's very doable, and so we won't have to see this as something that's coming again and again and again.

Copyright 2020 NPR. To see more, visit https://www.npr.org.

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