Gates attributed the increase in numbers due to lack of testing and contact tracing, as well as lack of wearing masks. He said other countries that had done those things effectively had seen the numbers decline.

“The range of behavior in the US today, some people are very conservative in what they do, and some people ignore the epidemic, it’s huge,” Gates said.

“Some people almost feel it is an unfavorable political problem,” he added, something he said he did not expect in America.

“The North Dakota governor, a friend of mine, must say ‘please don’t be cruel to people wearing masks’ that make thoughts like this explode.”

Gates rejected the White House’s claim that the increase in the number of cases was a direct result of increased testing, calling it “entirely wrong.”

He also expressed his disappointment at what he called the lack of US leadership to deal with the virus globally, which has caused developing countries – such as Brazil and India – to bear the biggest burden of the disease.

However, he said he still hoped that the US would “improve” and help get tools, especially vaccines, for everyone in the world.

Vaccine search

In terms of timeframe, Gates said that he was in harmony with Dr. Anthony Fauci, the nation’s top infectious disease expert, predicted that there would be a decent vaccine by the end of this year, or early 2021. He said he and Fauci were in constant contact.

During City Hall, Gates explained that there are two characteristics that are being evaluated in developing vaccines. First, that the vaccine prevents you from getting sick and second, that it prevents you from spreading it to others.

In the latter, he warned that “it is not guaranteed that the vaccine will be a perfect inhibitor of transmission.”

However, Gates said recent evidence showed that the antibody response was “very strong,” which indicates one year of immunity for anyone suffering from the disease.

The biggest hurdle, in his view, is not to develop or distribute vaccines – it will ensure people take it.

Because of the urgent need for this vaccine, the time for scientists to test it in various age groups and pregnant women will be reduced, he explained.

“It is a challenge to get a safety database to build confidence,” he said.

Finally Gates said he thought most people would accept it.

“If this is a great vaccine, including blocking its transmission, everyone will benefit from the fact that 70 to 80% of people will use the vaccine,” he said. “We should be able to get herd immunity if you go up to that level, so it really can – really exponentially – reduce numbers.”

However, he cautioned that the whole world needs to reach that level before people can go back on holiday abroad and safely welcome international students and sporting events.

New normal?

Asked whether people would accept the virus as a way of life – as it had received mass shootings – Gates said he hoped not.

“This is very severe. I hope the media continues to remind people about the tragedy represented here,” he said, stressing the injustice of the disease to the elderly, minorities and health care workers.

“Right now if you are in a nursing home, because they are very worried, you are actually living almost in a prison-like condition,” he said.

He said parents were right to worry about getting this and maybe dying.

“This is more than the children who died in Vietnam and that is a great national tragedy,” he said. “We are not ignoring that … this is bigger than that.”