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CNN Global Town Hall: Coronavirus Facts and Fears. Aired 12-1ap ET

Aired March 29, 2020 - 00:00   ET



BILL GATES, CO-CHAIR, BILL & MELINDA GATES FOUNDATION: So this is kind of a nightmare scenario that in 2015 I gave a (INAUDIBLE) lecture, I wrote an article in the New England Journal of Medicine and talked about how we needed to invest in new platforms so that we could quickly make diagnostics, make drugs, and make vaccines to stop an epidemic before it got to large numbers.

ANDERSON COOPER, CNN HOST: I know you did some of that investment, but was -- were all the things you called for or hoped would be done, were those done?

GATES: Basically almost none of them. A few countries, our foundation, and Wellcome Trust did fund a vaccine effort called the Coalition for Epidemic Preparedness and Innovation. And that -- and some of that work is being used to make the vaccine so it'll be the first to be ready for coronavirus.

But in terms of the testing, the antiviral drugs, not much happened. You know, people -- when you don't know that a problem will come around, sometimes people prepare like we prepare for war with war games and putting lots of money into that, but sadly we've gone long enough without a disease here in the United States that even though we had Ebola and Zika and SARS, not much happened.

The countries that really were affected by SARS actually are the ones that have done the best in this epidemic because they acted when the number of cases were still very, very small.

DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: So, Bill, when you give a talk like you did in 2015, and then you see what's happening now, I mean, could you have foreseen the rest of this, the sort of response, the lack of infrastructure, the lack of resources, no apparent strategy really out of the gate? Has that part of it surprised you given that, I mean, you were sounding the alarm five years ago?

GATES: Well, one of the things I called for is in that the same way we do war games on a regular basis and we say, OK, we're not ready to deal with surprises, I called for us to do germ games and look at, OK, who would talk to the private sector? Who would make sure that testing capacity was raised? Who would make sure that the right people are being tested, you know, not somebody without symptoms getting tested daily, rather, you know, medical personnel who have symptoms who really need to know?

And so I wouldn't have predicted exactly how slow and how somewhat chaotic the response has been. But if we had done those simulations, we would have seen some of those flaws in the system and, you know, behaved a little bit like the countries that have done the best on this one.

COOPER: It's important to remember that COVID-19 was only first found in humans a little over three months ago. It certainly feels like a lot longer than that given what we're going through. What stage do you think the pandemic is in right now in the United States and globally? And I guess, you know, what people at home want to know is how close are we to a peak here in the U.S.?

GATES: Well, the good news is that China did their shutdown, and they did it in a very serious way. And after a six-week period of a shutdown that's more extreme than even the best states in the United States are likely to do, they were able to start opening up again. And the total number of cases there is very, very small. So that's very good news.

And as people are developing models, they look at that Chinese data. They look at how the South Korean numbers have gotten under of control. So we're entering into a tough period that if we do it right we'll only have to do it once for six to 10 weeks. But we have to do it -- it has to be the whole country. We have to raise the level of testing and the prioritization of that testing quite dramatically in order to make sure we go through one shutdown, so that we take the medical problem and really stop it before there's a large number of deaths.

We do then get an economic problem, which is why you want to minimize the amount of time. And having states go with different things or thinking you can do it county by county, that will not work. The cases will be exponentially growing anywhere you don't have a serious shutdown.

COOPER: So even in -- because folks look -- people who want sort of county by county or say, you know, let's get back online faster say, well, look, in some states there's less than 200 cases. In many states there's less than 200 cases right now. You're saying even in those states the same kind of shutdown needs to occur?

GATES: Well, let's say you have 100 cases, and let's say you don't do a shutdown.


Then it grows 33 percent per day. So you take 100, you get 1,000, you get 10,000. It's exponential growth if you're not stopping it. The sooner you engage in the shutdown, the easier it is to get to that peak. We have not peaked.

You know, the parts of the country that are in shutdown by the -- in late April we should start to see the numbers peak there. They'll still be too high to open up, so you'll probably have to go another month to really get those numbers down. But any part of the country that has cases, and truthfully because of our problems with testing because we're not prioritizing testing the right way, a lot of those places actually do have cases.

But even if they have the hundred, that will grow and people do cross county boundaries. And so basically the whole country needs to do what was done in the part of China where they had these infections.

GUPTA: Yes, and it's worth pointing out, again, that states that had just a few cases last week have, you know, over 1,000 or sometimes 2,000 cases this week, to your point, Bill.

The other thing I'm curious about, you know, we keep hearing that the virus is going to dictate the timeline. Dr. Fauci has said that. When you look at this virus, we've got three-and-a-half months' worth of data now, 150 countries. If you apply all the analytics that Microsoft -- all the analytics that we can possibly apply to this, is how this is going to sort of progress and end knowable? I mean, can you give a clear answer depending on what sort of, you know, mitigation measures we have in place?

GATES: It's very likely that rich countries who uniformly throughout their country do a serious shutdown, that they will be able to avoid a high percentage of their population getting infected. That's what the exemplars, like some of the work in China and South Korea are telling us.

Now as you get to poorer countries, the difficulty of doing the isolation, where you live close by in slums, where you have to go out every day to get your food, it is going to be much, much tougher. And so, you know, by summer I think the rich countries that have been competently led on this will not have to go back into shutdown. And, you know, from the disease point of view, they'll avoid very large numbers of deaths.

And so in that phase we still will have a challenge with the developing countries.

COOPER: One of things that Dr. Fauci actually said in our last hour, which really concerned me, and I was asking him about the states that -- you know, I think there's more than a dozen or so that have a -- just 100 or 200 reported cases, he was saying how it's critical that -- you know, that those states, that they have testing there, that they test, and that contact -- do contact-tracing of all those who are known to be infected to really right now when the numbers are still low track it all.

And then I asked him -- he was using a lot of sort of future verbs about things needing to happen or plans. It didn't sound like --I asked him if it was actually happening now. He said it needs to happen a lot more. From what you're saying it has got to be happening right now because if there's not that contact-tracing in places where it seems like it hasn't really hit, we're going to see it hit.

GATES: That's right. I mean, we wish that we shut down even sooner in places like New York. Then you would have not had the medical overload that is such a huge challenge for them. Unless you're going to partition the country, the whole country has to be in this together. And we're not -- you know, I don't see us making people not cross county lines or something like that.

So it really is how many cases are in the country, and have we adopted in terms of testing -- testing prioritization and contact-tracing the right things. But the good news is we're seeing that countries that pay that price, which is a gigantic price, then the percentage of Chinese that are infected is like 0.01 percent. And so now, you know, stores are open there and closed in the rest of the world.

You know, that's -- I'm not sure you call it good news, but I totally agree with what Dr. Fauci said. He has been a very positive voice about the numbers driving this. And those numbers are very uncertain because of the -- still the disorganization of the testing capacity and where it's directed.

GUPTA: You know, it strikes me that -- I mean, you know the world of public health very well and you know the world of the economy very well, financial world very well.


They seem to be pitted against each other. And I don't normally know much about the financial world at all, but I think there's this idea, Bill, that maybe you can be a little incremental here, right?

Yes, we need to listen to the public health guidance and all that, but can we be a little incremental, start getting some things back to work, you know, so that we don't, you know, really devastate the economy that much? How do you respond to that?

GATES: Until we get the number of cases in the country down to small numbers where we can be doing testing and isolation against those small numbers, we need to make this our top priority. And it is super painful to drive this very high degree of social isolation I call shutdown.

The middle course really isn't there because it's hard to say, oh, go back to the theater for a week, you know, maybe or maybe not you'll be infected or infecting people. You know, until we get the certainty we've hit these low numbers, you know, I doubt even if you told people that they should be buying new houses and cars and, you know, hanging out in restaurants, I doubt they're going to want to do that.

You know, people want to protect older people. They want to protect their parents. And so the sooner, you know, we take this medicine, which is tough medicine, the sooner we'll be out of it and not have to go back into it again.


GUPTA: I'm sorry, just really quickly, when you say low numbers, I mean, are you talking about actual numbers or are you talking about spread? Because this is a virus that can spread to two or three people. That's a lot. I mean, if it spreads below -- to just below one person, is that what you're talking about or are you talking about actual numbers?

GATES: Well, the absolute numbers better be pretty low because you're going to have to have the testing capacity to take the remaining positives, see them early, and so you're not getting that exponential spread. And that's why looking at the other countries who acted sooner, and in some cases did not have to shut down to a full degree, that's where the lessons are.

You know, they can show us, OK, what was the medical history? So you see if asymptomatic are spreading. But, yes, the absolute numbers are going to have to be fairly low, and we'll have some degree of caution. We won't open up completely overnight and, you know, because we don't want quite the full exponentiation even off of the small base that we'll get ourselves to.

COOPER: And I don't want to be political in any way, but just in terms of for folks who are out there, you know, and looking forward, I always think it's better to know just factually what's coming down the pike than -- you know, than it's good to have hopes and aspirations, but it's good to also to know what's actually coming down the pike.

For people who are believing or imagining that, you know, in middle of April or early April people will be able to gather together in churches for, you know, Easter celebrations or, you know, go back to work in a regular way, it's sounding like you're saying that that's not -- you don't believe that's realistic.

GATES: No, it's not realistic. The numbers are still going up. That only happens after the numbers have peaked and are going down a lot and getting down to an absolute level. You know, there are some good things happening. The work on a vaccine, although that probably will take 18 months, that's going full speed ahead. Our foundation is funding that. We're looking at getting vaccines to everyone in the world. So in the long run that is the key thing.

We had a really positive result that people were wondering, did you have to have the medical person swab you in this way that they stuck it deep in your nose? We were able to prove, which -- on Monday the FDA made official that if you do a self-test where you don't have to have the medical worker with personal protection equipment, that self- test is as accurate as the one where the medical worker gives it.

So that means that by self-swabbing we'll be able to get a lot more tests done and only be limited by the PCR back-end capacity. So there's -- you know, there's good news coming. One of the therapeutics -- although none of them are proven out, but there are quite a few. We have a thing -- a foundation created called the Therapeutics Accelerator to really look at thousands of compounds and make sure we focus the human trials on the ones that have the most promise.

So, you know, innovation, which -- some of which we could have done in advance. But innovation really is happening. But, you know, when you look at those numbers, the U.S., you know, now with the most cases, you know, there is no state that has gotten to the point where their numbers are flat and are going down. And the testing capacity means we're quite blind to a lot of these cases right now. [00:15:17]

So, it can be done, but we're not -- you know, the light is not at the end of the tunnel in terms of a mid-April reopening.

COOPER: Can I just ask, on a personal basis, for your family, I assume you guys are self-isolating.

How is -- what is your life like now, compared to what it was? And how long do you think you are going to have to, as a family, live like you're living?

GATES: Well, there's some uncertainty about this.

But my view has been that through May, unfortunately, the schools will not -- are not likely to come back for this year, this school year. And that's about the range, late May, early June, that we will probably have to be like this.

You know, I'm learning how to do digital meetings. I happen to use a thing called Teams from Microsoft. But it's a very different lifestyle.

And it's very jarring. We're in a -- it's a scary time. Every morning, you get up, you see that number has increased. So, you know, learning to cope is -- you know, we're completely in unchartered territory.

But the scientists that our foundation gets to fund and work with, they are doing a great job. And the health workers are doing heroic work.

So, I do see it coming to an end. And if we do it properly, we will only be shut down in the U.S. for that one period of time.

COOPER: I don't know if you saw Sanjay Gupta's tutorial on how to wash your hands, but, to me, it was a revelation that you have to, like, clean your thumbs separately.

That, I was unaware of.


COOPER: You probably knew this, Bill.

GATES: I will have to go back and study that.



GUPTA: Not separately. But you do have to make sure you get your thumbs, for sure.

Let -- a few years ago, Bill, we talked -- I don't know if you remember -- talked about pandemic flu at that point and vaccines, and how quickly a vaccine could be deployed at that point, and if you did it months faster, you could save a lot of lives in a pandemic flu situation.

With this, you know, Dr. Fauci, I think, has been very clear that this is year, 18 months, whatever, that it will take before people could actually get this vaccine.

Are there -- are there -- and I know that he's right about that. But I'm just wondering, from a technological standpoint, are there ways to speed this up using genetically modified virus or anything to expedite the process?

GATES: Well, for the next pandemic, we should be able to make diagnostics very quickly, like hundreds of millions within two months.

We should be able to scale up antiviral drugs from a much bigger library within like six months. And by being ready with this RNA platform, we should be able to make vaccines in more like a year than a year-and-a-half.

And so we can. And I think governments this time probably will pay attention to making those investments for the next one.

You know, the -- one of the biggest open questions is the therapeutics. Can we very quickly find an antiviral drug that really means the number of people who have to go on the respirator is much lower and cuts down that death rate quite a bit?

It's tough enough in the U.S. with the -- we put a lot of money into our health system. If you think about this as you get to India, Nigeria, and the even poorer countries in Africa, just imagine what the overload is going to look like there.

And yet they won't be able to do the -- that isolation. And so, you know, we -- we -- as we have gotten the disease down with the low infection rate, we will have to be not letting people go to those countries or come from those countries hardly at all.

It'll be very strict in terms of how that testing is done. So, the sooner we solve this on a global basis, the sooner we can go back to the kind of world economy that actually was in very good shape before this came along.

GUPTA: And just to be clear, you think that there will be lessons learned and applied for the next pandemic?

It seems, sometimes, unless something is smacking us in the face, Bill, that people just don't pay attention, even when it comes to their own individual health, let alone public health.

GATES: Well, talk about being smacked in the face.

What's going on here is mind-blowing. Never in my lifetime has -- have we had to change our behavior and have this drastic effect on the economy in order to save lives.

[00:20:02] And, you know, there are people who wish we didn't have to do that. I -- that is fully understandable. This is some very tough medicine. But it's better to take the economic problem, where the economy can come back, than to allow it to spread throughout the country and take millions of deaths as the price that we have to pay here.

And so, yes, I think this is a smack on the head. You know, this will cost trillions of dollars. They just passed a $2 trillion relief bill, and now they're talking about more.

The kind of research to be ready for the next pandemic is a tens-of- billions number. So it'll look almost trivial compared to the price we're paying now. And that price would have been a lot lower if the world was more prepared.

COOPER: There -- a lot of people don't understand why a vaccine can't be developed sooner. The biggest reason for that is simply science, which I something we can't necessarily change.

But you're saying that it could down the road get to a place where it would take a year, not a year-and-a-half. Is that after spending the tens of billions you're talking about?

GATES: Yes, the -- you know, companies like Moderna, CureVac, Inovio, our foundation has been funding them to build vaccines in a somewhat different way.

It's an RNA platform that is very versatile, so the amount you have to change is very small. And you can build up your manufacturing, so that it is available. No matter what pathogen comes along, that manufacturing capacity is there, and certain elements of how you go through regulatory approval.

Because you're only changing one small piece, you would have had many of these RNA vaccines approved. People understand the safety profiles. So that would mean that, in the future, yes, that timeline is less.

Because you want things to be safe, and, you know, vaccines actually can, in weird cases, do an enhancement of the disease, you really need to test for that.

And so I don't think we will get much below a year. You know, we will challenge very smart people to work on that. But there -- the trade- off involved there is about the -- how confident are you that, when you're going out and giving this, that there's no side effects?

COOPER: I do just want to follow up on something you said, that it -- and I think it's important to point out that, as bad as this is, this could be worse, in terms of a virus -- you have talked about the potential of a pandemic that wipes out, you know, huge percentages of countries' populations, and that is entirely possible.

So, for anybody who doesn't think that this is reason enough to prepare for the next one, there -- something coming down the pike could be much worse, correct?

GATES: That's right.

You will see in the -- a lot of people try to show that viruses, their infectivity and how much they kill, the case fatality rate, those are separate things. And so smallpox is a very bad case, because it's very infective and it kills like 30 percent.

Here, fortunately, although there's still some uncertainty, you know, the case fatality rate is something like 1 percent. If you have a medical system that's able to take care of the severe cases, about 1 percent of those who are infected die.

And, yes, it could be worse. This is very, very bad, but still not the worst-case.

GUPTA: I have got a question sort of about how you see the role of the public sector vs. the private sector when it comes to something like this, a pandemic, you know, a global issue like this.

You know, you were talking about the testing. And there was a press conference at the White House where they had people from these various private diagnostic testing organizations and other consumer-facing organizations that were private.

You know, with something like this, is -- how does that collaboration happen? I mean, is there -- should the roles and the responsibilities be more equally, you know, divided, or at least described?

GATES: Well, the responsibility to take care of the health of the public, that's a governmental responsibility.

And so, in the case of testing, those companies aren't in a position to decide who should be tested and who shouldn't be tested. Those are societal priorities.

So, right now, it's fairly chaotic. I said somebody can get a test every day without symptoms, and a medical worker in another location doesn't have access to the test.

So, the values we have as a society are understanding the disease dynamics. And the very finite capacity of the way we're doing the tests now, which is the PCR machines, that is up to the government to get involved with.


In this case, state leaders have had to step in and take some responsibility there. But, you know, it's kind of unfortunate that we don't have a digital system that is ranking for the finite capacity we have exactly which ones should be taken care of there.

And maybe we will get that fixed or not. Maybe that'll strangely have to be at the state level.

But the government is in the role here. And it has to design the system. And then the private sector companies, you know, who own those machines, run those machines, they will step up. They will work super hard.

The clarity, though, has to come from the federal government.

GUPTA: You talk about vaccines and anticipating a pandemic like this.

If you go even one step further back, Bill, and say -- I read an article that said that this virus was actually found in bats sometime ago. It was a virus of concern for people who were looking for this, because it was a coronavirus, and there was a concern it could jump from animals to humans.

Do you think that this could have been prevented even earlier on from making that jump?

GATES: Well, having these markets where you have, you know, bats in a cage and pangolins and things like that, it's fairly clear the less we have of those, that somewhat reduces the chance.

But it won't reduce it to zero. And so you really do need the preparedness system there. And there are so many coronaviruses in animals, it would not have been possible to say, OK, this is the one to be afraid of.

We don't understand enough about that, how it transforms to cross the species barrier. There are literally millions of viruses out in animals. The number that cross over, like the flu does, is not very large.

But that's not very easy to predict. There are people who have looked at that, maybe someday. But that's outside of our ability. And so we have to have the tools, when it does cross over, to see, wow, if you're seeing human-to-human transmission, particularly respiratory transmission, then the world has to go on red alert.

And parts of the world went on red alert in January, and parts did not.

COOPER: You have talked tonight a number of times -- you have referenced the importance of testing.

And I just kind of want to circle back to that, because we're hearing from a number of, you know, public leaders that they seem to be de- emphasizing it, saying, look, we're not going to test the whole country.

And there's now guidelines that, if you have symptoms, you probably don't even need to get tested. As long as you're not really bad sick, you can just -- or very sick, you can stay at home, and, if things get worse, then contact a hospital or your doctor.

Can you just talk about the role testing has moving forward? I mean, obviously, we know the problems with the test that existed. We know all that, but, just moving forward, how important it is to keep testing.

And do you want to -- just to get data, is it you just test the people who have symptoms? Do you test people who have no symptoms whatsoever to kind of get some sort of a baseline?

GATES: Yes, for surveillance, you probably do want to go out and almost randomly pick people, even asymptomatic, to see if you're missing something there.

And our foundation, with partners in the Seattle area, actually has that going on. We took a flu study that we were doing before and repurposed it. Actually, that flu study was the first to see community spread of coronavirus in the U.S. and should have been a red flag when that was seen.

In any case, the testing is very key. The only reason we talk about what you do if you can't get a test is that demand will exceed supply, even as we get organized with more capacity and we're doing the prioritization, that not everyone will be able to be tested.

I mean, people are so concerned now that, if you really could test everybody, you know, that would be nice. But we don't have, you know, 300 million tests available, even if we're doing the right things.

Testing is how you know what's going on. That's where you see those red dots. That is the indicator that will tell you we're not doing enough of a shutdown, or, actually, now we can start to back off.

So, testing has to keep going up. Testing is very, very central. But we won't be able to get a test to everybody who just wants that peace of mind, unfortunately.

Eventually, we may have a strip test that tests for the virus, not for serology. But if it has the right sensitivity, we could have a scale- up there.

But, unfortunately, that's probably you know 6 to 9 months before we'll have that type of that home test.


COOPER: I know we got to let you go. Just finally, for - you know there's a lot of folks out there tonight watching or going to be watching this online or whenever tomorrow. What's your message to them? People are scared, people are worried, they've lost their jobs, they're -- they don't know how long they're going to be in their homes. What do you -- what's your message?

GATES: Well, this is a very challenging time. And we're all having to make huge changes to our lives that we never would have expected. People are rising to the challenge, you know, figuring out how to be at their home and reduce their contacts. That's really fantastic. People are figuring out how to volunteer, in many cases through virtual connections, tutoring and mentoring. People are giving money to philanthropies in the local areas that are stepping up to find where people may not have shelter or food and that's really fantastic.

You know, I'm an optimist. We'll be driven by the numbers, but I -- from what we've seen in other countries, if we do this well, and nationwide, these numbers will start to come down. And so there'll be a point, you know, hopefully in -- in 10 weeks or less, where we can start going back to normal.

That's a long time, though. I mean, it's a wild amount of time, and there will be this temptation to let off. Unfortunately, that will just mean that it -- it lasts longer or that we have to go back and do that again. So, you know, there's no need to panic, even though the change is a bit scary.

GUPTA: If I could just ask one more thing, because I think you're so -- your voice is so important here. But there's a lot of people who are watching right now who have not been affected by this, and they're feeling fine, they don't know anybody who's contracted the coronavirus. How do you best convey risk in a situation like this?

GATES: Well, if we do the shutdown properly, the percentage of people who get infected will actually be very low. That's the idea, is to not get up to like 1 percent, which, you know, then is 4 percent, 16 percent, 64 percent, if you keep letting it exponentiate that way. So you have to stop well short of that 1 percent.

You know, the damage, there will be a lot of economic damage. Somebody who owns a restaurant, somebody who's now -- their job is not there. That, you know, we'll have to be creative on this new ground how we do things like relief packages to help out and minimize a lot of that pain.

But the medical risk, if we do this thing well, the chance that you're going to get coronavirus and die of it is not super high. There are other diseases that will still be killing more people during this timeframe, if things are done well. We're really focused on this, because we need to be to change the behavior to nip it in the bud at modest percentages of the population.

COOPER: Well, Bill, thank you very much for being with us tonight. And thank you for the work that you and Melinda do all the time. Thank you so much. Really appreciate it.

GATES: Thank you. Great.

COOPER: Just ahead, the psychological impact of the pandemic not only for those families immediately affected, but for the millions whose daily life has been upended. We'll be right back.



COOPER: Welcome back. Dealing with the pandemic is, of course, not only enormous physical strain, but the longer this goes on, mental health and mental fitness are paramount. Take a look at this map. At least 20 states and several cities are under stay at home orders. New Hampshire will join them. Just moments ago, the governor announced the mandate that will go into effect tomorrow night there. Life sure is a lot different for more than half the country's population.

Joining Sanjay and me now is Dr. Christine Moutier, a psychiatrist who we've talked to before many times. Dr. Moutier, the last we spoke just about, I think, two weeks ago, so much has changed for everyone around the world. Let's just talk about gaining perspective on what's happening right now.

DR. CHRISTINE MOUTIER, PSYCHIATRIST: Yes, Anderson. It's amazing how things have evolved so quickly. But, you know, what I've noticed is that people are paying attention to their well-being, how they're coping, keeping their resilience up, and connecting with others.

And, you know, we can be really proud of that in this moment. It's actually a first time ever that during an infectious disease epidemic or pandemic we are paying attention to mental health. And one of the reasons that is so important is that right now we have the ability to change the outcome of the viral outbreak, the timing of that. And we have the potential to try some new things related to our brain health that we might not have tried before, because we are in such a different set of circumstances.

COOPER: When you talk about brain health, like what?

MOUTIER: Right, so when we think about mental health, the brain is a physical organ in the body. Just like every other organ in the body, it's interacting with our life, our choices, and the environment. And so the World Health Organization tells us that among all the causes of disability worldwide, depression is actually at the top of the list.

And so it's really -- in a way, it's time to focus on this, because we are not powerless. We can actually do something about the clarity of our mind, our mood, our sleep, our perceptions, our feelings, our thoughts. All of those are related to our brain health.

GUPTA: You know, Dr. Moutier, maybe it's because I'm somewhat of a control freak, but uncertainty feels like a particularly challenging thing to deal with. I mean, do you have any advice? I mean, people don't have a lot of certainty right now with regard to how this is -- or when this is going to end and the economy and all these things that we've been talking about. What do you tell folks like that?

MOUTIER: Yes, it's unsettling to all of us, to be in this uncertain time. But what I would encourage people to do is think about the ways that you can use some brain exercises -- they're really cognitive exercises, this stems from cognitive behavioral therapy and other disciplines that we can all tap into right now, actually, while telehealth is rising up to the fore and available to so many more.


But what I would encourage people to do is really think about what you have in your control and what you don't have in your control. Those are facts. You can get your head around that. And then you can move towards what is in your control, which actually is a lot. These are the choices that we can make for ourselves and our families right now.

COOPER: There's a lot of questions from viewers. And Nermeen in Canada wants to know, says, "I'm 39 weeks pregnant, I live in Kitchener, Waterloo, Ontario, and I'm wondering how I'm going to give birth and protect my baby and to be safe at the same time. Please advise me what to do, because I'm so stressed out with the current situation."

MOUTIER: Right, well this is a time where certain populations circumstances create an extra set of stress and burden. And, again, depending on it in this case, it's imperative, obviously, that she's staying in close contact with her OB/GYN, her health care provider, and working through what the plan will be, given the circumstance that is upon us right now.

You know, there is actually a whole movement, a whole group of individuals who are coming together around their pregnancy and around having newborns in the home right now. And you can tap into those resources. There's a lot of guidance actually going on from experts within OB/GYN and within -- there's actually a whole arena of women's mental health, as well.

GUPTA: You know, and I should point out I think last time you were on, Doctor, we sort of made this point that social distancing does not have to equal social isolation. I think that's an important message.

Let's get to another question. This one is from Karen in Fairfield County, Connecticut, which reads, "I have major depression and general anxiety. I'm 62 years old. I recently suffered a heart attack. And I'm recovering in a rehab center. I've seen a psychologist prior to this, and I was actually seeing a different psychologist while I was an inpatient here prior to the coronavirus crisis. Now I've not seen her in three weeks. I don't expect to see her until it's safe for visitors here. I will not be released from here because I have no one to care for me. My depression and anxiety have gotten worse. I have no one to talk to that is a mental health professional. What do I do?"

Dr. Moutier, I mean, you know, it's tough to -- you know, if people aren't allowed to, you know -- if they're socially distancing, keeping distance, to actually have these types of visits, to get the types of services, I mean, I really -- you have to feel for somebody like this.

MOUTIER: Yes. You know, I think in her circumstance, I would really go into an advocacy mode for yourself. I'd really just send you a lot of encouragement and support. There are psychiatric and psychological services that you can tap into even remotely, through video chat, and you can ask your care providers there in the hospital about that.

It's a time when people with a history of mental health conditions need to take extra special care of their mental health right now. And it is a time when we can do that. Even if you had never seen a mental health provider, there is the opportunity to do that now through telehealth services.

GUPTA: I'm really glad we're having this conversation, because I think there is a lot of focus on physical health, understandably. But a lot of people are dealing with this for real now. And besides the resources that Dr. Moutier mentioned, the CDC, I know, also has a page of resources. You can see the web address right there on your screen.

COOPER: Yeah, Dr. Moutier, as always, thank you so much.

Coming up, we're going to talk to five-time Olympic gold medal winner -- gold medal swimmer Katie Ledecky about the postponement of the 2020 Summer Games and what we all can do while we're isolating ourselves. We'll be right back.



COOPER: And welcome back to our fourth coronavirus town hall. We still have our social media scroll at the bottom of your screen. You can tweet your questions with the hashtag #CNNtownhall. You can also leave a comment on the CNN Facebook page.

Today was to have been opening day for Major League Baseball, one of countless sporting events either postponed or canceled because of the virus. The Summer Olympics in Japan, as you know, have been put off until 2021, which affects thousands of athletes worldwide who expected to compete. Among those athletes, Olympic gold medalist and a member of the past two U.S. Olympic teams, and one of the most dominant athletes in the world, swimmer Katie Ledecky.

Thanks so much for being with us. First of all, how do you feel about...

KATIE LEDECKY, U.S. OLYMPIC SWIMMER: Thanks for having me.

COOPER: Yes, how do you feel about the Olympics being postponed?

LEDECKY: It's obviously disappointing, but it was certainly the right call. I think we all expected it as we saw how things were going around the world and here in the U.S. A lot of athletes weren't able to train, and we could see in the future that that was going to be the case. And it doesn't really make sense to bring everyone from around the world together in the middle of a pandemic.

GUPTA: So how is Team USA then moving forward, Katie, now that these plans have been upended?

LEDECKY: Well, we're still waiting to hear when the Olympics will take place, what the actual dates will be. And then from there it will kind of be a ripple effect of scheduling and scheduling of our Olympic trials, which still need to be held, and a lot of competitions to prepare us for the games. So it's a lot of planning to be done now.

COOPER: So you're in Palo Alto, California. I assume you're -- what's your situation now? Are you able to even -- I mean, you're like -- are you like everybody that is trying to figure out how to work out in being socially isolated and stuck at home?

LEDECKY: Yes, so typically I train at Stanford. I'm a student at Stanford. And everything around here is closed down in the Bay Area, all the pools, everything. During these last couple of weeks we've been able to swim in some backyard pools, just very small groups. And really I'm not doing anything besides staying in my apartment trying to stay in shape the best I can. But pretty much doing what everyone else is, hunkering down. GUPTA: You know, I mean, I think exercise is such a big part of

staying mentally and physically healthy, especially when people are hunkered down, not just for adults but for kids, too. I have three kids and I think the reason they're watching this town hall tonight is because they knew you were going to be on, not for me.

But to the millions of kids out there who don't have sports as an outlet right now, Katie, what advice do you give them about staying active?


LEDECKY: Yes, it's very important. And it's tricky when pools close and you maybe can't participate in team sports and do things with other people. So I was doing a video call with some swimmers from back home yesterday, and I can tell that it's tough and they're facing this new challenge.

But I think I would encourage everyone to set some goals for themselves, whether it's in exercise or setting goals for the future for when they get to go back in, start competing again or practicing. And just find things outside of your normal routine to give a shot and do something different.

I'm probably going to be doing different kinds of workouts to try to stay in shape during this period of time and I encourage everyone to do their best with that too.


GUPTA: Do you think you'll have a hard time rebounding or do you think you'll be able to get back to your level of fitness?

LEDECKY: I think I'll be able to get back there pretty quickly. I think, you know, we're all facing the same uncertainty of we don't know when things will be back to normal and what that new normal will look like. But I think once we can start kind of knowing what that will look like and when the Olympics will exactly be, we can get back into hard training and work towards Tokyo.

COOPER: You're obviously a highly motivated person. I didn't work out today at home because I convinced myself that I had too much to do even though I really didn't do anything else. So how do you stay motivated? I mean, how do you force yourself to do it?

LEDECKY: Well, you know, my goals aren't changing. I still have goals that I want to achieve, goals that I was hoping to achieve this summer. But I'm perfectly fine with putting those on the back burner for next year and staying committed towards those goals. I think goal setting has been crucial for me and that's what keeps me so motivated every day to get out of bed and work out hard.

And I want to represent Team USA next year and do it really well. I think it's going to be really cool if everything comes together. Hopefully that -- you know, hopefully we can continue to fight this disease and reduce the spread and be able to compete in Tokyo. But I think when we get there, it's going to be a true celebration of the world being able to come together again.

COOPER: Yes, Katie Ledecky, appreciate all you do and thanks for being with us tonight.

GUPTA: Thank you.

COOPER: And best of luck.

LEDECKY: Thank you. Thanks for keeping us informed.

COOPER: Yes, well, thank you, appreciate it.

Up next, something to cheer all our spirits, our moment of hope. We'll be right back.



COOPER: We hope tonight has been an educational experience that used facts to cut through fear and myth. Before we go, though, we want to leave you with this moment of hope. Two stories, actually. The first, the antidote to so many good-byes that people have had to say far too early to loved ones.

GUPTA: Well, instead tonight we're presenting you with this, a hello. Now, as you know, visitors are not allowed in many hospitals as things go now. That goes as well for the families of newborns. Of course, if you're a grandparent or if you know a grandparent, then you know that nothing, absolutely nothing can keep a grandparent from seeing their first grandchild.

According to NBC10 in Boston, that's what happened at a hospital outside the city. The birthing unit at North Shore Medical Center is on the ground floor. And that gave the grandparents of an adorable little girl the ability to meet her through the window. Also gave them an opportunity to go outside and take a walk. In fact, grandparents from both sides of the family were able to walk to the window and see their grandchild.

Anderson, you'll notice they're still practicing their social distancing. We want to congratulate them.

COOPER: I love that they brought a ladder too so they can spend more time.

We also have one more moment of hope tonight. Nurses at the Cleveland Clinic in Ohio had ho left hopeful messages for a man in their care. They wrote them on the glass door of his room. When he left, the nurses found that the man had left a note of his own on the door. And I want to read the note to you in full because it needs to be heard. I'm quoting what he wrote.

He said: "This window has been the most impactful window in my life. On days when I watched you work hard to keep me and others alive, unable to thank you for the time that you poured into me. And although I will probably never get the chance to pour that same love and support into you, I want you to know that I think you are all rock stars. I watched some of you have good nights and some bad nights, but what was consistent every night was that you care for people. Today I leave this ICU a changed person, hopefully for the better, not only because of your medical healing and God's direction and guidance, but with the fact of knowing that there are such wonderful people dedicated to the care and concern of others. God bless each of you."

God bless doctors and nurses and X-ray technicians and medical technicians.


COOPER: Yes. There are so many people working for -- to keep all of us alive.

GUPTA: I mean, you know, I don't think I've seen anything quite like this, this sort of outpouring of gratitude. It's really pretty incredible, Anderson. I mean, you think about it, these doctors and nurses that are on the front lines, many of them who don't have personal protective equipment, they don't stay home. They say, I'm still showing up to work every day.

This week, as you know, Anderson, New York's Governor Cuomo, he asked for volunteers to help with the fight. Forty thousand health care workers, including students and retirees, they answered that call. All of that when you hear that makes what we do as individuals I think so important.

And right now there are millions of Americans who are heeding the guidance to stay home, living, I realize, with both the fear of the virus and the worry about their own economic future, but they're still doing their part. The world is different now than it was last month or even last week, for that matter.

But, you know, Anderson, I think these are the moments where our humanity really does shine through when we're challenged like this.

COOPER: Yes, it's a cliche, but it really is true, we are all in this together.

A lot of you asked how you can help, you can find out by going to

Sanjay, thank you. Please stay safe, be careful.


Thanks also to Dr. Anthony Fauci and Bill Gates, who joined us, and also to all of you who wrote in with your questions and to everyone who joined us tonight. Be careful. Be safe. We are all in this together.

Remember that tomorrow night we have another town hall, this one will be with Democratic presidential candidate Joe Biden, who joins us to discuss the coronavirus pandemic. That's tomorrow night, 8 p.m. Eastern, Joe Biden. The news continues right now with Chris Cuomo. Chris?