In a recent Q&A with The New York Times, Melinda Gates reflected on the COVID-19 pandemic, the challenges and hesitations around a vaccine, and “letting her heart break” over the suffering she has witnessed in parts of the world.

And in her own opinion piece in The Washington Post, Gates further expanded on the response to the national health crisis and what it has done to the caregiving system in the United States and women in particular. She called on President-elect Joe Biden to make it a priority to appoint a “czar for caregiving” when he takes office in January.

Gates, the wife of Microsoft co-founder Bill Gates, co-chair of the Bill and Melinda Gates Foundation, and founder of Pivotal Ventures, told the Times that she wasn’t surprised by the spread of the pandemic as much as she was by the economic impact. And she still finds it “insane” at this point, 10 months into the pandemic and 282,000 U.S. deaths later, that “we’re still debating whether people should wear a mask when they go in a store to buy their groceries.”

Here are a few highlights from the NYT Q&A:

  • Vaccine disinformation has been harsh and it is harmful. Gates attributes the spread to social media and conspiracy theorists who can easily connect to others during an age of heightened polarization. The fact that she and her husband have been targeted points to fear and people who are looking to point to somebody or some thing or some institution. The Trump administration has not helped with its politicization of vaccine development, she said.
  • On drug makers profiting off vaccines, Gates said a small profit makes sense “because we want them to stay in business,” but as far as how much profit, she said only “slightly above the marginal cost of the vaccine.”
  • When it comes to her own immense wealth and privilege and reconciling it against the suffering of so many people, Gates said she spends a lot of time reflecting the people she has met and what she has learned about their loss. She said she goes to a place where her heart “really hurts for everybody” and she cries a lot, and then asks how she can make the world better.

In her Post op-ed, Gates speaks to the crisis in child care and long-term care, how unaffordable and inaccessible much of it has been and how “women were filling the gaps at tremendous cost to their own economic potential.” During the pandemic, the situation went from bad to beyond worse, “especially for single mothers, essential workers and others working low-wage jobs with unpredictable hours,” Gates wrote.

By appointing a White House “czar,” as presidents have done during other national crises, President-elect Biden could show that the federal government is formally considering the needs of caregivers in all policymaking and legislation.

Such an official could work with Congress to get immediate relief for American families, advocate for a national paid family and medical leave law, and more.

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