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Bill Gates is still criticizing the state of COVID-19 testing in the US, calling it a “truly sad thing” at The Wall Street Journal CEO Summit this week. But he offered a glimmer of hope, noting that the antibody drugs used in President Donald Trump’s treatment could dramatically curb the death rate from COVID-19 once they’re approved by regulators and made available to the public.

This isn’t the first time that Microsoft’s co-founder and now full-time philanthropist has railed against US testing, which has faced slower-than-hoped turnaround times throughout the pandemic.

“The majority of all US tests are completely garbage, wasted,” he told Wired in August. Gates noted in the interview that the reimbursement system set up by the federal government pays at the same level for all tests, which means companies providing them just administer as many as possible. But the government could fix this if it changed the system to pay extra for results within 24 hours, a normal fee for 48 hours and nothing if it goes longer.

“They will fix it overnight,” he said.

Gates also noted that COVID-19 tests don’t necessarily need to jam deep into your nose, as they commonly have been. He said that a self-test that just reaches inside the top of your nose with a cotton swab is equally effective.

At the WSJ CEO Council Summit, Gates expressed optimism for drugs developed by companies such as Regeneron Pharmaceuticals.

“The reduction in death rate there could be pretty high, and those will be out in volume by the end of the year, at least in the rich countries,” he said.

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