The following is a transcript of an interview with former FDA Commissioner Scott Gottlieb that aired Sunday, August 9, 2020, on “Face the Nation.”
MARGARET BRENNAN: Welcome back to FACE THE NATION. We go now to former FDA commissioner Dr. Scott Gottlieb. He joins us from Stamford, Connecticut, this morning. Good morning to you–
DR. SCOTT GOTTLIEB: Good morning.
MARGARET BRENNAN: I know you’ve been dealing with power outages in Connecticut as well. So I thank you for- for coming on today. I want to ask you this overall number. It seems stunning. Five million coronavirus cases in the United States. Two and a half weeks ago, you predicted that by the end of the year we could be at 300,000 deaths. Is that still where you think we are headed?
DR. GOTTLIEB: Well, we’re definitely going to be somewhere between 200,000 and 300,000, and whether we’re closer to 200,000 or closer to 300,000 depends on what we do and how this evolves. We’ve now had two waves of this epidemic, the New York wave and now the wave through the Sunbelt, which is receding, although Texas is showing signs of an uptick at least in the last week and that needs to be followed closely. We’re probably going to have another wave. And the concern now is that this has become so pervasive across the country that it could start to infect more rural communities that have largely been untouched to date and probably are a little bit more complacent because they have been untouched, but are still very vulnerable because the infection hasn’t been there. And if- if this does become more pervasive across the country and it’s not just in the urban centers, but also in more rural parts of the country, that’s going to be far more difficult to control if it’s more widespread. And we’re seeing indications of that right now, the way it’s spreading in the Midwest and the west.
MARGARET BRENNAN: When does someone who has COVID stop being a risk to others?
DR. GOTTLIEB: Well, the data shows 10 days after the onset of symptoms, you’re no longer shedding virus that can cause someone else to become infected. So you’ll continue to shed virus for a persistent period of time. But when that virus has been cultured, it hasn’t grown, which means it’s dead virus. And so right now, the recommendation is that 10 days after the onset of symptoms, if those symptoms have resolved, if you don’t have severe illness, then you’re no longer contagious. Previously we were saying about two weeks, but the more recent data outlines about 10 days.
MARGARET BRENNAN: So we still have that question of, you know, what if you just don’t know. And since 40 percent of cases, according to the CDC, are asymptomatic, you don’t really necessarily know who is carrying the virus. So you’ve talked about the need to increase testing and to improve it. Should there be a requirement that teachers get tested before they go into a classroom, that anyone going back to the office full time get a test?
DR. GOTTLIEB: We’ll look, ideally, we would have that. If you look at what universities are doing right now that are reopening for on campus learning, they’re implementing widespread testing. They’re testing students two or three days a week. We don’t have the resources. We don’t have the capabilities right now in most districts to do that. And that really is the bottleneck. We need the- we need to implement more low cost tests, tests that could be done at the point of care or at the point of school or work. There’s going to be a saliva test that’s hopefully coming on the market, going to get an authorization from FDA in the next week, and that will provide more access to testing. But right now, we don’t have the testing available to implement the kind of oversight that we’d like. It is the case that if you’re asymptomatic, you’re less likely to spread the virus. CDC models that people who are asymptomatic are about 50 percent less likely to spread the virus and you’re probably most contagious right before you develop symptoms. And that’s really what leads to the super spreading events. People don’t know that they’re sick yet because they haven’t quite developed symptoms. They may be a day away from developing symptoms and they go into a confined space. And it leads to these situations where one case can lead to 30 cases. So after you’ve had symptoms for a number of days, your- your infectivity, your ability to spread the virus probably declines.
MARGARET BRENNAN: We’ve seen- when it comes to schools, we’ve seen these really troubling reports this week of a few children who have died after testing positive for COVID. You said time and again, children are not immune. It is just not clear what the impact of the virus is on them. What more do we know at this point? The president keeps saying they’re immune and we know that’s false, correct?
DR. GOTTLIEB: We need to have a degree of humility. Children are not immune to this virus. We have seen bad outcomes. The CDC recently documented 570 cases of the multisystem inflammatory syndrome in children. There’s more cases that are occurring. We’ve seen children die. There’s 86 kids who died from this and thousands that have been hospitalized. And so this is a risk in children. We haven’t fully characterized that risk and we’re learning new things about this virus all the time. There’s been data in the last few weeks that shows that the virus is having impacts on the hearts of adult patients, causing inflammation and some long term sequelae and cardiac symptoms in adults. Previously, we didn’t really understand that or know that, and so we’re learning a lot about this novel virus all the time. We need to have a degree of humility about the risks. We need to try to protect children. So if we do reopen schools and I believe we should, we need to do it with a sense of caution. This is complicated by the fact that there’s been really a mixed experience when it comes to reopening schools. We’ve seen some countries successfully do it. Germany, the Netherlands, Denmark have successfully reopened schools, albeit with a lot of measures to try to control the risk of outbreak. Sweden let their schools open, but on the other hand, Israel reopen schools and it led to outbreaks that then led to a resurgence nationally. And we’ve seen outbreaks in summer camps, the situation in Georgia and Missouri. We’ve seen large outbreaks among kids in summer camps. So we need to try to learn what went right, what went wrong as we step forward and try to reopen the schools this fall.
MARGARET BRENNAN: This week, the State Department warned that Russia is spreading disinformation about COVID, specifically vaccines. How should we understand this in terms of how vulnerable our country is?
DR. GOTTLIEB: Look, I think our country is vulnerable to this pathogen because we have unique risks owing to our federal system, owing to our culture, and we also have some vaccine hesitancy. So it’s going to be very important to imbue confidence in the vaccine when it eventually does come through the authorization or the approval process by FDA. So I think we’re vulnerable to that kind of information. The other thing to think about here is that this has now posed an asymmetric risk for the United States. Other countries looking in now can conclude that a respiratory pathogen poses a greater danger to the United States and perhaps other nations that have been grappling with this more successfully. And so it was always thought that a rogue nation would never unleash a pathogen deliberately. And I’m not saying this was a deliberate pathogen–
MARGARET BRENNAN: Right.
DR. GOTTLIEB: By all- everything we know, it was naturally occurring, but it was always thought a nation would never deliberately unleash a pathogen that can blow back on them. That thinking might have to be adjusted now that this is such an asymmetric risk to the United States relative to other nations that some of which are our adversaries.
MARGARET BRENNAN: Thank you very much, Dr. Scott Gottlieb. We’ll be right back.