The following is a transcript of an interview with former FDA Commissioner Scott Gottlieb that aired on Sunday, August 9, 2020 on “Face the Nation.”
MARGARET BRENNAN: Welcome back to FACE THE NATION. We now turn to former FDA Commissioner Dr Scott Gottlieb. He’s coming to us this morning from Stamford, Connecticut. Good morning–
DR. SCOTT GOTTLIEB: Good morning.
MARGARET BRENNAN: I know you’re also dealing with power outages in Connecticut. So I thank you for coming today. I want to ask you this general number. It looks beautiful. Five million cases of coronavirus in the United States. Two and a half weeks ago you predicted that we could be at 300,000 dead by the end of the year. Is that still where you think we’re headed?
DR. GOTTLIEB: Well, we’ll probably 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 it evolves. We have now had two waves of this epidemic, the New York wave and now the wave through the Sunbelt, which is receding, although Texas has shown signs of an uptick in the last week and that needs to be followed closely. We will probably have another wave. And the concern now is that this has become so pervasive throughout the country that it could start to infect more rural communities that to this day are largely untouched and probably a little more satisfied because they untouched, but still very vulnerable because the infection has not been there. And if- if it becomes more transparent throughout the country and it not only in the urban centers but also in more rural parts of the country, then it will become much more difficult to control as it is more widespread. And we see indications of that at the moment, the way it is 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 show 10 days after the onset of symptoms, you are no longer a virus that can cause someone else to become infected. That you will continue to shake virus for an ongoing period of time. But if that virus is cultured, it has not grown, which means it is dead virus. And so now, the recommendation is that 10 days after the onset of symptoms, if those symptoms are resolved, if you do not have a serious illness, then you are no longer contagious. Earlier we said about two weeks, but the more recent data outlines over 10 days.
MARGARET BRENNAN: That we still have the question of, you know, what if you just do not know. And because 40 percent of cases, according to the CDC, are asymptomatic, you do not really know who is carrying the virus. That you have talked about the need to increase and improve testing. Should there be a requirement for teachers to test before entering a classroom, for everyone to return to the office for a full test?
DR. GOTTLIEB: We’ll see, ideally, we should have that. If you look at what universities are currently doing that reopen on campus learning, they are implementing comprehensive testing. They test students two or three days a week. We do not have the resources. We do not currently have the capabilities in most districts to do so. And that’s really the problem. We need – we need to implement more low-cost tests, tests that can be done at the point of care than at the point of school or work. There will be a speech test that will hopefully hit the market, get an approval from the FDA next week, and that will give more access to tests. But at the moment we do not have the tests available to implement the kind of supervision we want. It is the case that if you are asymptomatic, you are less likely to spread the virus. CDC models show that people who are asymptomatic are about 50 percent less likely to spread the virus and you are probably the most contagious immediately before you develop symptoms. And that’s really what leads to the super spreading events. People do not know they are still sick because they have not fully 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 have had symptoms for a few days, your infectivity, your ability to spread the virus is likely to decrease.
MARGARET BRENNAN: We’ve seen – when it comes to schools, we’ve seen these really difficult reports this week of a couple of children who died after testing positive for COVID. You said over and over again, children are not immune. It is simply 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 it’s false, right?
DR. GOTTLIEB: We must have a measure of humility. Children are not immune to this virus. We have seen bad results. The CDC recently documented 570 cases of multisystem inflammatory syndrome in children. There are more cases that occur. We have seen children die. 86 children have died from this and thousands have been hospitalized. And so it is a risk in children. We have not fully characterized that risk and we are constantly learning new things about this virus. There have been data in recent weeks showing that the virus affects the hearts of adult patients, causing inflammation and some symptoms in the long term and heart in adults. Previously, we did not really understand or know that, and so we learn a lot about this novel virus all the time. We need to have a degree of humility about the risks. We must try to protect children. So when we reopen schools and I believe we should, we should do so with a sense of caution. This is complicated by the fact that there has really been a mixed experience when it comes to reopening schools. We have seen some countries do it successfully. Germany, the Netherlands, Denmark have successfully reopened schools, albeit with many measures in place to try to control the risk of outbreaks. Sweden left its schools open, but on the other hand Israel reopened schools and led to outbreaks that then led nationwide to a resurrection. And we have seen outbreaks in summer camps, the situation in Georgia and Missouri. We have seen major outbreaks among children in summer camps. That we should try to learn what went well, what went wrong when we step forward and try to open these schools this fall.
MARGARET BRENNAN: This week, the State Department warned that Russia is spreading disinformation about COVID, specifically faxes. 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 because of our federal system, because of our culture, and we also have some hesitation about vaccines. That it will be very important to instill confidence in the vaccine when it finally comes through the authorization or the approval process by FDA. That I think we are vulnerable to that kind of information. The other thing to think about here is that this now poses an asymmetric risk to the United States. Other countries looking now may conclude that a breathing pathogen poses a greater danger to the United States and perhaps other nations that are dealing with this success pose a greater danger. And so it was always thought that a rough people would never consciously release a pathogen. And I’m not saying this was a deliberate pathogen–
MARGARET BRENNAN: Right.
DR. GOTTLIEB: Through all we know, it happened naturally, but it was always thought that a nation would never consciously release a pathogen that could blow on its back. That thinking might need to be adjusted now that this is such an asymmetric risk to the United States relative to other peoples that some of us are opposed to.
MARGARET BRENNAN: Thank you very much, Dr. Scott Gottlieb. We’ll be back.
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