Transcript: Scott Gottlieb discusses coronavirus on "Face the Nation," April 5, 2020

Gottlieb says "very aggressive surveillance" needed to track future coronavirus spread

The following is a transcript of an interview with former FDA Commissioner Scott Gottlieb by CBS News' Margaret Brennan that aired Sunday, April 5, 2020, on "Face the Nation." 


MARGARET BRENNAN: And we go to Connecticut and former FDA commissioner Scott Gottlieb. Thank you for joining us again. 

DR. SCOTT GOTTLIEB: Thanks.

MARGARET BRENNAN: You just heard the descriptions there from a hospital in the- on the front lines up in New York. Dr. Fauci was pretty direct. He said it's not going to be an easy week. Do you believe that, as he says, mitigation is working?

DR. GOTTLIEB: Mitigation's clearly working. We're seeing cases slow in the Northeast and the northern states. The Sun Belt is going to be in for a tough week. We're going to see cases in the Sun Belt start to accelerate. I think the New York City health system is going to be brought right to the brink, but they're not going to go over. They're expanding their capacity to keep pace with their surge of demand, really a historic effort. And I don't think they're gonna run out of ventilators. They're doing things to convert existing devices into ventilators. And I think they'll keep pace with it. But it's a historic effort that's underway in New York right now, and we should make no mistake, what they're doing to try to keep pace with the increased demand. That demand is likely to peak in the next week or two. So we're gonna see a backdrop this week of- of severe strain on the New York City health care system at the same time that cases in the South--

MARGARET BRENNAN: Yeah.

DR. GOTTLIEB: --start to accelerate.

MARGARET BRENNAN: But what are some of the lessons of what we're seeing in New York right now? Because we're hearing, and I know you've been tweeting about, some of the unusual things. Younger patients being hospitalized at alarming rates in New York in particular. Why is that happening?

DR. GOTTLIEB: Right. Well, we don't understand. I mean, this infection is not just an infection that's causing severe outcomes in older Americans as was originally, initially put forward. A lot of young people are having bad outcomes, are intubated right now in the ICUs, with no comorbidities, no otherwise- no risk factors that would predict a bad outcome. There's pregnant women intubated and in hospitals right now. We need to understand that. There's been no publication, serious publication, by the CDC of the collective clinical experience in this United States- in the United States right now. So doctors are making decisions based on anecdote and their own clinical experiences. There's really no excuse for that right now. We need to start getting literature out right away to inform providers on what's working and what's not. You heard the hospital chief there say about 80- 70 to 80 percent of people who get intubated succumb to their infection. That's what I'm hearing from other hospitals. Doctors are now experimenting with more fluids. They're experimenting with high-flow oxygen. They're experimenting by putting patients in the prone position, meaning laying them on their stomach rather than on their backs when they're intubated. This is stuff that doctors are figuring out from their own clinical experience, but really what we should have is literature published by the CDC that delineates what's working and what's not so doctors--

MARGARET BRENNAN: Yeah.

DR. GOTTLIEB: --can take a more systematic, data-driven approach to these things.

MARGARET BRENNAN: So tell me about the timeline here. The president said this week that he thinks we should be able as a country to hold mass gatherings like the Republican National Committee in August. Is that too aggressive a timeline for you?

DR. GOTTLIEB: I think things are going to be permanently changed coming out of this until we get to a vaccine and we can fully vanquish this. We're not going to see a V-shaped recovery or a quick snapback absent the ability to get a highly effective drug in the hands of doctors that can mitigate the risk, either used as a prophylaxis to prevent infection in people who get exposed to this virus or treat people who get the virus and are- are likely at a high risk of a bad outcome. We can have that kind of drug by the summer and certainly by the fall. I don't see the kind of deliberate, industrial approach, all hands on deck approach, to trying to get that kind of therapeutic. And there are things that are promising right now that could be brought forward more quickly. But absent that, this is going to be an 80 percent economy. There are things that are not coming back. People are not going to crowd into conferences. 

MARGARET BRENNAN: Yeah.

DR. GOTTLIEB: They're not going to crowd into arenas. The marginal customer is not going back to movie theaters and cruises and Disneyland. And we need to accept that. Now, what changes that equation is technology. But we need a deliberate approach to getting that technology quickly.

MARGARET BRENNAN: So you've mentioned technology. The Fed president from St. Louis mentioned technology. Dr. Fauci has mentioned technology and surveillance. Specifically, what does that look like in the United States of America and how far are we from getting that?

DR. GOTTLIEB: Well, the massive surveillance system that we need to detect infection quickly, we're going to have- we're hopefully going to have in place. We should have that in place. We'll have the tools to do that. So we'll be able to identify cases when there are small outbreaks in the fall and use case-based interventions, basically isolating people with the infection and their close contacts. But what we also need is a drug that could be used either as a preventative tool, a prophylaxis, as a bridge to a vaccine or a treatment for people who are likely to have a bad outcome with this virus. There are about four or five drugs that I would say are in advanced stages of development that could be available by this summer. We need to place significant bets on each of those drugs and try to pull them through more quickly. This is a time for placing bets. This is a time for an industrial approach to this. It's not happening right now. I think it needs to happen. There's still time, but we need to recognize how important that is. Otherwise, these scenarios of this country just snapping back--

MARGARET BRENNAN: Yeah.

DR. GOTTLIEB: --and being something more than 80 percent economy just aren't going to come to fruition. And we need to prepare for what it looks like when you have a slower economy and more people unemployed in the fall.

MARGARET BRENNAN: I think it's an important point because you're saying there the science is not supportive of the economic theory, that this is just going to be a sharp return to what was normal.

DR. GOTTLIEB: Not unless we have the kind of breakthrough that we should be able to obtain. Like I said, one of these drugs should work. The- the strategy that looks the most promising are these antibody-based drugs where you basically develop an antibody that can directly target the viruses. Four experienced companies working on this. There's every reason to believe this strategy should work. It's worked in other settings of viruses. We need to start pulling those through more quickly. And there's a couple of antiviral drugs that directly target the virus and block its replication that look effective and maybe used early in the course of the disease will be effective. Nothing's a home run here, but we don't need a home run. What we need is a better toolbox, a good medicine cabinet coupled with- with very aggressive surveillance. That could be enough to really change the contours of the risk in the fall and allow people to feel comfortable going back out again.

MARGARET BRENNAN: All right. Dr. Gottlieb, always good to talk to you. 

DR. GOTTLIEB: Thanks a lot.

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