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Transcript: Scott Gottlieb discusses coronavirus on "Face the Nation," May 31, 2020

Gottlieb warns of uptick in coronavirus cases after protests
Gottlieb warns of uptick in coronavirus infections after widespread protests 08:31

The following is a transcript of an interview with former FDA Commissioner Scott Gottlieb by CBS News' Margaret Brennan that aired Sunday, May 31, 2020, on "Face the Nation." 

MARGARET BRENNAN: We go now to Westport, Connecticut, and former FDA commissioner Dr. Scott Gottlieb. Good to see you again. 


MARGARET BRENNAN: We were speaking earlier with the mayor of Atlanta who told her constituents, if you were in these protests, you need to go get yourself a COVID-19 test. When you look at this, these large scale gatherings around the country, what is your prediction of what this will mean?

DR. GOTTLIEB: Well, look, there's going to be a lot of issues coming out of what's happened in the last week, but one of them is going to be that chains of transmission will have become lit from these gatherings. And Minnesota, one of the hard hit states by the protests where you've seen large mass gatherings, that state has been seeing an uptick in cases to begin with. Even before these protests started, we saw rising hospitalizations in that state. So this country isn't through this- this epidemic. This is continuing to expand but at a much slower rate. But it's still expanding and we still have pockets of spread in communities that aren't under good control.

MARGARET BRENNAN: It sounds like you're saying this could be an accelerant. What we know already from the data is that the black and brown Americans are disproportionately impacted by the virus itself, are also disproportionately impacted by the job cuts, but they are carrying the burden of this outbreak. Why do you think that is happening and what is the policy response?

DR. GOTTLIEB: That's right. Black Americans and Hispanic and Latino Americans have been disproportionately impacted by COVID. I think it's a symptom of broader racial inequities in our country that we need to work to resolve. Really, you have to look at it across two dimensions. The first, why are there higher rates of COVID among these communities? And second, when people in these communities do get COVID disease, why are they dying at a higher rate? And the first has to do with a lot of issues of socioeconomic factors, low income issues related to overcrowded housing, where people work, the fact that they have to take crowded transportation, that they work in essential jobs, that they've had to continue to work and didn't have good PPE at work. We've seen black communities and Hispanic and Latino communities disproportionately in these kinds of circumstances. The second has to do with poor access to health care, a mistrust of the health care system, some discrimination in health care. And also back to the first factors, the- the economic factors, you see a higher burden of chronic disease in black communities and Hispanic communities in this country, often related to income inequities. And stopping the pandemic is going to depend on our ability to take care of our most medically and socially vulnerable. We absolutely need to resolve these underlying problems to eliminate the risk of pandemic spreading of the epidemic.

MARGARET BRENNAN: Well, we know the federal government is leaving the testing strategy part of this up to the states and local governments. So what should be the response? What do you tell governors to do? Is it triaging, testing for these communities?

DR. GOTTLIEB: That's exactly what it is. It's- it's taking resources and trying to get it into communities that you know are being disproportionately impacted by the disease. You think of people from communities that are disadvantaged. They already lack access to health care. They lack access to testing. So they're not only at higher risk, they don't have the same health care opportunities. And so you try to bring the testing into those communities, into work sites. The other thing we need to do is make sure that COVID doesn't become punitive, that having a diagnosis of COVID disease doesn't mean you lose your job, you lose your wages. And so we need to support people through the illness. We need to encourage them to get tested and self-identify. And so you really need to focus the resources on the medically-vulnerable communities where this vi- virus is going to spread more actively. So it's not just black and Hispanic communities. It's also institutions like nursing homes, places where there's vulnerable Americans. But you need to be focusing the resources on those settings.

MARGARET BRENNAN: You're talking to the most vulnerable in this country. We know, Dr. Fauci, in particular, you talked about the most vulnerable around the world. I want to ask you what you think the health impact is of what President Trump announced on Friday, which is that he is pulling the United States out of the World Health Organization ahead of the timeframe he had laid out. That he's just full scale cutting the U.S. off. What impact will it be?

DR. GOTTLIEB: Well, look, the president raises valid concerns about the WHO, but this is not the time to be pulling out the WHO. And I don't think pulling out was the right measure. We could have tried to reform the WHO from within, and we could've put pressure on China through the WHO, forcing China, for example, to admit Taiwan to the World Health Assembly. I think the net impact is going to see- be that we're seeing now this virus become epidemic in other parts of the world, particularly the Southern Hemisphere. It hasn't reached West Africa or South Africa in- in high numbers yet, but I think it will. We see it epidemic in Brazil, epidemic in India. The World Health Organization is a more important entity to a lot of those countries. It is their CDC. And so pulling out of the WHO right now and pulling away resources from that organization, I think is going to contribute to some of the adversity and hardships that these countries face as they try to battle COVID disease.

MARGARET BRENNAN: And do you just mean for COVID-19 or are you talking about having other health impacts?

DR. GOTTLIEB: Well, there's other health impacts. A lot of the programs that the WHO runs, we're going to try to support through other organizations. But there are programs that the WHO is the only contributor to those programs, and those are the ones that are going to suffer the most. So, for example, the polio eradication program, as best I can tell, the only entity funding that program is the WHO. So it's going to be hard for the United States to support that through other organizations. So you have to look at the programs where the WHO is the only funder. Those are going to be the hardest impact immediately by this.

MARGARET BRENNAN: Back in this country, the CDC did issue a new timeline this week. It basically pieced together some of the reporting we already knew. But what it said was that community transmission likely began in late January or early February 2020 after a single importation from China, followed by multiple importations from Europe. What does that reveal to you?

DR. GOTTLIEB: Well, this was looking at Washington state primarily, where we- we had a case that had come in in mid-January, and we thought that was the case that lit the spark of community spread within Washington state. What we learned was that wasn't the case. That didn't lead to sustained transmission, but there was a later case in early February that then led to a chain of transmission that ultimately resulted in the outbreak there. What it tells us is that we had an opportunity well into February to try to quell the outbreaks that ultimately led to this epidemic. And so we had a later window. So if we had gotten testing in place in early to mid-February that would have helped potentially spot some of these index cases. Also, the report talked about this- what we call syndromic surveillance, basically, that we were relying on data on how many people were coming to the emergency room with respiratory symptoms or how many people were reporting that they had the flu, but then testing negative for flu. And what we were saying was we weren't seeing a sharp uptick in that and therefore COVID wasn't spreading. But when you look back at that data, it wasn't flashing red, but it certainly wasn't flashing green. It was flashing yellow. It was a high end of the normal range for the last 15 years. And in fact, there were researchers like Marc Lipsitch and Caitlin Rivers and others who were reporting that at the time, that the data wasn't saying that there's definitely something else spreading, but what the data was saying was there seems to be a signal that something could be spreading. It was at the- at the high end of the range that we would have expected in a normal season. 

MARGARET BRENNAN: So there were war- warning signs. Dr. Birx said on Friday that about five percent of America or so has been tested. What do you make of- of those numbers?

DR. GOTTLIEB: Well, I think the operative number- look, we've ramped testing substantially in this country. There's no question about that. We're doing about 500,000 tests a day using primarily PCR, and that's going to grow substantially as we get new systems into the market. I think the important statistic to watch is how many tests are being run per day, not the total number tested over the last three months. And we're testing about half a million a day, which is high. I think that that's a good number and we're going to continue to grow that. I don't think testing capacity is going to be the challenge heading into the fall. I think getting access to testing is going to be the challenge. There'll be enough machines to run the tests. What there aren't going to be are sites to go get tested very easily. And that's again why we need to get testing into community sites, into workplaces as well, so people can get tested easily at work, especially places where people work where they can't social distance, where they're working on, for example, a shop floor or a warehouse where they're coming in contact with a lot of other people so they face higher risks.

MARGARET BRENNAN: Dr. Scott Gottlieb, always good to talk to you. We'll be back in a moment.

DR. GOTTLIEB: Thanks a lot.

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