Transcript: Scott Gottlieb discusses coronavirus on "Face the Nation," July 26, 2020
The following is a transcript of an interview with former FDA Commissioner Scott Gottlieb by CBS News' Margaret Brennan that aired Sunday, July 26, 2020, on "Face the Nation."
MARGARET BRENNAN: Welcome back to FACE THE NATION. We now go to former FDA commissioner Dr. Scott Gottlieb, who joins us from Westport, Connecticut. Good morning to you, Doctor.
DR. SCOTT GOTTLIEB: Good morning.
MARGARET BRENNAN: We're around 70,000 infections a day, 1,000 Americans dead. You've described this as four separate epidemics. Where are we now?
DR. GOTTLIEB: Well, the epicenter of the epidemic right now in the United States has been the Sunbelt, states like California, Texas, Arizona, Florida. There are signs that the cases in these states are starting to plateau. That- that trend is most discernible in Arizona and Texas right now, where you see the positivity rate declining. It's a little bit more of a mixed bag in Florida and California. I think we're going to have to wait another week to see how those states net out. But there are unmistakable signs that the epidemic seems to be slowing in these states. Now, at the same time, it seems to be heating up in other states. So if you look at states like Indiana, Ohio, Illinois, the District of Columbia, Georgia, Alabama, South Carolina, all hitting highs on the number of new cases being reported. So the epidemic may be shifting to other regions in the country. I think Arizona in particular is a very instructive case because if they're able to start to bring down the epidemic in that state, largely what will have done it is some selective action by the governor. He did take some targeted mitigation steps like closing the bars, but more the collective action of individuals to withdraw some of their actions, stay home a little bit more and more adherence to masks. And so if they're able to get the epidemic under control with those more targeted measures and more collective action on the parts of consumers, that's a good guidepost for the future and how other states may control their epidemics.
MARGARET BRENNAN: So Indiana, Illinois, Georgia, Alabama, you've highlighted them all. Would you recommend to those governors that they get ahead of it and do some of those things like shuttering bars and mandating masks?
DR. GOTTLIEB: I think that's exactly right. I think looking at what Governor Ducey did in Arizona is somewhat instructive. They did take some targeted mitigation steps in that state, like shutting bars, dialing back how many people could be in restaurants, closing movie theaters and other kinds of entertainment venues outside. At the same time, they did implement the mask mandate, a little late, but they did do it. And you did start to see consumers decrease their activity. Google mobility trends started to decline in the state. And so if that sort of trifecta of activity can have the effect of quelling an epidemic without the really significant mitigation steps that we took during the first wave of the epidemic, that's a hopeful sign. And it's also a suggestion that states that now have made gains in getting their epidemics under control, like the state of Connecticut that I'm in right now, perhaps they can keep their epidemics under control if they can just maintain adherence to things like masks and keep certain high risk congregate venues like bars closed through the duration of the really risky period for this epidemic in this country.
MARGARET BRENNAN: And it's interesting because, again, we are seeing the private sector make its own decisions. McDonald's joining Walmart, Starbucks, other large retailers this week in requiring masks to be worn indoors. Is this a way around the politics? I mean, do you look at
that and say this is what we should be doing?
DR. GOTTLIEB: I think so, and I think it's a very good way around the politics. If enough businesses mandate masks in their venues, you effectively have a national mask mandate. You know, Delta Airlines announced this week that if you don't wear masks on their planes, they may ban you from flying on their planes for life. I think you're going to see more collective action on the parts of businesses. I've been talking with some CEOs in the past week, and I think you're going to see more businesses come together to implement mask mandates in venues, especially indoor high risk venues, to try to keep this epidemic under control. I mean, if we really can manage to keep the epidemic under control heading into the winter until we get to a vaccine or some kind of therapeutic that changes the clinical trajectory of this illness just with masks, that's going to be something relatively simple that we can all do that doesn't really change our lives and allows us to maintain what's really important to us, like keeping some businesses open, like getting our kids back to school.
MARGARET BRENNAN: Well, we are looking at going back to school within a matter of weeks. I have been talking to people this week about testing. I know people who have been waiting weeks for results. I know LabCorp told F.T. this week that it's taking about four to six days for people to get results. You've said they're basically useless unless you get them within three days. Do you have to fix this before we can open schools safely?
DR. GOTTLIEB: I think you do. I think one of the things you need to look at in a local community is whether or not you can get test results, because if you can't get test results back in a timely fashion, you really don't have a way to detect whether there is an outbreak in the community or in the school. And while we do need to lean forward and try to open our schools because it's important to children, we need to prevent outbreaks from happening in the schools. We can't just let the infection run rampant inside the schools. And having good testing in place is going to be a critical tool. I talked to the CEO of LabCorp yesterday. They've gotten caught up. They're doing about 175,000 tests a week. They're going to be returning test results maybe within two or three days right now. Hopefully, Quest will get caught up as well. But if we do have other major epidemics, other major hotspots emerge, the testing system can become strained again. We're heading towards about 750,000 tests a day and will probably be at a million by the end of this month. So we have a lot of testing capacity. The problem is when you have these major epidemics in multiple regions of the country, it can strain the system.
MARGARET BRENNAN: The CDC did come out with guidelines this week on how to reopen schools, but they left out when you should shut them down. What is the benchmark that parents need to be looking for to make that decision?
DR. GOTTLIEB: Well, look, the CDC didn't put a benchmark in that guidance and I think it was unfortunate. I think in the absence of specific guidance to districts, you're likely to see more districts err on the side of caution. So I think CDC should have addressed this. It was probably deliberate that they didn't because they don't want to address something that was politically charged. But for local school districts, I think they need to be looking at what is the spread within the community. If you have uncontrolled spread within the community, it's going to be very hard to open against that backdrop. I think you need to look at the density of students in the schools. So you'll see some districts, for example, opening the elementary schools to five days a week in class learning because they can de-densify those schools. But maybe the high schools, they'll go to a hybrid model where it's harder to de-densify the schools. Schools are looking at retrofitting HVAC systems to improve air quality, the use of mandatory masks. And I think one of the most important features, and a lot of other countries did this with success is keeping students in defined cohorts or pods so you don't have--
MARGARET BRENNAN: Yeah.
DR. GOTTLIEB: --a lot of students intermingling. You have the same fifteen students gathering together.
MARGARET BRENNAN: But you're a parent. If you see a positivity rate above 5%, which is hotspot territory, do you send your kid to school?
DR. GOTTLIEB: I think somewhere in five to 10% it's starting to get iffy. Above 10% I think that's a threshold where you really want to think carefully about closing the school districts, because that is a sign that there is an epidemic underway inside that community. So those are the kinds of things you're looking at. I'm- I'm in Connecticut right now. We've got the infection under control. I think we're going to have the opportunity to open the schools here. But when you look at states like Florida or Southern California, I mean California has already made the decision not to open the schools. I think it's going to be very hard in parts of Florida to open schools on time because of the outbreaks. And you're also seeing a lot of parents make proactive decisions to keep their kids home. So districts in Maryland, for example, that were giving an option to parents, a flexible option to parents, they surveyed those parents and enough parents said we're not going to be sending our kids that the districts just made the decision to close the schools. And that shows that in the- in the setting of uncertainty and- and the lack of specific guidance about how to keep schools open, I think more parents are going to err on the side of caution. That's why it's very important to get specificity out of what the hard metrics are that CDC didn't do in this guidance. There's still time to do it.
MARGARET BRENNAN: Yeah.
DR. GOTTLIEB: But I think we need to think about it. Things like positivity rate. What is the local spread? What is the testing capacity in place in a local community? Those are the metrics you want to be looking at.
MARGARET BRENNAN: Right. I agree. More information is always better. I'm glad you gave us a benchmark. Always good to talk to you, Dr. Gottlieb.
