Transcript: Scott Gottlieb discusses coronavirus on "Face the Nation," March 22, 2020
The following is a transcript of an interview of former FDA Commissioner Scott Gottlieb by CBS News' Margaret Brennan that aired Sunday, March 22, 2020, on "Face the Nation."
MARGARET BRENNAN: Welcome back to FACE THE NATION. We turn now to former FDA commissioner Dr. Scott Gottlieb. He joins us from outside his home in Connecticut. Doctor, good to have you back with us.
DR. SCOTT GOTTLIEB: Thanks.
MARGARET BRENNAN: You've been talking to Congress. You talked to the administration. And you've been clear that you believe there was a failure to plan in January for March. And you're saying now, in March, we need to be looking ahead and planning for May. Exactly what is it that all of us need to be planning for?
DR. GOTTLIEB: Well, right now, we're engaging in broad based population based mitigation techniques, things like stay at home orders, closing schools. These are population level techniques to try to break off chains of transmission. That's the right thing to do in cities like San Francisco and New York, where we see hotspots, where we see epidemic spread. Unfortunately, we're not engaging in those tactics across the whole country. There should be some form of mitigation across the whole country because we're all at risk. But we need to start thinking about how we transition away from that. Come April, come May, when the epidemic curve starts coming down, we can't just take our foot off the brake immediately. We need to start it- start including and introducing what we call case based interventions, trying to do mass screening and identify people who either are infected or who've been in close contact with people who've been infected and go towards more of an individual person approach rather than a population level approach. That planning needs to be underway right now. We need to know how we're going to slowly transition into another paradigm. It's not a question of either or. It's a question of substituting in other techniques that are less intrusive to- for what we're doing now.
MARGARET BRENNAN: You heard Dr. Fauci say there's no doubt we're going to get hit. He mentioned New York. There are some projections from New York hospitals that a peak could hit within the next 20 days. What is it that Americans need to be prepared for?
DR. GOTTLIEB: Well, I think that the scenes out of New York are going to be shocking. I think that the hospitals in the next two weeks are going to be at the brink of being overwhelmed and we're going to start to see places like Javits Convention Center and other facilities used to start to house people. They're going to start getting thousands of admissions coming into that city. And this was infection that started two weeks ago. The time to hospitalization is nine to 12 days. I think there's other cities that are at extreme risk. New Orleans is at very high risk and they're not taking appropriate measures. This is a sticky virus. We're learning that much more of the transmission probably happens from touching contaminated surfaces. So any city that has a mass transit system is probably at risk and needs to be taking very aggressive steps. Cities like Chicago, San Francisco, New York, Boston. You've seen San Francisco implement tough measures.
MARGARET BRENNAN: Yeah.
DR. GOTTLIEB: Illinois recently implemented tough measures. We need to continue that right now.
MARGARET BRENNAN: Is there an existing antiviral drug that is effective and- in at least containing this or preventing someone from getting seriously ill?
DR. GOTTLIEB: No, there's drugs that look promising, there's drugs that are in- in proper trials. We really need to continue to conduct research to figure out what works. Right now, there is no drug that looks like it's proven so overwhelming in early stage clinical trials that we can say it's highly promising. There's drugs that suggest that they may have activity against this virus. But the other question is, when you introduce the drug, sometimes when you introduce an antiviral drug late in the course of the disease, after people are in the critical care unit and very sick, it may not provide a benefit. Sometimes you have to introduce an antiviral drug earlier. And that's how we treat the flu, for example, with drugs like Tamiflu. We introduced them earlier in the course of the illness and that's where they have the greatest benefit.
MARGARET BRENNAN: So you would agree with Dr. Fauci that there needs to be clinical trials of hydroxychloroquine and azithromycin, which the president said he thinks is already effective?
DR. GOTTLIEB: Absolutely, and that may not be the drug that ends up holding to his promise. The study that looked at that drug and showed activity was- was a study that involved about 20 patients and only six in the arm that showed the benefit. And the benefit that they showed was that they decrease the amount of virus in their- in their noses when you did nasal swabs in those patients. So it could very well be that the drug is reducing viral shedding, but having no impact on the clinical course of those patients. So the data on that is very preliminary. What we need to do is what we call a master protocol, where we basically test a lot of drugs at once. We randomize patients to different treatments so everyone gets a treatment if they need it and we figure out which is working the best. That's what we did with Ebola. We came up with some very--
MARGARET BRENNAN: Yeah.
DR. GOTTLIEB: --effective treatments against Ebola.
MARGARET BRENNAN: The Trump administration announced this past week that the first trial through NIH of a vaccine was started out in Seattle. Given the timeline for this, do resources need to be refocused from a vaccine into some of the treatments that- that you are talking about?
DR. GOTTLIEB: I think absolutely. We could have a drug, a potential prophylactic drug that could prevent people from getting an infection or even treating infection as early as this summer, especially when you look at some of the approaches where companies are developing antibodies that directly target the virus. I think this is highly promising. We need to be putting a lot of resources into that. Senator Daines introduced a provision in Capitol Hill that may be included in the final package and what it would do is it would basically scale up manufacturing right away for the promising treatments that make it into the government's sanction trials. So that if one ends up working, we're ready to distribute it on a mass scale. You have literally millions of doses available. Now, what's going to happen is a lot of those drugs won't work and we're going to end up throwing away the drug that we manufactured. But I think that's a small price to pay for the benefit of having drug available, if in fact one proves that it's working.
MARGARET BRENNAN: In other words, tax payers helping to subsidize some of this research immediately. When do you see us being able to plan about going back to normal life?
DR. GOTTLIEB: Well, I think it's going to be a slow transition. I think that the epidemic right now that's underway is probably going to peak sometime in April, probably late April and tail off into May and June and hopefully transmission will be broken off in July and August. We need to plan for what we're going to do in the fall to prevent another epidemic and outbreak. But life's never going to be perfectly normal till we get to a vaccine. We're always going to have to implement some measures, but they could be case based measures where we look at individuals and screened very aggressively for the virus and quarantine and isolate individual people rather than quarantining--
MARGARET BRENNAN: Yeah.
DR. GOTTLIEB: --mass populations. That's what we need to get to. That's going to be a transition but we can get there. There is light at the end of this tunnel.
MARGARET BRENNAN: Dr. Gottlieb, thank you.
