DAVID GREENE, HOST:
Now to the other big story we're covering - the coronavirus. The number of cases in the United States surpassed a thousand yesterday. Many parades and public gatherings are being canceled. Several colleges have told students not to come back after spring break. Scott Gottlieb is the former head of the Food and Drug Administration, an agency that plays a central role when it comes to testing during an outbreak like this. He headed the FDA during President Trump's first two years and joins us this morning. Dr. Gottlieb, thanks for being here.
SCOTT GOTTLIEB: Thanks for having me.
GREENE: Seems like the virus is really spreading rapidly right now in at least several areas of the country. What is your assessment of this current situation?
GOTTLIEB: Well, it's been spreading. It's been spreading since mid-January, and we're starting to see cases build in some areas of the country where we have very large outbreaks underway - Seattle certainly, Santa Clara, Northern California, parts of Northern California, parts of New York City, probably other cities as well. I think we're going to enter a period of rapid acceleration in number of cases, and it's going to start to show up in more people presenting to the hospital with significant respiratory disease. And I think over the next two weeks, things are going to evolve very quickly.
We will get through this. This is going to be a very difficult month or two, but we will get through this. And the question is, will we adopt the tough mitigation steps that we need to to really keep the epidemic from getting out of control?
GREENE: What is one or two - what are one or two key steps that you think are absolutely necessary to do that?
GOTTLIEB: Well, you look at cities like Seattle, where they have very large outbreaks underway and that they're on the cusp of losing control of, you need to really slow economic activity. You need to cancel gatherings of any kind, like they did in New Rochelle. You need to mandate that businesses have nonessential employees telework, close school districts. Those are some of the steps that you do to engage in what we call social distancing, trying to keep people apart.
We can't implement forced quarantines in this country or lockdowns. I think that we can't deny people their liberty. But what we can do is slow economic activity in a region where there's large outbreak to a point where people just stay home. They can't go to the mall. They can't go to large gathering places. They can't go to work. So they end up staying home.
GREENE: I want to talk about the federal government's response. There was this lack of testing, a shortage of supplies, a delay in distribution and getting results of tests was a big concern. Could the federal government done anything differently to be on top of this more quickly?
GOTTLIEB: Well, there's always things you could have done differently. I think the answer is yes. You know, if we had recognized early on that this was going to turn into a major epidemic - which, you know, perhaps we should have; people did - then you would have tried to get more testing online, in the private sector and among the academic labs.
Instead, we took a linear approach, where we let CDC go first, and we let the - and we let CDC manufacture a test for the public health labs. That's typically how it's supposed to work. But then when CDC had a challenge associated with that test, and problems happen, there was no Plan B and there was no Plan C. So getting the academic labs in the game early and getting the manufacturers into clinical labs, like Quest and LabCorp, in the game early, that would have been important. And that's something we should have done, you know, six weeks ago, four weeks ago and not two weeks ago.
GREENE: Did that have an impact? I mean, would we be in a different place today had some of those things been done earlier?
GOTTLIEB: Yeah, if we had sentinel surveillance in place - what we call sentinel surveillance, meaning that we were looking for the virus by testing people who were presenting with influenza-like illness but were testing negative for flu, then taking their samples and testing them for coronavirus - we would have spotted this earlier.
And we know we would spotted this earlier because in Seattle - and The New York Times chronicled this; they and Nature did an article about it over the weekend - in Seattle, some researchers got together and did just that on the side, and they were getting hits on the samples that they were testing for coronavirus. And that's, in fact, how Seattle found out that it had an outbreak early. Could there be other Seattles that we have detected yet because nobody in the community did what the researchers in Seattle were doing? It's possible.
GREENE: We just have a few seconds left. But I think a lot of people, when they hear from the former head of the FDA say we're going to get through this, that makes them feel good. Are you really confident and why?
GOTTLIEB: Well, I know we're going to get through it. You know, this is going to have a beginning and the end, and the only question is how big will the epidemic be. And we have the opportunity now, if we put in place tough measures now, to keep the epidemic down. I also believe that we're going to get a therapeutic to this. I think that we're going to solve this with innovation and hopefully have a treatment maybe as early as the fall.
GREENE: Scott Gottlieb, former commissioner of the Food and Drug Administration. Dr. Gottlieb, thank you so much.
GOTTLIEB: Thanks a lot. Transcript provided by NPR, Copyright NPR.
