The lack of widespread coronavirus testing early in the outbreak in the U.S. will be remembered as the nation’s biggest misstep in its pandemic response, Dr. Scott Gottlieb told CNBC on Friday.
Gottlieb, formerly Food and Drug Administration commissioner under President Donald Trump, made his comments in defense of the widespread stay-at-home orders that were implemented in cities and states across the country beginning in March.
“[February was] the critical the time frame when we could have done more to mitigate the spread and not have gotten ourselves into the situation in March that we had to then reach for the stay-at-home orders which had the devastating impact on the economy,” Gottlieb said on “Squawk Box.”
Gottlieb said the reason why broad lockdown orders became the default response was because “back in February and March, we had no idea where the virus was and was not spreading because we didn’t have diagnostic testing.” He added, “When history looks back on this, the lack of situational awareness at that time is going to be remembered as the great failing.”
Research has shown the lockdowns were effective in preventing additional cases of Covid-19, with one study from the University of California at Berkeley estimating nearly 5 million infections were spared in the U.S. However, some contend the economic damage caused by the broad shutdowns — millions out of work and businesses having to shutter — rendered them too extreme of a response.
“We absolutely had to shutdown New York City and do what we did in New York City and probably did a little too late,” Gottlieb said. “The health-care system in New York — the biggest, largest, best health-care system in the world — was literally on the brink of collapse.”
Yet Gottlieb acknowledged there is room to wonder whether different cities across the country could have reacted differently than the one-time epicenter of the outbreak, New York City, which on March 15 announced it was ordering restaurants, bars and schools to close. At the time, the entire state of New York had less than 800 confirmed cases.
“We probably had to implement a stay-at-home order in cities like [New Orleans], Detroit, maybe Chicago. Did we have to do it in Dallas? Probably not. Did we have to do it at that time in Miami? Probably not,” Gottlieb said. But, he emphasized, it was difficult to know where outbreaks were occurring without the testing available.
“We had to assume that it was spreading far more widely in the United States, at that point in time, than it was,” said Gottlieb, who led the FDA in the Trump administration from May 2017 to April 2019.
The early lockdown orders in places where, perhaps, the virus was not spreading widely were consequential because by the time Covid-19 outbreaks began to occur in those places, in May and into the summer, people in those regions had grown tired of the public health restrictions, according to Gottlieb.
“Had we not shutdown the South, at that time and it wasn’t spreading there, when it eventually got to the South, maybe we would have had more support for mitigation steps when we needed them. But by that time, people were exhausted and weren’t going to support more stringent mitigation,” he contended.
Gottlieb’s comments Friday come as the nation’s early steps to combat the coronavirus are under the scrutiny following revelations in a new book from journalist Bob Woodward that Trump had sought to publicly downplay the threat of Covid-19, with the president suggesting in a recorded interview for the book in mid-Mach that he did so because he did not want “to create a panic.” On Feb.7, according to the book, Trump also told Woodward that he understood the coronavirus to be “more deadly than even your strenuous flu.”
The U.S. has 6.4 million confirmed cases of Covid-19, the most of any nation in the world, according to data compiled by Johns Hopkins University. At least 191,802 people have died.
Coronavirus testing in the U.S. has been beset by challenges from the outset, including in early February when there were problems with tests sent out by the Centers for Disease Control and Prevention to labs across the country. Gottlieb has also previously indicated the U.S. should have done more to get private labs involved in the development of diagnostic tests in late January and February.
Gottlieb, who also worked at the FDA under former President George W. Bush, referenced a response strategy for a flu pandemic issued in 2006 to explain why the U.S. was unable to implement more targeted public health strategies early in the Covid-19 crisis.
“The pandemic planning always assumed you would have a diagnostic test and you’d be able to know where the virus was spreading,” he said. “But back in February and March, we had to assume it was spreading everywhere because we had no testing. That’s going to be looked back at as the key missing element here.”