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Scott Gottlieb, MD Profile picture
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17 Jan, 4 tweets, 1 min read
As current epidemic surge peaks, we may see 3-4 weeks of declines in new cases but then new variant will take over. It'll double in prevalence about every week. It'll change the game and could mean we have persistent high infection through spring until we vaccinate enough people.
New variants may change everything. They'll be 1% of all cases by end of next week, with hot spots in Florida and Southern California. But doubling every week, they'll be about 30% of all cases in 5 or 6 weeks. It'll be harder to hide from them, schools will be more vulnerable.
What can we do? We're in a race against time to get as much protective immunity into population as backstop against continued spread. The vaccine is our only tool. We also need to become more vigilant about masking. Quality of mask matters more now. N95 best, or double masking.
We still have a window of opportunity to slow its spread. The faster we can bring down infection rates now, the more we can stop chains of transmission. The same approaches apply: masking, distancing, avoiding risky congregate settings. We need to buy time while we can vaccinate.

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More from @ScottGottliebMD

Scott Gottlieb, MD Profile picture
1 Nov 20
THREAD: Covid cases are accelerating across the U.S. and we have some hard months ahead. We are at the beginning of exponential spread in many states. We need to take steps now to preserve life, and know that things will get better, and 2021 will be a very different year. 1/n
We’ll have better technology and therapeutics to address risk and protect people. We’ll have more experience caring for the sick. We’ll see infections decline as we get through this surge and enter spring. We must take steps to preserve and elevate what’s most important to us 2/n
That must include preserving in class learning for kids and re-opening schools. There are steps we can take right now to make sure kids can be back in school as current surge subsides, or keep more kids in school where classes are open. It starts with helping protect teachers 3/n
Read 6 tweets
Scott Gottlieb, MD Profile picture
28 Oct 20
It is deeply unfortunate that we head into Fall without enough doses of this drug. Many of us were talking about this as early as March. Regeneron did extraordinary work to secure their own manufacturing, but we needed a concerted industrial effort to get the supply we needed.
Re-upping this July Op Ed. Some of the same opportunities we identified here are still open to us. But we need to start taking steps immediately to have enough of these drugs to use as a backstop for high risk patients; and a bridge until we get a vaccine. wsj.com/articles/antib…
Re-upping this April Op Ed. wsj.com/articles/bet-b…
Read 4 tweets
Scott Gottlieb, MD Profile picture
23 Oct 20
The number of Covid cases, hospitalizations, and deaths is going to continue to grow sharply as we enter the winter; until all of us on our own start taking enough collective action to slow the spread. There is no seasonal backstop, and won’t be any new national policy action.
When people wear masks, it reduces likelihood of spreading Covid if they're an asymptomatic or pre-symptomatic carrier. A new @Nature study finds if 85% of Americans wore masks, we would save 95,000 people. Greater adherence to masking will reduce spread. nature.com/articles/s4159…
Masks can also protect you from contracting Covid if you are exposed to someone who is contagious; and the quality of the mask you wear can matter. The higher the quality of the mask, the greater the protection that it can afford you.
Read 4 tweets
Scott Gottlieb, MD Profile picture
11 Oct 20
A good reference from CDC on SARS-CoV-2 Virus Culture and Subgenomic RNA for Respiratory Specimens. Authors investigated 68 respiratory specimens from 35 coronavirus disease patients in Hong Kong, assessing them for subgenomic RNA and virus RNA by rtPCR. wwwnc.cdc.gov/eid/article/26…
Subgenomic mRNA is a newer test being used to assess for active infection and live virus and it's generally considered a good - but not foolproof - proxy for culturable, live virus.
As always, @ashishkjha with a timely and insightful explainer and assessment here:
Read 4 tweets
Scott Gottlieb, MD Profile picture
14 Sep 20
Thread: My longstanding public health perspective is a critical shortcoming of our early response was the lack of diagnostic testing to detect community spread and target early mitigation. We were situationally blind. So we over-relied on flu surveillance because it’s all we had
I first raised these concerns in writing on Jan 27, when I said "global spread appears inevitable. So too are...outbreaks in the U.S." and called for the rapid development of accessible diagnostics as a "key to enabling successful public health measures" cnbc.com/2020/01/26/op-…
There were regulatory hurdles that had to be cleared to enable academic and commercial labs to offer their own, lab developed tests that could help meet the testing demand. I outlined the "Catch-22" that was blocking these tests in a series of tweets.
Read 5 tweets
Scott Gottlieb, MD Profile picture
22 Aug 20
THREAD: For the last 6 months, FDA’s device center worked effectively with labs to advance hundreds of tests for Covid. A new HHS policy that extricates FDA from this work - and goes further, by removing any FDA role over any lab developed test - could put this work at risk. 1/x
At issue are lab developed tests. For a time, there was debate what FDA’s role was over these LDTs. It was long settled that LDTs were medical devices, subject to FDA oversight. For the vast majority of LDTs, FDA exercised enforcement discretion, and didn’t actively regulate 2/x
This FDA authority was articulated in countless guidances, enforcement actions, testimony. It was the subject of 2006 guidance that was cleared by HHS under Bush. Bipartisan legislation now moving through Congress would further codify the contours of this general framework. 3/x
Read 13 tweets

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