If we’d only listened to Scott Gottlieb, part II

I don’t get time to read full books anymore, but I devour book reviews. Thus I immediately jumped on a review of “Uncontrolled Spread” by Scott Gottlieb in the Wall Street Journal a week ago. Dr. Gottlieb, until 2019 head of the FDA under Trump, had one of the clearest views of the pandemic of anyone. I’ll discuss that review in my next post.

I know most of you won’t be able to read the article, unless you’re WSJ subscribers. I won’t try to summarize the article, but here is the most important passage in it:

If there’s one overarching theme of “Uncontrolled Spread,” it’s that the Centers for Disease Control and Prevention failed utterly. It’s now well known that the CDC didn’t follow standard operating procedures in its own labs, resulting in contamination and a complete botch of its original SARS-CoV-2 test. The agency’s failure put us weeks behind and took the South Korea option of suppressing the virus off the table. But the blunder was much deeper and more systematic than a botched test. The CDC never had a plan for widespread testing, which in any scenario could only be achieved by bringing in the big, private labs.

Instead of working with the commercial labs, the CDC went out of its way to impede them from developing and deploying their own tests. The CDC wouldn’t share its virus samples with commercial labs, slowing down test development. “The agency didn’t view it as a part of its mission to assist these labs.” Dr. Gottlieb writes. As a result, “It would be weeks before commercial manufacturers could get access to the samples they needed, and they’d mostly have to go around the CDC. One large commercial lab would obtain samples from a subsidiary in South Korea.”

At times the CDC seemed more interested in its own “intellectual property” than in saving lives. In a jaw-dropping section, Dr. Gottlieb writes that “companies seeking to make the test kits described extended negotiations with the CDC that stretched for weeks as the agency made sure that the contracts protected its inventions.” When every day of delay could mean thousands of lives lost down the line, the CDC was dickering over test royalties.

In the early months of the pandemic the CDC impeded private firms from developing their own tests and demanded that all testing be run through its labs even as its own test failed miserably and its own labs had no hope of scaling up to deal with the levels of testing needed. Moreover, the author notes, because its own labs couldn’t scale, the CDC played down the necessity of widespread testing and took “deliberate steps to enforce guidelines that would make sure it didn’t receive more samples than its single lab could handle.”

Dr. Gottlieb is much kinder to his friends and former colleagues at the FDA. My view is that the FDA shares in the failure. The FDA does not have authority over laboratory-developed tests, so in ordinary times a lab can develop a test without seeking FDA approval. But the FDA, using the Covid-19 emergency as a pretext, asserted that any SARS-CoV-2 test needed its approval before it could be deployed. Thus the logic of emergency was inverted. Instead of lifting regulations and giving priority to speed, the FDA increased regulation and slowed test deployment.

Dr. Gottlieb, to his credit, cannot be accused of hindsight bias. On Jan. 28, 2020, one month before the United States recorded its first Covid death, he and a co-author warned in these pages that we must “Act Now to Prevent an American Epidemic.” Correctly predicting that testing would be a bottleneck, he urged the CDC to bring in private test suppliers as quickly as possible. One wonders how many deaths might have been averted had Dr. Gottlieb’s advice been followed.

A really sad story, all the more so because nothing recounted here was at all inevitable. These were colossal problems that were entirely due to the fact that the administration at the time had already made the decision that, rather than try to suppress the epidemic, they would deny it (and within about a month, when it became clear that there was going to be a big death toll, the official position moved to “There’s nothing we can do about this”).

The result? More than 1 in 500 Americans has died of Covid-19. Sure, a lot would have died regardless of the administration’s actions and non-actions. But it would likely have been 1-200,000, not 706,317 (and counting). And the most consequential mistakes (or perhaps deliberate sabotage) were made by the CDC and the FDA in February 2020. Thanks a lot, esteemed public servants!

Note that both deaths and cases declined significantly last week, although they’re still far too high. Now it’s a race between the oncoming cold weather and somehow forcing a large number of the idiots who still haven’t been vaccinated to do the right thing.

The numbers

These numbers were updated based on those reported on the Worldometers.info site for Sunday, September 26.

Month	Deaths reported during month	Avg. deaths per day during period	Deaths as percentage of previous month’s
Month of March 2020	4,058	131
Month of April	59,812	1,994	1,474%
Month of May	42,327	1,365	71%
Month of June	23,925	798	57%
Month of July	26,649	860	111%
Month of August	30,970	999	116%
Month of Sept.	22,809	760	75%
Month of Oct.	24,332	785	107%
Month of Nov.	38,293	1,276	157%
Month of Dec.	79,850	2,576	209%
Total 2020	354,215	1,154
Month of Jan. 2021	98,604	3,181	119%
Month of Feb.	68,918	2,461	70%
Month of March	37,945	1,224	55%
Month of April	24,323	811	64%
Month of May	19,843	661	82%
Month of June	10,544	351	53%
Month of July	8,833	287	84%
Month of August	31,160	1,005	351%
Total Pandemic so far	706,317	1,214

 

I. Total deaths (as of Sunday)

Total US reported Covid deaths as of Sunday: 706,317

Average deaths last seven days: 1,520

Average deaths previous seven days: 2,302  

Percent increase in total deaths in the last seven days: 1.6%

II. Total reported cases (as of Sunday)

Total US reported cases as of Sunday: 43,570,983

Increase in reported cases last 7 days: 708,524 (=101,218/day)

Increase in reported cases previous 7 days: 1,005,682 (= 143,669/day)

Percent increase in reported cases in the last seven days: 1.6%  

I would love to hear any comments or questions you have on this post. Drop me an email at tom@tomalrich.com.