April 14, 2020

COVID-19: Mortality Rate & China’s Mistakes | Scott Gottlieb on The Editors with Rich Lowry

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Key Takeaways

• “This is a once in a century pathogen, this is going to change the way we live and there’s not an easy solution until we get to a vaccine” – Scott Gottlieb
• “There seems to be a correlation between poverty and deaths” – Scott Gottlieb
  • Poorer communities tend to be packed together which makes it difficult to socially distance, and the population tends to have more health problems such as smoking or diabetes
• COVID-19 is highly contagious:
  • 80% of people get mild to moderate disease 
  • 10-20% of people are asymptomatic
  • 10-15% end up with severe pneumonia
  • 10% require hospitalization
  • 5% end up in critical care
  • 1% end up dying 
• Less than 5% of the US population has been exposed to the coronavirus and look at all the death and problems it’s causing
• Had China been more aggressive in containing the virus back in November and forthcoming about the issue, then they might have been able to fully contain the virus
  • “This might’ve been an entirely avoidable world event” – Scott Gottlieb

Intro

• Scott Gottlieb (@ScottGottliebMD) is an American physician and investor who served as the 23rd Commissioner of the Food and Drug Administration from 2017 until April 2019
• Host: Rich Lowry (@RichLowry) 

Thoughts on COVID-19

• The coronavirus infects the lower area of the lungs which can cause the immune system to overreact and it ends up attacking and damaging the person’s lung tissue
• The coronavirus is similar to the Spanish Flu
  • “COVID-19 not only looks like Spanish Flu in terms of its distribution across the age range but looks far more fierce” – Scott Gottlieb
• South Korea did a better job at tracing contact cases than the US
  • The problem in the US is that infection spread so quickly that it became overwhelming to contact trace cases
• The are 3 options in a pandemic:
  • 1) Just let it spread everywhere, but hospitals will be at overcapacity and you’ll have a high morbidity rate
  • 2) You can do population based medication
  • 3) Or case-based interventions where you try to find who has the disease, test people aggressively, and ask people to self-isolate if they’re infectious
    • “Those are the only three options, there’s not really a good middle option” – Scott Gottlieb
• The US will be measuring the cost of COVID-19 for years to come
  • People who are showing early signs of heart disease or cancer won’t get diagnosed because practically every medical doctor is dealing with the coronavirus
  • Alcohol consumption is on the rise as is domestic abuse
    • “The implications of this, just the direct public health implications are enormous and probably immeasurable” – Scott Gottlieb
• “This is a once in a century pathogen, this is going to change the way we live and there’s not an easy solution until we get to a vaccine” – Scott Gottlieb
• The warm weather during the summer will help slow down the virus but we don’t know by how much
  • “It will still spread, but probably not with the same efficiency” – Scott Gottlieb
    • If the virus comes back in the Fall, the country will have to go into lockdown once again
• We need to destigmatize testing and get more people tested 
  • We need to incent those infected to stay home and self-quarantine so they don’t infect others 

COVID-19 Stats  

• Percent of COVID-19 deaths of people that were less than 65 years old:
  • Germany: 4.9% 
  • Italy: 9% 
  • Netherlands: 5.1% 
  • Portugal: 4.5%
  •  Spain: 4.6%
  • Sweden: 4.8%
  • Switzerland: 3%
• However, in the US it’s a different story:
  • Louisiana: 23%
  • Detroit: 21%
  • New York City: 29.9%
• “There seems to be a correlation between poverty and deaths” – Scott Gottlieb
  • Poorer communities tend to be packed together which makes it difficult to socially distance, and the population tends to have more health problems such as smoking or diabetes
    • “This is true of a lot of infectious diseases, they often become diseases of poverty and disproportionately affect people of lower socioeconomic groups for a whole variety of reasons”
• COVID-19 is highly contagious:
  • 80% of people get mild to moderate disease 
  • 10-20% of people are asymptomatic
  • 10-15% end up with severe pneumonia
  • 10% require hospitalization
  • 5% end up in critical care
  • 1% end up dying 
• Less than 5% of the US population has been exposed to the coronavirus and look at all the death and problems it’s causing
  • If nothing is done to stop the spread of the virus:
    • Hospitals were been overrun and “There will be no healthcare, it will be all covid” – Scott Gottlieb
    • There will be a lot of deaths from the virus
    • A large percentage of the population won’t be able to go to work or contribute to the economy

China’s Mistakes

• China did publish the sequenced strain of the virus but they didn’t make the live virus available–the US eventually got the virus, but it took several weeks
  • “This virus has changed the course of history, this had altered the world…this will permanently change how we live till we get to a vaccine” – Scott Gottlieb
    • China knew that wet markets created a risk for a deadly virus: “This is a consequence of something that came out of China…they set up the conditions to create this risk”
• Had China been more aggressive in containing the virus back in November and forthcoming about the issue, then they might have been able to fully contain the virus
  • “This might’ve been an entirely avoidable world event” – Scott Gottlieb
• China likely undercounted cases and deaths
  • However, lots of systems in many countries have become overwhelmed making it difficult to keep up with the data

Possible Solutions

• Scott believes a vaccine for COVID-19 is about 2 years away
• There are about 6 existing drugs that could potentially help treat the virus
  • However, these drugs must first be tested to see if they’re safe and effective for the general population