NEW YORK TIMES BESTSELLER
Physician and former FDA commissioner Scott Gottlieb asks: Has America’s COVID-19 catastrophe taught us anything?
In Uncontrolled Spread, he shows how the coronavirus and its variants were able to trounce America’s pandemic preparations, and he outlines the steps that must be taken to protect against the next outbreak. As the pandemic unfolded, Gottlieb was in regular contact with all the key players in Congress, the Trump administration, and the drug and diagnostic industries. He provides an inside account of how level after level of American government crumbled as the COVID-19 crisis advanced.
A system-wide failure across government institutions left the nation blind to the threat, and unable to mount an effective response. We’d prepared for the wrong virus. We failed to identify the contagion early enough and became overly reliant on costly and sometimes divisive tactics that couldn’t fully slow the spread. We never considered asymptomatic transmission and we assumed people would follow public health guidance. Key bureaucracies like the CDC were hidebound and outmatched. Weak political leadership aggravated these woes. We didn’t view a public health disaster as a threat to our national security.
Many of the woes sprung from the CDC, which has very little real-time reporting capability to inform us of Covid’s twists and turns or assess our defenses. The agency lacked an operational capacity and mindset to mobilize the kind of national response that was needed. To guard against future pandemic risks, we must remake the CDC and properly equip it to better confront crises. We must also get our intelligence services more engaged in the global public health mission, to gather information and uncover emerging risks before they hit our shores so we can head them off. For this role, our clandestine agencies have tools and capabilities that the CDC lacks.
Uncontrolled Spread argues we must fix our systems and prepare for a deadlier coronavirus variant, a flu pandemic, or whatever else nature -- or those wishing us harm -- may threaten us with. Gottlieb outlines policies and investments that are essential to prepare the United States and the world for future threats.
Gottlieb, who served in the Trump administration as FDA commissioner from 2017 to 2019, delivers a well-informed if self-serving take on America's botched response to Covid-19. Covering well-trod ground, Gottlieb recounts the first reports of a new respiratory disease emerging in China, the CDC's mistakes in developing and distributing a diagnostic test for the virus, shortfalls in the national stockpile of medical equipment, the use of mRNA technology to develop the first vaccines, and the politicization of preventive measures such as mask wearing. He notes that the Obama administration's pandemic response plan didn't discuss masking, and describes President Trump during a March 2020 White House visit as "well-briefed" by his staff and accepting of the need for "strong action" to mitigate the spread of the disease. Gottlieb's suggestions for how to better prepare for the next pandemic include using "the tools and tradecraft of our clandestine services" to gather information on foreign outbreaks, and manufacturing more "critical healthcare components and finished goods" in the U.S. Though he lucidly explains scientific and logistical matters, Gottlieb's tendency to cite his own Wall Street Journal op-eds grates. This pandemic postmortem is more concerned with boosting the author's reputation than breaking new ground.