Transcript: Scott Gottlieb discusses coronavirus on "Face the Nation," May 10, 2020
The following is a transcript of an interview with former FDA Commissioner Scott Gottlieb by CBS News' Margaret Brennan that aired Sunday, May 10, 2020, on "Face the Nation."
MARGARET BRENNAN: Welcome back to FACE THE NATION. We go now to Westport, Connecticut, and former FDA commissioner Dr. Scott Gottlieb. Good to have you back with us.
DR. SCOTT GOTTLIEB: Thank you.
MARGARET BRENNAN: We heard from the FDA that they have given emergency use authorization for the first antigen test to discover COVID-19, so that's any substance that causes your immune system to produce antibodies against it. How significant is this authorization? How will this work?
DR. GOTTLIEB: Well, I think this kind of technology is a real game changer, and this test was authorized by the FDA under the leadership of Jeff Shuren who runs that device center in 24 hours from receiving the application. What it is it's a very rapid test that could be used in a doctor's office. Doctors now have about 40,000 of these Sofia machines already installed in their offices. And you do a simple nasal swab and the test itself scans for the antigens that the virus produces. The test is about 85 percent sensitive. So let's say a hundred people come into a doctor's office who have COVID-19, 85 of them are going to be able to be tested positive with this test very quickly. It's a cheap test. It'll probably be about five dollars a test and you can get a result within five minutes. For the other 15, the doctors are going to have to have an index of suspicion that the patient may have COVID-19 and send off one of the PCR-based tests, which take about 24 hours to get the result back. But for those 85 patients that you could screen out right away, you're getting a very fast result and you can start to take action immediately. The company itself said that they're going to be able to produce about 200,000 of these tests starting right away. But in several weeks they'll be able to produce up to 1.5 million a week. So this dramatically expands our testing capacity as long as doctors are able to run these tests in their offices.
MARGARET BRENNAN: As long as they can run them. How different is this kind of testing from what we've heard so much about where states are struggling to get capacity and they're looking for, you know, reagents and cotton swabs? Does this solve those challenges?
DR. GOTTLIEB: Well, it helps solve the challenges. I mean, every test paradigm is a little bit different, has pros and cons. The PCR-based tests, where the states have struggled to get the testing supplies, those are more accurate, but they also take more time and they cost more to perform. The reimbursement is about a hundred dollars. Maybe if you do that at scale, you can get the cost down to fifty dollars. There is point-of-care-based systems like the Abbott machine that the White House is using or the GeneXpert, which is very reliable. Those take a little longer to get a result. Their sensitivity isn't as good as the PCR-based machines, with the exception of the GeneXpert, which is very accurate. These antigen based tests aren't as reliable, meaning they're not as sensitive. So they're going to miss some patients who have COVID. But in the hands of a doctor who already has a high index of suspicion that the patient may have the disease, and if they get a negative test and they still think the patient may be infected, they'll send off a PCR-based test. They allow you to dramatically expand testing. And they're very cheap. They're very easy to perform. And again, most doctors have these machines already in their offices. They're using them for strep throat and flu. The challenge is going to be what the guidance is from the CDC and public health agencies about how doctors test in their offices. If turning over a positive case in your medical office means that you have to do a deep cleaning and quarantine your nursing staff and close your office, doctors aren't going to be testing. And that would be unfortunate because there's a big, installed base of these tests already in place. So CDC has to come out with flexible guidelines on how doctors can protect their offices and protect their staff and also be testing in the community. Because if we can't do that, then we're not going to have access to tests. And the challenge won't be the platforms. There'll be plenty of capacity to perform tests. The challenge will become where can you go get the test?
MARGARET BRENNAN: You said this could be more accurate than the testing system the White House is currently using. Let me ask you about these aides who have been testing positive at the White House. Our top three medical officials in the U.S. government are now in self-quarantine because of possible exposure. They work in a White House that's a fortress. But the virus has still made it inside. I want to play for you what President Trump said this week when he revealed one of Vice President Pence's aides tested positive.
[CLIP BEGINS]
PRESIDENT TRUMP: She tested positive out of the blue. This is why the whole concept of tests aren't necessarily great. The tests are perfect, but something can happen between a test where it's good and then something happens. And all of a sudden she was tested very recently and tested negative. And then today, I guess for some reason, she tested positive.
[CLIP ENDS]
MARGARET BRENNAN: The president seems to be doubting the value of testing in the workplace. What's your view?
DR. GOTTLIEB: Well, look, I think testing has value in a workplace, especially when you're dealing with places where there's people who are at higher risk of getting infected. So you think about people who work on a shop floor or in a grocery store. The machine- the antigen-based tests that we're talking about here that was just approved is actually less sensitive than a machine that the White House is using. They're using an Abbott platform. But that flat- platform also has false negatives, meaning that sometimes patients- people are going to have the virus. But the test is going to say they don't. There's machines that are more accurate than that Abbott machine, like the GeneXpert. They take a little longer to perform the test. The reason why the White House prefers the Abbott machine is it gives a result in five to 15 minutes. GeneXpert takes about 45 minutes. And so I think that's why they prefer that platform. But this is why we need to have testing out in the community. This is why we need very accurate tests if we're going to be testing asymptomatic people. In the setting of a doctor's office where someone is symptomatic, using a test that doesn't have very high sensitivity might be OK because the doctor's going to run a confirmatory test anyway. But in the setting of where you're testing people who are asymptomatic, as the White House is doing, and you're trying to catch that- those people who don't have any symptoms, you want a very sensitive test for that kind of a purpose. And that's what we should be using out in the employment setting as well.
MARGARET BRENNAN: We've talked a lot about remdesivir. We interviewed the CEO of the company that makes that drug last week. He told us at that time the government would be deciding who the drug gets to and where. The rollout this week was pretty chaotic. Yesterday, HHS revealed its new plan for distribution. What does this indicate to you about how things will work in the future with other drugs or potentially a vaccine?
DR. GOTTLIEB: Well, look, I think we need to get a better system in place. If the government's going to take control of the supply of these kinds of therapeutics and they don't necessarily have to do that, they chose to do that, they need to have a good system in place for allocation. Here, in this case, Gilead gave a half a million doses to the federal government. They distributed initially about 4,000 in New York City, which is the city that I'm familiar with. I think they should've been trying to push out as many doses as fast as possible because more supply is coming into the market. There's no reason to hoard it or hold onto it. And so hopefully when they start to contemplate the next therapeutic and there will be more therapeutics in the fall or a vaccine and how they allocate that, they're going to have a better system in place based on clinical need.
MARGARET BRENNAN: All right. Thank you very much for your insight, Dr. Gottlieb.
