Gottlieb says shorter quarantine period would still capture “vast majority” of virus cases

17 min readNov 29, 2020

Dr. Scott Gottlieb, former commissioner of the Food and Drug Administration, said a shortened recommended quarantine period under consideration by the Centers for Disease Control and Prevention (CDC) should capture the “vast majority” of coronavirus infections.

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“What you want are recommendations that are prudent and practical that people are going to follow,” Gottlieb said Sunday in an interview with “Face the Nation.” “And when you have a 14-day quarantine period, that’s such a long period of time that a lot of people aren’t going to follow that anyway, and it makes it difficult to adhere to recommendations. So putting in place a 10-day quarantine period, even a seven-day quarantine period, you’re going to capture the vast majority of infections within that time frame.”

Transcript: Dr. Scott Gottlieb on “Face the Nation”

Under current guidelines, the CDC recommends people quarantine for 14 days after their last contact with a person who has COVID-19. But the health agency is considering shortening that time period. Admiral Brett Giroir, assistant secretary for health at the Department of Health and Human Services, told reporters Tuesday there is a “preponderance of evidence that a shorter quarantine complemented by a test might be able to shorten that quarantine period.”

The Trump administration, Giroir said, is “actively working on that type of guidance” and reviewing the evidence.

Gottlieb called the potential move by the CDC a “prudent step” that should have been considered earlier. Most people who are exposed to COVID-19 are going to be infected within five to seven days, he said, though there is evidence that some won’t become infected until 14 days after exposure.

“I think you need to balance the practicality of what you’re recommending with people’s ability and willingness to comply with it,” he said.

The possible change in recommendations from the CDC comes as the nation experiences its latest surge in coronavirus infections, and public health experts expect the number of cases to rise after the Thanksgiving holiday.

With more than 13.2 million confirmed coronavirus cases, according to Johns Hopkins University, and hospitalizations spiking, governors and mayors have begun to reimpose restrictions on restaurants and bars in an effort to mitigate the spread of the coronavirus, while many places require residents to wear masks in public.

Gottlieb said in areas of the northeast and mid-Atlantic, where governors took “more aggressive steps earlier,” he expects infection rates to remain lower than in other parts of the country. He also noted that in other areas where governors declined to implement stringent restrictions, such as mask mandates or closing bars and restaurants, there is little evidence their economies fared better than in places with stricter measures.

“What’s really keeping consumers home is the virus,” he said. “Why people aren’t going out to eat is they don’t want to go into restaurants and risk getting infected. It’s not the mandates and the state action that’s keeping people home. It’s the infection.”

While coronavirus cases continue to rise and top health experts warn the nation is facing a difficult winter, three pharmaceutical companies, Pfizer, Moderna and AstraZeneca, have reported positive late-stage trial results for their COVID-19 vaccines. On Tuesday, the CDC’s Advisory Committee on Immunization Practices is scheduled to meet to discuss allocation of a COVID-19 vaccine and make recommendations on who should receive it first.

Gottlieb conceded the country is “not going to have enough supply to vaccinate everyone” who could be eligible for a vaccine, but predicted the first tranche will go to health care workers and residents of long-term care facilities. But with only 40 million doses available throughout the month of January if Pfizer and Moderna receive emergency use authorizations from the FDA, he said there is “probably not enough vaccine to work fully through both of those groups.”

Transcript: David Beasley on “Face the Nation,” November 29, 2020

MARGARET BRENNAN: We know worldwide more than a quarter of a billion people are likely to be acutely hungry in 2020, and this crisis is getting worse. The UN’s World Food Program is the world’s largest organization, addressing hunger and promoting food security. And we go now to its executive director, David Beasley. He joins us from Florence, South Carolina. Good morning to you.

DAVID BEASLEY: Good morning to you.

MARGARET BRENNAN: That is a staggering estimate in terms of the number of people on the verge of acute hunger. And you say 270 million on the precipice of starvation. How much of this is due to the pandemic?

BEASLEY: Well, quite a bit of it. In fact, about half of that is due to the pandemic. When I joined the World Food Program a few years ago, the number of people that were marching toward the brink of starvation was about 80 million people. But over the past three years pre-COVID, it spiked up to 135 million. And you ask the question why? The primary reason was manmade conflict, compounded with climate extremes and fragile- fragile governments. But since COVID has come in and truly exacerbated every extenuating circumstances we had around the world, the numbers are going from 135 million from one year ago to 270 million people marching to the brink of starvation. This is not people going to bed hungry. This is people really struggling to get their next meal.

MARGARET BRENNAN: You warned recently that the coming year, 2021, could bring famines of biblical proportions. Where specifically are you most concerned?

BEASLEY: Well, there’s about 36 countries now that we feed 30 million people that they depend on us 100 percent. We assist about 100 million people on any given day, week or month right now around the world, we need to move that number up to about 138 million. But there are three dozen countries, and you talk about specifically, let me just hit a few, Yemen, Syria, South Sudan, Northeast Nigeria, DRC, and I could keep going from country to country to country around the world. In fact- and if we don’t address this, MARGARET, this is what we’re looking at- we’re looking at famines, destabilization and mass migration. And it’s a lot cheaper to come in and prevent it and do it right. You know, if people in the United States are struggling for food, what you imagine is happening in Niger, Burkina Faso or South Sudan.

MARGARET BRENNAN: You know, the US taxpayer is the single largest donor to the UN’s World Food Program. But we are going through a crisis here at home. You just heard how painful it is. What impact do you think that economic strain is going to have on the US ability to give to your organization?

BEASLEY: Well, it’s extremely important. That’s one of the things that I’m talking with leaders around the world, especially the United States, who is our number one donor as well as European leaders. You know, when you go back to the Syrian war, the European leaders did not step in at the right time, at the right place, and they paid a severe price. Syria was a nation of about 20 million people. The cost of supporting the Syrian in Syria is about 50 cents per day. That same Syrian ends up in Berlin or Brussels or London, it is 50 to 100 euros per day. And we know that people don’t want to leave home. But if they don’t have food and they don’t have some degree of peace and stability, they will do what any of us would do for our children. So it’s a lot cheaper to come in and prevent the destabilization than it is to have war and conflict afterwards. And the United States has always been the most generous nation on Earth. And I don’t expect the United States to back down now, because it’s going to be a lot cheaper to come in and do it right and prevent a lot of migration and a lot of destabilization and, in fact, a lot of deaths from hunger. People are dying now, about every five seconds a child dies from hunger. I mean, by the time you and I finish talking, MARGARET, we’re going to have several dozen children have died from hunger.

MARGARET BRENNAN: Before you were a humanitarian, you were a Republican governor in South Carolina. You were a politician. So I know you know the politics in this country right now. And you understand the complaints from President Trump in regard to the US taking on too much of a burden, an outsized responsibility when it comes to solving the world’s problems. How do you respond to that argument now at this time of need in this country?

BEASLEY: Well, one of the things that I have found when it comes to international aid, strategic, effective international aid, I call it the miracle on Pennsylvania Avenue at both ends. You know, when it seems like the Democrats and Republicans, MARGARET, they’re fighting over everything. But when it comes to food aid and stabilizing nations and preventing famine, it’s remarkable to watch the Republicans and the Democrats come together, lay aside their differences and literally do what they can. And it’s been quite a miracle to see. We went from about 1.9 billion when I arrived 3.5 years ago to now about almost four billion dollars from the United States. And so whether you talk about Bush, Obama or Trump and I know Biden will- we will have the support we need from Republicans and Democrats to help the needy people around the world. But this is a —

MARGARET BRENNAN: Yeah.

BEASLEY: — one time extraordinary crisis. And we’re going to have- actually we’re going to have to ask —

MARGARET BRENNAN: OK.

BEASLEY: — the billionaires to step up in a way they’ve never done before.

MARGARET BRENNAN: All right. Mr Beasley, thank you for your time. Congratulations to the World Food Program on the Nobel Peace Prize you’re about to receive. We’ll be back in a moment.

Transcript: Claire Babineaux-Fontenot on “Face the Nation,” November 29, 2020

MARGARET BRENNAN: This Thanksgiving many of us enjoyed an abundance of food, but more than 50 million people in this country are unsure of where their next meal is coming from, according to Feeding America. That is the nation’s largest hunger relief organization. And its CEO, Claire Babineaux-Fontenot, joins us from Dallas this morning. Good morning.

CLAIRE BABINEAUX-FONTENOT: Good morning.

MARGARET BRENNAN: Your organization says as a result of the pandemic, one in six Americans could face hunger. Where are you seeing the most need?

BABINEAUX-FONTENOT: Wow, what is really staggering is the fact that that’s on average across the country. There are actually communities in which one in two children face food insecurity. What we’re seeing is the things that you might imagine. So, communities of color are particularly vulnerable. They’re two times more likely to suffer with food insecurity. Also, rural communities are far more likely to suffer with food insecurity as well. So, it’s definitely not evenly spread, but on average, about one in six people in this country food insecure. That’s right.

MARGARET BRENNAN: That is staggering. 17 million of them children. How much of that is coming from school closures?

BABINEAUX-FONTENOT: Well, it’s a combination of things, actually. About 22 million children in the country before COVID relied on free and reduced lunch. It consistently is true that families with children are far more likely to suffer from food insecurity. So there are lots of things conspiring right now to cause vulnerable communities to really be reeling right now, not only with a- a health crisis, but with a food crisis as well.

MARGARET BRENNAN: I want to talk not just about describing the problem, but- but some of the suggestions you might have on solutions here. I know that states were ordered last month to do the most they possibly can in terms of providing money for food stamps. The typical payment, according to the USDA, is for a family of four to get $680 to last for a month. According to your organization, a third of the customers you are seeing at your food banks don’t even qualify for food stamps. What does that suggest to you about how out of a line the states and the federal government is with the absolute need you’re seeing on the front lines?

BABINEAUX-FONTENOT: Yeah, well, I’m so glad you started there because that’s one of the solutions. That’s something we could do right now that could help families that are struggling. So not only do we have many people who turn to us for help or people who don’t qualify but barely don’t qualify under current guidelines. But we also have a number of people who turn to us for help who qualify. But what they receive does not satisfy their needs for their families because of things like what you said. I want to throw out one more statistic, if you won’t- if you don’t mind, which is that the US Bureau of Labor Statistics just said that grocery prices right now are at a 50-year high and we’re simply not tracking with those increases in demand and- and lower supply when it comes to the federal nutrition program. So that’s something that we should definitely be looking at- at changing.

MARGARET BRENNAN: Cost of living just higher than what the social safety net is. I- I know you’ve been in contact with the Biden administration, incoming administration, and I know there’s a debate among some Democrats right now about whether to refocus, in some ways, the Agriculture Department on this question of hunger versus the traditional focus on rural America. What- what would you advise the incoming administration?

BABINEAUX-FONTENOT: I- I’d start by saying that’s a false choice. The need is so great out there. We ought to be doing both. There’s absolutely a role for the federal nutrition programs to play. That role, in fact, should be enhanced. And there’s also a role for our- our US based growers and- and producers to play. I’ll give you as one quick example, the USDA commodities represented about 1.7 billion meals of the five billion meals that our network was able to provide last year. If nothing happens with no intervention, we’re looking at a 50% decrease in those commodities next year while we’re seeing a 60% increase in demand. I- I really believe that we need to be thoughtful about how we look at near-term solutions, mid-term solutions and long-term solutions. And as I said, I believe that’s really a false choice.

MARGARET BRENNAN: Well, in the near term, we know the CARES Act, a lot of its support to Americans runs out at the end of December, leaving potentially almost seven million people pending eviction, 12 million Americans without unemployment benefits. What is that going to do? Are your food banks prepared to meet what is potentially a lot of new need?

BABINEAUX-FONTENOT: Well, I’ll tell you, I- I’ll bet on this network of remarkable people to do everything that they can all the time, but the simple truth is there’s no way that the charitable food system can do this alone. It’s going to require- it’s an all-in fight. It’s going to require policy interventions, regulatory interventions. It’s also public-private partnerships. I think we’ve got to get really serious about- about doing something about this, because in our country, we actually have the resources and the ingenuity that’s necessary to really solve these problems —

MARGARET BRENNAN: Yeah.

BABINEAUX-FONTENOT: — as nuanced and complex as they are.

MARGARET BRENNAN: Well, good luck to you and your organization. Thank you.

BABINEAUX-FONTENOT: Thank you for having me.

Transcript: Scott Gottlieb discusses coronavirus on “Face the Nation,” November 29, 2020

MARGARET BRENNAN: We want to go now to former FDA commissioner Dr. Scott Gottlieb, who joins us from Westport, Connecticut. He sits on the board at Pfizer, one of the drug companies preparing a vaccine. Good morning to you.

DOCTOR SCOTT GOTTLIEB: Good morning.

MARGARET BRENNAN: You could- you could really hear the concern and Dr. Birx’s description of what she thinks is about to hit this country. You look at South Dakota, it was the latest case to see one COVID death for every 1,000 residents. Is the whole country going to look like South Dakota?

DR. GOTTLIEB: Hopefully not. I think parts of the country are going to be able to do better than the Midwest is doing and certainly better than South Dakota and North Dakota are doing. If you see what’s happening in the Northeast and mid-Atlantic states where governors took more aggressive steps earlier, where there’s more consistent use of masks, where they took less infection going into this season, I think you’re going to see infection remain- rates remain lower than we’re seeing in other parts of the country like the Midwest. Also, there’s a lot of testing available here. So they’re taking more aggressive steps to try to contain the infection. If you look at states like South Dakota and the Midwest generally, you’re starting to see the number of new infections slow. And that’s a reflection of the fact that they’ve fully infected at least 30% of the population in states like South Dakota, and maybe as high as 50% if you look at some of the modeling. So at some point, you have such a high rate of infection in these parts of the country that you’re going to see a natural slowing of new infections because the people who are eligible to be infected, who are vulnerable, have already gotten the virus.

MARGARET BRENNAN: I mean, is that the strategy, the federal strategy to just hope for the best?

DR. GOTTLIEB: Well, look, quite frankly, that’s been the strategy of some people, this so-called herd immunity strategy. They don’t say that explicitly, but some people think that you really can’t stop this virus and we just have to let it run its course and do our best to protect those who are vulnerable. We’re not doing a very good job of protecting the vulnerable. Almost 8% of all nursing home residents have perished as a result of this pandemic since the start of the year. But there are some people who don’t think you can really fully stop this virus. I disagree with that. I think you look at parts of the country, look at New York, look at my home state of Connecticut. There’s a lot of infection here. These states are pressed right now, but you’re not seeing the widespread rates of transfer that you’re seeing in other parts of the country that haven’t taken more aggressive steps. And I would argue that the economy in South Dakota and parts of the country that let this run a little bit more and didn’t really take aggressive steps, didn’t put in place mask mandates, didn’t close congregate settings like bars and restaurants. I don’t think there’s real evidence that they’ve done better economically than parts of the country that took more prudent steps. What’s really keeping consumers home is the virus. Why- why people aren’t going out to eat is they don’t want to go into restaurants and risk getting infected. It’s not the mandates and the state action that’s keeping people home. It’s the infection.

MARGARET BRENNAN: The CDC is considering shortening the amount of recommended time for a quarantine. What does that accomplish?

DR. GOTTLIEB: Look, I think this is a prudent step. I think we should have contemplated this earlier because the reality is most people who get exposed to COVID are going to come down with COVID- who get exposed to coronavirus will come down with COVID within a short period of time, figure five to seven days. There are some outliers, and some people- there is evidence that some people won’t contract the infection until a full 14 days after exposure. But, what you want are recommendations that are prudent and practical that people are going to follow. And when you have a 14 day quarantine period, that’s such a long period of time that a lot of people aren’t going to follow that anyway. And it makes it difficult to adhere to recommendations. And so putting in place a 10-day quarantine period, even a seven-day quarantine period, you’re going to capture the vast majority of infections within that time frame. So I think you need to balance the practicality of what you’re recommending with people’s ability and willingness to comply with it.

MARGARET BRENNAN: You need a degree in psychology to figure out how to get people to comply these days. Dr. Fauci said on another network this morning, “There’s not enough vaccine right now to vaccinate health care workers next month. That’s the reason why this happens, that it goes to the states, that the amount of vaccine gets shipped locally. And then the final decision of how to do that properly will be left up to the states.” What does he mean? What- what should be the deciding factor in who gets the vaccine? And are we short on supply already?

DR. GOTTLIEB: We are short on supply. We’re- we’re not going to have enough supply to vaccinate everyone who could be eligible for this vaccine, who could benefit it- from cert- from it certainly. The federal government this week on December 1st is going to make recommendations of vaccine advisory committee that advises CDC will make recommendations on who should get the vaccine first, the so-called 1A group, the people who should get it immediately when it becomes available, hopefully in- in December, if there’s one or more authorization of vaccines this month, including from the company I’m on the board of, Pfizer. That’s going to be health care workers and residents of long term care facilities. There’s about 20 million health care workers who might be eligible and about three million residents of long term care facilities and staff of those facilities. Those will be the first group of patients who get access to it. That’s pretty much decided. They’re going to vote on it this week. But I wouldn’t be- I’d be very surprised if they deviate from that. But there’s only going to be 40 million doses available throughout the whole month of December if both companies get authorized on time. So, there’s probably not enough vaccine to work fully through both of those groups. And then there’s a question of who’s going to be in that second tranche, what we’re calling 1B. And there is some debate whether that’s going to be older Americans, those over the age of 65 or 75 or certain essential workers or some combination of both. There’s about 85 million essential workers who might be eligible to be vaccinated if you- if you bifurcate it to that group. And there’s about 50 million people over the age of 65, 20 million over the age of 75.

MARGARET BRENNAN: Yeah.

DR. GOTTLIEB: And so that’s going to be some debate about which group gets prioritized first.

MARGARET BRENNAN: When Dr. Birx says “vaccinate for impact,” what does that mean?

DR. GOTTLIEB: Well, it depends on what impact you’re trying to achieve. If you’re- if your goal is to maximize the preservation of human life with a vaccine than you would- you would bias the vaccine towards older Americans. You would try to get everyone over the age of 75 vaccinated first. There’s about 20 million of- of those in that group.

MARGARET BRENNAN: OK.

DR. GOTTLIEB: If your goal is to reduce the rate of infection, you would prioritize essential workers. So it depends on what impact you’re trying to achieve.

MARGARET BRENNAN: And a lot of that is going to rest on the shoulders of state governors. We’ll be covering this. Dr. Gottlieb, thank you for your insight. We’ll be right back.

Gottlieb says shorter quarantine period would still capture “vast majority” of virus cases

Transcript: David Beasley on “Face the Nation,” November 29, 2020

Transcript: Claire Babineaux-Fontenot on “Face the Nation,” November 29, 2020

Transcript: Scott Gottlieb discusses coronavirus on “Face the Nation,” November 29, 2020

Written by Azizul Haque

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