Rethinking of institutional, public health response needed to prevent next pandemic

LAS VEGAS — The United States is currently further in to the Delta variant epidemic wave than is being measured, former FDA commissioner Scott Gottlieb, MD, said during a presentation.

“Ascertainment around the country right now is very low, and testing is down,” Gottlieb said at the American Society of Cataract and Refractive Surgery meeting. “A lot of the testing that is being done is antigen testing that isn’t being recorded into the system.”

Moving forward, most COVID-19 reinfections will be mild, and challenges will come in older age groups, Gottlieb said. He predicted that the U.S. will administer 200 million vaccinations by the fall and that the virus will likely become endemic and require booster shots.

“If we’re going to contemplate [boosters], we need to start doing it soon,” he said.

One of the shortcomings in the country’s pandemic response, he said, was the inability to get manufacturers into the testing game early on. In the future, he said, the goal should not be to make sure the next pandemic “isn’t so bad” but instead to ensure it does not happen again. He called this goal “achievable” but said it will require rethinking of pandemic responsiveness overall.

“We have to think about public health preparedness through a lens of national security,” he said. “That is also going to mean getting our clandestine operators, like the CIA, more engaged in the public health mission doing surveillance around the world.”

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