Washington D.C., DC -- (ReleaseWire) -- 10/27/2014 --Nationally Syndicated Financial Myth Busting Radio Show with Host Dawn Bennett, CEO of Bennett Group Financial Services, LLC, on October 19, 2014 interviewed Dr. Scott Gottlieb, a practicing physician who has served in various capacities at the Food and Drug Administration, including Senior Adviser for Medical Technology and Director of Policy and Policy Development, and most recently he's been the Deputy Director for Medical and Scientific Affairs.
Last month Dr. Gottlieb wrote an op-ed titled “Heading off a bigger Ebola catastrophe” in which he says a more urgent international effort in West Africa is needed to stop the disease and save tens of thousands of lives. Dr. Gottlieb has a solution with three main elements to address stopping Ebola from becoming a catastrophe.
Here is the interview with Dr. Scott Gottlieb:
Dawn Bennett: Should Americans be worried about Ebola?
Dr. Scott Gottlieb: Yes we should be worried for two reasons. The first is that if the epidemic continues at its current pace in West Africa, which it seems to be, then we could be facing much more frequent and larger outbreak here in the U.S. The second reason we should be concerned is that months down the road we might start seeing these larger outbreaks. Another reason we should be concerned is that the individual cases that we've seen don't seem to have been handled well. We thought we knew how to handle this better than we do and we thought we were more prepared. Hopefully, we're going to use the time and what we learned from these incidents to better prepare for what seems to be an inevitable spread of this virus, if we don't come up with a vaccine or a drug.
Dawn Bennett: But our ability to prevent Ebola from spreading here doesn't actually reduce our obligations abroad. How do you propose we address those problems?
Dr. Scott Gottlieb: Right. I think that was the real problem early on as a lot of people quite frankly ignored the issue because they never saw it as a domestic threat. It wasn't just the United States, but other countries around the world. This always had the makings of a major humanitarian catastrophe. Early on I was comparing it to the earthquake in Haiti and tsunami in Thailand. I felt that it could become a catastrophe in that order. Now those estimates look like it's going to exceed the amount of death that we saw in those two other catastrophes. I think we need to address it by getting appropriate resources to the region to help them fight the virus, help deliver medical services to individuals, help offset the economic losses these countries are taking, and their inability to just get food and take care of basic needs because of the impact that the virus is having on their local population. So we need a tremendous relief effort and if you look at what we've done to help deal with this Ebola outbreak and compare it in proportion to what we did in for example the Haiti earthquake or the tsunami in Thailand, it's not even close to the proportion of relief and the money that was raised for those other two catastrophes. Yet I think the stakes here are much, much higher.
Dawn Bennett: I agree with you, I think we have a bigger issue here with this, especially here in the United States. Why isn't it greater?
Dr. Scott Gottlieb: I think a one-time cataclysmic event like an earthquake or a tsunami, the destruction becomes self-evident right from the outset, and it engenders a lot of support. I think in this case, the swelling nature of a viral epidemic does not have the impact of becoming apparent at all closer to the end. So it's really obvious to everyone at that point, and it's almost too late. So early on, when it was clear this is going to become a major catastrophe, but we still only had thousands of lives affected, not tens of thousands, it just didn't ride to the consciousness of a lot of people who have competing priorities. I think now that we are in the tens of thousands of people infected and dead, now it's time to become more apparent that this is a great humanitarian catastrophe.
Dawn Bennett: Do you think it's apparent to President Obama?
Dr. Scott Gottlieb: I think that the CDC director, for all the criticism that he's been receiving, did a very heroic thing in early September, when he came back from a trip to West Africa and used almost apocalyptic language to describe what he saw and it was highly, highly uncharacteristic for the CDC Director in talking about scope of the calamity and what the risk was to United States. I think that clearly pushed the president to do what he did, which was to go forward and deploy 3,000 troops to start to funnel aid in that region. The CDC Director has since backed off that bold talk, I think in part because he wants to be more cautious now that it's a domestic problem. Unfortunately the President, in my view, hasn't really ramped up his efforts. What we're doing now was probably appropriate for two months ago and what we should be doing now is to deal with a much different situation. The other thing I'll say though is, to the credit of the United States, even though I think our response has been inadequate, it's worse what other countries are doing. We are far exceeding what any other nation is doing so that should tell you something as well.
Dawn Bennett: On Friday, the White House announced it would create an Ebola czar, and this gentleman's name is Ron Klain and he's going to be taking the position. What do you think both about his position as well as Klain specifically? He has no medical background, no medical experience, do you think that's going to be a problem?
Dr. Scott Gottlieb: I don't think it's going to help. I don't understand what the White House is hoping to achieve. I evidently think that there is a political aspect of this problem and a messaging aspect to this problem because that's the areas in which Klain has expertise. So they brought someone in to manage that part, that aspect of the challenge. They still don't have anyone who is providing supervision across the relevant operating divisions of the federal government that have the authority, that are relevant, like NIH, like the CDC, like the Food and Drugs Administration. There is a position in the Secretary's Department specifically for providing that kind of leadership, but she hasn't been put into that role either. So there's really no one quarterbacking it. The Secretary of Health and Human Services who presumably would be the quarterback seems to be focused on year two of ObamaCare and the web site re-launch, so people seem to be acting on their own in various operating divisions and just trying to coordinate amongst themselves. There is no one in charge. Klain is not going to be in charge of managing the effort. He's going to be in charge of managing the message out of the White House. He was the Vice President's Chief of Staff during the swine flu when the Vice President famously went on the Today Show with Matt Lauer and said, during the outbreak of the swine flu, that he would not allow anyone in his family to be in any contained environment, including an airplane or a bus, and he, himself, would not fly on a commercial airplane, which caused the major sell-off in the airline stocks. It took about two days for the White House to walk back. So one would hope Klain is going to give better talking points to the President than he gave to his Vice President.
Dawn Bennett: The Director of NIH Francis Collins blames cuts to their budget for the lack of investment in Ebola cure, yet they spent millions on other projects in recent years. Where do you come down on this?
Dr. Scott Gottlieb: There was always money for these kinds of efforts, it just came down to a question of prioritization. A lot of the money that was made available for counter-measures for what would be weapons of mass destruction, that's where a lot of money for an Ebola vaccine came from and Ebola therapy. A lot of it went to Anthrax because it was perceived as a bigger threat. There was never shortage of money; it is the question of priority. It just wasn't prioritized very high. It's sort of politically tone deaf to start making those statements on the public health emergency and trying to point fingers to things like that, but some people around Washington always see it their way.
Dawn Bennett: We keep pointing to the United States government to fix this stuff, is there a case to be made that the medical community should be able to respond to this crisis without a government direction?
Dr. Scott Gottlieb: I think you make an excellent point because it's a misnomer that somehow CDC is in charge of delivering medical care. I don't want to take anything away from them, I give them a lot of credit. I think that they have been very adaptable in this current crisis and they've made some early missteps and had tragic consequences, but they have learned very quickly from those mistakes and we've seen them changing their posture very quickly. But what the CDC does is track and trace outbreaks; they do epidemiological surveillance and they give advice, they give medical advice around handling of things like specimens and handling of infectious pathogens. They don't deliver medical care. They don't go in and actually put a stethoscope on a patients' chests. That's not what they do. They give advice to people who deliver medical care. So it's really going to be incumbent upon the local authorities, local public health agencies and local medical institutions to try to step up their game. Major academic medical centres should be identifying teams of nurses and doctors who would be taking care of an Ebola patient if one arrived and drilling them. I worked in many academic hospitals and we drilled and trained around a lot of contingencies and this is a contingency they should be drilling on. The CDC is putting out advice on how they should be doing that, what the risks are. The CDC is going to have a lot of insight into that so they should look at the CDC guidelines very carefully. The CDC doesn't go in and actually do it. So you're right, it’s going to be incumbent upon local people to take some leadership here. So if you're a hospital like Elmhurst in Queens NY, where there’s a big community of immigrants who might be coming from the affected regions, you're at a higher risk of seeing the second Ebola case. Medical professionals should be drilling on that. I know some institutions are to their credit. Elmhurst is doing it.
Dawn Bennett: So this type of communication between hospitals on best practices and protocols, does the CDC simply issue an edict and then it arrives in somebody's inbox, in their email, and then the hospital's responsible for doing this? How does this type of communication typically work?
Dr. Scott Gottlieb: The CDC has roots of communication. They issue things like their morbidity/mortality weekly reports, which are very widely read, widely used about their surveillance activities looking at viral outbreaks. For example, this pathogen Enterovirus D68 which has been going around the country, they have been issuing a lot of MMWR reports showing how that virus is developing. They issue white papers to provide guidelines. In the Ebola case, they are actually developing what they call SWAT teams of CDC personnel that's going to go in and help and assist in training and oversee the training. These are the people who've been in the field with the virus in West Africa or other parts of Africa, who have some experience with that. The reality is that that experience is only partially relevant here because what we're learning, and what CDC is learning, is that taking care of an Ebola patient in modern hospitals is very different than taking care of an Ebola patient in the field. In the field, the protective gear you need probably isn't as significant as a protective gear you need in a modern academic medical centre by virtue of the fact that when we deliver intensive care in the U.S. in hospitals, we do much more for the patients, we are much more invasive, we do things as simple as multiple bedding changes and how we dispose the fluids. We are much more aggressive in the medical care. That's going to require more precautions and those are the things that they're learning. So even CDC's expertise in helping it oversee and assist, they're learning as they go to and it's a real challenge.
Dawn Bennett: There has been a lot back and forth about how contagious Ebola is. Even Present Obama says you can't catch it even if you're on a bus with someone who has it. Yet, even this past week there was a woman that began vomiting on a tour bus to the Pentagon, did you hear about this?
Dr. Scott Gottlieb: I did.
Dawn Bennett: And then of course the Arlington county's hazmat team came out and they were absolutely, completely full of caution and they transported this woman to the Virginia Hospital Centre. I'm just wondering is the CDC really getting a handle on this? Does President Obama understand what's going on with this? Even the CDC is currently trying to get in touch with everyone who was on that flight with that second nurse who was going from Ohio I think to Dallas. So which one is it?
Dr. Scott Gottlieb: I think the CDC in their public statements, think they recognize the scope of the threat domestically. I think the view is that the domestic outbreaks that we are seeing now is sort of a tip of the iceberg and you hope there won't be more outbreaks down the road and you do have to figure out how to respond to these. They are also equally focused on what's happening in West Africa because they know that if they don't head off this continued viral spread in that region, we won't be seeing these one-off cases. We're going to be seeing major outbreaks potentially in American cities, while we will never have an epidemic here assuming the virus doesn't mutate in a way that makes it much more contagious. We could see large outbreaks. For the President, I am not sure what's going on. I think the fact that we had The New York Times article where the President basically threw the CDC Director under the bus, then he brings in political operative who is a ‘messaging expert’ to handle this 'effort', I think it suggests to say that they have a political problem and maybe they are not recognizing the long-run issue here. It is also questionable how much they think that what they are doing is enough. Most people in the medical community don't think the U.S. response was even nearly adequate to address the challenge we face in West Africa. It might be the case that they think they've done their share and now their job is to get other nations to step up. I don't know. Certainly the actions that you see immediately around the President would not suggest that they see it as a major public health threat or major security threat, they see it as a major political threat. Maybe that's just because they are right before the election, maybe their attitude will change after the election.
Dawn Bennett: If the President named you Ebola czar, what's the first thing you would do?
Dr. Scott Gottlieb: I think the first thing I would do is to try to get more resources into West Africa, but assuming there's politics around there that I'm not fully aware of, I would try to create a network of hospitals here in the U.S that have been identified as capable of taking care of these patients. I think we need to get that network in place right away. CDC is working with these four hospitals with the bio- containment units. You don't need a bio- containment unit necessarily. I think we need to expand that network. We really have to have one referral centre in every metropolitan area where we know that there's special equipment, special personnel who are trained and drilled to handle an Ebola case. The other thing I would focus on is therapeutic. If the virus continues to spread as currently it is in West Africa, and if it does continue to drift, the only thing that's going to change the game is going to be a vaccine or therapeutic. Africa needs the vaccine, the United States needs a drug and therapeutics.
Dawn Bennett: What about the FDA? What role does it play in slowing up this process of mass production, producing of an Ebola antidote or some type of vaccine, or is it helping it?
Dr. Scott Gottlieb: We haven't seen a lot of leadership from the FDA. So if you look at these briefings on Capitol Hill of people who testified -- the head of the CDC is there, the head of NHI there, and FDA sends a very junior person who reports probably 6-7 levels below the Commissioner. It raises the question whether or not the leadership's really focused on this and how much of this is something that they're actively working on. That's concerning. The other thing is the statements of the FDA so far -- and I worked there, so I want to be careful what I say because they are my former colleagues -- but that statements of the agency so far seem to indicate that they're applying their traditional approach to drug development to the development of a therapeutic. There is a lot of reasons why I think we should dramatically change the paradigm, and make a product and make it available to West Africans, who in most cases are going to die if they don’t get it. We should allow the antivirals that look like they could work in this diseases, which are actually old drugs that are well understood. So we understand their safety profile very well, we just don't know how well that works with Ebola.
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Dawn Bennett is CEO and Founder of Bennett Group Financial Services. She hosts a national radio program called Financial Myth Busting http://www.financialmythbusting.com.
She discusses educational topics and events in the financial news, along with her thoughts on the economy, financial markets, investments, and more with her live guests, who have included Rock Legend Ted Nugent, as well as Steve Forbes and Grover Norquist. The show is a great complement to Dawn’s monthly investing seminars that take place at Tysons Corner in McLean, VA, where she discusses investing.
She can be reached on Twitter @DawnBennettFMB or on Facebook Financial Myth Busting with Dawn Bennett or firstname.lastname@example.org