Uncontrolled Spread review: Trump’s first FDA chief on the Covid

Joe Biden’s declaration that “America is coming back together” looks like a “mission accomplished” moment. Zigzagging on booster shots has left the public scratching its head and Biden’s poll numbers sagging. With a third Covid winter looming, the president’s competence is very much an issue.

Enter Scott Gottlieb, Donald Trump’s first commissioner at the Food and Drug Administration. Gottlieb left after less than two years with his reputation intact and even managed to pick a fight with the e-cigarette industry, to the delight of suburban moms and dads. By summer 2019, Pfizer’s shareholders had elected Gottlieb to its board – months before Covid placed the world in its grip.

In his narrative of the most severe pandemic in a century, Gottlieb lets us know what he has seen, what may well come next and what we can do before the next pandemic arrives. The book is informative and well paced. At times it gets into the weeds – but it doesn’t stay snagged.

According to Gottlieb, the Trump administration was poorly prepared, reacted badly and at times moved erratically and grudgingly.

Gottlieb does not believe the pandemic was preventable. Rather, with better leadership and alignment, he contends, we could have “delayed its onset and reduced its scope and severity”. Structural deficiencies made the task tougher but so did a “sizeable enterprise devoted to manufacturing skepticism” about measures like masks and vaccines. Gottlieb confirms that hydroxychloroquine is no cure.

Obviously, the search for a vaccine, Operation Warp Speed, was the notable exception to a series of missteps, “one of the greatest public health achievements in modern times”, according to Gottlieb. It “proved what government could accomplish when it functions well”.

But he takes China to task for stonewalling, criticizes the World Health Organization for its failure to press Beijing, and argues that pandemic prevention is an essential component of national security.

As for the virus’ origins, Gottlieb stresses that we may never know. He also makes clear that the Obama administration was not betting on a coronavirus walloping the US anytime soon – its public health measures were aimed elsewhere. Ron Klain, Biden’s chief of staff and Obama’s Ebola adviser, does not receive mention.

Uncontrolled Spread acknowledges that during medical crises, both parochial national interests and international cooperation emerge. This time, many were surprised by the interest that prevailed.

Transnational cooperation and domestic solidarity suffered under Covid.

“Covid normalized the breakdowns in a global order that it was presumed,…