Former FDA Commissioner Scott Gottlieb on the Covid Pill, Vaccines

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The Covid-19 pandemic propelled Scott Gottlieb from the relative obscurity of life as a former government official to a household name. In a new book, Uncontrolled Spread: Why Covid-19 Crushed Us and How We Can Defeat the Next Pandemic, the

Pfizer

(ticker: PFE) board member and former Food and Drug Administration commissioner paints a grim picture of the federal government’s response. But he sees reason for optimism, too. Vaccinations plus the latest surge may leave Americans with a  “wall of immunity,” he said in an interview.  

In a phone call last week, Gottlieb walked Barron’s through his expectations for children’s vaccines (coming for many within weeks), variants (we’ll need updated vaccines eventually), and other key milestones in the pandemic. This  transcript has been edited for clarity. 

Barron’s: Merck recently announced data related to a pill that it says could significantly reduce risk related to hospitalization and death. With that, what other advances can we expect?

Scott Gottlieb: The data from Merck looks quite strong. This is probably the most profound result I’ve seen in an oral antiviral for a respiratory disease in modern times. Plus, behind this drug are a number of others including one from Pfizer that’s in advanced development. There’s a drug from Roche that’s a little further behind that also looks very promising. Then, behind those three drugs is a host of other therapeutics in earlier stages of development. I think we’ll soon have one or more orally available antiviral drugs alongside effective vaccinations combined with therapeutic antibodies. 

Overall, this is going to become a manageable threat as a result of our technology. 

What will the Covid preventative regiment ultimately entail? 

It’s going to look a lot like how we approach the flu. I think, for the foreseeable future, there is likely to be an annualized Covid vaccination. 

However, for those who develop infections despite vaccination, for those who experience declining efficacy from the vaccine, and for those who don’t get vaccinated, there’s going to be an armamentarium of therapeutics available that will not only treat people who become symptomatic but will also potentially prevent the infection in people who are exposed. 

In time, antibody drugs will be available in a doctor’s office with a single injection as opposed to…