Gottlieb Addresses Coronavirus at Miami Breast Cancer Conference

The novel coronavirus (COVID-19) spreading across the world represents a distinct challenge for all physicians, especially oncologists who commonly treat patients with compromised immune systems. The spread of the virus was discussed by Scott Gottlieb, MD, during the keynote address at the 37th Annual Miami Breast Cancer Conference®. 

At this point, the number of new confirmed cases of coronavirus infection seems to change every day, with more than 100,000 infections reported worldwide. When looking at epidemiology data, Gottlieb noted a distinct spike in reported respiratory illnesses across the United States. He partially credited this to additional hospital visits due to worry over the virus. However, given a lack of widespread testing, he added that it could be wider spread of the virus than estimated. 

"I think we're facing some difficult months ahead of this," said Gottlieb. "Seeing what's happening in some of the cities, there's some speculation on just how bad this disease is. I think most of the modeling we've seen coming out, looking at South Korea, Italy, and certain parts of China, suggests the mortality rate will be about 1%, which is significantly more than the seasonal flu which is about 0.1%." 

Gottlieb noted that each country seems to be handling the coronavirus outbreak differently. In China, he noted there has been some success in containing the virus, but at significant social and human cost. However, there seems to be very little effort on the part of Iran to slow the virus, allowing it to "burn through their population," he said. 

"We're going to have to figure out what our American approach is to this to and how we're going to take more aggressive mitigation steps. We're losing a pretty narrow window to step in," Gottlieb said. "We really haven't stepped in with the kind of mitigation step and social distancing in these hot spots that you'd want to see to break the chain of transmission. I think this week is going to be critical." 

Effective and widespread testing has represented another challenge facing the prevention of coronavirus spread. The initial step in the process of creation of a test by the CDC went as planned, he said, however, there was a delay in the shipment of reagents to public health labs. Additionally, there was a breakdown in communication between the CDC and other testing organizations, such as LabCorp and Quest Diagnostics. 

"In an ideal world we would be doing what the Netherlands is doing. They're testing their indeterminate cases of the flu, so if someone shows up with the flu, gets swabbed, and shows up negative for the flu but still has a significant respiratory disease they'll then get tested for the coronavirus," said Gottlieb. "We announced that we're going to start doing that in 5 cities, but that's a small number." 

Testing strategies continue to evolve and change, in response to the spread of the disease. Additionally, there is the potential opportunity for innovation, as several companies are now working to find treatments for the virus, including Gilead Sciences and Moderna.