In Uncontrolled Spread, a New York Times Best Seller, Dr. Scott Gottlieb identifies the reasons why the US was caught unprepared for the pandemic and how the country can improve its strategic planning to prepare for future viral threats.

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Has America’s COVID-19 catastrophe taught us anything?

In Uncontrolled Spread, physician and former FDA commissioner Scott Gottlieb shows how the coronavirus and its variants were able to trounce America’s pandemic preparations, and he outlines the steps that must be taken to protect against the next outbreak. As the pandemic unfolded, Gottlieb was in regular contact with all the key players in Congress, the Trump administration, and the drug and diagnostic industries. He provides an inside account of how level after level of American government crumbled as the COVID-19 crisis advanced.

A system-wide failure across government institutions left the nation blind to the threat, and unable to mount an effective response.

We’d prepared for the wrong virus. We failed to identify the contagion early enough and became overly reliant on costly and sometimes divisive tactics that couldn’t fully slow the spread. We never considered asymptomatic transmission and we assumed people would follow public health guidance. Key bureaucracies like the CDC were hidebound and outmatched. Weak political leadership aggravated these woes. We didn’t view a public health disaster as a threat to our national security.

The woes of the CDC

Many of the woes sprung from the CDC, which has very little real-time reporting capability to inform us of Covid’s twists and turns or assess our defenses. The agency lacked an operational capacity and mindset to mobilize the kind of national response that was needed. To guard against future pandemic risks, we must remake the CDC and properly equip it to better confront crises. We must also get our intelligence services more engaged in the global public health mission, to gather information and uncover emerging risks before they hit our shores so we can head them off. For this role, our clandestine agencies have tools and capabilities that the CDC lacks.

Uncontrolled Spread argues we must fix our systems and prepare for a deadlier coronavirus variant, a flu pandemic, or whatever else nature — or those wishing us harm — may threaten us with. Gottlieb outlines policies and investments that are essential to prepare the United States and the world for future threats.


Dr. Gottlieb has a medical degree from Mount Sinai School of Medicine and did his residency in internal medicine at the Mount Sinai Medical Center. He holds a BA in economics from Wesleyan University.

About Scott Gottlieb

Scott Gottlieb, MD, is a resident fellow at the American Enterprise Institute. From 2017 to 2019 he served as the 23rd commissioner of the Food and Drug Administration. Dr. Gottlieb is also a special partner with the venture capital firm New Enterprise Associates and serves on the boards of Pfizer, Illumina, Aetion, and Tempus.

In addition to his frequent testimonies before Congress, Dr. Gottlieb is often published and interviewed by the media. He is a regular guest on Face The Nation and a contributor to CNBC, and his commentary and articles have appeared in Health Affairs, The Wall Street Journal, The Washington Post, and The New York Times, among other outlets.

What Others Are Saying

“[The author] urges that preparation for pandemics be considered a part of national security… These and other measures are urgently needed. If Covid-19 was the worst pandemic in recent history, ‘it won’t be the last.’ Of considerable interest to health policymakers and public-safety officials as well as students of epidemic disease.”

Kirkus Reviews,

Review for Uncontrolled Spread

“Well-informed…lucidly explains scientific and logistical matters.”

Publishers Weekly,

Review for Uncontrolled Spread

“From the first days of the pandemic, [Dr. Scott Gottlieb] offered a steady and authoritative voice of science and medicine to a worldwide audience of individuals and businesses grappling with the disease.”


The ICE House

“Everything he said or has written has been solid or excellent. Trying to think to find a comparable figure. Not sure if there’s another.”

Zeynep Tufekci,

The University of North Carolina

“Scott Gottlieb is like Jay Powell in being one of the few people whose expertise and competence are widely trusted on both sides of the aisle in DC.”

Josh Barro,

Business Insider

“Worth listening to Dr Gottlieb. Found him to be a honest broker and fair minded throughout an insane chapter.”

Josh Dawsey,

The Washington Post

“I really appreciate that Gottlieb tends to treat us like adults. He give people information with a fair amount of nuance. But he says what he really believes and doesn’t try to be overly prescriptive or play games with expectations or nudge people toward certain behaviors.”

Nate Silver,


“Dr. Gottlieb has been a strong, steady voice throughout the pandemic.”

Joe Scarborough,

Morning Joe

Dr. Gottlieb in the media

Dr. Gottlieb calls for “broader view” of coronavirus origins on Face the Nation

Dr. Gottlieb joined Squawk Box to discuss the spread of the delta variant.

Dr. Gottlieb joined Stephanie Ruhle for a wide-ranging interview on the state of the pandemic, Covid-19 shots for children, and possible vaccination mandates.

See a sneak peak

Years of inattention to these risks and underfunding of the key institutions, turf wars between federal agency heads, a lack of strong leadership that should have brought health agencies together in a coordinated way to solve problems, and bureaucratic hubris, all created a system failure. The pandemic was not inherently uncontrollable.

To help safeguard our public health, we need to identify those more fundamental weaknesses—the root causes of our vulnerability—to make sure this doesn’t happen again.

We must be better prepared when another dangerous pathogen inevitably emerges and threatens a global pandemic, but our purpose shouldn’t be simply to make sure we’re better equipped to respond, but to secure a greater assurance that a global contagion on the scale of COVID can never happen again. Reflecting on where our response fell short can provide a roadmap for how to be more effective when the next virus emerges. And there will almost certainly be a next one, maybe sooner than we care to believe.


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