Book Review: Scott Gottlieb’s “Uncontrolled Spread”: Debacle at the CDC, and Pandemics as a National Security Threat

By Lambert Strether of Corrente.

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I picked up a copy of former FDA Commissioner Scott Gottlieb’s Uncontrolled Spread the other day (Harper-Collins, $23.19, a New York Times bestseller). It’s “the first of the pandemic memoirs,” as Politico puts it in their interview with Gottlieb. (Here the transcript of another interview with Gottlieb in WaPo; he’s certainly articulate and well informed.) Eric Topol gives the Uncontrolled Spread his blessing:

Although Publishers Weekly introduces one of the few discordant notes:

Though he lucidly explains scientific and logistical matters, Gottlieb’s tendency to cite his own Wall Street Journal op-eds grates. This pandemic postmortem is more concerned with boosting the author’s reputation than breaking new ground.

A word about the author. Gottlieb is a member of the Republican aristocracy (as we might call them. His wife, Allyson Brooke Nemeroff, was the national advertising director for The New York Sun. Their wedding was at the Women’s National Republican Club in Manhattan). The National Journal has a detailed biography, from which we extract his work history

  • Resident Fellow, American Enterprise Institute, 2003-2017, 2019-Present
  • Partner, New Enterprise Associates (NEA), 2007-2017, 2019-Present
  • Commissioner, US Food and Drug Administration, 2017-2019
  • Managing Director, T.R. Winston & Company, 2013-2017
  • Policy Advisor, FDA, 2003-2007

And his business associations:

  • Serves on Pfizer’s Regulatory and Compliance and Science and Technology committees
  • Director at Illumina, a biotech company working on genetic variation and biological function analysis
  • Board member of Tempus, a technology company building a library of clinical and molecular data
  • Special Partner at venture capital company NEA, works on health care, devices, biopharma, and services teams; NEA investments include Crisper Therapeutics and Collective Health

Gottlieb is also said to own 1,000 units of Pfizer stock worth over $181,920 (as of May 27, 2021). Which isn’t all that much by elite standards, though not at all bad for such a young man (Gottlieb is an up-and-coming 49). He was also head of FDA for only two years, but seemingly left on good terms. His departure from FDA was amicable and he was praised by both parties. He also exhibits very good timing. (Napoleon, it is said, liked his generals to be lucky.) Gottlieb is plugged in enough to have the goods on many issues, and yet bears no responsibility for the policy outcomes.

In this brief review, I will present and comment upon extracts from the book. (I apologize for the images, which are readable but not pretty, but I don’t have a camera rig that flattens book pages and enables me to photograph them from a consistent height.) I will cover two topics: First, the debacle at the CDC, where Gottlieb reinforces all our priors, and then some; second, Gottlieb’s hair-brained and lunatic scheme to place our public health services, sclerotic though they may be, under the aegis of national security, and to involve clandestine operatives in epidemiology.

CDC Debacle

At NC we do have priors on the CDC (testing and PPE, data gathering, test kits, Walensky, aerosol transmission, VAERS, and the refusal to test for breakthrough cases, to list only some of the butchery). Gottlieb’s extensive and detailed bill of particulars provides a gripping narrative of institutional collapse. Here are a few of examples.

As readers know, CDC initially provided state and local labs with contaminated test kits. This certainly made it difficult for the State of New York, the initial epicenter of the epidemic, to protect the public health. Page 113:

The contaminated test kits were caused by a poorly designed manufacturing process, which CDC almost certainly knew and admitted contemporaneously. Page 121:

CDC maintained a parsimonious testing regime that deliberately ignored asymptomatic spread. Page 131:

The CDC’s original commitment to the theory of fomite transmission meant that it couldn’t shift paradigms to aerosol transmission. Page 212:

Nobody knows where the “six foot rule” comes from, including CDC. Page 213:

And nobody at CDC — not one single person — has ever been held accountable for any of this (none of which has anything to do with “political interference”). Trust the scientists my Sweet Aunt Fanny.

Pandemics and the National Security Community

Now we come to the lunatic part of the book, where Gottlieb proposes to place the public health mission of preventing pandemics under the aegis of the organs of state security. (This hair-raisingly cray cray part of the book, which is evidently the point of the exercise, goes more or less unmentioned in the press, from which I conclude that it’s conventional wisdom, and that I should go long stupid, here as in so many places.)

Gottlieb begins low-key, suggesting that we need to prescribe a “clearer role” for our “national security infrastructure.” Page 345:

But he soon escalates. Page 349:

“We’ll have to involve.” This is mere question begging. Surely the intelligence agencies are not the only state organs capable of prediction and analysis? (To be fair, I can understand why one might wish to fall back on one of the few institutions in our sclerotic state that actually does function, rather like calling in the Army to handle nursing home staffing or container jams.)

One obvious reason run screaming from the room if anybody proposes Gottlieb’s idea is this episode. From Scientific American, “How the CIA’s Fake Vaccination Campaign Endangers Us All“:

In its zeal to identify bin Laden or his family, the CIA used a sham hepatitis B vaccination project to collect DNA in the neighborhood where he was hiding. The effort apparently failed, but the violation of trust threatens to set back global public health efforts by decades.

It is hard enough to distribute, for example, polio vaccines to children in desperately poor, politically unstable regions that are rife with 10-year-old rumors that the medicine is a Western plot to sterilize girls—false assertions that have long since been repudiated by the Nigerian religious leaders who first promoted them. Now along come numerous credible reports of a vaccination campaign that is part of a CIA plot—one the U.S. has not denied.

The deadly consequences have already begun. Villagers along the Pakistan-Afghanistan border chased off legitimate vaccine workers, accusing them of being spies. Taliban commanders banned polio vaccinations in parts of Pakistan, specifically citing the bin Laden ruse as justification. Then, last December, nine vaccine workers were murdered in Pakistan, eventually prompting the United Nations to withdraw its vaccination teams. Two months later gunmen killed 10 polio workers in Nigeria—a sign that the violence against vaccinators may be spreading.

Such attacks could not come at a worse time. The global polio campaign has entered what should be its final stages. The number of cases has dropped from 350,000 in 1988 to 650 in 2011. The disease spreads naturally in only three countries—Afghanistan, Pakistan and Nigeria—down from more than 125 countries a quarter of a century ago. Disrupting or postponing vaccination efforts could fan a resurgence of polio around the world.

The distrust sowed by the sham campaign in Pakistan could conceivably postpone polio eradication for 20 years, leading to 100,000 more cases that might otherwise not have occurred, says Leslie F. Roberts of Columbia University’s Mailman School of Public Health. “Forevermore, people would say this disease, this crippled child is because the U.S. was so crazy to get Osama bin Laden,” he argues.

100,000 crippled children because CIA operatives hijacked a public health effort, good job. Gottlieb is, of course, aware of this episode. His idea is that if the public health people are “at the table” good things will happen. Perhaps the Norms Fairy will intervene, I don’t know. Page 370:

This is weak in the extreme; I have helpfully underlined the “could” and the “might.” Can Gottlieb really believe that public health officials have the clout to overrule the spooks? (Not to mention that the spooks probably have files on them.) Nevertheless, here is the picture he paints. Pages 371 and 372:

Dear Lord. Gottlieb wants to install CIA assets throughout China’s medical system (and it will have to be “throughout,” because we can’t predict where the next outbreak will occur). Putting aside the ethics, the obvious objection is that our assets will get whacked; China’s organs of counterintelligence have form. Further, such assets of ours as remain alive will be likely to have been “turned,” and will be feeding us bad data. Next, we knew of the Covid genome by January 3, 2020, because a heroic Chinese scientist, Zhang Yongzhen, uploaded it to an open source database. If Zhang had known he might have been shot as a spy, would he have been likely to do that? And of course, as soon as one of these networks is penetrated and broken up, which it will be, it will be farewell to international cooperation with the United States on anything on pandemic-related, not just with China but with the entire world. And rightly. The entire scheme is so crazed and sociopathic I can only conclude that the talented Mr. Gottlieb will be put in charge of it.[1]


In summary, Uncontrolled Spread gives a lot of insight into the United States’ institutional collapse in the face of the Covid pandemic. It’s quite disconcerting to find that the policy recommendations, the agenda, one might say, are utterly demented. But that’s life in these United States today!


[1] Unless it’s already happening and we don’t know about it, of course. If so, Gottlieb is just the man to sell it.

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About Lambert Strether

Readers, I have had a correspondent characterize my views as realistic cynical. Let me briefly explain them. I believe in universal programs that provide concrete material benefits, especially to the working class. Medicare for All is the prime example, but tuition-free college and a Post Office Bank also fall under this heading. So do a Jobs Guarantee and a Debt Jubilee. Clearly, neither liberal Democrats nor conservative Republicans can deliver on such programs, because the two are different flavors of neoliberalism (“Because markets”). I don’t much care about the “ism” that delivers the benefits, although whichever one does have to put common humanity first, as opposed to markets. Could be a second FDR saving capitalism, democratic socialism leashing and collaring it, or communism razing it. I don’t much care, as long as the benefits are delivered. To me, the key issue — and this is why Medicare for All is always first with me — is the tens of thousands of excess “deaths from despair,” as described by the Case-Deaton study, and other recent studies. That enormous body count makes Medicare for All, at the very least, a moral and strategic imperative. And that level of suffering and organic damage makes the concerns of identity politics — even the worthy fight to help the refugees Bush, Obama, and Clinton’s wars created — bright shiny objects by comparison. Hence my frustration with the news flow — currently in my view the swirling intersection of two, separate Shock Doctrine campaigns, one by the Administration, and the other by out-of-power liberals and their allies in the State and in the press — a news flow that constantly forces me to focus on matters that I regard as of secondary importance to the excess deaths. What kind of political economy is it that halts or even reverses the increases in life expectancy that civilized societies have achieved? I am also very hopeful that the continuing destruction of both party establishments will open the space for voices supporting programs similar to those I have listed; let’s call such voices “the left.” Volatility creates opportunity, especially if the Democrat establishment, which puts markets first and opposes all such programs, isn’t allowed to get back into the saddle. Eyes on the prize! I love the tactical level, and secretly love even the horse race, since I’ve been blogging about it daily for fourteen years, but everything I write has this perspective at the back of it.


  1. Jeremy Grimm

    We are supposed to trust to the goodwill and efficacy of our intelligence agencies in place of trusting the CDC, FDA, and our own common sense? For my two-cents — former FDA Commissioner Scott Gottlieb can take his book and go retire … somewhere very far far away. I do not trust the CDC or the FDA but the u.s. intelligence agencies!!!????? Really? Really, really!!!!!????? I have no wish to jump from the frying pan into the fire! I trust the u.s. intelligence agencies as far as I could throw the rock of Gibraltar.

    1. flora

      Excellent comment. Thank you. As for the value of Scott Gottlieb’s a revolving door careerist (imo), and entirely Pharma interested (imo) opinions, and not at all an impartial opinions? / oy. “What’s good for href=””>Scott Gottlieb’s re-volving door, Pfizer board member, and entirely Pharma interested (imo) opinions, and not at all impartial opinions? / oy. “What’s good for General Bull Moose Big Pharma is good for the USA.”

          1. skippy

            Reminds me of a conversation long ago on NC where some orthodox sort replied that ***we*** just need to better harness the creative powers of sociopaths, in the market place, because creative destruction, out with the old in with the new, EMH, and meritocracy of wealth is a divine choice[tm].

    2. Lambert Strether Post author

      > I trust the u.s. intelligence agencies as far as I could throw the rock of Gibraltar.

      Maybe we could set up an advisory committee for the CDC. Brennan, Clapper, and Comey could be on it. All the experts!

  2. skippy

    Resident Fellow, American Enterprise Institute, 2003-2017, 2019-Present : AEI advocates in favor of private enterprise, limited government, and democratic capitalism.

    Same mills pumping out the same corporatist product for decades and then some are confused as why all these “Public” institutions perform so badly …

  3. David in Santa Cruz

    The sooner that the U.S. government stops throwing-away trillions on the Military-Industrial Complex and its ludicrously incompetent “intelligence community” and joins the civilized nations of the world in making public health a priority, the better. That the U.S. news media persist in the demonization of “the Chinese virus” when it was the American push to destroy domestic wage work that made all-pervasive trade with China economically indispensable to our material life in the space of 25 years.

    Gottlieb comes from the same political clique who wanted to “shrink government so small that we can drown it in the bathtub,” and now perpetuates the negation of the necessity of democratic government, exhorting us to hand-off government’s essential public health functions to its least democratic branch, the Military-Industrial Complex — in order to protect the purity of the nation from “foreign” epidemics. This is the essence of fascism.

    We are led by dunces. Gottlieb is clearly one.

  4. albrt

    I know a PhD level scientist within the CDC. He was deployed on an emergency basis to nursing homes in March 2020 to try to figure out how spread could be controlled. He soon figured out that it couldn’t be controlled, not using any of the hand-hygiene and similar measures they were prepared to use. The only thing they could really do was close off separable units as soon as a case was detected, to try to keep the virus out of the other units.

    By March 2020 the CDC had unequivocal, ground level knowledge that the virus was in fact being spread through the air. The CDC leadership persistently and knowingly lied about it by insisting on a definition of “aerosol” based on particle-size, while refusing to acknowledge the actual and obvious behavior of the particles.

    1. Lambert Strether Post author

      > I know a PhD level scientist within the CDC. He was deployed on an emergency basis to nursing homes in March 2020 to try to figure out how spread could be controlled. He soon figured out that it couldn’t be controlled, not using any of the hand-hygiene and similar measures they were prepared to use. The only thing they could really do was close off separable units as soon as a case was detected, to try to keep the virus out of the other units.

      Thanks, albrt. Good information. I wonder if your PhD wants to blow the whistle….

  5. Gc54

    The problem is that it won’t be too many years before a “bad actor” well below state level will be able to release a customized pandemic agent to level the field in upcoming resource wars. If we have the CDC or “intelligence” agencies as the basis of response, we energy pigs can kill our @$$3$ goodbye.

  6. Elizabeth

    Actually, Gottleib’s cray cray idea might really appeal to the democrat party, since it is enthralled with the intelligence agencies. Think of all the possibilities the MIC could have – a super virus has been detected coming from Russia so the US must prepare for the new pandemic. Curfews, education centers (so people can fully understand the virus), and maybe even get those killer robot dogs to help the citizenry. The possibilities are endless. Maybe Hellary could even make public service announcements!

    What world do people like Gottleib live in? Dog help us all.

    1. Lambert Strether Post author

      > Actually, Gottleib’s cray cray idea might really appeal to the democrat party, since it is enthralled with the intelligence agencies.

      No question. And Gottleib, since he’s liked by both parties, is just the man for the job.

    2. T_Reg

      I think you can safely discard the word “might”. Authoritarian pandemic policy is very much in vogue in the Democratic Party, and they’re just as gung-ho on the military as the Republican Party. They have the additional advantage of coordinating with the owners of the mechanisms of propaganda, and have succeeded in converting erstwhile democratically-minded people to embrace the intelligence apparatus and support harsh pandemic measures like lockdowns and vaccine mandates.

  7. David

    It’s interesting that the idea that epidemics should be seen as a security threat has been a commonplace in left-wing and right-thinking circles such as development agencies for a generation now. It’s usually considered as part of “human security”, together with food, the climate, health in general, clean water and lots of other things: some would even include education and childcare. The idea was to replace the “hard” security concepts of the Cold War with something warm and cuddly. My impression, having followed the debate for some time, is that the idea has lost a lot of its momentum: critics have pointed out, quite reasonably, that the result is a concept of security that is so broad as to be useless. So it’s interesting to see the Right apparently coming around to the same idea. (It’s technically called “securitisation” of issues.)

    The problem here is ex post facto reasoning. It’s perfectly true that if by some chance you had recruited agents in the Chinese health system and they were in the right place and they had access to the right information and they passed it on, and it was correctly interpreted, you’d still be faced with the problem of how to react, and whether you believed what you were told. And of course you can hardly close down a country on the basis of a single intelligence report whose sources, you can’t, by definition, divulge. And supposing the epidemic had started in North Korea? Or Sudan? or Eritrea? Are you really going to recruit hundreds of agents all over the world on the off-chance that an epidemic may break out and the government will try to cover it up? This is magical thinking based on ignorance.

    It’s true that professional intelligence analysis is a skill that can be learned: there are books about it and university courses on it. Professional experienced analysts are probably your best bet for sifting complicated, technical and unreliable information. But like any other kind of analysis it’s dependent on the quality of the information, or even whether there is any information in the first place. And even if the analysis is right, there’s no guarantee that the political leadership will take the right decisions – as they clearly didn’t here.

    1. Lambert Strether Post author

      > It’s true that professional intelligence analysis is a skill that can be learned: there are books about it and university courses on it. Professional experienced analysts are probably your best bet for sifting complicated, technical and unreliable information.

      Why the analysts must be from the intelligence community, let alone be clandestine operatives, is beyond me. Is the country incapable of training people to sift “complicated, technical and unreliable information” unless they’re spooks? If so, we’re in even worse trouble than I thought.

      1. David

        Analysts are not involved in “clandestine operations” for the most part, although the public, ably assisted by the media, often assumes they are. They are basically people who sit in offices and sift information to produce conclusions. The only “clandestine” element of their job is that some part (usually not very large) of the information they are working with, has been clandestinely obtained. The more you get down in the weeds (say the communications protocols of Chinese nuclear submarines) the more the information is likely to be highly classified, but the actual intellectual disciplines have nothing covert about them at all. (Indeed, I’ve seen courses run by retired intelligence officers in which students use entirely media sources, evaluating them for reliability, false collateral implicit or overt bias etc. and attempt to produce a sensible conclusion: it’s the methodology that counts.)

        In principle, these disciplines can exist anywhere. There are plenty of people out there who call themselves “analysts”, often with “financial” or “technology” attached, but in nearly all cases they are just people who pontificate on the basis of varying levels of expertise. There are some well-funded organisations outside government (International Crisis Group is one) that produce serious analytical pieces, but their coverage is still relatively small. Most analysts work in government (not exclusively in the intelligence sector) because only government is willing to train people and give them experience for years before they become productive, and then employ them for many years afterwards. It’s hard to imagine a bank, for example, investing years in training an analyst, only to have them leave for a better job later. That’s why banks and similar institutions often recruit former government analysts who have the training.

        But in any case, as I said, the author has completely misunderstood the issue.

  8. MonkeyBusiness

    Scott Gottliebs is a double agent!!! The Chinese are paying him to plant this idea in the minds of American leaders. That way they get to feed our glorious leaders whatever s*** they like and see both Dems and Reps go bats*** crazy. Inception at its finest.

    Honestly if I am the Chinese, this is just another counterintelligence opportunity.

    CDC = Central Deterrence Committee. Brought to you by your best friends over at the CIA.

  9. VietnamVet

    If the nation doesn’t go on war footing, instead it delegates all public health authority to 50 states, doesn’t close all international air flights, is confused and ineffective; you’ll kill 750,000 Americans. Even more next time. More have died from coronavirus than died in combat in all of the U.S. wars. The cause is a dysfunctional government. The Profiteers are profiting, citizens are dying, and not one CEO has been jailed for their crimes. No one has even been fired for allowing two companies to corner the market in rapid coronavirus at home tests. Profit over lives! It is intentional manslaughter.

    1. T_Reg

      This can’t be emphasized strongly enough or often enough. The Prime Directive is that money is more important than life.

  10. LY

    Framing pandemics as national security against biological warfare is one way to make some people see it as a government issue. Right-wing ideologies – “there is no society” – such as neo-liberalism, libertarianism, etc. which AEI advocates, do not grok the idea of public health.

    Then again, framing PPE as a national security issue didn’t cause anything to fundamentally change.

  11. The Rev Kev

    Spooks are all about keeping secrets which is kinda their bread and butter. Public health, on the other hand, is or should be all about public trust and once that is broken you have, well, what we have right now. That Pakistani operation is just an example of what would happen if you mixed the two together. Can you imagine what would happen in America if it was up to the police to give out vaccinations? No, I wouldn’t want to go there too so having spooks involved is no good either. How could you trust the information that came out of them for thing like case number, death rates, etc.? You couldn’t. It is bad enough now.

    1. Lambert Strether Post author

      > How could you trust the information that came out of them for thing like case number, death rates, etc.? You couldn’t. It is bad enough now.

      Worse, anybody who disputed the data would be classified as a national security threat. That, too, is bad enough now.

      1. Mikel

        “…anybody who disputed the data would be classified as a national security threat.”

        And there you have the real reason for bringing up the “idea.”

    2. drsteve0

      I vaguely recall another Dr. Gottlieb that was a favored actor / golden boy in spook world. How’d that work out? Don’t think the two are related, hope not. Mixing medicine and spooks has predictably nightmarish outcomes.

  12. Freethinker

    If a pandemic should be classified as a national security threat, imagine the ensuing, intrusive public health mandates and tracking as well as top-secret classification status for related public health research and interventions. Also, one might imagine the criminalization, not just demonization and suppression, of alternative treatment users, purveyors, and researchers.

    From Gottlieb citation above, “The COVID pandemic…revealed gaps in the application of our own intelligence capabilities.” No. Many responses to the COVID pandemic revealed gaps in the wisdom and ethical capabilities of leaders in public entities. Intelligence without wisdom propagates bright, shiny, destructive actions.

  13. Anonymous

    It is already happening. Check out the newest Center at the Centers for Disease Control and Prevention:

    Check out who its day-to-day Operational head will be:

    And just who is Dylan George?

    Well, for one, a Vice President, Technical Staff in BNext at In-Q-Tel (IQT). And check out In-Q-Tel:

    According to George “Slam Dunk” Tenet…

    “We [the CIA] decided to use our limited dollars to leverage technology developed elsewhere. In 1999 we chartered … In-Q-Tel. … While we pay the bills, In-Q-Tel is independent of CIA.”

    1. Mantid

      Very good links and quite “telling”.
      First, consider that CDC’s funding is primarily from big pharma.
      Second, remember that funding for these vaccines (and perhaps the virus’ creation itself) have been supported and paid for via DARPA (military intelligence).
      In the CDC’s new and improved “disease forecasting center” promo article (linked above) comes these direct quotes:
      …… Connect: Expand broad capability for data sharing and integration; maximize interoperability with data standards and utilize open-source software and application programming interface capabilities, with existing and new data streams from the public health ecosystem and beyond.
      …….Inform: Translate and communicate forecasts; connect with key decision-makers across sectors including government, businesses, and non-profits, along with individuals with strong intergovernmental affairs and communication capacity for action.
      Therefore, one thing they are broadcasting is that they will collect medical and other data on you and share it with businesses, government, various individuals ….
      And you thought the vaccine passports were intrusive.
      They (large corporations, mil. intelligence, big pharma, the legal system ……..) will control where you can go, control your money/income, ability to travel (across town or across borders), who you can associate with, what dietary choices you make….
      Sounds far fetched, but if they can put you on the back burner for a knee operation because you haven’t been vaccinated, why couldn’t they not allow you into a library, a movie theater, a concert hall, a university or grade school …… Oh wait, they have those restrictions now. Tell your friends to read NC (and donate :-) and resist these incredible intrusions into your life. Tossing your smart phone and its insidious data collection systems would be a start.

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