A former Trump health official says life won't return to normal by the summer, warning camps and concerts will be cancelled even as coronavirus slows

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FDA Commissioner-designate Scott Gottlieb testifies during a Senate Health, Education, Labor and Pensions Committee hearing on April 5, 2017 at on Capitol Hill in Washington, D.C.

• After weeks of lockdowns, travel bans, and stay-at-home orders due to the novel coronavirus, Scott Gottlieb, former commissioner of the US Food and Drug Administration, says "normalcy" is still a long ways off.
• Gottlieb spoke with analysts at the investment bank Cowen, who published his views in a note to clients.
• Gatherings with lots of people, such as concerts, camps, and even college classrooms could prove too risky, even over the summer.
• Colder temperatures starting in September could help facilitate a "second wave" of coronavirus transmissions, even after a possible reprieve in July and August.
• Before social distancing measures are eliminated completely, the US needs widespread testing, regional responses to outbreaks, and a healthcare system with some empty beds.
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A former commissioner of the US Food and Drug Administration says "normalcy" is still a long ways off, as the coronavirus epidemic brings the US economy to a halt.

Analysts at the investment bank Cowen's Washington Research Group spoke with former FDA Commissioner Scott Gottlieb, and published a summary of the conversation in a note to clients.

"With the available data so far, Dr. Gottlieb believes April could be when COVID-19 cases would peak, June could be when regulations will start to loosen up albeit with reasonable protective measures like wearing masks, etc. and is hopeful that by July-August normalcy could return with certain limitations," the Cowen report said.

Those limitations would mean a summer that feels far from normal for many Americans, according to Gottlieb. There will likely continue to be limits on big gatherings of people, meaning concerts and summer camps might be canceled to avoid further outbreaks of the coronavirus, at least in parts of the country, according to Gottlieb.

Summer camp, schools, and colleges are in focus

"He expects persistent limitations on the size of public gatherings, at least in parts of the country, as we head into July and August, and many summer camps for kids will likely be canceled," the Cowen note says.

In the fall, focus will turn to schools and college campuses, the report says. Life won't get back to normal until we develop good treatments for the coronavirus, according to Gottlieb.

"Risk-limiting decisions combined with therapeutic development will be the ultimate arbiters of the country's transition back to a pre-outbreak lifestyle, as a vaccine is unlikely to be ready in the near future," the Cowen authors wrote.

Gottlieb, a physician by training, left his post at FDA about a year ago. He's now a resident fellow at the American Enterprise Institute and a special partner at the investment firm NEA. He also sits on the boards of several healthcare firms.

According to research published by AEI that Gottlieb helped author, the US is in "phase one" of four when it comes to slowing the spread of the outbreak, lifting restrictions, and better equipping itself for the next pandemic.

Crucial to phase one, among other goals not yet reached in the US, is increasing testing capacity many times over. Gottlieb believes at least 5 percent of the US population, or roughly 20 million people, should be tested. So far, only 0.3 percent of the country has been tested, and only 1 million tests will be available by the end of next week, according to Cowen.

There's a need for more widespread testing

More tests should happen "at the point of care," like for the flu, as well as population-level screening that allows authorities to handle outbreaks on a regional basis, according to Cowen.

And the widespread use of serologic tests, which measure immunity to viruses, could identify groups with "herd immunity" that may not need to stay home as much.

Also needed before normalcy is possible: contact tracing, special care for vulnerable populations, therapeutics, mass vaccination, and making sure the healthcare system is no longer overwhelmed, according to AEI and Gottlieb.

In Wuhan, hospital admissions grew until four weeks after the peak in infections, so a plateauing of hospital admissions wasn't seen until about 10 weeks after the crisis started, according to Cowen.

That could translate to some hospital beds freeing up in June, but hospitals can't return to business-as-usual practices overnight, Gottlieb told Cowen. The pandemic will pose costs on the back-end just as it did on the front-end, like cancellations to elective procedures.

A lot of respiratory viruses have a seasonality, because lower temperatures and humidity help facilitate transmission, according to Johns Hopkins. While that could mean reduced transmission in the summer, it also brings the risk of another wave of infection by September as lower temperatures return, according to Gottlieb.

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