If states that are experiencing flare-ups in coronavirus infections fail to take the necessary steps to address the spread, local outbreaks could "quickly get out of control," former Food and Drug Administration Commissioner Dr. Scott Gottlieb told CNBC on Monday.
States like Arizona, Texas and Florida that are seeing surges in confirmed cases, as well as spikes in hospitalizations, should in some cases be conducting aggressive contact tracing, Gottlieb said. Contact tracing occurs when trained personnel interview infected individuals to pinpoint where they were infected and to track down others who might have been exposed.
"We're not going to be able to shut down the country again this summer. We're probably not going to be able to shut down the country again this fall," Gottlieb said on CNBC's "Squawk Box." "And so we're going to need to try to isolate the sources of these outbreaks and take targeted steps. If we can't do that, these will get out of control."
Nationally, the virus continues to infect about 20,000 people each day, Gottlieb said, adding that it's a higher rate of infection than in many other countries that also grappled with large outbreaks. He noted that come autumn, other countries might place travel restrictions on Americans because of the high level of persistent spread.
"We seem to be complacent, to some degree, with 20,000 cases a day. That's an awful lot of infection," he said. "That's why we're seeing these flare-ups and these outbreaks. This is going to become the new norm — these kinds of sprawling outbreaks — if we continue to have this level of infection around the country."
In lieu of shutting down much of the economy and restricting movement again, Gottlieb said contact tracing and targeted responses will be key to the U.S. response.
Different states have made various commitments to contact tracing efforts, and the federal government has yet to outline specific criteria that states should strive to meet, such as the number of tracers per 100,000 residents. Oregon is one of the few states that publishes the results of its contact tracing efforts by indicating the percent of total infections that have been traced to an identified origin or cluster.
New York state has partnered with former New York City mayor and billionaire Michael Bloomberg and nonprofit Vital Strategies to build an "army of contact tracers." The state required that it have at least 30 contact tracers per 100,000 residents before any region could ease restrictions.
When reached for comment on Friday, Arizona's Maricopa County Public Health spokeswoman Sonia Singh told CNBC that it adjusts staff for "contact tracing up or down as needed in response to case count trends." She added that 90 additional staff are on the way, half of whom have already started.
Gottlieb said Arizona could take responsibility for contact tracing efforts away from the counties and centralize the effort under state leadership.
He added that the situation in Phoenix, Houston and other hot spots around the country is unlikely to become as bad as the outbreak in New York, "but it has the potential to." The current hot spots have an advantage that New York didn't, which is more widespread testing, Gottlieb said.
"This could quickly get out of control," he said. "What these states need to do, what these cities need to do is good contact tracing, not to find every individual who's infected, but to find the sources of infection, the activities that lead to the infection and take targeted mitigation steps."