Dr. Scott Gottlieb told CNBC on Friday he believes there continues to be a significant number of unreported coronavirus cases in the U.S., suggesting as many as 1 in 150 people in the country could be infected.
"We must have well over 700,000 infections a day, even though we're only diagnosing about 60,000," Gottlieb said on "Squawk Box." "Before, when we had come down, and we were sort of burning around 20,000 diagnosed infections a day, the conventional wisdom was the prevalence was 1 in 200 people. Now, it must be higher than that."
Gottlieb's comments come as the U.S. continues to report record, or near record, levels of daily new infections. While the increase can be partly attributed to added testing capacity, the overall rate of positive tests in the country also is increasing. That is an indication of growing community spread.
"It's going to be hard to get to a point where you could — you're not going to eliminate the infection — but get it down to levels that are much, much lower," said the former commissioner of the Food and Drug Administration. "The prevalence of actual infection in the country right now must be pretty high."
Gottlieb lamented the lack of coordination across states in responding to this surge in new infections. States experiencing worsening outbreaks in the South are not operating in the same manner as states that were hit hard earlier in the nation's epidemic, such as ones in the Northeast and Michigan, he said.
The latter states "sought to crush the virus like the Asian nations, like Western Europe," he said. "I don't think that Florida or Texas or Arizona, for that matter, are seeking to crush the virus at this point. I think they're just trying to keep the numbers down so their health-care systems don't become overwhelmed."
Gottlieb said he does not think the U.S. will, at this point, adopt a unified strategy to again reduce the rates of infection. But this presents a challenge for Northeastern states and others places where community infection levels did come down dramatically.
"Our borders are fairly porous," he said. "This is going to be a difficult task for the states that want to try to persevere the gains they made, paying a pretty big sacrifice to crush the virus, to have it not be reimported back into those states in meaningful numbers and see epidemics heading into the fall."
New York, New Jersey and Connecticut have implemented 14-day quarantine orders for travelers who arrived from states that exceed certain infection metrics. Enforcing such orders is difficult, but Gottlieb said states may try to intensify their effort to make sure travelers are complying. That could mean monitoring people when they arrive by plane, he said.
"I wouldn't be surprised to see that start to happen as these states in the Northeast continue to have relatively quiescent periods right now, and you watch things get worse in the South," he said.
Disclosure: Scott Gottlieb is a CNBC contributor and is a member of the boards of Pfizer, genetic-testing start-up Tempus and biotech company Illumina.