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As Las Vegas casinos prepare to reopen, Dr. Scott Gottlieb says they're high risk for coronavirus spread

Casinos could be a particularly high-risk area for spread of the coronavirus, former Food and Drug Administration Commissioner Dr. Scott Gottlieb said Thursday, as Las Vegas casinos prepare to reopen next week. 

Nevada Gov. Steve Sisolak gave casinos the green light to reopen on June 4, and several, including Caesars Palace, Bellagio, MGM Grand and Wynn Resorts, have announced plans to resume operations then. 

"You look at Las Vegas reopening its casinos," Gottlieb said on CNBC's "Squawk Box." "Those are the kinds of settings where I think you have more risk, where you have a lot of people crowding together, coming and going in indoor settings for sustained periods of time."

Gottlieb was responding to a question about images of crowded, outdoor gatherings around the country from Memorial Day weekend. It's concerning if people "are becoming complacent" about social distancing guidelines, he said, but "the bigger risk" occurs inside businesses.

Some studies, including some research endorsed by the White House, show the virus does not live as long nor spread as easily outside and in the sun as it does inside, particularly in a poorly ventilated area.

In making the announcement on Tuesday to reopen more businesses, including casinos, Sisolak cited data that showed the outbreak is in decline across Nevada. He said the test-positivity rate has fallen to 6.5% and confirmed Covid-19 hospitalizations have been on a downward trend across the state for more than 35 days. The state of roughly 3 million residents has tested more than 128,000 people, according to data compiled by the Covid Tracking Project.

"We continue to see a consistent and sustainable downward trajectory of percentage of positive Covid-19 cases and a decrease in the trend of Covid-19 hospitalizations," Sisolak said Tuesday at a news briefing.

The Nevada Gaming Control Board has been collaborating with health officials, Sisolak said, to determine when it's safe to reopen and how to reopen. At the request of the governor, the state's gaming authorities published requirements for a "phased and incremental resumption of gaming operations."

The requirements say that casinos are responsible for checking the temperature of guests, making masks available, keeping capacity limited to 50%, enforcing social distancing and more. However, it's not clear how the requirements will be enforced by the gaming authorities. 

"As we plan for these openings, the health and safety of our guests and employees is at the forefront of all we do," MGM Resorts' acting CEO Bill Hornbuckle said Wednesday in a statement. "The team is ready and we can't wait." 

The reopening of casinos comes as state and local officials across the country try to thread the needle of protecting public health while restarting the economy. Casinos employ hundreds of thousands of people in Nevada and contribute billions to the local economy. The coronavirus pandemic has brought the industry to a standstill, prompting mass furloughs.

Las Vegas Mayor Carolyn Goodman made headlines about a month ago when she offered to reopen nonessential businesses such as casinos in the city, adding that Las Vegas was caught in "a unique economic crisis." She argued in an interview with CNN's Anderson Cooper that Las Vegas could serve as a "control group" to see what happens when businesses reopen.