Florida and Texas are “wild card” states that could leave the United States with more deaths from the coronavirus if they don’t take tougher actions, former Food and Drug Administration (FDA) Commissioner Scott Gottlieb said in a Wednesday interview with CNBC.

Gottlieb said he was optimistic the U.S. could still flatten the curve and perhaps avoid the 100,00 to 240,000 coronavirus deaths that White House officials warned could result from the virus even if strict measures were taken across the country.

But he said he was worried about “populist” states such as Texas and Florida that he said had not taken stringent measures.

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“I think the real wild card here, and the decision point on whether or not we’re going to have the bad outcome that Drs. Fauci and Birx talk about, is what populist states like Texas and Florida do,” Gottlieb said, referring to Anthony Fauci Anthony FauciTrump disputes CDC director on vaccine timing, says 'he made a mistake' Trump health officials grilled over reports of politics in COVID-19 response Biden says to trust scientists on COVID-19 vaccine, not Trump MORE, the director of the National Institute of Allergy and Infectious Diseases, and Deborah Birx, the coordinator for the White House coronavirus task force.

Gottlieb, the FDA commissioner under President Trump Donald John TrumpBarr criticizes DOJ in speech declaring all agency power 'is invested in the attorney general' Military leaders asked about using heat ray on protesters outside White House: report Powell warns failure to reach COVID-19 deal could 'scar and damage' economy MORE from 2017 to 2019, said the two states hadn’t really taken aggressive steps even now and that “if they don’t get more aggressive we could be on the cusp of some bad outcomes.”

Both states, he said, have large urban areas with dense populations. And he said Florida is particularly in danger of a large epidemic.

“I don’t understand why those governors have not acted more forcefully right now,” said Gottlieb. “Especially when you look at a state like Florida.

“Florida has a very large epidemic underway. There’s multiple hot spots, they were probably seeded in early February. Now they have large clusters.”

He said the state was looking like New York, which has the most coronavirus cases in the nation, “only two weeks behind.”

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Florida also has an older population and many nursing homes that could be vulnerable to the coronavirus outbreak.

One thing the state has going for it, he said, is warming weather.

“Now they have a break as well. They have a warmer climate and humidity. That’s going to help them,” Gottlieb said.

Both states can avoid a worse crisis by taking aggressive actions now, he stressed. Gottlieb repeatedly pressed the states to do so, saying he did not understand why they had not acted more forcefully.

About four hours after this story was published, Florida Gov. Ron DeSantis Ron DeSantisFirst death reported from Hurricane Sally in Alabama Trump tells Gulf Coast residents to prepare for 'extremely dangerous' Hurricane Sally Polls show trust in scientific, political institutions eroding MORE (R) issued a new statewide order for people to stay at home.

DeSantis previously had ordered people in parts of southeast Florida to stay home, but had not issued an order for the entire state.

Texas Gov. Greg Abbot (R) on Tuesday issued an executive order implementing "essential services and activities protocols" for the entire state.

The protocols direct all people in Texas to "minimize non-essential gatherings and in-person contact with people who are not in the same household." The order also instructed people in Texas to "avoid eating or drinking in bars or restaurants" or visiting gyms and massage establishments. Tuesday's order was expanded to also urge people to avoid tattoo and piercing studios and cosmetology salons.

Residents of some cities in Texas, including Houston, Dallas and San Antonio, have all been told to stay home under the orders of more local officials.

Gottlieb said on Wednesday that there were some positive signs that social distancing measures keeping people in their homes were having the desired effect.

He said it looked like cases were falling in San Francisco and that those in Seattle haven't increased, despite a large cluster of cases and early efforts going poorly.

He also said the crisis in New York could peak next week as a result of social distancing measures.

Gottlieb also said cities like Chicago, Boston, Philadelphia and Detroit, which he said would have large outbreaks, did take steps to social distance earlier than other cities, which hopefully will have an impact.

This story was updated at 2:20 p.m.