The following is a transcript of an interview with Dr. Scott Gottlieb which aired on Sunday, April 10, 2022 on “Face the Nation.”
MARGARET BRENNAN: Welcome back to FACE THE NATION. We now turn to the COVID pandemic and the increase in cases in some parts of the country. Let’s go to Dr. Scott Gottlieb, former FDA commissioner and Pfizer board member. Good morning to you, Doctor. I mean the numbers, compared to where we were, obviously this is a dramatic improvement, but there are still 600 deaths a day. Here on the east coast we have had so many high profile infections. The Attorney General, the Speaker of the House, the Director of the CIA, the Secretary of Commerce. How do you characterize where we are now?
DR. SCOTT GOTTLIEB: Well, look, cases across the country are going down. We have about nine cases for every hundred thousand people a day. Therefore, the prevalence is low. There is no doubt that we are experiencing an outbreak here in the Northeast, also in the Mid-Atlantic, also in parts of Florida, which tends to follow the Northeast. It is largely driven by BA.2. And I think we’re dramatically underestimating the cases. We are probably only detecting one in seven or one in eight infections. So when we say that there are 30,000 infections a day, there are probably more than a quarter of a million infections a day. And right now they are concentrated in the northeast. And that’s because a lot of people are testing at home. They are not submitted for final PCR testing, so they are not counted. So when you look at the Northeast, for example, cases have increased 89% in the last 14 days in Washington, DC, 58% in New York City and 65% in New Jersey. So cases are rising in the northeast, the mid-Atlantic is rising. But the rest of the country now looks pretty good. And I think the network, the trajectory of the network is that we are likely to overcome this wave BA.2. It is likely to be regionalized. I don’t think it will become a nationalized epidemic of BA.2. And as we get deeper into the spring, we are likely to see these case counts decline, even here in the Northeast.
MARGARET BRENNAN: But from a practical perspective, when you say that we are dramatically underestimating COVID infections, the goal for the public is to look at the level of infection in your local community to make your own judgment. So if we can’t rely on the data locally, if the CDC is already saying, you know, things are fine, how can I accurately judge what’s really going on and when I have to put on my mask again? ?
DR. GOTTLIEB: Yes. Well, the CDC has shifted much of its measure to hospitalizations and away from looking at cases. And hospitalizations are low right now. There are 15,000 people hospitalized. This is the lowest point we have ever been in this pandemic. And I suspect that hospitalizations won’t increase much because a lot of the people who are getting infected with BA.2 right now are people who escaped the B.1 Omicron wave, and they largely escaped because they were. vaccinated. They were prudent. They took precautions, they tried. And so the simple fact is that many of the people who become infected right now are vigilantes. And they’re more likely to take decisive action once they diagnose an infection, get treatment, stuff like that. So I don’t think hospitalizations are going to increase much in terms of your local prevalence. It’s hard right now. I think you have to look at the state data and look at the weekly increases and just assume that we are only capturing a very small percentage of infections. Therefore, if you see cases increasing in your local community, this is a good indication that there is more infection than we are measuring.
MARGARET BRENNAN: So there are a lot of unmasked inland events that are still happening here in the Northeast Mid-Atlantic. Should the CDC change the definition of fully vaccinated to make sure it includes this booster dose? Does that make a difference?
GOTTLIEB: The booster dose clearly makes a difference, not only to reduce the risk of becoming infected and spreading the infection, but even more so to reduce the risk of a bad outcome. I think we are in this unusual period right now where we call these drivers. We are saying that people who are vulnerable to infection receive a vaccine every six months, this is effectively what we are doing to make sure they are up to date and have maximum protection. And we’re making the transition to this one, probably becoming an annual vaccination starting this fall. The problem is that we have been in continuous waves of spread. And therefore, to maintain people’s immunity, it is necessary, as this virus has evolved into these new variants, a reinforcement is required every six months. But I think the reality is that in the fall it will become an annual vaccine. And then the CDC will talk about being up to date. Have you been vaccinated this season? I think they are reluctant to pull the trigger right now because they are not sure what the recommendations will be in the fall. But it is more than likely that there will be a recommendation for everyone to take another dose in the fall. And this will be the beginning of this becoming an annual vaccine, I think.
MARGARET BRENNAN: But some of the CDC’s instructions, like close contact, still remain at that six-foot distance, 15 minutes long. Is it really a close contact? I mean, is it advisable to shake someone’s hand and kiss them on the cheek right now?
GOTTLIEB: Well, look, this is a close contact that shakes someone’s hand …
MARGARET BRENNAN: Even if it’s less than 15 minutes?
GOTTLIEB: – and kisses or hugs of air that were a close contact. Well, I mean, that’s the problem with the CDC guide. The CDC guide was always weird. He talked about 15 minutes accumulated as if it were a radiation exposure, that you have an increased risk of accumulated exposure. This is binary. Either you take it or not. And what the CDC is defining is a minimum standard for what they believe is close contact. But if you’re hugging someone, it’s definitely a substitute for 15 minutes of being around someone less than six feet away. And so we just have to be practical with that. Close contact is what we know to be close contact. As for the president, I hope he does well and doesn’t take him. I think he’s probably out of the woods for his exposure to the Speaker of the House, but to say that this was not a close contact where we have photos of him hugging the President, was clearly a close contact. I just think we need to be clear and practical about how we describe these things.
MARGARET BRENNAN: Well, I think people appreciate you being simple. So if you’re here in an area where there’s an increase, do you send your unvaccinated child to school with a mask on? And how long do these younger children stay unvaccinated?
GOTTLIEB: Yes. Look, I think masks on very young children have always been difficult because young children can’t wear medical masks and they don’t wear them well. And the fabric mask doesn’t offer much protection against this particular strain, which is probably an airborne virus. I think if you have a teen or an elderly child who can wear a mask well and you have access to comfortable KF-94 masks or KN-95 masks, or level three procedure masks, and the child can wear it comfortably and it is not interrupt: Interrupt your school day, I think thinking about masking for a week or two and the prevalence is high could be a prudent step. Masks should be something we look at when local prevalence is high, something we wear for temporary periods of time. So you might want to think about it a couple of a week while the prevalence is high. I think things will go down in the northeast over the next two to three weeks. I think we’ll see that things get a lot smaller. But right now the prevalence is quite high in the Northeast Mid-Atlantic.
MARGARET BRENNAN: And we’re still waiting for May as soon as possible for a children’s vax?
DR. GOTTLIEB: I think as soon as possible. So the data should come out of Pfizer in April. Obviously, Moderna has released its data. The FDA is very familiar with these data sets and therefore could act on them quickly. Assuming the data comes out in April, as expected, I think the agency could act in May. My intuition is that it will slip a bit because this sense of urgency will have dissipated because the levels of infection will be relatively low as we get to spring.
MARGARET BRENNAN: Dr. Gottlieb, thank you so much for your experience. We will be back soon.
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