Transcript: Dr. Scott Gottlieb on "Face the Nation," January 30, 2022

Gottlieb says Omicron immunity should provide "backstop" against BA.2 variant

The following is a transcript of an interview with Dr. Scott Gottlieb that aired Sunday, January 30, 2022, on "Face the Nation."


MARGARET BRENNAN: We go now to former FDA commissioner and Pfizer board member Dr. Scott Gottlieb, who made it out of the snowstorm in Connecticut and down here to Washington, D.C. this morning. That is dedication, doctor. Thank you. 

DR. SCOTT GOTTLIEB: Thank you. 

MARGARET BRENNAN: There is a new variant of concern BA2. The CDC says it's already here in the United States. How concerned do we need to be?

DR. SCOTT GOTTLIEB: You know, the question is, does this change the decision space? I don't think it does. I don't think it really changes the narrative. It maybe, perhaps extends the tail on the decline that we're seeing across the country. There's some critical questions. Is it more contagious? It appears to be more contagious. Data out of Denmark from the Serum Institute suggests it's about 1.5 times more contagious than the strain of Omicron that has made it around the US–

MARGARET BRENNAN: which is already so transmissible.

DR. GOTTLIEB: Exactly. Does it evade our immune system? Does it evade the immunity that we've acquired from Omicron infection or the vaccines? Most of the evidence so far, it's preliminary, suggests it does. And in fact, there's data out of the U.K. that suggests that a fully boosted person may be more protected against this new variant than they were against the original strain of Omicron. And then the final question is, is it more virulent? Is it more dangerous? And so far, based on what we've seen out of Denmark and the U.K., which are collecting very good data on this, it doesn't appear to be a more virulent strain.

MARGARET BRENNAN: So if you had Omicron, can you be reinfected with this version?

DR. GOTTLIEB: You should be protected. So the mutations in this new version are not in the receptor binding domain on the spike protein. That's the portion of the spike protein that we develop our best antibodies against that neutralize the virus. Most of the mutations are in a separate part of the spike protein called the N-terminal domain. So if you had Omicron infection, you should have protection against subsequent infection from this new variant. That's why I don't think this is going to create a huge wave of infection. What's likely to happen is as we were coming down, and coming down quite sharply in parts of the Northeast, Florida, the mid-Atlantic, you might see as this new strain starts to pick up, you might see that we start to slow down in that decline, but the decline will happen nonetheless. Right now, it represents probably about five percent of infections in the US, and we have so much Omicron immunity that's probably going to be a backstop against this really taking off.

MARGARET BRENNAN: So, you know, we've talked about it there every time that there is an infection, these child care centers have to shut down. That creates practical problems for parents who want to go out and participate in the economy. They want to show up for work. I mean, this is a drag for the country. The CDC issued new guidance to child care centers. It recommended toddlers remain masked. It lowered the recommendation for isolation post-infection to about five days. Is this prudent? Is this good health policy along with economic policy?

DR. GOTTLIEB: Look, I think they're doing all they can do, but the guidance really focuses on trying to prevent spread within the daycare center. I think we need to focus a little bit more attention on trying to prevent introduction into those settings, because once you get an infection in that setting it's hard to control. You know, you've got kids who don't wear masks very well. I think it's hard to ask a two or three year old to wear a mask. Even if you keep them in social pods, they're going to play together, so it's hard to control transmission within that setting. I think we should be focusing more on trying to keep the infection out in the first place.

MARGARET BRENNAN: Well, but to that point, and you know, because I ask you almost every week because my own kids can't get vaccinated, that that's just going to continue to be a risk right until the youngest children, four and under can get a vaccine. So this portion of the puzzle, and if a vaccine is greenlit for the youngest Americans, does it unlock everything else? Does this start to move us back to normal?

DR. GOTTLIEB: I don't think it unlocks everything else for a couple of reasons. Number one, a lot of- we're seeing a lot of parents with young kids aren't getting their kids vaccinated. Only about 25 percent of kids five to 11 have been vaccinated. It's been very disappointing. About 18 percent have been fully vaccinated. So I suspect that there's going to be some hesitation with the youngest kids as well. We can't fully explain it. Also, while the vaccines prevent infection, so a fully boosted adult has probably a 50 percent lower chance of getting infected in the first place with that vaccine. They're not- They're not 90 percent protective and probably in the younger kids, they're going to be a little less protective against infection. So you're still going to see kids be able to get infected even if they're vaccinated. What the vaccine is going to do is protect them from bad outcomes. And we've seen a lot of bad outcomes with kids. There is some indication if you listen to federal health officials that they may be rethinking the vaccine in zero- in six months to four years old. And I'm hopeful that you could see some movement on trying to entertain that application earlier. Ultimately, the decision resides with FDA, but there is some indication that there may be an early reaction on that application.

MARGARET BRENNAN: Dr. Fauci said this week the best- that it would be a three dose regimen for the youngest. You said best case would be March. Are you sticking with that?

DR. GOTTLIEB: Well, look, if the- if federal health officials in the agency decide to authorize this on the basis of two doses, it could be out much sooner. And I think the decision matrix has changed around the vaccine for six months to four year olds. And so far as we know that the vaccine isn't as protective at preventing infection. Previously, we had data showing that the childhood vaccine for four- six months to four years wasn't as protective against infection as the adult vaccine. That's the reason why they pushed it out and asked for that third dose, but now, if the goal of the vaccine is to get baseline immunity in the kids to prevent really bad outcomes, and you're really not using the vaccine as a tool to prevent infection in the first place, two doses could do that. Getting two doses into a child can provide baseline immunity that protects them from severe disease from hospitalization. And I think that may be why federal health officials are rethinking this if in fact they decide to authorize this on the basis of two doses. It could be out much sooner, perhaps as early as early March.

MARGARET BRENNAN: That could be a big development. We mentioned there, our Mark Strassmann was reporting on San Francisco being the first major city to roll back its indoor mask mandate. Here in D.C. that just extended it to the end of February, at least. Is there a clear benchmark yet for when health measures should be lifted?

DR. GOTTLIEB: Yeah, this is going to be a real challenge. So right now you look at a lot of federal health guidance, and it says that these measures should be lifted when there's low prevalence. The CDC defines low prevalence as 10 cases per 100,000 people per day. That was the old measure in the age of Omicron, with a much more contagious variant and with the fact that the population has a lot of immunity, so we're less susceptible overall, we may need to rethink that. We may need to decide that once we get to 20 cases per 100,000 per day, that may be the point at which we start to withdraw these things. I'm not so sure we're going to get to 10 anytime soon. Right now, Washington, D.C. is at 50, New York's at 75. With this new homegrown strain that's circulating, we may stall out around 20, and that may be the point where we have to consider withdrawing a lot of these measures.

MARGARET BRENNAN: OK, Dr. Gottlieb, thank you so much. 

DR. GOTTLIEB: Thanks a lot. Good to see you. 

MARGARET BRENNAN: Good to see you in person. And FACE THE NATION will be back in one minute.

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