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Full transcript of "Face the Nation" on August 1, 2021

8/1: Fauci, Manchin, Kashkari, Alroy-Preis, Gottlieb
8/1: Fauci, Manchin, Kashkari, Alroy-Preis, Gottlieb 46:07

On this "Face the Nation" broadcast moderated by John Dickerson:

  • Dr. Anthony Fauci — chief medical adviser to President Biden
  • Senator Joe Manchin — Democrat of West Virginia
  • Neel Kashkari — president of the Federal Reserve Bank of Minneapolis
  • Dr. Sharon Alroy-Preis — director of Israel's Public Health Services
  • Dr. Scott Gottlieb — former FDA commissioner

Click here to browse full transcripts of "Face the Nation."

JOHN DICKERSON: I'm John Dickerson in Washington. And this week on FACE THE NATION, U.S. health officials say the war against COVID-19 has changed, and the U.S. is back in the top spot when it comes to the highest number of new infections worldwide. Along with the surge in new cases, COVID anxiety is also making a comeback this summer. New CDC data shows vaccinated people who've caught the Delta variant may be just as contagious as non-vaccinated people. Indoor mask mandates in hot spots are back, and more health restrictions may be ahead.

WOMAN: Should Americans expect more guidelines coming out, more restrictions because of COVID?

PRESIDENT JOE BIDEN: In all probability.

JOHN DICKERSON: The Delta variant now accounts for more than eighty percent of COVID cases in the U.S. Vaccines still offer the best protection against severe illness and death, and the pleas for holdouts to get the shot are getting more dire.

PRESIDENT JOE BIDEN: This is an American tragedy. People are dying, and will die, who don't have to die. If you're out there unvaccinated, you don't have to die.

JOHN DICKERSON: We'll talk to Doctor Anthony Fauci and former FDA Commissioner Doctor Scott Gottlieb. Plus, we'll ask Doctor Sharon Alroy-Preis, the top public health official in Israel, what her country's learned from their vaccine campaign that can help the U.S. Then, America's economy is moving ahead, but there are troubled spots there, too. Inflation is rising, and the housing eviction moratorium has expired, now millions could lose their homes. We'll talk with Minneapolis Federal Reserve Bank president Neel Kashkari. Plus, infrastructure.

PRESIDENT JOE BIDEN: A fancy word for bridges, roads, transit systems, high-speed Internet, clean drinking water.

JOHN DICKERSON: The Senate is putting the finishing touches on a one trillion-dollar bill, it's a long time coming but there's still a long way to go. We'll talk with the key negotiator of the bipartisan deal, West Virginia Democratic Senator Joe Manchin.

It's all just ahead on FACE THE NATION.

Good morning, and welcome to FACE THE NATION. There is good news and bad news on the pandemic. The COVID-19 Delta variant is even worse than we thought, making it clear that this pandemic is far from over. But the reality appears to be sinking in. Nationally, vaccination rates are up by thirty percent for first doses in the last week. But we still have a long way to go. Our coverage begins with senior national correspondent Mark Strassmann. Mark.

MARK STRASSMANN (CBS News Senior National Correspondent): Good morning, John. More than half of America's counties are now considered high transmission areas for COVID. New daily cases are now higher than they were at this point last summer. And, yet, many Americans still cut loose as though this pandemic is over.

(Begin VT)

MARK STRASSMANN: Lollapalooza, Chicago's annual four-day music fest for tens of thousands of people, many of them unmasked, potentially a COVID-palooza. On Thursday ninety percent of concertgoers showed proof of vaccination, eight percent brought negative COVID tests, six hundred people without paperwork were turned away. The worry: This new Delta variant can spread like chickenpox. Even vaccinated people can get it and give it.

DR. GRANT COLFAX (San Francisco Director of Public Health): We are also in the midst of our fourth surge here in the city, and that surge is being driven by the Delta variant.

MARK STRASSMANN: At two San Francisco area hospitals, at least two hundred thirty-three staff members tested positive for the virus over the last month. Seventy-five percent of those infected had been vaccinated in America's most vaccinated city. Nationally, in the last week, COVID hospitalizations almost doubled, ninety-seven percent of them unvaccinated. In these forty-three states, the CDC predicted COVID deaths will likely rise over the next two weeks.

DAVID CANEPA: To those who are unvaccinated, shame on you.

MARK STRASSMANN: That's ninety million eligible Americans. One response: Vaccine mandates at Netflix, Google, Facebook, Morgan Stanley, and six hundred universities. All four million federal employees and military members either get a vaccine or face weekly testing. Fear is motivating. Almost five million people got shots in the last two weeks. Many of them in hot spot states with low vaccination rates, like Louisiana, Arkansas, and Mississippi.

MAN: All my doctors have basically told me I should get it, so we're here.

MARK STRASSMANN: But also increasingly apparent, the depth of denial.

REPRESENTATIVE BOB GOOD: Why are we testing healthy people to find out if they might be infected?

MARK STRASSMANN: And defiance.

RON DESANTIS: There will be no restrictions and no mandates in the state of Florida.

(Crowd cheering)

MARK STRASSMANN: His state set a record Friday for the highest number of new cases since the start of the pandemic. In Texas Governor Greg Abbott's anti-mandate executive order said, "Texans have mastered the safe practices that help to prevent and avoid the spread of COVID-19." On Friday, Texas reported more than thirteen thousand new cases, its highest single-day jump in almost six months.

MAYOR LATOYA CANTRELL (D-New Orleans, Louisiana): We have been here before. We've seen the movie over again. And what was once unpreventable, today it's preventable.

MAN: We're for freedom, baby.

MARK STRASSMANN: These protests are back because masking is back. New mandates in places like Washington, DC, Kansas City and Atlanta, regardless of vaccination status. No one likes wearing one; millions still refuse.

WOMAN: I don't agree with it because it takes away my individuality.

(End VT)

MARK STRASSMANN: Now some good news: almost a half million more Americans got their first shot yesterday. The CDC says that is, without question, the surest way out of this pandemic. John.

JOHN DICKERSON: Mark Strassmann, thank you.

We go now to President Biden's chief medical adviser, Doctor Anthony Fauci. Good morning, Doctor Fauci.

ANTHONY FAUCI, M.D. (Chief Medical Adviser to President Biden/Director, National Institute of Allergy and Infectious Diseases): Good morning, John.

JOHN DICKERSON: I'd like to start with the new thinking on COVID-19 that was part of the CDC's decision to change its mask guidance. We've been talking about the Delta variant for a while. But what is new in your understanding about the Delta variant this week?

ANTHONY FAUCI: Well, a confirmation of how easily it spreads from person to person but also we found that individuals who get breakthrough infections, namely people who are vaccinated, who might get infected, almost invariably they get either minimal symptoms or no symptoms at all. But since no vaccine is a hundred percent effective, you're going to see breakthrough infections. But what we've learned that's new, John, in answer to your question is that when you look at the level of virus in the nasopharynx of people who are vaccinated, who get breakthrough infections, it's really quite high and equivalent to the level of virus in the nasopharynx of unvaccinated people who get infected. That's very different from the Alpha variant. The Alpha variant the level of virus in a vaccinated person was extremely low compared in the-- in the vaccinated people compared to the unvaccinated people. Not so with Delta. So we know now that vaccinated people who get breakthrough infections can spread the virus to other people.

JOHN DICKERSON: Sticking on-- on that point, we've always known that it was not a hundred percent effective when you're vaccinated. So what-- among the breakthrough cases that we always knew would happen, in every breakthrough instance is it true that the ability to spread is high or is it a smaller subset of the breakthrough cases in which this discovery was made about the ability to spread?

ANTHONY FAUCI: Well, the phenomenon of the ability to spread is clear. We're seeing that very, very clearly in a number of situations. When you look at the data that we've gotten from a single study so far, and other studies are coming out, you have a variability. But the mean, the-- the sort of average or mean level of virus in the nasopharynx is really quite similar, almost identical on an average. So you would think, obviously, when you have biological variability, you're going to have some people high, some people low, some people in the middle. But the median or mean is going to be right there, which is very similar to the unvaccinated individual, which is troublesome, which tells you the potential for transmission is there.

JOHN DICKERSON: And that's why the mask guidance for those who have already been vaccinated, because there are these cases in which it's possible to spread.

ANTHONY FAUCI: Right. I mean, the-- the situation is that if you get breakthrough infections in-- in individuals who are vaccinated and they don't spread at all to anybody else, then you would not worry about if they went home to a vulnerable person in the household, children or an elderly person, there wouldn't be any issue. But since we know now that (a) they can transmit when they get breakthrough infections, even though, they have minimal symptoms or no symptoms, we know they can do it. We know the mechanistic reason for it is that the level of virus is high. So you want to make sure they don't get infected. And that's the reason why. And the fundamental basis for the CDC modifying their guidelines and saying, now, if you're in an area of a high or substantial trend-- level of virus, namely a red or an orange zone, you-- when you are in an indoor public setting, you need to wear a mask. That's the fundamental reason for that change.

JOHN DICKERSON: And-- so people who say, I don't want to wear a mask, it's my personal decision, that's the way they see it. As you see it, what decision are they making by not wearing a mask?

ANTHONY FAUCI: Well, one of the issues that- that just looms large, John, when you're dealing with this is that you understand people's feeling that they have the individual right to make their own decision. And-- and I respect that for sure. But the issue is if you're going to be part of the transmission chain to someone else, then your decision is impacting someone else. It's not only impacting you. And you've got to think about it that you are a member of society and you have a responsibility.

JOHN DICKERSON: Let me ask you about context here. In the CDC document there was an expression, someone wrote, "the war has changed" based on these new findings. But isn't the war essentially the same as it was, which is there are pockets of the country where there are not people getting vaccinated as much as they should be. And that's the big issue. And that-- that hasn't changed this week at all, despite what we've just been talking about for the last four minutes.

ANTHONY FAUCI: You're absolutely correct. We have a hundred million people in this country, John, who are eligible to be vaccinated, who are not vaccinated. We've really got to get those people to change their minds, make it easy for them, convince them, do something to get them to be vaccinated because they are the ones that are propagating this outbreak. So you're absolutely correct. That hasn't changed. What has magnified the problem, John, is that we're now dealing with a virus that has an extraordinary capability of spreading from person to person. So when you superimpose one on the other, you have a very difficult situation, a pool of unvaccinated people and a virus that spreads very efficiently.

JOHN DICKERSON: Looking at the Massachusetts-- the Provincetown study that was a part of this mask guidance, we've talked about the ability to transmit among those who are already vaccinated. But it looks like the story of that study could also be the vaccines work.

ANTHONY FAUCI: Oh, absolutely. I mean it's understandable how there could be kind of a dual or a mixed message from that study, but the predominant message is that if you are vaccinated and you get a breakthrough infec-- first of all, if you're vaccinated, you're much, much more protected against getting infected than an unvaccinated, who is completely vulnerable. So you have a degree of protection against infection. But the critical issue, John, is that if you do get infected, the likelihood of your getting a severe outcome of the infection is very low. It is much more likely that you will be either without symptoms or minimally symptomatic. So the vaccine is doing what you want it to do. It's protecting people from getting sick.

JOHN DICKERSON: There seems to be some evidence that the message is getting through. The total number of new vaccinated reported in the past seven days is the highest since the week of July Fourth. In low vaccination areas, the vaccination uptake is high. (a) What do you think is a result-- why is that happening? And then (b) when do we think we'll see the dividends from those vaccinations?

ANTHONY FAUCI: Well, I-- I think that's happening for two reasons. I think that, first of all, we're trying as hard as we can to make it as easy as possible for people to get vaccinated using trusted messengers. But I think when people realize and look around them and see that in the area where they live, the virus and the infection is escalating considerably compared to areas that have a high degree of vaccination. So it's sort of common sense. But I'm also gratified by seeing that even people who in the beginning were reluctant to promote vaccination are now doing it. I mean, people like Republicans like-- like Stephen Scalise or even Governor DeSantis talking about getting people vaccinated. Asa Hutchinson out there beating the bushes, getting people to get vaccinated. I think that's what's happening now.

JOHN DICKERSON: All right. Doctor Fauci, thank you so much for being with us and helping us understand all this. We appreciate it.

FACE THE NATION will be back in one minute. Stay with us.


JOHN DICKERSON: The Senate is reconvening this afternoon to resume consideration of a roughly one-trillion-dollar infrastructure bill. One of the Democrats leading the bipartisan negotiations is Senator Joe Manchin of West Virginia. Good morning, Senator.

SENATOR JOE MANCHIN (D-West Virginia/@ Sen_JoeManchin): Good morning, John. Good to be with you in person especially.

JOHN DICKERSON: Yeah, exactly. It's great to have you with us. So this isn't just an infrastructure bill. The President of the United States said this signals to the world that our democracy can function. So it's got a lot on-- on its shoulders here.


JOHN DICKERSON: And it's not done yet. What is the next set of steps for this to become law?

SENATOR JOE MANCHIN: John, I-- I-- it's-- it's ninety-nine and nine-tenths finished. They're drafting it. The text will be done. Hopefully, we'll introduce it today. We'll vote on it tonight. We'll start the amendment process hopefully on Monday if not. But we want to be done by Thursday. We want to move on, okay?

JOHN DICKERSON: But it's not just the Senate that speaks. The House has also--


JOHN DICKERSON: --has a role.

SENATOR JOE MANCHIN: Oh, yeah. No, I'm just saying it moves on from the Senate.



JOHN DICKERSON: But for it to become law it's linked up with this other piece of legislation, the budget bill. Do you not see that it's linked together?

SENATOR JOE MANCHIN: I've-- I've always believed that everything should-- should rise or fall on its own merits. When you had-- you just said something, the President of the United States tells the whole world. This is the President's bill. This is all of our bill. It's a Democrat, it's every Republican's bill. There's not an infrastructure need in the country that has an R or D name on it. And that's what brings us together, eighty percent popularity.


SENATOR JOE MANCHIN: So, yeah, we should be doing it.

JOHN DICKERSON: But the President also has other ideas about the country and, in fact, says they're vital after this pandemic.


JOHN DICKERSON: And those are all contained in his other budget bill.

SENATOR JOE MANCHIN: Right. I understand.

JOHN DICKERSON: So that's vital to him, too.


JOHN DICKERSON: And Nancy Pelosi has said only until the Senate passes that other budget bill will we let this infrastructure.


JOHN DICKERSON: So that's a roadblock it seems.

SENATOR JOE MANCHIN: I would never, ever, ever try to advise Speaker Pelosi on how she runs the-- the House. I think she does a marvelous job and-- and she'll do what she thinks is best for the House. But the bottom line is we've got a bill that eighty percent of the public, eighty percent of the public, we have a bill that mostly every Democrat and every Republican should be supporting the infrastructure bill-- so we'll see. It should go and fall or rise on its own. I really have said that.

JOHN DICKERSON: But what you're saying is the House should pass their infrastructure and then you go through the process.


JOHN DICKERSON: You meld it and the President votes on it.


JOHN DICKERSON: They shouldn't hold it up.

SENATOR JOE MANCHIN: I would not think that that would be the-- the best thing to do for the public right now. We're trying to show the whole world that we can operate. We're trying to show the country that we're back and we can do things in a bipartisan way. This is one of the big things. We don't expect to do the next bill bipartisan. That's reconciliation.


SENATOR JOE MANCHIN: That's strictly party line vote. And I said we will go on budget resolution. Let's look at the whole bill. But don't forget, we've got inflation. We've got a 28.6-billion-dollar debt. We have four billion dollars a day growing in debt. All this should be considered before we just jump in.

JOHN DICKERSON: Well, before we get to that budget bill, you mentioned a test of democracy. The first test is whether Republicans and Democrats can work together.


JOHN DICKERSON: Seems like the second test of democracy is this three-legged race you're in with House liberals, which is can Democrats agree that this other budget bill is not linked to infrastructure? Or can Joe Manchin sign on to a budget reconciliation that Bernie Sanders also agrees with?

SENATOR JOE MANCHIN: Well, it's all about compromise. That's what we've-- this has been a compromise. We've been working on this for six weeks and we finally come down to the last day of the last hour to get it finished. It takes compromise. You have to trust each other. You have to work. I respect my colleagues who believe something a lot different than I do. And I'm willing to listen and learn. And if we can find that compromise, we'll find it.

JOHN DICKERSON: Alexandra Ocasio-Cortez--


JOHN DICKERSON: --leader of the-- or one of the leaders of the progressive movement in the House--


JOHN DICKERSON: --has said she's got ten progressives who will block infrastructure unless you over in the Senate pass this budget bill.

SENATOR JOE MANCHIN: Well, you know, sometimes maybe you'll have fifteen or twenty Republicans that will see a good bill. Maybe there might be a hundred Republicans in the House that says, my God, I like this. Guess what? It takes care of my transportation. It's the greatest jobs bill we've ever had. It runs for five to ten years. It gives you total growth each year to try to stimulate the economy. So you know what everybody had that-- that was the-- there was a Hastert, remember the Hastert Rule?



JOHN DICKERSON: Only Republicans can vote by majority.

SENATOR JOE MANCHIN: That's crazy. I take a win whenever I can get it.

JOHN DICKERSON: Yeah, well, now you're advising Nancy Pelosi.

SENATOR JOE MANCHIN: No, I'm not. No, I'm not. No, I'm not.

JOHN DICKERSON: Let me ask--


JOHN DICKERSON: Let me ask you about this budget bill. It has inside of it a lot of the President's priorities. It's clocked in at about 3.5 trillion dollars.


JOHN DICKERSON: You have expressed some concerns about that cost. Is it the cost or is it paying for it that you--

SENATOR JOE MANCHIN: Well, they're saying it's all paid for. Now, if it's all paid for, you look at it in a different light, okay? There's a lot of great things in there. I've seen some of the things that need to be done and want-- and we all want to be done. But you get to the point like you do in your own private life, well can you afford to pay for it? So if-- I never voted for the 2017 tax cuts, okay? I've explained to Senator Schumer and everything. We've had good conversation. He's been great about trying to move this infrastructure, the traditional infrastructure. Right now he really has been pushing this, saying let's get a bill done. Now on the other bill, I've said let's look and see. You're going to make adjustments to the tax code.


SENATOR JOE MANCHIN: Are we still going to be competitive? Can we compete in a global market, if we can't--

JOHN DICKERSON: In other words, do taxes raise so high on business that they end up going to other countries?

SENATOR JOE MANCHIN: That's exactly. And, basically, we have a downturn in the economy and inflation skyrockets. We have problems. You have to be careful about all that.

JOHN DICKERSON: A lot of times-- and this happened on the infrastructure bill. You can find ways to pay for things that are a little fuzzy. So let's say it gets paid for. There are other things in this bill that might be-- need to be worked out between you and your fellow Democrats. The environment is one of them. There are a lot of environmental--


JOHN DICKERSON: What concerns you about the environmental provision?

SENATOR JOE MANCHIN: Well, my concern is basically being realistic and being practical about what's going on in the world. Within the next ten years, ninety percent of pollution is going to come from one continent: Asia. And China is going to have thirty-five hundred coal-fired plants. In America they make you believe-- we only have five hundred and four. There are sixty-six hundred operating and they're building another thousand sixty-three, none in America. And they're telling you-- making you think that, well, if you get rid of all the coal-fired plants, it basically solves the pollution. It doesn't.

JOHN DICKERSON: Well, It's-- it's a big signal to the rest of the world. And--

SENATOR JOE MANCHIN: The rest of the world is not going in that direction. We're the only country. If we get out of the fossil business, there will not be any R&D research and development. We have twelve billion dollars for carbon capture sequestration. If you don't do that, you're not going to save the climate.

JOHN DICKERSON: But what they would argue is the clock is ticking. If you wait--

SENATOR JOE MANCHIN: The clock is ticking and we're working.

JOHN DICKERSON: --for carbon sequestration, that is a long time from now--


JOHN DICKERSON: --and it might not even work.

SENATOR JOE MANCHIN: No, John, no, no. We know it does work. What we haven't been able to do has been able to do it in a more practical, profitable way to where it doesn't break the bank. So once we find that new--unlock that new technology, then that's a whole another game changer and we can get there. We're close.

JOHN DICKERSON: Can you come to compromise with the liberal members of the Senate on these issues of the environment--

SENATOR JOE MANCHIN: I would like to think so.

JOHN DICKERSON: --or does Joe Manchin, who once shot an environmental piece of legislation in a campaign ad, is it going to be too hard to get on you board?

SENATOR JOE MANCHIN: You know the reason I shot that campaign ad? Shot that ad-- that piece of legislation? They were asking us to do things that technology hadn't even been developed in. But now we have scrubbers, low-NOx boilers and baghouses for mercury. Once we're able to have a valued use for the-- for the carbon and make it into solid products to where we can use it for value added that'd be great.

JOHN DICKERSON: You think you can come to a compromise with Democrats who have said-- Senate Democrats have said this is central to this bill passing?

SENATOR JOE MANCHIN: Well, I can tell you one thing. I've always come to compromise. I've always tried to find the middle. Now, if they don't want to find the middle, that'd be up to them. I can always find that middle. But if you think you're going to eliminate your way to a cleaner environment, I don't totally disagree. You can innovate your way to it and the rest of the world will follow if you have the technology that they know they'll use.

JOHN DICKERSON: Two other quick questions I want to ask you. The President has said he wants to see some immigration provisions as a part of this budget bill--


JOHN DICKERSON: --including taking care of the Dreamers, those who were brought over here by their parents.


JOHN DICKERSON: Are you okay with that being included?

SENATOR JOE MANCHIN: First of all, I have-- I-- I was a solid supporter of the 2013 immigration bill that passed with sixty-eight votes bipartisan in the Senate. I'm still there. I think we should have a pathway to citizenship, should take care of our Dreamers, and we need those workers and those people basically in our-- legally in our system.

JOHN DICKERSON: Final question is on this eviction moratorium. It's lapsed.


JOHN DICKERSON: People could be evicted as soon as Monday. How can Democrats who are in charge of the White House, the House and the Senate fumble this?

SENATOR JOE MANCHIN: Well, there's no reason we should, but basically there's twenty billion dollars or more that haven't gone out the door. We have to make sure that we watch the fraud that is involved. There's been a lot of concerns about that getting the right people. But if there's money there then we can help people as they're getting their life back, vaccinations are plentiful. Everybody can have a vaccination. Job market, we have nine million jobs aren't fulfilled. Everybody should get back into normal flow. Be careful, get vaccinated, wear your mask, do whatever you have to do. Get back into the flow. And we should basically extend and help those who need it.

JOHN DICKERSON: All right. Senator Joe Manchin, thank you. You're going back to work in the Senate.

SENATOR JOE MANCHIN: Thank-- thank you, John.

JOHN DICKERSON: Senator, we appreciate it.

And we'll be right back with a lot more. Stay with us.


JOHN DICKERSON: As the country faces the threat of another COVID wave, millions of Americans face the risk of eviction. Some as early as tomorrow, as efforts to extend the federal eviction moratorium that has been in place since last September continue. The Biden administration today said they can extend the moratorium for federally-backed mortgages, but that's all they can do and that the rest is up to Congress. Congresswoman Cori Bush, a freshmen Democrat from Missouri is staging a protest at the Capitol to draw attention to this. She's been there since Friday night. We'll be right back.


JOHN DICKERSON: And we'll be back with a lot more FACE THE NATION. The head of the Minneapolis Fed, Neel Kashkari is up next. Plus, former FDA Commissioner Doctor Scott Gottlieb, and more. Stay with us.


JOHN DICKERSON: Welcome back to FACE THE NATION. The highly contagious Delta variant could also complicate America's economic recovery. We go now to Neel Kashkari, the president and CEO of the Minneapolis Federal Reserve Bank. Good morning.

NEEL KASHKARI (President, Federal Reserve Bank of Minnesota/@neelkashkari): Good morning, John.

JOHN DICKERSON:  Let's start with the Delta variant. What effect do you think it's having on the economy?

NEEL KASHKARI: Well, it's really-- it's creating a bunch of caution you know. Right now we have seven to nine million Americans who are still out of work that we need to get back into the job market. We believe that they're out of work because they've been nerve-- nervous about COVID, because of childcare issues, because of these enhanced unemployment benefits. So I was very optimistic the fall would be a very strong labor market with many of those Americans coming back to work. That's still my base-case scenario. But if people are nervous about the Delta variant, that could slow some of that labor market recovery and, therefore, be a drag on our economic recovery. So the sooner we can get people vaccinated, the sooner we can get Delta under control, the better off our economy is going to be.

JOHN DICKERSON: When people are coming back into the labor market or they have existing jobs we hear a lot of stories. We hear-- the President was asked at a town hall last week a restaurant owner said, I'm having trouble finding people. And the President said, yeah, well, you're going to have a tough go of it because people are negotiating for higher wages, for more benefits. What's your view of where jobs are right now and the leverage that workers may have and how that affects the economy?

NEEL KASHKARI: Well, this is-- this is unlike any other downturn any of us have lived through. So, the U.S. economy went through a rapid shutdown and now a rapid reopening. And there are a lot of adjustments that need to take place. And so we are seeing wages pick up, which is a good thing. They're picking up most quickly for the lowest income workers. And in some of those service sectors, like the restaurant workers. And you know what those folks are long overdue for a raise. So I think net-net that's positive. I think at the end of the day, there's going to be more of a balance between business and between the labor sector once we bring these seven to nine million Americans back to work. So right now, the economy is reopening more quickly than the-- than the labor supply is coming online. That mismatch is giving some workers some power. I think they deserve to have some power, but I think it's going to balance out as we get back to normal.

JOHN DICKERSON: And, by the way, do you still have a timeline for getting back to normal, your sense of the recovery and how it goes? As you said, we're in a situation where this is, you know, we haven't had to come out of a pandemic for more than a hundred years.

NEEL KASHKARI: Well, you know, in December of last year, the Federal Reserve said that we were going to keep our asset purchases going, which is a form of stimulus for the economy until we've made substantial further progress in the labor market. We're about a third of the way back from that-- where the hole was in December. So we've made progress, but we are still in a deep hole. I mean, seven to nine million Americans should be working right now if the pandemic had never happened. So that's a lot of Americans that we need to put back to work. And that's what I'm very focused on, how quickly we can get them back. You know, the last recovery took ten years to put everybody back to work. We cannot have another ten-year recovery. I'm optimistic it can happen more quickly. But is it six months or is it two years? I'm not sure.

JOHN DICKERSON: All right. Inflation. The question everybody wants an answer to. When we last talked, you thought it was perhaps temporary. You predicted, essentially, the increase in prices. Was it greater than you thought? And what's your baseline view about inflation?

NEEL KASHKARI: It was greater than I thought, but my baseline view is still that it's temporary. We're seeing a lot of inflation in a few sectors of the economy that are closely tied to the pandemic. So we're seeing most of the inflation in the auto sector and in travel and transportation. So hotels and things and air-- airline tickets and rental cars. But we're not seeing broader inflation across the economy as a whole. And some of it is just math. You know prices fell a lot last year. They're bouncing back. So the inflation readings looked really high. If you look across a two-year measure, inflation is around 2.3 or 2.4 percent. So I still think it's transitory, but we're paying very close attention. And financial markets are signaling that they think long-term inflation is solidly in check, in anchored around two percent, which is where we want it to be.

JOHN DICKERSON: What is your feeling then about the CEO of Intel said because of the microchip shortage, things might not get to normal until 2023? This week Anheuser-Busch said Budweiser is going to-- is having trouble because of supply issues. Caterpillar, the heavy equipment manager, is worried about it. Procter and Gamble said they're going to cost-- it's about two billion dollars in additional costs. These are a lot of sect-- the housing sector is having trouble because of supply issues. Those are a lot of different sectors that seem to be having issues with supply. Isn't that an inflation worry?

NEEL KASHKARI: It is an inflation worry, but I think in most of those cases, the expectation is those supply chain issues are going to get worked out. Remember, a year ago we couldn't get toilet paper. Now if you go to the grocery store, the shelves are full of toilet paper. Lumber prices skyrocketed. Now they're falling back down to earth. So these price increases are real. I'm not dismissing that. But a lot of the supply chain issues, I mean this is the market at work as businesses are trying to work out their-- their issues and become more efficient. And this is why it goes back to the virus. As the Delta variant is spreading around the world, it's creating issues all around the world in a lot of our global suppliers. So the more we can do to get control of the Delta variant, the more quickly we're going to be able to resolve many of these supply chain issues.

JOHN DICKERSON: Final question. Give people a template for thinking about the debate we're about to have here in Washington about spending. Senator Manchin was just on saying he's worried about the effect on the debt and deficit. The White House says unless this money is spent building American jobs, American growth won't be what we want it to be. How should people think about federal spending and this question of the debt and inflation?

NEEL KASHKARI: Well, long-term interest rates for U.S. government debt are very, very low. That signals that investors around the world have a lot of confidence in the U.S. economy to support that debt and to grow over the long term. Now, I think there's a difference between spending on infrastructure investment, where you can expect a reasonable rate of return and spending on consumption. The infrastructure bill that I've seen focuses on things like roads and bridges and broadband internet. Those things should be good for U.S. long-term economic growth. Those are smart things to invest in, from my humble opinion.

JOHN DICKERSON: All right. Neel Kashkari, thank you so much for being with us. We really appreciate it.

And we'll be right back.


JOHN DICKERSON: The number of COVID-19 cases is also surging internationally. But unlike the U.S. and other wealthier nations, vaccines are still in very short supply in most countries. Elizabeth Palmer reports.

ELIZABETH PALMER (CBS News Senior Foreign Correspondent/@CBSLizPalmer): Good morning. Health workers have now injected more than four billion doses of the coronavirus vaccine into arms worldwide, and, yet, that's just about a third of the minimum that's going to be needed to bring this pandemic under control.

(Begin VT)

ELIZABETH PALMER: Southeast Asia is still a hotspot. In Bangkok, monks came to get their shots after authorities saw COVID spreading in crowded temples. Meanwhile, refrigerated containers are back in service to store the dead. The first time they have been needed since Thailand's tsunami in 2004. In the south of neighboring Myanmar, medical staff had to evacuate patients from a flooded hospital. After a recent coup, public health systems are collapsing. And experts say half the country could be infected in the next two weeks. Even ground zero of this virus, China, which had controlled it early on, is facing a fresh outbreak in the city of Nanjing that's already spread to other cities. So far more than eighty percent of the vaccine doses worldwide have gone to higher-income countries, though, donations are at last starting to flow to the Global South--notably, Africa, where COVID deaths are up eighty percent in a month. In Nigeria, four million doses donated by the United States have now landed.


ELIZABETH PALMER: And Tanzania's new president, who replaces a vaccine denier, got her shot on TV--

(Samia Suluhu Hassan speaking foreign language)

ELIZABETH PALMER: --and urged people to do the same with a shipment of newly arrived Johnson & Johnson vaccine. Haiti, too, in chaos and suffering a serious COVID outbreak finally received five hundred thousand doses from the United States. But until mid-July, it had been the only country in the Americas to have had none at all.

(End VT)

ELIZABETH PALMER: The World Health Organization warns that as long as this vaccine inequity persists, this will be a two-track pandemic, and many of the world's poorest people will not even be offered their first shot until some time in 2023. John.

JOHN DICKERSON: Elizabeth Palmer in London.

One country that started vaccinating its population early on is Israel. That head-start means the U.S. and other countries are watching Israel's COVID and vaccine data for clues about what might happen in their future. Last week Israelis started giving those over the age of sixty booster shots, becoming the first country in the world to do so after data showed diminished protection against COVID among those who had been vaccinated eight months ago. To get a sense of what Israel is seeing, that may give us guidance as to next steps here in the U.S., we turn now to Sharon Alroy-Preis, who is Israel's director of public health services. She joins us from Jerusalem. Good morning.

DR. SHARON ALROY-PREIS (Israel's Director of Public Health Services): Good morning. Thank you for having me.

JOHN DICKERSON: Thank you for being with us. So Israel is seeing the same thing we have in the States, an uptick in cases because of the Delta variant. What is the biggest concern for you with the Delta variant?

DR. SHARON ALROY-PREIS: So there are two major concerns. One is that the Delta variant is fifty percent more infectious than the previous, the Alpha variant, which was fifty percent more infectious than the original one. And we still have a third of our population that is not immunized or has not been recovered. We have a large children population. And so that is, obviously, concerning. The other point is that we are seeing about fifty percent of the people who are infected right now are vaccinated, fully vaccinated individuals. So that is, obviously, of concern if previously, we thought that vaccinated, fully vaccinated individuals are protected. We're now see-- we now see that the vaccine effectiveness against disease is roughly forty percent. It still remains high for severe disease. But we are seeing diminished protection, especially for people who have been vaccinated earlier.

JOHN DICKERSON: So in that category of those where you're seeing diminished protection, is it possible to break out what portion is diminished because they received the vaccine earlier? And what portion is-- are those who've been vaccinated, who are infected, who have, for lack of a better term, a robust vaccine protection?

DR. SHARON ALROY-PREIS: That was the-- the million-dollar question for us. And we've been following this for several weeks now trying to tease apart whether it's a problem of elderly individuals who have lower immune system response, and that together with a Delta variant more infectious. We see this. Or it's really waning immunity. And what we have been seeing in the past several weeks is actually an evidence that there is waning immunity. We compare people both over the age of sixty, but also between sixteen to fifty-nine who were immunized early on. So we were fully vaccinated by the end of January, we see infection rate among them that is ninety per a hundred thousand which is double that of those who were fully vaccinated by March. So we see a drop in-- in the vaccine effectiveness against disease for those who have been vaccinated early on. And we see it for both elderly people over the age of sixty, but also for younger.

JOHN DICKERSON: And so that data, presumably, obviously, is what's leading to the booster shots. Have you been able to draw any conclusions from those who've gotten a booster shot? Has it worked as you'd hoped?

DR. SHARON ALROY-PREIS: So we've just started the booster shot. I will-- I have to explain that the decision to make a booster shot available is a combination of two. First is really the evidence of what we think is waning immunity and the difference between the infection rate between those who were vaccinated early on and those who were vaccinated later, but also the evidence that we have increased severe and critical condition-- hospitalization with severe and critical conditions among the sixty and above population who are fully immunized. And-- and that's together with the fact that we are seeing lack of-- lack of response to the vaccine over time has led us to suggest to people or actually allow them to be vaccinated a third time. So it's-- it's not just the fact that we're seeing more disease, but they're getting to severe and critical conditions.

JOHN DICKERSON: On the question of mask mandates, Israel has reinstated those. Are you seeing the same thing that-- that seemed to concern officials here in the United States about those who are vaccinated being capable of spreading? And that that was a finding they hadn't seen here in the States before.

DR. SHARON ALROY-PREIS: So we are-- we are looking at that. We are trying to introduce back what we call the green pass, which means people can go into events with a certificate that they have been vaccinated or recovered individuals or to be tested. In order to continue with this policy we needed to check if vaccinated individuals can infect others. We know that they can be infected. We see them. They're fifty percent of the confirmed cases on a daily basis now. But the question is whether they can infect others. And we actually saw that eighty percent of vaccinated individuals who have become confirmed cases themselves, eighty percent of them have zero contacts that have been confirmed and another ten percent have-- have only one contact that-- that was confirmed to be a case because of their connection with this individual. So their ability to-- to infect others is fifty percent lower than those who are not vaccinated.

JOHN DICKERSON: So just so I make it abundantly clear, those-- you-- you found that there is some very small amount of those who've been vaccinated who can spread, but it's quite small. The majority of those have been vaccinated--


JOHN DICKERSON: --you found are not spreading?

DR. SHARON ALROY-PREIS: Exactly, exactly. There is a spread among household contacts, but if we take household contacts out of the equation, this-- the-- the-- the risk of-- of confirmed case who is vaccinated to infect others is about ten percent for-- to infect one other individual and lower than ten percent to infect more than one.

JOHN DICKERSON: All right. Wonderful. Doctor Sharon Alroy-Preis, thank you so much for being with us. We really appreciate it.

DR. SHARON ALROY-PREIS: Sure. Thank you for having me.

JOHN DICKERSON: And we'll be right back.


JOHN DICKERSON: We go now to former FDA Commissioner Doctor Scott Gottlieb, who is also on the board of Pfizer, and he joins us from Westport, Connecticut. Good morning. All right. Let's start, Doctor Gottlieb, with what Doctor Alroy-Preis was saying about this very specific issue of breakthrough cases. So once people are vaccinated, there are some breakthrough, as everybody expected, that they would get infected. But what Doctor Alroy-Preis was saying was that of those breakthrough cases, ten-- only ten percent infect one other person, and the percentage is even lower for those who infect more than one. So it seems like the case of-- breakthrough cases is a small set. And then there's an even smaller set who might pass on the infection to others. Is that the way you see it?

SCOTT GOTTLIEB, M.D. (Former FDA Commissioner/@ScottGottliebMD): That's right. We know that there is more people with this Delta variant who've been vaccinated who are probably spreading the infection, but it's still a very small percentage of people who are becoming infected after vaccination and who then are going on to spread the infection to others. Remember, the original premise behind these vaccines were that they would substantially reduce the risk of death and severe disease and hospitalization. And that was the data that came out of the initial clinical trials. That premise is still fully intact. We still see that these vaccines are doing a very good job preventing symptomatic disease, preventing hospitalization and death. The second premise around these vaccines is that they would reduce the incidence of infection, any infection, including asymptomatic infection, and they can also reduce the risk of transmission. And, therefore, they would be an important public health tool in efffectively ending the epidemic, the pandemic, because they would prevent people from transmitting the virus. That premise is still intact. But what we see with the Delta variant is it's diminished. There is more evidence that people are likely to spread the Delta variant even after vaccination than they were likely to spread the other variants. But it's still a very small percentage of people. But we need to recognize, especially for vaccinated people who might be in contact with young children, with elderly individuals who are at risk, that there is a risk that they could develop a mild or asymptomatic infection and go on to spread it to others.

JOHN DICKERSON: So Doctor Fauci said that they found in this Provincetown study that the amount of virus in the nasopharynx was the same as somebody who had not been vaccinated. So help me understand, that seems like if you have-- if there's a breakthrough case, then you've got the ability to spread if it's in the nasopharynx. But then what Doctor Alroy-Preis was saying was a-- that it seemed like a much smaller group of people in the breakthrough category that could pass it on. So help me understand maybe the disconnect between those two.

SCOTT GOTTLIEB: Right, the CDC is inferring from this study that there's a risk of transmission in vaccinated individuals and, effectively, what they saw was what Doctor Fauci said. High levels of the virus in the nasopharynx of individuals who were vaccinated and became subsequently infected on par with the level of virus that you would see in someone who wasn't vaccinated. But we know two things. First of all, nasopharyngeal swabs, the virus titers that you see in those nasopharyngeal swabs, while it's suggestive of someone's ability to spread the virus, it doesn't prove that they're able to spread the virus. So it's not a perfect correlate with your ability to transmit the virus and how contagious you are. You really want to measure virus levels in the lower airways because that's where aerosols are created. And we know that you spread this virus through aerosols. We also have other evidence that came out this week that people who are vaccinated, even if their viral titers are very high initially for the first twenty-four hours after they become infected, even if they-- even if they're asymptomatic and infected, we know their viral titers fall much more quickly than those who are unvaccinated. So maybe after a day or two days or three days, they're much less likely to spread the virus than someone who remains unvaccinated. So, initially, someone who's vaccinated may-- may have the same level to spread the virus, may be on par with someone who's unvaccinated, but their ability to spread the virus probably diminishes more quickly. And, therefore, out in the community, if you were measuring their ability to transmit the virus, you would probably see on the whole, they're less likely to be contagious.

JOHN DICKERSON: So one of the challenges that we've talked about before is that we weren't testing every single breakthrough case. CDC was waiting until people got to the hospital. They had some inklings of-- of breakthrough cases that weren't at the hospital, but they weren't testing. Should we do more testing to get to the bottom of this and this question?

SCOTT GOTTLIEB: The CDC has cohorts. They have tens of thousands of people that they're following in cohorts who were vaccinated at different points in time and they're looking at that data. They peek at that data every two weeks to try to look at whether or not they're seeing a rising incidence of breakthrough cases in the vaccinated individuals. And-- and the data that came out to the Washington Post in some slides that were leaked to the Washington Post, do suggest that the CDC has some evidence of declining efficacy in the vaccinated population, particularly, older individuals who were vaccinated back in December and January. And that's causing a rethinking of this whole question around boosters. I do think we should be following this. CDC is following it in some smaller cohorts. Other countries are following it in much, much larger data sets, including the United Kingdom and Israel. And Israel really was the first to detect this rising incidence of breakthrough cases. And remember, two things are happening at once here. On the one hand, we have a much more contagious variant, the Delta variant, that's probably breaking through the vaccines a little bit more than the older variants. On the other hand, we have a population that is further out from when they were initially vaccinated. So if there's any declining efficacy of the vaccine, it's colliding up against a variant that's more contagious.

JOHN DICKERSON: So does this speed up the need for boosters, what-- these new findings that are-- that are showing the-- the breakthrough cases. Should that speed up their thinking about boosters here?

SCOTT GOTTLIEB: Well, look, I certainly think so for the elderly and the vulnerable population. And one of the-- one of the pieces of data that was in that CDC data said they looked at an outbreak in nursing homes and they found that the vaccines in that setting, in this outbreak was sixty-one percent effective at preventing infection. They were still eighty-five percent effective at preventing severe disease. So the initial premise is still intact that they're preventing people from getting very sick. But if you see some decline in their ability to protect particularly older individuals, vulnerable individuals from any infection at all, that's suggestive that, eventually, you're going to see the-- the-- the infection breakthrough in more cases in those individuals and start causing symptomatic illness.

JOHN DICKERSON: All right. Doctor Scott Gottlieb, as always, we really appreciate it. Thanks so much for being with us.

SCOTT GOTTLIEB: Thanks a lot.

JOHN DICKERSON: That's it for today. Until next week for FACE THE NATION, I'm John Dickerson.

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