On this "Face the Nation" broadcast moderated by Margaret Brennan:
- Dr. Francis Collins, director of the National Institutes of Health
- Senator Bernie Sanders, independent from Vermont
- Scott Kirby, CEO of United Airlines
- Dr. Scott Gottlieb, former FDA commissioner
Click here to browse full transcripts of "Face the Nation."
MARGARET BRENNAN: I'm Margaret Brennan in Washington. And this week on FACE THE NATION, the Biden administration's booster shot plans hit a roadblock, and Congress gets set for a fall budget showdown.
There is relief this morning in the nation's capital as the strong show of security at Saturday's rally in support of those arrested following the January 6th insurrection kept the crowds away. Nothing like the scene nine months ago. Now the focus turns to lawmakers, as both Houses of Congress return to Washington for the first time since the end of July. First up, consideration of a massive 3.5-trillion-dollar spending plan that threatens to shatter the fragile fault lines within the Democratic Party. We'll talk with Vermont Senator Bernie Sanders.
Plus, an FDA advisory panel overwhelming votes against widespread booster shots for adults, saying that the data is inconclusive. We'll ask the Director of the National Institutes of Health Dr. Francis Collins what happened.
Plus, we'll have a special conversation with former FDA Commissioner Dr. Scott Gottlieb. His new book, Uncontrolled Spread takes a hard look at America's covid failures and offers some solutions.
SCOTT GOTTLIEB, M.D. (Former FDA Commissioner/@ScottGottliebMD/Author, Uncontrolled Spread): We cannot allow something like this to hit us this bad again, so we have to prepare differently.
MARGARET BRENNAN: We'll also talk with United Airlines CEO Scott Kirby about how the travel industry is navigating the persistent pandemic threat.
Plus, a look at the fallout from the U.S. military's tragic mistake last month in Afghanistan.
It's all just ahead on FACE THE NATION.
MARGARET BRENNAN: Good morning, and welcome to FACE THE NATION. On the COVID front the news is still bleak. Nearly 10,000 Americans died last week of the virus. We now total more than 673,000 dead. Children, who are still not eligible for vaccines, account for almost 29% of all cases. And according to the AAP, there were nearly a quarter million new pediatric covid infections last week. We begin with Senior National Correspondent Mark Strassmann in Orlando.
MARK STRASSMANN (CBS News Senior National Correspondent): Instead of widespread booster, the Biden White House got a shot of rejection. An FDA advisory panel on Friday recommended Pfizer boosters only for vaccinated seniors and high-risk patients. A decision-making it challenging process even more so.
VIVEK MURTHY, M.D. (U.S. Surgeon General): If you want to roll out booster shots to the population, you can't flip a switch and make that happen overnight.
MARK STRASSMANN: Not in COVID America, where the virus now kills around nineteen hundred people a day, the highest average in six months. By any measure, COVID sorrow stalks Florida with a vengeance. More than fifty thousand Floridians already dead. An average of three hundred fifty more every day tops in America.
DR. VINCENT HSU: We've got to manage our behaviors. We got to get vaccinated.
MARK STRASSMANN: Doctor Vincent Hsu, an infectious disease physician, works at AdventHealth, Orlando. Systemwide AdventHealth has fifty hospitals with seventeen hundred COVID patients. More than half of them in Central Florida.
DR. VINCENT HSU: There is still a lot of issues with-- with taking care of these patients, supplies, space, as well as staffing.
MARK STRASSMANN: Continuous surges remain a threat?
DR. VINCENT HSU: We always have to be prepared for another surge.
MARK STRASSMANN: Critics blast the state's leadership for failing to protect the youngest Floridians.
SCOTT GOTTLIEB, M.D. (Former FDA Commissioner): The decision to keep-- trying to keep kids in school was the right decision. The decision to let the virus spread the way it has and not even employ mitigation in the schools, as they're doing now, I disagree with that decision.
MARK STRASSMANN: Pandemic politics surged blood pressures across the country.
CROWD (in unison): No more masks.
MARK STRASSMANN: In Ohio, state lawmakers threaten to block any mask mandate the governor tried to issue. And like his reaction--
GOVERNOR MIKE DEWINE (R-Ohio): Every single county is red-hot. Some counties are almost boiling over.
MARK STRASSMANN: At the United Nations, the global worry: a potential superspreader event starting on Tuesday. New York City has a vaccine mandate for conventions, but the U.N. has no power to enforce it.
ANTÓNIO GUTERRES (U.N. Secretary General): We, as Secretariat, cannot tell a head of state if he is not vaccinated that he cannot enter the United Nations.
MARK STRASSMANN: This hospital, Orlando's largest, is short hundreds of nurses despite retention bonuses and shift bonuses. And it's a crisis across America's hospitals. Early retirements, resignations, and a rash of sick days, staff burned out by this ongoing COVID siege. Margaret.
MARGARET BRENNAN: Mark, thank you.
We'd like to now welcome the director of the National Institutes of Health, Doctor Francis Collins, to the broadcast. Thank you for taking time this morning.
FRANCIS COLLINS, M.D. (Director, National Institutes of Health/@NIHDirector): I'm glad to be with you, Margaret.
MARGARET BRENNAN: Doctor, you predicted earlier this month that it may well be boosters are going to be recommended for almost everybody. That didn't happen on Friday. Do you still accept-- expect broad approval?
FRANCIS COLLINS: You know, we have to see how this plays out over the coming weeks because the data changes every day. I do think it was very significant that the FDA Advisory Committee voted unanimously in favor of offering boosters to people sixty-five and over and to others who have high-risk exposures like health care professionals. So we're starting down that path. They weren't convinced yet that the data required this for younger individuals who aren't at high risk. But I think some of the data we're seeing coming in, especially from Israel, tells me that it's likely that they will get to that point. But this was a start, and I know people were confused about different messages. But in a certain way, Margaret, this is the way it ought to be. Science sort of playing out in a very transparent way, looking at the data coming from multiple places, our country, other countries--
MARGARET BRENNAN: Yeah.
FRANCIS COLLINS: --and trying to make the best decision for right now. That's what they did.
MARGARET BRENNAN: But as a medical professional, your view is a third dose of the Pfizer vaccine will be necessary for everyone?
FRANCIS COLLINS: You know, yeah, I am a physician, a scientist, I'm not a politician, I'm trying to figure out what's the best answer here. The place that might still be somewhat questionable would be the very youngest individuals is the benefit risk needed there. But certainly, I think there will be a decision in-- in the coming weeks to extend boosters beyond the list that they approved on Friday.
MARGARET BRENNAN: So this advisory panel, as you said, gave a green light for sixty-five and up and those high risk. Who does that actually mean? Doctor-- Doctor Peter Marks, the FDA official who oversees vaccines, put teachers in that high-risk category. Do you agree with that?
FRANCIS COLLINS: I think they could be seen in that space. They are, after all, in circumstances, especially if they're in classrooms with kids under twelve who can't be vaccinated, where they are at higher risk of exposure than most of the rest of us. So maybe in that regard, they kind of fit into the same category as health care providers. The way in which the FDA panel made the vote, it was a little ambiguous. FDA is going to think about that.
MARGARET BRENNAN: Well, exactly because you wonder, is it just as risky being in a classroom as a hospital ward? And what does that mean for people like me who live with unvaccinated children? Does that put me in a high-risk category?
FRANCIS COLLINS: Margaret, that is a great question. And I think that is one the CDC will probably have their committee discuss in some seriousness on Wednesday and Thursday because, yes, you are in a circumstance with younger kids who can't be immunized where it is more likely that you could be exposed than somebody who's living alone.
MARGARET BRENNAN: We'll watch for that. If someone got the Moderna or the Johnson & Johnson vaccine and they fit into the sixty-five and older category, do they walk into their CVS this week and say, give me a third dose of Pfizer? Can you mix and match? And I know NIH is looking at this, so tell me what you're seeing so far.
FRANCIS COLLINS: So we are right in the middle of those trials to see, can you mix and match any one of the three that have emergency use authorization, can you start with one and boost with the others? We're going to know more about that just in the course of the next two or three weeks. Right now we don't have the answer. Moderna and J&J, by the way, have also submitted their booster data, so it's likely that FDA will be able to have a comment on that pretty soon. It's not quite in sync here. So people who got Moderna that would be including me need to sort of hang on here and see what the recommendation is for those of us who were interested in a booster and people shouldn't be rushing out right now and getting a booster before it's actually gone through this process, a fair number of people seem to be doing that. Hang on, people. Let's be clear, the vaccines right now in the U.S. are doing a great job of protecting people against severe disease hospitalization. What we're worried about is that it's beginning to erode and we're seeing more breakthrough cases and we don't want to get behind this virus. We want to stay ahead of it.
MARGARET BRENNAN: But the White House did want boosters broadly available this week. Do you still believe they will be widely available this week?
FRANCIS COLLINS: Well, part of the reason for this to get talked about a month ago was to be sure we were prepared. You know, I kind of think about this like when you're preparing for a hurricane. We have a system that starts noticing a tropical disturbance somewhere out there in the Atlantic long before there's a risk that it's going to hit New Orleans.
MARGARET BRENNAN: Right.
FRANCIS COLLINS: This is good. That's kind of what we're trying to do with COVID-19. So part of this announcement that this might very well, if FDA and CDC agree it'd be a good thing, was to get all the pharmacies, all of the other preparations together. So there wouldn't be a mad dash at the end--
MARGARET BRENNAN: Right.
FRANCIS COLLINS: --to try to actually implement this.
MARGARET BRENNAN: Right, which we saw with the Trump administration.
FRANCIS COLLINS: I think we are in a pretty good place by the end of this week.
MARGARET BRENNAN: Okay, well--
FRANCIS COLLINS: Yes.
MARGARET BRENNAN: So we know that next month is a target for a vaccine to five- and eleven-year-olds. What about preschoolers and the very young? When do you expect vaccines for them?
FRANCIS COLLINS: So the trials on kids under five are still going on. The data won't be submitted to FDA for a bit longer, so I think realistically we're not going to see approval in that space until very much later this year. I wouldn't want to put a precise date on it, though. There are so many uncertainties there about FDA's review and what the data looks like. But, as you said, kids five to eleven, the data is supposed to come in at the end of this month and FDA will be working 24/7 to go through it.
MARGARET BRENNAN: Mm-Hm.
FRANCIS COLLINS: So we all hope that can happen in weeks and not months.
MARGARET BRENNAN: Okay, so still potentially within this year for the very young. Quickly, as a doctor, there's going to be a massive gathering in New York City for the U.N. General Assembly this week. Are you concerned it'll be a superspreader event?
FRANCIS COLLINS: Well, I sure hope not. We've had enough of those, haven't we? I hope people are taking this with the appropriate seriousness as far as vaccines and mask wearing and not doing silly things, gathering indoors with masks off amongst people who are unvaccinated or even people who are vaccinated since we know they could also be breakthroughs and can be passing it along. So, yeah, New York, let's pay attention here. We're in the midst of a Delta surge. It is not a safe place to throw caution to the winds.
MARGARET BRENNAN: Doctor, thank you for your time this morning.
FACE THE NATION will be back in one minute with Vermont Senator Bernie Sanders. Stay with us.
MARGARET BRENNAN: We're back now with the chairman of the Senate Budget Committee, Vermont Independent Senator Bernie Sanders, who joins us from Burlington. Good morning to you, Senator.
SENATOR BERNIE SANDERS (I-Vermont/@SenSanders): Good morning.
MARGARET BRENNAN: Lots to get to with you today. But I do want to ask your reaction to news that the U.S. military killed seven children, three civilian adults in this drone strike. You have in the past been very critical of reliance on drone strikes. Are you comfortable with the Biden administration's "over-the-horizon" policy?
SENATOR BERNIE SANDERS: Well, I certainly hope they understand what happened and make sure that never happens again. And this is not only a human tragedy, it reflects on us before the entire world. It's unacceptable.
MARGARET BRENNAN: On immigration, I also want to get your reaction to what the Biden administration just said they're doing this weekend, which is to step up deportations, particularly of some of these Haitian migrants who have gathered in southern Texas, thousands of them. Congresswoman Ilhan Omar has called it inhumane. Do you agree with her and looking at what you're working on right now on Capitol Hill, do you expect immigration will be tucked into this three-and-a-half-trillion-dollar spending plan?
SENATOR BERNIE SANDERS: I hope it will in the sense that right now we have many, many millions of undocumented people in this country, people who are working hard. In fact, people who have maintained this economy, people doing the essential work, something like eleven million people. And I would hope very much, and I think the American people agree, that now is the time. And if we can do it through reconciliation, I'm there. I want to do it to move toward a path towards citizenship and comprehensive immigration reform through the reconciliation bill. That's my hope.
MARGARET BRENNAN: But that-- whether or not that can be done is still going to be decided. I know you say you want it done. But isn't this exactly the same kind of social policy that moderates are bulking-- balking at here because you're--
SENATOR BERNIE SANDERS: Well, actually--
MARGARET BRENNAN: --tucking it into a mechanism that even you--
SENATOR BERNIE SANDERS: Margaret, actually, the truth--
MARGARET BRENNAN: --have said in the past should just be used for budget and spending?
SENATOR BERNIE SANDERS: Well, the truth is that when you because we have no Republican support in trying to pass a significant piece of legislation representing working families, we have to do it through the so-called reconciliation process, which means that you have to obey the Byrd Rules. I won't go into-- bore you with all the details. So, it's something that we are arguing right now. But I do hope as we move toward what I believe is the most consequential piece of legislation for the working class of this country, as we demand that the wealthiest people and large corporations start paying their fair share of taxes as we lower the cost of prescription drugs as we expand Medicare--
MARGARET BRENNAN: Mm-Hm.
SENATOR BERNIE SANDERS: --to include dental care for seniors and hearing aids and eyeglasses as we lower the childhood poverty as we have already done, maintain that by fifty percent as a result of the American Rescue Plan. I hope that immigration reform is part of that general package.
MARGARET BRENNAN: But don't all these very worthy causes you're laying out deserve their own debate and consideration. You in the past have said--
SENATOR BERNIE SANDERS: Well--
MARGARET BRENNAN: --that this is not how this should happen.
SENATOR BERNIE SANDERS: Margaret right now we have-- right now, we have no Republican support. Zero. There's not one Republican who is prepared to stand up to the drug companies and lower the cost of prescription drugs.
MARGARET BRENNAN: And you may not have full Democratic support either.
SENATOR BERNIE SANDERS: Not one Republican who wants to build affordable housing. We can't do it without the reconciliation package. So right now, what we are doing and let's be clear, and I want the American people to understand it. We're taking on the pharmaceutical industry. We're spending millions and millions of dollars trying to make sure they could charge us ten times more than the people of other countries for drugs. We're taking on the health care industry--
MARGARET BRENNAN: Right.
SENATOR BERNIE SANDERS: --does not want to expand Medicare. We're taking on the fossil fuel industry who thinks it's okay to continue emitting carbon while destroying the planet.
MARGARET BRENNAN: Senator, but you have to--
SENATOR BERNIE SANDERS: This is really a--
MARGARET BRENNAN: You have to-- you also--
SENATOR BERNIE SANDERS: --monumental struggle.
MARGARET BRENNAN: I understand it's monumental and it's a struggle within your own party--
SENATOR BERNIE SANDERS: You understand that?
MARGARET BRENNAN: --to be frank because Senator Manchin just met this week with President Biden. He continues to say the number you're asking for, it's too big. It's too much. Will you meet with the President this week and do you plan to give anything here to get closer to the numbers--
SENATOR BERNIE SANDERS: Well, Margaret, I'll tell you this--
MARGARET BRENNAN: --that the moderates in your own party say need to be met?
SENATOR BERNIE SANDERS: Well, let me tell you this. We have started off, as you know, with, I would guess, eighty percent of the Democratic caucus supporting a six-trillion-dollar bill. Remember, this is over ten years. Per year it's less than we spend on the military. Now maybe you can tell me, or somebody else can tell me, how much we should spend to save the planet. Because what the scientists are telling us is that if we don't get a handle on climate change within the next few years, there will be irreparable damage. And you know what I got four kids and seven grandchildren. And I think we have a moral responsibility to leave them a planet that is healthy and is habitable--
MARGARET BRENNAN: Are you sure that President--
SENATOR BERNIE SANDERS: So we are working-- right now we got fifty, we got fifty votes. We're going to have to work it out, as we did with the American Rescue Plan. But I have already made, and my colleagues have made a major compromise, going from six trillion down to three and a half trillion.
MARGARET BRENNAN: So am I hearing you correctly when you say you are not willing to move on that three-and-a-half-trillion-dollar number, even if the President asks you to do it? I mean, are you risking losing out for that?
SENATOR BERNIE SANDERS: Right now-- look, right now what we are doing is we are engaging with the House and the Senate. It is a complicated proposal. All I am telling you is the three and a half trillion is much too low. A compromise has already been made; an agreement has been made. And the American people, by the way, poll after poll after poll are telling us--
MARGARET BRENNAN: Right.
SENATOR BERNIE SANDERS: --now is the time to stand up to powerful special interests. Now is the time to start representing working families. On all of these issues--
MARGARET BRENNAN: Right.
SENATOR BERNIE SANDERS: --they are enormously powerful and maybe, just maybe we can work for workers for a change and not just campaign wealthy campaign contributors.
MARGARET BRENNAN: You keep saying-- you keep saying the number of fifty votes, but it is well reported that Senator Manchin and Senator Sinema are not with you--
SENATOR BERNIE SANDERS: You know--
MARGARET BRENNAN: --on this within the Democratic Party. Are you certain--
SENATOR BERNIE SANDERS: Well, we went through this with the American Rescue Plan.
MARGARET BRENNAN: --that President Biden will get them all in line?
SENATOR BERNIE SANDERS: We dealt with this with the American Rescue Plan, which, as you know, is the most significant piece of legislation to take us out of the economic decline. And it cut childhood poverty by fifty percent. It provided unemployment benefits. It did what had to be done to get us out of the emergency. We came together.
MARGARET BRENNAN: Right.
SENATOR BERNIE SANDERS: And I expect because of the pressure of the American people we're going to come together again and do what has to be done.
MARGARET BRENNAN: Will you meet with President Biden this week, just like Senator Manchin did last?
SENATOR BERNIE SANDERS: I talked to, I talked to-- I'm happy to meet with the President any time, but at the end of the day, I think what--
MARGARET BRENNAN: So, no.
SENATOR BERNIE SANDERS: --the overwhelming majority of the American people want us to do is finally stand up for them, not just the drug companies and the health care industry and the fossil fuel industry.
MARGARET BRENNAN: Right.
SENATOR BERNIE SANDERS: This is what we are trying to do. It's an enormous fight. We're going to win it.
MARGARET BRENNAN: It's an enormous fight and we will track it. Thank you very much, Senator Sanders.
We'll be right back in a moment with more FACE THE NATION.
MARGARET BRENNAN: There were some big developments on the national security beat last week, including the Pentagon's admission of a tragic deadly mistake by U.S. military commanders last month as Americans were pulling out of Afghanistan. For more we turn to CBS senior national security correspondent David Martin. David, it's good to have you here. You heard Senator Sanders say how badly this reflects on the country in the eyes of the rest of the world. But policy-wise, doesn't this show also a flaw with the President's over-the-horizon strategy reliant on strikes like this?
DAVID MARTIN (CBS News Senior National Security Correspondent/@CBSDavidMartin): Well, this is the heart of the matter. What happens in Afghanistan matters here in the U.S. only if al-Qaeda and other terrorist groups there are able to make a comeback. The U.S. says it's going to prevent that with surveillance conducted from outside the country, drones flying from outside the country, what they call over the horizon. And that they will be able to detect a-- a plot in the works and then be able to disrupt it with a-- with a drone strike. But you have to say this mistake made in Kabul is not an encouraging precedent. They had six drones over Kabul that day--six. So now everybody is gone. They have to operate these drones from outside the country. Are they really going to be able to sustain that many drones over--
MARGARET BRENNAN: Six drones, and, yet, an aide worker is who they killed, who had no ties to ISIS.
DAVID MARTIN: It-- it was just a horrendous mistake and nobody claims it was anything but-- but that it happened in the context of a terrorist attack just a few days before. Communications, intercepts, telling them there was going to be another terrorist attack, and that it was going to evolve a white Toyota Corolla. And this aid worker just happened to be driving a white Toyota Corolla. And as he drive around Kabul just going about his business, at the same time, the drone operators are hearing this intercepts, talking about a white Corolla. And so each one of his entirely innocent stops becomes suspicious to them, especially when they see him loading containers into his trunk. They thought they were explosives when they ordered the strike and after-- after the investigation was done, of course, those containers held water which he was bringing home to his family because his home was without running water. I mean, it was-- it was just the final debacle of the Afghan war.
MARGARET BRENNAN: Well, and, you know, just this week, the-- the deputy CIA director told our Olivia Gazis that they're already tracking al-Qaeda members moving back to Afghanistan. So it raises the stakes on getting things right when it comes to--
DAVID MARTIN: Yeah.
MARGARET BRENNAN: --protecting the homeland. In this new book Peril that just came out there is extensive reporting about the decisions on both Presidents regarding Afghanistan. The chairman of the chief-- Joint Chiefs of Staff, the chief military advisor to the President said don't do it, don't do it this way. And the Secretary of Defense General Austin said the same thing to President Biden and he dismissed it.
DAVID MARTIN: He didn't dismiss it. He listened. They all give him credit for listening. But he just wasn't buying it. He just did not believe that it was worth the candle to remain in Afghanistan. Remember, Lloyd Austin had seen this movie before because he was the commander in Iraq during the Obama administration, when the Obama administration pulled all its combat troops out of Iraq, which gave rise to ISIS. And then he was the commander of the U.S. Central Command when ISIS came storming out of Syria--
MARGARET BRENNAN: Mm-Hm.
DAVID MARTIN: --and we had to basically fight the-- the war of Iraq all over.
MARGARET BRENNAN: Right.
DAVID MARTIN: So not only had he seen this movie before, he played a role in it. And-- and he had a great sense of foreboding.
MARGARET BRENNAN: And that is why that reporting is so important. David, thank you for your analysis and your time today. We'll be right back.
MARGARET BRENNAN: We'll be right back with a lot more FACE THE NATION. Stay with us.
MARGARET BRENNAN: Welcome back to FACE THE NATION.
We go now to United Airlines CEO Scott Kirby, who joins us from State College, Pennsylvania. Good morning to you.
SCOTT KIRBY (United Airlines CEO): Good morning.
MARGARET BRENNAN: United has said ninety percent of your employees are vaccinated following your mandate. What about contractors and for someone buying a ticket on your airline? How confident can they be they won't run into someone unvaccinated?
SCOTT KIRBY: Well, there are a lot of people that work in the airports that don't yet have a vaccine requirement, though the administration's role is going to ultimately take care of that. But one of the things that's important when you're traveling on an airplane, particularly once you're on the airplane, it's really the safest place you can be because of the airflow on an airplane, safest place you can be indoors. And so, wear your mask in the airport. That's a rule. And-- and before long, we'll have everyone in the airports vaccinated. Thanks to the administration's order.
MARGARET BRENNAN: Well, the Delta variant is causing problems in terms of people's willingness to buy tickets to get on planes. Your company announced that you're going to lose money the next two quarters. Why aren't people flying?
SCOTT KIRBY: Well, the Delta variant has obviously caused a downturn in-- in travel, it's particularly business travel. A lot of offices were expecting to be open again in September, and the Delta variant has pushed those opening dates back a few months. My guess is it will now be January. It appears that we've peaked in cases. Let's hope that that's the case. Let's hope that as we continue to get more people vaccinated, we really can get back to normal across the country. But the demand recovery really probably has been pushed back to January.
MARGARET BRENNAN: We'll watch and see. Would you advise the administration that they roll out another wave of mandates, this time for passengers? You know if TSA screens you to make sure you're not hurting your other passengers, potentially should they also check your card to see if you're vaccinated?
SCOTT KIRBY: Well, I think the administration is doing a really admirable job of trying to find all the levers to push to get the whole country vaccinated, and they have really got better data and science.
MARGARET BRENNAN: And they're discussing that. Should they do it?
SCOTT KIRBY: They-- you hear it sometimes. But I think the administration's perspective has been that getting people vaccinated at work, it's a one shot and you can really get a whole bunch of the country. You can get a high percentage of the country as opposed to making it a burden on people that are vaccinated every time you get on a plane, a train, any kind of public transportation to prove that you're vaccinated. So, for now, I think their approach of focusing on the employment and focusing on work is probably the right way to go. But they've got great data and science, and if they tell us that they want us to check everyone, we're prepared to do that as well.
MARGARET BRENNAN: When it comes to data and science, Doctor Scott Gottlieb, the former FDA commissioner, has argued that the Biden administration's travel restrictions that they've kept in place on Europe, on India and China, other countries, they don't really work. Have they given you a timeline on when those restrictions will be lifted?
SCOTT KIRBY: They haven't given us a timeline specifically, but they do talk to us a lot, and, you know, I think they're just trying to take a cautious approach and really put safety first as they go through the crisis. And given the case rates, you know, in Europe and the U.S. are similar in the high vaccination rates higher in Europe, actually. I'm hopeful that we'll get those borders, particularly to Europe, open soon, but they're following the data and the science. But we hope that-- that as-- as cases come down that that's something that will happen soon.
MARGARET BRENNAN: Do you think that's a political decision?
SCOTT KIRBY: I really think that they're just focused on trying to do the right thing here, and this is a lot of--
MARGARET BRENNAN: Yep.
SCOTT KIRBY: --uncertainty around what it means, and I think they're just focused on the right thing.
MARGARET BRENNAN: I want to ask you about some of what's being debated here on Capitol Hill. There are two huge bills, one of them, this 1.2-trillion-dollar infrastructure plan, it's got funding in airports included into the package. How necessary is it and how would you want that money to be programmed? What do you need it for?
SCOTT KIRBY: Yeah. So I-- I am very supportive of the entire infrastructure package, as is most of the business community. It's a great opportunity to invest in America coming out of-- out of this crisis. In airports, you know, you can fly around and see the airports. It's been a long time since we've had real investment in the airports. Our air traffic control system, you know, still flies in a lot of ways the same way we flew fifty, sixty years ago. And there's real opportunities to make it more efficient and it'd be good for the economy, good for customers, really kind of good for society as a whole.
MARGARET BRENNAN: So, you're for the 1.2. When it comes to the three-and-a-half-trillion-dollar spending bill, there's also some climate change related provisions tucked into it. We talked about that--
SCOTT KIRBY: Mm-Hm.
MARGARET BRENNAN: --with Senator Sanders. But for you--
SCOTT KIRBY: Yeah.
MARGARET BRENNAN: --in-- in private business, is-- is it just so expensive to make some of these changes on your own that you need American taxpayers to provide tax credits and to provide incentives for private businesses to go green?
SCOTT KIRBY: Well, particularly for the climate change initiatives, we do need government support, really to fund the investment. If you look at solar and wind, twenty years ago, they couldn't compete with coal or natural gas, and today it's cheaper. That's because the government provided credits to give certainty to invest in the industry, and that's what we need for things like sustainable aviation fuel. This really is an opportunity in America to drive investment, drive the next generation of great jobs that can be green, but also great jobs, great technology that we can export around the world.
MARGARET BRENNAN: So, for you, the benefit outweighs the risks here of spending that much money.
SCOTT KIRBY: Well, the climate change elements are a part of the three-and-a-half trillion so the climate change elements in particular, and I don't know--
MARGARET BRENNAN: Okay.
SCOTT KIRBY: --a hundred percent of what they are, but the ones I do know about I'm very supportive of and-- and--
MARGARET BRENNAN: All right.
SCOTT KIRBY: --hope that they pass either in this bill or somewhere else.
MARGARET BRENNAN: We'll watch. Thank you, Mister Kirby, for your time this morning.
We'll be right back.
MARGARET BRENNAN: Former FDA Commissioner Doctor Scott Gottlieb has been a valuable resource for this broadcast and our viewers throughout the COVID crisis, helping us cut through the confusion to tell you what you need to know. His new book, Uncontrolled Spread, takes a critical look at the mistakes America's leaders made in responding to this pandemic and how we need to better prepare for the next one. We sat down with him last week.
SCOTT GOTTLIEB, M.D. (Former FDA Commissioner/Author, Uncontrolled Spread/@ScottGottliebMD): I think that the public health establishment as a whole has taken a hit in the setting of this pandemic. And this isn't just a sort of Republican, Democrat, conservative, liberal thing. I think that there's a lot of people around the country who feel that the advice they got from public health officials wasn't precise, changed, wasn't-- wasn't formulated in a way where it was sort of immutable, wasn't carefully explained, wasn't propagated in a way that it could be assimilated into people's lives. You know how do I wear a mask? What mask should I wear? When should I wear a mask? When not? And things changed. And so people were confused by it and lost confidence in it.
MARGARET BRENNAN: You say the CDC, which is supposed to be the gold standard public health agency, "doesn't have an operational ca-- capability to manage a crisis of this scale." So if the CDC doesn't, who does?
SCOTT GOTTLIEB: Nobody does. I mean there was a perception early in the-- this crisis that the CDC has this, that they would have the capacity to develop a diagnostic test and deploy it and gather the data that we would need, sort of scope out what the contours of the response would be, and they would be able to deploy the diagnostic test and deploy the vaccine and stand up this infrastructure. They're not a logistical organization. CDC has a very retrospective mindset. It's a high-science organization that does deep analytical analysis of data that's oftentimes out of sync to when the decisions need to get made. They're not the Joint Special Operations Command. They don't surface real time information to-- to inform current policy making.
MARGARET BRENNAN: They're not a quick reaction force.
SCOTT GOTTLIEB: Right. They'd-- they'd rather take the data, analyze it for four months and publish it in the Morbidity and Mortality Weekly Report. And the idea that they were going to be able to mass manufacture a diagnostic test and forward deploy it, they clearly-- they contaminated their own test. So they-- they-- they botched the manufacturer of their test. But--
MARGARET BRENNAN: We needed to turn to private industry earlier in the pandemic.
SCOTT GOTTLIEB: We needed an all, but all-of-the-above approach. Certainly, by the end of January we had enough awareness that this could be a global pandemic, that someone could have hit the red button and said we need it-- an all-of-the-above-- above approach here. But CDC had the ball. CDC was following their standard blueprint. Their blueprint is-- could keep up with a slow-moving outbreak. But in a fast-moving epidemic like this, it was unmatched. Now, CDC should have raised their hand and said we really don't have this. I think--
MARGARET BRENNAN: Why didn't they?
SCOTT GOTTLIEB: I think it's very difficult for an agency to have this self-awareness that they don't have the capacity to respond in a way they're being asked. We needed to get FEMA and the DOD engaged with the CDC in trying to organize a national level response, and that-- that was a failure of political leadership I mean, and it was a failure of vision. But, you know, there were a lot of people who were good political leaders who wrongly assumed the CDC had this mission.
MARGARET BRENNAN: You say, "The point isn't that federal health officials were wrong, the point is they were working with faulty tools, faulty data sets."
SCOTT GOTTLIEB: Yeah, so--
MARGARET BRENNAN: They didn't know what they didn't know.
SCOTT GOTTLIEB: They didn't understand that this wasn't spreading like flu. If you're just looking for flu symptoms, you might not see coronavirus spreading. So they were very confident early on that there was no community spread. We should have been doing things differently in anticipation that this probably was spreading, we just weren't picking it up, which, in fact, was the case.
MARGARET BRENNAN: You also say this should have been viewed as a national security threat, and that's how we need to think of pandemics.
SCOTT GOTTLIEB: But I think the intelligence community has different tools that should be focused on this mission. We have to look at public health preparedness through the lens of national security. We make certain preparations for things that are unlikely to happen. But if they happen, they're so catastrophic that we have to prepare. We cannot allow something like this to hit us this bad again. So we have to prepare differently domestically. But, internationally, we rely on other nations to tell us when they have an outbreak. That has repeatedly failed. It failed in this case. China didn't surface the early information. They still haven't shared the source strain. So the question becomes can we still rely on the international health regulations and the W.H.O. and the World Health Assembly? Are we going to all hold hands again and promise that we really mean it this time and we're going to share information? Or do we need to get our clandestine services more engaged in this mission? And I think we're going to need to get our clandestine services more engaged in this mission. There was data very clearly available in China, in Wuhan, that if we were looking for it, we could have detected this much sooner. We could have answered some key questions. We could have seen the asymptomatic spread. We could have seen the human-to-human transmission. You could have had some key questions answered early that could have allowed us to mount a more robust response. And a two- or four-week head-start on something like this can make a very big difference.
MARGARET BRENNAN: What did you learn in the course of your research about the origins of COVID?
SCOTT GOTTLIEB: I learned that we're not going to answer this question absent one or two things happening. Either we find the intermediate host, the animal that was the-- that spread COVID, or there's a whistleblower inside China. Or someone close to this, who knows that this came out of a lab, comes forward, defects, goes overseas, or we intercept some communication that we shouldn't have had access to. Absent something like that, we're not going to be able to answer this question. This is going to be a battle of competing narratives. I think over time the side of the ledger that-- that says that this might have come out of a lab has grown more robust and the side of the ledger that says this came out of a natural species has not really moved.
MARGARET BRENNAN: When you say, come-- came out of a lab, you are saying through a lab accident, not a construct?
SCOTT GOTTLIEB: The administration has said this in the intelligence report they put out. They've sort of firmly debunked the idea that this was something that could have deliberately come out of a lab or was deliberately engineered.
MARGARET BRENNAN: Why do we need to know who Patient Zero is?
SCOTT GOTTLIEB: If we determine that this came out of a lab or we even assess that there's a high probability that this came out of a lab, I think it changes how we try to govern research internationally. The most speculative, most dangerous research often goes to the countries willing to conduct it. And the countries willing to conduct it are oftentimes the countries that have the poorest controls. The other thing we're going to need to look at is do we continue to do things like publish the sequences of novel viruses? Once you publish that sequence as part of normal scientific discourse and-- and part of the scientific process, you basically provide a recipe to anyone who's a rogue actor on how to manufacture that virus.
MARGARET BRENNAN: We're going to take a quick break, and we'll be back with a lot more of our conversation with Doctor Gottlieb. So, don't go away.
MARGARET BRENNAN: We're back with more of our conversation with former FDA Commissioner and Pfizer board member Doctor Scott Gottlieb.
MARGARET BRENNAN: What is the lesson for the Biden administration as they roll out boosters? Do they need to change the playbook from what the Trump administration did?
SCOTT GOTTLIEB: Yeah. I think the logistical lesson on the rollout of the boosters is that they need to have in place the infrastructure to actually distribute those vaccines in hard-to-reach communities and hard-to-reach settings. I think what the Biden administration has done here is by backing into an approximate date, they're now able to start that planning process in advance. If FDA does authorize it and the advisory committee of the CDC ultimately judges it to be appropriate for a certain population, they're going to be ready to start making it available in the nursing homes right away. So there's not going to be a delay. So I think they're in a better position. I don't know that the vaccine boosters are going to be controversial from the standpoint of, sort of, right versus left politics. I think where the fault lines are going to be is on some of the mandates that the administration is putting in place.
MARGARET BRENNAN: How does it sit with you when you hear members of your party, Republican Party, describe all this along civil liberties lines? Not making the medical argument, but simply around civil liberties.
SCOTT GOTTLIEB: Look, I think it's a misjudgment. There is this argument that this is an individual choice. Your choice to get vaccinated is an individual choice, and it's not an individual choice. This is a decision that affects your community. This is a collective choice. If you go-- and just like with childhood vaccinations. If you go into a school setting and you're not vaccinated for measles and you introduce measles into that setting, you're affecting your community. So I don't think governors should tell schools and businesses you can't mandate a vaccine. If a because makes a decision that the only way that I can protect my employees or my costumers is by having a fully vaccinated workforce, they should have the ability to make that decision.
MARGARET BRENNAN: But it's not just shots. We're talking about masks.
SCOTT GOTTLIEB: And the mask debate is inexplicable to me. Like, I can't decouple it, I can't explain it, I can't defend it. People generally have an apprehension about taking a medical product, especially when they're healthy, especially for a preventative purpose. I understand just, sort of, people's general questions and concerns about a novel medical product. But a mask is such a simple intervention. It's not going to cause you any harm. It's just an act of, you know, community responsibility, an act of respect. And I think, you know, the federal government is well within its right to mandate vaccinations for federal workers, for health care workers. I think even mandating vaccination within the Medicare program could be something that's defensible. But when you impose the mandate down to the level of small businesses, now you're setting up the political fault lines. You're taking something that was, sort of, subjectively political and it's going to be objectively political. So are you going to get enough benefit from a public health standpoint or the price you pay in terms of hardening those lines. I think that was worth a very vigorous debate. I hope the White House had it.
MARGARET BRENNAN: Which governors handled this the worst?
SCOTT GOTTLIEB: Certainly, looking at South Dakota, where this was just allowed to travel largely unfettered with public health interventions where you saw one of the highest death rates per capita, you have to look back and say that was a bad experience. Once we learned how to treat this, once we're able to reduce the case fatality rate by half, by the summer time, and we got there, we got there pretty quickly, states that were still excessively engulfed by this and had a lot of death and disease, those were, in part, policy decisions. Those were, in part, the result of policy choices that those states made.
MARGARET BRENNAN: I think about the first few days where this strange virus that was just surfacing started to make headlines here at home. You were starting to see things that weren't yet really being raised as red flags. How were you, on the outside, seeing things that they weren't seeing on the inside?
SCOTT GOTTLIEB: There was a presumption that the CDC has this, the department has this, the secretary of Health and Human Services is in control, so they let that health care apparatus run with the ball. It really wasn't until probably more like the end of February, the March timeframe, that you saw the White House really starting to get engaged and pull this away from the secretary of Health and Human Services and the Health Care Institutions and start to at least try to more accurately manage it. And that was the genesis of the coronavirus task force.
MARGARET BRENNAN: It's been reported that you were actually considered to come and run that task force. Is that true?
SCOTT GOTTLIEB: You know I don't know for sure. The President asked me to come in. I met with him. I met with the vice president, and they asked me to take a position as sort of as an advisor or help him oversee the task force after the vice president had been put in charge. That felt like it was moving along and more real. Ultimately, it didn't come together.
MARGARET BRENNAN: Why?
SCOTT GOTTLIEB: I don't know for sure. There were probably people in the White House who wanted to see me in that position, and probably people in the White House who didn't.
MARGARET BRENNAN: Do you regret though not being on the inside? You had been with the Trump administration till 2019.
SCOTT GOTTLIEB: Yeah, so I regret not being at the FDA. I don't know that there was much that I could have done dramatically differently inside the White House and, eventually, I would have worn out my welcome because there would have been people inside the White House who wouldn't have liked what I was preaching. If I had been at FDA with my staff, working with the-- the career staff in the device center I am pretty confident that we would have made a very hard pivot to try to instigate the private industry to start getting engaged in developing diagnostic tests early in January.
MARGARET BRENNAN: And so you wish somebody at the FDA was doing that?
SCOTT GOTTLIEB: I think that would have had to happen at the commissioner level. It couldn't happen below that level. If I would've called any big manufacturer, though, they would have done it. I have no doubt about that. Having been there and having made those calls and having known that CEOs responded positively in moments of public health crisis. That's the one thing I wish I was there to do and, you know, I wrote articles about doing that at the time, I was writing articles in January this is what we should do. But, you know, writing op-eds and putting things on Twitter isn't like being there and actually being able to pick up the phone and effectuate the action. I wish I was there. I think that that's-- the-- the FDA and the optives, the operational divisions of HHS, is where the action happens. That's where you can really affect the outcome. Affecting the outcome from the White House, much harder.
MARGARET BRENNAN: You write in March, when you went in to speak with the President that he was serious, he knew the grave risks.
SCOTT GOTTLIEB: There was a point in time when they were very concerned about this, willing to take dramatic actions. But later on their attitudes really changed to the point where when the President was contagious with COVID, he ceremoniously took his mask off. And so what message does that send to the country? But my view is that they were sold on the idea that you weren't going to be able to really affect the spread and that anything you did was just going to have so many repercussions in terms of impact on children who might not be in school, impact on the economy, that the costs were worse than the disease. And the schools is a perfect example of the lack of effective policy making. So the single reason why most schools remained shut was because the CDC was telling them they had to keep kids six feet apart. If-- if CDC had said you can only-- you have to keep kids three feet apart, then a lot of schools would have been able to open. And, in fact, when the Biden administration wanted to open schools in the spring, this past spring, they got the CDC to change that guidance from six feet to three feet.
MARGARET BRENNAN: And you write, the six feet was arbitrary?
SCOTT GOTTLIEB: The six feet was arbitrary in and of itself. Nobody knows where it came from. The initial recommendation that the CDC brought to the White House, and I talk about this, was 10 feet. And a political appointee in the White House said, we can't recommend 10 feet. Nobody can measure 10 feet. It's inoperable. Society will shut down. So the compromise was around six feet. Now imagine if that detail had leaked out. Everyone would have said, this is the White House politically interfering with the CDC's judgment. The CDC said 10 feet, it should be 10 feet, but 10 feet was no more right than six feet and, ultimately, became three feet. But when it became three feet, the--the basis for the CDC's decision to ultimately revise it from six to three feet was a study that they conducted the prior fall. So they changed it in the spring. They had done a study in the fall where they showed that if you have two masked individuals, two people wearing masks, the risk of transmission is reduced 70 percent with masks if you're three feet apart. So they said on the basis of that, we can now make a judgment that three feet is an appropriate distance. Which begs the question, if they had that study result in the fall, why didn't they change the advice in the fall? Why did they wait until the spring? This is how the whole thing feels arbitrary and not science based. So we talk about a very careful, science-based process and then these anecdotes get exposed, and that's where Americans start to lose confidence in how the decisions got made.
MARGARET BRENNAN: You do put blame on President Trump for a few things, but do you think, fundamentally, looking at everything you've analyzed, that the outcome of this pandemic would have been different if President Trump wasn't in office?
SCOTT GOTTLIEB: Well, look, it would have been different if we had different political decisions and the White House was exercising different leadership. There's no question about that. There's no question that the White House made mistakes, and the lack of consistency was a big mistake, and also the lack of using the White House as an effective bully pulpit to really galvanize a collective action that can make a difference on the margins. Allowing this to sort of get divided along political fault lines in the setting of an election when things were already-- the temperature was already very high, I think really hurt us. But stepping back from that, I think that there were fundamental weaknesses with our response that regardless of who is in power, we had an ill-prepared bureaucracy. We didn't have the right infrastructure. We didn't have the right agencies. The agencies weren't properly empowered. So even if you had competent leadership, very effective leadership up and down the chain, you still would have had some of the same problems.
MARGARET BRENNAN: The full conversation with Doctor Gottlieb about his book Uncontrolled Spread is in two parts on our website at facethenation.com. We'll be right back.
MARGARET BRENNAN: That's it for us today. Thank you for watching. Until next week, for FACE THE NATION, I'm Margaret Brennan.
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