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Transcript: Dr. Scott Gottlieb on "Face the Nation," December 5, 2021

The following is a transcript of an interview with former FDA Commissioner Dr. Scott Gottlieb that aired Sunday, December 5, 2021, on "Face the Nation."

MARGARET BRENNAN: We want to go now to former FDA commissioner Dr. Scott Gottlieb, who sits on the boards of Pfizer and Illumina. Good morning to you, doctor.


MARGARET BRENNAN: We have heard from the administration, there are a couple of dozen Omicron cases now here in the United States. Dr. Fauci said this morning, "too early still, but it does not look, there's a great degree of severity to it." Is it too early to say that?

DR. GOTTLIEB: It's too early to say that right now the infections, the best data is coming out of South Africa because they have more- they simply have more cases. And right now, all the evidence is that a lot of the people who are presenting with infection from this new variant are people who have been previously infected with Delta. Remember, South Africa had a very devastating Delta wave. Probably more than 90% of people in South Africa who are unvaccinated were infected with Delta. So, we don't know whether or not this new strain is inherently less virulent. So, it's a more moderate strain of COVID. It's not causing us severe illness or whether it's presenting that way simply because it's infecting people who already have some pre-existing immunity. So, they have some protection from COVID. So, they're getting infected, but they're not getting as sick. There was one study out of the Tshwane hospital, which is in Pretoria, a very hard-hit part of South Africa that came out yesterday. They looked at about 166 patients who have been admitted to the hospital since the beginning of the epidemic. In South Africa, they found 38 who are infected with COVID. Most were incidental pickups. They were people who are presenting to the hospital for an obstetrical reason or surgical reasons who are found to be COVID positive on admission. Of the nine people who had COVID pneumonia in the hospital, all were unvaccinated. So, the question right now is whether or not this is reinfected people who have Delta immunity and haven't been vaccinated, or whether it's going to also infect people who have- who've been vaccinated. There's some reason to believe that vaccines could be more protective than just immunity acquired through natural infection from Delta. That's going to be a critical question we need to figure out in the coming weeks because we have some important policy decisions that we need to make, depending on the answer.

MARGARET BRENNAN: Well, the latest infection we heard of overnight was in the state of Connecticut, where you live, and it looks like that individual has a connection back to that New York City convention that happened around mid-November. Is that now a super spreader event? I mean, for- for gatherings of that size in New York, you have to go through some screenings. They do require vaccination. Is this indicating to you some greater degree of worry than what you were saying last week?

DR. GOTTLIEB: Well, look, it's certainly a greater degree of worry hearing these anecdotes at that conference- that convention in New York only required one dose of vaccine. We don't know the quality of the masks that people were wearing. We have to presume most of the cloth masks, which aren't going to provide a very high degree of protection against something that's airborne like this. And we also have to keep in mind that we hear the anecdotes of the super spreader events like this. Where you have a single introduction and a lot of cases coming out of it, but we don't hear about all these situations where someone with this new variant came into contact with people and there wasn't any forward transmission because those don't get reported because there's no cases that result. So, I think we- we need to be careful about over interpreting these events. Now that said, it's concerning when you see a single introduction into a congregate setting and 30 infections resulting from it or more like we saw in Oslo, that does suggest something that's clearly airborne and looks more like measles than like the flu.

MARGARET BRENNAN: In South Africa, you were also seeing a spike in hospitalizations of those under the age of five. For parents like me, how concerned do we need to be?

DR. GOTTLIEB: Yeah, that's concerning. I mean, overall, about 11% of the hospitalizations have been under the age of two. And if you- if you look a little above that about, I think below the age of nine of almost 20% of hospitalizations and some of the hospitals, it's confounded by the fact that they're having a very big flu epidemic also in South Africa right now. And when a toddler presents to the hospital with a respiratory illness, what I'm told by physicians on the ground is that they make a presumptive diagnosis of COVID, even if- even if the kid doesn't test positive for COVID out of an abundance of caution. So, there may be some overreporting of COVID positives when it comes to very young children, but that's concerning. And we have to surmise that the kids are sort of a preserved population. They haven't had Delta infection at the same rate as adults, and they also haven't been vaccinated because they haven't rolled out vaccines to children below the age of 12 in any appreciable numbers. So, you know, the kids are a more vulnerable population to any new variant.

MARGARET BRENNAN: The president said no more lockdowns. He said he wants schools to try to stay open. Does the administration need to look at getting vaccine manufacturers to kind of reboot the existing vaccine to chase these mutations in the new variant?

DR. GOTTLIEB: Yeah, look, the companies are doing that. Pfizer, the company I'm on a board of, is doing that and they're going to start some manufacturing of that to be ready. This is going to be a really critical decision because what we've seen in the past, for example, when we engineered a vaccine to specifically target 1351, the old South African variant, was that vaccine worked well or appeared to work well against 1351 but didn't appear to provide as good coverage against all the other variants. And there's reason to believe that as you develop vaccines that are very specific to some of these new variants, they may not work as well against the full complement of different variants that we've seen. So, you want to try to stick with the ancestral strain, the Wuhan strain in- in the vaccine I think as long as possible. What happens is as the virus mutates, it probably starts to hide some of the viral targets on its surface. And so, you get a vaccine that doesn't provide as broad immunity to the full complement of targets on its surface. So, you get a more narrow vaccine.

MARGARET BRENNAN: And we'll hear from the World Health Organization later in the program. But I know they have suggested changing the vaccine could add to the issue of inequity around the world that we are seeing. They have said that it is all about available supply. That is the key problem they see on the African continent. Last Sunday, you told us of the eight countries under the U.S., travel ban, five of them had turned down shipments from Pfizer. We know Johnson & Johnson also said their shipments were turned down because the supply in at least South Africa that, you know, their coffers were full. Exactly what is the problem here? Why is the donation pile that the White House says they are making not getting where it needs to go?

DR. GOTTLIEB: And the White House has said the same thing that the donations from the White House have been turned down as well. Look, there was a point in time when there was inadequate supply, and the supply wasn't flowing into these countries. We're at a point right now where there is a lot of supply. Pfizer's pledged to donate 2 billion doses. And there's- we have to do the hard work of getting the infrastructure into the ground- on the ground. It also includes getting sophisticated technology into some of these regions, like the cold chain storage that's required. I think this is where the W.H.O. could be providing more global leadership. It's largely a political body. It's not on the ground. We need to do some kind of heavy-lift capability to get resources into some of these countries, so they have the logistical capacity to distribute these vaccines. You know, going into next year, we were probably going to be oversupplied with the vaccine. That equation may change now that we have this new variant and it's going to increase the premium on boosters. But regardless, I still think we're going to have enough supply to distribute it equitably around the globe, and it's going to be a question of getting shots in arms on the ground.

MARGARET BRENNAN: President Biden himself said that vaccine offers had been turned down, but he did talk about logistics. I want to ask you about something Chelsea Clinton tweeted, though, which I thought was interesting. I know you've seen it. She said, "we cannot donate our way out of the pandemic. We need tech transfers and investments to enable the world to vaccinate itself. Why does the White House continue the drip-drip donation approach rather than provide the global leadership to the world?" Is she right? 

DR. GOTTLIEB: Well, look, I can't speak for the- I can't speak for the White House. We do need to get capacities into these countries, so this isn't a recurrent problem. If COVID is going to be a long battle and it's going to be a recurrent virus that continues to mutate, countries need to have the capacity to- to deal with it on their own with global assistance, but not have to be so dependent upon western nations. Pfizer has worked to get a manufacturing facility into South Africa. They've partnered with a local company there. So, you are seeing efforts like that take root where there's- they've also donated the patents to the U.N. patent pool, our new orally available drug, and the U.N. is going to turn to Indian manufacturers to manufacture that for local- low- and middle-income countries. So, you are seeing efforts like that take shape. Merck's done the same thing with their oral pill. J&J's gotten manufacturing into South Africa. We need more of that. There's no question about that. But I think that's going to come through business collaborations and private collaborations directly between some of these countries and the companies. I don't think it's dependent upon march-in rights and sort of taking away intellectual property. I think there's ways to partner these efforts and get the support of the Western manufacturers to build out resources in local markets.

MARGARET BRENNAN: Well, we'll watch for that, and we'll get some answers from the World Health Organization shortly. Thank you. Dr. Gottlieb. FACE THE NATION will be back in a minute with the governor of Connecticut.

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