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Transcript: Scott Gottlieb on "Face the Nation," July 4, 2021

The following is a transcript of an interview with former FDA Commissioner Scott Gottlieb that aired on Sunday, July 4, 2021, on "Face the Nation."

ED O'KEEFE: We go now to former F.D.A. Commissioner Dr Scott Gottlieb who's on the board of Pfizer. Good morning, Doctor. Good to see you. Happy Fourth.


ED O'KEEFE: As we get started, I wanted to follow up on something Jeff Zients told us there in our conversation, that the science and trials weren't complete in terms of whether boosters- booster shots will be necessary. That's not what we've been hearing from drug companies and other medical professionals. In your view, are we going to need boosters this fall? 

DR. GOTTLIEB: I think some people will have the option of getting boosters. And I think it's going to be recommended for some people. The trials are ongoing. Jeff is right. Those trials are going to read out in the next couple of months. There is some data right now that does support the fact that when you get a booster, it does broaden your immunity and does deepen your immunity, meaning that you get more antibodies in terms of- from the initial response from the second shot and you get a broader complement of antibodies. You get what we call polyclonal response, which means you're getting antibodies against more parts of the virus, which does suggest that a booster could give you better immunity against some of these variants. I think where we're likely to end up with this, is that there could be a recommendation for certain people, people who are maybe over the age of 65 or 60, people who are out a certain length of time from receiving their second dose. And I think that that will be the recommendation that ACIP or CDC ultimately settles on, including people who may have pre-existing conditions that put them at higher risk of COVID disease. So the boosters are unlikely to be recommended for everyone. I think they'll be recommended for people who are at higher risk. And what we've seen from the clinical data and the clinical data that we have right now is people who have been naturally infected from COVID looking at the durability of their immunity. What we see from that data is that the immunity does decline over time. So when you look out seven or eight months from people who have been naturally infected, particularly among older individuals, the immunity does decline over time.

ED O'KEEFE: And when it comes to the Delta variant, which is now raging across many western and southern states, how many more Americans could be affected by that and how soon?

DR. GOTTLIEB: I think given how transmissible this variant is, it's likely to infect about 85% of the population or what- what I mean to say is 85% of the population is going to end up with some level of immunity to coronavirus. We now have a choice in terms of how we acquire that immunity. You can acquire it through vaccination or you're going to end up acquiring it through natural infection. I think people who choose to acquire it through natural infection may end up acquiring it more than once. But given how transmissible this is, it's probably going to infect or leave 85% of the population with immunity before it starts circulating with this level of velocity. We now have about 55% of the population with at least 1 dose of the vaccine in them. So it leaves a lot of people who are going to be vulnerable to this infection. We've probably infected about a third of the population. So some complement of people who have chosen to remain unvaccinated have been previously infected with the virus. But there's still a lot of vulnerable Americans when you talk about absolute numbers of people.

ED O'KEEFE: All right. Well, we need to take a short break, but we'll have more questions for Dr. Gottlieb in the next segment. Stay with us.


ED O'KEEFE: Welcome back to FACE THE NATION. We want to continue our conversation with former FDA commissioner Dr. Scott Gottlieb. Doctor, the White House is holding this big Independence Day event tonight. They've been talking broadly about declaring independence from the pandemic, or the idea that Americans will be able to feel a little more normal than they did this time last year. Would it be wise to be declaring independence from the pandemic right now?

DR. GOTTLIEB: Well, look, I wouldn't be declaring mission accomplished. I think this is going to be a long fight, but I think we have had a near term victory against the virus in terms of getting immunity to the population through vaccination. And- and virus levels are much lower than they were certainly last summer and are likely to remain low. I think you're seeing a decoupling between cases and hospitalizations and deaths because there's so much immunity in the population, not just through vaccination, but also through prior infection, people who have acquired immunity from prior infection. But this is likely to become an endemic virus. We're going to have to deal with it. It's likely to be on par with the second circulating flu this winter. At- at best, it's going to be on par with the second circulating flu. It could be a little bit worse. And I think we're going to need to think differently about respiratory pathogens generally in the wintertime and be more vigilant about the spread of diseases like flu and like coronavirus. Flu is fearsome enough. We were far too complacent about it. And given the fact that we're now going to have the equivalent of a second circulating flu, I don't think we could be complacent about the risk of respiratory pathogens in the workplace, in schools anymore. So people are going to need to be more vigilant. We're going to have to do some things differently. That doesn't mean our lives change, but this is going to be a new normal.

ED O'KEEFE:  Well, and about that, because you've talked a bit about how we have to start thinking differently. Does this mean, for example, we're probably going to have to keep a face mask in our pocket at all times or in our bag, especially come the fall in the winter, and that at times a company or a school or the airlines may say, hey, this week or during these few weeks might be best to mask up or just keep your distance? And is that going to become normal?

DR.GOTTLIEB: I think the use of masks is going to become more normalized. I think people are going to use them on a voluntary basis and certainly people are at higher risk from COVID, bad COVID outcomes or from influenza. But I think going to work with the sniffles is going to be frowned upon. I think businesses are going to have access to routine testing. I think there might be symptom checks within certain settings. If you have a congregate setting where a lot of people are getting together they might check symptoms. Feverguns might become more routine, even though they're not that helpful. I think you're going to see a veneer of safety superimposed upon normal life. That doesn't mean that there's going to be mask mandates reimposed. I'm not sure that's necessarily what we should be doing right now, given the substantially reduced overall death and disease we're seeing from coronavirus, which is likely to continue as long as this virus doesn't mutate in an untoward way. But I do think we're going to need to be more vigilant about the spread of respiratory pathogens. I mean, think back. It was always looked upon as being something that was somewhat brave if you toughed out a cold. That's going to be really frowned upon now. You don't want to be in a social setting where you don't feel well. You're going to be asked to stay home. So things are going to be different. I think we're going to deal differently with the risk of respiratory diseases in the wintertime.

ED O'KEEFE: So in other words, if you're that employee who shows up at the office with the cold and says, no, it's fine, I'm going to work through it, really, the boss should be telling you, no, go home. Rest up and don't get everybody else sick.

DR.GOTTLIEB: And you might- and you might have a symptom check before you even come to work where they ask you a series of questions. And if you're a child who shows up at school not feeling well, you'll be sent home as well, too. So I think societally we're just going to have a different etiquette around the risk of respiratory pathogens. We can't afford the morbidity and mortality from flu and coronavirus being twin viruses that circulate at very high levels. Again, we were too complacent about the flu. We let it infect and kill far too many people. I think we're going to have to think differently. That also means improving air quality in workplaces. We're going to be looking at things like air flow and filtration in the same way we greened buildings. I think we're going to make buildings more healthy as well.

ED O'KEEFE: Making his 68th appearance on FACE THE NATION, you have surpassed Bob Dole and Joe Biden, and you've got a ways to go to catch John McCain. But Dr. Scott Gottlieb, we appreciate you being here. And we'll be right back.

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