Transcript: Dr. Scott Gottlieb on "Face the Nation," April 10, 2022

The following is a transcript of an interview with Dr. Scott Gottlieb that aired Sunday, April 10, 2022, on "Face the Nation."

MARGARET BRENNAN: Welcome back to FACE THE NATION. We turn now to the COVID pandemic and the uptick in cases in some parts of the country. We go now to former FDA commissioner and Pfizer board member Dr. Scott Gottlieb. Good morning to you, Doctor. I mean the numbers — compared to where we were, obviously, this is a dramatic improvement, but still 600 deaths a day. Here in the East Coast, we've had so many high profile infections. The Attorney General, the Speaker of the House, the CIA Director, the Commerce Secretary. How do you characterize where we are right now?

DR. SCOTT GOTTLIEB: Well look, cases around the country are coming down. We have about nine cases per hundred thousand people per day. So prevalence is low. There's no question that we're experiencing an outbreak here in the northeast, also the mid-Atlantic, parts of Florida as well, which tends to track the northeast. It's driven largely by BA.2. And I think that we're dramatically undercounting cases. We're probably only picking up one in seven or one in eight infections. So when we say there are 30,000 infections a day, there's probably closer to a quarter of a million infections a day. And they're concentrated in the Northeast right now. And that's because a lot of people are testing at home. They're not presenting for definitive PCR tests, so they're not getting counted. So when you look at the Northeast, for example, cases are up 89% over the last 14 days in Washington, D.C., they're up 58% in New York City, up 65% in New Jersey. So cases are up in the Northeast, the mid-Atlantic are going up. But the rest of the country looks pretty good right now. And I think the net-- the net trajectory is that we're likely to get through this  BA.2 wave. It's likely to be regionalized. I don't think it's going to become a nationalized epidemic of BA.2. And as we get further into the spring, we're likely to see these case counts come down, even here in the northeast.

MARGARET BRENNAN: But from a practical perspective, when you say we're dramatically underreporting COVID infections, the guidance to the public is look at your local community infection level to make your own judgment. So if we can't trust the data at the local level, if the CDC is already saying, you know, things are looking great, how do I accurately judge what's actually happening and when I need to put my mask back on?

DR. GOTTLIEB: Yeah. Well, CDC has shifted a lot of their measurement towards hospitalizations and away- and away from actually looking at cases. And hospitalizations are low right now. There's 15,000 people hospitalized. That's the lowest point we've been at any point in this pandemic. And I suspect hospitalizations aren't going to go up a lot because a lot of the people who are getting infected right now with BA.2 are people who escaped the B.1 Omicron wave, and they escaped it in large measure because they were vaccinated. They were prudent. They took precautions, they tested. And so the simple fact is that a lot of the people who are getting infected right now are people who are vigilant. And they are more likely to take decisive action once they diagnose an infection, get treatments, things like that. So I don't think hospitalizations are going to tick up a whole lot in terms of knowing what your local prevalence is. It's tough right now. I think you have to look at the state data and you have to look at week over week increases and just assume that we're only capturing a very small percentage of infections. So if you see cases going up in your local community, that's a pretty good indication that there's more infection than what we're measuring.

MARGARET BRENNAN: So there are a lot of unmasked indoor events that are happening still here in the Northeast mid-Atlantic. Should the CDC change the definition of fully vaccinated to make sure it includes that booster dose? Does that make a difference?

GOTTLIEB: The booster dose clearly makes a difference, not only in reducing your risk of getting infected and spreading the infection, but even more so in reducing your risk of having a bad outcome. I think we're in this unusual period right now where we're calling these boosters. We're telling that people who are vulnerable to the infection to get a shot every six months, that's effectively what we're doing to make sure that they're up to date and have maximal protection. And we're transitioning towards this probably becoming an annual vaccination starting this fall. The problem is that we've been in continuous waves of spread. And so to maintain people's immunity, it's required as this virus has evolved into these new-- new variants, it's required a booster every six months. But I think the reality is that that by the fall, this will become an annual vaccine. And then the CDC is going to talk about being up to date. Have you had your vaccine this season? I think they're reluctant to pull the trigger on that right now because they're uncertain about what the recommendations are going to be in the fall. But it's more than likely that there'll be a recommendation for everyone to get another dose in the fall. And that will be the start of this becoming an annual vaccine, I believe.

MARGARET BRENNAN: But some of the CDC guidance, like close contact, still remains at this six feet of distance, 15 minutes of time. Is-is that actually close contact? I mean, is shaking someone's hand and kissing someone on the cheek advisable right now?

GOTTLIEB: Well, look, that's close contact shaking someone's hand…

MARGARET BRENNAN: Even if it's less than 15 minutes?

GOTTLIEB: - and air kissing or hugging that was close contact. Well, I mean, that's the problem with the CDC guidance. The CDC guidance was always bizarre. It talked about 15 cumulative minutes as if this is radiation exposure, that you have increased risk from cumulative exposure. This is binary. You either catch it or you don't. And what CDC is defining is a minimum standard for what they believe close contact is. But if you're hugging someone, that certainly supersedes 15 minutes of being around someone within six feet. And so we just need to be practical about this. Close contact is what we what we know close contact is. With respect to the President, I hope he does well and doesn't catch it. I do think he's probably out of the woods from his exposure to the Speaker of the House, but saying that that wasn't close contact where we have pictures of him hugging the Speaker, that clearly was close contact. I just think we need to be plainspoken and practical about how we describe these things.

MARGARET BRENNAN: Well, I think people appreciate you being plainspoken. So if you are here in an area where there is an uptick, do you send your unvaccinated child to school with a mask? And how long do those youngest children remain unvaccinated?

GOTTLIEB: Yeah. Look, I think that masks in very young kids has always been difficult because the young kids can't wear medical masks and they don't wear masks well. And the cloth mask isn't providing a lot of protection against this particular strain, which is probably an airborne virus. I think if you have an adolescent child or an older child who can wear a mask well and you have access to KF-94 masks or KN-95 masks that are comfortable, or level three procedure masks, and the child can wear it comfortably and it's not interrupt - interrupting their school day,  I think thinking about masking for a week or two and prevalence is high might be a prudent step to take. Masks should be something that we look to when local prevalence is high, something that we use for temporary periods of time. So you might want to think about it for a couple a week period while the prevalence is high. I think things will come down in the northeast over the next two or three weeks. I think we're going to see things come down sharply. But right now prevalence is pretty high in the northeast in the mid-Atlantic.

MARGARET BRENNAN: And we're still waiting for May at the earliest for a kiddie vax?

DR. GOTTLIEB: I think at the earliest. So the data should be out from Pfizer in April. Moderna has obviously released their data. FDA has a lot of familiarity with these data sets and so they could act quickly on them. Assuming the data comes out in April, as is expected, I think the agency could potentially act in May. My hunch is it will slip a little bit because that sense of urgency will have dissipated because infection levels will be relatively low as we get into the spring.

MARGARET BRENNAN: Dr. Gottlieb, thank you very much for your expertise. We'll be right back.

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