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Scott Gottlieb discusses coronavirus on “Face the Nation,” December 20, 2020

Thought Leader: Scott Gottlieb
December 21, 2020
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The following is a transcript of an interview with former FDA Commissioner Scott Gottlieb that aired December 20, 2020, on “Face the Nation.”

MARGARET BRENNAN: We go now to former FDA commissioner Dr. Scott Gottlieb- Gottlieb, he’s also on the board at Pfizer. He joins us from Westport, Connecticut. Good morning to you, doctor. As you know, COVID presents many challenges, many of them also technical for live television. So, we hope to continue that conversation in a moment. But I’m really glad you’re here to answer some of these outstanding questions. On- on the sheer numbers alone, the CDC is predicting about 75,000 more deaths during the first week of January. How much are Christmas gatherings going to add to the strain we are seeing on the system right now?

DOCTOR SCOTT GOTTLIEB: We saw a spike coming out of Thanksgiving, if you look at the analysis done on a state-by-state basis, there was anywhere between a 10% to a 40% increase in cases off of the baseline going into the holidays. Now, some of that was just the sheer magnitude of the virus building, but some of that was a consequence of the gatherings as well, which potentiated more spread. We’ll see it coming out of this holiday. It does seem to be the case that we’re on track probably to peak in terms of the number of infections somewhere around the first week in January. So we have three more weeks of increasing infections. We’ll see a peak in infections. We’ll start to see a decline. But once again, the health care system is going to continue to see a burden well past the peak and infections because of the delay in time to hospitalization and also a delay in time to death from COVID. So after those infections peak, we’ll continue to see deaths start to- continue to increase for another three weeks.

MARGARET BRENNAN: Another three weeks. When we spoke to the surgeon general, he indicated the CDC is still trying to get information about this new strain of the coronavirus that’s been detected in Europe. And it’s just prudent planning to act like it’s already here in the United States. What do we know about the lethality of this strain?

DR. GOTTLIEB: Well, it’s probably not more lethal, but we don’t fully understand its contours. There was a question of whether or not this- there is a new variant and there’s a question of whether or not it’s become the predominant strain in London because of what we call founders’ effect. It just got into London and got into some early super spreading events, or whether or not it’s the result of what we call selective pressure, it’s being selected for because it has qualities that make it more likely to spread. Increasingly, it does seem to be the latter. It seems like this new strain is more contagious. It doesn’t seem to be any more virulent, any more dangerous than run of the mill COVID. The next question is, will it obviate our natural immunity? So, will people who had COVID from the old strain be able to get this new strain or will it obviate our vaccines? And the answer is probably not. This virus mutates like all viruses. Flu vaccine mutates- flu mutates the most. And what viruses do is they change their surface proteins. And once they do that, the antibodies that we’ve developed against the- those surface proteins no longer work. Now, flu mutates very rapidly, changes its surface proteins very rapidly. So, we constantly need to get a new flu shot. Some viruses like measles don’t change their surface proteins. And so the measles shot we got 20 years ago still works. Coronavirus seems somewhere in the middle. It’s going to mutate–


DR. GOTTLIEB: –and change its surface proteins, but probably slow enough that we can develop new vaccines.

MARGARET BRENNAN: Well, for the vaccines we have, as I know, you’ve been watching this closely, there was a bumpy rollout this week to be generous here. General Perna, who is the logistics head of Operation Warp Speed, said it was his fault. But there’s a lot of finger pointing that happened over the course of the week between the Health and Human Services secretary blaming Pfizer. Pfizer saying that it’s not their fault. What exactly happened, and is the bottom line that it is fixed or can it be fixed?

DR. GOTTLIEB: Well, I’m on the board of Pfizer, as you know, they’re running a careful process, and so what they’re doing is they’re calling up the companies on, let’s say, Tuesday, and I believe it is a Tuesday. And they’re saying, how many doses do you have available for shipment next week? And they’re doing that because they want to give the states maximal visibility into what they’re going to get. And the companies do what’s called lot release. So at any one time, they have a certain amount of vaccine available. But as vaccine comes off the manufacturing line it’s constantly getting released. And so what they’ll do is they’ll let a vaccine sit for a period of time and then they’ll do testing on it to make sure it’s stable, to make sure it’s sterile. And so on Tuesday, companies will have a certain amount of vaccine available and they’ll report that to the government. But then on Wednesday, Thursday, Friday, Saturday and Sunday, more vaccine becomes available. But the amount that they’ll ship will be based on that Tuesday total. So, there is a vaccine that’s in the warehouse. Now, that vaccine is not going to be lost. It’s going to be shipped the subsequent week. You know, my view has been from a public health standpoint, we’re at the peak of this pandemic right now. Protective immunity is important to get out there. A vaccine that’s delivered next week is going to probably have a bigger public health impact than a vaccine delivered five weeks from now. So, we should be leaning forward and trying to get as much vaccine out as possible. What they’re trying to do is give maximal visibility to the states so the states have predictability. But the consequence of that, is that there is vaccine that’s in the warehouse that won’t be shipped next week but will be shipped the subsequent week.

MARGARET BRENNAN: All right. So it’s coming. Dr. Gottlieb, thank you very much for- for- for jumping into the breach and giving us your great analysis. We’ll be right back. We’ve got Ron Klain back, and hopefully able to hear when we return.

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