The following is a transcript of an interview with Dr. Scott Gottlieb that aired on Sunday, Dec. 18. 2022, on “Face the Nation.”
MARGARET BRENNAN: Another thing Americans are watching closely: that surge of viruses inundating us this holiday season. Dr. Scott Gottlieb is a former FDA commissioner and a Pfizer board member and we welcome you back, Dr. Gottlieb.
SCOTT GOTTLIEB: Thanks a lot.
MARGARET BRENNAN: The White House says this is the worst flu outbreak in a decade. RSV, COVID they’re surging. 77% of ICU beds in the country are currently full. How dangerous are these next few weeks?
GOTTLIEB: It’s going to be a difficult few weeks, we’re right in the thick of respiratory pathogen season. That’s the worst in recent memory. It’s being driven largely by flu. This is a historic year for flu, probably the worst in the last decade, as you mentioned. COVID is exacerbating that. We also have an epidemic of respiratory syncytial virus which seems to be abating right now. Flu also seems to be peaking in certain parts of the country, it’s rising in other parts of the country. It’s decreasing in the South, rising in the North. And COVID is contributing to that. It’s pressing families, it’s also pressing hospitals, as you mentioned. 80% of hospital beds right now are full, the hospitals haven’t been this full since the peak of the Omicron wave last winter. The difference is that last winter 25% of those hospital beds were filled with COVID admissions. Right now only 6% are filled with COVID admissions. So a lot of them are influenza admissions, and other respiratory pathogens like adenovirus, parainfluenza, all the things that plague us each winter, are coming back with a vengeance.
MARGARET BRENNAN: A lot of bugs. But if the flu vaccine is such a good match, as you’ve said before, to this current strain, why are so many Americans getting sick?
GOTTLIEB: Well, a lot of people aren’t getting the vaccine, first of all. And we know the vaccine isn’t 100% protective against infection. What the vaccine does in the setting of flu is reduce your chances of having a symptomatic infection and reduce your chances of having a severe outcome similar to how we’re using it with COVID. The predominant strain of flu right now that’s circulating is H3N2. The vaccine, as you said, is a very good match for that strain, maybe 60 to 70% protective. The other strain that’s circulating is H1N1, about 20% of infections are H1N1. The vaccine is also a good match for that strain. And the difference between those two strains is that H3N2 typically peaks earlier in the winter. H1N1 may peak later. So it’s not too late for people to get their flu vaccine. If people go out and get it now, they’re going to have some immediate protection from it. And we could see a situation as we’ve seen in other winters where the predominant strain, the H3N2, starts to decline. And then H1N1 infection picks up.
MARGARET BRENNAN: Well, the other thing particularly annoying parents of young kids like me is the shortage of antibiotics. Why don’t we have enough supply?
GOTTLIEB: It’s really demand driven. So distributors made estimates on how much demand there would be this year. They’ve had lower demand the past two years because there was less bacterial infections because we were all taking certain steps to prevent the spread of disease. Demand went up this year, they anticipated some increase in demand, but not as much as we’re seeing and not this early in the season. So it’s not any kind of disruption in supply. This isn’t like what we had with baby formula where manufacturers have been taken out of the market. This is a sophisticated supply chain, all the manufacturers are in the market. They just didn’t anticipate this much demand this early in the season. Supply should catch up with demand and there are alternatives for things that are in shortage, like amoxicillin, the oral suspension of Tamiflu is also in shortage. Doctors and pharmacies can compound that from the capsules. So there are alternatives. It’s just going to be difficult in some instances for families to get their hands on those alternatives.
MARGARET BRENNAN: Yes. You know- I know- I know you’re saying things are better versus where we were on the COVID front. But Dr. Fauci was on this program a few weeks ago, and he said he was tracking new COVID variants that evade the protection of monoclonal antibodies that are used for treatment and prevention. I know there’s been studies on that that also say the same thing about the vaccine. What level of protection is there against these new variants?
GOTTLIEB: Well, there was data out from the CDC on Friday that showed the vaccines providing good protection, particularly in the older individuals. The new vaccine. This- this new bivalent booster based on the new strain. So it’s based on BA.5. What we’re seeing right now is 40% of infections are BQ. 1.1, which is a derivative of BA.5, the strain that the vaccine is based on. About 30% of infections are BQ.1. There still should be good protection from the vaccine against those new variants. The one we’re more worried about is a variant called XBB. So far, that’s not spreading in the U.S. that much. It’s about 5% of infections. It’s held steady for about four weeks right now. That strain spread a lot in Asia, it didn’t spread a lot in Europe. So it could be the case that BQ.1 and 1.1 crowd out XBB, but the concern is that if XBB continues to persist, you could see a second wave this spring. We don’t think that’s going to happen, but it’s a possibility. But people are still gonna get good protection from the existing vaccines, the updated vaccine against the strains that are circulating right now. So the study that came out from CDC showed about 80- 70 to 80% protection from hospitalization from those over the age of 65. On top of the protection that they got from the old vaccine, so that’s quite meaningful for a lot of individuals.
MARGARET BRENNAN: I want to ask you about Title 42. In March of 2020, that was when the CDC director put this in place. It’s a public health law to expel migrants in order to stop the spread of disease. That was the premise. Is there any public health reason to keep it in place now?
GOTTLIEB: Well, look, I think as a matter of public health, we should be expiring a lot of these emergency measures that we’ve put in place. Not just Title 42, but also the national emergency that we put in place. I think what’s happening is a lot of these are being extended to serve other policy and political goals. And that’s ultimately going to undermine our ability to implement these public health measures in- in the future. If we need to have expedited removal of people crossing the border illegally, I think that should be contemplated in the context of broader immigration reform and as a matter of law enforcement, but not as a public health measure at this point. I think all of these public health emergency measures that we put in place should be expired.
MARGARET BRENNAN: Dr. Gottlieb, thank you so much, and I hope you stay healthy this holiday season.
GOTTLIEB: Thanks a lot.
MARGARET BRENNAN: We’ll be right back.
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