MARGARET BRENNAN: Joining us now is former FDA commissioner and Pfizer board member Dr. Scott Gottlieb. Good morning to you.
DOCTOR SCOTT GOTTLIEB: Good morning.
MARGARET BRENNAN: You told us last Sunday that we are entering the final end of this pandemic phase, but we could see an uptick in cases as we transition to the next phase. Twenty different states in this country are seeing an uptick. Should we prepare for a post-Thanksgiving spike?
DR. GOTTLIEB: Well, look, we’re going to see a post-holiday spike, there’s no question about that. People are exhausted right now, but we need to remain vigilant just for a little bit longer. I think we can finally see the light at the end of the tunnel in terms of declining prevalence on the back end of this Delta wave and also with the deployment of new technology that we have. We now have orally available drugs that should be available in the first quarter. We have vaccines available to children. So, we see that point in time when this is going to still be a pervasive risk, COVID, but it’s not going to be the prevalent risk it is right now where it’s- where it’s- dominates our lives. Now, when you look across the country, though, you really have to look at the country in terms of about 10 different regions and how this coronavirus has been experienced all through this pandemic. So, if you’re in parts of the south right now with the southeast, even if you’re in the Pacific Northwest, where cases are coming down quite dramatically or the plain states or certain mountain states, things are looking pretty good. And south- in the south, the prevalence is very low and unlikely to bump up substantially. But if you’re in the southwest right now, you’re in the Great Lakes region, Wisconsin, Minnesota, Michigan, you’re in parts of New England or western Pennsylvania or northern New York, or certain mountain states like Colorado, things don’t look good. You haven’t experienced the Delta wave yet, and things are going to get worse before they get better.
MARGARET BRENNAN: But you heard the Treasury secretary say basically everything is determined by the path of this virus when it comes to the economic recovery. When do we say COVID’s under control?
DR. GOTTLIEB: I think COVID is going to be under control in the back end of this Delta wave through a combination of population wide immunity- we’re going to have a lot of people with immunity, either through vaccination or through infection. People who choose not to get vaccinated are probably going to get infected by this Delta variant- as well as the more rapid and widespread deployment of the tools that we’re now getting available. The orally available antiviral drugs that people should have available in the first quarter if things go well, including one drug from the company I’m on the board of, Pfizer, as well as the widespread availability of vaccines, including for children. We now have the tools to really get this under control of COVID is not going away. This is going to be an endemic virus that stays with us a lot like the flu. We may have to get revaccinated for this on an annual basis, but this is not going to be sort of the pervasive risk that it is right now where it dominates our lives and dominates the economy. But there are some parts of the country that still haven’t had their- had their Delta wave that unfortunately you’re going to be hit pretty hard, especially the unvaccinated or under-vaccinated parts of the country, like the southwest right now or certain states around the Great Lakes. There’s a question of what happens in the tri-state region or the mid-Atlantic. We have higher vaccination rates and higher rates of prior infection. So far, they’re not seeing the big upticks. I think there’s still some risk in those parts of the country as well.
MARGARET BRENNAN: So, preparing us for that: The NBA is telling its players to get a booster shot as soon as possible. Dr. Fauci is saying publicly he’s leaning in pretty hard to the idea that it is absolutely essential. Why isn’t the CDC telling us to go get booster shots now?
DR. GOTTLIEB: Well, look, I think the confusing message around the boosters may, may end up being one of the biggest missed opportunities in this pandemic, we now see very clear evidence of declining vaccine effectiveness over time. There’s different reasons why that may be the case, but the trend is unmistakable. And this has been apparent since the end of the summer, now it’s very clear. Anyone who’s eligible for a booster, and most Americans probably are eligible for a booster at this point, should be going out and seeking it. And this is the fastest way that we can increase the total immunity in the population because someone who has an old vaccine that may only have 50% of its effectiveness left, they go out and get a booster. They restore 95% effectiveness based on the data that we’ve seen within a matter of days. So the fastest way that we can get increased immunity in the population and increase the total immunity in the population may be through boosting people who’ve already been vaccinated with two doses. Plus, it’s going to be easier to convert that person. It’s going to be much easier to convince someone who’s had two doses of vaccine to go out and get a third than to convince one of the 18% of Americans who’s chosen to remain unvaccinated this long to get vaccinated for the first time.
MARGARET BRENNAN: You just said that was one of the biggest missteps- missteps in this pandemic. This pandemic has been full of mistakes. Why is this the biggest one?
DR. GOTTLIEB: Yeah look, I- I think when we look back, this may be a very big missed opportunity to try to get ahead of this Delta wave, again, because this is going to be the fastest way that we can increase the total immunity in the population. We have to look at the immunity in terms of not just how many people have been vaccinated, but also the depth of immunity, how many people have a lot of residual immune protection against this virus and are going to be what we call a dead-end host and not going to be someone who can catch and spread this virus. And the fastest way to turn someone into a dead-end host is to get them fully vaccinated. There’s a lot of people with declining vaccine effectiveness right now who can both catch and spread this virus. If we give them a booster, we restore the full effectiveness of that vaccine. The other way, unfortunately, is to- to get immunity to the population quickly is to get people infected. And unfortunately, that’s the way a lot of people are choosing to do this. If you go out and start vaccinating someone right now for the first time, it might take five or six weeks for them to get full immunity in many parts of the country. This Delta wave will be over in five or six weeks, so we need to do what we can right now.
MARGARET BRENNAN: Understood. We’re 10 months into the administration. The president has nominated someone now to run the FDA. What do you think of this candidate?
DR. GOTTLIEB: Well, look, I think experience is important in these roles. That’s why Janet- Dr. Janet Woodcock has been very exceptional in this role. She has a lot of experience in the agency. Rob Califf also has a lot of experience running FDA, he is a previous FDA commissioner. I inherited his FDA, so I inherited his team when I came in. He had left at the end of the Obama administration, in the beginning of the Trump administration. I took over at the beginning of the Trump administration. I inherited his team. It was an outstanding team. I worked to keep them in place, most of them stayed. I also inherited his policies that he has set in motion, including around opioids, where he had set in motion an aggressive set of measures, increasing regulation on immediate release formulation of opioids education for providers. He also started the discussion around looking at the broader public health impact of the availability of opioids, which ultimately resulted in bipartisan legislation in the Support Act. So, Rob did a lot. I- I was the beneficiary of a lot of things that he set in motion.
MARGARET BRENNAN: Well, and- and opioids, of course, something that may come up in any hearing, and he’s already taking fire for, thank you for your perspective. The former FDA commissioner, Dr. Scott Gottlieb, we’ll be right back.
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