Transcript: Scott Gottlieb on “Face the Nation”

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The following is a transcript of an interview with former FDA Commissioner Scott Gottlieb that aired December 27, 2020, on “Face the Nation.”


MARGARET BRENNAN: We want to go now to former FDA commissioner Dr. Scott Gottlieb. He’s also on the board at Pfizer and joins us from Westport, Connecticut. Good morning to you. You predicted–

DOCTOR SCOTT GOTTLIEB: Good morning.

MARGARET BRENNAN: You predicted last Sunday we’d have about three more weeks of increasing infections. We ask you every week, where are we at this point? What are you thinking now?

DR. GOTTLIEB: Well, look, there are signs that the number of new daily cases is starting to plateau. It might be an extended plateau, but we’re seeing a leveling off in new cases right now. Some of that is the holiday effect. It’s underreporting around the holidays. But there is a discernible trend that we were taking even into the holidays. But, once again, the number of hospitalizations and the number of deaths is likely to lag by about two to three weeks. So even if we start to see a plateau in cases and a decline in the first week in January, it’s really not going to be towards the end of January that we start to see the burden on hospitals begin to lessen and we start to see deaths plateau. So we have a grim month ahead of us. We have a very difficult month ahead of us. And right now the cases are being led by the coasts: California, Massachusetts, New York, New Jersey to some extent. When you look at the Midwest, when you look at the Great Lakes region, Illinois, Michigan, you’re starting to see cases come down quite discernibly. So the places where the infection was first are now- it’s now slowing and it’s the East Coast and the West Coast and Florida as well, where cases are still building.

MARGARET BRENNAN: This was the deadliest week in the deadliest month for people in nursing homes and long-term care facilities. We know vaccinations began there last Monday. How soon do you think it will be before we see that relief?

DR. GOTTLIEB: Well, vaccinations are going to take about three weeks to get through all the nursing homes. I mean, we will start to see some- some indication that the vaccines are probably having an effect maybe as early as this week, because we know that immunity does start to kick in maybe a week after vaccination. They went into the skilled nursing facilities first and vaccinated there first because you have some of the highest risk people in those facilities. So that will start to have an impact on mortality trends with COVID. But, you know, it’s coming late in the season and it’s going to take a couple of weeks, maybe a week or 10 days for partial immunity to kick in. And to get full immunity, especially in an older population, you really need the booster. We do see in a younger population more robust immunity after that first dose. But in the older populations, it really requires a second dose to get the full effects of the immunity from the vaccine.

MARGARET BRENNAN: The president tweeted this morning, “Cases in California have risen despite the lockdown, yet Florida and others are open and doing well.” He seems to be encouraging the lifting of local restrictions. Is that medically advisable?

DR. GOTTLIEB: Well, look, Florida had 17,000 cases on the 26th. They have around 21,000 deaths now. I think they’re the fourth highest in the country in terms of the number of COVID deaths and the third highest in terms of the number of total cases. It is true that California is having a worse epidemic right now, although there’s some signs that the epidemic may be plateauing in Northern California. I don’t think any part of the country has really done especially well. We’ve covered every state has grappled with this. And so, I wouldn’t be trying to make comparisons between different states in terms of how they’ve approached this. Every state has had to approach it differently, because they’ve all had different challenges. Some states are far more dense, like California, than other states. Florida too is dense and I think that’s why they’re experiencing a very difficult epidemic right now. So, Florida is not out of the woods by a long shot.

MARGARET BRENNAN: Canada is now saying that it has detected evidence of that new strain of coronavirus on its shores. That means it’s here in North America. The US is set to begin requiring those coming from the United Kingdom where this is thought to have originated, and people will have to be tested within 72 hours of arrival. Is that going to make any impact?

DR. GOTTLIEB: Well, I think it’s probably here in the United States, and- and it could be here in a reasonable number at this point. Where- we don’t sequence a lot of samples in this country. And a lot of that sequencing that does get done, gets done in private labs, and doesn’t get aggregated into public database- that needs- databases. That needs to be fixed. In the U.K., they’re sequencing about 10% of all the samples. Here we’re doing a fraction of 1%. I’m on a board of Illumina, one of the companies that’s involved in sequencing. We probably need a better approach to more systematically sequenced strains in the United States to track changes and new variants in this virus. We’re not doing that. And so we probably wouldn’t be detecting it if it was here in sort of low numbers, which I suspect it is.

MARGARET BRENNAN: So it may be here, we just don’t know it. On the vaccine, nine and a half million doses of the two approved vaccines have been distributed. As of the week past, the CDC says a bit more than a million vaccinations have actually taken place. What do you think of this pace?

DR. GOTTLIEB: Well, the pace is slower than what was stated. I think it’s probably realistic to think that the pace is going to be a little bit slower, especially as we try to move through hard to vaccinate populations next month. I suspect there’s more than a million who have been vaccinated. There’s a lag in reporting. But the idea that we’re going to get to 20 million vaccines, vaccinations by the end of the year, that’s probably unrealistic at this point. And remember, that’s after they cut in half. They only shipped about 45% of the vaccines to states. So the states weren’t able to absorb this. Now, I think- I think they’ll get up and running and get better systems in place to distribute these vaccines more efficiently. I think they’re going to turn to CVS and Walgreens to start distributing them in the community, and that’s a pretty big footprint. But again, as you get out into the community, try to vaccinate a harder to reach population, it’s going to become significantly more difficult to get those vaccines out. And so the fact that we’ve struggled to vaccinate health care workers and nursing home patients, that shows we need to be investing more in these efforts.

MARGARET BRENNAN: Good point. Dr. Gottlieb, thank you as always for your analysis. And before you go I do want to—

DR. GOTTLIEB: Thanks a lot.

MARGARET BRENNAN: –thank you. The whole team wants to thank you for helping to guide our viewers and us through this crisis. And we want to thank your wife and your family for sacrificing your Sunday mornings so that you can join us here. We’ll see you next year.

DR. GOTTLIEB: Thanks for the opportunity. Thank you.

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