Transcript: Dr. Scott Gottlieb on "Face the Nation," August 20, 2023

The following is a transcript of an interview with Dr. Scott Gottlieb, former FDA commissioner, that aired on "Face the Nation" on August 20, 2023.

MARGARET BRENNAN: For a look at some health concerns on the horizon as we approach the end of summer, including a rise in COVID cases and questions about updates to vaccines, we're joined now by former FDA commissioner Dr. Scott Gottlieb. He also sits on the board of Pfizer, and it's great to have you here in person, doctor.

DR. SCOTT GOTTLIEB: Thanks a lot.

MARGARET BRENNAN: I want to start on some news we got Thursday. The CDC announced a highly-mutated strain of COVID has just shown up in Michigan BA.2.86. How concerned does the public need to be?

DR. GOTTLIEB: Well, right now I- I've talked to a number of virologists who are usually pretty staid, and they're pretty concerned about this. Right now, it doesn't appear to be spreading widely. There is seven strains that have been identified and sequenced in five different countries so the UK, Denmark, Israel, and now in the U.S. We don't know whether or not this has been spreading quietly, and we just didn't detect it, or it's something that's spreading very quickly. The concern is that when you look at these different strains that have been identified, they're genetically very similar so that suggests that it's probably spreading simultaneously in multiple countries. Whether or not this is going to be more transmissible than what we've seen before, that's the key question. Certainly, at this point, it doesn't appear more pathogenic so it doesn't appear to be more dangerous, but it may be more transmissible than the strains that are circulating now. And in that case, it could overtake them. It's too early to know. The testing's underway. I think we're going to know a lot more in a week or two. But to again put this in perspective, this new variant is as genetically different from Omicron as Omicron was from the original strain that emerged in Wuhan so this is a highly-mutated variant.

MARGARET BRENNAN: And that set off some alarm bells at that time. So we will watch this, but for people at home who say, 'Oh my gosh, I've heard someone has COVID.' The strain that's causing most infections is not this one.

DR. GOTTLIEB: Right. So right now the two strains that are circulating causing most of the infections is what's called EG.5. People have probably heard about that. It's called the 'Eris' strain. And this other strain FL. 1.5.1. They both have a very similar mutation in them called a 456 mutation that allows them to pierce the immunity that we've acquired from prior infections and also from prior vaccination so people are getting infected with that. The good news is is that where we are right now, relative to where we were last summer when BA.5 was spreading, is a lot better so there's far fewer infections. We have probably roughly about 600,000 infections a day happening based on the modeling work that's been done looking at wastewater data. And there's about 10,000 people that have been hospitalized in the last week. And to compare that to last year, last year at this point we had 40,000 people hospitalized, and we were running probably about 1.2 million infections a day.

MARGARET BRENNAN: Well, for those strains there is a booster shot that I know Pfizer has talked about coming to market soon. It's still not available. When do we expect it? And does it protect against these variants?

DR. GOTTLIEB: Right, so the data looks like the new booster, which is based on BA.1.15, which was the strain that emerged last spring looks like it will protect against these new variants. Now, my guess is these new variants, this infection rate from this wave of infection from EG.5 is going to be coming down by the time the new vaccine is available, which is going to be mid-September. So September 12 has been the date that they've talked about, but it's going to be some point in mid-September that these will be widely accessible in pharmacies and other health departments and so people can go out and get it. There's studies underway right now, what's called neutralization studies, basically laboratory studies to look at whether the new vaccine also covers this BA.2.86 variant that you talked about at the top of the show, and we'll have that data by the time the new vaccines become available. So by the time these are out in September, consumers will know how well it covers that new variant. We'll also probably know whether or not it's spreading.

MARGARET BRENNAN: And Moderna has one and perhaps others.

DR. GOTTLIEB: And Pfizer, and Novavax as well.

MARGARET BRENNAN: And Novavax. So what's different as we go into the fall and back to school is that the federal government emergency programs have largely stopped. So people have to actually plan getting their vaccine, you can't get them for free everywhere. How is that going to impact what the season looks like ahead?

DR. GOTTLIEB: Yeah, so insurers are going to cover these vaccines in the same way they cover flu vaccines for people who have insurance. For people who are underinsured or uninsured, the administration has a program where people are going to be able to get these for free at pharmacies. That program should be up and running by the time these vaccines become available. And they'll also be free of charge at federally-qualified community health centers, and also public health departments day one. So they should be widely accessible. It doesn't mean there's not going to be gaps in coverage and people who face certain hardships, but broadly, most people should be able to get these free of charge without a copay based on what I'm seeing right now from the insurance companies.

MARGARET BRENNAN: Of course, they have to choose to get them and we know what 17% of the population took the booster shot, according to the CDC last time around. Why does someone need to continue to update?

DR. GOTTLIEB: Yeah, look, I think we have to have a lot of humility around this virus. There's a lot we don't understand and it's continuing to surprise us, as it is with this BA.2.86 mutation, but this does look like it's going to be a flu-like paradigm where there's going to be new variants that emerge each year. Hopefully we'll guess right in terms of how we formulate the vaccines, but you're going need updated protection like you do from flu to try to match the vaccine against the variant that's circulating. People are still going to have residual immunity from prior infection, prior vaccination that protects them against severe disease, probably even if they don't get vaccinated, but if you want to update that protection and also get more protection against the possibility of infection, you will need to keep up to date with your vaccine. The flu vaccine, by the way, is available right now. I think–

MARGARET BRENNAN: Should you get it right now?

DR. GOTTLIEB: I think people should wait. I think that, you know, mid-September is probably a good time to get it. There's very little flu right now. Only one percent of the respiratory samples that were sequenced by CDC are actually flu so there's very little spreading. It does look like the flu vaccine is going to be a good match for the prevalent strain based on what we see in South America. South America is usually a good harbinger for our flu season. So that- it does look like that's going to be a good vaccine this year based on, you know, some preliminary judgments right now

MARGARET BRENNAN: And RSV?

DR. GOTTLIEB: RSV is another respiratory disease that we now have vaccines available for. We could protect ourselves from the three prevalent respiratory diseases that circulate each winter: RSV, flu, and now COVID.

MARGARET BRENNAN: Well, thank you, doctor, for laying out what the public needs to know. We'll be right back.

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