Transcript: Scott Gottlieb on "Face the Nation"

The following is a transcript of an interview with former FDA Commissioner Scott Gottlieb that aired May 9, 2021, on "Face the Nation."

JOHN DICKERSON: And we've got a lot to get to today, and we're going to begin with former FDA commissioner Dr. Scott Gottlieb. He sits on the board of Pfizer and he joins us from Westport, Connecticut. Good morning, Dr. Gottlieb.

DOCTOR SCOTT GOTTLIEB: Good morning.

JOHN DICKERSON: So I- every time we talk, we talk about where things are and then you kind of tell us where we're going to be. A few weeks ago, you were saying, you know, they should change the mask restrictions for outdoors if you're vaccinated. Your feeling now about maybe changing those mandates for indoor masks? You- you think they should be lifted, do you?

DR. GOTTLIEB: Well, look, COVID won't disappear. We're going to have to learn to live with it, but the risk is substantially reduced as a result of vaccination, as a result of immunity that people have acquired through prior infection. And so I think we're at the point in time when we can start lifting these ordinances in a wholesale fashion and people have to take precautions based on their individual risk. They have to judge their own individual risk and decide whether or not they're going to avoid crowds or wear masks based on their circumstances. But we've always said from a public health standpoint that we would set as a metric maybe when we get down to 10 cases per 100,000 people on a daily basis. Well, half the country's there right now. If you want to be more conservative and say five cases per 100,000 people, well, this week, by this week, probably about a quarter of states will be there. So we're at the point right now where we could start lifting these ordinances and allowing people to resume normal activity. Certainly outdoors, we shouldn't be putting limits on gatherings anymore. We should be encouraging people to go outside. In the states where prevalence is low, vaccination rates are high, and we have good testing in place and we're identifying infections. I think we could start lifting these restrictions indoors as well on a broad basis.

JOHN DICKERSON: When you talk about people's individual risk calculations, those have been all over the place. One of the things we've seen in these economic numbers on Friday was that people are still scared. Help people understand how they should think through making their own risk calculations after more than a year of kind of stabbing at trying to get some clarity to decide how to keep themselves safe.

DR. GOTTLIEB: Well, look, I think part of the hesitation right now is cultural. We have spent a year apart. We've spent a year being told to stay away from people and wear masks. I think it's going to take some time to get back in- in the normal swing of things and- and get that socialization back. But if you've been vaccinated with the mRNA vaccines or the J&J vaccine, your risk is very low from having a bad COVID outcome and your risk of getting an asymptomatic infection that you could spread to others is also substantially reduced. The data now does support that. So we could start drawing some firm conclusions and basing our public health advice on that. You know, there's one model that's out that says that if you were 65 and above your risk of succumbing to COVID, if you were infected with it was around one point one hundred during the peak of the infection and probably a little worse than that at the outset. That same model now predicts it's about one in 20,000 if you've been fully vaccinated and you're an immuno-competent person. So the risk is substantially reduced from vaccination. And I think you can sort of conclude that probably your risk from COVID if you're fully vaccinated, is comparable, maybe even less than your risk from flu if you're fully vaccinated in older individuals. So, you know, you can start resuming normal activity. I think the only residual risk for someone who's fully vaccinated is could you have asymptomatic infection that you don't know about? And if you're around someone who's immunocompromised, is vulnerable to COVID, you still want to be careful in those circumstances. But you know when you're in those circumstances and you always want to be careful in those circumstances because you don't want to pass an infection to someone who can't defend against it.

JOHN DICKERSON: So is it fair to interpret what you're saying is that if I've been vaccinated twice, even if I'm in an elderly population, that essentially the risk for me, I shouldn't think about it as a new thing, but I should think about it basically the way it would be with the regular old flu that where we are now is comparable to something we know before in terms of the kinds of risks we would take when we operated in regular life?

DR. GOTTLIEB: Look, I think that that's right. People get uncomfortable when you start comparing the- the rate of, you know, death and the risk of COVID to flu because of some of the comparisons that have been made in the past. But I think for, you know, most consumers who need something to anchor against, I think that that's a fair assessment that if you're fully vaccinated against COVID with one of the Western vaccines, your risk of having a bad outcome from COVID is about comparable to flu and maybe less because the vaccines for COVID are more effective than the vaccines for flu. So I think that that's a reasonable way for the average consumer to anchor their thinking about COVID right now. Again, the only residual concern I think a fully vaccinated person should have is, are they- are they themselves immunocompromised? I mean, and you know if you are. If you have a chronic disease that makes you more vulnerable, you'll know that new vaccines won't be as effective for you. And are you going to be around people who are immunocompromised? There you want to be more careful. That's where I would still exercise some caution. But outside of those circumstances, I think we can get back to doing normal things right now against the backdrop of a summer when prevalence is going to decline very quickly. I talked at- at the outset, about 10 cases per 100,000 or five cases per hundred- 100,000. We're dropping about one point every two or three days. So by the end of the next two weeks, most of the country is going to be around five or maybe a little bit more. It's going to be quite low, the prevalence.

JOHN DICKERSON: When you look at the map of places that have not had a lot of people getting vaccinated, do you expect that those will be, in the future, the places where we might see some occasional flare ups between now and- and the next big stage of this?

DR. GOTTLIEB: I think that's probably right. And as vaccine effectiveness perhaps declines as we head into the fall and the winter for people who were vaccinated a full year ago, I think we're going to have to look at the data closely on that, how much of a decline you get in protection. But that's a long ways off. We'll worry about that in the fall and the winter. I do think we're going to have to contend with COVID again this winter. And we may have to reimplement mask ordinances in certain settings where we have outbreaks or even close schools in certain settings. But I think it's going to be much more reactive. We're going to be reacting and putting public health measures in place based on measures of spread and not these sort of widespread ordinances that we have right now. I think we need to start lifting these things as the situation improves, also to demonstrate that we can do that and that we maintain our integrity and our ability to reimplement these things when we have to. The public has to trust that public health officials are going to lift these restrictions as quickly as they put them in place as the conditions improve. And that's probably partly what's holding back the economy right now. People are not going back to work, not just because of these benefits. I know there's been a lot of talk about that, but also because they're being told they have to wear masks and still have to exercise cautions that probably in many parts of this country you don't have to do. You look at San Francisco, 20 cases a day, more than 70% of the population vaccinated. Very good testing in place. They don't need mask ordinances indoors anymore and certainly not outside.

JOHN DICKERSON: All right, Dr. Scott Gottlieb, we really appreciate you every week. Thank you so much.

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