Transcript: Scott Gottlieb on "Face the Nation," May 23, 2021

Gottlieb says Americans should rely on "individual assessments" of COVID risk

The following is a transcript of an interview with former FDA Commissioner Scott Gottlieb that aired Sunday, May 23, 2021, on "Face the Nation."


JOHN DICKERSON: And we go now to FDA commissioner Dr. Scott Gottlieb, former FDA commissioner Dr. Scott Gottlieb, who sits on the board of Pfizer and joins us from Westport, Connecticut. Good morning. So--

DOCTOR SCOTT GOTTLIEB: Good morning.

JOHN DICKERSON: Dr. Gottlieb, we have been piling up some good numbers in the last couple of weeks we've been meeting together, but I wanted to focus on one. We're going to put up on the- on the screen the decline in hospitalizations for people to see. What does that say to you, that graph?

DR. GOTTLIEB: It shows really a rapidly declining overall vulnerability of the US population. I think we're still seeing a lot of cases per day, about 20,000 cases per day yesterday, and cases may not fall much below 10,000 because we're doing a lot of testing around the country. But the bottom line is that the people who are getting infected now tend to be people who are younger or less vulnerable to the infection because a lot of the vulnerable population has been vaccinated. About 85% of those above the age of 65 have now been vaccinated. So the people most likely to get into trouble with COVID have now been protected through vaccination. And you're seeing a rapidly declining rate of new hospitalizations as a consequence of that fact.

JOHN DICKERSON: So as Mark Strassmann said in his piece, we are entering into the post pandemic stage. So help us put together a kind of toolkit to navigate that post pandemic stage. What should individuals be keeping in their mind for that stage that might be different than what we were all been thinking about for the last year and a half?

DR. GOTTLIEB: Yeah, I think it's an environment right now where we're not going to rely necessarily on public health ordinances and mandates from governors and mayors to protect us, but we're going to have to protect ourselves based on our own assessment of our risk and our own comfort. And so if you're unvaccinated, you're going to be at higher risk. If you're in a high prevalence area where there's still a lot of infection, you're going to be at higher risk. If you have a pre-existing medical condition that could put you at higher risk because you're either immunocompromised, because of the medicine you might be on or you have a risk factor like heart disease or lung disease, you're going to be at higher risk as well. So I think people may need to make individual assessments of their risk as they make judgments about what they should and should be doing, like wearing a mask in an indoor setting and also judging the setting. If it's sort of, you know, crowded setting with a very mixed population, you don't know a lot of the people that's different than, you know, getting together in a household where, you know, a lot of people are vaccinated. And finally, we need to make a judgment about just what our comfort is. A lot of people have spent a year wearing masks, taking certain precautions. And so it's going to take some time for us to get comfortable again, going into settings without taking those precautions. I think there's nothing wrong with wearing a mask if you're still in an indoor setting, even in an environment where it's not- not mandated. And in some places, it's the etiquette. If you go into a pharmacy or a doctor's office, people expect you to be wearing a mask. So people have also got to make an assessment about what their comfort level is. And the good news is that I think culturally we've changed in that if you're walking around with a mask right now, you're not looked upon in an odd fashion. Whereas, you know, two years ago, if you wore a mask, everyone would take a step back from you.

JOHN DICKESON: That's right. Well, and maybe- so maybe people carry the mask in their pocket and use it as the circumstances require. I wanted to add to your point about those who are vaccinated and those who are not. In the calculation people are making in this post pandemic phase, if you choose not to get vaccinated, you're making a public health choice as well, not just for yourself, right, based on what we know about how the vaccine works? And- and what- if you're vaccinated, your ability to spread really almost disappears.

DR. GOTTLIEB: I think that's a key point. We haven't really talked about it as much because it's not currently in the approved labeling of the vaccines. And so FDA isn't in a position where they really can't speak to this directly and manufacturers can, of course, but CDC can, and they have. When they- when they lifted the recommendation for wearing masks indoors or outdoors, if you're vaccinated, what that change was predicated on was information that they have that gives them confidence that if you're fully vaccinated with one of the available vaccines, you're going to not only be much less likely to get infected, either symptomatic or asymptomatic infection, but if you do get infected, if you are vaccinated and you become asymptomatically infected, you're far less likely to transmit the infection. Now, we haven't fully quantified the magnitude of that, but it is substantial. So someone who is fully vaccinated, even if they do end up getting infected with the virus and either know they're infected or they don't know they're infected, they haven't developed symptoms, there's still going to be far less likely to spread that infection. So by getting vaccinated, you're protecting those around you, even if you're at lower risk, if you're someone who could potentially come into contact with the virus and put others at risk, and you don't want to be in that position of putting other people at risk. You have elderly parents, you have children, you have other people around you who may be vulnerable. Getting vaccinated is going to substantially reduce the likelihood that you could introduce the infection into a setting where other people could be put at risk.

JOHN DICKERSON: In our last minute, what about parents who want to know what to think about their kids who are under 12 and they're not being able to get vaccinated?

DR. GOTTLIEB: I think this gets back to some of the first points we discussed. You're going to have to make an assessment about the risk. I don't think kids need to be wearing masks outside anymore. I think CDC is going to have to revise its guidance for summer camps because wearing a mask, you know, is difficult in the summertime when it's hot. And I don't think that the risk merits that. But I do think parents need to make an assessment about the risk of the environment the child's going to be in. So, you know, in a crowded indoor, stuffy setting, in a classroom, for example, I think having kids continue to wear masks for a period of time is reasonable, still not in a very low prevalence environment. The rate of infection is coming down sharply. I think by June, we're probably going to be at one infection per 100,000 people per day, which is a very low level. It's what defines--

JOHN DICKERSON: All right. 

DR. GOTTLIEB: --as a very low level. So the risk is going to be quite low when we get to that point.

JOHN DICKERSON: All right, Dr. Scott Gottlieb, once again, thanks so much for your help. And we'll be back in a moment.

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