The following is a transcript of an interview with former FDA Commissioner Scott Gottlieb that aired Sunday, August 16, 2020 on “Face the Nation.”
MARGARET BRENNAN: We’re now going to former FDA Commissioner Dr. Scott Gottlieb. He’s out this morning in Westport, Connecticut. Good morning to you, doctor. Good to have you back.
DR. SCOTT GOTTLIEB: Good morning.
MARGARET BRENNAN: I want to start where we always do, that’s where we stand right now. 1,500 dead on Wednesday. That rate back to where we were in the spring. You heard Jared Kushner say in principle not as bad as spring, but what does it say about where we are right now, when we are at these levels and where we are headed?
DR. GOTTLIEB: Well, it’s been pretty persistent. We thought we would come down now, we would see dead pike and start falling as the epidemics in the southern states started to pick up and decrease. But there have been fairly persistent levels of infection, hospitalizations and deaths over the past few weeks. We have now had more than a thousand deaths a day for at least two weeks, averaging more than 50,000 infections per day. We hit 55,000 in the last day. Hospitalizations have declined a bit, but they haven’t really started to decrease very quickly. What is happening is because the cases are starting to decrease in the southern states, Arizona, Texas, Florida, we are starting to see infections pick up in other parts of the country. California is still growing. Truly, the only state that seems to be getting a bit of the Sun Belt epidemic states is Arizona. And we now have 14 states with positivity figures above 10%. Mississippi at 21%, Nevada at 17%, Florida at 18%. That there are still many states with pretty high positivity rates.
MARGARET BRENNAN: In an interview with Mr. Kushner, he said that most people die over 70. And he also talks about his confidence that sent his children back to personal classroom education, saying that children are six times more likely to die. of the flu then covid. Do you know where those numbers come from? Does that sound right to you?
DR. GOTTLIEB: Well, I do not know where the six times come from. We need to be careful, I think, about comparison with flu. This infection has not been as prevalent in children as flu is every year, there have been about 330,000 diagnosed infections. If you believe we diagnose one in five to one in 10 infections in children, there may have been about three million children infected here. Influenza is estimated to cause symptomatic disease in up to 11 million children each season. This was a 2018-2019 season. And it also causes a reasonable degree of asymptomatic infection in children. That prevalence is much higher. With flu, we see upwards of about 400 tragic deaths a year. We have already seen 90 deaths from COVID in children. And it just hasn’t been – probably it hasn’t been that preferred in children. And we also see regarding indications of post-viral syndromes, this multi-system inflammatory syndrome, which has affected 570 children, that has been recorded so far. That there is a lot that we do not understand about COVID in children. I think we need to be careful to make comparisons with flu and the death and illness we see in flu relative to COVID.
MARGARET BRENNAN: The CDC said this week that people who have recovered from COVID are essential for at least three months. What do we know about immunity?
DR. GOTTLIEB: That’s right. And so this was the first study where they could say with certainty that you have immunity for at least three months that would protect against reinfection. They actually said that people who have been exposed to COVID who have had infection in the last three months do not have to career themselves because the immunity is absolute. That does not mean you do not have long-term immunity. The study looked just after three months. COVID has not been long enough for us to study truly long-term immunity in people in the community. But it is likely that you will have a period of immunity that lasts anywhere from six to 12 months. It will be very variable. Some people will have less immunity, some people will have some more. But it is good news that they can document that people have really sterile immunity. They will not be re-infected for at least three months and probably longer than that after infection.
MARGARET BRENNAN: But this concept of herd immunity is it- and I mean, how close are we there? What do you think of it?
DR. GOTTLIEB: Apparently a long way from herd immunity. If you look at the seroprevalence studies in general, maybe 8% of the population as a whole is exposed here. In outbreak states like Arizona, it could be higher, closer to 25% based on some modeling, maybe as high as 20% in Florida based on certain modeling and 15% in Texas. We know that the seroprevalence in New York City is 20%. That this is approaching a level of immunity where the rate of transmission will begin to decrease. It is not very immune to herds, but you will see decreases in the rate of transmission due to that- that level of infection. There is also speculation about T-cell immunity, whether or not people who have had pre-infection with coronavirus have some residual T-cell memory that confers immunity. We do not know if the T cells give immunity, but we now know that people who have had previous infections with coronaviruses have other coronaviruses that we call cross-reactive T cells. That they have T cells that cross-react with this particular coronavirus. Well, whether that level of immunity should be demonstrated and we are not sure. Probably if it does, what it does is help prevent you from getting the COVID disease, but you will still get the coronavirus infection and maybe even they can transmit it.
MARGARET BRENNAN: The president announced Friday that McKesson Corporation will be a central distributor of COVID fax and supplies. But he also said the army is ready to distribute doses. Do you think it should be the private sector or the government that distributes a fax?
DR. GOTTLIEB: I think what the government needs to do is exploit the private sector, distribute white faxes to companies, distributors, manufacturers through the existing supply chain. I think that if the government tries to take these faxes physically and then distribute them through channels they set up, that could eventually lead to hiccups and delays in getting faxes to consumers. What they need to do is focus the existing supply chain on where they should allocate those faxes based on where they see the need and what the allocation system will be, based on who the faxes will eventually be approved for, or they are approved for workers in frontline health care initially authorized for people at higher risk. But I would not try to re-create the wheel here. I would use the existing supply chain which worked well to distribute many different faxes very quickly. We were able to spread the flu vaccine very efficiently through the existing supply chain.
MARGARET BRENNAN: OK, now, if and when we get there. And thank you very much, Dr. Gottlieb. We’ll be back in a moment.
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