The following is a transcript of an interview with former FDA Commissioner Scott Gottlieb that aired Sunday, September 27 2020, on "Face the Nation."
MARGARET BRENNAN: And we are back with former FDA commissioner Dr. Scott Gottlieb, who joins us from Westport, Connecticut. Good morning to you.
DR. SCOTT GOTTLIEB: Good morning.
MARGARET BRENNAN: Last Sunday, you said there are 30 states where there's an expanding epidemic. We spoke to the White House chief of staff this morning and pointed out to him that- that hospitalizations are no longer declining. What do we need to be prepared for? What does this trend indicate?
DR. GOTTLIEB: Well, I think there's still a question whether or not this is the beginning of an upsurge heading into the fall and the winter or we're seeing sort of a post Labor Day bounce. Clearly, we've seen a rise in cases across the country right now, hospitalizations, as you said, they were declining, they're no longer declining. There's some indication is starting to rise again, which would be expected now that cases are going up. Whether this is the start of a persistent trend heading into the fall, in the winter, or is just a temporary upsurge and we level off again, is unclear. I think that there's a lot of concern that we could start to see a real upsurge and this is a continuation of a broader trend underway as we head into the colder months. We were always facing heightened risk of increased spread of coronavirus as we headed into the fall and winter. Now we're there. We're starting to see that increase, and we're taking a lot of infection into a very dangerous season for this virus.
MARGARET BRENNAN: The chief of staff talked about his conversation with the FDA and drawing into question their revision to guidance, but he said it will be forthcoming on the vaccine. What did you interpret his comments to mean?
DR. GOTTLIEB: Well look, I- I don't think that this guidance represented a revision in the agency standards or any kind of high- higher bar. What this was, was an articulation of the principles and standards that the FDA has been using for a long time and frankly been communicating to the companies that are developing vaccines. So a lot of these principles have already been communicated to the companies and are, in fact, being followed. And as you know, I'm on the board of Pfizer, but I also talked to a lot of the other clinical development leads and the other companies working on vaccines. And I think that there was widespread agreement that these principles, as they were discussed in the press, were mostly in line with everyone's expectations. And so whether or not the agency issues the guidance, I think this is going to be the basis for which they make decisions. Now, I would prefer that they're able to issue the guidance in its entirety in the way that they envision it, because that would provide more transparency around the basis that they're using to judge these vaccines. But whether they release it or they don't, I think these are going to be the principles that govern that process.
MARGARET BRENNAN: And what should we expect from a vaccine? Dr. Fauci said this week that it won't be 100 percent effective. What can Americans expect?
DR. GOTTLIEB: Well, look, we don't know yet. We don't have the data. There's major trials underway with more than 30,000 patients in each trial. Pfizer enrolled 44,000, Moderna 30,000, J&J just announced a trial with 60,000 patients. These are major outcomes trials. So we should wait and see what the data ultimately shows. But the expectation is that this vaccine is going to be partially protective, a lot like the flu vaccine, where for certain people it will provide full immunity, but for other people it's not going to provide as much protection. Maybe it will lessen the severity of COVID if they contract the infection. But it's not going to provide what we call sterile immunity, which- which means you're not going to be able to get infected with COVID. There will be some people who still get infected with COVID. That's the expectation. Now, it could be that the vaccines prove to be much more effective than we expect. It could be that the vaccines proved to be a lot less effective than we expect. But I think that should be the base case, the- the basic expectation of individuals.
MARGARET BRENNAN: Do you agree with the CDC director that 90% of Americans remain susceptible to this virus?
DR. GOTTLIEB: That's what the data shows, I mean, CDC has some data that they've developed looking at antibodies across the country, basically layering tests onto normal blood draws being done by LabCorp and Quest to look at how many Americans have antibodies to coronavirus. And so they're deriving some of that information from that very large project that they've undertaken. But other studies seem to indicate about the same thing. About 10% of Americans have been exposed to this virus. The best modeling that I've seen that suggests that there could be a higher rate of exposure suggests that maybe it's as high as 15%. But most of the models project around 10%. So it means a lot of the country is still very susceptible to this virus. There's a lot of room for it to run.
MARGARET BRENNAN: And, you know, I ask you that because one of the members of the task force, Dr. Scott Atlas, directly refuted the CDC director. So I just wanted to be on the record clarifying that. There have been a lot of reports out there that even if you get COVID and you survive, that you have related health problems afterwards. What do we know at this point, what the impact of the virus is?
DR. GOTTLIEB: We don't know the full impact on the virus. What we're seeing in-in various studies is that there is some long-term sequelae related to the virus that we don't really understand what their relationship is to the virus itself. The virus does seem to trigger in certain people rarely, but in certain people some kind of autoimmune type of phenomena where you get some persistent symptoms from the virus. And when you're infecting so many people with the virus, as we are, even a small percentage of patients having some persistent symptoms ends up being a lot of people. And so there's more and more evidence of this. This syndrome hasn't been fully characterized, but there is- I think there is enough evidence right now to suggest that there are people who are having long term sequelae from the infection.
MARGARET BRENNAN: Dr. Gottlieb, thank you, as always, for your insight.