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Rate of Vaccinations against COVID-19 Increase in U.S. as Delta Variant Surges; National Institutes of Health Director Dr. Francis Collins Answers Questions about Going to Indoor Gatherings During Coronavirus Pandemic and Possibility of COVID Vaccine Booster Shot for Vaccinated Americans; Pandemic's New Phase: Answering Your Question. Aired 8-8:30a ET

Aired August 03, 2021 - 08:00   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

[08:00:00]

UNIDENTIFIED MALE: There are still about 90 million eligible Americans who are unvaccinated.

UNIDENTIFIED MALE: You don't screw around with this virus. This variant can kill you. So if you're not vaccinated, it's not too late.

(END VIDEO CLIP)

JOHN BERMAN, CNN ANCHOR: Good morning to our viewers here in the United States and all around the world. I'm John Berman with Brianna Keilar. This is a special hour of NEW DAY. For the next 60 minutes we're going to answer your questions about this phase of the pandemic, and this phase isn't good. Cases are surging in almost every state, particularly in the south and west. Some hospitals have already hit the breaking point with the rapid spread of the Delta variant infecting mostly the unvaccinated. Nationwide the number of people hospitalized has topped 50,000 for the first time since February. We're going to speak with a doctor on the front lines of this crisis at a hospital that has run out of beds this morning.

BRIANNA KEILAR, CNN ANCHOR: Many cities and states that were hoping to resume pre-pandemic life are now forced to impose mask restrictions yet again. So what does this mean for businesses, and for the most vulnerable among us? Children in classrooms who cannot be vaccinated. The White House finally reaching its goal of getting at least one shot into 70 percent of adult Americans, they thought, although it did happen one month later than they hoped.

This hour we will speak with the director of the NIH, Dr. Francis Collins, about the Biden administration's efforts to close the vaccination gap in more than half of the country where rates are below the national average. We're also going to be joined by our Dr. Sanjay Gupta.

BERMAN: Let's get a sense of where we stand right now in this country 18 months into the pandemic. Joining me, CNN senior data reporter Harry Enten. This is a special hour of NEW DAY, you are so special to kick it off for us. HARRY ENTEN, CNN SENIOR POLITICS WRITER AND ANALYST: Thank you.

BERMAN: Let's talk about where we are in terms of cases and hospitalizations.

ENTEN: Right. Look, here we are, seven-day average of new coronavirus cases. We're not as high as we were at the peak back in December and January. But look at this going back up again, nearing 100,000 new cases a day. You spoke about hospitalizations in that opening. Again here, what do we see? We see we're not nearly as high as that spike as we were back in December and January, but back all of the way we go with 50,000 new hospitalizations. If you look at cases, you look at hospitalizations, not exactly a pretty picture.

BERMAN: No, 50,000 not headed in the right direction. That's the issue. Heading up, both cases and hospitalization. Talk to me about where this is all happening compared with where we know people are vaccinated?

ENTEN: This, I think, is so important. The hotspots tend to be in the places where there are lower levels of vaccination. So this is new coronavirus cases, the seven-day average. Look at this, the top 25 most vaccinated states, look, on average 14 new cases per 100,000. But look at the bottom 25, more than double that at 29 per 100,000. And we see the exact same thing in hospitalizations. Look at this. The top 25 most vaccinated states, seven per 100,000 and bottom 25, look at that, more than double that at 17 per 100,000.

BERMAN: It's twice as bad in less vaccinated states.

ENTEN: That's right, it's twice as bad in the less vaccinated states. Why that is exactly we can't necessarily say, but what we can say is we wish that more people in those bottom 25 most vaccinated states would get vaccinated because that could, in fact, lessen the pandemic there.

BERMAN: Where are we headed in terms of vaccinations?

ENTEN: Yes, so look, if you look at the overall trend line, we're going up. This is Americans at least partially vaccinated. We're now up to nearly 60 percent of all Americans at least partially vaccinated. The trend line has generally been slowing over the last few months. But here's the key nugget. As things have gotten worse, look at this, the seven-day average back over the last three weeks, we have started to see a rise back again. Now more than 400,000 new people getting vaccinated every single day. That is a good thing. Fear does seem to be driving this, but whatever works to get more people vaccinated is a good thing in my mind.

BERMAN: Let's hope we continue to see these numbers go up. Harry Enten, thank you very much.

ENTEN: Thank you, sir.

KEILAR: We know that you have a lot of questions about the Delta variant, so we're going straight to the source. Joining us now to answer them is the director of the National Institutes of Health, Dr. Francis Collins. Sir, thank you so much for being with us this morning. We have been crowdsources questions from our viewers, and I want to start with this one. This is from Kathy from Elmira, New York. She said "I am 64 years old and received my second COVID shot mid- February. How concerned should I be that the U.S. is still not recommending a booster while other countries are already moving forward with this?"

DR. FRANCIS COLLINS, DIRECTOR, NATIONAL INSTITUTES OF HEALTH: Well, there is a lot of discussion about boosters, and we're looking at this virtually every day. At the present time, though, the data in the United States does not indicate that that's necessary. So Kathy should be reassured that the vaccine doses she got are highly effective, including against the Delta variant.

[08:05:00]

If we change that based upon the concerns about whether immunity wanes over time, then we're prepared to start offering boosters, particularly to high-risk individuals. But right now, looking at that data, we're not quite there. So people should be pretty reassured. The big message today is if you're not already vaccinated, then by all means get started. Go to Vaccines.gov, find out where you get your shot. It's going to easy to do, and it's free.

KEILAR: And then Lisa from Philly has this question for you. She says "When should a vaccinated person get a COVID test?" She's talking obviously about potential breakthrough cases here. She said, "i.e., what are the mild symptoms like? I don't want to be a spreader."

COLLINS: That's a great question. Again, let's be clear, breakthroughs are extremely unusual, but they are happening. The people who have breakthroughs, for the vast majority of them have mild symptoms like a cold. Some nasal congestion, maybe a little bit of a cough, maybe a low-grade fever. If that is happening to you and you're fully vaccinated, that would be a good reason to get a test, see whether you might in fact be carrying the virus and therefore should isolate yourself so that you're not spreading it to other people.

But again, the vaccinations do work. They don't completely prevent these mild symptoms, as Senator Lindsey Graham has just described in his own case this morning. But it is still so critical to get the vaccination, because otherwise your likelihood of hospitalization or even death is substantial, as you've heard from the stories that are being told all over the place today.

And by the way, I'm glad you all are telling some of these personal stories. Statistics, sometimes they kind of roll off people. But when you hear about Anthony Garcia like you talked about 10 minutes ago, or Michael, the father of five in Las Vegas whose final text to his wife was I should have gotten the damn vaccine, that's something to notice. These are real people who have lost their lives because of a decision to hold off on something we know is safe and effective. Don't hold off, America.

BERMAN: Jessica, who we talked to yesterday, said don't wait. Don't wait. And if her fiance had taken the vaccine, she thinks he would be alive today.

Listen, Dr. Collins, we received a lot of questions about the new restrictions suggested by the CDC, and then the idea of herd immunity. So let me take them in hand here. So are the suggestions for new mask requirements, are they meant to protect the vaccinated from getting sick, or are they really meant to keep the vaccinated from being vectors, carriers, who would infect the unvaccinated here?

COLLINS: It's both, and. Certainly, we know the main benefit of masks is that they prevent somebody who is carrying the virus from actually spreading it to those around them. That's the reason why we've been wearing masks for the last year or so. But there is also some protection for the mask wearer against virus that might be floating in their vicinity. So if you're fully vaccinated, you're likelihood of actually getting the virus is pretty low. It's even lower if you have that mask on.

But again, the main reason is once again we have got a lot of community spread. We have people in indoor settings where some are vaccinated, some are not. If we want to try to tamp down this terrorism Delta variant outbreak, the best thing we can do is get everybody vaccinated and get people to wear masks in those settings. And I know people are tired of that. And I know they think this seems like a flip-flop, but the data has changed. We are not making this recommendation now just for random reasons. We have new evidence that the masks really are going to be important to get us through this if you're indoors.

BERMAN: The notion of herd immunity, which I know some scientists like you may not have ever fully embraced or liked to begin with, but is it now just more or less obsolete, the idea that if we vaccine enough people that COVID will just go away? With the Delta variant, do we have to accept that it's here, but that the vaccines will make it survivable for 99 percent of us?

COLLINS: I think it is turning out to be probably more of the latter than the former. Although, again, if you are vaccinated, your likelihood of getting infected and spreading this virus is greatly reduced, so that contribute to a certain degree to herd immunity. But the idea we can get actually 80 percent of the public completely unable to harbor this virus, maybe that's not going to be achievable with this Delta variant. But we could still to a place where this becomes a nuisance instead of a threat to your life. And that means getting everybody vaccinated as quickly as possible.

KEILAR: I think a lot of people are trying to lead more normal lives, and to that point, B.R. from New York asks you, sir, "Should I go to a 300-person indoor wedding if everyone is vaccinated?" What would you tell them?

[08:10:00]

COLLINS: Well, I would say at the present time you should look carefully to see what the level of spread is in that community. Of course, with a wedding, people are coming from all over, so probably it's not just the community. It's where people came from. In that setting, knowing what we know now about how Delta can in fact infect vaccinated people, you would still want to insist that people wear masks or even consider moving the whole thing outdoors, which would even be better.

KEILAR: So to that point, big birthday coming up for former President Obama, his 60th birthday, and he has a lot of people coming to the party. Once you include staff, you're talking about almost 700 people on Martha's Vineyard at his estate there. It is outdoors. They are requiring a negative test. What about that? Because there are also a lot of weddings, big weddings, that are requiring a negative test. What about that if they're outdoors?

COLLINS: Well, the old thing about belt and suspenders. If you want to be sure you're being fully cautious, so yes, insisting everybody is vaccinated and having negative tests, that helps you. And having it outdoors, even more important, because it's very little evidence of infections happening in an outdoor setting. Almost all of these happen indoors because of the airflow situation.

I didn't get an invite to the Obama birthday party, so I don't know any more details than what you've just said, and I don't think I better weigh in on the pros and cons. I think they're doing everything they can to minimize the likelihood that this will be an occasion where infections happen.

KEILAR: We have to talk about it, though. It's important. It is a big gatherings at a time when we're seeing this Delta variant flare. And people are trying to think, can I do this? They want to know that, which is why we're asking about it with the details that we do have about it. A.S. from Colorado is asking -- sorry, go on, sir.

COLLINS: And everybody should be asking. A little silly example of this, I'm in a rock and roll band. We were supposed to be rehearsing tonight in somebody's basement. Everybody is vaccinated. But some have kids at home who are under 12. So instead, we're going to rehearse outside, and I hope the neighbors will forgive us.

KEILAR: I hope so, too. I hope you guys are decent. Maybe then they'll really enjoy what you're performing.

COLLINS: Hey, hey, we're more than decent. We're pretty good.

KEILAR: I'm sure it's great. I'm sure it's great. I'm sure it is. I didn't mean to cast aspersions on you.

So A.S. from Colorado says "My vaccinated son's college roommate is unvaccinated. What's the risk to my son?"

COLLINS: Well, that's not a great situation, because clearly this is a pandemic of the unvaccinated. That unvaccinated student is at high risk of getting infected, depending on how careful he or she is in terms of interactions. But in 75 percent of the counties right now we are at substantial or high risk, and so this is a likely event. The vaccinated student is therefore likely to get exposed, could certainly then develop a breakthrough infection. The reassuring thing is the vaccines work. That student is unlikely to

get anything more than symptoms like a cold. But it is an unnecessary thing. So I would hope that maybe something could be done to encourage the unvaccinated student to take responsibility both for him or herself, but also for the roommate. It's all about taking care of each other, not just each one of us all alone.

BERMAN: So Kate from New York has this question. "Has the Delta variant increased the risk for young children? My daughter is two years old and doesn't wear a mask. Should we avoid taking her indoors in public?"

COLLINS: It's clear that this variant is capable of causing serious illness in children. You have heard those stories coming out of Louisiana pediatric ICUs where there are kids as young as a few months old who are sick from this. That is rara. Certainly, younger people are less likely to fall ill. But anybody who tries to tell you, you don't have worry about it if you are a young, healthy person, there's many counterexamples all around us now.

So yes, you do need to think about it, and that's the reason why the recommendations are for kids under 12 that they avoid being in places where they might get infected, which means recommendations of mask wearing in schools and at home. Parents of unvaccinated kids should be thoughtful about this, and the recommendation of this is to wear masks there as well.

BERMAN: Let me just follow up on that.

COLLINS: I know that's uncomfortable. I know it seems weird, but it is the best way to protect your kids.

BERMAN: But I just again, want to fully understand if this is about protecting the kids from Delta, or is it an issue of worrying that the kids could then pass it on to other people? Is Delta making kids more sick? Are they getting sicker than they were? Is there any evidence of that from the previous variants?

COLLINS: There is suggestive evidence comparing Delta -- this is from studies in Singapore, in Scotland, in Canada, that, in fact, this is not just more contagious, but more --

DR. FRANCIS COLLINS, DIRECTOR, NATIONAL INSTITUTES OF HEALTH: -- evidence comparing delta.

[08:15:02]

This is from studies in Singapore, in Scotland, in Canada, that, in fact, this is not just more contagious, but more serious in various age groups. It's not as solid as I wish it was. We don't have really enough numbers to be confident, but it certainly tilts the balance in that direction.

JOHN BERMAN, CNN ANCHOR: Well, that -- I think you need to emphasize that if you see evidence of that. That's a change. Before, the big concern was that kids could get it, pass it to others but by in large they weren't becoming ill in great numbers in any kind of numbers that were causing deep concern.

But now, you're saying they can get sick enough that this is a worry.

COLLINS: It's sick enough it can be a worry. It frankly was before and perhaps it was underemphasized, in part now because older people who are vaccinated are not so much filling up hospitals. The average age has dropped significantly. So, now, we're seeing perhaps in this spectrum of illness more emphasis on younger people including kids.

Again, I don't want to overstate the confidence that we have about whether delta is more dangerous to children. The balance has not been fully settled there, but it's tipping in that direction.

BERMAN: All right. We're going to bring in CNN chief medical correspondent and rock and roll aficionado, Dr. Sanjay Gupta.

We were hearing about Dr. Collins and his rock and roll band.

Sanjay, I know you have questions for Dr. Collins.

DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Yeah, I always relish the opportunity to ask my former professor a couple questions.

I do want to follow up on the question Brianna asked about boosters quickly, because we just heard from Governor Edwards in Louisiana last night that 10 percent roughly of the patients in the hospitals are vaccinated and they are who you would imagine. They're people who are vulnerable, who are older. He was concerned about that.

We're not -- you're saying you're not recommending boosters now for anybody. What would be the trigger for that keeping in mind that it takes a while for those boosters to kick in and these numbers are going up?

COLLINS: Well, what we look at almost every day is what is the evidence about protection from people who got immunized many months ago? The concern is about whether that starts to fade over time and do you drop below a threshold where protection is effective. We watched closely evidence in Israel. And you've noticed that Israel

has now started offering boosters to individuals over 60. We don't quite see that in the U.S. data yet, but it's possible that may happen.

Again, I think we have to be evidence based here. When you consider that hospitalization for somebody who is fully vaccinated CDC says it's .004 percent of those 164 million people who are fully vaccinated. So that's extremely unlikely but you would want to watch the trends. We're fully prepared when the moment comes to be ready to make those recommendations for boosters if they're fully indicated.

Got to keep in mind, though, Sanjay, this is something we have to worry about.

The rest of the world is desperate for vaccines. If we go ahead with boosters, those vaccines are not able to go other places where they are also needed. So, we've got to think about our whole planet.

GUPTA: Yeah, no doubt. But there's also doses expiring in places as well as my parents in Florida have been telling me. So, that question came directly from them.

A question about treatments, Dr. Collins. We've obviously learned a lot. But right now, if someone who is vulnerable in particular -- start to develop symptoms even if they've been vaccinated and they're worried, should they go out and get some of these treatments like monoclonal? Where do we stand on that?

COLLINS: Well, the monoclonal antibodies clearly they have been shown to provide benefit in reducing hospitalizations and deaths in people who are at high risk and who have just tested positive. You have to give them early. They don't work if you wait until somebody is in the hospital. By that time, your own immune system responded to the infection.

I'm not aware how much data we have, though, about breakthrough infections. Again, those are mostly mild. Are the monoclonal antibodies appropriate in that situation?

I have not seen a recommendation about that.

GUPTA: And just finally, the term breakthrough infection. I was talking to your colleague, Bernie Graham, about this. He hates the term breakthrough infection because his point is that they were always expected. The vaccines work primarily at the lung and that's why they prevent serious severe illness.

The idea that people could carry the virus in their nose and mouth, he says that always expected and therefore he doesn't like the term. We keep describing this as rare. Is it really rare? If we were to randomly swab these vaccinated people, what do you think we would actually find?

COLLINS: Well, I associate myself with Bernie Graham's comments.

[08:20:00]

I think the term is terrible. It's scaring people and making it sounds as if the vaccines don't work.

Let me say very clearly, the vaccines are incredibly effective in preventing hospitalizations, severe cases, over 90 percent. So, let's not let the language get in the way of that.

You know, I don't know. It would depend a lot on what he level of community spread was where you started doing the swabbing. Some of that has been done and you pick up people who have virus in their nose who have no symptoms. Yeah, some of that is going on.

What is the attack rate if you put vaccinated people in a highly infectious environment? We don't really quite know. I suspect it's a lot lower than if you're unvaccinated even to be swab positive but it clearly happens.

And Bernie is right. We shouldn't be surprised by that. The vaccines were never designed to prevent asymptomatic virus in your nose. And that was not the point. The point was to keep people from getting sick and dying and they work incredibly well for that, make no mistake.

BRIANNA KEILAR, CNN ANCHOR: Dr. Collins, before I let you go to follow up on something you said earlier, I thought you said parents masking at home with children. Did you mention something about that? Can you tell us about when that should be occurring?

COLLINS: Well, again, look at CDC's recommendation. That's where I go whenever I want to be sure I'm telling this right.

But basically, if you are parents who have small children under 12 at home, they are susceptible for getting infected. If parents are out and about and might themselves be carrying the virus, you don't want to pass that along. So, many parents with that recommendation consider wearing masks for families at home to reduce this risk as long as the kids are unvaccinated especially if you're in a community that has very high transmission at the present time.

KEILAR: Dr. Collins, thank you so much. You've been incredibly generous with your time this morning. I know people have questions and it's helpful to hear straight from you.

Sanjay is going to be back with us later this hour with more of our viewer questions as well.

There are some strict guidelines coming from members and for employees at one of the nation's premiere fitness clubs. The CEO of Equinox will join us with the decision that might become a trend.

BERMAN: So, besides private businesses, can your employer or city, state government, require you to be vaccinated or wear a mask? We'll run through the top legal questions and one state dealing with a crisis at hospitals, states running out of beds. We'll take you there.

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[08:26:43]

KEILAR: Welcome back to a CNN special report on the pandemic's next phase.

Many governments and private businesses are grappling with the best ways to curve the spread and to protect people while maintaining personal freedoms.

So, let's talk about this. Let's get your legal questions answered with Elie Honig. He is a CNN legal analyst and former state and federal prosecutor.

All right. Let's tick through these things because people wonder what can and cannot happen here.

Can states, Elie, require residents to get vaccinated against COVID- 19?

ELIE HONIG, CNN SENIOR LEGAL ANALYST: Yeah, Brianna, this is an easy yes. We know this because the Supreme Court told us over 100 years ago in a famous case from 1905 called Jacobson versus Massachusetts where they mandated that all of the residents in that state or commonwealth get vaccinated against smallpox.

The Supreme Court said that's completely fine. The Supreme Court ruled it's within the police power of a state to enact a compulsory, mandatory vaccination law. Now, of course, there are politics involved in this.

What you have to show is a state is a reasonable medical need. There is going to be politics behind this. No state has done this yet. They absolutely can.

KEILAR: What about federal government? Can the federal government issue a nationwide vaccine mandate?

HONIG: Yeah. So, the answer is absolutely yes. The CDC director, Dr. Rochelle Walensky, last week, said that the Biden administration was looking into a federal vaccine mandate and ran it back and say there will be no federal mandate.

But we have the same Supreme Court case I talked about before that had to do with the state's authority but it applies to the federal government and there's a specific federal regulation that gives the federal government through the department of health and human services to make and enforce regulations necessary to prevent the introduction, transmission or spread of communicable diseases. COVID certainly would seem to fit squarely within that law.

KEILAR: And when it comes to mandates, does it matter legally that the FDA has only given emergency use authorization?

HONIG: It does not matter. That is not a legal designation. That's a scientific and medical designation. All you need to show is a reasonable medical necessity. We had these

statistics. We've seen them. Greater than 99.96 of people vaccinated do not get hospitalized. Greater than 99.99 percent do not die from COVID. If that's not medical necessity, I don't know whatever would be.

KEILAR: Can business owners require that employees get vaccinated?

HONIG: So, this is going to vary a bit state by state, but generally speaking, yes we've started to see more and larger businesses. Walmart, Google, Uber, Facebook, Disney and the NFL, and many, many others, either require their employees to get vaccinated or in the NFL's case to set important incentives or disincentives for people who don't get vaccinated.

Generally speaking, businesses have the right even the obligation to protect the safety and health of their employees. Also importantly, the federal EEOC, Equal Employment Opportunity Commission, has issued an opinion that it does not violate federal anti-discrimination laws to require your employees to get vaccinated, as long as you provide for narrow exemptions for religious or medical exceptions.

So, generally speaking, we are seeing more and more of these private employees. Generally speaking, it is going to be lawful.

KEILAR: What about customers? Can a business require that?