Over the weekend, the American public finally learned that the vaccinated were being forced to wear masks again because of a massive outlier in Massachusetts where vaccinated people at a beach gathering had a high viral load in their nasal pharynx. And when pressed on the data during an appearance on CBS’s Face the Nation on Sunday, Dr. Anthony Fauci claimed that viral load meant the vaccinated were spreading it at the same rate as the unvaccinated. But Fauci would be later proven wrong by a high-ranking Israeli public health official and a former FDA commissioner.
CBS moderator John Dickerson began by asking Fauci what new understanding did U.S. health officials possess that lead them to make their recommendation. And after avoiding the questions for a bit, Fauci eventually claimed: “When you look at the level of virus in the nasal pharynx of people who are vaccinated who get breakthrough infections, it’s really quite high and equivalent to the level of virus in the nasal pharynx of unvaccinated people who get infected.”
Looking for the details Fauci skirted around, Dickerson wondered if it was “true that the ability to spread is high, or is it a smaller subset of the breakthrough cases in which this discovery was made about the ability to spread?” Again, Fauci suggested that the viral load was “very similar to the unvaccinated individual. Which is troublesome. Which tells you the potential for transmission is there.”
But later, when Dickerson pressed Israel’s director of Public Health Services, Dr. Sharon Alroy-Preis on what they were seeing when it came to the vaccinated spreading COVID, she suggested they were seeing the exact opposite of what Fauci claimed.
According to her data, a vast majority of vaccinated people with confirmed cases were not spreading the virus, with roughly 10 percent spreading to only one other person (Click “expand”):
In order to continue with this policy, we needed to check if vaccinated individuals can infect others. We see them, they're 50 percent of the confirmed cases on a daily basis now. But the question is whether they can infect others. And we actually saw that 80 percent of vaccinated individuals who have become confirmed cases themselves, 80 percent of them have zero contacts that have been confirmed. And another 10 percent have only one contact that was confirmed to be a case because of their connection with this individual.
So, their ability to infect others is 50 percent lower than those who are not vaccinated.
Dickerson seemed confused that her data contradicted Fauci and the CDC and asked her to clarify. “There is a spread among household contacts,” she noted. “But if we take household contacts out of the equation, the risk of confirmed cases who are vaccinated to infect others is about 10 percent to infect one other individual, and lower than 10 percent to infect more than one.”
His confusion continued into his interview with former FDA commissioner and Pfizer board member, Dr. Scott Gottlieb. “So, it seems like breakthrough cases is a small set, and there is an even smaller set who might pass on infection to others. Is that the way you see it,” Dickerson asked.
“That's right. We know there are more people with this delta variant who’ve been vaccinated who are probably spreading the infection, but it is still a very small percentage of people who are becoming infected after vaccination, and who then are going on to spread the infection to others,” Gottlieb replied.
When asked to explain the “disconnect” between the Fauci and Alroy-Preis, Gottlieb suggested the CDC was drawing the wrong conclusion from the data. “The CDC is inferring from this study that there’s a risk of transmission in vaccinated individuals,” he said, comparing nasal pharynx to lower airway samples. “It is not a perfect correlate with your ability to transmit the virus or how contagious you are.”
Gottlieb also recalled that they have data that shows the vaccinated may only be contagious for roughly 24-48 hours, maybe as long as 72 hours.
The transcript is below, click "expand" to read:
CBS’s Face the Nation
August 1, 2021
10:36:39 a.m. EasternJOHN DICKERSON: I’d like to start with the new thinking on COVID-19 that was part of the CDC’s decision to change its mask guidance. We've been talking about the delta variant for a while, but what is new in your understanding about the delta variant this week?
DR. ANTHONY FAUCI: Well, a confirmation of how easily it spreads from person to person. But also, we found that individuals who get breakthrough infections, namely people who are vaccinated who might get infected, almost invariably they get either minimal symptoms or no symptoms at all. But since no vaccine is 100 percent affective, you're going to see breakthrough infections.
But what we've learned that is new, John, in answer to your question, is that when you look at the level of virus in the nasal pharynx of people who are vaccinated who get breakthrough infections, it’s really quite high and equivalent to the level of virus in the nasal pharynx of unvaccinated people who get infected. That’s very different from the alpha variant.
[With] the alpha variant, the level of virus in a vaccinated person was extremely low compared – in the vaccinated people compared to the unvaccinated people. Not so with delta. So, we know now that vaccinated people who get breakthrough infections can spread the virus to other people.
DICKERSON: Sticking on that point, we’ve always known that it was not 100 percent affective when you're vaccinated. So, among the breakthrough cases that we always knew would happen, in every breakthrough instance, is it true that the ability to spread is high, or is it a smaller subset of the breakthrough cases in which this discovery was made about the ability to spread?
FAUCI: Well, the phenomenon of the ability to spread is clear, we're seeing that very, very clearly in a number of situations. When you look at the data that we have gotten from a single study so far -- and other studies are coming out -- you have a availability, but the mean – the sort of average, mean level of virus in the nasal pharynx is really quite similar, almost identical on an average.
So, you would think, obviously, when you have biological variability, you will have some people high some people low some people the medial, but the median or mean is going to be right there, which is very similar to the unvaccinated individual. Which is troublesome. Which tells you the potential for transmission is there.
DICKERSON: And that's why the mask guidance for those who have already been vaccinated because there are these cases in which it’s possible to spread?
FAUCI: Right. I mean, the situation is that if you get breakthrough infections in individuals who are vaccinated and they don't spread at all to anybody else, then you would not worry about if they went home to a vulnerable person in their household, children or an elderly person -- there wouldn't be any issue.
But since we know now that (a) They can transmit when they get breakthrough infections, even though they have minimal symptoms or no symptoms, and we know they can do it. We know the mechanistic reason is that the level of virus is high, so you want to make sure they don't get infected. And that's the reason why and the fundamental basis for the CDC modifying their guidelines saying if you're in an area of a high or substantial level of virus, namely a red or orange zone, when you're in an indoor public setting, you need to wear a mask. That’s the fundamental reason for that change.
(…)
11:16:08 a.m. Eastern
DICKERSON: And the question of mask mandates, Israel has reinstated those. Are you seeing the same thing that seems to concern officials here in the United States about those who are vaccinated being capable of spreading, and that that was a finding they hadn't seen here in the states before?
DR. SHARON ALROY-PREIS (Israeli Dir. Public Health Services): So, we are looking at that. We're trying to introduce back what we call the green pass, which means people can go into events with a certificate they have been vaccinated, or recovered individuals, or to be tested.
In order to continue with this policy, we needed to check if vaccinated individuals can infect others. We see them, they're 50 percent of the confirmed cases on a daily basis now. But the question is whether they can infect others. And we actually saw that 80 percent of vaccinated individuals who have become confirmed cases themselves, 80 percent of them have zero contacts that have been confirmed. And another 10 percent have only one contact that was confirmed to be a case because of their connection with this individual.
So, their ability to infect others is 50 percent lower than those who are not vaccinated.
DICKERSON: Just so I make it abundantly clear, you found there is some very small amount of those who have been vaccinated who can spread, but it is quite small. The majority of those who have been vaccinated, you found, are not spreading?
ALROY-PREIS: Exactly. Exactly. There is a spread among household contacts. But if we take household contacts out of the equation, the risk of confirmed cases who are vaccinated to infect others is about 10 percent to infect one other individual, and lower than 10 percent to infect more than one.
(…)
11:20:22 a.m. Eastern
DICKERSON: Let's start, Dr. Gottlieb, with what Dr. Alroy-Preis was say about this very specific issue of breakthrough cases. So, once people are vaccinated, there are some breakthrough, that everybody expected they would get infected. But what Dr. Alroy-Preis was saying was that of those breakthrough cases, only 10 percent infect one other person, and the percentage is even lower for those who infect more than one.
So, it seems like breakthrough cases is a small set, and there is an even smaller set who might pass on infection to others. Is that the way you see it?
DR. SCOTT GOTTLIEB: That's right. We know there is more people with this delta variant who’ve been vaccinated who are probably spreading the infection, but it is still a very small percentage of people who are becoming infected after vaccination, and who then are going on to spread the infection to others.
Remember, the original premise behind these vaccines were that they would substantially reduce the risk of death and severe disease and hospitalization, and that was the date that that came out of the initial clinical trials. That premise is still fully intact.
(…)
DICKERSON: So, Dr. Fauci said they found in the Provincetown study that the amount of virus in the nasal pharynx is the same as somebody who had not been vaccinated. So, help me understand. That seems like, if there’s a breakthrough case, then you’ve got the ability to spread if it’s in the nasal pharynx, but then what Dr. Alroy-Preis was saying that it seemed like a much smaller group of people in the breakthrough category that could pass it on. So, help me understand maybe the disconnect between those too.
GOTTLIEB: Right. The CDC is inferring from this study that there’s a risk of transmission in vaccinated individuals. And effectively what they saw is what Dr. Fauci said, high levels of the virus in the nasal pharynx of individuals who are vaccinated and became subsequently infected, on par with the level of virus that you would see in someone who wasn't vaccinated.
But we know two things. First of all, nasopharyngeal swabs, the virus titers to see in those nasopharyngeal swabs while it is suggestive of someone's ability to spread the virus, it doesn't prove they're able to spread the virus. So, it is not a perfect correlate with your ability to transmit the virus or how contagious you are. You really want to measure virus levels in the lower airways because that’s where aerosols are created, and we know you spread this virus through aerosols.
And we have other evidence that came out this week that people who are vaccinated, even if their viral titers are very high initially for the first 24 hours after they’ve become infect, even if they're asymptomatic and infect; we know their viral titers fall much more quickly than those who are unvaccinated.
So, maybe after a day or two days or three days, they’re much less likely to spread the virus than someone who remains unvaccinated. So, initially someone who’s vaccinated may have the same level to spread the virus, may be on par with someone who is unvaccinated, but their ability to spread the virus probably diminishes more quickly. And therefore out in the community, if you were measuring their ability to transmit the virus, you would probably see on the whole they're less likely to be contagious.
(…)
