captioning sponsored by cbs >> dickerson: i'm john dickerson in washington, and this week on "face the nation," u.s. health officials say the war against covid-19 has changed, and the u.s. is back in the top spot when it comes to the highest number of new infections worldwide. along with it's surge in new cases, covid anxiety is also making a comeback this summer. new c.d.c. data shows vaccinated people who have caught the delta variant may be just as contagious as non-vaccinated people. and more health restrictions may be ahead.

the delta variant now accounts for more than 80% of covid cases in the u.s. vaccines still offer the best protection against severe illness and death, and the pleas for holdouts to get the shots are getting more dire. >> biden: this is an american tragedy. people are dying and will die, who don't have to die. if you're vaccinated, you don't have to die. >> dickerson: we'll talk to dr. anthony fauci and former f.d.a. commissioner dr. scott gottlieb. and we'll ask dr. sharon alroy-preis, the top health official in israel, what her country has learned from their vaccine campaign that can help the u.s. then...america's economy is moving ahead, but there are troubled spots there, too. inflation is rising, and the housing eviction moratorium has expired, and now millions could lose their homes. we'll talk with neel kashkari.

plus...infrastructure. >> biden: a fancy word for bridges, roads, -s ng wat de president is putting the finishing touches on a $1 o. we'll talk with west virginia democratic senator joe manchin. it is all just ahead on "face the nation." ♪ >> dickerson: good morning. and welcome to "face the nation." there is good news and bad news on the pandemic. the covid-19 delta variant is even worse than we thought, making it clear that this pandemic is far nm over.bulappeartokilly, the last week. but we still have a long way to go. our coverage begins with senior nationalma

strassmann. >> reporter: good morning, john. more than half of america's counties are now considered high transmission areas for covid. new daily cases are now higher than they were at this point last summer. and yet many americans still cut loose as though this pandemic is over. chicago's annual four-day musicfest for tense of thousands of people, many unmasked. on thursday, 90% of concert-goers showed proof of vaccination, 600 people without paperwork were turned away. the worry: this new delta variant can spread like chicken pox. even vaccinated people can get it and give it. >> we're in the midst of our fourth surge in the city, and that is being driven by the delta variat. >> reporter: at two san francisco area hospitals, at least 233 staff members

tested positive for the virus over the last month. 75% of those infected had been vaccinated in america's most vaccinated city. nationalecity. nationally, 97% were unvaccinated. in these 43states, the c.d.c. predicts covid deaths will likely rise. >> to those unvaccinated, shame on you. >> reporter: one response: vaccine mandate at netflix, google, facebook, morgan stanley, and 600 universities. all former and current military members get a vaccine or face weekly testing. fear is motivating. almost five million people got shots in the last few weeks. many in hot spot states with low vaccination rates, like louisiana, arkansas, and mississippi. >> all of my doctors have

basically told me i should get it, so we're here. >> reporter: but also increasingly apparent, the depth of denial. >>why are we testing healthy people to find out rections andndn ste of florida. [applause and cheering] >> reporter: his state set a record on friday for the highest number of new cases since the start of the pandemic. in texas, the governor's anti-mandate executive order says texans have mastered the safe practices that help to prevent and avoid the spread of covid-19. on friday, texas reported more than 13,000 new cases, its highest single-day jump in almost six months. >> we have been here before. we have seen the movie over again. and what was once unpreventable, today it is preventable. >> reporter: these protests are back because masking is back. new mandates in places like washington, d.c., kansas city and atlanta,

regardless of vaccination status. no one likes wearing one; millions still refuse. >> i don't agree with it because it takes away my individuality. >> reporter: now some good news: almost a half million more americans got their first shot yesterday. pthe c.d.c. says that is, without question, the surest way out of this pandemic. john? >> dickerson: mark strassmann, thank you. we go to president biden's chief medical advisor, dr. anthony fauci. >> doctor: good morning, john. >> dickerson: i would like to start with the new thinking on covid-19, that was part of the c.d.c.'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? >> doctor: a confirmation of how easily it spreads from person to person. 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% 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 th vus ine nasal pharynx, it is quite high and equivalent to the nasal pharynx of unvaccinated people who get infected. that is very different from the alpha variant. in the alpha variant, the level of virus was extremely low in the vaccinated people compared to the unvaccinated people. not so with delta. so we know that vaccinated people who get breakthrough infections can spread the virus to other people. >> dickerson: sticking on that point, we have always known that it was not 100% 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 d? phenomenon of the ability to spread is clear, we're eive clearly in a number of situations. when you look at the data we have gotten from a single study so far -- and other studies are coming out -- you have a availability, but the mean or average 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 and some people low, but the medium will be very similar to the unvaccinated person. which is troublesome.

it tells you the potential for transmission is there. >> dickerson: that's why the mask guidance because there are these cases in which it is possible to spread? >> doctor: right. the situation is 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 mi minimal symptoms or no symptoms, and we know the reason is that the level of virus is high, so you want to make sure they don't get infected. tht's the reason why and the fundamental basis for the c.d.c. 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. >> dickerson: so people who say, i don't want to wear a mask, that is my personal decision. that's the way they see it. as you see it, what decision are they making by not wearing a mask? >> doctor: one of the issues that looms when you're dealing with this is that you understand people's feelings that they have the individual right to make their own decision. and i respect that, for sure. but the issue is, if you're going to be part of the transmission chain to someone else, then your decision is impacting someone else. it is not only impacting you. and you've got to think about it that you are a member of society and you have a responsibility. >> dickerson: let me ask you about context here. in the c.d.c. document, there was an expression -- someone wrote: "the war has changed based on these new findings." but isn't the war the same, that there are

pockets of the country that are not getting vaccinated, and that's the big issue, and that hasn't changed despite what we have been talking about for the last four minutes? >> doctor: you're absolutely correct. we have 100 million people in this country, john, who are eligible to be vaccinated who are not vaccinated. we've really got to get those people to change their minds, make it easy for them, convince them, do something to get them to be vaccinated because they are the ones that are promulgating this outbreak. so you're absolutely correct. that hasn't changed. what has magnified the problem, john, is that we're now dealing with a virus that has an extraordinary capability of spreading from person to person. so when you super impose one on the other, you have a very difficult situation, a pool of unvaccinated people and a virus that spreads very efficiently. >> dickerson: looking at the masar this mask

guidance, we talked about the ability to transmit among those who are already vaccinated, but it looks like the story of that study could also be that vaccines work. >> doctor: oh, absolutely. it is understandable how there could be kind of a dual or a mixed message from that study, but the predominant message is that if you are vaccinated and you get a breakthrough infection -- first of all, if you're vaccinated, you're much, much more protected against getting infected from someone who is unvaccinated. but the critical issue, john, is if you do get infected, the likelihood of your getting a severe outcome of the infection is very low. it is much more likely that you will be either without symptoms or minimally symptomatic. so the vaccine is doing what you want it to do: it is protecting people from getting sick. >> dickerson: there seems to be some evidence that the message isgeing throug.

the total number of new vaccinated reported in the last seven days is the highest since the week of july 4th. in low vaccination areas, the vaccination uptake is high. (a) why is that happening? (b) when did you think we'll see the dividends from those vaccination? >> doctor: i think it is happening for two reasons. i think that, first of all, we're trying as hard as we can to make it as easy as possible for people to get vaccinated, using trusted messengers. i think when people realize and look around them and see that in the area where they live, the virus and the infection is escalating considerably compared to areas that have a high degree of vaccination. so it is sort of common sense. but i'm also gratified by seeing that even people who in the beginning were reluctant to promote vaccination are now doing it. people like republicans, like stev steve scalise, asa

hutchinson out there beg th bushes,courpeople tovaed. beg th bushes,courpeople tovaed. happening now. >> dickerson: dr. fauci, thank you so much for helping us go through this. this. "face and if samples are available. effects of botox® may spread hours to weeks after injection causing serious symptoms. alert your doctor right away, as difficulty swallowing, ...speaking, breathing, eye problems, or muscle weakness... ...can be signs of a life- threatening condition. side effects may include allergic reactions... ...neck and injection site pain... ...fatigue, and headache. don't receive botox® if there's a skin infection. tell your doctor your medical history, muscle or nerve conditions... ...and medications, including botulinum toxins, as these may increase the risk of serious side effects. most patients may pay as little as $0 for botox®. so, text to see how you can save.

botox® has been preventing headaches and migraines before they even start for 10 years. >> dickerson: the senate is reconvening this afternoon to resume consideration of a roughly $1 trillion infrastructure bill. one of the democrats leading the bipartisan negotiations is senator joe manchin of west virginia. good morning, senator. >> senator: good morning, john. >> dickerson: this isn't just an infrastructure bill. the president said this signals to the world that democracy can function. so it has a lot on its shoulders -- >> senator: it sure does. >> dickerson: what are the next steps for this to become law? >> i think it is 999.1%

done. we want to be done by thursday. we want to move on, okay? >> dickerson: but it is not just the senate that speaks. the house also has a role? >> senator: oh, yes. but i'm saying it moves on from the senate. >> dickerson: for it to become law, it is linked to the budget bill. do you not see that it is linked together? >> senator: i have always believed that everything should rise or fall on its own merits. you just said something that the president of the united states tells the whole world -- this is the president's bill, all of our bill. there is not an infrastructure need in the country that has an "r" or "d" on it. >> dickerson: but the president also has other ideas about the country, and they're all contained in this other budget bill. >> senator: i understand. >> dickerson: and nancy pelosi has said only when the senate passes this bill will we let this infrastructure bill through -- >> senator: i would never, ever try to advice

speaker pelosi on how she runs the house. i think she does a marvelous job. but the bottom line is: we have a bill that 80% of the public -- we have a bill that mostly every democrat and republican should be supporting, the infrastructure bill -- it should fall or rise on its own. >> dickerson: but you're saying that the house should pass their infrastructure, and then you go through the process and the president votes on it? they shouldn't hold it up? >> senator: i would not think that that would be the best to do for the public -- we're trying to sure the whole country we're back and we can do things in a bipartisan way. we don't expect to do the next bill by bipartisan, it is strictly a party-line vote. let's look at the whole bill. don't forget, we've got inflation. we've got a $28.6 trillion debt. all hi jump in.rswet ,t

the first i republicans and democrats can work together. it seems like the second test of democracy is this three-legged race with house liberals, or can joe manchin sign on to a budget reconciliation that bernie sanders also agrees with. >> senator: it is all about compromise. we've been working on this for six weeks. and we have finally come down to the last day or hour to get it finished. it takes compromise. i respect my leagues who believe something a lot different than i do and i'm willing to listen and learn. if we can find that compromise, we'll find it. >> dickerson: alexandria ocasio-cortez, one of the leaders of the progressive movements in the house, says she has 10 progressives will who block infrastructure unless you in the senate will pass this budget bill? >> senator: maybe you'll have 15 or 20 republicans

who will see a good bill, who say, my gosh, i like this, it takes care of my transportation, it is the greatest jobs bill we have ever had, it runs for five to ten years and gives you total growth each year to try to stimulate the economy. so, you know what -- there was a haster bill -- >> dickerson: only republicans can vote. >> senator: i'll take a win wherever i canget it. >> dickerson: let me ask you about this budget bill. it has inside of it a lot of the president's priorities. it is clocked in at $3.5 trillion. is it the cost or paying for it -- >> senator: they're saying it is all paid for. if it is all paid for, you look at it in a different light. there are a lot of great things in there, but you get to the point like you do in your private life: what can you afford to pay for. i never voted for the tax

cuts. i complained to chuck schumer, and hn grade about trying to move this infrastructure bill right now. he has been pushing this, let's get a bill done. on the other bill, i said, you're going to make adjustments to the tax bill. are we still going to be competitive? >> dickerson: in other words, are taxes raised so high on businesses that they go to another country? >> >> senator: ly. >> senator: exactly. we have to be careful on all of that. >> dickerson: you can find to ways to pay for things that are fuzzy. there are other things that need to be worked out. the environment is one of them. >> senator: sure. >> dickerson: what concerns you about the environment? >> senator: my concern is being realistic and practical about what is going on in the world. in the next 10 years, 10% of the pollution is going to come from one country, china.

there are 6600 operating, and none in america. they're making you think the coal-fire plants, it basically solves the pollution. it doesn't.ore re of the world -- >> senator: the rest of irecti if we gut o fuel -- >> dickerson: they would argue the clock is ticking -- >> senator: and we're working. we know it does work. what we haven't been able to do is to be able to do it in a practical, profitable way, where it doesn't break the bank. once we lock that new technology, it is a game-changer. >> dickerson: can you come to compromise with the liberal members of the senate on the issues of the environment? >> senator: i would like to think so. >> dickerson: or is it going to be too hard -- >> senator: the reason i shot that campaign ad, that piece of legislation,

they were asking us to do things that technology hadn't development. once we were able to have a valued use for the carbon and make it into solid products, where we can use it for value added, it would be great. >> dickerson: do you think you can come to a compromise with senate democrats who said this is central to this bill passing? >> senator: i have always tried to come to compromise. i've always tried to finds the middle. if they don't want to find the middle, that's up to them. if you think you're going to eliminate your way to a cleaner environment, i totally disagree. you can e innovate your way to it -- >> dickerson: two other quick questions: the president said he wants to see some immigration provisions as part of this budget bill, including taking care of the dreamers. are you okay with that being included? >> senator: i'm a solid supporter of the 2013 immigration bill that passed. i'm still there. i think we should have a

pathway to citizenship, we should take care of the dreamers, and we neethose worken our system. >> dickerson: on this eviction moratorium, people could be evicted as soon as monday. how could the democrats in the white house and the senate fumble this? >> senator: there is $20 billion that is going out the door. we have to watch for fraud. if there is money there, we can help people. vaccinations are plentiful. the job market, we have nine million jobs that are unfulfilled. be careful, get vaccinated, wear your mask, get back into the flow and we should basically extend and help wht. >> dickerson: senat joe manchin thank you. you're going back to work. >> senator: i appreciate it, john. >> dickerson: we'll be right back with more. stay with us.

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>> dickerson: welcome back to "face the nation." the highly contagious delta variant could also complicate america's economic recover rev. we go to neel kashkari, the president of the federal reserve bank of minneapolis. >> good morning, john. >> dickerson: let's start with the delta variant. what effect do you think it is having on the economy? >> right now we have seven to nine million americans who are still out of work that we need to get back into the job market. we believe they've been out of work because they're nervous about covid and because of the

enhanced unemployment. i was optimistic that it would be a good fall market. but if people are nervous about the delta variant, that could slow some of the labor market recovery and therefore be a during on au our economic recovery. so the sooner we can get people vaccinated and delta variant under control, the better the economy will be. >> dickerson: when people are coming back into the labor market or have existing jobs, we hear a lot of stories -- the president was asked is at the townhall last week, a restaurant owner said, i'm having trouble finding people. the president said, you're goig to have a tough go of it because people are higher wages, more benefits. what is your view of where jobs are and the leverage that workers may have and how that affects the economy? >> well, this is unlike any other downturn any of us have lived through the u.s. economy went through a rapid shutdown and now a

rapid reopening, and there are a lot of adjustments that need to take place. we're seeing wages pick up, most quickly for the lowest-income workers, and in some of the service sectors, like the restaurant workers. and those folks are long overdue for a raise. i think at the end of the day, i think there will be more of a balance between business and the labor sector once we bring the seven to nine million americans back to work. the economy is opening more quickly than the labor supply, and the mismatch is giving some workers some power, but i believe it will balance out as we get back to normal. >> dickerson: do you still have a timeline for getting back to normal, your sense of the recovery and how it goes? as you said, we're in the situation where -- we haven't had to come out of a pandemic for more than 100 years. >> well, you know in december of last year, the federal reserve said we're going to keep our asset purchase going until we

have made substantial further progress in the labor market. we're about a third of a way back from where the hole was in december, so we've made progress. but we're still in a deep hole. seven to nine million americans should be working right now if the pandemic had never happened. that's a lot of americans we need to put back to work. that's what i'm very focused on, how quickly we can get them back. e last recovery took 10 years to put everybody back to work. we cannot have another 10-year recovery. i'm optimistic it can happen more quickly, but is it six months or two years, i'm not sure. >> dickerson: inflation, the question everybody wants an answer to. when we last talked, you predicted essentially the increase in prices. was it greater than you thought? and what is your base line view about inflation? >> it was greater than i thought, but my base line is i still think it is temporary. we're seeing most of it

tied to the pandemic. so most of the inflation in is the auto sector and in travel and transportation, so hotels and airline tickets and rental cars. but we're not seeing broader inflation across the economy as a whole. some of it is just math. prices fell a lot last year. they're bouncing back, so the inflation readings look really high. if you look across a two-year measure, inflation is 2.3 or 2.4%. i think it is transitory, but we're paying very close attention. and financial markets are signaling they think long-term inflation is solidly in check at 2%, which is where we want it to be. >> dickerson: what is your feeling then about the -- the c.e.o. of intel said because of the microchip shortage, things might not get back to normal until 2023. ananheuser-busch is having

trouble, proctor & gamble said it will cost about $2 billion in additional costs, the housing sector is having trouble because of supply issues. that is a lot of sectors seeming to have issues with supply. isn't that an inflation worry? >> it is an inflation worry, but in most of thse cases, the expectation is those supply chains are going to get worked out. remember a year ago, you couldn't get toilet paper. now the shelves are full of toilet paper. lumber prices have skyrocketed, and now they're falling back down to earth. the price increases are real, i'm not dismissing that, but a lot of the supply chain issues -- this is the market at work as businesses are trying to work out their issues and become more efficient. this is why it goes back to the virus. as the delta variant is spreading around the world, it is creating issues all around the world in a lot of our global suppliers. so the more we can do to get control of the delta o reant, the more quickly

some of these supply chain issues. >> dickerson: senator manchin was just on saying he is worried about the effect on the debt and deficit. the white house says unless this money is spent building american jobs, american growth may not be what we want it to be. how should people think about the question of the debt and inflation? >> well, long-term interest rates for debt are very, very low. that signals that the investors around the world have a lot of confidence in the economy. i think there is a difference on spending on infrastructure, where you can expect a aren't amount of return -- infrastructure focuses roads and bridges -- those are smart things to invest in from my humble opinion. >> dickerson: neel kashkari, thank you so much for being with us. we really appreciate it.

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>> dickerson: the number of covid-19 cases is also otr wealthier nations, vaccines are still in very short supply in most countries. elizabeth palmer reports. >> reporter: good morning. health workers have now injected more than four billion doses of the coronavirus vaccine into arms worldwide,and yet that is just about a third of the minimum that is going to be needed to bring this pandemic under control. southeast asia is still a hot spot. in bangkok, monks came to get their shots. meanwhile, refrigerated containers are back in service to store the dead. the first time they have been needed since thailand's tsunami in 2004. in the south of neighboring myanmar, medical staff had to evacuate patients from a

flooded hospital after a recent coups, public health systems are collapsing. and experts say fully half of the country could be infected in the next two weeks. even ground zero of this fresh outbreak in the city of nanzing, which has already 80ad of the vaccines worldwide have gone to higher income countries, though donations are, at last, starting to flow to the global south. notably, africa, where covid attendants deaths are up . in nigeria, 40% of the doses have now landed. and tanzania's new president got her shot on tv and urged people to do the same with a shipment of newly arrived johnson & johnson vaccine. haiti, too, in chaos and

suffering a serious covid outbreak finally received 500,000 doses from the united states. but until mid-july, it had been the only country in the americas to have none at all. the world health organization warns that as long as this vaccine inequity persists, this will be a two-track pandemic, and many of the world's poorest people will not even be offered their first shot until some time in 2023, john? >> dickerson: one country that started vaccinating its country early on is israel. that means the u.s. and other countries are watching israel's covid and vaccine data for clues. last week israel started giving those over the age of 60 booster shots, becoming the first country in the world to do so, after data showed diminished protection against covid among those who had been vaccinated

eight months ago. to get a sense of what israel is seeing that may give us guidance as to next steps here in the u.s., we turn now to sharon alroy-preis, who is israel's director of public health services. she joins us from jerusalem. good morning. >> good morning. thank you for having me. >> dickerson: thank you for being with us. so israel is seeing the same thing we have in the states, an uptake in cases because of the delta variant. what is the biggest concern for you with the delta variant? >> so there are two major concerns: one is that the delta variant is 50% more infectious than the previous, the alpha variant, which was 50% more infectious than the original one. and we still have a third of our population that is not immunized. we have a large children's population. that is obviously concerning. the other point is we're seeing about 50% of the people who are infected right now are vaccinated,

fully vaccinated, individuals. that is obviously of concern. previously we thought if fully vaccinated individuals are protected, and we're now seeing that the effectiveness against disease is roughly 40%. it still remains high for severe disease, but we are seeing diminished protection, especially for people who were vaccinated earlier. >> dickerson: in the category where you're seeing diminished protection, is it possible to break out what portion is diminished because they received the vaccine earlier, or for those who have, for lack of a better word, a robust vaccine protection? >> that was the million-dollar question for us. we've been following this for several weeks now, trying to see if it is a problem of elderly individuals who have lower immune system response,

and that together with our delta variant, which is more infectious, we see this, or it is waning immunity. like we have been seeing in the past several weeks, it is actually an evidence that there is waning immunity. we compared people both over the age of 60, but also between 16t to 59, who were immunized early on, fully vaccinated by the end of january, and we see infection rates among them that is 90 per 100,000, which is double that of those who were fully vaccinated by march. so we see a drop in the vaccine affe effectiveness for those vaccinated early on, and we see it for those elderly people over the age of 60. >> dickerson: so that data, presumably, obviously, is what is ee to draw the boost

any conclusions from those who have gotten the boost shot, has it worked? >> we just started the boost shot. i have to explain the decision to make a booster shot available is a combination of two things: first is really the evidence of what we think is waning immunity, and the difference between the affection rates between those who were vaccinated early on and those who were vaccinated later. but, also, the evidence that we have increased, severe, critical -- hospitalizations with severe and critical conditions along the 60 and above populations who were fully immunized, and that together with the fact that we're seeing lack of response to the vaccine over time, has led us to suggest to people, or actually allow them to be vaccinated a third time. so it is no we're seei more

disease, but they're getting to severe and critical conditions. >> 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? >> so we are looking at that. we're trying to introduce back what we call the pact, 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% of the confirmed cases on a daily basis now. but the question is whether they can infect others. and we actually saw that 80% of vaccinated individuals who have become confirmed cases

themselves, 80% have zero contacts that have been confirmed. and another 10% have only one contact that was confirmed to be a case because of their connection with that individual. so their ability to infect others is 50% lowar not vaccinated. >> dickerson: just so i make it abundantly clear, you found there is a very small amount of those who have been vaccinated that can spread, but it is quite small. the majority of those vaccinated, you found, are not spreading? >> 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% to infect one other individual, and lower 10%

to infect more than one. >> dickerson: thank you so much for being with us. we really appreciate it. >> sure. thank you for having me. >> dickerson: and we'll be right back.

>> dickerson: we go now to former f.d.a. commissioner dr. scott gottlieb. who is also on the boardm westport, connecticut. ord morning. >> dickerson: let's start, dr. scott gottlieb, with sharon alroy-preis was say about this issue of breakthrough cases. once people are vaccinated, there are some breakthrough, that everybody expected they would get infected. but what she was saying was that of those breakthrough cases, only 10%, can infect one other person, and the percentage is even lower to 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? >> doctor: that's right. we know there is more people with this delta variant who have 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. the original premise behind these vaccines is 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 trials. that premise is still fully intact. the vaccines are doing a very good job preventing symptomatic disease and death. the second premise is that they would reduce the instance of any infection, including asymptomatic infection, and reduce the risk of transmission, and they would be an important health tool in effectively ending the pandemic. that premise is still intact, but what we see with the delta variant is it is diminished. there is more evidence that people are likely t spread the other variants.

we need to recognize, especially for vaccinated people who may be in contact with young children, there is a risk they could develop a mild or asymptomatic infection and spread it to others. >> dickerson: dr. fauci said they found in the province town study that the amount of virus in the nasal path is the same of somebody who was not vaccinated. that seems to say if there is a breakthrough case, it has the opportunity to spread if in the pharynx, but sharon alroy-preis said it was a much smaller group who could maybe then pass it on. help me understand. >> doctor: the c.d.c. is inferring from this study there is a risk of transmission in vaccinated individuals. effectively what they saw is what dr. fauci said, high levels in the nasal pharynx who became subsequently infected, on par with the level of

virus in someone who wasn't vaccinated. but nasal 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 correlet. you want to measure the virus in the airwaves because you spread this virus through aerosols. and we have other evidence that came out, people who are vaccinated, even if their viral titers are very high, even if they're asymptomatic, the viral titers fall manage more quickly than those unvaccinated. so after a day or two days, they are much less likely to spread the virus. so initially someone who is vaccinated may have the same level to spread the virus, on par with someone who is unvaccinatedbut eir ability to ly

diminishes more quickly. 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. >> dickerson: one of the challenges that we've talked about before is that we weren't testing every single breakthrough case. the c.d.c. was waiting until people got to the hospital. they had some inklings of breakthrough cases, but should we do more to get to the bottom of this question? >> doctor: the c.d.c. has cohorts who were vaccinated in different points in time, and they peek at that data every two weeks to see whether or not they're seeing arriving incidence of breakthrough cases in the vaccinated individuals. the data that came out to the "washington post" do suggests that the c.d.c. has some evidence of declining efficacy in the vaccinated popuere vaccinated back in december and january, and question of boosters.

i think we should be following this. the c.d.c. is following it in smaller cohorts. other countries are following it much, much larger data sets, including the united kingdom and israel. on the one hand, we have a much more contagious variant, the delta variant. on the other hand, we have a population that is further out from when they were initially vaccinated. so if there is any declining efficacy of the vaccine, it is climbing up against a variant that is more contagious. >> dickerson: does this speed up the need for boosters, the new findings that are showing breakthrough cases, should that speed up their anthe vulneralyboosterstain pulati onof te pieces of dataked at an outbreak in nursing homes, and it was 61% affective

at preventing infection. so the initial premise is still intact, that they're preventing people from getting very, very sick. but if you see some decline in their ability to protect from any infection at all, it suggests that eventually you'll see that the infection breakthrough in more cases in those individuals and start causing symptomatic illness. >> dickerson: dr. scott gottlieb, thank you so much for being with us. that is it for today. until next week for "face the nation," i'm john dickerson. at u.s. bank, our goal is getting you to where you really want to be. ♪ because side by side, there's no telling how far you'll go. ♪ u.s. bank. we'll get there together. ♪

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