He also predicted a quiet spring and summer 2022 since many people have been vaccinated or infected so immunity in the US is high. By the end of March, many mask mandates will go away, as is already happening in most states and a growing number of schools.
Gottlieb, a former FDA commissioner and Pfizer board member, who also co-chaired the Healthy Sail Panel, spoke in an NCLH briefing for travel partners and media.
Masking on public transportation
The CDC's mask mandate for public transportation runs until March 18, and Gottlieb thinks the agency will extend it by two or three weeks but give a definitive end date.
He acknowledged some people don't want mask mandates lifted and predicted many will still wear masks in congregate settings, particularly in winter when flu and COVID circulate.
'One-way masking works,' Gottlieb said, provided it's a high-quality mask like an N95.
Vaccination decision in spring 2023?
Gottlieb surmised US public health officials may take a decision on vaccination mandates in springtime 2023, after the country gets through another fall and winter to see if COVID enters the endemic phase.
'This a transition year then they'll decide whether they want vaccinations in congregate settings like cruising, whether this becomes part of the childhood immunization schedule,' Gottlieb said.
Part of this may also depend on whether the vaccines get reformulated to become highly effective against any transmission, which is very valuable for congregate settings like cruising. If so, vaccination may be a tool to keep around, like annual flu shots. Should the vaccines remain primarily a prevention from people from becoming very sick, that has less relevance to congregate settings and becomes more of a personal choice for protection, Gottlieb said.
For the next 12 months, he believes a lot of people are likely to get a booster to take them through the fall and winter.
Addressing cruisers' isolation/quarantine fears
Noting that NCLH passengers are a highly vaccinated population, President and CEO Frank Del Rio said they're not so concerned about catching COVID — because they're protected against serious illness — but they worry about having to isolate if they test positive or to quarantine if a close contact does.
The CDC's new opt-in cruise program reduced isolation/quarantine times for highly vaccinated ships. Del Rio asked where this policy may be heading?
Less testing in future, more personal responsibility
Over time, Gottlieb thinks COVID will become like flu: 'If you get infected, stay home,' he said, adding the hope that employers will 'help people do the right thing,' There will also be less mandatory testing so fewer people who are asymptomatic will be detected. In short, Gottlieb sees a transition from government-imposed rules on isolation/quarantine to the expectation that people take personal responsibility.
Therapeutics will play an important role, too, and Gottlieb thinks they'll become widely available and continue to evolve and become more effective.
He's going to cruise with family this summer
Gottlieb said he feels 'very confident' about taking a cruise with his children and another family this summer, and he's trying to get his parents to join.
'We're gong to be in an environment where the prevalence will be low ... I'm looking forward to cruising again,' he said.