A single line often inverts meaning once you see what it
answers, so neighbouring messages are always shown.
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Oct. 4, 2014 - Some drama today. A 35 year old man and his 5 yo daughter (Liberian Green card lives in New Jersey) flying from Monrovia on United Airlines to Brussels and then United to Newark. Man throws up on the Brussels - Newark flight. When plane lands CDC person on the ground judges that the person does not have Ebola and recommends that he be taken to hospital for checkup and releases the other passengers. To Tom Frieden's great dismay, the White House (Lisa Monaco) and Sylvia Burwell over-rule CDC decision and have Hazmat remove man and daughter to hospital and call lex Witt; PBS back the released passengers who were already either on the way home or boarding connecting flights in order to get their contact information and pass out forms telling them what to do if they get fever or sxs. Sylvia asked me to be on conference call discussing this with Lisa Monaco, Sec. Jay Johnson of DHS, Leslie Dach, Jennifer Palmieri of White House Comms and NSC Rand Beers and Ned Price. Decision on first call was to find out the clinical judgment of the hospital staff as to whether this person might have Ebola. If they felt there was a risk, they would do Ebola PCR, which would take 2 hours for primary result and up to 72 hours for confirmation. Decided to wait for second call in 2 hours. In between calls I called Tom Frieden to offer to help him out. He was greatly distressed that the WH and Sylvia over-ruled CDC and called the passengers back since the CDC person on the ground felt that the man did not have Ebola. He said he cannot do his job if he is being second-guessed by the Secretary and her team. He even spoke about resigning. I told him that this was ridiculous and that I would try to help him by speaking with Leslie and Sylvia. Also, Sylvia and Sec. Johnson (DHS) want to institute entry screening with questioning and temperaturetaking. There is already exit screening at the West African airports and Tom is against repeating things just to make people feel good. Sylvia and Leslie want my opinion and I will speak with Leslie tonight about this. On the second call at 5:30 PM (beautiful Fall day in DC with clear skies and 70 F), it was disclosed that the Jersey hospital found that the patient had no fever or abnormal labs; felt good; and had had an episode of vertigo. The patient will be released without restrictions and the passengers will be told that all is clear. Tom is beside himself. Also had long conversation with Mike Gerson today briefing him on story he is writing about the complexities of doing a vaccine trial for Ebola - scientific and ethical issues. Press today → NBC Today Show Weekend Edition; MSNBC with Alex Witt; PBS NewsHour Weekend Edition
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Oct. 5, 2014 - It is interesting that with the 24 hour News Cycle has created its own dynamic. Today (Sunday) the national news was totally dominated by Ebola. Now the questions center around whether we should do entry screening as passengers get off the plane from West Africa even though there is exit screening at the west African airports with temperature taking and questionnaires. DHS and some Congressmen want temperature taking at the entry level also, which would only cut the window of vulnerability down by hours that the person is on the plane. Yet, there will be a meeting at the White House today to discuss entry screening. Frieden is against it, but he is going to lose the argument. Leslie Dach and Sylvia asked me yesterday what I thought about it. I told them that it would be for PR reasons only since it really substantively makes no difference. I went on the Sunday Shows today with FOX News with Chris Wallace and face the Nation. Tom Frieden did This Week and Meet the press and State of the Union. Questions were related to Rand Paul and Bobby Jindal saying that we should shut down flights from West Africa. I totally disagreed. Also, there was concern on Rand Paul's part that our 3000 to 4000 troops that we are sending to West Africa will get infected and bring Ebola back to the USA. Ridiculous. I got many congratulatory e-mails from people telling me how well I did on the Sunday Shows. In the evening, I did CNN.
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Oct. 6, 2014 - White House meeting discussed increased entry screening, but no firm recommendations to date. Big 24 hour News topic is whether to close the borders to West African flights. I have been very vocally against this (as had Tom Frieden) since it will only isolate the West African countries and make them less able to deal with the epidemic. It could cause political instability and even government collapse. In my interviewers over the past 2 days I have said that to interviewers as good as Chris Wallace and as less experiences as Elizabeth Hasselbeck of FOX News. Two things have resulted:1) I am getting a lot of hate mail from crazy neo-Nazi types who say that we should not care about dysfunctional black Africans. In addition, bloggers are cheering me on about taking on the right wing news people about closing the borders. I do not feel that I have "taken them on"; I have just told them my opinion. Bloggers have been particularly hard on Elizabeth Hasselbeck saying she was completely over-matched in her interview with me. I did not know beforehand, but she apparently has been a star on "Survivor" and "The Voice" TV Shows. She clearly is very beautiful, and I do not think that she is stupid the way the bloggers are saying. Press appearances today: CNN New Day; Fox and Friends (Elizabeth Hasselbeck); Diane Rehm Show; MSNBC; PBS The NewsHour (Jeff Green) Seems that we (Cliff and I) have won the battle to convince people that we need to do an RCT for an Ebola Vaccine.
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Oct. 7, 2014 - Continued media frenzy. Each day they pick something else to hammer into the ground. Topic today is the POTUS considering increasing the level of screening by possibly introducing "entry" screening with temperature and questionnaire. Discussions divided along ideological lines. Right wing saying to close borders; execute or euthanize African patients. I have been on the air stressing the lack of rationale for closing the borders of African countries not permitting travel. For the first time since the old AIDS days, I am getting hate mail telling me to go "rot in hell". Also, the right wing bloggers who comment online after my TV clips are shown online are trashing me calling me a liberal asshole selling out to Obama and his socialist views and liberal leanings. Very weird stuff here. More press today → CNN New Day; Wilson Center teleconference (call in); WTOP Radio; MSNBC (Ronan Farrow); WCBS radio New York; FOX with Lou Dobbs; Alan Colmes Radio Show
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2014-10-08 00:00
Anthony S. Fauci
Oct. 8, 2014 - Media frenzy continues. White House came out today and indicated increased layer of screening at airport on the arrival/entry level with: 1) temperatures; 2) questionnaire about contacts; 3) presence of sxs; 4) quarantine if necessary. The White House in its ridiculous need to control the message will not let Tom Frieden or I do any TV today (OK for tomorrow) since they only want DHS out there delivering the message. Hate mail continues as well as just criticism from far right. Somewhat embarrassing AM phone call today on the HHS teleconference with Sylvia, Tom Frieden, Peggy Hamburg, me, Nicki Lurie, etc. Tom was concerned that with the POTUS announcement at 3:00 PM that they would not be able to implement the 4 items (see above) at the chosen airports of Kennedy, O'Hare, Dulles, Atlanta, and Newark within the next couple of days. He expressed this to Sylvia and she argued that they would have to do it since they told the White House at the last meeting with them that they would. Tom said that this was not his understanding and he was afraid that there might be some embarrassing slip-ups. Sylvia was not pleased and in her usual gentle way made it clear that CDC would have to make it happen. Very awkward moment on the phone.
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Oct. 9, 2014 - Mor of the same. Dallas patient) died today. Black community led by Jesse Jackson saying that he go suboptimal care because he is black (surprise, surprise for Jesse). Ton Frieden mad a statement at a World Bank meeting that Ebola could be the next AIDS. The press is jumping all over that and I am trying to bail him out by saying that there are very many dissimilarities and the major similarity is the fear associated with the early years of AIDS. Much Press today - CNBC (Sqwauk Box); FOX Business with Varney and Company; MSNBC with Andrea Mitchell; CNN with Wolf Blitzer X 2; AP TV.
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Oct. 10, 2014 - Sylvia Burwell calls me at 7:45 AM concerned about the media coverage of Tom Frieden's statement comparing Ebola to HIV/AIDS. Wants me to speak with Tom to get him to understand the problem with this statement. Called Tom right away and discussed with him. He now gets it and realizes that he should not have said it that way. I told him that the comparison is strong regarding the fear, but the magnitude and other aspects are very different. Continued doing much press → WTOP Radio; MSNBC with Craig Melvin; PBS Charlie Rose; Has interesting dinner hosted at the Fiola Mare (on 3050 K Street, N.W.) by Catherine and Wayne Reynolds. Usual DC Glitterati there. Had great conversation with ex-CIA Director Mike Hayden about what is going on with ISIS. He joked that the Ebola situation and me on TV is bumping ISIS of the media coverage. Great idea by Wayne Reynolds. Wolf Blitzer was at the dinner and Wayne (at the end of the dinner right before dessert had Wolf "interview" me in front of the people sitting at dinner just as if we were on the CNN TV set. The dinner crowd loved it. It was fun.
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Oct. 11, 2014 - Saturday conference call with Sylvia. Implementation of additional screening started at JFK Airport. Issue of a nurse who took care of may be infected. More later on that. Typical situation of what we will see more of especially as we approach the flu season. Everyone who has a fever, exposed or not thinks that they have Ebola. Press → NBC Today (Weekend); MSNBC with Alex Witt; PBS The NewsHour (Weekend)
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Oct 12, 2014 (Sunday) - A very important issue that arose this weekend. Very early in the morning at approximately 5:45 t0 6:00 AM, I received an e-mail from Leslie Dach that there would be a conference call with Sylvia, Lisa Monaco, White House Comms (Palmieri), Tom Frieden, me, etc. about a breaking situation. A nurse (turned out to be - see below) who had been caring for at the Dallas hospital reported to be ill. It is felt that there was likely an innocent, inadvertent breaking of protocol on the part of the nurse. She had taken direct care of during very serious parts of his illness including hemodialysis, intubation, and insertion of a rectal tube. The nurse became febrile on Friday evening, reported to authorities on Saturday, the preliminary Ebola test was done on Saturday and the results came back positive on Sunday (today), subsequently confirmed by CDC. I was just getting ready to go on the Sunday morning shows today when the phone call came to discuss what approach we would take. This ignited an extraordinary media frenzy in which Tom Frieden. I was virtually on every show. I was on "This Week" on ABC as well as "Meet the Press" as well as CNN "State of the Union" as well as evening CNN. There is now considerable concern in the country that the United States government keeps saying that we are prepared and then something like this happens which creates a credibility gap. I have been intensively emphasizing on my interviews that we need to distinguish between the unlikelihood that there will be an outbreak which still does not change since the contact tracing that has been done with the case is working and there is a good umbrella over and identification of the people who were contacts and they are currently being monitored either actively or on their own. This needs to be distinguished from a inadvertent breach of protocol in which a healthcare worker has gotten infected which is bad for health care workers but really has nothing to do with an outbreak in the country. I have been continually expressing this in my interviews. One issue that has come up is a concern on the part of nurses throughout the country that the use of the term "breach" in protocol implies that the nurses are to blame and this nurse in particular was to blame. I have been very active in emphasizing that this is not the case that this is an inadvertent, innocent, "breach" of protocol and that we need to intensify the training for the nurses. The nurses themselves have said that they are inadequately trained and although the protocol might be a good protocol, they are not trained to implement the protocol. The CDC has responded by being very proactive in increasing their training with webinars, conference calls, and active visits on the part of CDC staff to the involved hospital in Dallas as well as to anywhere else where this situation might arise. Press - This Week (ABC); Meet the Press, CNN State of the Union; CNN evening. Oct.13, 2014 - One of the busiest press days that I have had. Media frenzy at high pitch. Much, much criticism of the USG and CDC is particular saying that the USG and CDC keep telling us we have everything under control and still there are many mis-steps. I have been calmly explaining on TV and radio that people should not conflate what is working, i.e. the lack of an outbreak because of the proper implementation of isolation and care of Ebola patients and the infection of a health care worker. Clearly, HCWs are not implementing the CDC PPE protocol. CDC people went down to Dallas and the HCWS are doing a lot of things incorrectly. Thus, the ability of our hospital to recognize (dropped the ball with on the first ER visit) and treat Ebola safely (infected health care worker) is not working well. Clearly, HCWs have not really been properly trained and although they believe that they are following protocol, they are not. The outbreak still rages in West Africa. Today (Oct. 13) a second nurse who had taken care of had a couple of days ago flown home to Cleveland and had not had any sxs or fever. While is Cleveland, she developed a temperature of 99.3 F. The CDC cut-off is 101 F. The nurse (Amber Vinson) called the CDC and asked if she could fly home and the CDC person cleared her to fly. When she got to Dallas, it was clear that she was febrile and that theoretically, she had exposed the passengers on the flight from Cleveland back to Dallas. Major, major lapse in judgment on the part of CDC in letting her fly since she did not fulfill the precise definition of febrile. Now a massive contact tracing of the passengers is taking place with many of them already having taken connecting flights. This is causing a major crisis of confidence in the CDC and specifically for Tom Frieden. The fact that the CDC gave her permission to fly back to Dallas was made public on Oct. 15 Sylvia called me on my cell after a TV show and asked me to help her prepare over the phone for her media interviews the next day. She also tasked me to write 2 memos for her to the POTUS to explain why PCR screening at airports is not a good idea (Bill Gates suggested this to the POTUS) and also the explain to the POTUS what we are doing with therapies (a Senator told him that HHS is not doing enough on therapies. Press → CNN New Day; WTOP radio; Fox and Friends; NBC News; MSNBC with Andrea Mitchell; CBS Evening News; MSNBC Hardball with Chris Matthews; CNN with Wolf Blitzer; FOX News with Megyn Kelly; Good Morning America with Robin Roberts.