A single line often inverts meaning once you see what it
answers, so neighbouring messages are always shown.
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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.
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Oct. 14, 2014 - USG criticism high. Bill O'Reilly calling for resignation of Tom Frieden. I meet by phone with the New York Times Editorial Board. Also, I do NBC Nightly News, Fox News with Greta Van Susteren and MSNBC with Rachel Maddow. After I got off the air, Rachel tells her audience how proud she was of herself to have gotten me on her show since I was such an icon in medicine and public health.
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2014-10-14 00:00
Anthony S. Fauci
Oct. 14 -21, 2014 - From October 14 through October 21, the situation was so intense that I do not have time to document historical notes on a day by day basis. I am only doing this retrospectively now and will give dates as I recall. However over this period of time in light of the crisis of confidence against CDC and Tom Frieden related to a number of issues culminated by the fact that was allowed to fly back from Cleveland to Dallas, this was clear that Tom Frieden was in significant trouble over several days Sec. Burwell would call me usually in the late evening and nighttime asking for my advice about what we should do the CDC. At one point, I believe on October 14 or 15, she called me at night as I was in my car driving home. I parked the car in front of my house and continued to speak with her. Approximately 9 o'clock at night. She asked me what I thought about the possibility of removing Frieden from the job and wanted my advice about who could be a leading global health figure who could take Tom's place. I discussed forcibly with her that I believe that Tom was an outstanding public health official and a man of great integrity. However, I told her that I have to frankly tell her that Tom's staff is not serving him well. For example many of the people from CDC who of gone to Dallas to oversee the situation in the care of are people who know Ebola from behind the desk but left even never taking care of the patient or have done so many years ago. I told her to give Tom a chance and that I would try to speak to Tom about relying less on advice from his staff and more on his own judgment. Again during this time I have had multiple conversations, on a daily basis usually late at night with Tom Frieden. I will refer to these specifically below. In general, I was trying to convince him that it is possible that the CDC protocols as they exist on their website are not adequate for the tertiary care setting that we have in large hospitals such as Texas Presbyterian and elsewhere in the United States. Tom keeps on insisting that the CDC protocols have worked for decades in the field in Africa and that his staff tells him that the reason why the Dallas nurses got infected was likely be cost they had some breach in the protocol. I literally begged him over the phone that he should not say this and that we should re-examine the CDC protocols. This will all become clear after we admit to NIH Special Clinical Studies Unit (SCSU) at the NIH Clinical Center on Oct. 16, 2014 (see below).
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Oct. 15, 2014 - Media frenzy continues. I do CNN New Day, Morning Joe early in the AM. Talk of shipping patients out of Texas Presbyterian Health Hospital since they have had 2 infections of their nurses and they expect possibly more infections due to exposure of other hospital staff. Since got infected, others who were doing the same things that they were doing might also wind up infected and they wanted to clear out and transfer them. Today it is made public that CDC told Vinson she could fly back to Dallas from Cleveland. Very bad press for CDC and Tom.
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Oct. 16, 2014 - A truly transforming and important day here at NIH. First I testified before the House Committee on Energy and Commerce, Subcommittee on Oversight and Investigations chaired by Mr. Timothy Murphy (R-PA). Tom Frieden testified with me as did Luciana Borio of FDA, Robin Robinson of BARDA, and someone from Customs and Border Protection. Tom got hammered somewhat by the committee and was not strong and firm in his answers. He continues unfortunately to give a poor public appearance suggesting that he is not in control of the situation. He has shown the same slow deliberative response in the media which is costing him dearly since it is making him out to be less than he really is, which in my opinion is quite good. However, the most important event of the day was the fact that at 11:54 PM today, Thursday, October 16, 2014, Dallas nurse and now patient was transferred by air evacuation from Dallas to the NIH Clinical Center to be taking care of by us in the Special Clinical Studies Unit (SCSU). I had stopped off at Accura automobile showroom on Wisconsin Avenue where Diane Baker, Francis Collins's wife, was hosting a Friends of Patients at the NIH gala. I stayed there with Christine for an hour or so and then went back to the Clinical Center to await the arrival of i. I gathered with the SCSU staff at the ambulance entrance to the Clinical Center. Anthony Suffredini had accompanied [ij in the ambulance which drove from Frederick airport when the plane landed to the Clinical Center in Bethesda. Anthony was dressed in full personal protective equipment (PPE). When J Arrived Cliff Lane, Rick Davey, head of the SCSU, John Gallin, and I awaited her together with Tara Palmore who was dressed in full PPE gear. By the time we got settled upstairs in the SCSU it was in the middle of the night. I remember walking through the atrium at the Clinical Center to get on the elevator to go up to the SCSU, I had this extraordinary déja vu feeling of walking the halls late at night as an intern, resident, and chief resident at the New York HospitalCornell Medical Center where I often stayed up throughout the night taking care of patients. It was in fact an extraordinarily positive feeling that I had. I was doing something that I have always loved to do and continue to love to do - talking care of a sick patient in the middle of the night when there were only essential people around. Quiet, but intense.
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Oct. 17, 2014 (Friday) -- We (John Gallin, Cliff Lane, and I hold an incredibly well attended Town Hall meeting in Masur auditorium explaining to the NIH staff what we had done in admitting land why we felt that this was an important duty of ours. The crowd overflowed to Lipsett Auditorium and other rooms and still more people watched. on the webcast. Most people were supportive, but some objected such as Wyndom Wilson (NCI) who was concerned about our staff getting infected and then infecting others in the hospital. Typical Wyndom. Importantly, I did a press conference in front of the Clinical Center with dozens of TV cameras and reporters explaining why we admitted I a what the SCSU was all about. Intensive media interest. Staring from the night of| admission through Oct. 31, due to a number of crises and briefing that I needed to do and prepare for, I averaged about 3 to at the most 4 hours of sleep per night. I usually awoke at 3:00 AM to 4:00 AM having gone to sleep at midnight or later. The adrenaline surge must have awakened me, but that is what I did for several nights. Interesting situation arose. While cliff Lane was walking down a hall in the Clinical Center he ran into . They told Cliff that they were concermed since after the first night tha care of] in Dallas, she called her mother and sister and tried not to worry them, but did mention to them that she was unsure if they were properly protected with the PPE protocol that they were on. When ven! o Das i and tried to explain to a CDC person(s) who were there and they got the impression that the Texas Presbyterian Hospital people did not really want them to speak with the CDC. Cliff told me this and confirmed this in a conversation with Diana and Cathy as did John Gallin in a separate conversation.
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Oct. 18, 2014 --I talk to Nina through speaker phone. She is pleasant and I do not want to tire her since she is rather weak and worn out. Still have some diarrhea and has LFT abnormalities likely due to the experimental meds she received in Dallas. Besides a plasma transfusion from Kent Brantly she received ZMapp, Tekmira drug (siRNA), and Brincidofovir. Both brincidofvir and Tekmira could give LFT abnormalities. I appear on Good Morming America (weekend edition)