A single line often inverts meaning once you see what it
answers, so neighbouring messages are always shown.
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Jan. 30, 2020 - Another amazing and difficult day. Briefed the House Energy and Commerce Committee members in Rayburn 2123. All my friends kept saying I was a national hero and they "....felt safe in my arms (Eschoo)". Testifying with me were Bob redfield, Bob Kadlec and denise Hinton (FDA). The chaos: We had 2 PCCS led by Ruggiero and one Deputies lead by Mick Mulvaney with the usal cast of characters. Case in point. Mart Cetron who was listening in on the WHO call said that the epidemic was accelerating that this is was clear that the incubation period was shorter (2-5 days than was previously felt and that asymptomatic transmission was occurring. Thus, it was agreed to present to the POTUS a revised plan for containment: The 200 people at March Base would be quarantines for 15 days. Anyone coming in from Wuhan would be quarantined for 15 days. Anyone from any part of China would be voluntarily isolated for 15 days with monitoring by public health officials (State/Local). Azar would declare a Public Health Emergency and the State Department level alert would be level 4. The number of cases today are: 9480 with 213 deaths. It is increasing by about 25% per day. In 1 month it has surpassed SARS for 1 year (8000). WHO Declares a PHEIC Politico (Dan Diamond) is coming out with an article bashing badly Azar. HHS COMS had me speak to Dan and I greatly praised Azar. The POTUS announced the Coronavirus Task Force today (see below): Members of the President's Coronavirus Task Force: Secretary Alex Azar, Department of Health and Human Services Robert O'Brien, Assistant to the President for National Security Affairs Dr. Robert Redfield, Director of the Centers for Disease Control and Prevention Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health Deputy Secretary Stephen Biegun, Department of State ysHour; Ken Cuccinelli, Acting Deputy Secretary, Department of Homeland Security Joel Szabat, Acting Under Secretary for Policy, Department of Transportation Matthew Pottinger, Assistant to the President and Deputy National Security Advisor Rob Blair, Assistant to the President and Senior Advisor to the Chief of Staff Joseph Grogan, Assistant to the President and Director of the Domestic Policy Council Christopher Liddell, Assistant to the President and Deputy Chief of Staff for Policy Coordination Derek Kan, Executive Associate Director, Office of Management and Budget PRESS: FOX - "Fox and Friends"; ABC TV local; NBC TV local; PBS NewsHour; WTOP radio X2
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Jan. 31, 2020 - Another truly amazing day. Sequested in the White House essentially all day working out a proposal to put before the POTUS that would restrict travel from China. The proposal was driven largely by CDC (Marty Cetron) who felt that given the volume of people coning in from China by direct and even more importantly indirect flights it would be logistically impossible to effectively screen people at many, many airports and the diversion of people from their place of origin to selective airports would further complicate things. Also, the cases continue to sharply rise with 12000 cases and 259 deaths. Also, a NEJM report from Germany indicated that a Chinese woman came from Shanghai visited a colleague in Stockdorf Bavaria. She infected him when she had no sxs, returned to China and got sik on the plane. The german man then got sick and infected 2 other Germans. This would have bn the first truly documented case of transmission from an asymptomatic person, thus, adding to the concern about the accuracy of screening at airports. In addition, the WHO declared a PHEIC yesterday prompting Azar to declare a Public Health Emergency here in the USA. I disagreed with the latter since there were only 7 infections (6 travel) at the time. All this led to the conclusion of travel restriction. This was late in the afternoon - around 1:30-2:00 PM. The entire task force (above) plus Kellyanne Conway, Jessica Zitto (WH Coms) and a variety oof senior WH officials gatherd in the Roosevelt Room to hammer out how we would present this to the POTUS. The policy decision was: 1) Ban travel to the USA of all non-citizens who have been to China within the past 14 days. If you were in China, you need to go somewhere else (Paris, UK, etc.) until 14 days pass from the time you were in China. 2) If you are a citizen and were in the Hubei Province (includes Wuhan) and you return to USA, you are institutionally quarantined for 14 days. 3) If you come from any other part of China other than Hubei, you have voluntary isolation for 14 days. We wanted to present this to the POTUS befor the Stock Market closed so that we do not look like we held off to avoid bad effects. We went into the Oval Office at about 3:00 PM. We had been scheduled to go in at 2:30 PM but things backed up. Presentation was made to the POTUS by Azar, Bob Redfield and me. Trump as he did a couple of ddays ago posed many questions to me making sure that I thought it was a good idea. I said this was an imperfect process, but the best choice we have right now. He questioned me about what the difference was between this and flu. He somewhat brashly suggested even more stringent restrictions and was dyswaded by Kellyanne. She clearly has influence over the POTUS. Potus agreed and we immediately went out to the WH Press Briefing room that was packed. Azar led the presentation, but many questions were ansered by me. Interesting that impeachment was going on and the senate did not get the 4 GOP votes to allow witnesses to be called. This also dominated the news. We thought this would get us on the Sunday Talk Shows, but impeachment bumped us. White House is now fully convinced that I be the science/health spokesperson for the USG. Bob Redfield just does not come across very weel. He takes forever to say something and it is usually wondering. This drives the WH and HHS comms people crazy and so they are putting me out on all the requests. When I got back to my office, got call from Jeremy Farrar who sounded very concerned and conferenced me in with Kristian Anderson, an evolutionary biologist from Scripps. They had also been talking with Eddie Holmes, another evolutionary biologistfrom Sidney Australia. There have been conspiracy theories that the virus was given GOF by inserted mutations and deliberately or accidentally released in Wuhan. One theory was written by Indian investigators that HIV sequences were inserted by a Chinese person in Canada and released in Wuhan. Everyone thinks that is crazy, but the Farrar phone call was different. The people on the phone felt that the mutations around the furine cleavage site of the spike protein could not have occurred naturally since it would require an evolutionary "jump that they found nowhere in bat isolates. They bring up the possibility that this could have been deliberately inserted and either accidentally released or deliberately released by a crazy person in the lab, the former being the most likely. Jeremy was calling me for advice. I suggest that we get a larger group of qualified evolutionary biologists/virologists together under the auspices of a convening body and carefully look at this. We agreed to convene by phone the next day. I called Brian Harrison and Garrett Grigsby who arranged for a call with Azar to decide what to do. 1 several other Azar did not like the idea of WHO as convener because he feels (somewhat unfairly, I believe) that Tedros would immediately tell the Chinese and they would crush the attempt and/or think we are attacking them. We decided to have a 2-pronged approach strongly suggested by Kadlec who felt we had security responsibilities to investigate this ourselves. He would do this through OSTP and NAS. Meanwhile I would pursue a multinational approach with Jeremy. I decided to now bring in Francis. PRESS: The Today Show NBC; Lou Dobbs Fox; many print
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Feb. 1, 2020 - Conference call at 2:00 PM with Jeremy, Francis and several other scientists gathered by Jeremy (see below). Participants in the Feb., 2020 call included: • Francis Collins, Director of the U.S. National Institutes of Health, U.S.; • Anthony Fauci, Director of the U.S. National Institute of Allergy and Infectious Diseases, U.S.; • Jeremy Farrar, Director of the Wellcome Trust; • Patrick Vallance, U.K. Chief Scientific Adviser and Head of the Government Science and Engineering; • Kristian Anderson, Director of Infectious Disease Genomics, Scripps Research Translational Institute, CA, U.S.; • Christian Drosten, Director of Human Virology at the German Center for Infection Research at Charité - Universitätsmedizin, Germany; • Edward Holmes, Professor of Viral Evolution at University of Sydney; • Andrew Rambaut, Professor of Molecular Evolution, University of Edinburgh's Institute of Evolutionary Biology, U.K.; • Ron Fouchier, Deputy Head of Department of Viroscience, Erasmus Medical Center, NL; • Robert Garry, Professor of Virology, Tulane University School of Medicine, Louisana, U.S. ; • Mike Ferguson, Professor of Life Sciences at University of Dundee, U.K.; and • M.P.G. Koopmans, Head of Department of ViroScience, Erasmus Medical Center, NL. There was not total agreement about the likelihood of deliberate insertion. Ron Fouchier said he was sure that this could occur naturally and we should not waste our time and divert effort to pursue this. This is expected of him since he was the original GOF person with Yoshi Kawaoka. Also, Christian Drosten was with Ron; the rest felt that deliberate insertion was possible and given the fact that Dr. Zheng-Li Shi at the University of Wuhan has been working for years in GOF in coronaviruses to allow adaptation of the spike protein to bind to the human ACE2 receptor, we could not let this go. We decided to have Jeremy with Francis to contact Tedros with Stewart Simonson's help (I arranged this) to see if Tedros would convene experts. Meanwhile, the DHS and DOT and FAA are working hard on the logistics of diverting plans to selected airports that are associated with the capability of screening with questions and quarantining or moving to voluntary isolation. Airports are: LAX, SFO, Seattle, ATL, ORD, Hawaii, Newark, IAD, Detroit, DFW JFK, and Seattle PRESS: CNN (truck came to my house since I was so busy with wall-to-wall conference calls and hundreds of e-mails.;
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Feb. 2, 2020 - Call from Sylvia Burwell asking for clarification of the new policy regarding AU students who are returning fom China. Apparently, the policy is not up on the CDC website. Had daily Task Force call. Discussed the difficult logistics of airport funneling and quarantine/isolation at land crossings with Canada and Mexico. Cases now 14,551 and 304 deaths Now 3 aditional cases in USA = 11 Kansas City Chiefs beat SF 49ers - Patrick Mahomes stars abd comes back from 10 point deficit in the 4th quarter. PRESS: MSNBC; Fox Local TV; NBC Nightly News; CNN with Anna Cabrera
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2020-02-06 00:00
Anthony S. Fauci
Feb. 6, 2020 - Cases continue to soare with 28,018/563. Another packed day mostly at HHS and White House. Conspiracy theories still abound. The NAS group with OSTP met (see above) and decided that there was no clear evidence of malfeasance, but it should be looked into (see attachement below): NASEM Response to OSTP re Coronavi HO. Got good Briefed the Asia/East Asia Ambassadors on nCoV in Room EEOB-350. Then had long meeting of Coronavirus Task Force is Sit Room of WH chaired by Mick Mulvany at 4:00- 4:45PM when the core group of Task Force were called to Oval Office to brief POTUS. When we walked in the POTUS was not yet in the room. When he walked in with Melania, the first thing he did was say""Anthony, come here and say hello to Melania". Then, to my embarrassment in front of everyone (Kellyanne, Mick, Bob O'Brien and many in Cabinet) he told Melania that I was the smartest person in the world. We then sat down and briefed him and Melania. He asked what he could do and we said that since he would be calling Chinese President Xi Jinping late this evening, he could ask him to approve the WHO delegation of scientists that include CDC and NIH people. He did what he did last time and directed most of the questions to me, again ending with asking me if I thought that we were on the right track. During the task Force meeting, the issues came up of cruise ships (one in Yokohama, Japan, and one in New Jersey/New York) that had infected Chinese from Wuhan on them and discussion of how to handle quarantine for the rest of the passengers. PRESS: India TV; Podcast with Newt Gingrich; Podcast with Howard Buchner at JAMA (well-received by NYT and WSJ reporters.
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Feb. 7, 2020 - Started with 7:00 AM with a multi-party call hosted by WHO. Got good information. See below. 31,211/637. 61 infections on Japanese cruise ship. Chinese are starting to see a slight downtrend in cases. Perhaps we are turning things around in China? I warn on the call that we need to give developing countries the resources to do contact tracing and isolation or else as we decrease China, another country will become like China. Also, need serologies to determine extent of asymptomatic and minimally symptomatic infection so that we can determine the true case fatality rate among other things. Cancelled trip to Florida for Chris's birthday. So sorry. PRESS: Press conference at HHS with Azar, Redfield, Cuccinnelli, Biegun, Szabat; CNN; interviewed with: USA Today, Bloomberg Law (Jeannie Beaumann), Arizona republic, NY Times (Denise Grady), Bloomberg News (Bob Langreth; WJLA TV ABC7 (Local); CNN with Lou Dobbs.
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Feb. 8, 2020 - Numbers today: 34,867/724. First USCit died in Wuhan. Much press about this and the cruise ships in Japan and Bayonne. Infections and quarantine of the Japan ship (61 so far, including some USCits. 10 people under quarantine from airport screening at the 11 airports. People on Japanese ship getting cabin fever with v the quarantine quarantine. People on Bayonne ship have all been released and the Chinese nationals on the ship are going home. Tom Frieden called me this AM and we discussed various aspects of the outbreak. He and I are on the same page in thinking tht this is acting like a bad influenza in its transmissibility and that the denominator is much greater than 34,867 (above) making the case fatality rate (CFR) more like 0.2-0.3 % rather than 2.0%. PRESS: FOX and Friends; WTOP Radio; MSNBC
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Feb. 9, 2020 - Sunday, but it goes on. 37,593/814. People on the Japanese cruise ship are being released from quarantine. Outbreak still raging in China. Still only 12 cases in USA (9 travel from Wuhan and 2 spouses of 2 of the 9). Briefed the Governors at the Governors convention at the DC Convention Center PRESS: CNN International (good interview)
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Feb. 10, 2020 - 40,625/910. Outbreak still progressing. I will list below the quarantine centers associated with the various funneled airports: JB Pearl Harbor-Hickam, Hawaii (HNL) Great Lakes Training Center Navy Base, Illinois (ORD) Naval Air Station Joint Reserve Base, Texas (DFW) March ARB, California (LAX) Travis AFB, California (SFO) Dobbins ARB, Georgia (ATL) Fort Hamilton, New York (JFK) Naval Base Kitsap, Washington (SEA) Joint Base Anacostia, Washington DC (IAD) Joint Base McGuire-Dix-Lakehurst, New Jersey (EWR) Fort Custer Training Center, Michigan (DTW) The Department of Defense already has quarantine centers at Fort Carson in Colorado, Travis Air Force Base and Marine Corps Air Station Miramar in California, and Lackland Air Force Base in Texas. Ken Cucinnelli sends e-mail to Task Force saying that we should be much more aggressive in "mitigation" right now and not wait until outbreak in USA occurs. This triggers calls at HHS since it might look like HHS is not doing things correctly. Had a vigorous Task Force call at 4:00 PM to discuss merssaging and the fact that we need to prepare for mitigation. Ken Cuccinelli wants to prepare families and businesses to how they would respond to an outbreak. I pushed back saying that my experience with anthrax and the "duct tape" incident made me feel that this would inspire unnecessary panic or ridicule. We should prepare more forward-looking at the state and local health levels, not the family level. Infections on the Japanese Cruise ship up to 136. Sick people taken off and rest quarantined on ship. Question raised whether aerosol spread through ventilation system similar to spread of SARS in 2004 in Amoy Garden Apartment Complex in Hong Kong. 97 people die in China yesterday - most for a single day. CDC wants the airlines give them the contact information of passangers so that they can be tracked. Bob Redfield having trouble clearly articulating the process of converting from containment to mitigation. He is a good guy, but Bob is Bob. Azar/HHS/and WH are all putting me out there to explain things within our group and to the press. Bob seems OK and modestly wants to learn. I like him. PRESS: CNN (Jim Sciutto); Diane Rehm Podcast; Sean Hannity Radio Show; CNN International.