A single line often inverts meaning once you see what it
answers, so neighbouring messages are always shown.
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Feb. 11, 2020 - 13th American infected (San Diego). One of the people airevacuated by State to Miramar from Wuhan. Minimal sxs. 43,138/1018 Bob Kadlec offers the Japanese help in providing remdesivir in a compassionate use protocol to the people on the Diamond Princess cruise ship in Yokohama. >=mented. of cases Now 131 people infected and the rest are quarantined. I offer Cliff Lane to help with the protocol. A PCC document that I just read is proposing that even in Phase IV (see below) we should continue INA 212 (f) travel restrictions. I disagree with this since travel restrictions are to delay the entry of disease into your country. Once you have sustained transmission in your country, it is a waste of resources to try to keep out travelers. I cannot be on the PCC call this AM (on a panel at the Aspen Institute in DC) and so I called Bob Redfield and asked him to respresent me and my reservations about this: Phases of U.S. Government Response to the 2019 Novel Coronavirus (2019-nCoV) Phase I--Current Posture • Description: Foreign nationals who have been in China within 14 days prior to their actual or attempted entry into the United States are ineligible for admission under Section 212 (f) of the Immigration and Nationality Act (INA). Departments and agencies may exercise certain exemptions. Any person, but specifically U.S. citizens and legal permanent residents (LPRs) who have been: (1) in Hubei province within the past 14 days may be subject to 14 day mandatory quarantine; and (2) in China (outside Hubei province) within the past 14 days may be subject to screening and self-isolation for 14 days. All direct and indirect flights from China are funneled to 11 airports with enhanced CDC medical screening. CDC is coordinating with state and local health care clinicians to identify domestic cases, isolate cases, and conduct appropriate contact tracing. o Triggers: Already being implemented. • Objectives: (1) Contain the outbreak at its source, (2) minimize domestic importation of additional cases, (3) limit potential for domestic epidemic, and (4) prepare the domestic response mechanisms. • Messaging: Daily HHS and CDC briefings and on camera task force briefings as appropriate. Phase II--Aggressive Containment • Description: Expand the scope of the travel ban to account for additional states or territories. Apply quarantine measures above to people not covered by the travel ban, including U.S. persons, but who have traveled to these additional states or territories within the time frames described above. All direct and indirect flights from these additional states or territories will be funneled to the 11 airports with enhanced CDC medical screening. Consider reducing the number of airports to concentrate screening resources. CDC further coordinates with state and local health care clinicians to identify domestic cases, isolate cases, and conduct appropriate contact tracing. o Triggers: Sustained human to human transmission and exportation of cases without nexus to China. o China - domestic • Objectives: (1) Limit the outbreak to the source and additional outbreak areas, (2) minimize importation of additional cases, (3) limit potential for domestic epidemic, (4) additional preparation of the domestic response mechanisms and in some cases executing those plans, and (5) begin outreach to state and local authorities to prepare for Phase III and Phase IV. • Messaging: XYZ. • Specific Department and Agency Activities: XYZ. Phase III--Partial Mitigation • Description: Travel restrictions put in place by active INA 212(f) proclamations remain in place. Those not covered by any active travel bans, including U.S. persons from identified countries are allowed to travel to their final destination and may then be subject to self-isolation for 14 days, as coordinated by state and local authorities. Individuals who travel to the affected domestic areas or live in those areas may be subject to self-isolation for 14 days, as coordinated by state and local authorities. o Triggers: Sustained human to human transmission without nexus to China in two or more domestic locations. • Objectives: (1) Implement the national response, (2) reacting to the first domestic epicenters, and (3) mitigating and minimizing the impact of the disease. • Messaging: XYZ. • Specific Department and Agency Activities: XYZ. Phase IV--Mitigation • Description: Travel restrictions put in place by active INA 212(f) proclamations remain in place. Limit non-essential domestic travel, cancel public gatherings, social distancing, execute private sector and government continuity of operations. o Triggers: Wide-spread domestic human to human transmission, could be in cities or regional. • Objectives: (1) Preserve the functioning of critical infrastructure and mitigate impact to the economy and functioning of society, and (2) support community responses to the extent possible to mitigate illness, suffering, and death. • Messaging: XYZ. • Specific Department and Agency Activities: XYZ. WHO officially names the 2019-nCoV as "COVID19". Was on Panel at Aspen Institute chaired by Helen Branswell and with Nancy Messonnier and Ron Klain as co-panelists. Reminisced with Ron about the Ebole-White House days PRESS: NPR Radio 1A (Todd Zwillick); WTOP Radio; Press at the Aspen Institute (2300 N Street); FOX News (Lou Dobbs) ot using just lab
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Feb. 12, 2020 - 45,172/1115 Individual reports are coming out about various clinical characteristics. Unreviewed report now of virus in saliva of infected people. Let us see what kind of reponse that gets. Very busy day today with 4 Congressionald briefings! Also, complicated by wake of Eric Scorce today and funeral tomorrow. Much stress. First we briefed House members at Rayburn led by Rosa DeLauro, Nita Lowey and Tom Cole. Then we went to the Senate Dirksen to brief senators led by Lamar Alexander. Then to Capitol Visitors center to brief House members led by Eliot Engel. Then to Majority hosue leader Steny Hoyer's office to brief members. Steny was profuse in his praise for me, which was a little embarrassing On my way out of White House from the 4:00 to 5:00 PM Task Force meeting, ran into Larry Kudlow, who has become my new best friend. He joked about how many years I have been doing this and he has been following my career. His main question was when is this COVID19 going to crash the economy, i.e. when does he need to start worrying about it. It told him that we are OK for now but this could change rapidly if we start seing sustained person-to-person transmission. He asked me to keep him informed when in my opinion things are starting to go bad Having our second big multipeson conference call this AM with Mike Ryan, Tedros and WHO, Bruce Aylward (Canadian) called from China. He is part of WHO multi-national advance team in China. Still no invitation for US representation from China to be part of group. Azar getting very angry and blaming Tedros for not pushing with China to get us on the group. Azar feels that Tedros in bowing to Xi Jinping who does not want USA. Tough situation since Tedros and WHO depends greatly on China and often bows to them. PRESS: WTOP Radio; Bloomberg TV (by phone;
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Feb. 13, 2020 - 60,349/1369 Sharp increase in that they are not using just lab test for DX; they are using chest x-rays and CT scans of lung. Meeting at White House with Chairs and Ranking members of big 4 committees with Anne Schuket, General Paul Friedrichs, Bob Kadlec in Roosevelt Room. Kevin McCarthy, Steve Scalise, Greg Walden. Chaired by Mick Mulvaney. Also, Eric Ueland of WH Lewg there. Good questions. Many compliments PRESS: CBS This Morning (for showing tomorrow); FOX News (Lou Dobbs)
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Feb. 14, 2020 - 64,460/1384 Making plans to deal with Americans on Princess Diamond Cruise ship in Yokohama harbor. Cliff flying to Japan to help design a clinical trial to treat infected people with remdesivir. Then he is off to China as part of the WHO-sponsored delegation. Azar, Redfield, Kadlec and I briefed the entire Cabinet on a teleconference this AM PRESS: FOX Business; Spectrum News TV; Fox News with Dana perino;CBS This Morning ; CNBC
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2020-02-15 00:00
Anthony S. Fauci
Feb. 15, 2020 - 67,178/1527. Had White House Task Force conference call at 12:00 noon (Saturday). Big issue was the plan to get Americans off the Diamond Princess in Yokohama harbor. State will charter planes to get them to Lackland and Travis AF bases. Sick people will stay in Japanese hospitals. Uninfected and people whoise status is not clear will be flown out with the proper PPE for those who are thought to be at roisk of being infected. Also, discussed on the call the persistent problem of cruise ships in general, which could derail all polasn for containment since they scatter people from all over the world to all over the world. Important conference call chaired by Bob Kadlec with the ASPR and CDC people who are on the ground with the Diamond Princess Cruise ship in Yokohama. The conditions apper to be dreadful with major transmission on the boat. Many crew members getting infected. Japanese are not adhering to the required PPE. It seems that they are unaware of the potential transmissibility of the virus. The CDC people say the ship is like an "incubator" for the virus. One called it a cesspool of virus. This conversation makes it clear that we need to get US citizens off that ship. James Lawlor (Nebraska) and Michael Callahan (Mass. General) were on the call. PRESS: FOX News with Molly Line;
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Feb. 16, 2020 - 69,275/1670 (Sunday) Big discussion on phone with Kadlec, Anne Schuchat and Kevin (ASPR) on whether to remove a person from the evacuation plane who recently showed to be positive. Original plan was that anyone who was infected would not board plane evacuating people from the Diamond Princess. Now Kadlec and Kevin want to board them since people on the bus waiting to board have already been exposed on the bus to several people who are infected. Washington Post story by Jasmeen Abutaleb has me defending Azar against slurs against him (covertly by administration officials). I also say that w need to be fair to the POTUS (see below): "In fairness to the president, someone told him something that has a basis in reality. ... There is some validity in saying respiratory viruses like flu and coronavirus are seasonal," Fauci said. "The only thing is when you're dealing with a pandemic-type virus that is brand new, there's no way of knowing what's going to happen when the weather gets warm." Some officials have complained that Trump's comments about the virus emanate from his briefings with Azar, who they say has been overly controlling in the response and has told other doctors not to get too far into the details of the virus and the outbreak with Trump. Azar is disliked by many in the White House, four administration officials say. Fauci, however, said Azar has brought medical professionals with him to nearly every briefing and insisted they be part of Oval Office meetings. Azar "always defers to the scientists. That's the reason why whenever we're in the Situation room and the president would like some briefing, Alex always takes me and (CDC director) Bob Redfield in with him," Fauci said. "He always wants us to give the straight scientific information to the president." PRESS: Face the Nation (Margaret Brennan); nond Princess.
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Feb. 17, 2020 - 71,438/1775. 454 infected on Diamond Princess cruise ship. Heated discussion last evening (see above) with Bob Kadlec, Will Walters (State Med), Anne Schuchat, Kevin (ASPR) about whether to board people on the evacuation 747 plane who were originally scheduled to come home as "uninfected" after they just found out that 14 of them are in fact infected. The written agreement is that no documented infected people should get on the evac plane. Walters, Kevin and to some extent Bob Kadlec (he was complicit) insisted that since they were already on the bus, we should allow them on the plane. They said that we would not know what to do with them if they stayed since we could not leave them on the ship and the Japanese did not have facilities to take care of them (I do not believe the latter). Anne Schuchat vehemently argued that they should not be allowed to board since the public and written agreement was that they would be put on a plane WITHOUT infected people and this would be breaking that agreement. Nonetheless, Walters pushed and Kadlec (ASPR) caved and went along. Of note, later on (today) Walters said that he checked with me and I was OK with the boarding - a lie! On the call today Azar was upset since the entire Cabinet was questioning why we let them board and when he asked our stance, he heard that we (HHS) disagreed. He was upset that we did not speak with one voice and this looked bad. On the call today, I told him that State (Walters) was going to do what he wanted to do anyway no matter what we said. Of note, on these issues in foreign countries, State has the last word. Several of the 14 infected people from ship who were evacuated went to Nebraska. Also 3 additional people were notified while on the plane that they were infected. We air evacuated 328 people from Diamond Princess. 61 Americans elected to stay in Japan on the ship, but the Japanese want them off the ship because transmission is occurring on the ship. There are now 800+ non-China cases, 365 of which are on Diamond Princess. Now 28 countries have cases and within these there are 183 human to human transmissions. Singapore is problem with 68% of their cases are human to human PRESS: WTOP Radio; FOX (Caputo) TV; FOX Business TV; CNN (Wolf Blitzer Situation Room).
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Feb. 18, 2020 - 73,335/1876. More infections appearing on Diamond Princess. Good thing we got our people off the ship. Director of a major Wuhan hospital dies of COVID-19. Liu Zhiming, 51yo neurologist HS Did panel at the Council on Foreign Relations chaired by Fran Townsend. Bob Kadlec was other panelist. Much discussion about Cruise ship issues. Our planes land in Lakeland and Travis with evacuated Americans. Infected people shipped to University of Nebraska for containment; remainder of the uninfected go into 14 day quarantine PRESS: CNN New Day (Jim Sciutto and Alisyn Camerota); BBC Radio; CNN International; FOX America Newsroom; CNBC; FOX News (Laura Ingraham)
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Feb. 19, 2020 - 75,201/2012. On WHO weekly call with Mike Ryan. 1700 health care workers have been infected. Starting to discuss the role of environmental (surfaces) spread of virus, particularly in the context of the Diamond Princess. Mike Ryan makes good point that the stringent control efforts of China are putting pressure on the virus not to spread. This is somewhat artificial. He is concerned that the virus in other countries that cannot be so draconian in control we might see a resurgence of the virus that is being artificially controlled in China. CDC Comms concerned that I am being too hard on the Japanese by sayng publicly that their quarantine failed. They contacted Courtney. Too bad. I tell it like it is. They completely messed up the infection control on the Diamond Princess. They had over 500 people infected on the ship. Problem is that Japanese are releasing people into the community from the ship without the complete 14 day quarantine. They consider being on the ship as quarantine when it is not. We have "do not board" orders on the people who have left the ship until they are off the ship for 14 days. PRESS: NPR "Morning Edition"; KCBS Radio (San Francisco); FOX Business News; Siriusx Radio - Michael Smerconish; Nextstar TV; Wall Street Journal Pocast; NBC Nightly News (did not show - may show in AM); PBS NewsHour (William Brangham); FOX News (Lou Dobbs)