A single line often inverts meaning once you see what it
answers, so neighbouring messages are always shown.
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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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2020-02-19 00:00
Anthony S. Fauci
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)
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Feb. 20, 2020 - 75,752/2130. Had major discussions last evening among the HHS team. Some disagreement that we had to sort out between ASPR (Kadlec) and CDC (Cetron/Redfield) regarding when to trigger the transition from containment to mitigation. Kadlec wanted to do it if only 1 location (city, etc) had more than 3 rounds of transmission, whereas CDC wanted to trigger to be >3 rounds in more than one non-contiguous location (city, etc.) . After much conference call discussion we came to a compromise. Azar pissed off at a story in the Washington Post by Lena Sun. Someone leaked the story about the disagreement between CDC and State/ASPR regarding allowing infected Americans to board the evacuation plane taking people from the Diamond Princess back to the USA. Now this is a big story: "Infected patients put on plane against CDC advice" PRESS: Radio Free Asia (TV); The Doctors TV Show; Home Care Radio (HCR); NBC Nightly News (from yesterday)
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Feb. 21, 2020 - 76,775/2247. 1st patient to die from being on Diamond Princess. Had intense "Table Top"=like exercise with the WHTF in the Situation Room from 3:00to 5:00 PM. Discussed the plans and triggers of going from containment to mitigation. Lots of good discussion. Led by Mick Mulvaney. CNBC interview wa slightly hostile questioning the "controversial" decision of putting the infected evacuees from the Diamond Princess on the plane back to USA. After my explanation and after I was off the air, Mike Osterholm and Scott Gottlieb got on and starting spewing forth about the idea that we might be missing people in the UA who are infected. The hosts seemed to be pitting me against them. Typical media PRESS: BBC World Radio Show; NBC News print; WJLA Local TV by phone; CNBC (Meg Terrell)
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Feb. 22, 2020 - 77,932/2363. Seeing sustained transmissions in Japan and Korea. CDC issuing travel alert 2 - "consider postponing non-essential travel". This is a bad sign and could be the beginning of the transition to a pandemic. Press (see MSNBC below) still folucing on the decision to board infected people on the plane from the Diamond Princess ity spread now increasing PRESS: MSNBC; CNN with Michael Smerconish;
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Feb. 23, 2020 (Sunday) - 78,804/2463. Cases of community spread now increasing greatly in Japan, South Korea, Italy. Bob Kadlec called me this AM with emerging problem. We need to house some of the evacuees from the Diamond princess who are continuing to convert to virus positive in a place where we can isolate them and have them ready for acute medical care if they become ill. There are about 30 people thus far negative for infection who may soon convert, mostly elderly and frail about whom Kadlec is concerned. It is projected that 1 of 10 will convert and likely will get seriously ill as has been the case with other elderly people from the Diamond Princess who got ill in Japan and went to Japanese hospitals. They are now at air force bases Lakeland and Travis, but the military does not want to have responsibility for them if they are infected since they are concerned about "force protection". Also, and importantly, Bob Kadlec tried to get the people housed at Anniston, AL. Congressman Mike Rogers (R-AL) got furious and reemed out Kadlec saying he was going to destroy him. He got on the phone to President trump who was on a plane going to India and badmouthed Azar. Apparently, the POTUS called up Azar and was very pissed off. He told Azar he had to fix it or else, since the POTUS was originally angry that we even brought back infected Americans from the Diamond Princess. Azar then came to me asking me to help him "fix it". And so that is the origina of this saga. The suggestion is to ship them to the NIH Safra Lodge so that they have access to NIH SCSU. This would be disruptive to NIH, but there does not seem to be many alternatives. Had discussions with Francis (boarding a plane to Grand Cayman) and Larry while on my C & O canal walk with Chris about how to address this difficult and frustrating issue. Francis on way to Grand Cayman for vacation. This leave it to Larry and I to "fix". Had important conference call with NIH Clinical Center people - Jim Gillman, Tara Palmore, Rick Davey, etc. Tara makes good point that we realy cannot use the Safra lodge since even one infected person would nullify keeping uninfected people there. Decision was to skip the Lodge and put everyone in the Clinical Center. Gillman, Tara and Rick now huddling to figure out how to do this. I visit the Clinical Center group (Gillman, Tara, Rick, Henry Masur, David Henderson, nursing, etc in Clinical Center Room 6-3551 where they are convening to work this out. They present to me that they can make 11 beds available in the CC for evacuees who may convert. If they did the full 30 (i.e. +19), it would be dangerous for our staff since we cannot retrofit that many rooms with negative air flow and proper room for don/doff. We decide on 11 in CC and Rick works with Lauren Sauer at Hopkins for an additional 8 for a total of 19. We go with that. I contact Azar who contacts POTUS who is on plane Larry Kudlow to India with Melania. And so, it is "fixed". Azar called me to thank me for "saving his ass".