A single line often inverts meaning once you see what it
answers, so neighbouring messages are always shown.
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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".
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2020-02-24 00:00
Anthony S. Fauci
Feb. 24, 2020 - 79,524/2626. Situation getting worse in Italy, Korea, Japan, Iran. More reports of transmissions by asymptomatic people. Lots of discussions of when the WHO will declare this a "pandemic". WHO is saying that they are no longer using the terminology "pandemic" Stock Market plunging today about 1000 points as a result of coronavirus reports. Mick Mulvaney called my office today to give me the cell number of Larry Kudlow who wanted to speak with me. I called and Larry wanted my take on what is evolving with COVID-19 since it is critical to him in his assessment of the potential impact on the economy. He said he trusts my opinion over anyone else. OMB will release the Supplemental Request to the Congress tonight and I have a Congressional briefing with AZAR and the HHS team tomorrow AM. They did not request any for NIAID even though I put in for $145 million. Spoke with Azar a few days ago and he said that OMB and he would not be upset if the Congress added to the Supp request for money for me. Problem is thsat until then, I may need to defend why I am not getting or do not need additional money. Had dinner over mansion of Adrienne Arst. Chris Liddell and his wife Renee were also guests. PRESS: CBS Radio (NYC); AP TV; FOX Business (Lou Dobbs) Feb. 25,2020 - 80,277/2705 Major concern ove other countries surging in cases - Italy, South Korea, Iran. Stock Market staring to crash due to COVID-19. Supply chain concerns. 1st patient evacuated from Diamond Princess to Lackland supposedly will come to NIH since patient has since converted to virus positive. Big explosion of media. On the usual CDC press briefing, Nancy Messonnier made the comment that a pandemic and community spread in the USA is not a matter of IF, but a matter of WHEN and we should prepare to do things like close schools and do telework. This caused a firestorm of media frenzy around the world. The Stock Market tanked by 1000 points; the POTUS called up Azar asking what the hell is going on. I went into the media to try to calm the waters (see press below). Also, the press was zinging the POTUS and Larry Kudlow for saying right before Nancy made her statement that everything is under control in the USA (which it is for now - 14 cases with no community spread) while CDC officials (Messonnier) were saying that a USA outbreak was inevitable. Also, zinging the POTUS who is saying that a vaccine is imminent from India and (soon). He is obviously confusing the initiation of a phase 1 trial and having a vaccine ready. PRESS: WTOP Radio; CBS Radio (NYC); FOX with Bret Baier; CNN Situation Room with Wolf Bitzer; CNN International; CNN with Chris Cuomo; MSNBC; BBC Radio x2 Feb.26, 2020 - 81,187/2768. Should be a big day with the POTUS back from India and going to give a press conference this afternoon. Big day today! POTUS returned from India and wanted to clear up the issue of Nancy Messonnier's statement that sent the Stock Market crashing. The Task force, particularly Azar, me, Redfield, added Anne Schuchat, Mick M. met with Trump in the Oval Office and updated him on coronavirus situation. (Of note, we have 1st case of community acquired COVID-19 in a woman from Solano County, CA who had no epidemiologic link to anyone weith COVID-19. This could be the beginning of something bad) After we briefed POTUS in the White House, we went into the Cabinet Room and the other members of the Task Force briefed the POTUS a bit more. Then we went into the White House press Room which was more packed than I had ever seen it. People standing on chairs in the isles. POTUS made comments, then Azar, then Anne, then me on vaccines and therapy. The POTUS stayed for a long time (45 minutes) answering questions. He called Nancy Pelosi "Incompetent" in answer to a question For the most part he was OK, but tended a little bit to underplay the situation. After that we went back to the Oval Office with the POTUS to do a "post-mortem" on the press conference. Everyone felt good about the presser. There was much speculation that the POTUS would either get rid of AZAR or appoint a Czar. The press was geared for that. However, POTUS asked VP Pence to do overall coordination of the coronavirus effort. Clearly this was a compromise to not make Azar look bad since he is friends with Pence and at the same time silence/satisfy those who want a Czar and/or to get rid of Azar. Another interesting twist was that they announced that Debbie Birx would be the new "coronavirus coordinator" in the NSC. Apparently, she may have been fired from PEPFAR where there was considerable discontent about her leadership style (very dogmatic and inflexible) Finally, we all adjourned to VP Pence's office to discuss his new role in coordinating coronavirus activities. White House had us cancel all press briefing commitments since they wanted all the news to be the POTUS. This led to the impression that I was being "muzzled" and led to a real twitter forestorm PRESS: CNN New Day with John Berman and Alisyn Camerota; FOX News; CNBC Squawk Box;
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Feb. 27, 2020 - 82,446/2808. Very interesting things evolving. Got phone call from Azar this AM (while in Building 31 cafeteria). Azar is frustrated with the operational incompetence of the CDC and asked me to start thinking abou a possible replacement for Redfield at CDC in case Azar needs to replace him. He prefers a woman, and someone who is not an obvious anti-Trump person. Azar admits that regardless of all the PR, the fact is that Pence is now in charge. Also, Azar told me that Pence ordered the lockdown of all press by everyone including Azar. Azar is trying to turn this around since it is obviously a bad idea. Got phone call fom Tom Bossert (former Deputy National Security Advisor to Bush and National Security Advisor to Trump until John Bolton forced him out). Tom saw the press briefing on TV last night and was appalled by the denialism of the problem by Trump. He wanted to know if I was trying to bring in some reality testing. I told him that this was difficult. I emphasized that we should be testing thousands of people and not just a few hundred. With the 1st community case in CA, it is clear that there are other infected people out there in the USA. Also, there is a 2nd community case in California. Turned into an amazing day. Chris Cuomo calls me up and says that he wants me on his show since he is going to rip apart the CDC for not having enough tests available to screen for community spread cases (i.e. no known geographic connection). He says that people from NYC and elsewhere are calling us saying that they have suspicious cases and they cannot get test kits from CDC. Actually, this is for at least 2 reasons: 1) the CDC has not worked out the glitches in their kits and the criteria for testing a PUI (person under investigation) included their having an epidemiologic connection to a case. This is crazy since by definition, a community-based case (which we are trying to screen for) does not have any recognizable epi link. I realize that we have to fix the CDC problem and I call Brian Harrison and we both walk into Azar's office and explain that we need to get CDC, FDA together to loosen the regulatort constraints on getting tests out. It was my pushing that did it. They come up with a solution of regulatory relaxation of QC. Stock Market crashing! Also the issue of "muzzling Fauci" is going wild. See above: It started when the VP took over the Task Force and his Chief of Staff (Mark Short) and his comms person Katie Miller wanted to re-assess the communications. This was really triggered by the Nancy Messonnier's statement. I had agreed to a number of TV hits and we got word from the VP office to Bill Hall that we need to stand down on all media for the time being so that we can re-submit clearances. This got interpreted that Fauci was being muzzled and triggered an amazing twitter storm that was widely and virally tweated to not suppress the "great Fauci". I was getting hundreds and hundreds of emails of support. There is even a #freeFauci out there. phone call at home from President Trump taly, Iran, Japan. Big surprise was at 10:35 PM tonight I got a phone call at home from President Trump who wanted to chat about the coronavirus situation in general. We spoke for about 2025 minutes. I encouraged him not to underplay the seriousness of the situation since if it turns out bad, it would look like he is covering up. I even spoke to him from a political standpoint that his chances for re-election might be more damaged if he downplayed the potential spread of virus in the USA than if he said we may face serious problems and even if the Stock Market goes down further, he was at least honest and the country would respect him for it. I thought that he heard what I said, but the next day, he again underplayed it.
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Feb 27, 2020
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Feb. 28, 2020 - Much community spread in South Korea, Italy, Iran, Japan. Briefed the All House Membership at the Capitol Visitor Center. Question came up of whether I am muzzled and I explained that this was not the case. PRESS: MSNBC - Chris Matthews Hardball; FOX Business with Gregg Jarrett;
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Feb. 29, 2020 - 86,000/2941. Important Day - Went to Situation Room for a Saturday AM (10:00 AM task force meeting) when it became clear that there was several new cases of "community spread" There were already 14 cases (12 from Wuhan and 2 spouses). Then we learned a few days ago that there were 2 cases in California that were community based and both were now on respirators. The NEW information from yesterday is that there are now 6 additional cases - 1 in Oregon of a 45 yo who is now in the ICU and 5 cases near Seattle Washington, one of whom died last night; another one is hospitalized; and a 73 yo in long term care is now in an ICU; one just returned from Korea and so that might be a link for that person, but the others are unknown source. A new chapter in the outbreak. 6 hour meeting in the White House Situation Room. We increased travel alert to Italy and Korea and no travel to Iran. Level 3 for Italy and Level 4 to Northern Italy. Level 3 for Korea and Level 4 for Daegu in Korea. I suggest and it is accepted as the "Fauci Rule" of asking these countries to do exit screening on people coming from their country to USA. Meeting led by VP Pence. Trump joins meeting and we decide to make announcement at press briefing in WH press Room of new findings (plus the fact that they signed an agreement with the Talaban to end the war in Afghanistan). Pence and Mick Mulvney want me standing right next to the POTUS on the podium so that I can be seen on TV, and I make remarks about the recent community cases. POTUS speaks, then VP Pence, the Azar, then me, and then Redfield. They wanted just me, but I pushed to have Redfield also make remarks. During the question period, the issue again comes up about whether I am muzzled. I go to microphone and say I am not nor have I ever been muzzled. VP Pence and Azar to be on Sunday Morning Shows tomorrow PRESS: NBC Today Show; MSNBC;