A single line often inverts meaning once you see what it
answers, so neighbouring messages are always shown.
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Mar. 14, 2020 (Saturday) - CDC numbers (less than WHO numbers. 142,320/5388. 129 countries involved. China numbers going way down - only 11 new infections. Koreaa flattening out. USA - 2226 cases, 50 deaths, 532 new cases. POTUS came into the TF meeting with "USA" baseball cap on. We spent a lot of time talking about "ratings' of yesterday's press conference and its effect on the stock market. He dwelled on doing more press conferences and how the ratings would be even better than the best fake news TV ratings. He made the right decisions about now doing travel restrictions in UK + Ireland and so what I ma seeing is someone who actually makes decision that are bestr for the public health since he follows what the TF recommends (driven by me and Deb and CDC) but his public expression and even private expression is related to the fluff of ratings and publicity. And so he wants us to do 2 press conferences/day - one in AM and one in PM. Really interesting. We now will have no time to do work. Hope Hicks seems as uncomfortable with this as I am. I see her as a future ally. POTUS Did press conference and Alex Azar was not invited in order to make room for "diversity" on the podium with Ben Carson and Jerome Adams. Death by a 1000 cuts for Azar. I volunteered to Alex that in my introduction I would mention that the Declaration of Natuonal Emergency gacve Azar as Secertary enormous powers and flexibility to unshackle our response. I did so. Mahor positive profile of me in The Atlantic yesterday (03/13/2020) https://www.theatlantic.com/notes/2020/03/time-capsule-2-exceptional-drfauci/607957/?utm_campaign=share&utm_medium=email&utm_source=a (see below): As of today, March 13, 2020--three-plus years into the current administration, three months into public awareness of the coronavirus spread, seven-plus months until before the next election--Anthony Fauci is playing a role in which no previous Trump-era figure has survived. One other person has been in the spot Fauci now occupies. That is, of course, James Mattis, the retired four-star Marine Corps general and former secretary of defense for Trump. Former is the key word here, and the question is whether the change in circumstances between Mattis's time and Fauci's--the public nature of this emergency, the greater proximity of upcoming elections, the apparent verdict from financial markets and both international and domestic leaders that Donald Trump is in deep over his head--will give Fauci the greater leverage he needs, not just to stay at work but also to steer policy away from the abyss. Why is Anthony Fauci now, even more than James Mattis before him, in a different position from any other publicly visible associate of Trump's? 1. Pre-Trump credibility, connections, and respect. Fauci has been head of the National Institute of Allergy and Infectious Diseases, at the National Institutes of Health, since Ronald Reagan's first term, in 1984. (How can he have held the post so long? Although nothing in his look or bearing would suggest it, Fauci is older than either Bernie Sanders or Joe Biden. He recently turned 79.) Through his long tenure at NIH, which spanned the early days of the HIV/AIDS devastation and later experience with the SARS and H1N1 epidemics, Fauci has become a very familiar "public face of science," explaining at congressional hearings and in TV and radio interviews how Americans should think about the latest threat. He has managed to stay apart from any era's partisan-political death struggles. He has received a raft of scientific and civic honors, from the Lasker Award for health leadership, to the Presidential Medal of Freedom, awarded by George W. Bush. Thus, in contrast to virtually all the other figures with whom Trump has surrounded himself, Fauci is by any objective standard the best person for the job -- and is universally seen as such. This distinguishes him from people Trump has favored in his own coterie, from longtime consigliere Michael Cohen to longtime ally Roger Stone to longtime personal physician Harold Bornstein; and from past and present members of his White House staff, like the departed Michael Flynn and the returned Hope Hicks and the sempiternal Jared Kushner; and fish-out-of-water Cabinet appointees, like (to pick one) the neurosurgeon Ben Carson as Secretary of Housing and Urban Development. Put another way: Very plainly, Trump needs Fauci more than Fauci needs Trump. This is not a position Donald Trump has ever felt comfortable in-- witness the denouement with Mattis. 2. The ability not to abase himself before Trump. The first Cabinet meeting Donald Trump held, nearly three years ago, was unlike any other conducted in U.S. history, and very much like subsequent public appearance of Trump in company with his appointees. In that meeting, on June 12, 2017, as TV cameras were rolling, Trump went around the table and one-by-one had his appointees gush about how kind, wise, and far-sighted he was-- failing only to compliment him on his humility. (Tina Nguyen described the meeting at the time in Vanity Fair.) After praising himself, Trump called on others to praise him, starting with the reliable Mike Pence. "It is the greatest privilege of my life to serve as the vice president to a president who is keeping his word to the American people," Pence began. All the others followed his example--with the prominent exception of Mattis. He spent his "praise" time instead complimenting the men and women in uniform he led. No public event like that Cabinet meeting had happened before in the United States, simply because no other president has been as needy for in-public adulation as Trump is. Of course most politicians and all presidents are needy; you could not run for the presidency if you had a normal temperament. (Background reading on this point, while you're "socially isolating": Robert Penn Warren's All the King's Men.) Every political leader eats up the praise in private--"Wonderful job today, Mr. President--you were really connecting!", not to mention Veep--but all the rest of them have been savvy enough to know how tacky this looks in public. The modern exceptionillustrating-the-rule might have been Lyndon Johnson, with enough of the Sun King in his makeup to enjoy having people humble themselves before him. But holding a public adulation-fest? If George W. Bush had heard, say, Karl Rove start in that way, he would likely have said, "OK, Turd Blossom, what are you angling for?" Barack Obama--or John F. Kennedy, or Jimmy Carter-- would have arched an eyebrow as if to ask, "Hey, did you think you were still playing in the minors?" But what we saw in that Cabinet meeting, we have seen again and again from those around Trump. The most humiliating recent examples come from the people in charge of the coronavirus response: Pence again; Alex Azar, head of Health and Human Services; Robert Redfield, head of the Centers for Disease Control; and Seema Verma, in charge of Medicare and Medicaid. The beginnings and endings of their public statements, and the answers to many questions, are larded with praise for Trump and his "decisive and visionary action." (For the latest example, see Verma under questioning from Martha MacCallum of Fox News. Verma repeatedly dodges MacCallum's direct question about whether hospitals have enough ventilators and other supplies (as Fred Barbash laid out in the Washington Post. MacCallum makes one last try-- and Verma seeks refuge in saying, "And that's why the president has taken such a bold and decisive action." That claim made no logical sense to MacCallum or the listeners, but it reflected the inescapable logic of what is expected from members of the Court of Trump.) There is one exception: Anthony Fauci. He has occasionally said that he agrees with aspects of the administration's or the president's policies, but he has avoided the ritual selfabnegation. Of course Fauci held his job long before Trump came to town, and is not part of the normal round of high-level appointments each new administration makes. (To the best of my knowledge, though, directors of NIH institutes, like Fauci, serve "at the pleasure of the president" and so could be removed. If I'm wrong on that, will update. Update: Several NIH veterans have written in to say that Fauci's position is officially different from that of the NIH director, and is not directly a presidential-political appointment. Recent history teaches that a vindictive president can make things difficult even for career civil servants. But I am grateful for the clarification. ) But Fauci's polite but consistent reluctance to grovel cannot have gone unnoticed by the audience-of-one for all the other appointees: Trump himself. BIG DAY! 3. Daring to contradict Trump, in public. This is a step beyond anything Mattis attempted. Through the first two years of the administration, background-sourced stories and reports based on "those in a position to know the Secretary's thinking" laid out the increasing distance between Mattis's view of American interests and what Trump was saying and doing. But there is no precedent, from Mattis or anyone else, for what we have seen these past few weeks from Fauci at the podium. Is the coronavirus problem just going to go away (as Trump had claimed)? No, from Fauci. It is serious, and it is going to get worse. Is the testing system "perfect" (as Trump had claimed)? No, it is not working as it should. Is the U.S. once again the greatest of all nations in its response to the threat? No, it is behind in crucial aspects, and has much to learn from others. Fauci is saying all these things politely and respectfully. As an experienced Washington operator he knows that there is no reason to begin an answer with, "The president is wrong." You just skip to the next sentence, "The reality is..." But his meaning--"the president is wrong"--is unmistakable. Anthony Fauci has earned the presumption-of-credibility for his comments. Donald Trump has earned the presumption that he is lying or confused. A year ago that standoff--the realities, versus Trump-world obeisance--worked out against James Mattis. Will the balance of forces be different for Fauci? As of this writing, no one can know. PRESS: Press conference in WH press room; The Atlantic (see above)
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Mar. 15, 2020 (Sunday) - BIG DAY! 142,539/ USA = 2888 with 58 deaths and 662 new I did all 5 Sunday Shows today (my 3rd Fauci 5") with This Week on ABC, Meet the Press on NBC, Face the Nation on CBS, FOX with Chris Wallace and CNN. All went very well Had press conference at White House. POTUS made intro and then left for us to take Questions. Brett Giroir brought a bunch of USPHS officers with their dark blue work uniforms and told the press how great they are. I spent an hour before the press briefing in the VP's office. In preparing for the briefing which was geared to rolling out the high throughput tests in collaboration with the States and the private sector that will be operational in the next day or so, they wanted to spin it that this was unprecedented that no one has ever done this so quickly. Deb did not speak up which shows me that she is really inhibited by her Presidential appointee status. A little shame on her. I spoke up and said that several countries have already done what we are talking about, i.e. China, South Korea and so why not stop bragging and just say that we are entering a new phase of our response to COVID-19, i.e. a much more expansive testing capability. Hope Hicks and Jared Kuschner were my allies in this and both seem to now want to make sure that I am involved in everything and approve everything. The POTUS came in and misunderstood thinking that we (the USG) would be implementing the testing. He was pissed. Brett and VP corrected him. However, he remained in a bad mood. He then said that he wanted to show his face and make some remarks without Qs and As at the briefing. Hope felt this was dangerous and said he should not do it. He started to berate Hope in front of everyone say that he became president because he was good and dealing with the public and was pissed that Hope was trying to tell him what he could or could not do. I spoke with Bill de Blasio (Mayor - NYC) and convinced him based on what I was saying publicly and my conversation tonight to close the NYC schools (he had already decided based on what I was saying on TV). I went on to tell him he should close the bars and restaurants in NYC. He said that he would base this on my recommendation. I had a similar call with Ann O'Leary, the COS of Gov. Gavin Newsom of California. Ann said that based on my TV appearances today and yesterday, the Governor has decided to close the schools in California as well as the bars and restaurants. When I left the WH and crossed Pennsylvania and 17th Street, several cars honked their horns and shouted "thank you" out the window. Congress (Blount) call and wants to give us a lot more in a 2nr supplement.
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Mar. 16, 2020 - Came out with the guidelines that reflected my pushing for a more aggressive mitigation 15 day strategy → If you are elderly, self-isolate; do not congregate in groups >10 people; stay away from bars, restaurants, theaters, sporting events; if a community has community spread CLOSE the bars, restaurants and places of congregation; close schools where there is community spread; no visitors to nursing homes; if family member is sick, others in family should take extra percautions; only necessary travel, telework as much as possible. Press conference after was highly attended. Stock market dropped byu 3000 points, the biggest percentage drop in history. PRESS: ABC 20/20 coronavirus special with David Muir;
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Mar. 17, 2020 - 168,000/6700; 151 countries; USA 4529 cases (903 news); 84 deaths (16 new). At TF discussed supply chain issues; also testing still somewhat of an issue. Press conference with POTUS. He is now coming around (largely through my efforts) to say thatr this is really a serious problem, but he still always brags about how well we are doing as opposed to emohasizing the challenges ahead. I gave some support to Gov. Cuomo during a question of me. Issue arising of clains from France that hydroxychloroquine is effective in decreasing the duration of viral shedding and also is used as a prophylaxis in exposed people. All uncontrolled studies. PRESS: Press conference after TF. I was featured heavily in the presser; FOX with Laura Ingraham; Sean Hannity Radio; Barstool Sports Podcast
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2020-03-18 00:00
Anthony S. Fauci
Mar. 18, 2020 - WH wanted me to not wear myself out. Have had private car and driver since Mar. 13 (Friday). I will stay at NIH today and do some press tonight from truck at home. Very positive press with Laura Ingraham on FOX last night On WHO call, Dale Fisher (Australian working in Singapore) gave warning to other countries that after you lift the lock down, be prepared for a rebound and use the lockdown period to stock up on supplies, prepare alternative hospitals (gyms, schools, etc.) preserve PPE and not use them for unnecessary things. Also, from Italy, 12% of ICU patinets were 19-50 years od and ~30% were 50-70 yo; 50% of French patienets in ICU are under 60 yo. Bloomberg report on March 18 (Tommaso Ebhardt et al) said that in Italy 99% of thois who died had "othe illness". However, 75% of these had hypertension. These latter must have been on anti-hypertensive meds and so the issue of ACE inhibitors absolutely must be pursued. On TF call we discussed the Defense Production Act and a possible EO. Also, the VP said over the phone that he wanted me at the Pressor today and Katie (good for her) pushed back and said that I should stay at NIH. VP looked surprised. Probably will hear more about this. Also, at TF meeting they decided to fully embrace FEMA and make a big announcement about that with the POTUS today. New York City and State are facing a "Sophie's Choice" regarding PPE. They are very low and they have to make a decision of using PPE for testing versus giving to HCWs who are taking care of patients. Obviously, it goes to HCWs, but that will interfer with testing. This was related to me by phone call with Peter Staley, Mark Harrington, and James Krellerstein. rt, Also, had phone call with Major de Blasio who wants to go to "shelter in place for the entire city. He is asking my advice since Gov. Cuomo is pushing back. I advised DeBlasio to go ahead and do it. I will try to speak with Cuomo. POTUS called me up from Oval. He has Alex Azar, Steve Hahn, Bob Redfield Scott Gottlieb, and Deb Birx in the office with the usual WH crowd. They want me in on the discussion. A friend of POTUS (Tom Ellison of Ellison Foundation ?) said that he heards that someone gave Hydroxychloroquine (HC) to 51 people and 51 got better. POTUS has heard similar stories, including Remdesivir (R) about other drugs and wants to make these available. To my amazement and dismay, Azar said that he could approve HC and Remdesivir now with the powers that he has. Steve Hahn and to some extent Deb and Bob started to chime in that this would give people hope. I took a deep breath and said that this was wrong and should not be done. If you want expanded access (EA) of HC which is an approved drug, you can do it in an EA protocol and still get wide distribution and possibly learn something. I stated that with R it is different since this was not approved. In the chorus of eeveryone agreeing with the POTUS that we need to give hope to people, I insisted that we can do both, but in the context of a trial. To his credit, POTUS agreed with me as long as we get the drugs out there. They wanted to announce this today, but I convinced them to do so tomorrow when I am there. Below is an e-mail that I sent right after the conversation:
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Mar. 19, 2020 - >200,000/~10,000; USA - 9026/150; 2900 new. Italy >31,000 In the USA testing: ~70,000 tests with ~10% positive Met yet again with POTUS right before the press conference, which did not include me since it was predominantly an FDA issue with Steve Hahn. POTUS excited about making drugs (Chloroquine, Remdesivir, etc.) more accessible. Therapy was the theme of the day. They actually were going to go too far (see above) and make them all available on compassionate use. I convinced them not to. POTUS was hot to give out chloroquine or hydroxychloroquine since Jeff Ellison thinks that it is a great drug. Steve Hahn did a good job in stressing the need for safety and efficacy data. Katie Miller and Kelly Love are trying to not overload me and particularly Katie is sensitive to my time. Call with Gilead regarding remdesivir studies and supply PRESS: Marc Levin Radio; PBS NewsHour with Judy Woodruff; Facebook with Mark Zuckerberg and Priscilla Chan; CNN Town Hall with Anderson Cooper and Sanjay Gupta; NBC Evening News with Lester Holt
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Mar. 20, 2020 - Another day at the WH. Important TF meeting and press conference. During the day, Gov. Cuomo had a press conference that he wanted me on to join him, but I could not since I did not want to do a press conference outside of USG and the WGH would not let me do it anyway. Cuomo took a gigantic step forward. 90% of the new infections in the USA are now coming from NYC and Westchecter, but mostly NYC. Cuomo is essentially shutting down all non-essential activity in the city.. 100% of non-essential workers must stay at home and not intermingle. I strongly praised Cuomo for doing this at the Presser after the TF. We met with the POTUS (as usual) in the Oval. The theme of the presser will be the fact that we are now having only essential travel to Canada and Mexico, and IMPORTANTLY, no aliean/immigrants can enter the countrywithout proper papers from Canada or Mexico, although the order is clearly aimed at Mexico. The rationale is that we are shutting down entry to USA from China, South Korea, Iran, Europe and UK/Ireland and yet people from these same countries are crossing over from Mexico. If some are infected and we take them in, we put them in facilities including with unattended children, we could have another cruise ship situation. The decision relly was a public health decision. LAST NIGHT, Katie and Steve miller called me up and explained why the CDC order to do this was given (CDC was essentially told by state and DHS to do it). They wanted my support to emphasize that this was a pubic health decision and not an anti-immigrant decision. I believe that they have a good point. During the presser, the reporters continued to ask me about the free distribution of Hyrdoxycholorquine (HC) , which the POTUS wants, and my statements that the evidence to do this is purely anecdotal and there is no convincing evidence by an RCT that either HC ro remdesivir works. After the presser the press went wild saying how I again contradicted the POTUS and I received hundreds of e-ails of people thanking me, even though I did not intend to or like the idea of contradicting POTUS, but I need to stick with the science. They also had a tweet that went viral of me holding me head seemingly in disgust as the POTUS was talking. That wa not my intention. Most important part of the day and disturbing was my conversation with Mark Meadows and Marc Short together with Deb Birx Meadows praised me for a while and then got to the point. He wants me to consider the tone that I say that HC has no evidence of efficacy. I told him that I cannot compromise my scientific principles. Tough conversation. He wa being a gentleman, but he wanted me to go to a place that I would not go. 200; deaths 9800 Even more disturbing was the conversation where he wanted me to support the idea of lifting the mitigation restrictions after the 125 dya periods since if we do not do this, Mark fees thatwe will trigger a depression (not just a recession). Mark Short agreed with him, but seemed much more sensitive to the fact that I did not want to get into that kind of situation that would use my credibility to sell an economic and a political issue. After I left the office, Mark Meadows called my cell and said that afterhe looks at some modelling, he would like to sit down with me and figure out how we can resolve this issue. He did ask me directy, if I thought we needed to extend the mitigation program beyond 15 days and I said yes. He seemed to accept that. There certainly is more ahead. I called a meeting at my house with Cliff lane, Chrsitine and me to discuss how to handle this as we go forward. I cannot and will not compromise acting on my good judgment. However, I can understand Marks dilemma with the economy. There will be more discuss. Also, had conversation by phone with Governor John Bell Edwards of Louisiana who has ~400 cases in NOLA and wants my advice about how aggressive he should be and maybe copy NYC. He has already closed all the bars and restuarants. I told him to look at the inflection of the curve over the next day or so and contact his Commissione of Health. It the curve is steep, he should consider mandating only essential work and everyone else stays homw, but not quite yet. Also, Petrer Staley, Mark Harrington, James Krellenstein and others called late at night and told me that they had a bad situation in NYC where the desire to do many tests was eating up PPEs that were needed by HCWs who were taking care of COVID-19 patients. The implored me to speak out that ony necessary testing should be done, i.e. on hospitalized patient and those with sxs not in hospital, and not just anyone who wants a test. They sounded desparate that NYC would un out of PPEs within the next 7 days. I will bring this up to TF tomorrow. PRESS: CBS Evening News with Norah O'Donnell; FOX with Bill Hemmer; WH Press Conference; Major Washington Post Profile on me
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Mar. 22, 2020 (Sunday)- Cases continue to soar. 30,000 in USA with 400 deaths; Italy still escalating. My please to the TF regarding needing desparately to get PPEs and other supplies to NYC seems to be working since FEMA in pusing stuff to them. 250,000 tests now done not counting those from hospitals and medical centers Press is going wild with me. Front page in Washintgton Post yesterday and Op Ed by Maureen Dowd in NY Times today about me and my relationship with the POTUS. Profile by Peter Nicholas on me in The Atlantic. I am trying in several articles and on TV to clarify that the POTUS is tsalking about hope for therapies although there are no good data, while I must stick to the science and so fundamentally we are approaching this from different, but not conflicting standpoints. The press are crucifying the POTUS for "not listening to me and making crazy statements about "game-changing" therapies and praising me fot stivking to my guns. ORACLE (Larry Ellison - a bit of a loose cannon) . Mark Meadows wants CDC, FDA and me to help put together by 5:00 PM tomorrow an on line site for tracking availability of drugs like Hyroxychloroquine and Remdesivir and making these drugs available via a physician. Bad idea, but it will happen. I will go with this as long as it does not interfere with the conduct of RCTs. Cliff Lane helping out but employing NLM and NCATS people. I am giving him full authority since I have absolutely no extra time given what I am doing already. Also, Jared and Mark are very skeptical about the CDC modesl about the trajectory of the outbreak and what can be predicted regarding timing of modification of the mitigation. They want to see the data before they believe the models and get CDC out of the business of doing this alone and making policy - good for them - it is about time. I am getting Cliff to get MIDAS people in on this. Press conference (I did not attend) after the virtual TF meeting. POTUS went into detail with very granular numbers of all the things USG (mostly FEMA) is doing regarding sending masks, PPE, other equipment to high risk locations (Washingto State, CA, NYC, etc.) On TV programs, FEMA Pete Gaynor did not look good since he did not have any idea how many ventilators and other equipment was available. POTUS went on and on 3,300/391; new about all the things that we are doing. Very rambling and disorganized as he ad libs his speech I would have advised against this, since we are still getting calls that many locations do not have enough of anything. Also, they are talking about the now hundreds of thousands of tests that are out there and being done. However,as I have always said, testing for the sake of testing without reason only consumes PPEs of the people administering the tests. Looking at the presser from home on computer has made it clear how self-congratulatory the POTUS, VP and others appear on the stage. Title 42 enacted - use of National Guard to help. Role out of telemedicine without reguations so that people do not have to leave the house to interact with their physician. A lot of promises - I hope we can back them up. PRESS: CBS Face the Nation with Margaret Brennan; Multiple print features
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Mar. 24, 2020 - 392,000/17,000; 45,000/550 in USA. Cases still soaring in NYC. COVID Cases 3.24.20 powerpoint Incredible intrigue going on with people (likely WH staff) feeding total lies to media about the frayed relstionship between me and the POTUS. This is really bad stuff. I am getting calls from media (Reuters) saying that a source told them that the POTUS was screaming at me and being abusive about the issue of HC treatments. Total nonsense. See below. Typical of many aryicles over the past few days: In order to save Dr. Fauci, we must destroy him Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, is a study of calm and competence in the middle of a pandemic. Which makes him an endangered species, working as he does for a )20, 5:25 p.m. boss who is notoriously insecure and made his name shouting "You're fired!" on a reality TV show.