September 28, 2020 - Global USA 28 September 2020 1.Uncontrolled diffuse community spread in MN, WI, ND, 50 and Heartland IA, KS, NE, OK, MO where hospitalizations are rising fatalities will continue to increase across these regions -- slide 2 show rapid increase in test positivity in the red and orange states and rapidly rising cases, the stalling of any declines in new hospitalizations which will drive increase in fatalities over the next 3 weeks. Also the impact on Tribal Nations will drive substantial hospitalizations and fatalities 2.Fatalities one day (sat) : the original summer surge states CA, FL, TX (258), AZ, M5, AL, LA, SC, GA, NC (184) totally 442 and declining currently the Heartland and upper Midwest and MT, ND, SD (100 and climbing) 3. This diffuse spread is not solely university driven but most likely post Labor Day, end of vacations with silent spreading over the past 2-3 weeks through asymptomatic spread similar to post Memorial Day (that was undetected this time due to the change in CDC guidance on testing and many states dramatically decreasing testing): all majority of universities only testing symptomatics 4.Will be key to increase testing in the communities and states where hospitalizations are rising, where test positivity is rising and in communities where universities have more than 10% of their total student body COVID19 infected 5.lt will be key to return to the Heartland, WI, MN as well as UT and MT when possible to do a deep dive into the data and provide clear mitigation recommendations -- this community spread must be contained before weather drives individuals indoors to stay warm and we have an explosion of cases, hospitalizations and mortality similar to the southern surge when people came inside for cooling related to the heat in the South. 6.Florida and Texas have low testing rates and continued high mortality >100 deaths/day -- testing needs to increase significantly before reversal of mitigation efforts 7. Florida has significant residual disease and daily cases, reversing all mitigation efforts will result in rising cases in 2 weeks and rising hospitalizations in 3 weeks and rising mortality in-4 weeks -- the last week of October Red states ellow states Light Green states Dark Green states (>10% positive) (5 - <8% positive ) I - <5% positive) (<3% positive) AL, AR, FL, GA, IN, KY, AZ, CA, CO, DE, HI, IL, LA, ID, MT, NE, OK, SD, UT 1A, KS, MO, SC, WI MN, MS, NC, ND, NV, TN, MD, MI, OR, PA, WA, TX, VA WV, WY AK, CT, DC, MA, ME, NH, NJ, NM, NY, OH, RI, VT Dr. Fauci Top 20 Highly Cited Papers (Based on Web of Science, 09/28/2020) 1. Roberts AB, Sporn MB, Assoian RK, et al. "TRANSFORMING GROWTHFACTOR TYPE-BETA - RAPID INDUCTION OF FIBROSIS AND ANGIOGENESIS INVIVO AND STIMULATION OF COLLAGEN FORMATION INVITRO." Proceedings of the National Academy of Sciences of the United States of America. 1986;83(12):4167-4171. [2,613 citations] 2. Hoffman, G. S., G. S. Kerr, R. Y. Leavitt, C. W. Hallahan, R. S. Lebovics, W. D. Travis, M. Rottem, and A. S. Fauci. 1992. "Wegener Granulomatosis: An Analysis of 158 Patients." Annals of Internal Medicine 116 (6): 488-498. doi:10.7326/0003-4819-116-6-488. [2,060 citations] 3. Koenig, S., H. E. Gendelman, J. M. Orenstein, M. C. Dal Canto, G. H. Pezeshkpour, M. Yungbluth, F. Janotta, A. Aksamit, M. A. Martin, and A. S. Fauci. 1986. "Detection of AIDS Virus in Macrophages in Brain Tissue from AIDS Patients with Encephalopathy." Science 233 (4768): 1089-1093. doi:10.1126/science.3016903. [1,663 citations] 4. Pantaleo, G., C. Graziosi, J. F. Demarest, L. Butini, M. Montroni, C. H. Fox, J. M. Orenstein, D. P. Kotler, and A. S. Fauci. 1993. "HIV Infection is Active and Progressive in Lymphoid Tissue during the Clinically Latent Stage of Disease." Nature 362 (6418): 355-358. doi:10.1038/362355a0. [1,649 citations] 5. Fauci, A. S., B. F. Haynes, P. Katz, and S. M. Wolff. 1983. "Wegener's Granulomatosis: Prospective Clinical and Therapeutic Experience with 85 Patients for 21 Years." Annals of Internal Medicine 98 (1): 76-85. doi:10.7326/0003-4819-98-1-76.. [1,646 citations] 6. Hunder, G. G., D. A. Bloch, B. A. Michel, M. B. Stevens, W. P. Arend, L. H. Calabrese, S. M. Edworthy, et al. 1990. "The American College of Rheumatology 1990 Criteria for the Classification of Giant Cell Arteritis." Arthritis & Rheumatism 33 (8): 1122-1128. doi:10.1002/art.1780330810. [1,609 citations] 7. Lane, H. C., H. Masur, L. C. Edgar, G. Whalen, A. H. Rook, and A. S. Fauci. 1983. "Abnormalities of B-Cell Activation and Immunoregulation in Patients with the Acquired Immunodeficiency Syndrome." New England Journal of Medicine 309 (8): 453-458. doi:10.1056/NEJM198308253090803. [1,579 citations] 8. Kehrl, J. H., L. M. Wakefield, A. B. Roberts, S. Jakowlew, M. Alvarez-Mon, R. Derynck, M. B. Sporn, and A. S. Fauci. 1986. "Production of Transforming Growth Factor β by Human T Lymphocytes and its Potential Role in the Regulation of T Cell Growth." Journal of Experimental Medicine 163 (5): 1037-1050. doi:10.1084/jem.163.5.1037. [1,559 citations] 9. Fauci, A. S. 1988. "The Human Immunodeficiency Virus: Infectivity and Mechanisms of Pathogenesis." Science 239 (4840): 617-622. doi:10.1126/science.3277274. [1,523 citations] 10.Leavitt, R. Y., A. S. Fauci, D. A. Bloch, B. A. Michel, G. G. Hunder, W. P. Arend, L. H. Calabrese, et al. 1990. "The American College of Rheumatology 1990 Criteria for the Classification of Wegener's Granulomatosis." Arthritis & Rheumatism 33 (8): 1101-1107. doi:10.1002/art.1780330807. [1,392 citations] 11.Chun, T. -W, L. Stuyver, S. B. Mizell, L. A. Ehler, J. A. M. Mican, M. Baseler, A. L. Lloyd, M. A. Nowak, and A. S. Fauci. 1997. "Presence of an Inducible HIV-1 Latent Reservoir during Highly Active Antiretroviral Therapy." Proceedings of the National Academy of Sciences of the United States of America 94 (24): 13193-13197. doi:10.1073/pnas.94.24.13193. [1,317 citations] 12.Masi, A. T., G. G. Hunder, J. T. Lie, B. A. Michel, D. A. Bloch, W. P. Arend, L. H. Calabrese, et al. 1990. "The American College of Rheumatology 1990 Criteria for the Classification of churg-strauss Syndrome (Allergic Granulomatosis and Angiitis)." Arthritis & Rheumatism 33 (8): 1094-1100. doi:10.1002/art.1780330806. [1,287 citations] 13.Fauci, A. S., B. F. Haynes, and P. Katz. 1978. "The Spectrum of Vasculitis. Clinical, Pathologic, Immunologic, and Therapeutic Considerations." Annals of Internal Medicine 89 (5 I): 660-676. doi:10.7326/0003-4819-89-5-660. [1,272 citations] 14.Arend, W. P., B. A. Michel, D. A. Bloch, G. G. Hunder, L. H. Calabrese, S. M. Edworthy, A. S. Fauci, et al. 1990. "The American College of Rheumatology 1990 Criteria for the Classification of Takayasu Arteritis." 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ACQUIRED IMMUNODEFICIENCY SYNDROME - EPIDEMIOLOGIC, CLINICAL, IMMUNOLOGICAL, AND THERAPEUTIC CONSIDERATIONS. Annals of Internal Medicine. 1984;100(1):92-106. [887 citations] A -- 7,100,000/205,000 20.Folks TM, Justement J, Kinter A, Dinarello CA, Fauci AS. CYTOKINE-INDUCED EXPRESSION OF HIV-1 IN A CHRONICALLY INFECTED PROMONOCYTE CELLLINE. Science. 1987;238(4828):800-802. [872 citations] PRESS: Good Morning America TV; The Netherlands TV - Nieuwsuur; Canadian Journalism Foundation World News Day with Brian Stelter (Web TV); Steph Curry - State of Inspiration Interview; Aspen Institute - Fireside Chat with Helen Clark former PM of New Zealand