A single line often inverts meaning once you see what it
answers, so neighbouring messages are always shown.
-
November 22, 2020 - Global - 57,900,000/1,400,000; USA - 2,000,000/255,100 200,000 cases yesterday See UK below. Mitigation (closing bars, gyms; restricting indoor dining; confine dinners and activities to immediate households) works as shown in UK and even USA during the summer rise and decline: Daily New Cases in the United Kingdom Daily New Cases Cases per Day Data as of 0:00 GHT+0 40k # O ao = I % 14)\, = ook a i= i=] wk z 10 i=] = o ST ed ap gh gh a> a PP a "= bP PP ee ae et ab ah ee ae ah Gh a ae SEPM ge ys eee verre er . "ne ee ff of aa ® Dally Cases i f (] ~ f-day moving average New confirmed cases of Covid-19 in North Dakota, South Dakota, Wyoming, Minnesota, Montana and lowa Seven-day rolling average of new cases (per million), by number of days since 0.1 average daily cases (per million) first recorded 1,800 1,400 1,200 1,000 Number of days since 0.1 average daily cases (per million) first recorded Source: Financial Times analysis of data from the Covid Tracking Project. Data updated November 22 2020 2.09pm GMT. Interactive version: freom/feovid FINANCIAI North Dak Wyoming South Dak Minnesot. ® Montana lowa TIMES Some states may actually be starting to turn around as they start mitigating: Got a call from Nancy Messonnier expressing great concern that after the doses get delivered by Gen. Perna to the local state locations, that there is confusion in how to get the doses distributed. She says that the local health departments who have been given this responsibility either have no idea what they are doing or they need the resources that they do not have. She . -- 12,200,000/256,000 says her communications with Redfield are rare and she is distraught. She has more access to me than to Redfield. PRESS: Face the Nation (CBS) - with Margaret Brennan;
-
November 23, 2020 - Global - 58,400,000/1,400,000; USA - 12,200,000/256,000 Very concerned that the travel over Thanksgiving will exacerbate the current surge. Some states that are mitigating (IL, NM) and doing much better than those that are not (IN, SD) Really good news in that both Moderna and Pfizer on further analysis of ther data are reporting very good efficacy after first dose and prior to second dose. AstraZeneca is reporting today 70% efficacy (on average) with 1⁄2 dose prime and full dose boost. Strange that 1⁄2 + full did better than full + full • Toronto Goes Into 28-Day Lockdown As COVID-19 Cases Surge. Remember when we got hit badly early on and Canada did so well people said we did not do it right, but Canada did. We could not figure out what "it" was. Now with the Fall surge, Canada is getting badly hit as is every place else. 10. 23 November 2020 There are 30 states in the red zone and 9 states in orange zone = the duration of rising cases and the rate of rise greater than the spring or summer which will prolong the high fatalities for the next 4-6 weeks rapidly reaching over 300,000, BUT ILis already improving with mitigation but IN continues to deteriorate without mitigation For the first time in 7 weeks the Sunday cases were less than last week's Sunday cases -- building on this now is critical -- we need to make it clear that choices will drive a post Thanksgiving surge because of the underlying high viral load that will be an overwhelming threat to the health care system. The improvement is due to states aggressively mitigating and it will be very evident over the next 60 days that mitigation saved lives and the lack of mitigation resulted in unnecessary high fatalities, Europe is improving rapidly with mitigation and we are seeing early improvement in states with strang mitigation States that did not mitigate in the Fall surge will end up with population CFR equal to the Spring surge when treatment was suboptimal, (ND, 5D, MT etc] There are now 26 States in the red and orange for hospitalizations of COVID cases = care deteriorates across all patients with and without COVID when states enter the red zone Mew daily COVID confirmed admissions are over 10,000/day and inpatient COVID patients reaching historic highs -- there are not significant new improvements in treatment to further improve CFR which will remain near 10% for those over 70 and near 1% for those 40-69 - we will reach historic highs in daily fatalities Its not just the number of cases but the rate of rise - today's cases are reflective of spread 10-14 days ago - the rate of rapid rise in cases will translate ta a proportional rapid rise in hospitalizations and deaths - we cannot sustain another surge that we have experienced over the past 7 weeks There are state examples of changing the rate of rise of cases to change the rapid rise in hospitalizations to preserve hospital capacity = this is mo longer about preventing a crisis -- this is a crisis = this is about trying ta save as many lives as possible within the crisis and we have examples of states that are improving This will require a comprehensive Federal response with aggressive support te States to include statements that Europe and States with strong mitigation are improving: * Continued aggressive communication at the WH level masking requirements at all times outside of immediate household, physically distancing, hand hygiene AND critically limiting of social interactions to the immediate household for the next 60 days while we bridge to the rapid vaccination of the vulnerable populations decreasing hospitalizations and fatalities : this is a short term sacrifice to protect the vulnerable. . Continued critical guidance on Thanksgiving and throughout the Holiday season to limit indoor unmasking across households * Aggressive re-alignment of Ag testing towards finding and preventing unrelenting silent spread that continues to trigger community spread in waves . Expanding frequency of LTCF testing and aligning early vaccination into LTCF " Ensuring rapid tiering of those most vulnerable to rapid vaccine immunization access immediately upon EUA (CDC) . Short term mitigation interventions : restricting indoor dining and limiting andor closing areas of congregation without mask (bars, gyms and restricting indoor dining) will be needed as was successful in the USA in the summer and in Europe with -- 12,300,000/257,000 PRESS: RAI Italian TV; La Stampa/Vatican Radio interview with Paolo Mastriolli; Hcehinger Boston Radio (NPR); Yahoo Finance TV interview; Washington Post Live with Robert Costa; PBS NewsHour with Judy Woodruff; Zoom with Washingtonian Top Doctors
-
November 24, 2020 Global - 58,700,000/1,400,000 USA - 12,300,000/257,000 Surge continues. Europe starting to level off since they are shutting down in many countries. Despite CDC saying not to travel over holidays, millions of people, particularly students are crowding airports 24 November 2020 There are 29 statesin the red zone and 11 statesin orange zone--40 statesin fall resurgence -however casesare increasing across all states inclading the more populoms states which will significantly increase boespitalizations and fatalities All major metres lave or are excecling the spring aod summer surge cases except for NYC, MIA, HOW bat their nate of rise couhl drive them over their prior bighs in days Yesterday CA, OH. TX. IL. ES, BA, MN. FL NY. MI. WA, IN, CT were all at litstoric case high or were over 5000 cases'day with rising leepitalizations The deration of rising cases ad the rate of rive is greater than the spring or summer which willproleng the lugh fatalities for the wext 4-4 weeks rapidly reaching aver S00 (8M) American Eatalities -- testing (Mov testing wall be the eame at Get) and is not increasing at the rate of ibcreaking cases, hoepitalizations and Fatalities We need to make it clearthat choices (state and metro policy choices amd personal choices) will drive a post Thankspiving surae because of the underlying high viral load that will be an overwhelming threat to thee health care system. Many states are inadequately mitigating including prior suubelt states that mitigated wellin the summer. Aggressive mitigation needs te happen mow to prevent a catachyemic Holiday season for the boxpital systems. We found the fiends amd family small gatlerings driving hospitalizations during the state visits but we also know that these drivers appeared in the sunbelt atter the states fully mitigated in the public spaces - including signiticant reducing capacity or closing spaces where masks cannot be wer Current improvements are seen in 1-2 stvles aggressively mitigating and it wall be very evident over the next 60 clays that mitigwion saved lives and ihe lack of mitigation resulted in mnecessary high fatalities - States tht did net mitigate in the Pall surge willend wp with population CFR equal te the Spring surge when treatment was suboptimal - ND, SD, MT = states must be encoumged to advance polictes that mitigation against this Fall viral surge Europe countries with clear policies are improving rapidly with aggressive containment with mitigating policies and clear conmuaication and are carefully renpeniing There are now 27 States in the red and orange for hospitalizations of COVID cases -- care deterioretes across all patients with and withent COVID when states enter the red cone -- there are more states in this category everyday Confirmed Cases (Thousands) 2a) New Daily Confirmed COVID-19 Cases in the U.S. 2m 57.5 iim Hf I I _ EAA TA TT I I I I I I I PE PES SL PSs FF TSF Pe LSAT PE HE Oe Fe F FPR FE FF Ce ee? Dery Mu ig Avarape Biden tweeted today that he has not spoken to me but his staff has and I have been "very, very helpful". I had told he press that I had not heard from the Biden team since my conversations with Ron Klain were supposed to be confidential since over the past several days Ron has contacted me about my advice for CDC Director and FDA Commissioner. I recommended Rochelle Walensky for CDC. Ron called he and liked her. Also, Ron told me that there was push back by some against Josh Sharfstein whom I recommended for FDA. In order not to have a contradiction with Biden, I have told CNN (Kaitlan Collins, Jim Acosta, etc.) GMA PRESS: NBC Radio The Takeaway; Healthline Live Stream; MTV Interview; FOX News Local DC; Yahoo News TV; Global USA ,000/1,400,000; 12,700,000/261,300 ay at
-
November 25, 2020 - Global USA 11:00 AM call with Azar regarding the role of ACIP in the recommendation for the prioritization of the distribution of vaccine starting in December. Azar feels (with advice from Bob Charrow) that ACIP has no statuary authority of being involved in the process. Azar wants to act early to without ACIP involvement get vaccine to both HCWs and nursing home and other vulnerables (aged). This would require using all of the first supply as the prime (and not withholding half the doses for the boost), thus allowing us to vaccinate more of the high priority group and depend on the integrity of the supply chain to supply the booster doses. His intent is good, but I point out that this would be a PR disaster since we have been saying all along that an independent body (ACIP) would be very much involved in these recommendations. It would be interpreted as sidestepping a established process by political influence. My argument turns the tide to get ACIP involved with us from the beginning. They may agree with us (which is great) or they may not whereby we can say we included them in the process, but we do not accept their recommendation Ron Klain texted me last night after midnight. I was asleep. He sent me video of Joe and Jill giving Thanksgiving message to be careful over Thanksgiving. I will speak with Ron Today. Ron just texted me and said that they decided on Rochelle Walensky for CDC director on my recommendation!! PRESS: Good Morning America (ABC) with George Stephanopoulos; C-SPAN Washington Journal; WINS Radio (NYC); WGN TV (Chicago); Byron Allen and GRIO, an African-American online TV interview; Huffington Post (Jeff Young) - writing a piece on "A Day in the Life of Dr. Fauci"; McClatchy (Mike Wilner) print interview on vaccines; Kaiser News Interview (Lauren Weber); Interview with Scientific American (Charles Schmidt); November. 26, 2020 (Thanksgiving) Global - 59,800,000/1,400,000; 12,700,000/261,300 USA Surge continues Trump not addressing the outbreak at all Consumed with blasting sway at people and pardoning people like Gen. Flynn. Georgia Senate re-run about to occur to determine control of the Senate. Went on walk with Will and Joli to Mall and was "mobbed" by well-wishers who wanted photos with me. Went to the steps of Lincoln Memorial and read the speech of Lincoln on the opposite wall of the Gettysburg Address. Strikingly referable to today: "Men who worship the same God can be so far apart on fundamental issues...." PRESS: U.S. News
-
2020-11-25 00:00
Anthony S. Fauci
Nov. 25, 2020 / 8:44 PM Fauci, Harris top 'Time' 2020 Person of the Year nominees 10, .-- 12,800,000/263,000 27 November 2020 There are 279 atetes in the red sone and 11 etates if orange zone = 40 etates in full recurgence however cases are increasing e¢roas all etates including the mare populous etates which will significantly increase hoepitalizations and fatalities - data will be unvtable including fatalities due to reperting changes All major metros have or are exceeding the apring and summer aunpe cased except for NYC, Ma, HOU but their rate of rise could drive then ever their priar highs in days Ihave included C4, IL, TX, PA the primary drivers of the large national numbers of cases and fatalities at this time The duration of rising cases and the rate of rise is greater than the spring or summer whech will prolong the high fatalities forthe next 4-6 weeks rapedly reaching over 200,000 American fatalities rapidly (Mov testing willbe the same at Qct) and & mot increasing at the rate of increasing cases, hospitalizations and fatalities We need to make it clear that choices (state and metro policy choices and personal choices} will drive a post Thanksgiving surge because of the underlying high viral load that will be an oversvhelming threat to the health care system. Many states are inadequately mitigating including sunbelt states that mitigated well in the summer. Aggressive mitigation needs tohapgen now to prevent a catechysmic Holiday season forthe hosgitel systems. CFR; population will correlate with bevel of mitigation. The mitigation choices states are making or not making will direct correlate on level of fatalities. The impact of these choices om human life will be very evident. Current improvements are seen im 1-2 states aggressively mitigating and it will be wery evident over the mext G0 days that mitigation saved lives and the lack of mitigation resulted in unnecessary high fatalities - States that did not mitigate in the Fadl surge will end up with population CPR equal to the Spring surge when treatment was subogtimal - WD, $0, M7 -- states must be encouraged to advance policies that mitigation against this Fall viral sunge We found the friends and farnily small gatherings driving hospitalizations during the state visits but we also kncew that those drivers agpeared im the sunbelt after the states fully mitigated in the public spaces -- including significant reducing capacity or closing spaces where masks cannot be vweonn Euroge countries with clear polcies are Improving rapedly with aggressive containment with mitigating policies and clear communication and are carefully reopening There are ow 27 States in the red and orange for hospitalizations of COVID cases -- care deteriorates across all patients with and without OOVID when states enter the red zone -- there are nore states in this category everyday New daiy COVID conflrmed admiisons are over LODO day and inpathent COVID patients reaching histori: haghs BODO linoeading LOKweek), nearly 45%) of all confirmed OOVID admissions ane ower 70 and CFR remains mear 10% for those over 70 and near 1% for those 40-69 - ye will reach historic highs im dally fatalities Although we were beginning to see early signs of decreases iin the rate of rise of hospitalizations I remain deeply wonred about apost Thanksgiving surge that will once propel us towards 450,000 deaths as the Fall surge continues Inte the winter ifwe cant both mitigate in publbc spaces and convince Americans ofthe danger There are state examples of changing the rate of rise of cases to change the ragid rise im hospitalizations to preserve hospital capacity -- this isino kenger about preventing a crists -- this is a crisis -- thits is about trying to save as many lirees as possible within the criss and we have examples of states that are improving 1, The virus is accelerating faster than our response and this requires am even further accelerated and comprehensive Federal response with aggressive support to States te include strong statements that Europe and States with strong mitigation are improving = there is a clear roadmap to contain this virus and preserve the health system: . Continued aggressive communication at the WH level masking requirements at all times outside of immediate household, physically distancing, hand hygiene AND critically limiting of social interactions to the immediate household for the next 60 days while we bridge to the rapid vaccination of the vulnerable populations decreasing hospitalizations and fatalities : this is a short term sacrifice to protect the vulnerable, We must directly confront the myths that many Americans believe . Many Americans believe that masks don't work due to prior tweets, that the epidemic is a hoax, that the figure of 94% of those whe died had co-morbidities meant that they died from something else and we have inflated the fatalities - instead of understanding that the co-morbidities predisposed them to severe COVID ' Clear recommendations to States about the importance of short term mitigation interventions : restricting indoor dining and limiting and/or closing areas of congregation without mask (bars, gyms etc.) this was successful in the USA in the summer and was successful in Europe during their fall surge = states across the country are not mitigating adequately to preserve the health system . Continued critical guidance on the Holiday season to limit indoor unmasking across households if they choose to gather ' Aggressive re-alignment of Ag testing towards finding and preventing unrelenting silent spread that continues to trigger community spread in waves =a hand full of states are moving in this direction . Expansion of MAT testing now to ensure colleges can access routine regular cost effective testing in January . Expanding frequency of LICF testing and aligning early vaccination into LTCF . With Moderna's potential of one shot resulting in some protection - aggressive immunization of the elderly could dramatically change hospitalization rates and fatalities in the next 30-35 days . Ensuring rapid tlering of thase most vulnerable to rapid vaccine immunization access immediately upon EWA = this may require implementation support ta the states and full utilization of federal qualified health clinics
-
November 27, 2020 - Global - 60, 300,000/1,400,000; USA - 12,800,000/263,000 Now concerned about the post-Thanksgiving surge 2a) New Daily Confirmed COVID-19 Cases in the U.S. 2M FA EE \ Fy od Confirmed a : ps i a Mi qm oy say FF .-- 13,000,000/264,000 TRENDS IN HOSPITAL INPATIENT COVID UTILIZATION DURING THE LAST 8 WEEKS a --. Inpatient bed utilization cubegporien I heed OF ae Pe a a 'ik Hartharr, Markee: in bere Serene. Seeer Sernaehirs I J = ont by _ sap ry PP PPP rebate ee sae Record number of hospitalizations at >80,000
-
November 28, 2020 - Global - 61,300,000/1,400,000; USA - 13,000,000/264,000 oy Be Ue Rb pe iad 10. 11. 12. 28 November 2020 There are 29 states inthe red zone and 11 states in orange zone Data is unstable due ta Thankselving but in summary -- testing rates are static compared te October Cases are increasing especially in CA = incredibly high case counts despite Thanksgiving, the NorthEast, the Sunbelt with significant deterioration in AZ Data will be unstable including fatalithes due ta reporting delays -- but haspital new admissions should be real time and I will be tracking those carefully Hospitalizations new admissions and current inpatients with COVID approaching 100,000 but the rate of rise is slowing and next week could plateau There are now 29 States in the red and orange for hospitalizations of COVID cases -- care deteriorates across all patients with and without COVID when states enter the red zone -- there are more states in this category everyday This will allaw us to fully see the impact of Thanksgiving travel and gathering in 2 weeks a5 we should have peaked and should have declined We need to make it clear that choices (state and metre policy choices and personal choices) will drive a post Thanksgiving surge because of the underlying high viral load that will be an overwhelming threat to the health care system. Many states are currently Inadequately mitigating including sunbelt states that mitigated well in the summer. Aggressive mitigation needs to occur now to prevent a cataclysmic Holiday season for the hospital systerns. CFR and deaths/iM population will correlate with level of mitigation. The mitigation choloes states make or don't make will direct correlate with cumulative level of fatalities. It is net te late with the Holidays coming to change. The impact of these cheices on human life will be very evident. Current improvements are seen in 1-2 states aggressively mitigating and it will be very evident aver the next 60 days that mitigation saved lives and the lack af mitigation resulted in unnecessary high fatalities - States that did not mitigate will end up with population CFR equal to the Spring surge when treatment was suboptimal - NG, 50, MT-- states must be encouraged to advance policies that mitigation against this Fall viral surge We found the friends and farnily small gatherings driving hospitalizations during the state visits but we also know that these drivers appeared in the sunbelt after the states fully mitigated in the public spaces --including significant reducing capacity or closing spaces where masks cannot be warn Europe countries With clear policies are improving rapidly with aggressive containment with mitigating policies and clear communication and are carefully reapening Although we were beginning te see early signs of decreases in the rate of rise of hospitalizations I remain deeply worried about a post Thanksgiving surge that will once propel us towards 450,000 deaths as the Fall surge continues inte the winter If we can't both mitigate in public spaces and convince Americans of the danger -- convincing Governors and Mayors naw to mitigate post Thanksgiving and pre-Holidays is essential Reporting of cases will be inaccurate for the next couple of days due to Holiday. However, we can expect a post-Thanksgiving surge. Did filming with Janet Tobias and John Hoffmann for the NatGeo documentary. Went to the old RFK Stadium/Armory complex to view and film the 250,000 white flags put up by artist Susan in memory of those who died from COBID-19. Very reminiscent of the HIV/AIDS Quilt project. The crew filmed Chris and I walking through the acres of small white flags. Also filmed us from above with a drone. Trump bringing his argument before the Supreme Court. He has lost every court case (>30) except for one. The Supreme court issue relates to a lower court rejecting his claim that the Pennsylvania election was rigged. He and his lawyers (led by Rudy Giuliani) are an extreme embarrassment to the GOP and to the country. The rest of the world is looking at what is going on here incredulously. We look like a Banana Republic. I never would have imagined in my wildest dreams that our democracy would be so shook. It is still amazing how the ZGOP leaders do not abandon Trump. They are just afraid of him and what he can do after he leaves the Presidency to their political careers - Profiles in Cowardice. Received Deo et Patriae Award from Regis High School and President George W. Bush sent a letter of congratulations: Letter from President George W ts ant 10/1,400,000; USA -- 29 November 2020 There are 27 etates in the red zone and 11 states in erange rene and C4 included in the packet theugh testing in yellow zone Gata will be unstable including fatalities due to reporting delays -- but hospital mew admissions should be real time and I will be tracking those carefully --although still rising the rate of rise is decreasing. Current inpatients with COVID approaching 100,000 We will fully seo the impact of Thanksgiving travel and gathering in 2 weeks as we should have peaked and should have decline There are now 29 States in the red and orange forhospitalizations of GOVID cases -- care deteriorates morces all patients with and without COVID when states enter the red zone -- there are mone states in this category everyday We need to make it clear that choices (state and metro poboy choices and personal choices) will drive a post Thanksgiving sume because of the gerlying high viral Koad that will be an overwhelming Cheat 00 the health care system, Many states are currently madequatety mitigating mcluding sunbelt states that mitigated well in the summer, Aggressive mitigation meeds to occur mow to prevent 4 cataclemic Holiday season for the hoapital syitems, CFR and desthe/1M population wil correlate with level of mitigation. The mitigation choices stated make yall correlate with level of fatalities. Iti wat to late with the Holla coming to change. The impact of these choices on humec lite will be very evident. Current imGryemenis ane seen in 1-2 states agerestively mitipaling and it will be very evident over the newt 60 daws That mitigation saved fives and lack Of ralgation resulted in uinecessary high lateliies - Sates not mitipeting will ach population OFA equal to the Sprig sunk when lreelment wad suboptinial - WO, $0, MT -- sleles must be ercouraped to advance polices Cheat malggation ageing his Fall viral sure We Found the friends and farily small gatherings driving hospitalizations during the state visits hut those drivers agpeaned in the Sunbelt after the states Fully niitigated inthe public spaces -- including significant reducing cagacity or chosing spams where masks cannest be wenn Furope countries with clear policies are improving rapidty with aggressive containment with mitigating policies and clear oomenunécationm and are concfully reogening We were beginning to smo signs of decreases in the cate of rise of hospitalizations but a post Thanksgiving surge ontop ofaearly 100,00 inpatients will prone us towards 450,000 deaths as the Fall surge mows into winter ifwe can't both mitigate in public spaces and convinee Americans of the danger = convincing Governors and Mayors now to mitigate gost Thanksgiving and pre-Holidays is essential Got call from Ron Klain tonight at 5:15 PM. He wanted to fill me in on recent appointments (not announced yet) to make sure that I am OK with them: Josh Sharfstein (FDA), Vivek Murthy (Surgeon General), Rochelle Walensky (CDC), Jeff Zients (COVID-19 Czar), Gina Raimondo (Secretary of HHS). Ron said that Biden wanted to call me soon but he did not want to compromise me with the Trump people. They will clear with Meadows that the transition team can start getting in place and then Biden will call me. Got call last night from Mark Ghaly (Deputy Director for Community Health for the LA County Dept of Health Services). He has called me several times for advice. Frantic call saying that they are surging in LA County and very soon hospital beds will be overrun. He wants to do a 3 weeks shutdown of the city to "stop the surge" and wants my support since there is a large pushback to locking down. I agreed to support him.
-
November 29, 2020 - Global - 61,900,000/1,400,000; USA - 13,100,000/266,000 Now at end of Thanksgiving weekend. Expect further surges (Birx's daily report): 1. The summer surge post Memorial day-- USA baseline cases were at 25K day now >L60K/day, inpatients were <30K and now =90K -- we are ina very dangerous place fora further resurgence 2, The virus continues te accelerate faster than our response and this requires an even further accelerated and comprehensive Federal response with aggressive support te States to include strang statements that Europe and States with strong mitigation are impraying-- thereisa clear roadmap tecontainthis virus and preserve the health system: * Continued aggressive communication at the WH level masking requirements at all times outside of immediate household, physically distancing, hand hygiene AND critically limiting of social interactions to the immediate household for the next 60 days while we bridge to the rapid vaccination of the vulnerable populations decreasing hospitalizations and fatalities : thisis a short term sacrifice to protect the vulnerable, We must directly confront the myths that many Americans believe Americans believe that masks don't work, that the epidemic is a hoax, that the figure of !1% of those who died had camorbidities meant that they died trom something else and we have inflated the tatalities --instead af understanding that the co-morbidities predisposed them to severe COVID and deaths have been underreported Clear recommendations to States about the Importance of short term mitigation Interventlons ; restricting indoordining and limiting and/or closing areas of congregation without mask (bars, gyms ebc.) this was successful in the USA in the summer and was successfulin Europe during their tall surge - states across the country are not mitigating adequately to preserve the health System Continued critical guidance an the Holiday season to limitindoorunmasking across households it they choose to gather Aggressive re-allgnment of Ag testing towards tinding and preventing unrelenting silent spread that continues to trigger community spread in waves = a hand full of states are moving in this direction Expansionaf WAT testing now to ensure colleges and K-12 teachers can access routine regulartesting inJanuary Expanding frequency of LTC testing and aligning early vaccination Inte LICE With Medera's potential of one shot resulting In some protectbon - aggressive innnunization of the vulnerable and the elderly could dramatically change hospitalization rates and fatalities In the mext 30-35 days Ensuring rapid tiering of those most vulnerable to rapldvaccine Inmunization access Immediately uponEWaA--this may require implementationsupport to the states and full utilization of federal qualified health clinics Date Milestone Dec 1 Covid-19 illness documented (unpublicized Nov 17*) Jan 10 SARS-CoV-2 virus sequenced Jan 15 NIH designs mRNA vaccine in collaboration with Moderna Mar 16 Moderna Phase 112 trial begins May 2 Pfizer/BioNTech Phase 112 trial begins July 14 Moderna Phase 112 trial published in NEJM July 27, 28 Moderna and Pfizer/BioNTech Phase 3 trial begins Aug 12 Pfizer/BioNTech Phase 112 published in Nature October 22,27. Enrollment in both Phase 3 trials complete; >74,000 participants Nov 9 Pfizer/BioNTech announces interim analysis efficacy > 90% Nov 16 Moderna announces interim analysis efficacy 94.5% Nov 18 Pfizer/BioNTech announces 95% efficacy as final result Nov 20 1st EUA submitted by Pfizer/BioNTech Nov 27 Distribution of vaccine by UAL charter flights throughout US Dec 10 FDA External review of Pfizer/BioNTech EUA Dec 11 Phase 1a Vaccination begins for health care professionals* *Provisional on positive external review Photos below of Fauci making rounds with Clinical Center inpatient and Clinic Staff - from October 2020 - 13,300,000/266, 100 Fauci makeing rounds with Clinica PRESS: NBC Meet the Press with Chuck Todd; ABC This Week with Martha Raddatz
-
November 30, 2020 - Global - 62,400,000/1,500,000; USA - 13,300,000/266,100 We will see in the next few weeks whether the travel associated with Thanksgiving leads to a surge upon a surge. 95,000 people are currently hospitalized with COVID-19 - new record for this outbreak. Biden putting together his team. Very diversified with women and people of color. Trump still flailing about challenging without any hint of evidence that various states were won by him. He still has his Greek Chorus of people backing him although little by little they are being less vocal and explicit about backing him. The GOP is in a crisis in that many have lost credibility by not explicitly condemning Trump. They are all afraid since he does have almost 1⁄2 the country with him. He will definitely run in 2024 and they are afraid that they will lose his support if they come out against him. Terrible situation for democracy. Got call from Gov. JB Pritzker (D-IL) praising me for what I have been doing and asking for my backing for him to keep stringent public health measures (short of lock down). He is getting pushback from bars and restaurants and even from hard core people who do not want to wear masks. He said that I am so credible and respected that he would like to quote what I have said as backup for himself. He liked my statement on Sunday shows of "Close the bars; open the schools". He is very frustrated with people not wearing masks and told me he would like to just say: "Wear a fucking mask!" 30 November 2020 There are 26 states in the red zone and 10 states in orange zone -- data is extremely unstable due to the long Holiday break There aré two different regional dynamics in the pandemic. The Northern Plains and mast of the Heartland except OK is finally stabilizing after 8 weeks of unrelenting rise but from IN to OH to PA, the mid Atlantic, the NE region and the West Coast, TX and AZ continue to deteriorate which will drive up cases, hospitalizations and deaths. Currenth new admissions are stabilizing and the key will be whether Thanksgiving drives a super surge There are now 29 States in the red and orange for hospitalizations of COVID cases -- care deteriorates across all patients with and without COVID when states enter the red zone -- there are mare states in this category everyday -- decision by CDC on who [s immunized first will determine the future stability of the hospital system. Gee and Jan will be the key months for pressure on the hospital system and without prioritizing thase most like to require hospitalization and death could result in over all failure of critical care for all Americans independent of COVID status itis clear that choices (state and metro policy chobces and personal chelces) will drive a post Thanksgiving surge because of the underlying high viral load that will be an overwhelming threat to the health care system. Many states are currently inadequately mitigating Including sunbelt states that mitigated well in the summer. Aggressive mitigation needs to occur mow to prevent a cataclysmic Holiday season for the hospital systems. CFR and deaths/i1M population will correlate with level of mitigation. The mitigation cholces states make or don't make will direct correlate with curnulative level of fatalities, itis not to late with the Holidays coming to change. The impact of these choices on human life will be very evident. it will be very evident aver the next 60 days that mitigation saved lives and the lack of mitigation resulted in unnecessary high fatalities - States that did not mitigate will end up with population CFR equal te the Spring surge when treatment was suboptimal - ND, 5D, MT -- states must be encouraged to advance policies that mitigation against this Fall viral surge We found the friends and family small gatherings driving hospitalizations during the state visits but we also know that those drivers appeared in the sunbelt after the states fully mitigated im the public spaces -- including significant reducing capacity or closing spaces where masks cannot be worn Europe countries with clear policies are improving rapidly with aggressive containment with mitigating policies and clear communication and are carefully reopening Although we were beginning ta see decreases in the rate of rise of hospitalizations I remain deeply worried about a post Thanksgiving surge that could propel us towards 450,000 deaths as the Fall surge continues into the winter through Jan and Feb and if we can't both mitigate in public spaces and convince Americans of the danger --convincing Governors and Mayors now to mitigate past Thanksgiving and pre-Holidays is essential 1. Toprevent 4 post Thanksgiving surge a comprehensive Federal response with aggressive support to States to include strang statements that Europe and States with strong mitigation are improving -- there ls a clear roadmap to contain this virus and preserve the health system: * Continued aggressive communication at the WH level masking requirements at all times outside of immediate household, physically distancing, hand hygiene AND critically limiting of social interactions to the immediate household for the next 60 days while we bridge to the rapid vaccination of the vulnerable populations decreasing hospitalizations and fatalities : this is a short term sacrifice to protect the vulnerable. We must directly confront the myths that many Americans believe * Many Americans believe that masks don't work due to prior tweets, that the epidemic is a hoax, that the figure of 94%) of those who died had co-morbidities meant that they died fram something else and we have inflated the fatalities -- instead of understanding that the co-morbidities predisposed them to severe COVID ' Clear recommendations to States about the importance of short term mitigation interventions : restricting indoor dining and limiting and/or closing areas of congregation without mask (bars, gyrns etc.) this was successful in the USA in the summer and was successful in Europe during their fall surge -- states across the country are not mitigating adequately to preserve the health system ' Continued critical guidance on the Holiday season te limit indoor unmasking across households if they choose ta gather ' Aggressive re-alignment of Ag testing towards finding and preventing unrelenting silent spread that continues to trigger community spread in waves -- a hand full of states are moving in this direction ' Expansion of NAT testing now to ensure colleges and K-12 teachers can access routine regular testing in January ' Expanding frequency of LTCF testing and aligning early vaccination into LTCF ' With Moderna's potential of one shot resulting in some protection - aggressive immunization of the vulnerable and the elderly could dramatically change hospitalization rates and fatalitiesin the next 30-35 days * Ensuring rapid tiering of those most vulnerable to rapid vaccine Immunization access immediately upon EUA = this may require implementation support to the states and full utilization of federal qualified health clinics NATIONAL TIME Percent Test Positivity New Casen -- TOwy owing Aesrage Mi Chandy Tent Ponitiwity: -- 7-Day Aoeng cea i aly Cac Hew Hospital Admixsians Hew Deaths ' ah ah at ah ah = ch ab qi nh e 'at ah oh es qh ES a * ge ei i E ah ot at at ak a * a Ea |f= * "< a " -- Tay Binning Aerie Me Daily Conbirined Ad cca Ge Daily Suspected Anise = T-Dey Bowing deere Me Oaty Deaths Date Source COC Aggregate Data, Viniied Testing Datase, Unified HospitalDateset NOT FOR DISTRIBUTION // FOR OFFICIAL USE AND PLANNING PURPOSESONLY Sen. Rand Paul continues to act like an idiot: Rand Paul says Fauci owes parents and students an apology over pandemic measures BY DOMINICK MASTRANGELO - 11/30/20 12:01 PM EST 488 Sen. Rand Paul (R-Ky.) scolded Dr. Anthony Fauci in a tweet on Sunday, suggesting the nation's leading infectious disease expert apologize for his warnings about the danger coronavirus poses to school-aged children. "Dr. Fauci owes [Rand Paul] an apology," one of Paul's Twitter followers said. Paul responded: "No, he owes one to every single parent and school-age child in America. I told him this multiple times this summer." Fauci and Paul have clashed several times since the pandemic began, with the Kentucky Republican accusing Fauci of fear-mongering rhetoric and what he says is incorrect praise of so-called lockdown measures implemented to stem the spread of the virus. "Dr. Fauci, every day we seem to hear from you things we can't do. But when you're asked, 'Can we go back to school?' I don't hear much certitude at all. 'Well, maybe.' 'It depends.' Guess what? It's rare for kids to transmit this. I don't hear that coming from you. All I hear is, 'We can't do this, we can't do that, we can't play baseball,'" Paul said while demanding schools reopen during a Senate hearing in late June. "It's important to realize that if society meekly submits to an expert and that expert is wrong, a great deal of harm may occur when we allow one man's policy or one group of small men and women to be foisted on an entire nation." Fauci responded to Paul at the hearing, saying he feels "very strongly we need to do whatever we can to get the children back to school." During the early days of the pandemic, Fauci and other public health officials urged local school districts to consider all factors before deciding if it was safe to have children and teachers return to classrooms. On Sunday, Fauci clarified his position on school closures amid a nationwide spike in coronavirus cases this fall. "The default position should be to try as best as possible, within reason, to keep the children in school, to get them back to school," Fauci said on ABC's "This Week." "If you look at the data, the spread among children and from children is not very big at all, not like one would have suspected. So let's try to get the kids back. But let's try to mitigate the things that maintain and push the kind of community spread we are trying to avoid. And those are the things you know well. The bars, the restaurants ... those are the things that drive the community spread. Not the schools." • Did weekly Governor's call today led by VP Pence. • Moderna applied to FDA for an EUA for their mRNA vaccine. Their final data were very impressive. 94% efficacy and 30 severe outcomes, all in placebo, none in vaccine. Pfizer did this submission last week (Nov. 20) • Fireside chat with American Society of Hematology - 13,400,000/267,300 progress President Trump has done, • Did a nice 60 minute Facebook Live with Mark Zuckerberg PRESS: WUSA TV interview (Gabe Cohen); WTOP Radio; Yahoo News and Sports; iheart Radio; Cheddar TV; WedMD Magazine interview (I will be one of their public health "heroes"; Facebook Live with Mark Zuckerberg; BBC World News Radio;