December 5, 2020 - Global - 65,000,000/1,500,000; USA - 14,300,000/278,000

In context

A single line often inverts meaning once you see what it answers, so neighbouring messages are always shown.

1. 2020-12-01 00:00 Anthony S. Fauci open
   December 1, 2020 - Global - 62,700,000/1,500,000; USA - 13,400,000/267,300 Many GOP (such as Roy Blount) still supporting Trump who is becoming more and more unhinged. He is losing every court case that he appeals to overthrow the vote in a number of states. He rales that it is all a stolen election and that he won by a landslide. Very embarrassing. Blount refuses to call Biden the President -Elect. Scott Atlas resigns! I imagine that is because everything that is happening now with the surges has finally proven him to be incorrect on virtually everything that he has said. The one area where he was correct was in saying that school children are not the drivers of the outbreak. However, he was dead wrong in saying that mitigation does nothing and that when states peak and come down, it is because they have reached herd immunity. Yet, now we are seeing states and cities that peaked high months ago and now are peaking even higher. So much for heard immunity. Rand Paul still coming after me saying that I should shut everything down. The press is contradicting him by showing quotes from me to the contrary. What a jerk! I am staying above the fray. Alex Azar is becoming more sycophantic towards Trump as we get to the end of the administration. See below: Azar Touts Swift Progress On COVID-19 Vaccine Development. Fox News (11/30, Nelson, 27.59M) reports that on Monday, HHS Secretary Alex Azar said progress on the COVID-19 has been unprecedented. He told Fox News, "Think about this: 10 months into this pandemic hitting our shores, thanks to what President Trump has done, we believe we're going to have people getting vaccinated, millions of people, before Christmas this year. It's just unheard of in the history of public health, this accomplishment." He added that "the vaccine will be 'shipped' within 24 hours of FDA approval and then it would be up to 'nursing homes, hospitals, and pharmacies to get that dispensed.'" day the He was explaining to me why he California Governor: State At "Tipping Point" Of Pandemic. Reuters (11/30, Whitcomb, Caspani) reports California Gov. Gavin Newsom (D) "said on Monday the state was at a 'tipping point' in the COVID-19 pandemic that would soon overwhelm hospitals as political leaders nationwide turn to increasingly aggressive measures to hold back the latest • Had important call with Gov Cuomo who called me up. He was explaining to me why he had an independent panel look at the COVID-19 vaccines. He said that the skepticism about the FDA already existed (i.e. their doing an EUA for Hydroxychloroquine) and he was trying to ameliorate it. He also was concerned about managing expectations about how quickly the vaccines will make a big and broad difference. He and I agree that the difference will not be until mid to late summer. He told me about his conversations with Trump and how Trump wants to mend the fences with Cuomo despite the fact that he has been trashing him. He wants to change his residence back to NYC saying that it would be good for NYC. Cuomo pushed back and told him that he did not agree that it would be good for NYC. Also, Trump apologized for calling Chris Cuomo "Fredo". Cuomo believes that Trump is a psychopath and an evil man who just wants to manipulate for his future, which he knows is bleak. Cuomo also expressed disdain for Azar saying that he is a sycophant to Trump and does not understand that black and brown people will not get fair access to vaccines with the paltry amount of money that the USG is giving to the states for the implementation of the vaccine distribution. USG gave $200 million to NY, when they really need $1 billion. Cuomo told me the best thing that could happen for my legacy would be for Trump to fire me and then have Biden re-hire me. • Had call with Rob Manfred, Commissioner of MLB - He needed advice about the timing of Spring Training (February for pitchers) vis-à-vis the roll out of vaccines and when there would be enough people vaccinated so that he can both get his players vaccinated and have a degree of herd immunity present so that he can have spectators in the stands. I told him that by April there could be massive vaccinations IF people uptake the vaccine. We could have most people vaccinated by early summer which means they can start with half full stadiums and then by the World Series they could conceivably have packed stadiums. He might delay start of Spring Training from February to March. Also, he wants to offer stadiums and parking lots for massive vaccination programs. I told him that would be a CDC/local public health department issue. • Had Miami Mayors call. - The mayor of Miami-Dade County - Daniella Levine Cava now has COVID-19. Former Mayor Jimenez has COVID-19. Still remaining issue that Governor DeSantis is blocking the mayors attempts to mitigate. For example, he will not allow closing the bars and indoor restaurants. • Had call with Gary Bettman (NHL) about the coming hockey season • Task Force call - The VP still extracts "happy talk" out of a very sober report from Birx about the surge and the fact that we are perilously close to having our health care system 1 December 2020 Data is unstable but when cases nse despite the Holidays are they are across the West Coast, TX, Iid-Atlantic and ME it races more red flags There are 26 states in the red zane and 10 states in orange zone -- date & extremely unstable due ta the long Holiday break Thereare two different regione! dynamics in the panderic. L The Northern Plains. and mastof the Heartland except 8 is fimalhestabd ang after 2 weeks of uneelerting rise, Thess states will aliwus to secthe Thankegiving surge and beable to estimate the impact of theupooming Holidays and the messaging needed bo prevent a lanuanyand Febuary surge From iNito GH te, the mad Atientic, the ME region and the West Goes, TS and 42 continue to debenoratewhich will driveup cases, hos petalizations and deaths toeven high ttes.due to population sie and it will be difficult to estirnate the post Thankaaiving impact. Bo The current pecture could combine the Spong and Sumner surge states together inboa Winter sunge resulting inven higher hospetalaationsand deaths 4. Fach surge Spnng (100% fatalities), Summer [100k fatalitees:), Fall Surge I 100K fatalities) combening Spang and Summer could lead toa 200K Fatalities There are now 29 States in the red and orange fer hosgitalizatiens of COVID cages --gereral medical care deteriorates when slates enter Lie red gone --There are more states in this category eseryday = decision by COC on whe is emimuneced first will determine: the future stabelty of the hospital system. Dec and Jan willbe Lhe Rey months for pressure on the hosgital systemand wilhoul provritizing those Geely to require hospitalization and heghest rise of death could recult rower all fadure af critical care for all Amencans independent af OOWiD status Lwillbe wery evident over the mext 30 days thal mitigation saved lives and the lackal mitigation resulted in unnecessary high fatalities - Staves that did mat motgete will end up with population CFR equal ta the Spreng surge whentreatment was suboptimal W0, 50, MT states must be encouraged ta aceance policies Chak nabigabion against this Fall viral surge Europe: countrns with clear policies aire improving ranidhy with aggressive containment with motwating policies and clear camimunication and art carefully MOeTINg Although we were boginning to seo decmasas inthe rate of nse of hospetalcations a past Thanksgiving sumge thet could propel ws towards 450,000 deaths as the Fall sunge continues into the winter through Jan and Feb and if we cant bath mitigate in public spaces and convince Americans of the danger -- canwincing Gowamars and Mayors now to mitigate past Thanksgiving and pro-Holidays & espantial 1. To prevent a post Thanksgiving surge a comprehensive Federal response with agressive support to States to 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 -- ensuring the identification of silent spread and early Dx and Tx and those at risk for serious De: Continued aggressive communication at the WH level rnasking requirementsat all tires outside of immediate household, physically distancing, hand hygiene AND critically limiting of social interactions te the immediate househeld fer the neat 60 days while we bridge te the rapid vaccination of the vulnerable populations decreasing hospitalizations and fatalities : thisis ashort tern sacrifice to protect the vulnerable. We must directly confront the myths that many Americans believe * Many Americans believe that masks don't work due te prior tweets, thatthe epidemicis a hoax, that the figure ef 44 of those who died had eo-morbidities meant that they died from something ele and we have inflated the fatalities -instead of understanding that the co-rnerkidities precdipesed thern te severe COVID ' Clear recommendations to States about the importance of short term mitigation interventions © restricting indenr dining and limiting andor chasing areas of congregation without mask (bars, gyre ete.) this vas successful in the USA in the surnimner and was successful in Purope during their fall surge -- states across the country are net mitigating adequately ta preserve the health system ' Cantinutd critical guidane: on the Meliday seasen be limit indenr unmasking acres households if they choose ta Bathoet * Aggressive re-alignment of 4p testing towards finding and preventing unrelenting silent spread that carntinues te tigger community spread inwavwes --a hand fullof states are moving in this direction Exparcsionol MAT testing mow to ensure colleges and K-12 teachers can access routine: regular testing in lanuary * Expanding frequency of LTCF testing arcd 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 mast vulnerable to rapid vaccine immunization access immediately upom ELM -- this may require implementation support tothe states and full utilization of federal qualified health clinics over-run by the surge upon the surge. He and the Greek Chorus of the TF just cannot accept that we are in serious trouble. Very frustrating Some states starting to plateau while others continue to surge. See below: Danger of hospitals being overrun and lack of adequate staffing (see graphs below): DRAFT - PRE-DECISIONAL & DELIBERATIVE Leveraging CDC Areas of Concern Continuum Data Areas of ConcernClassifications: 1. Sustained Hotspot - communities that have had a high sustainedcase burden and may be higher risk for experiencing healthcare resource limitations 2. Hotspot - communities that have reached a threshold of disease activity considered as being of high burden 3. Emerging Hotspot - communities witha high likelihood to become hotspotsin the next 1-7 days 4. High Burden - Resolving - communities that were recently identified as hotspotsand are now improving ModerateBurden - communities with moderate disease activity 6. Moderate Burden - Resolving - communitiesthat have a moderate level of burden, but are demonstrating Improvement 7, Low Burden - communities with minimal activity Sources: COCs Areas of Concern Continuum -85% of hospitals and -90% of LTCFs are located in 'hotspot' counties Number of hospitals in countiesby AQC classification 3,654 (75.2%) (10.4%) el y (11.4%) me 3S) 0.78) 28) (0.28) Humber of LTCFs in counties by AOC classification 11,963 (80.9%) 1,074 (9.8%) 5.355) one (7.3%) on sai Sustained Hotspot Emerging High Moderate Moderate Law Hotspot Hotspot Burden Burden Burden Burden Resolving ing DRAFT » PRE-DECISIONAL& DELIBERATIVE Using CDC's Areas of Concerns classification & hospital-reported supply status--prioritize Distributors efforts Priorities for outreach * RI, LA, WI, UT, MN, MI, NM, OK, TN, MU li & a0 - I a=] I States nat digolayed g + WT (14% in hetspet, 25% . = reported PPE iqaue) Rie a 60) = ME (38%, 29%) = = Hi (69%, 28%) = » GA (TA, 15%) c @ : : = = 2 40 NH Law MN = = AL Tx c Wil @ MT 6c e®Ho aw eo IL usag| °AK = Py ow © lhUuNE . a (23.4%) @SD AR Mo A oc Ml ¢ AZ Fa by MA gs @ © ° =, "2. oH vA mOR BKY @ID CONC wy FL Bh DE = As ; ie pst ® States in top three quartiles % of population in a 'hotspot' county based on "Areas of Concern" classification (95.63%) = In data quality @ States in bottom quartile In data quality • Received Lifetime Achievement Award together with Henrietta Fore (Director of UNICEF) and David Beasley at elegant "virtual" gala. Praised by Barbara Bush in an interview and several celebrities • Heated discussion at TF meeting regarding the NIH Guidelines not being specific enough in its recommendations for mAb and CP. Typical Deb Birx wanting to push therapies more than the data justify. In the discussion, Pence was convinced by Deb and others - 13,600,000/270,000 (with no medical background) chimed in that saying "no evidence for or against the use of ......." Had long conversations with Cliff tonight and he is very reluctant to change the wording. VP was insistent that we indicate more strongly that the drugs work since Deb says that the clinicians are not using the drugs since they do not see a strong indication in the guidelines that the drugs work. Trying to work with Cliff who is adamant PRESS: Did Press Conference with Gov. Jared Polis (D-CO); WNBC NY TV;
2. 2020-12-02 00:00 Anthony S. Fauci open
   December 2, 2020 - Global - 63,400,000/1,500,000; USA - 13,600,000/270,000 Situation remains tenuous. Note from Deb Birx associated with her daily slide set: The situation we find ourselves is deteriorating beyond words. Please help me convey to senior leaders that is the worse combination of factors that we have seen since the beginning of the pandemic. Combining the Spring and Summer surge into a winter surge is what is deeply concerning. Despite my warnings there are OVP staff that undermine this message everyday and have greater access to the VP. I know its hard to see it coming, I know its hard to fathom, but it is coming even independent of the Thanksgiving potential due to the movement into populous states and nearly 50% of the country still believes this is being over blown, that it's a hoax, that masks don't work and I think the most damaging there is a set curve independent of mitigation - ie it doesn't matter what you do it will look the same. Yes there is an epidemic curve to both mitigated and unmitigated surges BUT the peak is higher and the duration of the surge is 2X longer without mitigation. Yes when hospitals get overwhelmed people do take more precautions and flatten the curve but that results in nearly 2X the fatalities as a mitigated response. Inadequately mitigated is nearly 2X the area under the curve as mitigated - 2X the hospitalizations and potentially 2X the deaths. Finally unlike the spring the asymptomatic group under 35 will not mitigate in the same way and will continue to drive infections and that is why more precautions must be implemented now - both state level mitigation policies and personal mitigation efforts. Deb 2600+ Deaths today. Worse since the NYC surge in early Spring (CURRENTLY HOSPITALIZED PER MILLION BY STATE Dec 01 I Hospitalized Per Million Peak - 968 in New York, April 13 uaa Under 100 100 - 250 250 - 500 Over 500 Source: The COVID Tracking Project ~ Under100 ©100-250 8250-500 WM Over 500 @ 2 December 2020 1. Data remains unstable (test positivity, cases, deaths as they come from the state reporting) but when cases rise despite the decreased reporting as there are across the West Coast, TX, Mid-Atlantic and NE it raises red flags 2. New admissions and inpatient census data comes directly and daily from the hospitals so that reporting is more reliable and although at record highs were stabilizing -- BUT as noted yesterday the improvements in the Northern Plains, Rocky Mountain States and Heartland is being offset by the surging hospitalization on the West Coast, Sunbelt, MidAtlantic and NE--these more populous states will drive this over the next 2-3 weeks independent of a post Thanksgiving surge as they reflect transmission before Thanksgiving 3. There are now 31 States in the red (23) and orange (&) zone for hospitalizations af COVID cases -- general medical care deteriorates when states enter the red zone -- there are more states in this category everyday -- decision by CDC on who is immunized first will determine the future stability of the hospital system. Dec and Jan will be the key months for pressure on the hospital system and without prioritizing thease likely to require hospitalization and highest risk of death could result in aver all failure of critical care for all Americans Independent of COVID status = UK is immunizing HCWs, LTCF and everyone over $0. Our hospitalizations and fatalities mirror this except in USA its over 70. 4. Please review slide 3-- as raised a couple of weeks ago-- the movement of the surge into populous states especially without adequate policies or without individual Americans mitigating will drive fatalities -- states with >100 yesterday -- TM (237), MI (195), PA (170), IL (146), IN (141), CA, MO, OH, WI -- bald states do nat have adequate mitigation policies -- the others are due to personal decisions 5. There aré two different regional dynamics in the pandemic. 1. The Northern Plains and most of the Heartland except OK is finally stabilizing after 8 weeks of unrelenting rise. These states will allow us to see the Thanksgiving surge and be able to estimate the impact of the upooming Holidays and the messaging needed to prevent a January and February surge 2. From IN te 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 te even high rates due to population size and it will be difficult to estimate the post Thanksgiving impact. 3. The current picture could combine the Spring and Summer surge states together inte a Winter surge resulting in even higher hospitalizations and deaths 4. Each surge Spring (100K fatalities], Summer (100K fatalities), Fall Surge (100K fatalities) combining Spring and Summer could lead to 200K fatalities 6. ft will be very evident aver the next 30 days that mitigation policies saved lives and the lack of mitigation resulted in unnecessary high fatalities • Call from Mark Meadows saying that it was OK to do press conference with Gov. Cuomo. Also, he really wanted a reality check on the fact that the MHRA of the UK has given their equivalent of an EUA to the Pfizer vaccine. He wanted to know if our FDA was dragging their feet. I totally supported the FDA, Peter Marks, and Steve Hahn and said that the UK were "hot-dogging" it and that even the EMA were blasting the UK for hot dogging. It seemed that Mark was on the brink of firing Hahn. Hope I blocked that together with George -- 13,800,000/273,000 To prevent as many fatalities as possible a comprehensive Federal response with aggressive support to States to include strang statements that Europe with strong mitigation are improving -- there is a clear roadmap ta contain this virus and preserve the health system -- ensuring the identification of silent spread and early Ox and Tx and those at risk for serious Dz: Reinstate 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 dué 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 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, 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 --even those states that mitigated In the surmmer are failing to mitigate now Continued critical guidance on the Holiday season to limit all indoor gatherings to Immediate household only 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 in the community in addition to the Pfizer priority to HCWs and LTCF could dramatically change hospitalization rates and fatalities in the next 30-35 days led • Got call from Jeff Zients in preparation of my briefing the Biden "landing team" tomorrow. Jeff wanted to alert me that Biden will be calling me right after the briefing. • Received the Eleanor Roosevelt Prize for Global Human Rights Advancement from the American Bar Association Center for Human Rights • PEOPLE Magazine names me 2020 Person of the Year together with George Clooney, Selena Gomez and Regina King PRESS: CNN: Elton John honors Anthony Fauci on World AIDS Day; CNN Heroes with Anderson Cooper; KTVQ TV - Billings, MT; ABC News PRIME (Online); Fox TV News; Frank Bruni writes in the NY Times: Anthony Fauci is the steely superhero of my deep state, and he's flanked and fortified by all the government health officials who also pushed back against the quackery of Scott Atlas, the Trump-flattering pandemic adviser who resigned on Monday
3. 2020-12-03 00:00 Anthony S. Fauci open
   December 3, 2020 - Global - 64,000,000/1,500,000; USA - 13,800,000/273,000 Records being broken: 3000 deaths yesterday; >100,000 hospitalizations; >200,000 new infections. With gauntlet of Today I met with President elect Biden's landing team. It was a good meeting that was led by Jeff Zientz, Vivek Murthy, and included David Kessler, John Auerbach, Tom Inglesby, at their process of the approval of the among others. We went on to discuss the challenges associated with the rollout of the vaccination campaign. In addition, I gave them my advice on what the most effective communication strategy would be for the upcoming administration. In addition, they wanted might take on what the challenges with be in the coming months of January, February, march, and beyond. It was an excellent conversation in which they all expressed their gratitude and respect for me for the work that I have been doing over the past several months. At exactly 3:00 PM, 1 hour as to the beginning of the meeting there was a prearranged call with President elect Joe Biden together with chief of staff Ron Klain. President-Elect Biden was very glad to chat with me and immediately stated that he wanted me to continue in my position as director, NIAID. In addition, he wanted me to be his chief medical adviser. Then, Ron and President elect Biden asked me a series of questions concerning some of the decisions that they would likely have to make in the coming months. Mayor Bill De Blasio called me up asking for advice about the surges that are occurring in NYC and how much of a lock down he should implement. He wanted to keep things mostly open until after the holidays and then shut down. I told him that this was a big mistake since by that time, the damage will have been done and he will have precipitated a major surge. I urged him to close the bars and restaurants and subsidize the establishments so that they do not go under. If he does that and discourages private, large gatherings, he could get away with keeping the shopping areas open. I apologize to the UK on BBC radio for implying that their process of the approval of the vaccine was rushed and sloppy PRESS: CBS News "The Takeout" with Major Garrett; Sky News UK TV; MSNBC with Andrea Mitchell; New York Times interview with Tara Pope Parker; KQED NPR Radio, San Francisco; BBC World News; New Zealand Herald (Dick Brass) print media; Bloomberg: - 14,000,000/276,000
4. 2020-12-04 00:00 Anthony S. Fauci open
   December 4, 2020 - Global - 64,500,000/1,500,000 USA - 14,000,000/276,000 Did photo shoot and interview with Alice Park of TIME Magazine. • I called up Rosa De Lauro to congratulate her on being chosen by Nancy Pelosi as Chair of the Appropriations Full Committee. She had tears in he eyes thanking me nd saying how excited she was that Biden has announced that I would be his Chief Medical Advisor. • Spoke with Don Fehr of the NHL Players Association about the likelihood of the NFL having a season and what my projection for 2021 was. wa 4 December 2020 Data remains unétable but when cases rise despite the decreased reporting across the West Coast, TX, Mid-Atlantic and NEit isa significant red flags -- there are histeric rate of rises in populous states = last week was our highest number of >40 and > 70 new admissions New admissions and inpatientcensus data comes directly and daily from the haspitals so that reperting is more reliable the improvements inthe Nerthern Plains, Rocky Mountain States and Heartland is being directly offset by the surging hospitalization anthe West Coast, Sunbelt, MidAtlantic and NE-- these more populous states will drive this aver the next 2-3 weeks independent of a post Thanksgiving surge as they reflect transmission before Thanksgiving and represent the areatest threat to haspital resilience- the current situationis mot sustainable All trends show that this escalation is occurring-even before the transmission fram Thanksgiving -- we should begin to see the full impact of Thanksgiving starting next week and as warned this Winter surge will be bigger, broader, and more deadly. It will bring together both the Spring and Sunomer surge into one overwhelming threat dramatically increasing hospitalizations and deaths ; even with the innowations this will be catastrophic without increased mitigation now ~ states without adequate public polhcles will have the highest fatallty rates per populathons equal to the Spring rates despite improvements In care due to the lack of mitigation We de nat have enough vaccine fer vulnerable Anvericans to change haspitalization and fatalities trends in Dase-Feb -- we need to kee clear te the Qrmerican people vaccines will haw: animpact inthe Spring but NOT awer the next 3 months. Eechavier change is aur sole intervervticn There are now 33 States in the red (24) and orange (9) zone for hospitalizations of COVID cases = general medical care deteriorates when states enter the red zone= there are more states in this category everyday = decision by COC on wha is immunized tirst will determine the future stabilityafthe hospital system and hospitalization rates - current plan will not change the pandemic dynamics impact on hospitals. The meverment of the surgeinta populous states especially without adequate policies or without individual Americans mitigating will drive fatalities and most of these states donat have adequate mitigation policies and fatalities will continue averaging over 2500/day 17 Kfweek, 70K/menth ata minimum reaching over 330K by New Years and 450K by the end of February without calls for action at the Federal, State, and Local level and using PSAs te combat the myths related to COVID throughout the country Ital be wery evident over the next 30 days that mitigation policies saves lives and the lack of mitigation results in preventable deaths Mew Cases Percent Tes Pew Vata atatate Me Pei Caves -- Fly Maren deere Me Daily Test Ponty New Deaths Hew Hospital oD Bee Tee Selatan he ee ty it Pomitivity Sataatat T.Day Moving Aearage Admissions & rs E Hie pita Adreiione aa i a ( % " ha a PULP te ata LW tatataaala ete" wells ele Rea eae yy yy Me Dely Cetra Ghreveers, Me Caiy Cet = 7-Day Boeing aera GS Deity eoreched Adem Source: COC slabe-reporied data (Cases and deaihs), CELR and Federal Aggregaie Testing Data, Unified Hospital Dataset Enable etaBote de Be So Geet ee ---- I-Oiy Mees bereges COMMRVED CASES OM A TAY ROLUMG AVEERGE CONFIRMED CASES DAILY IN LOS ANGELES-LONG BEACH-ANAHEIM, CA 7 DAY ROLLING AVERAGE HE range County, CA Tice Angeles Cait, 0 a, Jim Sciutto and Kate Sullivan -- 14,300,000/278,000 More records broken - 200,000 cases; 2885 deaths; >100,000 hospitalization. Hospitals are starting to get over-run. California starting lock-downs to avoid hospital crisis (see above figure) PRESS: NBC Today Show with Savannah Guthrie; Multiple press stories about Biden speaking with me, asking me to stay on as NIAID Director and offering me the title of Chief Medical Advisor; Greta Van Susteren "Full Court Press" TV (VOA); "Today with Kaye" Baltimore Radio Show; CNN Town Hall with Anderson Cooper and Sanjay Gupta; Biden said he asked Fauci to stay on and be a chief medical adviser in his administration
5. 2020-12-05 00:00 Anthony S. Fauci
   December 5, 2020 - Global - 65,000,000/1,500,000; USA - 14,300,000/278,000 Surge continues with more records broken. California locking down because they are at 15% or less of beds available and thousands of cases of coming in for hospitalizations. oa December 4920... In Most states -- this will allow us to see the Impact of Thanksgiving In the regions where cases and hospitalizations were stabilized before Thanksgiving -- the Northern Plains and Racky Mountain states Test positivity and case reporting is inoerrect at the State level in GA and VA and we are working with the states to correct this -- both have increasing hospitalizations The impravernents in the Northern Plains, Rocky Mountain States and Heartland is being directly offset by the surging cases and hospitalization on the West Coast, Sunbelt, MidAtlantic and NE--these more populous states will drive this over the next 2-3 weeks and when combined with a pending full Thanksgiving surge will represent the greatest threat to hospital systems and inpatlent care All trends show that this escalation was occurring even before the transmission from Thanksgiving --- we should begin to see the full impact of Thanksgiving starting next week and as warned this Winter surge will be bigger, broader, and more deadly. It will bring together both the Spring and Summer surge into one overwhelming threat dramatically increasing hospitalizations and deaths : even with the innevations this will be catastrophic without increased mitigation now -- states without adequate public policies will have the highest fatality rates per populations equal ta the Spring rates despite improvements in care due to the lack of mitigation = death rates in ND and §D and approaching NY/NJ #s We da not have enough vaccine for vulnerable Americans to change hospitalization and fatalities trends in Dec-Feb--- we need ta be clear ta the Armerican people vaccines will have an impact in the Spring but NOT over the next 3 manths. Behavior change and proactive testing ta find both the asymptamatic and symptomatic transmitters are our only interventians and states are still not testing carrectly te find both There are now 344 States in the red (24) and orange (10) zone for hospitalizations of COVID cases -- general medical care deteriorates when states enter the red zone -- there are more states in this category everyday -- decision by CDC on whe is immunized first will determine the future stability of the hospital system and hospitalization rates - current plan will nat change the pandemic dynamics impact on hospitals. The movement of the surge into populous states especially without adequate policies or without individual Americans mitigating will drive fatalities and mast of these states do not have adequate mitigation policies and fatalities will continue averaging over 2500/day 17K,/week, 70K/month ata minimum reaching over 330K by New Years and 450K by the end of February without calls for action at the Federal, State, and Local level and using P5As to combat the myths related to COVID throughout the country it will be very evident over the next 30 days that mitigation policies saves lives and the lack of mitigation results in preventable deaths 00 USA -- 14,500,000/280,000 Trump still insisting that the election was "rigged" and that he won by a landslide. More than 30 court cases have been thrown out as frivolous. Alyssa Farah resigns. Good for her. One of the few good people in the administration. This might mean that I am not allowed out in the media any more since she has always advocated for me.
6. 2020-12-06 00:00 Anthony S. Fauci open
   December 6, 2020 (Sunday) - Global - 65,900,000/1,500,000 USA - 14,500,000/280,000 Had important Zoom call today (11:00 AM) with Jeff Zients and Jake Sullivan - Jeff and Jake are going to make some policy announcements for the Biden tam next week (Tuesday0 and they wanted to make sure that it was cleared by me. They had 3 issues: 1) the 100 days of mask wearing. I advised that they say "at least 100 days" or give some indication that it might be longer since when they get to 100 days, we may need to extend; 2) they want to say that they will distribute100milindoses of vaccine in teh1st 100 days of the Biden administration. I warned that this might actually be an underestimate. They first need to check that we will actually have a supply (check with Perna, but also make sure that we do not seem that this is undershooting. Since we are now saying that we will have 40 million doses by the end of December and even more by the end of January, then 100 million by the first 100 days of the Biden administration is far too little; 3) Schools - I suggested that they always lead with saying that the default position is to open and keep open the schools. 6 December 2020 The improvementsin the Northern Plains, Rocky MountainStates and Heartland is being directly offset by the surging cases and hespitalization on the West Coast, Sunbelt, MidAtlantic and NE -- these more populousstates will drive this over the next 2-3 weeks and when combined with a pending full Thanksgiving surge will represent the greatest threat to hospital systems and general inpatient care-- this is not about ventilators and PPE this time -- this will be about the statf capacityto care for this volume of patients with and without cOVID 33 States are inthe COVID red zone for cases and test positivity and 9 states are in the orange zone for test + and red for cases There are now 34 Statesin the red (24) and orange (10) zone for hospitalizations of COVID cases -- general medical care deteriorates when states enter the red 2one-- there are riore states in this categery everyday decision by COC en wha i inmunined first will determine the future stability af the hospital system and hospitalization rates - current plan will net change the pandemic dynamics impact on hospitals Alltrends show that this escalation was occurring even before the transmission trom Thanksgiving -- we should begin ta see the full impact of Thanksaiving starting this week and as warned thls Winter surge will be bigger, broader, and more deadly. It will bring teaether both the Spring and Summer surge inte one overwhelming threat dramatically increasing hospitalizations and deaths: even with the innovations this will be catastrophic withoutincreased mitigation mow -- states without adequate publle pollcbes will have the highest fatallty rates per pepulations equal te the Spring rates despite Imprevernents In care due te the lack of mitigation --death rates In ND and SD and approaching N¥/MJ #5 We do not have enough vaccine for vulnerable Americans to change hospitalization and fatalities trendsin Dec-Feb-- we need to be clear to the Qmerican people vaccines will haw: animpact inthe Spring but NOT over the next 3 months, Behavior change and proactive testing te find both the asymptomatic and symptomatic transmitters are our only interventions and states are still net testing correctly to find kath The movernent of the surge into populous states especially without adequate policies or without individual Americans mitigating will drive fatalities and nvost of these states do not have adequate mitigation policies and fatalities will continue averagingover 2500/day 17 Kiweek, TOK /nvonth at amininun reaching over 330K by New Years and 450K by the end of February without calls for action at the Federal, State, and Local level and using PSs to combat the myths related to COVID throughout the country twill be very evident over the next 30 days that mitigation policies saves lives and the lack of mitigation results in preventable deaths on for They also want to announce on Tuesday the important role that I will have to be the Chief medical Advisor for the Administration. They will send me the wording to make sure that I am OK with it. Gov. Cuomo called me today (1:30 PM) - He wanted to touch bases with me in anticipation for the fact that I will be joining him tomorrow on a press conference for the state of MY. He wanted to brief me on what he was going to say. He and I have a growing and strong relationship. Received a call (3:00 PM) from Olivia Dalton from the Biden Transition team asking me to participate in an event (I asked to do it virtually) in Wilmington where Biden will announce his "health team" including me. We discussed my virtual remarks and other issues. Deb Birx on MTP pleading (as I have been doing) with the public to abide by public health mitigation methods. Example of state by state increases in deaths and cases: USA Total Hew Total New Total Aciive Tot Cases! Deathe' Total Testa! # State Cases Cases [7 Depths Daaths Recoversd Casas 1M pop 1M pop Tosts 1M pop Population USA Total T4772,555 4255,272 285,550 Carats) QGS,862 5,828,103 44,600 B63 203,884,001 615,959 California 24198 19,790 605,538 690,024 33,290 S01 24,675,478 624,502 99,512,223 2 I Texas 22.977 4,051, 256,966 45,921 7a2 12,406,532 427,838 28,995,001 a) Pennsylvania Tao 231,788 162,291 S612 Bré 5,859,001 457,663 12,801 89 New York 34.806 445,114 9 243,437 a7,239 1,793 20,173,461 1,037,006 19,459,561 S (iris 14,782 405,673 350,633 80,772 1,088 810,918,998 861,676 12,677 21 a I Floricta 18,007 668,358 351,821 48,305. BRA 12,857,007 5aH, 624 I 21477 ,7ar 7 I Qihie 6,882 306,950 143,131 39,093 BES 6,424,803 541,086 17,689,100 Michigan 10,118 165,269 24,5681 42,082 1,013 7,348,627 735,830 a6 657 a I ia 6,122 219,094 142,113 4,563 4,464,492 669,159 I 6,732,219 10) Georgia 9.725 S05224 = (178,405 46,561 4503002 452,462 10,617,423 ni I Kaneas 1,786 102,947 65,736 58,514 445,186 = - 290,112 I 2,013,314 Arizona 6085: $4,980 290,256 4aar4 S46 2,695,707 370,355 Taree? Mew Jersey 17,491 200,265 = 147,506 41114 1,858 6,175,836 65,018 8,882,190 4 Massachusetts 10,970 184,117 51,371 35,749 1,583 8,774,697 1,273,078 6,892,502 15 I Minnesota 293,151 41,918 60,106 baz 4,433,728 767,237 Saab 16) North Carolina 5,467 315,979 = 61,088 28,473 B21 05,461,220 «= B2O,7O7 = 10,488 084 7 Colorado a8 56,975 191,909 43,798 SEO 1,915,644 315,285 5,758,736 ti I vrisconsin 3,625 397,653 63,277 68,482 62a I 2,584,875 443,951 I 5.822.494 Oklahoma 1,060 177,564 29,451 52,787 2227 ttt 563,001 3,956,971 Daily New Deaths in the United States 4k 3k 2k Novel Coronavirus Daily Deaths oe sat @& 8 oF gf yt We ooh ve ® Daily Deaths il I Daily Deaths Deaths per Day Data as of 0:00 GMT+8 ans ( ~& 7-day moving average , i) I I I I il Pe PPS as gh PB ab gh Amhe PP SS aoe ate ate gh oe? pr a ge? GF oF oF oF o_o ow! OM" Confirmed Cases [Thousancs) New Dally Confirmed COVID-19 Cases In the U.S. a5 207.0 e¢ il ars ha, "ig, ty Day eee Day Mowing Avarage 14,600,000/281,3000
7. 2020-12-07 00:00 Anthony S. Fauci open
   December 7, 2020 - Global - 66,400,000/1,500,000; USA - 14,600,000/281,3000 Bracing for post-Thanksgiving surge! Deb's Daily Report: Data and reporting has stabilized and we are back on the same accelerating curve as before the delayed reporting and substantial declines in testing over the past 10 days. This week we expect to see the beginning of the post Thanksgiving surge as this would be when the silent spread starts to impact the more vulnerable Americans. We now have only 2 states (HI, VT) and DC in the green zone, 12 in the yellow and orange zone and 36 in the red zone. We are now seeing significant resurgence in all states except VT and HI and rapidly increasing cases across America that will lead to escalating hospitalizations the end of this week into next week and then fatalities. This is the worse situation we have faced and although vaccinations will help towards the end of Jan the next 7 weeks will be overwhelming if we don't work with states to increase their mitigation and provide the highest level of Administration support to the behavioral changes needed by every American. Deb ATERLGE ASESOM A TOY ROLLING. COMPRM ED 7 December 2020 The improvements in the Northern Plains, Rocky hauntain States and Heartlaned is being directly offset by the sunging cases and hospitalization onthe West Coast, Sunbelt, MidAtlantic and NE - these more populous states willdrive this over the next 2-3 weels and when combined with pending full Thanksgiving surge will represent the greatest threat ta hos pital systems and general impatient care--thisis mat about ventilatarsand PRE this time --this willbe stout the staff capacity ta care for this volume of patients with and without OOWID 39 States are in the GOWID ned none far cases and test positivity and S$ states are in the orange zone far test + and red far cases There are now 34 States im the reed (24) ane orange (210) 2one for hosaltalizationsaf OOVID cases -- general medical cone deteriorates when states enter the red zone -- there are more states inthis category everyday --decsion by COC on who ls immunized first will determine the future stability of the bosaltal system and hice pltalizathon rakes - current plan alll mat change the pandemic dynamics impact on hospitals (have included metro slides from across the USA. First thesseare the most metras withsimultaneous Increases In cases we have experienced thraughout this fandemic. (have included the 3 pathenns : metros fully escalating before Thanksgiving, metros at high plateau before: Thanksgiving and those that were imarceeling, before Thanksghving which willl allows to cee the impact of Holiday gatherings and praject them inta the next set of Holidays. We should begin to see the full bmq@act of Thanksgiving starting this week and 2s warned this Winter surge will be bigger, broader, and more deadly, Bringing together the Spring and Summer singe Into ame cverahiel ning threat Increasing hospitalizations and deaths > even with the Innicwathons this will be catashraphic without foreased mitigation now ~ states without adequate public polices will have the highest fatality rates per populations equal to the Spring rates daspita improvaniants In care due to the lack of mitigation. Wa do mot have anough waccine forwulmerable Anericans to change heapitalization and fatalities trands Im Dee-Fab -- we mecd ta be char tothe American pemple waceines will have an immact inthe: Spring but MT aver the next 3 months. Aehawior change and proactive: testing to find bath the asymptomatic amd symptomatic. 'transmitters anc ourandy Interventions ane states ane still mot testing conectly ta find both The mowement of ther surge inte papulous states especially without agequate palickess or with out Ind iuid wall Qumesricanes mitigating will drive fatalities and most of these states donot haat: adequate mitigation polickss and Fatalitics will contln averaging carer 2o0Ei day Lik Aweek, 70K month at a miindinnun reaching over 330K hy New Years and 450K by the ond of February without calls for action at the: Federal, State, and Local level and using PSAs to combat the myths related te OO¥ID throughout the counibry it wll be very evident ower the nowt 20 days that mitigation policies and behavioral change saves livesand the lack of mitigation results in preventable deaths CONFIRMED CASES DAILY IN NEW YORK-NEWARK-JERSEY CITY, NY¥-NJ-PA 7 DAY ROLLING AVERAGE loo 4 Othern Somerset County, Hi Pdorris County, Pll Monmouth Courtp, All Ackland Courts, Pay Orean County, All Aichereared County, H¥ Union County, Hl Peewus ic County, Hl Paiddlices Cousitp. A Pudeon Courty, Al Bergen Courtlp. a Come County, Bl Aiew York Gaunt, i WeHtchesler Counts, MY Ais cseg Count, HY Sulfolk Gaurnts, Av Grarc Courty, Ay Eings County Att Qucea County, Wr 10000 ai ano a0 See below for dire situation in NYC and Los Angeles COMMRVED CASES OM A TOAY ROLUMG WEEE CONFIRMED CASES DAILY IN LOS ANGELES-LONG BEACH-ANAHEIM, CA 7 DAY ROLLING AVERAGE Sang County, cA Mes Angeles Cosnity, 0, Joe Biden @ @!oeBiden - 2h eco Dr. Fauci isn't just one of our foremost experts on combating viruses--he is a good man and a tireless public servant. He has served six presidents and led us through some of our toughest challenges. Our administration, and our country, will be stranger because of his guidance. © 3.1K tl 78k 82.9K iT, At Task Force meeting on prior agreement between Deb and I, Deb says that the country is in dire straits and we need to give the message from above that this is serious and we must double down on mitigating. I jump in and say that we must be out there warning the people that if they do not mitigate, the hospitals will be over-run. The elephant in the room is that the POTUS is ignoring this and the message must come from him since the people who are not paying attention and who will not wear masks or not travel or not congregate are his people. The VP after the discussion got going for the first time ever got defensive and even hurt that we (mostly Deb) were implying that the administration was not taking the pandemic seriously. The issue is that maybe we are taking it seriously, but the POTUS and his people certainly are not. That is the lesion. The POTUS is undermining everything that we are trying to do. Deep down the VP has to realize this and still he fiercely defends the POTUS. Tragic! PRESS: CNN New Day with John Berman; Press conference with Gov. Cuomo (Boradcast from Albany, NY; Fireside chat with Norah O'Donnell (CBS) at the Milken Institute Future of Health Summit; Interview with Katy Kay for the Bloomberg American Health Summit; taping for ABC Special on Vaccines Biden-Harris Presidential Transition{] ane @Transition46 Dr. Anthony Fauci, America's preeminent expert on infectious diseases, has been among the most trusted voices throughout the pandemic. He will continue in his role and serve as Chief Medical Adviser on COVID-19 to President-elect Biden as we work to overcome this crisis. 3:05 PM - Dec 7, 2020 - Twitter Web App .-- 14,800,000/283,000 8 December 2020 The Impravements in the Narthern Plains, Rocky Mountain States and Heartland is being directly offset by the surging cases and hospitalization on the West Coast, Sunbelt, MidAtlantic and NE --- these more populous states will drive this over the next 2-3 weeks and when combined with the pending Thanksgiving surge will represent the greatest threat to hospital systems and general inpatient care -- this ls not about ventilators and PPE this tire -- this will be about the staff capacity to care for this volume of patients with and without COVID Testing declined during Thanksgiving time period and mow testing has resumed and test positivity is rising despite the increased testing indicating community spread 36 States are in the COVID red zone 9 states are in the orange zone, 3 states are in the yellow zone and 2 states and DC in green zone [have concentrated on hospitalization in this daily report -- an overall country COVID inpatient snapshot --slide 5, a time sequence of new daily admission slides 6-12 and a state by state summary of current daily admissions showing the states with rising admissions, states at a high plateau and states that are current improving. Slides 13-64. We should start to see the impact of Thanksgiving on hospitalizations towards the end of this week and into next week. There are now 35 States in the red (24) and orange (11) zone for hospitalizations of COVID cases -- general medical care deteriorates when states enter the red zone -- there are more states in this category everyday --decision by CDC on who is immunized first will determine the future stability of the hospital system and hospitalization rates - current plan will nat change the pandemic dynamics impact an hospitals. We should begin ta see the full impact of Thanksgiving starting this week and as warned this Winter surge will be bigger, broader, and more deadly. Bringing together the Spring and Summer surge into one overwhelming threat increasing hospitalizations and deaths : even with the innovations this will be catastrophic without increased mitigation now -- states without adequate public policies will have the highest fatality rates per populations equal ta the Spring rates despite improvements in care due to the lack of mitigation. We do not have enough vaccine for vulnerable Americans to change hospitalization and fatalities trends in Dec-Feb--- we need to be clear to the American people vaccines will have an impact in the Spring but NOT over the next 3 months. Behavior change and proactive testing ta find both the asymptomatic and symptomatic transmitters are our only interventions and states are still not testing correctly to find both The movement of the surge into populous states especially without adequate policies or without individual Americans mitigating will drive fatalities and mast of these states do not have adequate mitigation policies and fatalities will continue averaging aver 2500/day 17K/week, 7OK/manth at a minimum reaching over 330K by New Years and 450K by the end of February without calls for action at the Federal, State, and Local level and using PSAs to combat the myths related ta COVID throughout the country It will be very evident over the next 30 days that mitigation policies and behavioral change saved lives and the lack of mitigation resulted in preventable deaths
8. 2020-12-07 00:00 Anthony S. Fauci open
   December 7, 20207:56 AM ET JON MARCUS iL. 12. S00 New Daily Confirmed COVID-19 Cases in the U.S. 25) a 2m tel a " E =Soin 1m ' AAT ll I I j I I oS & ae, ee oe ~ & Ped » Ome Ss oo & A, aa 'te Pd ag Pal Hy '. we re 'ad Pd id rat Peer EP SE TOPE? Sy € s £e SF FSP IFS FS 20E0 Ce ee? Dery Mu ig Avarape 12 December 2020 Featuring the majornvetnas across the USA today The improvements im the in the Northen Plains, Rocky Mountain States and Heartland are currently holdinganed the declines are nwore raped iin the States mitigating -- MD, 1A, but Nationwide this is being offset by the surging cases and hospitalization on the West Coast, Sunbelt, Mid-Atlantic and North-East -- these imone populous states will drive caged and hospitalizations over the next 2-3 weeks stressing hospital sstena and general inpatient care : slide 6 ahorws the exquainding pandemic on both onasts similar to the Spring surge but with continued cases in the center of the country Early evidence of Thanksaning surge of cases across multigle metros : interesting patterns are evoking --states that were matigating before Thanksgring have a blunted increase in cases and those without mitigation especialtyacross the Sunbelt have langer increases -- the except to this LA where cases continue to escalate without improvement: 3 states (7X, UL, Pa, CA) daily deaths over 200 ane 3 states (KS, OH, FL) over 100 fday--these should be a hewer days with the peak forwoeek Wed Consistent with port Thanksgiving enhanced community aprend- 39 etates have increasing test positivity and 35 major metros = mort of our large metros now have increasing test positivity di ig Ing community spread Hodpitalizations are starting to rise again --the primary rise from Thanksgiving should be ower the newt 2 weeks There are meow 32 States in the ned (21) and orange (11) zone for hospitalizations of COWID cases = general medical care deteriorates when states enter the ned bone -- ang rovemnents mone Northern Plain and Rocky Mountan slates-- deacon by COC on veh 6 oreunaed first will de tennane the future stability of the hospital systen and hospitalization rates» cunsent plan will mot change the pandeméc dynamécs impact on hospitals but could decease quarantine = CO will head to sue ew muidarsé hat 10 days aller second immunization there is eo reason LO Quaranline ary ouned persone] alter emodsure. Fatality dadly rales are ow twice Lie Summer surge ad are now paasanp the Soaring sure twill bee critical thatimancclonal Ab and Ramdasiviriara used arian and more coraistenthy among vulnerable Arana ra This Winter surpe will be big per, broader, and more deadly but con stall be changed with messaging to states and health care providers, There Is inaufficlant vaccine of prioritization for vulnerable Amerk to changelh it and fatalities trancds in Owe-Fab we neind to be clear to ther American people vaccines will have an im@actin the Spring. Behavior change, proactive testing, aid improved use of therageutics can change the course ol this current surge: The movement of the surge into populous states especially without adequate policies or without individual Arvericans mitigating will drive fatalities, most states donot haw adequate mitigation policies and fatalities will continue averaging ower 2500) day 1K week, 70K imenath at a minim reaching ower 330K by Mew fears and 450K by the end of February without calls for action at the Federal, State, and Local level and using Pods to combat the COVID myths thiroughesut the country Ityeill be very evident over the nest 30 days that mitigation policies and behavioral change sayed lives 24,0 COMMRVED CASES OM A TOAY ROLUMG AvEERGE 10000 + + 0 + CONFIRMED CASES DAILY IN LOS ANGELES-LONG BEACH-ANAHEIM, CA 7 DAY ROLLING AVERAGE Sang County, cA Mice gles Cevnty, 'McKinnon. A spoof with me and Deb 1 -- 70,200,000/1,600,000 USA -- 16,000,000/298,000 PRESS: TWEET FROM BIDEN - I've seen him take on HIV/AIDS, H1N1, Ebola, Zika, COVID19, and every infectious disease in between, over his nearly forty years of service to our country. Trusted. A truth teller. A patriot." -- President-elect Biden on Dr. Anthony Fauci I was portrayed on Saturday Night Live by Kate McKinnon. A spoof with me and Deb Birx. They slammed Deb
9. 2020-12-08 00:00 Anthony S. Fauci open
   December 8, 2020 - Global 66,700,000/1,500,000; USA - 14,800,000/283,000 Daily New Cases in the United States Daily New Cases Cases per Day Data as of 0:00 GMT+0 300k 200k 100k ; Penal I Uta rel Ps Pes i {Sto ot StS oP eb re an St Ne OS eM St Ay re Se PP a a a FF PF aah gh GF FP FF Ph Pest et oe oF oF OF TW" WT Novel Coronavirus Daily Cases @ Daily Cases 9 -@ 3-day moving average [_] ~» 7-day moving average Harvey Alter to receive Nobel Prize in Physiology or medicine to be presented to hi at NIH (Natcher) by the Swedish Ambassador to the USA. I am invited and will use this as an excuse not to attend the "Vaccine Summit" at the White House today. Trump will use it as a PR stunt to claim credit for the vaccines. Pfizer (Bourla) and Moderna (Bancel) have pulled out of attending. Biden announced his medical team today in Wilmington, DE. I was announced as his "Chief Medical Advisor". I have made a video of my message to the group since I cannot attend (see above). • Had call with Joan Baez who wanted information about the effectiveness of masks in protecting you from acquisition of infection. Also, she is worried about her son and daughter-in-law who want to travel to South America. She wants to be able to tell them that I said that it was ill-advised. • Call with Ellen Sigal and then Larry Horowitz about FDA Commissioner. Lots of rumors and the usual anxiety about candidates. Josh Sharfstein is being considered but many people are pushing back. Kessler is being considered, but most everyone thinks that this is a bad idea. Janet Woodcock is emerging as a top choice. I like that. • Much concern that we did not contract with Pfizer for enough vaccine; we just did not accept their offer to provide more. Now it seems that this was a big mistake. Press are all over this. • Nancy Messonnier called. She is concerned that Gen. Perna is making decisions without proper knowledge and/or consultation with CDC. She has had long-standing problem with him. sent them for Wall Street Journal - 15,000,000/285,000 9 December 2020 The imarovenents in the Northern Plains, Rocky Mountain States and Heartland is beingdirectly offset by the surging cases and hospitalization onthe Weit Comet, Sunbelt, MidAtlantic and NE --these nore populous states will drive this over the mest 2-2 weeks and when combined with the pending Thanksgiving surge will represent the greatest threat to hosgital systems and general inpatient care Wie ore mow beginning to see the first evidence of impact of Thanksgiving family and friend gatherings -- see slides 10-19 --there are metrosthat were declining (heartland and upper micvyest) thatare mow increasing again and there are other northeast metros thet were rising that are now rising ata mone nopad rate. By ineset week I vill be able to define this more accurately and enaure we message about the upcoming Holidays Testing declined during Thankigiving time percd and nove testing haa resumed and test positivity niging deapite the inoneaded testing indhcating Community sired 36 States are in the COVID red 2one 9 alates are in Che Orenpe bone, J slates aren Hie yellow Done and 2 states and DC in green pone Hosnitalizations are starting to rise again --the primany rise from Thanksgiving sheould be over the neat 2 wrecks There ane now 35 Statesin the red (24) and orange (111) zone lor hospitalizations of COVID cases--peneral medical care delerionated when slates enter the ned zone -- there ancimenre states in this category everday -- decisien by cO00 on who is limvunized first will determine the furbure stability of the hospital aystem and loapetalization tates - cunent plan will mo. change the pandemic dynamics impact on hospital. Fatality Gaily rates are move bevice (he Sunime: surge ane will soon excead the Soaring surge This Wilnvter surge will ba bigger, broader, and mora daadly. Bringing tagether the states of the Soaring and Sumner surge inte one overwhelming therrat increasing hospitalaiions and deaths > evenwith De inmoeations this will be catastrophic without increased milgation now -- states without adequate public polices will have the highest fatality rates per populations equal to the Spring rates despite Improvements In care dua te the lack of mitigation. We do not have enough vaccine for vulnerable Americans to change hospétalization and fatalities trends in Dec-Feb--we need to be clear to Lie vimerican foonle vaccines will hares an impact in the Soring but MOT over ther niet 3 imeenths, Behavior change and proaction testing te find hath the asyinntamiatic: and symptomatic transmitters ae our only interventions and states are still mot testing correctly to find both The movenient of the surge into pogulous states especially without adequate polices or withaut individual Americana mltigating will drive fatalities, mast states do mot have adequate mitigation policies and fatalities will continue averaging aver P500dawy 17K week, TOK! month at aiminimumn reaching over 330K by Mew Years and 4508 by the end of February without calls for action at the Federal, State, and Lecal level and using PSAs to combat the COVID myths throughout the country Itwillbe wery cvident over the newt 20 days that mitigation polickes and behavioral change saved Ives and the lack of mitigation resulted in prewentabde deaths • Katie and Stephen Miller called me to thank me for the baby gift I sent them for daughter We had a nice discussion about life after Trump. • I was awarded "Sicilian of the Year" by the Magazine I Love Sicilia PRESS: KTWV Los Angeles Radio; BBC "Hard Talk", TV and Radio; Wall Street Journal CEO Council;

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