A single line often inverts meaning once you see what it
answers, so neighbouring messages are always shown.
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April 25, 2021 - Global - 146,100,000/3,100,000; USA - 31,800,000/569,000 We had an important zoom talk at 11:00 AM today with Jeff, me, Rochelle, Natalie, and Vivek regarding our response to the crisis in India. See above. Jeff is sensitive to our concerns and indicated that Jake Sullivan in NSC is already involved in sending materials to India including filters for vaccine production, oxygen supplies, ventilators, therapeutics such as remdesivir and favipiravir, sedation meds, test kits, and PPE. I brought up the fact that the real issue is sending our doses of the AZ vaccine that we now have on the shelf. The issue is that we keep saying that we will do this when we are confident that we will be able to vaccinate all Americans. However, this is somewhat contradictory since we have already publicly said that we have enough vaccine from Moderna and Pfizer to vaccinate everyone in the country who needs to be vaccinated. And so, it is clear that we're not going two need the AZ vaccine. Thus, why not send it off to India and other countries as soon as possible? Jeff and Natalie agreed and we will push this agenda soon. Release today! - National Security Advisor Jake Sullivan spoke by phone today with National Security Advisor Ajit Doval, expressing deep sympathy for the people of India following the recent spike in COVID-19 cases. Mr. Sullivan affirmed America's solidarity with India, the two countries with the greatest number of COVID-19 cases in the world. Building on the seven-decade health partnership between the United States and India --including battles against smallpox, polio, and HIV -- they resolved that India and the United States will continue to fight the global COVID-19 pandemic together. Just as India sent assistance to the United States as our hospitals were strained early in the pandemic, the United States is determined to help India in its time of need. To this end, the United States is working around the clock to deploy available resources and supplies. The United States has identified sources of specific raw material urgently required for Indian manufacture of the Covishield vaccine that will immediately be made available for India. To help treat COVID-19 patients and protect front-line health workers in India, the United States has identified supplies of therapeutics, rapid diagnostic test kits, ventilators, and Personal Protective Equipment (PPE) that will immediately be made available for India. The United States also is pursuing options to provide oxygen generation and related supplies on an urgent basis. The U.S. Development Finance Corporation (DFC) is funding a substantial expansion of manufacturing capability for BioE, the vaccine manufacturer in India, enabling BioE to ramp up to produce at least 1 billion doses of COVID-19 vaccines by the end of 2022. Additionally, the United States is deploying an expert team of public health advisors from the Center for Disease Control (CDC) and USAID to work in close collaboration with the U.S. Embassy, India's health ministries, and India's Epidemic Intelligence Service staff. USAID will also quickly work with CDC to support and fast-track the mobilization of emergency resources available to India through the Global Fund. I had an important zoom meeting today with Larry Corey an Emilio Emini about the same subject as above , namely, how the United states can play a major proactive role in getting mRNA vaccines to the developing world. In our discussion, it became clear that there are immediate needs as mentioned above; however, there is also the immediate need of getting vaccine doses to lower and middle income countries. The United states could exert leadership in pressuring Moderna and Pfizer to scale up their vaccine production and sell it two developing nations at cost for production which is approximately $6 per dose as compared to the $30 produced that we are currently paying here in the developed world. Apparently there are liability issues that the pharmaceutical companies are concerned with. These revolve around the fact that although the United States government can indemnify the companies against lawsuits here in the United states the companies feel that they are liable to being sued for adverse outcomes by people in the countries to whom they're providing vaccine. Some mechanism needs to be worked out to address this concern. I have asked Emilio and Larry to put a one pager together summarizing our discussion so that I can bring it to Jeff who could bring it to Ron Klain who could bring it to the president. More later. Breakthrough infections are very rare: COVID-19 vaccine breakthrough infections reported to CDC as of April 20 As of April 20, 2021, more than 87 million people in the United States had been fully vaccinated against COVID-19. Total number of vaccine breakthrough infections reported to CDC Females People aged =60 years Asymptomiatic infections Hospitalizations* Deaths? 7,157 4,580 (64%) 3,265 (46%) 2,078 (31%) 498 (7%) 88 (196) *167 (34%) of the 498 hospitalizations were reported as asymptomatic or not related to COVID-19. +11 (13%) of the 88 fatal cases were reported as asymptomatic or not related to COVID-19. Studies to date that showed COVID-19 vaccines reduce asymptomatic infection (transmission) Finding of xx% reduction in asymptomatic Reference Healthcare workers in England 85% Hal! Lancet, April 23, 2021 Healthcare workers in Israel 75% Amit, Lancet, March 6, 2021 Patients in Mayo Clinic health system 88.7% Pawlowski medRxiv, February 27, 2021 Israel Ministry of Health Pfizer press release, March 11, 2021 (nationwide) 94% (largest study} , Dagan NEJM, February 24, 2021 Israel general population (Pfizer) 90% i le Pre-surgical patients in Mayo Clinic 80% Tande Clin Inf Dis, March 10, 2021 system swabbed asymptomatically Healthcare workers in Cambridge 75% Weekes Authorea, February 24, 2021 University Hospitals First-line responders and HCWs in US 90% Thompson A. MMWR, March 30, 2021 Israel population (>16) with children unvaccinated For every 20-point increase in adult vaccination, rates of kids testing positive halves Milman O. Medrxiv. March 31, 2021 Long-term care facility, Spain 590% Salazar P. Medrxiv. April 13, 2021 Nursing home, U.S. 100% Cavanaugh MMWR, April 21, 2021 Front page of the Washington Post had a major article on the drastic situation in India and reported on the universal criticism there is of the United states in not doing something about it right now. I will be on ABC This Week with George Stephanopoulos this morning and will likely get asked questions about India. More studies showing that vaccines dramatically diminish asymptomatic infection and so great er argument for not needing to wear masks following vaccination: PRESS: ABC "The Week" with George Stephanopoulos; CNN - Weekend Prime Time with Jim Acosta; NYT: Fauci and other top U.S. health officials stress the urgency of vaccinations and their safety. https://nyti.ms/3dPn1ms Phenomenal article in the Sunday New York Times about me by Frank Bruni:
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April 26, 2021 - Global - 146,800,000/3,100,000; USA - 31,900,000/569,300 I had an interesting conversation with Vivek late last night. He called me up after we had a meeting with Jeff and the medical team concerning the guidelines that the CDC was about to put out regarding the wearing of masks outdoors as well as indoors in vaccinated versus unvaccinated people. Vivek was concerned about something that I had been concerned about for a long period of time. That is the CDC often puts things out that none of us can really adequately defend because it is either unclear or just does not make any sense. This is exactly what happened last night when Rochelle presented a color-coded guideline that no one could really understand . Yet, the CDC was about to put it out. To her credit, Rochelle ran it by the medical team. Rochelle is in a difficult position since she is new in the job and is reluctant the contradict her team which has been in place for decades. That is really the fundamental problem of the CDC. For as long as anyone can remember they are isolated in Atlanta, are extremely arrogant, and are offended if anyone on the outside asks to see their material before they actually put it out. They are very close-to-the-vest. I have known this for some time as have my colleagues here at NIH. However, it is interesting and in some respects gratifying that Vivek has now picked that up on his own and fully realizes the problem. • Did Town Hall with the Harvard T.H. Chan School of Public Health led by Sam Baker of Axios and included Mary Bassett, Karen DeSalvo, Garth Graham, and Michael Mina • Did Principal's meeting with Cabinet. Had a wonderful zoom session with President Obama - I was on a zoom one on one discussion with President Obama for the purpose of encouraging people to get vaccinated. He was his typical engaging and highly intelligent self. Similar to what my experience was when he was in the White House, he had a perfect grasp of all of the details surrounding vaccines. It just reminded me of what an incredible person he is and what an amazing president he was. We joked around a lot about what I had gone through over the last year. I even mentioned to him that during an interview with some of the sports reporters I had mentioned that if I went one on one with him in basketball even though he is very tall and has a great jump shot, I still would be able to dribble around him since I'm so fast. He started to laugh and said that I better stop talking a0 Confirmed Cases (Thousands) ,900,000/569,800 New Daily Confirmed COVID-19 Cases In the U.S. an ow om Te RT et oe om om oe ee Srean Ss a pw SS 2020/2021 rial ,000,000/570,400 trash to him because now he's mad and if we ever get to play together he'll block every one of my shots. The interview was really a terrific experience. PRESS: Newsy TV Interview with Kellan Howell; NBC TV interview with Lester Holt for the Aspen Institute Online;
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April 27, 2021 - Global - 147,500,000/3,100,000; USA - 31,900,000/569,800 Coming down. 2nd day in a row in the 30s: PRESS: Sanjay Gupta podcast; IAS Podcast on 40 years of HIV; White House Press Conference (spoke on variants); WTOP Radio with Megan Cloherty; NY Times Editorial Board; NPR - "All Things Considered" with Mary Louise Kelly; Windy City Times interview - 40 years of HIV; Interview for Research!America with Opray Winfrey; MSNBC with Chris Hayes;
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April 28, 2021 - Global -148,300,000/3,100.000; USA - 32,000,000/570,400 Letter to Dr. Collins from Republican Congressmen Cathy McMorris Rodgers, Brett Guthrie, and Morgan Griffith asking many questions about the origin of SRAS-Cov-2. Clearly trying to dig up dirt and implicate the NIH in collaborating with the Chinese leading somehow (???) to the release or escape of SARS-CoV-2 from the Wuhan lab: SKM_C754e2104280 6490.pdf I am starting to put much more pressure publicly on pushing for a global response to the pandemic by urging us to help low and middle income countries with focus now on Indias. See today's Washington Post: Covid-19 live updatesGlobal pandemic needs a more global response, Fauci says, amid record-breaking deaths in India Latest: How to access the risks of returning to the gym The Fauci "thing" is as thick as ever: • Francis and I were on a Zoom call with Stephane Bancell (CEO of Moderna) and Stephen Hose (President of Moderna). We discussed two things: the fact that we felt that Moderna should be doing more to provide vaccine for low and middle income countries. We wanted them to help out by transferring their technology two nations such as Senegal , Ethiopia, and countries in South America in order to allow those countries to make vaccines for themselves. They felt that this is something that they would likely do but that it would take at least two years for those countries to stand up their plants even if the technology was transferred. Their idea was a two-pronged approach. First, they are ramping up their capability of producing vaccine and by the end of 2022 they feel that they will be able to produce a total of 3 billion doses. They would be happy to make those doses available at a lower tiered price to the developing world. In addition, they 000,000/57 1,300 agreed that they would participate in a longer range plan to transfer technology 2 low and middle income countries to make their own vaccine. In addition, Frances and I spoke about the patent dispute between the NIAID Vaccine Research Center and Moderna. The story is that the lawyers of Moderna feel that the VRC people such as Barney Graham an others technically should not be inventors on the patent for the discovery of the vaccine. We strongly disagree with that an as a matter of fact so do Stephane and Stephen. they realize that it is unfair to exclude us from the patent; also it would be a public relations disaster for them if they excluded us. They promised that they would get this resolved soon. It is clear that Pfizer can do the same thing. In fact, Pfizer can likely produce 3 billion doses by the end of this year and even more next year . If this is possible which I believe that it is, then we could probably vaccinate the entire world that wants to be vaccinated within the next year and a half. PRESS: NBC "Today" with Savannah Guthrie; CNN with Jim Sciutto; Wall Street Journal - Robbie Whelan - Vaccines Appear to Be Slowing Spread of Covid-19 Infections With more than 37% of U.S. adults fully vaccinated, Anthony Fauci expects case numbers to drop significantly
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2021-04-29 00:00
Anthony S. Fauci
April 29, 2021 - Global -149,200,000/3,100,000; USA - 32,000,000/571,300 MMWR: Linked Clusters of SARS-CoV-2 Variant B.1.351 -- Maryland, January-February 2021 Back up again to 53,000/day: New Daily Confirmed COVID-19 Cases in the U.S. a ah1 aor Alir Thr eye Tet pie azz Tat byt ile TRIE pert EVt att CUT Oz/ET BLAEE BELT TEsLT ST/IT tt TAT GEAOL TT AST BACT ene 2020/2021 • Did a zoom podcast interview with Quinn Bradlee (son of Sally Quinn and the late Ben Bradlee). He is disabled and Sally asked me to do this. I could not refuse since I admired Ben so much and he was always so gracious and kind to Chris and me. He was so excited to have the opportunity to interview me. Important Issue: Francis Collins forwarded an email to me (see below )which triggered a concern about whether the Indian variant - B.1.617 was resistant two antibodies induced by vaccines. I forwarded this email to the medical team including Jeff Zients and Rochelle Walensky. Rochelle called me up and mentioned that her colleagues in Boston including those at the Broad Institute as well as Dan Barouch were finding that the Indian variant could be very problematic with regard to its resistance to vaccine induced antibodies. In addition, I spoke with Bob Seder and the work that he has been doing with monkeys also indicates that B.1.617 could be very problematic. Then, Jeff Zients called me up together with Natalie Quillian and feels that we should call a temporary halt on travel from India until we sought this out and based on the information that I sent him. This is a critical decision since if we don't block travel from India and things look bad later on we will be sharply criticized for not doing so. However , if we do block travel, there will be those who criticize us for doing so. This is very similar to the deliberations that we had during the Trump administration regarding China, the Eu and the UK. SEE E-MAILS BELOW starting with the e-mail that I sent to the medical team of Walensky, Vivek, Bechara, Slavitt, Zients, Nunez-Smith. (Rochelle subsequently forwarded it to Dawn O'Connell at HHS) Team: 1/NIAID) [E] gov>; Erbelding, Emily vholley@fnih.org>; Menetski, dur View Please see e-mail below from Dr. Venkatachalam to Francis Collins. Although this is still at the level of anecdote, I am hearing from people who are doing studies in vitro that the B.1.617 variant is at least as concerning as the B.1.351. We should discuss this at our next meeting. Best, Tony Anthony S. Fauci, MD Director National Institute of Allergy and Infectious Diseases Building 31, Room 7A-03 31 Center Drive, MSC 2520 National Institutes of Health Bethesda, MD 20892-2520 Phone: (301) 496-2263 FAX: (301) 496-4409 E-mail: afauci@niaid.nih.gov The information in this e-mail and any of its attachments is confidential and may contain sensitive information. It should not be used by anyone who is not the original intended recipient. If you have received this e-mail in error please inform the sender and delete it from your mailbox or any other storage devices. The National Institute of Allergy and Infectious Diseases (NIAID) shall not accept liability for any statements made that are the sender's own and not expressly made on behalf of the NIAID by one of its representatives.
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Apr 29, 2021 Jeff called me this morning and said that it would be best for them to arrange for me to speak one on one with the president over the next couple of days concerning the India issue . I believe that this is the best way to go. • regarding the situation at the Texas-Mexico border. The congressman has an interesting problem and an issue. Apparently, people coming from Mexico to the United states who are holding valid visas are not being allowed to come in through land crossings. Most of these people are poor and cannot afford to fly in. However, the wealthier people who can fly into the United states but who are required to have a test before they get on the plane are allowed to come in. This becomes an economic issue for the border towns in the United states such as Laredo. Visa-carrying Mexicans spend about $19 billion per year in the border towns. It becomes a serious economic issue if they are not allowed in. The congressman wants my help since Homeland Security says that this is a medical issue and the congressman points out that it is not a medical issue; but it is an economic issue. I explained to the congressman that I believe that Homeland Security thinks it is a medical issue because the people who come over on land crossings do not have testing readily available to them and so given the possibility that some of them are infected, Homeland Security considers this a medical issue. My suggestion for a solution is to figure out a way to get the United States side of the border to provide rapid testing for the visaholding Mexicans as they enter the country , and if they are negative, they are allowed to enter. I promised to check with the medical adviser to Homeland Security to see if we can straighten this out. I will have our staffs connect us. • Two countries that have done things differently from us - UK and Israel. They both locked down completely until their number started to come down sharoply and then they ramped up vaccinations and now their test positivity is 0.1%. See the results below: he New York Times: 00,000/574,700 The far right continues to accuse me of fostering dangerous gain-of-function research. The letter to the editor of the National Review refutes this: Letter to the Editor NR.pdf PRESS: Interview with Press Trust of India Washington Correspondent (print); Seattle NBC TV (on the "Fauci effect" in med schools); Science News interview with Aimee Cunningham; WBAL radio and TV (Baltimore); King TV (Seattle) - interview together with Larry Corey; Sheryl Stolberg in The New York Times: Pressure Mounts to Lift Patent Protections on Coronavirus Vaccines Dr. Anthony S. Fauci, Mr. Biden's chief medical adviser for the pandemic, said in an interview Monday that the drugmakers themselves must act, either by greatly expanding their manufacturing capacity to supply other nations at "an extremely diminished price" or by transferring their technology to let the developing world make cheap copies. He said he was agnostic on a waiver. "I always respect the needs of the companies to protect their interests to keep them in business, but we can't do it completely at the expense of not allowing vaccine that's lifesaving to get to the people that need it," Dr. Fauci said, adding, "You can't have people throughout the world dying because they don't have access to a product that rich people have access to."
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April 30, 2021 - Global - 150,100,000/3,200,000; USA - 32,100,000/572,200 We shut down travel from India - See above. Travel from India will cease for all non-USA citizens. Will start on Tuesday May 4. I am concerned that by delaying the actual shutting down we will be faced with the same situation that we faced with China and the European Union. In those circumstances there was a rush of people trying to get to the United states who are noncitizens, and so a large number of people who were likely infected in fluxed to this country. • Senator Lindsey Graham has written 2 letters to me telling me that I must go to the border and see the seriousness of the situation since I am the chief medical advisor to the president. Obviously this is a political ploy to embarrass president Biden. I just wrote back to senator Graham and told him that my job is to develop vaccines and drugs and to be involved in strictly medical issues, and that the border problems are the CDC, the Department of Homeland Security, or the Department of State. PRESS: Interview with India Express (print); White House Press briefing (discussed 2nd shot); Canadian Broadcasting Company (CBC) - TV; Fireside Cat Online with Canadian Genomic Forum; WBUR (NPR) - "On Point" with Meghna Chakrabarti; Instgram with Eva Longoria; Local TV for Memphis, TN and New Orleans, LA; 300,000/598,000 New Daily Confirmed COVID-19 Cases in the U.S. m KE my TH Le I im bm eta ] fos SLs a as Sb eLie Ttfe rie RYE CEE FL/E LE Eve Cove FEE diz Test ft OL/T eT f2R0 OZEL ELT MET Bz/ET TEyET STAT B11 [TT aro TT8C r/0T bt6 fatal) Pati oe /e Ez/o Ste aa ae Bile ca St tag Pfs "fg Tes Fag furs ots eg Pal) Stie cat VE THE SIE 2020/2021 00,000/600,000 Institute), Torrian Baskerville of NASTAD, Edward Bitarakwate, Uganda Country Director for EGPAF, and Joyce Ouma of National Empowerment Network of PLWH in Kenya, and Maureen Goodenow of OAR ● Had usual Zoom meet with Sec Becerra. I informed him of Novovax results. ● Had SCIF meeting with Deputies regarding global distribution of vaccines PRESS: Andy Slavitt tweets a strong defense of me; Health Care Radio Interview
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May 1, 2021 - Global - 151,000,000/3,200,000; USA - 32,100,000/573,000 I am going public that pharmaceutical companies should share their technologies with developing nations to allow them to make their own vaccine developed by the companies. Also, they should receive vaccines while the plants are gearing up in their own countries to start making product (see below) PRESS: MSNBC with Jasmeen Vossoughian; Washington Post - Dan Diamond: White House is split over how to vaccinate the world - The proposal was discussed last week by Anthony S. Fauci, a top coronavirus adviser to President Biden, and Katherine Tai, the U.S. trade representative, who spoke about ways to help the developing world as it reels from a worsening crisis. Fauci briefed Tai on the benefits of sharing technologies from companies that hold vaccine patents -- a position that he supports, arguing that it would allow developing countries to rapidly produce their own vaccines, said people with knowledge of White House deliberations who spoke on the condition of )0,000/573,800 New Daily Confirmed COVID-19 Cases In the U.S. a0 ta aly+ Thr rie ane THe Pre fri ane Tez Prt TEIT PEF EvT ont =f f2RT Beat ETAT SEE BE/TT bata STAT BET TTT tad TAL PAST fata) ons EWG nes ene ats Ga tye Eta Bie bata ae ane TAS Pris a TESS PES Lys os Er] Sere oitr Efe ote gz one ale 2020/2021 00,000/574,200 anonymity because of the conversations' sensitivity. Tai separately told colleagues that she's considered advocating to lift some patent protections but is still gathering information, said two of those people.
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May 2, 2021 - Global - 151,800,000/3,200,000; USA - 32,200,000/573,800 • Had dinner over Jeff Zients's house with wife Mary, Bob Seder and Deb Harman, Denis McDonough and wife Kari. Terrific time. Jeff is as wonderful on a personal basis as he is professionally. His home at 4500 Garfield Street, NW is absolutely magnificent. • Jeff Zients Called me this evening giving me a heads up that he might want me to write a one page memo the president Biden explaining to him the situation in India particularly with regard to the variants. I convinced him that it might be better to arrange for a phone call between me and the president so that I could respond to his questions rather than have him receive a memo that he would have questions about. Jeff said we could think about it overnight and decide tomorrow. PRESS: Connecticut Public Television "The Jane Whitney Show"