A single line often inverts meaning once you see what it
answers, so neighbouring messages are always shown.
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August 14, 2021 - Global - USA - 36,300,000/618,600 140,000 cases in the USA today. We had continued discussions today with Jeff and David Kessler as to how we are going to deal with the activists (Peter Staley et al) in our attempts to cooperate with them in getting doses to the developing world. We need to get them to understand that we are with them and trying to expand the number of doses we give ; However, they need to understand that we have already given more than the entire world combined. So they really need to recognize that we've done a lot at the same time that they work with us to do even more rather than attacking us for not doing enough. Moderna has not acted in good faith. They have actually put in their patent application and have explicitly said that Barney Graham, John Mascola, and Kizzy Corbett are not inventors of the M RNA 1273 patent. This is absolutely outrageous and I have had conversations with Francis Collins, Larry Tabak, and earlier this evening with Jeff indicating that we have to get a heavy hitting law firm to argue our case. I suggested as did Jeff that we employ the firm of Williams/Connelly to represent us. We are planning to roll out next week the program of giving a booster shot to everyone starting with those in long term care facilities and the elderly, but ultimately including everyone related to their anniversary date of their last shot. Clearly, we will get both praise and criticism for this.
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August 15, 2021 (Sunday) Heat wave throughout the country. I had a very intensive day with the medical team trying to fashion to coherent message to justify the announcement that we plan to make this week that we will be giving a booster shot to everyone who wants one regardless of age or underlying condition. This has been a very difficult situation since the data for diminution of efficacy regarding hospitalization and death are unclear because of the confounding variables of some studies dominated by delta , some studies dominated by alpha , and some studies with a combination of both. In addition, when we talk about hospitalizations , it is unclear from several of the studies whether those who were hospitalized were almost exclusively the elderly and /or people with underlying conditions. Jeff is bent on having a coherent sharp message about this when in fact that is very difficult to do given the paucity of data. If we are too precise we will be called out because we cannot back it with data. If we are general, Jeff feels that the public will be confused. I am trying to convince him that it is OK to say that we do not know nor do we have all of the data to make a decision and sometimes you have to make a clinical or public health decision just based on clinical judgment. In this case the judgment is that delta is a very bad virus and even though we don't have firm data yet that younger people are getting seriously ill, we don't want to be late to the game. I used the metaphor of Wayne Gretzky who always said it is important to skate where the puck will be rather than where the puck is. We do not wait until younger people start requiring hospitalizations before we decide that we want to give them a boost. My job in all of this is to give the immunological basis for providing a boost. Bottom line is that the controversy will be not that we need to give a boost, but do we really need to give it to everyone instead of just to the elderly and those who have underlying conditions. One of the most important aspects about all of this is that when you boost someone with a third dose at about six months or so after the original prime boost the level of antibody goes dramatically high and I believe that this would provide durable protection against delta and any other variants that come along. My concern is that the Medical Group will not articulate this concept well enough and I will have to be out there trying to pick up the pieces as is usually the case. Summary of what has been going on hat I might not have had he time to document. I am more and more astounded by the fact that our society is so dystopic in that untruth and out and out lies seemed to win the day . In addition, I am concerned that even good scientists playing a game of using their longstanding concern with gain of function to call attention to this by what is going on regarding the argument about the origin of the virus. There is no question in my mind based on so many factors including history, molecular makeup with the virus, among others that this virus naturally emerged from an animal reservoir. Yet , people like David Relman and others are not realizing that by their focusing on the gain of function which they believe is what we funded at Wuhan could possibly be the cause of SARS Co V2 when in fact they know that this is molecularly impossible. I have evolved into something that would have been unimaginable to me just a few years ago. There are some positive aspects to it ; However, for the most part I feel like it is no longer me. I am now probably one of the most recognizable faces in the world. Millions of people idolize me and the far right radical group absolutely hate me. I cannot go out in public to a restaurant or even walk through a crowd since someone immediately recognizes me and wants to take a picture or congratulate me or just say that they said hi to me. This is driving my security group crazy as they are afraid fair among these legions of admirers will be New Pediatric COVID Hospitalizations in the USA sa ae ' : ei ¥. ef i gs 7s : mS fF: ft : z ¢ ¢ "i ; ee; z wi "w Jan 20210 Apr 2021 Jul 2021 updated
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AUGUST 16, 2021 Pediatric hospitalizations surging: Someone leaked our plan for boosters. The press are texting me all evening. I am not answering. PRESS:
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August 17, 2021 There is a lot going on and a lot of moving parts. We have been working very hard on trying to get a plan and a program out to deliver third boost shots to people who have received the original two dose vaccine regimen for M RNA. This is a complicated issue because it appears that the vaccines in the United states as well as globally particularly in places like Israel and England among others are still holding strong and preventing hospitalization and deaths but there is a dramatic diminution with the delta variant in protection against infection and symptomatic disease. There is an inkling that we are starting to see increase in hospitalizations particularly in Israel in vaccinated people. Jeff together with the White House team has been working on a plan to be implemented starting September the 20th to get a third shot to everyone in a cadence beginning with those who originally had received the vaccine first. These people are fundamentally health care workers, the elderly, and people in long term care facilities and nursing homes. The problem is the data that definitively show that we are seeing an increase in hospitalizations with delta are not there yet. However , as I and others know from experience , when you are dealing with COVID-19 , particularly the delta variant, you may be behind the niaid.nih.gov> S.2ZOV C/OD) <aux7 @cdc.gov>; Levine, Rachel (HHS/OASH) alla (OS/ASPR/IO) (CTR) <Marcella.Nunez3.Phillips@hhs.gov>; Perry, Sherice (OS/IEA) curve by a few weeks at the time you realize you were behind the curve. I use the analogy of skating to where the puck will be not where it is now . In this regard, there will be criticisms that we acted too soon particularly since so many people around the world have not yet received any vaccine. This is countered by the fact that the United states is doing more than the rest of the world combined to get vaccine to lower middle income countries. There is an additional complicating issue here in that Jeff is insisting that when we announced this, it looks like it is a done deal and we are definitely going to do this . However, it really does depend on or authorization from the FDA together with recommendation from the CDC via advice from the ACIP. If we come out and definitively say we're going to do it prior to the FDA approval , it looks like we have politically influencing the FDA. I am warning Jeff about this because even though he is trying to do the right thing , we have to be careful that we don't look like we are tipping the scales and overriding the FDA. Janet Woodcock is very concerned about this and I do not blame her. Another complicating issue is that last night someone leaked our plan to the press and although we are going to make the announcement tomorrow the press is running wild with speculations and partial data right now. I have not answered any press calls because I do not want to get involved invalidating the breaking of a very strict code of silence. Shame on the person or persons who leaked this period now we have to explain things without necessarily giving everybody all the necessary information. In addition , we have faced with the usual problem of the CDC not giving us all the information that we need and even continuing to refer two embargoed MMWR papers to come out. We absolutely need to see those data if we are going to defend our policy. Email that I sent to Ian Sams:
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2021-08-18 00:00
Anthony S. Fauci
August 18, 2021 - Global - 208,500,000/4,400,000; USA - 37,100,000/621,300 Yesterday 180,000 cases. 7 day daily average >100,000 Had a very eventful and stressful day today; however things worked out well with the rollout of the booster plan at the White House press conference. Following that I briefed the president and VP in the Oval Office together with Vivek, Jeff, Rochelle, Berchara, and Marcella, and Natalie. Only Vivek and I in person. The president and vice president asked good questions , particularly with regard to the president's concern that this is contingent upon FDA and acip recommendations . He picked up right away on the concern that Jeff had that we needed to do this and make sure that we don't have a stumbling block with the FDA and acip. The one issue that could arise is that the FDA may feel that the risk benefit ratio of boosting young kids 18 years old and there abouts may not be favorable in the context of the risk of myocarditis balanced against the risk of their winding up in the hospital as a result of COVID. The president is having a bad few days given what is going on in Afghanistan with the Taliban having taken over the country in just a couple of days following withdrawal of USA troops. As expected the response to the rollout of the booster plan was very mixed, and quite understandably. The CDC messaging all along has been dysfunctional . I do not think that this is the fault of Rochelle, but just the function of the culture at CDC where they hang on to data without letting anybody know about it until it's ready to be published. We had another instance where Rochelle was very reticent to show any of the medical team what was in the upcoming MMWRs that actually impact greatly the booster roll out because in typical fashion it was "embargoed ". One cannot imagine how ridiculous this is that a public health agency is acting like an academic department in a Medical Center where the most important thing is publishing data as opposed to guiding public health decisions. I take this opportunity now to talk about it , but this has been a chronic problem literally for the decades that I have been the ing in the director of NIAID. Of note, Yasmeen Abutaleb wrote an article this morning in the Washington Post in which she described this exact problem. (see below). Getting back do the concept of boosters, it is very clear that it is the right thing to do . However, given the fluid nature of the situation , we had to make some "majestic leaps" by anticipating that something was going to happen such as diminution of vaccine protection and acting on this now even though the data we're not absolutely firm. A lot of people got bent out of shape about this, but they are not responsible for the public health and they could guess and say whatever they want as have many "talking heads" with impunity because if they are right they look great but if they are wrong , which they usually are, then no one really cares because they have no authority or responsibility. PRESS: NBC "Nightly News" with Lester Holt; CBS "Evening News" with David Begnaud; MSNBC "The Reid Out" with Joy Reid; CNN with Chris Cuomo; The Post's View Opinion: The covid-19 boosters have the same goals as the first shots: Survival and resilience nd death y, Dan Diamond and Lena H. Sun Global USA Washington Post: Fears over rising illness and death from the delta variant fuel Biden administration push for boosters Health officials expected to announce recommendation Wednesday that Americans get extra shots By Tyler Pager, Laurie McGinley, Dan Diamond and Lena H. Sun
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August 19, 2021 - Global USA Cases recently >200,000/day weekly average >100,000 Confirmed Cases (Thousands) ais qafa ane 51a Sia oT 6/21 7a New Daily Confirmed COVID-19 Cases in the U.S. ta) Lil ia et Pa oo a = m ~ Lal $28 ¢@ a FS SB EEA oF oo a & a = a a re 2020/2021 ala ae afi qs a Siz T=] 135.5 A s rs ais I just had a good conversation, my first conversation with New York State Lieutenant governor Kathy Hochul. Starting on Monday August 23rd she will be the governor of New York State replacing Andrew Cuomo who resigned affective August 23rd related to the sexual harassment scandal in which he was involved. The conversation with Kathy was very positive and she is very interested in working very closely with me and getting advice from me regarding how New York State should handle the explosive outbreak of the delta variant. Much press (see below) regarding the announcement yesterday on booster shots. I received an email late in the evening from Elizabeth Alexander the communications director for the first lady Jill Biden. She wanted me to edit an opinion piece that the first lady was writing for Time magazine . I spent about an hour late at night doing it for her.sorry one second PRESS: Another hour long TikTok/Instagram session with young "influencers" who amazingly have millions of followers; did 6 Regional TV hits at request of the White House: WSVN Miami with Lynn Martinez; WTVT Tampa with Craig Patrick; WTMJ Milwaukee with Charles benson; DBI Radio with Rene Miller; Univision (National) with Janet Rodriguez; Telemundo (National) Lourdes....; MSNBC with Andrea Mitchell; CNBC "Closing Bell" with Sara Eisen and Wilfred Frost; CNN with Jake Tapper;
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August 20, 2021 Cases still increasing: I had a conversation today with the Minister of Health of Gabon - Dr. Guy Patrick Obiang Ndong. The purpose of the meeting was for me to give him an idea of how we handle COVID in the United states and to answer some of his questions particularly around the area of misinformation and disinformation that has led to vaccine hesitancy which as it turns out is a major problem in southern Africa including his own country. We had a good conversation moderated by Ms. Anne Soy, a journalist from BBC. The MOH did not mention it but I'm sure there is this feeling of concern that we are planning to give out third shot boosts at the same time that Africa has very very little vaccine. I have explained on several of the TV shows and imprint that the USA has already given more doses to LMICs then the entire rest of the world combined (see above). In addition, we plan to give hundreds of millions more and they are also working with Peter Staley and the activists to provide major increases of doses to the rest of the world (see below ). There is still ongoing controversy among some people regarding whether the idea about giving a boost was justified by the data. I had a good conversation with Paul Offit who fields that we may have jumped the gun. Vincent Racaniello has written in his blog that he does not think that the boosters are justified. They are all waiting to see data regarding an increase in hospitalization as a result of delta and waning immunity. I still believe given the Israel data that boosters in their country are already showing a significant decreases in the number of breakthrough infections that we did the right thing in making our decision. In addition, those who object seemed to forget about the fact that short of hospitalizations a lot of people get seriously ill with symptoms and signs of long COVID that can be very troublesome. The boosters are safe and to put it in plain terms it can help, and it certainly cannot hurt.
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August 21, 2021 184,000 cases today!
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August 22, 2021 (Sunday) - (no shows for me today - predominantly Vivek Murthy) Had a zoom call today with Jeff and the medical team planning how we can roll out the booster situation putting all the pieces together with the FDA, the CDC, and the acip. We also heard that FISA will get it's BLA on Monday August 23rd. One of the important parts of the discussion was my relating data that we have received from the Minister of Health of Israel. The data clearly show that hospitalizations for people with two doses of vaccine are going up significantly particularly among the elderly and those with underlying conditions . In addition, they are showing that the efficacy of two doses against infection and symptomatic disease has dramatically diminished, and when you give the third dose boost, this turns it around dramatically and diminishes the breakthrough infections. These data are well ahead of the somewhat disjointed data from the CDC. However what it does do is_that we are correct in asking for boosters essentially for everyone. Global USA In addition, I am going to pursue with calls to Peter Staley and others (Krellenstein and Barr) as well as a follow up call with Jeff , David Kessler, and me to plan a more coherent strategy about getting doses led by the United states to the rest of the world. The plan to do this would be to increase dramatically the production capacity of the companies particularly moderna even if we have to deal with Lonza directly since Lonza is a major multilocation company that is producing the vaccine for Moderna. Stay tuned. In a follow up conversation with Jeff and David Kessler, Jeff was amenable to pursuing the plan of Peter and the activist group ; however, he wanted to make sure that we got the situation with the Moderna booster straight before we started to go to war with Moderna to get them to cooperate with us on the Lonza deal. I believe that Jeff is serious about this and we may in fact go that route once we get the approvals to use moderna as part of the booster plan. In this regard, Tom Frieden call me up tonight urging me to push ahead with the "nuclear option "a forcing moderna to cooperate in expanding capacity for the developing world. Tom feels that moderna or a bunch of used car salesman and he does not trust them at all. He has stated , which is partially true, that they would be nothing without the NIH and the federal government. In this regard, Beth Cameron from NSC wanted me to look over a summit plan for addressing the global issue of COVID. I wrote back to her and emphasized that I feel strongly that the United states should take a PEPFAR-type approach in assuming any leadership role in getting doses to low and middle income countries. The Israeli data are emerging as extremely important since it is clear , as they are about a month and a half ahead of us and everything, that the vaccine efficacy is diminishing significantly overtime against infection and symptomatic disease. However, unlike the situation here in the USA, the Israelis are starting to see a diminution in protection against hospitalization and death. This is exactly what we have predicted in our decision to move ahead with the booster program. Furthermore, the Israelis are starting to see a very positive effect following giving boosters to over 1,000,000 people in the sense that the number of infections have dramatically diminished in association with the administration of the boosters.