A single line often inverts meaning once you see what it
answers, so neighbouring messages are always shown.
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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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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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2021-08-20 00:00
Anthony S. Fauci
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.
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August 23, 2021 - Global USA BLA granted for Pfizer by the FDA!! I just did a site visit to the Department of State facility that does the screening for diplomatic pouches and mail. This is the facility that has been screening my mail ever since I had the anthrax scare with the power in one of my letters literally one year ago four days from now. Brett Rowland arrange for me to go there to thank the people in the facility and to encourage them in their work. They were very grateful but I took the time to visit them and there was the usual selfies galore. Another important issue today was that we were told by Larry Tabak at the state department wanted us to remove any names of people in Afghanistan that we are interacting with through Global USA grants or contracts from our public facing databases and websites. The reason for this is that we are concerned that the Taliban will use the websites to identify people in Afghanistan with connections to the United states and would then assassinate them. It is very clear that things are not going well following the withdrawal of U.S. troops from Afghanistan. The Taliban has easily taken over the country and now we are having trouble getting Americans as well as Afghanistan allies such as interpreters out of Kabul safely. It's a very bad time for the Biden administration since they are being severely criticized for not having the right intelligence capability to indicate to them that the Taliban would take over so quickly without allowing time for us to withdraw our own personnel in an orderly fashion. What we did was withdraw the military first thinking that we would have ample time to withdraw diplomats and other personnel safely . Obviously this is not the case and it is still a very tenuous situation in Afghanistan. PRESS: Podcast 70 Over 70; NPR "All Things Considered" with Mary Louise Kelly; Podcast "A Starting Point" with Mark Kassen and Chris Evans; PBS "NewsHour" with Judy Woodruff; MSNBC "Peacock" with Mehdi Hasan;
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August 24, 2021 - Global USA Cases, hospitalizations and deaths (to a lesser extent) continue to soar. More conspiracy theory like letters keep coming in from congressmen and senators trying to link us to the origin of COVID-19. This is an amazing and unbelievable waste of our time and has no bearing whatsoever on what we have actually done with that minor, minor $125,000 grant to the Wuhan institute of virology. It is totally mind boggling how they are distorting the truth to try and distract from the reality of what actually had happened during the Trump administration where he lied and underplayed the outbreak. Strange but not surprising thing happened as a result of several of the shows that I was on over the last 24 hours. On several of the TV shows I was talking mostly about the favorable aspect of the final approval of the BLA for Pfizer. However, in one of the conversations someone asked when I thought we were to get back to normal. I gave the usual caveats but then went on to say if we get as many people vaccinated as we possibly can as quickly as we possibly can we could diminish the number of cases and if we get through the winter which will be complicated by influenza and other respiratory infections, then I believe we could get back to some form of real normality by the spring of 2022. Much to my surprise I got a call this morning from Jeff clearly upset because the news media had jumped on that and said that Biden has been saying we're going to get out of this soon and Fauci who knows what's going on is saying it's going to be into next year. I am getting a little bit concerned, even though I understand Jeff's concern about the distortion of a message for a political purpose, that we may be tailoring a message that is not totally aligned with the truth. In fact, I believe we would be very lucky if we're back to normal by the spring of 2022. I told Jeff that from now on when asked to predict I will just say we don't know. This might actually not go over very well with the press anyway, but that is what I will say. Of note shortly after my call with Jeff, Courtney Rowe called me up in a much more Global USA conciliatory manner saying she understands how these things get taken out of context and said that she heard it a lot more the way I meant it; however, we really need to be careful that people would be distorting our message. I agree with her. PRESS: CBS "This Morning" with Gayle King; NBC "Today"; MSNBC "Morning Joe"; Telemundo TV Hoy Dia with Adamari Lopez;