A single line often inverts meaning once you see what it
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July 18, 2022 at 11:45 a.m. EDT New York Times (Sheryl Stolberg): Fauci Says He Will 'Almost Certainly' Retire by January 2025 Dr. Anthony S. Fauci, 81, said he expected to see out President Biden's current term. Wall Street Journal - Stephanie Armour and Betsy McKay Anthony Fauci Plans to Retire by End of Biden's Term One of the leading public faces of the U.S. public-health response to Covid-19 says he hasn't decided on exact date ---------------------------------- I had a very good talk today with Sam Bankman-Fried and his brother Gabriel Bankman who runs a foundation called "Guarding Against Pandemics". Also on the call were their associates Jacob Swett and Annabel Snidow. (see above) . We spoke about how Sam with his billions of dollars could partner with the NIH and pushing the scientific agenda for the prototype pathogen approach of pandemic preparedness. Sam is a good friend of senator Joe Manchin and Joe is the one who originally pointed Sam in my direction to see if somehow we can all work together to having some sort of a partnership where the Congress puts in a certain amount for pandemic preparedness using the prototype pathogen model and Sam puts in an equal amount to support the effort through NI AID. We left it that they put together a proposal and that I serve as the scientific advisor for the amount of money that Sam wants to put into this even though I must be careful and will be careful about not getting involved in writing any legislation since Manchin has been talking about writing this into a reconciliation bill. PRESS: CNN with Kate Bolduan; Reuters interview with Julie Steenhuysen; NBC Online Web; NPR with Rob Stein (talking about the Politico article (see above)
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July 19, 2022 I had an important conversation this morning with Peter Staley in which I asked his advice about messaging to the gay community regarding monkey pox. There seems to be a debate in New York City among public health officials versus some gay leaders. The tension is whether or not to tell gay men to hold off on multiple sexual partners until they get a PrEP version of the vaccine. Some people are saying that that would increase the stigma against gay men. However, Peter agrees with me that there is nothing wrong with and probably a good idea to tell gay men to just hold off and cool it for the next couple of weeks until we get enough vaccine to vaccinate all people who are at risk namely those who've had multiple sexual partners within the last 14 days. I will be out in the press talking about this and I just wanted to check with Peter as to whether he agreed with me and in fact he does. BA.5 dominating isolates: https: 100% 90% 80% 70% 60% 50% 40% % Viral Lineages Among Infections 30% 20% 10% 0% covid.cdc.gov/covid-data-tracker/#variant-proportions Q F = 4/23/22 4/30/22 5/7/22 5/14/22 N q ~~ NOWCAST 7/9/22 7/16/22 USA WHO label Lineage # USClass %Total 95%PI Omicron BA5 VOC 77.9% 75.8-79.9% BA.4 VOC 12.8% 11.3-14.4% BA.2.12.1 VOC 86% 7.8-9.5% BA.2 VOC 06% 0.6-0.7% B.1.1.529 voc 0.0% 0.0-0.0% BA.1.1 voc 0.0% 0.0-0.0% Delta B.1.617.2 VBM 0.0% 0.0-0.0% Other Other* 0.0% 0.0-0.0% * Enumerated lineages are US VOC and lineages circulating above 1% nationally in at least one week period. "Other" repr the agg lineages which are circulating <1% nationally during all weeks 'meciead: ** These data include Nowcast estimates, which are modeled projections that may differ from weighted estimates generated at later dates # AY.1-AY.133 and their sublineages are aggregated with B.1.617.2. BA.1, BA.3 and their sublineages (except BA.1.1 and its sublineages) are aggregated with B.1.1.529. For regional data, BA.1.1 and its sublineages are also aggregated with B.1.1.529, as they currently cannot be reliably called in each region. Except BA.2.12.1, BA.2 sublineages are aggregated with BA.2. Sublineages of BA.4 are aggregated to BA.4. Sublineages of BA.5 are aggregated to BA.5. PRESS: The Hill Health Summit Interview and streaming with Steve Clemons; Good Housekeeping with Zee Krstic; WHUR 96.3 FM DMV/ HBCU Network with Harold Fisher;WJLB 97.9 Detroit with Bushman; WNYM (FOX-NYC) TV with Lori Stokes;
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July 20, 2022 I just had an important conversation with Rochelle in which I related to her the conversation that I had last night with Carlos Del Rio in which Carlos articulated that there's a great deal of concern and agitation in the gay community, which I already am aware of, regarding the difficulty in getting TPOXX for the treatment of monkey pox. I decided to call Rachel and give her a heads up that the community is really starting to get very agitated to the point that they may be attacking the administration and her and the FDA and all of us in the press if we don't do something soon to cut down the difficulty in getting TPOXX to those in need. I suggested to her that she and the FDA think in terms of doing something akin to the parallel track approach that I initiated decades ago during the HIV pandemic. She will look into this with her people. I had a great meeting today in building 31 with Dr. Karl Lauterbach, the Minister of Health of Germany. He relied heavily very heavily on my advice about how to handle the decision about and distribution of booster shots for COVID in Germany. He is having some of nice laudation of me today: the same problems as we are having here in trying to decide what the correct booster should be in the fall. He has already ordered millions of doses of Moderna bivalent which is an omicron plus ancestral as well as Pfizer which is a BA.4/5 bivalent plus ancestral. Moderna is obviously pushing their product, but Karl was very interested in what my opinion was. I told him that on the advice of me and others, the FDA has already authorized the bivalent of BA.4/5 and ancestral for the full dose. It is now up to the CDC and teir ACIp to make a recommendation f who "should" versus "may" receive the dose. We also spoke about the tension regarding vaccinating people now who are at risk of severe complications given that there is a wave of infections in Germany as well as in the United States versus waiting until a more variant-specific boost is available in the fall. Germany is facing the same dilemma as we are in that some people in Germany are arguing in a very similar way to Paul Offit who is saying that we should not be vaccinating people now. Paul is smart and a good friend but he is a victim of what I consider making the perfect the enemy of the good. From a purely immunological standpoint it is obviously not optimal to have a boost now (ancestral) and require an even better boost (bivalend BA.4/5 + ancestral) just a couple of months down the pike. However, you have to balance the public health benefit of getting some form of vaccine to people who are at risk for infection and severe disease now compared to the relatively minor negative effects of giving a vaccine shot now followed in 2 to 3 months by a vaccine shot with a better boost. I was surprised that bloggers such as Paul Offit have a major impact globally. Karl mentioned to me that he and his colleagues listen very carefully to what I say and it would be very helpful to them to hear what I am telling him today and that I agree completely with him since he is absolutely in the same lane as I as well as many of my NIH colleagues including Rick Koup and others. It was a very stimulating conversation and I was on my A game. We then went on to discuss the issue of monkeypox. According to Karl monkey pox is out of control in Germany and similar to what we are seeing in the United States the gay community is very frustrated with the lack of as many vaccines as they need as well as the lack of easy access to antivirals. They seem to be having no trouble with diagnostics which are plentiful. I explain to him that our situation is very similar here in the United States. The conversation ended with him wanting to take a picture with me since his daughter who is 15 years old apparently is a great fan of mine. We exchanged cell phone numbers and he promised me that he would be calling me frequently. John Laureman (Bloomberg) wrote a very nice laudation of me today: An Early Farewell to America's Top Pandemic Expert July 21, 222 Harassment from the far right continues: ¥ Fauci: If Rand Paul Sends Message To Fauci: You'll Have To Testify Under Oath If GOP Wins. Fox News (7/20, 23.99M) reports, "Sen. Rand Paul, R-Ky., issued a warning to Dr. Anthony Fauci: If the GOP takes back Congress in the midterms, be prepared to testify under oath regarding the coronavirus pandemic." On Wednesday, he argued on "America Reports" that "the American people deserve the truth and answers on whether there was a cover-up for a lab leak in China." President Biden tested positive today (Thursday)! Tested negative on Tuesday, went to Boston on Wednesday; had mild sxs this AM and tested positive. https://www.whitehouse.gov/wp-content/uploads/2022/07/Letter-7.21.pdf Obvious media storm. He has mild sxs. I mentioned this to a sheesh during a briefing called this evening since we are all going on television tomorrow. Couple of interesting things related to the infection of the president. 1) I called up Kevin O'Connor who is the physician to the president and got a briefing from him for the simple reason then when I go out on TV and I'm asked whether or not I have been consulted with it would be rather embarrassing to say that they did not call the so-called most famous infectious diseases expert in the world, who happens to also be the chief medical advisor to the president. I explained to Kevin my concern about the anticoagulation. He understood my concern and said that he has started the president on low dose aspirin which is a good thing. Kevin explained that the president was negative for an antigen test on Tuesday, did not sleep well on Wednesday evening, and woke up on Thursday predominantly with fatigue. Tested himself on a routine basis which for him is 2 to three times per week. The test came back positive, confirmed by a PCR. Throughout the day he then began to get sniffles, at first a dry cough and then a loose cough. His temperature rose to 99.4 F, which came back to normal with tylenol. His oxygen saturation was 97 to 98%. He was resting reasonably comfortably when Kevin left him tonight. 2) We had a meeting with the comms people and Ashish Jha this late afternoon in preparation for media requests tomorrow. I was under the impression that they were going to spread out the request for morning shows between Ashish and me. I found out later in the evening that all the morning shows will go to Ashish and they will give me regional meeting in the afternoon. As mentioned several times above it is very clear that Ashish is trying to dominate the media scene with regard to COVID-19 and is telling his staff to lead me out of the major media hits. Again, he does a good job but it is a bit of Bush league to do that. I have asked Courtney to in Post article: communicate with the White House calms people and two in a very nice way ask them just what is going on here. Monkeypox continues to spread throughout the world. 15,000 cases worldwide in 70 countries; >2000 in USA: Monkeypox Virus Infection in Humans across 16 Countries -- April-June 2022 J.P. Thornhill, S. Barkati, S. Walmsley, J. Rockstroh, A. Antinori, L.B. Harrison, R. Palich, A. Nori, I. Reeves, M.S. Habibi, V. Apea, C. Boesecke, L. Vandekerckhove, M. Yakubovsky, E. Sendagorta, J.L. Blanco, E. Florence, D. Moschese, F.M. Maltez, A. Goorhuis, V. Pourcher, P. Migaud, S. Noe, C. Pintado, F. Maggi, A.-B.E. Hansen, C. Hoffmann, J.I. Lezama, C. Mussini, A.M. Cattelan, K. Makofane, D. Tan, S. Nozza, J. Nemeth, M.B. Klein, and C.M. Orkin, for the SHARE-net Clinical Group* The activist community is very angry. See Washington Post article:
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July 21, 2022 at 3:56 p.m. EDT PRESS: FOX "Good Day" NYC TV with Rosanna Scotto; WGN Chicago Radio with Peter McMurray and Rob Martier;
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2022-07-22 00:00
Anthony S. Fauci
July 22, 2022 Kevin O'Connor called me this morning at 10 48 AM to give me an update on the president's condition. He is quite stable has a slight fever up to 99F that is easily brought down by tylenol. He has a cough which started off as dry but now is a bit "loose" as described by Kevin which means it seems deeper in the chest. However, the president feels well enough to continue to work from the White House although he is a bit fatigued as you might expect. More later. PHYSICIAN TO THE PRESIDENT THE WHITE HOUSE 22 July 2022 MEMORANDUM FOR: KARINE JEAN-PIERRE ASSISTANT TO THE PRESIDENT AND WHITE HOUSE PRESS SECRETARY
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July 23, 2022 Yesterday I spoke with dawn O'Connell and told her that I would be very much in favor of the secretary declaring a public health emergency for monkeypox. She is now running it up the chain to see what others think about that.. I had my usual call this morning with Kevin O'Connor, the president's physician. It was a disturbing call because Kevin told me that Ashish is really trying to manipulate what Kevin says regarding the health of the president and Kevin is starting to get very aggravated by this. For example, Ashish did not want Kevin to mention that the president's temperature was 99.4F because then that would be a topic for the news discussion. That is completely ridiculous because it is totally expected that someone with a URI would have a mild temperature responsive to Tylenol. In addition, Ashish did not like the use of the word "malaise" which was the exact word the president used to describe how he felt. Ashish was afraid that that word would bring up recall of president Jimmy Carter and the negative response that the country had to his describing "malaise" in the country. And then finally in today's report Kevin wanted to put in a new symptom that the president complained of which was muscle aches, an entirely understandable symptom that has nothing to do with progression of disease. They insisted that he not add that. Kevin pushed back and said that he would not sign off on anything if they force him to hold back on what the true symptoms are. The = Menu Weekly edition Q. Search v Economist Graphic detail I It could have been worse Covid-19 vaccines saved an estimated 20m lives during their first year Their impact in poor countries depends on how effectively governments prioritised recipients Jul 7th 2022 < Share Estimated daily excess deaths, '000 First person given First COVAX- WHO labels WHO labels clinically approved funded doses Delta a variant Omicron a variant covid-19 vaccine given of concern of concern Deaths without vaccines Deaths averted directly Actual deaths, by income group of country High Upper-middle Lower-middle Fe Low May I jun I Jul I Aug I Sep I Oct I Nov I Dec "Among individuals who avoided infection thanks to other people's vaccinations Call from Larry Horowitz regarding Ron Klain saying to him (Larry) that the President wants to make some changes since Health area (COVID/MPX) is not going well. "Someone needs to get fired." Primary target is Becerra, but they feel that they cannot fire him since they never would get a replacement confirmed in he Senate. Next in line in Rochelle. They really are disappointed with Rochelle and want to fire her. They asked Larry for suggestions for replacements. Larry called me about this. He suggests Mark McLellan or Anne Schuchat. Wants names from me. Larry also called Jeff Z. They do not know that Jeff is working with me regarding my stepping down. Could get complicated. I called Jeff and we discussed the situation. See below my discussion the next day (Sunday) with Jeff. Had a long conversation with Jeff about the above issue concerning firing someone at HHS/CDC. Similar to the situation that I faced years ago with Secretary Burwell wanting to fire Tom Frieden because of poor performance with Ebola where I defended Tom, I found myself defending Rochelle. Rochelle is a wonderful person, but she does not have control over her agency and she has to learn to balance the politically expedient thing while still maintaining solid scientific principles. The problem is she relies too heavily on the entrenched people at CDC who are smart and will meaning but who have no oversight or quality control from the outside. This allows them to proceed with somewhat antiquated if not ossified ideas. As the discussion went the options were to fire Secretary Becerra; however, this would be very difficult since it would be tough to get a Senate confirmation for a secretary within a relatively acceptable period of time. The other option is to fire Rochelle, but now is not the time to do that and it would be against my recommendation. One of the points that Jeff made is that they are considering in a humane way to ask Rochelle to step down at the end of the year before the beginning of the second-half of the first term. Despite my trying to protect Rochelle there is a very good chance that that will happen. Kevin O'Connor continues to call me 2x/day. The president continues to improve and is completed his 4th day on Paxlovid. .He was out for four hours today by the pool doing reading work. The next big question is whether to give him eight days or 10 days instead of five days of pax livid. That would be a problem since it would be against FDA authorization and the public would cry out that we had treating him differently than other people. the concern on the part of the White House is that if he rebounds after he is negative for several days, he will likely be out talking and mingling with people. If he infects someone following an inadvertent rebound, he will be blamed for infecting other people. My suggestion would be to treat him for five days have him stay in the White House virtually for an additional five days testing him everyday if he turns negative as soon as he turns negative send him out even if it's before the 10 day. And have him wear a mask in order to avoid him inadvertently infecting people if he rebounds, I would just test him every morning before he gets up and goes out to meet with people. If he is negative he will be OK, if he is positive continued isolating. Emergency phone call among HHS people (Becerra, Dawn et al) regarding convincing POTUS (and Ron) to declare a Public Health Emergency (PHE) for MPX. Becerra says that POTUS will rely heavily on my opinion. Problem is that they are concerned that if you declare a PHE for monkey pox then why not declare it for gun violence or for reproductive rights. That sounds very much like the negativistic attitude of RON. --_- -- etiieeatieatinetidimedtinetne Mieatitdiatin' Mieiiediendmadtied SUBJECT: President Biden SARS-CoV-2 Update President Biden completed his second full day of PAXLOVID last night. His symptoms continue to improve. His primary symptoms, though less troublesome, now include sore throat, rhinorrhea, loose cough and body aches. His voice remains deep. His pulse, blood pressure, respiratory rate and temperature remain entirely normal. His oxygen saturation continues to be excellent on room air. His lungs remain clear. The President continues to tolerate treatment well. We will continue PAXLOVID as planned. His symptoms will continue to be treated supportively with oral hydration, acetaminophen (TYLENOL), and the albuterol inhaler that he uses as needed for cough (2-3 times a day). He is experiencing no shortness of breath at all. He will continue low dose aspirin as an alternative type of blood thinner. Our preliminary sequencing results have returned. The President's causative agent is most likely the BAS variant. This is the SARS-CoV-2 variant which is responsible for 75-80% of infections in the United States at this time. This data does not affect the treatment plan in any way. The President is responding to therapy as expected. The BAS variant is particularly transmissible and he will continue to isolate in accordance with Centers for Disease Control and Prevention (CDC) recommendations. We will continue to monitor him closely, during this very common outpatient treatment regimen. As promised, I will keep your office updated with any changes in his condition or treatment plan. Respectfully submitted, TOC ae Kevin C. O'Connor, D.O., FAAFP Physician to the President Associate Professor, The George Washington University School of Medicine & Health Sciences PRESS: ABC "Good Morning America" Weekend; CBS Mornings (Weekend); CNN "New Day" Weekend; Fox News with Neil Cavuto
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July 24, 2022 Kevin O'Connor continues to call me 2x/day. The President continues to improve and is completed his 4th day (Sunday) on Paxlovid. He was out for four hours today by the pool doing reading work. The next big question is whether to give him eight days or 10 days instead of five days of Paxlovid. That would be a problem since it would be against FDA authorization and the public would cry out that we had treating him differently than other people. The concern on the part of the White House is that if he rebounds after he is negative for several days, he will likely be out talking and mingling with people. If he infects someone following an unrecognized rebound, he will be blamed for infecting other people. My suggestion would be to treat him for five days, have him stay in the White House virtually up to an additional five days testing him everyday. If he turns negative, as soon as he turns negative send him out even if it's before the 10 day period. And have him wear a mask in order to avoid him inadvertently infecting people if he rebounds, I would be OK, if he is positive continued isolating. Had long conversation with Ashish who was asking my advice. He started off the conversation by saying that the White House continues to have a lot of problems with Rochelle, the latest of which was the apportionment of vaccine doses. (See discussion above about strong consideration of asking her to step down). Ashish said that Ron wants my take on the situation with Rochelle/CDC and the distribution of vaccine doses. She wants to divide the vaccines for monkey pox according to the formula of 25% according to cases and 75% according to risk. This is something that we had discussed yesterday in a call with the secretary. During that call I promised that I would back Rochelle's proposal because of the fact that if they do not distribute more, namely 75%, according to risk, when we have outbreaks related to "Southern Decadence" and other gay pride functions we will not have vaccine in place to counter it. However Ron Klain is adamant that he does not want vaccines shipped to locations in which there are few cases and when they do not get cases or they do not administer vaccine to their case countthat the vaccine goes to waste (you cannot reship vaccine). I made the following point to the secretary yesterday and I repeated it word for word to Ron today. I would be supportive of a 25% for cases and 75% for risk distribution only if the jurisdictions that received the 75% for risk are given the vaccines in small apportionments. For example if they were scheduled to get 400 vaccines, you would give them 100 and tell them that if they don't use that 100 expeditiously the next shipment of 100 would not be given to them but would be given to a jurisdiction that has a high number of cases. I explained this to Ron when he called me today and told him that that would be my position. He said that Ron is very interested in what I would do and that this would hold a great deal of weight in the discussions that we will have tomorrow, which is Monday. Had a long conversation with Jeff about the above issue concerning firing someone at HHS/CDC. Similar to the situation that I faced years ago with Secretary Burwell wanting to fire Tom Frieden because of poor performance with Ebola where I defended Tom, I found myself defending Rochelle. Rochelle is a wonderful person, but she does not have control over her agency and she has to learn to balance the politically expedient thing while still maintaining solid scientific principles. The problem is she relies too heavily on the entrenched people at CDC who are smart and will meaning but who have no oversight or quality control from the outside. This allows them to proceed with somewhat antiquated if not ossified ideas. As the discussion went the options were to fire Secretary Becerra; however, this would be very difficult since it would be tough to get a Senate confirmation for a secretary within a relatively acceptable period of time. The other option is to fire Rochelle, but now is not the time to do that and it would be against my recommendation. One of the points that Jeff made is that they are considering in a humane way to ask Rochelle to step down at the end of the year before the beginning of the second-half of the first term. Despite my trying to protect Rochelle there is a very good chance that that will happen. Kevin O'Connor continues to call me 2x/day. The president continues to improve and is completed his 4th day on Paxlovid. He was out for four hours today by the pool doing reading work. The next big question is whether to give him eight days or 10 days instead of five days of pax livid. That would be a problem since it would be against FDA authorization and the public would cry out that we had treating him differently than other people. the concern on the part of the White House is that if he rebounds after he is negative for several days, he will likely be out talking and mingling with people. If he infects someone following an inadvertent rebound, he will be blamed for infecting other people. My suggestion would be to treat him for five days have him stay in the White House virtually for an additional five days testing him every day if he turns negative as soon as he turns negative send him out even if it's before the 10 day. And have him wear a mask in order to avoid him inadvertently infecting people if he rebounds, I would just test him every morning before he gets up and goes out to meet with people. If he is negative he will be OK, if he is positive continued isolating. Of note, Ashish states that he wants Kevin to go up in front of the cameras to describe the President's condition, but it is Ron who does not want him to go up as well as Karine JeanPierre. That is interesting because I am hearing that it is Ron who does not want Kevin to get up in front of a camera. PRESS: MSNBC with Jonathan Capehart
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July 25, 2022 Spoke with Kevin O'Connor again this morning and evening. the president is doing extremely well and continues to improve. He we'll complete his fifth day of Paxlovid today. The next question will be when he can go out into society. I have a phone call with Ashish this afternoon and I will recommend that we not give him additional days of drug but that we have him stay masked inside for 5 days or until he tests negative by antigen test. They are concerned about rebound; however, I have told them that if he tests every morning for five to 10 days after his Paxlovid course ends and he does not show any positivity, he can go out that day and proceed with business. That would be much more acceptable to the general public then to give him an extra few days of drug which would not actually guarantee that he does not rebound. PHYSICIAN TO THE PRESIDENT THE WHITE HOUSE 25 July 2022 MEMORANDUM FOR: KARINE JEAN-PIERRE ASSISTANT TO THE PRESIDENT AND WHITE HOUSE PRESS SECRETARY
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July 26, 2022 Continuing my twice per day discussion with Kevin O'Connor regarding the president's condition. The POTUS Is doing very well and improving substantially each day. Today is one day following the termination of his Paxlovid therapy and his CT level is 35 which means that he has very little replication competent virus in his nasopharynx. He feels very well and we had a long discussion this evening with Kevin, Ashish Jha, and Ron Klain as to what the presidents activities could be looking forward. He tested negative today by antigen test and has a very nice CT level as mentioned above. The White House staff is concerned about possible rebound and I made a suggestion that he stay masked and in isolation until he gets two negative antigen tests in a row. After that he can go out and do duties on the outside provided that he does not travel and that he wears a mask. I would test him intimately a few times a week to see if he rebounds. It became clear to me that Ron Klain and the president rely heavily upon my advice but what to do with the president's condition. I have developed a very good relationship with Kevin O'Connor and he calls me twice a day. We had some serious discussions with secretary Becerra about having a consistent message about the distribution of the monkey pox vaccine. See above about the concern of having vaccine in places that are not being utilized well there are lines in other jurisdictions. I supported the CDC recommendation of distributing the vaccine with 75% to risk areas and 25% to actual cases so long as individual jurisdictions utilize the vaccine. The CDC will send out the vaccine in tranches that will not be followed up with more vaccine until the jurisdiction actually utilizes the vaccine so that we don't have unused doses in one area and demands more than supply in another area. We also discussed whether or not we should declare monkeypox a public health emergency. I argued strongly that we do that in order to send a signal to the MSM community that we are very serious about the situation that they find themselves under. We had the vaccine summit today in the Indian treaty room of the executive office building. I gave a talk on the NIH research agenda. Also I did an enormous amount of press today which overlapped with a number of meetings with the White House as well as with secretary becerra. Big time stressed today and I feel it. PRESS: CNN "New Day" with John Berman; MSNBC "Morning Joe"; NPR "All things Considered"; News Nation Now TV; MSNBC "The Reid Out" with Jason Johnson