Diary Prequel Package — page 371

that multiple agencies/people are in charge depending whether it is health, infection control, logistics, etc. Kent Brantley again was on the second panel. Still much interest and interviews with written press and blogs over the ongoing "disagreement" between Osterholm and me on the issue of the virus mutating to respiratory spread. Ian Lipkin gave an interview on CNN agreeing with me and putting down Osterholm. Meanwhile, the House voted to give POTUS authority to arm the Syrian Free Army to fight ISIS. The situation continues to heat up with various mathematical models projecting anywhere from 20,000 to 100,000 to a soon to be published CDC model that would indicate if we do not have a highly effective control program, the number of cases could reach 500,000 within several months. September 19, 2014 - I continue to do small amount of press (as the press is getting some fatigue with the same story) with Swedish National TV interview as well as a FOX news appearance. Of note is the fact that the White House communications people are acting in a very bizarre way. During the past week I have been receiving requests for appearances on a variety of TV shows for the upcoming weekend including CNN and MSNBC on Saturday, September 20, as well as Face the Nation and Fox news on Sunday, September 21. The White House has refused to say yes or no to clearance and despite multiple requests on the part of our communications people, namely, Courtney Billet and Patty Conrad, we have not received a positive or negative reply for clearance. This has gone on into the late evening of Friday, September 19 despite the fact that the programmers were waiting for me to be on shows on Saturday. This is an absolute unacceptable disgrace. The White House because of their inability to decide what should go out on the weekends and their extraordinary and unexplainable need to control all messages is putting all of us in the embarrassing position of being unresponsive to legitimate media requests to discuss things that are not in conflict with anything else the administration is doing. This is unequivocally the worst administration I have ever dealt with when it comes to the need to control the media. This evening I had a very intense and somewhat poignant conversation with Tom Frieden at 9 PM to 10 PM concerning how we are going to approach the issue of vaccines. Tom still has considerable concern about a truly randomized controlled trial to determine the efficacy of the vaccine when the control is not one of the vaccines themselves. He continues to struggle with the fact that we are not going to be able to get efficacy data unless we do have a control arm which conflicts with the emotional need to get vaccine to everyone as soon as possible. The difficulty here is that we might in fact truly need an effective vaccine if the epidemic continues to expand and reaches the CDC projected model of 500,000 cases within the next several months. Under those circumstances we will absolutely need an effective vaccine and if we do not know if it is effective it will be very difficult to widely distribute it. This is a painful dilemma that hopefully we can work out.