Tony's Diary Package — page 1000

'Marks hs.gov I Booster we (CDC)" <qyd2@cdc.gov>, "Berger, Sherri (CDC)" <sob8@cdc.gov>, Peter Marks <Peter.Marks@fda.hhs.gov>, "Marston, Hilary" <Hilary.Marston@fda.hhs.gov> Subject: Confidential - Next Steps on Expanding Eligibility for Additional Booster As a follow up, we're still working through the FDA statement and will circle back tomorrow morning with next steps. Thanks for your patience. Had a very interesting conversation with the HHS team regarding a memo at the secretary will be sending to the president regarding the declaration of a public health emergency (PHE). the secretary expressed some concern about whether we should do that or not but his staff actually wrote a memo making it seem like he definitely wanted it I brought this out to them when I read quickly the memo while we were on the Zoom and the secretary requested that I can't fully look at the memo and make comments. I actually think we should definitely declare a PHE and I modify it the conclusion of the memo to be unambiguous about this. It was really strange that the secretary said he had reservations and his staff wrote a memo that strongly recommended that we do it. In my memo back to them I told them that they have to make up their mind one way or the other and have the memo strongly recommend what he actually wants. I rewrote the conclusion assuming that he will take my recommendation to declare it July 30, 2022 (Saturday) Just got a call at 12 noon from Kevin O'Connor that the president has had a rebound with a positive antigen test today. He is asymptomatic. This is the real problem since there are no guidelines from the CDC which dictate what to do when you have someone who you are testing virtually every day. The CDC health advisory on what to do following a rebound after Paxlovid treatment does not mention testing at all. the duration of isolation is based purely on symptoms and time from resolution of symptoms. Here again it goes back to my objection many months ago of the guidelines the CDC put out about reentry into society following infection. I had insisted back then that even though it might not be practical for everyone to get testing and often people need to get back to work after five days, they still should have put some guidance in for people who can get tested period now we are flying in the dark. Ron Klain is going to want him out as soon as possible; however, given that he is known to now be antigen positive he has to isolate for five days and then the question will arise of how often to test him and if he is positive should he be let out even with a mask. Cliff Lane feels strongly that he should be in isolation so long as he is antigen positive and can go out once he has two negative tests in a row. Got a call from Ashish making sure that we are on the same page. Also, he asked me if we should start a 2nd course of Paxlovid. I told me not to unless the POTUS gets significant sxs