Tony's Diary Package — page 369

28 September 2020 1.Uncontrolled diffuse community spread in MN, WI, ND, 50 and Heartland IA, KS, NE, OK, MO where hospitalizations are rising fatalities will continue to increase across these regions -- slide 2 show rapid increase in test positivity in the red and orange states and rapidly rising cases, the stalling of any declines in new hospitalizations which will drive increase in fatalities over the next 3 weeks. Also the impact on Tribal Nations will drive substantial hospitalizations and fatalities 2.Fatalities one day (sat) : the original summer surge states CA, FL, TX (258), AZ, M5, AL, LA, SC, GA, NC (184) totally 442 and declining currently the Heartland and upper Midwest and MT, ND, SD (100 and climbing) 3. This diffuse spread is not solely university driven but most likely post Labor Day, end of vacations with silent spreading over the past 2-3 weeks through asymptomatic spread similar to post Memorial Day (that was undetected this time due to the change in CDC guidance on testing and many states dramatically decreasing testing): all majority of universities only testing symptomatics 4.Will be key to increase testing in the communities and states where hospitalizations are rising, where test positivity is rising and in communities where universities have more than 10% of their total student body COVID19 infected 5.lt will be key to return to the Heartland, WI, MN as well as UT and MT when possible to do a deep dive into the data and provide clear mitigation recommendations -- this community spread must be contained before weather drives individuals indoors to stay warm and we have an explosion of cases, hospitalizations and mortality similar to the southern surge when people came inside for cooling related to the heat in the South. 6.Florida and Texas have low testing rates and continued high mortality >100 deaths/day -- testing needs to increase significantly before reversal of mitigation efforts 7. Florida has significant residual disease and daily cases, reversing all mitigation efforts will result in rising cases in 2 weeks and rising hospitalizations in 3 weeks and rising mortality in-4 weeks -- the last week of October Red states ellow states Light Green states Dark Green states (>10% positive) (5 - <8% positive ) I - <5% positive) (<3% positive) AL, AR, FL, GA, IN, KY, AZ, CA, CO, DE, HI, IL, LA, ID, MT, NE, OK, SD, UT 1A, KS, MO, SC, WI MN, MS, NC, ND, NV, TN, MD, MI, OR, PA, WA, TX, VA WV, WY AK, CT, DC, MA, ME, NH, NJ, NM, NY, OH, RI, VT Dr. Fauci Top 20 Highly Cited Papers (Based on Web of Science, 09/28/2020) 1. Roberts AB, Sporn MB, Assoian RK, et al. "TRANSFORMING GROWTHFACTOR TYPE-BETA - RAPID INDUCTION OF FIBROSIS AND ANGIOGENESIS INVIVO AND STIMULATION OF COLLAGEN FORMATION INVITRO." Proceedings of the National Academy of Sciences of the United States of America. 1986;83(12):4167-4171. [2,613 citations] 2. Hoffman, G. S., G. S. Kerr, R. Y. Leavitt, C. W. Hallahan, R. S. Lebovics, W. D. Travis, M. Rottem, and A. S. Fauci. 1992. "Wegener Granulomatosis: An Analysis of 158 Patients." Annals of Internal Medicine 116 (6): 488-498. doi:10.7326/0003-4819-116-6-488. [2,060 citations] 3. Koenig, S., H. E. Gendelman, J. M. Orenstein, M. C. Dal Canto, G. H. Pezeshkpour, M. Yungbluth, F. Janotta, A. Aksamit, M. A. Martin, and A. S. Fauci. 1986. "Detection of AIDS Virus in Macrophages in Brain Tissue from