Tony's Diary Package — page 378

. Thad called Sean Conley and told him that this is what I would do. He agreed. Treached out again to Sean Conley to help again. No response. WH really shutting down comms with outside world. Kellyanne Conway, RNC Chair and two senators ( Senator Thom Tillis, Republican of North Carolina and Senator Mike Lee), Republican of Utah) infected plus Bill Stepien (Trump's Campaign manager); all were at the Rose Garden ceremony for Supreme Court Justice Amy Coney Barrett. It appears that this ceremony was a super-spreading event since all infected people were there and the timing is perfect L.Uncontrolled diffuse community spread in MN, WI, ND, SD and Heartland IA, KS, NE, OK, MO where hospitalizations and fatalities are rising and will continue to increase across these regions : as there is insufficient mitigation -- low mask wearing, low physical distancing and inadequate protection of vulnerable persons in community and weather driving communities indoors : LTCF aggressively being protected but uncontrolled community spread leads to infection of the vulnerable members of the community ~ hospitalization and fatalities 2.Tribal Nations from these regions will drive substantial hospitalizations and fatalities 3. The overarching concern relates to the balance of personal mitigation behaviors and the weather driving more activities indoors with the lower humidity increasing the K value (dispersion factor) with lower humidity the droplets partially evaporate allowing for longer suspension in the air and together -- poor personal mitigation and cooling weather with heating will increase the R value 4.Any baseline immunity in the population (ranging from 5-10%) in all states except NYC area and Miami FL can be offset and overcome by this weather element and increased indoor activities -- this is the concern about continued spread in states where the weather is changing (cooling) and the need for immediate mitigation actions by the leadership and the public collectively : conversely the improved weather across the south with movement outdoors from air conditioning will lower both R1 and decrease dispersion (K) ~ 5.tThere also needs to be careful proactive attention to the NE ~ planned travel there starting Monday 6.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): the majority of universities only testing symptomatic students with a tiny proportion of voluntary surveillance testing (except U of ILL and Clemson) 7.Will be key to increase testing in the communities and states where test positivity is rising to prevent further community spread to prevent increases in hospitalizations and fatalities 8.This first several tranches of BINAX to states should be prioritized to states with high community spread PRESS: Getting scores of calls from press and request to appear on every show. White House has indicated no press of any type until further notice. They do not want me or other government docs out there until further notice.