Tony's Diary Package — page 410

1/7 October 202 31 states with increasing test positivity (simultaneously more than we have had from the beginningofthe pandemic], 28 states with red zone number of cases/ 100,000 and many with a log phase rate of rise, 29 states with increasing daily haspitaladmissians, 21 states with rising fatalities, ER room visits for CLI are increasingin many regions. This is the broadest geographic spread we have had since the beginning of the pandemic and the rest states with rising hospitalizations. With current case rate expansionwe will achieve the greatest number of daily cases since the pandernic beganin the next week. Thisi¢ not due te increased testing but bread and ever increasing community spread -- there is significant new community spread in states with prior experience with this virus. There are no states, regions, or communities with enough prior COVID infection ta provide any substantial protection fram new carnimunity spread leading to hospitalizations and fatalities. This sequence of events must stop with the initial silent spread that can be effectively containedand mitigated. We have found trom careful analysis, nvodelling and triangulation ot all the data that community spread can be controlled without a lockdown as we have done but the tinve to act is critical and must be with the original detectian of the silent spread, ensuring infected individuals know how to limit their intection of others and with messaging on universal masking, physical distancing, and essential limitation of public and private gatherings indoors, There is an akeeolute necessity ol the Administration te wee this mormernt toask the American people towear masks, physical distance and avoid gatherings in both public and private spaces. WI, M1, AM are already constrained in buran resources te suppeort the increasing hospitalization rates and even with quer interventions the case fatality rate remains at 9% for Americans over 40, Soo slide # showing the relatioreshipat prior flu seasons fatalities with COVIDTS, nm sam Number Influenza Coded Ceathe. aa Fe ome Number COWID-19 Coded Death '4 --*, of Deaths Dus to PIC "e000 -- Seasonal Baseline Epidemic Threshold 14000 v 12000 Tiss) EH a] ; won 2 = = BOo0 # o ne Won naHhae Wh nmDDtD DM we Do OH w MMWR Week -- 8,100,000/218,500 October 18, 2020 - Global - 39,600,000/1,100,000; USA - 8,100,000/218,500 Surge continues: