Tony's Diary Package — page 477

16 November 2020 1. All states and major metros now are deteriorating except Hl -- there are 27 states inthe red zane and? states inerange zane-- major high populous states are now significantly deteriorating from MIL IL, IN, GH, PA, to MJ, M4 and western NY, CA-- this surge must be flattened 2. Cempared te last week cates ip 50%, hospitalizations up18% and deaths 26% - this rate of increase will crush the hespitals 3. Ta be erystal clear -- its not just the number of cases but the rate of rise - what we are decumenting today as new cases are reflective of spread 10-14 days age - the rate of rapid rise in cases will tranélate to a proportional rapid rise in hospitalizations and deaths 4, We need to change the rate of rise of cases to change the rapid rise in hospitalizations to preserve haspital capacity--this is no longer about preventing a crisis -- this is a crisis -- thisis about tryina te save as many lives as possible within the crisis 5. Europe hat shown os that the Fall surge can be cantained and hospital capacity sustainedand ifwe act mow we can da the came 6. Thisvaill require a comprehensive Federal response with agaressive support to States bo include: ' Aggressive communication at the WH level masking requirements at all tirnes outside of immediate househeld, physically distancing, hand hygiene AND critically limiting of social interactions te the immediate household for the next 60 days while we bridge to the rapid vaccination of the vulnerable populations decreasing hospitalizations and fatalities : thisis.a short tern sacrifice to protect the vulnerable. We need to decurnent precisely the number of vaccine doses availabh: over the nest ? week fer pilot reall out to LCE, . Aggressive re-alignment of 4g testing towards finding and preventing unrelenting silent spread that cantinues be trigger community spread inwaves > SOM Giroir and COC working with States and Tribal nations . Expanding frequency of LTC testing and aligning early vacelnation late LTCF * Ensuring rapid tiering of those most vulnerable to rapid vaccine immunization access imnovediately upean EUG (COC) . Short term interventions : in States with demonstrated haspitalstaffing under threat - restricting indoor dining and briefly limiting areas of congregation without mask (bars, gyms and restricting indoor dining} will be needed as was successful in the USA in the Summer 7. Withoutanimmediate change we will hit 200,000 cases/day and LSM casesfweek, and over 100,000 inpatients --this is unsustainable Date: 11 s20e0 I New Cases per 100K NEW CASES PER 100,000 IM THE WEEH: I National Picture 'OWE MONTH BEFORE TWO MONTHS BEFORE a eee a re Cases per 100K $20 Comin ast 14 Dury Mobs swe {9 10 to 50 (9 F1b 1h ® (107 te 198 Ee 200 me a08 (£00 of More All states are now showing significant increase in cases, this is the time sequence over the last 6 months. We have not seen a surge in testing in the last 30 days but are seeing deterioration across the country.