Tony's Diary Package — page 484

ut ke mm 10, 19 November 2020 All states and major metros now are deteriorating except HI = there are 29 states in the red zone and 9 states in orange zane BUT there is early evidence that strong early mitigation is impacting the rate of rise as specific states start to show a slowing of their cases New daily COVID confirmed admissions have reached 10,000/day and inpatient COVID patients reaching historic highs Last week 130% confirmed and suspected COVID cases were admitted = these drive PPE use = please review the daily data report =slide 5 Its not just the number of cases but the rate of rise - today's cases are reflective of spread 10-14 days ago - the rate of rapid rise in cases will translate toa proportional rapid rise in hospitalizations and deaths : but there is clear evidence that aggressive mitigation works We are now seeing the impact of the mitigation efforts put in place 2? weeks agoin the more populous states and suggestions of plateauing in these states see slide 6 -- this is very encouraging and we should reinforce these positive trends related to strang mitigation This joins the European data =slide 7 =that this Fall surge can be rapidly contained with mitigation We need ta change the rate of rise of cases to change the rapid rise in hospitalizations to preserve hospital capacity -- this is no longer about preventing a crisis = this is a crisis = this is about trying to save as many lives as possible within the crisis This will require a comprehensive Federal response with aggressive support to States to include: . Aggressive communication at the WH level masking requirements at all times outside of immediate household, physically distancing, hand hygiene AND critically limiting of social interactions to the immediate household for the next 60 days while we bridge to the rapid vaccination of the vulnerable populations decreasing hospitalizations and fatalities : this isa short term sacrifice to protect the vulnerable. We need to document precisely the number of vaccine doses available over the next 2 week for pilot roll out to LTCF. * Aggressive re-alignment of 4g testing towards finding and preventing unrelenting silent spread that continues to trigger community spread in waves : ADM Giroir and CDC working with States and Tribal nations . Expanding frequency of LTCF testing and aligning early vaccination into LTCF . Ensuring rapid tiering of those most vulnerable to rapid vaccine immunization access immediately upon EUA (CDC) . Short term Interventions : in States with demonstrated haspital staffing under threat - restricting indoor dining and limiting areas of congregation without mask (bars, gyms and restricting indoor dining) will be needed as was successful in the USA in the summer and in Europe Without an immediate change we will hit 200,000 cases/day and 15M cases/week, and over 100,000 inpatients -- this Is unsustainable in our hospital system Over the Last 30 Days * Cases have risen from an average of 503,783/ week to now 1,129,789/week 224% increase * New COVID confirmed admissions have risen from 5500/day to 10,500/day 91% increase * New COVID confirmed and suspected admissions have increased from 89,708/week to 130,695/week 46% increase * Inpatient COVID patients has risen from 47,204 to now 77,518 64% increase * Inpatients with COVID currently rising at 17% week over week witha project of 84,306 inpatients next week and 100,000 inpatients the week after assuming the same rate of discharge (if sicker patients are admitted the % increase will become greater week over week) * Deaths have risen from 5623/week to now 8244/week average 47% increase