Tony's Diary Package — page 492

10. 23 November 2020 There are 30 states in the red zone and 9 states in orange zone = the duration of rising cases and the rate of rise greater than the spring or summer which will prolong the high fatalities for the next 4-6 weeks rapidly reaching over 300,000, BUT ILis already improving with mitigation but IN continues to deteriorate without mitigation For the first time in 7 weeks the Sunday cases were less than last week's Sunday cases -- building on this now is critical -- we need to make it clear that choices will drive a post Thanksgiving surge because of the underlying high viral load that will be an overwhelming threat to the health care system. The improvement is due to states aggressively mitigating and it will be very evident over the next 60 days that mitigation saved lives and the lack of mitigation resulted in unnecessary high fatalities, Europe is improving rapidly with mitigation and we are seeing early improvement in states with strang mitigation States that did not mitigate in the Fall surge will end up with population CFR equal to the Spring surge when treatment was suboptimal, (ND, 5D, MT etc] There are now 26 States in the red and orange for hospitalizations of COVID cases = care deteriorates across all patients with and without COVID when states enter the red zone Mew daily COVID confirmed admissions are over 10,000/day and inpatient COVID patients reaching historic highs -- there are not significant new improvements in treatment to further improve CFR which will remain near 10% for those over 70 and near 1% for those 40-69 - we will reach historic highs in daily fatalities 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 ta a proportional rapid rise in hospitalizations and deaths - we cannot sustain another surge that we have experienced over the past 7 weeks There are state examples of changing the rate of rise of cases to change the rapid rise in hospitalizations to preserve hospital capacity = this is mo longer about preventing a crisis -- this is a crisis = this is about trying ta save as many lives as possible within the crisis and we have examples of states that are improving This will require a comprehensive Federal response with aggressive support te States to include statements that Europe and States with strong mitigation are improving: * Continued 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 is a short term sacrifice to protect the vulnerable. . Continued critical guidance on Thanksgiving and throughout the Holiday season to limit indoor unmasking across households * Aggressive re-alignment of Ag testing towards finding and preventing unrelenting silent spread that continues to trigger community spread in waves . 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 mitigation interventions : restricting indoor dining and limiting andor closing 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 with -- 12,300,000/257,000 PRESS: RAI Italian TV; La Stampa/Vatican Radio interview with Paolo Mastriolli; Hcehinger Boston Radio (NPR); Yahoo Finance TV interview; Washington Post Live with Robert Costa; PBS NewsHour with Judy Woodruff; Zoom with Washingtonian Top Doctors November 24, 2020 Global - 58,700,000/1,400,000 USA - 12,300,000/257,000 Surge continues. Europe starting to level off since they are shutting down in many countries. Despite CDC saying not to travel over holidays, millions of people, particularly students are crowding airports