Tony's Diary Package — page 511

(CURRENTLY HOSPITALIZED PER MILLION BY STATE Dec 01 I Hospitalized Per Million Peak - 968 in New York, April 13 uaa Under 100 100 - 250 250 - 500 Over 500 Source: The COVID Tracking Project ~ Under100 ©100-250 8250-500 WM Over 500 @ 2 December 2020 1. Data remains unstable (test positivity, cases, deaths as they come from the state reporting) but when cases rise despite the decreased reporting as there are across the West Coast, TX, Mid-Atlantic and NE it raises red flags 2. New admissions and inpatient census data comes directly and daily from the hospitals so that reporting is more reliable and although at record highs were stabilizing -- BUT as noted yesterday the improvements in the Northern Plains, Rocky Mountain States and Heartland is being offset by the surging hospitalization on the West Coast, Sunbelt, MidAtlantic and NE--these more populous states will drive this over the next 2-3 weeks independent of a post Thanksgiving surge as they reflect transmission before Thanksgiving 3. There are now 31 States in the red (23) and orange (&) zone for hospitalizations af COVID cases -- general medical care deteriorates when states enter the red zone -- there are more states in this category everyday -- decision by CDC on who is immunized first will determine the future stability of the hospital system. Dec and Jan will be the key months for pressure on the hospital system and without prioritizing thease likely to require hospitalization and highest risk of death could result in aver all failure of critical care for all Americans Independent of COVID status = UK is immunizing HCWs, LTCF and everyone over $0. Our hospitalizations and fatalities mirror this except in USA its over 70. 4. Please review slide 3-- as raised a couple of weeks ago-- the movement of the surge into populous states especially without adequate policies or without individual Americans mitigating will drive fatalities -- states with >100 yesterday -- TM (237), MI (195), PA (170), IL (146), IN (141), CA, MO, OH, WI -- bald states do nat have adequate mitigation policies -- the others are due to personal decisions 5. There aré two different regional dynamics in the pandemic. 1. The Northern Plains and most of the Heartland except OK is finally stabilizing after 8 weeks of unrelenting rise. These states will allow us to see the Thanksgiving surge and be able to estimate the impact of the upooming Holidays and the messaging needed to prevent a January and February surge 2. From IN te OH to PA, the mid Atlantic, the NE region and the West Coast, TX and AZ continue to deteriorate which will drive up cases, hospitalizations and deaths te even high rates due to population size and it will be difficult to estimate the post Thanksgiving impact. 3. The current picture could combine the Spring and Summer surge states together inte a Winter surge resulting in even higher hospitalizations and deaths 4. Each surge Spring (100K fatalities], Summer (100K fatalities), Fall Surge (100K fatalities) combining Spring and Summer could lead to 200K fatalities 6. ft will be very evident aver the next 30 days that mitigation policies saved lives and the lack of mitigation resulted in unnecessary high fatalities • Call from Mark Meadows saying that it was OK to do press conference with Gov. Cuomo. Also, he really wanted a reality check on the fact that the MHRA of the UK has given their equivalent of an EUA to the Pfizer vaccine. He wanted to know if our FDA was dragging their feet. I totally supported the FDA, Peter Marks, and Steve Hahn and said that the UK were "hot-dogging" it and that even the EMA were blasting the UK for hot dogging. It seemed that Mark was on the brink of firing Hahn. Hope I blocked that