Tony's Diary Package — page 517

oa December 4920... In Most states -- this will allow us to see the Impact of Thanksgiving In the regions where cases and hospitalizations were stabilized before Thanksgiving -- the Northern Plains and Racky Mountain states Test positivity and case reporting is inoerrect at the State level in GA and VA and we are working with the states to correct this -- both have increasing hospitalizations The impravernents in the Northern Plains, Rocky Mountain States and Heartland is being directly offset by the surging cases and hospitalization on the West Coast, Sunbelt, MidAtlantic and NE--these more populous states will drive this over the next 2-3 weeks and when combined with a pending full Thanksgiving surge will represent the greatest threat to hospital systems and inpatlent care All trends show that this escalation was occurring even before the transmission from Thanksgiving --- we should begin to see the full impact of Thanksgiving starting next week and as warned this Winter surge will be bigger, broader, and more deadly. It will bring together both the Spring and Summer surge into one overwhelming threat dramatically increasing hospitalizations and deaths : even with the innevations this will be catastrophic without increased mitigation now -- states without adequate public policies will have the highest fatality rates per populations equal ta the Spring rates despite improvements in care due to the lack of mitigation = death rates in ND and §D and approaching NY/NJ #s We da not have enough vaccine for vulnerable Americans to change hospitalization and fatalities trends in Dec-Feb--- we need ta be clear ta the Armerican people vaccines will have an impact in the Spring but NOT over the next 3 manths. Behavior change and proactive testing ta find both the asymptamatic and symptomatic transmitters are our only interventians and states are still not testing carrectly te find both There are now 344 States in the red (24) and orange (10) zone for hospitalizations of COVID cases -- general medical care deteriorates when states enter the red zone -- there are more states in this category everyday -- decision by CDC on whe is immunized first will determine the future stability of the hospital system and hospitalization rates - current plan will nat change the pandemic dynamics impact on hospitals. The movement of the surge into populous states especially without adequate policies or without individual Americans mitigating will drive fatalities and mast of these states do not have adequate mitigation policies and fatalities will continue averaging over 2500/day 17K,/week, 70K/month ata minimum reaching over 330K by New Years and 450K by the end of February without calls for action at the Federal, State, and Local level and using P5As to combat the myths related to COVID throughout the country it will be very evident over the next 30 days that mitigation policies saves lives and the lack of mitigation results in preventable deaths 00 USA -- 14,500,000/280,000 Trump still insisting that the election was "rigged" and that he won by a landslide. More than 30 court cases have been thrown out as frivolous. Alyssa Farah resigns. Good for her. One of the few good people in the administration. This might mean that I am not allowed out in the media any more since she has always advocated for me. December 6, 2020 (Sunday) - Global - 65,900,000/1,500,000 USA - 14,500,000/280,000 Had important Zoom call today (11:00 AM) with Jeff Zients and Jake Sullivan - Jeff and Jake are going to make some policy announcements for the Biden tam next week (Tuesday0 and they wanted to make sure that it was cleared by me. They had 3 issues: 1) the 100 days of mask wearing. I advised that they say "at least 100 days" or give some indication that it might be longer since when they get to 100 days, we may need to extend; 2) they want to say that they will distribute100milindoses of vaccine in teh1st 100 days of the Biden administration. I warned that this might actually be an underestimate. They first need to check that we will actually have a supply (check with Perna, but also make sure that we do not seem that this is undershooting. Since we are now saying that we will have 40 million doses by the end of December and even more by the end of January, then 100 million by the first 100 days of the Biden administration is far too little; 3) Schools - I suggested that they always lead with saying that the default position is to open and keep open the schools.