Friday, January 31, 2020

Another truly amazing day. Sequested in the White House essentially all day working out a proposal to put before the POTUS that would restrict travel from China. The proposal was driven largely by CDC (Marty Cetron) who felt that given the volume of people coning in from China by direct and even more importantly indirect flights it would be logistically impossible to effectively screen people at many, many airports and the diversion of people from their place of origin to selective airports would further complicate things. Also, the cases continue to sharply rise with 12000 cases and 259 deaths. Also, a NEJM report from Germany indicated that a Chinese woman came from Shanghai visited a colleague in Stockdorf Bavaria. She infected him when she had no sxs, returned to China and got sik on the plane. The german man then got sick and infected 2 other Germans. This would have bn the first truly documented case of transmission from an asymptomatic person, thus, adding to the concern about the accuracy of screening at airports. In addition, the WHO declared a PHEIC yesterday prompting Azar to declare a Public Health Emergency here in the USA. I disagreed with the latter since there were only 7 infections (6 travel) at the time. All this led to the conclusion of travel restriction. This was late in the afternoon - around 1:30-2:00 PM. The entire task force (above) plus Kellyanne Conway, Jessica Zitto (WH Coms) and a variety oof senior WH officials gatherd in the Roosevelt Room to hammer out how we would present this to the POTUS. The policy decision was: 1) Ban travel to the USA of all non-citizens who have been to China within the past 14 days. If you were in China, you need to go somewhere else (Paris, UK, etc.) until 14 days pass from the time you were in China. 2) If you are a citizen and were in the Hubei Province (includes Wuhan) and you return to USA, you are institutionally quarantined for 14 days. 3) If you come from any other part of China other than Hubei, you have voluntary isolation for 14 days. We wanted to present this to the POTUS befor the Stock Market closed so that we do not look like we held off to avoid bad effects. We went into the Oval Office at about 3:00 PM. We had been scheduled to go in at 2:30 PM but things backed up. Presentation was made to the POTUS by Azar, Bob Redfield and me. Trump as he did a couple of ddays ago posed many questions to me making sure that I thought it was a good idea. I said this was an imperfect process, but the best choice we have right now. He questioned me about what the difference was between this and flu. He somewhat brashly suggested even more stringent restrictions and was dyswaded by Kellyanne. She clearly has influence over the POTUS. Potus agreed and we immediately went out to the WH Press Briefing room that was packed. Azar led the presentation, but many questions were ansered by me. Interesting that impeachment was going on and the senate did not get the 4 GOP votes to allow witnesses to be called. This also dominated the news. We thought this would get us on the Sunday Talk Shows, but impeachment bumped us. White House is now fully convinced that I be the science/health spokesperson for the USG. Bob Redfield just does not come across very weel. He takes forever to say something and it is usually wondering. This drives the WH and HHS comms people crazy and so they are putting me out on all the requests. When I got back to my office, got call from Jeremy Farrar who sounded very concerned and conferenced me in with Kristian Anderson, an evolutionary biologist from Scripps. They had also been talking with Eddie Holmes, another evolutionary biologistfrom Sidney Australia. There have been conspiracy theories that the virus was given GOF by inserted mutations and deliberately or accidentally released in Wuhan. One theory was written by Indian investigators that HIV sequences were inserted by a Chinese person in Canada and released in Wuhan. Everyone thinks that is crazy, but the Farrar phone call was different. The people on the phone felt that the mutations around the furine cleavage site of the spike protein could not have occurred naturally since it would require an evolutionary “jump that they found nowhere in bat isolates. They bring up the possibility that this could have been deliberately inserted and either accidentally released or deliberately released by a crazy person in the lab, the former being the most likely. Jeremy was calling me for advice. I suggest that we get a larger group of qualified evolutionary biologists/virologists together under the auspices of a convening body and carefully look at this. We agreed to convene by phone the next day. I called Brian Harrison and Garrett Grigsby who arranged for a call with Azar to decide what to do. Azar did not like the idea of WHO as convener because he feels (somewhat unfairly, I believe) that Tedros would immediately tell the Chinese and they would crush the attempt and/or think we are attacking them. We decided to have a 2-pronged approach strongly suggested by Kadlec who felt we had security responsibilities to investigate this ourselves. He would do this through OSTP and NAS. Meanwhile I would pursue a multinational approach with Jeremy. I decided to now bring in Francis. PRESS: The Today Show NBC; Lou Dobbs Fox; many print