Wednesday, August 18, 2021

Global - 208,500,000/4,400,000; USA – 37,100,000/621,300 Yesterday 180,000 cases. 7 day daily average >100,000 Had a very eventful and stressful day today; however things worked out well with the rollout of the booster plan at the White House press conference. Following that I briefed the president and VP in the Oval Office together with Vivek, Jeff, Rochelle, Berchara, and Marcella, and Natalie. Only Vivek and I in person. The president and vice president asked good questions , particularly with regard to the president's concern that this is contingent upon FDA and acip recommendations . He picked up right away on the concern that Jeff had that we needed to do this and make sure that we don't have a stumbling block with the FDA and acip. The one issue that could arise is that the FDA may feel that the risk benefit ratio of boosting young kids 18 years old and there abouts may not be favorable in the context of the risk of myocarditis balanced against the risk of their winding up in the hospital as a result of COVID. The president is having a bad few days given what is going on in Afghanistan with the Taliban having taken over the country in just a couple of days following withdrawal of USA troops. As expected the response to the rollout of the booster plan was very mixed, and quite understandably. The CDC messaging all along has been dysfunctional . I do not think that this is the fault of Rochelle, but just the function of the culture at CDC where they hang on to data without letting anybody know about it until it's ready to be published. We had another instance where Rochelle was very reticent to show any of the medical team what was in the upcoming MMWRs that actually impact greatly the booster roll out because in typical fashion it was “embargoed “. One cannot imagine how ridiculous this is that a public health agency is acting like an academic department in a Medical Center where the most important thing is publishing data as opposed to guiding public health decisions. I take this opportunity now to talk about it , but this has been a chronic problem literally for the decades that I have been the director of NIAID. Of note, Yasmeen Abutaleb wrote an article this morning in the Washington Post in which she described this exact problem. (see below). Getting back do the concept of boosters, it is very clear that it is the right thing to do . However, given the fluid nature of the situation , we had to make some “majestic leaps” by anticipating that something was going to happen such as diminution of vaccine protection and acting on this now even though the data we're not absolutely firm. A lot of people got bent out of shape about this, but they are not responsible for the public health and they could guess and say whatever they want as have many “talking heads” with impunity because if they are right they look great but if they are wrong , which they usually are, then no one really cares because they have no authority or responsibility. PRESS: NBC “Nightly News” with Lester Holt; CBS “Evening News” with David Begnaud; MSNBC “The Reid Out” with Joy Reid; CNN with Chris Cuomo; The Post's View Opinion: The covid-19 boosters have the same goals as the first shots: Survival and resilience Fears over rising illness and death Washington Post: from the delta variant fuel Biden administration push for boosters Health officials expected to announce recommendation Wednesday that Americans get extra shots By Tyler Pager, Laurie McGinley, Dan Diamond and Lena H. Sun