Read Tony's Diary: The Prequel (Part 7 of 8)

with Greta Van Susteren and MSNBC with Rachel Maddow.
After I got off the air, Rachel tells her audience how proud she was of herself to have
gotten me on her show since I was such an icon in medicine and public health.
Oct. 14 -21, 2014 - From October 14 through October 21, the situation was so intense
that I do not have time to document historical notes on a day by day basis. I am only
doing this retrospectively now and will give dates as I recall. However over this period of
time in light of the crisis of confidence against CDC and Tom Frieden related to a
number of issues culminated by the fact that  was allowed to fly back from
Cleveland to Dallas, this was clear that Tom Frieden was in significant trouble over
several days Sec. Burwell would call me usually in the late evening and nighttime asking
for my advice about what we should do the CDC. At one point, I believe on October 14
or 15, she called me at night as I was in my car driving home. I parked the car in front of
my house and continued to speak with her. Approximately 9 o'clock at night. She asked
me what I thought about the possibility of removing Frieden from the job and wanted my
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379advice about who could be a leading global health figure who could take Tom's place. I
discussed forcibly with her that I believe that Tom was an outstanding public health
official and a man of great integrity. However, I told her that I have to frankly tell her that
Tom's staff is not serving him well. For example many of the people from CDC who of
gone to Dallas to oversee the situation in the care of  are people who know
Ebola from behind the desk but left even never taking care of the patient or have done so
many years ago. I told her to give Tom a chance and that I would try to speak to Tom
about relying less on advice from his staff and more on his own judgment.
Again during this time I have had multiple conversations, on a daily basis usually late at
night with Tom Frieden. I will refer  to these specifically below.  In general, I was trying
to convince him that it is possible that the CDC protocols as they exist on their website
are not adequate for the tertiary care setting that we have in large hospitals such as Texas
Presbyterian and elsewhere in the United States. Tom keeps on insisting that the CDC
protocols have worked for decades in the field in Africa and that his staff tells him that
the reason why the Dallas nurses got infected was likely be cost they had some breach in
the protocol. I literally begged him over the phone that he should not say this and that we
should re-examine the CDC protocols.  This will all become clear after  we admit
 to NIH Special Clinical Studies Unit (SCSU) at the NIH Clinical Center on Oct.
16, 2014 (see below).
Oct. 15, 2014 – Media frenzy continues.   I do CNN New Day, Morning Joe early in the
AM.  Talk of shipping patients out of Texas Presbyterian Health Hospital since they have
had 2 infections of their nurses and they expect possibly more infections due to exposure
of other hospital staff.   Since  got infected, others who were doing the
same things that they were doing might also wind up infected and they wanted to clear
 out and transfer them.
Today it is made public that CDC told Vinson she could fly back to Dallas from
Cleveland.   Very bad press for CDC and Tom.
Oct. 16, 2014 - A truly transforming and  important day here at NIH. First I testified
before the House Committee on Energy and Commerce, Subcommittee on Oversight and
Investigations chaired by Mr. Timothy Murphy (R-PA). Tom Frieden testified with me as
did Luciana Borio of FDA, Robin Robinson of BARDA, and someone from Customs and
Border Protection.  Tom got hammered somewhat by the committee and was not strong
and firm in his answers. He continues unfortunately to give a poor public appearance
suggesting that he is not in control of the situation. He has shown the same slow
deliberative response in the media which is costing him dearly since it is making him out
to be less than he really is, which in my opinion is quite good.
However, the most important event of the day was the fact that at 11:54 PM today,
Thursday, October 16, 2014, Dallas nurse and now patient  was transferred by
air evacuation from Dallas to the NIH Clinical Center to be taking care of by us in the
Special Clinical Studies Unit (SCSU). I had stopped off at Accura automobile showroom
on Wisconsin Avenue where Diane Baker, Francis Collins's wife, was hosting a Friends
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382correctly; you are not at risk of infection.”.   I was horrified to hear this.  Now comes the
revelation.
Cliff Lane and I stop off at Chris Grady’s office on 1st floor of the Clinical Center, now
late at night and I tell Chris the story about the CDC person.   While Cliff and I are
talking, Chris pulls up the CDC website and to my amazement she reads what its
guidelines are for PPE.   It is exactly what said she was wearing including the fact
that it resulted in open skin.   And so the CDC recommendations are much less stringent
than the MSF and the NIH PPEs.  In other words, the CDC guideliens are in fact
inadequate and  was following them when she likely got infected.   I got goose-
bumps.   I was incorrectly assuming that the CDC guidelines were like the NIH strict
PPEs.   In fact they are not.
That night I e-mail Tom Frieden to call me and I explain the situation and he says that his
people tell him that if you follow the guidelines even with that PPE protocol, the
experience in Africa says that you are protected unless you break protocol.  He then says
that we really cannot tell exactly how and when  got infected.  We could
not distinguish between the first 2 days and the days after they went to more stringent
protocols.   I went ballistic over the phone.   I begged him to please not listen to his staff.
I told him frankly as a friend and as someone who care about him that his staff “had no
fucking idea of what they were talking about since none of them who are advising him
have ever taken care of a patient, or if they have it was 10 years ago”.   I pleaderd with
him not to say that the nurses must have had a breach of protocol and to realize that the
CDC protocol was entirely inadequate for a tertiary hospital intensive care setting which
is where  got infected.  I told him that common sense tells you that open
skin is much more dangerous than full PPE and that it is essential to change the CDC
recommended PPE to insist on no open skin.  He agreed somewhat reluctantly and said
he would have to check with his staff.   I told him that I love him, but I really do not give
a shit what his staff says, he must change the protocol.   In fact, within the next couple of
days with help from me and Cliff and others, the CDC did change the protocol.

Oct. 21, 2014 – Jey Johnson, Secertary of DHS, announces that all flights from Liberia,
Sierra leone and Guinea must now enter the USA at one of the 5 designated airports
(O’Hare, Newark, IAD, JFK and Atlanta) that are now having entry screening.
CDC issues the new PPE guidelines emphasizing the 3 principles that I have insisted
upon during my many discussions with CDC (Frieden): 1) Training and drilling in
procedure of donning/doffing; 2) no exposed skin anywhere; 3) trained monitors for
donning and especially a WATSAN for doffing.
Did Weill Cornell Grand Rounds by video to an SRO audience.
Also, the White House now wants me to instruct physicians around the country on Ebola
via White House run teleconferences.   Now I am a press coach.   Did one today and now
they want me to do one tomorrow or next day. On the call were Rich Carmona, Zeke
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383Emanuel, among others.   It actually worked out quite well and was well-received.
Interesting how history repeats itself.   First, the White House gets the standard people
out such as CDC, HHS on health emergencies and the PR is horrible.   Example is my
friend Tommy Thompson with the Anthrax attacks of 2001 (he said it could come from
drinking water from a stream  - bad briefing from CDC).   Another example was Jeff
Coplan, then Diretor of CDC who arrogantly refused to brief Tommy Thompson or even
answer his calls.  Recall that  Stewart Simonson, who subsequently became my very
close friend convinced Tommy to fire Coplan and then I was the PR face of the USG to
“calm the nation” together with Julie Gerberding who replaced Coplan as CDC Director.
Now, after all of the misteps and the poor performance of Tom Frieden in the press and at
Hearings, the White House is falling all over themselves to get me on TV and elsewhere
educating the public and validating what the administration is doing.   Hence, my “Full
Ginsburg” on all of the Sunday TV Shows last weekend (October 8)
Getting many, many e-mails from colleagues around the country telling me how proud
they are of me and what an amazing job I am doing in the press with calming the country
and bringing scientific rigor to the situation in my explanations.
I get into Contact PPEs and visit  in her room with Cliff and Rick Davey. She was in
good spirits.   She is so sweet I told her that she looked good and she came back with
“You look great, yourself, Dr. Fauci.”   She was obviously glad to see me.   I believe it is
the happiness of knowing that she is getting better.   If note, her Ebola PCR is now
completely undetectable, and importantly, her Ebola specific IgM is >1600.   It had
previously been <400, which is actually undetectable.   The IgM means that she is in
immunological protection area.   Also, her LFTs are coming down.   We feel the
hepatotoxicity is due to the Brincidofovir. We move her out of isolation room tomorrow
and hopefully, home on Friday. Her labs are contained  below:
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384
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385No press today since HHS and White House wanted nothing on but the announcement of
the new PPEs by CDC and the DHS announcement of the 5 airports only.
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387might ultimately lead to collapse of the structure of the country and spread to other West
African countries. We repeat what we have said many times that the best way to protect
Americans from Ebola is to suppress the epidemic at its source in West Africa.
I went over to see  and her family including sister Kathy and mother Diane in
our special clinical studies unit at around 6:30 PM. As I have done every day, I was
accompanied by Rick Davey and Cliff Lane. has had four consecutive negative
PCRs and so we made the decision to move her out of the strict isolation room and put
her in a room where there was no need for contact isolation. In other words and we could
wear regular clothes and visit her.  Also, her dog Bentley had been shown to be PCR
negative at USAMRIID. On a visit tonight we began to plan her discharge exit from the
hospital and discussed just what course we would take regarding public announcements
and a press conference. I emphasized to  and her family that the choice was entirely
up to her and that we would help her to implement any decision that she makes. She is
leaning towards making a public announcement in front of the Clinical Center and having
a written statement that she reads and that she does not answer any questions. Hopefully
we will discharge her on Friday, 24 October.
Oct. 23, 2014 - Today was another hectic day regarding the possibility of implementing a
randomized controlled trial for a Ebola vaccine. As mentioned several times above there
is a nefarious attempt on the part of Jeremy Farrar of the Wellcome Trust  to derail plans
for an RCT of vaccine in Liberia. Cliff Lane has known him for a long time from when
he was in Vietnam with the Pasteur Institute. Jeremy feels that we should do open access
for distribution of vaccines particularly to healthcare workers without doing a controlled
trial. Jeremy has been a self-promoter and in my mind a hypocritical advocate for fairness
in global health. He completely does not get the fact that if we widely distribute a vaccine
to a black African country we run the risk of never knowing if it works and possibly
having a paradoxical harmful effect similar to what we saw in the STEP trial of an HIV
vaccine where the trial looked good in phase 1 following good animal data and when we
went into a double-blind, placebo-controlled trial, we found out that the people who
received the vaccine had a 41% greater chance of getting infected with HIV. If the same
happened with Ebola this would be a catastrophe. Yet the WHO, mostly in the form of
Marie-Paule Kieny, are acting in an extraordinarily unscientific way, even going so far as
to say that a randomized controlled trial is unethical. In fact, we feel that a wide
distribution of an unproven and potentially harmful vaccine would in fact be unethical. In
addition, they want to give it to the healthcare workers on open access and then possibly
do a randomized controlled trial on the rest of the people at  risk such as family members.
I cannot imagine how they do not realize that this in and of itself is unethical and violates
ethical equipoise. There is a big struggle going on with the USA led by Cliff Lane the
FDA, and Glaxo Smith Kline to be able to do a randomized controlled trial to as quickly
as possible determine efficacy so that we can ultimately distribute the vaccine to the
people who need it. WHO, who was been wrong on almost everything they have done
with this epidemic, is arguing that we really should distribute the vaccine according to
how they want to do it. We already have designed a phase 2/3 trial and it is ready to go.
We have buy-in from the Ministry of Health of Liberia. Glaxo Smith Kline is on board.
Yet WHO wants to be deeply involved in deciding how we do it vaccine trial. There is a
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390
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391
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392Oct. 24, 2014 - Today was an extraordinary day in the history of NIH. We discharged our
patient  via a densely attended press conference outside the north entrance of
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393the Clinical Research Center. It was a beautiful fall day, crisp air and 60° and sunny. At
12:30 PM, I walked out of the Clinical Center with my arm around and
accompanied by her sister Kathy and her mother Diana. Also, accompanying us was Dr.
Francis Collins, Dr. Cliff Lane, Dr. Richard Davey, and the nurses and technicians from
the Special Clinical Studies Unit of the NIH Clinical Center. Francis introduced me and I
announced to the world that was Ebola free. I gave a shout-out to the physicians and
nurses at Texas Presbyterian for taking such good care of her while she was there patient,
and I thanked our own staff of doctors and nurses for also taking extraordinary care of
I have come to become very fond of as she is such a sweet human being who
was so brave in taking care of the patient with a deadly disease caused by an infection she
contracted while taking care of him ( ). Over the past couple of days
while she was in the Unit, we would talk a lot about how she wants to exit the hospital
and she finally decided that she would give a very brief statement that we would help her
craft. She would give her own ideas and we would  put it in prose for her. It worked out
very well. They were in essence her own words and they were heartfelt. As I called her
up to the podium, I gave her a warm embrace in front of all the cameras. This embrace
was ultimately on the front page of the Washington Post the next day (Saturday, Oct. 25),
and on hundreds of newspapers, blogs, and Tweets and other social media.   It went
completely “viral”.    In addition, she gave me a ribbon of the colors of the nursing school
from which she graduated, Texas Christian University School of Nursing. And so I gave
a shout out to all the nurses of the world  as personified by the nurses at Texas Christian.
I answered a bunch of questions from the press after the press conference.
And then following the press conference something extraordinary also happened.
President Obama invited , and I(together with
Rick Davey and Cliff Lane) to the White House for a photo shoot as well as to talk and
chat with the President. The President was charming as usual, and gave her a public hug
in front of his photographers. We met for several minutes in the Oval Office with the
President and Sylvia Burwell.  Then Ronny Jackson, the President's physician showed us
around the White House and gave us a tour of the medical clinics in the White House.
The White House transportation group picked us up at the Clinical Center, drove us to the
White House, and then drove  her mother, his sister to a private plane in Baltimore
which flew her to her mother's home in Fort Worth, TX. It was a bittersweet goodbye
since we have become so fond of her and her family. I gave  and her family my
contact information including my cell phone number and told her to make sure if there
was any issues that they want to talk to me about that I am available to them 24 hours a
day.
I returned to the NIH completely exhausted but ready to get back to work of crafting
policies related to the emerging situation with healthcare workers returning from West
Africa infected as did Craig Spencer last night.
Oct. 25, 2014 -  An important meeting today Situation Room of White House. We
discussed the topic of what the movement and monitoring protocol would be for the
United States Government regarding HCWs who are returning from service in the 3
African countries. . The CDC has been changing their guide old journals and in a 27 June
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394two lines trying to keep up with the evolving situation. I heard from the White House and
Sylvia Burwell that the White House and Sylvia herself were very keen on my being at
the meeting at the White House in order to help develop a coherent policy. This was in
gun just a wallpapers response to the fact that , a Doctors Without
Borders emergency medicine physician working in Guinea had come back to New York
and was self-monitoring for symptoms and fever according the MSF protocol. This is the
ongoing protocol if someone at low but nonzero risk for infection returns to their country
of origin after serving in West Africa taking care of Ebola patient. However since there
were previous infections in the Ebola treatment unit where he worked, the evolving
guidelines put him in the category of a high risk person. Nonetheless, he was following
the doctors without Borders protocol which means that when you come back to your
country of origin after being in a West African country you should monitor yourself with
fever and symptoms and if you develop a fever call MSF and then report yourself to state
health authorities. As it turned out,  felt fatigued the previous day but
nonetheless went out for a run. The following day as mentioned above he took several
New York City subway rides to Brooklyn where he bowled and then went back and ate at
a restaurant in Manhattan. The next day he developed a fever of 103 F.  Technically he is
a for you you just tell me and I can't go to a and the same thing you stop. Exposed 2
friends at the bowling alley and the Uber driver who drove him back to his apartment in
Harlem. . Once he got a fever, proper protocol of hazmat transportation to Bellevue took
place as mentioned above. However, because of the concern about risk to New Yorkers
and people from New Jersey, Gov. Christie of New Jersey and Gov. Cuomo of New York
State surprised and shocked the New York City public health authorities as well as the
CDC and the US government (including President Obama) by declaring an absolute
quarantine on all healthcare workers coming back to the United States through New York
or Newark airports who had any contact with an Ebola patient. They either did not think
this out fully or it was a pure political move. This violates all of the principles that
indicate that people without symptoms are clearly not of danger or inffectious to others.
This is becoming a political issue without a doubt since both Governors Christie and
Cuomo are up for reelection and there is an outcry that we are worried too much about
people's rights than we are about the safety of the public. However, as I have had to
emphasize multiple times in the Press the danger of transmitting from an infected but
asymptomatic individual is vanishingly small. However the President asked Lisa Monaco
and Chief of Staff Denis McDonough to hold a principals policy committee meeting to
sort out what kind of response we should have to this declaration of quarantining by the
governors. This was a very important meeting for me to be at since it is very clear that we
need to do more than just passive monitoring since there needs to be some clinical
judgment and whether or HCWs, as well-meaning as they are, should actually leave their
apartment and enter into public transportation such as subway, bus or even airplane.
And so the PC meeting was held in the Situation Room at 2:30 PM on a beautiful crisp
fall day. At the meeting besides me and Tom Frieden by video from Atlanta, Chief of
Staff Denis McDonough, John Podesta, Gayle Smith, Leslie Dach, Sylvia Burwell, Susan
Rice, Defense Secretary Chuck Hagel, Ron Klain, USAID administrator Rajiv Shah,
Attyorney General Eric Holder, Amb. Samantha Power, DHS Sec. Jeh Johnson, Amb.
Powell from the Department of State, Presidential Counsel Eggleston, Valerie Jarrett,
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395Larry Kerr, among others. The discussions centered around modifying the guidelines for
monitoring and movement of returning health care providers who have served in West
African countries. The CDC continues to be shakey. They in my mind are not definitive
or clear enough with their guidelines. However, at the meeting,we at least decided that
we would have to scale up from passive monitoring to active monitor and in many cases
ultimately to direct monitoring.  The definitions of these are as follows: passive
monitoring - you take your temperature and evaluate your symptoms and do not tell
anyone unless there is a problem; active monitoring - you do the same as passive but you
tell someone; direct active monitoring is when you have someone else visit you at least
once a day and folow-up with a phone call, take your temperature evaluate your
symptoms and make a determination has to the degree of restriction that you might have
on a daily basis.  In this way, you have a repetitive clinical judgment concering restriction
as opposed to a broad sweeping quarantine for evryone.  We all decided that we need to
point out that healthcare workers are heroes and that if we in fact quarantine them
indiscriminately regardless of their stratification of risk that we would clearly
disincentivize them for wanting to volunteer as well as stigmatize them, which is already
occurring anyway.
 The White House has decided that I will be the face of the administration in explaining
this to the public and have now put me out today (Sunday) on all five major Sunday
morning shows. This includes ABC This Week (Martha Raddatz), CBS Face the Nation
(Charlie Rose), Fox News with Chris Wallace, CNN State of the Union with Candy
Crowley, and Meet the Press ( Chuck Todd). It is interesting and ironic after all of the
aggravation I have received from media people that I am now their hero and they want
me out there. This includes Jen Palmieri the head of White House communications,
Andrea Purse the director of media broadcast of the White House, and this gets translated
now down to the HHS level. There is still a lingering distrust by the public in the
government largely because of the missteps and lack of firm, definitive, clear, concise
and understandable guidelines of the CDC. I feel very badly for Tom Frieden since he is
an extraordinarily fine person and an outstanding public health official. However I
believe that his staff does not serve him well and the White House and HHS are now
giving me the extra burden of having to check their documents which makes it very
difficult since I have a lot of work to do and I am getting quite exhausted by all of this.
Oct. 26, 2014 - Today I did all five of the Sunday morning TV shows. As indicated
above this is referred to as the "Full Ginsburg" related to the fact Ginsburg, the
lawyer/family friend for Monica Lewinsky at the time that she blew the whistle on
President Clinton related to the now famous sex scandal appeared on all 5 Sunday TV
shows. I did this last week.   Since I had done a "Full Ginsburg" last week several of the
producers of the TV shows told me that this is the first time in their memory that any
individual has done all five TV shows for two weeks in a row. And so they are now
referring to this as a "Full Fauci". The shows went very well;  however, it became clear
that I was at odds with what Gov. Christie and Gov. Cuomo had done two days ago by
initiating a full quarantine for flights into New Jersey and New York. On each of the
shows I articulated two fundamental principles: 1) the safety of the American people
comes first and is the major goal; 2) all of our policy decisions relating monitoring
Released by Chairman Rand Paul
396movement and restrictions should be based on sound scientific principles and scientific
evidence. I reiterated that all scientific data show that a person who is without symptoms
does not transmit Ebola and that one must come into contact with bodily fluids of a
person who is sick with Ebola in order to contract people. Therefore, the principles
leading to a broad general quarantine for returning health care workers is deeply flawed.
Immediately following the shows, other shows and blogs and tweets pitted me against
Christie and Cuomo. In my discussions on the five TV shows, I did not criticize them. I
mentioned that I understood why they may feel that this is the best way to go; however, I
mentioned that if they had asked my advice I would have told them not to institute a
broad sweeping quarantine. I am being praised by people who are standing up for
scientific evidence and data and I'm getting hate mail from people who feel I am trying to
protect Obama. I am listing below cuts and pastes from a couple of representative e-mails
that I have received:
-----------------------------------------------------
From: M G <libssuckitraw@yahoo.com>
Doctor,
As you parrot the bullshit that came out of The Obomination, it makes you sound like a
moron.
No quarantining these infected boobs because it might hamper them volunteering? Are
you fucking serious? Do you KNOW how STUPID that sounded?
Yeah, we should just let them walk around, coughing, spewing,. sweating, touching other
people until we have a serious Ebola outbreak in the USA! If pray that if Ebola DOES
break out in the USA that somehow it only attacks dumbass liberals like you and removes
you from your misery. Idiot.
No wonder you're a member of Ovomit's Kakistocracy.
------------------------------------------------------------------
From: Unarmed Civilian <wes_t-one1@outlook.com>
Where did you get your degree from North Korea? You love Africa and Ebola so much
you go there. And don't come back. NO QUARANTINES....its the answer you'd expect
from a government agency whose greatest accomplishments are in the areas of corruption
and incompetence.
Does half of America have to come down with Ebola and be standing there bleeding from
there eyes before the EXPERTS know they are wrong.
Fuck you and Fuck your Opinions. Go take your expertise somewhere else.
LD
-----------------------------------------------------------------------
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397It is really rather disturbing that people feel so strongly about this, with all the undertones
of racism and what clearly is  Hate for president Obama.
During the times between shows, I exchanged e-mails with  checking on how
she was doing.   Below are some of those e-mails:
From Sunday, 26 Oct., 2014 at 10:41 AM:
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398I just saw you on Meet the Press! You did so great :) I will definitely keep you posted
with everything.
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401Following the five TV shows I was invited to a meeting in the Situation Room with
President Obama and senior cabinet officials and other staff.   The attendees at the
meeting were:
From: Esquivel, Hilda V. [<mailto:Hilda_V._Esquivel@nsc.eop.gov>]
Sent: Saturday, October 25, 2014 03:58 PM
To: DL-NSS_ExecSec_Coordination <DL-NSS_ExecSec_Coordination@nsc.eop.gov
<mailto:DL-NSS_ExecSec_Coordination@nsc.eop.gov>>
Subject: INVITATION: HSC Meeting on SUNDAY, 10/26, 12:30 - 1:30 p.m.

A Homeland Security Council meeting on Ebola Response with the President has been
scheduled for Sunday, October 26, 2014, from 12:30 - 1:30 p.m. in the White House
Situation Room.  The following are invited to attend.  Please confirm attendance to DL-
NSS_ExecSec_Coordination@nss.eop.gov <mailto:DL-
NSS_ExecSec_Coordination@nss.eop.gov> as soon as possible.  If you have any
questions, you may reach our office at  (202) 456-9461.
Thank you.
•         The Vice President
•         John Kerry, Secretary of State
•         Jack Lew, Secretary of the Treasury
•         Chuck Hagel, Secretary of Defense
•         Eric Holder, Attorney General
•         Sylvia Burwell, Secretary of Health and Human Service +1 (Leslie Dach, Senior
Counselor)
+CDC:  Thomas Frieden, Director of the Center for Disease Control and Prevention
+NIH:  Anthony Fauci, Director of the National Institute of Allergy and Infectious
Disease
•         Jeh Johnson, Secretary of Homeland Secretary
•         Denis McDonough, Assistant to the President and Chief of Staff
•         Shaun Donovan, Director of the Office of Management and Budget
•         Amb. Samantha Power, Representative of the United States of America to the United
Nations
•         Valerie Jarrett, Senior Advisor and Assistant to the President for Intergovernmental
Affairs and Public Engagement
•         John Podesta, Counselor to the President
•         Susan Rice, Assistant to the President for National Security Affairs
•         Neil Eggleston, Assistant to the President and Counsel to the President
•         John Holdren, Assistant to the President for Science and Technology and Director of
Science and Technology Policy
•         Antony Blinken, Assistant to the President and Deputy National Security Advisor
•         Lisa Monaco, Assistant to the President for Homeland Security and Counterterrorism
•         Benjamin Rhodes, Assistant to the President and Deputy National Security Advisor
for Strategic Communications and Speechwriting
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402•         Katie Fallon, Assistant to the President and Director of the Office of Legislative
Affairs
•         Jennifer Palmieri, Assistant to the President and Director of Communications
•         Rajiv Shah, Administrator of the U.S. Agency for International Development
•         Suzanne George, Deputy Assistant to the President and Executive Secretary and
Chief of Staff of the National Security Council
•         Rand Beers, Deputy Assistant to the President and Deputy Homeland Security
Advisor
•         Ron Klain, Ebola Response Coordinator
•         Amy Pope, Special Assistant to the President and Senior Director for Energy and
Climate Change
•         Gayle Smith, Special Assistant to the President and Senior Director for Development
and Democracy
•         Caroline Tess, Special Assistant to the President and Senior Director for Legislative
Affairs
•         Corey Gruber, Senior Director for Preparedness Policy
•         Edward ‘Ned” Price, Assistant Press Secretary for National Security Affairs
•         Larry Kerr, Director for Medical Preparedness and Policy Rajiv Shah, Administrator
of the U.S. Agency for International Development
The discussion centered around developing a policy of direct, active monitoring to
preserve the scientific principles as well as to avoid the issue of a broad quarantine that
had been initiated by Christie and Cuomo as indicated above. There was a two and one
half-hour discussion at a meeting that was supposed to take one hour. When the President
first came in he appeared extremely tired and somewhat detached. However, he quickly
perked up and got involved in discussion. There was some disagreement around the room
with Jeh Johnson of DHS feeling uncomfortable with just a direct, active monitoring
since he felt that there would soon be many more healthcare workers entering the country
and the social issues of public fear and concern would not be satisfied by just a direct
active monitoring. Chuck Hagel has already indicated that returning military personnel
from West Africa would be confined to barracks for 21 days following return from West
Africa. However this is a much different story than civilians since military have the
capability of easily confining personnel to barracks and providing them with all the
necessary comforts and not demeaning them or stigmatizing them. I articulated several
times, and the P resident referred to me and asked me questions multiple times regarding
my recommendation that a direct active monitoring guided by matching the stratified risk
experienced by the healthcare worker to a stratified stringency of restriction we could
functionally accomplish the same thing as a broad quarantine for everyone. The president
agreed mostly with what I said but he felt we should go a little bit further and encourage
the healthcare workers to restrict themselves to some degree even if technically they were
cleared to move around. Samantha Power was connected to the meeting by
teleconference from Guinea where she had just landed. She mentioned that the West
Africans there were very concerned about a possible quarantine.   We had been with her
the day before at the prior PC meeting. Again, Tom Frieden was relatively reserved
during the discussion; however, it was tough since he was connected by teleconference.
The final decision which has not yet been implemented since it awaits a document from
Released by Chairman Rand Paul
403the CDC that hopefully would state that  the clinical judgment of the monitor would
decide on a day by day basis what the restrictions of the healthcare worker would be. We
want to make sure that an overly strict health official would not just say no to everything
that has to do with freedom of movement. In this regard, we suggested that we put down
some fundamental principles and guidelines which the public health official acting as the
direct monitor could use in his/her decision-making process.
The president commented towards the end of the discussion that we really need to have
some clarity to this and not keep chasing after things.   He bemoaned that over the past 3
weeks he has spent literally most of his time on this issue of Ebola and Ebola has killed
one person in the USA, at the same time that he is dealing with ISIS, Iran, Ferguson
shooting, ACA, border children and just 2 days ago (Friday) a deranged high school
student in Washington State killed 2 fellow students, wounded several others and then
shot himself.   And so the POTUS was quite frustrated in his classically “calm” way
Hopefully, we can get some crisp guidelines out soon. I continued to get a lot of hate mail
related to the position that I articulated on the TV shows. After the White House meeting
I went on a power walk with Christine had something to eat, and am now trying to catch
up on the pounds of work and hundreds of e-mails that have piled up.
On another issue, Marie-Paule Kieny and WHO are up to mischief again and trying to
take over, or at least greatly influence the conduct of the randomized controlled trial for
Ebola vaccine that Cliff has put together. It is truly extraordinary. First they said that such
a trial was unethical. Now that we have agreement on the part of many parties including
the companies as well as the Ministry of Health of Liberia, the WHO wants to butt in
again and be involved in the design of the trial. I will have to get Sylvia Burwell involved
in trying to block this egregious interference in an area which they have no expertise.
They can always play their trump card and say with self-righteousness that they are only
interested in the well-being and safety of Africans. However, we all know that that is not
their motivation. They have been trying to block this trial and they have not been
successful. Here again they want to insert themselves now that the trial is almost on its
way. Cliff and I and Peggy Hamburg will likely seek Sylvia Burwell's help in getting to
Margaret Chan, Dir. Gen. of WHO, to have her tell the WHO people to back off.
Oct. 27, 2014 – Furor against Governors’ decision on quarantine.   I am in the eye of the
storm due to my 5 appearances on Sunday TV giving scientific reasons against blanket
quarantine.   2 days ag, nurse  returned to Newark from West Africa after
taking care of Ebola patients.  She got caught in the quarantine issue and was put in an
old hospital tent in New Jersey and (as she says) was treated like a criminal/prisoner.
Officials at airport initially thought that she had fever since they did a skin tem while she
was flushed.   Turned out she had no fever and ultimately tested negative.   Christie
looking real bad on this one.   She is playing it out by suing and being very vocal that her
human rights were violated.   Ultimately, she was let go to drive to Maine to see her
boyfriend.
    Cuomo now backing off a bit and leaning towards direct, active monitoring. CDC
revising M and M document.  Tom and I want the “direct” part of the monitoring to be
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404able to be done by Skype or Face Time.   However, Ron Klain thinks that the POTUS and
Jeh Johnson want actual physical presence of monitor (health official, nurse, etc.).
Trying to reconcile.
Had important conversation with Jen Cohn of MSF Switzerland who kindly got on a
teleconference reps from MSF of many countries (Brussels, Paris, Geneva) to discuss the
RCT Ebola vaccine trial that Cliff is actively planning to start in Monrovia in December
following completion of the Phase 1 trial that started in Maryland in Sept. (ChAd3) and
Oct (VSV).   Looks like MSF wants to be helpful.   They are asking good questions about
supply for post-trial distribution, etc.   They seem to not be against an RCT.
CDC came out with new interim guidelines for Monitoring and Movement of people
(including HCWs) returning from West African Ebola countries.   Now based a lot on
what I and Tom have been articulating at the recent White House meetings.   First
stratification of risks to the person; and then matching the risk to the degree of
monitoring and then using clinical judgment when needed to determine level of
restriction.   All based on knowledge of how virus is spread.   Risks:  high, some, low but
not zero.  Monitoring: passive – take your own temperature and sxs and no need to
actively tell anyone; active – take your own temp and sxs and report to a health official;
direct, active – someone else takes your temp at least 1x per day and evaluates sxs and
then makes clinical judgment as to your restriction on a daily basis
Immediately following their release of guidance and the press briefing by Tom Frieden,
the White House put my out on all the evening TV shows that were either taped or live
from studio in Building 10:  PBS NewsHour; CNN Situation Room; ABC, CBS, and
NBC Evening News.
Oct. 28, 2014  - The political issues are heating up around Ebola with the elections only 1
week away. Gov. Christie is standing firm in saying that the US government, particularly
the CDC, are playing catch-up with Ebola and that his initiation of a quarantine for 21
days for healthcare workers and other travelers returning from West Africa is the way to
go. I have been on multiple television programs specifically indicating that I respect the
opinion of the governors and that I understand that they are trying in good faith to do the
best for their constituents. However, several TV commentators have now pitted me
against Gov. Christie, feeding him with somewhat out-of-context quotes from TV
interviews indicating that I am directly challenging him as being unscientific. He is
lashing back saying that I am just defending the administration. He sometimes mixes me
up with CDC. However, he has mentioned me by name several times in discussions on
TV interviews. I am very concerned about this politicizing of an important global health
problem. I was on Good Morning America with George Stephanopoulos, CNN with
Sanjay Gupta, and MSNBC with Morning Joe early this morning. In fact the ABC
producer came all the way into the NIH to make sure that the interview with George
Stephanopoulos went well. Immediately after I appeared on GMA, Gov. Christie
appeared and Matt Lauer was instigating him telling him that scientists like me was
saying that he "got it wrong on" thus instigating Christie to lash back at the scientific and
public health community including me. This is really a very unfortunate evolution of
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405events since as has always been the case, I stay out of politics and try to just do the right
thing for public health.
I appeared via Skype on the Diane Rehm Show this AM and made it clear that I was not
criticizing Christie.
The POTUS made a brief speech in front of Marine 1 as he was about to take off re-
affirming what I said on Sunday TV (without invoking my name) that we are driven by
science and not by fear and so there is no reason to do a blanket quarantine on all
returning HCWs since they are heroes and we do not want to discourage them from
volunteering.
Ben Bradlee died at age 93 a few days ago and I have been invited to the service at
National Cathedral and to the family reception at Ben and Sally Quinn’s home in
Georgetown.   However, with the Ebola AM calls and the fact that I have to be at the WH
later for the POTUS greeting and honoring the HCWs (see below), I cannot make the
service.   Too bad.   I really liked Ben.
I am completely exhausted now and I have hundreds and hundreds of e-mails to catch up
on. It feels like I'll never catch up since the White House, the department, and the media
are making extraordinary demands on me. The White House has decided because of my
ability to be quick on my feet and articulate a clear and concise message in front of the
TV camera that they are putting me out on TV for virtually every issue that comes up
regarding Ebola. What a change of pace from just a short while ago when for one reason
or another HHS and/or the White House never approved any big TV for me. Now they
actually set  up shows and have Andrea Purse working closely with me. Such is life.

The POTUS came out today and reiterated the reasons (my reasons) for following the
science and not having a quarantine for returning HCWs.   Typically, HHS shut me down
on the many requests for TV appearances for me since they never let anyone out there
when the POTUS speaks.   Believe it or not, I am glad since I am exhausted.
Today and yesterday, there have been a considerable number of false alarms with people
from West Africa (just arriving) having fever, vomiting, etc. and getting worked up only
to have any of a number of other diseases from malaria to rhinovirus.
Still getting much hate mail!
Got e-mail from Andrea Purse asking about the safety of returned HCWs  from West
Africa (USA people) who have been invited to the WH tomorrow to be congratulated by
the POTUS (with handshakes).  Some came back less than 21 days ago and so they
wanted to be sure it was OK.   Cannot violate our own principles, but people are
somewhat nervous.   I looked at list and said it was OK.   Then Sylvia Burwell called me
up and wanted me to speak with Ronny Jackson to make sure that Ronny asks them if
they were in high risk category.
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406Oct. 29, 2014 - Eventful day today with another visit to the White House and once again
meeting with the President. The President wanted to show his support for health care
workers who have returned from West Africa, those who will be going soon to West
Africa, and the NIH nurses and doctors who had taken care of  There were
several events. At approximately 3 PM the president met in the Green Room with Kent
Brantly, myself, and a group of healthcare workers including Dan Chertow from NIH
who had returned from Liberia about 1 month ago, people from Hopkins, people from
Samaritan's purse, as well as three NIH nurses – Glory Inwang, and Anitra Fitzgerald-
Monroe, and Kimberly Jeffries. He congratulated everyone, took individual pictures with
each of us and then went into the East Room where he was introduced by Brantly and
gave a compassionate speech on how healthcare workers were heroes, and how we
should treat them with respect and how we should monitor and allow them to move about
according to principles consistent with the scientific data. This was obviously a
reiteration of what he had said before and what I have been saying continually on
national TV. However, it was clearly also a thinly veiled jab at Gov. Christie who has
instituted the quarantine of returning health care workers in New Jersey. Following the
ceremony I adjourned to the Roosevelt Room with Raj Shah, Sylvia Burwell, Gayle
Smith, and Ron Klain, to meet with the cohort of healthcare workers for the purpose of
learning from them about their experiences in getting suggestions from them about how
to improve our effort in response to the Ebola epidemic in Africa and at home.
I had interesting discussions with .   He told me that there was no way the he
got infected while in the ETUs treating Ebola patients since he was completely covered
with PPEs, he is experienced and there were no breaches.   He believes that he got
infected when he was called to the ER to see a potential Ebola patient (woman).   He was
dressed in “contact” dress (not full PPE) but he did not touch the patient and called for a
nurse to admit the patient since she clearly had Ebola.   Accompanying the woman was
her adolescent daughter who was crying and very upset that her mother was sick.
took the girl outside to comfort her.   He took off his gloves so as not to contaminate the
girl and put his arm around her shoulder.   When he looked at her, it became clear that
she was likely also sick.  She ultimately ran away and was never documented to have
Ebola, but  feels that this was the likely incident that go him infected, i.e. touching
without gloves an Ebola patient.   He did not fully realize this until he later reflected on
that incident in the ER.
After that I came back to the NIH and I practiced putting on personal protective
equipment with Rick Davey. The purpose of the practice was because we are hosting a
group of TV doctors tomorrow brought to the NIH by the White House to demonstrate to
them our Special Clinical Studies Unit and how we Don and Doff our PPE's. It should be
a good day tomorrow.
Oct. 30, 2014 – Started the day with a 6:40 AM interview on WTOP. Another interesting
day today. I was a panelist at the  Washington Ideas Forum sponsored by The Atlantic
magazine that took place at the Harmon Center for the Performing Arts on F and 6th
Street, N.W.  I was interviewed on stage by David Brooks, well-known columnist for the
New York Times. The panel was broadcast live on C-SPAN as well as streamed online
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407on their website. Of the people involved in this forum were Secretary of State John
Kerry, Chris Matthews of NBC, and a large number of other notables.
After that I went back to the NIH and hosted a whole group of network producers with
full camera TV coverage on the process of donning and doffing for personal protective
equipment. I demonstrated to them what we do in the process of taking care of patients
with Ebola, in this case specifically  Following the demonstration which was
done by nurse specialist Kevin Barrett and hospital epidemiologist Tara Palmore, I did a
long series of TV interviews with the cameras that were there during my step-by-step
demonstration of the donning and doffing.   Clips appeared on a variety of news outlets.
An extraordinary situation occurred last night in which the state of Louisiana made an
announcement that certain scientists and others who were planning to attend the annual
meeting of the American Society of Tropical Medicine and Hygiene during the first week
of November in New Orleans would not be allowed to attend the meeting. In essence they
said that these people need to be quarantined if they came from a West African country or
if they had taken care of the patient with Ebola within the last 21 days. This is an
extension of the quarantine craziness that was started by Governors Christie and Cuomo.
In essence, they are barring scientists from a meeting where their expertise and
experience is most needed.
Finally, I have been informed that I have been named in the civil action lawsuit against
Pres. Obama, me, Thomas Friedman, Secretary Burwell, and DHH Secretary Jeh Johnson
for promoting terrorism and discrimination. They are accusing us of colluding with
president Obama who is a Muslim citizen of Kenya and trying to destroy African
countries by introducing Ebola into society. You just cannot make this stuff up.
Received a note today (dated Oct. 16, 2014) from Hilary Rodham Clinton  saying that
she was thinking of me and cheering me on saying that “The American people are
fortunate to have your leadership at NIH as we face the challenge of Ebola”.
Oct. 31, 2014 – Jeff Drazen, Editor of NEJM, contacted me to put him in touch with
some of the trusted AIDS activists with whom I have worked over the years to get them
to write a piece in the NEJM on the similarities between the stigma of HIV/AIDS and the
current “stigma” against HCWs (regarding the quarantine discussed above).   I pointed
him to Peter Staley and Gregg Gonsalves and they are willing to do this.
Kaci  Hickox  still defying orders from the Governor of Maine to remain in quarantine.
A court judge upheld her right to not be quarantined.   I did an interview for yahoo.com
and refused to get into the battle between Kaci and the State of Maine.
HHS does not want me to do TV since the news is focused on Kaci and it would be better
for me not to get into that battle.
Nov. 1, 2014 – Things calming down.   Reports of decreased infections in Liberia,
particularly Monrovia.   Not sure if this is real or if the infections are now occurring in
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408remote areas without good reporting.   Also, the issue of second waves in Guinea and
Sierra Leone.   CDC having to put much effort into investigating Person Under
Investigation (PUIs).   These are people who are from West Africa who get a fever or
nausea or vomiting for any of a number of benign reasons.   Since they are from West
Africa, these are being investigated, sometimes using PPEs, which is an “abundance of
caution”, but a major investment (?waste) of effort.
Cliff Lane is in Monrovia doing spade work for the hopefully upcoming RCT for the
Ebola vaccine.
Heard on Secretary’s call this AM (8:30 AM on Saturday) that now WHO (likely Marie-
Paule Kieny) wants WHO to be responsible for the DSMBs of all clinical trials in West
Africa.   This is an egregious attempt on the part of WHO to stay “relevant” in an area in
which they have no expertise.   It is “stunning” to me how they just want to insert
themselves into things where they quite frankly are incompetent.  They already have
made it clear that they just want to distribute unproven interventions (vaccines and
treatments) and even though we seem to be winning the argument, they keep coming
back in insidious ways to try to derail the scientific clinical trials process.   Amazing!!
Nov. 2, 2014 – Quiet Sunday.   Trying to catch up on piles on my desk.  Election on
Tuesday.   Concern that the GOP will take the Senate, which means Obama is in trouble
with both House and Senate in GOP control.
Despite reports that the number of cases in Liberia are decreasing rapidly, new reports
today indicate that the cases in Sierra Leone are sharply increasing.   I have warned that
Ebola comes in waves and that we should not be complacent and the WH should refrain
from saying that things are “turning around”.
Nov. 3, 2014 – Ron Klain visited NIH today (He had visited CDC last week).   He
wanted to familiarize himself with what the various components of government were
doing in Ebola.   I made a presentation to him in the VRC, showed him the lab where
Nancy Sullivan works and where she developed the ChAd3 Ebola vaccine.   Then we
took him over to the Clinical Center to see Julie Ledgerwood’s vaccine clinic where the
phase 1 trial took place.   Then we showed him the SCSU and the room where we took
care of    Ron was impressed and wants me to come to the WH on Friday to
give a shortened version of my presentation at a meeting where the POTUS is hosting
certain Congressional leaders.
Tom Frieden spontaneously called me up to thank me for being so supportive of him.   I
have been continually serving as a late night (by phone or e-mail) sounding board for him
in his attempts to negotiate his having to deal with some many factions (ASPR, HHS,
USAID, etc.)   Last night I helped him out by strongly suggesting that he not listen to the
modelers who tell him “exactly” how many news cases of Ebola to expect in the USA
over a period of time.   I warned him that the models are based on assumptions and
multiple variables and can be very misleading and he should not “own” data that comes
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409from models or else it will come back to bite him.   I urged him to totally resist such
predictions.   He was very grateful for my advice.
Nov. 4, 2014 – GOP takes control of the Senate in today’s elections.   Frenzy calming
down.   Little press interest – like shutting off the faucet.
Nov. 5, 2014 – Preparing for Hearings of the Senate Full Appropriations Committee
(Mikulski).   Tom Frieden and I will testify together with Sylvia Burwell.   POTUS
publicly requests $6.18 Billion in “emergency” funds for Ebola.   We will dwefend this at
Hearing on Nov. 12.
Nov. 6, 2014 – Still calm.  No Ebola Press.   Did Hearing prep by teleconference with
Sylvia.
Nov. 7-11, 2014 – Still calm.   Mostly  preparing for Senate Appropriations Hearing on
Nov. 12.   POTUS  asking for $6.18 Billion in emergency funding for Ebola (Domestic
and International).   NIH portion is $238 million.  Went to EEOB on Nov. 10 to rehearse
for Hearing with Ron Klain.

Nov. 11 – very good meeting in Building 10, 4th Floor Medical Board Room with clinical
investigators who took care of Ebola patients at Emory, Nebraska, NIH.   Also, DoD and
HHS present with presentation of individual clinical data from the USA patients.  It
became clear to me that it is impossible to determine if any of the experimental drugs
given to the patients (ZMapp, Brincidofovir, favipiravir, convalescent sera, TKM-Ebola)
helped or did harm (likely did some harm.   Decision was to develop a clinical protocol
for future USA patients and also to be used as prototype for Africa.   Protocol should be
RCt with standard medical care (fluid and electrolyte replacement) as the control arm.
The data also suggested to me that if you keep patients alive with medical care, that the
body’s immune system will almost always clear the virus (likely without experimental
drugs).
Nov. 12, 2014 – Successful Hearing today before the Full Senate Appropriations
Committee chaired by Barbara Mikulski with Richard Shelby as Ranking Minority.
Sylvia Burwell, Jeh Johnson (DHS), Michael Lumpkin (DoD), Heather Higginbottom
(DoS) testified and then accompanying witnesses went to the Table.   Tom Frieden and I
were the “accompanying” witnesses for Sylvia.   All went well. About 18-20 Senators
appeared.  Tom Harkin made a statement that this was his last official Hearing and he
wanted to specifically call me out as a great public servant with whom he has worked on
this committee for 30 years.   This elicited a round of applause from the audience.
Patrick Leahy also remarked that he has been working with me “forever”.   All-in-all, a
very good Hearing.
Nov. 13, 2014 – Difficult situation arising regarding the conduct of the Phase 2/3 trials of
Ebola vaccine in Liberia/Sierra Leone.   The companies (first GSK; now also J & J, who
do not even have a candidate ready) are balking at going ahead with the trials unless they
get “global indemnification”.   This is unprecedented to demand for a Phase 2/3 trial
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410since we (NIH) are the sponsors and we are liable.   Nonetheless, GSK feels that although
the PREP act would protect us and indirectly them, they feel that in international courts
GSK (even though they are not the sponsors of the trial) could be sued given the sensitive
nature of the situation (African countries, instability in the countries, brand new vaccine
platform for them –Cad3 vector -, accelerated development with questions regarding lot
consistency (because of the fast pace of development).  This would be terrible if the trials
are stalled because of this.   I have phone call today with Moncef Slaoui, Chairmen of
GSK for Global Vaccines.
Also, despite our conclusions from meeting on Nov. 11 (see above) the Oxford/Wellcome
Trust people are working with MSF to start “open label” trials with various therapeutics
without a control arm.   What the hell is going on here?   I am very disappointed in the
Brits, especially the Wellcome Trust and Oxford people who clearly are grandstanding.
Call with Moncef Slaoui went well.   Reasonable discussion.  I stated that the USG could
never give “global indemnification” since it would invite frivolous lawsuits.   Moncef felt
the same about our providing insurance for them since it would also invite lawsuits.   We
agreed upon some form of a process that provides for limited liability and cpas on
settlements.   I will follow-up with summary e-mail to Moncef with copy to Ron Klain
with who I spoke tonight and relayed to him the conversation with Moncef.   Ron is
flexible, but said that we cannot “guarantee” anything to Moncef, but we will proceed in
good faith to find a solution.
Nov. 15, 2014 –  Sierra Leone surgeon, resident of Maryland, green
card resident, married to US Citizen hospitalized at University of Nebraska having gotten
infected in Sierra Leone.  He is critically ill and may not survive.   He entered Nebraska
Hospital with Creatinine of 16, pH of 7.1 and K+ of 2.0.  NIH is thus up next for a
patient.
Nov. 17, 2014 –  dies at Nebraska Medical Center.
Nov. 19, 2014 - Today I testified before a  Congressional Hearing of the House
Committee on Commerce and Energy, Health Subcommittee chaired by Congressman
Pitts from Pennsylvania with Dr. Burgess of Texas as the vice chair, and Mr. Henry
Waxman of California as the ranking member. It was a lively hearing that went very well
but with some interesting sharp interchanges between me and Dr. Cassidy from
Louisiana. He is a physician who tried to show off about his medical knowledge in the
hearing; however, during the exchange it became clear that he really did not know what
he was talking about. In addition, Congressman Tim Murphy somewhat attacked me
saying that I have been condescending to people who question the issue of conmtrolled
trials with placebo limb, transmission, patient isolation and quarantine. I did not have the
opportunity to refute him; however, after he had left when Mr. Burgess who took over the
chair of the committee when Mr. Pitts left gave us the opportunity of a summary
statement, I question Mr. Murphy's characterization of me as being condescending and
clearly stated that our most important goal with interventions is to first do no harm and
then hopefully benefit people and although many individuals feel that this is insensitive,
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411in fact it is not insensitive, but is the time-honored way of determining the safety and
efficacy of interventions. In addition, after she had left I countered the somewhat snide
remark of Mrs. Blackburn who had also made a statement without giving me the
opportunity to respond. She said that we were negligent in not getting countermeasures
done quickly and that industry can do better than we can. I stated after she left that we
have been trying to get partnerships with industry for over 10 years in the development of
Ebola vaccines and that only recently were pharmaceutical companies willing to partner
with us.
All in all it was a very positive Hearing.
Nov. 20, 2014 – Did Newsmaker Luncheon talk at the National Press Club on Ebola.
Got much play in the printed press.   Things still calm regarding Ebola with attention
switching from the threat in the USA to background issues like the $6.18 billion request
from the POTUS (see above Senate Hearing).   Also, some increasing noise from
Congressman Tim Murphy (R-PA) regarding his pushing for the leaders of the 3 Ebola
hospitals (NIH, Emory, Nebraska) to quarantine for 21 days their staff that took care of
Ebola patients and not allow them to see other patient for 21 days.   We are all adamantly
against this and I have been the vocal one saying that we must stick with the science and
the CDC recommendation of stratification of risks to HCWs balanced by the stratification
of monitoring and restrictions.   Murphy is not happy with me.
Had dinner with Danny Hultzen and his father Chris.   Discussed the situation with his
shoulder injury.   He feels good and looks great.   I have a strong feeling that if his
shoulder holds out, he will make it to the MLB with the Seattle Mariners.
Nov. 25, 2014 – Did Webcast for Harvard School of Public Health on Ebola.  Panel
discussion with Barry Bloom and others.
NEJM paper to come out of Thursday (Thanksgiving) reporting on the results of the
phase 1 trial of the NIAID/GSK Ebola vaccine (Ledgerwood et al).  Embargoed until
Wednesday (Nov 26) at 5:00 PM.   And so press starting to get excited about it.
Thus, did CBS Evening News tape for Friday PM?  Also, Medscape Interview. And
plenty of embargoed print interviews.   As expected, the Brits (Wellcome Trust, Adrian
Hill from Oxford) are downplaying the study saying the required dose is too high and the
durability is low without a booster.  They are amazing.
Nov. 26, 2014 – Much press associated with the NEJM paper.   Did AP TV, BBC TV,
Cox TV, Bloomberg print, Reuters print, BBC radio and then later at night BBC TV
again.
POTUS comes out with White House statement congratulating “Francis Collins and Tony
Fauci and their teams….” On the successful phase 1 trial of an Ebola vaccine and
announces that he will visit NIH on Dec. 2 to congratulate the NIH teams and to
emphasize the need for the requested $6.18 billion supplemental for Ebola.
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412Nov. 27, 2014 (Thanksgiving) – Again, still interest in the NEJM paper.   Did BBC TV
via phone plus my photo, CNN International via phone plus my photo.  Also did
NewsHour with Judy Woodruff.   WETA picked me up with an Uber car and promised to
take me to the studio in Arlington, do interview, and get me back in time for
Thanksgiving visit and dinner at 4:00 PM at Joanne and Jim’s house.   They did it on
time.
Nov. 30, 2014 – Did CNN International discussing Ebola vaccine
Dec. 1, 2014 – World AIDS Day.   Went to White House and gave main lecture at the
WAD ceremonies in the South Court Auditorium.   My talk went over so well that they
started clapping at the final sequence of slides of the maps of USA and the world
becoming free of AIDS even before my talk ended.   Also speaking were Susan Rice,
Secretary of State John Kerry (shouted out to me), Secretary Burwell (many shout outs to
me), Gayle Smith (also praised me), Bishop Yvette Flunder (gave moving
sermon/speech).   Then panel with Debbie Birx, Mark Dybul, Greg Millett, Helene Gayle
– chaired by Sylvia Burwell.
Came back to NIH to do walk-through for the POTUS visit to NIH tomorrow.
Did CNN International and NPR Morning Edition radio with Scott Horsley.
Dec. 2, 2014 - Today was most extraordinary day. Began with a  presentation that I made
together with Debbie Birx (PEPFAR) at the Russell Senate office building.  We made a
dual presentation in celebration of world AIDS Day to a group of Senate and House
staffers. It went over very well. I rushed back to the NIH in time to do an interview with
Andrea Mitchell on MSNBC about the successful phase 1 Ebola vaccine trial conducted
here at NIH that was recently published in the New England Journal of Medicine. When I
got back to NIH we began the preparation for the 4:00 PM visit by Pres. Obama. It was
an extremely  successful visit. I led him on a tool of the Vaccine Research Center, gave
him a brief introduction of the history of the center, telling him the story about my
conversation with Pres. Clinton in December of 1996 when Clinton promised me that he
would have a vaccine center built for us on the NIH campus. Nancy Sullivan presented to
him on the 2nd Floor of the VRC her work on the development of an Ebola vaccine. We
then took him to the 5th floor where Mario Roederer showed him the intricacies of the
FACS machine.  The President was very relaxed, warm, and highly complementary of me
and the NIH. Following the tour of the VRC, I rode with the president in the presidential
limousine from the VR across campus to Building 10 where he addressed an overflow
crowd of the entire NIH community in Masur auditorium. He thanked me specifically
several times during the talk and he thanked various components of the NIH community
for their work on Ebola and other important diseases. He specifically gave a shout out to
the VRC people, the people who conducted the phase 1 trial, and to the nurses and staff
who took care of  in October.  During his talk to the NIH community, the
president gave me many compliments and shout outs. In particular he joked about how
had told me how to use FaceTime. In addition, he joked that "Tony and I were
findly reminiscing about SARS and H1N1". He then said after a big laugh "that's what
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413these guys do for fun".  The President mentioned my name multiple times during the talk.
It was a great day for NIH.
Following the visit, I rushed downtown to the Mellon Auditorium on 13th St. and
Constitution Avenue to participate in the dinner given by the Friends of the Global Fight,
chaired by Mike Gerson (Washington Post).  On the panel with me were Mark Dybul and
Deborah Birx. I ran into many people who I know and like at the dinner. These include
Peter Staley who I am very fond of from our many experiences over the years in the
activist days. Peter looked bright and alert but rather thin and drawn likely due to his
many years of being on antiretroviral therapy.   They showed a short clip of his icon
speech at the International AID Meeting in San Francisco in 1990 when he said that
someday people will speak of the deadly plague and how some stood up to confront it.   I
cry every time I hear that speech.   In 1990, I gave a speech at the meeting right after
Peter.  Former Sen. Chris Dodd gave me several shout outs about the work that I have
done over decades, calling me a national hero. Nancy Pelosi gave a talk in which he
mentioned several times our extraordinary relationship over the years in fighting HIV
AIDS.  All this praise was quite moving and gave me an added perspective about the
many years (decades) that I have been involved in this struggle.  All in all it was a great
evening.   The following day the story with my picture (with the POTUS, Nancy
Sullivan, and Sylvia Burwell) were in the Washington Post and New York Times as well
as on the Evening News programs.
Dec. 3, 2014 – At his request, went to the Rayburn Office Building office of Chairman
Timothy Murphy (R-PA).  Murphy was upset with me at a recent Hearing (see above)
when he said that I was making condescending statements about quarantine and why we
should not have quarantines.   He invited me down to his office to discuss further at a
10:00 AM meeting.  With him was Committee Staffer Alan Slobodin (of past outside
activity investigation fame) and Murphy’s Chief of Staff Susan Mosychuk and his
legislative Director Brad Grantz.   Murphy had also been giving Tom Frieden grief about
the same issue.   Meeting actually went well – cordial, respectful.   The underlying theme
was still the need in his mind for quarantining of all West African entrants to USA or
better restrict travel of West Africans (3 countires0 to USA and provide an “air bridge” to
bring in USA HCWs.   Also, he was concerned that with the latest proposal for 32
additional Ebola-ready hospitals in the USA that we should quarantine the USA HCWs
after seeing Ebola patients.  He was OK with just direct, active monitoring of the NIH,
Emory and Nebraska HCWs, but he felt that since the other 32 hospitals were less trained
and so would likely have a greater chance of getting infected, then they should be
quarantined since (as a former Clinical Psychologist) he feels that people deny sxs and so
he does not trust them.   He is against the part of the $6.18 billion supplemental request
for Ebola on the grounds that we do not needs all the additional hospitals (I actually do
not entirely disagree with him as I have expressed to our own people).   The meeting
ended cordially.
Dec. 4, 2014 – Gave Ebola talk at the new FDA facility in White Oak.   Quite a place!
Huge!   They loved the talk.   Also,  new infectious diseases issue.   The H3N2
component of the 2014-2015 influenza vaccine is mismatched to the early circulating
Released by Chairman Rand Paul
414strain of H3N2, which is predominant over H1N1 and B, the latter of which match the
vaccines.   The match for H3N2 is only 48%.   I was on WTOP explaining this.   Could
be a bad influenza winter.

December 5, 2014 - I participated with Ron Klain at a Georgetown University event
chaired by Pres. Jack DiGoia in Gaston Hall at the Healey Building. We discussed
various aspects of the Ebola outbreak. I have grown to become truly fond and respectful
of Ron Klain since he assumed the position as the Ebola Response Coordinator for the
USG. He will be leaving the USG employment and will return to his position as CEO of
Case Holdings and General Counsel for Revolution, L.C.
Also did some press with the London Times print and Bloomberg TV today.
Had a call with Jack Whitescarver. I am concerned with him since he does not appear
well. His hematocrit is low and he is short of breath. I believe he is having a slow
gastrointestinal bleed and is likely experiencing mild to moderate congestive heart
failure.
December 6, 2014  - I participated at the PRIM&R conference in Baltimore where I gave
the keynote address on ethical considerations in HIV/AIDS. This was on a Saturday
morning. Christine is a major player in this organization and spent the weekend there. I
drove to Baltimore on Friday night and had dinner with Chris at the Baltimore Hilton
Hotel Bar (lots of fun) and stayed with her in her hotel room that night. The following
morning (Sat. Dec. 6) gave my talk to an audience of around 2500 people and got a
standing ovation.
Drove back to DC and had dinner with Alec Whyte at Matisse restaurant.   Caught up on
stuff.   Always great to see Alec
December 8, 2014 -  I am getting particularly concerned with what I feel is noncollegial
behavior on the part of the UK, particularly Dame Sally Davies (Chief Health Officer of
UK) as well as the Oxford group personified by Adrian Hill and Jeremy Ferrar who are
bad mouthing our randomized controlled trial idea behind our backs. However, this is the
stuff that we deal with all the time.
 I am also getting concerned that the incidence of infection of Ebola in Liberia is so low
that this may have an issue with our conduct of the randomized controlled trial in Liberia.
Cliff will leave Dec. 10 for Liberia for the third time in 5 weeks. We have to consider the
possibility of doing a trial also in Sierra Leone.
Had contentious IC Director meeting concerning the issue of presenting reports (that I
believe are flawed) to the Advisory Committee to the Director (ACD) on the Intramural
research Program (IRP) and the AIDS Portfolio.   Issue is that some outside group (ACD)
want to homogenize the IRP to make it “trans-NIH” as opposed to being directed to the
mandate of the IC in question.   I am totally against this since this flies in the face of the
NIAID mandate of being a “strike force” for emerging IDs such as AIDS, SARS, and
Released by Chairman Rand Paul
415Ebola.   People like Eric Green (NHGRI) disagree with me.   I do not like or trust Eric as
I believe that he resents me because he is intimidated by my accomplishments and
notoriety.   That is life.  Also, the “elephant” in the room with the distribution of the
AIDS money by OAR that no one wants to address is that NIDA is spending about $180
million on drug abuse issues when ~7% of USA cases are drug abuse and one can stop
this with needle exchange.   I feel they should get some money, but not that much when
we do not have enough to conduct vaccine trials that could end the pandemic.
Dec. 9, 2014 – Participated in the The Atlantic STEM summit at GW (cold and rainy
day).   Was interviewed by my old media friend Frank Sesno (formerly of CNN and
NPR) who now heads the Public Affairs Institute at GW.   Nice crowd, good questions,
well-received.
Dec. 10, 2014 – Gave talk at Italian Embassy on Ebola followed by being interviewed by
Ted Koppel, my old buddy from “Night Line”.   Great interview.   Ted praised me as a
national hero.   Today “Time” magazine named the “Ebola HCWs” as “Persons of the
Year”   great choice as they put themselves in serious harm’s way.
Dec. 11, 2014 – Will receive new patient at SCSU.  nurse ftrom San
Francisco volunteering in Sierra Leone with NGO got needle stick injury taking care of
documented critically ill Ebola patient.   High risk exposure.  Flying in today.
Woods_MedEvacFile.
docx
Saw  this evening.  Donned and doffed just droplet precautions since she is
asymptomatic.   Showered out anyway.  is comfortable, received VSV post-exposure
prophylaxis.  Presented Ebola talk to ACD (Advisory Committee to the Director) of NIH.
Great reception.   Moncef Slaoui (GSK) is member of ACD and he was cordial and
agreed completely about the need for an RCT for Ebola Vaccine.   Ian Lipkin (also on
ACD) strongly felt against it and wants open access.   Am surprised at Ian since I thought
he was more of a scientist.   Note that he is not a clinical investigator; he is a good friend
of mine.   He is moved by all the suffering and death.
The Swiss Phase 1 trial on VSV has been put on hold due to 4 cases out of 39 of
“arthritis” (mild).   We have seen arthralgias and myalgias (expected) in our VSV trial at
the Clinical Center, but not arthritis even at 10x the dose of the Swiss study.  Puzzling….
Gave entrance interview with producer from CBS who wants to do a profile on me.
Dec. 12, 2014 – Went to White House today for meeting 1:45 PM to 3:00 PM in the
Roosevelt Room.   Crystal clear, crisp and cold December day.   Meeting was to review
the situation with the Ebola-ready hospitals and Assessment Hospitals in the USA and to
discuss the shifting of resources from Liberia (low infection rate now) to Sierra Leone
(rising infection rate).   Present at the meeting were:  POTUS, VP Biden, Lisa Monaco,
Released by Chairman Rand Paul

416Susan Rice, Denis McDonough, Ron Klain, Sylvia Burwell, Chairman, Joint Chiefs
Martin Dempsey, Tom Frieden by teleconference from Atlanta, Samantha Powers by
teleconference from NYC – UN, Assistant Secretary Heather Higginbottom from State,
Nancy Lindborg from USAID, Raj Shah – USAID.   Ron Klain asked me to review for
the POTUS the status of the vaccine plans as well as to explain the situation with the
VSV adverse event of arthritis (see above).   POTUS asked a few other questions of me.
He referred a few times to his trip to NIH.   Good meeting
Did WTOP today
December 12 – 14, 2014 – Cliff Lane has now gone to Liberia for the fourth time in
order to set the stage for the upcoming randomized, placebo controlled, double-blind,
clinical trial for the GSK/NIAID and the VSV vaccines. We are still getting nefarious
comments and undermining of our efforts by the people from the UK, particularly Jeremy
Farrar and Adrian Hill among others. They continue to inappropriately talk about the
inadequacy of our vaccine efforts even though they are working with the same vaccine. It
is unbelievable to me how nefarious they can be when the main goal should be to develop
a vaccine to save the lives of so many unfortunate people in the West African countries.
Nonetheless we will forge on and hopefully prove the safety and efficacy of this vaccine.
December 15, 2014 -  traveled to George Washington University to give a lecture for
Bopper Deyton’s course given at the Marvin Center at GW. It was an inspiring crowd of
first-year medical students who were very excited to hear from me about the history of
HIV and my involvement in it. That afternoon I participated by teleconference in an
Ebola meeting that took place at the IOM sponsored dually by the IOM and the
Rockefeller Foundation. The meeting was chaired by Secretary-General of the WHO, Dr.
Margaret Chan. Many players were there in person or by phone including Paul Farmer
from Liberia, as well as several Liberian and Sierra Leoneon and Guinean health
officials.  I presented the efforts in the development of vaccines and therapeutics
December 16, 2014. Participated in a panel discussion on Ebola vaccines and
therapeutics at the Center for Strategic and International Studies (CSIS) at 1616 Rhode
Island Ave. NW. The panel was chaired by Steve Morrison. Other panelists included
Julie Gerberding of Moncef Slaoui of GSK, Johan Von Hoof (Janssen and J & J), and
Rohit Malpani (MSF).   Good discussion about response to the epidemic.
 December 17, 2014 -  Feature article about me including a picture on the Federal Page
of the Washington Post. I gave credit in the article to many of the people involved in
Ebola effort. It is noteworthy that although I saved Tom Friedman's job by convincing
Sylvia Burwell not to fire him during the missteps by the CDC,  Time magazine included
Tom Friedman as one of the Persons of the Year in their “Ebola Fighters” issue. They did
not even mention my name once.   Years ago – Time did the same thing with making
David Ho “Man of the Year” and now this.  Such is life…
December 19, 2014 – The puzzle of why Adrian Hill (and Jeremy Farrar) have been bad-
mouthing the NIH/GSK approach of a high dose prime without the necessity of a boost.
Released by Chairman Rand Paul
418early years (1981-1984) when he was Director.   He was gay, but closeted.   KLarry
Kramer outted him and said that his closet status prevented him from asking for more
AIDS money.   I succeeded Richard and immediately asked for more money.
Jan 8, 2015 – Did a 1 hour interview of a prolife on me by Brian Lamb to show in 2
weeks on C-SPAN.
Jan. 15, 2015 – Number of cases very low in Liberia.   Surge in cases in Sierra leone
starting to come down.  Liberian vaccine trial getting ready to start at end of January,
beginning of February.   Cliff Lane in Liberia now.   I will go within a few weeks (likely
early February).
Received award today at the Willard Hotel of 2014 Washingtonian of the Year from
Washingtonian magazine.   Seven other winners including Gerry Sigal and Arch
Campbell.
To White House tomorrow to update the “Deputies” on the upcoming vaccine trials in
West Africa.
Over past week terrible tragedy of terrorism in Paris with Jihadists murdering 12 people
at the Charlie Hebdo satirical magazine offices.   Today another thwarted terrorist attempt
in Belgium.   Europe on high alert.
Jan. 16, 2016  - White House (EEOB – 374) meeting with Deputies chaired by Ron
Klain.   Subject matter was vaccine trials and if there is any change in approach now that
infections are so low, particularly in Liberia.   Also discussed indemnification, liability
and compensation for trials.  Also discussed the need (or not) for 46 hospitals to be
“ready” to receive Ebola patients (see above).   I have always been against this since, in
my mind, most of the hospitals that have volunteered to be “Ebola treatment Units” in the
USA are really after the government funds that go with it.   The Deputies group was
discussing reluctance to tell other hospitals that 46 is enough and we will not support any
more.   I made myself clear that we should just stop recruiting hospitals that we do not
need and that could likely not be able to handle an Ebola patient if they had to.
Also, met in the AM with Delegation from India (“Vijay) to discuss NIAID – India
collaborations, particularly the Vaccine Action program (VAP), which has been onging
for many years. and importantly, a delegation from Liberia and Sierra Leone.   The
deputy Minister of Sierra Leone (SL) is Dr. Madina Rahman.   She definitely “gets it”
about the advantage of a RCT and wants to have us conduct such a trial in SL.   This is
key, since SL is where all the infections are right now with very few in Liberia.   I will
hook her up with Cliff Lane who is on his way back to USA from Liberia.
Jan. 17, 2015 – Writer and photographer from Financial Times (of London)  came to my
home today (Saturday) to do story on personal aspects of me.
Jan. 20, 2015 – Visit to NIH of Chairman Tom Cole (R-OK) of the Appriopriations
Subcommittee.   Accompanied by Rosa DeLauro, Nita Lowy, Andy Harris , Dent,
Womack.   I presented work on universal flu vaccine, Ebola, Antimicrobila resistance.
Released by Chairman Rand Paul
420Jan. 29, 2015 – Here comes a sticky issue.   The CDC (Anne Schuchat) give press
conference updating on measles situation.   Today I got several requests to go on TV with
CNN (Anderson Cooper), Bloomberg, other networks such as CBS Morning Show.   Sara
Baldauf at HHS tells Patty and Courtney to hold on all TV appearances since “CDC has
the lead”.   Yet, I have been on multiple shows over the past couple of weeks on measles.
This idiot Sara is stuck on the Obama Administration theme that you can only have one
message and one Federal official talking about anything.    She does not understand that
the press want me.
Jan. 30, 2015 – Happens again.   Martha Raddatz wants me for ABC This Week on
Sunday and other Sunday shows.    She says no.   Courtney calls up and asks for an
explanation.   Sara says CDC has lead.   As usual, Courtney says but the Shows are
asking specifically for Tony and there was an agreement between Francis Collins and Bill
Corr that when networks and cable ask for me they can get me.   Sara says she does not
know anything about this agreement. Sara also says, I am not really saying no to Dr.
Fauci, I am just saying that you should give it to CDC.   Courtney insists that “You are in
fact saying no to Dr. Fauci”.
I must include in my book this unbelievable controlling theme for the Press of the HHS
and Obama Administration.   They would rather have a jerk out there than violate their
inexplicable rule of various lanes for various topics.   Truly a bunch of assholes.
Jan. 31 – Feb. 1, 2015 – Francis Collins sent an e-mail to Sylvia Burwell explaining the
situation with ASPA and my media appearances.   Sylvia says that she will ask Leslie to
take care of it and that there should not be any restrictions on me.   However, over the
weekend, approval for several requests for me are delayed making it very inconvenient
for Patty Conrad to arrange them, and some requests are denied.   Also, Sarah Baldauf
now sends me talking points on things that are actually scientific issues!!   Unbelievable.
She monitors my TV appearances and comments on them to me via e-mail. She even
makes suggestions on scientific issues.  I told Francis and he agrees that this must stop.
He spoke to the ASPA today and he will speak with Leslie Dach.
   (Feb. 1) -The big feature on me in the Sunday “Home” section of the Financial Times
came out today.   Many tweets and e-mails from people all over the world who loved the
piece.   It was a feature about me as a person and my home with great pictures of the
various rooms in the house and the deck, which they described as my favorite
“object/thing”.   That is what they do with all of these features – they ask the “celebrity’
what his/her favorite thing is.   Mine was my deck.
      Also, today (Sunday – Feb. 1) the crew from “CBS- Sunday Morning” visited my
house and filmed the last part of what will be an hour feature on me within the next few
weeks.   Producer is Emmy-nominated Sari Aviv and famous NPR correspondent (now
doing CBS) Scott Simon.  They filmed Chris and I running on the track at American
University and then back in the kitchen making a typical Sunday breakfast.
      Also, BBC is doing a feature on me similar to the CBS feature.  Theirs will show
globally.   They followed me around NIH and interviewed a bunch of people including
activists.

Released by Chairman Rand Paul
421Feb. 2, 2015 – Now Governor Chris Christie is saying that parent should have the choice
of not vaccinating their children.   He said this juxtaposed against the POTUS saying on a
Sunday Morning Show that parents should vaccinate their children and “there really is no
good reason not to”.   Now the media are playing up the conflict between Christie and the
POTUS similar to the quarantine for Ebola issue.   Everyone wants me on the press to
comment.   I am picking and choosing with whom I speak since the press definitely wants
to put me between Christie and Obama.
     Was on NBC Nightly New and NPR with Richard Harris about the measles issue.
This is becoming the media hype similar to the Ebola issue.   Now Rand Paul is weighing
in saying parents should decide about vaccinations.   Mike Gerson did a great job in his
Post column describing the issue.   He quoted me directly.   Chris Wallace of Fax News
Sunday wants me to debate Rick Perry or Carla Fiorina.   We shall see.
     Cooked dinner tonight at my house (Linguine with scampi and marinara sauce) for
Harold Varmus and Chris.   I have Harold over the house and cook dinner for him about
4X per year.   Also, used to do this with Gary Nabel when Gary was Director of VRC
before he went to Boston to Sanofi to be with his wife Betsy Nabel who is CEO of
Brigham and Women’s Hospital.   I do this since Harold is alone in DC without his wife
Connie who stayed in NYC when Harold came down to be Director of NCI.   He stays in
DC in an apartment on Connecticut Avenue near the Zoo on Monday-Thursday and then
takes Amtrak back to NYC for Thursday night through Sunday night.  Always an
enjoyable evening.
Feb. 3, 2015 – Testified today at Congressional Hearing of Commerce and Energy
oversight Committee (Tim Murphy (R-PA) Chair on Influenza and why the match of
vaccine was wrong.   Multiple things putting me at the forefront – measles, Ebola, bad flu
season.
Will do Rachel Maddow Show tonight.   Measles is all over the news.   Also, ISIS sent a
video where they burned alive a captive Jordanian pilot.
See e-mail below from Cliff.   Serious problem with integrity of the Welcome trust
people and Chimerix.   The Welcome trust Oxford group were the ones that criticized us
for wanting to do RCTs.   We insisted that it was the safest and best way to determine
efficacy or harm.   They said we were unethical.   They are unethical and we cannot say
anything because of “confidentiality”.
From:  Lane, Cliff (NIH/NIAID) [E]
Sent: Tuesday, February 03, 2015 5:08 PM
To: Borio, Luciana (FDA/OC); Fauci, Anthony (NIH/NIAID) [E]
Cc: Margaret Hamburg
Subject: Re: Daily Mail: Low infection rate halts Ebola vaccine trials in Liberia
Confidential -
Released by Chairman Rand Paul
422This is a complete distortion. The trial was stopped because patients died and the FDA
sent a threatening letter to the company.  Questions on this will undoubtedly come up as
we launch the ZMapp trial.  These same individuals accused us in print of being unethical
for doing RCTs.
Lu - I need to know what I (or Tony) can say publicly.  For the first time in a 35 year
career at the NIH I am taking my gloves off.
Tony - I intend to severe any and all collaborations we have with the Wellcome Trust
over what I consider to be completely unethical behavior and lack of integrity.
Peggy - if I had not worked with you when you were a special assistant in Tony's off ice
there is no chance I would see such a note to the FDA Commissioner.  I apologize in
advance.
Somewhere in HHS we need to move from political correctness and deference to our
colleagues in other agencies to doing the right thing and trying our best to identify
effective countermeasures for Ebola virus disease.  It is possible my judgement is being
skewed by spending too much time in West Africa.  In fact, however, it  I think it has
been honed.  I think we need a blunt meeting with the Secretary and Leadership of FDA,
CDC and NIH to put the cards on the table face up.
Cliff
On Feb 3, 2015, at 7:27 PM, Doepel, Laurie (NIH/NIAID) [E]
<LDOEPEL@niaid.nih.gov> wrote:
Low infection rate halts Ebola vaccine
trials in Liberia
By Afp
Published: 14:17 EST, 3 February 2015 | Updated: 14:17 EST, 3 February 2015
Britain's Wellcome Trust said that clinical trials it was funding for a new
Ebola vaccine in Liberia were halted on Tuesday due to a fall in new
cases.
"The current position is that there is no realistic prospect of the trial
enrolling sufficient patients to be able to reach a conclusion about the
Released by Chairman Rand Paul
423efficacy of the drug," the Wellcome Trust, Britain's biggest scientific
research charity, said in a statement.
"Therefore the trial has been terminated," it added.
The Wellcome Trust said the decision was taken on Tuesday after the
pharmaceutical company Chimerix, which manufactures the brincidofovir
vaccine, said it was withdrawing from the trial on Friday.
The first large-scale trials of two other Ebola vaccines --
GlaxoSmithKline's Chad3-EBO-Z and rVSV-ZEBOV, manufactured by
Merck and Newlink -- began in Liberia on Monday.
Tuesday's decision was taken by the Trial Steering Committee, which
includes scientists from Liberia, the University of Oxford and Medecins
Sans Frontieres.
"We're delighted that infections are falling, but fewer patients makes it
more difficult to carry out the robust scientific studies needed," Peter
Horby from the University of Oxford, who was leading the trial, said in a
statement.
Jeremy Farrar, director of the Wellcome Trust, which is funding a multi-
million pound therapeutics platform for experimental Ebola treatments,
said it was "disappointing" that the trial could not continue.
"It is essential that other studies of potential treatments and vaccines
continue and hopefully will still be able to deliver meaningful results for
this and the inevitable future epidemics of Ebola," he said.
Stephen Kennedy, a study investigator from the Pacific Institute for
Research and Evaluation in Liberia added: "The scientific community will
move on without any clear evidence regarding the role of brincidofovir in
the management of Ebola."
Weekly Ebola infections in west Africa have dropped to below 100 for
the first time in more than six months, the WHO said last week, raising
hopes the worst-ever outbreak of the virus is coming to an end.
Released by Chairman Rand Paul
424The World Health Organisation said it had now shifted its efforts in
Guinea, Liberia and Sierra Leone -- the countries worst-hit by the
epidemic -- from slowing the spread to stamping it out completely.

Feb. 4, 2015 – Max Cooper gave WALS Lecture at NIH.   Went to dinner with him and
Chris last night at Cesco Osteria on Woodmont Avenue in Bethesda.  Still great press
interest in the Measles situation now that Presidential hopefuls Chris Christie, Rand Paul
and others have commented on it.   Rand Paul put his foot in his mouth by saying that
there are reports of children who walk and talk normally before MMR and then
immediately after, they can no longer walk, talk, and are autistic.
Good experience on Rachel Maddow Show last night.   We stuck to the science and did
not get involved with the politics, although she dumped all over Christie and Paul.   Ran
into Gov. Howard Dean in the NBC Green Room and he was very critical of Paul.
Did Geraldo Rivera Radio Show today and Jose Diaz Belart on MSNBC.   The Sunday
Shows want me on several times.   Let us see if HHS allows it vis-a-via prior discussions.
ISIS burns alive and shows the video on the internet a Jordanian jet fighter pilot shot
down over Syria.   The Jordanians are outraged and execute Al-Qaeda prisoners in
retaliation.  Big news
Feb. 5, 2015 –  Media continues over measles.   Was on Fox National news.  Also,
Buzzfeed print; Wall Street Journal.   Gave talk on Ebola at the Columbia Country Club
in Bethesda on Connecticut Avenue.   Biggest crowd they have ever had at these events
(Distinguished Lecture Series)
Feb. 6, 2015 – HHS approving all my media now.   Today did CNN New Day; The Hill.
Also did radio interview with John Castamidas for  his NYC Sunday Show.  Was
supposed to do MSNBC with Andrea Mitchell and another ABC Show but was cancelled
because Jordanian aircraft bombed ISIS in Syria and the ISIS claims that the bombs
killed and American woman whom ISIS had kidnapped and was holding hostage.   Now
all news stations are covering this.
Feb. 7, 2015 – Measles still hot.   Emerging reaction by press and bloggers against
mothers who do not vaccinate their children.
I appear on CNN with Poppy Harlow about measles
Feb. 8, 2015 – Appear on Sunday TV “Face the Nation” with Bob Shieffer.   Appear with
CBS Dr. Jon LaPook.
  Fly to Austin, TX for LaMontagne Lecture tomorrow.
Feb. 9, 2015 – Give Inaugural John Ring La Montagne Lecture at University of Texas.
John did undergraduate and Masters at U of T.  His widow Elaine was present and his
brother Greg.   Freezing weather in DC and major historic snow storms in New England
Released by Chairman Rand Paul
426I so rarely go out to lunch -- so I was completely crushed that I
missed the extraordinary moment when one of the world's leading doctors
paid me a house call.  Thank you so much for the wonderful letter and
incredible gift.  I can tell people now that while infamously do NOT
have a medical degree I DO have a certificate from the NIH!!!!
On a serious note, I cannot tell you how grateful I am personally for
your counsel, candor and wisdom during my tenure at the White House.
And as an American, I can't tell you how grateful I am for your
leadership for our country and the world.
I hope our paths cross again some day.  Until then, I am your greatest
fan and admirer....
With thanks,
Ron
Sent from my iPhone
Feb. 20, 2015 – Outbreak of CRE (Carbapenem-resistant enterobacteriaceae) infections
at UCLA related to a contaminated duodenoscope for ERCP (endoscopic retrograde
cholangiopancreatography).
Went on WTOP to discuss the CRE situation at UCLA.   Never a dull moment!
Feb. 21, 2015 – Went on CNN to discuss the 7 cases of CRE that occurred with 2 deaths
at UCLA in association with contamination of duodenoscope used for ERCP.   Press is
trying to blame FDA since FDA knew about the problem with duodenoscope
contamination for a few years.   I did not throw FDA under the bus since there is not
much they can do about it except to alert hospitals to clean the instruments as best as
possible.   Cannot pull the 20,000 or so instruments (made by Olympus) since 500,000
procedures are done in the USA each year and many are life-saving and avoid serious
surgery.   It is a risk/benefit issue.   Peggy Hamburg ran into Chris in Safeway and Peggy
must have seen the CNN interview since she told Chris to thank me for not throwing
FDA under the bus.
Feb. 23, 2015 – I am finally convincing Tom Frieden not to oppose the therapeutic RCT
for ZMapp that Cliff wants to expand from Liberia to Sierra Leone since there are very
few cases of Ebola in Liberia and still several new cases each day in Sierra Leone.   The
RCT for the vaccine trial is coming along well in Liberia.  I was supposed to go to
Liberia yesterday, but have postponed the trip since my back is hurting badly and also
because the president of Liberia (Ellen Johnson Sirleaf) is visiting HHS and I need to be
there to help greet her.
Measles still in the press.  Will discuss live tonight on BBC TV with Katty Kay
Feb. 24, 2015 – Went to NYC for the DDCF Board of Trustees Meeting.  Good to see the
Board.   Have missed a couple of meetings due to the Ebola crisis.
Released by Chairman Rand Paul
427Big breakthrough in food allergy published in the NEJM.   NIAID funded the study.
Showed that early age consumption of peanut products in children with diathesis for
allergic reaction significantly decreases incidence of peanut allergy after 60 months.
I appeared and was interviewed by Jeff Green on The NewsHour to discuss it.
Feb. 27, 2015 – Still in an amazing cold wave in Washington, D.C.   A few days ago it
was 2 below at IAD.
Went to Humphrey Building today at 8:00 AM to meet with Liberian President Ellen
Johnson Sirleaf.   Hosted by Sylvia Burwell.   Her staff included Liberian Minister to the
USA, among others.   On our side was Peggy Hamburg, Cliff Lane, Francis Collins, Tom
Kenyon (CDC).   Has good conversation about our efforts in Liberia, particularly the
vaccine trial and the ZMapp trial that was announced today in Liberia.   The President
profusely thanked us for helping out with their Ebola issue.   She is a very sharp lady.
Feb. 28, 2015 – Had another one of those great dinners hosted by Catherine and Wayne
Reynolds at the Book Room of the Jefferson Hotel.   Freezing weather.   Great guests
including Vernon Jordan and his wife Ann; David Petraeus and wife Molly, Jim Johnson
and his date Heather (?), Buffy Cafritz.   Interesting discussions by Jordan on the political
arena of Hilary Clinton and her candidacy.  Petraeus spoke about the ISIS treat, Iraq and
the Middle East.   One of the best of the Reynolds’s dinners.   Chris could not be there.
She was in Northern California cheering on Ali who was running a marathon in the Napa
Valley.
March 3, 2015 – Testified before the House Labor – HHS Appropriations Subcommittee
for the NIH budget.   As usual for the past few years, it was only a 2 hour Hearing with
Francis Collins testifying and me backing him up at the table together with Gary Gibbons
(NHLBI), Tom Insel (NIMH), Nora Volkow (NIDA) and Jon Lorsch (NIGMS).   Hearing
started early (8:30 AM)   since Benjamin Netanyahu was speaking before a Joint Session
of Congress at the invitation of Speaker Boehner and against the wishes of Obama.  He
was making the argument that the USA was making a “bad deal” with Iran on nuclear
control versus sanctions.
     During the Hearing Congressman Andy Harris (R-MD) made the point that he felt that
we were spending too much on AIDS compared to other diseases with much more of a
morbidity and mortality impact on the USA.   He wants to allocate money strictly
according the disease burden in the USA.   Hence, this would destroy funding for malaria
and TB and greatly hurt funding for AIDS.   Obviously, I will be opposing this.
     Still record cold weather and lots of snow in DC.
March 5, 2015 – Was supposed to go to Boston yesterday evening in order to speak at an
Ebola Forum at Harvard today.   However, a big snow storm was forecast for DC for
today and I was afraid that I would get stuck in Boston. I wisely, did not go and actually
gave my talk and Panel discussion via “GoToMeeting”, which worked very well.   Paul
Farmer was on the panel in Boston.   Good thing that I did not go since DC got 8 inches
Released by Chairman Rand Paul
428of snow and all flights were cancelled from Boston to DC.  I would have been stuck
there.
March 6, 2015 – Met with Nina Russell and Emilio Emini from the Bill and Melinda
Gates foundation (BMGF),  Emilio is taking over as the Director of Global Health for
BMGF and he wanted to review our mutual commitments for the AIDS vaccine plans
(i.e. the P5 follow-up of the RV144 study).   He wanted to re-examine the criteria for
moving forward with candidates.   Emilio generaly thinks that he knows everything;
however, on this one he has a valid point and so we will do this together.
Cliff Lane in Liberia (also Sierra Leone) now for the 7th time in a few months trying now
to expand the RCT vaccine trial to Guinea and also expand the therapeutic trials with
ZMapp to Sierra Leone and possibly Guinea since there are virtually no patients in
Liberia.   Cliff and I had phone call early (6:30 AM) with Cliff in Sierra Leone, me in DC
at home, and Yves Levy and Jean-Francois Delfraissy in Paris to try and get a
collaboration going in Guinea for the trials since the French have a presence in Guinea.
March 9, 2015 -  Went downtown today to be the BBC studio to do the final taping of
the segment that they will be doing on HIV/AIDS were I am the moderator and narrator.
In the afternoon, I attended the FDA/NIH Leadership Council meeting to discuss better
ways of collaboration between the NIH and FDA.
March 10, 2015 -  Gave the after dinner talk at the Project Hope Board meeting at the
Willard Hotel in Washington DC. I spoke on Ebola: The Perfect Storm. It was extremely
well received and the evening was pleasant. Ran into former Secretary of HHS Louis
Sullivan.
March 11, 2015 -  Was Visiting Professor at the John's Hopkins Hospital and Medical
School. Gave two major talks: 1) a formal lecture on Ebola, and 2) a lecture to the
students and fellows on my career as a scientist, clinician, policymaker.
March 12, 2015 - There was a considerable misunderstanding involving a situation in
Sierra Leone. Cliff Lane is trying to expand the randomized controlled trial of ZMapp
versus standard of care in countries in addition to Liberia with the protocol he has already
started. As it turns out the commanding general in charge of the British military hospital
in Sierra Leone, Brig. Gen. Tim Hodgetts, was under the misimpression regarding the
protocol was standard of care to see ZMapp + standard of care versus standard of care
alone . And so he said that this trial was unethical and refused to participate in it. The
reason why this is important  is because an American citizen who works for Partners in
Health became infected while working in Sierra Leone. We had made arrangements to air
evacuate the patient to the NIH clinical Center as soon as possible. Because the patient
was in the British facility, we wanted to start the randomization to one or the other arm of
the protocol while the patient was still in Sierra Leone before flying back the United
States. Brigadier General Hodgetts stated that he would give ZMapp as a compassionate
use but would not participate in the randomized protocol. He felt it was unethical to delay
the flight to the USA by giving the person a placebo if in fact the person randomized to
Released by Chairman Rand Paul
430did not see any droplets coming out of his mouth as he coughed; however,  I remember
thinking thank goodness for the PPE. This experience brought into sharp relief for me the
reason for the high case fatality of Ebola and why so many HCWs get infected. If were in
West Africa, would be dead and Rick, Anthony and I would have gotten infected
taking care of him if we did not have the state-of-the-art PPE.  After an hour and 45 min.
we doffed and waited for his parents.
They came with Bible in hand to visit their son. Rick Davey, Cliff
Lane, and I spent well over an hour with them explaining the situation and the
seriousness of it. We then brought them into the nurse’s station where they were able to
speak with their son through video link. They could see him but he could not see them.
Of note before we brought them into the nurse’s station to see him through the video,  we
mentioned to that we were going to bring them into the room. He got very
concerned that he wanted to get cleaned up from the diarrhea that soiled his bed and was
over parts of his leg. In addition, his PIC line was bleeding around site and so that needed
to be cleaned up. It took the nurses about 45 min. to an hour to get him perfectly clean so
that he could feel comfortable talking to his parents even though his parents would not be
able to see any of the soiled linen or pajamas from the distance that they were at the video
link. It was a very moving conversation between the parents and
ended up the conversation by reading a passage from the Old Testament. And then he
turned to us in the room and said “what a wonderful country we live in that would put so
much effort into the saving the life of one person - our son. There was not a dry eye in the
room.
I went home that night completely exhausted and went with Christine to Bourbon Steak
bar and restaurant at the Four Seasons Hotel in Georgetown to unwind.
March 15, 2015. Came into work again today which is Sunday. The day has turned into a
very bright sunny day with a brisk wind. Again, I went to the SCSU and Rick Davey and
I went in together to take care of . Some lab parameters are better and some are
worse. The most worrisome of all is his respiratory situation. We have corrected what we
believe is over hydration by cutting down on his fluids and giving him a diuretic.
However his temperature is still 39 and he is still breathing at 35 to 40 breaths per
minute. Of particular concern is the fact that on 2 L/min of nasal oxygen, his oxygen
saturation is still only about 88%. Also, on call is Bob Danner from the ICU. Bob
increased the nasal oxygen to 4 L/min and we had a discussion about the possibility that
we might need to intubate the patient since he will likely soon get soon very tired from
breathing at 35 to 40 breaths per minute. Cliff Lane was on a phone conversation with the
people from Emory and Nebraska and they mentioned that even when they thought that
they had very good control of intake and output of fluids, around day 8 to 10 of illness,
patients often had unexplained accelerated respiratory difficulty requiring prolonged
intubation. I hope that it does not come to that with  however, it is entirely
conceivable that it will. I will go over to the SCSU again tonight for a conference with all
of the team to make these decisions.
Drama tonight in the SCSU.        Some change in status.  All metabolic
numbers, BP and cardiovascular, kidneys etc. were fine and even improving.   However,
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431he continued to be tachypneic at 35-38 resp/min.  During the day, his OxSats were in the
low nineties and he responded first to increasing nasal O2 from 2 to 4L/min.   However,
as we got into the evening, his OxSats dropped into the high 80s.  His resp. rate was 38-
40.  We considered elective intubation at that point, but watched him for another hour to
see if he would stabilize.   Instead, his OXSats dropped to 78-80 despite increasing the
nasal O2.  His resp. rate went to 40+.  At that point we did an elective intubation
performed by Bob Danner of the Clinical Center ICU.   It was uneventful and now he is
paralyzed with deep sedation and on the respirator.   His OxSat is now 99-100% and the
machine  is set at 15; he is breathing on his own at 20/min.   We spoke to our colleagues
at Emory and Nebraska who had taken care of Ebola patients in an intensive care setting.
They said that this was exactly what they had seen, i.e. a patient seems to be doing well
with good numbers and then goes into an ARDS picture.   They intubated them and after
a variable period of time, the patients (2 in number) recovered.   Hopefully, that is what
we will see with   He went through the night without incident.
March 16, 2015 – Spent 2 hours in the SCSU “Hot Zone” with Bob Danner (ICU
specialist) and Kwan (ID Fellow).   went into renal shutdown likely due to Acute
Tubular Necrosis (ATN).  We spent the time trying to balance the pushing of fluids with
giving Lasix diuretic.  Now at 24 hours after intubation, his pulmonary situation is
fine.   He is on 35% with 5 PEP and his Sats are 95-100%.   His BP and cardiovascular
function are fine.  Labs are all about the same and a little better except for one disturbing
trend.   His creatinine has gone from 0.8 to 1.0 to 1.3 to 1.6 to 1.9 just 1 hour ago.   From
6:00 to 7:00 PM he put out no urine after having put out about 40 cc the prior hour.   We
pushed fluids and he has only put out about 25 cc/hour over the past 3 hours.  Diarrhea is
still profuse.   We are going to continue to push fluids to see if he opens up.   Looks like
ATN, which is puzzling since he has always had good perfusion with good BPs.   The
people at Emory tell us that this is exactly what they saw with their sickest patient, i.e.
patient’s numbers look good, then unexpected ARDS, the latter corrected by
intubation/respirator, then unexplained ATN requiring dialysis, followed by prolonged
and slow recovery.   Strange disease this Ebola.   We will continue to push fluids during
the night and then (depending on his creatinine), consider the option of
dialysis.   Hopefully, we will not have to go there.
March 17, 2015 – Went to morning report at 8:00 AM.   Bob Danner reviewed what
happened after I left the Unit last night.   Creatinine now up to 2.5.   Patient clearly in
renal shutdown.
Larry Altman gave very nice James C. Hill Memorial Lecture at the Lipsett Auditorium
on the Journalistic Hx of AIDS.
Decided not to go to the Wilson Center for the Tom Daschle/Bill Frist dinner since
renal function continues to deteriorate and I want to go to the “sign off”
meeting in the SCSU at 6:30 PM.   At SCSU, Creatinine up to 3.3.   .   I am looking for a
silver lining, but the upward trajectory of the creatinine is slightly less than it was
yesterday.   We may need to dialyze him, but I am hoping that his creatinine stabilizes at
3.7 to 3.9 and then starts to slowly come down without dialysis.   Having said that, we
Released by Chairman Rand Paul

432will not hesitate to dialyze him.  Also, he has some strange neurologic manifestations
with an atypical tonic/clonic movements, but no other manifestations of brain or cord
disease.  There is a whole new chapter of Ebola disease manifestations to be written now
that we can keep people alive who otherwise would have died days ago if there were in a
Unit in West Africa without the equipment and manpower that we have.   Last night there
were 6 of us in the room with him.   The good news is that his AST is starting to come
down and the best news is that his CT value is now 29.96, which means to me that his
immune system is starting to control the virus replication.    If the downward trend of his
virus continues and we can just keep him stable for the next 4 or 5 days, I believe and
hope that we can get him through this.
Meeting more ICU docs including Parker Ruhl from NHLBI.   She is on call tonight and
checked with her at 10:00 PM by phone.
     Also, am doing nightly e-mail reports to Paul Farmer who is in Peru with his daughter
Catherine.
March 19, 2015 -    All non-renal numbers going in the right direction.   Still in acute
renal failure; however, the rise in creatinine is perhaps a bit less “steep” – creatinine 5.9
and BUN 111.  We may well have to start dialysis today.   Decision to be made mid-day
today.   His cycle (CT) is now up to 31.5 and so his immune system is certainly clearing
the virus.  Persistent fever prompting broad antibiotic coverage.   Had a scary episode last
night.   As we were tapering him off heavy sedation it appeared that he was calm and
doing well with the taper.  However with two nurses in the room and the rest of us
(physicians, nurses, WatSans, et al) taking evening report, he abruptly woke up in a
delirium flailing his arms and legs despite soft restraints (he is 6’2” and very strong).   He
pulled out his PIC line and pulled out the tubing to his endotracheal tube.    It was a
nightmare for the 2 nurses in the room who had to simultaneously press down with a
towel on the bleeding PIC line site, bag him through the endotracheal tube, hold him
down and try to get Versed into him.   We all got up and scrambled to Don but this took
(even going at light speed) about 5 minutes leaving the 2 nurses in the room with 5
minutes of terror. Dan Chertow, Rick Davey and Tara Palmore went in and Bob Danner
and I manned the nurses station and read the monitor to the people in the room.   We
decided that it would ne dangerous and non-productive to have everyone in the
room.   Real scare came when Neil (head nurse on that shift), who was one of the 2
nurses with Kim, doffed, he noticed when he took off his inner glove that his hand was
bleeding.  As you can imagine, the trauma of the prior 5 minutes and now a bloody hand
brought us all, particularly Neil, over the top.   Luckily, the blood was his (injured his
hand against bed rail when holding down patient) and his gloves were intact.   Tara
Palmore checked his gloves by filling them with water and there were no leaks.   We
soon got everything under control and he is now the same as pre-event, only now under
heavy sedation, which we would have had to do anyway if we ultimately decide to
dialyze him.   PIC line was replaced by VAT (Vascular access Team).
March 20, 2015 – Patient stable this AM.   First day of Spring today and we have snow
in DC.   What a winter – Ugh!  Went in again today to go over patient with Dan Chertow.
In for about 65 minutes.  Making morning (8:00 AM) and evening (6:30 PM) report now
every day with the Unit staff.
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433March 21, 2015 - Good news. Creatinine stabilized for 3 determinations in a row at
around 6 with BUN at around 115. We may get away without having to dialyze. Main
problem now is meningoencephalitis. Avi Nath (NINDS- neurologist) helping out with
neuron-management.   He can only do so by history and video since he is not trained to
enter room. We cannot fully evaluate this until we lighten up his sedation, given what
happened the other night, we will do this very slowly. We have started low dose heparin
now that his platelets are coming up. CT (Cycle threshold) is now 34.5!   All we need to
do is avoid PEs and bleeding. More later.
Now the Norwegians and to some extent the Canadians (much less so) are getting upset
with us since we are working with the Guineans via INSERM (Delfraissy/Levy) and the
interaction between the Liberians and Guineans to expand the vaccine RCT to Guinea,
where there are still cases.   The Norwegians are trying to do a “Ring Vaccination” study
around cases similar to what was done with smallpox.   However, the smallpox situation
was using a proven, highly effective vaccine.   You do not “test” a vaccine in a ring
“study”.   The Norwegians are concerned that our introduction of an RCT where they are
doing a Ring study would be a problem.   I can understand what their concern is;
however, the elephant in the room is the fact that there study is not a study.   It is a
“distribution” of an unproven product.   This is the same European mentality that just
because this is a serious disease, then there is no room for research; just distribute what
you have.   This same mentality led to Guinea adopting Favipiravir as standard of care
based on an open access study that claimed benefit; however, when the data was
presented at the CROI meeting, it was clear that there was no indication of efficacy since
the outbreak incidence was shifting during the study and historical controls were not
valid.   God bless Cliff for sticking to his guns about RCT and good science.   In this
regard, my old friend Tore Godal from Norway e-mailed me with concern about our
study since he is one of the Norwegians who are pushing the Ring study.  Of note, in their
communications, nowhere are there any Guineans.   Sounds like the old paternalism.
March 22, 2015 (Sunday)– Spent all of the day at NIH and hours in the SCSU in with
patient and doing AM and PM rounds.   Danny Jaswal was the ICU attending and Tuan
was the ID person.   Avi Nath did neuro exam and actually wwent into the room after
getting trained in PPE
March 23, 2015 - .   I have some good news.   His renal function continues to improve
with a creatinine today of 3.6.  He is in the polyuric phase of ATN with a urine output
after stopping Lasix over the past 24 hours of >100 cc/hr. His LFTs have
normalized.   His cardiopulmonary function is good.   On neuro exam today, his board-
like stiff neck can now bend by 45 degrees and his sustained clonus is now down to 5
beats.   We had our  ophthalmologist (Rachel Bishop) examine him today with a neat
gadget hooked onto a cell phone, which together with a hand lens gave us a good look at
his retina.    Good news is that he has no papilledema and no evidence of clinically
significant uveitis.   Tomorrow morning we will attempt to stop his ketamine and
fentanyl and gradually taper off his propofol.   If he wakes up without being combative
and is stable for a period of time, we will consider pulling his endotracheal tube.  His CT
is 37 and so he is almost cleared of virus from his blood. Fingers crossed.
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434Paul Farmer called my cell phone as I was getting ready to do today and I gave him a
summary of  progress.
Having “political issues” with the Norwegians getting upset that Cliff and I want to
extend our RCT vaccine trial to Guinea since they are doing the ring vaccination there.
See my comments above.
March 24, 2015 – Same political issues regarding the potential NIH RCT in Guinea.
Kai Kupferschmidt from Nature wanting to do a story about “rivalry among scientists.
Like the Peter Duesberg situation decades ago, they are “equating” us with Marie-Paul
Kieny of WHO.   I cannot say to Kai, but Marie-Paul is an idiot.   Had long 3-way
conversation over the phone:  Kai who just flew in from berlin for the Filovirus Meeting
in DC tomorrow is connected from his hotel here in DC; Cliff from his home and me
from my home (10:00 PM).   We try to explain to Kai that we are not trying to interfere
with the “Ring” trial; we just want to get the correct answer for the good of all of West
Africa.   He keeps pushing that they started off with Guinea and now that Liberia has
few/no infections, we want to go to Guinea and “ruin” their study.   Nonsense.   You can
do 2 studies simultaneously in as large a country as Guinea.   Besides, ring vaccination is
not a study; it is vaccine distribution of an unproven vaccine.
March 25, 2015 - Good news at SCSU:   We extubated  uneventfully! Went in to
see him and he is emotionally very grateful for what our team did for him.   Paul Farmer
came up from Haiti to visit as well as the other PIH personnel (contacts to
 who are “nested” in the Maryland area for observation in case they develop sxs.
Organ system function markedly improving.  Creatinine 1.4!!  Still some muscle
weakness.   Will leave urinary catheter in tonight and keep him NPO since his voice is
very weak and his trachea is irritated.  CT is 39+; however, his CT of his trachea aspirate
is 26.   Could there be sequestration of virus in tracheal secretions or is this just
accumulation of dead virus
Kai (above) is still agitating with questions to Cliff about our upsetting the Norwegian
study.
Met with Morgan Fairchild in my office today at 3:30 PM to discuss what NIAID could
do for Chronic Fatigue Syndrome, now re-named Severe Exertion Intolerance Disease
(SEID).
Will give talk tomorrow at the Filovirus Meeting in DC and so will miss Harold
Varmus’s last IC Director meeting.   Said goodbye to him and Connie today.  I will miss
him greatly.
March 26, 2015 – I have been chosen by Fortune magazine as one of the world’s 50
greatest leaders.   Also, I am on Time magazine list for voting “100 of the world’s most
influential people”
Patient doing well.
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435Gave talk at the 7th International Filovirus Meeting at Marriott Hotel at Metro Center run
by Heinz Feldmann.   Talk went over very well.   Kai Kupferschmidt was in audience and
was blown away when I showed slides of me in PPE taking care of    He came
over afterwards and is writing a short online blog on how incredible it is that a director of
a large research institute who is 74 years old is taking care of an Ebola patient.
Spent a full hour with  in the SCSU.   He is now very talkative; however, he does
have a slight expressive aphasia.   His strength is coming back and he is taking a soft diet
(apple sauce, etc.).   Creatinine now 1.2.   CT around 39.   May still have some virus in
tracheal secretions.   He has an occasional cough that is dry; may be slightly aspirating
due to pharyngeal muscle weakness.  Paul Farmer heading out tomorrow to go back to
West Africa via Boston.
March 27, 2015 - Today was a very interesting day. The patient is wide-awake all of his
chemistry numbers are normal. I spent a full hour in the room with him speaking with
him about a variety of subjects. He clearly is in somewhat of a hypomanic state. He
continually speaks and in a pressured manner.  We now know that he has a depressive
disorder on meds and this hypomanic state could be a combination of our inadvertently
taking him off his psychotropic meds (although his ketamine, etc.) would substitute for
that) and his developing a manic phase to his underlying depression as a result of the
amazing stress of his illness.  As far as his organ system function goes he is doing very
well except for some residual weakness and conjunctivitis in his right eye. We hope that
this is not Ebola uveitis. He will be seen by ophthalmology tomorrow.
Cliff Lane and I had a very disturbing conversation today with Yves Levy (President of
INSERM) who is in Paris. It is becoming very clear that Marie-Paule Kieny (WHO) for
political reasons in order to show that the World Health Organization was doing
something for Ebola has been pushing a ring vaccination trial in Guinea together with the
Norwegians. Cliff and I (mostly the hard work of Cliff) are working with the Guineans to
expand our Liberian RCT vaccine trial to Guinea where there are still infections going
on.   WHO and the Norwegians do not want us to start the RCT in Guinea and are leaking
to the press that we are trying to “derail” their trial.   In fact, the Norwegian government
has complained to our State department about our trying to start the RCT in Guinea.   The
French (Levy and Delfraissy) agree with Cliff and I that the ring vaccination in Guineas
will not be able to determine efficacy.   Of note, both Levy and Delfraissy are on the
scientific advisory board for that trial even though they do not believe that it is
scientifically sound.   I gently chastised Yves on the phone telling him that he should
resign from the board.   Bottom line is that he told Cliff and me that this is politically
sensitive since Marie-Paule is pushing the ring trial purely for “political reasons” in
trying to show that WHO is “doing something and leading something”.   For some
inexplicable reason, she has gotten the Norwegians (John-Arne…) to buy into this.   Yves
knows as do Cliff and I that Marie-Paule is close to being incompetent and knows
nothing about the research method of clinical trials.   First, there should not be a ring
vaccination since ring approach assumes that the vaccine works.  We are trying to
determine scientifically if it works.   Everyone knows that an RCT is the “gold standard”
Released by Chairman Rand Paul

436to determine safety and efficacy.   We are convinced that the Guineans would go along
with the best scientific approach.   Yet, WHO is trying to block the initiation of our trial
until they have finished their trial that everyone with any sense knows that the ring trial
will be inadequate.   This is “politics” at its worst.   Marie-Paule should really be fired.  If
we were the type to leak this to the press such as to Jon Cohen or Kai Kupferschmidt
from Science, this would be a scandal for WHO.
Finally, in the arena of incompetence and politics, the “Favipiravir study” in Guinea done
by MSF and the French is claiming to show that it works (see above) even though there is
no control group except an “historical control”.   Now the French are telling us that the
Guineas are making Favi part of their standard of care (SOC).   Thus, is we want to
extend out ZMapp study to Guinea (where there are infections), then we would not be
able to compare SOV versus SOC + ZMapp as we are doing in the USA and Liberia, and
now Sierra Leone.   The FDA and we feel that FAVI should not be SOC and if fact might
be harmful.  We will try to work with the health and political types in Guinea to get a
proper ZMapp study going.   Truly amazing politics, ignorance, and LACK of
INTEGRITY on the part of people including people in WHO.   MSF just does not know
much about doing clinical research, even though they are “heroes” for their clinical care
work.
March 28, 2015 – Unusually cold, clear day for Spring in Bethesda.  Around 28 in the
AM.  Patient continues to do well.   Still hypomanic and not getting any sleep.   We are
reluctant to medicate him too much due to concern about prolonged QTC.
Cliff and I continued our conversation by phone with Yves Levy in Paris and us in Cliff’s
conference Room on the 4th Floor of the ACRF in Building 10.  Yves now agrees with
everything that I indicated in note from March 27 (above).   He will work to help get the
RCT done in Guinea and we will work together with the RCT therapy trial in that the
French will try to do the SOC + FAVI Versus SOC+FAVI+ZMAPP and we will do  SOC
versusSOC + ZMapp.
March 29, 2015 – Sat up about 45 minutes with today (Sunday – sunny but very
cold for end of March in DC – 23 degrees F).   Continues to improve markedly.  Moving
all extremities well.   Left arm issue resolving.   Conjunctivitis improving.   Sitting up
and eating progressive diet.   Speaking every day with his mother and friend who come
up from Houston where he lives.   We are considering changing status to “Fair”.   Of
note, we still get very weak PCR signal from sweat, saliva and urine one or more of
which alternates on different days from weakly positive to negative.   This will have
implication for his release and for broad policy given that the Liberian woman got
infected (and died) from her sex partner who was an Ebola patient in the 100+ day of
recovery.     Interesting to see how this will all play out.
March 30, 2015 –  getting much better with strength and neuro approaching
normal.   Still too weak to get out of bed, but can stand for 1 minute.   Eating voraciously;
maybe too much since he has been having Gatorade, pizza, ham sandwiches and actually
vomited.   After this he felt fine.   Have upgraded his condition from “serious” to “fair”.
Released by Chairman Rand Paul

437CT in blood is negative (40 CT)   Also, urine, saliva is negative.   Interesting issue is that
axillary sweat is persistently positive (~32 CT).
Cliff and I will meet with the US Ambassador to Guinea at the State department
tomorrow to try and work out the issue with performing an RCT vaccine trial in Guinea.
Marie-Paule Kieny is truly a fraud and acting purely on political motives.   The WHO
does not want us or anyone to start an RCT in Sierra Leone with ZMapp until they finish
their TKM-EBOV open access trial (treat one ETU) and compare it historically to
another ETU.  This stance even though the pre-clinical data on ZMapp are infinitely more
promising than those from TKM-EBOV.   They would rather finish their study and delay
the start of a trial with a promising drug just because they “politically” want to be a
player.
Also, in the vein of everybody wants to be somebody, various groups including Welcome
Trust, and even the BMGF want to start the Global Research Collaboration for Infectious
Diseases Preparedness (GloPID-R) – a network of funding organizations in the area of
infectious Diseases research.   Obviously, we are the major player and these other
organizations have little to ad, but they want a network that would require us to go to
endless meetings and give them a say of what the direction of the research would be.
Ugh!   Been there, done that with the HIV Vaccine Enterprise, etc.
March 31, 2015 –  continues to improve with increased strength.   Need to figure
out way to get him back to Dallas where his parents live.   He lives in Houston.
Technically, since he is now PCR negative X2, he can fly commercial; however, the
optics will be bad – people get hysterical if they find out he is an ex-Ebola patient.   And
so wrote to Paul Farmer to see if PIH will pay for a charter for him to fly from DC to
Dallas.
 Cliff and I went down to State Department to meet with US Ambassador to Guinea –
Alexander Mark Laskaris to get his help in smoothing the way for us to do the RCT for
the Ebola vaccine in Guinea since Guinea is where the infections are and the Norwegians
and WHO clearly do not want us to do the trial there (see above).   Laskaris totally gets
that WHO are the “bad” guys and have lost all credibilityand he will support us.
Chris and I took out Denise and jack to Fiola Mare restaurant in Georgetown for jack’s
80th birthday.
Below is final communication between Harold Varmus in his last official day as NCI
Director and me.   He has been a dear friend as NIH Director and over the past 5 years as
NCI Director:
From:  Varmus, Harold (NIH/NCI) [E]
Sent: Tuesday, March 31, 2015 3:51 PM
To: Fauci, Anthony (NIH/NIAID) [E]
Subject: Re: Nice article
Released by Chairman Rand Paul

438Tony, thanks.   I had hoped to stop  by your office for a farewell in person today, but events overtook
that possibility.   (I had meetings all morning and then other distractions up to train time.   Besides,
you were probably suited up on the Ebola ward!)
I expect to see you in NYC very soon; this time I will cook for you (or take you to one of our
neighborhood hot spots).
Best to you and Chris.   You got me through some crises of confidence and intention, even without
realizing what you had done and I am now eager for my new life.
HV
From: <Fauci>, Anthony Fauci <AFAUCI@niaid.nih.gov>
Date: Tuesday, March 31, 2015 at 3:43 PM
To: Harold Varmus <harold.varmus@nih.gov>
Subject: Nice article
Harold:
    I cannot let these waning hours of your final day as an official NIH- ER go by without again
bidding you a fond farewell, a farewell from NIH, but not from our friendship. Hope to see you again
soon.
Best,
Tony
April 1, 2015 – continues marked improvement.   Sitting up in cardiac chair; off
full PPE and now on contact isolation only.   He walked with help from the hot zone
room to the contact isolation room.   even played an April Fool’s joke on Rick
Davey by feigning severe illness when Rick came in the room.   claimed that he
did not know who Rick was or who Nurse Megan was.   Parents delighted.
Tom Burton of Wall Street Journal is digging into the story about the conduct of
Welcome trust, WHO and Chimerix (brincidofavir).   He is a smart reporter and is
catching on to the scandalous conduct of these parties.
April 2, 2015 – Gave Q and A-type lecture on 7th floor of Humphrey Building hosted by
Bill Schultz the General Counsel of HHS.   Big crowd of all the OGC people from the
department.   I told the story (via questions from Bill) about my dealings with multiple
administrations.
After the session 12:30 PM to 1:30 PM, Sylvia Burwell had asked to see me in her office.
She had just come back from the White House.   She profusely thanked me and the NIH
team for all we are doing with  and with the vaccine trials.   Apparently Tom
Frieden had told her that he did not want to CDC to “move into Guinea” because of the
instability.   A bit puzzling since the CDC is already there.   We still plan to extend the
RCT vaccine trial to Guinea.
Released by Chairman Rand Paul

439 up and walking.   Unfortunately, despite 3 negative CT’s for blood, he reverted
(after one negative) to positive in his left axilla sweat/skin.
April 3, 2015 – doing great.  Dilemma is the persistently weakly + PCR of
axillary sweat.   Has resting tachycardia that might be subclinical cardiomyopathy.   Has
been seen in other recovered patients in the USA (Emory/Nebraska).
Gregg Gonsalves (old ACT-UP and TAG) who is now a Ph.D. student at Yale has
brought to NIH (7A-24) a few (three) Yale students to interview me on a piece that they
are writing on the issues with unnecessary quarantine of people working with Ebola.
They are interviewing me because of the stand that I took in opposition of Gov. Cuomo
and Christie a few months ago.
April 5, 2015 (Easter Sunday) – CBS ran their Sunday AM special profile of me in a Q
and A with Scott Simon (NPR).   It turned out magnificently.   I received scores and
scores of e-mails of congratulations, many-fold more than even when I did 2 “Full
Ginsberg’s” a few months ago.   E-mails from as diverse people as Gary Edson, Josh
Bolton, Lisa Monaco (NSC), Catherine and Wayne Reynolds, old friends from NY
Hospital, etc., etc.
Will have to make decision about doing a single PCR on  axilla and if negative,
then stop testing rather than looking for 2 consecutive negatives.   This is unchartered
waters, since he has already had multiple negative blood PCRs.
April 6, 2015 – Axillary sweat PCR now negative.   We will take him out of isolation
tomorrow and have upgraded his condition from “fair” to “good”.   Plan to do MRI of
heart (still has sinus tachycardia at rest) and brain and then discharge him sometime this
week.
April 7, 2015 –  now out of isolation due to negative blood and axillary sweat.
 semen specimen shows high level of PCR signal – 18 CT!   Clearly the semen
is a privileged site for the virus since his blood has been consistently negative.
Preparations for extending the RCT vaccine trial to Guinea coming along.   Cliff doing
yeoman’s work with the French (Yves Levy – INSERM and Jean Francois Delfraissy).
French are intent on showing that they are taking the lead in this.  This relates to their
traditional relationship with Guinea.
Will go to White House tomorrow to discuss with the POTUS and NSC  “getting to zero
in Guinea”.
April 8, 2015 – Larry Kramer’s new book is out.  See review from the NY Times  below
and see yellow highlight:
Released by Chairman Rand Paul

440Larry Kramer’s Novel ‘The American
People’ Adds a Gay Dimension to History
By ALEXANDRA ALTER APRIL 7, 2015
Photo
Larry Kramer, the author of a hefty new novel (or, as he would have it, history) of the
United States. He is working on a second volume. Credit Todd Heisler/The New York
Times
Fourteen years ago, the playwright and activist Larry Kramer was preparing to die. His
liver was failing, and the prognosis was grave.
Released by Chairman Rand Paul
441He summoned an old friend, Will Schwalbe, editor in chief of Hyperion Books, and made
him the steward of his novel in progress, a rambling history of homosexuality and AIDS
in the United States. He told Mr. Schwalbe to self-publish it if necessary, using money
from Mr. Kramer’s estate.
It didn’t come to that. Mr. Kramer survived a liver transplant and finished the book, a
project he had begun more than 30 years ago. Now, at 79 and against all odds and
expectations, he has lived to see it published. The first volume, “The American People,
Volume 1: Search for My Heart,” weighing in at 775 pages, comes out Tuesday from
Farrar, Straus and Giroux. Mr. Kramer has already thrown himself into finishing the
second volume, which is to come out in 2017.
“Larry lives to write,” said Mr. Schwalbe, who is now an executive vice president at
Macmillan. “There’s no doubt in my mind that Larry’s writing is what keeps him alive.”
Photo
Mr. Kramer, 79, defied the odds and lived to see the publication of “The American
People.” Credit Todd Heisler/The New York Times
“Magnum opus” doesn’t seem like a robust enough phrase to describe the scope of “The
American People,” which stretches back to the prehistoric swamps of the Everglades and
concludes, in the second volume, in contemporary New York City. When Farrar acquired
the two volumes in 2010, the narrative had swelled to around 4,000 pages.
Blending farce and tragedy, autobiography and fiction, it opens as Fred Lemish, a stand-
in for Mr. Kramer, is struggling to finish writing a book titled “The American People,” a
far-reaching historical exposé that describes Alexander Hamilton, George Washington,
Abraham Lincoln, Mark Twain and other major historical figures as gay. “He’s been
struggling with this history for many years,” Mr. Kramer writes of his fictional
counterpart.
Released by Chairman Rand Paul
442Mr. Kramer said he was driven to write the book because he had long felt that gays had
been excluded from history books, written out or ignored. “Most history is written by
straight people, and they don’t have gaydar,” Mr. Kramer said during an interview at his
apartment in Greenwich Village. “People say, ‘Can you prove to me that George
Washington was gay?’ and I say, ‘Can you prove to me that he wasn’t?’ ” (As evidence,
Mr. Kramer notes that Washington “was surrounded by men, and he designed all their
uniforms himself.”)
In the novel, and in conversation, Mr. Kramer criticizes historians and scholars like Stacy
Schiff, Ron Chernow and Doris Kearns Goodwin for glossing over homosexuality in
American history. If he had had his way, he would simply have called the book a work of
history rather than fiction, he said.
“Farrar Straus said call it a novel, that way the lawyers will leave you alone,” he said.
“But I believe everything in the book is true. It may look like fiction, but to me, it’s not.”
Mr. Chernow, the author of a well-regarded 2004 biography of Alexander Hamilton, said
he was surprised to be called out in Mr. Kramer’s novel, particularly as he brings up in
his book the possibility that Hamilton might have been bisexual. “I’m glad that Larry
Kramer is raising the issue, I’m just mystified at why he’s attacking me, when I thought
he would have applauded the fact that I take this seriously,” Mr. Chernow said. “It’s a
legitimate issue for historians or novelists, but we also have to be careful not to ransack
history in service of a political agenda.”
As for Mr. Kramer’s theory about Washington, Mr. Chernow countered that it was
common in that era for generals to design soldiers’ uniforms. If conflicting early reviews
are any indication, “The American People” is likely to be as polarizing and controversial
as Mr. Kramer’s other works. While Kirkus Reviews praised the novel as “breathtakingly
well-written,” others have taken a dimmer view. “To call it a rough read at times would
be an understatement,” a reviewer wrote in Publishers Weekly.
“It’s like being hit by a truck, the book is so all over the place,” the novelist Andrew
Holleran, who has known Mr. Kramer since the 1970s, said of the book. “What I admired
as a writer was the imaginative energy and the amount he takes on.”
Jonathan Galassi, the president and publisher of Farrar, Straus and Giroux, said the book
struck him as ambitious and provocative, both as a work of literature and as an act of
protest.
“This book is, in a way, a culmination of all his artistic activity,” he said. “Larry is a great
polemicist and a fighter, and this book is part of his polemic about gay history and the
roles of gays in our society. He’s still fighting and he’s using art to do it.”
Mr. Kramer never set out to be a political activist and said that in some ways he was ill-
suited to the role. “They say I’m obnoxiously noisy and angry, but I’m actually a bit of a
shy person,” he said.
Released by Chairman Rand Paul
443Early in his career, Mr. Kramer wanted to write comedy. After graduating from Yale, he
worked in the film industry, and was nominated for an Oscar for his screenplay
adaptation of the D. H. Lawrence novel “Women in Love” (1969). In 1978 he published a
controversial novel, “Faggots,” a satire of rampant drug use and promiscuity among gays
in New York. “It’s meant to be a comic novel — it made me laugh,” he said.
His mission changed in the early 1980s, when H.I.V. and AIDS began spreading rapidly
among gays and claimed the lives of two friends. He was a founder of the Gay Men’s
Health Crisis, a nonprofit support organization for those affected by the disease, and later
started Act Up, a protest group that brought attention to the AIDS crisis. His activism
spilled into his writing, with plays like “The Normal Heart” and “The Destiny of Me,”
which center on gay characters confronting the AIDS epidemic and take aim at
indifferent politicians and institutions.
Mr. Kramer’s activism was closely and messily intertwined with his personal life. In
1989, he learned he was H.I.V. positive and suffering from liver damage, the result of
hepatitis B. He credits Dr. Anthony Fauci, director of the National Institute of Allergy
and Infectious Diseases, for being among a handful of doctors who saved him by giving
him experimental drugs. Mr. Kramer once vilified Dr. Fauci in print, calling him “an
incompetent idiot” and a murderer, for his early approach to fighting the spread of AIDS.
“The man who I criticize for allowing the virus to spread is the man who saved my life,”
Mr. Kramer said.
Mr. Kramer’s acerbic and belligerent style has often alienated friends and supporters. He
and the playwright Tony Kushner had a blowout over Mr. Kushner’s screenplay for the
Steven Spielberg movie “Lincoln” (2012), because Mr. Kramer felt that Mr. Kushner
should have depicted Lincoln as a gay man. “He and I had a major falling out over this,”
Mr. Kramer said. “I so wanted him to put that in the movie.” (In “The American People,”
Mr. Kramer strikes back with his own fictional Lincoln, who has a male lover and often
lustily utters “mighty fine” after their encounters.)
These days, Mr. Kramer seems much less bellicose, though no less passionate. He speaks
in a tremulous near-whisper and relies on a hearing aid and a cane. He spent much of last
year in hospitals being treated for abdominal infections and almost died twice, he said.
He was bedridden in 2013 when he and his longtime partner, the architect David
Webster, were finally married in the intensive care unit of NYU Langone Medical
Center.
Mr. Kramer’s writing has taken on a greater urgency lately. He has been writing for five
or six hours every day, seven days a week. His progress is visible in the towering stacks
of manuscript pages that cover a large table in his living room, which doubles as a work
space. He is also working on a screenplay for a sequel to “The Normal Heart” and is the
subject of an HBO documentary, “Larry Kramer: In Love and Anger,” which will be
shown in June, just after his 80th birthday.
Released by Chairman Rand Paul
445take them back to Dallas, TX.   He could have flown commercial; however, we wanted to
avoid the ignorant panic if anyone found out that he did so.
Very cold day here in Bethesda/DC.   Went doe to HHS to reception honoring retiring
Deputy Secretary Bill Corr.   He was very pleased that I came down there.   Bill was
Chief-of-Staff to Donna Shalala for 8 years and then 6 years with this administration as
Deputy Secretary.   A fine man and excellent Public Servant.
Amazing thing happened to Dan Chertoff who has been a leading player in the care of
   Dan wore himself out taking day call every day in the SCSU (as well as coming
in at night during the crisis periods).   To make matters worse, his father passed away
during all of this.   And so now that it is over, he took his wife Jessica and his child for a
vacation in the Dominican Republic.   His went through all of the appropriate
notifications of travel via our OMS, the State of Maryland, the CDC, and the embassy of
Dominican Republic.   Somewhere along the way, someone, including the CDC, dropped
the ball and did not inform him that the DR has a policy of not accepting people who
have taken care of Ebola patients even though by our criteria, he is “low, but not zero
risk” and so should have no travel restrictions.   Bottom line is that the DR kicked him
out of DR soon after he landed.   They were waiting for his at his hotel and with
apologies, put him and his family on a plane at their expense and sent him back to the
USA.   Amazing bullshit!   Truly unbelievable how stupid they are and how incompetent
were the people that should have warned Dan.
April 10, 2015 – Jack Whitescarver and Wendy Wertheimer sent in to Francis Collins
their letter of resignation from the OAR.   Jack is 78 and wanted to stay until he reached
80.   However, he and Francis have not been getting along since Francis feels that Jack
has been too slow and non-specific in shifting the AIDS money to focus on the high
priority areas such as vaccine, prevention, cure and co-morbidities.  The relationship has
soured and so Jack feels that it is time to go.  I, myself, love Jack, but am not satisfied
with how they are handling the re-distribution of the AIDS money.   Clearly there is too
much AIDS money in NIDA and in NCI that is not being used for AIDS projects and to
call it AIDS-related is a stretch.   We had a meeting in my library today with Larry
Tabak, Wendy W. and Jack to discuss this issue.   I got pissed off at Wendy since she
essentially accused me of saying (which I did not) that behavioral research grants were
not good science.   That is not what I said.   I said that we were doing proportionately too
much behavioral research out of NIDA and that the Congress (Rep Andy Harris R-MD et
al) are trying to decrease the AIDS budget (see above) and we had better be spending it
all on research that is high priority such as vaccine and cure; otherwise, they will have an
excuse to cut the budget.   Larry Tabak is totally in my corner and even Jack admitted
that he agreed.   However, the behavioralist community keeps pushing to do a lot of
behavioral research.   Clearly, the studies might be sound, but they do not contribute to
the end of the pandemic.   You can study behavior when it comes to AIDS; however, it
has been very difficult to “change” behavior.
April 11, 2015 – Went to Reception/dinner at Jamie Gorelick (former assistant attorney
general in Clinton Adm) and Rich Waldron’s home in Chevy Chase in honor of Roger
Released by Chairman Rand Paul

446Glass winning the Sabin Medal for developing a rotavirus vaccine.  Mostly NIH people
and some of Roger’s old friends.
April 13, 2015 – Washington Nationals getting off to a very bad start.   Many errors and
no hitting.   Also, their excellent pitching staff is getting blasted.
Went to Tyson’s Corner Ritz-Carlton at invitation of David Rubenstein (CEO of Carlyle
Group) to talk to their annual meeting (~600 top CEO managers of Carlyle activities).
Format was David interviewing me on Stage 1-on-1 right after lunch.   David obviously
is very taken up by me and really likes me (likewise).   Remember, he tried to recruit me
to Carlyle several years ago for $1 million flat salary plus commissions.   Many in the
group said to me that I was the best invited speaker at any of the former annual meetings.
Besides, they pay the others a handsome honorarium.
AAAS (new CEO Rush Holt) chose me to be one of a couple of people to give the
laudation for Alan Leshner who is retiring as CEO of AAAS.   Very elegant function at
the Women’s Museum of the Arts on New York Avenue and 12th Street, N.W.   Alan was
very moved by my remarks.
April 15, 2014 – Testified at a House Appropriations Subcommittee Hearing at 10:00
AM in Room 2358B of the Rayburn Building.   Topic was Ebola response.   I represented
NIH.  Also testifying was Nicki Lurie (ASPR), Tom Frieden and Robin Robinson
(BARDA).   I did well, but Nicki and Tom caught some criticism for the fact that the
ETUs that they recommended got built and only 2 of 11 actually admitted a patient and of
the 2 that admitted patients, only 25 patients were seen.   Criticism was the lack of
flexibility to stop the building when it became clear that the epidemic was decreasing
rapidly as they were building the ETUs.   Committee nevertheless complimented us on
the Ebola response.   Rep. Harris (R-MD) was a bit snarky with Tom Frieden saying that
his daughter is an ICU nurse at Hopkins and she does not know how to don PPE and that
reflects a lack of planning on the part of the USG.   He is misguided.
Had disturbing meeting with Francis Collins, Larry Tabak, Jim Anderson, and Kathy
Hudson in Building 1, Room 116 concerning the re-prioritization of the AIDS budget
through OAR.   It is now clear that Francis not only wants to assure that the highest
priority AID research is done with AIDS dollars, he actually wants to decrease the
amount of money going for AIDS research and redirect it to non-AIDS, i.e. decrease the
AIDS allocation.   He is using the review of the AIDS portfolio as an excuse for this.   I
warned him that this is not a good idea and will be met with pushback from the
community.   I also believe that Francis might be trying to ingratiate himself with the
GOP since he may be covering his bets in case a Republican becomes POTUS and he
wants to keep his job as NIH Director.   Just a thought.
April 17, 2015 – Had meeting at HHS in Room 305A in Humphrey Building with the
Presidents of Liberia (Ellen Johnson Sirleaf), Sierra Leone (Ernest Koroma) and Guinea
(Alpha Conde) to discuss the status of the Ebola outbreak.   Much good will with
expressions of cooperation and collaboration.   The Presidents insisted (appropriately)
Released by Chairman Rand Paul
447that we cannot rest until the cases go to zero.   Also, they spoke of developing sustainable
infrastructure that will be available for the next outbreak of Ebola or any other disease.
President Koroma spoke of his desire to establish an African CDC.   I described for
President Sirleaf the successful implementation of the RCT for vaccine (in Liberia) and
the RCT for ZMapp (in Liberia and Sierra Leone).   She obviously already knew about
this since we had briefed her previously and she knew that we were also helping to
renovate clinics in Redemption Hospital and JFK Hospital in Monrovia.   Of note, when
President Conde heard that we were doing these trials in Liberia he expressed (through a
French translator) his strong desire for us to do such trials in Guinea.   Obviously, this is
good news for Cliff who is trying to get around the nonsense of the Norwegians and
WHO regarding their trying to stop us from doing the trial (see above).   Meeting ended
very well.
April 19, 2015 (Sunday) – Was inducted in the Washington, D.C. Hall of Fame
(Historical Society of the District of Columbia).   Category of Science and technology.
Black tie affair at the Liason Hotel on New Jersey Avenue, N.W.   DC Mayor Muriel
Bowser was present and ceremony MC’d by Former DC mayor Sharon Pratt.   Of note is
fact that I was the only white person to be inducted (total of 12 inductees for various
categories (arts, literature, law, business, etc.).   Also, of the approximately 300 people in
the ballroom, except for one other person, Chris and I were the only white people – all
were African-American.
April 21, 2015 – Pat White who now works for “ACT for NIH” got Chris and I invited to
an affair at the Eisenhower Theater at the Kennedy Center.   It was an interview
conducted on stage by Bob Shieffer (CBS Face the Nation) with Bill Clinton and Colin
Powell.   The evening was MC’d by Norah O’Donnell (NBC).   Great interview.   Elegant
dinner followed upstairs in the Atrium.   Had opportunity of nice conversations with
President Clinton and especially Colin Powell who is always extremely friendly with me.
Also chatted with Nancy Pelosi, Majority Whip Kevin McCarthy, Mack McCarty, Sen.
Richard Durbin among others.   Really a fun evening.
During the day, met with Mike Gerson who is interested in partnering with a producer to
make a documentary of the global response to HIV, concentrating on the PEPFAR story.
And so he met with me in my office for 1 hour to discuss various aspects of the historical
evolution of PEPFAR.
April 23, 2015 – Conference call with MSF (Joanne Liu and Sophie Delaunay), Tom
Frieden and Cliff Lane about”BioBank” and study of specimens that had been stored
from Ebola patients.   Interesting that MSF, who has never been interested in research
and who often put down research since that focused on care now want to lead the effort.
Joanne and Sophie are good people and this manifests the dichotomy and heterogeneity
of MSF.   Many conflicts within their ranks.   Bottom line is that we agreed since we all
are interested in this that we do the best possible science with true transparency and that
above all, the data belong to the West Africans.
Released by Chairman Rand Paul
448April 25, 2015 – Went with Chris to the Annual Garden Party at the Beall-Washington
House at 2920 – R Street, N.W. that precedes the White House Correspondents’ Dinner
tonight.   Usual DC scene of TV stars and Hollywood stars such as Michael Kelly from
“House of Cards” among others.   Many people commented about my performance on
TV during the Ebola crisis this past Fall.  The Brunch was sponsored by Steve and Jean
Case, Tammy Haddad, Mark Ein, etc..
That evening went to WH Correspondents’s Dinner at the Washington Hilton on
Connecticut Avenue and Florida Avenue.   Was guest of Tom Burton and the Wll Street
Journal.   President Obama gave good comedy show followed by Saturday Night Live’s
Cecily Johnson.  She was not particularly funny, but OK.
April 26, 2015 – Went to the Annual NAS Garden Party at NAS Headquarters on C
Street and 22-23rd Street, N.W.   Usual scene of seeing old friends.  As always, great to
see Max and Rosalie Cooper.
April 28, 2015 – Wonderful evening at the home of Ambassador Esther Coopersmith
(2230 S Street, N.W.) who gave “A List” party in honor of Barbra Streisand who is a
strong advocate of the Women’s Heart Alliance, an organization calling attention to the
unrecognized burden of heart disease among women.   Beautiful DC Spring evening
(magical) – perfect temperature, crystal clear sky.   I had the pleasure of spending much
face-to-face time with Barbra.   She clearly knew who I was when introduced.  She knew
the connection to Larry Kramer as she was supposed to produce “The Normal Heart” for
Hollywood, but did not as it went to HBO.   I was seated directly across from her at a
narrow table and right next to Esther Coopersmith, the hostess.   Amazing crowd with
many politicians – Nita Lowy and Rosa DeLauro (who kept shouting me out in their
remarks); Ed Markey who gave a short speech and said “Wow, what a party – I am sitting
here with Tony Fauci!”; Sen John McCain, Chris Dodd, Lloyd Hand, James Brolin
(Barbra’s husband and father of Josh Brolin), Kathleen Kennedy Townsend, Gary
Gibbons (the only other NIH person), Catherine and Wayne Reynolds, Diane Rehm,
henry Waxman, Irene Pollin, Anita Mcbride, Rima Al-Sabah, Sen. Franken, Debbie
Dingel, and many other notables.   Barbra was amazingly nice – warm, sincere, funny,
friendly.   I was surprised since Harold Varmus had told me that on a prior visit by
Barbra to NIH when he was Director and I was not present, Harold said that Barbra was
aloof and not friendly.   Totally opposite tonight.   You get the feeling you could really be
her friend.
April 30, 2015 – testified before the Senate Appropriations Subcommittee with Francis
Collins, Gary Gibbons, Tom Insel, Jon Lorsch, and Doug Lowy.   Committee now
chaired by Roy Blount (R-MO).   Hearing went well.   Concomitantly with Hearing has
been the drafting and revising of the 21 Century Cures Act developed by Fred Upton (R-
MN) and Diane DeGette (D-CO).   Clearly, Francis Collins (who denies it) had a lot to do
with this since it authorizes (and appropriates – weird for an authorization committee) $2
billion per year for 5 years to NIH Director to ONLY be spent on Precision Medicine,
young investigators, and “other research” TBD.   This is a bad idea to earmark that much
money in the NIH budget.
Released by Chairman Rand Paul
449May 2, 2015 – Went to Children’s Inn Gala at the Ritz-Carlton at Tyson’s Corner.   Big
shout out for me by the MC for my Ebola and other work.
May 5, 2015 – Dedicated Building 4 today as the Lowell Weicker Building.   I gave the
main laudatio and Lowell loved it as did his wife Claudia, who I knew from the old days
when she was his staffer.   He divorced his wife to marry Claudia.   Nice ceremony
attended by Sen. Tom Harkin, Rep. Dave Obey, Tim Schriver.
Was visited today by Harry Jaffe the National Editor at The Washingtonian.   Harry
wants very much for me to write a book.   Says he has been following my career and that
I have a “couple of books in me”.   He wants to help as an editor, co-writer and/or agent.
He has written several books himself, including the best seller “Dream City” about
Marion Barry.
May 6, 2015 – Went to Detroit to receive honorary doctorate of LAWS from Wayne
State Univerity.  President Roy Wilson whom I know from his years ta NIH and he was
on the Search Committee that I co-chaired with Gary Gibbons for the Director of
NIMHD.  Very nice trip.   Absolutely beautiful weather – 50-60 and bright sun.  Had
very pleasant dinner in Roy spectacular apartment near Wayne State Univ.   Roy was
born in Japan of African-American father (officer in Air Force) and Japanese mother.
He is fit and handsome guy.   His apartment was a combination of modern American and
Kyoto-like Japanese décor.   Really nice.
May 7, 2015 -  Received degree today from WSU.   On plane back, zsat behind an
African American man and his wife/girlfriend.   He looked around 60 years old and in
great shape.   I helped him open the upper luggage bin and our eyes met.   He looked
straight at me and said with a big smile: “Did you dye your hair gray so that a young man
like you would look more distinguished?”.   I told him that unfortunately it was age.   He
asked me how old I was and I told him 74.   He smiled and said he was 69 and gave me a
fist pump.   I noticed a massive diamond-studded ring on his finger.   He pointed to it and
said: “Do you know what this is?”   I said no and he said it was a Hall of Fame Ring.   I
looked at him and apologized and said I am very sorry, but I do not recognize you.   He
said:   I am Lem Barney, Hall of Fame cornerback for the Detroit Lions from 1967
through 1977, and you are that wonderful doctor who does so much for the world.   I told
him how much I admired his play over so many years with the Lions.   We hugged and
shook hands for a long time.   Wonderful encounter!
May 9, 2015 – Chris has been in Zimbabwe and South Africa for the past 2 weeks giving
lectures on Ethics.   She wrote me a wonderful 30th Anniversary letter:
Dear Tony.docx
May 2015
Released by Chairman Rand Paul
450Dear Tony:
Happy 30th Anniversary!  Thank you for a wonderful 30 years. I have had a little time to reflect
and so wanted to share some thoughts with you.
In my view, these have been 30 great years.  Thirty years seems like a long time, and yet I cannot
imagine life without you. It has actually gone by pretty quickly.  We love each other and work
and play together- all of which I hope will continue for many years to come.  We have three
incredible kids, a comfortable and enjoyable life, and good health.  We can talk to each other
about the mundane, the philosophical, the political, and the speculative.  We laugh and cry
together.  We run and cook and even (lately) play tennis together.
I am only one of many many who have great admiration and respect for all that you have done
and continue to do. You have done remarkable things at work and made amazing contributions
to science and to your country.  I hope that my support and encouragement have been helpful
to you and that I have not interfered with your many successes.
My hope is that over these following years we will find time to enjoy life as much as possible.
There is so much to learn and do and see.  It would be fun to do it together.
Thank you for being my lover, my friend, my advisor, my companion, my critic.  Thank you for
putting up with the bags under my eyes and the weight of the world on my shoulders.  Thank
you for being a great father and husband.
I look forward to celebrating our anniversary together.
I love you.
Christine
May 11, 2015 – Liberia now declared Ebola free (no cases in 42 days – double the
maximum incubation period of 21 days.
May 12, 2015 –  is back today and yesterday for his follow-up visit.   I
flew back from DDCF meeting early to catch him before he left hospital.   He came to
my office with Rick Davey to say hello.   He looks great.   Feels good except for some
easy fatiguing.   His brain MRI shows some improvement.   The CT on semen is now up
to 27-29 from 18 previously.   Hence, virus clearing from semen.   Still on eye drops for
Ebola uveitis.   Tears negative.
When he visited in my office in Building 31, we hugged and had a great conversation.
He gave me a letter that was very moving.  Letter below:
Released by Chairman Rand Paul

451
This is what makes it worthwhile!!
Released by Chairman Rand Paul
452May 14, 2015 - I am very disturbed by the situation regarding the conflict of principles
between scientists (ourselves) and certain health officials in Europe concerning the
conduct of randomized controlled clinical trials in the Ebola outbreak in West Africa. I
am absolutely astounded by the lack of scientific rigor demonstrated by people like
Jeremy Farrar the head of the Wellcome Trust and certain scientists at Oxford University
including Peter Horby and Adrian Hill. I am also surprised that Peter Piot is also sharply
criticizing any placebo-controlled trials particularly of drugs. We have considerable
experience with HIV and in other arenas where the artificial show of compassion in a
serious disease that results in wide distribution of unproven drugs leads to a double
jeopardy of never proving that an intervention works or not, and more importantly misses
the possibility that they are actually harming people. The British and as well as people at
WHO and Doctors without Borders by taking somewhat of a self-righteous approach that
any research done in the setting of an Ebola outbreak is unethical are actually hurting
people.   The Oxford group actually covered up that several patients given open access to
Brincidofavir died and they never reported it.   They said that the study was stopped
because there were no more infections, when this was a blatant misrepresentation. There
have been dueling criticisms in the press between our approach and theirs about this. A
recent Wall Street Journal article by reporter Tom Burton analyzed this carefully and
blasted the Europeans for giving out medicines in an open access manner while likely
hurting people with drugs that have clear toxicity that have really no pre-clinical
indication that they would work. In my mind Cliff Lane is a true hero in this as he is
designed and implemented randomized controlled trials for vaccines in Liberia as well as
controlled randomized trials without a placebo for certain drugs like ZMapp.
I am terribly disappointed with Tom Frieden who continues to insist that you cannot do a
randomized controlled trial of the vaccine in countries like Guinea because this would
interfere with the public health effort of getting the epidemic down to zero. Clearly, as
well-meaning as he may be, he does not have a clue about how to design or implement a
clinical trial. Again I am really very disappointed with him, with the WHO, with the
Wellcome Trust, and with individual characters such as Jeremy Farrar and Marie-Paule
Kieny at WHO. They really should be ashamed of themselves.
May 17, 2015 – Received honorary doctorate of Public Service from George Washington
University in a beautiful ceremony on the National Mall right in front of the Washington
Monument.   Commencement Speaker was Tim Cook, CEO of Apple.   At the ceremonial
dinner the night before at the Corcoran Gallery of Art on 17th Street, N.W., a student
member of the Board of Trustees got a piece of meat stuck in his throat and was choking.
I did a Heimlich maneuver and dislodged the piece of steak.   Obviously, the crowd was
delighted and gave me a big round of applause.  The next day (today) at the graduation
ceremony, President Knapp mentioned this in his citation for my honorary doctorate.   It
also got tweeted around.
May 19-21, 2015 -   Honorary doctorates at Columbia University in NYC (Doctor of
Science) on May 20 and The Johns Hopkins University in Baltimore (Doctor of Humane
Letters) on May 21.
Released by Chairman Rand Paul
454Elijah Cummings – Congressman from Baltimore gave very moving comments (in his
wonderful preacher fashion) about the recent riots in Baltimore related to the police
killing of Freddie Gray.  He spoke of his own growing up and still living in the
neighborhood where the riots took place.
Leon Fleisher – world renowned concert pianist.   He was wonderful and they showed a
clip of his playing the piano.   He gave words of wisdom.   “Listen and do not be afraid of
silence.”   Also, “Procrastination saves time”
Edwin Catmull, the CEO of Pixar Animation Studio.   Produced the first computer
animated film “Toy Story” and also “Frozen”.   Has won 5 Academy Awards.
May 21, 2015 – Received the Special Recognition Award for Science and Medicine at
the Sons of Italy Foundation Gala at the National Building Museum.   Phil Piccigallo
gave a very nice and warm laudation of me with many old photos of me in different
“historic” situations.   Also, met at the dinner;  Anita McBride (former chief-of-Staff to
Laura Bush), General Ray Odierno and his wounded warrior son Anthony (arm blown off
by an IED in IraQ).
May 26, 2015 – Gave an “Interview” talk with Joe Palca (NPR) at the Ripley Center of
the Smithsonian.  Good crowd, good questions.
May 27, 2015 – Hosted 30 Staff members from the Senate Appropriations and Oversight
committees at the Special Clinical Studies Unit (SCSU) at the Clinical Center where we
took care of  and    I did for them the complete donning and
doffing procedure, which they absolutely loved.   Many questions.
Did a telebriefing for the release of the START study data (DSMB recommended
stopping the study due to highly positive results).   Clearly starting ARVs at greater than
500 CD4+ T cell count was much more beneficial (p <0.001) than waiting until counts
drop to 350.   Got much attention.   Front page of NY Times with my picture in ONLINE
version of Times.   Also the next night (May 28), I appeared with Judy Woodruff on the
NewsHour.
May 28, 2015 – Went to UN to participate in Panel at ECOSOC Council (Economic and
Social Council), chaired by Paul Farmer to discuss sustainable health systems in light of
the Ebola outbreak.   Bill Clinton gave the Keynote and we shook hands and exchanged
pleasantries.   On the panel with me was the actor Jeffrey Wright (“Angels in America”
“Boardwalk Empire”.   He has won an Emmy, a Golden Globe and a Tony.   Very nice
man.   Says that he has been a fan of mine for years.   He is working to improve the
conditions of miners in Sierra Leone.
June 1, 2015 – Gave lecture at the Sulgrave Club on Dupont Circle.   Upper Crust old
women’s club.   Quite charming and elegant Building between P and Massachusetts Ave,
right on DuPont Circle.   Spoke on Ebola.   Adoring crowd.   Met John Quinnan with
Released by Chairman Rand Paul

455whom I did my first research project in the summer between my 1st and 2nd year at
Cornell – the summer that I met Lynne Williams.
June 2, 2015 – Spoke with Doug brooks (ONAP) about setting up a meeting with him,
me, Valeria Jarrett and Denis McDonough to discuss possibility of starting a PEPFAER
for the USA to end the AIDS pandemic here.
June 3, 2015 – Chris and I went to function in the Mansfield Room of the US capitol as
gusts of Wayne and Catherine Reynolds in one of their usual wonderful social events.
They were honoring Congresswoman Debbie Dingel, Sens. Roy Blount, Thad Cochrane
and Diane Feinstein for their contribution to the Arts.  I introduced Debbie Dingel.
Great crowd.   I chatted with old friends Fred Hiatt of Washington Post, Rick Atkinson,
Chris Matthews, Bob Barnett, etc.   Great evening.
June 5, 2015 – Things heating up with MERS in South Korea.   Now at 40 cases and 4
deaths – largest outbreak outside of the Arabian Penisula.   Index case is a 68 year
Korean man who travelled in the Arabian Penisula (KSA, Qatar, UAE, etc) came back to
Korea was hospitalized and set off a chain of infections among people in same room and
even on same ward as well as family members and HCWs.
I appeared on Wolf Blitzer (CNN) to discuss the situation.
June 6, 2015 – Steve Holland admitted a patient (25 year old woman from India) with
XDR TB today.   NSC heard about it and as usual pushed the panic button and wanted us
to provide a press statement and Qs and As.   We did and this triggered much press
interest.
June 8, 2015 – Did my BSC presentations or LIR Overview and Immunopathogenesis
Section accomplishments.   My primary reviewers were Arturo Casadevall and Larry
Corey.   Review went extremely well.
Press interest now heating up for both MERS and the XDR patient here at NIH.
Did interview with Katty Kay for BBC on MERS.
June 9, 2015 = Did WTOP interview on MERS and XDR TB.   Also, for XDR TB did
MSNBC with Andrea Mitchell, NBC Nightly News, CBS Nightly News and Telemundo
TV, Channel 8 News, ABC Nightly News
Harold Varmus came back to Bethesda and visited with me.   He is doing fine at Weill-
Cornell.   Came down for a dinner with Francis Collins, Shirley Tilghman, Marc
Kirschner, and Ron Daniels to discuss the systemic problems with the biomedical
research enterprise related to the paper that Harold, bruce Alberts, Kirschner and
Tilghman wrote in PNAS.
Released by Chairman Rand Paul
456June 10, 2015 -   Long interview with me on XDR TB patient by Denise Grady appeared
today in the NY Times.   Also, did FOX Channel 25 Local News this AM.
Got report from BSC and was told that “Outstanding” was not a sufficient adjective to
describe how good my laboratory and my section was.   Praised my leadership and it was
the first time that every single person in a given laboratory got “outstanding”.  Called the
lab a “National Treasure”.
June 12, 2015 – Did Bloomberg TV on MERS, which is still going on in South Korea.
Now up to 133 cases and 14 deaths.   We here at level of HHS are already having the
usual conference calls of preparedness regarding development of therapeutics and
vaccines.
June 15, 2015 – had dinner over my house with Eric Goosby and Chris – the now
traditional sausage and rigatoni dinners that I have had with Eric, Harold Varmus, and
Gary Nabel over the years.   Eric is in town for and IOM workshop.   He also is seeking
my assistance in obtaining a grant from the DDCF and also NIH now that he is out of
government and pursuing global health issues.  Of note, he has recently been appointed as
the UN Secretary General’s Special Envoy for TB.
Tom Frieden is balking at supporting the proposal for the IOM Study on lessons learned
in the Ebola response.   I will be supporting the study with NIAID funds.  Tom still is not
really on the same page with me about what went on during the response.   He is still
fixating on have the IOM study focus on “alternative clinical trial designs” instead of the
RCT.  Also, he is still against Cliff trying to extend the RCT to Guinea.   Tom feels that
the Guineans will react badly to a trial and be paranoid that we are trying to kill them.
This conflicts with the fact that the WHO is already doing a ring vaccination (poor
design) study in Guinea.   Anyway, conversation with Tom are still very cordial and I like
him – just disagree with him sometimes.
June 16, 2015 - I am in the midst of preparing my talk for the International AIDS Society
to take place in Vancouver. As usual I am taking this very seriously and doing multiple
drafts.
Cliff Lane and I had a teleconference with individuals from Drs. Without Borders (MSF);
in particular, we spoke with Sophie Delaunay along with Jennifer Cohen of MSF. The
discussion was the interest on the part of MSF to be a major player in the development of
a Biobank for specimens in West Africa related to the Ebola outbreak. Cliff and I are
somewhat skeptical about this issue since MSF rarely, if ever, gets involved in
biomedical research, and when they do, we have had concerns about their capability in
this regard. CDC (Tom Frieden) agrees completely with us on this and has skepticism
about their involvement.  They are a wonderful organization when it comes to taking care
of patients; however, we have had some difficult experiences with their inability to really
appreciate the importance of the scientific method when doing research.
Released by Chairman Rand Paul
457Today I had the first meeting for the search committee for the director of the division of
intramural research to replace Kathy Zoon.   The Committee is co-chaired by Cliff Lane
and Gary Gibbons.
June 17, 2015 -  I gave a talk at the HPTN/IMPAACT meeting at the Crystal Gateway
Marriott Hotel on Jefferson Davis Hwy. in Crystal City, Virginia. This was an important
talk because I introduced to the investigators the difficulty that we are having now with
certain members of Congress wanting to decrease the AIDS budget and even move
money out of the AIDS bucket into other institutes. I showed the audience a C-SPAN clip
of my debating with Senator Cassidy (R-Tea Party) from Louisiana where he was talking
about matching allocation of funds with the number of disability adjusted life years
(DALYs) in this country. If this approach were followed, it would have a serious negative
impact on all global health research, particularly research on infectious diseases. I
articulated well my objection to this. Some people have picked this up and put it on
YouTube, and the clip has gone viral. In addition, I spoke to the group about future
directions of focusing the AIDS research specifically on ending the epidemic so that
ultimately we will not have to spend any money on AIDS.  This would be an important
public health accomplishment, and it would silence the people who want to take money
from AIDS prematurely before we have ended the AIDS epidemic.
Tonight, I flew to Atlanta to participate in the Charles C Shepard Science Award
Ceremony in Atlanta at the CDC headquarters.
June 19, 2015 -  I gave a lecture at the CDC on the subject of " Ending the HIV AIDS
pandemic: From scientific advances to public health implementation". The lecture was
extremely well accepted by the CDC community. I had time to chat with my dear friend
Tom Frieden about a number of issues of mutual interest. I was shown around the
absolutely beautiful new CDC campus that I had not been on for several years. The
campus has been completely transformed by beautiful, architecturally creative buildings.
It is very clear that I am highly respected and revered by the CDC community. Tom
introduced mew as a “living legend”.   It was a great visit that I enjoy very much and it
cemented my relationship with our colleagues at the CDC.
June 20, 2015 -  I viewed the preview of the soon to be shown on HBO documentary on
Larry Kramer entitled “Larry Kramer: In Love and Anger”. It was played at the Naval
Heritage Center on 701 Pennsylvania Ave. NW. The documentary is a moving story of
Larry Kramer's complicated life. I was prominently featured in the documentary
interacting on multiple occasions with Larry.
June 22, 2015  - I gave a lecture at Georgetown University O’Neill Institute at the Law
School on New Jersey Avenue, NW Summer Program on Infectious Diseases and the
Law. Again very well received by the group there.
We are in the middle of an extraordinary heat wave now in Washington DC with
temperatures reaching 95- 100° with sunny skies during the day and massive
thunderstorms at night.
Released by Chairman Rand Paul
458June 23, 2015 -  I had a very nice breakfast meeting at the American City Diner with Bill
Schultz who is the general counsel for the Department of Health and Human Services. I
met with Bill at the suggestion of Pulitzer Prize winning author and close friend of mine
Rick Atkinson. Rick was concerned if I got involved with Don Fehr, who offered to be an
unofficial agent for me and read over my manuscript as well as tell me how to write a
book proposal for an editor, that this informal arrangement could spell out to the a legal
issue later.  This arrangement might also be something that is frowned upon by the
department. And so Rick recommended that I meet with Bill and get his legal advice. My
meeting with Bill was terrific. He was extremely encouraging to me about writing my
book. He agreed with Rick that I should hold off making even any informal arrangements
with anyone and I should just go ahead and continue to write my chapters and when I am
ready to leave the government to then put together my proposal and “shop” it around to
different publishers and agents. I will take his advice and go that way.
This evening I gave a presentation to the AIDS Clinical Trials Group (ACTG) annual
meeting at the Renaissance Hotel Downtown at 999 – 9th Street Northwest. The talk was
very similar to what I gave to the HPTN/IMPAACT group.
June 24, 2015 -  I participated with the NIH and CDC team here at NIH in Wilson Hall
of Building 1 as well as in Room 151 in the meeting with the Vice Premier of China Jiu
Yandong.  The meeting was hosted by Sylvia Burwell (Sec., HHS).  I presented a talk on
the role of NIH in the response to the Ebola Outbreak.   I interacted with several of my
Chinese colleagues including the Director of the Chinese CDC.   An agenda of the
meeting is given in the PDF below:
draft agenda.pdf
June 25 – June 27, 2015 -  I travel to Aspen, Colorado to be a participant in the 2015
Aspen Ideas Festival, Spotlight health. It was a most enjoyable experience as I attended
several of the panels on areas that were of my own interest and expertise, and even some
areas that are not my areas of expertise. With regard to my direct participation, on the
morning of Friday, June 26 , I participated in a “Tutorial Session” which was a panel on
the topic of “Be Preared: Infectious diseases are here to stay”. On the panel with me were
Larry Brilliant, Neeraj Mistry, and Storn Kabuluzi of Malawi.  The Panel was chaired by
Judy Woodruff of The NewsHour (PBS). Judy is an old friend and it was a very lively
panel. An added plus for the experience was that I finally got to meet Larry Brilliant who
is one of the icons of global health, having participated actively in the eradication of polio
from India during his time at WHO. He is the kind of person who I think could be a really
good friend. He obviously has an incredible amount of respect for me. The panels that I
enjoyed watching were the health and Healthcare session on the morning of June 26,
which was a breakfast session right before my session. The speakers with Tom Daschle,
Henry Waxman, Bill Frist and the panel was chaired by Steve Clemons, Editor-at-Large
for Atlantic magazine. It was a most joyful time for so many of us in Aspen because the
Released by Chairman Rand Paul
459Supreme Court had voted by 6 to 3 to uphold the Affordable Care Act and the tax credit
for those who live in states that do not have their own exchanges. In addition, the
following day the Supreme Court ruled by 5 to 4 to strike down the prohibition on gay
marriage. The Obama administration has had an amazing couple of days.
On Friday evening of June 26 it was a wonderful reception at the home of Gail and Al
Engelberg who live on a beautiful mansion overlooking the mountains of Aspen and
Aspen Valley. The reception was in honor of former secretaries of Health and Human
Services. These included David Matthews, Kathleen Sebelius, Donna Shalala, Tommy
Thompson.  It was great to see Tommy Thompson again as well as all of the others. Of
note Donna Shalala wanted to talk to me in her new capacity as the CEO of the Clinton
Foundation.  Apparently Chelsea Clinton had been approached by people from MSF and
WHO to help fund the controversial “ring vaccination” study of the Ebola vaccine that
they are conducting in Guinea. As I had mentioned, both Cliff and I feel that this is a
flawed study since it has no control group. Donna wanted to know whether the Clinton
Foundation should get involved. I recommend strongly to her that they do not support
this study and if, in fact, Chelsea Clinton feels that she wants to support it, then it is
importantfor the Clinton Foundation to get an outside group to look seriously at the
design of the study, which I have a lot of trouble with, as well as to examine the data that
is a ready been collected. Donna thanked me for :”Covering my back as you always do”.
The reception was idyllic in that views were breathtaking, the skies were crystal clear and
the weather was warm without any humidity. I met many wonderful people at the
reception including a nice conversation with my old friend Ashley Judd, who looked
absolutely beautiful. She complimented me on “how great I looked”  and on the
important work that I have been doing for so long. She was with a little dog and was
barefoot. She is an amazing looking woman and a really devoted global health advocate.
She was there to talk about her reflections on global health on the following day. One of
the people I ran into who was very complimentary was a Zoe Baird, who called me the
epitome of the true public servant. She said that I was incomparable in what I have done
over so many years for the people of the country in the world. It was a very moving and
sincere compliment to me. The following day on Saturday, June 27,  I participated in a
panel on the “Looming Antibiotic Crisis”.  On the panel with me was Peggy Hamburg
and Ramanan Laximinarayan, who heads the Global Network for Neglected Tropical
Diseases.   He is a terrific guy with whom I had the opportunity to fly back to Denver
with that same morning. All in all it was one of the best trips that I had taken in that the
atmosphere was beautiful, the social interactions were in extremely positive, and I got the
opportunity to do my thing in front of a lot of important people who have also become
over the years good friends.
June 29, 2015 - I had two interesting encounters today by telephone with very interesting
people

Summary:
Watcher-discovered document from paul-readingroom (2026.07.27_Diary-Prequel-.pdf), auto-indexed 2026-08-05.

Excerpt: with Greta Van Susteren and MSNBC with Rachel Maddow.    After I got off the air, Rachel tells her audience how proud she was of herself to have  gotten me on her show since I was such an icon in medicine and public health. Oct. 14 -21, 2014 - From October 14 through October 21, the situation was so intense  that I do not have time to document historical notes on a day by day basis. I am only  doing this retrospectively now and will give dates as I recall. However over this period of  time in light of the crisis of confidence against CDC and Tom Frieden related to a  number of issues culminated by the fact that  was allowed to fly back from  Cleveland to Dallas, this was clear that Tom Frieden was in significant trouble over  several days Sec. Burwell would call me usually in the late…