DEPARTMENT OF HEALTH & HUMAN SERVICES Office of the Secretary Assistant Secretary for Public Affairs Washington, D.C. 20201 Case No. 2020-00719-FOIA-OS American Oversight v. HHS, Civil No. 20-cv-00947 September 25, 2020 Austin Evers Executive Director American Oversight Dear Mr. Evers: This letter is the first interim response to your March 18, 2020, Freedom of Information Act (FOIA) request. American Oversight requests all email communications (including email messages, complete email chains, email attachments, calendar invitations) sent by the government officials specified below containing any of the following key terms: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. EUA “Emergency Use” Test Testing “the WHO” W.H.O. “World Health Organization” Kit LDT CLIA RNA Extraction Quest LabCorp Roche Qiogen 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. “Thermo Fisher” Thermofisher Hologic “Panther Fusion” Wadsworth RT-PCR Oscar CureVac “University of Washington” “Seattle Flu study” Greninger POTUS Reagent 30. 564 564(b) “mainland China” “close contact” “issue guidance” HHS Officials: 1. Assistant Secretary for Health Brett Giroir 2. Anyone serving as Chief of Staff to Assistant Secretary for Health Giroir, including, but not limited to, Carla Haddad 3. Principal Deputy Assistant Secretary for Health Sylvia Trent-Adams 4. Deputy Assistant Secretary for Health Paul Reed 5. Assistant Secretary for Preparedness & Response Robert Kaldec 6. Principal Deputy Assistant Secretary for Preparedness & Response Kevin Yeskey 7. Deputy Assistant Secretary for Preparedness & Response & BARDA Director Rick Bright A\11 ICA FDA Officials: 1. Jeffrey Shuren, Director of the Center for Devices and Radiological Health 2. William Maisel, Director of the Office of Product Evaluation and Quality 3. Timothy Stenzel, Office of Health Technology 7 (In Vitro Diagnostics and Radiological Health) PVERSIGHT 4. Denise Hinton, Chief Scientist 5. Uwe Scherf, Director, Division of Microbiology Devices, Office of In Vitro Diagnostics and Radiological Health, Center for Devices and Radiological Health CDC Officials: 1. Robert Redfield, Director 2. Anne Schuchat, Principal Deputy Director 3. Stephen Lindstrom, Team Lead, Respiratory Virus Diagnostics Team, Centers for Disease Control and Prevention 4. Daniel Jernigan, Influenza Division at Centers for Disease Control and Prevention 5. Toby Merlin, Director, Division of Preparedness and Emerging Infections (DPEI) 6. Mark Frank, Deputy Director, Division of Emergency Operations at Centers for Disease Control and Prevention During the course of litigation, American Oversight modified the scope of its request. The Department processed 606 pages of potentially responsive records captured in the agency’s search for FOIA request 2020-00719-FOIA-OS. After a careful review of these pages, I have determined to release 155 pages to you in their entirety, I am further releasing 204 pages in part, with portions redacted, pursuant to Exemptions (b)(4), (b)(5), and (b)(6) of the FOIA (5 U.S.C. §552 (b)(5) and (b)(6)), and I am withholding 2 pages. Furthermore, I have determined that 245 pages should be sent for consultation to other agencies and returned to this Department for final disposition. FOIA exemption (b)(4) permits agencies, as a matter of discretion, to withhold trade secrets and commercial or financial information obtained from a person which is privileged or confidential. FOIA exemption (b)(5) protects inter-agency or intra-agency memoranda or letters which would not be available by law to a party other than an agency in litigation with the agency. This exemption protects documents that would be covered by any privilege an agency could assert in a civil proceeding. These privileges include, among others, the deliberative process privilege, the attorney-client privilege, and the attorney work-product privilege. FOIA exemption (b)(6) permits a Federal agency to withhold information and records about individuals in “personnel and medical files and similar files, the disclosure of which would constitute a clearly unwarranted invasion of personal privacy.” The definition of “similar files” has historically been broadly interpreted to include a wide variety of files, and the United States Supreme Court has held that Congress intended the term "similar files" to be interpreted broadly, rather than narrowly. I have analyzed these records and find they meet the threshold requirement of this exemption. Additionally, I have reviewed and weighed the public interest in disclosure of this information against the privacy interest in nondisclosure, and found that the privacy interest outweighs the public’s interest in disclosure. We will continue to review the remaining records as efficiently and expeditiously as possible, consistent with our available resources and the Order of the Court. Should you have questions or concerns regarding the Department’s response and\or the processing of your request, any such issues should be communicated to your legal counsel and Department of Justice Attorney representing the Department in this matter. Sincerely yours, Brandon J. Gaylord Director FOI/Privacy Act Division Enclosure(s) VERSIGHT Giroir, Brett (HHS/OASH) To: Broido, Tara (HHS/OASH) Heck, Mia (HHS/OASH); CC: Bante, Katie (O5/OASH) Subject: Re: Number of confirmed U.S. coronavirus cases spikes to 34 Date: 2020/02/2115:07:12 Priority: Normal Type: Note ThAt is a markedly different statement Sent from my iPhone On Feb 21, 2020, at 12: 17 PM, Broido, Tara (HHS/OASH) wrote: □ Subject: Number of confirmed U.S. coronavirus cases spikes to 34 Number of confirmed U.S. coronavirus cases spikes to 34 By David Lim 02/21/2020 01: 10 PM EST There are now 34 confirmed coronavirus cases in the United States, including 18 people evacuated from the Diamond Princess cruise ship, the CDC said today. "We're not seeing community spread in the United States yet, but it's very possible , even likely that itmay eventually happen," Nancy Messonnier, director of CDC's National Center for Immunization and Respiratory Diseases, told reporters. The updated count comes am.id concern from some public health experts that domestic screening capabilities are too lirn.ited to detect cases before they spark larger outbreaks. The vast majority of state and local public health labs still do not have the ability to screen patient samples for the virus. CDC's plan to use its influenza surveillance network to screen samples that test negative for the flu and other common respiratory viruses for the coronavirus is AMERICAN PVERSIGHT HHS-20-0580-A-000001 not yet active. The agency is in the process of starting up corona virus screening through its flu surveillance network and hopes to have that in place at six sites by next week, Messonnier said. To view online : https://protect2.fireeye.com /url?k=f9114979-a5455005-f9117846-0cc4 7adc5fa2 58b30b7027c l 9b32&u=https://subscriber.politicopro. com/healthcare/whi teboard/202 0/02/number-of-confirm ed-us-coronavirus-cases-sp ikes-to-34- 397 686 1 You received this POLITICO Pro content because your customized settings include: Public Health. To change your alert settings, please go to https: //protect2.fireeye.com /url?k =a8bc7747 -f4e86e3b-a8bc4678 -0cc47adc5fa2 d 14b 1bah 260b a6e9& u=h ttps: //subscriber. politicopro.co ml settings. PO I COPRO This email alert has been sent for the exclusive use of POLITICO Pro subscriber , tara .broido@hhs.gov . Fo1warding or reproducing the alert without the express , written permission of POLITICO Pro is a violation of copyright law and the POLITICO Pro subscription agreement. Copyright © 2020 by POLITICO LLC. To subscribe to Pro, please go to politicopro.com. This email was sent to tara.broido @hhs .gov by: POLITICO, LLC 1000 Wilson Blvd. Arlington, VA 22209 USA Sender: Giroir, Brett (HHS/OASH) Heck, Mia (HHS/OASH); Bante, Katie (O5/OASH) ; Broido, Tara (HHS/OASH) Sent Date: 2020/02/21 15:07: 11 Delivered Date: 2020/02/21 15:07: 12 AMERICAN PVERSIGHT HHS-20-0580-A-000002 Giroir, Brett (HHS/OASH) To: Brady, Will (HHS/IOS) Subject: RE: Line X Date: 2020/02/04 09:09:00 Priority: Normal Type: Note (b)(5) BG Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 -----Original Message----From: Brady, Will (HHS/IOS) Sent: Tuesday, February 4, 2020 9:08 AM To: Giroir, Brett (HHS/OASH) Subject: Line X b)(5) Sent f rom my 1Phone Giroir, Brett (HHS/OASH) Recipient: Brady, Will (HHS/IOS) Sent Date: 2020/02/04 09:09:44 Delivered Date: 2020/02/04 09:09:00 AMERICAN PVERSIGHT HHS-20-0580-A-000003 Giroir, Brett (HHS/OASH) Orsega, Susan(OS/OASH) Subject: RE: HHSInternational SPOTREP:Novel Coronavirus,Wuhan, China (Update #36) Date: 2020/02/04 08:39:00 Priority: Normal Type: Note Thank you (b)(5) Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690- 7694 From: Orsega, Susan (OS/OASH) Sent: Tuesday, February 4, 2020 8:32 AM To: Giroir, Brett (HHS/OASH) Subject: RE: HHS International SPOTREP:Novel Coronavirus, Wuhan, China (Update #36) b)(5) V/R From: Giroir, Brett (HHS/OASH) Sent: Tuesday, February 4, 2020 7:03 AM To: Orsega, Susan (OS/OASH) Subject: FW: HHS International SPOTREP:Novel Coronavirus, Wuhan, China (Update #36) Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 AMERICAN PVERSIGHT HHS-20-0580-A-000004 From: OS Secretarys Operations Center Sent: Tuesday, February 4, 2020 6:58 AM To: OS Secretarys Operations Center Subject: HHS International SPOTREP:Novel Coronavirus, Wuhan, China (Update #36) UNCLASSIFIED / / FOR OFFICIAL USE ONLY HHS International Source: SPOTREP: Novel Coronavirus, Wuhan, China (Update #36) HHS b)(5) Wave 2 Repatriation • Tentative arrival time: UPDATED • Flight 1 to Travis AFB: 1 hour delayed departure due to current winds; departure time (0630ET) 4Feb20; Arrive at Travis (0130ET) 5Feb20 • Flight 2 to Travis AFB: med crew swap only; Arrive at Travis 05Feb20 (0130ET) • Flight 3 to Travis AFB: 07Feb20 (0130ET); Lackland (0830ET) • Flight 4 to Miramar: 07Feb20 ( 0130ET); Omaha (0S00ET) 7Feb20 new b)(5) • DoD providing 2 backup sites for potential &Camp Ashland, NE Repatriation: quarantine - Fort Carson, CO HHS Posture • • HHS SOC is activated to Leve l 1 (24/7) as of 02Feb20. Deployed Personnel and Posture • Travis AFB: Total personnel (120); IMT (12), LRAT (5), ACF (12), Medical Screening (51), Medical Support (24), Fit Testers (2), USMS (14) For more details, please see attached HHS SLB for Novel Coronavirus, HHS SLB for Wuhan, China Repatriation, and CDC SitRep for Novel Coronavirus. When: 04Feb20 AMERICAN PVERSIGHT 0655ET HHS-20-0580-A-000005 Actions/Follow-Up: The SOC will continue to monitor this incident and report as needed. This message was distributed to the 2019 nCoV IMT, 2019 nCoV Interagency, 2019 nCoV IST, 2019 nCoV Senior Leadership and SOC SPOTREP-SITREP Distribution Lists. UNCLASSIFIED / / FOR OFFICIAL USE ONLY Prepared by: Christi Bonaparte, Watch Officer Approved by: Brandon Britton, Senior Watch Officer Secretary's Operations Center U.S. Department of Health and Human Services (HHS) Assistant Secretary for Preparedness and Response (ASPR) 200 Independence Ave S.W. Washington D.C. 20201 Office: (202) 619 - 7800 Fax: 800-514-4256 Email: hhs.soc@hhs.gov :::-:::: Description: Description: Description: Description: Description: Description: Description: Description: Description: cid: image001.png@01CCFC4D. 92F36DD0 Description: CONFIDENTIALITY NOTICE: This e-mail communication and any attachments may contain confidential and privileged information for the use of the designated recipients. If you are not the intended recipient, (or authorized to receive for the recipient) you are hereby notified that you have received this communication in error and that any review, disclosure, dissemination, distribution or copying of it or its contents is prohibited. If you have received this communication in error, please destroy all copies of this communication and any attachments and contact the sender by reply e-mail or telephone (202-619-7800). Sender: Recipient : Giroir, Brett (HHS/OASH) Orsega, Susan (OS/OASH) Sent Date: 2020/02/04 08:39:58 Delivered Date: 2020/02/04 08:39:00 AMERICAN PVERSIGHT HHS-20-0580-A-000006 Giroir, Brett (HHS/OASH) To: Subject: Migliaccio-Grabill,Kate (HHS/OASH) FW: FOUO/SBU:RegionalHealth Administrator and RegionalDirector visit to Travis AFB/Solano County-SITREP Date: 2020/02/10 21:44:00 Priority: Normal Type: Note (b)(5) Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Johns, Matthew (HHS/OASH) Sent: Monday, February 10, 2020 9:27 PM To: Giroir, Brett (HHS/OASH) ; Trent-Adams, Sylvia (HHS/OASH) Cc: AvilesMendoza, Guillermo (OS/OASH) ; Orsega, Susan (OS/OASH) Subject: FOUO/SBU: Regional Health Administrator and Regional Director visit to Travis AFB/Solano County-SITREP ///FOUO-SENSITIVE BUT UNCLASSIFIED/// ADM, RADM, I hope this finds you both well. Mr. Heidig (Ed) and I just finished our site visit to Travis AFB and Solano County to observe and discuss the overa ll effort in support of the repatriation mission. Travis AFB, HHS-led Incident Management Team: AMERICAN PVERSIGHT HHS-20-0580-A-000007 b)(5) Meeting with Travis AFB Wing Vice Commander: -Met with Travis Wing leadership and discussed numerous coordination steps and details of working with public, country health dept. and CDC (b)(5) Meeting with Solano County Supervisors, Director of Public Health and County Health Officer (joined by Travis AFB Public Health Officer) -RD and RHA shared our appreciation for the work of Solano County and our continued commitment to build on our existing relationship on SUD and EHE b)(5) Photos attached: 1. PHSCCofficers witting within the IMT (near flight line-no covers) 2. RHA and RD photo with Travis AFB Wing leadership (near flight line-no covers) 3. RHA and RD photo with PHSCCACF Case Managers (covered) Kind regards, CDRJohns MatthewC. Johns,MPH Commander, United States Public Health Service Regional Health Administrator-Region 9 Office of the Assistant Secretary for H ea Ith Office of the Secretary United States Department 90 7 th of Health and Human Services Street, Suite 5-100 San Francisco, CA 94103 AMERICAN PVERSIGHT HHS-20-0580-A-000008 Phone: (415)437-8102 __, H6_) ___ Mobi le: l(b_ ..... Email: Matthew.Johns@HHS.gov Website: https://www.hhs.gov/ash/about-ash/regional-offices/region-9/index.html HHS Region 9: In the Service of Health (In Officio Salutis) for Arizona , California , Nevada, Hawaii, American Samoa, Commonwealth of the Northern Mariana Islands, Federated States of Micronesia, Guam, Marshall Islands and the Republic of Palau ..... and 150 Federally-recognized Tribes. Giroir, Brett (HHS/OASH) Recipient: Migliaccio-Grabill, Kate (HHS/ OASH) Sent Date: 2020 / 02/ 10 21 :44 :39 Delivered Date: 2020 / 02/ 10 21 :44 :00 AMERICAN PVERSIGHT HHS-20-0580-A-000009 Giroir, Brett (HHS/OASH) Johns, Matthew (HHS/OASH) ; To: Trent-Adams, Sylvia (HHS/OASH) CC: Subject: AvilesMendoza, Guillermo (OS/OASH) ; Orsega, Susan (OS/OASH) RE: FOUO/SBU : Regional Health Administrator and Regional Director visit to Travis AFB/Solano County-SITREP Date: 2020/02/10 21:43:00 Priority: Normal Type: Note Thank you (b)(6) Keep up the great work BG Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Johns, Matthew (HHS/OASH) Sent: Monday, February 10, 2020 9:27 PM To: Giroir, Brett (HHS/OASH) ; Trent-Adams, Sylvia (HHS/OASH) Cc: AvilesMendoza, Guillermo (OS/OASH) ; Orsega, Susan (OS/OASH) Subject: FOUO/SBU: Regional Health Administrator and Regional Director visit to Travis AFB/Solano County-SITREP ///FOUO-SENSITIVE BUT U NCLASSIFlED/// ADM, RADM, AMERICAN PVERSIGHT HHS-20-0580-A-000010 I hope this finds you both well. Mr. Heidig (Ed) and I just finished our site visit to Travis AFB and Solano County to observe and discuss the overall effort in support of the repatriation mission. Travis AFB, HHS-led Incident Management Team: -RHA and RD briefed the larger all-hands IMT and provided our appreciation for their dedication and continued effort (b)(5) Meeting with Travis AFB Wing Vice Commander : -Met with Travis Wing leadership and discussed numerous coordination steps and details of working with public, country hea lth dept. and CDC (b)(5) Meeting with Solano County Supervisors, Director of Public Health and County Health Officer (joined by Travis AFB Public Health Officer) -RD and RHA shared our appreciation for the work of Solano County and our continued commitment t o build on our exist ing relationship on SUD and EHE b)(5) Photos attached: 1. PHS CC officers witting w ithin the IMT (near flight line -no covers) 2. RHA and RD photo w ith Travis AFB Wing leadership (near flight line -no covers) 3. RHA and RD photo with PHS CC ACF Case Managers (covered) « File: IMG_2020 -02-10_ 15-17-33.jpg » « File: IMG_2020-02-10 _ 15-17-45.JPG » « File: IMG_ 2020 -02-10_ 18-04-18.JPG » Kind regards, CDRJohns AMERICAN PVERSIGHT HHS-20-0580-A-000011 MatthewC. Johns,MPH Commander, United States Public Health Service Regional Health Administrator-Region 9 Office of the Assistant Secretary for Health Office of the Secretary United States Department of Health and Human Services th 90 7 Street, Suite 5-100 San Francisco, CA 94103 Phone: (415)437-8102 ~ Mobile: ~l (b_H6_) ___ Email: Matthew.Johns@HHS.gov Website: https://www.hhs.gov/ash/about-ash/regional-offices/region-9/index.html HHS Region 9: In the Service of Health (In Officio Salutis) for Arizona , California, Nevada, Hawaii, American Samoa, Commonwealth of the Northern Mariana Islands, Federated States of Micronesia , Guam, Marshall Islands and the Republic of Palau .....and 150 Federally-recognized Tribes. Giroir, Brett (HHS/GASH) Johns, Matthew (HHS/GASH) ; Trent-Adams, Sylvia (HHS/OASH) ; Recipient: Avi lesMendoza, Guillermo (OS/OASH) ; Orsega, Susan (OS/GASH) Sent Date: 2020/02/10 21 :43 :42 Delivered Date: 2020/02/10 21 :43 :00 AMERICAN PVERSIGHT HHS-20-0580-A-000012 Giroir, Brett (HHS/OASH) Johns, Matthew (HHS/OASH); To: Trent-Adams, Sylvia (HHS/OASH) CC: Orsega, Susan (OS/OASH) ; AvilesMendoza, Guillermo (OS/OASH) Subject: RE: UNCLASSIFED//FOUO: HHS Movement CONOPS Date: 2020/02/01 13:42:00 Priority: Normal Type: Note Thank you for that. RADM Orsega is rostering now and I am sure you will be called as needed. Best BG Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Johns, Matthew (HHS/OASH) Sent: Saturday, February 1, 2020 1:33 PM To: Giroir, Brett (HHS/OASH) ; Trent-Adams, Sylvia (HHS/OASH) Cc:Orsega, Susan (OS/OASH) ; AvilesMendoza, Guillermo (OS/OASH) Subject: Fwd: UNCLASSIFED//FOUO:HHS Movement CONOPS Admirals, I hope this message finds you all well. (b)(S) ~---------------------~ (b)(5) AMERICAN PVERSIGHT HHS-20-0580-A-000013 b)(5) Kind regards, CDR Johns Matthew C. Johns, MPH Commander, United States Public Health Service Regional Health Administrator-Region 9 Office of the Assistant Secretary for Health Office of the Secretary United States Department of Health and Human Services 90 7th Street, Suite 5-100 San Franc isco, CA 94103 Phone: (415)437-8102 I Mobile: l(b)(6) Email: Matthew.Johns@HHS.gov Website: https ://www.hhs.gov/ash/about-ash/ regional-office s/region-9 /index.html HHS Region 9: In the Service of Health (In Officio Salutis) for Arizona , California, Nevada, Hawaii, American Samoa, Commonwealth of the Northern Mariana Islands, Federated States of Micronesia, Guam, Marshall Islands and the Republic of Palau ..... and 150 Federally recognized Tribes. From : "Austin, Brad (OS/ASPR/EMMO)" Subject: FW: UNCLASSIFED //FOUO: HHS Movement CONOPS Date: 01 February 2020 09:08 To: "Johns, Matthew (HHS/OASH)" Brad Austin, MPH, FACHE Captain, U.S. Public Health Services ASPR Region IX Celll(b)(6 ) !Region IX Duty Officer: (602) 603-8700 Brad.Aust in@hhs .gov or ASPR.R9@hhs.gov From: Lee, Scott (OS/ASPR/EMMO) Sent: Friday, January 31, 2020 10:11 PM To: DFOR Regional Operations Branch Subject: FW: UNCLASSIFED//FOUO: HHS Movement CONOPS AMERICAN PVERSIGHT HHS-20-0580-A-000014 UNCLASSIFIED//FOR OFFICIAL USE ONLY CLOSEHOLD - DO NOT DISTRIBUTE OUTSIDE HHS Please use to brief your RDs,ACF RA, and RHAs ERALL CLASSIFICATION OF THIS Ken, Regards, CAPT Scott Lee Federal Health Coordinating Officer (FHCO) Department of Health &Human Services Office of the Assistant Secretary for Preparedness &Response (816) 591-0390 (913) 210-0179 Sender: Giroir, Brett (HHS/OASH) Johns, Matthew (HHS/OASH) ; Trent-Ada ms, Sylvia (HHS/OASH) ; Recipient: Orsega, Susan (O5/OASH) ; AvilesMendoza, Guillermo (OS/OASH) Sent Date: 2020/02/01 13:42:55 Delivered Date: 2020/02/01 13:42:00 AMERICAN PVERSIGHT HHS-20-0580-A-000015 Giroir, Brett (HHS/OASH) ASFR Model and Demo Clearances (OS/ASFR) ; Moughalian, Jen (HHS/ASFR) ; Brady, Will (HHS/IOS) ; Mango, Paul (HHS/IOS) ; Parker, Jim (HHS/IOS) ; Brooks, John (CMS/QA) ; Arbes, Sarah (HHS/ASL) ; Morse, Sara (HHS/ASL) ; OS OGC-IO ControlDesk (HHS/OS/OGC) ; Cleary, Kelly (HHS/OGC) ; Destro, Brenda (HHS/ASPE) ; McGuffee, Tyler Ann (HHS/IOS) ; Delew, Nancy (HHS/ASPE) ; Sheingold, Steven (HHS/ASPE) ; Peters, Christie (OS/ASPE) ; Kennedy, Gavin (HHS/ASPE) ; Robinson, Vicki L (OIG/IO) ; Uehlecke, Nick (HHS/IOS) ; Mandi, Stella (OS/ASPE) ; Keane, Thomas (OS/IOS) ; Flanzer, Samantha C (OIG/O□ G) ; Copsey, Amanda W (OIG/OCIG) ; Weiser, Christopher J (OIG/OCIG) ; Fulmer, Brendan (HHS/IOS) ; States, Leith (HHS/OASH) ; Reed, Paul (HHS/OASH) ; Armstrong, Rebekah (HHS/ASL) ; Chappel, Andre (HHS/ASPE) ; Glassman, Karen (OIG/OCIG) ; Flanzer, Samantha C (OIG/O□G) ; AMERICAN PVERSIGHT HHS-20-0580-A-000016 Alley, Dawn E. (CMS/CMMI); Finegold, Kenneth (HHS/ASPE); Farran, Patti A. (CMS/CM); Pequigney, SusanA. (CMS/CM); CMSCMMRegulation Coordination ; Kinney, John (HHS/ASL) West, Toni M. (CMS/OSORA); Moton, Teresa L. (CMS/OSORA); LeGore,Janet A. (CMS/OSORA); Elder, Mark (HHS/ASFR); Cochran, Norris (HHS/ASFR); Overstreet, Elizabeth (OS/ASFR); McMillen, Cheryl (HHS/ASFR); Swenson-OBrien, Alicia (O5/ASPE); Fischbach,Aaron (O5/IOS) ; Davis, Walter (HHS/ASFR); Perkins, Claire (O5/ASFR); Pollock, Kimberly (CMS/OFM); Deering, Jacob (HHS/ASFR) Subject: RE: Requestfor Clearance- Round 2: EmergencyTriage, Treat, and Transport (ET3) Model NOFO- by 2pm 2/24/2020 Date: 2020/02/20 17:11:00 Priority: Normal Type: Note Concur. b)(5) Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 AMERICAN PVERSIGHT HHS-20-0580-A-000017 From: ASFR Model and Demo Clearances (OS/ASFR) Sent: Thursday, February 20, 2020 11:18 AM To: ASFR Model and Demo Clearances (OS/ASFR); Moughalian, Jen (HHS/ASFR) ; Brady, Will (HHS/IOS) ; Mango, Paul (HHS/IOS) ; Parker, Jim (HHS/IOS) ; Giroir, Brett (HHS/OASH) ; Brooks, John (CMS/OA) ; Arbes, Sarah (HHS/ASL) ; Morse, Sara (HHS/ASL) ; OS OGC-IO ControlDesk (HHS/OS/OGC) ; Cleary, Kelly (HHS/OGC) ; Destro, Brenda (HHS/ASPE) ; McGuffee, Tyler Ann (HHS/IOS) ; Delew, Nancy (HHS/ASPE) ; Sheingold, Steven (HHS/ASPE) ; Peters, Christie (OS/ASPE) ; Kennedy, Gavin (HHS/ASPE) ; Robinson, Vicki L (OIG/IO) ; Uehlecke, Nick (HHS/IOS) ; Mandi, Stella (OS/ASPE); Keane, Thomas (OS/IOS) ; Flanzer, Samantha C (OIG/OCIG) ; Copsey, Amanda W (OIG/OCIG) ; Weiser, Christopher J (OIG/OCIG) ; Fulmer, Brendan (HHS/IOS) ; States, Leith (HHS/OASH) ; Reed, Paul (HHS/OASH) ; Armstrong, Rebekah (HHS/ASL) ; Chappel, Andre (HHS/ASPE) ; Glassman, Karen (OIG/OCIG) ; Flanzer, Samantha C (OIG/OCIG) ; Alley, Dawn E. (CMS/CMMI) ; Finegold, Kenneth (HHS/ASPE) ; Farran, Patti A. (CMS/CM) ; Pequigney, Susan A. (CMS/CM) ; CMS CMM Regulation Coordination ; Kinney, John (HHS/ASL) Cc:West, Toni M. (CMS/OSORA) ; Moton, Teresa L. (CMS/OSORA) ; LeGore, Janet A. (CMS/OSORA) ; Elder, Mark (HHS/ASFR) ; Cochran, Norris (HHS/ASFR) ; Overstreet, Elizabeth (OS/ASFR); McMillen, Cheryl (HHS/ASFR) ; Swenson-OBrien, Alicia (OS/ASPE); Fischbach, Aaron (OS/IOS) ; Davis, Walter (HHS/ASFR) ; Perkins, Claire (O5/ASFR) ; Pollock, Kimberly (CMS/OFM) ; Deering, Jacob (HHS/ASFR) Subject: RE: Request for Clearance - Round 2: Emergency Triage, Treat, and Transport (ET3) Model NOFO - by 2pm 2/24/2020 Reviewers, Unfortunately, the 2/19 email below included the incorrect files for your review. Please use the attached red line and clean versions of the NOFO, and comment log for the ET3 model. Best, Jake From: ASFR Model and Demo Clearances (OS/ASFR) Sent: Wednesday, February 19, 2020 2:21 PM To: ASFR Model and Demo Clearances (OS/ASFR) ; Moughalian, Jen (HHS/ASFR) ; Brady, Will (HHS/IO5) ; Mango, Paul (HHS/IOS) ; Parker, Jim (HHS/IOS) ; Giroir, Brett AMERICAN PVERSIGHT HHS-20-0580-A-000018 (HHS/OASH) ; Brooks, John (CMS/OA) ; Arbes, Sarah (HHS/ASL) ; Morse, Sara (HHS/ASL) ; OS OGC-1O ControlDesk (HHS/OS/OGC) ; Cleary, Kelly (HHS/OGC) ; Destro, Brenda (HHS/ASPE) ; McGuffee, Tyler Ann (HHS/IOS) ; Delew, Nancy (HHS/ASPE) ; Sheingold, Steven (HHS/ASPE) ; Peters, Christie (OS/ASPE) ; Kennedy, Gavin (HHS/ASPE) ; Robinson, Vicki L (OIG/1O) ; Uehlecke, Nick (HHS/IOS) ; Mandi, Stella (OS/ASPE); Keane, Thomas (OS/IOS) ; Flanzer, Samantha C (OIG/OCIG) ; Copsey, Amanda W (OIG/OCIG) ; Weiser, Christopher J (OIG/OCIG) ; Fulmer, Brendan (HHS/IOS) ; States, Leith (HHS/OASH) ; Reed, Paul (HHS/OASH) ; Armstrong, Rebekah (HHS/ASL) ; Chappel, Andre (HHS/ASPE) ; Glassman, Karen (OIG/OCIG) ; Flanzer, Samantha C (OIG/OCIG) ; Alley, Dawn E. (CMS/CMMI) ; Finegold, Kenneth (HHS/ASPE) ; Farran, Patti A. (CMS/CM) ; Pequigney, Susan A. (CMS/CM) ; CMS CMM Regulation Coordination ; Kinney, John (HHS/ASL) Cc: West, Toni M . (CMS/OSORA) ; Moton, Teresa L. (CMS/OSORA) ; LeGore, Janet A. (CMS/OSORA) ; Elder, Mark (HHS/ASFR) ; Cochran, Norris (HHS/ASFR) ; Overstreet, Elizabeth (OS/ASFR) ; McMillen, Cheryl (HHS/ ASFR) ; Swenson -OBrien, Alicia (OS/ASPE); Fischbach, Aaron (OS/IOS) ; Davis, Walter (HHS/ASFR) ; Perkins, Claire (OS/ASFR) ; Pollock, Kimberly (CMS/OFM) Subject: Request for Clearance - Round 2: Emergency Triage, Treat, and Transport (ET3) Model NOFO by 2pm 2/24/2020 Good Evening, (b)(5) Thanks and as always let us know if you have any questions or concerns. Best, Jake AMERICAN PVERSIGHT HHS-20-0580-A-000019 Jake Deering U.S. Departme nt of Health and Human Services Office of the Secretary I ASFR I Off ice of Budget jacob .dee ri ng@hhs .gov (202) 690-7194 (202) 841-2907 From : ASFR Model and Demo Clearances (OS/ASFR) Sent: Wednesday, January 15, 2020 10:39 AM To: Mougha lian, Jen (HHS/ASFR) ; Brady, Wi ll (HHS/IOS) ; Mango, Paul (HHS/IOS) ; Parker, Jim (HHS/IOS) ; Giro ir, Brett {HHS/OASH) ; Brooks , John (CMS/OA) ; Arbes, Sarah (HHS/ASL) ; Mo rse, Sara (HHS/ASL) ; OS OGC-1OControlDesk {HHS/OS/OGC) ; Cleary, Kelly {HHS/OGC) ; Destro, Brenda {HHS/ASPE) ; McGuffee, Tyler Ann (HHS/IOS) ; Delew , Nancy {HHS/ASPE) ; Sheingold , Steven {HHS/ASPE) ; Peters, Christie (OS/ASPE); Kennedy, Gavin {HHS/ASPE) ; Robinson, Vicki L (OIG/1O) ; Uehlecke, Nick {HHS/IOS) ; Mand i, Stella (OS/ASPE) ; Keane, Thomas (OS/ASA/IOS) (CTR) ; Flanzer, Samantha C (OIG/OCIG) ; Copsey, Amanda W (OIG/OCIG) ; We iser, Christopher J (OIG/OCIG) ; Fulmer, Brendan (HHS/IOS) ; States, Leith (HHS/OASH) ; Reed, Paul (HHS/OASH) ; Armstrong, Rebekah (HHS/ASL) ; Chappe l, Andre (HHS/ASPE) ; Glassman, Karen (OIG/OCIG) ; Flanzer, Samantha C (OIG/OCIG) ; Alley, Dawn E. (CMS/CMMI) ; Finegold, Kenneth {HHS/ASPE) ; Kinney, John (HHS/ASL) <.lohn.Kinney@hhs.gov > Cc: West, Ton i M. (CMS/OSORA) ; Moton, Teresa L. (CMS/OSORA) ; LeGore, Janet A. (CMS/OSORA) ; Deer ing, Jacob (HHS/ASFR) <.lacob.Deering@hhs.gov >; Elder , Mark (HHS/ASFR) ; Cochran, Norr is (HHS/ASFR) ; Overstreet, Elizabeth {OS/ASFR); McM illen, Chery l (HHS/ASFR) ; Swenson -O'Brien, Alic ia (HHS/OS) ; Fischbach, Aaron {OS/IOS) ; Davis, Wa lter (HHS/ASFR) ; Perkins, Claire (OS/ASFR) Subject: Request for Clearance - Emergency Triage, Treat, and Transport {ET3) Model NOFO - by 4pm 1/29/2020 Good Morning, (b)(5) AMERICAN PVERSIGHT HHS-20-0580-A-000020 b)(5) Thanks and as always let us know if you have any questions or concerns. Best, Jake Jake Deering U.S. Department of Health and Human Services Office of the Secretary I ASFR I Office of Budget jacob.deering@hhs.gov (202) 690-7194 (202) 841-2907 Sender: Giroir, Brett (HHS/OASH) ASFRModel and Demo Clearances (O5/ASFR); Moughalian,Jen (HHS/ASFR); Brady, Will (HHS/IOS) ; Recipient: Mango, Paul (HHS/IOS) ; Parker, Jim (HHS/IOS) ; Brooks, John (CMS/QA); AMERICAN PVERSIGHT HHS-20-0580-A-000021 Arbes, Sarah (HHS/ASL) ; Morse, Sara (HHS/ASL) ; OS OGC-IO ControlDesk (HHS/OS/OGC) ; Cleary, Kelly (HHS/OGC) ; Destro, Brenda (HHS/ASPE) ; McGuffee, Tyler Ann (HHS/IOS) ; Delew, Nancy (HHS/ASPE) ; Sheingold, Steven (HHS/ASPE) ; Peters, Christie (OS/ASPE) ; Kennedy, Gavin (HHS/ASPE) ; Robinson, Vicki L (OIG/1O) ; Uehlecke, Nick (HHS/IOS) ; Mandi, Stella (OS/ASPE) ; Keane, Thomas (OS/IOS) ; Flanzer, Samantha C (OIG/OCIG) ; Copsey, Amanda W (OIG/OCIG) ; Weiser, Christopher J (OIG/OCIG) ; Fulmer, Brendan (HHS/IOS) ; States, Leith (HHS/OASH) ; Reed, Paul (HHS/OASH) ; Armstrong, Rebekah (HHS/ASL) ; Chappel, Andre (HHS/ASPE) ; Glassman, Karen (OIG/OCIG) ; Flanzer, Samantha C (OIG/OCIG) ; Alley, Dawn E. (CMS/CMMI) ; Finegold, Kenneth (HHS/ASPE) ; Farran, Patti A. (CMS/CM) ; Pequigney, Susan A. (CMS/CM) ; CMS CMM Regulation Coordination ; Kinney, John (HHS/ASL) ; West, Toni M. (CMS/OSORA) ; Administrative Group Moton, Teresa L. (CMS/OSORA) ; LeGore, Janet A. (CMS/OSORA) ; AMERICAN PVERSIGHT HHS-20-0580-A-000022 Elder, Mark (HHS/ASFR); Cochran, Norris (HHS/ASFR); Overstreet, Elizabeth (OS/ASFR); McMillen, Cheryl (HHS/ASFR); Swenson-OBrien,Alicia (OS/ASPE); Fischbach,Aaron (OS/10S) ; Davis, Walter (HHS/ASFR); Perkins, Claire (OS/ASFR); Pollock, Kimberly (CMS/OFM); Deering, Jacob (HHS/ASFR) Sent Date: 2020/02/20 19:59:28 Delivered Date: 2020/02/20 17:11:00 AMERICAN PVERSIGHT HHS-20-0580-A-000023 Giroir, Brett (HHS/OASH) Heck, Mia (HHS/OASH) Broido, Tara (HHS/OASH); CC: Bante, Katie (O5/OASH) Subject: RE: White House fears coronavirus could shape Trump's 2020 fortunes Date: 2020/02/2118:10:00 Priority: Normal Type: Note Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Heck, Mia (HHS/OASH) Sent: Friday, February 21, 2020 6:10 PM To: Giroir, Brett (HHS/OASH) Cc: Broida, Tara (HHS/OASH) ; Bante, Katie (OS/OASH) Subject: Re: White House fears coronavirus could shape Trump's 2020 fortunes Copy Sent from my iPhone On Feb 21, 2020, at 5:53 PM, Giroir, Brett (HHS/OASH) wrote: □ Brett P. Giroir, MD AMERICAN PVERSIGHT HHS-20-0580-A-000024 ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Broido, Tara (HHS/OASH) Sent: Friday, February 21, 2020 5:37 PM To: Giro ir, Brett {HHS/OASH) Cc: Heck, Mia (HHS/OASH) ; Bante, Katie (OS/OASH) Subject: FW: White House fears coronavirus could shape Trump's 2020 fortunes Sharing the latest Politico Story. From: POLITICO Pro Health Care Sent: Friday, February 21, 2020 5:31 PM To: Broido, Tara (HHS/OASH) Subject: Wh ite House fears coronavirus could shape Trump's 2020 fortunes White House fears coronavirus could shape Trump's 2020 fortunes By Dan Diamond, Adam Cancryn 02/21/2020 05:29 PM EST The Trnmp administration is bracing for a possible coronavirns outbreak in the United States that could sicken thousands - strai ning the government's public health response and threatening an economic slowdown in the heat ofPresident Donald Trump's reelection campaign. That stark realization has taken hold in high-level White House meetings, during which some administration officials have voiced concerns the coronavirus is already spreading undetected within U.S. borders, two officials told POLITICO. Though Trump in public has downplayed the virus, privately he has voiced his own anxieties, rebuking public health leaders over last week's decision to fly home 14 Americans who tested positive for the virus while aboard a cruise ship off Japan, said three individuals with knowledge of the situation. Trump was w01Tiedthat tran sporti ng the Americans to the United States without adequate precautions could create new risks, the individuals said. "The biggest current threat to the president's reelection is this thing getting out of control and creating a health and economic impact," said Chris Meekins , a Raymond James financial analyst and former Trump administration HHS emergency-preparedness official. An HHS spokesperson said the administration is committed to protecting public health and preparing for multiple scenarios due to the novel nature of the virus. "As we've said all along, the risk to Americans is low, but we expect the numbers to increase ," the spokesperson said, AMERICAN PVERSIGHT HHS-20-0580-A-000025 declining to characteri ze the nature of the discussions. But there has been ten sion within the Trump administration over the response so far. Four officials acknowledged that the process has hit bumps, with high-pressure debates over resources and plamling occasionally reopening fault lines between the White House and HHS that frrst emerged over Trump's broader health agenda. Some of the biggest challenges have been within the health deprutrnent , with the Centers for Disease Control revising its quru·antines , opposing the evacuation of the Diamond Princess cruise sllip - despite evidence that a quarantine imposed by Japanese authorities had failed and infections were spreading - and raising general questions about the agency ' s level of prepru·edness . Only 34 cases have been confirmed in the United States, including those brought home from the cruise ship. But the outbreak , now in its third month , has exploded overseas. More than 75,000 cases of the respiratory illness have been confirmed in China and at least 2,200 people have died. Infections are surging in areas outside the epicenter in Hubei Province , spreading rapidly to South Korea, Singapore, Iran and Japan in recent days. The virus currently has no cure, can be spread by people who have no outward symptoms and appears to pose a significant 1isk to the elderly. CDC Director Robert Redfield acknowledged last week that officials expect person-to-person transmission in local communities , whether this yeru· or next. The White House stressed that its inter-agency response team led by Health and Human Services Secretary Alex Azar is working "around the clock. " "President Trump 's top priority is the health and welfare of the American people , which is why he established the President's Corona virus Task Force to contain the spread of the virus, " a spokesperson told POLITICO. "Every precaution is being taken as this situation continues to change hourly. " Meanwhile, the White House remains worried about growing economic risk s, with Chinese production plunging in recent weeks and U.S. companies like Apple and Walmart with significant investments in the country reporting they're taking financial hits . Seruor officials fear that a sustained outbreak could slow global markets and upend a strong U.S. economy that has been central to Trump 's political pitch. The administration 's fumbled evacuation of about 400 Americans from the marooned cruise ship brought into focus multiple gaps in preparedness, said four individuals with knowledge of the episode. U.S. officials spent 10 days with little information about conditions aboard the ship , relying on Japanese health deprutment reports rather than dispatching CDC staff. That left U.S. health officials at odds over whether an evacuation was necessary before politica l pressure intensified . Officials managing the evacuation last Saturday were later surprised to learn , while busing evacuees to a Japanese airfield, that 14 Americans they were transporting were reported to have tested positive for coronavirus . The State Department decided to fly the Americans back over AMERICAN PVERSIGHT HHS-20-0580-A-000026 CDC's objections , the Washington Po st first reported. Officials continue to second-guess the original, swift decision to leave Americans aboard the ship for days, even as infections multiplied . "I think that was one of the cruelest human experiments I've seen in my entire career ," said Michael Osterholm , director of University of Minnesota's Center for Infectious Disease Research and Policy, who has advised federal health officials on the response. "That was truly one of our public health lesser moments. " ADl\flNISTRA TION ELEV ATES VIRUS FIGHT TO TOP PRIORITY The fate of Trump ' s response rests on Azar , who has modeled plans based on his experience fighting SARS and other pandemics as a senior health official in the George W. Bush administration. The health secretary - who is steering the response in addition to his other duties - has been near-constantly flanked by top scientists like CDC ' s Redfield and veteran infectious disease specialist Anthony Fauci at White House meetings, congressional briefings and televised updates . The wide-ranging administration strategy has pulled together disparate offices like the Transportation Department and border patrol to handle the practicalities of travel and homeland secmity , as well as scientists at the National Institutes for Health, working to devise potential treatments. It' s also drawn in top political officials like Joe Grogan , the White House Domestic Policy Council chief, who was picked for the coronavirus task force amid worries about how the outbreak would affect Trmnp's broader agenda. Azar has frequently leaned on Robert Kadlec, his assistant secretary for emergency and preparedness, whose team played a key role in evacuating the Diamond Princess last week. Kadlec - viewed by Azar as a problem-solver who was tapped to reunify separated migrant families in 2018 - also had prepared national disaster management personnel to handle pandemics by putting them through speciali zed training to handle infectious disease issues two years ago, said two individuals . One question that's been raised at senior meetings is whether the official U.S. count of coronavirus cases is too low, given the virus' ability to incubate for weeks. POLITICO reported on Thursday that only three of the nation ' s more than 100 public health laboratories had even verified the CDC's corona.virus diagnostic test for use, further delaying screening efforts. " [S]ince most people with the virus suffer only a mild illness, dozens and perhaps even hundreds of cases may be circulating undetected ," Luciana Borio, a former ational Security Council fellow, and Scott Gottlieb, the former FDA commissioner, argued in a Wall Street Journal op-ed on Friday, calling for more screening. Meanwhile, the administration has kept in constant contact with Congress about its response efforts - a sharp departure for an administration that's been in a near constant state of warfare with congressional Democrats , lawmakers and aides said. Officials including Azar, Redfield and Fauci have provided multiple briefings on their latest AMERICAN PVERSIGHT HHS-20-0580-A-000027 findings, in some cases spending more than an hour behind closed doors fielding questions and concerns. "The administration is fully engaged," Rep. Greg Walden of Oregon, the top Republican on the House Energy and Commerce Committee , said following a meeting earlier this month. "We're holding our own right now, which is where you want to be." The administration also has quietly worked with blue states like California and officials in staunchly Democratic cities like New York City . "The federal government is working closely with state, local, tribal , and territorial partners , as well as health sector partners outside the government , to respond to this public health threat ," said the HHS spokesperson. CRACKS EMERGE AS CRISIS DRAGS ON Still, there are signs that the bipartisan solidarity is beginning to fray. The White House last week invited several top-level Democrats and Republicans to a West Wing briefing led by acting chief of staff Mick Mulvaney ,billing it in part as an opportunity to offer critiques of the administration's response. That guest list included the chairs and ranking members of relevant committees , along with Senate Majority Leader Mitch McConnell and top House Republican Kev in McCarthy . But neither Senate Minority Leader Chuck Schumer nor House Speaker Nanc y Pelosi - who have clashed repeatedly and publicly with the president - received an invite, multiple aides confinned. HHS referred questions to the White House, which declined comment. Some Democrats , meanwhile , have stepped up their rhetoric against the administration, targeting in paiticular Trump's 2018 decision to eliminate the position dedicated to handling global health security threats. "You 're kind of dealing with a government that doesn't care about government, and then overlay your normal bumbling incompetence onto the possibility of a global pandemic ," Sen. Brian Schatz of Hawaii said on MSNBC this week. "To the extent that we ' ve been fortunate with this disease, it's because of the epidemiology of the disease, not because of some sort of coordinated response." Schatz, along with several other Democrats like Massachusetts Sen. and presidential hopeful Elizabeth Warren, have pushed for the appointment of a single National Security Council official to coordinate the administration's efforts. Others questioned whether the administration is adequately preparing for the potentially disastrous consequences of a monthslong outbreak, including disrupted drug supply chains, shortages of protective equipment and a growing financial toll on hospitals. During one Capitol Hill briefing, Azar appeared dismissive of questions about the funding outlook for state and local providers , aides said, telling members that the federal government had already given them lots of AMERICAN PVERSIGHT HHS-20-0580-A-000028 money in the past. Pelosi, meanwhile, has made a point to lavish praise on Fauci - a long-time NIH official beloved on both sides of the aisle - telling reporters after one closed-door briefing that she had full confidence in his ability to manage the response. As for Azar? "All I know about Azar is thathe used to work for a pharmaceutical company ," she said. More substantially, both Republicans and Democrats have been struck by HHS' refusal to seek additional funding to fight the disease , rather than shifting funds from other parts of the department. The resistance has prompted speculation that Azar is loath to offer any sign the outbreak could worsen on his watch. "They don't want to make it a bigger thing ," one senior Democratic aide said. "They squeeze the other coffers dry to cover themselves on coronavirus." Meekins - the former HHS official-turned-financial analyst, who this week warned investors the chance of "notable widespread cases" in the United States is 20 percent - said that a significant outbreak this year could overshadow the president's other initiatives ahead of November. "This is one of those things where if you prevent a problem , you get very little credit - but the downside is if it goes wrong," Meekins said. Yet there's one boon for Trump, amid the growing scrutiny: He doesn't have to deal with the kind of fearmongering he helped stoke as a private citizen during the 2014-2016 Ebola outbreak in Africa. Among elected officials, only Republican Sen. Tom Cotto n of Arkansas has publicly suggested the virus could have more questionable , manmade origins than China is willing to let on, though he has emphasi zed that he has no evidence and merely wants the issue investigated. Administration officials have not ruled out that the virus originated from a lab accident , carefully choosing their words when asked directly about the possibility. "It is important not to speculate and while we do not yet know the source of origin of this virus, we will not jump to any conclusions. We await the scientific evidence ," said the HHS spokesperson. Trump's deputies in the meantime have urged the president to restrain his public rhetoric. Officials also are working to navigate the delicate relationship with China, already strained by trade battles and other policy clashes , without further antagoni zing global partners or overly alarming Americans. But one specific episode underscores fears that Trump may not be willing to stay silent for long, especially if the virus' spread threatens his political prospects. In a Feb . 7 tweet, Trump asserted that efforts to combat coronavirus "will be successful , especially as the weather starts to warm AMERICAN PVERSIGHT HHS-20-0580-A-000029 &the virus hopefully becomes weaker, and then gone." He's repeated the claim that the virus will dissipate in April to a group of governors, frustrating health officials inside and outside the administration who worry it could create a false sense of security. There is little scientific evidence for the theory , heightening concerns that if cases suddenly start to accelerate, that single tweet will undo months of work to assure Americans they're handling the crisis. "We can't say that it's been contained. We lost containment a long time ago," said Osterholm. "We're in uncharted territory right now." To view online: https: //protect2.fireeye.com/url?k=697f4772-352b5e0e-697f764d-0cc47adc5fa2c0997fef068 70622&u =h ttps ://subscriber. politicopro. com/heal th-care / article /2020/02 /whitehouse- fears-coronavirus-could-shape-trumps-2020-fortunes-1883031 You received this POLITICO Pro content because your customized settings include: Public Health, Health. To change your alert settings, please go to https ://protect2.fireeye.com/url ?k=7 6cd63de-2a997 aa2-76cd52el-0cc4 7 adc5fa2be0643 ab 7217 6417 &u=https://subscriber .politicopro.com/settings. PO ITCOPRO This email alert has been sent for the exclusive use of POLITICO Pro subscriber , tara.broido@hhs.gov. Forwarding or reproducing the alert without the express, written permission of POLITICO Pro is a violation of copyright law and the POLITICO Pro subscription agreement. Copyright © 2020 by POLITICO LLC. To subscribe to Pro, please go to politicopro.com. This email was sent to tara.broido@hhs.gov by: POLITICO, LLC 1000 Wilson Blvd. Arlington, VA 22209 USA Sender: Giroir, Brett (HHS/OASH) Heck, Mia (HHS/OASH); Broido, Tara (HHS/OASH); Bante, Katie (OS/OASH) AMERICAN PVERSIGHT HHS-20-0580-A-000030 Sent Date: 2020/02/2118:10:41 Delivered Date: 2020/02/2118:10:00 AMERICAN PVERSIGHT HHS-20-0580-A-000031 Giroir, Brett (HHS/OASH) Orsega, Susan(OS/OASH) CC: Trent-Adams, Sylvia (HHS/OASH) Subject: RE: Summary: 2019 positive nCoVtest for Miramar evacuee Date: 2020/02/10 18:05:00 Priority: Normal Type: Note Oh boy! Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Orsega, Susan (OS/OASH) Sent: Monday, February 10, 2020 5:31 PM To: Giroir, Brett (HHS/OASH) Cc: Trent-Adams, Sylvia (HHS/OASH) Subject: FW: Summary: 2019 positive nCoV test for Miramar evacuee Sir and Ma'am Please see below. From: OS Secretarys Operations Center Sent: Monday, February 10, 2020 5:23 PM To: SOCASPRSLT Subject: Summary: 2019 positive nCoV test for Miramar evacuee UNCLASSIFIED I I FOR OFFICIAL USE ONLY Good afternoon Dr. Kadlec, BLUF: Miramar Passenger with positive nCoV test result. • • The SOC was notified by the Deputy FHCO of a positive nCoV test result for one of the passengers currently quarantined at Miramar IMT currently working to send the individual to the hospital for isolation AMERICAN PVERSIGHT HHS-20-0580-A-000032 • IMT is working with the CDC to identify contacts and take appropriate actions The SOC will continue to monitor this incident and report as needed. UNCLASSIFIED / / FOR OFFICIAL USE ONLY Very Respectfully, Secretary's Operation Center U.S. Department of Health and Human Services (HHS) Assistant Secretary for Preparedness and Response (ASPR) 200 Independence Ave S.W. Washington D.C. 20201 Office: (202) 619 - 7800 Fax: (202) 619 - 8602 Email: hhs.soc@hhs.gov cid:image002.png@01D5DC39.E7D748B0 CONFIDENTIALITY NOTICE: This e-mail communication and any attachments may contain confidential and privileged information for the use of the designated recipients. If you are not the intended recipient, (or authorized to receive for the recipient) you are hereby notified that you have received this communication in error and that any review, disclosure, dissemination, distribution or copying of it or its contents is prohibited. If you have received this communication in error, please destroy all copies of this communication and any attachments and contact the sender by reply e-mail or telephone (202-619-7800). Sender: Recipient: Giroir, Brett (HHS/OASH) ( FYDIBOHF23SPDL T)/CN= RECIPIENTS/CN Orsega, Susan (OS/OASH); Trent-Adams, Sylvia (HHS/OASH) Sent Date: 2020/02/10 18:05:28 Delivered Date: 2020/02/10 18:05:00 AMERICAN PVERSIGHT HHS-20-0580-A-000033 Giroir, Brett (HHS/OASH) Valentine, Steven (HHS/OASH) Subject: RE: PossibleSGactivity - PREVENTS Date: 2020/02/10 15:30:00 Priority: Normal Type: Note Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Valentine, Steven (HHS/OASH) Sent: Monday, February 10, 2020 3:29 PM To: Giroir, Brett (HHS/OASH) Subject: RE: Possible SG activity - PREVENTS They have proactively been reaching out to him - my impression is they want "the Surgeon General" for PR. Confidential pre-decisional deliberative process From: Giroir, Brett (HHS/OASH) Sent: Monday, February 10, 2020 3:23 PM To: Valentine, Steven (HHS/OASH) Subject: RE: Possible SG activity - PREVENTS Why is the SG involved? I guess it is fine of course, but has he done any work on this??? Brett P. Giroir, MD ADM, US Public Health Service AMERICAN PVERSIGHT HHS-20-0580-A-000034 Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Valentine, Steven (HHS/OASH) Sent: Monday, February 10, 2020 1:20 PM To: Harrison, Brian (HHS/105) ; Stecker, Judy (05/105) ; Mango, Paul (HHS/105) Cc: Bird, Catherine (05/0GC) ; Pollard, Ashton (05/105) ; Giroir, Brett (HHS/OASH) ; Harder, Kristina (HHS/105) ; Heck, Mia (HHS/OASH) ; Sherman, Jennifer (HHS/OASH) Subject: FW: Possible SG activity - PREVENTS All, (b)(5) k Thanks, Steven Confidential pre-decisional deliberative process From: Sherman, Jennifer (HHS/OASH) Sent: Monday, February 10, 2020 12:48 PM To: Valentine, Steven (HHS/OASH) ; Harder, Kristina (HHS/105) Subject: Possible SG activity - PREVENTS b)(5) AMERICAN PVERSIGHT HHS-20-0580-A-000035 age 36 ithheld pursuant to exemption b)(5) f the Freedom of Information Act AMt HICAN pVERSIGHT HHS-20-0580-A-000036 (b)(5) Jenn Sherman Director of Public Affairs Office of the Surgeon General Department of Health and Human Services (HHS) Giroir, Brett (HHS/OASH) Recipient: Valentine, Steven (HHS/OASH) Sent Date: 2020/02/10 15:30:51 Delivered Date: 2020/02/10 15:30:00 AMERICAN PVERSIGHT HHS-20-0580-A-000037 Trent -Adams, Sylvia (HHS/OASH) Haddad, carla (HHS/OASH) ; Orsega, Susan (O5/OASH) ; Giroir, Brett (HHS/OASH) CC: Schwartz, Erica (HHS/OASH) ; Kellogg, Rachel (HHS/OASH) Subject: RE: Drive through Testing Denver Col Date: 2020/03/13 13:17:16 Priority: Normal Type: Note Thank you . From: Haddad, Carla (HHS/OASH) Sent: Friday, March 13, 2020 1:16 PM To: Orsega, Susan (OS/OASH) ; Trent-Adams, Sylvia (HHS/OASH) ; Giroir, Brett (HHS/OASH) Cc: Schwartz, Erica (HHS/OASH) ; Kellogg, Rachel (HHS/OASH) Subject: RE: Drive through Testing Denver Col Thanks. Adding Rachel Kellogg as well. From: Orsega, Susan (OS/OASH) Sent: Friday, March 13, 2020 1:10 PM To: Trent-Adams, Sylvia (HHS/OASH) ; Giroir, Brett (HHS/OASH) Cc: Schwartz, Erica (HHS/OASH) ; Haddad, Carla (HHS/OASH) Subject: RE: Drive through Testing Denver Col Carla, Adding you to the email. From: Trent-Adams, Sylvia (HHS/OASH) Sent: Friday, March 13, 2020 1:01 PM To: Orsega, Susan (OS/OASH) ; Giroir, Brett (HHS/OASH) Cc: Schwartz, Erica (HHS/OASH) Subject: RE: Drive through Testing Denver Col AMERICAN PVERSIGHT HHS-20-0580-A-000038 A few updates. From: Orsega, Susan (OS/OASH) Sent: Friday, March 13, 2020 12:50 PM To: Giroir, Brett (HHS/OASH) Cc:Schwartz, Erica (HHS/OASH) ; Trent -Adams, Sylvia (HHS/OASH) Subject: Drive through Testing Denver Col Sir, b)(5) AMERICAN PVERSIGHT HHS-20-0580-A-000039 sent frommy1 one Sender: Trent-Adams, Sylvia (HHS/OASH) Haddad, Carla (HHS/OASH) ; Orsega, Susan (OS/OASH) ; Giroir, Brett (HHS/OASH) ; Schwartz, Erica (HHS/OASH) ; Kellogg, Rachel (HHS/OASH) Sent Date: 2020/03/13 13:17:16 Message Flags: Unread AMERICAN PVERSIGHT HHS-20-0580-A-000040 Trent-Adams, Sylvia (HHS/OASH) From: GROUP (FYDIBOHF23SPDLT)/CN= RECIPIENTS/CN=650D027641442169334514 Kellogg, Rachel (HHS/OASH) ; Sus> Kadlec, Robert (OS/ASPR/IO) ; Giroir, Brett (HHS/OASH) ; Schwartz, Erica (HHS/OASH) ; Smith, Brad (CMS/QA) ; Haddad, Carla (HHS/OASH) ; Valentine, Steven (HHS/OASH) ; Yeskey, Kevin (OS/ASPR/IO) ; Greene, Jonathan (OS/ASPR/EMMO) ; Shuy, Bryan (OS/ASPR/IO) ; Herrmann, Jack (OS/ASPR/OEA) ; Guyton, Cedric (OS/OASH) Subject: RE: PLANNING PURPOSESONLY - TESTING SITES Date: 2020/03/13 14:02:41 Priority: Normal Type: Note copy -----Original Message----From: Kellogg, Rachel (HHS/OASH) Sent: Friday, March 13, 2020 2:01 PM To : Orsega, Susan (OS/OASH) Cc: Kadlec, Robert (OS/ASPR/IO) < Robert.Kad lec@hhs.gov >; Giroir, Brett (HHS/OASH) ; Schwartz, Erica (HHS/OASH) < Erica.Schwartz @hhs.gov >; Smith, Brad (CMS/QA) ; Haddad, Carla (HHS/OASH) ; Valentine, Steven (HHS/OASH) ; Yeskey, Kevin (OS/ ASPR/IO) ; Greene, Jonathan (OS/ ASPR/EMMO) ; Shuy, Bryan (OS/ASPR/IO) ; Herrmann, Jack (OS/ASPR/OEA) ; Trent-Adams, Sylvia (HHS/OASH) ; Guyton, Cedric (OS/OASH) Subject: Re: PLANNING PURPOSESONLY - TESTING SITES [b )(S) Sent from my iPhone > On Mar 13, 2020, at 1:50 PM, Orsega, Susan (OS/OASH) wrote: > > Sirs, Adding others. > > > > > > -----Original Message----From: Kadlec, Robert (OS/ASPR/IO) Sent: Friday, March 13, 2020 12:54 PM To : Giroir, Brett (HHS/OASH) Cc: Orsega, Susan (OS/OASH) ; Schwartz, Erica (HHS/OASH) ; AMERICAN PVERSIGHT HHS-20-0580-A-000041 Smith, Brad (CMS/QA) ; Haddad, Carla (HHS/OASH) ; Valentine, Steven (HHS/OASH) ; Kellogg, Rachel (HHS/OASH) ; Yeskey, Kevin (OS/ASPR/IO) ; Greene, Jonathan (OS/ASPR/EMMO) ; Shuy, Bryan (OS/ASPR/IO) ; Herrmann, Jack (OS/ASPR/OEA) > Subject: Re: PLANNING PURPOSESONLY - TESTING SITES > b)(5) > Sent from my iPhone > >> On Mar 13, 2020, at 12:18 PM, Giroir, Brett (HHS/OASH) wrote : >> b)(5) >> BG >> >> >> >> >> >> >> Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington , DC 20201 Office Phone: 202-690-7694 >> >> >> >> >> >> >> >> ----- Original Message----From : Giroir, Brett (HHS/OASH) Sent: Friday, March 13, 2020 12:05 PM To: Susan Orsega (OS/OASH) (Susan.Orsega@hhs.gov) Cc: Schwartz, Erica (HHS/OASH) Subj ect: FW: >> >> Can we ta lk7 >> >> >> >> >> >> >> >> Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washingt on, DC 20201 Office Phone: 202-690-7694 >> >> >> >> >> >> ----- Original Message----From : Giroir, Brett (HHS/OASH) Sent: Friday, March 13, 2020 11:55 AM To: Giroir, Brett (HHS/OASH) Subj ect : >> >> >> Sen de r :ITrent-Adams, Sylvia (HHS/OASH) 7BFAFD132- Kellogg, Rachel (HHS/OASH) ; Orsega, Susan (OS/OASH) ; Kadlec, Robert (O5/ASPR/IO) ; Giroir, Brett (HHS/OASH) ; Schwartz, Erica (HHS/OASH) ; Smith, Brad (CMS/QA) ; Haddad, Carla (HHS/OASH) ; Valentine, Steven (HHS/OASH) ; Yeskey, Kevin (OS/ASPR/IO) ; Greene, Jonathan (OS/ASPR/EMMO) ; Shuy, Bryan (OS/ASPR/IO) ; Herrmann, Jack (OS/ASPR/OEA) ; Guyton, Cedric (OS/OASH) Sent Date: 2020/03/13 14:02:40 Delivered Date: 2020/03/13 14:02 :41 Message Flags: Unread AMERICAN PVERSIGHT HHS-20-0580-A-000043 Giroir, Brett (HHS/OASH) Bante, Katie (OS/OASH) Giroir, Brett (HHS/OASH) ; Harder, Kristina (HHS/105) ; Gray, Oneika (HHS/OASH) ; Valentine, Steven (HHS/OASH) ; To: Heck, Mia (HHS/OASH) ; Broida, Tara (HHS/OASH) ; Haigwood, Patricia (HHS/OASH) ; Channer, Amber (OS/OASH) Subject: CONFIRMED: Rx Drug Abuse & Heroin Summit Date: 2020/02/10 15:50:51 Start Date: 2020/04/15 16:00:00 End Date: 2020/04/15 19:00:00 Priority: Normal Type: Appointment Location: Gaylord Opryland Resort; Nashville, TN Event: Rx Summit Date: Wednesday April 15, 5:45 - 6:45PM CST Entire Session Time: Plenary Duration is 5:45 to 6:45, 10 Minute Speaking Time, EMK and Dr. Redfield ADM Giroir participation time: 10 Minutes Session Title: No title. Session Description: Evening plenary series of Principals from HHS speaking ASH Speaking Time: 10 minutes Session Format: Typical plenary session. Stage Set Up: RXSummit backdrop with podium with RX Summit podium sign could possibly do a Fireside Chat (Mia asking ADM Giroir). AMERICAN PVERSIGHT HHS-20-0580-A-000044 Int rodu ction: Will know at a later date . Other speakers: EMK, Dr. Redfield, Commissioner Hahn has been invited pending response. Location: Gaylord Opryland Nashville Audience: 3500 - 4000 attendees Video: They have only livestreamed POTUS,unlikely t o livestream is possible they will record it . Media: Open press. Social Media: #RXSummit2020 #thisiswhywemeet Note: With EMK and Dr. Redfield (COMM Hahn invited for same plenary session) we want to avoid repeating HHS messaging. We should coordinate with the other offices on messaging - on logs call Doug mentioned Meth will be a very large topic at the conference and even alcohol - as a country we don't talk about alcohol (RX Summit is not limited to opioid use). (b_)(_6)____ OASH Staffing: LCDRNicole Carr1 ..... 6 Event POC: Kristy Ward rb_ ..... )(_ )____ ___. ~ Giroir, Brett (HHS/OASH) ; Bante, Katie (OS/OASH) Giroir, Brett (HHS/OASH) ; Harder, Kristina (HHS/105) ; Gray, Oneika (HHS/OASH) ; Valentine, Steven (H HS/OASH) ; Recipient: Heck, Mia (HHS/OASH) ; Broida, Tara (HHS/OASH) ; Haigwood, Patricia (HHS/OASH) ; Channer, Amber (OS/OASH) Sent Date: 2020/02/10 15:50 :51 AMERICAN PVERSIGHT HHS-20-0580-A-000045 Trent -Adams, Sylvia (HHS/OASH) Giroir, Brett (HHS/OASH) ; Migliaccio-Grabill, Kate (HHS/OASH) ; To: Broida, Tara (HHS/OASH) ; Heck, Mia (HHS/OASH) Subject: RE: Tweet by Mike Pence on Twitter Date: 2020/03/14 21:15:14 Priority: Normal Type: Note Very nice! From: Giroir, Brett (HHS/OASH) Sent: Saturday, March 14, 2020 9:12 PM To: Migliaccio-Grabill, Kate (HHS/OASH) ; Broida, Tara (HHS/OASH) ; Heck, Mia (HHS/OASH) ; Trent-Adams, Sylvia (HHS/OASH) Subject: Tweet by Mike Pence on Twitter Mike Pence (@Mike Pence) 3/1 4/2 0, 8:57 PM Spent time at D @HHSGov □ today to check in on the progress of expanded Coronavirus testing for the American people. pi c.twitter.com/F OvHB 0GXA o Do wnl oad the Twitter app Sen t from my 1"Phone Sender: Trent-Adams, Sylvia (HHS/GASH) Giroir, Brett (HHS/GASH) ; Migliaccio-Grabi ll, Kate (HHS/OASH) ; Recipient: Broida, Tara (HHS/OASH) ; Heck, Mia (HHS/GASH) Sent Date: 2020/03/14 21: 15: 11 Delivered Date: 2020/03/14 21: 15: 14 Message Flags: Unread AMERICAN PVERSIGHT HHS-20-0580-A-000046 AMERICAN PVERSIGHT HHS-20-0580-A-000047 Haddad, Carla (HHS/OASH) Pence, Laura (HHS/ASL) ; To: Giroir, Brett (HHS/OASH) Arbes, Sarah (HHS/ASL) ; Gross, Karas (FDA/OC) ; Kellogg, Rachel (HHS/OASH) Subject: RE: Testing in Arkansas Date: 2020/03/15 13:17 :20 Priority: Normal Type: Note Adding Rachel as well. -----Origina l Message----From: Pence, Laura (HHS/ASL) Sent: Sunday, March 15, 2020 1: 16 PM To: Giroir, Brett (HHS/OASH) Cc: Haddad, Carla (HHS/OASH) ; Karas (FDA/OC) < Karas.Gross@fda.hhs.gov> Subject: Testing in Arkansas Arbes, Sarah (HHS/ASL) ; Gross, (b)(S) Haddad, Carla (HHS/OASH) Pence, Laura (HHS/ASL) ; Giroir, Brett (HHS/OASH) ; Arbes, Sarah (HHS/ASL) ; Gross, Karas (FDA/OC) ; Kellogg, Rachel (HHS/OASH) Sent Date: 2020/03/15 13:17:19 Delivered Date: 2020/03/15 13:17:20 Message Flags: Unread AMERICAN PVERSIGHT HHS-20-0580-A-000048 Giroir, Brett (HHS/OASH) Gray, Oneika (HHS/OASH) To: Giroir, Brett (HHS/OASH) Subject: HOLD:ASTHO& NACCHO Date: 2020/02/1116 :57:55 Start Date: 2020/02/20 16:00:00 End Date: 2020/02/20 17:00:00 Priority: Normal Type: Appointment Dear colleagues at ASTHO & NACCHO, I would like to inquire your availability to join a call with Assistant Secretary for Health Admiral Brett Giroir to discuss near real-time drug testing data that HHS will receive and enhance efforts and targeted approaches in fighting the overdose crisis. This call is intended to provide your organization leadership the ability to provide early notification to members that HHS could be in touch with them to alert them of drug use trends within states and jurisdictions. [For more background on the data please click here.] Would you or a designee from ASTHO & NACCHO leadership be available to participate in a call on any of the following days/times? ■ ■ ■ February 19, 4:00PM ET February 20, 4:00PM ET February 21, 10:30AM ET Please advise on availability, and thank you in advance for your help in scheduling this. Sincerely, Mia Mia Palmieri Heck Director of External Affairs Office of the Assistant Secretary for Health U.S. Department of Health and Human Services (202) 578-6071 Giroir, Brett (HHS/OASH); Gray, Oneika (HHS/OASH) Recipient: AMERICAN PVERSIGHT Giroir, Brett (HHS/OASH) HHS-20-0580-A-000049 Sent Date: 12020/02/1116 :57:55 AMERICAN PVERSIGHT HHS-20-0580-A-000050 Giroir, Brett (HHS/OASH) Giroir, Brett (HHS/OASH) ; Shuren, Jeff (FDA/CDRH); Stenzel, Timothy (FDA/CDRH); Monroe, Steve (CDC/DDPHSS/OLSS/OD) ; Lenihan, Keagan (FDA/OC) ; Kellogg, Rachel(HHS/OASH); Bante, Katie (OS/OASH) Subject: COVID Testing Date: 2020/03/11 07:02:56 Start Date: 2020/03/11 08:30:00 End Date: 2020/03/11 09:00:00 Priority: Normal Type: Appointment Location: (b)(6) IParticipant:Kb)(6) I Giroir, Brett (HHS/OASH) Giroir, Brett (HHS/OASH) ; Shuren, Jeff (FDA/CDRH); Stenzel, Timothy (FDA/CDRH); Monroe, Steve (CDC/DDPHSS/OLSS/OD) ; Lenihan, Keagan (FDA/OC) ; Kellogg, Rachel(HHS/OASH); Bante, Katie (OS/OASH) Sent Date: 2020/03/11 07:02:56 AMERICAN PVERSIGHT HHS-20-0580-A-000051 Giroir, Brett (HHS/OASH) Giroir, Brett (HHS/OASH) ; Shuren, Jeff (FDA/CDRH) ; Stenzel, Timothy (FDA/CDRH) ; Monroe, Steve (CDC/DDPHSS/OLSS/OD) ; Lenihan, Keagan (FDA/OC) ; Kellogg, Rachel (HHS/OASH) ; Bante, Katie (OS/OASH) CC: Haddad, Carla (HHS/OASH) Subject: COVID Testing Date: 2020/03/11 07:02:56 Start Date: 2020/03/11 08:30:00 End Date: 2020/03/11 09:00:00 Priority: Normal Type: Appointment Location: (b)(6) IParticipant: l(b)(6) I Giroir, Brett (HHS/OASH); Shuren, Jeff (FDA/CDRH); Stenzel, Timothy (FDA/CDRH); Monroe, Attendees: Steve (CDC/DDPHSS/OLSS/OD); Lenihan, Keagan (FDA/OC); Kellogg, Rachel (HHS/OASH); Bante, Katie (OS/OASH); Haddad, Carla (HHS/OASH) Giroir, Brett (HHS/OASH) Giroir, Brett (HHS/OASH) ; Shuren, Jeff (FDA/CDRH) ; Stenzel, Timothy (FDA/CDRH) ; Monroe, Steve (CDC/DDPHSS/OLSS/OD) ; Lenihan, Keagan (FDA/OC) ; Kellogg, Rachel (HHS/OASH) ; Bante, Katie (OS/OASH) ; Haddad, Carla (HHS/OASH) Sent Date: 2020/03/11 07:02:56 AMERICAN PVERSIGHT HHS-20-0580-A-000052 Giroir, Brett (HHS/OASH) Giroir, Brett (HHS/OASH); Shuren, Jeff (FDA/CDRH); Stenzel, Timothy (FDA/CDRH); Monroe, Steve (CDC/DDPHSS/OLSS/OD) ; Lenihan, Keagan(FDA/OC) ; Kellogg, Rachel (HHS/OASH); Bante, Katie (OS/OASH); Haddad, Carla (HHS/OASH); Schwartz, Suzanne(FDA/CDRH); Valentine, Steven (HHS/OASH) Subject: COVIDTesting Date: 2020/03/11 07:02:56 Start Date: 2020/03/11 08:30:00 End Date: 2020/03/11 09:00:00 Priority: Normal Type: Appointment Location: Call bridge:~b)(6) !Participants: ~b)(6) I Giroir, Brett (HHS/OASH);Shuren, Jeff (FDA/CDRH);Stenzel, Timothy (FDA/CDRH);Monroe, Lenihan, Keagan (FDA/OC); Kellogg, Rachel(HHS/OASH); Attendees: Steve (CDC/DDPHSS/OLSS/OD); Bante, Katie (OS/OASH);Haddad, Carla (HHS/OASH) Giroir, Brett (HHS/OASH) Giroir, Brett (HHS/OASH); Shuren, Jeff (FDA/CDRH); Stenzel, Timothy (FDA/CDRH); Monroe, Steve (CDC/DDPHSS/OLSS/OD) ; Lenihan, Keagan(FDA/OC) ; Kellogg, Rachel (HHS/OASH); Bante, Katie (OS/OASH); Haddad, Carla (HHS/OASH); Schwartz, Suzanne(FDA/CDRH); Valentine, Steven (HHS/OASH) AMERICAN PVERSIGHT HHS-20-0580-A-000053 Sent Date: 12020/03/11 07:02:56 AMERICAN PVERSIGHT HHS-20-0580-A-000054 Giroir, Brett (HHS/OASH) Giroir, Brett (HHS/OASH); Shuren, Jeff (FDA/CDRH); Stenzel, l7mothy (FDA/CDRH); Monroe, Steve (CDC/DDPHSS/OLSS/OD) ; Lenihan, Keagan(FDA/OC) ; To: Kellogg, Rachel(HHS/OASH); Bante, Katie (OS/OASH); Haddad, Carla (HHS/OASH); Schwartz, Suzanne(FDA/CDRH); Valentine, Steven (HHS/OASH); Murphy, Ryan (OS/ASPA) Subject: COVIDTesting Date: 2020/03/11 07:43:42 Start Date: 2020/03/11 08:30:00 End Date: 2020/03/11 09:00:00 Priority: Normal Type: Appointment Location: Call bridge:~b)(6) IParticipants:~b)(6) I Giroir, Brett (HHS/OASH);Shuren, Jeff (FDA/CDRH);Stenzel, Timothy (FDA/CDRH);Monroe, Attendees: Steve (CDC/DDPHSS/OLSS/OD); Lenihan, Keagan (FDA/OC); Kellogg, Rachel(HHS/OASH); Bante, Katie (OS/OASH);Haddad, Carla (HHS/OASH) Giroir, Brett (HHS/OASH) Giroir, Brett (HHS/OASH); Shuren, Jeff (FDA/CDRH); Stenzel, l7mothy (FDA/CDRH); Monroe, Steve (CDC/DDPHSS/OLSS/OD) ; Lenihan, Keagan(FDA/OC) ; Recipient: Kellogg, Rachel(HHS/OASH); Bante, Katie (OS/OASH); Haddad, Carla (HHS/OASH); Schwartz, Suzanne(FDA/CDRH); Valentine, Steven (HHS/OASH); Murphy, Ryan (OS/ASPA) Sent Date: 2020/03/11 07:43:42 AMERICAN PVERSIGHT HHS-20-0580-A-000055 Trent -Adams, Sylvia (HHS/OASH) Haddad, carla (HHS/OASH) ; To: Orsega, Susan (OS/OASH) CC: Schwartz, Erica (HHS/OASH) ; Kellogg, Rachel (HHS/OASH) Subject: RE: Drive through Testing Denver Col Date: 2020/03/13 13:59:06 Priority: Normal Type: Note copy From: Haddad, Carla (HHS/OASH) Sent: Friday, March 13, 2020 1:56 PM To: Trent-Adams, Sylvia (HHS/OASH) ; Orsega, Susan (OS/OASH) Cc: Schwartz, Erica (HHS/OASH) ; Kellogg, Rachel (HHS/OASH) Subject: RE: Drive through Testing Denver Col FYIADM Giroir/Rachel are both at the WH today and offline for the next hour or so. From: Trent-Adams, Sylvia (HHS/OASH) Sent: Friday, March 13, 2020 1:17 PM To: Haddad, Carla (HHS/OASH) ; Orsega, Susan (O5/OASH) ; Giroir, Brett (HHS/OASH) Cc: Schwartz, Erica (HHS/OASH) ; Kellogg, Rachel (HHS/OASH) Subject: RE: Drive through Testing Denver Col Thank you . From: Haddad, Carla (HHS/OASH) Sent: Friday, March 13, 2020 1:16 PM To: Orsega, Susan (OS/OASH) ; Trent-Adams, Sylvia (HHS/OASH) ; Giroir, Brett (HHS/OASH) Cc: Schwartz, Erica (HHS/OASH) ; Kellogg, Rachel (HHS/OASH) Subject: RE: Drive through Testing Denver Col Thanks. Adding Rachel Kellogg as well. AMERICAN PVERSIGHT HHS-20-0580-A-000056 From: Orsega, Susan (OS/DASH) Sent: Friday, March 13, 2020 1:10 PM To: Trent-Adams, Sylvia (HHS/OASH) ; Giroir, Brett (HHS/OASH) Cc:Schwartz, Erica (HHS/OASH) ; Haddad, Carla (HHS/OASH) Subject: RE: Drive through Testing Denver Col Carla, Adding you to the email. From: Trent-Adams, Sylvia (HHS/DASH) Sent: Friday, March 13, 2020 1:01 PM To: Orsega, Susan (OS/DASH) ; Giroir, Brett (HHS/OASH) Cc:Schwartz, Erica (HHS/OASH) Subject: RE: Drive through Testing Denver Col A few updates. From: Orsega, Susan (OS/OASH) Sent: Friday, March 13, 2020 12:50 PM To: Giroir, Brett (HHS/OASH) Cc:Schwartz, Erica (HHS/OASH) ; Trent-Adams, Sylvia (HHS/OASH) Subject: Drive through Testing Denver Col Sir, Following the call with Laurie Konsella (RHA) , here is the situation. b)(5) AMERICAN PVERSIGHT HHS-20-0580-A-000057 b)(5) See pictures sent frommy iPh one Sender: Trent-Adams, Sylvia (HHS/OASH) Haddad, Carla (HHS/OASH) ; Orsega, Susan (O5/OASH) ; Recipient: Schwartz, Erica (HHS/OASH) ; Kellogg, Rachel (HHS/OASH) Sent Date: 2020/03/13 13:59:03 Delivered Date: 2020/03/13 13:59:06 AMERICAN PVERSIGHT HHS-20-0580-A-000058 AMERICAN PVERSIGHT HHS-20-0580-A-000059 Trent-Adams, Sylvia (HHS/OASH) From: GROUP (FYDIBOHF23SPDLT)/CN= RECIPIENTS/CN=650D027641442169334514 Kellogg, Rachel (HHS/OASH) ; Sus> Kadlec, Robert (OS/ASPR/IO) ; Giroir, Brett (HHS/OASH) ; Schwartz, Erica (HHS/OASH) ; Smith, Brad (CMS/QA) ; Haddad, Carla (HHS/OASH) ; Valentine, Steven (HHS/OASH) ; Yeskey, Kevin (OS/ASPR/IO) ; Greene, Jonathan (OS/ASPR/EMMO) ; Shuy, Bryan (OS/ASPR/IO) ; Herrmann, Jack (OS/ASPR/OEA) ; Guyton, Cedric (OS/OASH) Subject: RE: PLANNING PURPOSESONLY - TESTING SITES Date: 2020/03/13 14:02:41 Priority: Normal Type: Note copy -----Original Message----From: Kellogg, Rachel (HHS/OASH) Sent: Friday, March 13, 2020 2:01 PM To : Orsega, Susan (OS/OASH) Cc: Kadlec, Robert (OS/ASPR/IO) < Robert.Kad lec@hhs.gov >; Giroir, Brett (HHS/OASH) ; Schwartz, Erica (HHS/OASH) < Erica.Schwartz @hhs.gov >; Smith, Brad (CMS/QA) ; Haddad, Carla (HHS/OASH) ; Valentine, Steven (HHS/OASH) ; Yeskey, Kevin (OS/ ASPR/IO) ; Greene, Jonathan (OS/ ASPR/EMMO) ; Shuy, Bryan (OS/ASPR/IO) ; Herrmann, Jack (OS/ASPR/OEA) ; Trent-Adams, Sylvia (HHS/OASH) ; Guyton, Cedric (OS/OASH) Subject: Re: PLANNING PURPOSESONLY - TESTING SITES All, will be in touch ASAP. ADM Giroir with POTUS righ t now. Sent from my iPhone > On Mar 13, 2020, at 1:50 PM, Orsega, Susan (OS/OASH) wrote: > > Sirs, Adding others. > > > > > > -----Original Message----From: Kadlec, Robert (OS/ASPR/IO) Sent: Friday, March 13, 2020 12:54 PM To : Giroir, Brett (HHS/OASH) Cc: Orsega, Susan (OS/OASH) ; Schwartz, Erica (HHS/OASH) ; AMERICAN PVERSIGHT HHS-20-0580-A-000060 Smith, Brad (CMS/QA) ; Haddad, Carla (HHS/OASH) ; Valentine, Steven (HHS/OASH) ; Kellogg, Rachel (HHS/OASH) ; Yeskey, Kevin (OS/ASPR/IO) ; Greene, Jonathan (OS/ASPR/EMMO) ; Shuy, Bryan (OS/ASPR/IO) ; Herrmann, Jack (OS/ASPR/OEA) > Subject: Re: PLANNING PURPOSESONLY - TESTING SITES > (b)(5) > Sent from my iPhone > >> On Mar 13, 2020, at 12:18 PM, Giroir, Brett (HHS/OASH) wrote : >> (b)(5) >> BG >> >> >> >> >> >> >> Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington , DC 20201 Office Phone: 202-690-7694 >> >> >> >> >> >> >> >> ----- Original Message----From : Giroir, Brett (HHS/OASH) Sent: Friday, March 13, 2020 12:05 PM To: Susan Orsega (OS/OASH) (Susan.Orsega@hhs.gov) Cc: Schwartz, Erica (HHS/OASH) Subj ect: FW: >> >> Can we ta lk7 >> >> >> >> >> >> >> >> Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washingt on, DC 20201 Office Phone: 202-690-7694 >> >> >> >> >> >> ----- Original Message----From : Giroir, Brett (HHS/OASH) Sent: Friday, March 13, 2020 11:55 AM To: Giroir, Brett (HHS/OASH) Subj ect : >> >> >> Sen de r :ITrent-Adams, Sylvia (HHS/OASH) 7BFAFD132- Kellogg, Rachel (HHS/OASH) ; Orsega, Susan (OS/OASH) ; Kadlec, Robert (O5/ASPR/IO) ; Giroir, Brett (HHS/OASH) ; Schwartz, Erica (HHS/OASH) ; Smith, Brad (CMS/QA) ; Haddad, Carla (HHS/OASH) ; Valentine, Steven (HHS/OASH) ; Yeskey, Kevin (OS/ASPR/IO) ; Greene, Jonathan (OS/ASPR/EMMO) ; Shuy, Bryan (OS/ASPR/IO) ; Herrmann, Jack (OS/ASPR/OEA) ; Guyton, Cedric (OS/OASH) Sent Date: 2020/03/13 14:02:40 Delivered Date: 2020/03/13 14:02 :41 AMERICAN PVERSIGHT HHS-20-0580-A-000062 Bright, Rick (O5/ASPR/BARDA) Giroir, Brett (HHS/OASH) ; To: Dodgen, Daniel (O5/ASPR/SPPR) Haddad, carla (HHS/OASH) ; Tegeris, John (OS/ASPR/BARDA) (CTR) ; Seals, Jonathan (O5/ASPR/BARDA) Subject: RE: CV- 19 Anti-vira l candidate Date: 2020/03/11 15:57:41 Priority: Normal Type: Note (b)(5) From: Giroir, Brett (HHS/OASH) Sent: Wednesday, March 11, 2020 3:43 PM To: Dodgen, Daniel (OS/ASPR/SPPR) Cc: Bright, Rick (OS/ASPR/BARDA) ; Haddad, Carla (HHS/OASH) Subject: FW: CV-19 Anti-viral candidate b)(5) BG Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 AMERICAN PVERSIGHT HHS-20-0580-A-000063 Office Phone: 202-690-7694 From: David Shanahan Sent: Wednesday, March 11, 2020 2:29 PM To: Giroir, Brett (HHS/OASH) Subject: CV-19 Anti-viral candidate Brett , (b)(4) Regards, David Shanahan Sender: Bright, Rick (OS/ASPR/BARDA) Giroir, Brett (HHS/OASH) ; Dodgen, Daniel (O5/ASPR/SPPR) ; Haddad, (aria (HHS/OASH) ; Tege ris, John (OS/ASPR/BARDA) (CTR) ; Seals, Jonathan (OS/ASPR/BARDA) Sent Date: 2020/03/11 15:57:40 Delivered Date: 2020/03/1115:57:41 AMERICAN PVERSIGHT HHS-20-0580-A-000064 Giroir, Brett (HHS/OASH) To: Foley, Diane (HHS/OASH) Haddad, carla (HHS/OASH); CC: Valentine, Steven (HHS/OASH) Subject: RE: notification about report release Date: 2020/02/04 13:32:00 Priority: Normal Type: Note OK I sent back to Jen and Caitryn Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Foley, Diane (HHS/OASH) Sent: Tuesday, February 4, 2020 1:17 PM To: Giroir, Brett (HHS/OASH) Cc: Haddad, Carla (HHS/OASH) ; Valentine, Steven (HHS/OASH) Subject: RE: notification about report release Good morning, (b)(5) AMERICAN PVERSIGHT HHS-20-0580-A-000065 (b)(5) Thanks, Diane Diane Foley MD, FAAP Deputy Assistant Secretary Office of Population Affairs Office of the Assistant Secretary for Health/HHS Phone: 240-453-2826 (office-direct) rb )(6 l ~cell) From: Giroir, Brett (HHS/OASH) Sent: Saturday, February 1, 2020 11:33 AM To: Foley, Diane (HHS/OASH) Cc: Haddad, Carla (HHS/OASH) ; Valentine, Steven (HHS/OASH) Subject: RE: notification about report release Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Foley, Diane (HHS/OASH) Sent: Saturday, February 1, 2020 11:26 AM To: Giroir, Brett (HHS/OASH) Subject: RE: notification about report release Hi, (b)(5) AMERICAN PVERSIGHT HHS-20-0580-A-000066 b)(5) Diane Diane Foley MD, FAAP Deputy Assistant Secretary Office of Population Affairs Office of the Assistant Secretary for Health/HHS Phone: 240-453-2826 (office-direct) rb )(6) cell) I From: Giroir, Brett (HHS/OASH) Sent: Saturday, February 1, 2020 11:08 AM To: Foley, Diane (HHS/OASH) Subject: RE: notification about report release Thanks Diane Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690- 7694 From: Foley, Diane (HHS/OASH) Sent: Thursday, January 30, 2020 8:16 AM To: Giroir, Brett (HHS/OASH) Subject: Fwd: notification about report release AMERICAN PVERSIGHT HHS-20-0580-A-000067 Good morning, Please find attached a memo describing a report that OPA is planning to post on our website. I have also attached the research brief and the complete study. This study is the result of a study funded by OASH, ASPE,and ACF. I am happy to provide further information . Diane Diane Foley MD, FAAP Deputy Assistant Secretary Office of Population Affairs Office of the Assistant Secretary for Health/HHS Phone: 240-453-2826 (office-direct) l(b)(6) !(cell) X Sender: Giroir, Brett (HHS/OASH) Foley, Diane (HHS/OASH) ; Haddad, Carla (HHS/OASH) ; Valentine, Steven (HHS/OASH) Sent Date: 2020/02/04 13:32:00 AMERICAN PVERSIGHT HHS-20-0580-A-000068 Giroir, Brett (HHS/OASH) Valentine, Steven (HHS/OASH) CC: Haddad, Carla (HHS/OASH) Subject: RE: running samples at CDCand timing Date: 2020/03/09 10:23:06 Priority: Normal Type: Note Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Valentine, Steven (HHS/OASH) Sent: Monday, March 9, 2020 10:16 AM To: Giroir, Brett (HHS/OASH) Cc: Haddad, Carla (HHS/OASH) Subject: FW: running samples at CDCand timing FYSA Confidential pre-decisional deliberative process From: Fink, Dorothy (05/0ASH) Sent: Monday, March 9, 2020 10:14 AM To: Valentine, Steven (HHS/OASH) Subject: running samples at CDCand timing Steven, AMERICAN PVERSIGHT HHS-20-0580-A-000069 b)(5) Dorothy Dorothy Fink, MD Deputy Assistant Secretary for Women's Health Direct or, Offi ce on Women's Health Office of the Assistant Secretary for Health U.S. Department of Health and Human Services Disclaimer: This message is intended for the exclusive use of the recipient(s) named above. It may contain information that is PRE-DECISIONAL, PROTECTED,PRIVILEGED,and/or CONFIDENTIAL,and it should not be disseminated, distributed, or copied to persons not authorized to receive such information. All sensitive documents must be properly labeled before dissemination via email. If you are not the intended recipient, any dissemination, distribution, or copying is strictly prohibited without the permission of the sender . If you have received this communication in error, please erase all copies of the message and its attachments and notify us immediately. Giroir, Brett ( HHS/OASH) Recipient: Valentin e, Ste ven (H HS/ OASH) ; Haddad, Carla (HHS/OASH) Sent Date: 2020 / 03/09 10:23 :05 Delivered Date: 2020/03/09 10:23 :06 AMERICAN PVERSIGHT HHS-20-0580-A-000070 Giroir, Brett (HHS/OASH) To: Migliaccio-Grabill,Kate (HHS/OASH) Valentine, Steven (HHS/OASH); Bante, Katie (O5/OASH) ; CC: Heck, Mia (HHS/OASH); Haddad, Carla (HHS/OASH) Subject: FW: WAPONews Alert: Workers without protective gear or proper training met coronavirus evacuees, HHSwhistleblower says Date: 2020/02/27 17:37:49 Priority: Normal Type: Note b)(5) BG Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Broida, Tara (HHS/OASH) Sent: Thursday, February 27, 2020 4:55 PM To: Giroir, Brett (HHS/OASH) ; Trent-Adams, Sylvia (HHS/OASH) ; Schwartz, Erica (HHS/OASH) ; Orsega, Susan (OS/OASH) ; Adams, Jerome (HHS/OASH) Cc: Heck, Mia (HHS/OASH) ; Valentine, Steven (HHS/OASH) ; Haddad, Carla (HHS/OASH) ; Sherman, Jennifer (HHS/OASH) ; Migliaccio-Grabill, Kate (HHS/OASH) ; Kellogg, Rachel (HHS/OASH) Subject: Fwd: WAPO News Alert: Workers without protective gear or proper training met coronavirus evacuees, HHS whistleblower says Full text is below By Lena H. Sun and Yasmeen Abutaleb AMERICAN PVERSIGHT HHS-20-0580-A-000071 Feb. 27, 2020 at 4: 18 p.m. EST Officials at the Department of Health and Human Services sent more than a dozen workers to receive the first Americans evacua ted from Wuhan. China. the epicenter of the coronavirus outbreak.without proper training for infection control or appropriate protective gear, according to a whistleblower complaint. The workers did not show symptoms of infection and were not tested for the virus. according to lawyers for the whistleblower, who is a senior HHS official based in Washington who oversees workers at the Administration for Children and Families, a unit within HHS. The whistleblower is seeking federal protection because she alleges she was unfairly and improperly reassigned after raising concerns about the safety of these workers to HHS officials , including those within the office of Health and Human Services Secretary Alex Azar. She was told Feb. 19 that if she does not accept the new position in 15 days, which is March 5, she would be terminated. The whistleblower has decades of experience in the field, received two HHS department awards from Azar last year, and has received the highest performance evaluations , her lawyers said. The complaint was filed Wednesday with the Office of the Special Counsel, an independent federal watchdog agency. The whistleblower's lawyers provided a copy of a redacted 24-page complaint to The Washington Post. A spokesman for the Office of the Special Counsel said he could not comment on complaints filed with the office. The complaint alleges that HHS staff were "improperly deployed " and were "not properly trained or equipped to operate in a public health emergency situation. " The complaint also alleges that the workers were potentially exposed to coronavirus because appropriate steps were not taken to protect them, and staff were not trained in wearing personal protective equipment , even though they had face-to-face contact with returning passengers. The workers were in contact with passengers in an airplane hangar where evacuees were received and on two other occasions: when they helped distribute keys for room assignments and hand out colored ribbons for identification purposes. "We take all whistleblower complaints very seriously and are providing the complainant all appropriate protections under the Whistleblower Protection Act. We are evaluating the complaint and have nothing further to add at this time ," HHS spokeswoman Caitlin Oakley said. The whistleblower, in her complaint , states that "appropriate steps were not taken to quarantine , monitor, or test [the workers] during their deployment and upon their return home." The repatriated Americans were among those evacua tedfrom Wuhan and quarantined on military bases in California and Texas because they were considered at high risk for contracting the flulike illness. About 14 personnel from the Administration for Children and Families, or ACF, were sent to March Air Force base in Riverside County, California, and another team of about 13 ACF personnel were sent to Travis Air Force in Fairfield , California , according to the complaint and the whistleblower ' s lawyer , Ari Wilkenfeld. Several people within HHS voiced objection to sending the ACF personnel to receive passengers , according to a person familiar with the conversations , who spoke on the condition of anonymity to discuss private deliberations. A second person familiar with the situation said the workers were not tested for coronavirus because none of them met the criteria , which was restricted at that time to people who had recent travel to China or contact with a confirmed case . The workers also did not exhibit any symptoms , the person said. If they had, appropriate protocol would have been followed. AMERICAN PVERSIGHT HHS-20-0580-A-000072 The deployments took place Jan. 28 to 31, around the time when the first planeload of evacuees arrived at March , and Feb. 2 to Feb. 7, during the time when additional flights were arriving at Travis. The planes each caITied about 200 Americans who were repatriated from Wuhan. After their deployments , the workers returned to their normal duties , some taking commercial airline flights to return to their offices around the country, the lawyers said. "Our client was concerned that ACF staff - who were potentially exposed to the coronavirus were allowed to leave quarantined areas and retmn to their communitie s, where they may have spread the coronavirus to others ," said Lauren Naylor , one of the whistleblower ' s lawyers. The whistleblower is also seeking assistance from the office of Rep. Jimmy Gome z, (D-Ca.) , a member of the House Ways and Means committee and vice chair of the House Oversight Committee, according to a Gomez spokesman . During a hearing Thursday , Gome z asked Azar whether any employees from ACF could have been sent to help with the repatriation of Americans from Wuhan, China without any training in emergency response. Azar replied that some ACF employees were involved. Asked what sort of health and safety training the personnel received, and whether any of them were exposed to high-risk evacuees from China , Azar said: "They never should have been without P.P.E ," referring to personal protective equipment. Asked whether any protocols may have been broken, given the urgency on the ground, Azar replied that urgency was never a reason for breaking safety protocol s. "I don't believe that has taken place ," Azar said said, adding that health and safety protocols "should always be followed. " He said that he did not personally know the names of the team , but that other department officials did. Pressed by Gomez what the department would do if untrained employees were exposed to the virus , Azar said: "I'd want to know the full facts, and we 'd take appropriate remedial efforts." The whistleblower said she received an email Jan. 25 about a potential deployment within ACF to support repatriation of the evacuated Americans, according to her lawyer. She initially supported the effo1ts because they had the "appearance that this was within ACF' s scope ," Naylor said. But later, she discovered the teams were dispatched without her knowledge by other senior officials at HHS. It was part of the agency ' s "all-hands-on-deck " mission, aylor said, but it broke agency protocol about what kinds of employees should respond to health emergencies. The whistleblower said she later found out about the deployment when she heard directly from some employees and other senior officials at HHS. Some workers expressed concern about the lack of protec tive gear to the ACF team leader on the ground. That person joined ACF in September and had "no training or experience in any federal emergency management , public health emergency response , or safety or operational protocols to run the mission ," the complaint states. ACF personnel typically deal with supporting people recovering from natural disasters, such as floods and fires , and helping victims apply for temporary assistance , all of which are under the category of human services, the whistleblower ' s lawyers said. HHS officials broke established protocols for emergency support by sending ACF workers to a health emergency, for which they have no training , Naylor said. ACF, which has about 1,300 employees, has come under attack in recent years because of its role in sheltering and taking custody of migrant children who crossed the U.S .-Mexico border who were separated from them by the Department of Homeland Security. The workers' concerns about potential expo sure to coronavirus were not addressed, the whistleblower's lawyers said. AMERICAN PVERSIGHT HHS-20-0580-A-000073 "She was involuntarily assigned to a position in a subject matter where she has no expertise," said Wilkenfeld, her lawyer , in an interview Thursday. The agency said the reason for the rea ssignment was "necessar y to meet the need s of the department ," according to a memo she received. "If I did not accept involuntary reassignment, I would be termi nated from federal service through adverse personnel action," according to her complaint. Begin forwarded message: From: The Washington Po st Date: February 27, 2020 at 4: 19:48 PM EST To: tara.broido@hhs.gov Subject: [MARKETING EMAIL]News Alert: Workers without protective gear or proper training met coronavirus evacuees, IIlIS whistleblower says Reply-To: The Washington Po st News Alert Feb 27, 4:19 PM Workers without protective gear or proper training met coronavirus evacuees, HHS whistleblower says A complaint alleges that staffers from the Department of Health and Human Services were "improperly deployed" and were not trained in wearing personal protective equipment before they assisted Americans evacuated from Wuhan, China, and quarantined on military bases. The whistleblower is seeking federal protection because she says she was improperly reassigned after raising concerns with the office of HHS Secretary Alex Azar. Read more» AMERICAN PVERSIGHT HHS-20-0580-A-000074 ADVERTISE\t1ENT You received this email because you signed up for news alerts from The Washington Post. Manage my newsletters and alerts I Unsubscribe Privacy Policy I Help ©2020 The Washington Post, 1301 K St NW, Washington DC 20071 Sender: Giroir, Brett (HHS/OASH) Migliaccio-Grabill, Kate (HHS/OASH) ; Valentine, Steven (HHS/OASH) ; Bante, Katie (OS/OASH) ; Heck, Mia (HHS/OASH) ; Haddad, Carla ( HHS/ OASH) Sent Date: 2020/02/27 17:37:48 Delivered Date: 2020/02/27 17:37:49 AMERICAN PVERSIGHT HHS-20-0580-A-000075 Giroir, Brett (HHS/OASH) Ettinger, Michael (Legal) ; To: Haddad, carla (HHS/OASH) Bergman, Stanley ; CC: Mlotek, Mark ; Bhansali, Seema Subject: RE: Matt Bassett said to give the Admiral a call. Date: 2020/03/13 16:52:45 Priority: Normal Type: Note received Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Ettinger, Michael (Legal) Sent: Friday, March 13, 2020 2:47 PM To: Haddad, Carla (HHS/OASH) Cc: Bergman, Stanley ; Mlotek, Mark ; Bhansali, Seema ; Giroir, Brett (HHS/OASH) Subject: Matt Bassett said to give the Adm iral a call. Hi Carla, Matt Bassett said to reach out to the Admira l. We called the Admira l's office, but were told to email you. Henry Schein has ident ified 3 compan ies that have filed EUAs for lateral flow quick tests and nasal swab tests to test for COVID-19 that deliver results in 15-30 minutes. Two of these companies have been selling millions of tests in China and Korea and the third company is a start up with similar technology. We can have 40,000 tests on Monday, 1 million tests a week from now, and then in April we can ramp up to 1 million tests per day. We are quite concerned that these tests will be sold to other countries unless the government quickly approves the EUAs and buys some tests. AMERICAN PVERSIGHT HHS-20-0580-A-000076 The big benefit of these tests is that it can be used in the home after a telehealth encounter so that people do not have to go to hospitals and doctor offices which would stress the healthcare system beyond its capabilities. We have a whole set of protocols that would be issued as part of this, including multiple testing, given that the antigens may not appear for several days. Henry Schein is prepared to respond to the government's call to action and partner to alleviate the urgent need for wide availability of rapid testing. As the world's largest distributor of healthcare solutions to the office-based practitioner , we have unique reach to get these products to market quickly and educate medical professionals on best practices. Henry Schein has five strategic distribution centers across the U.S. (29 globally) which enable us to have 99% of our orders shipped the day they are received. Henry Schein (NASDAQ: HSJC) understands that healthcare is a coordinated effort and we actively engage in discussions with the WHO, HHS , and others to be a thought-leader and private-sector partner, including in the GHSA Private Sector Roundtable and Pandemic Supply Chain etwork. www.henryschein.com Dr. Peggy Hamburg and Dr. Louis Sullivan both know us well if you need further points of reference on our company and capabilities. If helpful, our CEO and other senior executives would welcome the opportunity to get on a phone call with you immediately to discuss the details of our plan how we can move this forward quickly before these tests get deployed to other parts of the world. Besides myself (my contacts are below), you can reach out to our Chairman, Stan Bergman at 631.704 .2852 or Mark Mlotek at 917.847 .3445 . Best Regards, Michael S. Ettinger Senior Vice President, Corporate &Legal Affairs and Chief of Staff Henry Schein, Inc . 135 Duryea Road Melville, NY 11747 631.843.5993 (o) 631.843.5660 (f) rb) (6) Please consider the environment before printing this email. E-mail messages may contain viruses, worms, or other malicious code. By reading the message and opening any attachments, the recipient accepts full responsibility for taking protective action against such code. Henry Schein is not liable for any loss or damage arising from this message. AMERICAN PVERSIGHT HHS-20-0580-A-000077 The information in this email is confidential and may be legally privileged. It is intended solely for the addressee(s 1. Access to this e-mail by anyone else is unauthorized. Sender: Giroir, Brett (HHS/OASH) Ettinger , Michael (Legal) ; Haddad, Carla ( HHS/DASH) ; Mlotek, Mark ; Bhansali, Seema Car>; Sent Date: 2020/03/13 16:52:44 Delivered Date: 2020/03/13 16:52:45 AMERICAN PVERSIGHT HHS-20-0580-A-000078 Giroir, Brett (HHS/OASH) Stenzel, Timothy (FDA/CDRH); To: Shuren, Jeff (FDNCDRH) Kellogg, Rachel (HHS/OASH); Haddad, Carla (HHS/OASH); Hahn, Stephen ; Giroir, Brett (HHS/OASH) Subject: FW: Matt Bassett said to give the Admiral a call. Date: 2020/03/13 16:54:34 Priority: Normal Type: Note Best Brett Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Ettinger, Michael (Legal) Sent: Friday, March 13, 2020 2:47 PM To: Haddad, Carla (HHS/OASH) Cc: Bergman, Stanley ; Mlotek, Mark ; Bhansali, Seema ; Giroir, Brett (HHS/OASH) Subject: Matt Bassett said to give the Admiral a call. Hi Carla, Matt Bassett said to reach out to the Admiral. We called the Admiral's office, but were told to email you. AMERICAN PVERSIGHT HHS-20-0580-A-000079 Henry Schein has identified 3 companies that have filed EUAs for lateral flow quick tests and nasal swab tests to test for COVID-19 that deliver results in 15-30 minutes. Two of these companies have been selling millions of tests in China and Korea and the third company is a start up with similar technology. We can have 40,000 tests on Monday, 1 million tests a week from now, and then in April we can ramp up to 1 million tests per day. We are quite concerned that these tests will be sold to other countries unless the government quickly approves the EUAs and buys some tests. The big benefit of these tests is that it can be used in the home after a telehealth encounter so that people do not have to go to hospitals and doctor offices which would stress the healthcare system beyond its capabilities. We have a whole set of protocols that would be issued as part of this, including multiple testing, given that the antigens may not appear for several days. Henry Schein is prepared to respond to the government's call to action and partner to alleviate the urgent need for wide availability of rapid testing. As the world's largest distributor of healthcare solutions to the office -based practitioner, we have unique reach to get these products to market quickly and educate medical professionals on best practices . Henry Schein has five stra tegic distribution centers across the U.S. (29 globally) which enable us to have 99% of our orders shipped the day they are received. Henry Schein (NASDAQ: HSIC) understands that healthcare is a coordinated effort and we actively engage in discussions with the WHO, HHS, and others to be a thought -leader and private-sector partner, including in the GHSA Pri vate Sector Roundtable and Pandemic Supply Chain etwork. www.henryschein.com Dr. Peggy Hamburg and Dr. Louis Sullivan both know us well if you need further points of reference on our company and capabilities. If helpful, our CEO and other senior executives would welcome the opportunity to get on a phone call with you immediately to discuss the details of our plan how we can move this forward quickly before these tests get deployed to other parts of the world. Besides myself (my contacts are below), you can reach out to our Chairman, Stan Bergman at 631. 704.2852 or Mark Mlotek at 917.847.3445. Best Regards, Michael S. Ettinger Senior Vice President , Corporate &Legal Affairs and Chief of Staff Henry Schein, Inc . 135 Duryea Road Melville, NY 11747 AMERICAN PVERSIGHT HHS-20-0580-A-000080 631.843.5993 (o) 631.843.5660 b)(6) Please consider the environment before printing this email. E-mail messages may contain viruses, worms, or other malicious code. By reading the message and opening any attachments, the recipient accepts full responsibility for taking protective action against such code. Henry Schein is not liable for any loss or damage arising from this message. The information in this email is confidential and may be legally privileged. It is intended solely for the addressee(s ,. Access to this e-mail by anyone else is unauthorized. Sender: Giroir, Brett (HHS/OASH) Stenzel,Timothy (FDA/CDRH); Shuren, Jeff (FDNCDRH) ; Kellogg, Rachel (HHS/OASH); Haddad, Carla (HHS/OASH); Hahn, Stephen ; Giroir, Brett (HHS/OASH) Sent Date: 2020/03/13 16:54:33 Delivered Date: 2020/03/13 16:54:34 AMERICAN PVERSIGHT HHS-20-0580-A-000081 Trent-Adams, Sylvia (HHS/OASH) Valentine, Steven (HHS/OASH); Orsega, Susan (OS/OASH); Schwartz, Erica (HHS/OASH) Haddad, Carla (HHS/OASH); Santiago, Yvonne (HHS/OASH/OSG); Guyton, Cedric (OS/OASH) Subject: FW: Corps COVIDSupplemental Request Date: 2020/03/09 12:32:13 Priority: Normal Type: Note Hello Everyone, Please see below a rough draft response to ASFRfor 0MB. I need your edits as soon as possible. Thank you, STA b)(5) AMERICAN PVERSIGHT HHS-20-0580-A-000082 b)(5) From: Brown, Mark (HHS/ASFR) Sent: Monday, March 9, 2020 11:45 AM To: Valentine, Steven (HHS/OASH) ; Cochran, Norris (HHS/ASFR) Cc: Giroir, Brett (HHS/OASH) ; Moughalian, Jen (HHS/ASFR) ; Trent -Adams, Sylvia (HHS/OASH) ; Schwartz, Erica (HHS/OASH) ; Orsega, Susan (OS/OASH) ; Roman, Ruth (HHS/OASH) ; Thanh, Hoa (HHS/OASH) ; Haddad, Carla (HHS/OASH) ; Guyton, Cedric (OS/OASH) ; Smolin, Jennifer (HHS/ASFR) ; Hittle, Taylor (HHS/ASFR) Subject : RE: Corps COVID Supplemental Request Steven, AMERICAN PVERSIGHT HHS-20-0580-A-000083 (b)(5) Mark From: Valentine, Steven (HHS/OASH) Sent: Monday, March 9, 2020 10:41 AM To: Brown, Mark (HHS/ASFR); Cochran, Norris (HHS/ASFR) Cc: Giroir, Brett (HHS/OASH) ; Moughalian, Jen (HHS/ASFR) ; Trent-Adams, Sylvia (HHS/OASH) ; Schwartz, Erica (HHS/OASH) ; Orsega, Susan (OS/OASH) ; Roman, Ruth (HHS/OASH) ; Thanh, Hoa (HHS/OASH) ; Haddad, Carla (HHS/OASH) ; Guyton, Cedric (OS/OASH) ; Smolin, Jennifer (HHS/ASFR) ; Hittle, Taylor (HHS/ASFR) Subject: Corps COVID Supplemental Request Norris, Mark: In follow up of last week's call, attached is a revised request for supplemental funds for the Commissioned Corps. It was shared with Dr. Kadlec, who gave it his support. Let us know if you'd like a follow up meeting or phone call. Thank you, Steven « File: 3.9.2020 Corps COVID-19 Submission.docx » Steven Valentine Deputy Assistant Secretary for Health, Policy Office of the Assistant Secretary for Health (DASH) U.S. Department of Health and Human Services {HHS} Office : (202) 401 -7003 / Cell: rb )(5 ) ~ Steven.valentine@hhs.gov Confidential pre-decisional deliberative process Se AMERICAN PVERSIGHT nd Trent-Adams, Sylvia (HHS/OASH) Valentine, Steven (H HS/OASH) ; Orsega, Susan (OS/OASH) ; Schwartz, Erica (HHS/OASH) ; Recipient: Haddad, Carla (HHS/OASH) ; Santiago, Yvonne (HHS/OASH/OSG) ; Guyton, Cedric (OS/OASH) Sent Date: 2020/03/09 12:32: 12 Delivered Date: 2020/03/09 12:32: 13 AMERICAN PVERSIGHT HHS-20-0580-A-000085 Giroir, Brett (HHS/OASH) To: Broido, Tara (HHS/OASH) Heck, Mia (HHS/OASH); Migliaccio-Grabill,Kate (HHS/OASH); Valentine, Steven (HHS/OASH); Haddad, Carla (HHS/OASH); Kellogg, Rachel (HHS/OASH) Subject: RE: WSJ: HHS Secretary Is Largely Sidelined in U.S. Effort to Battle Coronavirus Date: 2020/03/11 17:49:28 Priority: Normal Type: Note Thank you Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Broido, Tara (HHS/OASH) Sent: Wednesday, March 11, 2020 5:48 PM To: Giroir, Brett (HHS/OASH) Cc: Heck, Mia (HHS/OASH) ; Migliaccio-Grabill, Kate (HHS/OASH) ; Valentine, Steven (HHS/OASH) ; Haddad, Carla (HHS/OASH) ; Kellogg, Rachel (HHS/OASH) Subject: WSJ: HHS Secretary Is Largely Sidelined in U.S. Effort to Battle Coronavirus FYI, you are mentioned HHS, which responded on behalf of Mr. Azar, said the department did nothing to delay testing. Dr. Kadlec was unavailable for comment. HHS Assistant Secretary Brett Giroir, speaking for him, denied that Dr. Kadlec and Mr. Azar had slowed down the distribution of tests. AMERICAN PVERSIGHT HHS-20-0580-A-000086 HHS Secretary Is Largely Sidelined in U.S. Effort to Battle Coronavirus Alex Azar's role in fighting epidemic wanes; supporters say he is being unfairly scapegoated By Stephanie Armour and Thomas M Burton March 11, 2020 3 :00 pm ET Health and Human Services Secretary Alex Azar appeared taken aback late last month when lawmakers questioned whether someone else should lead the nation's response to coronavirus. "I serve as the lead on this while it's a public-health emergency," he said at a congressional budget hearing on Feb. 26. "It's just the longstanding doctrine that this should be led by HHS with a public-health emergency." About six hours later, President Trump made an appearance in the White House briefing room after a trip from India to say he was putting Vice President Mike Pence in charge. The vice president, he said, has "a certain talent for this." After emerging early on as the White House's public face in the battle against coronavirus and the head of a task force formed to wage it, Mr. Azar has since been noticeably absent from a number of task-force briefings even though he officially still leads the group. The president has voiced his continued support for Mr. Azar and praised him for doing a "great job." Still, the evident decision to downsize his role reflects Mr. Trump's vote of no confidence in the nation's top health official and suggests that Mr. Azar wields waning influence in the White House on health-policy decisions, according to interviews with about a dozen people in the Trump administration and on Capitol Hill. As head of the task force, Mr. Azar adopted an approach to managing the coronavirus task force that alienated some other officials at HHS and other government entities, according to people familiar with the situation. They say AMERICAN PVERSIGHT HHS-20-0580-A-000087 he played favorites when deciding who would travel or appear in public events and briefings , micromanaged decisions to such a degree that agencies couldn ' t act swiftly, and didn't keep everyone in the loop. Mr. Azar, a former pharmaceutical-industry executive who likes to quote management theory, praised the president for increasing Mr. Pence's role. Several people who support Mr. Azar said his job is so vast that it makes sense to have him less focused on coronavirus as cases mushroom. They praise his work on Mr. Trump's signature issues , such as reducing opioid overdose deaths , and say he is being unfairly scapegoated over coronavirus. Two people familiar with discussions said Mr. Azar's job could be on the line, but another person said Mr. Trump was unlikely to pursue a major shake up that could reflect executive turmoil during the outbreak. The president has defended Mr. Azar's handling of coronavirus. "It is FAKE NEWS that @HHSGov @SecAzar is "sidelined" from the great job he is doing on the Corona Virus Task Force. He has the total confidence of the @VP and myself, and is doing a fantastic job, as the numbers would indicate!" Mr. Trump tweeted on March 6. Problems began early on. About a month ago, Joe Grogan, the director of the White House's Domestic Policy Council, and Maria Bonner, a special assistant to the president for domestic policy , pushed for giving U.S. patients broad access to diagnostic coronavirus tests, a senior government official said. Fast development of widespread diagnostic tests was the best way to get ahead of the virus, Mr. Grogan and Ms. Bonner said, according to the senior official. These would have included lab-developed tests made at about 400 major U.S. academic hospitals, as well as tests made by big commercial makers of diagnostics , including Roche Holding AG, Abbott Laboratories and Laboratory Corp. of America Holdings. The lab-developed tests needed an emergency-use authorization from the Food and Drug Administration - an agency within HHS- to move ahead. It took until Feb. 29 for the FDA to clear them, largely because Mr. Azar and Robert Kadlec, an assistant secretary at HHS , wanted the Centers for Disease Control and Prevention-another HHS agency-to make and distribute the nation's diagnostic tests, according to one of the people familiar with the matter. A lack of tests has frustrated state leaders who are trying to contain the virus. HHS, which responded on behalf o(Mr. Azar, said the department did nothing to delay testing. Dr. Kadlec was unavailable for comment. HHS AMERICAN PVERSIGHT HHS-20-0580-A-000088 Assistant Secretary Brett Giroir, speaking for him, denied that Dr. Kadlec and Mr. Azar had slowed down the distribution of tests. Mr. Azar's office also hampered the flow of information , according to three people familiar with the situation. At one point, Ill-IS called drug manufacturers to track possible drug shortages rather than having FDA do the work, according to one person familiar with the planning. The decision caused officials at FDA to worry their agency wouldn't get fast or accurate information directly from companies that had provided it to others in HHS , the person said. The makeup of the corona virus task force angered some in the various agencies because it excluded leaders such as FDA chief Stephen Hahn, some people familiar with the matter said. Mr. Azar dictated who would travel to certain coronavirus briefings or events and at times sidelined officials, according to three of those people. The situation spiraled in the waning days of February. Mr. Azar said the virus was "contained" in a Feb. 25 news briefing, but at the time very few Americans had been tested. Critics including New York Gov. Andrew Cuomo accused the administration of mixed messaging. The same day, a top CDC official said to expect community spread in the country and the stock market lurched downward. Mr. Trump, who was in India, became livid, according to two people familiar with the situation. The president felt Mr. Azar was losing control of the administration's message, which was that the situation was under control, according to the people. The complaints are the latest trouble for Mr. Azar, a close ally of Mr. Pence who already had detractors when he took the lead on the coronavirus task force. For months, Ill-IS was roiled by an internal battle between Mr. Azar and Seema Verma, who heads up a division at Ill-IS that oversees Medicare and Medicaid. The feud turned so rancorous that the vice president called Mr. Azar and Ms. Verma to a meeting in December to broker an uneasy truce. Mr. Azar has also clashed with Mr. Grogan, who disagreed with his proposa l to halt drug rebates. And in January, an angry Mr. Trump yelled on the phone at Mr. Azar, saying there hadn't been enough progress on lowering drug prices, according to two people familiar with the situation. SHARE YOUR THOUGHTS How has the federal government handled the coronavirus outbreak so far? Join the conversation below. AMERICAN PVERSIGHT HHS-20-0580-A-000089 Responding on behalf of Mr. Azar, HHS said Mr. Trump and Mr. Azar have a great relationship. It also said all relevant members of the administration have been involved in the virus response, and that travel requirements change quickly depending on the rapidly evolving situation. Mr. Azar continues to sound upbeat. "Our testing in the United States has been very consistent, if not more aggressive, than similarly impacted countries," he said in a March 5 news briefing. About 8,500 people have been tested in CDC and public-health labs as of Wednesday, federal data shows, as doctors, administrators and state officials continue to say demand isn't being met. South Korea has said it can test as many as 10,000 patients a day. https :ljwww.wsj.com/ a rti cles/h hs-secreta ry-is-Iarge ly-side Iin ed-i n-u-s-effort-to-battl ecoronavi ru s-115839 53145? mod=sea rch res u lts&page= l&pos= 1 Sender: Giroir, Brett (HHS/OASH) Broido, Tara (HHS/OASH) ; Admin istrat ive Group Heck, Mia (HHS/OASH) ; Migliaccio -Grabill, Kate (HHS/OASH) ; Recipient: Valent ine, Steven (HHS/OASH) ; Haddad, Carla (HHS/OASH) ; Kellogg, Rachel (HHS/OASH) Sent Date: 2020/03/1117:49:27 Delivered Date: 2020/03/11 17:49:28 AMERICAN PVERSIGHT HHS-20-0580-A-000090 Trent-Adams, Sylvia (HHS/OASH) Giroir, Brett (HHS/OASH); Valentine, Steven (HHS/OASH); To: Haddad, Carla (HHS/OASH); Kellogg, Rachel(HHS/OASH) Orsega, Susan (OS/OASH); Schwartz, Erica (HHS/OASH); AvilesMendoza,Guillermo (OS/OASH) Subject: Fwd: COVID-19 Drive In Testing - more information plus a second site in Colorado Date: 2020/03/13 18:47:07 Priority: Normal Type: Note FYSA Sent from my iPhone Begin forwarded message: From: "Konsella, Laurie (HHS/OASH)" Date: March 13, 2020 at 5:41 :55 PM EDT To: "Trent-Adams , Sylvia (HHS/OASH)" , "Orsega , Susan (OS/OASH)" Subject: RE: COVID-19 Drive In Testing - more information plus a second site in Colorado (b)(S) AMERICAN PVERSIGHT HHS-20-0580-A-000091 b)(5) From: Trent -Adams, Sylvia (HHS/OASH) AMERICAN PVERSIGHT HHS-20-0580-A-000092 Sent: Friday, March 13, 2020 10:48 AM To: Konsella, Laurie (HHS/OASH) ; Orsega, Susan (OS/OASH) Subject: RE: COVID-19 Drive In Testing Thank you so very much! From: Konsella, Laurie (HHS/OASH) Sent: Friday, March 13, 2020 12:11 PM To: Orsega, Susan (OS/OASH) Cc:Trent -Adams, Sylvia (HHS/OASH) Subject: RE: COVID-19 Drive In Testing State websites: https://www.colorado.gov/pacific/cdphe/news/cdphe-open-first-drive-testingce nte r-state-la b-lowry https://www .colorado.gov/pacific/cdphe/covid-19-testi ng There will be a news conference with the Governor today at 12:30 eastern . From: Orsega, Susan (OS/OASH) Sent: Friday, March 13, 2020 8:37 AM To: Konsella, Laurie (HHS/OASH) Cc: Trent-Adams, Sylvia {HHS/OASH) Subject: COVID-19 Drive In Testing Dear Laurie, Thank you for the discussions. (b)(5) AMERICAN PVERSIGHT HHS-20-0580-A-000093 PHONE CALL BACK TO RADM Trent-Adams and me by no later EST Daily 1200 https://www.thedenverchannel.com/news /national /coronavirus /denver-drive-upcovid-19-testing-facility-to-set-cut-off-limit-thursday-amid-high-dcmand Rear Admiral Susan M. Orsega, FNP-BC, FAAN, FAANP Director, Commissioned Corps Headquarters Office of the Surgeon General United States Public Health Service U.S. Department of Health and Human Services I IOI Wootten Parkway Rockville, Maryland 20852 Office Phone: 240-453-6080 Cell phone *b)(6) Email: susan.orsega@hhs.gov I Trent-Adams, Sylvia (HHS/OASH) Giroir, Brett (HHS/OASH); Valentine, Steven (HHS/OASH); Haddad, Carla (HHS/OASH); Kellogg, Rachel(HHS/OASH); Orsega, Susan (OS/OASH); Schwartz, Erica (HHS/OASH); AvilesMendoza,Guillermo (O5/OASH) Sent Date: 2020/03/13 18:47:06 Delivered Date: 2020/03/13 18:47:07 AMERICAN PVERSIGHT HHS-20-0580-A-000094 Trent-Adams, Sylvia (HHS/OASH) To: Johns, Matthew (HHS/OASH) Giroir, Brett (HHS/OASH); AvilesMendoza, Guillermo (O5/OASH) ; Kellogg, Rachel (HHS/OASH); Haddad, Carla (HHS/OASH); Valentine, Steven (HHS/OASH) Subject: Re: Follow up on Bay Area testing pilot and larger scale testing for PandemicCOVID-19 Date: 2020/03/13 21:49:04 Priority: Normal Type: Note Thank you CDR Johns. Your assistance will be greatly appreciated. Your knowledge of the region and local area will help get this moving as we tackle this challenging situation. Sent from my iPhone On Mar 13, 2020, at 8:30 PM, Johns, Matthew (HHS/OASH) wrote: □ ADM, RADM, I hope this message finds you both well. b)(S) AMERICAN PVERSIGHT HHS-20-0580-A-000095 b)(5) Kind regards, CDR Johns MatthewC. Johns,MPH Commander, United States Public Health Service Regional Health Administrator-Region 9 Office of the Assistant Secretary for Health Office of the Secretary United States Department of Health and Human Services 90 7th Street, Suite 5-100 San Francisco, CA 94103 Phone: (415)437-8102 Mobile: l~ (b_l(5_l ---~ Email: Matthew.Johns@HHS.gov Website: https://www.hhs.gov/ash/about 9/ind ex. html -ash/regional -offices/region - HHS Region 9: fn the Service of Health (fn Officio Salutis) for Arizona , California, Nevada, Hawaii, American Samoa, Commonwealth of the Northern Mariana Islands, Federated States of Micronesia, Guam, Marshall Islands and the Republic of Palau ... ..and 150 Federally-recognized Tribes. Trent-Adams, Sylvia (HHS/OASH) Sender: GROUP (FYDIBOHF23SPDLT)/CN= RECIPIENTS/CN=650D027641442169334514 Johns, Matthew (HHS/OASH) ; Giroir, Brett (HHS/OASH) ; Avi lesMendoza, Guillermo (O5/OASH) ; Kellogg, Rachel (HHS/OASH) ; Haddad, Carla (HHS/OASH) ; Valentine, Steven (HHS/OASH) Sent Date: 2020/03/13 21 :49 :03 Delivered Date: 2020/03/13 21 :49 :04 AMERICAN PVERSIGHT HHS-20-0580-A-000097 Giroir, Brett (HHS/OASH) Stenzel, Timothy (FDA/CDRH); Kellogg, Rachel (HHS/OASH); Lenihan, Keagan(FDA/OC) ; Berger, Sherri (CDC/OCOO/OD); Monroe, Steve (CDC/DDPHSS/OLSS/OD) ; Schuchat, Anne MD (CDC/OD) ; Schwartz, Suzanne (FDA/CDRH) ; Shuren, Jeff (FDA/CDRH); Haddad, carla (HHS/OASH) Subject: RE: IDT Call Date: 2020/03/06 12:58: 17 Priority: Normal Type: Note Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Stenzel, Timothy Sent: Friday, March 6, 2020 12:54 PM To: Kellogg, Rachel (HHS/OASH) ; Giroir, Brett (HHS/OASH) ; Lenihan, Keagan (FDA/OC) ; Berger, Sherri (CDC/OCOO/OD) ; Monroe, Steve (CDC/DDPHSS/OLSS/OD); Schuchat, Anne MD (CDC/OD) ; Schwartz, Suzanne (FDA/CDRH) ; Shuren, Jeff (FDA/CDRH) ; Haddad, Carla (HHS/OASH) Subject: RE: IDT Call b)(5) AMERICAN PVERSIGHT HHS-20-0580-A-000098 Best, Tim Timothy T. Stenzel, MD, PhD Director, OHT7: Office of In Vitro Diagnostics and Radiological Health Office of Product Evaluation and Quality Center for Devices and Radiological Health U.S. Food and Drug Administration Timoth y.Stenzel @fda.hhs.go v Jennifer Campbell Administrative Assistant OHT7: Office of In Vitro Diagnostics an d Rad iological Health Office of Product Evaluation and Quality CDRH I Food and Drug Admin ist rat ion White Oak, Bldg. 66 3403 I 10903 New Hampshire Avenue Ph: 301-796 -7692 Jennifer.Campbell @fda.hhs.gov I Silver Spring, MD 20993 Excellent customer service is important to us. Please take a moment to provide feedback regarding the customer service you have received: https: /lwww.research.net /s/cdrhcustomerservice?ID = l 900&S =E From: Kellogg, Rachel (HHS/OASH) Sent: Friday, March 6, 2020 12:52 PM To: Stenzel, Timothy ; Giroir, Brett (OS) ; Lenihan, Keagan ; Berger, Sherri (CDC) ; Monroe, Stephan S (CDC) ; Schuchat, Anne (CDC) ; Schwartz, Suzanne ; Shuren, Jeff ; Haddad, Carla (OS) Subject: RE: IDT Call Thank you, Tim . (b)(5) From: Stenzel, Timothy Sent: Friday, March 6, 2020 11 :27 AM To: Giroir, Brett (HHS/OASH) ; Lenihan, Keagan (FDA/OC) ; Berger, Sherr i (CDC/OCOO/OD) ; Monroe , Steve (CDC/DDPHSS/OLSS/OD) ; Schuchat , Anne MD (CDC/OD) ; Schwartz, Suzanne (FDA/CDRH) ; Shuren , Jeff (FDA/CDRH) ; Haddad, Carla (HHS/OASH) Cc: Kellogg, Rachel (HHS/OASH) Subject: RE: IDT Call b)(5) AMERICAN PVERSIGHT HHS-20-0580-A-000099 Best, Tim Timothy T. Stenzel, MD, PhD Director, OHT7: Office of In Vitro Diagnostics and Radiological Health Office of Product Evaluation and Quality Center for Devices and Radiological Health U.S. Food and Drug Administration Timothy.Stenzel@fda.hhs.gov Jennifer Campbell Administrative Assistant OHT7: Office of In Vitro Diagnostics and Radiological Health Offic e of Product Evaluation and Quality CDRH I Food and Drug Administration White Oak, Bldg. 66 3403 I 10903 New Hampshire Avenue Ph: 301-796 -7692 Jennifer.Campbell@fda.hhs.gov I Silver Spring, MD 20993 Excellent customer service is important to us. Please take a moment to provide feedback regarding the customer service you have received: https:/l www.research.net/s/cdrhcustomerservice?ID=l 900&S=E -----Original Appointment----From: Gray, Oneika (HHS/OASH) On Behalf Of Giroir, Brett (HHS/OASH) Sent: Friday, March 6, 2020 10:57 AM To: Stenzel, Timothy; Lenihan, Keagan; Berger, Sherri (CDC); Monroe, Stephan S (CDC); Schuchat, Anne (CDC); Schwartz, Suzanne; Shuren, Jeff; Haddad, Carla (OS) Cc: Kellogg, Rachel (OS) Subject: IDT Call When: Friday, March 6, 2020 11:00 AM-11:15 AM UTC-05:00 Eastern Time US &Canada). Where: ASH Conference Room; 716G (b)(B) Sender: Giroir, Brett (HHS/OASH) Stenzel, Timothy (FDA/CDRH) ; Kellogg, Rachel (HHS/OASH) ; Lenihan, Keagan (FDNOC) ; Berger, Sherri (CDC/OCO0/OD) ; Monroe, Steve (CDC/DDPHSS/OLSS/OD) ; Schuchat, Anne MD (CDC/OD) ; Schwartz, Suzanne (FDA/CDRH) ; Shuren, Jeff (FDA/CDRH) ; Haddad, Carla (HHS/OASH) Sent Date: 2020/03/06 12:58:17 AMERICAN PVERSIGHT HHS-20-0580-A-000100 Giroir, Brett (HHS/OASH) Lenihan, Keagan(FDNOC) ; To: Stenzel, Timothy (FDA/CDRH) Berger, Sherri (CDC/OCOO/OD); Monroe, Steve (CDC/DDPHSS/OLSS/OD) ; Schuchat, Anne MD (CDC/OD) ; CC: Schwartz, Suzanne (FDA/CDRH); Shuren, Jeff (FDNCDRH) ; Haddad, Carla (HHS/OASH); Kellogg, Rachel (HHS/OASH) Subject: RE: IDT Call Date: 2020/03/06 12:58:47 Priority: Normal Type: Note Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Lenihan, Keagan Sent: Friday, March 6, 2020 11:52 AM To: Stenzel, Timothy (FDA/CDRH) Cc: Giroir, Brett (HHS/OASH) ; Berger, Sherri (CDC/OCOO/OD) ; Monroe, Steve (CDC/DDPHSS/OLSS/OD); Schuchat, Anne MD (CDC/OD) ; Schwartz, Suzanne (FDA/CDRH) ; Shuren, Jeff (FDA/CDRH) ; Haddad, Carla (HHS/OASH) ; Kellogg, Rachel (HHS/OASH) Subject: Re: IDT Call Sent from my iPhone AMERICAN PVERSIGHT HHS-20-0580-A-000101 On Mar 6, 2020, at 11:26 AM, Stenzel, Timothy wrote: b)(5) Best, Tim Timothy T. Stenzel, MD, PhD Director, OHT7: Office of In Vitro Diagnostics and Radiological Health Office of Product Evaluation and Quality Center for Devices and Radiological Health U.S. Food and Drug Administration Timothy.Stenzel@fda.hhs.gov Jennifer Campbell Adminis trative Assistant OHT7: Office of In Vitro Diagnostics and Radiological Hea lth Office of Product Evaluation and Quality CDRH I Food and Drug Administration White Oak, Bldg. 66 3403 110903 New Hampshire Avenue Ph: 301-796 -7692 Jennifer.Campbell@fda.hhs.gov I Silver Spring, MD 20993 Exce llent customer service is important to us. Please take a moment to provide feedback regarding the customer service you have received: https://www.rcscarch.net /s/cdrhcustomcrscrvicc?ID = 1900&S=E -----Ori gi na I Appointment----From: Gray, Oneika (HHS/OASH) <0neika.Gray@hhs.gov >0n Behalf Of Giroir, Brett (HHS/OASH) Sent: Friday, March 6, 2020 10:57 AM To: Stenzel, Timothy; Lenihan, Keagan; Berger, Sherri (CDC); Monroe, Stephan S (CDC); Schuchat, Anne (CDC); Schwartz, Suzanne; Shuren, Jeff; Haddad, Carla (OS) Cc: Kellogg, Rachel (OS) Subject: IDT Call When: Friday, March 6, 2020 11:00 AM-11:15 AM (UTC-05:00) Eastern Time (US &Canada). Where: ASH Conference Room; 716G ;rb) (5) I Giroir, Brett (HHS/OASH) Recipient: Lenihan, Keagan (FDNOC) ; Stenzel, Timothy (FDA/CDRH) ; Berger, Sherri (CDC/OCOO/OD) ; Monroe, Steve (CDC/DDPHSS/OLSS/OO) ; Schuchat, Anne MD (CDC/OD) ; Schwartz, Suzanne (FDA/CD RH) ; Shuren, Jeff (FDNCDRH) ; Haddad, Carla (HHS/OASH) ; Kellogg, Rachel (HHS/OASH) Sent Date: 2020/03/06 12:58:46 Delivered Date: 2020/03/06 12:58:47 AMERICAN PVERSIGHT HHS-20-0580-A-000103 Giroir, Brett (HHS/OASH) Rachel Sher < rsher@rarediseases.org>; To: Kellogg, Rachel (HHS/OASH) ; Haddad, carla (HHS/OASH); CC: Reed, Paul (HHS/OASH) ; Valentine, Steven (HHS/OASH) Subject: RE: Rare DiseasesAdvisory Committee Date: 2020/03/09 13:59:20 Priority: Normal Type: Note Thank you. I am really caught up in Corona virus. It is possible we could chat by phone, but I have had no time and don't expect much .. To make sure we get your points, I would prefer you outline the issue with CAPT Reed (pediatrician) and DAS Policy Mr. Valentine soon to make sure we have visibility. They are copied Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Rachel Sher Sent: Monday, March 9, 2020 1:52 PM To: Kellogg, Rachel (HHS/OASH) Cc: mbuzzelli@rared iseases.org; Giroir, Brett (HHS/OASH) Subject: Re: Rare Diseases Advisory Committee Hi Rachel, We were delighted to see the announcement regarding the advisory committee. Hopefully, you saw the social media posts we did expressing our appreciation. We would love to connect with you again on newborn screening . We are hearing that the HELP Committee intends to hold a markup of the bill in early April. As we mentioned during our meeting that day, Senator Paul has crafted an amendment that we are extremely concerned about AMERICAN PVERSIGHT HHS-20-0580-A-000104 because of its impact on the conduct of critically necessary testing on dried blood spots. We know that many of the HHS agencies (including NIH, CDC, and OHRP) share our concerns. It would be great to connect to discuss strategy and responses to this amendment now that we know the markup is on the horizon. Could we find a time to come in and meet with you, and with Dr. Giroir, if possible? If an in-person meeting would be difficult, we would be happy to do a call as well . Thanks, Rachel On Mon, Mar 2, 2020 at 11:02 AM Kellogg, Rachel (HHS/OASH) wrote: Hi Rachel, Yes, please work with me to schedule any follow-up meetings. I will follow up with you and Melanie in a separate chain. Thank you! Rachel From: Rachel Sher Sent: Monday, March 2, 2020 10:09 AM To: Giroir, Brett (HHS/OASH) Cc: mbuzzelli@rarediseases.org; Kellogg, Rachel (HHS/OASH) Subject: Re: Rare Diseases Advisory Committee Hi Dr. Giroir, Thank you for your note. Our advocates were thrilled to have the opportunity to meet with you. We would very much appreciate the opportunity to meet with you again, either with our advocates present or with just our NORD staff. That is fantastic news about the Advisory Committee too. We look forward to hearing more details about when this news will be public so that we can help amplify the importance of the Committee's work. In terms of what is next on our agenda, we'd love to continue the conversation about Medicaid issues and would also love to discuss some FDA- related concerns. How should we proceed? Should we work with Rachel to set up a time to meet again? We appreciate your strong leadership on these issues on behalf of the rare disease community. Thanks , Rachel AMERICAN PVERSIGHT HHS-20-0580-A-000105 On Sun , Mar 1, 2020 at 6:59 PM Giroir , Brett (HHS /OAS H) w rote: Good Evening, I want to state again how terrific it was to meet with NORD and all the patient advocates. I sincerely hope that we can build on this foundational meeting to advance our common agendas going forward. In terms of the Advisory Committee, Rachel has been on point in follow up. This has been resolved to your satisfaction. You do not need to spend any more time or political capital on this issues Stay tuned for information that should not be too long in coming. Let us know what the next item is on your agenda! Best wishes, Brett Brett P. Giroir, MD ADM, USPublic Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC20201 Office Phone: 202-690-7694 Rachel L. Sher, J.D., M.P.H. Vice President , Policy and Regulatory Affairs National Organization for Rare Disorders p: 202 .588.5700 , ext. 112 f: 202.588.5701 a: 1779 Massachusetts Ave. , NW, Suite 500, Washington, DC 20036 w: rarediseases.orq e: rsher@rarediseases.org X I X X Image removed by sender. X Image removed by sender. X Image removed by sender. ==-== Image removed by sender. Image removed by sender. Confidentiality Note: This email and any attachments may contain confidential and privileged material for the sole use of the intended AMERICAN PVERSIGHT HHS-20-0580-A-000106 recipient. Any review, use, distribution or disclosure by others is strictly prohibited. If you are not the intended recipient (or authorized to receive for the recipient), please delete the email, along with any attachments, without copying or disclosing it and notify the sender by reply email immediately. X Rachel L. Sher, J.D. , M.P.H. Vice President, Policy and Regulatory Affairs National Organization for Rare Disorders p: 202.588.5700 , ext. 112 f: 202.588.5701 a: 1779 Massachusetts Ave ., NW, Suite 500, Washington , DC 20036 w: rarediseases.org e: rsher@rarediseases.org X X X X ==-== Confidentiality Note: This email and any attachments may contain confidential and privileged material for the sole use of the intended recipient. Any review, use, distribution or disclosure by others is strictly prohibited. If you are not the intended recipient (or authorized to receive for the recipient), please delete the email, along with any attachments, without copying or disclosing it and notify the sender by reply email immediately. Sender: Giroir, Brett (HHS/OASH) Rachel Sher < rsher@rarediseases.org>; Kellogg, Rachel (HHS/OASH) ; ; Haddad, (aria (HHS/OASH) ; Reed, Paul (HHS/OASH) ; Valentine, Steven (HHS/OASH) Sent Date: 2020/03/09 13:59:19 Delivered Date: 2020/03/09 13:59:20 AMERICAN PVERSIGHT HHS-20-0580-A-000107 Giroir, Brett (HHS/OASH) Foley, Diane (HHS/OASH) ; Valentine, Steven (HHS/OASH) ; Haddad, Carla (HHS/OASH) Subject: FW: notification about report release Date: 2020/02/05 21:40:22 Priority: Normal Type: Note Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Moughalian, Jen (HHS/ASFR) Sent: Wednesday, February 5, 2020 9:27 PM To: Giroir, Brett (HHS/OASH) ; Shuy, Caitrin (HHS/ASFR) Cc: Hittle, Taylor (HHS/ASFR) Subject: RE: notification about report release From: Giroir, Brett (HHS/OASH) Sent: Tuesday, February 4, 2020 4:46 PM To: Moughalian, Jen (HHS/ASFR); Shuy, Caitrin (HHS/ASFR) Subject: RE: notification about report release nope Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 AMERICAN PVERSIGHT HHS-20-0580-A-000108 Office Phone: 202-690-7694 From: Moughalian, Jen (HHS/ASFR) Sent: Tuesday, February 4, 2020 3:39 PM To: Giroir, Brett (HHS/OASH) ; Shuy, Caitrin (HHS/ASFR) Subject: RE: notification about report release rb )(5) From: Giroir, Brett (HHS/OASH) Sent: Tuesday, February 4, 2020 1:32 PM To: Moughalian, Jen (HHS/ASFR); Shuy, Caitrin (HHS/ASFR) Subject: FW: notification about report release Follow Up I know you are swamped, but wanted to keep this on your radar when you can come up for air Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690- 7694 From: Foley, Diane (HHS/OASH) Sent: Tuesday, February 4, 2020 1:17 PM To: Giroir, Brett (HHS/DASH) Cc: Haddad, Carla (HHS/OASH) ; Valentine, Steven (HHS/OASH) Subject: RE: notification about report release Good morning, (b)(5) AMERICAN PVERSIGHT HHS-20-0580-A-000109 b)(5) Thanks, Diane Diane Foley MD, FAAP Deputy Assistant Secretary Office of Population Affairs Office of the Assistant Secretary for Health/HHS Phone: 240-453-2826 (office-direct) l(b)(6 l !(cell) From: Giroir, Brett (HHS/OASH) Sent: Saturday, February 1, 2020 11:33 AM To: Foley, Diane (HHS/OASH) Cc: Haddad, Carla (HHS/OASH) ; Valentine, Steven (HHS/OASH) Subject: RE: notification about report release Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Foley, Diane (HHS/OASH) Sent: Saturday, February 1, 2020 11:26 AM To: Giroir, Brett (HHS/OASH) Subject: RE: notification about report release Hi, (b)(5) AMERICAN PVERSIGHT HHS-20-0580-A-000110 (b)(5) On another note, thank you so much for visiting Tower this week. It was so appreciated by our staff and goes a long way to help them not feel forgotten away from all of the action at Humphrey. Diane Diane Foley MD, FAAP Deputy Assistant Secretary Office of Population Affairs Office of the Assistant Secretary for Health/HHS Phone: 240-453-2826 (office-direct) l(b)(6) ~ eelI) From: Giroir, Brett (HHS/OASH) Sent: Saturday, February 1, 2020 11:08 AM To: Foley, Diane (HHS/OASH) Subject: RE: notif ication about report release Thanks Diane b)(5) Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690- 7694 From: Foley, Diane (HHS/OASH) Sent: Thursday, January 30, 2020 8:16 AM AMERICAN PVERSIGHT HHS-20-0580-A-000111 To: Giroir, Brett (HHS/OASH) Subject: Fwd: notification about report release Good morning , (b)(5) Diane Diane Foley MD, FAAP Deputy Assistant Secretary Office of Population Affairs Office of the Assistant Secretary for Health/HHS Phone: 240-453-2826 (office-direct) l(b)(6) l(cell) X Sender: Giroir, Brett (HHS/OASH) Foley, Diane (HHS/OASH) ; Valentine, Steven (HHS/OASH) ; Haddad, Carla ( HHS/OASH) Sent Date: 2020/02/05 21:40:20 Delivered Date: 2020/02/05 21:40:22 AMERICAN PVERSIGHT HHS-20-0580-A-000112 Trent -Adams, Sylvia (HHS/OASH) To: Schwartz, Erica (HHS/OASH) Valentine, Steven (HHS/OASH) ; Orsega, Susan (OS/OASH) ; Haddad, Carla (HHS/OASH) Subject: RE: FEMA Request Date: 2020/03/09 15:50:55 Priority: Normal Type: Note Thank you. From: Schwartz, Erica (HHS/OASH) Sent: Monday, March 9, 2020 3:50 PM To: Trent-Adams, Sylvia {HHS/OASH) Cc: Valentine, Steven {HHS/OASH) ; Orsega, Susan {OS/OASH) ; Haddad, Carla {HHS/OASH) Subject: FEMA Request RADM Trent-Adams, We spoke with Ms. Oscar and informed her that we are not able to pursue a MOU with FEMA at this time. However, they can request their requirements with ASPR as they normally would do. v/r, RADM Erica Schwartz, MD, JD, MPH Deputy Surgeon General Office of the Surgeon General United States Public Health Service U.S. Department of Health and Human Services 200 Independence Ave SW, Suite 701-H Washington, DC 2020 l Office Phone: 202-401-4660 Email: erica.schwartz@hhs.gov From: Oscar, Cherry Sent: Thursday, March 5, 2020 9:40 PM To: Orsega, Susan {OS/OASH) Subject: FW: HHS Doctor AMERICAN PVERSIGHT HHS-20-0580-A-000113 Good evening RADM Orsega, (b)(5) Respectfully, Cherry Oscar Chief, Disaster Safety Operations Branch (DSOB) Environmental Safety and Health Office (ESH) Office of the Chief Administrative Officer (OCAO) Federal Emergency Management Agency (FEMA) U.S. De artment of Homeland Security (OHS) Cell: (b)(5) Fax: 540.504.2598 cherry.oscar@fema.dhs.gov Sender: Trent-Adams, Sylvia (HHS/OASH) Schwartz, Erica (HHS/OASH) ; Valentine, Steven (HHS/OASH) ; Recipient: Orsega, Susan (OS/OASH) ; Haddad, c.arla (HHS/OASH) Sent Date: 2020/03/09 15:50:54 Delivered Date: 2020/03/09 15:50:55 AMERICAN PVERSIGHT HHS-20-0580-A-000114 Giroir, Brett (HHS/OASH) Schwartz, Erica (HHS/OASH) ; Trent-Adams, Sylvia (HHS/OASH) ; Orsega, Susan (OS/OASH) CC: Haddad, Carla (HHS/OASH) ; > Subject: RE: Smell Test Needed ... Date: 2020/02/29 19:48: 12 Priority: Normal Type: Note Thank you Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Schwartz, Erica (HHS/OASH) Sent: Saturday, February 29, 2020 7:43 PM To: Giroir, Brett (HHS/OASH) ; Trent-Adams, Sylvia (HHS/OASH) ; Orsega, Susan (OS/OASH) Cc: Haddad, Carla (HHS/OASH) ; Valentine, Steven (HHS/OASH) Subject: RE: Smell Test Needed ... ADM Giroir, b)(5) v/r, RADM Erica Schwartz, MD, JD, MPH Deputy Surgeon General Office of the Surgeon General United States Public Health Service U.S. Department of Health and Human Services AMERICAN PVERSIGHT HHS-20-0580-A-000115 200 Independence Ave SW, Suite 701-H Washington, DC 2020 l Office Phone: 202-401-4660 Email: erica.schw artz@hhs. gov From: Giroir, Brett (HHS/OASH) Sent: Saturday, February 29, 2020 7:09 PM To: Trent-Adams, Sylvia (HHS/OASH) ; Schwartz, Erica (HHS/OASH) ; Orsega, Susan (OS/OASH) Cc: Haddad, Carla (HHS/OASH) ; Valentine, Steven (HHS/OASH) Subject: Smell Test Needed ... Importance: High ...from this team. b)(5) BG Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 Sender: Giroir, Brett (HHS/OASH) Schwartz, Erica (HHS/OASH) ; Trent -Adams, Sylvia (HHS/OASH) ; Orsega, Susan (O5/OASH) ; Haddad, carla (HHS/OASH) ; Valentine, Steven (HHS/OASH) Sent Date: 2020/02/29 19:48: 11 Delivered Date: 2020/02/29 19:48:12 AMERICAN PVERSIGHT HHS-20-0580-A-000116 Trent-Adams, Sylvia (HHS/OASH) From: GROUP (FYDIBOHF23SPDLT)/CN= RECIPIENTS/CN=650D027641442169334514 Valentine, Steven (H HS/OASH) ; To: Haddad, Carla (HHS/OASH) I Subject: FW:~b)(5) Date: 2020/03/15 19:49 :55 Importance: High Priority: Urgent Type: Note FYSA From: Chang, William (HHS/OGC) Sent: Sunday, March 15, 2020 7:35 PM To: Giroir, Brett (HHS/OASH) ; Trent-Adams, Sylvia (HHS/OASH) ; Boehler, Adam ; Fulmer, Brendan (HHS/IOS) Cc: Charrow, Robert (HHS/OGC) I Subject: ~b)(5) Importance: High b)(5) Trent -Adams, Sylvia (HHS/OASH) Recipient: Valentine, Steven (HHS/OASH) ; Haddad, Carla (HHS/OASH) Sent Date: 2020/03/15 19:49:54 Delivered Date: 2020/03/15 19:49:55 AMERICAN PVERSIGHT HHS-20-0580-A-000117 Giroir, Brett (HHS/OASH) Adams, Jerome (HHS/OASH) CC: Subject: Haddad, carla (HHS/OASH) RE: Final Briefing Memo and TPs for White HouseOpportunity and Revitalization Council Event in North carolina Date: 2020/02/07 08:30:03 Priority: Normal Type: Note (b)(5) Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Adams, Jerome (HHS/OASH) Sent: Friday, February 7, 2020 8:22 AM To: Giroir, Brett (HHS/OASH) Subject: Fwd: Final Briefing Memo and TPs for White House Opportunity and Revitalization Council Event in North Carolina b)(5) V ADM Jerome Adams 20th US Surgeon General Subject: Re: Fina l Briefing Memo and TPs for White House Opportunity and Revitalization Council Event in North Carolina AMERICAN PVERSIGHT HHS-20-0580-A-000118 b)(5) Sent from my iPhone On Feb 7, 2020, at 7:59 AM, Haddad, Carla (HHS/OASH) wrote: (b)(5) Sent from my iPhone On Feb 7, 2020, at 7:21 AM , Sherman , Jennifer (HHS/OASH) wrnte: (b)(5) On: 07 February 2020 06:37 , "Adams, Jerome (HHS/OASH)" wrote: Janet/Jenb)(5) AMERICAN PVERSIGHT HHS-20-0580-A-000119 b)(5) VADM Jerome Adams 20th US Surgeon General On Feb 6, 2020, at 1:35 PM, Campos , Rafael (OS/OASH) (CTR) wrote: Sender: Giroir, Brett (HHS/OASH) Adams, Jerome (HHS/OASH) ; Recipient: Haddad, carla (HHS/OASH) Sent Date: 2020/02/07 08:30:03 AMERICAN PVERSIGHT HHS-20-0580-A-000120 Trent-Adams, Sylvia (HHS/OASH) To: Giroir, Brett (HHS/OASH) Valentine, Steven (HHS/OASH); CC: Haddad, Carla (HHS/OASH) Subject: Update Date: 2020/03/16 13:20:43 Priority: Normal Type: Note 5ic• lboth went to Walter Reed today to be tested for COVID-19.~was tested and is home on 5 day quarantine pending results and~is awaiting testing. She is being seen by staff physician right now. I will keep you posted. Best regards, Sylvia l(b)(6) Sent f rom my 1Phone Trent-Adams, Sylvia (HHS/OASH) Giroir, Brett (HHS/OASH) ; Valentine, Steven (HHS/OASH); Haddad, Carla (HHS/OASH) Sent Date: 2020/03/16 13:20:42 Delivered Date: 2020/03/16 13:20:43 AMERICAN PVERSIGHT HHS-20-0580-A-000121 Giroir, Brett (HHS/OASH) To: Haddad, carla (HHS/OASH) Wainwright, Jacob (HHS/OASH/10); CC: Mikre, Meriam (HHS/OASH) Subject: RE: FORREVIEW:Kb)(5) I Date: 2020/02/24 20:14:00 Due Date: 2020/02/23 19:00:00 Priority: Normal Type: Note Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690- 7694 From: Haddad, Carla (HHS/OASH) Sent : Monday, February 24, 2020 6:13 PM To: Giroir, Brett (HHS/OASH) Cc:Wainwright, Jacob (HHS/OASH/1O); Mikre, Meriam (HHS/OASH) Subject: FOR REVIEW:=i(b.,..., )(5 """)---------. ADM Giroir, (b)(5) AMERICAN PVERSIGHT HHS-20-0580-A-000122 Thanks, Carla b)(5) From: Hodges, Katrina (HHS/OGC) Sent: Monday, February 24, 2020 3:58 PM To: Haddad, Carla (HHS/OASH) Cc:Wainwright, Jacob (HHS/OASH/10); Beattie, Allison (HHS/OGC) ; Clark, Tamara (OS/OGC) Subject: RE: l(b)(5) I Carla, b)(5) Please do not hesitate to reach out with any questions. Thanks very much, b)(5) Katrina L. Hodges U.S. Dept. of Health &Human Services Office of the General Counsel Direct: (404) 562-7829 From: Hodges, Katrina (HHS/OGC) AMERICAN PVERSIGHT HHS-20-0580-A-000123 Sent: Friday, February 21, 2020 4:18 PM To: Haddad, Carla (HHS/OASH) Cc:Wainwright, Jacob (HHS/OASH/10) ; Beattie, Allison (HHS/OGC) ; Clark, Tamara (OS/OGC) I Subject: RE:l(b)(5) Thanks, Carla. This is very helpful- appreciate it. Katrina L. Hodges U.S. Dept. of Health &Human Services Office of the General Counsel Direct: (404) 562-7829 From: Haddad, Carla (HHS/OASH) Sent: Friday, February 21, 2020 2:38 PM To: Hodges, Katrina (HHS/OGC) Cc:Wainwright, Jacob (HHS/OASH/10) ; Beattie, Allison (HHS/OGC) ; Clark, Tamara (OS/OGC) Subject: RE:fb)(S) I Hi Katrina, (b)(5) Let me know if this information is sufficient. Thanks, Carla From: Hodges, Katrina (HHS/OGC) Sent: Friday, February 21, 2020 12:08 PM To: Haddad, Carla (HHS/OASH) Cc:Wainwright, Jacob (HHS/OASH/10) ; AMERICAN PVERSIGHT Beattie, Allison (HHS/OGC) HHS-20-0580-A-000124 ; Clark, Tamara (OS/OGC) Subject: REfb )(5) I Carla, (b)(5) Thanks, Katrina L. Hodges U.S. Dept. of Health &Human Services Office of the General Counsel Direct: (404) 562-7829 b)(5) From: Haddad, Carla (HHS/OASH) Sent: Monday, December 9, 2019 3:10 PM To: Clark, Tamara (05/0GC) Cc: Wainwright, Jacob (HHS/OASH/10); Voltaire, Jean-Michel (HHS/OGC) ; Hodges, Katrina (HHS/OGC) Subject: RE :rb )(5) I Tamara and team, b)(5) Thanks, Carla (b)(5) From: Clark, Tamara (05/0GC) Sent: Monday, December 9, 20 19 11:14 AM To: Haddad, Carla (HHS/OASH) AMERICAN PVERSIGHT HHS-20-0580-A-000125 Cc:Wainwright, Jacob (HHS/OASH/10) ; Voltaire, Jean-Michel (HHS/OGC) ; Hodges, Katrina (HHS/OGC) Subject: RE:l(b)(5) I Thank you, Carla. I'll set up a call just to touch base quickly. Based on the below, I don't think it needs to be a long call. From: Haddad, Carla (HHS/OASH) Sent: Monday, December 9, 2019 8:27 AM To: Clark, Tamara (OS/OGC) ; Voltaire, Jean-Michel (HHS/OGC) ; Hodges, Katrina (HHS/OGC) Cc:Wainwright, Jacob (HHS/OASH/10) Subject: RE:l(b)(S) I (b)(5) I hope this is helpful. Thanks, Carla From: Clark, Tamara (05/0GC) Sent: Monday, December 9, 2019 9:08 AM To: Haddad, Carla (HHS/OASH) ; Voltaire, Jean-Michel (HHS/OGC) ; Hodges, Katrina (HHS/OGC) I Subject:~b)(5) b)(5) Tamara S. Clark U.S. Dept. of Health &Human Services Office of the General Counsel 601 E. 12th St. Kansas City, MO 64106 Office: (816) 426-5423 tamara .clark @hhs .gov Sender: Giroir, Brett (HHS/OASH) Haddad, carla (HHS/OASH) ; Wainwright, Jacob (HHS/OASH/IO) ; Mikre, Meriam (HHS/OASH) Sent Date: 2020/02/24 20:13:57 Delivered Date: 2020/02/24 20:14:00 AMERICAN PVERSIGHT HHS-20-0580-A-000127 Giroir, Brett (HHS/OASH) To: Broido, Ta ra (HHS/OASH) Heck, Mia (HHS/OASH) ; Migliaccio-Grabill, Kate (HHS/OASH) ; Haddad, Carla ( HHS/ OASH) Subject: RE: Public health labs press FDA to allow homegrown coronavirus tests Date: 2020/02 / 24 20:14:59 Priority: Normal Type: Note Thank you Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690- 7694 From: Broida, Tara (HHS/OASH) Sent: Monday, February 24, 2020 8:13 PM To: Gir oir, Brett (HHS/OASH) Cc: Heck, Mia (HHS/OASH) ; M igliaccio -Grabill, Kate (HHS/OASH) Subject: Fwd: Public health labs press FDA to allow homegrown coronavirus tests FYI Begin forwarded message : From: "POLITICO Pro Health Care" Date: February 24, 2020 at 7:16:40 PM EST To: Subject: Public health labs press FDA to allow homegrown coronavirus tests Reply-To: "POLITICO subscriptions" Public health labs press FDA to allow homegrown coronavirus tests By David Lim AMERICAN PVERSIGHT HHS-20-0580-A-000128 02/24/2020 07: 15 PM EST Public health laboratories urged the FDA on Mo nday to permit them to create their own tests for the coronavirus, after problems with a diagnostic developed by CDC prevented its wides pread rollou t. FDA typically allows "laboratory developed tests" - which are designed , manufactured and used within a single lab - to be used without close regulatory scrutiny. But the agency requires labs to submit such tests for review during health emergencies to prevent harm from false or misleading results from compounding a crisis. The coronavirus does not appear to be an exception. "No test should be used without being validated," FDA spokesperson Stephanie Caccomo said. "In the context of a public health emergency, false results can lead to significant adverse public health consequences." The FDA has traditionally shied away from allowing the use of LDTs in emergency situations. In 2016, the agency sent a letter to two Ho uston hospitals that created an LDT to rapidly detect the Zika virus, expressing concern that the agency had not reviewed the "high-risk" test. But Association of Public Health Laboratories Executive Director Scott Becker said that the coronavims requires a different approach. The vims is spreading in multiple countries, and the CDC's efforts to expand testing capability beyond its labs have run into trouble. Only five state and local public health labs - in California , ebraska , Illinoi s, evada and Tennessee-have verified the CDC diagnostic for use since the FDA approved it on an emergency basis on Feb. 4 , he said. APHL hopes to work with FDA to develop a policy that allows some labs to market a LDT without submitting it for FDA review, Becker told POLITICO - adding that it doesn't make sense for more than 100 labs to file individual emergency use authority applications. "We believe a more expeditious route is needed at this time," Becker and Grace Kubin , director of the Laboratory Services Section at the Texas Department of State Health Services, wrote to FDA Commissioner Stephen Hahn on Monday. "What we're suggesting is that public health labs be viewed as a group to do this," Becker told would want to do this in a network sort of POLITICO. "It isn ' t every lab on their own-we fashion . We could also enable confirmation at another public health laboratory to ensure confidence ." The letter says that labs could work together towards a standard protocol, purchase reagents and supplies from a common source and recommend a minimum standard approach for validating test results. Caccomo says that the FDA is working with more than 70 test developers on products for the vims. The agency can complete reviews for such tests in as little as one day, she added - AMERICAN PVERSIGHT HHS-20-0580-A-000129 ensuring that it is effective and meets the minimum standards for emergency use. Some major hospitals are also starting to develop LDTs for coronavirus screening , but are concerned that FDA rules do not permit them to actually start testing patients, according to Michael Mina , associate medical director of molecular diagnostics at Brigham and Women's Hospital. "We're actually trying to get our test up and rnnning, even though we don't know if we'll be able to use it," Mina said. "I know that Mass General Hospital is also thinking about doing something very similar. I presume all the major academic hospitals are at least considering it." The American Clinical Laboratory Association , which represents large commercial labs like LabCorp and Quest Diagnostics, declined to comment on whether LDTs should be used to help increase the countly's capacity to screen for the corona virus. Historically, the lab industry trade lobby has maintained LDTs are not medical devices and subject to FDA regulation. To view online : https://protect2.fireeye .com/ url?k=9ef849fl -c2ad402 l -9ef8 7 8ce-0cc4 7a6a52 dea6 l e2b96e3 8a 143a& u=https ://subscriber .po liticopro.com/heal th-care/article/2020/02/publicheal th-la bs-press-f da-to-allow-homegr own-coronavirus- tests- 1884096 You received this POLITICO Pro content because your customized settings include: Public Health. To change your alert settings, please go to https://protect2.fi reeye.com /url?k=e8b605e e-b4e30c3e-e8b634dl-0cc4 7a6a52de4224dc 2cea772f51&u=https://subscriber.politicopro.com /settings. PO ITCOPRO This email ale1t has been sent for the exclusive use of POLITICO Pro subscriber , tara.broido@hhs.g ov. Forwarding or reproducing the alert without the express, written permission of POLITICO Pro is a violation of copyright law and the POLITICO Pro subscription agreement. Copyright © 2020 by POLITICO LLC. To subscribe to Pro, please go to politicopro.co m. This email was sent to tara.broido @hhs.gov by: POLITICO, LLC 1000 Wilson Blvd. Arlington, VA 22209 USA Se Giroir, Brett (HHS/OASH) Recipient: Broido, Tara (HHS/OASH); Heck, Mia (HHS/OASH) ; Migliaccio-Grabill, Kate (HHS/OASH) ; Haddad, Carla ( HHS/OASH) Sent Date: 2020/02/24 20: 14: 58 Delivered Date: 2020/02/24 20:14:59 AMERICAN PVERSIGHT HHS-20-0580-A-000131 Giroir, Brett (HHS/OASH) To: Trueman, Laura (HHS/IEA) Stecker, Judy (OS/IOS) ; Johnston, Darcie (HHS/IEA) ; Haddad, Carla (HHS/OASH) Subject : RE: Speak to NACCHOBefore 10:30AM Tomorrow Date: 2020/03/02 12:51:42 Priority: Normal Type: Note (b)(6) Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Trueman, Laura (HHS/I EA) Sent: Monday, March 2, 2020 12:05 PM To: Giroir, Brett (HHS/DASH) Cc: Stecker, Judy (OS/IOS) ; Johnston, Darcie (HHS/IEA) Subject: Speak to NACCHO Before 10:30AM Tomorrow Importance: High Dr Giroir b)(5) AMERICAN PVERSIGHT HHS-20-0580-A-000132 (b)(5) Laura Laura C. Trueman Director, Office of Interg overnmental and External Affairs U.S. Department of Health and Human Services 200 Independence Avenue SW Washington D.C. 20201 Laura.Trueman@hhs.gov 202-690-6060 (main office) Giroir, Brett (HHS/OASH) Trueman, Laura (HHS/IEA) ; Stecker, Judy (OS/IOS) ; Recipient: Johnston, Darcie (HHS/IEA) ; Haddad, Carla (HHS/OASH) Sent Date: 2020/03/02 12:51:42 AMERICAN PVERSIGHT HHS-20-0580-A-000133 Giroir, Brett (HHS/OASH) To: Haddad, carla (HHS/OASH) Subject: RE: FOR REVIEW:l(b)(5) I Date: 2020/02/24 21:08:14 Priority: Normal Type: Note I am looking forward to working with you, and seeing you grow in this leadership role. Buckle up. This will not be easy.... BG Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Haddad, Carla (HHS/OASH) Sent: Monday, February 24, 2020 8:18 PM To: Giroir, Brett (HHS/OASH) Cc: Wainwright, Jacob (HHS/OASH/1O); Mikre, Meriam (HHS/OASH) Subject: RE: FOR REVIEW:,(b ..,,.l .,..., )(S """ )----------, Thank you! I'll send forward tomorrow morning. From: Giroir, Brett (HHS/OASH)
Sent: Monday, February 24, 2020 8:14 PM To: Haddad, Carla (HHS/OASH) Cc: Wa inwright, Jacob (HHS/OASH/1O); Mikre, Meriam (HHS/OASH) Subject: RE: FOR REVIEW:~ rb-)(5-)--------~ Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) AMERICAN PVERSIGHT HHS-20-0580-A-000134 200 Independence Avenue, SW Washington, DC20201 Office Phone: 202-690-7694 From: Haddad, Carla (HHS/OASH) Sent : Monday, February 24, 2020 6:13 PM To: Giroir, Brett {HHS/OASH) Cc: Wainwright, Jacob {HHS/OASH/1O) ; Mikre, Meriam {HHS/OASH) Subj ect: FOR REVIEW j~(b-)(5-)--------~ ADM Giroir, b)(5) Thanks, Carla b)(5) From: Hodges, Katrina (HHS/OGC) Sent : Monday, February 24, 2020 3:58 PM To: Haddad, Carla (HHS/OASH) Cc: Wainwright, Jacob (HHS/OASH/1O); Beattie, Allison (HHS/OGC) ; Clark, Tamara (OS/OGC) Subject : REfb )(5) I Carla, b)(5) AMERICAN PVERSIGHT HHS-20-0580-A-000135 b)(5) Please do not hesitate to reach out with any questions. Thanks very much, b)(5) Katrina L. Hodges U.S. Dept. of Health &Human Services Office of the General Counsel Direct: (404) 562-7829 From: Hodges, Katrina (HHS/OGC) Sent : Friday, February 21, 2020 4:18 PM To: Haddad, Carla (HHS/OASH) Cc: Wainwright, Jacob (HHS/OASH/1O); Beattie, Allison (HHS/OGC) ; Clark, Tamara (OS/OGC) Subject: RE:rb )(5) I Thanks, Carla. This is very helpful- appreciate it. Katrina L. Hodges U.S. Dept. of Health &Human Services Office of the General Counsel Direct: (404) 562-7829 From: Haddad, Carla (HHS/OASH) Sent : Friday, February 21, 2020 2:38 PM To: Hodges, Katrina (HHS/OGC) Cc: Wainwright, Jacob (HHS/OASH/1O); Beattie, Allison (HHS/OGC) ; Clark, Tamara (OS/OGC) Subject: RE1(b)(5) I AMERICAN PVERSIGHT HHS-20-0580-A-000136 Hi Katrina, b)(5) Thanks, Carla From: Hodges, Katrina (HHS/OGC) Sent : Friday, February 21, 2020 12:08 PM To: Haddad, Carla (HHS/OASH) Cc: Wainwright, Jacob (HHS/OASH/10) ; Beatt ie, Allison (HHS/OGC) ; Clark, Tamara (OS/OGC) Subject: RE:~b)(5) I Carla, (b)(5) Thanks, Katrina L. Hodges U.S. Dept. of Health &Human Services AMERICAN PVERSIGHT HHS-20-0580-A-000137 Office of the General Counsel Direct: (404) 562-7829 b)(5) From: Haddad, Carla (HHS/OASH) Sent: Monday, December 9, 2019 3:10 PM To: Clark, Tamara (05/0GC) Cc:Wainwright, Jacob (HHS/OASH/10); Voltaire, Jean-Michel (HHS/OGC) ; Hodges, Katrina (HHS/OGC) Subject: RE:~b)(S) I Tamara and team, b)(5) Thanks, Carla (b)(5) From: Clark, Tamara (OS/OGC) Sent: Monday, December 9, 2019 11:14 AM To: Haddad, Carla {HHS/OASH) Cc:Wainwright, Jacob (HHS/OASH/10); Voltaire, Jean-Michel (HHS/OGC) ; Hodges, Katrina (HHS/OGC) Subject: RE:~b)(5) I Thank you, Carla. I'll set up a call just to touch base quickly. Based on the below, I don't think it needs to be a long call. From: Haddad, Carla {HHS/OASH) Sent: Monday, December 9, 2019 8:27 AM To: Clark, Tamara (OS/OGC); Voltaire, Jean-Michel (HHS/OGC); Hodges, Katrina (HHS/OGC) Cc:Wainwright, Jacob (HHS/OASH/10) Subject: REP) (5) I b)(5) AMERICAN PVERSIGHT HHS-20-0580-A-000138 b)(5) I hope this is helpful. Thanks, Carla From: Clark, Tamara (05/0GC) Sent: Monday, December 9, 2019 9:08 AM To: Haddad, Carla (HHS/0ASH) ; michel.Voltaire Voltaire, Jean-Michel (HHS/0GC) ; Hod es Katrina (HHS/0GC) Subject (b)(S) b)(5) Tamara S. Clark U.S. Dept. of Health &Human Services Office of the General Counsel 601 E. 12th St. Kansas City , MO 64106 Office: (816) 426-5423 tamara.clark @hhs.gov Sender: Recipient: Giroir, Brett (HHS/OASH) Haddad, Carla (HHS/OASH) Sent Date: 2020/02/24 21:08:13 Delivered Date: 2020/02/24 21:08:14 AMERICAN PVERSIGHT HHS-20-0580-A-000139 Giroir, Brett (HHS/OASH) Alexander Billioux ; Smith, Brad (CMS/QA) ; Trent-Adams, Sylvia (HHS/OASH) Omar Khalid ; CC: Haddad, Carla (HHS/OASH) Subject: RE: Request for clarification on staffing drive-through testing centers Date: 2020/03/16 14:06:49 Priority: Normal Type: Note These are all answerable. I am at WH and will let my leadership ops team work with you. But briefly 1. We are not setting up any specific requirement for staffing, to my knowledge. This is state led and federal supported. The PHScan also support a few personnel to assist or supervise 2. Test throughput depends on the size of your POD system. We will review your requirements with our FEMA team. Carla, can you do this? 3. We do not know the turnaround time as yet. We are expecting 48 hours but cannot guarantee. Please note: We can support the drive thru with our own swabs and PPE. We want to support your priorities and system. We can adapt to what you need. I can spend more time on this with you later. BG Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Alexander Billioux Sent: Monday, March 16, 2020 1:51 PM To: Giroir, Brett (HHS/OASH) Cc: Omar Khalid Subject: Request for clarification on staffing drive-through testing centers AMERICAN PVERSIGHT HHS-20-0580-A-000140 Dear Adm. Giroir, Thank you for your update this morning with the President. I do have a few questions as we are looking at the logistics for the drive through testing centers, and I would appreciate you directing me to the person who might be able to work with us to answer these questions: - Staffing of PODs: We will likely not be able to operate these drive through centers if the staffing requirement remains a MD overseeing nurses. We think a model with a resident or APRN overseeing EMT/paramedics would be more workable. - Vo lume/ through -put of tests: We would need to understand the daily limit on processing of our tests. This will dictate the daily volume of tests we aim to achieve. Result Turn around Times: We wanted to confirm the turn around time for these results? We are current ly processing samples from the priority populations you are targeting (health care workers, nursing home residents, prisoners, and hospitalized patients) in our hospital labs. If the turn around time for these will be longer (48 hours) we would prefer to use the swabs in our hospitals (as they have a critical shortage of swabs and viral transport medium that would be best allocated to those priority populations (most of which will not be able to drive to a drive through testing center) Thank you for your help and connecting me to anyone on your team who I can further discuss these quest ions with. Thanks, Alex Alexander Billioux, MD DPhil FACP Pronouns: He/Him/His Assistant Secretary Office of Public Health Louisiana Department of Health 628 North 4 th Street Baton Rouge, LA 70802 Email: alexander.billioux@la.gov Office: 225-342-6188 Cellfb)(6) I ::::-:::::: cid:image005.png@01D52B45.11586080 cid :image002.jpg@01D51AB4. 7B8ECFD0 Sender: Recipient: AMERICAN PVERSIGHT Giroir, Brett (HHS/OASH) Alexander Billioux ; Smith, Brad (CMS/OA) ; Trent-Adams, Sylvia (HHS/OASH); (FYDIBOHF23SPDL Omar Khalid ; Haddad, c.arla (HHS/OASH) (FYDIBOHF23SPDL Sent Dat e : 2020/03/16 14:06:49 AMERICAN PVERSIGHT HHS-20-0580-A-000142 Giroir, Brett (HHS/OASH) To: Heck, Mia (HHS/OASH) Haddad, carla (HHS/OASH) ; Broida, Tara (HHS/OASH) ; CC: Migliaccio-Grabill, Kate (HHS/OASH) ; Channer, Amber (O5/OASH) Subject: RE: Newsweek - Questions regarding coronavirus mortal ity rate Date: 2020/03/07 08: 10: 25 Priority: Normal Type: Note b)(S) Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690- 7694 From: Heck, Mia (HHS/OASH) Sent: Saturday, March 7, 2020 8:09 AM To: Giroir, Brett (HHS/OASH) Cc: Haddad, Carla (HHS/OASH) ; Broida, Tara (HHS/OASH) ; Migliaccio -Grabill, Kate (HHS/OASH) ; Channer, Amber (OS/OASH) Subject: Re: Newsweek - Questions regarding coronavirus mortality rate b)(S) (b)(S) AMERICAN PVERSIGHT HHS-20-0580-A-000143 b)(5) Sent from my iPhone On Mar 7, 2020, at 8:06 AM, Giroir, Brett (HHS/OASH) wrote: n (b)(5) Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Heck, Mia (HHS/OASH) Sent: Saturday, March 7, 2020 8:01 AM To: Giroir, Brett (HHS/OASH) Cc: Haddad, Carla (HHS/OASH) ; Broida, Tara (HHS/OASH) ; Migliaccio-Grabill, Kate (HHS/OASH) ; Channer, Amber (OS/OASH) Subject: Re: Newsweek - Questions regarding coronavirus mortality rate (b)(5) Sent from my iPhone AMERICAN PVERSIGHT HHS-20-0580-A-000144 Giroir, Brett (HHS/OASH) Orsega, Susan (OS/OASH); Trent-Adams, Sylvia (HHS/OASH); To: Adams, Jerome (HHS/OASH); (FYDIBOHF23SPDL T)/cn =Recipients/cn=184fe51f7350400b8a99dabd6Sac0db5-Adams, Schwartz, Erica (HHS/OASH) Migliaccio-Grabill, Kate (HHS/OASH); Valentine, Steven (HHS/OASH); Haddad, Carla (HHS/OASH) Subject: RE: 10 MAR2020 COVID-19 Mission Date: 2020/03/10 21:16:36 Priority: Normal Type: Note Thank you I think I am off calls, so if you want to catch up, let me know Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Orsega, Susan (OS/OASH) Sent: Tuesday, March 10, 2020 9:16 PM To: Giroir, Brett (HHS/OASH) ; Trent-Adams, Sylvia (HHS/OASH) ; Adams, Jerome (HHS/OASH) ; Schwartz, Erica (HHS/OASH) Cc: Migliaccio -Grabill, Kate (HHS/OASH) ; Valentine, Steven (HHS/OASH) ; Haddad, Carla (HHS/OASH) Subject: 10 MAR 2020 COVID-19 Mission « File: COVID-19 Outbreak Mission Update. 10MAR2020 (003).pptx » Dear Sirs and Ma'ams AMERICAN PVERSIGHT HHS-20-0580-A-000145 As of 10 March 2020, a total of 826 Corps Officers are deployed CCHQ a total of 479 officers have deployed; 158 officers are currently deployed; 6 officers rostered for upcoming deployments INTRAGENCY:CDC: 178 officers (145 are currently deployed & 33 have completed their deployment) ASPR: 39 Officers currently deployed NIH: 13 officers (data from 3/1/2020) ROB cont inues to staff ASPRTask Orders as they are received; 2 14-person HMTFs deployed in addition to IMT support for nursing facility in Kirkland, WA Medical clearance and fit testing scheduled for 07Mar2020 postponed until 13 Mar2020 pending supplies Regards, Susan M . Orsega Rear Admiral, Commissioned Corps Headquarters Director United States Public Health Service Office of the Surgeon General /US Department of Health and Human Services 240 -453 -6080 Email: susan.orsega@hhs.gov Giroir, Brett (HHS/OASH) Orsega, Susan (OS/OASH) ; Trent-Adams, Sylvia (HHS/OASH) ; Adams, Jerome (HHS/OASH) ; Schwartz, Erica (HHS/OASH) ; Migliaccio-Grab ill, Kate (HHS/OASH) ; Valentine, Steven (HHS/OASH) ; Haddad, Carla (HHS/OASH) Sent Date: 2020/03/10 21 :16:35 Delivered Date: 2020/03/10 21:16:36 AMERICAN PVERSIGHT HHS-20-0580-A-000146 Giroir, Brett (HHS/OASH) To: Reed, Paul(HHS/OASH) CC: Haddad, carla (HHS/OASH) Subject: RE: HHSInteragency VTC-COVID-19 Date: 2020/02/25 13:56:17 Priority: Normal Type: Note Copy that Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Reed, Paul (HHS/OASH) Sent: Tuesday, February 25, 2020 1:26 PM To: Giroir, Brett (HHS/OASH) Cc: Haddad, Carla (HHS/OASH) Subject: RE: HHS lnteragency VTC-COVID-19 Sir, (b)(5) p~ CAPT Paul Reed, MD AMERICAN PVERSIGHT HHS-20-0580-A-000147 U.S. Public Health Service --- "In Officio Salutis" Deputy Assistant Secretary for Health (Medicine and Science) Office of the Assistant Secretary for Health Department of Health and Human Services From: Haddad, Carla (HHS/OASH) On Behalf Of Giroir, Brett (HHS/OASH) Sent: Monday, February 24, 2020 5:57 PM To: Reed, Paul (HHS/OASH) Subject: RE: HHS lnteragency VTC-COVID-19 Good evening CAPT Reed, Are you available to join this VTC tomorrow? ADM Giroir is unable to listen in and was hoping that you could listen in on the call for situational awareness. Please let me know. Thanks, Carla -----0 rigi na I Ap poi ntme nt----From: OS Secretarys Operations Center Sent: Tuesday, February 18, 2020 3:29 PM To: OS Secretarys Operations Center; Alexander , Daniel (fema.dhs.gov); Amparo, Alex (fema.dhs.gov); Anderson, Lindsey (fema.dhs.gov); Apodaca, Michael (fema.dhs.gov); Balint, Thomas (fema.dhs.gov); Bean, Bridget (fema.dhs.gov); Bettis, Elizabeth (fema.dhs.gov); OS Bibo, David; Blaz, Christopher (fema.dhs.gov); Bowlds, Wendy (fema.dhs.gov); Bowman, Scott (fema.dhs.gov); Breslin, Thomas; Casey, Michael (fema.dhs.gov); Castillo, Carlos (fema.dhs.gov); Clarke, Russell (fema.dhs.gov); Clever, Traci (fema.dhs.gov); Comans, Mary (fema.dhs.gov); Cranston, Anvaline (fema.dhs.gov); Criman, Thomas (fema.dhs.gov); Doolin, Joel (fema.dhs.gov); Naar, Alex (FAA.GOV); Dorko, Jeffrey (fema.dhs.gov); Dozar, Joshua (fema.dhs.gov); Dugan, Moises (fema.dhs.gov); Dunne, Nicole (fema.dhs.gov); Edwards, Eric (fema.dhs.gov); Endrikat, Fred (fema.dhs.gov); Eswood, Louis (fema.dhs.gov); Ey Ill, Elwood (fema.dhs.gov); Fl Military Aide (peter.jennison@associates.fema.dhs.gov ); Fema-operations.Center (OHS.GOV);FEMA-LRC-Chief(fema.dhs.gov); Fema.Nrc-watch-dhs (OHS.GOV); FEMA-NWC (OHS.GOV); FEMA-NWC-TMT (fema.dhs.gov); Filipponi, Karen (fema.dhs.gov); Fischer, Lauren (fema.dhs.gov); Forbes, Melissa (fema.dhs.gov); Fuller, Gregory Scott (fema.dhs.gov); Gammon, Carla (fema.dhs.gov); Gaynor, Pete (fema.dhs.gov); Gibson, Levi (fema.dhs.gov); Glenn, Robert (fema.dhs.gov); Greenberg, Jeremy (fema.dhs.gov); Grimm, Michael (fema.dhs.gov); Harper, Jay (fema.dhs.gov); Heigh berger, Eric (fema.dhs.gov); Huang, Paul (fema.dhs.gov); Hutchinson, Lytwaive (fema.dhs.gov); IMAT Crisis (fema.dhs.gov); IMAT-East (fema.dhs.gov); IMAT West (fema.dhs.gov); Jackson, Liz (fema.dhs.gov); James, Lavar (fema.dhs.gov); Johnson, Jo Linda (fema.dhs.gov); Jones, Brian R. 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(hud.gov); Nguyen, Jason (associates.fema.dhs.gov); Keller, Jason R. (aphis.usda.gov); Marineau, Jason (ios.doi.gov); Cooke, Jasper (fema.dhs.gov); Mckinney, Jazmine (fema.dhs.gov); Byard, Jeffrey (fema.dhs.gov); Raymond, Jeremy (va.gov); Moore, JKevin (fema.dhs.gov); Murphy, J (ens.gov); Burchette, Joe (fema.dhs.gov); Bitterman, John (associates.fema.dhs.gov); Felker, John (hq.dhs.gov); Oconnor, John (hq.dhs.gov); Bitterman, John R. {MIL); OS Valliere, John; Juskie, John (ios.doi.gov); Nelson, John (ios.doi.gov); Reyes, Jorge (dot.gov); Rodriguez, Jose (fema.dhs.gov); Couch, Joseph (fema.dhs.gov); Kochanski, Joseph (fema.dhs.gov); Lamana, Joseph (OS/ASPR/EMMO); Barnes, Joshua (HHS.GOV); Unger, Juliann (ed.gov); Benson, Kailie (uscg.mil); Newell, Karen (va.gov); Perelin, Katherine (fema.dhs.gov); Reid, Katherine (fema.dhs.gov); Brown, Kelly (hq .dhs.gov); Quinlan, Kelly (fema.dhs.gov); Scott, Kenisha (associates.fema.dhs.gov); Buell, Kenneth (hq.doe.gov); Holmes, Kerry (fema.dhs.gov); Stewart, Kevin (fema.dhs.gov); Coleman, Kimberly (fema.dhs.gov); PfirrmannPowell, Kimberly (fema.dhs.gov); Stout, Kimberly (redcross.org); Sykes, Kimberly (fema.dhs.gov); Kufta, K (fed.us); Alkire, Lauren (fema.dhs.gov); Ratchford Jr, Lewis (va.gov); Branum, Lisa (DOI.GOV); Touhey, Lucy (usda.gov); Lowe, Lynda (sba.gov); Esnard, Malita (fema.dhs.gov); Bergman, Marc (usace.army.mil); Gallagher, Mark (fema.dhs.gov); Millican, Mark (fema.dhs.gov); Harvey, Mark P. (nsc.eop.gov); Tierney, MaryAnn (DHS/FEMA); Matthews, Denise (DOL.GOV); Hopkins, Mc (usgs.gov); McCarthy, Megan (atf.gov); Bridges, Melinda (fema.dhs.gov); Wiehenstroer, Melissa (fema.dhs.gov); Serach, Michael (usda.gov)); Paddock, Michael (NOAA); George, Michael S. (fema.dhs.gov); Tamillow, Mike (MIL); Vineyard, Michael (OS/ASPR/10); Callahan, Mike {dot.gov); Wilkinson, Nachelle (fema .dhs .gov); Grant, Natalie (ACF); ncc@hq.dhs.gov ; Anderson, Neal {hq.dhs.gov); Tang, Newton {fema .dhs.gov); Palmer, Nicholas (associates .fema .dhs .gov); Bolleurs, Noell A. (MIL); Caldwell, Paige (fema.dhs.gov); Caldwell, Paige (MIL); Gray, Patricia (fema .dhs .gov); Ford, Paul (DHS/FEMA); Kim, Paul (VA.GOV); Preusse, Paul (fema.dhs .gov); Rennert, Peter (fema.dhs.gov); Doucet, Phillip (ATF.GOV); Cychosz, Rachel (fema.dhs.gov); Holland, Rena (HUD.GOV); Fossett, Renee (gsa.gov); Button, Richard (uscg.mil); Chavez, Richard {dot .gov); Jacques, Richard (DHS.GOV); Schueneman, Richard (nnsa .doe .gov); Ziebart, Ricky (fema.dhs .gov); Carter, Robert (GSA.GOV); OS Salesses, Robert; Mccloy, Robert (ATF.GOV); Rutledge, Robert {hq .dhs .gov); Schroder, Robert (fema .dhs .gov); rsflg (fema .dhs .gov); Clarke, Russell A.(nsc.eop.gov); Fox, Sandra (fema.dhs.gov); Burgess, Scott (fema.dhs.gov); Lundgren, Scott (noaa.gov); Panzer, Scott (fema .dhs.gov); Mcnamee, Shannon (REDCROSS.ORG);Martin, Sharon (fema.dhs.gov); Pandey, Siddharth (DHS.GOV); slegarza (ts.fed.us); Snyder, Elizabeth (fema.dhs.gov); Heath, Stanley (hq.dhs.gov); Reissman, Stephan (noaa.gov); Elson, Stephen B. (hq.dhs.gov); Mason, Stephen D. {MIL); Elson, Stephen (associates.fema.dhs.gov); Wade, Stephen (fema.dhs.gov); Hortin, Steve (fns.usda.gov); Hoffman, Sydney (fema.dhs.gov); OS Taylor, Troy; Kennedy, Ted (OS/ASPR/SPPR); Mall, Tehmina (fema.dhs.gov); Theroux, Emily (fema.dhs.gov); Browning, Thomas (mail.mil); Lacrosse, Thomas (MIL); Murray, Thomas (fema.dhs.gov); Britt, Timothy (fema.dhs.gov); Montgomery, Travis (DHS.GOV); Kurz, Victor (fema.dhs.gov); Gonzalez, Waddy (fema.dhs.gov); Randall, Warren (atf.gov); Wheeler, Young (DOL.GOV); FEMA-ESFlS-Coordination (fema.dhs.gov); HQ-OEADirectors (fema.dhs.gov); 9-awa-ash -woc (FAA.GOV); Ps.goc-cog.sp (CANADA.CA); gmb -sitroom (cbp.dhs.gov); CC (NTSB.GOV); US Army Corps of Engineers - Operations Center; Allen, Stephen (hq.dhs.gov); cisa.iocc (cisa.dhs.gov); ciocc-nccwatch (cisa.dhs.gov); ciocc.physical (cisa.dhs.gov); ciocc.cyber (cisa.dhs.gov); Dept of Transportation - Crisis Management Center; COMMAND.CENTER2 (USDOJ.GOV);COMM CTR (ATF.GOV); Dept of Homeland Security - CWMD watchdesk; dniwatch(DNI.GOV); Department of Commerce EOC; edexecsec (ed.gov); Dept of Energy - Office of Emergency Management; DOI Watch Office (DOI.GOV); Department ofTreasury EOC; OS.COMMAND.CENTER(STATE.GOV);EOC Report (CDC); Environmental Protection Agency - Emergency Operations Center; Sioc (FBI.GOV); fccopcenter (fee.gov); fletcexecsec (fletc.dhs.gov); fpsimc (hq.dhs.gov); fpsintel (fps.dhs.gov); Fpsimc (DHS.GOV); suitland.megacenter (hq.dhs.gov); HQS-DG-LST-NRCINFO{MIL); heoc (hud.gov); dhs.intel.cetc.watch (hq.dhs.gov); hsintel (ice.dhs.gov); Dept of Justice - Justice Command Center; cdo.jtwc (NAVY.MIL); AMERICAN PVERSIGHT HHS-20-0580-A-000150 MTAC (NCIS.NAVY.MIL); Nee (MIL); nccic (us-cert.gov); nctc-ops (ucia.gov); Nice (OHS.GOV); js.pentagon.j3.list.addo (mail.mil); NNC.CMDCTRDIR.OMB (NORTHCOM.MIL); noc.swo (hq .dhs.gov); nnc.peterson.n-ncn2c2.mbx.interagency -omb (mail.mil); Nuclear Regulatory Commission - Operations Center; ogcexecsec (hq.dhs.gov); OperationsCenter (STATE.GOV); USDA- EOC; OPSSOO (JS.PENTAGON.MIL); ARC Disaster Operations Center; roc.ndw.fcm (NAVY.MIL); Vanatta, Robert (hq.dhs.gov); Sit.Room (OHS.GOV); cdo.tsa (tsa.dhs.gov); tsa.oia.watch (tsa.dhs.gov); Ofdadutyofficer (USAID.GOV); uscis.c2 (dhs.gov); ops center (dm.usda.gov); pios-onduty (usss.dhs.gov); VA Integrated Operations Center (VA IOC) Watch Officer; Brumfield, Ty (OHS.GOV); Campbell, Matt (fema.dhs.gov); Key, Debbie L. (hud.gov); Friedman, N (eda.gov); Potosnak, Ryan (fema.dhs.gov); FEMA-Rl WATCHOFFICER(fema-dhs.gov); FEMA-MOC-BOTHELL(fema.dhs.gov); FEMA-MOC-DENTON (fema.dhs.gov); FEMA-MOC-DENVER(fema.dhs.gov); FEMA-MOC-FREDERICK(fema.dhs.gov); FEMAMOC-MAYNARD (fema.dhs.gov); FEMA-MOC-THOMASVILLE (fema.dhs.gov); fema-r03-rrcc -watch (OHS.GOV); FEMA-R2-Watch0fficer (fema.dhs.gov); FEMA-R4-WatchUnit (fema.dhs.gov); FEMA-RSWatch; FEMA-R6-Watch (fema.dhs.gov); FEMA-R7-Watch0ps (fema.dhs.gov); FEMA-R8-Duty0fficer (fema.dhs.gov); FEMA-R8-RRCC-DIRECTOR(fema.dhs.gov); FEMA-R9Watchofficer (fema.dhs.gov); Erickson, Somer (fema.dhs.gov); Hylton, Roberto (fema.dhs.gov); Jacques, Richard (dhs.gov); Kennedy, Kam (redcross.org); Kohtz, Carol J. (associates.fema.dhs.gov); Lynne, Elisa (associates.fema.dhs.gov); Macintyre, Anthony (OHS.GOV); NOAA-LNO (fema.dhs.gov); Scannelli, Vincent (HQ.OHS.GOV); Villarreal, Xavier (DLA.MIL); Young, Joseph (fema.dhs.gov); CENTER(fema.dhs.gov); Fish, Kristen (fema.dhs.gov); Krebs, Christopher (hq.dhs.gov); NOAA SPC(noaa.gov); Wleith (USGS.GOV); mblanpied (usgs.gov); applegate (usgs.gov); Flennoy, Jason (dot.gov); Geringer-Frazier, Barbara (usda.gov); Griffin, S (ts.fed.us); Sabin, Brian (usda.gov); Usher, Zachary (fema.dhs.gov); Greene, Jonathan (OS/ASPR/EMMO); Mccreary, Kenneth (OS/ASPR/SPPR);Hrdina, Chad (OS/ASPR/SPPR);Cheatham, Reggie (epa.gov); EPA; Wenning, Stephanie (@epa.gov); Colby, Michelle - OHS, Washington, DC; O'Connor, Mike - OHS, Washington, DC; Barrett, Todd -OHS, Washington, DC; Schlieger, Brian (epa.gov); Fantinato, Jessica (USDA.GOV); Andersen, Nicholas (hq.doe.gov); Rutledge, Robert (cisa.dhs.gov); Ahrens, Dana (cisa.dhs.gov); 2019 nCoV Senior Leadership; Sims, Andrew (OS/ASPR/EMMO) ; Young, Joseph LTC US ARMY; Flowers, Artensie (OS/ASPR/EMMO); Slay, Lorenzo Jr LtCol USAF; Monahan, Kenneth (MAIL.MIL); Falone, Emily (OS/ASPR/EMMO); Blanchette, Glenn (OS/ASPR/EMMO); Lincoln, Carol (OS/ASPR/EMMO); Bermingham, John (CDC/DDPHSIS/CPR/DEO); Hall, Bill (HHS/ASPA); 'joshua.barnes@sba.gov'; Torrens, Luis (OS/ASPR/EMMO); Coviello, Daniel (HRSA); Ricketts, Kimberley (OS/ASPR/EMMO); Egan, Sarah (fema.dhs.gov); Tate, Anna (OS/ASPR/SPPR)(CTR); Evans, Catherine (OS/ASPR/SPPR)(CTR); 'David.Chawaga@fema.dhs .gov'; Rousseaux, Charles; ASPRCOMMS; 'cbpcoronavirusmailbox@cbp.dhs.gov'; Field Operations and Response Division; Dickinson, Jeanette (OS/ASPR/EMMO); Thornton, Cody (mail.mil); 'phyllis.erkins@dls.mil'; CoronavirusSmallGroup (state.gov); TFJPOl Diamond Princess Response; LeMar-Reiman, Amy N; Henwood, Eugene J; Kane, EIieen (OS/ASPR/OEA); Mcclellan, Wesley (OS/ASPR/SPPR);Austin, Meredith (uscg.mil); Hill, April (OS/ASPR/EMMO); Sanchez, Luis (OS/ASPR/OEA); Sprow, Kyle (OS/ASPR/SPPR)(CTR); Farmer, William (OS/ASPR/SPPR);Kadlec, Robert (OS/ASPR/10); Sauer, Michael (OS/ASPR); Dodgen, Daniel (OS/ASPR/SPPR);FDA Emergency Operations (FDA) Subject: HHS lnteragency VTC-COVID-19 When: Tuesday, February 25, 2020 12:30 PM-1:30 PM (UTC-05:00 Eastern Time US &Canada . Where: HHS ASPRConference Room 6th Floor; VTC; Dial-in b)(B) AGENDA COVID-19 INTERAGENCY VIDEO TELECONFERENCE Tuesday, 25 February 2020 at 12:30 p.m. ET AMERICAN PVERSIGHT HHS-20-0580-A-000151 PLEASE NOTE that this is the same agenda as the previous VTC, changes may be forthcoming. Objective • Provide information sharing among Emergency Support Functions on Federal response actions to the COVID-19 to date • Focus briefings on current situation and describe specific issues requiring Federal interagency actions Opening Comments • Dr. Robert Kadlec or Dr. Kevin Yeskey • Senior Leadership Intent • Strategic Priorities COVID-19 Situat ion Update • Centers for Disease Control and Prevention (CDC) Repatriation Status of U.S. Citizens • CAPT Scott Lee, Federal Health Coordinating Official (FHCO); Traveler Screening into the United States • Situation Report- CDC • Military Housing Update Supporting Airport Screenings - DoD/OSD and DoD/NORTHCOM • OHS Support to Traveler Supporting - OHS/Countering of Weapons Mass Destruction (CWMD) Review and Input to Pandemic Crisis Action Plan (PANCAP) • Mr. Ken McCreary, ASPR Plans • Reference PANCAP Synchronization Matrices • Request Federal DepartmenUAgency Responsibilities under Phases 1C, 2A, 2B , and 2C Task Force Update • CAPT Christopher Perdue, Chief of Staff; • Supply Chain Task Force Lead ; • Communications Task Force Lead; • Healthcare Resiliency Task Force Lead ; • Medical Countermeasures Task Force Lead ; lnteragency Support • Emergency Support Functions o ESF #1 - Transportation o ESF #2 - Emergency Communications o ESF #3 - Public Works and Engineering o ESF #4 - Fire Fighting o ESF #5 - Planning o ESF #6 - Mass Care, Emergency Assistance, Temporary Housing, &Human Services o ESF #7 - Logistics o ESF #8 - Public Health and Medical Services AMERICAN PVERSIGHT HHS-20-0580-A-000152 o ESF #10 - Oil and Hazardous Material o ESF #11 - Agriculture o ESF #12 - Energy o ESF #13 - Public Safety and Security o ESF #14 - Cross Sector, Business, and Infrastructure o ESF #15 - External Affairs • • U.S. Coast Guard Department of Defense , Office of the Secretary of Defense o U.S. Northern Command o National Guard Bureau o Defense Logistics Agency - Closing Comments • Dr. Robert Kadlec or Dr. Kevin Yeskey ; Connection Instructions • • Please mute your microphone at all times when not speaking • • Do not put your phone on hold during the conference call • • Do not dial both the Audio Bridge and the Video Bridge from the same room • FEMA Video participants including Jabber/Movi participants: From your VTC unit please dial~t least 20 minutes before the conference starts to conduct Audio/Video checks with the Video Ope~ Center. • Non-FEMA Video artici ants: will need to have their techn ical staff contact the FEMA Video Operations Center (b)(6) to determine a dial-in method and conduct an Audio/Video test at least one hour prior to connecting to this conference . Participants are required to: • Properly reserve a video teleconferencing room, if needed, through your resource manager in advance and notify local IT of the reservation. • Confirm your VTC dial in number is correct prior to connecting. • Dial the conference number provided above and perform an Audio and Video quality check with the voe • Keep all microphones mu ted, unless speaking. Note: FEMA VOC Video technicians frequently mon itor more than one conference , but can only monitor audio for one at a time . If you do have a prob lem with the conference that r£auires jmmedjjte ass istance , please ca ll the FEMA Video Operations Center onfb .__)(6) __, ____ The video bridge will be available 30 minutes prior to the scheduled start time. If you require assistance connecting or have questions, please call the FEMA Video Operat ions Center onl (b)(6) I NOTE: To connect to this conference after the scheduled start time, you must contact the FEMA Video Operations Center . Sender: Recipient: AMERICAN PVERSIGHT Giroir, Brett (HHS/DASH) Reed, Paul (HHS/DASH); HHS-20-0580-A-000153 Haddad, Carla ( HHS/OASH) Sent Date: 2020/02/25 13: 56: 14 Delivered Date: 2020/02/25 13:56:17 AMERICAN PVERSIGHT HHS-20-0580-A-000154 Trent-Adams, Sylvia (HHS/OASH) Valentine, Steven (HHS/OASH) ; To: Haddad, c.arla (HHS/OASH) Subject: FW: FYSA: A Messagefrom NTEUsomeone shared with me Date: 2020/03/1 2 15:32:59 Priority: Normal Type: Note FYSA From: Handley, Elisabeth (OS/OASH/ORI) Sent: Thursday, March 12, 2020 3:18 PM To: Roman, Ruth (HHS/OASH) ; Trent -Adams, Sylvia (HHS/OASH) Subject: FYSA:A Message from NTEU someone shared with me Subject:A Message from NTEU -----Original Message- ---From: NTEU National President To: HHS Employees <> Sent: Thu, Mar 12, 2020 2:52 pm Subject: A Message from NTEU HHS Silence on Coronavirus Puts Employees at Risk The lack of regard for employee welfare has reached a new, dangerous low at HHS. For weeks, NTEU has made multiple requests for critical plans and answers to basic safety questions regarding coronavirus . These requests continue to be ignored by the department , including three letters from National President Tony Reardon to Secretary Alex Azar . In Reardon 's second letter , sent on Monday , he reiterated concerns employees have raised about HHS' response to the coronavirus. Reardon urged Secretary Azar to formally adopt flexible telework and work schedule policies as this outbreak continues . In the face of this health crisis , frontl ine employees deserve clear and timely information, and assurances that their employer is prioritizing AMERICAN PVERSIGHT HHS-20-0580-A-000155 their safety. These are assurances HHS has refused to provide to NTEU. And , even as coronav irus is declared a pandemic , HHS is still reviewing its continuity of operations plan (COOP). On Monday, Deputy Secretary Eric D. Hargan wrote that, effective immediately, operating and staff heads have the authority to cancel or postpone all non-essential travel , and limit attendance at large meetings that are not mission-critical , which is a positive step. Apparently , HHS is evaluating and testing IT systems to prepare for an influx of telework , if required. NTEU believes it is required right now and that HHS would be better prepared for this pandemic if many of its OpDivs had not spent the better part of the past two years trying to limit or eliminate telework. HHS is following the Office of Personnel Management human resources flexibilit ies and authorities for COVID-19 located on OPM's COVID-19 website. Employees are encouraged to visit the Centers for Disease Control and Prevention 's (CDC) website for up-to-date information and guidance . NTEU's primary concern is your health and well-being. We will continue to press HHS to take proactive steps to keep employees safe at work . NTEU has collected coronavirus information in one location. Click here for general information. NTEU members, click here to access agency-specific information. Five Senators Write to FDA Commissioner on Foreign Travel Led by Sen. Chris Van Hollen (D-MD) , a group of senators wrote to FDA Commissioner Hahn asking about foreign travel and employees safety. "We write today to request information about your agency's plans for FDA inspections in China in light of the outbreak of a new coronavirus , COVID-19, first identified in Wuhan City, Hubei Province , China, and the serious potential health risk the outbreak could pose to FDA's compliance and inspection personnel. Additionally , we strongly urge you to establ ish open lines of communication with your workers and their union representatives now, as you make plans to resume inspections in China. FDA employees deserve a seat at the table as agency leadership has discussions and develops policies related to inspections in China," the Feb. 28 letter states. The senators went on to ask about management's communication of information with employees and NTEU. The FDA did respond to NTEU's letter sent weeks ago expressing concerns about inspection trips abroad and employee health. Chief Operating Officer James Sigg said that FDA employees stationed in China are being repatriated to the United States and that FDA is following State Department and CDC guidel ines. He did not fully answer questions regarding inspection trave l. Sen. Van Hollen's office has shared with NTEU that since the letter was drafted , he has broadened his concern about travel to other countries in addition to China and to other HHS agencies beyond the FDA. Stay Informed with NTEU By signing up for our free e-newsletter with a personal, non-governmental email address to never miss a critical update. " ...to ensure that every federal employee is treated with dignity and respect." AMERICAN PVERSIGHT HHS-20-0580-A-000156 You are currently subscribed to hhspetit ion as : route216@verizon .net. To u nsubscr ibe click here: https ://protect2 .fire eye .com/ur l? k=caf 4 7 acd-96a 1731 d-caf 44bf20cc4 7a6a52ded06bb414a304e9d 0& u=http ://I ists. nteu. org/u?id=24218115 .20a51a Sb75fbe836285adca 561 e50f57 &n= T & l=hhspetition&o=627220 (It may be necessary to cut and paste the above URL if the line is broken) or send a blank email to leave-627220-2421811 5.20a 5 1a5b75fbe836285adca561e 50f57(n)lists .nteu .ora Sender: Recipient: Trent-Adams, Sylvia ( HHS/OASH) Valentine, Steven (HHS/ OASH) ; Haddad, Carla ( HHS/ OASH) Sent Date: 2020/ 03/12 15:32:59 AMERICAN PVERSIGHT HHS-20-0580-A-000157 Giroir, Brett (HHS/OASH) Monroe, Steve (CDC/DDPHSS/OLSS/OD) ; Shuren, Jeff (FDA/CDRH); Stenzel, Timothy (FDA/CDRH); Schwartz, Suzanne (FDA/CDRH) Haddad, carla (HHS/OASH); Bante, Katie (OS/OASH); McGowan,Robert (Kyle) (CDC/OD/OCS); Lenihan, Keagan(FDA/OC) ; Monroe, Steve (CDC/DDPHSS/OLSS/OD) n1 Subject: RE: Testing Huddle Date: 2020/03/11 06:51:58 Priority: Normal Type: Note We will send a call in Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Monroe, Steve (CDC/DDPHSS/OLSS/OD) Sent: Wednesday, March 11, 2020 6:45 AM To: Shuren, Jeff (FDA/CDRH) ; Giroir, Brett (HHS/OASH) ; Stenzel, Timothy (FDA/CDRH) ; Schwartz, Suzanne (FDA/CDRH) Cc: Haddad, Carla (HHS/OASH) ; Bante, Katie (OS/OASH) ; McGowan, Robert (Kyle) (CDC/OD/OCS) ; Lenihan, Keagan (FDA/OC) ; Monroe, Steve (CDC/DDPHSS/OLSS/OD) Subject: Re: Testing Huddle 08:30 works for me AMERICAN PVERSIGHT HHS-20-0580-A-000158 Steve Monroe , PhD Assoc Dir Lab Sci &Safety CDC Sent using Outlook for Android From: Shuren, Jeff Sent: Wednesday, March 11, 2020 6:33:33 AM To: Giro ir, Brett (HHS/OASH) ; Stenzel, Timothy (FDA/CDRH) ; Monroe, Steve (CDC/DDPHSS/OLSS/OD); Schwartz, Suzanne (FDA/CDRH) Cc: Haddad, Carla (HHS/OASH) ; Bante, Katie (OS/OASH) ; McGowan, Robert (Kyle) (CDC/OD/OCS) ; Lenihan, Keagan ( FDA/OC) Subject: Re: Testing Hudd le 8:30 would be great. Will include Suzanne , as well. In addition we are making arrangements with the FDA ' s emergency operat ion center to have a 24/7 call line for technical assistance. From: Giroir , Brett (HH S/OASH) Date: March 11, 2020 at 6:28:28 AM EDT To: Shuren , Jeff , Stenzel, Timothy , Monroe , Stephan S (CDC) Cc: Haddad , Carla (OS) , Bante, Katie (OS) , McGowan, Robert K (CDC) , Lenihan , Keaga n Subject: Testing Huddle Importance: High b)(5) AMEHICAN PVERSIGHT HHS-20-0580-A-000159 Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 Sender: Giroir, Brett (HHS/OASH) Monroe, Steve (CDC/DDPHSS/OLSS/OD) ; Shuren, Jeff (FDNCDRH) ; Stenzel, Timothy (FDA/CDRH) ; Schwartz, Suzanne (FDA/CDRH) ; Haddad, Carla (HHS/OASH) ; Bante, Katie (O5/OASH) ; McGowan, Robert (Kyle) (CDC/OD/OCS) ; Lenihan, Keagan (FDNOC) ; Monroe, Steve (CDC/DDPHSS/OLSS/OD) Sent Date: 2020/03/11 06:51:56 Delivered Date: 2020/03/11 06:51:58 AMERICAN PVERSIGHT HHS-20-0580-A-000160 Giroir, Brett (HHS/OASH) Bante, Katie (OS/OASH) Shuren, Jeff (FDA/CDRH); Stenzel, l7mothy (FDA/CDRH); Monroe, Steve (CDC/DDPHSS/OLSS/OD) ; Lenihan, Keagan (FDA/OC) ; To: Kellogg, Rachel (HHS/OASH); Bante, Katie (OS/OASH); Haddad, Carla (HHS/OASH); Schwartz, Suzanne(FDA/CDRH); Valentine, Steven (HHS/OASH) Subject: COVID Testing Date: 2020/03/11 08:16:54 Start Date: 2020/03/11 08:30:00 End Date: 2020/03/11 09:00:00 Priority: Normal Type: Schedule.Meet ing.Request Location: Call bridge:l(b)(6) !Participants: l(b)(6) I Shuren, Jeff (FDA/CDRH);Stenzel, Timothy (FDA/CDRH);Monroe, Steve (CDC/DDPHSS/OLSS/OD); Lenihan, Keagan (FDA/OC); Kellogg, Rachel (HHS/OASH);Bante, Attendees: Katie (OS/OASH); Haddad, (aria (HHS/OASH);Schwartz, Suzanne(FDA/CDRH);Valentine, Steven (HHS/OASH) Giroir, Brett (HHS/OASH) ; Bante, Katie (OS/OASH) Shuren, Jeff (FDA/CDRH); Stenzel, l7mothy (FDA/CDRH); Monroe, Steve (CDC/DDPHSS/OLSS/OD) ; Lenihan, Keagan (FDA/OC) ; Kellogg, Rachel (HHS/OASH); Bante, Katie (OS/OASH); Haddad, Carla (HHS/OASH); Schwartz, Suzanne(FDA/CDRH); Valentine, Steven (HHS/OASH) Sent Date: 2020/03/11 08:16:51 Delivered Date: 2020/03/11 08:16:54 AMERICAN PVERSIGHT HHS-20-0580-A-000162 Haddad, Carla (HHS/OASH) To: Haddad, Carla (HHS/OASH) Subject: Increased telehealth flexibilities for pharmacists Date: 2020/03/16 17:30:22 Due Date: 2020/03/15 20:00:00 Priority: Normal Type: Note b)(5) Haddad, Carla (HHS/OASH) Recipient: Haddad, Carla (HHS/OASH) Sent Date: 2020/03/16 17:30:20 Delivered Date: 2020/03/16 17:30:22 AMERICAN PVERSIGHT HHS-20-0580-A-000163 Reed, Paul(HHS/OASH) To: Haddad, (aria (HHS/OASH) Subject: RE: HUD/HHSdiscussionon low income impacts Date: 2020/03/11 10:34:23 Priority: Normal Type: Note (b)(5) p~ CAPT Paul Reed, MD U.S. Public Health Service --- "In Officio Sa/utis" Deputy Assistant Secretary for Health (Medicine and Science) Office of the Assistant Secretary for Health Department of Health and Human Services From: Haddad, Carla (HHS/OASH) Sent: Wednesday, March 11, 2020 10:17 AM To: Reed, Paul (HHS/OASH) Subject: RE: HUD/HHS discussion on low income impacts From: Reed, Paul (HHS/OASH) Sent: Wednesday, March 11, 2020 9:20 AM To: Haddad, Carla (HHS/OASH) Subject: Re: HUD/HHS discussion on low income impacts b)(5) AMEHICAN PVERSIGHT HHS-20-0580-A-000164 CAPT Paul Reed , MD U.S . Public Health Service Deputy Assistant Secretaiy for Health Department of Health and Human Services On: 11 March 2020 09: 15, "Haddad, Carla (HHS/OASH)" wrote: Good morning CAPT Reed, Are you able to join this call today? ADM Giroir is on the invite as well but likely will not be able to attend so I want to make sure there is coverage. Thanks, Carla -----Original Appointment----From: Lim, Evelyn Sent: Wednesday, March 11, 2020 8:40 AM To: Lim, Evelyn; Seats, Christopher L; Little, Jeffrey D; Kaelin, Karolyn A; Butler, Jay C. (CDC/DDID/OD); Peacock, Georgina (CDC/DDNID/NCBDDD/DHDD); Reed, Paul (HHS/OASH); Macrae, Jim (HRSA); HHhauck@hrsa.gov ; Giroir, Brett (HHS/OASH) Subject: HUD/HHS discussion on low income impacts When: Wednesday, March 11, 2020 2:30 PM-3:00 PM (UTC-05:00) Eastern Time (US &Canada). I Where:l (b)(B) Dear HHS partners, The sub task force directed HUD and HHS to provide them a summary of what we are doing for low income individuals, multi family properties , and the homeless. This discussion is to ensure we have coordinated our plans and messages so that we may provide a summa1y to the TF. Please forward if I've missed anyone. Thank you, Evelyn C: Kb)(6) I Sender: Recipient: Reed, Paul (HHS/OASH) Haddad, Carla (HHS/OASH) Sent Date: 2020/03/11 10:34:22 Delivered Date: 2020/03/11 10:34:23 AMERICAN PVERSIGHT HHS-20-0580-A-000165 Giroir, Brett (HHS/OASH) To: Campbell, Taylor (O5/OASH) Haddad, carla (HHS/OASH); Kellogg, Rachel (HHS/OASH); Valentine, Steven (HHS/OASH); CC: Wainwright, Jacob (HHS/OASH/IO) ; Heck, Mia (HHS/OASH); Broida, Tara (HHS/OASH) Subject: RE: **FOR REVIEW--URGENT**CLEARANCE_0248: CDC"Coronavirus Disease2019 (COVID19) Update: Diagnostic test supplies" Date: 2020/03/11 15:32:26 Priority: Normal Type: Note I got this directly and already CLEARED Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Campbell, Taylor (OS/OASH) Sent: Wednesday, March 11, 2020 3:31 PM To: Giroir, Brett (HHS/OASH) Cc: Haddad, Carla (HHS/OASH) ; Kellogg, Rachel (HHS/OASH) ; Valentine, Steven (HHS/OASH) ; Jacob (HHS/OASH/1O) ; Wainwright, Heck, Mia (HHS/OASH) ; Broida, Tara (HHS/OASH) Subject: **FOR REVIEW--URGENT** CLEARANCE_0248:CDC "Coronavirus Disease 2019 (COVID-19) Update: Diagnostic test supplies" Importance: High ADM Giro ir, AMERICAN PVERSIGHT HHS-20-0580-A-000166 b)(5) Thank you Taylo r From: OS HHSPress (HHS/ASPA) Sent: Wednesday, March 11, 2020 3:13 PM To: OS - ASPA- Clearance ; OS OGC-IO Contro lDesk (HHS/OS/OGC) ; Stecker, Judy (OS/IOS) ; Murphy, Ryan (OS/ASPA) ; Caliguiri, Laura (FDA/OC) ; Giroir, Brett (HHS/OASH) ; Steele , Danielle (HHS/IOS) ; White, Caroline (HHS/OGC) ; Stimson, Bri an (HHS/OGC) ; Charrow, Robert (HHS/OGC) ; Keveney, Sean (HHS/OGC) ; Chang, W illiam (HHS/OGC) ; Barry, Danie l J (HHS/OGC) ; Amin, Stacy (FDA/OC) ; ASPRCOMMS ; ASPRMEDIA (OS/ASPR/COO) ; Routh , Jenn ifer (NIH/NIAID) [El ; Conrad , Patricia (NIH/NIAID) [El ; Billet , Courtney (NIH/NIAID) [El ; Wojtowicz , Emma (NIH/OD) [El ; Akinso, Wo leola (NIH/OD) [El ; Fine, Amanda (NIH/OD) [El ; Fritz, Craig (NIH/OD) [El ; My les, Renate (NIH/OD) [El ; Broida, Tara (HHS/OASH) ; Channer, Amber (OS/OASH) ; Heck, Mia (HHS/OASH) ; Kotwick i, Lauren (HHS/OASH) ; Migliacc io-Grabill , Kate (HHS/DASH) ; Sherman , Jennifer (HHS/OASH) ; Bonds, Michel le E. (CDC/OD/OADC) ; Galatas, Kate (CDC/OD/OADC) ; Heldman, Amy B. (CDC/OD/OADC) ; Patr ick, Kera (CDC/OD/OADC) ; CDC OADC ASPA Clearance Cc:OS HHSPress (HHS/ASPA) ; Caccamo, Stephanie (FDA/OC) ; 20 19-nCoV FDA IMG JIC <2019-nCoVFDAIMGJIC@fda.hhs.gov >; OCOEAOMA-Press (FDA) <0COEAOMA -Press@fda.hhs.gov > Subject: CLEARANCE_0248:CDC "Coronav irus Disease 2019 (COVID-19) Update: Diagnostic test supplies " Importance: High CLOSE-HOLD/ URGENT Agency /Offic e: CDC AMERICAN PVERSIGHT HHS-20-0580-A-000167 Subject: Coronavirus Disease 2019 (COVID-19) Update: Diagnostic test supplies b)(5) V/r, Mike Robinson Strategic Planning, ASPA 202-690-6885 -desk I-mobile rb )(B) INTERNAL HHS USE ONLY! INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BYLAW: This information has not been publically disclosed and may be privileged and confidential. This document must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the full extent of the law. Sender: Giroir, Brett (HHS/OASH) Campbell, Taylor (O5/OASH) ; Haddad, Carla (HHS/OASH) ; Kellogg, Rachel (HHS/OASH) ; Valentine, Steven (HHS/OASH) ; Wainwright, Jacob (HHS/OASH/IO) ; Heck, Mia (HHS/OASH) ; Broido, Tara (HHS/OASH) Sent Date: 2020/03/11 15:32:25 Delivered Date: 2020/03/11 15:32:26 AMERICAN PVERSIGHT HHS-20-0580-A-000168 Giroir, Brett (HHS/OASH) Pence, Laura (HHS/ASL) ; Car> Arbes, Sarah (HHS/ASL) Subject: RE: 11: 15 friday Date: 2020/03/05 17:11:12 Priority: Normal Type: Note Carla setting up with you She is my new COS We can make it work Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 -----O rigina l Message----From: Pence, Laura (HHS/ASL) Sent: Thursday , March 5, 2020 4:57 PM To: Giroir, Brett (HHS/OASH) ; Harder, Kristina (HHS/IOS) Cc: Arbes, Sarah (HHS/ASL) Subject: 11: 15 friday b)(5) Giroir, Brett (HHS/OASH) Pence, Laura (HHS/ASL) ; Haddad, Carla (HHS/OASH) ; Arbes, Sarah (HHS/ASL) Sent Date: 2020/03/05 17: 11:10 Delivered Date: 2020/03/05 17: 11: 12 AMERICAN PVERSIGHT HHS-20-0580-A-000169 Trent-Adams, Sylvia (HHS/OASH) From: GROUP (FYDIBOHF23SPDLT)/CN= RECIPIENTS/CN=650D027641442169334514 Valentine, Steven (H HS/OASH) ; Haddad, Carla (HHS/OASH) ; To: Broido, Tara (HHS/OASH) ; Heck, Mia (HHS/OASH) Subject: FW: Thank you - and follow-up email Date: 2020/03/17 19:01:43 Priority: Normal Type: Note FYSA From: Baker, Michael (OS/IEA) Sent: Tuesday, March 17, 2020 6:58 PM To: Baker, Michael (OS/IEA) Cc: Trent-Adams, Sylvia (HHS/OASH) Subject: Thank you - and follow-up email Dear State Health Officials Thank you so much for listening to HHS on the ASTHO call earlier this evening. As we mentioned, our goal is to increase the synergy between the testing operations that have stood up and the rollout of the HHStesting sites across the country. We hope to highlight locations for testing for COVID-19 everywhere in the nation. If you are willing and able to share the information from testing sites in your states, we would greatly appreciate it. Please find below some of the key pieces of information that we are seeking. - Facility Name - Facility Address o Street Address o City o County o State - o Zip code Phone Number (if applicable) - Days/Hours of Operation Requirements for Testing, if any (i.e. note from physician, age, symptoms, travel) Drive-thru, walk-in, or other? {If other, please specify.) AMERICAN PVERSIGHT HHS-20-0580-A-000170 We thank you for your continued partnership and support. ASTHO and its members have always been a key partner of HHS, and we appreciate everything that you do. Please don't hesitate to reach out to me if there are any questions. I can be reached via email or my phone number below. Thank you! Michael Michael Baker Office of Intergovernmental and External Affairs Office of the Secretary U.S. Department of Health and Human Services 202-439- 7829 Trent-Adams, Sylvia (HHS/OASH) Valentine, Steven (HHS/OASH); Haddad, Carla (HHS/OASH); Recipient: Broida, Tara (HHS/DASH) ; Heck, Mia (HHS/OASH) Sent Date: 2020/03/17 19:01:42 Delivered Date: 2020/03/17 19:01:43 AMERICAN PVERSIGHT HHS-20-0580-A-000171 Giroir, Brett (HHS/OASH) Bante, Katie (OS/OASH) To: Haddad, Carla (HHS/OASH) Subject: FW: COVIDTesting Date: 2020/03/11 07:43:42 Start Date: 2020/03/11 08:30:00 End Date: 2020/03/11 09:00:00 Priority: Normal Type: Schedule.Meeting.Request Location: b)(6) !Participant: l(b)(6) I From: Giroir, Brett (HHS/OASH) Sent: Wednesday, March 11, 2020 11:03:00 AM UTC To: Giroir, Brett (HHS/OASH);Shuren, Jeff (FDA/CDRH);Stenzel, Timothy (FDA/CDRH);Monroe, Steve (CDC/DDPHSS/OLSS/OD); Lenihan, Keagan(FDA/OC); Kellogg, Rachel(HHS/OASH);Bante, Katie (O5/OASH) Subject: COVIDTesting When: Wednesday March 11, 2020 12:30 PM-1:00 PM. Wherekb)(6) I Participant: l(b)(6) I Giroir, Brett (HHS/OASH); Bante, Katie (OS/OASH) Recipient: Haddad, Carla (HHS/OASH) Sent Date: 2020/03/11 07:43:39 Delivered Date: 2020/03/11 07:43:42 AMERICAN PVERSIGHT HHS-20-0580-A-000172 Giroir, Brett (HHS/OASH) Giroir, Brett (HHS/OASH); Kadlec, Robert (OS/ASPR/IO); Yeskey, Kevin (OS/ASPR/IO); Mccreary, Kenneth (OS/ASPR/SPPR) ; Flowers, Artensie (O5/ASPR/EMMO); Adams, Steven A. (ASPR/SNS); Cooper, Kevin (OS/ASPR/ORM); Dozer, Joshua (fema.dhs.gov) ; Kellogg, Rachel(HHS/OASH); Orsega, Susan (OS/OASH); Smith, Brad (CMS/OA); Robinson, William (CMS/CMMI) Schwartz, Erica (HHS/OASH); Guyton, Cedric (OS/OASH); CC: Trent-Adams, Sylvia (HHS/OASH); Smith, Damon (HHS/OASH); Dellamura, Joseph Subject : COVID Meeting re: Supplies Date: 2020/03/13 22:45:21 Start Date: 2020/03/14 08:30:00 End Date: 2020/03/14 09:00:00 Priority: Normal Type: Appointment Location: HHH 716-G II Call-inl(b)(6) I Pc~b)(6) I Giroir, Brett (HHS/OASH);Kadlec, Robert (OS/ASPR/IO);Yeskey, Kevin (OS/ASPR/IO); Mccreary, Kenneth (O5/ASPR/SPPR);Flowers,Artensie (OS/ASPR/EMMO);Adams, Steven A. (CDC/SNS/DSNS);Cooper, Kevin (OS/ASPR/ORM);Dozar, Joshua (fema.dhs.gov); Rachel Attendees: Kellogg (HHS/OS)(Rachel.Kellogg@hhs.gov);Orsega, Susan (OS/OASH);Smith, Brad (CMS/OA); Robinson,William (CMS/CMMI);Schwartz, Erica (HHS/OASH) (Erica.Schwartz@hhs.gov);Guyton, Cedric (OS/OASH)(Cedric.Guyton@hhs.gov);Trent-Adams, Sylvia (HHS/OASH);Smit h, Damon (HHS/OASH);Dellamura, Joseph Team ASPR, We are having a meeting at 0830 tomorrow morning in ADM Giroir's conference room {729-G) to discuss COVID lab testing site plans. We need ASPRin the room to discuss SNSand additional ASPRsupport. The team will include ADM Giroir, Brad Smith and FEMA. Please confirm who will be in attendance. AMERICAN PVERSIGHT HHS-20-0580-A-000173 Thank you, Rachel RachelKellogg,RN Policy Advisor Office of the Assistant U.S. Department Mobile:l(b)(6) Secretary for Health of Health & Human Services I Giroir, Brett (HHS/OASH) Giroir, Brett (HHS/OASH) ; Kadlec, Robert (O5/ASPR/IO) ; Yeskey, Kevin (OS/ASPR/IO) ; Mccreary, Kenneth (OS/ASPR/SPPR) ; Flowers, Artensie (OS/ASPR/EMMO) ; Adams, Steven A. (ASPR/SNS) ; Cooper, Kevin (OS/ASPR/ORM) ; Dozar, Joshua (fema.dhs.gov) ; Kellogg, Rachel (HHS/OASH) ; Orsega, Susan (OS/OASH) ; Smith, Brad (CMS/OA) ; Robinson, William (CMS/CMMI) ; Schwartz, Erica (HHS/OASH) ; Guyton, Cedric (OS/OASH) ; Trent-Adams, Sylvia (HHS/OASH) ; Smith, Damon (HHS/OASH) ; Dellamura, Joseph Sent Date: 2020/03/13 22 :45 :2 1 AMERICAN PVERSIGHT HHS-20-0580-A-000174 Kadlec, Robert (OS/ASPR/IO) Kadlec, Robert (OS/ASPR/IO) ; Swain, Matthew (OS/ONC) ; Matthews, Ebonie (OS/ONC) (CTR) ; Ford-Barnes, Arwenthia (OS/ ASPR/IO) ; Shuy, Bryan (OS/ASPR/IO) ; Austin, Meredith (uscg .mil) ; To: Moreno, Rafael (OS/ ASPR) < Rafael. Moreno@hhs.gov>; Sauer, Michael (OS/ASPR) ; Yeskey, Kevin (OS/ASPR/IO) ; Holland, Tara (OS/ASPR/EMMO) ; Kost, Michelle (OS/ONC) ; Hunt, Richard (OS/ASPR/EMMO) CC: Rucker, Donald (OS/ONC) Subject: TO BE RESCHEDULED:Dr. Donald Rucker - National Coordinator of Health IT - Discuss open source app Date: 2020/03/05 17:24 :31 Start Date: 2020/03/06 12:00:00 End Date: 2020/03/06 12:30:00 Priority: Normal Type: Appointment Location: I 330 Switzer Bldg, NC Conference Room (7010) -rb )(B) ~Participant) Kadlec, Robert (OS/ASPR/IO); Swain, Matthew (OS/ONC); Matthews, Ebonie (OS/ONC) (CTR); Ford-Barnes, Arwenthia (OS/ASPR/1O); Shuy, Bryan (OS/ASPR/IO) (Bryan.Shuy@hhs .gov); Attendees: Austin, Meredith (uscg.mil); Moreno, Rafael (OS/ASNIOS); Sauer, Michael (OS/ASPR); Yeskey, Kevin (OS/ASPR/IO); Holland, Tara (OS/ASPR/EMMO); Kost, Michelle (OS/ONC); Hunt, Richard (OS/ASPR/EMMO); Rucker, Donald (OS/ONC) Good morn ing, (b)(6) Can ou lease add this call-in number to the appointment? b)(6) l ~-------------~ Please send me the bio/any and all information on Ramesh Raskar from MIT's Media Lab as soon as possible. ASPR Meeting Request Form Dr. Robert P. Kadlec Assistant Secretary for Preparedness and Response (ASPR) 200 Independence Ave, SW- Washington DC 20201 AMERICAN PVERSIGHT HHS-20-0580-A-000175 Date of your request : March 5, 2020 11 Date/time of the event: (DUE TO THE HIGH DEMAND MEETING REQUEST(S) WITH DR. KADLEC EACH MEETING WILL BE MAX TO 30MINSFriday , March 6 th THE FORM MUST BE COMPLETED AND RETURNED TO ME BEFOREYOUR MEETING IS CONFIRMED Topic of the meeting: Objective/Goa I of the meeting: Lead Staff /Who did you speak to about your request: (Dr. Kadlec requested this meeting is NOT an answer) Discuss open source app (in beta stage) with Ramesh Raskar from MIT's Media Lab . This app is part of an alliance between the Mayo Clinic, MIT , Harvard and WHO: A digital privacy preserving solution to allow individuals to learn about their own expo sure and risks to epidemics . A demonstration of a secure and private solution that will ease privacy concerns as well as ' transparency vs utility ' trade off for the health officials. The key idea is to (i) allow an individual to learn if they have been near someone who was later diagnosed as infected (ii) provide this ability WITHOU T the user ever sharing their raw information to anyone else and (iii) provide tools for health authorities to share the trails of infected individuals without ever sharing the raw information with anyone . Dr. Don Rucker, National Coordinator of HealthIT Has this request been approved by anyone from the Immediate Office (10) staff? If yes, by whom? Dr. Kadlec's Role (make a decision/way forward): Infonnational Who is request ing this meeting/POC Dr. Donald Rucker, ational Coordinator of HealthI T (Name, Cell and email): (Dr. Kadlec requested this meeting Donald.Rucker@hhs.gov Phone: 202 - 401 -5197 is not sufficient/be specific) Proposed Timing for the meeting: 30m ins/45mins/1 hour: AMERICAN PVERSIGHT Request 30min. l 2noon - 12:30pm HHS-20-0580-A-000176 Is a Conference Call Line needed? If so, who will initiate the conference call? Yes - O C will initiate the call Exact location/ city/ state/room 330 Switzer Bldg , number of the event/meeting: C Conference Room (70 I 0) Will there be briefing material provided? If yes, please send to Arwenthia Ford-Barnes and No Victoria Callahan BY NOON THE DAY BEFOREYOUR ACTUAL MEETING HHSStaff Attendees: External Attendees (please provide name/title/email) Kevin. Yesky- Kevin.Yeskey@hhs.govRichard Hunt Richard.Hunt@hhs.gov Ramesh Raskar, Ass. Professor, MIT Media Lab raskar(a),media.mit.edu POC FOR THE ASPR: Arwenthia.FordBames(@,hhs.gov - off: 202 205 8905 iphone: ~b)(6) I Kadlec, Robert (OS/ASPR/1O) Kadlec, Robert (OS/ASPR/IO) ; Swain, Matthew (O5/ONC) ; Matthews, Ebonie (O5/ONC) (CTR) ; Ford- Barnes, Arwenthia (O5/ASPR/IO) ; Shuy, Bryan (O5/ASPR/IO) ; Austin, Meredith (uscg.mil) ; Recipient: Moreno, Rafael (OS/ASPR) ; Sauer, Michael (OS/ASPR) ; Yeskey, Kevin (OS/ASPR/IO) ; Holland, Tara (O5/ASPR/EMMO) ; Kost, Michelle (O5/ONC) ; Hunt, Richard (O5/ASPR/EMMO) ; Rucker, Donald (O5/ONC) Sent Date: 2020/03/05 17:24:31 AMERICAN PVERSIGHT HHS-20-0580-A-000177 From: Sherman, Susan (HHS/OGC); Greene, Jonathan (OS/ASPR/EMMO); Lee, Scott (OS/ASPR/EMMO) Subject: Re: URGENTfb) (5) URGENT 1- Date: 2020/02/21 23:07:37 Priority: Normal Type: Note b)(5) Sent from my iPhone On Feb 21, 2020, at 10:54 PM, Sherman , Susan (HHS/OGC) wrote: n b)(5) On Feb 21, 2020, at 8:17 PM, Yeskey, Kevin (OS/ASPR/IO) wrote: Jen and Susan, Kevm Sent from my iPhone Begin forwarded message: From: "Osinoff, Joanne (USACAC)" Date: February 21, 2020 at 8:08:29 PM EST To: "Hunt, Marty (USDOJ.GOV )" , "Lamana, Joseph AMERICAN PVERSIGHT HHS-20-0580-A-000178 (OS/ASPR/EMMO)" , "Yeskey, Kevin (OS/ASPR/1O)" , "Falcon, Jessica (OS/ASPR/SIIM)" , "Rotz, Lisa (CDC/DDID/NCEZID/DGMQ)" , "De La Motte Hurst, Christopher (CDC/DDID/NCEZID /DGMQ)" , "Misrahi , James J. (CDC/OCOO/OGC)" Cc: "Harris, David M. (USACAC)" , "Beck, Daniel (USACAC)" Subject: URGENT - b)(5 ) b)(5) URGENT □ Gentle persons: (b)(5) Thank you. Joanne Osinoff Joanne S. Osinoff I Assistant United States Attorney Chief I General Civil Section United States Attorney's Office I Central District of California Federal Building, Room 7516 I 300 N. Los Angeles St. Los Angeles, California 90012 T: 213.894.68801 F: 213.894.7819 1Joanne.Osinoff@usdoj.gov AMERICAN PVERSIGHT I HHS-20-0580-A-000179 From: Nahal Kazemi Sent: Friday, February 21, 2020 3:19 PM To: Hanna, Nick (USACAC); usacac.civil@usdoj.com ; USACAC-CV-CivilRights Subject: Notice of Ex Parte TRO application Dear Counsel: We represent the City of Costa Mesa, California and Katrina Foley, in her individual capacity as a Costa Mesa resident. We understand that the United States of America, the United States Department of Health and Human Services, the United States Department of Defense, the United States Air Force, the Centers for Disease Control and Prevention, the State of California, Fairview Developmental Center (Fairview), the California Governor's Office of Emergency Services, and the California Department of General Services (the "Defendants") intend to relocate from 35-50 patients individuals already diagnosed with the Coronavirus from a secure location on Travis Air Force Base, where they are isolated from population centers, to Costa Mesa, a densely populated city within a county of over 3 million. And that, further, Defendants plan to do so without first determining the suitability of the facility where these individuals will be housed. The Defendants' plan was announced at the eleventh hour, late last night, with no efforts to include local government leaders or public health officials. Based upon these planned actions, the City of Costa Mesa and Ms. Foley will be filing an ex parte application for a temporary restraining order in the United States District Court for the Central District of California later today. The ex parte application will seek an order asking the Court to order Defendants to refrain from transferring individuals exposed to or infected with the Coronavirus to Fairview in Costa Mesa until an adequate site survey can be completed, and, if the facility can be made suitable for this purpose, until all necessary improvements to the facility are made to ensure the housing of infected individuals there possess no threat to the health and safety of the community. The City and Ms. Foley will assert that granting this relief under Federal Rule of Civil Procedure 65, the Administrative Procedure Act, 42 U.S.C.§ 1983, the Fifth and Fourteenth Amendment rights to procedural and substantive due process, and the Tenth Amendment. AMERICAN PVERSIGHT HHS-20-0580-A-000180 Please let us know immediately by email or telephone if the Government intends to oppose the application. If we do not hear from you within the next 30 minutes, we will inform the Court that we have not received the Government's position. Regards, Nahal Kazemi ahal Kazemi Senior Counsel 18300 Von Karman Ave., Suite 930 I Irvine, California 92612-1057 949.476.8700 Fax 949.476.0900 nkazemi@kelleranderle.com I https://protect2.fireeye.com/url?k= lc885a3a-40dc4346-lc886b05-0cc47adc5fa243deebdb305b611a&u=http://www.kelleranderle.com/ CONFIDENTIALITY NOTICE: This e-mail transmission, and any documents, files or previous e-mail messages attached to it, may contain confidential informat ion that is legally privileged. If you are not the intended recipient, or a person responsible for delivering it to the intended recipient, you are hereby notified that any disclosure, copying, distribution or use of any of the information contained in or attached to this message is STRICTLY PROHIBITED.If you have received this transmission in error, please immediately notify us by reply e-mail at info@kelleranderle.com or by telephone at 949.476.8700 and destroy the original transmission and its attachments without reading them or saving them to disk. Thank you. David and Joanne, Please see the below notification of the intent to use the Fairview Developmental Center to house individuals infected with coronavirus. The email was sent last night from the California Office of Emergency Services to the Emergency Manager for the City of Costa Mesa (Jason Dempsey). Please note that the email indicates the infected persons at Travis AFB are under a federal quarantine, according to Mr. Acosta. As I mentioned on the phone, I will send conformed copies of our filings when they are available. Thank you. Nahal Naha l Kazemi Senior Counsel AMERICAN PVERSIGHT HHS-20-0580-A-000181 18300 Von Karman Ave., Suite 930 I Irv ine, Californ ia 92612- 1057 949.476 .8700 Fax 949.476 .0900 nkazemi@kelleranderle.com I https://protect2.fireeye.com/url?k= 09bccdf5-55e8d489-09bdcca-0cc47adc5fa2d2a2aec623b82db l&u =http://www. kelleranderle .com/ CONFIDENTIALITY NOTICE: This e-mail transmission, and any documents, fi les or previous e-mail messages attached to it, may contain confidential information that is legally privileged. If you are not the intended recipient, or a person responsible for delivering it to the intended recipient, you are hereby notified that any disclosure, copying, distribution or use of any of the information contained in or attached to this message is STRICTLY PROHIBIT ED. If you have received this t ransmission in error, please immediately notify us by reply e-mail at info@kelleranderle.com or by telephone at 949.476.8700 and destroy the original tra nsmission and its atta chments w ithout reading them or saving them to disk. Thank you. From : Acosta, Jim@CalOES(mailto:Jim.Acosta@CalOES.ca.govl Sent: Thursday, February 20, 2020 6:18 PM To: DONNA BOSTON; DEMPSEY,JASON S. Cc: Weiss, Dan@CalOES; Brown, Sonia@CalOES; Ponce, Cruz@Caloes Subject : Fairview para meters These guidelines are proposa ls at th is t ime, and are for off icial use only not for release. Jim Acosta Regional Admin istrator (Acting) California Governor's Office of Emergency Services Southern Region Operat ions Office : (562 795-2939 b)(B) Mobile : .__ _. _____ Jim.acosta@caloes .ca.gov Protocol for Symptomatic Persons Wh ile at Travis Air Force Base, under a federal quarant ine order , HHS medical staff w ill evaluate and prov ide medical care. If an ind ividual presents with Nove l Coronavirus symptoms the following protocol would be imp lemented. • Individua l would be transported by local ambulance provider to a nearby health care facility where they would be evaluated and tested for Nove l Coronavirus. AMERICAN PVERSIGHT HHS-20-0580-A-000182 • If test is positive, the person would be provided supportive care. They would not return to Travis Air Force Base, instead they would be transferred either to Fairview Developmental Center (California residents) or Alabama (non -California residents). • If test is negative, the person would be discharged and sent back via ambulance to Travis Air Force Base to finish out the remainder of their quarantine order. Sheltering for Confirmed Positive Persons Those individuals who test positive, once they have been provided supportive care and are able to be discharged: • Federal HHS would transport any individual tested positive, who is a California resident, and once provided supportive care and stabilized, to Fairview Developmental Center via air ambulance. • Non-California residents would be transferred by federal HHS to Alabama. Fairview Developmental Center Operational Logistics • Planning assumption that we would expect 30 -50 individuals. • Federal HHS would need to commit to providing the following: • Security and potential fencing • Onsite medical care including primary care, mental health, and supportive care • Wrap -around Services • Feeding AMERICAN PVERSIGHT HHS-20-0580-A-000183 • Cleaning and sanitation • Case management and logistics for departure • Individuals who would require hospitalization would be transported via ambulance to a local health care facility in Orange County. Sender: Sherman, Susan (HHS/OGC); Greene,Jonathan (OS/ASPR/EMMO); Lee, Scott (OS/ASPR/EMMO) Sent Date: 2020/02/21 23:07:36 Delivered Date: 2020/02/21 23:07:37 Message Flags: Unsent AMERICAN PVERSIGHT HHS-20-0580-A-000184 Yeskey, Kevin (OS/ASPR/IO) Thompson, Donna (OS/ASPR/IO) (CTR) OS - ASPR - PDAS ; SNS DISTRO (OS/ASPR) ; Wong, Diana (OS/ASPR/SIIM) ; Asher, Jason (OS/ASPR/SIIM) (CTR) ; To: Clay, Matt (OS/ASPR/SIIM) (CTR) ; Imbr iale, Samuel (OS/ASPR/SIIM) ; Rybak, Bailey (OS/ASPR/OEA) ; ; ; Thompson, Donna (OS/ASPR/IO) (CTR) ; Genzer, Boris (OS/ASPR/MFHC) (CTR) ; Jenkins, Karren (OS/ASPR/MFHC) ; Lamana, Joseph (OS/ASPR/EMMO) ; Lightne r, Louis (OS/ASPR/EMMO) ; Maccorkle, Matthew (OS/ASPR/ORM) (CTR) ; Lincoln, Carol (OS/ASPR/EMMO) ; Csernak, David (OS/ASPR/EMMO) ; Jackson, Jacklyn (OS/ASPR/EMMO) ; Garza, Roberto (OS/ASPR/EMMO) ; Chaboudy, Mary (OS/ASPR/MFHC) ; Beaty, Garrett (OS/ASPR/ORM) ; Hastings, Elizabeth (OS/ASPR/EMMO) ; Burks, Dagayla (OS/ASPR/EMMO) (CTR) ; Birdwell, Grace (OS/ASPR/PDAS/MFHC) (CTR) ; Hoang, Due (OS/ASPR/ORM) ; Okyere, Isaiah (OS/ASPR/MFHC) ; Levine, Cheryl (OS/ASPR/EMMO) ; Thomas, Richard (OS/ASPR/EMMO) ; AMERICAN PVERSIGHT HHS-20-0580-A-000185 Brannman, Shayne (O5/ASPR/EMMO) ; Harahan, Kevin (O5/ASPR/EMMO) ; Roman, Maurice (OS/ASPR/ORM) ; Petillo, Jay (OS/ASPR/MFHC) ; Martin, Andrewnette (O5/ASPR/MFHC) ; Glost er, Kimberly (OS/ASPR/MFHC) ; Harris, Kimberly (OS/ASPR/MFHC) (CTR) ; Sheehan, Christopher (OS/ASPR/EMMO) ; Littlefield, Jill (OS/ASPR/EMMO) (CTR) ; Huie, Jimmy (CDC/SNS/DSNS) ; Lepore, Kristen (OS/ASPR/EMMO) (CTR) ; Libby, Mark (OS/ASPR/EMMO) ; Mensah, Eric Oswald Kouete (CDC/SNS/DSNS) ; Baker, Mary (CDC/SNS/DSNS) ; Williams, Bob (OS/ASPR/ORM) ; Ohaya, Adolphus (CDC/SNS/DSNS) (CTR) ; Barton, Jessie-Kate (OS/ASPR/EMMO) ; Braxton, Makoto (OS/ASPR/ORM) ; Moore, William (OS/ASPR/EEAA) ; Rubio, Cynth ia (OS/ASPR/ORM) ; Lamoureux, Joseph (OS/ASPR/EMMO) ; Reyes, Francisco (CDC/SNS/DSNS) ; Aufenanger, Sharyn (OS/ASPR/MFHC) ; Lofton, Adam (OS/ASPR/EMMO) ; Adams, Michael (CDC/SNS/DSNS) ; Sturrock, Lochlin (OS/ASPR/EMMO) ; Jackson, Linda (HHS/ASPR) ; Vento, Stephany (OS/ASPR/EMMO) ; Mazurek, Audrey (OS/ASPR/EMMO) (CTR) ; Reyes, Elizabeth (OS/ASPR/MFHC) ; AMERICAN PVERSIGHT HHS-20-0580-A-000186 Missimer, Steven (O5/ASPR/MFHC) ; Bell, Gary (OS/ASPR/ORM) (CTR) ; Eisemann, Darla (OS/ASPR/MFHC) ; Sims, Shane (O5/ASPR/EMMO) ; Qadri, Shafi A. (CDC/SNS/DSNS) (CTR) ; Cua, Eduardo (O5/ASPR/EMMO) ; Sturrock, Kenneth (OS/ASPR/EMMO) ; Martin, Jyl (OS/ASPR/SPPR) ; Mcdaniel, Michele (OS/ASPR/EMMO) ; Hernandez, Cameron (OS/ASPR/ORM) ; Woodfolk, Diana (OS/ASPR/MFHC) ; Herrmann, Jack (OS/ASPR/OEA) ; Bossler, Sumner (O5/ASPR/ORM) ; Finne, Kristen (OS/ASPR/EMMO) ; Brown, Michael (CDC/SNS/DSNS) (CTR) ; Eapen, Shirley (CDC/SNS/DSNS) (CTR) ; Kemp, Micha (OS/ASPR/MFHC) ; Brown, Daneen (OS/ASPR/MFHC) (CTR) ; Scott, Danita (OS/ASPR/ORM) ; Administrative Zane, Thomas C. (CDC/SNS/DSNS) (CTR) ; Brown, Marsha (OS/ASPR/ORM) ; Black, Delaine (OS/ASPR/ORM) ; McQueen, Lynn (OS/ASPR/MFHC) ; Scharf -Bell, Helga (OS/ASPR/EMMO) ; Dolinsky, David (OS/ASPR/MFHC) ; Mann, Travis (OS/ASPR/EMMO) ; Renshaw, Michele D. (CDC/SNS/DSNS) ; Libert, Thomas (O5/ASPR/MFHC) ; Porta, James (CDC/SNS/DSNS) ; Arthur, Bonnie (OS/ASPR/ORM) ; Wright, Annette (CDC/SNS/DSNS) ; Torres, Maribel (OS/ASPR/MFHC) ; AvilesMendoza, Guillermo (OS/OASH) ; Valdes, Allan (OS/ASPR/ORM) ; Greene, Sara (OS/ASPR/EMMO) ; Percy, Marietta (OS/ASPR/MFHC) ; Scales, Brenda (CDC/SNS/DSNS) ; Hinson, Kamelya (CDC/SNS/DSNS) ; Beyer, Alexis (OS/ASPR/EMMO) ; Aziz, Hesham (OS/ASPR/ORM) ; Stear, Jason (CDC/SNS/DSNS) ; Peavy, Rosha (OS/ASPR/MFHC) ; Presley, Shailee (CDC/SNS/DSNS) ; Estrada, Ryan (OS/ASPR/ORM) ; Pietz, Ferdinand H. (CDC/SNS/DSNS) ; Santoyo, Steven (OS/ASPR/ORM) ; Williams, Aimee (OS/ASPR/EMMO) ; Owen, Caleb (OS/ASPR/ORM) ; Waindle, Michael J. (CDC/SNS/DSNS) (CTR) ; Wacker, Purry (OS/ASPR/ORM) ; Martin, Shantez (CDC/SNS/DSNS) (CTR) ; Bacon, Jennifer (CDC/SNS/DSNS) ; Frenette, Jennifer (OS/ASPR/EMMO) ; Beyerlein, Ron (OS/ASPR/ORM) ; Staley, Michael (OS/ASPR/EMMO) ; Hall, Dana (OS/ASPR/EMMO) ; Williams, Angela (CDC/SNS/DSNS) (CTR) ; Zarychta, William (OS/ASPR/EMMO) ; Chen, Andrew (OS/ASPR/EMMO) ; Young, Thor (OS/ASPR/PDAS/EMMO) ; Mcletchie, Lana (CDC/SNS/DSNS) ; Wade, Stacy (CDC/SNS/DSNS) ; Stephan, Briana (OS/ASPR/SIIM) ; AMERICAN PVERSIGHT HHS-20-0580-A-000188 Haugen, Jill (CDC/SNS/DSNS) ; Ray, Leondra (OS/ASPR/MFHC) ; Pascarelli, Frank (CDC/SNS/DSNS) ; Evans, Pamela (OS/ASPR/EMMO) ; Green, Tracy (OS/ASPR/ORM) ; Dockery, Miesha (OS/ASPR/MFHC) ; Formanski, Stephen (OS/ASPR/EMMO) ; Tobin, George (OS/ASPR/EMMO) ; Lopez, Javier (OS/ASPR/MFHC) ; Lee, Scott (OS/ASPR/EMMO) ; Sutton Clawson, Susan M. (OS/ASPR/EMMO) ; Hutson, Angela (OS/ASPR/ORM) ; Weir, Charles (OS/ASPR/10) ; Adair, Denielle (OS/ASPR/MFHC) ; Andrews , Sean (OS/ASPR/EMMO) ; Johnson, Lindak (OS/ASPR/ORM) ; Peerbolte, Stacy (OS/ASPR/EMMO) ; Kleckley, Virginia V. (CDC/SNS/DSNS) (CTR) ; Neff, Matthew (OS/ASPR/ORM) ; Mackay, Thomas (OS/ASPR/EEAA) ; Wise, Torri (OS/ASPR/MFHC) (CTR) ; Kim, Mark (OS/ASPR/MFHC) ; Troutman, Cathy (OS/ASPR/ORM) ; Brown, James (CDC/SNS/DSNS) ; Fox, Thomas R. (Tom) (CDC/SNS/DSNS) ; White, Jonathan (OS/ASPR/EMMO) ; Smith, Kimberly (OS/ASPR/EMMO) ; Cote, Mick (OS/ASPR/EMMO) ; Stokes, Patricia M. (CDC/SNS/DSNS) (CTR) ; Eckes, Jeanne (OS/ASPR/EMMO) ; Mock, Martha (CDC/SNS/DSNS) ; AMERICAN PVERSIGHT HHS-20-0580-A-000189 Debarros, Jean-Pierre CAPT USPHS HHS (USA) ; Teneyck-Mims, Aubrie (OS/ASPR/ORM) ; Kaul, Rachel (OS/ASPR/EMMO) ; Bunkley, Shelia (OS/ASPR/MFHC) ; Weldon, Christopher E. (CDC/SNS/DSNS) ; Bethea, Tenisha (OS/ASPR/EMMO) ; Nguyen , David (OS/ASPR/MFHC) ; Watt, Melissa (OS/ASPR/EMMO) ; White, Catalina (OS/ASPR/EMMO) ; Smart, DeRamus (OS/ASPR/ORM) ; Busse, Edward (OS/ASPR/ORM) ; Richardson, Joel (OS/ASPR/ORM) ; Martin, Cornelious (CDC/SNS/DSNS) ; Silva, Vitelio (CDC/SNS/DSNS) ; Zernick, Timothy (OS/ASPR/EMMO) ; Cooper, Kevin (OS/ASPR/ORM) ; Henderson, Clifford (CDC/SNS/DSNS) (CTR) ; Callahan, Victoria (OS/ASPR/IO) (CTR) ; Raspberry, Jenny (OS/ASPR/EMMO) ; Tisdale, Kathleen (CDC/SNS/DSNS) ; Devore, Adam (OS/ASPR/IO) ; Whitehead, Germaine (OS/ASPR/EMMO) ; Acey, Derrick (OS/ASPR/MFHC) ; Link, Paul (OS/ASPR/EMMO) ; Pereira, Esmeralda (OS/ASPR/EMMO) ; Greninger, Darren (OS/ASPR/EMMO) (CTR) ; Smith, Diane (OS/ASPR/EMMO) ; Cosgrove, Sandra (OS/ASPR/EEAA) ; Leddy, Brennan (OS/ASPR/EMMO) (CTR) ; Nelson, Maurice (O5/ASPR/EMMO) ; Evans, Ashlie (OS/ASPR/ORM) ; AMERICAN PVERSIGHT HHS-20-0580-A-000190 Garcia, Carilyn (OS/ASPR/EMMO) ; Dowe, Yolanda (OS/ASPR/ORM) ; Perdue, Cheryl (OS/ ASPR/ORM) ; Kuhn-McClain, Tonya (OS/ASPR/ORM) ; Nguyen, Tuongvi (OS/ASPR/ORM) (CTR) ; Marks, Lucia (OS/ASPR/EMMO) ; Borza, Sarah (OS/ASPR/ORM) ; Williams, Rafiat (OS/ASPR/EMMO) ; Gaines, David (OS/ASPR/ORM) ; Roach-Seymour, Sonia (OS/ASPR/EMMO) (CTR) ; Ramirez, Gabriela (OS/ASPR/EMMO) ; Spells, Ashley (OS/ASPR/ORM) (CTR) ; Tise, Stephen (OS/ASPR/EMMO) ; Snowden, Terria (OS/ASPR/MFHC) ; Fosu, Kwame (OS/ASPR/MFHC) ; Harris, Charlene (OS/ASPR/MFHC) (CTR) ; Pettis, Patricia (OS/ASPR/EMMO) ; Ricketts, Kimberley (OS/ASPR/EMMO) ; Eldridge, Schuyler (OS/ASPR/MFHC) ; Llopis, Alvarez (O5/ASPR/ORM) ; Lee, Sherline (OS/ASPR/EMMO) ; Beck, Leslie (OS/ASPR/EMMO) ; Griffith, Brian (OS/ASPR/EEAA) ; Lee, Jeffery (OS/ASPR/ORM) ; Pope, Julien (O5/ASPR/MFHC) ; Butterworth, Virginia (OS/ASPR/EEAA) ; Bourg, Michael (OS/ASPR/ORM) ; Czarzasty, James (OS/ASPR/EMMO) ; Ruiz, Joanna (O5/ASPR/MFHC) (CTR) ; Bishop, Robert (OS/ASPR/ORM) ; Cameron, Megan (OS/ASPR/MFHC) ; Mcmahon, William (OS/ASPR/MFHC) (CTR) ; AMERICAN PVERSIGHT HHS-20-0580-A-000191 Pacewicz, Alicia (O5/ASPR/ORM) ; Leggett, Cameo (O5/ASPR/MFHC) (CTR) ; Page, Lauren (OS/ASPR/MFHC) ; Frizzell, Rebecca (O5/ASPR/MFHC) ; Miller, Jennifer M. (O5/ASPR/ORM) ; France ll, Edward (OS/ASPR/ORM) ; Lemus, Balmore (O5/ASPR/ORM) ; Pigman, Steven (OS/ASPR/EMMO) ; Edison, Nicole (O5/ASPR/ORM) ; Boateng, Cecily (O5/ASPR/ORM) ; Rice, Cheri (CDC/SNS/DSNS) ; Smart, John (O5/ASPR/EMMO) ; Tandez, Jeannette (O5/ASPR/EMMO) (CTR) ; Watts, Kara (OS/ASPR/MFHC) (CTR) ; Miron, Claudia (OS/ASPR/EMMO) ; Dugas, Robert (O5/ASPR/EMMO) ; Stankewicz, Todd (O5/ASPR/EMMO) ; Kittrell, Demetrius (O5/ASPR/ORM) ; Mam, Alissa (OS/ASPR/MFHC) (CTR) ; Stein, Avi (O5/ASPR/PDAS/ORM) ; (FYDIBOHF23SPDLT)/cn=Recipients/cn=8f2646c519144a419badfc7f74cbc72b-Stein, Daniels, Miles (O5/ASPR/MFHC) ; Sorensen, Kirsten (OS/ASPR/EMMO) ; Austin, Brad (OS/ASPR/EMMO) ; Banner, Gregory (O5/ASPR/EMMO) ; Barno, Adam (O5/ASPR/ORM) ; Odom, Janet (O5/ASPR/EMMO) ; Hardge, Darryl (OS/ASPR/EMMO) ; Krutsinger, Angela (O5/ASPR/EMMO) ; Jack, Kimberly (O5/ASPR/EMMO) ; Sanchez, Natalie (O5/ASPR/EMMO) ; Obiako, Moji (O5/ASPR/EMMO) ; Vongchan, Patrick (OS/ ASPR/EMMO) ; AMERICAN PVERSIGHT HHS-20-0580-A-000192 Allen, Carol Matamoro(OS/ASPR/ORM) ; Ruark, Gail (OS/ASPR/ORM) ; Parkinson, Elizabeth (OS/ASPR/EMMO) ; Feeney, Kathryn (OS/ASPR/IO) (CTR) ; Harper, Victor (OS/ASPR/ORM) ; Weerasinghe, Disna (OS/ASPR/MFHC) (CTR) ; Lockhart, Che (OS/ASPR/ORM) ; Cederberg, Christina (OS/ASPR/EEAA) ; Kleinman, Gary (OS/ASPR/EMMO) ; Soucie, Mark (OS/ASPR/PDAS/EMMO) ; Young, Mark (OS/ASPR/EMMO) ; Robertson, Bob (CDC/SNS/DSNS) ; Dubay, Johanna (OS/ASPR/MFHC) ; Dafflitto, Scott (OS/ASPR/EMMO) ; Hubbs, Vivian (CDC/SNS/DSNS) ; McCoy, Lawrence (CDC/SNS/DSNS) ; Wagner, Duane (OS/ASPR/EMMO) ; Golden, Kimberly (CDC/SNS/DSNS) ; Kilbane, Edward (OS/ASPR/EMMO) ; Rowland, Natasha Y. (CDC/SNS/DSNS) ; Davids, Kimberly (OS/ASPR/EMMO) ; Johnson, Jonathan (OS/ASPR/MFHC) ; Mann, Rosemary (OS/ASPR/MFHC) (CTR) ; Vargese, Bavan (OS/ASPR/ORM) (CTR) ; Efuwape, Adedayo (OS/ASPR/ORM) (CTR) ; Hill, Veronica (OS/ASPR/MFHC) ; Dillard, Lisa (CDC/SNS/DSNS) ; Robinson, Trinise (CDC/SNS/DSNS) (CTR) ; Falcon, Jessica (OS/ASPR/SIIM) ; Newman, Kimberly (OS/ASPR/MFHC) ; Holland, Tara (OS/ASPR/EMMO) AMERICAN PVERSIGHT HHS-20-0580-A-000193 Subject: OPDASAll Hands Date: 2020/02/27 09:22 :17 Start Date: 2020/02/27 14:00:00 End Date: 2020/02/27 15:15:00 Priority: Normal Type: Schedule.Meeting.Request . . O'Neill Conference RoomsWillow, Cedar - Sub-Basement/ Dial-In Numbe~(b)(6) Loca t ion. AccessCode:Kb)(6) I I OS - ASPR- PDAS;SNS DISTRO(OS/ASPR);Wong, Diana (OS/ASPR/SIIM);Asher, Jason (OS/ASPR/SIIM)(CTR); Clay, Matt (OS/ASPR/SIIM)(CTR); Imbriale, Samuel (OS/ASPR/SIIM); Rybak, Bailey (OS/ASPR/OEA);Thompson, Donna (OS/ASPR/IO)(CTR); Genzer, Boris (OS/ASPR/MFHC)(CTR); Jenkins, Karren (OS/ASPR/MFHC);Lamana, Joseph (OS/ASPR/EMMO); Lightner, Louis (OS/ASPR/EMMO);Maccorkle, Matthew (OS/ASPR/ORM)(CTR); Lincoln, Carol (OS/ASPR/EMMO);Csernak, David (OS/ASPR/EMMO);Jackson, Jacklyn (OS/ASPR/EMMO); Garza, Roberto (OS/ASPR/EMMO);Chaboudy, Mary (OS/ASPR/MFHC);Beaty, Garrett (OS/ASPR/ORM);Hastings, Elizabeth (OS/ASPR/EMMO);Burks, Dagayla (OS/ASPR/EMMO) (CTR); Birdwell, Grace (OS/ASPR/PDAS/MFHC) (CTR); Hoang, Due (OS/ASPR/ORM);Okyere, Isaiah (OS/ASPR/MFHC);Levine, Cheryl (OS/ASPR/EMMO);Thomas, Richard (OS/ASPR/EMMO);Brannman, Shayne (OS/ASPR/EMMO);Harahan, Kevin (OS/ASPR/EMMO); Roman, Maurice (OS/ASPR/ORM);Petillo, Jay (OS/ASPR/MFHC);Martin, Andrewnette (OS/ASPR/MFHC);Gloster, Kimberly (OS/ASPR/MFHC);Harris, Kimberly (OS/ASPR/MFHC) (CTR); Sheehan, Christopher (OS/ASPR/EMMO);Littlefield, Jill (OS/ASPR/EMMO)(CTR); Huie, Jimmy (CDC/SNS/DSNS);Lepore, Kristen (OS/ASPR/EMMO)(CTR); Libby, Mark (OS/ASPR/EMMO);Mensah, Eric Oswald Kouete (CDC/SNS/DSNS);Baker, Mary (CDC/SNS/DSNS);Williams, Bob (OS/ASPR/ORM);Ohaya, Adolphus (CDC/SNS/DSNS) (CTR); Barton, Jessie-Kate (OS/ASPR/EMMO);Braxton, Makoto (OS/ASPR/ORM); Moore, William (OS/ASPR/EEAA);Rubio, Cynthia (OS/ASPR/ORM);Lamoureux, Joseph (OS/ASPR/EMMO); Reyes, Francisco(CDC/SNS/DSNS);Aufenanger, Sharyn (OS/ASPR/MFHC);Lofton, Adam (OS/ASPR/EMMO);Adams, Michael (CDC/SNS/DSNS);Sturrock, Lochlin (OS/ASPR/EMMO); Jackson, Linda (HHS/ASPR);Vento, Stephany (OS/ASPR/EMMO);Mazurek, Audrey (OS/ASPR/EMMO)(CTR); Reyes, Elizabeth (OS/ASPR/MFHC);Missimer, Steven (OS/ASPR/MFHC);Bell, Gary (OS/ASPR/ORM)(CTR); Eisemann, Darla (OS/ASPR/MFHC);Sims, Shane (OS/ASPR/EMMO);Qadri, Shafi A. (CDC/SNS/DSNS)(CTR); Cua, Eduardo (OS/ASPR/EMMO); Sturrock, Kenneth (OS/ASPR/EMMO);Martin, Jyl (OS/ASPR/SPPR); Mcdaniel, Michele (OS/ASPR/EMMO);Hernandez, Cameron (OS/ASPR/ORM);Woodfolk, Diana Attendees: (OS/ASPR/MFHC);Herrmann, Jack (OS/ASPR/OEA);Bossler, Sumner (OS/ASPR/ORM);Finne, Kristen (OS/ASPR/EMMO ); Brown, Michael (CDC/SNS/DSNS ) (CTR); Eapen, Shirley (CDC/SNS/DSNS)(CTR); Kemp, Micha (OS/ASPR/MFHC);Brown, Daneen (OS/ASPR/MFHC) (CTR); Scott, Danita (OS/ASPR/ORM);Zane, Thomas C. (CDC/SNS/DSNS)(CTR); Brown, Marsha (OS/ASPR/ORM);Black, Delaine (OS/ASPR/ORM);McQueen, Lynn (OS/ASPR/MFHC); Scharf-Bell, Helga (OS/ASPR/EMMO); Dolinsky, David (OS/ASPR/MFHC);Mann, Travis (OS/ASPR/EMMO);Renshaw, Michele D. (CDC/SNS/DSNS);Libert, Thomas (OS/ASPR/MFHC); Porta, James (CDC/SNS/DSNS);Arthur, Bonnie (OS/ASPR/ORM);Wright, Annette (CDC/SNS/DSNS);Torres, Maribel (OS/ASPR/MFHC); AvilesMendoza,Guillermo (OS/OASH); Valdes, Allan (OS/ASPR/ORM);Greene, Sara (OS/ASPR/EMMO);Percy, Marietta (OS/ASPR/MFHC);Scales, Brenda (CDC/SNS/DSNS);Hinson, Kamelya (CDC/SNS/DSNS);Beyer, Alexis (OS/ASPR/EMMO);Aziz,Hesham (OS/ASPR/ORM);Stear, Jason (CDC/SNS/DSNS); Peavy, Rosha (OS/ASPR/MFHC);Presley, Shailee (CDC/SNS/DSNS);Estrada, Ryan (OS/ASPR/ORM);Pietz, Ferdinand H. (CDC/SNS/DSNS);Santoyo, Steven (OS/ASPR/ORM); Williams, Aimee (OS/ASPR/EMMO);Owen, (aleb (OS/ASPR/ORM);Waindle, MichaelJ. (CDC/SNS/DSNS)(CTR); Wacker, Purry (OS/ASPR/ORM);Martin, Shantez (CDC/SNS/DSNS) (CTR); Bacon,Jennifer (CDC/SNS/DSNS);Frenette, Jennifer (OS/ASPR/EMMO);Beyerlein, Ron (OS/ASPR/ORM);Staley, Michael (OS/ASPR/EMMO);Hall, Dana (OS/ASPR/EMMO); Williams, Angela (CDC/SNS/DSNS)(CTR); Zarychta, William (OS/ASPR/EMMO);Chen, Andrew (OS/ASPR/EMMO);Young, Thor (OS/ASPR/PDAS/EMMO); McLetchie,Lana (CDC/SNS/DSNS ); Wade, Stacy (CDC/SNS/DSNS);Stephan, Briana (OS/ASPR/SIIM); Haugen, Jill (CDC/SNS/DSNS);Ray, Leandra (OS/ASPR/MFHC);Pascarelli, Frank (CDC/SNS/DSNS);Evans, Pamela (OS/ASPR/EMMO);Green, Tracy (OS/ASPR/ORM);Dockery, Miesha (OS/ASPR/MFHC); Formanski, Stephen (OS/ASPR/EMMO);Tobin, George (OS/ASPR/EMMO); Lopez, Javier (OS/ASPR/MFHC); Lee, Scott (OS/ASPR/EMMO);Sutton Clawson, Susan M. (OS/ASPR/EMMO); Hutson, Angela (OS/ASPR/ORM);Weir, Charles (OS/ASPR/IO); Adair, Denielle (OS/ASPR/MFHC);Andrews, Sean (OS/ASPR/EMMO);Johnson, Lindak (OS/ASPR/ORM); Peerbolte, Stacy (OS/ASPR/EMMO);Kleckley, Virginia V. (CDC/SNS/DSNS) (CTR); Neff, AMERICAN PVERSIGHT HHS-20-0580-A-000194 Matthew (OS/ASPR/ORM);Mackay, Thomas (OS/ASPR/EEAA);Wise, Torri (OS/ASPR/MFHC) (CTR); Kim, Mark (OS/ASPR/MFHC);Troutman, Cathy (OS/ASPR/ORM);Brown, James (CDC/SNS/DSNS);Fox, Thomas R. (Tom) (CDC/SNS/DSNS);White, Jonathan (OS/ASPR/EMMO);Smith, Kimberly (OS/ASPR/EMMO);Cote, Mick (OS/ASPR/EMMO);Stokes, Patricia M. (CDC/SNS/DSNS)(CTR); Eckes,Jeanne (OS/ASPR/EMMO);Mock, Martha (CDC/SNS/DSNS);Debarros, Jean-Pierre CAPTUSPHSHHS (USA); Teneyck-Mims, Aubrie (OS/ASPR/ORM);Kaul, Rachel(OS/ASPR/EMMO);Bunkley, Shelia (OS/ASPR/MFHC);Weldon, Christopher E. (CDC/SNS/DSNS);Bethea, Tenisha (OS/ASPR/EMMO);Nguyen, David (OS/ASPR/MFHC);Watt, Melissa (OS/ASPR/EMMO);White, Catalina (OS/ASPR/EMMO);Smart, DeRamus (OS/ASPR/ORM);Busse, Edward (OS/ASPR/ORM);Richardson,Joel (OS/ASPR/ORM); Martin, Cornelious (CDC/SNS/DSNS);Silva, Vitello (CDC/SNS/DSNS);Zernick, Timothy (OS/ASPR/EMMO);Cooper, Kevin (OS/ASPR/ORM);Henderson, Clifford (CDC/SNS/DSNS) (CTR); Callahan, Victoria (OS/ASPR/10)(CTR); Raspberry,Jenny (OS/ASPR/EMMO);Tisdale, Kathleen (CDC/SNS/DSNS);DeVore, Adam (OS/ASPR/10);Whitehead, Germaine (OS/ASPR/EMMO);Acey, Derrick (OS/ASPR/MFHC);Link, Paul (OS/ASPR/EMMO);Pereira, Esmeralda(OS/ASPR/EMMO);Greninger, Darren (OS/ASPR/EMMO)(CTR); Smith, Diane (OS/ASPR/EMMO);Cosgrove, Sandra (OS/ASPR/EEAA);Leddy, Brennan (OS/ASPR/EMMO) (CTR); Nelson, Maurice (OS/ASPR/EMMO);Evans,Ashlie (OS/ASPR/ORM);Garcia, Carilyn (OS/ASPR/EMMO);Dowe, Yolanda (OS/ASPR/ORM);Perdue, Cheryl (OS/ASPR/ORM);KuhnMcClain,Tonya (OS/ASPR/ORM);Nguyen, Tuongvi (OS/ASPR/ORM)(CTR); Marks, Lucia (OS/ASPR/EMMO);Borza, Sarah (OS/ASPR/ORM);Williams, Rafiat (OS/ASPR/EMMO);Gaines, David (OS/ASPR/ORM);Roach-Seymour,Sonia (OS/ASPR/EMMO)(CTR); Ramirez, Gabriela (OS/ASPR/EMMO);Spells, Ashley (OS/ASPR/ORM)(CTR); Tise, Stephen (OS/ASPR/EMMO); Snowden, Terria (OS/ASPR/MFHC);Fosu, Kwame (OS/ASPR/MFHC);Harris, Charlene (OS/ASPR/MFHC)(CTR); Pettis, Patricia (OS/ASPR/EMMO);Ricketts, Kimberley (OS/ASPR/EMMO);Eldridge, Schuyler (OS/ASPR/MFHC);Llopis, Alvarez (OS/ASPR/ORM);Lee, Sherline (OS/ASPR/EMMO);Beck, Leslie (OS/ASPR/EMMO);Griffith, Brian (OS/ASPR/EEAA); Lee, Jeffery (OS/ASPR/ORM);Pope, Julien (OS/ASPR/MFHC);Butterworth, Virginia (OS/ASPR/EEAA);Bourg, Michael (OS/ASPR/ORM);Czarzasty,James (OS/ASPR/EMMO);Ruiz, Joanna (OS/ASPR/MFHC)(CTR); Bishop, Robert (OS/ASPR/ORM);Cameron, Megan (OS/ASPR/MFHC);Mcmahon, William (OS/ASPR/MFHC)(CTR); Pacewicz,Alicia (OS/ASPR/ORM);Leggett, Cameo (OS/ASPR/MFHC)(CTR); Page, Lauren (OS/ASPR/MFHC); Frizzell, Rebecca(OS/ASPR/MFHC);Miller, Jennifer M. (OS/ASPR/ORM);Francell, Edward (OS/ASPR/ORM);Lemus, Balmore (OS/ASPR/ORM)(CTR); Pigman, Steven (OS/ASPR/EMMO); Edison, Nicole (OS/ASPR/ORM);Boateng, Cecily (OS/ASPR/ORM);Rice, Cheri (CDC/SNS/DSNS); Smart, John (OS/ASPR/EMMO);Tandez, Jeannette (OS/ASPR/EMMO)(CTR); Watts, Kara (OS/ASPR/MFHC)(CTR); Miron, Claudia (OS/ASPR/EMMO);Dugas, Robert (OS/ASPR/EMMO); Stankewicz, Todd (OS/ASPR/EMMO);Kittrell, Demetrius (OS/ASPR/ORM);Mam, Alissa (OS/ASPR/MFHC)(CTR); Stein, Avi (OS/ASPR/PDAS/ORM);Daniels, Miles (OS/ASPR/MFHC); Sorensen, Kirsten (OS/ASPR/EMMO);Austin, Brad (OS/ASPR/EMMO);Banner, Gregory (OS/ASPR/EMMO);Barno, Adam (OS/ASPR/ORM);Odom, Janet (OS/ASPR/EMMO);Hardge, Darryl (OS/ASPR/EMMO);Krutsinger, Angela (OS/ASPR/EMMO);Jack, Kimberly (OS/ASPR/EMMO);Sanchez, Natalie (OS/ASPR/EMMO);Obiako, Moji (OS/ASPR/EMMO); Vongchan, Patrick (OS/ASPR/EMMO);Allen, Carol Matamoro(OS/ASPR/ORM);Ruark, Gail (OS/ASPR/ORM);Parkinson, Elizabeth (OS/ASPR/EMMO);Feeney, Kathryn (OS/ASPR/10) (CTR); Harper, Victor (OS/ASPR/ORM);Weerasinghe, Disna (OS/ASPR/MFHC)(CTR); Lockhart, Che (OS/ASPR/ORM);Cederberg, Christina (OS/ASPR/EEAA);Kleinman, Gary (OS/ASPR/EMMO);Soucie, Mark (OS/ASPR/PDAS/EMMO); Young, Mark (OS/ASPR/EMMO); Robertson, Bob (CDC/SNS/DSNS);Dubay, Johanna (OS/ASPR/MFHC);Dafflitto, Scott (OS/ASPR/EMMO);Hubbs, Vivian (CDC/SNS/DSNS);McCoy, Lawrence (CDC/SNS/DSNS); Wagner, Duane (OS/ASPR/EMMO);Golden, Kimberly (CDC/SNS/DSNS);Kilbane, Edward (OS/ASPR/EMMO);Rowland, Natasha Y. (CDC/SNS/DSNS);Davids, Kimberly (OS/ASPR/EMMO); Johnson, Jonathan (OS/ASPR/MFHC);Mann, Rosemary(OS/ASPR/MFHC)(CTR); Vargese, Bavan (OS/ASPR/ORM)(CTR); Efuwape, Adedayo (OS/ASPR/ORM)(CTR); Hill, Veronica (OS/ASPR/MFHC);Dillard, Lisa (CDC/SNS/DSNS);Robinson, Trinise (CDC/SNS/DSNS)(CTR); Falcon, Jessica (OS/ASPR/SIIM); Newman, Kimberly (OS/ASPR/MFHC);Holland, Tara (OS/ASPR/EMMO) Event Title: OS/ASPR/OPDAS All Hands Event Location: O'NeillConferenceCenter Event Date: Thursday,February27, 2020 AMERICAN PVERSIGHT HHS-20-0580-A-000195 Event Time: 2 :00PM - 3: lSPM Agenda: • Welcome and Opening Remarks, Dr. Yeskey • Hails, Farewells, and Employee Spotlights • COVID-19 Operational Activities • COVID-19 Planning Scenarios (SIIM) • OPDAS Program Updates (E2A2 , MFHC, ORM , EMMO) • Q&A w/PDAS & the Directors Also, here are the slides , for attachment. OPDAS A LL-HANDS When it's time, join the meeting from here: Join the meeting When: Thursday, February 27, 2020 , 2:00PM - 3:15PM (1 hr 15 mins), Eastern Standard Time (New York, GMT-05:00). Access Information Meeting Number: b)(6) I Password : (This meeting does not require a password.) Audio Connection AMERICAN PVERSIGHT HHS-20-0580-A-000196 b)(6) ~Meeting Server Main Number) Access Code: b)(6) I Yeskey, Kevin (OSLASPBfIO); Thom12son,Donna (OSLASPRLIO) (CTR) OS - ASPR- PDAS i SNS DISTRO(OSLASPR)i Wong, Diana (OSLASPBfSIIM) ; Asher, Jason (OSLASPRLSIIM) (CTR) ; Clay, Matt (OSLASPRLSIIM) (CTR) ; Imbriale, Samuel (OSLASPBLSIIM) i Rybak, Bailey (OSLASPBfOEA); Thom12son,Donna (OSLASPRLIO) (CTR) ; Genzer, Boris (OSLASPBLMFHC) (CTR) ; Recipient: Jenkins, Karren (OSLASPBLMFHC) ; Lamana, Jose12h(OSLASPBLEMMO) ; Lightner, Louis (OSLASPRLEMMO) ; Maccorkle, Matthew (OSLASPRLORM) (CTR) ; Lincoln, carol (OSLASPRLEMMO) ; Csernak, David (OSLASPBLEMMO) ; Jackson, Jacklyn (OSLASPRLEMMO) ; Garza, Roberto (OSLASPRLEMMO) ; Chaboudy, MaQ:'.(OSLASPBLMFHC) i Beaty, Garrett (OSLASPBfORM); Hastings, Elizabeth (OSLASPRLEMMO) ; Burks, Dagayla (OSLASPRLEMMO) (CTR) ; Birdwell, Grace (OSLASPB,LPDASLMFHC) (CTR) ; Okyere, Isaiah (OSLASPB,LMFHC) ; Levine, Che!}'I (OSLASPRLEMMO) ; Thomas, Richard (OSLASPB,LEMMO) ; Brannman, Shayne (OSLASPRLEMMO) ; Harahan, Kevin (OSLASPB,LEMMO) ; Roman, Maurice (OSLASPRLORM) ; Petillo, Jay (OSLASPB,LMFHC) ; Martin, Andrewnette (OSLASPRLMFHC) ; Gloster, Kimberly (OSLASPRLMFHC) ; Harris, Kimberly (OSLASPRLMFHC) (CTR) ; Sheehan, Christogher (OSLASPB,LEMMO) ; Littlefield, Jill (OSLASPB,LEMMO) (CTR) ; Huie, Jimmy (CDCLSNSLDSNS) ; Leggre, Kristen (OSLASPRLEMMO) (CTR) ; Libby, Mark (OSLASPRLEMMO) ; Mensah, Eric Oswald Kouete (CDCLSNSLDSNS) ; Baker, Ma!}' (CDCLSNSLDSNS) ; Williams, Bob (OSLASPB,LORM) ; Ohaya, Adolghus (CDCLSNSLDSNS) (CTR) ; Barton, Jessie-Kate(OSLASPRLEMMO) ; Braxton, Makoto (OSLASPB,LORM) ; Moore, William (OSLASPRLEEAA) ; ; Lamoureux,Josegh (OSLASPRLEMMO) ; Reyes, Francisco(CDCLSNSLDSNS) ; AMERICAN PVERSIGHT HHS-20-0580-A-000198 Aufenanger, Sha!Yn(OSLASPRLMFHC) ; Lofton, Adam (OSLASPBLEMMO) i Adams, Michael (CDCLSNSLDSNS) ; Sturrock, Lochlin (OSLASPBLEMMO) ; Jackson, Linda (HHSLASPR); Vento, Stei:1hany(OSLASPBLEMMO) ; Mazurek,Audrey (OSLASPBLEMMO) (CTR) ; Reyes, Elizabeth(OSLASPRLMFHC) ; Missimer, Steven (OSLASPRLMFHC) ; Bell, Ga!Y (OSLASPBLORM) (CTR) ; Eisemann,Darla (OSLASPBLMFHC) Sims, Shane (OSLASPBLEMMO) ; Qadri, Shafi A. (CDCLSNSLDSNS) (CTR) ; Cua, Eduardo (OSLASPRLEMMO) ; Sturrock, Kenneth (OSLASPBLEMMO) ; Martin, Jyl (OSLASPRLSPPR) ; Mcdaniel, Michele (OSLASPRLEMMO) ; Hernandez,Cameron (OSLASPRLORM) ; Woodfolk, Diana (OS[ASPRLMFHC) ; Herrmann, Jack (OSLASPBLOEA) ; Bossler, Sumner (OSLASPRLORM) ; Finne, Kristen (OSLASPBLEMMO) ; Brown, Michael (CDC[SNS[DSNS)(CTR) ; Eagen, Shirley (CDCLSNSLDSNS) (CTR) ; (FYDIBOHF23SPDL Kemi:1,Micha (OSLASPBLMFHC) ; Brown, Daneen (OSLASPRLMFHC) (CTR) ; Scott, Danita (OSLASPRLORM) ; (CTR) ; Brown, Marsha (OSLASPRLORM) ; Black, Delaine (OS[ASPRLORMl ; McQueen,Lynn (OSLASPRLMFHC) i AMERICAN PVERSIGHT HHS-20-0580-A-000199 Scharf-Bell, Helga (OSLASPRLEMMO) ; Dolinsky, David (OSlASPRlMFHC) i Mann, Travis (OSlASPB[EMMO); Renshaw, Michele D. (CDCLSNSLDSNS) ; Libert, Thomas (OSLASPRLMFHC) ; Porta, James (CDCLSNSLDSNS) ; Arthur, Bonnie (OSLASPB[ ORM) ; Wright, Annette (CDCLSNSLDSNS) ; Torres, Maribel (OSLASPB[MFHC) ; AvilesMendoza,Guillermo (OSLOASH); Valdes, Allan (OSlASPRlORM); Greene, Sara (OSLASPB[EMMO) ; Perg,, Marietta (OSLASPRLMFHC) ; Scales, Brenda (CDCLSNSLDSNS) ; Hinson, Kamelya (CDClSNSlDSNS) ; Beyer, Alexis (OSLASPRLEMMO) ; Aziz, Hesham(OSLASPB[ORM) ; Stear, Jason (CDCLSNSLDSNS) ; Pea~, Rosha (OSLASPB[MFHC) i Presley, Shailee (CDCLSNSLDSNS) ; Estrada, R},'an(OSLASPRLORM) ; Pietz, Ferdinand H. (CDCLSNSLDSNS) ; Santo},'o,Steven (OSLASPBLORM) ; Williams, Aimee (OSLASPRLEMMO) ; Owen, Caleb (OSLASPRLORM) ; Waindle, MichaelJ. (CDCLSNSLDSNS) (CTR) ; Wacker, PurtY (OSLASPBLORM) ; Martin, Shantez (CDCLSNSLDSNS) (CTR) ; Bacon, Jennifer (CDCLSNSLDSNS) ; Frenette, Jennifer (OSLASPRLEMMO) ; Beyerlein, Ron (OSLASPRlORM) ; Staley, Michael (OSlASPB[EMMO); AMERICAN PVERSIGHT HHS-20-0580-A-000200 Hall, Dana (OSLASPRLEMMO) ; Williams, Angela (CDCLSNSLDSNS) (CTR) ; Chen, Andrew (OSLASPRLEMMO) ; Young, Thor (OSLASPBLPDASLEMMO) ; McLetchie, Lana (CDCLSNSLDSNS) ; Wade, Sta9' (CDCLSNSLDSNS) ; Steghan, Briana (OSLASPRLSIIM) ; Haugen, Jill (CDCLSNSLDSNS) ; Ray, Leandra (OSLASPRLMFHC} ; Pascarelli,Frank (CDQSNSLDSNS); Evans, Pamela(OSLASPBLEMMO) ; Green, Tra9' (OSLASPBLORM) ; Docke!Y,Miesha (OSLASPBLMFHC) ; Formanski, Steghen (OSLASPBLEMMO) ; Tobin, George (OSLASPBLEMMO) ; Logez,Javier (OSLASPBLMFHC) ; Lee, Scott (OSLASPRLEMMO) Sutton Clawson, Susan M. (OSLASPBLEMMO) ; Hutson, Angela (OSLASPRLORM) ; Weir, Charles (OSLASPRLIO) ; Adair, Denielle (OSLASPRLMFHC) i Andrews, Sean (OSLASPBLEMMO) ; Johnson, Lindak (OSLASPBLORM) ; Peerbolte, Stag, (OSLASPRLEMMO) ; Kleckley,Virginia V. (CDCLSNSLDSNS) (CTR) ; Neff, Matthew (OSLASPRLORM) ; ; Wise, Torri (OSLASPRLMFHC) (CTR) ; Kim, Mark (OSLASPBLMFHC) i (FYDIBOHF23SPDL T)Lcn=RecigientsLcn= 1abd4138fddd4d6ca762c02a Troutman, Cathy (OSLASPRLORM) ; Brown, James (CDCLSNSLDSNS) ; Fox, Thomas R. (Tom) (CDCLSNSLDSNS) ; White, Jonathan (OSlASPRlEMMO); Smith, Kimberly (OSLASPRLEMMO) ; Cote, Mick (OSlASPRlEMMO); Stokes, Patricia M. (CDCLSNSLDSNS) (CTR) ; Eckes,Jeanne (OSLASPRLEMMO) ; Mock, Martha (CDCLSNSLDSNS) ; Debarros, Jean-Pierre CAPTUSPHSHHS (USA) ; Teneyck-Mims, Aubrie (OSLASPRLORM) : Kaul, Rachel (OSLASPBLEMMO) ; Bunkley, Shelia (OSLASPBLMFHC) ; Weldon, Christogher E. (CDCLSNSLDSNS) ; Bethea, Tenisha (OSLASPRLEMMO) ; Nguyen, David (OSLASPRLMFHC) ; Watt, Melissa(OSLASPRLEMMO) ; White, Catalina (OSLASPB[EMMO) ; Smart, DeRamus(OSLASPBLORM) : Busse, Edward (OSLASPRLORM) ; Richardson,Joel (OSLASPBLORM) ; Martin, Cornelious (CDCLSNSLDSNS) ; Silva, Vitelio (CDCLSNSLDSNS) ; Zernick, Timothy (OSLASPRLEMMO) ; Cooger, Kevin (OS[ASPBLORM); Henderson, Clifford (CDCLSNSLDSNS) (CTR) ; Callahan, Victoria (OSLASPRLIO) (CTR) ; Rasgber[Y,Jenny (OS[ASPRlEMMO); Tisdale, Kathleen (CDCLSNSLDSNS) ; Devore, Adam (OSLASPRLIO) ; Whitehead, Germaine (OSLASPRLEMMO) : Acey, Derrick (OSLASPRLMFHC) ; Link, Paul (OSLASPRLEMMO) ; Pereira, Esmeralda(OSLASPRLEMMO) ; Greninger, Darren (OSLASPRLEMMO) (CTR) ; Smith, Diane (OSLASPRLEMMO) ; Cosgrove,Sandra (OSLASPB[EEAA) ; Leddy, Brennan (OSLASPRLEMMO) (CTR) ; Nelson, Maurice (OSLASPRLEMMO) ; Evans,Ashlie (OSLASPB[ORM) ; Garcia, Carilyn (OSLASPB[EMMO) ; Dowe, Yolanda (OS[ASPRLORM) ; Perdue, Che[YI(OSLASPB[ORM) ; Kuhn-McClain,Tonya (OSLASPB[ORM) ; Nguyen, Tuongvi (OSLASPRLORM) (CTR) ; Marks, Lucia (OSLASPB[EMMO) ; Borza, Sarah (OSLASPRLORM) ; Williams, Rafiat (OSLASPB[EMMO) ; Gaines, David (OSLASPRLORM) ; Roach-Seymour,Sonia (OSLASPRLEMMO) (CTR) ; Ramirez,Gabriela (OSLASPRLEMMO) ; S~lls, Ashley (OSLASPB[ORM) (CTR) ; Tise, Ste12hen(OSLASPRLEMMO) ; Snowden, Terria (OSLASPRLMFHC) ; Fosu, Kwame (OSLASPB[MFHC) ; Harris, Charlene (OSLASPB[MFHC) (CTR) ; Pettis, Patricia (OSLASPRLEMMO) ; Ricketts, Kimberley (OSLASPRLEMMO) ; Eldridge, Schuyler (OSLASPRLMFHC) ; Llogis, Alvarez (OSLASPRLORM) ; Lee, Sherline (OSLASPRLEMMO) ; (FYDIBOHF23SPDL T)Lcn=Recigients[cn=51923406df8e4ab8901ccaa9c6eddc21-Lee, Beck, Leslie(OSLASPRLEMMO) ; Griffith, Brian (OSLASPRLEEAA) ; Lee, Jeffe[Y (OSLASPB[ORM) ; AMERICAN PVERSIGHT HHS-20-0580-A-000203 Page, Julien (OSLASPRLMFHC) ; Butterworth, Virginia (OSlASPRlEEAA)i Bourg, Michael (OS[ASPBLORM) ; Czarzastv,James (OSLASPRLEMMO) ; Ruiz, Joanna (OSlASPRlMFHC)(CTR) ; Bishog, Robert (OS[ASPBLORM) Cameron, Megan (OSLASPRLMFHC) ; Mcmahon, William (OSLASPRLMFHC) (CTR) ; Pacewicz,Alicia (OSlASPRLORM) ; Leggett, Cameo (OS£ASPR£MFHC) (CTR) ; Page, Lauren (OSlASPBLMFHC) ; Frizzell, Rebecca(OSlASPRlMFHC); Miller, Jennifer M. (OSLASPBLORM) ; Francell, Edward (OSlASPRlORM); Lemus, Balmore (OS[ASPRLORM) ; Pigman, Steven (OSLASPBLEMMO) ; Edison, Nicole (OSLASPRLORM) ; Boateng, Cecil>:: (OSlASPRLORM) ; Rice, Cheri (CDClSNSLDSNS) ; ; Tandez, Jeannette (OSlASPRlEMMO)(CTR) : Watts, Kara (OSLASPRLMFHC) (CTR) i Miron, Claudia (OSLASPRlEMMO) ; Dugas, Robert (OSLASPBLEMMO) ; Stankewicz,Todd (OSLASPBLEMMO) ; Kittrell, Demetrius (OSLASPRLORM) i Mam, Alissa (OSlASPRLMFHC) (CTR) ; Stein, Avi (OSLASPRlPDASlORM) ; Daniels, Miles (OSlASPRlMFHC): (FYDIBOHF23SPDLT)Lcn=Recigients[cn=fa4ad4dedc84cd59d4b24599425a375-Daniels, Sorensen, Kirsten (OSLASPRLEMMO) : Austin, Brad (OS[ASPBLEMMO) : Banner, Grego!Y(OSLASPRLEMMO) ; Barno, Adam (OSLASPRLORM) i Odom, Janet (OSLASPRLEMMO) ; Hardge, Dar!}'I (OSLASPBLEMMO) ; Krutsinger, Angela (OSLASPRLEMMO) ; Jack, Kimberly (OSLASPBLEMMO) i Sanchez,Natalie (OSLASPBLEMMO) i Obiako, Moji (OSLASPRLEMMO) ; Vongchan, Patrick (OSLASPBLEMMO) ; Allen, Carol Matamoro(OSLASPRLORM) ; Ruark, Gail (OSLASPBLORM) i Parkinson, Elizabeth (OSLASPBLEMMO) ; Feeney, Kath!}'n (OSLASPRLIO) (CTR) ; Harger, Victor (OSLASPRLORM) ; Weerasinghe, Disna (OSLASPRLMFHC) (CTR) i Lockhart, Che (OSLASPRLORM) ; Cederberg, Christina (OSLASPRLEEAA) ; Kleinman, Ga!}' (OSLASPRLEMMO) ; Soucie, Mark (OSLASPRLPDASLEMMO) ; Young, Mark (OSLASPBLEMMO) ; Robertson, Bob (CDCLSNSLDSNS) ; Dubay, Johanna (OSLASPRLMFHC) ; Dafflitto, Scott (OSLASPRLEMMO) ; Hubbs, Vivian (CDCLSNSLDSNS) i McCoy, Lawrence (CDCLSNSLDSNS) ; Wagner, Duane (OSLASPRLEMMO) ; Golden, Kimberly (CDCLSNSLDSNS) ; Kilbane, Edward (OSLASPBLEMMO) i Rowland, NatashaY. (CDCLSNSLDSNS) ; Davids, Kimberly (OSLASPBLEMMO) ; (FYDIBOHF23SPDL T)Lcn=Recigients[cn=f8fe96676cde4e97b970a61c7ebfd5d Johnson, Jonathan (OSLASPBLMFHC) ; Mann, Rosema!}'(OSLASPRLMFHC) (CTR) ; Vargese, Bavan (OSLASPRLORM) (CTR) ; Efuwa~. Adeda~o (OSLASPB[ORM) (CTR) ; Hill, Veronica (OS[ASPB[MFHC) ; Dillard, Lisa (CDCLSNSLDSNS); Robinson, Trinise (CDCLSNSLDSNS)(CTR) : Falcon, Jessica (OS[ASPRLSIIM) ; Newman, Kimberl~ (OSLASPRLMFHC); Holland, Tara (OSLASPRLEMMO); · ~ Sent Date: 2020[02[27 09:22:02 Delivered Date: 2020L02L27 09:22:17 AMERICAN PVERSIGHT HHS-20-0580-A-000206 Kadlec, Robert (OS/ASPR/IO) Ford-Barnes, Arwenthia (OS/ASPR/IO) Ford-Barnes, Arwenthia (OS/ASPR/1O) ; Callahan, Victoria (OS/ASPR/IO) (CTR) ; Shuy, Bryan (OS/ASPR/IO) ; Debarros, Jeanpierre (OS/ASPR/EMMO) ; Phillips, Sally (OS/ASPR/SPPR) ; jean-pierre p debarros (MIL) ; Debarros, Jean-pierre (MIL) ; Thornton, Cody R. (OS/ASPR/SIIM) ; Marrero, Abraham (MAIL.MIL) ; Mccreary, Kenneth (OS/ASPR/SPPR) ; Monahan, Kenneth (OS/ASPR/EMMO) ; Monahan, Kenneth (MAIL.MIL) ; Soza, Liza (MIL) ; Vincent, Erik (OS/ASPR/EMMO) ; SOC DOD Northcom Liaison Officer (HHS/ASPR) ; To: Yeskey, Kevin (OS/ASPR/IO) ; Vongchan, Patrick (OS/ASPR/EMMO) ; Marrero, Abraham (OS/ASPR/EMMO) ; Brooks, Paul (O5/ASPR/IO) ; Bratcher-Bowman, Nikki (O5/ASPR/IO) ; Soza, Liza (OS/ASPR/EMMO) ; Sauer, Michael (OS/ASPR) ; Moreno, Rafael (OS/ASPR) ; Sakris, Derek (O5/ASPR/EMMO) ; Austin, Brad (OS/ASPR/EMMO) ; Banner, Gregory (OS/ASPR/EMMO) ; Bartlett, Jonathon (OS/ASPR/EMMO) ; Byrd, Mark (O5/ASPR/EMMO) ; Chen, Andrew (OS/ASPR/EMMO) ; Cockrill, Jennifer (OS/ASPR/EMMO) ; Cua, Eduardo (OS/ASPR/EMMO) ; Dickinson, Jeanette (OS/ASPR/EMMO) ; Eckes, Jeanne (OS/ASPR/EMMO) ; Falone, Emily (OS/ASPR/EMMO) ; Formanski, Stephen (OS/ASPR/EMMO) ; Garner, Michael (OS/ASPR/EMMO) ; Gibbons, John (OS/ASPR/EMMO) ; Libby, Mark (OS/ASPR/EMMO) ; Lightner, Louis (OS/ASPR/EMMO) ; Rascher, Robert L. (OS/ASPR/EMMO) ; Raspberry, Jenny (OS/ASPR/EMMO) ; Andrews, Sean (OS/ASPR/EMMO) ; Blanchette, Glenn (OS/ASPR/EMMO) ; Bowman, Thomas (OS/ASPR/EMMO) ; Buell, Rick (OS/ASPR/EMMO ; Evans, Pamela (OS/ASPR/EMMO) ; Fitzgera ld, Denis (OS/ASPR/EMMO) ; Hall, Dana (OS/ASPR/EMMO) ; Harahan, Kevin (OS/ASPR/EMMO) ; Kleinman, Gary (OS/ASPR/EMMO) ; Mayer, Harry (O5/ASPR/EMMO) ; Odom, Janet (OS/ASPR/EMMO) ; Raheem, Murad (OS/ASPR/EMMO) ; Sturrock, Kenneth (OS/ASPR/EMMO) ; Taylor, Amyo (OS/ASPR/EMMO) ; Young, Mark (OS/ASPR/EMMO) ; Young, Thor (OS/ASPR/PDAS/EMMO) ; Smart, John (OS/ASPR/EMMO) ; Smith, Diane (O5/ASPR/EMMO) ; Stankewicz, Todd (OS/ASPR/EMMO) ; Voirin, Anthony (OS/ASPR/EMMO) ; Weir, Charles (OS/ASPR/IO) ; Imbriale, Samuel (OS/ASPR/SIIM) ; AMERICAN PVERSIGHT HHS-20-0580-A-000208 Thompson, Donna (OS/ASPR/IO) (CTR) ; ASPR Region 4 (HHS/ASPR/OEM) ; Holland, Tara (OS/ASPR/EMMO) ; Mann, Travis (OS/ASPR/EMMO) ; Lee, Scott (OS/ASPR/EMMO) ; SOC Information Management Section Chief (OS/ASPR) ; OS - ASPR - Security Team ; Vineyard, Michael (OS/ASPR/IO) ; Espinosa, Gregorio (OS/ASPR/SIIM) ; Huang, Cindy (OS/ASPR/SIIM) ; Wolf, Laura (OS/ASPR/SIIM) ; Maycock, Brett (OS/ONS) ; De Vore, Jazmin (O5/ONS) ; Sims, Andrew (O5/ASPR/EMMO) Bright, Rick (O5/ASPR/BARDA) ; Waters, Cicely (OS/ASPR/OEA) ; Kennedy, Ted (OS/ASPR/SPPR) ; CC: ; TRANSCOM Scott AFB TCSG Room Surgeon General ; ; Hill, April (OS/ASPR/EMMO) Subject: The ASPR to address the LNO's and REC's Date: 2020/02/28 10:54:40 Start Date: 2020/02/28 13:00:00 End Date: 2020/02/28 14:00:00 Priority: Normal Type: Schedule.Meeting.Request Location: 523B; large conference room Ford-Barnes , Arwenthia (OS/ASPR/1O); Callahan, Victoria (OS/ASPR/IO) (CTR); Shuy, Bryan (OS/ASPR/IO) (Bryan.Shuy@hhs.gov); Debarros, Jeanpierre (OS/ASPR/EMMO) (Jeanpierre.DeBarros@hhs.gov); Sally Phillips (Sally.Phillips@hhs.gov); jean-pierre p debarros (MIL); Debarros, Jean-pierre (MIL); Thornton, Cody R. (OS/ASPR/SIIM); Marrero, Abraham (MAIL.MIL); Mccreary, Kenneth (OS/ASPR/SPPR); Monahan, Kenneth (OS/ASPR/EMMO); Monahan, Kenneth (MAIL.MIL); Soza, Liza (MIL); Vincent, Erik (OS/ASPR/EMMO); SOC DOD Attendees: Northcom Liaison Officer (HHS/ASPR); Yeskey, Kevin (OS/ASPR/IO) (Kevin.Yeskey@hhs.gov); Vongchan, Patrick (O5/ASPR/EMMO) (Tanapume.Vongchan@hhs.gov); Marrero, Abraham (OS/ASPR/EMMO) (Abraham.Marrero@hhs.gov); Brooks, Paul (OS/ASPR/IO) (Paul.Brooks@hhs.gov); Bratcher-Bowman, Nikki (O5/ASPR/IO); Soza, Liza (O5/ASPR/EMMO); Sauer, Michael (O5/ASPR); Moreno, Rafael (OS/ASPR); Bright, Rick (O5/ASPR/BARDA); Waters, Cicely (OS/ASPR/OEA); Kennedy, Ted (OS/ASPR/SPPR); edward.gabriel@fema.dhs.gov; AMERICAN PVERSIGHT HHS-20-0580-A-000209 TRANSCOMScott AFB TCSGRoom Surgeon General; edward.gabriel@dhs.fema.gov; Sakris, Derek (OS/ASPR/EMMO);Austin, Brad (OS/ASPR/EMMO);Banner, Gregory (OS/ASPR/EMMO); Bartlett, Jonathon (OS/ASPR/EMMO);Byrd, Mark (OS/ASPR/EMMO);Chen, Andrew (OS/ASPR/EMMO);Cockrill, Jennifer (OS/ASPR/EMMO);Cua, Eduardo (OS/ASPR/EMMO); Dickinson, Jeanette (OS/ASPR/EMMO); Eckes,Jeanne (OS/ASPR/EMMO);Falone, Emily (OS/ASPR/EMMO); Formanski, Stephen (OS/ASPR/EMMO);Garner, Michael (OS/ASPR/EMMO); Gibbons, John (OS/ASPR/EMMO);Libby, Mark (OS/ASPR/EMMO);Lightner, Louis (OS/ASPR/EMMO);Rascher,Robert L. (OS/ASPR/EMMO);Raspberry,Jenny (OS/ASPR/EMMO); Andrews, Sean (OS/ASPR/EMMO);Blanchette, Glenn (OS/ASPR/EMMO);Bowman, Thomas (OS/ASPR/EMMO);Buell, Rick (OS/ASPR/EMMO;Evans, Pamela (OS/ASPR/EMMO);Fitzgerald, Denis (OS/ASPR/EMMO);Hall, Dana (OS/ASPR/EMMO);Harahan, Kevin (OS/ASPR/EMMO); Kleinman, Gary (OS/ASPR/EMMO);Mayer, Harry (OS/ASPR/EMMO);Odom, Janet (OS/ASPR/EMMO);Raheem, Murad (OS/ASPR/EMMO);Sturrock, Kenneth (OS/ASPR/EMMO); Taylor, Amyo (OS/ASPR/EMMO);Young, Mark (OS/ASPR/EMMO);Young, Thor (OS/ASPR/PDAS/EMMO); Smart, John (OS/ASPR/EMMO);Smith, Diane (OS/ASPR/EMMO); Stankewicz, Todd (OS/ASPR/EMMO); Voirin, Anthony (OS/ASPR/EMMO);Weir, Charles (OS/ASPR/IO); Imbriale, Samuel (OS/ASPR/SIIM);Thompson, Donna (OS/ASPR/IO)(CTR); ASPRRegion 4 (HHS/ASPR/OEM);Holland, Tara (OS/ASPR/EMMO);Mann, Travis (OS/ASPR/EMMO);Lee, Scott (OS/ASPR/EMMO);SOCInformation Management Section Chief (OS/ASPR);OS - ASPR- Security Team; Vineyard, Michael (HHS/ASPR/OEM) (michael.vineyard@hhs.gov); Espinosa,Gregorio (OS/ASPR/SIIM); Huang, Cindy (OS/ASPR/SIIM); Wolf, Laura (OS/ASPR/SIIM); Maycock, Brett (OS/ONS); De Vore, Jazmin (OS/ONS); Sims, Andrew (OS/ASPR/EMMO); Hill, April (OS/ASPR/EMMO);OS OSSI #2 -----Origin a I Appointment----From: Voice & Video Services Sent: Thursday, February 27, 2020 1:33 PM To: Voice & Video Services; Ford-Barnes, Arwenthia (OS/ASPR/1O); Moreno, Rafael (OS/ASPR); Maycock, Brett (OS/ONS); Huang, Cindy (OS/ASPR/SIIM) Subject: S-VTCASPR Meeting with LNOs and RECs When: Friday, February 28, 2020 1:00 PM-2:00 PM (UTC-05:00) Eastern Time (US & Canada). Where: Dia1:fb)(6) 11 Pin:l(b)(6) I Please see below for SVTCand Audio dial in: HSDN Dial in:f~b-)(B-)------~ From a Secret level STE/Viper phone. Dial rb)(B) ~ wait for the audio announcement, then dial rb)(B) land pressthe blue Send button in the upper left (STEonly). Viper phone participants would press the Enter button. For assistance please contact OHSVVOC at UnclassrH 5) fb)(6) I .___ __ __. -----Origina I Appointment----From: Voice & Video Services Sent: Thursday, February 27, 2020 12:55 To: Voice & Video Services; Huang, Cindy (OS/ASPR/SIIM) AMERICAN PVERSIGHT HHS-20-0580-A-000210 Subject: S-VTC ASPR Meet ing with LNOs and RECs When: Friday, February 28, 2020 13:00-14:00 (UTC-05:00) Eastern Time (US & Canada). Pinj(b)(6 ) Where: Dial:l(b)(B) II HSDN Dial in J.... '.b-)(B _)______ I __. 02/27/2020 - BMB- Created S-VTCon HSDN. Conference will be available at 12:30 PM ESTfor testing. For assistance please contact OHS VVOC at Unclass: 1877-457-4736. wait for the audio From a Secret level STE/Viper phone. Diall(b)(B) 5 land press the blue Send button in the announcement, then diall(b)( ) upper left (STEonly). Viper phone participants would press the Enter button I Good afternoon All, The ASPR, Dr. Robert Kadlec would like to address the LNO and REC'sTeams this Friday, February 22, 2020. Please adjust your calendars and make arrangements for your SVTC as soon as possible. We apologize for any inconvenience. Need Security# from ASPR Security asap Cindy Huang Intelligence Operations Specialist Division of Intelligence I Security, Intel, Information Management {SIIM) Office of Incident Command and Control (ICC) HEALTHAND HUMAN SERVICES(DHHS) I Assistant Secretary for Preparedness and Response(ASPR) Desk: (202) 730-8608 I Mobile: rb)(B) SIPR/HSDN: cindy.huang@dhs.sg,..,,. o=v.~g~ov---~ Anthony Woodrome Information Manager Intelligence & Analysis Division Office of National Security U.S. Department of Health and Human Services Office: 202-260-6460 Cell: rb )(6) Intelligence & Analysis Division Address: osonsiad@hhs.gov I Brett Maycock Senior Advisor for Homeland Security CDR, United States Public Health Service AMERICAN PVERSIGHT HHS-20-0580-A-000211 Office of Security & Strategic Information (OSSI) U.S. Department of Health & Human Services Office: 202-260-7509 Ce11:l(b)(6) Secure:K~b_)(6_) -~ Unclassified email: Brett.Maycock@hhs.gov SIPR/HSDN: Brett.M.Maycock@dhs.sgov.gov JWICS: MaycockB@hhs.id.ic.gov I Kadlec, Robert (OS/ASPR/IO); Ford-Barnes,Arwenthia (OS/ASPR/IO) Ford-Barnes, Arwenthia (OS/ASPR/1O); Callahan, Victoria (OS/ASPR/IO)(CTR) ; Shuy, Bryan (OS/ASPR/IO) ; Debarros, Jeanpierre (OS/ASPR/EMMO); Phillips, Sally (OS/ASPR/SPPR); jean-pierre p debarros (MIL) ; Debarros, Jean-pierre (MIL) ; Thornton, Cody R. (O5/ASPR/SIIM) ; Marrero, Abraham (MAIL.MIL) ; Mccreary, Kenneth (OS/ASPR/SPPR); Monahan, Kenneth (O5/ASPR/EMMO); Recipient: Monahan, Kenneth (MAIL.MIL) ; Soza, Liza (MIL) ; Vincent, Erik (OS/ASPR/EMMO); SOCDOD Northcom Liaison Officer (HHS/ASPR); Yeskey, Kevin (OS/ASPR/IO) ; Vongchan, Patrick (OS/ASPR/EMMO); Marrero, Abraham (OS/ASPR/EMMO); Brooks, Paul (O5/ASPR/IO) ; Bratcher-Bowman, Nikki (O5/ASPR/IO) ; Soza, Liza (O5/ASPR/EMMO); Sauer, Michael (OS/ASPR); AMERICAN PVERSIGHT HHS-20-0580-A-000212 Moreno, Rafael (O5/ASPR) ; Sakris, Derek (OS/ASPR/EMMO) ; Austin, Brad (OS/ASPR/EMMO) ; Banner, Gregory (O5/ASPR/ EMMO) ; Bartlett, Jonathon (OS/ASPR/EMMO) ; Byrd, Mark (OS/ASPR/EMMO) ; Chen, Andrew (OS/ASPR/EMMO) ; Cockrill, Jennifer (O5/ASPR/EMMO) ; Cua, Eduardo (OS/ASPR/EMMO) ; Dickinson, Jeanette (OS/ASPR/EMMO) ; Eckes, Jeanne (OS/ASPR/EMMO) ; Falone, Emily (O5/ASPR/ EMMO) ; Formanski, Stephen (OS/ASPR/EMMO) ; Garner, Michael (OS/ASPR/EMMO) ; Gibbons, John (OS/ASPR/EMMO) ; Libby, Mark (OS/ASPR/EMMO) ; Lightner, Louis (O5/ASPR/EMMO) ; Rascher, Robert L. (O5/ASPR/EMMO) ; Raspberry, Jenny (O5/ASPR/EMMO) ; Andrews, Sean (OS/ASPR/EMMO) ; Blanchette, Glenn (OS/ASPR/EMMO) ; Bowman, Thomas (OS/ASPR/EMMO) ; Buell, Rick (O5/ASPR/EMMO ; Evans, Pamela (OS/ASPR/EMMO) ; Fitzgerald, Denis (OS/ASPR/EMMO) ; Hall, Dana (O5/ASPR/EMMO) ; Harahan, Kevin (OS/ASPR/EMMO) ; Kleinman, Gary (O5/ASPR/EMMO) ; Mayer, Harry (OS/ASPR/EMMO) ; Odom, Janet (O5/ASPR/EMMO) ; Raheem, Murad (OS/ASPR/EMMO) ; Sturrock, Kenneth (OS/ASPR/EMMO) ; Taylor, Amye (OS/ASPR/EMMO) ; Young, Mark (O5/ASPR/ EMMO) ; Young, Thor (OS/ASPR/PDAS/EMMO) ; Smart, John (OS/ASPR/EMMO) ; Smith, Diane (OS/ASPR/EMMO) ; Stankewicz, Tod d (OS/ASPR/EMMO) ; Voirin, Anthony (OS/ASPR/EMMO) ; Weir, Charles (OS/ASPR/10) ; Imb riale, Samuel (OS/ASPR/SIIM) ; Thompson , Donna (OS/ASPR/10) (CTR) ; ASPR Region 4 (HHS/ASPR/OEM) ; Holland, Tara (OS/ASPR/EMMO) ; Mann, Travis (OS/ASPR/EMMO) ; Lee, Scott (OS/ASPR/EMMO) ; SOC Information Management Section Chief (OS/ASPR) ; OS - ASPR - Security Team ; Vineyard, Michael (OS/ASPR/10) ; Espinosa, Gregorio (OS/ASPR/SIIM) ; Huang, Cindy (OS/ASPR/SIIM) ; Wolf, Laura (OS/ASPR/SIIM) ; Maycock, Brett (OS/ONS) ; De Vore, Jazmin (OS/ONS) ; Sims, Andrew (OS/ASPR/EMMO) ; Bright, Rick (OS/ASPR/BARDA) ; Waters, Cicely (OS/ASPR/OEA) ; Kennedy, Ted (OS/ASPR/SPPR) ; ; TRANSCOM Scott AFB TCSG Room Surgeon General ; ; Hill, April (OS/ASPR/EMMO) Sent Date: 2020/02/28 10:54:32 Delivered Date: 2020/02/28 10:54 :40 AMERICAN PVERSIGHT HHS-20-0580-A-000214 From: To: jo hn Subject: Fwd: Seeking your advice Date: 2020/03/10 20:21:41 Priority: Normal Type: Note Sent from my iPhone Begin forwarded message: From: "Cardo, Denise M. MD (CDC/DDID/NCEZID /DHQP)" Date: March 10, 2020 at 7 :40: 17 PM EDT To: "Yeskey , Kevin (OS/ASPR/IO)" Subject: Re: Seeking your advice □ Heard that NY state announced they will produce their own. From: Cardo , Denise M. MD (CDC/DDID/NC EZID/DHQP ) Sent: Tuesday, March 10, 2020 5:03:46 PM To: Yeskey, Kevin (OS/ ASPR/IO) Subject: RE: Seeking your advice We do not have guidance on how institutions could make their own hand sanitizer. Let me check if others in my division are involved in these discussions. From: Yeskey, Kevin (OS/ASPR/IO) Sent: Tuesday, March 10, 2020 4 :47 PM To: Cardo, Denise M. MD (CDC/DDID/NCEZID/DHQP) Subject: Fwd: Seeking your advice Denise, Has CDC developed any guidance on hand sanitizer? See below Sent from my iPhone Begin forwarded message: AMERICAN PVERSIGHT HHS-20-0580-A-000215 From: John Prescott Date: March 10, 2020 at 1:17:53 PM EDT To: "Yeskey, Kevin (OS/ASPR/IO)" Subject: FW: Seeking your advice □ Kevin, Does ASPR have any guidance on institution s making their own hand sanitizer? There is obviously a shortage nationally and institutions are wondering about manufacturing their own. A seemingly minor problem but reflective of where we are. Thanks in advance. John From: David Skorton Sent: Tuesday, March 10, 2020 12:51 PM To: John Prescott ; Janis Orlowski ; Ross McKinney Cc:Jennifer Schlener ; Frank Trinity Subject: FW: Seeking your advice Importance: High For your adv ice on a response. Mary and I are longtime colleagues. thanks. David J. Skorton, MD President and CEO X Association of American Medical Colleges 655 K Street , N.W., Washington , D.C. 20001-2399 T 202-828-0460 E djskorton@aamc.org www.aamc.org AMERICAN PVERSIGHT HHS-20-0580-A-000216 From: Mary Hendrix Sent: Tuesday, March 10, 2020 12:49 PM To: David Skorton Subject: Seeking your advice Importance: High Information Security Warning • External Email: Do not dick on links or open attachments unless you trust the sender. Dear David - we are in a real bind at our university, and I am sure others are as well - regarding the lack of availability of commercial hand sanitizers. Our School of Nursing is willing to generate a hand sanitizer, following a simple WHO recommended formulation. However, our General Counsel warns that we are not allowed to generate this product for campus use - without being a registered manufacturer with the FDA. During this time of campus visits and other large gatherings, where washing hands is not always easily possible, we wanted to supply hand sanitizers - until our back-ordered shipment of the product arrives. Are you aware of a work-around during this coronavirus crisis? With special thanks for your help, Mary Mary J.C. Hendrix President Shepherd University P.0. Box 5000 301 N. King St. Shepherdstown, WV 25443-5000 T 304-876-5107 F 304-876 -6007 mhendr ix@shepherd .edu https :/Ip rotect2 .fi reeye .co mlu rl?k =b99 36b 19-e5c 74232-b9935a 26-0cc4 7a 6d 17cc5b97af5e4613048d &u =https ://p rotect2. fireeye .com/ u rl ?k=615a0051 -3d0e 192d615a316e-Occ47a dc5fa2 -c9379e54747 d0432&u=http://www.s hep he rd.ed u/ Excellence Innovation Opportunity: Training the Next Generation of Leaders and Model Citizens This email contains confidential and proprietary information . It is for the intended recipient only . If an addressing or transmission error has misdirected this email, please delete this message and notify the sender immediately. If you are not the intended recipient, you may not use, disclose, copy or print this email. From: Alan Perdue Sent: Tuesday, March 10, 2020 8:21 AM AMERICAN PVERSIGHT HHS-20-0580-A-000217 To: Sonya Sholley ; Mary Hendrix The regs of the FDA are definitive; hand sanitizers are regulated and any manufacture of it that extends beyond personal use requires being registered w FDA as a drug manuifacturer. A partner at Crowell &Moring in DC emailed me back this morning, fully confirming my analysis of the regs. There is an approved recipe for hand sanitizer from FDA, which any manufacturer could use w/o it being a "new drug" but you have to be a registered manufacturer. That involves fees and significant quality control. The degree of the regulation is illustrated in the fact that FDA ordered Purcell to take several of their sanitize rs OFF the market in January of this year. ... Also, it is apparently not permitted to advertise that any hand sanitizer helps prevent Coronavirus .... FDA has created two categories of emergency exceptions for Coronavirus. 1 is for some limited leeway in developing the testing, and 1 is for some leeway in masks . K Alan Perdue General Counsel Shepherd University Sender: < Kevin.Yeskey@hhs.gov> Recipient: john Sent Date: 2020/03/10 20:21:40 Delivered Date: 2020/03/10 20:21:41 Message Flags: Unsent AMERICAN PVERSIGHT HHS-20-0580-A-000218 Kadlec, Robert (OS/ASPR/IO) Trinidad, James (O5/ASPR/SIIM) ; To: Redd, John (O5/ASPR/SPPR) ASPRData (HHS/ASPR); OS SecretarysOperations Center ; SOCASPRSLT ; SOCInformation ManagementSection Chief (O5/ASPR) Subject: RE: 2019-nCoVOpen Media Report -31JAN2020 Date: 2020/01/31 19:19:06 Priority: Normal Type: Note Test.. ..thank you so much Jonathan From: Trinidad, James (OS/ASPR/SIIM) Sent: Friday, January 31, 2020 7:18 PM To: Redd, John (OS/ASPR/SPPR) Cc:ASPR Data (HHS/ASPR) ; OS Secretarys Operations Center ; SOC ASPR SLT ; SOC Information Management Section Chief (OS/ASPR) Subject: Re: 2019-nCoV Open Media Report -31JAN2020 Hi John, (b)(5) Best, James ODA Duty Officer James Phillip Trin idad, M.P.H., M.S. Commander (CDR) , U.S. Public Health Service Public Health Analyst Office of the Assistant Secretary for Preparedness and Response (ASPR) Office of Security, Intelligence, and Information Management (SUM) Information Management Division (IMD) Operational and Data Analytics Branch (ODA) O'Neill Building: 200 C St SW, Room 5310-C , Washington, DC 20024 E-mail: james.trinidad@hhs.gov AMERICAN PVERSIGHT HHS-20-0580-A-000219 Offic e: 202-730-8738 Cell: fb )(6) I On: 31 January 2020 18:11, "ASPRData (HHS/ASPR)"wrote : From: OS Secretarys Operations Center Sent: Friday, January 31, 2020 6: 11:26 PM (UTC-05:00) Eastern Time (US &Canada) To: SOC Information Management Section Chief (OS/ASPR); ASPR Data (HHS/ASPR) Cc: OS Secretarys Operations Center Subject: FW: 2019-nCoV Open Media Report -31JAN2020 ALCON, Please see the comments below. Very Respectfully, Paul Netzel Watch Officer Watch Branch Secretary's Operations Center (SOC) Assistant Secretary for Preparedness and Response (ASPR) Phone: 202-619-7800 Email: hhs.soc@hhs.gov cid: imageOO 1. png@O 1 D4B7F4 .412FEC70 CONFIDENTIALITY NOTICE: This e-mail communication and any attachments may contain confidential and privileged information for the use of the designated recipients. If you are not the intended recipient, (or authorized to receive for the recipient) you are hereby notified that you have received this communication in error and that any review, disclosure, dissemination, distribution or copying of it or its contents is prohibited. If you have received this communication in error, please destroy all copies of this communication and any attachments and contact the sender by reply e-mail or telephone (202-6197800). From: Redd, John (OS/ASPR/SPPR) Sent: Friday, January 31, 2020 6:08 PM To: OS Secretarys Operations Center Cc: SOCASPRSLT; SOCInformat ion Management Section Chief (OS/ASPR) Subject: RE: 2019-nCoV Open Media Report - 31JAN2020 AMERICAN PVERSIGHT HHS-20-0580-A-000220 (b)(5) John From: OSSecretarys Operations Center Sent: Friday, January 31, 2020 5:46 PM To: OSSecretarysOperations Center Subject: 2019-nCoVOpen Media Report -31JAN2020 UNCLASSIFIED / / FOR OFFICIAL USE ONLY Good Afternoon All, Attached is the 31Jan20 2019 Novel Coronavirus Open Media Report. BLUF: The number of confirmed cases and deaths has dramatically increased since yesterday. HHS Secretary Alex Azar declared a public health emergency for the U.S. and ordered any U.S. citizens returning from the center of the outbreak in China to be quarantined for 14 days. The U.S. State Department elevated the travel advisory (Level 4 - Do Not Travel) restricting travel to China. The CDC orders a 14-day coronavirus quarantine for the U.S. citizens repatriated from Wuhan, China. South Korea is reporting its first case of tertiary transmission, the first of its kind outside of China. Officials from several states are addressing false information about the coronavirus that is spreading online and through social media. Epidemiology: • Please refer to the CDC SITREP for official case counts by location. • Traditional news med ia reports death toll of 213 (all in China), with 9,776 cases confirmed (9,658 (98.8%) in China). This represents a dramatic increase from yesterday's reporting of 7,819 cases and 170 deaths in China. • Since yesterday's open media report, first cases were reported in UK, Russia, Italy, and Sweden. Public Health Response: • HHS Secretary Azar declares "Public Health Emergency" in the US. • President Trump signs order for temporary suspension of entry to people who pose a risk of transmitting coronavirus. U.S. citizens returning from the center of the outbreak in China are to be quarantined for 14 days. • Facebook partners with Harvard University School of Public Health and National Tsing Hua University in Taiwan for sharing aggregated AMERICAN PVERSIGHT HHS-20-0580-A-000221 mobility data and population density maps for forecasting outbreak models. Supply Chain: • India bans export of protective masks and clothing. Evacuation/Repatriation • The CDC has ordered a federal 14-day quarantine for nearly all the Americans who recently returned from Wuhan, China. • Riverside County Public Health issued order requiring American evacuee who attempted to leave March ARB to be quarantined for full 14 days. Trave l Considerations • US State Department orders travel advisory of "Level 4: Do Not Travel" for China, an expansion from a "Level 4: Do Not Travel" advisory specifically for Hubei Provence, China ordered on 27Jan2020. Advisory states that US persons in China should consider departing using commercial means, and non-essential US government personnel defer travel to China. False Information and Public Sentiment • Facebook aims to limit spread of misinformation, harmful content (i.e., could pose physical risk to readers), and hashtags related to misinformation on Facebook and Instagram platforms while directing members to helpful information through use of third-party factcheckers. Harmful content may include claims designed to discourage treatment, take inappropriate precautions, use of false cures Please see the attached Open Media Report for additional information. This message was distributed to 2019 nCov Distribution Lists, ASPR SLT, SOC Section Chiefs, SOC Leadership, and appropriate SMEs. UNCLASSIFIED / / FOR OFFICIAL USE ONLY Prepared by: Secretary's Operations Center U.S. Department of Health and Human Services (HHS) Assistant Secretary for Preparedness and Response (ASPR) 200 Independence Ave., S.W. Washington, D.C. 20201 Office: (202) 619-7800 Fax: 800-514-4256 Email: hhs.soc@hhs.gov AMERICAN PVERSIGHT HHS-20-0580-A-000222 :::-:::: Description: Description: Description: Description: Description: Description: Description: Description: Description: cid: image00 1. png@0 1CCFC4D.92F36DD0 Description: CONFIDENTIALITY NOTICE: This e-mail communication and any attachments may contain confidential and privileged information for the use of the designated recipients. If you are not the intended recipient, (or authorized to receive for the recipient) you are hereby notified that you have received this communication in error and that any review, disclosure, dissemination, distribution or copying of it or its contents is prohibited. If you have received this communication in error, please destroy all copies of this communication and any attachments and contact the sender by reply e-mail or telephone (202-6197800). Sender: Kadlec, Robert (OS/ASPR/IO) Trinidad, James (OS/ASPR/SIIM) ; Redd, John (OS/ASPR/SPPR) ; ASPR Data (HHS/ASPR) ; Recipient: OS Secretarys Operations Center ; SOC ASPR SLT ; SOC Info rmation Management Section Chief (OS/ASPR) Sent Date: 2020/01/3119:19:05 Delivered Date: 2020/01/31 19: 19:06 AMERICAN PVERSIGHT HHS-20-0580-A-000223 Bright, Rick (O5/ASPR/BARDA) Cooper, Kevin (OS/ASPR/ORM) ; To: Adams, Steven A. (CDC/SNS/DSNS) Disbrow, Gary (OS/ASPR/BARDA) ; Johnson, Robert (OS/ASPR/BARDA) ; Yeskey, Kevin (OS/ASPR/IO) Subject: Quick question short fuse Date: 2020/03/1118 :24 :24 Priority: Normal Type: Note Fouo confidential. Kevin and Steve, Thanks. Rick. Bright, Rick (OS/ASPR/BARDA) Cooper, Kevin (OS/ASPR/ORM) ; Adams, Steven A. (CDC/SNS/DSNS) ; Disbrow, Gary (OS/ASPR/BARDA) ; Johnson, Robert (OS/ASPR/BARDA) ; Yeskey, Kevin (OS/ASPR/IO) Sent Date: 2020/03/1118 :24 :23 Delivered Date: 2020/03/1118 :24:24 AMERICAN PVERSIGHT HHS-20-0580-A-000224 Kadlec, Robert (O5/ASPR/IO) Moughalian, Jen (HHS/ASFR) ; Johnston, Darcie (HHS/IEA) ; Stecker, Judy (O5/IOS) McGowan, Robert (Kyle) (CDC/OO/OCS) ; Yeskey, Kevin (O5/ASPR/IO) ; Shuy, Bryan (O5/ASPR/IO) ; Rigas, Laura (HHS/IEA) ; Lothrop, Julia (HHS/IEA) ; Trueman, Laura (HHS/IEA) Subject: RE: Need answers specifics for Arkansas Governor Date: 2020/02/28 15: 18:48 Priority: Normal Type: Note We have a pre-solicitation this buy notice for 500 M masks that is o ut as of t oday. Ad min ask is enough t o cover From: Moughalian, Jen (HHS/ASFR) Sent: Friday, February 28, 2020 3:10 PM To: Kadlec, Robert (OS/ASPR/1O); Johnston, Darcie (HHS/IEA) ; Stecker, Judy (OS/IOS) Cc: McGowan, Robert (Kyle) (CDC/OD/OCS) ; Yeskey, Kevin (OS/ASPR/1O) ; Shuy, Bryan (OS/ASPR/1O); Rigas, Laura (HHS/IEA) ; Lothrop, Julia (HHS/IEA) ; Trueman, Laura (HHS/IEA) Subject: RE: Need answers specifics for Arkansas Governor From: Kadlec, Robert (OS/ASPR/1O) Sent: Friday, February 28, 2020 2:59 PM To: Moughalian, Jen (HHS/ASFR) ; Johnston, Darcie (HHS/I EA) ; Stecker, Judy (OS/IOS) Cc: McGowan, Robert (Kyle) (CDC/OD/OCS) ; Yeskey, Kevin (OS/ASPR/1O) ; Shuy, Bryan (OS/ASPR/1O); Rigas, Laura (HHS/IEA) ; Lothrop, Julia (HHS/I EA) ; Trueman, Laura (HHS/IEA) AMERICAN PVERSIGHT HHS-20-0580-A-000225 Subject: RE: Need answers specifics for Arkansas Governor b)(5) est Bob From: Mougha lia n, Jen (HHS/ASFR) Sent: Friday, February 28, 2020 2:51 PM To: Johnston, Darcie (HHS/IEA) ; Stecker, Judy (OS/1O5) Cc: Kadlec, Robert (OS/ASPR/1O) ; McGowan, Robert (Kyle) (CDC/OD/OCS) ; Yeskey, Kevin (OS/ASPR/1O); Shuy, Bryan (OS/ASPR/1O) ; Rigas, Laura (HHS/IEA) ; Lothrop, Julia (HHS/IEA) ; Trueman, Laura (HHS/IEA) Subject: RE: Need answers specifics for Arkansas Governor b)(5) From: Johnston, Darcie (HHS/IEA) Sent: Friday, February 28, 2020 2:44 PM To: Stecker, Judy (05/105) Cc: Kadlec, Robert (OS/ASPR/1O); McGowan, Robert (Kyle) (CDC/OD/OCS) ; Yeskey, Kevin (OS/ASPR/1O); Shuy, Bryan (OS/ASPR/1O) ; Rigas, Laura (HHS/IEA) ; Lothrop, Julia (HHS/IEA) ; Trueman, Laura (HHS/IEA) ; Moughalian, Jen (HHS/ASFR) Subject: RE: Need answers specifics for Arkansas Governor (b)(5) Darcie L. Johnston Director, Intergovernmental Affairs U.S. Department of Health and Human Services Office of the Secretary 202-690-1058 (office) rb )(B) ~ eelI) From: Stecker, Judy (OS/1O5) Sent: Friday, February 28, 2020 2:43 PM To: Johnston, Darcie (HHS/IEA) Cc: Kadlec, Robert (OS/ASPR/1O); McGowan, Robert (Kyle) (CDC/OD/OCS) ; Yeskey, Kevin (OS/ASPR/1O); Shuy, Bryan (OS/ASPR/1O) ; Rigas, Laura (HHS/IEA) ; Lothrop, Julia (HHS/IEA) ; Trueman, Laura (HHS/IEA) ; Moughalian, Jen AMERICAN PVERSIGHT HHS-20-0580-A-000226 (HHS/ASFR) Subject: Re: Need answers specifics for Arkansas Governor (b)(5) Sent from my iPhone On Feb 28, 2020, at 2:41 PM , Johnston, Darcie (HHS/IEA) wrote: □ Thank you! Darcie L. Johnston Director, Intergovernmental Affairs U.S. Department of Health and Human Services Office of the Secretary 202-690-1058 (office} rb )(6) ~cell} From: Kadlec, Robert (OS/ASPR/IO) Sent: Friday, February 28, 2020 2:41 PM To: Johnston, Darcie (HHS/I EA) ; McGowan, Robert (Kyle) (CDC/OD/OCS) ; Yeskey, Kevin (OS/ASPR/IO) ; Shuy, Bryan (OS/ASPR/IO) Cc: Stecker, Judy (OS/IOS) ; Rigas, Laura (HHS/IEA) ; Lothrop, Julia (HHS/I EA) ; Trueman, Laura (HHS/I EA) Subject: RE: Need answers specifics for Arkansas Governor b)(5) From: Johnston, Darcie (HHS/I EA) Sent: Friday, February 28, 2020 2:22 PM To: Kadlec, Robert (OS/ASPR/IO) ; McGowan, Robert (Kyle) (CDC/OD/OCS) ; Yeskey, Kevin (OS/ASPR/IO) ; Shuy, Bryan (OS/ASPR/IO) Cc: Stecker, Judy (OS/IOS) ; Rigas, Laura (HHS/IEA) ; Lothrop, Julia (HHS/I EA) ; Trueman, AMERICAN PVERSIGHT HHS-20-0580-A-000227 Laura (HHS/I EA) Subject: RE: Need answers specifics for Arkansas Governor b)(5) Darcie L. Johnston Director, Intergovernmental Affairs U.S. Department of Health and Human Services Office of the Secretary 202-690-1058 (office} rb )(6) [cell} From: Kadlec, Robert (OS/ASPR/IO) Sent: Friday, February 28, 2020 2:18 PM To: Johnston, Darcie (HHS/I EA) ; McGowan, Robert (Kyle) (CDC/OD/OCS) ; Yeskey, Kevin (OS/ASPR/IO) ; Shuy, Bryan (OS/ASPR/IO) Cc: Stecker, Judy (OS/IOS) ; Rigas, Laura (HHS/I EA) ; Lothrop, Julia (HHS/I EA) Subject: RE: Need answers specifics for Arkansas Governor (b)(5) From: Johnston, Darcie (HHS/I EA) Sent: Friday, February 28, 2020 1:45 PM To: McGowan, Robert (Kyle) (CDC/OD/OCS) ; Kadlec, Robert (OS/ASPR/IO) ; Yeskey, Kevin (OS/ASPR/IO) ; Shuy, Bryan (OS/ASPR/IO) Cc: Stecker, Judy (OS/IOS) ; Rigas, Laura (HHS/I EA) ; Lothrop, Julia (HHS/I EA) Subject : Need answers specifics for Arkansas Governor Importance: High The Governor spoke w ith Vice President Pence today. He asked the VP for 2 things: AMERICAN PVERSIGHT HHS-20-0580-A-000228 1. The ability to have state-level testing so they do not have to send samples to the CDC. The VP told the Governor the state should have that next week. 2. An adequate supply of PPE for future needs. The VP mentioned that the federal government is looking at emergency authorities to ensure this. Thank you, Darcie Darcie L. Johnston Director, Intergovernmental Affairs U.S. Department of Health and Human Services Office of the Secretary 202-690-1058 l(bl(6l Sender: (office) l(cell) Kadlec, Robert (OS/ASPR/IO) Moughalian,Jen (HHS/ASFR); Johnston, Darcie (HHS/IEA) ; Stecker, Judy (O5/IOS) ; McGowan,Robert (Kyle) (CDC/OO/OCS); Yeskey, Kevin (OS/ASPR/IO); Shuy, Bryan (OS/ASPR/1O); Rigas, Laura (HHS/IEA) ; Lothrop, Julia (HHS/IEA) ; Trueman, Laura (HHS/IEA) Sent Date: 2020/02/28 15:18:47 Delivered Date: 2020/02/28 15:18:48 AMERICAN PVERSIGHT HHS-20-0580-A-000229 Kadlec, Robert (O5/ASPR/IO) Johnston, Darcie (HHS/IEA) ; To: Stecker, Judy (O5/IOS) McGowan, Robert (Kyle) (CDC/OD/OCS) ; Yeskey, Kevin (O5/ASPR/IO) ; Shuy, Bryan (O5/ASPR/IO) ; CC: Rigas, Laura (HHS/IEA) ; Lothrop, Julia (HHS/IEA) ; Trueman, Laura (HHS/IEA) ; Moughalian, Jen (HHS/ASFR) Subject: RE: Need answers specifics for Arkansas Governor Date: 2020/02/28 15:20:45 Priority: Normal Type: Note yes From: Johnston, Darcie (HHS/IEA) Sent: Friday, February 28, 2020 2:44 PM To: Stecker, Judy (05/105) Cc: Kadlec, Robert (OS/ASPR/1O); McGowan, Robert (Kyle) (CDC/OD/OCS) ; Yeskey, Kevin (OS/ASPR/1O); Shuy, Bryan (OS/ASPR/1O) ; Rigas, Laura (HHS/IEA) ; Lothrop, Julia (HHS/IEA) ; Trueman, Laura (HHS/IEA) ; Moughalian, Jen (HHS/ASFR) Subject: RE: Need answers specifics for Arkansas Governor b)(5) Darcie L. Johnston Director, Intergovernmental Affairs U.S. Department of Health and Human Services Office of the Secretary 202-690-1058 (office) rb) (6) eel I) I( AMERICAN PVERSIGHT HHS-20-0580-A-000230 From: Stecker , Judy (05/ 105) Sent: Friday , February 28, 2020 2:43 PM To: Johnston, Darcie (HHS/I EA) Cc: Kadlec, Robert (OS/ASPR/IO) ; McGowan , Rober t (Kyle) (CDC/OD/OCS) ; Yeskey, Kevin (OS/ASPR/IO) ; Shuy, Bryan (OS/ASPR/IO) ; Rigas, Laura (HHS/IEA) ; Lothrop, Julia (HHS/IEA) ; Trueman, Laura (HHS/IEA) ; Moughalian, Jen (HHS/ASFR) Subject: Re: Need answers specifics for Arkansas Governor b)(5) Sent from my iPhone On Feb 28, 2020 , at 2:41 PM, John ston , Darcie (HHS/IEA) wrote: □ Thank you! Darcie L. Johnston Director, Intergovernmental Affairs U.S. Department of Health and Human Services Office of the Secretary 202-690-1058 (office} rb )(6) I(cell} From: Kadlec, Robert (OS/ASPR/IO) Sent: Friday, February 28, 2020 2:41 PM To: Johnston, Darcie (HHS/I EA) ; McGowan, Robert (Kyle) (CDC/OD/OCS) ; Yeskey, Kevin (OS/ASPR/IO) ; Shuy, Bryan (OS/ASPR/IO) Cc: Stecker, Judy (OS/IOS) ; Rigas, Laura (HHS/I EA) ; Lothrop, Julia (HHS/I EA) ; Trueman, Laura (HHS/I EA) Subject: RE: Need answers specifics for Arkansas Governor b)(5) From: Johnston, Darcie (HHS/I EA) AMERICAN PVERSIGHT HHS-20-0580-A-000231 Sent: Friday, February 28, 2020 2:22 PM To: Kadlec, Robert (OS/ASPR/IO) ; McGowan, Robert (Kyle) (CDC/OD/OCS) ; Yeskey, Kevin (OS/ASPR/IO) ; Shuy, Bryan (OS/ASPR/IO) Cc: Stecker, Judy (OS/IO5) ; Rigas, Laura (HHS/I EA) ; Lothrop, Julia (HHS/I EA) ; Trueman, Laura (HHS/I EA) Subject: RE: Need answers specifics for Arkansas Governor (b)(5) Darcie L. Johnston Director, Intergovernmental Affairs U.S. Department of Health and Human Services Office of the Secretary 202-690-1058 (office} l(b)(6) (cell} I From: Kadlec, Robert (OS/ASPR/IO) Sent: Friday, February 28, 2020 2:18 PM To: Johnston, Darcie (HHS/I EA) ; McGowan, Robert (Kyle) (CDC/OD/OCS) ; Yeskey, Kevin (OS/ASPR/IO) ; Shuy, Bryan (OS/ASPR/IO) Cc: Stecker, Judy (OS/IO5) ; Rigas, Laura (HHS/I EA) ; Lothrop, Julia (HHS/I EA) Subject: RE: Need answers specifics for Arkansas Governor From: Johnston, Darcie (HHS/I EA) Sent: Friday, February 28, 2020 1:45 PM To: McGowan, Robert (Kyle) (CDC/OD/OCS) ; Kadlec, Robert (OS/ASPR/IO) ; Yeskey, Kevin (OS/ASPR/IO) ; Shuy, Bryan (OS/ASPR/IO) Cc: Stecker, Judy (05/105) ; Rigas, Laura (HHS/I EA) AMERICAN PVERSIGHT HHS-20-0580-A-000232 ; Lothr op, Julia (HHS/IEA) Subject: Need answers specifics for Arkansas Govern or Importance : High The Governor spoke with Vice President Pence today. He asked the VP for 2 things: 1. The ability to have state-leve l testing so they do not have to send samples to the CDC. The VP to ld the Governor the state should have that next week. 2. An adequate supply of PPE for future needs. The VP ment ioned that the federal government is looking at emergency aut horities to ensure this. Thank you, Darcie Darcie L. Johnst on Directo r, Inte rgovernmen t al Aff airs U.S. Departmen t of Healt h and Human Services Off ice of t he Secret ary 202-690-1058 (office) f b)(6) I(cell) Sender: Kadlec, Robert (OS/ASPR/IO) Johnston, Darcie (HHS/IEA) ; Stecker, Judy (OS/10S) ; McGowan, Robert (Kyle) (CDC/OD/OCS) ; Yeskey, Kevin (OS/ASPR/IO) ; Shuy, Bryan (OS/ASPR/IO); Rigas, Laura (HHS/IEA) ; Lothrop, Julia (HHS/IEA) ; Trueman, Laura (HHS/I EA) ; Moughalian, Jen (HHS/ASFR) Sent Date : 2020/02/28 15:20:44 Delivered Date : 2020/02/28 15:20:45 AMERICAN PVERSIGHT HHS-20-0580-A-000233 Kadlec, Robert (O5/ASPR/IO) Yeskey, Kevin (O5/ASPR/IO) ; Callahan, Michael V.,M.D. ; Redd, John (O5/ASPR/SPPR) ; Childs, Richard (NIH/NHLB I ) [El ; ,f:b)(6) @unmc.edu> Subject: Fwd: Afternoon Update of Dr. Levitt's COVID- 19 Update for 28 February 2020 Date: 2020/02/28 16:45:45 Priority: Normal Type: Note Note attachments. Sent from my iPhone Begin forwarded message: From: "Robert Levitt" 4 (b)(B) @hotmail.com> Subject: Afternoon Update of Dr. Levitt's COVID-19 Update for 28 February 2020 Dear All, NEJM this afternoon posted online three very important articles re: COVID19. Because of their importance and the WHO increase in threat level today, I have prepared an afternoon edition of my Update before the weekend begins. I thank the NEJM for releasing these articles prior to the weekend. I know that Update recipients have been busy in meetings all day today and have not seen these articles. SARS-CoV-2will not take the weekend off and neither will our public servants I'm certain. Thank you all. BillGates has written a 'what needs to be done' Perspective for the Journal. See pdf attached above. As you know the Bill and Melinda Gates Foundation has donated at least $100 Million to the effort to end the spread of COVID-19 and treat infected patients, esp. in low or middle income countries; e.g., sub-Saharan Africa. Gates lists what needs to be done; all efforts involve cooperation between countries and huge investments of money. AMERICAN PVERSIGHT HHS-20-0580-A-000234 Guhan, et. al. have reported in the Journal the clinical characteristics of the largest group of COVID-19 patients to date: 1099 patients. See pdf above. Note no patient included in this sample population was lost to follow-up. Because we are entering the weekend I have abstracted the Guhan report below: Sample population represent 15% of patients hospitalized with COVID-19 in China. Only 5% were admitted to the ICU; 2.3% had mechanical ventilation; 1.4% died. 72% of non-Wuhan patients had contact with Wuhan residents. Diagnosis confirmed by RT-PCR. Nearly 90% had fever; 66% had cough. Increasing age and comorbidities increased the risk of COVID-19, but only by 20%. CT scans showed ground glass opacities {GGO} in non-severe and severe cases; GGO were greater in the severe cases; distribution was peripheral and posterior (reverse bat wing on CXR)by my review of Supplementary Appendix CT images. No CT abnormalities in 18% of nonsevere cases and 3% of severe cases. Lymphopenia (<1500/cm3} was seen in 88% of cases; thrombocytopenia and leukopenia in 33% of cases. Patients were treated with antibiotics, anti-virals, some with steroids, oxygen. Average hospital stay was 12 days for those discharged at time of publication. Fauci, et. al. have an Editorial re: Guhan report. See pdf attached above. Authors note that the incubation period is 9-12 days so there is an interval to treat infected patients before the disease becomes manifest. But we need a treatment to do this. NIAID, CDC in U.S. and the Chinese CDC have hundreds of ongoing clinical trials. The authors emphasize that this epidemic can be controlled before its pandem ic, but only if the whole world pulls together. Note that the BBCtoday reports 210 deaths among 388 infected Iranian patients. This is a very large discrepancy compared to the 34 deaths reported by the Iranian government. If the BBC investigators who went to Iranian hospitals are correct, the next question is whether the excess deaths were due to lack of ICUs or equipment or whether the SARS-CoV-2 infecting Iran has mutated from coronavirus infecting China. See: https://www .bbc.com/news/worl d-m idd le-east-51673053 RGL, M.D. If you wish to unsubscribe to this email service, please contact Dr. Robert Levitt at l(b)(6) ~ hotmail.com and include in the subject line: Unsubscribe. Disclaimer: This email expresses the views, thoughts, and opinions of the author and no other organization, group or individual. The information in this email is AMERICAN PVERSIGHT HHS-20-0580-A-000235 intended solely for personal non-commercial use. The author may have made unintentional errors. This email may contain copyrighted material; its inclusion in this email constitutes a 'fair use" of copyrighted material as provided in Section 107 of the US Copyright Law. If you wish to use the copyrighted material beyond "fair use", you must obtain permission from the copyright owner. Kadlec, Robert (O5/ASPR/IO) Yeskey, Kevin (O5/ASPR/IO) ; Callahan, Michael V.,M.D. ; Redd, John (OS/ASPR/SPPR); Childs, Richard (NIH/NHLBI) [El ; ,kb)(6) blunmc.edu> Sent Date: 2020/02/28 16:45:39 Delivered Date: 2020/02/28 16:45:45 AMERICAN PVERSIGHT HHS-20-0580-A-000236 Kadlec, Robert (OS/ASPR/IO) Waters, Cicely (OS/ASPR/OEA); Shuy, Bryan (OS/ASPR/IO); Yeskey, Kevin (OS/ASPR/IO); Greene, Jonathan (OS/ASPR/EMMO); Imbriale, Samuel (OS/ASPR/SIIM); Allen, Ronald (OS/ASPR/OEA); Phillips, Sally (OS/ASPR/SPPR) ; (FYDIBOHF23SPDL T)/cn =Recipients/cn=Sd6ce8134846423cb83b5b28464edb60-Phi Bratcher-Bowman, Nikki (OS/ASPR/IO); Herrmann, Jack (OS/ASPR/OEA); Petillo, Jay (OS/ASPR/MFHC); Eldridge, Schuyler (OS/ASPR/MFHC) Subject: RE: ASTHO/NACCHO SOCLNO - confirmed Date: 2020/02/28 17:29:31 Priority: Normal Type: Note Thank you From: Waters, Cicely (OS/ASPR/OEA) Sent: Friday, February 28, 2020 5:22 PM To: Kadlec, Robert (OS/ASPR/10) ; Shuy, Bryan (OS/ASPR/10) ; Yeskey, Kevin (OS/ASPR/10) ; Greene, Jonathan (OS/ASPR/EMMO) ; Imbriale, Samuel (OS/ASPR/SIIM) ; Allen, Ronald (OS/ASPR/OEA) ; Phillips, Sally (OS/ASPR/SPPR); Bratcher-Bowman, Nikki (OS/ASPR/10) ; Herrmann, Jack (OS/ASPR/OEA) ; Petillo, Jay (OS/ASPR/MFHC) ; Eldridge, Schuyler (OS/ASPR/MFHC) Subject: ASTHO/NACCHO SOC LNO - confirmed Dr. Kadlec, b)(5) AMERICAN PVERSIGHT HHS-20-0580-A-000237 Regards, Cicely Cicely L. Waters Director, Office of External Affairs Assistant Secretary for Preparedness and Response U.S. Department of Health and Human Services 200 C St, SW Washington , D.C. 20201 (o) 202-205-0714 (m) l._ __, (b_ H6_) __ cicely.waters@hhs .gov Kadlec, Robert (OS/ASPR/IO) Waters, Cicely (OS/ASPR/OEA); Shuy, Bryan (OS/ASPR/10) ; Yeskey, Kevin (OS/ASPR/IO); Greene, Jonathan (OS/ASPR/EMMO); Imbriale, Samuel (OS/ASPR/SIIM); Allen, Ronald (OS/ASPR/OEA); Phillips, Sally (OS/ASPR/S PPR) ; Bratcher-Bowman, Nikki (OS/ASPR/IO); Herrmann, Jack (OS/ASPR/OEA); Petillo, Jay (OS/ASPR/MFHC); Eldridge, Schuyler (OS/ASPR/MFHC) Sent Date: 2020/02/28 17:29:30 Delivered Date: 2020/02/28 17:29:31 AMERICAN PVERSIGHT HHS-20-0580-A-000238 Kadlec, Robert (O5/ASPR/IO) Cote, Mick (O5/ASPR/EMMO); To: Yeskey, Kevin (O5/ASPR/IO) Greene, Jonathan (O5/ASPR/EMMO); Horahan, Kevin (O5/ASPR/EMMO); CC: Shuy, Bryan (O5/ASPR/IO) ; Austin, Meredith (uscg.mil) Subject: RE: Grand PrincessTick Tock Bullets Date: 2020/03/08 10:58:20 Priority: Normal Type: Note Thanks Mick just what the doctor ordered From: Cote, Mick (OS/ASPR/EMMO) Sent: Sunday, March 8, 2020 10:57 AM To: Kadlec, Robert (OS/ASPR/10) ; Yeskey, Kevin (OS/ASPR/10) Cc: Greene, Jonathan (OS/ASPR/EMMO) ; Harahan, Kevin (05/ASPR/EMMO) ; Shuy, Bryan {OS/ASPR/10) ; Austin, Meredith (uscg.mil) Subject: Grand Princess Tick Tock Bullets b)(5) AMERICAN PVERSIGHT HHS-20-0580-A-000239 b)(5) Kadlec, Robert (OS/ASPR/IO) Cote, Mick (OS/ASPR/EMMO) ; Yeskey, Kevin (OS/ASPR/IO) ; Greene, Jonathan (OS/ASPR/EMMO) ; Recipient: Harahan, Kevin (OS/ASPR/EMMO) ; Shuy, Bryan (OS/ASPR/IO) ; Austin, Meredith (uscg.mil) Sent Date: 2020/03/08 10:58 : 19 Delivered Date: 2020/03/08 10:58 :20 AMERICAN PVERSIGHT HHS-20-0580-A-000240 Kadlec, Robert (O5/ASPR/IO) Cote, Mick (O5/ASPR/EMMO); To: Yeskey, Kevin (O5/ASPR/IO) Greene, Jonathan (O5/ASPR/EMMO); Horahan, Kevin (O5/ASPR/EMMO); Shuy, Bryan (O5/ASPR/IO) ; CC: (FYDIBOHF23SPDL Austin, Meredith (uscg.mil) ; Redd, John (O5/ASPR/SPPR); Callahan, Michael V.,M.D. Subject: RE: Grand PrincessTick Tock Bullets Date: 2020/03/08 11:11:43 Priority: Normal Type: Note (b}(5} From: Cote, Mick {OS/ASPR/EMMO) Sent: Sunday, March 8, 2020 10:57 AM To: Kadlec, Robert {OS/ASPR/10) ; Yeskey, Kevin {OS/ASPR/10) Cc: Greene, Jonathan {OS/ASPR/EMMO) ; Horahan, Kevin (OS/ASPR/EMMO) ; Shuy, Bryan (OS/ASPR/10) ; Austin, Meredith (uscg.mil) Subject: Grand Princess Tick Tock Bullets b}(5} AMERICAN PVERSIGHT HHS-20-0580-A-000241 b)(5) Kadlec, Robert (O5/ASPR/IO) Cote, Mick (O5/ASPR/EMMO) ; Yeskey, Kevin (O5/ASPR/IO) ; Greene, Jonathan (O5/ASPR/EMMO) ; Harahan, Kevin (O5/ASPR/EMMO) ; Shuy, Bryan (O5/ASPR/IO) ; Austin, Meredith (uscg.mil) ; Redd, John (O5/ASPR/SPPR) ; Callahan, Michael V.,M.D. Sent Date: 2020/03/08 11:11: 40 Delivered Date: 2020/03/08 11:11: 43 AMERICAN PVERSIGHT HHS-20-0580-A-000242 Giroir, Brett (HHS/OASH) To: OS SecretarysOperations Center Yeskey, Kevin (OS/ASPR/10); Orsega, Susan (O5/OASH) ; SOCLeadership; CC: Shuy, Bryan (OS/ASPR/10); Kadlec, Robert (OS/ASPR/10); Austin, Meredith (uscg.mil) Subject: RE: COVID-19Open Media Report 29Feb20 Date: 2020/02/29 17:20:34 Priority: Normal Type: Note OK CDC reports 2 individuals tested presumptive+ from the facility. There is 100% chance that the remaining 50+ all have COVID and that we can expect even more to become ill soon. Media Statement For Immediate Release Saturday,Feb.29,2020 Contact: CDC Media Relations 404-639-3286 CDC, Washington State Report First COVID-19 Death There also are ongoing investigations into possible outbreaks in health care settings The Centers for Disease Control and Prevention (CDC) and public health officials in the state of Washington have reported three hospitalized patients who have tested presumptive-positive for the virus that causes COVID-19, including one patient who died. AMERICAN PVERSIGHT HHS-20-0580-A-000243 • • Two of the patients are from a long-term care facility (LTCF) where one is a health care worker. Additional residents and staff of the LTCF who have not yet been tested for COVID-19 are reportedly either ill with respiratory symptoms or hospitalized with pneumonia of unknown cause. • • The patient who died, a male in his 50s, was being treated at the same hospital. He was not a resident of the LTCF. CDC enoneously identified the patient as female in a briefing earlier today with the President and Vice President. While there is an ongoing investigation, the source of these infections is cunently unknown. Circumstances suggest person-to-person spread in the community , including in the LTCF. CDC spokesperson Dr. Nancy Messonnier said, "Our hearts go out to the family of the patient who died as well as the families of the people who are caught up in this outbreak. The health of the residents, staff and community of this skilled nursing facility are a top priority. We will work with Public Health - Seattle and King County to support the care of the patients, the safety of the health care workers, and the well-being of the people in the swTounding community." This is the first reported death in the United States from COVID-19 , as well as the first reported case in a health care worker and the first possible outbreak in a LTCF. These reports from Washington follow others of community spread in Oregon and two places in California earlier this week. While there is still much to learn about the unfolding situations in California, Oregon and Washington , preliminary information raises the level of concern about the immediate threat for COVID-19 for certain communities in the United States. Most people in the United States will have little immediate risk of exposw-e to this virus, but some people will be at increased risk depending on their exposures. The greatest risk is to those who have been in close contact with people with COVID-19. People with suspected or confirmed exposure should reach out to their state or local public health depaitment. CDC is sending a team of experts to support the investigation in Washington. Dr. Messonnier said, "We recognize that this is a difficult time; we are facing a historic public health challenge. We will continue to respond to COVID-19 in an aggressive way to contain and blunt the threat of this virus. While we still hope for the best, we continue to prepare for this virus to become widespread in the United States." These three cases bring the total number of COVID-19 cases detected through the U.S. public health system to 22. The federal government will continue to respond aggressively to this rapidly evolving situation. Testing for the virus that causes COVID-19 was conducted in Washington state using the CDC rRT-PCR. Results will be confirmed at CDC, but a presumptive positive result using the CDC test is treated as a positive for public health response purposes and a coordinated public health response has begun. For more information about COVID-19 visit www.cdc.gov/covid19 . AMERICAN PVERSIGHT HHS-20-0580-A-000244 Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: OSSecretarys Operations Center Sent: Saturday, February 29, 2020 5:09 PM To: Giroir, Brett (HHS/OASH) Cc:Yeskey, Kevin (OS/ASPR/IO); Orsega, Susan (OS/OASH) ;SOC Leadership ; Shuy, Bryan (OS/ASPR/IO); Kadlec, Robert (OS/ASPR/IO); Austin, Meredith (uscg.mil) ; OSSecretarys Operations Center Subject: RE:COVID-19 Open Media Report 29Feb20 ADM Giroir, (b)(5) I have added additional ASPRleadership to the email chain for awareness. V/r Matt Peitzman Deputy Director Secretary's Operations Center 202-619-7800 Hhs.soc@hhs.gov CONFIDENTIALITY NOTICE: This e-mail communication and any attachments may contain confidential and privileged information for the use of the designated recipients . If you are not the intended recipient, (or authorized to receive for the recipient) you are hereby notified that you have received this communication in error and that any review, disclosure, dissemination, distribution or copying of it or its contents is prohibited. If you have received this communication in error, please destroy all copies of this communication and any attachments and contact the sender by reply e-mail or telephone (202-619-7800). AMERICAN PVERSIGHT HHS-20-0580-A-000245 From: Giroir, Brett (HHS/DASH) Sent: Saturday, February 29, 2020 4:35 PM To: OSSecretarys Operations Center Cc:Yeskey, Kevin (OS/ASPR/IO); Orsega, Susan(OS/OASH) Subject: RE:COVID-19 Open Media Report 29Feb20 Importance: High Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC20201 Office Phone: 202-690-7694 From: OSSecretarys Operations Center Sent: Saturday, February 29, 2020 4:32 PM To: OSSecretarys Operations Center Subject: COVID-19 Open Media Report 29Feb20 UNCLASSIFIED / / FOR OFFICIAL USE ONLY Good afternoon all, Attached is the 29Feb20 COVID-19 Open Media Report. BLUF: One woman cases of COVID-19 teacher in Oregon. actions being taken in her SO's has died from COVID - 19 in Washington State. Two new were reported in a high school student in Washington and in a school President Trump held a press briefing to provide an update and new to prevent further spread of COVID-19 in the U.S. Epidemiology: Official case counts are distributed via the COVID-19 Morning CDC Updates and COVID-19 SLBs. • • Traditional news media reports over 85,000 cases globally, and more than 3,000 worldwide deaths . The vast majority of cases remains in mainland China . • • Two new cases of COVID-19 were reported in the Seattle, WA area. Both cases are reported to be 'presumptive positive' while awaiting confirmation of the Public Health lab's results by the CDC. One was a high school student who contracted the virus from the commun ity. The second case is a woman in her sos who traveled to Daegu, South Korea. • • Washington State has reported the first U.S. death from COVID-19 . • • A healthcare worker at a long-term care facility in Kirkland, Washington is reported as testing positive for COVID-19. AMERICAN PVERSIGHT HHS-20-0580-A-000246 Public Health/Clinical Response: • • Governor Inslee has issued a state of emergency in Washington State due to the newly reported cases of COVI D-19. • • The President gave an update today about COVID-19. The president and experts informed people that the risk currently remains low to the general population . Health Care workers will be given the proper supplies while treating patients with COVID19. • • FDA issued a guidance document on 29 February 2020 allowing more laboratories to conduct diagnostic testing for COVID-19. The guidance document will allow 300400 academic laboratories and several community hospitals to run this diagnostic test. Public Sentiment • • Many Tw itter accounts show that people are worried about the spread of COVID19. People are suggesting stocking up on groceries and other supplies in case of an outbreak in their communities. Please see the attached Open Media Report for additional information. distributed to the 2019 nCoV Distribution Lists. This message was Pre pa red by: Secretary's Operations Center U.S. Department of Health and Human Services (HHS) Assistant Secretary for Preparedness and Response (ASPR) 200 Independence Ave. S.W. Washington D.C. 20201 Office (202) 619-7800 Fax : 800-514-4256 Email: hhs.soc @hhs.gov cid: image001.png@0lD5E9B2.F84B1BA0 Data enclosed in this email are subject to the Privacy Act of 1974, as amended. Contents shall not be disclosed, discussed, or shared with individuals unless they have a direct needto-know in the performance of their official duties. Unauthorized disclosure of this information may result in civil or criminal penalties. CONFIDENTIALITY NOTICE: This e-mail communication and any attachments may contain confidential and privileged information for the use of the designated recipients. If you are not the intended recipient, (or authorized to receive for the recipient) you are hereby notified that you have received this communication in error and that any review, disclosure, dissemination, distribution or copying of it or its contents is prohibited. If you have received this communication in error, please destroy all copies of this communication and any attachments and contact the sender by reply e-mail or telephone (202-619-7800). UNCLASSIFIED AMERICAN PVERSIGHT / / FOR OFFICIAL USE ONLY HHS-20-0580-A-000247 Sender: Giroir, Brett (HHS/OASH) OS SecretarysOperations Center ; Yeskey, Kevin (OS/ASPR/IO); Orsega, Susan (OS/OASH); SOCLeadership; Shuy, Bryan (O5/ASPR/IO) ; Kadlec, Robert (OS/ASPR/IO); Austin, Meredith (uscg.mil) Sent Date: 2020/02/29 17:20:33 Delivered Date: 2020/02/29 17:20:34 AMERICAN PVERSIGHT HHS-20-0580-A-000248 Kadlec, Robert (O5/ASPR/IO) Giroir, Brett (HHS/OASH) Stecker, Judy (O5/IOS) ; Brookes, Brady (CMS/OA) ; Yeskey, Kevin (O5/ASPR/IO) ; Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) ; (b)(6) ; CC: Berger, Sherri (CDC/OCOO/OD) ; Redfield, Robert R. (CDC/OD) ; Shuy, Bryan (O5/ASPR/IO) ; Harrison, Brian (HHS/IOS) ; Herrmann, Jack (OS/ASPR/OEA) ; Mango, Paul (HHS/IOS) nt I Subject: Re: Outtakes from Call with Kaiser Permanente and HCA Date: 2020/03/08 23 :48 :48 Priority : Normal Type: Note 5 Thanks Brett f.... b-)( _) ______________ ___,IBest. Bob Sent from my iPhone On Mar 8, 2020, at 3:59 PM, Giroir, Brett (HHS /OASH) wrote: (b)(5) Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW AMERICAN PVERSIGHT HHS-20-0580-A-000249 Washington, DC 20201 Office Phone: 202-690-7694 From: Stecker, Judy (OS/IOS) Sent: Sunday, March 8, 2020 2:45 PM To: Brookes, Brady (CMS/OA) Cc: Kadlec, Robert (OS/ASPR/1O); Giroir, Brett (HHS/OASH) ; Yeskey, Kevin (OS/ASPR/1O); Jernigan, Daniel B. (CDC/DDID/NCIRD/1D) ;l (b)(6) l~cms. hhs.gov>; Berger, Sherri (CDC/OCOO/OD) ; Redfield, Robert R. (CDC/OD) ; Shuy, Bryan (OS/ASPR/1O); Harrison, Brian (HHS/IOS) ; Herrmann, Jack (OS/ASPR/OEA) ; Mango, Paul (HHS/IOS) Subject: Re: Outtakes from Call with Kaiser Permanente and HCA Can these issues wait till that meeting or do these need to be done today Bob/Paul? Sent from my iPhone On Mar 8, 2020, at 2:04 PM, Brookes , Brady (CMS/OA) wrote: □ + The Administrator Co11Jide11tial {IIU/ deliberative, pre-decisional commtmicatio11 From: Kadlec, Robert (OS/ASPR/1O) Sent: Sunday, March 8, 2020 1:59 PM To: Giroir, Brett (HHS/OASH) ; Yeskey, Kevin (OS/ASPR/1O); Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) Cc: Berger, Sherri (CDC/OCOO/OD) ; Redfield, Robert R. (CDC/OD) ; Shuy, Bryan (OS/ASPR/1O) ; Harrison, Brian (HHS/IOS) ; Brookes, Brady (CMS/OA) ; Herrmann, Jack (OS/ASPR/OEA) ; Harrison, Brian (HHS/IOS) ; Mango, Paul (HHS/IOS) ; Stecker, Judy (OS/IOS) Subject: Outtakes from Call with Kaiser Permanente and HCA Importance: High AMERICAN PVERSIGHT HHS-20-0580-A-000250 b)(5) Sender: Kadlec, Robert (OS/ASPR/IO) Giroir, Brett (HHS/OASH); Stecker, Judy (OS/IOS) ; Brookes, Brady (CMS/OA); Yeskey, Kevin (O5/ASPR/IO) ; Jernigan, Daniel 8. (CDC/DDID/NCIRD/10); AMERICAN PVERSIGHT HHS-20-0580-A-000251 CMSSVl ; Berger, Sherri (CDC/OCOO/OD); Redfield, Robert R. (CDC/OD) ; Shuy, Bryan (OS/ASPR/IO); Harrison, Brian (HHS/IOS) ; Herrmann, Jack (OS/ASPR/OEA); Mango, Paul (HHS/IOS) Sent Date: 2020/03/08 23:48:47 Delivered Date: 2020/03/08 23:48:48 AMERICAN PVERSIGHT HHS-20-0580-A-000252 Kadlec, Robert (OS/ASPR/IO) To: Brookes, Brady (CMS/OA) Mango, Paul (HHS/IOS) ; Giroir, Brett (HHS/OASH); Pollard, Ashton (O5/IOS) ; Stecker, Judy (OS/IOS) ; Yeskey, Kevin (OS/ASPR/IO); Jernigan, Daniel B. (CDC/DDID/NCIRD/ID); CMSSVl ; Berger, Sherri (CDC/OCOO/OD); Redfield, Robert R. (CDC/OD) ; Shuy, Bryan (OS/ASPR/1O); Harrison, Brian (HHS/IOS) ; Herrmann, Jack (OS/ASPR/OEA); Blackford, Carol W. (CMS/CM); Harrison, Brian (HHS/IOS) Subject: Re: Outtakes from Call with Kaiser Permanenteand HCA Date: 2020/03/09 00 :00: 13 Priority: Normal Type: Note Thanks Brady appreciate the considered response. Please tell Seema thank you too. We will work with CDC and we will include you (CMS) on future actions and collaboration. Best. Bob Sent from my iPhone On Mar 8, 2020, at 11:38 PM, Brookes , Brady (CMS/QA) wrote: □ All, b)(5) AMERICAN PVERSIGHT HHS-20-0580-A-000253 age 082 ithheld pursuant to exemption b)(5) f the Freedom of Information Act AMt HICAN pVERSIGHT HHS-20-0580-A-000254 (b)(5) Confidential and deliberative, pre-decisio11al communication From: Mango, Paul (HHS/IOS) Sent: Sunday, March 8, 2020 4:30 PM To: Giroir, Brett (HHS/OASH) ; Pollard, Ashton (OS/IOS) Cc: Stecker, Judy (OS/IOS) ; Brookes, Brady (CMS/OA) ; Kadlec, Robert (OS/ASPR/IO) ; Yeskey, Kevin (OS/ASPR/IO) ; Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) ; CMS SVl ; Berger, Sherri (CDC/OCOO/OD) ; Redfield, Robert R. (CDC/OD) ; Shuy, Bryan (OS/ASPR/IO) ; Harrison, Brian (HHS/IOS) ; Herrmann, Jack (OS/ASPR/OEA) Subject: Re: Outtakes from Call with Kaiser Permanente and HCA ADM- we'll get you an invite to the PMO meeting at l l00am and will welcome your participation on these issues if you are available. Ashton please note Sent from my iPhone On Mar 8, 2020, at 3:59 PM, Giroir , Brett (HHS/OASH) wrote: □ b)(5) Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW AMERICAN PVERSIGHT HHS-20-0580-A-000255 Washington, DC 20201 Office Phone: 202-690-7694 From: Stecker, Judy (05/105) Sent: Sunday, March 8, 2020 2:45 PM To: Brookes, Brady (CMS/OA) Cc: Kadlec, Robert (OS/ASPR/1O); Giroir, Brett (HHS/OASH) ; Yeskey, Kevin (OS/ASPR/1O) ; Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) ; CMS SVl <5V1@cms.hhs.gov >; Berger, Sherri (CDC/OCOO/OD) ; Redfield, Robert R. (CDC/OD) ; Shuy, Bryan (OS/ASPR/1O); Harrison, Brian (HHS/1O5) ; Herrmann, Jack (OS/ASPR/OEA) ; Mango, Paul (HHS/1OS) Subject: Re: Outtakes from Call with Kaiser Permanente and HCA Can these issues wait till that meeting or do these need to be done today Bob/Paul? Sent from my iPhone On Mar 8, 2020, at 2:04 PM, Brookes, Brady (CMS/OA) wrote: □ + The Administrator Confidential and deliberative, pre-decisional co111111unict1tion From: Kadlec, Robert (OS/ASPR/1O) Sent: Sunday, March 8, 2020 1:59 PM To: Giroir, Brett (HHS/OASH) ; Yeskey, Kevin (OS/ASPR/1O); Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) Cc: Berger, Sherri (CDC/OCOO/OD) ; Redfield, Robert R. (CDC/OD) ; Shuy, Bryan (OS/ASPR/1O) ; Harrison, Brian (HHS/1OS) ; Brookes, Brady (CMS/OA) ; Herrmann, Jack (OS/ASPR/OEA) ; Harrison, Brian (HHS/1OS) ; Mango, Paul (HHS/1OS) AMERICAN PVERSIGHT HHS-20-0580-A-000256 ; Stecker, Judy (05/105) Subject: Outtakes from Call with Kaiser Permanente and HCA Importance : High b)(5) AMERICAN PVERSIGHT HHS-20-0580-A-000257 Sender: Kadlec, Robert (O5/ASPR/IO) Brookes, Brady (CMS/OA); Mango, Paul (HHS/IOS) ; Giroir, Brett (HHS/OASH); Pollard, Ashton (OS/IOS) ; Stecker, Judy (O5/IOS) ; Yeskey, Kevin (O5/ASPR/IO) ; Jernigan, Daniel B. (CDC/DDID/NCIRD/ID); CMSSVl ; Berger, Sherri (CDC/OCOO/OD); Redfield, Robert R. (CDC/OD) ; Shuy, Bryan (OS/ASPR/1O); Harrison, Brian (HHS/IOS) ; Herrmann, Jack (O5/ASPR/OEA); Blackford, Carol W. (CMS/CM); Harrison, Brian (HHS/IOS) Sent Date: 2020/03/09 00 :00: 11 Delivere d Date: 2020/03/09 00 :00: 13 AMERICAN PVERSIGHT HHS-20-0580-A-000258 Kadlec, Robert (O5/ASPR/IO) Lee, Scott (O5/ASPR/EMMO); Yeskey, Kevin (O5/ASPR/IO) ; ; Voirin, Anthony (O5/ASPR/EMMO); Yue, David (OS/ASPR/EMMO); Tewell, Adam (O5/ASPR/SPPR); Redd, John (O5/ASPR/SPPR) Subject: FW: CoronavirusBriefing for OC/LA Members Request Date: 2020/02/20 09: 52: 11 Priority: Normal Type: Note From: Pence, Laura (HHS/ASL) Sent: Thursday, February 20, 2020 9:44 AM To: Shuy, Bryan (OS/ASPR/10) ; Yeskey, Kevin (OS/ASPR/10) ; Kadlec, Robert (OS/ASPR/10) Cc: Arbes, Sarah (HHS/ASL) Subject: Fwd: Coronavirus Briefing for OC/LA Members Request (b)(5) Begin forwarded message: From: "Seigel, Jessica" Date: February 20, 2020 at 9:41:13 AM EST To: "Pence, Laura (HHS/ASL)" , "Morse, Sara (HHS/ASL)" Cc: "Beck, Gary (OS/IEA)" , "Brand, Anstice M. (CDC/0D/CDCWO)" Subject: RE: Coronav irus Briefing for OC/LA Members Request Hi Laura, We received the below message from one of our constituents . Is there any advice/information that we can offer him? AMERICAN PVERSIGHT HHS-20-0580-A-000259 Dear Katie Porter I am emailing you on my parents behalf, who are United States citizens. My parentsJb )(6 ) ~ were on the Diamond Princess, which was quarantined in Japan. They both te..., st,e....,. .... d_p_o...., si.,..,. tiv_e_f,,... o_r _, c:crvrc'>-19 and were hospitalized at Gunma University Hospital outside Tokyo. Both my mother and father have developed pneumonia and are in isolation. My father is in critical condition and is currently on an artificial lung. I am emailing you because i'm seeing treatments used elsewhere in the world (specifically Gilead Remdesivir) with successful results, but my father's doctor says he is not allowed to use it in Japan. can my father be given the drug since he is an American? If not, is there anyway in which he can be transferred to a hospital at a military base in Japan? Or is there an option to send a military doctor to administer the drug? Both my mother and my father boarded the Diamond Princess without any respiratory issues. During the weeks of quarantine, my father developed a fever and a cough. After testing positive, he was removed from the ship and placed in the hospital. Initial chest x-rays indicated signs of pneumonia. After a couple days, his condition worsened and he was provided oxygen. Subsequently, he was intubated and placed on an artificial lung. Please help us in this desperate time of need. Thank you, Jessica JessicaSeigel Senior Legislat ive Assistant Congresswoman Katie Porter (CA-45) 1117 Longworth House Office Build i ng Wash i ngton, D.C. 20515 (202)-225-5611 From: Pence, Laura (HHS/ASL) < Laura.Pence@hhs.gov > Sent: Wednesday, January 29, 2020 10 :13 AM To: Seigel, Jessica ; Morse, Sara (HHS/ASL) Cc: Beck, Gary (OS/IEA) ; Brand , Anstice M. (CDC/OD/CDCWO) Subject: RE: Coronavirus Briefing for OC/LA Members Request Hi Jessica, I wanted to make sure you saw this statement from CDC last night (below). Additionally, CDC, ASPR, and NIAID will be providing a briefing to House members at 2pm today in the eve auditorium. Do you think your boss will be there? There will be an opportunity for members to ask questions there. AMERICAN PVERSIGHT HHS-20-0580-A-000260 Lastly, CDC is doing regular phone calls with Hill staff to pro vide updates and answer questions. Have you been included on those? If not, I will make sure you are added. Best, Lau ra Pence Deputy Assistant Secretary for Legislation, Discretionary Health U.S. Department of Health and Human Services (202) 690 -7538 CDC Media Statement Jan.28,2020 For Immediate Release Contact: CDC Media Relations (404) 639-3286 HHS and CDC supporting safe, expedient departure of US citizens The U.S. Government is relocating appro ximately 210 U.S. citizens from Wuhan, China back to the United States. The Department of State has the lead for the safe and expedient ordered departure of US citizens. The Department of Health and Human Services (HHS) and Centers for Disease Control and Prevention (CDC) are collaborating with the Department of State on the logistics of public health evaluations for every traveler on the flight. HHS and CDC are working with partners to ensme that any traveler who develops symptoms during their journey receives appropriate medical care. Our primary objective is to facilitate the safe return of these Americans while protecting the public ' s health. These individual s will be screened before they take off ; monitored during the dmation of the flight by medical personnel on board; screened again on landing to refuel in Anchorage , Alaska ; monitored on the last leg of the flight by medical personnel on board; evaluated upon arrival at March Air Reserve Base in Riverside County , California; and then monitored for symptom s po st-arrival. From: Seigel, Jessica Sent: Tuesday, January 28, 2020 5:04 PM To: Pence, Laura {HHS/ASL) ; Morse, Sara {HHS/ASL) Cc: Beck, Gary {OS/IEA) Subject: RE: Coronavirus Briefing for OC/LA Members Request AMERICAN PVERSIGHT HHS-20-0580-A-000261 Wonderful - thank you! From: Pence, Laura (HHS/ASL) Sent: Tuesday, January 28, 2020 4 :37 PM To: Seigel, Jessica ; Morse, Sara (HHS/ASL) Cc: Beck, Gary (OS/IEA) Subject: RE: Coronavirus Briefing for OC/LA Members Request Hi Jessica, I apologize for the delay in responding. We are hoping to set something up very soon. Will circle back with more info. Best, Laura From: Seigel, Jessica Sent: Tuesday, January 28, 2020 12:04 PM To: Morse, Sara (HHS/ASL) Cc: Pence, Laura (HHS/ASL) ; Beck, Gary (OS/IEA) Subject: RE: Coronavirus Briefing for OC/LA Members Request Thank you Sara! Gary and Laura - we'd li ke to set up something at the CDC's convenience, understanding that I'm sure you're being bombarded with these requests right now. Best, Jessica From: Morse, Sara {HHS/ASL) Sent: Tuesday, January 28, 2020 12:02 PM To: Seigel, Jessica Cc: Pence, Laura {HHS/ASL) ; Beck, Gary (OS/IEA) Subject: Re: Coronavirus Brief ing for OC/LA Members Request Hi Jessica, looping you in w ith Laura and Gary who can be of assistance . Thanks, Sara Sent from my iPhone On Jan 28, 2020, at 11:51 AM, Seigel, Jessica wrote : AMERICAN PVERSIGHT HHS-20-0580-A-000262 Hi Sara, Please see the attached request for a briefing for Orange and Los Angeles Counties on the CDC's efforts to stop the spread of the coronavirus in the area. Best, Jessica JessicaSeigel Legislative Assistant Congresswoman Katie Porter (CA-45) 1117 Longworth House Office Building Washington, D.C. 20515 (202)-225-5611 Sender: Kadlec, Robert (OS/ASPR/10) Lee, Scott (OS/ASPR/EMMO) ; Yeskey, Kevin (O5/ASPR/IO) ; ; Voirin, Anthony (OS/ASPR/EMMO) ; Yue, David (OS/ASPR/EMMO) ; Tewell, Adam (OS/ASPR/SPPR) ; Redd, John (O5/ASPR/SPPR) Sent Date: 2020/02/20 09: 52: 10 Delivered Date: 2020/02/20 09:52:11 AMERICAN PVERSIGHT HHS-20-0580-A-000263 Trent-Adams, Sylvia (HHS/OASH) From: GROUP (FYDIBOHF23SPDLT)/CN= RECIPIENTS/CN=650D027641442169334514 Kellogg, Rachel (HHS/OASH) ; Sus> Kadlec, Robert (OS/ASPR/IO) ; Giroir, Brett (HHS/OASH) ; Schwartz, Erica (HHS/OASH) ; Smith, Brad (CMS/QA) ; Haddad, Carla (HHS/OASH) ; Valentine, Steven (HHS/OASH) ; Yeskey, Kevin (OS/ASPR/IO) ; Greene, Jonathan (OS/ASPR/EMMO) ; Shuy, Bryan (OS/ASPR/IO) ; Herrmann, Jack (OS/ASPR/OEA) ; Guyton, Cedric (OS/OASH) Subject: RE: PLANNING PURPOSESONLY - TESTING SITES Date: 2020/03/13 14:02:41 Priority: Normal Type: Note copy -----Original Message----From: Kellogg, Rachel (HHS/OASH) Sent: Friday, March 13, 2020 2:01 PM To : Orsega, Susan (OS/OASH) Cc: Kadlec, Robert (OS/ASPR/IO) < Robert.Kad lec@hhs.gov >; Giroir, Brett (HHS/OASH) ; Schwartz, Erica (HHS/OASH) < Erica.Schwartz @hhs.gov >; Smith, Brad (CMS/QA) ; Haddad, Carla (HHS/OASH) ; Valentine, Steven (HHS/OASH) ; Yeskey, Kevin (OS/ ASPR/IO) ; Greene, Jonathan (OS/ ASPR/EMMO) ; Shuy, Bryan (OS/ASPR/IO) ; Herrmann, Jack (OS/ASPR/OEA) ; Trent-Adams, Sylvia (HHS/OASH) ; Guyton, Cedric (OS/OASH) Subject: Re: PLANNING PURPOSESONLY - TESTING SITES All, will be in touch ASAP. ADM Giroir with POTUS righ t now. Sent from my iPhone > On Mar 13, 2020, at 1:50 PM, Orsega, Susan (OS/OASH) wrote: > > Sirs, Adding others. > > > > > > -----Original Message----From: Kadlec, Robert (OS/ASPR/IO) Sent: Friday, March 13, 2020 12:54 PM To : Giroir, Brett (HHS/OASH) Cc: Orsega, Susan (OS/OASH) ; Schwartz, Erica (HHS/OASH) ; AMERICAN PVERSIGHT HHS-20-0580-A-000264 Smith, Brad (CMS/QA) ; Haddad, Carla (HHS/OASH) ; Valentine, Steven (HHS/OASH) ; Kellogg, Rachel (HHS/OASH) ; Yeskey, Kevin (OS/ASPR/IO) ; Greene, Jonathan (OS/ASPR/EMMO) ; Shuy, Bryan (OS/ASPR/IO) ; Herrmann, Jack (OS/ASPR/OEA) > Subject: Re: PLANNING PURPOSESONLY - TESTING SITES > (b)(5) > Sent from my iPhone > >> On Mar 13, 2020, at 12:18 PM, Giroir, Brett (HHS/OASH) wrote : >> b)(5) .;, .;, >> BG >> >> >> >> >> >> >> Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington , DC 20201 Office Phone: 202-690-7694 >> >> >> >> >> >> >> >> ----- Original Message----From : Giroir, Brett (HHS/OASH) Sent: Friday, March 13, 2020 12:05 PM To: Susan Orsega (OS/OASH) (Susan.Orsega@hhs.gov) Cc: Schwartz, Erica (HHS/OASH) Subj ect: FW: >> >> Can we ta lk7 >> >> >> >> >> >> >> >> Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washingt on, DC 20201 Office Phone: 202-690-7694 >> >> >> >> >> >> ----- Original Message----From : Giroir, Brett (HHS/OASH) Sent: Friday, March 13, 2020 11:55 AM To: Giroir, Brett (HHS/OASH) Subj ect : >> >> >> Sen de r :ITrent-Adams, Sylvia (HHS/OASH) 7BFAFD132- Kellogg, Rachel (HHS/OASH) ; Orsega, Susan (OS/OASH) ; Kadlec, Robert (O5/ASPR/IO) ; Giroir, Brett (HHS/OASH) ; Schwartz, Erica (HHS/OASH) ; Smith, Brad (CMS/QA) ; Haddad, Carla (HHS/OASH) ; Valentine, Steven (HHS/OASH) ; Yeskey, Kevin (OS/ASPR/IO) ; Greene, Jonathan (OS/ASPR/EMMO) ; Shuy, Bryan (OS/ASPR/IO) ; Herrmann, Jack (OS/ASPR/OEA) ; Guyton, Cedric (OS/OASH) Sent Date: 2020/03/13 14:02:40 Delivered Date: 2020/03/13 14:02 :41 AMERICAN PVERSIGHT HHS-20-0580-A-000266 Giroir, Brett ( HHS/OASH) Kadlec, Robert (O5/ASPR/IO) ; To: Yeskey, Kevin (OS/ASPR/10) CC: Kellogg, Rachel (HHS/OASH) ; Orsega, Susan (O5/OAS H) Subject: FDA- materi als Date: 2020/03/13 18:19:2 4 Priority: Normal Type: Note b)(5) Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 Se AMEHICAN PVERSIGHT nd Giroir, Brett (HHS/OASH) HHS-20-0580-A-000267 Kadlec, Robert (O5/ASPR/IO) ; Yeskey, Kevin (O5/ASPR/IO) ; Recipient: Kellogg, Rachel (HHS/OASH) ; Orsega, Susan (O5/OASH) Sent Date: 2020/03/13 18:19:24 AMERICAN PVERSIGHT HHS-20-0580-A-000268 Kadlec, Robert (O5/ASPR/IO) OS - ASPRStaff ; To: SNS DISTRO(O5/ASPR) Subject: POTUSFinal Dec Letter.pdf Date: 2020/03/13 18:23:01 Priority: Normal Type: Note Kadlec, Robert (O5/ASPR/IO) OS - ASPRStaff ; Recipient: SNS DISTRO (O5/ASPR) Sent Date: 2020/03/13 18:21:45 Delivered Date: 2020/03/13 18:23:01 AMERICAN PVERSIGHT HHS-20-0580-A-000269 Bright, Rick (OS/ASPR/BARDA) 'Callahan, Michael V.,M.D.' 1j'b)(6) @lmgh.harvard.edu>; Kadlec, Robert (OS/ASPR/10); Pence, Laura (HHS/ASL) Yeskey, Kevin (OS/ASPR/10); Elvander, Erika (OS/OGA); Zebley, Kyle (HHS/OS/OGA); Shuy, Bryan (OS/ASPR/10); CC: Arbes, Sarah (HHS/ASL); Grigsby, Garrett (HHS/OS/OGA); Lane, Cliff (NIH/NIAID) (E] ; Marston, Hilary (NIH/NIAID) [ E] Subject: RE: 2 COVIDpositive patients in Japan Date: 2020/02/20 16:07:47 Priority: Normal Type: Note ALCON, Rick Rick A. Bright, PhD Director Biomedical Advanced Research and Development Authority (BARDA) Deputy Assistant Secretary for Preparedness and Response Office of the Assistant Secretary for Preparedness and Response (ASPR) US Department of Health and Human Services (HHS) +1 202 260 8535 (Office) From: Callahan, Michael V.,M.D. ~(b)(6) @mgh.harvard.edu> Sent: Thursday, February 20, 2020 2:55 PM To: Kadlec, Robert (OS/ ASPR/1O); Pence, Laura (HHS/ ASL) ; Bright, Rick (OS/ ASPR/BARDA) Cc: Yeskey, Kevin (OS/ASPR/1O); Elvander, Erika (OS/OGA) ; Zebley, Kyle (HHS/OS/OGA) ; Shuy, Bryan (OS/ASPR/1O); Arbes, Sarah (HHS/ASL) ; Grigsby, AMERICAN PVERSIGHT HHS-20-0580-A-000270 Garrett (HHS/OS/OGA) ; Callahan, Michael V.,M .D. 4 (b)(6 ) ~mgh.harvard.edu> Subject: Re: 2 COVID positive patients in Japan Copy b)(5) Happy to help. me ~b)(6) From: Kadlec, Robert (OS/ASPR/10) Sent: Thursday, February 20, 2020 2:38 PM To: Pence, Laura (HHS/ASL) ; Bright, Rick (OS/ASPR/BARDA) ; Callahan, Michael V.,M.D. fb )(6) ~ mgh.harvard.edu > Cc:Yeskey, Kevin (OS/ASPR/10) ; Elvander, Erika (OS/OGA) ; Zebley, Kyle (HHS/OS/OGA) ; Shuy, Bryan (OS/ASPR/10) ; Arbes, Sarah (HHS/ASL) ; Grigsby, Garrett ( HHS/OS/OG A) Subject: Re: 2 COVID positive patients in Japan External Email - Use Caution Rick and Mike plea se respond Asap. Thank s Sent from my iPhone On Feb 20, 2020, at 2:33 PM , Pence , Laura (HHS/ASL ) wrote: (b)(5) AMERICAN PVERSIGHT HHS-20-0580-A-000271 We discussed a treatment plan in which we would utilize two drugs in the hopes of improving his condition. The doctors have fonnally appealed to Japan's Ministry of Health for him to use these drugs: I) Favipiravir /Fapilavir 2) Remdesivir T would like your assistance to see if you can work with the Ministry of Health to approve the use of these drugs for my father. The doctors indicated that it normally takes IO days to receive a response. However, we may not have enough time to wait as his condition is worsening. Thanks. Stanley Wong From: Yeskey, Kevin (OS/ASPR/10) Sent: Thursday, February 20, 2020 12:50 PM To: Elvander, Erika (OS/OGA) ; Zebley, Kyle {HHS/OS/OGA) Cc: Pence, Laura {HHS/ASL) ; Shuy, Bryan (OS/ASPR/10) ; Kadlec, Robert (OS/ASPR/10) ; Arbes , Sarah {HHS/ASL) ; Grigsby, Garrett {HHS/OS/OGA) Subject: RE: 2 COVID positive pat ients in Japan (b)(5) From: Yeskey, Kevin {OS/ASPR/10) Sent: Thursday, February 20, 2020 12:06 PM To: Elvander, Erika (OS/OGA) ; Zebley, Kyle {HHS/OS/OGA) Cc: Pence, Laura {HHS/ASL) ; Shuy, Bryan (OS/ASPR/10) ; Kadlec, Robert (OS/ASPR/10) ; Arbes, Sarah {HHS/ASL) ; Grigsby, Garrett {HHS/OS/OGA) Subject: RE: 2 COVID posit ive pat ients in Japan b)(5) From: Elvander, Erika (OS/OGA) Sent: Thursday, February 20, 2020 11:47 AM To: Zebley, Kyle (HHS/OS/OGA) Cc: Pence, Laura (HHS/ASL) ; Shuy, Bryan (OS/ASPR/10) ; Yeskey, Kevin (OS/ASPR/10) ; Kadlec, AMERICAN PVERSIGHT HHS-20-0580-A-000272 Robert (OS/ASPR/1O); Arbes, Sarah (HHS/ASL) ; Grigsby, Garrett (HHS/OS/OGA) Subject: Re: 2 COVID positive pat ients in Japan b)(5) Cheers. Erika Erika Elvander Director, Asia and the Pacific Off ice of Global Affairs, HHS Sent from my iPhone On Feb 20, 2020, at 11:40 AM, Zebley , Kyle (HHS/OS/OGA) wrote: Adding our Asia Pacific Director Erika Elvander for her thoughts here. From: Pence, Laura (HHS/ASL) Sent: Thursday, February 20, 2020 11:36 AM To: Shuy, Bryan (OS/ASPR/1O); Yeskey, Kevin (OS/ASPR/1O); Kadlec, Robert (OS/ASPR/1O) Cc: Arbes, Sarah (HHS/ASL) ; Grigsby, Garrett (HHS/OS/OGA) ; Zebley, Kyle (HHS/OS/OGA) Subject: 2 COVID positive patients in Japan + OGA to see if we can help with this const ituent request On Feb 20, 2020, at 9:43 AM, Pence, Laura (HHS/ ASL) wrote: AMERICAN PVERSIGHT HHS-20-0580-A-000273 Begin forwarded message: From: "Seigel, Jessica" Date: February 20, 2020 at 9:41:13 AM EST To: "Pence, Laura (HHS/ASL)" , "Morse, Sara (HHS/ASL)" > Cc: "Beck, Gary (OS/IEA)" , "Brand, Anstice M. (CDC/00/CDCWO)" Subject: RE: Coronavi rus Briefing fo r OC/LA Members Request Hi Laura, We received the below message from one of our constituents . Is there any advice/information that we can offer him? Dear Katie Porter I am emailing you on my parents behalf, who are United were States citizens. My parents,l(b)(6) on the Diamond Princess, which was quarantined in Japan. They both tested positive for COVID-19 and were hospitalized at Gunma University Hospital outside Tokyo. Both my mother and father have developed pneumonia and are in isolation. My father is in critical condition and is currently on an artificial lung. I I am emailing you because i'm seeing treatments used elsewhere in the world (specifically Gilead Remdesivir) with successful results, but my father's doctor says he is not allowed to use it in Japan. Can my father be given the drug since he is an American? If not, is there anyway in which he can be transferred to a hospital at a military base in Japan? Or is there an option to send a military doctor to administer the drug? Both my mother and my father boarded the Diamond Princess without any respiratory issues. During the weeks of quarantine, my father developed a fever and a cough. After testing positive, he was removed from the ship and placed in the hospital. Initial chest x-rays indicated signs of pneumonia. After a couple days, his condition worsened and he was provided oxygen. Subsequently, he was intubated and placed on an artificial Iung. AMERICAN PVERSIGHT HHS-20-0580-A-000274 Pleasehelp us in this desperatetime of need. Thank you, Jessica Jessica Seigel Senior Legislative Assistant Congresswoman Katie Porter {CA-45) 1117 Longworth House Office Building Washington, D.C. 20515 {202)-225-5611 From: Pence, Laura {HHS/ASL) Sent: Wednesday, January 29, 2020 10:13 AM To: Seigel, Jessica ; Morse, Sara {HHS/ASL) Cc: Beck, Gary {OS/IEA) ; Brand, Anstice M. {CDC/OD/CDCWO) Subject: RE: Coronavirus Briefing for OC/LA Members Request Hi Jessica, I wanted to make sure you saw this statement from CDC last night (below). Additionally, CDC, ASPR,and NIAID will be providing a briefing to House members at 2pm today in the eve auditorium. Do you think your boss will be there? There will be an opportunity for members to ask questions there. Lastly, CDC is doing regular phone calls with Hill staff to provide updates and answer questions. Have you been included on those? If not, I will make sure you are added. Best, Laura Pence Deputy Assistant Secretary for Legislation, Discretionary Health U.S. Department of Health and Human Services AMERICAN PVERSIGHT HHS-20-0580-A-000275 CDC Media Statement Jan.28,2020 For Immediate Release Contact: CDC Media Relations (404) 639-3286 HHS and CDC supporting safe, expedient departure of US citizens The U.S. Government is relocating approximately 210 U.S. citizens from Wuhan, China back to the United States. The Departme nt of State has the lead for the safe and expedient ordered departure of US citizens . The Department of Health and Human Services (HHS) and Centers for Disease Control and Prevention (CDC) are collaborating with the Department of State on the logistics of public health evaluations for every traveler on the flight. HHS and CDC are working with partners to ensure that any traveler who develops symptoms during their jomney receives appropriate medical care. Our primary objective is to facilitate the safe return of these Americans while protecting the public's health. These individual s will be screened before they take off; monitored during the duration of the flight by medical personnel on board; scree ned again on landing to refuel in Anchorage, Alaska; monitored on the last leg of the flight by medical personnel on board; evaluated upon arrival at March Air Reserve Base in Riverside County, California; and then monitored for symp tom s post-arrival. From: Seigel, Jessica AMERICAN PVERSIGHT HHS-20-0580-A-000276 Sent: Tuesday, January 28, 2020 5:04 PM To: Pence, Laura (HHS/ASL) ; Morse, Sara (HHS/ASL) Cc: Beck, Gary (OS/IEA) Subject: RE: Coronavirus Briefing for OC/LA Members Request Wonderfu I - thank you! From: Pence, Laura (HHS/ASL) Sent: Tuesday, January 28, 2020 4:37 PM To: Seigel, Jessica ; Morse, Sara (HHS/ ASL) Cc: Beck, Gary (OS/IEA) Subject: RE: Coronav ir us Briefing for OC/LA Members Request Hi Jessica, I apologize for the delay in responding . We are hoping to set something up very soon . Will circle back with more info . Best, Laura From: Seigel, Jessica Sent: Tuesday, January 28, 2020 12:04 PM To: Morse, Sara (HHS/ASL) Cc: Pence, Laura (HHS/ASL) ; Beck, Gary (OS/IEA) Subject: RE: Coronavirus Briefing for OC/LA Members Request Thank you Sara! Gary and Laura - we'd like to set up something at the CDC's convenience, understanding that I'm sure you're being bombarded with these requests right now. Best, AMERICAN PVERSIGHT HHS-20-0580-A-000277 Jessica From: Morse, Sara (HHS/ASL) Sent: Tuesday, January 28, 2020 12:02 PM To: Seigel, Jessica Cc: Pence, Laura (HHS/ASL) ; Beck, Gary (OS/IEA) Subject: Re: Coronavirus Briefing for OC/LA Members Request Hi Jessica, looping you in with Laura and Gary who can be of assistance. Thanks, Sara Sent from my iPhone On Jan 28, 2020, at 11:51 AM, Seigel, Jessica wrote: Hi Sara, Please see the attached request for a briefing for Orange and Los Angeles Counties on the CDC's efforts to stop the spread of the coronavirus in the area. Best, Jessica Jessica Seigel Legislative Assistant Congresswoman Katie Porter (CA-45) 1117 Longworth House Office Building Washington, D.C. 20515 (202)-225-5611 The information in this e-mail is intended only for the person to whom it is addressed. If you believe this e-mail was sent to you in error and the e-mail contains patient information, please contact the Partners Compliance HelpLine at AMERICAN PVERSIGHT HHS-20-0580-A-000278 http ://www. partners.org /complia nceline. If the e-mail was sent to you in error but does not contain patient information, please contact the sender and properly d.1spose of t he e-ma1. ·1 Sender: Bright, Rick (OS/ASPR/BARDA) 'Clllahan, Michael V.,M.D.' ¥b)(6) lilm gh. harvard.edu >; Kadlec, Robert (OS/ASPR/10) ; Pence, Laura (HHS/ASL) ; Yeskey, Kevin (OS/ASPR/10) ; Elvande r, Erika (OS/OGA) ; Zebley, Kyle (HHS/OS/OGA) ; Shuy, Bryan (OS/ASPR/IO) ; Arbes, Sarah (HHS/ASL) ; Grigsby, Garrett (HHS/OS/OGA) ; Lane, Cliff (NIH/NIAID) [El ; Marston, Hilary (NIH/NIAID) [E] Sent Date: 2020/02/20 16:07: 46 Delivered Date: 2020/02/20 16:07:47 AMERICAN PVERSIGHT HHS-20-0580-A-000279 Giroir, Brett (HHS/OASH) To: Kadlec, Robert (O5/ASPR/IO) Yeskey, Kevin (OS/ASPR/10); Kellogg, Rachel (HHS/OASH); CC: Orsega, Susan (O5/OASH) ; Shuy, Bryan (OS/ASPR/10) Subject: RE: FDA - materials Date: 2020/03/13 21:00:47 Priority: Normal Type: Note Thanks Bob. b)(5) Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Kadlec, Robert (OS/ASPR/10) Sent: Friday, March 13, 2020 6:53 PM To: Giroir, Brett (HHS/OASH) Cc:Yeskey, Kevin (OS/ASPR/10) ; Kellogg, Rachel (HHS/OASH) ; Orsega, Susan (OS/OASH) ; Shuy, Bryan (OS/ASPR/10) Subject: Re: FDA- materials Brett. b)(5) AMERICAN PVERSIGHT HHS-20-0580-A-000280 Sent from my iPhone On Mar 13, 2020, at 6:19 PM, Giroir, Brett (HHS/OASH) wrote: (b)(5) Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 Se AMERICAN PVERSIGHT Giroir, Brett (HHS/OASH) nd er: (FYDIBOHF23SPDLT)/CN=RECIPIENTS/CN=A56FCE4755704C4CA031D621B46FD6F7 HHS-20-0580-A-000281 Kadlec, Robert (O5/ASPR/IO) ; Yeskey, Kevin (O5/ASPR/IO) ; Kellogg, Rachel (HHS/OASH) ; Orsega, Susan (O5/OASH) ; Shuy, Bryan (O5/ASPR/IO) Sent Date: 2020/03/13 21:00:47 AMERICAN PVERSIGHT HHS-20-0580-A-000282 Kadlec, Robert (OS/ASPR/IO) Redd, John (OS/ASPR/SPPR) ; Yeskey, Kevin (OS/ASPR/IO) ; Lee, Scott (OS/ASPR/EMMO) Tew ell, Adam (OS/ASPR/SPPR) ; Yue, David (OS/ASPR/EMMO) ; Childs, Richard (NIH/NHLBI) [El ; Phillips, Sally (OS/ASPR/SPPR) ; Shuy, Bryan (OS/ASPR/IO) Subject: RE: Demobil ization and swabbing updates Date: 2020/02/21 06:03:44 Priority: Normal Type: Note Thanks great work How are the 4 doing clinically? ----- Original Message----From: Redd, John (OS/ASPR/SPPR) Sent: Friday, February 21, 2020 6:03 AM To: Kadlec, Robert (OS/ASPR/IO) ; Yeskey, Kevin (OS/ASPR/IO) ; Lee, Scott (OS/ASPR/EMMO) Cc: Tewell, Adam (OS/ASPR/SPPR) ; Yue, David (OS/ASPR/EMMO) ; Childs, Richard (NIH/NHLBI) [El ; Phillips, Sally (OS/ASPR/SPPR) ; Shuy, Bryan (OS/ASPR/IO) Subject: Re: Demobilization and swabbing updates I have a very encouraging update: b)(S) John From: Redd, John (OS/ASPR/SPPR) Sent: Friday, February 21, 2020 1:33:55 AM To: Kadlec, Robert (OS/ASPR/IO) ; Yeskey, Kevin (OS/ASPR/IO) ; Lee, Scott (OS/ASPR/EMMO) Cc: Tewell, Adam (OS/ASPR/SPPR) ; Yue, David (OS/ASPR/EMMO) ; Childs, Richard (NIH/NHLBI) [El Subject: Demobilization and swabbing updates Sirs, I am keeping this distribution very small; please pass along as you see fit. First: t hankfully, the four swabs were successfully collected in a complicated operation that was executed perfectly; there were no deviations in practice, errors, or breaches in PPE. At my insistence, we had a CDC observer there (Dr. Bower), who agreed with this assessment. The swabs are on their way to the Japanese lab and left at about 1730 local time. AMERICAN PVERSIGHT HHS-20-0580-A-000283 (b)(5) Second, this afternoon I authorized departure of 23 of the 53 ASPR deployers, based upon the criterion that they had no association with the repatriation operation and therefore no passenger contact, nor social contact with the four symptomat ic people. (b)(5) Your deployers are performing admirably and completing with aplomb tasks that literal ly have never been required of DMATs or the USPHS. More news as events warrant, John Kadlec, Robert (O5/ASPR/IO) Redd, John (OS/ASPR/SPPR) ; Yeskey, Kevin (OS/ASPR/IO) ; Lee, Scott (OS/ASPR/EMMO) ; Tewell, Adam (OS/ASPR/SPPR) ; Recipient: Yue, David (OS/ASPR/EMMO) ; Childs, Richard (NIH/NHLBI) [El ; Phillips, Sally (OS/ASPR/SPPR) ; Shuy, Bryan (OS/ASPR/IO) Sent Date: 2020/02/21 06 :03 :43 Delivered Date: 2020/02/21 06:03:44 AMERICAN PVERSIGHT HHS-20-0580-A-000284 Giroir, Brett (HHS/OASH) Chang, William (HHS/OGC) ; Kane, EIieen (O5/ASPR/OEA) ; Trueman, Laura (HHS/IEA) ; Murphy, Ryan (OS/ASPA) ; Johnston, Darcie (HHS/IEA) ; To: Stecker, Judy (05/105) ; Shuy, Bryan (OS/ASPR/10) ; Yeskey, Kevin (O5/ASPR/IO) ; Greene, Jonathan (OS/ASPR/EMMO) ; Michael, Gretchen (OS/ASPR/OEA) Bonds, Michelle E. (CDC/OD/OADC) ; Schuchat, Anne MD (CDC/OD) ; Arbes, Sarah (HHS/ASL) Subject: RE: nCoV - ASPR - Washington Post on quarantining Lackland evacuees/ URGENT REQUEST Date: 2020/03/09 21:40:06 Priority: Normal Type: Note Call me if a auestion. b)(S) Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Chang, William (HHS/OGC) Sent: Monday, March 9, 2020 6:58 PM AMERICAN PVERSIGHT HHS-20-0580-A-000285 To: Kane, EIieen (O5/ASPR/OEA) ; Trueman, Laura (HHS/IEA) ; Giroir, Brett (HHS/OASH) ; Murphy, Ryan (O5/ASPA) ; Johnston, Darcie (HHS/I EA) ; Stecker, Judy (05/105) ; Shuy, Bryan (OS/ASPR/IO) ; Yeskey, Kevin (OS/ASPR/IO) ; Greene, Jonathan (O5/ASPR/EMMO) ; Michael, Gretchen (O5/ASPR/OEA) Cc: Bonds, Michelle E. (CDC/OD/OADC) ; Schuchat, Anne MD (CDC/OD) ; Arbes, Sarah (HHS/ASL) Subject: RE: nCoV -ASPR - Washington Post on quarantining Lackland evacuees/ URGENT REQUEST (b)(5) Office of the General Counsel U.S. Department of Health and Human Services 202-690-7741 (o) rb )(6) re) From: Kane, EIieen (OS/ASPR/OEA) Sent: Monday, March 9, 2020 5:52 PM To: Trueman, Laura (HHS/IEA) ; Giroir, Brett (HHS/OASH) ; Murphy, Ryan (OS/ASPA) ; Johnston, Darcie (HHS/I EA) ; Stecker, Judy (OS/IO5) ; Shuy, Bryan (OS/ASPR/IO) ; Yeskey, Kevin (OS/ASPR/IO) ; Greene, Jonathan (O5/ASPR/EMMO) ; Chang, William (HHS/OGC) ; Michael, Gretchen (O5/ASPR/OEA) Cc: Bonds, Michelle E. (CDC/OD/OADC) ; Schuchat, Anne MD (CDC/OD) ; Arbes, Sarah (HHS/ASL) Subject: RE: nCoV -ASPR - Washington Post on quarantining Lackland evacuees/ URGENT REQUEST (b)(5) AMERICAN PVERSIGHT HHS-20-0580-A-000286 (b)(5) From: Trueman, Laura (HHS/IEA) Sent: Monday, March 9, 2020 5:39 PM To: Giroir, Brett (HHS/OASH) ; Murphy, Ryan (O5/ASPA) ; Johnston, Darcie (HHS/IEA) ; Stecker, Judy (05/105) ; Shuy, Bryan (OS/ASPR/IO) ; Yeskey, Kevin (OS/ASPR/IO) ; Greene, Jonathan (O5/ASPR/EMMO) ; Chang, William (HHS/OGC) ; Kane, EIieen (OS/ASPR/OEA) ; Michael, Gretchen (OS/ASPR/OEA) Cc: Bonds, Michelle E. (CDC/OD/OADC) ; Schuchat, Anne MD (CDC/OD) ; Arbes, Sarah (HHS/ASL) rb)(5)Subject: RE' nCoV - ASPR- Wash ingt On Postl on q Uara nti n i ng Lackland evacuees/ URGENT REQUEST From: Giroir, Brett (HHS/OASH) Sent: Monday, March 9, 2020 5:21 PM To : Murphy, Ryan (OS/ASPA) ; Johnston, Darcie (HHS/IEA) ; Stecker, Judy (OS/IOS) ; Shuy, Bryan (OS/ASPR/IO) ; Yeskey, Kevin (OS/ASPR/IO) ; Greene, Jonathan (OS/ASPR/EMMO) ; Chang, William (HHS/OGC) ; Kane, EIieen (O5/ASPR/OEA) ; Michael, Gretchen (OS/ASPR/OEA) Cc: Bonds, Michelle E. (CDC/OD/OADC) ; Trueman, Laura (HHS/IEA) ; Schuchat, Anne MD (CDC/OD) ; Arbes, Sarah (HHS/ASL) Subject: RE: nCoV - ASPR - Washington Post on quarantining Lackland evacuees/ URGENT REQUEST AMEHICAN PVERSIGHT HHS-20-0580-A-000287 Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Murphy, Ryan (OS/ASPA) Sent: Monday, March 9, 2020 5:06 PM To: Giroir, Brett (HHS/OASH) ; Johnston, Darcie (HHS/I EA) ; Stecker, Judy (OS/IOS) ; Shuy, Bryan (OS/ASPR/1O); Yeskey, Kevin (OS/ASPR/1O); Greene, Jonathan (OS/ASPR/EMMO) ; Chang, William (HHS/OGC) ; Kane, EIieen (OS/ASPR/OEA) ; Michael, Gretchen (OS/ASPR/OEA) Cc: Bonds, Michelle E. (CDC/OD/OADC) ; Trueman, Laura (HHS/IEA) ; Schuchat, Anne MD (CDC/OD) ; Arbes, Sarah (HHS/ASL) Subject: RE: nCoV -ASPR - Washington Post on quarantining Lackland evacuees/ URGENT REQUEST (b)(5) From: Giroir, Brett (HHS/DASH) Sent: Monday, March 9, 2020 5:05 PM To: Johnston, Darcie (HHS/I EA) ; Stecker, Judy (OS/1OS) ; Murphy, Ryan (OS/ASPA) ; Shuy, Bryan (OS/ASPR/1O); Yeskey, Kevin (OS/ASPR/1O); Greene, Jonathan (OS/ASPR/EMMO) ; Chang, William (HHS/OGC) Cc: Bonds, Michelle E. (CDC/OD/OADC) ; Trueman, Laura (HHS/IEA) ; Schuchat, Anne MD (CDC/OD) ; Arbes, Sarah (HHS/ASL) Subject: RE: nCoV - ASPR - Washington Post on quarantining Lackland evacuees/ URGENT REQUEST OK Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW AMERICAN PVERSIGHT HHS-20-0580-A-000288 Washington, DC 20201 Office Phone: 202-690-7694 From: Johnston, Darcie {HHS/IEA) Sent: Monday, March 9, 2020 5:03 PM To: Giroir, Brett {HHS/OASH) ; Stecker, Judy {05/105) ; Murphy, Ryan {O5/ASPA) ; Shuy, Bryan (OS/ASPR/1O) ; Yeskey, Kevin (OS/ASPR/1O); Greene, Jonathan {O5/ASPR/EMMO) ; Chang, William {HHS/OGC) Cc: Bonds, Michelle E. (CDC/OD/OADC) ; Trueman, Laura {HHS/IEA) ; Schuchat, Anne MD {CDC/OD) ; Arbes, Sarah {HHS/ASL) Subject: RE: nCoV - ASPR - Washington Post on quarantining Lackland evacuees/ URGENT REQUEST (b)(5) Adding Will Chang Darcie L. Johnston Director, Intergovernmental Affairs U.S. Department of Health and Human Services Office of the Secretary 202-690-1058 (office) l(b)(6) I(cell) From: Giroir, Brett {HHS/OASH) Sent: Monday, March 9, 2020 4:26 PM To: Stecker, Judy {O5/1OS); Murphy, Ryan (OS/ASPA) AMERICAN PVERSIGHT HHS-20-0580-A-000289 Cc: Bonds, Michelle E. (CDC/OD/OADC) ; Trueman, Laura (HHS/IEA) ; Schuchat, Anne MD (CDC/OD) ; Giroir, Brett (HHS/OASH) ; Johnston, Darcie (HHS/IEA) Subject: FW: nCoV - ASPR- Washington Post on quarantining Lackland evacuees/ URGENT REQUEST Importance: High Please see attached. Note the comments I am happy to chat about these answers. There are some issues we really have to discuss. Darcie may have updates Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690- 7694 From: Schuchat, Anne MD (CDC/OD) Sent: Monday, March 9, 2020 3:48 PM To: Giroir, Brett (HHS/OASH) Cc: Berger, Sherri (CDC/OCOO/OD) Subject: FW: nCoV - ASPR- Wash ington Post on quarantin ing Lackland evacuees/ URGENT REQUEST (b)(5) From: Bonds, Miche lle E. (CDC/OD/OADC) Sent: Monday, March 9, 2020 3:29 PM To: Berger, Sherri (CDC/OCOO/OD) ; McGowan, Robert (Kyle) (CDC/OD/OCS) ; Schuchat, Anne MD (CDC/OD) Cc: Galatas, Kate (CDC/OD/OADC) ; Patrick, Kera (CDC/OD/OADC) ; CDC IMS JIC OADC LNO -2 Subject: FW: nCoV - ASPR- Washington Post on quarantining Lackland evacuees/ URGENT REQUEST Reporter : Can you confirm ASPR is now in charge? W ill ASPRcontinue to allow releasing quarant ined people from Lackland to leave after 14 days and two sequent ial negative tests, for those that agree to be tested, even though San Antonio filed an unsuccessful emergency lawsu it asking that the number of AMERICAN PVERSIGHT HHS-20-0580-A-000290 tests be three and the quarantine period be extended to 28 days? And what will the protocol be for those who test positive at the base and must be treated at a hospital or go to a negative pressure room for 14 days if they're asymptomatic? Will they also be allowed to go after two sequential negative tests? Importantly, our story will also note that the UNMC protocol for positive COVID-19 patients is different; it's THREEsequential tests, not two. ASPR Proposed response: b)(5) (b)(5) From: Stecker, Judy (OS/1OS) Sent: Monday, March 9, 2020 1:21 PM To: Murphy, Ryan (OS/ASPA) Cc: Michael, Gretchen (OS/ASPR/OEA) ; Kane, EIieen (OS/ASPR/OEA) ; Waters, Cicely (OS/ASPR/OEA); Bonds, Michelle E. (CDC/OD/OADC) ; Galatas, Kate (CDC/OD/OADC) ; Trueman, Laura (HHS/I EA) ; Johnston, Darcie (HHS/IEA) ; Rigas, Laura (HHS/IEA) ; McKeogh, Katherine (OS/ASPA) ; Hall, Bill (HHS/ASPA) AMEHICAN PVERSIGHT HHS-20-0580-A-000291 Subject: Re: PLEASEREAD FW: Washington Post reporter -- story on COVID-19 response on quarantining Lackland patients that ASPRhas now taken over. deadline urgent b)(5) Sent from my iPhone On Mar 9, 2020, at 12:54 PM, Murphy, Ryan (OS/ASPA) wrote: □ b)(5) b)(5) -Ryan From: Thorman, Caroline (ACF) Sent: Monday, March 9, 2020 12:40 PM AMERICAN PVERSIGHT HHS-20-0580-A-000292 To: Murphy, Ryan (OS/ASPA) Subject: FW: Washington Post reporter -- story on COVID-19 response on quarantining Lackland patients that ASPR has now taken over. deadline urgent Can you confirm ASPRis now in charge? Will ASPRcontinue to allow releasing quarantined people from Lackland to leave after 14 days and two sequential negative tests, for those that agree to be tested, even though San Antonio filed an unsuccessful emergency lawsuit asking that the number of tests be three and the quarantine period be extended to 28 days? And what will the protocol be for those who test positive at the base and must be treated at a hospital or go to a negative pressure room for 14 days if they're asymptomatic? Will they also be allowed to go after two sequential negative tests? Importantly, our story will also note that the UNMC protocol for positive COVID-19 patients is different; it's THREEsequential tests, not two. Many thanks, Caroline Thorman Director of Communications Administration for Children &Families (ACF) Health and Human Services (HHS) Desk: 202 401-4777 Cell:(b)(B) From: Satija, Neena Sent: Sunday, March 8, 2020 6:03 PM To: Thorman, Caroline (ACF) Subject: Fw: Washington Post reporter -- story on COVID-19 response on quarantining Lackland patients that ASPR has now taken over. deadline urgent Neena Satija Investigative Reporter Washington Post 202-334-7054 @neenareports From: Satija, Neena Sent: Sunday, March 8, 2020 3:51 PM To: gretchen.michael@hhs.gov ; elaine.kane@hhs.gov AMERICAN PVERSIGHT HHS-20-0580-A-000293 Subject: Washington Post reporter -- story on COVID-19 response on quarantining Lackland patients that ASPRhas now taken over. deadline urgent Dear Gretchen and Elaine, My name is Neena Satija and I'm a reporter for the Washington Post. I have been trying to get in touch with HHS on a story about coronavirus response when it comes to the Wuhan and Diamond Princess (and soon, Grand Princess) cohorts sent to Lackland Air Force Base, and I have had no luck with the CDC.So I'm going to you -- also because we have been told today that ASPRis now in charge of those quarantine ops instead of the CDC. Getting in touch with HHS in general for the past few weeks has been tough; in fact it took me several days simply to confirm, for instance, that OCEPHRwas involved in the repatriation effort ... and we really do want to be fair and accurate, so I'm really hoping you can help!! My colleague Arel is Hernandez and I have a story that may run tomorrow or the following day about the frustration among state and local officials in Texas, especially officials in San Antonio, regarding lack of communication from the administration on COVID-19 response, in particular, what to do with cohorts from Wuhan and the Diamond Princess (and, soon, the Grand Princess) cruise ship. We will report that state and local officials were assured that anyone sent to Lackland from Wuhan back on Feb. 1 would remain quarantined on base -- but instead, after the plane landed, San Antonio officials were immediately called upon not only to take the one woman who tested positive and had symptoms to a community hospital to be treated, but even to secure an ambulance to take her off Lackland. Essentially state and local officials were given no advanced warning that the DOD would now allow anyone who tested positive for COVID-19 to stay on base, whether asymptomatic or not. It appears as though state and local authorities had the tools in place to plan for these issues quickly. But what happened raises serious questions about the administration's handling of this public health emergency, especially after the release of that patient from Wuhan before a positive test result came back. I have contacted CDC multiple times for comment on our story with no answer. Then I found out today that ASPRis now in charge of quarantining protocols going forward as opposed to CDC. It's all the more important we hear from you now that dozens more cruise ship passengers, this time from the Grand Princess cruise ship, are now headed to Lackland. The administration has assured folks that it will quarantine them at the base. But what about those who test positive? Can you confirm ASPRis now in charge? Will ASPRcontinue to allow releasing quarantined people from Lackland to leave after 14 days and two sequential AMERICAN PVERSIGHT HHS-20-0580-A-000294 negative tests, for those that agree to be tested, even though San Antonio filed an unsuccessful emergency lawsuit asking that the number of tests be three and the quarantine period be extended to 28 days? And what will the protocol be for those who test positive at the base and must be treated at a hospital or go to a negative pressure room for 14 days if they're asymptomatic? Will they also be allowed to go after two sequential negative tests? Importantly, our story will also note that the UNMC protocol for positive COVID-19 patients is different; it's THREEsequential tests, not two. I'm hoping you can help me confirm some of the basic details and perhaps provide any other comment. You can also reach me on my cell at l(b)(6) I Thanks! Neena Satija Investigative Reporter Washington Post 202-334-7054 @neenareports Sender: Giroir, Brett (HHS/OASH) Chang, Wi lliam (HHS/OGC) ; Kane, EIieen (OS/ASPR/OEA) ; Trueman, Laura (HHS/IEA) ; Murphy, Ryan (OS/ASPA) ; Johnston, Darcie (HHS/IEA) ; Stecker, Judy (OS/IOS) ; Shuy, Bryan (OS/ASPR/1O) ; Yeskey, Kevin (O5/ASPR/IO) ; Greene, Jonathan (OS/ASPR/EMMO) ; Michael, Gretchen (OS/ASPR/OEA) ; Bonds, Michelle E. (CDC/OD/OADC) ; Schuchat, Anne MD (CDC/OD) ; Arbes, Sarah (HHS/ASL) Sent Date: 2020/03/09 21:40:06 AMERICAN PVERSIGHT HHS-20-0580-A-000295 AMERICAN PVERSIGHT HHS-20-0580-A-000296 Kadlec, Robert (OS/ASPR/IO) Yeskey, Kevin (OS/ASPR/I O) ; Greene, Jonathan (OS/ASPR/EMMO) ; Lee, Scott (OS/ASPR/EMMO) Subject: Fwd: Request for Federal Staffing to Support the Texas Center for Infectious Disease Date: 2020/03/0119 :56 :57 Priority: Normal Type: Note Sent from my iPhone Begin forwarded message: From: "Hellerstedt ,John W (DSHS)" Date: March 1, 2020 at 7:53:02 PM EST To: "Robert Redfield (olx l @cdc.gov )" , "Robert Kadlec (robert.kad lec@hhs.gov )" Cc: "Sims,Jennifer (DSHS)" , "Garcia ,Ricky (DSHS)" , "Cole,Kirk (DSHS)" , "Grnber ,David (DSHS)" Subject: Request for Federal Staffing to Support the Texas Center for Infectious Disease Dear Drs. Kadlec and Redfield: The State of Texas has been providing a facility for individuals repatriated to the United States who cannot stay at JBSA-Lackland due to symptoms or positive testing in Japan. To date, Texas resources have been used to staff the facility. The Texas Department of State Health Services is requesting that a federal HHS/CDCteam take over the care of the repatriated individuals at the Texas Center for Infectious Diseases (TCID). The HHS/CDC team would be responsible for all aspects of care for repatriated patients residing at TCID, including medical care, supportive care and feeding. The following tasks would be conducted: AMERICAN PVERSIGHT HHS-20-0580-A-000297 Twice daily medical assessments of patients to include temperature checks, housekeeping, and food/personal need services. Teams must don and doff between each patient. Doctor on-call and on-site 24/7 to answer any medical questions that may arise and can support above team(s) conducting medical assessment and patient care activities. Decontamination of facility areas such as hallways, including wiping down surfaces and mopping floors between group medical assessments or anytime a patient is brought to or taken from TCID. Administrative duties to include updating patient records, resting, and preparing for the next set of patient rounds or the need for any emergent interventions that could arise. These requested resources will only provide support to current repatriated patients at TCID or persons currently under quarantine at Lackland who may need to be moved to TCID due to symptoms. Texas intends to cease operation of TCID for the purpose of serving repatriated individuals once any current patients are released, or any patients who are transferred in from the current Diamond Princess cohort at Lackland due to symptoms are released. Texas will not expand the number of beds currently available, which is 22, and will not expand to serve any future repatriation efforts. The State is submitting an Assistance Request Form to the federal government officially conveying the requested team. In addition, Texas intends to submit in the near future a request for reimbursement of state costs for the operation and support of TCID as well as the ambulances and related support at JBSA-Lackland. Thank you for your consideration. John Hellerstedt, MD Commissioner Texas Department of State Health Services Kadlec, Robert (O5/ASPR/IO) Yeskey, Kevin (O5/ASPR/IO) ; Greene, Jonathan (O5/ASPR/EMMO) ; Lee, Scott (O5/ASPR/EMMO) Sent Date: 2020/03/0119:56:56 Delivered Date: 2020/03/0119 :56 :57 AMERICAN PVERSIGHT HHS-20-0580-A-000298 AMERICAN PVERSIGHT HHS-20-0580-A-000299 Kadlec, Robert (O5/ASPR/IO) Yeskey, Kevin (O5/ASPR/IO) ; To: Shuy, Bryan (OS/ASPR/1O) Subject: Re: URGENT- City of Costa Mesaseeks to prevent Movement of persons with Coronovirus URGENT Date: 2020/02/21 20:35:28 Priority: Normal Type: Note b)(5) Sent from my iPhone On Feb 21, 2020, at 8: 17 PM, Yeskey , Kevin (OS/ASPR/IO) wrote: Jen and Susan, See below . f~b)(s-,-------~ Kevin Sent from my iPhone Begin forwarded message: From: "Osinoff, Joanne (USACAC)" Date: February 21, 2020 at 8:08:29 PM EST To: "Hunt, Marty (USDOJ.GOV )" , "Lamana , Joseph (OS/ASPR/EMMO)" , "Yeskey, Kevin (OS/ASPR/IO)" , "Falcon, Jessica (OS/ASPR/SIIM)" , "Rotz, Lisa (CDC/DDID/NCEZID/DGMQ)" , "De La Motte Hurst, Christopher (CDC/DDID/NCEZID/DGMQ)" , "Misrahi, James J. (CDC/OCOO /OGC)" Cc: "Hanis, David M. (USACAC)" , "Beck, Daniel (USACAC)" Subject: URGENT - City of Costa Mesa seeks to prevent Movement of persons with Coronovirus - URGENT □ Gentle persons: AMERICAN PVERSIGHT HHS-20-0580-A-000300 b)(5) Thank you. Joanne Osinoff Joanne S. Osinoff I Assistant United States Attorney Chief I General Civil Section Uni ted States Attorney's Office I Central District of California Federal Building, Room 7516 I 300 N. Los Angeles St. I Los Angeles, California 90012 T: 213.894.6880 I F: 213.894.7819 1Joanne.0sinoff @usdoj.gov From: Nahal Kazemi Sent: Friday, February 21, 2020 3:19 PM To: Hanna, Nick (USACAC); usacac.civil@usdoj.com ; USACAC-CV-CiviI Rights Subject: Notice of Ex Parte TRO application Dear Counsel: We represent the City of Costa Mesa, California and Katrina Foley, in her individual capacity as a Costa Mesa resident. We understand that the United States of America, the United States Department of Health and Human Services, the United States Department of Defense, the United States Air Force, the Centers for Disease Control and Prevention, the State of California, Fairview Developmental Center (Fairview), the California Governor's Office of Emergency Services, and the California Department of General Services (the "Defendants") intend to relocate from 35-50 patients individuals already diagnosed with the Coronavirus from a secure location on Travis Air Force Base, where they are isolated from population centers, to Costa Mesa, a densely populated city within a county of over 3 million. And that, further, Defendants plan to do so without first determining the suitability of the facility where these individuals will be housed . The Defendants' plan was announced at the eleventh hour, late last AMERICAN PVERSIGHT HHS-20-0580-A-000301 night, with no efforts to include local government leaders or public health officials. Based upon these planned actions, the City of Costa Mesa and Ms. Foley will be filing an ex parte application for a temporary restraining order in the United States District Court for the Central District of California later today. The ex parte application will seek an order asking the Court to order Defendants to refrain from transferring individuals exposed to or infected with the Coronavirus to Fairview in Costa Mesa until an adequate site survey can be completed, and, if the facility can be made suitable for this purpose, until all necessary improvements to the facility are made to ensure the housing of infected individuals there possess no threat to the health and safety of the community. The City and Ms. Foley will assert that granting this relief under Federal Rule of Civil Procedure 65, the Administrative Procedure Act, 42 U.S.C.§ 1983, the Fifth and Fourteenth Amendment rights to procedural and substantive due process, and the Tenth Amendment. Please let us know immediately by email or telephone if the Government intends to oppose the application. If we do not hear from you within the next 30 minutes, we will inform the Court that we have not received the Government's position . Regards, Nahal Kazemi Nahal Kazemi Senior Counsel =-= Keller/ Anderle LLP 18300 Von Karman Ave., Suite 930 I Irvine, California 92612-1057 949.476.8700 Fax 949.476.0900 nkazemi@kelleranderle.com I https://protect2.fireeve.com/url?k= lc885a3a-40dc4346-lc886b05-0cc47adc5fa243deebdb305b611a&u =http://www.kelleranderle.com/ ::1vCard CONFIDENTIALITYNOTICE: This e-mail transmission, and any documents, files or previous e-mail messages attached to it, may contain confidential informatio n that is legally privileged. If you are not the intended recipient, or a person responsible for delivering it to the intended recipient, you are hereby notified that any disclosure, copying, distribution or use of any of the information contained in or attached to this message is STRICTLYPROHIBITED.If you have received this transmission in error, please immediately notify us by reply e-mail at info@kelleranderle.com or by telephone at 949.476.8700 and destroy the original transmission and its attachments without reading them or saving them to disk. Thank you. David and Joanne, AMERICAN PVERSIGHT HHS-20-0580-A-000302 Please see the below notification of the intent to use the Fairview Developmental Center to house individuals infected with coronav irus. The ema il was sent last night from the California Office of Emergency Services to the Emergency Manager for the City of Costa Mesa (Jason Dempsey). Please note that the email ind icates the infected persons at Travis AFB are under a federa l quarantine, according to Mr. Acosta. As I mentioned on the phone, I will send conformed copies of our filings when they are available . Thank you. Nahal Nahal Kazemi Senior Co unsel =-= Keller /Anderle LLP 18300 Von Karman Ave., Suite 930 I Irvine, California 92612-1057 949.476.8700 Fax 949.476.0900 nkazemi@kelleranderle.com I https://protect2.fireeye.com/url?k= 09bccdf5-55e8d489-09bcf cca-0cc47adcSf a2d 2a2aec623b82d b l&u =http://www.kelleranderle.com/ :!I vCard CONFIDENTIALITY NOTICE: This e-mail transmission, and any documents, files or previous e-mail messages attached to it, may contain confidential information that is legally privileged. If you are not the intended recipient, or a person responsible for delivering it to the intended recipient, you are hereby notified that any disclosure, copying, distribut ion or use of any of the information contained in or attached to this message is STRICTLY PROHIBITED. I f you have received this transmission in error, please immediately notify us by reply e-mail at info@kelleranderle.com or by telephone at 949.476.8700 and destroy the original transmission and its attachments without reading them or saving them to disk. Thank you. From: Acosta, Jim@CalOES [mailt o:Jim.Acosta@CalOES.ca.gov] Sent: Thursday, February 20, 2020 6:18 PM To: DONNA BOSTON;DEMPSEY,JASONS. Cc: We iss, Dan@CalOES; Brown, Sonia@CalOES; Ponce, Cruz@Caloes Subject: Fairview parameters These guide lines are proposals at this time, and are for official use only not for release. Jim Acosta Regional Administrator (Acting) Californ ia Governor's Office of Emergency Services Southern Region Operations Office: (562) 795-2939 Mobile: (b)(6 ) Jim.acosta AMERICAN PVERSIGHT ca oes.ca. ov HHS-20-0580-A-000303 Protocol for Symptomatic Persons While at Travis Air Force Base, under a federal quarantine order, HHS medical staff will evaluate and provide medical care. If an individual presents with Novel Coronav irus symptoms the following protocol would be implemented. • Individual would be transported by local ambulance provider to a nearby health care facility where they would be evaluated and tested for Novel Coronavirus. • If test is positive, the person would be provided supportive care. They would not return to Travis Air Force Base, instead they would be transferred either to Fairview Developmental Center (California residents) or Alabama (non -California residents) . • If test is negative, the person would be discharged and sent back via ambulance to Travis Air Force Base to finish out the remainder of their quarantine order . Sheltering for Confirmed Positive Persons Those individuals who test positive, once they have been provided supportive care and are able to be discharged: • Federal HHS would transport any individual tested positive, who is a Californ ia resident, and once provided supportive care and stabilized, to Fairview Developmental Center via air ambulance. • Non-California residents would be transferred by federal HHSto Alabama. Fairview Developmental Center Operational Logistics AMERICAN PVERSIGHT HHS-20-0580-A-000304 • Planning assumption that we would expect 30 -50 individuals. • Federal HHS would need to commit to providing the following: • Security and potential fencing • Onsite medical care including primary care, mental health, and supportive care • Wrap-around Services • Feeding • Cleaning and sanitation • Case management and logistics for departure • Individuals who would require hospitalization would be transported via ambulance to a local health care facility in Orange County. Sender: Kadlec, Robert (OS/ASPR/10) Yeskey, Kevin (OS/ASPR/IO) ; Recipient: Shuy, Bryan (O5/ASPR/IO) Sent Date: 2020/02/21 20:35:27 Delivered Date: 2020/02/21 20:35:28 AMERICAN PVERSIGHT HHS-20-0580-A-000305 Kadlec, Robert (O5/ASPR/IO) OS - ASPRStaff ; To: SNS DISTRO(O5/ASPR) Subject: Stay Informed, Get Involved and Stay Healthy. Date: 2020/02/03 14:56:02 Importance: High Priority: Urgent Type: Note Good Afternoon: I want to thank and commend all of you who spent the last couple of weeks (and weekends) pre pa ring for and responding to the risks of the novel coronavirus (2019-nCoV) outbreak. This week, Secretary Alex Azar held a press conference alongside Centers for Disease Control and Prevention (CDC) Director Robert Redfield, National Center for Immunization and Respiratory Disease {NCIRD) Director Nancy Messonnier, and National Institute of Allergy and Infectious Diseases {NIAID) Director Anthony Fauci to provide further details on the Department's coordinated public health response to the 2019 nCoV, including the role ASPRis playing within the response. This event is posted to the HHS YouTube channel. I want to thank my OEA colleagues for helping to make this event a success. Moving forward, OEA will work across ASPR to frame our daily talking points . These high level talking points are posted to the EM Portal and the ASPRPortal. I encourage all staff to review daily to learn the latest on our activities, and those of our intra- and interagency partners, including the CDCand NIH. Secretary Azar also held a press conference at the White House with myself, Dr Fauci and Dr Redfield as well as senior State, Transportation and Homeland Security representing the Task Force established by the President. The 2019 nCoV outbreak is a dynamic situation, and we are still learning about characteristics of this novel virus like transmissibility, virulence, case fatality rate, susceptible populations for example .. In response, the Secretary's Operations Center is fully activated to support CDC's Emergency Operations Center and to support coordination with other ESFpartners. We have convened the Disaster Leadership Group to bring together Assistant Secretary-level officials from across HHS to discuss the evolving outbreak and align HHS OPDIV/STAFFDIVpreparedness and response activities. We are working with FEMA to evaluate and adjust incident management structures and plans as appropriate . We have also activated our Emergency Support Function (ESF)8 interagency partners DoD, VA, OHSand others. Currently, there are no licensed therapeutics, vaccines or cleared diagnostics for this novel coronavirus . Testing products approved for other indications and developing new products are a high priority. BARDA is aggressively working with colleagues across the USG and the private sector to align medical product development efforts. For example, BARDA is coordinating with CDCto expand manufacturing of diagnostic assays. BARDA is also looking at the effectiveness of existing therapeutics, such as those in development for MERS-CoV, against the 2019-nCoV, and AMERICAN PVERSIGHT HHS-20-0580-A-000306 is coordinating with the Department of Defense and Department of Veterans Affairs on other MCM candidates. ASPRis supporting health care system preparedness efforts, primarily through HPP's healthcare coalition network, to provide general information on the virus and promote training opportunities. We are also working with our partners that participate in our National Ebola Treatment Network. Likewise, CIP is sharing information with private sector partners on issues related to supply chain management and critical infrastructure protection so they can plan and respond appropriately. ASPRstaff from Region Emergency Coordinators, USPHSofficers, NDMS and ASPRIT specialists are currently deployed to help with repatriation efforts. There are no words that I can say to express my appreciation to each and every one of you for working as a team to address a complex set of challenges and using your skills, experience and commitment to address this global public health risk. The weeks ahead will likely be long and the operational tempo is likely to increase. I have extreme confidence that we will fulfill our mission: to protect Americans and save lives. If you are interested in helping to support our ongoing efforst to bring home our citizens safely and quickly, please contact SOC.Support@hhs.gov for more information on how you can help. In the meantime, please review the daily talking points. I also recommend staff visit the CDC website to learn more about the 2019-nCoV. While the immediate risk of this new virus to the American public is low at this time, there are everyday preventive actions CDC recommends to stop the spread of germs. Cover your cough and sneeze, wash your hands frequently, if you are sick stay home and if you haven't done it yet get your flu shot. We need you healthy please take care of yourself. Thank you again for your efforts service and commitment. Sincerely, Bob ASPR Kadlec, Robert (OS/ASPR/IO) OS - ASPRStaff ; Recipient: SNS DISTRO(O5/ASPR) Sent Date: 2020/02/03 14:52:40 Delivered Date: 2020/02/03 14:56:02 AMERICAN PVERSIGHT HHS-20-0580-A-000307 Kadlec, Robert (OS/ASPR/IO) To: Rapuano, Kenneth P HON OSD OUSDPOLICY(USA) ; Friedrichs, Paul A Brig Gen USAFJS OOCS (USA) OS Salesses,Robert ; Yeskey, Kevin (OS/ASPR/IO); Shuy, Bryan (OS/ASPR/IO)i Thornton, Cody R CDR USPHSOSDOUSDPOLICY(USA) ; Ford-Barnes,Arwenthia (OS/ASPR/IO); Florick, Davis L CIV OSDOUSDPOLICY(USA) Subject: Re: [Non-DoD Source] Setting up a Time to talk Date: 2020/01/30 10:13:20 Priority: Normal Type: Note Fysa just spoke to WW State #s now 4 acft and up to 1000 pax. Sent from my iPhone On Jan 30, 2020 , at 7:47 AM, Kadlec , Robert (OS/ASPR/IO) wrote: Looping Gene ral Fri edrichs JCSSG From: Rapuano, Kenneth P HON OSD OUSD POLICY(USA) Sent: Thursday, January 30, 2020 7:13 AM To: Kadlec, Robert (OS/ASPR/1O) Cc: OS Salesses, Robert ; Yeskey, Kevin (OS/ASPR/1O) ; Shuy, Bryan (OS/ASPR/1O) ; Thornton, Cody R CDR USPHSOSD OUSD POLICY(USA) ; FordBarnes, Arwenthia (OS/ASPR/1O) ; Florick, Davis L CIV OSD OUSD POLICY(USA) Subject: Re: [Non-DoD Source] Setting up a Time to talk Davis from my office will reach out to set a time. Best, Ken Kenneth P. Rapuano Assistant Secreta1y of Defense for Homeland Defense &Global Secw-ity Office: 703-697- 7728 AMERICAN PVERSIGHT HHS-20-0580-A-000308 On Jan 30, 2020, at 07:08 , Kadlec , Robert (OS/ASPR/IO) wrote: DA Ii active links contained in this email were disabled. Please verify the identity of the sender , and confirm the authenticity of all links contained within the message prior to copying and pasting the addres s to a Web browser. I think that is what I want to go over. Mr Anderson represented DOD via SVTC and I am not sure he may have heard or gotten all that transpired in the roo m o r heard what was tasked because it was fairly vague. The dilemma is State is looking to move 700+ all at the same time. That was a shocker and one that we had not anticipated. My team is working COAs true to my promise t o your team to avoid o r not involve your department . Once again the fuse on this is very short and we are working hard to keep that promise. I want to apprise you of what we are trying to do with the disadvantage of time and resources. Bob From: Rapuano, Kenneth P HON OSD OUSD POLICY(USA) Sent: Thursday, January 30, 2020 7:02 AM To: Kadlec, Robert (OS/ASPR/1O) Cc: OS Salesses, Robert ; Yeskey, Kevin (OS/ASPR/1O); Shuy, Bryan (OS/ASPR/1O) ; Thornton, Cody R CDR USPHSOSD OUSD POLICY (USA) ; Ford-Barnes, Arwenthia (OS/ASPR/1O); Florick, Davis L CIV OSD OUSD POLICY(USA) Subject: Re: [Non -DoD Source] Setting up a Time to talk Bob - please give me your understanding of the conclusions, taskings, and other actions resulting from that meeting, particularly with regard to DOD , as I'm receiving multiple feeds and they're not all consistent. Best, Ken Kenneth P. Rapuano AMERICAN PVERSIGHT HHS-20-0580-A-000309 Assistant Secretary of Defense for Homeland Defense &Global Security Office: 703-697-7728 < tel:703-697-7728 > On Jan 30, 2020 , at 06:13, Kadlec , Robert (OS/ASPR/IO) >wrote: □ Dear Ken and Bob: I am assuming you already got a brief out from the DC turned PCwith POTUSlate yesterday afternoon and the table drop done by State at that meeting I would like to arrange a call after noon today to discuss. My team is putting together COA's that I will be briefed on at noon. Cody will be at that meeting. Thanks Best Bob Sender: Kadlec, Robert (OS/ASPR/IO) Rapuano, Kenneth P HON OSD OUSDPOLICY(USA) ; Friedrichs, Paul A Brig Gen USAFJS OOCS (USA) ; OS Salesses, Robert ; Yeskey, Kevin (OS/ASPR/IO); Recipient: Shuy, Bryan (O5/ASPR/IO) ; Thornton, Cody R CDR USPHSOSDOUSDPOLICY(USA) ; Ford-Barnes, Arwenthia (O5/ASPR/IO) ; Florick, Davis L CIV OSDOUSDPOLICY(USA) Sent Date: 2020/01/30 10:13:19 Delivered Date: 2020/01/30 10:13:20 AMERICAN PVERSIGHT HHS-20-0580-A-000310 Bright, Rick (O5/ASPR/BARDA) Yeskey, Kevin (O5/ASPR/IO) Subject: RE: COVID-19- Potential Option For Infected/Mild Cases-Clinical PharmacologyInpatient Study Units Date: 2020/02/14 14:52:22 Priority: Normal Type: Note Rgr. Hilary Marston has some questions. Can I connect her to you or to someone else who she can talk with? And, btw, the barda POC assessing our CRO network for general capability is Robin Mason robin.mason@hhs.gov 202-205-0329 From: Yeskey, Kevin (OS/ASPR/IO) Sent: Friday, February 14, 2020 12:55 PM To: Bright, Rick (OS/ASPR/BARDA) Subject: Re: COVID-19 - Potential Option For Infected/Mild Cases- Clinical Pharmacology Inpatient Study Units Those sites just don't have the capacity Sent from my iPhone On Feb 14, 2020, at 12:52 PM, Bright, Rick (OS/ASPR/BARDA) wro te: □ For NIH, I have alerted Hilary Marston and she is the POC. Hilary.Marston@nih.gov 301-451-2435 Cellfb)(B) I Office: For BARDA, I am connecting with our Clinical Trial lead now. Also, are the NETECsavailable, or already filled? From: Yeskey, Kevin (OS/ASPR/IO) Sent: Friday, February 14, 2020 12:32 PM To: Bright, Rick (OS/ASPR/BARDA) Subject: Fwd: COVID-19 - Potential Option For Infected/Mild Cases- Clinical Pharmacology Inpatient Study Units AMERICAN PVERSIGHT HHS-20-0580-A-000311 Rock b)(5) Thanks Sent from my iPhone Begin forwarded message: From: "Finne, Kristen (OS/ASPR/ EMMO)" Date: February 14, 2020 at 12:06:55 PM EST To: "Yeskey, Kevin (OS/ASPR/IO)" Cc: "Greene , Jonathan (OS/ASPR/EMMO)" , "Scharf-Bell , Helga (OS/ASPR/EMMO)" , "Lamana, Joseph (OS/ASPR/ EMMO)" Subject: RE: COVID-19 - Potential Option For Infected/Mild Cases- Clinical Pharmacology Inpatient Study Units □ b)(5) Sincerely, Kristen Kristen Finne Director, HHS emPOWER Program Senior Program Analyst, HHS/ASPR/EMMO/Readiness Cell: 202-823-1362, Email : kristen.finne@hhs .gov HHS em POWER Map 3.0 URL: https://em powerma p.hhs.gov/ This.emai l tr ansmission is inten ded for the exclus ive use of the recipient(s) name d above. It may contain info rmat ion that is protec t ed, pr ivileged, or conf ident ial and It shoul d no t be dissem inated, distr ibuted or copie d to person not authorized, in this ema il, to receive such information . Under the Privacy Act of 1975, all data of a private natu re is protected from unautho r ized disclosure. If you hare not the int ended recip ient, any dissem inat ion 1 distr ibut ion, or copy ing is strictly proh ibited . If you t hink you have received this ema il in error 1 pleas.e email the sender immed iat ely at Kristen .fi nne@hhs .gov and destroy the or igina l. From: Yeskey, Kevin (OS/ASPR/10) Sent: Friday, February 14, 2020 11:50 AM AMERICAN PVERSIGHT HHS-20-0580-A-000312 To: Finne, Kristen {OS/ASPR/EMMO) Cc:Greene, Jonathan {OS/ASPR/EMMO) ; Scharf-Bell, Helga {OS/ASPR/EMMO) ; Lamana, Joseph {OS/ASPR/EMMO) Subject: Re: COVID-19 - Potential Option For Infected/Mild Cases- Clinical Pharmacology Inpatient Study Units Do you have a POC? Sent from my iPhone On Feb 14, 2020 , at 11:26 AM , Finne, Kristen (OS/ASPR/EMMO) wrote: □ Hi Kevin and Jonathan, b)(5) AMERICAN PVERSIGHT HHS-20-0580-A-000313 b)(5) Sincerely, Kristen Kristen Finne Directo r, HHS em POWER Program Senior Program Ana lyst, HHS/ASPR/EMMO/R eadiness Cell:l(b)(6) Email: kristen.finne@hhs.gov HHS emPOW ER Map 3.0 URL: https://empowermap.hhs.gov/ ! This emai l transmission is intended for the exclusive use of t he recipient(s) named above. It may contain informat ion that Is protected, privileged, or confldentlal and It should not be disseminated, distribtJted or copied to person not authorized, in this ema il1 to receive such info rmat ion. Under the Privacy Act of 19751 all data of a pr ivate natu re is protected from unaut horized disclosure . If you hare not the int ended rec1pient, any disseminati on, distr ibut ion, or copying is strict ly proh ibit ed . If you think you have received this email In er ror, please ema il the sender Immed iately at Kristen.f inne@hhs.gov and destroy the original. Sender: Recipient: Bright, Rick (0S/ASPR/BARDA) Yeskey, Kevin (0S/ASPR/IO) Sent Date: 2020/02/ 14 14:52:2 1 Delivered Date: 2020/02/ 14 14:52:22 AMERICAN PVERSIGHT HHS-20-0580-A-000314 Kadlec,Robert (OS/ASPR/IO) Phillips, Sally (O5/ASPR/SPPR) CC: Yeskey, Kevin (OS/ASPR/IO) Subject: RE: FYSA: One Healthcare Coalition LeaderViews Date: 2020/03/14 09:35:03 Priority: Normal Type: Note Didn't see this thank you From: Phillips, Sally (OS/ASPR/SPPR) Sent: Saturday, March 14, 2020 9:19 AM To: Kadlec, Robert (OS/ASPR/10) Cc:Yeskey, Kevin (OS/ASPR/10) Subject: Fwd: FYSA:One Healthcare Coalition Leader Views I don 't see you copied. If you have already been made aware of this input we are getting I apologi ze for the duplication. Sent from my iPhone Begin forwarded message: From: "Brannman , Shayne (OS/ASPR/EMMO)" Date: March 14, 2020 at 9:01 :34 AM EDT To: "Herrmann , Jack (OS/ASPR/O EA)" , "Scharf-Bell, Helga (OS/ASPR/EMMO)" , "Perdue , Christopher (OS/ASPR/SPPR)" , "Wolf, Laura (OS/ASPR/SIIM)" , John Hick , "Finne, Kristen (OS/ASPR/ ENIMO)" , "Levine, Cheryl (OS/ASPR/EMMO)" , "Hunt, Richard (OS/ASPR/EMMO)" , "Czarzasty, James (OS/ASPR/EMMO)" , "Phillips , Sally (OS/ASPR/SPPR)" , "Hannah , Jennifer (OS/ASPR/EMMO)" , "Holland , Tara (OS/ASPR/EMMO)" , "Greene, Jonathan (OS/ASPR/EMMO)" , "Lamana , Joseph (OS/ASPR/EMMO)" , "Kaul, Rachel (OS/ASPR/EMMO)" Subject: FYSA: One Healthcare Coalition Leader Views AMERICAN PVERSIGHT HHS-20-0580-A-000315 BTW CDCguidance for healthcare providers is not being followed consistently across hospitals. Kaiser Permanente hospitals in CA are telling ERstaff NOT to wear masks even when caring for a suspect PUI or in triage. Nurses there want to strike. PPEis being rationed at many locations. And still being locked up. Also am hearing that healthcare providers are being denied tests even when they have cared for suspect patients and are symptomatic themselves with fever, etc. They are concerned that they may be carrying the virus home to their children and elder parents. There is also concern about the burden of EMR charting; there is still no abbreviated "disaster charting" for CERNERor EPICEMR platforms. Can keyboards also become vectors for transmission? Many ER's have computers in the treatment rooms for charting. I noted that some states are implementing drive through screening stations. Wish we had that! No rapid TAT test but maybe that will be available soon. On the good news front, colleagues are using ASPRTRACIEresources including the PPECalculator. It is daunting how much PPEis needed for a 300-400 bed hospital. Sorry for the length of this email. I know that you have a lot on your plate ..... Sender: Kadlec, Robert (O5/ASPR/IO) Phillips, Sally (O5/ASPR/SPPR); Recipient: Yeskey, Kevin (O5/ASPR/IO) Sent Date: 2020/03/14 09:35:02 Delivered Date: 2020/03/14 09:35:03 AMERICAN PVERSIGHT HHS-20-0580-A-000316 Bright, Rick (O5/ASPR/BARDA) Bartrum, John (O5/ASPR)(CTR) ; Shuy, Bryan (OS/ASPR/1O); To: Yeskey, Kevin (OS/ASPR/IO); Phillips, Sally (O5/ASPR/SPPR) Johnson, Robert (O5/ASPR/BARDA); CC: Disbrow, Gary (O5/ASPR/BARDA) Subject: RE: Flash need in next 30mDate: 2020/02/26 14:28:43 Priority: Normal Type: Note PREPAct will be important to provide a liability umbrella for manufactures of MCMs that could be used under EUA and for emergency response Antitrust authority may become essential if we need to utilize mix and match like options to combine vaccine antigen and adjuvants from different companies, etc. From: Bartrum, John (OS/ASPR) (CTR) Sent: Wednesday, February 26, 2020 2:23 PM To: Shuy, Bryan (OS/ASPR/10) ; Bright, Rick (OS/ASPR/BARDA) ~hhs.gov>; Yeskey, Kevin (OS/ASPR/10) ; Phillips, Sally (OS/ASPR/SPPR) Subject: RE: Flash need in next 30m~(b)(5) b)(5) -----Original Message----From: Shuy, Bryan (OS/ASPR/10) Sent: Wednesday, February 26, 2020 2:02 PM To: Bright, Rick (OS/ASPR/BARDA) ; Yeskey, Kevin (OS/ASPR/10) AMEHICAN PVERSIGHT HHS-20-0580-A-000317 ; Phillips, Sally (OS/ASPR/SPPR) Subject: Flash need in next 30m(b)(5) Sent from my iPhone Sender: Bright, Rick (OS/ASPR/BARDA) Bartrum, John (OS/ASPR) (CTR) ; Shuy, Bryan (OS/ASPR/10) ; Yeskey, Kevin (OS/ASPR/10) ; Recipient: Phillips, Sally (OS/ASPR/SPPR) ; Johnson, Robert (OS/ASPR/BARDA) ; Disbrow, Gary (OS/ASPR/BARDA) Sent Date: 2020/02/26 14:28:42 Delivered Date: 2020/02/26 14:28:43 AMERICAN PVERSIGHT HHS-20-0580-A-000318 Kadlec,Robert (O5/ASPR/IO) To: Wood, Bob CC: Yeskey, Kevin (O5/ASPR/IO); Herrmann, Jack (O5/ASPR/OEA) Subject: Re: AHCA/NCALOffering COVID-19Webinar Tomorrow Date: 2020/03/02 14:13:01 Priority: Normal Type: Note Great Bob thanks for reaching out. And we stand by to assist. Best. Bob Sent from my iPhone On Mar 2, 2020, at 1:51 PM, Wood, Bob wrote: FYI. Thank you for your time today! We will follow up shortly on a follow up call this afternoon. -Bob From: AHCA/NCAL Sent: Monday, March 2, 2020 1:46 PM To: Wood, Bob Subject: AHCA/NCAL Offering COVID-19 Webinar Tomorrow To view this email as a web page, go here. AMERICAN PVERSIGHT HHS-20-0580-A-000319 AHCA. NCAL. AMERICAN HEALTH CARE ASSOCIATION NATIONAL CENTER FOR ASSISTED LIVING COVID-19 Webinar Tomorrow AHCA/NCAL will host a COVID-19 webinar for all long term care providers tomorrow. Tuesday, March 3 4:00 - 5:15 pm ET 1 the interest of public health, this webinar is open to all long term care providers, including members and non-meml AHCA/NCAL. 'he webinar will include an update from Centers for Disease Control and Prevention (CDC) officials and AHCA/NCAI Join the Webinar o Participate: ,EASE TEST YOUR COMPUTER IN ADVANCE! (b)(6) ~ HHS-20-0580-A-000320 T U...,,l,IIJ""'"l.L llow the instructions below 15 minutes prior to the scheduled start time to join the web portion as well as the phone This email was sent to: bwood@bgrdc.com This email was sent by: American Health Care Association 1201 L St. NW Washington, DC 20005 United States We respect your right to privacy - view our policy Updat e Profi le Sender: Kadlec, Robert (O5/ASPR/IO) Wood, Bob ; Yeskey, Kevin (O5/ASPR/IO) ; Herrmann, Jack (O5/ASPR/OEA) Sent Date: 2020/03/02 14:12:58 Delivered Date: 2020/03/02 14:13:01 AMERICAN PVERSIGHT HHS-20-0580-A-000321 Bright, Rick (O5/ASPR/BARDA) Wallace, Rodney (OS/ASPR/BARDA) Lee, John (OS/ASPR/BARDA) ; Francis, Troy (OS/ASPR/BARDA) ; McCord, Matthew (O5/ASPR/BARDA) ; Humes, Rosemary (OS/ASPR/BARDA) ; Davenport, Matthew (OS/ASPR/BARDA) ; Smith, Jordan (OS/ASPR/BARDA) (CTR) ; DeMarco, Kerry (O5/ASPR/BARDA) (CTR) ; Speight, Rekia (OS/ASPR/BARDA) (CTR) ; Eder, Paul (OS/ASPR/BARDA) ; Sincock, Stephanie (O5/ASPR/BARDA) ; Scrivens, Brian (OS/ASPR/BARDA) (CTR) ; Boston, Donna (OS/ASPR/BARDA) ; (FYDIBOHF23SPDLT) /cn =Rec i pients/cn =5blab70262d34e749096f617dea6a235-Boston, CC: Kramp, William (OS/ASPR/BARDA) ; Naraghi-Arani, Pejman (OS/ASPR/BARDA) (CTR) ; Yang, Justin (OS/ASPR/BARDA) ; Selimovic Ph.D, Seila (O5/ASPR/BARDA) ; Sciarretta, Kimberly (O5/ASPR/BARDA) ; Mittar , Dev (O5/ASPR/BARDA) (CTR) ; Bearinger, Jane (OS/ASPR/BARDA) (CTR) ; Rao, Prakash (O5/ASPR/BARDA) (CTR) ; Moroni, Maria (O5/ASPR/BARDA) ; Silva, Ivan (OS/ASPR/BARDA) ; Wax, Marie (OS/ASPR/BARDA) (CTR) ; EI-Badry, Nina (OS/ASPR/BARDA) ; Chapman, Joseph (O5/ASPR/BARDA) ; Disbrow, Gary (OS/ASPR/BARDA) ; Johnson, Robert (OS/ASPR/BARDA) ; Benford, Jaffrey (OS/ASPR/BARDA) ; Lambert, Linda (OS/ASPR/BARDA) ; Donis, Ruben (OS/ASPR/BARDA) ; Merkeley, Tyler (OS/ASPR/BARDA) ; Kadlec, Robert (OS/ASPR/IO) ; Shuy, Bryan (OS/ASPR/IO) ; Petillo, Jay (OS/ASPR/MFHC) ; Yeskey, Kevin (OS/ASPR/IO) ; Phillips, Sally (OS/ASPR/SPPR) ; Eldridge, Schuyler (OS/ASPR/MFHC) Subject: Re: Hologic Award Date: 2020/03/07 05 : 12: 12 Priority: Normal Type: Note This is truly amazing! And I don't think I've ever heard Rodney gush so much over anything. He's right to do so! Americans are in desperate need of diagnostics to address the coronavirus outbreak. People need to know when they're infected. Healthcare workers , emergency responders, nursing home staff, everyone needs to know if they are at risk or have been exposed. This is a critical need. Diagnostics can save lives! You all delivered! On Hologi c and I know you have a full portfolio of things corning around the corner next week and onward. 13 days is unprecedented and way faster than we imagined the EZ-BAA could deliver. And I agree with Rodney , I think it went even faster. Whoa! And beyond new awards, om entire dx team is truly a beacon of interagency leadership and collaboration. Your contribution and expertise is widely recognized in the enablement of diagnostic programs across the board , including the Herculean effort that you put into enabling LabCorp to start testing Friday and Quest coming on board Monday. Because of you, more Americans can now get tested for this new Corona virus. I am grateful and I know that all of America is grateful for your expertise, service , leadership, teamwork and compassion. AMERICAN PVERSIGHT HHS-20-0580-A-000323 Truly impressive work. I hope that you can get some rest over the weekend. And thank you for showing me a gushy side of Rodney. Sir, you are a hero and We are lucky to have you at the helm. Thank you for leading, for stretching the boundaries of the possible, for bending , pushing, listening and leading. Sounds like your physical therapy probably. We are so grateful. Thank you. Rick. On Mar 6, 2020, at 4:00 PM, Wallace, Rodney (OS/ASPR/BARDA) wrote: □ Troy made it officia I, the Ho logic contract is signed! Congratulations to All of you! You all contributed in some way to make this happen. I and the rest of BARDA leadership are extremely grateful for your hard work and dedication that resulted in this award. Over the coming weeks, this effort will result in a substantial increase in the testing capacity to identify Covid-19 cases, both in the US and Worldwide. About½ of the Panther Fusion instruments needed to perform this test are in the US. It is amazing how quickly this submission was processed. Troy tells me 13 days, but I know it was actually faster than that, once we got things moving. Subsequent submission have gotten into negotiations, from submission in less than a week. Just amazing. I also know, many of you were working nights and weekends to make this happen, and for this I am truly greateful. Take a few moments this weekend to enjoy this accomplishment. It's important! But, we are in a Public Health Emergency so we can only celebrate for a moment and them get back to it. We have important work to still get done! Thank you! Rodney L. Wallace Director, Detection, Diagnostics, &Devices Infrastructure Division {DODI) Biomedical Advanced Research and Development Authority (BARDA) Office of the Assistant Secretary for Preparedness and Response (ASPR) US Department of Health and Human Services (HHS) Mailing Address: 330 Independence Avenue, SW, Room G644 Washington, DC 20201 Office: +1-202-205-3983 Mobile: fbl(B) I AMERICAN PVERSIGHT HHS-20-0580-A-000324 Email: rodney.wallace@hhs.gov Website: https:1/MedicalCountermeasures.qov 0 pen SoIicitation: https://www.fbo.gov/spg/H 00003/ l isti ng. htm I HS/OO5/OAS PHEP/BAA-18-100-SOL- Legally Privleged - This e-mail transmission and any documents attached to it may contain information that is legally privileged. If you are not the intended recipient, or a person responsible for delivering this transmission to the intended recipient, you are hereby notified that any disclosure, copying, distribution, or use of this transmission is strictly prohibited. If you have received this transmission in error, please immediately notify the sender and destroy the original transmission, attachments, and destroy any hard copies. Note to contractors: nothing in this e-mail is intended to constitute contractual direction or to impact cost, price, or schedule contained in the contract. If the contractor believes there is an impact, the contractor must disregard that portion of the communication and contact the Contracting Officer for direction Bright, Rick (OS/ASPR/BARDA) Wallace, Rodney (O5/ASPR/BARDA) ; Lee, John (O5/ASPR/BARDA) ; Francis, Troy (O5/ASPR/BARDA) ; McCord, Matthew (OS/ASPR/BARDA) ; Humes, Rosemary (O5/AS PR/BARDA) ; Davenport, Matthew (O5/ASPR/BARDA) ; Recipient: Smith, Jordan (OS/ASPR/BARDA) (CTR) ; DeMarco, Kerry (O5/ASPR/BARDA) (CTR) ; Speight, Rekia (O5/ASPR/BARDA) (CTR) ; Eder, Paul (O5/ASPR/BARDA) ; Sincock, Stephanie (OS/ASPR/BARDA) ; Scrivens, Brian (O5/ASPR/BARDA) (CTR) ; Boston, Donna (OS/ASPR/BARDA) ; Kramp, William (OS/ASPR/BARDA) ; Naraghi-Arani, Pejman (O5/ASPR/BARDA) (CTR) ; Yang, Justin (OS/ASPR/BARDA) ; Selimovic Ph.D, Seila (OS/ASPR/BARDA) ; Sciarretta, Kimberly (OS/ ASPR/BARDA) ; Mittar, Dev (OS/ASPR/BARDA) (CTR) ; Bearinger, Jane (OS/ASPR/BARDA) (CTR) ; Rao, Prakash (OS/ASPR/BARDA) (CTR) ; Moroni, Maria (O5/ASPR/BARDA) ; Silva, Ivan (O5/ASPR/BARDA) ; Wax, Marie (OS/ASPR/BARDA) (CTR) ; EI-Badry, Nina (OS/ASPR/BARDA) ; Chapman, Joseph (O5/ASPR/BARDA) ; Disbrow, Gary (OS/ASPR/BARDA) ; Johnson, Robert (OS/ASPR/BARDA) ; Benford, Jaffrey (OS/ASPR/BARDA) ; Lambert, Linda (OS/ASPR/BARDA) ; Donis, Ruben (OS/ASPR/BARDA) ; Merkeley, Tyler (OS/ASPR/BARDA) ; Kadlec, Robert (OS/ASPR/1O) ; Shuy, Bryan (OS/ASPR/IO) ; Petillo, Jay (O5/ASPR/MFHC) ; Yeskey, Kevin (OS/ASPR/IO) ; Phillips, Sally (OS/ASPR/SPPR) ; Eldridge, Schuyler (O5/ASPR/MFHC) Sent Date: 2020/03/07 05 : 12: 10 Delivered Date: 2020/03/07 05 : 12: 12 AMERICAN PVERSIGHT HHS-20-0580-A-000326 Kadlec, Robert (O5/ASPR/IO) Giroir, Brett (HHS/OASH) ; Yeskey, Kevin (O5/ASPR/IO) ; Herrmann, Jack (O5/ASPR/OEA) CC: Shuy, Bryan (O5/ASPR/IO) Subject: Fwd: AHCA/NCAL Offering COVID-19 Web inar Tomorrow Date: 2020/03/02 14:57:22 Priority: Norma l Type: Note Please include Dr Giroir in conversations with the nursing facilities let's set this up ASAP Sent from my iPhone Begin forwarded message: From: "Wood , Bob" Date: March 2, 2020 at 1:51 :28 PM EST To: "Robert .kadlec @hhs.gov " , "Kevin. Y eskey @hhs.gov " , "John.Herrmann @hhs.gov " Subject: FW: AHCA/NCAL Offering COVID-19 Webinar Tomorrow FYI. Thank you for your time today! We will follow up shortly on a follow up call this afternoon. -Bob From: AHCA/NCAL Sent: Monday, March 2, 2020 1:46 PM To: Wood, Bob Subject: AHCA/NCAL Offering COVID-19 Webinar Tomorrow To v iew t his ema il as a web page, go here . AMERICAN PVERSIGHT HHS-20-0580-A-000327 1 AHCA. AMERICAN HEALTH NCAL. CARE ASSOCIATION NATIONAL CENTER FOR ASSISTED LIVING COVID-19 Webinar Tomorrow AHCA/NCAL will host a COVID-19 webinar for all long term care providers tomorrow. Tuesday, March 3 4:00 - 5:15 pm ET the interest of public health, this webinar is open to all long term care providers, including members and non-meml AHCA/NCAL. he webinar will include an update from Centers for Disease Control and Prevention (CDC) officials and AHCA/NCAI Join the Webinar ----- AMt'RICAN PVERSIGHT HHS-20-0580-A-000328 o Participate: ,EASE TEST YOUR COMPUTER IN ADVANCE! ~-----------------------~ ·ect your web browser to the following URL: (b)(B) b)(6) ~ THE DAY OF THE EVENT llow the instructions below 15 minutes prior to the scheduled start time to join the web portion as well as the phone sed audio. 1. • Direct your web browser to the following URL: b)(B) (b)(6) 2. 3. 'OU • Please enter your display name, e-mail address, number of people sitting in with you, and press "Enter Meetir • You will listen to today's program via streaming audio, or through your computer speakers. If the presentation out, please refresh your screen by pressing F5 or CommandR for a MAC. need technical assistance, please send a message in the chat or e-mail ahca@commpartners.com . tay Up to Date ;it our webpage here daily for the latest information that AHCA/NCAL has to share with our members about COVIDICA/NCAL is working nationally with the CDC to ensure our members are receiving necessary supplies and guidanc went the spread of this disease. OFace book AMERICAN PVERSIGHT Or witter AHCA I Ov ouTube I Provider NCAL 4e unked ln HHS-20-0580-A-000329 This email was sent to: bwood@bgrdc.com This email was sent by: American Health Care Association 1201 L St. NW Washington, DC 20005 United States We respect your right to privacy - v iew our policy Updat e Profi le Sender: Kadlec, Robert (O5/ASPR/IO) Giroir, Brett (HHS/OASH) ; Yeskey, Kevin (O5/ASPR/IO) ; Recipient: Herrmann, Jack (O5/ASPR/OEA) ; Shuy, Bryan (OS/ASPR/1O) Sent Date: 2020/03/02 14:57:21 Delivered Date: 2020/03/02 14:57:22 AMERICAN PVERSIGHT HHS-20-0580-A-000330 Giroir, Brett (HHS/OASH) To: Kadlec, Robert (O5/ASPR/IO) Phillips, Sally (O5/ASPR/SPPR); Yeskey, Kevin (OS/ASPR/10); Jernigan, Daniel B. (CDC/DDID/NCIRD/ID); Shuy, Bryan (O5/ASPR/IO) ; Schuchat, Anne MD (CDC/OD) ; Moreno, Rafael (OS/ASPR) Subject: RE: Guidancefor Termination of Isolation Date: 2020/03/10 06:45:37 Priority: Normal Type: Note Making sure this is high in your box. b)(5) Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Giroir, Brett (HHS/OASH) Sent: Monday, March 9, 2020 6:25 PM To: Kadlec, Robert (OS/ASPR/1O) Cc: Phillips, Sally (OS/ASPR/SPPR); Yeskey, Kevin (OS/ASPR/1O) ; Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) ; Shuy, Bryan (OS/ASPR/1O); Schuchat, Anne MD (CDC/OD) ; Giroir, Brett (HHS/OASH) ; Moreno, Rafael (OS/ASPR) Subject: Guidance for Termination of Isolation Importance: High RKb)(5) AMERICAN PVERSIGHT HHS-20-0580-A-000331 (b)(5) Let me know if you have any questions. V/r BG Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 Sender: Giroir, Brett (HHS/OASH) Kadlec, Robert (OS/ASPR/10) ; Phillips, Sally (O5/ASPR/SPPR) ; Yeskey, Kevin (O5/ASPR/IO) ; Jernigan, Daniel B. (CDC/DDID/NCIRD/10) ; Shuy, Bryan (OS/ASPR/1O) ; Schuchat, Anne MD (CDC/OD) ; Moreno, Rafael (O5/ASPR) Sent Date: 2020/03/10 06:45:35 Delivered Date: 2020/03/10 06:45:37 AMERICAN PVERSIGHT HHS-20-0580-A-000332 Kadlec, Robert (OS/ASPR/IO) Cetron, Marty (CDC/DDID/NCEZID/DGMQ); Knutson, Donna (CDC/DDNID/NCEH/OD) ; Perdue, Christopher (O5/ASPR/SPPR); Weir, Charles (O5/ASPR/IO) Redfield, Robert R. (CDC/OD); Schuchat, Anne MD (CDC/OD) ; McGowan, Robert (Kyle) (CDC/OD/ OCS) ; Cote, Mick (OS/ASPR/EMMO); Yeskey, Kevin (OS/ASPR/IO) Subject : Need your URGENTAttention Please Date : 2020/03/15 09:10:58 I mportance: High Priority : Urgent Type: Note b)(5) Thanks This would be a huge help. Bob Kadlec, Robert (OS/ASPR/IO) Recipient : AMERICAN PVERSIGHT Cetron, Marty (CDC/DDID/NCEZID/DGMQ); Knutson, Donna (CDC/DDNID/NCEH/OD) ; Perdue, Christopher (OS/ASPR/SPPR) ; Weir, Charles (OS/ASPR/IO) ; Redfield, Robert R. (CDC/OD) ; Schuchat, Anne MD (CDC/OD) ; McGowan, Robert (Kyle) (CDC/OD/OCS) ; Cote, Mick (O5/ASPR/EMMO) ; Yeskey, Kevin (OS/ASPR/IO) Sent Date: 2020/03/15 09: 10:57 Delivered Date: 2020/03/15 09: 10:58 AMERICAN PVERSIGHT HHS-20-0580-A-000334 Giroir, Brett (HHS/OASH) To: Moreno, Rafael (OS/ASPR) Phillips, Sally (O5/ASPR/SPPR); Yeskey, Kevin (OS/ASPR/10); Jernigan, Daniel B. (CDC/DDID/NCIRD/ID); Shuy, Bryan (O5/ASPR/IO) ; Schuchat, Anne MD (CDC/OD) ; Strategic COVID-19Tracker Team ; Kadlec, Robert (O5/ASPR/IO) ; Waters, Cicely (O5/ASPR/OEA) Subject: RE: Guidancefor Termination of Isolation Date: 2020/03/10 11:27:59 Priority: Normal Type: Note He cleared it verbally with me and it is on the way through the CDC process Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Moreno, Rafael (OS/ASPR) Sent: Tuesday, March 10, 2020 11:24 AM To: Giroir, Brett (HHS/OASH) Cc: Phillips, Sally (OS/ASPR/SPPR); Yeskey, Kevin (OS/ASPR/1O) ; Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) ; Shuy, Bryan (OS/ASPR/1O); Schuchat, Anne MD (CDC/OD) ; Strategic COVID-19 Tracker Team ; Kadlec, Robert (OS/ASPR/1O) ; Moreno, Rafael (OS/ASPR) ; Waters, Cicely (OS/ASPR/OEA) Subject: RE: Guidance for Termination of Isolation Good morning sir, AMERICAN PVERSIGHT HHS-20-0580-A-000335 I don't believe that the boss met the 1000 timeline and not tracking any others in ASPRthat did or at least not in this thread. Did you clear already at the 1000? If so, is there a timeframe that we should be looking at for the clearance of the rollout plan? Just need to ensure that I am capturing this on the bosses tracker for his evening folder. Thank you. V/r Rafael Moreno III Special Assistant to the ASPR Immediate Office, Assistant Secretary for Preparedness and Response (ASPR) US Dept. Health and Human Services (HHS) Desk: (202) 260 -1042 Ce11: l(b)(6) I rafael.moreno@hhs.gov From: Giroir, Brett (HHS/OASH) Sent: Monday, March 9, 2020 6:25 PM To: Kadlec, Robert (OS/ASPR/1O) Cc: Phillips, Sally (OS/ASPR/SPPR); Yeskey, Kevin (OS/ASPR/1O) ; Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) ; Shuy, Bryan (OS/ASPR/1O); Schuchat, Anne MD (CDC/OD) ; Giroir, Brett (HHS/OASH) ; Moreno, Rafael (OS/ASPR) Subject: Guidance for Termination of Isolation Importance: High RK(b)(5) Let me know if you have any questions. V/r BG AMERICAN PVERSIGHT HHS-20-0580-A-000336 Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 Sender: Giroir, Brett (HHS/OASH) Moreno, Rafael (O5/ASPR) ; Phillips, Sally (O5/ASPR/SPPR) ; Yeskey, Kevin (OS/ASPR/10) ; Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) ; Shuy, Bryan (O5/ASPR/IO) ; Schuchat, Anne MD (CDC/OD) ; Strategic COVID-19 Tracker Team ; Kadlec, Robert (OS/ASPR/10) ; Waters, Cicely (OS/ASPR/OEA) Sent Date: 2020/03/10 11:27:58 Delivered Date: 2020/03/10 11:27:59 AMERICAN PVERSIGHT HHS-20-0580-A-000337 Kadlec, Robert (O5/ASPR/IO) Osinoff, Joanne (USACAC); Chang, William (HHS/OGC); Ricketts, Jennifer D (CIV) ; Shuy, Bryan (O5/ASPR/IO) ; To: Falcon, Jessica(O5/ASPR/SIIM) ; Yeskey, Kevin (O5/ASPR/IO) ; McGowan,Robert (Kyle) (CDC/OD/OCS) Misrahi, James J. (CDC/OCOO/OGC); Beck, Daniel (USACAC); Stannard, Paula (HHS/IOS) ; Stimson, Brian (HHS/OGC); Hecht, Jonah (HHS/OGC) Subject: RE: TRO ISSUEDPRECLUDING MOVEMENTOF PERSONS WITH CORONAVIRUS FROMTRAVIS AFB TO COSTAMESA Date: 2020/02/22 15:51:24 Priority: Normal Type: Note b)(5) From: Osinoff, Joanne (USACAC) Sent: Saturday, February 22, 2020 3:47 PM To: Kadlec, Robert (OS/ASPR/1O) ; Chang, William (HHS/OGC) ; Ricketts, Jennifer D (CIV) ; Shuy, Bryan (OS/ASPR/1O) ; Falcon, Jessica (OS/ASPR/SIIM) ; Yeskey, Kevin (OS/ASPR/1O) ; McGowan, Robert (Kyle) (CDC/OD/OCS) Cc: Misrahi, James J. (CDC/OCOO/OGC) ; Beck, Daniel (USACAC) ; Stannard, Paula (HHS/IOS) ; Stimson, Brian (HHS/OGC) ; Hecht, Jonah (HHS/OGC) Subject: RE: TRO ISSUED PRECLUDINGMOVEMENT OF PERSONSWITH CORONAVIRUS FROM TRAVIS AFB TO COSTA MESA Than ks. Joanne AMERICAN PVERSIGHT HHS-20-0580-A-000338 From: Kadlec, Robert (OS/ASPR/IO) Sent: Saturday, February 22, 2020 12:45 PM To: Chang, William (HHS/OGC) ; Ricketts, Jennifer D (CIV) ; Shuy, Bryan (OS/ASPR/IO) ; Falcon, Jessica (OS/ASPR/SIIM) ; Yeskey, Kevin (OS/ASPR/IO) ; McGowan, Robert (Kyle) (CDC/OD/OCS) Cc: Misrahi, James J. (CDC/OCOO/OGC) ; Osinoff, Joanne (USACAC) ; Beck, Daniel (USACAC) ; Stannard, Paula (HHS/IOS) ; Stimson, Brian (HHS/OGC) ; Hecht, Jonah (HHS/OGC) Subject: RE: TRO ISSUED PRECLUDINGMOVEMENT OF PERSONSWITH CORONAVIRUS FROM TRAVIS AFB TO COSTA MESA b)(5) From: Chang, William (HHS/OGC) Sent: Saturday, February 22, 2020 3:34 PM To: Ricketts, Jennifer D (CIV) ; Shuy, Bryan (OS/ASPR/IO) ; Kadlec, Robert (OS/ASPR/IO) ; Falcon, Jessica (OS/ASPR/SIIM) ; Yeskey, Kevin (OS/ASPR/IO) ; McGowan, Robert (Kyle) (CDC/OD/OCS) Cc: Misrahi, James J. (CDC/OCOO/OGC) ; Osinoff, Joanne (USACAC) ; Beck, Daniel (USACAC) ; Stannard, Paula (HHS/IOS) ; Stimson, Brian (HHS/OGC) ; Hecht, Jonah (HHS/OGC) Subject: Re: TRO ISSUED PRECLUDINGMOVEMENT OF PERSONSWITH CORONAVIRUS FROM TRAVIS AFB TO COSTA MESA We are confinning and will update ASAP . Office of the General Counsel U.S. Department of Health and Human Services l(b)(6) l(c) 202.690 .7741 (o) On: 22 February 2020 15:25, "Ricketts, Jennifer D (CIV)" wrote: Will, Thanks, Jennifer AMERICAN PVERSIGHT HHS-20-0580-A-000339 From: Chang, W illiam (HHS/OGC) Sent: Saturday, February 22, 2020 12:09 AM To: Shuy, Bryan (OS/ASPR/ IO) ; Kadlec, Robert (OS/ASPR/IO) ; Falcon, Jessica (OS/ASPR/SIIM) ; Yeskey, Kevin (OS/ASPR/IO) ; McGowan, Robert (Kyle) (CDC/OD/OCS) Cc: M israhi, James J. (CDC/OCOO/OGC) ; Osinoff , Joanne (USACAC) ; Beck, Daniel (USACAC) ; Stannard, Paula (HHS/IOS) ; Stimson, Brian (HHS/OGC) ; Ricketts, Jenn ifer D (CIV) Subject: FW: TRO ISSUED PRECLUDING MOVEMENT OF PERSONSWITH CORONAVIRUS FROM TRAVIS AFB TO COSTA MESA Importance: High Dear ASPR and CDC: b)(5) -Will Office of the General Counsel U.S. Department of Health and Human Services 202 -690-7741 (o) ~b)(6) AMERICAN PVERSIGHT l(c) HHS-20-0580-A-000340 From: Osinoff, Joanne (USACAC) Sent: Friday, February 21, 2020 11:27 PM To: Ricketts, Jennifer D (CIV) ; Beck, Daniel (USACAC) ; Foster, Joseph (CDC/OCOO/OGC) ; Misrahi, James J. (CDC/OCOO/OGC) ; Stimson, Brian (HHS/OGC) ; Aust in, Samantha (HHS/OGC) ; Morrell, David M. (CIV) ; Ricketts , Jennifer D (CIV) ; Powell, Amy (CIV) ; Chang, W illiam (HHS/OGC) ; Benor, David E. (HHS/OGC) ; Tress, Deborah W. (CDC/OCOO/OGC) ; Ghosh, Sudevi (CDC/OCOO/OGC) ; Yueh, Lena (CDC/OCOO/OGC) ; Ford, Kenya S. (CDC/OCOO/OGC) ; Coyle, Garrett (CIV) ; Vigen, Leslie (CIV) ; Hunt, Marty (USDOJ.GOV) ; Yeskey, Kevin (OS/ASPR/1O); Falcon, Jessica (OS/ASPR/SIIM) ; Rotz, Lisa (CDC/DDID/NCEZID/DGMQ) <1er8@cdc.gov>; De La Motte Hurst, Christopher (CDC/DDID/NCEZID/DGMQ) ; Misrahi, James J. (CDC/OCOO/OGC) ; Harris, David M. (USACAC) ; Beck, Daniel (USACAC) ; Bacon, Antoinette T. (ODAG) ; Gannon, Curtis E. (OLC) ; W inslow, Sara (USACAN) Cc: Beckenhauer, Eric (CIV) ; Powell, Amy (CIV) ; Morrell, David M. (CIV) Subject: TRO ISSUEDPRECLUDINGMOVEMENT OF PERSONSWITH CORONAVIRUS FROM TRAVIS AFB TO COSTA MESA Importance: High Gentle persons, b)(5) Thanks so much. Joanne Osinoff Joanne S. Osinoff I Assistant United States Attorney Chief I General Civil Section United States Attorney's Office I Centra l District of California AMERICAN PVERSIGHT HHS-20-0580-A-000341 Federal Building, Room 7516 I 300 N. Los Angeles St. I Los Angeles, California 90012 T: 213.894.6880 I F: 213.894.7819 IJoanne.Osinoff@usdoj.gov Sender: Kadlec, Robert (OS/ASPR/10) Osinoff, Joanne (USACAC) ; Chang, William (HHS/OGC) ; Ricketts, Jennifer D (CIV) ; Shuy, Bryan (O5/ASPR/IO) ; Falcon, Jessica (OS/ASPR/SIIM) ; Yeskey, Kevin (OS/ASPR/10) ; Recipient: McGowan, Robert (Kyle) (CDC/OD/OCS) ; Misrahi, James J. (CDC/OCOO/OGC) ; Beck, Daniel (USACAC) < Daniel. Beck@usdoj.gov>; Stannard, Paula (HHS/IOS) ; Stimson, Brian (HHS/OGC) ; Hecht, Jonah (HHS/OGC) Sent Date: 2020/02/22 15:51:23 Delivered Date: 2020/02/22 15:51:24 AMERICAN PVERSIGHT HHS-20-0580-A-000342 Kadlec, Robert (O5/ASPR/IO) Waters, Cicely (O5/ASPR/OEA); Michael, Gretchen (OS/ASPR/OEA); Oxner, Julie (O5/ASPR/OEA); Yeskey, Kevin (O5/ASPR/IO) ; Shuy, Bryan (OS/ASPR/IO); Berger, Sherri (CDC/OCOO/OD); Dreyzehner,John (CDC/DDPHSIS/CPR/OD) ; Cetron, Marty (CDC/DDID/NCEZID/DGMQ) Subject: FW: Military Preparing Quarantine Centers For CoronavirusPatients In US, Pentagon Says Date: 2020/02/10 05:41:54 Priority: Normal Type: Note From: Jim Ainsworth '4bl(6 l ~comcast.net> Sent: Monday, February 10, 2020 12:02 AM To: Adams, Jerome (HHS/OASH) ; Kadlec, Robert (OS/ASPR/1O) ; Fauci, Anthony (NIH/NIAID) [El ; Tabak, Lawrence (NIH/OD) [El ; Esper, Mark HON SD ; Norquist, David HON SD ; Alyssa.Farah@sd.mil; vayl.s.oxford .civ@mail.mil; darsie.d.rogers.mil@mail.mil; philip .r.ibanez.mil@mail.mil; FEMA-NIMS@fema.dhs.gov; fema-rlinfo@fema.dhs.gov; peter.gaynor@fema.dhs .gov; Kaniewski, Daniel ; Penn, Damon ; Tribble, Ahsha ; Fenton, Robert ; Cummings, Michael ; Russell, Tony ; MalloryJS@state.gov; Tobert, Gwen (STATE.GOV) Subject: Military Preparing Quarantine Centers For Coronavirus Patients In US, Pentagon Says Military Prepar ing Quarantine Centers For Coronavirus Patients In US, Pentagon Says AMERICAN PVERSIGHT HHS-20-0580-A-000343 • • • • BY CHARLES DUNCAN MIAMI HERALD FEBRUARY 07, 2020 10:39 AM Eleven military bases near major airports in the United States are setting up quarantine centers for possible coronavirus patients, the Department of Defense said. Eleven military bases near major airports in the United States are setting up quarantine centers for possible coronavirus patients, the Department of Defense said. The Pentagon already agreed to house up to 1,000 people for quarantine after they returned to the United States from areas with the virus, the Associated Press reports. As of Friday, more than 31,400 people have been infected with the 2019 coronavirus worldwide, with most in mainland China, according to the AP. More than 630 people have died from the virus, almost all in China, the AP reports. "These are tertiary locations, and HHS already has primary and secondary locations identified that are not DOD facilities," the Pentagon said. Each base will be able to house up to 20 patients along with public health personnel and equipment. The agreement lasts until Feb. 22, the DOD said. "DOD personnel will not be in direct contact with the evacuees and will minimize contact with personnel supporting the evacuees," the Pentagon said. If anyone tests positive for the virus, public health officials with DHHS will move them to a civilian hospital, according to the statement. The new quarantine centers are: JB Pearl Harbor-Hickam, Hawaii (HNL) Great Lakes Training Center Navy Base, Illinois (ORD) Naval Air Station Joint Reserve Base, Texas (DFW) March ARB, California (LAX) AMEHICAN PVERSIGHT HHS-20-0580-A-000344 Travis AFB, California (SFO) Dobbins ARB, Georgia (ATL) Fort Hamilton, New York (JFK) Naval Base Kitsap, Washington (SEA) Joint Base Anacostia, Washington DC (IAD) Joint Base McGuire-Dix-Lakehurst, New Jersey (EWR) Fort Custer Training Center, Michigan (DTW) The Department of Defense already has quarantine centers at Fort Carson in Colorado, Travis Air Force Base and Marine Corps Air Station Miramar in California, and Lackland Air Force Base in Texas. Sender: Kadlec, Robert (OS/ASPR/IO) Waters, Cicely (OS/ASPR/OEA) ; Michael, Gretchen (OS/ASPR/OEA) ; Oxner, Julie (O5/ASPR/OEA) ; Yeskey, Kevin (OS/ASPR/IO) ; Recipient : Shuy, Bryan (OS/ASPR/IO) ; Berger, Sherri (CDC/OCOO/OD) ; Dreyzehner, John (CDC/DDPHSIS/CPR/OD) ; Cetron, Marty (CDC/DDID/NCEZID/DGMQ) Sent Date: 2020/02/10 05:41:53 Delivered Date: 2020/02/10 05:41:54 AMERICAN PVERSIGHT HHS-20-0580-A-000345 Kadlec, Robert (OS/ASPR/IO) Fauci, Anthony (NIH/NIAID) [ E] ; Redfield, Robert R. (CDC/OD) ; Giroir, Brett (HHS/OASH) ; Hahn, Stephen Schuchat, Anne MD (CDC/OD) ; Yeskey, Kevin (OS/ASPR/IO) ; Schwartz , Suzanne (FDA/CDRH) ; Adams, Steven A. (ASPR/SNS) ; CC: Ottem, Ronald (Ron) (ASPR/SNS) ; Harrison, Brian (HHS/IOS) ; Mango, Paul (HHS/IOS) ; Mecher, Carter (VA.GOV) Subject: URGENT: Swab Testing for Influenza Consuming LIMITED SUPPLYOF VIRAL Swabs and Test Kits Date: 2020/03/16 10:51:33 Importance: High Priority: Urgent Type: Note All-I discussions with major domestic manufacturer of viral swabs need for COVID testing learned demand for flu testing has dramatically increased diverting swabs available from COVID testing(e .g. 800K swabs made by this manufacturer being sent to support flu testing this week) In talking with clinicians in NY and NY, limits in availability of hospital testing and dependence on PH lab testing an delays have them testing all suspect cases for flu and if negative managing patients as presumptive COVID positive AND using large quantities of PPE. Epi data indicates below indicates in areas where COVID transmission high ROK and WA and NY circulating lab diagnosis flu low. AMERICAN PVERSIGHT HHS-20-0580-A-000346 Kadlec, Robert (OS/ASPR/IO) Fauci, Anthony (NIH/NIAID) (E) ; Redfield, Robert R. (CDC/OD); Giroir, Brett (HHS/OASH); Hahn, Stephen ; Schuchat, Anne MD (CDC/OD) ; Yeskey, Kevin (OS/ASPR/IO); Recipient: Schwartz, Suzanne (FDA/CDRH); Adams, Steven A. (ASPR/SNS); Ottem, Ronald (Ron) (ASPR/SNS); Harrison, Brian (HHS/IOS) ; Mango, Paul (HHS/IOS) ; Mecher, Carter (VA.GOV) Sent Date: 2020/03/16 10:51:29 Delivered Date: 2020/03/16 10:51:33 AMERICAN PVERSIGHT HHS-20-0580-A-000347 Giroir, Brett (HHS/OASH) Kadlec, Robert (OS/ASPR/IO); Horahan, Kevin (OS/ASPR/EMMO); Greene, Jonathan (O5/ASPR/EMMO) Yeskey, Kevin (O5/ASPR/IO) ; Phillips, Sally (OS/ASPR/SPPR) ; CC: Shuy, Bryan (OS/ASPR/IO) ; Bante, Katie (OS/OASH) Subject: RE: CMScall on Nursing Home Task Force Date: 2020/03/10 14:06:31 Priority: Normal Type: Note I will lean into this as soon as I return Sally or Jonathan - can you make sure I intersect on this? Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Kadlec, Robert (OS/ASPR/1O) Sent: Tuesday, March 10, 2020 12:59 PM To: Horahan, Kevin (OS/ASPR/EMMO) ; Greene, Jonathan (O5/ASPR/EMMO) ; Giroir, Brett (HHS/OASH) Cc:Yeskey, Kevin (OS/ASPR/1O); Phillips, Sally (OS/ASPR/SPPR) ; Shuy, Bryan (OS/ASPR/1O) Subject: CMS Call on Nursing Home Task Force b)(5) AMERICAN PVERSIGHT HHS-20-0580-A-000348 (b)(5) Giroir, Brett (HHS/OASH) Kadlec, Robert (O5/ASPR/IO) ; Harahan, Kevin (O5/ASPR/EMMO) ; Greene, Jonathan (O5/ASPR/EMMO) ; Yeskey, Kevin (O5/ASPR/IO) ; Phillips, Sally (O5/ASPR/SPPR) ; Shuy, Bryan (O5/ASPR/IO) ; Bante, Katie (O5/OASH) Sent Date: 2020/03/10 14:06 :30 Delivered Date: 2020/03/10 14:06 :31 AMERICAN PVERSIGHT HHS-20-0580-A-000349 Kadlec, Robert (OS/ASPR/IO) To: Hassell, David (Chris) (OS/ASPR/IO) Shuy, Bryan (OS/ASPR/IO); Ford-Barnes, Arwenthia (OS/ASPR/1O); Adams, Steven A. (CDC/SNS/DSNS); Brady, Will (HHS/IOS) ; CC: (FYDIBOHF23SPDL Austin, Meredith (uscg.mil) ; Yeskey, Kevin (OS/ASPR/IO); ; Shuren, Jeff (FDA/CDRH) Subject: Re: N95 decon and reuse -- preparatory to 3M call Date: 2020/02/23 12:00:13 Priority: Normal Type: Note (b)(5) Sent from my iPhone On Feb 23, 2020 , at 11:39 AM, Hassell, David (Chris) (OS/ ASPR/IO) wrote: Dr KadlecRef your question about decontamination and reuse of N95 masks, possibly relevant to the 3M call today: Bottom line is that they cannot be effectively decontaminated for reuse. The Institute of Medicine (IOM) did a study in 2006 ("Reusability of Facemasks During an Influenza Pandemic"), which also included discussion of SARS. Their conclusion was that "current medical (surgical and procedure) masks commonly used in the United States cannot be effectively cleaned and should therefore be discarded after a single use. Any method of decontaminating a disposable N95 filtering facepiece respirator must remove the viral threat, be harmless to the user, and not compromise the integrity of the various elements of the respirator. The committee found no validated method of decontaminationthat meets these criteria. " [Finding #2, emphasis mine] 3M and other manufacturers participated in this study. HHS sponsored the study, but it is unclear whether we pursued the IOM follow-up research AMERICAN PVERSIGHT HHS-20-0580-A-000350 recommendations, which included decon. I'm still checking internally and with the IOM (now NASEM) committee. Note that there are many references available regarding decon of nonwoven materials, such as used in masks, Tyvek suits, etc. These generally deal with decon prior to sanitary disposal, but not with decon for reuse. For reference, all lOM report findings re N95: Finding 1: The committee could not identify or find any simple modifications to the manufacturing process that would permit disposable N95 respirators to be reused without increasing the likelihood of infection. Finding 2: Any method of decontaminating a disposable N95 filtering facepiece respirator must remove the viral threat, be harmless to the user, and not compromise the integrity of the various elements of the respirator. The committee found no method of decontamination that met all three criteria. Finding 3: The committee found no simple modifications to currently existing N95 filtering facepiece respirators that would obviate the need for fit-test ing. Finding 4: Many versions of reusable {elastomeric) respirators on the market have facepieces that can be cleaned and reused . Some of these are available in fullfacep iece versions that also offer eye protection and may prevent conjunctiva! transmission. These respirators can be reused by single or multiple wearers and, although they are more expensive than the disposable N95 respirators, should be considered as an alternative to filter ing facepieces . Chris D. Christian Hassell, PhD Senior Science Advisor Assistant Secretary for Preparedness and Response (ASPR) Department of Health and Human Services (HHS) Washington, DC 20201 David.Hassell@hhs.gov +1-202-692-4641 (office) l(b)(6) !(mobile) -----Original Appointment ----From: Ford-Barnes, Arwenthia (OS/ASPR/1O)On BehalfOf Kadlec, Robert (OS/ASPR/1O) Sent: Sunday, February 23, 2020 11:17 AM To: Shuy, Bryan (OS/ASPR/1O);Ford-Barnes, Arwenthia (OS/ASPR/1O);Adams, Steven A. (CDC/SNS/DSNS);Callahan, Victoria (OS/ASPR/1O)(CTR);Brady, Will (HHS/IOS); Austin, Mered it h (uscg.mil ); Hassell, David (Chris) (OS/ASPR/1O); AMERICAN PVERSIGHT HHS-20-0580-A-000351 Yeskey, Kevin (OS/ASPR/IO) Cc:shl @fda .hhs.gov; Shuren, Jeff (FDA/CDRH); t mfruchterman@mmm .com Subject: 3M When: Sunday, February 23, 2020 2:00 PM-2:45 PM (UTC-05:00) Eastern Time (US &Canada). Where: Dial in f.... 6 b_) (_ )________ ___, HOLD: 3M Scheduled: Sunday, Feb 23, 2020 from 1:00 PM to 1:45 PM Location: TBD Invitees: Steve Hahn, Shuy, Bryan (OS/ASPR/IO), Callahan, Victoria (OS/ASPR/IO) (CTR), Jeffrey Shuren, Kadlec, Robert (OS/ASPR/IO), Ford-Barnes, Arwenthia (OS/ASPR/IO), Adams, Steven A. (CDC/SNS/DSNS) Kadlec, Robert (OS/ASPR/IO) Hassell, David (Chris) (OS/ASPR/IO); Shuy, Bryan (O5/ASPR/IO) ; Ford-Barnes,Arwenthia (O5/ASPR/IO) ; Adams, Steven A. (CDC/SNS/DSNS); Recipient: Brady, Will (HHS/IOS) ; (FYDIBOHF23SPDL T)/cn =Recipients/cn=fa 197652dadf4048ad6764b3f9d4a528-Brady, Austin, Meredith (uscg.mil) ; Yeskey, Kevin (O5/ASPR/IO) ; ; Shuren, Jeff (FDA/CDRH) Sent Date: 2020/02/23 12:00:12 Delivered Date: 2020/02/23 12:00:13 AMERICAN PVERSIGHT HHS-20-0580-A-000352 Kadlec, Robert (O5/ASPR/IO) To: Ezernack, Paige (O5/ASPR/SPPR) Phillips, Sally (O5/ASPR/SPPR); Dodgen, Daniel (O5/ASPR/SPPR); DeBord, Kristin (O5/ASPR/SPPR); Yeskey, Kevin (O5/ASPR/IO) ; Austin, Meredith (uscg.mil) ; (FYDIBOHF23SPDL T)/cn =Recipients/en=9d5f9850a051458eaed1ef5833Se3c19-Meredith. Shuy, Bryan (O5/ASPR/IO) ; Wolf, Laura (O5/ASPR/SIIM) Subject: Re: Following up on a DPA issue Date: 2020/03/02 18:43:11 Priority: Normal Type: Note Thank you. Sent from my iPhone On Mar 2, 2020, at 6:41 PM, Ezernack , Paige (OS/ASPR/SPPR) wrote: Yes, sir. Will have to you by COB tomorrow. Thank you for speaking with us today - appreciate your guidance. V/R Paige L. Paige Ezernack Sr Policy Analyst ASPR/SPPR On Mar 2, 2020 , at 6:39 PM , Kadlec , Robert (OS/ASPR/IO) wrote: □ AMERICAN PVERSIGHT HHS-20-0580-A-000353 Kadlec, Robert (O5/ASPR/IO) Ezernack, Paige (O5/ASPR/SPPR) ; Phillips, Sally (O5/ASPR/SPPR) ; Dodgen, Daniel (O5/ASPR/SPPR) ; DeBord, Kristin (OS/ASPR/SPPR) ; Recipient: Yeskey, Kevin (O5/ASPR/IO) ; Austin, Meredith (uscg.mil) ; Shuy, Bryan (OS/ASPR/IO) ; Wolf, Laura (OS/ASPR/SIIM) Sent Date: 2020/03/02 18:43 : 10 Delivered Date: 2020/03/02 18:43 : 11 AMERICAN PVERSIGHT HHS-20-0580-A-000354 Kadlec, Robert (O5/ASPR/IO) To: Lenihan, Keagan(FDNOC) Johnston, Darcie (HHS/IEA) ; Shuy, Bryan (OS/ASPR/1O); Stecker, Judy (O5/IOS) ; Yeskey, Kevin (O5/ASPR/IO) ; Waters, Cicely (O5/ASPR/OEA); Trueman, Laura (HHS/IEA) ; Stevens, Lee (OS/IEA) ; Baker, Michael (OS/IEA) ; Heidig, Edward (HHS/IEA) ; Graham, John (HHS/IEA) ; McGowan,Robert (Kyle) (CDC/OD/OCS) Subject: Re: Governors request Date: 2020/02/28 12:28:50 Priority: Normal Type: Note (b)(S) Sent from my iPhone On Feb 28, 2020, at 12:26 PM, Lenihan, Keagan wrote: We can't give specifics on shortages. Sent from my iPhone On Feb 28, 2020, at 12:25 PM, Johnston, Darcie (HHS/IEA) wrote: □ AMERICAN PVERSIGHT HHS-20-0580-A-000355 b)(5) Darcie L. Johnston Director, Intergovernmental Affairs U.S. Department of Health and Human Services Office of the Secretary 202-690-1058 (office) r) (B) l(cell) From: Shuy, Bryan (OS/ASPR/IO) Sent: Friday, February 28, 2020 12:21 PM To: Johnston, Darcie (HHS/I EA) Cc: Stecker, Judy (05/105) ; Kadlec, Robert (OS/ASPR/IO) ; Yeskey, Kevin (OS/ASPR/IO) ; Waters, Cicely (OS/ASPR/OEA) ; Trueman, Laura (HHS/IEA) ; Stevens, Lee (OS/IEA) ; Baker, Michael (OS/IEA) ; Heidig, Edward (HHS/IEA) ; Graham, John (HHS/IEA) ; McGowan, Robert (Kyle) (CDC/OD/OCS) ; Lenihan, Keagan (FDA/OC) Subject: Re: Governors request Sent from my iPhone On Feb 28, 2020 , at 12:15 PM , Johnston, Darcie (HHS/IEA) wrote: Bryan and Kevin Please respond with the answers. Thanks Darcie Darcie L. Johnston Director, Intergovernmental Affairs U.S. Department of Health and Human Services AMERICAN PVERSIGHT HHS-20-0580-A-000356 Office of the Secretary 202-690-1058 l(bl(Bl (office} (cell} I From: Stecker, Judy (OS/IOS) Sent: Friday, February 28, 2020 10:26 AM To: Johnston, Darcie (HHS/IEA) Cc:Trueman, Laura (HHS/IEA) ; Stevens, Lee (OS/IEA) ; Baker, Michael (OS/IEA) ; Heidig, Edward (HHS/I EA) ; Graham, John (HHS/I EA) ; McGowan, Robert (Kyle) (CDC/OD/OCS) ; Lenihan, Keagan (FDA/OC) Subject: Re: Governors request Adding the CoS from FDA and CDC who should be able to assist in answers on these qs Sent from my iPhone On Feb 28, 2020, at 10: 18 AM, Johnston, Darcie (HHS/IEA) wrote: n b)(5) AMERICAN PVERSIGHT HHS-20-0580-A-000357 b)(5) Darcie L. Johnston Director, Intergovernmental Affairs U.S. Department of Health and Human Services Office of the Secretary 202-690-1058 (office) rb)(6) eelI) I( Sender: Kadlec, Robert (O5/ASPR/IO) Lenihan, Keagan (FDA/OC) ; Johnston, Darcie (HHS/IEA) ; Shuy, Bryan (OS/ASPR/IO) ; Stecker, Judy (OS/IOS) ; Yeskey, Kevin (O5/ASPR/IO) ; Waters, Cicely (O5/ASPR/OEA) ; Recipient: Trueman, Laura (HHS/IEA) ; Stevens, Lee (OS/IEA) ; Baker, Michael (OS/IEA) ; Heidig, Edward (HHS/IEA) ; Graham, John (HHS/IEA) ; McGowan, Robert (Kyle) (CDC/OD/OCS) Sent Date: 2020/02/28 12:28:50 AMERICAN PVERSIGHT HHS-20-0580-A-000358 Kadlec, Robert (OS/ASPR/IO) To: OS ASPRIHR Program IHR - ASPRand DesigneesContact ; CC: OS SecretarysOperations Center Subject: Re: URGENTAPPROVALREQUIRED:Potential PHEIC- Confirmation of novel coronavirus (nCoV) - Washington State, U.S. Date: 2020/01/2119:35:31 Priority: Normal Type: Note Approved Kadlec Sent from my iPhone On Jan 21, 2020, at 7:27 PM , OS ASPR IHR Program wrote: Good Evening Dr. Kadlec b)(5) AMERICAN PVERSIGHT HHS-20-0580-A-000359 b)(5) Adam Tewe ll ASPR IBR Program U.S Department of Health and Human Service (HHS) Office of the Assistant Secretary for Preparedness and Response (ASPR) Office of Incident Command and Control (ICC) Washington, DC Mobile: 202 360-3066 Kadlec, Robert (OS/ASPR/1O) Recipient: OS ASPR!HR Program ; IHR - ASPRand DesigneesContact ; OS SecretarysOperationsCenter Sent Date: 2020/01/2119:35:29 Delivered Date: 2020/01/2119:35:31 AMERICAN PVERSIGHT HHS-20-0580-A-000361 DEPARTMENT OF HEALTH & HUMAN SERVICES Office of the Secretary Assistant Secretary for Public Affairs Washington, D.C. 20201 Case No. 2020-00719-FOIA-OS American Oversight v. HHS, Civil No. 20-cv-00947 October 26, 2020 Austin Evers Executive Director American Oversight Sent via email: foia@americanoversight.org Dear Mr. Evers: This letter is the second interim response to your March 18, 2020, Freedom of Information Act (FOIA) request. American Oversight requests all email communications (including email messages, complete email chains, email attachments, calendar invitations) sent by the government officials specified below containing any of the following key terms: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. EUA "Emergency Use" Test Testing "the WHO" W.H.O. "World Health Organization" Kit LDT CLIA RNA Extraction Quest LabCorp Roche Qiogen 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. "Thermo Fisher" Thermofisher Hologic "Panther Fusion" Wadsworth RT-PCR Oscar CureVac "University of Washington" "Seattle Flu study" Greninger POTUS Reagent 30. 564 564(b) "mainland China" "close contact" "issue guidance" HHS Officials: 1. Assistant Secretary for Health Brett Giroir 2. Anyone serving as Chief of Staff to Assistant Secretary for Health Giroir, including, but not limited to, Carla Haddad 3. Principal Deputy Assistant Secretary for Health Sylvia Trent-Adams 4. Deputy Assistant Secretary for Health Paul Reed 5. Assistant Secretary for Preparedness & Response Robert Kaldec 6. Principal Deputy Assistant Secretary for Preparedness & Response Kevin Yeskey 7. Deputy Assistant Secretary for Preparedness & Response & BARDA Director Rick Bright A\11 ICA FDA Officials: 1. Jeffrey Shuren, Director of the Center for Devices and Radiological Health 2. William Maisel, Director of the Office of Product Evaluation and Quality 3. Timothy Stenzel, Office of Health Technology 7 (In Vitro Diagnostics and Radiological Health) 4. Denise Hinton, Chief Scientist 5. Uwe Scherf, Director, Division of Microbiology Devices, Office of In Vitro Diagnostics and Radiological Health, Center for Devices and Radiological Health PVERSIGHT Page 2 of 2 Case No. 2020-00719-FOIA-OS American Oversight v. HHS, Civil No. 20-cv-00947 CDC Officials: 1. Robert Redfield, Director 2. Anne Schuchat, Principal Deputy Director 3. Stephen Lindstrom, Team Lead, Respiratory Virus Diagnostics Team, Centers for Disease Control and Prevention 4. Daniel Jernigan, Influenza Division at Centers for Disease Control and Prevention 5. Toby Merlin, Director, Division of Preparedness and Emerging Infections (DPEI) 6. Mark Frank, Deputy Director, Division of Emergency Operations at Centers for Disease Control and Prevention During the course of litigation, American Oversight modified the scope of its request. The Department processed 610 pages of potentially responsive records captured in the agency's search for FOIA request 2020-00719-FOIA-OS. After a careful review of these pages, I have determined to release 222 pages to you in their entirety, I am further releasing 331 pages in part, with portions redacted, pursuant to Exemptions (b)(4), (b)(5), and (b)(6) of the FOIA (5 U.S.C. ?552 (b)(5) and (b)(6)). Furthermore, I have determined that 57 pages should be sent for consultation to others and returned to this Department for final disposition. Note: there was a Red Dawn e-mail chain mistakenly left in the records that was processed. The Department will put its best effort to avoid this happening in the future. FOIA exemption (b)(4) permits agencies, as a matter of discretion, to withhold trade secrets and commercial or financial information obtained from a person which is privileged or confidential. FOIA exemption (b)(5) protects inter-agency or intra-agency memoranda or letters which would not be available by law to a party other than an agency in litigation with the agency. This exemption protects documents that would be covered by any privilege an agency could assert in a civil proceeding. These privileges include, among others, the deliberative process privilege, the attorney-client privilege, and the attorney work-product privilege. FOIA exemption (b)(6) permits a Federal agency to withhold information and records about individuals in "personnel and medical files and similar files, the disclosure of which would constitute a clearly unwarranted invasion of personal privacy." The definition of "similar files" has historically been broadly interpreted to include a wide variety of files, and the United States Supreme Court has held that Congress intended the term "similar files" to be interpreted broadly, rather than narrowly. I have analyzed these records and find they meet the threshold requirement of this exemption. Additionally, I have reviewed and weighed the public interest in disclosure of this information against the privacy interest in nondisclosure, and found that the privacy interest outweighs the public's interest in disclosure. We will continue to review the remaining records as efficiently and expeditiously as possible, consistent with our available resources. Should you have questions or concerns regarding the Department's response and\or the processing of your request, any such issues should be communicated to your legal counsel and Department of Justice Attorney representing the Department in this matter. Sincerely yours, for Brandon J. Gaylord Director FOI/Privacy Division H SEnclosure(s) Giroir, Brett (HHS/OASH) Giroir, Brett (HHS/OASH) ; Shuren, Jeff (FDA/CDRH) ; Stenzel, Timothy (FDA/CDRH) ; Monroe, Steve (CDC/DDPHSS/OLSS/OD) ; Lenihan, Keagan (FDA/OC) ; To: Kellogg, Rachel (HHS/OASH) ; Bante, Katie (OS/OASH) ; Haddad, Carla (HHS/OASH) ; Schwartz, Suzanne (FDA/CDRH) ; Valentine, Steven (HHS/OASH) ; Murphy, Ryan (OS/ASPA) Subject: COVID Testing Date: 2020/03/11 07:02:56 Start Date: 2020/03/11 08:30:00 End Date: 2020/03/11 09 :00 :00 Priority: Normal Type: Appointment Location: Call bridge:Kb )(6) I Giroir, Brett (HHS/OASH); Shuren, Jeff (FDA/CDRH); Stenzel, Timothy (FDA/CDRH); Monroe, Attendees: Steve (CDC/DDPHSS/OLSS/OD); Lenihan, Keagan (FDA/OC); Kellogg, Rachel (HHS/OASH); Bante, Katie (OS/OASH); Haddad, Carla (HHS/OASH) Giroir, Brett (HHS/OASH) Giroir, Brett (HHS/OASH) ; Shuren, Jeff (FDA/CDRH) ; Stenzel, Timothy (FDA/CDRH) ; Monroe, Steve (CDC/DDPHSS/OLSS/OD) ; Recipient: Lenihan, Keagan (FDA/OC) ; Kellogg, Rachel (HHS/OASH) ; Bante, Katie (OS/OASH) ; Haddad, Carla (HHS/OASH) ; Schwartz, Suzanne (FDA/CDRH) ; AMERICAN PVERSIGHT HHS-20-0580-B-000001 Valentine, Steven (HHS/OASH) ; Murphy, Ryan (O5/ASPA) Sent Date : 2020/03/11 07:02:56 AMERICAN PVERSIGHT HHS-20-0580-B-000002 Haddad, Carla (HHS/OASH) To: Giroir, Brett (HHS/OASH) Subject: FW: TASKERS3/11/20 Subtask Force Call Date : 2020/03/12 11:21:35 Priority: Normal Type: Note From: Dareshori, Zack (HHS/IOS) Sent: Wednesday, March 11, 2020 9:35 AM To: Strategic COVID-19 Tracker Team Subject: TASKERS3/11/20 Subtask Force Call Haddad, Carla (HHS/OASH) Recipient: Giroir, Brett (HHS/OASH) Sent Date : 2020/03/12 11:21:35 AMERICAN PVERSIGHT HHS-20-0580-B-000003 Giroir, Brett (HHS/OASH) To: Giroir, Brett (HHS/OASH) Subject: FW: Urgent Messaging Date: 2020/03/12 23:51:22 Priority: Normal Type: Note Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 -----Original Message----From: Callahan, Michael V.,M.D. ~(b)(6) @mgh.harvard.edu> Sent: Thursday, March 12, 2020 4:07 PM T : Bi in er, Paul,M.D. ; S~enoy, Erica Seiguer,M.D.,Ph.D. b)(6) mgh.harvard.edu>; Orf, Harry W.,Ph.D. b)(6) mgh.harvard.edu>; Lawler, James V bl(6l unmc.edu> Cc: Orf, Harry W.,Ph.D. ~mgh.harvard.edu>; Shenoy, Erica Seiguer,M.D.,Ph.D. fb )(6) ~mgh.harvard.edu>; Kadlec, Robert (OS/ASPR~obert.Kadlec@hhs.gov>; Giroir, Brett (HHS/OASH) ; !(b)(6) ~unmc .edu Subject: Urgent Messaging CLASSIFICATION: SBUC CAVEAT: DO NOT FORWARD Paul, Erica and Harry In follow up to yesterday's conversation I am including both the Assistant Secretary of Health, Admiral Brett Giroir and the Assistant Secretary for Public Health Preparedness and Response, Dr Robert Kadlec on this thread as evidence of their support for the need to immediately escalate all national hospital systems to a state of high readiness. Admiral Giroir is a neonatal intensivist and has designed and analyzed mass casualty infection ( ARDS) systems under his former federal positions. Dr.Kadlec of course needs no introduction. Issue : Medical system preparedness in the US is moving too slow compared the propagat ion of the virus. Foreign cities with equivalent HCN to those in US are either performing well are failing based on the time to trigger of disaster operations. Action: A priority focus is the need to speed up * necessary* screening of all high risk patients to avoid the need for scheduled visits to HCF over the next 100 days when hospitals pose a significant threat to immune vulnerable patients. This effort ( "Burst and Coast") has the advantage of also unloading ambulatory care clinics and personnel so that these assets can be devoted to management of convalescing COVID19 patients that still require FiO2 and skilled nursing care. As a reminder LOS for C19 patients is 1.5-2.4 times that of severe hospitalized influen za As also discussed in our call yesterday, Seattle and San Francisco are both approximately where Milan was on March 1 yet one city is failing whereas the more challenging city-San Francisco- is showing possible evidence of resiliency. These differences are attributed to the timing and aggressiveness of NPI and early implementation of HICS. ** This email proposes to put the best of our US !CS-trained mass casualty infectious disease experts together with you, Paul, and you, Erica, to add to the non-federal voice that is getting the word out nationwide. AMERICAN PVERSIGHT HHS-20-0580-B-000004 Action: 1. Paul, I am connect ing you on this email to long term NSC policy expert and clinical intensivist, Carter Mescher, who has the confidence of those above for t he immediate purpose of evaluating the Singapore, Taiwan and Hong Kong systems that inspired San Francisco to initiate impressive NPi s among a diverse, non compliant and fearful populace. Carter Mescher has, with other experts and analytics, assembled a list of systems with proven effectiveness . 2. Erica, in this email I am connecting you to Jana Broadhurst MD PhD, s ID trained NAAT expert who executed the UNMC EUA and James Lawler of UNMC, who worked with me on mu ltip le Ebola outbreaks and who is a expert at scaling clinical infectious diseases systems for mass casualty infections. Lawler is on route back to CONUS so his reply may be delayed. In the inte rim I will provide content and help you engage the nations ID community through pre existing channels. Please note other institut ions and health care networks have also been contacted to address other elements of mass casualty infection preparedness and the preservation of critica l medical infrastructures. Please do respond to emails and arrange time to speak with the individua ls above as they are working on the National stage . Michael Callahan MD MSPH DTM&H, DMCC (UK) Rescue Medicine HASTY Team 1 On Operations Special Advisor to the Assistant Secretary of Public Health Preparedness and Response U.S Dept of Health and Human Services Humphrey Building 6th Floor Washington, DC The information in th is e-mail is intended only for the person to whom it is addressed. If you believe this e-mail was sent to you in error and the e-mail contains patient information, please contact the Partners Compliance Helpline at http://www .partners .org/comp lianceline . If the e-mai l was sent to you in error but does not contain patient information, ?1. PIease contact t he sender and proper Iv d.1sposeof t he e-ma1 Giroir, Brett (HHS/OASH) Giroir, Brett (HHS/OASH) Sent Date : 2020/03/12 23:51:22 AMERICAN PVERSIGHT HHS-20-0580-B-000005 Giroir, Brett (HHS/OASH) Brooks, John T. (CDC/DDID/NCHHSTP/DHPSE) ; To: Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) Meaney Delman, Dana M. (CDC/DDNID/NCBDDD/DBDID) ; Armstrong, Gregory (CDC/DDID/NCEZID/OD) ; Schuchat, Anne MD (CDC/OD) ; Berger, Sherri (CDC/OCOO/OD) ; Giroir, Brett (HHS/OASH) Subject: RE: Guidance for Termination of Isolation Precautions COVID- 19 - Decision Memo CONTAINMENT_3_8_2020_JB_DMD Date: 2020/03/10 07:53:59 Priority: Normal Type: Note b)(5) Best BG Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Brooks, John T. (CDC/DDID/NCHHSTP/DHPSE) Sent: Monday, March 9, 2020 3:41 PM To: Giroir, Brett (HHS/OASH) ; Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) AMERICAN PVERSIGHT HHS-20-0580-B-000006 Cc: Meaney Delman, Dana M. (CDC/DDNID/NCBDDD/DBDID) ; Armstrong, Gregory (CDC/DDID/NCEZID/OD) ; Schuchat, Anne MD (CDC/OD) ; Berger, Sherri (CDC/OCOO/OD) Subject: RE: Guidance for Terminat ion of Isolation Precaut ions COVID-19 - Decision Memo CONTAINMENT_ 3_8_ 2020_JB_ DMD b)(5) AMERICAN PVERSIGHT HHS-20-0580-B-000007 John T. Brooks, MD - Chief Medical Officer CDC Division of HIV/AIDS Prevention 1600 Clifton Road NE, Mailstop D-21 Atlanta, GA 30333 Desk: 404-639-3894 I Cel1:l(b)(6) Email: zud4@cdc.gov AMERICAN PVERSIGHT HHS-20-0580-B-000008 From: Giroir, Brett (HHS/OASH) Sent: Monday, March 9, 2020 2:07 PM To: Brooks, John T. (CDC/DDID/NCHHSTP/DHPSE) ; Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) Cc: Berger, Sherri (CDC/OCOO/OD) ; Schuchat, Anne MD (CDC/OD) ; Meaney Delman, Dana M. (CDC/DDNID/NCBDDD/DBDID) Subject: RE: Guidance for Termination of Isolation Precautions COVID-19 - Decision Memo CONTAINMENT_ 3_8_ 2020_JB_ DMD Sure I am on 12 in Mitch Wolff office My mobile is fb_ ....)(6_)___ ___, Brett P. Giroir, MD AMERICAN PVERSIGHT HHS-20-0580-B-000009 ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Brooks, John T.(CDC/DDID/NCHHSTP/DHPSE)< zud4@cdc.gov > Sent: Monday, March 9, 2020 2:05 PM To: Giroir, Brett (HHS/OASH) ; Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) Cc: Berger, Sherri (CDC/OCOO/OD) ; Schuchat, Anne MD (CDC/OD) ; Meaney Delman, Dana M. {CDC/DDNID/NCBDDD/DBDID) ; Giroir, Brett {HHS/OASH) Subject: Re: Guidance for Termination of Isolation Precautions COVID-19 - Decision Memo CONTAINMENT- 3- 8- 2020 - JB- DMD Doh! Apologies. Will get back shortly. Best ifl call you. John T. Brooks, J\ID - Chief Medical Officer CDC, Division of HIV/AIDS Prevention 1600 Clifton Road NE, Mailstop D-21 Atlanta, GA. 30319 404-639-3894 From: Giroir, Brett (HHS/OASH) Sent: Monday, March 9, 2020 1:56:47 PM To: Brooks, John T. (CDC/DDID/NCHHSTP/DHPSE); Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) Cc: Berger, Sherri (CDC/OCOO/OD) ; Schuchat, Anne MD (CDC/OD) ; Meaney Delman, Dana M. (CDC/DDNID/NCBDDD/DBDID) ; Giroir, Brett (HHS/OASH) Subject: RE: Guidance for Termination of Isolation Precautions COVID-19 - Decision Memo CONTAINMENT_3_8_2020_JB_DMD THANK YOU. (b)(5) AMERICAN PVERSIGHT HHS-20-0580-B-000010 I am here on 12 and able to chat in person or by phone BG Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Brooks, John T. (CDC/DDID/NCHHSTP/DHPSE) Sent: Monday, March 9, 2020 1:38 PM To: Giroir, Brett (HHS/OASH) ; Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) Cc: Berger, Sherri (CDC/OCOO/OD) ; Schuchat, Anne MD (CDC/OD) ; Meaney Delman, Dana M. (CDC/DDNID/NCBDDD/DBDID) Subject: RE: Guidance for Termination of Isolation Precautions COVID-19 - Decision Memo CONTAINMENT_ 3_8_2020_JB_ DMD Available when you are ADM to discuss.Am offline for about 45 minutes then back. b)(5) AM[ \J PVERSIGHT HHS-20-0580-B-000011 (b)(5) From: Giroir, Brett (HHS/OASH) < Brett.Giroir@hhs.gov > Sent: Monday, March 9, 2020 9:29 AM To: Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) Cc: Berger, Sherri (CDC/OCOO/OD) ; Schuchat, Anne MD (CDC/OD) ; Meaney Delman, Dana M. (CDC/DDNID/NCBDDD/DBDID) ; Brooks, John T. (CDC/DDID/NCHHSTP/DHPSE) Subject: RE: Guidance for Terminat ion of Isolation Precautions COVID-19 - Decision Memo CONTAINMENT_ 3_8_ 2020_JB_ DMD b)(5) Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) Sent: Monday, March 9, 2020 8:48 AM To: Giroir, Brett (HHS/OASH) Cc: Berger, Sherri (CDC/OCOO/OD) ; Schuchat, Anne MD (CDC/OD) ; Meaney Delman, Dana M. (CDC/DDNID/NCBDDD/DBDID) ; Brooks, John T. (CDC/DDID/NCHHSTP/DHPSE) Subject: Guidance for Termination of Isolation Precaut ions COVID-19 - Decision Memo CONTAINMENT- 3- 8- 2020 - JB- DMD ADM Giroir : b)(5) AMERICAN PVERSIGHT HHS-20-0580-B-000012 (b)(5) Dan. Sender: Giroir, Brett (HHS/OASH) Brooks, John T. (CDC/DDID/NCHHSTP/DHPSE) ; Jernigan, Daniel B. (CDC/DDID/NCIRD/ID); Meaney Delman, Dana M. (CDC/DDNID/NCBDDD/DBDID); Recipient: Armstrong, Gregory (CDC/DDID/NCEZID/OD); Schuchat,Anne MD (CDC/OD) ; Berger, Sherri (CDC/OCOO/OD); Giroir, Brett (HHS/OASH) Sent Date: 2020/03/10 07:53:58 Delivered Date: 2020/03/10 07:53:59 AMERICAN PVERSIGHT HHS-20-0580-B-000013 Giroir, Brett (HHS/OASH) To: Simcox, Edwin (OS/IOS) Valentine, Steven (HHS/OASH); CC: Giroir, Brett (HHS/OASH) Subject: Ticks and Lyme Date: 2020/01/25 07:59:29 Priority: Normal Type: Note Good Morning Ed (b)(5) My very best Brett Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 Giroir, Brett (HHS/OASH) Simcox, Edwin (OS/IOS) ; Valentine, Steven (HHS/OASH); Giroir, Brett (HHS/OASH) AMERICAN PVERSIGHT HHS-20-0580-B-000014 Sent Date: 2020/01/25 07:59:27 Delivered Date: 2020/01/25 07:59:29 AMERICAN PVERSIGHT HHS-20-0580-B-000015 Kadlec, Robert (OS/ASPR/IO) Giroir, Brett (HHS/OASH) ; To: Schwartz, Erica (HHS/OASH) CC: Shuy, Bryan (OS/ASPR/IO) ; Cooper, Kevin (OS/ASPR/ORM) Subject : STAT Request Date: 2020/03/13 14:07:04 Priority : Normal Type: Note b)(5) Kadlec, Robert (OS/ASPR/IO) Giroir, Brett (HHS/OASH) ; Schwartz, Erica (HHS/OASH) ; Recipient: Shuy, Bryan (OS/ASPR/IO) ; Cooper, Kevin (OS/ASPR/ORM) Sent Date : 2020/03/13 14:07:03 Delivered Date : 2020/03/13 14:07:04 AMERICAN PVERSIGHT HHS-20-0580-B-000016 Bright, Rick (O5/ASPR / BARDA) To: Aj ay Royan CC: Giroir, Brett (HHS/ OASH) ; Tegeris, John (O5/ ASPR / BARDA) (CTR) Subject: Re: Adimab/ COVID-19mission Date: 2020/02/26 07:42:55 Priority: Normal Type: Note Dear ADM Giroir, Thank you for the introduction to Mr. Royan and to Adimab. As you know, we are reviewing every possible option for treatments for people with COVID-19 and I welcome the opportunity to learn more about Adimab. Dear Mr. Royan, Thank you for the important work that you are doing to develop treatments for people exposed to a variety of infectious diseases. Your challenge of locating starting materials to develop monoclonal antibodies are familiar to us and we may be able to assist you with some of the information you are seeking to move forward w ith your COVID-19 candidate. BARDA has established a Medical Countermeasure Task Force that includes subject matter experts from across HHS (BARDA, ASPR,FDA, NIH, CDC) and the Dept of Defense. To simplify matters, we created a single point of entry for all potential med ical countermeasures fo r Coronavirus. The submission banner is at www.medicalcountermeasures.gov . I encourage you to submit your information there as soon as it is convenient for you. In addition, I have copied Dr. John Tegeris from BARDA who leads the "CoronaWatch" (formerly BARDA TechWatch) program and coord inates the meet ing with our interagency partners. My suggestion is that John reach out to you and Dr. Gerngross directly today to facilitate that meeting as soon as feasible. Thank you again for your dedicat ion to addressing infect ious diseases to ensure pub lic health and national security. I look forward to learning more about your technology. Always feel free to reach out to me as well and I can ensure you are connected appropr iate ly with in our organization. Best regards, Rick Rick A. Bright, PhD AMERICAN PVERSIGHT HHS-20-0580-B-000017 Director, BARDA Deputy Assistant Secretary for Preparedness and Response Office of the Assistant Secretary for Preparedness and Response US Department of Health and Human Services +1202 260 8535 (Office) From: Brett Giroir Date: Wednesday, February 26, 2020 at 7:09 AM To: Ajay Royan , "Bright, Rick (OS/ASPR/BARDA)" Cc: Rick Perry fb )(B) @gmail.com > Subject: RE: Adimab/COVID-19 mission Good Morning Mr. Royan (and Secretary Perry). Thank you sincerely for your willingness to contribute to the national efforts to combat COVl19. Antibody therapeutics could of course have an important role as we move forward. As such, I have contacted the Director of BARDA (Deputy Assistant Sec) Rick Bright, who is copied. He is the appropriate person and in the best place to potentially assist. Mr. Royan - consider this an e-introduction. Dr Bright will get you into the BARDA flow absolutely as soon as possible. Let me know if I can help or facilitate in the future. V/r Brett Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Ajay Royan Sent: Tuesday, February 25, 2020 10:18 PM To: Giroir, Brett (HHS/OASH) Cc: Rick Perry 4 (b)(6) e)gmail.com> Subject: Adimab/COVID-19 mission Dear Rick, Thank you kindly for the call yesterday, and for connecting us. AMERICAN PVERSIGHT HHS-20-0580-B-000018 Dear Dr. Giroir, It's a pleasure to met you over email. The team at Adimab - an antibody discovery platform based in New Hampshire -was previously successful at isolating and sequencing antibodies contra the 2014 Ebola outbreak. I spoke yesterday with Dr. Tillman Gerngross , the founder of Adimab ; he and his team are standing by to help in any way they can. As with the ebola situation , this is outside of the company's normal commercial course but very much in line with their public service mission and technical capabilities. Below are two backgrounders that might be helpful to introduce Adimab: 1.) A high-level summary of Adimab's work with USAMRIID and others to isolate an antibody therapy for the 2014 Ebola strain that affected the US https :// p rotect2. fire eye. com/u rl? k=43e0 b 72f-1 fb5beff-43e0861 0-0cc4 7a6a52dec51 024d 359d9adc4& u= https ://www .ad i ma b.com/ news/201 6-02-1 8-anti-ebol a-virusa nti bodies 2.) The resultant paper published 2016 in Science https:/ /science.sciencemag .org/content/351 /6277 /1078 b)(4) It would be my pleasure to connect Dr. Gerngross {tillman.gerngross@adimab.com ) with you or follow-up as otherwise appropriate. And to be helpful in this or any other way, given our involvement with a growing group of motivated and talented technologists who are getting activated around this mission. With thanks and my best, Ajay AMERICAN PVERSIGHT HHS-20-0580-B-000019 Adimab Scientists Report the Isolation of Highly Potent Anti-Ebola Virus Antibodies from Recent Zaire Outbreak Adimab, LLC, a global leader in the discovery of human antibodies, today reported the isolation of a broad panel of neutralizing anti-Ebola virus antibodies from a survivor of the recent Zaire outbreak. The work, published online today in the journal Science, highlights the remarkable speed of Adimab's recently launched single B cell isolation platform, and constitutes the largest panel of functional anti-Ebola antibodies reported in the scientific literature to date. The sequences of all antibodies isolated in this study will be made freely available to the research community through the GenBank database. "Our Science paper describes the first in-depth view into the human antibody response to Ebola virus," said Laura Walker, Ph.D., Senior Scientist at Adimab, and the corresponding author of the study. "Within weeks of receiving a blood sample from a survivor of the 2014 Ebola outbreak, we were able to isolate and characterize over 300 monoclonal antibodies that reacted with the Ebola virus surface glycoprotein." After the initial isolation and characterization of the anti-Ebola antibodies at Adimab, several leading institutions in the field of virology, including The Scripps Research Institute, La Jolla, CA and the US Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, MD, provided an in-depth analysis of the therapeutic potential of these newly isolated antibodies. "Over the past decade, our laboratory has analyzed over one hundred antibodies against the Ebola virus," commented Pamela Glass, Ph.D., Senior Investigator at USAMRIID. "Several of the antibodies provided by Dr. Walker's team display the most potent neutralization and protection we have ever seen." Additional structural analysis at The Scripps Research Institute provided further insight into the diversity of the human immune response to Ebola. "The antibody panel discovered by Adimab covers every previously known binding site on Ebola virus and their work further revealed a new, highly potent neutralizing site, that has not been reported to date," said Prof. Andrew Ward, Scripps Research Institute, a co-author of the study. "In less than two months the Adimab team isolated more neutralizing Ebola antibodies than the entire Ebola field has reported in the past two decades," noted Tillman Gerngross, Ph.D., CEO and Co-Founder of Adimab and a Professor of Bioengineering at Dartmouth College. 'The global public health community has been looking for a rapid response platform to emerging infectious disease threats and Laura's team has set an entirely new standard for rapidly isolating protective antibodies that could be turned into effective therapeutics. We now have a broadly applicable platform to deal with these threats." "Not only has the Adimab team isolated an extensive panel of therapeutically promising Ebola antibodies in such a short time frame, but the fact that they have made these antibodies available to the research community for further studies is remarkable and AMERICAN PVERSIGHT HHS-20-0580-B-000020 shows their humanitarian intent to advance the field without regard for commercial gain," said John Dye, Ph.D., Chief of Viral Immunology at USAMRIID. Adimab separately noted that it has applied its B cell isolation platform against the respiratory syncytial virus (RSV) with similar results. The Company also intends to demonstrate the applicability of the B cell isolation platform against the Zika virus. The study, entitled "Isolation of Potent Neutralizing Antibodies from a Survivor of the 2014 Ebola Virus Outbreak", is available online and will be published in the February 18th, 2016 issue of Science. The sequences generated in this work will be made available to the research community via GenBank. About Adimab Over the past six and a half years, Adimab has established antibody discovery collaborations with over 35 pharmaceutical companies including many leading drug companies, such as Merck, Novo Nordisk , Biogen, GSK, Roche, Novartis, Eli Lilly, Genentech, Celgene, Gilead, Kyowa Hakko Kirin, and Sanofi. Sender: Bright, Rick (O5/ASPR/BARDA) Ajay Royan ; Giroir, Brett (HHS/OASH) ; Tege ris, John (O5/ASPR/BARDA) (CTR) Sent Date: 2020/02/26 07:42:54 Delivered Date: 2020/02/26 07:42:55 AMERICAN PVERSIGHT HHS-20-0580-B-000021 Kadlec, Robert (OS/ASPR/IO) To: Brookes, Brady (CMS/OA) Mango, Paul (HHS/IOS) ; Giroir, Brett (HHS/OASH); Pollard, Ashton (O5/IOS) ; Stecker, Judy (OS/IOS) ; Yeskey, Kevin (OS/ASPR/IO); Jernigan, Daniel B. (CDC/DDID/NCIRD/ID); b)(6) I; Berger, Sherri (CDC/OCOO/OD); Redfield, Robert R. (CDC/OD) ; Shuy, Bryan (OS/ASPR/1O); Harrison, Brian (HHS/IOS) ; Herrmann, Jack (OS/ASPR/OEA); Blackford, Carol W. (CMS/CM); Harrison, Brian (HHS/IOS) Subject: Re: Outtakes from Call with Kaiser Permanenteand HCA Date: 2020/03/09 00 :00: 13 Priority: Normal Type: Note Thanks Brady appreciate the considered response. Please tell Seema thank you too. We will work with CDC and we will include you (CMS) on future actions and collaboration. Best. Bob Sent from my iPhone On Mar 8, 2020, at 11:38 PM, Brookes , Brady (CMS/QA) wrote: ? All, b)(5) AMERICAN PVERSIGHT HHS-20-0580-B-000022 bJ(5] b}(5} Confidential and deliberative, pre-decisio11al communication From: Mango, Paul (HHS/IOS) Sent: Sunday, March 8, 2020 4:30 PM To: Giroir, Brett (HHS/OASH) ; Pollard, Ashton (OS/IOS) Cc: Stecker, Judy (OS/IOS) ; Brookes, Brady (CMS/OA) ; Kadlec, Robert (OS/ASPR/1O); Yeskey, Kevin (OS/ASPR/1O); Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) ; CMS SVl ~cms.hhs.gov>; Berger, Sherri (CDC/OCOO/OD) ; Redfield, Robert R. (CDC/OD) ~cdc.gov>; Shuy, Bryan (OS/ASPR/1O); Harrison, Brian (HHS/fOS) ; Herrmann, Jack (OS/ASPR/OEA) Subject: Re: Outtakes from Call with Kaiser Permanente and HCA Sent from my iPhone On Mar 8, 2020 , at 3:59 PM , Giroir , Brett (HHS/OASH) wrote: ? b}(5} Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW AMERICAN PVERSIGHT HHS-20-0580-B-000024 Washington, DC 20201 Office Phone: 202-690-7694 From: Stecker, Judy (05/105) Sent: Sunday, March 8, 2020 2:45 PM To: Brookes, Brady (CMS/OA) Cc: Kadlec, Robert (OS/ASPR/1O); Giroir, Brett (HHS/OASH) ; Yeskey, Kevin (OS/ASPR/1O) ; Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) ; CMS SVl ~ cms.hhs.gov >; Berger, Sherri (CDC/OCOO/OD) ; Redfield, Robert R. (CDC/OD) ~ cdc.gov >; Shuy, Bryan (OS/ASPR/1O); Harrison, Brian (HHS/1O5) ; Herrmann, Jack (OS/ASPR/OEA) ; Mango, Paul (HHS/1OS) Subject: Re: Outtakes from Call with Kaiser Permanente and HCA Sent from my iPhone On Mar 8, 2020, at 2:04 PM, Brookes, Brady (CMS/OA) wrote: ? + The Administrator Confidential and deliberative, pre-decisional co111111unict1tion From: Kadlec, Robert (OS/ASPR/1O) Sent: Sunday, March 8, 2020 1:59 PM To: Giroir, Brett (HHS/OASH) ; Yeskey, Kevin (OS/ASPR/1O); Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) Cc: Berger, Sherri (CDC/OCOO/OD) ; Redfield, Robert R. (CDC/OD) 'fb )(6) ~ cdc.gov >; Shuy, Bryan (OS/ASPR/1O) ; Harrison, Brian (HHS/1OS) ; Brookes, Brady (CMS/OA) ; Herrmann, Jack (OS/ASPR/OEA) ; Harrison, Brian (HHS/1OS) ; Mango, Paul (HHS/1OS) AMERICAN PVERSIGHT HHS-20-0580-B-000025 ; Stecker, Judy (05/105) Subject: Outtakes from Call with Kaiser Permanente and HCA Importance : High (b)(5) AMERICAN PVERSIGHT HHS-20-0580-B-000026 Sender: Kadlec, Robert (O5/ASPR/IO) Brookes, Brady (CMS/OA); Mango, Paul (HHS/IOS) ; Giroir, Brett (HHS/OASH); Pollard, Ashton (O5/IOS) ; Stecker, Judy (O5/IOS) ; Yeskey, Kevin (O5/ASPR/IO) ; Jernigan, Daniel B. (CDC/DDID/NCIRD/ID); b)(6) l; Berger, Sherri (CDC/OCOO/OD); Redfield, Robert R. (CDC/OD) ; Shuy, Bryan (OS/ASPR/1O); Harrison, Brian (HHS/IOS) ; Herrmann, Jack (O5/ASPR/OEA); Blackford, Carol W. (CMS/CM); Harrison, Brian (HHS/IOS) Sent Date: 2020/03/09 00 :00: 11 Delivere d Date: 2020/03/09 00 :00: 13 AMERICAN PVERSIGHT HHS-20-0580-B-000027 Giroir, Brett (HHS/OASH) Hahn, Stephen ~fda.hhs.gov>; Lenihan, Keagan (FDA/OC) ; Pence, Laura (HHS/ASL) Stenzel, l7mothy (FDA/CDRH) ; Murphy, Ryan (OS/ASPA) ; Stecker, Judy (OS/IOS) ; Mango, Paul (HHS/IOS) ; Giroir, Brett (HHS/OASH) Subject: Current Numbers in the System. Date: 2020/03/11 09:19:23 Priority: Normal Type: Note b)(5) (b)(5) AMERICAN PVERSIGHT HHS-20-0580-B-000028 b)(5) Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 Giroir, Brett (HHS/OASH) Hahn, Stephen ; Lenihan, Keagan (FDA/QC) ; Pence, Laura (HHS/ASL) ; Stenzel, Timothy (FDA/CDRH); Recipient: Murphy, Ryan (OS/ASPA); Stecker, Judy (OS/IOS) ; Mango, Paul (HHS/IOS) ; Giroir, Brett (HHS/OASH) Sent Date: 2020/03/11 09:19:20 AMERICAN PVERSIGHT HHS-20-0580-B-000029 Delivered 09:19:23 Kadlec, Robert (OS/ASPR/IO) Giroir, Brett (HHS/OASH) Yeskey, Kevin (OS/ASPR/IO); Kellogg, Rachel (HHS/OASH); CC: Orsega, Susan (O5/OASH) ; Shuy, Bryan (O5/ASPR/IO) Subj ect : Re: FDA - materials Date: 2020/03/13 18:53:25 Priority : Normal Type: Note b)(5) Sent from my iPhone On Mar 13, 2020, at 6: 19 PM, Giroir, Brett (HHS/OASH) wrote: b)(5) AMEF- ? ~ PVERSIGHT HHS-20-0580-B-000031 Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 Sender: Kadlec, Robert (O5/ASPR/ IO) Giroir, Brett (HHS/OASH) ; Yeskey, Kevin (O5/ASPR/IO) ; Kellogg, Rachel (HHS/OASH) ; Orsega, Susan (OS/OASH) ; Shuy, Bryan (OS/ASPR/IO) Sent Date: 2020/03/13 18:53:25 AMERICAN PVERSIGHT HHS-20-0580-B-000032 Kadlec, Robert (OS/ASPR/IO) Dr. Eva K Lee ; Giroir, Brett (HHS/OASH) ; Fauci, Anthony (NIH/NIAID) [E] ; Redfie ld, Robert R. (CDC/OD) ; To: Redd, John (OS/ASPR/SPPR) ; Shuy, Bryan (OS/ASPR/IO) ; Lee, Scott (OS/ASPR/EMMO) ; Yeskey, Kevin (O5/ASPR/IO) Carter Mecher ; Richard Hatchett ; Tracey McNamara 1(b)(6) fglwesternu.edu>; ; l(b)(6) ~gmail.com>; Dodgen, Daniel (O5/ASPR/SPPR) ; DeBord, Kristin (OS/ASPR/SPPR) ; Phillips, Sally (OS/ASPR/SPPR) ; David Marcozzi 1'.:b)(6) ~som.umaryland.edu>; Hepburn, Matthew J CIV USARMY (USA) ; Lisa Koonin ~(b)(6) @gmail.com>; Walters, William (STATE.GOV) ; HARVEY, MELJSSA; Wolfe, Herbert (OHS.GOV) ; alexander.eastman@hq .dhs.gov ; CC: EVANS, MARIEFRED ; Callahan, Michael V.,M.D. {b )(6) lilmgh.harvard.edu>; jwl educ@UTMB.EDU j(b)(6) fi)utmb.edu >; ~email.unc.eau>; Johnson, Robert (OS/ASPR/BARDA) ; Yeskey, Kevin (OS/ASPR/IO) ; Disbrow, Gary (O5/ASPR/BARDA) ; Redd, John (O5/ASPR/SPPR) ; Hassell, David (Chris) (OS/ASPR/IO) ; Hamel, Joseph (OS/ASPR/IO) ; Dean, Charity A@CDPH ; Lawler, James V ; Martin, Gregory J (MartinGJ@state.gov) ; Borio, Luciana < LBorio@iqt.org>; Hanfling, Dan < DHanfling@iqt.org >; eric.mcdonald@sdcounty.ca .gov ; Wade, David ; AMERICAN PVERSIGHT HHS-20-0580-B-000033 david.a.tarantino@cbp.dhs.gov; WILKINSON,THOMAS; david.gruber@dshs.texas.gov ; KAUSHIK,SANGEETA; }imed.cornell.edu> Nathaniel Hupert ~/b\/6\ Subject: Re: Red Dawn Breaking, COVID-19Collaborative, Feb 16 start Date: 2020/02/23 23:35:39 Priority: Normal Type: Note Eva Is this true?! If so we have a huge whole on our screening and quarantine effort. (Dr Lee is a at GaTech. ) Means of spread A study from AMA confirmed many of the parameters assumed in our models: - A 20-year old infected with COVID-19 left Wuhan and went on infecting 5 relatives. When they tested positive, she was finally isolated, but tested negative still, and later tested positive, and remain normal on chest CT with no fever, stomach or respiratory symptoms (cough or sore throat as late as Fen 11 (time of the papert study duration). So spreading and its wide scope is unavoidable because there exists these very healthy individuals who can spread effectively -- even during incubation period -- while they remain perfectly healthy. It also showcases difficulty in testing -- negative test -- may not be the end of it. Sent from my iPhone On Feb 23, 2020, at 7:38 AM, Dr. Eva K Lee wro te: A few things I want to highlight -1. Means of spread A study from AMA confirmed many of the parameters assumed in our models: - A 20-year old infected with COVID-19 left Wuhan and went on infecting 5 relatives. When they tested positive, she was finally isolated, but tested negative still, and later tested positive, and remain normal on chest CT with no fever, stomach or respiratory symptoms (cough or sore throat as late as Fen 11 (time of the papert study duration). So spreading and its wide scope is unavoidable because there exists these very healthy individuals who can spread effectively -- even dwing AMERICAN PVERSIGHT HHS-20-0580-B-000034 incubation period -- while they remain perfectly healthy. It also showcases difficulty in testing -- negative test -- may not be the end of it. 2. Iranian cases, though mysterious since the origin was not traced to China, may very well show that COVID-19 virus is very adaptable and mutating rapidly. 3. Long recovery The long recovery period is troubesome and must be taken seriously by health providers as they prepare for hospitali zation. Therei s not much surge capacity in hospitals. So they must be innoative in the staggering process and isolation is of paramount importance. Government/Local should be readied for supplementing medical tents outside hospitals when needed (clearly extra staff too). 4. Citizes' view I was traveling so I did a real-time on-the-road analysis of human behavior and anxiety level. I overheard many people -- (a) asked when CDC would tell us more on what to do. -- (b) wish they could pull their kids out of school but there is no such option as part of the preventive measure (not announced by CDC). -- (c) wish CDC would recommend tele-work options so they don't have to travel and expose themselves and their family to unneccessary risk. -- (d) have no clue what the government is doing to keep the risk low as it is now. What exactly is being implemented to keep it low. 5. Resource-limited countries I pray that it would not reach the resourcelimited countries like many in Africa (though it seems unavoidable). I cannot imagine the consequence . 6. What we must do: We must leverage the knowledge from other countries to better prepare ourselves . Japan's Crusi s shows the importance of TIMELY proper isolation and STRATEGIC operations logistics in testing and in quarantine. South Korea (contrasting with Hong Kong , Singapore) demonstrates critical importance of EARLY social distancing and high compliance community NPI intervention. China's latest lockdown of 1/2 billion people truly signifies that gravity and unchartered terrority of this virus. No country would take to such extreme measure. 7. CFR Since over 90% of influenza is never recorded /known , this COVID19 seems to fall into similar spirit now, with so many cases of asymptomtic and transmission while incubating. While the hue CFR remains unknown , the CFR of tested positive cases should offer a good compa1ison to the CFR of tested positive flu cases. That gives us a clearer estimate of health-resource burden. evalee-gatech @pm.me https ://newton .isye.gatech .edu/DrLee/ AMERICAN PVERSIGHT HHS-20-0580-B-000035 mobile: 404-432-6835 Sent with ProtonMail Secw-e Email. ------- Original Message ------On Saturday , February 22, 2020 10:19 PM, Carter Mecher w rote: Updates South Korea (+123 with +2 deaths)-Total deaths 4 cases 556; Total https://www .cdc.go.kr/board/board.es?mid=a30402000000&bid =0030 Singapore (+3)--Total cases 89; Total deaths 0 Hong Kong (unchanged)--Total cases 69; Total deaths 2 Japan-Total cases 135; Total deaths 1 Sent from Mail for Windows 10 From: Carter Mecher Sent: Saturday , February 22, 2020 6:28 AM To: Richard Hatchett; Dr. Eva K Lee Cc: Tracey McNamara; Caneva, Duane;l(b)(6) p)gmail.com; Dodgen, Daniel (OS/ASPR/SPPR) : DeBord, Kristin (OS/ASPR/SPPR) : Phillips, Sally (OS/ASPR/SPPR); David Marco zzi; Hepburn, Matthew J CIV USARMY (USA): Lisa Koonin; Wargo Michael; Walters, William (STATE.GOV); HARVEY, MELISSA; WOL FE, HERBERT; Eastman, AMERICAN PVERSIGHT HHS-20-0580-B-000036 Alexander ; EVAN S, MAR IEFRED; Callahan, Michael V.,M.D.;l(b)(6) t:yUTMB.EDU Jb)(6) @email. unc.edu; Johnson, Robert (OS/ASPR/ BARDA); Yes key, Kev in; Disbrow, Gary (OS/ASPR/BARDA) ; Redd, Johnt(OS/ASPR/SPPR); Hassell, David (Chris) (OS/ASPR/1O); Hamel, Josep h (OS/ASPR/1O); Dean, Charity A@CDPH ; Lawle r, James V ; Kadlec, Robert (OS/ASPR/1O): 'Martin, Gregory J (MartinGJ @state.gov)'; Borio, Luciana; Hanfling. Dan; McDona ld, Eric; Wade, David; TARAN TINO, DAVID A; WILKINS ON . THOMAS ; Dav id Gruber (david.gruber @dshs.texas .gov); KAUSHI K, SANGEETA; Nathaniel Rupert Subject: RE: Red Dawn Breaking , COVID-19 Collaborative , Feb 16 start Roundup this morning. Singapore and Hong Kong are holding steady- both have implemented NPls pretty early and have good surveillance. Things are really accelerating in South Korea. Case count increased to 433 with 2 deaths. https://www .cdc .go.kr/board/board .es?mid=a30402000000&b id =0030 Report below of COVID hitting Samsung's mobile device factory , which has now been shut down. This is what will happen here. The greate st concern is what this would mean for critical infrastrncture sectors (including components of our healthcare system) , The strategies I outlined for outpatient clinics could be used by business (most especially CI sectors) to maintain business continuity. It is as simple as the old saying , "Don ' t put all your eggs in one basket. " It is both contingency planning (continuity of operations /continuity of business) and application ofNPls/TLC (especially social distancing in the community supported by home isolation and home quarantine). We now have COVID in several countries across the ME (Iran, Israel , Egypt, Lebanon , UAE). We added Iran the day before yesterday and 3 countries yesterday (Israel, Egypt and Lebanon) . Iran already appears to have a well established AMERICAN PVERSIGHT HHS-20-0580-B-000037 outbreak that will be tough to slow down given the estimated size with 5 deaths already (that is where Wuhan was by Jan20). Japan is also seeing acceleration with local tran smission (119 cases). Italy is another area to watch. https://protect2.fireeye .com/url?k=c92f3 372-957b2a0ec92fD24d-Occ47adc5fa2927014023 819d8ec&u =https ://www.ilgazzettino.it/nordest / ...DO yaql09ac4o84 Numerous infected in the hospital of Schiavonia (Padua) "And unfortunately , what the expe1ts feared since yesterday has occun-ed, when it was discovered that two patients had been hospitali zed for about ten days at the Schiavoni.a hospital (Padua) without knowing that they had contracted the Coronavirus: since yesterday evening everyone those who attended the hospital were subjected to a swab to detect any infections , and the examination gave positive results in numerous cases. It means that there are other people, probably among those who attended the ward where two patient s were hospitali zed, who are now positive for the virus and consequently could in tum have spread the infection. Already yesterday evening the Governor of Veneto Luca Zaia ordered the progressive evacuation of the Padua hospital which should take place within 5-6 days ." "The hospital is sun-ounded by a 'sanitary cordon' , with Carabinieri, workers of the Red Cross and Civil Protection. Cardiology chief Giampaolo Pasquetto arrived outside the hospital for a few minutes and reported the results of the swabs 'as far as I have been able to know from my colleagues so far,' he said. The modern structure is located between the town s of Este and Monselice and was recently inaugurated to serve the Euganean Hills area." https://www.reu ters.com/article/us-china-heal th-southkoreasamsung-e lec/samsung-electronics-confirms-coronavirus -caseat-phone-facto ry-complex- in-south-korea-idUSKCN20G0CG SEOUL (Reuters) - Samsung Electronics said on Saturday that one coronavirus case had been confirmed at its mobile device factory complex in the southeastern city of Gumi, causing a shutdown of its entire facility there until Monday morning. AMERICAN PVERSIGHT HHS-20-0580-B-000038 Samsung Electronics , the world ' s top smartphone maker , said the floor where the infected employee worked would be shut down until the morning of Feb. 25 . "The company has placed colleagues who came in contact with the infected employee in self-quarantine and taken steps to have them tested for pos sible infection ," Samsung said in a new s release . Samsung's factory in Gumi accounts for a small port ion of its total smartphone production , and it makes high-end phones , mostly for the dome stic market. Sam sung produce s mo st of its smartphones in Vietnam and India . Gmni is close to the city of Daegu , home to a church at the center of South Korea 's largest corona virus outbreak. South Korea said on Saturday that the number of people infected with the coronaviru s in the country had more than doubled to 433. Samsung said production at its chip and display factories in other parts of South Korea would not be affected. Sent from Mail for Windows 10 From: Carter Mec her Sent: Friday , Febrnary 21, 2020 6:52 PM To: Richard Hatchett; Dr. Eva K Lee Cc: Tracey McNamara ; Caneva, Duane ;l(b)(B) @gmail.com ; Dodgen, Daniel (OS /ASPR/SPPR) : DeBo rd, Krist in (OS/AS PR/SP PR) ; Phillips, Sally (OS/AS PR/SP PR); David Marco zzi; Hepburn. Matthew J CIV USARMY (USA) : Lisa Koon in; Wargo M ichael ; Walte rs. William (STATE.GOV) ; HARVEY, ME LISSA ; WOLFE, HERBERT ; Eastman, Alexander; EV ANS, MARIEFRED; Callahan, Michael V ..M.D. ;l(b)(6) @UTMB.EDU; Kb )(6) fa)email.unc.edu; Johnson, Robe rt (OSI ASPR/ BARDA); Yeskey , Kevin; Disbrow, Gary (OS/ASPR/BARDA); Redd, Johnt(OS /AS PR/SPPR) ; Hassell, David (Chris) (OS/AS PR/1O); Hamel, Joseph (OS/AS PR/1O); Dean. Charity A@CDPH ; Lawle r, James V ; Kadlec, Robert (OS/ASPR/1O) : AMERICAN PVERSIGHT HHS-20-0580-B-000039 'Mar tin. Greg ory J (MartinGJ@s tate.gov)'; Borio. Luciana; Hanfl ing. Dan ; McDo nald, Eric ; Wade, David; TARANTINO, DAVID A; WILKINS ON, THOMAS ; Dav id Gruber (david.gruber@dshs. texas.gov) ; KAUSHIK. SANGEETA; Na thaniel Rupert Subject: RE : Red Dawn Breaking, COVID-19 Co llaborat ive, Feb 16 start Wuhan to add 19 additional hospital (when combined with the other 3 hospitals , this wou ld add 30,000 beds). Just to put that in perspective. o o There are 2.8 hospital beds in the US per 1,000 popu lation. o o 30,000 beds is about the number of beds we would have for a population of 11 M. When you add the 30,000 beds plus the 13,348 other beds added (total of 43 ,300 beds) o o There are 4.5 ho spita l beds in Ch ina per 1,000 popu lation o o 43 ,300 beds is about the number of beds in China for a popu lation of 9.6 M o o Wuhan will have nearly doubled its bed capacity How hard would that be for us to double bed capacity in any major US city? (Really isolation bed s for mild illness) https ://www .straits times .corn/ asia/ east-asia/coronavirus-wuhanto-activate -one-more-temporary-hospital-with-3690beds?fbclid=Iw ARI otfl 4xNxKiuBRuODJzoTDMJWHueF9g Tc 06ulIM9nM2u-3VTpohOtFt7s WUHAN (XINHUA) - Wuhan , the epicentre of the corona virus outbreak , plans to build another 19 makeshift hosp itals to receive more infected patients, local authoritie s said Friday (Feb 21) . Upon their completion , all the makeshift hospital s in Wuhan are expected to offer 30,000 beds on Feb 25, said Mr Hu Yabo , AMERICAN PVERSIGHT HHS-20-0580-B-000040 deputy mayor of Wuhan at a press briefing on epidemic prevention and control. To date, Wuhan has converted 13 existing venues into temporary hospitals , with a total of 13,348 beds , and about 9,313 beds have been put into use to treat patients with mild symptom s, said Mr Hu. Sent from Mail for Windows 10 From: Carter Mec her Sent: Friday , Febrnary 21, 2020 1:59 PM To: Richard Hatchett; Dr. Eva K Lee Cc: Tracey McNamara ; Caneva, Duane ;l(b)(B) @gmail.com; Dodgen, Daniel (OS/ ASPR/SPPR) : DeBord, Krist in (OS/AS PR/SPPR) ; Phillips, Sally (OS/AS PR/SPPR); David Marcozzi ; Hepburn, Matthew J CIV USARMY (USA) : Lisa Koonin; Wargo Michael ; Walters, William (STATE.GOV); HARVEY, MELISSA; WOLFE, HERBERT ; Eastman, Alexander; EV ANS, MARIEFRE D; Callahan, Michael V .oM.D.; l(b)(6) @UTMB.EDU; Kb )(6) fa}email.unc.edu; Johnso n, Robert (OS/ASPR/ BARDA); Yeskey, Kev in; Disbrow, Gary (OS/ASPR/BARDA) ; Redd, Johnt(OS/AS PR/SPPR) ; Hassell. David (Chris) (OS/AS PR/IO) ; Hamel, Joseph (OS/AS PR/IO) ; Dean. Charity A@CDPH ; Lawler , James V ; Kadlec, Robert (OS/ASPR/IO ): 'Martin. Gregory J (Marti nGJ@s tate.gov)' ; Borio, Luc iana; Hanfling, Dan; McDonald. Eric; Wade, David; TARAN TINO. DAVID A; WILKINSON, THOMAS; David Grnber (david.gruber@dshs.texas .gov); KAUSHI K, SANGEETA ; Nat haniel Hupert Subject: RE: Red Dawn Breaking , COVID-19 Collaborative , Feb 16 start Weekly CDC update looks like flu might be on the downslope (good news). Watching the curves of % positive flu tests and ILI (should track one another as flu is receding). Trouble is the data repo1ted today is for the week ending Feb 15 (so a week old). AMERICAN PVERSIGHT HHS-20-0580-B-000041 Our inpatient nursing sick leave is tracking ILI (current thru 2120)-nothing unusual Sent from Mail for Windows 10 From: Carter Mec her Sent: Friday, February 2 1, 2020 10:54 AM To: Richard Hatchett; Dr. Eva K Lee Cc: Tracey McNamara; Caneva. Duane; l(b)(6) @gmail.com; Dodgen, Daniel (OS/ASPR/SPPR) ; DeBo rd, Krist in (OSI ASPR/SPPR) : Phillips. Sally (OSI ASPR/SPPR) ; David Marco zzi; Hepburn. Matthew J CIV USARMY (USA) ; Lisa Koonin; Wargo Michael; Walters, William (STATE.GOY); HARVEY, MELISSA; WOLFE. HERBERT ; Eastman , Alexander ; EV ANS. MARIEFRED ; Callaha n. Michael V .oM.D.; fb)(6) tg}UTMB.EDU; ~ email.unc.edu; Johnson, Robert (OS/ASPR/BARDA) : Yeskey, Kevin; Disbrow , Gary (OSIASPR/BARDA) ; Redd, Johnt(OSI ASPR/SPPR) ; Hassell, David (Chris) (OSIASPR/IO) : Hamel, Joseph (OSIASPR/IO) : Dean. Charity A@CDPH; Lawler, James V; Kadlec, Rober t (OS/ASPR/IO); 'Martin , Gregory J (Martin GJ@state .gov)'; Borio, Luc iana ; Hanfling. Dan ; McDo nald. Eric ; Wade, David; TARANTINO, DAVID A; WILKINSON. THOMAS; David Gruber (david.gruber@dshs. texas.gov) : KAUSHIK, SANGEETA; Nathaniel Hupert Subjec t: RE : Red Dawn Breaking , COVID - 19 Collaborat ive, Feb 16 start Singapore and Hong Kong are holding the line. Both implemented NPis early. No change in numbers from Hong Kong and Singapore saw its case count increase by only 1 for the past two days. AMERICAN PVERSIGHT HHS-20-0580-B-000042 Japan rep01ied to have 107 cases. First repo11edcase in young children (se below) Hokkaido boy 1st Japan case of coronavirus infection under 10 February 21, 2020 (Mainichi Japan) SAPPORO -- Two elementary school brother s and a woman in her 40s in Hokka ido have been infected with the new corona virus, with the younger sibling becomi ng the first infection under 10 in Japan , Hokkaido Gov. Naomichi Suzuki announced on Feb. 21. Some graphic s of the drop off in travel in China (pretty dramatic) Jan-23 Feb-13 Sent from Mail for Window s 10 From: Carter Mecher Sent: Friday, Febm ary 21, 2020 10:28 AM To: Richard Hatchett; Dr. Eva K Lee Cc: Tracey McNamara; Caneva, Duane; ~b)(6) @gmail.com; Dodgen, Daniel (OS/ASPR/SPPR) : DeBord, Kristin (OSI ASPR/SPPR) ; Phillips, Sally (OSI ASPR/SPPR); David Marcozzi; Hepburn, Matthew J CIV USARMY {USA): Lisa Koonin; Wargo Michael; Walters, William (STATE.GOV); HARVEY, MELISSA; WOLFE. HERBERT; Eastman, AMERICAN PVERSIGHT HHS-20-0580-B-000043 Alexander; EV ANS, MARIEFRED; Callahan, Michael V.,M.D j (b)(6) @UTMB.EDlJ ;kb)(6) @email.unc.edu; Johnson, Robert (OS/ASPR/BARDA) ; Yeskey, Kevin; Disbrow, Gary (OS/ASPR/BARDA); Redd, Johnt(OS /ASPR/SPPR) ; Hassell, David (Chris) (OS/ASPR/1O); Hamel, Joseph (OS/ASPR/1O) ; Dean, Charity A@CDPH; Lawler, James V; Kadlec, Robert (OS/ASPR/1O) : 'Martin, Gregory J (MartinGJ @state.gov)'; Borio, Luciana; Hanfling. Dan; McDonald, Eric; Wade, David; TARANTINO, DAVID A; WILKINSON. THOMAS; David Gruber (david.gruber @dshs.texas .gov) ; KAUSHIK, SANGEETA; Nathaniel Rupert Subject: RE: Red Dawn Breaking , COVID-19 Collabo rative, Feb 16 start https ://www. cdc. go .kr/board/board.es ?mid=a30402000000& bid =0030 Here is the best link to track cases in South Korea. South Korea is now up to 204 cases and 1 death (South Kore a is where Wuhan was 1 month ago). Sent from Mail for Window s 10 From: Carter Mecher Sent: Friday, Febrnary 21, 2020 10:02 AM To: Richard Hatchett; Dr. Eva K Lee Cc: Tracey McNamara; Caneva, Duane; l(b)(B) @gmail.com; Dodgen, Daniel (OS/ASPR/SPPR): DeBord, Kristin (OS/ASPR/SPPR) ; Phillips, Sally (OS/ASPR/SPPR); David Marcozzi; Hepburn, Matthew J CIV USARMY (USA); Lisa Koonin; Wargo Michael; Walters, William (STATE.GOV); HARV EY. MELISSA; WOLF E, HERB ERT; Eastman, Alexander; EV ANS, MARIEFRED; Callahan, Michael V.,M.D .;l(b)(6) @UTMB.EDU; ~b)(6) ta}email.unc.edu; Johnson. Robert (OSI ASPR/BARDA); Yeskey, Kevin; Disbrow, Gary (OS/ASPR/BARDA); Redd, Johnt(OS /ASPR/SPPR); Hassell, David (Chris) (OS/ASPR/1O) ; Hamel, Joseph (OS/ASPR/1O) ; Dean, Charity A@CDPH ; Lawler. James V; Kadlec. Robert (OS/ASPR/1O) : 'Martin, Gregory J (MartinGJ @state.gov)'; Borio, Luciana; AMERICAN PVERSIGHT HHS-20-0580-B-000044 Hanfling, Dan; McDona ld, Eric ; Wade, David; TARAN TINO. DAVID A; WILKINSON , THOMAS ; Dav id Gruber (david.gruber@dshs.texas .gov): KAUSHIK, SANGEETA ; Nathaniel Hupert Subject: RE: Red Dawn Breaking , COVID-19 Collaborative , Feb 16 start On a totally different note. Others have been plying with and modifying the notional conops for a healthcare system. I set up some simple rules : 1. o Protect uninfected patients and staff from infectious patients and staff (using all the tools that we have including home isolation and home quarantine , cohorting/physical separation, PPE, telehealth , etc.) 2. o Provide acute care for COVID patients (continuum of ER-inpatient care-intens ive care) 3. o Support mildly ill COVID patients in home isolation-telehealth 4. o Support patients in voluntary home quarantine-telehealth 5. o Continue to address the usual mix of healthcare needs for patients (from outpatient care to acute care to mental health care to long term care) a. o Outpatient clinics and providers focus on wellness to minimize ER visits/hospitalization to unburden the acute care system- leverage telehealth b. o Continue to provide acute care and inpatient mental health care (continuum of ER-inpatient care-inten sive care) for non-COVID condition s c. o Protect high-risk patients in residential/long term care (nursing homes , hospice , long term psychiatry , etc.) The notional conops divides the healthcare system into hot and safe areas. The hot area is only acute care: ER-acute inpatient care-ICU care. The safe areas include a separate acute care area (ER-acute inpatient care-ICU care) , all the outpatient clinics /care, other inpatient care areas such as mental health , as AMERICAN PVERSIGHT HHS-20-0580-B-000045 well as long term/residential care (nursing home, hospice, long term psychiatry, etc .). Triage will not be easy (between hot and safe). Best I could come up with would be: (1) anyone already on home isolation or home quarantine (may need a medical record flag); (2) anyone with ILI (could narrow that down with a negative rapid flu test); (3) anyone with a sick household member with suspected COVID. Could be very difficult for an unconscious /confused, or trauma patient etc. , but would probably err on the side of hot and think of additional layered strategies to minimize patient risk within that area (private rooms, patient PPE ?). T1iage would need to err on the side of keeping the safe area safe. The mitigation measures are our best tools to reduce community transmission and reduce the probability of an infectious patient getting into a safe area. If we have a breach in a safe inpatient area, it pretty much converts that inpatient area into a hot area . That also means that we have the staff in that area exposed (because of limited availability of PPE , the staff in the safe area would not be PPE-PPE would have been directed to the staff in the hot area). Those staff would likely need to be placed on quarantine . The effect is we now have a much larger hot area with even fewer staff. That would really be a mess. You have the same problem in the outpatient areas. Have a sick patient slip through and come in contact with a number of the clinic staff (not in PPE), and we now need to quarantine all those staff. In contrast to a breach for the inpatient area , the outpatient area can still operate as a safe area (just minus those staff who would now be on quarantine). But do that a few times and pretty soon you have nobody left to fight. One way I thought about dealing with this scenario is to take the outpatient staff and split them in two . One group works the clinic (physically present) for the usual clinic hours for a 14 day stretch (1 incubation period). Another group works from home ( and practices social distancing , etc. , really acting as if they are on home quarantine) and leverages telehealth technology to care for patients and help with monitoring those patients in home isolation and home quarantine. After 14 days the groups switch. [All along we monitor employees daily (whether at work or at AMERICAN PVERSIGHT HHS-20-0580-B-000046 home) for symptoms or sick househo ld members ] In the event of a breach , the group s immediately switch and the group that was working is placed on actual home quarantine (but still continue s to work from home leveraging telehealth ). That way if a breach does happen , we have a fallback respon se (that we are con stantly practicing) that allow s us to sustain outpatient care. For the inpatient areas, I thought about the lone survivor model (holding back 1 Secretary and staff in the event that the government is decapitated). So think of a small group (would need to think thru what the compo sition of that team would look like for each area (acute care, inpatie nt mental health , long term care) that would at least provide the nucleus of the expertise necessary to reconstitute the service in the event of a major breach). This smaller group would vary in team member s every 2 weeks and would rotate to work from home for 14 days stretches and practice social distancing (acting as if they were on home quarantine ). They could also assist via telehealth (inpatient consultation , etc., while out of the hospital). Is anyone thinking along these lines (really continuity of operation s for the healthcare system) ? Sent from Mail for Windows 10 From: Carter Mecher Sent: Friday , Febrnary 21, 2020 8:35 AM To: Richard Hatchett; Dr. Eva K Lee Cc: Tracey McNamara; Caneva, Duane; ~b)(6) @gmail.com ; Dodgen, Daniel (OS/ASPR/SPPR) : DeBord, Krist in (OS/ASPR/SPPR) ; Phillips, Sally (OS/ASPR/SPPR); David Marco zzi; Hepburn, Matthew J CIV USARMY (USA) : Lisa Koonin; Wargo Michael ; Walters, William (STATE.GOV) ; HARVEY, MELISSA; WOLFE, HERBERT ; Eastman, Alexander; EV ANS, MARIEFRED; Callahan, Michael V .oM.D.;l(b)(6) tyUTMB.EDU *b)(6) tyemail.unc.edu; Johnson, Robert (OS/ASPR/BARDA); Yeskey, Kevin; Disbrow, Gary (OS/ASPR/BARDA); Redd, AMERICAN PVERSIGHT HHS-20-0580-B-000047 Johnt(OS /ASPR/SPPR); Hassell, David (Chris) (OSI ASPR/1O); Hamel, Joseph (OS/ ASPR/1O); Dean, Charity A@CDPH; Lawler, James V; Kadlec, Robert (OS/ASPR/1O) : 'Martin, Gregory J (MartinGJ@state.gov)'; Borio, Luciana; Hanfling. Dan; McDonald, Eric; Wade. David; TARANTINO. DAVID A; WILKINSON, THOMAS; David Gruber (david.gruber@dshs.texas.gov): KAUSHIK, SANGEETA; Nathaniel Rupert Subject: RE: Red Dawn Breaking, COVID-19 Collaborative, Feb 16 start https ://www.cbc.ca /news /canada /ottawa /diamond-princesscoronavirus-trenton-cornwall-1.5470386 Canada flies home passengers from cruise line. Data in article: 47 of 256 Canadians contract https ://protect2. fireeye. com / url ?k=96ebd 7bc-cabfcec096ebe683-0cc47 adc 5fa216a39afbec00c653&u =https: //www.timesofisrael.com/israel ...ne e-diagnosed / Israel confirms first coronavirus case as cruise ship returnee diagnosed One of 11 Israelis who anived in the morning after quarantine aboard Diamond Princess ship tests positive, after entering 14day isolation at Sheba Medica l Center Trying to track cruises ship passenger /crew by country (data is sketchy) Country Passengers /Crew us 434 330 256 241 78 Hong Kong Canada Australia UK AMERICAN PVERSIGHT Total Confirmed Cases ICU Admissions 58 1? 47 48 6 Deaths % Infec ted 13% 18% 20% 8% HHS-20-0580-B-000048 Italy South Korea Israel Japan Subtotal Total 35 14 11 l 9% 2 1,399 3,711 160 634 17% Sent from Mail for Windows 10 From: Carter Mecher Sent: Friday, February 21, 2020 5:46 AM To: Richard Hatchett; Dr. Eva K Lee Cc: Tracey McNamara; Caneva, Duane;l(b)(B) @gmail.com; Dodgen, Daniel (OSI ASPR/SPPR) : DeBord, Kristin (OS/ ASPR/SPPR) ; Phillips, Sally (OSI ASPR/SPPR) ; David Marcozzi; Hepburn, Matthew J CIV USARMY (USA): Lisa Koonin; Wargo Michael; Walters. William (STATE.GOV); HARVEY, MELISSA; WOLFE, HERBERT; Eastman, Alexander; EV ANS, MARIEFRED; Callahan, Michael V .oM.D.;l(b)(6) @UTMB.EDU; ~b)(6) @email.unc.edu; Johnson, Robert (OSI ASPR/BARDA); Yeskey, Kevin; Disbrow, Gary (OS/ASPR/BARDA); Redd, Johnt(OS / ASPR/SPPR) ; Hassell, David (Chris) (OS/ASPR/IO) ; Hamel, Joseph (OS/ASPR/IO) ; Dean. Charity A@CDPH; Lawler, James V; Kadlec, Robert (OS/ASPR/IO): 'Martin, Gregory J (MartinGJ@state .gov)'; Borio, Luciana; Hanfling, Dan; McDona ld, Eric; Wade, David; TARANTINO, DAVID A; WILKINSON, THOMAS; David Gruber (david.gruber @dshs.texas.gov) ; KAUSHIK. SANGEETA; Nathaniel Hupert Subject: RE: Red Dawn Breakin g, COV ID- 19 Collabora tive, Feb 16 start China has again modified its reporting (first it added clinical cases to lab confirmed cases on Feb- 12). Now it is subtractin g out those clinical cases and limiting numbers to lab confam ed). Have continued to follow the hospitalization data from Hubei (see below). AMERICAN PVERSIGHT HHS-20-0580-B-000049 Here is the data being reported by Hubei and Wuhan. Data is pretty sketchy prior to Jan-21. Hubei 2019-nCoV Confirmed Hospital Data Date 1/14/20 1/15/20 1/16/20 1/17/20 1/18/20 1/19/20 1/20/20 1/21/20 1/22/20 1/23/20 1/24/20 1/25/20 1/26/20 1/27/20 1/28/20 1/29/20 1/30/20 1/31/20 2/ 1/20 2/2/20 2/3/20 2/4/20 2/5/20 2/6/20 2/7 /20 2/8/20 2/9/20 2/ 10/20 2/ 11/20 2/12/20 AMERICAN PVERSIGHT Total Current Inpatients 6 5 5 8 136 170 239 399 494 658 915 1,64 5 2,567 3,349 4,334 5,486 6,738 8,565 9,618 10,990 12,627 14,314 15,804 19,835 20,993 22,160 25,087 26,121 33,693 Mild Disease 100 126 176 304 365 472 1,013 1,877 2,450 3,346 4,392 5,444 7,003 7,917 8,857 10,107 11,230 11,802 14,640 15,746 16,655 18,743 18,880 26,609 Severely Critically Cum Ill Ill Discharges 6 5 5 8 33 35 51 71 106 129 221 563 563 671 711 804 956 1,118 1,223 1,557 1,809 2,328 3,161 4,188 4,093 4,269 5,046 5,724 5,647 3 9 12 24 23 57 69 127 228 277 290 338 444 478 576 711 756 841 1,007 1,154 1,236 1,298 1,517 1,437 31 32 85 44 47 80 90 116 166 215 295 396 520 633 817 1,113 1,439 1,795 2,222 2,639 3,441 Cum Deaths 2 2 2 3 4 7 15 17 24 39 52 76 100 125 162 204 249 294 350 414 479 549 618 699 780 871 974 1,068 1,310 HHS-20-0580-B-000050 Cum I Inpatient s 6 7 7 10 139 174 246 416 549 729 1,052 1,423 2,714 3,554 4,586 5,806 7,153 9,074 10,263 11,800 13,626 15,496 17,239 21,647 23,212 24,826 28,283 29,828 38,444 2/13/20 2/ 14/20 2/ 15/20 2/16/20 2/ 17/20 2/18/20 2/ 19/20 2/20/20 36,719 38,107 39,447 40,814 41,957 43,471 43,745 42,056 27,081 27,955 29,051 31,017 30,987 32,225 32,567 31,059 7,953 8,276 8,439 8,024 9,117 9,289 9,128 8,979 1,685 1,876 1,957 1,773 1,853 1,957 2,050 2,018 4,131 4,774 5,623 6,639 7,862 9,128 10,337 11,788 1,426 1,457 1,596 1,696 1,789 1,921 2,029 2,144 Sent from Ma il for Window s 10 From: Carter Mecher Sent: Friday , Febrnary 21, 2020 5:09 AM To: Richard Hatchett; Dr. Eva K Lee Cc : Tracey McNamara ; Caneva, Duane; l(b)(6) @gmail.com ; Dodgen, Daniel (OSI ASPR/SPPR) : DeBord, Kristin (OS/AS PR/SPPR) ; Phillips, Sally (OS/ASPR/SP PR); David Marcozzi; Hepburn, Matthew J CIV USARMY (USA) : Lisa Koonin; Wargo Michael; Walte rs, William (STATE.GOV) ; HARVEY. MELISSA; WOLFE, HERBERT; Eastman. Alexander; EV ANS, MARIEFRED; Callahan, Michael V.,M.D .;l(b)(6) lq}UTMB.EDU;~b)(6) @email.unc.edu ; Johnson, Robert (OSI ASPR/BARDA); Yeskey, Kevin; Disbrow. Gary (OS/ASPR/BARDA); Redd, Johnt(OS/ASPR/SPPR) ; Hassell, David (Chris) (OS/ASPR/IO) ; Hamel, Joseph (OS/ASPR/IO) ; Dean, Charity A@CDPH ; Lawler, James V; Kadlec, Robert (OS/ASPR/IO) : 'Martin. Gregory J (MartinGJ@state.gov)'; Borio, Luciana; Hanfling, Dan; McDonald. Eric; Wade, David; TARANTINO. DAVID A; WILKINSON, THOMAS ; Dav id Gruber (david.gruber@dshs.texas .gov); KAUSHIK, SANGEETA; Nathaniel Hupert Subject: RE: Red Dawn Breaking , COV ID-19 Collaborati ve, Feb 16 start More on South Korea (sounds just like wha t happened at Jefferson Ba1Tacks, just outside St. Louis, in 1918, armed with the exact same tools they had more than 100 years ago to control AMERICAN PVERSIGHT HHS-20-0580-B-000051 42,276 44,338 46,666 49,149 51,608 54,520 56,111 55,988 an outbreak). I assume they must also be taking measures within the base to limit spread (keeping infectious individuals apart from those not yet infected with isolation and quarantine and social distancing). https :// en.yna .co.kr/view /AEN20200221003 0003 2 5?section=nat ional/defense SEOUL, Feb . 21 (Yonhap) -- The military is making all-out efforts to prevent the new coronavirus from spreading further into the banacks , officials said Friday, after the country's first infections in the armed forces were confirmed. Earlier in the day, a Navy sailor on the southern island of Jeju was confirmed to have contracted COVID-19 in the first such case among service personnel here. Following the confirmation, the Navy has checked the temperature of all personnel at the base where the infected sailor served and quarantined all those who had contacts with the person , it said. "We have carried out disinfection work at the base and are devoting all our efforts to preventing the spread of the new virus ," the Navy said in a release . An officer each from the Anny and the Air Force were also confinned to have the virus the same day. The militaiy is now working to identify per sonnel who have visited the southeastern city of Daegu and the surrounding orth Gyeongsang Province since Feb. 10, as these areas have recently seen a surge in the number of infected people. More than 5,000 service personnel are estimated to have visited the region during their vacation according to the military's preliminary investigation. On Thursday night , the defense ministry said all personnel will be barred from vacationing , staying outside their bases and meeting visitors starting Saturday. The decision was made at a meeting of top defense officials presided over by Defense Minister Jeong Kyeong-doo , during which he called for "extraordinary measures" to contain the spread of the virus. AMERICAN PVERSIGHT HHS-20-0580-B-000052 Amid growing fears over the disease , the government called off a planned ceremony to mark the 60th anniversary of a pro democracy movement in Daegu , which was designated a "special care zone" over the virus earlier in the day. Sent from Mail for Windows 10 From: Carter Mecher Sent: Thur sday, February 20, 2020 9:21 PM To: Richard Hatchett; Dr. Eva K Lee Cc: Tracey McNamara; Caneva. Duane; Kb)(6) (C)gmail.com; Dodgen. Daniel (OS/ASPR/SPPR) : DeBord. Kristin (OSI ASPR/SPPR) ; Phillips. Sally (OS/ ASPR/SPPR) ; David Marcozzi ; Hepburn, Matthew J CIV USARMY (USA) : Lisa Koonin; Wargo Michael; Walters. William (STATE.GOY); HARVEY. MELISSA; WOLF E. HERBERT; Eastman. Alexander ; EV ANS, MARIEFRED; Callahan, Michael V.,M.D .;l(b)(6) tyUTMB.EDU; l(b)(6) fUTMB.EDU;l(b)(6) @email.unc.edu; Johnson. Robert (OSI ASPR/BARDA) ; Yeskey, Kevin; Disbrow. Gary (OS/ASPR/BARDA); Redd, Johnt(OS/ASPR/SPPR ); Hassell . David (Chris) (OS/ASPR/IO) ; Hamel, Joseph (OS/ASPR/I O); Dean, Charity A@CDPH; Lawler. James V; Kadlec, Rober t (OS/ASPR/IO): 'Martin, Gregory J (MartinGJ@s tate.gov)'; Borio, Luciana; Hanfling, Dan ; McDo nald, Eric ; Wade, Dav id; TARANTINO . DAVID A; WILKINSON, THOMAS ; Dav id Gruber (david.gruber@dshs. texas.gov) ; KAUSHIK. SANGEETA; Nathaniel Rupert Subject : RE: Red Dawn Breaking, COVID - 19 Collaborative , Feb 16 start From Feb-15 to Feb-20 the number of confirmed cases increased from 355 to 634 (increa se of 279). The number of asymptomatics increased from 73 to 322 (increa se of 249). So from Feb-15 to Feb-20 , 249 of the 279 confirmed cases (89%) were asymptomatic. Seems a little odd. Also, read reports that all passenger s and crew have beem tested (but reports only note that 3,066 of the 3,711 have been tested). Date AMERICAN PVERSIGHT Event Cumulative Cumulat Number of Number Confirmed Case s Death: HHS-20-0580-B-000055 20-Jan 25-Jan I-Feb AMERICAN PVERSIGHT Cruise ship departs from Yokohama Japan 80 year old passenger disembarks in Hong Kong 80 year old passenger confirmed to have COVID-19 When results known, certificate of landing cance led and ship under quarantine . Tests for the vims wou ld be administered to three groups : those with symptoms, those who got off in Hong Kong, and those who had close contact with the infected passenger. 3-Feb 5-Feb 6-Feb 7-Feb 8-Feb 10-Feb 11-Feb 12-Feb 13-Feb 14-Feb Ship arrives in port of Yokohama Japan 10 passengers and crew confirmed + 31 more passengers and crew confirmed + 30 more passenger and crew confirmed+ 9 more passenger and crew confirmed + 66 more passenger and crew confirmed + 39 more passenger and crew confirmed + 28 more passenger and crew confi1med + 15 more passenger and crew confinned + 67 more passenger and crew confirmed + 10 41 61 70 136 175 203 218 285 15-Feb 70 more passenger and crew confirmed+ 355 16-Feb 329 American evacuated from cruise ( 14 of the evacuees found to be ship +) 61 Americans remained on 44 board Americans remained hospita lized in Japan 369 17-Feb 85 more passenger and crew confirmed + 454 18-Feb 19-Feb 167 more passenger and crew confirmed + 2 deaths 621 621 2 20-Feb 13 more passenger and crew confirmed + 634 2 HHS-20-0580-B-000056 Sent from Ma il for Windows 10 From: Carter Mecher Sent: Thursday , February 20, 2020 4:49 PM To: Richard Hatchett; Dr. Eva K Lee Cc: Tracey McNamara ; Caneva. Duane ;l(b)(6) @gmail.com ; Dodgen, Daniel (OS/ ASPR/SPPR) : DeBord. Kristin (OS/AS PR/SPPR) : Phillips. Sally (OS/AS PR/SPPR); David Marcozzi ; Hepburn, Matthew J CIV USARMY (USA) : Lisa Koonin; Wargo Michael ; Walters, William (STATE.GOV); HARVEY. MELISSA; WOLFE. HERBE RT; Eastman. Alexander; EV ANS. MARIEFRED; Callahan, Michael V.,M.D .;l(b)(6) ~UTMB.EDU ;Kb )(6) r}email.unc.edu; Johnson. Robe rt (OS/ASPR/ BARDA); Yeskey, Kevin ; Disbrow. Gary (OS/ASPR/BARDA); Redd, Johnt(OS/ ASPR/SPPR) ; Hassell, David (Chris) {OS/ASPR/IO); Hamel , Josep h (OS/ASPR/IO) ; Dean, Charity A@CDPH; Lawler. James V ; Kadlec. Robert {OS/ASPR/IO) : 'Martin, Gregory J (MartinGJ@sta te.gov)'; Borio, Luciana; Hanfling, Dan; McDonald, Eric ; Wade, David; TARAN TINO, DAVID A; WILKINSON, THOMA S; Dav id Gruber (david.gruber@dshs.texas .gov); KAUSHIK, SANGEETA ; Nathaniel Rupert Subject: RE: Red Dawn Breaking , COVID-19 Collaborative , Feb 16 start This is new o o Now 634 cases confirmed on the cruise ship (3,063 tested) (so not all the ship and crew have been tested 3.711) o o Slightly more than half are asymptomatic (previously we heard that 73 of 355 are asymptomatic ) o o 28 in serious condition (4.4%) Japan's Health Minister Katsunobu Kato told Parliament the two people from the Diamond Princess cruise ship who died had "received the best medical treatment" but couldn't be saved after catching the novel coronavirus on board. As of Thursday , 634 passengers and crew members were diagno sed with the virus out of 3,063 tested. Slightly more than half have no symptom s at all, AMERICAN PVERSIGHT HHS-20-0580-B-000057 officials said, and many of the remainder have only mild fever or a cough . Amon g patient s who tested po sitive for the virus, 28 were reported in seriou s condition Thursday. Doctors have said the vim s can be particu larly harmfu l in elderl y patie nts, and one of the two fatal cases from the Diamond Prince ss, a Japanese man in his 80s, had pre-existing bronchial asthma and had been treated for angina . The other , a Japanese woma n in her 80s without underlying illnesses, came down with a fever on Feb. 5, the same day passengers were told they would be quarantined in their cabins for two week s, according to health ministry official s. The next day , she started suffer ing from diarrhea and saw a doctor on board. She wasn ' t taken to a hospital until Feb. 12 when she started sufferin g shortne ss of breath. Her viru s test came back positive the following day, and despite treatment with antiviral drugs normally used to treat HIV infection , she died Thur sday. Asked about the woma n 's case, health ministry official Hirosh i Umeda said, "I believe it was handled promptly. " He said the ship was a difficult environment for medic al staff but they worked day and night and tried to prioritize the most serious cases. Sent from Mail for Window s 10 From: Carter Mecher Sent: Thm sday, February 20, 2020 11:00 AM To: Richard Hatchett; Dr. Eva K Lee Cc: Tracey McNamara; Caneva, Duane; l(b)(6) @gmail.com; Dodgen, Daniel (OS/ASPR/SPPR) : DeBord, Kristin (OSI ASPR/SPPR) ; Phillips, Sally (OSI ASPR/SPPR); David Marcozzi; Hepburn, Matthew J CIV USARMY {USA): Lisa Koonin; Wargo Michael; Walters, William (STATE.GOV); HARVEY, MELISSA; WOLFE. HERBERT; Eastman, Alexander; EV ANS, MARIEFRED; Callahan, Michael V.,M.D .; ~b)(6) @UTMB.EDU; ~b)(6) lq}email.unc.edu; Johnson, Robert (OS/ASPR/BARDA); Yeskey, Kevin; Disbrow, Gary (OS/ASPR/BARDA); Redd, Johnt(OS /ASPR/SPPR) ; Hassell, David {Chris) (OS/ASPR/IO) : Hamel, Joseph (OSIASPRIIO) : Dean, Charity A@CDPH; Lawler, James V; Kadlec, Robert (OS/ASPR/IO): AMERICAN PVERSIGHT HHS-20-0580-B-000058 'Martin. Gregory J (MartinGJ@s tate.gov)'; Borio. Luciana; Hanfl ing. Dan ; McDo nald, Eric ; Wade, David; TARANTINO, DAVID A; WILKINS ON, THOMAS ; Dav id Gruber (david.gruber @dshs. texas.gov) ; KAUSHIK. SANGEETA; Nathaniel Rupert Subject: RE : Red Dawn Breaking, COVID-19 Collaborative, Feb 16 start Keep an eye on South Korea too. Seeing rapid growth in cases in South Korea (see story below) South Korea now rep01iing 104 cases and 1 death today. South Korea now implementing NPis. This story is eerily reminiscent of the actions taken at Jefferson Barracks near St. Louis in 1918. Also attached are update for Singapore (85 cases; 46 in hospital/4 in ICU; 4 kids , only 1 in hospital) and Hong Kong (69 cases , still no kids reported). Both have implemented NPls (small increases in cases today). Japan has reported 10 new cases today- total now is 94. South Korea reports first virus death as Daegu struggles to contain outbreak https ://protect2. fireeye. com/url ?k= 3b907 5da-67 c46ca63b9044e5 -0cc47 adc5 fa208635f0e3 1fl 241 a&u=https://www.stripes.com /news/pacific ...b reak-1. 619407 SEOUL , South Korea- South Korea reported its first coronavirns -linked death Thursday, while the U.S. military tightened restrictions on travel to the southea stern city of Daegu due to an outbreak in infections in the area. Daegu also urged residents to stay home as the city of 2.5 million people and surrounding areas struggled to contain an outbreak of the pneumonia-like disease. The Army garrison in Daegu also restricted access and announced that schools and nonessential busine ss would be closed for a second day on Friday. AMERICAN PVERSIGHT HHS-20-0580-B-000059 In an exception to policy , U.S. service members were authorized to wear face masks in uniform "regardless of air quality conditions," according to the garrison's Face book page. Fast-moving developments this week were a blow to South Korea's hope that the crisis was easing. Instead, dozens of new cases were confirmed in recent days, with the total number of infections soaring to 104 on Thursday, according to the Korea Centers for Disease Control and Prevention U.S. Forces Korea said, "there remains zero confirmed cases of USFK personnel with COVID-19 ." The virus first appeared in December in Wuhan , China, and spread to nearly 30 countries. More than 2,000 people have died - most in mainland China . A South Korean man in his 60s died Wednesday at a hospital in the southeastern city of Cheongdo and posthumously tested positive for the virus , the KCDC said Thursday. It was South Korea's first death from the virus. USFK raised the risk level for the military community to moderate on Wednesday and banned all nonessential travel to Daegu due to an outbreak linked to a church near the Army garrison in the city. On Thursday, USFK added that all travel by American troops to, from and around Daegu requires authori zation from their leadership . The precaution was "highly encouraged" for all family members, civilians and contractors as well. "All off-installation travel for all USFK populations should be minimi zed to reduce potential contamination ," USFK announced on its website. U.S. Army Garrison Daegu, about 200 miles southeast of Seoul, also said visitors not performing mission essential or official business would be denied access as it implemented health checks at the gates . Nonessential personnel were not required to go to work on Friday and most activities would be suspended, including the schools, it said. AMERICAN PVERSIGHT HHS-20-0580-B-000060 The garrison also recommended that members of the mili tary community avoid public places and tran spoitation in the city, including store s, restauran ts and other heavily congested area s until the situation is brought under control. Self-quara ntine measures were ordered for any American troop s who had visited the affec ted New World Chmch , but garri son commander Col. Edward Ballanco said earlier Thur sday that no Americans were known to have done so. He also urged America ns to avoid a local ho spital where the wom an believed to have been a carrier was treated. The garri son also lifted limit s on wearing face ma sks for America n troops in unifo rm, who nonnall y are only allowed to wear them on days with extreme pollution. Sent from Mail for Window s 10 From: Carter Mecher Sent: Thur sday, Febru ary 20, 2020 8:20 AM To: Richard Hatchett; Dr . Eva K Lee Cc: Tracey McNamara; Caneva. Duane; l(b)(B) @gmail.com; Dodgen. Daniel (OS /ASPR/SPPR) : DeBord. Kristin (OSI ASPR/SPPR) ; Phi llips. Sally (OS/ ASPR/SPPR) ; David Marcozzi ; Hepbmn, Matthew J CIV USARMY (USA) : Lisa Koonin; Wargo Michael; Walters. William (STATE.GOY); HARVEY. MELISSA; WOLFE. HERBERT; Eastman. Alexander; EV ANS, MARIEFRED; Callahan, Michael V.,M.D .Jb )(6) @UTMB.EDU; Kb )(6) lq}email.unc.edu; Johnson, Robert (OSIASPR/BARDA) ; Yeskey, Kevin; Disbrow, Gary (OS/ASPR/BARDA); Redd, Johnt(OS /ASPR/SPPR) ; Hassell, David (Chris) (OS/ASPR/IO) : Hamel, Joseph (OS/ASPR/IO) : Dean, Charity A@CDPH; Lawler, James V; Kadlec, Robert (OS /ASPR/IO) : 'Martin, Gregory J (MartinGJ@state.gov)'; Borio, Luciana; Hanfl ing, Dan; McDona ld, Eric; Wade, Dav id ; TARANTINO, DAVID A; WILKINSON, THOMAS; David Gruber (david.gruber@dshs.texas.gov) : KAUSHIK. SANGEETA; Nathaniel Rupert Subject: RE: Red Dawn Breaking , COV ID- 19 Collaborative , Feb 16 start AMERICAN PVERSIGHT HHS-20-0580-B-000061 Last thing. Keep a very close eye on Japan. The outbreak is starting to take off there with numbers of cases scattered across the country with no link to known cases. We are also seeing nosocomial transmission (a number of healthcare workers infected). There is also a large number of cases hospital ized in Japan related to the cruise ship, and now the relea se of large number s of passengers from the cruise ship into the community. Yesterday they reported a total of 84 cases----caught up to Singapore. But unlike Singapore , Japan has been slow to implement NPi s. The other concern is that Japan 's population is disprop01iionately aged (it has the highest % age 65 of any country ). In Japan , 27% of the population is ::: 65; in the US, 15.6% of the populat ion is ::: 65. And Japan can also claim the large st city in the world (metro Tokyo with 38 M people- pretty much the population of California crammed into an area smaller than the size of Connect icut). Japan also has the 10th largest city in the world (Osaka with 19 M people ). Sent from Ma il for Window s 10 From: Carter Mecher Sent: Thur sday, February 20, 2020 7: 15 AM To: Richard Hatchett; Dr. Eva K Lee Cc: Tracey McNamara; Caneva, Duane; l(b)(6) p)gmail.com; Dodgen, Daniel (OS/ASPR/SPPR) ; DeBord, Kristin (OSI ASPR/SPPR) ; Phillips, Sally (OSI ASPR/SPPR) ; David Marcozzi ; Hepburn, Matthew J CIV USARMY {USA); Lisa Koonin; Wargo Michael; Walters. William (STATE.GOV); HARVEY, MELISSA; WOLFE, HERBERT; Eastman, Alexander; EV ANS, MARIEFRED ; Callahan, Michael V.,M.D .; fb)(6) r}UTMB.EDU ; Kb )(6) @email.unc.edu ; Johnson, Robert (OSI ASPR/BARDA); Yeskey, Kevin; Disbrow. Gary (OS/ASPR/BARDA); Redd, Johnt(OS/ASPR/SPPR) ; Hassell, David (Chris) (OSI ASPR/IO) ; Hamel, Joseph (OSI ASPR/IO) ; Dean, Charity A@CDPH; Lawler, James V; Kadlec, Robert (OS/ASPR/IO) ; 'Martin. Gregory J (MartinGJ@state.gov)'; Borio, Luciana; Hanfl ing, Dan; McDona ld, Eric; Wade, David ; TARANTINO, DAVID A; WILKINSON, THOMAS ; Dav id Gruber (david.gruber@dshs.texas.gov) ; KAUSHIK. SANGEETA; Nathaniel Hupert Subject: RE: Red Dawn Breaking, COV ID-19 Collaborative , Feb 16 start AMERICAN PVERSIGHT HHS-20-0580-B-000062 What has me w01Tiedis what happened on the cruise ship is a preview of what will happen when this virus makes its way to the US healthcare system (not to mention institutionali zed highrisk populations in the US, like nursing homes). I'm not sure that folks understand what is just over the horizon. Remember the story about Mann Gulch? We are at the equivalent of about 5:44. I anticipate that when we reach 5:45, there is going to be chaos and panic to get anything in place. I doubt that what we would then hurriedly put in place will be any better than what they did on that cruise ship. As a consequence, would expect much the same results. I listened to the discussion yesterday. After listening to James and Michael describe the conditions on and around the cruise ship, I wondered whether anyone in healthcare leadership (outside the expertise at om biocontainrnent facilities) is thinking about infection control practices for any staff entering areas of a hospital caring for COVID patients (like changing clothes before entering and perhaps wearing scrubs, not bringing personal items into the area like iphones, ipads, stethoscopes, white coats, pw-ses, briefcases, etc.)? And instituting policies that require all patients to phone for clearance to enter prior to presenting at safe acute and non-acute areas including community based clinics? Are we confident of the infection control practices of acute care staff (that they know the basics of how to don and doff PPE and behavior while in PPE?) Would HCWs in outpatient clinics or long term care facilities be any better prepared than the crew on board the cruise ship or the responders in Japan? I'm no expe1t in infection control and would defer to the expertise in this group. I was just a little surprised how little this seemed to be a concern for the healthcare leaders gathered yesterday. I think we are getting close to the point where we need to drop those things that are not critical and focus on the most important things. AMERICAN PVERSIGHT HHS-20-0580-B-000063 We are going to have a devil of time with lab confirmation-it is just too slow (they had a 2 day turnaround on the cruise ship) and we just don't have the capacity for the volume of tests we would anticipate. Charity has stressed this point again and again. That means we are going to have to fly blind early on. Perhaps the best we are going to be able to do in the near term if things begin to accelerate is screen all suspect cases (pretty much anyone with ILI symptoms) with a quick flu test and assume anyone who tests negative is suspected COVID until proven otherwise ; and treat everyone who tests positive with Tamiflu. It will prove problematic early on, but as the epidemic barrels along , COVID will displace everything (at that point we will just assume that anyone with a fever or ILI has COVID). The problem is in the beginning. It is going to be so hard to sort things out. Matt, James and others are pushing for more rapid screening-but we just aren't there yet. The consequence is that we will be placing patients with resp illness (that is not flu and presumed to be COVID) in areas with actual COVID patients. I hate to do that, but not sw-e how it could be avoided early on. But we would only do that for those who are ill enough to be hospitali zed. The large number of asymptomatic and mildly ill patients would be under home isolation (so no worries about mixing confirmed and suspected patients). The downside is that we would have larger number of people is isolation and home quarantine than is really necessary (and the consequence of increased workplace absenteeism). And it is because home isolation and home quarantine are so important , healthcare systems (and not just public health) have to grab a hold of operationalizing those NPis with both hands. A while back, I created some prescriptions (tongue in cheek), just to underscore that physicians do have a role in isolation and quarantine (it is not limited to public health). We might not have pharmaceuticals available to treat COVID, but why can't we write prescriptions for non-pharmaceuticals? I don't think healthcare leaders appreciate this point. Every COVID patient we admit or see in the ER will require us to follow up with household members to make sure they know to home quarantine (need to do the same anywhere in our system we find a patient who is infected). You could not imagine the pushback I have received when I proposed that we must have an active rolepeople seem to think that state and local public health is alone responsible for this. I would think public health will be overwhelmed and taking charge of this is our best strategy to keep om safe areas safe . AMERICAN PVERSIGHT HHS-20-0580-B-000064 I would be intere sted to hear how other healthcare system s and public health leader s are thinking about this. Sent from Ma il for Window s 10 From: Carter Mecher Sent: Thursday , February 20, 2020 6:39 AM To: Richard Hatchett; Dr . Eva K Lee Cc: Tracey McNamara; Caneva, Duane Jb)(6) @gmail.com ; Dodgen, Daniel (OSI ASPR/SPPR) : DeBord, Kristin (OS/ASPR/SPPR) ; Phillips, Sally (OS/ASPR/SPPR); David Marcozzi; Hepburn, Matthew J CIV USARMY (USA) : Lisa Koonin; Wargo Michael; Walters, William (STATE.GOV); HARVEY, MELISSA; WOLFE, HERBERT; Eastman. Alexander; EV ANS, MARIEFRED; Callahan, Michael V.,M.D .;l(b)(6) @UTMB.EDU; fb)(6) @email.unc.edu; Johnson, Robert (OSI ASPR/BARDA); Yeskey, Kevin; Disbrow, Gary (OS/ASPR/BARDA); Redd, Johnt(OS /ASPR/SPPR) ; Hassell, David (Chris) (OS/ASPR/IO) ; Hamel, Joseph (OS/ASPR/IO) ; Dean, Charity A@CDPH; Lawler, James V; Kadlec, Robert (OS/ASPR/IO) : 'Martin, Gregory J (MartinGJ@state.gov)'; Borio, Luciana; Hanfling, Dan; McDonald, Eric; Wade, David; TARANTINO. DAVID A; WILKINSON, THOMAS ; Dav id Gruber (david.gruber @dshs.texas.gov) ; KAUSHIK, SANGEETA ; Nathaniel Hupert Subject: RE: Red Dawn Break ing , COVID-19 Collaborative , Feb 16 start Keeping track of the outbreak aboard the cruise ship. The latest update is the announcement of 2 deaths (both patients in their 80s). An 87-year-old man and an 84-year -old woman, died on the 20th. Both were Japane se (the 87-year-old man was hospitali zed on Feb-11 and the 84-year-old women on Feb12). So time to death from recognition of infection was 8-9 day s. On Feb-12 , the total number of confirmed cases was 203 . So estimated CFR back dating the denominator to Feb - 12 is 1% . Assuming a denominator of 621 , the CFR is 0.3% . if deaths AMERICAN PVERSIGHT HHS-20-0580-B-000065 are lagging by 8-10 days (and confirmed cases plateau) , we should have a pretty good estimate of CFR for he entire group in another week or so. Will need to peel off the number of cases involving the crew member to get a better estimate of CFR in the elderly. These numbers are within the range we have been estimating. The 2,666 passengers are similar in age (and likely in comorbidities) to the population we see in a nursing home or residential care facility . The 1,045 crew are a proxy for a young healthy population . It will be important to look at the outcomes separately. One of the concerns is how a 'remake of this movie' could play out in similarly confined populations of elderly frail Americans. Here are the numbers of long term care facilities /programs in the US that care for the frail elderly. A large number of locations and a large number of residents /paiticipants. I know that healthcare leaders were engaged yesterday , is anyone engaging this sector (long term care)? The healthcare leaders seemed more concerned about critical supply shortages (akin to the IV fluid shortage). Listening to them , it felt like their concerns seemed almost divorced from the threat of COVID. Number of Number of [Number o1 umber of Number of Facilities / Agencies / Beds Residents Participants Communities Centers Nursing Homes Residential Care Hospice Care Adult Day Care 15,600 28,900 1,700,000 996 ,100 1,300,000 811,500 4,300 4,600 1,400,000 286,300 Source: https ://www .cdc.gov /nchs /fastats/nursing-homecare .htm The outbreak on the cruise ship should be the wake up call for leaders in long te1m care (and I would think healthcare overall). AMERICAN PVERSIGHT HHS-20-0580-B-000066 Here is a summary of the cruise ship data (as of Feb 20) Date 20-Jan 25-Jan I-Feb AMERICAN PVERSIGHT Cumulative umber of Confirmed Cases Event Cumulat umber Death: Cruise ship departs from Yokohama Japan 80 year old passenger disembarks in Hong Kong 80 year old passenger confirmed to have COVID-19 When results known, certificate of landing canceled and ship under quarantine. Tests for the virus would be administered to three groups: those with symptoms , those who got off in Hong Kong, and those who had close contact with the infected passenger. 3-Feb 5-Feb 6-Feb 7-Feb 8-Feb IO-Feb 11-Feb 12-Feb 13-Feb 14-Feb Ship arrives in port of Yokohama Japan 10 passengers and crew confirmed + 31 more passengers and crew confirmed + 30 more passenger and crew confirmed + 9 more passenger and crew confirmed + 66 more passenger and crew confirmed + 39 more passenger and crew confirmed + 28 more passenger and crew confirmed + 15 more passenger and crew confirmed + 67 more passenger and crew confirmed + 10 41 61 70 136 175 203 218 285 15-Feb 70 more passenger and crew confirmed+ 355 16-Feb 329 American evacuated from cruise ( 14 of the evacuees found to be ship +) 61 Americans remained on board 44 Americans remained hospitalized in Japan 369 17-Feb 85 more passenger and crew confinned + 454 18-Feb 19-Feb 167 more passenger and crew confirmed + 2 deaths 621 621 HHS-20-0580-B-000067 2 Data by country is a bit sketchy Total Confirmed Cases ICU Admissions 58 1 Country Passengers us 434 330 256 241 78 35 14 32 46 6 1,388 142 Hong Kong Canada Australia UK Italy South Korea Japan Subtotal Deaths New virus cruise ship disembarks and kills two Japanese passengers in hospital February 20, 2020 11:38 Two Japanese men and women in their 80s who were hospitalized and treated for the virus were killed on the 20th in a cruise ship passenger who was confirmed to be infected with the new coronavirus. This is the first time a cruise ship passenger has died and three people have been killed in the country. As of the 19th, 621 cruise ships out of approximately 3,700 crew members and passengers on the cruise ship where outbreaks of the new coronavirus were confirmed were confirmed. According to government officials, two of them, a 87-year-old man and an 84-year-old woman, died on the 20th. Both were Japanese and had a basic illness and were confirmed to have been infected with the virus, so it was said that men were hospitalized on the 11th of this month and women on the 12th to be treated. This is the first time a cruise ship passenger has died. In addition, three people have been killed in Japan, following the death of a woman in her 80s living in Kanagawa Prefecture on the 13th of this month. AMERICAN PVERSIGHT HHS-20-0580-B-000068 Sent from Ma il for Windows 10 From: Carter Mecher Sent: Wednesday , February 19, 2020 10:05 PM To: Richard Hatchett; Dr. Eva K Lee Cc: Tracey McNamara ; Caneva. Duane ;l(b)(6) @gmail.com ; Dodgen, Daniel (OS/ASPR/SPPR) : DeBord. Kristin (OS/ASPR/SPPR) : Phillips. Sally (OS/ASPR/SPPR); David Marcozzi ; Hepburn, Matthew J CIV USARMY (USA) : Lisa Koonin; Wargo Michael ; Walters, William (STATE.GOV); HARVEY. MELISSA; WOLF E. HERB ERT; Eastman. Alexander ; EV ANS. MARIEFRED; Callahan, Michael V.,M.D .;l(b)(B) @UTMB. EDU ;fb)(6) @email.unc.edu; Johnson. Robe rt (OS/ASPR/ BARDA); Yeskey, Kevin ; Disbrow. Gary (OS/ASPR/BARDA); Redd, Johnt(OS / ASPR/SPPR) ; Hassell, David (Chris) {OS/ASPR/I O); Hamel , Josep h (OS/ASPR/IO) ; Dean, Charity A@CDPH; Lawler. James V ; Kadlec. Robert {OS/ASPR/IO) : 'Martin, Gregory J (MartinGJ @state.gov)'; Borio, Luciana; Hanfling, Dan; McDonald, Eric ; Wade, David; TARAN TINO, DAVID A; WILKINSON, THOMAS ; Dav id Gruber (david.gruber @dshs.texas .gov); KAUSHIK, SANGEETA ; Nathaniel Rupert Subject: RE: Red Dawn Breaking , COVID-19 Collaborative , Feb 16 start More puzzle pieces. Italy https ://protect2. fireeye. com/url ?k=e5d0 524 7-b9844 b3 be5d06378-0cc47 adc5 fa2el6553f827677d60&u =https ://www.jouma lgazette .net/news/wo rld/20200216 /guarantine-ends-for-germans-italy -to-fly-citizensfrom-ship Italy plans to evacuate 35 Italians from the cruise ship o o 25 Italian crew members (includ ing the ship's captain) o o 15 passengers AMERICAN PVERSIGHT HHS-20-0580-B-000069 UK https ://www.telegraph.co.uk/global-heal th/science-anddisease /coronavirus-news-uk-c hina-singapore-death -toll-latest/ UK plans to evacuate British passengers Friday 2/21 78 British passengers on board 4 confirmed COVID the Foreign Office 2 passengers on board say they are infected Hong Kong https ://www. japantimes.co. jp/news/2020/02/ 16/national/s ciencehealth/canada-evacuate-passe ngers-corona virus-cov id l 9diamo nd-princess-cru ise-ship/ There are around 330 Hong Kong residents on board , including 260 holding Special Administrative Region of Hong Kong passports and roughly 70 people with foreign ones. South Korea https ://www. japantimes.co. jp/news/2020/02/ 18/national/sciencehealth/ south-korea-evacuate-diamo nd-princess/ The South Korean government is sending a pre sidential plane to Japan on Tuesday afternoon to evacuate several citizens on a coronavirns-stricken cruise ship docked in Yokohama , a government official said Tuesday. 14 South Korean s - nine passengers and five crew members Canada https://www .japant imes.co .jp/news/2020 /02/ l 8/national/sciencehealth/canada-d iamond-pr incess -covid 19/ Global Affairs Canada had confirmed that 32 out of256 Canadians on the ship had tested positive. Canadian passenger s are set to be evacuated from the virus-hit boat soon, passengers will be screened before boarding the evacuation aircraft , and those who exhibit symptoms of COVID19 will be transferred to the Japanese health care system AMERICAN PVERSIGHT HHS-20-0580-B-000070 Australia https ://www .news.com. au/trave 1/travel-updates/healthsafety/unusual-rescue-fl i ght-ahead-fo r-austra lian-evac uees-ofthe-diamond -princess /news story/564e590be c70b71825c897 df85d0bc24 Australia evacuated passengers from the cru ise ship today . o o o o o ~ 180 evacuated o 15 declined evacuation o 36 confirmed COVID hospitali zed in Japan o 10 new ly confirmed had to stay behind So there were a total of ~241 Australians aboard the ship; 46 tested + (19%) The story from Austra lia sounds familiar (see below). Australian cruise passengers arrive to Darwin after Diamond Princess virus outbreak ordeal Feb 20 A rescue mission of Austra lian cruise ship passengers from Japan has officially landed in Darwin , but the flight wasn't free from drama. Thousands of peop le sharing toilet s, poo ls and buffets - is this the petri dish of the sea? The Qantas coronavirus rescue flight, carrying about 180 citizens and pennanent residents on board from Japan , has landed in Austra lia. Qanta s flight 6032 touched down in Darwin at 8.11am local time , after being slightly delayed from takeoff our of Haneda. AMERICAN PVERSIGHT HHS-20-0580-B-000071 The last-minute drama hit the rescue mission when 10 Australians, who were set to leave the coronavirus-hit Diamond Princess ship and head to the airport , were told they had tested positive to coronavirus and had to stay behind. About 180 citizens and permanent residents , who have spent the past fo1tnight on the quarantined cruise ship off the coast of Japan , had taken up the Federa l Government's offer of a seat on the repatriation flight to Austra lia. They join another 36 Australians who contracted coronavirus on the Diamond Princess and are being treated in Japan. About 15 of their relatives declined the offer of repatriation to stay with them. The Australians on board will be screened for coronavirus five times before they are taken to a quarantine facility at Howard Qantas boss Alan Joyce praised the crew who took part in the repatriation flight as well as two previous Qantas chartered flights that brough t Australians home from virus epicentre Wuhan. "It took literally thousands of hours to plan complex operations like these ," Mr Joyce said at t press conference today. "The crew were all volunteers and they did us proud. " Yesterday, Australians who were cleared to finally disembark the Diamond Princess were driven by bus to Haneda Airport for the chartered flight home. They first needed to pass a health check to receive an approval of disembarkation notice by Japanese quarantine officials. They were then screened several more times before they could board the Qantas 74 7. On the plane , they had no contact with Qantas crew, who remained upstairs for the flight. Food for passengers was already waiting for them at their seats when they boarded. If they passed the latest health check, they would have been given "approval of disembarkation" notices by Japanese quarantine officials, which grant them permission to enter Japan. From Y okoharna Port , where the ship was docked, they boarded buses to Haneda Airport. AMERICAN PVERSIGHT HHS-20-0580-B-000072 Brisbane student Tehya Pfeffer, 18, who has been quarantined on the Diamond Princess with her grandmother Cathy, was among them. "At 10.30am (local time, 12.30pm AEDT) we will start to be screened and given luggage tags and wrist bands ," Ms Pfeffer told news.com.au yesterday . "At 5pm we have to have our luggage put outside, and at 6pm we will disembark the ship and go through a makeshift customs. This is where we use our wrist bands. "An d then we will take a bus to the airport and at around 12am Thursday we will fly to Darwin." On the evacuation flight, cabin crew would not be making direct contact with evacuees. Meals were already waiting for passengers at their seats when they boarded, and Qantas staff remained upstairs. All those returning to Australia on the Qantas flight will spend two weeks in quarantine at the Howard Springs facility, in addition to the two weeks in lockdown they've had on the ship. Sent from Mail for Windows 10 From: Carter Mecher Sent: Wednesday , February 19, 2020 8:36 PM To: Richard Hatchett; Dr. Eva K Lee Cc: Tracey McNamara; Caneva, Duane; l(b)(6) @gmail.com; Dodgen, Daniel (OSI ASPR/SPPR): DeBord, Kristin (OS/ASPR/SPPR); Phillips, Sally (OS/ASPR/SPPR); David Marcozzi; Hepburn, Matthew J CIV USARMY (USA): Lisa Koonin; Wargo Michael; Walters, William (STATE.GOV); HARVEY, MELISSA; WOLFE, HERBERT; Eastman, Alexander; EV ANS, MARIEFRED; Callahan, Michael V .oM.D .;l(b)(6) @UTMB.EDU; fb)(6) r}email.unc.edu; Johnson, Robe1i (OS/ASPR/BARDA); Yeskey, Kevin; Disbrow, Gary (OS/ASPR/BARDA); Redd, Johnt(OS /ASPR/SPPR); Hassell, David (Chris) (OS/ASPR/IO); Hamel, Joseph (OS/ASPR/IO); Dean. Charity AMERICAN PVERSIGHT HHS-20-0580-B-000073 A@CDPH; Lawler, James V; Kadlec, Rober t (OS/AS PR/IO): 'Martin , Gregory J (Martin GJ@state .gov)'; Bor io, Luc iana ; Hanfl ing, Dan; McDo nald, Eric ; Wade, Dav id; TARANTIN O, DAVID A; WILKINSON, THOMAS; David Gruber (david.gruber@dshs.texas.gov) : KAUSHIK, SANGEETA; Nat haniel Rupert Subject: RE: Red Dawn Breaking, COVID-19 Collaborative, Feb 16 start South Korea cases are taking off. S. Korea reports 31 more cases on 2/20 ; total now at 82 Singapore , Hong Kong , Japan , and South Korea are the new front lines. Matter of time before travel from those areas will raise concerns. Sent from Mail for Windows 10 From: Carte r Mec her Sent: Wednesday , February 19, 2020 4:45 PM Subject: RE: Red Dawn Breaking , COVID-19 Collaborative , Feb 16 start Was listening to the discussion today. There was a discussion about the shortages of PPE. There was also discussion re Pis , but I'm not sure that most folks appreciate that the NPis that have been arrayed as part of the TLC strategy to reduce disease transmission in the community can be leveraged to create safer compartments or spaces by shunting disease toward the home . By implementing these intervention s, one could reduce the likelihood of disease in workplace s (by home isolation and home quarantine-- keeping sick employee s at home and keeping employees who are well but potentially infected because someone is sick in their hou sehold , at home). Adding in other social distancing measures including social distancing at work, helps to reduce community transmission (adds additional protection to the workplace) . The con sequence is shunting AMERICAN PVERSIGHT HHS-20-0580-B-000074 disease to the home--120 M different compartments in the US, and making the workplace the safe place. That is potentially very important for critical infrastructure. The answer is not PPE for these employees. And why would we expect that employees in these sectors would have any better IPC with the use of PPE than we saw with staff on the Diamond Princess? Healthcare is a key critical infrastructure. It is different from the other sectors in that it will be attracting patients with COVID like a magnet. It is hard to imagine how one could makes healthcare a safe workplace. But it is only hard to imagine how one could do that unless you begin to look a little closer at the different components of the healthcare system and the roles each component might play during this pandemic. To illustrate this, I took a stab at developing a conops or roadmap to look at the various pieces of the healthcare system . The shunting of disease is really fractal. Just as we can look at shunting disease across a community into one compartment (the home) to make other compartments safer, we can do the same within our healthcare system-shunt disease to the acute care area where COVID patients will be concentrated. What are the strategies to do that? This conops is notional. It is purposely designed for a severe outbreak with severe disease and assumes that the healthcare system must somehow continue to limp along and continue to care for the background disease we see dwing normal times (strokes, AMis, fractures and trawna, appendicitis, other serious infections, CHF, diabetic emergencies, psychotic episodes, preeclampsia, complicated deliveries, end stage renal disease and dialysis, etc.) as well as sustain outpatients with chronic conditions that require monitoring and care to keep them well and out of the ER and out of the hospital. Sent from Mail for Windows 10 From: Carter Mecher AMERICAN PVERSIGHT HHS-20-0580-B-000075 Sent: Wednesday, February 19, 2020 2:36 PM To: Richard Hatchett; Dr. Eva K Lee Cc: Tracey McNamara; Caneva, Duane ; fb)(6) @gmail.com ; Dodgen, Daniel (OSI ASPR/SPPR) : DeBord. Kristin (OS/ASPR/SPPR) ; Phillips, Sally (OS/ASPR/SPPR) ; David Marcozzi ; Hepburn, Matthew J CIV USARMY (USA) : Lisa Koonin; Wargo Michael ; Walters, William (STATE.GOV); HARVEY. MELISSA; WOLFE, HERBER T; Eastman, Alexander; EV ANS, MARIEFRED; Callahan, Michael V.,M.D .; fb)(6) @UTMB.EDU ;~b)(6) @email.unc.edu; Johnson, Robe 1i (OSI ASPR/BARDA); Yeskey. Kevin ; Disbrow. Gary (OS/ASPR/BARDA) ; Redd, Johnt(OS /ASPR/SPPR) ; Hassell. David (Chris) (OS/ASPR/IO) ; Hamel , Josep h (OS/ASPR/IO) ; Dean, Charity A@CDPH; Lawler, James V ; Kadlec, Robert (OS/ASPR/IO) : 'Martin, Gregory J (MartinGJ@state.gov)'; Borio, Luciana; Hanfling, Dan; McDonald. Eric; Wade, David; TARAN TINO. DAVID A; WILKINSON , THOMAS ; Dav id Gruber (david .gruber@dshs.texas .gov); KAUSHIK, SANGEETA ; Nathaniel Hupert Subject: RE: Red Dawn Breaking , COVID-19 Collaborative , Feb 16 start Update for South Korea (see attached) 51 cases ; 1 child Colombia confirms first case of Coronavirus - citizen on Japan cruise ship Februaiy 17th, 2020, 09:06 AM @Stats Alerts BREAKING: Colombia confirms first case of Coronavirus Colombia confirms first case of coronavirus: citizen was on a Diamond Princess cruise Sent from Ma il for Windows 10 AMERICAN PVERSIGHT HHS-20-0580-B-000076 From: Carter Mecher Sent: Wedne sday, February 19, 2020 10:05 AM To: Richard Hatchett; Dr. Eva K Lee Cc: Tracey McNamara; Caneva, Duane; l(b)(B) IDgmail.com; Dodgen, Daniel (OS/ASPR/SPPR) : DeBord. Kristin (OS/ ASPR/SPPR) ; Phillips, Sally (OS/ ASPR/SPPR) ; David Marcozzi; Hepburn, Matthew J CIV USARMY {USA): Lisa Koonin; Wargo Michael; Walters. William (STATE.GOV); HARVEY. MELISSA; WOLFE. HERBERT; Eastman. Alexander; EV ANS, MARIEFRED; Callahan, Michael V.,M.D .Jb)(6) @UTMB.EDU ;~b)(6) @email.unc.edu; Johnson, Robert (OS/ASPR/BARDA); Yeskey, Kevin; Disbrow. Gary (OS/ASPR/BARDA); Redd, Johnt(OS /ASPR/SPPR) ; Hassell, David (Chris) (OS/ASPR/IO) ; Hamel, Joseph (OS/ASPR/IO) ; Dean, Charity A@CDPH; Lawler, James V; Kadlec, Robert (OS/ASPR/IO): 'Martin, Gregory J (MartinGJ@state.gov)'; Borio, Luciana; Hanfling, Dan; McDonald, Eric; Wade, David; TARANTINO, DAVID A; WILKINSON, THOMAS ; David Gruber (david.gruber @dshs.texas.gov) ; KAUSHIK. SANGEETA; Nathaniel Hupert Subject: RE: Red Dawn Breaking , COV ID- 19 Collabora tive, Feb 16 start Update on HK (65 cases ; no children) and Singapore (84 cases ; 49 currently hospitalized/4 in ICU; still only 4 children (2 asymptoma tic/2 hospitalized). Sent from Mail for Windows 10 From: Carter Mecher Sent: Wednesday, Februar y 19, 2020 8:20 AM To: Richard Hatchett; Dr. Eva K Lee Cc: Tracey McNamara; Caneva, Duane; l(b)(6) @gmail.com; Dodgen, Daniel (OSI ASPR/SPPR) : DeBord. Kristin (OS/ASPR/SPPR) ; Phillips, Sally (OS/ASPR/SPPR); David Marcozzi; Hepburn, Matthew J CIV USARMY (USA): Lisa Koonin; Wargo Michael; Walters, William (STATE.GOV); HARVEY, MELISSA; WOLFE, HERBERT; Eastman, Alexander; EV ANS, MARIEFRED; Callahan, Michael V .oM.D.; l(b)(6) fg2UTMB.EDU;rb)(6) fg}email.unc.edu; AMERICAN PVERSIGHT HHS-20-0580-B-000077 Johnson, Robert (OSI ASPR/BARDA) ; Yeskey, Kevin; Disbrow , Gary (OS/ASPR/BARDA) ; Redd , Johnt(OS / ASPR/SPPR); Hassell, David (Chris) (OS/ASPR/1O); Hamel, Joseph (OS/ASPR/1O); Dean. Charity A@CDPH; Lawler, James V; Kadlec, Robert (OS/ASPR/1O): 'Martin, Gregory J (MartinGJ@state .gov)' ; Borio, Luciana; Hanfl ing, Dan ; McDona ld, Eric ; Wade, Dav id; TARANTINO, DAVID A; WILKINSON, THOMAS; David Gruber (david.gruber@dshs. texas.gov); KAUSHIK. SANGEETA; Nathaniel Rupert Subject: RE : Red Dawn Breaking, COV ID-19 Collaborative, Feb 16 start As of yesterday , there are 251 Canadians on board the Diamond Princess, of whom 34 have tested positive. https :// globalnews. ca/news /65 67907 /c ...hip-canadians / Canada walks back expected departure date for evacuees of Japanese cruise ship By Staff The Canadian Press Posted February 19, 2020 7:47 am Updated February 19, 2020 7:49 am Global Affairs says the departure date for a plane that will carry Canadians home from a coronavirus-stiicken cruise ship in Japan is yet to be confirmed. Spokeswoman Barbara Harvey says the departure will be settled once final arrangement s are made with the Japanese government and the cruise ship company. A news release from the company operating the Diamond Princess cruise ship says the Canadian flight has been "s hifted" to early Friday morning. Sent from Mail for Windows 10 From: Carter Mec her Sent: Wednesday , February 19, 2020 8:09 AM To: Richard Hatchett; Dr. Eva K Lee Cc: Tracey McNamara ; Caneva, Duane ; l(b)(B) B)gmail.com; Dodgen, Daniel (OS/ASPR/SPPR) : DeBord, Kristin (OS/ASPR/SPPR) ; Phillips, Sally (OS/ASPR/SPP R); David AMERICAN PVERSIGHT HHS-20-0580-B-000078 Marcozzi; Hepburn, Matthew J CIV USARMY {USA): Lisa Koonin; Wargo Michael; Walters, William (STATE.GOV); HARVEY, MELISSA; WOLFE, HERBERT; Eastman. Alexander; EV ANS, MARIEFRED; Callahan, Michael V .oM.D.; l(b)(B) l@UTMB.EDU; ~b)(6) r}email.unc.edu; Johnson, Robe1i (OSI ASPR/BARDA); Yeskey, Kevin; Disbrow, Gary (OS/ASPR/BARDA); Redd, Johnt(OS /ASPR/SPPR); Hassell. David (Chris) (OS/ASPR/IO) ; Hamel. Joseph (OS/ASPR/IO); Dean. Charity A@CDPH; Lawler, James V; Kadlec, Robert (OS /ASPR/IO) : 'Martin. Gregory J (MartinGJ@state .gov)'; Borio, Luciana; Hanfling, Dan; McDonald. Eric; Wade, David; TARANTINO. DAVID A; WILKINSON, THOMAS; David Gruber (david.gruber @dshs.texas .gov) ; KAUSHIK, SANGEETA; Nathaniel Rupert Subject: RE: Red Dawn Breaking, COVID-19 Collaborative, Feb 16 start 621 cases on cruise ship ( 17% of the passengers and crew have been infected). https: //www .channelnewsasia .corn/news ...itive-12450498 79 more people test positive for COVID-19 on Diamond Princess cruise ship 19 Feb 2020 06:21PM (Updated: 19 Feb 2020 06:30PM) TOKYO: An additional 79 cases of coronavirus have been discovered aboard the Diamond Princess cruise ship in Japan, the health ministry said Wednesday (Feb 19), bringing the total to 621. Sent from Mail for Window s 10 From: Carter Mecher Sent: Wednesday, Fe bruary 19, 2020 6:06 AM To: Richard Hatchett; Dr. Eva K Lee AMERICAN PVERSIGHT HHS-20-0580-B-000079 Cc: Tracey McNamara; Caneva, Duane; l(b)(6 ) @gmail.com; Dodgen, Daniel (OS/ASPR/SPPR); DeBord, Kristin (OSI ASPR/SPPR): Phillips, Sally (OSI ASPR/SPPR); David Marcozzi; Hepburn, Matthew J CIV USARMY (USA); Lisa Koonin; Wargo Michael; Walters. William (STATE.GOV); HARVEY, MELISSA; WOLFE, HERBERT; Eastman, Alexander; EV ANS, MARIEFRED; Callahan, Michael l@UTMB.EDU; rb)(B) @email.unc.edu; V .oM.D.; l(b)(6 ) Johnson, Robert (OSI ASPR/BARDA); Yeskey, Kevin; Disbrow, Gary (OSIASPR/BARDA); Redd, Johnt(OSI ASPR/SPPR); Hassell, David (Chris) (OSIASPR/1O): Hamel, Joseph (OSIASPR/1O): Dean. Charity A@CDPH; Lawler, James V; Kadlec, Robert (OS/ASPR/1O); 'Martin, Gregory J (MartinGJ@state.gov)'; Borio, Luciana; Hanfling, Dan; McDonald, Eric ; Wade, David; TARANTINO, DAVID A; WILKINSON, THOMAS; David Gruber (david.gruber@dshs.texas.gov): KAUSHIK, SANGEETA; Nathaniel Rupert Subject: RE: Red Dawn Breaking, COVID-19 Collaborative, Feb 16 start I saw a news story yesterday (WashPost) that testing was completed. So we should know in the next coupe of days. Also saw a story about the 100 or so Americans left behind (44 in hospitals and 61 who declined evacuation). https:llmainichi. jplenglish/articles l20200219 lp2g/00m/0in/0280 00c Hard to find data on the status of those still hospitalized in Japan. James made a very important point yesterday. Although the passengers are elderly (2,666 passengers), the crew members are relatively young (1,045 crew members). James also expected the attack rates to be very high among the crew members (they were housed together in a relatively small space aboard the ship, perfect conditions for explosive disease transmission). So this combined data on passengers (elderly) and crew (young and healthy) will be invaluable in terms of helping understand severity. I would think that Japan also realizes how invaluable AMERICAN PVERSIGHT HHS-20-0580-B-000080 this data is. Japan will be in the best position to asses s the impact on the crew , since they will know the results of lab screenin g and hospitalization of all + crew member s (as well as the monitori ng quaranti ne of the rest of the crew over the next 14 days). But now that the passe ngers are being dispersed, it will be importan t for several nation s to share the data on these passengers- it is really our best chance to under stand severity (would need collaboration of the US, Canada , Austra lia, Hong Kong , Japan). Sent from Mail for Window s 10 From: Richard Hatchett Sent: Wedne sday, February 19, 2020 4 :47 AM To: Dr . Eva K Lee; Carter Mecher Cc: Tracey McNamara; Caneva, Duane;l(b)(B) @gmail.com; Dodgen, Daniel (OS/ASPR/SPPR) : DeBord. Kristin (OS/ ASPR/SPPR) ; Phillips. Sally (OS/ ASPR/SPPR); David Marcozzi; Hepburn, Matthew J CIV USARMY (USA) : Lisa Koon.in; Wargo Michael; Walters, William (STATE.GOY); HARVEY, MELISSA; WOLFE, HERBERT; Eastman, Alexander; EV ANS, MARIEFRED; Callahan, Michael V.,M.D .Jb)(6) @UTMB.EDU; l(b)(6) lyemail.unc.edu; Johnson, Robert (OSI ASPR/BARDA) ; Yeskey, Kevin; Disbrow. Gary (OS/ASPR/BARDA); Redd, Johnt(OS / ASPR/SPPR) ; Hassell . David (Chris) (OS/ASPR/IO) : Hamel, Joseph (OS/ASPR/IO) : Dean, Charity A@CDPH; Lawler, James V; Kadlec, Robert (OS/ASPR/IO) : 'Martin, Gregory J (MartinGJ@state.gov)'; Borio. Luciana; Hanfl ing, Dan; McDona ld, Eric; Wade, Dav id; TARANTINO, DAVID A; WILKINSON, THOMAS; David Gruber (david.gruber@dshs.texas.gov) : KAUSHIK, SANGEETA; Nathaniel Rupert Subject: RE: Red Dawn Breaking, COV ID-19 Collaborative , Feb 16 start I understand from contacts at WHO that Japan is testing everyone on the Diamond Prince ss, so we should have a complete accounting of that closed population (and thus a nice dataset to inform severity estimates). AMERICAN PVERSIGHT HHS-20-0580-B-000081 From: Dr. Eva K Lee Sent: 19 February 2020 03:54 To: Carter Mecher Cc: Tracey McNamara ; Caneva, Duane ; Richard Hatchett ;l(b)(6) [4gmail.com ; Dodgen, Daniel (OS/ASPR/SPPR) ; DeBord , Kristin (OS/ASPR/SPPR) ; Phillips, Sally (OS/ ASPR/SPPR) ; David Marcozzi 1(b)(B) @som.umaryland .edu> ; Hepburn , Matthew J CIV USARMY (USA) ; Lisa Koonin ; Wargo Michael ; Walters , William (STATE.GOV ) ; HARVEY, MELISSA ; WOLFE, HERBERT ; Eastman , Alexander ; EV ANS, MARI EFRED ; Callahan , Michael V.,M.D. b)(B) m h.harvard.edu>; ~b)(6) @UTMB.EDU;l(b)(6) r}email.unc.edu; Johnson, Robert (OS/ASPR/BARDA) ; Yeskey, Kevin ; Disbrow , Gary (OS/ASPR/BARDA) ; Redd , Johnt(OS / ASPR/SPPR) ; Has sell, David (Chris) (OS/ASPR/IO) ; Hamel , Joseph (OS/ASPR/IO) ; Dean, Charity A@CDPH ; Lawler, James V ; Kadlec , Robert (OS/ASPR/IO) ; 'Martin , Gregory J (MartinG J@state.gov )' ; Borio , Luciana ; Hanfling , Dan ; McDonald , Eric ; Wade , David ; TARANTINO, DAVID A ; WILKINSON, THOMAS ; David Gruber (david.gruber@ds hs.texas .gov) ; KAUSHIK, SANGEETA ; Nathaniel Hupert 1b)(6) ta}med.cornell.edu> Subject: RE: Red Dawn Breaking , COVID-19 Collaborative , Feb 16 start AMERICAN PVERSIGHT HHS-20-0580-B-000082 Just talked to a lab director in Hong Kong U. They tested 3,600 passengers and crews on World Dream in 24 hours , all using the defin itive RT-PCR test. The tests were performed in government labs. They disembarked everyone after 3 days (all came back negat ive) . And they are still performing contact tracing and monitoring on all at the moment. old news: https ://www.scmp.com/news/hong-kong/hea lthenvi ran ment/article/3049714/coronavi rus-3600-passengers-a ndcrew-mem bers For surveillance , regional hospitals do an init ial screening, then suspected cases are tested by a governmental lab for confirmation . Schools are still closed for another month . evalee-gatech @pm.me https ://newton.isye .gatech.edu /Dr Lee/ mobile: 404-432-6835 Sent wi th ProtonMail Secure Ema il. ------- O1i ginal Message ------On Tuesda y, February 18, 2020 7:56 PM , Carter Meche r wrote: Japan inching toward mitigation AMERICAN PVERSIGHT HHS-20-0580-B-000083 Abe urges people with cold-like symptoms to avoid work, school Today 06:30 am JST 24 Commen ts TOKYO Prime Minister Shinzo Abe on Tuesday advised people across the country not to go to work or school if they develop cold-like symptoms, as the country grapples with the spread of a new coronavirus orig inating in China. Workplaces in the country, known for their long hours, need to encourage people to take days off without hesitation if they do not feel well, Abe said. "The first thing that I want the people of Japan to keep in mind is to take time off school or work and refrain from leaving the house if they develop coldlike symptoms such as fever," Abe told a meeting of a government task force on the viral outbreak. Teleworking is an "effective alternative" to help prevent the virus from spreading further, Abe said. He made the remarks as the government is scrambling to contain the virus that originated in Wuhan , with more people with no obvious link to China getting infected in Japan. The globa l outbreak of the disease called COVID19 has prompted some event organizers in Japan to rethink their plans for hosting mass gatherings. The number of confirmed cases in Japan has topped 600, including over 500 passengers and crew on the Diamond Princess, a quarantined cruise ship docked at Yokohama near Tokyo with more than 3,000 confined. The steady rise in infections in various parts of Japan has raised public concern, prompting the AMERICAN PVERSIGHT HHS-20-0580-B-000084 health ministry to ask people who develop symptom s such as a temperatw-e of 37.5 C or higher for at least fow-days to consult local health care centers and go to designated hospital s. The period is set shorter for the elderly , those with underlying condition s and pregnant women. As Tokyo and other major cities in the country are notorious for packed rush-hour trains, commuters have been encouraged by a government panel of medical expert s to go to work earlier or later than usual as the risk of infection is increased in crowds. On Tuesday , Fujitsu Ltd and Hitachi Ltd said they are expanding teleworking , though Japanese companie s overall have been slow to introduce it. Sent from Mail for Windows 10 From: Tracey McNamara Sent: Tuesday, February 18, 2020 4:38 PM To: Dr. Eva K Lee; Caneva, Duane Cc: Carter Mec her ; Richard Hatchett ; l@gmail.com ; Dodgen. Danie l (OSI ASPR/S PPR) ; DeBord. Kristin (OSI ASPR/S PPR) ; Phillips, Sally (OSI ASPR/SPPR) ; Dav id Marcozz i; Hepburn, Matthew J CIV USARMY (USA); Lisa Koon in; Wargo Michael; Walters. William (STATE.GOY) ; HARVEY. MELISSA; WOLFE. HERBERT; Eastman, Alexander ; EV ANS, MARIEFRED ; Callahan, Michae l V.,M.D.; ~b)(6 ) @UTMB.EDU; .,,...K b,..,.., )(6..) ----,---, @email.unc.edu; Johnson. Robert (OS/AS PR/BARDA) ; Yeskey. Kevin ; Disbrow, Gary (OS/ASPR/BARDA) ; Redd, Johnt(OS/ASPR/SPPR) ; Hassell, David (Chris) (OSIASPR/IO) ; Hamel. Joseph (OSIASPR/IO) ; Dean. Charity A@CD PH; Lawler, James V; Kad lec. Robe rt (OS/ASPR/ IO) ; 'Martin, l(b)(6 ) AMERICAN PVERSIGHT HHS-20-0580-B-000085 Gregory J (MartinGJ@state.gov)'; Borio, Luciana; Hanfling, Dan; McDonald, Eric; Wade, David; TARANTINO, DAVID A; WILKINSON, THOMAS; David Gruber (david.gruber@dshs.texas.gov); KAUSHIK, SANGEETA; Nathaniel Rupert Subject: RE: Red Dawn Breaking , COVID-19 Collaborative, Feb 16 start I must be psychic. This just came out. Like I said - Oxford Nanopore Sequencers are being sent to China! Tracey https://protect2. fireeye.com/ url?k=0a860669-56d21f150a863 756-0cc47adc5fa24fc7adc96dfbde59&u=https: //globalbiodefense.com/new swire/oxford-nanoporesequencers-have-left-uk-forchina-to-support-rapid-nearsample-coronavirussequencing-for-outbreaksurveillance/ To: 'Caneva, Duane' ; Carter Mecher ; Richard AMERICAN PVERSIGHT HHS-20-0580-B-000086 Hatchett ; Dr. Eva K Lee ; (b)(B) mail.com Cc: b)(B) mail.com (bH6 ) mail.com> 1(b)(6 ) ~gmail.co m>; Dodgen, Daniel (OS/ASPR/SPPR) ; DeBord, Kristin (OS/ ASPR/SPPR) ; Phillips, Sally (OS/ASPR/SPPR) ; David Marco zzi (b)(6) som.uma land.edu> ; Hepburn , Matthew J CIV USARMY (USA) ; Lisa Koonin 1b)(B) KYgmail.com>; Wargo Michael ; Walters, William (STATE.GOV ) ; HARVEY , MELISSA ; WOLFE , HERBERT ; Eastman , Alexander ; EVANS , MARIEFRED ; Callahan, Micha el V.,M.D. ; rb)(B) 1muTMB.EDu ; l(b)(6 ) r}email.unc.edu; Johnson , Robert (OS/ASPR/BARDA) ; Yeskey , Kevin ; Disbrow , Gary (OS/ASPR/BARDA) ; Redd , John (OS/ASPR/SPPR) ; Hassell , David (Chris) (OS/ASPR/IO) ; Hamel , Joseph (OS/ASPR/IO) ; Dean, Charity A@CDPH AMERICAN PVERSIGHT HHS-20-0580-B-000087 ; Lawler , @unmc.edu> ; James V 1(b)(5) Kadl ec, Rob ert (OS/ASPR/1O) ; 'Martin , Gregory J (MartinGJ@state.gov )' ; Borio , Luciana ; Hanfling , Dan ; McDonald , Eric ; Wade , David ; TARAN TINO , DAVID A ; WILKINSO N, THOMAS ; David Gruber (david. gruber@dshs. texas. gov) ; KAUSHIK , SANGEETA ; Nathaniel Rup ert Subject: RE: Red Dawn Breaking , COVID 19 Collaborati ve, Feb 16 start Hello all - Clearly, the most important thing of all is a reliable , real-time diagnostic test that can differentiate between flu and COVID-19. CDCs test kits were recalled because states said they were not working. Now they have to remanufacture the faulty reagent. How long will that take? If and when more kits are available, will they be available in AMERICAN PVERSIGHT HHS-20-0580-B-000088 sufficient quantity that all health care providers will have access? In all of this, I have not heard anyone talk about the N anopore MinION technology that has been used for Ebola. What gives??? It is field deployable and can be run inhouse. Hospital labs can run thousands of samples at once. It gives results of all viruses, bacteria, protozoa, fungi, in 2 hours. We all know this technology is quite promising. Why aren't we going gangbusters to validate this rapid technology and get it to all diagnosticians? If ever there was a time to invest in a diagnostic technology, this is it! Tracey From: Dr. Eva K Lee Sent: Tuesday , February 18, 2020 1:06 PM To: Caneva, Duane AMERICAN PVERSIGHT HHS-20-0580-B-000089 Cc: Carter Mecher ; Richard Hatchett ; @westernu .edu> ; Tracey McNamara ~(b)(B) l(b)(B) @gmail.com; Dodgen , Daniel (OS/ASPR/SPPR) ; DeBord, Kristin (OS/ ASPR/SPPR ) ; Phillip s, Sally (OS/ASPR/SPPR ) ; ~avid Marcozzi @som.umaryland.edu>; Hepburn , Matthew J CIV USARMY (USA) ; Lisa Kooni n (b)(6 ) mail.com>; Wargo Michael ; Walter s, William (STATE.GOV ) ; HARVEY, MELISSA ; WOLFE, HERB ERT ; Eastman, Alexander ; EVAN S, MARI EFRED ; Callahan, Michael V.,M.D. fb )(B) @mgh.harvard.edu>; 6 l(b)( ) @UTMB.EDU; rb )(6) @email.unc.edu; Johnson, Robert (OS/ ASPR/BARDA) ; Yeskey, Kevin ; Disbrow , Gary (OS/ASPR/BARDA) ; Redd , J ohnt(OS /ASPR/SPPR ) ; Ha ssell, David (Chri s) (OS/ASPR/IO ) ; Hamel , Joseph (OS/ASPR/IO) ; Dean , Charity A@CDPH ; Lawler , Jame s V b)(B) unmc.edu>; Kadlec , Robert (OS/ASPR/IO ) ; 'Martin, Gregory J (Mart inGJ@state.gov) ' ; Borio , Luciana ; Hanfling , Dan ; McDonald , Eric ; Wade , David ; TARANTINO , DAVID A ; WILKINSON, THOMAS ; David (b)(B) AMERICAN PVERSIGHT HHS-20-0580-B-000090 Gruber (david.gruber@dshs.texas.gov ) ; KA USIITK, SANGE ET A ; fymed.comell.edu> Nathaniel Rupert 1(b)(6) Subject: RE: Red Dawn Breaking , COVID-19 Collaborative, Feb 16 start Carter , Just listened in to our state COVID-19 respon se effort update. Georgia has no COVID - 19 cases yet, and hence they remain in the containment period where they place medium-risk individuals on supervised monitoring of home quarantine , advise them to take temperature daily and report any respiratory symptoms (24/7). Educate them not to show up in ED, or any place without facilitation. To avoid potential disease spread, they are advised to remain at home. The next stage will be mitigation when a confirmed case is reported. That will initiate the pandemic planning and community-ba sed NPI will be considered. This includes social distancing -telework, teleclass , etc. I assume at cities where there are confirmed local COVID-19 cases, the public health leaders have already begun the mitigation phase now and hence are practicing some degree of social distancing and rolling out telework , and various strategies to protect health in the population and to maintain business continuity already. Is that true or they are still waiting to execute their operations? There are not many tests needed here in Georgia. But rapid robust and reliable testing kits (Tracey's AMERICAN PVERSIGHT HHS-20-0580-B-000091 reporting of current bottleneck) remain critical in all communities with positive cases. If we have such means, testing can also be conducted (sampling) on some flu-like cases at strategic selected cities also. ------- Original Message ------On Tuesday, February 18, 2020 2:20 PM, Dr. Eva K Lee wrote: Duane, Yes. (asymptomatic or mild symptoms) this is the worry at the very start, and it remains the most critical. Hence even 1% of infection for us -can balloon out of proportion and we can't handle. Shedding not only during infection period, but also post-recovery. It's a very long timeline that we have to deal with. Then you have all the university siudents. Students travelled to China and came back to school, they asked health service if they needed to quarantine or take any action, theadvice -- no need. Those are missed opportunities. Again, seasonal influenza affects 8-10% Americans, 0. 7% of those infected required hospitalization, and morality is roughly 0.1%. So it is easy to "calculate" all these numbers backwards ... So 20% ofCOVID-19 infected may need hospitalization, mortality is 10-30 times higher than seasonal flu. How much can we tolerate before anyone would spring into action? Keep in mind , some begin to infect rapidly upon contracting the virus, the incubation is so short (and so long) and infectious too during that period (with much being unknown). AMERICAN PVERSIGHT HHS-20-0580-B-000092 Carter , I think you will expect heterogeneous approaches from different communities in the overall response strategy , since it depends on the social setting and the demographics and more impo1tantly the local resources . We have to optimize for sure. ------- Original Message ----- -On Tuesday, February 18, 2020 1:51 PM, Caneva, Duane wrote: Seems to me a big challenge will be asymptomatic or mild symptoms in kids, spread through the schools, shed to parents who staff both categories acute and nonacute care clinics. If there are several days of asymptomatic shedding, how do you prevent spread to the vulnerable , high risk patients in each category? Will mild symptoms drive complacent compliance ? From: Carter Mecher Sent: Tuesday, February 18, 2020 1:32 PM AMERICAN PVERSIGHT HHS-20-0580-B-000093 Subject: RE: Red Dawn Breaking, COVID-19 Collaborative, Feb 16 start CAUTION: This email originated from outside of DHS. DO NOT click links or open attachments unless you recognize and/or trust the sender. Contact your component SOC with questions or concerns. My thinking is evolving in terms of healthcare system response. Initially I described how I would refocus the outpatient clinics away from COVID care and leverage the NPis of isolation and quarantine to help keep the workplace safe (for the clinic staff and other patients) rather than a strategy that employs PPE. I would only use the outpatient clinic staff to help with telephone /home care support of those patients under home isolation or home quarantine--to help with compliance/adherence to isolation and quarantine , monitoring their health, and optimizing the care of their other chronic medical conditions (to keep them out of the ER and the hospital). But as I thought more about this, it occurs AMERICAN PVERSIGHT HHS-20-0580-B-000094 to me that this can be generalized beyond outpatient clinics. I would think about dividing our healthcare system into two big pieces: (1) acute care (EDs, acute inpatient care , critical care); and (2) non-acute care including outpatient clinics (PC/Family Practice, pediatrics, OB/GYN, medical specialty, surgical specialty, dental , mental health , rehab , etc.) , as well as other inpatient areas (inpatient mental health, substance abuse , nursing homes , hospice care , memory care, assisted living, etc.). Inpatient surgery (and I suppose labor and delivery) is part of acute care, but for this outbreak, it probably best belongs bundled with the other non-acute inpatient areas. I would anticipate that the tripwire for implementing NPis (community transmission) , will also be the trigger for healthcare systems to dial down or tum off elective admissions (primaiily surgical) to free up acute cai?e and ICU/monitored meds. The most effective way to protect these nonacute areas is by shunting potential COVID patients away from these areas and either providing this type AMERICAN PVERSIGHT HHS-20-0580-B-000095 of care while the patients is hospitalized in acute care or thru telephone care/home care for patients with mild illness receiving care at home. And the most effective way to shunt these patients away from non-acute care areas is thru the implementation of early and aggressive NPis of isolation of the ill and home quarantine of household contacts (and not fit testing the world and passing out PPE that we don't have). Sent from Mail for Windows 10 From: Caiier Mecher Sent: Tuesday, February 18, 2020 11:02 AM To: Richai?d Hatchett; Caneva, Duane; Tracey McNamara; Dr. Eva K Lee;fbl(6 l @gmail.com cd (b)(B) @gmail.com fbH6 l @gmail.com > ; Dodgen. Daniel (OS/ASPR/SPPR); DeBord. Kristin (OS/ASPR/SPPR); Phillips. Sally (OS/ASPR/SPPR); David Marcozzi; Hepburn. Matthew J CIV USARMY (USA); Lisa AMERICAN PVERSIGHT HHS-20-0580-B-000096 Koonin; Wargo Michael; Walters, William (STATE.GOV) : HARVEY, MELISSA; WOLFE, HERBERT; Eastman, Alexander; EV ANS, MARIEFRED; Callahan, Michael V.,M.D.; (bl(6l UTMB.EDU; 6 (bl( l email.unc.edu ? Johnson, Robert (OS/ASPR/BARDA); Yeskey, Kevin; Disbrow, QfilY (OS/ASPR/BARDA); Redd, John (OS/ASPR/SPPR); Hassell, David (Chris) (OS/ASPR/IO); Hamel, Joseph (OS/ASPR/IO); Dean, Charity A@CDPH; Lawler, James V; Kadlec. Robert (OS/ASPR/IO); 'Martin, Gregory J (MartinGJ@state.gov)'; Borio, Luciana; Hanfling, Dan; McDonald. Eric; Wade, David; TARANTINO, DAVID A; WILKINSON, THOMAS; David Gruber (david. gruber@dshs. texas gQ_y};KAUSHIK, SANGEETA; Nathaniel Hupert Subject: RE: Red Dawn Breaking, COVID-19 Collaborative, Feb 16 start AMERICAN PVERSIGHT HHS-20-0580-B-000097 More puzzle pieces re the cruise ship outbreak. o Abo ut 2/3r ds of the pass enge rs have been teste d so far (2,4 04 out of 3,71 1). o 61 Ame ncan s opte d to rema Ill onbo ard and not be evac uate d. Japan has completed tests for all passengers and crew aboard the ship as of Monday, but the results for the last batch of tests aren't expected until Wednesday, the day AMERICAN PVERSIGHT HHS-20-0580-B-000098 that the quarantine is slated to end. So far, results are back for 2,404 pas senger s and crew , out of the 3,711 who were on board the ship when the quarantine began on Feb. 5. Japanese Health Minister Katsunobu Kato said Tuesday that people who have tested negative for the virus would start leaving on Wednesday , but that the process of releasing passengers and crew won't be finished until Friday , according to the Washi ngton Post. The remaining 61 American passengers on the DP who opted not to join the evacuation will not be allowed to retwn to the US until March 4, according to the American embassy in Tokyo . The governments of Australia, Hong Kong and Canada have also said they would evacuate passengers . Elsewhere, Japan confirmed three more cases of the virus. This time , they were confirmed in Wakayama, a prefecture in eastern Japan. Sent from Mail for Windows 10 AMERICAN PVERSIGHT HHS-20-0580-B-000099 From: Carter Mecher Sent: Tuesday , Februa ry 18, 2020 10:50 AM To: Richard Hatchett; Caneva, Duane; Tracey McNamara; Dr. Eva K Lee; rjglassjr @gmail.com Cc: b)(6) ail.com b)(6) Dodgen, Daniel (OS/ASPR/SPPR); DeBord, Kristin (OS/ASPR/SPPR); Phillips, Sally (OS/ASPR/SPPR); David Marcozzi; Hepburn. Matthew J CIV USARMY (USA); Lisa Koonin; Wargo Michael; Walters, William (STA TE.GOV) : HARVEY. MELISSA; WOLFE. HERB ERT; Eastman, Alexander; EV ANS, MARIEFRED; Callahan, Michael V. ,M.D. : l(b)(5)lyuTMB. EDU; Kbi( 6) ? @email.unc.edu; Johnson, Robert (OS/ASPR/BARDA); Yeskey, Kevin; Disbrow, QfilV (OS/ASPR/BARDA); Redd. John (OSI ASPR/SPPR); Hassell, David (Chris) (OS/ASPR/IO); Hamel, Joseph (OS/ASPR/IO) : Dean, Charity A@CDPH; AMERICAN PVERSIGHT HHS-20-0580-B-000100 Lawler. James V; Kadlec. Robert (OS/ASPR/IO); 'Martin. Gregory J (MartinGJ@state.gov)'; Borio. Luciana; Hanfling. Dan; McDona ld, Eric; Wade. David; TARANTINO. DA YID A; WILKINSON. THOMAS; David Gruber (david .gruber@dshs .texas ,.g,QY}; KAUSHIK. SANGEETA; Nathaniel Rupert Subject: RE: Red Dawn Break ing , COVID-19 Collaborati ve, Feb 16 strui Maybe he was misquoted or it was a typo- perh aps what was meant was 4 per 100 (and that would be a low estimate) Sent from Mail for Windows 10 From: Richard Hatchett Sent: Tuesday , Febru ary 18, 2020 10:45 AM To: Carter Mecher; Caneva, Duane; Tracey McNamara; Dr. Eva K Lee; fb )(6) ~gmail.com AMERICAN PVERSIGHT HHS-20-0580-B-000101 Cd (bl(6 l @gmail.com :j (b)(6) tzygmail.com> ; Dodgen, Daniel (OSI ASPR/SPPR); DeBord, Kristin (OSI ASPR/SPPR); Phillips, Sally (OSI ASPR/SPPR); David Marcozzi; Hepburn, Matthew J CIV USARMY (USA); Lisa Koonin; Wargo Michael; Walters, William (STA TE.GOV) ; HARVEY, MELISSA; WOLFE. HERBERT; Eastman, Alexander; EV ANS, MARIEFRED; Callahan, Michael V .oM.D.; ~b)(6) fyUTMB.EDU; ~ email .unc .edu; Johnson, Robert (OSIASPR/BARDA); Yeskey, Kevin; Disbrow. Gary (OS/ASPR/BARDA) ; Redd, John (OSI ASPR/SPPR); Hassell, David (Chris) (OS/ASPR/IO): Hamel, Joseph (OSIASPR/IO) ; Dean. Charity A@CDPH; Lawler, James V; Kadlec, Robert (OSIASPR/IO) ; 'Martin. Gregory J (MartinG J@state.gov )'; Borio, Luciana; Hanfling, Dan; McDonald, Eric; Wade, David; TARANTINO. DAVID A; WILKINSON, THOMAS; David Gruber (david. gruber@dshs. texas ~;KAUSHIK, AMERICAN PVERSIGHT HHS-20-0580-B-000102 SANGEETA ; Nathanie l Hupert Subject: RE: Red Dawn Breaking, COVID-19 Collaborative , Feb 16 start Note that 4/ 100,000 would imply that only 440 people have been infected. From: Carter Mecher Sent: 18 February 2020 15:26 To: Caneva, Duane ; Tracey McNamara fb )(B) @westernu.e du>; Dr. Eva K Lee ; Dodgen , Daniel (OS/ASPR/SPPR) ; DeBord , Kristin (OS/ASPR/SPPR ) ; Phillip s, Sally (OS/ASPR/SPPR) ; David Marcozzi b)(6 ) AMERICAN PVERSIGHT HHS-20-0580-B-000103 @som.umary land.edu>; Hepburn , Matthew J CIV USARMY (USA) ; Lisa Koonin 4 (b)(B) l@gmail.com> ; Wargo Michael ; Walters , William (STATE.GOV ) ; HARVEY , MELISSA ; WOLFE, HERBERT ; Eastman , Alexander ; EV ANS , MARI EFRED ; Callahan , Michael V.,M.D. 4(b)(6) @mgh .harvard.edu>; (b)(B) UTMB.EDU; (b)(B) email.unc .eduJohnson, Robert (OS/ASPR/BARDA) ; Yeskey, Kevin ; Disbrow , Gary (OS/ASPR/BARDA ) ; Redd, John (OS/ASPR/SPPR ) ; Ha ssell, David (Chri s) (OS/ASPR/IO ) ; Hamel, Joseph (OS/ASPR/IO ) 4(b)(B) AMERICAN PVERSIGHT HHS-20-0580-B-000104 ; Dean , Charity A@CDPH ; Richard Hatchett ; Lawler , James V ~(b)(B) @unmc.edu >; Kadlec , Robert (OS/ASPR/IO) ; 'Martin, Gregor y J (MartinG J@state.gov) ' ; Borio, Luciana ; Hanfling, Dan ; McDon ald, Eric ; Wade , David ; TARANTINO , DAVIDA ; WILKINSON, THOMAS ; David Gruber (david. gruber@dshs. texas .gov) ; KAUSHIK , SANG EETA ; Nathaniel Rupert fbl(6) lymed.comell.e du> Subject: RE: Red Dawn Breaking , COVID - 19 Collaborati ve, Feb 16 strui AMERICAN PVERSIGHT HHS-20-0580-B-000105 WHO estimates 80% of patient with COVID-19 have mild disease and recover; that implies that 20% have severe disease. WHO estimated that 14% develop pneumonia and 5% are considered critical. [We were estimating that 12% of cases needed hospitalization (so 88% did not) and 2% needed ICU care (with mortality of patients with pneumonia in the ICU generally between 15%-50% so a CFR of 0,3%-1.0 %). Also noet his comment on sparing children . The latter comments are reminiscent of the early comments of public health leaders during the 1918 pandemic - always minimi zing. I have no idea where an attack rate of 4 per 100,000 comes from.] https ://www. channelnewsa sia.com/news /world/cov id19-coronavirus -who-chinapatients-have-milddisease- 124450 10 GENEVA: The new novel coronavirus only causes mild disease for 80 per cent of infected patients, said the World Health Organization on Monday (Feb 17). Speaking to reporters, WHO chief AMERICAN PVERSIGHT HHS-20-0580-B-000106 Tedros Adhanom Ghebreyesus said that 14 per cent of patients would have severe diseases such as pneumoma. "Around five percent of cases are considered critical with possible multi-organ failure, septic shock and respiratory failure and, in some cases, death ," he added. Tedros also said there were "relatively few cases" among children and more research was needed to understand why. The WHO chief also warned against "blanket measures" over the novel coronavims outbreak, pointing out the epidemic outside of China was only affecting a "tiny" proportion of the population . Ryan said that even at the epicentre of the crisis in the city of Wuhan in central Hubei Province, the "attack rate" - a measure of the speed of spread of the vims - was four per 100,000. "This is a very serious outbreak and it has the potential to grow, but we need to balance that in terms of the number of people infected. Outside Hubei this epidemic is affecting a ve1y, very tiny, AMERICAN PVERSIGHT HHS-20-0580-B-000107 tiny proportion of people ," he said . Tedro s also referred to an apparent decline in new cases of the disease in recent day s but said that the trend "must be interpreted very cautiously". Sent from Mail for Windows 10 From: Carter Mecher Sent: Tuesday , February 18, 2020 10:15 AM To: Caneva, Duane; Tracey McNamara; Dr. Eva KLee; l(b)(6) @gmail.com Cc: (b)(6) mail.com mail.com > ; Dodgen, Daniel (OS/ASPR/SPPR); DeBord, Kristin (OS/ASPR/SPPR); Phillips, Sally (OS/ASPR/SPPR); Dav id Marcozz i; Hepburn, Matthew J CIV USARMY (USA); Lisa Koonin ; Wargo Michae l; Walte rs, William (STATE.GOV) ; HARVEY, MELISSA; WOLFE, HERBERT ; b)(B) AMERICAN PVERSIGHT HHS-20-0580-B-000108 Eastman. Alexander; EV ANS, MARIEFRED; Callahan. Michae l V .oM.D.; l(b)(6) @UTMB.EDU; l(b)(6) lyemail.unc .edu; Johnson, Robert (OS/ASPR/BARDA); Yeskey, Kevin; Disbrow, QfilY (OSI ASPR/BARDA) ; Redd, John (OSI ASPR/SPPR); Hassell , David (Chris) (OSI ASPR/10): Hamel, Joseph (OS/ASPR/IO); Dean, Charity A@CDPH; Richard Hatchett; Lawler, James V; Kad lec, Robert (OS/ASPR/10): 'Martin. Gregory J (MartinGJ@state .gov)'; Borio, Luciana; Hanfling, Dan; McDonald. Eric; Wade. David; TARANTINO, DAVID A; WILKINSON, THOMAS; David Gruber (david. gruber@dshs. texas ~;KAUSHIK, SANGEET A; Nathaniel Rupert Subject: RE: Red Dawn Breakin g, COVID-19 Collaborative , Feb 16 start Update on crui se ship, Japan (implementing NPis) AMERICAN PVERSIGHT HHS-20-0580-B-000109 and South Korea (evacuating pas sengers) https ://www. channe lnewsa sia.com/news /asia/covid 19 -japan-virus- testingcomp lete-g uarantinecruise-ship-12445788 88 more people test positive for COVID-19 on Diamond Princess cruise ship. The new cases take the total number of confirmed cases on the Diamond P1incess to 542 - the biggest cluster outside the epicentre in China. [Almost 15% of the crew and passengers have been infected.] Japan has also confirmed at least 65 cases domestically , including many involving people with no history of recent travel to China. Authorities have said the virus is being transmitted locally now, and have asked citizens to avoid crowds and nonessential gatherings. On Monday , the amateur portion of the Tokyo Marathon , which had been expected to attract some 38,000 runners, was cancelled . Only elite athletes will now be able to take part. The public AMERICAN PVERSIGHT HHS-20-0580-B-000110 celebration for Emperor Naruhito's birthday has also been scrapped over virus fears. South Korea will send a presidential aircraft on Tuesday to fly back four nationals and one Japanese spouse, an official told reporters. There are 14 South Koreans on board in total, but the other ten have declined to be evacuated from the ship because they live in Japan , the Y onhap news agency reported. Vietnam NPis https: //protect2. fireeye.co m/url?k =5a2fa482067bbdfe-5a2f95bd0cc4 7adc 5fa2a5b86bc 1581cf39 c&u=htt ps :// saigoneer. com/ saigonhealth/ ...ue-to-cov id-19 Due to COVID-19: As of February 15, all 63 provinces and cities in Vietnam have extended their school closing time, 56 of which- including Saigon - have announced that school s will be closed until the end of February. Ho Chi Minh City ' s People Committee proposing students stay at AMERICAN PVERSIGHT HHS-20-0580-B-000111 hom e until the end of March. Sent from Mail for Windows 10 From: Carter Mecher Sent: Tuesday , February 18, 2020 7 : 10 AM To: Caneva. Duane; Tracey McNamara; Dr. EvaKLee; ~b)(6) @gmail.com Cc b)(6 l ail.com mail.com > ; Dodgen. Daniel (OS IASPR/SPPR); DeBord. Kristin (OSI ASPR/SPPR); Phillips. Sally (OSI ASPR/SPPR); David Marcoz zi; Hepburn. Matthew J CIV USARMY (USA); Lisa Koonin; Wargo Michael; Walters, William (STATE.GOV) ; HARVEY, MELISSA; WOLFE, HERBERT; Eastman. Alexander; EV ANS. MARI EFRED; Callahan, Michael V .oM.D.; b)(6l UTMB. EDU; (bl(6 l email.unc.edu; Johnson, Robert (OSI ASPR/BARDA); (bl(6 l AMERICAN PVERSIGHT HHS-20-0580-B-000112 Yeskey, Kevin; Disbrow, Gary (OSI ASPR/BARDA); Redd, John (OS/ ASPR/SPPR); Hassell, David (Chris) (OSI ASPR/IO): Hrunel, Joseph (OS/ASPR/1O); Dean. Charity A@CDPH; Richard Hatchett; Lawler, James V; Kadlec, Robert (OS/ASPR/IO): 'Martin, Gregory J (MartinGJ@state .gov)'; Borio, Luciana; Hanfling, Dan; McDonald, Eric; Wade, David; TARANTINO, DAVID A; WILKINSON, THOMAS; David Gruber (david.gruber@dshs.texas ~;KAUSHIK, SANGEETA; Nathaniel Hupert Subject: RE: Red Dawn Breaking, COVID-19 Collaborative, Fe b 16 start More things to keep an eye on (attached links of stories and translations of news report s) : Yesterday a 5 th flight of evacuees from Hubei arrived in Japan. There were 65 on board and 7 people were symptomatic (11 %). Watch for the AMERICAN PVERSIGHT HHS-20-0580-B-000113 number of confirmed-it will provide a point estimate of prevalence of COVID-19 in Hubei as of yesterday. Sounds like this is the last flight japan will accept. Yesterday , Japan provided an update of all cases in Japan: o 53 peop le were infec ted m Japa n and trave lers from Chin a o 454 pass enge rs and crew mem bers on CrUIS e ship s, and o AMERICAN PVERSIGHT 13 peop HHS-20-0580-B-000114 le retm ned on chart er a!fcr aft. o 520 peop le in total o 23 peop le were deter mme d to be seno usly ill Watching for other countries to evacuate passengers from cruise ship o AMERICAN PVERSIGHT 256 Can adia ns on the Dia mon d Prin cess crms HHS-20-0580-B-000115 e ship o o 32 teste d+ (as of Feb17) A plan e chart ered by the Can adia n gove mm ent has left for Japa n to evac uate its natio nals aboa rd a virus -hit crms e ship off Yok oha ma, TV Asa AMERICAN PVERSIGHT HHS-20-0580-B-000116 hi repo rted on Tues day, citin ga twee thy Can ada' s forei gn lllllll ster Can't find anything about other countries evacuating passengers (UK, Hong Kong, Italy, etc.) Last thing. Arn seeing stories from Japan re patients going from clinic to clinic with resp symptoms and fever and being confirmed. They are finding nosocomial transmission - so underscores the concerns outlined in the proposal I outlined for re-aligning outpatient clinics. Sent from Mail for Windows 10 AMERICAN PVERSIGHT HHS-20-0580-B-000117 From: Carter Mecher Sent:Monday , February 17, 2020 10:39 PM To: Caneva, Duane; Tracey McNamara; Dr. EvaKLee; fb l(6) ~gmai l.com Cc b)(6) ail.corn mail.corn >; Dodgen, Danie l (OSI ASPR/SPPR); DeBord, Kristin (OSI ASPR/SPPR); Phillips, Sally (OSI ASPR/SPPR); David Marcozzi; Hepburn, Matthew J CIV USARMY (USA); Lisa Koonin; Wargo Michael; Walters, William (STA TE.GOV) ; HARVEY, :MELISSA; WOLFE, HERBERT ; Eastman, Alexander; EV ANS, MARIEFRED; Callahan, Michael V.,M .D.; (b)(6l UTMB.EDU; b)(6) ernail.unc.edu; Johnson, Robert (OSI ASPR/BARDA); Yeskey, Kevin; Disbrow, Gary (OSI ASPR/BARDA); Redd, John (OSI ASPR/SPPR); Hassell, David (Chris) (OS/ASPR/1O): Hamel, Joseph (OS/ASPR/1O); Dean, Charity A@CDPH; Richard Hatchett; Lawler, James V; Kadlec, Robert (OSI ASPR/1O): 'Martin, Gregory J b)(6 l AMERICAN PVERSIGHT HHS-20-0580-B-000118 (MartinG J@state.gov )'; Borio, Luciana ; Hanfling, Dan; McDo nald, Eric; Wade. David; TARAN TINO. DA YID A; WILKINS ON, THOMAS ; David Grube r (david. gruber@dshs. texas ggy}; KAUSHIK. SANGEETA ; Nathan iel Ru pert Subject: RE: Red Dawn Breaking , COVID-19 Collaborative, Feb 16 start I really need help thinking thru the testing piece (screening for COVID-19). How do we protect the staff in outpatient clinics (where all the ILi is typically seen) and conserve PPE by shifting all the mild illness away from clinics and toward patients ' homes using telephone care/telehealth and home healthcare and employing home isolation for those who are infected and voluntary home quarantine for otherwise well (but expo sed and potentially infected) household contacts? Having all the suspected patient s coming in to clinics to be screened really defeats the purpose. So how would very large numbers of AMERICAN PVERSIGHT HHS-20-0580-B-000119 outpatients get screened? Home screening? Drive thru screening? Or creating a free standing screening facility for rapid screening? Has anyone thought this thru (how you screen for disease plus promote adherence /compliance to home isolation and home quarantine and shift outpatient care of patients with mild disease to telephone/home care to protect outpatient clinic staff? Looking for practical solutions . Just to remind you, here are the estimates of demand (assuming we would need to screen all ILI)-about 88K per day in primary care clinics across the US. US Data US population Hospital Beds ICU Beds Hospital Admissions ER Visits Family Practice /PC Visits Total Deaths A Day in the US Hospita l Admissions Inpatient Census (85% occupancy) ICU Census (85% occupancy) ER Visits AMERICAN PVERSIGHT 325,700 ,000 924, 107 81,790 36,353,946.00 145,600,000 481,963 ,000 2,813,503 99,600 785,491 69,522 398,904 HHS-20-0580-B-000120 Family Practice /PC Visits 1,320,447 Deaths 7,708 Current Background of Illness Similar to COVID-19 2019-20 Flu Season MMWR Week 5 ILI Rate 6.7% 1.4M hospitalizations annually for pneumonia Medicare Average LOS Pneumonia 6 days 55,672 pneumonia &influenza deaths annually Daily Hospital Admissions Pneumonia Hospital Census Pneumonia Daily ILI cases seen in ERs Daily ILI cases seen in FP/PC clinics Daily pneumonia &influen za deaths 3,836 23,014 26,727 88,470 153 Sent from Mail for Windows 10 From: Carter Mecher Sent:Monday,February 17, 2020 9:04 PM To: Caneva, Duane ; Tracey McNamara; Dr. Eva KLee; ~b)(6) li}gmail.com Cc: mail.com b)(B) mail.com > ; Dodgen, Daniel (OSI ASPR/SPPR); DeBord, Kristin (OSI ASPR/SPPR); Phillips, Sally AMERICAN PVERSIGHT (b)(B) HHS-20-0580-B-000121 (OSI ASPR/SPPR); David Marcozzi; Hepburn, Matthew J CIV USARMY (USA); Lisa Koonin; Wargo Michael; Walters, William (STA TE.GOV) : HARVEY. MELISSA; WOLFE. HERBERT; Eastman, Alexander; EV ANS, MARIEFRED; Callahan, Michael V .oM.D.; (b)(6 ) UTMB.EDU; b)(6) email.unc .edu ? Johnson. Robert (OS/ASPR/BARDA); Yeskey, Kevin; Disbrow, Gary (OS/ASPR/BARDA); Redd, John (OSI ASPR/SPPR); Hassell, David (Chris) (OS/ASPR/IO); Hamel. Joseph (OS/ASPR/IO): Dean, Charity A@CDPH; Richard Hatchett; Lawler, James V; Kadlec. Robert (OS/ASPR/IO); 'Martin. Gregory J (MartinGJ @state.gov)'; Borio, Luciana; Hanfling, Dan; McDonald. Eric; Wade, David; TARANTINO, DAVID A; WILKINSON, THOMAS; David Gruber (david.gruber@dshs.texas ~;KAUSHIK, SANGEETA; Nathaniel Rupert Subject: RE: Red Dawn Breaking, COVID-19 Collaborative, Feb 16 strui AMERICAN PVERSIGHT HHS-20-0580-B-000122 I tinkered with the strategy for integrating outpatient clinics and hospitals for the care of COVID-19 patient s. Propo sing this for my system. Sent from Mai l for Window s 10 From: Carter Mecher Sent : Monday , February 17, 2020 7: 17 PM To: Caneva. Duane; Tracey McNamara; Dr. EvaKLee; l(b)(B) @gmail.com Cc: (b)(B) ail.com mail.com> ; Dodgen, Dan iel (OSI ASPR/SPPR); DeBord, Kristin (OS/ASPR/SPPR); Phillips, Sally (OSI ASPR/S PPR); David Marcozzi; Hepburn, Matthew J CIV USARMY (USA); Lisa Koonin; Wargo Michael; Walters. William (STA TE.GOV) ; HARVEY, MELISSA ; WOLFE, HERBERT; Eastman. Alexander; EV ANS, MARIEFRED ; (b)(B) AMERICAN PVERSIGHT HHS-20-0580-B-000123 Callahan, Michael V.,M .D.; (bl(6 l UTMB.EDU; b)(Bl email.unc.edu ? Johnson, Robert (OS/ASPR/BARDA); Yeskey, Kevin; Disbrow, Gary (OS/ASPR/BARDA); Redd, John (OS/ASPR/SPPR); Hassell, David (Chris) (OS/ASPR/IO); Hamel, Joseph (OS/ASPR/IO); Dean, Charity A@CDPH; Richard Hatchett; Lawler, James V; Kadlec, Robert (OS/ASPR/IO); 'Martin, Gregory J (MartinG J@state.gov )'; Borio. Luciana; Hanfling, Dan; McDonald, Eric; Wade, David; TARANTINO. DA YID A; WILKINSON. THOMAS; David Gruber (david .gruber @dshs.texas ,?.QY}; KAUSHIK, SANG EETA; Nathaniel Rupert Subject: RE: Red Dawn Breaking, COVID-19 Collaborative, Feb 16 start More details on evacuation of American passengers aboard the cruise ship. Total evacuated: 177 + 151 = 328 AMERICAN PVERSIGHT HHS-20-0580-B-000124 https:/ /www.usatoday.com/ story/travel/cruises/2020/0 2/17 /coronavirus-diamondprincess-evacuees-testpositi ve-allowed-flyunited-states /4 783 787002/ Fourteen evacuees from the Diamond Princess cruise ship quarantined in Japan were allowed to fly back to the United States Sunday despite testing positive for coronavirus, the U.S. State Department and Health and Human Services said in a joint statement. The evacuees were not symptomatic . "These individual s were moved in the most expeditious and safe manner to a speciali zed containment area on the evacuation aircraft to isolate them in accordance with standard protocols ," the statement, published Sunday, read. The State Departme nt was unaware the individuals had coronaviru s when they were bein g removed from the ship; they had tested negative ju st a few days before, Robert Kadlec, the assistant secretary for prepared ness and respon se at the U.S. Department of Health AMERICAN PVERSIGHT HHS-20-0580-B-000125 &Human Services , said on a phone call with reporters. "If those results had come back four hours earlier before we'd started to disembark the ship and before these people were evacuees within an evacuation system , then it would've been a different discussion." Dr. William Walters, director of operational medicine at the U.S. Department of State , said on the call. Kadlec said that individuals received multiple screenings when moving from ship to bus to plane and a more extensive medical assessment upon arrival. Two charter flights carrying the Diamond P1incess passengers landed at military bases in California and Texas overnight , starting the clock on a 14-day quarantine period to ensure those passengers don 't have coronavirus . In total, approximately 380 Americans were on board the Diamond P1incess ship for the duration of the cruise and quarantine at sea. 'Something went awry': Why did US break Diamond Princess coronav irus quarantine? AMERICAN PVERSIGHT HHS-20-0580-B-000126 One plane carrying American passengers touched down at Travis Air Force Base in northern California just before 11:30 p.m. Sunday local time. A second flight arrived at Lackland Air Force Base in Texas around 2 1/2 hours later, early Monday. The California flight had 177 people on it, seven of whom tested positive for coronavirus, Walters said. An additional three people were isolated during the flight for fever. Upon arrival, 171 stayed in Travis while six traveled to Omaha. It's unclear which passengers were transferred there and whether initial tests were positive or whether they were at risk for the virus. The Texas flight had 151 people board and included the other seven who tested positive for coronavirus. Two additional passengers were isolated on account of fever. All passengers who tested positive for coronavirus then moved on to Omaha. The aircraft design allowed passengers to sit in isolation thanks to a plastic divider at the tail of the aircraft . AMERICAN PVERSIGHT HHS-20-0580-B-000127 13 high-risk passengers await test results at Nebraska Medical Center Officia ls from the University of Nebraska Medical Center and Nebraska Medicine confirmed that they are assessing 13 adults at their quarantine and biocontainment facility in Omaha . "Late last night at about 2 or 3 a.m., we were asked to bring some individuals here who had either tested positive or had a high likelihood of testing positive because of symptoms they were exhibit ing," said Dr. Chris Kratochvil , the executive director at the University of Nebraska Medica l Center's Global Center for Health Security. Twelve of them are housed in the quarantine center while one man was transferred to the hospital's biocontainment unit for testing and observation because of symptoms including cough, fever, shortness of breath , lightheadedness and an undisclosed chronic condition that would make AMERICAN PVERSIGHT HHS-20-0580-B-000128 him particularly vulnerable to the COVID-19 virus. "He is doing good and in stable condition at this time," reported Shelly Schwedhelm, Nebraska Medicine's executive director of emergency management and biopreparedness. She went on to note that "the folks in the quarantine center have all been tested, and we're waiting for those results ." She added that the other 12 are isolated in "very nice rooms with WiFi, TV and a small refrigerator - a lot of the amenities at hotels but with engineering controls" to prevent contaminated air from escapmg. Their test results, which are due back Monday afternoon, will determine whether the patients will be allowed to see their spouses or leave their rooms. Regardless of whether they test positive or negative , all of the new arrivals will spend at least 14 days in the facility , and any who test positive will likely stay longer, said Dr. Mike Wadman, the co-medical director of the National Quarantine Unit. AMERICAN PVERSIGHT HHS-20-0580-B-000129 Kratochvil says it's possible that they may be asked to take more patients should more of the Diamond Princess passengers now m quarantine at the airbases test positive. Dr. Anthony Fauci , director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, told the USA TODAY editorial board and reporters Monday that the original idea to keep people safely quarantined on the ship wasn't umeasonable. But even with the quarantine process on the ship, virus transmission still occurred. "The quarantine process failed," Fauci said. "I'd like to sugarcoat it and try to be diplomatic about it, but it failed. People were getting infected on that ship. Something went awry in the process of the quarantining on that ship. I don't know what it was , but a lot of people got infected on that ship." USA TODAY reached out to Princess Crnises for clarification on how many Americans from the ship have the vims. AMERICAN PVERSIGHT HHS-20-0580-B-000130 Sent from Mail for Windows 10 From : Caneva. Duane Sent: Monday , February 17, 20204 :51 PM To: Carter Mecher; Tracey McNamara; Dr. EvaKLee ; ~b)(Bl ~gmail.com C cj (bl(6 l @gmail.com l(b)(6) @gmail.com>; Dodgen. Dan iel (OS/ASPR/SPPR); DeBord, Kristin (OSI ASPR/SPPR); Phillips. Sally (OS/ASPR/SPPR); David Marcozzi; Hepburn, Matthew J CIV USARMY (USA); Lisa Koonin; Wargo Michael; Walters, William (STATE.GOV) ; HARVEY. MELISSA; WOLFE. HERBERT; Eastman, Alexander; EV ANS, MARIEFRED; Callahan, Michael V .oM.D.; fbl(6 l @UTMB. EDU; l(b)(6) @email.unc.edu; Johnson, Robert (0S /ASPR/BARDA); Yeskey, Kevin; Disbrow, Gary (OSI ASPR/BARDA) ; Redd, John (OS/ ASPR/SPPR); Hassell. David (Chris) AMERICAN PVERSIGHT HHS-20-0580-B-000131 (OS/ASPR/IO) ; Hamel, Joseph (OS/ASPR/IO); Dean, Charity A@CDPH; Richard Hatchett; Lawler, James V; Kadlec. Robert (OS/ASPR/IO) ; 'Martin. Gregory J (MartinG J@state.gov )'; Borio. Luciana; Hanfling. Dan; McDona ld, Eric; Wade, David; TARANTINO, DA YID A; WILKINSON, THOMAS; David Gruber (david .gruber@dshs.texas ,.g,QY}; KAUSHIK, SANGEETA; Nathaniel Hupert Subject: Re: Red Dawn Brea king , COVID-19 Collaborati ve, Feb 16 start + Bob Gla ss Get Outlook for iOS From: Carter Mecher Sent: Mond ay, February 17, 2020 4:47:38 PM To: Trac ey McNamara '4b )(6) @westemu.ed !!.>;Dr . Eva K Lee Cc: l(b)(6) ti)gmail.com ; Canev a, Duane AMERICAN PVERSIGHT HHS-20-0580-B-000132 ; Dodgen, Daniel (OS/ASPR/SPPR) ; DeBord , Kristin (OS/ASPR/SPPR) ; Phillips , Sally (OS/ASPR/SPPR) ; David Marcozzi 4(b)(5) @som.umaryl and.edu>; Hepburn , Matthew J CIV USARMY (USA) ; Lisa Koonin 1'b )(6) @gmail.com> ; Wargo Michael ; Walters, William (STATE .GOV) ; HARVEY , MELISSA ; WOLFE , HERB ERT ; Eastman, Alexander ; EVANS , MARI EFRED ; Callahan , Michael V.,M.D. 1b )(6) @mgh. harvard.edu>; b)(6 ) UTMB .EDU (b)(6) email.unc.edu>; Johnson, Robert (OS/ASPR/BARDA) ; Yeskey, Kevin ; AMERICAN PVERSIGHT HHS-20-0580-B-000133 Disbrow , Gary (OS /ASPR/BARDA) ; Redd , John (OS /ASPR/SPPR) ; Ha ssell , David (Chris) (OS /ASPR/IO) ; Hamel , Joseph (OS /ASPR/ IO) ; Dean , Charity A@CDP H ; Richard Hatchett ; Lawler , James V fb )(6) @unmc.edu > ; Kadlec , Robert (OS /ASPR/IO) ; 'Martin , Gregory J (MartinGJ@state.gov )' ; Borio , Luciana ; Hanfling, Dan ; McDonald , Eric ; Wade, David ; TARANTINO , DAVID A ; WILKINSON , THOMAS ; David Gruber (david. gruber@dshs. texas. gQy) ; KAUSHIK., SANGE ETA ; Nathaniel Rupert b)(6) med.cornell.ed u> Subject: RE: Red Dawn Breaking, COVID-19 Collaborative, Feb 16 start CAUTION: This email originated from outside of DHS. DO NOT click links or open attachments unless you recognize and/or trust the sender. Contact your component SOC with questions or concerns. A co1Tection. Should not have included breakdown of hospitalized since we have spotty data 9or could have used a range). Only solid data we have is number confirmed (58), number in hospital (44), and number in ICU (2:1). Mix of hospital patients is unknown (from the Singapore data the ratio of hospitalized to ICU has ranged from 6: 1 to 13: 1 from two data points). So estimates of severity looking only at the American passengers: ~400 total American passengers 58 confirmed to have COVID-19 AMERICAN PVERSIGHT HHS-20-0580-B-000135 12 Asymptomatic (20%) 46 Symptomatic (80%) (44 cases actually hospitalized) -2%of total cases requiring ICU admission ( 1 case) Expected mortality for patients with pneumoma admitted to ICU (1550%); assummg 2% of those who become infected with COVID-19 require ICU care, these mortality rates equate to a CFRof 0.3%-1. 0% Sent from Mail for Windows 10 From: Carter Mecher Sent:Monday,February 17, 2020 4 : 15 PM AMERICAN PVERSIGHT HHS-20-0580-B-000136 To : Tracey McNamara; Dr. Eva K Lee Cc : b)(6) mail.com mail.com > ; Caneva, Duane; Dodgen, Daniel (OSI ASPR/SPPR); DeBord, Kristin (OSI ASPR/SPPR); Phillips, Sally (OS/ASPR/SPPR); David Marcozzi; Hepburn, Matthew J CIV USARMY (USA); Lisa Koonin; Wargo Michael ; Walters, William (STATE.GOV) ; HARVEY, MELISSA; WOLFE, HERBERT; Eastman, Alexander; EV ANS, MARI EFRED; Callahan, Michael V.,M .D.; b)(6) UTMB. EDU; b)(B) email.unc.edu; Johnson, Robert (OSI ASPR/BARDA) ; Yeskey, Kevin; Disbrow, Gary (OSI ASPR/BARDA); Redd, John (OS/ASPR/SPPR); Hassell, David (Chris) (OS/ASPR/IO) : Hamel, Joseph (OS/ASPR/IOt Dean, Charity A@CDPH; Richard Hatchett; Lawler, James V; Kadlec, Robert (OSI ASPR/IO) : 'Martin, Gregory J (MartinGJ @state.gov)'; Borio, Luciana; Hanfling, Dan; McDonald, Eric; Wade, David; TARANTINO, DA YID A; WILKINSON, b)(B) AMERICAN PVERSIGHT HHS-20-0580-B-000137 THOMAS; David Gruber (david. gruber@dshs. texas ~;KAUSHIK, SANGEETA; Nathaniel Rupert Subject: RE: Red Dawn Breaking, COVID-19 Collaborative, Feb 16 start Latest data from Singapore (77 cases; 4 children, 2 are asymptomatic) and Hong Kong (60 cases; no children) More puzzle pieces. Singapore status: https://protect2.firee ye.com/url?k=f6750fe4aa211698-f6753edb0cc47adc5fa27 6d29cc40fd8c03 f&u=http s://www.moh.gov.sg/newshighligh ...tion-confirmed Update on condition of confirmed cases To date, a total of 24 cases have fully recovered from the infection and have been discharged from hospital. Of the 53 confirmed cases who are still in hospital, most are stable or AMERICAN PVERSIGHT HHS-20-0580-B-000138 improving. Four are in critical condition in the intensive care unit. [Ratio of hosp italized to ICU of53 14 or - 13:1] Con sistent with estimate s in earl ier ema il. [On Feb12 Singapore reported that 8 patient s were in ICU. ] Sent from Mail for Windows 10 From: Carter Mecher Sent:Monday , February 17, 2020 2:57 PM To: Tracey McNamara; Dr. EvaK Lee Cc: Caneva, Duane; Dodgen, Dan iel (OSI ASPR/SPPR); DeBord, Kristin (OSI ASPR/SPPR); Phillips, Sally (OSI ASPR/SPPR); David Marcozzi; Hepburn, Matthew J CIV USARMY (USA); Lisa Koonin; Wargo Michae l; Walters, William (STA TE.GOV) ; HARVEY, l\1ELISSA; WOLFE, HERBERT ; Eastman, Alexander; EV ANS, MARIEFRED; Callahan, Michae l AMERICAN PVERSIGHT HHS-20-0580-B-000139 V .oM.D.; lyUTMB.EDU; l(b)(6) lyemail.unc.edu; Johnson, Robert (OS/ASPR/BARDA); Yeskey, Kevin; Disbrow, Gary (OS/ASPR/BARDA); Redd, John (OS/ASPR/SPPR); Hassell. David (Chris) (OS/ASPR/IO); Hamel. Joseph (OS/ASPR/IO); Dean, Charity A@CDPH; Richard Hatchett; Lawler, James V; Kadlec, Robert (OS/ASPR/IO); 'Martin, Gregory J (MartinGJ@state.gov)'; Borio, Luciana; Hanfling. Dan; McDonald. Eric; Wade, David; TARANTINO, DA YID A; WILKINSON. THOMAS; David Gruber (david.gruber@dshs.texas ~;KAUSHIK, SANGEETA; Nathaniel Hupert; l(b)(6) @gmail.com l(b)(B) Subject: RE: Red Dawn Breaking, COVID-19 Collaborative, Feb 16 start Trying to estimate severity by bringing a number of pieces together. AMERICAN PVERSIGHT HHS-20-0580-B-000140 The Diamond Princess Cruise Ship had a crew of 1,745 and 2,666 passengers (total pf 3,711) Approximately 400 of the passengers are Americans (11 %). Several days ago (Feb-13) we attempted to estimate disease severity using the current data being reported by the media (number of confirmed cases and ICU cases) as well as data on the outbreak in Singapore (number of confirmed cases, number hospitalized, and number in ICU) (see attached Word file) . Given the additional information becoming available (including more specific information being reported by the media on the numbers of Americans infected), I was interested in an updated crude estimate of severity (and to see how well the early predictions of severity matched with what was being reported by the media on illness in the Americans . See latest re the crnise ship outbreak below (two stories). We can glean from these stories that the number infected is now up to 454. And 14 positive passengers were included among the Americans who were evacuated to the US . Canada, South Korea, AMERICAN PVERSIGHT HHS-20-0580-B-000141 Italy and Hong Kong announced Sunday that they would also arrange charter flights to evacuate their citizens. A few additional piece s of data. News report s yesterday stated that 73 of the 355 confirmed cases from the cruise ship were asymptomatic (20%) . Also, yesterday the media quoted Dr. Fauci that the total number of American s who were confirmed to have COVID yesterday and who remained at hospitals in Japan at 44. Assuming that thi s number does not include the 14 confirmed cases that were evacuated , sugge sts that the total number of American s with confirmed COVID is 58. An earlier news report from Feb - 12 re a couple from California , noted the husband was in the ICU in Japan (so at least 1 American in the ICU). [" .. .remained in a hospital intens ive care unit and has been able to communicate with his family, his wife said in a phone interview from the ship , where she rema ined in quarantine. " https ://protect2. fireeye. co m/url?k =5b014cc3075555bf-5b017dfc0cc4 7adc 5fa25be62cfl a8 l 6fc6d&u= http s ://web.archive .org/web/20 200212093 725/https ://ww w.ocregister .com/2020/02 / AMERICAN PVERSIGHT HHS-20-0580-B-000142 11/southem-califomiaman-on-cruise-sent-to -ahospital-in-tokyo-with-ahigh-fever-tested-forcoronavirus / ] So, piecing all the data together: The ~400 Americans account for 11% of the 3,711 passengers and crew of the Diamond Princess. The 58 confirmed cases among Americans account for 12% of the 454 total confirmed COVID cases Assuming that proportion of asymptomatic cases in Americans is similar to the proportion of asymptomatic cases for the entire ship (73/355 or 20%), we would estimate the number of Americans with asymptomatic infection at ~ 12. Symptomatics would be 46. If 2% of cases result in ICU admission (based on earlier estimates on Feb-12 where 4 ICU cases were reported with 203 total confirmed cases), we would expect ~9 ICU cases overall with 454 infected. Media reports from today note 19 of the passengers are "seriously ill, with some of whom treated in intensive care units." AMERICAN PVERSIGHT HHS-20-0580-B-000143 (Would be helpful to quantify "some" - from the earlier data, we would estimate about half that number would require ICU care at some point). For the 54 Americans confirmed to have COVID, we would estimate 1 would require ICU care if2% of cases required ICU care (we are already aware of at least 1 American who was receiving ICU care in Japan). So estimates of severity looking only at the American passengers: ~400 total American passengers 58 confirmed to have COVID-19 12 Asymptomatic (20%) 46 Symptomatic (80%) ~55% of total cases mildly ill (hospitalized for isolation only) (31 cases) ~25% of total cases acutely ill requiring inpatient care (15 cases) ~2% of total cases requiring ICU admission ( 1 cases) AMERICAN PVERSIGHT HHS-20-0580-B-000144 E X p e C t e d m 0 r t a I t y f 0 r p a t e n t s w t h p n e u m 0 n a AMERICAN PVERSIGHT HHS-20-0580-B-000145 a d m I t t e d t 0 I C u ( 1 5 5 0 % ) a s s u m n g 2 % 0 f t h 0 s AMERICAN PVERSIGHT HHS-20-0580-B-000146 e w h 0 b e C 0 m e n f e C t e d w I t h C 0 V I D I 9 r e q u r e I C AMERICAN PVERSIGHT HHS-20-0580-B-000147 u C a r e t h e s e m 0 r t a 1 t y r a t e s e q u a t e t 0 a C F R AMERICAN PVERSIGHT HHS-20-0580-B-000148 0 f 0 3 % l 0 % Those estimates fit pretty well with the estimates from Feb-13. To firm up these numbers it would be useful to have actual numbers from Japan on ICU admissions, number requiring mechanical ventilation, number in the hospital because they are acutely ill, and number in the hospital because of isolation only (mildly ill or asymptomatic). Also would be helpful to have more granular information on the Americans (hospital data in Japan including number acutely ill, number needing ICU admission, and number only in the hospital for isolation). Would also be critical to gather /compile the same information from Canada, South Korea, Italy , Hong Kong, and other nations as they also evacuate their citizens . The cruise ship is a circumscribed population where it is possible to get a AMERICAN PVERSIGHT HHS-20-0580-B-000149 handle on severity fairly early in an epidemic. The limitation though, is the population on board that ship is elderly (so need to be careful about generalizing to the entire population). But it is the best data we have. The reason why this is so important is decisions re the implementation of NPis depend upon severity (the more severe the more intense the NPis). The sooner we have a more accurate assessment of severity, the better for making plans for NPis. Story #1 https: //protect2. fireeye. co m/url?k=fb4el b73a71 a020f- fb4e2a 4c0cc47 adc 5fa26b70ca76908c81a4&u =htt ps://www3.nhk.or.jp /news/ html/20200217 /k 10012289 341000.html?utm int=new s contents newsmain 001 Translation New virus cruise ship confirmed 99 new AMERICAN PVERSIGHT HHS-20-0580-B-000150 infections February 17, 2020 18:54 A new outbreak of the coronavirus was confirmed on February 17, with 99 new passengers and crew members infected on a cruise ship. As a result, 454 passengers and crew members of cruise ships have been infected , of which 19 are severely affected. According to the Ministry of Health, Labor and Welfare , a total of 99 new passengers , including 85 passengers and 14 crewmembers , were revealed on March 17 on the cruise ship "Diamond P1incess" anchored in Yokohama Port. Among them, there are 43 Japanese. This means that a total of 1723 passengers and crew members were inspected on the cruise ship, and a total of 454 infections were confirmed. According to the Ministry of Health, Labor and Welfare, 19 of the confirmed individuals are seriously ill, some of whom are being treated in intensive care units. According to the Ministry of Health, Labor and AMERICAN PVERSIGHT HHS-20-0580-B-000151 Welfare, the Ministry of Health, Labor and Welfare said that infections were confirmed one after another on cruise ships. Need to be analyzed quickly." The Ministry of Health, Labor and Welfare has a policy to conduct a virus test on all passengers and crew members remaining on board, and those who have a negative result will be asked to leave the ship after the 19th. Story #2 Fourteen people who were evacuated from the Diamond Princess cruise ship and flown back to the Un ited States on charter flights tested positive fomo vel coronavirus, according to a joint statement from the US Departments of State and Health and Human Services. The passengers are among the more than 300 people removed from the ship, which is docked off the Japanese port city of Yokohama, Sunday night AMERICAN PVERSIGHT HHS-20-0580-B-000152 and flown to military bases in the United States. US officials were notified that they had tested positive for coronavirus during the evacuation process, after passengers had disembarked the ship, the agencies said in the joint statement Monday. The passengers had been tested two to three days before the evacuation flights, the statement said. "After consultation with HHS officials , including experts from the HHS Office of the Assistant Secretary for Preparedness and Response , the State Department made the decision to allow the 14 individuals, who were in isolation , separated from other passengers , and continued to be asymptomatic , to remain on the aircraft to complete the evacuation process ," the agencies said. One charter flight caITying evacuated Americans arrived at Travis Air Force Base near Fairfield, California, around 11:28 p.m. local time Sunday. A second arrived at Joint Base San AntonioLackland in San Antonio , Texas at 3:56 a.m. local time Monday. The passengers who tested positive were isolated from AMERICAN PVERSIGHT HHS-20-0580-B-000153 the other passengers during the flights, the statement said. And all passengers are being "closely monitored" throughout the flight. "Any who become symptomatic will be moved to the speciali zed containment area, where they will be treated," the statement said. After the flights land, any passengers that developed symptoms on the flights and those who had already tested positive will be transported to "an appropriate location for continued isolation and care." The remaining passengers will remain under quarantine for 14 days. Passengers arriving to Travis Air Force Base will be housed in the same facility as evacuees who arrived from Wuhan earlier this month, a spokesperson for the base told CNN. New evacuees will be kept in a separate area of the Westwind Inn on the base, the spokesperson said. Before the announcement about the infected flight passengers, some Americans aboard the Diamond Princess said they didn't want to take a chance being evacuated for AMERICAN PVERSIGHT HHS-20-0580-B-000154 fear they would be subject to possible infection. Sacramento resident Matthew Smith told CNN affiliate KOVR that he would rather deal with issues in Japan than be evacuated and quarantined in the United States. "We decided we would just face whatever consequences here rather than exposing ourselves to that situation," Smith told the affiliate. "It kind of didn't make any sense if the us was fearful that these were infected people which is why they're going to quarantine them for another 2 weeks to have thrown them all together" Smith's wife Katherine Codekas was met with some surprise when she told authorities that she and her husband weren't going to go with the other American evacuees , KOVR reported. "They came back around again and I said no we're not going and they very sincerely wished us luck but there was a little look of surprise on their face," Codekas explained to the affiliate. "You know, it's not like we're the last helicopter off the roof top in Ho Chi Mihn City," she told AMERICAN PVERSIGHT HHS-20-0580-B-000155 KOVR. "We're on a boat and we're watching people go away and people just make different choices about how they want to confront the viru s." Sent from Mail for Windows 10 From: Carter Mecher Sent:Monday , February 17, 2020 11:00 AM To: Tracey McNamara; Dr. EvaKLee Cc: Caneva, Duane; Dodgen, Dan iel (OSI ASPR/S PPR); DeBord, Kris tin (OSI ASPR/SPPR); Philli ps, Sally (OSI ASPR/S PPR); David Marcozzi; Hepburn, Matthew J CIV USARMY (USA) ; Lisa Koonin; Wargo Michael; Wal ters, William (STA TE.GOV) ; HARVEY, MELISSA ; WOLFE, HERBER T; Eastman, Alexander; EV ANS, MARIEFRED ; Callahan, Michae l V.,M.D.; (b)(6) UTMB.E DU; b)(B) email.unc .edu ? Johnson, Robert AMERICAN PVERSIGHT HHS-20-0580-B-000156 (OS /ASPR/BARDA); Yeskey, Kevin; Disbrow, Gary (OS /ASPR/BARDA); Redd, John (OSI ASPR/SPPR); Hassell, David (Chris) (OS/ASPR/IO); Hamel, Joseph (OS/ASPR/IO); Dean, Charity A@CDPH; Richard Hatchett; Lawler, James V; Kadlec, Robert (OS /ASPR/IO); 'Martin, Gregory J (MartinGJ@state.gov)'; Borio, Luciana; Hanfling, Dan; McDonald, Eric; Wade, David; TARANTINO. DA YID A; WILKINSON. THOMAS; David Gruber (david .gruber@dshs .texas g_Q_y}; KAUSHIK, SANGEETA; Nathaniel Hupert Subject: RE: Red Dawn Breakin g, COVID -19 Collabo rative, Feb 16 start Attached is Bob Glass ' original paper- his coauthor was his high-school age daughter. Her e is a link to anothe r paper. Glass RJ, Gla ss LM, Beyeler WE, Min HJ. AMERICAN PVERSIGHT HHS-20-0580-B-000157 Targeted social distancing designs for pandemi c influenz a. Emerg Infect Dis [serial on the Internet]. 2006 Nov [date cited] . http://dx.doi.org / 10.320 l /e idl211.060255 Sent from Mail for Window s 10 From: Carter Mecher Sent : Mond ay,F ebruary 17, 2020 9:59 AM To: Tracey McNamara; Dr. EvaKLee Cc: Caneva, Duane; Dodgen, Daniel (OS/ASPR/SPPR); DeBord. Kristin (OS/ASPR/SPPR); Phillips. Sally (OS/ASPR/SPPR); David Marcozzi; Hepburn. Matthew J CIV USARMY (USA); Lisa Koonin; Wargo Michael; Walters, William (STA TE.GOV) : HARVEY. MELISSA; WOLFE. HERBERT; Eastman, Alexander; EV ANS. MARIEFRED; Callahan, Michael V .oM.D.; l(b)(6) @UTMB.EDU; rb )(6) @email.unc.edu; AMERICAN PVERSIGHT HHS-20-0580-B-000158 Johnson, Robert (OSI ASPR/BARDA) ; Yeskey, Kevin ; Disbrow, Gary (OSIASPR/BARDA); Redd, John (OSI ASPR/SPPR); Hassell, David (Chris) (OSIASPR/IO) ; Hamel, Josep h (OS/ASPR/IO); Dean, Charity A@CDPH ; Richard Hatchett; Lawler, James V; Kadlec, Robert (OSI ASPR/IO) ; 'Martin. Gregory J (MartinGJ @state.gov)'; Borio, Luciana; Hanfling, Dan ; McDona ld, Eric ; Wade. Dav id; TARAN TINO. DA YID A; WILKINSON, THOMAS ; Dav id Gruber (david.gruber@dshs.texas ,.g,QY}; KAUSHIK. SANG EETA; Nathaniel Rupert Subject: RE: Red Dawn Breaking , COVID-19 Collaborative , Feb 16 start This is the original graph of Bob Glass' data. He modeled the various intervention s alone or in combination. Along one axis are the social distancing measures from doing nothing , to just closing school s but AMERICAN PVERSIGHT HHS-20-0580-B-000159 allowing kids to mix in the community, to social distancing of kids in the community but keeping schools open , to only social distancing of adults in the community, to closing schools and adults social distancing , to kids and adults social distancing in the community , to closing schools and social distancing of kids in the community, to a combo of all 3. Along the other axis are other interventions including doing nothing, to quarantine (Q), treatment of the ill with antivirals (T) , prophylaxis of contacts (P), and various combinations. We observed what we called a "cliff effect" or phase transition or a discontinuity once you closed schools and implemented social distancing among kids. The effect was nonlinear and dramatic. As a consequence we began a deep dive to better understand the school environment (including the transportation system half the school age kids use each day) and school age kids. An unsung hero in all this was Lisa Koonin (who was at CDC at the time). If Richard birthed TLC , Lisa kept the baby alive in the neonatal ICU. AMERICAN PVERSIGHT HHS-20-0580-B-000160 We still have much to learn about this virus. Thus far, it seems to be sparing kids (just like SARS). We have been monitoring the reports from China as well as the detailed data we can see from Hong Kong, Singapore, and Japan-the numbers of kids remain very low and disease appears to be mild. Nonetheless, TLC (and the NPis) is focused on reducing disease transmission (effectively decreasing Ro )-the interventions are really agnostic to severity. It is why CDC had to scale the implementation of TLC (later called CMG) to severity . Despite the absence of severe disease in kids, we really are still in the dark in terms of the amount of asymptomatic disease or mild sub-clinical disease in kids because we just haven't been able to look. I never forgot this graph of the data from Bob Glass and the inflection point that was observed when the combo of closing schools and social distancing of kids was implemented in his model. Although closing schools is complicated by its 2nd and 3rd order impacts, it is actually a AMERICAN PVERSIGHT HHS-20-0580-B-000161 pretty clean inter vention in term s of actually pulling the trigger (much cleaner than the other compo nents of TLC). If this outbreak prove s to be as severe as om initial estimate s, we should think long and hard before dismissing the early implementation of this strategy (closing school s and social distancing of kids). Sent from Mai l for Windows 10 From: Carter Mecher Sent:Monday , February 17, 2020 8:57 AM To: Tracey McNamara ; Dr. Eva K Lee Cc: Caneva, Duane; Dodgen. Daniel (OS/ASPR/SPPR); DeBord. Kristin (OSI ASPR/SPPR); Phillips, Sally (OSI ASPR/SPPR); Dav id Marcozz i; Hepburn, Matthew J CIV USARMY (USA); Lisa Koonin; Wargo Michae l; Walte rs, Will iam (STATE.GOV) ; HARVEY, MELISSA; WOLFE. HERBERT ; Eastman, Alexander ; EV ANS, MARIEFRED; AMERICAN PVERSIGHT HHS-20-0580-B-000162 Callahan, Michael V.,M .D.; ~b)(6) lyUTMB.EDU; l(b)(B) @email.unc.edu; Johnson, Robert (OS/ASPR/BARDA); Yeskey, Kevin; Disbrow, Gary (OS/ASPR/BARDA); Redd, John (OS/ASPR/SPPR); Hassell, David (Chris) (OS/ASPR/IO); Hamel, Joseph (OS/ASPR/IO); Dean, Charity A@CDPH; Richard Hatchett; Lawler, James V; Kadlec, Robert (OS/ASPR/IO); 'Martin, Gregory J (MartinG J@state.gov )'; Borio. Luciana; Hanfling, Dan; McDonald, Eric; Wade, David; TARANTINO. DA YID A; WILKINSON. THOMAS; David Gruber (david .gruber @dshs.texas ,?.QY}; KAUSHIK, SANG EETA; Nathaniel Rupert Subject: RE: Red Dawn Breaking, COVID-19 Collaborative, Feb 16 start NPi s are going to be central to our respon se to this outbreak (assuming our estimates of severity prove accurate ). This email group has grown since we began (not quite AMERICAN PVERSIGHT HHS-20-0580-B-000163 epidemic-level growth, but getting there) . Looking ahead, I anticipate we might encounter pushback over the implementation of NPis and would expect similar concerns /arguments as were raised back in 2006 when this strategy first emerged. It was one of the reasons I shared the updated data on US households from American Community Sw-vey, data on USDA programs for nutritional support (including school meal programs), data on schools and enrollment, and even data on juvenile crime. The data that was gathered back in 2006 on social density in various environments (homes , offices /workplaces, schools, daycare, etc., is unchanged). For additional background and context , we attached are 3 papers on NPis and TLC for those who are interested. Richard Hatchett deserves full credit for bi1thing the idea of TLC (it was actually developed in response to the threat of HSN 1 and later adopted for pandemic influenza response). Duane , perhaps you can store these documents on MAX for safe keeping and access? The first paper is an historical review of the 1918 pandemic (the AMERICAN PVERSIGHT HHS-20-0580-B-000164 comparison of Philadelphia and St. Louis is emblematic of the lesson from 1918 that timing matters when deploying NPis - need to be early) . The second paper is modeling work that was done to evaluate these strategies. At the time, modelers were focused on how best to contain an outbreak overseas (really focusing on using antivirals primarily for treatment and prophylaxis). They focused their models to evaluate the effectiveness of various strategies and quantities of antiviral medications required to quench an emerging outbreak. There were 3 groups who were doing this work back then. They each present their data in that paper. A few things to note. In all the model runs, they did not model perfection or 100% adherence (actually far from it). You will see scenarios from 30/60 (meaning 30% compliance and 60% ascertainment) on up to 90/80 ). (See figures 1) Even leaky implementation can reduce overall attack rates. The modelers also looked at timing of implementation (see figure 3). At the time there was a great deal of skepticism - was hard for people to believe this was AMERICAN PVERSIGHT HHS-20-0580-B-000165 possible. Or even if TLC could be effective, was implementation practical given the challenges trying to implement and the 2nd and 3rd order consequences (especially of closing schools). But the modeling data combined with the historical data was the tipping point. Marty Cetron from CDC and Howard Markel from U of Michigan, published a more extensive historical review of the 1918 pandemic showing much the same. Since then, a group within CDC continued to work on this (collecting additional data from the 2009 pandemic and elsewhere). They published an update of CMG in MMWR in 2017. https://protect2.firee ye.corn/url?k=3985fc8765d le5fb-3985cdb80cc47adc5fa2bb4a28993b5aa9e0&u =htt ps://www.cdc.gov /media/d pk/cdc-24-7 /preventingpandemicinfluenza/ communitymitigation-guidelines-forpreventing-pandemicflu.html The third paper, is a more recent paper (from 2017) that Richard shared with me. The paper is a little dense, but AMERICAN PVERSIGHT HHS-20-0580-B-000166 I found this paper useful because it provides a vocabulary for strategies that we have raised (Symptom Monitoring vs Quarantine of potentially infected but symptom-free contacts during an epidemic). This paper identifies those conditions where SM or Q is preferred. Figure 1 is useful for understanding the challenges given the picture that seems to be emerging with this virus. This outbreak seems closer to pandemic flu than SARS in terms of transmission dynamics (and hence the NPis we would need to employ) . Lastly, another person, Bob Glass at Los Alamos, also did work on this separately from the MIDAS group. He actually began this work as part of a science fair project for his daughter (using social contacts of his daughter and her classmates at school to model disease transmission). He knew someone at VA who forwarded his work to us (chain of transmission). Early on (even before the MIDAS group modeled TLC), we had a "Eureka" moment when we graphed his data in Excel (I can share that single graph to anyone interested). Bob Glass was also interested in trying to AMERICAN PVERSIGHT HHS-20-0580-B-000167 determine when you could let up on the NPis during a pandemic. Here is a story about Bob Glass and that work published in Fast Company https ://protect2. fireeye. co m/url ?k= 3 862f8 806436e1fu -3862c9b~ 0cc4 7adc 5fa29ce5 af3 l e3c2cd64&u=http s://www .fastcompany.com/ 3058542 /the-scientists who-si mulate-the-e nd-ofthe-wor ld I will see if I can find his work on when to reopen school s. Decisions in term s of letting up on NPis could be critical down the line. Sent from Mai l for Windows 10 From: Tracey McNamara Sent:Sunday, February 16, 2020 7: 10 PM To: Carter Mecher ; Dr. EvaKLee Cc: Caneva, Duane; Dodgen. Daniel (OS/ASPR/S PPR); DeBord. Kristin (OS/ASPR/SPPR) ; Phillips. Sally (OS/ASPR/S PPR); David Marcozz i; Hepburn. Matthew J CIV USARMY (USA); Lisa AMERICAN PVERSIGHT HHS-20-0580-B-000168 Koonin; Wargo Michael; Walters, William (STATE.GOV) : HARVEY, MELISSA; WOLFE, HERBERT; Eastman, Alexander; EV ANS, MARIEFRED; Callahan, Michael V.,M.D.; l(b)(6) @UTMB.EDU; l(b)(6) ~email.unc.edu; Johnson, Robert (OS/ASPR/BARDA); Yeskey, Kevin; Disbrow, QfilY (OS/ASPR/BARDA); Redd, John (OS/ASPR/SPPR); Hassell, David (Chris) (OS/ASPR/IO); Hamel, Joseph (OS/ASPR/IO); Dean, Charity A@CDPH; Richard Hatchett; Lawler, James V; Kadlec, Robert (OS/ASPR/IO): 'Martin, Gregory J (MartinGJ @state.gov)'; Borio, Luciana; Hanfling. Dan; McDonald, Eric; Wade, David; TARANTINO, DAVID A; WILKINSON. THOMAS; David Gruber (david.gruber@dshs.texas ~;KAUSHIK, SANGEETA; Nathaniel Hupert Subject: Re: Red Dawn Breaking, COVID-19 Collaborative, Feb 16 start AMERICAN PVERSIGHT HHS-20-0580-B-000169 Here is the link to a town hall mtg at the Munich Security Conference . Share d by Dr Christian Haggenmill er , Dorector of the German Defe nse Instit ute. https :// p rotect2. fire eye. c om/url?k=ec4e0592b01 a 1cee-ec4e34ad0cc4 7adc5fa2c00af41 a 186719a2&u=h ttps ://secu rityconference .org/en/medialibrary/ass et/town ha 11-on-thecoronav irus-outb rea k20200215-1000/ Tracey Get Outlook for Android From: Dr. Eva K Lee Sent: Sunday, February 16, 2020 3:05:43 PM To: Carte r Mecher Cc: Caneva, Duane ; Dodgen, Daniel (OSIASPR/SPPR) ; DeBord, Kristin (OSIASPR/SPPR) ; Phillips, Sally (OSIASPR/SPPR) ; David Marcozz i ; Hepburn, AMERICAN PVERSIGHT HHS-20-0580-B-000170 Matth ew J CIV USARMY (USA) : Lisa Koonin ~gmail.com>; argo Michael ; Walters , William (STATE.GOV ) ; HARVEY , MELISSA ; WOLF E, HERB ERT ; Eastman , Alexander ; EV ANS , MARI EFRED ; Callahan , Michael V.,M.D. ~(b)(6) @mgh. harvard.edu>; l(b)(6 ) EyUTMB.EDU (b)(B) utmb.edu> ; emai l.unc.edu 1(b)(6) @email.unc.edu>; Johnson , Robert (OS/ASPR/BARDA) ; Yeskey , Kevin ; Disbrow, Gary (OS/ASPR/BARDA) ; Redd , John (OS/ASPR/SPPR) ; Hassell , David (Chris) (OS/ASPR/IO) ; Hamel , Joseph (OS/ASPR/IO) ; Tracey McNamara t )(B) AMERICAN PVERSIGHT HHS-20-0580-B-000171 ~(b)(6) ~westemu.ed !!>; Dean , Charity A@CDPH ; Richard Hatchett ; Lawler, James V 1(b)(6) r)umnc.edu >; Kadlec, Robert (OS/ASPR/IO) ; 'Martin, Gregory J (MartinGJ @state.gov) ' ; Borio, Luciana ; Hanfling , Dan ; McDonald , Eric ; Wade , David ; TARANTINO, DAVID A ; WILKINSON, THOMAS ; David Gruber (david. gruber@dshs. texas. gov) ; KAUSHIK, SANGEETA ; Nathaniel Rupert Subject: RE: Red Dawn Breaking, COVID-19 Collaborative, Feb 16 start Hi Carter, great points. AMERICAN PVERSIGHT HHS-20-0580-B-000172 1. Separate cw-rent ED/ICU patients from COVID-19 is a must. 2. Migrating current ED/ICU (non-COVID) patients to other care sites is great idea. 3. Caring for COVID-19 patients: leveraging ED/ICU personnel for high compliance and usage of limited resources (PPE everything that goes with it) is very critical. Strategic usage and minimizing nonmedical staff is necessary -- either these operators are well-trained and protected, or they cannot be there. 4. Concentrating care within ED/ICU for COVID-19 ensures rapid learning and sharing of knowledge among workers as they take care of these patients. Clearly from the standpoint of data collection and clinical symptoms recording and organization, it is more feasible and allow for immediate analysis and feedback. AMERICAN PVERSIGHT HHS-20-0580-B-000173 5. Strategic prioriti zation of limited resources is extremely important. We must do it now, because the supply chain is already being affected and it can go worse. 6. Primary care and call centers are good. If you want to do strategic testing , this is also a good place to involve. 7. So few children are reported among the confirmed positive cases. They may be good spreaders (not necessarily have to be super) and the more vulnerable people would be ones show up with symptomatic disease characteristics (or no/mild symptoms). Best , Eva evalee-gatech@pm.me https ://newton .isye.gatech. edu/DrLee/ mo b 1'l e: l(b)(6) ~-----~ Sent with ProtonMa il Secure Email. AMERICAN PVERSIGHT HHS-20-0580-B-000174 ------- Original Message On Sunday, Febrnary 16, 2020 4:30 PM , Carter Mecher w r ote: Wanted to bounce something off this group. I have been concerned about some of the preparedness efforts of healthcare systems as they are rampmgup their capabilities to care for patients with COVID-19 presenting anywhere in their system. Staff working in ERs and ICUs are pretty familiar with the care of these types of patients and the use of AMERICAN PVERSIGHT HHS-20-0580-B-000175 appropriate PPE (standard contact and airborne precautions including eye protection) . Th e staff at the hospitals undergo fit testing for respirators , etc. Staff in outpatient clinics ( especially remote community based outpatient clinics) don't typically undergo fit testing for respirators. So ERs and ICUs have muscle memory for isolating patients and providing care to patients with infectious respiratory disease. Com munity based outpatient clinics do not. As part of the preparedness efforts, there has been interest in fit testing AMERICAN PVERSIGHT HHS-20-0580-B-000176 outpatient clinic staff and supplying these clinics with PPE and establishing procedures for evaluating COVID-19 patients in the community based clinics. Given the projected shortages of PPE, that just doesn't seem like the most prudent approach. Rather than expand the care of potential COVID-19 patients to community based outpatient clinics, I would focus on hospital care--ERs and inpatient areas (especially ICUs). I would not pursue fit testing for staff working in outlying clinics. As a strategy, I suggested AMERICAN PVERSIGHT HHS-20-0580-B-000177 dividing COVID patients into two categories( 1) those with illness that is mild enough to be cared for at home (self care or care by other family members); or (2) those who are sick enough to be seen in the ER for possible hospitalization . I would refocus the efforts of outlying clinics away fromCOVID and toward keeping nonCOVID patients with the usual mix of acute and chronic illnesses we see from hypertension to CHF to diabetes, etc., out of the ER and out of the hospital. That is what they can do to help unburden ERs and hospitals for the surge inCOVID AMERICAN PVERSIGHT HHS-20-0580-B-000178 patients in ERs and hospitals. I would leverage telephone care as much as possible to handle patients with mild disease seeking care related to COVID (and quickly develop algorithms to determine who has mild disease and can be managed by telephone at home and who needs to evaluated in the ER). Think of it like the program Lisa developed for pandemic influenza (Nurse On Call) on steroids, minus the antiviral piece. Could we repurpose and leverage that program for COVID? Such a strategy would help to conserve our PPE supply AMERICAN PVERSIGHT HHS-20-0580-B-000179 (avoid the expansion of fit testing and the redirection of already limited supplies of PPE to outlying clinics) and not ask outlying clinics to do something they don't typically do (that usually doesn't out tmn out very well). If the outlying clinics focused on what they normally do (caring for patients with chronic diseases), they could help the ER and hospitals cope with the demands of COVID. I would think about Urgent Care centers in the same way- to help to decompress ERs. I also think that we need to start thinking about strategies to AMERICAN PVERSIGHT HHS-20-0580-B-000180 conserve PPE for hospitals. I'm concerned about the projected burn rates and the supply chains for PPE. Click on Amazon and check out the prices now. Or click on WalMart (can't pick up any masks from WalMart now). I saw one supplier selling 200 surgical masks on WalMart's site for only $459.99. Such a deal. Asa conservation strategy, we might think about limiting the amount of staff interacting with infected patients and cohorting patients (even thinking of strategies to minimize need for housekeeping or food service or lab services from entering AMERICAN PVERSIGHT HHS-20-0580-B-000181 areas with COVID patients--think Ebola-like strategies (not out of concern of disease transmission but simply to limit number of staff to conserve PPE). Could do something similar with ERs (akin to what pediatricians do to separate sick call patients from other appointments). I have recommend prioritizing PPE for EDs and ICUs as well as specific inpatient areas where we would likely initially cohort patients, not pursuing fit testing of outpatient clinic staff, and shifting patients with mildCOVID disease to telephone care and away from AMERICAN PVERSIGHT HHS-20-0580-B-000182 outpatient clinics. I know several of you are part of large healthcare systems. Am curious how others are approaching this challenge. I am also resending the questions I posed for handling sick ER/hospital staff or staff members with a confirmed case of COVID in their household. Carter Sent from Mai l for Windows 10 From: Caneva, Duane Sent: Sunday , AMERICAN PVERSIGHT HHS-20-0580-B-000183 February 16, 2020 3:24 PM To: Dodgen, Daniel (OS/ASPR/S PPR); DeBord. Kristin (OS/ASPR/S PPR); Phillips. Sally (OS/ASPR/S PPR); David Marcozzi; Hepburn. Matthew J CIV USARMY (USA); Lisa Koonin; Wargo Michael; Walters, William (STATE .GO .Y}; HARVEY. MELISSA; WOLFE. HERBERT; Eastman, Alexander ; EVANS. MARIEFRE D; Callahan, Michae l V .oM.D .; ~b)(6) @UT MB.EDU; rb )(B) @ema il .unc .edu; Johnson, Robert (OSIASPRJB AMERICAN PVERSIGHT HHS-20-0580-B-000184 ARDA): Yeskey, Kevin; Disbrow, Gary (OSIASPRJB ARDA) ; Redd, John (OS/ASPRJS PPR); Hassell, David (Chris) (OS/ASPR/1 Q}; Hamel, Joseph (OS/ASPR/1 Q}; Tracey McNamara; Dean, Charity A@CDPH; Richard Hatchett; Lawler, James V; Kadlec, Robert (OS/ASPR/1 Q}; 'Martin, Gregory J (MartinGJ @s tate.gov)'; Borio, Luciana; Hanfling. Dan; McDonald, Eric; Wade, David; TARANTIN O,DAVID A; WILKINSO N., THOMAS; AMERICAN PVERSIGHT HHS-20-0580-B-000185 David Gruber (david. gruber @dshs.texas. gQ_Y}; KAUSHIK, SANGEETA ; Dr. Eva K Lee; Nathaniel Rupe rt; Carter Mecher Subjec t: Re: Red Dawn Breaking , COVID-19 Collaborative , Feb 16 start Sorry for spam. + Carrer Get Outlook for iOS From : Caneva , Duane Sent: Sunday , February 16, 2020 10:21 :38 AM To: Dod gen, Daniel (OS/ASPR/SP PR) ; DeBord , Kristin (OS/ASPR/SP PR) ; Phillip s, Sally (OS/ASPR/SP PR) ; David Marco zzi fb )(6) @ som.umarylan d.edu>; Hepburn , Matthew J CIV USARMY (USA) ; Lisa Koonin ; Wargo Michael ; Walters , William (STATE.GOV ) ; HARV EY, MELISSA ; WOLFE , HERBERT AMERICAN PVERSIGHT HHS-20-0580-B-000187 ; Eastman , Alexander ; EVANS, MARIEFRED ; Callahan , Michael V.M.D. b)(6) m h.h arvard.edu>; ~ MB.EDU ~ mb.edu>; @email. unc.edu 1(b)(6) r)emai l.unc.edu>; John son, Robert (OS/ASPR/B ARDA) ; Yeskey, Kevin ; Disbrow , Gary (OS/ASPR/B ARDA ) ; Redd, John (OS/ASPR/SP l(b)(B) PR) ; Hassell, David (Chri s) (OS/ASPR/IO AMERICAN PVERSIGHT HHS-20-0580-B-000188 ) ; Ham el, Joseph (OS/ASPR/10 ) ; Tracey McNamara ; Dean, Charity A@CDPH ; Richard Hatchett ; Lawler, James V @unmc.edu>; Kadlec, Robert (OS/ASPR/10 ) ; 'Martin , Gregory J (MartinGJ @st ate.gov) ' ; Borio, Luciana ; Han fling, Dan ; McDonald, Eric ; Wade , David TARANTINO , DAVIDA ; Barie, Ralph S 4(b)(6) tyemai l.unc.edu>; WILKINSON, THOMAS ; Hassell, David (Chris) (OS/ASPR/IO ) ; David Grnber ( david.gruber @dshs. texas. g ov) ; KAUSHIK, SANGEETA ; Dr. Eva KLee ; Nathaniel Hupert {b )(6) @m ed.comell.edu > Subject: RE: Red Dawn AMERICAN PVERSIGHT HHS-20-0580-B-000190 Breaking , COVID-19 Collaborative, Feb 16 start Some Mark Lipsitch Tweets copied. Sorry, might not be in the right order. .. "So far, we have conducted tests for 1,219 individuals. Of those, 355 people tested positive. Of those, 73 individuals are not showing symptoms," Japan's health minister says Marc Lipsitch (@mlipsitch) 14/02/2020, 17:42 I did actually say the quote that is going around , but the article contained vital context -- we don't know what proportion are symptomatic. Also we have only a rough estimate of what proportion of symptomatic people will have severe outcomes. pic.twitter.com/cWzvINSZBm Marc Lipsitch (@mli psitc !!) AMERICAN PVERSIGHT HHS-20-0580-B-000191 14/02/2020, 17:43 Why do I think a pandemic is likely? The infection is in many parts of China and many countries in the world, with meaningful numbers of secondary transmissions. The scale is much larger than SARS for example (where the US had many introductions and no known onward transmission) Marc Lipsitch (@mlipsitc !!) 14/02/2020, 17:45 Why do I think 40-70% infected? Simple math models with oversimple assumptions would predict far more than that given the RO estimates in the 2-3 range (8090%). Making more realistic assumptions about mixing, perhaps a little help from seasonality, brings the numbers down Marc Lipsitch (@mlipsitch ) 14/02/2020, 17:48 pandemic flu in 1968 was estimated to _ symptomatically _ infect 40% of the population, and in 1918 30%. Those likely had RO less than COVID-19. Below is from stacks.cdc.gov /view/cdc/11425 pie. twitter.com/EMwjEpA49s Marc Lipsitch (@mlipsitch) 14/02/2020, 17:49 What could make this scenario not happen? 1) conditions in Wuhan AMERICAN PVERSIGHT HHS-20-0580-B-000192 could be so different in some fundamental way from elsewhere that we are mistaken in expecting further outbreaks to have basic aspects in common. No reason I know of to think that but a formal possibility Marc Lipsitch (@mlipsitch) 14/02/2020 , 17:53 2) There could be a higher degree of superspreading than has been appreciated ("dispersion in RO") which could mean that many locations outside Wuhan could "get lucky" and escape major onward transmission. hopkinsidd .github .io/nCo VSandbox /D . .. . Marc Lipsitch (@mlipsitch) 14/02/2020 , 17:53 2) There could be a higher degree of superspreading than has been appreciated ("dispersion in RO") which could mean that many locations outside Wuhan could "get lucky" and escape major onward transmission. hopkinsidd. github.io /nCo V -Sand box/D ... . Marc Lipsitch (@mlipsitch) 14/02/2020, 17:55 3) Control measures could be extremely AMERICAN PVERSIGHT HHS-20-0580-B-000193 effective in locations that have had time to prepare. Maybe in a few, but seems unlikely that is the case in all, especially countries with stretched health systems. Marc Lipsitch (@mlipsi tch) 14/02/2 020, 17:56 4) Seasonal factors could be much more powerful at reducing transmission than we currently expect. That doesn't help the Southern hemisphere , and is not consistent with behavior in China (preprint in queue from D@M auSantillana D et al.) From: Caneva, Duane Sent: Sunday, February 16, 2020 9:39 AM To: Dodgen, Daniel (OS/ASPR/S PPR) ; DeBord, Kristin (OS/ASPR/S PPR) ; Phillips, Sally AMERICAN PVERSIGHT HHS-20-0580-B-000194 (OS/ASPR/S PPR) ; David Marcozzi 4 (b)(6) @som.umary land.edu>; Hepburn, Matthew J CIV USARMY (USA) ; LisaKoonin {b )(6) @ gmail.com>; Wargo Michael ; Walters, William (STATE.GO V) ; HARV EY, MELISSA ; WOLF E, HERBERT ; Eastman, Alexander ; EVANS, AMERICAN PVERSIGHT HHS-20-0580-B-000195 MARI EFRE D ; Callahan , Michael V .,M.D. b)(6) l(b)(6) @UT MB.EDU; @email .unc.edu; John son , Robert (OS/ASPR/B ARDA ) ; Yeskey , Kevin ; Disbrow , Gary (OS/ASPR/B ARDA ) ; Redd , John (OS/ASPR/S PPR) ; Hassell , David (Chris) (OS/ASPR/I 0) ; Hamel , Joseph (0S /ASPR/I 0) ; Tracey McNamara fb )(6) @westernu.e du>; Dean , Charity A@CDPH ; Caneva, Dua ne ; Richa rd Hatche tt ; Lawle r, James V (b)(6) ~)( unrnc.edu >; Kadlec , Robe rt (0S /ASPR/I 0) ; 'Maitin , Gregory J (MartinG J@s tate.gov) ' ; Borio , Luciana ; Hanfli ng, Dan ; McDonald , Eric ; Wade , David ; Barie, Ralph s l(b)(6) l@ema il.unc .edu>; WILKINSO N, THOMAS ; Has sell, David (Chri s) (OS/ASPRI! 0) ; David Gruber (david. gruber @dshs .texas . gov) ; KAUSHIK., SAN GEETA Subject: Red Dawn AMERICAN PVERSIGHT HHS-20-0580-B-000198 Breaking, COVID-19 Collaborative , Feb 16 start Pw-pose: This is a new Red Dawn String to cut down the size from the previous string, opportunity to provide thoughts, concerns, raise issues , share information across vanous colleagues responding to COVID-19. Including all from previous string plus a few additional folks. Duane C. Caneva, MD, MS Chief Medical Officer Department of Homeland Security 202-254-6901 (o) AMERICAN PVERSIGHT HHS-20-0580-B-000199 (c) Duane.Caneva @hg.dhs.gov DCaneva@dh s.1c.gov Executive Assistant: Nie hole Bwton, nichole .burton 2@associates. hq.dhs.gov, 202-254-8284 (U) Warning : This document is UNCLASSIFIED // FOR OFFICIAL USE ONLY (U// FOUO). It contains infor mation that may be exempt from public release under the Freedom of Informa t ion Act AMERICAN PVERSIGHT HHS-20-0580-B-000200 HHS-20-0580-B-000201 Kadlec, Robert (OS/ASPR/IO) Dr. Eva K Lee ; Giroir, Brett (HHS/OASH) ; Fauci, Anthony (NI H/NIAID) [E] ; Redfield, Robert R. (CDC/OD) ; Redd, John (OS/ASPR/SPPR); Shuy, Bryan (OS/ASPR/IO) ; Lee, Scott (O5/ASPR/EMMO); Yeskey, Kevin (OS/ASPR/10) ; Carter Mecher ; Richard Hatchett ; Tracey McNamara 4'b)(6) l:ilwesternu.edu>; Caneva, Duane ( OHS.GOV) ; J(b)(6) ~gmail.com>; Dodgen, Daniel (OS/ASPR/SPPR) ; DeBord, Kristin (OS/ASPR/SPPR) ; Phillips, Sally (OS/ASPR/SPPR) ; David Marcozzi fb) (6) @som.umaryland.edu>; Hepburn, Matthew J CIV USARMY(USA) ; Lisa Koonin ?b) (6) laigmail.com>; Walters, William (STATE.GOV) ; HARVEY, MELISSA ; Wolfe, Herbert (OHS.GOV) ; alexander.eastman@hq.dhs.gov ; EVANS, MARIEFRED ; Callahan, Michael V.,M.D. ; jwleduc@UTMB. EDU l(b)(6) ~utmb.edu >; ~email.unc.edu>; Johnson, Robert (OS/ASPR/BARDA) ; Yeskey, Kevin (OS/ASPR/IO) ; Disbrow, Gary (OS/ASPR/BARDA) ; Redd, John (OS/ASPR/SPPR) ; Hassell, David (Chris) (OS/ASPR/IO) ; Hamel, Joseph (OS/ASPR/IO) ; Dean, Charity A@CDPH ; Lawler, James V {b) /6) !j)unmc.edu>; Martin, Gregory J (MartinGJ@state.gov) ; Borio, Luciana < LBorio@iqt.org>; Hanfling, Dan ; eric.mcdonald@sdcounty.ca .gov ; Wade, David ; david.a.tarantino@cbp.dhs.gov ; WILKINSON, THOMAS ; david. gruber@dshs .texas.gov ; KAUSHIK, SANGEETA; Nathaniel Hupert Sent Date: 2020/02/23 23:35:35 Delivered Date: 2020/02/23 23:35:39 AMERICAN PVERSIGHT HHS-20-0580-B-000203 Kadlec, Robert (O5/ASPR/IO) To: Kellogg, Rachel (HHS/OASH) Mccreary, Kenneth (O5/ASPR/SPPR); Flowers, Artensie (O5/ASPR/EMMO); Cooper, Kevin (O5/ASPR/ORM) ; Ford-Barnes,Arwenthia (O5/ASPR/IO) ; Shuy, Bryan (O5/ASPR/IO) ; Giroir, Brett (HHS/OASH); Pereira, Esmeralda (O5/ASPR/EMMO) Su bject: Re: COVID Meeting re: Supplies Dat e : 2020/03/13 22:16:31 Prior ity: Normal Type: Note + Esmeralda Sent from my iPhone On Mar 13, 2020, at 10: 14 PM, Kellogg, Rache l (HHS/OASH) wrote: ? Team ASPR, b)(5) Thank you, Rachel Rachel Kellogg, RN Policy Adv isor Off ice of the Assistant Secretary for Health U.S. Departme nt of Healt h &Human Services Mobi le: rb)(6) I AMERICAN PVERSIGHT HHS-20-0580-B-000204 Sender: Kadlec, Robert (O5/ASPR/IO) Kellogg, Rachel (HHS/OASH) ; Mccreary, Kenneth (O5/ASPR/SPPR) ; Flowers, Artensie (O5/ASPR/EMMO) ; Cooper, Kevin (O5/ASPR/ORM) ; Recipient: Ford-Barnes, Arwenthia (O5/ASPR/IO) ; Shuy, Bryan (O5/ASPR/IO) ; Giroir, Brett (HHS/OASH) ; Pereira, Esmeralda (O5/ASPR/EMMO) Sent Date: 2020/03/13 22 :16:29 Delivered Dat e: 2020/03/13 22 :16:31 AMERICAN PVERSIGHT HHS-20-0580-B-000205 Haddad, Carla (HHS/OASH) To: Giroir, Brett (HHS/OASH) Kellogg, Rachel (HHS/OASH); CC: Valentine, Steven (HHS/OASH) Subject: RE: Matt Bassett said to give the Admiral a call. Date: 2020/03/13 23:02:48 Priority: Normal Type: Note b)(5) From : Giroir, Brett (HHS/OASH) Sent : Friday, March 13, 2020 4:55 PM To : Stenzel, Timothy (FDA/CDRH) ; Shuren, Jeff (FDA/CDRH) Cc: Kellogg, Rachel (HHS/OASH) ; Haddad, Carla (HHS/OASH) ; Hahn, Stephen ; Giroir, Brett (HHS/OASH) Subject: FW: Matt Bassett said to give the Admiral a call. Tim b)(5) Best Brett Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 AMERICAN PVERSIGHT HHS-20-0580-B-000206 From: Ettinger, Michael (Legal) Sent: Friday, March 13, 2020 2:47 PM To: Haddad, Carla (HHS/OASH) Cc: Bergman, Stanley ; Mlotek, Mark ; Bhansali, Seema Subject: Matt Bassett said to give the Admiral a call. >; Giroir, Hi Carla, Matt Bassett said to reach out to the Admiral. We called the Admiral's office , but were told to email you. Henry Schein has identified 3 companies that have filed EUAsfor lateral flow quick tests and nasal swab tests to test for COVID-19that deliver results in 15-30 minutes. Two of these companies have been selling millions of tests in China and Korea and the third company is a start up with similar technology. We can have 40,000 tests on Monday, 1 million tests a week from now, and then in April we can ramp up to 1 million tests per day. We are quite concerned that these tests will be sold to other countries unless the government quickly approves the EUAs and buys some tests. The big benefit of these tests is that it can be used in the home after a telehealth encounter so that people do not have to go to hospitals and doctor offices which would stress the healthcare system beyond its capabilities. We have a whole set of protocols that would be issued as part of this, including multiple testing, given that the antigens may not appear for several days. Heruy Schein is prepared to respond to the goverrunent ' s call to action and partner to alleviate the urgent need for wide availability of rapid testing. As the world ' s largest distributor of healthcare solutions to the office-based practitioner , we have unique reach to get these products to market quickly and educate medical professionals on best practices. Henry Schein has five strategic distribution centers across the U.S. (29 globally) which enable us to have 99% of our orders shipped the day they are received. Heruy Schein (NASDAQ: HSIC) understands that healthcare is a coordinated effort and we actively engage in discussions with the WHO , HHS , and others to be a thought-leader and private-sector partner, including in the GHSA Private Sector Roundtable and Pandemic Supply Chain etwork. www.henryschein.com Dr. Peggy Hamburg and Dr. Louis Sullivan both know us well if you need further points of reference on our company and capabilities. If helpful, our CEO and other senior executives would welcome the opportunity to get on a phone call with you immediately to discuss the details of our plan how we can move this forward quickly before these tests get deployed to other parts of the world. Besides m self (my contacts are below), you can reach out to our Chairman, Stan Bergman at (b)(B) or Mark Mlotek at~b)(6) I AMERICAN PVERSIGHT HHS-20-0580-B-000207 Best Regards, Michael S. Ettinger Senior Vice President , Corporate &Legal Affairs and Chief of Staff Henry Schein , Inc. 135 Duryea Road Melville, NY 11747 631.843.5993 (o) 631.843.5660 (f) fbl (6) l(c) Please consider the enviromnent before printing this email. E-mail messages may contain viruses, worms, or other malicious code. By reading the message and opening any attachments, the recipient accepts full responsibility for taking protective action against such code. Henry Schein is not liable for any loss or damage arising from this message. The information in this email is confidential and may be legally privileged. It is intended solely for the addressee(s ,. Access to this e-mail by anyone else is unauthorized. Sender: Haddad, Carla (HHS/OASH) Giroir, Brett (HHS/OASH); Kellogg, Rachel (HHS/OASH); Valentine, Steven (HHS/OASH) Sent Date: 2020/03/13 23:02:46 Delivered Date: 2020/03/13 23:02:48 From: Namal NawanaKb)(6) ~gmail.com> To: Ettinger, Michael (Legal) Mlotek, Mark ; Haddad, Carla (HHS/OASH); Bhansali, Seema ; Bergman, Stanley Subject: Re: Matt Bassett said to give the Admiral a call. Date: 2020/03/13 21: 19:58 Priority: Normal Type: Note Michael, AMERICAN PVERSIGHT HHS-20-0580-B-000208 thanks for making this connection. Carla, I have had the privilege of leading multiple global healthcare companies including Smith and Nephew Plc and Alere inc., formerly the worlds largest point of care in-vitro diagnostic test company, supply ing some 1.5 Billion tests annually. I've copied Paresh Patel, the principal author of the document. We are at your disposition to discuss the materials presented at any time, Yours sincerely, Narnal Nawana On Fri, Mar 13, 2020 at 9:11 PM Ettinger, Michael (Legal) wrote: Hi Carla, In follow up to our emails this afternoon with Admiral Giroir , a document t explaining the science related to the Velocity /SD Biosensor product is attached. I have also copied amal Nawana, the CEO of Velocity should you or the Admiral have questions. Will leave in your hands to pass this along. We stand ready to serve the needs of the nation. Again, many thanks. Please consider the enviromnent before printing this email. E-mail messages may contain viruses, worms, or other malicious code. By reading the message and opening any attachments, the recipient accepts full responsibility for taking protective action against such code. Henry Schein is not liable for any loss or damage arising from this message. The information in this email is confidential and may be legally privileged. It is intended solely for the addressee(s). Access to this e-mail by anyone else is unauthorized. Sender: Namal Nawana fb )(6) ~gmail.com> Ettinger, Michael(Legal) ; Mlotek, Mark ; Haddad, carla (HHS/OASH); Bhansali,Seema ; Bergman, Stanley Sent Date: 2020/03/13 21: 19:32 Delivered Date: 2020/03/13 21: 19:58 AMERICAN PVERSIGHT HHS-20-0580-B-000209 Kadlec, Robert (OS/ASPR/IO) Giroir, Brett (HHS/OASH); Michael Osterholm ~umn .edu> Subject: Fwd: URGEN T ASPRACTIONS Date: 2020/02/27 12: 11:51 Priority: Normal Type: Note For your review. We will refine and finalize but want your initial impressions and comments today. Best. Bob Sent from my iPhone Begin forwarded message: From: "Callahan, Michael V.,M.D." Cc: "Callahan, Michael V.,M.D." <,_~b _)(_6)_____ Subject: Fw: URGENT ASPR ACTIONS ._@-=m=gh=?=h=arv"--'--"a"""rd=o..a..ed==u> ...,_ @,;;,.=..=. m= g=h= .h=a=rv ...c..-= ar'-" d'-'--. e"d-'"-=u > Read Time: 3 mins FYSA b)(5) From: Callahan , Michael V.,M.D. fb)(B) @mgh.harvard .edu> Sent: Thur sday , February 27, 2020 11:35 AM To: Caneva , Duane ; Carter Mecher ; Lawler, Jame s V 4(b)(6) tyunmc.edu>; Marcozzi , David 4 (b)(6) @som.u maryland.edu> ; Hepburn, Matthew J CIV USARMY (USA) ; Richard Hatchett ; Callahan , Michael V.,M.D. (b)(6) m h.harva rd.edu> Subject: URG E T ASPR ACTIONS AMERICAN PVERSIGHT HHS-20-0580-B-000210 Mustelids At request of Carter I am pushing this out now. Synopsis: cu1TentASPR team and federal agencies encumbered by bureaucracy , fear of peer disapproval and lack of appreciation for magnitude of threat hamper speed of deci sion, decision-logic and prioritization. Communication is painful, ineffective, and slow. Individual initiative is lacking and accountability is zero. Domain expertise in ICS and mass casualty infections is low . This approach operates on Incident Command (IC) structw-e with clear accountability, pw-e mission focus and requirement that those involved clear their outlook for 3 months. All meetings are standup , focus on critic items and restricted to 10 mins. Overnight comms is mandatory and email chimes are activated for CRITIC emails. The following workthreads have been developed with Dr . Kadlec's approval and independently from ASPR HHS and without their knowledge. The approach is familiar to EM and CC specialities, Disaster management and triage (DISMA) and disaster medicine (DISMED) with supplements from DMCC and DMA T and lessons learned from prior outbreaks, in particular the prior H5s and H7 and SARS Kowloon. You are all certain to make this better; and I have no p1ide in authorship. There are 7 workthreads. We might need 14 or 5. These below are lacunae in our federal response 1. o Immediate Development of Minimum Standard Diagnostic Testing for COVID19" Description, need, examples deferred to James. Recommend : tbd 2. o Preservation of Primary Care during C19: US hospital capacity is in the 90% range, ERsoccupancy is in the 99% range and ICU bed vacancy is low due to flu. Must focus on novel strategies to push out primary care to outlying centers to allow for detection-triage-care of primary care. These efforts include Singapore, Rescue Medicine programs and some (admittedly) from my institution. Actions include 1. o Burst and Coast: DISMA term for preparing vulnerable populations for interruption of health care originally due to conflict, and typhoon seasons. Basically nationalized HCN forcibly increase the speed of throughput of critical screening procedures in weeks before disruption AMERICAN PVERSIGHT HHS-20-0580-B-000211 of medical care. I propose it be considered for widespread transmisison ofC19. These include running systems at 3-fold normal, around the clock in the weeks before widespread community transmission. Examples include critical dental, PAP, Mamo, Colo, Dx Cath, EGD, PFT, ETT around the clock with young workers seen 2000h-0800 and elderly and YPWC seen daily. This allows for 50-80 day push out of scheduled screening at MGH and Brigham and Womans. Estimates from your institutions will likely be close to these. The Coast can be expanded the earlier you start. There are specific examples by specialty and 9 experts from Mayo, MGH, U Washington, CaseWestern and UAB are weighing in on this. The experts need to be Too Big To Kill, by the bureaucratic antibodies (CDC, NIH mouse doctors, etc). Recommend: immediate convening of national experts and physician specialist organization in major medical disciplines to assist in guidance of 90 day coast. 2. o HCF Avoidance: subclinical infection and long incubation periods are particularly problematic. Latency in C19 infection among well documented Nanjing MD visitors to Wuhan-2 and Leushenshan hospitals have exceeded the data-penic 14day Q period. Ergo, we must do everything to prevent routine primary care from accessing HCF. Burst and Coast is one system; provisioning 3 mo of perscription drugs. Among our IC NOCs (please, discretion here) and long term expatriates living in austere environments, there is precedent for Stand By Therapy (SBT), the use of pre-provisioned medications that can be remotely directed for use by those suffering certain likely illnesses (e.g. standby RDT and selfRx of malaria, SBT for odontologic infections, SBT for ILi with zanamivir in H275Y endemic flu areas; Nitrates-ASA-L6Beta blockers vs GI cocktail for those with cardiac risks, and more. There is a legal precedence for this in Travel Medicine, and CMS will reimburse for 3 mo supplies for this group). AMERICAN PVERSIGHT HHS-20-0580-B-000212 Recommend: Immediate engagement with CMS and reimbursement agencies, and physician. Recommend: immediate analysis of systems to create long-latency periods between health care visitation. 3. o Deferred High Risk and Unknown Health Risks: contraception is recommended in CHian in endemic areas. No data yet, but abstracting from other systemic viral illnesses, C19 could produce a version of TORCH or other flavi-like congenital malformations; other deferred items are TKR, and other elective orthopedic procedures, bone marrow transplant for transfusion supported CLL or APA; CABG etc. Recommend: active notification of surgeons, oncologists, clinical laboratories, dentists, gynecologists and select patient education portals to accelerate high priority screening and intervention needs, and triage of non-critical procedures for at least 90+ days. 3. o Preservation of Critical Care Capacity: 68-72% of infections are minimally ill or do not require home care (backed out from W-2/Nanjing 4400 hospitalized patients). Of those needing care, they are divided between non ICU (IVF, anti-emetic, electrolyte repletion and late-admitted convalescence with post C19 sequelae) at 15-18% and 9-11% requiring ICU care, typical skilled nursing, special procedures, high FiO2, HOM and ventilation. This is based on experience at a "pretty good" hospital, designed for large scale ILi outbreaks and staffed by Western trained MDs. ignoring the differences we are likely to see similar impacts to US HCF at percentages determined by community testing (to identify the denominator, which does not exist, because the CDC will not adopt one of 4 HTP PCRassays developed elsewhere ...James will carry this one). Burst and Coast and pushing out Primary care to communities will help preserve capacity for critically ill yet salvageable patients. If you accept this as reasonable, here are some steps done overseas: 1. o Cohorting HCW Workers: Chinese military is running 3 teams of MD-RN-RT-Lab personnel that do 10 day rotations, which will capture about 80-90% of incubations. This is ok since AMERICAN PVERSIGHT HHS-20-0580-B-000213 they have endless PCRcapacity. Teams are either providing care, at home (Barracks) supporting those providing care, or doing prevmed; or on home leave in protected residence. Singapore MOD, and hospitals SGH and TTSH have plans to do this, as have critical financial service groups who cannot interrupt trading (where markets are still open). Key weaknesses of cohorting from China are: no mixing of cohorts. Failure to isolate, leads to infection across cohorts; major dependance on EMR pass off of patients; absolute separation of contaminating services such as food delivery, visitors and portable x ray units; employee unhappiness (cancelled vacations, babies, soccer games) Recommend: hospital networks initiate trial work cohorting at 10-40% rotating employee cohorts to include WFH policies to pre-test electronic sign in, encryption and ability of home workers to support in-hospital personnel. 2. o Fortifying HCW (and dependents): W2 collapsed because the absence of skilled HCW as well as absence of PPENPI. HCW absenteeism was driven by illness, and need to care for in home elderly, who are at highest risk. In other disasters here in the US, police and Fire have abandoned their duties to save family members. The best example is Katrina, were NO cruisers were seen 100mil north packed full of luggage and kids. This was addressed in DISMA by assurances that families will be protected and provisioning in advance. Now, in Singapore, home liaise personnel, round on eacch HCW family to ensure all needs are being met. China military is alleged to be doing the same (by non military Chinese docs). Fortification and support of HCW famillies prevents distraction and increases commitment to duties. US has some key experts in this area, led by SC of San Fran and Texas DEM. ICSalso has examples of this. Physical Fortification of HCW involves uninterrupted access to PPE,early AMERICAN PVERSIGHT HHS-20-0580-B-000214 access to prophylactic therapies and forthcoming vaccines and support for food, sleep and downtime. Recommend: initiate contract service organizations to support HCW families during cohort cycles, and to support families that fall ill due to HAI with C19. 3. o Scaled, Remotely Delivered Expertise: some examples: Indonesian ventilators are being run in Singapore using internet based controls; Chinese sequencers in Nigeria transmit sequence data on pathogen identify and AMR patterns to inform development of new diagnositics-and other genetic intelligence TBD later and Epic style Standard of Care systems are being used to identify poor outcomes in medical networks. Multiple US teams are proposing "app this/a pp that" to ASPR,for smart phone based systems that scale the unsealable: highly trained specialists. This section works to rapidly expand the lessons learned of the most experienced across the US HCN, thus allowing rural 50 med hospitals to handle cases normally referred, and for C19 care, to address the growing list of unusual manifestations of this disease, currently not discussed anywhere in the West. I know nothing about this area, but have access to MITRE, GOOGLEand former DARPA app developers who can assist. Google Ventures and Open Philanthrophy helped Rescue Medicine develop a Ebola App, to help distribute medical consultation to lesser skilled clinicians. We can consider that here. Anyone? Recommend : no domain expertise 4. o Smart Medical Devices: this refers to expanded use of next generation POCsystems which diagnose and respond within one infrastructure. examples are iSTAT units which blue tooth alert for K <3.8; rising Cr, lactate, BUN etc. Ventilators such as Philips 2000 and Enhanced SAVEii are non-pressurized gas, battery driven units that do not squander cylinder 02, and unload pulmonologist and RTs from the lower 90% of ventilation decisions. Lab AMERICAN PVERSIGHT HHS-20-0580-B-000215 diagnostics, not bedside, are wired for software updates. BACTEC8000s can alert Clin Micro to patient culture results (although this is not as yet FDA approved). Carter or someone else can comment on escalation of this approach. One plea from DISMA is that systems are resilience, capable of moving from pre-hospital to hospital, a criteria that expands our massive prehospital communities capabilities, supports ventilator enclaves and other MCI operations. Recommend: recommend all future procurement of disaster medical and hospital continuity medical devices be selected based on autonomy from grid, interoperability with multiple wifi and pre-existing hospital systems and most importantly, ability to support lesser skilled medical care providers. 5. o Fast Launch Consultancy: convene the greatest evidence based collection of C19 data from ASEAN for rapid dissemination to US HCW, Pharmas and other key elements. We screwed this up with EBOV and care in CONUS repeated mistakes made years previously in DRC.In this scenario, Face Time and other systems can be used as instition based Instructor Trainers, to allow local adoption of basic care principals and to inform groups with small case loads of less commonly encountered sequela or atypical presentations. This can be executed now. CDC is asking for this information from ASPR,a bad sign. Recommend : this team (Wolverines) be quickly cross trained by Lawler, Callahan and others who have CoV clinical expertise, for purpose of generating Gen 1.0 best practices guidelines to guide physicians in distant centers across US. Be advised, CDChas no clinical expertise in this area, and has degraded ability to gain same from foreign partners. 4. o COVID20: epizoonotic mutable RNA viruses evolve quickly through extended transmission into new species. The vet and Asian poultry industries point this out with endless vaccine do-overs for the same HSNx avian viruses. C19 in China is now encountering human AMERICAN PVERSIGHT HHS-20-0580-B-000216 convalescent immunity which will select for immune evading isolates. This is drift, not shift, but threatens the concept of immune-hardened workforces. This topic brings out the apocalyptic types that we all know form anthrax and HPAI. There is a more rational group that is informed by genetic hysteriesis, or the strain on genetic mutation, that assesses probability of fitness or evasion. The point is demonstrated now with the differences in idiotype antibodies from the PBMCs from December survivors versus the newer mAbs isolated from February survivors. We should put some energy into this so BARDA doesn't let Regeneron squander $500M (as planned) on a shitty Washington state antibody mAb from January, when we can have access to higher avidity (immune polished) mAbs from elite survivors (those with high risk factors, but trivial disease). Darwinian selection in China can accelerate our response to both C19, and might prevent C20. Recommend : this group and trusted colleagues in academic institutions and federal agencies, restore OCON US surveillance capability led by NAMRUs, AFRIMS, former PREDICT and PROPHECY performers and (overseas) sister institutions of major medical centers. 5. o BARDA Tech Counsel: BARDA needs immediate oversight of currently planned boondoggle programs that are known to be too futuristic, previously unsuccessful, conflicted by secondary gain, or clinically non-viable for mass casualty infection operations. This list is long. Speaking here, briefly as a big pharma guy, I am emphatic and not alone in stating that massive dollars are now being directed at biotech companies by untrained unqualified individuals. The planned emergency appropriation dollars are being awarded almost completly on the presence of a pre-existing contract history with BARDA and the exploitation and misuse of the OTA. Many intended awards are evidence based(Gilead; remdosivir) and some can be guided to be worth the investment (Regeneron) but nearly all others are not plausible. Several have disclosed through other channels (consulting with COVID19 "experts") that they are exploiting the near complete absence of pharmaceutical life cycle, regulatory and clinical translation expertise at BARDA. Current performers AMERICAN PVERSIGHT HHS-20-0580-B-000217 have openly confided this is a great time to grab money from BARDA guppies, a JPM term for BARDA reviewers. Still, if correctly advised by non-conflicted pharma C-suite and FDA regulatory advisors, the anticipated multi billion dollar investment in the next weeks could be salvaged in the following ways: 1. o Pharma truth: the purpose of this effort is to prevent the squandering of current resources. ). Current BARDA investments in MCM cannot ever be turned into approved therapies to help USA in the first wave. If they do not help us now, we should consider reallocating them to any MCM that can reduce morbidity and death. Restated, if the HCN do not have a MCM against C19 in the next 3 months, we do not have one that matters. Tech counsel, featuring CEOsconvened by an extra ASPRcommittee and run by CEO pharma (including Geberding, Peggy, Martine Rothblatt, Elias Zarhouni, Anne Depey, Mike Watson) accounted for approximately $400B in annual pharma profit. This group produced a report called the Securing a Biodefense Industrial Base for US Gov. It dissected the huge claims of the current BARDA, cried fowl on the absence of human clincial corroboration and identified more viable technologies that could have been funded at that period of time. This report was ignored by BARDA. These CEOs,still under the 2019 2 year CDA, can be reconvened to prevent a BARDA flop against C19. Recommend: Immediate oversight of BARDA investments by other USG Agencies, former FDA officials and non-conflicted CEOs already under CDA. MITRE has this report, and the CDAs and is the ASPR FFRDC. 2. o Clinical Trut h: multiple MCMs being contemplated for funding by BARDA, and by NIAID are impossible to administer in the chaotic treatments setting of mass casualty care. In DMCC operations we select therapies that do not tie up critical personnel (avoid remdosivir if possible), do not risk personnel (use po vs IV in VHFs; avoid BIPAP in H7N9 care), require minimal medical training (fentynl patch; use of AMERICAN PVERSIGHT HHS-20-0580-B-000218 oral vs IV), require no post treatment medical monitoring (avoid FQ, use macrolides; switch ZMAP for M144), do not produce AEs that masquerade as disease specific findings (sedatives; NSAIDs in VHF), do not interact with other therapies (CoArtem QTCs in Ebola), and have a high therapeutic index (doxy vs cipro for empiric abx of newly admitted Ebola patients). Recommend: Wolverines immediately convene Target Product Profiles (TPP) suitable for high throughput, treat-and-release mass casualty infection response operations ... and not BARDA products which require highly trained physicians, complex logistics tail, cold chain, post treatment monitoring and complex and iterative GMP campaigns that threaten supply. 3. o Urgent need for Diagnostics: added here to again emphasize importance. James to comment. From: Caneva , Duane Sent: Thursday, February 27, 2020 7:59 AM To: Carter Mecher ; Lawler, James V b)(6) unmc.edu>; Callahan, Michael V.,M.D. b)(6) m h.harvard.edu>; Marcozzi, David b)(6) som.umar land.edu>; Hepburn, Matthew J CIV USARMY (USA) ; Richard Hatchett Subject: RE: Action s to take now External Email - Use Caution We'll take a stab on detention facility (congregate setting) actions, since ours is a real mess (250 federal, state, county prisons , jai ls, facilities that constantly mix AMERICAN PVERSIGHT HHS-20-0580-B-000219 international detainees around the nation-apparently it's a secret sauce for disease spread). Also, as Tracey M always reminds us, don't forget about domestic pets as platforms or reservoir for disease... Apparently, USG has a bit of a gap looking at that. From: Carter Mecher Sent: Thursday, February 27, 2020 7:44 AM To: Lawler, James V 1(b)(6) ~unmc.edu>; Callahan, Michael V.,M.D . 6 ~(b)( ) @mgh.harvard.edu>; Marcozzi, David ~(b)(6) @som.umaryland.edu>; Caneva, Duane ; Hepburn, Matthew J CIV USARMY(USA) ; Richard Hatchett Subject: Actions to take now CAUTION:This email originated from outside of DHS. DO NOT click links or open attachments unless you recognize and/or trust the sender. Contact your component SOC with questions or concerns. Bob asked for a list of actions to take now (beyond the NPls). This from the request he gave to Michael. I think he wants things for healthcare systems (really acute care and clinics) and vulnerable components like nursing homes and dialysis, etc. To get things started. Here is James' list. Patient hardening - provide additional prescr iption meds to provide 2 months of supply for every patient if possible. Patients who cannot get such large stockpiles (narcotics etc) should be signed up for by-mail or other refill mechanism that doesn't require in-person visit. Semi-elective surgeries (those that can avoid complications and will need to be done in the next 6 months) should be moved up to immediate to get these off the table. Purely elective things should continue until triggers indicate time to commence NPI in that community . More complicated patients should be tuned up as best as can be over the next several weeks. Facility hardening - Clinics, ERs,Acute Care etc should initiate parallel/separated tr iage lines for Ill/URI patients that do not cross streams with non ILi/URi immediately. Admission screening should occur for all elective or non-acute ID admissions. URI/Ill should be identified and either not admitted or cohorted. Ward cohorting should start immediately- admissions with pneumonia should be cohorted with dedicated wards and staff that do not mix. Outpatient practices should consider engaging home visit/home care options starting now to defer visits. ERsand outpatient clinics should engage telehealth resources for acute issue tr iage, follow-ups, med refills etc to defer visits to clinics or ERs. Facilities should start expanding inventories of all major rx and supply stocks to be able to absorb interruptions of supply chain. Renovation/construction projects that may interrupt workflow or space capacity should be thought through and delayed or adjusted. AMERICAN PVERSIGHT HHS-20-0580-B-000220 Staff hardening - HCW staff will need their personal medical conditions addressed and 2-month stockpile of meds. Should address family member medical issues as well to to avoid staff distraction. Family support resources should be made available for HCW planning - elder care, child care etc. Additional staff should be considered to supplement ward staff and education and training implemented for appropriate IPC practices. Sent from Mail for Windows 10 The information in this e-ma il is intended only for the person to whom it is addressed. If you believe this e-ma il was sent to you in error and the e-mail contains patient information, please contact the Partners Compliance HelpLine at http: //www.partners.org /complianceline. If the e-mail was sent to you in error but does not contain patient information, please contact the sender and properly dispose of the e-mail. Kadlec, Robert (OS/ASPR/IO) Giroir, Brett (HHS/OASH) ; Michael Osterholm ~umn.edu> Sent Date: 2020/02/27 12:11:50 Delivered Date: 2020/02/27 12: 11:51 AMERICAN PVERSIGHT HHS-20-0580-B-000221 Haddad, Carla (HHS/OASH) Harder, Kristina (HHS/10S) ; Friedman, Richard (HHS/OGC); Giroir, Brett (HHS/OASH); To: Tatem, Anne (HHS/OS/ASL); Pence, Laura (HHS/ASL) ; Mikre, Meriam (HHS/OASH) Subject: RE: Kb)(5) (b)(5) I I Date: 2020/03/02 11:16:22 Priority: Normal Type: Note From: Harder, Kristina (HHS/IOS) Sent: Monday, March 2, 2020 11:07 AM To: Friedman, Richard (HHS/OGC) ; Giroir, Brett (HHS/OASH) ; Tatem, Anne (HHS/OS/ASL) ; Haddad, Carla (HHS/OASH) Subject: RE: l(b)(5) +Carla From: Friedman, Richard (HHS/OGC) Sent: Monday, March 2, 2020 10:55 AM To: Giroir, Brett (HHS/OASH) ; Harder, Kristina (HHS/IOS) ; Tatem, Anne (HHS/OS/ASL) Subject: fb) (5) Richard Friedman (cell)l,__ (b_)(6 _) ___ AMERICAN PVERSIGHT __, HHS-20-0580-B-000222 From: George, Bryan [mailto:Bryan.Georqe@fda.hhs.gov] Sent: Monday, March 02, 2020 8:06 AM To: Friedman, Richard (HHS/OGC); Pence, Laura (HHS/ASL); Tatem, Anne (HHS/OS/ASL); Giroir, Brett (HHS/OASH); Harder, Kristina (HHS/IOS); Schwarcz, Cristi L. (CDC/OD/CDCWO); Everett, Chris (NIH/OD) [El Subject: RE: ~Kb-)(5-)---------------------------~ I l(b)(5) b)(5) Thanks, Bryan From: Friedman, Richard (HHS/OGC) Sent: Monday, March 02, 2020 12:14 AM To: Pence, Laura (OS) ; Tatem, Anne (OS) ; Giroir, Brett (OS) ; Harder, Kristina (OS) ; Schwarcz, Cristi L (CDC); Everett, Chris L (NIH) ; George, Bryan Subject: FW: fb )(5) I l(b)(5) Adding ASL. Richard Friedman (b-)(6_) ___ (cell) ._l __. From: Friedman, Richard (HHS/OGC) Sent: Monday, March 02, 2020 12: 12 AM To: Giroir, Brett (HHS/OASH); Harder, Krist ina (HHS/IOS); Schwarcz, Cristi L. (CDC/OD/CDCWO); Everett, Chris (NIH/OD) [E]; George, Bryan (FDA/QC) Subje ct : l(b)(5) l(b)(5) b)(5) Richard Friedman (cell),__l (bl_(B_l __ ___, ***** b)(5) AMERICAN PVERSIGHT HHS-20-0580-B-000223 Richard Friedman 202-690-7766 Sender: Haddad, Carla (HHS/OASH) Harder, Kristina (HHS/IOS) ; Friedman, Richard (HHS/OGC) ; Giroir, Brett (HHS/OASH) ; Recipient: Tatem, Anne (HHS/OS/ASL) ; Pence, Laura (HHS/ASL) ; Mikre, Meriam (HHS/OASH) Sent Date: 2020/03/02 11:16:21 Delivered Date: 2020/03/02 11:16:22 AM[ HICAN PVERSIGHT HHS-20-0580-B-000224 Kadlec,Robert (OS/ASPR/IO) Giroir, Brett (HHS/OASH) Subject: Re: URGENTASPRACTIONS Date: 2020/02/27 13:OS:10 Priority: Normal Type: Note Sent from my iPhone On Feb 27, 2020, at 12:47 PM, Giroir, Brett (HHS/OASH) wrote: Bob, b)(5) BG Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Kadlec, Robert (OS/ASPR/1O) Sent: Thursday, February 27, 2020 12:12 PM To: Giroir, Brett (HHS/OASH) ; Michael Osterholm ~ umn.edu> Subject: Fwd: URGENTASPRACTIONS For your review. We will refine and finalize but want yow- initial impressions and comments today. Best. Bob Sent from my iPhone AMEHICAN PVERSIGHT HHS-20-0580-B-000225 Begin forwarded message: From: "Callahan, Michael V .,M.D ." ~(bl (6 l @mgh.harvard.edu> Date: February 27, 2020 at 11:44:10 AM EST To: "Bob Kadlec " Cc: "Callahan , Michael V.,M.D." ~(b)(6) @mgh.harvard.edu> Subjec t: Fw: URGENT ASPR ACTIONS Read Time: 3 mins FYSA b)(5) From: Callahan, Michael V.,M.D. {b )(B) @mgh.harvard.edu> Se nt: Thursday, February 27, 2020 11:35 AM To : Caneva, Duane ; Carter Mecher ; Lawler, James V fb )(6) ~unmc.edu >; @som.umaryland.edu>; Hepburn, Matthew J CIV Marcozzi, David 4b )(6) USARMY {USA) ; Richard Hatchett ; Callahan, Michael V.,M.D. j(b)(6) H>mgh.harvard.edu> Subject: URGENTASPRACTIONS Mustelids At request of Carter I am pushing this out now. Synopsis: cunent ASPR team and federal agencies encumbered by bureaucracy , fear of peer disapproval and lack of appreciation for magnjtude of threat hamper speed of decision , decision -logic and prioritization. Communication is painful, ineffective, and slow. Individual initiative is lacking and accountability is zero. Domain expertise in ICS and mass casualty infections is low. This approach operates on Incident Command (IC) structure with clear accountability, pure mission focus and requirement that those involved clear their AMERICAN PVERSIGHT HHS-20-0580-B-000226 outlook for 3 months. All meetings are stand-up , focus on critic items and restricted to 10 mins. Overnight comms is mandatory and email chimes are activated for CRITIC emails. The following workthreads have been developed with Dr. Kadlec's approval and independently from ASPR HHS and without their knowledge. The approach is familiar to EM and CC specialities, Disaster management and triage (DISMA) and disaster medicine (DISMED) with supplements from DMCC and DMA T and lessons learned from prior outbreaks , in particular the prior H5s and H7 and SARS Kowloon. You are all certain to make this better; and I have no pride in authorship. There are 7 workthreads. We might need 14 or 5. These below are lacunae in our federal response 1. o Immediate Development of Minimum Standard Diagnostic Testing for COVID19" Description, need, examples deferred to James. Recommend : tbd 2. o Preservation of Primary Care during C19: US hospital capacity is in the 90% range, ERs occupancy is in the 99% range and ICU bed vacancy is low due to flu. Must focus on novel strategies to push out primary care to outlying centers to allow for detection-triage-care of primary care. These efforts include Singapore, Rescue Medicine programs and some (admittedly) from my institution. Actions include 1. o Burst and Coast: DISMA term for preparing vulnerable populations for interruption of health care originally due to conflict, and typhoon seasons. Basically nationalized HCN forcibly increase the speed of throughput of critical screening procedures in weeks before disruption of medical care. I propose it be considered for widespread transmisison ofC19. These include running systems at 3-fold normal, around the clock in the weeks before widespread community transmission. Examples include critical dental, PAP, Mamo, Colo, Dx Cath, EGD, PFT, ETTaround the clock with young workers seen 2000h0800 and elderly and YPWC seen daily. This AMERICAN PVERSIGHT HHS-20-0580-B-000227 allows for 50-80 day push out of scheduled screening at MGH and Brigham and Womans. Estimates from your institutions will likely be close to these. The Coast can be expanded the earlier you start. There are specific examples by specialty and 9 experts from Mayo, MGH, U Washington, CaseWestern and UAB are weighing in on this. The experts need to be Too Big To Kill, by the bureaucratic antibodies (CDC, NIH mouse doctors, etc). Recommend: immediate convening of national experts and physician specialist organization in major medical disciplines to assist in guidance of 90 day coast. 2. o HCF Avoidance: subclinical infection and long incubation periods are particularly problematic. Latency in C19 infection among well documented Nanjing MD visitors to Wuhan-2 and Leushenshan hospitals have exceeded the data-penic 14day Q period. Ergo, we must do everything to prevent routine primary care from accessing HCF. Burst and Coast is one system; provisioning 3 mo of perscription drugs. Among our IC NOCs (please, discretion here) and long term expatriates living in austere environments, there is precedent for Stand By Therapy (SBT), the use of pre-provisioned medications that can be remotely directed for use by those suffering certain likely illnesses (e.g. standby RDT and selfRx of malaria, SBTfor odontologic infections, SBTfor Ill with zanamivir in H275Y endemic flu areas; Nitrates-ASA-LG-Beta blockers vs GI cocktail for those with cardiac risks, and more. There is a legal precedence for this in Travel Medicine, and CMS will reimburse for 3 mo supplies for this group). Recommend: Immediate engagement with CMS and reimbursement agencies, and physician. Recommend: immediate analysis of AMERICAN PVERSIGHT HHS-20-0580-B-000228 systems to create long-latency periods between health care visitation. 3. o Deferred High Risk and Unknown Health Risks: contraception is recommended in CHian in endemic areas. No data yet, but abstracting from other systemic viral illnesses, C19 could produce a version of TORCH or other flavi-like congenital malformations; other deferred items are TKR, and other elective orthopedic procedures, bone marrow transplant for transfusion supported CLLor APA; CABG etc. Recommend: active notification of surgeons, oncologists, clinical laboratories, dentists, gynecologists and select patient education portals to accelerate high priority screening and intervention needs, and triage of non-critical procedures for at least 90+ days. 3. o Preservation of Critical Care Capacity: 68-72% of infections are minimally ill or do not require home care (backed out from W-2/Nanjing 4400 hospitalized patients). Of those needing care, they are divided between non ICU (IVF, anti-emetic, electrolyte repletion and late-admitted convalescence with post C19 sequelae) at 15-18% and 9-11% requiring ICU care, typical skilled nursing, special procedures, high FiO2, HDM and ventilation. This is based on experience at a "pretty good" hospital, designed for large scale Ill outbreaks and staffed by Western trained MDs. ignoring the differences we are likely to see similar impacts to US HCFat percentages determined by community testing (to identify the denominator, which does not exist, because the CDCwill not adopt one of 4 HTP PCRassays developed elsewhere ...James will carry this one). Burst and Coast and pushing out Primary care to communities will help preserve capacity for critically ill yet salvageable patients. If you accept this as reasonable, here are some steps done overseas: AMERICAN PVERSIGHT HHS-20-0580-B-000229 1. o Cohorting HCW Workers: Chinese military is running 3 teams of MD-RN-RTLab personnel that do 10 day rotations, which will capture about 80-90% of incubations. This is ok since they have endless PCRcapacity. Teams are either providing care, at home (Barracks) supporting those providing care, or doing prev-med; or on home leave in protected residence. Singapore MOD, and hospitals SGH and TTSH have plans to do this, as have critical financial service groups who cannot interrupt trading (where markets are still open). Key weaknesses of cohorting from China are: no mixing of cohorts. Failure to isolate, leads to infection across cohorts; major dependance on EMR pass off of patients; absolute separation of contaminating services such as food delivery, visitors and portable x ray units; employee unhappiness (cancelled vacations, babies, soccer games) Recommend: hospital networks initiate trial work cohorting at 10-40% rotating employee cohorts to include WFH policies to pre-test electronic sign in, encryption and ability of home workers to support inhospital personnel. 2. o Fortifying HCW (and dependents): W2 collapsed because the absence of skilled HCW as well as absence of PPENPI. HCW absenteeism was driven by illness, and need to care for in home elderly, who are at highest risk. In other disasters here in the US, police and Fire have abandoned their duties to save family members. The best example is Katrina, were NO cruisers were seen lO0mil north packed full of luggage and kids. This was addressed in DISMA by assurances that families will be protected and provisioning in advance. Now, in Singapore, home liaise personnel, round on eacch HCW family to ensure all needs are being met. China military is alleged to be AMERICAN PVERSIGHT HHS-20-0580-B-000230 doing the same (by non military Chinese docs). Fortification and support of HCW famillies prevents distraction and increases commitment to duties. US has some key experts in this area, led by SC of San Fran and Texas DEM. ICSalso has examples of this. Physical Fortification of HCW involves uninterrupted access to PPE,early access to prophylactic therapies and forthcoming vaccines and support for food, sleep and downtime. Recommend: initiate contract service organizations to support HCW families during cohort cycles, and to support families that fall ill due to HAI with C19. 3. o Scaled, Remotely Delivered Expertise: some examples: Indonesian ventilators are being run in Singapore using internet based controls; Chinese sequencers in Nigeria transmit sequence data on pathogen identify and AMR patterns to inform development of new diagnositics-and other genetic intelligence TBD later and Epic style Standard of Care systems are being used to identify poor outcomes in medical networks. Multiple US teams are proposing "app this/a pp that" to ASPR,for smart phone based systems that scale the unsealable: highly trained specialists. This section works to rapidly expand the lessons learned of the most experienced across the US HCN, thus allowing rural 50 med hospitals to handle cases normally referred, and for C19 care, to address the growing list of unusual manifestations of this disease, currently not discussed anywhere in the West. I know nothing about this area, but have access to MITRE, GOOGLEand former DARPA app developers who can assist. Google Ventures and Open Philanthrophy helped Rescue Medicine develop a Ebola App, to help distribute medical consultation to lesser skilled clinicians. We can consider AMERICAN PVERSIGHT HHS-20-0580-B-000231 that here. Anyone? Recommend : no domain expertise 4. o Smart Medical Devices: this refers to expanded use of next generation POC systems which diagnose and respond within one infrastructure. examples are iSTAT units which blue tooth alert for K <3.8; rising Cr, lactate, BUN etc. Ventilators such as Philips 2000 and Enhanced SAVEii are nonpressurized gas, battery driven units that do not squander cylinder 02, and unload pulmonologist and RTs from the lower 90% of ventilation decisions. Lab diagnostics, not bedside, are wired for software updates. BACTEC8000s can alert Clin Micro to patient culture results (although this is not as yet FDA approved). Carter or someone else can comment on escalation of this approach. One plea from DISMA is that systems are resilience, capable of moving from pre-hospital to hospital, a criteria that expands our massive prehospital communities capabilities, supports ventilator enclaves and other MCI operations. Recommend: recommend all future procurement of disaster medical and hospital continuity medical devices be selected based on autonomy from grid, interoperability with multiple wifi and preexisting hospital systems and most importantly, ability to support lesser skilled medical care providers. 5. o Fast Launch Consultancy: convene the greatest evidence based collection of C19 data from ASEAN for rapid dissemination to US HCW, Pharmas and other key elements. We screwed this up with EBOV and care in CONUS repeated mistakes made years previously in DRC. In this scenario, Face Time and other systems can be used as instition based Instructor Trainers, to allow local adoption of basic care principals and to inform groups with small case loads of AMERICAN PVERSIGHT HHS-20-0580-B-000232 less commonly encountered sequela or atypical presentations. This can be executed now. CDC is asking for this information from ASPR,a bad sign. Recommend : this team (Wolverines) be quickly cross trained by Lawler, Callahan and others who have CoV clinical expertise, for purpose of generating Gen 1.0 best practices guidelines to guide physicians in distant centers across US. Be advised, CDC has no clinical expertise in this area, and has degraded ability to gain same from foreign partners. 4. o COVID20: epizoonotic mutable RNA viruses evolve quickly through extended transmission into new species. The vet and Asian poultry industries point this out with endless vaccine do-overs for the same HSNx avian viruses. C19 in China is now encountering human convalescent immunity which will select for immune evading isolates. This is drift, not shift, but threatens the concept of immunehardened workforces. This topic brings out the apocalyptic types that we all know form anthrax and HPAI. There is a more rational group that is informed by genetic hysteriesis, or the strain on genetic mutation, that assesses probability of fitness or evasion. The point is demonstrated now with the differences in idiotype antibodies from the PBMCs from December survivors versus the newer mAbs isolated from February survivors. We should put some energy into this so BARDA doesn 't let Regeneron squander $S00M (as planned) on a shitty Washington state antibody mAb from January, when we can have access to higher avidity (immune polished) mAbs from elite survivors (those with high risk factors, but trivial disease). Darwinian selection in China can accelerate our response to both C19, and might prevent C20. Recommend : this group and trusted colleagues in academic institutions and federal agencies, restore OCONUS surveillance capability led by NAMRUs, AFRIMS, former PREDICTand AMERICAN PVERSIGHT HHS-20-0580-B-000233 PROPHECY performers and (overseas) sister institutions of major medical centers. 5. o BARDA Tech Counsel: BARDA needs immediate oversight of currently planned boondoggle programs that are known to be too futuristic, previously unsuccessful, conflicted by secondary gain, or clinically non-viable for mass casualty infection operations. This list is long. Speaking here, briefly as a big pharma guy, I am emphatic and not alone in stating that massive dollars are now being directed at biotech companies by untrained unqualified individuals. The planned emergency appropriation dollars are being awarded almost completly on the presence of a pre-existing contract history with BARDA and the exploitation and misuse of the OTA. Many intended awards are evidence based(Gilead; remdosivir) and some can be guided to be worth the investment (Regeneron) but nearly all others are not plausible. Several have disclosed through other channels (consulting with COVID19 "experts") that they are exploiting the near complete absence of pharmaceutical life cycle, regulatory and clinical translation expertise at BARDA. Current performers have openly confided this is a great time to grab money from BARDA guppies, a JPM term for BARDA reviewers. Still, if correctly advised by nonconflicted pharma C-suite and FDA regulatory advisors, the anticipated multi billion dollar investment in the next weeks could be salvaged in the following ways: 1. o Pharma truth: the purpose of this effort is to prevent the squandering of current resources. ). Current BARDA investments in MCM cannot ever be turned into approved therapies to help USA in the first wave. If they do not help us now, we should consider reallocating them to any MCM that can reduce morbidity and death. Restated, if the HCN do not have a MCM against C19 in the next 3 months, we do not have one that matters. Tech counsel, featuring CEOs convened by an extra ASPRcommittee and AMERICAN PVERSIGHT HHS-20-0580-B-000234 run by CEO pharma (including Geberding, Peggy, Martine Rothblatt, Elias Zarhouni, Anne Depey, Mike Watson) accounted for approximately $4008 in annual pharma profit. This group produced a report called the Securing a Biodefense Industrial Base for US Gov. It dissected the huge claims of the current BARDA, cried fowl on the absence of human clincial corroboration and identified more viable technologies that could have been funded at that period of time. This report was ignored by BARDA. These CEOs,still under the 2019 2 year CDA, can be reconvened to prevent a BARDA flop against C19. Recommend: Immediate oversight of BARDA investments by other USG Agencies, former FDA officials and nonconflicted CEOs already under CDA. MITRE has this report, and the CDAs and is the ASPR FFRDC. 2. o Clinical Truth: multiple MCMs being contemplated for funding by BARDA, and by NIAID are impossible to administer in the chaotic treatments setting of mass casualty care. In DMCC operations we select therapies that do not tie up critical personnel (avoid remdosivir if possible), do not risk personnel (use po vs IV in VHFs; avoid BIPAP in H7N9 care), require minimal medical training (fentynl patch; use of oral vs IV), require no post treatment medical monitoring (avoid FQ, use macrolides; switch ZMAP for M144), do not produce AEs that masquerade as disease specific findings (sedatives; NSAIDs in VHF), do not interact with other therapies (CoArtem QTCs in Ebola), and have a high therapeutic index (doxy vs cipro for empiric abx of newly admitted Ebola patients). Recommend: Wolverines immediately convene Target Product Profiles (TPP) suitable for high throughput, treat-andrelease mass casualty infection response AMERICAN PVERSIGHT HHS-20-0580-B-000235 operations ... and not BARDA products which require highly trained physicians, complex logistics tail, cold chain, post treatment monitoring and complex and iterative GMP campaigns that threaten supply. 3. o Urgent need for Diagnostics: added here to again emphas ize importance. James to comment. From: Caneva, Duane Sent: Thursday, February 27, 2020 7:59 AM To: Carter Mecher ; Lawler, James V b)(6) unmc .edu>; Callahan, Michael V.,M.D. ,..,..,..,..,.,..---..-----~~~ r_v~a~ rd_.e ~d~u>; Marcozzi, David __ __Jr--'-~~~~ la_n~d~ .e~d~u>; Hepburn, Matthew J CIV USARMY (USA) ; Richard Hatchett Subject: RE:Actions to take now L..._ External Email - Use Caution We'll take a stab on detention facility (congregate setting) actions, since ours is a rea l mess (250 federa l, state, county pr isons, jails, facilit ies that constant ly mix internationa l detainees around the nation-apparently it's a secret sauce for disease spread). Also, as Tracey M always rem inds us, don't forget about domestic pets as platforms or reservo ir for disease ... Apparent ly, USG has a bit of a gap look ing at that. From: Carter Mecher Sent: Thursday, February 27, 2020 7:44 AM To: Lawler, James V ; Callahan, Michael V.,M .D. AMERICAN PVERSIGHT HHS-20-0580-B-000236 6 l--b)(.,.)____ .J>-'-'m=hc:..: .h..:..: a::..:. r-=v=a:....: rd::..:. o=ed =u>; Ma rcozzi, David som.umar land.edu >; Caneva, Duane ; Hepburn, Matthew J CIV USARMY(USA) ; Richard Hatchett Subject: Actions to take now b)(6) CAUTION: This email originated from outside of DHS. DO NOT click links or open attachments unless you recognize and/or trust the sender. Contact your component SOCwith questions or concerns . Bob asked for a list of actions to take now (beyond the NPls). This from the request he gave to Michael. I th ink he wants things for healthcare systems (really acute care and clinics) and vulnerable components like nursing homes and dialysis, etc. To get things started. Here is James' list. Patient hardening - provide additional prescription meds to provide 2 months of supply for every patient if possible. Patients who cannot get such large stockpiles (narcotics etc) should be signed up for by-mail or other refill mechanism that doesn't require in-person visit. Semi-elective surgeries (those that can avoid complications and will need to be done in the next 6 months) should be moved up to immediate to get these off the table. Purely elective things should continue until triggers indicate time to commence NPI in that community. More complicated patients should be tuned up as best as can be over the next several weeks. Facility hardening - Clinics, ERs,Acute Care etc should initiate parallel/separated triage lines for ILi/URi patients that do not cross streams with non ILi/URi immediately. Admission screening should occur for all elective or non-acute ID admissions. URI/ILi should be ident ified and either not admitted or cohorted. Ward cohort ing should start immediatelyadmissions with pneumonia should be cohorted with dedicated wards and staff that do not mix. Outpatient practices should consider engaging home visit/home care options starting now to defer visits. ERsand outpatient clinics should engage telehealth resources for acute issue triage, follow -ups, med refills etc to defer visits to clinics or ERs. Facilities should start expanding inventories of all major rx and supply stocks to be able to absorb interruptions of supply chain. Renovation/construction projects that may interrupt workflow or space capacity should be thought through and delayed or adjusted . Staff hardening - HCW staff will need their personal medical conditions addressed and 2-month stockpile of meds. Should address family member medical issues as well to to avoid staff distraction. Family support resources should be made available for HCW planning - elder care, child care etc. Additional staff should be considered to supplement ward staff and education and training implemented for appropriate IPC practices. AMERICAN PVERSIGHT HHS-20-0580-B-000237 Sent from Mail for Windows 10 The infom1ation in this e-mail is intended only for the person to whom it is addressed. If you believe this e-mail was sent to you in error and theemail contains patient information , please contact the Partners Compliance HelpLine at http://www.partners.org /complianceline . If the e-mail was sent to you m error but does not contain patient information , please contact the sender and properly dispose of the e-mail. Sender: Recipient: Kadlec, Robert (O5/ASPR/IO) Giroir, Brett (HHS/OASH) Sent Date: 2020/02/27 13:05:09 Delivered Date: 2020/02/27 13:05:10 AMERICAN PVERSIGHT HHS-20-0580-B-000238 Trent-Adams, Sylvia (HHS/OASH) AvilesMendoza,Guillermo (OS/OASH); To: Giroir, Brett (HHS/OASH) CC: Johns, Matthew (HHS/OASH) Subject: RE: Update on COVID-19from Region 9 (Sunday 3/8/2020) Date: 2020/03/09 09:30:35 Priority: Normal Type: Note Thank you CDR.This is a great way to share best practices and learn for each other. Please make sure we document the communication and strategies presented. From: AvilesMendoza, Guillermo (OS/OASH) Sent: Monday, March 9, 2020 7:36 AM To: Trent-Adams, Sylvia (HHS/OASH); Giroir, Brett (HHS/OASH) Cc:Johns, Matthew (HHS/OASH) Subject: Re: Update on COVID-19 from Region 9 (Sunday 3/8/2020) 09Mar20 0720 ET Good morning, ADM Giroir, RADM Trent-Adams and CDRJohns, FYSA (b)(S) The WIG for the OASH/RHA's COVID-19 weekly call: Share best practices among RHAs on preparedness and response postures for COVID-19 that will Enhance Situational Awareness (SA) on current responses and identify opportunities RHAs to support preparedness for COVID-19. AMERICAN PVERSIGHT for HHS-20-0580-B-000239 V/R, GAM Guillermo J. Aviles-Mendoza, J.D., LL.M. Deputy Assistant Secretary for Health, Regional Health Op erations (Acting) Commander, U.S . Public Health Service Office of the Assis tant Secretary for Health U .S. Department of Health &Human Services E-mail: Guillermo.Aviles-Mendoza@hhs.gov Office: + 1-202-260-6113 Mobile j~ (b_l(6_l____ ~ "In Officio Salutis" Commissioned Corps of the U.S. Public Health Service. https: //usphs.gov Mission: Protect, Promote and Advance the Health and Safety of the Nation. USPHS Core Values: Service, Excellence, Leadership and Integrity. NOTE : This e-mail may contain sensitive and/or privileged information. If you are not the intended recipient (or have received this email in error) please notify the sender immediately and destroy this email. Any unauthorized copying, disclosure , or distribution of the material in this e-mail is strictly forbidden. Under the Privacy Act of 1974, all data of a private nature must be protected from unauthorized disclosure . Sent from iPhone On: 09 March 2020 06:49, "Trent-Ad a ms, Sylvia (HHS/OASH)" wrote: Thank you CDRJohns. We will share with the RHAs. Please keep us posted as things evolve. If you need anything do not hesitate to call. Sent from my iPhone On Mar 9, 2020, at 5:53 AM, Giroir, Brett (HHS/OASH)wrote: This is a very useful update. Thank you AMERICAN PVERSIGHT HHS-20-0580-B-000240 BG Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Johns, Matthew (HHS/OASH) Sent: Sunday, March 8, 2020 11:47 PM To: AvilesMendoza, Guillermo (OS/OASH) ; Trent Adams, Sylvia (HHS/OASH) Cc: Giroir, Brett (HHS/OASH) Subject: Update on COVID-19 from Region 9 (Sunday 3/8/2020) RADM, CDR, I hope this message finds you both well. (b)(5) AMERICAN PVERSIGHT HHS-20-0580-B-000241 b)(5) Kind regards, CDRJohns MatthewC. Johns,MPH Commander, United States Public Health Service Regional Health Administrator-Region 9 Office of the Assistant Secretary for Health Office of the Secretary United States Department of Health and Human Services 90 7th Street, Suite 5-100 San Francisco, CA 94103 Phone: (415)437-8102 Mobile: ._l (b_H5_l ___ ___, Email: Matthew .Johns@HHS.gov AMERICAN PVERSIGHT HHS-20-0580-B-000242 Website: https:/ /www.hhs.gov /ash/about-ash/regional-offices /region-9/index.html HHS Region 9: In the Service of Health {In Officio Salutis) for Arizona, California, Nevada, Hawaii, American Samoa, Commonwealth of the Northern Mariana Islands, Federated States of Micronesia, Guam, Marshall Islands and the Republic of Palau ..... and 150 Federally-recognized Tribes. Sender: Trent-Adams, Sylvia (HHS/OASH) AvilesMendoza, Guillermo (O5/OASH) ; Giroir, Brett (HHS/OASH) ; Johns, Matthew (HHS/OASH) Sent Date: 2020/03/09 09:30:33 Delivered Date: 2020/03/09 09:30:35 AMERICAN PVERSIGHT HHS-20-0580-B-000243 Kadlec, Robert (O5/ASPR/IO) Giroir, Brett (HHS/OASH) ; Yeskey, Kevin (O5/ASPR/IO) ; Herrmann, Jack (O5/ASPR/OEA) CC: Shuy, Bryan (O5/ASPR/IO) Subject: Fwd: AHCA/NCAL Offering COVID-19 Web inar Tomorrow Date: 2020/03/02 14:57:22 Priority: Norma l Type: Note (b)(5) Sent from my iPhone Begin forwarded message: From: "Wood , Bob" Date: March 2, 2020 at 1:51 :28 PM EST To: "Robert .kadlec@hhs.gov " , "Kevin. Y eskey@hhs.gov " , "John.Herrmann@hhs.gov " Subject: FW: AHCA/NCAL Offering COVID-19 Webinar Tomorrow FYI. Thank you for your time today! We will follow up shortly on a follow up call this afternoon. -Bob From: AHCA/NCAL Sent: Monday, March 2, 2020 1:46 PM To: Wood, Bob Subject: AHCA/NCAL Offering COVID-19 Webinar Tomorrow To view this email as a web page, go here . AMERICAN PVERSIGHT HHS-20-0580-B-000244 1 AHCA. AMERICAN HEALTH NCAL. CARE ASSOCIATION NATIONAL CENTER FOR ASSISTED LIVING COVID-19 Webinar Tomorrow AHCA/NCAL will host a COVID-19 webinar for all long term care providers tomorrow. Tuesday, March 3 4:00 - 5:15 pm ET the interest of public health, this webinar is open to all long term care providers, including members and non-meml AHCA/NCAL. he webinar will include an update from Centers for Disease Control and Prevention (CDC) officials and AHCA/NCAI Join the Webinar ----- AMt'RICAN PVERSIGHT HHS-20-0580-B-000245 o Participate: ,EASE TEST YOUR COMPUTER IN ADVANCE! ?ect your web browser to the following URL: https://protect2.fireeye.com/url?k=ddc06ae8-81956338-ddc05bd7:47a6a52dele2fa829df29a8&u=http://eventcenter.commpartners.com/se/Meetings/Browser Test New .aspx?account. id=Com mP ~ THE DAY OF THE EVENT llow the instructions below 15 minutes prior to the scheduled start time to join the web portion as well as the phone sed audio. Direct your web browser to the following URL: https://protect2.fireeye.com/url?k=19f3db2e-45a6d2fe19f3ea11-0cc47a6a52de1b218eea704459e4&u=http://eventcenter.commpartners.com/se/Rd/Mt.aspx?694884 2. o Please enter your display name, e-mail address, number of people sitting in with you, and press "Enter Meetir 3. o You will listen to today's program via streaming audio, or through your computer speakers. If the presentation out, please refresh your screen by pressing F5 or CommandR for a MAC. 'OU need technical assistance, please send a message in the chat or e-mail ahca@commpartners.com . 1. o tay Up to Date ;it our webpage here daily for the latest information that AHCA/NCAL has to share with our members about COVIDICA/NCAL is working nationally with the CDC to ensure our members are receiving necessary supplies and guidanc went the spread of this disease. OFace book AMERICAN PVERSIGHT Or witter AHCA I Ov ouTube I Provider NCAL 4eu nked ln HHS-20-0580-B-000246 This email was sent to: bwood@bgrdc.com This email was sent by: American Health Care Association 1201 L St. NW Washington, DC 20005 United States We respect your right to privacy - v iew our policy Updat e Profi le Sender: Kadlec, Robert (O5/ASPR/IO) Giroir, Brett (HHS/OASH) ; Yeskey, Kevin (O5/ASPR/IO) ; Recipient: Herrmann, Jack (O5/ASPR/OEA) ; Shuy, Bryan (OS/ASPR/1O) Sent Date: 2020/03/02 14:57:21 Delivered Date: 2020/03/02 14:57:22 AMERICAN PVERSIGHT HHS-20-0580-B-000247 Haddad, Carla (HHS/OASH) To: Giroir, Brett (HHS/OASH) CC: Wainwright, Jacob (HHS/OASH/IO) Subject: RE: FORREVIEW : Slides for Dr. Birx Date: 2020/03/12 13:28:39 Priority: Normal Type: Note From: Haddad, Carla (HHS/OASH) Sent: Thursday, March 12, 2020 12:52 PM To: Giroir, Brett (HHS/OASH) Subject: FOR REVIEW:Slides for Dr. Birx Importance: High b)(5) << File: COVID-19-TestingSlides_vl.pptx >> From: Wainwright, Jacob (HHS/OASH/1O) Sent: Thursday, March 12, 2020 12:32 PM To: Haddad, Carla (HHS/OASH) ; Giroir, Brett (HHS/OASH) Subject: RE:Talkers Good afternoon, Best, Jacob AMERICAN PVERSIGHT HHS-20-0580-B-000248 From: Haddad, Carla (HHS/OASH) Sent: Thursday, March 12, 2020 11:32 AM To: Giroir, Brett (HHS/OASH) Cc:Wainwright, Jacob (HHS/OASH/1O) Subject: RE: Talkers b)(5) From: Giroir, Brett (HHS/OASH) Sent: Thursday, March 12, 2020 11:24 AM To: Haddad, Carla (HHS/OASH) Subject: Talkers << File: FACTSABOUT LABORATORYTESTING3.12.20 Bullets.docx >> Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 Haddad, Carla (HHS/OASH) Giroir, Brett (HHS/OASH) ; Recipient: Wainwright, Jacob (HHS/DASH/IO) Sent Date: 2020/03/12 13:28 :38 Delivered Date: 2020/03/12 13:28:39 AMERICAN PVERSIGHT HHS-20-0580-B-000249 Giroir, Brett (HHS/OASH) To: OS SecretarysOperations Center Yeskey, Kevin (OS/ASPR/10); Orsega, Susan (O5/OASH) ; SOCLeadership; CC: Shuy, Bryan (OS/ASPR/10); Kadlec, Robert (OS/ASPR/10); Austin, Meredith (uscg.mil) Subject: RE: COVID-19Open Media Report 29Feb20 Date: 2020/02/29 17:20:00 Priority: Normal Type: Note b)(5) Media Statement For Immediate Release Saturday,Feb.29,2020 Contact: CDC Media Relations 404-639-3286 CDC, Washington State Report First COVID-19 Death There also are ongoing investigations into possible outbreaks in health care settings The Centers for Disease Control and Prevention (CDC) and public health officials in the state of Washington have reported three hospitalized patients who have tested presumptive-positive for the virus that causes COVID-19, including one patient who died. AMERICAN PVERSIGHT HHS-20-0580-B-000250 o o Two of the patients are from a long-term care facility (LTCF) where one is a health care worker. Additional residents and staff of the LTCF who have not yet been tested for COVID-19 are reportedly either ill with respiratory symptoms or hospitalized with pneumonia of unknown cause. o o The patient who died, a male in his 50s, was being treated at the same hospital. He was not a resident of the LTCF. CDC enoneously identified the patient as female in a briefing earlier today with the President and Vice President. While there is an ongoing investigation, the source of these infections is cunently unknown. Circumstances suggest person-to-person spread in the community , including in the LTCF. CDC spokesperson Dr. Nancy Messonnier said, "Our hearts go out to the family of the patient who died as well as the families of the people who are caught up in this outbreak. The health of the residents, staff and community of this skilled nursing facility are a top priority. We will work with Public Health - Seattle and King County to support the care of the patients, the safety of the health care workers, and the well-being of the people in the swTounding community." This is the first reported death in the United States from COVID-19 , as well as the first reported case in a health care worker and the first possible outbreak in a LTCF. These reports from Washington follow others of community spread in Oregon and two places in California earlier this week. While there is still much to learn about the unfolding situations in California, Oregon and Washington , preliminary information raises the level of concern about the immediate threat for COVID-19 for certain communities in the United States. Most people in the United States will have little immediate risk of exposw-e to this virus, but some people will be at increased risk depending on their exposures. The greatest risk is to those who have been in close contact with people with COVID-19. People with suspected or confirmed exposure should reach out to their state or local public health depaitment. CDC is sending a team of experts to support the investigation in Washington. Dr. Messonnier said, "We recognize that this is a difficult time; we are facing a historic public health challenge. We will continue to respond to COVID-19 in an aggressive way to contain and blunt the threat of this virus. While we still hope for the best, we continue to prepare for this virus to become widespread in the United States." These three cases bring the total number of COVID-19 cases detected through the U.S. public health system to 22. The federal government will continue to respond aggressively to this rapidly evolving situation. Testing for the virus that causes COVID-19 was conducted in Washington state using the CDC rRT-PCR. Results will be confirmed at CDC, but a presumptive positive result using the CDC test is treated as a positive for public health response purposes and a coordinated public health response has begun. For more information about COVID-19 visit www.cdc.gov/covid19 . AMERICAN PVERSIGHT HHS-20-0580-B-000251 Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: OSSecretarys Operat ions Center Sent: Saturday, February 29, 2020 5:09 PM To: Giroir, Brett (HHS/OASH) Cc:Yeskey, Kevin (OS/ASPR/IO); Orsega, Susan (OS/OASH) ; SOC Leadership ; Shuy, Bryan (OS/ASPR/IO); Kadlec, Robert (OS/ASPR/IO); Austin, Meredith (uscg.mil) ; OSSecretarys Operations Center Subject: RE:COVID-19 Open Media Report 29Feb20 ADM Giroir, b)(5) V/r Matt Peitzman Deputy Director Secretary's Operations Center 202-619-7800 Hhs.soc@hhs.gov CONFIDENTIALITY NOTICE: This e- mai l communication and any attachments may contain confident ial and pr iv ileged information for the use of the designated recip ients . If you are not the intended recip ient, (or authorized to receive for the recipient) you are hereby notified that you have rece ived this communication in error and that any review, disclosure, disseminat ion, distr ibut ion or copying of it or its contents is proh ibited. If you have rece ived th is commun icat ion in error, please destroy all copies of this commun icat ion and any attachments and contact the sender by reply e-mail or te lephone (202-619 - 7800). AMERICAN PVERSIGHT HHS-20-0580-B-000252 From: Giroir, Brett (HHS/DASH) Sent: Saturday, February 29, 2020 4:35 PM To: OSSecretarys Operations Center Cc:Yeskey, Kevin (OS/ASPR/IO); Orsega, Susan(OS/OASH) Subject: RE:COVID-19 Open Media Report 29Feb20 Importance: High Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC20201 Office Phone: 202-690-7694 From: OSSecretarys Operations Center Sent: Saturday, February 29, 2020 4:32 PM To: OSSecretarys Operations Center Subject: COVID-19 Open Media Report 29Feb20 UNCLASSIFIED / / FOR OFFICIAL USE ONLY Good afternoon all, Attached is the 29Feb20 COVID-19 Open Media Report. BLUF: One woman cases of COVID-19 teacher in Oregon. actions being taken in her SO's has died from COVID - 19 in Washington State. Two new were reported in a high school student in Washington and in a school President Trump held a press briefing to provide an update and new to prevent further spread of COVID-19 in the U.S. Epidemiology: Official case counts are distributed via the COVID-19 Morning CDC Updates and COVID-19 SLBs. o o Traditional news media reports over 85,000 cases globally, and more than 3,000 worldwide deaths . The vast majority of cases remains in mainland China . o o Two new cases of COVID-19 were reported in the Seattle, WA area. Both cases are reported to be 'presumptive positive' while awaiting confirmation of the Public Health lab's results by the CDC. One was a high school student who contracted the virus from the commun ity. The second case is a woman in her sos who traveled to Daegu, South Korea. o o Washington State has reported the first U.S. death from COVID-19 . o o A healthcare worker at a long-term care facility in Kirkland, Washington is reported as testing positive for COVID-19. AMERICAN PVERSIGHT HHS-20-0580-B-000253 Public Health/Clinical Response: o o Governor Inslee has issued a state of emergency in Washington State due to the newly reported cases of COVI D-19. o o The President gave an update today about COVID-19. The president and experts informed people that the risk currently remains low to the general population . Health Care workers will be given the proper supplies while treating patients with COVID19. o o FDA issued a guidance document on 29 February 2020 allowing more laboratories to conduct diagnostic testing for COVID-19. The guidance document will allow 300400 academic laboratories and several community hospitals to run this diagnostic test. Public Sentiment o o Many Tw itter accounts show that people are worried about the spread of COVID19. People are suggesting stocking up on groceries and other supplies in case of an outbreak in their communities. Please see the attached Open Media Report for additional information. distributed to the 2019 nCoV Distribution Lists. This message was Pre pa red by: Secretary's Operations Center U.S. Department of Health and Human Services (HHS) Assistant Secretary for Preparedness and Response (ASPR) 200 Independence Ave. S.W. Washington D.C. 20201 Office (202) 619-7800 Fax : 800-514-4256 Email: hhs.soc @hhs.gov cid: image001.png@0lD5E9B2.F84B1BA0 Data enclosed in this email are subject to the Privacy Act of 1974, as amended. Contents shall not be disclosed, discussed, or shared with individuals unless they have a direct needto-know in the performance of their official duties. Unauthorized disclosure of this information may result in civil or criminal penalties. CONFIDENTIALITY NOTICE: This e-mail communication and any attachments may contain confidential and privileged information for the use of the designated recipients. If you are not the intended recipient, (or authorized to receive for the recipient) you are hereby notified that you have received this communication in error and that any review, disclosure, dissemination, distribution or copying of it or its contents is prohibited. If you have received this communication in error, please destroy all copies of this communication and any attachments and contact the sender by reply e-mail or telephone (202-619-7800). UNCLASSIFIED AMERICAN PVERSIGHT / / FOR OFFICIAL USE ONLY HHS-20-0580-B-000254 Sender: Giroir, Brett (HHS/OASH) OS SecretarysOperations Center ; Yeskey, Kevin (OS/ASPR/IO); Orsega, Susan (OS/OASH); SOCLeadership; Shuy, Bryan (O5/ASPR/IO) ; Kadlec, Robert (OS/ASPR/IO); Austin, Meredith (uscg.mil) Sent Date: 2020/02/29 17:20:33 Delivered Date: 2020/02/29 17:20:00 AMERICAN PVERSIGHT HHS-20-0580-B-000255 Bright, Rick (O5/ASPR/BARDA) To: Giroir, Brett (HHS/OASH) Subject: Re: Adimab/COVID- 19 mission Date: 2020/02/25 23: 15:44 Priority: Normal Type: Note (b)(5) On Feb 25, 2020, at 10:31 PM, Giroir , Brett (HHS/OASH) wrote: n (b)(5) Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Bright, Rick (OS/ASPR/BARDA) Sent: Tuesday, February 25, 2020 10:30 PM To: Giroir, Brett (HHS/DASH) Subject: Re: Adimab/COVID-19 mission (b)(5) Thanks. Rick. AMERICAN PVERSIGHT HHS-20-0580-B-000256 On Feb 25, 2020, at 10:23 PM, Giroir , Brett (HHS/OASH ) wrote: ? (b)(5) BG Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Ajay Royan Sent: Tuesday, February 25, 2020 10:18 PM To: Giroir, Brett (HHS/OASH) Cc: Rick Perry b)(6 ) mail.com > Subject: Adima VID-19 mission Dear Rick, Thank you kindly for the call yesterday , and for connecting us. Dear Dr. Giroir, It's a pleasure to met you over email. The team at Adimab - an antibody discovery platform based in New Hampshire - was previously successful at isolating and sequencing antibodies contra the 2014 Ebola outbreak. I spoke yesterday with Dr. Tillman Gerngross , the founder of Adimab ; he and his team are standing by to help in any way they can. As with the ebola situation , this is outside of the company's normal commercial course but very much in line with their public service mission and technical capabilities. AMERICAN PVERSIGHT HHS-20-0580-B-000257 Below are two backgrounders that might be helpful to introduce Adimab: 1.) A high-level summary of Adimab's work with USAMRIID and others to isolate an antibody therapy for the 2014 Ebola strain that affected the US https :// p rotect2. fire eye. com/u rl?k=43e0 b 72f-1 fb5beff-43e0861 00cc4 7a6a52dec51024d359d9adc4&u=https://www.adimab.com/news/2016-0218-anti-ebola-vi rus-antibodies 2.) The resultant paper published 2016 in Science https ://scie nee.science mag. o rg/ conte nt/351 /62 77/ 10 78 b)(4) It would be my pleasure to connect Dr. Gerngross (tillman.gerngross@adimab.com ) with you or follow-up as otherwise appropriate. And to be helpful in this or any other way , given our involvement with a growing group of motivated and talented technologists who are getting activated around this mission. With thanks and my best, Ajay Adimab Scientists Report the Isolation of Highly Potent Anti-Ebola Virus Antibodies from Recent Zaire Outbreak Adimab, LLC, a global leader in the discovery of human antibodies, today reported the isolation of a broad panel of neutralizing anti-Ebola virus antibodies from a survivor of the AMERICAN PVERSIGHT HHS-20-0580-B-000258 recent Zaire outbreak. The work, published online today in the journal Science, highlights the remarkable speed of Adimab's recently launched single B cell isolation platform, and constitutes the largest panel of functional anti-Ebola antibodies reported in the scientific literature to date. The sequences of all antibodies isolated in this study will be made freely available to the research community through the GenBank database. "Our Science paper describes the first in-depth view into the human antibody response to Ebola virus," said Laura Walker, Ph.D., Senior Scientist at Adimab, and the corresponding author of the study. "Within weeks of receiving a blood sample from a survivor of the 2014 Ebola outbreak, we were able to isolate and characterize over 300 monoclonal antibodies that reacted with the Ebola virus surface glycoprotein." After the initial isolation and characterization of the anti-Ebola antibodies at Adimab, several leading institutions in the field of virology, including The Scripps Research Institute, La Jolla, CA and the US Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, MD, provided an in-depth analysis of the therapeutic potential of these newly isolated antibodies. "Over the past decade, our laboratory has analyzed over one hundred antibodies against the Ebola virus," commented Pamela Glass, Ph.D., Senior Investigator at USAMRIID. "Several of the antibodies provided by Dr. Walker's team display the most potent neutralization and protection we have ever seen." Additional structural analysis at The Scripps Research Institute provided further insight into the diversity of the human immune response to Ebola. "The antibody panel discovered by Adimab covers every previously known binding site on Ebola virus and their work further revealed a new, highly potent neutralizing site, that has not been reported to date," said Prof. Andrew Ward, Scripps Research Institute, a co-author of the study. "In less than two months the Adimab team isolated more neutralizing Ebola antibodies than the entire Ebola field has reported in the past two decades," noted Tillman Gerngross, Ph.D., CEO and Co-Founder of Adimab and a Professor of Bioengineering at Dartmouth College. "The global public health community has been looking for a rapid response platform to emerging infectious disease threats and Laura's team has set an entirely new standard for rapidly isolating protective antibodies that could be turned into effective therapeutics. We now have a broadly applicable platform to deal with these threats." AMERICAN PVERSIGHT HHS-20-0580-B-000259 "Not only has the Adimab team isolated an extensive panel of therapeutically promising Ebola antibodies in such a short time frame, but the fact that they have made these antibodies available to the research community for further studies is remarkable and shows their humanitarian intent to advance the field without regard for commercial gain," said John Dye, Ph.D., Chief of Viral Immunology at USAMRIID. Adimab separately noted that it has applied its B cell isolation platform against the respiratory syncytial virus (RSV) with similar results. The Company also intends to demonstrate the applicability of the B cell isolation platform against the Zika virus. The study, entitled "Isolation of Potent Neutralizing Antibodies from a Survivor of the 2014 Ebola Virus Outbreak", is available online and will be published in the February 18th, 2016 issue of Science. The sequences generated in this work will be made available to the research community via GenBank. About Adimab Over the past six and a half years, Adimab has established antibody discovery collaborations with over 35 pharmaceutical companies including many leading drug companies, such as Merck, Novo Nordisk, Biogen, GSK, Roche, Novartis, Eli Lilly, Genentech, Celgene, Gilead, Kyowa Hakko Kirin, and Sanofi. Sender: Recipient: Bright , Rick (OS/ASPR/BARDA) Giroir, Brett (HHS/OASH) Sent Date: 2020/02/25 23: 15:43 Delivered Date: 2020/02/25 23: 15:44 AMERICAN PVERSIGHT HHS-20-0580-B-000260 Giroir, Brett (HHS/OASH) To: Migliaccio-Grabill,Kate (HHS/OASH) Susan Orsega (OS/OASH)(Susan.Orsega@hhs.gov) Subject: FW: HHS Domestic SPOTREP:Novel Coronavirus, Wuhan, China (Update #14) Date: 2020/01/25 08:45:00 Priority: Normal Type: Note Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: OS Secretarys Operations Center Sent: Friday, January 24, 2020 8 :23 PM To: OS Secretarys Operations Center Subject: HHS Domest ic SPOTREP: Novel Coronavirus, Wuhan, China (Update #14) UNCLASSIFIED I I FOR OFFICIAL USE ONLY HHS Domestic SPOTREP: Novel Coronavirus, Wuhan, China (Update #14) What: There are two confirmed cases of 2019-nCoV (Washington and Illinois). o o o in the United States Members of U.S. Senate were briefed on 24Jan20 o A press release was also issued Entry screening is taking place at Atlanta (ATL), Chicago (ORD) airports, San Francisco (SFO), Los Angeles (LAX), and John F Kennedy (JFK). o To date 2,204 persons on 239 flights have been screened as of 23Jan20 and 1 was referred for medical evaluation. CDC has detailed several staff to WHO in Geneva who are assisting with the nCoV response. Medical Care and Countermeasures: (b)(5) AMERICAN PVERSIGHT HHS-20-0580-B-000261 (b)(5) Laboratory and Epidemiology: For more details, please see attached CDC SITREP for Novel Coronavirus. When: 24Jan20 2022ET Where: International Why: CIR: Disease - International Actions/Follow-Up: The SOC will cont inue to monitor this incident and report as needed. This message was distributed to the SOC SPOTREP-SITREP Distribution List. UNCLASSIFIED / / FOR OFFICIAL USE ONLY Prepared by: Brian Pittman, Watch Officer Approved by: RHibano Dokong, Senior Watch Officer Secretary's Operations Center U.S. Department of Health and Human Services (HHS) Assistant Secretary for Preparedness and Response (ASPR) 200 Independence Ave S.W. Washington D.C. 20201 Office: (202) 619 - 7800 Fax: (202) 619 - 8602 Email: hhs.soc@hhs.gov :::c:: Description: Description: Description: Description: Description: Description: Descr iption: Description: Description: Cid: image001.png@01CCFC4D. 92F36DD0 Description: CONFIDENTIALITY NOTICE: This e-mail communication and any attachments may contain confidential and privileged information for the use of the designated recipients. If you are not the intended recipient, (or authorized to receive for the recipient) you are hereby notified that you have received this communication in error and that any review, disclosure, dissemination, distribution or copying of it or its contents is prohibited. If you have received this communication in error, please destroy all copies of this communication and any attachments and contact the sender by reply e-mail or telephone (202-619-7800). Sender: Recipient: AMERICAN PVERSIGHT Giroir, Brett (HHS/OASH) Migliaccio-Grabill,Kate (HHS/OASH); HHS-20-0580-B-000262 Susan Orsega (OS/OASH) (Susan.Orsega@hhs.gov) Sent Date: 2020/01/25 08:45:51 Delivered Date: 2020/01/25 08:45:00 AMERICAN PVERSIGHT HHS-20-0580-B-000263 Giroir, Brett (HHS/OASH) Susan Orsega (O5/OASH) (Susan.Orsega@hhs.gov) Subject: FW: HHS International FYSA:Novel Coronavirus, Wuhan, China (Update #9) Date: 2020/01/21 21: 15:00 Priority: Normal Type: Note Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: OS Secretarys Operations Center Sent: Tuesday, January 21, 2020 9:14 PM To: OS Secretarys Operations Center Subject: HHS International FYSA:Novel Coronavirus, Wuhan, China (Update #9) HHS Internat iona l FYSA : Nove l Coro navirus, Wu ha n, China (Update #9) The current situation relates to an outbreak of Novel Coronavirus in Wuhan, China . CDC confirmed the first case of Novel Coronavirus o o o o o o o in the United States: CDC deployed a multidisciplinary team to Washington to assist with clinical management, contact tracing and communications. 297 cases of confirmed 2019-nCoV in 6 countries as of 21Jan20. CDC is planning for scale up of screening of travelers from Wuhan in airports in Atlanta (ATL) and Chicago (ORD), in addition to San Francisco (SFO), Los Angeles (LAX) and John F Kennedy (JFK) and consider funneling passengers (re-ticketing) from Wuhan through these 5 airports 1,265 persons were screened as of 20lan20 and none were referred for medical evaluation. CDC Travel health notice was elevated to level 2, practice enhanced precautions on 21Jan20. CDC laboratory is coordinating to provide assays and reagents to priority countries which is being initiated this week. Initiating manufacturing of reagents for 2019-nCoV real time RT-PCR assay for domestic and international distribution. Supporting infection prevention and control discussions as needed for US persons under investigation and potential confirmed cases. AMERICAN PVERSIGHT HHS-20-0580-B-000264 The SOC and ASPR IHR program will continue to monitor this incident and report as needed. This message was sent to the SOC FYSA Distribution List. Prepared by: Brian Pittman, Watch Officer Approved by: CDR Christi Bonaparte, Senior Watch Officer Secretary's Operation Center U.S. Department of Health and Human Services (HHS) Assistant Secretary for Preparedness and Response (ASPR) 200 Independence Ave S.W. Washington D.C. 20201 Office: (202) 619 - 7800 Fax: (202) 619 - 8602 Email: hhs.soc@hhs.gov :::c:: Description: Description: Description: Description: Description: Description: Description: Description: Description: cid: image001.png@01CCFC4D. 92F36DD0 Description: CONFIDENTIALITY NOTICE: This e-mail communication and any attachments may contain confidential and privileged information for the use of the designated recipients. If you are not the intended recipient, (or authorized to receive for the recipient) you are hereby notified that you have received this communication in error and that any review, disclosure, dissemination, distribution or copying of it or its contents is prohibited. If you have received this communication in error, please destroy all copies of this communication and any attachments and contact the sender by reply e-mail or telephone (202-619-7800). Sender: Giroir, Brett (HHS/OASH) Recipient: Susan Orsega (OS/OASH)(Susan.Orsega@hhs.gov) Sent Date: 2020/01/21 21: 15:13 Delivered Date: 2020/01/21 21:15:00 AMERICAN PVERSIGHT HHS-20-0580-B-000265 Giroir, Brett (HHS/OASH) Schwartz, Erica (HHS/OASH) ; Trent-Adams, Sylvia (HHS/OASH) ; Orsega, Susan (OS/OASH) CC: Haddad, Carla (HHS/OASH) ; > Subject: RE: Smell Test Needed ... Date: 2020/02/29 19:48:00 Priority: Normal Type: Note Thank you Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Schwartz, Erica (HHS/OASH) Sent: Saturday, February 29, 2020 7:43 PM To: Giroir, Brett (HHS/OASH) ; Trent-Adams, Sylvia (HHS/OASH) ; Orsega, Susan (OS/OASH) Cc: Haddad, Carla (HHS/OASH) ; Valentine, Steven (HHS/OASH) Subject: RE: Smell Test Needed ... ADM Giroir, b)(5) v/r, RADM Erica Schwartz, MD, JD, MPH Deputy Surgeon General Office of the Surgeon General United States Public Health Service U.S. Department of Health and Human Services AMERICAN PVERSIGHT HHS-20-0580-B-000266 200 Independence Ave SW, Suite 701-H Washington, DC 2020 l Office Phone: 202-401-4660 Email: erica.schw artz@hhs. gov From: Giroir, Brett (HHS/OASH) Sent: Saturday, February 29, 2020 7:09 PM To: Trent-Adams, Sylvia (HHS/OASH) ; Schwartz, Erica (HHS/OASH) ; Orsega, Susan (OS/OASH) Cc: Haddad, Carla (HHS/OASH) ; Valentine, Steven (HHS/OASH) Subject: Smell Test Needed ... Importance: High b)(5) BG Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 Sender: Giroir, Brett (HHS/OASH) Schwartz, Erica (HHS/OASH) ; Trent -Adams, Sylvia (HHS/OASH) ; Orsega, Susan (O5/OASH) ; Haddad, carla (HHS/OASH) ; Valentine, Steven (HHS/OASH) Sent Date: 2020/02/29 19:48: 11 Delivered Date: 2020/02/29 19:48:00 AMERICAN PVERSIGHT HHS-20-0580-B-000267 Bright, Rick (O5/ASPR/BARDA) Giroir, Brett (HHS/OASH) ; To: Dodgen, Daniel (O5/ASPR/SPPR) Haddad, carla (HHS/OASH) ; Tegeris, John (OS/ASPR/BARDA) (CTR) ; Seals, Jonathan (O5/ASPR/BARDA) Subject: RE: CV- 19 Anti-vira l candidate Date: 2020/03/11 15:57:42 Priority: Normal Type: Note (b)(5) From: Giroir, Brett (HHS/OASH) Sent: Wednesday, March 11, 2020 3:43 PM To: Dodgen, Daniel (OS/ASPR/SPPR) Cc: Bright, Rick (OS/ASPR/BARDA) ; Haddad, Carla (HHS/OASH) Subject: FW: CV-19 Anti-viral candidate (b)(5) BG Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 AMERICAN PVERSIGHT HHS-20-0580-B-000268 Office Phone: 202-690-7694 From: David Shanahan Sent: Wednesday, March 11, 2020 2:29 PM To: Giroir, Brett (HHS/OASH) Subject: CV-19 Anti-viral candidate Brett , (b)(4) Regards, David Shanahan Sender: Bright, Rick (OS/ASPR/BARDA) Giroir, Brett (HHS/OASH) ; Dodgen, Daniel (O5/ASPR/SPPR) ; Haddad, (aria (HHS/OASH) ; Tege ris, John (OS/ASPR/BARDA) (CTR) ; Seals, Jonathan (OS/ASPR/BARDA) Sent Date: 2020/03/11 15:57:40 Delivered Date: 2020/03/11 15:57:42 AMERICAN PVERSIGHT HHS-20-0580-B-000269 Kadlec,Robert (O5/ASPR/IO) To: Mango, Paul (HHS/IOS) CC: Giroir, Brett (HHS/OASH) Subject: RE: Critical supplies for testing labs Date: 2020/03/14 08:03:46 Priority: Normal Type: Note Bob From: Mango, Paul (HHS/IOS) Sent: Saturday, March 14, 2020 7:58 AM To: Kadlec, Robert (OS/ASPR/1O) Cc:Giroir, Brett (HHS/OASH) Subject: Critica l supplies for test ing labs b)(5) Sent from my iPhone Begin forwarded message: From: Julie Khani Date: March 14, 2020 at 7 :55 :37 AM EDT To: " Mango, Paul (HHS/IOS)" Subject: Supplies Total immediate need: o N95 Respirators: 96,000 o Government exemption for fit testing regulations for N95s o Ear-Loop Masks: 3,000,000 These numbers are based on 2-months of supply needs. Assuming re-use, each employee requires: 4 - N95s/EE (2/mth) and 30 - Ear Loop Masks o PSCPhlebotom ist s {6,200): (1/day) AMERICAN PVERSIGHT HHS-20-0580-B-000270 o IOP Phlebotomists (4,700): (1/day) Lab Workers (13,000): (1/day) Logistics Couriers (3800): PSCPatients (2,200 PSCs): o o o Sender: Recipient: 4 - N95s/EE (2/mth) and 30 - Ear Loop Masks 4 - N95s/EE (2/mth) and 30 - Ear Loop Masks 30 - Ear Loop Masks (1/day) 2,200,000 (15/day per PSC) Kadlec,Robert (OS/ASPR/IO) ( FYDIBOHF23SPDL T)/CN= RECIPIENTS/CN Mango, Paul (HHS/IOS) ; Giroir, Brett (HHS/OASH) Sent Date: 2020/03/14 08:03:45 Delivered Date: 2020/03/14 08:03:46 Message Flags: Unread AMERICAN PVERSIGHT HHS-20-0580-B-000271 Giroir, Brett (HHS/OASH) Heck, Mia (HHS/OASH) ; To: Wainwright, Jacob (HHS/OASH/10) CC: Subject: Valentine, Steven (HHS/OASH) RE: Webinar Announcement: Final 2018 Mortality Data Release with a Special Highlight on Maternal Mortality Date: 2020/01/25 09:49:00 Priority: Normal Type: Note Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Heck, Mia (HHS/OASH) Sent: Friday, January 24, 2020 5:23 PM To: Giroir, Brett (HHS/OASH) ; Wainwright, Jacob (HHS/OASH/10) Cc: Broida, Tara (HHS/OASH) ; Valentine, Steven (HHS/OASH) Subject: RE: Webinar Announcement: Final 2018 Mortality Data Release with a Special Highlight on Maternal Mortality From: Giroir, Brett (HHS/OASH) Sent: Friday, January 24, 2020 5:12 PM To: Wainwright, Jacob (HHS/OASH/10) ; Heck, Mia (HHS/OASH) Subject: FW: Webinar Announcement: Final 2018 Mortality Data Release with a Special Highlight on Maternal Mortality AMERICAN PVERSIGHT HHS-20-0580-B-000272 Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: National Center for Health Statistics (NCHS) (CDC) Sent: Friday, January 24, 2020 12:01 PM To: Giroir, Brett (HHS/OASH) Subject: Webinar Announcement : Final 2018 Mortality Data Release with a Special Highlight on Maternal Mortality !Image removed by sender. National Center for Health Statistics Scientific Reports! January 24, 2020 Webinar Announcement: Final 2018 Mortality Data Release with a Special Highlight on Maternal Mortality The National Center for Health Statistics (NCHS) will release the Final 2018 Mortality File and accompanying reports on Thursday, January 30, 2020. In addition to reports highlighting life expectancy and drug overdose, NCHS will release new reports on maternal mortality measurement in the United States, along with detailed data files for researchers. With the rele, of these data and reports, NCHS is resuming publication of an official Maternal Mortality Rate ? the first time since 2007. Join NCHS for a webinar, open to the public, on Thursday, January 30th, at 2:30pm EST, to learn more about the final mortality data release, maternal mortality data, and the new accompanying reports. NCHS will provide detailed information on reporting of maternal mortality statistics, how reporting has changed as states have added a pregnancy checkbox on their death certificates, changing in coding procedures, and the release of the first official national Maternal Morta Rate since 2007. AMERICAN PVERSIGHT HHS-20-0580-B-000273 Webinar Details Thursday , January 30th, at 2:30-3:30 pm EST Partici ants can ?oin the Sk e meetin via the free Skype Meeting App at: (b)(6) For the full experience (i.e. audio , video, and chat) , attendance through the Skype Meeting App is recommended. However, participants may also dial-in to the audio conference line at (855) 348-8390, Access Code fb )(5) I It is recommended that those wishing to attend via Skype should test their systems prior to the meetin1 ensure access . Hel for Sk e can be found at: b)(6 ) (b)(6) Live captioning will also be setup for this event. A URL for real-time closed captioning is forthcoming. For the latest information lease see webinar details at: (b)(6) II II II II Centers for Disease Control and Prevention 1600 Clifton Rd Atlanta, GA 30329 1-800-CDC-INFO (800-232-4636) TTY: 888-232-6348 ucstions or Problems AMERICAN PVERSIGHT I Unsubscribe HHS-20-0580-B-000274 aj Image removed by sender. Sender: Giroir, Brett (HHS/OASH) Heck, Mia (HHS/OASH) ; Wainwright, Jacob (HHS/OASH/IO) ; Valent ine, Steven (HHS/OASH) Sent Date: 2020/01/25 09:49:32 Delivered Date: 2020/01/25 09:49:00 AMERICAN PVERSIGHT HHS-20-0580-B-000275 Kadlec, Robert (OS/ASPR/IO) Chang, William (HHS/OGC) ; To: Harrison, Brian (HHS/IOS) Redfield, Robert R. (CDC/OD) ; Cetron, Marty (CDC/DDID/NCEZID/DGMQ) ; Charrow, Robert (HHS/OGC) ; Stimson, Brian (HHS/OGC) ; Stannard, Paula (HHS/IOS) ; CC: McGowan, Robert (Kyle) (CDC/OD/OCS) ; Giroir, Brett (HHS/OASH) ; Shuy, Bryan (OS/ASPR/IO) ; Stecker, Judy (OS/IOS) ; Mango, Paul (HHS/IOS) Subject: RE:~b)(5) I Date: 2020/03/14 09:06:23 Priority: Normal Type: Note (b)(5) From: Chang, William (HHS/OGC) Sent: Saturday, March 14, 2020 8:50 AM To: Harrison, Brian (HHS/1OS) Cc: Redfield, Robert R. (CDC/OD) ~cdc.gov>; Cetron, Marty (CDC/DDID/NCEZID/DGMQ) ; Charrow, Robert (HHS/OGC) ; Stimson, Brian (HHS/OGC) ; Stannard, Paula (HHS/1OS); McGowan, Robert (Kyle) (CDC/OD/OCS) ; Giroir, Brett (HHS/OASH) ; Kadlec, Robert (OS/ASPR/1O); Shuy, Bryan (OS/ASPR/1O); Stecker, Judy (OS/1OS); Mango, Paul (HHS/IOS) 5 Subject: fb ...._H_)__________ __, Attorney-Client Privilege; Attorney-Work AMERICAN PVERSIGHT Product; Deliberative and Pre-decisional HHS-20-0580-B-000276 Brian: b)(5) Best, Will Kadlec, Robert (O5/ASPR/IO) Chang, William (HHS/OGC) ; Harri son, Brian (HHS/IOS) ; Redfie ld, Robert R. (CDC/OD) ; Recipient: Cetron, Marty (CDC/DDID/NC EZID/D GMQ) ; Charrow, Robert (HHS/ OGC) ; St imson, Brian (HHS/OGC) ; AMERICAN PVERSIGHT HHS-20-0580-B-000277 Stannard, Paula (HHS/IOS) ; McGowan, Robert (Kyle) (CDC/O0/OCS) ; Giroir, Brett (HHS/OASH) ; Shuy, Bryan (OS/ASPR/IO) ; Stecker, Judy (OS/IOS) ; Mango, Paul (HHS/IOS) Sent Date: 2020/03/14 09:06 :22 Delivered Date: 2020/03/14 09:06:23 Message Flags: Unread AMERICAN PVERSIGHT HHS-20-0580-B-000278 Bright, Rick (O5/ASPR/BARDA) To: Giroir, Brett (HHS/OASH) Subject: Re: Adimab/COVID- 19 mission Date: 2020/02/26 07:43:20 Priority: Normal Type: Note From: Brett Giroir Date: Wednesday, February 26, 2020 at 7:09 AM To: Ajay Royan , "Bright, Rick (OS/ASPR/BARDA)" Cc: Rick Perry i(b)(6) @gmai l.com> Subject: RE: Adimab /COVID-19 mission Good Morning Mr. Royan (and Secretary Perry). Thank you sincerely for your willingness to contribute to the national efforts to combat COVl19. Antibody therapeutics could of course have an important role as we move forward. As such, I have contacted the Director of BARDA (Deputy Assistant Sec) Rick Bright, who is copied. He is the appropriate person and in the best place to potentially assist. Mr. Royan - consider this an e-introduction. Dr Bright will get you into the BARDA flow absolutely as soon as possible. Let me know if I can help or facilitate in the future. V/r Brett Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Ajay Royan Sent: Tuesday, February 25, 2020 10:18 PM To: Giroir, Brett (HHS/OASH) AMERICAN PVERSIGHT HHS-20-0580-B-000279 Cc: Rick Perry Subject: Adimab/COVID -19 mission Dear Rick, Thank you kindly for the call yesterday , and for connecting us. Dear Dr. Giroir, It's a pleasure to met you over email. The team at Adimab - an antibody discovery platform based in New Hampshire -was previously successful at isolating and sequencing antibodies contra the 2014 Ebola outbreak. I spoke yesterday with Dr. Tillman Gerngross , the founder of Adimab ; he and his team are standing by to help in any way they can. As with the ebola situation , this is outside of the company's normal commercial course but very much in line with their public service mission and technical capabilities. Below are two backgrounders that might be helpful to introduce Adimab: 1.) A high-level summary of Adimab's work with USAMRIID and others to isolate an antibody therapy for the 2014 Ebola strain that affected the US https://protect2.fireeye.com/url?k=43e0b72f-1fb5beff-43e08610 -0cc47a6a52de c51 024d 359d9adc4&u = https ://www .adima b.co ml news/201 6-02-18-a nti-ebola-vi rusanti bodies 2.) The resultant paper published 2016 in Science https://science.sciencemag.org/content/351 /6277 /1078 b)(4) It would be my pleasure to connect Dr. Gerngross (tillman.gerngross@adimab.com ) with you or follow-up as otherwise appropriate. And to be helpful in this or any other way, given our involvement with a growing group of motivated and talented technologists who are getting activated around this mission. With thanks and my best, Ajay AMERICAN PVERSIGHT HHS-20-0580-B-000280 Adimab Scientists Report the Isolation of Highly Potent Anti-Ebola Virus Antibodies from Recent Zaire Outbreak Adimab, LLC, a global leader in the discovery of human antibodies, today reported the isolation of a broad panel of neutralizing anti-Ebola virus antibodies from a survivor of the recent Zaire outbreak. The work, published online today in the journal Science, highlights the remarkable speed of Adimab's recently launched single B cell isolation platform, and constitutes the largest panel of functional anti-Ebola antibodies reported in the scientific literature to date. The sequences of all antibodies isolated in this study will be made freely available to the research community through the GenBank database. "Our Science paper describes the first in-depth view into the human antibody response to Ebola virus," said Laura Walker, Ph.D., Senior Scientist at Adimab, and the corresponding author of the study. "Within weeks of receiving a blood sample from a survivor of the 2014 Ebola outbreak, we were able to isolate and characterize over 300 monoclonal antibodies that reacted with the Ebola virus surface glycoprotein." After the initial isolation and characterization of the anti-Ebola antibodies at Adimab, several leading institutions in the field of virology, including The Scripps Research Institute, La Jolla, CA and the US Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, MD, provided an in-depth analysis of the therapeutic potential of these newly isolated antibodies. "Over the past decade, our laboratory has analyzed over one hundred antibodies against the Ebola virus," commented Pamela Glass, Ph.D., Senior Investigator at USAMRIID. "Several of the antibodies provided by Dr. Walker's team display the most potent neutralization and protection we have ever seen." Additional structural analysis at The Scripps Research Institute provided further insight into the diversity of the human immune response to Ebola. "The antibody panel discovered by Adimab covers every previously known binding site on Ebola virus and their work further revealed a new, highly potent neutralizing site, that has not been reported to date," said Prof. Andrew Ward, Scripps Research Institute, a co-author of the study. "In less than two months the Adimab team isolated more neutralizing Ebola antibodies than the entire Ebola field has reported in the past two decades," noted Tillman Gerngross, Ph.D., CEO and Co-Founder of Adimab and a Professor of Bioengineering at Dartmouth College. 'The global public health community has been looking for a rapid response platform to emerging infectious disease threats and Laura's team has set an entirely new standard for rapidly isolating protective antibodies that could be turned into effective therapeutics. We now have a broadly applicable platform to deal with these threats." "Not only has the Adimab team isolated an extensive panel of therapeutically promising Ebola antibodies in such a short time frame, but the fact that they have made these antibodies available to the research community for further studies is remarkable and AMERICAN PVERSIGHT HHS-20-0580-B-000281 shows their humanitarian intent to advance the field without regard for commercial gain," said John Dye, Ph.D., Chief of Viral Immunology at USAMRIID. Adimab separately noted that it has applied its B cell isolation platform against the respiratory syncytial virus (RSV) with similar results. The Company also intends to demonstrate the applicability of the B cell isolation platform against the Zika virus. The study, entitled "Isolation of Potent Neutralizing Antibodies from a Survivor of the 2014 Ebola Virus Outbreak", is available online and will be published in the February 18th, 2016 issue of Science. The sequences generated in this work will be made available to the research community via GenBank. About Adimab Over the past six and a half years, Adimab has established antibody discovery collaborations with over 35 pharmaceutical companies including many leading drug companies, such as Merck, Novo Nordisk , Biogen, GSK, Roche, Novartis, Eli Lilly, Genentech, Celgene, Gilead, Kyowa Hakko Kirin, and Sanofi. Sender: Recipient: Bright, Rick (O5/ASPR/BARDA) Giroir, Brett (HHS/OASH) Sent Date: 2020/02/26 07:43:19 Delivered Date: 2020/02/26 07:43:20 AMERICAN PVERSIGHT HHS-20-0580-B-000282 Giroir, Brett (HHS/OASH) Schwartz, Erica (HHS/OASH) ; To: Susan Orsega (O5/OASH) (Susan.Orsega@hhs.gov) Subject: FW: CDC Media Statement: CDCAnnounces Additional COVID-19 Presumptive Positive Cases Date: 2020/02/29 08:04:00 Priority: Normal Type: Note From: Hall, Bill (HHS/ASPA) Sent: Friday, February 28, 2020 11:49 PM Subject: Fw: CDC Media Statement: CDC Announces Additional COVID-19 Presumptive Positive Cases From: Media@cdc.gov (CDC) Sent: Friday, February 28, 2020 11:30:34 PM To: Media@cdc.gov (CDC) Subject: CDC Media Statement: CDCAnnounces Additional COVID-19 Presumptive Positive Cases Media Statement For Immediate Release Friday, Feb. 28, 2020 Contact: CDC Media Relations (404) 639-3286 CDC Announces Additional COVID-19 Presumptive Positive Cases The Centers for Disease Control and Prevention (CDC) is aware of four new presumptive positive cases of COVID-19 announced by state public health authorities who are currently conducting investigations. o o California has announced a second possible instance of community spread. o o Oregon has announced its first possible instance of community spread. o o The state of Washington has announced two presumptive cases. One is likely travel related. The other is the state's first possible instance of community spread. AMERICAN PVERSIGHT HHS-20-0580-B-000283 Community spread means spread of an illness for which the source of infection is unknown. One previous possible instance of community spread was announced in California on February 26. The four patients tested positive for the virus that causes COVID-19 in their respective states using the CDC-developed rRT-PCR. They are considered presumptive positive cases pending CDC confirmatory testing. However , CDC and State and local public health authorities are proceeding with public health investigations and response activities as if these were confirmed cases. With both confirmed and presumptive positive cases , CDC recommends healthcare providers follow the Interim Infection Prevention and Control Recommendations for Patients with Confirmed Corona virus Disease 2019 (COVID-19) or Persons Under Investigation for COVID19 in Healthcare Settings . These four cases bring the total number of COVID-19 cases detected through the U.S. public health system to 19. The federal government has been working closely with state , local, tribal, and territorial partners, as well as public health partners, to respond to this public health threat. Unprecedented, aggressive effo1ts have been taken to contain the spread and mitigate the impact of this virus. CDC and federal partners have been preparing for the detection of additional instances of personto-person spread of COVID-19 for weeks. The federal governn1ent will continue to respond aggressively to thjs rapidly evolving situation. For more infonnation about COVID-19 visit www.cdc.gov/covid19 . #tt# U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES CD C works 24/7 protecting America's health, safety and security. Whether diseases start at home or abroad, are curable or preventable, chronic or acute, or from human activity or deliberate attack, CDC responds to America's most pressing health threats. CDC is headquartered in Atlanta and has experts located throughout the United States and the world. Sender: Giroir, Brett (HHS/OASH) Schwartz, Erica (HHS/OASH) ; Recipient: Susan Orsega (OS/OASH) (Susan.Orsega @hhs.gov) Sent Date: 2020/02/29 08:04:28 Delivered Date: 2020/02/29 08:04:00 AMERICAN PVERSIGHT HHS-20-0580-B-000284 Giroir, Brett (HHS/OASH) To: Fink, Dorothy (OS/OASH) Heck, Mia (HHS/IEA) (Mia.Heck@hhs.gov); CC: Valentine, Steven (HHS/OASH); Kellogg, Rachel(HHS/OASH) Subject: RE: Idea for Heart Month Maternal Health Roundtable Date: 2020/01/25 15:36:00 Priority: Normal Type: Note Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Fink, Dorothy (OS/OASH) Sent: Saturday, January 25, 2020 3:15 PM To: Giroir, Brett (HHS/OASH) Subject: Idea for Heart Month Maternal Health Roundtable Good afternoon, ADM Giroir, b)(5) AMERICAN PVERSIGHT HHS-20-0580-B-000285 Dorothy Dorothy Fink, MD Deputy Assistant Secretary for Women's Health Director, Office on Women's Health Office of the Assistant Secretary for Health U.S. Department of Health and Human Services Disclaimer: This message is intended for the exclusive use of the recipient(s) named above. It may contain information that is PRE-DECISIONAL,PROTECTED,PRIVILEGED,and/or CONFIDENTIAL,and it should not be disseminated, distributed, or copied to persons not authorized to receive such information. All sensitive documents must be properly labeled before dissemination via email. If you are not the intended recipient, any dissemination, distribution, or copying is strictly prohibited without the permission of the sender. If you have received this communication in error, please erase all copies of the message and its attachments and notify us immediately. Giroir, Brett (HHS/OASH) Fink, Dorothy (OS/OASH); Heck, Mia (HHS/IEA) (Mia.Heck@hhs.gov); Valentine, Steven (HHS/OA5H) ; Kellogg, Rachel(HHS/OASH) Sent Date: 2020/01/25 15:36:51 Delivered Date: 2020/01/25 15:36:00 AMERICAN PVERSIGHT HHS-20-0580-B-000286 Kadlec,Robert (O5/ASPR/IO) Giroir, Brett (HHS/OASH) Subject: Fwd: Coronavirustest NOT Allowed despite Admiral Brett P. Giroir, assistant secretary of health Advice Date: 2020/03/16 22:09:27 Priority: Normal Type: Note Sent from my iPhone Begin forwarded message: From: "Yeskey, Kevin (OS/ASPR/IO)" Date: March 16, 2020 at 9:51: 10 PM EDT To: "Kadlec, Robert (OS/ASPR/IO)" Subject: Re: Coronavirus test NOT Allowed despite Admiral Brett P. Giroir, assistant secretary of health Advice ? Done Sent from my iPhone On Mar 16, 2020 , at 9:01 PM, Kadlec , Robert (OS/ASPR/IO) wrote : Sent from my iPhone Begin forwarded message: From: "Giroir, Brett (HHS/OASH)" Date: March 16, 2020 at 8:32:42 PM EDT To: "Yeskey, Kevin (OS/ASPR/IO)" Cc: "Kadlec, Robert (OS/ASPR/IO)" AMERICAN PVERSIGHT HHS-20-0580-B-000287 Subject: FW: Coronavirus test NOT Allowed despite Admiral Brett P. Giroir, assistant secretary of health Advice ? ~b)(5) Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 Fromfb)(6 ) l<~b)(6 ) @gmail.com> Sent: Monday, March 16, 2020 7:17 PM To: Yeskey, Kevin (OS/ASPR/1O); Collins, Christine (OS/ASPR/EMMO) Cc: Giroir, Brett (HHS/OASH) Subject: Coronavirus test NOT Allowed despite Admiral Brett P. Giroir, assistant secretary of health Advice Dr Yeskey and CPT Collins, I asked for a CV test before going home on March l 7t I am 70 year old mrrse on DMAT for 23 years and left 14 day deployment at Pt Magu and came directly to Miramar and completed 4 day deployment . I had direct contact with PPE on properly taking care of 4 positive patients in hotel at Miramar. Despite explaining why I wanted test to Kathryn the safety officer over phone and to Pam Evans who delivered a R TW letter saying I was a lo risk. I received the same letter after working 14 days at PT Magu with little interaction with a healthy guest. Today at the White House an update was given by the Administration and the following was stated by Admiral Giroir: Admiral Brett P. Giroir, assistant secretary of health at the Department of Health and Human Services, said gear and federal health care workers were being shipping out Monday. Health officials said they were focusing those tests on two groups: Healthcare workers and first responders, as well as those who are 65 and older with a AMERICAN PVERSIGHT HHS-20-0580-B-000288 symptoms of respiratory problems and a fever of at least 99.6 degrees . The officials implored Americans to help prioritize those two groups . I am de mobbing tomorrow and still want a test before I leave because of the 4 patients with positives and my age. I told Pam Evans that was wrong to deny me a test . I would like to know if you , Dr Yeskey can approve a swab before I leave San Diego tomorrow. Respectfully, Sender: Recipient: Kadlec, Robert (OS/ASPR/IO) Giroir, Brett (HHS/OASH) Sent Date: 2020/03/16 22:09:27 AMERICAN PVERSIGHT HHS-20-0580-B-000289 Reed, Paul(HHS/OASH) Giroir, Brett (HHS/OASH) Subject: Re: HHSInteragency VTC-COVID-19 Date: 2020/02/24 17:59:59 Priority: Normal Type: Note Of course. I will dial in and provide any relevant updates via email afterwards. P~ CAPT Paul Reed, MD U.S. Public Health Service Deputy Assistant Secretary for Health Department of Health and Human Services On: 24 February 2020 17:57, "Giroir, Brett (HHS/OASH)"wrote: Good evening CAPT Reed, Are you available to join this VTC tomorrow? ADM Giroir is unable to listen in and was hoping that you could listen in on the call for situational awareness. Please let me know. Thanks, Carla -----Original Appointment----From: OS Secretarys Operations Center Sent: Tuesday, February 18, 2020 3:29 PM To: OS Secretarys Operations Center; Alexander, Daniel (fema.dhs.gov); Amparo, Alex (fema.dhs.gov); Anderson, Lindsey (fema.dhs.gov); Apodaca, Michael (fema.dhs.gov); Balint, Thomas (fema.dhs.gov); Bean, Bridget (fema.dhs.gov); Bettis, Elizabeth (fema.dhs.gov); OS Bibo, David; Blaz, Christopher (fema.dhs.gov); Bowlds, Wendy (fema.dhs.gov); Bowman, Scott (fema.dhs.gov); Breslin, Thomas; Casey, Michael (fem a .d hs.gov); Castillo, Carlos (fem a .d hs.gov); Clarke, Russell (fema.dhs.gov); Clever, Traci (fema.dhs.gov); Comans, Mary (fema.dhs.gov); Cranston, Anvaline (fema.dhs.gov); Criman, Thomas (fema.dhs.gov); Doolin, Joel (fema.dhs.gov); Naar, Alex (FAA.GOV); Dorko, Jeffrey (fema.dhs.gov); Dozar, Joshua (fema.dhs.gov); Dugan, Moises (fema.dhs.gov); Dunne, Nicole (fema.dhs.gov); Edwards, Eric (fema.dhs.gov); Endrikat, Fred (fema.dhs.gov); Eswood, Louis (fema.dhs.gov); Ey Ill, Elwood (fema.dhs.gov); Fl Military Aide AMERICAN PVERSIGHT HHS-20-0580-B-000290 {peter.jennison@associates.fema.dhs.gov ); Fema-operations.Center (OHS.GOV); FEMALRC-Chief (fema.dhs.gov); Fema.Nrc-watch-dhs (OHS.GOV); FEMA-NWC (OHS.GOV); FEMANWC-TMT (fema.dhs.gov); Filipponi, Karen (fema.dhs.gov); Fischer, Lauren (fema.dhs.gov); Forbes, Melissa (fema.dhs.gov); Fuller, Gregory Scott (fema.dhs.gov); Gammon, Carla (fema.dhs.gov); Gaynor, Pete (fema.dhs.gov); Gibson, Levi (fema.dhs.gov); Glenn, Robert (fema.dhs.gov); Greenberg, Jeremy (fema.dhs.gov); Grimm, Michael (fema.dhs.gov); Harper, Jay (fema.dhs.gov); Heighberger, Eric (fema.dhs.gov); Huang, Paul (fema.dhs.gov); Hutchinson, Lytwaive (fema.dhs.gov); IMAT Crisis (fema.dhs.gov); IMAT-East (fema .dhs .gov); IMAT West (fema.dhs.gov); Jackson, Liz (fema.dhs.gov); James, Lavar (fema.dhs.gov); Johnson, Jo Linda (fema.dhs.gov); Jones, Brian R. 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(MIL); Mcbrearty, Andrew (VA.GOV); Hower, Andrew (nps.gov); Andryushchenko, Margarita (fema.dhs.gov); Battaglia, Anthony (fema.dhs.gov); Gonzalez, Arnie (fema.dhs.gov); Gellner, Asheleigh 0. {MIL); Bahamonde, Marty (fema.dhs.gov); Curran, Ben AMERICAN PVERSIGHT HHS-20-0580-B-000291 (fema.dhs.gov); Dinsmore, Ben (fsis.usda.gov); Korson, Benjamin (fema.dhs.gov); Kennedy, Beth (MIL); Beth, Bradley (dol.gov); Martsching, Bradley 0. (MIL); White, Brandon (fema.dhs.gov); Armstrong, Brett (GSA.GOV); Yoo, Brianne (fema.dhs .gov); Krane, Bryan (fema.dhs.gov); Morgan, Butch (dot.gov); Mason, Byron (ACF); Holmes, Carolyn A. (MIL); Ward, Cassandra (fema.dhs.gov); Welker, Catherine (fema.dhs.gov); Gorman, Chad (fema.dhs.gov); Alexander, Charles (MIL); Heltsley, Charles (fema.dhs.gov); Davidson, Christina M. (MIL); Howlett, Christine (fema.dhs.gov); Algiere, Christopher (FirstNet.gov); Brunner, Christopher (fema.dhs.gov); Felski, Christopher (atf.gov); Tuttle, Christopher (hq.dhs.gov); Vaughan, Christopher (fema .dhs.gov); Russell, Cora (usda .gov); Jiron, Dan (osec.usda.gov); Tulis, Dana S. (MIL); Berry, Daniel J. 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(hq.dhs.gov); Mason, Stephen D. (MIL); Elson, Stephen (associates.fema .dhs.gov); Wade, Stephen (fema .dhs .gov); Hortin, Steve (fns .usda.gov); Hoffman, Sydney (fema.dhs.gov); OS Taylor, Troy; Kennedy, Ted (OS/ASPR/SPPR);Mall, Tehmina (fema.dhs.gov); Theroux, Emily (fema .dhs .gov); Browning, Thomas (mail.mi l); Lacrosse, Thomas (MIL); Murray, Thomas (fema.dhs.gov); Britt, Timothy (fema .dhs.gov); Montgomery, Trav is (OHS.GOV); Kurz, Victor (fema .dhs .gov); Gonzalez, Waddy (fema.dhs .gov); Randall, Warren (atf.gov); Whee ler, Young (DOL.GOV); FEMA-ESFlS-Coord ination (fema.dhs .gov); HQ-OEADirectors (fema .dhs .gov); 9-awa-ash -woc (FAA.GOV); Ps.goc-cog .sp (CANADA.CA); gmb-sitroom (cbp .dhs .gov) ; CC (NTSB.GOV); US Army Corps of Engineers - Operations Center; Allen, Stephen (hq.dhs.gov); cisa.iocc (cisa.dhs .gov); ciocc-nccwatch (cisa.dhs.gov); ciocc.physical (cisa.dhs .gov) ; ciocc.cyber (cisa.dhs .gov); Dept of Transp ortation - Crisis Management Center ; COMMAND .CENTER2(USDOJ.GOV); COMMCTR (ATF.GOV); Dept of Homeland Security - CWMD watchdesk; dniwatch(DNI.GOV) ; Department of Commerce EOC; edexecsec (ed .gov); Dept of Energy - Office of Emergency Management; DOI Watch Office (DOI.GOV); Department of Treasury EOC; OS.COMMAND .CENTER(STATE.GOV);EOC Report (CDC); Environmental Protection Agency - Emergency Operations Center; Sioc (FBI.GOV); fccopcenter (fee.gov); fletcexecsec (fletc.dhs .gov); fpsimc (hq .dhs .gov); fpsintel (fps.dhs.gov); Fpsimc (DHS.GOV); suitland.megacenter (hq.dhs .gov); HQS-DG-LST-NRCINFO (MIL); heoc (hud.gov); dhs.intel.cetc.watch (hq.dhs .gov); hsintel (ice.dhs.gov); Dept of Justice - Justice Command Center; cdo.jtwc (NAVY.MIL); MTAC (NCIS.NAVY.MIL); Nee (MIL); nccic (us-cert.gov); nctc-ops (ucia.gov); Nice (DHS.GOV);j s.pentagon.j3 .list.addo (mail.mil) ; NNC.CMDCTRDIR.OMB (NORTHCOM.MIL); noc.swo (hq .dhs.gov) ; n-nc.peterson .nncn2c2.mbx. interagency-omb (mail.mil); Nuclear Regulatory Commission - Operations Center; ogcexecsec (hq.dhs .gov); Operat ionsCenter (STATE.GOV); USDA - EOC; OPSSOO (JS.PENTAGON.MIL); ARC Disaster Operations Center; roc.ndw.fcm (NAVY.MIL); Vanatta, Robert (hq.dhs.gov); Sit.Room (DHS.GOV); cdo.tsa (tsa.dhs.gov); tsa.oia.watch (tsa.dhs.gov); Ofdadutyofficer (USAID.GOV); uscis.c2 (dhs.gov) ; ops center (dm.usda.gov) ; pios-onduty (usss.dhs.gov); VA Integrated Operations Center (VA IOC) Watch Officer; Brumfie ld, Ty (OHS.GOV); Campbell, Matt (fema .dhs.gov); Key, Debbie L. 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(associates.fema.dhs.gov); Lynne, Elisa (associates.fema.dhs.gov); Macintyre, Anthony (OHS.GOV); NOAA-LNO (fema.dhs.gov); Scannelli, Vincent (HQ.OHS.GOV); Villarreal, Xavier (DLA.MIL); Young, Joseph (fema.dhs.gov); CENTER (fema.dhs.gov); Fish, Kristen (fema.dhs.gov); Krebs, Christopher (hq.dhs.gov); NOAA SPC (noaa.gov); Wleith (USGS.GOV);mblanpied (usgs.gov); applegate (usgs.gov); Flennoy, Jason (dot.gov); Geringer -Frazier, Barbara (usda.gov); Griffin, S (ts.fed.us); Sabin, Brian (usda.gov); Usher, Zachary (fema.dhs.gov); Greene, Jonathan (OS/ASPR/EMMO); Mccreary, Kenneth (OS/ASPR/SPPR);Hrdina, Chad (OS/ASPR/SPPR);Cheatham, Reggie (epa.gov); EPA; Wenning, Stephanie (@epa.gov); Colby, Michelle - OHS, Washington, DC; O'Connor, Mike - OHS, Washington, DC; Barrett, Todd -OHS, Washington, DC; Schlieger, Brian (epa.gov); Fantinato, Jessica (USDA.GOV); Andersen, Nicholas (hq.doe.gov); Rutledge, Robert (cisa.dhs.gov); Ahrens, Dana (cisa.dhs.gov); 2019 nCoV Senior Leadership; Sims, Andrew (OS/ASPR/EMMO); Young, Joseph LTC US ARMY; Flowers, Artensie (OS/ASPR/EMMO); Slay, Lorenzo Jr LtCol USAF; Monahan, Kenneth (MAIL.MIL); Falone, Emily (OS/ASPR/EMMO); Blanchette, Glenn (OS/ASPR/EMMO); Lincoln, Carol (OS/ASPR/EMMO); Bermingham, John (CDC/DDPHSIS/CPR/DEO); Hall, Bill (HHS/ASPA); 'joshua.barnes@sba.gov '; Torrens, Luis (OS/ASPR/EMMO); Coviello, Daniel (HRSA); Ricketts, Kimberley (OS/ASPR/EMMO); Egan, Sarah (fema.dhs.gov); Tate, Anna (OS/ASPR/SPPR)(CTR); Evans, Catherine (OS/ASPR/SPPR)(CTR); 'David .Chawaga@fema.dhs .gov '; Rousseaux, Charles; ASPRCOMMS; 'cbpcoronavirusmailbox@cbp.dhs.gov '; Field Operations and Response Division; Dickinson, Jeanette (OS/ASPR/EMMO); Thornton, Cody (mail.mil); 'phyllis.erkins@dls .mil '; CoronavirusSmallGroup (state.gov); TFJP0l Diamond Princess Response; LeMar-Reiman, Amy N; Henwood, Eugene J; Kane, EIieen (OS/ASPR/OEA); Mcclellan, Wesley (OS/ASPR/SPPR);Aust in, Meredith (uscg.mil); Hill, April (OS/ASPR/EMMO); Sanchez, Luis (OS/ASPR/OEA); Sprow, Kyle (OS/ASPR/SPPR)(CTR); Farmer, William (OS/ASPR/SPPR); Kadlec, Robert (OS/ASPR/1O);Sauer, Michael (OS/ASPR); Dodgen, Daniel (OS/ASPR/SPPR); FDA Emergency Operations (FDA) Subject: HHS lnteragency VTC-COVID-19 When: Tuesday, February 25, 2020 12:30 PM-1:30 PM {UTC-05:00) Eastern Time {US &Canada). Where: HHS ASPR Conference Room 6th Floor; VTC; Dial-in:fb )(6 ) PIN: l(b)(B) (Muted) ~-~ I AGENDA COVID -19 INTERAGENCY VID EO TELECONF ERENCE Tuesday , 25 February 2020 at 12:30 p.m. ET Call-in Number: (b)(6) Muted Pl N :.,.. (b- )(..,.. 6)-----,,-----' PLEASE NOTE that this is the same agenda as the previous VTC, changes may be forthcoming. Object ive o Provide information sharing among Emergency Support Functions on Federal response actions to the COVID-19 to date AMERICAN PVERSIGHT HHS-20-0580-B-000294 o Focus briefings on current situat ion and describe specific issues requiring Federal interagency actions Opening Comments o Dr. Robert Kadlec or Dr. Kevin Yeskey o Senior Leadership Intent o Strategic Priorities COVID-19 Situation Update o Centers for Disease Control and Prevention (CDC) Repatriation Status of U.S. Citizens o CAPT Scott Lee, Federal Health Coordinating Official (FHCO) ; Traveler Screening into the United States o Situation Report - CDC o Military Housing Update Supporting Airport Screenings - DoD/OSD and DoD/NORTHCOM o OHS Support to Traveler Supporting - OHS/Countering of Weapons Mass Destruction (CWMD) Review and Input to Pandemic Crisis Action Plan (PANCAP) o Mr. Ken McCreary , ASPR Plans o Reference PANCAP Synchronization Matrices o Request Federal Department/Agency Responsibilities under Phases 1C, 2A , 2B, and 2C Task Force Update o CAPT Christopher Perdue, Chief of Staff; o Supply Chain Task Force Lead; o Communications Task Force Lead; o Healthcare Resiliency Task Force Lead ; o Medical Countermeasures Task Force Lead ; lnteragency Support o Emergency Support Functions o ESF #1 - Transportation o ESF #2 - Emergency Communications o ESF #3 - Public Works and Engineering o ESF #4 - Fire Fighting o ESF #5 - Planning o ESF #6 - Mass Care, Emergency Assistance , Temporary Housing, &Human Services o ESF #7 - Logistics o ESF #8 - Public Health and Medical Services o ESF #10 - Oil and Hazardous Material o ESF #11 - Agriculture o ESF #12 - Energy o ESF #13 - Public Safety and Security o ESF #14 - Cross Sector , Business, and Infrastructure o ESF #15 - External Affairs AMERICAN PVERSIGHT HHS-20-0580-B-000295 o o U.S. Coast Guard Department of Defense, Office of the Secretary of Defense o U.S. Northern Command o National Guard Bureau o Defense Logistics Agency Closing Comments o Dr. Robert Kadlec or Dr. Kevin Yeskey; Connection Instructions o o Please mute your microphone at all times when not speaking o o Do not put your phone on hold during the conference call o o Do not dial both the Audio Bridge and the Video Bridge from the same room o FE ? o ? ? ants includin Jabber/Movi ? ? ants: From your VTC unit please dia l at least 20 minutes before the conference starts to conduct AudioNideo checks with the Video Operations Center . o Non-FEMA Video artici to have their technica l staff contact the FEMA Video Operations Center b)(6) to determine a dia l-in method and conduct an AudioNideo test at least one our prior to connecting to this conference . o Participants are required to: o Properly reserve a video teleconferencing room, if needed, through your resource manager in advance and notify local IT of the reservation . o Confirm your VTC dial in number is correct prior to connecting. o Dial the conference number provided above and perform an Audio and Video quality check with the o Keep all microphones muted , unless speaking . voe Note: FEMA voe Video technicians frequently monitor more than one conference , but can only monitor audio for one at a time . If you do have a problem with the conference that re uires immediate assistance , please call the FEMA Video Operations Center on (b)(6) The video bridge will be available 30 minutes prior to the scheduled start time . If you re,...u_ir_e_~ assistance connecting or have questions , please call the FEMA Video Operations Center on (b)(6) l(b)(6) I ,..__ _ ___, NOTE: To connect to this conference after the scheduled start time, you must contact the FEMA Video Operations Center. Sender: Recipient: Reed, Paul (HHS/OASH) Giroir, Brett (HHS/OASH) Sent Date: 2020/02/24 17:59:57 Delivered Date: 2020/02/24 17:59:59 AMERICAN PVERSIGHT HHS-20-0580-B-000296 Haddad, Carla (HHS/OASH) To: Giroir, Brett (HHS/OASH) Wainwright, Jacob (HHS/OASH/10); CC: Mikre, Meriam (HHS/OASH) I Subject: FORREVIEW:l(b)(5) Date: 2020/02/24 18:13:14 Priority: Normal Type: Note ADM Giroir, b)(5) Thanks, Carla From: Hodges, Katrina (HHS/OGC) Sent: Monday, February 24, 2020 3:58 PM To: Haddad, Carla (HHS/OASH) Cc:Wainwright, Jacob (HHS/OASH/10) ; Beattie, Allison {HHS/OGC) ; Clark, Tamara (OS/OGC) Subject: REj(b)(5) I Carla, (b)(5) AMERICAN PVERSIGHT HHS-20-0580-B-000297 b)(5) Please do not hesitate to reach out with any questions. Thanks very much, << File: >> b)(5) '-----------------------------' << Message: FW: Please forward to US HHS: Leon County FL Adult Civil Citation Network>> Katrina L. Hodges U.S. Dept. of Health & Human Services Office of the General Counsel Direct: (404) 562-7829 From: Hodges, Katrina (HHS/OGC) Sent: Friday, February 21, 2020 4:18 PM To: Haddad, Carla (HHS/OASH) Cc: Wainwright, Jacob (HHS/OASH/1O); Beattie, Allison (HHS/OGC) ; Clark, Tamara (OS/OGC) I Subject: RE: l(b)(5) Thanks, Carla. This is very helpful- appreciate it. Katrina L. Hodges U.S. Dept. of Health & Human Services Office of the General Counsel Direct: (404) 562-7829 From: Haddad, Carla (HHS/OASH) Sent: Friday, February 21, 2020 2:38 PM To: Hodges, Katrina (HHS/OGC) Cc: Wainwright, Jacob (HHS/OASH/1O); Beattie, Allison (HHS/OGC) AMERICAN PVERSIGHT HHS-20-0580-B-000298 ; Clark, Tamara (OS/OGC) Subject: RE: l(b)(S) I Hi Katrina, b)(5) Thanks, Carla From: Hodges, Katrina (HHS/OGC) Sent: Friday, February 21, 2020 12:08 PM To: Haddad, Carla (HHS/OASH) Cc:Wainwright, Jacob (HHS/OASH/10) ; Beattie, Allison (HHS/OGC) ; Clark, Tamara (OS/OGC) Subject: RE: l(b)(5) I Carla, b)(5) Thanks, AMERICAN PVERSIGHT HHS-20-0580-B-000299 Katrina L. Hodges U.S. Dept. of Health & Human Services Office of the General Counsel Direct: (404) 562-7829 << File:f.... b_)(5 _l ____________________ __.r > From: Haddad, Carla (HHS/OASH) Sent: Monday, December 9, 2019 3:10 PM To: Clark, Tamara (05/0GC) Cc:Wainwright, Jacob (HHS/OASH/10) ; Voltaire, Jean-Michel (HHS/OGC) ; Hodges, Katrina (HHS/OGC) I Tamara and team, (b)(5) Thanks, Carla << File: (b)(5) docx >> From: Clark, Tamara (OS/OGC) Sent: Monday, December 9, 2019 11:14 AM To: Haddad, Carla (HHS/OASH) Cc:Wainwright, Jacob (HHS/OASH/10) ; Voltaire, Jean-Michel (HHS/OGC) ; Hodges, Katrina (HHS/OGC) Subject: RE:fbl(5) I (b)(5) From: Haddad, Carla (HHS/OASH) Sent: Monday, December 9, 2019 8:27 AM To: Clark, Tamara (OS/OGC) ; Voltaire, Jean-Michel (HHS/OGC) ; Hodges, Katrina (HHS/OGC) Cc:Wainwright, Jacob (HHS/OASH/10) Subject: REl(b)(S) I b)(5) AMERICAN PVERSIGHT HHS-20-0580-B-000300 b)(5) Thanks, Carla From: Clark, Tamara (05/0GC) Sent: Monday, December 9, 2019 9:08 AM To: Haddad, Carla (HHS/OASH) ; Voltaire, Jean-Michel (HHS/OGC) ; Hodges, Katrina (HHS/OGC) Subject:l(b)(S) I b)(5) Tamara S. Clark U.S. Dept. of Health & Human Services Office of the General Counsel 601 E. 12th St. Kansa s City , MO 64106 Office: (816) 426-5423 tamara. clark @hhs.gov Sender:IHaddad,carla (HHS/OASH) Giroir, Brett (HHS/OASH) ; Wainwright, Jacob (HHS/OASH/10) ; Mikre, Meriam (HHS/OASH) Sent Date: 2020/02/24 18:13:12 Delivered Date: 2020/02/24 18: 13: 14 From: Singer, Paul To: Hodges, Katrina (HHS/OGC) Subject: FW: Please forward to US HHS: Leon County FL Adult Civil Citation Network Date: 2020/02/23 18:51:53 Priority: Normal Type: Note Hi Katrina - forwarding the response on the Leon County information to you all. Thanks again for setting up the call last week. From: Mange, Steve Sent: Sunday, February 23, 2020 5:37 PM To: Singer, Paul Cc: Jennifer Peacock Subject: Please forward to US HHS: Leon County FL Adult Civil Citation Network Paul, As promised, below is some additional information about the Leon County FL Adult Civil Citation Network. Please forward to US HHS counsel who were on the phone call last week. Thanks! Steve From: Charlier, Jae Sent: Sunday, February 23, 2020 9:57 AM To: Mange, Steve Subject: Re: Leon County FL Adult Civil Citation Network Steve, Greetings! [not relevant portion of email deleted] AMERICAN PVERSIGHT HHS-20-0580-B-000302 As for Civil Citation, yes, here you go with two links below. Two notes on Civil Citation. First, I can introduce you to Tom Olk, the co-founder of Civil Citation (Greg Frost, the other co-founder, has retired from Tallahassee PD but I can get to him too if you like). Second, unlike the three other existing brands (LEAD, PAARi, and QRT) Civil Citation is highly developed with software, documents, process flows, training, etc ... so it w ill look different on the website. Just roll with it. It is deflection just ahead in terms of development. Third, I think that Civil Citat ion's main lift is that it uses an existing police procedure e.g. issuing of a citation as the mechanism for deflect ion. This means it's a well -known process and that's important. Of course, th is is a civil, not a criminal citation, and it is about connecting to treatment, not fines and fees or taking no action. Civil Citat ion is not Citation in Lieu of Arrest it is Citation with Treatment . Ok, if you need more, including that connection to Tom, just ask. https ://p rotect2. fi reeve .com/ u rl? k=6ee 2efc5-32b6c6ee-6ee 2defa-0cc4 7a6d 17cc7e bS65644b060602&u =https:// civi !citation. net/ and here too: htt ps:// po peente r .asu.ed u/ sites/ defaul t /files/ civi I citation network. pdf I hope you are doing well! Warm Regards, Be Counted! Participate in the National Sur vey to Assess Law Enfor cement-led Div ersion Programs and Fire/EMS-l ed Respon ses to the Opioid Crisis and help stakeholders better understand diversion efforts. Learn more: COAP-Survey.norc.org Jae A. Charlier, M.P.A. Executive Director TASC's Center for Health and Justice Executive Director Police, Treatment, and Community Collaborative (PTACC) PTACCDeflection Resource Center Home jchar lier@tasc.org (312) 573-8302 https ://protect2 .fireeye .com/url?k =c0c7 1d31-9c93341a -c0c72c0e-0cc47a6d 17cc3703adf729e30c34&u=http://www .linkedin.com/in/jacchar lier AMERICAN PVERSIGHT HHS-20-0580-B-000303 https://protect2 .fireeye .com/url?k=766fc6a2-2a3bef89-766ff79d-0cc4 7a6d 17ccb51ca7b3577404 75&u =http://www .centerforhealthand justice.erg/ Pronouns: He/His/Him ***** g.texas.gov> Sender: Singer, Paul Sent Date : 2020/02/23 18:51:44 Delivered Date : 2020/02/23 18:51:53 AMERICAN PVERSIGHT HHS-20-0580-B-000304 Kadlec, Robert (O5/ASPR/IO) Giroir, Brett (HHS/OASH) Stecker, Judy (O5/IOS) ; Brookes, Brady (CMS/OA) ; Yeskey, Kevin (O5/ASPR/IO) ; Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) ; CMS SV1 ; CC: Berger, Sherri (CDC/OCOO/OD) ; Redfield, Robert R. (CDC/OD) ; Shuy, Bryan (O5/ASPR/IO) ; Harrison, Brian (HHS/IOS) ; Herrmann, Jack (OS/ASPR/OEA) ; Mango, Paul (HHS/IOS) nt Su bject: Re: Outtakes from Call with Kaiser Permanente and HCA Date: 2020/03/08 23 :48 :49 Priority : Normal Type: Note _________________________ b)(5) .__ __, Best. Bob Sent from my iPhone On Mar 8, 2020, at 3:59 PM, Giroir, Brett (HHS/OASH) wrote: ? (b)(5) Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW AMERICAN PVERSIGHT HHS-20-0580-B-000305 Washington, DC 20201 Office Phone: 202-690-7694 From: Stecker, Judy (OS/IOS) Sent: Sunday, March 8, 2020 2:45 PM To: Brookes, Brady (CMS/OA) Cc: Kadlec, Robert (OS/ASPR/1O); Giroir, Brett (HHS/OASH) ; Yeskey, Kevin (OS/ASPR/1O); Jernigan, Daniel B. (CDC/DDID/NCIRD/1D) ; CMS SVl ~cms.hhs.gov>; Berger, Sherri (CDC/OCOO/OD) ; Redfield, Robert R. (CDC/OD) ~cdc.gov>; Shuy, Bryan (OS/ASPR/1O); Harrison, Brian (HHS/IOS) ; Herrmann, Jack (OS/ASPR/OEA) ; Mango, Paul (HHS/IOS) Subject: Re: Outtakes from Call with Kaiser Permanente and HCA b)(5) Sent from my iPhone On Mar 8, 2020, at 2:04 PM, Brookes , Brady (CMS /OA) wrote: ? + The Administrator Co11Jide11tial {IIU/ deliberative, pre-decisional commtmicatio11 From: Kadlec, Robert (OS/ASPR/1O) Sent: Sunday, March 8, 2020 1:59 PM To: Giroir, Brett (HHS/OASH) ; Yeskey, Kevin (OS/ASPR/1O); Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) Cc: Berger, Sherri (CDC/OCOO/OD) ; Redfield, Robert R. (CDC/OD) fb) (6) ~ cdc.gov >; Shuy, Bryan (OS/ASPR/1O) ; Harrison, Brian (HHS/IOS) ; Brookes, Brady (CMS/OA) ; Herrmann, Jack (OS/ASPR/OEA) ; Harrison, Brian (HHS/IOS) ; Mango, Paul (HHS/IOS) ; Stecker, Judy (OS/IOS) Subject: Outtakes from Call with Kaiser Permanente and HCA Importance: High AMERICAN PVERSIGHT HHS-20-0580-B-000306 b)(5) Sender: Kadlec, Robert (OS/ASPR/IO) Giroir, Brett (HHS/OASH); Stecker, Judy (OS/IOS) ; Brookes, Brady (CMS/OA); Yeskey, Kevin (O5/ASPR/IO) ; Jernigan, Daniel 8. (CDC/DDID/NCIRD/ID); AMERICAN PVERSIGHT HHS-20-0580-B-000307 CMSSVl ; Berger, Sherri (CDC/OCOO/OD); Redfield, Robert R. (CDC/OD) ; Shuy, Bryan (OS/ASPR/IO); Harrison, Brian (HHS/IOS) ; Herrmann, Jack (OS/ASPR/OEA); Mango, Paul (HHS/IOS) Sent Date: 2020/03/08 23:48:47 Delivered Date: 2020/03/08 23:48:49 AMERICAN PVERSIGHT HHS-20-0580-B-000308 Giroir, Brett (HHS/OASH) To: Orsega, Susan (OS/OASH) Trent-Adams, Sylvia (HHS/OASH); Adams, Jerome (HHS/OASH); Schwartz, Erica (HHS/OASH) Subject: RE: CDC2019nCOVQuadReport 1/25 Date: 2020/01/26 10:02:00 Priority: Normal Type: Note Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Orsega, Susan (OS/OASH) Sent: Sunday, January 26, 2020 10:01 AM To: Giroir, Brett (HHS/OASH) Cc:Trent-Adams, Sylvia (HHS/OASH) ; Adams, Jerome (HHS/OASH) ; Schwartz, Erica (HHS/OASH) Subject: RE: CDC 2019nCOVQuad Report 1/25 Sir, (b)(5) From: Giroir, Brett (HHS/OASH) AMERICAN PVERSIGHT HHS-20-0580-B-000309 Sent: Sunday, January 26, 2020 9:57 AM To: Orsega, Susan (OS/OASH) Cc: Trent-Adams, Sylvia (HHS/OASH) ; Adams, Jerome (HHS/OASH) ; Schwartz, Erica (HHS/OASH) Subject: RE: CDC 2019nCOVQuad Report 1/25 Thank you Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Orsega, Susan (OS/OASH) Sent: Sunday, January 26, 2020 8:40 AM To: Giroir, Brett (HHS/OASH) Cc: Trent-Adams, Sylvia (HHS/OASH) ; Adams, Jerome (HHS/OASH) ; Schwartz, Erica (HHS/OASH) Subject : CDC 2019nCOVQuad Report 1/25 << File: CDC 2019nCoV Quad Summary - 25Jan2020Final.pptx >> b)(5) V /R Rear Admira l Susan M. Orsega, FNP-BC, FAAN, FAANP Director, Commissioned Corps Headquarters Office of the Surgeon General United States Public Health Service U.S. Department of Health and Human Services 1 LOIWootten Parkway Rockville, Maryland 20852 Office Phone: 240-453-6080 Ce ll phone: fbH6 ) I AMERICAN PVERSIGHT HHS-20-0580-B-000310 Emai l: susan.orsega@hhs.gov Giroir, Brett (HHS/OASH) Orsega, Susan (OS/OASH) ; Trent-Adams, Sylvia (HHS/OASH) ; Recipient: Adams, Jerome (HHS/OASH) ; Schwartz, Erica (HHS/OASH) Sent Date: 2020/01/26 10:02:06 Delivered Date: 2020/01/26 10:02:00 AMERICAN PVERSIGHT HHS-20-0580-B-000311 Giroir, Brett (HHS/OASH) To: Dr. Brian M. Pierce 4'.b)(6) ~gma il.com> Subject: RE: DARPAprogram to decontaminate buildings using chlorine dioxide Date: 2020/02/29 09:08:00 Priority: Normal Type: Note Thanks Brian Great to hear from you Yes, lots of moving parts these days! Brett Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Dr. Brian M. Pierce Sent: Friday, February 28, 2020 9:49 AM To: Giro ir, Brett (HHS/OASH) Subject: DARPA program to decontaminate buildings using chlorine dioxide Hi Brett, I'm sure you are very busy these days , but I thought that you might find helpful a reference to an old DARPA program to decontaminate building s contaminated with Bacillus anthracis : Deve lopment and Field Testing of a Mobile Chlorine Dioxide Generation System for the Decontamination of Buildings Contaminated with Bacillu s anthracis https://cfpub.epa.gov/si/si public record report.cfm?Lab=NHSRC&dirEntryid=193203&fed or g id= 1253&address=nhsrc&view=desc&sortBy=pubDate Year&showCriteria= 1&count=25&sea rchall=Fumigation%2520OR%2520fumigant I realize that this effort dealt with a bacterium , but the techniques that were developed and lessons learned might help those looking at ways to decontaminate buildings contaminated with the SARS-CoV-2 virus . There are likely other DARPA program s from that period that might have some useful informa tion. AMERICAN PVERSIGHT HHS-20-0580-B-000312 I left DARPA last August, and am now independent spending about half my time at the University-Affiliated Research Center (UARC) at the University of Maryland called the Applied Research Laboratory for Intelligence and Security (ARLIS). Best regards , Brian Sender: Giroir, Brett (HHS/OASH) Recipient: Dr. Brian M. Pierce ,t:b)(6) tlJgmail.com> Sent Date: 2020/02/29 09:08:39 Delivered Date: 2020/02/29 09:08:00 AMERICAN PVERSIGHT HHS-20-0580-B-000313 Giroir, Brett (HHS/OASH) To: Haddad, carla (HHS/OASH) Wainwright, Jacob (HHS/OASH/10); CC: Mikre, Meriam (HHS/OASH) Subject: RE: FORREVIEW:~b)(5) I Date: 2020/02/24 20:13:00 Priority: Normal Type: Note Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Haddad, Carla (HHS/OASH) Sent : Monday, February 24, 2020 6:13 PM To: Giroir, Brett (HHS/OASH) Cc:Wainwright, Jacob (HHS/OASH/1O); Mikre, Meriam (HHS/OASH) Subject: FOR REVIEW:fb.,..,. .,,.)(6 "'")---------. ADM Giroir, b)(5) AMERICAN PVERSIGHT HHS-20-0580-B-000314 Thanks, Carla <> b)(5) .docx >> < Sent: Monday, February 24, 2020 3:58 PM To : Haddad, Carla (HHS/OASH) Cc:Wainwright, Jacob (HHS/OASH/10) ; Beattie, Allison (HHS/OGC) ; Clark, Tamara (OS/OGC) _________ Subject: RE:.__ (b)(S) ___, Carla, (b)(5) Thanks very much, <> Katrina L. Hodges U.S. Dept. of Health &Human Services Office of the General Counsel Direct: (404) 562-7829 docx >> < Cc:Wainwright, Jacob (HHS/OASH/10) ; Beattie, Allison (HHS/OGC) ; Clark, Tamara (OS/OGC) Subject: RE:~b) (5l I Thanks, Carla. This is very helpful - appreciate it. Katrina L. Hodges U.S. Dept. of Health &Human Services Office of the General Counsel Direct: (404) 562-7829 From: Haddad, Carla (HHS/OASH) Sent: Friday, February 21, 2020 2:38 PM To: Hodges, Katrina (HHS/OGC) Cc:Wainwright, Jacob {HHS/OASH/10) ; Beattie, Allison (HHS/OGC) ; Clark, Tamara (OS/OGC) Subject: RE:~b)(5) I Hi Katrina, b)(5) Thanks, Carla From: Hodges, Katrina (HHS/OGC) Sent : Friday, February 21, 2020 12:08 PM To: Haddad, Carla (HHS/OASH) Cc:Wainwright, Jacob (HHS/OASH/10) ; Beattie, Allison (HHS/OGC) ; Clark, Tamara (OS/OGC) Subject: RE: (b)(S) AMERICAN PVERSIGHT HHS-20-0580-B-000316 Carla, (b)(5) Thanks, Katrina L. Hodges U.S. Dept. of Health &Human Services Office of the General Counsel Direct: (404) 562-7829 <> From: Haddad, Carla (HHS/OASH) Sen t: Monday, December 9, 2019 3:10 PM To : Clark, Tamara (OS/OGC) Cc: Wainwright, Jacob (HHS/OASH/10) ; Voltaire, Jean-Michel (HHS/OGC) ; Hodges, Katrina (HHS/OGC) Subject: RE:fb) (5) I Tamara and team, b)(5) Thanks, Carla <> From: Clark, Tamara (OS/OGC) Sent: Monday, December 9, 2019 11:14 AM To: Haddad, Carla (HHS/OASH) Cc: Wainwright, Jacob (HHS/OASH/10) ; Voltaire, Jean-Michel (HHS/OGC) AMERICAN PVERSIGHT HHS-20-0580-B-000317 ; Hodges, Katrina (HHS/OGC) I Subject: RE:fbl (5) b)(5) From: Haddad, Carla (HHS/OASH) Sent: Monday, December 9, 2019 8:27 AM To: Clark, Tamara (OS/OGC); Voltaire, Jean-Michel (HHS/OGC); Hodges, Katrina (HHS/OGC) Cc:Wainwright, Jacob (HHS/OASH/10) Subject: RE:rb) (5) I (b)(5) Thanks, Carla From: Clark, Tamara (05/0GC) Sent: Monday, December 9, 2019 9:08 AM To: Haddad, Carla (HHS/OASH); Voltaire, Jean -Michel (HHS/OGC); Hod es, Katrina (HHS/OGC) Subject (b)(S) AMERICAN PVERSIGHT HHS-20-0580-B-000318 (b)(5) Tamara S. Clark U.S. Dept. of Health &Human Services Office of the General Counsel 601 E. 12th St. Kansas City, MO 64106 Office: (816) 426-5423 tamara. clark@hhs.gov Sender: Giroir, Brett (HHS/OASH) Haddad, carla (HHS/OASH) ; Wainwright, Jacob (HHS/OASH/10) ; Mikre, Meriam (HHS/OASH) Sent Date: 2020/02/24 20:13:57 Delivered Date: 2020/02/24 20: 13 :00 AMERICAN PVERSIGHT HHS-20-0580-B-000319 Giroir, Brett (HHS/OASH) To: Broido, Ta ra (HHS/OASH) Heck, Mia (HHS/OASH) ; Migliaccio-Grabill, Kate (HHS/OASH) ; Carla Haddad (HHS/OASH) (Carla.Haddad@hhs.gov) Subject: RE: Public health labs press FDA to allow homegrown coronavi rus tests Date: 2020/02/24 20:14:00 Priority: Normal Type: Note Thank you Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Broida, Tara (HHS/OASH) Sent: Monday, February 24, 2020 8:13 PM To: Gir oir, Brett (HHS/OASH) Cc: Heck, Mia (HHS/OASH) ; M igliaccio-Grabill, Kate (HHS/OASH) Subject: Fwd: Public health labs press FDA to allow homegrown coronavirus tests FYI Begin forwarded message: From: "POLITICO Pro Health Care" Date: February 24, 2020 at 7:16:40 PM EST To: Subject: Public health labs press FDA to allow homegrown coronavirus tests Reply-To: "POLITICO subscription s" Public health labs press FDA to allow homegrown coronavirus tests AMERICAN PVERSIGHT HHS-20-0580-B-000320 By David Lim 02/24/2020 07: 15 PM EST Public health laboratories urged the FDA on Monda y to permit them to create their own test for the coronavirus , after problems with a diagnos tic developed by CDC preven ted its widespread rollou t. FDA typically allows "laboratory developed tests" - which are designed, manufactured and used within a single lab - to be used without close regulatory scrutiny. But the agency requires labs to submit such tests for review during health emergencies to prevent harm from false or misleading results from compounding a crisis. The coronavirus does not appear to be an exception. "No test should be used without being validated," FDA spokesperson Stephanie Caccomo said. "In the context of a public health emergency, false results can lead to significant adverse public health consequences." The FDA has traditionally shied away from allowing the use of LDTs in emergency situations. In 2016 , the agency sent a letter to two Ho uston hospitals that created an LDT to rapidly detect the Zika vims , expressing concern that the agency had not reviewed the "high-risk" test. But Association of Public Health Laboratories Executive Director Scott Becker said that the coronavirus requires a different approach. The virus is spreading in multiple countries , and the CDC's efforts to expand testing capability beyond its labs have run into trouble. Only five state and local public health labs - in California , ebraska, Illinois , evada and Tennessee- have verified the CDC diagnostic for use since the FDA approved it on an emergency basis on Feb. 4, he said. APHL hopes to work with FDA to develop a policy that allows some labs to market a LDT without submitting it for FDA review , Becker told POLITICO - adding that it doesn ' t make sense for more than 100 labs to file individual emergency use authority applications. "We believe a more expeditious route is needed at this time ," Becker and Grace Kubin, director of the Laboratory Services Section at the Texas Department of State Health Services, wrote to FDA Commissioner Stephen Hahn on Monday. " What we 're suggesting is that public health labs be viewed as a group to do this," Becker told POLITICO. "It isn't every lab on their own - we would want to do this in a network sort of fashion . We could also enable confirmation at another public health laboratory to ensme confidence." The letter says that labs could work together towards a standard protocol , purchase reagents and supplies from a common source and recommend a minimum standard approach for validating test results. Caccomo says that the FDA is working with more than 70 test developers on products for the AMERICAN PVERSIGHT HHS-20-0580-B-000321 vims. The agency can complete reviews for such tests in as little as one day , she added ensuring that it is effective and meets the minimum standard s for emergency use. Some major hospital s are also starting to develop LDT s for coronavi.rus screening , but are concerned that FDA mles do not permit them to actually start testing patients, according to Michael Mina , associate medical director of molecular diagno stics at Brigham and Women's Hospital. "We ' re actually trying to get our test up and running , even though we don 't know if we ' ll be able to use it," Mina said. "I know that Mass Genera l Hospital is also trunking about doing something very similar. I pre sume all the major academic hospital s are at least considering it." The American Clinical Laboratory Association, which repre sents large commerci al labs like LabCorp and Quest Diagno stics , declined to comment on whether LDTs should be used to help increase the country's capacity to screen for the corona vims. Historically, the lab industry trade lobby has maintained LDTs are not medical device s and subject to FDA regulation. To view onlin e: https ://protect2. fireeye .corn/url ?k=9ef849fl -c2ad402 l -9ef8 7 8ce-0cc4 7a6a52dea61e2b96e38a 143a&u=https://subscriber.politicopro.com /health-care /article/2020/02 /publicheal th-la bs-press-f da-to-allow-homegrown-coronavims-tests-18 84096 You received this POLITICO Pro content because your customized settings include: Public Health. To change your alert settings, please go to https://protect2.fireeye.com/url?k=e8b605ee-b4e30 c3e-e8b634 dl-0 cc47a6a52de4224dc2cea772f51&u= https://subscriber.politicopro.com/settings . PO ITCOPRO This email alert has been sent for the exclusive use of POLITICO Pro subscr iber, tara.broido @hhs.gov. Fo1warding or reproduc ing the alert without the express , written permi ssion of POLITICO Pro is a violation of copyright law and the POLITICO Pro subscription agreement. Copyright (C) 2020 by POLITICO LLC. To subscribe to Pro, please go to politicopro.com . This email was sent to tara.broido @hhs.gov by: POLITICO , LLC 1000 Wilson Blvd. Arlington , VA 22209 USA Se AMERICAN PVERSIGHT Giroir, Brett (HHS/ OASH) HHS-20-0580-B-000322 Broido, Tara (HHS/OASH) ; Heck, Mia (HHS/OASH) ; Recipient: Migliaccio-Grabill, Kate (HHS/OASH) ; Carla Haddad (HHS/OASH) (Carla.Haddad@hhs.gov) Sent Date: 2020/02/24 20:14:58 Delivered Date: 2020/02/24 20: 14 :00 AMERICAN PVERSIGHT HHS-20-0580-B-000323 Haddad, Carla (HHS/OASH) To: Giroir, Brett (HHS/OASH) Wainwright, Jacob (HHS/OASH/10); CC: Mikre, Meriam (HHS/OASH) I Subject: RE: FORREVIEW: l(b)(5) Date: 2020/02/24 20:18:27 Priority: Normal Type: Note Thank you! I'll send forward tomorrow morning. From: Giroir, Brett (HHS/OASH) Sent: Monday, February 24, 2020 8:14 PM To: Haddad, Carla (HHS/OASH) Cc:Wainwright, Jacob (HHS/OASH/1O) ; Subject: RE: FOR REVIEW:.,,..rb.,...,,) (5e-,-) ----------. Mikre, Meriam (HHS/OASH) Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Haddad, Carla (HHS/OASH) Sent: Monday, February 24, 2020 6:13 PM To: Giroir, Brett (HHS/OASH) Cc:Wainwright, Jacob (HHS/OASH/1O) ; Mikre, Meriam (HHS/OASH) Subject: FOR REVIEW:.... l(b_)(5 _)________ _, ADM Giro ir, AMERICAN PVERSIGHT HHS-20-0580-B-000324 (b)(5) Thanks, Carla <> docx >> < Sent: Monday, February 24, 2020 3:58 PM To: Haddad, Carla (HHS/OASH) Cc: Wainwright, Jacob (HHS/OASH/10) ; Beattie, Allison (HHS/OGC) ; Clark, Tamara (OS/OGC) Subject: RE:fb )(S) I Carla, b)(5) Thanks very much, AMERICAN PVERSIGHT HHS-20-0580-B-000325 <> Katrina L. Hodges U.S. Dept. of Health &Human Services Office of the General Counsel Direct: (404) 562-7829 '-----------------------------' docx >> < Cc: Wainwright, Jacob (HHS/OASH/1O); Beattie, Allison (HHS/OGC) ; Clark, Tamara (OS/OGC) Subject: RE:fbl(5l I Thanks, Carla. This is very helpful - appreciate it. Katrina L. Hodges U.S. Dept. of Health &Human Services Office of the General Counsel Direct: (404) 562-7829 From: Haddad, Carla (HHS/OASH) Sent: Friday, February 21, 2020 2:38 PM To: Hodges, Katrina (HHS/OGC) Cc: Wainwright, Jacob (HHS/OASH/1O); Beattie, Allison (HHS/OGC) ; Clark, Tamara (OS/OGC) Subject: REj(b)(5) I Hi Katrina, b)(5) AMERICAN PVERSIGHT HHS-20-0580-B-000326 Thanks, Carla From: Hodges, Katrina (HHS/OGC) Sent: Friday, February 21, 2020 12:08 PM To: Haddad, Carla (HHS/OASH) Cc:Wainwright, Jacob (HHS/OASH/10); Beattie, Allison (HHS/OGC) ; Clark, Tamara (OS/OGC) Subject: RE:fb)(5) I Carla, b)(5) Thanks, Katrina L. Hodges U.S. Dept. of Health &Human Services Office of the General Counsel Direct: (404) 562-7829 <> From: Haddad, Carla (HHS/OASH) Sent: Monday, December 9, 2019 3:10 PM To: Clark, Tamara (OS/OGC) Cc:Wainwright, Jacob (HHS/OASH/10); Voltaire, Jean-Michel (HHS/OGC) ; Hodges, Katrina (HHS/OGC) Subject: RE:~b) (5) I Tamara and team, AMERICAN PVERSIGHT HHS-20-0580-B-000327 (b)(5) Thanks, Carla <> From: Clark, Tamara (05/0GC) Sent: Monday, December 9, 2019 11:14 AM To: Haddad, Carla (HHS/OASH) Cc: Wainwright, Jacob (HHS/OASH/10); Voltaire, Jean -Michel (HHS/OGC) ; Hodges, Katrina (HHS/OGC) Subject: RE:fbl(5l I b)(5) From: Haddad, Carla (HHS/OASH) Sent: Monday, December 9, 2019 8:27 AM To: Clark, Tamara (OS/OGC); Voltaire, Jean -Michel (HHS/OGC); Hodges, Katrina (HHS/OGC) Cc: Wainwright, Jacob (HHS/OASH/10) Subject: RE:fb )(S) I b)(5) AM[ \N PVERSIGHT HHS-20-0580-B-000328 Thanks, Carla From: Clark, Tamara (05/0GC) Sent: Monday, December 9, 2019 9:08 AM To: Haddad, Carla (HHS/OASH) ; Voltaire, Jean-Michel (HHS/OGC) ; Hodges, Katrina (HHS/OGC) Subject:l(b)(5) I b)(5) Tamara S. Clark U.S. Dept. of Health &Human Services Office of the General Counsel 601 E. 12th St. Kansas City, MO 64106 Office: (816) 426-5423 tamara.clark @hhs.gov Sender: Haddad, Carla (HHS/OASH) Giroir, Brett (HHS/OASH); Wainwright, Jacob (HHS/OASH/IO) ; Mikre, Meriam (HHS/OASH) Sent Date: 2020/02/24 20:18:26 Delivered Date: 2020/02/24 20: 18:27 AMERICAN PVERSIGHT HHS-20-0580-B-000329 Haddad, Carla (HHS/OASH) To: Giroir, Brett (HHS/OASH) Subject: Re: FORREVIEW: ~b)(5) I Date: 2020/02/24 21:27:32 Priority: Normal Type: Note b)(5) On Feb 24, 2020, at 9:08 PM, Giroir, Brett (HHS/OASH) wrote: BG Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC20201 Office Phone: 202-690-7694 From: Haddad, Carla (HHS/OASH) Sent: Monday, February 24, 2020 8:18 PM To: Giroir, Brett (HHS/OASH) Cc: Wainwright, Jacob (HHS/OASH/1O); Mikre, Meriam (HHS/OASH) Subject: RE: FOR REVIEW:l(~b_)(5 _)________ ~ rb) (5) From: Giroir, Brett (HHS/OASH) Sent: Monday, February 24, 2020 8:14 PM To: Haddad, Carla (HHS/OASH) Cc: Wainwright, Jacob (HHS/OASH/1O); Mikre, Meriam (HHS/OASH) Subject: RE: FOR REVIEW:~ rb_)(5 _)________ ~ l(b)(5) AMERICAN PVERSIGHT HHS-20-0580-B-000330 b)(5) Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Haddad, Carla (HHS/OASH) Sent: Monday, February 24, 2020 6:13 PM To: Giroir, Brett (HHS/OASH) Cc: Wainwright, Jacob (HHS/OASH/1O) ; Mikre, Meriam (HHS/OASH) 5 Subject: FOR REVIEW:f~b-)(_l ________ ~ ADM Giroir, (b)(5) Thanks, Carla <> <> From: Hodges, Katrina (HHS/OGC) Sent: Monday, February 24, 2020 3:58 PM To: Haddad, Carla (HHS/OASH) Cc: Wainwright, Jacob (HHS/OASH/1O) ; Beattie, Allison AMERICAN PVERSIGHT HHS-20-0580-B-000331 (HHS/OGC) ; Clark, Tamara (OS/OGC) Subject: RE: rb )(5) I Carla, (b)(5) Thanks very much, <> <> Katrina L. Hodges U.S. Dept. of Health &Human Services Office of the General Counsel Direct: (404) 562 -7829 From: Hodges, Katrina (HHS/OGC) Sent: Friday, February 21, 2020 4:18 PM To: Haddad, Carla (HHS/OASH) Cc: Wainwright, Jacob (HHS/OASH/10) ; Beattie, Allison (HHS/OGC) ; Clark, Tamara (OS/OGC) Subject: RE:fb)(5) I Thanks, Carla. This is very helpful - appreciate it. Katrina L. Hodges AMERICAN PVERSIGHT HHS-20-0580-B-000332 U.S. Dept. of Health &Human Services Office of the General Counsel Direct: (404) 562-7829 From: Haddad, Carla (HHS/OASH) Sent: Friday, February 21, 2020 2:38 PM To: Hodges, Katrina (HHS/OGC) Cc: Wainwright, Jacob (HHS/OASH/10); Beattie, Allison (HHS/OGC); Clark, Tamara (OS/OGC) Subject: REfb )(S) I Hi Katrina, (b)(5) Thanks, Carla From: Hodges, Katrina (HHS/OGC) Sent: Friday, February 21, 2020 12:08 PM To: Haddad, Carla (HHS/OASH) Cc: Wainwright, Jacob (HHS/OASH/10); Beattie, Allison (HHS/OGC); Clark, Tamara (OS/OGC) Subject: RE:l (b)(5) I Carla, AMERICAN PVERSIGHT HHS-20-0580-B-000333 b)(5) Thanks, Katrina L. Hodges U.S. Dept. of Health &Human Services Office of the General Counsel Direct: (404) 562-7829 5 <> From: Haddad, Carla (HHS/OASH) Sent: Monday, December 9, 2019 3:10 PM To: Clark, Tamara (OS/OGC) Cc: Wainwright, Jacob (HHS/OASH/10) ; Voltaire, JeanMichel (HHS/OGC) ; Hodges, Katrina (HHS/OGC) Subject: RE~ .(b __)(5 _l ________ ~ Tamara and team, Thanks, Carla <> From: Clark, Tamara (OS/OGC) Sent: Monday, December 9, 2019 11:14 AM To: Haddad, Carla (HHS/OASH) Cc: Wainwright, Jacob (HHS/OASH/10) ; Voltaire, JeanMichel (HHS/OGC) ; Hodges, Katrina (HHS/OGC) Subject: RE1 .(b __H_ 5)---------~ AMERICAN PVERSIGHT HHS-20-0580-B-000334 From: Haddad, Carla (HHS/OASH) Sent: Monday, December 9, 2019 8:27 AM To: Clark, Tamara (OS/OGC) ; Voltaire, Jean-Michel (HHS/OGC) ; Hodges, Katrina (H HS/OGC) Cc:Wainwright, Jacob (HHS/OASH/10) Subject: RE: l(b)(5) I b)(5) Thanks, Carla From: Clark, Tamara (OS/OGC) Sent: Monday, December 9, 2019 9:08 AM To: Haddad, Carla (HHS/OASH) ; Voltaire, Jean-Michel (HHS/OGC) ; Hodges, Katrina (HHS/OGC) Su~ect:_r_~_)________ AMERICAN PVERSIGHT _ HHS-20-0580-B-000335 Tamara S. Clark U.S. Dept. of Health &Human Services Office of the General Counsel 601 E. 12th St. Kansas City, MO 64106 Office: (816) 426-5423 tamara.clark@hhs.gov Sender: Recipient: Haddad, (.aria (HHS/OASH) Giroir, Brett (HHS/OASH) Sent Date: 2020/02/24 21:27:31 Delivered Date: 2020/02/24 21:27:32 AMERICAN PVERSIGHT HHS-20-0580-B-000336 Trent-Adams, Sylvia (HHS/OASH) Giroir, Brett (HHS/OASH); Valentine, Steven (HHS/OASH); To: Haddad, Carla (HHS/OASH); Kellogg, Rachel(HHS/OASH) Orsega, Susan (OS/OASH); Schwartz, Erica (HHS/OASH); AvilesMendoza,Guillermo (OS/OASH) Subject: Fwd: COVID-19 Drive In Testing - more information plus a second site in Colorado Date: 2020/03/13 18:47:07 Priority: Normal Type: Note FYSA Sent from my iPhone Begin forwarded message: From: "Konsella, Laurie (HHS/OASH)" Date: March 13, 2020 at 5:41 :55 PM EDT To: "Trent-Adams , Sylvia (HHS/OASH)" , "Orsega , Susan (OS/OASH)" Subject: RE: COVID-19 Drive In Testing - more information plus a second site in Colorado ? Colorado drive through testing Site #1: Who is managing or leading this? Colorado Department of Public Health and Environment (state Health department) Contact: Stephanie Burke, 720-289-8616. Email: Stephanie.Burke@state.co.us Location: State lab: 8100 East Lowry Blvd, Denver, CO 80230 What is law enforcement role? National Guard will assist today with traffic control. There are no restrooms at the drive-through site and people must stay in their vehicles. People who were turned away earlier in the week will get priority today Hours of operation? Weekdays, 10 - 2. Schedule is posted on state website and state facebook page. The site was closed early today due to inclement weather. AMERICAN PVERSIGHT HHS-20-0580-B-000337 Prescription process: written or electronic copy of a doctor's order. People are told not to go to the doctor's office. They should call and have order faxed or emailed. They must have photo ID. They must remain in their vehicles. How is communication to the public organized? State health department website and news releases, facebook What resources are being used to run this? State, local. private? State How many individuals have been tested? Total : 650 according to open media reports How are other supplies provided? Kits: CDC Other items (Swabs, etc) from the open market. State funds. What are the gaps? Delay in receipt of additional CDCtest kits. The state has requested another 900. Their supply this am was about 150. Any other specifics regarding the drive through? What are their short falls? Traffic issues: On Thursday, there were so many cars in the line that they closed the drive thru. The state plans to work with local health departments to open additional drive through locations especially in the mountain resort communities where the community spread has been higher. I do not have an update about the workforce questions: who is doing the testing, what additional workforce needs have been identified but the Governor outlined statewide healthcare worker needs in his press briefing: https://www.coloradoan.com/story/news/2020/03/13/coloradogovernor-jared-polis-has-announcement-coronavirus/5041865002/ Specifically he announced more actions around testing and treatment: o o Fast-tracking licenses for medical professionals who are licensed in other states but either live or are visiting Colorado for an extended time. o o Contracting dozens of nurses from out of state o o Authorizing paramedics and EMTs to administer testing o o Asking doctors and nurses not currently in the workforce to contact their past employer in the event "surge capacity" is needed o o Employing National Guard medics to provide additional testing capacity and training of community providers Site 2: Operated by University of Colorado Health System. Located in Colorado Springs. (Note: the first COVID-19 death was just reported this afternoon in Colorado Springs.) It will be open 9 - 530, M-F. A doctor's note and phot ID will be required. The UCHealth site is a collaboration with the state health department and the county. More information: https://gazette.com/health/coronavirustesti ng-la b-i n-colo rado-spri ngs-ope n i ng-tod ay/a rti cle 0ead8aa 7 -656f-5248-88090bf03b8 lc80a. htm I And https: //gazette .com/ news/ coron avi rus-1ive-u pd ates-co Iara do-s-fi rst-covi d-d eat h-in/ article b86e1636-6527-llea-ae4a-976a515b624b.html From: Trent -Adams, Sylvia (HHS/OASH) AMERICAN PVERSIGHT HHS-20-0580-B-000338 Sent: Friday, March 13, 2020 10:48 AM To: Konsella, Laurie (HHS/OASH) ; Orsega, Susan (OS/OASH) Subject: RE: COVID-19 Drive In Testing Thank you so very much! From: Konsella, Laurie (HHS/OASH) Sent: Friday, March 13, 2020 12:11 PM To: Orsega, Susan (OS/OASH) Cc:Trent -Adams, Sylvia (HHS/OASH) Subject: RE: COVID-19 Drive In Testing State websites: https://www.colorado.gov/pacific/cdphe/news/cdphe-open-first-drive-testingce nte r-state-la b-lowry https://www .colorado.gov/pacific/cdphe/covid-19-testi ng There will be a news conference with the Governor today at 12:30 eastern . From: Orsega, Susan (OS/OASH) Sent: Friday, March 13, 2020 8:37 AM To: Konsella, Laurie (HHS/OASH) Cc: Trent-Adams, Sylvia {HHS/OASH) Subject: COVID-19 Drive In Test ing Dear Laurie, Thank you for the discussions. (b)(5) AMERICAN PVERSIGHT HHS-20-0580-B-000339 b)(5) Rear Admiral Susan M. Orsega, FNP-BC, FAAN, FAANP Director, Commissioned Corps Headquarters Office of the Surgeon General United States Public Health Service U.S. Department of Health and Human Services 1IOI Wootten Parkway Rockville, Mary land 20852 Office Phone: 240-453-6080 Cell phone: kb)(6) I Email: susan.orsega@hhs.gov Trent-Adams, Sylvia (HHS/OASH) Giroir, Brett (HHS/OASH); Valentine, Steven (HHS/OASH); Haddad, Carla (HHS/OASH); Kellogg, Rachel(HHS/OASH); Orsega, Susan (OS/OASH); Schwartz, Erica (HHS/OASH); AvilesMendoza,Guillermo (O5/OASH) Sent Date: 2020/03/13 18:47:06 Delivered Date: 2020/03/13 18:47:07 AMERICAN PVERSIGHT HHS-20-0580-B-000340 Giroir, Brett (HHS/OASH) Sylvia Trent-Adams (HHS/OASH) (Sylvia.Trent-Adams@hhs.gov) ; Valentine, Steven (H HS/OASH) ; Susan Orsega (OS/OASH) (Susan.Orsega@hhs.gov) Subject: FW: HHS Statement on Coronavirus Supplementa l Request Date: 2020/02/25 06 :55:00 Priority: Normal Type: Note Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Oakley, Caitlin B. (OS/ASPA) Sent: Monday, February 24, 2020 10:04 PM To: Oakley, Caitlin B. (O5/ASPA) Subject: HHS Statement on Coronavirus Supplemental Request Good evening, Here is a statement from HHS: "The Administration has been effectively utilizing all available resources to protect the American people from COVID-19. Today, the White House sent a supp lemental request to Congress to make $2.5 billion available for COVID-19 response efforts, including an emergency supplemental appropriation of 1.25 billion. HHS will also use the Secretary's transfer authority to provide needed resources to continue the Department's robust and multi-layered public health preparedness and response efforts - including public health smveillance, epidemiology, laboratory testing, support for state and local governments and other key partners, advanced research and development of new vaccines, therapeutics and diagnostics, advanced manufacturing enhancements, and suppo1i for the Strategic National Stockpile." AMERICAN PVERSIGHT HHS-20-0580-B-000341 Read the letter here: https://www.whitehouse.gov/wpcontent/uploads/2020/02/Corona virus-Supplemental-Request-Letter-Final. pdf All the best, Caitlin B. Oakley Deputy Assistant Secretary, National Spokesperson Office of the Assistant Secretary for Public Affairs U.S. Deprutment of Health and Human Services caitlin.oaklev@hhs.gov Giroir, Brett (HHS/OASH) Sylvia Trent-Adams (HHS/OASH)(Sylvia.Trent-Adams@hhs.gov) ; Valentine, Steven (HHS/OASH); Susan Orsega (OS/OASH)(Susan.Orsega@hhs.gov) Sent Date: 2020/02/25 06:55:49 Delivered Date: 2020/02/25 06:55:00 AMERICAN PVERSIGHT HHS-20-0580-B-000342 Trent-Adams, Sylvia (HHS/OASH) Johns, Matthew (HHS/OASH) ; To: Giroir, Brett (HHS/OASH) AvilesMendoza, Guillermo (O5/OASH) ; Roman, Ruth (HHS/OASH) ; Valentine, Steven (HHS/OASH) Subject: RE: Update on COVID-19 from Region 9 (Sunday 3/8/2020) Date: 2020/03/09 12:38:23 Priority: Normal Type: Note Thank you, STA From: Johns, Matthew (HHS/OASH) Sent: Monday, March 9, 2020 12:06 PM To: Trent-Adams, Sylvia (HHS/OASH) ; Giroir, Brett (HHS/OASH) Cc: AvilesMendoza, Guillermo (OS/OASH) Subject: Re: Update on COVID-19 from Region 9 (Sunday 3/8/2020) Thank you ADM Giroir and RADM Trent-Adams, b)(5) AMERICAN PVERSIGHT HHS-20-0580-B-000343 b)(5) Thank you for your consideration. Kind regards, CDRJohns Matthew C. Johns, MPH Commander, United States Public Health Service Regional Health Administrator-Region 9 Office of the Assistant Secretary for Health Office of the Secretary United States Department of Health and Human Services 90 7 th Street, Suite 5-100 San Francisco, CA 94103 Phone: (415)437-8102 Mobilefbl(6) Email: Matthew.Johns@HHS.gov Website: https: //www.hhs.gov /ash/about-ash/regional-offices I /region-9/index.html HHS Region 9: In the Service of Health (In Officio Salutis) for Arizona, California, Nevada, Ha waii, American Samoa , Commonwealth of the Northern Mariana Islands, Federated States of Micronesia , Guam, Marshall Island s and the Republic of Palau .....and 150 Federa lly -recognized Tribes. On: 09 March 2020 03:49, "Trent-Adams, Sylvia (HHS/OASH)" wrote: Thank you CDR Johns. We will share with the RHAs. Please keep us posted as things evolve. If you need anything do not hesitate to call. Sent from my iPhone On Mar 9, 2020, at 5:53 AM, Giroir, Brett (HHS/OASH) wrote: This is a very useful update. Thank you AMERICAN PVERSIGHT HHS-20-0580-B-000344 BG Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Johns, Matthew (HHS/OASH) Sent: Sunday, March 8, 2020 11:47 PM To: AvilesMendoza, Guillermo (O5/OASH) Cc: Giroir, Brett (HHS/OASH) Subject: Update on COVID-19 from Region 9 (Sunday 3/8/2020) >; Trent- RADM, CDR, I hope th is message finds you both well. b)(5) AMERICAN PVERSIGHT HHS-20-0580-B-000345 (b)(5) Kind regards, CDRJohns MatthewC. Johns,MPH Commander, United States Public Health Service Regional Health Administrator-Region 9 Office of the Assistant Secretary for Health Office of the Secretary United States Department of Health and Human Services 90 7th Street, Suite 5-100 San Francisco, CA 94103 Phone: (415)437-8102 5 Mobile: l~ (b_l( _l ---~ Email: Matthew.Johns@HHS.gov Website: https://www.hhs.gov /ash/about-a sh/reg ional-offices /region-9/index.html AMERICAN PVERSIGHT HHS-20-0580-B-000346 HHS Region 9: In the Service of Health {In Officio Salutis) for Arizona , California, Nevada, Hawa ii, Amer ican Samoa, Commonwealth of the Northern Mariana Islands , Federated States of Micronesia , Guam, Marshall Islands and the Republic of Palau .....and 150 Federally -recogn ized Tribes. Sender: Trent-Adams, Sylvia (HHS/OASH) Johns, Matthew (HHS/OASH) ; Giroir, Brett (HHS/OASH) ; AvilesMendoza, Guillermo (OS/OASH) ; Roman, Ruth (HHS/CASH) ; Valentine, Steven (HHS/CASH) Sent Date: 2020/03/09 12:38:22 Delivered Date: 2020/03/09 12:38:23 AMERICAN PVERSIGHT HHS-20-0580-B-000347 Giroir, Brett (HHS/OASH) To: Butler, Jay C. (CDC/DDID/OD) Subject: Fwd: HHSInternational FYSA:Novel Coronavirus,Wuhan, China (Update #6) Date: 2020/01/20 21:45:03 Priority: Normal Type: Note Sent from my iPhone Begin forwarded message: From: "OS Secretarys Operations Center" To: "OS Secretarys Operations Center" Subject: HHS International FYSA: Novel Coronavirus, Wuhan, China (Update #6) HHS International FYSA: Novel Coronavirus, Wuhan, China (Update #6) The current situation rel ates to an outbreak of Novel Coronavirus (2019-nCoV) in Wuhan City, Hubei Province, China. Some patients were linked to a large local seafood and animal market. o o o o o AMERICAN PVERSIGHT 218 cases of confirmed 2019-nCoV in 4 countries as of January 20th CDC is planning for scale up of screening of travelers from Wuhan in multiple airports o Atlanta (ATL) and Chicago (ORD), in addition to San Francisco (SFO), Los Angeles (LAX) and John F Kennedy (JFK) o 1,120 persons were screened as of 19Jan20 and none were referred for medical evaluation CDC has activated the Emergency Operations Center in response to the 2019-nCoV outbreak The CDC laboratory has tested specimens from one patient, which tested negative for the 2019-nCoV using the CUA-certified real time RT-PCR assay o Is currently processing specimens from another patient as of 20Jan20 The Global Migration Task Force on 20Jan20, held conference call with city and state health department officials with jurisdiction over the Atlanta (ATL) and Chicago (ORD) airports to discuss traveler entry screening issues HHS-20-0580-B-000348 o o Medical Care and Countermeasures Task Force is working closely with Epi TF on revising Home Care documents with link to guidance on isolation for confirmed patients, as well as patients who test negative but are still under investigation PPE supply chain partners engaged to increase awareness on supply chain status o NIOSH is meeting with International Safety Equipment Association (ISEA) and Health Industry Distributors Association (HIDA) on Tuesday for an update on PPE supply chain status. For more details, please see attached CDC SITREP for Novel Coronavirus. The SOC will continue to monitor this incident and report as needed. This message was sent to the SOC FYSA Distribution List. Prepared by: Juan Ospina, Watch Officer Approved by: Rhibano Dokong, Senior Watch Officer Secretary's Operation Center U.S. Department of Health and Human Services (HHS) Assistant Secretary for Preparedness and Response (ASPR) 200 Independence Ave S.W. Washington D.C. 20201 Office: (202) 619 - 7800 Fax: (202) 619 - 8602 Email: hhs.soc@hhs.gov ::::-:::: Description: Description: Description: Description: Description: Description: Descrip tion: Description: Description: cid: image00 1. png@0 1CCFC4D.92F36DD0 Descr iption: CONFIDENTIALITY NOTICE: Th is e-mail communication and any attachments may contain confidential and privileged information for the use of the designated recipients. If you are not the intended recipient, (or authorized to receive for the recipient) you are hereby notified that you have received this communication in error and that any review, disclosure, dissemination, distribution or copying of it or its contents is prohibited. If you have received this communication in error, please destroy all copies of this communication and any attachments and contact the sender by reply e-mail or telephone (202-6197800). Sender: Recipient: Giroir, Brett (HHS/OASH) ( FYDIBOHF23SPDL T)/CN= RECIPIENTS/CN Butler, Jay C. (CDC/DDID/OO) Sent Date: 2020/01/20 21:45:02 Delivered Date: 2020/01/20 21:45:03 AMERICAN PVERSIGHT HHS-20-0580-B-000349 HHS-20-0580-B-000350 Giroir, Brett (HHS/OASH) To: Fink, Dorothy (O5/OASH) CC: Kellogg, Rachel(HHS/OASH) Subject: RE: National Center for Health Statistics Webinar Announcement: Final 2018 Mortality Data with a Special Highlight on Maternal Mortality on Thursday, January 30, 2019 at 2:30pm Date: 2020/01/23 19:26:00 Priority: Normal Type: Note Sure thing Tomorrow might be tight but certainly Monday - and happy to chat over the weekend Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Fink, Dorothy (OS/OASH) Sent: Thursday, January 23, 2020 7:00 PM To: Giroir, Brett (HHS/OASH) Subject: FW: National Center for Health Statistics Webinar Announcement: Final 2018 Mortality Data with a Special Highlight on Maternal Mortality on Thursday, January 30, 2019 at 2:30pm FYSA. We need to catch up. Dorothy Fink, MD Deputy Assistant Secretary for Women's Health Director, Office on Women's Health Office of the Assistant Secretary for Health U.S. Department of Health and Human Services Disclaimer: This message is intended for the exclusive use of the recipient(s) named above. It may contain information that is PRE-DECISIONAL,PROTECTED,PRIVILEGED,and/or CONFIDENTIAL,and it should not be disseminated, distributed, or copied to persons not authorized to receive such information. All sensitive documents must be properly labeled before dissemination via email. If you are not the intended recipient, any dissemination, distribution, or copying is strictly prohibited without the permission of the sender. If you have received this communication in error, please erase all copies of the message and its attachments and notify us immediately. AMERICAN PVERSIGHT HHS-20-0580-B-000351 From: Wagner, Lisa {CDC/DDPHSS/NCHS/OD) Sent: Thursday, January 23, 2020 5:39 PM To: Wagner, Lisa {CDC/DDPHSS/NCHS/OD) Subject: Nationa l Center for Health Statistics Web inar Announcement : Final 2018 Mortality Data with a Special Highlight on Maternal Mortality on Thursday, January 30, 2019 at 2:30pm Webinar Announcement: Final 2018 Mortality Data Release with a Special Highlight on Maternal Mortality The National Center for Health Statistics (NCHS) will release the Final 2018 Mortality File and accompanying reports on Thursday, January 30 , 2020. In addition to reports highlighting life expectancy and drug overdose, NCHS will release new reports on maternal mortality measurement in the United States, along with detailed data files for researchers. With the release of these data and reports, NCHS is resuming publication of an official Maternal Mortality Rate for the first time since 2007. Join NCHS for a webinar, open to the public, on Thursday, January 30th, at 2:30pm EST, to learn more about the final mortality data release, maternal mortality data, and the new accompanying reports. NCHS will provide detailed information on reporting of maternal mortality statistics, how reporting has changed as states have added a pregnancy checkbox on their death certificates, changing in coding procedures, and the release of the first official national Maternal Mortality Rate since 2007. Webinar Details Thursday, January 30th, at 2:30-3:30 pm EST r~, Participants can join the Skype meeting via the free Skype Meeting App at: I For the full experience (i.e. audio, video , and chat) , attendance through the Skype Meeting App is recommended. However, articipants may also dial-in to the audio conference line atl(b)(6) rb )(6) I IAccessCode:,_b)_(6_) ____, It is recommended that those wishing to attend via Skype should test their systems prior to the meetinato ensureaccess.Helofor Skvoecan be foundat: Live captioning will also be setup for this event. A URL for real-time closed captioning is forthcoming. For the latest information oleasesee webinardetailsat? AMERICAN PVERSIGHT HHS-20-0580-B-000352 Lisa Wagner, MPA Health Policy Analyst, Outreach HHS/CDC National Center for Health Statistics Direct: (301) 458-4185 I LWagner2@cdc.gov www.cdc.gov/nchs I @NCHStats Sender: Recipient: Giroir, Brett (HHS/OASH) Fink, Dorothy (O5/OASH) ; Kellogg, Rachel (HHS/OASH) Sent Date: 2020/01/23 19:26:26 Delivered Date: 2020/01/23 19:26:00 AMERICAN PVERSIGHT HHS-20-0580-B-000353 Kadlec,Robert (O5/ASPR/IO) Giroir, Brett (HHS/OASH) Subject: Re: Update w/ test #s from this morning Date: 2020/03/03 18:07:38 Priority: Normal Type: Note Copy Sent from my iPhone On Mar 3, 2020, at 5:24 PM , Giroir, Brett (HHS /OASH) w rote: Just got this .... Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Berger, Sherr i (CDC/OCOO/OD) Sent: Tuesday, March 3, 2020 5:23 PM To: Giro ir , Brett (HHS/OASH) Cc: Lenihan, Keagan (FDA/OC) Subject: Update w/ test #s from th is morning From: Berger, Sherr i (CDC/OCOO/OD) Sent: Tuesday, March 3, 2020 9:31 AM To: Lenihan, Keagan ; Hall, Bill (HHS/ASPA) ; McGowan, Robert (Kyle) (CDC/OD) Subject: RE: Test kit TPs b)(5) AMERICAN PVERSIGHT HHS-20-0580-B-000354 (b)(5) From: Lenihan, Keagan Sent: Tuesday, March 3, 2020 9:29 AM To: Hall, Bill (HHS/ASPA) ; Berger, Sherri (CDC/OC00/0D) Subject: Re: Test kit TPs (b)(5) Sent from my iPhone On Mar 3, 2020 , at 9:24 AM , Hall, Bill (HH S/ASPA ) wrote: ? Fro m: Lenihan, Keagan Sent: Tuesday, March 3, 2020 9:16 AM To: Hall, Bill (HHS/ASPA) Subject: RE: Test kit TPs b)(5) AMERICAN PVERSIGHT HHS-20-0580-B-000355 (b)(5) From: Hall, Bill (HHS/ASPA) Se nt: Tuesday, March 3, 2020 9:01 AM To: Lenihan, Keagan Subject: Test kit TPs (b)(5) Will iam Hall Deputy Assistant Secretary for Public Affairs (Public Health) Off ice of the Assistant Seereta ry fo r Public Affairs U.S. Department of Health &Human Services Washington , DC Direct: 202-690-634 4 ~b~)(6 ~)--~ M obile: k Email: bil l.hall@hhs.gov www .hhs.gov X Sender: Recipient: Kadlec, Robert (OS/ASPR/IO) Giroir, Brett (HHS/OASH) Sent Date: 2020/03/03 18:07:37 Delivered Date: 2020/03/03 18:07:38 AMERICAN PVERSIGHT HHS-20-0580-B-000356 Giroir, Brett (HHS/OASH) To: Callahan, Michael V.,M.D. ~(b)(6) CC: ~mgh.harvard.edu> Valentine, Steven (HHS/OASH) Subject: RE: Hey boss Date: 2020/01/28 06:44:00 Priority: Normal Type: Note Of course this is really incredibly helpful insight. I am second viola in this, but still involved and mostly interacting by training and sending Commissioned Corps wherever needed. Let me know as soon as you are here. And of course the family! Brett 6 Mobil ~~'.b _H_)___ ~ Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Callahan, Michael V.,M.D . {b)(B) @mgh.harvard .edu> Sent: Tuesday, January 28, 2020 1:02 AM To: Giroir, Brett (HHS/OASH) Cc: Valentine, Steven (HHS/OASH) Subject: Re: Hey boss Brett FYSA Jay suggested I reach out so you are aware of Chinese reporting through our institutioninstitution programs . It may be helpful. Here are a few FYSAs: Through MGH, I have a long standing visiting appointment at Nanjing Hospital 2. The focus is on mass casualty infections . It's a great hospital. 3 faculty were my fellows many years back. AMERICAN PVERSIGHT HHS-20-0580-B-000357 We have great insight into national control efforts and deterioration of medical capability relayed to us through am ICU video rounds . As of Jan 26 we have *277* closely monitored 20 l 9nCo V patients under care and 22 released and 1 dead . -Death is by ARDS. Plasma VL is typically negative. - BAL in LRTI patients is e"S-e/\6 per ml which is lower then seen in Kowloon SARS. - CFR is likely low- not the 2% cited by Tony to Congress. Our angry Chinese colleagues ask a simple question " how can you determine a CFR when you have no test and cannot identify the denominator" fair point. - China has ~23000 Under daily obs with confirmed infectious contacts. -Daily monitoring and rep01is of low infectivity suggestion a RO closer to 1.4 then 2.5 quoted by the modelers. -Incubation for the small n of primary contacts is averaging 9 days. This will be a major challenge (pre-Sx travelers , minimally ill will propagate virus into distant communities. High Confi points: -Actual incidence , per Chinese hospitals , is 4X reported to WHO - multiple disincentives to report actual incidence because Central Party will over react. Wuhan hospital calls this " don't test/ don't tell". Not helpful. - impact on digital call centers for pricing stock ( esp Nikei) are significant. ASEA markets will be hit more directly by cyber service inte1Tuption then by disrupted manufacturing. Several colleagues conscripted to protect trading floors from CoV. - western style hospitals, including the 3330 bed modern Wuhan Univ Hospital 2, are stressed because they are having a bad flu year. CoV is overwhelming the hospital and HCW. - -PPV and supplemental 02 supples are near limits , but still adequate ( per Wuhan Colleague reports on Jan 26) -HCW Abandonment is now being reported by two hospitals in Wuhan. - China suspending emergency trial using anti SARS mAb. No Data available on results. ( this is directed against same epitope as BARDA anti Co V mAb) - efficacy or small molecules DAA V such as lepinivir cannot be assessed because of crappy randomization and uneven supportive care. - China is trying to organize Phase 2 style trials in other provinces ahead of virus appearance. - health care-seeking Chinese travelers and those evading home quarantine are identified as key accelerators to Co V spread. That's the end of HIGH CONFI data that is verified by our bedside ICU guys and local public health. I was asked to stay in CONUS and supp01i Bob K. ( .. :.Nothing gets the band back together like a pandemic). I will start end of week with .5 FTE to ASPR . Let me know ifI can be helpful to your team or action items. I hope we cross paths. I've re read your email below. Shannon would like to see you, without me, and show off the strapping little fighters she is raising . IfI relocate to DC they will visit. Best to a Jill, Made line and Jaqueline . AMERICAN PVERSIGHT HHS-20-0580-B-000358 Please foiward any specific questions. My hospital cell i~~(b_H6_) ___ ~ Be well Michael Michael Callahan MD MSPH DTM&H Director , Clinical Translation Vaccine &Imrnunotherapy Center Massachusetts General Hospital Boston , MA On Jan 23, 2019, at 18:33, Giroir, Brett (HHS/OASH) wrote: ? External Email - Use Caution IT takes me a while to get to email, but of course I would like to see you. I would rather see your wife and children, but I will settle for you .... Copying my COSfor daytime appointments. Happy to meet after hours. Target rich environment for innovation and intel - happy to be part of the team that can make it happen. Cheers! BG Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) Senior Advisor for Opioid Policy 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Callahan, Michael V.,M .D. fb )(B) Sent: Wednesday, January 23, 2019 11:02 AM AMERICAN PVERSIGHT @mgh.harvard.edu > HHS-20-0580-B-000359 To: Giroir, Brett (HHS/OASH) Subject: Hey boss Brett I tried to catch you at Carl's cell immunotherapy meeting yesterday but my flight was delayed. I am in contact with Bob K and Joe Hamel about how I can use my powers for good. Specifically, last month I saw my 900th ebola ( or Marburg ) patient over 6 outbreaks- the highest patient census recorded by WHO; have instituted elopement prevention from ETUs and border detection on the DRC-Uganda border; tested 3 emergency use VHF therapies including ZMAP ( which is a irony given that we made it for free in the AMP program back in 2006); have a appointment at Peking University for care ofH7N9 and H5Nl patients ( boosted lanimivir trial) and have brought 2 CARTs to clinic (CD38 and BCMA for MM) and have collected the best innovators from Wattendorf's ADEPT program - and refugees from Moderna to launch a transgene encoded biologics company, now with JPM and Goldman funding and a IPO in 2019 with a premoney of 300mm. This is all ok, but I'd like to assist in federal service- specifically with my access to zoonotic infected patients and to help protect the Nation from infected health careseeking refugees and natural or human promulgated mass casualty infections and Poisonings. I'd like to get on your calendar when you have a breather. I'm in DC now so thought I'd see ifl can take you away from Jill for a coffee or beer. If not convenient I'll travel back when you have time ( I'm back in DRC in 10 days and attending in Boston Feb 20-March 10). I really hope you, Jill, Madeline and Jaqueline and now the grandkid)s are well and that our paths cross soon. I'll make sure I am ebola PCR exonerated before any meeting. Be well Michael ( PS: I'm funding Kevin Tracy on a totally cool project which he and I will share shortly). Michael V Callahan MD, DTM&H, MSPH Director, Clinical Translation Vaccine &Imrnunotherapy Center (VIC) Division of Infectious Diseases Massachusetts General Hospital Harvard Medical School AMERICAN PVERSIGHT HHS-20-0580-B-000360 Boston, Massachusetts The infonnation in this e-mail is intended only for the person to whom it is addressed. If you believe this e-mail was sent to you in error and the e-mail contains patient information, please contact the Partners Compliance HelpLine at http://www.partners.org /complianceline . If the e-mail was sent to you in error but does not contain patient information , please contact the sender and properly dispose of the e-mail. Sender: Giroir, Brett (HHS/OASH) Callahan, Michael V.,M.D. 4:b)(6) jg)mgh.harvard.edu>; Recipient: Valentine, Steven (HHS/OASH) Sent Date: 2020/01/28 06:44:07 Delivered Date: 2020/01/28 06:44:00 AMERICAN PVERSIGHT HHS-20-0580-B-000361 Giroir, Brett (HHS/OASH) To: Reed, Paul(HHS/OASH) CC: Haddad, carla (HHS/OASH) Subject: RE: HHSInteragency VTC-COVID-19 Date: 2020/02/25 13:56:00 Priority: Normal Type: Note Copy that Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Reed, Paul (HHS/OASH) Sent: Tuesday, February 25, 2020 1:26 PM To: Giroir, Brett (HHS/OASH) Cc: Haddad, Carla (HHS/OASH) Subject: RE: HHS lnteragency VTC-COVID-19 Sir, (b)(5) p~ CAPT Paul Reed, MD AMERICAN PVERSIGHT HHS-20-0580-B-000362 U.S. Public Health Service --- "In Officio Salutis" Deputy Assistant Secretary for Health (Medicine and Science) Office of the Assistant Secretary for Health Department of Health and Human Services From: Haddad, Carla (HHS/OASH) On Behalf Of Giroir, Brett (HHS/OASH) Sent: Monday, February 24, 2020 5:57 PM To: Reed, Paul (HHS/OASH) Subject: RE: HHS lnteragency VTC-COVID-19 Good evening CAPT Reed, Are you available to join this VTC tomorrow? ADM Giroir is unable to listen in and was hoping that you could listen in on the call for situational awareness. Please let me know. Thanks, Carla -----0 rigi na I Ap poi ntme nt----From: OS Secretarys Operations Center Sent: Tuesday, February 18, 2020 3:29 PM To: OS Secretarys Operations Center; Alexander , Daniel (fema.dhs.gov); Amparo, Alex (fema.dhs.gov); Anderson, Lindsey (fema.dhs.gov); Apodaca, Michael (fema.dhs.gov); Balint, Thomas (fema.dhs.gov); Bean, Bridget (fema.dhs.gov); Bettis, Elizabeth (fema.dhs.gov); OS Bibo, David; Blaz, Christopher (fema.dhs.gov); Bowlds, Wendy (fema.dhs.gov); Bowman, Scott (fema.dhs.gov); Breslin, Thomas; Casey, Michael (fema.dhs.gov); Castillo, Carlos (fema.dhs.gov); Clarke, Russell (fema.dhs.gov); Clever, Traci (fema.dhs.gov); Comans, Mary (fema.dhs.gov); Cranston, Anvaline (fema.dhs.gov); Criman, Thomas (fema.dhs.gov); Doolin, Joel (fema.dhs.gov); Naar, Alex (FAA.GOV); Dorko, Jeffrey (fema.dhs.gov); Dozar, Joshua (fema.dhs.gov); Dugan, Moises (fema.dhs.gov); Dunne, Nicole (fema.dhs.gov); Edwards, Eric (fema.dhs.gov); Endrikat, Fred (fema.dhs.gov); Eswood, Louis (fema.dhs.gov); Ey Ill, Elwood (fema.dhs.gov); Fl Military Aide (peter.jennison@associates.fema.dhs.gov ); Fema-operations.Center (OHS.GOV);FEMA-LRC-Chief(fema.dhs.gov); Fema.Nrc-watch-dhs (OHS.GOV); FEMA-NWC (OHS.GOV); FEMA-NWC-TMT (fema.dhs.gov); Filipponi, Karen (fema.dhs.gov); Fischer, Lauren (fema.dhs.gov); Forbes, Melissa (fema.dhs.gov); Fuller, Gregory Scott (fema.dhs.gov); Gammon, Carla (fema.dhs.gov); Gaynor, Pete (fema.dhs.gov); Gibson, Levi (fema.dhs.gov); Glenn, Robert (fema.dhs.gov); Greenberg, Jeremy (fema.dhs.gov); Grimm, Michael (fema.dhs.gov); Harper, Jay (fema.dhs.gov); Heigh berger, Eric (fema.dhs.gov); Huang, Paul (fema.dhs.gov); Hutchinson, Lytwaive (fema.dhs.gov); IMAT Crisis (fema.dhs.gov); IMAT-East (fema.dhs.gov); IMAT West (fema.dhs.gov); Jackson, Liz (fema.dhs.gov); James, Lavar (fema.dhs.gov); Johnson, Jo Linda (fema.dhs.gov); Jones, Brian R. (fema.dhs.gov); Kamoie, Brian (fema.dhs.gov); Keldsen, Donald (fema.dhs.gov); Kim, Myung (fema.dhs.gov); Kittrie, Zachary (fema.dhs.gov); Koziol, Lauralee (fema.dhs.gov); Langley, Monica (fema.dhs.gov); Leckey, Eric (fema.dhs.gov); Lewis, Leviticus (fema.dhs.gov); Liggett, Christopher (fema.dhs.gov); Lipka, Daniel (fema.dhs.gov); Logan, Christopher (fema.dhs.gov); Lorenz, Gena (fema.dhs.gov); MacIntyre, Anthony (fema.dhs.gov); Manchester, Michael (fema.dhs.gov); Marten, Lexi (fema.dhs.gov); Maurstad, David AMERICAN PVERSIGHT HHS-20-0580-B-000363 (fema.dhs.gov); Mccane, Bobby (fema.dhs.gov); McFarland, Marcie (fema.dhs.gov); McKean, Kelly (fema.dhs.gov); Mintz, Carol (fema.dhs.gov); Nalepa, Jessica (fema.dhs.gov); Nelms, Jordan (OHS.GOV); Niedernhofer, Nancy (fema.dhs.gov); Okada, Ted (fema.dhs.gov); Parker, Robert (fema.dhs.gov); Payne, Matthew S (fema.dhs.gov); Penn, Damon (fema.dhs.gov); Peterson, Mark J (fema.dhs.gov); Phelan, Regis (fema.dhs.gov); Plostock, Michael (fema.dhs.gov); Rabin, John (fema.dhs.gov); Ralston, Jennifer (fema.dhs.gov); Red, Dennis (fema.dhs.gov); Richardson, Yasamie (fema.dhs.gov); Roy, William (fema.dhs.gov); Salazar, Jose (fema.dhs.gov); Schweitzer, Robert (fema.dhs.gov); Scott, Dean (fema.dhs.gov); Sevier, Adrian (fema.dhs.gov); Short, Joseph (fema.dhs.gov); Showman, Tracey; Shufro, Nick (fema.dhs.gov); Slade, Douglas (fema.dhs.gov); Smith, Christopher B (fema.dhs.gov); Smith, Heather R (fema.dhs.gov); Stewart, Jessica (fema.dhs.gov); Travis, Alexandra (fema.dhs.gov); Turi, Keith (fema.dhs.gov); Turner, Chris (fema.dhs.gov); Ventresca, Melissa (fema.dhs.gov); Vick, Hannah (fema.dhs.gov); Weber, Mario (fema.dhs.gov); Webster, Dean (fema.dhs.gov); Wehagen, Robby (fema.dhs.gov); AAVTC,PortsmouthOSl (uscg.mil); Danjczek, Peter (fema.dhs.gov); Early, Emily (hq.dhs.gov); Edge, Elizabeth (fema.dhs.gov); EPA (epamail.epa.gov); Evetts, Mark (HQ.OHS.GOV); FEMA-NCP-CRC-WATCH(fema.dhs.gov); FEMA-NRCC-cssc(fema.dhs.gov); FEMA-NRCC-MlControl (fema.dhs.gov); FEMA-NRCC-NRCSC(fema.dhs.gov); FEMA NRCCPlanning (FEMA.DHS.GOV); FEMANRCC-rssc(fema.dhs.gov); FEMA-NRCC-sasc(OHS.GOV); FEMA-VOC (fema.dhs.gov); IMT3 Information Management (OS/ASPR);Sweeney, Jay L. (MIL); JOC Dir PACOM (pacom.mil); Jones, Julius (fema.dhs.gov); Laura L.. McClure; Travis, Matthew {hq .dhs.gov); Wombacher, Matthew (hq.dhs.gov); McGough, Daniel (HQ.OHS.GOV); Michael.Quinn.OnPrem (hq .dhs .gov); National Guard Bureau Joint Operations Center (MIL); NGB (MIL); NOC.SWO.Restricted {hq.dhs.gov); Rockabrand, Ryan (fema.dhs.gov); Brear, Scott {hq.dhs .gov); Buchanan, Scott {hq.dhs .gov); Smith, Timothy D. (fema.dhs.os); Harris, Steve {hq.dhs .gov); Street, Stacey (DHS.GOV); Tamillow, Michael {fema .dhs .gov); Travis, Matthew {OHS.GOV); Treasury (treasury.gov); Wales, Brandon {HQ.OHS.GOV);Leary, Adam (OS/ASPR/SPPR);Lotto, Adrienne (hq .doe .gov); Finn, Alyson (noaa.gov); Smith, Amanda {fema .dhs.gov); Wood, Ambria (fema .dhs .gov); Smith, Andrew M. (MIL); Mcbrearty, Andrew (VA.GOV); Hower, Andrew (nps .gov); Andryushchenko, Margarita (fema.dhs.gov); Battaglia, Anthony {fema .dhs.gov); Gonzalez, Arnie (fema.dhs.gov); Gel Iner, Asheleigh 0 . (MIL); Bahamonde, Marty {fema .dhs .gov); Curran, Ben (fema.dhs.gov); Dinsmore, Ben (fsis.usda.gov); Korsen, Benjamin (fema.dhs.gov); Kennedy, Beth (MIL); Beth, Bradley (dol.gov); Martsching, Bradley 0. {MIL); White, Brandon (fema.dhs.gov); Armstrong, Brett (GSA.GOV); Yoo, Brianne (fema.dhs.gov); Krane, Bryan (fema.dhs.gov); Morgan, Butch (dot.gov); Mason, Byron (ACF); Holmes, Carolyn A. {MIL); Ward, Cassandra (fema.dhs.gov); Welker, Catherine (fema.dhs.gov); Gorman, Chad (fema.dhs.gov); Alexander, Charles {MIL); Heltsley, Charles (fema.dhs.gov); Davidson, Christina M. {MIL); Howlett, Christine (fema.dhs.gov); Algiere, Christopher (FirstNet.gov); Brunner, Christopher (fema.dhs.gov); Felski, Christopher (atf.gov); Tuttle, Christopher (hq.dhs.gov); Vaughan, Christopher (fema.dhs.gov); Russell, Cora (usda.gov); Jiron, Dan (osec.usda.gov); Tulis, Dana S. {MIL); Berry, Daniel J. {MIL); Allen, David (fema.dhs.gov); Higgin Botham, David (hq.dhs.gov); Villyard, David (hq.dhs.gov); Hill, Deborah (usda.gov); Clark, Debra (fema.dhs.gov); Garner, DeLane (fema.dhs.gov); Fisher, Dennis (fema.dhs.gov); Johnson, Deonna (fema.dhs.gov); Jaastad, Derrick; Rose Jr, Douglas (associates.fema.dhs.gov); Bartosh, Ernest (DOC.GOV); Egraeden (TALUSANALYTICS.COM);Koren, Elizabeth (fema.dhs.gov); Soucie, Eric (fema.dhs.gov); Tawadrous, Fady (fema.dhs.gov); Stewart, Farrah (fema.dhs.gov); FEMA-ActionOffice-ORR - Response (fema.dhs.gov); FEMA-ESFLG(fema.dhs.gov); FEMA-MDWG (fema.dhs.gov); Bizzell, Freddie {MIL); Maung, George (fema.dhs.gov); Bennett, Gerilee (fema.dhs.gov); Esa, Gibran (fema.dhs.gov); Russell, Glen (fema.dhs.gov); Malvin, Gregory (OS/ASPR/SPPR);gsachs (ts.fed.us); Wulfkuhle, Gustav (fema.dhs.gov); Haynes, Harry E. {MIL); Bartholomew, Heather (fema.dhs.gov); Harkenrider, Hmarie (fema.dhs.gov); Fuller, Holly (fema.dhs.gov); Ross, James C. {MIL); Stahlman, James {MIL); Hardy, James (fema.dhs.gov); Marquis, James (fema.dhs.gov); Rosebrock, James (ATF.GOV); Griffin, James S. {MIL); Clem, Jameson AMERICAN PVERSIGHT HHS-20-0580-B-000364 (fema.dhs.gov); Clark, Jamie (hq.doe.gov); Golrick, Janet M. (hud.gov); Nguyen, Jason (associates.fema.dhs.gov); Keller, Jason R. (aphis.usda.gov); Marineau, Jason (ios.doi.gov); Cooke, Jasper (fema.dhs.gov); Mckinney, Jazmine (fema.dhs.gov); Byard, Jeffrey (fema.dhs.gov); Raymond, Jeremy (va.gov); Moore, JKevin (fema.dhs.gov); Murphy, J (ens.gov); Burchette, Joe (fema.dhs.gov); Bitterman, John (associates.fema.dhs.gov); Felker, John (hq.dhs.gov); Oconnor, John (hq.dhs.gov); Bitterman, John R. {MIL); OS Valliere, John; Juskie, John (ios.doi.gov); Nelson, John (ios.doi.gov); Reyes, Jorge (dot.gov); Rodriguez, Jose (fema.dhs.gov); Couch, Joseph (fema.dhs.gov); Kochanski, Joseph (fema.dhs.gov); Lamana, Joseph (OS/ASPR/EMMO); Barnes, Joshua (HHS.GOV); Unger, Juliann (ed.gov); Benson, Kailie (uscg.mil); Newell, Karen (va.gov); Perelin, Katherine (fema.dhs.gov); Reid, Katherine (fema.dhs.gov); Brown, Kelly (hq .dhs.gov); Quinlan, Kelly (fema.dhs.gov); Scott, Kenisha (associates.fema.dhs.gov); Buell, Kenneth (hq.doe.gov); Holmes, Kerry (fema.dhs.gov); Stewart, Kevin (fema.dhs.gov); Coleman, Kimberly (fema.dhs.gov); PfirrmannPowell, Kimberly (fema.dhs.gov); Stout, Kimberly (redcross.org); Sykes, Kimberly (fema.dhs.gov); Kufta, K (fed.us); Alkire, Lauren (fema.dhs.gov); Ratchford Jr, Lewis (va.gov); Branum, Lisa (DOI.GOV); Touhey, Lucy (usda.gov); Lowe, Lynda (sba.gov); Esnard, Malita (fema.dhs.gov); Bergman, Marc (usace.army.mil); Gallagher, Mark (fema.dhs.gov); Millican, Mark (fema.dhs.gov); Harvey, Mark P. (nsc.eop.gov); Tierney, MaryAnn (DHS/FEMA); Matthews, Denise (DOL.GOV); Hopkins, Mc (usgs.gov); McCarthy, Megan (atf.gov); Bridges, Melinda (fema.dhs.gov); Wiehenstroer, Melissa (fema.dhs.gov); Serach, Michael (usda.gov)); Paddock, Michael (NOAA); George, Michael S. (fema.dhs.gov); Tamillow, Mike (MIL); Vineyard, Michael (OS/ASPR/10); Callahan, Mike {dot.gov); Wilkinson, Nachelle (fema .dhs .gov); Grant, Natalie (ACF); ncc@hq.dhs.gov ; Anderson, Neal {hq.dhs.gov); Tang, Newton {fema .dhs.gov); Palmer, Nicholas (associates .fema .dhs .gov); Bolleurs, Noell A. (MIL); Caldwell, Paige (fema.dhs.gov); Caldwell, Paige (MIL); Gray, Patricia (fema .dhs .gov); Ford, Paul (DHS/FEMA); Kim, Paul (VA.GOV); Preusse, Paul (fema.dhs .gov); Rennert, Peter (fema.dhs.gov); Doucet, Phillip (ATF.GOV); Cychosz, Rachel (fema.dhs.gov); Holland, Rena (HUD.GOV); Fossett, Renee (gsa.gov); Button, Richard (uscg.mil); Chavez, Richard {dot .gov); Jacques, Richard (DHS.GOV); Schueneman, Richard (nnsa .doe .gov); Ziebart, Ricky (fema.dhs .gov); Carter, Robert (GSA.GOV); OS Salesses, Robert; Mccloy, Robert (ATF.GOV); Rutledge, Robert {hq .dhs .gov); Schroder, Robert (fema .dhs .gov); rsflg (fema .dhs .gov); Clarke, Russell A.(nsc.eop.gov); Fox, Sandra (fema.dhs.gov); Burgess, Scott (fema.dhs.gov); Lundgren, Scott (noaa.gov); Panzer, Scott (fema .dhs.gov); Mcnamee, Shannon (REDCROSS.ORG);Martin, Sharon (fema.dhs.gov); Pandey, Siddharth (DHS.GOV); slegarza (ts.fed.us); Snyder, Elizabeth (fema.dhs.gov); Heath, Stanley (hq.dhs.gov); Reissman, Stephan (noaa.gov); Elson, Stephen B. (hq.dhs.gov); Mason, Stephen D. {MIL); Elson, Stephen (associates.fema.dhs.gov); Wade, Stephen (fema.dhs.gov); Hortin, Steve (fns.usda.gov); Hoffman, Sydney (fema.dhs.gov); OS Taylor, Troy; Kennedy, Ted (OS/ASPR/SPPR); Mall, Tehmina (fema.dhs.gov); Theroux, Emily (fema.dhs.gov); Browning, Thomas (mail.mil); Lacrosse, Thomas (MIL); Murray, Thomas (fema.dhs.gov); Britt, Timothy (fema.dhs.gov); Montgomery, Travis (DHS.GOV); Kurz, Victor (fema.dhs.gov); Gonzalez, Waddy (fema.dhs.gov); Randall, Warren (atf.gov); Wheeler, Young (DOL.GOV); FEMA-ESFlS-Coordination (fema.dhs.gov); HQ-OEADirectors (fema.dhs.gov); 9-awa-ash -woc (FAA.GOV); Ps.goc-cog.sp (CANADA.CA); gmb -sitroom (cbp.dhs.gov); CC (NTSB.GOV); US Army Corps of Engineers - Operations Center; Allen, Stephen (hq.dhs.gov); cisa.iocc (cisa.dhs.gov); ciocc-nccwatch (cisa.dhs.gov); ciocc.physical (cisa.dhs.gov); ciocc.cyber (cisa.dhs.gov); Dept of Transportation - Crisis Management Center; COMMAND.CENTER2 (USDOJ.GOV);COMM CTR (ATF.GOV); Dept of Homeland Security - CWMD watchdesk; dniwatch(DNI.GOV); Department of Commerce EOC; edexecsec (ed.gov); Dept of Energy - Office of Emergency Management; DOI Watch Office (DOI.GOV); Department ofTreasury EOC; OS.COMMAND.CENTER(STATE.GOV);EOC Report (CDC); Environmental Protection Agency - Emergency Operations Center; Sioc (FBI.GOV); fccopcenter (fee.gov); fletcexecsec (fletc.dhs.gov); fpsimc (hq.dhs.gov); fpsintel (fps.dhs.gov); Fpsimc (DHS.GOV); suitland.megacenter (hq.dhs.gov); HQS-DG-LST-NRCINFO{MIL); heoc (hud.gov); dhs.intel.cetc.watch (hq.dhs.gov); hsintel (ice.dhs.gov); Dept of Justice - Justice Command Center; cdo.jtwc (NAVY.MIL); AMERICAN PVERSIGHT HHS-20-0580-B-000365 MTAC (NCIS.NAVY.MIL); Nee (MIL); nccic (us-cert.gov); nctc-ops (ucia.gov); Nice (OHS.GOV); js.pentagon.j3.list.addo (mail.mil); NNC.CMDCTRDIR.OMB (NORTHCOM.MIL); noc.swo (hq .dhs.gov); nnc.peterson.n-ncn2c2.mbx.interagency -omb (mail.mil); Nuclear Regulatory Commission - Operations Center; ogcexecsec (hq.dhs.gov); OperationsCenter (STATE.GOV); USDA- EOC; OPSSOO (JS.PENTAGON.MIL); ARC Disaster Operations Center; roc.ndw.fcm (NAVY.MIL); Vanatta, Robert (hq.dhs.gov); Sit.Room (OHS.GOV); cdo.tsa (tsa.dhs.gov); tsa.oia.watch (tsa.dhs.gov); Ofdadutyofficer (USAID.GOV); uscis.c2 (dhs.gov); ops center (dm.usda.gov); pios-onduty (usss.dhs.gov); VA Integrated Operations Center (VA IOC) Watch Officer; Brumfield, Ty (OHS.GOV); Campbell, Matt (fema.dhs.gov); Key, Debbie L. (hud.gov); Friedman, N (eda.gov); Potosnak, Ryan (fema.dhs.gov); FEMA-Rl WATCHOFFICER(fema-dhs.gov); FEMA-MOC-BOTHELL(fema.dhs.gov); FEMA-MOC-DENTON (fema.dhs.gov); FEMA-MOC-DENVER(fema.dhs.gov); FEMA-MOC-FREDERICK(fema.dhs.gov); FEMAMOC-MAYNARD (fema.dhs.gov); FEMA-MOC-THOMASVILLE (fema.dhs.gov); fema-r03-rrcc -watch (OHS.GOV); FEMA-R2-Watch0fficer (fema.dhs.gov); FEMA-R4-WatchUnit (fema.dhs.gov); FEMA-RSWatch; FEMA-R6-Watch (fema.dhs.gov); FEMA-R7-Watch0ps (fema.dhs.gov); FEMA-R8-Duty0fficer (fema.dhs.gov); FEMA-R8-RRCC-DIRECTOR(fema.dhs.gov); FEMA-R9Watchofficer (fema.dhs.gov); Erickson, Somer (fema.dhs.gov); Hylton, Roberto (fema.dhs.gov); Jacques, Richard (dhs.gov); Kennedy, Kam (redcross.org); Kohtz, Carol J. (associates.fema.dhs.gov); Lynne, Elisa (associates.fema.dhs.gov); Macintyre, Anthony (OHS.GOV); NOAA-LNO (fema.dhs.gov); Scannelli, Vincent (HQ.OHS.GOV); Villarreal, Xavier (DLA.MIL); Young, Joseph (fema.dhs.gov); CENTER(fema.dhs.gov); Fish, Kristen (fema.dhs.gov); Krebs, Christopher (hq.dhs.gov); NOAA SPC(noaa.gov); Wleith (USGS.GOV); mblanpied (usgs.gov); applegate (usgs.gov); Flennoy, Jason (dot.gov); Geringer-Frazier, Barbara (usda.gov); Griffin, S (ts.fed.us); Sabin, Brian (usda.gov); Usher, Zachary (fema.dhs.gov); Greene, Jonathan (OS/ASPR/EMMO); Mccreary, Kenneth (OS/ASPR/SPPR);Hrdina, Chad (OS/ASPR/SPPR);Cheatham, Reggie (epa.gov); EPA; Wenning, Stephanie (@epa.gov); Colby, Michelle - OHS, Washington, DC; O'Connor, Mike - OHS, Washington, DC; Barrett, Todd -OHS, Washington, DC; Schlieger, Brian (epa.gov); Fantinato, Jessica (USDA.GOV); Andersen, Nicholas (hq.doe.gov); Rutledge, Robert (cisa.dhs.gov); Ahrens, Dana (cisa.dhs.gov); 2019 nCoV Senior Leadership; Sims, Andrew (OS/ASPR/EMMO) ; Young, Joseph LTC US ARMY; Flowers, Artensie (OS/ASPR/EMMO); Slay, Lorenzo Jr LtCol USAF; Monahan, Kenneth (MAIL.MIL); Falone, Emily (OS/ASPR/EMMO); Blanchette, Glenn (OS/ASPR/EMMO); Lincoln, Carol (OS/ASPR/EMMO); Bermingham, John (CDC/DDPHSIS/CPR/DEO); Hall, Bill (HHS/ASPA); 'joshua.barnes@sba.gov'; Torrens, Luis (OS/ASPR/EMMO); Coviello, Daniel (HRSA); Ricketts, Kimberley (OS/ASPR/EMMO); Egan, Sarah (fema.dhs.gov); Tate, Anna (OS/ASPR/SPPR)(CTR); Evans, Catherine (OS/ASPR/SPPR)(CTR); 'David.Chawaga@fema.dhs .gov'; Rousseaux, Charles; ASPRCOMMS; 'cbpcoronavirusmailbox@cbp.dhs.gov'; Field Operations and Response Division; Dickinson, Jeanette (OS/ASPR/EMMO); Thornton, Cody (mail.mil); 'phyllis.erkins@dls.mil'; CoronavirusSmallGroup (state.gov); TFJPOl Diamond Princess Response; LeMar-Reiman, Amy N; Henwood, Eugene J; Kane, EIieen (OS/ASPR/OEA); Mcclellan, Wesley (OS/ASPR/SPPR);Austin, Meredith (uscg.mil); Hill, April (OS/ASPR/EMMO); Sanchez, Luis (OS/ASPR/OEA); Sprow, Kyle (OS/ASPR/SPPR)(CTR); Farmer, William (OS/ASPR/SPPR);Kadlec, Robert (OS/ASPR/10); Sauer, Michael (OS/ASPR); Dodgen, Daniel (OS/ASPR/SPPR);FDA Emergency Operations (FDA) Subject: HHS lnteragency VTC-COVID-19 When: Tuesday, February 25, 2020 12:30 PM-1:30 PM (UTC-05:00 Eastern Time US &Canada). Where: HHS ASPRConference Room 6th Floor; VTC; Dial-in: (b)(B) PIN: b)(B) (Muted) AGENDA COVID-19 INTERAGENCY VIDEO TELECONFERENCE Tuesday, 25 February 2020 at 12:30 p.m. ET AMERICAN PVERSIGHT HHS-20-0580-B-000366 PLEASE NOTE that this is the same agenda as the previous VTC, changes may be forthcoming. Objective o Provide information sharing among Emergency Support Functions on Federal response actions to the COVID-19 to date o Focus briefings on current situation and describe specific issues requiring Federal interagency actions Opening Comments o Dr. Robert Kadlec or Dr. Kevin Yeskey o Senior Leadership Intent o Strategic Priorities COVID-19 Situat ion Update o Centers for Disease Control and Prevention (CDC) Repatriation Status of U.S. Citizens o CAPT Scott Lee, Federal Health Coordinating Official (FHCO); Traveler Screening into the United States o Situation Report- CDC o Military Housing Update Supporting Airport Screenings - DoD/OSD and DoD/NORTHCOM o OHS Support to Traveler Supporting - OHS/Countering of Weapons Mass Destruction (CWMD) Review and Input to Pandemic Crisis Action Plan (PANCAP) o Mr. Ken McCreary, ASPR Plans o Reference PANCAP Synchronization Matrices o Request Federal DepartmenUAgency Responsibilities under Phases 1C, 2A, 2B , and 2C Task Force Update o CAPT Christopher Perdue, Chief of Staff; o Supply Chain Task Force Lead ; o Communications Task Force Lead; o Healthcare Resiliency Task Force Lead ; o Medical Countermeasures Task Force Lead ; lnteragency Support o Emergency Support Functions o ESF #1 - Transportation o ESF #2 - Emergency Communications o ESF #3 - Public Works and Engineering o ESF #4 - Fire Fighting o ESF #5 - Planning o ESF #6 - Mass Care, Emergency Assistance, Temporary Housing, &Human Services o ESF #7 - Logistics o ESF #8 - Public Health and Medical Services AMERICAN PVERSIGHT HHS-20-0580-B-000367 o ESF #10 - Oil and Hazardous Material o ESF #11 - Agriculture o ESF #12 - Energy o ESF #13 - Public Safety and Security o ESF #14 - Cross Sector, Business, and Infrastructure o ESF #15 - External Affairs o o U.S. Coast Guard Department of Defense , Office of the Secretary of Defense o U.S. Northern Command o National Guard Bureau o Defense Logistics Agency - Closing Comments o Dr. Robert Kadlec or Dr. Kevin Yeskey ; Connection Instructions o o Please mute your microphone at all times when not speaking o o Do not put your phone on hold during the conference call o o Do not dial both the Audio Bridge and the Video Bridge from the same room o FEMA Video participants including Jabber/Movi participants: From your VTC unit please dial~t least 20 minutes before the conference starts to conduct Audio/Video checks with the Video Operations Center. o Non-FEMA Video artici ants: will need to have their techn ical staff contact the FEMA Video Operations Center b)(6) to determine a dial-in method and conduct an Audio/Video test at least one hour prior to connec mg Participants are required to: o Properly reserve a video teleconferencing room, if needed , through your resource manager in advance and notify local IT of the reservation. o Confirm your VTC dial in number is correct prior to connecting . o Dial the conference number provided above and perform an Audio and Video quality check with the voe o Keep all microphones muted, unless speaking. Note: FEMA VOC Video technicians frequently monitor more than one conference , but can only monitor audio for one at a time . If you do have a problem with the conference that re uires immediate assistance , please call the FEMA Video Operations Center on (b)(6) The video bridge will be available 30 minutes prior to the scheduled start time. If you reaujre assistarce connecting or have questions, please call the FEMA Video Operat ions Center on~f_)(_6)___ ~_ NOTE: To connect to this conference after the scheduled start time, you must contact the FEMA Video Operations Center . Sender: Recipient: AMERICAN PVERSIGHT Giroir, Brett (HHS/DASH) Reed, Paul (HHS/DASH); HHS-20-0580-B-000368 Haddad, Carla ( HHS/OASH) Sent Date: 2020/02/25 13: 56: 14 Delivered Date: 2020/02/25 13:56:00 AMERICAN PVERSIGHT HHS-20-0580-B-000369 Trent-Adams, Sylvia (HHS/OASH) To: Johns, Matthew (HHS/OASH) Giroir, Brett (HHS/OASH); AvilesMendoza, Guillermo (O5/OASH) ; Kellogg, Rachel (HHS/OASH); Haddad, Carla (HHS/OASH); Valentine, Steven (HHS/OASH) Subject: Re: Follow up on Bay Area testing pilot and larger scale testing for PandemicCOVID-19 Date: 2020/03/13 21:49:04 Priority: Normal Type: Note Thank you CDR Johns. Your assistance will be greatly appreciated. Your knowledge of the region and local area will help get this moving as we tackle this challenging situation. Sent from my iPhone On Mar 13, 2020, at 8:30 PM, Johns, Matthew (HHS/OASH) wrote: ? ADM, RADM, I hope this message finds you both well. b)(S) AMERICAN PVERSIGHT HHS-20-0580-B-000370 (b)(5) Kind regards, CDRJohns MatthewC. Johns,MPH Commander, United States Public Health Service Regional Health Administrator-Region 9 Office of the Assistant Secretary for Health Office of the Secretary United States Department of Health and Human Services 90 7th Street, Suite 5-100 San Francisco, CA 94103 Phone: (415)437-8102 _. Mobile: (b_l(6_l ____ Email: Matthew.Johns@HHS.gov Website: https://www.hhs.gov/ash/about -ash/regional -offices/region 9/ind ex. html l.... HHS Region 9: fn the Service of Health (fn Officio Salutis) for Arizona , California, Nevada, Hawaii, American Samoa, Commonwealth of the Northern Mariana Islands, Federated States of Micronesia, Guam, Marshall Islands and the Republic of Palau ..... and 150 Federally-recognized Tribes. Trent-Adams, Sylvia (HHS/OASH) Sender: GROUP (FYDIBOHF23SPDLT)/CN= RECIPIENTS/CN=650D027641442169334514 Johns, Matthew (HHS/OASH) ; Giroir, Brett (HHS/OASH) ; Avi lesMendoza, Guillermo (O5/OASH) ; Kellogg, Rachel (HHS/OASH) ; Haddad, Carla (HHS/OASH) ; Valentine, Steven (HHS/OASH) Sent Date: 2020/03/13 21 :49 :03 Delivered Date: 2020/03/13 21 :49 :04 AMERICAN PVERSIGHT HHS-20-0580-B-000372 Giroir, Brett (HHS/OASH) To: Haigwood, Patricia (HHS/OASH) Subject: RE: Pop Up Talk Tomorrow (THOUGHTS) Date: 2020/01/24 08:21:00 Priority: Normal Type: Note Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Haigwood, Patricia (HHS/OASH) Sent: Friday, January 24, 2020 8:08 AM To: Giroir, Brett (HHS/OASH) Subject: RE: Pop Up Talk Tomorrow (THOUGHTS) From: Giro ir, Brett (HHS/OASH) Sent: Friday, January 24, 2020 6 :59 AM To: Haigwood, Patricia (HHS/OASH) Subject: RE: Pop Up Talk Tomorrow (THOUGHTS) Importance: High Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW AMERICAN PVERSIGHT HHS-20-0580-B-000373 Washington, DC 20201 Office Phone: 202-690-7694 From: Haigwood, Patricia (HHS/OASH) Sent: Friday, January 24, 2020 12:28 AM To: Giroir, Brett (HHS/OASH) Subject: RE: Pop Up Talk Tomorrow (THOUGHTS) b)(5) From: Giroir, Brett (HHS/OASH) Sent: Thursday, January 23, 2020 5:56 PM To: Haigwood, Patricia (HHS/OASH) Subject: RE: Pop Up Talk Tomorrow (THOUGHTS) Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Haigwood, Patricia (HHS/OASH) Sent: Thursday, January 23, 2020 5:55 PM To: Giroir, Brett (HHS/OASH) Subject: Re: Pop Up Talk Tomorrow (THOUGHTS) (b)(5) Sent from my iPhone On Jan 23 , 2020, at 5:53 PM , Giroir, Brett (HHS /OASH) wrote: rb )(5) Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW AMERICAN PVERSIGHT HHS-20-0580-B-000374 Washington, DC 20201 Office Phone: 202-690-7694 From: Haigwood, Patricia (HHS/OASH) Sent: Thursday, January 23, 2020 5:53 PM To: Giro ir, Brett (HHS/OASH) Cc: Valentine, Steven (HHS/OASH) Subject: Re: Pop Up Talk Tomorrow (THOUGHTS) Will do. I' ll be at a dinner till around 9 but can send after. Sent from my iPhone On Jan 23, 2020 , at 5:51 PM , Giroir , Brett (HHS/OASH ) wrote: (b)(5) Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690- 7694 From: Haigwood, Patricia {HHS/OASH) Sent: Thursday, January 23, 2020 5:49 PM To: Giroir, Brett (HHS/OASH) Subject: Re: Pop Up Talk Tomorrow Yes Stev en just have me the heads up AMERICAN PVERSIGHT HHS-20-0580-B-000375 Sent from my iPhone On Jan 23, 2020, at 5:45 PM, Giroir, Brett (HHS/OASH) wr ote: Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 Sender: Recipient: Giroir, Brett (HHS/OASH) ( FYDIBOHF23SPDL T)/CN=RECIPIENTS/CN Haigwood, Patricia (HHS/OASH) (FYDIBOHF23SPDL T)/ en=Recipients/cn=6f7552ba649f42369f5d2cce45889841-Haigwood, Sent Date: 2020/01/24 08:21:53 Delivered Date: 2020/01/24 08:21:00 AMERICAN PVERSIGHT HHS-20-0580-B-000376 Haddad, Carla (HHS/OASH) To: Giroir, Brett (HHS/OASH) CC: Valentine, Steven (HHS/OASH) Subject: RE: Dr. Giroir Speakto House RepublicanConferencetoday? Date: 2020/03/16 15:41:21 Priority: Normal Type: Note Please disregard. McCarthy's office will circle back with us later this week for a call. From: Haddad, Carla (HHS/OASH) Sent: Monday, March 16, 2020 3:16 PM To: Giroir, Brett (HHS/OASH) Cc: Valentine, Steven (HHS/OASH) Subject: FW: Dr. Giroir Speak to House Republican Conference today? Importance: High ASL would like to confirm your participation in a conference call with all House Republicans today. Time: 5-5:45pm (I will request start time at SlSpm to give you more time to get back to HHH) Format: Cheney would kick it off, then Rep. Scalise would talk, and then Leader McCarthy would would introduce him. Then YOU would give 5 mins of remarks. And then spend the remaining 15 mins in Q&A. From: Arbes, Sarah (HHS/ASL) Sent: Monday, March 16, 2020 3:08 PM To: Haddad, Carla (HHS/OASH) ; Kellogg, Rachel (HHS/OASH) Cc: Morse, Sara (HHS/ASL) ; Pence, Laura (HHS/ASL) ; Valentine, Steven (HHS/OASH) ; Heck, Mia (HHS/OASH) ; Kellogg, Rachel (HHS/OASH) ; Bante, Katie (OS/OASH) ; Broida, Tara (HHS/OASH) Subject: RE: Dr. Giroir Speak to House Republican Conference today? AMERICAN PVERSIGHT HHS-20-0580-B-000377 For the format, Rep. Cheney would kick it off, then Rep. Scalise would talk, and then Leader McCarthy wou ld would introduce him. Then he would give 5 mins of remarks. And then spend the remaining 15 mins in Q&A. Call would be 5 - 5:45pm if he can swing it. From: Haddad, Carla (HHS/OASH) Sent: Monday, March 16, 2020 3:03 PM To: Arbes, Sarah (HHS/ASL) ; Kellogg, Rachel (HHS/OASH) Cc: Morse, Sara (HHS/ASL) ; Pence, Laura (HHS/ASL) ; Valentine, Steven (HHS/OASH) ; Heck, Mia (HHS/OASH) ; Kellogg, Rachel (HHS/OASH) ; Bante, Katie (OS/OASH) ; Broida, Tara (HHS/OASH) Subject: RE: Dr. Giroir Speak to House Republican Conference today? Adding a few others. What's the anticipated format for the call? Will ADM Giroir be the only HHS rep? From: Arbes, Sarah (HHS/ASL) Sent: Monday, March 16, 2020 2:47 PM To: Haddad, Carla (HHS/OASH) ; Kellogg, Rachel (HHS/OASH) Cc: Morse, Sara (HHS/ASL) ; Pence, Laura (HHS/ASL) Subject: Dr. Giroir Speak to House Republican Conference today? Hi Carla and Rachel, Would Dr. Giroir be available to address all House Republicans via conference call at 5:00pm today to give them an update on testing? Sarah Haddad, Carla (HHS/OASH) Recipient : Giroir, Brett (HHS/OASH); Valentine, Steven (HHS/OASH) Sent Date: 2020/03/16 15:41:20 Delivered Date: 2020/03/16 15:41:21 AMERICAN PVERSIGHT HHS-20-0580-B-000378 HHS-20-0580-B-000379 Giroir, Brett (HHS/OASH) To: Perlin Jonathan Subject: FW: See request from Adm Giroir t hrough Anne Schuchat Date: 2020/02/29 14:29:00 Priority: Normal Type: Note Answer I received, below. Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Schuchat, Anne MD (CDC/OD) Sent: Saturday, February 29, 2020 1:42 PM To: Giroir, Brett (HHS/OASH) ; Yeskey, Kevin (OS/ASPR/1O) ; Lenihan, Keagan (FDA/OC) Subject: FW: See request from Adm Giroir through Anne Schuchat ADM Giroir: Our team provided the update below regarding both N95s and other 'industrial' respirators that sketches out what is currently available language and what future steps related to expanded repirators language may be. Kevin or Keagan may have visibility to other aspects. From: Patel, Anita (CDC/DDID/NCIRD/OD) Sent: Saturday, February 29, 2020 1:35 PM To: Schuchat, Anne MD (CDC/OD) Cc:Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) ; Messonnier, Nancy (CDC/DDID/NCIRD/OD) ; Pillai, Satish K. (CDC/DDID/NCEZID/DPEI) Subject: RE: See request from Adm Giroir through Anne Schuchat Dr. Schuchat, We have a webpage to address respirator supply conservation strategies. Under "Conventional Capacity Strateg ies", we outline that the respirators non-surgical N95s may be used in the hospital setting. Language for th is is pasted below and can be found at this link : https://www.cdc .gov/coronavirus / 2019ncov/h cp/ respirator-supply-strategies. ht m I In addit ion, FDA and CDCare developing an EUA for the use of any CDC/NIOSH approved respirator (I.e., the "industr ial" ones). The goal is to have th is by beginning of next week. By issuing an EUA the respirators becomes covered through FDA mechan ism. One of the pre-requ isite for countermeasures regard ing coverage under PREPAct is that the countermeasures must be approved or cleared under the AMERICAN PVERSIGHT HHS-20-0580-B-000380 FD&C Act, licensed under the PHSAct, or authorized for emergency use under sections of 564, 564A or 564B of the FD&C Act (i.e., EUA or EUI). Let us know if there are additional quest ions. Best, Anita Conventi onal Capacity Strateg ies: https://www .cdc.gov/coronavirus/2019-ncov/hcp/respiratorsu pp ly-strateg ies.ht m I Surgical N95 respirators Surgical N95 respirators (also referred as a medical respirator) are recommended only for use by HCP who need protection from both airborne and flu id hazards (e.g., splashes, sprays). These respirators are not used or needed outs ide of healthcare settings. In times of shortage, only HCP who are work ing in a ster ile field or who may be exposed to high velocity splashes, sprays, or splatters of blood or body fluids should be prov ided these respirators. Othe r HCPcan use standard N95 respirators . If surgical N95 respirators are not available, and there is a risk that the worker may be exposed to high velocity splashes, sprays, or splatters of blood or body fluids, then a facesh ield should be worn over the standard N95 respirator . Use of alternat ives to N95 respirators Use alternatives to N95 respirators where feasible. These include other classes of filtering facepiece respirators, elastomeric half -mask and fu ll facepiece air pur ifying respirators, powered air purifying respirators (PAPRs)where feasib le. All of these alternatives w ill provide equivalent or higher protection than N95 respirators. NIOSH approves other filter ing facepiece respirators that are at least as protective as the N95. These include N99, Nl00, P95, P99, Pl00 , R95, R99, and Rl00. Elastomeric respirators are sometimes referred to as reusable respirators because the facepiece is cleaned and reused but the filter cartridges are discarded and rep laced when they become unsuitable for further use. Similar to N95 respirators, elastomer ic respirators require annual fit testing. Elastomeric respirators should not used in surgical settings due to concerns that air coming out of the exhalat ion valve may contaminate the ster ile fie ld. PAPRsare reusable respirators that are typica lly loose-fitting hoods or helmets. These respirators are battery -powered w ith blower that pulls air through attached fi lters or cartr idges. The filter is typically a high-efficiency part iculate air (HEPA) filter . Loose-fitt ing PAPRsdo not require fit-test ing and can be used with facial hair . However, PAPRsshould not be used in surgical settings due to concerns that the blower exhaust and exhaled air may contaminate the sterile field. Facilities using elastomeric respirators and PAPRsshould have up to date cleaning/dis infection procedures, wh ich are an essential part of use for protection against infect ious agents . Sender: Giroir, Brett (HHS/ OASH) Recipient: Perlin Jonathan Sent Date: 2020/ 02/29 14:29:08 Delivered Date: 2020/02/29 14:29:00 AMERICAN PVERSIGHT HHS-20-0580-B-000381 Giroir, Brett (HHS/OASH) To: Heck, Mia (HHS/OASH) Beckham, Tammy (HHS/OASH); Broida, Tara (HHS/OASH); Valentine, Steven (HHS/OASH) Subject: Re: Share Your Story to Help End HIV Date: 2020/01/ 24 11:37:44 Priority: Normal Type: Note Sent from my iPad On Jan 24, 2020, at 11:36 AM, Heck, Mia (HHS/OASH) wro te: ? b}(S} From: Giroir, Brett (HHS/OASH) Sent: Friday, January 24, 2020 11:24 AM To: Beckham, Tammy (HHS/OASH) ; Broida , Tara (HHS/OASH) ; Heck, Mia (HHS/OASH) Cc: Valentine, Steven (HHS/OASH) Subject: Re: Share Your Story to Help End HIV b)(S} Sent from my iPad On Jan 24, 2020, at 9:25 AM, Giroir, Brett (HHS/OASH) wrote: ? AMERICAN PVERSIGHT HHS-20-0580-B-000382 BG Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Centers for Disease Contro l and Prevention Sent: Friday, January 24, 2020 9:16 AM To: Giroir, Brett (HHS/OASH) Subject: Share Your Story to Help End HIV Let's Stop HIV Together What' s New INFORMATION FROM THE CDC'S LET'S STOP HIV TOGETHER C Let's Stop HIV Together. Information from the CDC's Let's Stop HIV Together Car AMERICAN PVERSIGHT HHS-20-0580-B-000383 You are subscr ibed to Let's Stop HIV Together Campaign from the Division of HIV/AIDS Preven Share Your Story to Help End HIV Additional Reso1 Hello friends! Let's Stop HIV To lnstagram It's almost that time of year again: We're planning our next video and photography production for CDC's Let's Stop HIV Together campaign and we're looking to tell new stories. CDC HIV/AIDS \A CDC HIV Facebo CDC is developing new prevention resources as part of its Let 's Stop HIV Together campaign. The goal of this campaign component is to prevent new HIV transmissions by promoting proven interventions , including PrEP (pre-exposure prophylaxis) , syringe service programs , and treatment as prevention. HIV/AIDS Twitter Interested in sharing your story about HIV prevention or treatment? Click the link below to leave us your contact information, and we'll make sure you receive the casting notice when it is released in the coming months. Compensation will be provided . Spots are limited so please apply soon and share this email to help us get the word out. Thank you for your support! HIV.gov CLICK HERE FOR SURVEY Get Tested National Preventii Information Netw< CDC-INFO Please contact u:: questions, commi feedback. ~ SUBSCRIBE TO @THIS EMAILLIS this emai AMERICAN PVERSIGHT HHS-20-0580-B-000384 Centers for Disease Control and Prevention 1600 Clifton Rd Atlanta, GA 30329 1-800-CDC-!NfO (800-232-4636) TTY: 888-232-6348 uestions or Problems Sender: I Unsubscribe Giroir, Brett (HHS/OASH) Beckham, Tammy (HHS/OASH) ; Broida, Ta ra (HHS/OASH) ; Recipient: Valentine, Steven (HHS/OASH) ; Heck, Mia (HHS/OASH) Sent Date: 2020/01/24 11:37:44 AMERICAN PVERSIGHT HHS-20-0580-B-000385 Giroir, Brett (HHS/OASH) Schuchat, Anne MD (CDC/OD) ; Yeskey, Kevin (OS/ASPR / 10) ; Lenihan, Keagan (FDA/OC) Subject: RE: See request from Adm Giroir through Anne Schuchat Date: 2020/02/29 14:29:00 Priority: Normal Type: Note Thank you Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Schuchat, Anne MD (CDC/OD) Sent: Saturday, February 29, 2020 1:42 PM To: Giroir, Brett (HHS/OASH) ; Yeskey, Kevin (OS/ASPR/1O) ; Lenihan, Keagan (FDA/OC) Subject: FW: See request from Adm Giro ir through Anne Schuchat ADM Giroir: Our team provided the update below regarding both N95s and other 'industrial' respirators that sketches out what is current! available Ian ua e and what future ste s related to expanded repirators language may be. (b)(5 l From: Patel, Anita (CDC/DDID/NCIRD/OD) Sent: Saturday, February 29, 2020 1:35 PM To: Schuchat, Anne MD (CDC/OD) Cc: Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) ; Messonnier, Nancy (CDC/DDID/NCIRD/OD) ; Pillai, Satish K. (CDC/DDID/NCEZID/DPEI) Subject: RE: See request from Adm Giroir through Anne Schuchat Dr. Schuchat, We have a webpage to address respirator supply conservation strategies. Under "Conventional Capacity Strategies", we outline that the respirators non-surgical N95s may be used in the hospital setting. Language for this is pasted below and can be found at this link: https://www.cdc.gov/coronavirus/2019ncov /hep/respirator-supply-strategies. htm I AMERICAN PVERSIGHT HHS-20-0580-B-000386 In add it ion, FDA and CDCare deve loping an EUA for the use of any CDC/NIOSH approved respirator (I.e., the "indust rial" ones). The goal is to have this by beginning of next week. By issuing an EUA the respirators becomes covered through FDA mechan ism. One of the pre-requisite for countermeasures regard ing coverage under PREPAct is that the countermeasures must be approved or cleared under the FD&C Act, licensed under the PHSAct, or authorized for emergency use under sections of 564, 564A or 564B of the FD&C Act (i.e., EUA or EUI). Let us know if there are additional quest ions. Best, Anita Convent iona I Ca pa city Strateg ies: https ://www .cdc.gov/ coron avi rus/2019-n cov/hep/ respiratorsupp ly-strateg ies.ht m I Surgical N95 respirators Surgical N95 respirators (also referred as a medical respirator) are recommended only for use by HCP who need protection from both airborne and flu id hazards (e.g., splashes, sprays). These respirators are not used or needed outs ide of healthcare settings. In times of shortage, only HCP who are work ing in a ster ile field or who may be exposed to high velocity splashes, sprays, or splatters of blood or body fluids should be prov ided these respirators. Othe r HCPcan use standard N95 respirators . If surgical N95 respirators are not available, and there is a risk that the worker may be exposed to high velocity splashes, sprays, or splatters of blood or body fluids, then a faceshield should be worn over the standard N95 respirator . Use of alternat ives to N95 respirators Use alternatives to N95 respirators where feasible. These include other classes of filtering facepiece respirators, elastomeric half -mask and fu ll facepiece air purifying respirators, powered air purifying respirators (PAPRs)where feasib le. All of these alternatives w ill provide equivalent or higher protection than N95 respirators. NIOSH approves other filter ing facepiece respirators that are at least as protective as the N95. These include N99, Nl00, P95, P99, Pl00 , R95, R99, and Rl00. Elastomeric respirators are sometimes referred to as reusable respirators because the facepiece is cleaned and reused but the filter cartridges are discarded and rep laced when they become unsuitable for further use. Similar to N95 respirators, elastomer ic respirators require annual fit testing. Elastomeric respirators should not used in surgical sett ings due to concerns that air com ing out of the exhalation valve may contam inate the ster ile field . PAPRsare reusable respirators that are typically loose-fitting hoods or helmets . These respirators are battery-powered with blower that pulls air through attached filters or cartr idges. The filter is typically a high-efficiency part iculate air (HEPA) filter . Loose-fitt ing PAPRsdo not require fit-test ing and can be used with facial hair . However, PAPRsshould not be used in surgical settings due to concerns that the blower exhaust and exhaled air may contaminate the sterile field. Facilities using elastomeric respirators and PAPRsshould have up to date cleaning/dis infection procedures, which are an essential part of use for protection against infectious agents . AMERICAN PVERSIGHT HHS-20-0580-B-000387 From: Schuchat, Anne MD (CDC/OD) Sent: Saturday, February 29, 2020 11:43 AM To: Messonnier, Nancy (CDC/DDID/NCIRD/OD) ; Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) Subject: FW: Question from HCA President/CMO From: Giroir, Brett (HHS/OASH) Sent: Saturday, February 29, 2020 11:34 AM To: Schuchat, Anne MD (CDC/OD) ; Lenihan, Keagan (FDA/OC) ; Yeskey, Kevin (OS/ASPR/1O) Subject: Question from HCA President/CMO (b)(5) V/r BG Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 Sender: Giroir, Brett (HHS/OASH) Schuchat, Anne MD (CDC/OD) ; Yeskey, Kevin (OS/ASPR/IO); Recipient: (FYDIBOHF23SPDL Lenihan, Keagan(FDNOC) AMERICAN PVERSIGHT HHS-20-0580-B-000388 Sent Date: 2020/02/29 14:29:1 7 Delivered Date: 2020/02/29 14:29:00 AMERICAN PVERSIGHT HHS-20-0580-B-000389 Giroir, Brett (HHS/OASH) To: Subject: Broido, Tara (HHS/OASH) RE: WAPONews Alert: Workers without protective gear or proper training met coronavirus evacuees,HHSwhistleblower says Date: 2020/02/27 17:40 :00 Priority: Normal Type: Note Exactly what the department needs today!!! Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Broida, Tara (HHS/OASH) Sent: Thursday, February 27, 2020 4:55 PM To: Giroir, Brett (HHS/OASH) ; Trent -Adams, Sylvia (HHS/OASH) ; Schwartz, Erica (HHS/OASH) ; Orsega, Susan (OS/OASH) ; Adams, Jerome (HHS/OASH) Cc: Heck, Mia (HHS/OASH) ; Valentine, Steven (HHS/OASH) ; Haddad, Carla (HHS/OASH) ; Sherman, Jennifer (HHS/OASH) ; Migliaccio-Grabill, Kate (HHS/OASH) ; Kellogg, Rachel (HHS/OASH) Subject: Fwd: WAPO News Alert: Workers without protect ive gear or proper training met coronavirus evacuees, HHS whistleblower says Full text is below By Lena H. Sun and Yasmee n Abut aleb Feb. 27, 2020 at 4: 18 p .m. EST Officials at the Department of Health and Human Serv ices sent more than a dozen wor kers to receive the first Americans evacuated from Wuhan, China, the epicenter of the coronavirus outbreak, without proper training for infection control or appropriate protective gear , according to a whistleblower complai nt. The workers did not show symptoms of infection and were not tested for the virus. according to lawyer s for the whi stleblower , who is a senior HHS official ba sed in Wa shington who over sees worker s at the Admini stration for Children and Familie s, a unit within HHS. AMERICAN PVERSIGHT HHS-20-0580-B-000390 The whistleblower is seeking federal protection because she alleges she was unfairly and improperly reassigned after raising concerns about the safety of these workers to HHS officials , including those within the office of Health and Human Services Secretary Alex Azar. She was told Feb. 19 that if she does not accept the new position in 15 days, which is March 5, she would be tenninated. The whistle blower has decades of experience in the field, received two HHS department awards from Azar last year , and has received the highest performance evaluations, her lawyers said. The complaint was filed Wednesday with the Office of the Special Counsel, an independent federal watchdog agency. The whistleblower's lawyers provided a copy of a redacted 24-page complaint to The Washington Post. A spokesman for the Office of the Special Counsel said he could not comment on complaints filed with the office . The complaint alleges that HHS staff were "improperly deployed" and were "not properly trained or equipped to operate in a public health emergency situation." The complaint also alleges that the workers were potentially exposed to coronavirusbecause appropriate steps were not taken to protect them , and staff were not trained in wearing personal protective equipment, even though they had face-to-face contact with returning passengers. The workers were in contact with passengers in an airplane hangar where evacuees were received and on two other occasions: when they helped distribute keys for room assignments and hand out colored ribbons for identification pmposes. "We take all whistleblower complaints very seriously and are providing the complainant all appropriate protections under the Whistleblower Protection Act. We are evaluating the complaint and have nothing further to add at this time ," HHS spokeswoman Caitlin Oakley said. The whistleblower, in her complaint, states that "appropriate steps were not taken to quarantine, monitor , or test [the workers] during their deployment and upon their return home. " The repahiated Americans were among those evacua tedfrom Wuhan and quarantined on military bases in Californ ia and Texas because they were considered at high risk for contracting the flulike illness. About 14 personnel from the Administration for Children and Families , or ACF , were sent to March Air Force base in Riverside County , California, and another team of about 13 ACF personnel were sent to Travis Air Force in Fairfield, California , according to the complaint and the whistleblower's lawyer, Ari Wilkenfeld . Several people within HHS voiced objection to sending the ACF personnel to receive passengers, according to a person fa1niliar with the conversations, who spoke on the condition of anonymity to discuss private deliberations. A second person familiar with the situation said the workers were not tested for coronavirus because none of them met the criteria , which was restricted at that time to people who had recent travel to China or contact with a confirmed case. The workers also did not exhibit any symptoms, the person said. If they had , appropriate protocol would have been followed. The deployments took place Jan . 28 to 31, around the time when the first planeload of evacuees arrived at March, and Feb. 2 to Feb. 7, during the time when additional flights were arriving at Travis. The planes each ca1Tiedabout 200 Americans who were repatriated from Wuhan. After their deployments, the workers returned to their normal duties , some taking commercial airline flights to return to their offices around the counhy, the lawyers said. "Our client was concerned that ACF staff - who were potentially exposed to the coronavirus were allowed to leave quarantined areas and return to their communities , where they may have spread the corona virus to others, " said Lauren Naylor , one of the whistleblower's lawyers. AMERICAN PVERSIGHT HHS-20-0580-B-000391 The whistleblower is also seeking assistance from the office of Rep. Jimmy Gome z, (D-Ca.) , a member of the Hou se Ways and Means committee and vice chair of the House Oversight Committee, according to a Gomez spokesman. During a hearing Thursday , Gome z asked Azar whether any employees from ACF could have been sent to help with the repatriation of Americans from Wuhan, China without any training in emergency response . Azar replied that some ACF employees were involved. Asked what sort of health and safety training the personnel received, and whether any of them were exposed to high-risk evacuees from China , Azar said: "They never should have been without P.P.E ," referring to personal protective equipment. Asked whether any protocols may have been broken, given the urgency on the ground, Azar replied that mgency was never a reason for breaking safety protocols. "I don't believe that has taken place," Azar said said, adding that health and safety protocols "should always be followed. " He said that he did not personally know the names of the team , but that other department officials did . Pressed by Gomez what the department would do if untrained employees were exposed to the virus, Azar said: "I'd want to know the full facts, and we'd take appropriate remedial efforts." The whistleblower said she received an email Jan. 25 about a potential deployment within ACF to support repatriation of the evacuated Americans, according to her lawyer. She initially supported the eff01ts because they had the "appearance that this was within AC F' s scope ," Naylor said. But later , she discovered the teams were dispatched without her knowledge by other senior officials at HHS. It was part of the agency ' s "all-hands-on-deck" mission, aylor said , but it broke agency protocol about what kinds of employees should respond to health emergencies. The whistleblower said she later found out about the deployment when she heard directly from some employees and other senior officials at HHS. Some workers expressed concern about the lack of pro tective gear to the ACF team leader on the ground . That person joined ACF in September and had "no training or experience in any federal emergency management , public health emergency respon se, or safety or operational protocols to run the mission ," the complaint states. AC F personnel typically deal with supporting people recovering from natural disasters, such as floods and fires , and helping victims apply for temporary assistance , all of which are under the category of human services , the whistleblower's lawyers said. HHS officials broke established protocols for emergency support by sending AC F workers to a health emergency, for which they have no training, Naylor said. ACF , which has about 1,300 employees, has come under attack in recent years because of its role in sheltering and taking custody of migrant children who crossed the U.S .-Mexico border who were separated from them by the Department of Homeland Security. The workers' concerns about potential exposure to corona virus were not addressed , the whistleblower's lawyers said . "She was involuntarily assigned to a position in a subject matter where she has no expertise ," said Wilkenfeld , her lawyer , in an interview Thursday. The agency said the reason for the reassignment was "necessary to meet the needs of the department," according to a memo she received. "If I did not accept involuntary reassignment, I would be terminated from federal service through adverse personnel action, " according to her complaint. Begin forwarded message: AMERICAN PVERSIGHT HHS-20-0580-B-000392 From: The Washington Post Date: February 27, 2020 at 4: 19:48 PM EST To: tara.broido@hhs .gov Subject: [MARKETING EMAIL]News Alert: Workers without protect ive gear or proper training met coronavirus evacuees , HHS whistleblower says Reply-To: The Was hington Post News Alert Feb 27 , 4 .19 PM Workers without protective gear or proper training met coronavirus evacuees, HHS whistleblower says A complaint alleges that staffers from the Department of Health and Human Services were "improperly deployed" and were not trained in wearing personal protective equipment before they assisted Americans evacuated from Wuhan, China, and quarantined on military bases. The whistleblower is seeking federal protection because she says she was improperly reassigned after raising concerns with the office of HHS Secretary Alex Azar. Read more>> AMERICAN PVERSIGHT HHS-20-0580-B-000393 ADVERTISE\t1ENT You received this email because you signed up for news alerts from The Washington Post. Manage my newsletters and alerts I Unsubscribe Privacy Policy I Help (C)2020 The Washington Post, 1301 K St NW, Washington DC 20071 Sender: Recipient: Giroir, Brett (HHS/OASH) Broido, Tara (HHS/OASH) Sent Date: 2020/02/27 17:40:23 Delivered Date: 2020/02/27 17:40:00 AMERICAN PVERSIGHT HHS-20-0580-B-000394 Giroir, Brett (HHS/OASH) Migliaccio-Grabill,Kate (HHS/OASH); To: Orsega, Susan (OS/OASH) Schwartz, Erica (HHS/OASH); Trent-Adams, Sylvia (HHS/OASH); CC: Valentine, Steven (HHS/OASH); Harder, Kristina (HHS/IOS) Subject: RE: ACF Requestfor Resources Date: 2020/01/27 13:18:00 Priority: Normal Type: Note Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Migliaccio -Grabill, Kate (HHS/OASH) Sent: Monday, January 27, 2020 1:13 PM To: Giroir, Brett (HHS/OASH) ; Orsega, Susan (OS/OASH) Cc: Schwart z, Erica (HHS/OASH) ; Trent-Adams, Sylvia (HHS/OASH) ; Valentine, Steven (HHS/OASH) ; Harder, Kristina (HHS/IOS) Subject: RE: ACF Request for Resources Hi ADM Giroir, b)(5) AMERICAN PVERSIGHT HHS-20-0580-B-000395 Kate From : Giroir , Brett (HHS/OASH) Sent : Monday, January 27, 2020 1:05 PM To : M igliaccio-Grabi ll, Kate (HHS/OASH) ; Orsega, Susan (OS/OASH) Cc: Schwartz, Erica (HHS/OASH) ; Trent -Adams, Sylvia (HHS/OASH) ; Valentine , Steven (HHS/OASH) ; Harder, Krist ina (HHS/IOS) Subject : RE: ACF Request for Resources (b)(5) b)(5) Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 AMEHICAN PVERSIGHT HHS-20-0580-B-000396 From: M igliaccio -Grabi ll, Kate (HHS/OASH) Sent: Monday, January 27, 2020 1:01 PM To : Giroir, Brett (HHS/OASH) ; Orsega, Susan (OS/OASH) Cc: Schwartz, Erica (HHS/OASH) ; Trent -Adams, Sylvia (HHS/OASH) Subje ct: RE: ACF Request for Resources Hi Sir, (b)(5) (b)(5) AMEHICAN PVERSIGHT HHS-20-0580-B-000397 From: Giro ir, Brett (HHS/DASH) Sent: Monday, January 27, 2020 12:58 PM To: M igliaccio -Grabi ll, Kate (HHS/OASH) ; Orsega, Susan (OS/OASH) Cc: Schwartz, Erica (HHS/OASH) ; Trent -Adams, Sylvia (HHS/OASH) Subject: RE: ACF Request for Resources I am back if you need to find me Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: M igliaccio-Grabill, Kate (HHS/OASH) Sent: Monday, January 27, 2020 9:13 AM To: Giroir, Brett (HHS/OASH) ; Orsega, Susan (OS/OASH) Cc: Schwartz, Erica (HHS/OASH) ; Trent-Adams, Sylvia (HHS/OASH) Subject: RE: ACF Request for Resources Hi Sir, (b)(5) Thank you, Kate From: Giro ir, Brett (HHS/OASH) Sent: Monday, January 27, 2020 7:41 AM To: Orsega, Susan (OS/OASH) ; M igliaccio -Grabill , Kat e (HHS/OASH) Cc: Schwartz, Erica (HHS/OASH) ; Trent -Adams, Sylvia (HHS/OASH) Subject: RE: ACF Request for Resources + CDR Grabill AMERICAN PVERSIGHT HHS-20-0580-B-000398 b)(5) BG Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Orsega, Susan (OS/OASH) Sent: Monday, January 27, 2020 6:37 AM To: Giroir, Brett (HHS/OASH) Cc: Schwartz, Erica (HHS/OASH) ; Trent-Adams, Sylvia (HHS/OASH) Subject: RE: ACF Request for Resources Sir (b)(5) V/R From: Giro ir, Brett (HHS/OASH) Sent: Monday, Janua ry 27, 2020 6:33 AM To: Orsega, Susan (OS/OASH) Cc: Schwartz, Erica (HHS/OASH) ; Trent-Adams, Sylvia (HHS/OASH) AMEHICAN PVERSIGHT HHS-20-0580-B-000399 Subject: FW: ACF Request for Resources b)(5) Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Kadlec, Robert (OS/ASPR/IO) Sent: Monday, January 27, 2020 12:28 AM To: Imbriale, Samuel (OS/ASPR/SIIM) Cc: SOC ASPR SLT ; Lamana , Joseph (OS/ASPR/EMMO) ; Grant, Natalie (ACF) ; Mason , Byron (ACF) ; OS Secretarys Operat ions Center ; SOC Leadership ; ASPR Region 10 (HHS/ASPR) ; ASPR Region 9 (HHS/ASPR) ; SOC Information Management Section Chief (OS/ASPR) ; SOC Resource Coordination Section Chief (HHS/ASPR) ; SOC Resource Coordinat ion Resource and Mobilizat ion (HHS/ASPR) ; Orsega, Susan (OS/OASH) ; SOC Administ ration and Finance Section Chief (HHS/ASPR) ; SNS Ops (CDC.GOV) ; Harper, Victor (OS/ASPR/ORM) ; RedDOG-Response (HHS/OPHS) Subject: Re: ACF Request for Resources Copy let' s discuss I. Am Sent from my iPhone On Jan 27 , 2020 , at 12:09 AM , Imbriale , Samuel (OS/ASPR/SIIM ) wrote: Dr . Kadlec and ASPR SLT , b)(5) AMERICAN PVERSIGHT HHS-20-0580-B-000400 (b)(5) V/r, Sam Imbriale, MPH Director, Information Management Division Director Actin Secretary's Operations Center Cell (b) (Bl ~-----~ Samuel.imbriale@hhs .gov Sent from mobile device - please excuse typos. Sender: Giroir, Brett (HHS/OASH) ( FYDIBOHF23SPDL T)/CN=RECIPIENTS/CN Migliaccio-Grabill, Kate (HHS/OASH); Orsega, Susan (OS/OASH); Schwartz, Erica (HHS/OASH); Recipient: Trent-Adams, Sylvia (HHS/OASH); Valentine, Steven (HHS/OASH); Harder, Kristina (HHS/IOS) (FYDIBOHF23SPDL T)/ en=Recipients/en=2ae4la 17eef54468834316f71bd8ea02-Pelekoudas, Sent Date: 2020/01/27 13:18:25 AMERICAN PVERSIGHT HHS-20-0580-B-000401 Delivered 13:13:00 Giroir, Brett (HHS/OASH) Heck, Mia (HHS/OASH); To: Trueman, Laura (HHS/IEA) Subject: WH meeting with potus on ends Date: 2020/01/24 15:34:06 Priority: Normal Type: Note b)(5) Sent rom mv iPhone Giroir, Brett (HHS/OASH) Recipient: Heck, Mia (HHS/OASH); Trueman, Laura (HHS/IEA) Sent Date: 2020/01/24 15:34:05 Delivered Date: 2020/01/24 15:34:06 AMERICAN PVERSIGHT HHS-20-0580-B-000403 Giroir, Brett (HHS/OASH) To: Jill Giroir ~(b)(6) Subject: ~gmail.com> Fwd: WAPONews Alert: Workers without protective gear or proper training met coronavirus evacuees,HHSwhistleblower says Date: 2020/02/27 19:06:13 Priority: Normal Type: Note Sent from my iPhone Begin forwarded message: From: "Giroir, Brett (HHS/OASH)" Date: February 27, 2020 at 5:37:00 PM EST To: "Migliaccio-Grabill, Kate (HHS/OASH)" Cc: "Valentine, Steven (HHS/OASH)" , "Bante, Katie (OS/OASH)" , "Heck, Mia (HHS/IEA) (Mia.Heck @hhs.gov)" , "Carla Haddad (HHS/OASH) (Carla.Haddad @hhs.gov )" Subject: FW: WAPO News Alert: Workers without protective gear or proper training met coronavirus evacuees, HHS whistleblower says ? This does not appear to involve officers. But letting you know for situational awareness. I have not heard any issues about our officers not being prepared. BG Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Broido, Tara (HHS/OASH) Sent: Thursday, February 27, 2020 4:55 PM To: Giroir, Brett (HHS/OASH) ; Trent-Adams, Sylvia (HHS/OASH) ; Schwartz, Erica (HHS/OASH) ; AMERICAN PVERSIGHT HHS-20-0580-B-000404 Orsega, Susan (OS/OASH) ; Adams, Jerome (HHS/OASH) Cc: Heck, Mia (HHS/OASH) ; Valentine, Steven (HHS/OASH) ; Haddad, Carla (H HS/OASH) ; Sherman, Jennifer (HHS/OASH) ; Migliaccio -Grabill, Kate (HHS/OASH) ; Kellogg, Rachel (HHS/OASH) Subject: Fwd: WAPO News Alert: Workers without protective gear or proper training met coronavirus evacuees, HHS whistleblower says Full text is below By Lena H. Sun and Yasmeen Abut aleb Feb . 27, 2020 at 4: 18 p.m. EST Officials at the Department of Health and Human Services sent more than a dozen workers to rece ive the first Ame ricans evac uated from W uhan , China, the epicenter of the corona virus outbreak. without proper training for infection control or approp1iate protective gear , according to a whistleblower complaint. The workers did not show symptoms of infection and were not tested for the vim s.according to lawyers for the whistleblower , who is a senior HHS official based in Washington who oversees workers at the Administration for Children and Families, a unit within HHS. The whistleblower is seeking federal protection because she alleges she was unfairly and improperly reassigned after raising concerns about the safety of these workers to HHS officials , including those within the office of Health and Human Services Secretary Alex Azar. She was told Feb. 19 that if she does not accept the new position in 15 days, which is March 5, she would be terminated. The whistleblower has decades of experience in the field , received two HHS department awards from Azar last year, and has received the highest performance evaluations , her lawyers said. The complaint was filed Wednesday with the Office of the Special Counsel, an independent federal watchdog agency. The whistleblower's lawyers provided a copy of a redacted 24-page complaint to The Washington Post. A spokesman for the Office of the Special Counsel said he could not comment on complaints filed with the office. The complaint alleges that HHS staff were "improperly deployed" and were "not properly trained or equipped to operate in a public health emergency situation." The complaint also alleges that the workers were po tentia lly exposed to coron avi rusbecause appropriate steps were not taken to protect them, and staff were not trained in wearing personal protective equipment, even though they had face-toface contact with returning passengers. The workers were in contact with passengers in an airplane hangar where evacuees were received and on two other occasions: when they helped distribute keys for room assignments and hand out colored ribbons for identification pw-poses . AMERICAN PVERSIGHT HHS-20-0580-B-000405 "We take all whistleblower complaints very seriously and are providing the complainant all appropriate protections under the Whistleblower Protection Act. We are evaluating the complaint and have nothing further to add at this time ," HHS spokeswoman Caitlin Oakley said. The whistleblower , in her complaint, states that "appropriate steps were not taken to quarantine, monitor, or test [the workers] during their deployment and upon their return home ." The repatriated Americans were amo ng those evac uatedfrom Wuhan and quaran tined on military bases in Ca lifornia and Texas because they were considered at high 1isk for contracting the flu-like illness. About 14 personnel from the Administration for Children and Families, or ACF, were sent to March Air Force base in Riverside County, California, and another team of about 13 ACF personnel were sent to Travis Air Force in Fairfield, California, according to the complaint and the whistleblower's lawyer, Ari Wilkenfeld . Several people within HHS voiced objection to sending the ACF personnel to receive passengers, according to a person familiar with the conversations , who spoke on the condition of anonymity to discuss private deliberations. A second person familiar with the situation said the workers were not tested for coronavirus because none of them met the criteria, which was restricted at that time to people who had recent travel to China or contact with a confirmed case. The workers also did not exhibit any symptoms, the person said. If they had , appropriate protocol would have been followed. The deployments took place Jan. 28 to 31, around the time when the first planeload of evacuees arrived at March, and Feb. 2 to Feb. 7, during the time when additional flights were arriving at Travis. The planes each carried about 200 Americans who were repatriated from Wuhan. After their deployments, the workers returned to their normal duties, some taking commercial airline flights to return to their offices around the country , the lawyers said. "Om client was concerned that ACF staff - who were potentially exposed to the coronavirus - were allowed to leave quarantined areas and return to their communities, where they may have spread the coronavirus to others ," said Lauren Naylor , one of the whistleblower' s lawyers. The whistleblower is also seeking assistance from the office of Rep. Jimmy Gomez, (D-Ca .), a member of the House Ways and Means committee and vice chair of the House Oversight Committee, according to a Gomez spokesman. During a hearing Thursday, Gome z asked Azar whether any employees from ACF could have been sent to help with the repatriation of Americans from Wuhan , China without any training in emergency response . Azar replied that some ACF employees were involved. Asked what sort of health and safety training the personnel received, and whether any of them were exposed to high-risk evacuees from China, Azar said: "They never should have been without P.P .E," referring to personal protective equipment. Asked whether any protocols may have been broken, given the urgency on the ground, Azar replied that urgency was never a reason for breaking safety protocols. AMERICAN PVERSIGHT HHS-20-0580-B-000406 "I don't believe that has taken place ," Azar said said , adding that health and safety protocols "should always be followed." He said that he did not personally know the names of the team, but that other department officials did. Pressed by Gomez what the department would do if untrained employees were exposed to the virus, Azar said: ''I'd want to know the full facts, and we'd take appropriate remedial efforts." The whistleblower said she received an email Jan. 25 about a potential deployment within ACF to support repab?iation of the evacuated Americans, according to her lawyer. She initially supported the efforts because they had the "appearance that this was within ACF ' s scope," Naylor said. But later , she discovered the teams were dispatched without her knowledge by other senior officials at HHS. It was pa1t of the agency's "all-hands-on-deck" mission , Naylor said, but it broke agency protocol about what kinds of employees should respond to health emergencies. The whistleblower said she later found out about the deployment when she heard directly from some employees and other senior officials at HHS. Some workers expresse d concern abo ut the lack of protect ive gear to the ACF team leader on the ground. That person joined ACF in September and had "no training or experience in any federal emergency management , public health emergency response, or safety or operational protocols to run the mission, " the complaint states. ACF personnel typically deal with supporting people recovering from natw-al disasters , such as floods and fires , and helping victims apply for temporary assistance , all of which are under the category of human services, the whistleblower ' s lawyers said. HHS officials broke established protocols for emergency suppmt by sending ACF workers to a health emergency, for which they have no training , Naylor said. AC F, which has about 1,300 employees , has come under attack in recent years because of its role in shel tering and taking cus tody of migra nt childre n who crossed the U.S.-Mexico border who were separated from them by the Department of Homeland Secw-ity. The workers' concerns about potential exposure to coronavirus were not addressed, the whistleblower's lawyers said. " She was involuntarily assigned to a position in a subject matter where she has no expertise ," said Wilkenfeld, her lawyer , in an interview Thursday. The agency said the reason for the reassignment was "necessary to meet the needs of the department ," according to a memo she received. "If I did not accept involuntary reassignment , I would be terminated from federal service through adverse personnel action ," according to her complaint. Begin forwarded message: From: The Washington Post Date: February 27, 2020 at 4: 19:48 PM EST To: tara .bro ido@hhs.gov Subject: [MARKETING EMAIL]News Alert: Workers without protective gear or proper training met coronavirus evacuees, HHS whistleblower says Reply-To: The Washington Post AMERICAN PVERSIGHT HHS-20-0580-B-000407 News Alert Feb 27 , 4 :19 PM Workers without protective gear or proper training met coronavirus evacuees, HHS whistleblower says A complaint alleges that staffers from the Department of Health and Human Services were "improperly deployed" and were not trained in wearing personal protective equipment before they assisted Americans evacuated from Wuhan, China , and quarantined on military bases. The whistleblower is seeking federal protection because she says she was improperly reassigned after raising concerns with the office of HHS Secretary Alex Azar. Read more>> AMERICAN PVERSIGHT HHS-20-0580-B-000408 ADVERTISEMENT You received this email because you signed up for news alerts from The Washington Post. Manage my newsletters and alerts I Unsubscribe Privacy Policy I Help (C)2020 The Washington Post, 1301 K St NW, Washington DC 20071 Se nd Giroir, Brett (HHS/OASH) Recipient: Jill Giroir AMERICAN PVERSIGHT HHS-20-0580-B-000409 Sent Date: 2020/02/27 19:06:12 Delivered Date: 2020/02/27 19:06:13 AMERICAN PVERSIGHT HHS-20-0580-B-000410 Giroir, Brett (HHS/OASH) To: Aj ay Royan CC: Rick Perry ~(b)(6) ~gmail.com> Subject: RE: Adimab/COVID-19mission Date: 2020/02/25 22:21:00 Priority: Normal Type: Note I am on it Let me make a couple connections. Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Ajay Royan Sent: Tuesday, February 25, 2020 10:18 PM To: Giroir, Brett (HHS/OASH) Cc: Rick Perry Subject: Adimab/COVID-19 mission Dear Rick, Thank you kindly for the call yesterday , and for connecting us. Dear Dr. Giroir, It's a pleasure to met you over email. The team at Adimab - an antibody discovery platform based in New Hampshire -was previously successful at isolating and sequencing antibodies contra the 2014 Ebola outbreak. I spoke yesterday with Dr. Tillman Gerngross , the founder of Adimab; he and his team are standing by to help in any way they can. As with the ebola situation, this is outside of the company's normal commercial course but very much in line with their public service mission and technical capabilities. Below are two backgrounders that might be helpful to introduce Adimab: 1.) A high-level summary of Adimab's work with USAMRIID and others to isolate an antibody therapy for the 2014 Ebola strain that affected the US AMERICAN PVERSIGHT HHS-20-0580-B-000411 https :// p rotect2. fire eye. com/u rl? k=43e0 b 72f-1 fb5beff-43e0861 0-0cc4 7a6a52de c51 024d 359d9adc4& u= https ://www .ad i ma b.com/ news/201 6-02-18-anti-ebola-vi rusa nti bodies 2.) The resultant paper published 2016 in Science https://science.sciencemag .org/content/351 /6277 /1078 b)(4) It would be my pleasure to connect Dr. Gerngross (tillman .gerngross@adimab.com ) with you or follow-up as otherwise appropriate. And to be helpful in this or any other way, given our involvement with a growing group of motivated and talented technologists who are getting activated around this mission . With thanks and my best, Ajay Adimab Scientists Report the Isolation of Highly Potent Anti-Ebola Virus Antibodies from Recent Zaire Outbreak Adimab, LLC, a global leader in the discovery of human antibodies, today reported the isolation of a broad panel of neutralizing anti-Ebola virus antibodies from a survivor of the recent Zaire outbreak. The work, published online today in the journal Science, highlights the remarkable speed of Adimab's recently launched single B cell isolation platform, and constitutes the largest panel of functional anti-Ebola antibodies reported in the scientific literature to date. The sequences of all antibodies isolated in this study will be made freely available to the research community through the GenBank database. "Our Science paper describes the first in-depth view into the human antibody response to Ebola virus," said Laura Walker, Ph.D., Senior Scientist at Adimab, and the corresponding author of the study. "Within weeks of receiving a blood sample from a survivor of the 2014 Ebola outbreak, we were able to isolate and characterize over 300 monoclonal antibodies that reacted with the Ebola virus surface glycoprotein." After the initial isolation and characterization of the anti-Ebola antibodies at Adimab, several leading institutions in the field of virology, including The Scripps Research Institute, La Jolla, CA and the US Army Medical Research Institute of Infectious AMERICAN PVERSIGHT HHS-20-0580-B-000412 Diseases (USAMRIID), Fort Detrick, MD, provided an in-depth analysis of the therapeutic potential of these newly isolated antibodies. "Over the past decade, our laboratory has analyzed over one hundred antibodies against the Ebola virus," commented Pamela Glass, Ph.D., Senior Investigator at USAMRIID. "Several of the antibodies provided by Dr. Walker's team display the most potent neutralization and protection we have ever seen." Additional structural analysis at The Scripps Research Institute provided further insight into the diversity of the human immune response to Ebola. "The antibody panel discovered by Adimab covers every previously known binding site on Ebola virus and their work further revealed a new, highly potent neutralizing site, that has not been reported to date," said Prof. Andrew Ward, Scripps Research Institute, a co-author of the study. "In less than two months the Adimab team isolated more neutralizing Ebola antibodies than the entire Ebola field has reported in the past two decades," noted Tillman Gerngross, Ph.D., CEO and Co-Founder of Adimab and a Professor of Bioengineering at Dartmouth College. "The global public health community has been looking for a rapid response platform to emerging infectious disease threats and Laura's team has set an entirely new standard for rapidly isolating protective antibodies that could be turned into effective therapeutics. We now have a broadly applicable platform to deal with these threats." "Not only has the Adimab team isolated an extensive panel of therapeutically promising Ebola antibodies in such a short time frame, but the fact that they have made these antibodies available to the research community for further studies is remarkable and shows their humanitarian intent to advance the field without regard for commercial gain," said John Dye, Ph.D., Chief of Viral Immunology at USAMRIID. Adimab separately noted that it has applied its B cell isolation platform against the respiratory syncytial virus (RSV) with similar results. The Company also intends to demonstrate the applicability of the B cell isolation platform against the Zika virus. The study, entitled "Isolation of Potent Neutralizing Antibodies from a Survivor of the 2014 Ebola Virus Outbreak", is available online and will be published in the February 18th, 2016 issue of Science. The sequences generated in this work will be made available to the research community via GenBank. About Adimab Over the past six and a half years, Adimab has established antibody discovery collaborations with over 35 pharmaceutical companies including many leading drug companies, such as Merck, Novo Nordisk, Biogen, GSK, Roche, Novartis, Eli Lilly, Genentech, Celgene, Gilead, Kyowa Hakka Kirin, and Sanofi. AMERICAN PVERSIGHT HHS-20-0580-B-000413 Sender: Recipient: Giroir, Brett (HHS/OASH) Ajay Royan ; Rick Perry 1'.:b)(6) l?lgmail.com> Sent Date: 2020/02/25 22:21:55 Delivered Date : 2020/02/25 22:21:00 AMERICAN PVERSIGHT HHS-20-0580-B-000414 Kadlec, Robert (OS/ASPR/IO) To: Giroir, Brett (HHS/OASH) Subject: Re: Is there a prebrief for the Sec to morrow-:> Date: 2020/03/15 07:50:01 Priority: Normal Type: Note (b)(5) Sent from my iPhone > On Mar 15, 2020, at 7:36 AM, Giroir, Brett (HHS/OASH) wrote: >~-----------------------------~ > b)(5) >~-----------------------------~ > > > > > > > Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690 -7694 > > > ----- Origina l Message----> From: Kadlec, Robert (OS/ASPR/IO) > Sent: Sunday, March 15, 2020 7:32 AM > To: Mango, Paul (HHS/IOS) > Cc: Harrison, Brian (HHS/IOS) ; Grigsby, Garrett (HHS/OS/OGA) ; Stecker, Judy (OS/IOS) ; Tignor, Beth (HHS/IOS) ; Giroir, Brett (HHS/OASH) > Subject: Re: Is there a prebrief for the Sec tomorrow-:> > > +Giroir > > Sent from my iPhone > >> On Mar 15, 2020, at 6: 17 AM, Mango, Paul (HHS/IOS) wrote: >> >> Sent from my iPhone >> >>>> On Mar 14, 2020, at 10:48 PM, Harrison, Brian (HHS/IOS) wrote: >>> ,..,,...,.~-----, >>> l(b)(5) >>> '-?_____ _, >>> Brian Harrison >>> Chief of Staff >>> U.S. Department of Health and Human Services >>> 202.690.7000 >>> brian.harrison@hhs.gov >>> >>> >>>>> On Mar 14, 2020, at 10:06 PM, Grigsby, Garrett (HHS/OS/OGA) wrote: >>>> >>>> ? AMERICAN PVERSIGHT HHS-20-0580-B-000415 Haddad, Carla (HHS/OASH) Giroir, Brett (HHS/OASH); To: Gray, Oneika (HHS/OASH) Subject: RE: Urgent 40 minute warning from IDT on ability to ship tests-3 day pause likely!!! Date: 2020/03/06 10:24:52 Priority: Normal Type: Note Yes, on it. From: Giroir, Brett (HHS/OASH) Sent: Friday, March 6, 2020 10:22 AM To: Haddad, Carla (HHS/OASH) ; Gray, Oneika (HHS/OASH) Subject: FW: Urgent 40 minute warning from IDT on ability to ship tests -3 day pause likely!!! Importance: High Can you set up an 1100 call for 15 min? Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Giroir, Brett (HHS/OASH) Sent: Friday, March 6, 2020 10:19 AM To: Stenzel, Timothy ; Lenihan, Keagan (FDA/OC) ; Berger, Sherri (CDC/OCOO/OD) Cc: Monroe, Steve (CDC/DDPHSS/OLSS/OD); Schuchat, Anne MD (CDC/OD) ; Schwartz, Suzanne (FDA/CDRH) ; Shuren, Jeff (FDA/CDRH) Subject: RE: Urgent 40 minute warning from IDT on ability to ship tests-3 day pause likely!!! Importance: High Can we have a call at 1100 for 15 minutes please??? (b)(5) AMERICAN PVERSIGHT HHS-20-0580-B-000416 Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Stenzel, Timothy Sent: Friday, March 6, 2020 10:01 AM To: Giroir, Brett (HHS/OASH) ; Lenihan, Keagan (FDA/OC) ; Berger, Sherri (CDC/OCOO/OD) Cc: Monroe, Steve (CDC/DDPHSS/OLSS/OD); Schuchat, Anne MD (CDC/OD) ; Schwartz, Suzanne (FDA/CDRH) ; Shuren, Jeff (FDA/CDRH) Subje ct: RE: Urgent 40 minute warning from IDT on ability to ship tests -3 day pause likely!!! Admiral, b)(5) b)(5) AMEHICAN PVERSIGHT HHS-20-0580-B-000417 (b)(5) Best, Tim Timothy T. Stenzel, MD, PhD Director, OHT7: Office of In Vitro Diagnostics and Radiological Health Office of Product Evaluation and Quality Center for Devices and Radiological Health U.S. Food and Drug Administration Timothy.Stenzel@fda.hhs.gov Jennifer Campbell Administrative Assistant OHT7: Office of In Vitro Diagnostics and Rad iological Health Office of Product Evaluation and Quality CDRH I Food and Drug Administ rat ion White Oak, Bldg. 66 3403 I 10903 New Hampshire Avenue Ph: 301-796-7692 Jennifer.Campbell@fda.hhs.gov I Silver Spring, MD 20993 Excellent customer service is important to us. Please take a moment to provide feedback regarding the customer service you have received: https://www.research.net/s/cdrhcustomerservice?ID=1900&S=E From: Gir oir, Brett (HHS/OASH) Sent: Friday, March 6, 2020 9:02 AM To: Stenzel, Timothy ; Lenihan, Keagan ; Berger, Sherri (CDC) Cc: Monroe, Stephan S (CDC); Schuchat, Anne (CDC); Schwartz, Suzanne ; Shuren, Jeff Subject: RE: Urgent 40 minute warning from IDT on ability to ship tests -3 day pause likely!!! AMEHICAN PVERSIGHT HHS-20-0580-B-000418 Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Stenzel, Timothy Sent: Friday, March 6, 2020 8:02 AM To: Giroir, Brett (HHS/OASH) ; Lenihan, Keagan (FDA/OC) ; Berger, Sherri (CDC/OCOO/OD) Cc: Monroe, Steve (CDC/DDPHSS/OLSS/OD); Schuchat, Anne MD (CDC/OD) ; Schwartz, Suzanne (FDA/CDRH) ; Shuren , Jeff (FDA/CDRH) Subject: RE: Urgent 40 minute warning from IDT on ability to ship tests -3 day pause likely!!! (b)(5) Best , Tim Timothy T. Stenzel, MD, PhD Director, OHT7: Office of In Vitro Diagnostics and Radiological Health Office of Product Evaluation and Quality Center for Devices and Radiological Health U.S. Food and Drug Administration Timothy.Stenzel@fda.hhs .gov Jennifer Campbell Adm inistrative Assista nt OHT 7: Office of In Vitro Diagnos tics and Radi ological Health Office of Product Evalua t ion and Quality CDRH I Food and Drug Adm inistration Whit e Oak, Bldg. 66 34 03 I 10903 New Ham pshire Avenue I Silver Spr ing, MD 20993 Ph: 301 -796 -7692 Jennifer.Campbell@fda.hhs.gov Excellent customer service is important to us. Please take a moment to provide feedback regarding the customer service you have received: https://www .research .net/s/cdrhcustomerservice?ID=1900&S=E From: Giroir, Brett (HHS/OASH) Sent: Friday, March 6, 2020 7:48 AM AMERICAN PVERSIGHT HHS-20-0580-B-000419 To: Stenzel, Timothy ; Lenihan, Keagan ; Berger, Sherri (CDC) Cc: Monroe, Stephan S (CDC); Schuchat, Anne (CDC); Schwartz, Suzanne ; Shuren, Jeff Subject: RE: Urgent 40 minute warning from IDT on ability to ship tests-3 day pause likely!!! V/r BG Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Stenzel, Timothy Sent: Thursday, March 5, 2020 7:00 PM To: Giroir, Brett (HHS/OASH) ; Lenihan, Keagan (FDA/OC) ; Berger, Sherri (CDC/OCOO/OD) Cc: Monroe, Steve (CDC/DDPHSS/OLSS/OD); Schuchat, Anne MD (CDC/OD) ; Schwartz, Suzanne (FDA/CDRH) ; Shuren, Jeff (FDA/CDRH) Subject: RE: Urgent 40 minute warning from IDT on ability to ship tests-3 day pause likely!!! Dear Admiral, (b)(5) AMERICAN PVERSIGHT HHS-20-0580-B-000420 b)(5) Best , Tim Timothy T. Stenzel, MD, PhD Director, OHT7: Office of In Vitro Diagnostics and Radiological Health Office of Product Evaluation and Quality Center for Devices and Radiological Health U.S. Food and Drug Administration Timothy .Stenzel@fda.hhs .gov Jennifer Campbell Adminis trative Assistant OHT7: Office of In Vitro Diagnos tics and Radi ological Health Office of Product Evaluation and Quality CDRH I Food and Drug Administ rat ion Whi te Oak, Bldg. 66 34 03 I 10903 New Ham pshire Avenue Ph: 301 -796 -7692 Jennif er.Campbell@fda.hhs.gov I Silver Spring , MD 20993 Excellent customer service is important to us. Please take a moment to provide feedback regarding the customer service you have received: https://www.research.net/s/cdrhcustomerservice?ID=1900&S=E From: Stenzel, Timothy Sent: Thursday, March 5, 2020 5:56 PM To: Giroir, Brett (OS) ; Lenihan, Keagan ; Berger, Sherr i (CDC) Cc: Monroe, Stephan S (CDC); Schuchat, Anne (CDC); Schwartz, Suzanne ; Shuren, Jeff Subject: RE: Urgent 40 minute warning from IDT on ability to ship tests-3 day pause likely!!! (b)(5) Best , Tim Timothy T. Stenzel, MD, PhD Director, OHT7: Office of In Vitro Diagnostics and Radiological Health Office of Product Evaluation and Quality Center for Devices and Radiological Health U.S. Food and Drug Administration Timothy.Stenzel@fda.hhs.gov Jennifer Campbell Administrative Assistant AMEHICAN PVERSIGHT HHS-20-0580-B-000421 OHT7: Office of In Vitro Diagnostics and Radiological Health Office of Produc t Evalua tion and Quality CDRH I Food and Drug Administration White Oak, Bldg. 66 3403 I 10903 New Hampshire Avenue Ph: 301 -796 -7692 ]ennifer.Campbell@fda.hhs.gov I Silver Spring, MD 20993 Excellent customer service is important to us. Please take a moment to provide feedback regarding the customer service you have received: https://www.research.net/s/cdrhcustomerservice?ID=1900&S=E From: Stenzel, Timothy Sent: Thursday, March 5, 2020 5:46 PM To: Giroir, Brett (OS) ; Lenihan, Keagan ; Berger, Sherr i (CDC) Cc: Monroe, Stephan S (CDC); Schuchat, Anne (CDC); Schwartz, Suzanne ; Shuren, Jeff Subject: RE: Urgent 40 minute warning from IDT on ability to ship tests-3 day pause likely!!! Hi Admiral, b)(5) Feel free to call anyt ime. My cell is .... rb_l(_ B___ l ___, Best , Tim Timothy T. Stenzel, MD, PhD Director, OHT7: Office of In Vitro Diagnostics and Radiological Health Office of Product Evaluation and Quality Center for Devices and Radiological Health U.S. Food and Drug Administration Timothy .Stenzel@fda .hhs .gov AMERICAN PVERSIGHT HHS-20-0580-B-000422 Jennifer Campbell Administrative Assistant OHT7: Office of In Vitro Diagnostics and Radio logical Health Office of Produc t Evalua tion and Quality CDRH I Food and Drug Adminis t ration White Oak, Bldg. 66 3403 I 10903 New Hampshire Avenue I Silver Spring, MD 20993 Ph: 301 -796- 7692 Jennifer.Campbell@fda.hhs.gov Excellent customer service is important to us. Please take a moment to provide feedback regarding the customer service you have received: https ://www .research .net/s/cdrhcustomerservice?ID=1900&S=E From: Giroir, Brett (HHS/OASH) Sent: Thursday, March 5, 2020 5:31 PM To: Lenihan, Keagan ; Berger, Sherri (CDC) ; Stenzel, Timothy Cc: Monroe, Stephan S (CDC); Schuchat, Anne (CDC) Subject: RE: Urgent 40 minute warning from IDT on ability to ship tests-3 day pause likely!!! b)(5) Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Lenihan, Keagan Sent: Thursday, March 5, 2020 4:19 PM To: Giroir, Brett (HHS/OASH) ; Berger, Sherri (CDC/OCOO/OD) ; Stenzel, Timothy (FDA/CDRH) Cc: Monroe, Steve (CDC/DDPHSS/OLSS/OD); Schuchat, Anne MD (CDC/OD) ; Redfield, Robert R. (CDC/OD) 4'b)(6)~ cdc.gov>; Hahn, Stephen ~ fda.hhs.gov > Subject: RE: Urgent 40 minute warning from IDT on ability to ship tests -3 day pause likely!!! +Tim From: Giroir, Brett (HHS/OASH) Sent: Thursday, March 5, 2020 4:18 PM To: Berger, Sherri (CDC) ; Lenihan, Keagan Cc: Monroe, Stephan S (CDC); Schuchat, Anne (CDC); Redfield, Robert R (CDC) 1b )(6)~ cdc.gov >; Hahn, Stephen AMERICAN PVERSIGHT HHS-20-0580-B-000423 Subject: RE: Urgent 40 minute warning from IDT on ability to ship tests -3 day pause likely!!! Importance: High b)(5) Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Berger, Sherri (CDC/OCOO/OD) Sent: Thursday, March 5, 2020 4:13 PM To: Giroir, Brett (HHS/OASH) Cc: Monroe, Steve (CDC/DDPHSS/OLSS/OD); Schuchat, Anne MD (CDC/OD) Subject: FW: Urgent 40 minute warning from IDT on ability to ship tests-3 day pause likely!!! From: Kuhnert-Tallman, Wendi (CDC/DDID/OD) Sent: Thursday, March 5, 2020 4:13 PM To: Terrill, Roman ; Stenzel, Timothy (FDA/CDRH) ; Lindstrom, Stephen (CDC/DDID/NCIRD/DVD) ; Shuren, Jeff (FDA/CDRH) Cc: Villanueva, Julie M. (CDC/DDID/NCEZID/DPEI) ; Flannery, Ellen (FDA/CDRH) ; Schwartz, Suzanne (FDA/CDRH) ; Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) Subject: RE: Urgent 40 minute warning from IDT on ability to ship tests -3 day pause likely!!! b)(4) Thanks, wendi Wendi Kuhnert-Tallman Office - 404-639-3103 Mobile l ._ (b_)(_6)__ AMERICAN PVERSIGHT _. HHS-20-0580-B-000424 From: Terrill, Roman Sent: Thursday, March 5, 2020 3:58 PM To: Stenzel, Timothy (FDA/CDRH) ; Kuhnert-Tallman, Wendi (CDC/DDID/OD) ; Lindstrom, Stephen (CDC/DDID/NCIRD/DVD) ; Shuren, Jeff (FDA/CDRH) Cc:Villanueva, Julie M. (CDC/DDID/NCEZID/DPEI); Flannery, Ellen (FDA/CDRH) ; Schwartz, Suzanne (FDA/CDRH) ; Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) Subject: Urgent 40 minute warning from IDT on ability to ship tests-3 day pause likely!!! To my friends at FDA and CDC, and elsewhere within HHS: (b)(4) Please advise ASAP. Thanks, Roman Please be advised that this email may contain confidential information. If you are not the intended recipient, please notify us by email by replying to the sender and delete this message. The sender disclaims that the content of this email constitutes an offer to enter into, or the acceptance of, any agreement; provided that the foregoing does not invalidate the binding effect of any digital or other electronic reproduction of a manual signature that is included in any attachment. Sender : Haddad, (aria (HHS/OASH) Giroir, Brett (HHS/OASH); Recipient: Gray, Oneika (HHS/OASH) Sent Date: 2020/03/06 10:24:49 Delivere d Date: 2020/03/06 10:24:52 AMERICAN PVERSIGHT HHS-20-0580-B-000425 Giroir, Brett (HHS/OASH) Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) ; Schuchat, Anne MD (CDC/OD) n/ Berger, Sherri (CDC/OCOO/OD) ; CC: Giroir, Brett (HHS/OASH) Subject: FW: Outtakes from Call with Kaiser Permanente and HCA Date: 2020/03/08 15:58:23 Due Date: 2020/03/27 20:00:00 Importance: High Priority: Urgent Type: Note Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Mango, Paul (HHS/1O5) Sent: Sunday, March 8, 2020 2:53 PM To: Stecker, Judy (05/105) Cc: Kadlec, Robert (OS/ASPR/1O); Giroir, Brett (HHS/OASH) ; Yeskey, Kevin (OS/ASPR/1O); Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) ; Berger, Sherri (CDC/OCOO/OD) ; Redfield, Robert R. (CDC/OD)~cdc.gov>; Shuy, Bryan (OS/ASPR/1O); Harrison, Brian (HHS/1O5) ; Brookes, Brady (CMS/OA) ; Herrmann, Jack (O5/ASPR/OEA) Subject: Re: Outtakes from Call with Kaiser Permanente and HCA rb) (S) Sent from my iPhone AMERICAN PVERSIGHT HHS-20-0580-B-000426 On Mar 8, 2020 , at 2:44 PM , Stecker , Judy (OS/IOS) wrote: q (b)(5) Sent from my iPhone On Mar 8, 2020, at 2:03 PM , Mango, Paul (HHS/IOS) wrote: Sent from my iPhone On Mar 8, 2020 , at 1:58 PM , Kadlec , Robert (OS/ASPR/1O) wrote: n b)(5) AMERICAN PVERSIGHT HHS-20-0580-B-000427 b)(5) Sender: Giroir, Brett (HHS/OASH) Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) ; Schuchat, Anne MD (CDC/OD) ; Recipient: Berger, Sherri (CDC/OCOO/OD) ; Giroir, Brett (HHS/OASH) Sent Date: 2020/03/08 15:58 :21 Delivered Date: 2020/03/08 15:58 :23 AMERICAN PVERSIGHT HHS-20-0580-B-000428 Giroir, Brett (HHS/OASH) To: Stenzel, Timothy Subject: RE: Any new news? Date: 2020/03/09 22:33:00 Priority: Normal Type: Note Thank you You are great Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Stenzel, Timothy Sent: Monday, March 9, 2020 10:30 PM To: Giroir, Brett (HHS/OASH) Subject: RE:Any new news? Hi Admiral, b)(5) AMERICAN PVERSIGHT HHS-20-0580-B-000429 b)(5) Best , Tim Timothy T. Stenzel, MD, PhD Director, OHT7: Office of In Vitro Diagnostics and Radiological Health Office of Product Evaluation and Quality Center for Devices and Radiological Health U.S. Food and Drug Administration Timothy .Stenzel@fda .hhs .gov Jennifer Campbell Administrative Assistant OHT7: Office of In Vitro Diagnostics and Radiological Health Office of Produc t Evalua tion and Quality CDRH I Food and Drug Administration Whit e Oak, Bldg. 66 3403 I 10903 New Hampshire Avenue Ph: 301 -796 -7692 )ennifer.Campbell@fda.hhs.gov I Silver Spring, MD 20993 Excellent customer service is important to us. Please take a moment to provide feedback regarding the customer service you have received: https ://www.research.net/s/cdrhcustomerservice?ID=1900&S=E From: Giro ir, Brett (HHS/OASH) Sent: Monday, March 9, 2020 6:47 PM To: Stenzel, Timot hy Subject: Any new news? Cheers BG Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 AMERICAN PVERSIGHT HHS-20-0580-B-000430 Sender: Giroir, Brett (HHS/OASH) Recipient: Stenzel, Timothy Sent Date: 2020/03/09 22:33:07 Delivered Date: 2020/03/09 22:33:00 AMERICAN PVERSIGHT HHS-20-0580-B-000431 Giroir, Brett (HHS/OASH) Judy Stecker (O5/ASPA) (Judy.Stecker@hhs.gov) Schuchat, Anne MD (CDC/OD) ; CC: Bonds, Michelle E. (CDC/OD/OADC) Subject: FW: nCoV - ASPR- Washington Post on quarantining Lackland evacuees/ URGENTREQUEST Date: 2020/03/09 15:51:00 Priority: Normal Type: Note Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Bonds, Michelle E. (CDC/OD/OADC) Sent: Monday, March 9, 2020 3:29 PM To: Berger, Sherri (CDC/OCOO/OD) ; McGowan, Robert (Kyle) (CDC/OD/OCS) ; Schuchat, Anne MD (CDC/OD) Cc:Galatas, Kate (CDC/OD/OADC) ; Patrick, Kera (CDC/OD/OADC) ; CDC IMS JIC OADC LNO -2 Subject: FW: nCoV - ASPR- Washington Post on quarantining Lackland evacuees/ URGENTREQUEST Reporter: Can you confirm ASPRis now in charge? Will ASPRcontinue to allow releasing quarantined people from Lackland to leave after 14 days and two sequential negative tests, for those that agree to be tested, even though San Antonio filed an unsuccessful emergency lawsuit asking that the number of tests be three and the quarantine period be extended to 28 days? And what will the protocol be for those who test positive at the base and must be treated at a hospital or go to a negative pressure room for 14 days if they're asymptomatic? Will they also be allowed to go after two sequential negative tests? Importantly, our story will also note that the UNMC protocol for positive COVID-19 patients is different; it 's THREEsequential tests, not two. AMERICAN PVERSIGHT HHS-20-0580-B-000432 (b)(5) From: Stecker, Judy (05/105) Sent: Monday, March 9, 2020 1:21 PM To: Murphy, Ryan (O5/ASPA) Cc: Michael, Gretchen (O5/ASPR/OEA) ; Kane, EIieen (OS/ASPR/OEA) ; Waters, Cicely (O5/ASPR/OEA) ; Bonds, Michelle E. (CDC/OD/OADC) ; Galatas, Kate (CDC/OD/OADC) ; Trueman, Laura (HHS/I EA) ; Johnston, Darcie (HHS/IEA) ; Rigas, Laura (HHS/IEA) ; McKeogh, Katherine (OS/ASPA) ; Hall, Bill (HHS/ASPA) Subject: Re: PLEASEREAD FW: Washington Post reporter -- story on COVID-19 response on quarantining Lackland patients that ASPR has now taken over. deadline urgent b)(5) Sent from my iPhone AMERICAN PVERSIGHT HHS-20-0580-B-000433 On Mar 9, 2020, at 12:54 PM , Murphy , Ryan (OS/ASPA) wrote: b)(5) - Ryan From: Thorman, Caroline (ACF) Sent: Monday, March 9, 2020 12:40 PM To: Murphy, Ryan (OS/ASPA) Subject: FW: Washington Post reporter -- story on COVID-19 response on quarantining Lackland patients that ASPRhas now taken over. deadline urgent Can you confirm ASPRis now in charge? Will ASPRcontinue to allow releasing quarantined people from Lackland to leave after 14 days and two sequential negative tests, for those that agree to be tested, even though San Antonio filed an AMERICAN PVERSIGHT HHS-20-0580-B-000434 unsuccessful emergency lawsuit asking that the number of tests be three and the quarantine period be extended to 28 days? And what will the protocol be for those who test positive at the base and must be treated at a hospital or go to a negative pressure room for 14 days if they're asymptomatic? Will they also be allowed to go after two sequential negative tests? Importantly, our story will also note that the UNMC protocol for positive COVID-19 patients is different; it's THREEsequential tests, not two. Many thanks, Caroline Thorman Director of Communications Administration for Children &Families (ACF) Health and Human Services (HHS) Desk: (202) 401-4777 Cell :fb) (6) I From: Satija, Neena Sent: Sunday, March 8, 2020 6:03 PM To: Thorman, Caroline (ACF) Subject: Fw: Washington Post reporter -- story on COVID-19 response on quarantining Lackland patients that ASPRhas now taken over. deadline urgent Neena Satija Investigative Reporter Washington Post 202-334-7054 @neenareports From: Satija, Neena Sent: Sunday, March 8, 2020 3:51 PM To: gretchen.michael@hhs.gov ; elaine.kane@hhs.gov Subject: Washington Post reporter-- story on COVID-19 response on quarantining Lackland patients that ASPRhas now taken over. deadline urgent Dear Gretchen and Elaine, AMERICAN PVERSIGHT HHS-20-0580-B-000435 My name is Neena Satija and I'm a reporter for the Washington Post. I have been trying to get in touch with HHS on a story about coronavirus response when it comes to the Wuhan and Diamond Princess {and soon, Grand Princess) cohorts sent to Lackland Air Force Base, and I have had no luck with the CDC.So I'm going to you -- also because we have been told today that ASPRis now in charge of those quarantine ops instead of the CDC. Getting in touch with HHS in general for the past few weeks has been tough; in fact it took me several days simply to confirm, for instance, that OCEPHRwas involved in the repatriation effort ... and we really do want to be fair and accurate, so I'm really hoping you can help!! My colleague Arel is Hernandez and I have a story that may run tomorrow or the following day about the frustration among state and local officials in Texas, especially officials in San Antonio, regarding lack of communication from the administration on COVID-19 response, in particular, what to do with cohorts from Wuhan and the Diamond Princess (and, soon, the Grand Princess) cruise ship. We will report that state and local officials were assured that anyone sent to Lackland from Wuhan back on Feb. 1 would remain quarantined on base -- but instead, after the plane landed, San Antonio officials were immediately called upon not only to take the one woman who tested positive and had symptoms to a community hospital to be treated, but even to secure an ambulance to take her off Lackland. Essentially state and local officials were given no advanced warning that the DOD would now allow anyone who tested positive for COVID-19 to stay on base, whether asymptomatic or not. It appears as though state and local authorities had the tools in place to plan for these issues quickly. But what happened raises serious questions about the administration's handling of this public health emergency, especially after the release of that patient from Wuhan before a positive test result came back. I have contacted CDC multiple times for comment on our story with no answer. Then I found out today that ASPRis now in charge of quarantining protocols going forward as opposed to CDC. It's all the more important we hear from you now that dozens more cruise ship passengers, this time from the Grand Princess cruise ship, are now headed to Lackland. The administration has assured folks that it will quarantine them at the base. But what about those who test positive? Can you confirm ASPRis now in charge? Will ASPRcontinue to allow releasing quarantined people from Lackland to leave after 14 days and two sequential negative tests, for those that agree to be tested, even though San Antonio filed an unsuccessful emergency lawsuit asking that the number of tests be three and the quarantine period be extended to 28 days? And what will the protocol be for those who test positive at the base and must be treated at a hospital or go to a negative pressure room for 14 days if they're asymptomatic? Will they also be allowed to go after two sequential negative tests? Importantly, our story will also note that the AMERICAN PVERSIGHT HHS-20-0580-B-000436 UNMC protocol for positive COVID-19 patients is different; it's THREEsequential tests, not two. I'm hoping you can help me confirm some of the basic details and perhaps provide any other comment. You can also reach me on my cell atrb)(6) I Thanks! Neena Satija Investigative Reporter Washington Post 202-334-7054 @neenareports Sender: Giroir, Brett (HHS/OASH) Judy Stecker (O5/ASPA)(Judy.Stecker@hhs.gov); Schuchat, Anne MD (CDC/OD) ; Bonds, Michelle E. (CDC/OD/OADC) Sent Date: 2020/03/09 15:51:50 Delivered Date: 2020/03/09 15:51:00 AMERICAN PVERSIGHT HHS-20-0580-B-000437 Giroir, Brett (HHS/OASH) Haynes, Lia (CDC/DDPHSIS/CPR/OD); To: Johnston, Darcie (HHS/IEA) Limbago, Brandi (CDC/DDID/NCIRD/OD); CC: Monroe, Steve (CDC/DDPHSS/OLSS/OD) n/ Subject: RE: Dr Haynes, have you spoken with the Pennsylvanialab yet this morning? Date: 2020/03/11 10:07:00 Priority: Normal Type: Note fantastic Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Haynes, Lia (CDC/DDPHSIS/CPR/OD)<1oh5@cdc.gov> Sent: Wednesday, March 11, 2020 10:02 AM To: Giroir, Brett (HHS/OASH) ; Johnston, Darcie (HHS/I EA) Cc: Limbago, Brandi (CDC/DDID/NCIRD/OD) ; Monroe, Steve (CDC/DDPHSS/OLSS/OD) Subject: RE: Dr Haynes, have you spoken with the Pennsylvania lab yet this morning? (b)(S) Brandi Limbago on behalf of Lia Hayes AMERICAN PVERSIGHT HHS-20-0580-B-000438 From: Giroir, Brett (HHS/DASH) Sent: Wednesday, March 11, 2020 9:51 AM To: Johnston, Darcie (HHS/I EA) Cc: Haynes, Lia (CDC/DDPHSIS/CPR/DD)<1oh5@cdc.gov> Subject: RE: Dr Haynes, have you spoken with the Pennsylvania lab yet this morning? Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Mango, Paul (HHS/IDS) Sent: Wednesday, March 11, 2020 9 :49 AM To: Johnston, Darcie (HHS/IEA) ; Giroir, Brett (HHS/DASH) Cc: Haynes, Lia (CDC/DDPHSIS/CPR/DD)<1oh5@cdc.gov> Subject: Fwd: Dr Haynes, have you spoken with the Pennsylvania lab yet this morning? Sent from my iPhone Begin forwarded message: From : "Haynes, Lia (CDC/DDPHSIS /CPR/OD)" Date: March 11, 2020 at 9:42:58 AM EDT To : "Mango, Paul (HHS/IOS)" Cc: "Jernigan, Daniel B. (CDC/DDID/NCIRD /ID)" , "Trueman, Laura (HHS/IEA)" , "Limbago, Brandi (CDC/DDlD/NCIRD /OD)" , "Haynes , Lia (CDC/D DPHSIS /CPR/OD)" Subj ect: RE: Dr Hay nes, have you spoke n with the Pennsylvan ia lab yet this morning? (b)(5) (b)(5) Please feel free to call me at b)(6 l Lia -----Original Message----From: Mango, Paul (HHS/IOS) AMERICAN PVERSIGHT HHS-20-0580-B-000439 Sent: Wednesday, March 11, 2020 9:14 AM To: Haynes, Lia (CDC/DDPHSIS /CPR/OD) Cc: Jernigan, Daniel B. (CDC/DDID/NCIRD /ID) ; Trueman, Laura (HHS/IEA) Subject: Dr Haynes , have you spoken with the Pennsylvania lab yet this morning ? Sent from my iPhone Sender: Giroir, Brett (HHS/OASH) Haynes, Lia (CDC/DDPHSI S/CPR/OD) ; Johnston, Darcie (HHS/IEA) ; Recipient: Limbago, Brandi (CDC/DDID/NCIRD/OD) ; Monroe, Steve (CDC/DDPHSS/OLSS/OD) Sent Date: 2020/03/11 10:07:22 Delivered Date: 2020/03/11 10:07:00 AMERICAN PVERSIGHT HHS-20-0580-B-000440 Giroir, Brett (HHS/OASH) To: Schuchat,Anne MD (CDC/OD) CC: Berger, Sherri (CDC/OCOO/OD) Subject: RE: nCoV- ASPR- Washington Post on quarantining Lacklandevacuees/ URGENTREQUEST Date: 2020/03/09 16:01:00 Priority: Normal Type: Note Please take a look Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Schuchat, Anne MD (CDC/OD) Sent: Monday, March 9, 2020 3:48 PM To: Giroir, Brett (HHS/OASH) Cc: Berger, Sherri (CDC/OCOO/OD) Subject: FW: nCoV - ASPR- Washington Post on quarantining Lackland evacuees/ URGENT REQUEST (b)(5) From: Bonds, Michelle E. (CDC/OD/OADC) Sent: Monday, March 9, 2020 3:29 PM To: Berger, Sherri (CDC/OCOO/OD) ; McGowan, Robert (Kyle) (CDC/OD/OCS) ; Schuchat, Anne MD (CDC/OD) Cc: Galatas, Kate (CDC/O0/OADC) ; Patrick, Kera (CDC/O0/OADC) ; CDC IMS JIC OADC LNO -2 Subject: FW: nCoV - ASPR- Washington Post on quarantining Lackland evacuees/ URGENT REQUEST AMERICAN PVERSIGHT HHS-20-0580-B-000441 Reporter: Can you confirm ASPRis now in charge? Will ASPRcontinue to allow releasing quarantined people from Lackland to leave after 14 days and two sequential negative tests, for those that agree to be tested, even though San Antonio filed an unsuccessful emergency lawsuit asking that the number of tests be three and the quarantine period be extended to 28 days? And what will the protocol be for those who test positive at the base and must be treated at a hospital or go to a negative pressure room for 14 days if they're asymptomatic? Will they also be allowed to go after two sequential negative tests? Importantly, our story will also note that the UNMC protocol for positive COVID-19 patients is different; it's THREEsequential tests, not two. b)(5) From: Stecker, Judy (05/105) Sent: Monday, March 9, 2020 1:21 PM To: Murphy, Ryan (O5/ASPA) Cc: Michael, Gretchen (O5/ASPR/OEA) ; Kane, EIieen (O5/ASPR/OEA) ; Waters, Cicely (O5/ASPR/OEA) ; Bonds, Michelle E. (CDC/OD/OADC) ; Galatas, Kate (CDC/O0/OADC) ; Trueman, Laura (HHS/I EA) ; Johnston, Darcie (HHS/IEA) ; Rigas, AMERICAN PVERSIGHT HHS-20-0580-B-000442 Laura (HHS/IEA) ; McKeogh, Katherine (05/ASPA) ; Hall, Bill (HHS/ASPA) Subject: Re: PLEASEREAD FW: Washington Post reporter -- story on COVID-19 response on quarantining Lackland patients that ASPRhas now taken over. deadline urgent (b}(5} Sent from my iPhone On Mar 9, 2020, at 12:54 PM, Murphy, Ryan (OS/ASPA) wrote: n b}(5} -Ryan AMERICAN PVERSIGHT HHS-20-0580-B-000443 From: Thorman, Caroline (ACF) Sent: Monday, March 9, 2020 12:40 PM To: Murphy, Ryan (OS/ASPA) Subject: FW: Washington Post reporter -- story on COVID-19 response on quarantining Lackland patients that ASPR has now taken over. deadline urgent Can you confirm ASPRis now in charge? Will ASPRcontinue to allow releasing quarantined people from Lackland to leave after 14 days and two sequential negative tests, for those that agree to be tested, even though San Antonio filed an unsuccessful emergency lawsuit asking that the number of tests be three and the quarantine period be extended to 28 days? And what will the protocol be for those who test positive at the base and must be treated at a hospital or go to a negative pressure room for 14 days if they're asymptomatic? Will they also be allowed to go after two sequential negative tests? Importantly, our story will also note that the UNMC protocol for positive COVID-19 patients is different; it's THREEsequential tests, not two. Many thanks, Caroline Thorman Director of Communications Administration for Children &Families (ACF) Health and Human Services (HHS) Desk: (202) 401-4777 Ce111(b)(6) I From: Satija, Neena Sent: Sunday, March 8, 2020 6:03 PM To: Thorman, Caroline (ACF) Subject: Fw: Washington Post reporter -- story on COVID-19 response on quarantining Lackland patients that ASPR has now taken over. deadline urgent Neena Satija Investigative Reporter Washington Post 202-334-7054 @neenareports AMERICAN PVERSIGHT HHS-20-0580-B-000444 From: Satija, Neena Sent: Sunday, March 8, 2020 3:51 PM To: gretchen.michael@hhs.gov ; elaine.kane@hhs.gov Subject: Washington Post reporter -- story on COVID-19 response on quarantining Lackland patients that ASPRhas now taken over . deadline urgent Dear Gretchen and Elaine, My name is Neena Satija and I'm a reporter for the Washington Post. I have been trying to get in touch with HHS on a story about coronavirus response when it comes to the Wuhan and Diamond Princess (and soon, Grand Princess) cohorts sent to Lackland Air Force Base, and I have had no luck with the CDC.So I'm going to you -- also because we have been told today that ASPRis now in charge of those quarantine ops instead of the CDC. Getting in touch with HHS in general for the past few weeks has been tough; in fact it took me several days simply to confirm, for instance, that OCEPHRwas involved in the repatriation effort ... and we really do want to be fair and accurate, so I'm really hoping you can help!! My colleague Arel is Hernandez and I have a story that may run tomorrow or the following day about the frustration among state and local officials in Texas, especially officials in San Antonio, regarding lack of communication from the administration on COVID-19 response, in particular, what to do with cohorts from Wuhan and the Diamond Princess (and, soon, the Grand Princess) cruise ship . We will report that state and local officials were assured that anyone sent to Lackland from Wuhan back on Feb. 1 would remain quarantined on base -- but instead, after the plane landed, San Antonio officials were immediately called upon not only to take the one woman who tested positive and had symptoms to a community hospital to be treated, but even to secure an ambulance to take her off Lackland. Essentially state and local officials were given no advanced warning that the DOD would now allow anyone who tested positive for COVID-19 to stay on base, whether asymptomatic or not. It appears as though state and local authorities had the tools in place to plan for these issues quickly. But what happened raises serious questions about the administration's handling of this public health emergency, especially after the release of that patient from Wuhan before a positive test result came back. I have contacted CDC multiple times for comment on our story with no answer. Then I found out today that ASPRis now in charge of quarantining protocols going forward as opposed to CDC. It's all the more important we hear from you now that dozens more cruise ship passengers, this time from the Grand Princess cruise ship, are now headed to Lackland. The administration has assured folks that it will quarantine them at the base. But what about those who test positive? AMERICAN PVERSIGHT HHS-20-0580-B-000445 Can you confirm ASPRis now in charge? Will ASPRcontinue to allow releasing quarantined people from Lackland to leave after 14 days and two sequential negative tests, for those that agree to be tested, even though San Antonio filed an unsuccessful emergency lawsuit asking that the number of tests be three and the quarantine period be extended to 28 days? And what will the protocol be for those who test positive at the base and must be treated at a hospital or go to a negative pressure room for 14 days if they're asymptomatic? Will they also be allowed to go after two sequential negative tests? Importantly, our story will also note that the UNMC protocol for positive COVID-19 patients is different; it's THREEsequential tests, not two. I'm hoping you can help me confirm some of the basic details and perha,s provide any other comment. You can also reach me on my cell atf: .... b_ )(B_ )____ __,J Thanks! Neena Satija Investigative Reporter Washington Post 202-334- 7054 @neenareport s Sender: Giroir, Brett (HHS/OASH) Schuchat, Anne MD (CDC/OD) ; Recipient: Berger, Sherri (CDC/OCOO/OD) Sent Date: 2020/03/09 16:01:27 Delivered Date: 2020/03/09 16:01:00 AMERICAN PVERSIGHT HHS-20-0580-B-000446 Giroir, Brett (HHS/OASH) To: Becker,Scott I APHL CC: Kellogg, Rachel(HHS/OASH) Subject: RE: Scott, The Admiral wanted a direct connectionto you. Date: 2020/03/11 10:27:00 Priority: Normal Type: Note I am on IM as well Thanks for the info Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Becker, Scott I APHL Sent: Wednesday, March 11, 2020 10:26 AM To: Giroir, Brett (HHS/OASH) Cc: Kellogg, Rachel (HHS/OASH) Subject: RE:Scott, The Admiral wanted a direct connection to you. Hi, we are in our IM meeting right now and we will try to figure out best approach . Even with high throughput, there are some issues our members are finding while bringing this up but we are gathering those issues and will track down technical assistance. I'm really going to need a little time to figure this out. Also, below is a morning update on testing status, this is not capacity. We will figure out how to best capture volume/capacity but please give us time . There have been no reported changes in PHL testing status since yesterday afternoon. The total number of verified labs offering testing is 79. This includes one or more PHL in 50 states plus DC. We know of 12 additional labs who plan to bring on testing and we will continue to reach out to PHLs to update their status with us. This includes 5 in progress, 7 waiting for kits, and 3 in progress to become a qualified laboratory (i.e. passing the influenza PT,training, etc). Thanks, Scott AMERICAN PVERSIGHT HHS-20-0580-B-000447 From: Giroir, Brett (HHS/DASH) Sent: Wednesday, March 11, 2020 9:53 AM To: Becker, Scott I APHL Cc: Kellogg, Rachel (HHS/DASH) Subject: RE: Scott, The Admiral wanted a direct connection to you. CAUTION: This emai l originated from outside of the organization . Do not click links or open attachments unless you recognize the sender and know the content is safe. Scott, Crazy day as always. But do you have an overall update about your labs? Who is ok, who is short of what, who does high throughput and not? We get individual calls but do not have the big picture - trying to ascertain the big picture. BG Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Becker, Scott I APHL Sent: Wednesday, March 11, 2020 9 :18 AM To : Giroir, Brett (HHS/DASH) Subject: RE: Scott, The Adm iral wanted a direct connection to you. And mine is~ fb_)(6_) ___ ~1 Thank you. From: Giro ir, Brett (HHS/DASH) Se nt: Wednesday, March 11, 2020 9 :12 AM To : Stenzel, Timothy (FDA/CDRH) ; Becker, Scott Cc: Monroe, Stephan Subject: RE: Scott, The Adm iral wanted a direct connection to you. I APHL CAUTION: This emai l originated from outside of the organization . Do not click links or open attachments unless you recognize the sender and know the cont ent is safe. And Scott My mobile is l(b)(6) AMERICAN PVERSIGHT HHS-20-0580-B-000448 Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Stenzel, Timothy Sent: Wednesday, March 11, 2020 8:56 AM To: Becker, Scott I APHL Cc:Giroir, Brett (HHS/OASH) ; Monroe, Steve (CDC/DDPHSS/OLSS/O0) Subject: RE: Scott, The Adm iral wanted a direct connection to you. Scott ' s contact info Scott J. Becker (he/h im) Chief Executive Officer P +1240.485.2747 I Ml~(b-)(B-) ----~ scott.becker@aphl.org I @scott jbecker Associat ion of Public Health Laboratories 8515 Georgia Avenue, Suite 700 Silver Spring, MD 20910 Best, Tim Timothy T. Stenzel, MD, PhD Director, OHT7: Office of In Vitro Diagnostics and Radiological Health Office of Product Evaluation and Quality Center for Devices and Radiological Health U.S. Food and Drug Administration Timothy .Stenzel@fda .hhs .gov Jennifer Campbell Administrat ive Assista nt OHT 7: Office of In Vitro Diagnos tics and Radi ological Health Office of Pro duct Evalua tion an d Quality CDRH I Food and Drug Administrat ion Whit e Oak, Bldg. 66 34 03 I 10903 New Hampshire Avenue I Silver Spr ing, MD 20993 Ph: 301 -796 -7692 Jennifer.Campbell@fda.hhs.gov Excellent customer service is important to us. Please take a moment to provide feedback regarding the customer service you have received: https://www .research .net/s/cdrhcustomerservice?ID=1900&S=E AMERICAN PVERSIGHT HHS-20-0580-B-000449 From: Stenzel, Timothy Sent : Wednesday, March 11, 2020 8:41 AM To: Becker, Scott I APHL Cc:Giroir, Brett (OS) ; Monroe, Stephan S (CDC) Subject : Scott, The Admiral wanted a direct connection to you. Best, Tim Timothy T. Stenzel, MD, PhD Director. OHT7: Office of In Vitro Diagnostics and Radiological Health Office of Product Evaluation and Quality Center for Devices and Radiological Health U.S. Food and Drug Administration Timothy .Stenzel@fda .hhs.gov Jennifer Campbell Administrative Assistant OHT7: Office of In Vitro Diagnostics and Rad iologic al Health Office of Product Evaluation and Quality CDRH I Food and Drug Administration White Oak, Bldg. 66 3403 I 10903 New Hampshire Avenue Ph : 301 -796 -7692 )ennifer.Campbell@fda.hhs.gov I Silver Spring , MD 20993 Excellent customer service is important to us. Please take a moment to provide feedback regarding the customer service you have received: https :/fwww.research.net/s/cdrhcustomerservice?ID =1900&S=E This email has been scanned for spam and viruses by Proofpoint Essen tials. Click here to report this email as spam . This email has been scanned for spam and viruses by Proofpoint Esse ntials. Click here to report this email as spam . AMERICAN PVERSIGHT HHS-20-0580-B-000450 Sender: Giroir, Brett (HHS/OASH) Becker,Scott I APHL; Recipient: Kellogg, Rachel(HHS/OASH) Sent Date: 2020/03/11 10:27:44 Delivered Date: 2020/03/11 10:27:00 AMERICAN PVERSIGHT HHS-20-0580-B-000451 Giroir, Brett (HHS/OASH) To: Kadlec, Robert (O5/ASPR/IO) Phillips, Sally (O5/ASPR/SPPR); Yeskey, Kevin (OS/ASPR/10); Jernigan, Daniel B. (CDC/DDID/NCIRD/ID); Shuy, Bryan (O5/ASPR/IO) ; Schuchat, Anne MD (CDC/OD) ; Moreno, Rafael (OS/ASPR) Subject: RE: Guidancefor Termination of Isolation Date: 2020/03/10 06:45:00 Priority: Normal Type: Note Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Giroir, Brett (HHS/OASH) Sent: Monday, March 9, 2020 6:25 PM To: Kadlec, Robert (OS/ASPR/1O) Cc: Phillips, Sally (OS/ASPR/SPPR); Yeskey, Kevin (OS/ASPR/1O) ; Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) ; Shuy, Bryan (OS/ASPR/1O); Schuchat, Anne MD (CDC/OD) ; Giroir, Brett (HHS/OASH) ; Moreno, Rafael (OS/ASPR) Subject: Guidance for Termination of Isolation Importance: High RK- AMERICAN PVERSIGHT HHS-20-0580-B-000452 (b)(5) Let me know if you have any questions. V/r BG Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 Sender: Giroir, Brett (HHS/OASH) Kadlec, Robert (OS/ASPR/10) ; Phillips, Sally (O5/ASPR/SPPR) ; Yeskey, Kevin (O5/ASPR/IO) ; Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) ; Shuy, Bryan (OS/ASPR/1O) ; Schuchat, Anne MD (CDC/OD) ; Moreno, Rafael (O5/ASPR) Sent Date: 2020/03/10 06:45:35 Delivered Date: 2020/03/10 06:45:00 AMEHICAN PVERSIGHT HHS-20-0580-B-000453 Giroir, Brett (HHS/OASH) Brennan, Patrick (OS/ASPA); To : Kellogg, Rachel(HHS/OASH) Subject: FW: Current Numbers in the System. Date: 2020/03/1111:07:00 Priority: Normal Type: Note Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Giroir, Brett (HHS/OASH) Sent: Wednesday, March 11, 2020 9:19 AM To: Hahn, Stephen ; Keagan Lenihan (FDA/OC) (Keagan.Lenihan@fda .hhs .gov) ; Laura Pence (HHS/IOS) (Laura.Pence@hhs.gov) Cc: 'Stenzel, Timothy' ; Ryan Murphy (OS/ASPA) (Ryan.Murphyl@hhs.gov) ; Judy Stecker (OS/ASPA) (Judy.Stecker@hhs.gov) ; Mango, Paul (HHS/IOS) ; Brett Giroir (HHS/OASH) (Brett.Giroir@hhs.gov) Subject : Current Numbers in the System. b)(5) AMERICAN PVERSIGHT HHS-20-0580-B-000454 (b)(5) Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW AMERICAN PVERSIGHT HHS-20-0580-B-000455 Washington, DC 20201 Office Phone: 202-690-7694 Giroir, Brett (HHS/OASH) Brennan, Patrick (OS/ASPA) ; Recipient: Kellogg, Rachel (HHS/OASH) Sent Date: 2020/03/1111 :07 :56 Delivered Date: 2020/03/1111 :07 :00 AMERICAN PVERSIGHT HHS-20-0580-B-000456 Giroir, Brett (HHS/OASH) To: Hahn, Stephen <5H1@fda.hhs.gov> Subject: FW: info on what needs to be ordered - i will check on t he backlog Date: 2020/03/ 10 19:14:00 Priority: Normal Type: Note Can you give me a call? Re kits and extraction, and all that is testing l(b)(6) I Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Schuchat, Anne MD (CDC/OD) Sent: Tuesday, March 10, 2020 7:13 PM To: Giroir, Brett (HHS/OASH) Cc: Berger, Sherri (CDC/OCOO/OD) Subject: Fwd: info on what needs to be ordered - i will check on the backlog (b)(5) From: Schuchat, Anne MD (CDC/OD) Sent: Tuesday, March 10, 2020 10:55:41 AM To: Ghaly, Mark (CHHS) Subject: RE: info on what needs to be ordered - i will check on the backlog Not sure wh ich you mean. If you mean tht graph of daily tests run by cdc and by public health labs it is here https ://www.cdc.gov/ coro navi rus/2019-n cov /testi ng-i n-u s.htm I (page down to see the graph - it is after the map of what states are testing vs. in progress of getting test validated) . Re the backlog - here is the summary : National shortage of the quiagen extract ion components - request to Qiagen to send letter to cdc about comparability of their research use only products vs. good manufactur ing products as a means to let us AMERICAN PVERSIGHT HHS-20-0580-B-000457 get FDA to permit those products being shipped out to fill the gap. We have not gotten that letter so this is in that company's hands. Labs could try to use a different platform (eg the magnapure made by roche) which does not rely on those Qi agen products. Some places a re pursuing that route. I don't have info yet if any of the CA Counties are close to being able to do that. Commercial testing is starting to get moved out by Lab corps and soon by quest - this is private sector and not run out of CDC. From: Ghaly, Mark (CHHS) Sent: Tuesday, March 10, 2020 10:42 AM To: Schuchat, Anne MD (CDC/OD) Subject: Re: info on what needs to be ordered - i will check on the backlog Hi, can you please send me the link to your testing diagram? Ty Also, any news on backlog . Sent from my iPhone On Mar 10, 2020, at 6:31 AM, Schuchat, Anne MD (CDC/OD) wrote: Anne Schuchat, MD Principal Deputy Director Centers for Disease Control and Prevention Rear Adm iral, US Public Health Service (Retired) Sender: Giroir, Brett (HHS/OASH) Recipient: Hahn, Stephen Sent Date: 2020/03/10 19: 14:36 Delivered Date: 2020/03/10 19: 14:00 AMERICAN PVERSIGHT HHS-20-0580-B-000458 Giroir, Brett (HHS/OASH) To: Moreno, Rafael (OS/ASPR) Strategic COVID-19Tracker Team ; CC: Susan Orsega (OS/OASH)(Susan.Orsega@hhs.gov) Subject: RE: ASPRSCTT#018 Date: 2020/03/09 16:16:00 Priority: Normal Type: Note b)(5) Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Moreno, Rafael (OS/ASPR) Sent: Monday, March 9, 2020 3:33 PM To: Giroir, Brett (HHS/OASH) Cc: Strategic COVID-19 Tracker Team Subject: RE: ASPRSCTT#018 Good afternoon Admiral Giroir, (b)(5) AMERICAN PVERSIGHT HHS-20-0580-B-000459 b)(5) Rafael Moreno III Special Assistant to the ASPR Immediate Office, Assistant Secretary for Preparedness and Response (ASPR) US Dept. Health and Human Services (HHS) Desk: (202) 260-1042 ce11fbl(6l I rafael.moreno@hhs.gov From: Strategic COVID-19 Tracker Team Sent: Monday, March 9, 2020 3:17 PM To: Giroir, Brett (HHS/OASH) Cc: Moreno, Rafael (OS/ASPR) Subject: FW: ASPRSCTT#018 Good afternoon ADM Giroir, (b)(5) Thank you Sir. AMERICAN PVERSIGHT HHS-20-0580-B-000460 v/r raw Robert A. Windom Captain, USPHS HHS/ASPR Senior Advisor to USSOUTHCOM Dept of Health and Human Services J7 /9 - Exercises and Coalition Affairs U.S. Southern Command Tel: 305. 437.0523 / DSN: 567 Ce11: fbl(6) I HHS Office of the Assistant Secretary for Preparedness and Response (ASPR)- Saving Lives. Protecting Americans Giroir, Brett (HHS/OASH) Moreno, Rafael (OS/ASPR) ; Strategic COVID- 19 Tracker Team ; Susan Orsega (OS/OASH) (Susan.Orsega@hhs.gov) I Sent Date: 2020/03/09 16: 16:50 Delivered Date: 2020/03/09 16: 16:00 AMERICAN PVERSIGHT HHS-20-0580-B-000461 Giroir, Brett (HHS/OASH) Hall, Bill (HHS/ASPA); Heck, Mia (HHS/OASH); To: Murphy, Ryan (O5/ASPA) ; Stecker, Judy (O5/IOS) McKeogh,Katherine (O5/ASPA); Kane, EIieen (O5/ASPR/OEA); Bante, Kat ie (O5/OASH) Subject: RE: Wall Street Journal inquiry for Dr. Kadlec Date: 2020/03/10 19:43:00 Priority: Normal Type: Note We always do! Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Hall, Bill (HHS/ASPA) Sent: Tuesday, March 10, 2020 2:30 PM To: Giroir, Brett (HHS/OASH) ; Heck, Mia (HHS/OASH) ; Murphy, Ryan (OS/ASPA) ; Stecker, Judy (OS/105) Cc: McKeogh, Katherine (05/ASPA) ; Kane, EIieen (05/ASPR/OEA) ; Bante, Katie (05/0ASH) Subject: RE: Wall Street Journal inquiry for Dr. Kadlec b)(5) From: Giro ir, Brett (HHS/OASH) Sent: Tuesday, March 10, 2020 2:15 PM To : Heck, M ia (HHS/OASH) ; Murphy, Ryan (05/ASPA) ; Stecker, Judy (05/105) Cc: Hall, Bill (HHS/ASPA) ; McKeogh, Katherine (05/ASPA) ; Kane, EIieen (05/ASPR/OEA) ; Bante, Katie AMERICAN PVERSIGHT HHS-20-0580-B-000462 (OS/OASH) Subject: RE: Wa ll Street Journal inquiry for Dr. Kadlec (b)(5) Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Heck, M ia (HHS/OASH) Sent: Tuesday, March 10, 2020 2:13 PM To: Giroir, Brett (HHS/OASH) ; Murphy, Ryan (OS/ASPA) ; Stecker, Judy (OS/IOS) Cc: Hall, Bill (HHS/ASPA) ; McKeogh, Katherine (OS/ASPA) ; Kane, EIieen (OS/ASPR/OEA) ; Bante, Katie (OS/OASH) Subject: RE: Wa ll Street Journal inquiry for Dr. Kadlec (b)(5) From: Giroir, Brett (HHS/OASH) Sent: Tuesday, March 10, 2020 2:11 PM To: Murphy, Ryan (OS/ASPA) ; Heck, Mia (HHS/OASH) ; Stecker, Judy (OS/IOS) Cc: Hall, Bill (HHS/ASPA) ; McKeogh, Katherine (OS/ASPA) ; Kane, EIieen (OS/ASPR/OEA) ; Bante, Katie (OS/OASH) Subject: RE: Wall Street Journal inquiry for Dr. Kadlec b)(5) AMEHICAN PVERSIGHT HHS-20-0580-B-000463 Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Murphy, Ryan (05/ASPA) Sent: Tuesday, March 10, 2020 12:33 PM To: Heck, M ia (HHS/OASH) ; Stecker, Judy (05/105) Cc: Giroir, Brett (HHS/OASH) ; Hall, Bill (HHS/ASPA) ; McKeogh, Katherine (OS/ASPA) ; Kane, EIieen (OS/ASPR/OEA) ; Bante, Katie (05/0ASH) Subject: RE: Wall Street Journal inquiry for Dr. Kadlec (b)(5) AMERICAN PVERSIGHT HHS-20-0580-B-000464 (b)(5) From: Heck, M ia {HHS/OASH) Sent: Tuesday, March 10, 2020 12:26 PM To: Murphy, Ryan (05/ASPA) ; Stecker, Judy {OS/IOS) Cc: Giroir, Brett (HHS/OASH) ; Hall, Bill (HHS/ASPA) ; McKeogh, Katherine {OS/ASPA) ; Kane, EIieen (OS/ASPR/OEA) ; Bante, Katie (05/0ASH) Subject: RE: Wall Street Journal inquiry for Dr. Kadlec b)(5) From: Murphy, Ryan {05/ASPA) Sent: Tuesday, March 10, 2020 11:57 AM To: Stecker, Judy {05/IOS) ; Heck, M ia {HHS/OASH) Cc: Giroir, Brett (HHS/OASH) ; Hall, Bill (HHS/ASPA) ; McKeogh, Katherine {OS/ASPA) ; Kane, EIieen (OS/ASPR/OEA) ; Bante, Katie {05/0ASH) Subject: RE: Wall Street Journal inquiry for Dr. Kadlec rb )(5) From: Stecker, Judy (05/IOS) Sent: Tuesday, March 10, 2020 11:55 AM To: Heck, M ia (HHS/OASH) Cc: Murphy, Ryan (05/ASPA) ; Giro ir, Brett (HHS/OASH) ; Hall, Bill (HHS/ASPA) ; McKeogh, Kather ine (05/ASPA) ; Kane, EIieen (OS/ASPR/OEA) ; Bante, Katie {OS/OASH) Subject: Re: Wall Street Journal inquiry for Dr. Kadlec (b)(5) Sent from my iPhone AM[ HICAN PVERSIGHT HHS-20-0580-B-000465 On Mar 10, 2020 , at 11:47 AM, Heck, Mia (HHS/OASH) wrote: b}(5} Mia Sent from my iPhone On Mar 10, 2020, at 11:06 AM , Stecker, Judy (OS/IOS) wrote: Sent from my iPhone On Mar 10, 2020 , at 10:43 AM , Murphy , Ryan (OS/ASPA ) wrote: From: Heck, Mia (HHS/OASH) Sent: Tuesday, March 10, 2020 10:40 AM To : Giro ir, Brett (HHS/OASH) ; Stecker, Judy (OS/IOS) ; Hall, Bill (HHS/ASPA) ; Murphy, Ryan (OS/ASPA) Cc: Kane, EIieen (OS/ASPR/OEA) ; Bante, Katie (OS/OASH) Subject: RE: Wall Street Journal inquiry for Dr. Kadlec Will do. From : Giroir, Brett (HHS/OASH) Sent: Tuesday, March 10, 2020 10:39 AM To: St ecker, Judy (OS/IOS) ; Hall, Bill (HHS/ASPA) ; Murphy, Ryan (05/ASPA) AMERICAN PVERSIGHT HHS-20-0580-B-000466 Cc: Heck, Mia (HHS/OASH) ; Kane, EIieen (OS/ASPR/OEA) ; Bante, Katie (OS/OASH) Subject: FW: Wall Street Journal inquiry for Dr. Kadlec (b)(5) Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Kadlec, Robert (OS/ASPR/10) Sent: Tuesday, March 10, 2020 10:35 AM To: Giroir, Brett (HHS/OASH) Subject: Fwd: Wall Street Journal inquiry for Dr. Kadlec Sent from my iPhone Begin forwarded message: From: "Burton, Tom" Date: March 10, 2020 at 9:40:46 AM EDT To: "Kane, Elleen (OS/ASPR/OEA)" , "Kadlec, Robert (OS/ASPR/IO)" Subject: Fwd: Wall Street Journal inquiry for Dr. Kadlec AMERICAN PVERSIGHT HHS-20-0580-B-000467 ? We're about to post a story on this. I want to call attention to our inquiry and give Dr. Kadlec a chance to respond. Thank you, Tom Burton 202 862-6611 ---------- Foiwarded message --------From: Burton, Tom Date: Mon, Mar 9, 2020 at 6:24 PM Subject: Wall Street Journal inquiry for Dr. Kadlec To: Kane , Elleen (HHS/ASPR/COO) Elleen, For a story to be posted tomorrow , we would very much like to get comment from Dr. Kadlec to a statement from a senior government official that Dr. Kadlec, along with Secretary Azar, wanted the administration to use and distribute tests from the CDC , which had the effect of delaying broader distribution of all coronavirus tests including those from hospitals and private companies. Could you please email or call me tonight please , or ask Dr . Kadlec to do so? Thank you, Tom Burton Thomas M. Burton, Staff Reporter The Wall Street Journal 1025 Connecticut Ave. N.W., #800 Washington, D.C. 20036 W: 202 862-6611 __, Cell j,(b) __ _(5_) __ Follow me @TomBurtonWSJ Thomas M. Burton, Staff Reporter The Wall Street Journal I 025 Connecticut Ave. N.W., #800 Washington, D.C. 20036 AMERICAN PVERSIGHT HHS-20-0580-B-000468 W: 202 862-6611 Follow me @TomBurtonWSJ Sender: Giroir, Brett (HHS/OASH) Hall, Bill (HHS/ASPA); Heck, Mia (HHS/OASH); Murphy, Ryan (OS/ASPA); Stecker, Judy (OS/l05) ; McKeogh,Katherine (O5/ASPA); Kane, EIieen (OS/ASPR/OEA); Bante, Katie (OS/OASH) Sent Date: 2020/03/10 19:43:38 Delivered Date: 2020/03/10 19:43:00 AMERICAN PVERSIGHT HHS-20-0580-B-000469 Giroir, Brett (HHS/OASH) To: Stenzel, Timothy Subject: RE: Quest has no supply issues to report. Date: 2020/03/11 13:42:00 Priority: Normal Type: Note AWESOME Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Stenzel, Timothy Sent: Wednesday, March 11, 2020 1:33 PM To: Giroir, Brett (HHS/OASH) Subject: FW: Quest has no supply issues to report. FYI Best, Tim Timothy T. Stenzel, MD, PhD Director, OHT7: Office of In Vitro Diagnostics and Radiological Health Office of Product Evaluation and Quality Center for Devices and Radiological Health U.S. Food and Drug Administration Timothy.Stenzel@fda.hhs.gov Jennifer Campbell Administrative Assistant OHT7: Office of In Vitro Diagnostics and Radiological Health Office of Product Evaluation and Quality CDRH I Food and Drug Administration White Oak, Bldg. 66 3403 I 10903 New Hampshire Av enue I Silver Spring, MD 20993 Ph: 301 -796 -7692 Jennifer.Campbell@fda.hhs.gov Excellent customer service is important to us. Please take a moment to provide feedback regarding the customer service you have received: https ://www.research.net/s/cdr hcustomerservice?ID=1900&S=E AMERICAN PVERSIGHT HHS-20-0580-B-000470 From: Wagner, Michael J Sent: Wednesday, March 11, 2020 1:07 PM To: Stenzel, Timothy Cc:Shuren, Jeff ; Schwartz, Suzanne Subject: Quest has no supply issues to report. Hi Tim, Thank you. Quest has no supply issues to report. The California lab is running full t ilt. 3 shifts a day. 7 days a week. Other Quest labs are working on the ir CLIA validations. Michael Michael J. Wagner, Esq. Quest Diagnostics Incorporated I Legal Department I 1311 Calle Batido I San Clemente, CA 92673 USA phone + 1 949. 940. 7360 I m icha el.j .wagn er@ gu estd iagnost ics .com I www.guestdiagnostics.com I Please think about resource conservation before you print this message From: Stenzel, Timothy Sent: Wednesday, March 11, 2020 9:56 AM To: Wagner, Michael J Cc:Shuren, Jeff ; Schwartz, Suzanne Subject: RE: Quest testing capacity /Trade Secret - Confidential CAUTION: This email originated from outside of the organization. Do not click links or open attachments unless you recognize the sender and know the content is safe. Thanks Michae l, Are you seeing any potential supply issues that would interfere with your max capacity test ing? Best, Tim Timothy T. Stenzel, MD, PhD Director, OHT7: Office of In Vitro Diagnostics and Radiological Health Office of Product Evaluation and Quality Center for Devices and Radiological Health U.S. Food and Drug Administration Timothy.Stenzel@fda.hhs.gov Jennifer Campbell Adm inistrativ e Assistan t AMERICAN PVERSIGHT HHS-20-0580-B-000471 OHT7: Office of In Vitro Diagnostics and Radiological Health Office of Product Evalua tio n and Quality CDRH I Food and Drug Administration White Oak, Bldg. 66 3403 I 10903 New Hampshire Avenue Ph: 301 -796 -7692 ]ennifer.Campbell@fda.hhs.gov I Silver Spring, MD 20993 Excellent customer service is important to us. Please take a moment to provide feedback regarding the customer service you have received: https://www.research.net/s/cdrhcustomerservice?ID =1900&S =E The contents of this message, together with any attachments, are intended only for the use of the person(s) to which they are addressed and may contain confidential and/or privileged information . Further, any medical information herein is confidential and protected by law. It is unlawful for unauthorized persons to use, review, copy, disclose, or disseminate confidential medical information. If you are not the intended recipient, immediately advise the sender and delete this message and any attachments . Any distribution, or copying of this message, or any attachment, is prohibited. Sender: Giroir, Brett (HHS/OASH) Recipient: Stenzel, Timothy Sent Date: 2020/03/11 13:42:22 Delivered Date: 2020/03/11 13:42:00 AMERICAN PVERSIGHT HHS-20-0580-B-000472 Giroir, Brett (HHS/OASH) To: Cohn, Amanda (CDC/DDID/N ? RD/OD) Subject: RE: Older adult web links Date: 2020/03/09 16:40:00 Priority: Normal Type: Note You rock Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Cohn, Amanda (CDC/DDID/NCIRD/O0) Sent: Monday, March 9, 2020 4:27 PM To: Giroir, Brett (HHS/OASH) Subject: RE: Older adult web links This was already happening and is going live today: People at Risk for Serious Illness from COVID19 If you are at higher risk of getting very sick from COVID-19, you should: oo Stock up on supplies oo Take everyday precautions to keep space between yourself and others oo When you go out in public, keep away from others who are sick, limit close contact and wash your hands often . o o Avoid crowds as much as possible oo Avoid cruise travel and non-essential air travel AMERICAN PVERSIGHT HHS-20-0580-B-000473 o o During a COVID-19 outbreak in your community, stay home as much as possible to further reduce your risk of being exposed. From: Gir oir, Brett (HHS/OASH) Sent: Monday, March 9, 2020 4:12 PM To: Cohn, Amanda (CDC/DDID/NCIRD/OD) Subject: FW: Older adult web links b)(5) Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Schuchat, Anne MD (CDC/OD) Sent: Monday , March 9, 2020 3:39 PM To: Giroir, Brett (HHS/OASH) Cc: Messonnier, Nancy (CDC/DDID/NCIRD/OD) Subject: FW: Older adult web links From: Cohn, Amanda (CDC/DDID/NCIRD/OD) Sent: Monday, March 9, 2020 3:14 PM To: Schuchat, Anne MD (CDC/OD) ; Messonn ier, Nancy (CDC/DDID/NCIRD/OD) Cc: Meaney Delman, Dana M. (CDC/DDNID/NCBDDD/DBDID) ; Peacock, Georg ina (CDC/DDNID/NCBDDD/DHDD) ; Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) ; Ethier, Kathleen (CDC/DDID/NCHHSTP/DASH) Subject: Older adult web links AMERICAN PVERSIGHT HHS-20-0580-B-000474 Dr. Schuchat, b)(5) Sender: Giroir, Brett (HHS/OASH) Recipient: Cohn, Amanda (CDC/DDID/NORD/O0) Sent Date: 2020/03/09 16:40:45 Delivered Date: 2020/03/09 16:40:00 AMERICAN PVERSIGHT HHS-20-0580-B-000475 Giroir, Brett (HHS/OASH) To: Stenzel, Timothy (FDNCDRH) Subject: Update Date: 2020/03/12 14:40:00 Priority: Normal Type: Note (b)(5) Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 Giroir, Brett (HHS/OASH) Recipient: Stenzel, Timothy (FDNCDRH) Sent Date: 2020/03/12 14:40:38 Delivered Date: 2020/03/12 14:40:00 AMERICAN PVERSIGHT HHS-20-0580-B-000476 Giroir, Brett (HHS/OASH) To: ~(O5/ IOS) Hahn, Stephen ~fda .hhs.gov>; Keagan Lenihan (FDNOC) (Keagan.Lenihan@fda.hhs.gov) ; Ryan Murphy (O5/ASPA) (Ryan.Murphyl @hhs.gov) Subject: FW: Quest has no supp ly issues t o report . Date: 2020/03/11 13:43:00 Priority: Normal Type: Note From Dr. Stenzel at FDA From: Wagner, Michael J Sent: Wednesday, March 11, 2020 1:07 PM To: Stenzel, Timothy Cc: Shuren, Jeff ; Schwartz, Suzanne Subject: Quest has no supply issues to report. Hi Tim, Thank you. Quest has no supply issues to report. The California lab is running full tilt. 3 shifts a day. 7 days a week. Other Quest labs are working on their CLIA validations. Michael Michael J. Wagner, Esq . Quest Diagnostics Incorporated I Legal Department I 1311 Calle Batido I San Clemente, CA 92673 USA pho ne +1 949.940 .7360 I michael.j . wagner @ guestdiagnostics.com I www. q uestd iaqnost ics .com I Please think about reso urce conservat ion before you print th is message From: Stenzel, Timothy Sent: Wednesday, March 11, 2020 9:56 AM To: Wagner, Michael J AMERICAN PVERSIGHT HHS-20-0580-B-000477 Cc:Shuren, Jeff ; Schwartz, Suzanne Subject: RE: Quest testing capacity /Trade Secret - Confidential CAUTION: This email originated from outside of the organization. you recognize the sender and know the content Do not click links or open attachments unless is safe. Thanks Michae l, Are you seeing any potential supply issues that would interfere with your max capacity test ing? Best, Tim Timothy T. Stenzel, MD, PhD Director. OHT7: Office of In Vitro Diagnostics and Radiological Health Office of Product Evaluation and Quality Center for Devices and Radiological Health U.S. Food and Drug Administration Timothy.Stenzel@fda.hhs.gov Jennifer Campbell Administrative Assistant OHT7: Office of In Vitro Diagnostics and Radiologic al Health Office of Product Evaluation and Quality CDRH I Food and Dru g Administration White Oak, Bldg. 66 3403 I 10903 New Hampshire Avenue I Silver Spring, MD 20993 Ph: 301 -796 -7692 ]ennifer.Campbell@fda.hhs.gov Excellent customer service is important to us. Please take a moment to provide feedback regarding the customer service you have received: https://www.research.net/s/cdrhcustomerservice?ID=1900&S=E The contents of this message, together with any attachments, are intended only for the use of the person(s) to which they are addressed and may contain confidential and/or privileged information. Further, any medical information herein is confidential and protected by law. It is unlawful for unauthorized persons to use, review, copy, disclose, or disseminate confidential medical information. If you are not the intended recipient, immediately advise the sender and delete this message and any attachments. Any distribution, or copying of this message, or any attachment, is prohibited. Sender: Giroir, Brett (HHS/OASH) ~0S/IOS) ; Hahn, Stephen (b)(6 fda.hhs.gov>; Keagan Lenihan FDA/QC) (Keagan.Lenihan@fda.hhs.gov) ; Ryan Murphy (0S/ASPA) (Ryan.Murphy1@hhs.gov) Sent Date: 2020/03/11 13:43:42 Delivered Date: 2020/03/11 13:43:00 AMERICAN PVERSIGHT HHS-20-0580-B-000478 Giroir, Brett (HHS/OASH) To: Shuy, Bryan (OS/ASPR/IO) Subject: Testing Date: 2020/03/12 09:42:00 Priority: Normal Type: Note Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 Giroir, Brett (HHS/OASH) Recipient: Shuy, Bryan (OS/ASPR/IO) Sent Date: 2020/03/12 09:42:38 Delivered Date: 2020/03/12 09:42:00 AMERICAN PVERSIGHT HHS-20-0580-B-000479 Giroir, Brett (HHS/OASH) To: Stenzel, Timothy Subject: RE: Update Date: 2020/03/12 14:57:00 Priority: Normal Type: Note (b)(5) Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Stenzel, Timothy Sent: Thursday, March 12, 2020 2:50 PM To: Giroir, Brett (HHS/OASH) Subject: RE: Update See answers below . Best , Tim Timothy T. Stenzel, MD, PhD Director, OHT7: Office of In Vitro Diagnostics and Radiological Health Office of Product Evaluation and Quality Center for Devices and Radiological Health U.S. Food and Drug Administration Timothy.Stenzel@fda.hhs.gov Jennifer Campbell Administrative Assistant OHT7: Office of In Vitro Diagnostics and Rad iological Health Office of Product Evaluation and Quality CDRH I Food and Dru g Administration White Oak, Bldg. 66 3403 I 10903 New Hampshire Avenue Ph: 301 -796 -7692 )ennifer.Campbell@fda.hhs.gov AMERICAN PVERSIGHT I Silver Spring, MD 20993 HHS-20-0580-B-000480 Excellent customer service is important to us. Please take a moment to provide feedback regarding the customer service you have received: https://www.research.net/s/cdrhcustomerservice?ID=1900&S=E From: Giroir, Brett (HHS/OASH) Sent: Thursday, March 12, 2020 2:41 PM To: Stenzel, Timothy Subject: Update b)(5) Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 Sender: Giroir, Brett (HHS/OASH) Recipient: Stenzel, Timothy Sent Date: 2020/03/12 14:57:55 Delivered Date: 2020/03/12 14:57:00 AM[ HICAN PVERSIGHT HHS-20-0580-B-000481 Giroir, Brett (HHS/OASH) Lenihan, Keagan ; To: Murphy, Ryan (OS/ASPA) Pratt, Michael (OS/ASPA); ASPA-Deputies ; Bonds, Michelle E. (CDC/OD/OADC) Subject: RE: Social monitoring - testing Date: 2020/03/10 20:27:00 Priority: Normal Type: Note b)(5) Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690- 7694 From: Lenihan, Keagan Sent: Tuesday, March 10, 2020 8:24 PM To: Murphy, Ryan (O5/ASPA) Cc: Pratt, Michael (OS/ASPA) ; ASPA-Deputies ; Giroir, Brett (HHS/OASH) ; Bonds, Michelle E. (CDC/OD/OADC) Subject: Re: Social monitoring - testing AMEHICAN PVERSIGHT HHS-20-0580-B-000482 Sent from my iPhone On Mar 10, 2020, at 7:37 PM , Murphy , Ryan (OS/ASPA) w rote: On Mar 10, 2020, at 6:34 PM, Pratt, Michael (OS/ASPA) w rote: ? https ://twitter. com /ja keta p per/ stat us/ 123 750045 22 22 222 33 6 Jake Tapper @jaketapper Washington firefighters who responded to nursing home face longer quarantine as bottlenecks delay testing: https ://t.co/tmgYJ3 i jbv?a mp= 1 https ://twitter. com/ja keta pper /status/123 748977711867 4944 Jake Tapper @jaketapper CNN's @Omar Jimenez reports that a spokesman for Life Care Center in Kirkland WA says the nursing facility has finally begun testing employees after what many considered a long delay. Test results are not yet available for 30 employees who were tested off site. 1/ https://twitter.com/NitzaSoledad/status/1237502741968191490 Nitza Soledad Perez @N itzaSoledad While Germany has drive -in testing facilities, ppl in the US struggle to get screened for coronavirus. Health and Human Services D @SecAzar D just said to the public that there is a surplus of tests. The misinformation from the White House continues. #COVID19 #coronavirus https ://twitter .com/ma rkkn o Iler/status/ 123 7502685 839945 728 Mark Knoller @markknoller Though millions of Coronavirus tests are being produced, @SecAzar says persons who want to be tested need to go through their doctor or hospital AMERICAN PVERSIGHT HHS-20-0580-B-000483 and cannot just demand a test. Stresses persons should call their doctor and ask to be considered for a Coronavirus test. https://twitter.com/chrislhayes/status/1237502187762257931 Chris Hayes @chrislhayes Hey doctors: as @SecAzar says there's actually a "surplus" of tests available, I'm curious if this your experience at point of care as of today, March 10th. https://twitter.com/laallergydoc/status/1237503671534927872 Marc Meth, MD @chrislhayes The answer is no. I've tried to get swabs to actually perform the testing if needed to give to Quest or Labcorp and there are NONE available. https ://twitter. com/rcbutte rl/statu s/ 123 7502598 791512065 RB @rcbutterl No! I cant keep hearing these answers. I'm a primary care doctor in Albany, NY. There are no tests unless a patient meets strict criteria which DO NOT include travel to Seattle, Westchester or California! https://twitter.com/MORDEllO/status/1237503914703904768 MORDEl @MORDEll0 Untrue. Sick patients must meet a critical 3+ level to be tested in California . https ://twitter. com/Mo IlyJongFast/ statu s/12 37502 769495506946 Molly Jong-Fast @MollyJongFast "there are millions oftests out there now," say @SecAzar but this doesn't sound right Michael J. Pratt Director, Strategic Communications &Campaigns Office of the Assistant Secretary for Public Affairs U.S. Department of Health and Human Services m ichael. pratt@hhs.gov Im) 202.690.7471 Irb) (6 ) Sender: Giroir, Brett (HHS/OASH) Lenihan, Keagan ; Murphy, Ryan (O5/ASPA) ; Pratt, Michael (O5/ASPA) ; AMERICAN PVERSIGHT HHS-20-0580-B-000484 ASPA-Deputies ; Bonds, Michelle E. (CDC/OD/OADC) Sent Date: 2020/03/10 20:28:00 Delivered Date: 2020/03/10 20:27:00 AMERICAN PVERSIGHT HHS-20-0580-B-000485 Giroir, Brett (HHS/OASH) To: Campbell, Taylor (O5/OASH) Haddad, carla (HHS/OASH); Kellogg, Rachel (HHS/OASH); Valentine, Steven (HHS/OASH); CC: Wainwright, Jacob (HHS/OASH/IO) ; Heck, Mia (HHS/OASH); Broida, Tara (HHS/OASH) Subject: RE: **FOR REVIEWBY 4:00 PM** POTUSLetter on Coronavirusfor use by Presidential Correspondence Date: 2020/03/11 13:57:00 Priority: Normal Type: Note Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Campbell, Taylor (OS/OASH) Sent: Wednesday, March 11, 2020 10:39 AM To: Giroir, Brett (HHS/OASH) Cc: Haddad, Carla (HHS/OASH) ; Kellogg, Rachel (HHS/OASH) ; Valentine, Steven (HHS/OASH) ; Wainwright, Jacob (HHS/OASH/1O) ; Heck, Mia (HHS/OASH) ; Broida, Tara (HHS/OASH) ; Campbell, Taylor (OS/OASH) Subject: **FOR REVIEW BY 4:00 PM** POTUSLetter on Coronavirus for use by Presidential Correspondence Importance: High AMERICAN PVERSIGHT HHS-20-0580-B-000486 Thank you, Taylor From: Puesan, Cesar (HHS/OS/IOS) Sent : Wednesday, March 11, 2020 10:03 AM To: Shuy, Bryan (OS/ASPR/1O); ASPR Exec Sec (OS/ASPR) ; OASHIO Control Desk (OS/OASH) <0ASHl0Contro1Desk@hhs.gov >; Adams, Jerome (HHS/OASH) ; rcc@cdc.gov ; Cashman, Sandra (CDC/OD/OCS) ; Toye, Sally (CDC/OD/OCS) ; Pollock, Rachel (NIH/OD) [E] ; Varnado, Martina (FDA/OC) ; Amin, Stacy (FDA/OC) Cc: Harrison, Brian (HHS/IOS) ; Stecker, Judy (OS/IOS) ; Bird, Catherine (OS/OGC) ; Agnew, Ann (HHS/IOS) ; Brennan, Patrick (OS/ASPA) ; Foster, Timothy (OS/ ASPA) Subject: POTUS Letter on Coronavirus for use by Presidential Correspondence Importance: High (b)(5) Thanks Sender: Giroir, Brett (HHS/OASH) Campbell, Taylor (OS/OASH) ; Haddad, Carla ( HHS/OASH) ; Kellogg, Rachel (HHS/OASH) ; Valentine, Steven (HHS/OASH) ; Wainwright, Jacob (HHS/OASH/IO) ; Heck, Mia (HHS/OASH) ; Broido, Tara (HHS/OASH) Sent Date: 2020/03/11 13:57:48 Delivered Date: 2020/03/11 13:57:00 AMERICAN PVERSIGHT HHS-20-0580-B-000487 Giroir, Brett (HHS/OASH) To: Brooks, John T. (CDC/DDID/NCHHSTP/DHPSE) Jernigan, Daniel B. (CDC/DDID/NCIRD/ID); Schuchat, Anne MD (CDC/OD) ; Meaney Delman, Dana M. (CDC/DDNID/NCBDDD/DBDID) Subject: RE: Guidancefor Termination of Isolation PrecautionsCOVID-19- DecisionMemo CONTAINMENT _3_8_2020_JB_DMD Date: 2020/03/09 16:52:00 Priority: Normal Type: Note b)(5) Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Brooks, John T. (CDC/DDID/NCHHSTP/DHPSE) Sent: Monday, March 9, 2020 3:48 PM To: Giroir, Brett (HHS/OASH) Subject: RE: Guidance for Termination of Isolation Precautions COVID-19 - Decision Memo CONTAINMENT- 3- 8- 2020 - JB- DMD voila From: Giroir, Brett (HHS/OASH) Sent: Monday, March 9, 2020 3:12 PM To: Brooks, John T. (CDC/DDID/NCHHSTP/DHPSE) AMERICAN PVERSIGHT HHS-20-0580-B-000488 Subject: RE: Guidance for Termination of Isolation Precautions COVID-19 - Decision Memo CONTAINMENT_ 3_8_2020_JB_ DMD (b)(5) Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Brooks, John T. (CDC/DDID/NCHHSTP/DHPSE) Sent: Monday, March 9, 2020 2:59 PM To: Giroir, Brett (HHS/OASH) Subject: RE: Guidance for Termination of Isolation Precautions COVID-19 - Decision Memo CONTAINMENT_ 3_8_2020_JB_ DMD Calling in a moment From: Gir oir, Brett (HHS/OASH) Sent: Monday, March 9, 2020 2:07 PM To: Brooks, John T. (CDC/DDID/NCHHSTP/DHPSE); Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) Cc: Berger, Sherri (CDC/OCOO/OD) ; Schuchat, Anne MD (CDC/OD) ; Meaney Delman, Dana M. (CDC/DDNID/NCBDDD/DBDID) Subject: RE: Guidance for Termination of Isolation Precautions COVID-19 - Decision Memo CONTAINMENT_ 3_8_2020_JB_ DMD Sure I am on 12 in Mitch Wolff office My mobile isl(b_ ..... l(_6 l____ _, Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Brooks, John T. (CDC/DDID/NCHHSTP/DHPSE) Sent: Monday, March 9, 2020 2:05 PM To: Giroir, Brett (HHS/OASH) ; Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) AMERICAN PVERSIGHT HHS-20-0580-B-000489 Cc: Berger, Sherri (CDC/OCOO/OD) ; Schuchat, Anne MD (CDC/OD) ; Meaney Delman, Dana M. (CDC/DDNID/NCBDDD/DBDID) ; Giroir, Brett (HHS/OASH) Subject: Re: Guidance for Termination of Isolation Precautions COVID-19 - Decision Memo CONTAINMENT_ 3_8_ 2020_JB_ DMD Doh! Apologies. Will get back shortly. Best ifl call you. John T. Brooks, MD - Chief Medical Officer CDC , Division of HIV/AIDS Prevention 1600 Clifton Road NE, Mailstop D-21 Atlanta, GA. 30319 404-639-3894 From: Giroir, Brett (HHS/OASH) Sent: Monday, March 9, 2020 1:56:47 PM To: Brooks, John T. (CDC/DDID/NCHHSTP/DHPSE) ; Jernigan, Daniel B. (CDC/DDID/N ClRD/ID) Cc: Berger, Sherri (CDC/OCOO/OD) ; Schuchat, Anne MD (CDC/OD) ; Meaney Delman, Dana M. (CDC/DDNID/NCBDDD/DBDID) ; Giroir, Brett (HHS/OASH) Subject: RE: Guidance for Termination of Isolation Precautions COVID-19 - Decision Memo CONTAINMENT- 3- 8- 2020 - JB- DMD THANK YOU. b)(5) I am here on 12 and able to chat in person or by phone BG Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) AMERICAN PVERSIGHT HHS-20-0580-B-000490 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Brooks, John T.(CDC/DDID/NCHHSTP/DHPSE)< zud4@cdc.gov > Sent: Monday, March 9, 2020 1:38 PM To: Giroir, Brett {HHS/OASH) ; Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) Cc: Berger, Sherri (CDC/OCOO/OD) ; Schuchat, Anne MD (CDC/OD) ; Meaney Delman, Dana M. {CDC/DDNID/NCBDDD/DBDID) Subject: RE: Guidance for Terminat ion of Isolation Precautions COVID-19 - Decision Memo CONTAINMENT- 3- 8- 2020 - JB- DMD Available when you are ADM to discuss. Am offline for about 45 minutes then back. b)(5) From: Giroir, Brett (HHS/OASH) < Brett.Giroir@hhs.gov > Sent: Monday, March 9, 2020 9:29 AM AMERICAN PVERSIGHT HHS-20-0580-B-000491 To: Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) Cc: Berger, Sherri (CDC/OCOO/OD) ; Schuchat, Anne MD (CDC/OD) ; Meaney Delman, Dana M. (CDC/DDNID/NCBDDD/DBDID) ; Brooks, John T. (CDC/DDID/NCHHSTP/DHPSE) Subject: RE: Guidance for Termination of Isolation Precautions COVID-19 - Decision Memo CONTAINMENT_ 3_8_2020_JB_DMD (b)(5) Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) Sent: Monday, March 9, 2020 8:48 AM To: Giroir, Brett (HHS/OASH) Cc: Berger, Sherri (CDC/OCOO/OD) ; Schuchat, Anne MD (CDC/OD) ; Meaney Delman, Dana M . (CDC/DDNID/NCBDDD/DBDID) ; Brooks, John T. (CDC/DDID/NCHHSTP/DHPSE) Subject: Guidance for Termination of Isolation Precautions COVID-19 - Decision Memo CONTAINMENT- 3- 8- 2020 - JB- DMD ADM Giroir: Dan. Sender: Giroir, Brett (HHS/OASH) ( FYDIBOHF23SPDL T)/CN=RECIPIENTS/CN Brooks,John T. (CDC/DDID/NCHHSTP/DHPSE) ; Jernigan, Daniel B. (CDC/DDID/NCIRD/ID); T)/ en=Recipients/cn=eaSle 17a084644918dbee2d9b4db2a0f Schuchat,Anne MD (CDC/OD); MeaneyDelman, Dana M. (CDC/DDNID/NCBDDD/DBDID) Sent Date: 2020/03/09 16:52:44 AMERICAN PVERSIGHT HHS-20-0580-B-000492 Delivered 16:52:00 Giroir, Brett (HHS/OASH) Brooks, John T. (CDC/DDID/NCHHSTP/DHPSE) ; Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) Meaney Delman, Dana M. (CDC/DDNID/NCBDDD/DBDID) ; Armstrong, Gregory (CDC/DDID/NCEZID/OD) ; Schuchat, Anne MD (CDC/OD) ; Berger, Sherri (CDC/OCOO/OD) Subject: RE: Guidance for Term ination of Iso lat ion Precautions COVID-19 - Decision Memo CONTAINMENT_3_8_2020_JB_DMD Date: 2020/03/09 17:00:00 Priority: Normal Type: Note (b)(5) Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Brooks, John T.(CDC/DDID/NCHHSTP/DHPSE) Sent: Monday, March 9, 2020 3:41 PM To: Giroir, Brett (HHS/OASH) ; Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) AM[ HICAN PVERSIGHT HHS-20-0580-B-000494 Cc: Meaney Delman, Dana M. (CDC/DDNID/NCBDDD/DBDID) ; Armstrong, Gregory (CDC/DDID/NCEZID/OD) ; Schuchat, Anne MD (CDC/OD) ; Berger, Sherri (CDC/OCOO/OD) Subject: RE: Guidance for Termination of Isolation Precautions COVID-19 - Decision Memo CONTAINMENT_ 3_8_ 2020_JB_ DMD (b)(5) AMERICAN PVERSIGHT HHS-20-0580-B-000495 John T. Brooks, MD - Chief Medical Officer CDC Division of HIV/AIDS Prevention 1600 Clifton Road NE, Mailstop D-21 Atlanta, GA 30333 Desk: 404-639-3894 Cell:rb )(6) I Email: zud4@cdc.gov AMERICAN PVERSIGHT HHS-20-0580-B-000496 From: Giroir, Brett (HHS/OASH) Sent: Monday, March 9, 2020 2:07 PM To : Brooks, John T. (CDC/DDID/NCHHSTP/DHPSE) ; Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) Cc: Berger, Sherri (CDC/OCOO/OD) ; Schuchat, Anne MD (CDC/OD) ; Meaney Delman, Dana M. (CDC/DDNID/NCBDDD/DBDID) Subject : RE: Guidance for Termination of Isolation Precautions COVID-19 - Decision Memo CONTAINMENT_3_8_2020_JB_DMD Sure I am on 12 in Mitch Wolff office My mobile i~~(b_)(6_l ____ ~ Brett P. Giroir, MD AMERICAN PVERSIGHT HHS-20-0580-B-000497 ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Brooks, John T.(CDC/DDID/NCHHSTP/DHPSE)< zud4@cdc.gov > Sent: Monday, March 9, 2020 2:05 PM To: Giroir, Brett (HHS/OASH) ; Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) Cc: Berger, Sherri (CDC/OCOO/OD) ; Schuchat, Anne MD (CDC/OD) ; Meaney Delman, Dana M. {CDC/DDNID/NCBDDD/DBDID) ; Giroir, Brett {HHS/OASH) Subject: Re: Guidance for Termination of Isolation Precautions COVID-19 - Decision Memo CONTAINMENT- 3- 8- 2020 - JB- DMD Doh! Apologies. Will get back shortly. Best ifl call you. John T. Brooks, J\ID - Chief Medical Officer CDC, Division of HIV/AIDS Prevention 1600 Clifton Road NE, Mailstop D-21 Atlanta, GA. 30319 404-639-3894 From: Giroir, Brett (HHS/OASH) Sent: Monday, March 9, 2020 1:56:47 PM To: Brooks, John T. (CDC/DDID/NCHHSTP/DHPSE); Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) Cc: Berger, Sherri (CDC/OCOO/OD) ; Schuchat, Anne MD (CDC/OD) ; Meaney Delman, Dana M. (CDC/DDNID/NCBDDD/DBDID) ; Giroir, Brett (HHS/OASH) Subject: RE: Guidance for Termination of Isolation Precautions COVID-19 - Decision Memo CONTAINMENT_3_8_2020_JB_DMD THANK YOU. b)(5) AMf=n1vAN PVERSIGHT HHS-20-0580-B-000498 I am here on 12 and able to chat in person or by phone BG Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Brooks, John T. (CDC/DDID/NCHHSTP/DHPSE) Sent: Monday, March 9, 2020 1:38 PM To: Giroir, Brett (HHS/OASH) ; Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) Cc: Berger, Sherri (CDC/OCOO/OD) ; Schuchat, Anne MD (CDC/OD) ; Meaney Delman, Dana M. (CDC/DDNID/NCBDDD/DBDID) Subject: RE: Guidance for Termination of Isolation Precautions COVID-19 - Decision Memo CONTAINMENT_ 3_8_2020_JB_ DMD Available when you are ADM to discuss.Am offline for about 45 minutes then back. b)(5) AM[ HICAN PVERSIGHT HHS-20-0580-B-000499 (b)(5) From: Giroir, Brett (HHS/OASH) < Brett.Giroir@hhs.gov > Sent: Monday, March 9, 2020 9:29 AM To: Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) Cc: Berger, Sherri (CDC/OCOO/OD) ; Schuchat, Anne MD (CDC/OD) ; Meaney Delman, Dana M. (CDC/DDNID/NCBDDD/DBDID) ; Brooks, John T. (CDC/DDID/NCHHSTP/DHPSE) Subject: RE: Guidance for Terminat ion of Isolation Precautions COVID-19 - Decision Memo CONTAINMENT_ 3_8_ 2020_JB_ DMD (b)(5) Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) Sent: Monday, March 9, 2020 8:48 AM To: Giroir, Brett (HHS/OASH) Cc: Berger, Sherri (CDC/OCOO/OD) ; Schuchat, Anne MD (CDC/OD) ; Meaney Delman, Dana M. (CDC/DDNID/NCBDDD/DBDID) ; Brooks, John T. (CDC/DDID/NCHHSTP/DHPSE) Subject: Guidance for Termination of Isolat ion Precaut ions COVID-19 - Decision Memo CONTAINMENT- 3- 8- 2020 - JB- DMD ADM Giroir : b)(5) AM[ HICAN PVERSIGHT HHS-20-0580-B-000500 b)(5) Dan. Sender: Giroir, Brett (HHS/OASH) Brooks, John T. (CDC/DDID/NCHHSTP/DHPSE) ; Jernigan, Daniel B. (CDC/DDID/NCIRD/ID); Meaney Delman, Dana M. (CDC/DDNID/NCBDDD/DBDID); Recipient: Armstrong, Gregory (CDC/DDID/NCEZID/OD); Schuchat, Anne MD (CDC/OD) ; Berger, Sherri (CDC/OCOO/OD) Sent Date: 2020/03/09 17:00:43 Delivered Date: 2020/03/09 17:00:00 AMERICAN PVERSIGHT HHS-20-0580-B-000501 Giroir, Brett (HHS/OASH) Stenzel, Timothy ; To: Sauer, Robert Tomasello, Jennifer (FDA/CDRH); CC: Kellogg, Rachel (HHS/OASH) Subject : RE: Test numbers for congressional letter Date : 2020/03/13 12:04:00 Prior ity : Normal Type : Note (b)(5) AM[ HICAN PVERSIGHT HHS-20-0580-B-000502 Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Stenzel, Timothy Sent: Friday, March 13, 2020 11:57 AM To: Sauer, Robert Cc: Tomasello, Jennifer (FDA/CDRH) ; Giroir , Brett (HHS/OASH) Subject: RE:Test numbers for congressiona l letter Admira l, See attached letter and latest numbers I am sharing w ith t his team . Best , Tim Timothy T. Stenzel, MD, PhD Director, OHT?: Office of In Vitro Diagnostics and Radiological Health Office of Product Evaluation and Quality Center for Devices and Radiological Health U.S. Food and Drug Administration Timothy.Stenzel@fda.hhs.gov Jennifer Campbell Administrative Assistant OHT7: Office of In Vitro Diag nos ti cs an d Radi ological Health Office of Produc t Evalua tion and Quality CDRH I Food and Drug Administrat ion W hit e Oak, Bldg. 66 3403 I 10903 New Hampshire Aven ue I Silver Spr ing, MD 20993 Ph : 301 -796 -7692 ]ennifer.Campbell@fda.hhs.gov Excellent customer service is important to us. Please take a moment to provide feedback regarding the customer service you have received: htlps://www .research .net/s/cdrhcustomerservice?ID=1900&S=E From: Sauer, Robert Sent: Friday, Ma rch 13, 2020 11:53 AM To: Stenzel, Timothy Cc: Tomasello, Jennifer Subject: Test numbers for congressiona l letter Tim, AMERICAN PVERSIGHT HHS-20-0580-B-000503 b)(5) Thanks, Rob Robert Sauer Deputy Director DPOM: Division of Program Operations and Management I OHT7: Office of In Vitro Diagnostics and Radiological Health CDRH I Food and Drug Administration White Oak, Bldg. 66 Rm 3434 I 10903 New Hampshire Avenue I Silver Spring, MD 20993 Tel: 301-796-3580 Robert.A.Sauer@fda .hhs.gov Excellent customer service is important to us. Please take a moment to provide feedback regarding the customer service you have received : https ://www.research.net/s/cdrhcustomerservice?ID=1960&S=E. Sender: Giroir, Brett (HHS/OASH) Stenzel, Timothy ; Sauer, Robert ; Tomase llo, Jennifer (FDA/CDRH) ; Kellogg, Rachel (HHS/OASH) Sent Date: 2020/03/13 12:04:06 Delivere d Date: 2020/03/13 12:04:00 AMERICAN PVERSIGHT HHS-20-0580-B-000504 Giroir, Brett (HHS/OASH) OS HHSPress (HHS/ASPA) ; OS - ASPA - Clearance ; OS OGC-IO ControlDesk (HHS/OS/OGC) ; Stecker, Judy (O5/IOS) ; Murphy, Ryan (OS/ASPA) ; Caliguiri, Laura (FDA/QC) ; Steele, Danielle (HHS/IOS) ; White, Caroline (HHS/OGC) ; Stimson, Brian (HHS/OGC) ; Charrow, Robert (HHS/OGC) ; Keveney, Sean (HHS/OGC) ; Chang, William (HHS/OGC) ; Barry, Daniel J (HHS/OGC) ; Amin, Stacy (FDA/QC) ; ASPRCOMMS; To: ASPRMEDIA (OS/ASPR/COO) ; Routh, Jennifer (NIH/NIAID) [ E] ; Conrad, Patricia (NIH/NIAID) [ E] ; Administrative Group Billet, Courtney (NIH/NIAID)[ E] ; Wojtowicz, Emma (NIH/OD) [E] ; Akinso, Woleola (NIH/OD) [E] ; Fine, Amanda (NIH/OD) [El ; Fritz, Craig (NIH/OD) [El ; Myles, Renate (NIH/OD) ( E] ; Broido, Tara (HHS/OASH) ; Channer, Amber (OS/OASH) ; Heck, Mia (HHS/OASH) ; Kotwicki, Lauren (HHS/OASH) ; Migliaccio-Grabill, Kate (HHS/OASH) ; Sherman, Jennifer (HHS/OASH) ; AMERICAN PVERSIGHT HHS-20-0580-B-000505 Bonds, Michelle E. (CDC/OD/OADC); Galatas, Kate (CDC/OD/OADC); Heldman, Amy B. (CDC/OD/OADC); Patrick, Kera (CDC/OD/OADC); CDCOADCASPAClearance<0ADCASPAC1earance@cdc.gov> Caccamo,Stephanie (FDA/OC) ; CC: 2019-nCoVFDA IMG JIC <2019-nCoVFDAIMGJIC@fda.hhs.gov>; OCOEAOMA-Press (FDA) Subject: RE: CLEARANCE_0248: CDC"CoronavirusDisease2019 (COVID-19) Update: Diagnostic test supplies" Date: 2020/03/11 15:26:00 Priority: Normal Type: Note Concur and AWESOME Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: OS HHSPress (HHS/ASPA) Sent: Wednesday, March 11, 2020 3:13 PM To: OS - ASPA- Clearance ; OS OGC-10 ControlDesk (HHS/05/0GC) ; Stecker, Judy (05/105) ; Murphy, Ryan (05/ASPA) ; Caliguiri, Laura (FDA/OC) ; Giroir, Brett (HHS/OASH) ; Steele, Danielle (HHS/105) ; White, Caroline (HHS/OGC) ; Stimson, Brian (HHS/OGC) ; Charrow, Robert (HHS/OGC) ; Keveney, Sean (HHS/OGC) ; Chang, William (HHS/OGC) ; Barry, Daniel J (HHS/OGC) ; Amin, Stacy (FDA/OC) ; ASPRCOMMS; ASPRMEDIA (05/ASPR/COO) ; Routh, Jennifer (NIH/NIAID) [El ; Conrad, Patricia (NIH/NIAID) [El ; Billet, Courtney (NIH/NIAID) [El ; (NIH/OD) [El ; Wojtowicz, Emma Akinso, Woleola (NIH/OD) [El ; Fine, Amanda (NIH/OD) [El ; Fritz, Craig (NIH/OD) [El ; Myles, AMERICAN PVERSIGHT HHS-20-0580-B-000506 Renate (NIH/OD) [El ; Broida, Tara (HHS/OASH) ; Channer, Amber (OS/OASH) ; Heck, Mia (HHS/OASH) ; Kotwicki, Lauren (HHS/OASH) ; Migliaccio-Grabill, Kate (HHS/OASH) ; Sherman, Jennifer (HHS/OASH) ; Bonds, Michelle E. (CDC/OD/OADC) ; Galatas, Kate (CDC/OD/OADC) ; Heldman, Amy B. (CDC/OD/OADC) ; Patrick, Kera (CDC/OD/OADC) ; CDC OADC ASPA Clearance <0ADCASPAC1earance@cdc.gov> Cc: OS HHSPress (HHS/ASPA) ; Caccamo, Stephanie (FDA/QC) ; 2019-nCoV FDA IMG JIC <2019-nCoVFDAIMGJIC@fda .hhs.gov>; OCOEAOMA-Press (FDA) Subject: CLEARANCE_0248: CDC "Coronavirus Disease 2019 (COVID-19) Update: Diagnostic test supplies" Impor tance: High CLOSE-HOLD/ URGENT Agency /Office: CDC Subject: Coronavirus Disease 2019 (COVJD-19) Update: Diagnostic test supplies 5 Materials: .... ~b_ H_)_________________ ___, Deadline for comments: Before 4:30 p.m. today, Wednesday, March 11 Planned release date: Wednesday, March 11 Driving event: Global coronavirus 2019 outbreak; authorization V/r, Mike Robinson Strategic Planning, ASPA 202-690-6885 - desk ~b)(5) I-mobile INTERNAL HHS USE ONLY! INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BYLAW: AMERICAN PVERSIGHT HHS-20-0580-B-000507 This information has not been publically disclosed and may be privileged and confidential. This document must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the full extent of the law. Sender: Giroir, Brett (HHS/OASH) OS HHSPress (HHS/ASPA) ; OS - ASPA - Clearance ; OS OGC-IO ControlDesk (HHS/OS/OGC) ; Stecker, Judy (OS/IOS) ; Murphy, Ryan (OS/ASPA) ; Caliguiri, Laura (FDA/OC) ; Steele, Danielle (HHS/IOS) ; White, caroline (HHS/OGC) ; Stimson, Brian (HHS/OGC) ; Charrow, Robert (HHS/OGC) ; Keveney, Sean (HHS/OGC) ; Chang, William (HHS/OGC) ; Barry, Daniel J (HHS/OGC) ; Amin, Stacy ( FDA/ OC) ; Recipient: ASPRCOMMS; ASPRMEDIA (OS/ASPR/COO) ; Routh, Jennifer (NIH/NIAID) [E] ; Conrad, Patricia (NIH/NIAID)[ E] ; Billet, Courtney (NIH/NIAID)(E] ; Wojtowicz, Emma ( NIH/OD) [El ; Akinso, Woleola (NIH/OD) [E] ; Fine, Amanda (NIH/OD) [El ; Fritz, Craig (NIH/OD) (E] ; Myles, Renate (NIH/OD) ( E] ; Broido, Tara (HHS/OASH) ; Channer, Amber (OS/OASH) ; Heck, Mia (HHS/OASH) ; Kotwicki, Lauren (HHS/OASH) ; AMERICAN PVERSIGHT HHS-20-0580-B-000508 Migliaccio-Grabill, Kate (HHS/OASH) ; Sherman, Jennifer (HHS/OASH) ; Bonds, Michelle E. (CDC/OD/OADC) ; Galatas, Kate (CDC/OD/OADC) ; Heldman, Amy B. (CDC/OD/OADC) ; Patrick, Kera (CDC/OD/OADC) ; CDC OADC ASPA Clearance <0ADCASPAC1earance@cdc.gov>; Caccamo, Stephanie (FDA/OC) ; 2019-nCoV FDA IMG JIC <2019-nCoVFDAIMGJIC@fda.hhs.gov>; OCOEAOMA-Press (FDA) Sent Date: 2020/03/11 15:26:03 Delivered Date: 2020/03/11 15:26:00 AMERICAN PVERSIGHT HHS-20-0580-B-000509 Giroir, Brett (HHS/OASH) Orsega, Susan (OS/OASH); Trent-Adams, Sylvia (HHS/OASH); To: Adams, Jerome (HHS/OASH); (FYDIBOHF23SPDL T)/cn =Recipients/cn=184fe51f7350400b8a99dabd6Sac0db5-Adams, Schwartz, Erica (HHS/OASH) Migliaccio-Grabill, Kate (HHS/OASH); Valentine, Steven (HHS/OASH); Haddad, Carla (HHS/OASH) Subject: RE: 10 MAR2020 COVID-19 Mission Date: 2020/03/10 21:16:00 Priority: Normal Type: Note Thank you I think I am off calls, so if you want to catch up, let me know Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Orsega, Susan (OS/OASH) Sent: Tuesday, March 10, 2020 9:16 PM To: Giroir, Brett (HHS/OASH) ; Trent-Adams, Sylvia (HHS/OASH) ; Adams, Jerome (HHS/OASH) ; Schwartz, Erica (HHS/OASH) Cc: Migliaccio -Grabill, Kate (HHS/OASH) ; Valentine, Steven (HHS/OASH) ; Haddad, Carla (HHS/OASH) Subject: 10 MAR 2020 COVID-19 Mission << File: COVID-19 Outbreak Mission Update. 10MAR2020 (003).pptx >> Dear Sirs and Ma'ams AMERICAN PVERSIGHT HHS-20-0580-B-000510 As of 10 March 2020, a total of 826 Corps Officers are deployed CCHQ a total of 479 officers have deployed; 158 officers are currently deployed; 6 officers rostered for upcoming deployments INTRAGENCY:CDC: 178 officers (145 are currently deployed & 33 have completed their deployment) ASPR: 39 Officers currently deployed NIH: 13 officers (data from 3/1/2020) ROB cont inues to staff ASPRTask Orders as they are received; 2 14-person HMTFs deployed in addition to IMT support for nursing facility in Kirkland, WA Medical clearance and fit testing scheduled for 07Mar2020 postponed until 13 Mar2020 pending supplies Regards, Susan M . Orsega Rear Admiral, Commissioned Corps Headquarters Director United States Public Health Service Office of the Surgeon General /US Department of Health and Human Services 240 -453 -6080 Email: susan.orsega@hhs.gov Giroir, Brett (HHS/OASH) Orsega, Susan (OS/OASH) ; Trent-Adams, Sylvia (HHS/OASH) ; Adams, Jerome (HHS/OASH) ; Schwartz, Erica (HHS/OASH) ; Migliaccio-Grab ill, Kate (HHS/OASH) ; Valentine, Steven (HHS/OASH) ; Haddad, Carla (HHS/OASH) Sent Date: 2020/03/10 21 :16:35 Delivered Date: 2020/03/10 21:16:00 AMERICAN PVERSIGHT HHS-20-0580-B-000511 Giroir, Brett (HHS/OASH) To: Phillips, Sally (OS/ASPR/SPPR) CC: Shuy, Bryan (OS/ASPR/IO) Subject: HRSAand IHS Date: 2020/03/10 09:41:00 Priority: Normal Type: Note Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 Giroir, Brett (HHS/OASH) Phillips, Sally (OS/ASPR/SPPR); Recipient: Shuy, Bryan (OS/ASPR/IO) Sent Date: 2020/03/10 09:41:45 Delivered Date: 2020/03/10 09:41:00 AMERICAN PVERSIGHT HHS-20-0580-B-000512 Giroir, Brett (HHS/OASH) Kane, EIieen (O5/ASPR/OEA); Murphy, Ryan (O5/ASPA) ; Stecker, Judy (O5/IOS) ; Broido, Tara (HHS/OASH); Migliaccio-Grabill,Kate (HHS/OASH) Galatas, Kate (CDC/OD/OADC); Bonds, Michelle E. (CDC/OD/OADC); CDCI MSJIC Media -2 ; CC: Michael, Gretchen (O5/ASPR/OEA); Waters, Cicely (O5/ASPR/OEA); Hall, Bill (HHS/ASPA) Subject: RE: nCoV- ASPR- Washington Post on quarantining Lacklandevacuees Date: 2020/03/09 18:03:00 Priority: Normal Type: Note b)(5) Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Kane, EIieen (O5/ASPR/OEA) Se nt: Monday, March 9, 2020 5:37 PM To : Murphy, Ryan (O5/ASPA) ; Stecker, Judy (05/105) ; Broida, Tara (HHS/OASH) ; Migliaccio-Grabill, Kate (HHS/OASH) ; Giroir, Brett (HHS/OASH) Cc: Galatas, Kate (CDC/OD/OADC) ; Bonds, Michelle E. (CDC/OD/OADC) ; CDC IMS JIC Media -2 ; Michael, Gretchen (O5/ASPR/OEA) ; Waters, Cicely (OS/ASPR/OEA) ; Hall, Bill AMERICAN PVERSIGHT HHS-20-0580-B-000513 (HHS/ASPA) Subject: RE: nCoV - ASPR - Washington Post on quarantining Lackland evacuees (b)(5) From: Murphy, Ryan (OS/ASPA) Sent: Monday, March 9, 2020 5:14 PM To: Kane, EIieen (OS/ASPR/OEA) ; Stecker, Judy (OS/IOS) ; Broido, Tara (HHS/OASH) ; Migliaccio -Grabill, Kate (HHS/OASH) Cc:Galatas, Kate (CDC/OD/OADC) ; Bonds, Michelle E. (CDC/OD/OADC) ; CDC IMS JIC Media -2 ; Michael, Gretchen (OS/ASPR/OEA) ; Waters, Cicely (OS/ASPR/OEA) ; Hall, Bill (HHS/ASPA) Subject: RE: nCoV - ASPR - Washington Post on quarantining Lackland evacuees Added you to the chain AMERICAN PVERSIGHT HHS-20-0580-B-000514 From: Kane, EIieen (OS/ASPR/OEA) Sent: Monday, March 9, 2020 4:57 PM To: Stecker, Judy (OS/1O5); Murphy, Ryan (O5/ASPA) ; Broida, Tara (HHS/OASH) ; Migliaccio -Grabill, Kate (HHS/OASH) Cc: Galatas, Kate (CDC/OD/OADC) ; Bonds, Michelle E. (CDC/OD/OADC) ; CDC IMS JIC Media -2 ; Michael, Gretchen (OS/ASPR/OEA) ; Waters, Cicely (OS/ASPR/OEA) ; Hall, Bill (HHS/ASPA) Subject: RE: nCoV - ASPR - Washington Post on quarantining Lackland evacuees From: Stecker, Judy (05/105) Sent: Monday, March 9, 2020 4:44 PM To: Murphy, Ryan (O5/ASPA) Cc: Kane, EIieen (OS/ASPR/OEA) ; Galatas, Kate (CDC/OD/OADC) ; Bonds, Michelle E. (CDC/OD/OADC) ; CDC IMS JIC Media -2 ; Michael, Gretchen (OS/ASPR/OEA) ; Waters, Cicely (OS/ASPR/OEA) ; Hall, Bill (HHS/ASPA) Subject: Re: nCoV-ASPR - Washington Post on quarantining Lackland evacuees Sent from my iPhone On Mar 9, 2020, at 4:34 PM, Murphy , Ryan (OS/ASP A) wrote: ? From: Kane, EIieen (OS/ASPR/OEA) Sent: Monday, March 9, 2020 4:17 PM To: Galatas, Kate (CDC/OD/OADC) ; Bonds, Michelle E. (CDC/OD/OADC) ; CDC IMS JIC Media -2 ; Stecker, Judy (OS/IOS) ; Murphy, Ryan (OS/ASPA) Cc: Michael, Gretchen (O5/ASPR/OEA) ; Waters, Cicely (OS/ASPR/OEA) ; Hall, Bill (HHS/ASPA) Subject: RE: nCoV - ASPR- Washington Post on quarantining Lackland evacuees Adding Judy and Ryan. AMERICAN PVERSIGHT HHS-20-0580-B-000515 (b)(5) Vr, EIieen From: Galatas, Kate (CDC/OD/OADC) Sent: Monday, March 9, 2020 3:53 PM To: Kane, EIieen (OS/ASPR/OEA) ; Bonds, Michelle E. (CDC/OD/OADC) ; CDC IMS JIC Media -2 Cc: Michael, Gretchen (OS/ASPR/OEA) ; Waters , Cicely (OS/ASPR/OEA) ; Hall, Bill (HHS/ASPA) Subject: RE: nCoV - ASPR- Washington Post on quarant ining Lackland evacuees (b)(5) Kate Galatas, MPH Deputy Associate Director for Communication Centers for Disease Control and Prevention Office: 404-639-2064 Cel I:l(b)(6) AMERICAN PVERSIGHT I HHS-20-0580-B-000516 Email: kkg2@cdc.gov From: Galatas, Kate (CDC/OD/OADC) Sent: Monday, March 9, 2020 3:16 PM To: Kane, EIieen (OS/ASPR/OEA) ; Bonds, Michelle E. (CDC/O0/OADC) ; CDC IMS JIC Media -2 Cc: Michael, Gretchen (OS/ASPR/OEA) ; Waters, Cicely (OS/ASPR/OEA) ; Hall, Bill (HHS/ASPA) Subject: RE: nCoV - ASPR- Wash ington Post on quarant ining Lackland evacuees Rest is fine. Kate Galatas, MPH Deputy Associate Director for Communication Centers for Disease Control and Prevention Office: 404-639-2064 CelI: fb )(6) Email: kkg2@cdc.gov I From: Kane, EIieen (OS/ASPR/OEA) Sent: Monday, March 9, 2020 3:10 PM To: Galatas, Kate (CDC/OD/OADC) ; Bonds, Michelle E. (CDC/OD/OADC) ; CDC IMS JIC Media -2 Cc: Michae l, Gretchen (OS/ASPR/OEA) ; Waters, Cicely (OS/ASPR/OEA) ; Hall, Bill (HHS/ASPA) Subject: RE: nCoV - ASPR- Washington Post on quarantining Lackland evacuees Thanks. Anything else? From: Galatas, Kate (CDC/OD/OADC) Sent: Monday, March 9, 2020 3:08 PM To: Kane, EIieen (OS/ASPR/OEA) ; Bonds, Michelle E. (CDC/OD/OADC) ; CDC IMS JIC Media -2 Cc: Michael, Gretchen (OS/ASPR/OEA) ; Waters , Cicely (OS/ASPR/OEA) ; Hall, Bill (HHS/ASPA) Subject: RE: nCoV - ASPR- Wash ington Post on quarant ining Lackland evacuees (b)(5) AMERICAN PVERSIGHT HHS-20-0580-B-000517 b)(5) Kate Galatas, MPH Deputy Associate Director for Communication Centers for Disease Control and Prevention Office: 404-639-2064 Cell:fb)(6) I Email: kkg2@cdc.gov AMERICAN PVERSIGHT HHS-20-0580-B-000518 From: Kane, EIieen (OS/ASPR/OEA) Sent: Monday, March 9, 2020 2:48 PM To: Bonds, Michelle E. (CDC/OD/OADC) ; Galatas, Kate (CDC/OD/OADC) ; CDC IMS JIC Media -2 Cc: Michael, Gretchen (OS/ASPR/OEA); Waters, Cicely (OS/ASPR/OEA); Hall, Bill (HHS/ASPA) Subject: nCoV - ASPR- Washington Post on quarantining Lackland evacuees (b)(5) Can you confirm ASPRis now in charge? Will ASPRcontinue to allow releasing quarantined people from Lackland to leave after 14 days and two sequential negative tests, for those that agree to be tested, even though San Antonio filed an unsuccessful emergency lawsuit asking that the number of tests be three and the quarantine period be extended to 28 days? And what will the protocol be for those who test positive at the base and must be treated at a hospital or go to a negative pressure room for 14 days if they're AMERICAN PVERSIGHT HHS-20-0580-B-000519 asymptomatic? Will they also be allowed to go after two sequential negative tests? Importantly, our story will also note that the UNMC protocol for positive COVID-19 patients is different; it's THREEsequential tests, not two. b)(5) From: Stecker, Judy (OS/1OS)<.ludy.Stecker@hhs.gov > Sent: Monday, March 9, 2020 1:21 PM To: Murphy, Ryan {OS/ASPA) Cc: Michael, Gretchen {OS/ASPR/OEA) ; Kane, EIieen (OS/ASPR/OEA) ; Waters, Cicely {OS/ASPR/OEA) ; Bonds, Michelle E. (CDC/OD/OADC) ; Galatas, Kate {CDC/OO/OADC) ; Trueman, Laura (HHS/I EA) AMERICAN PVERSIGHT HHS-20-0580-B-000520 ; Johnston, Darcie (HHS/I EA) ; Rigas, Laura (HHS/IEA) ; McKeogh, Katherine (OS/ASPA) ; Hall, Bill (HHS/ASPA) Subject : Re: PLEASEREAD FW: Washington Post reporter -- story on COVID-19 response on quarant ining Lackland patients that ASPR has now taken over. deadline urgent b)(5) Sent from my iPhone On Mar 9, 2020 , at 12:54 PM, Murp hy, Ryan (OS/ASPA) wrote : b)(5) -Ryan AMERICAN PVERSIGHT HHS-20-0580-B-000521 From: Thorman, Caroline (ACF) Sent: Monday, March 9, 2020 12:40 PM To: Murphy, Ryan (O5/ASPA) Subject: FW: Washington Post reporter -- story on COVID-19 response on quarantining Lackland patients that ASPRhas now taken over. deadline urgent Can you confirm ASPRis now in charge? Will ASPRcontinue to allow releasing quarantined people from Lackland to leave after 14 days and two sequential negative tests, for those that agree to be tested, even though San Antonio filed an unsuccessful emergency lawsuit asking that the number of tests be three and the quarantine period be extended to 28 days? And what will the protocol be for those who test positive at the base and must be treated at a hospital or go to a negative pressure room for 14 days if they're asymptomatic? Will they also be allowed to go after two sequential negative tests? Importantly, our story will also note that the UNMC protocol for positive COVID-19 patients is different; it's THREEsequential tests, not two. Many thanks, Caroline Thorman Director of Communications Administration for Children &Families (ACF) Health and Human Services (HHS) Desk: (202) 401-4777 Cell:KbH6 ) I From: Satija, Neena Sent: Sunday, March 8, 2020 6:03 PM To: Thorman, Caroline (ACF) Subject: Fw: Washington Post reporter -- story on COVID-19 response on quarantining Lackland patients that ASPRhas now taken over. deadline urgent Neena Satija Investigative Reporter Washington Post 202-334-7054 AMERICAN PVERSIGHT HHS-20-0580-B-000522 @neenareports From: Satija, Neena Sent: Sunday, March 8, 2020 3:51 PM To: gretchen.michael@hhs.gov ; elaine.kane@hhs.gov Subject: Washington Post reporter -- story on COVID-19 response on quarantining Lackland patients that ASPRhas now taken over. deadline urgent Dear Gretchen and Elaine, My name is Neena Satija and I'm a reporter for the Washington Post. I have been trying to get in touch with HHS on a story about coronavirus response when it comes to the Wuhan and Diamond Princess (and soon, Grand Princess) cohorts sent to Lackland Air Force Base, and I have had no luck with the CDC. So I'm going to you -- also because we have been told today that ASPRis now in charge of those quarantine ops instead of the CDC. Getting in touch with HHS in general for the past few weeks has been tough; in fact it took me several days simply to confirm, for instance, that OCEPHRwas involved in the repatriation effort ... and we really do want to be fair and accurate, so I'm really hoping you can help!! My colleague Arelis Hernandez and I have a story that may run tomorrow or the following day about the frustration among state and local officials in Texas, especially officials in San Antonio, regarding lack of communication from the administration on COVID-19 response, in particular, what to do with cohorts from Wuhan and the Diamond Princess (and, soon, the Grand Princess) cruise ship. We will report that state and local officials were assured that anyone sent to Lackland from Wuhan back on Feb. 1 would remain quarantined on base -- but instead, after the plane landed, San Antonio officials were immediately called upon not only to take the one woman who tested positive and had symptoms to a community hospital to be treated, but even to secure an ambulance to take her off Lackland. Essentially state and local officials were given no advanced warning that the DOD would now allow anyone who tested positive for COVID19 to stay on base, whether asymptomatic or not. It appears as though state and local authorities had the tools in place to plan for these issues quickly. But what happened raises serious questions about the administration's handling of this public health emergency, especially AMERICAN PVERSIGHT HHS-20-0580-B-000523 after the release of that patient from Wuhan before a positive test result came back. I have contacted CDC multiple times for comment on our story with no answer. Then I found out today that ASPR is now in charge of quarantining protocols going forward as opposed to CDC. It's all the more important we hear from you now that dozens more cruise ship passengers, this time from the Grand Princess cruise ship, are now headed to Lackland. The administration has assured folks that it will quarantine them at the base. But what about those who test positive? Can you confirm ASPRis now in charge? Will ASPRcontinue to allow releasing quarantined people from Lackland to leave after 14 days and two sequential negative tests, for those that agree to be tested, even though San Antonio filed an unsuccessful emergency lawsuit asking that the number of tests be three and the quarantine period be extended to 28 days? And what will the protocol be for those who test positive at the base and must be treated at a hospital or go to a negative pressure room for 14 days if they're asymptomatic? Will they also be allowed to go after two sequential negative tests? Importantly, our story will also note that the UNMC protocol for positive COVID-19 patients is different; it's THREEsequential tests, not two. I'm hoping you can help me confirm some of the basic details and perhaps provide any other comment. You can also reach me on my cell I atl (b)(6) Thanks! Neena Satija Investigative Reporter Washington Post 202-334-7054 @neenareports Sender: Giroir, Brett (HHS/OASH) Kane, EIieen (O5/ASPR/OEA); Recipient: Murphy, Ryan (O5/ASPA) ; Stecker, Judy (OS/IOS) ; Broido, Tara (HHS/OASH) ; Migliaccio-Grabill, Kate (HHS/OASH) ; Galatas, Kate (CDC/OD/OADC) ; Bonds, Michelle E. (CDC/OD/OADC) ; CDC IMS JIC Media -2 ; Michael, Gretchen (O5/ASPR/OEA) ; Waters, Cicely (O5/ASPR/OEA) ; Hall, Bill (HHS/ASPA) Sent Date: 2020/03/09 18:03:49 Delivered Date: 2020/03/09 18:03:00 AMERICAN PVERSIGHT HHS-20-0580-B-000525 Giroir, Brett (HHS/OASH) To: Brooks,John (CMS/QA) CC: Mango, Paul (HHS/105) Subject: RE: Developingof point-of-care test for COVID-19 Date: 2020/03/12 10:00:00 Priority: Normal Type: Note Thank you Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Brooks, John (CMS/OA) Sent: Thursday, March 12, 2020 9:59 AM To: Giroir, Brett (HHS/OASH) Cc: Mango, Paul (HHS/IO5) Subject: RE: Developing of point-of-care test for COVID-19 b)(5) From: Giroir, Brett (HHS/OASH) Sent: Thursday, March 12, 2020 9:53 AM To: Brooks, John (CMS/OA) Cc: Mango, Paul (HHS/IO5) Subject: RE: Developing of point-of-care test for COVID-19 (b)(5) Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) AMERICAN PVERSIGHT HHS-20-0580-B-000526 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Brooks, John (CMS/OA) Sent: Thursday, March 12, 2020 9:49 AM To: Giroir, Brett {HHS/OASH) Cc: Mango, Paul {HHS/IOS) Subject: FW: Developing of point-of-care test for COVID-19 Hi Brett, (b)(5) John From: Beck, Gary (OS/IEA) Sent: Wednesday, March 11, 2020 3:10 PM To: Dempsey, Donald A.< Donald.Dempsey@CVSHealth.com > Cc: Brooks, John (CMS/QA) Subject: RE: Developing of point-of-care test for COVID-19 Yes. That'll be great! Gary M. Beck Office of the Secretary I Intergovernmental and External Affairs U.S. Department of Health and Human Services From: Dempsey, Donald A.< Donald.Dempsey@CVSHealth.com > Sent: Wednesday, March 11, 2020 3:08 PM To: Beck, Gary (OS/IEA) AMERICAN PVERSIGHT HHS-20-0580-B-000527 Cc: Brooks, John {CMS/OA) Subject: RE: Developing of point -of-care test for COVID-19 Hi Gary, We are having a call with our chief CMO and Joe Grogan and some of the White House team tomorrow at 10:30am - would you be able to join that? I can forward the invite. Thanks, Don From: Beck, Gary {OS/IEA) [mailto:Gary.Beck@hhs.gov ) Sent: Tuesday, March 10, 2020 5:44 PM To: Dempsey, Donald A. Cc: Brooks, John (CMS/OA) Subject: [EXTERNAL]RE: Developing of point -of -care test for COVID-19 Hey Don - I'm actually very interested in speaking w ith them if they have time this week or next week . Gary M. Beck Office of the Secretary I Intergovernmental and ExternalAffairs U.S. Department of Health and Human Services From: Brooks, John (CMS/OA) Sent: Tuesday, March 10, 2020 10:07 AM To: Dempsey, Donald A.< Donald.Dempsey@CVSHealth.com >; Beck, Gary (OS/IEA) Subject: RE: Developing of point-of-care test for COVID-19 Thanks Don - we will share with the team. From: Dempsey, Donald A.< Donald.Dempsey@CVSHealth.com > Sent: Tuesday, March 10, 2020 9:46 AM To: Beck, Gary (OS/IEA) ; Brooks, John {CMS/OA) Subject: Develop ing of point-of-care test for COVID-19 Importance: High Hi Gary and John, I wanted to make you aware of this effort and if you can please make the Secretary aware (as well as anyone else at HHS you thinks needs to know). CVSHealth and Gates Foundation are investors in LumiraDx, which is a private company operated by executives with 30 years of experience in point of care testing. LumiraDx currently offers a variety of point-of-care tests on their new platform. In light of the COVID-19 pandemic, b)(4) (b)(4) AMERICAN PVERSIGHT HHS-20-0580-B-000528 You can see the attached presentation for more information. We are happy to set up a call if you have questions about this effort. Thanks, Don I Donald Dempsey Vice President , Policy and Regulatory Affairs p 202-772-3534 I c Kb)(6) f 202-772-3535 CVS Health 1275 Pennsylvania Avenue , NW, Suite 700, Washington , DC 20004 donald.dempsey@cvshealth.com I II CONFIDENTIALITY NOTICE: This communication and any attachments may contain confidential and/or privileged information for the use of the designated recipients named above. If you are not the intended recipient. you are hereby notified that you have received this communication in error and that any review, disclosure, dissemination, distribution or copying of it or its contents is prohibited. If you have received this communication in error, please notify the sender immediately by email or telephone and destroy all copies of this communication and any attachments. Sender: Giroir, Brett (HHS/OASH) ( FYDIBOHF23SPDL T)/CN=RECIPIENTS/CN Brooks,John (CMS/QA); ( FYDIBOHF23SPDL T)/cn =Recipients/en=3a5ec1419ddc4a43a9fb6 Recipient: Mango, Paul (HHS/IOS) (FYDIBOHF23SPDLT)/ en=Recipients/en= ld8863b643654blaad9a38c952af613e-Ma Sent Date: 2020/03/12 10:00:08 Delivered Date: 2020/03/12 10:00:00 AMERICAN PVERSIGHT HHS-20-0580-B-000529 Giroir, Brett (HHS/OASH) To: Campbell, Taylor (O5/OASH) Haddad, carla (HHS/OASH); Kellogg, Rachel (HHS/OASH); Valentine, Steven (HHS/OASH); CC: Wainwright, Jacob (HHS/OASH/IO) ; Heck, Mia (HHS/OASH); Broida, Tara (HHS/OASH) Subject: RE: **FOR REVIEW--URGENT**CLEARANCE_0248: CDC"Coronavirus Disease2019 (COVID19) Update: Diagnostic test supplies" Date: 2020/03/11 15:32:00 Priority: Normal Type: Note Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Campbell, Taylor (OS/OASH) Sent: Wednesday, March 11, 2020 3:31 PM To : Giroir, Brett (HHS/OASH) Cc: Haddad, Carla (HHS/OASH) ; Kellogg, Rachel (HHS/OASH) ; Valentine, Steven (HHS/OASH) ; Wainwright, Jacob (HHS/OASH/IO) ; Heck, Mia (HHS/OASH) ; Broida, Tara (HHS/OASH) Subject: **FOR REVIEW--URGENT** CLEARANCE_0248:CDC "Coronavirus Disease 2019 (COVID-19) Update: Diagnostic test supplies" Imp ortan ce: High ADM Giro ir, AMERICAN PVERSIGHT HHS-20-0580-B-000530 Thank you Taylor From: OS HHSPress (HHS/ASPA) Sent: Wednesday, March 11, 2020 3:13 PM To: OS - ASPA- Clearance ; OS OGC-IO ControlDesk (HHS/OS/OGC) ; Stecker, Judy (OS/IOS) ; Murphy, Ryan (OS/ASPA) ; Caliguiri, Laura (FDA/OC) ; Giroir, Brett (HHS/OASH) ; Steele, Danielle (HHS/IOS) ; White, Caroline (HHS/OGC) ; Stimson, Brian (HHS/OGC) ; Charrow, Robert (HHS/OGC) ; Keveney, Sean (HHS/OGC) ; Chang, W illiam (HHS/OGC) ; Barry, Daniel J (HHS/OGC) ; Amin, Stacy (FDA/OC) ; ASPRCOMMS ; ASPRMEDIA (OS/ASPR/COO) ; Routh, Jenn ifer (NIH/NIAID) [El ; Conrad, Patricia (NIH/NIAID) [El ; Billet , Courtney (NIH/NIAID) [El ; Wojtowicz, Emma (NIH/OD) [El ; Akinso, Woleola (NIH/OD) [El ; Fine, Amanda (NIH/OD) [El ; Fritz, Craig (NIH/OD) [El ; Myles , Renate (NIH/OD) [El ; Broida, Tara (HHS/OASH) ; Channer, Amber (OS/OASH) ; Heck, Mia (HHS/OASH) ; Kotwick i, Lauren (HHS/OASH) ; Migliaccio -Grabill, Kate (HHS/DASH) ; Sherman, Jennifer (HHS/OASH) ; Bonds, Michelle E. (CDC/OD/OADC) ; Galatas, Kate (CDC/OD/OADC) ; Heldman, Amy B. (CDC/OD/OADC) ; Patrick, Kera (CDC/OD/OADC) ; CDC OADC ASPA Clearance Cc:OS HHSPress (HHS/ASPA) ; Caccamo, Stephanie (FDA/OC) ; 2019 -nCoV FDA IMG JIC <2019-nCoVFDAIMGJIC@fda.hhs.gov >; OCOEAOMA-Press (FDA) <0COEAOMA-Press@fda.hhs.gov > Subject: CLEARANCE_0248:CDC "Coronavirus Disease 2019 (COVID-19) Update: Diagnostic test supplies" Importance: High CLOSE-HOLD/ URGENT Agency /Office: CDC AMERICAN PVERSIGHT HHS-20-0580-B-000531 Subject: Coronavirus Disease 2019 (COVID-19) Update: Diagnostic test supplies o l(b)(5) Matenals:,______________________ _, Deadline for comments: Before 4:30 p.m. today, Wednesday, March 11 Planned release date: Wednesday, March 11 Driving event: Global coronavirus 2019 outbreak; authorization V/r, Mike Robinson Strategic Planning, ASPA 202-690-6885 -desk rb)(B) ~mobile INTERNAL HHS USE ONLY! INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BYLAW: This information has not been publically disclosed and may be privileged and confidential. This document must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the full extent of the law. Sender: Giroir, Brett (HHS/OASH) Campbell, Taylor (O5/OASH) ; Haddad, Carla (HHS/OASH) ; Kellogg, Rachel (HHS/OASH) ; Valentine, Steven (HHS/OASH) ; Wainwright, Jacob (HHS/OASH/IO) ; Heck, Mia (HHS/OASH) ; Broida, Tara (HHS/OASH) Sent Date: 2020/03/11 15:32:25 Delivered Date: 2020/03/11 15:32:00 AMERICAN PVERSIGHT HHS-20-0580-B-000532 Giroir, Brett (HHS/OASH) To: Meaney Delman, Dana M. (CDC/DDNID/NCBDDD/DBDID) Armstrong, Gregory (CDC/DDID/NCEZID/OD) ; Schuchat, Anne MD (CDC/OD) ; Berger, Sherri (CDC/OCOO/OD) ; Brooks, John T. (CDC/DDID/NCHHSTP/DHPSE) ; Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) ; Bell, Michael MD (CDC/DDID/NCEZID/DHQP) Subject: RE: Guidance for Termination of Isolation Precautions COVID-19 - Decision Memo CONTAINMENT_3_8_2020_JB_DMD Date: 2020/03/09 18:0 5:00 Priority: Normal Type: Note Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Meaney Delman, Dana M. (CDC/DDNID/NCBDDD/DBDID) Sent: Monday, March 9, 2020 5:48 PM To: Giroir, Brett (HHS/OASH) Cc: Armstrong, Gregory (CDC/DDID/NCEZID/OD) ; Schuchat, Anne MD (CDC/OD) ; Berger, Sherri (CDC/OCOO/OD) ; Brooks, John T. (CDC/DDID/NCHHSTP/DHPSE); Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) ; Bell, Michael MD (CDC/DDID/NCEZID/DHQP) Subject: RE: Guidance for Termination of Isolation Precautions COVID-19 - Decision Memo CONTAINMENT- 3- 8- 2020 - JB- DMD ADM Giroir, AMERICAN PVERSIGHT HHS-20-0580-B-000533 (b)(5) Best Dana Dana Meaney -Delman MD MPH Principal Deputy Incident Manager COVID-19 Response Cell rb )(6) I From: Giro ir, Brett (HHS/OASH) Sent: Monday, March 9, 2020 5:01 PM To: Brooks, John T. (CDC/DDID/NCHHSTP/DHPSE) ; Jernigan, Daniel B. (CDC/DDID/NCIRD/ ID) Cc: Meaney Delman, Dana M . (CDC/DDNID/NCBDDD/DBDID) ; Armstrong, Gregory (CDC/DDID/NCEZID/OD) ; Schuchat, Anne MD (CDC/OD) ; Berger, Sherri (CDC/OCOO/OD) Subject: RE: Guidance for Terminat ion of Isolat ion Precautions COVID-19 - Decision Memo CONTAINMENT_ 3_8_ 2020_JB_ DMD (b)(5) AMEHICAN PVERSIGHT HHS-20-0580-B-000534 (b)(5) Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Brooks, John T. (CDC/DDID/NCHHSTP/DHPSE) Sent : Monday, March 9, 2020 3:41 PM To : Giroir, Brett (HHS/OASH) ; Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) Cc: Meaney Delman, Dana M. (CDC/DDNID/NCBDDD/DBDID) ; Armstrong, Gregory (CDC/DDID/NCEZID/OD) ; Schuchat, Anne MD (CDC/OD) ; Berger, Sherri (CDC/OCOO/OD) Subje ct: RE: Guidance for Termination of Isolation Precautions COVID-19 - Decision Memo CONTAINMENT_ 3_8_2020_JB_ DMD (b)(5) AML1,1vAN PVERSIGHT HHS-20-0580-B-000535 (b)(5) John T. Brooks, MD - Chief Medical Officer CDC Division of HIV/AIDS Prevention 1600 Clifton Road NE, Mailstop D-21 Atlanta, GA 30333 AMERICAN PVERSIGHT HHS-20-0580-B-000536 Desk:404-639-3894 Cell:rb )(B) I Email: zud4@cdc.gov From: Giro ir, Brett (HHS/OASH) Sent: Monday, March 9, 2020 2:07 PM To: Brooks, John T. (CDC/DDID/NCHHSTP/DHPSE) ; Jern igan, Daniel B. (CDC/DDID/NCIRD/ ID) Cc: Berger, Sherri (CDC/OCOO/OD) ; Schuchat, Anne MD (CDC/OD) ; Meaney Delman, Dana M. (CDC/DDNID/NCBDDD/DBDID) Subject: RE: Guidance for Terminat ion of Isolat ion Precautions COVID-19 - Decision Memo CONTAINMENT_ 3_8_ 2020_JB_ DMD AMERICAN PVERSIGHT HHS-20-0580-B-000537 Sure I am on 12 in Mitch Wolff office My mobile is rb) (B) I Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Brooks, John T.(CDC/DDID/NCHHSTP/DHPSE)< zud4@cdc.gov > Sent: Monday, March 9, 2020 2:05 PM To: Giroir, Brett (HHS/OASH) ; Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) Cc: Berger, Sherri (CDC/OCOO/OD) ; Schuchat, Anne MD (CDC/OD) ; Meaney Delman, Dana M. (CDC/DDNID/NCBDDD/DBDID) ; Giroir, Brett (HHS/OASH) Subject: Re: Guidance for Termination of Isolation Precautions COVID-19 - Decision Memo CONTAINMENT- 3- 8- 2020 - JB- DMD Doh! Apologies. Will get back shortly. Best ifl call you. John T. Brooks, Nill - Chief Medical Officer CDC, Division of HIV /AIDS Prevention 1600 Clifton Road NE, Mailstop D-21 Atlanta, GA. 30319 404-639-3894 From: Giroir, Brett (HHS/OASH) Sent: Monday, March 9, 2020 1:56:47 PM To: Brooks, John T. (CDC/DDID/NCHHSTP/DHPSE); Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) Cc: Berger, Sherri (CDC/OCOO/OD) ; Schuchat, Anne MD (CDC/OD) ; Meaney Delman, Dana M. (CDC/DDNID/NCBDDD/DBDID) ; Giroir, Brett (HHS/OASH) Subject: RE: Guidance for Termination of Isolation Precautions COVID-19 - Decision Memo CONTAINMENT_3_8_2020_JB_DMD THANK YOU. AMERICAN PVERSIGHT HHS-20-0580-B-000538 b)(5) I am here on 12 and able to chat in person or by phone BG Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Brooks, John T. (CDC/DDID/NCHHSTP/DHPSE) Sent: Monday, March 9, 2020 1:38 PM To: Giroir, Brett (HHS/OASH) ; Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) Cc: Berger, Sherri (CDC/OCOO/OD) ; Schuchat, Anne MD (CDC/OD) ; Meaney Delman, Dana M. (CDC/DDNID/NCBDDD/DBDID) Subject: RE: Guidance for Terminat ion of Isolation Precautions COVID-19 - Decision Memo CONTAINMENT_ 3_8_ 2020_JB_ DMD Available when you are ADM to discuss. Am offline for about 45 minutes then back. (b)(5) AMERICAN PVERSIGHT HHS-20-0580-B-000539 (b)(5) From: Giroir, Brett (HHS/OASH) < Brett.Giroir@hhs.gov > Sent: Monday, March 9, 2020 9:29 AM To: Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) Cc: Berger, Sherri (CDC/OCOO/OD) ; Schuchat, Anne MD (CDC/OD) ; Meaney Delman, Dana M. (CDC/DDNID/NCBDDD/DBDID) ; Brooks, John T. (CDC/DDID/NCHHSTP/DHPSE) Subject: RE: Guidance for Termination of Isolation Precautions COVID-19 - Decision Memo CONTAINMENT_ 3_8_2020_JB_ DMD (b)(5) Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) Sent: Monday, March 9, 2020 8:48 AM To : Giroir, Brett (HHS/OASH) AMERICAN PVERSIGHT HHS-20-0580-B-000540 Cc: Berger, Sherri (CDC/OCOO/OD) ; Schuchat, Anne MD (CDC/OD) ; Meaney Delman, Dana M. (CDC/DDNID/NCBDDD/DBDID) ; Brooks, John T. (CDC/DDID/NCHHSTP/DHPSE) Subject: Guidance for Termination of Isolation Precautions COVID-19 - Decision Memo CONTAINMENT_ 3_8_ 2020_JB_ DMD ADM Giroir: Sender: Giroir, Brett (HHS/OASH) Meaney Delman, Dana M. (CDC/DDNID/NCBDDD/DBDID) ; Armstrong, Gregory (CDC/DDID/NCEZID/OD) ; Schuchat, Anne MD (CDC/OD) ; Berger, Sherri (CDC/OCOO/OD) ; Brooks, John T. (CDC/DDID/NCHHSTP/DHPSE) ; Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) ; Bell, Michael MD (CDC/DDID/NCEZID/DHQP) Sent Date: 2020/03/09 18 :OS:12 Delivered Date: 2020/03/09 18:05:00 AMERICAN PVERSIGHT HHS-20-0580-B-000541 Giroir, Brett (HHS/OASH) To: Becker, Scott I APHL Subject: RE: PHLs Date: 2020/03/12 10:01:00 Priority: Normal Type: Note Yes Tag me Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Becker, Scott I APHL Sent: Thursday, March 12, 2020 10:00 AM To: Giroir, Brett (HHS/OASH) Subject: RE: PHLs Yes, I am tweeting out at 10 am. Tagging cdc, fda and hhs . Do you want me to tag you also? From: Giroir, Brett (HHS/OASH) Sent: Thursday, March 12, 2020 8:28 AM To: Becker, Scott I APHL Subject: RE: PHLs CAUTION: This emai l originated from outside of the organization . Do not click links or open attachments unless you recognize the sender and know the content is safe. Could you issue a statement from the APHL? This is important for the country and good for you 81 labs up and running in all 50 states. Tests are ongoing as of last night without interruption do the great effort of our public health labs. Even if you tweet it, it is an important message Many thanks for considering AMERICAN PVERSIGHT HHS-20-0580-B-000542 Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Becker, Scott I APHL Sent: Thursday, March 12, 2020 8:23 AM To: Giroir, Brett (HHS/OASH) Subject: RE: PHLs Good morning, as of 4 pm yesterday (I don't suspect anything has happened overnight) : There have been 2 CA local PHLs added to our list of verified and testing : Shasta and San Bernardino The total number of verified labs offer ing testing is 81. This includes one or more PHL in 50 states plus DC. No one has reported having to interrupt testing as of last night and CDC and the companies have stated to us that PHLs are prioritized. We reinforced messages to the PHLs on our weekly national call on Weds at 3 pm about work ing through the IRR for ordering. FDA also joined the call and that practice will continue. Thanks, Scott From: Giroir, Brett (HHS/OASH) Sent: Thursday, March 12, 2020 8:15 AM To: Becker, Scott I APHL Subject: PHLs CAUTION: This email originated from outside of the organization . Do not click links or open attachments unless you recognize the sender and know the content is safe. Good Morning, Do you have a situationa I report on the status of the PHLs? How many are up and running today? Has any lab had to interrupt testing for lack of reagents? I have asked CDCfor the number of tests done by CDC and PHLs Thank you BG AMERICAN PVERSIGHT HHS-20-0580-B-000543 Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 This email has been scanned for spam and viruses by Proofpoint Essen tials. Click here to report this email as spam. This email has been scanned for spam and viruses by Proofpoint Essentia ls. Click here to report this email as spam. Sender: Giroir, Brett (HHS/OASH) Recipient: Becker,Scott I APHL Sent Date: 2020/03/12 10:01:11 Delivered Date: 2020/03/12 10:01:00 AMERICAN PVERSIGHT HHS-20-0580-B-000544 Giroir, Brett (HHS/OASH) To: Subject: Mango, Paul (HHS/10S) FW: Guidancefor Termination of Isolation PrecautionsCOVID-19- DecisionMemo CONTAINMENT _3_8_2020_JB_DMD Date: 2020/03/09 18:05:00 Priority: Normal Type: Note Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Meaney Delman, Dana M. (CDC/DDNID/NCBDDD/DBDID) Sent: Monday, March 9, 2020 5:48 PM To: Giroir, Brett (HHS/OASH) Cc:Armstrong, Gregory (CDC/DDID/NCEZID/OD) ; Schuchat, Anne MD (CDC/OD) ; Berger, Sherri (CDC/OCOO/OD) ; Brooks, John T. (CDC/DDID/NCHHSTP/DHPSE); Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) ; Bell, Michael MD (CDC/DDID/NCEZID/DHQP) Subject: RE: Guidance for Termination of Isolation Precautions COVID-19 - Decision Memo CONTAINMENT_3_8_2020_JB_DMD ADM Giroir, (b)(5) AML1 llVf"'\N PVERSIGHT HHS-20-0580-B-000545 b)(5) Best Dana Dana Meaney -Delman MD MPH Principal Deputy Incident Manager COVID-19 Response Cellfb)(5) I From: Giro ir, Brett (HHS/OASH) Sent: Monday, March 9, 2020 5:0 1 PM To: Brooks, John T. (CDC/DDID/NCHHSTP/DHPSE) ; Jern igan, Daniel B. (CDC/DDID/NCIRD/ID) Cc: Meaney Delman, Dana M. (CDC/DDNID/NCBDDD/DBDID) ; Armstrong, Gregory (CDC/DDID/NCEZID/OD) ; Schuchat, Anne MD (CDC/OD) ; Berger, Sherri (CDC/OCOO/OD) Subject: RE: Guidance for Terminat ion of Isolation Precautions COVID-19 - Decision Memo CONTAINMENT_ 3_8_ 2020_JB_ DMD b)(5) Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW AMEHICAN PVERSIGHT HHS-20-0580-B-000546 Washington, DC 20201 Office Phone: 202-690-7694 From: Brooks, John T.(CDC/DDID/NCHHSTP/DHPSE)< zud4@cdc.gov > Sent: Monday, March 9, 2020 3:41 PM To: Giroir, Brett {HHS/OASH) ; Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) Cc: Meaney Delman, Dana M. {CDC/DDNID/NCBDDD/DBDID) ; Armstrong, Gregory (CDC/DDID/NCEZID/OD) ; Schuchat, Anne MD (CDC/OD) ; Berger, Sherri (CDC/OCOO/OD) Subject: RE: Guidance for Termination of Isolation Precautions COVID-19 - Decision Memo CONTAINMENT- 3- 8- 2020 - JB- DMD b)(5) AMEHICAN PVERSIGHT HHS-20-0580-B-000547 John T. Brooks, MD - Chief Medical Officer CDC Division of HIV/AIDS Prevention 1600 Clifton Road NE, Mailstop D-21 Atlanta, GA 30333 Desk: 404-639-3894 I Cell :fb)(6l Email: zud4@cdc.gov AMERICAN PVERSIGHT HHS-20-0580-B-000548 From: Giroir, Brett (HHS/OASH) Sent: Monday, March 9, 2020 2:07 PM To: Brooks, John T. (CDC/DDID/NCHHSTP/DHPSE) ; Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) Cc: Berger, Sherri (CDC/OCOO/OD) ; Schuchat, Anne MD (CDC/OD) ; Meaney Delman, Dana M. (CDC/DDNID/NCBDDD/DBDID) Subject: RE: Guidance for Termination of Isolation Precautions COVID-19 - Decision Memo CONTAINMENT_3_8_2020_JB_DMD Sure I am on 12 in Mitch Wolff office My mobile b_l (6_l___ __, isr.... Brett P. Giroir, MD AMERICAN PVERSIGHT HHS-20-0580-B-000549 ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Brooks, John T.(CDC/DDID/NCHHSTP/DHPSE)< zud4@cdc.gov > Sent: Monday, March 9, 2020 2:05 PM To: Giroir, Brett (HHS/OASH) ; Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) Cc: Berger, Sherri (CDC/OCOO/OD) ; Schuchat, Anne MD (CDC/OD) ; Meaney Delman, Dana M. {CDC/DDNID/NCBDDD/DBDID) ; Giroir, Brett {HHS/OASH) Subject: Re: Guidance for Termination of Isolation Precautions COVID-19 - Decision Memo CONTAINMENT- 3- 8- 2020 - JB- DMD Doh! Apologies. Will get back shortly. Best ifl call you. John T. Brooks, J\ID - Chief Medical Officer CDC, Division of HIV/AIDS Prevention 1600 Clifton Road NE, Mailstop D-21 Atlanta, GA. 30319 404-639-3894 From: Giroir, Brett (HHS/OASH) Sent: Monday, March 9, 2020 1:56:47 PM To: Brooks, John T. (CDC/DDID/NCHHSTP/DHPSE); Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) Cc: Berger, Sherri (CDC/OCOO/OD) ; Schuchat, Anne MD (CDC/OD) ; Meaney Delman, Dana M. (CDC/DDNID/NCBDDD/DBDID) ; Giroir, Brett (HHS/OASH) Subject: RE: Guidance for Termination of Isolation Precautions COVID-19 - Decision Memo CONTAINMENT_3_8_2020_JB_DMD THANK YOU. (b)(5) AMERICAN PVERSIGHT HHS-20-0580-B-000550 I am here on 12 and able to chat in person or by phone BG Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Brooks, John T. (CDC/DDID/NCHHSTP/DHPSE) Sent: Monday, March 9, 2020 1:38 PM To: Giroir, Brett (HHS/OASH) ; Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) Cc: Berger, Sherri (CDC/OCOO/OD) ; Schuchat, Anne MD (CDC/OD) ; Meaney Delman, Dana M. (CDC/DDNID/NCBDDD/DBDID) Subject: RE: Guidance for Termination of Isolation Precautions COVID-19 - Decision Memo CONTAINMENT_ 3_8_2020_JB_ DMD Available when you are ADM to discuss.Am offline for about 45 minutes then back. (b)(5) AMEHICAN PVERSIGHT HHS-20-0580-B-000551 b)(5) From: Giroir, Brett (HHS/OASH) < Brett.Giroir@hhs.gov > Sent: Monday, March 9, 2020 9:29 AM To: Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) Cc: Berger, Sherri (CDC/OCOO/OD) ; Schuchat, Anne MD (CDC/OD) ; Meaney Delman, Dana M. (CDC/DDNID/NCBDDD/DBDID) ; Brooks, John T. (CDC/DDID/NCHHSTP/DHPSE) Subject: RE: Guidance for Terminat ion of Isolation Precautions COVID-19 - Decision Memo CONTAINMENT_ 3_8_ 2020_JB_ DMD b)(5) Brett P. Giroir, MD ADM, US Public Health Service Assistant Secretary for Health (ASH) 200 Independence Avenue, SW Washington, DC 20201 Office Phone: 202-690-7694 From: Jernigan, Daniel B. (CDC/DDID/NCIRD/ID) Sent: Monday, March 9, 2020 8:48 AM To: Giroir, Brett (HHS/OASH) Cc: Berger, Sherri (CDC/OCOO/OD) ; Schuchat, Anne MD (CDC/OD) ; Meaney Delman, Dana M. (CDC/DDNID/NCBDDD/DBDID) ; Brooks, John T. (CDC/DDID/NCHHSTP/DHPSE) Subject: Guidance for Termination of Isolat ion Precaut ions COVID-19 - Decision Memo CONTAINMENT- 3- 8- 2020 - JB- DMD ADM Giroir : b)(5) AMERICAN PVERSIGHT HHS-20-0580-B-000552 (b)(5) Dan. Sender: Recipient: Giroir, Brett (HHS/OASH) Mango, Paul (HHS/l05) Sent Date: 2020/03/09 18:05:56 Delivered Date: 2020/03/09 18:05:00 AMERICAN PVERSIGHT HHS-20-0580-B-000553