https://www.documentcloud.org/documents/20793561

Page 2318

From: Trevor Mundel (b)(6)

Sent: Monday, March ---– 9, 2020 5:57 PM

-~~ To: Collins, Francis (NIH/OD) [E] _ CbH_6)>; Fauci, Anthony (NIH/NIAID) [E]

(b)(6)>

Cc: Dan Wattendorf (b)(6); Jennifer Weisman -–!:=~=-..::~—- (b )( 6) >

Subject: COVID-19

Dear Francis, Tony,

I wanted to give you a heads up on a call that Bill will have with Vice President Pence tomorrow around

the COVID-19 situation. As you might be aware, we have been running an influenza transmission study

in Seattle for the last 2 years. This involves at-home testing for ILi-symptomatic individuals (who log-in

via a web app) and collection of nasal swabs, which are then sequenced for a range of respiratory

pathogens . Dan can give you more details on this study if you have questions. When the Coronavirus

situation arose, we added this to the list of pathogens and hence were able to detect some of the early

cases in Washington.

The CDC has been very interested in the approach and at one point we had the highest screening

capacity in the US (though only 400 samples per day, so I hope this is no longer true). At the same time,

we have developed a COVID-19 at-home screening and information system with robust software that

approximates what China was doing but also takes into account the opt-in requirements that are

necessary in the US.

We want to propose going beyond the Seattle area- this would be gated only by availability of testing.

We can deploy this ready-now system more broadly in the US. Ideally we would also do a parallel

outreach to some African countries. I'd be interested in your views and would be happy to jump on a

quick call.

Warm regards,

Trevor

Trevor Mund el, MD, PhD

President, Global Health Program

>>13824834

KAWASAKI ?

FauciEmails page 933

Jeremy:

Thanks for the heads up. Is there any more detailed description of the precise

clinical manif estation s? They describe a "multisystem inflammatory state 11

• It is

vasculitis or anything more specific? Could be an infectious agent that has

nothing to do with SARS-CoV-2 infection even though some children are

circumstantially infected with SARS-CoV-2or it could be a post-SARS-CoV-2

inflammatory syndrome , perhaps a Kawasaki syndrome-like disease. Please keep

me informed if you hear any further information.

Best regards,

Tony

Anthony S. Fauci, MD

>>13824834

FauciEmails Page 1487

Working in the lab of Sheldon Wolff, Fauci studied the molecular nature

of fever. The field of immunology was still young, but scientists were

rapidly learning how to manipulate the smallest components of

individual cells, which opened the way to a decade of discovery.

Chronic fevers can have a number of underlying causes, ==among them an

uncommon condition known as vasculitis- an inflammation of the

blood cells that often occurs when the body's immune system

mistakenly attacks its own blood vessels. Many of Fauci's vasculitis

patients suffered from rare inflammatory diseases, such as

granulomatosis with polyangiitis , which damages blood vessels in the

lungs, kidneys, and other organs. ==The disease was almost always fatal.

Fauci and his infectious-disease colleagues at the N.I.H. were frequently

asked to visit the National Cancer Institute, which was in the same

building as his lab, to consult on patients who were receiving

chemotherapy. The drugs suppressed tumors, but they were highly toxic.

And they had another side effect, Fauci told me: "Those people are

susceptible to a lot of things like infections and bleeding, because the

treatment has destroyed their immune systems."

>>13825050 FauciEmails page 1488 (continued)

Problem - Reaction - Solution

Working in the lab of Sheldon Wolff, Fauci studied the molecular nature

of fever. The field of immunology was still young, but scientists were

rapidly learning how to manipulate the smallest components of

individual cells, which opened the way to a decade of discovery.

Chronic fevers can have a number of underlying causes, among them an

uncommon condition known as vasculitis- an inflammation of the

blood cells that often occurs when the body's immune system

mistakenly attacks its own blood vessels. Many of Fauci's vasculitis

patients suffered from rare inflammatory diseases, such as

granulomatosis with polyangiitis , which damages blood vessels in the

lungs, kidneys, and other organs. The disease was almost always fatal.

Fauci and his infectious-disease colleagues at the N.I.H. were frequently

asked to visit the National Cancer Institute, which was in the same

building as his lab, to consult on patients who were receiving

chemotherapy. The drugs suppressed tumors, but they were highly toxic.

And they had another side effect, Fauci told me: "Those people are

susceptible to a lot of things like infections and bleeding, because the

treatment has destroyed their immune systems."

>>13825329

Jesuits

>>13825344