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Hospital COVID protocols: who wrote each layer

A nurse watched a Senate roundtable and wrote that every hospital in the country got the same treatment guidelines, the same payment rules, the same visitor bans, the same staff mandate and the same legal shield. We went looking for the author. No single author turns up. There is a chain, and every link answers to the next.

By the FCHDS research desk, 6 October 2026. Every claim is sourced. Numbered sources are at the end, and the documents we hold are on file.

On 28 September 2026, Sen. Ron Johnson filled a room in the Russell Senate Office Building with twenty-one people and let them talk for four hours about what happened inside American hospitals during COVID.[1, 2] Nurses. A trauma surgeon. A lawyer who represents 212 families in 40 states. A physician who sits in the Oklahoma Senate. Johnson's office says it holds 583 testimonies from 46 states. Twenty-one people spoke.[2]

Johnson's office describes what they said: remdesivir and ventilation "forced on patients as the only viable options," ivermectin and monoclonal antibodies denied "even when rigid hospital protocols were failing," families kept from dying relatives, and "callous comments by doctors and nurses to unvaccinated patients and their families." These are people who watched what happened at the bedside, and several of them paid for saying so. They are owed more than four hours in a Senate office building.[2]

A nurse who watched the roundtable wrote a post that Wall Street Apes circulated: "It was handed to us from the top down. Every hospital got the same treatment guidelines, guidelines that said in writing, not a mandate, but every hospital followed this like it was the law."[3] She added the payment rules, the lockouts, the staff mandate and a legal shield that runs to 2029. "If you didn't follow it, you were out."

She was right about almost all of it. We checked each claim against the Federal Register, the Congressional Record, CMS manuals, court files, lobbying disclosures and the drug company's own filings. Then we asked the question underneath hers: who wrote these rules?

Different hands wrote each layer: an NIH panel, HHS's preparedness office, Congress and the Medicare agency, the Medicare agency again, the HHS Secretary, and each hospital's own administration. The layers lean on each other. Two of the documents say in writing that they bind no one. The hospitals acted as if all of them did.

Six layers

  1. The treatment guidelines. Written by a panel at the National Institutes of Health.[4]
  2. The drug. The Department of Health and Human Services signed a deal with Gilead Sciences that governed who got remdesivir from July through September 2020 and recorded its price.[5]
  3. The money. Congress wrote a 20 percent Medicare bonus on the payment for each COVID inpatient stay. The Centers for Medicare and Medicaid Services (CMS) added a second payment for stays that used remdesivir.[6, 7]
  4. The visitors and the staff mandate. CMS wrote the nursing-home visitor ban and the staff vaccine mandate.[8, 9]
  5. The legal shield. HHS declared COVID countermeasures immune from suit, and has extended the declaration to 31 December 2029.[10, 11]
  6. The hospital's own daily orders. This is the layer a nurse actually touches. A surgeon at the hospital that treated the first American COVID patient swears under penalty of perjury that his chief medical officer sent staff "weekly to daily directives" relaying CDC and CMS requirements for more than a year.[12]

The NIH panel says its guidelines "should not be considered mandates."[4] CMS's own explainer for the 20 percent bonus says it is "not intended to grant rights or impose obligations."[13] Hospitals followed the guidelines and the payment rules as if they were law. The surgeon swears that at Everett "it was understood that you would lose your job and/or license if you did not maintain compliance," and that he was taught at a CMS-compliance conference that non-compliance "meant certain financial destruction and bankruptcy for that hospital or medical group."[12]

The rest of this article follows the layers one at a time, then the people who sat around the table when they were written.

The panel that wrote the treatment protocol

The panel began in March 2020 at the request of the White House Coronavirus Task Force, passed through the HHS Secretary to NIH. Anthony Fauci's institute, NIAID, "initiated the formation" of it. The first guidelines went up on 21 April 2020.[4] Three co-chairs ran it: Roy Gulick of Weill Cornell, Cliff Lane of NIAID and Henry Masur of the NIH Clinical Center.[14, 15] Over four years it voted 438 times.[16]

It never published how a single member voted. It never published a rule requiring a member to sit out a vote on a product made by a company that paid them. The only conflict-of-interest procedure on record is that the co-chairs reviewed disclosures twice a year "to determine suitability for membership," and that panel leadership used them to decide whether a member should take part.[14, 4, 16]

The disclosure tables show why that matters. In April 2020 eleven panel members listed a financial relationship with a drug company. Nine of the eleven listed Gilead, the maker of remdesivir: Aberg, Adimora, Baker, Bedimo, Daar, Gandhi, Glidden, Naggie and Tebas. Gulick, Lane and Masur each wrote "None."[14, 17]

Lane wrote "None" while serving as the last-named author of ACTT-1, the NIAID-sponsored trial whose results carried the panel's remdesivir recommendation. The trial paper says Gilead employees took part in protocol discussions and weekly calls, and that NIAID "ultimately made all decisions."[18] NIAID's statisticians proposed changing the trial's main measure to time to recovery on 22 March 2020, after about 7 percent of patients had enrolled; the amendment is dated 1 April. FDA's reviewer called the change reasonable.[19] The Government Accountability Office found federal agencies spent about $162 million on remdesivir research through 2020 and ended up with no patent rights; Gilead held them.[20]

Eight weeks that decided the drug

The sequence is the story, so here it is in order.

Five months later the largest remdesivir trial reported. WHO's Solidarity study followed 11,330 hospitalized patients and found 301 deaths among 2,743 on remdesivir against 303 among 2,708 on standard care, with no reduction in ventilator use or hospital stay.[28] That was 15 October. FDA approved remdesivir a week later on the strength of NIAID's trial; the review does not discuss Solidarity.[29, 30] On 2 November a Medicare payment that names remdesivir began paying.[7] On 20 November WHO's guideline panel, reporting no conflict of interest among its members, conditionally recommended against remdesivir for hospitalized patients.[31] The NIH panel's guideline cited Solidarity for the first time on 11 February 2021.[27]

NIAID's own trial found patients recovered in a median of 10 days on remdesivir against 15 on placebo. Deaths by day 29 were 11.4 percent against 15.2 percent, a difference too small to count statistically.[18] Solidarity, the French DisCoVeRy trial of 857 patients and the 2023 Cochrane review all found little or no effect on deaths in hospitalized patients.[28, 32, 33] Gilead's Veklury sales were $2.8 billion in 2020, $5.6 billion in 2021 and $3.9 billion in 2022.[34, 35, 36]

The deal

The agreement that governed who got remdesivir from July through September 2020 is a three-party memorandum dated 27 June 2020, between HHS, Gilead and the drug distributor AmerisourceBergen. HHS did not buy the drug. Hospitals paid. HHS's Assistant Secretary for Preparedness and Response, Robert Kadlec, signed for the government.[5]

The terms read like a franchise agreement. Gilead would "use commercially reasonable efforts" to supply about 501,900 treatment courses for July through September. "ASPR will set allocation quantities," and Gilead and the distributor "shall have no responsibility or discretion" over which hospitals got the drug. The price was $520 a vial, about $3,250 a course. If Gilead could not sell August or September allocated stock by 31 October, even after offering it to foreign governments, "HHS agrees to indemnify Gilead ... for the losses associated with the Excess Product at $390 per vial," up to 145,000 courses, a ceiling of about $353 million. And the memorandum states that the PREP Act's immunity and pre-emption protections "extend to the participation of Gilead and Distributor in this MOU."[5]

Under HHS's plan the preparedness office set each state's share and state health departments chose the hospitals.[37] New Jersey's memo of 26 June 2020, written for the donated stock a day before the memorandum, shows how one state ran it: report twice a week, and "Failure to report data may negatively affect qualification for future allocations." It left the prescribing call to "the attending physician of record."[38]

Seven weeks before Kadlec signed, six Democratic senators wrote that they were "concerned by recent reports" that he had "failed to disclose" to the Senate and the Office of Government Ethics that he co-founded a company in 2012 and consulted for Emergent BioSolutions, which had received more than $733 million from his office.[39] Emergent paid his consulting firm $120,000 a year from 2012 to 2015. Emergent's executive chairman confirmed the $360,000 total under oath on 19 May 2021.[40] The stockpile moved from CDC to Kadlec's office in 2018. The Washington Post reported that moving it was part of Emergent's 2017 corporate strategy.[41, 39]

On 11 February 2020, Fauci's diary shows Kadlec offering Japan remdesivir under compassionate use for Diamond Princess passengers, before any trial had reported.[42] The memorandum wrote the Secretary's PREP Act immunity into the deal.

The bonus

Section 3710 of the CARES Act, signed 27 March 2020, orders Medicare to raise the payment weight of any hospital stay for "an individual diagnosed with COVID-19" by 20 percent.[6] That is the bonus the nurse described. It was 15 percent when it first appeared.

On 19 March the Senate Republican leadership's bill, S. 3548, carried a 15 percent add-on. The Finance Committee's own summary of it says 15.[43, 44] The American Hospital Association told its members that same day to ask their lawmakers for "a Medicare add-on payment equal to 25% of the diagnosis-related group."[45] On Friday 20 March the association's advisory still described 15. By Sunday 22 March, as the Republicans released a revised bill, its advisory described 20.[46] A House Ways and Means summary dated 23 March, describing the Senate text as of Sunday 22 March, said the add-on "is more generous than earlier drafts: 20 percent, as compared to 15 percent in the first draft."[47]

Nobody has said who changed the number. The hospital lobbies were loud in those days. On 20 March the Federation of American Hospitals raised its funding request to $225 billion. On 21 March the association's executive vice president told Modern Healthcare he expected the Senate's opening offer to be "massaged and improved."[48] Politico called the $100 billion hospital fund that followed "a major win for hospital lobbies" and wrote that "provider lobbyists in the past several days moved the needle considerably on funding talks."[49] The Federation's chief executive said of the finished bill: "It provides what we asked for."[50]

The second payment came in November. CMS's rule for the new COVID-19 treatments add-on pays part of a stay's extra cost on stays that used a listed product, a ceiling of roughly $19,500 a case at the rule's own example threshold of about $30,000. The rule lists two products: convalescent plasma and remdesivir. CMS said the purpose was to avoid "financial disincentives for hospitals to provide new COVID-19 treatments."[7, 51] Ivermectin and hydroxychloroquine were not on the list.

The relief fund dwarfed both. HHS said in August 2021 it was "distributing $178 billion to hospitals and healthcare providers." The Government Accountability Office found providers kept $135 billion, about $84 billion of it to hospital-based systems. The first $30 billion went out by each provider's share of Medicare fee-for-service payments, not by COVID cases.[52, 53, 54]

The $40,000 ventilator figure in the nurse's post matches a Kaiser Family Foundation study of 2017 Medicare claims ($40,218) that excluded the 20 percent bonus; it is not a CMS estimate. The $24,000 figure matches no Medicare figure in that study.[55] The real average, from the HHS inspector general's audit of $2.7 billion in COVID claims for September to November 2020, was about $16,300 a claim.[56] Nurses say they were told to code patients as COVID for the money. The inspector general audited that question on a sample of 149 of 166,107 claims and found 146 correct and three wrong. The sample covered three months of Medicare fee-for-service claims. The claims at the hospitals named in Johnson's testimonies have not been pulled.

The lobby inside the billing system

The American Hospital Association told its members to ask for the bonus, tracked it through its member advisories, and then went to CMS to defend it. On 6 April it asked CMS to extend the 20 percent to long-term care hospitals.[57] In August CMS announced that for admissions from 1 September it would require a positive COVID test on the record to keep the money, and said it would recoup the payment if none was there.[58] The association wrote to CMS Administrator Seema Verma on 26 August: "we urge CMS to allow provider documentation to suffice if the test result is unavailable." Its reasoning: "The U07.1 diagnosis code therefore remains sufficient for identifying COVID-19 cases for the DRG add-on policy."[59]

The association does not only lobby the billing system. It chairs and staffs part of it. It owns the copyright on the UB-04 billing manual, which the National Uniform Billing Committee calls "the only official source of UB Data." AHA staff chair that committee and hold its secretariat, and the committee told hospitals how to flag COVID claims on 23 March 2020, four days before the law was signed.[60] The association is one of four "Cooperating Parties" that approve the ICD-10-CM Official Guidelines, which federal law makes mandatory and which say, of COVID, that "the provider's documentation that the individual has COVID-19 is sufficient" to assign the code the bonus is keyed to.[61, 62] The association spent $19.5 million lobbying in 2020, its own filings show.[63]

The Federation of American Hospitals' first-quarter filing says it "advocated in support of lifting sequester, increasing DRG payments."[64]

Now the file. The Senate Finance Committee's own 19 March summary of the add-on carries the author tag "Baker, Brett (Finance)."[44] The Finance Republicans' health staff in those years included a Brett Baker: Senior Advisor, Health Policy under Chuck Grassley in 2018, and Deputy Health Policy Director under Mike Crapo by February 2021.[65] In April 2022 a Brett Baker is a registered lobbyist for the American Hospital Association at The Nickles Group, the firm that was already the association's outside lobbyist in 2020. His form lists Senate Finance Committee jobs under Crapo, Grassley and Hatch, "Deputy Health Policy Director; Health Policy Dir.; Senior Policy Advsr; Policy Advisor," and a House Ways and Means professional-staff post as his government experience.[66] That is a revolving door: a senior Finance Republican health aide through February 2021 is the hospital lobby's man in 2022.

What reached the bedside

James Miller was a trauma and acute-care surgeon who also worked in critical care at Providence Regional Medical Center Everett in Washington State, the hospital that treated the first American COVID patient.[67] He signed a 72-paragraph declaration under penalty of perjury on 31 May 2024. It names the hospital officials who, he swears, carried the federal requirements to the staff.[12]

In late February or early March 2020, he swears, Stephen Campbell, chief medical officer of the Providence Medical Group, informed him that "the CDC had sent us a powerful antiviral." Miller says the drug was "understood to be remdesivir, which was given to the hospital as compassionate use directly from the CDC," and swears Campbell's representations about its effectiveness were "inaccurate."[12] The New England Journal of Medicine's report on the first U.S. case confirms that doctors at Providence "pursued compassionate use" of remdesivir for him.[67]

"The Chief Medical Officer, Jay Cook, would send out weekly to daily directives to the staff and physicians providing updates of the CDC and CMS requirements ... throughout the entire COVID crisis (over one year). ... it was understood that you would lose your job and/or license if you did not maintain compliance with the unscientific and constantly shifting federal health requirements." Dr. James Miller, sworn declaration, 2024.[12]

Miller swears that masking, ventilator use, protective equipment, staff vaccination, distancing and the shutdown of elective surgery "were all determined by the federal health agencies and forced upon the staff and patients by the hospital administrators." He swears that after the directives began, "the hospital's unanticipated mortality in indexed trauma surgery patients increased by more than 100% (doubled)," and that "the administration was confronted with this data and made no changes."[12] He swears he found Medicare fraud by several providers in March 2020, "with the approval of the Chief Medical Officer of the hospital," reported it to authorities, and that administrators then tried to fabricate grounds to fire him and go after his license. He swears the default on death certificates assigned to him was COVID, and that the hospital's COVID numbers turned downward on or about 17 March 2020 while leadership went on publishing inflated counts and collecting federal aid.[12] After he resigned in January 2022, he swears, four requests for a fair hearing on a "microaggression" investigation that cleared him were denied by Cook, the chief of surgery and two committee heads.

By Miller's account those directives carried the CDC and CMS requirements to the hospital's staff. No copy is public. Washington's public records law covers state and local agencies, not a private hospital system like Providence, and state law shields hospital peer-review files.[68, 69, 70] The copies sit in Providence's system and in the inboxes of the physicians who received them. A Senate committee's letter to Providence is the tool that gets them.

Other doctors fought the protocols at their own cost. Paul Marik, a critical-care physician in Norfolk, Virginia, sued Sentara Healthcare on 9 November 2021 over its ban on ivermectin and other drugs in his protocol. He swore that he believed about half the patients admitted to his ICU had received or were getting remdesivir, and that he does not prescribe it and stops it. The injunction hearing was on 18 November, the date on a letter suspending his privileges for 14 days that Marik found on 20 November. The judge denied the injunction on 23 November. Sentara's own guidelines listed remdesivir starting criteria drawn from the NIAID trial and did not require the drug.[71]

What the evidence said, and what the protocols did

Early in 2020 the profession's own guideline told doctors to watch patients on high-flow oxygen and "early intubation in a controlled setting if worsening occurs."[72] Reported deaths among ventilated COVID patients averaged 45 percent across 69 studies and 57,420 patients.[73] At Northwell in New York, by 4 April 2020, 24.5 percent of 1,151 ventilated patients had died and 72.2 percent were still in hospital; the claim that 88 percent died divides 282 by the 320 whose outcome was known.[74]

One steroid worked. Britain's RECOVERY trial, funded in part by the Wellcome Trust and the Gates Foundation, showed dexamethasone helped patients on oxygen or ventilators, and NIH recommended it for ventilated patients and for patients on supplemental oxygen on 25 June 2020.[75, 76] The panel recommended against hydroxychloroquine in June 2020 and against ivermectin in August 2020 outside a trial. In February 2021 it moved ivermectin to "insufficient evidence ... to recommend either for or against."[77, 78, 79] The payment rule named neither drug.

Visitors, mandates and the shield

On 13 March 2020 CMS told nursing homes to "restrict visitation of all visitors and non-essential health care personnel, except for certain compassionate care situations, such as an end-of-life situation." David R. Wright signed it.[8] CMS's later visitation memo, QSO-20-39-NH, revised on 8 May 2023 as the emergency ended, says "Visitation is allowed for all residents at all times."[80] The nurse's post called the policy "the same green light to lock families out"; the first federal visitation memo was this one.[3]

On 5 November 2021 CMS required 15 types of Medicare- and Medicaid-certified providers, hospitals and nursing homes among them, to ensure their staff were vaccinated. CMS Administrator Chiquita Brooks-LaSure approved the rule and HHS Secretary Xavier Becerra signed it.[9] Two federal courts blocked it in late November. On 13 January 2022 the Supreme Court stayed both injunctions, five to four, with Thomas, Alito, Gorsuch and Barrett dissenting.[81] CMS withdrew it in June 2023.[82]

The legal shield is older than both. Azar signed the PREP Act declaration on 10 March 2020, putting into effect the Act's rule that, "subject to other provisions," a covered person "shall be immune from suit and liability under federal and state law with respect to all claims for loss caused by, arising out of, relating to, or resulting from the administration to or use by an individual of a covered countermeasure," except for claims of "willful misconduct."[10] HHS has amended it twelve times. The twelfth, signed by Becerra in December 2024, runs it to 31 December 2029.[11] Injured patients go to a federal compensation program; only willful-misconduct claims can reach court. As of 1 July 2026 it had received 14,146 COVID claims, decided 7,584, found 112 eligible and paid 62.[83]

Who was at the table

The federal offices above answered to the HHS Secretary. The people in them also kept company with a small circle outside government that had been rehearsing outbreaks since 2001.

Fauci spoke with Bill Gates on a schedule his diary calls "every 2 weeks." On 1 April 2020 he wrote that Gates "wants the BMGF to partner with me (NIAID) and BARDA in the advanced development and scaleup of vaccines, therapeutics." On 11 June the calls covered monoclonal antibodies and "other therapies." The calls were still biweekly in January 2021.[84, 85, 86] On 23 April 2020, two days after the NIH panel's first guidelines, Gates wrote that remdesivir was "the leading drug candidate in this category."[87] Gates, Wellcome and Mastercard had committed up to $125 million to a COVID-19 Therapeutics Accelerator on 10 March.[88] Asked in August what treatment he would ask for, Gates answered, "Remdesivir."[89] By 26 October the Accelerator had awarded $98.6 million, $2.8 million of it for manufacturing.[90] Almac Sciences announced "a grant of $500,000 by the COVID-19 Therapeutics Accelerator towards developing cost effective, scalable processes for the production of the active pharmaceutical ingredient (API) of the drug remdesivir."[91] The Foundation's own grants ledger lists Almac at $490,763 "to develop a biocatalytic approach for the development of Remdesivir," and Asymchem of Tianjin, China, at $141,000 "to enable a lower cost process for production of Remdesivir API." Two later grants fund a simplified-administration study at Brigham and Women's and an oral remdesivir prodrug at UC San Diego ($1,179,538).[92] Gates's money paid to make Gilead's drug cheaper to manufacture; the Foundation's ledger shows no grant to Gilead.

Gates described the arrangement himself. His 2022 book recalls a first call with Fauci in March 2020: "Our foundation was backing many of them, and I wanted to make sure our agenda for developing and deploying innovations was aligned with his." He wanted to know what Fauci was saying publicly about distancing and masks "so I could help by echoing the same points when I did interviews," and the two "would check in monthly for the rest of the year." Fauci's diary says every two weeks.[93, 84] The January 2022 draft of the book, which Sen. Rand Paul's committee released, listed "Gilead's Remdesivir" among the antivirals for which the Foundation was "placing advance orders" and said remdesivir was not "effective enough to warrant using them broadly." The published book drops Gilead's name and the Foundation's role from the advance-orders sentence and softens the remdesivir paragraph. The same release holds Fauci's email to Gates of 8 January 2022: he edited Chapter 9 and gave the manuscript to David Morens, who "destroyed it after reading it." The acknowledgments thank both men for reviews.[94, 93]

On 1 February 2020 Fauci joined a teleconference with Wellcome Trust director Jeremy Farrar, NIH director Francis Collins, Britain's chief scientific adviser Patrick Vallance and virologists including Kristian Andersen and Christian Drosten.[95] In 2021 his diary records a "regular every two week call with our UK colleagues."[96] Fauci, Farrar and the Gates Foundation's Chris Elias sat together on the Global Preparedness Monitoring Board that issued "A World at Risk" in September 2019.[97]

That report is the script. Its warning: "a very real threat of a rapidly moving, highly lethal pandemic of a respiratory pathogen killing 50 to 80 million people and wiping out nearly 5% of the world's economy. The world is not prepared." Its third chapter is titled "Preparing for the worst: a rapidly spreading, lethal respiratory pathogen." It asked donors to fund "broad-spectrum antivirals," "targeted therapeutics," "surge manufacturing capacity" and "appropriate non-pharmaceutical interventions," which a footnote defines as "school and business closures, airline and transportation protocols." Its stated goal was a world where "distributed manufacturing of vaccines (including nucleic acid types) begins within days of obtaining the new sequences and effective vaccines are pre-tested and approved for use within weeks." It named "misinformation" spread by social media as a threat to disease control. It set its progress checks for "September 2020." Germany, the Gates Foundation, Wellcome and Resolve to Save Lives paid for the board's secretariat, and Johns Hopkins's Center for Health Security and Wellcome wrote background papers for it.[97] A month later Johns Hopkins, the World Economic Forum and the Gates Foundation staged Event 201. In March 2020 the Foundation co-founded the Therapeutics Accelerator, and by August it was funding lower-cost manufacture of remdesivir. The report does not name SARS-CoV-2 or Wuhan. It names the pathogen class, the countermeasures, the closures and the censorship rationale, and each one arrived on schedule.

Elias held senior Population Council posts before he became chief executive of PATH in 2000, and he has run global development at the Gates Foundation since 2012.[98] Three months before the first confirmed U.S. COVID case, on 18 October 2019, he sat at a table at Event 201, an exercise run by Johns Hopkins's Center for Health Security, the World Economic Forum and the Gates Foundation. The scenario was a coronavirus from bats to pigs to people with "a fictional antiviral drug that can help the sick but not significantly limit spread." In the scenario it killed 65 million people in 18 months. The other players included the head of China's CDC, a former CIA deputy director, CDC's Stephen Redd and executives of Johnson & Johnson, Edelman and NBCUniversal.[99, 100, 101] Its recommendations asked governments for "more resources" for "development and surge manufacturing of vaccines, therapeutics, and diagnostics"; told international organizations that "healthcare institutions" among others would need financial support; and, in the seventh, asked media companies to commit that "false messages are suppressed including though [sic] the use of technology."[102]

Tom Inglesby, who directs the Johns Hopkins center that ran Event 201, was a volunteer on the Biden-Harris transition's HHS team in 2020.[103] In 2021 he was Senior Policy Advisor for the COVID-19 response in the HHS Secretary's office, then Senior Advisor on the White House COVID-19 Response Team and National Coordinator for Testing.[104]

The Rockefeller Foundation published its National COVID-19 Testing Action Plan on 21 April 2020, the day the NIH panel posted its first guidelines. It proposed using hospitalized patients' records "to determine optimal treatment paradigms."[105] The foundation had given the Atlantic Council $30 million the year before.[106] The council interviewed Pfizer's chief executive on 9 November 2021; he said of people who purposefully spread vaccine misinformation, "Those people are criminals," and the council gave him an award the next day.[107, 108] Its Scowcroft Center now houses the Bipartisan Commission on Biodefense.[109] Kadlec was the study director of the panel that became that commission in 2014, and Emergent BioSolutions is among its past donors.[110, 111]

The older machine is documented too. On 8 June 1973 General William H. Draper Jr., honorary chairman of the Population Crisis Committee, and General Maxwell Taylor told State Department officials they had "talked to General Scowcroft in Mr. Kissinger's office about it in terms of the possibility of a NSC study" of population growth.[112] The committee's printed rosters list Draper as honorary chairman, Hugh Moore of the Dixie Cup fortune as vice chairman and treasurer, and Taylor, General William Westmoreland, former Sen. Joseph Tydings and publisher Cass Canfield among its officers and directors; Princeton's archive says Moore's fund founded the committee.[113, 114, 115, 116] On 23 March 1974 Brent Scowcroft proposed the study to Kissinger, citing "frequent letters which the President and you have received, principally from Bill Draper."[117] Kissinger wrote on the memo, "Brent, we don't need Pres. OK for NSSM's," and signed National Security Study Memorandum 200 on 24 April 1974. The study, labeled "The Kissinger Report" on its own cover, went to the Ford White House, and on 16 October 1975 Kissinger recommended that Ford endorse its policy recommendations, with exceptions.[118, 117, 119, 120] The Rockefeller Foundation funded the publication and worldwide distribution of the committee's 1973 Ditchley conference report.[114]

Fauci's own road runs through Vice President Cheney's office. His diary records Cheney's office backing his biodefense program in 2002, and Cheney's chief of staff, Lewis "Scooter" Libby, phoning him mid-meeting to demand a same-day write-up.[121] The Bipartisan Commission on Biodefense lists Libby as an ex officio member.[122]

All of this is public record now. The calls are in Fauci's own diary, the exercise is on a Johns Hopkins website and the rosters sit in public libraries. No record we hold shows who in that circle asked for which hospital rule. That is the record to demand.

What it adds up to

A nurse said every hospital got its orders from the top down and that anyone who asked questions was out. The record bears her out on the guidelines, the drug deal, the bonus and the hospital's own orders. A panel with no published rule requiring a member to sit out a vote on a company's product, and nine members who listed Gilead, wrote the treatment protocol. An agreement signed by an official six senators had written to over his undisclosed Emergent ties governed the drug's allocation, recorded its price and agreed to indemnify Gilead for certain unsold stock at $390 a vial. A bonus that began at 15 percent was raised to 20 in the same days the hospital lobby told its members to ask for 25, and nobody has said who changed the number. A lobby that owns the billing manual defended the bonus to the agency that pays it. A surgeon swears his hospital's daily orders arrived as federal requirements with a threat to his license attached. Patients who filed injury claims over the shielded products have been paid in 62 of 7,584 decided cases.

In this system no one signs the whole order. Six offices each sign one piece. The remedy is old and ordinary: put names on decisions. Publish the votes. Bar the people who take a company's money from voting on its product. Pay for outcomes, not for a named drug. Let families into the room.

Americans were told to trust the hospital and follow the science. The hospital was following a stack of rules written in six offices, two of which said in writing that they bound no one. A patient's right to choose a treatment, to say no, to have a daughter at the bedside, depends on finding the person who took it away. No single person who took it away has been found. The list below is how to start.

What to ask for

Every item below can be demanded by a letter from a senator, a records request, a subpoena or a court. Each would put a name on a decision.

  1. The hospital's daily directives. Ask Dr. Miller what he kept. Ask Sen. Johnson's committee to write Providence for Jay Cook's directives and the hospital's remdesivir criteria. Request Washington Department of Health records of remdesivir allocated to Providence Everett, and Snohomish County health department communications with the hospital.[70]
  2. The Senate Republican text of 22 March 2020 (about 580 pages) and the drafting files of Majority Leader McConnell's office and the Finance Committee Republican staff, to find who changed 15 to 20.[123, 124]
  3. Brett Baker's March 2020 title from a Senate staff directory, the dates he left the committee and joined the lobbying firm, and the Finance Committee's confirmation of who authored the 19 March summary.[66]
  4. The NIH panel's votes, minutes and conflict reviews by Freedom of Information Act request to NIH.[16]
  5. The unredacted HHS-Gilead memorandum, the donation agreement and the allocation records from HHS and its preparedness office, and an answer on whether HHS ever paid the indemnity.[5]
  6. The ethics filings of Azar, Hahn, Verma, Collins, Redfield, Birx, Walensky, Becerra and Brooks-LaSure.
  7. The coding trail: the AHA's Coding Clinic text for early 2020, the CDC coding committee's materials of 17 and 18 March 2020, and who asked CDC to move the COVID diagnosis code's start date up from October to 1 April 2020.[125, 62]
  8. Hospital claims data for the hospitals named in the Johnson testimonies, to test the coding charge.[2]
  9. CMS's hospital visitation memos of March 2020 and the rulemaking record behind the staff mandate.[8, 9]
  10. The Gates Foundation's Therapeutics Accelerator award ledger: which donor paid for which award, the six 2021-22 generic-manufacturer grants ($12.0 million, Cipla, Dr. Reddy's, Macleods, Hetero, YaoPharma, Mylan) for "a low-cost COVID therapeutic," the contribution agreements behind the NIH ACTIV partnership, and the Foundation's 990-PF filings for 2019 to 2021.[92]
  11. The Rockefeller Foundation's grant schedules for 2020 and 2021, the Gates Foundation's grants to Johns Hopkins, WHO and CEPI, and the Atlantic Council's donor lists, to find which of these circles paid for which rule.
  12. The Nixon Library's NSSM 200 files and the Ford Library's files on the 1975 decision memo, which would show who drafted the population study.[117, 119, 120]

Johnson's office holds 583 testimonies, and twenty-one people spoke. The rest belong in the public record.

Sources

  1. Sen. Ron Johnson, media advisory, 16 September 2026: roundtable on COVID-19 hospital protocols, Russell Senate Office Building https://www.ronjohnson.senate.gov/2026/09/16/media-advisory-sen-johnson-to-lead-roundtable-discussion-covid-19-hospital-protocols-real-stories-from-real-people/
  2. Sen. Ron Johnson, video release of the 28 September 2026 roundtable "COVID-19 Hospital Protocols: Real Stories from Real People" https://www.ronjohnson.senate.gov/2026/09/30/video-release-sen-johnsons-full-roundtable-discussion-covid-19-hospital-protocols-real-stories-from-real-people/
  3. Social-media post by Wall Street Apes quoting an unnamed nurse after the roundtable (text on file: data/hospital_protocols/social_wsa_nurse_post_pasted_20261005.txt)
  4. Kuriakose et al., "Developing Treatment Guidelines During a Pandemic Health Crisis: Lessons Learned From COVID-19," Annals of Internal Medicine 2021;174:1151-8 https://pmc.ncbi.nlm.nih.gov/articles/PMC8252833/
  5. HHS-Gilead-AmerisourceBergen Memorandum of Understanding, 27 June 2020 (signed for HHS by Robert Kadlec; Wayback) https://web.archive.org/web/2021id_/https://www.hhs.gov/sites/default/files/gilead-mou.pdf
  6. CARES Act, Pub. L. 116-136, section 3710 https://www.congress.gov/116/plaws/publ136/PLAW-116publ136.htm
  7. CMS interim final rule CMS-9912-IFC, 85 FR 71142, 6 November 2020 (the add-on payment for new COVID-19 treatments) https://www.govinfo.gov/content/pkg/FR-2020-11-06/pdf/2020-24332.pdf
  8. CMS memo QSO-20-14-NH, 13 March 2020, signed David R. Wright (Wayback capture; copy on file: research_dumps/hospital_writeup/sources_A/cms_QSO-20-14-NH_13Mar2020_wayback.pdf)
  9. CMS interim final rule, Omnibus COVID-19 Health Care Staff Vaccination, 86 FR 61555, 5 November 2021 https://www.govinfo.gov/content/pkg/FR-2021-11-05/pdf/2021-23831.pdf
  10. PREP Act declaration for COVID-19 countermeasures, 85 FR 15198, 17 March 2020 (signed Alex Azar) https://www.govinfo.gov/content/pkg/FR-2020-03-17/pdf/2020-05484.pdf
  11. 12th Amendment to the PREP Act declaration, 89 FR 99875, 11 December 2024 (extends to 31 December 2029) https://www.govinfo.gov/content/pkg/FR-2024-12-11/pdf/2024-29108.pdf
  12. Declaration of James P. Miller, M.D., 31 May 2024, under penalty of perjury, 28 U.S.C. 1746 https://www.midwesterndoctor.com/api/v1/file/3013de2e-427e-4ee6-8114-a307aaa2ec3d.pdf
  13. CMS MLN Matters article MM11764 (change request 11764, transmittal R10058CP) implementing section 3710 https://www.cms.gov/files/document/mm11764.pdf
  14. NIH COVID-19 Treatment Guidelines, first edition, 21 April 2020 (archived PDF; copy on file: data/gilead_remdesivir/nih_guidelines_first_edition_20200421_wayback.pdf), roster and disclosure tables Appendix A
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  17. NIH panel financial-disclosure tables, April, July and October 2020 editions (archived HTML; copies on file: data/gilead_remdesivir/nih_panel_disclosure_wayback_20200802.html and _20201101.html)
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  23. Fauci emails, 29 April 2020 (BuzzFeed/FOIA release; structured copy on file: data/covid_origin_docs/buzzfeed_fauci/fauci_email_data_structured.json)
  24. White House transcript, 29 April 2020, meeting with Gov. Edwards (Fauci: "This will be the standard of care") https://trumpwhitehouse.archives.gov/briefings-statements/remarks-president-trump-meeting-governor-edwards-louisiana/
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  35. Gilead Sciences Form 10-K for 2021 (Veklury sales) https://www.sec.gov/Archives/edgar/data/882095/000088209522000007/gild-20211231.htm
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  38. New Jersey Department of Health memo, 26 June 2020, remdesivir distribution, reporting and use https://nj.gov/health/legal/covid19/06-26-2020_RemdesivirDistributionReporting_andUseforTreatment_ofPatients.pdf
  39. Letter from Sens. Murray, Warren, Casey, Hassan, Murphy and Baldwin to Robert Kadlec, 8 May 2020 (copy on file: source_documents/kadlec/2020-05-08_Senate_ethics_letter_to_Kadlec_6signatories.pdf)
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  41. Washington Post, 4 May 2020, on the stockpile chief and Emergent (syndicated copy on file: source_documents/kadlec/)
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  43. S. 3548, 116th Congress, as introduced 19 March 2020, section 4409 (15 percent) https://www.congress.gov/bill/116th-congress/senate-bill/3548/text
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  49. Politico, Susannah Luthi and Rachel Roubein, "Congress gives hospitals $100B they demanded in coronavirus package," 25 March 2020 (copy on file: data/hospital_protocols/cares3710_press_politico_20200325_hospitals_100b.txt) https://www.politico.com/news/2020/03/25/congress-hospitals-coronavirus-funding-148152
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