Public Health

Andrea Garcia, JD, MPH, looks at the numbers as U.S. COVID cases continue upward

. 9 MIN READ

Watch the AMA's daily COVID-19 update, with insights from AMA leaders and experts about the pandemic.

 

 

AMA Chief Experience Officer Todd Unger takes a look at this week’s COVID-19 trends with AMA Director of Science, Medicine and Public Health, Andrea Garcia, including the U.S. hitting a new record in daily cases.

Learn more at the AMA COVID-19 resource center.

Speakers

  • Andrea Garcia, JD, MPH, director, science, medicine and public health, AMA

AMA COVID-19 Daily Video Update

AMA’s video collection features experts and physician leaders discussing the latest on the pandemic.

Unger: Hello, this is the American Medical Association's COVID-19 update. Today, we're taking our weekly look at the numbers, trends and latest news about COVID-19. Filling in for Dr. Mira irons, we have Andrea Garcia, the AMA's director of science, medicine, and public health in Chicago. I'm Todd Unger, AMA's Chief Experience Officer in Chicago. Ms. Garcia, let's jump into this week's numbers. Unfortunately, it's been a bad week, not a lot of good news. What's happening across the country with new cases and deaths?

Garcia: Yeah, you're right, Todd. Unfortunately the news isn't improving. We continue to break records. As you know, last week we surpassed the three million mark in terms of COVID cases. Today we're at 3,308,312 cases at 135,219 deaths. We hit a new record in daily cases on Friday, approaching the 70,000 case mark, and really across the states, the numbers continue to rise. At this point, we're seeing 44 states reporting increases. Only three of those states in the Northeast are showing a decrease in cases. Those are Maine, New Hampshire and Rhode Island. Florida on Friday, or over the weekend, really broke another record in terms of the pandemic with 15,299 cases. That's the highest number we've seen from any state over the course of the pandemic. And we're also seeing...

Unger: And that includes New York at the height of the pandemic?

Garcia: It does. Yeah, it does. It's the highest of any jurisdiction. So we're also seeing hospitalizations increase. At the peak in April, we were at 60,000 hospitalizations and that curve is going back up. We're we're nearing the 52,000 hospitalizations per day. So unfortunately things continue to go in the wrong direction.

Unger: I know in his interview with Dr. Fauci, between Dr. Bauchner and Dr. Fauci on the JAMA podcast, Dr. Fauci suggested there might be a lag explaining some of that disconnect apparent between cases and deaths. Are you starting to see that tick upwards now?

Garcia: Absolutely. We are seeing that and Dr. Fauci in his interview said it could be a few things. It could be that we're seeing younger people who are infected who don't really have the same fatality as we see in older individuals who have more co-morbid conditions, or it could be that we're doing a better job protecting those vulnerable populations, those elderly populations, because we know they are at higher risk. Or it could be the lag. And unfortunately, I think what we're seeing is the lag, because now we are seeing cases increase hospitalizations increase, and deaths increase and they're increasing in the Southeast, Southwest and the West. So that's making up for the decrease we're seeing in the mid Atlantic region, in the Northeast and in the Midwest.

Unger: And if our viewers haven't seen that interview between Dr. Howard Bauchner at JAMA and Dr. Fauci, please take a look on the JAMA site. Ms. Garcia, what other trends have you seen over the last week?

Garcia: It's more of the same and we're continuing to hear about PPE shortages. That continues to be an ongoing problem. And as you know, the AMA's written several letters to the administration calling for them to invoke the DPA to really get more PPE in the hands of healthcare providers. We're hearing in the hotspots that they're running out of ICU beds in counties in Texas and in Arizona and in Florida. That's a real problem. And then even if you have the ICU beds, you're going to see staffing shortages. So how do you make sure you have enough health professionals to care for those patients?

And we know in Texas, several federal disaster management assistance or DMAT teams are coming in to help provide that staffing support that is going to be so needed. We saw the volunteers coming into New York, some of these hotspots are going to start to need volunteer health professionals coming in. The other issue with testing, we continue to see a shortage in testing supplies, lag in getting test results. Some test results are taking more than a week, which is a big problem if you want to effectively do contact tracing and stop the spread. We really need to get testing supplies. And then finally Remdesivir. We know that that is a therapeutic that we have to treat patients, but a for us getting it to those hotspots, it's just not enough to meet demand at this point.

Unger: This doesn't really suggest a good foundation for a lot of the talk around school openings in the fall and sports along with them. What can you talk to about that?

Garcia: Yeah, so the school openings, as a mom of young kids, that has been highly controversial in my community, and I'm not envious of the school administrators who are having to make these difficult decisions. I think we're hearing a lot of people saying that in-person education full-time is really the goal here, but how do we do that safely and how do we ensure we're able to protect students? It may not be a universal answer for all communities across the country. If you're in a hot spot and you're opening schools full-time, and you're not able to socially distance, then that can certainly exacerbate the problem. So it really needs school administrators to work with our state and local health departments on that issue and as we consider opening.

Unger: It seems like there was some confusion last week regarding school openings and CDC guidelines. Can you add any clarification on that?

Garcia: At this time I can't. We obviously have regular conversations with the CDC and they mentioned on our partner call today that they are going to be issuing new guidance, but we haven't seen that yet, and we look forward to reviewing it.

Unger: In terms of other clarifications, there was some news from the WHO, World Health Organization, acknowledging that the virus can linger in the air indoors. What's different about that guidance than before, and what are the implications of that?

Garcia: Yeah, so everyone has primarily believed that this disease spreads through when people sneeze or cough, but this isn't like measles, which lingers in the air for two hours and you have the possibility to catch that way just being in a similar space. But what the WHO said this week is that they can't rule out short range aerosol transmission in certain indoor settings. So if you're in an indoor setting that is poorly ventilated for a prolonged period of time with someone who is positive, that aerosol transmission may be a possibility. I mean, this is one of those areas where we need more evidence and we're looking for that evidence to make the best informed decisions. So this is one of those places where we may see evidence or guidance evolve as we have additional information.

Unger: You know, there's been some question about that very concept of things evolving, what does that mean? Does that mean things were wrong before, or is it just really clarification based on new learning?

Garcia: It's really the latter. It's that clarification based on new learning. It can be difficult, but this is a novel virus, and a lot of the guidance that is posed for that reason is based on what information we know at this point. The guidance is going to change as we learn more, and I think making that clear to the public is really important.

Unger: Well, finally, what kind of key messages are coming from the AMA this past week?

Garcia: Well, there are a couple of letters that went out last week that listeners should be aware of, one, the AMA called on the administration to reconsider the ill-advised decision around international students, that basically if schools such as medical schools moved to an online only format, that would change the status of these students. A second letter that went out was around the World Health Organization and the U.S. withdrawal from the WHO. We joined with AAP, AASP and ACP to really condemn that move, especially in the middle of a global pandemic where collaboration is so important. And then finally a very important public health issue that's not really COVID-related, but equally one that our listeners should be aware of is around police brutality. So the AMA put out a letter to legislators last week outlining police reforms that would address law enforcement violence as minoritized communities. So take a look at those recommendations about which are based on AMA policy.

Unger: Any additional news or takeaways for the coming week?

Garcia: No, the message is the same. Wear a mask, stay six feet apart, and wash your hands.

Unger: That is the good word. And thank you for being with us here today, Ms. Garcia, and sharing your perspective and your weekly update. That's it for today's COVID-19 update. We'll be back tomorrow with another segment. For updated resources, visit AMA's COVID resource center at ama-assn.org/covid-19. Thanks for joining us and take care.


Disclaimer: The viewpoints expressed in this video are those of the participants and/or do not necessarily reflect the views and policies of the AMA.

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