Public Health

Mira Irons, MD, discusses the latest trends as U.S. surpasses 5 million cases

. 10 MIN READ

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

 

 

In today’s COVID-19 update, Todd Unger, AMA chief experience officer and Mira Irons, MD, AMA chief health and science officer, take a look at the weekly numbers, trends and latest news about COVID-19, including the U.S. passing a new milestone with five million people now infected with the virus.

Learn more at the AMA COVID-19 resource center.

Speakers

  • Mira Irons, MD, chief health and science officer, 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 with AMA's Chief Health and Science Officer, Dr. Mira Irons in Chicago. I'm Todd Unger, AMA's Chief Experience Officer in Chicago. Dr. Irons, let's start by reviewing this week's numbers, a new milestone this weekend. Tell us what's happening across the country with new cases and deaths.

Dr. Irons: Yes. So Todd, we continue to set records. The new milestone this weekend was that the United States passed the 5 million mark for people who have been infected with COVID. That's almost about a quarter of the world's cases that we know of. If you look at the exact numbers as of this morning, 5,045,564 people have been infected and 162,938 deaths. You know, as I said last week, we somehow have become immune to these figures, but every one of those deaths is someone's mother, father, child, or aunt or uncle.

If you look at other records, Florida has surpassed the 500,000 mark in cases. We're seeing there is some improvement if you take the country as a whole. You might remember about a week or so ago, we were talking about 70,000 new cases every day. That over the last week has been in more in the 50,000 to 60,000 range. You know, they're all big numbers. So we take any decreases as maybe a positive sign. And the death rate has been about a thousand per day across the United States.

Southern states looking a little better. Their positivity rate is decreasing slightly. A good sign, but still the numbers are high in some of those states. The United States as a whole looks at about eight to 9% positive across the country. But you know, that includes states that are doing really well and states that are not doing as well. But the concern is that there's been a slow uptick in cities like Chicago, Baltimore, Boston, that have been able to contain the virus over the last month or so. And what we've learned from the South is a small uptick can become a surge if it isn't taken care of right away.

Unger: So we continue to see kind of a shift around the country and we are seeing some localities take special actions in a more aggressive way to stop the pandemic.

Dr. Irons: Yeah, absolutely. I think that some of the governors and local mayors are starting to look at these things more closely. Chicago started a mask campaign last week. Illinois started a mask campaign last week. The governor of Illinois has decided that they can fine businesses of up to $2,500 if people are found not to be wearing masks. The Houston mayor says that they can impose a fine of up to $250 per person, per individual, if they're not wearing masks and in public. So they're putting some penalties out there to try to get people to comply with the mask orders.

Unger: Well, let's talk some about some of the other trends and key events from this past week. Let's talk about for starters Dr. Birx, who made some headlines last week with her assessment of the pandemic. Can you talk a little bit about that?

Dr. Irons: Sure. She did. You know, the statement that she made last week was that what we're seeing now is different than what we experienced. March and April we were really looking at large cities, large urban centers and some of the surrounding centers, but now we're really starting to see COVID spread into the rural environments and settings where there previously were very, very low levels of COVID and that's a concern.

Unger: So other news. School reopenings continue to make headlines and cause questions, any insight on that?

Dr. Irons: Well, what we're hearing is pretty much all over the place. If you look at colleges, for example, Johns Hopkins recently announced that for the fall they're not going to have on-campus students. Whereas Notre Dame is open today for students coming onto campus. If you look at schools in cities, the Chicago Public School System is going to have virtual education for the fall. Whereas in the South, we've actually seen, Florida has some counties opening today. Georgia opened last week. So it seems like it is pretty much all over the place.

For now Governor Cuomo of New York has signaled that schools can open because their positivity rate in the state is low. In the 1% range, but he's leaving it up to districts, towns and cities to make their own decisions based on how safely they can reopen the schools. The Georgia high school that we talked about last week, and that you may have seen the pictures in the news with the crowded hallways of students that really weren't wearing masks from what you could tell from the picture, is closed today and tomorrow for deep cleaning, because nine students have tested positive. So I think we're going to learn a lot, sadly, by what happens over the next few days to weeks.

Unger: Yeah, that kind of very viral photograph of that packed hallway was quite telling. Another photograph that of course many of us have seen over the weekend is the very, very large rally, I believe in South Dakota, motorcycle riders. I think the estimates are up to 250,000 people. That has to be one of the most enormous events during this pandemic.

Dr. Irons: Yeah. And the super-spreading events still continue to be a concern. You know, the virus is spread from person to person. Large numbers of people in close contact for long periods of time are going to just increase the spread. And what we're talking about is that there's a combination of the super-spreader, having someone at the appropriate time that can spread the virus in a specific, super-spreading event. It's almost as though those two things have to come together. But in addition to the rally, the motorcycle rally that you referred to, you know, the beaches. There are pictures of people congregating on beaches, large groups of people in churches. And so these large events are still occurring.

Unger: And we are still seeing the role of asymptomatic people in spreading through community. How is that going?

Dr. Irons: Well, I think the concern is that there is a high asymptomatic carrier rate, either people who never develop symptoms, or who are presymptomatic and just don't know that they have it. And so because you can't tell who is either asymptomatic or presymptomatic, the only way to really protect others and to protect yourself is to do mitigation measures like wearing a mask and social distancing.

Unger: There was a lot of confusion about the reliability of testing last week when Ohio Governor Mike DeWine had a positive test result that was later contradicted with a negative test. Should we be worried about the reliability of testing in addition to all the other testing challenges that we're seeing?

Dr. Irons: No. I think that what is important is to know what tests you're getting and what you can expect of that test, and to also work with someone who can interpret that test within the context of your symptoms. So we know that the diagnostic test for COVID, the most accurate, the one with the least a false negative rate is the PCR test, the molecular test. That test takes time. It has to be done in a laboratory, and it may have, depending on what lab does it, anywhere from 12 to 24 hours to several days. There's also an antigen test, which actually doesn't look at the genetic material, but looks at the protein of the virus. That test result can come within a half an hour to an hour, but it has a higher false negative rate.

And so you have to weigh those two tests depending on whether or not you're symptomatic. The important thing is, if you have symptoms or if you've had a close exposure, think you might have COVID, to actually remain quarantined until you get your test result. I don't know what the circumstances were with the governor of Ohio, but another issue that may give a false negative result is timing. You're tested either too early or too late in the course of your condition, or just not getting a good specimen. You know, getting a good nasal swab is really hard to do. And so not having a good specimen. Or having it transported in the right way can give you a false negative.

Unger: Vaccine development continues to be in the news. Can you report anything new on that front?

Dr. Irons: So there are six vaccines that are currently in the group that the government is supporting. Two of those vaccines went into phase three clinical trials just two weeks ago today. The third, the Oxford AstraZeneca vaccine, will be joining the U. S. clinical trials sometime in the near future. And the others are sort of along the pipeline, are in the pipeline also.

The important thing is that each phase three trial is going to require 30,000 people. So that's a lot of people. It's important to get people from all different ages, demographics, racial and ethnic groups, and also those with comorbidities. Because you want to make sure that the vaccine is effective in all of the populations that will get it. And so anyone that would like to volunteer for a vaccine trial, you can go to coronavirus.gov and just scroll down to whether you want to volunteer in a trial and sign up.

Unger: Interesting. Well lastly, what key messages from the AMA do you want people to hear this week?

Dr. Irons: So the key messages. I'll start with we released a new report along with the Pew Charitable Trusts about the barriers to combating antibiotic resistance in outpatient settings. This is one of the things that the AMA has been concerned about throughout the years, is the increasing rates of antibiotic resistance, which is not a good thing anywhere, but it's certainly not a good thing during a pandemic when people need to have effective medications. And so that was released. But the other really exciting thing is the MaskUp campaign that the AMA started last week, really encouraging the use of masks, showing people how to wear them correctly, covering the nose and the mouth, because if we all work together, we really have a better chance of tackling this.

Unger: Well, thank you so much, Dr. Irons for being here today and sharing your update. We'll look forward to talking with you again next week.

That's it for today's COVID-19 update. We'll be back tomorrow with another segment. For resources on COVID-19, visit 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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