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

In today’s COVID-19 update, AMA Chief Experience Officer Todd Unger and AMA Chief Health and Science Officer Mira Irons, MD, take a look at the numbers, trends and latest news about COVID-19, including the impact of the passing of Supreme Court Justice Ruth Bader Ginsburg and the possible future implications for health care.

Learn more at the AMA COVID-19 resource center.


  • Mira Irons, MD, chief health and science officer, AMA


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, before we dive into the numbers, let's take a moment to acknowledge Ruth Bader Ginsburg passing last Friday and the implications for health care and medicine.

Dr. Irons: Thanks a lot, Todd. I think that we're all still reeling from hearing about her passing. One of my colleagues at the AMA this morning called it a gut punch. And I think we're still trying to think about what the implications are. Justice Ginsburg was a pioneering advocate for gender equality and women's rights. When I think about it, my entire generation of women would not, and our daughters, moving forward, would not have had the opportunities that we have had it not been for her. But there are also implications to medicine. With having her leave the court, and obviously the ACA, the future of ACA hangs in the balance and other implications. We will be monitoring it closely.

Unger: Thank you. Well, let's move to looking at the week's numbers. We are approaching a grim milestone very soon. Let's talk about what's happening with the country, in the country with new cases and deaths.

Dr. Irons: The numbers this morning from the Hopkins Dashboard are 6,812,470 people have been diagnosed with COVID. That may actually be an under-representation, given all of the, of the weather and the natural disasters that we've experienced in the country over the last few weeks. We may be testing fewer people than are out there. The current death rate, the death toll is 199,517. We are nearing that grim milestone of 200,000, may have already exceeded it today. But certainly, when the numbers are updated, we will be past that 200,000 grim milestone. The National Cathedral in Washington yesterday tolled it's mourning bell 200 times, one for each thousand people who had died because of COVID-19. I think it's safe to say it's a number that we never expected to see, I think, in our lifetimes.

Unger: Geographically, what are we seeing in terms of patterns of infection?

Dr. Irons: Well, after a week of looking as though things were coming down in the southern states and looking at somewhere in the 30s to 40,000 daily averages, we're starting to come up. We're starting to see some upticks in the Midwest and also the Southwest, as well as the states like Utah. When we think back to the spring, Utah was one of the States that was doing really well, but we're starting to see some upticks around the country.

Unger: As well as in Europe. What I think we're reading now are potential surges in the UK, as well as other parts of Europe, so what's much to keep your eye on. In terms of those kinds of events that are leading to further outbreaks, any comments on what's driving that?

Dr. Irons: Well, schools and college campuses are driving it, as we've been talking about for the last few weeks, but also large super spreader events. The motorcycle rally in Sturgis, South Dakota. We've seen upticks in the Dakotas because of that and even as far as Minnesota. There was another large rally in Missouri, the Lake of the Ozarks, I believe over the weekend, so we're getting prepared to see the upticks that happened from that. And then we're also looking at the effect of, the effect of moving indoors if you look at what's happening in Oregon. Many people have had to shelter indoors because of the fires in Oregon. And so the early reports are they're starting to see an uptick in positives because of that.

Unger: That's really an unexpected outcome of an already terrible situation. Let's talk about additional news. There's been a lot over the past week. News broke late last week that the guidance on the CDC website was posted without going through the agency scientific review process. What happened here?

Dr. Irons: We talked about this a few weeks ago. When the guidance came out in terms of who should be tested in the CDC guidance that came out, people who had known exposures to COVID, who are asymptomatic were not listed as needing to be tested which sent off red flags everywhere because that didn't make sense. And the AMA, as well as other organizations, immediately called for the evidence that supported that recommendation. It just didn't make sense. And so what we began to hear last week is that that guidance had actually not gone through the necessary scientific review processes at the CDC and that it was not what the CDC scientists felt it should be. And so this past Friday that guidance was changed, and it became clear that if you were exposed to someone who has COVID, and that exposure is defined as at least 15 minutes in the presence of someone who's positive, you should have a test.

Unger: That is much more consistent, obviously, with the statement from the AMA. It is very concerning overall. I mean, what are your concerns here in terms of the kind of changing of course and clarity of messaging?

Dr. Irons: Oh, well, obviously, we've seen and we've made statements that science should not be politicized. Science is science. Evidence is evidence, and the facts should speak for themselves. And so from the beginning of the pandemic, the spokespeople for the AMA, in all of our statements, have really focused on the fact that evidence, science and data should really drive our actions. If we think back to Dr. Harris, when she was being interviewed in March and April, she started off many of her interviews by saying, "Let's see what the evidence, let's start with what the evidence shows." And that's always been our guiding star.

Unger: Well, Dr. Irons, you mentioned school openings as being a particular driver. Can you talk a little bit about what we're seeing across states in regard to both school and college reopenings?

Dr. Irons: Yeah. We're starting to see, not only in the Midwest, but as you bring people back into congregate living facilities, you're going to see an uptick. And we've talked to in the past about Ohio State and Indiana University and Notre Dame and some of the others, and that's just continuing around the country. We've seen large numbers going up in Wisconsin recently. In Boulder County, Colorado, we've seen an increase in their numbers. Cases have risen sharply in Utah. And so it seems as though the college openings are really are starting upticks in their communities.

Now, the important thing there is for the colleges to actually identify those people, isolate them and so that they don't continue to spread. But I think that some colleges are responding. I heard this morning, some are calling off, canceling spring break to try to keep kids from all going out to the beaches or to have other large gatherings. We're in unprecedented times. And I think that college administrators are trying as best as they can to try to control things on their campuses.

Unger: Well, finally, anything new to report with vaccines and treatments this week?

Dr. Irons: We're seeing a lot of transparency. There are two vaccines in phase three trials in the United States, the Moderna vaccine, that's going through the NIH trials network and the Pfizer vaccine, that's going through their network. Both those companies have actually made public the trial protocols, the clinical trial protocols, which is usually not something that's done. And they're over 100 page documents, but it lays out exactly what the trials are, what the end points are and how each of the manufacturers, how they're going to evaluate the data to determine efficacy. Over the weekend, the AstraZeneca Oxford vaccine, that trial was halted in the United States, but was resumed in the UK, they also made their trial protocol transparent and available to the public. That degree of transparency, as I said, has not been seen before, but we're following this very closely.

Unger: What's the reason for that? If that's not something normal, why are they releasing that publicly?

Dr. Irons: Well, I think that it's hard to tell. I don't want to speak for them. But I think that the stakes are really high here. As you know, there's been a lot of involvement, public involvement in this. There have been concerns because of terms like Operation Warp Speed that this process is going too quickly. And so there are large numbers of people who are hesitant about the vaccine, people who normally line up first, because they believe in vaccines. So being transparent with the data and allowing people to understand that the rigor in determining safety and efficacy is still there will be very important.

Unger: Well, thank you so much for being with us here this week and sharing your latest updates, Dr. Irons. We'll see you soon for another COVID-19 update. For updated resources on COVID-19 visit Thanks for joining us today and please 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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