Public Health

Mira Irons, MD, reviews trends in cases and developments with vaccines

. 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, AMA Chief Experience Officer Todd Unger and AMA Chief Health and Science Officer Mira Irons, MD, review COVID-19 numbers and trending topics related to the pandemic over the past week, including news regarding vaccine development and antibody treatment.

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 Chief Health and Science Officer, Dr. Mira Irons in Chicago. I'm Todd Unger, AMA Chief Experience Officer in Chicago.

Dr. Irons, we received some big news with vaccine this week. Before we get into the numbers, can you talk about developments on the vaccine front?

Dr. Irons: Sure. I'll be happy to. So, as you know there've been multiple companies’ vaccines in phase three trials, and we've all been waiting the results of those trials. And what we heard this week from Pfizer, that's working on an mRNA vaccine. And this is data that's been released from the company. Is that an interim analysis by their review board, their advisory board has shown that the vaccine appears to be greater than 90% effective. Now, it's important to note that that's an interim analysis, they're actually doing a larger analysis once they hit their threshold. They didn't release safety data, we hear that safety data is coming up possibly next week, or within a week or so. We really don't know how severe or how mild or moderate the cases of COVID were, and the vaccine arm of the trial. So, there's a lot of ifs, but a vaccine that's greater than 90% effective, if that number holds, I think is more than any of us would have hoped for going into this.

Unger: That's very much on the high end of what we were hoping. Is that correct?

Dr. Irons: Yes. The FDA had actually set the bar for an application for authorization or licensing at 50%. There are many vaccines that have less efficacy than that. 90% is in the range of something like the measles vaccine, so we'll see. I think we're waiting to hear the results. It sounds as though from the company that there will be an application for authorization within a month or so. And we'll have more data, then we'll be able to look at the data and listen in to the advisory board discussions.

Unger: So, obviously very positive development. Does that mean that we're turning the corner on this right away?

Dr. Irons: Well, it's the first good news that we've had in a long time, but vaccines are only effective if people get vaccinated. And I think that we really have to address the vaccine hesitancy that's out there, and it's going to take a while for enough of the country to get vaccinated in order to start to feel safe. So, vaccination is the first step, but I think that we're going to be wearing masks, We're going to be social distancing for a while yet, but it's a little bright, it's a little good news in a time where we aren't seeing a lot of goodness

Unger: Before we get into the numbers, can you talk a little bit about a treatment that the FDA granted emergency authorization to yesterday, it's the Eli Lilly treatment.

Dr. Irons: Right. And that's also another bit of good news here, is that the FDA issued an emergency use authorization for the Eli Lilly monoclonal antibody drug. Now in emergency use authorization, isn't licensing, it's still an investigational drug, and the way this is written is that it's specific to certain people. It was authorized for use on an outpatient basis, to individuals who are over 12 years of age and over 40 kilos in weight, who are developing severe manifestations of COVID-19. So, it's meant for people with mild to moderate disease, but only for those who have... Who fall into the high risk categories. It is an infusion, it's a single IB infusion, and the next step now is to create infusion centers where people can go. But the first step is really to speak to your physician if you fall into the high risk category, and then the physician will take it from there.

Unger: All right. Well, it's good to have positive news because on the numbers side, not positive at all. Can you talk a little bit about the latest cases, deaths and trends that you're seeing?

Dr. Irons: Yeah, absolutely. You're right. The numbers just keep going up and up. And it seems as though, from listening to people that we're in this for the next weeks to months. We've been worried about the fall, and we're in it. Today's number earlier today, 10,110,552 people have been diagnosed with COVID, and 238,251 people have died. I can't even imagine, several months ago we were thinking - are we going to stop at 60,000? And here we are going higher and higher. Just yesterday 745 new coronavirus deaths, and 130,553 new cases were reported in the United States. And over the past week, the average has been over 116,000 cases per day, and an increase of 64% from the average two weeks ago.

Unger: That's incredible numbers. Now globally, we're talking more than 50 million people infected, and more than a million people have died. So, these numbers are pretty astronomical. Are you seeing any specific trends, on a state by state basis here in the US?

Dr. Irons: Yeah, although the entire country is lighting up, it's really the middle part of the country, the Midwest and the Northern Midwest, where we're seeing the increase in cases. And as opposed to earlier in the pandemic, it's some rural areas also that have fewer resources and are more stressed with this. We're starting to see states like Nebraska, Colorado, Wyoming that we hadn't heard about as epicenters earlier on. Deaths are rising, and more than half the country and nationwide hospitalizations have more than doubled since mid-September.

Unger: So, we're starting to see what we saw earlier in the pandemic, with literally hospitals exceeding capacity. Can you talk a little bit about what we're seeing in terms of those numbers?

Dr. Irons: Yeah, more than 54,800 people were hospitalized across the country on Friday, more than a thousand people were hospitalized in Colorado alone, Indiana reported over 4,900 new cases. And governors are now starting to impose some restrictions in their States.

Unger: Well, speaking of restrictions, we're seeing a return to some of those, more dramatic ones in Europe. Can you talk about what's happening there? More specifically.

Dr. Irons: It's harder to quantify in Europe by one count from the European Center for Disease Control and Prevention, which includes Turkey, Armenia and Azerbaijan and its tally. Total cases have reached over 11.8 million. We do know that the hospital crunch in Europe has grown more dire, new data for 21 nations shows that there's more COVID-19 patients now than in the Springs worst days threatening to overwhelm stretched hospitals. More than twice as many people in Europe are hospitalized with COVID 19 as in the U S adjusted for the population. And there's beginning to institute lockdowns and significant restrictions to try to gain control of the virus.

Unger: So, here we are moving into the winter, the dreaded second wave or a continuation of the first of course is occurring. What is the prognosis as we look at these potential drivers?

Dr. Irons: Well, the drivers are the same that we've been talking about. Cold weather, pandemic fatigue, and of course schools. Responding to the fatigue, some state governors are trying to walk that line by strongly urging mask wearing and other precautions rather than mandating them. However, the governor of Utah on Sunday had to step over that line, and others might do the same. He announced a new state of emergency including a mask mandate that would apply statewide, and also is limiting social gatherings to households only. I believe that that's for the next two weeks, try to reign in some of this before Thanksgiving and before the holiday season starts. But we're seeing the same in many States around the country.

President elect, Joseph Biden, announced the creation of a coronavirus advisory task force on Monday, and they had their first meeting. The individuals on that are senior individuals, physicians, public health experts, academicians. Very thoughtful people in terms of creating a plan or a strategy to fight the pandemic. We're starting... We continue to see things in schools. Colleges are continuing to drive a significant number of new cases. So, far a quarter of a million COVID-19 infections have been reported in colleges and universities. In one survey, one last tallied, October 22nd campus cases were at 214,000, and now it's more than 252,000. That's just in two weeks, and the bulk of cases have occurred since students returned from the fall semester. So, some colleges are trying to modify what happens after the holiday. If kids go home for Thanksgiving, they may be doing a hybrid model where they won't be returning to campus. Others are suggesting testing either before you leave or when you come back, but, it's a significant concern.

Unger: Well, finally, a number of key messages coming out of the AMA this week. Can you talk about a few of those?

Dr. Irons: Sure. Today we're all watching the ACA debate at the hearing at the Supreme court. On Monday, the AMA released a statement from the California attorney general, Xavier Becerra, on the Affordable Care Act ahead of the oral arguments today in California versus Texas. The AMA has also issued an amicus brief in the case defending the ACA. California attorney General's office is leading a coalition of 20 States, and the district of Columbia in defense of the ACA. Dr. Bailey, the AMA president statements said particularly in the middle of a public health crisis, and with COVID-19 cases at an all time high, this lawsuit poses an immediate threat to the lives, health, and well-being of people across the country. As we explained in our advocacy brief to the court, this lawsuit threatens to strip 20 million Americans of health care insurance coverage. And numerous patient protections, that enjoy broad bipartisan support.

Unger: Finally, one other thing about the AMA and the AOA issuing a joint statement. Can you talk a little bit about that?

Dr. Irons: Yeah. So, the AOA and the AMA, the American Osteopathic Association, and the AMA issued a joint statement on November 4th, uniting and gets misrepresentation of osteopathic physicians. Osteopathic physicians, also known as doctors of osteopathic medicine, DOs, are fully licensed physician, practice in every specialty area. Doctors and medicine, MDs and DOs have equivalent training and practice rights. If you look at physicians in the United States, osteopathic physicians accounts for approximately 8% to 11%, and this is particularly important to recognize this in a pandemic.

Unger: Well, thank you so much, Dr. Irons, that's it for today's COVID-19 update. We'll see you tomorrow with another segment. For resources on COVID 19, visit ama-assn.org/COVID-19. Thanks for joining us 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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