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 weekly numbers, trends and latest research about COVID-19, including a new JAMA study that shows young people can face severe manifestations from the virus.

Learn more at the AMA COVID-19 resource center.

Speakers

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

Transcript

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, also in Chicago. Dr. Irons, let's start by reviewing this week's numbers. What's happening across the country with new cases and deaths from COVID-19?

Dr. Irons: Todd, the numbers are still going up. We seem to start like that every week with this update. Currently, the numbers from this morning are 6,520,733 people have been identified as having COVID-19, and 194,087 people have died from COVID-19. If you look globally, more than 29 million people have been diagnosed, and over 924,000 deaths have occurred due to COVID-19.

Unger: At this rate, we're looking at that very significant milestone of 200,000 deaths within, what, a week?

Dr. Irons: I think so. If you look at the seven-day average, which is always a better way of looking at the numbers than daily, since they seem to go up and down, especially over weekends, we're still at just under 35,000 deaths per day. I'm sorry, just under 35,000 new cases per day, and about 734 deaths per day. At that figure, we're probably looking at seven or eight days, if things continue the way they are, to reach that really sad 200,000.

Unger: We are seeing that's a variation state by state. We see a surge in places like North Dakota, perhaps driven by the rally there from several weeks ago, but also, throughout the Midwest. What can you comment on that?

Dr. Irons: Yeah. As you said, North Dakota had more than 460 new cases last week, a single-day record for them. West Virginia, which has been relatively silent is also showing a new record of more than 340 cases. We're starting to see a mini uptick or, I hate to use the word "surge," since we've been in this all along, but we're starting to see increases in Midwest that are felt to be secondary to college campus increases. And also, North Dakota and South Dakota, secondary to the motorcycle rally that occurred there.

Unger: Well, there've been a couple of pieces of interesting research over the past week. Why don't we start by talking about the CDC's report about the riskiness involved with restaurant, at bars?

Dr. Irons: Yup. This report hit the media last week. The CDC did a case control study where they looked at the exposures that were reported by a group of people who were diagnosed as having COVID-19 and those who were symptomatic, but not diagnosed as having COVID-19. What they found is, if you looked at the people that were COVID positive, they were three times more likely to have had a contact with someone who was COVID positive, but also, more likely, about twice as likely, to have dined in a restaurant, or gone to a bar, or a coffee house.

Now, you have to look at the study closely. They were small numbers. It was a small study, and they didn't distinguish in the restaurants whether it was outdoor dining versus indoor dining, and the same with bars and coffee houses. But they did issue an interesting risk-based analysis in terms of restaurant eating, what's low risk and what's high risk, that ranges from take-out to curbside pickup, to outdoor dining where the tables are far apart, to indoor dining with low ventilation, with close tables as the highest risk.

Unger: There's been an additional study this week regarding young people that came out in JAMA. Why don't you talk a little bit about those results, which have been surprising?

Dr. Irons: Well, they have been. We keep hearing about the fact that young people are less likely to suffer the severe manifestations of COVID, but we're finding out that that isn't true anymore. There is increasing concern in young people. Last week, there was a research letter that was published in JAMA Internal Medicine from a group in Boston that looked at over 3,000 young adults. Now, that was defined as the ages of 18 to 34. It was that age range. They looked at hospitalized young adults and what occurred, what their clinical course was. What they found was that one out of five ended up in the ICU, and one out of 10 ended up on ventilators. The traditional thinking or what we thought early on was that if younger people were affected with COVID, they were more likely to have mild disease. And that just isn't true. It isn't panning out. We've known that. We've heard of these cases, but now, we have the evidence to prove that.

Unger: Wow. That is surprising. Can you talk a little bit about some of the news that came out over this weekend regarding the CDC and questions about whether there is attempted interference in reports that are so crucial to tracking what's happening right now?

Dr. Irons: Yeah. There have been reports really beginning, I think, on Friday about concerns that reports from the CDC had been amended or changed in some ways before they've been issued. That certainly is concerning. As you know, the AMA from the very beginning of the pandemic, starting with Dr. Harris's national address at the National Press Center back in April on the importance of science in decision-making, really affirmed the fact that we needed evidence-based solutions and policies to build societal trust. The AMA has always, from the very beginning, believed that evidence-based science and data play an essential role in protecting public health in the face of the COVID pandemic. And we continue to call for an environment in which physicians, scientists, and other experts are free to communicate the evidence-based information about safety and efficacy of drugs and other information that we have about the pandemic.

Unger: Yes, that is incredibly crucial. Thank you for the comments there. Let's turn our attention to school openings, and the spread continues to be an issue there. I noticed that at my Alma Mater undergraduate, Miami University, some trouble there in regard to people breaking the rules. It seems to be an issue at many colleges. Can you talk about that?

Dr. Irons: Yeah, absolutely. The numbers change daily, and they seem to change by a factor of 10 or 100 daily. We're now looking at over 88,000 cases of COVID positive infections occurring in college campuses nationwide. They tie back to gatherings. It's what we've been talking about from the beginning of the pandemic. It's large gatherings that are occurring, where the virus is spreading. So, at Miami University and Ohio, students who knew they tested positive hosted a Labor Day party for other students. The University of Wisconsin and Madison moved all of their classes online, and they're currently quarantining students in two of their largest dorms. The message is still, wear a face mask, socially distance, wash your hands, and large gatherings are really concerning.

Unger: All right. Thank you. On to vaccines. Some news there from the AstraZeneca study, which had placed pause, but seems to be proceeding there. Can you about what you're seeing in those trials?

Dr. Irons: Sure. I'll start with the AstraZeneca trials. The Oxford AstraZeneca vaccine has been in phase three trials in the UK and in Brazil for a while now. They started phase three trials in the United States just within the last month. Those were put on pause last week because a trial participant in the UK developed some neurologic symptoms that were deemed to be a serious adverse reaction. And so, the trials were put on pause worldwide for that vaccine. It actually showed that the safety and the data monitoring system works in following the data closely and putting those trials on pause. That trial has actually been resumed in the UK after review by the data safety monitoring board there, and a decision by their equivalent of the FDA, that it was safe for the trial to resume.

We still haven't heard anything about when or whether their trial will resume in the United States. They're starting with the UK first. In terms of the US, there are two phase three trials going on. The Moderna vaccine that's going through the NIH trials network. It has now recruited over 23,000 people, well on their way to the 30,000 that they're hoping to recruit. They are still, however, looking for minorities because they're trying to recruit all subpopulations of people. They have recruited, currently, 22,000% of the people in the trial are from the Latinx community, but only 11,000... I mean, 23%. 22% are in the Latinx community, and 11% are in the African American community. The goal is for the additional or what's left of the 7,000 is really trying to focus on communities of color so that there's a good representation.

The Pfizer vaccine is also in phase three trials. They have recruited over 25,000 people. But once again, 11% Latinx, 8% African American. The goal is really to increase minority enrollment. There was a news report just this morning that they have applied to the FDA to actually increase the numbers of their trials to 44,000. Still don't know what the response has been because increasing the numbers has to be approved by the FDA, but there's an intent to do that.

Unger: Well, hard to believe, but there still continue to be misconceptions out there about prevention and treatment of COVID-19. Can you talk a little bit about a recent poll that highlights some of those problems?

Dr. Irons: Yeah, the Kaiser Family Foundation had a poll just last week of almost 1,200 adults that was conducted about two weeks ago. It found that one in five people still believe that wearing a mask causes health problems, and one in four say that hydroxychloroquine is an effective treatment for COVID-19. We know that both of those things are not true. And so, it's just another reason that physicians really have to talk to their patients about what the evidence supports and what the data supports, and that it's important to wear a mask, socially distance, wash your hands, and do all the right things.

Unger: Beyond those key messages, is there anything else from the AMA that you'd like people to hear this week?

Dr. Irons: Sure. Just as a reminder that other significant health problems continue. Last week, there was research published in JAMA that showed a greater proportion of Americans, particularly communities of color, were living with uncontrolled blood pressure in 2017 and 2018 than were previously. So, blood pressure control has worsened, continues to be a major effort of the AMA, and is still a problem. And so, the AMA and the American Heart Association released a joint statement last week reaffirming our commitment to working together to equip physicians and all Americans, particularly communities of color with resources to lower blood pressure rates across the country.

Unger: Well, thank you so much. I appreciate you being here today and sharing your perspective with us, Dr. Irons. That's it for today's COVID-19 update. We'll see you tomorrow with another segment. For updated resources on COVID-19, visit ama-assn.org/covid-19. Thanks for joining us, and please take care.

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