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 experts discuss a somber milestone, losing more than 200 thousand lives in the U.S. due to COVID-19, and how we can forge a path forward in battling the virus.

Learn more at the AMA COVID-19 resource center.

Speakers

  • Susan R. Bailey, MD, president, AMA
  • Patrice Harris, MD, MA, psychiatrist and immediate past president, AMA
  • Gerald Harmon, MD, president-elect, AMA

Transcript

Unger: Hello, this is the American Medical Association’s COVID-19 Update. Today's update marks a somber milestone. Losing 200,000 lives in the United States to this pandemic was unthinkable when the virus first emerged earlier this year. We now take a moment to remember those we've lost.

Today we'll discuss the focus on where we go from here. To help us with the path forward, I'm joined by Dr. Susan Bailey, AMA's president, and an allergist and immunologist in Fort Worth, Texas, Dr. Patrice Harris AMA's immediate past president, as well as a psychiatrist and former public health director in Atlanta, and Dr. Gerald Harmon, AMA's president-elect, and a family medicine specialist in South Carolina. I'm Todd Unger, AMA's chief experience officer in Chicago. Dr. Bailey, let's start with you. What's within our control to slow the spread of this pandemic in the coming months?

Dr. Bailey: Todd, even though we've reached this incredibly tragic milestone of 200,000 dead in the United States and almost a million dead across the world, our strategy, really hasn't changed. We still have to focus on our basic public health measures, washing your hands frequently, wearing a mask, keeping your distance, staying away from large crowds. Our advice hasn't changed. We know that it works. We just have to keep up the momentum, even though we're all getting very tired of this. There's a lot of battle fatigue out there, but until we have good therapeutics and a safe and effective vaccine, we've got to keep up our basic mask-wearing, hand-washing, distance-keeping.

Unger: Dr. Harris or Dr. Harmon, anything to add to that?

Dr. Harris: I think Dr. Bailey's right. It is important to note that we still have agency. Part of the struggle with this pandemic is feeling that we don't have control, and certainly there are things that we can't control. But as Dr. Bailey said, those basic public health measures are within our control and we just need to act on what we can do.

Dr. Harmon: I agree. Right now, our best offense, still is a good defense, and that's what you're hearing from Drs. Bailey and Harris. We're still defensive but we're just about getting better on our offensive measures too.

Dr. Bailey: I find acting almost as a cheerleader when I do virtual patient visits now. I just want to say, "Are you wearing your mask?" They say, "Yes," and I'm like, "Good. Keep it up." Trying to encourage people that, yes, you're still doing the right thing. No, don't slack.

Unger: Well, Dr. Harris, we know these numbers have taken a tremendous mental health toll on both physicians and patients. How do you suggest that we cope with this challenge as we head into the fall and the winter and what should physicians be watching for?

Dr. Harris: Well, absolutely. It's important to talk about this aspect of the pandemic and pre-COVID-19, we were seeing increased numbers of physicians with burnout and increased numbers of physicians who had symptoms of anxiety and depression. So, it's important that we elevate this topic. By the way, I want to note that certainly our physicians and other health care professionals on the front lines saw this day in and day out. But physicians in their practices, they had to reduce hours. They had to be innovative and creative and had more stress into how to continue to maintain patient access.

Physicians across this country, those on the front lines and those who are not on the front lines, have been impacted and have seen the mental health toll. First, I know physicians are so good at taking care of everyone else. Sometimes we're not so good at taking care of ourselves. That's the first priority. We need to make sure we prioritize our own self-care, meeting our own needs. We have family obligations. That is first. It's cliche. When we get on planes, put on your own mask before helping others, and so in this instance, we should do all that we can to take care of ourselves, all of ourselves, our mental health included, during this time,

Unger: Dr. Harmon, what role do you see preventive care playing in keeping the spread to a minimum?

Dr. Harmon: That's a great question because we all know that we've had this COVID pandemic for six months or more now. But meanwhile, all the other issues that we had before the coronavirus pandemic are still with us, diabetes, hypertension, behavioral health issues, the opioid crisis, all the things that my fellow physicians on this call are very familiar with. Preventative care must go on. We have to keep our patients with access to us and our offices and our practices. We need to make sure that they feel confident we're giving them a safe environment to receive this preventative care and this continuing care.

We need to do what you've heard from Drs. Bailey and Harris. We're still role models. We wash our hands, we keep our distance. We screen them appropriately before we let others into our lobbies and waiting areas. We've done all the social distancing. We've re-strategized the way to continue to open our practices and provide this preventive care.

Unger: Dr. Bailey you mentioned, obviously supporting your patients in terms of taking those steps to reduce the risk. Let's talk about another role that physicians are playing in helping curving this spread, and that's really raising their voices and being heard. Can you talk a little bit about the physician's role that way, especially in terms of correcting misperceptions?

Dr. Bailey: I think that now, more than ever, physicians need to stand up and be advocates for their patients and for their profession. There's so much misinformation out there. Now we're hearing a lot of vaccine distrust and hesitancy that is increasing because of concerns about the coronavirus vaccines that are being developed. We need to speak up for science and evidence. We need to tamp down the fear and anxiety, which may or may not be related. We need to, please, try to keep things apolitical. This is a public health crisis. This is a matter of science and research. We need to keep the politics out of it and do our best to maintain the mission of the AMA, to promote the art and science of medicine and the betterment of public health. That must always be at our side.

Unger: Dr. Harmon, anything to add to that?

Dr. Harmon: We absolutely have to serve as the beacon of shining light to our public health commitment, to the betterment of public health, which is what the AMA mission's all about. We need to provide reasonable, thoughtful and dynamic public health advice. One of the challenges we find is that the data changes at times, the science will change, and that is sometimes misperceived as a changing political dynamic, when reality is that it's the science. A couple of weeks ago. I wasn't sure whether I should be using a particular treatment such as steroids in the face of an acute coronavirus pulmonary infection.

There was some question about it. Now that we've had some meta- analysis published in JAMA that says, "No, that's pretty good therapy." I've had to, not so much shift course, but at least think about my paradigms for treating my patients here locally. Just today I started ordering, or I just ordered some appropriate therapy for a coronavirus patient, I just left a few minutes ago.

Unger: Dr. Harris, I'm curious, what did you learn? You were really speaking for the AMA in that early part of the pandemic. What did you learn about communicating and raising the level of physician voices in this pandemic?

Dr. Harris: Well, something was amplified that I saw during my years as public health director. That was, first of all, the public craves clear, consistent, evidence-based information. They want that information from a trusted source, and they can handle the truth if you will. Right? Our physicians, on an individual basis want us to know as much as we can. They want that knowledge to be based on the science, but they can handle not so great information as long as we're clear and we're consistent and we show a path forward and we show how they can act and have agency, getting back to what Dr. Bailey and Dr. Harmon have said. Wearing a mask, keeping our distance, those things that we can do. Clear, consistent communication from a trusted source was important pre-COVID, and it's important now, and it will be important going forward, any time, whether or not there is a public health crisis.

Unger: Dr. Bailey, we're heading into the fall and winter, obviously some challenges ahead. How should we be preparing for them?

Dr. Bailey: Fall means that flu season is getting closer. Now that it's September, it's time for everyone to start making sure that they get their flu vaccine sometime before the end of October. We don't need a twin-demic, as I've heard it called. We don't need to have flu and COVID out there at the same time, because either one can overwhelm our health care resources. Both of them together would be an absolute nightmare, and people would not be able to get the care that they need. We need to start thinking ahead about getting the flu vaccine. How are we going to handle the holidays coming up? What are we going to do about Thanksgiving? What are we going to do about Christmas? How can we keep ourselves, our patients and our families safe as we go into this very special time of year,

Unger: Dr. Harmon, what have we learned in the last six months that will be most helpful in guiding us through the end of the year? Even thinking on the clinical front, for instance.

Dr. Harmon: Well, we've learned a lot, and we have still, we have a lot to learn, Todd. We have learned that these basic measures continued, well they don't cure COVID. They do prevent its spread. They mitigate the transmissibility of the disease. When we do that, then we've taken a lot of the teeth out of this evil disease, this virus. If they can't infect a large percentage of our population, they're not going to get sick. They're not going to overwhelm our resources. What we've also learned about, and Dr. Bailey alluded to, we've learned about the value of vaccines.

As we approach this flu vaccination season, influenza vaccine, historically, we've been perhaps a little complacent as a society, maybe even as providers about foot-stomping and enforcing the appropriateness of getting that influenza vaccine. This year's going to be more challenging. Typically, some of the flu vaccinations that we give in our community are given at work and yet people are working from home. That's going to cut us back by a substantial number. You don't get it from the job, you're going to have to make an effort to get it. It might be an access issue then.

One might be concerned about going to the hospital or health department because they're worried about perhaps being exposed to COVID. Some have lost their jobs. Maybe their insurance won't cover the vaccination anymore, so there's a concern there. There's also a misperception among some that getting the flu vaccine will protect you from the coronavirus. No, won't do it. It'll protect you from that twin-demic that Dr. Bailey alluded to. But it, really you're going to have to have another vaccination as soon as we get the science, the validation and the appropriateness with the clinical indications for getting that, hopefully to come, coronavirus vaccine.

Unger: Well, last question. I'd like to hear your personal thoughts and what you'd like to share with physicians as we acknowledge the tremendous loss that we've seen with this pandemic. Dr. Harris, why don't you start?

Dr. Harris: I do. First, I though, I want to amplify something that Dr. Bailey said, and it's about, she reminds us to prepare and plan. It's human nature. None of us are happy about not being able to do what we normally do, but we can begin to focus on what we can do. It is a good idea to plan ahead for the holidays with an ear and an eye towards what we can do. It will be different, but we can do different things to celebrate holidays, birthdays, graduations, all those milestones. I think that's important information. But certainly and clearly, we just passed this tragic milestone where lives are lost.

I've said from the beginning, that data is critical and these are important data points, but behind those data points are humans and lives and families. So, I get up every morning and I center myself on what do we need to do as a profession, as an AMA individually today, that day, because we don't want to feel overwhelmed, to improve how we are handling this pandemic again, either on an individual level or on a community level. I think that's where we should focus. What can we do? Because we do have agency. We will get through this, but we will get through this based on science, evidence and the data.

Unger: Dr. Bailey, Dr. Harmon, anything to add to that.

Dr. Bailey: Yes. Even though we're coming into the fall with an undercurrent of grief and of loss of many things, fall in our society, in many ways, is a time of new beginnings. The start of a school year, even though it's a rocky start, it's a new start. Many people are invigorated by a fall weather. I think that we need to realize that, yes, it's okay to feel that grief, to feel that loss. We need to feel those losses and grieve them, but also that there are going to be better days ahead. It may look different than it has in the past, but we have the tools that we need now to mitigate the spread of this virus. We're working hard on tools to beat it, and we just have to have the faith that we keep doing what we're doing, and there will be brighter days ahead.

Dr. Harmon: Todd, my ears were burning a little while ago when Dr. Harris was talking about taking care of ourselves as providers. I started to grab my ears and hide them because I was afraid they'd be turning red. We as doctors, we as health care providers, we really, we put up the good front. We tend to be the image. We're the role models, as it were and we're afraid sometimes to let our feelings and our emotions interrupt that. We have to be careful. We're good at compartmentalizing our needs as physician providers and we're very careful in keeping our guard up.

But one of the things I want us all to do is realize, this is a somber time, with 200,000 Americans deceased as a result of this virus. I'll tell you though, one of the things I've learned when I talk with my patients, and I did it just today, when I went into a patient's room, who unfortunately as an older patient that has coronavirus, and they're automatically isolated because we have to put on almost a chemical warfare suit to go in there and see them. You have to put a mask on you. You can't talk. You have to talk like this when you talk to them, and they're already a little bit hard of hearing.

So, they're socially distanced, in addition to being physically distanced. It is difficult. What this patient wanted to know when I went in and talked to her, I said, "You know, you're sick." She was scared. She was on oxygen. She was anxious. I said, "You're going to get over this. Whenever we get through, and I'll make sure you're here today, we'll make sure for the next couple of days. My prediction is, you're going to do well. You're going to, when you look in the rear view mirror, this is going to be a bad time, but you're going to have an opportunity to talk about this to your grandkids and other folks."

She looked at me. She almost broke down into tears. She said, "Dr. Harmon, you're the first person who's told me that." We need to remember this. This is a serious disease, but we need to keep our spirits up, and we need to keep the spirits of our patients and our motives pure here. We're doing the right thing. We need to take care of ourselves and we need to take care of our patients from an emotional standpoint, also.

Unger: That's amazing perspective. Dr. Harmon, Dr. Bailey, Dr. Harris, thank you so much for being with us here today, and for all the work that you're doing. The AMA would like to take this moment also to thank all of those who've worked so hard to fight COVID-19. Whether you're on the front lines, treating patients in your practice, organizing PPE drives at your medical school, educating future physicians or making sure that the information you pass on is based on science and evidence. Stay well and stay safe. We'll be back soon with another COVID-19 update. For updated resources on COVID-19, visit ama-assn.org/COVID-19. Thanks for joining us today.


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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