Watch the AMA's COVID-19 Update, with insights from AMA leaders and experts about the pandemic.
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In today’s COVID-19 Update, a discussion with AMA's Director of Science, Medicine & Public Health, Andrea Garcia, JD, MPH, reviewing COVID-19 vaccine numbers and trending topics related to the pandemic over the past week. Also covering recently released studies from the CDC and what the data tells us about the effectiveness of COVID vaccines.
Learn more at the AMA COVID-19 resource center.
- Andrea Garcia, JD, MPH, director of science, medicine & public health, American Medical Association
Unger: Hello, this is the American Medical Association's COVID-19 Update video and podcast. Today we have our weekly look at the numbers, trends and latest news about COVID-19 with AMA's Director of Science, Medicine and Public Health Andrea Garcia in Chicago. I'm Todd Unger, AMA's chief experience officer also in Chicago. Andrea, President Biden saying basically losing patients big headlines last week were about the big push on vaccine mandates. Can you give us more details about that?
Garcia: Yeah. Todd, thanks for having me back. On Thursday, President Biden announced that he would use the full force of his presidency to push two-thirds of U.S. workers to be vaccinated by requiring private sector companies with more than 100 employees to either require vaccination or weekly testing. So OSHA will look at issuing an emergency temporary standard to implement this requirement. He also moved to mandate vaccines for health care workers in most settings that receive Medicare or Medicaid reimbursement. That includes but is not limited to hospitals, dialysis facilities, ambulatory surgical settings and home health agencies. The plan also requires federal executive branch workers to be vaccinated as well as employees of contractors that do business with the federal government. These are the most expansive actions the president has taken to control the pandemic to date. And they also, like you said, seem to reflect his frustration with the roughly 80 million Americans who are eligible for vaccines that have not yet gotten them. In his speech on Thursday, he said we've been patient but our patience is wearing thin and your refusal has cost all of us.
Unger: Lot of pushback that we're seeing right now. Do we expect these mandates to stick?
Garcia: I think we'll have to see. We certainly can expect legal challenges to the president's use of workplace rules, to establish vaccine mandates. We know that employers generally have a duty to take action to ensure that their workers are safe and that OSHA does have the authority to quickly issue a rule known as an emergency temporary standards. If it can show that workers are exposed to a grave danger and that the rule is necessary to address that danger and White House officials believe that the emergency authority provided by Congress under the Occupational Safety and Health Act of 1970 is a legitimate and legal way to combat the COVID-19 pandemic. However, they acknowledged that the law's emergency provisions, which have been used to protect workers from asbestos and other industrial dangers have never been used to require a vaccine before. On Friday morning, we heard President Biden respond to threats of lawsuits from those who are opposed to the plan, being, "Have at it."
Unger: I see. Have at it. That is pretty strong statement coming back from that. Besides mandates, there were other aspects of the president's plan. It's kind of a detailed multilevel approach. Can you give us more details about what else was included?
Garcia: Yeah, there's a lot in there. I think, another interesting part was expanding COVID testing, aiming to make rapid COVID-19 test kits more affordable and accessible. That's by mobilizing test manufacturers to ramp up production. The administration wants to send hundreds of millions of rapid and at-home tests to long-term care facilities, to community testing sites, to critical infrastructure in congregate settings. And that's in hopes of making it easier to identify infections earlier and to contain outbreaks. Major retailers have also joined the push by offering at home tests to consumers at less than two-thirds of the normal price for the next three months. This plan could make home and point of care testing, a more routine part of our nation's strategy for managing the pandemic, which so far has relied largely on lab-based testing to detect cases and to see our public health decisions.
Unger: And it's funny, I don't know if it's just my perception or not but it seems like we hear less about testing and certainly about less about contact tracing. Is this, kind of latest move, part of a larger shift toward more individual level mitigation measures than kind of public or mask-type approaches?
Garcia: I think that's right. We know that rapid antigen testing makes it much easier to get tested for COVID-19 and it helps to detect infectious cases before they spread. So instead of waiting days for results from a slower but more accurate PCR tests, more Americans could test themselves before going to weddings, before traveling or before attending a conference and they can get results in minutes. This will help protect people against the virus that we know isn't going anywhere anytime soon. And we heard AMA President Gerald Harmon call this a game changer for physicians with small practices, especially in those areas where testing is more difficult to come by. He explained that if a patient is symptomatic on a Saturday, all many small town communities have is an emergency department. So if patients are able to test at home instead of waiting, physicians can get a head start on recommending treatment, which is better than telling a patient, "Let's get you tested and wait 72 hours for a result before we can do anything."
Unger: Yeah, that is a game changer. I agree with Dr. Harmon for so many reasons, access and just convenience for people to make sure that something doesn't happen in that 72-hour period while you're waiting. It seems the totality of this plan is coming at a time when it's obviously very needed. We're still falling well below other wealthy countries in terms of vaccination rates. And in fact, this is a shocker. We have the lowest vaccination rate among the world's wealthiest democracies. What is happening there?
Garcia: Yeah, that's right. Japan had held that spot until fairly recently. However, the percentage of its population that has received at least one dose has now edged past the U.S. That's leaving Americans last for that category among the world's seven wealthiest large democracies. We're still slightly ahead in terms of our percentage of fully vaccinated people but Japan is vaccinations at a much quicker pace than we are here in the U.S. They're administering more than a million vaccine doses per day. That's 300,000 above the U.S. average. Even though the U.S. population is 2.6 times the size of Japan. And Canada currently leads the G-seven countries in vaccination rates with almost three quarters of its population, at least partially vaccinated as of last Thursday.
Unger: What are our vaccination rates at this point?
Garcia: So 209.4 million people or 63.1% have received at least one dose of the COVID vaccine, including 178.7 million people or 53.8% who've been fully vaccinated. The CDC is also reporting more than 1.78 million fully vaccinated people have received that additional dose that was authorized August 13 for people with weakened immune system.
Unger: And more proof that the vaccines work, we've been seeing it play out in the numbers but there's additional evidence that came up from the CDC on Friday with more data that shows the vaccines do make a difference. Can you tell us about that, the research?
Garcia: Yeah. So three large studies published Friday by the CDC really highlight the effectiveness of vaccines in preventing COVID related hospitalizations and deaths. The research underscores really the conviction among scientists that these vaccines are effective. And vaccine misinformation is leading to vaccine related concerns and refusal. And that is what is prolonging the pandemic. Hopefully these studies will boost confidence in vaccines, which have been eroded amid reports of breakthrough infections. So the cumulative data have made it clear that the nation cannot hope to end the pandemic with 37% of Americans not having received a single dose of COVID-19 vaccine. We know cases and hospitalizations are only expected to rise as we move indoors into homes, schools and offices in the fall.
Unger: Can you give us a little bit more in terms of specifics? The numbers are pretty impressive in terms of the protection that the vaccine provides.
Garcia: Yeah, that's right. So one of the studies looked at more than 600,000 COVID-19 cases in 13 states between April and July, concluded that individuals who were not fully vaccinated were more susceptible to infection, hospitalization and death from the virus. So specifically there were 4.6 times more likely than vaccinated individuals to become infected, 10 times more likely to be hospitalized and 11 times more likely to die from the virus. The vaccine protection against hospitalization death remains strong even with the Delta variant being the dominant strain but the vaccines effectiveness in preventing infection has dropped from 91%, 78%, according to this study.
Unger: Boy, those are some compelling numbers. Almost five times more likely to become infected, 10 times more likely to be hospitalized, 11 times more likely to die. That's compelling data. And hopefully people will look at that and make the choice to get vaccinated. There were some other data in the studies, particularly around waning immunity. Can you give us the background on that?
Garcia: Yeah, so the two other studies published on Friday did detect some waning from the vaccines, particularly among older adults. So we do know that older adults who are vaccinated are still far more protected than those who aren't but these findings could certainly help inform future decisions on the need for additional doses or booster shots in the population.
Unger: So our numbers, obviously with that kind of unvaccinated population, continue to be part of this surge. Are we seeing any improvements in the hotspots of the past few weeks?
Garcia: So we recently surpassed 40 million COVID cases since the start of the pandemic with more than four million of those cases reported in the past few weeks. Deaths in the U.S. continue to rise but hospitalizations and the reports of new cases could potentially be showing early signs of leveling off. I hate to say that. It's kind of too soon to know for sure but we are seeing some hints that things could be starting to slow down. The South experienced the worst of the summer surge but the outbreak is now easing in that region of the country. Tennessee has been leading the country recently in cases per capita but after weeks of growth, the rate of increases in new cases have started to slow there. The upper Midwest and the Northeast so far have avoided the worst of the Delta but cases continue to rise in Ohio, in Maine and in North Dakota.
Unger: Read this morning, cases in Idaho up as well. And a lot of patients having to move to other states, including Washington. Any other kind of messages that the AMA would like folks to hear this week?
Garcia: So, this week, I would just note that following the release of Biden's more aggressive plan to get the pandemic under control, the AMA issued a press release that stated with the rapid rise of SARS-CoV-2 Delta variant, the alarming increase in COVID-19 related deaths and hospitalizations and our health systems and physicians stretch thin, the AMA is pleased by the administration's significant efforts to help get this pandemic under control. The statement went on to say that aggressive measures will be needed to prevent further widespread transmission of COVID-19 and that the AMA look forward to reviewing and providing input on the administration's full plan.
Unger: Thanks so much, Andrea, for being with us this week for your update. We'll be back soon with another COVID-19 segment. In the meantime, for additional resources on COVID-19, visit ama-ssn.org/COVID-19. Thanks for joining us. 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.