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

In today’s COVID-19 Update, a discussion with AMA's Director of Science, Medicine & Public Health Andrea Garcia to review COVID-19 vaccine numbers and trending topics related to the pandemic over the past week. Also covering the CDC statement regarding vaccine effectiveness and the Indiana University vaccine mandate decision.

Learn more at the AMA COVID-19 resource center.


  • Andrea Garcia, JD, MPH, director of science, medicine & public health, American Medical Association

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 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. Ms. Garcia will be doing our weekly updates going forward. Welcome Andrea. How are you today?

Garcia: I'm doing well. Thanks for having me, I appreciate the opportunity to be here.

Unger: Well, this last week we've really seen the divide widen between the vaccinated and the unvaccinated. Can you give us a little bit more detail and tell us what the numbers are showing?

Garcia: Yeah, in taking a look at the numbers in the U.S., we've reached about 34,133,951 reported COVID cases and 609,268 deaths. It's hard to believe but it was less than a month ago that new cases reported nationally bottomed out at about 11,000 per day. But COVID-19 cases are increasing again and we're at about 26,000 new cases per day.

On Friday, officials reported back COVID-19 infections in the U.S. rose nearly 70% in a single week and we're also at a point where we're seeing hospitalizations and deaths increase by about 36% and 26% respectively. Infections rose in every state last week but counties with low vaccination rates were far more likely to have bigger jumps.

Unger: This not a good trend obviously, and those numbers are pretty staggering in such short order from when we were making so much progress. A big report from The New York Times over the weekend about Arkansas in particular, and even people who were going through 10 days in the ICU still not sold on the vaccine. Can you give us some state by state look at what's happening there?

Garcia: Yeah, so Florida which we know is a populous state and is a population that is not highly vaccinated, they're really seeing a surge in cases right now. Arkansas and Missouri continue to be hotspots. We're still hearing that COVID wards are opening up again in hospitals there, and Nevada is also seeing an influx in COVID patients.

We need to keep in mind that among the 25 counties with the sharpest increase in cases, all but one had fewer than 40% of their residents vaccinated and 16 had vaccinated fewer than 30%. So this is in contrast to the upper Midwest, the Northeast and the West Coast, including Chicago, Boston and San Francisco where COVID-19 infections remain relatively low.

With that being said, we did see LA County this past week reinstate their indoor mask requirement for everyone, including those who are vaccinated and we could see other counties follow suit. While per capita cases remain relatively low in LA County, they're really seeing sharp increases. So, they're averaging about 1,000 new cases per day and back in June that was about 200 cases per day. So, I think that's the reason why they're implementing these additional prevention measures.

Unger: At the root of this as we're seeing every day is the Delta variant. Can you give us more details on what's happening there?

Garcia: Yeah, so we know the Delta variant is highly contagious. It makes up a majority of new U.S. cases and it's really spreading rapidly and fueling the national uptick. It's sending younger previously healthy people to the hospital and doctors in states suffering from those surges are indicating the vast majority of those who are hospitalized at this point have not been vaccinated. So, we know that vaccines are playing a large role in this. They're effective against the variant, they're effective against serious illnesses and new cases and hospitalizations are primarily climbing in places with low vaccination rates.

So, when we think about the fact that we have about 160 million people across the country who are fully vaccinated, who are protected against the virus, including the Delta variant, we also need to keep in mind that there are about 100 million people in the U.S. who are still susceptible to COVID-19. So overall our outlook looks a bit better than previous surges but the pandemic is far from over in the U.S.

Unger: Yes, as President Biden said, we have a pandemic among the unvaccinated, and this is a huge problem. Now on the other end of this, there's still a lot of concern about breakthrough infections. I hear that from my vaccinated friends. Are there concerns about the vaccines' effectiveness at this point?

Garcia: So, I think overall we know that these vaccines are really amazing tools and they are highly effective and they were developed to prevent severe illness and death. They don't deliver what we call sterilizing immunity, meaning they may not prevent infections entirely. So, we saw the CDC issue a statement on Friday saying they have multiple programs in place in collaboration with state and local partners, they're tracking vaccine effectiveness. Overall they're saying vaccines are highly effective and they're a critical tool to bring the pandemic under control but really no vaccines are 100% effective in preventing illness in the vaccinated.

There's going to be a small percentage of fully vaccinated people who still get sick, who are still hospitalized or who die from COVID-19. As with other vaccines, this is the expected. The number of people who are vaccinated as that number goes up, we could see more breakthrough cases.

Unger: We're still seeing those breakthrough cases though at a very, very low percentage, under 1%. Is that in terms of certainly hospitalizations and deaths?

Garcia: Yeah. Yeah, that's exactly right. So we do know that even if there is a breakthrough infection, which like we said, that's a small minority of people, it's very likely that those individuals will have a mild or an asymptomatic infection. Where we'll be concerned is when we start seeing a lot of vaccinated people ending up in the hospital and that's not really what the data is showing us right now.

Unger: So obviously the slowdown in the vaccination effort is a big concern, to say it mildly. What do the numbers look like there?

Garcia: Yeah, so providers are administering about 521,000 doses per day on average. It's about an 85% decrease from the peak, which was 3.38 million on April 13. So, the CDC's reporting about 186.3 million people who've received one dose of COVID-19 vaccine. That's 56.1% of the population, about 161.5 million or 48.6% have been fully vaccinated. Then in terms of those adults who've received one vaccine dose, which as we know was the Biden administration's goal by July 4, we're at about 68.3%. So we're getting closer to that 70% mark but we're still not quite there.

Unger: As a person who comes from a marketing background, I guess the inability to market something that's free doesn't really require a lot of behavior change and will save your life is really tough. It just shows there's just a pretty enormous challenge out there to get those unvaccinated folks vaccinated at this point. So on that topic kind of in related news of getting people vaccinated, we did see a decision come through this week that could set a precedent for vaccine mandates in colleges. Can you tell us about that?

Garcia: Yeah, so on Monday a federal judge upheld Indiana University's COVID-19 vaccine mandate ruling that they could require students to be vaccinated against the virus. In May, IU had announced that faculty, staff and students would be required to get COVID-19 vaccines before returning in the fall. They also said that students who did not comply would have their class registration canceled and would be barred from campus activities.

I think it's really important to note that the requirement there allowed for exemptions. So if you had a medical contraindication or religious objections, or you had the option to attend class virtually instead of getting vaccinated. So, there was some flexibility. The judge in the case really pointed to the 14th Amendment as permitting the university to pursue a reasonable and due process of vaccination and rule that that was in legitimate interest of public health for faculty and students and staff.

Unger: That's kind of the second decision. We've seen one at a health system in Texas and now we have one at a university, so that's kind of two data points in that direction.

Garcia: Yeah. Yep, that's right. It'll be interesting to see where these decisions fall out. I mean, we know universities across the country are considering mandates, we have about 400 campuses requiring vaccines at this point. Of course this decision will be appealed in Indiana and obviously there are other suits that have been filed regarding mandates.

Unger: We had a very interesting conversation with Dr. Audiey Kao here at the AMA about the ethics of vaccine mandates. I encourage folks to take a look at that on our YouTube channel. Andrea, it's great to have you here. Thanks so much for providing perspective on where we stand this week. We'll see you again next week for more. That's it for today's COVID-19 Update. For more resources on COVID-19, visit Thanks for joining us, 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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