Public Health

Andrea Garcia, JD, MPH, discusses latest trends as schools and universities reopen

. 9 MIN READ

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

 

 

AMA Chief Experience Officer, Todd Unger and AMA experts take a weekly look at the numbers, trends and latest news about COVID-19, and note that even though the number of cases is slowly declining, there's concern about the number of cases in some states.

Learn more at the AMA COVID-19 resource center.

Speakers

  • Andrea Garcia, JD, MPH, director, science, medicine and public health, 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. Filling in for Dr. Mira Irons, we have Andrea Garcia, the AMA's director of science, medicine and public health in Chicago. I'm Todd Unger, AMA's chief experience officer in Chicago. Ms. Garcia, let's start by reviewing this week's numbers. What's happening across the country with new cases and deaths?

Garcia: Thanks, Todd. So, as of today, there have been 6,330,316 confirmed cases of COVID and 189,733 deaths. We're nearing that 190,000 mark. We're coming on of a holiday weekend, so reporting may be delayed even more than it is on a typical weekend. But overall, I think we're seeing the numbers continue to slowly decline. We're averaging about 38,000 cases per day. And, while this does represent the nine percent decreases over two weeks ago, we're still seeing pretty concerning levels in a number of states across the country, and we're definitely not out of the woods yet. In terms of hospitalizations and deaths, those also continue to decrease overall. Hospitalizations are around 32,000 per day, this is coming down from the peak of about 60,000 hospitalizations. Deaths are still well below the peak of 2000 per day. They're right around the 850 deaths per day mark, so obviously it's still a very serious concern.

And while they're declining, the decline is not as steep as we had hoped that it would be. Just in looking back, I think over the summer, I think the last time we talked, the Northeast was doing okay, but we were seeing an increase in cases in the Midwest and really in the Southern States. But, I think us, as we progressed, I think Georgia, Florida, California, Arizona and Texas have really turned things around. We're seeing a decrease cases in those states. If you look at Arizona's numbers, for example, at one point they had more than 3000 cases per day, and they're now averaging about 500. So, some really good news for those states. But, in other states we're still seeing increases, so if you look at Iowa, North Dakota, South Dakota, there are some concerns around this spread in those states. And, we know that some of those increases are tied to colleges and universities.

Unger: So, the good news is that we are seeing some decreases. I guess the bad news is that the numbers still remain pretty high relative to, either the start of the summer or midsummer; so not out of the woods at any rate.

Garcia: Exactly.

Unger: Well, let's talk a little bit about some of the trends. You mentioned colleges and universities, obviously return to the classrooms is a big driver here. What are you seeing in that regard at either at the graduate level or high schools?

Garcia: Yeah. So, I think Labor Day really represents a shift to fall, in many ways. And, we're starting to talk about flu season and here in Chicago, it's certainly getting colder, and when you know we're expecting more people to spend time in doors, which we know is riskier than spending time outside. So, many schools opened this Tuesday. A lot of districts opened with students doing full remote learning. If you look at Chicago, Houston, Dallas, Baltimore, some of the suburbs of Washington, D.C., they're in full remote learning with the expectation that if numbers decline enough in those communities, that they may be able to switch to a hybrid or in-person learning at some point throughout the year. But, other jurisdictions like New York city are anticipating opening in-person, and I mean they're pushing back the start date in order to get things in place to prepare for the students and teachers to arrive safely. So yeah, we'll see what happens.

Certainly some of the districts opened earlier in August, and we've seen some outbreaks in schools, and they had to shut down for a number of days, but in other jurisdictions, things are going fine, so a lot of this depends on how things are going in the community. And, you mentioned colleges and universities, I think that's a different ball game, of course, because you have people living in close quarters and we continue to see a number of outbreaks on college campuses. I think West Virginia University is the most recent one in the news. And, they've had to close and switch to remote learning for a while, while they get their cases under control. I think the numbers we've seen are 51,000 COVID cases tied to colleges and universities in the U.S. and 60 deaths.

Unger: And, I think week before last, we had Dr. Brian Casey, president of Colgate University, where my daughter attends. And, the good news is they've made it through gate one, are out of quarantine, so that's a piece of good news at the college level. Well, let's talk a little bit more about the schools and reopenings, and the complications around testing with children. Can you talk a little bit about that?

Garcia: Yeah. I've seen this in my own community, so it's something I'm certainly familiar with. And, I think it's something that's probably been happening for a while, but it's certainly exacerbated now that schools are reopening. And, that is just that many tests sites aren't testing kids and that could be for a number of reasons. It could be they don't think kids can do a nasal swab on their own, if it's self administered, it could be the test they're using isn't necessarily approved in kids, it could be them assuming that most kids have insurance and they can get tested at their pediatrician's office.

But, I think what we know is that many of the pediatrician's offices aren't doing tests or don't have the capability to do them. So, there are a number of challenges around getting kids tested. I think for working parents this is a challenge, because if your kid has symptoms of COVID, which as we know overlap with cold and flu symptoms, which are going to be ramping up shortly then you either have to have a negative test or your child has to stay home for 14 days to be cleared. So, being able to get a test to know whether the child is negative or positive, it's really important.

Unger: And, that really is quite a bottleneck then and then you add on even trying to do isolation contact tracing in that environment, that must be tough.

Garcia: Yeah. I mean, if you can't identify the cases, then doing contact tracing is really difficult.

Unger: Well, let's talk a little bit about the confusion and misperceptions of this week, anything that you can clarify for the folks out there.

Garcia: So, there weren't a lot of misconceptions this week. I think the one thing that we did know that was in the news, is that there was a hypothesis that was published in the New England Journal of Medicine. And, their hypothesis was that, if people are wearing masks, the wearer may be exposed to low levels of the virus. So, they may have an asymptomatic infection and that asymptomatic infection may result in them being protected from future infection. I think, you probably heard me say ifs and mights and maybe a lot, as I was just talking. We don't know if a low dose results in an asymptomatic infection. And, we don't know if an asymptomatic infection will protect you in the future. So, I think we just need to, you know, we want people to come up with hypotheses and we need to test them. We don't want people to make decisions based on these, right. So, people should be, keep doing what you're doing, wear a mask, socially distance and wash your hands. Those are the things that we know protect you.

Unger: Well, anything new to report on the front in terms of vaccine development and treatments?

Garcia: Yeah. So, we talked about the AMA doing a letter to the FDA on science transparency and the vaccine process. And, we saw similar letters from health officials. This week, we saw pharmaceutical companies come out and say that they are going to stand with science and that they are not going to put forth a vaccine for approval, until they have the necessary safety and efficacy data, so that was big news.

And, then just to mention the news around AstraZeneca, with their clinical trial being paused. I think, there was a lot of information out there on that, but I think what we need to focus on is the fact that, this is built in the clinical trials. If we see an adverse event, this is what we want to happen, right. We want to pause, we want to figure out if this adverse event was related to the vaccine or not. And, I think AstraZeneca is doing the right thing here and in protecting those participants in the trial.

Unger: Well finally, what key messages does the AMA want people to hear this week, in addition to the statements you've previously mentioned on testing?

Garcia: So, this week the AMA released the 2021 CPT code set. And this update relates to medicine's common language, reducing the burden on physicians, COVID-19 testing and tech-enabled medical services. It represents the first major update to evaluation and management codes in more than 25 years. So the AMA is going to be developing resources and getting those out to physicians and health care organizations to help make this transition to the new code set.

Unger: Excellent. That is it for today's COVID-19 update. I want to thank you, MS. Garcia for being here today and sharing your important information and perspectives with us. We'll see you tomorrow for another COVID-19 update. 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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