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, JD, MPH, on COVID-19 vaccine numbers and trending topics related to the pandemic over the past week. Also covering the spread of Omicron across the U.S. and globally, as well as New York City's vaccine mandate for private employees.

Learn more at the AMA COVID-19 resource center.

Speaker

  • 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 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, Omicron continues to dominate the headlines this week, including news late last week that it's been found in multiple states across the country. It's here. How widespread is it?

Garcia: Well, thanks for having me, Todd. It's still too early to say how widespread the new variant is or will be in the U.S. We know that typically by the time we learn of a variant, it's already been silently spreading for some time. And that is definitely the case here. We know that the first case of Omicron reported in the U.S. was detected in California. That was someone who had recently traveled to South Africa but there have certainly been other cases. One of the early ones in the U.S. had been traced to an anime convention in New York. But that link with that case is not entirely clear. We know the first case involved a health care analyst who traveled to the convention from Minneapolis and tested positive for COVID on November 23. That's of course, a day before we had even heard of Omicron. His case is the first known instance of Omicron spreading within the U.S. So it wasn't associated with travel. And while multiple people at the convention have since tested positive for COVID, it's not clear whether their cases are all a result of the new variant.

The authorities really have yet to confirm transmission of Omicron at the convention itself. So most likely, the virus is outpacing our public health surveillance effort as it's done in the past.

Unger: Why is this so difficult to track?

Garcia: I think it has a lot to do with the lag time that comes with our surveillance efforts. We know it takes time for a person to develop symptoms, to get tested, to receive their results. And then it typically takes between four and eight days from the time a sample is swabbed to identify which variant caused the infection. So that means the data we have, what we're noticing today is already a week old.

Unger: You mentioned this anime convention. You've got 53,000 people in attendance. What do you do when someone who attended comes down with this variant?

Garcia: Yeah. With so many people there and just the lag in testing and surveillance that could be up to two weeks. Public health expert have said everyone who attended that event should think of themselves as a close contact and follow CDC guidance accordingly. So that means fully vaccinated people who've had an exposure should wear a mask for up to 14 days and get tested three to five days after exposure. And of course, if that test is positive, then they should isolate.

Unger: Confirms my decision to not go to any anime conferences at this point. You mentioned a little bit upfront about how widespread this is. How many states do we see cases with the variant so far?

Garcia: Yeah. So on Sunday, CDC Director Rochelle Walensky reported that it had been identified in at least 16 states so far. We know that number is changing quickly though. As of Monday, The New York Times had that number at 18 states, including, like we talked about, California, New York, Colorado, Connecticut, New Jersey among others. And that number is just going to continue to rise. With that being said, 99% of the cases we're seeing in the U.S. are still a result of the Delta variant. Dr. Walensky and other experts have said, this is still our main concern.

Unger: And that's a message that comes through from Dr. Walensky. It came from Dr. Hotez last week and really everybody we talked to, which is we're in the middle of a Delta surge. We need to keep our eye on this ball. I saw that the case numbers are back at the 100,000 mark. Can you give us some details on where we stand with cases and hospitalizations this week?

Garcia: Yeah. In that same interview, Dr. Walensky said that we're seeing about 90,000 to a 100,000 cases a day right now in the U.S. And that's consistent with The New York Times, which on Friday said that health departments are identifying around 95,000 cases a day. That's the same number we were seeing prior to Thanksgiving. The New York Times is reporting that many Northern states are continuing to struggle, New Hampshire, Michigan, Minnesota, those are the states that are really leading the country right now in cases per capita. We're seeing more than 55,000 COVID patients who are hospitalized nationwide. That's much fewer than we were seeing in September but it still represents an increase of about 15% over for the last two weeks.

Unger: Obviously, the Omicron, the variant, this is a global problem. One of the stunning numbers that Dr. Hotez talked about in his interview last week was that only 8% of folks in Africa have been vaccinated. And we know in large unvaccinated populations, we're going to see the emergence of variants like this. What are we seeing globally at this point with this new variant?

Garcia: Yeah. So the new variant has been detected in at least 45 nations worldwide. That number too continues to rise. There have been a spike of Omicron cases in Europe, most notably in Britain where cases have doubled and in Denmark where cases have tripled over the weekend. It's worth noting that both of those countries are considered leaders in genomic sequencing. So it could be more adept at identifying cases of the new variant than some other countries are.

Unger: So we've seen very quick response to this with travel, which is I think a little bit different than where we were originally with this. So we've got stricter requirements for international travel, including stricter testing. That's now been implemented but where does this go? How do we evolve from here?

Garcia: Yeah. On Monday, the U.S. began requiring international travelers to provide proof of a negative test taken no more than a day before their flights. And so just as a reminder, the previous recommendation was that fully vaccinated passengers could provide proof of a negative test taken within 72 hours of departure. So this new requirement may be difficult for some travelers because it can take more the a day to receive test results. And that could mean certainly additional headaches and fees for testing in order to get that quick turnaround for people who plan to travel internationally for the holidays. This really comes at a time when the travel industry is rebounding. And we know TSA reported the Sunday after Thanksgiving was the busiest travel day at U.S. airports since February of 2020.

Unger: Although we still don't know a lot about Omicron and health officials continue to say that getting vaccinated and boosted remains our best defense at this point, particularly because most of the cases in the U.S. are still being caused by the Delta variant, where are we with vaccinations as of this week?

Garcia: According to the CDC this week, a total of 236 million Americans have received one dose. So that's about 71.1% of the total population and of those, 199.3 million are fully vaccinated, so 63.8% of the population. So far, the CDC is estimating that 47 million people have received the booster dose.

Unger: I saw a little bit of news that demand for the vaccinations is up with the emergence of omicron and we hope that that trend will continue. One thing that we have seen coming out of New York City is that the mayor there took a major step this week in announcing a vaccine mandate for all private employers. What is the news there?

Garcia: I mean, that's right. And I think this is really the first mandate of this kind in the U.S. We've, obviously, seen the OSHA mandate for private employers and health care worker mandates but we haven't really seen local or state jurisdictions putting forth mandates for private employees. So this would apply to about 184,000 businesses. Employees who work in person at private companies must have one dose of the vaccine by December 27. Remote workers will not be required to get the vaccine. This difference differs from the federal rule in that there's no testing option as an alternative but New York City does plan to offer exemptions for valid medical or religious reasons. And I think it's important to note that New York City already has put vaccine mandates in place for city workers and for employees and customers at indoor restaurants, gyms and other venues.

And now that five to 11-year-olds are eligible for the vaccine, those mandates will expand. And so that age group must have one dose to enter a restaurant in theaters starting on December 14. And we know that adults will need two doses to enter starting on December 27, except those who received the single shot J&J vaccine.

Unger: Well, finally, the AMA did put out a release in response to the Biden administration's COVID-19 plan, which does include expanded opportunities for vaccination and testing. You want to give any details about that?

Garcia: The AMA released a statement last Thursday in response to the Biden administration's COVID-19 plan, which as you mentioned, includes expanded opportunities for vaccination and testing. That statement's out that "President Biden's plan will make our communities and the world safer in the face of the evolving pandemic and confirmed cases of Omicron, the Omicron variant. Physicians see a lot to like in this plan. We've rolled up our sleeves and will continue to play a pivotal role in safeguarding our patients and communities." The statement went on to note that to "those who are unvaccinated, please do your part and get vaccinated to help reduce the toll that this virus is having on yourself and those you love. And to those who have not yet gotten a booster, do not wait. To help protect those who aren't yet eligible for vaccination, we also urge the public to continue taking evidence-based public health precautions, such as physical distancing and wearing face masks."

Unger: Hashtag listen to your doc. Andrea, thanks so much for being with us here today. That's it for today's COVID-19 Update. We'll be back with another segment next week. In the meantime, for resources on COVID-19, visit ama-assn.org/COVID-19. 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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