Watch the AMA's 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 reviews rising COVID-19 case numbers and trending topics related to the pandemic over the past week with AMA Director of Science, Medicine and Public Health Andrea Garcia, JD, MPH. Also covering developments in COVID hot spots across the nation, the CDC's clarified stance on masks, and Dr. Fauci's "five phases of the pandemic."

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 the 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, thanks for joining us. Case numbers continue to climb and many hospitals we're seeing are at or near capacity. The question that is on everybody's mind is if we peaked, are we looking at the right numbers and what's the latest news?

Garcia: Well, thanks for having me, Todd. And I agree, we are hearing a lot of questions about whether or not cases are peaking. We heard from the surgeon general, Vivek Murthy, who talked to CNN on Sunday and he said that the next few weeks are definitely going to be tough. We're seeing those cases surpass 800,000 for the first time. But the challenge really is, in predicting the peak, is that the country's in different places, right? We're not all moving at the same pace. So Omicron, that we've started in some parts of the country earlier than others. So we shouldn't expect to see a national peak in the coming days. He then pushed for vaccination and boosters to help keep people out of the hospital and said that the government is working on providing more resources for hospitals. He also addressed the ongoing testing challenges that the country faces, saying Omicron really created an extraordinary rise in demand and admitted that we certainly have more that we need to do on testing.

Unger: So while we may not be seeing a national peak in cases in the coming days, there are some indication that maybe in the early hotspots of the Omicron variant surge, that we're seeing some relief. Is that true or not?

Garcia: Yeah, that is true. So if we look at New York, which was one of those early hotspots in the surge, there's some good news there. On Sunday, the governor there told New Yorkers that the COVID forecast was improving, saying the COVID clouds are parting. She's basing this forecast on the fact that over the past week, those skyrocketing rate of new cases of COVID in New York, they began to slow down and then they began to fall. So the test positivity rate in that state are down as well. It's at 13% over the weekend and that's down from 23% a few weeks ago. So definitely some good news in New York.

Unger: Any other signs of improvement? I see maybe some other states in the Northeast and other places.

Garcia: Yeah, definitely, in the Northeast, we look at New Jersey, Massachusetts, Connecticut, Rhode Island. Those also were seeing declines in cases there. The New York Times reported that Puerto Rico, Cleveland, here in Chicago and in Washington, D.C., those are some cities where we're also seeing some improvements as of last week. But like we talked about, we're seeing other states and other jurisdictions really head in the opposite direction. So infections were up about 400% over prior weeks in Alaska and Oregon and Utah. And I think the other thing that we just need to keep in mind is as we talk about case counts, we're really looking at an under count here, as we know, more and more people are using those at-home rapid antigen tests so those numbers of infections are really an under count.

Unger: So one of the things that's very perplexing right now is you see some streams of news that say the Omicron variant is less severe. And on the other hand, you see hospitals way over capacity. Some of the stories that we're seeing in the news are just absolutely heartbreaking. Are they still struggling? And what about this juxtaposition in those two kinds of streams of information?

Garcia: Yeah, so hospitalizations are still rising in the U.S. And we are hearing some officials say that the number of people admitted to the hospital for COVID is beginning to slow down, but hospitals remain under tremendous strain. And we know ICUs, as of last week, on average, were about 82% full. And hospitals, I think, are struggling to manage those staffing shortages. And that is leaving physicians and nurses in a position of having to make really difficult decisions about whose care they have to prioritize.

We know in Oklahoma City, on Monday, four hospitals issued a statement saying they have no ICU beds available. And I think the average number of people hospitalized in the U.S. with COVID is around 157,000. That's an increase of 54% over two weeks. And that is now at a point that's higher than any previous point in the pandemic. We've heard this conversation about hospitalized for COVID or hospitalized with COVID and so these numbers do include people who are hospitalized for other reasons but are testing positive for the virus. And the other point that people are looking at is deaths. And so we are around 1,900 deaths reported each day. That number is a 54% increase over the past two weeks.

Unger: So again, to dig into my earlier question, again, a lot of the news you see is this variant is possibly less severe and yet we're seeing over capacity, increase in deaths. What's the story there?

Garcia: So part of it is that this variant is so transmissible that the sheer number of cases has resulted in a huge influx of patients seeking care. And we also need to keep in mind, we still have a pretty large percentage of the population that isn't vaccinated. So when we say overall, it's less severe, it's still impacting that unvaccinated population pretty hard.

Garcia: The U.S. is averaging around 790,000 new daily cases. And we know from our previous conversations that with the holiday weekend, that that number is an under count. And we're hearing stories from emergency departments that sound like they did earlier in the pandemic with patients lining hallways, waiting for care and hospital staff that are just totally overwhelmed. We know that the federal government is sending in the National Guard to some areas to help, but the situation in many communities continues to be dire.

Unger: Speaking of staffing, do we expect the Supreme Court's decision that was issued late last week, which upheld the vaccine mandate for health care workers who work at facilities that receive federal funds, is that going to have any impact on the situation or because it was essentially upheld, is that business as usual?

Garcia: So the AMA supports that decision to mandate vaccination for health care workers. And of course we were disappointed that the Supreme Court did not also uphold that OSHA emergency temporary standard for other employees at large businesses to be vaccinated or tested regularly. We did come out with a statement last Thursday that's saying as much. And to quote that statement directly, "Now, more than ever, workers in all settings across the country need common sense, evidence-based protection against COVID-19 infection, hospitalization and death, particularly those who are immunocompromised or can't get vaccinated due to a medical condition." And that statement went on to urge large employers to really do their part to safeguard their workforce and their community by mandating vaccination and testing on their own.

With that being said, to answer your initial question, we are hearing from the New York Times and other sources over the weekend that the country is bracing for further staffing shortages, as hospitals wrestle with some of that resistance to be vaccinated among some staff.

Unger: Where are we then with vaccination nationally? Are we still making progress, or is that stalled?

Garcia: So according to the CDC, this week, a total of 248.7 million Americans have received one dose, that's 74.9% of the total population and of those, 209 million are fully vaccinated. So 62.9%. And the CDC's estimating right now about 79.7 million people who have received their booster dose.

Unger: Vaccination, obviously our best defense against severe infection but not our only defense. This week, the CDC also clarified its stance on masks. What is the update there?

Garcia: So last Friday, the CDC essentially acknowledged that cloth masks do not offer as much protection as a surgical mask or respirators. And while at this point, I think it's widely known to the general public that respirators do provide better protection, I think this is the first time where CDC has explicitly addressed those different levels of protection by mask type. And the agency also updated their site to note that there is no longer a shortage of respirators.

Unger: So is the CDC now officially recommending respirators or not?

Garcia: No, so the language notes that properly fitted respirators provide the highest level of protection but they didn't go so far as to recommend that everyone wear an N95. The language now says that a respirator may be considered in certain situations and by certain people when greater protection is needed or desired. And I know some people feel like that recommendation didn't go far enough. I think the CDC continues to say that the best mask is the mask that you're going to wear. They note that for some people, N95s might not be comfortable, and I think they just want to keep that in mind. I personally have switched to an N95 and I find it very comfortable so I would of keep an open mind in giving them a try, given the level of protection they provide.

Unger: I have switched too. One of the other kind of interesting, the question marks that are out there, some are wondering that if because Omicron is so transmissible, so many people are getting it, that it's going to finally help us reach herd immunity, end the pandemic. There's a lot of talk out there about super immunity, particularly with breakthrough cases, people being vaccinated already. Is this a possibility or not?

Garcia: Dr. Fauci weighed in on this question recently, and I think the conclusion is it's too soon to tell. On Monday, he was asked at the online World Economic Forum if this may be the year that the virus becomes endemic, meaning that it's still circulating but it's not disruptive to society. And while he did say that the sheer volume of cases could have a meaningful impact on collective immunity, it's really still an open question as to whether Omicron is going to be that live virus vaccination that everyone is hoping for. And that's because we still have a great deal of variability with new variants emerging. So we could see a new variant that alludes immune response and that could affect our ability to reach herd immunity. He also said in that conversation, that we're really in that first phase of what he considers to be the five phases of the pandemic.

Unger: Oh, goodness. If this is just still the first phase, that's a little intimidating. Talk to me about this. What are the other phases beyond phase one?

Garcia: Yeah, so the first phase is that truly pandemic phase. So this is where the whole world is really very negatively impacted. And I think we can agree that we're definitely still in that phase. And the remaining four are deceleration, control, elimination and eradication. And I think most people are saying we're not going to reach eradication with COVID-19, there's only been one human infectious disease that has been eradicated and that's smallpox. However, once countries reach that control phase where the virus becomes less disruptive in its presence, then the virus will be considered endemic. And so that's the stage where you really learn to live with the virus.

Unger: And then beyond that, phase five is what?

Garcia: Phase five is really, I think we're probably not going to reach it but so that's eradication.

Unger: I got it now. So kind of deceleration, control.

Garcia: Control.

Unger: Elimination.

Garcia: Elimination.

Unger: And eradication. Okay. So hopefully those remaining four phases will come and we'll get out of the disruption period as quickly as possible. Thank you so much for clarifying that. It takes me a while to get, have it sink in. Andrea, thanks for being with us here today. That's it for today's COVID-19 Update video and podcast. We'll be back with another segment shortly. 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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