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, to review COVID-19 vaccine numbers and trending topics related to the pandemic over the past week. Also covering challenges faced by southern states in the wake of Hurricane Ida and the U.S. re-returning to a daily average of more than 100,000 COVID-19 patients hospitalized.
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. Today we're taking 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, the big news over the weekend, of course, was Louisiana and Hurricane Ida. It's a state that's already struggling with a COVID surge. Then on top of that, you've got complications from the hurricane. Can you talk about what's happening there and how preparations were complicated by the pandemic?
Garcia: Yeah, certainly. Thanks for having me, Todd. I think the hospitals in Louisiana are really facing two public health emergencies at once. In trying to prepare for Hurricane Ida, we know some of these hospitals would normally have opted to move patients either further inland or even out of state. But with so many hospitals already stretched to capacity due to COVID-19, moving patients became really difficult, if not impossible. Louisiana's medical director went as far as asking residents last Friday to avoid unnecessary emergency room visits to preserve what little capacity was left. And public health officials now are concerned because the hurricane may ultimately affect the state's high COVID-19 case loads as we see people fleeing their homes to stay with relatives or to stay in shelters and that could create conditions conducive to the spread of the virus. And we know the situation in Louisiana, they have the country's fifth highest COVID hospitalization rate and a pretty low COVID vaccination rate, which is I think well below 50% at this point.
Unger: Well, I know we're just really being able to take stock of what's happened there. Power's out, a really tough situation. Any early read on the aftermath so far?
Garcia: Yeah, I mean, I think it's too soon to really know the full extent of the damage either in Louisiana or in neighboring Mississippi. We are hearing about hospitals in southeast Louisiana that have sustained roof damage, water leaks and at least three of the hospitals directly in the path of the storm are now evacuating their patients. With power out, like you mentioned, throughout the region and the water supply also shut down, some hospitals are relying on generator power and water wells on site. I think if there is a positive it's that so far few people are coming into the hospitals with injuries from the storm. It's still early, so that could change.
I think the other pressing thing these hospitals are going to be facing is related to staffing and their employees. I mean, certainly, hospital staffing were onsite throughout the emergency but they have to worry about whether their homes were destroyed, the situation their family is in and then you have to be able get other health care providers to the hospital to relieve those who rode out the storm in that situation. We know health care workers are already stretched to the max with the pandemic, so really a difficult situation.
Unger: I'm not sure I could have thought of another way to add stress to a situation. I saw pictures of physicians, residents, medical students hunkered down in their quarters down in New Orleans. Our thoughts are with them, their health care teams and everyone down there. In speaking of the situation with the hurricane, we'll continue to monitor that situation down there. Timing is so important, given the new high we're seeing with hospitalizations across the country. Sadly, a number we haven't seen since the winter peak before vaccinations. What can you tell us about that?
Garcia: Yeah, that's right. The U.S. reached a daily average of more than 100,000 hospitalized COVID-19 patients over the past week. That is higher than any previous surge except last winter's and you'll remember at that point we were seeing nearly 140,000 people hospitalized per day. But as you noted, that was before the U.S. population was eligible to get vaccinated on a large scale. So to be seeing this number now, I think it's certainly concerning. Hospitalizations nationwide have increased by nearly 500% in the past two months, and again, that's particularly across the southern states. It's fueled by some of the country's lowest vaccination rate and widespread opposition to evidence-based public health measures like mask requirements. The influx of patients is really straining hospitals, it's straining our health care workforce. Deaths are rising to more than 1,000 per day. That's the first time since March that we've seen it at those levels. And cases are at 39,048,678, so we are averaging about 156,000 cases per day at this point.
Unger: The strain that this is placing on the health care system both in terms of infrastructure but also in terms of the staffing and personnel. Can you give us a little bit more specifics on that?
Garcia: Yeah, so we know that there's a shortage of bedside nurses and that's complicating efforts both to treat hospitalized COVID-19 patients but it's also leading to longer emergency room waiting times for those people who need care. So, in August alone, one in five ICUs had reached or exceeded 95% of full beds. Alabama was one of the first states to run out of ICU beds. We are hearing that the University of Tennessee Medical Center in Knoxville on Thursday requested assistance from the National Guard. Based on data from HHS, Florida has the most hospitalized patients than any other state due to COVID and that is followed by Texas. In previous surges, hospitals had been forced to expand capacity by creating makeshift ICUs and areas reserved typically for other care like hallways or other spare rooms. And we are certainly at that point again in a number of states.
Unger: I mean, that is scary. In a lot of those states where mask mandates are being opposed, the situation is very dire. We know that a lot of this hospitalization surge has been driven by the Delta variant, particularly in unvaccinated populations. Any progress on the vaccination front in terms of pace this past week?
Garcia: Some. Right now, we're at 204.7 million people or 61.7% of the population that have received at least one dose of a COVID-19 vaccine and about 173.8 million people or 52.4% who are fully vaccinated. As of Friday, the seven-day average for the number of administered doses reported by the CDC was 877,756. That's about a 6% increase from the previous week, so that's a good sign. The CDC also reported that about 955,000 fully vaccinated people have received an additional dose of the vaccine since August 13 and that's when the FDA authorized and the CDC recommended third doses for some immunocompromised patients. This figure does not include the estimated 1.2 million people in the U.S. who received unauthorized additional doses prior to that mid-August recommendation.
Unger: Well, we know another complicating factor is back to school. Seeing a lot of young people heading back right now. We talked with Dr. Paul Offit last week about the rising COVID cases and hospitalizations in children and young people and different approaches to safety protocols among schools. Is there any news on that front?
Garcia: I think the biggest news there is that the U.S. Department of Education has initiated an investigation into five states whose prohibitions on universal mask mandates in schools may run counter to civil rights laws that protect students with disabilities who may be at higher risk for severe illness. So the five affected states are Iowa, Oklahoma, South Carolina, Tennessee and Utah. The Department of Education said they are not currently investigating Florida, Texas, Arkansas or Arizona because the bans on universal indoor masks in those jurisdictions are either not being forced in schools due to litigation or due to other state action. So, as a reminder, the CDC recommendation is that everyone in schools wear masks, regardless of vaccination status, so schools can more safely resume in-person instruction. The AAP agrees with that recommendation and certainly the AMA does as well. And I think this new action is another example of the escalating tension and politicization over evidence-based public health measures.
Unger: Speaking of mandates, can you talk about messages from the AMA on that topic over the past week?
Garcia: Yeah, so shortly after we spoke last week the AMA released a statement encouraging the public and private sectors to adopt COVID-19 vaccine mandates. The statement noted that incentives really haven't gotten us where we need to be with the Delta variant filling hospitals and overwhelming physicians and all frontline health care workers. We need to provide help and really the only way to regain the upper hand in this fight is requiring vaccinations, the vaccine mandates. The simple fact is unless a significant percentage of our population is vaccinated against COVID-19, we could be stuck fighting this virus for many more months or years to come, and now is really the time for public and private sectors to come together, listen to the science and mandate vaccination.
Unger: Well, that's a good message to end on, Andrea. Thanks for being with us here today and sharing your perspective. We'll be back with another COVID updates. 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.