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 Andrea Garcia, JD, MPH, AMA's director of science, medicine & public health, on COVID-19 vaccine numbers and trending topics related to the pandemic over the past week. Also covering an increase in COVID cases as the U.S. surpassed 50 million on Monday, new data from a major study released by South Africa’s largest health insurer on vaccine efficacy against Omicron, and an update on Pfizer's COVID pill.

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, thanks for joining us. This is going to be our last update for 2021 together. It's been a pretty somber week I would say. Bad cheer for the holidays as we head into them, as we passed some grim milestones for the pandemic overall in terms of cases and deaths. Where are we right now with those?

Garcia: Well, thanks for having me back. And you're right, the total number of COVID cases in the U.S. surpassed 50 million on Monday. That's according to the New York Times. They've made several comparisons to try and help people truly understand the size of that number. It's more than the combined population of Georgia, Michigan, North Carolina and Ohio, more than the entire population of Spain and nearly 18 times the number of dollars an American college graduate can expect to earn in a lifetime. It's also likely an under count, as we know many people don't experience symptoms or get tested when they feel sick or may take an at-home test, which often doesn't get counted in that number.

Unger: I saw one of those diagrams about where cases are in the dangerous territory across the states and it looked pretty broad. Where are cases increasing? Is that in most of the country at this point?

Garcia: Daily reports of new cases, which fell steadily in the early fall, have been rising sharply in the last few weeks. We're currently averaging around 120,000 cases per day in the U.S. and this is mostly still due to the Delta variant, which has continued to spread, especially in the Midwest, the Southwest and in New England. And as we've discussed, much still remains unknown about the new Omicron variant, so it's difficult to predict where things are headed but experts are expecting that the holidays and the winter weather will probably make matters much worse.

Unger: Gosh, I remember just a few weeks ago we were under 100,000, now we're at 120. What about hospitalizations and deaths? Are we seeing trends there too?

Garcia: Yeah. So depending on which of the databases you look at, some had us closing in on 800,000 deaths in the U.S. on Monday and others had us reaching and surpassing that milestone on Monday. I think either way that number is pretty devastating. According to the New York Times, 75% of people who've died of COVID in the U.S. or about 600,000 of the nearly 800,000 who've died so far have been 65 or older. That means about one in a hundred older Americans have died from the virus. For people younger than 65 that ratio is closer to one in 1,400. But COVID has become the third leading cause of death of Americans 65 and older, it's right behind heart disease and cancer. More than 1,200 people in the U.S. are still dying from COVID each day and most of those are 65 and older.

Unger: Those are incredible numbers. Very sad. Are we seeing any patterns with those deaths? Are they regionally? Are they concentrated? What do you see?

Garcia: So, throughout the summer we know that most people dying from the virus were concentrated in the south but the most recent 100,000 deaths, beginning in early October, have really been spread out across the country, largely in the middle of the U.S. from Pennsylvania to Texas, the Mountain West and Michigan. I think it's also worth noting that the most recent 100,000 deaths have all occurred in less than 11 weeks. And that's really a sign that the pace of deaths is moving more quickly once again. It's really faster than at any time, other than last winter's surge.

Unger: So obviously that makes getting vaccinated and boosted even more important right now. Where do we stand with vaccinations and boosters?

Garcia: According to the CDC, this week a total of 239.3 million Americans have received one dose. That's about 72.1% of the total population. Of those 202.2 million are fully the vaccinated. That's 60.9% of the population. And CDC's estimating that 54.4 million people have received a booster dose. I think it's also worth noting that it's been exactly one year since we began distributing vaccines in this country. On December 14, 2020, we all watched as a nurse in Queens became the first person in the nation to receive a COVID vaccine outside of a clinical trial. And I think the numbers probably aren't what we had hoped that they would be but we should obviously acknowledge that we've come a long way.

Unger: We certainly have. And Andrea, we've had a chance to talk about that over the course of the year and I remember when those numbers were under 10. It's just that we have 40% more people to go to get to where we need to.

In a move that might help bump those numbers even more, we did see eligibility for boosters expand this year or excuse me this past week. What's the news there?

Garcia: Yeah, so eligibility for the Pfizer booster was expanded to include 16 and 17-year-olds. The move by the FDA and CDC really cleared the way for several million teenagers to receive that additional shot. Adolescents in that 16 and 17-year-old category can get boosters if they are six months past their initial Pfizer vaccine series. And just as a reminder, the CDC did strengthen their booster recommendation and they are now encouraging everyone 16 and older to receive a booster dose. And although we don't have all the answers on the Omicron variant, initial data does suggest that boosters help broaden and strengthen protection against the new variant.

Unger: Speaking of the new variant, lots of learning there. What are we finding out this week about Omicron?

Garcia: So we know now have the results from a major South African study, which does give us a bit more information. The study was done by Discovery Health, that's South Africa's largest insurer, and they looked at 211,000 positive COVID cases. 78,000 were attributed to the Omicron variant. I think the good news there is the study found that the new variant appears to cause less severe illness than earlier variants but it does appear to be more resistant to the two-dose Pfizer-BioNTech vaccine, which we know was largely used in South Africa. And looking at the data, it showed that the risk of hospital admissions among adults who contracted COVID was 29% lower in South Africa's initial pandemic wave that occurred in March of 2020. That's after adjusting for vaccination status.

Unger: So I guess that's the thing that's on a lot of people's minds, is about the vaccine effectiveness. There was some news there about the Pfizer vaccine portion of that. How protected are we?

Garcia: So, I think there's really good news and bad news. The study showed that the two doses of the Pfizer vaccine provided just 33% protection against infection. That's much less than the level for other variants detected in the country. But the study showed the vaccine provided 70% protection in fully vaccinated individuals against severe complications that would require a patient to be hospitalized. I think we should keep in mind that that protection against hospital admissions was reduced from about 93% against Delta in South Africa but 70% is still regarded as very good protection.

Unger: It is. And that's two doses though, that's not with a booster. Is that correct?

Garcia: That's right.

Unger: So more to find out there. Just more emphasis on get that full vaccine regimen done, including your booster shots. Also gave us some data on children. Can you tell us more about that?

Garcia: Yeah. The early data suggests that children appear to have a 20% higher risk of hospital admission with complications when infected with Omicron. The study did note that overall the risk of children being admitted to the hospital for COVID-19 complications remains low and the symptoms in children generally included sore throat, nasal congestion and a fever for two or three days and most children recovered after three days.

Unger: What about the booster? We just talked for a moment about it but is there evidence either way on how we should think that this either strengthens or doesn't the case for booster shots?

Garcia: Yeah, I mean, it's still early. There's still a lot we don't know but the data we've seen so far does suggest that. The last Wednesday Pfizer reported its initial lab results testing the Omicron variant and their data showed a significant reduction in the two-dose vaccines of the ability to fight Omicron infection. They also found that a booster dose offered significant protection against the variant and they noted that the two-dose vaccine may still protect against severe disease. So obviously two doses might not be enough to protect you against infection from this new variant but a booster dose does help. And as a result of that, we're seeing growing support for boosters among public health experts. And data from both Israel and Britain has shown that an extra dose can sharply lower a person's likelihood of catching COVID-19 and getting sick and that's really leading to more countries expanding their booster program. We do know that Pfizer and Moderna have said that they would be able to produce vaccines that are specifically tailored to the new variant in roughly three months but it's not yet clear if those vaccines specific to the variant are going to be necessary.

Unger: Well, I guess that is some good news. On the tough challenge part, we see Omicron spreading across Europe. What are we seeing here in the states in terms of a new variant?

Garcia: So Omicron has been detected in 33 states and I think the CDC is estimating that it accounts for about 3% of new U.S. cases, so Delta is still the primary variant here in the U.S. but recent testing does show that Omicron is now surging in Washington state. Researchers at the University of Washington found that 13% of 217 positive COVID-19 specimens collected last Wednesday had the mutation and that was up from 7% of samples they had tested the day before and 3% of samples the day before that.

Unger: Wow.

Garcia: So while this is a really small sample size, it is suggesting that this variant is highly transmissible.

Unger: On the positive news front, we did see some good news about the COVID pill coming out of Pfizer. What can you tell us about that?

Garcia: Yeah. So Pfizer announced the results of their highly anticipated study for its oral antiviral pill. It's confirming that it helps prevent severe disease, even from Omicron. In Tuesday's announcement, Pfizer said that given within three days of the onset of symptoms, the treatment reduced the risk of hospitalization and death by 89% and given within five days, that risk was reduced almost as much to 88%. And last month, Pfizer did ask the FDA to authorize its pill based on preliminary data. The new results should help strengthen the company's application, which could mean that Americans have access to the pill within weeks.

Unger: That would be very positive news to carry into the new year. And if you haven't yet, a good New Year's present would be to get fully vaccinated, including those boosters. Andrea, thank you for spending the time this year giving updates and keeping people up to speed on developments with the pandemic.

That's it for today's COVID-19 Update. We'll look forward to being back with you in the new year. In the meantime, for additional resources on COVID-19, visit ama-assn.org/COVID-19. Thanks for joining us today 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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