Featured topic and speakers
In today’s COVID-19 Update, Mira Irons, MD, AMA's chief health and science officer, also reviews COVID-19 numbers and trending topics related to the pandemic over the past week, the issue of variants and vaccine effectiveness in Israel.
Learn more at the AMA COVID-19 resource center.
Speakers
- Mira Irons, MD, chief health and science officer, AMA
Transcript
Unger: Hello, this is the American Medical Association's COVID-19 Update. Today we have our weekly look at the numbers, trends and latest news about COVID-19 with AMA's chief health and science officer Dr. Mira Irons in Chicago. I'm Todd Unger, AMA's chief experience officer in Chicago. Let's start with the numbers, Dr. Irons. What are we looking at in terms of this week's numbers and what's happening across the country with new cases and deaths?
Dr. Irons: Well, sure Todd, so today's numbers are 27,641,151 individuals diagnosed in the United States. We know the true number is really higher. And 485,337 people have died of COVID-19 in the United States. I'm going to talk about numbers now, that the good news is we haven't heard for a while, at least the numbers over the weekend are that 63,850 new cases were reported in the United States on Sunday. And at least 1,080 new coronavirus deaths were reported over the past week. That's been an average of just over 91,000 cases per day, which is a decrease of 39% from the average two weeks earlier. And the number is far less than what we were saying on this videotape, than the country's peak of more than 300 cases reported on January 8th. And 47 states are now reporting sustained process.
Although the deaths have declined a bit in recent days, the seven-day average is really about 3,000. And they actually range, if you look at every day over the last seven days, the reported numbers range anywhere from a thousand to over 5,000. And one of the reasons for that is reporting variability. An example of that is that officials in Ohio discovered a data reporting error that resulted in about 4,000 deaths not being announced when they occurred. And so, the thing to remember here is, and while I'd really like to look at this in a positive light, it's good that case numbers are coming down, but we are not out of the woods yet.
Unger: We're closing in on a 500,000 death milestone, which is horrendous. And what I hear you saying is we're still at incredibly high levels. They may be down from where they were at their peak, but this is still serious. And we're not out of the woods. We have some issues with variants coming up that are causing great concern. Can you speak to that?
Dr. Irons: Yeah. So, highly infectious variants continue to pose a threat to the progress we've seen. The variant first I've seen in South Africa was detected in Illinois and California for the first time last week. In Florida, where infections continue to decline, officials have found hundreds of cases of the variant first described in Britain. And I heard this morning that over a thousand cases of the U.K. variant have been found in 39 states. And so, we're starting to see these variants occur in the United States, but also the U.S. is ramping up their surveillance, their genomic surveillance. So I wouldn't be surprised if we hear more about this moving forward.
Unger: Yeah. We spoke with Dr. Peter Hotez and talked to him about the variant situation. He described the situation as potentially dire, and really saying looking ahead to March and April could be very problematic.
Dr. Irons: Yeah, absolutely.
Unger: So let's talk about what the trends and drivers that we're seeing this week are.
Dr. Irons: So the biggest trends and drivers is the news that the CDC weighed in on the school debate. And they released their long awaited guidance at the end of last week for how to reopen schools quickly drawing from scientific evidence on adequate precautions. They also said that vaccinating teachers is a priority, but not a precondition for reopening. The agency said that even in communities with high transmission rates, elementary school students may receive at least some in-person instruction safely. Middle and high school students may attend in person classes safely when the virus is less prevalent, but may need to switch to hybrid or remote learning in communities experiencing intense outbreaks.
And I think that they're basically stressing what we've talked about for awhile is that the mitigation measures are important. Schools have to have the resources in order to mitigate, but the community prevalence of viral activity is also really important. So you take all three of those things together to make your decision. The agency's guidance repeats the idea that school should be the last to close and the first to reopen in any community. And it can be done if it's done safely and guided by what we know about public health and science.
Unger: Yeah. That is a big change. I know a lot of parents are looking forward to having their kids back in school. So hopefully that will continue to move forward. Another event that was different this year is the celebration in New Orleans with Mardi Gras, any perspective on that?
Dr. Irons: Well, I think the intent is to try to decrease the potential for super spreader events. And community officials are starting to really understand this and how they can have a role in trying to keep the virus from spreading. So New Orleans tamped down its annual Mardi Gras celebrations this past week and health officials in other cities warned would be revelers to do the same. New Orleans mayor, LaToya Cantrell, ordered bars closed during the Mardi Gras weekend, parades were canceled and there were limits on gatherings.
Unger: All right. I want to kind of circle back to something we mentioned earlier in this, which is about variants. Because there was new or additional news on variants that was released over the weekend. Can we talk a little bit more about what's happening there?
Dr. Irons: Absolutely. So on Sunday a new study was released on a preprint server that identified seven variants that appear to have originated in the U.S., And they all had a mutation at the same amino acid site. It's not clear yet whether the shared mutation makes the variance more contagious, but because it appears in a gene that influences how the virus enters cells, the scientists are highly suspicious. It's really difficult to answer even basic questions about how prevalent the new variants are because the country sequences genomes from less than 1% of coronavirus test samples.
Now we have heard from the CDC that surveillance is increasing. So we hope to hear more about this in the future. But these variants that this particular study has identified really started to appear late summer, early fall. And it's really hard to say whether they're spreading now. The way the coronavirus behaves is still fairly mysterious. So it's difficult to know what the substitutions are doing and how they actually may impact community spread, community disease and general health. But what's important to note is that this is an RNA virus and mutations will occur when the virus is multiplying within cells. So the important thing to remember is that we need to continue to double down on mitigation measures to prevent transmission and new infections because every new infection provides an opportunity for the virus to mutate.
Unger: That's so important to keep in mind as we see decreasing numbers. It is not time to lighten up on those kinds of mitigation measures. And we're looking at possible variants that are more easily to transmit, possibly more dangerous. We need to keep pedal to the metal on those mitigation measures right now. It also makes getting people vaccinated more quickly an even more urgent situation. So let's turn our attention to talking about vaccines. Can you give us the latest news there?
Dr. Irons: Absolutely. And this is positive. We're hearing more positive news about vaccines. The pace of vaccination continues to pick up. More than 70 million vaccine doses have been distributed in the U.S. And about 52.8 million have been administered, according to the CDC. Of that 52 million, more than 38 million individuals have received one dose and more than 14 million have received two. And the U.S. is now administering 1.7 million shots a day, exceeding President Biden's goal.
The other thing just over the weekend that we're hearing is some good news about the effectiveness of the Pfizer vaccine in Israel. Israel's largest health care provider on Sunday reported a 94% drop in symptomatic COVID-19 infections amongst 600,000 people who received two doses of Pfizer's vaccine in the country's biggest study to date. The same group was also 92% less likely to develop severe illness from the virus. And in addition to that, researchers at the Weizmann Institute of Science, who've been tabulating national data, said on Sunday that a sharp decline in hospitalization and serious illness identified earlier among the first age group to be vaccinated age 60 or older was seen for the first time.
So while hospitalizations and serious illnesses were still rising in younger age groups who began vaccinations a week later, this is additional evidence of the effectiveness of that vaccine. The only other news is that, and I think we mentioned this last week, is that FDA officials announced that the outside experts, the advisory group would discuss the Johnson and Johnson vaccine at a public meeting on February 26th.
Unger: There was some additional news too, about the Moderna vaccine. The FDA said that Moderna could put really up to 40% more vaccine in vials. How does that work? And when will we start to see the impact of something like that?
Dr. Irons: I don't know the timing of that, but when the FDA authorizes a vaccine, the authorization includes manufacturing, packaging, efficacy, safety, all of the different components. So Moderna applied to the FDA, I think within the last few weeks, to ask for approval to add more vaccine doses to the vials that they were distributing and the FDA agreed to that last week.
Unger: So that is good news. Well, let's talk finally about any news that needs to be cleared up this week. One is the situation you mentioned earlier, which is with decreasing numbers we see the temptation to start pulling back on mitigation numbers. And across the states, are you seeing that as a trend?
Dr. Irons: Yeah. You know, we are starting to see it as a trend. And I think that it's understandable on the one hand because cities and states have used activity level within the community, number of hospital beds, number of ICU beds as metrics for backing off or instituting restrictions. So what we're seeing is governors easing up on restrictions across many states. One virologist said relaxing restrictions would now be courting disaster.
As the number of virus cases and hospitalizations have fallen, the governors of Montana, Iowa and North Dakota and Mississippi have recently ended statewide mask wearing mandates. In New York, Governor Cuomo has allowed indoor dining to resume at 25% capacity, though experts have repeatedly warned that maskless activities such as eating in enclosed spaces are high risk. I think we've heard Dr. Walensky during her interviews say that it's even more important now to double down. We understand, I understand, that this has been a long year and that people want to hear good news and start to open up cities and towns. But now more than ever with novel variants, we need to be strategic with these reopening efforts and be slow and not rush things.
Unger: Well, that might be one good benefit of all these winter storms and the snow, at least we're getting here in Chicago, is we literally can't go anywhere. Finally, any other things that the AMA wants people to hear this week?
Dr. Irons: Yeah. So last week, a broad coalition of health care and employer groups, including the AMA, called for achieving universal health coverage by expanding financial assistance to consumers, bolstering enrollment and outreach efforts, and taking additional steps to protect those who have lost or are at risk of losing employer based coverage because of the economic downturn caused by the COVID-19 pandemic. The affordable coverage coalition encompasses groups representing the nation's doctors, hospitals, employers and health insurance providers that collectively serve hundreds of millions of American patients, consumers and employers. The joint commitment by such a broad array of interests is a significant milestone on the path toward universal coverage, which has remained an elusive goal within the U.S. health care system.
Unger: Well, thanks so much Dr. Irons. We'll keep our eye closely on the data as it comes in, and we'll be back with another update with Dr. Irons next week. Thanks for joining us today. If you want more information about COVID-19, you can visit the AMA site at ama-assn.org/COVID-19. Thanks for joining us. Please take care.
Disclaimer: The viewpoints expressed in this podcast are those of the participants and/or do not necessarily reflect the views and policies of the AMA.
