AMA Update covers a range of health care topics affecting the lives of physicians, residents, medical students and patients. From private practice and health system leaders to scientists and public health officials, hear from the experts in medicine on COVID-19, medical education, advocacy issues, burnout, vaccines and more.
Featured topic and speakers
AMA's Vice President of Science, Medicine and Public Health, Andrea Garcia, JD, MPH, breaks down the latest vaccine news including why now is still a great time to get the flu vaccine and how your mood could impact how effective the flu vaccine is. She also discuss the latest rise in COVID-19 cases and the particularly hard impact COVID and RSV are having on children this year. Plus, key takeaways from CDC Director Dr. Mandy Cohen’s Congressional testimony and details about the CDC’s upcoming webinar with the AMA on respiratory virus season. AMA Chief Experience Officer Todd Unger hosts.
- Register for AMA's fireside chat with CDC Director Mandy Cohen, MD, MPH, and NCIRD Director Demetre Daskalakis, MD, MPH, on the fall and winter respiratory virus season.
- CDC resources and toolkit for National Influenza Vaccination Week available.
- New wastewater COVID dashboard via CDC National Wastewater Surveillance System (NWSS).
- Visit RespVaxView for CDC COVID-19, flu and RSV vaccination dashboards.
- Free COVID tests by mail still available.
- Call or text 9-8-8 if you or anyone you know needs help. The National Suicide Prevention Lifeline is now: 988 Suicide and Crisis Lifeline. It provides free 24/7 confidential support for people in distress, crisis resources for you or your loved ones, and best practices for professionals in the U.S.
- The AMA is your powerful ally in patient care. Join now.
Speaker
- Andrea Garcia, JD, MPH, vice president, science, medicine & public health, American Medical Association
Transcript
Unger: Hello and welcome to the AMA Update video and podcast. Today, we have our weekly look at the headlines with the AMA's Vice President of Science, Medicine and Public Health, Andrea Garcia. I'm Todd Unger, AMA's chief experience officer in Chicago. Welcome back, Andrea.
Garcia: Todd, thanks for having me.
Unger: Well, let's start with discussion about our new CDC director, Dr. Mandy Cohen. She made her debut in front of Congress. Andrea, what did she discuss and what were the key takeaways?
Garcia: Yeah, so she certainly fielded a lot of questions about the CDC's early pandemic response, which of course, predated her tenure at the agency, as well as the spike in childhood pneumonia in China that we discussed last week and confirmed, again, that there's no evidence of a new or novel pathogen involved. A lot of time was spent on those two issues, but she also talked about where we are now with respiratory viruses in the U.S.
According to Dr. Cohen, RSV this season is in full swing. It may be close to peaking. Flu season is just beginning across most of the country, but those cases are accelerating quickly. She said, so far, the flu season looked like a typical season, and many more cases are expected in December and January.
Of the three, she said COVID still remains the most serious threat. Although those case levels are still relatively low, they are quickly rising and COVID is still the primary cause of respiratory virus-related hospitalizations and deaths. She said we're seeing about 15,000 hospitalizations. And I know that the number has gone up since that conversation. And about 1,000 deaths are happening every single week. So she really stressed the importance of vaccination.
Unger: Well, Andrea, speaking of respiratory illnesses and Dr. Cohen, I know that we are partnering with the CDC on a webinar with Dr. Cohen. Andrea, tell us a little bit about the webinar itself and how physicians can register.
Garcia: So the CDC and the AMA are teaming up to cohost a fireside chat about fall and respiratory virus season. We know that we're getting a lot of questions from physicians about how to protect themselves, their patients, their coworkers and their communities from flu, COVID and RSV. And so this webinar will cover vaccinations and other tools that can really keep everyone safe and healthy this season. It's taking place on December 12 at 1:45 P.M. Eastern time.
You mentioned it will feature CDC Director Mandy Cohen as well as the acting director of NCIRD Dr. Demetre Daskalakis, who's been on this show before, and then of course, AMA's own immediate past chair and ACIP liaison, Dr. Sandra Fryhofer. You can register and submit questions in advance, and we'll be sure to drop the link in the description of this episode.
Unger: That's fantastic. And again, a reminder—that discussion will be taking place on December 12 at 1:45 P.M. Eastern time. And, as Andrea mentioned, you can find a description of that webinar and information about registering in the link to this in the description of this episode. Andrea, I thought I also read somewhere that this season has been particularly hard on children. Is that true?
Garcia: Yeah, unfortunately, it is. And data from the CDC shows that in the week ending November 18, more than 10% of doctor's visits among children younger than five in the U.S. were for influenza-like illness. That's about three times higher than average for all ages. And of course, it's well above that national baseline. There was an article on CNN about pediatric hospital beds. Those are filling up. Federal data shows that about three-fourths of pediatric hospital beds are currently in use nationwide, and capacity really hasn't been this strained since mid-December of 2022.
And as we just discussed, while COVID represents the vast majority of respiratory virus hospitalizations overall, RSV is the most common culprit among children, with weekly admission rates rising 69% since that first week of October. Hopefully, the assessment that we are nearing the peak for RSV is correct and we'll soon be seeing those cases come down.
Unger: Absolutely. Those are pretty astronomical numbers. Andrea, you also mentioned that flu season was just beginning, and that we expect many more cases soon. Are people out of time to get that flu shot or can they still get vaccinated?
Yes, in fact, this is National influenza vaccination week. It's the CDC's annual observance to remind people six months and older that there is still time to benefit from the protection of a flu vaccine this season. I think many people don't realize is that flu season can really go into the spring, and CDC data shows that last season flu vaccination coverage was low among certain high-risk groups—so pregnant people and children.
It's really critical to remind people that vaccination reduces the risk of illness and flu-related hospitalization if you do get sick. There is definitely still time to get that vaccine this season. CDC has put together a tool kit with shareable resources to help physicians get the word out to their patients. And we'll also be sharing the link to that tool kit in the description of this episode.
Unger: All right, that's great. Thank you for that information. And staying on the topic of flu vaccines for a minute, there's apparently a new study out there that suggests the vaccine may work better if you're in a good mood when you get it. Andrea, first of all, is that possible, and is that true?
Garcia: Well, there was an article that came out over the weekend in The Washington Post, which was based on the results of a British study that found that people who got the flu shot when they were in a positive mood produced higher levels of antibodies. The data on mood and vaccine is pretty limited, but there is some science behind the idea that lifestyle factors—so diet, exercise, even social interaction—may affect how much protection we get from vaccines and not just flu vaccines.
So, in general, if you are doing the things that we know keep you healthy, like getting enough sleep, regularly exercising and connecting with others, that might help strengthen your immune response. Even a short burst of exercise, like a brisk walk, after getting your vaccine could be helpful. Similarly, getting vaccinated on a particularly stressful day may lower your immune response.
Unger: So that might be a good excuse next time I want to avoid a stressful meeting—just tell people I've got a vaccine after this. Andrea, that's good to know. We also now have data indicating that it's safe for older people to get both the flu and the RSV vaccines at the same time, of course, saving them a trip. Tell us more about that.
Garcia: Yeah, so the CDC's recommendation has been that these vaccines can be coadministered. There is new data from a recent study that showed when given together, Pfizer's RSV vaccine and the seasonal flu vaccine generated robust immune response and were well-tolerated among older adults when they were coadministered. The study also showed that immune response to both vaccines were noninferior when they were given at the same time compared with the vaccines when they were given a month apart. So those findings were published in Clinical Infectious Diseases, and this data should really help build confidence in coadministration of the vaccines and will hopefully help increase uptake.
Unger: Absolutely. That does sound like good news. I want to step back a second, go back to something you talked about earlier, which is COVID being one of the very serious threats right now. I know you said earlier that cases are rising. Have things changed a lot since last week?
Garcia: The variant we discussed last week, BA.2.86, is continuing to make headlines, and that's because it increased almost triple-fold over a two-week period. It's responsible for about 1 in 10 COVID cases right now. HV.1 is still the most prevalent COVID variant in the U.S., and it's making up about 31.7% of cases. Right now, all indicators are pointing to rising COVID numbers. And, as we've discussed before, wastewater tracking is one of those early indicators that health officials increasingly rely on to gauge that activity of SARS-CoV-2 and other viruses.
And we did see CDC launch a new wastewater data tracking dashboard, and that's great because it's making it easier to track local and national trends, even by variant. If we look at the data on that dashboard, wastewater SARS-CoV-2 detection are at high levels nationally and especially in the Midwest. When we look at severity indicators, hospitalizations are continuing to rise and emergency department visits are up about 10.6% compared to the previous week, and deaths are holding steady, but we know that those numbers are still far too high.
Unger: All right, well, we'll keep our eye on that because it sounds like we may have a couple of difficult months ahead of us. But on a longer-term front, there is some better news. It's that life expectancy is beginning to creep back up. Tell us more about what that means.
Garcia: Well, we could talk about this for hours because there are so many different factors that go into calculating this. But according to the preliminary data that CDC released last week, life expectancy in the U.S. has begun to climb again. It increased by more than a year from 2021 to 2022. In 2021, life expectancy at birth was 76.4. And in 2022, it's 77.5 years. That year-plus increase is largely due to a drop in COVID deaths, declines in deaths from heart disease, unintentional injuries—so think drug overdoses—cancer and homicide also contributed.
To put this in context, it represents a partial recovery. From 2019 to 2021, we lost about 2.4 years in life expectancy. And although those numbers are trending in the right direction, we still have a lot of work to do to get to where we should be, especially when we compare ourselves to other wealthy nations. Deaths from other diseases, like flu, pneumonia, fetal and infant conditions, and kidney disease all rose in 2022.
But it's not just diseases. The rate of suicide involving firearms in the U.S. has reached the highest level since officials began tracking it more than 50 years ago. So when you begin to dig deeper into these numbers, you really get a sense of some of the challenges that we still need to address as we head into the new year.
Unger: All right, thank you so much, Andrea, for joining us today and giving us all those important updates. That's it for today's AMA Update. We'll be back soon with another episode. If you enjoyed this discussion, make sure to support AMA by becoming a member at ama-assn.org/join. We'll be back soon with another AMA Update. Be sure to subscribe for new episodes and find all our videos and podcasts at ama-assn.org/podcasts. 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.
Subscribe to AMA Update
Get videos with expert opinions from the AMA on the most important health care topics affecting physicians, residents, medical students and patients—delivered to your inbox.
