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
What COVID variant are we on? How dangerous is the new COVID variant? Where does listeria come from? What deli meats have listeria? Is measles still around?
Our guest is AMA Vice President of Science, Medicine and Public Health Andrea Garcia, JD, MPH. AMA Chief Experience Officer Todd Unger hosts.
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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: Thanks, Todd. I appreciate the opportunity to be here.
Unger: Well, we've got a lot on the agenda for today's discussion. The COVID wave, an ongoing listeria outbreak and another measles outbreak here in the U.S. Andrea, let's start with COVID since that's still making headlines and we are firmly in the back-to-school season.
The AMA's vaccine expert, Dr. Sandra Fryhofer, recently filled us in on the updated COVID vaccines and when to get them. But how are we looking with cases?
Garcia: Well, Todd, we've talked before about the fact that we typically see delays in data reporting after long holiday weekend, so we're still really waiting for the data to catch up. We do know from past experience that a busy Labor Day holiday weekend can accelerate transmission following those increases in travel and then more gatherings with friends and family.
We know that the Transportation Security Administration was projecting that this past holiday weekend would end up being the busiest Labor Day travel period on record. And according to that, while many people typically gather outside for Labor Day in some areas, we know that extreme heat drove people indoors, which could also contribute to those increases in holiday spread.
Unger: How were we looking before we headed into the holiday weekend?
Garcia: Yeah, so according to the CDC, prior to the weekend, COVID activity continued to rise in many areas, but it was also showing some early signs of decline. In others, wastewater detections. Nationally, we're still at a very high level.
And then if you look at the CDC data by geographic area, levels were decreasing in the West, but they were increasing in the South and the Midwest and in the Northeast. We do continue to see that KP.3.1.1 variant climb. It's now making up just over 42% of cases in the U.S.
According to the CDC's latest weekly respiratory illness summary, we do know that hospitalizations from COVID remain elevated. That's especially true for seniors and children who are younger than two years old. Deaths from COVID are also low compared to where they were in previous years, but they did increase in late August.
I think the other thing to keep an eye on, and we know doctors and scientists are keeping an eye on this as well, is yet another subvariant, and that is XEC that could surpass KP.3.1.1 in the coming weeks. It was first detected in Germany, and while it's been detected here in the U.S., the prevalence is low and there's not a lot of data on this new subvariant at this point in time.
Unger: All right. Well, we'll keep our eye on that. Especially important since, of course, we're headed back into school, any considerations there?
Garcia: Yeah, I think that could mean that we're going to continue to see elevated rates into the fall. There was a recent article on today.com that really tried to help put this in perspective, looking at comparisons in back to school over previous years, and we saw in 2021 and 2020, for example, COVID levels were actually low as kids headed back to school, but that was likely because we had more widespread mitigation measures in place in 2022.
We know the summer wave was earlier, so the peak had passed by the start of August. At that time, wastewater levels were around 7.92, and that's compared to 3.23 the same time of year in 2023. If we look at 2024, levels were at 8.31, the week ending August 3, and 8.82, the week ending August 10. So that makes this the highest levels of COVID we've seen heading into the back-to-school season. As we've mentioned, there have been some signs of decline, but it's really too early to tell at this point if the peak has truly passed.
Unger: Interesting, and we'll of course, keep our eye on that as well. But adding to that, we've heard that some pediatricians are planning to scale back on COVID vaccines this fall due to lack of demand. Andrea, tell us more about that.
Garcia: Well, Todd, I think this is challenging, particularly for smaller physician practices. They have to purchase vaccines up front, and then they get reimbursed for them for those doses when they immunize patients. If there's low demand and an inability to return the vaccines that were ordered and not used, then we see these practices absorbing the cost, and we know that many small practices can't afford to do that.
There was a recent article from KFF Health News. It said that the lack of demand is driving some pediatricians, who are now preordering the updated COVID vaccine for fall and winter, to cut back from previous years.
And we know CDC recommends that anyone six months or older get the updated COVID vaccination during the 2023-24 vaccination season. We saw only about 15% of eligible children in the U.S. receive the vaccine. I think if we start to see physicians across the country make similar calculations, it could make finding doses of the vaccine, especially for young children, more difficult.
Unger: And Andrea, I know the AMA's message continues to be this—get vaccinated. It's so important. As you said, the virus continues to evolve and vulnerable people are still at risk.
Let's move on from COVID and switch topics to something completely different, and that is risks we face from things like deli meat. We've seen this in the headlines in the last couple of weeks, but recently, it's made national news. Andrea, tell us more about what's going on.
Garcia: Well, Todd, those concerns about bacteria in deli meat are unfortunately aren't anything new. However, last week we saw the CDC remind the public to avoid eating recalled deli meats amid a listeria outbreak that has expanded to become the nation's largest since the one linked to cantaloupe back in 2011.
This outbreak began back in July. It's been reported on by multiple sources, including CNN and The New York Times over the past week. That CNN headline urged everyone to check their fridge.
Taking a look back at where this began, Boar's Head issued a recall in late July for more than 7.2 pounds million of its ready-to-eat liverwurst and other deli meat products, and that was due to concern about potential listeria contamination.
Since then, we've seen CDC report a total of 57 people who've been hospitalized across 18 states. We know that nine people have died in connection with this outbreak, as the CDC pointed out that true number of illness is probably much higher because some people have a milder case and they aren't necessarily tested for listeria. There's also a lag time between when an illness happened and when scientists can connect it with an ongoing investigation.
Unger: So, Andrea, what does it exactly mean to go check your fridge? I know I'm not really sure necessarily what brand of deli meats in there, but what do you—what do you do?
Garcia: Yeah, so CDC is specifically advising consumers to look for EST. 12612 or P-12612 inside the USDA mark of inspection on labels. Some of these products could have a shelf life and sell-by dates into October of 2024. Those recalled products are liverwurst, ham, baloney, sausage and roasted bacon.
Boar's Head has said that any new products now available at deli counters are not subject to the recall. However, listeria bacteria is hardy. It can stay on surfaces like countertops and meat slicers, so you don't even have to eat a contaminated product to get sick. It can spread easily at delis transferring from equipment to surfaces to hands and food.
And while refrigeration does not kill the bacteria, we know that heat can. So pregnant people, those who are 65 and older, those with weakened immune systems are advised to avoid eating any deli meat unless it's been heated until it steams or it reaches that internal temperature of 165 degrees Fahrenheit.
If you have had deli meat at home, clean the refrigerator and any contaminated surfaces that may have come in contact with it, and watch out for those symptoms of listeriosis, which include fever, muscle aches and fatigue. It can take up to 10 weeks for those symptoms to develop. Doctors should also be on the lookout for these symptoms in patients and report any suspected cases to their local health officials.
Unger: Wow, that's quite a wind-up time. Hard to remember what one ate 10 weeks ago, even, so I can see why that's so hard to track down. Any insight into why this has become such a widespread problem?
Garcia: Well, that outbreak has been linked to a Boar's Head facility in Virginia that reportedly had repeated violations of federal food safety regulations. There are documents from the USDA showing 84 noncompliaces in that facility from January of 2022 to August of 2024. 69 of those were reported since August of 2023.
Insects and mold were reportedly identified at that facility that's been linked to the recall. We know that Boar's Head has said that it's paused production at this facility, and it will remain closed until it can produce safe product.
Unger: Absolutely. Well, all of that is great information, and we'll continue to track that story as it develops. Let's move on to our third and final topic for today's AMA Update, and that is the resurgence of measles that we're seeing in certain parts of the U.S. Andrea, what do we need to know there?
Garcia: While those headlines have really largely been focused on Oregon, which is now experiencing the largest measles outbreak that that state has seen in over three decades, Minnesota is also seeing an increase in cases.
That outbreak is mostly affecting children in the Somali community. This really mirrors a larger trend of rising measles cases across the U.S. this year. According to the CDC, nearly one third of the measles cases since the COVID pandemic have occurred in the past three months. And we know that as of Tuesday, the CDC is reporting that we've seen 236 cases of measles in the U.S. so far this year. That compares to 58 cases in all of 2023.
Health experts do continue to attribute the reappearance of this disease to the falling rate of children getting their MMR vaccinations and have noted that the outbreaks are mostly confined to pockets of the population where young people have not been vaccinated. We do know that two doses of the MMR vaccine are 97% effective at preventing measles.
Unger: Well, Andrea, let's take a closer look at what's happening in Oregon at the moment. Just how bad are those numbers?
Garcia: Well, according to the Oregon Health Authority, all of those infected during the current outbreak were unvaccinated. In terms of how it compares to other outbreaks this year, Illinois and Minnesota are the only states to have reported more measles cases than Oregon so far this year.
Illinois had 67, Minnesota had 41. That compares to the 31 in Oregon. According to the CDC, Oregon has one of the highest vaccine exemption rates for kindergartners in the country. I think that really brings us back full circle to the back-to-school season, and how important it is for children to get all of their recommended vaccines this year.
Unger: We'll take that full circle moment to wrap up this week's conversation. Andrea as always, thanks so much for being here and sharing this information. If you found this discussion valuable, you can support more programming like it by becoming an AMA member at ama-assn.org/join. You can find all our videos and podcasts as always at ama-assn.org/podcasts. Thanks for joining us today. 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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