Watch the AMA's daily COVID-19 update, with insights from AMA leaders and experts about the pandemic.
Featured topic and speakers
In today’s COVID-19 Update, AMA's Chief Health and Science Officer, Mira Irons, MD, discusses the B.1.1.7 variant, a record day for vaccinations, the CDC's updated guidance around “hygiene theater,” and COVID-19 numbers and trending topics related to the pandemic over the past week.
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'll take 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, also in Chicago. Dr. Irons, let's break it down. What are we looking at in terms of cases and overall trends for COVID-19 this week?
Dr. Irons: Well, we're starting to see numbers go up. Some people are calling it an inflection point, and not quite sure why, but current numbers today are 31,198,546 cases and 562,067 deaths. Overall, as I said, we're seeing COVID cases and hospitalizations on the rise. At least 700 new COVID deaths and 64,285 new cases were reported in the United States on Saturday.
Over the past week, there's been an average of just shy of 68,000 cases per day, an increase of 11% from the average two weeks earlier, and a number that as we've said before, is still way too high. Hospitalizations are also starting to follow that trend, up 7.3% over the previous week. But thankfully deaths have continued to decrease. Case numbers nationally are largely stagnant, but there's a high variability from state to state. Infection levels remain low in most of the West and the South, but are increasing rapidly in parts of the Midwest and the East.
Unger: Let's talk about that because I think what we're seeing here in terms of trends it's pretty astounding, because we're seeing up to not quite a half of all these new cases coming from just a handful of states. What are you seeing there?
Dr. Irons: Yeah, absolutely. Johns Hopkins University reported last week, as you said, that just five states have accounted for about 43% of new cases over the last week. Those include New York, Michigan, Florida, Pennsylvania and New Jersey. Those states are home to 22% of the U.S. population. But in addition to that, nearly half of the states are seeing a rise in new cases. Michigan continues to be the hardest hit, the worst in America, with more than 7,000 new cases daily. But with residents weary of restrictions, Governor Gretchen Whitmer has avoided calling for another lockdown and is instead appealing to personal responsibility. The Michigan governor's position not to lockdown represents a larger shift we're starting to see in the politics of the pandemic, which is increasingly being shaped by growing public impatience and the hope that's offered by vaccines.
Unger: Boy, it's a tough situation and hope that we don't see those kinds of increases because obviously the virus doesn't respect state lines. What other kinds of drivers are we seeing right now?
Dr. Irons: Well once again, it's a race between the variants and the vaccinations. You know, a lot of this is really about the variants right now. The U.K. B.1.1.7 variant is now the dominant strain in the U.S. We know that this variant is driving many of the cases we're seeing in Michigan. As we've discussed previously, experts say the variant is more contagious, may cause more severe disease and is also potentially more deadly. We're also seeing that U.S. hospitals are admitting more young adults in their 30s and 40s with severe COVID symptoms. Again, this is thought to be a direct result of the variants, and also the fact that we have still not vaccinated enough of the population to begin to make a huge difference here.
Unger: Well, let's talk a little bit about the race. The vaccination acceleration has been dramatic. I remember when we were talking a couple months ago saying, "Hey, we need to get over a million vaccinations a day." That 3 million was going to be this number that was going to be kind of like a dramatic milestone. But lo and behold, new record, 4.6 million doses of COVID-19 vaccines in one day. That's huge.
Dr. Irons: It is huge. You know, the 4.6 million doses on Saturday is more than 500,000 higher than the old record last Saturday, so it really reflects the increasing pace. And I think if we just talk to people in the community, we're beginning to see that. The CDC also said on Saturday, about 117.1 million people have received at least one dose of the COVID vaccine. That's about half of U.S. adults. And about 70.7 million people have been fully vaccinated by either the Johnson & Johnson single-dose vaccine, or the two-dose series made by Pfizer-BioNTech and Moderna. So we're getting there.
You know, this all comes as last Tuesday President Biden moved up his deadline by two weeks to April 19th for states to make every American adult eligible for coronavirus vaccination. This announcement actually follows the lead of states around the country that were already meeting that timetable. And in other vaccine news, Pfizer and BioNTech has requested the FDA's approval to use their vaccine in 12- to 15-year-olds. We still don't know the date of when that's going to be reviewed, but we'll continue to watch that.
Unger: Gosh, I remember when it was just kind of 10 or 12 million people having gotten vaccines, so we are really seeing those numbers increase. Do you think the obstacle we just ran into, at least for J&J, was having some real problems on the production side, is going to hamper those efforts?
Dr. Irons: Well, I think it'll hamper efforts to actually scale up more. You know, J&J has hit some stumbling blocks in production because of the supplies of its one-dose vaccine will plunge next week. We're seeing reports of deliveries set to fall by 86%. And that's a single dose one-in-one vaccine, so that is certainly going to impact future numbers. The main reason, as the White House Pandemic Response Coordinator explained on Friday, is that federal regulators will need to approve production at a Baltimore manufacturing plant that's had some concerns. Federal officials also said that Moderna and Pfizer-BioNTech could make up some of the shortfall. They've also pointed out that some states are not currently using all the vaccine allocated to them. So we'll have to see what this does to the numbers, but certainly a bit of a setback.
Unger: Well, and a lot of countries around the world have kind of made bigger bets on the AstraZeneca vaccine, and continuing to be a complicated story there. Do you want to break that down as well?
Dr. Irons: Yeah, it certainly is. You know, there's been some new research that has identified unusual antibodies that appear to have caused, in very rare cases, serious and sometimes fatal blood clots in people who received the AstraZeneca vaccine. This research was published in the April 9th edition of The New England Journal. Two papers, one from Germany and one from Norway, found that people who develop the clots after vaccination had produced antibodies that activated their platelets, a blood component involved in clotting. The clinical syndrome looked a lot like immune thrombotic thrombocytopenia. That's what Germany called it. The report from Norway indicated the condition is similar to autoimmune heparin-induced thrombocytopenia.
There have been, thankfully, not many patients, so the data is still being collected. Not sure why this is happening. Younger people appear to be more susceptible than older ones, but researchers say no preexisting health conditions are known to predispose people. So what we've seen is that some countries are actually shifting the population age that can get this vaccine. But while the vaccine hasn't been authorized for use in the United States, this has been a crushing blow to global efforts to halt the pandemic, because the AstraZeneca shot, which is easy to store and relatively cheap, has been a mainstay of vaccination programs in more than a hundred countries.
Unger: Well, that is tough news. Another update that came out last week was from the CDC, and it was reminiscent. We passed by a grocery store yesterday with my family and were reminiscing about wiping down all those groceries that we got just only a year ago. But the CDC is coming back now and saying it's kind of the end of what they called "hygiene theater". What is that?
Dr. Irons: Late last week, the CDC updated its guidelines on the dangers of coronavirus infection from touching surfaces that might have droplets, a doorknob, a subway pole or another surface. What they noted was that the risk is extremely low. Driving this thinking was the belief that the vaccine was spread primarily through large respiratory droplets that could theoretically fall onto surfaces, and then you pick them up by touch and pass them onto mucous membranes in the nose or the eyes.
As we all remember, this led to this frenzy nicknamed hygiene theater, where we saw people stocking up on Clorox wipes and companies and schools closing regularly for deep cleanings. What we've learned over the past year is that the virus spreads almost entirely through the air. And experts now say that while it's theoretically possible to catch the virus from a surface, it requires something of a perfect storm, lots of recently deposited virus particles on a surface that are then quickly transferred to someone's hand and then to the face.
Unger: Well, I was a germophobe even before the pandemic began and tried to not to touch anything, but this does make me feel better, and I'm sorry to the people at Clorox for this news but good for the rest of us. But just make sure to keep washing those hands. In terms of those disinfectants, are we released from this or is there other guidelines in terms of keeping things clean?
Dr. Irons: Yeah. The updated guidelines say that chemical disinfectants are not needed to keep surface transmission low, just hand-washing, mask wearing and in most cases, cleaning surfaces with regular soap and water. So yes, physicians still need to tell their patients to wash their hands. No confusion about that. But it's the elaborate deep cleanings that have become commonplace that are not doing so much to eliminate spread. You know, these deep cleanings have led to closed playgrounds, taking nets off basketball courts, quarantining books in the library. And what we're learning is that we don't have to be taking those measures. It's worth noting this is what scientists have been saying for months, but common sense, soap and water, are important.
Unger: I was unaware of the taking off of the nets in basketball courts. That does seem a bit extreme. People need to just know that wearing masks, keeping your distance, washing your hands and get that vaccine when you can. That's the key here. Any other messages from AMA that you'd like to share this week?
Dr. Irons: Well, three messages. It's been a busy week. On April 7th as new COVID cases were peaking in the U.S. in late 2020, most physicians reported that health plans continue to impose bureaucratic prior authorization policies that delay access to necessary care and sometimes result in serious harm to patients. According to new survey results issued last Wednesday by the AMA, nearly one-third, 30% of physicians reported that prior authorization requirements have led to a serious adverse event for a patient in their care according to the survey. And the findings in the survey illustrate a critical need to streamline or eliminate low-value prior authorization requirements to minimize delays or disruptions in care delivery.
On April 8th, the AMA applauded the Biden administration's executive actions to curb gun violence. This includes requiring background checks for ghost guns. We urge a rapid rule-making process to stop the proliferation of these dangerous weapons. The AMA also supports red flag laws allowing family members, intimate partners, household members and law enforcement personnel, to petition a court for the removal of a firearm when there is high or imminent risk for violence. But these actions are just a first step.
Then finally, on April 8th the AMA applauded the CDC for recognizing racism as a public threat. A quote from that statement, "As the COVID-19 pandemic continues to disproportionately plague Black and brown communities, it's clear that collective action from all stakeholders is needed to dismantle systemic racism and confront, imbed, and advance equity across our health care system." The AMA applauds the CDC for formally recognizing racism as a public health threat and elevating and sharing the work of the AMA through its new racism and health initiative.
Unger: That is a very strong statement and consistent with policy coming out of the AMA, last year that recognized racism as a public health threat. So applauding the CDC for their stand as well. Well, thank you so much Dr. Irons for being here today. That's it for today's COVID-19 Update. We'll be back with another segment shortly. 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.
