Featured topic and speakers
In today’s COVID-19 Update, AMA's Chief Health and Science Officer Mira Irons, MD, reviews COVID-19 vaccine numbers and trending topics related to the pandemic over the past week. Dr. Irons also discusses travel news post-Memorial Day weekend, as well as recent CDC announcements pertaining to mask guidance for summer camp and investigating "breakthrough infections."
Learn more at the AMA COVID-19 resource center.
Speaker
- Mira Irons, MD, chief health and science officer, AMA
Transcript
Unger: Hello, this is the American Medical Association's COVID-19 Update. Today, we 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 in Chicago. Dr. Irons, very different Memorial Day weekend, including moving my daughter out of the house after a year of being here with us during the pandemic. Can you talk about how this is looking from a public health perspective?
Dr. Irons: Sure. The biggest difference is probably the pervasive sense of optimism right now. Looking back a year ago, it was canceled parades and all crowded gatherings were banned. We were then on a cusp of recording 100,000 deaths from the coronavirus. This year, parades and barbecues took place across the country and vaccinated people were being urged to get outside and enjoy the holiday. But hundreds of people are still dying each day, pushing the death count in the United States past 594,000, an enormous toll that few envisioned a year ago. But the vaccinations over the past six months and proved to be a game changer. To sum it up, a year ago, we were at the end of the beginning of the pandemic in the U.S. and now we're at the beginning of the end.
Unger: Well, it does feel different, especially in regard to travel where we're seeing peak numbers back at the airports. Are we concerned about this?
Dr. Irons: Well, there are concerns. They are big crowds. Travel is back, both in the air and on the road. Air travel has been climbing for much of this year and hit a pandemic peak on Friday when more than 1.95 million passengers passed through TSA security checkpoints. That level was last reached in early March 2020 as the virus was just beginning to spread. The concern is that with increased travel, we're also seeing more passengers resisting mask mandates. As a reminder, masks are still required on all modes of public transportation. TSA's mandate says that passengers remained fully masked throughout their flights and the CDC's guidance still says even fully vaccinated people need to mask up on airplanes and on mass transit. But in reaction to this, we've seen a surge in disruptive and sometimes violent behavior on recent flights.
Unger: That's sad, and I've read a lot about that. More mask guidance from the CDC, this time in relation to summer camps. Can you talk more about that?
Dr. Irons: Yeah. And this guidance, as with everything in this pandemic, is nuanced. So the CDC relaxed its guidance Friday for summer camps saying that vaccinated adolescents do not need to wear masks at camp and that even younger campers who have not been inoculated can generally not wear masks when outdoors. So this new guidance removed some inconsistencies between the earlier camp recommendations that all staffers and campers wear masks and the evidence that masks are rarely needed outdoors. The updated guidance comes as older teens and camp staff also are eligible for vaccination, and more recently campers ages 12 to 15. However, many camps also serve younger children who cannot yet be vaccinated, and for those, it becomes more complicated. Unvaccinated people are strongly encouraged to wear masks indoors and outdoors in crowds or when close to others for prolonged periods. And since it may not be possible for camps to know who is vaccinated and who is not, the CDC does note that camps may still choose to follow the previous guidance, which was masks for all.
Unger: And speaking of vaccinations and younger people, can we talk a little bit about how those numbers are looking?
Dr. Irons: Well, they're still climbing, but the climb is slowing down. Half of people in the U.S. have started the vaccination process and 40% are fully vaccinated, but the number of doses administered each day has fallen about half from its April peak. So looking at the specific numbers, more than 167 million Americans have received at least one dose. That's 50.5%. And over 135 million are fully vaccinated, just shy of 41%. If you just look at people over the age of 18, over 50% are fully vaccinated. So more than 62% of people six to 18 and older have received at least one dose, and that's the number President Biden is looking at to reach 70% by July 4.
Unger: Do you think we're going to hit that number?
Dr. Irons: I think so. I'm hopeful, and I think the biggest gains recently are in kids between 12 and 15 years of age, but we'll see. Maybe we'll pull some parents in as their kids are being vaccinated.
Unger: We also saw the potential for another vaccine authorization for this age group. Can you talk about it?
Dr. Irons: So Moderna, the other manufacturer of the other mRNA vaccine said last Tuesday that its coronavirus vaccine authorized only for use in adults was powerfully effective in the 12 to 17-year-olds and that it planned to apply to the FDA in June for authorization to use the vaccine in adolescents. Even though 12 to 15-year-olds are just 5% of the population, numbering nearly 17 million, experts say that reaching them can have significant benefits for the rest of the country.
Unger: Well, you mentioned up front we are still seeing cases and deaths and particularly a divergence between, of course, those are vaccinated and who are unvaccinated. Can you first start at the top level in terms of the numbers?
Dr. Irons: Sure. So in terms of confirmed cases, 33,264,595 individuals, and tragically 594,568 people have died from COVID-related illness. The case numbers, however, are continuing to plummet. About 23,000 new infections are being identified each day, the fewest in nearly a year. Several states in the Midwest and Northeast have seen reports of new cases decline by more than 50% over the last two weeks. No state is seeing a major increase in cases and the daily death rate is at its lowest level since last summer.
Unger: So that divergence though, between the unvaccinated and the vaccinated, it tells a different story when you start to dig into those numbers, doesn't it?
Dr. Irons: Oh, it certainly does. That's a great point. This encouraging picture that we're talking about is being driven by vaccinated people. There's still a danger for the unvaccinated, and that's where the nuance kicks in. As more people receive vaccines, cases are occurring mostly in the increasingly narrow slice of the unprotected population. The Washington Post recently adjusted its case, death and hospitalization rates to account for that and found that in some places the virus continues to rage among those who haven't received a shot. Adjustments for vaccination show the rate among susceptible unvaccinated people is 73% higher than the standard figures being publicized, and with that adjustment, the national death rate is roughly the same as it was two months ago and is barely inching down. Unvaccinated people are getting the wrong message. They think it's safe to take off their masks and it's not.
Unger: I looked at that Washington Post data as well and it's pretty clear that you need to get vaccinated right now. Those levels are still at the high levels they were months ago for unvaccinated people. Speaking of vaccinated people and the issue of breakthrough infections, where someone who has the vaccine still contracts COVID-19, can you talk about CDC's announcement that it's not going to keep investigating these breakthrough infections? What does this mean and why?
Dr. Irons: So the CDC has stopped investigating breakthrough coronavirus infections in vaccinated people unless the cases cause serious disease that leads to a hospitalization and death. It's still going to continue to gather the data about mild breakthrough cases that are reported to the agency voluntarily by local health departments, but will only investigate the most serious cases of breakthrough infections. We knew that the vaccines were, if you look at the mRNA vaccines, 94% effective against symptomatic disease, so we knew we were going to get some breakthrough infections. But it's the hospitalizations, those that are severe or leading to death, that are the concern. And the agency until May was monitoring all cases. A report issued last Tuesday said that at the end of April, when some 101 million Americans had been vaccinated, the agency had received 10,261 reports of breakthrough infections from 46 states and territory territories.
But of those, 995 people were known to have been hospitalized and 160 had died, though not all as a direct result of COVID-19, the new study said. So I think this is a way to prioritize and understand the cases that are associated with severe disease, which is what we care about the most.
Unger: So things are working in the way they should and when they don't looking at those more extreme cases to understand better, is that basically the path here?
Dr. Irons: Yes, absolutely.
Unger: Well, just finally in closing, any new messages from the AMA this week that you want to share?
Dr. Irons: Sure. Last Wednesday, the AMA issued a statement on ongoing global COVID-19 challenges. The statement read, "While our country continues to make progress in vaccinating people and the resulting decline in COVID infections, we remain amidst a global pandemic with rising COVID-19 illness and deaths in India, Brazil, Argentina and many other countries. We'll continue to urge global cooperation in the fight against this virus providing vaccines and medical supplies that will help diminish the humanitarian crisis that we are seeing throughout the world. Importantly, many physicians from India and other countries practice medicine throughout the United States and have worked hard throughout the pandemic to protect us here while watching their loved ones abroad suffer illness and death in their countries of origin. We continue to urge support and will facilitate coordination amongst the U.S. government, the United Nations, World Health Organization, World Medical Association and other partners in responding to the global pandemic, which will continue to be of international concern for the foreseeable future."
Unger: Dr. Irons, thanks so much for those thoughts and for the rest of your perspective. That's it for today's COVID-19 Update. We'll be back soon with another segment. In the meantime, for additional information on COVID-19, visit ama-assn.org/COVID-19. Thanks for joining us today. 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.
