Featured topic and speakers
In today’s COVID-19 Update, AMA's Chief Health and Science Officer Mira Irons, MD, to review COVID-19 vaccine numbers and trending topics related to the pandemic over the past week. Also covering global look at COVID-19 trends, recently released CDC guidance for schools and state-by-state hotspots—including Springfield, Missouri, outbreak.
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 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 also in Chicago. Today's update, a bit bittersweet. This will be the last COVID-19 Update with Dr. Irons, who will be moving on to become the president and CEO of the College of Physicians of Philadelphia. We're going to miss you, Dr. Irons. I feel like we have been through the fire together over the last 54 episodes of the COVID-19 Update. It's been a pleasure and an honor, and I wish you the best of luck in your new role. Well, for the last time, Dr. Irons, I'd like you to take us through the numbers. Globally, we passed a tragic milestone last week. Can you talk about what that was and what it means?
Dr. Irons: Yes. Yes, Todd. The world's known coronavirus death toll passed 4 million last Thursday, a loss roughly equivalent to the population of Los Angeles according to the Center for Systems Science and Engineering at Johns Hopkins University. It took nine months for the virus to climb 1 million lives and the pace has quickened since then. The second million were lost in three and a half months, the third in three months and the fourth in about two and a half months. Keep in mind, those are officially reported figures, which are widely believed to undercount pandemic related deaths, particularly in lower income countries.
Many blamed these numbers on both variants and inequities in the distribution of vaccines. We're seeing the virus run rampant and countries with lower vaccination rates, including parts of Asia, Africa and South America. While the U.S. and other countries are donating money and hundreds of millions of vaccines, recent estimates say it will take 11 billion doses for this to get under control at a global level. So we clearly still have a long way to go.
Unger: Indeed, we do. It's largely a different story here in the states. Can you tell us a little bit about what the new U.S. numbers look like this week?
Dr. Irons: It is, Todd. But it's continuing to change. Every day is a new story with us. So current numbers as of today, 33,890,840 known cases of COVID-19 and 607,445 deaths. While it's a much better story here than it is in other parts of the world, we are by no means done with this virus. As a recent New York Times article put it, "We're down but not out." Cases on hospitalizations are on the rise and especially in areas with low vaccination coverage. If you look at the CDC's seven day averages as of July 9, new cases are up 16%, 14,885 new cases per day, and hospitalizations are up 8.6%. Data from recent week show that adults ages 18 to 49 now account for more than 40% of COVID-19 associated hospitalizations. Deaths in the U.S. are as low as they have been since the early days of the pandemic, thankfully down 25.2% in the last seven-day average.
But the Delta variant has seeded local outbreaks. As we discussed last week, Arkansas, Missouri and Louisiana are still hotspots. All have seen a sharp rise in cases. Arkansas which was averaging fewer than 140 cases a day in early June is now adding more than 600 cases most days, about 35% of Arkansas residents are fully vaccinated compared with 48% of people nationwide. Compare that to most places on the West Coast and East of the Mississippi River, which are relatively stable right now. Cook County, Illinois, home to Chicago is identifying fewer than a hundred cases each day. Vermont, which is leading the country with two-thirds of its residents fully vaccinated is identifying fewer than 10 new cases a day.
Unger: That's an interesting use of the term, down but not out, which normally has kind of a more positive connotation. I did see this morning an interesting tweet from Dr. Peter Hotez. He called it kind of the "Scarlet letter L" forming across the United States with "Scarlet" being where areas of kind of higher proportion of COVID cases and Missouri is kind of where that all began. Seems like that state and surrounding states are particularly struggling. Can you give us a little bit more detail about the situation there?
Dr. Irons: Yeah, absolutely. We actually saw a hospital in Springfield, Missouri, run out of ventilators this past week, something we haven't seen with hospitals since much earlier in the pandemic. Staff there said it was unlike anything they've seen during the past 16 months. Friday, that same hospital also reported that 95% of those who were hospitalized were not vaccinated. Missouri has been averaging about a 1,000 new cases per day, a 44% increase over the past two weeks. But worrisome, that is a fraction of the state's November peak when its average topped 5,000—still is headed in the wrong direction. Hospitalizations are up 25% in the state from two weeks ago.
Unger: Now I'm assuming, but could you tell me, is this the Delta variant that's driving that kind of increase?
Dr. Irons: Yeah, I think there's really no question that the Delta variant has driven this outbreak. The CDC estimates the variant was behind nearly three-fourths of the new cases in Missouri. Missouri has a vaccination rate of 40%, well below the national rate of 48%. Many counties there have vaccination rates in the teens and twenties, and like the rest of the country, the number of Missourians seeking the vaccine has also dwindled. Nearly 50,000 were getting vaccinated each day in mid-April. On Thursday, it was just 7,000. A federal surge response team that we talked about last week has been dispatched to the state to try to help with this.
Unger: Speaking of vaccinations. How is that going? What's the pace look like? Where are we?
Dr. Irons: It's still slow. The CDC reports about 184.4 million people have received at least one dose of the COVID-19 vaccine. That's about 55.5% of the population—including about 159.5 million people, 48% of the population who have been fully vaccinated. The percentage of adults, people over the age of 18 who have received at least one shot is at 67.7%, creeping closer to that 70% mark but still not there. As we mentioned, the pace of vaccination continues to slow across the country. As of Friday, providers were administering about 590,000 doses per day on average, a decrease of about 82% from the peak of 3.38 million reported on April 13.
Unger: Well, in other vaccine related news, we heard from Pfizer last week that they were working on a booster shot. Can you give us more details about what's happening there?
Dr. Irons: Yeah. Yes. On Thursday, Pfizer announced that it was developing a version of the coronavirus vaccine that targets the Delta variant. It expects to begin clinical trials of the vaccine in August. The company also reported promising results from studies that people who received a third dose of the original vaccine. It said that a booster given six months after the second dose of the vaccine increases the potency of antibodies against the original virus and the Beta variant by five to tenfold. However, it's important to remember that the question as to whether we will even need boosters is still up for debate. On Thursday, the FDA and CDC said in a joint statement that generally Americans who have been fully vaccinated do not need a booster shot at this time.
Unger: Well, more to come on that. The CDC also released new guidance for schools on Friday. Can you tell us what they're saying?
Dr. Irons: Certainly did and we're hearing a lot of talk about this. The CDC urged schools on Friday to fully reopen in the fall, even if they cannot take all the steps the agency recommends to curb the spread of the coronavirus. This is a departure from the CDC's past recommendations for schools. The agency also said school districts should use local health data to guide decisions about when to tighten or relax prevention measures like masking and physical distancing. You might remember, this is something we talked about from the beginning of the pandemic. Many see this as an acknowledgement that students have suffered during long months of virtual learning and that a uniform approach is not useful when virus case loads and vaccination rates vary so greatly from place to place. Virtually, all of the nation's major school districts plan to return to regular in-person instruction in the fall. But the challenge will be convincing hesitant parents.
Unger: You mentioned that this is a departure from the guidance from before. How's it different?
Dr. Irons: So one major shift is the recommendation for physical distancing. It continues to advise that students be spaced at least three feet apart but with a new caveat. If maintaining such spacing would prevent schools from bringing all students back, they could rely on a combination of other strategies like indoor masking, testing and enhanced ventilation. In another shift, the CDC made clear that masks could be optional for vaccinated people in line with its recommendations for the general public. With Delta spreading and children under 12 still ineligible for vaccination, it did recommend that unvaccinated students and staff members keep wearing masks. It also said that schools may opt to require universal masking if local cases were rising. It's also strongly urging schools to promote vaccination which is, of course, vital in our efforts to keep the numbers down.
Unger: Absolutely. Finally, any additional messages that the AMA wants us to hear this week?
Dr. Irons: On July 7, the AMA and the Satcher Health Leadership Institute at the Morehouse School of Medicine announced the selection of 12 physicians as the inaugural fellows for the Medical Justice in Advocacy Fellowship, a new collaborative initiative empowering physician-led advocacy to advance health equity, removing barriers to optimal health for all. The fellowship will cultivate physicians as the next generation of advocacy leaders as they work collaboratively to generate and exchange solutions for implementing healthy equity projects focused on ensuring better health outcomes and closing health gaps for patients and their communities.
Unger: Well, congratulations to the recipient of those fellowships. Very excited for them. Dr. Irons, thanks again for being here today and with us over the course of the last year—keeping the focus on science and helping us put together the kind of resources that physicians and patients need as we dealt with an incredible pandemic. That's it for today's COVID-19 Update. For more resources on COVID-19, visit 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.
