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 Chief Experience Officer Todd Unger and AMA Chief Health and Science Officer Mira Irons, MD, review COVID-19 numbers and trending topics, as well as vaccine news and holiday precautions.
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're taking 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, we received some more big news about vaccines this week. Can you tell us about the announcement from Moderna?
Dr. Irons: Absolutely, and it was promising news. So, you might remember that last week we talked about Pfizer, and they provided some results from their interim analysis that was very promising, showed that the vaccine looked to be effective in more than 90% of the individuals in the trial. Well, Moderna this week announced their interim results, and looking at their results, it looks as though the vaccine is greater than 94% effective. So, it really comes in at the same rate as were Pfizer was, the journal also provided some safety information, that there were no serious significant safety concerns associated with it. So, they're both really promising. I think that we have to wait, we have to see all the data. This was data that was released by both of the companies themselves, and the complete data of the complete trials will be submitted to the FDA. Those will be made public, and will be debated by the external advisory committee, but really promising to begin with.
Unger: Those are really in the kind of best-case scenario range options. Is that correct?
Dr. Irons: Yes. Yeah. It tells us all it did was that when they provided the data, the chance of meeting their primary endpoint was whether you either were diagnosed with COVID or not. Didn't tell us anything about severity of illness in the patients, but that'll be forthcoming when all of the data is released.
Unger: I think people are still processing what the vaccine availability means. Can you talk a little bit about what the reality of the situation is for people for the coming months?
Dr. Irons: Yeah, so the reality is that it's going to take time. Vaccines are only effective if people get vaccinated, and it's going to take a long time to deploy this vaccine across the population. And enough people are going to have to line up and get vaccinated in order for the vaccine really to do what we want it to do, to achieve herd immunity. And it's going to take a while to do that. I think that the ASA panel at the CDC will determine prioritization based on which vaccines, the performance of the vaccines that got authorized. Right now, it looks as though the early phases will be health care workers and people at high risk. People in those categories, with decreased deployment over time to people who are at lower risk. But people are estimating that it's probably going to be into the spring before we can really get the vaccine to everybody that wants it. And that means that we're still going to have to be vigilant, still going to have to wear masks, still going to have to socially distance, and still going to have to do the hand-washing. Can't let our guards down.
Unger: So, it's possible it could be some light at the end of the tunnel, but for now, doubling down on the things that we know work is critical. And that's especially important given the numbers that we're seeing across the country in terms of cases and deaths. Will you speak to this week's numbers?
Dr. Irons: Sure. So, the numbers keep going up. Today's number 11,207,088 individuals have been diagnosed with COVID. We think that probably is an underestimate. And 247,229 people have died. If you'd like to look at averages, the seven-day average over the past week has been over 155,000 cases per day, an increase of 82% from an average two weeks ago. The number of new cases has risen every day for more than a month in the United States, and it's now killing more than a thousand Americans per day. If you look at the rate of rise, we're in this third surge and it's an exponential rise. The last million cases occurred just in the last six days.
There were some really disturbing also results data that was issued yesterday, I believe, by the American Academy of Pediatrics and the Children's Hospital Association. More than one million U.S. children have been diagnosed with COVID-19. We don't think about that because the symptoms thankfully seem to be less in children, but in terms of that exponential rise in just a one-week period ending November 12th, almost 112,000 new cases in children have been diagnosed, which is a significant increase. So, we're on the rising part of the curve.
Unger: So, I can remember earlier in the pandemic when Dr. Fauci made a prediction that we were moving toward a hundred thousand new cases a day, and now we are so far in excess of that, that it is pretty frightening. When you're looking at a kind of a state by state or regional situation, are there any things that stick out?
Dr. Irons: Well, I think that certainly there are, I mean the entire country's red. Last week, I think when we spoke, Vermont and Maine were still in the not trending poorly or uncontrolled, but now it's the entire country. But things are looking particularly worrisome in the Midwest, from Nebraska, north to Canada and the east to Chicago. Cities like Chicago, Milwaukee, Omaha, Des Moines, Minneapolis, hospital beds are filling up. Some states are re-instituting, lockdowns, restricting gatherings and closing schools. Here in Chicago as of yesterday, we've been on a stay at home advisory. That's pretty much asking people to stay at home, except for non-essential reasons. Michigan has suspended all in-person learning for college and high school, and indoor dining for the next three weeks.
Even new cases in New Jersey. After that first surge in the New York, Connecticut, New Jersey area, they were really keeping their numbers down. They had sobering numbers over the weekend, nearly 9,000 reported infections over two days. And in response, the governor there announced new limits on gatherings effective on Tuesday. So, we're starting to see governors in different states start instituting mat mask mandates, limit gatherings, restrict or close all indoor dining to try to get this under control.
Unger: That's particularly significant, since some of those dates were real holdouts and opposed mass mandates for a long time, and are now seeing the effects of that. So, a very tough situation. We're also facing another potential driver coming up here with Thanksgiving next week, and complicated by return of college students home and back to school, perhaps in some cases. Can you talk about that?
Dr. Irons: Yeah, absolutely. So, Thanksgiving and the upcoming holidays continue to be a cause for concern. Large numbers of people, families gathering indoors with poor ventilation are really a set up for spreading the virus. For students that are coming home or individuals that are quarantining before they come to visit family, a two-week quarantine started two weeks ago. So, people should have started to quarantine. A lot of colleges are either suggesting that people stay, or not return after they go home. So, there are certainly concerns. And I think a lot of organizations and the CDC, everyone's suggesting that people really limit their Thanksgiving gatherings to just their own households. And if that can't be the case, then people should be wearing masks indoors, make sure you ventilate appropriately. But if there's ever a year to really just spend Thanksgiving with the people that you live with, this is probably it.
Unger: The CDC does have some guidance on their website about assessing risk for small holiday gatherings. And on the subject of the CDC, I think we've seen the CDC become increasingly assertive, especially in light of a lot of misinformation and their surge in cases. Can you talk about that shift, and some of the key messages that the CDC wants us to hear?
Dr. Irons: Yeah, the CDC has started to issue scientifically based guidance, things that we always look to the CDC to do, and they, for whatever reason, weren't able to do that as easily earlier on the pandemic. But they seem to be back on it. Last week they issued guidance on the benefits of masks, that masks actually protect the wearer in addition to protecting people from transmission, that at least two layers or more of cloth for a mask are more effective. They've also issued guidance on strict requirements for cruise lines, updated science on the infection in children, and the risks for airborne viruses indoors, how to try to mitigate that increased risk. They're doing them without a lot of publicity. They're just posting them online, not holding press conferences. Prior to this pandemic, whenever the CDC, a lot of times when the CDC would issue really important guidance, they'd have a press briefing, they'd have a press conference so that people understood it. Now the guidance is just being posted, and we're doing our best to try to amplify it.
Unger: Well lastly, there are lots of messages coming out of the AMA over the past week. We've had our Special Meeting of the House of Delegates and a lot of announcements. Can you talk about some of the key things we're hearing from the AMA this week?
Dr. Irons: Yeah, so pretty much three key announcements. Tuesday, November 17th, in a joint letter to the Trump administration, the AMA, the AHA and the ANA urged full cooperation and sharing of all critical COVID-19 information with the Biden transition team. In the letter, we specifically stated all information about the capacity of the Strategic National Stockpile, the assets from Operation Warp Speed and plans for dissemination of therapeutics and vaccines, needs to be shared as quickly as possible to ensure that there's continuity in strategic planning, so that there's no lapse in our ability to take care of patients. That was issued on November 17th, today.
Last Wednesday, November 11th, the AMA released a public service announcement urging the three key actions as COVID continues to spike across the country. The same things we've been talking about all the time, wearing masks, socially distance, hand hygiene. And on Tuesday, November 10th, the AMA published an update to the CPT code set that includes vaccine specific codes for coronavirus immunizations. All of this is necessary to be done ahead of time to prepare for those vaccines, and this has been work that the CPT editorial panel and the AMA has done very closely with the CDC to prepare the country for vaccinations.
Unger: Well, thank you so much for all of these updates and your perspectives, Dr. Irons. That's it for today's COVID-19 update. We'll see you tomorrow with another segment. For resources on COVID-19, visit ama-assn.org/covid-19. Thanks for joining us, and 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.
