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, Todd Unger, AMA chief experience officer and Mira Irons, MD, AMA chief health and science officer, discuss this week’s numbers and trends for the COVID-19 pandemic, showing that the surge continues in many states.
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 in Chicago. Dr. Irons, let's start by reviewing this week's numbers, still very bad news.
Dr. Irons: Absolutely. Todd, the surge continues, which is the sad news. Today's numbers from this morning is that 3,831,430 people in the United States have been diagnosed with COVID-19 and we've had 140,909 deaths. That's an increase of 58,000 from yesterday. I think we hit a record last Friday of 75,000 cases. If we think back just a few weeks ago, we were looking at 20,000 new cases a day in the United States and over the last few weeks, it's consistently been 50,000, 60,000, 70,000 cases. If you look at the uptick in cases, the burden continues to be in the south. Florida, Georgia, Arizona, Texas, also into California. Although we're starting to see upticks in states where we haven't seen big surges and we're starting to see states dial back as the upticks are starting.
Unger: One of the questions a few weeks ago was why the mortality rates seem to be kind of trailing the actual number of new cases. Are you seeing now an uptick in hospitalizations and in that mortality rate?
Dr. Irons: Yeah, absolutely. I think that we've known that the hospitalizations and the mortality seems to follow a new diagnosis by at least several weeks so that this isn't surprising that we're now seeing the trend up in hospitalizations. We are hearing that hospitals and ICUs are exceeding or reaching capacity in Florida, Texas. Texas Medical Center reported that they were beyond ICU capacity. Volunteer physicians, military physicians are being deployed to some of the southern states. So we are starting to see that increase in hospitalizations that we were frankly, expecting.
I think that fortunately we are not seeing the percentage of ICU admissions per hospitalization that we saw back in the spring. There may be several reasons for that. One might be that people are getting to the hospital earlier. We are protecting our vulnerable populations, but also there are some treatments available now that weren't available back then, Dexamethasone, Remdesivir. And so that seems to be maybe some encouraging news, as opposed to what we were experiencing back in the spring.
Unger: We are seeing an uptick in the death toll. We're seeing a rise of about 60% in the past week in Arizona, Texas also breaking records there, but still sits well below some of the numbers we were seeing earlier in the pandemic. Can you give us some perspective on that?
Dr. Irons: Yeah, I think that there are probably several different reasons for that. The first is that the average age of people being diagnosed now, as opposed to in the spring, is about a decade and a half younger. We do know that younger people seem to have less severe manifestations. People may be getting to the hospital earlier, at an earlier stage. I think the health care system is also more prepared to take care of patients with severe COVID. We've had a lot of experience in that area. We do have some treatments, Remdesivir is available, Dexamethasone is available, and we are protecting our vulnerable populations. If you think back to the spring, a lot of the people that were severely affected and dying were those in nursing homes. And so we have learned a lot since that time so there are probably a variety of reasons that explain that.
Unger: Well, Dr. Irons, one big news item this week was the government's order for hospitals to bypass the CDC and instead send all their COVID-19 patient information to a central database in Washington and it's under HHS. Can you talk about what this means in terms of transparency and data collection?
Dr. Irons: Yeah. So Todd, since April, hospitals have had dual reporting requirements. They were reporting both to the CDC and also to HHS. So it was extremely burdensome for hospitals to be reporting to two different groups that were changing requirements all the time. The CDC database is more robust, but it's also less nimble. They can't just add new reporting requirements within 24 hours. So the decision last week was made to only require that hospitals report to HHS. The reasoning behind that was that rapid information was necessary for allocation to inform federal efforts. The AMA has been reassured that the CDC would have access to that data. So we're hoping that we see that, but the AMA has also always said that data is very important, it's important to guide actions during the pandemic and transparency of the data is also very important. So we're following that closely.
Unger: I mean the HHS database is not open to the public. What impact does that have on folks who are building models and other health officials?
Dr. Irons: Well, it's a concern. A lot of the models and the databases that we look to, to look at ICU utilization, ventilator use, even Remdesivir utilization, we're getting that data from the CDC. And so if that data isn't transparent, if the HHS data is not publicly available, or if it doesn't seamlessly get transmitted back to the CDC, that information won't be available.
Unger: Well, there was concern, there was some disappearance of some of that real time data from the CDC dashboard. There is concern and I think some of the nation's governors are asking to actually delay that shift. Any thoughts there?
Dr. Irons: Well, I think it's important. It's important that that data be available and we're monitoring it closely.
Unger: So moving on to other trends in the news that we see. You mentioned some rollbacks, we're seeing that in certain states, controversy with masks, let's talk about what are the hottest trends that you're seeing.
Dr. Irons: I think the rollbacks are the new trends. If you look at Miami-Dade County imposed a new curfew that starts at eight at night, 8:00 p.m. until 6:00 in the morning. Cities like Chicago, where we're seeing a small uptick, are responding really early and beginning to roll back and not allowing bars to serve just alcohol if they don't have the ability to serve food, limiting the number of people in gyms, limiting the number of people that can be together. So states are starting to roll back requirements. We see new counties starting to add mask requirements. I think probably about half the states have mandatory mask laws, Lake County, Indiana, which is almost a suburb of Chicago, now has a mandatory mask law as of this morning for public areas.
And we also see businesses really stepping up. Large businesses like Walmart, where stores are actually in states that do not have mask requirements, Costco, BJ's, some of the other large businesses are requiring masks. But masks have become politicized. It's odd to me that something that's so important for public health could become a political issue. But I think that as the numbers are surging, as businesses are starting to come in and recognize that masks will not only protect people, but will protect their employees, their own employees, essential workers from getting exposed. I'm hoping that the tide is starting to turn.
Unger: Yes and we still see resistance in a couple of states, some kind of squabbles between governors and mayors. What are the thoughts on that?
Dr. Irons: Well, it's hard to understand as a physician. It's hard for me to understand how something that's really simple, really simple that has been proven to protect people and to decrease transmission, can become such a contentious issue. But what it really comes down to is individual responsibility. And I think that if we can sort of reframe this and just refocus on explaining to the public why it really is important for them to wear masks, to protect other people, to protect their family members, to protect others that they come into contact with. The one difference we have with COVID-19 is the high rate of asymptomatic infection. We're kind of used to with other conditions, isolating ourselves if we have symptoms of illness, if we have a fever, if we have a runny nose or a cough, people tend to somewhat self isolate. But we don't see that with COVID, there's a significant asymptomatic carrier frequency. So because of that, you don't know if you have COVID, so that wearing a mask is just a really reasonable thing to do.
Unger: And I understand that even when some people do get tested, the turnaround times on some of those tests is so long that that in itself can further complicate things.
Dr. Irons: Yeah, yeah. Absolutely. What we're seeing from elite firms, especially specimens that are going to the large reference labs, are five, seven, eight day turnaround times. If you think about that, unless someone is quarantining themselves from the time they send that specimen until they get the result, people are out interacting with others before they even get their test results. So it's beyond the time of being able to protect people or isolate yourself.
Unger: So last question, there was more controversy around the school guidelines, school reopenings. Any perspective on that? There was some talk of the CDC changing their guidance.
Dr. Irons: So as far as we've heard, the CDC has not changed their guidance, but they may be. They may be issuing additional clarification or additional guidance to go along with the guidance they put out. I think that Dr. Fauci has been saying all along that the school reopening decisions have to be made within the context of activity of COVID within your community. So I think that's the important distinction that's kind of been lost in this national discussion. There are communities with very low COVID activity and potentially school systems in those communities may reopen differently, or may have different considerations than a school system where there's really active COVID-19 disease. And I think it's those individual decisions that are going to be made locally that are really going to be important.
Unger: Last comment. AMA statement on the death of Congressman John Lewis. Can you talk a little bit about that?
Dr. Irons: Oh, a really important statement that the AMA put out last week. I think we were all affected by the death of Congressman Lewis and if I could just read from the statement. It was, "In his death, we've lost a champion against injustice everywhere, in health and other policies where inequities persist. The AMA and physicians across America unite today in national mourning."
Unger: Well, thank you very much. That is it for today's COVID-19 update. Again, Dr. Irons, thanks for being with us here today and sharing your important information. We look forward to talking to you again next week and hopefully we have some better news.
We'll be back tomorrow with another COVID-19 update and for updated resources on COVID-19, go to ama-assn.org/COVID-19. Thanks for joining us today 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.
