Watch the AMA's daily COVID-19 update, with insights from AMA leaders and experts about the pandemic.
Featured topic and speakers
AMA Chief Experience Officer Todd Unger speaks with AMA Chief Health and Science Officer Mira Irons, MD, on the latest trends and news about COVID-19, including what's happening across the country as states begin to reopen.
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 a look at the numbers, trends and latest news about COVID-19. This is the first in what will be a weekly update with AMA's top health and science expert, to keep you informed as our company reopens. I'm joined today by Dr. Mira Irons, AMA's chief health and science officer in Chicago. I'm Todd Unger, AMA's chief experience officer, also in Chicago. Dr. Irons, let's first talk about the numbers. What's happening across the country with new cases and deaths?
Dr. Irons: Todd, today the numbers are that we have 2,094,205 people infected with COVID and 115,732 deaths. When you look at those numbers, they're actually both new cases and deaths are remaining pretty stable across the United States. But looking at an aggregate figure really doesn't tell you the real story. What we know from the pandemic so far is that going back two months, different parts of the country were variably affected. The cities were much more affected than other parts of the country: Chicago, New Orleans, New Jersey, New York City, San Francisco and LA. We're seeing the same thing now. What we're seeing is that many of those cities that were really affected early on have started reopening much more slowly, and their numbers are dropping, but we're seeing increases in other parts of the country that hadn't experienced the upticks and surges that other parts had seen. So, stable is not really where we want to be.
Unger: So really, the trend right now is you're seeing a different set of hotspots, increases in COVID cases and deaths in different areas than we were initially in the pandemic?
Dr. Irons: Yep, absolutely. We're seeing surges, upticks in about 22 states as of this morning. Most of those are in the south: Florida, Tennessee, South Carolina, North Carolina, Alabama. And also in the southwest, in the Sun Belt, so Arizona. Utah didn't have much of a surge and now they're seeing upticks. We're seeing upticks in Oregon also. At the same time, we're seeing Illinois, that had a prolonged plateau, start to really come down, and decreasing cases in the Northeast. It's these new areas of surges in many States that didn't have a significant COVID load that are really concerning right now.
Unger: A few weeks ago, around Memorial Day, we saw a lot of those particular states with photographs and video of a lot of people out celebrating without masks. We've also had another key trend, which are a protest across the nation where people are side by side. Are you seeing the impact of those in the numbers yet?
Dr. Irons: Yeah, that's exactly. Well, we're seeing the impact of reopening across the country. Reopening has to occur. We know that we couldn't keep the country locked down forever. We were prepared to see increases happening across the country due to really how governors and individual states are reopening their states. What I think we hadn't expected to see was the fact that people kind of went from 0 to 100 in many of these states. We know that social distancing worked, we know that wearing masks worked, we know that washing hands works. But when you look at some of the images from the states where you're seeing surges, large groups of people, no social distancing, not wearing masks. They easily explain the upticks that we're seeing.
Unger: You just said that pretty much the three areas of guidance are: maintain social distancing, wear masks, wash your hands. There's been some confusing guidance or changes along the way. Let's work to clarify this. There was, for a moment, a question mark around whether you could get this through touch. From the CDC, what was the clarification on that, Dr. Irons?
Dr. Irons: We know that this is a respiratory virus. We know that it's actually spread by droplets, respiratory droplets that either come out from sneezes and coughs and/or aerosols that are produced through talking. There was a confusion early on about how much it could be spread through fomites, from droplets that are sitting on surfaces, and I think that the current guidances that that's a very, very insignificant mode of transmission, mainly because you wouldn't have a huge load of droplets on a surface. And then you somehow have to get them into your--touch your face with it, into your mouth, into your nose, into your eyes, so that the hand washing piece of it is really important. But I think that what we know is that the main form of transmission really is person to person contact within six feet, and that's what really informs the social distancing and the masks.
The thing that happened last week also, or the week before, is that there was some confusion coming out of the WHO in terms of how much spread occurs from asymptomatic people. Originally, it seemed as though the statement was that there wasn't significant spread from asymptomatic people, and then that had to be walked back. The explanation was that there was confusion over the definition of asymptomatic versus presymptomatic. To be honest, it really doesn't matter because what matters is that we know that people without symptoms, either because they're asymptomatic, and they'll never develop symptoms, or they're pre-symptomatic and will develop symptoms in a few days, can still transmit the virus. So that you can't feel comfortable being close to someone who doesn't have any symptoms and assume that you can't catch this from them.
Unger: As we navigate the reopening, has there been any progress on developing treatments? Where do we stand on the vaccine trials at this point?
Dr. Irons: The quick answer is no effective treatment at this time. I think that there are over, I think, 2,000 different clinical trials that are out there with different forms of therapy. We had some good news with remdesivir, which is an antiviral, come out a few weeks ago. That showed some promise in patients that are hospitalized; not patients that were intubated and ventilated, but hospitalized. There's no data to show effectiveness of remdesivir in people who, from a prophylactic standpoint, at this point.
There is a lot of discussion about hydroxychloroquine and chloroquine. The clinical studies have shown that neither drug is effective for the treatment of COVID-19, and there were safety issues. Just today, the FDA actually revoked the emergency use authorization for both of those medications for treatment of COVID-19.
There's some promising work on the use of convalescent plasma, and some trials have been started just over the weekend, over the last few days on monoclonal and polyclonal antibodies. There's a lot of work being done in terms of developing therapies, but right now, no effective treatment for the severely affected patients, aside from remdesivir. That does have a modest effect.
Unger: Well, this past week, the AMA has been quite busy putting out a number of statements related to COVID-19. The first was on PPE. Can you elaborate on that?
Dr. Irons: Yeah. Well, PPE is a concern. PPE supplies have been a concern from the very beginning of the pandemic, and they're still in short supplies. PPE is how we protect our health care workforce. One of the reasons we worry about surges isn't just that people will be affected and people will be hurt in a significant, a good number may pass, may die, because of this, but because it also puts a strain on PPE supplies for health care workforce. And it also decreases the ability of physicians to see patients for routine care and for non-urgent procedures. So, PPE is a concern. The AMA is working very hard to ensure that PPE supplies are available, but it's of special concern for doctors who are reopening their practices right now, because they need those supplies in order to reopen their practices to see people, to care for their chronic conditions.
Unger: You mentioned a little bit about this before, but AMA also urged vigilance on COVID mitigating steps. Will you cover those three steps again, just to make sure that is clear.
Dr. Irons: Absolutely. The message is: the pandemic is not over. The three steps everybody really has to remember is, maintain social distancing, wear a mask and wash your hands. It's as simple as that. But even though we'd like it to be over, it's not, but those are the three steps everybody has to do.
Unger: I would say that would really be the key takeaway for this week. Continue to practice those three steps as we reopen, and try to do so safely. That's it for today's COVID-19 update. I want to thank you, Dr. Irons. We look forward to see you again with another update next week. For more information on COVID-19, visit the AMA site, ama-assn.org/COVID-19. Thanks for being with us here today and 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.
