Public Health

Mira Irons, MD, looks at Biden administration COVID response

. 10 MIN READ

Watch the AMA's daily COVID-19 update, with insights from AMA leaders and experts about the pandemic.

 

 

In today’s COVID-19 Update, Mira Irons, MD, AMA's chief health and science officer, reviews the recent executive orders from the administration and the numbers and trending topics related to the pandemic over the past week.

Learn more at the AMA COVID-19 resource center.

Speakers

  • Mira Irons, MD, chief health and science officer, AMA

AMA COVID-19 Daily Video Update

AMA’s video collection features experts and physician leaders discussing the latest on the pandemic.

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 in Chicago.

Just a few changes this week, Dr. Irons. We've got a new administration, a new president, a slew of executive orders passed to help address the COVID-19 pandemic. Let's start there. Can you take us through some of the week's key actions and tell us what kind of impact do we expect to see from them on our pandemic response?

Dr. Irons: Sure, Todd. Well, it certainly was a busy week, and keeping up with all of this took some time. But the first thing to say is the AMA did issue a statement that is hailing President Joe Biden's first flurry of executive orders to address the COVID-19 pandemic, and also those on climate change, immigration and LGBTQ issues. He reengaged the World Health Organization, which is of utmost importance. This is a global pandemic and we are not going to successfully address this threat without engaging the entire world.

He also advanced racial equity among the other policies. As promised, he launched the 100 day mask challenge, which we've talked about before, and did what he can. He mandated universal mask wearing within federal jurisdictions.

The other really important thing that I think will resonate with physicians is that he created the position of a COVID-19 response coordinator. The coordinator will be Jeff Zients, who helped revive the healthcare.gov after its rocky rollout in 2013. I think that all of... I come from the hospital environment and the name on the chart, very often we say, "Whose name is on the chart?" and that's the attending physician and that's the person that is in charge. So I kind of look at this on an uber level, on a federal level as the person that will be in charge of this effort.

Overall, it's great to see federal leadership. We also heard Dr. Fauci speak last week about the importance of science. And all of this together are good first steps on issues critical to improving the health of the nation.

Unger: It's been interesting. We're hearing from Dr. Fauci about speaking more and being more transparent about the science, and there's clearly just greater investment here and leadership in the pandemic space. So that's great news. Obviously very positive steps. We are hearing from some people they don't think it's going far enough. So do you think there's truth to that? Or what more can we, should we be doing at this point?

Dr. Irons: I think that the first step is having a clear plan, and it appears that there is a plan, there is an effort to engage with the states.

To be perfectly honest, I would just say let's give him some time on this. I think they're trying to get their arms wrapped around this. They are saying all the right things and they're hitting all the right components, identifying where the gaps might be, working with the states, focusing on PPE and testing. And we'll be monitoring it closely. I think it's important to keep an eye on this, but we're only one week into this.

Unger: There's other opinion pieces saying we should be on kind of wartime footing for this, which is something you are kind of hearing from the Biden administration. You're seeing outside companies now coming in, everybody from Amazon kind of joining in this saying, "Yeah, let's kind of put it on that footing." Is that what you're seeing too?

Dr. Irons: I think so. And I think that it's early days, but just the fact that the administration is willing to invoke the Defense Production Act to make sure that we have all the components that are necessary for vaccine distribution, to me, I think it seems as a sign that they're moving in this direction.

Unger: That's excellent, because the other records that we keep breaking are really terrible ones, a new one regarding coronavirus cases in the U.S. Can you talk more about the numbers this week?

Dr. Irons: Yeah. Well, as we say every week, the numbers don't look good. And we've known that this would be really the most dire time of this pandemic. So the numbers as of this morning, 25,128,825 individuals who have been confirmed to have COVID. I always say that the real number is probably, or people feel that it's probably seven to eight times that. And deaths related to COVID, as of this morning, 419,228. We passed another milestone on Saturday afternoon where 25 million confirmed cases were recorded in the United States. The official tally works out to about one in every 13 people in this country, or about 7.6% of the population.

And again, to put it all in perspective, and looking at the pace of the numbers I think is really important, it took the United States more than nine months to reach 10 million cases. Just let that sink in for a minute. That milestone was passed on November 8th, just before a holiday surge that accelerated the rate of new infections and brought weeks of record-shattering hospitalizations and deaths.

By the last day of 2020, the country had added another 10 million cases in just seven weeks, getting to 25 million took another three more weeks. And more than 4,000 deaths were announced in the United States on both Wednesday and Thursday of last week, two of the three highest daily totals of the pandemic.

That said, we are starting to see evidence of some relief. In recent days, COVID cases have been dropping steadily across the United States and hospitalizations have also been falling. And over the past week, the average has been a little over 176,000 cases per day, a decrease of 31% from the average two weeks earlier. Have we plateaued and are starting to come down? Hopefully. It may be too early to say that, but I think we're hoping that these numbers will continue to drop.

Unger: Is there concern that this kind of lull as temporary while we're seeing this variant or these different variants kind of catch on?

Dr. Irons: Yeah, well, I think that that's the big question. The U.K. Variant, which we know from the data from the U.K. Is more transmissible, is now in 23 states. I heard this morning a report that it could become the dominant variant in the U.S. By March. And so public health experts have likened the situation to a race between vaccination and the new variants, and the winner will determine whether the U.S. Is approaching a turning point in its battle against the coronavirus, now entering year two.

I think what we know so far is the variant that's been prevalent in Britain and a new variant have been found most often in Southern California and Florida, but we're seeing people changing behavior. The University of Michigan said Saturday that it suspended all sports activities for up to two weeks and told athletes, coaches and team staff members to quarantine immediately after several cases of a more transmissible variant were found among people linked to the athletic department. Among the 26,000 National Guard members deployed to Washington for the inauguration, 200 tested positive for the coronavirus.

And so I think all of this emphasizes that we have to continue with the public health mitigation measures that we've been talking about for some time now.

Unger: Absolutely. Well, let's talk about the important topic of vaccines. We've already discussed goals for increasing the pace of the rollout, but have we seen any real progress on the ground this week? Any more news on a possible third FDA authorization?

Dr. Irons: So I'll answer that second question first. Nothing yet, but there are some reports that Johnson & Johnson and/or AstraZeneca may be ready to submit an application to the FDA in February. That's just a few weeks away. We haven't seen any interim results from the phase three studies. So we're just going to have to wait on that one.

In terms of distribution, there are still significant challenges. The vaccine is delivered to the state and territory jurisdictions. States are determining how to distribute the vaccine to their populations. We know that supply is an issue. And we knew this. We knew that it was going to take time to wrap up manufacturing. And we're seeing these discrepancies in data between what has been delivered to states and the shots that have gotten in the arms, but even from a data standpoint, there are delays in the data being inputted at the local level, and then it goes to the state, and then it goes to the CDC.

So, I think that what we're hearing, and this is largely through the media also, is that people are trying to wrap their arms around this a little better, but the focus is to get shots in arms, and that's a good thing.

Unger: Absolutely. Well, last off, are there any key messages the AMA wants folks to hear this week?

Dr. Irons: Well, I think the major message last week was the statement on the U.S. Passing 400,000 COVID-19 deaths. I think we have to keep recognizing these tragic days, and the statement read one in every 820 people in our country have died during this pandemic, often alone, typically away from family and friends, comforted only by physicians and nurses in layers of PPE.

With a more contagious strain of COVID-19 spreading rapidly across the country, the simple steps we've advocated for months are more important than ever. Wear your mask, practice physical distancing and wash your hands to help reduce illness and death, protect yourselves and your loved ones by getting the COVID-19 vaccine when it's your turn.

The other message is we're applauding the Biden administration's first day actions, and also for taking swift action to boost PPE, testing and vaccine supplies to activate the Defense Production Act.

Unger: Yes, that hopefully... it's hard to believe a year later, we are still worrying about PPE. And with these variants, it becomes even more important. So that is excellent.

Well, thanks so much, Dr. Irons, for being here today. That's it for today's COVID-19 update. We'll be back with another segment tomorrow. For resources on COVID-19, visit ama-assn.org/COVID-19. Thanks for joining us. 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.

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