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, take a weekly look at the numbers and trends on COVID-19, including which states are seeing cases coming down and low positivity rates.
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. Can you tell us what's happening?
Dr. Irons: Sure, so when we look at the current numbers for today, there are 5,705,455 people who have been diagnosed with COVID, and the death rate is currently at 176,816. You look at that globally, the global death toll has surpassed 800,000 on Saturday. When the CDC sort of projects out what the death rate might look like, we're looking at probably nearly 195,000 deaths by mid-September, a number that four or five months ago, we really hoped we would get nowhere near.
If we look at the rest of the country, so that's sort of the ... If you look at those figures, that's the impact of this pandemic in the country. If you look at what's happening now in the United States, the numbers are getting better. Two or three weeks ago, we were talking about 70,000 new cases a day. Over the last few weeks, that's come down.
Now we're looking at the mid-forties, 45, 43,000 per day, as an average over the last week. Although those numbers are coming down, that's still higher than the peak numbers in April, so it's just something important to think about. If we look at deaths though, as we discussed last week, there were about a thousand, or a little more than a thousand per day averaging, so that's continuing. However, hospitalizations are starting to come down. So with the numbers coming down, hospitalizations are also starting to come down, so the hope is that we'll see that death rate start to decrease also.
Unger: Any other kind of state-by-state interesting trends?
Dr. Irons: Arizona and Florida, which were heavily impacted states over the last few weeks, those numbers are starting to come down. On the other hand, Arkansas and Tennessee reported their single highest death rate on Friday. We do know that deaths follow new cases when we're looking at the numbers, so that may be just something that's playing out. Hard to know what's happening in California with the wildfires and with the data collection problems. It's hard to get a good handle on those numbers.
If you look at the map of the United States though, the states that are really doing well are still in that Northeast corridor, the New England states. New York, New Jersey, and Connecticut, their positivity rate is less than 1%, and it's staying at that rate. But other states are coming into the low 2, less than 2%, less than 3% range, Michigan, New Mexico, some of the other states, so we're starting to see some better numbers.
Well, good. Now that cases have been somewhat slowing since their July peak, we do see a number of things, trends that could affect that in the coming months. Can you talk a little bit about what those key trends or key events might look like?
Dr. Irons: There's a few things all coming together when you look at the differences in numbers. So it could just be that we're testing less. You always worry because our testing numbers are coming down. However, hospitalizations are also coming down, so that's probably not the answer. I think more people are wearing masks. More states and cities are having mask mandates. More businesses are encouraging and requiring mask use. So I think all of those things together are potentially leading to the positive numbers we're seeing.
However, on the other hand, we've got schools opening, and I think what we've seen over the last few weeks is a variety of things. The University of North Carolina Chapel Hill opened and then closed. Notre Dame opened and then they're pausing on their in-person education. Some colleges are hiring their own contact tracers, and the University of Tennessee did that, so as they see positives, they can actually identify where those people are and contact trace to isolate those people.
Sadly, I think we're seeing that a lot of the contact tracing is leading back to off-campus parties and large gatherings. But it's just another example of the fact that a college is really another congregate living facility, just like a nursing home. And so you have large numbers of people living together and your surveillance has to be higher, and I hate to just blame the students on this. It's just that the surveillance processes have to be in place to identify new cases and isolate them.
Unger: Well, we're starting, I think, to see a little bit of the impact, too, of that very, very large motorcycle rally in South Dakota. Any news on that?
Dr. Irons: Well, we're starting to see some reporting of increased numbers from that, so I think that's another thing we're looking at. People are really going to follow that really closely.
Unger: And then finally, how about childcare centers? Some news from the CDC on that?
Dr. Irons: Yeah, there was a really interesting MMWR that came out last week that actually provides some good news and some good advice for childcare centers and also potentially schools. Rhode Island opened up their childcare centers again at the beginning of June, and so the MMWR, I mean, the CDC, looked at the case rates in childcare centers from the beginning of June until the end of July, and there were over 600 childcare centers open in that time period. But they had very strict guidelines. They had reduced enrollment. They had stable student-teacher groups that didn't intersect with other groups.
They had enhanced cleaning and disinfection. Masks where required of all adults. Daily symptom checks were required on everybody. And they actually found that those measures, plus working really closely with the Department of Health, they only found secondary transmission in four of over 600 childcare centers. I think it's really good news and reinforces the guidance that CDC put out for childcare centers and schools with regards to how to do this safely.
The other thing they saw, which I think does also tell us something, is that the increase in cases that they saw happened in the last two weeks in July when they saw an increase in community transmission in Rhode Island, so it aligned with that, and also tells us that as community transmission starts to go up, that's when people have to start paying closer attention to things.
Unger: Well, on the treatment front, there's some news over the weekend, want to get some clarification about the use of convalescent plasma to treat COVID-19. This has been something that's been in the news for quite some time, but big announcement over the weekend. You see the market is up. What's the news here in regard to convalescent plasma?
Dr. Irons: The FDA yesterday issued an emergency use authorization for the use of convalescent plasma for the treatment of COVID-19. It was a controversial decision. There was a lot of discussion last week about the fact that the NIH and other officials were actually asking the FDA to hold back until there was more evidence presented before the EUA was issued. What we have, we've been talking about evidence and the need for evidence and data from the beginning of the pandemic. We also talked about the fact that the real studies that tell us about efficacy of drugs or other therapeutics are randomized controlled trials, and I think that's the thing that has been missing with convalescent plasma.
The data that we have out there are largely from observational studies. Now, they're large. They're large observational studies and case-controlled studies, but they really aren't randomized controlled trials where you actually have a treated group and a non-treated group so that you can make sure that the decisions you're making about whether something's effective for a specific disease has the data to support that.
Unger: Any idea when those kinds of tests will come out?
Dr. Irons: It's unclear. Sometimes when you issue an emergency use authorization, it actually works against being able to recruit into randomized controlled trials, because in order to recruit into a randomized controlled trial, you may be randomized to treatment or you may be randomized to control. And so it works against that a bit. I think that the important thing to think about is that the data; there were some positive results that made it seem as though, that showed that it could be of benefit, but we didn't have the trials to support that completely.
Unger: Okay. Well, lastly, any key messages from AMA that we want people to hear this week?
Dr. Irons: Yep, so the AMA last week had a statement that opposed the HHS expansion of pharmacies and pharmacy interns' ability to administer vaccines to children between the ages of three and 18. That was of concern because childhood vaccinations are often given within the context of a holistic well-child care and preventative care, and so separating this out raised concerns.
Unger: All right. Well, thank you so much for your weekly update, Dr. Irons. That's it for today's COVID-19 Update. We'll see you tomorrow with another episode of the COVID Update. For resources, please 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.
