Mira Irons, MD, looks at what’s driving the overseas resurgence of the virus

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

In today’s COVID-19 update, AMA Chief Experience Officer Todd Unger and AMA Chief Health and Science Officer Mira Irons, MD, take a look at the numbers, trends and latest news about the COVID-19 pandemic, including the continuing uptick in number of cases in the U.S. and a resurgence of the virus overseas.

Learn more at the AMA COVID-19 resource center.

Speakers

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

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. The trends don't look good.

Dr. Irons: No, they don't. They don't, Todd. We talked about this last week, that we were starting to see an uptick. And that's continued, sadly. So we currently, as of this morning, 8,155,894 people have been diagnosed as having COVID. And 219,676 people have died from COVID-19. If you look at the numbers, the seven day average is running at about 56,000 which is higher than it was last week in terms of people, new infections. And the death rate, the number of people have died is sort of staying at about 700. Up from what it was, but is sort of holding. But the daily numbers are really telling the story. And so last Wednesday, 59,000. Last Thursday, 63,000. Last Friday, 69,000. And if you think about it, those were a lot higher than what we were even talking about just two or three weeks ago.

Unger: So, this is, obviously, a global phenomenon. Can you talk about what we're seeing overseas?

Dr. Irons: Oh, well, we're seeing in a wave, a resurgence of COVID overseas. Globally, over 40 million people have been infected and over 1.1 million people have died. But the difference between the U.S. and overseas is the fact that we're kind of on our third peak in the United States. After that first peak, we never came down to a really low baseline. What Europe did was it actually went up, and we all remember what was happening in the spring in Europe, in Italy, and in France, and in the UK. But they came down to really low levels. They are now on a significant peak that that is going up.

Unger: So, what's driving that? A lot of these countries were hit early and hit very hard. They seem to reign it in and bring it under control. What's leading to the sudden spike.

Dr. Irons: Well, two things, or maybe more than two things. The first is the August vacations. I think in Europe, seem to have started the uptick, many people believe. But the cold weather. They're experiencing the same cold weather that we're experiencing. People are going from being outdoors a lot to being indoors a lot. And COVID fatigue is also occurring. Isn't just occurring in the United States. It's occurring globally. And I think people are just becoming, they're not only becoming fatigued, but they're becoming complacent. And that's leading to an increase in transmission.

Unger: And that's hard news given that we have a long haul ahead of us.

Dr. Irons: Absolutely.

Unger: Can you talk about state by state in the U.S., what are we seeing in terms of trends?

Dr. Irons: Yeah, so, as of this morning, I heard that 38 states are seeing increases in numbers in the last two weeks. 30 states, 25% or more. And the states that are being—at least seven states have set new records for single day. Colorado, Idaho, Indiana, Minnesota, New Mexico, North Dakota and West Virginia all set records on Friday. We're still kind of seeing that Midwest, the Northern part of the Midwest, the Rockies, but also Wisconsin. Wisconsin opened a field hospital over the weekend. North Dakota, which wasn't really affected much at all early on in the pandemic is seeing significant increases in numbers and significant problems with ICU bed capacity. And it looks like it's coming back.

Unger: You mentioned weariness, fatigue, exhaustion. People are just really exhausted with this. What are the other drivers that we're seeing underlying these numbers?

Dr. Irons: Well, some of it could be testing. As more people are being tested, we may be picking up the more asymptomatic people, the people who were asymptomatic and may not have been tested earlier. But as we said before, hospitalizations are up. So, it's not all the asymptomatic people. Rallies. Rallies are still occurring. Large super spreader events are still occurring. There's a school update. The president of the State University of New York at Oneonta resigned after more than 700 students tested positive. And that's the worst outbreak of any public university in the state. Nick Saban, the head football coach at the University of Alabama announced that he tested positive. And I think that the University of Florida and Louisiana State postponed the next game after 21 football players tested positive. And we're just when people come together, it's a respiratory virus. People come together in close contact for long periods of time, there's going to be an increased risk of transmission.

Unger: Any news on the vaccine or treatment front this week?

Dr. Irons: No, the only news that is out there is the FDA Vaccines and Related Biological Products Advisory Committee is meeting this week on the 22nd. It's a scheduled meeting. There have been no applications, but that's the external advisory committee that will advise Dr. Hahn and the FDA on any new vaccine applications that come. It's a public meeting. Anyone can listen in. And they may be talking about how they would look at the data that comes from the new applications. The last week, we talked about the fact that the Johnson & Johnson vaccine was on hold because of what's being called a mysterious illness in one person. Still don't know anything more about that. So, there hasn't been any more information on that. And in terms of treatment, sort of shifting from vaccines to treatment, the Lilly monoclonal antibody trial was placed on pause, on hold last week. Also, no information on that, but we do hear that the data safety monitoring board will be discussing it at a pre-planned meeting that was already scheduled for October 26.

Unger: Okay. Any misconceptions we need to clear up this week?

Dr. Irons: Yeah, masks. It keeps coming back. There's a lot of talk over the weekend and over the week about masks and how they're not helpful. We know that's not true. The Center for Disease Control, the CDC, and the World Health Organization have all talked about the fact that masks will decrease the rate of transmission. We have scientific studies that have proven that. And that seems to be something that keeps cropping up.

Unger: Well, finally, any key messages from the AMA this week?

Dr. Irons: Yeah, two non-COVID related. On Tuesday, there was a press release that responding to the limited access to mental health care. A new physician collaborative was formed to promote the integration of behavioral and mental health care and to overall health care. It's led by several of the nation's leading organizations and called the Behavioral Health Integration Collaborative. Also, on Tuesday, there was a press release. The American Medical Association, the American Hospital Association and the American Nursing Association called on the white house to rescind the executive order on diversity trainings. So, that's two things that the AMA has focused on over the last week. But we keep coming back to COVID. The focus really needs to be wear masks, social distance, protect yourselves, protect your families.

Unger: Great advice. Well, thank you so much for being with us here today. Dr. Irons, we'll see you next week for another update. In the meantime, 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.

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