Public Health

Mira Irons, MD, on post Fourth of July numbers and the Delta variant

. 9 MIN READ

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

 

 

In today’s COVID-19 Update, discussion with AMA's Chief Health and Science Officer Mira Irons, MD, to review COVID-19 vaccine numbers and trending topics related to the pandemic over the past week. Also covering the rapidly spreading Delta variant and state-by-state mask recommendations.

Learn more at the AMA COVID-19 resource center.

Speaker

  • 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 also in Chicago. Dr. Irons, this is a pretty different holiday weekend for the Fourth. How did this one compare to where we were last year?

Dr. Irons: Oh, absolutely, totally different. For the most part, we saw Americans returned to their July 4 rituals and we're obviously in a completely different place because of the vaccines. If we think back a year ago, and I think it's important to think back, a year ago, the United States celebrated Independence Day largely by staying home. The country went into last year's holiday weekend, having set records for new coronavirus cases in six out of the nine previous days. At that point, about 600 people were dying from the virus each day. On July 2, the country set what was then a record, 53,000 new reported cases. Governors were forced to slow their reopening plans and in the months that followed, the pandemic grew much, much worse.

So compare that to this year, with reports of new cases holding steady at about 12,000 a day, the lowest since testing became widely available. The U.S. average of fewer than 300 daily deaths from COVID-19 is a decline of 23% over the past two weeks, hospitalizations are also dropping. You know, we also saw people traveling again though, about 48 million Americans were expected to travel from July 1 to 5, a 40% jump over last year. TSA reported screening nearly 2.2 million people on July 3 alone, the most since March 5, 2020, about a week before the WHO declared a pandemic.

Unger: My family and I were among those travelers over the weekend and glad to be able to see my in-laws on the Jersey shore for the first time in almost two years. So thank you science and thank you medicine for that vaccine. Dr. Irons, thinking about that vaccine, we came up a little bit short in terms of the goal that President Biden had said, in terms of getting 70% of Americans at least one shot. Where do we stand and what does that mean for our ongoing efforts from here on?

Dr. Irons: It's true. We have fallen short of that goal, but the White House is putting a positive spin on it. Pointing out that as of last week, 70% of Americans ages 30 and up have received at least one shot. The most recent numbers show 182.7 million Americans have received at least one shot, which is 55% of the population. Of those, 157.6 million are fully vaccinated, or 47.5% of the population, just under half. In looking at the President's number, a little more than 67% of people in the country 18 and older have gotten at least one vaccine dose. That said, about a hundred million people in the country have yet to receive a single vaccine shot and the supply of vaccines far outstrips the demand. Public health officials are struggling to motivate the vaccine holdouts. That's the larger problem right now—even with ample supply, the vaccination drive continues to remain relatively flat.

Unger: Well, if anyone needed any motivation, the Delta variant spread that we're seeing across the country should provide that a lot of danger there. Can you talk a little bit about how that's driving the numbers across the country?

Dr. Irons: Oh, absolutely. As we always do, we'll start with the numbers. 33,748,698 people have been diagnosed with COVID and tragically 605,933 people have died. What we saw as vaccinations ramped up was a sharp drop in cases through the spring, but that's now leveled off. The spread of the Delta variant remains worrisome for the unvaccinated. Dr. Rochelle Walensky, director of the CDC, issued her greatest warning yet last Thursday, when she said that nearly 25% of new infections have been linked to Delta, up from 6% in early June. She said she expects the Delta variant will eclipse the Alpha variant in the coming weeks. According to more recent estimates released by the CDC that has in fact already happened.

Data updated by the CDC on Tuesday evening shows the Delta variant was estimated to account for 51.7% of all new cases across the country as of July 3. In some parts of the country, the Delta strain now accounts for more than 80% of new infections, including some Midwestern states like Missouri, Kansas and Iowa. The CDC has said that variant proportions are dynamic and difficult to predict due to reporting delays, the presence of multiple variants and changing incidents. But a little over a month ago, the data showed the Delta variant was estimated to account for just 3% of all new cases in the U.S. So it's rising.

Unger: That's a pretty scary stuff. We're starting to see that play out in these areas with low vaccination rates. How is that kind of looking that, and I think it's changing really, over the course of the last month?

Dr. Irons: Oh absolutely, and it is tied to low vaccination rates. Essentially the Delta variant is creating hotspots particularly in, as you mentioned, states with low vaccination rates. In some parts of Texas, Arkansas and Missouri, for instance, there's been a sharp rise in cases. In Missouri, for example, caseloads increased more than 40% from two weeks earlier. Dr. Walensky's reported a thousand counties across the country where fewer than 30% of the residents are vaccinated. The Delta variant poses the greatest risk in these areas. States are responding. For example, state officials in Nevada are redoubling efforts to push the vaccine and been one of the worst outbreaks in the country right now. It's focusing efforts on Clark County, home to Las Vegas, where the governor announced he would be deploying additional mobile vaccine units and offering grants to community organizations doing direct outreach to vaccine hesitant residents. In Arkansas, the governor urged on vaccinated people celebrating the holiday weekend to remain masked or socially distant. Arkansas has 300 people hospitalized with COVID-19 for the first time since March.

Unger: It is heartbreaking because a lot of the deaths are obviously preventable with a vaccine. We're starting to see stories of physicians kind of back at it, in that kind of overwhelming situation. Understandably on pretty low reserves in terms of being tired at this point. With this kind of spread of the variant, some states, are they back to urging even vaccinated people to wear masks? What's the guidance?

Dr. Irons: Yes. Some states are and it is a little confusing. So yes, the CDC guidelines have not changed, but some states are urging rather than mandating the use of masks in certain high-risk situations. So for example, in Los Angeles, public health officials have urged residents to begin wearing masks again in public places, including restaurants and stores. The city had dropped its public mass mandate June 15. Illinois Governor J.B. Pritzker said last Wednesday that residents of the state even fully vaccinated should begin to wear masks again in high-risk situations, including crowded indoor gatherings. So while the CDC has stood behind its advice that people who are fully vaccinated against the coronavirus do not need to wear masks, Dr. Walensky has said that there are instances where local authorities might impose more stringent measures to protect the unvaccinated. This is the important part of this risk. She said those masking policies are not to protect the vaccinated, they are to protect the unvaccinated. Also continued, everybody should consider their own situation if they would feel more comfortable wearing a mask.

Unger: Well, to get those vaccination rates moving again, there have been renewed efforts at the federal level. Can you talk about some of the ones that are most significant?

Dr. Irons: Yeah, absolutely. On Tuesday, the president called for employers to set up clinics at work and to offer paid time off for workers as part of a renewed push to reach Americans who remain unvaccinated. He outlined five areas of concentration, all avenues he had already pursued. The first, targeted community by community, door to door outreach. The second, a fresh push to get vaccines to primary care doctors. Third, a boost in efforts to get vaccines to pediatricians and other providers who serve younger people, so that adolescents ages 12 to 18 can get their shots. Finally, expanded mobile clinic efforts and the workplace changes. The governments also announced the formation of surge response teams and these intended to combat the Delta variant by deploying additional expertise and supplies to hotspots.

The staff for these surge response teams would come from CDC, FEMA and HHS. The dedicated teams working with communities at higher risk for are already experiencing outbreaks due to the spread of the Delta variant. Their low vaccination rate will include a mix of virtual support and on the ground personnel, helping deploy additional supplies as requested by local officials, such as testing or therapeutics. Finally, as Dr. Fauci said in a recent interview, the last mile is always the hardest. We're actually on the last quarter mile.

Unger: Well, that is progress, but still that hard part to go. Thanks so much, Dr. Irons, for your perspective. We'll be back with another COVID-19 Update soon. In the meantime, 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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