Featured topic and speakers
In today’s COVID-19 Update, Mira Irons, MD, AMA's chief health and science officer, also provides the latest on vaccines, unmasked fans at the Super Bowl and that even though we are seeing a drop in the number of new cases and deaths, the numbers are still high.
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 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. Dr. Iron's, let's start with the numbers. We hear news about the cases going down. We hear news about variants. Let's talk about the numbers, what's happening across the country?
Dr. Irons: Well, sure, Todd. So we hit another milestone over the weekend. Over 27 million confirmed cases. The number for today is 27,008,760 confirmed cases and 464,539 deaths as of this morning. However, as you said, there actually is some encouraging news. So on Saturday, at least 2,662 new coronavirus deaths, which is less than 3000, and 105,027 new cases were reported in the U.S. Both of those numbers are lower than we have seen in quite a long time for a single day. If you look at it sort of in an aggregate, over the past week, there's been an average of 121,677 cases a day, a decrease of 31% from the average two weeks earlier. You might remember we were talking about numbers and the 200,000s. The seven day rolling average of new cases is trending down in almost every part of the country. However, while all of that is encouraging, that number is still 104% higher than the summer peak on July 25th, when the seven day average was just over 66,000.
Unger: Wow. Okay. So that's a huge point that the perception may be that they're falling, but we are still at a very, very high level.
Dr. Irons: Yep. Absolutely. Hospitalizations are also falling. They're down 16%. However, the seven-day average of deaths is up about 2%, and we know that deaths follow case identification or diagnosis. There's also been some delays in reporting. I think that it's an encouraging trend, but there are worrisome variants. There are differences in the part of the country. So we can't really let our guards down. We really have to stay with us.
Unger: I think I'd like to focus a little bit on the variance because we are starting to see evidence of quicker sources spread in certain geographies in the states. Do you want to talk about that?
Dr. Irons: Sure. So the variant first found in Britain, which is the B.1.1.7 variant is rapidly spreading in the U.S. Over 600 cases have been identified and it's doubling every 10 days. Dr. Fauci and others have said that it will likely, or it may become the dominant variant in the U.S. in March, and that's why we really have to kind of hold ourselves back here and look at the decreasing in cases that we're seeing now with some concern because of this variant, which is more transmissible really starts to take hold, those numbers are going to start to go up.
Now, the good news I heard this morning, genomic sequencing surveillance has increased tenfold. And as of the press conference this morning, they will include academic, commercial and state labs and increase the surveillance three to four fold over that. There was also some new research, not yet peer reviewed, that came out that pretty much seconded what Dr. Fauci said, that it could become the predominant variant in March, and also that it's spreading particularly quickly in Florida.
Unger: And that's a problem because I think we saw a lot of pictures coming out of the Super Bowl weekend with a lot of unmasked fans and a lot of bar-crawling down in the Florida area and hope that doesn't turn into its own super spreader event.
Dr. Irons: Absolutely. I think that the public health officials and physicians were warning Americans around against gathering for Super Bowl parties with people from other households, but you're right. There were a lot of pictures yesterday on the TV of crowds without masks, and that's an easy way of putting yourself and your family in danger.
Unger: Well, let's talk a little bit about vaccines. Can you give us the latest news on what's happened over the past week and the status of our rollout?
Dr. Irons: Yeah. So the good news, a good milestone finally, is that more Americans have received at least one dose of the COVID-19 vaccine that have tested positive for the virus, an early, but hopeful milestone. It looks as though states are getting their arms around how to ramp up the distribution mechanisms. And at this time, the problem is that the supply is less than the demand.
In terms of new vaccines that are coming out, on Thursday, Johnson & Johnson submitted a request for emergency use authorization from the FDA for its single dose Coronavirus vaccine. That vaccine has been shown in studies to be especially effective at preventing severe cases and death, and if authorized would be a third vaccine option in the U.S. In terms of the regulatory process, the FDA has announced that their external advisory committee VRBPAC will review the data during a public meeting on February 26. Generally, the agenda and supporting data are published on the FDA website two days before that meeting. So if anyone would like to review the data that the manufacturers has submitted, that's one way they can do that.
Unger: Excellent. In terms of the rollout itself, there's been talk about increasing supply and just getting that kind of daily dose up. What do we see in terms of the rollout?
Dr. Irons: So the CDC reported that more than 2.2 million doses were given on Saturday, 1.6 million on Friday, and this brings the latest seven day average to 1.4 million doses a day, which approaches President Biden's new goal of 1.5 million shots per day. There's still a large gap between the states administering vaccines at the highest and lowest rates. Alaska's been given first doses to 14% of its residents, by comparison only about 6.3% of residents of Idaho have received a shot, but we are hearing that there actually are delays and not only the data being put into the system, but then the data making its way to the states and to the CDC.
Dr. Irons: There is some new data on the effect or the efficacy of the vaccines, either in the pipeline or those currently available against variants. We learned over the weekend that South Africa halted use of the AstraZeneca vaccine in their country where evidence emerged that the vaccine did not protect clinical trial participants from mild or moderate illness caused by the more contagious variant, the South African variant. It's not yet clear if these are just news reports if it protects against a more severe cases, but they've put that on pause.
Pfizer and Moderna have both said that preliminary laboratory studies indicate that their vaccines while still protective are less effective against the South African variant. Although, it's important to say that they have both of those manufacturers, Pfizer and Moderna, have said that the vaccines are effective against the U.K. variant. Novavax and Johnson & Johnson have also sequenced test samples from their clinical trial participants in South Africa, and both reported lower efficacy than in the U.S., But once again, until we see the data, it's really unclear what that efficacy is.
Although, more contagious variants are spreading. And top U.S. health officials sounded notes of optimism on Sunday that both the supply of vaccines and the rate of vaccination will steadily increase. One news item that came out today said that Pfizer announced that it expects to nearly cut in half the amount of time it takes to produce their vaccine, and this is due to efficiencies that have been found in the system that they've learned while scaling up their manufacturing, so that's good news on the supply side. And also in terms of the distribution, I guess this is given the Super Bowl yesterday, the NFL is making all of its 30 state stadiums available as max vaccination sites. So hopefully those two will come together, supply, demand and also distribution, a third, and we'll begin to see more people vaccinated.
Unger: And hopefully we'll start to see some of the states that are lagging behind others to learn from their best practices across the country, so that when that supply is fixed, we'll be able to continue getting shots in arms.
Unger: Well, let's continue to the next topic, which is misinformation. What are we seeing this week that we can clarify for our viewers out there?
Dr. Irons: So it's not really misinformation per se, but I think that many people are confused about what and who dictates where vaccines go in the U.S., who gets them, how they're prioritized and physicians are likely receiving a lot of these questions. To be honest, people who are confused for good reason, it's really confusing.
Federal, state and local health authorities across the U.S. are using dozens of algorithms to help determine where the vaccines are sent. In the end, the federal vaccines are sent from the federal government to the states and the states decide how to prioritize that vaccine distribution based on what is going on in their state and what they feel is best. Although, their formulas generally follow guidelines from the CDC about who to prioritize.
So the result is that Americans are experiencing why disparities in vaccine access, and this is especially confusing if people have relatives in different states and some relatives may live in the state with a lower age cutoff than another. Just as an example, Oregon, for instance, has prioritized teachers over the elderly, an approach that could help schools and businesses open. New Jersey has put smokers ahead of educators, which could save lives. Any of that could change. So I think that the best that information that a physician can give a patient is really to check with their state in terms of what group of individuals the state is currently vaccinating and where they might fit in that prioritization.
Unger: Yeah, that is hard because in the days of social media, when you see a lot of different people getting their shots across different states, I think I read an article over the weekend. It creates a vaccine envy. And so it is the best thing is to check your state and see where they stand right now. Well, finally, are there any key messages from the AMA that people should hear this week?
Dr. Irons: Yeah. Once again, the American Hospital Association, American Medical Association and the American Nurses Association released a public service announcement urging the American public to get the COVID-19 vaccine when it's their turn. The PSA stresses that the vaccines are safe, effective and help us all as we work together to defeat COVID-19.
In addition, and this is also important, on Wednesday, the Maternal Immunization Task Force and its partners, which included the AMA, urge the COVID-19, that COVID-19 be available to pregnant individuals. All pregnant individuals who choose to receive the COVID-19 vaccine must be allowed to do so in alignment with their state and local vaccination allocation plan. This includes the estimated 330,000 health care workers who are pregnant and should be allowed to receive the vaccine as part of the first phase of vaccine distribution plans. Reports of pregnant individuals being refused vaccination are really concerning.
Unger: Absolutely. Well, thank you for clarifying that, and that is it for today's COVID-19 update. Thanks for watching, and Dr. Irons, thanks as usual for being here. We'll be back with another update shortly. 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 podcast are those of the participants and/or do not necessarily reflect the views and policies of the AMA.
