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What kills the most Americans? What type of flu is going around? How much is a flu test? How many people died from COVID? What causes heart disease in women?
AMA's Vice President of Science, Medicine and Public Health, Andrea Garcia, JD, MPH, discusses cardiovascular disease statistics, heart disease in women, the latest bird flu developments and flu tests at home. AMA Chief Experience Officer Todd Unger hosts.
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Speaker
- Andrea Garcia, JD, MPH, vice president, science, medicine & public health, American Medical Association
Transcript
Garcia: Cardiovascular diseases, including heart disease and stroke, now claim more lives in the U.S. than all forms of cancer and accidental deaths combined. And one startling statistic suggests that in the U.S., someone dies of cardiovascular disease every 34 seconds. And nearly 2,500 people die from cardiovascular disease every single day.
Unger: Hello and welcome to the AMA Update video and podcast. Today, we have our weekly look at the headlines with the AMA's Vice President of Science, Medicine and Public Health, Andrea Garcia. I'm Todd Unger, AMA's chief experience officer. Welcome, Andrea.
Garcia: Thanks, Todd. Good to be here.
Unger: Well, it's only been a week since we last talked, but there have already been more developments with bird flu. Andrea, what can you tell us?
Garcia: Well, last Wednesday, the USDA announced that six dairy herds in Nevada have been infected with a different version of H5N1. And that detection was reportedly found through the USDA's national milk testing program that we've talked about. It launched in early December.
This is concerning because until recently, dairy herds in the U.S. had been infected with a form of bird flu known as genotype B3.13. The genotype D1.1, which was detected in Nevada cattle, had only ever previously been detected in wild birds and poultry. So, this indicates that D1.1 has now in fact spilled over into cows.
Unger: Andrea, what exactly does it mean that the virus has kind of spilled over from birds to cows?
Garcia: Well, I think, Todd, this spillover really just means it's gone from one animal to another. But it really is important because it changes our understanding of this outbreak. So, scientists have believed that we saw a single spillover event from birds to cattle in the Texas panhandle in late 2023 to trigger this current outbreak.
This finding points to at least one additional instance of the virus hopping from birds into dairy cattle. One expert quoted in a recent NPR article really likened the situation to whack-a-mole. So even if you get rid of one strain, another one pops up.
Now, it's still not clear how long this genotype of the virus has been circulating in cattle, whether it's widespread or even what the implications of this may be. Some experts do fear that it could mark a new chapter in the outbreak or that bird flu may become endemic in the U.S., meaning it's here to stay.
Unger: Andrea, what can you tell us about the difference between the two genotypes? Is there any cause for additional concern beyond what you mentioned?
Garcia: Well, so far, the clinical signs in cows appear to be similar. So, they typically lose their appetite. Their milk production drops. And thankfully, most seem to recover with veterinary care. However, the D1.1 genotype could potentially be more dangerous to humans. So, of the 67 human cases of bird flu detected in the U.S. so far, one of the only patients infected with D1.1 was in Louisiana.
And if you recall that patient became severely ill and ultimately died. That patient was over the age of 65. They did have underlying health conditions. So that certainly could have been a contributing factor. The 13-year-old girl in Canada who also became severely ill and was hospitalized but did eventually recover was also infected with the D1.1 genotype. So, I think while the CDC notes the risk to the general public is still low, obviously, Todd, this is something we are continuing to very closely follow.
Unger: All right. And we will continue to track those developments as they arise. Andrea, let's now turn to seasonal flu for a moment. How are the numbers looking out there?
Garcia: Well, not great. The amount of acute respiratory illness causing people to seek health care is at a very high level nationally. Cases of flu seem to be peaking in the U.S. for a second time this season. And according to a recent CNN article that analyzed the CDC data, after doctor's visits for flu dipped early this year. They jumped past the previous season peak at the end of January. And we're at about a 30% test positivity rate. And there are still months to go in flu season.
Given these numbers, chances are if you haven't already had the flu yourself, you likely know somebody who has. The CDC estimates that there have been at least 24 million illnesses, 13,000 deaths, including 57 pediatric deaths from flu this season. And hospitalizations are rising, too.
Unger: Andrea, we also have more tools at our disposal. Let's talk a little bit more about that.
Garcia: Yeah, Todd, we talked about a few months ago that this is the first season that we've had at-home flu test available or even combined at-home flu and COVID tests. Now, these tests could help patients get treatments, such as antivirals, much sooner. And although most people will get better in a few days without medication, the CDC says that antiviral medications, like Tamiflu, are more effective when they're given in the first two days of symptoms.
We've, however, seen pretty slow adoption of these tests. Part of the reason could be cost. These tests are not covered by insurance. And they typically run about $30 for a pack of two. If you do take a test and test positive for either COVID or flu, it's still best to isolate to limit spread and also to contact your physician. And the sooner, the better. If you test negative but you are experiencing symptoms, you may have tested too soon. So take another test a couple of days later.
Unger: All right. That's very good advice. Andrea, you mentioned the word COVID, so let's take a step back here and focus on COVID for a moment. It is really hard to believe, but we recently passed the five-year mark of when COVID was first declared a public health emergency here in the U.S. Andrea, what have we learned, and where do we stand today?
Garcia: Well, that five-year mark actually passed with very little fanfare on January 31. There was an article by ABC News that did mention the milestone and how five years later, it's become integrated into our way of life. And we now expect two peaks of COVID each year—one in the summer, one in the winter. Although we are seeing what appears to be our mildest winter yet, it's important that we still remember that COVID causes a substantial amount of illness each year.
In late December, for example, it was around 600 people who were dying each week in the U.S. And while that's substantially less than last winter, when the number was around 2,000, or during the Omicron surge at the end of 2021, when deaths were topping 10,000, it's certainly not insignificant. And there was actually a new poll that showed that many Americans do still see COVID as a public health threat.
Unger: Tell us a little bit more about that. In what way?
Garcia: Well, there was a U.S. News and World Report article that recently was published that was based on the results of a new HealthDay Harris poll. It said that nearly 3-in-4 people, so about 72%, agree that COVID is still a serious public health issue, including more than a third who strongly agree.
Now, we've seen slow adoption of at-home flu tests, but at-home COVID tests have been around much longer. According to the same poll, people are apt to respond to any symptoms they might develop, with nearly 3-in-4 saying they would in fact take an at-home test, go to the doctor or pharmacy to get tested for COVID.
I think the takeaway here is that although COVID has become a way of life for us, it's still an infection that we need to take seriously. And just as a reminder, CDC recommends that people with COVID stay home, stay away from others, until at least 24 hours after their fever has ended, their symptoms have improved. And they also recommend that people mask and keep their distance from others for five days afterwards.
Unger: I've been watching the show The Pit. And there have been flashbacks back to the early days of COVID. And you kind of forget how just incredibly destructive and scary that that time was, and so still living with those consequences and thinking about it, apparently. In closing, Andrea, I want to draw attention to another non-virus, health-related threat that we don't talk a lot about much here, and that's heart disease. There's been some recent news. What do we need to know?
Garcia: Well, according to newly released data in the American Heart Association's 2025 heart disease and stroke statistics update, heart disease remains the leading cause of death in the U.S. And that report said that while medical advances have helped more people live longer with cardiovascular diseases, many of the risk factors that lead to these diseases really do continue to grow at alarming rates.
So looking more specifically at these risk factors, the report indicates that nearly 47% of U.S. adults have high blood pressure. More than 72% of U.S. adults have unhealthy weight, with nearly 42% having obesity as defined by BMI.
More than half of U.S. adults have type 2 diabetes or prediabetes. Cardiovascular diseases, including heart disease and stroke, now claim more lives in the U.S. than all forms of cancer and accidental deaths combined. And one startling statistic suggests that in the U.S., someone dies of cardiovascular diseases every 34 seconds. And nearly 2,500 people die from cardiovascular disease every single day.
Unger: Wow, those are huge numbers. Andrea, I know February is American Heart Month. And some efforts throughout this month are devoted toward women's heart health in particular. What can you tell us about that effort?
Garcia: Well, heart disease also remains the number one cause of death in women. Many factors unique to women can raise heart disease risk, including pregnancy-related conditions and hormonal changes related to menopause. And while efforts have been made to raise awareness of women's heart health, many challenges do persist.
For example, symptoms of heart disease in women are under-recognized. They're under-reported. And we know women are under-represented in cardiology clinical trials and other research, to name a few. February, as American Heart Month, is especially a good time to talk about and bring attention to these issues, including how risk factors disproportionately affect certain communities.
Efforts are happening around the country to promote heart health all month long. Heart.org has a ton of information if people are interested.
Unger: All right. Again, that is heart.org for more information. Well, that wraps up today's episode. Andrea, thank you so much for being here and keeping us informed. If you found this discussion valuable, you can support more programming like it by becoming an AMA member at ama-assn.org/join. You can always find all our videos and podcasts at ama-assn.org/podcasts. Thanks for joining us today. 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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