Featured topic and speakers
In today’s COVID-19 Update, AMA Chief Experience Officer Todd Unger reviews rising COVID-19 case numbers and trending topics related to the pandemic over the past week with AMA Director of Science, Medicine and Public Health Andrea Garcia, JD, MPH. Also covering state-wide mandates lifting for masks in school and the latest developments on when a COVID vaccine will be available for kids under five.
Learn more at the AMA COVID-19 resource center.
Speaker
- Andrea Garcia, JD, MPH, director of science, medicine & public health, American Medical Association
Transcript
Unger: Hello, this is the American Medical Association's COVID-19 Update video and podcast. Today we have our weekly look at the numbers, trends and latest news about COVID-19 with AMA's Director of Science, Medicine and Public Health Andrea Garcia in Chicago. I'm Todd Unger, AMA's chief experience officer in Chicago. Andrea, thanks for joining us again. Last week, Congress passed the omnibus bill, which will help fund relief for the Ukraine and many other initiatives. Actually, we talked the other day to Jason Marino at AMA's advocacy about what was included in there for telehealth but there wasn't money in there for COVID relief package. I'd like to talk first off about what happens to the White House's plan to combat COVID both nationally and globally that we talked about last week.
Garcia: Yeah, well, it's good to be back Todd and Congress approved and the president signed that $1.5 trillion spend bill last Friday. Like you said, that bill does not include that 15.6 billion emergency aid package that is meant to fund the pandemic, the president's pandemic strategy. And that number started out at 22.5 billion, it was negotiated down to 15.6 and then as we said, it was removed from the package altogether at the last minute in order to help get that bill passed. And so the fate of the president's plan remains unclear at this point.
Unger: Is there any chance that it would be considered and passed separately from the larger spending bill?
Garcia: So the administration has said, they're going to try to get the bill passed in the coming days but whether or not that happens remains to be seen. Jen Psaki, the White House press secretary really praised the passage of that larger spending bill as an example of what bipartisan work can accomplish. And she said that we're going to continue to call on Congress to provide the funds urgently needed to prevent severe disruptions in our COVID response.
Unger: Well, if that doesn't happen and the bill doesn't pass, how is that going to affect our pandemic response?
Garcia: So, a White House spokesperson said last week that if Congress does not appropriate more money, testing capacity would start declining in March. And then the funds that are used to pay for COVID testing and treatments for tens of millions of uninsured Americans would run out in April. With that being said, the administration did secure some funding for pandemic preparedness. That includes 745 million for BARDA or the Biomedical Advanced Research and Development Authority and 845 million for the Strategic National Stock Stockpile. I think as we all know that national stockpile is really important when it comes to things like having PPE for our health care workers, which we know was really a significant challenge early on in the pandemic and definitely put lives in danger. So that funding is really good to see.
Unger: Well, it is good news for the National Stockpile and of course was one of the major issues early on in the pandemic. But as we've been talking with other guests, this issue about being prepared for the next pandemic is really, really critical. Especially in light of one of the recent markers, I guess we could say, which was the second anniversary of COVID being declared a pandemic by the World Health Organization. Can you remember that? Seems like a long time ago. I know that I can remember exactly where I was at that moment but where are we now from a global perspective?
Garcia: Yeah, so it was two years ago. It was March 11, 2020, when the WHO characterized COVID as a pandemic. I think little did we know that we would have over 452 million cases, over six million deaths and we're getting closer to that one million deaths here in the U.S. alone. At the time of that declaration in 2020, the U.S. had 1,263 cases and 37 deaths. If you remember, that's when the NBA suspended its season, there was news about Tom Hanks and Rita Wilson having COVID. It does feel like a really long time ago but while we continue to see reported cases and deaths declining nationally and globally, it's been the WHO, who's continued to urge vigilance pointing to global inequities. Really the agency is saying that countries shouldn't be too quick to declare the pandemic over and let their guard down. The WHO director said that the pandemic is far from over and it will not be over anywhere until it is over everywhere.
Unger: And it is not over everywhere. While things feel better here in the States. We see other countries where the numbers are really taking off. China, Germany. What are you seeing globally?
Garcia: Well, China is dealing with the largest surge of infection since COVID first emerged in central China, more than two years ago. That surge has reached 1,420 cases. So when we compared that to what we're seeing in the U.S., it's still pretty low but it's prompting new lockdowns and several of China's largest factory cities have suspended production, including those that make Toyota cars and Apple phones. In Shanghai, schools are switching to online learning and cinemas, theaters, museums and restaurants have closed. I think Hong Kong too is struggling to get a handle on its worst outbreak since the start of the pandemic. So cases there are starting to come down.
Unger: Thankfully, it is a different story here, although as you point out, it's not over until it's over everywhere. With cases in the States continuing to drop, we are seeing a lot of releasing of restrictions, so to speak. Do you see that in the numbers, reflecting that as well?
Garcia: Yeah. So COVID cases continue to reach their lowest levels since last summer. We're averaging around 35,000 cases. Fewer cases are being reported each day, fewer people are being hospitalized with COVID hospitalizations have fallen more than three quarters from their January peak. So we're hovering around 28,000 per day. We do continue to see around 1,400 deaths most days. That number is dropping but it's still too high. But we are seeing these really significant declines in almost every state at this point.
Unger: And because of that, we are seeing restrictions being lifted as we talked about before, particularly around mask mandates. What's the latest news here?
Garcia: Yeah. So early last week Hawaii became the 50th and final state to announce that they're dropping their universal indoor mask mandate. It will no longer be in effect as of the end of March. We also saw Oregon and Washington state. And those two states are really known for having pretty cautious COVID strategies. They're lifting their statewide mask mandates on Saturday. So masking there will be option in more settings.
Unger: And are we seeing public schools begin to follow suit as well?
Garcia: We are. So some of the nation's largest school districts are beginning to go mask optional. California stopped requiring masks in schools on March 11, Illinois' mask requirement for schools ended on February 28. Chicago public schools kept their mask mandate in place but this week are going mask optional. New York State, their mandate ended on March 2 and as of March 7, students in New York City no longer have to wear masks in indoors in public schools.
Unger: Of course, I know because I've been on a couple flights lately that there are still places where masks are being mandated at the federal level. Where are those places?
Garcia: So, yeah, TSA has extended its mask mandate. So passengers must still wear masks on planes, on buses, public transit. And that includes the transportation hubs like airports and train stations. And that's through at least April 18. We know the CDC has said, they're going to be looking at their guidelines on masking in public transit. They'll be working with federal agencies to revise their masking policies, looking at cases, the risk of new variants, among other factors. So I would expect in the next month that we'll see a new framework from CDC on masking in public transit.
Unger: Well, I'm sure for a lot of people, the end of mask mandates is a sense of relief. And one of those kind of steps toward normalcy but that's not the same for everyone. How are you seeing the response to the lifting of mask mandates?
Garcia: Yeah, it's definitely an uncertain time. I think for some people who've remained particularly vigilant throughout the pandemic. This shift is going to feel abrupt and unsettling. Others who live in states like Texas and Florida have been living without mask requirements for quite some time already. And I think people are trying to answer questions about whether they should go maskless in public, whether it's going to make other people feel uncomfortable at the gym, at the supermarket. They may be worried about alienating or infecting vulnerable friends and family, and certainly we know that people who are immunocompromised are feeling left behind and unsure at this point of what to do now due to their own personal risks. I think we're seeing, at least I know for my own kids, we're hearing some parents say they're really glad that their children can attend school without wearing a mask. Some are citing concerns about speech development or facial recognition in really young kids. And I think others are worried that kids who are still too young to get vaccinated are going to be at greater risk of infection without masking.
Unger: And that particular topic is one that's kind of confusing because we've had what feel like stops and starts on the vaccine front for children under five. Is there any progress there or news?
Garcia: So, as we know, FDA temporarily postponed that effort to authorize the Pfizer vaccine in the youngest children in February that was due to doubts about the vaccines’ effectiveness in that age group. It was not about safety. It was mostly due to dosing challenges. In Pfizer's trial adolescence, age 12 to 17 were given a 30 microgram dose. That's the same dose that we give to adults but children age five to 11 received 10 micrograms. And then in those six months to five-years-old, the dose with three micrograms. And the thought now is really that those doses might have been too low to produce an adequate and lasting immune response. There were some reports, however, that higher doses produced too many fevers. So scientists are really looking for that Goldilocks dose, strong enough for lasting protection but not so strong that it causes worrisome side effects like high fevers.
Unger: And where does Pfizer stand on that?
Garcia: So Pfizer is testing that third dose to see if it can deliver the level of protection that two doses couldn't. We're expecting them to seek authorization next month for that three shot regimen for children under five. The dose is about one-tenth as strong as those for people age 12 and up. But I think that the big news over the past couple of days, which is what came from Moderna, their vaccine is currently only authorized for adults but they're expecting this week to send initial data to the FDA on how well their vaccine works in children under six. That's a two-dose series at a quarter the strength of their adult dose for children under six. And so, if the results are positive, we should see a round of regulatory review by FDA, perhaps as early as April. And hopefully we'll have some clarity in the coming weeks and some good news for those parents who are waiting for that last group to become eligible.
Unger: And we'll keep following that news as it progresses and keep you updated. That's it for today's episode. Andrea, thanks so much for being here. We'll be back soon with another COVID-19 Update video and podcast. 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 podcast are those of the participants and/or do not necessarily reflect the views and policies of the AMA.
