AMA Update September 6, 2024 N/A 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 in Chicago. Welcome back, Andrea. Garcia: Thanks, Todd. I appreciate the
opportunity to be here. Unger: Well, we've got
a lot on the agenda for today's discussion. The COVID wave, an
ongoing listeria outbreak and another measles outbreak
here in the U.S. Andrea, let's start with COVID since
that's still making headlines and we are firmly in the
back-to-school season. The AMA's vaccine expert,
Dr. Sandra Fryhofer, recently filled us in on
the updated COVID vaccines and when to get them. But how are we
looking with cases? Garcia: Well, Todd, we've
talked before about the fact Labor Day COVID surge that we typically see
delays in data reporting after long holiday weekend,
so we're still really waiting for the data to catch up. We do know from past experience
that a busy Labor Day holiday weekend can accelerate
transmission following those increases
in travel and then more gatherings with
friends and family. We know that the Transportation
Security Administration was projecting that this past
holiday weekend would end up being the busiest Labor Day
travel period on record. And according to that,
while many people typically gather outside for
Labor Day in some areas, we know that extreme heat
drove people indoors, which could also contribute
to those increases in holiday spread. Unger: How were we
looking before we headed into the holiday weekend? COVID wastewater data 2024 Garcia: Yeah, so according to
the CDC, prior to the weekend, COVID activity continued
to rise in many areas, but it was also showing
some early signs of decline. In others, wastewater
detections. Nationally, we're still
at a very high level. And then if you look at the
CDC data by geographic area, levels were decreasing
in the West, but they were increasing in
the South and the Midwest and in the Northeast. We do continue to see that
KP.3.1.1 variant climb. It's now making up just over
42% of cases in the U.S. According to the CDC's latest
weekly respiratory illness summary, we do know that
hospitalizations from COVID remain elevated. That's especially true for
seniors and children who are younger than two years old. Deaths from COVID
are also low compared to where they were
in previous years, but they did increase
in late August. Omicron XE (COVID XEC subvariant, KP3, COVID variant kp.3.1.1) I think the other thing to keep
an eye on, and we know doctors and scientists are keeping
an eye on this as well, is yet another subvariant, and
that is XEC that could surpass KP.3.1.1 in the coming weeks. It was first
detected in Germany, and while it's been
detected here in the U.S., the prevalence is
low and there's not a lot of data on
this new subvariant at this point in time. Unger: All right. Well, we'll keep
our eye on that. Especially important
since, of course, we're headed back into school,
any considerations there? COVID back to school 2024 Garcia: Yeah, I
think that could mean that we're going
to continue to see elevated rates into the fall. There was a recent
article on today.com that really tried to help
put this in perspective, looking at comparisons in back
to school over previous years, and we saw in 2021
and 2020, for example, COVID levels were actually low
as kids headed back to school, but that was likely because we
had more widespread mitigation measures in place in 2022. We know the summer
wave was earlier, so the peak had passed
by the start of August. At that time, wastewater
levels were around 7.92, COVID wastewater testing results: How accurate is wastewater testing for COVID? and that's compared to 3.23
the same time of year in 2023. If we look at 2024,
levels were at 8.31, the week ending August 3, and
8.82, the week ending August 10. So that makes this the
highest levels of COVID we've seen heading into
the back-to-school season. As we've mentioned, there have
been some signs of decline, but it's really too early
to tell at this point if the peak has truly passed. Unger: Interesting,
and we'll of course, keep our eye on that as well. But adding to that, we've heard
that some pediatricians are planning to scale
back on COVID vaccines this fall due to lack of demand. Andrea, tell us more about that. Where to get new COVID vaccine 2024 (COVID vaccine reimbursement) Garcia: Well, Todd, I think this
is challenging, particularly for smaller physician practices. They have to purchase
vaccines up front, and then they get
reimbursed for them for those doses when
they immunize patients. If there's low demand
and an inability to return the vaccines that
were ordered and not used, then we see these practices
absorbing the cost, and we know that
many small practices can't afford to do that. KFF Health News: Pediatric COVID vaccine 2024 (kids COVID vaccine) There was a recent article
from KFF Health News. It said that the
lack of demand is driving some pediatricians, who
are now preordering the updated COVID vaccine for
fall and winter, to cut back from previous years. And we know CDC recommends that
anyone six months or older get the updated COVID vaccination
during the 2023-24 vaccination season. We saw only about 15% of
eligible children in the U.S. receive the vaccine. I think if we start to see
physicians across the country make similar
calculations, it could make finding doses
of the vaccine, especially for young
children, more difficult. Unger: And Andrea, I know
the AMA's message continues to be this-- get vaccinated. It's so important. As you said, the virus
continues to evolve and vulnerable people
are still at risk. Let's move on from
COVID and switch topics to something
completely different, and that is risks we face
from things like deli meat. We've seen this in the headlines
in the last couple of weeks, but recently, it's
made national news. Andrea, tell us more
about what's going on. Cold cuts listeria: Deli meat recall 2024 Garcia: Well, Todd,
those concerns about bacteria in deli
meat are unfortunately aren't anything new. However, last week we saw
the CDC remind the public to avoid eating recalled
deli meats amid a listeria outbreak that has expanded
to become the nation's largest since the one linked
to cantaloupe back in 2011. This outbreak
began back in July. It's been reported on
by multiple sources, including CNN and The New
York Times over the past week. That CNN headline urged
everyone to check their fridge. Listeria monocytogenes: Boar's Head listeria 2024 (meat recall today) Taking a look back
at where this began, Boar's Head issued a
recall in late July for more than 7.2 pounds million
of its ready-to-eat liverwurst and other deli meat
products, and that was due to concern
about potential listeria contamination. Since then, we've
seen CDC report a total of 57 people who've been
hospitalized across 18 states. We know that nine people
have died in connection with this outbreak,
as the CDC pointed out that true number of
illness is probably much higher because some
people have a milder case and they aren't necessarily
tested for listeria. There's also a lag time between
when an illness happened and when scientists
can connect it with an ongoing investigation. Unger: So, Andrea,
what does it exactly mean to go check your fridge? I know I'm not really sure
necessarily what brand of deli meats in there, but what
do you-- what do you do? Listeria recall list: Boar's Head EST 12612 Garcia: Yeah, so CDC is
specifically advising consumers to look for EST. 12612 or
P-12612 inside the USDA mark of inspection on labels. Some of these
products could have a shelf life and sell-by
dates into October of 2024. Listeria outbreak list of products (boarshead listeria) Those recalled products are
liverwurst, ham, baloney, sausage and roasted bacon. Boar's Head has said
that any new products now available at deli counters
are not subject to the recall. Bacterial infection: Is listeria contagious? However, listeria
bacteria is hardy. It can stay on surfaces like
countertops and meat slicers, so you don't even have to
eat a contaminated product to get sick. How to prevent listeria (deli meat pregnancy) It can spread easily at delis
transferring from equipment to surfaces to hands and food. And while refrigeration
does not kill the bacteria, we know that heat can. So pregnant people, those
who are 65 and older, those with weakened immune
systems are advised to avoid eating any
deli meat unless it's been heated until
it steams or it reaches that internal
temperature of 165 degrees Fahrenheit. If you have had
deli meat at home, clean the refrigerator and
any contaminated surfaces that may have come in
contact with it, Listeriosis: Listeria symptoms and watch out for those
symptoms of listeriosis, which include fever,
muscle aches and fatigue. It can take up to 10 weeks
for those symptoms to develop. Doctors should also be on the
lookout for these symptoms in patients and report
any suspected cases to their local health officials. Unger: Wow, that's
quite a wind-up time. Hard to remember what one
ate 10 weeks ago, even, so I can see why that's
so hard to track down. Any insight into
why this has become such a widespread problem? Boar's Head recall: USDA recalls 2024 Garcia: Well, that outbreak has
been linked to a Boar's Head facility in Virginia
that reportedly had repeated violations of
federal food safety regulations. There are documents
from the USDA showing 84 noncompliaces in that
facility from January of 2022 to August of 2024. 69 of those were reported
since August of 2023. Insects and mold were
reportedly identified at that facility that's
been linked to the recall. We know that Boar's
Head has said that it's paused production
at this facility, and it will remain closed until
it can produce safe product. Unger: Absolutely. Well, all of that is
great information, and we'll continue to track
that story as it develops. Let's move on to our third and
final topic for today's AMA Update, and that is the
resurgence of measles that we're seeing in certain
parts of the U.S. Andrea, what do we need to know there? Garcia: While those
headlines have really largely Measles 2024: Measles outbreak Oregon, measles Minnesota been focused on Oregon, which
is now experiencing the largest measles outbreak that that state
has seen in over three decades, Minnesota is also seeing
an increase in cases. That outbreak is mostly
affecting children in the Somali community. This really mirrors
a larger trend of rising measles cases
across the U.S. this year. Measles cases in U.S. by year According to the
CDC, nearly one third of the measles cases
since the COVID pandemic have occurred in the
past three months. And we know that as
of Tuesday, the CDC is reporting that we've seen
236 cases of measles in the U.S. so far this year. That compares to 58
cases in all of 2023. MMR vaccine: Measles mumps rubella vaccine Health experts do
continue to attribute the reappearance of this disease
to the falling rate of children getting their MMR
vaccinations and have noted that the
outbreaks are mostly confined to pockets
of the population where young people have
not been vaccinated. We do know that two
doses of the MMR vaccine are 97% effective at
preventing measles. Unger: Well, Andrea,
let's take a closer look at what's happening in
Oregon at the moment. Just how bad are those numbers? Oregon measles outbreak vaccinated vs unvaccinated Garcia: Well, according to
the Oregon Health Authority, all of those infected
during the current outbreak were unvaccinated. In terms of how it compares
to other outbreaks this year, Illinois and Minnesota
are the only states to have reported more
measles cases than Oregon so far this year. Illinois had 67,
Minnesota had 41. That compares to
the 31 in Oregon. Measles Oregon: Measles vaccine exemption According to the
CDC, Oregon has one of the highest vaccine exemption
rates for kindergartners in the country. I think that really
brings us back full circle to the back-to-school
season, and how important it is for children to get all
of their recommended vaccines this year. Unger: We'll take that full
circle moment to wrap up this week's conversation. Andrea as always, thanks
so much for being here and sharing this information. 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 find all our videos
and podcasts as always at ama-assn.org/podcasts. Thanks for joining us today. Please take care. N/A