Heart failure, stroke and COVID the latest research with Andrea Garcia, JD, MPH

Aug 26, 2023

Heart failure, stroke and COVID the latest research with Andrea Garcia, JD, MPH

The latest news you need to know about XBB.1.5, norovirus, and avian influenza.

AMA’s Vice President of Science, Medicine and Public Health, Andrea Garcia, JD, MPH, shares new data from the CDC detailing COVID-19 mortality rates for vaccinated and unvaccinated people, preliminary findings on coronavirus infection and heart complications from a small study at Columbia University in NYC, as well as the latest research on lasting heart problems related to COVID infection published in the Journal of the American College of Cardiology. American Medical Association CXO Todd Unger hosts.

00:00 AMA Update for Feb. 22, 2023
00:40 XBB.1.5 variant
01:24 Rising COVID cases in Western states (Montana, Wyoming)
01:47 COVID cases in the US
01:59 COVID-19 hospitalizations and deaths
02:27 COVID deaths remain high
03:06 US COVID vaccination rate
04:07 Bivalent booster reduces COVID death risk by 14X, CDC data shows
05:10 New study finds heart complications caused by COVID
05:46 COVID infection increases risk for heart failure and stroke
06:45 COVID vaccines may protect against cardiovascular events, new JACC study finds
08:00 Norovirus cases rise nationwide, CDC reports
08:45 Norovirus symptoms, transmission, and treatments
10:10 Avian influenza A(H5N1)
10:59 Bird flu outbreak
11:12 Can humans get bird flu? (CDC says risk of infection is low)

Visit the AMA Update video page for more videos in this series: https://www.ama-assn.org/ama-update-v…

Content

0 ->

0.57 -> Unger: Hello and welcome to the AMA uUpdate video and podcast.

3.82 -> Today, we have our weekly look at the headlines

5.79 -> with the AMA's Vice President of Science, Medicine and Public

9.03 -> Health Andrea Garcia in Chicago.

11.47 -> I'm Todd Unger, AMA's chief experience officer,

13.71 -> also in Chicago.

14.73 -> Welcome back, Andrea.

15.84 -> Garcia: Good to be back with you this week.

18.9 -> Unger: Well, last week, we were off to attend

20.82 -> the AMA's National Advocacy Conference in D.C.

23.91 -> I hope you caught that amazing discussion with Todd Askew,

28.38 -> our head of advocacy in D.C. It's almost enough time to make

32.82 -> me forget about the subvariant XBB.1.5.

37.44 -> Andrea, what's happening out there with that?

42.04 -> Garcia: Well, if we look at the CDC variant tracker,

45.3 -> XBB.1.5 is now responsible for about 80% of COVID cases here

51.69 -> in the U.S. There's no question that it continues to be

55.5 -> the most dominant variant right now.

57.36 -> And that continues to grow week over week.

59.7 -> The last time we reported, about two weeks ago,

62.34 -> it was responsible for about 64% of cases.

65.68 -> And so with that continued dominant of XBB.1.5,

69.81 -> those same variants BQ.1.1 and BQ.1 have decreased.

74.01 -> And now, they're representing only about 16% of new cases.

78.803 -> Unger: Well, with the move to that

80.22 -> being the more dominant strain, are

81.69 -> we seeing an impact on cases?

84.39 -> Garcia: Well, if we look at the New York Times data,

86.58 -> reported cases are declining nationally,

89.79 -> but the pace of that decrease is starting

92.25 -> to slow in recent days.

94.35 -> This has been driven by rising COVID cases in about half

97.8 -> of all states.

98.85 -> If we look at Western states, like Montana and Wyoming,

102.3 -> cases there have increased about 55% in the past two weeks.

106.74 -> But nationally, we're at about 36,000 cases, on average.

110.73 -> Overall, that's a decrease of about 10%

113.19 -> in the last two weeks.

114.51 -> Unger: And what about hospitalizations and deaths?

117.66 -> How do those correspond?

120.21 -> Garcia: So on average, we're seeing about 28,800 people

124.53 -> hospitalized with COVID daily.

126.69 -> That's a decrease of about 5% over the last two weeks.

131.4 -> And hospitalizations have increased

134.04 -> in many parts of the West where cases are also increasing.

139.6 -> But we're not seeing those same increases across the board.

143.01 -> In other parts of the U.S., hospitalizations

145.53 -> have leveled off.

147.21 -> If we look at the data for deaths,

149.55 -> they remain persistently high.

151.92 -> On average, around 3,000 people are still

154.68 -> dying of COVID in the U.S. each week.

157.02 -> We're still seeing daily averages that are hovering just

160.32 -> under 400 deaths per day.

162.27 -> I think the good news that is a decrease of about 17%

165.93 -> compared to two weeks ago, but that number

168 -> is still far too high.

169.298 -> Unger: It is really high.

170.34 -> And one thing that I notice is not as high

172.98 -> is just what we hear about, the need to get vaccinated.

177.84 -> A lot of just the general chatter about that

180.69 -> seems to be at a much lower level.

183.18 -> Are we making progress in terms of getting people vaccinated?

187.358 -> Garcia: Well, not really.

188.4 -> Only about 60 million Americans have received that updated

192.87 -> bivalent booster dose.

194.79 -> And while that sounds like a big number, it's only about 16%

198.63 -> of the U.S. population.

200.25 -> And with daily deaths still high despite cases decreasing,

203.79 -> the CDC is urging everyone six months of age and older

207.18 -> to get that bivalent booster if they haven't already.

210.36 -> There was a recent CDC report that

212.76 -> revealed that bivalent booster recipients had

218.58 -> higher protection against infection

220.56 -> and significantly higher protection against death

223.83 -> than those who receive the monovalent booster

226.59 -> or were unvaccinated.

228.22 -> And that's especially true among older adults.

231.09 -> And of course, these findings are

232.53 -> consistent with previous studies that

234.24 -> found people who have not been vaccinated

237.06 -> run much higher risk of dying from COVID-19 than those who've

241.05 -> been vaccinated.

242.64 -> Unger: Andrea, tell us specifically,

245.28 -> what do we seeing from those stats?

248.49 -> Garcia: So if you take a look at this graphic from the CDC,

251.77 -> people who received the bivalent booster

254.16 -> were 14 times less likely to die from COVID than people

258.81 -> who were unvaccinated and three times less

261.839 -> likely to die than those who only

263.7 -> received the original monovalent COVID-19 vaccines.

267.78 -> All eligible people can and should

269.7 -> get that bivalent booster dose two months

271.92 -> after their COVID primary series or their last monovalent

275.61 -> booster dose.

276.6 -> And we know, for many people, it's

278.19 -> been much longer than two months.

279.93 -> And at this point, there's really no reason to wait.

283.05 -> Unger: Andrea, those are really amazing stats,

285.81 -> 14 times less likely to die than being unvaccinated?

289.62 -> Three times less likely than if you just

293.55 -> receive the original shot but not the boosters?

297.51 -> Really important.

298.99 -> And now, there's even more reason to avoid COVID.

304.08 -> We've got some evidence that it can also

306.18 -> lead to heart complications.

308.31 -> Tell us more about those findings.

311.28 -> Garcia: We've known for some time

312.96 -> now that COVID can cause damage to the heart.

315.21 -> But a new study is taking a look at some of the molecular level

319.74 -> changes that are thought to be caused by the virus that

322.86 -> can potentially lead to lasting problems,

326.13 -> such as irregular heartbeats and heart failure.

328.87 -> I think it's important to note that this research is still

331.32 -> preliminary.

332.07 -> The findings were presented earlier this week

335.01 -> at the biophysical society meeting in San Diego.

337.74 -> But they haven't yet been published

339.45 -> in a peer-reviewed journal.

341.7 -> Unger: Tell us a little bit more about how that particular study

344.55 -> was conducted.

346.41 -> Garcia: So researchers from Columbia University

349.35 -> examined autopsied heart tissue from people who had COVID.

353.46 -> And they found that the infection can cause changes

356.73 -> in the calcium channels that ultimately

359.07 -> affect how the heart beats.

360.81 -> And it can also trigger inflammation and oxidative

364.65 -> stress in the heart.

366.51 -> To study the changes further, a mouse model

369.33 -> with utilized, and the patterns observed

372.39 -> were consistent with the changes observed in human hearts.

375.84 -> The study was small, and the next step

378 -> would be to conduct the research on a larger scale.

380.86 -> But the message from researchers to physicians

383.43 -> is that doctors should be aware of changes related

387.18 -> to the heart due to COVID-19 infections

390 -> and should be looking for those changes.

391.86 -> The researchers hope that this study

394.23 -> leads to increased awareness and eventually treatments for those

398.07 -> whose hearts have been damaged by COVID infections.

401.22 -> Unger: Andrea, can getting vaccinated help

403.59 -> with that situation?

405.472 -> Garcia: Now, there's actually another new study

407.43 -> that was published this week in the Journal of the American

410.85 -> College of Cardiology.

412.44 -> It suggests that vaccination may protect

415.74 -> against major cardiovascular events,

418.38 -> like heart attacks and strokes that are associated with COVID.

422.1 -> And that study analyzed data from nearly two million people

425.43 -> in the National COVID Cohort Collaborative database.

429.75 -> Around 218,000 people had received

433.08 -> at least one dose of an mRNA vaccine or the J&J vaccine.

439.05 -> And according to the research, even partial vaccination

442.89 -> was associated with a risk of lower cardiovascular events

447.21 -> for at least six months.

449.13 -> More research is going to be needed

450.75 -> to confirm whether COVID vaccination reduces the risk

453.84 -> of these cardiovascular events.

455.4 -> But this provides good evidence and another good reason

459.54 -> to get vaccinated.

461.923 -> Unger: Thanks, Andrea.

462.84 -> Now, the last thing I think we all want to think about

465.54 -> is yet another virus that's out there.

467.32 -> But I did see something on social media.

469.325 -> It said, wash your hands and hope

470.7 -> you don't get this because we now

473.1 -> have another pretty common contagious virus that

476.4 -> seems to be on the uptick.

478.65 -> What do we need to know?

480.708 -> Garcia: Well, you're probably talking

482.25 -> about norovirus, which, as you mentioned,

484.59 -> is highly contagious.

486.63 -> Sometimes it's referred to as stomach flu,

488.85 -> but it's not actually related to the influenza virus.

493.14 -> And according to the CDC, norovirus is rising nationwide.

496.83 -> It appears to be at a seasonal high.

499.77 -> The average percent of norovirus tests coming back positive

503.88 -> is at about 17%, which is higher than at any point

508.41 -> it was in 2022.

509.94 -> And here in the Midwest, we've really

511.98 -> had the highest average of test positivity in the nation.

517.44 -> Unger: Good reason that I don't touch anything.

520.32 -> What are the symptoms?

521.966 -> I think we can guess that.

523.049 -> And how do you treat norovirus?

525.87 -> Garcia: The virus typically comes with GI symptoms,

528.27 -> like diarrhea, vomiting, nausea, stomach pain, mild fever.

532.53 -> And aches and pains are also possible.

535.95 -> Norovirus is a leading cause of foodborne illness in the U.S.

539.43 -> It spreads easily through hands, surfaces,

543.57 -> as well as through food and water.

545.25 -> And it's commonly spread through direct contact

548.67 -> with an infected person, such as by caring for them

551.46 -> or sharing food or eating utensils with them.

554.53 -> And I think it's important to keep in mind that individuals

557.37 -> with the virus can transmit it for days and even

560.55 -> up to two weeks after they're feeling better.

563.76 -> And it really only takes a few particles

566.58 -> to make you sick with this virus.

568.63 -> So as you said, take those infection control precautions.

574.74 -> There is no treatment for norovirus,

577.05 -> but the CDC does recommend drinking lots of fluid

579.69 -> to prevent dehydration.

581.31 -> And the illness typically resolves within a few days.

584.01 -> It's rare, but people can be hospitalized

586.71 -> or die in some cases.

589.74 -> Unger: I'm washing my hands in my own mind right now.

594 -> Now, let's talk yet about something else.

597 -> Another headline that's cropped up is about bird flu.

599.995 -> Now, I've been reading about that

601.37 -> since wreaking havoc across the country, certainly,

605.27 -> on the avian side.

606.38 -> But what about humans?

608.18 -> Is this something that we need to be worried about?

611.57 -> Garcia: Well, avian influenza or bird flu

613.79 -> is really getting some renewed attention that the flu virus

620.6 -> that is causing attention, it's type A. It's H5N1.

624.41 -> It's a highly pathogenic avian flu.

627.62 -> According to CDC, H5N1 viruses are well

630.89 -> adapted to spreading efficiently among wild birds and poultry.

635.27 -> And they've been detected among many regions of the world.

638.75 -> It was first identified in the U.S. in January of 2022.

643.22 -> The U.S. continues to experience outbreaks

645.62 -> in wild birds and poultry.

647.45 -> And we've seen some sporadic infections

650.75 -> in different mammals, including bears, foxes and skunks.

654.41 -> And that's been true in Canada and the U.S.

657.29 -> Unger: How worried do we need to be?

660.052 -> Garcia: Well, the virus has been detected

661.76 -> in wild birds in all 50 states and it's caused

664.64 -> poultry outbreaks in 47 states.

666.86 -> It's affected more than 58 million commercial and backyard

670.97 -> poultry flocks.

672.395 -> But to answer your question about how much we

674.27 -> need to worry, the short answer is

676.22 -> the CDC is saying the risk to the general public right now

679.94 -> is low.

681.35 -> The current outbreak in poultry and birds

683.9 -> continues to mostly be an animal health issue.

687.41 -> These H5N1 bird flu viruses do not currently

690.95 -> have that ability to bind easily to receptors

694.67 -> in the upper respiratory tract of humans

696.71 -> or to transmit among people.

699.11 -> But we're watching this closely.

701.36 -> As we know, viruses mutate.

702.95 -> That could make it more easily transmitted

704.87 -> among people in the future and potentially between people.

708.84 -> And that's the real worry, as usual.

711.44 -> We'll continue to keep an eye and provide

713.27 -> any updates as needed.

715.057 -> Unger: Well, Andrea, if there's a virus out there,

717.14 -> we know that you'll keep us updated.

718.89 -> Thanks so much for being here with us today.

722.01 -> And we'll be back with another episode soon.

724.16 -> You can find all our videos and podcasts

726.44 -> at ama-assn.org/podcasts.

729.95 -> Thanks for joining us today and please, take care.

732.2 -> [MUSIC PLAYING]

735.25 ->

Source: https://www.youtube.com/watch?v=P-WGj-vtkog