AMA Update: Key Health Care Insights
The AMA Update delves deep into critical health care topics that significantly impact the lives of physicians, residents, medical students, and patients alike. This wide-ranging coverage includes perspectives from various experts in the medical field, spanning private practice leaders, health system executives, scientists, and public health authorities. Topics discussed encompass pressing issues such as COVID-19, medical education, advocacy challenges, burnout among health professionals, vaccines, and other vital areas.
Featured Topic and Speakers
Is it safe to indulge in McDonald’s menu items? How accurate are expired COVID tests? Where can one conveniently procure at-home COVID test kits? Are we facing the risk of human-to-human transmission of bird flu? The AMA’s Vice President of Science, Medicine and Public Health, Andrea Garcia, JD, MPH, illuminates these concerns, including insights on the recent E. coli outbreak linked to McDonald’s, potential symptoms of bird flu in humans, and guidelines concerning at-home COVID-19 tests and their usage. This episode is hosted by AMA Chief Experience Officer, Todd Unger.
In-Depth Discussion
Unger: Hello and welcome to the AMA Update video and podcast. Today, we have our weekly recap of the headlines, featuring insights from Andrea Garcia. Todd Unger: Andrea, it’s a pleasure to see you again. Garcia: Likewise! Thanks for having me. Unger: This episode of the Update covers several topics: bird flu concerns, new COVID and flu testing advancements, and even Quarter Pounders. It’s a unique mix, to say the least. Let’s kick things off with the bird flu issue. When we last spoke, we were awaiting the results of blood work regarding a potential human transmission case in Missouri. Do we have any updates on that front?
Garcia: As a reminder, the Missouri patient represents the first confirmed case of H5 bird flu in the U.S. without any evident contact with infected animals. The serology tests we were anticipating were specialized assessments conducted by the CDC aimed at detecting antibodies in individuals who had close interactions with that patient, including both healthcare providers and a household member. Thankfully, all five healthcare professionals tested negative for H5 in every assay conducted, indicating no infection with the bird flu. One of the household contacts displayed some antibody immune response evidence, albeit not across all serological tests, suggesting a possible but unconfirmed exposure to H5.
Unger: That’s a bit intricate. What is the key takeaway from these findings? Are we clear of concerns regarding human-to-human transmission?
Garcia: Based on the CDC’s assessment, the evidence gathered from these tests effectively rules out person-to-person spread between the Missouri patient and those medical personnel. The symptoms expressed by these contacts did not stem from exposure to that patient. Correspondingly, the household contact and the patient had similar immunologic outcomes and symptom onset dates, implying a shared exposure to bird flu rather than direct transmission. During a CDC briefing, officials noted that the household contact wouldn’t be classified as an official case, as they did not meet the infection testing criteria outlined by the CDC and WHO. Currently, we have recorded 36 reported cases of H5 infections in the U.S. for 2024. The results from Missouri have been seen as positive news by infectious disease experts, reinforcing that bird flu isn’t spreading in a sustainable manner among humans, though questions remain unanswered.
Unger: To summarize, while there’s relief about the absence of human-to-human transmission evidence, multiple questions still linger. Can you clarify which specific questions are being raised?
Garcia: Certainly. The two individuals who tested positive for H5 in Missouri didn’t exhibit standard flu symptoms; rather, they experienced gastrointestinal issues like diarrhea, which initially led investigators to suspect possible food poisoning. Experts are puzzled over whether the H5N1 virus played a role in those symptoms or if they were dealing with concurrent infections. Additionally, we still don’t know how the patient and their household contact initially contracted the virus.
Unger: As time progresses, especially heading into the autumn and winter seasons, isn’t it likely to become increasingly challenging to identify these cases?
Garcia: Indeed, it is plausible. Although testing options for bird flu are expanding, making them available through several commercial labs, including Quest Diagnostics, the chances of detecting specific cases may lessen as respiratory viruses gain traction this fall and winter. The CDC will persist in monitoring unfamiliar activities. Moreover, while influenza A H5 can sometimes be detected through wastewater analysis, it has its limitations; once detected, it doesn’t specify the source, which could range from a person to livestock or even contaminated milk discarded into the environment. The most impactful action anyone can take currently is to get vaccinated if they are eligible. The AMA recently emphasized this message, urging prompt vaccination against flu, COVID, and RSV, as timely measures can help curtail virus spread in communities.
Unger: That’s a significant reminder, and we appreciate the information. Looking ahead, we plan to speak with Dr. Sandra Fryhofer next week regarding the expanded guidelines for some of those vaccines. Andrea, tell us about the new at-home testing options that are becoming available, particularly as we approach the colder months.
Garcia: The new at-home test kits function similarly to traditional at-home COVID tests. You simply swab your nostril’s inner surface, immerse it in a solution, and then apply droplets onto a test strip, with results expected in approximately 15 minutes. Like the original at-home COVID tests, these combination tests perform best if you exhibit symptoms and are only marginally more expensive than standard COVID tests, priced around $30 for a pack containing two tests. These combination tests are set to play an essential role as we transition into peak viral season. However, it is vital for people to know about their existence, have access to them, and understand their proper usage.
Unger: Regarding the efficacy of these at-home tests, what are the general expectations?
Garcia: Their effectiveness mirrors that of existing COVID-only testing, which the FDA has determined should reliably identify the virus approximately 80% of the time when someone is indeed infected. Most of the newly available tests are antigen-based, targeting specific viral proteins. There is also a molecular test manufactured by Pfizer that is more sensitive due to its focus on detecting genetic material. This particular test is on the more expensive side, around $40. These tests are bound to contribute significantly, enabling individuals to determine early in their illness which infection they may have, facilitating timely and appropriate treatment.
Unger: Indeed, early treatment is crucial, particularly for COVID and flu cases. Thanks for shedding light on that, Andrea. Now, switching gears to a pressing issue that has made headlines recently: the E. coli outbreak linked to McDonald’s. Can you elaborate on the current situation?
Garcia: In a statement over the weekend, McDonald’s revealed that the contaminated slivered raw onions had come from a Taylor Farms facility located in Colorado Springs. These onions were distributed to an extensive network of about 900 restaurants across 12 states. McDonald’s has since removed all slivered onions produced by this facility as of October 22 and has decided to cease sourcing onions from there indefinitely.
Unger: What specifics do we have about those affected by this outbreak? Is there an anticipation of more reported cases? You’ve mentioned the removal of those onions—what additional developments are in the pipeline?
Garcia: The CDC has reported that individuals falling ill between September 27 and October 10 are aged between 13 and 88 years. At least 22 individuals have been hospitalized, with two suffering from severe conditions that could result in kidney failure. Tragically, one older adult in Colorado with pre-existing health conditions has died. Unfortunately, we anticipate additional cases. Numerous individuals recover without seeking medical attention or undergoing E. coli testing. Moreover, it typically takes about three to four weeks to ascertain if a sick person is part of a larger outbreak. Consequently, the CDC has assessed the ongoing risk to public health as very low. Nevertheless, this situation underscores a broader, persistent challenge in ensuring fresh produce remains uncontaminated. Unlike meat products, bacteria in fresh produce cannot be eliminated through cooking. Certain experts recommend steering clear of typical bacterial suspects, such as sprouts, bagged salad greens, and cantaloupe, to avoid illness.
Garcia: The crucial takeaway is that the more an item is handled and processed from farm to table—like slicing, pre-washing, or ingredient addition—the greater the likelihood of bacteria introduction and dissemination. This emphasizes the need for robust food safety measures and strategies to prevent foodborne illnesses.
Unger: We will remain vigilant in monitoring developments concerning this situation as we near the holiday season. To conclude this week’s episode, I want to extend my gratitude to you, Andrea, for your insights and for sharing this crucial information. If you found today’s discussion beneficial, consider supporting our work by becoming a member of the AMA at ama-assn.org/join. Additionally, you can access all our videos and podcasts at ama-assn.org/podcasts. Thank you for joining us today. 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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