COVID-19 Update: Fauci Testifies, Cases Hit New Records

Victoria Giardina

June 23, 2020

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

Here are the coronavirus stories Medscape's editors around the globe think you need to know about today:

Fauci Testifies: More COVID-19 Testing to Come

US public health officials said in testimony before a Congressional committee that they plan to increase COVID-19-testing efforts and have not been ordered to slow down, despite claims from President Donald Trump that he had given such orders

"None of us have ever been told to slow down on testing," said Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases. "We're going to be doing more testing, not less," he said, adding that more testing, specifically enough to conduct surveillance, is necessary, "if you want to get your arms around and understand exactly what's going on in community spread."

The United States has now performed about 27 million COVID-19 tests, averaging 500,000 tests per day, said Admiral Brett P. Giroir, MD, Assistant Secretary for Health at the US Department of Health and Human Services. Giroir, who coordinates testing for the federal government, said the aim was to conduct 40 to 50 million tests a month by the fall.

Record-High Cases in Texas, Arizona, Nevada

Early this week, Texas, Arizona, and Nevada reported record-high numbers of new COVID-19 cases in a single day. Texas reported more than 5000 new cases on Monday, a single-day record for the state. Also, Louisiana reported 1300 cases on Tuesday — its highest number since April 7. 

The World Health Organization (WHO) also on Monday reported COVID-19 resurgences in countries that had previously suppressed transmission, such as South Korea, which announced that it is in the midst of a "second wave" of infections around Seoul. Countries reported more than 183,000 new cases to the WHO on Sunday, the organization said, the highest number for a single day yet.

Flu-COVID "Collision" Projected for Fall

Public health and infectious disease experts caution that the United States needs to increase its influenza vaccination rate substantially in the fall to mitigate the potential coupling of COVID-19 with the seasonal flu. The typical proportion of people who get the flu shot — 40% to 50% — should be higher, they say, especially without a COVID-19 vaccine.

"When you have a collision of these two things happening at the same time, I think we're going to be in real trouble," the chief of the infectious diseases division at Massachusetts General Hospital, Boston, told Medscape Medical News . The Centers for Disease Control and Prevention (CDC) confirmed it is planning a major public awareness campaign this year to raise the percentage of people who get flu shots.

Higher COVID-19 Hospitalizations for Black Americans

Black Americans enrolled in Medicare are four times more likely than white Americans to be hospitalized for COVID-19, according to data from the Centers for Medicare & Medicaid Services (CMS), which outlined prominent racial disparities in health outcomes during the pandemic.

"The disparities in the data reflect long-standing challenges facing minority communities and low income older adults," CMS Administrator Seema Verma said.

Black Americans had a hospitalization rate of 465 per 100,000 black Medicare beneficiaries, while per-capita hospitalization rates were 258 for Hispanics, 187 for Asians, and 123 for whites.

ED Visits for Life-threatening Conditions Declining

Emergency department (ED) visits for myocardial infarction (MI), stroke, and hyperglycemic crisis dropped considerably in the 10 weeks following March 13, the date COVID-19 was declared a national emergency, CDC scientists report. Compared with the previous 10 weeks, ED visits were down by 23% for MI, 20% for stroke, and 10% for hyperglycemic crisis.

"Deaths not associated with confirmed or probable COVID-19 might have been directly or indirectly attributed to the pandemic," the CDC investigators reported. "The striking decline in ED visits for acute life-threatening conditions might partially explain observed excess mortality not associated with COVID-19."

COVID-19 Threatens Patients With COPD

Even if they dodge COVID-19, individuals with chronic obstructive pulmonary disease (COPD) could experience diagnostic and treatment delays during the pandemic, physicians worry. One big concern: shortages of medications such as albuterol inhalers.

"Generic medications are key to access for patients with chronic lung disease, so once the generic albuterol becomes available, this should help with access," said one pulmonologist. "In the meantime, some companies help provide medications at reduced cost, but usually only on a short time basis. In addition, some pharmacies have lower-cost albuterol inhalers, but these are often not supplied with a full month of dosing."

Dexamethasone RECOVERY Trial Published

The United Kingdom's RECOVERY trial on dexamethasone treatment of severely ill COVID-19 patients is now published as a preprint. Investigators described the treatment as a "major breakthrough" in their announcement of the results last week. 

Based on the preliminary information, UK hospitals implemented the drug as a standard treatment for COVID-19 patients receiving oxygen or mechanical ventilation. In the United States, some hospitals had not yet changed protocols based on the announced results.

In Memoriam

As frontline healthcare workers care for patients with COVID-19, they commit themselves to difficult, draining work and also put themselves at risk for infection. More than 1500 throughout the world have died. 

Medscape has published a memorial list to commemorate them. We will continue updating this list as, sadly, needed. Please help us ensure this list is complete by submitting names with an age, profession or specialty, and location through this form

If you would like to share any other experiences, stories, or concerns related to the pandemic, please join the conversation here.

Victoria Giardina is Medscape's editorial intern. She has previously written for "The Dr. Oz Show" and is currently a National Lifestyle Writer for Her Campus. She can be reached at vgiardina@webmd.net or on Twitter @VickyRGiardina.

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