vaccine. after lunch in 25 or 30 minutes or so, they will hear from the public about their concerns over the pfizer vaccine. pfizer officials will present their case for an emergency use authorization at 1:00 p.m. eastern. that will be followed by the fda's response at 2:00 p.m. and the committee discussion, followed by the vote starts at 3:10 eastern. we will resume live coverage when they return here on c-span3. until they return, we are going to show you from earlier the fda panel presentation on the epidemiology of covid-19. >> as of december 8th, over 14.8 million covid-19 cases and over 280,000 associated deaths have been reported in the united states.

the peak was driven by activity in the new york metro area, inc activity across much of the southern u.s. since mid-september daily counts of new cases have again been on the rise with even sharper increases since mid-october. in submission of these slides in advance of this meeting we have now surpassed 15 million cases, and 285,000 deaths nationally, with over 200,000 new cases, and over 2,500 new deaths reported yesterday. in addition to reported cases cdc uses several other systems to track the pandemic, which are compiled in the weekly surveillance summary called covid view. this weekly report includes the percent positivity of molecular tests for sars-cov-2, the virus

that causes covid-19, shown in blue, as well as syndromic surveillance for covid-19 like illness among ambulatory patients shown in red. both of these leading indicators have been increasing since september. also included in covidview are weekly hospitalization rates shown in gray which are currently at the highest point since the beginning of the pandemic. and also the percent of deaths due to covid-19, influenza, or pneumonia based on death certificates shown in green, both of which are lagging indicators that have been increasing since october. one component of the weekly covidview report is an assessment of covid-19 hospitalizations through covid net. covid net conducts hospitalization surveillance in 14 states, representing about 10% of the u.s. population.

patients must be a resident of the surveillance area and have a positive sars-cov-2 test within 14 days prior to or during hospitalization. data are updated weekly on an interactive website. while focused on the more severe end of the illness spectrum, covid net provides active population-based surveillance, thus overcoming some of the biases with past surveillance and robust data on the epidemiology of covid-19. looking at weekly hospitalization rates by age we see that each of the peaks in april, late july and currently have been most pronounced among adults aged 65 years and older. hospitalization rates in children have been considerably lower than those among adults, but have remained stable or increasing since the spring. note that the last few data

points are subject to reporting lag, and may increase subsequently. looking at the cumulative hospitalization rates through late november from covid net and stratifying by age group we see a strong increasing trend with increasing age. as of november 28th adults aged 65 years and older had a cumulative rate of 756 per 100,000, which is roughly equivalent to one in every 130 people in this age group being hospitalized with covid-19. this rate is approximately 4.5 times greater than that of adults aged 18 to 49. covid net surveillance has also helped to identify significant racial and ethnic disparities in the rates of covid-19. shown here are age adjusted cumulative hospitalization rates by race and ethnicity,

demonstrates rates are three to four times greater among persons that are hispanic or latino, non-hispanic american indian or alaska native or non-hispanic black or african-american compared with those non-hispanic white. these disparities are likely -- prevalence of underlying medical conditions, access to care and other socioeconomic factors. to help further keep apart these issues and identify risk factors for severe covid-19 cdc and public health partners analyze the relative rates of in hospital mortality from covid net using models that adjust for age, sex, race and ethnicity, smoking and several underlying medical conditions. as shown in the red box, older age was the strongest independent risk factor for in hospital deaths and the risk increased with increasing age.

other characteristics significantly associated include male sex, renal disease, chronic lung disease, cardiovascular disease, neurologic disorder and diabetes. combining data from covid net with population-based data from the behavioral risk factor surveillance system, we like wise developed models to assess risk for covid-19 hospitalization. among adults with specific underlying conditions. again, after adjusting for age, sex and race and ethnicity, the risk for covid-19 associated hospitalization was greatest for adults with severe obesity, chronic kidney disease and diabetes, as shown in the red box. compared with adults without these conditions, those that have them were three to five times more likely to be hospitalized for covid-19.

furthermore, the risk of covid-19 hospitalization increased with the number of underlying medical conditions, as shown in the red box on this table. while specific risks varied depending on the specific underlying medical condition, adults with three or more conditions had five times the risk of covid-19 hospitalization, compared to adults with no conditions. due to increased age, underlying medical conditions, and the congregant living situation, residents of long-term care facilities have been disproportionately impacted by covid-19. as shown here residents of these facilities comprise nearly 50% of covid-19 hospitalizations among adults aged 75 to 84 years, and nearly two-thirds of covid-19 hospitalizations among adults aged 85 years and older.

as such the advisory committee for immunization practices or acip recently recommended long-term care facility residents as a priority group to receive initial doses of covid-19 vaccines once approved. similarly, health care personnel have been prioritized for vaccination to preserve capacity to care for patients with covid-19 and other illnesses. again, based on covid net data, 6% of adults hospitalized with covid-19 were health care personnel, with nursing related occupations being most frequent. health care personnel hospitalized with covid-19 had similar prevalence of underlying medical conditions, most notably obesity, as that observed among adults hospitalized with covid-19. all adults. likewise, a similar proportion of severe clinical outcomes, including icu admission,

mechanical ventilation and death occurred among health care personnel as that across all adult covid-19 hospitalizations. as we prepare for covid-19 vaccines it's important to establish baselines to assess their future impact and maintain ongoing assessments of the total burden of sars-cov-2 infections in the u.s. to that end cdc has implemented a nationwide prevalence survey to help track the number of people with evidence of previous sars-cov-2 infection, including milder infections that do not result in care seeking or testing for acute infection. these involve biweekly testing of approximately 50,000 residual specimens from commercial laboratories for antibodies against sars-cov-2. through the first few rounds of this survey, estimated prevalence has ranged from 0.4

to 23% across u.s. jurisdictions. however, as of late september less than 10% of specimens from most jurisdictions have evidence of previous sars-cov-2 infection. in general, the highest prevalence was observed among children and adults aged less than 50 years, and lowest among older adults, aged 65 and older. using the different multiplier modeling approach, which uses reported cases and other data sources to then account for underdetection and underreporting, cdc recently released estimates of the total number of hospitalizations, illnesses, and infections with sars-cov-2 in the u.s. this analysis estimated that one of every 2.5 hospitalized cases and one of every 7.1 nonhospitalized cases may have been nationally recorded.

applying these multipliers to reported cases through the end of september you'll do a national estimate of 2.4 million hospitalizations, 44.8 million illnesses, and 52.9 million total infections. as the figure to the right shows, most estimated hospitalizations occurred among older adults while most illnesses and infections were among younger adults. so in summary now as of december 9th over 15 million cases and over 285,000 deaths associated with covid-19 have been reported in the united states. however, based on prevalence surveys and models the total estimated number of infections is likely two to seven times greater than reported cases. though, less than 10% of the population in most states had evidence of previous infection

through september. factors associated with increased risk for severe covid-19 include older age, racial and ethnicgroup membersh specific underlying medical conditions. ongoing surveillance in studies will further developments and implementation of candidate vaccines, including assessment of their impacts, safety, and effectiveness. lastly, even with the promising advent of covid-19 vaccines, there's continued need for nonpharmaceutical interventions, including mask use, physical distancing, hand hygiene, and environmental disinfection to bring an end to this devastating pandemic. finally, i'd like to acknowledge the thousands of health care professionals who have worked tirelessly on the cdc covid-19 response, including the dedicated staff from the respiratory viruses branch. thank you.

>> covid -- i think i wasn't -- i wasn't on at first. thank you so much for being clear about the differential impact of covid-19 and the u.s. population. we have time for relatively few questions. i see dr. misner, do you have your hand raised? >> yes, sir. thank you very much for that presentation, doctor. i would like to ask you about the severity of disease, particularly in older

adolescents, that is, individuals who are 16 and 17 years of age, because they have been included in the company's request for an eua. i assume it's unlikely that hospitalizations and disease are broken down by age, but is it safe to assume that adolescents who are 16 and 17 years of age are similar in the five tr5 thr 17-year-old age group? >> thank you for that quell. so of course as we refine to smaller and smaller age brackets, the numbers get smaller, particularly in children where overall we see lower rates, particularly of severe disease of hospitalization. in general, we do see higher

rates of hospitalization among children aged 0 to 5 relative to those aged 5 to 17. of course this is potentially confounded by differential rates of care seeking. there are certainly lower thresholds for care seeking for the youngest and most vulnerable children. however, as we start to look at the more mild end of the illness spectrum and look at rates of dedication of sars-cov-2 virus using molecular, we see an indication of higher rates of infection among older children, among adolescents, particularly as we look at older teenagers and people in their young 20s. much of this may have been driven in part by outbreaks in the fall among institutes of higher education. but the broader impacts in children perhaps are not

entirely clear until the full resumption of normal activities ensues in the united states, including in-person education across all schools in the united states. so we'll continue to monitor closely, but thus far, the indication the highest rates of illness, severe illness in young children, but higher rates of infection in older children. >> thank you. >> dr. reuben? >> thanks, dr. hall. i was interested in the multiplier that you described that applies to the diagnosis of infection. do you think that applies to deaths as well? >> yeah, so we have used at cdc the same multiplier model previously for tracking

influenza and generating inseason estimates of the disease burden. that same approach has been used previously to estimate deaths in the same manner that i presented today for hospitalizations and milder illness. there are, of course, differential multipliers that would have to be considered for deaths as the rates of underreporting of death are different than those for milder infection. in general, we have better capture of deaths. we have lower rates of underreporting and underascertainment for death. as folks are aware, the dynamics of the pandemic itself have greatly changed those multipliers, so there's a considerable time component that needs to be factored in when using these multiplier models. so the underreporting of deaths, for example, has changed over time, and the aboutbution has changed. but we have several efforts

under way using these nolgtsds generate estimates of death. we do feel as with hospitalizations and illnesses that the reported number of deaths is likely an underestimate of the true number of deaths. >> thank you. >> thank you. dr. ganz, we're going to go over a little bit, but please keep your questions short. >> thank you very much. thank you for that. and i agree, heroic effort to all of the people who are working on this. i had two quick questions. the data concerning the imimmunosuppressed individual is not enough to use in terms of how we're thinking about high-risk populations. there are registries looking at this, but it would be nice to

have national information you could provide to us. i didn't see information from pregnant women, which is a population which we're all concerned about and we've definitely seen post-natal contraption to young infants who've been hospitalized. if you would just take those up. >> thank you for those comments. absolutely there are numerous surveillance efforts currently under way to assess the impacts of covid-19 in pregnant women. in the interest of time, unfortunately, i didn't have a chance to describe those. another surveillance system called set met, which was established during the zika epidemic, we have been very closely monitoring the impacts of covid-19 in both pregnant women and subsequently following up. the rates have been relatively low thus far, but as we amass

data, we hope to have more specific estimates of the risks that are posed to pregnant women and their infants. the early indication is there may be a higher risk of preterm delivery among pregnant women infected with covid-19 relative to women without covid-19. but there's ongoing efforts to assess those and other potential pregnancy read it risks and fetal outcomes. >> thank you very much, dr. hall. >> the food and drug administration's committee of external experts is meeting today to determine if the pfizer biontech covid-19 vaccine is safe enough for an emergency use authorization. shortly they'll hear testimony from members of the public followed by pfizer's presentation on the vaccine. later, the panel will debate and vote on authorization. we'll have live coverage when they resume