Vast majority of the youngest Americans remain unvaccinated against COVID

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(NEW YORK) — It has now been two months since the start of the COVID-19 vaccine rollout for the youngest Americans, and despite some initial enthusiasm from a select group of parents, the vast majority of children under the age of 5 remain completely unvaccinated.

About 941,000 children, under the age of five have now received their first shot of a COVID-19 vaccine, newly updated federal data shows. The overall total represents approximately 4.8% of the 19.5 million U.S. children in that age group.

Just 182,000 of those children, or less than 1%, have been fully vaccinated.

When broken down by age group, data shows that the majority of children under 5 who have received at least one shot are between the ages of 2 and 4 — 682,000, compared to just 259,000 children under the age of 2.

Preliminary data reported by states shows that several states in the Northeast currently have the highest share of children under 5 vaccinated with at least one dose. Washington, D.C. continues to lead the nation with nearly 15% of its jurisdiction’s children under 5 vaccinated with their first shot, followed by Vermont (10.4%), and Massachusetts (6.87%).

Mississippi has the lowest percentage of children under 5 vaccinated, with 0.47% of children with their first shot, followed by Alabama (0.64%) and Louisiana (0.79%).

The overall totals, thus far, are notably lower than prior predictions, which had already suggested the initial rollout would be sluggish.

A recent Kaiser Family Foundation COVID-19 Vaccine Monitor survey found that many parents remain reluctant to vaccinate their young children.

As of July, 43% of parents with children ages 6 months to 4 years old said they will “definitely not” get their child vaccinated against COVID-19. In comparison, when polled in April, 27% of parents had stated they would “definitely not” get their child vaccinated against the virus.

Thirteen percent of parents said they would only inoculate their child, if required, and 27% reported they were waiting to see whether to vaccinate their child.

Only 7% of parents reported they got their child vaccinated right away, while another 10% of parents said that they were still planning to get their child vaccinated “right away.”

However, some officials have said that more children, particularly those under 5, may be vaccinated as the rollout continues, and they visit their pediatrician for their annual visit.

To date, about 29.6 million children ages 17 and under have received at least one COVID-19 vaccine dose. However, data also shows that just under 43.4 million eligible kids are still completely unvaccinated.

Less than a quarter of eligible children, ages 5 to 17, have also been boosted.

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Why rape exceptions in abortion bans are more complicated in reality

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(NEW YORK) — Since the Supreme Court’s reversal of Roe v. Wade in June, several states have enacted strict abortion bans.

At least 15 states have ceased nearly all abortion services and an additional four states have bans that have been blocked in court and are undergoing legal challenges.

Despite an ABC News/Washington Post poll finding 79% of Americans support making abortion legal in exceptions of rape, only four states with active bans allow for such exceptions, according to the Guttmacher Institute, a research group focusing on sexual and reproductive health.

Proponents of anti-abortion bills have argued that a fetus should not be “punished” because of the crime and be allowed a chance to be born, but they are trying to help women find some recourse after suffering through a horrific act.

But abortion rights advocates and experts told ABC News it’s more complicated than that. They say that while such exceptions do help prevent a pregnant person from living through the trauma of giving birth to their rapist’s baby, they say the exceptions may work in theory but not in reality.

They explained some of the language in these laws make it unclear how a provider is supposed to validate a patient’s accusation of rape, or the providers may be scared to act due to fear they will be prosecuted if they act outside the law.

Additionally, they say women may be too scared to come forward when they’ve been raped, or if they do and are required to report the assault to the police, may experience additional trauma by having to relive the crime.

“It’s not whether there’s simply a law that happens to be on the books,” Michele Goodwin, a law professor at the University of California, Irvine, whose expertise includes health law and reproductive rights, told ABC News. “It’s whether the law is more real than illusory. For so many of the exceptions that are being drafted now, what you have is not entirely meaningless but so difficult to navigate that they essentially become kind of a fool’s gold.”

She added, “One can have rights on paper, but they become very useless and lack meaning until they’re placed in practice.”

Of the states with abortion exceptions for rape, three — Georgia, Idaho and Mississippi — require a police report to be filed before requesting an abortion.

Oklahoma also has an abortion ban, HB 4327, signed by Gov. Kevin Stitt in May with exceptions for rape that requires a police report as well. However, the state has passed multiple contradictory abortion bills in the past year including one a month earlier that Stitt signed, which does not have exemptions for rape or incest.

State Rep. Jim Olsen said the exceptions for rape were added because the bill allowed anyone who “aids or abets” an abortion to be sued for up to $10,000 in damages but lawmakers didn’t want the rapist to be allowed to sue.

However, he believes that generally abortion bans should not include exceptions for rape.

“It is not the baby’s fault the circumstances of their conception, if it was something as horrible as that,” he told ABC News. “The baby has the same right to life that you and I have. And again, it’s not the baby’s fault the circumstances of their conception.”

Olsen continued, “Now, rape is a horrible, horrible, horrible crime and somebody needs to be punished for that. But it shouldn’t be the baby. It should be the rapist who gets punished for it.”

Most sexual assaults are not reported

However, most rapes are not reported to the police. In fact, according to the Rape, Abuse & Incest National Network, two out of every three sexual assaults go unreported.

Elizabeth Nash, interim associate director of state issues at the Guttmacher Institute, said there are several reasons why someone might not report their rape – especially if they’re pregnant – including fear of retribution from the rapist [or the person who raped them], fear people won’t believe them or fear of ostracization from their community.

“When you combine the need to report in order to access an abortion, you’re really putting a barrier in place for someone to get the abortion that they need,” she told ABC News.

Goodwin said having to report the assault can be like a second trauma for a victim of rape.

“There is tremendous trauma that can result from being pregnant when one does not wish to be that is only magnified after one has been raped, becomes pregnant, and due to that rape, and then has to go through the interrogation,” she said. “Because, when a person, when a woman, when a child files a report about being raped, it’s not as if someone presents them with a comfortable environment. Instead, questions are asked, and those questions without the proper training and sensitivity can be quite harsh.”

Experts say abortion providers may be unsure how to proceed in exceptions for rape. Although the laws require a police report to be filed, it’s unclear if anything specific needs to be in the report or if the victim needs to take any other steps.

“It’s not entirely clear what all is required or if providers will be able to meet the letter of the law in providing an abortion under the rape exception,” Nash said. “There’s this concern that if a provider tries to meet the requirements of the exception that, in some way, they will fall short and then the state will prosecute them in some way.”

She said these exceptions could potentially dissuade providers from performing abortions under the rape exception for fear of potential prosecution or lead to clinics moving their services across state lines where abortion access is freer.

For example, even though North Dakota’s abortion ban, which includes an exception for rape, is currently blocked in court, the state’s sole abortion clinic — the Red River Women’s Clinic located in Fargo — said it will be providing abortions in Minnesota.

“Abortion is still legal in North Dakota, for now,” the clinic wrote on its website. “However, Red River Women’s Clinic has made the commitment to continue to provide abortion care to our region, so we have moved our services across the river to Moorhead, MN.”

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WHO monkeypox expert details challenges, next steps in emergency preparedness

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(NEW YORK) — The monkeypox outbreak continues to grow globally with over 14,000 cases in the U.S. alone, according to the U.S. Centers for Disease Control and Prevention.

Dr. Rosamund Lewis, the World Health Organization’s Technical Lead for the monkeypox outbreak, spoke with “ABC News Live” Thursday about the latest updates and what health agencies are doing to combat the spread.

ABC NEWS: Thank you so much for your time tonight, Dr. Lewis. Big picture is the World Health Organization’s thinking about declaring monkeypox a pandemic.

LEWIS: At the moment, the situation is that there are 38,000 cases of monkeypox in the world reported.

It certainly is a concerning figure that the number of cases continues to rise. On the 23rd of July of this year, the World Health Organization declared a public health emergency of international concern. This is under the international health regulations, and it is the highest level of alert the WHO can already declare. So, we are on alert and doing everything possible.

ABC NEWS: So focusing a little bit on the U.S., [which] accounts for about a third of all cases worldwide. Why do you think that is?

LEWIS: There are a number of countries that have concerning situation. So, at the moment there are other countries in the Americas that are also seeing steep increases in the number of cases. And part of that may be the spread of the virus. Another component may be increasing access to testing. There are countries in Europe that began their outbreak earlier and they are already beginning to see some sort of leveling off of the new cases being reported.

ABC NEWS: Dr. Lewis, when you speak about control, 98% of the cases have been among men, almost all of whom are men who have sex with other men. How can you balance the need to warn gay men that they’re at higher risk without stigmatizing them?

LEWIS: It’s a really fine line to walk and it’s a really most important question, so thank you for that. It’s the most important work that any public health agency can be doing right now and working with community organizations of people who are affected by this outbreak. Contributing to stigma is not a solution and not for anyone. Because what happens with that is it actually undermines the outbreak response. Contributing to stigma, in any way, may drive people away from testing, [and] drive people away from seeking vaccines. They may even drive people away from seeking care. And so in that way, the outbreak can continue to spread.

ABC NEWS: To your point that all segments of the population feel supported, we would like to do a quick rapid fire round through some of the common questions that people may have. I hope you’re okay with that. First up, can the virus be spread among people with no symptoms?

LEWIS: This is something we don’t know yet. We do know that people can have infection without symptoms, but it is not yet known whether they can spread it at that time. That’s another area that we’re monitoring very closely.

ABC NEWS LIVE: Can you get infected twice?

LEWIS: This has occurred. People have been infected more than once. We don’t know yet how often this might happen.

ABC NEWS LIVE: And what are the first signs of infection?

LEWIS: So the first symptoms have been fever, feeling unwell, backache, muscle aches, and then followed by a rash. And now we’re seeing right now sometimes that is flipped around. Sometimes people are having a rash and then followed by fever or other symptoms, and the rash can be milder or can be more severe. We are basically seeing a whole range of how this disease can present right now.

ABC NEWS LIVE: Lastly, Dr. Lewis, with schools starting across the globe, there is a concern about cases starting to spread more among children. What do people need to know in that context?

LEWIS: So this pattern, as you described, has been very consistent. And the folks who are at higher risk and need to figure out what information, they need to protect themselves are people who are having predominantly multiple sexual partners.

It doesn’t have to be only men. It can be other groups who may be having active sexual activities with people that they don’t know so well or in situations where they’re multiple partners at once. So this could happen on a college campus, for example. Obviously, we’re talking about young people here.

The risk to children is really quite low at the moment because the spread in general population has not really manifested; it’s not taken off. We have seen some children exposed in different ways, but the numbers are really very small at the moment. Usually, that happens in a household setting and that is typical. That is very common.

It’s always been known that people can transmit through hugging, kissing, whether that be household members who also share towels, for example. And so historically, for monkeypox, that has been described as the mode of transmission-close proximity in the household.

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Less than 60% of kids are vaccinated against polio in some NYC neighborhoods

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(NEW YORK) — Some of New York City’s area have less than 60% of kids fully vaccinated against polio, according to data from the city’s Department of Health.

Just last week, officials found traces of the poliovirus in the city’s wastewater system. Officials believe the virus has been in the system since April.

This comes after an unvaccinated Rockland County man tested positive for polio and displayed symptoms of paralysis.

According to the DOH data, the Williamsburg, Battery Park City and Bedford-Stuyvesant/Ocean Hill/Brownsville zip codes all report a vaccination level under 60% for children 6 months to 5 years of age.

The Brooklyn neighborhoods that show low vaccination rates in young kids are linked to the Hasidic Jewish populations that have become increasingly adamant against vaccinations, experts say.

The overall New York City polio vaccination rate for that age group is 82.6%, according to the DOH.

Experts say the rates in low-vaccinated neighborhoods are alarming because unvaccinated populations will allow a greater spread, opening the way for more severe cases.

Adam J. Ratner, director of pediatric infectious diseases at NYU Langone Health, told ABC News that 75% of those infected with polio have no symptoms. Another 20-25%, he said, will experience mild symptoms such as fatigue or low fevers. Less than 1% of polio cases are paralytic, according to the CDC.

Because of the rarity of the Rockland County case, experts believe many individuals must have been infected in the area to lead to the paralytic case.

“When we see one case of paralysis, that very likely means that several hundred people have actually been exposed and infected with the polio virus,” Roy M. Gulick, chief of the Weill Cornell Medicine Division of Infectious Diseases, told ABC News.

New York state has some of the strictest vaccination requirements for schools across the nation. In 2019, the state eliminated all nonmedical exemptions for required vaccinations in schools, including the three-dose vaccination for polio.

So, how are so many young children in New York City unvaccinated?

Experts say there are two main factors: the COVID-19 pandemic and the spread of misinformation.

The pandemic had multiple effects on vaccination status, according to experts, including the fact that kids weren’t physically in school, so vaccination enforcement was essentially paused, and that parents weren’t taking their kids to the doctor for routine checkups and immunizations due to lockdowns.

Ratner said that despite the harsher requirements established in 2019, many communities are still playing “catch-up,” particularly because parents faced less pressure to take their kids to the doctor for routine vaccinations during remote learning.

Part of why today’s parents are not so worried about getting their kids vaccinated is because people have forgotten how terrible the virus actually is, Ratner and Gulick both said.

Practically all adults in the U.S. are vaccinated against polio because their parents watched the destruction of rampant polio in the 1950s, Gulick said.

“People may have heard of it, but others will have not,” Gulick said. “It’s the older people who remember it well, about how transmissible it was, the fear of getting polio and the dreaded complications in terms of paralysis.”

Parents today take the vaccine for granted, Gulick said. The other part, though, is misinformation.

“I’m thinking specifically of Orthodox Jewish communities in in Brooklyn, where there are some Orthodox Jewish groups that have very high levels of vaccine hesitancy,” Ratner said. “I think that the Orthodox Jewish community has unfortunately been directly targeted by anti-vaccine groups that have spread misinformation in the community, which is unfortunate.”

Walter Orenstein, a polio expert at Emory University and former director of the United States’ National Immunization Program, told ABC News that these communities have been plagued by anti-vaccination groups spreading allegations of danger with vaccines.

Orenstein said it’s all about finding “the right messenger to give the right message” when it comes to battling misinformation.

“We need to work with them, to better understand what vaccines are, how they work and all the efforts that are made to assure they’re not only effective, but safe before they’re made available,” Orenstein said.

Ratner said it’s essential for parents to understand that it is a dangerous choice to not vaccinate their kids against polio, both for those children and for their communities.

If these low-vaccinated communities do not decide to start vaccinating their children, paralytic cases will increase, Ratner said.

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New report warns about privacy of period-tracking, pregnancy apps after Roe v. Wade overturned

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(NEW YORK) — A new report is shining a spotlight on potential privacy concerns loopholes in apps that collect women’s personal health information following the reversal of Roe v. Wade.

Abortion is now nearly banned in at least 15 states as a result of the Supreme Court’s decision on June 24 to overturn the landmark 1973 Roe ruling — which legalized abortion at the federal level — and send the issue back to the states.

A report released Wednesday by the Mozilla Foundation, a non-profit organization that advocates for online privacy, concluded that among 25 popular reproductive health apps, most apps were found to have very vague privacy policies surrounding how they will share data with law enforcement.

Eighteen of the products earned Mozilla’s label of “*Privacy Not Included” meaning users’ data may not be secure, and eight failed to meet the foundation’s “minimum security standards.”

Among the apps examined by Mozilla’s staff researchers were pregnancy apps, period trackers and wearables, all products that collect personal reproductive information like weight, birth plans, pregnancy journals and doctors’ appointments.

Only one app – Euki – was ranked in Mozilla’s “Best of” category. The app Natural Cycles earned a commendable mention by Mozilla.

Other wearables and apps that ranked near the top of Mozilla’s list include Garmin, Apple Watch, Whoop Strap 4, Oura Ring and Fitbit.

Caltrider said the privacy policies of the reproductive health apps researched were similar to the privacy policies of apps used for things like sharing recipes and photos.

“Anything that you share is no longer secure and that’s just an expectation that you should have if you share something with these apps and it’s not stored locally,” Jen Caltrider, a co-author of the report and the lead of Mozilla Foundation’s *Privacy Not Included online guide, told ABC News. “If the app collects information about your sexual activity, your sexual orientation, your moods, symptoms, pregnancy, your due date, any of it, just expect that that that information is no longer yours to control.”

Pregnancy and period-tracking apps have millions of users every month who utilize the technology to better understand and help control their reproductive health. The apps can tell you when to expect your next period, if you might be pregnant and how far along you are, when you are the most fertile for conceiving and what sorts of symptoms you usually experience.

Reproductive health apps’ ability to share data with law enforcement is of particular concern for women who live in states where abortion has been limited or banned, according to Caltrider.

“What we found was most companies had fairly vague statements, that it was hard to tell whether companies would voluntarily disclose data to law enforcement if they came asking,” said Caltrider. “Unfortunately there were a number of companies where we just couldn’t tell what their data sharing plans were, and that worries us.”

Leah Fowler, a research assistant professor at the University of Houston Law Center, told ABC News that consumers should not expect the health data they enter on apps to be protected in the same way it would be at a hospital or doctors’ office.

“When we think about data in a consumer context, it doesn’t have any of those special protections we tend to expect in other health contexts, like going to the doctor,” said Fowler, whose research focuses on health law and policy. “The information you might give an app when you’re playing Candy Crush or Angry Birds in many ways isn’t different than the type of data you’re giving an app in a health context, even if it feels particularly intimate and can become quite intimate when you’re talking about period and fertility trackers.”

Both Caltrider and Fowler said that period tracking, pregnancy and fertility apps can be smart, useful tools to use, as long as users do their own research.

“I think that each individual consumer has to do a cost-benefit analysis of how useful they find the product and the types of risks they may be exposed to depending on where they live,” said Fowler. “And I think that there are lots of products available that will allow them to use what are ultimately very useful, very popular tools without exposing them to as much risk. For example, one that might store data locally on your phone or that doesn’t participate in third-party data sharing.”

Consumers should be able to find an app’s privacy policy when they download the app on their phone, according to Caltrider.

She said to be wary of privacy policies that are either too short or too long, adding, “If companies can’t clearly articulate what data they’re collecting, how they’re using that data, who they’re sharing that with, it’s a flag.”

Both experts said another red flag warning is if a company uses the word “sell” or “share” in its privacy policy, meaning they can sell and share your information.

And if you go to download an app and can’t find the privacy policy, Caltrider said she would advise not downloading the app.

In addition, Caltrider said that apps made by companies based in Europe tend to have tighter privacy restrictions than do companies based in other locations, including the United States.

“I do encourage people to at least look and see if they have a privacy policy,” said Caltrider. “If you don’t want to read the whole thing, do a search and see if they have the word sell in there and talk about selling your data. See if they do targeted, interest-based advertising with third parties.”

She continued, “There are some little tells that will let users know oh, this company is treating my data more like a business asset and using it for purposes beyond just providing the service.”

Statements from companies

ABC News reached out to all of the companies listed in Mozilla’s report. Here are the responses we received.

Sprout

“It appears [the Mozilla Foundation] incorrectly stated the app does not have a Privacy Policy. It has always been and is freely available since the launch of the app on the app’s product page on the Apple App Store and Google Play Store — a Privacy Policy is required by Apple and Google and can be viewed in the corresponding app privacy and data safety sections. Customers can also access our Privacy Policy within the app and on our website: https://sprout-apps.com/privacy-policy.html.

Our Sprout Pregnancy app has always been privacy focused and is one of the only pregnancy apps on the market that does not require an account to use the app (no username or password) and the app data is only backed up to the user’s personal iCloud or Google Drive account.

We have also responded to Mozilla’s questions and you can contact them for additional information.”

Euki

“We are pleased that Euki is being recognized in this way. Our ultimate goal remains getting Euki to anyone who can benefit from a comprehensive, inclusive and of course secure app for sexual and reproductive health. Access to abortion services is essential health care, a critical part of our human rights, and abortion access must be protected. Euki can help and we want to ensure that it gets in the hands of anyone who can benefit from its unique features and privacy protocols.

Natural Cycles

“At Natural Cycles we have always been committed to protecting our user’s data as a regulated medical device and we’re fully supportive of Mozilla’s mission and assessment. We are of the mindset that every app – even if they have strong privacy protections like ours – should be working even harder to protect data on their user’s behalf. I can confirm our team is working rigorously to ensure that not only is Natural Cycles the most scientifically-backed fertility app, that we have the strongest data protections too.”

Clue Period & Cycle Tracker

“You can find Clue’s stance about privacy here from the co-CEOs: Data is power, and responsibility: what we believe as Clue’s Co-CEOs and here: Patient Data Privacy at Clue: A statement from the Co-CEOs.

Whoop Strap 4

“At WHOOP, our mission is to unlock human performance. We exist to improve the lives of our members, not invade them. We have invested heavily, and will continue to invest, in features and security to protect the privacy and security of our members’ data. We believe this should be the standard for all companies providing wearable devices and health tracking technology.”

Flo Ovulation & Period Tracker

“We understand that our users place trust in our technology to keep their sensitive information private, and the responsibility we have to provide a safe and secure platform for them to use. This is why Flo has never, and will never share any health data with any company but Flo. We will never make user data the source of our revenue because that would go against our core promise to our users.

In March 2022, Flo completed an external, independent privacy audit which confirmed Flo’s own practices are consistent with its publicly stated privacy policy. Beyond this, the independent audit specified, “From both a governance and operational perspective, Flo was able to demonstrate a commitment to the privacy and security of its users’ data and has devoted appropriate resources and personnel to ensuring it maintains those commitments.”

In an effort to further protect reproductive health information of our users, Flo recently announced the launch of ‘Anonymous Mode.’ Flo already uses security best practices, including encryption of all data and passcode protection, however this new feature deidentifies data on a deeper level by removing personal email, name and technical identifiers. In the event that Flo receives an official request to identify a user by name or email, Anonymous Mode will prevent Flo from being able to connect data to an individual, meaning Flo would not be able to satisfy the request.

Beyond this, we provide security measures designed to protect individual user data and privacy rights. As of last week, Flo is now the first period & ovulation tracker to achieve the ISO 27001 certification, the internationally recognized standard for information security. This certification affirms that Flo protects users’ data at the highest standard possible.

Flo remains committed to ensuring the utmost privacy for our users. Some of the additional measures we take include: – Data Encryption: Data is transferred to our servers in an encrypted form. – Data Separation: Personal user data (that can be used to identify an individual person, e.g., e-mail) is kept separately from data logged in the app (e.g., specific user inputs). This measure helps to prevent users from being identified. – Rigorous Supplier Due Diligence: We only work with suppliers who meet our minimum privacy and security standards – Regular Privacy Risk Assessments: We undertake regular risk assessments on all processing activities to ensure risks are identified and removed.

You are welcome to read our Privacy Portal, which gives more detailed info on our data protection policies: https://flo.health/privacy-portal. You also may find this landing page on how Flo responds to data requests useful: https://flo.health/flo-user-response-data-requests.”

Preglife Pregnancy App

“We are very happy that Mozilla is [doing] audits like this. Personal privacy is something we take very seriously, and we are positive for all efforts that highlight the importance of privacy.

Not so happy about not performing better than what we did but when reading the audit, it clearly states that we at Preglife take privacy very seriously. Our privacy policy is well written, easy to understand, and I am confident that our wish to keep our user’s privacy secure shines through. The fact that we allow simple passwords is unfortunate but true. We don’t deny that. However, it is on our “to-do list” and something that we were about to fix within the coming weeks. But in the light of this audit and the increased need for privacy for our U.S. users, we will make this our top priority, meaning we will fix this ASAP.

In the audit Mozilla were unable to verify if we use encryption or not — but we do. All personal data that is transferred from the app is encrypted. All databases are encrypted.

Also stated in the audit, we allow users to use Preglife without creating an account. If you use Preglife in that way you never have to worry about any data loss since all data is stored locally on your handset. The downside is that if you lose your phone or if it breaks you risk losing valuable data. However, in the light of current events in the U.S., some users may feel that is a risk they are willing to take to be totally ‘off the grid.'”

Glow Nature & Glow Baby

“We strongly disagree with Mozilla’s review and we are working closely with Mozilla on their rating process, including sending them all the legal facts to address their concerns and claims.

We do not share personal data with anyone and will never sell user’s data. It’s simply against our core values. We have an extensive set of features and internal protocols that protect user data. We have also implemented 3rd party annual privacy and security assessments to ensure our platform provides the highest level of data protection for our users. Every single employee at Glow is required to go through privacy and security-related training.

Our number one goal is to build the best products for our users and doing anything that violates their trust would go against our values. Even in the case where we have been asked to provide information to law enforcement, we have always examined those requests in extreme detail and take action ONLY when it is protecting our users. We will continue to uncompromisingly protect our users’ privacy and personal health information. Period.”

ABC News’ Laryssa Demkiw, Michela Moscufo, MaryAlice Parks, Jeca Taudte, Sony Salzman and Cheyenne Haslett contributed to this report.

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New COVID guidelines ease in-person work but won’t spur return to office, experts say

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(WASHINGTON) — Apple on Monday made headlines as the latest major company to call its workers back to the office, setting a deadline for early next month that will require workers to do their jobs in person three days each week, Bloomberg reported.

The move came days after the Centers for Disease Control and Prevention released new guidelines that softened the recommended precautions for preventing the spread of COVID.

The guidelines, announced last Thursday, recommended institutions screen otherwise healthy individuals for the virus in most settings, and the new rules set aside the 6-feet standard for social distancing.

Further, the guidelines relaxed a five-day quarantine period for unvaccinated individuals after an exposure to COVID. Instead, following an exposure, unvaccinated people should forego the quarantine but wear a mask for 10 days and test after five days, the CDC said.

The change in CDC policy will make it easier for employers to bring workers back to the office, shifting the public health responsibility to individual workers and away from businesses, while allowing all workers to stay on the job after a COVID exposure, public health experts told ABC News. The move reflects an approach that aims to mitigate spread but not prevent infection entirely, as widespread immunity and treatments reduce the risk of severe illness, they added.

However, the CDC guidelines will not spur a rapid shift back to in-person work, or even any shift at all, since public health concerns no longer make up the primary reason behind remote work, economists told ABC News. Rather, the widely held preference among employees for some degree of remote work — combined with the leverage afforded to workers as employers struggle to fill openings — should preserve the current level of remote work, the economists added.

“Even as COVID recedes as a reason for all these work arrangements, they’ve now developed a momentum of their own,” Julia Pollak, a labor economist for job site ZipRecruiter, told ABC News. “It’s difficult to put the genie back in the bottle.”

In recent months, the U.S. economy has reached a stable level of roughly 30% of all paid working days done from home, said Jose Maria Barrero, a finance professor at Instituto Tecnológico Autónomo de México, a private university in Mexico City, who co-authors a regular survey on remote work. When limited to jobs for which it is possible to work from home, such as managerial-style roles, the proportion of paid working days done at home rises to between 50% and 60%, he added.

Early in the pandemic, employees wanted to work remotely far more than businesses wanted to accommodate them, Barrero said. Over time, however, that gap has narrowed considerably, in part because companies have conceded to the preferences of workers, who retain significant leverage in a tight labor market. In light of how stable the level of at-home work has become, even if economic or public health conditions change, the proportion of workdays done in-person will likely remain consistent, he said.

“We’re actually pretty close to what the post-pandemic normal is going to be,” Barrero said.

That view of a permanent remote workplace contradicted the newfound ease for employers under the recently released guidelines. However, the outlook aligned with the reaction to the guidelines voiced by several epidemiologists, who said the new rules reflect a shift toward living with covid as a permanent feature of everyday life, much like remote work.

The removal of quarantine for unvaccinated people upon exposure, for instance, shows a willingness to accept that people have largely given up stringent limits in the activity of their personal lives, Amesh Adalja, a senior scholar at Johns Hopkins Center for Health Security, told ABC News.

“This is much more real-world guidance,” he said. “Because people live in a certain way outside of work, that means exposures are ubiquitous.”

Meanwhile, workplaces benefit from the widespread immunity that has resulted from vaccine uptake or contraction of covid, said Wafaa El-Sadr, a professor of epidemiology and medicine at the Columbia University Mailman School of Public Health. Plus, remedies like vaccine boosters and treatments limit the likelihood of severe illness in the event of an infection, she added.

“There is a major shift in how people consider Covid-19, and getting infected with this virus,” El-Sadr told ABC News. “The shift has been happening slowly and this solidifies that shift to a different frame of mind.”

Still, the relaxation of workplace precautions like testing of asymptomatic people risks making businesses vulnerable to outbreaks, especially if the U.S. experiences another surge in cases, said Julia Raifman, a professor at the Boston University School of Public Health.

“Each of the tools we have are important — none of them are sufficient on their own to mitigate the harms of covid,” she said. “We need all of them.”

In either case, ​​the ranks of those working at the office are not likely to grow anytime soon, said Barrero, the Mexico City-based economist.

“The question of return to work is much bigger than the pandemic, infections, and COVID at this point,” he said.

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COVID-19’s negative impact on caregivers and 4 ways to help them

Luis Alvarez/Getty Images

(NEW YORK) — The COVID-19 pandemic has had unprecedented effects on our society and even more so on our senior population, as they struggle to manage care. In some cases, they are without their loved ones being able to visit them, creating a further sense of isolation, heightened anxiety and depression due to fear of contracting the virus.

Statistics show 43% of seniors experienced loneliness during this period. While taking care of loved ones is priority, caregivers experienced higher levels of stress as they tried to manage their own needs while taking care of their loved ones, leading to further negative health outcomes.

Per research conducted by the National Rehabilitation Research and Training Center, family caregivers experienced more negative effects from the pandemic than those who weren’t, including more emotional, physical and financial burdens. Female caregivers, younger caregivers and especially families with lower incomes experienced significant issues.

The pandemic has increased our awareness on the burden our caregivers face. We would need to further create a strong ecosystem to address this issue.

Here are four ways we can address and support our caregivers as part of a care infrastructure for better health in our nation.

Most of our caregivers spend 78% of their income to take care of their loved ones, leading them to diminish their savings and retirement. There are also situations where caregivers have to leave their jobs, leading to lesser incomes, more debts, unpaid bills and reduced Social Security retirement benefits. Some solutions that have emerged include adopting policies that allow flexible work hours. Furthermore, municipalities can provide tax credits to employers offering a minimum number of weeks of paid leave to family caregivers, make tax credit eligibility criteria more accessible to middle income families and extend job protections.

Second, caregivers face enormous difficulty being able to access services within their communities such as transportation, tailored meals and in-home health services due to lack of financial stability, better nutrition education and understanding resource availability overall. According to the National Alliance for Caregiving, 27% of caregivers found it very difficult and 62% of the caregivers needed training and access to information to better understand how to take care of themselves and their loved ones. Systems need modernization and integration as it can be difficult to find all information that is needed in one place. Finally, mental health services would be critical for caregivers as well as for their loved ones they are supporting.

Caregiver burnout is significant for professional and family caregivers. The exhaustion and burden of work results in caregivers not being able to attend to their own needs and have a state of physical, mental and emotional exhaustion. There needs to be additional support for caregivers to provide relief and mitigate the risk of burnout.

Fourth but not least, we need to leverage technology. By 2020, approximately 120 million older Americans will need care at home. According to the American Association of Retired Persons (AARP), the majority of caregivers—some 45 million—will be unpaid (compared to 5 million paid caregivers), and many will care for more than one aging family member. Technologies such as telehealth and bio sensors, with their capabilities to meet members where they are and to proactively detect health concerns, could help provide education, consultation, psychosocial/cognitive behavioral therapy (including problem solving training), data collection and monitoring, clinical care delivery and social support. Better data and predictive analytics will lead to more tailored interventions. As technology is used by caregivers, it will require digital literacy as well to be as effective but could also reduce caregiver burden.

In conclusion, caregivers are an integral part of our society. They need additional support, access to mental health professionals, care infrastructure and a living wage. We need to move forward by creating solutions at the intersection of innovation, partnerships and awareness. Employers for example can create partnerships with caregiver organizations. Our caregivers need care in order to give care.

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This is how mifepristone and misoprostol induce abortions

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(NEW YORK) — Just under 1 million people utilized abortion services in the U.S. in 2020, according to recent data from the Guttmacher Institute. Another report from Guttmacher in 2016 showed that 90% of abortion patients in the U.S. obtained their procedure in the first trimester.

Medication abortion is approved by the Food and Drug Administration for up to 10 weeks into pregnancy, but there is good literature that has shown it is an effective method of abortion up to 11 weeks. This means the majority of people seeking abortion services are able to get medication abortions, Dr. Deborah Bartz, a gynecologist at Brigham and Women’s in Boston, told ABC News in an interview.

The abortion pill is the most common form of abortion in first trimester pregnancies, with recent data showing that 54% of those eligible now choose to undergo medication abortion over a procedure, Bartz said.

As access to abortion continues to be restricted in many states, more may choose to self-manage their abortions for several reasons, such as not being able to afford to travel for care, according to Dr. Meera Shah, chief medical officer of Planned Parenthood Hudson Peconic.

Self-managed abortions were often risky pre-Roe, but abortion medication has offered a safe method for self-induced abortions.

Many patients in other countries have taken the abortion pill past 11 weeks, and there are several ongoing studies underway for usage of the pill beyond 11 weeks, Bartz said.

“You can take medications and induce pregnancy expulsion, essentially, at any gestation. It’s just as of right now, our literature indicates that 11 weeks is the upper limit on when we should be recommending that to most patients,” Bartz said.

The most robust and effective way to get a medication abortion is by taking two pills: mifepristone and misoprostol, Bartz said.

Mifepristone, which is taken first, blocks the hormone progesterone. Progesterone is needed for the pregnancy to grow inside the uterus. When mifepristone is taken, it begins the process of emptying the uterus.

Mifepristone can be taken at home or in a healthcare provider’s office.

The second medication, misoprostol is taken within 24 to 48 hours of the first medication. This causes uterine cramping and cervical softening and expels the pregnancy from the body, Bartz said.

Misoprostol causes cramping and bleeding, similar to a heavy period or miscarriage, to empty the uterus, according to Dr. Meera Shah, Chief Medical Officer of Planned Parenthood Hudson Peconic.

“By taking the two medications together, what an individual is doing is essentially inducing a miscarriage. There are other means of doing medication abortion, and many people in the United States and throughout the world use misoprostol only. That is also a very good regimen,” Bartz said.

The Mifepristone-Misoprostal regimen is about 95% effective if taken within the first 11 weeks of pregnancy, while the misoprostal alone is about 85% effective, Bartz said.

The process itself takes a couple of hours. The further along patients are in the pregnancy, the more complex their symptoms may be and the longer their symptoms might last, according to Bartz.

Patients typically experience bleeding and cramping, which can be more severe the further along they are in pregnancy. This typically results within one to five hours, Bartz said.

“It’s probably a little bit more intense than like the first day of a person’s period. So, a little bit heavier bleeding than a period, a little bit more cramps than a period. But, there are many patients who experience symptoms that are not much more than their period,” Bartz said.

It is recommended that patients not be alone when they take the pills in case they experience more pain than expected or have heavy bleeding. Patients are usually advised to take pain medication, like ibuprofen, and maybe an anti-nausea medication ahead of time, before the cramps start, Bartz said.

Patients also experience flu-like symptoms including fevers, chills, nausea, vomiting and diarrhea, all of which is normal with medication abortions, Bartz said.

When a person becomes pregnant, they are automatically in a higher risk category than someone who is not pregnant. So, getting an abortion of any kind puts a patient at less risk than if they continue a pregnancy, according to Bartz.

“The risk of maternal mortality associated with full term pregnancy and delivery is about 14 times higher than the risk of interrupting a pregnancy with a either medical or surgical abortion,” Bartz said.

Roughly 5% of patients experience incomplete abortions, meaning the pregnancy does not pass in its entirety. In these rare cases, the medication might not work the first time around, and they either have a continuing pregnancy or they have clinically significant pregnancy tissue that does not pass all the way, Bartz said.

“So they actually potentially would need either a second dose of the medications or to undergo the surgical the uterine aspiration procedure to bring those that pregnancy tissue out after they’ve taken that medication if it hasn’t worked. But 95% of patients, have the medication work just fine the first time,” Bartz said.

Rarely, some patients who experience severe bleeding may need to call their physician’s office or be seen in an emergency room for a blood transfusion. Less than 1% of patience experience bleeding significant enough that they would need a blood transfusion, Bartz said.

“If a patient is bleeding so heavily that she’s soaking pads a pad, an hour for a couple of hours, then we would want to see her,” Bartz said.

Another rare risk is the risk of an infection. As the cervix opens up a bit, there is a low risk that an infection could travel to the uterus, but doctors do not even prescribe antibiotics to prevent risk of infection because there is more risk from taking the antibiotic than there is of getting an infection, Bartz said.

Patients can experience mild or moderate bleeding and cramping on and off for up to a month after taking the abortion pill. Most get their next period one to two months after the abortion, according to Dr. Meera Shah, Chief Medical Officer of Planned Parenthood Hudson Peconic.

Having an abortion does not decrease your chance of having a healthy pregnancy later on, or affect your future overall health unless a rare, serious complication occurs or is left untreated, according to Shah.

 

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CDC director acknowledges mistakes to staff in internal message

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(ATLANTA) — Centers for Disease Control and Prevention Director Rochelle Walensky made a remarkable acknowledgment of her agency’s failures during the COVID-19 pandemic as she delivered a message to her staff Wednesday.

Her message, given in an internal video viewed by ABC News, addressed employees about the plan to overhaul the agency, following an internally initiated review which found that the CDC’s handling of the COVID-19 pandemic fell short of the crisis.

“To be frank, we are responsible for some pretty dramatic, pretty public mistakes. From testing, to data, to communications,” Walensky said to the camera in front of a blue CDC backdrop.

“As an agency, even with all the terrific work we do, we still suffer the consequences from these mistakes. After over 18 months serving in this position, learning and living the many lessons from our COVID-19 response, and receiving feedback from many internal and external interested parties, this is the right time to take a step back and strategically position CDC to facilitate and support the future of public health,” Walensky said.

Those conversations, she added, yielded “loud and clear” key principles to “promote public health action and communication; conduct and disseminate exceptional science,” and “serve our partners, prioritizing the American people first.”

“All of us collectively are being asked to look to the future and build a stronger CDC to tackle what lies ahead. This is our watershed moment,” Walensky said.

“We must pivot, take appropriate action, and lead the systemic changes required to equitably protect health, safety and security of all Americans,” she said — especially because neither the pandemic nor her agency’s response to it, is finished.

Walensky’s message, delivered in a more than 14-minute recording, follows a scathing internally initiated review of how the CDC handled COVID-19, which found its approach toward the pandemic failed to meet the moment of crisis and offered a series of changes intended to revamp the agency and make it more nimble.

That review, ordered by Walensky in April, comes after the CDC had come under frequent fire for its muddled and inconsistent messaging on COVID mitigation measures.

During interviews with roughly 120 agency staff and key external stakeholders, the review found that it “takes too long for CDC to publish its data and science for decision making,” that its guidance is “confusing and overwhelming” and that agency staff turnover during the COVID response “created gaps and other challenges for partners,” according to findings obtained by ABC News.

“The COVID-19 pandemic and our agency-wide response is not over. Our important work continues,” Walensky said in her video. “There have been too many tragic deaths from this virus and we must do all we can to prevent more.”

The threat of other infectious diseases’ spread means now is the time for public health infrastructures to shore up their defenses, she noted.

“Now the global monkeypox outbreak requires increased attention and efforts,” Walensky said. “We will continue to activate the personnel and resources necessary to fulfill our public health mission.”

In the video, Walensky promised to “develop new systems and processes to equitably deliver all of CDC science and program activities to the American people,” with “data modernization, laboratory capacity, rapid response to disease outbreaks, and preparedness within the US and around the world.”

“These changes will inform what CDC can do during a pandemic, along with every day during normal operations in our infectious and non-infectious disease portfolios to ensure a CDC science reaches the public in a timely and implementable manner,” she said.

“We must also strengthen the agency’s ability to respond to public health threats,” she said. “This is an agency-wide top priority to respond when we are called upon.”

Walensky emphasized the importance of “breaking down organizational silos in favor of a ‘One CDC mindset,'” increasing accountability and supporting equity efforts across the agency, she said.

“Change is hard. I know that. This is our time to change. And we will all need to roll up our sleeves to move CDC forward,” Walensky said, and “apply” the “COVID-19 lessons learned” by “sharing scientific findings and data faster.”

“The future of CDC is dependent upon applying the lessons learned from the last few years, whether it’s under my direction or a future CDC director, regardless of who is sitting in the seat, an honest and unbiased read of our recent history will yield the same conclusion. It is time for CDC to change,” she said.

“I recognize that our growth will involve some uncomfortable moments for many of us. We will hold ourselves accountable and we will be open to feedback,” Walensky said. “I owe it to you to work hard with the agency’s leadership to make CDC better and I’m grateful to have you in this with me.”

ABC News’ Cheyenne Haslett and Eric M. Strauss contributed to this report.

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Baby girl born with one lung and given 20% chance of survival goes home

Courtesy Joshua Valliere

(SAN DIEGO) — A California girl has beaten the odds to reunite with her twin and return home with her family after a six-month stay at a San Diego hospital.

Charlotte and her twin sister, Olivia, were born to Karla and Joshua Valliere last December, but in January, Charlotte was suddenly admitted to Rady Children’s Hospital with breathing difficulties and a respiratory infection.

At first, the Vallieres didn’t know what was wrong. Olivia was healthy, and although Charlotte had been born with one lung, she hadn’t had any issues after birth.

“Her one lung grew like 1.5 sizes, so it was compensating for the lack of the second one. So [doctors] did run all the studies. She was totally fine — oxygenation, everything 100%, so we were cleared to go after four days in the hospital,” Karla Valliere told Good Morning America. “It was six weeks at home — total bliss. Everything was great … and all of a sudden she started having breathing problems.”

The Vallieres took their daughter to Rady on Jan. 29, and she was admitted and placed on an extracorporeal membrane oxygenation machine, or ECMO.

Dr. Matthew Brigger, chief of the pediatric otolaryngology division at Rady Children’s Hospital, started seeing Charlotte, who was just six weeks old at the time. Charlotte would eventually be diagnosed with tracheal stenosis and complete tracheal rings. This meant she had a birth defect with her airway where the rings in her trachea were abnormal and she had an abnormal narrowing of the trachea, or windpipe. She also had a blood vessel wrapped around her trachea.

“This set of anomalies, with the single lung, with the way the aorta was wrapped around the trachea itself and the trachea being this narrow, is actually fairly rare,” Brigger told GMA.

“We knew that she had a critical airway that if anything were to progress, trying to keep her intubated, that was gonna potentially injure the airway and give us more difficulty in repairing it. So the ECMO was sort of a bridge to surgery,” he continued.

But the surgery was a major one and in order to do it, Brigger and the rest of Charlotte’s doctors had to wait until she was big enough, since she and her twin had been born a few weeks early and therefore, Charlotte was small for her age.

“Initially I [told the parents], ‘Well, if we can get through surgery, I’m gonna give her 50-50,” Brigger said. “[But] I’m thinking more 20% of getting through surgery at the time, just knowing how much that we had to go through.”

Despite the low chance of survival, Charlotte’s surgery was a success.

“Fortunately, Charlotte’s a fighter and we got to do the surgery. She sailed through surgery,” he said.

The Vallieres said that throughout the monthslong stay in the hospital and all the ups and downs, with Charlotte’s complications, multiple surgeries and treatment, they drew strength from their own daughter.

“The thing that I think that I believe got us through was her. She never gave any sign of weakness,” the mom of two said.

After spending 185 days in the hospital, Charlotte was finally discharged on Aug. 1, and her parents and twin sister were there to celebrate and bring her home.

“It was just a lot of emotions and it was just a roller coaster. But now we have them together, so it’s worth it,” Karla Valliere added.

Today, Brigger said he doesn’t anticipate Charlotte needing a second lung at all and her future looks bright.

“Prognosis is very good. She may not be running marathons in the future but she is Charlotte so it’s hard to say. She’s proved people wrong all along. I expect her to be able to live a good life,” he said.

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