New Apple Watch feature designed to help women track fertility: What to know

Apple

(NEW YORK) — The newest model of the Apple Watch will offer women features to track their menstrual cycles and when they may be the most fertile, Apple announced Wednesday at a launch event at the company’s California headquarters.

Among the Apple Watch Series 8’s advanced features is a temperature sensor that offers an estimate for the last time a woman wearing the watch has ovulated.

According to the company, temperature data collected by the watch’s sleep tracking and sleep focus features is used to help determine ovulation, the process in which an egg is released from the ovary and becomes available to be fertilized.

Most women’s basal body temperature — the temperature when the body is fully at rest — increases slightly during ovulation and remains elevated until the end of the menstrual cycle, according to the American College of Obstetricians and Gynecologists.

The Series 8 will come with two sensors — one on the back of the watch, close to the skin, and one under the watch display — to allow for more accurate temperature tracking, according to Apple.

Apple says that after using the watch’s sleep features for five nights, the device will begin to recognize temperature changes. After around two menstrual cycles, watch users will be able to start receiving estimates on when they ovulated during their last cycle.

Users will receive a notification of when they have likely ovulated about three to five days after ovulating, according to the company.

“Knowing when ovulation has occurred can be helpful for family planning, and Apple Watch Series 8 makes it easy and convenient by providing these estimates in the Health app,” Apple says on its website. “Temperature sensing also enables improved period predictions.”

The Series 8, available starting Sept. 16, will retail starting at $399.

Apple is offering the new features at a time when apps and wearables that collect women’s health information have been in the spotlight due to potential privacy concerns.

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.

In the wake of this summer’s Supreme Court ruling overturning Roe v. Wade, 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, experts say.

Apple went to great lengths Wednesday to detail its privacy protections, noting that all health and fitness data is encrypted.

The company also said that no health data is shared without users’ permission, explaining that users have to manually make the selection to share data.

Leah Fowler, a research assistant professor at the University of Houston Law Center, told ABC News in August 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.”

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Cancers in adults below 50 have ‘dramatically increased’: Report

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(NEW YORK) — Early onset cancers defined as cancers discovered in adults younger than 50 years old, have “dramatically increased” around the world over the last few decades, according to a new report by researchers at Boston’s Brigham and Women’s Hospital.

Researchers said breast, colon, esophagus, kidney, liver, and pancreas cancers among others have shown a drastic rise beginning in the 1990s.

“From our data, we observed something called the birth cohort effect. This effect shows that each successive group of people born at a later time (e.g., decade-later) have a higher risk of developing cancer later in life, likely due to risk factors they were exposed to at a young age,” Shuji Ogino, MD, Ph.D., professor and physician-scientist, said in the report, suggesting increasing risk with each generation.

According to Brigham and Women’s Hospital’s report, exposures from conception to when someone’s 19 years old play a role in cancer diagnoses before a person turns 50.

The study found that rising incidence is partially attributable to early screenings for some of these cancers, however, early life exposures such as people’s diet, weight, lifestyle, environmental exposure, and microbiome may factor into what’s contributing to early-onset cancer, but more information on individual exposures is needed, according to the report.

“Even in-utero exposures can lead to cellular reprogramming, including epigenetic alterations, that might have long-lasting effects on susceptibility to chronic diseases,” researchers wrote.

Factors such as alcohol consumption increases the risk of cancers, the report found. Between the 1960s to early 2010s, alcohol consumption increased in many countries.

Another study from April found that moderate alcohol consumption has increased the risk of cancer in women.

“We’re finding that probably anywhere between 5% to 10% of all cancers worldwide are due to alcohol use,” Dr. Suneel Kamath, a GI clinical oncologist at Cleveland Clinic Cancer Center, told “Good Morning America” in April.

An American Cancer Society report from January found that almost 2 million new cancer cases are expected to be diagnosed in the U.S. this year, with over 600,000 Americans dying from cancer in 2022.

ABC News’ Mary Kekatos contributed to this report.

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What you need to know about ‘original antigenic sin’ with fall COVID boosters around the corner

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(NEW YORK) — With new COVID variant-specific booster shots set to roll out in the coming week, vaccine scientists argue that more research is needed to understand how a person’s early immune response — either through vaccination or infection itself — may impact future protection against a constantly evolving virus.

The body learns its best defensive moves during its first encounter with a virus, according to experts. However, once a virus evolves, the immune system is slower to respond.

That is a phenomenon called “original antigenic sin,” or “immune imprinting.”

Scientists say that despite nearly three years of living amid a pandemic there are unanswered questions. For example: What’s the best way to maximize protection through vaccination? What vaccine formula would deliver the broadest immune coverage? How often should people receive booster shots?

The answers would help public health authorities decide future vaccination strategies such as the vaccine’s formula and when doses are administered.

What is original antigenic sin or immunological imprinting?

“There’s a theory that our immunological response to the first exposure to a virus may sort of imprint your immune system,” said John Brownstein, an ABC News contributor and chief innovation officer at Boston Children’s Hospital.

The human immune system’s best playbook is against an invader it already knows, experts say. But the COVID virus has continued to shape-shift, evolving into new variants that are still recognizable, but slightly different from predecessors.

“In other words, the first antigens that you’re exposed to [are] the ones your immune system is most trained to recognize and respond to more strongly the next time,” said Dr. Dan Barouch, director of the center for virology and vaccine research at Beth Israel Deaconess Medical Center.

What does this all mean in terms of COVID vaccines and boosters?

Some experts say they are concerned that frequent boosting with the original version of the vaccine may have inadvertently exacerbated immune imprinting. At this point in the pandemic, some adults have received four or more doses of the same vaccine.

Although still theoretical, some scientists worry about a potential backfire, with frequent boosting handcuffing the body’s natural immune system and leaving it exposed to radically different variants that might emerge in the future.

“Where this matters is if you keep giving booster doses with [original] strain, and continue to lock people into that original response. It makes it harder for them to respond then to essentially a completely different virus,” says Dr. Paul Offit, professor of pediatrics at Children’s Hospital Philadelphia.

Other scientists disagree, arguing the immune system is adaptable and dynamic. Boosters, they argue, will not freeze the immune system in place.

Meanwhile, updated boosters are slated to roll out this week. These boosters are specifically designed against new omicron sub variants BA.4 and BA.5.

“When we have an omicron-specific booster, it doesn’t make sense not to use that,” said Dr. Anna Durbin, director, center for immunization research Johns Hopkins Bloomberg School of Public Health. “The omicron spike protein is very, very different from the spike protein in the current vaccine.”

But even when facing new variants, studies show the original booster continued to reduce the risk of severe illness from COVID-19. Those fully vaccinated with at least the primary series were five times less likely to die from COVID in the summer of 2022, according to the Centers for Disease Control and Prevention.

“I think the worry is that if the virus keeps mutating, maybe the [original] vaccine is not going to continue to do well against that, but I suspect that we’re still going to do very well against severe disease and hospitalization,” said Dr. Paul Goepfert, professor of medicine in the UAB Division of Infectious Diseases.

The timing of vaccines may also need to be taken into account, as the nation moves from original doses to updated boosters.

“It is true that the best boosts typically are the ones that are given infrequently, that immunologically, if you boost too much and too frequently, then you often have a lower immune response at the end,” said Barouch.

Does this affect the future of the pandemic?

“I don’t really think [immune imprinting] poses a threat,” said Durbin. “I don’t think it’s going to inhibit the ability of the immune system to recognize other variants or to induce immune responses to other variants, whether that’s through infection, or through vaccines.”

With the virus continuously evolving, experts note that continuous research is key to understanding how phenomena such as immune imprinting could affect the fight against COVID.

“I don’t see it as causing a problem but it’s an important line of research that needs to be investigated,” said Brownstein. “We don’t fully know whether this concept actually is harmful, or even a benefit for future, potential risks to infection.”

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Pediatric COVID-19 infections increase as kids head back to school

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(NEW YORK) — As children head back to the classroom for the academic year, new data shows that pediatric COVID-19 infection rates have increased for the second consecutive week.

Last week, more than 90,600 additional child COVID-19 cases were reported, an increase of 14% from two weeks prior, when just under 80,000 cases were reported, according to a new report from the American Academy of Pediatrics (AAP) and the Children’s Hospital Association (CHA).

The increase comes despite an overall plateauing of COVID-19 infections nationally.

Overall, totals remain significantly lower than during other parts of the pandemic. Since mid-May, data shows that new cases have plateaued, fluctuating between a high of about 68,000 to 112,000 cases.

However, many Americans who are taking at-home tests are not submitting their results, and thus, experts say daily case totals are likely significantly higher than the numbers that are officially reported.

More than 14.5 million children have tested positive for the virus since the onset of the pandemic, and since the beginning of 2022, approximately 6.65 million reported cases have been added. Children represent about a fifth of all reported cases on record.

Despite the uptick in infections, with COVID-19 vaccine mandates in schools still virtually nonexistent, millions of children remain completely unvaccinated.

Overall, about 43.1 million eligible children remain completely unvaccinated, according to federal data.

Most of the nearly 30 million children who have received at least one shot are older children. The vast majority of the youngest Americans under the age of 5 — or just 1 million out of the 19.5 million children in that age group — have yet to receive a COVID-19 shot, according to federal data.

AAP and CHA said there is an “urgent” need to collect more age-specific data to assess the severity of illness related to new variants, as well as potential longer-term effects.

“It is important to recognize there are immediate effects of the pandemic on children’s health, but importantly, we need to identify and address the long-lasting impacts on the physical, mental and social well-being of this generation of children and youth,” the organizations wrote.

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Mystery as to why new COVID variants have stalled in growth

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(NEW YORK) — Throughout much of the pandemic, there has been a constant shifting in terms of which COVID-19 variants are most dominant, at a given time, in the U.S.

However, for the last five weeks, federal data shows that there has been little to no growth in the different proportions of COVID-19 variants in the country.

For more than nine months, the omicron variant, and its subvariants, have been dominant in the U.S. But now, health experts say it is unclear why the growth of the omicron strains appears to have stagnated, or why it is that no other significant variants have emerged to challenge its dominance.

“Unlike previous variants, BA.5 appears to have more staying power. A mix of higher transmissibility, waning immunity and relaxed restrictions likely contribute to the ability of this variant to find more hosts to infect,” said John Brownstein, Ph.D., an epidemiologist at Boston Children’s Hospital and an ABC News contributor.

BA.5 is currently estimated to account for about 88.6% of new COVID-19 infections — a share that has plateaued over the last five weeks, according to updated data from the Centers for Disease Control and Prevention.

BA.4 currently accounts for an estimated 2.8% of new cases in the U.S., and a recently identified subvariant, BA.4.6, is estimated to account for 8.4% of new cases — up slightly from last week when the subvariant accounted for 7.6% of new cases.

Combined, the BA.4 and BA.5 subvariants account for nearly 100% of new cases in the U.S., according to the CDC data.

The BA.4 and BA.5 subvariants appear to have a transmission advantage over the original omicron strain, according to the World Health Organization, and thus, scientists have been closely monitoring the increase in reported cases. At this time, it does not appear as though BA.5 has an increase in severity.

The slowing of the omicron strain’s growth pattern leaves many questions unanswered as to whether there will be viral resurgence in the fall and winter.

“We still have open questions as to what this means for a fall surge and the opportunities for a new variant to displace it,” Brownstein said.

The stagnation of growth with the omicron variants comes as the U.S. appears to experience a parallel plateauing of new COVID-19 infections. The nation had been reporting consistent declines throughout the late summer, but in recent weeks, that number has been hovering around 84,000 new cases each day, according to the CDC.

As previously reported, dozens of states have moved to shutter public testing sites, with more at-home COVID-19 tests now available. Most Americans are not reporting their results to officials, and thus, experts suggest that infection totals are likely significantly undercounted.

Just over 400,000 tests are being reported each day, marking the lowest number of confirmed tests since the onset of the pandemic.

Although new case rates are still dropping in parts of the West, across areas of the Northeast, the Midwest and even parts of the South, case rates have plateaued at a high level or are showing signs of increasing again.

Hospital admission levels also appear to be plateauing nationally. About 5,100 virus-positive Americans are entering the hospital each day, down by about 3.7% in the last week, according to CDC data.

Death rates also remain persistently high, with hundreds of Americans still losing their lives to the virus each day. According to the CDC, the average number of daily COVID-19-related deaths remains more than 400 deaths reported each day.

Thousands are still losing their lives every week, and over the last seven days alone, the U.S. has reported more than 2,800 deaths — still one of the highest weekly totals in months.

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Black and Hispanic Americans are less likely to receive monkeypox vaccines: CDC

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(NEW YORK) — Black and Hispanic Americans make up the majority of monkeypox cases in the United States but are underrepresented when it comes to vaccine distribution.

According to data from the Centers for Disease Control and Prevention, as of Aug. 31, people of color make up more than two-thirds of reported cases in the nation with 29% of cases reported among Hispanics and 37.8% reported among Black people.

However, the share of monkeypox vaccines that minorities have received tells a different story. Only 22.1% of first doses of the JYNNEOS vaccine have been administered to Hispanic Americans and 10.4% have been given to Black Americans, data from the CDC shows.

Comparatively, white and Asian Americans make up 27.4% and 2.9% of cases, respectively, and have received 44.2% and 7.6%, respectively, of monkeypox vaccine first doses.

“Unfortunately, it’s not that surprising,” said Dr. Mark Abdelmalek, an ABC News contributor and an associate professor of dermatology at the Perelman School of Medicine at the University of Pennsylvania — who has treated monkeypox patients. “History kind of repeats itself. We see heath disparities across so many aspects of medicine and to think that this wouldn’t be one of them is a little naïve.”

He added, “I mean we saw it with COVID. It speaks to the fact that we have a lot of work to do to meet people where they are.”

Similar trends in racial/ethnic disparities can be seen on a city level.

In Philadelphia, Black or African American residents make up 55% of all monkeypox cases but just 24% of vaccinations, city data shows. Hispanic or Latino residents account for 16% of all cases but 12% of vaccinations.

Meanwhile, white Philadelphians make up 24% of cases but have received 56% of first doses.

Similarly, in New York City, as of Sep.1, Hispanics account for 32.7% of monkeypox infections and Black people account for 26.3% of infections. However, Hispanic residents have only received 23.3% of vaccine doses and Black residents have received 12.0%. according to data from the city’s Department of Health & Mental Hygiene.

By comparison, 24.2% of monkeypox infections in the Big Apple are among white residents but this population has received 45.5% of available first vaccine doses.

“The problem with infectious diseases is they often get a head start on attacking our communities before even a lot of people are aware,” Abdelmalek said. “So, these viruses already have a head start and then when you put into the equation, the fact that there might be certain populations like Black and Hispanic that have less access to medicine, the gap becomes even wider.”

Abdelmalek said a few ways to narrow these gaps include the medical community partnering with local businesses to get the word out about populations at-risk and vaccines and making sure social media platforms have messages that are targeted at traditionally underserved communities.

He also recommends people reach out and ask their doctor if they are eligible for the monkeypox vaccine and, if so, how they can receive.

“We should encourage [people] that you’re not bothering your doctor by calling them and asking them about could you get the vaccine,” Abdelmalek said. “Especially if you’re part of an underserved population. You can be empowered to call your doctor and advocate for yourself.”

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News anchor’s medical scare on live TV raises awareness of women’s risk of stroke

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(TULSA, Okla.) — An Oklahoma news anchor and a TV actress are raising awareness about women’s stroke risk at any age by sharing their own experiences.

Julie Chin, an anchor for Tulsa, Oklahoma, NBC affiliate KJRH, was anchoring a live broadcast on Sept. 3, when she began to experience difficulty speaking.

“I’m sorry,” Chin said, interrupting the broadcast to throw it to the station’s meteorologist. “Something is going on with me this morning and I apologize to everybody.”

Chin later shared an update on Facebook, writing that her doctors believe she suffered the “beginnings of a stroke” while on the air.

“The episode seemed to have come out of nowhere. I felt great before our show. However, over the course of several minutes during our newscast, things started to happen,” she wrote. “First, I lost partial vision in one eye. A little bit later my hand and arm went numb. Then, I knew I was in big trouble when my mouth would not speak the words that were right in front of me on the teleprompter. If you were watching Saturday morning, you know how desperately I tried to steer the show forward, but the words just wouldn’t come.”

Chin wrote that her coworkers called 911, and she was hospitalized for several days while undergoing multiple medical tests.

“There are still lots of questions, and lots to follow up on, but the bottom line is I should be just fine,” she wrote, adding, *Most importantly* I’ve learned that it’s not always obvious when someone has a stroke, and action is critical. This acronym helps identify the symptoms to look for: BE FAST and then if needed, be fast and call 911.”

“BE FAST” is a version of the acronym “FAST,” which is intended to help people remember the different signs of a stroke and what to look for, according to the American Stroke Association. It stands for “face drooping” or numbness of the face; “arm weakness” or numbness of the arms or legs on one side of the body; “speech difficulty” or slurred speech; and “time to call 911,” which reminds people to act quickly if you — or someone else — are experiencing any of the aforementioned symptoms.

“NCIS” star Pauley Perrette also revealed recently that she nearly died from a “massive stroke” a year ago at the age of 52.

Perrette, now 53, took to Twitter on Sept. 2 to share an update on her recovery.

“I feel good. Been through a lot in the last two years, things that are harder than having a stroke … but I am still here,” said Perrette, who suffered the stroke not long after she lost her father to COVID-19.

The actress told ABC News she had one of the major warning signs of stroke — numbness in half of her body — but that she was not aware that it was a warning sign.

In addition to sudden numbness in the face, arm or leg, especially on one side of the body, other warning signs of a stroke include facial drooping, vision changes, dizziness or loss of balance and difficulty speaking, according to the Centers for Disease Control and Prevention.

Stroke is the fifth leading cause of death for women in the United States. One in 5 women between the ages of 55 and 75 will have a stroke, according to the CDC.

“Women need to be aware of this. Women of all ages need to be aware of this,” ABC News chief medical correspondent Dr. Jennifer Ashton said Tuesday on “Good Morning America.” “This isn’t just something that happens to men and older men.”

Ashton said that for both men and women, common risk factors include high blood pressure, high cholesterol, smoking, obesity and diabetes. Women have other risk factors, including hormones.

“Any hormonal state — being pregnant, taking birth control pills, taking hormone replacement therapy, we call it a class effect. It increases the risk of clotting,” said Ashton. “That doesn’t mean we don’t use those medications. That doesn’t mean women avoid pregnancy to avoid stroke, in most cases, but you need to know.”

The highest rates for stroke remain among older populations, and women generally live longer than men, but over the past several decades the stroke rates for younger adults have increased by more than 40%, according to the American Heart Association.

Signs of a stroke can develop quickly over hours and even days, according to the National Heart, Lung and Blood Institute. Symptoms can also depend on the type of stroke and the area of the brain that’s affected, the institute also reported.

The Centers for Disease Control and Prevention reported that 4 in 5 strokes are preventable in women. Ashton said that women can prevent strokes or lower risk factors by creating healthy habits.

“If you smoke, do everything in your power to quit,” said Ashton. “You want to control your blood pressure, know what both of your numbers are and control it in a safe range and then [maintain a] healthy lifestyle — moderate or no use of alcohol, exercise and eating well, they are massively important.”

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Mysterious outbreak in Argentina solved: Legionnaires’ disease behind illness that sickened 11

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(NEW YORK) — A mysterious outbreak that sickened 11 people in Argentina, killing four, has been solved.

Health authorities said the illness was likely caused by Legionella, the bacteria that leads to Legionnaires’ disease.

The outbreak has been contained to a health clinic in San Miguel de Tucumán, which is the capital city of Tucumán province and is located 670 miles northwest of Buenos Aires.

Minister of Health Carla Vizzotti said during a press conference Sunday that four samples — including blood, respiratory and tissues samples — of the deceased patients tested positive for the bacteria.

“The genome of the Legionella bacterium was detected,” she told reporters. “The suspicion is that it is Legionella pneumophila.”

However, she said the results are preliminary and further testing is being conducted.

Legionnaires’ is a severe form of pneumonia caused by inhaling the bacteria in small droplets of water or accidentally swallowing water containing Legionella.

The disease is not contagious, but outbreaks can spread if the bacteria get into a building’s water supply including in shower heads, sink faucets, hot water tanks, heaters and other plumbing systems.

Although most people recover from Legionnaires’ with antibiotics, certain patients — including those who are immunocompromised or who suffer from chronic lung diseases — can develop complications that can be fatal.

According to the World Health Organization, the cases appeared between Aug. 18 and Aug. 25 with patients complaining of fever, muscle aches, abdominal pain and difficulty breathing along with pneumonia symptoms.

Of the 11 cases, eight were among the clinic’s health workers and three were among patients. Three of the four deaths occurred among health workers.

The median age of the cases is 45 and seven are male, according to the WHO. Ten people had underlying conditions that put them at risk for severe disease, including the four deaths.

As of Sept. 3, four people remain hospitalized and three are recovering at home.

Argentinian health authorities said they are conducting contract tracing to prevent further spread of the disease. Of the contacts that have been identified so far, none have developed symptoms.

“Sporadic outbreaks of legionellosis pneumonia have been reported in Argentina before,” the WHO said in a statement. “There are robust surveillance activities being implemented in the affected health facility.”

The statement continued, “Nonetheless, in the absence of an identified source of Legionella bacteria, the risk of developing Legionellosis for people working or hospitalized at the same health facility is currently moderate.”

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‘No man’s land’: Long COVID knocks young workers out of the job market

Waldo was an avid skier and taught skiing on the weekends. – Courtesy Victoria Waldo

(WASHINGTON) — Less than a month after Victoria Waldo recovered from COVID, she woke up feeling drunk.

Dizzy and slurring her speech, she went to the emergency room only to be sent home after routine blood work turned up negative.

The newly engaged 26-year-old, who worked long days in finance at a start-up and taught skiing on the weekends, would spend the next several months in a haze on her couch in her Washington, D.C., apartment.

Unable to focus, she lost her job. At one point, she stumbled upon a pair of slippers she liked and asked her fiancé who they belonged to. They were hers, he said, a Christmas gift from his sister.

Another time, she forgot what her wedding planner looked like and introduced herself to the woman as if the two had never met.

“I had no idea what was going on. Nobody diagnosed me with anything. Everyone said I was fine based on my labs. Someone asked me if I was on my period,” she said.

Now, at an age when many young professionals consider financing a home, traveling or starting a family, Waldo is weighing her options. Her employer didn’t offer disability insurance with her job — a benefit she didn’t think she’d need as a healthy twenty-something. So she’s waiting to see if her condition improves with time — and burning through her cash savings in the meantime.

“I think in a parallel universe where none of this happened, we would be doing that now,” she said of house hunting. But “instead, I’m kind of like, ‘Oh, I want to see if we can get away with this cheap rent again.”

‘A mass disabling event’

More than two years after COVID began, millions of survivors say they still don’t feel right. Brain fog, difficulty breathing, and intense fatigue are among the symptoms they say are still lingering in their bodies — upending their ability to work and derailing their financial independence.

The government estimates as many as 7 million to 23 million people are impacted by long COVID, and a Census Bureau survey suggests that among people who have been infected, one in five still experience lingering symptoms.

Vaccination is expected to significantly reduce a person’s chance of developing long COVID. That immunity though wanes with time and doctors say some people — like Waldo who was fully vaccinated but days away from a booster shot when she caught the virus — can still be young and healthy when they get sick.

Advocates have called this phenomenon a kind of “mass disabling event” that both insurers and the federal government have yet to reckon with. Data on disability claims with private insurers tied to long COVID aren’t publicly available. And while disability claims with the federal government’s Social Security program currently remain flat for now, at least one economist says that might not last for long.

“This is a $3.5 trillion problem,” said David Cutler, a professor of economics at Harvard University, whose calculations factor in lost earnings, medical care and lower quality of life.

“And there are very few 3.5 trillion problems that we know as little as we know about this,” he said.

‘This is not in their heads’

Doctors and scientists have long suspected that viral infections might be to blame for other chronic or debilitating diseases and conditions with mysterious origins, including multiple sclerosis, rheumatoid arthritis and chronic fatigue syndrome.

Then came COVID, triggering a wave of 93 million viral infections in the U.S. in just two years. Hospitals quickly began to see patients like Waldo show up at emergency rooms and doctors’ offices with symptoms they couldn’t explain.

Dr. Alba Azola, who helps run the post-acute COVID team at The Johns Hopkins Hospital in Baltimore, Maryland, said she might consult with a half a dozen other specialists or more to rule out other causes before diagnosing someone with long COVID. After that, she said, her team will have to go back-and-forth several times with insurers and employers to help their patients secure job accommodations.

“This is not in their heads,” Azola said of her patients. “This is not something that is just to get out work or a disability scam. These patients just want to be themselves again.”

One of Azola’s patients, Jazmin Holcombe, is among the luckier ones when it comes to her work life. After four months in the hospital with COVID, the 29-year-old was able to return to her job working from her home office in marketing. She hadn’t been vaccinated when she contracted the virus last year because, she said, she had been nervous about a new vaccine and she mostly stayed at home.

But she’s still far from her old self. Now, rather than planning trips or going to concerts like she used to, Jazmin spends much of her time doing physical therapy at the hospital, carrying with her an oxygen tank wherever she goes. She said her doctors hope to have a better idea by the end of the year what her prognosis will be.

“No one knows yet,” she said.

‘No man’s land’

That uncertainty in the lives of young long haulers and its impact on the economy has caught the attention of senior government officials and scientists.

The National Institutes of Health has launched a $1.5 billion study to identify the causes and find treatments for long COVID. And, the Biden administration has added long COVID as a condition that qualifies as a disability under the American Disability Act — a move that requires employers to grant work accommodations.

Also, the Labor Department has teamed up with the Centers for Disease Control and Prevention and Surgeon General’s office to crowdsource ideas from the public on “workplace challenges” tied to long COVID.

Taryn Williams, assistant secretary of labor for disability employment policy, said she hopes to have an analysis of that effort in coming months. In the meantime, she said, people can go to www.covid.gov/longcovid to see what benefits they might be eligible for. They also can get free counseling through the Job Accommodation Network at askjan.org, she said.

“We do not know yet the full extent of the impact of long COVID on the economy or the workforce. But we do know that public health and safety are critical to a healthy economy, which is why we are so focused on this,” Williams said.

For now though, employer accommodations can still be scarce, especially without legal help.

Mark DeBofsky, a disability attorney and law professor at the University of Illinois-Chicago John Marshall Law School, said people should know that many lawyers — including himself — won’t bill their clients until they win a case. He said he advises his clients to save any medical documentation they have and collect statements from family members about how they might have changed.

Keeping detailed journals of their symptoms can be a good idea too, he said.

“I think it’s still a mixed bag,” DeBofsky said about insurance companies and employers responding to long COVID patients.

“Every disability claim is very complex, and I don’t begrudge the insurance companies for really doing their due diligence,” he added.

But even people who keep detailed records can get rejected, like Frantz Dickerson, a 55-year-old sales executive who worked during the pandemic for a company that sold and fixed elevators. Dickerson’s job was to drive into Philadelphia where he would stand on rooftops or climb into the elevator shafts of high-rise buildings and hospitals to ensure safety and order fixes.

After being diagnosed with long COVID — a mental state he describes as feeling as though his brain went from a 10-lane highway down to two lanes — his doctors suggested he take time off to rebuild his cognitive and physical abilities.

But according to his employer’s disability insurer, Dickerson could still work in sales. That’s because the insurer defined a sales job as mostly sitting at a desk, even if that wasn’t an accurate description of what he did. His former employer did not respond to requests for comment, and his insurer said it won’t discuss individual cases due to privacy concerns.

“I was kind of in this no man’s land,” Dickerson said of his rejection. “Insurance says that I’m not disabled, but my work says, ‘no, you can’t come back until your doctor fully releases you.’ And my doctors were not fully releasing me because they understood long COVID.”

Dr. Benjamin Abramoff, who treated Dickerson as head of PennMedicine’s post-COVID care clinic and confirmed the details in his case, said he oftentimes will spend hours filling out paperwork for patients. Abramoff said he knows of other doctors and clinics that have pulled back from the specialty because they don’t have the staff or resources to do it.

Abramoff said he wants more data on effective treatments and is watching ongoing studies closely. But he also would like to see insurers agree to use the same standardized forms.

“It is a big administrative burden,” he said. Insurers “send in the forms and the forms get rejected for technicalities (such as) a box that wasn’t filled out quite right. And then it has to come back to be filled out again or edited.”

Dickerson eventually switched sales jobs to one that’s fully remote. After several months of therapy, he says he’s doing better now that he’s learned how to pace himself and take breaks if he needs it, including playing his guitar — something he was encouraged to do by his doctor.

As for Waldo, she eventually landed an official diagnosis of long COVID: “Post COVID-19 Condition ICD10 code U09.9” — a medical code that didn’t exist until about a year ago.

But she’s close to draining her once-impressive cash savings of $70,000 to pay for medical treatments and living expenses – money she had hoped to use to buy a house someday and maybe travel.

In the meantime, she’s still planning to get married next year. But everything else, including starting a family, is on hold for now.

“I just don’t know what my body can handle,” she said.

ABC News producers Vika Aronson, Kelly Terez, Iru Ekpunobi and Cate Barbera contributed to this report.

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Monkeypox cases are on the decline in New York City, data shows

NYC Department of Health & Mental Hygiene

(NEW YORK) — Monkeypox cases appear to be on the decline in the epicenter of the country’s outbreak.

Data from the New York City Department of Health & Mental Hygiene shows that as of Aug. 30, the latest date for which data is available, the Big Apple recorded a seven-day rolling average of 9 infections.

That’s an 82% decline from the seven-day rolling average of 50 recorded two weeks ago.

Since the outbreak began in mid-May, no state — or city — has recorded more monkeypox cases than New York, so a drop in infections could be a prediction of what is to come for the rest of the country.

“The good news is monkeypox is declining,” Dr. Roy Gulick, chief of the division of infectious diseases at Cornell University’s Weill Medical College, told ABC News. “Globally it’s declining and across the United States but being really led by the major cities and we’ve seen it right here in New York.”

Even as the U.S. approaches 20,000 total infections, nationwide trends appear to show a drop, according to data from the Centers for Disease Control and Prevention.

As of Aug. 31, the seven-day rolling average of cases in the U.S. sits at 281, the lowest number recorded since July 25, according to an ABC News analysis of CDC data.

The outbreak has primarily been concentrated in men who have sex with men, a group that includes people who identify as gay, bisexual, transgender and nonbinary, although health officials have said anyone — regardless of sexual orientation — is at risk if they have direct contact with an infected patient

Health experts say men who fall into this category have been likely doing a good job following doctors’ advice in proper precautionary measures.

A joint survey from the CDC, Emory University and Johns Hopkins University found that about one-half of gay, bisexual, and other men who have sex with men reduced their number of sexual partners, their number of one-time anonymous partners and reduced their use of dating apps.

“Health departments as well as community advocates and organizations have really gotten the word out about monkeypox,” Gulick said. “Not only that it was something people needed to pay attention to, but also what to look for, what to do if you had lesions, when you should go see your doctor, and then how to avoid passing it to other people. Or if you didn’t have it, how to avoid getting it in the first place.”

People at risk changed their behavior in response to the threat, he added.

On Thursday, the NYC DOHMH announced it will begin making second doses of the monkeypox vaccine available for those who received their first dose at least 10 weeks earlier.

Walk-ins for first doses will also be accepted a city-run sites, a sign that scarcity of the vaccines is abating.

“Here in New York City, more than 70,000 monkeypox vaccines have been given and recently there was a recommendation to split the dose — make one dose into five doses — and that strategy is also being rolled out, so more vaccines are available,” Gulick said. “We did hear about waiting lists and long waits and trouble getting appointments initially for vaccines, but that really is not the case anymore.”

However, Gulick added the outbreak isn’t over and urged people in high-risk categories to keep taking precautions.

“Although the numbers are encouraging because they’re going down, there is still a risk,” he said. “So, people who are at risk should absolutely seek out the vaccine, talk to their providers about whether they should get it or not and then people should be aware of contacts or changing their behavior to reduce the number of contacts that they have to avoid getting monkeypox.”

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