(WASHINGTON) — President Joe Biden and first lady Jill Biden will be hosting the cast of Apple TV+’s Ted Lasso at the White House Monday to discuss the importance of talking about mental health.
Several actors from the hit show including Jason Sudeikis, Hannah Waddingham and Brett Goldstein will visit to discuss why people should address “mental health to promote overall well-being.”
Biden tweeted a suggestion to the visit Sunday with a photo of a sign that reads, “BELIEVE” above one of the doors to the Oval Office, which references the sign that the title character, played by Sudeikis, hangs above his office door.
According to a press release from the streaming service, the themes of Ted Lasso have focused on “optimism, kindness, and determination.”
The series, which saw its third season premiere last week, has also not shied away from depicting mental health struggles.
Lasso is an American football coach who moves to England to coach a Premier League soccer team. He generally has a sunny disposition, but cracks begin to show as past trauma catches up with him.
Dr. Sharon Fieldstone, played by Sarah Niles, is brought in to help one of the team’s soccer players after a penalty kick gone wrong shakes him up. However, she soon begins to have one-on-one conversations with all the players.
Although Lasso initially resists Fieldstone’s attempts to have a session with him, he eventually visits her after experiencing a debilitating panic attack.
Over a series of sessions, Lasso and Fieldstone dig down to discover the root cause of Lasso’s anxiety.
Ted Lasso co-creator and cast member Brendan Hunt, who plays Coach Beard, told Phil Lipof on “ABC News Live” Friday that the response from fans to Lasso entering therapy has been overwhelmingly positive.
“The feedback we’ve gotten from people on this show is so uniquely moving — and has been from the beginning for various reasons — but, when we added the therapy element, heard back from a lot of different people about how therapy has helped their lives and some people who were just finally taking the step to start therapy because of the show,” Hunt said.
In several speeches, including his most recent State of the Union in January, Biden has said one of the key proposals of his administration is improving mental health.
The administration has provided more than $500 million to help states launch the 988 Suicide and Crisis Lifeline and has distributed funds to help more schools hire mental health professionals that can connect with students either in person or via telehealth.
Biden has also called on lawmakers to pass legislation that would prevent social media companies from collecting personal data on children and teenagers as well as ban targeted advertising to children.
“President Biden has made addressing the mental health crisis a core pillar of his Unity Agenda,” the White House said in a statement. “His strategy is focused on training more providers, making care more affordable and accessible, and creating healthier and safer communities, including online.”
The White House did not immediately return ABC News’ request for comment.
Sydney Benes with head of security Nate Sanders at Sullivan’s Pub. Sanders said Benes is looking to press charges against the two men who pushed her chair down the stairs and damaged it. — Julia Zukowski
(ERIE, Pa.) — Sydney Benes, a Mercyhurst University student whose unattended wheelchair was pushed down stairs in a viral video, hopes her story can be used for change and she can be an advocate for others in her situation.
The incident occurred March 11 at Sullivan’s Pub in Erie, Pennsylvania. A video posted to Twitter shows fellow student Carson Briere pushing Benes’ wheelchair down the stairs at the eatery and walking away.
Benes, a double amputee who lost her legs in a car accident in 2021, uses the chair while learning to use her prosthetics.
“All that was going through my head was ‘man I hope this was an accident, I hope that this wasn’t on purpose,” Benes told ABC News.
Nate Sanders, head of security at Sullivan’s Pub, said he was helping Benes go into the bathroom downstairs when he heard a loud noise.
“We heard something that sounded like somebody falling down the steps. We went out and checked, didn’t see any sign of anybody falling, but when it was time to bring her back up the stairs, we found her chair at the bottom of the steps,” he told ABC News.
Once they checked the footage, Sanders said they identified who it was, forced the boys to apologize to Benes, and escorted them out of the establishment.
“I grabbed him on the shoulders and said, ‘I’ve got video of you tossing a wheelchair down the steps like it’s time to go,” he said.
Sanders said the two student-athletes are now banned from the bar.
While there has been a GoFundMe created for Benes, she said she didn’t intend to keep all of the money raised to replace the broken wheelchair even though the goal was exceeded. Instead, she wants to donate the money to other causes and hopes this is an opportunity for change and fair treatment of people who are disabled.
“I can use it to show people what we go through, what we have to deal with, and how we wish to be treated,” she said. “We are treated like things, like second-class citizens; we’re not treated with respect.”
Mercyhurst University said Carson Briere and two other student-athletes were placed on an interim suspension from their athletic teams, per school policy, pending the outcome of the investigation. Briere has issued an apology.
“I am deeply sorry for my behavior on Saturday. There is no excuse for my actions, and I will do whatever I can to make up for this serious lack of judgment,” he said.
Briere’s father, interim Philadelphia Flyers GM Daniel Briere, also issued a statement of apology on his son’s behalf.
“I was shocked to see Carson’s actions in the video that was shared on social media. They are inexcusable and run completely counter to our family’s values of treating people with respect. Carson is very sorry and accepts full responsibility for his behavior,” he said.
ABC News reached out to the Erie Police Department for comment on the investigation and has not heard back.
A 28-week ultrasound of the baby’s head shows normal brain structures that should have formed and then separated in the midline are not there. — Courtesy Kylie Overdorf
(NEW YORK) — Kylie Beaton was looking forward to having her second child later this year. Now, she’s faced with carrying an unviable pregnancy to its end due to Texas’ highly restrictive abortion ban.
According to a report from her doctor, Beaton’s baby has a rare, severe condition impacting the development of its brain, but she is unable to access abortion care in her home state.
“To have a woman go through so much torture along the way that’s going to stay with them forever,” Beaton told ABC News. “Whatever the case may be, you have to look at things from a different perspective.”
Texas has several abortion bans in place that prohibit nearly all abortions, except when a mother’s life is at risk or there is a risk of serious bodily harm. The state has civil and criminal penalties for performing banned abortions.
Beaton, who has a 4-year-old daughter with her husband, Seth, said the couple had been actively trying to get pregnant when they conceived the unviable pregnancy. Seth had been hospitalized with COVID pneumonia in June 2021. When he was finally released six months later, the couple started trying to have a baby right away, Beaton said. Beaton has polycystic ovary syndrome, which can make it harder for women to get pregnant, so it was all the more joyful when she learned their efforts were successful.
“I was really excited when we found that it was a boy, but that was short-lived,” Seth Beaton told ABC News. “Right now, I’m just terrified for my wife. She’s the strongest person I know and she’s just helpless right now. And it’s not fair for her and other women. And we have a daughter, I couldn’t imagine my daughter ever having to go through this.”
At her 20-week ultrasound appointment, Beaton said her physician discovered the fetus had a rare, severe anomaly — called alobar holoprosencephaly — in which the fetus’s brain does not develop into two hemispheres as it normally would, and the major structures of the brain remain fused in the middle.
The brain splitting into two hemispheres is a “critical stage in the development” and can impact the development of the nose, mouth and throat, Dr. Katie McHugh, an Indiana OB-GYN and abortion provider, told ABC News. The condition results in a very painful life and death for the fetus, McHugh said.
“Often times we will offer, if not recommend, pregnancy termination,” McHugh said.
The anomaly occurs in about 1 in 250 fetuses, but in just 1 in 16,000 live births, according to the Cleveland Clinic. In her seven years practicing as a maternal fetal medicine specialist, Dr. Carrie Rouse, an OB-GYN and maternal fetal medicine specialist at Indiana University Health, said she has only come across five cases. Beaton’s 28-week ultrasound shows the severity of her baby’s anomaly.
“The inside appears very empty,” said Rouse, who is not treating Beaton, but looked at her ultrasound. “The normal brain structures that we would see, that should have formed and then separated in the midline, are not there where they normally would be. This is a very concerning ultrasound.”
Beaton said her physicians told her the baby could survive out of the womb for a couple of weeks, at most, in the event that the pregnancy ends in a live birth. Rouse agreed with this assessment, pointing to what she said is a lack of development of normal brain tissue and empty fluid filling the head.
“This anomaly is typically lethal for most infants within days to weeks,” Rouse said. “Outliers are only able to survive with significant amount of invasive procedures and interventions.”
Babies with this condition never reach developmental milestones, meaning they won’t have any intentional interactions like smiling, and often can’t see, have severe seizures and hormonal abnormalities, according to Rouse. Very few outliers are able to survive up to a year and the level of intervention needed for babies with this condition to survive is extremely high; they often need mechanical ventilation or a life support machine, multiple medications and repeated lab draws, Rouse said.
“They live to a year with basically heroic measures,” Rouse said.
Beaton said her physician referred her to a specialist a week after her diagnosis. However, she said the specialist confirmed that due to the overturning of Roe v. Wade, and Texas’ “trigger” law effectively outlawing nearly all abortions, the physicians’ hands were tied. She said the specialist told her he could not do anything to end the pregnancy unless Beaton developed a severe health issue or if the fetus dies in the womb.
Anti-abortion group Texas Right to Life has routinely argued that fetuses should be “honored and protected in law no matter how long or short their lives may be,” according to a statement earlier this month.
Representatives for Texas Gov. Greg Abbott, Attorney General Ken Paxton and state Sen. Bryan Hughes, who authored one of the state’s abortion bans, did not immediately respond to ABC News’ request for comment about Beaton’s situation.
Beaton said she wanted to have a vaginal delivery, feeling like a scar from a cesarean section would be a constant reminder of what she had lost. A C-section also means that the couple would be advised to wait 12 to 18 months before trying to get pregnant again, the typical time physicians recommend women wait so their uterus can recover from surgery, according to the Center for Advanced Reproductive Medicine and Fertility.
“With this condition, in particular, because the head, the fetal head, develops at a different rate, often because of fluid collections, most of the time vaginal delivery is not an option. And so cesarean delivery is required,” McHugh said. “And this is going to be major abdominal surgery, with risks associated with it — for a baby that has maybe no chance of a normal life or potentially of survival at all, depending on the severity.”
Unable to get care in Texas, Beaton said she booked an appointment to get an abortion at a clinic in New Mexico in February.
But, she said when she went in for an ultrasound days before her appointment, she was told her baby’s head had grown too big and she could no longer get the procedure. The facility’s cutoff for abortions is 23 weeks and six days she said and the fetus’s head was already measuring at what it typically would at over 23 weeks of pregnancy.
“From there, we were pretty let down,” Kylie Beaton said.
She said she was referred to a clinic in Colorado that provides later-term abortion care, but that facility told them it would cost between $10,000 to $15,000 for the procedure, which was financially out of question, Beaton said. The New Mexico clinic would have provided the same procedure for $3,500, Kylie Beaton said. Neither estimate includes the cost of travel and accommodation.
Since then, the fetus’s head has continually increased in size, filling with fluid, she said. At her appointment on Monday, when she was 28 weeks pregnant, the fetus’s head size was measuring at what it typically would be at 39 weeks, a full-term pregnancy, the ultrasound showed.
“On that ultrasound, the head is measuring significantly larger than it should be. It’s measuring about 10 weeks further along than she actually is, which is very concerning,” Rouse, the Indiana Health System OB-GYN, said.
Rouse said Beaton’s C-section could be more complicated and risky as her pregnancy continues.
“You worry about ongoing growth of the fetal head of causing more complications at the time of delivery, like hemorrhage, needing a blood transfusion, needing to use a larger incision on her abdomen in order to to remove the infant, needing to use a larger and different incision on the uterus in order to remove the infant,” Rouse said. “There’s a risk of possibly uterine rupture just because of the stretch on the uterus. All of these things would make me pretty worried.”
“For a condition for which we expect the baby to pass away soon after birth, that baby is going to pass away because of the alobar holoprosencephaly, whether they are born at 39 weeks or earlier,” Rouse added.
Beaton said her physicians in Texas contacted other doctors in the state, hoping they had heard of an alternative regarding the state’s laws that would permit them to induce her labor since the baby’s head was at full term. Ultimately, Beaton said, doctors determined the size of the baby’s head was not a good enough reason to induce labor because her health is still not at risk.
“And if the state were to find out, they would most likely press charges,” Kylie Beaton said.
Texas’ anti-abortion law makes it a second-degree felony for any attempt by a medical professional to perform, induce or attempt an abortion, and a first-degree felony if the abortion is carried out.
“My specialist and my OB both had said I had to go essentially full term to at least 37 weeks unless something happens to either the baby or I, then they could induce,” Kylie Beaton said.
The couple said the law has left them feeling helpless and frustrated over not being able to make a humane decision for their baby.
“I mean, for them to say, ‘Well, you need to wait until you’re in a health crisis, a health issue to where your life’s in jeopardy, then that’s when we can take it.’ Well, then why do we have doctors?” Kylie Beaton said.
“Why are we taking medications for things like high blood pressure? Why don’t you wait until you have a heart attack? Or until you have, you know, the signs that you’re having a stroke to be on medication? All those things? It’s kind of the same way, if you look at it from our perspective,” she added.
Before this pregnancy, Beaton said she never would have considered getting an abortion. Now, she believes abortions should be allowed in cases like hers and for women with other health conditions to get the care they need.
“I’m personally not for it being a way of birth control. I do believe that there are certain instances where I deem that it is necessary,” she said. “Never in a million years would I expect or believe that we will be going through what we’re going through now.”
(NEW YORK) — Across the country, Republican lawmakers have introduced legislation that restricts transgender health care for minors.
At least eight states have passed laws or policies restricting this care, and 23 more state legislatures are considering similar legislation of their own.
Medical experts say that understanding transgender identities, gender dysphoria and how gender-affirming treatments work is key to understanding the impact these bans may have on patients.
“When it becomes too political, it becomes more about paying attention to very short sentences, but not paying attention to nuance” said Dr. Hussein Abdul-Latif, a pediatric endocrinologist at the Children’s Hospital of Alabama with a special focus on gender care.
“And that’s unfortunate, because this is not something that is very simple.”
Why do people undergo gender-affirming care?
Gender-affirming care can help treat gender dysphoria, which refers to the stress of being in a body that doesn’t feel like one’s own, according to the Diagnostic and Statistical Manual, Fifth Edition, which provides up-to-date information on mental health conditions.
People experiencing gender dysphoria may feel that their physical body does not match their inner sense of who they are or that they do not desire the gender identity typically associated with their assigned sex at birth.
This can cause distress, depression and anxiety, according to medical experts. However, being transgender is not a mental illness.
“There’s not a blood test, there’s not an MRI we can do to determine who’s … dealing with dysphoria,” said Dr. Andrew Goodman, the medical director for Callen-Lorde, a community health center in Manhattan that specializes in LGBTQ health care. “We have to listen to people, and to trust them and what they’re telling us.”
A national survey in 2015 by The National Center for Transgender Equality reported that of the more than 27,000 trans Americans who responded, 38% of them knew they were trans before 5 years old, and 60% knew they were trans before 10.
Is gender diversity a new concept?
No. There is documentation of gender diverse individuals in a wide range of cultures around the world throughout history, dating back centuries.
Medical treatment for gender dysphoria, as it’s known today, was introduced in the early to mid-1900s in Germany.
Modern gender-affirming care is based on “decades of clinical experience and research and, therefore, they are not considered experimental, cosmetic or for convenience,” per the World Professional Association for Transgender Health standards of care.
What is gender-affirming care?
Gender-affirming care is about supporting someone’s identity, said Dr. Goodman. It helps align their physical appearance with their gender identity, and can include puberty blockers, hormone medications, and surgery.
Trans individuals often transition socially — by changing their name and pronouns, or dressing differently — before beginning any medications.
“I look for the need, the crisis… when the dysphoria really starts to intensify,” said Dr. Goodman, who explained this can be when a trans youth starts seeing puberty-related changes in their body.
Puberty blockers are used in people who have not started or completed puberty. Pausing puberty allows children to explore their gender identity without the growth of permanent sex characteristics, Dr. Abdul-Latif explained.
Puberty blockers mimic the body’s natural hormone, called GnRH, which suppresses the release of testosterone for biological males or estrogen for biological females, according to the U.S. Department of Health and Human Services.
These are typically offered during the early stages of puberty, according to the Endocrine Society treatment guidelines. This stage of puberty can be determined by changes in the body such as enlargement in the testicles or breast bud formation. The average age for this developmental stage is 11-12 years old for biological males and 10-11 for biological females.
If these are stopped, a child will resume undergoing puberty with little to no proven side effects, according to medical experts ABC News spoke with.
Once kids are in the later stages of puberty, typically around the age of 15, they are no longer a candidate for puberty blockers and would transition to hormone therapy, explains Dr. Abdul-Latif. They are directly given estrogen or testosterone, based on their gender identity.
Changes from hormone therapy occur slowly and are less reversible, he explains, such as changes in voice and body hair.
The World Professional Association for Transgender Health guidelines recommend a thorough biopsychosocial evaluation prior to initiation of hormone therapy, including a letter from a mental health professional, informed consent from the parents in accordance with national laws, and a thorough discussion of the risks and benefits with both patients and parents.
It’s not unusual for patients to stop hormone therapy and decide that they have transitioned as far as they wish, according to Abdul-Latif.
“A very important idea that I share with them is that they can change their mind anytime they want to, even when they start hormone therapy or puberty blockers,” Abdul-Latif said. “That is important for me to make sure that they are not continuing because of fearing that they will disappoint me. I certainly would not be disappointed. I’m there to serve them.”
According to the American Academy of Pediatrics, gender-affirming surgery is only done on adolescents on a case-by-case basis. It does not come without risk, said Goodman, but for those experiencing severe distress with their body, surgery can be a major source of relief.
Surgeries include the removal of breast tissue, creating the appearance of breast tissue, or reconstructing of genitalia.
Is gender-affirming care safe?
All medications, surgeries or vaccines come with some kind of risk and gender-affirming care is no different, according to physicians. However, knowing the risks and benefits of treatment – and of not treating a condition – can help families make an informed decision.
“I never phrase the conversation [with patients] as this is totally benign…there are risks here. But the thing that we’re really considering is are these risks worth taking on because of the benefits? Because of the misery of dysphoria, because of how much it might be holding you back?” Goodman said.
“I can point to dozens of cases in my own practice where those risks absolutely were worth the benefits. We have made people’s lives tremendously better because we started hormones when they were at a young age.”
There is evidence of a slight reduction in bone mineral density for those on estrogen therapy for male to female transition. Dr. Abdul-Latif says he warns patients of this risk beforehand and if patients start to develop pain or weakness, dosing can be adjusted to lessen the effects.
Early research shows that testosterone therapy might increase cholesterol levels. However, a study published by the American Heart Association, has not demonstrated any evidence of increased cardiovascular risk.
Those receiving hormone therapy need routine lab monitoring and may require medication to manage their cholesterol.
Oral estrogen has been shown to increase risk of blood clots. When Dr. Abdul-Latif starts a patient on this medication, he strongly encourages patients not to smoke cigarettes as that can further increase risk of blood clots. Depending on the situation, he may switch to a non-oral form of estrogen as it carries less risk.
Estrogen therapy can decrease sperm count, so Dr. Abdul-Latif recommends trans women freeze their sperm before starting therapy. The long term effects of testosterone on fertility are still being studied, however this is discussed in detail before starting hormone therapy.
But those potential risks are often outweighed by the benefits.
Major national medical associations, including the American Academy of Pediatrics, the American Medical Association, the American Academy of Child and Adolescent Psychiatry, and over 20 more agree that gender-affirming care is safe, effective, beneficial, and medically necessary.
Transgender youth are more likely to experience anxiety, depressed mood and suicidal ideation and attempts, often due to gender-related discrimination and gender dysphoria.
Gender-affirming hormone therapy has been proven to improve the mental health of transgender adolescents and teenagers, according to a recent study in the New England Journal of Medicine.
It’s rare for people to reverse a transition after undergoing gender affirming care, according to research published in the journal LGBT Health. Research found that those who reverse their transition often do so because of pressures from family and social stigma.
Rates of regret for gender affirmation surgery are extremely low — research shows they hover around 1%. Rates of regret for knee and hip surgeries are significantly higher, studies show.
Ultimately, said Goodman, every trans child should be addressed individually.
“This is a purely medical decision between parents and families and physicians,” said Dr. Abdul-Latif. “It does not need interference and added pressure on a family that is already under pressure.”
(NEW YORK) — On the third anniversary of COVID-19 being declared a global pandemic, public health experts can point to clear instances where the United States succeeded in beating back the virus and others where it didn’t.
Even as the virus continues to spread, data from the Centers for Disease Control and Prevention show that weekly cases, hospitalizations and deaths are declining, and the nation survived its first winter since the pandemic began without a true winter wave.
Public health experts said that while the U.S. government and federal health agencies succeeded in many aspects — including the rollout of vaccines and at-home tests — there are also lessons to be learned from mixed messaging.
“I think it’s important to remember that we lost millions and millions of lives and that we don’t forget all the things we’ve learned,” Dr. Priya Sampathkumar, a professor of medicine and the head of infection control for Mayo Clinic, told ABC News. “So learning is one thing but retaining that memory and being ready to come together to prevent another pandemic is really important.”
Speedy rollout of the vaccines
Experts agree that the development and rollout of the COVID-19 vaccines is one of the country’s biggest successes.
In April 2020, the Trump administration launched “Operation Warp Speed” to fast-track the development and production of COVID-19 vaccine, providing unlimited funding and other resources to pharmaceutical companies.
The majority of vaccines, from the first steps of academic research to arriving on the market, generally take 10 or more years to be available, experts said. However, researchers were able to perform several steps usually performed in a linear fashion simultaneously, allowing companies to obtain U.S. Food and Drug Administration authorization and scale up production without lessening vaccine safety requirements.
“It really unlocked a new sort of a new era of vaccine,” said Dr. John Brownstein, an epidemiologist and chief innovation officer at Boston Children’s Hospital and an ABC News contributor. “We’ve recognized that we can develop and deploy a vaccine in actually reasonably fast pace from identification of a new virus to actual first prototype.”
“For the first time, we recognize that there’s a lot of places that can be parallel process, so the process of manufacturing, and regulatory approval can happen relatively simultaneously,” he added.
Sampathkumar said another reason the vaccines were able to be developed so quickly is because the genome sequence, or the genetic makeup, of the virus was uploaded quickly to global databases.
“We really very quickly sequenced the virus from the first case being reported in China in late December to about seven weeks later, we have the entire sequence of the SARS-CoV-2 virus, which was step towards making a vaccine,” she said. “For most previous viral epidemics, it took anywhere from six to 18 months to do that. So that very first step happened so quickly and set the stage for vaccine development.”
Additionally, the relatively new technology of messenger RNA, or mRNA, was used. While most vaccines use a weakened or inactivated virus to stimulate an immune response, mRNA vaccines teach the body how to make proteins that can trigger an immune response and fight off an infection.
Because researchers can design mRNA vaccines more quickly than they can produce the live or weakened pathogens needed for a traditional vaccine, mRNA vaccines against COVID-19 were quickly developed, tested, mass produced and delivered to the general population, preventing millions of hospitalizations and deaths, according to analyses.
At-home COVID tests available for everyone
Polymerase chain reaction (PCR) tests are considered the “gold standard” when it comes to COVID-19 testing. They look for genetic material from the virus and are considered to be very accurate.
However, in the early days of the pandemic, they had a very long turnaround time because samples must be sent to a laboratory and be analyzed by a medical professional.
Companies quickly began scaling up production of rapid at-home antigen tests, which check for antigens, or proteins on the surface of the virus.
While less accurate than PCR tests, these rapid tests are still considered quite accurate when used in people with symptoms of infection and can deliver results in 15 minutes or less.
Sampathkumar said the widespread use of at-home tests was “very amazing” because it was, for many Americans, the first time they were able to test themselves at home for a virus, compared to flu tests and strep tests that are often performed at doctors’ offices, urgent care centers or hospitals.
“When you think about it, when you’re feeling sick or when you’re infectious to others, it’s the worst possible time to expect you to go to a crowded clinic or hospital,” she said.
Last winter, the Biden administration launched a website where Americans could request free at-home rapid COVID tests delivered to their doorsteps.
“Making the tests available to every person living in the U.S., you could order the tests and have them delivered to your home for free was also a major step forward,” Sampathkumar said.
Mixed messaging
Experts say public health officials made missteps by having mixed messaging about preventive measures like masking.
In February and March 2020, officials including then Surgeon General Dr. Jerome Adams and Dr. Anthony Fauci downplayed the need for the general public to wear masks.
However, in early April, the CDC changed its guidance and recommended that everyone wear a mask or face covering.
While reports have suggested the CDC and other officials delayed recommending masking because they were worried about causing a run on masks and other PPE supplies for health care workers, experts say this also means agencies didn’t provide the clear messaging that the public needed.
“I think that that kind of mixed messaging created enormous space for doubt enormous space for skepticism among the public,” Dr. Richard Keller, a professor in the department of medical history and bioethics at the University of Wisconsin School of Medicine and Public Health, told ABC News. “It created levels of uncertainty that were really unnecessary and deep and eventually became harmful.”
The experts say it’s normal for their understanding of a virus to evolve as more information is learned, but they noted that public health officials did not do a good job of communicating that process to the public.
“That was really made clear through the pandemic: our inability to communicate the nuance of science as the science was evolving,” Brownstein said. “That was really our Achilles heel because we were not able to explain to the public that a recommendation could change based on how the science evolves.”
People viewing COVID-19 deaths as victims’ fault
Keller said that as the pandemic has worn on, many Americans have come to view COVID-19 deaths as the fault of the victims and lost a sense of compassion.
Some of this may have been the fault of public health messaging including the Biden administration calling it a “pandemic of the unvaccinated” and stressing how much more likely people are to die of COVID if they don’t get vaccinated.
According to the CDC’s most recent estimates, people who are up to date on their vaccines have a nearly tenfold lower risk of dying compared to an unvaccinated person. Other risk factors include lower socioeconomic status and/or underlying medical conditions such as diabetes and hypertension.
“To label this a ‘pandemic at the unvaccinated’ suggests the people who are dying are dying because it’s their own fault,” Keller said. “I think that’s a harmful message because it does a couple of things.”
“It suggests that people are to blame for their own misfortune. It also mischaracterizes the true nature of mortality statistics as ti where people are dying and what their circumstances are,” he added.
(NEW YORK) — More than 40,000 graduating medical students learned Friday where they will spend the next three to seven years of their medical training.
With the United States grappling with a simultaneous shortage of primary care physicians and a rural health care crisis, many of the graduating students are set to enter the front lines of the country’s health care shortage.
At least 136 rural hospitals and health systems closed between 2010 and 2021, and over 40% of rural hospitals operate with negative profit margins. Despite billions of dollars in investment in health care, hospitals throughout the United States face the possibility of shutting down.
“I would say it is probably the worst time for health care that we ever experienced,” Joanne Conroy, the chief executive officer and president of Dartmouth Health, told ABC News. She noted that increased costs, inflation, limited housing, and workforce shortages have made running rural hospitals more challenging.
“We know what to do if we face another pandemic,” Conroy said. “The question is whether or not we have the financial resilience in order to survive it.”
Many hospitals that remain open have cut costs to survive, offering fewer services and beds.
In 2020, 47% of rural community hospitals did not provide obstetric services, with 89 obstetric units closing between 2015 and 2019. Seven million women reside in counties with limited or no access to maternity care, impacting half a million newborns annually.
According to Conroy, patients can already feel the impact of the crisis, noting that some women in New Hampshire need to drive two hours to deliver their babies. Other effects include fewer available beds in emergency rooms, delays for elective surgery and longer wait times for prescriptions or ambulance pickups.
For new medical professionals entering their residency, especially those joining rural systems, the circumstances of the struggling health systems are out of their control.
“It is not my job to fix all of the problems for an entire community, that’s impossible. When you feel like that’s your responsibility, burnout is basically inevitable,” said Katie Stevenson, a Tufts medical student. “When you feel like your goal is to do the best you can with the resources you have, you are able to right-size your expectations a bit.”
An increasing number of students are entering medical school programs that focus on rural medicine. In 2019, the Health Resources and Services Administration issued grants to create 32 newly accredited rural residency programs, supplementing the preexisting programs.
This year, Tufts School of Medicine will graduate its tenth class of students from its Maine Track MD program – a partnership with Maine Medical Center that allows students to pursue a community-based curriculum and gain financial incentives to encourage primary-care specialties.
Graduating roughly 40 students annually, 27% of Maine Track students have been matched to programs in Maine and 47% have been matched into primary care programs, according to Dena Whitesell, an assistant dean for students at Tufts and psychiatrist at Maine Medical Center.
“We know that students and residents who live in an area [and] who train in an area are more likely to practice in that area in the future,” Whitesell said.
Liv Fauver, a Tufts student who matched with a University of Vermont residency program, grew up in rural New Hampshire and said she felt motivated to work in a similar community where she could positively impact the local residents.
“I think for me, my goal is to live and work in the community that I serve,” she said. “So I’m really in a place where I go home or go to the grocery store and see my patients all the time, because that’s the world that I live in and work in.”
While rural hospitals have closed in record numbers, PCPs – medical professionals who patients regularly use for checkups and other routine care – face additional challenges, especially in rural areas, according to experts.
Greg Sawin, a PCP who has practiced in Massachusetts and Maine as well as Duke University School of Medicine professor, said he worries that the goals of primary and long-term preventative care can sometimes be at odds with larger health care systems.
“We get paid to do things to people. We don’t get paid to keep populations healthy,” he said.
Moreover, he believes the costs associated with medical schools – including the high cost, the likelihood of incurring debt and substantially higher pay to pursue competitive specialties like orthopedic surgery or dermatology, for example – disincentivize primary care options like family or internal medicine.
“It can be very appealing to want to go into a specialty where you’re guaranteed to make more money and pay that debt off more easily,” Stevenson said.
Owen Foster lives in rural Vermont and has felt the impact of the decreased number of available PCPs, spending six months to book an appointment with a doctor. Living in a rural area, Foster shares his dilemma with millions of Americans in rural areas impacted by the shortage of PCPs.
“You need basic things at certain intervals in your life,” he told ABC News. “If you don’t have a primary care provider, you can’t get that and you can’t get the referrals you need, so it’s really, really difficult.”
What makes Foster’s experience unique is his position as the state of Vermont’s top health care regulator. As chair of Vermont’s Green Mountain Care Board, he oversees the quality and cost of the state’s health care system.
Learning about the shortage of primary-care physicians in Vermont, Foster decided to use the opportunity to find a PCP as a chance to examine the market as a “secret shopper.”
“What I found was I was completely incapable of getting a doctor,” he said. “I called eight places and the best I got was on an indefinite wait list, which never came to fruition.”
Rural areas comprise about two-thirds of the primary care health professional shortage areas nationwide, even though only 20% of Americans live in rural areas.
The problem is also likely to worsen over time. Projections indicate that the United States will likely suffer a shortage of between 17,800 and 48,000 PCPs by 2034.
Moreover, health care professionals believe that the shortage of PCPs can make other elements of health care more expensive and worsen overall patient outcomes. Sawin gave the example of a person getting strep throat. Without a PCP, the person might go to a local hospital emergency room, which is significantly more expensive than other treatment options.
“In terms of mismatch of resources, you know, a kid with strep throat showing up in the ER is like cutting butter with a chainsaw,” Sawin said.
Foster added that primary care providers are “critical to controlling the costs of a health care system” due to their role in the early identification of issues, their ability to diagnose mental health issues, and their approach to preventative medicine.
According to Foster, PCPs in rural areas, however, struggle to find and retain staff, negotiate with insurance companies and prevent burnout. The shortage of PCPs, combined with the increased health care needs of the older population in rural areas, creates a concerning combination.
Despite these issues, Foster said he was optimistic about some approaches to make primary care more financially feasible, including adding a floor for PCP spending within health plans and government involvement in rate setting.
A new generation of students graduating from rural track programs also has the potential to reverse the tide of the PCP shortage in rural areas, with 571 additional primary care matches this year. Stevenson, for example, matched with the Swedish Cherry Hill rural program in Washington state.
“I think we have an opportunity in this country to do a much better job of taking care of our patients if we do a better job of funding primary care and preventative care and creating healthy environments,” Stevenson said.
(NEW YORK) — A new report suggests the virus that causes COVID-19 may be linked to raccoon dogs that were illegally being sold at a wet seafood market in China.
First reported in The Atlantic, a team of scientists from around the world announced Thursday they believe the virus, SARS-CoV-2, originated at the Huanan Seafood Wholesale Market in Wuhan, where the outbreak began.
It comes amid swirling debate about the origins of the pandemic, after a report from the U.S. Department of Energy concluded with “low confidence” that it was the result of a lab leak.
According to the report, researchers at the Chinese Center for Disease Control and Prevention uploaded new data from swab samples collected in January 2020 at the market — including of the floors, walls and cages containing animals — to the open global genome sequencing database GISAID.
From there, the international team, which included virologists and biologists, downloaded the samples and analyzed them.
The samples that came back positive for the virus also contained genetic material of several animals, particularly large amounts matching the common raccoon dog.
Although this doesn’t definitively prove that the virus definitely jumped from raccoon dogs to humans, the team said it is the strongest evidence to date of the natural transmission theory.
“This is a really strong indication that animals at the market were infected,” Dr. Angela Rasmussen, one of the virologists involved in the new report, told The Atlantic. “There’s really no other explanation that makes any sense.”
Members of the research team, who have not yet published their findings, did not immediately return ABC News’ request for comment.
The findings also support other scientific research indicating that the virus likely spilled over from animals into people in and around the Huanan Seafood Wholesale Market.
Raccoon dogs are known to harbor other viruses that jump from animals to humans. For example, a October 2003 report found a virus very similar to SARS-CoV-1, which is a cousin of the new coronavirus, in a raccoon dog and among humans at a live animal market in Guangdong, China.
Although most experts now believe the SARS outbreak in 2002-03 in China was linked to bats, raccoon dogs are believed to have been brief accidental hosts of the virus.
Currently, four U.S. agencies and the National Intelligence Council say the virus was the result of natural transmission that jumped from animals to humans.
Late last month, the Department of Energy changed its stance from “undecided” to “low confidence” that the COVID-19 pandemic “most likely” was the result of a laboratory leak, becoming the second agency, after the FBI, to believe a lab accident resulted in the global health emergency.
(NEW YORK) — The number of new cases of babesiosis, a tick-borne illness, increased significantly between 2011 and 2019 in the United States, a new CDC report found. It’s also spreading consistently in three new states — now, the disease is endemic in 10 states in the Northeast and Midwest.
The increase isn’t surprising, said Dr. Peter Chin-Hong, an infectious disease specialist at the University of California, San Francisco, in an email to ABC News. It’s consistent with what experts are seeing with other tick-borne diseases, like Lyme disease.
There are likely multiple factors behind the increases, including human behavior and warmer weather. More people are moving to areas with ticks and are interacting with animals (like deer and mice) that the ticks feed on, Chin-Hong said. Climate change may also be playing a role, he says. “A warmer climate may increase tick survival, shorten the life cycle of ticks (so many more cycles possible in a season) and increase the duration of tick season.”
Usually, the parasite infects humans after being bitten by certain ticks. These ticks are commonly found in wooded, bushy or grassy areas. They are most likely to bite during the spring, summer and fall, though adult ticks may still bite during the winter if temperatures are above freezing. While there is no vaccine available, the disease can be prevented by limiting tick exposure.
Once infected, symptoms can vary. Symptoms can range from none at all to fevers, headaches, kidney failure, and even death. In 2019, there were a total of eight deaths reported. According to the CDC, patients with symptoms can be treated with a combination of antibiotics and antiparasitic drugs.
Before this new report, the CDC only considered seven U.S. states to have consistent number of babesiosis. This included Connecticut, Massachusetts, Minnesota, New Jersey, New York, Rhode Island, and Wisconsin. However, the newly released data shows that Maine, New Hampshire and Vermont have similar or higher number of new cases.
Between 2011 and 2019, 16,456 cases of babesiosis were reported in 37 states, according to the report. Most cases overall were reported in New York (4,738). The highest incidence was reported in Rhode Island (18 cases per 100,000 people in 2015). Vermont, Maine and New Hampshire had the largest increase in the number of new cases. Rates of new cases increased in Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New York, Rhode Island and Vermont.
In addition to changes in human behavior and climate, there has also been increased awareness of babesiosis in the past decade, said Dr. Amesh Adalja, an infectious disease expert at Johns Hopkins Center for Health and Security, in an email to ABC News. That may also contribute to the increased number of cases. “More clinicians are ordering tests,” he said. With testing, doctors started to find cases in new areas.
Preventing babesiosis and other tick-borne illnesses
People should be aware of their risk of contracting babesiosis when traveling or living in areas where the illness is more common. The best way to prevent tick-borne illnesses is avoiding ticks. People can minimize tick exposure by covering exposed skin, using repellants and walking on cleared paths in wooded areas, the CDC says.
Anyone spending time outside in areas where there might be ticks should check their body, clothing, and pets for ticks after coming inside, the CDC says. Showering within 2 hours of being outdoors and putting clothes in the dryer on high heat can also prevent tick bites.
If you do find a tick, pull it straight out with tweezers.
Babesiosis isn’t the only disease ticks can carry — they can also spread Lyme disease, Rocky Mountain spotted fever, and anaplasmosis.
People should seek medical attention if they happen to fall ill after a tick bite, Chin-Hong says.
Lauren M. Cuénant, D.O., is a Physical Medicine and Rehabilitation resident at the University of Miami/Jackson Memorial Hospital and a contributor to the ABC News Medical Unit.
(NEW YORK) — A new double lung transplant technique was successful for two patients with lung cancer, Northwestern Medicine announced. The hospital said it’s leveraging that success into a new clinical program that will offer transplants to patients with end-stage lung cancer.
“Every morning when I open my eyes, like, I just can’t believe it, and life has different meaning now,” said Tannaz Ameli, the second person with lung cancer to receive the transplant, during a press briefing.
Lung cancer is currently the third most common type of cancer in the United States after skin cancer first, and breast cancer in women and prostate cancer in men second, according to the CDC. Yet more people die from lung cancer than any other type of cancer.
Treatment for lung cancer mostly depends on how much that cancer has spread. Patients may be treated with targeted medications, chemotherapy, radiation or surgery to remove the tumor. But those treatments don’t always work, and for some people, a lung transplant is their only option.
Single lung transplants have been successfully performed since the 1980s, and now, more than 1500 single lung transplants happen each year, according to the CDC. But lung transplants for lung cancer aren’t common.
That’s because there’s a high risk that cancer cells will spread from the lung into the rest of the body during the procedure — making it more likely the cancer will come back, said Dr. Ankit Bharat, chief of thoracic surgery and director of Northwestern Medicine Canning Thoracic Institute, in a press release.
When a patient needs both lungs replaced, the lungs are usually removed one after the other, Bharat said. If the first lung is transplanted while the other cancerous lung is still in the body, there’s a risk of the cancer spreading from that lung to the rest of the body, he said.
But Northwestern Medicine’s surgery team found a way to minimize that risk. Their approach allows surgeons to remove the cancerous lung from the body while the patient is hooked up to a bypass machine, which diverts their blood away from the heart and lungs. If blood doesn’t flow through the cancer during the surgery, the risk of the cancer spreading is less.
“We feel quite confident that we’ll be able to help some patients with no other options,” said Bharat. He said that the surgery involves “delicately taking both cancer-ridden lungs out at the same time along with the lymph nodes, washing the airways and the chest cavity to clear the cancer, and then putting new lungs in.”
He added, “These patients can have billions of cancer cells in the lungs, so we must be extremely meticulous to not let a single cell spill into the patient’s chest cavity or blood stream.”
The team at Northwestern Medicine first used the technique on Albert Khoury, a man from Chicago who came to them in 2021 after chemotherapy failed to treat his stage 4 lung cancer. His condition continued to worsen, and he ended up in the intensive care unit, according to a press release.
His doctor at Northwestern Medicine, oncologist Dr. Young Chae, said that a double lung transplant may be his only hope. Without one, Chae said Khoury wasn’t expected to live more than a year.
So, on Sept. 25, 2021, after 2 weeks on the transplant list, Khoury became the first person with lung cancer to have a successful double lung transplant.
One year later, Ameli, who lived in Minnesota, was also diagnosed with stage 4 lung cancer. She said that she tried chemotherapy, but just like for Albert Khoury, it wasn’t enough. Her husband had seen a video about Khoury’s procedure, she said, and he scheduled an appointment with a surgeon at Northwestern Medicine. She was a candidate — and received the second successful double lung transplant in July 2022.
“We’re so happy,” Ameli said at the press briefing. “I’m back. I did it. I made it.”
Because of those successes, Northwestern Medicine is launching a first-of-its-kind clinical program for people with end-stage lung disease.
The program plans to follow the outcomes of its first 75 patients who receive double lung transplants for lung cancer in a new research registry called DREAM (Double Lung Transplant Registry Aimed for Lung-limited Malignancies). While patients can receive a double lung transplant as a part of the clinical program without enrolling in the voluntary DREAM research registry, researchers hope to use the data to follow overall survival, disease-free survival and transplant rejection rates.
“I hope that all cancer patients can be as lucky as me and Albert were,” Ameli said. “Every day we wake up and we’re thankful for it.”
Aerial Petty, DO, is a family medicine resident at New York-Presbyterian/Columbia University Irving Medical Center and a contributor to the ABC News Medical Unit.
(SALT LAKE CITY) — Utah Gov. Spencer Cox has signed a bill into law banning abortion clinics in the state, making it the latest to restrict the procedure since the Supreme Court overturned Roe v. Wade.
Cox, a Republican, signed H.B. 467 after it passed the state Senate on March 2 and state House on March 3, both along party lines.
Abortion clinics will be required to close either by the end of the year or when their licensee expires, whichever comes first.
Additionally, after May 2 of this year, the Utah Department of Health and Human Services will not be allowed to grant or renew a license of an abortion clinic.
Under the legislation, all abortions will be required to take place in a hospital, which is defined as “a general hospital licensed by the state.”
Currently, Utah bans abortion after 18 weeks. The ban was passed in 2019 but didn’t go into effect until the Supreme Court overturned Roe. H.B. 467 also removes the rape and incest exemption from this law.
Cox previously told reporters he would sign the bill, which also defined the term “abortion” to remove any confusion surrounding the law.
“One of the concerns with the trigger bill that medical providers had across the state was there a lack of clarity that would have made it hard for them to perform legal abortions,” Cox said at the time.
The governor’s office referred ABC News to Cox’s press conference on PBS Thursday when reached for comment.
Anti-abortion groups, such as Pro-Life Utah, applauded the decision.
“Thank you, Governor Cox for signing this bill into law!” the group said in a statement. “We value your commitment to protect the pre-born.”
However, abortion rights advocates, slammed the bill and said it basically eliminates access in the state.
“HB 467 is nothing but shameful procedural and political maneuvering intended to get around a valid court decision and prevent Utahns from accessing abortion,” Alexis McGill Johnson, president and CEO of Planned Parenthood Federation of America, said in a statement when the bill first passed the state House. “Today’s passage is just one part of a nationwide campaign by anti-abortion extremists to end legal abortion throughout the United States, and it will have devastating impacts on Utah communities.”
Utah lawmakers also passed a law in 2020 banning all abortions except if the mother’s health is in danger or in cases of rape and incest reported to the police.
However, the ban was blocked from going into effect after the 3rd District Court issued an injunction, which was upheld by the state Supreme Court.
