(NEW YORK) — COVID-19 call centers and testing sites are closing across the United States as more Americans look to move on from the pandemic and with the emergency declaration set to end in May.
In Rockland County, New York — just north of New York City — the call center closed Tuesday after three years in operation.
The center was launched in early March 2020 after the county’s health department became inundated with telephone calls from people asking questions about the virus. According to a press release, the center received 19,163 calls during its operation and provided residents and businesses with information about COVID-19 guidance, testing sites, testing results and how to schedule vaccination appointments.
“I commend our staff for their tireless efforts to assist the community during this global pandemic,” said county health commissioner Dr. Patricia Schnabel in a statement. “As the number of COVID-19-related calls continues to decrease, the health department is able to reallocate personnel to other critical health work.”
In nearby Massachusetts, the state’s department of public health announced Monday it is shutting down its remaining free PCR testing sites, which were known as “Stop the Spread” sites, at the end of March.
UMass Memorial Health, which runs one of the sites in Worcester — located in central Massachusetts — cited “less demand for COVID-19 testing” as the reason behind the health department’s decision.
Drive-thru testing sites are also coming to an end. Carilion Clinic, a health system based in Roanoke, Virginia, closed its drive-thru testing sites on Wednesday.
According to a press release, the sites completed more than 340,000 tests over the course of three years and saw staff members often working from 5 a.m. until 11 p.m.
Kim Roe, vice president of family and community medicine, said testing personnel “truly worked tirelessly these past three years; their work was invaluable in keeping our workplace and communities safe.”
“A closure is an odd thing to celebrate, but this is a moment to recognize all that was accomplished as we transition into the endemic stage of this virus,” her statement continued.
It comes as several COVID data trackers also shut down, including Johns Hopkins University’s Coronavirus Resource Center, one of the first to launch in early 2020 and a vital source that filled in information gaps.
The U.S. Department of Health and Human Services also shut down its data website last month but has kept the Centers for Disease Control and Prevention’s dashboard running.
According to the CDC, COVID-19 cases have been declining for several weeks. During the week of Feb. 22 — the latest date for which data is available — a total of 236,131 cases were recorded in the U.S., a 48.2% decline from the 455,866 cases recorded the week of Jan. 11.
Hospitalizations and deaths, both of which are traditionally lagging indicators, have also been trending downward. Over the same period, weekly deaths have fallen from 4,448 to 2,407, according to CDC data.
The data also shows the seven-day average of hospitalizations declined from 39,837 on Jan. 11 to 22,766 on Feb. 22.
(NEW YORK) — An emergency room doctor is opening up about “one of the most interesting cases” she’s seen in her career so far and, in the process, warning people about wire grill brush injuries.
Dr. Meghan Martin, a pediatric emergency medicine physician at Johns Hopkins All Children’s Hospital in St. Petersburg, Florida, opened up about the case in a Feb. 18 TikTok post and since then, it’s gone viral, garnering over 34 million views in less than two weeks.
“One of the most interesting cases that I’ve had to date was a 4-year-old boy who was at a barbecue eating when he suddenly grabbed his ear and started crying, complaining of ear pain,” Martin said in her two-minute video.
Martin, who aims to share accessible pediatric health information on social media, went on to describe how she and other doctors responded to the case and eventually unraveled the medical mystery.
“We did a [CT scan] of the neck, which included the ears with contrast, and we did a ton of labs, gave him fluids, just did every test that we could think of doing. And we got our answer on the [CT scan],” she continued.
In an interview with ABC News’ Good Morning America, Martin said the case stretched over several days because doctors had first thought they had an idea of what was going on.
“One of the things that I didn’t share in the TikTok was that the initial complaint was actually a bee sting to the ear and that was one of the reasons that we were focusing on that area so much,” she said.
Martin and her team figured out the culprit of the boy’s pain had been a metal piece of a wire from a grill brush that had somehow found its way into the food he had eaten.
“We ended up seeing a small foreign body in the neck that was a grill brush wire and it had created a little abscess around itself because it was a small foreign body in the neck,” Martin explained. “We consulted the ear, nose and throat surgeon who was able to remove it successfully and the kid recovered beautifully. But in the end, we found out that that grill brush had been in the hamburger that he’d been eating at the time.”
The boy was able to make a full recovery after surgery and treatment, according to Martin, who noted the case was one she saw a couple of years ago and was the first case she saw where a wire injury affected the neck area.
Although Martin called this incident an “exceptionally rare case,” she added that she’s seen at least three similar cases as an ER doctor and recommends that people consider avoiding metal grill brushes completely, if possible.
“When it comes to grill brushes, there are multiple safe options on the market right now,” Martin said. “There are wooden grill brushes, there are ones that are like sponges or scrubbers, there’s even sprays that you can use and then just wipe off the grill. So there are lots of other opportunities to clean your grill, rather than using these [wire brushes] that can be dangerous.”
In addition, Martin suggested people get checked by a medical professional if they experience any pain or other symptoms after eating food off a grill.
“If anyone is eating something that just came off the grill and all of a sudden they have pain, or maybe in the next couple of days they develop some symptoms … they’re vomiting, they have really bad abdominal pain, it is something to think about to get an X-ray or some other imaging modality that can check to see if there was a piece of a wire that was lodged in the food that they ate,” Martin said.
(LOS ANGELES) — A couple has filed a lawsuit against a California-based fertility clinic alleging the clinic transplanted an embryo with a cancer mutation during in vitro fertilization, despite the couple specifically cautioning against it.
Melissa and Jason Diaz allege in their lawsuit, filed this week in Los Angeles, that the fertility clinic they used, HRC Fertility, has a “tragic pattern” of using genetic material like eggs, sperm and embryos “in a manner contrary to its patients’ instructions” and concealed material information from its customers.
The Diazes claim that, in their case, less than one year after their son was born, they discovered he had the CDH1 mutation for hereditary diffuse gastric cancer, a genetic disease that increases the risk for a specific form of stomach cancer known as diffuse gastric cancer, according to the National Institutes of Health.
Five years ago, in 2018, Jason Diaz, then 32, was diagnosed with diffuse gastric cancer and had to undergo chemotherapy, followed by a gastrectomy, or stomach-removal surgery. Genetic testing later confirmed that Jason Diaz, who has a family history of gastric cancer, carried the CDH1 mutation, according to the lawsuit.
Jason Diaz said in a news conference Wednesday that he and his wife specifically chose to undergo IVF to have children in order to have testing that would help them avoid passing the CDH1 mutation to their child.
“I wouldn’t want anyone on earth to experience this type of pain and now I will be forced to watch my own son, my own flesh and blood, go through this after Melissa and I worked so hard to protect him,” Jason Diaz said. “Every day my heart is hurting for my baby boy, knowing the pain and challenges he has ahead of him.”
The Diazes say they told the clinic and the doctor named in the lawsuit, HRC Fertility and reproductive endocrinologist Dr. Bradford A. Kolb, that they had chosen IVF to prevent having a child with the CDH1 mutation. According to the lawsuit, the couple also had their embryos screened for the BRCA-1 breast cancer mutation, which Melissa Diaz carries.
“Dr. Kolb knew from the time of his first visit with them, on December 12, 2018, that they intended to avoid passing on this rare mutation for stomach cancer,” the lawsuit states. “Jason and Melissa’s genetic counselor sent reports regarding testing for the specific mutations directly to Dr. Kolb in 2019.”
The couple claim in the lawsuit that Melissa Diaz had her eggs retrieved in 2020, and those eggs were used to create embryos that were tested for the CDH1 and BRCA-1 genes.
In August 2020, according to the lawsuit, Kolb transferred one embryo that did not have either mutation, but that pregnancy ended in a miscarriage.
In January 2021, Melissa Diaz underwent a second embryo transfer, which resulted in the birth of her son. The Diazes were told that embryo did not have the CDH1 gene, when records later showed that it did, according to the lawsuit.
“HRC [Fertility] told us that we had one male embryo that had my BRCA-1 mutation and not the stomach cancer mutation,” Melissa Diaz said in the news conference Wednesday. “That embryo was going to be our plan B because the BRACA mutation causes breast and ovarian cancer, so the likelihood of it negatively impacting a boy was significantly less than a girl.”
She continued, “So in January 2021, we informed HRC that we wanted to proceed with the male embryo that HRC told us only had the BRCA-1 mutation.”
The couple claim in the lawsuit that they discovered the alleged error last July, when Melissa Diaz received a copy of her embryo report as they prepared for another embryo transfer for a second child.
“To her horror, Melissa also recognized the first embryo — clearly designated as carrying the mutant allele for hereditary diffuse gastric cancer — as the embryo transferred on January 8, 2021,” the lawsuit states. “Embryo #1 had become her beloved infant son.”
The Diazes claim in the lawsuit that HRC Fertility later presented them with “falsified records” that covered up handwritten notes showing which embryo had been transferred.
“HRC Fertility’s falsified records from October 2022 are evidence of HRC Fertility’s knowledge of and intent to hide its misconduct,” the lawsuit states.
The lawsuit also states that HRC Fertility later provided the records that included the handwritten notes in December 2022.
The Diazes say they have simultaneously filed an arbitration claim regarding the wrongful transfer of the embryo.
The lawsuit announced this week is aimed at what is described in the complaint as “HRC’s fraudulent concealment of material information to its customers — more particularly, the fact that HRC Fertility has a long history of misusing its customers’ biological material, in direct contradiction to its customers’ instructions.”
“Moreover, it concealed that its processes and procedures are insufficient to prevent such grave errors,” the lawsuit states. “Had it made such disclosures, Jason and Melissa never would have entrusted HRC Fertility and Doctor Kolb with their genetic material.”
The Diazes are suing for monetary damages and injunctive relief and are seeking a trial by jury, according to the lawsuit.
In addition to HRC Fertility and the couple’s medical provider, Kolb, one additional HRC Fertility employee, identified as the clinic’s IVF coordinator, is also named in the lawsuit.
HRC Fertility told ABC News in a statement it “stands by the professionalism and expertise of our medical staff.”
“At HRC Fertility, our mission is to provide world-class care to all our patients struggling with parenthood. The family planning journey requires many difficult choices. We take all of our patients’ choices and concerns very seriously and are committed to providing the highest quality of care,” the statement said. “We deeply empathize with this family’s situation. However, the patients associated with the case sought genetic testing and genetic counseling outside of HRC Fertility, and with an outside party; they wished to have a male embryo transferred, which we carried out according to the family’s explicit wishes and in accordance with the highest level of care.”
“At HRC Fertility, our mission is to provide quality and compassionate care to all our patients struggling with parenthood and we understand that family planning requires many difficult choices,” the statement continued. “We offer a variety of fertility procedures so all families, regardless of challenges, can have the opportunity to become parents. We have successfully helped thousands of individuals, couples and families become loving parents, including the patients involved in this story.”
“We also stand by the professionalism and expertise of our medical staff and pride ourselves on adhering to the highest standards for patient care, patient records, results, and testing at all our locations,” the statement added. “Since 1988, we have remained dedicated to helping hopeful parents build families through assisted reproductive technology, compassion, expertise, innovation, cutting-edge research and personalized care.”
Melissa Diaz said Wednesday she and her husband are hopeful they will have a second child, but will be on guard more through the process.
“I’m very scared and nervous to go through it again to try to have a second baby, but this time, I will ask my questions. I will double check,” she said. “It’s heartbreaking that it had to come to this, but just be aware of what’s going on with your own body, what they’re trying to do with your body.”
(NEW YORK) — One baby got a special homecoming parade three months after he was born weighing only 1 pound and 15 ounces.
Samantha Desmond, 28, of Peabody, Massachusetts, was only 25 weeks pregnant, her baby roughly the size of a head of cauliflower, when her water broke — nearly three months before her February due date.
“It was a healthy pregnancy, up until it wasn’t,” Desmond told ABC News’ Good Morning America. “My water broke while I was at work. I didn’t know what was happening, but surely I wasn’t thinking that [my water broke] because I was only six months pregnant.”
Desmond said she drove herself to Salem Hospital before being rushed by an ambulance to Massachusetts General Hospital in Boston.
“The best case scenario would have been me staying [in the hospital] for three months,” Desmond said. “The longer he stayed in my belly, the safer it was going to be for him, right? Well, I only lasted three days.”
Baby Mateo was born on Oct. 28, 2022, and was immediately placed in intensive care. Desmond said she and her husband Marsid Jakic would visit their baby boy every day.
“He’s spent Halloween, Thanksgiving, Christmas, New Year’s, all of the holidays in the NICU, and the nurses would make posters for him and take pictures, and they just really made every day special,” said Desmond, who said they would travel 30 to 40 minutes every night after work to visit their son. “Every single night, every holiday, every day, just doing our best.”
Finally, after months of visits and family holidays spent in the hospital, the couple got the good news: baby Mateo could come home.
“I said to myself, ‘He can’t just come home simply. He needs a big entrance,'” Desmond said.
Desmond said she was inspired by her husband’s Albanian traditions to set up a homecoming parade. So she reached out to her friends, Det. Andrew Greenberg and his wife, Officer Sam Doherty, who both work at the Peabody Police Department, to see if they could help, and he quickly set up a police escort for Mateo on Feb. 20.
“As we’re coming down every street that we came down, every intersection was blocked off. It wasn’t just one police escort. It was the entire day shift,” Desmond said. “As soon as [other officers] got word of what was going on, everybody wanted part of it. And they’re all waving. It was beautiful.”
Peabody Police Lt. David Bonfanti said Sgt. Michael Bettencourt and the entire patrol team sprung into action to help a community member who had been through so much.
“Well, you know, we’re all fathers and mothers first. You think of what that family is going through and we can take literally three minutes out of our day, to make something special for a family that’s gone through so much. They were excited,” Bonfanti said. “They were able to make a positive […] impact on a community member for the city.”
Now, Mateo weighs more than 9 pounds and 13 ounces and is enjoying life at home. Desmond said she is beyond grateful for all of the support her family has received.
“[Mateo] has been so strong and has overcome everything that came up,” she said. “I make this joke constantly, but he was literally just done cooking. He did not need [40 weeks] and he’ll prove it for the rest of his life.”
(NEW YORK) — An imminent ruling from a Texas federal judge could soon block the use of a common abortion medication across the United States, leaving one drug available.
More than half of all abortions in the United States use a combination of two drugs, mifepristone and misoprostol, according to the Guttmacher Institute, a research group focusing on sexual and reproductive health.
However, a lawsuit is asking that mifepristone be pulled from the market just months after the Supreme Court overturned Roe v. Wade.
The lawsuit claims mifepristone is not safe, and the U.S. Food and Drug Administration didn’t study it closely enough before it was approved.
Misoprostol would still be available for both abortions and miscarriages on its own, but as an off-label use.
OB-GYNs and abortion providers tell ABC News that data from around the world shows misoprostol is safe and effective — and that they’re ready to provide misoprostol-only abortions — but that the two-dose regimen is more effective.
“We’ve got over 20 years of data showing the safety and efficacy of mifepristone and misoprostol for abortions,” Dr. Alisa Goldberg, an associate professor of obstetrics, gynecology and reproductive biology at Harvard Medical School, told ABC News. “And we know from at least 20 years of data that this regimen works better than misoprostol alone, but if that’s all we have, it’s a safe and reasonable option for patients as well.”
Mifepristone and misoprostol together
Typically, to either induce an abortion or help manage an early miscarriage, mifepristone is taken first. It’s been approved by the FDA since 2000.
Mifepristone works by blocking a hormone called progesterone, which is needed for a pregnancy to continue. This causes the uterine lining to stop thickening and to break down, detaching the embryo.
“It just gets the body primed and ready for the rest of the abortion and then the next step is you take misoprostol,” Dr. Laura Laursen, an OB-GYN at Rush University Medical Center in Chicago, told ABC News.
The second drug, misoprostol, taken 24 to 48 hours later, causes the uterus to contract and dilates the cervix, which will expel the embryo.
When used in combination, the two drugs are nearly 97% effective at terminating a pregnancy, according to a 2015 systematic review from the University of California, Davis.
Is misoprostol effective and what are the side effects?
Currently, the only FDA label use of misoprostol is for gastric ulcers. However, there are several off-label uses for obstetrical and gynecological purposes including treating postpartum hemorrhaging and softening and opening the cervix for patients ready to give birth vaginally, experts told ABC News.
Numerous countries don’t have access to mifepristone and, therefore, only use misoprostol for abortions.
One 2019 study found “misoprostol alone is effective and safe and is a reasonable option for women seeking abortion in the first trimester.”
Another systematic review conducted in July 2020 found misoprostol, especially given in higher doses, was safe and effective in terminating a pregnancy.
However, research suggests that using misoprostol with mifepristone is more effective than misoprostol alone.
“The issue with misoprostol is that it generally takes longer to complete the abortion,” said Laursen. “It’s generally at least three to four doses of misoprostol, three hours apart. So, you know, at least 12 to 18 hours.”
She continued, “There’s more side effects. There is generally more nausea, more diarrhea associated with it.”
How abortion care could change
If mifepristone loses FDA approval, clinicians who provide abortions will be able to offer either surgical abortions or misoprostol-only abortions, but the new regimen will include extra training to properly communicate to patients their options.
“For many of us, it’s going to be the first time we’re prescribing this regimen, many of us didn’t provide abortions before mifepristone was available,” Laursen said. “For us who are experts in dealing with abortion care, we are going to be working through a new system and a new dosing regimen and something that we’re all a little less comfortable with.”
Jennifer Welch, president and CEO of Planned Parenthood of Illinois, said clinics in the state will be ready to provide misoprostol-only abortions.
Illinois clinics have seen an influx of patients travel for abortion care because every state it borders has significantly limited abortion care since the Dobbs v. Jackson Women’s Health Supreme Court decision that saw Roe overturned, according to the Guttmacher Institute.
Mifepristone being banned means patients may lose access to telehealth services to get abortion pills and clinics could be even more inundated.
“The Dobbs decision already made abortion out of access fir many patients who live in states that have banned or so heavily restricted abortion,” Welch said. “And we anticipate that [banning mifepristone] will just make it more difficult for some patients to get the care that they want and need.”
Goldberg said even if people have to rely on misoprostol-only abortions, it’s another step towards stripping Americans of certain reproductive freedoms.
“We know from misoprostol-only abortions that are that are offered around the world that it is a safe and effective option,” she said. “But we also know that mifepristone-misoprostol is better and it’s a shame if we lose it.”
(TACOMA, Wash.) — Health officials in Washington state said they are set to arrest a woman Friday after they said she has been avoiding treatment or isolation for tuberculosis for over a year.
The Tacoma-Pierce Health Department said the unidentified woman hasn’t complied with several court orders filed since January 2022.
Judge Philip Sorenson issued a civil arrest warrant on Feb. 24 after he found the patient was in civil contempt for refusing to comply with his order that she either resume taking her medication or voluntarily isolate herself, according to the health department.
The patient has until March 3 to comply with the order or she will be taken to a specially designated facility at the Pierce County Jail for isolation, testing and treatment, the health department said.
“In each case like this, we are constantly balancing risk to the public and the civil liberties of the patient. We are always hopeful a patient will choose to comply voluntarily. Seeking to enforce a court order through a civil arrest warrant is always our last resort,” Nigel Turner, a spokesman for the Tacoma-Pierce County Health Department said in a statement.
Attorney information for the infected patient wasn’t immediately available.
TB is caused by a bacterium that can attack vital organs, usually the lungs, and lead to fever, severe cough and possibly death, according to the U.S. Centers for Disease Control and Prevention. The disease can spread when an infected person coughs or speaks and TB bacteria gets into the air, the CDC said. Healthy individuals may then breathe in these bacteria and become infected, according to the CDC.
Although the disease is curable with medication, treatment can take anywhere from three to nine months, according to the CDC.
The Tacoma-Pierce Health Department has legal authority to seek court orders to persuade TB patients to take treatments and isolate according to Washington state law. Turner said this is the third time in 20 years that the health department has had to seek a court order to detain a TB infected patient who refused treatment.
Turner said that health officials worked with the infected patient’s family to persuade her to comply with the health orders.
The woman was under an involuntary isolation order from Dec. 25, 2022, to Feb. 8, according to the health department. Health officials said the woman started treatment but she left before it was complete.
There are roughly 10 million TB cases reported annually around the world, according to the health department. Tacoma averages about 20 cases annually, the health department said.
(JACKSON, Miss.) — Mississippi Gov. Tate Reeves signed a bill banning puberty blockers, hormone therapy and surgeries for people under 18 in the state who are seeking gender-affirming health care.
The state joins six other states — Alabama, Arkansas, Arizona, Florida, South Dakota and Utah — with laws or policies that ban minors from accessing care.
Studies, including research in the medical journal JAMA Surgery, have shown that gender-affirming care can be life-saving for transgender and nonbinary children and adolescents, promoting positive mental and physical health.
Transgender youth are more likely to experience poor mental health, suicide, substance use and other health risks due to discrimination and stigma, according to the CDC.
The new legislation also prevents public funds or tax deductions for gender-affirming procedures, “places enforcement procedures on the Mississippi State Board of Medical Licensure and stops Medicaid from covering gender transition for persons under 18,” according to Reeves’ office.
“At the end of the day, there are two positions here. One tells children that they’re beautiful the way they are. That they can find happiness in their own bodies. The other tells them that they should take drugs and cut themselves up with expensive surgeries in order to find freedom from depression,” Reeves said in a statement on the signing of the bill. “I know which side I’m on. No child in Mississippi will have these drugs or surgeries pushed upon them.”
The law sparked outrage among the LGBTQ community and allies in the state, calling Reeves’ decision an “act of violence.”
“He and the lawmakers who pushed this bill in Mississippi are willfully ignoring the unique needs of transgender young people, interfering with their medical care and sending a stigmatizing, exclusionary message,” said Mickie Stratos, president of The Spectrum Center of Hattiesburg, an LGBTQ advocacy organization.
They continued, “Advocates for transgender equality in Mississippi and beyond will continue doing everything in our power to care for and protect trans youth in our state.”
Rob Hill, state director of Human Rights Campaign Mississippi, slammed Reeves, saying in a statement that the governor “doesn’t have an ounce of medical training.”
“He is in no position to dictate the decisions that doctors and their patients make about health care,” Hill said. “This is nothing more than an attempt to inflate his flagging poll numbers ahead of a difficult reelection campaign.”
Several major national medical associations, including the American Academy of Pediatrics and the American Public Health Association, say that gender-affirming care is safe and effective. The American Medical Association has deemed it “medically necessary.”
(NEW YORK) — Dr. Deborah Horn wants to give her patients with obesity the best possible care. But too often, the conversation in appointments isn’t focused on picking the best treatment options, which sometimes includes anti-obesity medication.
Instead, the conversations are focused on cost and insurance coverage.
“When we’re sitting in front of a patient and thinking, how can we best help this patient, and if medication is the best route, coverage should really be the last thing we think about,” says Horn, the medical director for the UTHealth Houston Center of Obesity Medicine and Metabolic Performance. “Unfortunately, with the state of access, coverage becomes the first thing.”
Over 40% of adults in the United States have obesity, which the Centers for Disease Control and Prevention defines as a body mass index of 30 or higher. While body mass index is not an indication of health, obesity is linked with heart disease, stroke, type 2 diabetes and certain types of cancer.
Newer anti-obesity medications like semaglutide (the active ingredient in Wegovy and diabetes medication Ozempic) can be highly effective for people with obesity. But analysis and reports show that drugs used for weight loss aren’t often covered by Medicare, most Medicaid programs, and some commercial insurances, limiting access to the drugs — which can cost over $1,300 out of pocket for a month’s supply.
“If patients are on Medicare or Medicaid, the conversation is about what patients can manage for themselves financially,” Horn says. “That’s a frustrating conversation for patients.”
As conversations around semaglutide and other similar drugs continue, Impact x Nightline explores issues surrounding the drugs, and the effects they’re having on patients who have been struggling with weight loss in an episode now streaming on Hulu.
Medicaid coverage for anti-obesity drugs vary state by state.
“States have the option, but are not required, to cover weight loss medication,” a Centers for Medicare & Medicaid Services spokesperson said in an email to ABC News.
Coverage doesn’t map neatly onto obesity rates in states.
“Louisiana, for example, has a pretty high rate of obesity, they cover anti-obesity medication in their Medicaid program,” says Timothy Waidmann, a senior fellow in the Health Policy Center at the Urban Institute and author of the report Obesity across America.
Colorado’s Medicaid program doesn’t cover these types of drugs, and they have the second lowest obesity rate in the United states, according to America’s Health Rankings.
While Medicare doesn’t cover these types of drugs, beneficiaries enrolled in Medicare Advantage plans might have the medications covered.
However, this leaves a majority of Medicare enrollees without coverage for these types of drugs, forcing them to pay high out-of-pocket costs, or go without.
The coverage gaps could deepen economic and racial disparities around obesity, experts say. Patients who can afford to pay out-of-pocket for the drug are the ones who are able to access treatment.
“The biggest struggle we have in clinic is equity in care,” Horn says.
Horn, other experts, and obesity advocacy organizations are pushing for Congress to pass the Treat and Reduce Obesity Act, which would (among other things) expand anti-obesity medication coverage for people on Medicare.
Right now, coverage of anti-obesity medications by commercial insurance plans is mixed, and often varies by employer to employer, Horn says. But if Medicare covers the drugs, other plans would likely follow, she says.
“If we can get Medicare to cover the medications — no one wants to be worse than Medicare,” she says.
The success rates of the newer drugs like semaglutide and the new awareness around them might help move the needle and push more commercial insurance and Medicaid programs to cover the medications, experts say.
“I think, broadly, the popularity will only work to increase the number of states that offer coverage,” Waidmann says.
Older anti-obesity medications weren’t nearly as effective for weight loss as semaglutide and the other newer compounds, like tirzepatide (the active ingredient in diabetes medication Mounjaro), Horn says. They lead to around the same amount of weight loss as bariatric surgery — which Medicare and most Medicaid programs do cover.
“They’ve closed the gap,” Horn says. “We have medications that are as efficacious or almost as efficacious as surgery. Patients should be given a choice.”
But for now, patients who could benefit from these medications are stuck in a bind. Horn says she has a patient who lost over 100 pounds on semaglutide, but his insurance recently changed, and the drug will no longer be covered.
“He’s sitting at home thinking, ‘what is going to happen next?’ He knows his physiology,” Horn says. “You’re left feeling like your hands are tied.”
(NEW YORK) — The news that the U.S. Department of Energy now believes with “low confidence” that the COVID-19 pandemic “most likely” was the result of a laboratory leak in China, resulted in a firestorm of debate across the internet.
First reported by The Wall Street Journal and not independently confirmed by ABC News, the DOE, which oversees a system of laboratories in the U.S., changed its stance from undecided — becoming the second agency, after the FBI, to believe a lab accident resulted in the global health emergency.
Four other U.S. agencies believe the virus was a result of natural transmission and that the virus, known as SARS-CoV-2, jumped from animals to humans at a wet market. Two other agencies are undecided.
“There’s just no consensus across the government,” John Kirby the National Security Council Coordinator for Strategic Communications told reporters Monday. “The President believes that it is important that we get to the bottom of this.”
Without seeing the report that made the DOE reach its conclusion, “it really becomes impossible to speculate,” said Dr. John Brownstein, an epidemiologist and chief innovation officer at Boston Children’s Hospital, and an ABC News contributor.
“Without it, it’s very hard to make any type of judgment on what took place,” he said. “And I think, ultimately, all hypotheses remain on the table. While this headline is very attention grabbing, it doesn’t really change the game in any significant way.”
What we know from the report
The Journal acknowledged that it has not seen the report and relied on the account of people who have read the document.
One of the only details known is that the conclusion was reached with “low confidence.”
“The fact is that the Department of Energy changing its position to ‘low confidence’ means that the amount of evidence in the direction of lab leak or natural spillover is still very limited,” Brownstein said.
It also means the DOE is not dismissing the natural transmission theory.
“Academic molecular biologists are of this position, that this was a natural event, just as the other two coronavirus transmissions from wild species to humans were: first SARS, and then MERS,” Dr. William Schaffner, an infectious disease specialist and a professor of preventive medicine at Vanderbilt University Medical Center, told ABC News.
This is in reference to severe acute respiratory syndrome (SARS), which resulted in a global outbreak in 2003 and Middle East Respiratory Syndrome (MERS), which caused an outbreak in 2012. Both are “cousins” of SARS-CoV-2.
“Now, we have these two positions,” Schaffner said. “We don’t know on what basis this last report came to its conclusion, but I don’t think it’s going to resolve the issue to the satisfaction of everyone.”
What the report doesn’t tell us
Because the public hasn’t seen the report, it’s unclear what evidence caused the DOE to change its mind, where that evidence came from and what the term “lab leak” even means.
Dr. Stuart Ray, a professor of medicine at Johns Hopkins University, said when people hear “lab leak,” there’s a few scenarios they might come up with.
“One is that people imagine that someone in a lab was engineering mutations into a coronavirus genome, and making a bioweapon or something like that, and that it leaked out,” he told ABC News. “Others might be thinking that people were collecting specimens from bats or other animals and growing them in the lab and then some of that virus leaked out.”
Ray continued, “I can imagine that some people are imagining they were just handling bats and someone in the lab got infected in the lab and then went out. There’s a wide range of things that might be meant, but because this report has not been shared, we don’t know what they meant by that.”
Lab leak and natural transmission?
Experts told ABC News that even if the COVID-19 pandemic did occur as the result of a lab leak, it doesn’t mean that natural transmission didn’t occur.
In fact, it could mean a hypothetical patient zero was infected at the laboratory before spreading the illness elsewhere.
“You could see them operating in sequence,” Schaffner said. “Let’s say the lab leak were correct and the virus then began to infect people and some of those persons then went to the wet market.”
He continued, “And that wet market then became an amplification location where many, many people were infected, and that then set off the epidemic. That’s a possibility.”
Why knowing the origins matters
The experts said we may never know the origins of SARS-CoV-2, similarly to how we don’t know the origins of other viruses, such as Ebola.
However, knowing the origins can help us determine if biosafety protocols weren’t followed so they can be addressed and revised, if necessary.
“I think we want to know that publicly funded research or that all research is done responsibly,” Ray said. “And we want to know whether there are dangers associated with this type of research…I think we’d want to know if that is the case. If it turns out that that virology research does pose a risk, then we want to understand those risks and how best to manage them.”
Ray also added that research into SARS and MERS helped pharmaceutical companies develop a vaccine, so virology research doesn’t necessarily equal dangerous.
Dr. Peter Chin-Hong, an infectious disease specialist at the University of California, San Francisco, told ABC News. He acknowledged there is a scientific and public health benefit to knowing the virus’ origins but said the knowledge won’t change how the world was disrupted.
“Some people may say that it’s important for accountability or reparations of some sort, but, for me, it’s already happened, and it shouldn’t be an excuse for why we don’t need to continue to try to control this as a global community by the tools that we have,” he told ABC News.
He also said the real focus should be learning lessons from the COVID-19 pandemic so we can be better prepared to respond to future epidemics and pandemics.
“You have to be open to the possibility of either situation, but it shouldn’t take away from what do we have to do now, which is the continue to make sure that everyone’s protected, not only from this, but from future outbreaks and pandemics,” Chin-Hong said.
(ST. LOUIS) — For over nine months, Delayne Ivanowski of Kirkwood, Missouri, kept a secret from her dad that ended up saving his life.
Delayne Ivanowski, a 25-year-old nurse at Mercy Hospital in St. Louis, donated her kidney to her dad John Ivanowski, who told his daughter for months that he did not want her to be his donor.
“I told her, I’m not taking your kidney,'” John Ivanowski, 60, told ABC News. “I told her that flat out.”
John Ivanowski was diagnosed two years ago with IgA nephropathy, a type of kidney disease that can lead to kidney failure, according to the National Institutes of Health.
The disease ultimately led John Ivanowski to be on dialysis for four to five hours, four days a week, a quality of life that his daughter said was not right for him.
“He likes to walk my dog and run with my dog and he wants to do all this stuff, but now he’s hooked up to a machine,” she told ABC News. “I don’t think that’s any way that anybody should have to live.”
Delayne Ivanowski said while her dad on dialysis, she made the decision to try to donate her kidney to him, despite his opposition. She said she knew that without her becoming a living donor for her dad, he could wait years to find a donor.
“I was like, ‘I’m going to do it. I don’t care how mad he is at me. I don’t care if he kicks me out of the house or hates me or doesn’t say a word to me for the rest of my life,'” she said. “At least he’ll be living a good life and not hooked up to a machine.”
Without Delayne Ivanowski’s intervention to donate her own kidney, John Ivanowski could have remained on the transplant waiting list for several years, according to his doctor, Dr. Jason Wellen, kidney and pancreas transplant surgical director at the Washington University & Barnes-Jewish Transplant Center.
“There are over 100,000 people in the country right now waiting for a kidney transplant,” Wellen told ABC News. “The one way we can get people transplanted within a few months is if they come to us with a living donor.”
Wellen added that, as a father of three, he understood John Ivanowski’s concern for his own daughter, but said living donors face no additional medical risks.
“We spend a tremendous amount of energy and resources and effort to work on every person that comes forward as a living donor,” he said. “To the point that we feel extremely comfortable knowing that if we approve for them donation, that they’ll have no higher risk for the rest of their life of renal failure or any other medical issues.”
John Ivanowski said his opposition to his daughter donating one of her kidneys to him came from not wanting anything to happen to her, now or in the future. He said he was especially concerned after losing his son, Delayne Ivanowski’s only sibling, to neuroblastoma, a type of cancer, nearly 16 years ago.
“I thought, I lost my boy and if anything happened to Delayne, I don’t know what I would do,” he said. “It was a big concern.”
Knowing her dad’s opposition and concerns, Delayne Ivanowski went through the months-long process of getting approved to be her dad’s kidney donor in secret, even while living at home with him and her mom.
The secret mission, she said, included dozens of phone calls with social workers, doctors and nurses out of hearing range of her dad, as well as undergoing blood work and countless medical tests, often at the same clinic as her dad, all without him knowing.
John Ivanowski said he had no idea what his daughter was up to, but does remember getting the life-changing phone call last August that the transplant team had found him a donor.
“They called me at work and said, ‘We’ve got an anonymous donor,’ and I about dropped the phone and thought are you kidding me?,” he recalled. “People can be on the [kidney waiting] list for five, six, seven, eight years and go through dialysis for that long, and I just couldn’t believe it.”
On the day of the transplant, Feb. 16, the team at Washington University & Barnes-Jewish Transplant Center took special precautions to make sure John Ivanowski would not see his daughter, according to Wellen.
“We had to figure out how to put them in separate areas of the pre-op area and how to make it so they didn’t see each other in the post-op area and make sure that they were in different parts of the floor until she was ready to let him know that she was the donor,” Wellen said. “It took a lot of teamwork and effort behind-the-scenes to respect her request to make sure that he didn’t know it was her.”
After a successful transplant surgery, during which the father and daughter were in side-by-side operating rooms, Delayne Ivanowski and her dad recovered in rooms just steps away from each other on the same floor.
The day after the surgery, John Ivanowski learned his anonymous donor was his daughter when she walked into his room wearing a hospital gown.
“I knew right away,” he said. “I was upset. I was just in shock. I looked at my wife and was like, ‘Are you kidding me?'”
A video Delayne Ivanowski posted of the moment she walked into her dad’s room has gone viral on TikTok, garnering hundreds of thousands of views.
John Ivanowski — who will be on anti-rejection medication for the rest of his life, but no longer needs dialysis — said the shock and anger have since subsided, saying, “I wouldn’t change a thing. I feel so much better.”
Delayne Ivanowski, who should have no lasting side effects or complications from the transplant, said she also wouldn’t change anything about the way she helped her dad, saying, “I’m not good at being told no.”
She said she hopes her family’s story helps raise awareness of the need for organ donation. Over 104,000 people are currently on the waiting list in the United States for a lifesaving organ transplant, according to UNOS.
“If anything, I’ve saved one life and hopefully I can, with awareness and other things, save other lives by encouraging people to become donors or to take that next step and go get the testing done to become a match,” said Delayne Ivanowski. “It hurts, but all the pain is worth it in the end, I think.”
