LA City Council votes unanimously to ban the sale of flavored tobacco products

Mario Tama/Getty Images

(LOS ANGELES) — The Los Angeles City Council voted unanimously Wednesday to ban the sale of flavored tobacco products.

The ban, which goes into effect Jan. 1, 2023, ends the sale of flavored e-cigarettes, menthol cigarettes and flavored cigars.

The ordinance does not ban the possession or use of flavored tobacco for those aged 21 and older.

It also exempts existing hookah lounges in the city that received tobacco retailer permits before January that sell shisha tobacco for either on-site or off-site use.

“We just took a huge step forward against Big Tobacco’s deadly agenda in Los Angeles,” Councilman Mitch O’Farrell, who proposed the ban, tweeted Wednesday after it passed 12-0. “It’s time we put these protections in place for our youth and save lives.”

A version of the ordinance drafted last year exempted menthol cigarettes from the ban, but Black council members argued against the exemption due to high rates of menthol cigarette use among Black Americans.

Studies have found Black Americans are the most likely racial/ethnic group to use menthol cigarettes and are 25 times more likely than white Americans to do so.

“Menthol is included in this ban, as it should be,” Marqueece Harris Dawson, a Black councilman, said before the vote, according to City News Service. “It is a flavor just like every other flavor and it would have been extremely disappointing if we had said we’re going to protect people and children from uptake of tobacco, except for the flavor that we know Black people first and Latinos second use the most.”

The ordinance is now heading to the desk of Mayor Eric Garcetti, who is expected to sign it into law.

Anti-tobacco groups praised the vote and said the action will prevent children from becoming addicted to smoking and/or vaping.

“The Los Angeles City Council today took bold action to protect kids from tobacco addiction, save lives and advance health equity,” Matthew Myers, president of the advocate group Campaign for Tobacco Free Kids, said in a statement to ABC News. “The Council’s landmark action will help prevent the tobacco industry from addicting another generation of kids.”

The Centers for Disease Control and Prevention has said any use of tobacco products by children and teenagers is unsafe, but most use begins with flavored products.

The federal health agency found that, in 2021, 80.2% of high schoolers and 74.6% of middle schoolers who reported use of tobacco products in the past 30 days said they had used a flavored tobacco product in that period.

Additionally, 85.8% of high school students and 79.2% of middle school students who reported use of e-cigarettes — the most commonly used tobacco product among youth — in the past 30 days said they used flavored e-cigarettes.

Research has shown nicotine, the addictive drug found in tobacco products, can harm a developing adolescent brain and increases the risk of developing psychiatric disorders and cognitive impairment.

Copyright © 2022, ABC Audio. All rights reserved.

FDA audited over baby formula crisis

AlasdairJames/Getty Images

(NEW YORK) — The Health and Human Services’ Office of Inspector General is launching an audit into how the Food and Drug Administration responded leading up to the massive February recall of baby formula and closure of Abbott Nutrition’s Sturgis plant.

OIG will examine whether the FDA upheld its duty “to safeguard the nation’s food supply, including infant formula and ensure all ingredients are safe” and if FDA regulators followed proper recall protocol once a deadly bacteria had been detected inside the plant.

The Sturgis, Michigan, plant was shut down in mid-February after contamination issues inside had been linked to four infants being hospitalized with a rare but serious bacterial infection, two of whom ultimately died.

The review of the FDA’s actions marks an extraordinary and uncommon move from the watchdog agency.

The American public and lawmakers alike have been searching for accountability on the ongoing infant formula shortage — a now-national supply crisis which was exacerbated by Abbott’s contamination issues and ultimate shutdown.

This is not first time Abbott’s quality control had come under questioning.

Federal regulators warned months ago of potential problems at a manufacturing plant for baby formula, according to documents and a public timeline of the events.

The FDA found sanitation issues at Abbott’s Sturgis plant in September 2021, saying it “did not maintain a building used in the manufacture, processing, packing or holding of infant formula in a clean and sanitary condition,” according to an inspection report.

Copyright © 2022, ABC Audio. All rights reserved.

Gun suicide soars as cause of death among youth: Report

Emily Fennick / EyeEm/Getty Images

(NEW YORK) — The rate of young people taking their own lives with firearms in the U.S. has increased faster than for any other age group, and the youth suicide rate is at its highest point in more than 20 years, according to a new gun violence prevention report by Everytown For Gun Safety and first obtained by ABC News.

While firearm suicide overall increased about 2% during the pandemic, the rate among young people increased 15% and nearly half of all suicide attempts by young people involve a gun, researchers with Everytown For Gun Safety found.

Experts have not pinned down exactly what is causing more young people to turn to suicide with guns, the report notes. But increased anxiety and depression, likely exacerbated by the pandemic, along with the impacts of social media and cyberbullying are among the theorized drivers.

“The research shows pretty clearly that people who struggle with mental illness are much more likely to be victims than perpetrators of violent crimes,” Everytown research director Sarah Burd-Sharps told ABC News. “That said, certainly knowing the warning signs and learning to talk about mental health — particularly, we’re talking about young people — so the way we talk about mental health with young people in our lives is a huge part of the solution.”

“One of the most effective things we can do to help young people in crisis is to keep it out of their hands,” Burd-Sharps said.

The report’s authors point to “red flag” laws as a plausible solution that allow for temporary restrictions on firearm ownership when a person is determined to pose an extreme risk to themselves or others. So far, 19 states have passed such laws that allow local authorities and family members to petition in civil court for the restriction of a person’s firearm access, according to Everytown.

“Research shows they save lives,” Burd-Sharps said. “They very much prevent youth suicide, so it’s it’s one of the most important policies that can reduce this, tragic spike in youth gun suicide.”

Safe storage measures for parents who own guns as well as waiting periods for gun purchases are among tools that can help create a safety buffer when someone is in the throes of a mental health episode, Burd-Sharps added.

The firearm-related increases documented in the new report track with overall increases in teen and young adult suicide in recent years. Between 2007 and 2018 the suicide rate among those age 10 to 24 increased nearly 60%, according to the Centers for Disease Control and Prevention.

The split-second between pulling the trigger of a firearm and the projectile’s impact makes suicide attempts with guns much more lethal too. Overall, acts of suicide are fatal in 8.5% of cases while acts of suicide involving a firearm are fatal 90% of the time, according to a 2019 study published in the Annals of Internal Medicine.

Suicides have long been a driver of firearm-related deaths. More than half of all gun deaths in 2020 were suicides, according to a 2022 Pew Research Center report.

Boys and young men are disproportionately afflicted by firearm suicide and are seven times more likely to kill themselves with a gun compared to their female peers, according to the CDC.

Racial and ethnic minority groups in the U.S. are among those hit hardest by the increased suicide rate, Burd-Sharps said. A lack of access to mental health care resulting in higher rates of untreated depression as well as traumatic exposure to discrimination and racism are among the driving factors.

Suicide is the third leading cause of death among children and young people ages 10 to 24, according to the CDC.

If you are struggling with thoughts of suicide or worried about a friend or loved one, help is available. Call the National Suicide Prevention Lifeline at 1-800-273-8255 [TALK] for free, confidential emotional support 24 hours a day, 7 days a week.

Copyright © 2022, ABC Audio. All rights reserved.

Older Americans bore brunt of COVID-19 deaths during the omicron wave

Morsa Images/Getty Images

(NEW YORK) — From the onset of the COVID-19 pandemic, the elderly have borne the brunt of the virus’ deadly wrath.

Now, newly updated federal data shows that despite widespread vaccination among seniors, virus death rates among older Americans surged to near-record levels during the first omicron wave.

Over 90% of seniors have been fully vaccinated, but about 30% of those fully vaccinated have yet to receive their first booster shot. To date, just under 10 million Americans 65 and older have received their second booster — representing about 28.5% of those who had already received their first shot.

Even with overall high vaccination rates in older populations, nearly three-quarters of the COVID-19 deaths reported in the U.S. have been among people over the age of 65.

Experts say the reason for the renewed surge may be due to a number of factors, including waning immunity, relatively low booster uptake compared to primary vaccination series and general vulnerability to the virus among the group. In addition, the sheer scale of the spread of the virus during the omicron wave was significantly higher compared to prior waves of the virus.

Although the number of virus-related deaths in Americans over 75 has consistently been higher than all other age groups, according to data from the Centers for Disease Control and Prevention (CDC), there were some lulls.

As the virus receded in late June 2021, and the group’s vacci​nation rate increased, the death rates for those older age groups approached levels comparable to younger people.

However, during the delta wave, in late 2021 and 2022, the disparities in death rates began to increase again with the more transmissible variant, which was better at evading vaccines. They further widened when the omicron wave hit the U.S. in the winter of 2021, a variant that was even more transmissible than delta.

In early January 2022, CDC death data — broken down by age group per 100,000 people — shows that people over 75 had a COVID-19 death rate that was 136 times higher than that of people between the ages of 18 and 29. Similarly, people between 65 and 74 had a COVID-19 death rate that was 45 times higher than that of people between the ages of 18 and 29.

Throughout the spring, overall death rates took a downturn again, as the first omicron wave receded, but as of mid-April, older Americans continue to see more deaths than younger populations.

In recent months, Hispanic Americans 75 and older have had a death rate per capita that was notably higher than other demographic groups of the same age.

During the omicron surge in January, Hispanic Americans over 75 were 2.7 times more likely to die from COVID-19, compared to white Americans and Asian Americans of the same age. They were also 1.7 times more likely to die from COVID-19, compared to their Black counterparts, and 3.7 times more likely to die compared to their American Indian/Alaska Natives.

Last month, the CDC announced that it is “strengthening” its recommendation for Americans over the age of 12 who are immunocompromised and those over the age of 50 receive their second booster shot.

“Only 38% of those 50 to 64 and 43% of those 65 and older have received a vaccine dose in the past six months. This leaves about 60% of older Americans without the protection they may need to prevent severe disease, hospitalization, and death,” CDC director Dr. Rochelle Walensky said during a meeting of the agency’s independent advisors in May. “We know immunity wanes over time, and we need to do all we can now to protect those most vulnerable.”

Copyright © 2022, ABC Audio. All rights reserved.

FDA accepts Pfizer application for COVID vaccine in kids under 5, clearing way for June timeline

Artur Widak/NurPhoto via Getty Images, FILE

(NEW YORK) — Pfizer announced Wednesday that it has completed its application to the U.S. Food and Drug Administration for a three-dose COVID-19 vaccine in children aged 6 months to under 5 years old, and the federal agency has accepted the application.

“Pfizer and BioNTech completed a rolling application to the U.S. Food and Drug Administration (FDA) for emergency use authorization (EUA) of the 3-µg [microgram] dose of the Pfizer-BioNTech COVID-19 Vaccine for children 6 months through 4 years of age (also referred to as 6 months to under 5 years of age) on June 1, 2022,” the company said in a statement.

The FDA said in a statement that it received Pfizer’s request for an EUA.

“We recognize parents are anxious to have their young children vaccinated against COVID-19 and while the FDA cannot predict how long its evaluation of the data and information will take, we will review any EUA request we receive as quickly as possible using a science-based approach,” the agency said.

Last month, Pfizer announced that its vaccine for younger children was 80% effective against symptomatic COVID-19.

However, the company said this estimate is preliminary and is subject to change as more data is collected.

The FDA’s independent advisory panel, Vaccines and Related Biological Products Advisory Committee, is planning public hearings in mid-June to discuss both Pfizer’s and Moderna’s vaccines in younger children. The FDA said Wednesday it would hold a VRBPAC meeting on June 15 to discuss both Pfizer and Moderna’s EUA requests for this population — 6 months through 4 years old for Pfizer and 6 months through 5 years old for Moderna.

Moderna asked the FDA to authorize its two-dose vaccine for children under age 6 on April 28.

During the omicron surge, the company said its vaccine was 51% effective against infection including asymptomatic and mild infection, among those aged 6 months to under age 2, and 37% effective for those aged 2 to 5.

If the FDA decides to authorize vaccines for younger children after the hearing and the Centers for Disease Control and Prevention’s independent advisers agree, it could mean vaccines could be available for those under 5 years old by the end of June.

Pfizer’s shots are three micrograms each, one-tenth the dose offered to adults, while Moderna’s shots are 25 micrograms each, one-quarter of its adult-sized dose.

Although children under 5 are the last age group for which vaccines need to be approved, polls suggest there could be sluggish uptake.

An April 2022 poll from the Kaiser Family Foundation found that only 18% of parents plan to vaccinate their kids under age 5 right away once the vaccine is authorized.

Many are hesitant, with 27% saying they will “definitely not” get their children in this age group vaccinated and 11% saying only if it is required for school.

The remaining 38% said they want to “wait and see” before getting their young children vaccinated.

Copyright © 2022, ABC Audio. All rights reserved.

Reported COVID-19 infection levels nearly six times higher than last Memorial Day

SONGPHOL THESAKIT/Getty Images

(NEW YORK) — Millions of Americans traveled for Memorial Day weekend at levels not seen since before the onset of the pandemic.

It marked a return to normalcy for many and a chance to gather with family and friends.

But in reality, the situation was far from normal — with confirmed COVID-19 cases nearly six times higher than last Memorial Day, according to data from the Centers for Disease Control and Prevention.

And case totals are likely even higher than are being reported this year with the widespread availability of at-home testing.

This week also marks the eighth consecutive week of increasing COVID-19 cases in the U.S., the data shows.

On average, the U.S. is reporting nearly 110,000 new cases every day, and for the seventh consecutive week, COVID-19 cases among children have also increased. Last week, 112,000 additional pediatric COVID-19 cases were reported, a doubling of case counts from the four weeks prior, according to a new report from the American Academy of Pediatrics (AAP) and the Children’s Hospital Association (CHA). Last year, at this time, the U.S. was reporting around 10,000 pediatric cases a week.

The U.S. also continues to see an increase in the overall number of patients requiring care for COVID-19. On average, more than 3,500 virus-positive Americans are being admitted to the hospital each day.

However, the hospitalization level is nowhere near its peak, and while virus-related deaths are ticking up, they are not near peak levels either.

Last week, updated CDC data also revealed that more than half of the U.S. population is now living in a county that has a high or medium community risk level for COVID-19.

A total of 55.7% of Americans are currently living in a high or medium community risk county. Nearly a quarter of those people — 23.1% — are living in a high-risk community, while just under a third — 32.6% — are living in a medium risk county.

The high community level suggests there is a “high potential for healthcare system strain” and a “high level of severe disease” and thus, the CDC recommends that people wear a mask in public indoor settings, including schools, while under the medium risk level, if an individual is considered at “increased risk,” they are recommended to speak with their healthcare provider about whether or not they should wear a mask.

There are signs that some areas of the country may be seeing a slow of infections. In New England, new case rates have declined by 18% in the last week, according to CDC.

However, many areas of the region — including counties in Massachusetts, New York, New Jersey, Connecticut, Delaware, as well as the northern part of Pennsylvania — are still considered high risk.

Amid the rise in infections, a growing list of school districts and universities are now moving to bring back mask requirements.

Last week, students in Philadelphia and Providence, Rhode Island, were made to put their masks back on, ahead of the end of the school year amidst increasing infection rates in the community.

In Delaware, where every county is currently considered “high” risk for COVID-19, according to the CDC’s definition, the University of Delaware reinstated its masking requirement for all indoor spaces, and across the country, in California, officials at the University of California Los Angeles and University of Hawaiʻi both recently brought back their face covering requirements.

Copyright © 2022, ABC Audio. All rights reserved.

COVID-19 cases plateau in New York City, indicating latest surge may be over

Carol Yepes/Getty Images

(NEW YORK) — COVID-19 cases in New York City have plateaued, signaling that the latest surge is at least slowing, if not over.

An ABC News analysis of city data shows 4,204 confirmed and probable cases were recorded on May 24 — the latest date for which data is available — with a seven-day rolling average of 3,312.

This is the lowest average recorded in the last two weeks.

Other key metrics also indicate the latest wave may be subsiding.

The percent positivity rate — the percentage of tests that come back positive — is currently at 8.64%, according to the New York City Department of Health and Mental Hygiene. This is a drop from the average of 10.95% over the last 28 days.

Additionally, the seven-day average of hospitalizations has dropped 15.4% from 84 to 71.

“​​In all likelihood, we’re on the other side of this particular surge, but at the same time it’s not dropping dramatically because of…behavior,” said Dr. John Brownstein, an epidemiologist at Boston Children’s Hospital and an ABC News contributor. “We essentially have two opposing forces, one where we have a lot of immunity in the population from vaccination and infection.”

He continued, “On the other hand, people are starting to enjoy congregating and going to indoor concerts, festivals, sporting events. These will create opportunities for the virus to spread.”

Perhaps unsurprisingly, the unvaccinated population has made up the largest share of COVID cases, hospitalizations and deaths in the city.

As of May 14, unvaccinated New York City residents were recording 1,826.25 cases per 100,000 people, data from the health department shows.

By comparison, those who are vaccinated but not boosted were recording 183.02 cases per 100,000 and those who are boosted were recording 310.69 cases per 100,000.

In addition, the unvaccinated were hospitalized with COVID-19 at a rate of 188.55 per 100,000 compared to 5.65 per 100,000 for those vaccinated but not yet boosted and 4.96 per 100,000 for those boosted.

“Of course, we know that there’s the probability of breakthrough infections with vaccination, but the outcomes of those breakthroughs are drastically different,” Brownstein said. “As we look at the severe outcomes, the hospitalizations and the deaths as a result of infection, those who are unvaccinated bear a far greater burden of that risk.”

He added, “Despite us being quite far into the vaccination campaign, the urgency to get people vaccinated and boosted is still there and will continue to be there, especially as we see surges in the coming months.”

Even as New York City and the Northeast appear to be plateauing, cases are rising in other parts of the country.

Hawaii is currently leading the U.S in cumulative cases per 100,000 over the last seven days at 623 per 100,000, according to the Centers for Disease Control and Prevention.

Additionally, over the last two weeks, the seven-day rolling average of COVID-19 infections has increased 78.7% in California and 33.2% in Washington state, CDC data shows.

“We’ve seen a pattern emerge where the Northeast has often been a leading indicator of surges that will take place in other parts of the country,” Brownstein said. “Surges are not uniform across the country. Surges happen at the local level and they’re not necessarily happening.at the exact same time.”

He continued, “What we experience in one part of the country, another part may experience weeks or months later.”

Brownstein also said testing totals could be undercounted because of the number of people who are testing at home and not reporting positive results to health authorities.

“It’s possible we could hit a surge and be well in the midst of it before we know it’s happening,” he said.

He encouraged people to exercise caution and, if case counts rise in their areas, to follow mitigation measures that reduce the risk of spread, such as wearing masks.

“We’re in a much better place and we have wide availability of therapeutics now, so we have better ways of managing this pandemic, but clearly people can still play a role in helping reduce any surges in communities in the coming months,” Brownstein said.

Copyright © 2022, ABC Audio. All rights reserved.

Unlikely monkeypox outbreak will turn into a pandemic, WHO says

Pavlo Gonchar/SOPA Images/LightRocket via Getty Images

(NEW YORK) — The World Health Organization said Monday it doesn’t believe the monkeypox outbreak currently spreading around the world will turn into a pandemic.

Since May 13, at least 257 cases of the rare disease have been confirmed in 23 countries where the virus is not endemic — mostly in Europe and North America — and 120 are suspected.

Of those infections, 14 are confirmed or suspected across eight states in the U.S., according to the Centers for Disease Control and Prevention.

So far, no deaths have been reported in non-endemic countries.

The disease is not typically found outside of countries in central and western Africa, which has raised fears of community transmission.

According to the WHO, at the present time, there is no clear link between the cases reported and travel from endemic countries.

When asked during a public session Monday if the recent outbreak could turn into a pandemic, Dr. Rosamund Lewis, the WHO’s technical lead for monkeypox, replied, “The answer is we don’t know, but we don’t think so.”

“At the moment, we are not concerned about a global pandemic,” Lewis continued.

Other public health officials have said the risk for spread is generally low.

The WHO stated the majority of cases have been reported among men who identify as gay, bisexual or men who have sex with men. Monkeypox can still be transmitted to anyone with exposure to it.

“We are concerned that individuals may acquire this infection through high-risk exposure if they don’t have the information they need to protect themselves,” Lewis said.

She offered recommendations for people to lower their risk of infection, including avoiding those with confirmed or suspected cases of monkeypox and — if caring for someone with the disease — avoiding skin-to-skin contact, washing hands regularly, wearing a mask and cleaning contaminated surfaces.

“Collectively, the world has an opportunity to stop this outbreak,” Lewis said. “There’s a window of opportunity where this can be contained.”

When people are infected with monkeypox, it is generally a mild illness with the most common symptoms being fever, headache, fatigue, muscle aches, backache and swollen lymph nodes.

Patients can develop a rash and lesions that often begin on the face and extremities before spreading to the rest of the body. Symptoms usually last two to four weeks before dissipating.

Animals pass the disease to humans either through a bite or a scratch, and people can also catch monkeypox from preparing and consuming infected bush meat.

Human-to-human transmission occurs either through hugging, touching or prolonged face-to-face contact as well as by touching an infected person’s clothing or bedsheets.

The WHO said there are many “unknowns” about the outbreak including if the virus is being sexually transmitted or via close contact when engaging in sex. It’s also unclear whether monkeypox can spread if a person is asymptomatic.

However, officials stressed the risk to the general public remains low and shouldn’t be compared to COVID-19.

“Monkeypox is very different from COVID-19,” Dr. Sylvie Briand, the director of epidemic and pandemic preparedness and prevention at WHO, said during the public session. “We don’t want people to panic or be afraid and maybe think that it’s like COVID but worse.”

She added, “This monkeypox disease is not COVID-19. It is a different virus; it’s a different disease.”

Copyright © 2022, ABC Audio. All rights reserved.

FDA investigating hepatitis A outbreak possibly linked to organic strawberries

alvarez/Getty Images

(NEW YORK) — The U.S. Food and Drug Administration and the Centers for Disease Control and Prevention are investigating an outbreak of hepatitis A that is possibly linked to two brands of organic strawberries that were sold at several retailers in the U.S. and Canada.

FreshKampo and HEB branded strawberries purchased by consumers between March 5 and April 25 should not be eaten, according to the FDA.

The affected strawberries, which are past their shelf life, were sold at retailers nationwide, including Aldi, HEB, Kroger, Safeway, Sprouts Farmers Market, Trader Joe’s, Walmart, Weis Market and WinCo Foods.

Cases of hepatitis A have been reported by consumers in California, Minnesota and Canada, all of whom purchased strawberries before falling ill. At least 17 illnesses and 12 hospitalizations have been recorded so far nationwide, according to the FDA.

Hepatitis A is a contagious virus that can ultimately cause liver disease, according to the FDA. Symptoms include fatigue, nausea, vomiting, abdominal pain, jaundice, dark urine and pale stools. Infections typically recover within one to two weeks, though in rare cases, it may become chronic.

Strawberries should be thrown away if you are unsure what brand was purchased, or when and where they were bought, the FDA recommended. Frozen strawberries should also be thrown away.

Anyone experiencing symptoms of hepatitis A after consuming strawberries should contact their health care provider.

Copyright © 2022, ABC Audio. All rights reserved.

What restrictions were in place the last time COVID cases were so high

Kent Nishimura / Los Angeles Times via Getty Images

(NEW YORK) — Despite widespread vaccination and several available treatments, the U.S. is recording as many COVID-19 cases now at the tail end of the omicron peak as it was last summer during the delta surge.

On Wednesday, the latest date for which data is available, 181,000 new infections were reported, according to the Centers for Disease Control and Prevention.

Over the last seven days, the country has recorded a total of 766,949 cases of the virus, although the true caseload is likely much higher.

This is on par with late August 2021, when the U.S. was recording between 182,000 and 187,000 new infections every day.

However, mitigation measures in the U.S. looked very different at the time. Although there were no lockdowns, several indoor venues mandated masks, vaccine passports were in effect in many large cities and one state even required proof of vaccination or a negative test to enter.

After the omicron wave that swept the country this past winter, an estimated 60% of Americans has been left infected since the start of the pandemic, many with much milder cases — even though studies suggest omicron is more infectious than delta — so communities started loosening restrictions.

Although the latest omicron subvariants appear to be even more transmissible than the original variant, a combination of vaccination, boosters and effective and readily available therapeutics appear to have muted the impact of severe disease.

Masking indoors

“When we think about summer 2021, we were in a different place in many ways,” Dr. Stuart Ray, a professor of medicine at Johns Hopkins University, told ABC News. “We’d had vaccines for only about six months … The delta variant became the predominant variant in the U.S. mid-summer.”

The delta variant was first identified in March 2021 and quickly took over as the dominant variant, accounting for most U.S. cases during the summer. Before that, the country had been seeing encouraging declines in infections.

By late July 2021, the CDC was urging all Americans in COVID hot spots regardless of vaccination status to wear masks indoors.

At the time, states with high transmissions were mostly in the Southeast, Midwest and Southwest, including Alabama, Florida, Louisiana, Missouri and Texas.

Through summer and fall 2021, some states were still imposing face coverings indoors including schools and even for the vaccinated; however, masks were also still required on public transportation, including in airports and on planes — a measure that has since been lifted.

Amid increasing COVID-19 cases in recent weeks, some school districts have reimposed mask mandates including in Philadelphia; Brookline, Massachusetts; and Providence, Rhode Island as well as universities such as the University of Delaware and the University of Hawaii, though the vast majority have not.

“Each district and each local health department is going to have to look at their own metrics and decide what the trigger is for bringing back mask mandates,” Dr. Michael Smith, a professor of pediatrics and medical director of the pediatric antimicrobial stewardship program at Duke University School of Medicine, told ABC News. “I wish we never had to do it, but they work.”

Vaccine passports

Starting in August 2021, New York City became the first city in the U.S. to require venues — including restaurants, gyms and movie theaters — to check for proof of vaccination.

Several cities followed suit including Boston, Chicago, Los Angeles, Minneapolis and St. Paul, New Orleans, Philadelphia and San Francisco.

Currently, no cities have vaccine mandates in place restricting indoor activities and some states have banned requiring vaccination proof altogether.

Florida was the first state to do so in April 2021 and several GOP-led states followed including Arizona, Georgia, Montana and Wyoming.

Ray said even with COVID-19 cases rising, he doesn’t see vaccine passports making a return.

“I don’t think it’s likely that vaccine passports are going to become a widespread measure, in part because they’re hard to implement,” he said.

He added that people can get around the passport requirement by showing forged vaccination cards and that there is not standardized electronic system to prevent it from happening.

Ray continued, “You would think that we could, but we don’t have an electronic system where people could display a QR code on their phone that shows that they have a verifiable vaccine history. Without technology like that, the system is not really in place logistically.”

Hawaii’s COVID-19 travel restrictions

Long after states had dropped their COVID-19 measures for domestic travelers in 2020, Hawaii kept its restrictions in place.

American visitors to the islands needed to show either proof of vaccination or a negative COVID-19 test taken one to three days before their departure.

Those who didn’t have either were subject to a mandatory 10-day quarantine.

Gov. David Ige announced the state would drop its so-called Safe Travels Program for domestic travelers on March 26 due to lower cases and hospitalizations but keep rules in place for international travelers.

Dr. Vandana Madhavan, clinical director of pediatric infectious diseases at Massachusetts General Hospital, said that even though increasing COVID infections may lead to the return of mask mandates, not all restrictions will need to return because the country has learned how to better treat and prevent the virus over the last two years.

“We’re at a very different point with other preventative measures,” she told ABC News. “More people are eligible to get vaccinated and a number of populations are eligible for boosters.”

She continued. “Also, we have a number of different options for therapeutics. We have oral and IV options, and options for both people who are at high risk before they get to the hospital and once, they get to the hospital.”

Madhavan added that COVID restrictions can be viewed as a “dimmer” that gets “dialed up” when cases rise and “dialed down” once cases fall.

“I view it not as an on and off switch at this point but a dimmer dial,” she said. “And so, we may have to dial up for a while, make sure that we’re not at the point where we’re stressing resources and then we can dial back.”

Copyright © 2022, ABC Audio. All rights reserved.