Health

(NEW YORK) — Amid a flu season that started earlier than expected there’s also been a higher number of strep A cases in children this year.

The Centers for Disease Control and Prevention issued an advisory warning last month about the increase to make sure clinicians and public health authorities know how to identify and treat the infection.

While each disease can turn into a serious case on its own, in rare cases, the two can infect people, particularly children, at once and lead to severe, or even fatal, complications, according to health experts.

A 5-year-old boy from Greenville, Michigan, died on New Year’s Eve after testing positive for the flu and then developing strep A, according to ABC News Grand Rapids affiliate WZZM.

Public health experts said influenza can weaken the immune system, which can then make people — including children — susceptible to secondary infections.

“Influenza is a respiratory virus, meaning it infects the nasal passages, the passages of the back of your throat, and then the lining of the lungs,” Dr. Lori Handy, an attending physician in the division of infectious diseases at Children’s Hospital of Philadelphia, told ABC News. “Anytime those areas are particularly irritated, they break down some of your normal immune defenses that would protect against secondary bacterial infections and the bacteria really take advantage of that breakdown and go ahead and enter your body.”

There are several pathways by which the immune system response can breakdown as a result of flu infection. One Yale University study found flu triggers an increase in levels of serum glucocorticoid, a steroid hormone, which suppresses the immune system.

Dr. Sam Dominguez, an infectious disease specialist at Children’s Hospital Colorado, said there is also evidence the flu can decrease macrophages, a type of immune system cell that destroys bacteria and other organisms, or that the virus allows bacteria to adhere better to respiratory cells.

“That allows bacteria to gain entry into the body more easily and so that’s an advantage that the bacteria can utilize if you had an influenza infection,” he told ABC News.

Although it’s not incredibly common to see children with this type of co-infection, doctors said they do see cases every year.

Dominguez said he and his colleagues in the hospital are “definitely seeing more cases this year than last year.”

Children’s hospitals and health agencies across the U.S. have been observing an increase in cases of invasive group A strep infections among kids.

Strep A typically causes about 1,500 to 2,300 deaths in the U.S. every year, according to the CDC.

The CDC told ABC News it has seen childhood strep A infections in late 2022 return to levels seen during pre-pandemic years, and that it is monitoring the situation.

“CDC issued a health advisory on Dec. 22 to notify clinicians and public health authorities about an increase in pediatric invasive group A streptococcal, or iGAS, infections. The advisory highlights the importance of early recognition and appropriate treatment of these diseases,” the CDC said in its statement.

“It’s too soon to say whether iGAS case numbers are rising beyond what we would normally expect from GAS seasonal patterns, pre-pandemic. The overall number of iGAS cases is relatively low and iGAS infections are rare,” the statement continued.

The experts stressed the importance of making sure parents get their children vaccinated against the flu if they haven’t done so already.

As of Dec. 24 — the latest date for which data is available — 47.5% of all children have received a flu vaccine, according to CDC data.

“The influenza vaccine is very good at preventing severe disease in terms of saving you from getting hospitalized or dying of influenza and then, second of all, it prevents you from getting the secondary bacterial infections on top of that,” Dominguez said.

While young children and children with underlying health conditions are at higher risk for severe flu disease or hospitalization, even relatively healthy children can develop complications.

“While parents may feel like, ‘My child generally doesn’t get sick, I’m going to skip vaccine this year,’ we see generally healthy children get severely ill both from influenza and then complicated bacterial infections after,” Handy said. “So, we really need everybody to be vaccinated to keep everybody out of the hospital, and also just reduce transmission within the community. So, it’s about both protecting yourself but then protecting all of those people you come in contact with.”

They also recommended that families follow the same advice offered throughout the course of the pandemic including thoroughly washing your hands, staying home when sick and speaking to your primary care doctor.

ABC News’ Emma Egan, Nicole Wetsman and Dr. Nicole McLean contributed to this report.

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(NEW YORK) — The New York City nurses’ strike finally ended after the hospitals and the employees reached a tentative agreement early Thursday morning.

More than 7,000 nurses at Montefiore Bronx and Mount Sinai Hospital — two of the city’s largest hospitals — walked off the job for three days as they argued for better pay, safer staffing and better working conditions.

The hospitals and the New York State Nurses Association, which represents the nurses, said the tentative deal meant nurses would be returning to work.

“This is a historic victory for New York City nurses and for nurses across the country,” Nancy Hagans, NYSNA president, said in a statement. “Through our unity and by putting it all on the line, we won enforceable safe staffing ratios at both Montefiore and Mount Sinai where nurses went on strike for patient care.”

The statement continued, “Today, we can return to work with our heads held high, knowing that our victory means safer care for our patients and more sustainable jobs for our profession.”

Although the striking nurses have argued for fair compensation, one of their biggest grievances is the nurse-to-patient ratio, which measures how many patients a nurse is responsible for, at a hospital, arguing that their contract did not address these ratios.

Under the agreement at Montefiore, new safe staffing ratios will be implemented in the emergency department. This will come with new staffing language and financial penalties if safe staffing levels are not met in all units.

Also included are a 19.1% compounded wage increase, a commitment to creating 170 new nursing positions and lifetime health coverage for eligible retired nurses.

Montefiore will also develop nurse student partnerships to recruit local Bronx nurses so they can stay as union nurses at the hospital.

“We came to these bargaining sessions with great respect for our nurses and with proposals that reflect their priorities in terms of wages, benefits, safety, and staffing,” Dr. Philip Ozuah, president and CEO of Montefiore Medicine, said in a statement. “We are pleased to offer a 19% wage increase, benefits that match or exceed those of our peer institutions, more than 170 new nursing positions and a generous plan to address recruitment and retention.”

Meanwhile, Mount Sinai did not reveal what was in the agreement reached between hospital administrators and nurses, saying in a short statement “our proposed agreement is similar to those between NYSNA and eight other New York City hospitals. It is fair and responsible, and it puts patients first.”

Mount Sinai previously told ABC News that it had also offered a 19% compounded wage increase to nurses during negotiations.

However, the nurses said Mount Sinai agreed to safe nurse-to-patient ratios that will be firmly enforced so there will be enough nurses to care for patients, and that the ratios will take effect immediately.

Gov. Kathy Hochul visited the striking nurses outside Mount Sinai Thursday morning and commended them for reaching a deal so they could return to work.

“So these individuals [who] are angels here on Earth can get back to saving lives, and helping the most vulnerable people in our society, those who enter these doors sick,” she said. “The city can take a sigh of relief, as well as continue to applaud and champion the men and women who were walking in the doors behind us this morning.”

ABC News’ Ahmad Hemingway and Peter Charalambous contributed to this report.

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(GENEVA) — The World Health Organization said Wednesday China is “heavily underreporting” the number of COVID-19 deaths as a wave of infections sweeps the country.

The Chinese Center for Disease Control and Prevention has not posted a daily briefing on COVID-19 to its website since Jan. 8 and has reported just 37 deaths since the “zero COVID” policy was lifted on Dec. 7 for a total of 5,272 deaths since the pandemic began.

According to data from Johns Hopkins Coronavirus Resource Center, China has seen nearly 18,000 deaths since the pandemic started.

“WHO still believes that deaths are heavily underreported from China, and this is in relation to the definitions that are used but also to the need for doctors and those reporting in the public health system to be encouraged to report these cases and not discouraged,” Michael Ryan, executive director of WHO Health Emergencies Program said during a press conference in Geneva.

Ryan praised many of China’s measures to reduce the burden of disease including administering antivirals early in the course of infection and expanding designated beds in intensive care units but called for more reporting.

“We are working ever closer with our colleagues in China to try and understand better the transmission dynamics, but we still do not have adequate information to make a full comprehensive risk assessment,” he said.

Throughout most of the pandemic, China implemented very strict measures, including widespread lockdowns, quarantines in government buildings and mass testing in an attempt to prevent outbreaks.

However, after large outcries and growing public resentment over the disruption to daily life, Beijing eased the restrictions and reopened its borders.

Public health experts have said that under-vaccination and large swaths of unprotected vulnerable populations in China will lead to hundreds — if not thousands — of deaths.

The WHO has said that it has not detected a variant of concern in China, but cases have skyrocketed.

In response, Japan and South Korea have enacted entry requirements for people traveling from China.

Japan has restricted flights from China to certain Japanese cities but is allowing visitors from China provided they show proof of a negative COVID-19 test. Meanwhile, South Korea is also requiring proof of a negative COVID-19 test and stopped issuing short-term visas at its consulates in China through January.

In retaliation, China stopped issuing new short-term visas to both countries and said the rule will remain in place until the “discriminatory” entry restrictions are lifted.

ABC News’ Joseph Simonetti contributed to this report.

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(NEW YORK) — Black men and women are more likely to die from prostate, uterine and breast cancer compared to other races, according to new data from the American Cancer Society.

That’s despite vast improvements in cancer death rates overall in the United States. Rates of cancer deaths have declined by 33% overall since 1991, according to the group’s annual report on cancer trends. The analysis projects that 609,820 people will die from cancer in 2023.

Advancements have been made to raise public awareness about the importance of cancer screening and make healthcare resources more readily available to under-represented populations in the U.S., according to the report. However, racial disparities still persist despite these advancements.

Gaps in survival are particularly notable for prostate cancer. The death rate for prostate cancer among Black men was two to three times higher than those in every other racial group, according to the new report.

“Disparities are profound,” said Dr. Karen Knudsen, chief executive officer at the American Cancer Society, at a press briefing Thursday.

Experts say the reasoning behind those disparities isn’t entirely clear. “A higher incidence of genetic changes associated with more aggressive disease may be one cause. However, other causes—such as reduced access to healthcare and higher uninsured rates—are equally important,” said Dr. Paul Corn, interim chair of genitourinary medical oncology at The University of Texas MD Anderson Cancer Center.

Overall, prostate cancer is the second leading cause of cancer death in men. Since 2014, rates have increased by 3% per year after two decades of decline. This means 99,000 more cases of prostate cancer are being diagnosed compared to what would be expected if the number of cases remained stable.

In addition, doctors are catching cases of prostate cancer at more advanced stages, making them harder to treat. “We are not catching these cancers early enough to have an opportunity to cure men of prostate cancer,” Knudsen said.

Racial disparities are also pronounced in breast and uterine cancer. Black women are 40% more likely to die from breast cancer than white women, and have the highest death rates from uterine cancer, according to the recently released report. These rates persist even though Black women have a lower likelihood of being diagnosed with uterine cancer, and a 4% lower breast cancer incidence compared to white women.

There has been limited success in development treatment strategies to improve life expectancy for women with uterine cancer, which ranks 24th in National Cancer Institute research funding. The new report highlights the importance of directing more resources to uterine cancer research, said Dr. Jolyn Taylor, assistant professor of Gynecologic Oncology at The University of Texas MD Anderson Cancer Center.

Still, there’s been major progress in addressing other types of cancer. There was a 65% decrease in cervical cancer rates in women between 2012 and 2019, according to the report, which shows the impact of the HPV vaccine. That vaccination can prevent cancers caused by the HPV virus, which includes cervical cancer.

The American Cancer Society also says it’s taking steps to tackle rising rates of prostate cancer. Today the organization announced the launch of an initiative called IMPACT — Improving Mortality from Prostate Cancer Together. The initiative will include research, patient support, and advocacy programs, according to a statement. The organization aims to “reduce death rates from prostate cancer in all demographics and disparities for Black men by 2035,” Knudsen said in the statement.

Jennifer Miao, MD, is a fellow physician in cardiology at Yale School of Medicine/Yale New Haven Hospital and a member of the ABC News Medical Unit.

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(NEW YORK) — Vermont Sen. Bernie Sanders, the incoming chair of the committee focused on health, on Tuesday called out Moderna for looking at a more-than-quadruple spike of its COVID-19 vaccine prices.

“How many of these Americans will die from COVID-19 as a result of limited access to these lifesaving vaccines?” Sanders wrote to Moderna’s CEO, Stéphane Bancel. “In the midst of a deadly pandemic, restricting access to this much needed vaccine is unconscionable.”

“I am writing you to reconsider your decision and refrain from any price increases,” he urged.

Sanders’ letter was in response to recent comments from Moderna’s CEO that the company was considering raising prices for its COVID-19 shots to $110-130 per dose, once vaccines move into the private market. That’s up from the $26 per dose now, which is what the vaccines cost under the current government contract.

Pfizer, too, has said that it plans to increase its prices to somewhere between $110-130 per dose.

In a statement to ABC News, Moderna maintained that its “COVID-19 vaccines and boosters will continue to be available at no cost for the vast majority of people in the United States.”

“While we are still in discussions with stakeholders on the price of our COVID-19 vaccines, Moderna is committed to pricing that reflects the value that COVID-19 vaccines bring to patients, healthcare systems, and society,” a company spokesperson said.

A Pfizer spokesperson referred ABC News to an investor call in the fall in which company officials stressed that they believed the majority of people would not have to pay out of pocket but that the increased price of the vaccine matched its value.

For the duration of the COVID-19 pandemic, the government has purchased bulk quantities of vaccine and distributed them for free to Americans. But without more funding, which Congress has not been able to agree upon, the government plans to move vaccines and COVID-19 treatments to the private market, where they will be covered by insurance or paid for upfront by uninsured patients.

The move to the commercial market could happen as soon as this fall but depends on when the federal supply of vaccines runs out.

Sanders, in his letter to Moderna on Tuesday, disagreed with the vaccine companies’ assessments that the majority of people wouldn’t feel the price increase.

He argued that it will cost taxpayers billions of dollars because Medicaid and Medicare will continue to pay for vaccines, as mandated by the CARES Act, but will now have to do so at much higher price.

He also wrote that people on private insurance could see premiums go up as companies try to offset the rising cost of vaccines. Private insurance companies also have to continue to cover vaccines because of the CARES Act — though it’s not clear to what extent.

The biggest impact will be felt by uninsured people, who will have to pay outright for vaccinations, Sanders wrote.

He called the consideration to raise prices “particularly offensive” because Moderna developed its COVID-19 vaccine in partnership with the National Institutes of Health, a government agency, and was given $1.7 billion by the government to develop its mRNA vaccine.

“In other words, you propose to make the vaccine unaffordable for the residents of this country who made the production of the vaccine possible. That is not acceptable,” Sanders wrote.

Health and Human Services Secretary Xavier Becerra was asked Wednesday morning if the federal government had the ability to work with vaccine companies on the cost increase and said it was largely up to the manufacturers.

The pricing “is something that is within the hands of those manufacturers and the distributors,” he said.

“We will do everything we can to make sure that the cost of a COVID vaccine remains affordable,” he added.

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(NEW YORK) — Sesame has joined the U.S. Food and Drug Administration’s list of major food allergens and will soon be added to labels of packaged food to protect consumers.

The eight initial food allergens that cause the majority of serious food-related allergic reactions — all established in 2004 — include milk, eggs, fish, crustacean shellfish, tree nuts, peanuts, wheat and soybeans, according to the FDA. Sesame is the ninth food to be added to the list.

As of Jan. 1, 2023, the agency stated that sesame is required to be labeled as an allergen on food packages, including dietary supplements.

“Even though the requirement that sesame be listed on the label as an allergen is in effect — you still may find food products for sale that don’t list sesame as an allergen on the label,” the FDA stated. “The law establishing this sesame labeling does not require food products that were already on their way to the store or in stock before 2023 to list sesame as an allergen on the label.”

During this transition period, consumers should note that food products on store shelves that were produced prior to Jan. 1 will not be removed or relabeled.

“Because some packaged foods can have a long shelf life, it’s hard to say when pre-2023 stock will be replaced with food products carrying the required labels,” the FDA statement continued. “So, proceed with caution during this transition period.”

The FDA also said that this serves as an important reminder for shoppers to always check labels on food products each time, since labels and ingredients can change, even if it’s a staple you’ve eaten before without an allergic reaction.

With the new labeling requirements, the name of the food source of a major allergen must appear either in parentheses following the name of the ingredient, such as “natural flavor (sesame),” or immediately next to the list of ingredients, such as “contains sesame.”

“Sesame has always been required to be listed in the ingredient statement if it was an added ingredient, with a few exceptions,” the FDA explained. “Now that sesame is a major food allergen, the FDA expects that it be specifically listed as sesame on the label if it’s part of another ingredient, like ‘natural flavor,’ or ‘spice mix.'”

The new sesame labeling requirements apply to packaged foods, but allergen labeling for foods that aren’t packaged, like fresh bagels in a grocery bin, may vary. For customers with allergy concerns, the FDA suggests asking store employees for food allergen information.

The change was made through the Food Allergy Safety, Treatment, Education, and Research (FASTER) Act, a federal law passed in 2021. The other eight major food allergens were defined through a federal law passed in 2004.

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(NEW YORK) — COVID-19 remained the leading cause of law enforcement deaths in 2022 despite the number attributed to the virus dramatically declining.

A new report released Wednesday by the National Law Enforcement Officers Memorial Fund looked at preliminary data and found that 226 federal, state, tribal and local law enforcement officers died last year while in the line of duty.

Of those deaths, 70 can be attributed to COVID-19. However, this is an 83% decline compared to the 405 officers who died from COVID-19-related complications in 2021.

“While America’s law enforcement officers are still battling the deadly effects of the COVID-19 pandemic, there has been a significant reduction in such overall deaths, likely attributed to reduced infection rates and the broad availability and use of vaccinations,” the report read.

Marcia Ferranto, CEO of NLEOMF, told ABC News to recognize an officer line of duty death from COVID as such, each case is reviewed by a medical team and then by a group of 13 law enforcement peers.

“At that point, it is determined whether this would be considered a line of duty death,” she said. “At this point, for 2022, we’re looking at recognizing 70 of these COVID-related cases as official line of duty deaths and each one, tragic.”

In 2021, 586 officers died in the line of duty, a 61% decline year-over-year, that can be attributed directly to the reduction of COVID-19 deaths.

According to the report, firearms-related incidents were the second-highest cause of death in 2022, followed by traffic-related incidents and other.

The “other” category included health-related deaths including heart attacks, stroke and effects from the September 11 attacks as well as accidents including aircraft crashes, falling objects, fires and falling to their deaths.

The report found that Texas had the highest number of law enforcement COVID-19 deaths with 16, followed by Illinois with six, New York with five, Alabama with four and Oklahoma and Tennessee with four each.

Overall, of the 226 fatalities, 204 were male and 22 were female. The average age was 44 years old with an average of 15 years of service. Additionally, each officer left an average of two children behind.

“These numbers bring it close to home and really humanize these men and women, these incredible men and women who are choosing law enforcement as their profession,” Ferranto said.

She said an investment in officer safety and wellness programs can hopefully help drive down these numbers even further in 2023.

Since the COVID-19 pandemic began, only has the virus been the leading cause of death among law enforcement officers but firefighters and other protection service employees had the occupations with the highest death rates from COVID-19.

According to a recent report published by the National Center for Health Statistics — a branch of the Centers for Disease Control and Prevention — those with protective service occupations had the highest COVID-19 death rate at 60.3 deaths per 100,000 workers in 2020.

This was twice as high as the overall workers’ COVID-19 death rate in 2020, which sits at 28.6 per 100,000.

The authors of the report said this was likely attributed to protective service employees not having jobs that allow them to stay at home as well as working in proximity to others — both colleagues and the public — increasing their risk of infection.

One of those deaths was Niagara Falls Police Department detective Kristina Zell, who passed away from a COVID-related illness in November 2022.

According to local affiliate WKBW, Zell began her career with the NFPD in March 2000 and worked her way up from patrol officer to a detective specializing in sex crime investigations.

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(NEW YORK) — Tens of thousands of Americans have reported a COVID-19 test result to the National Institutes of Health’s website that launched in November.

The site, MakeMyTestCount.org, allows people to anonymously report the results of any brand of at-home COVID-19 test.

In updated data exclusively provided to ABC News, 24,000 people have reported a test result to the site. Additionally, three-fourths of the results are a positive test and women were more likely to report a test result than men.

“I think there’s a greater number of people who are testing for COVID at this time than are being reported on this website. So, this is just sort of a small raindrop in a huge storm,” Dr. Sarah Elisabeth Waldman, an associate professor in the division of infectious diseases at UC Davis Medical Center, told ABC News.

When asked about the discrepancy in women- and men-reporting levels, “I don’t think it’s specific to COVID. I think this is more specific to women in general, having higher rates of self-reporting on voluntary websites and other programs,” she added.

Public health experts said it’s great that there is a place for people to import test results and that more people are doing so than expected — but questions remain about self reported data that could give scientists a better idea of where the virus is spreading and who is most affected.

They also warned that there may be a bias in who is inclined to report test results.

“The fact that we’re seeing three out of four reported tests as positive definitely doesn’t mean that three out of four people are actually positive. Likely, it means that people are more inclined to report a positive than a negative result,” Andrew Weitz, Ph.D., a program director at the NIH and co-lead of the project, told ABC News.

But that doesn’t mean reporting of at-home test results is not beneficial to health officials. In fact, the more results that are provided, the clearer their understanding of COVID in the community is.

“The absolute numbers may or may not tell the whole story, but what I think the public health community is going to start getting a better handle on is how the trends can help us understand that story,” Dr. Krishna Juluru, a presidential innovation fellow at the NIH and co-lead of the project, told ABC News.

Experts also urged the public to report their at-home test results regardless of whether positive or negative to provide health officials with a better sense of what is going on in the community.

“Without the negatives, we don’t have a good idea of what the overall positivity rate might be, and where we’re seeing real significant increases,” Matthew Binnicker, Ph.D., director of the clinical virology laboratory at Mayo Clinic, told ABC News. “We need to be able to determine where COVID is most prevalent, where we’re experiencing a surge [and] we need to have the total number of tested including positive and negatives to really get a good sense of that.”

The NIH is also launching a pilot program in one county in Pennsylvania that will provide free COVID-19 health services entirely virtually. Up to 8,000 eligible residents are anticipated to participate in the program.

Under the program, a patient sick with COVID-19 could receive at-home rapid tests, telehealth sessions and at-home treatments like Paxlovid without leaving their house.

“It’s largely focused on a home setting, but we also allow individuals to have options so if they want to pick up a test at a local community center, after a telehealth consultation if they want to go pick up their medications at a local pharmacy, we allow that as well,” said Juluru.

Since anti-viral drugs, such as Paxlovid, cannot be taken with some other medications, patients must meet with a clinician before any therapeutics are sent to their home.

There are plans to expand the program to multiple other sites throughout the year.

“This is a pilot program, so we’re kind of doing it in the spirit of learning as much as possible,” said Weitz.

A main goal for the scientists at the NIH is, “to understand what’s working, what’s not and how can we improve things if there were to be a larger scale rollout of this program,” he added.

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(NEW YORK) — Gov. Kathy Hochul announced Tuesday that New York will invest $1 billion to address mental health needs.

Hochul laid out her plans for addressing the mental health care system in a speech at the Assembly Chambers in Albany on Tuesday afternoon.

“When it comes to keeping people safe and protecting their well-being, fixing New York’s mental health care system is essential — and long overdue,” the governor said at the State of the State address.

According to Hochul, over 3,000 New Yorkers experiencing “severe mental illness or addiction” live on the city’s streets and in their subways, and there aren’t enough inpatient psychiatric beds and outpatient services.

As part of her plan, New York will add 1,000 inpatient psychiatric beds, provide funds for 150 new beds in state-run facilities and add 850 psychiatric beds back to hospitals. This accounts for over half the beds the state lost since 2014, Hochul said.

“I’m declaring that the era of ignoring the needs of these individuals is over. Because our success as government leaders is measured by our ability to lift up and support all our constituents,” she said.

New York also plans to build more than 3,500 housing units offering mental health services.

Rates of mental illnesses in the state has been on the rise and the problem was only exacerbated because of the COVID-19 pandemic, according to Hochul.

A coalition of pediatric groups declared children’s mental health challenges during the COVID-19 pandemic a “national emergency” in October 2021.

“Young people have endured so much throughout this pandemic and while much of the attention is often placed on its physical health consequences, we cannot overlook the escalating mental health crisis facing our patients,” Dr. Lee Savio Beers, American Academy of Pediatrics president, told ABC News in a statement at the time.

Hochul said New York plans to “reduce unmet mental health needs among children by at least half in the next five years.”

“Whether we’re talking about a child with behavioral challenges or an adult suffering from depression, no one should go without a screening or a doctor’s appointment or counseling,” the governor said. “And cost should never be a barrier.”

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(NEW YORK) — The nurses strike in New York City has extended into its second day with more than 7,000 walking out of two major hospitals.

Nurses at Montefiore Medical Center in the Bronx and Mount Sinai Hospital in Harlem say that low pay, lack of staffing and unsafe working conditions are burning out hospital employees and putting patients at risk.

“Can’t stop, won’t stop until we get a fair contract!” the New York State Nurses Association tweeted Monday night, announcing that the picket line would continue into Tuesday.

The hospitals have been forced to divert ambulances to other medical centers, postpone non-elective surgeries and call in temporary staffers, but the nurses say they’ve been pushed to the brink.

“There’s multiple reasons for why we all need to be paying attention,” Gretchen Purser, an associate professor of sociology and a labor expert at Syracuse University’s Maxwell School of Citizenship and Public Affairs, told ABC News. “Nurses are really bargaining for the collective good. They are putting, first and foremost, patients’ safety above all else and that was the breaking point — they’ve been working under less-than-ideal conditions that jeopardized the safety of patients.”

One of the nurses’ biggest grievances is the nurse-to-patient ratio, which measures how many patients a nurse is responsible for, at a hospital.

Research has shown that when staffing levels are high and nurses are only taking care of a few patients, there is a lower risk of patients dying as well as a lower risk of infections, medication errors, ulcers and hospital-acquired pneumonia.

What’s more, patients are more likely to have shorter stays when there are more nurses, officials said.

One New York State analysis, conducted in 2021, estimated adequate nursing staff levels could save 4,370 lives and $720 million over a two-year period due to shorter hospital stays and fewer readmissions.

The nurses say the hospitals are supposed to have low nurse-to-patient ratios, but they often end up being much higher.

Marcelo Cantu, a nurse at Montefiore for 19 years, who works in the cardiothoracic unit, told ABC News every nurse is supposed to have three patients, but can often end up with four or five due to staffing shortages. He said even one extra patient can affect the level of care.

“Our patients require a lot of time — we’re not only monitoring their recovery but teaching them how to physically recover from what they’ve been through, teaching them about their new medications, teaching them about lifestyle changes,” he said. “We’ve had to learn how to prioritize and because we’re working short, sometimes the quality suffers and that’s very difficult to deal with.”

Montefiore said it is offering a 19.1% compounded wage increase over the next three years with pay increases for each level of experience.

What’s more, the hospital has also offered to add 115 registered nursing positions to the emergency department, 11 registered nursing to the labor and delivery department and 23 nurse practitioner positions.

Mount Sinai told ABC News in a statement it also offered a 19.1% increased wage proposal, but those nurses rejected the offer.

The nurses argue that the pay increase is not the main reason for the strike but rather the current contract does not address nurse-to-patient ratios.

“I’ll be the first to say a nurse deserves a fair compensation,” Cantu said. “But it’s not about money, it’s about the allocation of that money in order to provide better care.”

He continued, “It’s frustrating and heartbreaking when we fall short in areas not critical to their life but critical to the patients’ experience. These are human beings, not just a list of symptoms in front of us.”

Labor and economic experts say that when nurses go on strike, the stakes are not just high for them but also for the community at large as well.

“All of us are either going to need care in a hospital or have loved ones who need care in a hospital and its nurses who are the frontlines of that,” Purser said.

“We need nurses to be able to do their jobs properly because if we get sick or we’re older, and we’re at our most vulnerable or disabled, that’s when we need a nurse,” Joelle Leclaire, an associate professor of economics and finance at SUNY Buffalo State, told ABC News. “If we can’t have proper nursing ratios, fewer of us are actually going to be able to overcome conditions that affect our well-being in our health.”

She added that’s an economic impact as well because nurses are not getting paid their full wages when they’re on strike.

“If they’re not being paid now that they’re striking, and the longer that they strike, that money doesn’t go back into the economy,” Leclaire said. “So that’s another piece of it, too, which granted is smaller, but it’s still a piece.”

Montefiore said it has since introduced several new offers, including establishing average patient ratio, to end the strike.

“Montefiore remains at the bargaining table, committed to an equitable agreement that reflects the priorities of our dedicated nurses. Contingency plans remain in place to ensure our hospitals remain open, because Montefiore is, and always will be, here for The Bronx,” a statement released Tuesday read.

ABC News’ Sasha Pezenik, Nicole Wetsman and Youri Benadjaoud contributed to this report.

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