(NEW YORK) — The Centers for Disease Control and Prevention are warning of a rise in eating and tic disorders among teenage girls during the COVID-19 pandemic.
Echoing prior research, the proportion of emergency department visits with eating disorders doubled among adolescent girls; those for tic disorders approximately tripled during the pandemic. Tic disorders are characterized by repeated twitches, movements or sounds that people do involuntarily.
“The results of the report are unsurprising,” said Dr. Neha Chaudhary, child psychiatrist at Harvard Medical School and chief medical officer at BeMe Health. “This is quite in line with what I’m seeing in my clinical practice and what I’m hearing from teens directly. Many teens with preexisting conditions like depression or anxiety noted worsening of their symptoms since the pandemic, while others without previously diagnosed conditions noted having symptoms for the first time.”
In their report, the CDC researchers said eating disorders can be triggered by pandemic-related stress, such as lack of structure and daily routine. But they said the increased visits for tic disorders was “atypical” because tic disorders usually start earlier in childhood, and more typically among males.
Researchers have suggested that exposure to severe tics on social media might be associated with the increased tic disorder visits among teenage girls, calling them “TikTok Tics.” These types of tic disorders have distinct features from Tourette syndrome, which is a tic disorder often diagnosed in younger children. In addition, tic disorders can be triggered by stress.
In 2021, several major pediatric health organizations announced a national emergency in child and adolescent mental health. In the past 10 years, there has been a rise in child and adolescent mental health issues, and by 2018, suicide was the second-leading cause of death for youth ages 10 to 24. These issues have worsened in the context of pandemic-related stressors, which have disrupted safety and stability of families and daily living structure.
LGBTQ children are even more at-risk of suicide, according to Elizabeth Thompson, CEO of the National Eating Disorders Association.
“The sky rocketing increase in numbers (50 and 70% over previous time periods) reported by the CDC relative to children’s visits to the emergency room during COVID for self harm or suicidality due to increasing mental health issues, including eating disorders, mirrors what we have seen as we analyzed our Helpline data,” Thompson said in a statement.
“Teens everywhere have been hit harder than most groups by the stress of the pandemic,” said Chaudhary. “It’s no wonder that their mental health has been declining when their usual supports — like structure, routine and peer connections — have been ripped out from under them for the past two years.”
In a second report released Friday, the CDC found a drop in overall emergency department visits for any reason in the past two years. Experts caution the lower rate of emergency department visits could be because people were afraid to visit medical centers during the pandemic.
But despite the overall drop, there was a rise in emergency department visits for specific reasons, such as self-harm, firearm injuries, drug poisonings and mental health conditions such as eating disorders, particularly in teenage girls.
“Some teens have shared that during times of great uncertainty, they find themselves changing their eating patterns as an unsuccessful attempt to regain a sense of control,” said Chaudhary. “They often realize that it’s happening, but find it difficult to stop without additional support.”
Eating disorders affect 9% of the U.S. population, and will affect close to 30 million Americans in their lifetime, according to the National Association of Anorexia Nervosa and Associated Disorders.
Parents, siblings and friends should be aware of signs of eating disorders, which can include restricting food intake as well as routinely binge-eating and/or purging.
“I commend the teens who are reaching out to professionals for help, even via ED visits,” said Chaudhary. “I hope to see more proactive supports in places for teens so that they can get help with their mental health conditions before it becomes an emergency.”
If you think you or someone you know has an eating disorder, call ANAD’s helpline at 1 (888)-375-7767, for free emotional support and referrals for resources. 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. Even if it feels like it — you are not alone.
ABC News’ Cristina Corujo contributed to this report.
Aiya Aboubakr is an internal medicine resident at New York Presbyterian-Weill Cornell Medical Center, and a contributor to the ABC News Medical Unit. Sony Salzman is the coordinating producer of the Medical Unit.
(NEW YORK) — New Mexico and Virginia this week joined a growing number of states, cities and local communities that are going “mask optional” as omicron variant cases start to decline nationwide.
New Mexico Gov. Michelle Lujan Grisham lifted the state’s indoor mask mandates on Thursday and Virginia Gov. Glenn Youngkin on Wednesday declared an end to his state’s mask mandates in public schools.
The Centers for Disease Control and Prevention, however, has yet to update its federal guidance on masks, although it is expected to loosen mask guidance as early as next week. The federal agency still recommends that “If you are 2 years or older and are not up to date with your COVID-19 vaccines, wear a mask indoors in public.”
Some experts caution that relaxing COVID-19 safety measures too early may lead to a potential resurgence of the virus in the near future.
In light of changing mask guidance, it’s up to parents to figure out what they’re comfortable with and to convey their decisions to kids. Dr. John Brownstein, an epidemiologist with Boston’s Children Hospital, Dr. Amanda Mintzer, a clinical psychologist with the Child Mind Institute, and Dr. Neha Chaudhary, a child psychiatrist and chief medical officer of BeMe Health, spoke with ABC News’ Good Morning America on the best way families can make that risk-tolerance decision and how to talk to kids and teens.
Mintzer recommended that parents do their due diligence and stay open-minded before deciding what they are comfortable with. She also suggested parents talk to children about respecting other families and their decisions too.
“(It) may be different from the mainstream and that’s OK, too. Everybody has to do what makes them feel comfortable and I would say, as much as we can, encourage our kids to follow the program that we’re setting for them rather than comparing,” she said.
Here are what the experts recommend for parents and caregivers as they navigate questions from children:
Talk together as a family
Brownstein, Mintzer and Chaudhary emphasize that, above all, parents should talk to kids, see what each family member is comfortable with and make decisions collectively.
“The decision really is a family decision and it goes to probably a number of factors, which is whether the child and family are fully vaccinated and whether there’s anybody in the family and household that may have any underlying conditions where you might want that extra level of protection to protect the family,” Brownstein said.
Chaudhary also emphasized a family’s unique circumstances and said to discuss guidance from the CDC and other sources together.
“Framing it as a set of family rules can be helpful when there’s conflicting information out there on what to do, when, or where,” she explained via email.
“I think always remember that kids take their cues from their parents,” Mintzer said. “And so it goes back to values – what is important for your family? If you are a family that really still strongly believes that your child should be masked, despite the fact that let’s say, maybe their school isn’t requiring that, I think it’s about imparting that value to your kids.”
Set an example
Another key to remember? Practice what you preach, Mintzer said.
“You can’t tell your kid to do this (or that), if you’re not doing it as well,” she said.
If a child is frustrated with having to wear a mask, Chaudhary added, “Parents should validate their children’s feelings where they can, by saying things like, ‘I know you’re tired of having to wear a mask. I also wish we didn’t have to anymore,’ while modeling how to manage frustration and still abide by the rules. Kids are always watching parents to see how they handle situations, including frustrating ones.”
Be flexible
One of the biggest lessons from the pandemic has been that guidance continues to evolve, Mintzer said.
“The most important message is encouraging flexibility, that these are changing times and that different government officials are making different decisions and we’re just trying to get the best information that we can,” she said. “It’s hard to be flexible sometimes and sometimes it doesn’t even make sense. It’s important for us to practice going with the flow.”
If you and your family decide to make changes, Mintzer said that it’s important to let kids and teens know that and to know that it’s acceptable to do so.
“I think we want to instill in them that it’s OK to do something different and we want to do what makes us feel good, and we might change our minds, and that’s fine, too,” she said.
Brownstein added, “The important thing here is, there’s no one size fits all. Every family, every child, everyone has a slightly different context by which they make these decisions. And we have to apply the family dynamics with what’s happening in the school with what’s happening in the community to arrive at a decision that makes the most sense. So, it’s not like there’s one right way to do this.”
Use age-appropriate messages
When talking to kids under 5 about mask-wearing and not mask-wearing, “It can help to make the mask-wearing some sort of a game or enjoyable experience,” Chaudhary suggested. “Consider getting a mask with your child’s favorite superhero on it, or putting kids on a point system where they are rewarded for mask-wearing. If masks are no longer required per the guidelines (for example, for kids who are over the age of 2 and vaccinated), parents can just inform kids that the rule has changed.”
For children between 5-11 years old, Chaudhary pointed out, “Kids at this age are focused on rules – understanding what rules apply to them or what happens if they abide by the rules versus break them. Having a frank conversation about what those rules are, why they exist, and what the consequences are can be a helpful starting point for kids in grade school, particularly late elementary through middle school.”
Finally, with teenagers, Chaudhary added, “Ask them what their understanding is of a certain topic. That can serve as a starting point to build off of in explaining guidelines as well as how you as a family expect to approach the guidelines and mask-wearing.”
(NEW YORK) — A Tennessee family is speaking out to share memories of their 7-year-old daughter, who died Feb. 7, less than 72 hours after testing positive for COVID-19.
“She was just a happy, healthy, normal, beautiful soul,” Jennifer Graviss said of her daughter, Adalyn. “She was just so sweet, an amazing kid.”
Jennifer Graviss and her husband Adam Graviss, of Knoxville, Tennessee, said Adalyn, whom they described as an active and healthy child, had been feeling fine until early in the morning of Feb. 4, when she complained of feeling hot.
When they took her temperature and saw it was 102 degrees, they said they gave her an at-home COVID-19 test, on which she tested positive.
Adalyn, a second-grade student, stayed home from school that day and appeared to be feeling fine, according to her parents. It was not until the following night, they said, that she started struggling to walk and speak.
“It was right around the nine o’clock hour when we noticed her speech was all but gone, though she was still responding to us,” said Adam Graviss. “By 10 o’clock, I was in the emergency room [with her], and she was unresponsive at that point.”
“It was just so fast,” he continued. “Hours before going to the hospital, she was running in the front yard.”
Adalyn was quickly transported to Monroe Carell Jr. Children’s Hospital at Vanderbilt in Nashville, where she was put on an ECMO machine, a lifesaving device that pumps and oxygenates a patient’s blood outside the body.
“Even while it was happening, it didn’t seem real,” Adam Graviss said of his daughter’s rapid decline. “Her levels were improving and then she just took a turn for the worse.”
In addition to a severe case of COVID-19, doctors diagnosed Adalyn with both severe myocarditis, inflammation of the heart, and acute disseminated encephalomyelitis (ADEM), inflammation of the brain and spinal cord that can quickly cause neurological damage, according to the National Institutes of Health (NIH).
ADEM attacks the body quickly and often follows a viral or bacterial infection, according to the NIH.
Amid the surge of the omicron variant in the U.S., infectious disease experts noticed a pattern of brain inflammation, or encephalomyelitis, following cases of COVID-19, particularly among children, according to Dr. Isaac Thomsen, a pediatric infectious disease expert who helped care for Adalyn at Monroe Carell Jr. Children’s Hospital at Vanderbilt.
Thomsen said Adalyn’s case of ADEM was one of the most rapid and severe cases he has seen in his career. He said she was also the first pediatric patient he has treated who presented with both COVID-related ADEM and severe myocarditis at the same time.
“The combination is probably what ultimately cost her her life, “Thomsen said. “That is pretty rare among viruses, this ability of COVID to hit both of those [the heart and the brain] at the same time.”
Adalyn was not yet vaccinated against COVID-19. At age 7, she had just become eligible for the vaccine in November and her parents said they were still considering it. The Gravisses said Adalyn was diligent about following COVID-19 safety protocols, including wearing a face mask at school and washing her hands.
Jennifer Graviss gave birth to the couple’s second child, a baby named Ella, on Jan. 28, and she said the whole family quarantined at home outside of Adalyn going to school in the time before and after the baby’s birth.
“We were just very cautious,” said Jennifer Graviss, adding that Adalyn was particularly cognizant. “If a kid was coughing she would ask to be moved because she didn’t want baby Ella to get it.”
Adalyn also had no known underlying health issues that would cause or predict such severe illness, according to her parents as well as Thomsen.
“This is a big reason of why we don’t roll the dice on a virus like this,” Thomsen said of COVID-19’s unpredictably when it comes to who it affects and how severely. “This is not something to mess around with.”
“The takeaway for parents is this is a virus that we have got to take very seriously and one we have a safe and effective vaccine for,” he said.
Children ages 5 and older are now eligible to receive Pfizer’s two-dose vaccine. Children ages 12 and older are also eligible to receive a Pfizer vaccine booster shot.
Remembering a beloved daughter, big sister
The Gravisses said they are still shocked that they are now planning funeral arrangements for their beloved daughter, who became a big sister to Ella just one week before her death.
“She waited for years to be a big sister,” said Jennifer Graviss. “Every night she would pray for God to give her a baby to be a big sister, and that’s what we’re so thankful for, that she was able to experience that for five days.”
Jennifer Graviss said that Adalyn treated Ella like her own baby doll, dressing her up and waking up an extra 30 minutes before school every day so that she could have more time to hold her.
“She would just sing to her and she would sit there and tell her stories like, ‘I’m going to be your best friend. Sissy’s going to show you so much, how to dance and how to play basketball and as soon as you’re big enough, we’re going to church,'” she said of Adalyn. “She just wanted to be with the baby all the time.”
Adam Graviss said he is comforted knowing Ella will have her big sister as her protector, saying, “She’s going to have the coolest guardian angel looking over her, protecting her.”
The Gravisses said their daughter loved things like playing basketball and dancing, going to church and being around her friends. The family held a celebration of life for Adalyn last week for her school friends, basketball teammates and fellow Girl Scouts and dance classmates.
“All her friends are wearing shirts that say, ‘Love Like Adalyn,'” Jennifer Graviss said. “She just had the biggest heart. She loved her friends. She hugged teachers that weren’t even her teacher every morning. She would stop by the [school] office and give an update every day about baby Ella.”
One of Adalyn’s former teachers started a GoFundMe for the family to help cover Adalyn’s medical and funeral expenses.
Jennifer Graviss and her husband said they are now finding comfort in seeing how vibrant a life Adalyn led and in knowing they have “no regrets” because of the time and attention they gave their daughter.
“We did everything with her, everything she wanted to do, from going to Disney World to playing basketball in the driveway in the dark to playing UNOs tournaments every night,” Jennifer Graviss said. “She was just a happy girl.”
Jennifer Graviss noted that while Adalyn loved everyone, she had a special fondness for her dad.
“She did everything with [her] daddy,” she said, adding that Adalyn encouraged her dad to watch YouTube videos to improve at putting her hair in a bun for dance class. “Every basketball game that she’d make a shot, she’d look back for daddy to be cheering her on. They were best buds.”
“We just never wanted to be without her,” Adam Graviss said. “We would have people all the time asking to babysit her and let us go out for a date night, but we never did. We just wanted to be with her.”
He continued, “She was just really fun, and we just took her everywhere. That’s what makes it so hard. She was our best friend.”
(NEW YORK) — The Food and Drug Administration is warning consumers not to use certain powdered infant formulas made at Abbott Nutrition’s Sturgis, Michigan, facility amid an investigation into four infant illnesses.
Parents should discard any affected formula, according to the agency. Specifically, the FDA is advising consumers not to use Similac, Alimentum or EleCare powdered infant formulas if: the first two digits of the code are 22 through 37, and the code on the container contains K8, SH or Z2, and the expiration date is 4-1-2022 (APR 2022) or later.
“As a result of the ongoing investigation, along with the U.S. Centers for Disease Control and Prevention and state and local partners, the FDA is alerting consumers to avoid purchasing or using certain powdered infant formula products produced at this facility,” a press release stated.
“This is an ongoing investigation, and the firm is working with the FDA to initiate a voluntary recall of the potentially affected product,” it said, noting the FDA has “initiated an onsite inspection at the facility.”
In a press release, the FDA announced it is investigating consumer complaints of Cronobacter sakazakii and Salmonella Newport infections that resulted in four infant illnesses and hospitalizations in three states — Minnesota, Texas and Ohio. Cronobacter may have contributed to a death in one case, according to the report.
According to the FDA, Cronobacter bacteria can cause life-threatening infections such as sepsis or meningitis.
“Symptoms of sepsis and meningitis may include poor feeding, irritability, temperature changes, jaundice (yellow skin and whites of the eyes), grunting breaths and abnormal movements. Cronobacter infection may also cause bowel damage and may spread through the blood to other parts of the body,” the FDA says. “Parents and caregivers of infants who have used these products, and are concerned about the health of their child, should contact their child’s health care provider.”
Products made at the Sturgis, Michigan, facility are available across the U.S.
“As this is a product used as the sole source of nutrition for many of our nation’s newborns and infants, the FDA is deeply concerned about these reports of bacterial infections,” said Frank Yiannas, the FDA deputy commissioner for food policy and response in a press release. “We want to reassure the public that we’re working diligently with our partners to investigate complaints related to these products, which we recognize include infant formula produced at this facility, while we work to resolve this safety concern as quickly as possible.”
The FDA will provide consumer safety information on the investigation as it becomes available.
ABC News’ Sony Salzman and Stephanie Ebbs contributed to this report.
(NEW YORK) — Boosters helped reduce the risk of contracting the omicron variant after it spread at a convention in New York City, according to a new study published by the Centers for Disease Control and Prevention Thursday.
In the report, the authors describe “a large indoor convention in New York … with approximately 53,000 attendees from 52 U.S. jurisdictions and 30 foreign countries during Nov. 19 – 21, 2021.”
Although the convention is never named, the description matches the Anime NYC convention that was held at the Javits Center in Manhattan over those dates.
Overall, the report found that convention attendees who were boosted were less likely to contract COVID-19 and that a small percentage of household contacts later tested positive.
According to convention rules, attendees were required to have received at least one COVID-19 vaccine dose and wear masks indoors.
The first case was reported to the CDC by the Minnesota Department of Health on Dec. 2 in a man — called Patient A — who had flown to New York City for the convention, the report said.
For the report, the CDC teamed up with the MDH and state and local departments across the country interviewing Patient A, and 23 of his 29 close contacts from 13 states who also attended the convention.
Patient A had traveled to New York City on November 18. He was fully vaccinated and received a booster shot earlier in November, according to the authors.
However, he developed symptoms on Nov. 22 and subsequently tested positive for COVID-19, after which he notified all his close contacts, the report said.
Of the 23 attendees contacted, 16 tested positive for the virus, equating to an attack rate of 70%.
All the contacts were fully vaccinated, but only 11 had received a booster dose before going to the convention, according to the report. The authors indicate that having a booster dose lowered the odds of testing positive for COVID-19.
Ten of the 12 people, or 83%, who didn’t receive a booster tested positive for the virus while six of the 11 people, 55%, who tested positive were boosted, meaning there were 1.5 times fewer infections in boosted individuals.
“Data from this investigation reinforce the importance of COVID-19 booster doses and early notification in combination with other multicomponent prevention measures to limit transmission and prevent severe illness from omicron and other SARS-CoV-2 variants,” the authors wrote.
Additionally, 15 of the 20 contacts who said they always wore a mask during the convention tested positive anyway, according to the report.
Recently, the CDC has stated that N95 masks are more effective at preventing infection with the omicron variant than surgical masks and cloth masks.
All of attendees who reported COVID-19 infections said they experienced at least one symptom, with median duration lasting 11 days. The most commonly reported symptoms included nasal congestion, fatigue, cough and sore throat, the report said.
After returning home from the convention, 16 of the attendees exposed 20 household contacts who did not attend the convention, the report said.
In total, 99% of the household contacts were fully vaccinated and 50% had received a booster dose, the authors noted.
Of the 18 household contacts who were subsequently tested, six, or 33%, received positive results, including four who had received boosters.
The authors noted that people testing positive for COVID despite being fully vaccinated demonstrates omicron’s ability to — at least partially — evade the protection offered by vaccines.
“However, illness was relatively mild among this cohort, consistent with evidence that vaccinated persons with infections are less likely to experience serious illness,” they wrote.
Two of the positive household contacts were parents of the convention attendees, two were grandparents and two were siblings, according to the report.
Four of the six household contacts said they had fewer than five symptoms with the most common being nasal congestion, fatigue, cough, runny nose and change in taste.
No hospitalizations or deaths were reported among anyone who received a positive test either in the attendee group in the household contact group, the report said.
Overall, five of the attendees’ samples and three from the household contacts underwent genomic sequencing and were confirmed to be linked to the omicron variant, according to the authors.
The authors said there are limitations to the report including that some people who attended the convention used at-home antigen tests rather than laboratory PCR tests to confirm a negative result.
Because rapid tests are more likely to report false negatives than lab tests, some COVID cases may have been missed.
Additionally, because seven of Patient A’s close contacts could not be reached for interviews, results may be skewed.
However, the researchers say the report shows the importance of getting fully vaccinated and boosted, as well as masking indoors, to prevent infection from the omicron variant as well as severe disease and death.
(NEW YORK) — Mosquitoes may be smarter than we think, and that could make getting rid of them and the diseases they carry even more difficult, according to new research.
Scientists who studied two species of mosquitoes that spread diseases such as dengue, Zika and West Nile fever — Aedes aegypti and Culex quinquefasciatus — found that the females learned to avoid pesticides after a single non-lethal exposure, a study published Thursday in Nature found.
The researchers exposed the female mosquitoes to non-lethal doses of common anti-mosquito pesticides and found that mosquitoes that had been pre-exposed to a pesticide avoided passing through a pesticide-treated net in order to reach a food source at a higher rate than those who had not been pre-exposed, according to the paper.
In addition, the survival rate of pre-exposed mosquitoes was more than double that of mosquitoes that had not been pre-exposed.
The findings suggest that mosquitoes that have been exposed to non-lethal doses of pesticides learn to avoid these pesticides and, as a result, may seek out safer food sources and resting sites, allowing them to survive to reproduce.
Pre-exposed mosquitoes were also more likely to rest in a container that smelled of a control substance, rather than in a container that smelled of a pesticide, the researchers found.
Pesticide resistance has increased among mosquitoes in recent decades, but the extent to which has been unclear until now.
“Mosquitoes have been learning,” Frederic Tripet, a behavioral ecologist and director at the Centre for Applied Entomology and Parasitology at Keele University in the U.K., told ABC News. “We just didn’t know about it.”
In 2012, Tripet co-authored another study that showed mosquitoes were capable of learning — that they could associate different patterns, visual cues, or smells with a positive or negative experience. Those findings suggested that the learning may be relevant to their relationship with pesticides, Tripet said.
“So they’re there. They get this first bad experience,” Tripet said. “And if we don’t kill them at first instance, then they learn to avoid that.”
The learning, combined with the physiological resistance to the pesticides, compounds the difficulties in ridding the mosquitoes with pesticides, said Tripet, who collaborated on the research for this study with the Vector Control Unit of University Sains Malaysia in Penang, Malaysia.
New solutions will be necessary to better control mosquito populations, Tripet added. One way may be to devise a chemical compound that has a delayed reaction, therefore if it does not kill a mosquito the first time, the insect will not associate the smell with a negative experience, he said.
Learning can also be disrupted by adding an attractive smell to the mix, Tripet said.
(NEW YORK) — After months of unrelenting surges, COVID-19 infections and hospitalizations are falling rapidly across the United States, a welcome reprieve for many Americans, who are hoping that the decline will herald the beginning of the end of a difficult two years and a return to a much-awaited normalcy.
Although COVID-19 infections remain at levels comparable to prior peaks, with an average of 147,000 new cases still reported each day, politicians across the country, sensing the public pandemic fatigue, are eagerly moving to lift restrictions.
In just the last week, governors in 11 states and Washington, D.C., have announced an end to their statewide masking policies and other mitigation measures. Federal agencies and local jurisdictions are also moving to cut down on publicly available COVID-19 data.
Although health experts agree the COVID-19 decline is encouraging, many are urging caution not to declare victory prematurely out of fear of a potential viral resurgence. Many experts are also expressing concern over declining data availability.
“While we are in a much better place than we were a month ago, we still have to apply caution. Opening too quickly can lead to unnecessary increases in transmission that will only prolong the current surge and potentially accelerate the pace of a new variant,” said Dr. John Brownstein, an epidemiologist at Boston Children’s Hospital and an ABC News contributor.
The Centers for Disease Control and Prevention is also remaining vigilant, advising Americans to keep their masks on, particularly in areas of high or substantial transmission, despite contradictory messaging from state leaders.
“We are looking at all of our guidance based not only on where we are right now in the pandemic, but also on the tools we now have at our disposal, such as vaccines, boosters, tests and treatments and our latest understanding of the disease,” CDC Director Dr. Rochelle Walensky told reporters Wednesday during a White House COVID-19 briefing, adding that the agency could “soon” deliver updated mitigation guidance.
“We want to give people a break from things like mask-wearing, when these metrics are better, and then have the ability to reach for them again should things worsen,” Walensky said.
However, despite encouraging downward trends of new cases, hospitalization totals and deaths rates remain high, she added.
Across the country, about 80 million Americans are still unvaccinated, and more than half of those who are eligible to receive a booster shot have yet to do so, according to federal data.
Some health experts are concerned that the accuracy of COVID-19 case counts is potentially underestimated, given the increasing availability of home tests, which are rarely reported to health authorities.
“In addition to asymptomatic or mild cases, which can go unrecognized by infected people who do not get tested, positive rapid home tests are also not being counted,” Dr. Maureen Miller, professor of epidemiology at Columbia University’s Mailman School of Public Health, told ABC News. “There are also an unknown number of people who chose not to get tested, because they can either not afford to be infected because they don’t get paid if they’re sick or they don’t want to know or believe that they have contracted COVID-19.”
‘This is not the time to let our guard down’
Nearly two years into the pandemic, there is a feeling of exhaustion among Americans over the need to wear masks and other mitigation measures.
“If you really want to get the epidemic behind you, put it in the rearview mirror, just saying you’re done with COVID — you may be done with COVID, but COVID is not done with the United States, nor is COVID done with the world. We’ve got to do what it takes to get it to be done,” Dr. Anthony Fauci, chief medical adviser to the White House, said during an appearance on MSNBC on Tuesday. “We’re not out of the woods yet.”
Health experts believe that though these frustrations are valid, the benefits to keeping these measures in place for a bit longer would be beneficial in preventing another resurgence.
“This is not the time to let our guard down. Pulling back on restrictions has to be incredibly nuanced and based on robust data produced at the local level,” Brownstein said.
The issue of when is the right time to end mitigation measures remains complicated, particularly given the understanding from scientists that this virus will never be fully eradicated.
“Does that mean we have to wear masks for the rest of our lives? No, because we don’t usually design interventions that last forever, particularly ones that are not well tolerated,” said Dr. Jennifer Nuzzo, lead epidemiologist for the Johns Hopkins Coronavirus Resource Center.
It is important to consider feasibility and implementation issues, given how tired people are of the pandemic and the willingness of the public to continue to adhere to certain measures, Nuzzo said, adding that it is important for health officials to determine when is a decent time to relax mandates.
Miller told ABC News she feels strongly the time to lift restrictions is not now.
“Removing mask requirements is a huge mistake,” Miller said. “I understand the urge to not want to wear masks anymore. I hate wearing a mask. I do it anyway. Although cases are decreasing, every state in the United States has elevated levels COVID-19 spread. Not one state is on track for containment. That means there has to be preventive mechanisms in place to slow the spread, and the subsequent hospitalizations and deaths.”
Health experts are particularly concerned about individuals who are residually at risk, those who are immunocompromised and children under 5, particularly because about one-third of Americans are not fully vaccinated.
“The most frightening aspect of removing masking requirements … is the expectation that only the unvaccinated should continue to mask. The unvaccinated are the least likely to wear masks when requirements are in place,” Miller added. “Removing masking requirements ensures that infectious people will encounter susceptible people in greater numbers — with no protections in place to prevent infection. I would expect to see the number of cases rise.”
A drop in data availability
The pullback in the reporting of COVID-19 data by both the federal and state governments is also of great concern to epidemiologists, who have been using the data to help track the course of the pandemic and guide mitigation decision-making.
Since the beginning of the delta surge, dozens of states have ended daily virus data reports. In addition, last month, the Department of Health and Human Services ended the requirement for hospitals to report several key COVID-19 metrics, including a daily total of the number of COVID-19 deaths, the number of emergency department overflow and ventilated patients and information on critical staffing shortages.
“There’s no reason that we should be turning off data streams. Not only does it hamper our current response, but it will leave us more vulnerable to any future waves,” Dr. David Dowdy, an infectious disease epidemiologist at Johns Hopkins Bloomberg School of Public Health, told ABC News.
The curtailment of COVID-19 data stems from “political decisions to downplay the pandemic and the availability of rapid home tests with no requirement to report data to health authorities,” Miller said, adding that available data for hospitalization and deaths still “provide the most compelling evidence that COVID-19 continues to wreak havoc around the country.”
Nuzzo stressed that the most effective and efficient way to track the virus is by having a deliberate, active surveillance plan and consistently monitoring and testing certain subsets of the population across the country in order to determine the frequency with which people are getting infected, as well as who is getting infected.
Analyses of wastewaters, sequencing and data pertaining to infections, hospitalizations and deaths are all critical strategies in understanding the epidemiology of COVID-19, and whether or not it is changing. Each source of data is important, Nuzzo said, because they all “tell you something slightly different, so you kind of need them all in order to add it all up to help you triangulate your way to the truth.”
Not the last one
When exactly the nation will transition from a pandemic to an endemic phase is still up for debate. According to scientists, although the virus will never be fully eradicated, eventually, people will have gained enough immune protection from vaccines or from natural infection that there will be less transmission with milder infections and fewer hospitalizations and deaths, potentially, exhibiting similarities to the flu.
However, for now, many health experts stress that it is critical that Americans remain vigilant, because, as demonstrated by the rapid emergence and spread of the delta and omicron variants, there could still be highly transmissible mutations of the virus, leading to another significant surge.
“Though many might declare victory on the pandemic, we are clearly very far from where we want to be right now, especially with billions of people yet to be vaccinated and the threat of a new variant looming,” Brownstein said.
Nuzzo added that Americans have to be open to the possibility of having to reverse course, and reimplement restrictions.
“Now, some people would argue that means we should never lift the recommendations because people won’t want to go back,” Nuzzo said, likening the use of constant restrictions to a building with no fire that has a fire alarm going off all day. People will ignore the alarm, she stressed, thus, there is some value in giving people a break and then bringing back masks and other measures, if necessary.
Ultimately, she said, COVID-19 will not be the last pandemic the globe will face.
“We need to build and maintain your social habits, so that we can continue to get people to act,” Nuzzo said. “People are weary, and will they be ready to go through something again? Or will they just say, ‘Forget it. I’m done’? I think that we need to kind of replenish the trust.”
(ATLANTA) — The Centers for Disease Control and Prevention was expected as early as next week to loosen its guidance on indoor masking as COVID cases and hospitalizations continue to drop and the White House considers a new nationwide strategy to move past the pandemic.
In a press briefing Wednesday, CDC Director Rochelle Walensky said the agency was looking at new metrics for relaxing pandemic guidance, including masks, and would deliver that updated guidance “soon.”
The idea would be that local communities could relax COVID restrictions, such as indoor masking, based on such factors as ICU bed capacity. While Walensky hasn’t offered specifics on what the benchmarks might entail, she has said hospitalization levels are a key barometer.
“We want to give people a break from things like mask wearing when these metrics are better, and then have the ability to reach for them again should things worsen,” Walensky told reporters.
The upcoming guidance comes as an increasing number of Democratic governors have already announced plans to lift mask mandates at the end of February or in March. Those decisions have largely been seen as a political calculation, driven by pandemic fatigue among voters.
The CDC has urged states to continue to recommend masks so long as the case number remain high, even as it considers new benchmarks. NBC News first reported on the timing of the expected guidance as early as next week.
“Omicron cases are declining, and we are all cautiously optimistic about the trajectory we are on,” Walensky said Wednesday. “Things are moving in the right direction that we want to remain vigilant to do all we can so that this trajectory continues.”
The White House denied any political involvement in the timing of the CDC’s upcoming announcement. President Joe Biden is set to deliver his State of the Union address on March 1 in which he’s expected to lay out his own detailed plan to move the nation forward.
When ABC News asked at the press briefing if the Biden administration had pressed the public health agency for new guidance by the end of the month — ahead of Biden’s speech — a White House official insisted the CDC had not been given a timetable.
Jeff Zients, Biden’s chief COVID coordinator, said: “CDC is clearly in the lead here on the substance and the timing of masking guidance.”
(INDIO, Calif.) — Coachella is dropping all COVID-19 restrictions ahead of this year’s festival.
“In accordance with local guidelines, there will be no vaccination, testing or masking requirements at Coachella 2022,” a statement on the Coachella website reads.
The update comes after organizers announced last October that Coachella 2022 would require attendees to show either proof of vaccination or a negative test. That was amended from the initial policy announced by Coachella organizer Goldenvoice and its parent company, AEG Presents, which required full vaccination for admittance.
While no COVID-19 protocols will be enforced at Coachella ’22, its website notes that the policy is subject to change, depending on “applicable public health conditions.”
Additionally, the site now includes a “COVID-19 warning,” which cautions that the virus is an “extremely contagious disease that can lead to severe illness and death.”
“There is an inherent and elevated risk of exposure to COVID-19 in any public place or place where people are present and there is no guarantee, express or implied, that those attending the festival will not be exposed to COVID-19,” the site reads.
Coachella ’22 takes place April 15-17 and April 22-24, and will be headlined by Billie Eilish, Ye — the artist formerly known as Kanye West — and Harry Styles .
The festival hasn’t been held since 2019 due to the pandemic.
(NEW YORK) — Researchers revealed on Tuesday that an American, described as a middle-aged woman of mixed race, has likely been cured of HIV after undergoing a new transplant procedure using donated umbilical cord blood.
The patient, who needed a stem cell transplant for leukemia, reportedly developed a new HIV-resistant immune system following a breakthrough procedure in which she was genetically matched with umbilical cord stem cells that contained an HIV-resistant mutation.
She was part of a study that began in 2015 designed to monitor outcomes of 25 people with HIV in the U.S. who underwent a transplant, according to the National Institute of Allergy and Infectious Diseases.
Dr. Yvonne Bryson, an infectious disease physician at UCLA, who led the study, discussed their team’s finding along with the patient’s condition at the Conference on Retroviruses and Opportunistic Infections this week.
“Today, we reported the third known case of HIV remission and the first woman following a stem cell transplant and using HIV-resistant cells,” Bryson said in a press conference.
“This case is special for several reasons: First, our participant was a U.S. woman living with HIV of mixed race, who needed a stem cell transplant for treatment of her leukemia. And she would find a more difficult time finding both a genetic match and one with the HIV-resistant mutation to both cure her cancer and potentially her HIV. This is a natural, but rare mutation,” she said.
Bryson added that while this approach of using genetically-matched umbilical cord blood with HIV-resistant mutation opens the door to more diverse populations and studies, she confirmed there is no current routine screening in place in the U.S. for this mutation.
Previously, only two men have been cured of HIV using a bone marrow or stem cell transplant. And while this is the third known case, according to Bryson’s team, of HIV remission in an individual who received a stem cell transplant of any kind, experts in the field caution that this method is not ideal for curing the many millions of HIV-positive people around the globe today.
Bryson said there could eventually be “approximately at least 50 [people] per year that may benefit from this.”
In an interview with Community Health Center, Inc., Dr. Anthony Fauci, the leading expert in infectious disease in the U.S., whose work in HIV care and treatment innovation spans four decades, said, “I don’t want people to think that now this is something that can be applied to the 36 million people [globally] who are living with HIV.”
“This person had an underlying disease that required a stem cell transplant. … It is not practical to think that this is something that’s going to be widely available,” Fauci added. “It’s more of a proof of concept.”
While there is no practical and applicable cure for HIV on a large scale, there have been incredible strides in HIV treatment over the years that allow individuals to live a normal and healthy life.
Known as U=U, or Undetectable=Untransmittable, if an HIV-positive person begins HIV treatment and brings the virus in their body to an undetectable level, the individual cannot transmit the virus to someone as long as they remain on said treatment or medication.
Last month, the U.S. Food and Drug Administration approved the first long-acting injectable drug for HIV prevention.
Until recently, the only medications licensed and approved by the FDA for HIV prevention or pre-exposure prophylaxis, most commonly known as PrEP, were daily pills, which slow the progression of an HIV infection in the body.
PrEP is usually taken daily so that it builds up in in a person’s system, to the point that if there is an HIV infection, it prevents the virus from replicating and spreading throughout the body.
When taken as prescribed, PrEP services reduce the risk of getting HIV from sex by about 99%, according to new data from the Centers for Disease Control and Prevention. Now, individuals who feel at-risk of HIV infection have the option of taking the daily pill, or the new shot every two months, after two initiation injections administered one month apart.
On the vaccine front, Moderna recently announced that it’s launched early stage clinical trials of an HIV mRNA vaccine. ABC News previously reported that the biotechnology company teamed up with the nonprofit International AIDS Vaccine Initiative to develop the shot, which uses the same technology as Moderna’s successful COVID-19 vaccine.
Because bone marrow transplantation is a dangerous and risky procedure, it is considered unethical to perform on people with HIV, unless the person also has cancer and needs a transplant as part of their treatment.
