Health

(WASHINGTON) — The drug overdose epidemic in the United States, now primarily driven by synthetic opioids like ultra-deadly fentanyl, costs the nation roughly $1 trillion a year, according to a new bipartisan congressional report released Tuesday.

“Whether measured in lives or in dollars, the United States’ drug overdose epidemic should shock everyone,” the report reads. “It is unacceptable.”

The report provides a unique level of comprehensive review into the opioid crisis, with particular emphasis on the need to improve mental health services and expand health care access for those suffering from addiction.

A White House Council of Economic Advisers assessment pegged the cost of the opioid crisis at $700 billion three years ago.

The new report derives the new $1 trillion estimate based on the increase in overdose deaths seen since 2018.

Drug overdose deaths have more than doubled in recent years, from about 44,000 in 2013, to more than 100,000 between May 2020 and April 2021. Overdose incidents are responsible for more deaths in the U.S. each year than firearms, suicide, homicide or car crashes, according to the report.

When it comes to understanding the demand for synthetic opioids, the report’s authors wrote: “Authorities are largely flying blind.”

“The United States does not have the data infrastructure to adequately measure the amount of illegally manufactured synthetic opioids consumed in the United States or the number of people who use them,” the report reads.

Tracking fentanyl is difficult, especially when it comes mixed with other substances, including counterfeit pills, which users might not know are fake.

A series of target raids done across the U.S. last year as part of a new crackdown on counterfeit prescription medication resulted in the seizure of 1.8 million fake pills, and authorities saw increases in the number that contained fentanyl, according to the Drug Enforcement Administration. The number of fentanyl-laced pills seized during the enforcement push at the time was enough to kill 700,000 people.

“The United States has never experienced such a rapid and unprecedented shift in illegal drug markets, especially a shift that is causing so much death,” the report reads.

Rep. David Trone, D-Md., and Sen. Tom Cotton, R-Ark., chair the bipartisan commission that produced the over 500-page report.

Combating the opioid crisis is personal for Trone, as his 24-year-old nephew died from a fentanyl overdose in 2016. That family tragedy has fueled his continued work on the issue.

“We’ve got to put names behind these statistics, because we’re numbed,” Trone said. “We just hear these big numbers.”

Transnational criminal organizations rely on raw materials sourced from China and trafficking routes through Mexico to maintain an expansive supply chain which has funneled fake versions of Oxycontin, Vicodin and Xanax, or stimulants like Adderall.

“The cartels are entrepreneurs and are phenomenally powerful with $100 billion-plus business and they have really shaped their drug to fit the American market,” Trone said.

A significantly greater level of potency, about 50 times that of heroin, combined with being relatively easy to manufacture, makes fentanyl an attractive product for drug traffickers.

Counterfeit versions of real prescription drugs also create challenges in identifying the scope of the demand and marshaling resources for treatment, according to the congressional report.

“It’s incomprehensible that our government’s reaction has been so inadequate,” Trone said.

The report recommends elevating the head of the White House Office of National Drug Control Policy to a cabinet level position and empowering the office to analyze trends and respond to threats more quickly.

This week, the DEA announced the launch of a new enforcement initiative aimed at dismantling illicit drug trafficking networks in communities across the country. A majority of the networks already identified by the DEA are known for distributing fentanyl or methamphetamines.

“DEA will bring all it has to bear to make our communities safer and healthier, and to reverse the devastating trends of drug-related violence and overdoses plaguing our Nation,” the agency’s chief administrator, Anne Milgram, said Monday.

But the new congressional report is clear to emphasize the need for a public health solution as well. Methadone and buprenorphine, two treatment medications designed to reduce opioid cravings and withdrawal symptoms, are identified as two of the most effective intervention methods.

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(NEW YORK) — Several states across the country are considering lifting mask mandates in schools in an attempt to return to some semblance of normalcy.

New Jersey Gov. Phil Murphy and Delaware Gov. John Carney announced Monday that mask mandates in schools will come to an end in March. Illinois school districts will be deciding whether or not to make masks optional after a judge ruled against the state’s mandate.

Additionally, Virginia Gov. Glenn Youngkin issued an executive order last month allowing parents to choose whether their child will wear a mask in schools, although it was temporarily halted by a judge Friday.

Experts say it is too soon to end mask mandates in schools because vaccination rates are not high enough yet among the school-age population and new cases are still being reported.

“It is not safe at this time for schools to rescind mask mandates [because] even though we do have decent levels of vaccination in the older age groups, as populations get younger, the proportion who are vaccinated gets lower,” Dr. Mercedes Carnethon, vice chair of the department of preventive medicine and a professor of epidemiology and pulmonary and critical care at Northwestern University Feinberg School of Medicine, told ABC News.

Currently, 22.6% of Americans ages 5 to 11 and 56.4% of those ages 12 to 17 are fully vaccinated against COVID-19, according to the Centers for Disease Control and Prevention.

“The proportion of parents who have chosen vaccination for their children is very low and we know that masking works to stop the spread of the coronavirus,” Carnethon said. “Rescinding those mandates where children 5 and up spend their days, I believe we will see rapid spread.”

Proponents of mask mandates say COVID-19 is not an endemic disease yet and lifting mandates will trigger a major rise in cases.

In Wyoming, Laramie County School District 1 — located in the capital of Cheyenne — reported a spike in cases just two weeks after the Board of Trustees voted to end the mask mandate.

First reported by the Wyoming Tribune Eagle, nearly 400 students and 100 staff have tested positive between Jan. 24 and Feb. 4, an ABC analysis of school district data shows.

Similarly, Hopkinton High School in Massachusetts was the first public school in the state to drop masks altogether but reinstituted the mandate after a rise in cases.

Murphy said a drop in COVID-19 infections linked to the omicron variant led him to lift the mask mandate.

“Balancing public health with getting back to some semblance of normalcy is not easy,” Murphy tweeted. “But we can responsibly take this step due to declining COVID numbers and growth in vaccinations.”

Dr. Stanley Weiss, a professor of biostatistics & epidemiology at Rutgers School of Public Health, called it a politically motivated decision.

“Gov. Murphy’s decision is a politically-based one because there is tremendous pressure coming upon everyone to get rid of the pandemic and stop talking about it and stop dealing with it because we’re all tired of this pandemic,” he told ABC News. “It is not scientifically based and I don’t think it is a rational approach based upon what we’re still seeing.”

According to Patch New Jersey, in-school transmission in the state has increased over the past month.

Between Jan. 4 and Jan. 10, there were 11 cases among students and 17 cases among staff. However, between Jan. 25 and Jan. 31, there were 398 cases among students and 57 among staff.

“I have problems with the change in policy,” Weiss said. “Yes, it’s a limited number of cases, but if you look over time, the new outbreaks have been continuing to increase in schools. The number of student cases and staff cases has not declined. It hasn’t gone away.”

In Illinois, some districts have already made mandates optional after a judge ruled school districts statewide cannot require students to wear masks in classrooms.

“If data were driving these decisions, we wouldn’t at all remove mask mandates right now,” said Carnethon. “The school districts in the regions of Illinois that are making this optional appear to be closely aligned with the geopolitical sentiment.”

Carnethon said districts where schools mask mandates are being removed are typically ones with limited testing ability and “limited enthusiasm” for policies such as requiring vaccinations in public spaces.

“These communities continue to be high-district transmission communities. These are the very decisions that are going to prolong the pandemic and lead to far more suffering than we need to have happen,” she said.

Those in favor of ending the mandates in schools say the public health focus needs to shift to learning to live with COVID-19 and more attention should be given to individual choice.

An increase in cases isn’t necessarily a bad thing due to children’s low risk of severe illness, according to some experts. Others, like Dr. Julia Raifman, disagree.

“I think cases are a problem,” Raifman, an assistant professor of health law, policy and management at Boston University School of Public Health who researches state-level policy responses to the pandemic, told ABC News.

She continued, “Cases are a problem because more cases do mean more hospitalizations and deaths. There’s no way around that. More cases mean more missed work and more missed school. More cases mean more people with lingering symptoms. More cases mean more of the unknown health impacts 10 years later.”

Raifman added that school mask mandates should not disappear completely and that one way to keep them in place is to have more outdoor class time for kids because masks are not recommended for outdoors and students and teachers could take a break from wearing face coverings.

She gave the example of Nevada, which has a policy that enacts mask mandates when cases in a county are high.

“If people are really eager for them to end, I recommend that they not end them, that they put in place a data-driven approach that turns on the mask policies when we need them when there are big surges,” Raifman said.

 

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(NEW YORK) — As new cases of COVID-19 decline across the country for the first time in weeks, the debate over face masks for kids is reaching a fever pitch.

New Jersey Gov. Phil Murphy, a Democrat who has imposed some of the strictest pandemic-related mandates in the United States, is expected to announce Monday that the state’s requirements for masks in schools will end the second week of March. The move would follow a decision last month by Pennsylvania Gov. Tom Wolf, also a Democrat, to rescind his state’s mask mandate for schools.

More than one dozen states and Washington, D.C., currently require face masks in schools, while the Democratic governors of New York and Connecticut have said that they are reevaluating school mask mandates set to expire later this month. Other states, like Texas and Virginia, have banned mandates, according to an analysis by Education Week, an education-focused news organization.

In Virginia, where Gov. Glenn Youngkin’s executive order allows families to opt their children out of mask requirements at school, at least seven school districts have filed a lawsuit against the order.

Last week, in Loudoun County, Virginia, where the district’s school board voted last month to keep its mask mandate, 29 students were suspended for not wearing face masks. Three families are currently suing the district’s school board over its enforcement of the mask mandate despite the governor’s order.

The mask debate has also moved to the courtroom in Illinois, where a judge last week ruled against Gov. JB Pritzker’s school mask mandate after parents and teachers from more than 150 districts filed lawsuits, according to WLS-TV, an ABC station in Chicago.

Studies show that masking in school dramatically reduces the risk of COVID-19 transmission. Fewer outbreaks means schools can stay open for in-person learning. But some parents wonder how masking might interfere with in-person learning.

Karla Alsop, a mom of three in Virginia, blames masks for her daughter’s difficulty with reading. Alsop’s daughter attends a public school in Stafford County, where schools continue to follow a mask mandate.

“She’s saying that she can’t read like a second grader and she’s afraid to go to school. I can’t, as a parent, let that go,” Alsop told ABC News. “This is about parents having the rights to make the best decisions for their kids regarding their health, regarding their education.”

So far, studies show that for most children, masking at school has minimal effect on development and learning comprehension.

Research shows kids also look at body language and eyes for social cues, according to Dr. Erica Lee, attending psychologist at Boston Children’s Hospital.

“That’s something we can still see and still be very expressive with, even if you’re wearing a mask,” Lee said of body language cues.

In Florida, where mask mandates in schools were dropped last fall, Kimberly Lasher continues to send her three daughters, ages 11, 9 and 6, to school wearing masks.

“We just chose to wear masks, I think, to help protect those who maybe aren’t taking the same precautions,” said Lasher. “Perhaps if my daughter is wearing a mask, that can prevent them from spreading COVID to another student or even a teacher and, in our opinion, every little bit helps, for sure.”

According to a poll released last August, 69% of people of supported their local school districts requiring teachers, students and administrators to wear masks in schools at the start of the school year. The same poll, released by Axios/IPSOS, found one in three Americans support state laws prohibiting local governments from requiring masks.

Pediatric cases of COVID-19 surged over the holidays amid the omicron variant but dropped for the first time since Thanksgiving, according to a report by the American Academy of Pediatrics and the Children’s Hospital Association.

About 808,000 children tested positive last week, down from a peak of 1,150,000 cases reported the week ending Jan. 20.

The organizations, however, warn that pediatric cases remain “extremely high” and triple the peak level of the delta surge in the summer of 2021.

Though children ages 5 and older are now eligible to be vaccinated against COVID-19, more than 28 million eligible children remain completely unvaccinated, according to federal and census data.

Both the American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC) continue to recommend universal indoor masking at schools for all people ages 2 and older, regardless of vaccination status.

Dr. Elissa Perkins, a mom and a Boston Medical Center emergency room doctor with expertise in infectious diseases, said she believes there needs to be a more nuanced approach when it comes to kids and masks.

Perkins told ABC News she was a “very early proponent” of community-wide masking, but said her philosophy began to change as vaccines became more widely available, including to kids.

Most health experts counter that because even vaccinated kids can still transmit the virus, removing mask mandates could pose risks to younger siblings.

“That, for me, was the start of the inflection point when it became time to think about what are we accomplishing with mandatory masks,” she said. “At the same time, masks went from being what were what were initially a short-term intervention to a long-term intervention.”

Perkins continued, “Masks have become a long-term intervention, and we need to examine what the possible downsides might be if we plan to continue them.”

Researchers at the National Institutes of Health (NIH) have heard parents’ concerns and are now studying the potential downstream effects of prolonged masking for children, according to Dr. James A. Griffin, chief of the NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development.

“We do understand that one of the areas where masks do impair children is in their ability to understand what is being said to them,” said Griffin. “The difference between being able to understand a ‘bill’ and a ‘dill’ with the mask on that ‘d’ and ‘b’ sound can be very hard to distinguish without being able to see the lips, so there are challenges … we do recognize.”

Rachel Simmons, a parenting expert and the author of of the bestselling book Odd Girl Out, said if parents are concerned about their child’s struggles due to mask-wearing, they can help their kids cope by creating a plan.

“When our kids have a plan for who they can go see, what they can do when they get stressed out, research tells us they will have the tools to deal with the situation when it comes up,” said Simmons, who also recommends teaching kids mindfulness exercises, like feeling their feet on the ground, and supplying them with something calming, like a fidget toy, note or mint, to use during the day.

For parents who are struggling with how to respond to their child’s school if they don’t agree with the mask policy, Simmons said the best approach is to be a “partner” to the school.

“If you’re difficult to deal with as a parent, it will be harder to get heard,” she said. “So don’t send emails late at night. Be a partner to the school. Show your kids that you can respect someone even when you disagree.”

Simmons added, “And remember, your best way to be heard is if you have other parents standing with you.”

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(NEW YORK) — Groundbreaking research by several top American medical centers has identified a COVID pandemic spike in cases of so-called “broken heart syndrome,” a potentially deadly stress-induced heart condition that doctors say is disproportionately impacting women.

“My heart felt like it was pounding out of my chest,” said Mary Kay Abramson, 63, of Brookeville, Maryland, who was diagnosed with the condition last year. “It just felt like the blood just couldn’t get through the heart fast enough.”

An otherwise healthy and active corporate travel agent, Abramson said the episode occurred without symptoms or warning signs and even surprised the doctors trying to diagnose it.

“[My cardiologist] comes up to my head and says, ‘have you been under a lot of stress, because your arteries look fine?'” Abramson said of the hospital bed conversation last year. “So, yeah, a little bit: I’ve been furloughed for three months. COVID is going on. You know, can’t get out and do things. We’re shut down. So, yeah, I have been under a lot of stress!”

It was a classic case of Takotsubo cardiomyopathy, or broken heart syndrome, her doctors say. The rare but dangerous form of heart disease is triggered by intense emotional or physical stress when a sudden flood of hormones is believed to stun the heart into pumping less efficiently.

Teams of experts at Cedars-Sinai in Los Angeles, Cleveland Clinic and Johns Hopkins have each been tracking a recent surge in cases, likely spiking substantially during the pandemic, they say. The data is still being gathered and long-term implications examined.

“I don’t know how much we can really blame COVID, or how much of this is that we’re just recognizing more of it,” said Dr. Noel Bairey Merz, director of the Barbra Streisand Heart Center at Cedars-Sinai. “But heart disease is the leading killer of women and all ages, including teenagers, midlife women and older women. This is just a component of that major killer. So it’s really something that needs to be addressed.”

Bairey Merz says cases of broken heart syndrome have risen up to 10 times faster among middle-aged and older women than among younger women and men over the last decade. The disease is most common in this group as well.

Thirty-four-year-old tech recruiter Jenna Pilja of Huntington Beach, California, thought she was mentally prepared to give birth to her first child during COVID but was suddenly overcome last year after an emergency Cesarean section, potentially triggering a broken heart episode.

“Hearing that my son might not have been OK, that certainly could have triggered me, maybe more because of past trauma,” Pilja said. “Despite being on pain medication, I was able to feel some concerning symptoms. I had really bad dizziness and I had the worst headache I’ve ever had in my life.”

Her doctor later diagnosed the episode as a probable case of Takotsubo cardiomyopathy. Pilja is still undergoing evaluation but is expected to make a full recovery.

“As cardiologists we always think the heart is the most important organ. It’s the brain and the brain controls everything,” said Bairey Merz.

The brain-heart connection is at the center of Dr. Bairey Merz’s research at the Cedars-Sinai Smidt Heart Institute. ABC News got an exclusive look inside the hospital’s high-tech simulation center where imaging data illustrates how stress can literally break a heart.

“You hear people say, ‘oh, she’s broken-hearted’ or somebody is broken-hearted because they had a breakup… but they may come in with this and it’s a real diagnosis. It was just, like, unbelievable to me,” said Zearlisha Kinchelow, 35, a single mom and nursing student in Kansas City, Missouri, who was diagnosed with a broken heart.

“They just told me I was at 10% heart function,” she said. Her heart function has since returned to normal with therapy and changes to her diet and exercise, she said.

For Elaine Kamil, 75, a pediatric nephrology specialist in Los Angeles, immense grief after the unexpected death of her 31-year-old-son physically took a toll on her heart.

“The pain was severe. I got lucky,” said Kamil, who believes she has had multiple episodes of broken heart syndrome in the past few years. “I think it’s important to make sure that whoever you’re seeing — cardiologists understand Takotsubo [cardiomyopathy] and what the best treatments there are.”

While many hearts heal quickly, Bairey Merz says one in five people who suffers a broken heart will have another attack within 10 years.

“Taking care of yourself is definitely more than, you know, just taking care of your body,’ said Pilja. “It’s really about looking after your mental health and your overall well-being and making sure that you’re taking time to engage in activities that help relax you and help you process your emotions in a useful way.”

Growing evidence suggests doing so is one key to maintaining a healthy heart.

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(NEW YORK) — During the Summer Olympics in Tokyo last year, star gymnast Simone Biles shined a light on the mental health struggles many Olympians face when she decided to withdraw from competition.

Now, the United States’ best figure skaters, skiers and snowboarders will be vying for gold medals as they also deal with the strain of a global pandemic for the second year in a row.

“The Olympics present particularly unique challenges for elite athletes,” Dr. Joshua Norman, a sports psychiatrist at The Ohio State University Wexner Medical Center, told ABC News. “Many of them train their entire life for this one moment and a lot of them are removed from their support systems.”

He continued: “With the isolated experience of being at Olympic Village, with having such intense focus on competition … and particularly in today’s climate with COVID-19 with the athletes being tested multiple times a day and then they’re further isolated out of fear of getting COVID-19, it’s a very unique experience that can place significant physical and mental strain on the elite athletes.”

For the Winter Olympics in Beijing, Team USA has made it a priority to address and protect the mental health of its more than 200 athletes.

What Team USA plans to do

Athletes will have access to therapists and psychiatrists throughout the Olympic Village and venues, ability to attend individual or group therapy sessions and a crisis hotline they can call, Dr. Jessica Bartley, the U.S. Olympic & Paralympic Committee’s director of mental health services, said during a media summit in October 2021.

She said that most of the athletes underwent several mental health screenings.

“The majority of our winter athletes, we actually did some mental health screens around anxiety, depression, eating disorders, sleep, alcohol and drug use over the summer,” Bartley said. “And then we’re going to repeat that. And just trying to keep tabs on them a little bit too.”

Team USA has also compiled a list of counselors whom athletes can contact and will allow free access to wellness apps.

In addition to the pressure of competing, Olympians will have several strict rules in place during the Games including staying within the closed loop system that doesn’t allow outsiders, daily screening and testing, mask-wearing with few exceptions and avoiding hugs or handshakes, according to the Olympics playbook.

Norman said the athletes do what they can to be physically and mentally prepared, but that some of the stringent measures may be hard to handle.

“Certainly, once arriving there and that being such a strange experience — particularly for those who it’s their first time participating in the Olympics — it can be somewhat of an overwhelming experience at times,” he said.

Athletes putting their mental health first

Dr. Leela Magavi, a psychiatrist with several patients who are student and professional athletes, offered some tips for athletes. For example, instead of practicing all day, athletes can take mindfulness walks, write in a journal or spend time talking to family members.

She also recommended that Team USA advocate for athletes expressing their thoughts openly.

“Rather than asking a close-ended question, ‘Are you depressed or anxious?’ ask ‘How are you coping with the anxiety?'” Magavi told ABC News. “When they’re anxious and internalizing those feelings, they don’t sleep as well, they don’t eat as well, they don’t play as well.”

Norman said that it’s important not only for athletes to keep on top of any current treatments, but to have constant communication with their support staff for any new or evolving conditions that may be affecting them.

Biles is not the first athlete to speak out about mental health. Michael Phelps, the most decorated Olympian of all time, has been candid about his struggles with ADHD, depression and even suicidal thoughts.

However, Biles is perhaps the most high-profile athlete to pull out of events to focus on her mental health after she revealed she had “the twisties,” which is when a gymnast loses their sense of where they are in the air.

“​​Whenever I think about Biles’ decision, she really helped people speak up,” Magavi said. “I’ve had people say, ‘I never thought you could even do that. If you were experiencing something like twisties, that could even say that.’ I do think that her decision did bridge the gap between mental and physical health.”

And it seems like some professional athletes have followed suit.

Prior to the NHL announcing that no hockey players would be traveling to the Olympics due to Beijing’s strict COVID measures, Las Vegas Golden Knights goalie Robin Lehner said he would not be playing for the Swedish national team, citing mental health struggles.

Lehner, who has been open about his bipolar disorder diagnosis, said that after consulting with his doctors, he had made the difficult decision to stay in the U.S. instead.

“Reality is that what [has] been said about how it’s going to be is not ideal for my mental health,” he tweeted Dec. 6. “Took long time to make [a] decision with my psychiatrist and family. My well-being [has to] come first and being locked down and not knowing what happens if you test positive is [too] much of a risk for me.”

The experts commended Lehner for his decision and called it “courageous.”

“It takes an enormous amount of confidence to speak up,” she said. “Athletes are accustomed to internalizing their feelings. When athletes are unable to sleep, eat or function, it’s often tied to a poor sports performance.”

How athletes speaking up removes the stigma

Magavi said that she hopes more athletes speaking out about mental health removes some of the pressure they face.

“Athletes are human beings like you and I,” she said. “Athletes have all kinds of insecurities. They want to win the gold as much as we want them to win it for us. But they also have the right to determine whether they want to play.”

“They are more attenuated with their bodies, their emotions and, if they’re feeling the time is not right, it’s their decision,” she added.

Norman said that athletes speaking up could also remove the stigma around mental health for everyday Americans and help them realize how common mental health conditions are.

“You’re not alone. Folks who are extremely high achieving like Simone Biles, Michael Phelps, a lot of elite athletes, also struggle with mental health conditions,” he said. “I think having folks like that with those types of platforms speaking out, it really helps not only other athletes but folks within the general population that may look up to these athletes. It may help them seek treatment.”

The psychiatrists added that giving Olympians a chance to address their mental health concerns will lead to better performances and, in turn, lead to more medals for the U.S.

“If we come back with healthy, safe players, we may also bring back the gold,” Magavi said. “It’s a win-win situation.”

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(ATLANTA) — The Centers for Disease Control and Prevention launched a new dashboard Friday that tracks COVID-19 in wastewater samples across the country.

The data comes from the federal agency’s National Wastewater Surveillance System, which connects more than 400 sites across 28 states and the District of Columbia.

More than 34,000 samples have been collected representing 53 million Americans, Dr. Ann Kirby, program lead for the CDC’s National Wastewater Surveillance System, said during a media briefing.

Over the last 15 days, the dashboard shows that 98% of treatment facilities have detected the virus in all of their samples.

However, 70% of all facilities say the amount of virus found in samples has decreased compared to two weeks ago — a sign that COVID-19 cases are on the decline.

Between 40% and 80% of COVID-19 patients shed genetic material from the virus, or viral RNA, in their feces.

When stool is flushed down the toilet, it flows through a drainage system into a treatment facility, where it becomes part of wastewater.

The same tests that are used to determine if someone is positive — what are known as PCR tests — can also detect the virus in wastewater samples.

During the media briefing, Kirby said wastewater surveillance provides public health officials with “a better understanding of COVID-19 trends in communities.”

Because people shed the virus when they are in the early stages of infection, increases in levels of viral RNA in wastewater are often seen before the number of cases rise.

This makes wastewater an early warning system of sorts and helps predict where COVID-19 outbreaks are going to occur.

“These can inform important public health decisions such as where to allocate mobile testing and vaccination sites,” Kirby said. “Public health agencies have also used wastewater data to forecast changes in hospital utilization, providing additional time to mobilize resources in preparation for increasing cases.”

Dr. John Brownstein, an epidemiologist at Boston Children’s Hospital and an ABC News contributor, said wastewater samples helped predict the omicron wave before it even hit.

“Well ahead of when we knew this omicron wave was creating this massive increase in cases, we saw the signal in the wastewater, and the sort of scale of amount of virus that was detected in wastewater was far greater than any other point in the pandemic,” said Brownstein, who is a member on the board of advisors of wastewater analytics company Biobot.

This is not the first time that wastewater surveillance has been used to track public health concerns.

Several countries overseas have used the tool to monitor polio outbreaks. In many European cities, public health officials have used wastewater surveillance to track opioid use.

Brownstein said wastewater has even been used to track the flu and can continue to be useful when COVID becomes a more seasonal, endemic disease.

“It can be absolutely used to look at early signals of any viral disease,” he said. “I think wastewater can be part of the public health fabric for just general surveillance. While COVID may become more sort of an endemic, seasonal virus, having a window into when we may see surges — especially with new variants — will be super critical.”

However, wastewater surveillance has some limitations. About one-fifth of U.S. households are not connected to a public sewer and use septic systems instead, according to the Environmental Protection Agency.

This means wastewater testing would not be able to detect viral spread in 20% of American homes.

Additionally, Kirby said the testing cannot determine if a community is free from infection, so it’s best if it’s used in conjunction with other tools such as case-based surveillance.

But, if Americans do start to see rates of viral RNA in wastewater increase, they can implement the same measures they would use if cases were rising, just earlier.

“You want to take all the same actions: masking, distancing, getting vaccinated if you’re not, testing if you’re feeling sick,” Kirby said. “But with wastewater, you can start doing those a few days earlier and those extra days can really make a difference in the ultimate trajectory of that surge in your community.”

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(BEIJING) — For the 2022 Winter Olympics in Beijing, officials have established a series of rules to prevent the spread of COVID-19.

This will mark the second Olympics since the pandemic began, which will be held between Feb. 3 and Feb. 20. The Paralympic Games will follow from March 4 to March 13.

China has enforced strict measures to limit the spread of the virus within its borders and there will be no loosening of these restrictions when it comes to the Olympics.

This means no spectators aside from a few local fans, a closed loop system, a rigorous testing program and stringent measures for those who test positive.

ABC News took a closer look at some of the rules that have been established for the Games.

Vaccinate or undergo quarantine

According to the Olympics playbook, all participants must be fully vaccinated at least 14 days before arriving in Beijing to avoid quarantine.

Only certain exceptions will be made if an athlete has a history of allergic reaction to a component of the vaccine or is using any immunosuppression medication.

Games officials also recommend that all participants receive a booster before traveling to China.

Anyone who is not vaccinated has to quarantine in Beijing for 21 days before being allowed in the closed loop system.

Regardless of vaccination status, all athletes and personnel must take two PCR tests at least 24 hours apart within 96 hours of their flight to China.

Closed loop system

Similar to Tokyo, Beijing has implemented a closed loop system in which athletes, coaches and their staff will undergo daily screening and testing.

Additionally, buses and trains designated for the Games will specifically move participants to the opening and closing ceremonies, training venues, competition venues, victory ceremonies and the Olympic Village, where most of the athletes are staying.

“This is to ensure there is no contact with the general public or anyone outside of the closed loop,” according to the playbook.

Minimizing physical interaction

The playbook also offers guidance for how athletes can minimize contact with each other while in the closed loop system.

Officials recommend athletes avoid hugs and handshakes and stay away from enclosed spaces or large crowds.

Individuals are also required to keep 2 meters (6 feet) from athletes, and athletes must keep 1 meter (3 feet) from each other.

Mask-wearing will be enforced at all times except “when training, competing, eating, drinking, sleeping, when alone, or during interviews, stand-ups and live presentations,” the playbook states.

Criteria for testing positive

Games officials said they are expecting more COVID-19 cases to emerge.

During a press conference last month, Dr. Brian McCloskey, chair of the Olympics medical expert panel, said the goal is “zero spread” not “zero cases.”

Because of this, Beijing has adjusted its rules regarding the threshold for when someone is considered to be positive with a figure known as the cycle threshold (CT) value.

After a sample is collected, it is isolated and undergoes multiple amplification cycles in an effort to detect viral RNA, or genetic material.

The CT value is the number of cycles needed before RNA is found, at which point the machine stops working. The higher the number, the less infectious a person is considered.

Previously, participants had to meet a CT value of 40 to be considered positive for COVID-19. Now they will have to meet a standard of 35.

What happens when participants test positive?

Any athletes who test positive will immediately be removed from the Games and the Olympic Village.

Symptomatic participants will be taken to a designated hospital while those who are asymptomatic will be in an isolation facility.

Sick individuals will not be allowed back into the closed loop system until all symptoms clear and they test negative twice in a row with two tests taken 24 hours apart.

Few spectators

There will be very few spectators in the stands to watch the athletes compete in the Games.

No fans from other countries are allowed to attend and only spectators who are selected will be allowed to watch the events in person.

“In order to ensure the safety of all participants and spectators, it has been decided that tickets should not be sold anymore but be part of an adapted program that will invite groups of spectators to be present on site during the Games,” according to an announcement released on Jan. 17.

Leaving China

All athletes and personnel will be transported to Beijing Capital International Airport using transportation services designated specifically for the Games.

Close contacts of anyone who has tested positive will be able to leave China as long as they test negative within the last 24 hours.

No more than 24 hours before leaving China, travelers will be required to fill out the online Customs Health Declaration form to show to airport officials and/or gate agents before boarding flights.

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(NEW YORK) — For Christmas two years ago, Jessica Harvey Galloway was gifted a home DNA test kit by her parents, mom Jeanine Harvey and her dad, John Harvey, who goes by Mike.

They never expected that the test they used from Ancestry.com would indicate that Jessica was not at all related to Mike, who is of Italian descent.

“We got the results and logged on. There’s Irish, English, German, Welsh, French all these things. And there’s no Italian Sicilian. I mean nothing,” Jessica recalled on “Good Morning America.”

Nearly 30 years ago, the Harveys turned to Dr. Nicholas J. Spirtos, a doctor at Summa Health System’s Akron Campus in Ohio to help them on their journey to becoming parents. With the help of IVF, the couple conceived a daughter.

But according to the family, the DNA test showed Jessica’s biological father was someone else entirely — a complete stranger to the family.

“It revealed a trauma that I never could have imagined. It’s taken every ounce of my power to remain strong for myself and my family as we try to move forward,” Jeanine Harvey told “GMA.”

“Learning that your entire reality isn’t what you believed it to be is hard to explain,” Mike Harvey added. “It’s like waking up in someone else’s life.”

Now, the Harveys are suing Summa Health and Dr. Spirtos, alleging they were the victims of medical malpractice, negligence and a breach of contract, among other claims, according to a copy of the lawsuit obtained by “GMA.”

The Harveys are being represented by Peiffer Wolf Carr Kane Conway & Wise, LLP of Cleveland. One of their lawyers, Adam Wolf, told “GMA,” “You can’t go back in time and change things. All we can do at this point is demand accountability and demand regulation and oversight so that we don’t have more people in the Harvey situation.”

“We are aware of an allegation that has been made claiming in 1991 a patient was artificially inseminated with the semen from a person who is not her husband,” Summa Health said in a statement to “GMA.” “We take this allegation seriously and understand the impact this has on the family. At this point, we have not met with the family or conducted testing of our own. Given the very limited information that we have and the amount of time that has passed, it remains our hope that the attorneys representing the family will work with us to make that next step a priority.”

As for Jessica, who said she has always been passionate about her genealogy and father’s Italian heritage, she hopes to move past the shocking news.

“My priority going forward is focusing on my family, regardless of DNA or blood,” she said.

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(ATLANTA) — Gay and lesbian adults are more likely to have been vaccinated against COVID-19 than heterosexual adults, federal officials said Thursday.

A new study from the Centers for Disease Control and Prevention found 85.4% of gay and lesbian Americans above age 18 had received at least one vaccine dose as of October 2021.

By comparison, 76.3% of heterosexuals reported receiving at least an initial dose by the same date.

Additionally, gay and lesbian adults were more likely to be concerned about COVID-19 and to believe in the safety and efficacy of vaccines.

“We know that the prevalence of certain health conditions associated with severe COVID-19 illness, such as cancer, smoking, and obesity, are higher in LGBT populations, and access to health care continues to be an issue for some people in the LGBT community,” Dr. A.D. McNaghten, a member of the CDC’s COVID-19 Emergency Response Team and corresponding author of the study, told ABC News. “We wanted to see if vaccination coverage among LGBT persons was the same as non-LGBT persons.”

For the survey, CDC researchers collected data from the National Immunization Survey Adult COVID Module between Aug. 29, 2021 and Oct. 30, 2021.

The data also showed that bisexual and transgender adults had similar vaccination rates to heterosexual adults with 72.6% of bisexual adults fully vaccinated by the end of October, as were 71.4% of transgender adults.

When it came to race/ethnicity, gay white men and lesbian white women had higher rates of vaccination at 94.1% and 88.5%, respectively, receiving at least one dose compared to heterosexual white men and women at 74.2% and 78.6%, respectively.

Hispanic gay men also had higher COVID vaccination rates at 82.9% compared to 72% of Hispanic heterosexual men.

However, Black and Hispanic lesbian women had lower rates of vaccination at 57.9% and 72.6%, respectively, compared to Black and Hispanic heterosexual women at 75.6% and 80.5%, respectively.

McNaghten said the disparity between the percentage of white gay men with at least one vaccine dose and Black lesbian women with at least one dose is “alarming.”

The survey also found that gay, lesbian and bisexual adults were more likely to believe in the safety and protection of vaccines than heterosexual adults.

A total of 76.3% of gay and lesbian adults said they were “completely” or “very” confident in the safety of COVID vaccines, as did 70.4% of bisexual adults. Comparatively, only 63.9% of heterosexual adults said they felt the same way.

Additionally, 90.8% of gay and lesbian adults and 86.8% of bisexual adults said COVID vaccines are “very” or “somewhat” important to protect themselves compared to 80.4% of heterosexual adults.

Transgender and nonbinary adults, on the other hand, were confident about vaccine protection but not safety, with 83.2% saying they believed vaccines were necessary to protect against COVID, but only 62.8% saying they believed the shots are safe.

The researchers found 56.8% of gay and lesbian adults and 51.3% of bisexual adults were “very” or “moderately” concerned about COVID compared to 48.1% of heterosexual adults.

The authors note there are limitations of the study including that participants self-reported their vaccination status and potentially selected a sexual orientation category they didn’t identify with because they didn’t see an option that fit them.

But McNaghten says it is vital to make sure the LGBT population is vaccinated. She added that further studies are needed to figure out why there are differences by gender and race/ethnicity among gay and lesbian men and women.

“Additional research could help determine if these differences are associated with socioeconomic or health care access issues, and if there are factors influencing vaccine uptake or vaccine hesitancy within specific groups,” she said.

In the study, the authors said it is important to include sexual orientation and gender identity when collecting data on vaccination status to help eliminate disparities.

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(NEW YORK) — Millions of Americans have purchased rapid COVID-19 tests online or at local stores and signed up to receive test kits through a free government program.

Unlike conventional, lab-processed PCR tests, which may detect infection earlier in the course of illness but can take days to get a result, at-home rapid tests can let you know if you are likely contagious in less than 15 minutes. Many specialists see them as a crucial tool in the off-ramp to the pandemic — assuming Americans know how and when to use them.

Public health specialists say rapid tests are good for a range of scenarios, including testing after symptoms and to lower the risk of passing the virus to others, including children not yet eligible for vaccination or those at higher risk for severe illness.

“In the last two months alone, I’ve used home testing for all three of the major indications: experiencing COVID symptoms, after a known COVID exposure and prior to a gathering indoors with higher-risk individuals,” said Dr. Alok Patel, clinical assistant professor of pediatrics at Stanford University.

Test if you have symptoms

“Ultimately, if you’re noticing something has changed and are experiencing unusual symptoms, that’s a good reason to test yourself,” said Dr. Todd Ellerin, director of infectious diseases at South Shore Health in Weymouth, Massachusetts.

Symptoms of COVID-19 include fever, cough, congestion, sore throat, muscle aches, fatigue, headaches, vomiting and diarrhea. Several COVID-19 symptoms overlap with the common cold or the flu and the only way to really know the difference is through testing. So if you have symptoms, stay home and be sure to test.

Test to protect others

Even if you do not have symptoms, testing is helpful after possible or known exposures, before indoor or large gatherings, prior to travel or when seeing high-risk or immunocompromised individuals.

“I use tests before I gather unmasked with friends and family who are at high risk of hospitalization if they develop COVID-19. I am particularly cautious around people receiving cancer treatment and relatives living in assisted-living facilities,” said Dr. Alyssa Bilinski, assistant professor of health policy at Brown School of Public Health.

Some schools with children too young to be eligible for vaccinations require weekly rapid tests Monday mornings before starting the week. Other schools allow vaccinated students to return after a known exposure using rapid tests to make sure they remain negative in a program called “test to stay.”

Test if you’ve been exposed

“If you are asymptomatic but have been within 6 feet of an individual with COVID-like symptoms or a positive test for a combined total of 15 minutes or more during a 24-hour period, you should get tested,” said Dr. Jay Bhatt of Family Christian Health Center near Chicago.

The Centers for Disease Control and Prevention have an online Coronavirus Self-Checker that can help you decide when to test.

Vaccination status should not affect testing decisions or interpretation of results. “With omicron’s higher rates of breakthrough, testing broadly applies to everyone regardless of vaccination status,” said Dr. John Brownstein, epidemiologist at Harvard University.

Taking a test and interpreting results

Make sure your at-home test is authorized by the Food and Drug Administration and follow the manufacturers’ instructions exactly, from storage to sample collection to expiration. So far, FDA-authorized over-the-counter rapid tests use nasal swabs, but do not require you to go very deep into the nose. Some require mixing solution and/or dropping three, four or six drops on a card, but they are all designed for adults who are not health care workers.

Rapid tests are very reliable if they come back positive, but if they record a negative, a confirmation PCR test may be necessary at least 24 hours later. So if you test positive, especially if symptomatic, it is safe to assume you have COVID-19 and should quarantine according to CDC guidelines.

In contrast, negative results can be less accurate and should be interpreted with a tiered approach.

If you are symptomatic but test negative, a false negative is possible. Negative tests should also be interpreted with caution if you’ve had a known COVID contact or possible exposure, like travel.

In this scenario, it is critical to do serial tests at least 24 hours apart. Follow your test’s specific instructions. Rapid test results can change quickly, so a negative test is only trustworthy for eight to 12 hours. If quarantining is not feasible while you serially test, mask and distance as best as possible.

You can consider PCR testing if you need more definitive results, although if you’ve previously had COVID-19, a PCR test can be positive for up to three months afterward.

“If I have symptoms and my rapid test is negative, I will do a PCR. If I am asymptomatic and an initial rapid is negative, I will test for two more days in 24-hour intervals and continue masking and distancing as best as possible. If I have to be with someone who is high-risk or immunocompromised, I would get a PCR test before being around that individual,” said Bhatt.

The Biden administration has purchased 1 billion rapid tests and any household in America can order a set of four tests at no cost through covidtests.gov. Tests are also available at many pharmacies and online stores. Insurance companies are required to reimburse each family member for up to eight OTC rapid tests per month, but consumers must initially lay out $10 to over $30 per test.

“If we’re hoping to test as many people as possible, home testing cannot be cost-prohibitive,” said Dr. Simone Wildes, an infectious diseases specialist at South Shore Health.

While using at-home tests is a new skill we are all learning, the key is to take a thoughtful, stepwise approach based on your risk factors, exposures, symptoms and possibility of transmission.

“Do your due diligence just like you check the weather. Before we go outside, we check to see if we need a raincoat or an umbrella and grab equipment to protect ourselves from exposure,” said Dr. Darien Sutton, an emergency medicine physician and ABC News contributor.

“We should think of this virus in the same way,” he added.

Nitya Rajeshuni, M.D., M.S., a pediatrics resident at the Children’s Hospital of Philadelphia, University of Pennsylvania, is a contributor to the ABC News Medical Unit.

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