Health

(NEW YORK) — The latest COVID-19 variant of concern, omicron, first reported to the World Health Organization from South Africa last week — and now detected throughout the U.S. — continues to worry many Americans with still much unknown about the virus.

Health authorities continue to urge calm as scientists across the globe search for answers.

“Right now, we’re really in a state of knowledge acquisition,” said Dan Barouch, director of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center in Massachusetts. “We really need to know more. We need to know how pathogenic it is. We need to know how transmissible it is and we need to know whether or not it evades antibody responses induced by the vaccines.”

Experts caution that answers to those questions may not come for months.

“What’s going to happen is our band of confidence is going to narrow over time as opposed to saying in this amount of time we will have an answer. And that’s what we have to recognize,” said John Brownstein, epidemiologist and chief innovation officer at Boston Children’s Hospital. “We just need to have some patience,” Brownstein added.

When will we know about omicron transmission?
Researchers, however, expect to have estimates for transmissibility “probably ahead of some of the other questions that we have,” said Brownstein.

In a press conference Wednesday, WHO COVID technical lead, Dr. Maria Van Kerkhove, said there is some suggestion omicron may be more transmissible but it’s too early to say definitively. “We expect to have more information on transmission within days, not necessarily weeks,” Van Kerkhove said.

“Based on the data collected through surveillance, we have a rough estimation of the proportion of infections that relate to omicron where you can start to make basic estimates of transmissibility very quickly,” said Brownstein.

During the White House COVID-19 briefing on Friday, Dr. Anthony Fauci, the White House’s chief medical adviser, said as more omicron cases are detected, the Centers for Disease Control and Prevention would be able to model how the new variant will spread, similar to how quickly CDC predicted the delta variant would spread from the initial 3% to 4% of cases to nearly all cases.

“We really don’t know what’s going to happen, how well it is going to compete or not compete with delta, but we will know as more cases occur and what the doubling time of the relative percentage of omicron versus delta will be,” Fauci said.

When will we know how effective current COVID-19 vaccines are on omicron?
The Food and Drug Administration said in a statement on Tuesday it is working “as quickly as possible” to evaluate the potential impact of omicron on current treatments, vaccines and tests and said it expects to have answers in the next few weeks.

If a modification to current vaccines is necessary, vaccine manufacturers say they are prepared to make those modifications quickly.

In a statement on Sunday, Pfizer and BioNTech said they have been monitoring the effectiveness of their vaccine against emerging variants and if a “vaccine-escape variant emerges” they expect to be able to make a “tailor-made vaccine against that variant in approximately 100 days, subject to regulatory approval.”

Matt Barrows, Moderna’s senior director of manufacturing told ABC News that the company has the capacity to produce an omicron-specific booster vaccine within a month if it becomes necessary. He said experiments testing the efficacy of their current vaccine against omicron are ongoing and will take at least two to three weeks.

“Although we haven’t proven it yet, there’s every reason to believe that if you get vaccinated and boosted that you would have at least some degree of cross protection, very likely against severe disease, even against the Omicron variant,” said Fauci.

When will we know if omicron causes more serious illness?
Learning if this version of the virus is deadlier could take many months, experts say.

“We don’t even know if omicron will have the ability to overtake delta and we’re dealing with a delta surge right now. There’s a lot of ifs and a lot of open questions,” said Brownstein.

Currently, the delta variant is driving nearly all cases across the U.S., with 99.9% of cases in the country from the delta variant.

Health officials are encouraged by the mild symptoms the omicron cases are experiencing so far. According to health officials, the man who tested positive for omicron in Minnesota is fully vaccinated and had been boosted in early November. The woman identified in Colorado is also reported to be experiencing only mild symptoms and was fully vaccinated, however not boosted.

Early cases identified in South Africa have also reported no severe disease according to local officials. “Right now it does not look like there’s a big signal of a high degree of severity, but it’s too early to tell,” said Fauci, in an interview with CNN.

As of today, there are more than 400 confirmed cases of Omicron in over 30 countries across the globe, including in the US. As scientists work on getting more answers, experts are urging to not wait and get vaccinated or boosted if eligible.

“As it stands now with the information we have, you do the best with the information you have in front of you and that information says that you get an incredible advantage by getting that booster,” said Brownstein.

Barouch said that the only way to stop new variants is to vaccinate people across the globe.

On Friday, the White House announced that it’s shipping out 11 million more vaccines worldwide in an effort to increase vaccination around the world. The U.S. has shipped 291 million doses so far and President Joe Biden announced plans Thursday to provide 200 million more doses worldwide in the next 3 months.

“Currently, sub-Saharan Africa has less than a seven percent vaccination rate. And so it’s not a surprise that new variants are emerging in that part of the world,” Barouch said. “The only way to stop these variants is to have a widespread vaccination campaign that really reaches all four corners of the planet.”

Esra Demirel, M.D., is an OB-GYN resident physician at Northwell Health-North Shore University Hospital & LIJ Medical Center and is a contributor to the ABC News Medical Unit.

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(PENNSYLVANIA) — Omicron has been making headlines as cases of the new COVID-19 variant continue to be detected in the United States. While the strain is concerning, health officials are heeding that delta continues to fuel widespread transmission and is a problem now.

That’s the current case in Pennsylvania, where the number of daily confirmed COVID-19 infections crossed 10,000 Friday for the first time since the state’s winter wave.

In the past week, the number of COVID-19 cases, case rates, hospitalizations and patients on ventilators have all gone up, according to state data. Amid its latest surge, Pennsylvania has one of the highest COVID-19 hospitalization rates in the U.S.

“We continue to see a tremendous amount of COVID-19 patients,” Dr. Eugene Curley, the medical director of infectious disease for WellSpan Health, which has six acute care hospitals in south-central Pennsylvania, told ABC News.

One month ago, there were about 250 COVID-19 patients total being treated across the six hospitals; on Friday, that number was 310, Curley said. The peak, during last year’s winter surge, was around 430, he said.

The University of Pittsburgh Medical Center, which operates over 35 hospitals throughout Pennsylvania, has seen its second-highest number of COVID-19 patients since the pandemic began, hospital officials said. As of Friday morning, there were 779 patients with active COVID-19 infections admitted across all UPMC facilities; the peak, in December 2020, was 1,250, UPMC Chief Medical Officer Dr. Donald Yealy told ABC News.

“Across our system, we’re at about two-thirds to three-quarters of what that peak is,” he said. “So it is very, very brisk.”

The state’s current surge has been building since late summer, Yealy said. It reached a peak in late September before “there was the beginning of a pullback in activity,” Yealy said.

“That pullback no longer exists and we are back on essentially an upward trajectory,” he continued.

It’s hard to predict if Thanksgiving gatherings will have an impact on hospitalizations; holidays are a “wild card,” Curley said. But many people in the state have no protection against COVID-19, Yealy noted, which will help fuel transmission.

Statewide, around 41% of residents have still not gotten fully vaccinated, according to federal data. Within some counties, that percentage is in the 60s, state data shows.

Unvaccinated people continue to represent the vast majority of hospitalized COVID-19 patients, including those who are in intensive care units, state and hospital data shows.

For the 30 days ending Nov. 2, nearly 75% of people hospitalized due to COVID-19 were unvaccinated, according to state data.

Across WellSpan’s six acute-care hospitals, over 90% of COVID-19 patients in the ICU and on ventilators since early September have been unvaccinated, the health system said this week.

“Those numbers just reinforce what we already know — is these vaccinations are safe and effective,” Curley said.

Pennsylvania Gov. Tom Wolf has urged people to get vaccinated if they haven’t already.

“In Pennsylvania and around the country, the vaccine is still our strategy, so get your shot,” the governor said last week on KDKA-AM radio, according to The Associated Press.

A renewed push for vaccination and boosters has come amid the spread of omicron, which has concerned scientists due to its large number of mutations. The variant has been detected in at least 11 states — including Pennsylvania, where the state’s first case was identified Friday in a man from northwest Philadelphia, health officials said.

For Curley, if concerns around the omicron variant encourage people to get vaccinated, that’s a good thing. But he warned that delta “is here now.”

“People need to get vaccinated for that reason,” he said. “If you’re out there and you’re eligible to be vaccinated, get vaccinated now because of delta.”

Rochelle Walensky, director of the Centers for Disease Control and Prevention, echoed that sentiment on Friday in an interview on CNN.

“We now have about 86,000 cases of COVID right now in the United States being diagnosed daily and 99.9% of them, the vast majority of them, continue to be delta,” she said. “And we know what we need to do against delta. And that is get vaccinated. Get boosted if you’re eligible and continue all of those prevention measures, including masking.”

It is too soon to tell if omicron will overtake delta as the predominant variant in the U.S., she said. Though either way, the actions will likely remain the same, experts say.

“The truth of the matter is, both delta, which is the predominant variant now, and omicron are easily transmitted. And so the concerns are really not changed all that much, and the actions that we all need to take remain exactly the same,” Yealy said. “Get vaccinated, wear a mask indoors and in crowds, keep a little distance and if you get sick, don’t go out with others and get tested as quickly as possible.”

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(WASHINGTON) — When the U.S. Supreme Court heard arguments Wednesday over a Mississippi law that would ban most abortions after 15 weeks of pregnancy, a headline-making line of questioning came from the court’s newest justice, Amy Coney Barrett.

Barrett, a conservative justice appointed last year by former President Donald Trump, questioned whether adoption rather than abortion could resolve the “burdens of parenting” noted in Roe v. Wade and Casey v. Planned Parenthood, the two major Supreme Court rulings on abortion that protect a woman’s right to end a pregnancy before fetal viability.

Since Roe v. Wade was decided in 1973, the Supreme Court has never allowed states to prohibit the termination of pregnancies prior to fetal viability outside the womb, roughly 24 weeks, according to medical experts.

During Wednesday’s arguments, Barrett, a mom of seven with two adopted children, questioned Julie Rikelman, a Center for Reproductive Rights attorney arguing against Mississippi’s 15-week ban, about safe haven laws, which protect parents from criminal prosecution if they leave unwanted infants at designated places, like hospitals. All 50 States, the District of Columbia, and Puerto Rico have enacted safe haven legislation, but rules and regulations vary by state, according to the Department of Health and Human Services’ Children’s Bureau.

“Insofar as you and many of your amici focus on the ways in which forced parenting, forced motherhood, would hinder women’s access to the workplace and to equal opportunities, it’s also focused on the consequences of parenting and the obligations of motherhood that flow from pregnancy,” said Barrett. “Why don’t the safe haven laws take care of that problem?”

“It seems to me that the choice more focused would be between, say, the ability to get an abortion at 23 weeks or the state requiring the woman to go 15, 16 weeks more and then terminate parental rights at the conclusion,” she said. “Why — why didn’t you address the safe haven laws and why don’t they matter?”

Rikelman responded by pointing out the unique risks that pregnancy alone carries, saying in court, “We don’t just focus on the burdens of parenting, and neither did Roe and Casey. Instead, pregnancy itself is unique. It imposes unique physical demands and risks on women and, in fact, has impact on all of their lives, on their ability to care for other children, other family members, on their ability to work.”

It is a point echoed by reproductive physicians, who say talking about adoption in place of abortion misses the realities of people’s lives and the dangers of pregnancy.

If the Supreme Court were to uphold the Mississippi ban, as the conservative majority appeared headed toward, legal scholars say it could clear the way for stringent new restrictions on abortion in roughly half the country.

“‘I’m unfortunately not surprised that adoption was brought up so much, because I think people feel that pregnancy is this non-issue medical condition,” said Dr. Leilah Zahedi, a Tennessee-based maternal fetal medicine specialist and fellow with Physicians for Reproductive Health. “It’s very infuriating to be honest, because it shows their ignorance in the fact that pregnancy is not an uncomplicated condition for the majority of the United States.”

“Pregnancy is probably one of the most dangerous things a woman does in her life, bar none,” she said.

The U.S. is also a particularly dangerous place to give birth. It has the highest maternal mortality rate among developed countries, according to a 2020 study from the Commonwealth Fund, a healthcare policy-focused nonprofit organization.

Black women are three to four times more likely to die during childbirth or in the months after than white, Asian or Latina women, while Indigenous women are two to three times more likely, according to the Centers for Disease Control and Prevention.

Physicians like Dr. Nisha Verma, a board-certified OBGYN who provides abortion care, point out that abortion, on the other hand, is “incredibly safe.”

“The risk of childbirth is as high as 10 times higher than the risk of abortion,” said Verma, also a fellow with the American College of Obstetricians and Gynecologists. “That’s a lot of risk to ask someone to take on.”

The American College of Obstetricians and Gynecologists was among 25 medical organizations who together filed an amicus brief in the Dobbs v. Jackson Women’s Health case that is now before the Supreme Court, arguing the Mississippi law is “fundamentally at odds with the provision of safe and essential health care, with scientific evidence, and with medical ethics.”

Providers like Verma also point to statistics showing that restrictions on abortion impact people who are the most vulnerable to complications from pregnancy and childbirth.

Around 75% of abortion patients are low-income residents, and nearly 60% of U.S. women of reproductive age live in states where access to abortion is restricted, according to the Guttmacher Institute, a reproductive rights organization.

In her response to Barrett, Rikelman cited the maternal mortality statistics in Mississippi alone, saying, “It’s 75 times more dangerous to give birth in Mississippi than it is to have a pre-viability abortion, and those risks are disproportionately threatening the lives of women of color.”

In addition to the physical risks people face during pregnancy, there are also other factors to consider, like the lack of safeguards for pregnant people in the U.S., experts say.

The U.S. does not have universal health care and does not provide universal child care. And as the Supreme Court weighs its decision on the Mississippi law, the U.S. remains the only industrialized, modernized country in the world without federally mandated paid family leave, according to data compiled by the Organization for Economic Cooperation and Development.

The House of Representatives last month passed a social spending plan that includes four weeks of paid family leave, eight weeks less than what was in the original spending package proposed this year by President Joe Biden. But that bill faces an uphill battle in the Senate, with Sen Joe Manchin, D-W.Va., a critical vote, opposed to the paid leave provision.

“Abortion is not an isolated political issue,” said Verma, weighing in on Justice Barrett’s specific comments on adoption. “I think the way that adoption was presented as just this easy alternative to abortion completely disregards the real experiences that people are having. It’s a decision that’s happening in the context of people’s lives.”

In the majority of cases when providers talk to pregnant people about the option of abortion, they also provide them with information on the option of adoption, according to Verma. She said, in her experience, a person’s decision on their own pregnancy is not one made lightly, and is not one made without considering all options.

“The decision-making process is different for every person, but it is a decision that people are making carefully and intentionally with all of the information and in the context of their own lives,” she said. “It’s not something that we can impose on people.”

Verma continued: “I see patients all the time making decisions to have an abortion from a place of love and compassion.”

There were over 620,00 legal induced abortions in the U.S. in 2019, the most recent data available, according to the CDC. At the end of the same year, 2019, there were around 122,000 children waiting to be adopted out of the U.S. foster care system, government data shows.

Overall, just over 110,000 adoptions took place in the U.S. in 2014, the most recent data available, according to the National Council for Adoption, a national advocacy organization that promotes adoption.

Ryan Hanlon, acting CEO and president of the National Council for Adoption, said the organization does not have a position on Dobbs v. Jackson Women’s Health.

Speaking specifically on safe haven laws, Hanlon said the goal should be to meet pregnant people and provide them with comprehensive information before they would find themselves in what he described as the “crisis” of leaving a child under the law.

“Safe haven laws can be a really wonderful thing, but by the time we’ve gotten to that point, we’ve already experienced a crisis,” he said. “What I would hope for any woman who’s experiencing an unplanned pregnancy is that she’s getting information and support well before then, and for those women who do choose to place their child for adoption, that they are getting support before, during and after the birth.”

ABC News’ Devin Dwyer contributed to this report.

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(NEW YORK) — As health officials expected, the United States has now confirmed several cases of the omicron variant, which was first identified in Botswana and has since been detected in at least 35 counties.

The World Health Organization declared omicron a variant of concern on Friday. Earlier this week, the agency said the overall global risk is “very high” due to the variant’s large number of mutations, including on the spike protein of the virus, though there are still many unknowns, including information on its transmissibility, severity and impact on immunity.

Here’s what we know so far about the variant in the U.S.

First states to detect cases

The first three cases of the omicron variant identified in the U.S. were detected in fully vaccinated Americans with recent travel histories. All three people experienced mild symptoms, health officials said.

The first case was detected in California in an individual who had returned from South Africa on Nov. 22. The person, who was not yet eligible for a booster dose, sought COVID-19 testing a few days upon returning to San Francisco after developing symptoms, and genomic sequencing testing confirmed the case to be omicron on Wednesday, health officials said. All close contacts have been contacted and have tested negative.

Colorado confirmed a case of the omicron variant Thursday in a woman from Arapahoe County who had recently traveled to southern Africa. State epidemiologists had flagged the testing specimen for genome sequencing due to the recent travel history. The resident was eligible for a booster but had not yet received it, health officials said.

Through its regular surveillance of COVID-19 case specimens, Minnesota detected an omicron case Thursday in a Hennepin County resident who had recently traveled to New York City to attend the Anime NYC 2021 convention from Nov. 19 to 21. The man, who had received a booster dose in early November, developed mild symptoms on Nov. 22 and sought testing on Nov. 24. It seems likely that the transmission occurred at the NYC convention, but that is not certain, health officials said. His symptoms have since resolved. A close contact tested positive for COVID-19, though tests to confirm if that is also omicron have yet to be conducted, health officials said.

Thursday evening, New York Gov. Kathy Hochul announced that at least four cases of the omicron variant had been detected in the state. They included a 67-year-old, fully vaccinated woman in Suffolk County who recently traveled from South Africa, and then three residents in New York City. A fifth case is also suspected to be omicron, Hochul said. All cases are mild.

A second California case was also announced Thursday evening, in a fully vaccinated Los Angeles County resident who had returned from South Africa on Nov. 22, health officials said. The infection “is most likely travel-related,” the Los Angeles County Department of Public Health said.

The detected cases illustrate the need to seek out testing based on travel history and symptoms, as well as the importance of sharing travel history with public health officials, health experts said. The Centers for Disease Control and Prevention currently advises that people who recently traveled internationally should get tested three to five days upon their return regardless of symptoms or vaccination status. NYC officials have also encouraged all attendees of the Anime NYC 2021 convention, estimated to be around 53,000, to get tested immediately and take precautions such as social distancing.

No cause for panic

Health experts have said the presence of the omicron variant in the U.S. is not surprising, and while concerning, it is not a reason to panic.

“At this point, I’m not terribly alarmed,” Colorado Gov. Jared Polis told reporters Thursday during a briefing on the omicron case.

The governor said that if community transmission is occurring in Colorado, it’s very small because no omicron variant has been discovered in wastewater analysis yet. Roughly 15% of all positive COVID-19 tests are sequenced in Colorado.

San Francisco Department of Public Health Director Dr. Grant Colfax told reporters during a briefing yesterday that the case was “not a cause for us to panic” and that the city “is prepared” for this.

Leaders in New York and Minnesota had similar messages.

“We’re ready for it. This is not surprising,” New York Gov. Kathy Hochul said during an on-camera briefing earlier Thursday.

“This news is concerning, but it is not a surprise,” Minnesota Gov. Tim Walz said in a statement. “We know that this virus is highly infectious and moves quickly throughout the world.”

Minnesota Department of Health Commissioner Jan Malcolm echoed that sentiment during a briefing Thursday, saying omicron is something to take seriously but “not a reason to panic.”

“We’re at a stage where there is still a lot we need to learn about omicron,” she said.

Officials in the cities and states where the variant has been detected have said they don’t plan to make any changes to health orders at this time.

Impact on travelers

White House chief medical adviser Dr. Anthony Fauci told reporters Wednesday he doesn’t think a domestic flight policy for testing or vaccination due to omicron is necessary right now but said it’s always something under consideration.

“These kinds of things we always talk about and consider. But right now, I’m not so sure we need testing for air travel in this country,” he said.

There are strengthened requirements for travelers coming to the U.S. amid the spread of the omicron variant. On Thursday, President Joe Biden announced that all passengers must show proof of a negative COVID-19 test within one day of flying into the U.S., regardless of their vaccination status or nationality.

“This tighter testing timetable provides an added degree of protection as scientists continue to study the omicron variant,” he said during a briefing.

Unvaccinated Americans already were required to show proof of a negative test within one day of traveling. The new rule, which goes into effect Monday, expands that one-day requirement to all vaccinated travelers coming into the U.S. from other countries. Unvaccinated nonresidents are currently barred from boarding a flight to the U.S.

Delta still dominant

Amid concerns about the omicron variant, health experts have stressed that delta is still a major issue in the U.S., where close to 100,00 new cases are diagnosed daily. Delta comprises 99.99% of new COVID-19 cases.

“I think omicron is another kind of wake-up call, and we needed another one,” Malcolm, with the Minnesota Department of Health, said. “Even though we might feel like we’re done with the pandemic, it is most certainly not done with us.”

Health officials have urged people to get vaccinated and get boosters and to continue to follow COVID-19 guidelines such as wearing a mask indoors while in public, test if you have symptoms and stay home if you’re sick.

ABC News’ chief medical correspondent, Dr. Jennifer Ashton, told David Muir on Thursday that vaccinations remain the most important tool we have in combatting COVID-19 this winter.

“Some protection is better than none, and while we learn about the many mutations that omicron has … we have to double down on what we know is going to be our best tool in the toolbox, and that is vaccination,” Ashton said.

Regarding boosters, Fauci has urged Americans who are eligible to get the shot now.

“Right now, I would not be waiting,” he said Wednesday. “People say, well, if we’re going to have a booster-specific vaccine, should we wait? If you are eligible, namely six months with a double mRNA dose, or two months with the J&J, get boosted now.”

“We may not need a variant-specific boost,” he added.

ABC News’ Matthew Fuhrman, Cheyenne Haslett and Arielle Mitropoulos contributed to this report.

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(NEW YORK) — As the U.S. Supreme Court continues to weigh whether to leave Texas’s unprecedented six-week abortion ban, SB8, in place, a new law that also restricts abortion access is going into effect in the state.

Starting Thursday, people in Texas will have a narrower window in which they can receive abortion-inducing medication, including the two most commonly used medications, mifepristone and misoprostol.

Senate Bill 4, or SB4, cuts the window in which physicians are allowed to give the medication from 10 weeks of pregnancy to seven weeks.

The new law also prohibits mailing abortion-inducing drugs, a restriction that contrasts with a federal regulation enacted in April by the Biden administration that temporarily allows the medication to be mailed during the COVID-19 pandemic.

Current Texas law already bans providers from administering medication abortion using telemedicine, according to Abigail R.A. Aiken, MD, MPH, PhD, associate professor of public affairs at the University of Texas at Austin and principal investigator with Project SANA, a research project focused on self-managed abortion in the U.S.

“We’ve seen many states be able to open up new models of care where clinic-based providers can now do medication abortion by telemedicine,” said Aiken. “I think Texas is very clear that they don’t want providers here to follow suit and be able to start doing those kinds of new models where you would do a phone consultation with a provider and then have the pills mailed to your house for use at home.”

The bill, signed into law by Gov. Greg Abbott on Sept. 24, also adds new requirements around medication abortions, including an in-person examination by a physician, a mandatory follow-up visit within 14 days and new reporting requirements for providers.

The bill also creates a state jail felony offense for “a person who intentionally, knowingly, or recklessly violates provisions relating to abortion-inducing drugs,” but exempts pregnant people on whom a medication abortion is “attempted, induced or performed,” according to the bill summary.

Though SB4 is being enacted in Texas, medication abortion is now a very common method used for abortions in the first 10 weeks of pregnancy. In 2019, 42% of all abortions in the U.S. were early medical abortions, meaning medications were taken at nine weeks or earlier after conception, according to the Centers for Disease Control and Prevention.

Medication abortions were first approved by the Food and Drug Administration in 2000. FDA guidelines advise that abortion-inducing pills are safe to use up to 70 days, or 10 weeks, after conception, though evidence shows it can be safe even later in pregnancy, according to the American College of Obstetricians and Gynecologists.

In most cases in a medication abortion, mifepristone is taken first to stop the pregnancy from growing. Then, a second pill, misoprostol, is then taken to empty the uterus.

Of the two medications, mifepristone is more restricted by the FDA. Since 2011, the agency has applied a risk evaluation and mitigation strategy to mifepristone, preventing it from being distributed at pharmacies or delivered by mail like other prescription drugs.

It must be ordered, prescribed and dispensed by a health care provider who meets certain qualifications, and may only be distributed in clinics, medical offices, and hospitals by a certified health care provider, according to FDA guidelines.

The FDA’s rules, combined with state restrictions like the one in Texas, have the effect of not only limiting when, where and how people can get abortions, but also potentially misguiding people on the safety of medication abortion, according to Dr. Bhavik Kumar, a staff physician at Planned Parenthood Center for Choice in Houston.

“What’s important to note is that the medication used in medication abortion has been used in this country for 21 years and it is extremely safe,” said Kumar. “We’ve learned a lot since it was first introduced and can use it in different ways that are more patient-centered, more evidence-informed and really optimizes science and medicine so that patients get the care that they need.”

Speaking of the new law now in effect in Texas, he added, “What Senate Bill 4 is doing is inserting itself squarely into my relationship with my patients and telling me how to practice medicine, and it’s not in the best interest of my patients. It’s actually causing more harm to my patients and it’s taking options away from them.”

Abortion rights advocates say SB4 also has the likelihood of signaling to other states that further restrictions on medication abortion can be put in place.

In South Dakota in September — the same month SB4 was signed into law in Texas — Gov. Kristi Noem, a Republican, issued an executive order directing the state’s Department of Health to establish rules requiring that abortion-inducing drugs only be prescribed and dispensed by a state-licensed physician after an in-person examination. Noem said she also plans to pass legislation next year that makes “these and other protocols permanent.”

Across the country, more than 30 states require clinicians who administer medication abortion to be physicians, while 19 states require the clinician providing a medication abortion to be physically present when the medication is administered, according to the Guttmacher Institute.

“I think we have to see this is another continuation of the trajectory of trying to really make abortion a right on paper only in the United States,” said Aiken. “It’s another way of placing barriers in the way of people.”

She continued, speaking of restrictive abortion laws in some states, “I think what it’s doing in reality is creating this really uneven picture where you have some states that are moving in the direction of more and more and more accessible care, but the reality in other states is completely the reverse, so we’re looking at that uneven picture where your access really depends on your zip code.”

Both Aiken and Kumar mentioned the affect laws like SB4 in Texas have on the most vulnerable populations.

Around 75% of abortion patients are low-income residents, and nearly 60% of U.S. women of reproductive age live in states where access to abortion is restricted, according to the Guttmacher Institute, a reproductive rights organization.

“It has been the case in Texas now for decades that we have seen low-income people and communities of color just bear this disproportionate brunt of negative impacts of these laws,” said Aiken. “So this is an equity issue and it’s a justice issue as well as a health care issue.”

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(OKEMOS, Mich.) — Michigan is in the midst of its fourth COVID-19 wave — and there is no end in sight, hospital officials said.

Cases and hospitalizations are rivaling levels seen in earlier parts of the pandemic, when vaccines weren’t widely available. The surge also comes at a time when non-COVID-19-related patients are being admitted, flu cases are emerging and health systems are understaffed, Brian Peters, CEO of the Michigan Health & Hospital Association, told ABC News.

Unvaccinated people continue to make up the majority of those infected with COVID-19, including severe cases of the infection. Roughly around three-quarters of COVID-19 cases, hospitalizations and deaths were in unvaccinated people from Oct. 21 to Nov. 19, according to state data.

Around 45% of the state remains unvaccinated, according to federal data.

“The situation right here in Michigan is as dire as it has ever been since the start of this pandemic,” Peters said.

Michigan reported a nearly 20% positivity rate in the past week, and every county is currently at the state’s highest risk level for transmission.

Michigan is not alone in seeing COVID-19 cases and hospitalizations increase due to the delta variant, especially as colder weather has approached, people have gathered indoors more and pandemic fatigue has long set in. Though the duration of this surge, and the speed with which cases have “skyrocketed” in the past three weeks, is alarming, Dr. Darryl Elmouchi, president of Spectrum Health West Michigan, which operates 14 hospitals, told ABC News.

“If you look at most other states, and all the surges we’ve had, usually you start at a low point and you go up really quickly, and then you come down pretty quickly,” he said. “What happened for us is we went up gradually enough, but we went up high enough, with [positivity rates] in the teens, that when we shot up, we shot up from that baseline.”

“This has far surpassed anything we’ve seen before — both in how long it’s been going on, and now its seemingly never-ending peak,” he added. “We just don’t know when the end will be, and we’re very worried it will have a very long tail.”

Michigan reported its second-highest number of COVID-19 cases and case rates in the past week, according to the state’s latest weekly coronavirus report, released Tuesday. That follows records set in both cases and case rates the previous week. Hospitalized COVID-19 patients also increased 13% during the past week, the report found.

“I felt like probably the surge we had last fall was going to be the worst we’ve ever seen. I never would have guessed that we would be in yet another surge and that it would be the worst surge yet,” Sandra Gilman, a nurse and hospital supervisor for Spectrum Health, told ABC News.

At Spectrum Health West Michigan, unvaccinated COVID-19 patients are generally about nine years younger and only have two comorbidities, as opposed to four, when compared to vaccinated patients, “meaning that they’re younger and healthier when they’re coming in,” Elmouchi said.

“That tells us the importance of being vaccinated,” he said. “And that’s what’s so heartbreaking for our teams, is that they see all these people that are so sick, being on the ventilator and even dying, and they know it’s preventable. It’s heart-wrenching.”

Due to a mix of early nursing retirements, pandemic burnout and a “rising tide of violence” against health care staff, Michigan hospitals are treating the latest surge in COVID-19 patients amid a staffing shortage, according to Peters. There are approximately 875 fewer staffed hospital beds in Michigan than in November 2020, he said.

“That is incredibly concerning, because there’s not a rapid or easy solution to that problem,” Peters said.

Amid the staffing strain, this week, the Department of Defense temporarily deployed nearly four dozen medical personnel, including registered nurses, doctors and respiratory therapists, to two hospital systems in the state.

The help is welcome, though more is needed, Peters said, especially as the pandemic only worsened an existing health care workforce shortage. Among other measures, his organization is advocating for a $650 million special appropriation in the state legislature that would provide payments to health care staff to encourage them to stay in their jobs, as well as offer incentives for training programs to increase the number of workers in the pipeline, he said.

For now, hospital capacity remains a concern throughout the state, where every region, from urban to rural, is a “hotspot,” Peters said.

At Spectrum Health West Michigan, the intensive care units are operating at 147% of their traditional capacity, Elmouchi said.

Statewide, hospitals are operating at almost 85% occupancy, according to state data.

In recent weeks, some hospitals have had to divert patients to other hospitals and delay elective procedures, Peters said.

“That doesn’t necessarily create a quality-of-care problem as much as it can be a convenience problem,” he said. “But what we’re very fearful of, is that if these COVID numbers don’t level off and decline, you’re going to start seeing real access challenges, where literally there’s no more capacity to care for patients, COVID or otherwise, in certain communities.”

“We’re doing everything we possibly can to avoid that outcome, but without the public’s help, that’s our future,” he added.

Health officials are urging residents to get vaccinated and receive booster shots and to mask up indoors in public settings to help alleviate the surge — especially amid concerns and questions around the transmissibility and mutations of the new omicron variant, which was first detected in the U.S. Wednesday in California.

“Ensuring that as many Michiganders as possible are vaccinated remains the best protection we have against COVID-19 — including variants of concern,” Dr. Natasha Bagdasarian, Michigan’s chief medical executive, said in a statement this week.

Peters said he has been encouraged by the continued increase in vaccinations in the state, including among newly eligible pediatric populations, but “those numbers aren’t growing rapidly enough.”

“[Omicron] is yet another reason for the public to get vaccinated now without waiting any longer,” he said. “I fear that there are so many Michiganders, and I’m sure it’s true outside of Michigan as well, but who believe that the pandemic is largely over. And nothing could be further from the truth.”

ABC News’ Arielle Mitropoulos contributed to this report.

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(NEW YORK) — This is the fourth and final episode of ABC News Digital’s four-part series “Green New Future,” which highlights innovators and environmental solutions.

While climate change and poor air quality are global issues concerning all people, 29-year-old Darren Riley has found that the ZIP code people are born into can disproportionately put them in harm’s way.

Riley’s father ended up in a coma in the ICU due to asthma-related illnesses in 2014, Riley told ABC News. It was his father’s words from seven years before that made him realize the connection between a person and where they live.

“I was a product of my environment,” Riley’s father had told him.

Riley, who also developed asthma himself, said he set out to find a way to alleviate systemic issues and allow people from all areas an equal opportunity in quality of life. He is now the CEO and co-founder of JustAir Solutions, a company that creates air quality monitoring networks to provide cities and individuals data on their breathing environment.

“I think air quality is a sliver of all of many injustices that we see in the world that we can really focus on,” Riley told ABC News.

The disproportionate impact of pollution is one example of a host of systemic issues that people of color, lower wealth communities and indigenous populations are facing, advocates say.

These issues are “fueled by environmental racism,” Mustafa Ali, vice president of environmental justice, climate and community revitalization at the National Wildlife Federation, told ABC News.

Through discriminatory practices such as redlining, cities in the U.S. have been divided and designed with toxic industries disproportionately running through areas inhabited by communities of color, according to Ali.

This affects the quality of the air people breathe, which research has found can determine the long-term health of their lungs and subsequently, their life expectancy.

“We have 100,000 people who die prematurely from air pollution in our country,” Ali said.

This issue came to the forefront over 50 years ago when Congress passed the Clean Air Act, which set out to control and reduce air pollution across the nation by keeping track of the quality of air that citizens were inhaling.

The U.S Environmental Protection Agency mandates that cities track their air quality levels using a monitor that tracks dust, metals and other matter that could affect the lungs.

The EPA regulations state there must be a minimum of one monitor per city, but community advocates argue there must be more. Grand Rapids, Michigan, where Riley piloted his project, has just one monitor that reports on the city’s air quality level.

Data from that monitor is used to approximate the air quality level for the entire city and its suburbs, Jim Meeks, the chairman of JustAir, told ABC News.

But Riley was curious about the difference in air quality levels across neighborhoods, which the lone monitor set up by the EPA could not capture. He deployed 11 sensors across Grands Rapids — five in the downtown area, five in the Roosevelt Park neighborhood and one adjacent to the EPA monitor.

When comparing data from his sensors in the metro downtown area of Grand Rapids versus Roosevelt Park, the neighborhood with the highest non-white population, Riley found stark differences in the air quality levels.

The Roosevelt Park sensors recorded far more unhealthy days than the one near the EPA monitor, Riley said.

“There are disparities between sensors within a city,” Riley told ABC News. “And one sensor doesn’t detect that.”

JustAir’s sensors are currently only used in Grand Rapids, but Riley hopes to expand his company to other cities such as Detroit and Chicago, believing that the data could inform governments and individuals to take action.

He said he hopes his company will bring change to the nation’s struggle with poor air quality and its health impacts.

The key to fighting air pollution-related health disparities lies in the re-prioritization of resources and budgets and breaking through the existing political polarization, according to Ronda Chapman, equity director at The Trust for Public Land.

“This is a non-partisan concern when we’re talking about the health and well-being of individuals,” Chapman told ABC News. “And so when we have the data to back it up, that’s how we’re able to better make the case for investing in green infrastructure, investing in neighborhoods and investing in communities.”

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(WASHINGTON) — The Biden administration is preparing to implement new travel guidelines that would require proof of a negative COVID-19 test within one day of flying into the U.S., including for vaccinated people, a spokesperson from the Centers for Disease Control and Prevention confirmed.

The expected change comes as the country beefs up surveillance for the omicron variant, the first case of which in the U.S. has been identified in California, the California and San Francisco Departments of Public Health said Wednesday. The CDC said the person traveled from South Africa on Nov. 22.

Omicron has been deemed a “variant of concern” by the World Health Organization and had been detected in over 20 countries as of Tuesday.

“CDC is working to modify the current global testing order for travel as we learn more about the omicron variant; a revised order would shorten the timeline for required testing for all international air travelers to one day before departure to the United States,” CDC spokesperson Kristen Nordlund said Tuesday night. “This strengthens already robust protocols in place for international travel, including requirements for foreign travelers to be fully vaccinated.”

Under the current guidelines, people from other countries who are not fully vaccinated cannot travel to the U.S., while people who are fully vaccinated can as long as they provide proof of a negative COVID-19 test within three days of traveling. For unvaccinated Americans, the guidelines already required proof of a negative test within one day of traveling. The potential new rule would expand that one-day requirement to all vaccinated travelers coming into the U.S. from other countries.

For post-travel recommendations, the CDC also suggests vaccinated travelers get tested three to five days after arriving in the U.S. and that unvaccinated travelers stay home to self-quarantine for a full seven days, even if they test negative during that timeframe.

Earlier on Tuesday, the White House confirmed it was considering updates around testing requirements and said policy discussions were ongoing across the government as more is learned about the omicron variant.

More updates on the country’s response to the variant are expected Thursday.

CDC Director Rochelle Walensky outlined some of the expected changes at the White House COVID-19 briefing on Tuesday morning. She said the CDC is analyzing 80,000 COVID-positive tests per week — or about one in seven tests — looking for the omicron variant. The delta variant continues to account for 99.9% of all tests analyzed, Walensky said.

Asked if she was confident in the CDC’s surveillance system given how many other countries had detected the variant before the U.S., Walensky said the system is “robust.”

The director also said the CDC is working on expanding a surveillance program in the nation’s four busiest international airports, John F. Kennedy International Airport, San Francisco International Airport, Newark Liberty International Airport and Hartsfield-Jackson Atlanta International Airport, which would allow for more COVID-19 tests on international arrivals — though there was no indication that testing would be mandatory for arriving travelers or which arriving planes would be offered the tests.

In the meantime, experts are calling on all Americans to get vaccinated if they haven’t yet and to get boosted if they’re over 18 and were fully vaccinated over six months ago. Of those eligible for a booster, 100 million Americans haven’t gotten one yet, the White House said on Tuesday, while just about 20% of fully vaccinated Americans have, the CDC’s vaccine data shows.

Though the data on how transmissible and severe the omicron variant is will not be available for a few more weeks, as scientists around the globe work to gather it, experts believe it’s unlikely it will completely chip away at the protection from vaccines and boosters, particularly when it comes to hospitalization and death.

“Remember, as with other variants, although partial immune escape may occur, vaccines and particularly boosters give a level of antibody that even with variants like delta, give you a degree of protection, particularly against severe disease,” Dr. Anthony Fauci, chief medical adviser to the White House, said on Tuesday.

On Tuesday, Pfizer BioNTech asked the Food and Drug Administration to consider expanding the booster recommendation to include 16- and 17-year-olds. The agency is expected to review the request in the coming weeks.

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(NEW YORK) — Period pain is a fact of life for many women, yet many don’t know that what they are experiencing might not be normal.

“When it comes to period pain, a lot of people just don’t know what they don’t know,” Dr. Nita Landry, a Los Angeles-based OBGYN, said. “Which makes sense, because the only period that you’ve ever had is your period.”

In some cases, people may expect their period to be painful based on what they’ve seen on social media or heard repeated in pop culture — that experiencing pain is just part of having a period.

In other cases, it may be because their mom or grandmother or aunt told them that painful periods “are just the way it is” for women in the family, according to Landry.

“It could be that everybody is experiencing period pain that was never properly diagnosed, and it was never properly treated,” Landry said. “So then everybody ends up suffering unnecessarily.”

More than half of women who menstruate have some pain for one to two days of their cycle, according to the American College of Obstetricians and Gynecologists (ACOG).

For most women, the pain is mild, but for others it can be debilitating, which is a sign it’s time to seek help, Landry said.

“Periods are not fun, that’s not really a secret,” she said. “But, they are not supposed to make you miserable either. They should not be debilitating.”

Here are five facts to know about periods and pain:

1. There are different types of period pain.

The technical term for period pain is dysmenorrhea.

Primary dysmenorrhea is the most common type of dysmenorrhea and is caused by natural chemicals in the uterus lining. It is the cramping pain that comes before or during a period, according to ACOG.

Secondary dysmenorrhea is also a recurrent, cramping pain, but it is the result of an underlying medical issue in the reproductive organ.

“For example, if a person has endometriosis, which is where tissue that’s similar to the inside lining of the uterus gets outside of the uterus, or if someone has uterine fibroids, which are benign growths in the wall of the uterus, then those conditions can lead to secondary dysmenorrhea,” Landry said.

With secondary dysmenorrhea, the pain often lasts longer than normal period cramps and can worsen over time.

“When you think about pain with periods and what’s normal, pain can start about a day or so before a woman’s menstrual period starts, but it typically tapers off within two or three days,” Landry said. “If you find that your pain is extending beyond your menstrual period, then that’s not normal.”

2. Period pain is caused by a hormone-like chemical called prostaglandins.

Women experience pain during their periods because of a natural, hormone-like chemical called prostaglandins.

During a menstrual cycle, prostaglandins cause the uterine muscle to contract, which compresses some of the blood vessels that pump blood into the uterus.

“Blood is going to carry oxygen, so when you decrease blood flow to the uterus, you’re going to have a lower level of oxygenation, and, as a general rule, your body does not like to be deprived of oxygen,” she explained. “Whenever you are deprived of oxygen, you can experience pain.”

“So when we think about pain with periods, you have the uterine contractions, the contractions will decrease blood flow, less blood flow means less oxygen and less oxygen translates as pain,” she said.

Some people may naturally produce larger amounts of prostaglandins, which means they will likely experience more pain during their periods, and some people may be more susceptible to pain, according to Landry.

And just because a person has a light period flow does not mean they can’t experience painful cramps during their cycle, she noted.

“Please don’t make the assumption that, ‘My periods hurt, but my flow is not that heavy so it’s not a big deal,'” Landry said. “It’s still a big deal because pain is pain, and who wants to live with period pain if there’s something that can treat you effectively?”

3. Lifestyle habits can make period pain better or worse.

If you do not have an underlying issue, factors like what you eat and how you handle stress can also have an impact on the pain you experience, according to Landry.

“Being under a lot of stress actually makes your period worse,” she said, and, “Fatty foods increase the production of prostaglandins, and that’s going to increase period cramps.”

Smoking can also make period pain worse, because it constricts blood vessels, which decreases blood flow to the uterus, Landry said.

On the other hand, she said, exercise is a lifestyle habit that is helpful in lessening pain during the menstrual cycle, as is getting good sleep.

“A lot of things can come into play when it comes to determining why some people have more painful periods compared to others or even why the same person may experience different levels of pain during their periods from menstrual cycle to menstrual cycle,” Landry said.

4. These are red flags to look for when it comes to period pain.

The biggest warning to look for when it comes to period pain, according to Landry, is how it is impacting your life.

“If you are missing school or if you are missing work or you’re just missing life in general, that’s a red flag,” she said. “That’s not how your period is supposed to be.”

Other red flags include period pain that gets progressively worse or that continues past your menstrual cycle or changes with age.

“If you didn’t have period pain before, but you’re 25 or older and you start to experience a different type of pain, that’s also a red flag,” she said. “Because that could indicate that there’s an underlying issue that developed more recently that needs to be addressed.”

Landry said the most important thing is for women to talk to their health care provider about their period pain.

“If your health care provider tells you that period pain is normal even though you’re missing school, you’re missing work, you’re missing out on life, then talk to another health care provider,” she said, “I don’t want you to suffer unnecessarily.”

5. Period pain can be treated.

For mild period pain, Landry recommends adjusting lifestyle habits such as diet, exercise and stress management and using natural remedies like a warm bath or a heating pad.

Women can also take over-the-counter pain relievers, called nonsteroidal anti-inflammatory drugs (NSAIDs), in the first one to two days of their period to reduce the production of prostaglandins.

Women with bleeding disorders, asthma, aspirin allergies, liver damage, stomach disorders or ulcers should not take NSAIDs, according to ACOG.

Hormonal therapies, like birth control, are also frequently used to treat period pain.

Landry said there is also research to support the idea that some vitamins, including vitamins B and E as well as magnesium and Omega 3 fatty acids, may be helpful when it comes to easing period pain.

Some women also find alternative remedies such as acupuncture and acupressure helpful, too, according to Landry.

“There are so many different treatment options that your doctor can talk to you about,” she said. “Make sure you give them a chance to tell you about all of them before you decide to grin and bear [the pain].”

GoodMorningAmerica.com is tackling a different taboo women’s health topic each month, breaking down stigmas on everything from mental health to infertility, STDs, orgasms and alcoholism.

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