(NEW YORK) — If the United States switched completely to cleaner energy vehicles and power plants, it would not only benefit the environment but also save an estimated 110,000 lives and $1.2 trillion in health costs over the next 30 years, the American Lung Association says in a new report.
“These numbers are enormous,” said Will Barrett, the national senior director of clean air advocacy for the health organization. “It’s hard to wrap your head around. $1.2 trillion in public health benefits and 100,000 lives saved.”
Pollution from traditional cars and other vehicles has long been known to affect human health, leading to higher rates of lung disease and other illnesses.
“Right now, today, people’s health is suffering because of our dependence on combustion technologies for energy for transportation,” said Barrett, the lead author of the new report.
“We know that kids and seniors along with people with asthma, lung disease, and heart disease, are at risk due to unhealthy air,” said Dr. Philip Harber, an adjunct professor at the University Of Arizona’s College Of Public Health, who was not a coauthor of the new report.
The report finds that additional health benefits include avoiding nearly 3 million asthma attacks nationwide.
The harmful impacts of pollution disproportionately affect lower income communities and communities of color, more often living near major sources of pollution such as highways, power plants and refineries, the report says.
About 3% of U.S. counties with the highest populations of people of color would disproportionately benefit from a transition to electric vehicles and non-combustion electricity generation, the report estimates.
Currently, about 11% of cars and other vehicles sold in the 4th quarter of 2021 use clean energy, and roughly 20% of power plant generation is green, according to the U.S. Energy Information Administration. Experts say the nation doesn’t need a full transition all at once, and even modest improvements now will start saving lives.
“Even without fully green power production, the results will be worthwhile,” said Harber.
“Not being able to do a complete transition is not a reason to delay doing what is feasible now,” he said.
The recently-passed federal infrastructure bill includes of $2.5 billion for zero-emission school buses and $7.5 billion to expand the national infrastructure for electric vehicles.
“That this is a down payment on what we really need is a much larger broader investment in incentive programs for purchases of vehicles,” Barrett said.
Harber says the transition to electric vehicles can start small. Even if you “only get one local pizza chain to use electric vehicles, that symbolism matters to a community,” he said.
“If we put more money into fossil fuel infrastructure today, it’s going to be there for decades. And it will continue to do damage to people’s lungs, people’s hearts, and our environment,” Barrett said.
Matt Feeley, MD, is a resident physician in Occupational and Environmental Medicine from the Johns Hopkins Bloomberg School of Public Health, and a contributor to the ABC News Medical Unit.
(NEW YORK) — The antiparasitic drug ivermectin did not reduce the risk of being hospitalized with COVID-19, according to a large study published Wednesday in The New England Journal of Medicine.
Ivermectin was popularized as an alternative COVID-19 treatment despite a lack of strong evidence it helps. The recent study is among the largest that has failed to show a benefit.
In the study, researchers in Brazil compared more than 1,300 patients, some given ivermectin and others given placebo, and found no difference between the groups.
Early in the pandemic, lab experiments on cells suggested ivermectin could have some promise, but studies in people failed to back that up.
Some studies on ivermectin are ongoing, but today, we have several highly effective vaccines and COVID-19 treatments, with robust studies in people showing they work to dramatically reduce COVID-19 risk.
(NEW YORK) — As the National Suicide Prevention Lifeline prepares to launch its new three-digit number in July, mental health experts worry about workforce capacity issues hindering the ability to provide 24/7 crisis care.
The federal government has allocated a significant amount of funding to assist in the implementation of the new Lifeline number, 988, in a bi-partisan effort to address mental health concerns and assist in suicide prevention. The infusion of funding comes as mental health experts explore the impact the COVID-19 pandemic has had on the nation’s population over the last two years.
Still, despite federal funding efforts to assist in the 988 implementation, call centers across the nation remain underfunded and understaffed at the state and local level. This means that calls from people seeking help may be funneled to one of the Lifeline’s national backup call centers, or go unanswered if the backup centers are overwhelmed.
At its current capacity, about 85% of calls to the Lifeline are answered at either the local or national backup level, according to a report from the Substance Abuse and Mental Health Services Administration.
“24 Months That Changed the World,” airs tonight at 10 p.m. EDT on ABC and tomorrow on Hulu.
The number of calls to the Lifeline is expected to increase following the adoption of the new number, according to SAMHSA.
“Fortunately, most [states] are taking this as an opportunity and are working towards increasing their Lifeline call centers within the network,” said Hannah Wesolowski, chief advocacy officer for the National Alliance on Mental Illness. “But when somebody calls in, and they wait, and they hang up — we have one chance to get this right for a person. Lives are literally at risk. These are people who are in crisis, might be having suicidal ideation. It’s incredibly risky when those calls don’t get through.”
Wesolowski explained that local call centers connect people to mental health care providers in their communities, as well as other resources, while the backup centers may not be able to provide that service.
“We want to deescalate the immediate crisis, which is what those trained crisis counselors do, but we also want to connect them to resources so they stay well,” Wesolowski said. “We don’t want to just have them keep cycling into crises — crisis after crisis — it’s really important that they get connected to needed care so they can get well and stay well beyond that crisis situation. So it’s those local crisis counselors that can really make those connections. When there’s not that local capacity. It’s a huge concern.”
Despite concern over full readiness ahead of the 988 launch, Lifeline Executive Director Dr. John Draper told ABC News that efforts to support the network at the state level have grown.
“We’ve never seen this level of activity in terms of states committing interest, and then being dedicated to supporting local crisis centers,” Draper said.
He explained that crisis centers have typically been seen as “peripheral” to the mental health system, but after 20 years of research around the efforts of the Lifeline, the understanding of their importance has shifted.
“It’s basically a free mental health service for people who are in distress. So that’s what some states are starting to realize is by investing in these centers, they can actually save costs, they can keep people from unnecessarily going to emergency departments, they can people keep people from certainly unnecessarily engaging with police for mental health and suicidal crisis,” Draper said. “If we can engage [people in crisis] in ways through a system that is really designed to care for them, as opposed to scare them, then we are going to be much more effective in keeping them healthy in the community. And that’s really what we’re trying to do.”
The system Draper described is often referred to as a “continuum of care” for people experiencing a mental health crisis.
Activists say the ideal version of this continuum would include locally operated call centers, mobile crisis response teams and community care facilities, which are sometimes referred to as crisis stabilization units.
Wesolowski explained that about 80% of calls to the Lifeline can be deescalated over the phone. Of the remaining 20%, a large portion can be addressed appropriately by a mobile crisis response team, which includes mental health professionals, paramedics and social workers. Those that require further care could be taken to a crisis stabilization facility, where they can receive short-term psychiatric urgent care, rather than being taken to a hospital.
Mobile crisis response teams and stabilization facilities are even less prevalent across the nation than call centers, making their availability to someone in crisis dependent on that person’s location.
However, several cities have implemented pilot programs to provide mobile crisis response services as an alternative to a law enforcement response for people experiencing a mental health emergency.
Last August, Denver announced it would be expanding its Support Team Assisted Response (STAR) Program after what the city called a “successful one-year pilot,” in a press release.
In that first year, the city says the program handled 1,400 calls.
“Of those, there were no arrests, no injuries and no need for police back up,” according to the press release.
In areas where these services are not available, law enforcement is often called to respond to someone in crisis, which can lead to escalation of the situation including that person’s arrest or even their death.
“I think that’s a really important component, to take law enforcement out of it,” Wesolowski said. “We don’t ask law enforcement to respond to other health care crises. That’s not their job. We ask medical professionals to do that. And mental health is health. So it’s really important that we take a mental health approach to these crises and provide health, not handcuffs.”
Over the last two years, a more widespread focus has been placed on suicide prevention and mental health care as experts weigh in on the effects the COVID-19 pandemic has had on the mental health of Americans.
Last month, U.S. Surgeon General Dr. Vivek Murthy testified before the Senate Finance Committee about the dramatic impact the pandemic has had on the mental health of young Americans, in particular.
Suicide attempts among young people have increased during the pandemic. The Centers for Disease Control and Prevention reported last year that emergency department visits for teen girls who had attempted suicide were up more than 50% at the start of the pandemic, compared to 2019.
Murthy will discuss the need to address the mental health crisis among America’s youth during “20/20” special, which focuses on the impacts of the pandemic over the last two years.
If you are struggling with thoughts of suicide or worried about a friend or loved one, help is available. Call the National Suicide Prevention Lifeline at 1-800-273-8255 [TALK] for free, confidential emotional support 24 hours a day, 7 days a week.
(NEW YORK) — When David Bookstaver tested positive for COVID-19 he happened to have a telehealth consult with his doctor already scheduled that day, to talk about going on medication to moderate his high blood pressure.
On that call Bookstaver, 63, says his doctor mentioned his age and hypertension made him eligible for Paxlovid, Pfizer’s antiviral pill treatment, which has proven highly effective at keeping higher-risk patients out of the hospital, and preventing them from getting even sicker.
Bookstaver is fully vaccinated and boosted and didn’t feel too ill at the time – but warding off a turn for the worse seemed prudent. The doctor sent a prescription for the new medication to the pharmacy and his wife was kind enough to pick up his medicine and bring it home.
But when he read over the drug information, Bookstaver’s eyes caught on some of the fine print: the cholesterol medication he was already on – and the blood pressure medication he had also just been prescribed – were both listed as having potentially harmful interactions with the Paxlovid he had just been given.
“If I was really sick I probably would have gobbled the first dose up and not looked,” Bookstaver said. “I think most people don’t do due diligence. They trust their doctor implicitly. But if people aren’t checking the contraindications labels I think they kind of need to be told.”
Though highly effective, Paxlovid, like some other medications, does carry the risk of certain dangerous interactions with many other commonly prescribed drugs – including those which manage heart conditions and cholesterol. It is also not recommended for patients with severe kidney or liver problems.
“If we’re seeing increased concentrations of a statin, this could lead to muscle aches that then lead to impaired kidney function.” Dr. Jay Bhatt, an internal medicine physician and instructor at the University of Illinois School of Public Health and an ABC News contributor said. Complications like these, he said, often require hospitalizations for close monitoring.
Without knowing exact medication dosages it’s difficult to say just how dangerous potential side effects could have been, but Bhatt, who was not involved in Bookstaver’s treatment, said it’s a good thing it was caught by the patient beforehand.
As for the blood pressure medications, “we would be concerned about people’s blood pressure going so low that we’re not getting enough blood flow to the parts of the body that need it. People can pass out and fall. For old patients with comorbidities, that could have serious complications,” Bhatt said.
“Some drugs come with more considerations than others — the prescribing of this particular drug is complex, and it requires a lot of care,” Dr. Inga Lennes, senior vice president of ambulatory care at Massachusetts General Hospital, told ABC News. “There has to be a nuanced discussion between a doctor and a patient to make that determination about what is best and safest for your health: talking about not just about their true medication history, what they’re on — but also why they’re on it — is so important.”
The drug’s tangle of contraindications poses a treatment protocol catch-22: a patient’s qualifying risk factors that qualify them for Paxlovid may mean they’re already taking other medications for those risk factors which disqualify them for Paxlovid, experts said.
Pfizer told ABC News in a statement it is working to educate healthcare providers on how to manage “potential drug to drug interactions.”
“We are also working with some of the largest telemedicine companies to ensure their HCPs are knowledgeable about PAXLOVID and ready to treat appropriate patients, and we are reaching out to pharmacy customers directly to help address questions,” the company said.
Bookstaver said he chose not to use his prescription.
This shifting terrain of COVID treatments makes it all the more crucial for doctors to be aware of their patients’ full medical profile before signing off on a new prescription, experts said, since there may be potential harms in shifting around their usual drug regimen. And because a prescribing physician or pharmacy staff member dispensing the pills may not be familiar with the full gamut of drug interactions, they said it also underscores the importance of people advocating for their own health and being watchful of how their medicines interact.
“This is not a quick conversation like — oh, you’re COVID positive? You’re a certain age? Here, here’s your prescription,” Lennes said. “We’ve employed a real massive education effort to make sure that our people who are prescribing these really understand — there are some drugs that are very specific, they can only be given in certain situations for certain things and under certain circumstances, and it would be dangerous or unwise or unhelpful to prescribe them in any situation.
“All of those micro decisions add up to complexities both for providers and for patients that are hard to navigate and make it harder to automate,” Lennes said.
Paxlovid’s unique effect comes from the synergy of its two antiviral components. One part blocks the enzyme that breaks down the antivirals, leading to high levels of both medications in the body. A long list of other common medications use this enzyme, too – like the statins Bookstaver had already been taking.
The blood pressure medication he was set to start that same day, Amlodipine, is another one that uses these liver enzymes. These typically benign medications effectively become overdosed when taken with Paxlovid.
“Usually the adverse effects are an extension of what the drug is used for. For medications used for your blood pressure, you can have an interaction when your blood pressure gets way too low, dangerously low”, Dr. Stephanie Widmer, an emergency medicine physician and medical toxicologist, told ABC News. As for statins, “there is the risk of liver injury, and there’s the risk of severe muscle injury and breakdown, which could then lead to kidney injury.”
The Food and Drug Administration’s fact sheet on Paxlovid notes an extensive list of drug-drug interactions for health care providers, noting “caution is warranted” with Amlodipine, that “clinical monitoring of patients is recommended” and a dose decrease of the blood pressure drug may be needed if co-administered with Pfizer’s COVID pill.
Some of these interactions are absolute contraindications and must be stopped, while others are minimal and considered relative interactions, experts told ABC News.
In some cases a patient can pause their other treatments while they’re taking the COVID antiviral – three Paxlovid pills twice a day for five days. But for some patients, forgoing the other lifesaving medicines they’re already dependent on for a full business week may asking the impossible.
“No matter what medications you’re on, because the list is so long, you have to have the conversation with your doctor on if this is the right medication for me and what interactions am I at risk for,” Widmer said.
If dangerous drug interactions are unavoidable, doctors may recommend the antiviral pill from Merck instead, called molnupiravir, which has shown to be somewhat less effective than Pfizer’s but does not have any known medication interactions. However it is not authorized for people under 18, out of concerns it may impact bone and cartilage growth, and it is not recommended during pregnancy.
“I don’t think most people spend the time reading the fine print,” Bookstaver said – adding, he’s glad he did. “And especially if a person feels bad, they just want to feel better.”
ABC News’ Eric M. Strauss and Sony Salzman contributed to this report.
Y. Jay Lin, M.D., is an emergency medicine resident at NYU & Bellevue Hospital in New York and a contributor to the ABC News Medical Unit.
(NEW YORK) — Bruce Willis’ family has announced the actor has been diagnosed with aphasia and is “stepping away” from his career due to the diagnosis.
The 67-year-old actor’s wife, Emma Heming Willis; his ex-wife, Demi Moore; and his daughters shared a photo of him on Instagram on Wednesday with a lengthy message on his health.
“To Bruce’s amazing supporters, as a family we wanted to share that our beloved Bruce has been experiencing some health issues and has recently been diagnosed with aphasia, which is impacting his cognitive abilities,” their message began. “As a result of this and with much consideration Bruce is stepping away from the career that has meant so much to him.”
According to the Mayo Clinic, aphasia is “a condition that robs you of the ability to communicate,” and the disorder can impact one’s “ability to speak, write and understand language, both verbal and written.”
The medical nonprofit says the language disorder “typically occurs suddenly after a stroke or a head injury.”
There are several different types of the language disorder, and the condition “usually occurs suddenly, often following a stroke or head injury, but it may also develop slowly, as the result of a brain tumor or a progressive neurological disease,” according to the National Institute on Deafness and Other Communication Disorders.
The impact of treatment depends on “the cause of the brain injury, the area of the brain that was damaged and its extent, and the age and health of the individual,” according to the NIDCD.
The disorder affects around 2 million people in the United Statues, the National Aphasia Association says, and almost 180,000 Americans are diagnosed with it every year.
The Die Hard actor’s family did not provide further details on his condition but did expression their gratitude for support from his fans.
“This is a really challenging time for our family and we are so appreciative of your continued love, compassion and support,” the message from the actor’s family read. “We are moving through this as a strong family unit, and wanted to bring his fans in because we know how much he means to you, as you do to him.”
“As Bruce always says, ‘Live it up,’ and together we plan to do just that,” they added.
(NEW YORK) — Two years after the COVID-19 pandemic began, mental health challenges still impact youth.
But in a new one-hour ABC News primetime special anchored by Good Morning America’s Robin Roberts, U.S. Surgeon General Dr. Vivek Murthy said children have struggled with mental health long before the pandemic.
“The pandemic’s been more challenging for some children,” Murthy told ABC News chief medical correspondent Dr. Jennifer Ashton. “If we wanna address this, we’ve got to listen to kids.”
In October 2021, the American Academy of Pediatrics found “soaring rates of mental health challenges among children, adolescents, and their families over the course of the COVID-19 pandemic.”
Two months later, Murthy issued an advisory on the youth mental health crisis, emphasizing that mental health challenges are present among children and young adults.
To help young people heal, Murthy has been doing listening tours with youth across the country.
In the ABC News primetime special “24 Months That Changed the World,” Ashton sits down with Murthy and kids at Ida B. Wells Middle School. in Washington, D.C.
“I felt like that little kid in me disappeared and I started worrying about stress,” said Daylan Joya, a student at Ida B. Wells Middle School.
Added student Machi Brooks: “Don’t just treat us like, ‘Oh, you’re a child.’ Treat us like what we’ve been through is as equal to what you’ve been through.”
At a high school in Mason, Ohio, the Hope Squad was created to help students with their mental health.
“Tons of people needed help during the pandemic,” Kaya Rossey, a member of William Mason High School’s Hope Squad, told ABC News.
In one exercise, students role-played how to handle self-harming behavior when they spot it.
Dr. Alok Patel, a physician at Stanford Children’s Health and ABC News contributor, said a “silver lining” of the pandemic is that it’s opened the conversation on mental health.
“One silver lining that has come is the amount of discussion and awareness that has happened to talk about their own mental health struggles,” said Patel.
“24 Months That Changed the World” airs on a special edition of 20/20 on Wednesday, March 30, on ABC. It will air the next day on Hulu.
(NEW YORK) — Throughout the COVID-19 pandemic, disease surveillance efforts that rely on testing and variant sequencing have been critical tools in the global efforts to fight the virus.
Without these tools, experts said, the spread of COVID-19 could have been exponentially greater, potentially resulting in many more deaths.
“Testing and sequencing have been critical to understanding where the virus is and how it is evolving. This is critical information for response and mitigation efforts,” Dr. Rebecca Katz, professor and director of the Center for Global Health Science and Security at Georgetown University, told ABC News.
Surveillance tools have helped health officials make important recommendations throughout the pandemic — including the decision to green light booster doses for extra protection, and decision to pull back on some monoclonal antibody treatments authorized for COVID-19, following concerns that it was not effective against certain variants.
However, as the omicron surge has receded, usage of those key tools, namely testing, has also declined — a choice that has been a source of great concern for health experts as the more transmissible, omicron subvariant, BA.2, spreads across the U.S.
Although some Americans are still getting PCR tests, considered the gold standard of testing, reported testing levels are now at their lowest point in eight months, with numbers dropping by nearly 75% since the beginning of the year.
Lab testing is also key to detecting variants because genetic sequencing, the primary method of detecting new variants, cannot be conducted.
Even wastewater surveillance, which provides some measure of early warning, does not indicate variants present or give a clear indication of the number of cases.
“With reduced testing we have less visibility into disease transmission as well as virus evolution,” Katz said. “Certainly, the decline in testing we are seeing both in the U.S. and around the world is concerning. We are losing our situational awareness.”
Over the last month, the United Kingdom, which has been a global leader in COVID-19 sequencing, reported nearly 200,000 sequences, the highest of any country, to GISAID, the international database that tracks changes in the virus. Throughout the pandemic, the U.K. has been at the forefront of COVID-19 sequencing.
Comparatively, the U.S., which ranks third behind Denmark for sequencing, has reported about 35,000 sequences in the last 30 days.
Getting ahead of the curve
Last week, a new study found that the Centers for Disease Control and Prevention’s program to detect COVID-19 variants in international air travelers, using genetic sequencing, revealed that the first BA.2 case in the U.S. had actually been weeks before it was first reported.
“Earlier detection of new SARS-CoV-2 variants of interest and concern allows researchers and public health officials the needed time to gather information about transmissibility, virulence, and vaccine effectiveness to enable adjustments to treatment and prevention strategies,” the researchers wrote, adding that the surveillance measure could be used as an early warning system for future outbreaks.
Across the globe, BA.2 now accounts for approximately 86% of sequences from the last four weeks, World Health Organization technical director Dr. Maria Van Kerkhove reported earlier this month. She stressed that declines in surveillance could ultimately put the world at risk as the virus continues to spread.
“It’s really critical that we have testing and it’s really critical that we have sequencing … that the systems that have been put in place for surveillance, for testing, for sequencing right now be reinforced, that they are not taken apart, because we need to move on to the next challenge,” Van Kerkhove said.
In order to track new variants, teams have been sequencing the virus’ genetic material to identify its strain, lineage and specific mutations.
“We’ve only just realized the value of these methods for our communities and our health. Instead of fully recognizing this, we’re considering stopping. This is short-sighted,” said Davida S. Smyth, Ph.D., a professor and microbiologist at Texas A&M University, who has been tracking COVID-19 in New York City’s wastewater since the summer of 2020.
Wastewater will continue to be an important tool as a preliminary indicator of COVID-19 trends in the U.S. However, adequate genetic sequencing is also needed in order to identify new variants in the water.
“The only way we can track the virus is through a combination of clinical sequencing and wastewater sequencing,” Smyth said. “Wastewater can in fact serve as an early warning system. Without sequencing, we cannot determine the identity of the virus variants that are circulating and without testing we cannot know how prevalent it is.”
Closing down testing sites
Of additional concern for some experts has been the decision to close down testing sites in favor of at-home testing. From coast to coast, dozens of states have moved to shutter public testing sites.
With at-home tests now widely available, most Americans are also not reporting their results to officials, and thus, experts say that infection totals are likely undercounted.
“The less data we have, the less insight — even predictive insight — we have to create evidence-based public health policy,” Jessica Malaty Rivera, an epidemiologist at the Pandemic Prevention Institute, told ABC News.
In addition, officials are unable to sequence at-home tests, which means potential mutations or new variants could go undetected, experts say.
“The fact is, we’ve never tested enough. And I worry we’ve fallen Into the fallacy of ‘testing less, means less COVID.’ That’s a dangerous approach to this next phase of the pandemic,” Malaty Rivera said.
Funding key
Health officials and experts agree that access to adequate funding will also be essential to the country’s ability to keep the virus under control.
CDC Director Dr. Rochelle Walensky said in an interview earlier this month that government funding is essential to the agency’s ability to monitor variants, and study other key COVID-19 issues.
Recognizing that we still do not know everything about COVID-19 will be important, Smyth added, as the virus has frequently proven itself to be erratic and unpredictable.
“I am concerned given that we’ve likely not seen the last of emergent SARS-CoV-2 variants and we’ve likely not seen the last of what this virus can do in response to vaccines and our immune system,” Smyth said. “Without observation and surveillance, we could be blindsided. We’re not out of the woods yet.”
Marti Hines, far left, poses with Selma Blair, center, and a friend in this undated photo. (Courtesy Marti Hines)
(NEW YORK) — When Marti Hines woke up one morning four years ago while on vacation and was unable to move the left side of her body, she said it did not even cross her mind that she, at age 34, could have multiple sclerosis (MS).
Even after an MRI found over 20 lesions on her brain and spinal cord and she was formally diagnosed with MS, Hines said she spent close to six months in “anger and denial,” not willing to believe she had the disease, a chronic disorder of the central nervous system that can cause problems with vision, balance and muscle control.
“Being a Black woman at 34, it just added to me not being able to take in this information,” Hines, now 38, told ABC News’ Good Morning America. “Nothing seemed to make sense.”
When she looked online for information about MS, Hines said the results not only terrified her, but also did not seem to reflect her, a young, Black woman who was healthy and active and had a busy career as a filmmaker and event planner.
“It’s a pretty terrifying thing to try to deep dive and look into, so I was very scared,” said Hines. “And then as I was getting on that road of acceptance, and trying to find resources, I really noticed I wasn’t finding a lot of myself.”
In the same month that Hines was diagnosed, August 2018, actress Selma Blair was also diagnosed with the same disease, while in her 40s.
When Blair shared her diagnosis publicly, Hines said she was still in her own “denial” about having MS.
Over the years though, Blair speaking out about her battle with MS has helped Hines, and she believes countless other people with MS, women in particular.
“I appreciate the awareness that she brought to the disease,” said Hines, who says she has since met Blair at MS-related events. “I feel like this illness has a face now. You can say you have MS and people have some kind of touchpoint to it. I think it’s amazing that she has been so open and vulnerable.”
A changing face of a disease that strikes young women at higher rates
Blair and other actresses who have spoken publicly about battling MS in recent years, from Christina Applegate to Jamie Lynn Sigler, have begun to change the perception of MS, according to both patients and experts.
The three women, now in their 30s and 40s, represent the most common population of MS patients — young and female — who have not always been the public face of the disease, even though it has long affected them disproportionately.
The average age of the start of symptoms for people with MS is between the ages of 20 to 40, and the disease is three times more common in women than men, according to the National Institutes of Health (NIH) and the National Multiple Sclerosis Society (NMSS), a nonprofit organization focused on raising MS awareness and increasing research.
“The label of MS these days doesn’t necessarily conjure up the same image as it did maybe 20, 30 years ago,” said Dr. Suma Shah, a board-certified neurologist at Duke University who specializes in MS. “We used to hear MS and think this is someone who’s going to have disability, who’s going to have a really rough disease course. We’re in a place now where we can’t assume that about the diagnosis.”
While there is no known cause of MS, it is believed to be an autoimmune disease in which the body attacks myelin, the tissue that surrounds nerves, including those in the brain and spinal cord, according to the NIH.
It is an unpredictable disease, one that causes different symptoms with variable timing and frequency in different people, from fatigue, numbness or tingling, weakness, dizziness and vertigo to, in the most severe cases, rendering a person unable to write, speak or walk, the NIH says.
Even for each individual patient, the symptoms of MS can vary at times, ranging from mild to the extreme pain of a flare-up of the disease, as Hines knows well.
“If you have MS, you’re just highly sensitive, so anything that messes with the balance that I try to keep myself at will trigger these symptoms, and then they kind of roll into a domino effect of one another,” said Hines. “It’s only been about three-and-a-half years since I’ve had MS, but I’ve forgotten what it feels like to feel good.”
Why it is women like Hines who are young and otherwise healthy who are disproportionately stricken with MS remains a mystery that researchers are still trying to solve, according to Shah.
“What we’ve looked at specifically are whether there are something genetic, specifically on the X chromosome, which women have two of, whether there’s something hormonal and then environmental factors,” she said. “I think it really is that perfect storm for one individual person of how genetics, hormones, and environmental factors all play in together to allow MS to flourish.”
“And in that young, early 20s, 30s period, we don’t know why. It may just be that again, that perfect storm of having the right genetics and the right hormone levels to allow it to flourish,” Shah explained.
For some women, the disease can strike suddenly, as with the case of Hines, who said she woke up one morning unable to move and received a diagnosis just hours later.
The more common path though is that it can take months or years for a woman to get a diagnosis of MS. In the case of Blair, she has said it took several years to get a diagnosis, a time during which she said she self-medicated and felt like she was “not taken seriously by doctors.’
“I was ashamed and I was doing the best I could and I was a great mother, but it was killing me,” Blair, whose son was 7 years old at the time of her diagnosis, told ABC News’ Robin Roberts in 2019. “And so when I got the diagnosis I cried with some relief. Like, ‘Oh, good, I’ll be able to do something.'”
Adding to the difficulty of diagnosing MS is that symptoms may start and then fade away and later return, or in other cases they may develop gradually over many years. The four main types of MS are named according to the progression of symptoms, according to the NIH.
With relapsing-remitting MS, the most common type of the disease, symptoms occur in attacks, called a relapse or exacerbation, followed by a period of remission that may last for weeks, months or years, according to the NIH.
People with secondary-progressive MS have usually had a history of MS attacks and their symptoms and ability to function worsen over time. In the two more severe and rare forms of MS — primary-progressive MS and progressive-relapsing MS — people’s symptoms worsen from the beginning, with no remission, according to the NIH.
There are no specific tests that diagnose MS, which means doctors often rely on ruling out other conditions with similar symptoms. MRIs can also identify lesions on the brain and spinal cord to help diagnose MS.
“It’s really hard because I think for an individual, the sooner you pursue diagnosis, the longer you have to live with seeing your body in your life through this new lens,” said Shah. “But from a medical standpoint, that allows us to start high efficacy-medication early so that we can prevent downstream disability.”
There is no cure for MS, but there are medications now available to help delay the progression of the disease and to decrease the frequency and intensity of symptoms, according to Shah.
“I tell people when I diagnose them, the way that they look on the day they meet me, that’s the goal, no more disability,” she said. “And we have really good medications that get us pretty close to that these days.”
Breaking the stigma of an ‘invisible disease’
What Blair, Applegate and Sigler have done in speaking out about their battles with MS is to put names, faces and experiences to what advocates and patients describe as an “invisible disease.”
“Despite the fact that an estimated million people live in the U.S. with MS and that three-quarters of them are women, so we’re talking about 750,000 women, it is a very invisible disease in many ways,” said Julie Fiol, associate vice president of healthcare access for the NMSS. “It’s invisible in that people aren’t aware of it, don’t quite know what it is when they hear it, and because the symptoms can be invisible.”
When Moyna John, a 30-year-old mother, was diagnosed with MS over two years ago, she said even people close to her struggled to understand her illness at first because she wasn’t in a wheelchair, for instance.
“Some people close to me were like, ‘Well, you look fine,'” recalled John. “People within the chronic illness community in general hate hearing the, ‘but you don’t look sick’ phrase, because it’s not a compliment. We are sick.”
John, of Queens, New York, said that aside from the physical symptoms she deals with as part of her MS battle — from brain fog and fatigue to blurry vision and pain — there is a constant mental health struggle as well.
“This diagnosis came and completely derailed me. I was super depressed trying to figure out what life would be like now and how I would be an adequate mother and adequate wife and all these things,” said John, whose son is now 4. “I still deal with a lot of depression, a lot of anxiety, and that’s something that I have to navigate on a regular basis.”
John said that part of her acceptance of MS has been her work to make the disease less invisible for others, particularly for Black women.
“When I started to look into it, I thought this doesn’t seem to be something that affects women that look like me … I didn’t see young mothers. I didn’t see Black people at all,” she recalled. “I went to a support group and everyone was older, everyone was white, their symptoms were a lot more severe, and it kind of sent me spiraling.”
John began to share her journey on social media, where she said she found that, “Having some sort of community is beautiful.
“I feel like a lot of people don’t realize how much having someone who looks like you matters. It can be really isolating, feeling like you’re the only person dealing with this,” she said. “I think me sharing about me being a mom kind of helps people to think, wow, you can live a life that is busy and still exist.”
Likewise, Hines said she found so much support from the online community of people with MS that she started a YouTube channel, Marti’s MS Life, to document her own journey and create another space for women to talk openly.
“Most people can’t really understand what it means to be in pain every second of every day. Not being able to understand that makes the sick person feel even more isolated. You don’t want to be the person who has the cloud over them,” said Hines. “Everyone asks how you are and you just say, ‘I’m fine,’ because you probably wouldn’t talk to me anymore if I told you how I was.”
Sarah Walsh, a 37-year-old mom of two in Los Angeles, was diagnosed with MS three years ago, just after her oldest child’s first birthday.
She said that because people can’t physically see her MS symptoms, like pain and fatigue and vision loss, she makes sure to talk with friends, family, colleagues and strangers about the disease.
“It may be counterintuitive to people, but I kind of wear it as my badge of honor,” said Walsh. “I’m very transparent about it, like, ‘I’m Sarah and I have MS,’ and I don’t tell people to feel bad, it’s more that I just want people to know.”
Walsh said she also talks openly about her MS because “the burden is too great to do it on your own.”
“I feel like if I had stayed quiet about it, it would have done something to me in a negative capacity mentally,” said Walsh. “What’s helping me stay positive is to talk about it, to be supported.”
She continued, “I just never want the MS to beat me. That’s my goal. I’m very adamant about that. It won’t be the only thing that’s left at the end of day.”
(WASHINGTON) — A second round of booster shots was authorized for everyone over the age of 50 by the Food and Drug Administration on Tuesday, kicking off the regulatory process for shots to likely be available in pharmacies sometime this week.
Everyone 12 and older is already eligible for a booster shot five months after their initial vaccine series, if they received an mRNA vaccine like Pfizer or Moderna, or two months after getting the J&J vaccine.
But for those over 50, determined to be a vulnerable age group, officials have decided that the data on waning immunity justifies making another shot available for people who are four months after their first boost.
The decision now moves over to the Centers for Disease Control and Prevention for CDC Director Rochelle Walensky to give instructions on how to implement the authorization.
She is expected to announce that fourth shots should be made available to anyone over 50 who wants one, but not to outright recommend it, leaving the decision up to individuals and their doctors. Shots could then be administered within the week.
So far there is limited U.S. data on second boosters. But data from Israel indicates that an additional booster shot can give a temporary bump in protection, reducing the risk of dying for adults over 60.
Several countries, including Israel, Chile and Sweden, have begun offering fourth COVID-19 doses to older adults and other at-risk groups.
Dr. Anthony Fauci, chief medical adviser to the White House, has said he expects that additional boosters would “reconstitute” people back to the maximal level of antibodies, rather than boost people higher than their previous immune responses from any of the earlier shots.
But he said that the body’s B cell and T cell response, which have more of an effect on the duration of immunity, may incrementally be increased with each additional boost.
And while Tuesday’s announcement only applies to older Americans, a decision for the rest of the population will soon be underway.
The FDA will convene a panel of vaccine experts on April 6 to discuss the plan. The experts will talk about the efficacy of booster shots and the potential need for a variant-specific booster instead of continual booster shots designed for the initial strain of COVID-19.
A decision would likely be made later this summer or fall.
Older people who get a booster this spring would also likely be advised to get another boost in the fall, alongside the general population, if that’s the recommendation, said an official familiar with the booster discussions.
But boosting too frequently could cause fatigue, a dilemma that many public health experts are weighing.
“We’re going to have to learn to live with mild disease at some point,” Dr. Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia, told ABC News. Frequent boosting “is not a reasonable thing to do, and it’s not something most people will do anyway.”
Pfizer’s CEO Albert Bourla has also acknowledged the impracticality of people rigorously staying up to date with shots every few months.
“We can’t have vaccines every five, six months,” said Bourla, speaking on CNBC. But until they have new-and-improved boosters ready to go, Pfizer and Moderna executives argue fourth doses will be needed by at least some older Americans soon.
Of course, the vast majority of Americans have yet to get even a first booster shot. Of the nearly 90 million fully vaccinated Americans, about half got their shots more than five months ago but still haven’t gotten a booster shot.
Among seniors 65 and over, uptake has been a bigger success. About two-thirds of seniors have gotten their first booster shot so far.
(NEW YORK) — Another COVID-19 vaccine booster shot may be on the horizon for Americans, as the U.S. Food and Drug Administration is expected to greenlight a fourth dose for those aged 50 and older as soon as Tuesday.
It comes after Pfizer-BioNTech requested the FDA authorize a fourth dose for Americans aged 65 and older earlier this month and Moderna asked the same, but for those aged 18 and older.
Several other countries have already begun administering a second booster, and the Centers for Disease Control and Prevention currently recommends immunocompromised Americans receive a fourth dose.
Two officials familiar with the matter told ABC News the fourth shots will likely be only offered and not formally recommended.
Experts suggest U.S. health officials want another booster authorized for the rest of the population before the next potential COVID-19 wave.
“This is an attempt to be sort of ahead of what might happen in the future,” said Dr. John Brownstein, an epidemiologist at Boston Children’s Hospital and an ABC News contributor. “We will likely have another surge, whether sooner or later we don’t quite know, but there is a recognition that, over time, immunity wanes.”
He added, “And booster protection is at least helpful for those older and with underlying conditions.”
What is the data behind recommending a fourth dose?
Several countries, including Israel, Chile and Sweden, have begun offering fourth COVID-19 doses to older adults and other at-risk groups.
However, very few studies have been released exploring the benefits of a fourth dose. All are from Israel.
One study, published in the New England Journal of Medicine, looked at 274 health care workers who received a Pfizer or Moderna vaccine four months after their first shot.
The team found a fourth shot boosted antibody levels comparable to those seen after a third dose but did not boost protection against infection.
There were no hospitalizations in either the single-boosted group or double-boosted group.
Another study, which was published Thursday and has not yet been peer-reviewed, looked at more than 563,000 patients between 60 and 100 years old.
Over the study period, about 58% of the group received a second booster dose.
They found that participants who received a second booster dose were less likely to die within 40 days of vaccination, after adjusting for baseline health status and other factors.
“The second study was the one that made everyone pay attention … that sort of changed the discussion [about recommending a fourth dose], I think,” Dr. Peter Chin-Hong, an infectious diseases specialist at the University of California, San Francisco, told ABC News. “But if you look at a percentage, that’s kind of still very low. So basically, getting a booster in that population results in low mortality just overall.”
Brownstein said the data is limited and should be interpreted with caution, but added that Israel has been a harbinger of what’s to come in the U.S.
“Israel has already been a reasonably good indicator of what we might see in the U.S., both the impact of COVID and the efficacy of vaccines,” he said. “I think that provides some support with those who want to get that additional shot.”
Should I get a fourth dose if I’m above age 50?
Although there have not been specific studies looking at the risk of COVID-19 infection or complications in those aged 50 and older who have been doubled boosted compared to those aged 49 and younger, other studies have shown that overall protection declines in older populations.
“It might seem arbitrary, but data suggests that after age 50, your ability to fight infection decreases,” Brownstein said. “The number of underlying chronic conditions increases with age, too.”
But experts said there is no current evidence to suggest that young, healthy Americans need a fourth vaccine dose.
Chin-Hong pointed to recent CDC data, which, as of Jan. 29, showed the rate of COVID deaths among those aged 18 to 49 was 0.8 per 100,000 for the unvaccinated, 0.13 for those fully vaccinated and 0.10 for those vaccinated and boosted.
“The benefit of just being vaccinated is really the discussion rather than how many boosters you got,” he said.
What if I’ve had omicron recently?
Chin-Hong said he doesn’t think boosted Americans who were infected with omicron during the most recent wave need to get a fourth shot.
He added that a COVID-19 infection will likely have boosted antibody levels high enough that a fourth shot won’t add much protection.
“For these people, when you get an infection, it’s almost like getting a shot itself,” he said. “You can consider it as your own booster shot and that hybrid immunity will generally be thought of as being very powerful.”
Chin-Hong added, “You can run out and get the shot any time if you’re eligible but, in terms of biological need, it’s probably less important, particularly if you’ve gotten a recent breakthrough infection.”
