(LOS ANGELES) — Los Angeles Unified School District said it’s keeping its mask mandate in place — at least temporarily — even as California drops its requirement for masks in indoor public settings.
Several K-12 schools across the state dropped their face covering requirements Monday after the state lifted its mandate over the weekend.
Last month, Los Angeles County Public Health said it would follow the state’s move and allow the 80 school districts in the country to decide whether or not they want to keep mask mandates.
LAUSD, the second-largest school district in the country, said it does not want to drop the mask requirement yet as it works towards a plan with partners, including teachers’ unions, to move away from mandates and towards “strongly recommending” masks indoors.
“The science that informed the on-ramp to the protective protocols currently in place, which have ensured the well-being of our students and workforce, must, too, inform the off-ramp as health conditions improve,” LAUSD said in a statement on Twitter Friday.
“Los Angeles Unified continues to take a science-based approach to COVID-19 policy and is currently working with labor partners and other stakeholders to transition from required indoor masking to a strong recommendation for indoor masking,” the statement continued.
LAUSD did not indicate when its mask mandate might be lifted.
COVID-19 cases and hospitalizations in California have been declining for several weeks as the omicron wave tapers off.
As of March 11, the seven-day rolling average for cases was 4,625, according to the Centers for Disease Control and Prevention, the lowest number recorded since Dec. 1, 2021, before the omicron wave.
Similarly, the seven-day average for virus-related hospitalizations in The Golden State sits at 319, a figure not recorded since July 19, 2021, CDC data shows.
However, parents are divided on the mandate with some saying it’s time for masks to be removed and others still worried about a potential rise in cases.
“I think it’s time,” one parent, Elisa Smith, told ABC News affiliate KABC-TV. “If it’s time for us adults to take them off, I think it’s time for the children to take them off.”
“I want them to keep it on. I do, personally,’ another parent, Claudia Angulo, told KABC. “Why? Because it’s still out there, the virus, just to be safe.”
Ending mask mandates have received some pushback from teachers’ unions.
L.A. County public health officials made the announcement last month regarding the end of mask mandates, United Teachers Los Angeles said in a statement it would be “premature” to drop such requirements.
“The district has requested to bargain with UTLA over health and safety protocols currently in place at LAUSD schools,” a spokesperson for the union told ABC News in a statement. “We met with the district on Friday for an initial discussion over their proposed changes, and a follow-up session is scheduled for Wednesday, March 16.”
(LOS ANGELES) — Hailey Bieber is on the mend after experiencing stroke-like symptoms last week.
Over the weekend, the 25-year-old model told her fans what happened on her Instagram stories and said it was “one of the scariest moments I’ve ever been through.”
“On Thursday morning, I was sitting at breakfast with my husband when I started having stroke-like symptoms and was taken to the hospital,” Bieber wrote. “[The doctors] found I had suffered a very small blood clot to my brain, which caused a small lack of oxygen, but my body had passed it on its own and I recovered completely within a few hours.”
In the U.S., strokes are the fifth cause of death and leading cause of disability, according to the American Stroke Association. It occurs when a blood vessel that carries oxygen and nutrients to the brain is either “blocked by a clot or bursts.” Usually when this happens, the American Stroke Association says, part of the brain can’t get the blood and oxygen it needs.
Board-certified emergency medicine physician and ABC News contributor Dr. Darien Sutton said there are three types of strokes. He said he believes Bieber had a transient ischemic attack, or “mini-stroke.”
“That’s when blood supply is temporarily reduced,” Sutton said. “And that can cause symptoms lasting anywhere from minutes to up to 24 hours.”
What was perhaps most shocking in Bieber’s case was her age, as strokes usually occur in older adults.
“It’s incredibly uncommon for a patient who is young and healthy to present a stroke, as it predominantly occurs in those over the age of 60,” Sutton said. “But I will say, given the pandemic, we’ve seen increased rates of COVID-19 associated with cardiovascular disease as well as stroke.”
Last month, Nature published an article about a massive study in which researchers found that the rates of many conditions such as heart failure and stroke “were substantially higher in people who had recovered from COVID-19 than in similar people who hadn’t had the disease.”
The risk was elevated for those who were younger than 65 and lacked risk factors such as obesity or diabetes.
Bieber’s health scare comes one month after her husband, Justin Bieber, contracted COVID-19. The singer, who has since recovered from the disease, had to postpone multiple concert dates on his Justice World Tour, including a show in Las Vegas, which was later rescheduled to June.
While Bieber is now home and thankful for the care she received from doctors and nurses, Sutton said the model did the right thing and encourages people to take note of the signs and symptoms of stroke.
“We all know the typical symptoms of a stroke, which can include sudden numbness or weakness on one side of the body, but I want to help clarify some other important symptoms,” Sutton said, pointing out that other symptoms can include sudden changes in speech, sudden changes in vision, sudden severe headache or acute dizziness.
“If you have any of these symptoms, it’s important to get help,” Sutton added. “An important tip is to take note of the time. When you get to the emergency room, we ER doctors are going to want to know how long these symptoms have been going on, and it helps direct our clinical care.”
(ORO-MEDONTE, Ontario) — When Chloe McKnight was born 15 months ago, she had what looked like a slight scratch on her forehead, according to her mom, Ashley McKnight.
As Chloe grew, the mark grew too, becoming more prominent and beginning to resemble a red stain on her forehead, according to McKnight, from Oro-Medonte, Ontario.
At less than 2 months old, Chloe was diagnosed with a hemangioma, a noncancerous tumor made up of extra blood vessels, according to the American Academy of Pediatrics.
Hemangiomas, sometimes known as baby birthmarks, are the most common benign tumors in infants, occurring in around 5% of all births in the United States, according to the AAP.
While most hemangiomas go away on their own, Chloe’s kept growing, according to McKnight.
“It didn’t look like it was reserving at all and it just gradually got larger and larger,” she said. “At first it was just really flat and red, and then it started to grow in height.”
McKnight, also mom to two sons ages 3 and 5, said she extended her maternity leave out of concern for Chloe’s safety.
“It’s basically a tumor of blood vessels that would bleed if she were to bump it,” said McKnight. “Always that was in the back of our minds, just making sure that she never hit it or anything.”
As the tumor grew, McKnight said she and her husband and Chloe’s brothers treated it as just part of Chloe, touching it and kissing it, but acknowledged that it drew attention in public.
“If you were going out, you would always be reminded of it because people would obviously look up and be curious and wonder what it is,” she said, adding that the coronavirus pandemic helped the family to be in their “own little bubble” at home.
As Chloe got older and the tumor continued to grow, McKnight said she and her husband searched for a surgeon who could remove the tumor with as little damage as possible to Chloe’s face.
Through a Facebook group for parents of children with hemangiomas, the McKnights met Dr. Gregory Levitin, director of vascular birthmarks and malformations at New York Eye and Ear Infirmary of Mount Sinai in New York City.
Levitin described Chloe’s tumor as “unusually large” and one for which “there is no textbook” when it comes to operating.
“When I get these large ones, to have one on the forehead skin is an incredibly challenging area because you don’t have a lot of extra tissue to borrow from,” he said. “It acts like a cancer in the sense that it invades and takes up valuable tissue in the face.”
In January, Chloe and McKnight traveled to New York City for Chloe to undergo surgery.
Levitin removed Chloe’s tumor in a three-hour surgery in which he focused on not only controlling the blood vessels in the tumor, but also making sure her face appeared the same after surgery.
“[The tumor] dropped and touched the muscle of the forehead, so preserving the muscle and allowing her to have facial expressions was important,” said Levitin. “We wanted the shortest scar possible and so finding ways to manipulate the tissue to get the shortest scar possible was equally important.”
Levitin was able to successfully remove Chloe’s hemangioma and the recovery has been surprisingly easy, according to McKnight.
“I feel like she had a harder time with teething pain than with this whole process,” said McKnight. “It made me realize how resilient children are.”
While the swelling on Chloe’s forehead will take more months to go down, the toddler is even more active than before surgery, according to McKnight.
“She’s go, go, go all the time,” she said. “She was just herself and off to the races.”
Levitin said he often sees a transformation like that in patients because hemangiomas can be unknowingly taxing as they take up energy stores in the body.
“They take up a lot of blood volume and, in doing so, process a lot of the blood and nutrients,” he said. “I hear many stories about parents who feel within 24 hours that there’s been a transformation in their children’s behavior and energy.”
Levitin described it as “incredibly rewarding” to be able to make such an impact on a child.
“It’s an incredibly rewarding part of my job when I can take a child from a mother’s arms and return her back to that mother’s arms afterwards completely changed and with an appearance which is how she was first born, and now how she’ll live for the rest of her life,” he said.
(NEW YORK) — Colorectal cancer is expected to claim the lives of more than 52,000 Americans this year, according to the American Cancer Society.
This is why, as the world tries to return to a sort of normalcy after the COVID-19 pandemic, doctors say health screenings — particularly for cancer — should be made an urgent priority.
“Colorectal cancer is the third-leading cause of cancer deaths in the United States, yet about a quarter of people ages 50 to 75 have never been screened for this devastating disease,” said Dr. Michael Barry, vice chair of the U.S. Preventive Services Task Force, or USPSTF, a panel of national experts in disease prevention and evidence-based medicine.
“Fortunately, we know that screening for colorectal cancer is effective and saves lives,” Barry said.
Doctors are trying to raise awareness that even people in their 40s should be getting screened. Thankfully, there are multiple ways to reduce the risk of colon cancer, including understanding when you should get screened.
Get screened: The most effective way to reduce your risk of colon cancer is to get screened routinely, beginning at age 45, according to the USPSTF. With expanded screening guidelines, more people can be screened for colorectal cancer resulting in significantly more lives saved. Several testing options are available — some are completed yearly while others may be done every 10 years. Together, doctors and patients should consider which screening option is best for them.
“Colonoscopies help identify polyps or precancerous growths as well as potentially provide treatment by removal at the same time” says Dr. Madhu Vennikandam, a gastroenterology fellow at Sparrow Hospital, an affiliate of Michigan State University College of Human Medicine.
Know your family history: Doctors say it’s essential to know whether your mother or father’s side of the family has a history of colon cancer. If there is a family history, you should begin screening at age 40, or 10 years before the diagnosis of the youngest first degree relative.
Barry adds, “people who have any signs or symptoms of colorectal cancer or a personal history of colorectal cancer, polyps, or a personal or family history of genetic disorders should talk to their clinicians to ensure that they get the care they need”.
Monitor diet: Medical experts recommend eating more fruits, vegetables, and whole grain while eating less beef, pork and processed meats.
Stop smoking: There are at least 70 chemicals in tobacco products which can cause cancer. According to a study published in the Clinical and Translational Gastroenterology journal, current smokers are estimated to have a 48% higher risk of colon cancer than people who never smoke.
Weight loss and exercise: Obesity (defined as a BMI greater than 30) is linked with a higher risk of 13 types of cancers, including colorectal cancer. In men, colorectal cancer is the most common obesity-associated cancer. With just 30 to 60 minutes of moderate to vigorous physical activity daily, you could reduce your risk of having the disease.
“Fortunately, we know that screening for colorectal cancer is effective and saves lives. If you’re 45 or older, talk to your clinician about this life-saving screening,” said Barry.
Pooja Sharma, M.D., is a family medicine resident at Emory University in Atlanta and a contributor to the ABC News Medical Unit.
(NEW YORK) — The beginning of daylight saving time marks the arrival of spring every year. For some, the time difference can cause feelings of fatigue or more serious health symptoms.
First proposed over 200 years ago as an economical suggestion to maximize daylight hours and conserve candles, we continue to “spring forward” with one 23-hour day to transition our clocks.
According to the American Heart Association, in addition to the fatigue, the transition can also affect your heart and brain. Hospital admissions for an irregular heartbeat pattern known as atrial fibrillation, as well as heart attacks and strokes, increase in the first few days of daylight saving time.
“Daylight saving time feels kind of like jetlag from traveling across time zones,” said Dr. Angela Holliday-Bell, a pediatrician and certified clinical sleep specialist.
“Your body needs time to readjust to a new light/dark cycle, so it can be hard on the body and hard on sleep,” Holliday-Bell said.
This cycle, also known as the circadian rhythm, is a fine-tuned system that our bodies use to regulate time, she said. For most people, that cycle is about 24 hours and 15 minutes.
“It dictates all the processes that occur in your body — including sleep, wake and digestion,” said Holliday-Bell. Even the immune system is controlled by your circadian rhythm, meaning “when you lose an hour, you’re losing some immune function as well,” she explains.
Sleep deprivation can also slow the executive function of the brain, which explains the increase in car accidents seen with the time transition of daylight savings. Mood can suffer too.
Experts agree that there are several strategies to prepare your body all year round and for the days leading up to daylight savings time.
Start to wind down earlier in the evening.
Even for a few days, adjusting your sleep-wake cycle can help you feel more well-rested. Try moving your bedtime up in fifteen minute increments in the days before the clock sets back, until you’ve reached the one hour you’ll lose on Sunday.
Maximize natural light.
“Light is the strongest influence on circadian rhythms,” says Dr. Holliday Bell. “Getting natural light as soon as you can when you first wake up helps to reinforce your circadian rhythm.”
Limit caffeine.
The extra coffee might feel necessary to get through the fatigue, but too much caffeine is not heart healthy. It also lasts in the body for a long time, which can affect the ability to fall asleep or sleep restfully in the evening.
Gradual lifestyle improvements all year long and a concerted effort in the days leading up to the transition can help to soften the disruption to your circadian rhythm, so you can save daylight without losing anything else.
Chidimma J. Acholonu is a pediatric resident physician at the University of Chicago and a contributor to the ABC Medical Unit.
(NEW YORK) — Health care providers that serve the transgender community in Alabama are struggling to make sense of a new bill moving quickly through the state legislature.
The Vulnerable Child Protection Act would ban gender-affirming care for transgender youth in the state.
Pediatric endocrinologist Hussein Abdullatif, who provides gender-affirming care for trans youth, said the legislation leaves many questions: Will trans youth be able to continue seeing their physicians? Will they be able to receive their medications?
“I worry about my patients,” Abdullatif told ABC News. “They already are showing a great deal of anxiety related to what’s going to happen.”
Abdullatif says it is not only his transgender patients’ physical health but also their mental health that is of concern. He said he has seen firsthand the way discrimination and lack of care can affect his trans patients.
“I do know of a kid who already attempted three times suicide — not because of law, of course, because they haven’t passed it yet — but because of resistance by the mother of the child to the idea of being transgender,” he said.
The bill states that anyone who provides gender-affirming care, including puberty blockers, hormone therapy or physical gender-affirming surgeries to anyone under 18, could be convicted of a felony and face up to 10 years in prison and a $15,000 fine.
The bill’s sponsor, Republican Sen. Shay Shelnutt, called gender-affirming health care, “child abuse.”
“We don’t want parents to be abusing their children. We don’t want to make that an option, because that’s what it is, it’s child abuse. This is just to protect children,” Shelnutt said on Feb. 23 on the state Senate floor.
Yet experts say the notion of gender-affirmation as child abuse as well as language used in the legislation — for instance — the claim that people can experience “permanent sterility, that result from the use of puberty blockers, cross-sex hormones, and surgical procedures” are forms of misinformation.
Debunking myths about transgender health care and gender-affirmation
The bill refers to “minors” and “surgical procedures” but in Alabama, gender-affirming surgeries aren’t allowed until a patient reaches the age of legal majority for medical decisions, which is 19.
“When lawmakers attempt to practice medicine with a life without a license, they realize quickly that there was a lot more they didn’t understand than what they thought they did,” said Morissa Ladinsky, an associate professor of pediatrics at the University of Alabama at Birmingham Department of Pediatrics.
The bill’s language also makes claims about mental health and gender affirmation which some experts say are false.
“Individuals who undergo cross-sex cosmetic surgical procedures have been found to suffer from elevated mortality rates higher than the general population. They experience significantly higher rates of substance abuse, depression, and psychiatric hospitalizations,” the legislation reads.
However, research from the Centers from Disease Control and Prevention found higher rates of substance abuse, depression and suicidal ideation were linked to stigma, discrimination and victimization experienced by this population.
Research shows that people who have gender-affirming surgery had significantly lower odds of psychological distress, tobacco smoking, and suicidal ideation compared with trans people with no history of gender-affirming surgery.
As for hormone therapy and puberty blockers, physicians say gender-affirming care comes after long discussions between parents and their children, as well as between families and their physicians.
Puberty blockers provide an individual and their family time to determine if a child’s gender identity is long-lasting, according to the Mayo Clinic.
Trans youth may face stress and anxiety from puberty development, including breast or facial hair growth, that does not align with their gender identity. Puberty blockers can help offer relief from that stress, experts say.
If an adolescent child stops taking the treatment, puberty resumes.
“It’s harmless and it’s not something that locks you in a certain decision that you cannot leave,” Abdullatif said.
Hormone therapy, which induces male or female physical changes, also helps address the needs of transgender teens in affirming their identity.
The legislation also makes the claim that puberty blockers can cause infertility or other health risks.
According to Ladinsky, these potential side effects only present real risks after puberty and are not a risk to youth taking puberty blockers.
Gender-affirming youth care is supported by several national medical organizations such as the American Medical Association, American Academy of Child and Adolescent Psychiatry, the American Academy of Pediatrics and the American Academy of Family Physicians.
“The worry is that we will have an epidemic of suicide because of a bill that calls itself the [Vulnerable Child Protection Act],” said Abdullatif.
Bills seen by advocates as anti-trans have also been proposed in past Alabama legislatures, as well as in states including Idaho and Arkansas. Arkansas is currently facing lawsuits against its bill that was passed into law last year despite the governor’s veto, and bans gender-confirming treatments for transgender youth.
“This is a government overreach,” Gov. Asa Hutchinson said at the news conference in April 2021.. “You are starting to let lawmakers interfere with health care and set a standard for legislation overriding health care. The state should not presume to jump into every ethical health decision.”
Ladinsky says it keeps her up at night to think about the patients who are just now understanding their gender identities.
She said she worries youth will believe “my state has made the choice to erase me.”
(NEW YORK) — Inside hundreds of pharmacies across the country, high-risk Americans who test positive for COVID-19 have been told they will soon be able to find and fill a prescription for oral medication directly at the store.
The new White House “test to treat” program, touted as a one-stop shop for antiviral pills from Pfizer and Merck, aims to create a free and streamlined approach to get sick people the lifesaving care they need, when they need it.
Although Pfizer and Merck’s COVID-19 pills were authorized in December, scarce supply has made them difficult to access.
Major pharmacies have already begun ordering their new “test to treat” supply directly from the federal government, and anticipate being able to start as early as this week. CVS will offer end-to-end access to the pills at their nearly 1,200 MinuteClinic locations as soon as this week, spokesperson Matthew Blanchette told ABC News, while a Walgreens spokesperson said patients will be able to get the antiviral pills at “select stores” where provider partners are available to assess and prescribe medication.
The idea is for everyday Americans to be able to visit their local pharmacy for a rapid test, and if positive, “you can be treated right there on the spot,” said Dr. Simone Wildes, an infectious disease expert from South Shore Health.
As clinic doors open to this new initiative, however, numerous puzzle pieces must align to ensure the smooth rollout the president has hoped for.
“We’re leaving no one behind or ignoring anyone’s needs as we move forward,” President Joe Biden said of the plan during his State of the Union address last week, emphasizing his administration has “ordered more pills than anyone in the world has.”
The program’s promised scope hinges on sufficient participating locations and drug supplies.
And in a development that could jeopardize the program’s future, House Speaker Nancy Pelosi announced this week that COVID-19 funding would be stripped from an upcoming government funding and Ukraine emergency aid package — an element hotly contested by some members.
Without this additional pandemic funding, the White House has warned there could be “dire” consequences: the U.S. could run out of pill supplies by the end of the summer.
The government has so far purchased 20 million doses of Pfizer’s COVID-19 pill, Paxlovid, although it’s not expected to be widely available until later this spring.
And there are other hurdles. Test to treat’s reach is bounded by the requirement that there must be a prescribing health care provider on site, a feature at a fraction of the tens of thousands of pharmacies in the country.
Some pharmacy groups have chafed against the required authority, like a nurse practitioner or physician’s assistant, who must prescribe the pills on-site.
“We were anticipating something that would really have an impact on the pandemic and on patients being able to access medications and instead we’re underwhelmed with the missed opportunity of what this could have been,” said Michael Ganio, American Society of Health-System Pharmacists’ senior director of pharmacy practice and quality.
While the plan is a step in the right direction, “further action is needed” to enhance equity and access, National Association of Chain Drug Stores’ President and CEO Steven Anderson said, adding that the current test-to-treat plan “does not leverage fully the health and wellness professionals and access points in America’s pharmacies.”
Conversely, the American Medical Association called the plan “well-intentioned” but that it “oversimplifies challenging prescribing decisions by omitting knowledge of a patient’s medical history, the complexity of drug interactions, and managing possible negative reactions.”
The drugs are not appropriate for everyone. Merck’s Molnupiravir, for example, is not recommended during pregnancy or for minors, while Pfizer’s Paxlovid runs the risk of negatively interacting with other commonly prescribed drugs, including medicines that manage heart conditions and cholesterol, and those with severe kidney or liver problems.
Another issue, doctors say, is that patients will need to start taking the pills within days of developing symptoms, which means participating stores need to be convenient enough to access quickly, and with enough rapid tests to diagnose in time.
To connect patients with convenient pickup sites, the government is developing a website to help people find a site near them, set to launch later this month.
“The biggest issue is making sure that you get seen and diagnosed rapidly because you’ve got a five-day window of opportunity for Paxlovid to be optimally effective,” said Dr. Amesh Adalja, senior scholar at Johns Hopkins Center for Health Security and an infectious disease physician.
“If you’re a high-risk individual, you want to make the diagnosis as quickly as possible,” said Dr. Todd Ellerin, director of infectious diseases at South Shore Hospital. “And then make contact with a health care provider.”
(NEW YORK) — A group of kidney donors is going to great heights to educate others about being a live organ donor.
The Kidney Donor Athletes, a national organization working to educate and change the perception around live organ donation, is doing so through their “one kidney climb.” This year, on March 10, which marks World Kidney Day, the group of 22 kidney donors are climbing to the summit of Mount Kilimanjaro in Tanzania.
“The purpose of this climb is to show people around the world that it’s possible to thrive on one kidney,” Tracey Hulick, founder of Kidney Donor Athletes, told ABC News’ Good Morning America.
Hulick and the rest of the climbers are part of 22 separate donation chains. When someone donates to a stranger on behalf of someone they know, it sets off a chain reaction and an opportunity for many more lives to be saved. The donors who are taking part in the climb have different reasons for donating.
“Growing up, I had a classmate who passed away because he couldn’t find a bone marrow donor,” Samantha Carreiro of Dover, New Hampshire, said. “In that moment, I kind of just knew that given the chance to help somebody eventually in my life, I would do so.”
Carreiro eventually donated a kidney to a spin instructor at a gym she belonged to for years. She learned that he needed a kidney and knew this was something she was supposed to do.
For Steve Wilson of Katonah, New York, he was inspired to become a kidney donor after learning about his high school acquaintance’s daughter, who received a life-saving kidney transplant from a woman in their hometown.
He said he was “excited” for the recipient and her parents and was deeply moved by the “ultimate act of selflessness” from the donor. Wilson said he later donated his kidney to a 53-year-old woman in Seattle.
“It’s a way to leave an imprint on the world, to make somebody’s life better, to give somebody else a second chance at life,” Wilson added. “To see their children grow up and maybe their grandchildren.”
Patients need kidney transplants if theirs start to fail and are no longer able to rid the body of toxins, according to the University of Chicago Medicine. Patients can become tired, lose their appetite, become nauseous and wind up ill.
There are approximately 97,000 people on the National Kidney Transplant List, and more than 3,000 are added to the list each month. However, many patients spend years on the waiting list because there aren’t enough organs available, according to the University of Chicago Medicine.
The National Kidney Foundation notes that 13 people die each day while waiting for a life-saving kidney transplant.
Through their climb, the Kidney Donor Athletes are hoping to get the message out there that it’s possible to live on one kidney, and they hope to inspire others to donate, too.
“Something that’s important to all of us is to normalize kidney donations,” Patty Graham, a Kidney Donor Athlete from Boulder, Colorado, said. “We’re not heroes, we’re normal people. We lead normal lives. In fact, all the donors — I know our lives are even better and more enhanced after donation.”
“What is life if we’re not helping each other?” Carreiro added.
(NEW YORK) — Despite being among the first eligible for COVID-19 booster shots, many nursing homes are struggling to boost residents and staff, experts say.
Nationally, about 72% of residents are boosted in each nursing home, according to data from the Center for Medicare & Medicaid Services.
But in about one-third of U.S. states, booster rates for residents are less than the national average among nursing homes, and three states have yet to crack an average of 60% of residents boosted in each facility.
Booster shots have been shown to be more protective against omicron and other COVID-19 variants. And nursing home residents continue to be among the most vulnerable people in terms of potential for severe illness and death — nearly 151,000 people in nursing homes have died since the beginning of the pandemic, CMS data shows.
While significantly higher than the 44% of Americans who have received a booster, experts say levels in nursing homes are lower than they’d like to see. Ideally, they should match the rate of vaccination — currently 87% of residents fully vaccinated per facility.
When it comes to booster uptake among nursing home staff members, the numbers are even lower than residents.
Only about 39% of staff members per facility have received booster shots, the CMS data shows, and more than half of states have rates below the national average of nursing homes.
“People may feel like, ‘Well, you got two shots and there’s no value’ or even ‘You had two shots and you had COVID already,'” Dr. Cindy Prins, an associate professor of epidemiology at the University of Florida College of Public Health and Health Professions, told ABC News. “I think we need to remember that our immunity can wane, especially in our older folks, and they need to keep getting that renewed protection and the booster will give them that.”
In three states, less than 60% of nursing residents are boosted on average
It’s well known that nursing home residents are among the highest at risk for severe COVID-19 complications due to their ages, likelihood of underlying conditions and the fact that they live in congregate settings.
“The other caveat to understand is that, in those that are over the age 65, sometimes it’s a little more difficult for them to develop responses to vaccines,” so getting a booster helps them mount an immune response, Dr. Katherine Baumgarten, medical director for infection prevention at Ochsner Health System in New Orleans, told ABC News.
Yet some nursing homes have been struggling to boost their residents. In three states — Florida, Arizona and Nevada — not even 60% of residents per facility on average have been boosted.
Florida has the lowest rate in the country at about 55%. By comparison, South Dakota has the highest rate at 87.56%.
The Florida Department of Health did not reply to ABC News’ request for comment on why rates are low.
“It’s absolutely something to be concerned about. That’s unacceptable,” Dr. David Grabowski, a professor of healthcare policy at Harvard Medical School, told ABC News. “With omicron and with potential new variants, having the most vulnerable individuals — these residents in nursing homes that have been the hardest hit by the pandemic — to have them not fully protected is really unfortunate.”
A February 2022 preprint study from France found nursing home residents who received a booster shot of the Pfizer-BioNTech vaccine had high levels of neutralizing antibodies against infection from the delta and omicron variants for at least three months.
Prins said she believes part of the reason booster uptake is low among the resident population in some states is because boosters were not promoted as much as the initial vaccines.
“In Florida, the initial vaccines were very much promoted for our older population,” she said. “It was very strongly put out there that seniors were first and they were going to get vaccinated.”
Prins continued, “But I didn’t see that same messaging with the booster. We haven’t placed the same emphasis on it at the state level that we did with that initial vaccine campaign for seniors.”
There are other theories for why the booster rate among nursing homes residents is lower than public health experts would like it to be.
Grabowski said the initial vaccine rollout was centralized, with the federal government partnering with CVS and Walgreens to distribute the shots to nursing homes.
“When it came time to do the booster rollout, this was really left up to the nursing homes to handle the booster clinics,” he said. “They do a flu vaccine every year for staff and residents and there was some thought that they could do this. Some did but there was also some really slow rollout that highlighted the haves and have nots across nursing homes.”
Grabowski continued, “Nursing homes were dealing with a lot during that period, and this was not something that was prioritized in those facilities and we’ve seen those low rates.”
Booster rollout has been slow among staff
Experts say it’s not just the elderly population in nursing homes who have been slow to get boosted — it’s also staff members.
According to CMS data, 12 states don’t even have an average of 30% of staff with boosters per facility. Florida is once again the state with the lowest rate at 24.52% while California has the highest rate at 68.58%.
Prins said it is possible the low booster rates for nursing home staff are partially due to many being ineligible for a third dose because they completed their vaccine series less than five months ago.
But she believes “that does not cover the extent of that lower booster rate” and said the low numbers are “concerning.”
“When you have this kind of facility, the virus gets brought in obviously, and it’s coming in with the people who are most mobile and most often there and that’s going to be your staff members,” Prins said. “[The low number] is absolutely a worry because that puts residents at high risk.”
Since the omicron wave, weekly cases and deaths in nursing homes have declined drastically. However, during the week ending Feb. 20, 2022, there were 620 resident deaths, the highest number since the week ending Jan. 2.
Mandates may be the only way to increase booster rates
The experts say there are a few ways to try and drive booster rates up in nursing homes.
Grabowski said for residents, it would help for the booster rollout to be more centralized with clinics set up by the federal government rather than left up to individual facilities.
However, he believes it will take mandates for booster rates among staff to rise dramatically. As of Tuesday, five states require COVID boosters for nursing home workers: California, Connecticut, Massachusetts, New Mexico and New York.
“The mandates are important here,” he said. ‘I think with boosters, with staff, it’s probably going to take mandates to make sure they go forward with the booster.”
The doctors add that, in addition, it could help to do sit-downs with small groups of nursing home staff to address their concerns and explain why boosters are beneficial. Baumgarten suggested this could include dispelling the ideas that boosters are ineffective or that they don’t reduce the risk of breakthrough infections.
“Nursing homes are a vulnerable population and we want to protect those who are vulnerable,” she said. “Everything that we can do to prevent them from being exposed or at risk for developing COVID important for us to do. If it’s simple enough to get a booster — which it is, they’re readily available, side effects are minimal — we should do that to help protect those around us.”
(NEW YORK) — Pfizer announced Wednesday it is launching a clinical trial to study the effectiveness of its COVID-19 antiviral pill in young children.
The treatment, Paxlovid, was authorized in December 2020 by the U.S. Food and Drug Administration for emergency use in patients aged 12 and older who have mild-to-moderate symptoms and are at increased risk of severe illness.
The new trial is planning to enroll 140 children between ages 6 and 17 who will be split into two groups.
One group will weigh between 44 and 88 pounds and the other groups will weigh more than 88 pounds.
The group that weighs more than 88 pounds will be given the dose currently authorized for teens and adults while the group that weighs less will be given a smaller dose.
“Since the beginning of the pandemic, more than 11 million children under the age of 18 in the United States alone have tested positive for COVID-19, representing nearly 18% of reported cases and leading to more than 100,000 hospital admissions,” Mikael Dolsten, chief scientific officer and president of worldwide research, development and medical at Pfizer, said in a company statement.
“There is a significant unmet need for outpatient treatments that can be taken by children and adolescents to help prevent progression to severe illness, including hospitalization or death,” Dolsten said.
Children under age 6 will not be included in this study, but Pfizer said research is ongoing to determine the best dose for the youngest of children
Pfizer’s pill was hailed as a game-changer because it was the first COVID treatment that did not require an infusion, making it more convenient to give to patients.
The pill is made up of two medications: ritonavir, commonly used to treat HIV and AIDS, and nirmatrelvir, an antiviral that Pfizer developed to boost the strength of the first drug.
Together, they prevent an enzyme the virus uses to make copies of itself inside human cells and spread throughout the body.
Paxlovid is currently given as three pills twice daily over the course of five days.
Clinical trial data showed the pill reduced the risk of hospitalization and death for COVID patients by 89% within three days of the onset of symptoms compared to a placebo.
According to clinicaltrials.gov, the pediatric trial has three locations including Mississippi, South Carolina and Texas.
ABC News’ Sony Salzman contributed to this report.
