Health

(NEW YORK) — It was more than 90 degrees in Moranda Rasmussen’s Portland, Oregon, apartment during a historic heat wave late last month when the 27-year-old began to panic. They have cerebral palsy and depression and rely on Supplemental Security Income while they work on their degree.

They said they couldn’t afford an air conditioner and couldn’t charge their electric wheelchair battery because it could easily overheat. Taking antidepressants also wasn’t an option, because it makes it difficult to regulate their body temperature.

Rasmussen said they were left scrambling for a solution to escape the searing heat, which reached a high of 115 degrees. In Portland, the average high temperature in June is around 74 degrees.

“We don’t get temperatures like that in the Pacific Northwest,” Rasmussen said. “I was just really frantic. What if we have more days like this? When am I going to be able to take my medication again? When am I going to be able to charge my wheelchair again?”

With heat waves battering the Northwest and Northeast and heatwave season extending and intensifying, people with disabilities like Rasmussen are preparing for the worst. Though climate change is impacting communities across the globe, experts say disabled people will likely be adversely affected by global weather extremes, including events where evacuation is needed.

It is unclear how many of the 106 people who are believed to have died due to the heat wave in Oregon were disabled. In Multnomah County, many of those who died were found alone and without air conditioning or a fan, according to the county medical examiner. According to the Centers for Disease Control and Prevention, more than half of the people who die from hyperthermia-related causes, when the body is unable to cool itself, had an underlying cardiovascular condition.

Multnomah County Chair Deborah Kafoury has since demanded that local agencies work to open three 24-hour cooling centers and nine cooling spaces, reach out to seniors, people with disabilities and pregnant women directly, and coordinate with 60 outreach groups focused on people without housing or shelter.

Rasmussen, along with climate and disability activists, is calling on policymakers to not only remember disabled residents in their emergency plans but to turn the tide on climate change in an effort to mitigate the plights of people with disabilities in the future.

“Disabled people are the first people to be set aside,” Rasmussen said. “A lot of policy around disabled folks needs to change.”

1 in 4 adults in the US

In a study by the United Nations, the organization affirmed that climate change will continue to have direct and indirect impacts on the human rights of people with disabilities. In climate emergencies, disabled people disproportionately experience higher rates of morbidity and mortality, and are typically the least able to access emergency support, the study said.

The Centers for Disease Control and Prevention defines a disability as any mental or physical condition that makes it “more difficult for the person with the condition to do certain activities” or “interact with the world around them.” Some 61 million adults, or 1 in 4, have a disability in the United States, and roughly one billion people across the globe have some kind of disability.

The diverse population includes people with mental illnesses, chronic health conditions, physical or visual impairments and others.

“I cannot sweat to cool down my body — if it’s a very hot day, I don’t have that thermoregulation,” said Alex Ghenis, a disability and climate activist who founded Accessible Climate Strategies, a disability consulting organization, who has a severe spinal cord injury and lives in Oakland, California. “Anybody really with a cardiovascular or chronic health condition is going to be disproportionately affected by extreme heat events on the physiological level.”

However, the way that climate change affects people with disabilities is as diverse as the population.

“With folks experiencing the effects of wildfire smoke, a lot of disabilities have respiratory components to them,” Ghenis said. “Someone with asthma is going to have a hard time with smoke, and someone who uses a ventilator is going to have a hard time with the smoke.”

Director of the Disability Mobility Initiative Anna Zivarts said her organization aims to help people who don’t have transportation or accessible forms of public transportation to get around.

Transportation is vital to escaping wildfires, heading to a cooling shelter, stockpiling goods during an emergency, or getting to a health professional. Even when they arrive, many public facilities are inaccessible to people with mobility impairments, service animals and more.

Almost 14% of disabled people have a mobility disability, with serious difficulty walking or climbing stairs, according to the CDC.

Disabled people are also more likely to be impoverished and experience high unemployment rates, according to the National Council on Disability, an independent U.S. agency.

“Many folks in the disability community are poor,” Zivarts said. “So they can’t afford to flee, to relocate, to get air conditioners, to have a car, to hire an Uber. There’s so many reasons that people get trapped or stuck in situations that are really, really harmful.”

This often gives them a disadvantage when it comes to fighting, escaping, or living with the consequences of climate change.

A way forward

Climate activists, in agreement with the United Nations’ findings, recommend collaborations with leaders of the disability rights movement to create accessible and disability-inclusive solutions to climate change and emergency events.

“We are constantly having to move and live in a world that doesn’t exist for us,” Marlena Chertock said. “People are forced to create workarounds and build things that work for themselves and come up with creative solutions. So, there’s a lot that people could learn from people with disabilities.”

Columbia University’s Climate Adaptation Initiative states that protections for people with disabilities are essential in emergency planning and that as long as much of the country’s infrastructure remains inaccessible, it prioritizes the non-disabled and puts disabled people at risk.

Ghenis said that the solutions range from simple fixes — like, making emergency shelters accessible and providing quality public transportation — to structural changes that could lift disabled people out of poverty and ensure that they’re protected in an emergency.

Rasmussen went online to vent about their poor living conditions — and after their plea for help went viral, they were able to crowd-fund an air conditioner. They want lawmakers to know that disabled activists are prepared to hold them accountable.

“One of the biggest things that lawmakers and policymakers can do is really put pressure on these corporations to do better,” Rasmussen said. “Things definitely need to change.”

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(NEW YORK) — One 9-year-old is getting an early start in the medical field.

When Angelica Gunn, 30, from Belton, Missouri, started having intense contractions on June 28, her husband was at work. A week before her expected due date of July 9, and having gone into false labor just a couple days prior, Gunn wasn’t sure if this time was the real deal.

“Then midday the contractions just kicked in really hard,” Gunn told ABC News’ Good Morning America. “I felt the urge to push all of a sudden.”

With no one home but her daughter Aakayla, 9, and her son, 4, Gunn knew she would have to ask for Aakayla’s help in delivering the baby.

“I just screamed for my daughter to come in,” she said. “I was like, ‘Something’s happening, you’re going to have to look and tell me what’s going on because I don’t know.’ I kind of just felt intense pressure and like [the baby’s] head was coming out.”

Initially, Gunn was worried about having her daughter help at a young age, but knew the baby was coming no matter what and that she would need assistance to deliver safely.

“In that moment I was like, this is a moment we’re going to have to share together and it’s a bond her and her sister will have forever,” she said. “All that other stuff just went away out of my mind and I focused on the moment at hand.”

A nurse and certified doula, Gunn was able to coach her daughter through the delivery while also weathering the contractions and pushing.

“I think that my instincts kicked in,” she said. “I was able to help her even though I was still screaming in pain.”

At first, Aakayla was hesitant but then “hopped right in,” said Gunn.

“I think in that moment she realized, ‘OK, it’s just me and mommy. I’m going to have to help her because daddy’s not here,'” Gunn said. “It’s kind of just amazing how she did that. She didn’t cry, she didn’t freak out or anything.”

Aakayla brought her mom towels and when it was time for the final push about three hours later, she was able to grab her new baby sister Aubree and hand her up to her mom.

“She’s very bold and very brave for doing all of that,” Gunn said.

Paramedics arrived soon after Gunn gave birth, taking mom and daughter to the hospital to make sure everything was OK.

Gunn added of Aubree: “She’s doing good and the kids love [her] — they’re just wanting to hold her 24/7.”

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(NEW YORK) — A highly contagious variant of the novel coronavirus that was initially identified in India is now the dominant strain in the United States, according to the Centers for Disease Control and Prevention.

Data updated by the CDC on Tuesday evening shows the so-called delta variant, also known as B.1.617.2, was estimated to account for 51.7% of all new cases of COVID-19 across the country as of July 3.

The variant, which has been detected in all 50 states, was also estimated to account for more than 50% of new cases in five of the 10 regions into which the U.S. Department of Health and Human Services divides the country. HHS Region 7 — compromising Iowa, Kansas, Missouri and Nebraska — had the highest at 80.7%.

“Variant proportions are dynamic and difficult to predict due to reporting delays, the presence of multiple variants, and changing incidence,” the CDC told ABC News in a statement on Tuesday evening.

A little over a month ago, CDC data showed the delta variant was estimated to account for just 3% of all new cases in the U.S..

Health officials and experts alike have warned that the delta variant is a more infectious version of the disease, and preliminary data indicates it may increase the risk of hospitalization. The variant has also shown to be particularly dangerous to those who are unvaccinated or partially vaccinated against COVID-19.

However, current evidence suggests that the full dosage of a COVID-19 vaccine is highly effective in preventing hospitalizations and serious illness.

After being initially identified in India in October, the delta variant has since been reported in at least 98 countries around the globe, according to the World Health Organization. It was first detected in the U.S. in March.

The WHO declared delta a “variant of concern” in May, and the CDC upgraded its classification of the strain last month from “variant of interest” to a “variant of concern.” Both the WHO and the CDC say that variants of concern have shown to spread more easily than others and cause more severe disease.

During a press briefing on July 2, WHO director-general Tedros Adhanom Gebreyesus warned that the delta variant is “spreading quickly in countries with low and high vaccination coverage.” He noted that the variant continues to evolve and mutate, which requires constant evaluation and “careful adjustment of the public health response.”

“We are in a very dangerous period of the pandemic,” Tedros said.

CDC director Rochelle Walensky said health officials are concerned about the delta variant mutating to a point where it evades the existing COVID-19 vaccines.

“That’s really what we’re actively trying to prevent, which is why we’re really encouraging people to get vaccinated,” Walensky told ABC News in an interview last month. “I will say, as worrisome as this delta strain is with regard to its hyper-transmissibility, our vaccines work. Right now, they are working and they require actually two doses or to be fully vaccinated to work. So I would encourage all Americans to get your first shot and when you’re for your second, get your second shot and you’ll be protected against this delta variant.”

Since the start of the pandemic, the U.S. has reported more than 33.7 million confirmed cases of COVID-19 and over 605,000 deaths from the disease, according to data collected by Johns Hopkins University.

More than 182 million people in the U.S. have received at least one dose of a COVID-19 vaccine, including over 157 million — 47.5% of the population — who are fully vaccinated, according to the CDC.

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(WASHINGTON) — President President Joe Biden is doubling down on efforts to get more Americans vaccinated despite missing his self-imposed Fourth of July deadline of having 70% of American adults vaccinated with at least one dose and 160 million people fully vaccinated.

The president was briefed on the state of the coronavirus by his COVID-19 response team Tuesday afternoon and continued to urge Americans to roll up their sleeves and get vaccinated — particularly as the delta variant continues to spread across the country.

“Our fight against this virus is not over. Right now, as I speak to you, millions of Americans are still unvaccinated and unprotected. And because of that, their communities are at risk, their friends are at risk, the people that they care about are at risk. This is an even bigger concern because of the delta variant,” Biden said in remarks Tuesday afternoon.

The president said one topic of discussion during his briefing was the alarming rate of spread for the variant he described as “more easily transmissible” and “potentially more dangerous.”

“It seems to me it should cause everybody to think twice. And it should cause reconsideration, especially to young people who may have thought that they didn’t have to be vaccinated, didn’t have to worry about it and didn’t have to do anything about it up to now.”

The president stressed the efficacy of the vaccine against the delta variant, and said the administration’s efforts to get more shots into arms was far from over — pledging to “devote the remainder of the summer to a special focus on five ways to make gains” in the vaccination rate, in part by turning to a hyperlocal focus in place of mass vaccination sites.

“We need to go to community by community, neighborhood by neighborhood and, oftentimes, door to door — literally knocking on doors — to get help to the remaining people protected from the virus,” Biden said.

“We’re gonna put even more emphasis on getting vaccinated in your community, close to home, conveniently, at a location you’re already familiar with,” Biden said, “First thing we’re gonna do, this includes 42,000 local pharmacies where folks with questions can talk to the pharmacists they know and already have … dealt with.”

The White House will also focus on getting the vaccines to more family doctors and health care providers, according to Biden, to allow those hesitant to get the vaccine “from the folks that they know and they trust the most.”

The administration will also increase the number of vaccines available to pediatric doctors in an effort to ramp up rates among children 12 to 18 as they prepare for the upcoming school year.

Biden reiterated the administration’s call to employers to reduce barriers for their employees to get their shots and said the administration would expand their mobile clinic outreach in an additional effort to meet Americans where they already are.

“At special events, summer festivals, sporting events, as well as places of worship, wherever we can find people gathered,” he said

The White House faces an uphill battle on that front. A new ABC News-Washington Post poll found that among unvaccinated Americans, 74% said that they are unlikely to get the vaccine.

White House press secretary Jen Psaki was pressed Tuesday afternoon about the polling and if unvaccinated Americans were still persuadable. Psaki said that the community approach was already having an impact.

“So, we’ve seen, actually, even people who didn’t — had no intention of getting the vaccine for a range of reasons, maybe they didn’t know how to get it, maybe they don’t know where to get it, maybe they were scared of the impacts, actually get vaccinated. And that, to us, is an encouraging sign that we can continue to press and make progress moving forward,” she said.

While neither of Biden’s July Fourth goals have been met, the president did tout the strides the U.S. has made under his administration, teasing that his goal of having 160 million Americans fully vaccinated should be met at the end of this week — only a few days off from his self-imposed deadline.

“We can’t get complacent now. The best thing you can do to protect yourself and your family and the people you care about the most is get vaccinated. The best thing the community can do to protect themselves is to increase vaccination rates. You can do this. You can do this. Let’s finish the job, finish it together,” he said.

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(LEAGUE CITY, TX.) — Nearly 150 children and adults have tested positive for COVID-19 after attending a church summer camp in Texas, officials announced.

The Clear Creek Community Church, based in League City, Texas, announced that Sunday services would be canceled this week due to the number of cases.

Over 400 people participated in Camp Creek, a four-day camp for 6th to 12th graders, in late June.

Upon returning, more than 125 of the people who attended tested positive for the virus, the church said in a statement, and “hundreds more were exposed to COVID-19 at camp.”

The Galveston County Health District, which is investigating the outbreak, told ABC News that 57 Galveston County youth and adults who attended the camp tested positive for COVID-19 and more than 90 people, including non-Galveston County residents, have self reported to the district that they tested positive for the virus, bringing the total tally to at least 147.

It’s not clear if the campers who are eligible for the vaccine were vaccinated prior to the camp trip. The church has not responded to ABC News’ request for comment.

The church is contacting all those impacted.

“From the beginning of the pandemic, we have sought to love our neighbors by practicing strict safety protocols. We are surprised and saddened by this turn of events. Our hearts break for those infected with the virus,” Bruce Wesley, the church’s lead pastor, said in the statement.

The church recommended in-person worship starting April 7 and allowed for the removal of masks in May, in accordance with the state’s phased reopening.

The Galveston County Health District was notified of the first positive case tied to the camp on June 27, GCHD said in a release.

GCHD officials told ABC News on Tuesday the delta variant was identified in three test samples tied to the outbreak, and additional samples are being tested.

Of the 57 Galveston County cases, six are breakthrough cases, defined as someone becoming infected more than 14 days after their second COVID-19 vaccination, according to the department.

In total, 47 of the cases are among those 12 years and older, and 10 cases are in children younger than 12.

“This is a reminder that COVID-19 is still here and we have to take precautions,” Dr. Philip Keiser, the Galveston County local health authority, said. “If you’re old enough to get vaccinated and haven’t, now is the time. These vaccines are safe and offer the best protection against COVID-19 to you, your family and your community.”

In Galveston County, the population of those aged 12 and up is 57% partially vaccinated and 52% fully vaccinated. Overall in Texas, 51% of the population aged 12 and up is fully vaccinated, per state data.

White House officials recently said younger Americans seem “less eager” to get the COVID-19 vaccine. At the moment, anyone 12 and older can receive the Pfizer vaccine. Those who are 18 and older are eligible for the Moderna and Johnson & Johnson vaccines.

“Younger people, particularly those in their 20s, have felt less vulnerable to the disease and, therefore, less eager to get shots. They were made eligible later, so they have not been eligible as long, and we continue to see hundreds of thousands of young people vaccinated each week,” White House COVID-19 Response Coordinator Jeff Zients told ABC “This Week” co-anchor Martha Raddatz.

In a new ABC News/Washington Post poll, among those not vaccinated, 74% said they probably or definitely won’t get a shot, which is up from 55% in April.

The result may be increased cases among youth. Centers for Disease Control and Prevention data released July 2 shows that confirmed COVID-19 admissions among those under 18 increased 11% over the past week.

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(LEAGUE CITY, TX.) — More than 125 children and adults have tested positive for COVID-19 after attending a church summer camp in Texas, officials announced.

The Clear Creek Community Church, based in League City, Texas, announced that Sunday services would be canceled this week due to the number of cases.

More than 125 children and adults have tested positive for COVID-19 after attending a church summer camp in Texas, officials announced.

The Clear Creek Community Church, based in League City, Texas, announced that Sunday services would be canceled this week due to the number of cases.

It’s not clear if the campers who are eligible for the vaccine were vaccinated prior to the camp trip. The church has not responded to ABC News’ request for comment.

The church is contacting all those impacted.

“From the beginning of the pandemic, we have sought to love our neighbors by practicing strict safety protocols. We are surprised and saddened by this turn of events. Our hearts break for those infected with the virus,” Bruce Wesley, the church’s lead pastor, said in the statement.

The church recommended in-person worship starting April 7 and allowed for the removal of masks in May, in accordance with the state’s phased reopening.

The Galveston County Health District is investigating the outbreak.

The department was notified of the first positive case tied to the camp on June 27, GCHD said in a release.

“This is a reminder that COVID-19 is still here and we have to take precautions,” Dr. Philip Keiser, the Galveston County local health authority, said. “If you’re old enough to get vaccinated and haven’t, now is the time. These vaccines are safe and offer the best protection against COVID-19 to you, your family and your community.”

In Galveston County, the population of those aged 12 and up is 57% partially vaccinated and 52% fully vaccinated. Overall in Texas, 51% of the population aged 12 and up is fully vaccinated, per state data.

White House officials recently said younger Americans seem “less eager” to get the COVID-19 vaccine. At the moment, anyone 12 and older can receive the Pfizer vaccine. Those who are 18 and older are eligible for the Moderna and Johnson & Johnson vaccines.

“Younger people, particularly those in their 20s, have felt less vulnerable to the disease and, therefore, less eager to get shots. They were made eligible later, so they have not been eligible as long, and we continue to see hundreds of thousands of young people vaccinated each week,” White House COVID-19 Response Coordinator Jeff Zients told ABC “This Week” co-anchor Martha Raddatz.

In a new ABC News/Washington Post poll, among those not vaccinated, 74% said they probably or definitely won’t get a shot, which is up from 55% in April.

The result may be increased cases among youth. Centers for Disease Control and Prevention data released July 2 shows that confirmed COVID-19 admissions among those under 18 increased 11% over the past week.

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(NEW YORK) — While COVID-19’s surge has ebbed, violence is on the rise across the United States.

There has been a rash of gun violence in what President Joe Biden called an “epidemic,” including several public mass shootings, increases in incidents in major metropolitan areas and an uptick in road rage clashes.

While dramatic declines in levels of coronavirus have engendered new hope and optimism for some, the effects of the pandemic and the measures taken to combat it linger, simmering tensions brought to a boil and manifesting themselves in anger, and in some cases, violence, experts say.

Federal authorities saw that swell in violence spurred on by COVID’s hardships coming — before the pandemic even got into full swing.

An internal Department of Homeland Security memo obtained by ABC News from spring of 2020 warned that the emotional, mental and financial strain exacerbated by the new coronavirus pandemic combined with social isolation — especially if prolonged — may “increase the vulnerability of some citizens to mobilize to violence.”

“The outbreak of Covid-19, and government’s response to it, have intensified concerns that could accelerate mobilization to violence with extended periods of social distancing,” the memo reads, noting such isolation is a “known risk factor” in inciting violent extremism, along with “financial stress and work disruptions, including unexpected unemployment and layoffs” also “increasing.”

Even as the nation and globe was locking down, the memo, which has not been previously reported, urged agency partners to develop an “action plan” for when communities begin to return to “normal” activities, predicting “the increase in mass gatherings, combined with the lengthy social isolation and other life stressors,” may create environs churned up by COVID, and ripe for violent upheaval.

When reached by ABC News regarding these early warnings, DHS declined comment.

As a tentative reopening got underway in May, DHS Secretary Mayorkas established the Center for Prevention Programs and Partnerships, and a domestic terrorism branch in the Department’s Office of Intelligence & Analysis, aimed at shoring up the Department’s “whole-of-society approach” to thwarting extremisim and other targeted violent acts in the U.S.

Attorney General Merick Garland announced a ‘renewed commitmen’t and multi-pronged Justice Department effort to reduce violent crime through community engagement, targeted enforcement, and interagency collaboration.

Violent crime has “spiked since the start of the pandemic over a year ago,” President Biden said in late June, announcing a range of actions and federal support towards targeting gun violence.

“And as we emerge from this pandemic with the country opening back up again, the traditional summer spike may even be more pronounced than it usually would be,” Biden said.

Pandemic a ‘tipping point’

It wasn’t just federal officials sounding the alarm last year. Doctors — including psychologists — say the pressure of the pandemic may be exacerbating acts of violence and aggression.

“COVID has been a tipping point,” Dr. Aimee Harris-Newon a clinical psychologist in Chicago who focuses on wellness and preventive care. “On top of too much chronic stress, the impact of all this trauma… now everything is starting to leak out.”

And some experts say psychological stressors were already mounting prior to the pandemic.

“We were already in a weakened condition when the pandemic hit — class divisions, overt racism, partisanship, a really poor social support infrastructure — so if you think about the effect of the pandemic on an ‘epidemic’ of shootings — it’s like the immune system of the United States was already suppressed,” Jeffrey Butts, director of the research and evaluation center at John Jay College of Criminal Justice, told ABC News.

“The social, psychological and economic distress in our country has surpassed people’s ability to cope, and there hasn’t been enough support,” added Dr. Marni Chanoff, a psychiatrist and founder of the integrative wellness group at McLean Hospital. “There is no road map on how to navigate this time.”

‘COVID turned up the volume’

When Mohammed Abdelmagied heard loud bangs near his Times Square kebab and hot dog stand the last Sunday in June, he thought it was firecrackers — someone celebrating an early Fourth of July, or maybe freedom from COVID-19.

It wasn’t: it was gunfire: something he never expected in the area where he’s worked for 13 years — a heavily policed place where shootings have been relatively rare.

“I turn my face to the square, I heard everything but I didn’t see nothing,” Abdelmagied, 46, told ABC News.

Two shootings in two months at the Crossroads of the World have brought a flood of police to the area, in a city that until recently had become a model of safety in major metropolitan areas. These flares of gunfire aren’t only in New York, nor have they remained only within city limits across the country.

Major U.S. cities have been rocked by spates of gun violence over the past few months, part of an already rising trend which did not stop during lockdown, but has become more visible as the country reopens.

“Shortly after a resumption of ‘normal’ life,” the memo from spring of 2020 says, tensions already brewing, then exacerbated during the pandemic, may provide an opportune moment for violent extremism, and violent attacks.

Not including suicides, more than 19,400 people died by gun violence in 2020, up from roughly 15,440 in 2019, and far past the rates in years prior, according to Gun Violence Archive, a nonprofit research group.

In 2021, there have already been more than 10,000 gun violence deaths — with nearly six months left to go.

“Covid turned up the volume,” and has fomented a disintegration of social connections and norms, Butts said.

“Then we see some of these horrible shootings — the actual magnitude of the increase is undeniable,” Butts added.

It’s not just gun violence on the rise: acts of aggression on airplanes have also hit new highs — and not only more flight disruptions, but more violent ones as well.

The Federal Aviation Administration is investigating a record number of potential violations of federal law in unruly passenger cases — identifying more than 490 cases this year so far where passengers potentially broke the law by “interfering with the duties of a crew member.” That’s more than double the amount of cases investigated in 2020; and more than two and a half times the amount in 2019.

Airlines have now reported more than 3,200 reports of disruptive passengers to the FAA this year; the vast majority — more than 2,400 — involve people who refused to wear a mask.

In a Homeland Security Threat Assessment released in October 2020, authorities also underscored concerns arising from COVID-19’s impact, where “anti-government and anti-authority violent extremists could be motivated to conduct attacks in response to perceived infringement of liberties and government overreach as all levels of government seek to limit the spread of the coronavirus that has caused a worldwide pandemic.”

Isolation effect

While social media helped maintain personal connections during quarantine, it can also be quite alienating, experts say — and present an opportunity for online radicalization.

In addition, pandemic job loss can be both heavy financial and psychological burdens.

And the unprecedented loss of life and loved ones to the virus, with more than 600,000 deaths in the U.S. alone, has taken an unspeakable toll, experts say.

Isolating factors like these can increase the risk of engaging — or attempting to engage — in violent extremism, according to the DHS memo.

“These risks are likely to become more widespread as public health measures are expanded — or the timeframe for maintaining social distancing increases,” the memo warned, underscoring the research-backed “need to build social links and bridges to prevent social isolation, which in turn, reduces the risk of radicalization to violence.”

Social distancing has been key to stopping the virus’ spread — but after more than a year of being fearful of anyone near potentially being infected, experts point out that self-preservation may have amplified feelings of mistrust in our communities.

“Someone who’s coming towards you on the sidewalk, and you’d think, you’re spraying your droplets at me!” Butts said. “People were afraid. More so than before, we had to see other people as a potential deadly threat.”

Americans are also still reeling from the economic and emotional blow dealt by COVID-19, despite the ebb of infection, and signs of improvement in the labor market, according to Pew polling this spring; those most vulnerable to the virus have also borne the brunt of its financial fallout.

Breaking the cycle

Tensions boiling over across the U.S. have fed what’s becoming a vicious cycle difficult to break; experts worry, that residual anxiety and collective trauma may outlast the pandemic itself.

“That kind of mental and emotional wear and tear doesn’t go away,” Butts continued. “All the harm that results will be festering for some time. That’s a huge concern.”

As some Americans’ anger about the state of the nation abates from where it was during the summer 2020 COVID surge — experts urge vigilance about what that receding rage might leave in its wake.

Even as the nation prepares to celebrate the Fourth of July and some measure of freedom from COVID, federal authorities are raising concerns about the possibility of domestic terror and violence, including mass shootings, as the 2021 summer season gets into full swing.

Whatever the new normal might be, Chanoff notes getting there will take time.

“The human spirit is resilient and the human capacity to heal is enormous,” Chanoff said. “But without support, I think that these things will likely continue to rise.”

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(NEW YORK) — It’s been a school year like no other in recent memory — combining the challenge of remote and hybrid learning for millions with the agony and strain of a pandemic that has killed more than 600,000.

Mental health has taken a toll on many students and staff alike.

So as districts prepare for the fall after the first full year during the coronavirus pandemic, many are looking at ways to help best address the mental health needs of students, especially those who may have experienced trauma, anxiety or social isolation.

One Ohio school district will welcome back students with more counselors and social workers on hand. Hilliard City Schools in Columbus has added seven new school counselors, up to 42, and 10 more social workers, for 15 total, Director of Student Well-Being Mike Abraham told ABC News.

“Anxiety has always been high with this generation,” Abraham said. “With the pandemic, some students have become very comfortable with isolation, not having to deal with the anxiety that school might bring or their peers bring. That’s what all districts are dealing with coming back now that these kids are together — giving them strategies to be able to deal with their anxiety, to deal with whatever mental health issues that they’re struggling with.”

The school district, which has nearly 17,000 students, is tapping into federal relief money earmarked for K-12 public schools to pay for the new positions.

Last month, Iowa officials announced the state is launching a new pre-K-12 school mental health center that would expand training and resources that support mental health needs in schools.

The Iowa Department of Education is putting $20 million in federal pandemic relief toward the center, which aims to “address the impact pandemic-related disruptions have had on students and will focus on strengthening mental health support moving forward,” Iowa Department of Education Director Ann Lebo said in a statement.

And the Miami-Dade County school district is exploring using federal relief funds to hire more mental health clinicians as most of the district’s 334,000 students are expected to return to in-person learning this fall, the Miami Herald reported last month.

Other initiatives targeting school culture include adding mental health as an excused absence. That will be the case for Montgomery County Public Schools, Maryland’s largest school district, starting in the fall, Board of Education member Patricia O’Neill told ABC News Washington, D.C., affiliate WJLA-TV.

“I think coming off the pandemic this year, adults and students recognize the challenges that mental health has brought about,” O’Neill told the station. “We had to figure out how to make this change and elevate the importance of mental health, as it may be a barrier to learning.”

Range of mental health concerns

The full impact of the pandemic on students will take time to understand, Kelly Vaillancourt Strobach, director of policy and advocacy for the National Association of School Psychologists and a school psychologist, told ABC News. One area of concern is emergency department visits for attempted suicide or suicide ideation, she said.

In 2020, mental health-related emergency department visits among those aged 12 to 17 increased 31% compared to 2019, according to the Centers for Disease Control and Prevention. Visits for suspected suicide attempts in girls that age from Feb. 21 to March 20, 2021, were 50.6% higher than the same period in 2019, the agency reported.

A report published in Pediatrics also found “significant increases” in the number of emergency department visits for suicide ideation and attempts in youth for certain months in 2020 when compared to the previous year.

Isolation due to remote learning is another concern. A recent report from a team of researchers at the Graduate Center, City University of New York found that 91% of New York City parents surveyed agreed there should be “increased mental health supports for students due to social isolation from COVID-19.”

Meanwhile, some students may not have experienced any toll on their mental health, and may have even thrived virtually, Vaillancourt Strobach said.

“We don’t know the level of trauma that individual students have had. We don’t know their family situation, if they lost somebody, if parents have lost jobs,” she said. “So what we are encouraging schools to do is really in those first couple of weeks, just infuse a lot of social-emotional learning, give kids the opportunity to talk about what’s happened over the last year.”

“There’s a lot of focus and attention on learning loss, or lost instructional time. Certainly it’s important that we address student’s academic needs, but if we don’t have a handle on their social-emotional learning and their mental health needs, the academics are never going to come,” she added.

‘All about adjustment’

Summer to fall can often be a tough transition for students in general, Janine Domingues, a clinical psychologist at the Child Mind Institute and the manager of curriculum development and professional training for its school and community programs, noted.

“That first month of school is all about adjustment,” she told ABC News. “Now, even more so, it’s a whole different ball game.”

Students may experience anxiety and stress while getting acclimated to the classroom and a new routine, she said.

When Centennial High School in Corona, California, welcomed back students on campus for their last quarter this past school year, it was an adjustment for some students returning for in-person learning, Josh Godinez, a counselor at the school and chair of the board of the California Association of School Counselors, told ABC News.

“It was almost like the isolation allowed them to create almost somewhat of a fantasy of what they remembered about school. And then showing up to the social distancing partitions, only half their class being there, everybody in masks, it wasn’t that picture that they had created,” he said. “Things start to get back to normal, but aren’t really back to normal.”

As a counselor, Godinez said he worked with students on an individual level to address any anxiety, apprehension, grief or fears students had.

“There was no one response when they came back to school,” he said.

A call for lasting change

Come the fall, Centennial High School, which has about 3,300 students, will have brought on a new counselor, focusing on English learners, bringing them to nine total, Godinez said.

The pandemic has helped bring more attention to the importance of mental health support in school, particularly as districts have an infusion of federal funding that could be put toward more staffing or training, and how schools can foster a healing-centered environment “focusing on social-emotional well-being,” Domingues said.

“This year has kind of really helped propel that mission forward,” she said.

The attention and funding come as schools nationally are largely understaffed when it comes to support staff like social workers and psychologists, experts said.

The National Association of School Psychologists recommends a ratio of no more than 500 students per school psychologist. In the 2019-2020 school year, the national ratio was estimated to be more than double, and only one state met the recommended ratio, the organization said.

The National Association of Social Workers and American School Counselor Association both recommend a ratio of 250 students per social worker and counselor, which most states also fail to meet, according to a 2019 ACLU report.

“We’ve had 100,000 traumatized school communities in this country,” Robert Boyd, president of the School-Based Health Alliance, which promotes school-based health centers in the U.S., told ABC News. “We’re coming into this with not enough school behavioral health specialists. … We didn’t have it before the pandemic.”

The pandemic relief funds could help bring those ratios down, the experts ABC News spoke with said, though noted more rural areas often face a staffing shortage. Boyd’s organization is also focused on diversifying school support staff, which tends to be white women, he said.

Some schools may need to lean on community providers, Vaillancourt Strobach said. Trained grief counselors, for instance, may include pastors and morticians, Boyd noted.

Beyond dealing with staffing shortages, districts may build up their programs, only to not be able to sustain them in the long term.

“Are we going to make a lot of really good progress because there’s been so much attention paid to the importance of school mental health, and then with the American Rescue Plan dollars hit their limit, are we going to be back at square one?” Vaillancourt Strobach said.

Mental health professionals hope this spotlight leads to lasting change and funding support, beyond the pandemic.

“We don’t need to focus on student mental health just because of COVID,” Vaillancourt Strobach said. “The need has always been there; as a nation, we are finally paying attention to it.”

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(NEW YORK) — One woman was prepared for every aspect of her daughter’s birth — except for the location.

Emily Geller Hardman, 35, was 37 weeks pregnant when she attended a family wedding in Lancaster, Pennsylvania, with her husband, Travis Hardman. Still far enough out from her projected due date, she figured it was fine to attend and felt nothing out of the ordinary during the wedding. Just hours later, when they were back in their hotel room, however, the opera singer said her water broke. But she didn’t rush to the hospital.

“The amniotic fluid was clear and there were no contractions,” Hardman told ABC News’ Good Morning America. “And this was a first-time labor for me. Statistically, most first-time labors are about 16 to 24 hours, so in my head we had plenty of time.”

When Hardman woke up to her first contraction around 3 a.m., she knew it was time to go even if it meant giving birth in the car.

“In my head I was thinking that I’ve been preparing for this for three years,” she said. “I can certainly do early labor in the car.”

Hardman’s firstborn, Wesley, 2, was born via cesarean delivery. She initially wanted to do a vaginal birth, but circumstances forced her into a C-section.

After what she described as a traumatic experience, she was determined to have an unmedicated vaginal birth at a hospital an hour away from their home in Briarcliff Manor, New York, with midwives and a doula on hand.

“I was very involved in the physiological birth world,” Hardman said, adding that she read books, listened to podcasts and did prenatal exercises to prepare herself mentally and physically for a second birth on her terms.

Armed with just her knowledge, signals from her body and the GentleBirth meditation app, Hardman guided herself through labor while her husband drove.

“My husband’s driving and the entire time I’m focusing on listening to the app to get me through each contraction,” she recalled. “I was just riding the waves and hoping we were going to make it back. We still didn’t realize how fast this was going.”

Around 5:30 a.m., they were able to pull over so Hardman could stand and stretch.

“At that point, once I stood up, I think gravity hit and I started bearing down,” Hardman said. “My water starts leaking again. But I knew that we had to get back in the car and get to the hospital so I willed myself back into the backseat.”

Hardman tried her best not to push so that she could hold on until they arrived at the hospital, but when her contractions started coming faster and even more intense, she knew she wouldn’t be able to help it.

“This baby was coming out of me one way or another,” she said. “I either needed to, for lack of a better word, get on board with what was happening and just allow my body to do what it was doing or I could fight it tooth and nail, which didn’t seem like it was going to be helpful.”

“I could feel myself bearing down and pushing,” Hardman continued. “I instinctively just reached down because I’m feeling so much pressure and I feel the top of a baby’s head starting to crown.”

She told her husband to pull over, but there was nowhere for them to do so safely.

“He’s trying to pull over anywhere he can and as he’s doing that, we’re still driving and her entire body just flies out in one contraction,” Hardman said. “There was no pushing stage of her head slowly coming and then waiting for the next contraction and resting. It was just a one-shot deal — she just flew out.”

What Hardman described is a phenomenon known as fetal ejection reflex, in which the body “expels” a baby involuntarily without any forced pushing on the person’s part.

Despite the circumstances surrounding her daughter’s birth, Hardman said the experience wasn’t stressful. As an opera singer, she’s used to high-stress situations and believes that experience, in addition to all the work she put in, helped her handle everything as smoothly as possible.

“You have to perform at a high level under stress, so you’re used to those types of situations and having to focus on what you’re doing and not how you’re doing,” Hardman said.

“I remember I felt relieved,” she said of her feelings after giving birth to her daughter, Rosemary Claire. “I thought something like, ‘I did it.’ It was empowering and a very healing experience. I do feel very lucky.”

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(NEW YORK) — More than a week after the building collapse in Surfside, Florida, 24 people have so far been confirmed dead, with 126 still unaccounted for. As search and rescue crews race the clock to retrieve survivors and remains, they’ve had to contend with several barriers: falling debris, a tropical storm looming off the coast and limited time to recover hope from the rubble.

Undeterred, rescue workers in Florida have worked tirelessly, already moving millions of pounds of debris, with teams working up to 12-hour shifts every day — putting their own safety on the line, and with their own skin in the game. Thursday, the body of one of a first responder’s daughter was discovered among the ruins.

Mental wellness peer teams have been deployed to support the responders. When President Joe Biden arrived at Surfside Thursday, local officials called for increasing psychological supports for those affected by this tragedy.

“This isn’t just a Florida tragedy — it’s also a national and international event. We’re planning on appealing to the President for the best PTSD support possible for the men and women who are working in conditions that resemble more of a warzone than a normal search and rescue mission,” State Fire Marshal Jimmy Patronis said in a statement before Biden’s visit.

Dr. Nomi Levy-Carrick, a psychiatrist at Brigham and Women’s Hospital who previously worked in New York City with survivors of the 9/11 attacks, said that while first responders have been trained to deal with the physical and mental demands of their job, that training does not make them invulnerable to the trauma they witness — and may internalize — while on scene.

“In the aftermath of something traumatic like this, there is so much loss, grief, sadness, even anger. There can sometimes [be] levels of stress that approach toxic levels that make first responders vulnerable to PTSD and other mental health conditions like depression. And the risk to community members, who don’t even have this training or experience? It’s even greater” she said.

Post-traumatic stress disorder — meaning sustained symptoms of trauma that continue many months to years later — is a mental health condition that can develop in the aftermath of traumatic events. PTSD can include things like flashbacks of the traumatic event, nightmares, intense or prolonged psychological distress to stimuli that resemble or symbolize aspects of the traumatic events, and recurrent intrusive memories of the event.

With both workers and community members at risk, Levy-Carrick says that finding meaning can be essential, and protective. “Having a sense of meaning and purpose, whatever that may be, is a very important factor that supports resilience. … It’s important that people feel supported and maintain their social connections through this.”

“Rest and sleep are an essential component of physical and mental endurance, especially in situations with an uncertain end point” said Dr. Ripal Shah, a clinical assistant professor of psychiatry and behavioral sciences at Stanford University School of Medicine. She has worked in health care disaster settings in Puerto Rico, Nepal, Indonesia and Haiti.

Shah said it’s important that rescuers are given enough time to take care of themselves.

“If there is adequate manpower, limiting the number of shifts in a row, giving enough time in between in shifts, can be so important for mental health recovery,” she said.

The sense of responsibility to help survivors and clear the scene, can bring some measure of hope, comfort or information to the families — and all can drive rescuers to keep going, some have expressed.

“It’s not every day that you get to go help and do this,” Andrew Schmidt, a firefighter on Southwest Florida’s Urban Search and Rescue Task Force 6, told station WINK.

“We’re holding up because we’re all holding up for that hope, that faith that we are going to be able to rescue somebody,” Andy Alvarez, the Miami-Dade Fire Rescue’s deputy incident commander overseeing search and rescue efforts, said.

In the tent city set up for crews’ work, a community has come together: volunteers from Surfside and from around the country have brought food and water to support the rescuers, and the Surfside community has set up memorials and prayer circles for those waiting on news.

The massive search and rescue operation is not yet over; nor are all the answers about why this happened are apparent as of yet. And, experts say, the long-term psychological effects from the collapse and loss of life will have ripple effects over time. And while the risks for PTSD are there, Dr. Levy-Carrick said it does not mean it’s what is fated for these workers and the Surfside community.

“PTSD is not inevitable…The risks are very real though for the workers and communities; we should look for how people can support each other and how the community is coming together. It’s part of the way that you can retain hope amidst such tragedy,” Levy-Carrick said.

Jacinta Leyden, M.D., is a psychiatry resident physician at Harvard’s Brigham and Women’s Hospital and a contributor to the ABC News Medical Unit.

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