Health

(BOULDER, Colo.) — Last September, Ryan Christoff found his then 16-year-old daughter barely breathing in their home near Boulder, Colorado.

Little did he know at the time, but his daughter was suffering from an overdose. She had taken a half of a Percocet pill given to her by her then boyfriend not knowing that it was laced with Fentanyl – a synthetic opioid used to treat severe pain and is up to 50 times more powerful than heroin.

“I’m bored in my room,” said Sofia Christoff, who said she had found some “powder” substance. “I crushed it up, took a line. Felt kind of sparkly for two seconds and then I woke up in the hospital.”

Ryan Christoff said he had known that his daughter “smoked a little weed” occasionally, but had no idea that the sophomore had actually been secretly experimenting with a long list of drugs.

“Cocaine, Xanax, Ketamine once. Acid, Shrooms, Adderall,” said Sofia Christoff. “So just pills. Just like everything I could get my hands on.”

During that year, she was suspended from school and her grades fell.

“I felt stupid that I should have known,” said Ryan Christoff. “I just didn’t think she was doing that.”

Sergeant David Cohen of the Lafayette Colorado Police Department was in the vicinity when the frantic 9-1-1 call came in from Sofia Christoff’s father.

Cohen arrived on the scene in minutes as the 9-1-1 dispatcher and started chest compressions. He quickly administered Narcan to an unconscious and barely breating Sofia Christofff. Within seconds, she began gasping for air, according to Cohen. She was taken to the hospital, but was released only hours later.

Cohen said he used his training and experience to recognize the situation.

“I mean, I don’t know if it ever became clear to me until I administered Narcan, and it worked,” said Cohen, who said he also noticed “miscellaneous drug paraphernalia” in the bedroom.

On that day, Sofia Christoff survived. Others who have experienced Fentanyl-linked drug overdoses have not been as lucky.

“I get daily reports of suspected individuals who have passed away as a result of Fentanyl overdoses,” said Denver Police Chief Paul Pazen.

Pazen said bringing awareness to the issue is key.

“Folks think that this might be something else that they’re ingesting. So bringing awareness to this issue that that pill may not be Percocet. That pill may not be Xanax. That that pill may contain Fentanyl and potentially could be deadly is critical.”

Deaths linked to synthetic opioids like Fentanyl have nearly doubled over the past two years, according to data released by the Centers for Disease Control and Prevention (CDC).

Additional CDC data revealed that of the more than 100,000 people who died from drug overdoses in a 12 month period ending in October 2021, nearly two-thirds of those deaths are linked to synthetic opioids like Fentanyl.

Fentanyl is cheap to produce and extremely potent, so it is sometimes mixed into other illicit drugs heroin, meth and cocaine and other pain pills like Percocet, Xanax, Vicodin and Oxycontin and can create a lethal combination, according to Pazen.

“It’s so cheap, it’s so easy to move, it’s so addictive for the end user,” Pazen said. “We are going to need everybody coming together as a country, as a state, federal, state, local law enforcement.”

In March, Colorado’s House of Representatives introduced a bill to enact stiffer criminal penalties on those involved with the sale and distribution of Fentanyl.

For Sofia Christoff, she said that buying drugs is as easy as sending the right emoji to a “plug,” a drug dealer who often finds customers on apps like Snapchat.

“I’m looking for a little plug emoji or like a fire emoji or you’re just whatever emoji the normal dealers have,” said Christoff.

“If you know where to go, it’s really easy,” she added.

The use of emojis to connect with drug dealers is not unique to Colorado, but now so common across the country that the U.S. Drug Enforcement Agency released a cheat sheet for parents and guardians to raise awareness of the emojis commonly used to buy drugs on social media.

“I cannot emphasize enough how deadly this drug is to human life, especially to unsuspecting youth in our community,” said Tatum King, a Homeland Security investigator. “These pills are widely available and often sold for dollars apiece on social media.”

On April 1, Snapchat issued a statement that detailed their efforts to flush out drug-related content and announced steps to curb illegal activity, saying they have “zero tolerance” for the promotion of illegal drugs on its platform.

Sofia Christoff said she carries the weight of her near-death experience everyday.

“’I’m the one that came back like, why me? So I’m just trying to have the mindset that I’m here, and I was a lucky one, and I gotta make it worth it,” said Christoff.

Sofia Christoff is now enjoying her junior year of high school and said she’s looking forward to being back on the field with her softball team next season. Her father is now on a mission to educate other teens and parents on the dangers of drug use and carries Narcan wherever he goes.

“I would want people to see that it can happen to even someone like Sofia, to even their daughter, to even their son,” he said. “Even [to] people you think you know it is the least likely to happen to, it can happen.”

Last month, Ryan Christoff and his now 17-year-old daughter visited the Lafayette Police Department to meet Sergeant David Cohen again, six months after his quick actions saved a life. After both giving him giant hugs of gratitude, Ryan Christoff gave the officer a framed picture of his daughter saying, “that’s her celebrating her birthday which she was only able to experience because of you.”

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(NEW YORK) — Tennis superstar Serena Williams is describing in her own words the life-threatening complications she faced while giving birth to her daughter, and how she advocated to save her own life.

Williams, 40, gave birth to her daughter, Olympia, with husband Alexis Ohanian, in September 2017, in an emergency cesarean section.

In the new book Arrival Stories: Women Share Their Experiences of Becoming Mothers, a collection of essays helmed by Amy Schumer and Christy Turlington Burns, Williams writes, “Giving birth to my baby, it turned out, was a test for how loud and how often I would have to call out before I was finally heard.”

Williams writes in her essay, an adaptation of which was published by ELLE.com, that after her C-section, she underwent three surgeries due to complications that included an embolism, or clot, in one of her arteries, and a hematoma, a collection of blood, in her abdomen.

She describes in the essay what she remembers happening the day after she gave birth, when the complications began.

“In 2010, I learned I had blood clots in my lungs—clots that, had they not been caught in time, could have killed me. Ever since then, I’ve lived in fear of them returning. It wasn’t a one-off; I’m at high risk for blood clots. I asked a nurse, ‘When do I start my heparin drip? Shouldn’t I be on that now?,'” she wrote, referring to a drug that is delivered by IV and helps to prevent blood clots. “The response was, ‘Well, we don’t really know if that’s what you need to be on right now.’ No one was really listening to what I was saying.”

“The logic for not starting the blood thinners was that it could cause my C-section wound to bleed, which is true. Still, I felt it was important and kept pressing,” she wrote. “All the while, I was in excruciating pain. I couldn’t move at all—not my legs, not my back, nothing.”

Williams said at times she felt like she was dying, but she insisted to a nurse that she get on a heparin drip and have a CAT scan done on her lungs.

“Finally, the nurse called my doctor, and she listened to me and insisted we check. I fought hard, and I ended up getting the CAT scan. I’m so grateful to her,” said Williams. “Lo and behold, I had a blood clot in my lungs, and they needed to insert a filter into my veins to break up the clot before it reached my heart.”

The discoveries from the CAT scan led Williams to undergo her third and fourth surgeries. One week later, she was discharged from the hospital and able to go home with Olympia.

Williams writes that she believes it was because she was “heard and appropriately treated” that her life was saved.

“In the U.S., Black women are nearly three times more likely to die during or after childbirth than their white counterparts. Many of these deaths are considered by experts to be preventable,” she writes. “Being heard and appropriately treated was the difference between life or death for me; I know those statistics would be different if the medical establishment listened to every Black woman’s experience.”

The United States has the highest rate of maternal mortality among developed nations, data shows, with a growing and disproportionate impact on women of color.

Black women are more likely than white, Asian or Latina women to die from pregnancy-related complications regardless of their education level or their income, data shows.

One reason for the disparity is that more Black women of childbearing age have chronic diseases, such as high blood pressure and diabetes, which increases the risk of pregnancy-related complications like preeclampsia and possibly the need for emergency C-sections, according to the Centers for Disease Control and Prevention.

But there are socioeconomic circumstances and structural inequities that put Black women at greater risk for those chronic conditions. And Black women often have inadequate access to care throughout pregnancy, which can further complicate their conditions, according to a 2013 study published in the American Journal of Obstetrics and Gynecology.

In December, when the Biden administration issued a “nationwide call to action” on the maternal health crisis in the U.S., Vice President Kamala Harris called the “systemic inequities” that affect pregnant people of color a “matter of life and death.”

“Regardless of income level, regardless of education level, Black women, Native women, women who live in rural areas, are more likely to die or be left scared or scarred from an experience that should be safe and should be a joyful one,” said Harris. “And we know a primary reason why this is true — systemic inequities, those differences in how people are treated based on who they are, and they create significant disparities in our health care system.”

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(NEW YORK) — April is Autism Acceptance Month, a time to embrace the differences of people with autism spectrum disorder (ASD), a developmental disability that impacts roughly one in 44 children in the United States, according to a study from the Centers for Disease Control and Prevention.

For Eric Garcia, a Washington, D.C.-based journalist and the author of the book We’re Not Broken: Changing the Autism Conversation, it’s also a time to remember that people with autism are “everywhere.”

“Autistic people work in every sector,” he told ABC News’ Good Morning America. “They’re doctors and lawyers and waitresses. They’re car mechanics. They’re journalists. They’re everywhere.”

Fashion designers Tommy and Dee Hilfiger said three of their seven children have been diagnosed with ASD.

The couple said they first noticed signs of autism in their kids early on.

“Our son was counting steps at one-and-a-half years old and at 2, he stopped counting, stopped speaking. He was babbling quite a bit and then just stopped,” Tommy Hilfiger said Tuesday on GMA. “So we had him tested and obviously, it was a bit of a shock. But once you get over the shock, you then plan to do something about it.”

The designer said he and his wife sought out expert advice for each of their children, who have exhibited different symptoms.

He added that one of his top tips for parents is to know the signs of autism in order to be able to recognize them in your child and get help early on.

“Early intervention is really the key,” said Tommy Hilfiger. “If you sense that your child is off in any way … if they’re not responding or if they seem like they’re in their own world, you should get them tested, and the earlier you get them tested, the sooner you can intervene.”

In addition to seeking out expert advice, the Hilfigers say building a support system within the autism community has really helped them as parents.

“I think it’s really crucial that you talk to pediatricians,” said Dee Hilfiger. “And once the child is diagnosed, I think the most helpful thing for us and for other parents is to seek out other parents.”

“When you receive that diagnosis, it can be quite devastating but I think seeking out the support of friends made a big, big difference for us,” she added.

What to know about autism

People with autism have a wide variety of traits affecting communication, behavior and socialization, according to the CDC. The “spectrum” in autism spectrum disorder means that there’s a wide range of symptoms and severity.

A child of any race, socioeconomic status or ethnic group can get ASD. Boys though are four times more likely to be diagnosed with autism than girls, based on a study of children aged 8 years old. Kids that have a sibling with autism, and especially a twin, are more likely to have autism. Those with developmental disabilities or genetic and chromosomal diseases such as Down syndrome are also more likely to have ASD. There is also evidence that kids born to older parents have an increased risk of autism, according to several studies.

Garcia points out that autism “manifests itself in very different ways” in each person with the condition.

For Garcia, he experiences “stimming,” which involves making repetitive movements or sounds, a calming tactic for when one feels overwhelmed. Garcia said for him that can mean playing with his tie and taking his class ring on and off.

“A lot of times I can just completely be overwhelmed and almost want to have a meltdown, like to the point where it’s difficult for me to communicate or speak,” he said. “And that’s just my way to deal with all the sounds that we’re having all around here.”

Autism can be identified as early as infancy, although most children are diagnosed after the age of 2. There is no medical test to diagnose autism, so doctors watch a child’s behavior and development to make a diagnosis, according to the CDC.

“Someone might have the communication delay, but may not have the motor skill delay,” said Dr. Jen Clark, a New York-based clinical psychologist and specialist in autism. “They may experience sounds and lights in a very different way than you and I would and sometimes they can experience a sensory overload and they may wear headphones and this will help to make the noise not as severe, but also they may avoid certain situations where it’s just too overwhelming.”

The CDC notes that in some cases, people are not diagnosed with autism until they are teens or adults.

Experts say though that early detection of ASD is key, as is early intervention.

“When a child is young, the brain is capable of change,” said Clark, also the director of COAST Club, which offers therapy and social groups for children, teens and young adults with autism.

Early signs of autism in children may include, but are not limited to, little or no smiling and limited eye contact by 6 months; little to no babbling, pointing or response to their name by 12 months; and few or no meaningful two-word phrases by 24 months, according to the CDC.

Clark added that children may exhibit additional signs such as flapping of the hands, spinning, twirling and walking on their toes. She also says lining up toys, instead of playing with them in the way they’re intended to be played with, may also be a sign.

“If you do see these behaviors in your child, these are behaviors that are associated with ASD and important to mention to your pediatrician,” she said.

Treatment comes in many different forms, from mental health therapy to occupational, physical and speech therapies. Sometimes medications can be helpful for things related to ASD, like mood problems or inability to focus.

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(NEW YORK) — A mom of four from Indiana went from giving drawing prompts to her daughters to thousands of strangers online, inadvertently creating a community of what she describes as “amazing people” who have turned to art for a mental health break amid the pandemic.

In March 2020, Angie Carel’s job came to a standstill as the coronavirus pandemic upended her life.

“My business was shut down due to COVID and that’s when my daughter came home from college. My other daughters were doing remote learning, so everybody was in my house and that’s when we started drawing,” Carel, a marketing agency owner, told ABC News’ Good Morning America. “It started with just myself and my daughters doing the drawings. And then we were sharing our drawings on social media and then that built up into a following on social media.”

Two years later, Simple Daily Drawing now boasts more than 30,000 followers and Carel has posted over 625 daily drawing prompts since April 2020. About 8,000 members worldwide also post their creations in a separate, private group every day, sharing stories to go along with their illustrations.

“It organically grew into what it is,” Carel said. “I wasn’t going to continue drawing past the COVID shutdown. It was something that I was just doing while we were shut down to disconnect, get out of my own head, get my daughters out of their own heads.”

“But then, so many people started joining and posting why they were drawing and how it was helping them and so that’s why I continued to do it. And now, almost every single day, somebody posts how much the daily drawings are helping them,” Carel said.

In the beginning, Carel asked her children to draw amusing, lighthearted sketches — a smiling turtle, a sunbathing hippo, and a thirsty camel.

“We were just drawing to have fun,” the 43-year-old mom said, adding that her husband and 3-year-old son also joined in on the drawing sessions.

The daily drawing prompts have grown more diverse, with abstract suggestions and ideas open for interpretation. Recent prompts have ranged from “Perspective: From Above” to “Nostalgia,” and one of Carel’s latest favorites includes a close-up drawing of a green eye.

Carel said she’s heard from all sorts of members who find their way to the drawing group and commented on how it has made a difference in their lives.

However, she’s also encountered unexpected stories from members as well about how art has helped them work through trauma.

“I get emotional about it because it’s like, I’m just giving you something to draw, but these stories that come out of it with mental health, in particular, are shocking and amazing,” said Carel. “And people, they’re vulnerable in the group and they share the stories with others. “

Carel, who has a graphic design background, added that she feels motivated to keep the drawing group going.

“I started drawing because of the way it helped me cope with COVID, but that translates into so many people’s lives for so many other reasons. And they started posting these stories and then I was like, I can’t just shut this group down,” she said.

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(WASHINGTON) — Nationwide distribution of one of the last remaining monoclonal antibody treatments is being paused “effective immediately” since it has shown to be ineffective against the COVID-19 BA.2 subvariant now dominating every region of the country, an internal letter sent Tuesday afternoon from the federal government to states and obtained by ABC News said.

States and stakeholders should not expect any further shipments of sotrovimab, from GSK and Vir Biotechnology, from which the Food and Drug Administration has pulled authorization nationwide.

Sotrovimab was one of two monoclonal therapies in the U.S. arsenal that worked against previous variants. Now, the omicron subvariant has shown to chip away at its efficacy.

The government and FDA had already been incrementally limiting sotrovimab distribution in pockets of the country where BA.2 had been creeping up as the prevailing COVID strain. Tuesday, the FDA announced it would pull back authorization completely.

The agency said it will continue to monitor BA.2’s spread across the country, and that doctors and patients should use one of the other treatments that have held up against BA.2 — the one other monoclonal that still works, bebtelovimab from Eli Lilly; Paxlovid, or the antiviral pills from Pfizer; or molnupiravir from Merck.

Monoclonals have become a mainstay in our COVID medicine cabinet. Their ability to curb hospitalization rates, particularly among unvaccinated high-risk patients, has made them a key component in Biden’s COVID plan.

But new evolving strains of the virus have forced health care officials to recalibrate existing treatments — and this is not the first time the U.S. has seen COVID treatments get shut down when a new variant of concern stymies its efficacy.

GSK tells ABC it is prepping further data on whether a higher dose would hold up better against the omicron subvariant, which it’s sharing with relevant health and regulatory bodies.

The internal letter urges health care providers to make sure they are up to date with which variants impact what treatments, since it’s constantly shifting — and for providers to be aware of the variant makeup in their region in order to “guide treatment decisions” in an optimal way for their patients.

Meanwhile, the national COVID-19 medicine cabinet is once again getting whittled down by new variants and by limited supplies.

Weekly allocations of many COVID therapies had already been scaled down while further COVID relief funding stalled in Congress, and the government cut back on the amount of treatments shipped to states.

Though Senate negotiators had struck a deal for $10 billion in additional funding, its passage is far from guaranteed. It is unclear if this slimmed-down version of what the White House wanted will cover the country’s needs should another infection surge emerge. Without sufficient funding, the White House previously said the U.S. supply of the antiviral pills like Paxlovid could run out by September.

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(NEW YORK) — As the nation approaches the grim milestone of 1 million lives confirmed lost to COVID-19, a new report reveals the “devastating and disproportionate” impact of the virus on low-income communities in the U.S., offering an initial analysis of the deadly consequences of poverty, economic insecurity and systemic racism.

“Poverty was not tangential to the pandemic, but deeply embedded in its geography,” researchers wrote. “Poverty and widespread inequality increases vulnerability to crises. While vaccines will prevent the worst impacts of COVID-19, they will not inoculate against poverty.”

The report, produced by the The Poor People’s Campaign in collaboration with the U.N. Sustainable Development Solutions Network, found that death rates in the lowest income group were double the death rates of those in the highest income group.

In addition, counties with disproportionately more Black residents had a significantly higher COVID-19 death rate than counties that did not.

The pandemic exacerbated preexisting social and economic disparities that existed prior to the emergence of COVID-19, the report found.

“Crises do not unfold independently of the conditions from which they arise,” researchers said. “The pandemic exacerbated preexisting social and economic disparities that have long festered in the US, including a deeply divided society, widespread poverty, a weak social safety net, inadequate living conditions, and a lack of trust in science that predated COVID-19.”

Prior to the onset of the pandemic, there were 140 million low-income people living in the U.S., accounting for approximately 40% of the population — including more than half of children in the country.

“Widespread and unequal distribution of wealth, income and resources prior to the pandemic created the conditions for many of the negative outcomes associated with the virus,” researchers wrote.

Death rates have varied throughout the pandemic, in each of the various surges. Researchers found that the two deadliest waves were the winter surge of 2020-2021, accounting for nearly 40% of all deaths to date, and the recent omicron surge, accounting for nearly 20% of deaths so far, according to data from Johns Hopkins University.

With the exception of the first COVID-19 surge, U.S. counties with the “lowest median income had death rates at least two times higher than that of the counties with the highest income.”

Preexisting disparities in health care access, wealth distribution and housing insecurity created “disastrous effects” for some Americans, as the virus exacerbated gaps in access that “caused increased harm to populations based on their class, race, gender, geography, and ability.”

Findings also suggested that pandemic job losses were concentrated among low-income workers, and that Americans living in poverty were the most likely to miss work due to COVID-19. Furthermore, Black and Hispanic women were most likely to lose full-time jobs.

Researchers stressed that adequate living wages, shared economic prosperity and inclusive welfare programs can address some of the concerns discussed in the report. In addition, ensuring universal and affordable health care, housing, water, access to utilities, quality public education and guaranteeing a robust democracy “will establish a more equitable foundation upon which we can build back better from the pandemic.”

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(NEW YORK) –Through lockdowns, remote working, travel restrictions and school closures — many have not had a cold in two years. Now cold and flu rates appear to be on the rise as Americans return to pre-COVID activities sans masks.

Dr. Peter Chin Hong at UC San Francisco says his hospital is seeing an influx of cold and flu complaints.

“Usually we’ve gotten several colds a year for most people,” he told ABC News. “I think not having them means when you do get one it lasts a little bit longer.”

While cold and flu symptoms can often resemble COVID-19 symptoms, the Centers for Disease Control and Prevention says testing may be necessary to confirm a diagnosis.

Dr. Hong stressed the importance of returning to public life with caution.

“It’s really crucial to keep up your street smarts not just about COVID, but these other pathogens that you can transmit,” he said.

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(NEW YORK) — In the seven months since Texas enacted a law that bans nearly all abortions after six weeks of pregnancy, its northern neighbor, Oklahoma, has felt the impact.

“We are essentially having to turn the vast majority of people away from getting abortions because we just cannot keep up with the volume,” said Dr. Christina Bourne, the medical director of Trust Women, which operates an abortion care clinic in Oklahoma City and one in Wichita, Kansas. “We could be doing abortions 24 hours a day and not keep up with the volume that is demanded of us.”

Now, Oklahoma appears close to enacting its own abortion ban, which providers like Bourne and others in surrounding states say could lead to a whole region of the country lacking adequate abortion access.

In late March, the Oklahoma House passed a measure, House Bill 4327, that would ban abortion at any point in the pregnancy unless it is “to save the life” of the pregnant person or if the pregnancy is the result of “rape, sexual assault or incest that has been reported to law enforcement.”

Like Texas’ law, HB 4327 also allows for citizens to sue for up to $10,000 anyone who performs or “aids and abets” an abortion.

Earlier last month, the Oklahoma Senate passed a similar bill, SB 1503.

“We know that patients who need abortion are not going to stop seeking it, it’s just going to get harder and harder for them to access,” said Emily Wales, the interim CEO and president of Planned Parenthood Great Plains, which covers Arkansas, Oklahoma, Kansas and parts of Missouri. “Right now, patients may be traveling a few hundred miles from home, five or six hours, they’re going to add another five or six hours to get to the Kansas City area or to Wichita, and for some patients, that won’t be feasible.”

So far in 2022, the two Planned Parenthood clinics in Oklahoma that offer abortion services have seen more patients from Texas than from Oklahoma, according to Wales.

If the anti-abortion bills in Oklahoma are signed into law as expected, experts say women who have the means will have to travel further for abortion care, while those who don’t will not get care.

“We expect that the facilities that remain open in other states will be overwhelmed, as we have already seen with Senate Bill 8, with residents from other states coming in to get care,” said Dr. Kari White, an associate professor and faculty research associate at the University of Texas at Austin. “And there are some people for whom these longer distances are are just going to be impossible, and they will consider either other ways to try to end their pregnancies by ordering medications online or potentially doing something unsafe, and other people will be forced to continue their pregnancies.”

White, who is also the lead investigator of the Texas Policy Evaluation Project, has studied the impact of Texas’ six-week abortion ban. According to her research, around 1,400 Texans have gone to another state for abortion care each month since SB8 went into effect in September, with 45% traveling to Oklahoma.

“We’ve certainly heard from some of the people we’ve interviewed in our study that they were willing to wait a little bit longer to get an abortion in Oklahoma because they could travel to Oklahoma, but it was too far for them to go to a state like New Mexico,” she said. “They just couldn’t make it work in terms of the additional cost, the time away from work or their child care responsibilities.”

New Mexico and Colorado, which have less stringent abortion restrictions, are likely to become hotspots for women in the region who have the means to travel for abortion care.

Those states have also felt the impact from SB8, according to Planned Parenthood, which reported a more than 1,000% increase in abortion patients with Texas zip codes at Planned Parenthood health centers in Colorado and a more than 100% increase at Planned Parenthood health centers in New Mexico compared to the previous year.

Other states that surround Oklahoma — Kansas, Missouri and Arkansas — face their own restrictions on abortion access and are dealing with already overwhelmed systems, experts say.

The two Planned Parenthood clinics that provided abortion care in Missouri have been closed in the last few years due to state restrictions, according to Wales, who added, “Missourians for a long time have been living the Texas crisis, where the majority of them are forced to flee their home state for care already.”

Arkansas has around three abortion clinics statewide currently, while Kansas has four, according to Sandy Brown, president of the Kansas Abortion Fund, a volunteer-run, nonprofit organization that helps fund Kansan women seeking abortion care.

“Our clinics here have been swamped,” Brown said. “They just can’t absorb the volume of people coming in from other states. Now, if Oklahoma happens, it’s really, really going to be bad, because we already can’t almost handle the patients that are coming in now.”

In May or June, the Supreme Court will announce its ruling on a 15-week ban in Mississippi and whether or not it is constitutional. If the Supreme Court determines the ban is constitutional, it could mean Roe v. Wade is either overturned or fundamentally weakened.

More than half of the nation’s 50 states are prepared to ban abortion if Roe is overturned, according to a report from the Guttmacher Institute, a reproductive rights organization.

If that happens, another factor to watch will be whether states that have banned abortion make it increasingly difficult for their residents to obtain abortions in other states, Mary Ziegler, visiting professor of constitutional law at Harvard Law School and author of Abortion and the Law in America: Roe v. Wade to the Present, told ABC News earlier this year.

In the meantime, abortion rights advocates and providers say they worry that the far distances people are having to travel to seek abortion care means the most vulnerable people, such as those without the financial resources to travel, are being left behind.

“Traveling is an option and has always been an option for affluent white people,” Bourne said. “Through abortion restrictions, we are legislating people who experience intersecting identities, poverty, people of color, queer folks, people with many children, people with busy lives who are going to be left out of that and forced to carry a pregnancy to term that perhaps otherwise wouldn’t have.”

Wales, of Planned Parenthood Great Plains, said that as clinics in Oklahoma and Kansas have seen increased demand for abortion services, that has resulted in a delay in services for the type of general reproductive health care, like contraception and cancer screening, that makes up the majority of the clinics’ work.

“The increased need in abortion and the restrictions from the states … those things have pushed family planning patients and other types of care back,” Wales said. “It also means our family planning patients are coming in more concerned, more confused about what is available to them, because they just understand that rights are being restricted.”

“It has created a great deal of fear, I think, among the people we see,” she said.

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(NEW YORK) — A new COVID-19 variant has been identified in the United Kingdom, but experts say there is no cause for alarm yet.

The variant, known as XE, is a combination of the original BA.1 omicron variant and its subvariant BA.2. This type of combination is known as a “recombinant” variant.

Public health experts say that recombinant variants are very common and often crop up and disappear on their own.

“Right now, there’s really no public health concern,” said Dr. John Brownstein, an epidemiologist and chief innovation officer at Boston Children’s Hospital and an ABC News contributor. “Recombinant variants happen over and over. In fact, the reason that this is the XE variant recombinant is that we’ve had XA, XB, XC, XD already, and none of those have turned out to be any real concern.”

According to an update last week from the U.K. Health Security Agency, 637 cases of XE have been identified as of March 22, with the earliest detected Jan. 19.

An early indication from the U.K. suggests XE could be slightly more transmissible than BA.2, but the World Health Organization said more research is needed.

Meanwhile, XE makes up less than 1% of total COVID-19 cases that have undergone genomic sequencing in the U.K., and there is no evidence to suggest that the variant can escape vaccines, cause more severe disease or is more deadly.

“This particular recombinant, XE, has shown a variable growth rate, and we cannot yet confirm whether it has a true growth advantage,” Professor Susan Hopkins, chief medical adviser for UKHSA, said in a statement.

So far, no cases of the recombinant variant have been reported in any other country, including the United States.

Brownstein said there are still a lot of unanswered questions surrounding XE, but that — in the U.S. — there is a high level of protection both from vaccines and from natural immunity during the omicron wave.

“It’s possible it may be more transmissible, but that doesn’t necessarily mean it’s more severe,” he said. “And given the sheer number of infections we’ve already seen with omicron, it’s really unclear whether even being slightly more transmissible means we’ll see any impact of this variant whatsoever.”

Brownstein said one of the reasons the U.K. was able to pick up on the variant as quickly as it did is because of its robust surveillance system.

According to the global database GISAID, the U.K. has submitted more than 1 million omicron samples for genomic surveillance. The U.S. has submitted more than 781,000.

“The U.K. has done a phenomenal job of sequencing a large number of cases, doing analyses and producing the output of that work,” he said. “So you could see the identification of XE actually as a positive because it shows that our public health systems are working, identifying new variants even when the case numbers are super small.”

Brownstein added, “This shows that some of these variants can be needles in a haystack, and here we have an example of one being identified very early on.”

The World Health Organization released its own report saying it is monitoring XE, but there is no evidence yet that it is a variant of concern like alpha, delta and omicron.

“WHO will continue to closely monitor and assess the public health risk associated with recombinant variants” and will “provide updates as further evidence becomes available,” the organization said in a report published March 29.

Brownstein said variants will continue to emerge, but it is important for people to follow COVID-19 mitigation measures so they don’t get a chance to spread.

“Being vaccinated and boosted, as well as practicing good hygiene and following public health recommendations all help to drive transmission down in the community,” he said. “When we have uncontrolled spread, that’s when the virus is given chances to mutate.”

The UKHSA said it is also monitoring two other recombinant variants known as XD and XF, both of which are a combination of the delta variant and BA.1.

To date, only 38 cases of XF have been identified in the U.K. and none since mid-February while the XD variant has only been identified in global databases in 49 cases, mostly in France.

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(NEW YORK) — California was the first state to mandate that high schools start no earlier than 8:30 a.m. Pediatrician Dr. Bert Mandelbaum hopes New Jersey will be the second.

New Jersey is one of several states exploring later school start times, as educators and health professionals grapple with concerns about the pandemic’s impact on youth’s mental health.

“I think we’re at the right time that people are willing to listen and do the right thing for kids,” Mandelbaum, who chairs the American Academy of Pediatrics New Jersey chapter’s Task Force on Adolescent Sleep & School Start Times, told ABC News. “I think the pandemic heightened everyone’s awareness of the mental health needs.”

The task force has advocated for later start times for several years as a way to promote healthy sleep habits among adolescents, though Mandelbaum believes the pandemic’s toll helped lead to state lawmakers last month introducing legislation that proposes pushing statewide high school start times in New Jersey to no earlier than 8.30 a.m., starting in the 2024-2025 school year. State Democrats said the bill was “beginning the work of addressing this national youth mental health crisis.”

At a ‘tipping point’

Other states that have introduced similar bills during the pandemic include New York, where the proposal is at the committee level, and Tennessee, where it’s been referred to summer study. The Tennessee AAP chapter voiced its support for the bill amid a “national emergency in children’s mental health.”

Several school districts are also shifting to later start times, including Denver and Philadelphia.

“I feel like we have reached a tipping point,” Phyllis Payne, implementation director for Start School Later, an organization that advocates for later school start times, told ABC News.

The AAP, the Centers for Disease Control and Prevention and the American Academy of Sleep Medicine are among several health authorities that support later start times to allow students to get optimal sleep — which for teenagers is between 8 and 10 hours a night.

The CDC has found that most middle and high school students don’t get enough sleep, making them more likely to have poor school performance, engage in unhealthy risk behaviors and suffer from depressive symptoms, it said.

Later school start times would better align with adolescents’ biological sleep rhythms, which cause them to go to bed later, experts say.

Research has found that in high schools with delayed start times, from 8:30 a.m. on, students got more sleep, academic outcomes and attendance rates improved, and car crashes involving teen drivers decreased.

“A lot of high schools start at 7 a.m. or 7:30 — that puts these kids in this really terrible position,” Kimberly Fenn, an associate professor of psychology and director of the Sleep and Learning Lab at Michigan State University, told ABC News. “Any amount they can shift back is going to benefit the students.”

Early start times also often limit light exposure in the morning, which can have an impact on student learning, according to Rebecca Spencer, an associate professor of psychological and brain sciences at the University of Massachusetts Amherst.

“When we’re instead waking up to darkness, we lack that external alerting signal, that bright light that it takes to signal it is time to be awake and helps you focus,” Spencer told ABC News. “So if you take that away from kids, it presents as grogginess and inattentiveness, but it has broad ramifications. It’s gonna tell you how they’re going to perform cognitively. It’s gonna tell you how their behavior is going to be, behavior and mood in the classroom.”

For this reason, among others, many sleep experts have spoken out against a potential move to permanent daylight saving time, which Congress is currently considering instead of changing the clocks twice a year.

“My guess is that sleep scientists as a whole would say, OK, we should stop the bouncing back and forth. But going with standard time, from a sleep perspective, is the better way to go so that you have that light in the morning more often,” Spencer said. “That helps their cognitive function.”

‘Change is challenging’

The Edina School District was the first district in the U.S. to change to a later starting time for their high school, shifting from 7:20 am. to 8:30 a.m. in the 1996-1997 school year, according to research from the University of Minnesota.

Since then other school districts throughout the country have made similar shifts, though advocates for later start times believe tackling the issue at the state level will help address logistical concerns around making the move, such as for parents’ work schedules and programming school athletics.

“I think that we are at a point now where we’re recognizing that this really is the right thing to do,” Payne said. “But change is challenging. People don’t like change.”

The California School Boards Association had opposed California’s law due to logistical concerns for families when it passed in 2019. Ahead of the state’s shift to a later school start time, which goes into effect in July, one teacher argued in CalMatters that the policy is a “disaster in the making” for an already overwhelmed education system. In response, a physician specializing in sleep medicine and an advocate for student health argued that the shift “has never been more urgent” due to the pandemic’s toll on youth mental health.

Mandelbaum, who said he got involved in advocating for later school start times to promote the science behind the policy, has only heard of one instance where a school district that made the shift reverted to its old, earlier schedule. But it “failed because of poor implementation” — highlighting the need for all stakeholders to be involved early on in the proposal process, he said.

For Mandelbaum, the pandemic has shown that schools can adapt quickly to change.

“Schools went virtual within a weekend,” he said. “The idea that we can do big things is there.”

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