(NEW YORK) — As inflation continues to send food prices soaring, more Americans are turning to dollar stores to save on groceries. But can you find healthier options while still cutting costs?
While dollar stores are usually known to carry highly processed, packaged foods, some are beginning to offer nuts, fruits, vegetables and dairy products.
ABC News’ Becky Worley appeared on Good Morning America Monday to discuss what healthy options you may be able to find at a dollar store near you:
(NEW YORK) — Recently, an update to the national COVID-19 strategy was released, designed to manage the virus so most Americans can return to daily life without disruption.
The country is moving to a new phase in which the COVID-19 threat changes from “pandemic” to “endemic.” That means the virus will likely continue to circulate within the population, but at low rates or seasonally.
The updated strategy should fill us with optimism. But we should couple that with a healthy dose of caution.
“As we move toward a COVID-controlled life, it’ll be ever-important to assess for real-time changes in the virus and its community impact because we know just how unpredictable this virus can be,” said Dr. Atul Nakhasi, an internist at the Martin Luther King Jr. Outpatient Center in Los Angeles.
How can we know if it’s safe to unmask and resume our normal activities? What signals should we look for to determine if we need to resume social distancing? Below are five indicators that may provide us with answers.
1. Case numbers:
In Los Angeles County, where Nakhasi practices, public health officials have developed an alert system designed to signal the risk level of the virus. If the number of new cases stays below 200 per 100,000 people, then the risk level remains low.
Though vaccination plays a key role in keeping case numbers low, it’s not the only way to get there. Most people who become infected with COVID-19 develop some level of immunity to the virus. Widespread infections combined with vaccinations have led one group of scientists to determine that 73% of Americans are, at least for now, immune to omicron, the dominant variant. They say that percentage could increase to 80% by mid-March.
2. Hospitalizations:
If we see hospitalizations continue to decrease and remain stable, that will suggest endemicity. The CDC has pivoted away from case numbers to focus on hospitalizations. That’s because, even if the overall reported number of cases stay low, an increase in hospitalizations could indicate that the virus has mutated and the risk of infection may be increasing rapidly.
“A new phase of the pandemic requires a recalibration of metrics that directly highlight true population impact,” said ABC News contributor and Chief Innovation Officer at Boston Childrens Hospital John Brownstein, P.h.D.
“While cases have uncoupled from severe illness, hospitalization numbers will continue to be a robust indicator that public health can rely on,” he added. “Though not the most timely (measure), hospital capacity will continue to reflect risk levels in communities and help guide decisions on mitigation efforts.”
3. Death rates:
According to Jodie Guest, an epidemiologist at Emory University, one measure of the severity of the virus is death rates. If we see fewer than 100 COVID-19 deaths a day nationwide, according to Guest, the virus has reached the endemic phase. Of course, we will need to keep an eye on variants and particular regions of the country where community spread may be different.
4. Wastewater samples:
Yeah, it’s gross, but the wastewater that flows through our sewer systems can tell us a lot about diseases that might be circulating in the community. In fact, data from the CDC’s National Wastewater Surveillance System showed that 70% of wastewater facilities found that virus levels had decreased compared to two weeks ago — another sign COVID-19 cases are on the decline.
Wastewater samples are especially important because people shed the virus when they are in the early stages of infection. That means we can identify rising infection rates even before people begin to show symptoms.
Dr. Ted Smith, an associate professor of environmental medicine at the University of Louisville School of Medicine, said that “wastewater concentrations are dropping in North America.” Though he cautions that infection rates typically drop in the spring and summer, “the genomics is supportive of a tamped situation.”
5. Outbreak clusters:
If we’ve learned anything at all about COVID-19, it’s that it’s highly contagious. That means public health officials need to be able to identify clusters of outbreaks in schools and workplaces, which likely portend rising levels of disease.
One big caveat:
As we move into the endemic phase of the virus, many people will be tempted to think COVID is a thing of the past. If only it were so. For one thing, every community is different. Vermont’s vaccination rate is around 80%, while Alabama’s is closer to 50%. Residents of these two states are facing two very different scenarios in the months ahead.
Likewise, even in cities like Los Angeles, Nakhasi warned that “it’s really important for us to recognize the disproportionate impact this virus has had on our under-resourced and vulnerable communities and prioritize their health, well-being, and life as we prepare for the next surge.”
Also, just because fewer of us are getting sick, doesn’t mean we shouldn’t take smart precautions like washing our hands and continuing to get booster shots when recommended.
“We are in an endemic phase when cases, hospitalizations, and deaths have reached a steady state,” said Dr. Megan Ranney, a practicing physician and dean at Brown University’s School of Public Health. “Remember, though, that ‘endemic’ is not the same as ‘not dangerous.'”
Dr. Jay Bhatt is an internist, instructor at UIC School of Public Health and an ABC News contributor.
(NEW YORK) — As many states relax COVID-19 protocols, birthing practices continue to be impacted by the virus nearly two years after the World Health Organization declared it a global pandemic.
Kyaira White is set to give birth for a second time during the pandemic, with her baby due in late spring.
“I was hoping things would be over,” White, of Ellenwood, Georgia, told ABC News. “I’m just not looking forward to having to have a C-section and have your mask on.”
As a first-time mom, White didn’t know what to expect when she gave birth to her son last year.
“Everything was so new to me,” she said.
Weeks after recovering from COVID-19, she tested positive for the virus upon admission on what she said turned out to be a faulty batch of rapid tests. She said she wasn’t able to see her son in the neonatal intensive care unit for several days until it was sorted out.
“The hospital kind of was just giving me the runaround because they knew I didn’t know anything,” she said.
Much has been learned about the virus in the past two years, particularly around the risk of infection for newborns following delivery, allowing medical associations to update their guidance. However, COVID-19 continues to complicate families’ plans, oftentimes limiting who can be at the hospital and, if a parent tests positive before the delivery, restricting visits to NICUs.
Some hospitals also may still lag on standards of care when it comes to keeping otherwise healthy COVID-positive mothers and their newborns together, which can help foster bonding and breastfeeding, by instead separating them, according to Dr. Lori Feldman-Winter, a professor of pediatrics at the Cooper Medical School of Rowan University and the chair of the American Academy of Pediatrics’ Section on Breastfeeding.
“We understand how to care for mothers and babies during the pandemic, even when mothers present with positive PCRs for COVID,” Feldman-Winter told ABC News. For instance, immediate skin-to-skin contact was something “we weren’t sure about early in the pandemic,” but which the AAP currently recommends, she said.
Varying practices across hospitals means pregnant women should be prepared to advocate for themselves, and that hospitals might need to improve their care practices, according to Feldman-Winter.
“It is shocking, actually, how long it takes to get policies from the AAP into practice,” she said.
Where the latest guidance stands
AAP’s clinical guidance on care for infants born to a mother with a confirmed or suspected case of COVID-19 has remained largely unchanged since May 2021. The organization says that mothers and infants can room-in safely, as long as the mother is well enough.
“The evidence to date suggests that the risk of the newborn acquiring infection during the birth hospitalization is low when precautions are consistently taken to protect newborns from maternal infectious respiratory secretions,” the AAP said.
The Centers for Disease Control and Prevention also note that the latest evidence “suggests that the chance of a newborn getting COVID-19 from their birth parent is low, especially when the parent takes steps (such as wearing a mask and washing hands) to prevent spread before and during care of the newborn.” It advises birth parents to talk to their health care provider about the the “risks and benefits” of rooming-in and shares precautions to take in the hospital. “Having your newborn stay in the room with you has the benefit of making breastfeeding easier, and it helps with parent-newborn bonding,” it says.
The American College of Obstetricians and Gynecologists also advises that COVID-positive mothers and their infants “should ideally room-in according to usual facility policy,” due to the benefits of early and close contact, including “increased success with breastfeeding, facilitation of mother-infant bonding, and promotion of family-centered care.”
“Decision-making around rooming-in or separation should be free of any coercion, and facilities should implement policies that protect an individual’s informed decision,” it says.
The guidance deviates when an infant is in the NICU, where there typically is separation following a positive test, Gail Bagwell, president of the National Association of Neonatal Nurses, told ABC News.
“We cannot risk having moms in the NICU that are COVID-positive because the other babies are immunocompromised,” Bagwell said. “That said, our goal is to not separate moms from their babies. It’s a balancing act between the trauma that the baby could experience from not being with its mother to keeping every other child in that NICU safe.”
In practice
Early on in the pandemic, when much wasn’t known about the virus, COVID-positive mothers would often be separated from their newborns in the hospital. That started to shift in summer 2020 with updated CDC guidance that emphasized the mother’s autonomy in the decision, according to Dr. Melissa Bartick, an assistant professor of medicine at Harvard Medical School who studies breastfeeding.
“Unfortunately, a lot of hospitals had this separation policy, and they never changed that policy,” explained Bartick, who said she continues to hear reports of COVID-positive mothers and their infants being separated.
How long hospitals require COVID-positive parents to isolate before being able to visit the NICU may also vary from 10 to 14 days, Bagwell said.
It’s difficult to assess nationally what hospitals’ policies are currently when it comes to COVID-positive mothers due to a lack of tracking. The CDC’s national survey of Maternity Practices in Infant Nutrition and Care does look at room-in policies, though the 2020 survey did not address COVID-19 specifically, Feldman-Winter said.
“It would be useful to have a survey of exactly what hospitals are doing now with respect to infected mothers and infants, and … if they are separating, why they’re still separating,” Bartick said. “That would be useful to know because that should not be a standard of care right now.”
Hospital policies may be impacted by COVID-19 transmission in the area, their interpretations of CDC guidance and their risk tolerance, Bagwell said.
“Some people have lower tolerance for risk and other people have a higher tolerance for risk,” she said.
Whether a hospital is designated as a baby-friendly facility, meaning it has practices that optimize mother-baby bonding, could also impact room-in policies, according to Becky Mannel, clinical assistant professor at the University of Oklahoma Health Sciences Center and director of the Oklahoma Breastfeeding Resource Center.
“Most hospitals, especially if they were hospitals who were really already trying to follow best practice and keep moms and babies together … I would think that most hospitals are back to doing that,” she said. “We still have hospitals that didn’t have that as routine practice, so it’d be really easy for them to use COVID as an excuse to continue doing what they want to do.”
New moms may also be put in a tough spot trying to decide what to do if they test positive for COVID-19, Mannel said.
“If they’re actually not giving you really all of the current recommendations, have you made an informed choice at a time that you’re extremely vulnerable?” she said.
Kimarie Bugg, president of the Atlanta-based breastfeeding advocacy group Reaching Our Sisters Everywhere, said some moms may be able to advocate for themselves, while others might not have enough information.
“They say, ‘OK, fine, I’ll do whatever you say,'” she told ABC News. “It’s inconsistent.”
With her second baby due later this spring, White is optimistic she will have a smoother experience. She hopes she’ll be able to have her mother, in addition to her husband, with her for support — unlike last year, when she was only able to have one support person.
“Some things are definitely changing, but since COVID it’s been really different and painful. People aren’t even able to get into the hospital at all,” Bugg said. “So many grandmothers I know are sitting in the parking lot while their daughter’s in the hospital because they cannot go in.”
Where guidance goes from here
As more is learned about the virus, that could continue to impact guidance and policies, Bagwell said.
“It depends on what we find out,” she said. “As we learn more about this disease, as it goes from the very pandemic type of state that we’re in now to more endemic, like seasonal flu, I would predict that things would again change more.”
For instance, she said, during certain times of year NICU visitors are limited to just parents due to the flu.
The designs of NICUs — often open bays with multiple infants in the same area — also could have an impact on protocols. Even before COVID-19, there was a push for more family centered care in NICUs, such as private rooms with beds, Bagwell said.
“The newer NICUs that are being built are incorporating more of the single-patient room design into their NICU design,” Bagwell said. “Parents are caregivers and they’re the ones that take the babies home, so we want them there 24/7 if possible.”
The behavior of future variants could also impact guidance, Feldman-Winter said.
“It’s always ‘to be continued,'” she said. “That’s why we call the guidance ‘interim guidance,’ which we look at monthly, really, to see if we need to update or reaffirm.”
(NEW YORK) — Black New Yorkers were hit disproportionately hard during the omicron wave compared to white New Yorkers, according to a new analysis from the city’s Department of Health & Mental Hygiene published Wednesday.
Black New York City residents were hospitalized for COVID-19 at a rate more than two times greater than white residents.
For example, during the week ending Jan. 1, 2022, Black people were being hospitalized at a rate of 120.45 per 100,000 while white people were hospitalized at a rate of 47.14 per 100,000 that week, according to city data.
This is a much larger gap than seen during previous waves such as the delta wave in fall 2021 or the winter wave of 2020-21.
“This finding represents the impact of multiple points of failure in our system to adequately safeguard the health of Black New Yorkers,” the authors wrote. “It mirrors extensive national evidence documenting racial inequities in COVID-19 outcomes affecting Black persons across the United States.”
The report also found COVID-19 hospitalizations were much higher in New York City neighborhoods with a high percentage of Black residents.
For example, in the Bronx ZIP code 10469, which is about 53% Black, the hospitalization rate during January 2022 was about 274 per 100,000.
By comparison, the Manhattan ZIP code 10075, which is 87% white, had a hospitalization rate of 112 per 100,000 for the same period.
To address why there are such disparities, and how to narrow the gap, the NYC DOHMH also detailed structural racism that has played a role in why Black New Yorkers experienced worse outcomes.
One of these factors is that Black New Yorkers were at greater risk for COVID-19 exposure because they were less likely to be able to work from home since the start of the pandemic.
Additionally, the report also noted that Black residents are more likely to live in “multi-generational homes without adequate space for quarantine and isolation” which increases the risk of being exposed to the virus.
There have also been inequities in making such Black New Yorkers get vaccinated or boosted.
At the start of the omicron wave — Dec. 11, 2021 — only about 50% of Black residents were fully boosted compared to about 60% of white residents and a citywide rate of about 70%.
What’s more, by that same date, about 10% of Black New Yorkers had received a booster shot compared to about 25% of white New Yorkers “in part because fewer had completed their primary vaccination to be eligible for an additional dose,” the report states.
There were also delays in diagnosing Black residents with COVID-19.
The report found about 1 in 4 Black New Yorkers were not diagnosed until five days or longer after symptoms appeared compared to about 1 out of 4 other New Yorkers who took four or more days to get diagnosed.
“These extended times from COVID-19 symptom onset to diagnosis are driven in part by structural barriers such as decreased access to COVID-19 testing or time off work to seek testing,” the authors wrote.
However, there were some bright spots in the report. To close racial gaps, the city’s Taskforce for Racial Inclusion and Equity initiative identified 74 ZIP codes where vaccination rates needed to be boosted.
By February 2022, 73 of those ZIP codes had at least 70% of residents fully vaccinated compared to 14 ZIP codes as of July 2021.
“While the drivers of health inequities are complex and rooted in centuries of structural racism and disinvestment, the Health Department is committed to identifying solutions to protect and promote health today while also building long-term strategies to address structural factors,” the authors wrote.
(TALLAHASSEE, Fla.) — Florida’s state Senate on Thursday passed a bill that bans abortions after 15 weeks, the same gestational limit currently being reviewed by the U.S. Supreme Court.
The bill, HB 5, which passed the state House in February, is expected to move quickly to the desk of Republican Gov. Ron DeSantis, who has previously said he is supportive of a ban after 15 weeks.
If signed by DeSantis, the bill will go into effect July 1.
The bill does not make exceptions for rape or incest, but does allow for exceptions if the fetus has a fatal abnormality or in cases when the mother is at risk of death or “substantial or irreversible physical impairment.”
Those exceptions would require written certification from two physicians.
Currently, abortions are allowed in Florida up to 24 weeks of pregnancy.
Abortion rights advocates argue that banning abortion after 15 weeks will further harm patients who need care the most, including people of color, people of limited economic means and people who lack health insurance.
Dr. Sujatha Prabhakaran, chief medical officer at Planned Parenthood of Southwest and Central Florida, told ABC News that doctors like herself are “scared and sad” about the bill’s potential impact.
“The biggest impact of the bill is going to be hurting our patients’ access to the care that they need,” said Prabhakaran, also a practicing OB-GYN in Sarasota, Florida. “We know that when there are these restrictions, it doesn’t mean that the need for the care goes away, it just means that it makes it even harder for patients to access the care.”
HB 5’s passage in the Senate comes as the Supreme Court is reviewing a similar Mississippi law that bars abortion after 15 weeks.
In the case, Mississippi, Dobbs v. Jackson Women’s Health, the state of Mississippi is arguing to uphold a law that would ban most abortions after 15 weeks of pregnancy, while Jackson Women’s Health, Mississippi’s lone abortion clinic, argues the Supreme Court’s protection of a woman’s right to choose the procedure is clear, well-established and should be respected.
Since the Roe v. Wade ruling and the 1992 Planned Parenthood v. Casey ruling that affirmed the decision, the court has never allowed states to prohibit the termination of pregnancies prior to fetal viability outside the womb, roughly 24 weeks, according to medical experts.
If the Supreme Court rules in Mississippi’s favor and upholds the law — as is expected because of the court’s current conservative makeup — the focus will turn to states, more than half of which are prepared to ban abortion if Roe is overturned, according to the Guttmacher Institute, a reproductive rights organization.
Because the states that plan to ban abortion are focused in specific geographic regions, including the South, the expected effect is that women will have to travel much longer distances, at a greater cost and inconvenience, to seek abortion care, according to Elizabeth Nash, interim associate director of state issues at the Guttmacher Institute,
“If you’re thinking about the average abortion costing $550, and then somebody trying to navigate a trip of several hundred miles, you’re adding hundreds of dollars to the cost and you’re asking that person to pull that money together very quickly,” she told ABC News in January. “That is an insurmountable burden for so many.”
Prabhakaran said she and other doctors in Florida are already seeing patients from states as far away as Texas, which last year enacted a law that bans abortions after six weeks of pregnancy.
As of 2017, abortions in Florida represent just over 8% of all abortions in the U.S., according to the Guttmacher Institute.
According to Prabhakaran, a 15-week ban in Florida has the potential to force pregnant people to travel as far as North Carolina and Washington, D.C., for care.
“While abortion is very safe, the the higher the gestational age, the more risk there is potentially to patients who have a complication,” she said, adding that the lack of access also means some patients will continue with high-risk pregnancies while others will seek other care. “What I worry is going to start to happen again is that patients will be taking care from unqualified providers, and that that will put them at risk.”
Elena Hung and her 7-year-old daughter, Xiomara, of Maryland. Xiomara was born with a number of medical conditions affecting her airway, lungs, heart and kidneys. – Elena Hung
(NEW YORK) — When coronavirus shut down the nation nearly two years ago, 7-year-old Xiomara Hung and her family were quick to retreat to their Maryland home in an effort to help curb the spread of the virus and avoid any potential infection.
Like many children across the country, Xiomara and her brother were forced to trade their backpacks for laptops as the virus forced schools online.
However, unlike most students, who are now back to in-person schooling, Xiomara, who was born with a number of medical conditions affecting her airway, lungs, heart and kidneys, has not yet been able to return. Because she is immunocompromised, her parents have been faced with the difficult decision to keep her away from her peers in virtual schooling while the virus is still circulating.
“It’s been really hard,” Xiomara’s mother, Elena Hung, told ABC News. “But in a way, it wasn’t a hard decision. Do we keep her safe and alive, or do we send her to school? The goal is absolutely her to go to school, but I have to weigh that against her safety. There’s no point in going to school, if she’s going to get sick, and she might end up in the hospital.”
The consequences of losing that in-person interaction has been “extremely difficult” as “they are missing out on very important social development.”
Although the omicron surge appears to be steadily subsiding in the U.S., for families like Xiomara’s, the pandemic feels far from over.
“The past two years has been very difficult for us, and even now, more so in 2022, as we are seeing mask mandates lifted, we are seeing fewer protections for people who are disabled and immunocompromised and chronically ill. In so many ways, we feel like we are being left behind as people are trying to return to ‘normal,'” said Hung, who co-founded the organization Little Lobbyists, which aims to advocate for children with complex medical needs.
Across the country, dozens of states and cities, led by both Republicans and Democrats, have moved rapidly in recent weeks to declare an end to COVID-19 restrictions.
“With more New Yorkers getting vaccinated, and the steady decline over the past several weeks in cases and hospitalizations from Omicron, we are now entering a new phase of the pandemic,” New York Gov. Kathy Hochul said in a statement this week upon lifting the mask mandate for schools.
Hochul’s message of a nation moving on in its fight against COVID-19 echoes that of many state and local legislators, as well as President Joe Biden, who, during his State of the Union address Tuesday, declared that “COVID-19 no longer needs to control our lives.”
However, despite the president’s suggestion that “we’re leaving no one behind or ignoring anyone’s needs as we move forward,” many immunocompromised Americans say they indeed feel “left behind.”
“We do lead lives that make us look at life and death differently, but we also have normal life,” Hung said. “Xiomara is a kid, who does all the things that a typical 7-year-old does. Her normal is the same normal. But she can’t accept that normal, if anybody’s going back to school, not wearing a mask.”
‘Immunocompromised patients matter’
With pandemic “fatigue” strong, many Americans have been vocal in their hope to leave COVID-19 behind and return to a long desired sense of normalcy.
Last week, the Centers for Disease Control and Prevention unveiled their new plan for determining COVID-19 risk in communities, and updated its recommendations for mask-use.
Under the new risk levels, approximately 90% of the U.S. population now lives in areas deemed to have low or medium threats to their local hospitals, and thus can stop wearing masks.
“Americans in most of the country can now be mask-free,” White House coronavirus response coordinator Jeff Zients said in a briefing on the plan Wednesday.
The administration has also pledged to take key steps to help individuals who are disabled, including those who suffer from weak immune systems.
“We will continue to address the specific needs of seniors, people living with disabilities and people who are immunocompromised. These are the Americans who need our focus and attention right now,” added Health and Human Services Secretary Xavier Becerra.
However, doctors say those at highest risk should still be wary of taking off their masks.
Across the country, about 2.7% of the population, according to the CDC, are living with weakened immune systems because of a variety of causes, such as active cancer treatment, organ or stem transplant or primary immune deficiency diseases.
For some of these 7 million high-risk Americans, COVID-19 has been “devastating.”
“I see the devastating effects of this viral infection every day as it leads to death and disability of my patients who were previously leading healthy, active lives,” Dr. Jeannina Smith, medical director of the transplant and immunocompromised host service at the University of Wisconsin, told ABC News. “Omicron was not mild for our patients.”
COVID-19 has been the “leading cause of death” in transplant programs at the University of Wisconsin for the last two years, Smith said.
“Immunocompromised patients matter,” Smith stressed. “The new CDC guidelines have absolutely left my patients behind, effectively abandoning them. The goal of the new cutoffs for COVID activity only focus on keeping hospitals from being overwhelmed, with a stated understanding they will not prevent infection. My patients are still dying of COVID despite every medical advance.”
Vaccines have been shown to be less effective for people living with weakened immune systems, putting them at greater risk of serious COVID-19 disease and death compared to the general population.
There are also many Americans with other chronic or long-term conditions, such as diabetes or asthma, who could become quite ill if they were infected.
“COVID-19 remains a threat for most vulnerable Americans — poor, rural patients, minorities, patients that are old or with comorbidities, immunocompromised, or with cancer and the vaccine-hesitant. Many patients will have one or more of these categories,” Dr. Jaime Imitola, the director of UConn Health’s division of multiple sclerosis and translational neuroimmunology, told ABC News.
Getting back to ‘normal’ right now may not be possible for everyone
Vulnerability to infection is a great concern to many immunocompromised Americans. However, many are also anxious about facing increased isolation as states lift mask mandates and other pandemic safeguards.
“Everyone wants to go back to normal but that normal sacrifices our normal,” said Christa Xavier, 30, of Pennsylvania.
Xavier, who suffers from fibromyalgia, was also a former smoker, putting her at increased risk of severe disease. Prior to the pandemic, she worked for 10 years in retail, a career that she has been forced to abandon due to her condition.
“It’s just been extraordinarily difficult to find work that is remote. That’s really tough,” said Xavier.
Now an artist, Xavier feels confined to her home as she fears potential infection with people taking off their masks.
“It basically feels like just being left behind. It’s like everyone is kind of looking at me like, ‘Well, you really should maybe just get back to normal.’ I don’t think anyone really understands what it’s like,” Xavier said. “I could just go outside and within two weeks, I could be dead. … I’m not risking that to go to Target.”
A new KFF poll released this month found that while nearly two-thirds of Americans reported they are worried about the potential economic and social repercussions of retaining COVID-19 restrictions, 61% of those surveyed also said that they are concerned that the move to end mitigation efforts will put immunocompromised people at increased risk.
Even with the Biden administration’s promise that treatments and free high-quality masks will be made widely available to those at high-risk, Xavier said that as mitigation measures drop, she fears a potential viral resurgence should a new variant emerge.
“It felt like it’s just, ‘Well, you guys can wear masks,'” she explained, in reference to the president’s remarks at this year’s State of the Union. “That’s not going to be enough if we have a deadlier variant, or more-contagious variant.”
With 2022 midterm elections approaching, governors have picked up on the fact that Americans are tired of the pandemic’s restrictions, particularly the mask mandates, Xavier argued, which advocates fear may severely affect marginalized communities.
“I think a lot of the politicians … have agendas,” said Xavier. “They want to make it look like things are going awesome, and it kind of feels like immunocompromised people are getting sacrificed.”
COVID-19 must still be monitored closely to keep vulnerable safe, experts say
Health experts fear that the waning omicron surge could be erroneously equated with the end of the epidemic, and thus, the relaxation of COVID-19 safety measures could lead to the emergence of vaccine-escaping variants, potentially leading to another surge of infections.
“There are still emerging threats, like long COVID-19, COVID-19 reinfections and new mutants that will escape the immune system,” Imitola said. “Reducing the restriction will have a domino effect in complacency that will affect the patients that are at higher risk. During this winter, we have seen an increase in the number of cases of COVID in patients that are immunocompromised due to the reduction of mask-wearing and no vaccination and putting the guard down in social gatherings.”
Smith stressed that authorities must continue to monitor a wide array of COVID-19 metrics, not limited to hospital capacity, in order to prevent infections in the vulnerable. In addition to high-quality free masks and equitable access to home testing to identify infection early, Smith advocated for “safe spaces” to be created in grocery stores, pharmacies and schools where everyone is masked to protect the immunocompromised.
Health experts also urge businesses to continue to keep the safety immunocompromised staff in mind, so they can feel comfortable at work and are not forced to work remotely.
“I understand that we are all tired, and I am not asking people to stop their lives,” said Hung, but waiting a little longer before doing away with mitigation efforts might “save someone’s life.”
Immunocompromised Americans are an integral part of the community and workplaces, and their absence would be keenly felt, Xavier added.
“We are not optional members of society,” Xavier said. “You can’t just tell us to shut ourselves away and wear a mask forever. Our ‘normal’ matters just as much as everyone else’s.”
(NEW YORK) — While much of the country is relieved to move into a new phase of the COVID-19 pandemic, millions of families with young, unvaccinated children have looked on with frustration, feeling forced to now raise their guard even higher.
“Just going to the grocery store is less safe now, because we can’t rely on other people protecting him by wearing a mask,” said Rebecca Sanghvi, the mother of a 2-year-old son.
Vaccines for children under 5 years old aren’t expected until sometime in the spring. During his State of the Union address, President Joe Biden said scientists were working hard to get them authorized and pledged to “be ready with plenty of vaccines if and when they do.”
Sanghvi, an instructional coach with the Washington, D.C., Public Schools, her husband and their 5-year-old have led a cautious life during the pandemic to protect their youngest family member.
She knows that there’s a very low chance of her son getting severely sick, but after two years of near-misses, her and her husband can barely afford taking time off work for another quarantine.
They do the necessities, like going to work and attending school, but they don’t dine indoors or go to crowded indoor places, like museums. They don’t see friends indoors. Playdates are at the park, outside.
She wishes the Centers for Disease Control and Prevention had waited for young kids to get access to vaccines before easing the national guidelines for masks, which put 70% of the country in areas where it was no longer required.
“I want to protect my kids. And [masks] seem like not an overwhelming price to pay with all of the unknowns that there are,” Sanghvi said.
Her son is one of about 20 million kids in the U.S. who still can’t get vaccinated — the last age group in the country.
Doctors urge parents to hang on for a few more months
The American Academy of Pediatrics recommends all kids under 5 continue to wear masks — a recommendation that will likely stand until vaccines are available for that group sometime in late spring, said Moira Szilagyi, president of the organization.
The hope is that transmission continues to decrease until then, at least reducing some stress around the virus, and the vaccine could arrive before a potential increase in cases over the summer.
“I share their pain. We see families in our offices and practice settings every day whose children are stuck in this in-between world,” Szilagyi said.
But now is not the time to let your guard down, Szilagyi and other doctors emphasized.
“You should continue to do everything you can to prevent the infection, because we don’t have a great way of telling if your kid will do great or your kid will not,” said Dr. Diego Hijano, a pediatric infectious disease specialist at St. Jude Children’s Research Hospital.
Many parents also worry about their young children developing long COVID, even if the initial infection is mild. But the research is still limited.
Children can get long COVID, experts said, but it’s less common than in adults. When vaccines become available, that is expected to further reduce the risk, as it has for kids ages 5 to 11.
So what are the best ways to stay protected?
In the meantime, experts say that even if other people aren’t wearing masks around kids, they can still be relatively protected if they wear high-quality masks themselves, like surgical masks, N95-equivalent masks made for children, or even cloth masks with at least two layers.
“It will be at least some defense — and enough to make it worthwhile,” said Szilagyi.
Doctors also recommend “cocooning” children with vaccinated people — surrounding them with family and friends who are up to date on their vaccines and boosters.
“If you can get parents, siblings, grandparents on board — that’s the first step because that’s the best way to protect the kid in the house,” Hijano said.
And playing outside without masks is relatively safe, said Hijano, who has young kids.
Traveling has also been proven to be low risk, particularly road trips, and outings to the movie theater, where the seats are relatively spaced out, can be a good activity, he said.
And in the next few weeks, watch for continued improvements in the pandemic’s trajectory.
“Clearly, when masks come off, then that will increase the risk, particularly for unvaccinated children under 5,” said Dr. Dan Barouch, a virologist at Beth Israel Deaconess Medical Center.
“But that is somewhat counterbalanced by the fact that the overall number of cases is much, much reduced compared with where we were a month or two ago and the severity of illness with omicron is lower than the severity of illness with delta or the prior variants,” he said.
Barouch, too, recommended continued mask-wearing and avoiding public indoor gatherings until things improve, as did Dr. Robert Frenck, a vaccine researcher at Cincinnati Children’s Hospital.
“There’s no data to show that the masks are dangerous. There’s no data to show that kids can’t recognize emotion. In fact, there’s data to show kids can recognize emotion because they pick up most of the emotion out of the eyes,” Frenck said.
He urged people to respect one another’s decisions around masks.
“A parent should be allowed to make their decision about a mask,” he said. “And they should feel no recrimination by anyone because they made the decision for their child.”
(NEW YORK) — When the first coronavirus vaccines were shipped out across the country more than a year ago, millions of Americans waited eagerly for their turn to get a shot, hoping that it would lead to a return to normal.
In the spring of 2021, after every adult became eligible for the vaccine, over 2 million people a day were getting their first dose. However, in recent months, with most of those willing to get their shots now inoculated, vaccination rates have plummeted.
The number of Americans who are receiving their first COVID-19 vaccine now stands at a pandemic low, with fewer than 80,000 Americans initiating vaccination each day. Further, since December, the rate of people getting boosted has also fallen significantly, dropping from 1 million booster shots administered a day to less than 140,000.
“Dropping of local vaccine mandates and the end of the omicron surge are likely contributing to a stalling out in first time vaccines and boosters,” said John Brownstein, Ph.D., an epidemiologist at Boston Children’s Hospital and an ABC News contributor. “Unfortunately, at this point, there are not many tools left in the toolbox to encourage people to be up to date.”
Although there are certainly fewer unvaccinated than vaccinated people in the U.S., tens of millions of Americans remain unvaccinated and unboosted. Across the country, more than 58 million eligible Americans remain unvaccinated, while 87.6 million Americans — about half of those currently eligible to be boosted — have yet to receive their supplemental dose.
Amid the declining interest, some scientists and health officials say it is possible Americans could need an additional booster this fall, or seasonal boosters in the future, to address waning vaccine immunity or new coronavirus variants.
“The potential future requirement for an additional boost or a fourth shot for mRNA or a third shot for J&J is being very carefully monitored in real time, and recommendations, if needed, will be updated according to the data as it evolves,” White House chief medical adviser Dr. Anthony Fauci during a press briefing last month.
The experts interviewed by ABC News are concerned about how to convey that message while maintaining trust as well as how additional doses might further exacerbate inequities in access and care around the country.
Since the fall, immunocompromised Americans have already had the option to receive a fourth mRNA dose. However, for the general public, the benefit of additional doses still is not clear.
In an interview with Bloomberg TV last week, Fauci said that the Centers for Disease Control and Prevention is studying data on a “month-by-month basis,” and should durability rates continue to fall, officials will have to decide whether to begin offering a fourth dose, particularly to those at higher risk, such as the elderly.
However, even if data emerges indicating the need for a fourth dose, convincing Americans to get another shot may present a new set of challenges.
“I think we can expect to see less uptake of fourth doses than we saw of third doses,” Dr. Shira Doron, an infectious disease physician and hospital epidemiologist at Tufts Medical Center, told ABC News. “A change in the messaging around the goal of the vaccination program would help a lot.”
Some people point erroneously to the increase in breakthrough infections as a reason to not get vaccinated, she said.
Thus, experts say, it is important for public health experts to emphasize the benefit of vaccination, and how dramatically reducing the risk of developing severe illness or dying if infected.
In December, a period of omicron dominance, unvaccinated people were 14 times more likely to die of COVID-19 compared to people who received the one-shot Johnson & Johnson shot or two shots of Pfizer and Moderna vaccines.
Health experts also caution that if a fourth dose is eventually needed, it will be important for health officials to outline what the purpose of an additional dose would be.
“Are we trying to prevent all infections, or are we trying to prevent severe disease?” Doron asked. “Public messaging that is honest about the waning effectiveness for infection and focuses on a need for additional doses only when effectiveness against severe disease has waned, and only for those populations in whom that has happened, might help restore trust and increase vaccine uptake.”
Evidence exhibiting protection against severe illness and death, will ultimately be paramount, Brownstein added.
“Clinical data, combined with real-word evidence, must show that additional shots provide critical protection against severe illness and death,” he said.
Experts are particularly concerned about the continued growing racial disparity in the current booster drive, and the impact such gaps in uptake could have on populations that are already at increased risk of severe COVID-19 outcomes.
Black and brown Americans are currently lagging in the booster effort, with only 39.5% of eligible Hispanic/Latino Americans boosted, and 43.8% of eligible Black Americans boosted. Asian Americans lead every race/ethnicity group, with 58.9% of the eligible population boosted.
“Vaccine rollouts have highlighted critical inequities in access and education, leading to concerning differences in vaccination rates across race and ethnicity,” Brownstein explained.
If additional shots are needed in the future, experts worry about deepening inequities.
“A fourth shot strategy is likely to only further inequities in protection unless accompanied with direct efforts to bring the entire population up to date,” Brownstein added.
As health officials plan for the months and years ahead, Doron suggested there are several potential ways to proceed, including switching to an annual vaccination should a seasonal pattern with COVID-19 emerge or waiting for continued signs of waning effectiveness and recommending a fourth dose then, particularly to those at high risk.
“Any determination that additional booster doses are needed will be based on data available to the agency,” a representative from the FDA told ABC News in a statement.
Regardless of how officials decide to move forward, experts say it will be essential to convince Americans of the importance and benefits of vaccines, and thus, that low COVID-19 vaccination rates could not only undermine recovery prospects, but potentially also lead to another surge of infections in the advent of a new variant.
“The case for a fourth shot needs to be incredibly compelling, if we expect the American public to get on board,” Brownstein said. “The focus should continue to be on primary care providers and frontline health care workers to continue to educate the public on the value of vaccines.”
(ATLANTA) — The gap in COVID-19 vaccination uptake between rural and urban Americans is continuing to widen, a federal report published Thursday found.
As of Jan. 31, 2022, 75.4% of people aged five and older living in urban counties have received at least one dose of the vaccine, according to the Centers for Disease Control and Prevention.
By comparison, just 58.8% of those living in rural areas had been given at least an initial shot — a nearly 17% difference.
However, a previous report by the federal health agency found that, in April 2021, the gap was smaller with 45.7% of urban residents given at least one dose of the COVID vaccine compared to 38.9% of rural residents.
This means that in the span of nine months, disparities based on geographic location have more than doubled.
The authors say the large gap is likely due to less access to health care and increased vaccine hesitancy in rural areas.
“Addressing barriers to vaccination in rural areas is critical to achieving vaccine equity, reducing disparities, and decreasing COVID-19-related illness and death in the United States,” the authors wrote.
According to the new report, 46 states had higher COVID vaccine uptake in urban areas than in rural areas with just one state — Arizona — having higher coverage in rural areas.
Three states: Delaware, New Hampshire and Rhode Island, and Washington, D.C., have no rural counties so differences in vaccination coverage could not be evaluated.
In both rural and urban counties, women were more likely to be vaccinated than men.
Data showed 77.4% of urban women and 61.4% of rural women had received at least one dose by the end of January compared to 73.2% of urban men and 55.7% of rural men, respectively.
This is similar to the CDCs report looking at April 2021 vaccination rates, which also showed more women getting vaccinated.
Among all age groups, vaccination uptake was higher in urban counties with the largest difference being among 12-to-17-year-olds.
The report showed just 38.7% of rural teenagers had received at least an initial vaccine dose compared to 64.9% of urban teenagers.
However, the researchers found that there was relatively no difference in the percentage of people in rural or urban areas who received booster or additional doses, both being similarly low.
About 50.4% of fully vaccinated urban residents had received a booster shot as of Jan. 31, 2022 as had 49.7% of rural residents.
The CDC authors noted Americans living in rural counties tend to be aged 65 or older and have more pre-existing conditions.
This puts them at high risk of severe COVID-19 complications and is why rates of death from the virus are higher in rural areas than in urban areas.
Dr. Matt Feeley, part of ABC News’ Medical Unit, contributed to this report.
(NEW YORK) — In the early days of the coronavirus pandemic, as hospitals became overrun, a group of doctors began touting an anti-parasitic medicine called ivermectin as a viable treatment for COVID-19, one going as far as calling it a “miracle cure” for the coronavirus, despite experts in the medical community urging caution and warning that science so far did not support its use in the treatment of COVID-19 outside of a clinical trial.
“There is a drug that is proving to be a miraculous impact, and when I say miracle, I do not use that term lightly,” Dr. Pierre Kory, a critical care physician, said at a congressional hearing in December 2020. “And I don’t want to be sensationalized.”
Major health institutions like the FDA and CDC issued warnings urging against the use of ivermectin as a COVID-19 treatment, even as a group called the Front Line COVID-19 Critical Care Alliance, co-founded by Kory, and another group called America’s Frontline Doctors, continued to promote the drug on their websites, on social media and at speaking engagements — making ivermectin one of the most controversial topics related to the pandemic.
The drug, commonly used for livestock and pets in an animal-grade formula, is also FDA-approved in a human formula to treat parasitic infections and skin conditions such as scabies. In 2020, as the medical community was furiously looking for ways to treat coronavirus patients, and vaccines still seemed like a distant dream, a study in Australia suggested that ivermectin could “stop the SARS-CoV-2 virus growing in cell culture” in a laboratory.
But what happened in that test tube didn’t prove that the drug could heal a person sick with COVID-19 or prevent COVID-19 in people, and the university website where the study is posted warns that “whilst shown to be effective in the lab environment, ivermectin cannot be used in humans for COVID-19 until further testing and clinical trials have been completed to establish effectiveness of the drug.”
Ivermectin advocates often cite “dozens” of studies that show benefits of ivermectin in combating COVID-19, but a closer look at the studies shows that some of them have been retracted for flawed or fabricated data and analysis, while many randomized trials have shown no benefits. There have been some small studies that did suggest positive effects of ivermectin on treating COVID-19 patients, but no large, rigorous, randomized controlled trial has shown that COVID-19 is effective at treating or preventing COVID-19, medical experts say.
The general consensus in the medical community now is that there’s not enough data to recommend ivermectin for routine use as a COVID-19 treatment, said Dr. Adrian Hernandez, professor of medicine and vice dean and executive director of Duke Clinical Research Institute, who is leading a nationwide clinical trial on potential treatments for COVID-19. And doctors point out that there are side effect risks with any pharmaceuticals, so using the medication for unintended purposes may be dangerous.
And even with the arrival of highly effective treatments and vaccines, support for ivermectin has continued among some vaccine skeptics, including Kory, who have championed the drug as a COVID-19 cure and a key part of early treatment, and have urged Americans to stock up on it.
In August, prescriptions for ivermectin jumped to nearly 25 times the normal rate, to 88,000 per week, up from just 3,600 per week before the pandemic, according to the CDC.
“Let me just say very clearly that ivermectin is not a recommended treatment for COVID-19,” U.S. Surgeon General Vivek Murthy said in August. “It is not a recommended drug to prevent COVID-19.”
At your doorstep within days
Despite the warnings from health agencies about unproven COVID-19 treatments, several physicians groups have partnered with telemedicine platforms and pharmacies to offer easy access to drugs like ivermectin. But the easy access comes at a cost, with a telemedicine visit and the cost of the prescription typically ranging from $90-$300.
ABC News was able to obtain 28 pills of ivermectin for a total of $339, including a $90 telemedicine consultation fee and a charge of $249 from an online pharmacy — which included a $25 shipping fee for overnight delivery — after filling out an application and providing a medical history through a telemedicine platform, and having a brief conversation with someone who claimed to have no knowledge about the drug or COVID-19.
It was an unusual process for obtaining a medicine: Georgia-based ABC News Senior National Correspondent Steve Osunsami first spoke with a woman who said she was calling from Alabama and described herself as a technical nurse, while a Florida-based nurse practitioner — who didn’t speak with Osunsami but had a license to practice in Georgia — sent the prescription for the pills to a New York pharmacy that then shipped the pills to Georgia.
Osunsami began the process by registering online, after which he was contacted by the woman in Alabama. “Which one of the medications are you interested in?” she asked Osunsami, who told her he was interested in ivermectin. The woman then asked him if he had high blood pressure or allergies, and took some additional information.
“All right, that’s all the information I need,” the woman said. “So let’s send this to the pharmacy.”
Asked if there was anything else to know about the drug, the woman directed Osunsami to the pharmacy that would fill his prescription.
“I don’t have any medical knowledge as far as medicine or even about COVID,” said the woman. “I don’t have any medical knowledge at all. I’m so sorry, but I really don’t.”
But no matter, because the prescription was already on its way.
Osunsami was not asked if he wanted a consultation with a doctor or a pharmacist. He did receive some guidance including how to use the medicine and what side effects to look out for with the drug.
‘Millions of dollars being made’
One year after his congressional testimony, Kory doubled down on the anti-parasitic drug, calling ivermectin the “single greatest solution to the pandemic” in a blog post earlier this month — even though top health agencies have said ivermectin is not yet proven to be effective against the coronavirus.
And just days ago, Kory launched his own telemedicine platform that offers ivermectin as part of its treatment protocols. For $250, his website offers a 15-minute “‘Meds on Hand’ Treatment Kit” consultation with a nurse practitioner through text or telephone — and for a premium of $950, you can even arrange a personalized visit with Kory himself. The website doesn’t say whether the platform sends the drugs to a pharmacy or it sells them directly. It says ivermectin is part of their treatment protocol.
The website offers ivermectin and a few other drugs like hydroxychloroquine, a once-promising COVID-19 treatment that had its FDA emergency authorization revoked after it failed to show a benefit in large studies, as part of its COVID-19 treatment protocols.
Neither Kory, representatives for his new telemedicine platform, or members of the Front Line COVID-19 Critical Care Alliance responded to ABC News’ multiple requests for comment regarding promoting the use of drugs for the treatment of COVID-19 that have not been proven to be effective treatments for the disease.
Critics say that at least one other group is capitalizing on the interest in ivermectin — apparently by leveraging a network of doctors available to write the prescriptions.
ABC News obtained an email sent by Encore Telemedicine, an entity that was connecting patients to telemedicine services for people seeking consultation through the physicians group America’s Frontline Doctors. In the email, Encore Telemedicine sought to entice physicians to “become part of an ivermectin ‘COVID-19 project'” with the potential to receive “tens of thousands of dollars per month” from prescribing ivermectin and hydroxychloroquine.
“We can send you as many patients per day at $30 per patient per encounter as you would like,” the email stated. “We have physicians making tens of thousands of dollars per month.”
Neither Encore Telemedicine nor America’s Frontline Doctors responded to ABC News’ requests for comment. Encore Telemedicine’s website has been down for several months.
The booming online industry of telemedicine offering unproven COVID-19 treatments like ivermectin has caught the attention of lawmakers, who have launched an investigation into America’s Frontline Doctors and SpeakWithAnMD.com, a telemedicine platform.
In a letter sent by the House Subcommittee on the Coronavirus Crisis to America’s Frontline Doctors, House investigators refer to Encore Telemedicine, the company that ABC News obtained the email from, as the parent company of SpeakWithAnMD.com.
The House probe, launched in October, is investigating the entities for allegedly “spreading misinformation and facilitating access to disproven and potentially hazardous coronavirus treatments, such as hydroxychloroquine and ivermectin.”
“Attempts to monetize coronavirus misinformation have eroded public confidence in proven treatments and prevention measures and hindered efforts to control the pandemic,” Rep. James E. Clyburn (D-S.C.), chairman of the House Subcommittee on the Coronavirus Crisis, wrote in a letter to Dr. Simone Gold, the leader of America’s Frontline Doctors, over the fall.
“We think there are millions of dollars being made by various groups selling misinformation,” Clyburn told ABC News. “[We’re] doing what we think is necessary to try to get to the bottom of this.”
