Health

(NEW YORK) — Amid growing concerns about the impact of the pandemic on Americans’ mental health, and the rollout of a new three-digit number for the National Suicide Prevention Lifeline this summer, advocates say local call centers across the nation remain underfunded and understaffed for an expected increase in call volume.

Despite the effort to improve the system, they say, people in crisis could face delays — or might not be able to reach a counselor at all.

On July 16, the Lifeline will transition from its current 10-digit hotline number to the much easier to remember 988, modeled after the 911 emergency number for police and fire.

The 24-hour hotline has been in service since 2005, and in that time has received more than 20 million calls from people looking for help.

“What we’re building on is a proven, existing service that’s shown to reduce emotional distress and suicidality,” Lifeline Executive Director Dr. John Draper told ABC News. “It’s essentially scaling up that service to make sure that we’re going to be able to reach more people and serve them more effectively.”

When possible, calls are received by the nearest crisis center, but if a local center cannot handle them, they get routed to one of several national backup centers that receive federal funding to maintain staffing.

“And the more that happens, the longer people wait. And that’s something you don’t want for people in crisis,” Draper said is the case when there’s not enough money.

The Substance Abuse and Mental Health Services Administration (SAMHSA), which allocates federal funding for the program, estimates a 25% increase in callers to the Lifeline for fiscal year 2022. The 988 number will only be operational for the final three months of that period.

During the first full year of 988 implementation, FY2023, SAMHSA estimates calls received will reach 7.6 million, which is more than double the most recently recorded metrics.

This year, the federal government allocated $282 million through SAMHSA for 988 implementation, an amount stakeholders call “unprecedented.”

The organization has two major goals for supporting the Lifeline crisis center network, according to John Palmieri, acting lead for the 988 and behavioral health crisis team at SAMHSA.

“One of them is making sure that there is that safety-net infrastructure that exists at the national level, so that when individuals call, if for some reason those calls aren’t able to be received at the local level, that there’s a national safety net to support those individuals in crisis,” Palmieri said.

A total of $177 million dollars is dedicated to fund the backup centers with the other $105 million going to states and territories to support local crisis centers.

“We really feel like from the perspective of the individual in crisis, it really is best for them to be connected at the local level to the degree possible, to be better integrated with the local system of care, to provide wraparound services and so on,” Palmieri said.

An internal 2021 survey of local crisis centers in the Lifeline network found that only about 43% were explicitly funded to answer Lifeline calls, according to Draper.

“They were simply volunteering their services because their organization, their agency’s mission, aligned with ours,” Draper said. “And so they would basically borrow staff from other lines of business, who were dedicated to other lines of business, to help answer calls that were unfunded. So that’s the steep hill that we have to climb.”

Since its inception, the Lifeline network has been underfunded, according to Draper. With the transition to a three-digit number looming, even more funding is needed to ensure centers are adequately staffed to accommodate the expected increase in callers.

As it stands, Draper says about 20% of calls that should be answered at the local level are currently being picked up through the national backup network. Even with the national backup network, a SAMHSA report shows that at its current capacity, the Lifeline can only address approximately 85 percent of calls.

Because local crisis centers are funded at the state level, resource allocation and sustainability of funding are inconsistent across state lines.

The National Academy for State Health Policy (NASHP) has been tracking state level legislation around the implementation of 988.

“States are all over the map on this,” said Kitty Purington, senior program director for NASHP. “And I think there are many states who have not really grappled with what sustainability looks like going forward.”

When Congress enacted legislation to designate 988 as the new Lifeline number in 2020, that law included a provision allowing states to place a tax on cell phone bills to support the service. Similar taxes are used to support emergency medical and law enforcement services through 911 call centers.

Few states have enacted legislation to impose these taxes so far. A handful of others have implemented exploratory committees or provided some funding for the rollout of the new number.

“There’s going to be some time to build this out,” Purington said. “And potentially, it’s going to be something that states are going to be doing for years.”

She compared the transition to the implementation of emergency services through 911 call centers.

“People say [911] took like 60 years to really get its footing,” Purington said. “It took decades for people to really understand and have 911 be really the go-to number. And so, this is not going to be like flipping a switch.”

Stakeholders in the mental health field remain optimistic, despite the underfunding of the program. Laurel Stine, senior vice president of public policy at the American Foundation for Suicide Prevention, said, “ultimately, 988 is more than just a number.”

“It is an opportunity to really reimagine the behavioral health crisis response system,” Stine said.

Stine says the vision of an ideal 988 system would include well-resourced crisis centers across the country, the ability to provide follow-up care as needed, mobile mental health crisis response teams and crisis stabilization centers.

“We understand fully that a lot has to occur,” Stine said. “There are states that are well equipped, and have mobile crisis teams and are well-resourced and there’s others that are not. And so the local level of readiness is varied.”

The overall need is pressing.

U.S. Surgeon General Vivek Murthy recently sounded the alarm to lawmakers over an increase in suicide attempts among young people during the the pandemic.

And President Joe Biden called mental health a priority in his State of Union address earlier this month, saying, “let’s get all Americans the mental health services they need.”

If you are struggling with thoughts of suicide or worried about a friend or loved one, help is available. Call the National Suicide Prevention Lifeline at 1-800-273-8255 [TALK] for free, confidential emotional support 24 hours a day, 7 days a week.

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(NEW YORK) — As experts warn of a growing mental health crisis among kids due to the coronavirus pandemic, new data shows the mental health struggles kids faced even prior to the pandemic.

Between 2016 and 2020, the number of children ages 3 to 17 who were diagnosed with anxiety grew by 29% and those with depression by 27%, according to a U.S. Department of Health and Human Services (HHS) study published Monday in JAMA Pediatrics, a medical journal.

From 2019 to 2020, researchers found a 21% increase in children with behavior or conduct problems, according to the study.

“Our research highlights a critical need to support both children and their caregivers to improve families’ mental and emotional well-being,” Dr. Michael Warren, a co-author of the study, said in a statement. “This includes ensuring access to timely health care services and addressing social determinants of health to support children and families’ overall well-being.”

The study was conducted using data from the National Survey of Children’s Health (NSCH), which collects data on 36 separate health-related measures, including preventive health checkups, mental health diagnoses, physical activity and caregiver well-being, according to HHS.

In addition to finding an increase in the diagnosis of mental health conditions, the study also found that children’s physical activity decreased by 18% between 2016 and 2020. In addition, the proportion of kids with unmet health care needs grew by 32%, according to the study.

The study comes on the heels of a warning last year from the U.S. surgeon general of a growing mental health crisis among young people. Organizations representing child psychiatrists, pediatricians and children’s hospitals also declared a national emergency for youth mental health in 2021.

“I’m deeply concerned as a parent and as a doctor that the obstacles this generation of young people face are unprecedented and uniquely hard to navigate and the impact that’s having on their mental health is devastating,” U.S. Surgeon General Vivek Murthy said in testimony before senators in December.

The Centers for Disease Control and Prevention reported last year that emergency department visits for suicide attempts among teen girls were up more than 50% at the beginning of the pandemic compared to the same period in 2019.

Dr. Darien Sutton, a board-certified emergency medicine physician and ABC News medical contributor, said parents should realize that mental health conditions, including anxiety, may look different in kids than adults.

In children, anxiety in particular can manifest with irritability, mood changes, changes to interest in activities, and in physical conditions like stomachaches and headaches, according to Sutton.

“The first advice that I give to any parent is to have an open and honest conversation with your child at a level that they can understand,” said Sutton. “It’s important to know that your role in that conversation is to make sure that you validate and support their concerns.”

Sutton said parents should also reach out to their child’s pediatrician if they have concerns, or reach out for support through help lines like The National Suicide Prevention Lifeline at 1-800-273-8255.

If you are in crisis or know someone in crisis, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or contact the Crisis Text Line by texting HOME to 741741. You can reach Trans Lifeline at 877-565-8860 (U.S.) or 877-330-6366 (Canada) and The Trevor Project at 866-488-7386.

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(NEW YORK) — When the coronavirus receded across much of the globe last month and the omicron surge declined, many Americans were hopeful that was perhaps the signal that the United States was entering a new phase of the pandemic.

However, new data indicators, domestically and internationally, suggest that the virus continues to spread.

Although official counts of COVID-19 infections and hospitalizations are still declining, new wastewater data updated this week from the Centers for Disease Control and Prevention shows the United States may be seeing the beginnings of an uptick in COVID-19 infections.

Between Feb. 24 and March 10, 37% of wastewater sites that are monitored by the CDC have seen an increase of 100% or more in the presence of the COVID-19 virus in their wastewater. Approximately 30% of these sites have seen an increase of 1,000% or more.

“It is likely we will see a new rise in cases across the United States as our wastewater data is showing a concerning signal,” said Rebecca Weintraub, assistant professor of global health and social medicine at Harvard Medical School. “Now is a key moment to communicate why we need to accelerate the uptake of the COVID-19 vaccine, remind communities why boosters are needed, secure an ongoing supply of tests and N95 to communities — especially the red zones.”

Throughout the pandemic, wastewater surveillance has been a tool used as a preliminary indicator of COVID-19 trends in the U.S.

Because asymptomatic patients can shed the virus, wastewater surveillance can capture infections that may not have been identified in official counts. In addition, many Americans are taking at-home COVID-19 tests and are not reporting their results to officials, and thus, experts say, infection totals are likely undercounted.

Wastewater data is sparse across the country, but indicators show some sites in the Northeast, including in New York, Connecticut and Pennsylvania, as well as across Ohio, have seen notable increases in the presence of COVID-19 in local wastewater.

In New York City, some sites saw a 50% increase in the presence of COVID-19 in the city’s wastewater.

COVID-19 trouble brewing overseas

The uptick in the presence of COVID-19 in U.S. wastewater sites comes as other countries in Europe and in Asia are seeing significant viral resurgences.

Across some parts of Asia, COVID-19 has been surging to unprecedented levels. In Hong Kong, the number of virus-positive residents requiring hospitalization has been pushing health care facilities to the edge.

In China, more than 50 million people in the northeastern province of Jilin and the southern cities of Shenzhen and Dongguan, are heading into lockdown after a viral resurgence.

In Europe, COVID-19 cases have steadily been rising after many countries have moved to end COVID-19 restrictions.

Since the beginning of the month, new cases per capita in the United Kingdom have grown by 32% and hospitalizations are also up by 5% in the last week. In Germany, infections are up by 45%, while in Italy, daily cases have increased by 26%.

“Across Europe and in the U.K., we are seeing COVID-19 cases go up in countries just exiting from an Omicron BA.1 surge,” Dr. Sam Scarpino, managing director of pathogen surveillance at the Rockefeller Foundation and a member of its Pandemic Prevention Institute, told ABC News. “Since the beginning of the SARS-CoV-2 pandemic, what’s happened in Europe has happened around the globe. … We can’t afford to sit around and let this early warning from Europe again go unheeded.”

Many health experts have been raising the alarm about the global increase in infections and hospitalizations, suggesting that Americans should be prepared for the U.S. to follow a similar viral trend.

“The next wave in Europe has begun,” Dr. Eric Topol, professor of molecular medicine at Scripps Research, said in a tweet and a blog post on Saturday. “Any proclamation that the pandemic is over ignores the potential recrudescence of a new variant with high transmission and immune escape.”

Presence of omicron subvariant BA.2 steadily growing

What is behind this latest COVID-19 resurgence is still unclear. However, experts say it is likely a confluence of factors.

“While we know from genome sequences that the BA.2 omicron subvariant is what’s infecting people, we still don’t know what’s causing the resurgence,” Scarpino said. “Is it the increased transmissibility of BA.2, more vaccine breakthroughs, relaxing of non-pharmaceutical interventions, waning immunity, or all of the above?”

Last month, U.S. officials from the CDC unveiled a new plan for determining COVID-19 risk in communities and updated its recommendations for use of face coverings, allowing nearly all of the country to go mask-free under the new guidelines.

Across the pond, in the U.K., Prime Minister Boris Johnson recently declared an end to the country’s COVID-19 mitigation measures. Similarly, countries such as Denmark and the Netherlands have already ended restrictions, while in France, most COVID-19 limitations were lifted on Monday, just weeks before the presidential elections.

The presence of BA.2, a subvariant of omicron, has also been growing rapidly across the globe.

“BA.2 is itself highly transmissible, and both BA.1 and BA.2 appear to generate comparatively short-lived protection against reinfection. So it is likely that the combination of higher inherent transmissibility and higher rates of interaction as restrictions ease are combining to generate this resurgence,” Matthew Ferrari, director of the Center for Infectious Disease Dynamics at Pennsylvania State University, told ABC News.

In the U.S., the presence of BA.2 has been nearly doubling every week, according to federal data. Estimates indicate that the omicron subvariant now comprises an estimated nearly 11% of new cases in the U.S. as of March 5.

“We’ve been watching it closely, of course,” White House press secretary Jen Psaki said during a White House press briefing on Monday, pointing to the fact that BA.2 appears to be more transmissible. “We currently have about 35,000 cases in this country. We expect some fluctuation, especially at this relatively low level, and certainly that to increase.”

Experts say how significant a COVID-19 resurgence could be is still unclear, given how many Americans were infected in the nation’s omicron surge.

“I am hopeful that the large U.S. omicron wave will dampen a new surge, but I am concerned that we will see a resurgence as restrictions are eased,” Ferrari said. “Dropping masks and other restrictions will necessarily result in an increase in risk. How big that increase will be remains to be seen.”

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(LOS ANGELES) — Los Angeles Unified School District said it’s keeping its mask mandate in place — at least temporarily — even as California drops its requirement for masks in indoor public settings.

Several K-12 schools across the state dropped their face covering requirements Monday after the state lifted its mandate over the weekend.

Last month, Los Angeles County Public Health said it would follow the state’s move and allow the 80 school districts in the country to decide whether or not they want to keep mask mandates.

LAUSD, the second-largest school district in the country, said it does not want to drop the mask requirement yet as it works towards a plan with partners, including teachers’ unions, to move away from mandates and towards “strongly recommending” masks indoors.

“The science that informed the on-ramp to the protective protocols currently in place, which have ensured the well-being of our students and workforce, must, too, inform the off-ramp as health conditions improve,” LAUSD said in a statement on Twitter Friday.

“Los Angeles Unified continues to take a science-based approach to COVID-19 policy and is currently working with labor partners and other stakeholders to transition from required indoor masking to a strong recommendation for indoor masking,” the statement continued.

LAUSD did not indicate when its mask mandate might be lifted.

COVID-19 cases and hospitalizations in California have been declining for several weeks as the omicron wave tapers off.

As of March 11, the seven-day rolling average for cases was 4,625, according to the Centers for Disease Control and Prevention, the lowest number recorded since Dec. 1, 2021, before the omicron wave.

Similarly, the seven-day average for virus-related hospitalizations in The Golden State sits at 319, a figure not recorded since July 19, 2021, CDC data shows.

However, parents are divided on the mandate with some saying it’s time for masks to be removed and others still worried about a potential rise in cases.

“I think it’s time,” one parent, Elisa Smith, told ABC News affiliate KABC-TV. “If it’s time for us adults to take them off, I think it’s time for the children to take them off.”

“I want them to keep it on. I do, personally,’ another parent, Claudia Angulo, told KABC. “Why? Because it’s still out there, the virus, just to be safe.”

Ending mask mandates have received some pushback from teachers’ unions.

L.A. County public health officials made the announcement last month regarding the end of mask mandates, United Teachers Los Angeles said in a statement it would be “premature” to drop such requirements.

“The district has requested to bargain with UTLA over health and safety protocols currently in place at LAUSD schools,” a spokesperson for the union told ABC News in a statement. “We met with the district on Friday for an initial discussion over their proposed changes, and a follow-up session is scheduled for Wednesday, March 16.”

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(LOS ANGELES) — Hailey Bieber is on the mend after experiencing stroke-like symptoms last week.

Over the weekend, the 25-year-old model told her fans what happened on her Instagram stories and said it was “one of the scariest moments I’ve ever been through.”

“On Thursday morning, I was sitting at breakfast with my husband when I started having stroke-like symptoms and was taken to the hospital,” Bieber wrote. “[The doctors] found I had suffered a very small blood clot to my brain, which caused a small lack of oxygen, but my body had passed it on its own and I recovered completely within a few hours.”

In the U.S., strokes are the fifth cause of death and leading cause of disability, according to the American Stroke Association. It occurs when a blood vessel that carries oxygen and nutrients to the brain is either “blocked by a clot or bursts.” Usually when this happens, the American Stroke Association says, part of the brain can’t get the blood and oxygen it needs.

Board-certified emergency medicine physician and ABC News contributor Dr. Darien Sutton said there are three types of strokes. He said he believes Bieber had a transient ischemic attack, or “mini-stroke.”

“That’s when blood supply is temporarily reduced,” Sutton said. “And that can cause symptoms lasting anywhere from minutes to up to 24 hours.”

What was perhaps most shocking in Bieber’s case was her age, as strokes usually occur in older adults.

“It’s incredibly uncommon for a patient who is young and healthy to present a stroke, as it predominantly occurs in those over the age of 60,” Sutton said. “But I will say, given the pandemic, we’ve seen increased rates of COVID-19 associated with cardiovascular disease as well as stroke.”

Last month, Nature published an article about a massive study in which researchers found that the rates of many conditions such as heart failure and stroke “were substantially higher in people who had recovered from COVID-19 than in similar people who hadn’t had the disease.”

The risk was elevated for those who were younger than 65 and lacked risk factors such as obesity or diabetes.

Bieber’s health scare comes one month after her husband, Justin Bieber, contracted COVID-19. The singer, who has since recovered from the disease, had to postpone multiple concert dates on his Justice World Tour, including a show in Las Vegas, which was later rescheduled to June.

While Bieber is now home and thankful for the care she received from doctors and nurses, Sutton said the model did the right thing and encourages people to take note of the signs and symptoms of stroke.

“We all know the typical symptoms of a stroke, which can include sudden numbness or weakness on one side of the body, but I want to help clarify some other important symptoms,” Sutton said, pointing out that other symptoms can include sudden changes in speech, sudden changes in vision, sudden severe headache or acute dizziness.

“If you have any of these symptoms, it’s important to get help,” Sutton added. “An important tip is to take note of the time. When you get to the emergency room, we ER doctors are going to want to know how long these symptoms have been going on, and it helps direct our clinical care.”

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(ORO-MEDONTE, Ontario) — When Chloe McKnight was born 15 months ago, she had what looked like a slight scratch on her forehead, according to her mom, Ashley McKnight.

As Chloe grew, the mark grew too, becoming more prominent and beginning to resemble a red stain on her forehead, according to McKnight, from Oro-Medonte, Ontario.

At less than 2 months old, Chloe was diagnosed with a hemangioma, a noncancerous tumor made up of extra blood vessels, according to the American Academy of Pediatrics.

Hemangiomas, sometimes known as baby birthmarks, are the most common benign tumors in infants, occurring in around 5% of all births in the United States, according to the AAP.

While most hemangiomas go away on their own, Chloe’s kept growing, according to McKnight.

“It didn’t look like it was reserving at all and it just gradually got larger and larger,” she said. “At first it was just really flat and red, and then it started to grow in height.”

McKnight, also mom to two sons ages 3 and 5, said she extended her maternity leave out of concern for Chloe’s safety.

“It’s basically a tumor of blood vessels that would bleed if she were to bump it,” said McKnight. “Always that was in the back of our minds, just making sure that she never hit it or anything.”

As the tumor grew, McKnight said she and her husband and Chloe’s brothers treated it as just part of Chloe, touching it and kissing it, but acknowledged that it drew attention in public.

“If you were going out, you would always be reminded of it because people would obviously look up and be curious and wonder what it is,” she said, adding that the coronavirus pandemic helped the family to be in their “own little bubble” at home.

As Chloe got older and the tumor continued to grow, McKnight said she and her husband searched for a surgeon who could remove the tumor with as little damage as possible to Chloe’s face.

Through a Facebook group for parents of children with hemangiomas, the McKnights met Dr. Gregory Levitin, director of vascular birthmarks and malformations at New York Eye and Ear Infirmary of Mount Sinai in New York City.

Levitin described Chloe’s tumor as “unusually large” and one for which “there is no textbook” when it comes to operating.

“When I get these large ones, to have one on the forehead skin is an incredibly challenging area because you don’t have a lot of extra tissue to borrow from,” he said. “It acts like a cancer in the sense that it invades and takes up valuable tissue in the face.”

In January, Chloe and McKnight traveled to New York City for Chloe to undergo surgery.

Levitin removed Chloe’s tumor in a three-hour surgery in which he focused on not only controlling the blood vessels in the tumor, but also making sure her face appeared the same after surgery.

“[The tumor] dropped and touched the muscle of the forehead, so preserving the muscle and allowing her to have facial expressions was important,” said Levitin. “We wanted the shortest scar possible and so finding ways to manipulate the tissue to get the shortest scar possible was equally important.”

Levitin was able to successfully remove Chloe’s hemangioma and the recovery has been surprisingly easy, according to McKnight.

“I feel like she had a harder time with teething pain than with this whole process,” said McKnight. “It made me realize how resilient children are.”

While the swelling on Chloe’s forehead will take more months to go down, the toddler is even more active than before surgery, according to McKnight.

“She’s go, go, go all the time,” she said. “She was just herself and off to the races.”

Levitin said he often sees a transformation like that in patients because hemangiomas can be unknowingly taxing as they take up energy stores in the body.

“They take up a lot of blood volume and, in doing so, process a lot of the blood and nutrients,” he said. “I hear many stories about parents who feel within 24 hours that there’s been a transformation in their children’s behavior and energy.”

Levitin described it as “incredibly rewarding” to be able to make such an impact on a child.

“It’s an incredibly rewarding part of my job when I can take a child from a mother’s arms and return her back to that mother’s arms afterwards completely changed and with an appearance which is how she was first born, and now how she’ll live for the rest of her life,” he said.

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(NEW YORK) — Colorectal cancer is expected to claim the lives of more than 52,000 Americans this year, according to the American Cancer Society.

This is why, as the world tries to return to a sort of normalcy after the COVID-19 pandemic, doctors say health screenings — particularly for cancer — should be made an urgent priority.

“Colorectal cancer is the third-leading cause of cancer deaths in the United States, yet about a quarter of people ages 50 to 75 have never been screened for this devastating disease,” said Dr. Michael Barry, vice chair of the U.S. Preventive Services Task Force, or USPSTF, a panel of national experts in disease prevention and evidence-based medicine.

“Fortunately, we know that screening for colorectal cancer is effective and saves lives,” Barry said.

Doctors are trying to raise awareness that even people in their 40s should be getting screened. Thankfully, there are multiple ways to reduce the risk of colon cancer, including understanding when you should get screened.

Get screened: The most effective way to reduce your risk of colon cancer is to get screened routinely, beginning at age 45, according to the USPSTF. With expanded screening guidelines, more people can be screened for colorectal cancer resulting in significantly more lives saved. Several testing options are available — some are completed yearly while others may be done every 10 years. Together, doctors and patients should consider which screening option is best for them.

“Colonoscopies help identify polyps or precancerous growths as well as potentially provide treatment by removal at the same time” says Dr. Madhu Vennikandam, a gastroenterology fellow at Sparrow Hospital, an affiliate of Michigan State University College of Human Medicine.

Know your family history: Doctors say it’s essential to know whether your mother or father’s side of the family has a history of colon cancer. If there is a family history, you should begin screening at age 40, or 10 years before the diagnosis of the youngest first degree relative.

Barry adds, “people who have any signs or symptoms of colorectal cancer or a personal history of colorectal cancer, polyps, or a personal or family history of genetic disorders should talk to their clinicians to ensure that they get the care they need”.

Monitor diet: Medical experts recommend eating more fruits, vegetables, and whole grain while eating less beef, pork and processed meats.

Stop smoking: There are at least 70 chemicals in tobacco products which can cause cancer. According to a study published in the Clinical and Translational Gastroenterology journal, current smokers are estimated to have a 48% higher risk of colon cancer than people who never smoke.

Weight loss and exercise: Obesity (defined as a BMI greater than 30) is linked with a higher risk of 13 types of cancers, including colorectal cancer. In men, colorectal cancer is the most common obesity-associated cancer. With just 30 to 60 minutes of moderate to vigorous physical activity daily, you could reduce your risk of having the disease.

“Fortunately, we know that screening for colorectal cancer is effective and saves lives. If you’re 45 or older, talk to your clinician about this life-saving screening,” said Barry.

Pooja Sharma, M.D., is a family medicine resident at Emory University in Atlanta and a contributor to the ABC News Medical Unit.

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(NEW YORK) — The beginning of daylight saving time marks the arrival of spring every year. For some, the time difference can cause feelings of fatigue or more serious health symptoms.

First proposed over 200 years ago as an economical suggestion to maximize daylight hours and conserve candles, we continue to “spring forward” with one 23-hour day to transition our clocks.

According to the American Heart Association, in addition to the fatigue, the transition can also affect your heart and brain. Hospital admissions for an irregular heartbeat pattern known as atrial fibrillation, as well as heart attacks and strokes, increase in the first few days of daylight saving time.

“Daylight saving time feels kind of like jetlag from traveling across time zones,” said Dr. Angela Holliday-Bell, a pediatrician and certified clinical sleep specialist.

“Your body needs time to readjust to a new light/dark cycle, so it can be hard on the body and hard on sleep,” Holliday-Bell said.

This cycle, also known as the circadian rhythm, is a fine-tuned system that our bodies use to regulate time, she said. For most people, that cycle is about 24 hours and 15 minutes.

“It dictates all the processes that occur in your body — including sleep, wake and digestion,” said Holliday-Bell. Even the immune system is controlled by your circadian rhythm, meaning “when you lose an hour, you’re losing some immune function as well,” she explains.

Sleep deprivation can also slow the executive function of the brain, which explains the increase in car accidents seen with the time transition of daylight savings. Mood can suffer too.

Experts agree that there are several strategies to prepare your body all year round and for the days leading up to daylight savings time.

Start to wind down earlier in the evening.

Even for a few days, adjusting your sleep-wake cycle can help you feel more well-rested. Try moving your bedtime up in fifteen minute increments in the days before the clock sets back, until you’ve reached the one hour you’ll lose on Sunday.

Maximize natural light.

“Light is the strongest influence on circadian rhythms,” says Dr. Holliday Bell. “Getting natural light as soon as you can when you first wake up helps to reinforce your circadian rhythm.”

Limit caffeine.

The extra coffee might feel necessary to get through the fatigue, but too much caffeine is not heart healthy. It also lasts in the body for a long time, which can affect the ability to fall asleep or sleep restfully in the evening.

Gradual lifestyle improvements all year long and a concerted effort in the days leading up to the transition can help to soften the disruption to your circadian rhythm, so you can save daylight without losing anything else.

Chidimma J. Acholonu is a pediatric resident physician at the University of Chicago and a contributor to the ABC Medical Unit.

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(NEW YORK) — Health care providers that serve the transgender community in Alabama are struggling to make sense of a new bill moving quickly through the state legislature.

The Vulnerable Child Protection Act would ban gender-affirming care for transgender youth in the state.

Pediatric endocrinologist Hussein Abdullatif, who provides gender-affirming care for trans youth, said the legislation leaves many questions: Will trans youth be able to continue seeing their physicians? Will they be able to receive their medications?

“I worry about my patients,” Abdullatif told ABC News. “They already are showing a great deal of anxiety related to what’s going to happen.”

Abdullatif says it is not only his transgender patients’ physical health but also their mental health that is of concern. He said he has seen firsthand the way discrimination and lack of care can affect his trans patients.

“I do know of a kid who already attempted three times suicide — not because of law, of course, because they haven’t passed it yet — but because of resistance by the mother of the child to the idea of being transgender,” he said.

The bill states that anyone who provides gender-affirming care, including puberty blockers, hormone therapy or physical gender-affirming surgeries to anyone under 18, could be convicted of a felony and face up to 10 years in prison and a $15,000 fine.

The bill’s sponsor, Republican Sen. Shay Shelnutt, called gender-affirming health care, “child abuse.”

“We don’t want parents to be abusing their children. We don’t want to make that an option, because that’s what it is, it’s child abuse. This is just to protect children,” Shelnutt said on Feb. 23 on the state Senate floor.

Yet experts say the notion of gender-affirmation as child abuse as well as language used in the legislation — for instance — the claim that people can experience “permanent sterility, that result from the use of puberty blockers, cross-sex hormones, and surgical procedures” are forms of misinformation.

Debunking myths about transgender health care and gender-affirmation

The bill refers to “minors” and “surgical procedures” but in Alabama, gender-affirming surgeries aren’t allowed until a patient reaches the age of legal majority for medical decisions, which is 19.

“When lawmakers attempt to practice medicine with a life without a license, they realize quickly that there was a lot more they didn’t understand than what they thought they did,” said Morissa Ladinsky, an associate professor of pediatrics at the University of Alabama at Birmingham Department of Pediatrics.

The bill’s language also makes claims about mental health and gender affirmation which some experts say are false.

“Individuals who undergo cross-sex cosmetic surgical procedures have been found to suffer from elevated mortality rates higher than the general population. They experience significantly higher rates of substance abuse, depression, and psychiatric hospitalizations,” the legislation reads.

However, research from the Centers from Disease Control and Prevention found higher rates of substance abuse, depression and suicidal ideation were linked to stigma, discrimination and victimization experienced by this population.

Research shows that people who have gender-affirming surgery had significantly lower odds of psychological distress, tobacco smoking, and suicidal ideation compared with trans people with no history of gender-affirming surgery.

As for hormone therapy and puberty blockers, physicians say gender-affirming care comes after long discussions between parents and their children, as well as between families and their physicians.

Puberty blockers provide an individual and their family time to determine if a child’s gender identity is long-lasting, according to the Mayo Clinic.

Trans youth may face stress and anxiety from puberty development, including breast or facial hair growth, that does not align with their gender identity. Puberty blockers can help offer relief from that stress, experts say.

If an adolescent child stops taking the treatment, puberty resumes.

“It’s harmless and it’s not something that locks you in a certain decision that you cannot leave,” Abdullatif said.

Hormone therapy, which induces male or female physical changes, also helps address the needs of transgender teens in affirming their identity.

The legislation also makes the claim that puberty blockers can cause infertility or other health risks.

According to Ladinsky, these potential side effects only present real risks after puberty and are not a risk to youth taking puberty blockers.

Gender-affirming youth care is supported by several national medical organizations such as the American Medical Association, American Academy of Child and Adolescent Psychiatry, the American Academy of Pediatrics and the American Academy of Family Physicians.

“The worry is that we will have an epidemic of suicide because of a bill that calls itself the [Vulnerable Child Protection Act],” said Abdullatif.

Bills seen by advocates as anti-trans have also been proposed in past Alabama legislatures, as well as in states including Idaho and Arkansas. Arkansas is currently facing lawsuits against its bill that was passed into law last year despite the governor’s veto, and bans gender-confirming treatments for transgender youth.

“This is a government overreach,” Gov. Asa Hutchinson said at the news conference in April 2021.. “You are starting to let lawmakers interfere with health care and set a standard for legislation overriding health care. The state should not presume to jump into every ethical health decision.”

Ladinsky says it keeps her up at night to think about the patients who are just now understanding their gender identities.

She said she worries youth will believe “my state has made the choice to erase me.”

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(NEW YORK) — Inside hundreds of pharmacies across the country, high-risk Americans who test positive for COVID-19 have been told they will soon be able to find and fill a prescription for oral medication directly at the store.

The new White House “test to treat” program, touted as a one-stop shop for antiviral pills from Pfizer and Merck, aims to create a free and streamlined approach to get sick people the lifesaving care they need, when they need it.

Although Pfizer and Merck’s COVID-19 pills were authorized in December, scarce supply has made them difficult to access.

Major pharmacies have already begun ordering their new “test to treat” supply directly from the federal government, and anticipate being able to start as early as this week. CVS will offer end-to-end access to the pills at their nearly 1,200 MinuteClinic locations as soon as this week, spokesperson Matthew Blanchette told ABC News, while a Walgreens spokesperson said patients will be able to get the antiviral pills at “select stores” where provider partners are available to assess and prescribe medication.

The idea is for everyday Americans to be able to visit their local pharmacy for a rapid test, and if positive, “you can be treated right there on the spot,” said Dr. Simone Wildes, an infectious disease expert from South Shore Health.

As clinic doors open to this new initiative, however, numerous puzzle pieces must align to ensure the smooth rollout the president has hoped for.

“We’re leaving no one behind or ignoring anyone’s needs as we move forward,” President Joe Biden said of the plan during his State of the Union address last week, emphasizing his administration has “ordered more pills than anyone in the world has.”

The program’s promised scope hinges on sufficient participating locations and drug supplies.

And in a development that could jeopardize the program’s future, House Speaker Nancy Pelosi announced this week that COVID-19 funding would be stripped from an upcoming government funding and Ukraine emergency aid package — an element hotly contested by some members.

Without this additional pandemic funding, the White House has warned there could be “dire” consequences: the U.S. could run out of pill supplies by the end of the summer.

The government has so far purchased 20 million doses of Pfizer’s COVID-19 pill, Paxlovid, although it’s not expected to be widely available until later this spring.

And there are other hurdles. Test to treat’s reach is bounded by the requirement that there must be a prescribing health care provider on site, a feature at a fraction of the tens of thousands of pharmacies in the country.

Some pharmacy groups have chafed against the required authority, like a nurse practitioner or physician’s assistant, who must prescribe the pills on-site.

“We were anticipating something that would really have an impact on the pandemic and on patients being able to access medications and instead we’re underwhelmed with the missed opportunity of what this could have been,” said Michael Ganio, American Society of Health-System Pharmacists’ senior director of pharmacy practice and quality.

While the plan is a step in the right direction, “further action is needed” to enhance equity and access, National Association of Chain Drug Stores’ President and CEO Steven Anderson said, adding that the current test-to-treat plan “does not leverage fully the health and wellness professionals and access points in America’s pharmacies.”

Conversely, the American Medical Association called the plan “well-intentioned” but that it “oversimplifies challenging prescribing decisions by omitting knowledge of a patient’s medical history, the complexity of drug interactions, and managing possible negative reactions.”

The drugs are not appropriate for everyone. Merck’s Molnupiravir, for example, is not recommended during pregnancy or for minors, while Pfizer’s Paxlovid runs the risk of negatively interacting with other commonly prescribed drugs, including medicines that manage heart conditions and cholesterol, and those with severe kidney or liver problems.

Another issue, doctors say, is that patients will need to start taking the pills within days of developing symptoms, which means participating stores need to be convenient enough to access quickly, and with enough rapid tests to diagnose in time.

To connect patients with convenient pickup sites, the government is developing a website to help people find a site near them, set to launch later this month.

“The biggest issue is making sure that you get seen and diagnosed rapidly because you’ve got a five-day window of opportunity for Paxlovid to be optimally effective,” said Dr. Amesh Adalja, senior scholar at Johns Hopkins Center for Health Security and an infectious disease physician.

“If you’re a high-risk individual, you want to make the diagnosis as quickly as possible,” said Dr. Todd Ellerin, director of infectious diseases at South Shore Hospital. “And then make contact with a health care provider.”

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