Health

(NEW YORK) — The United States marked a new stage in the government’s response to the COVID-19 pandemic when President Joe Biden announced in his State of the Union address Tuesday that “COVID-19 no longer need control our lives.”

The World Health Organization declared a global pandemic in March 2020 due to rapid spread of COVID-19 all across the globe.

However, as many experts believe the virus that causes COVID-19 will never be eradicated, the world must at some point transition away from “pandemic” and toward an “endemic” phase.

Pandemics are a widespread, rapid spread of disease, with exponentially rising cases over a large area. Endemic viruses, meanwhile, are constantly present and have a fairly predictable spread. That predictability allows health care systems and doctors to prepare and adapt, reducing loss of life.

For a pandemic to reach an endemic phase, it would need to be “a situation where you have a background level” of disease, said Dr. Daniel McQuillen, president of the Infectious Diseases Society of America and a senior physician in the division of infectious diseases at Beth Israel Lahey Health in Massachusetts.

This means that, while some people would still get infected, it wouldn’t be an unbearable number with devastating consequences that overwhelms the public, hospital systems and providers.

The seasonal flu, or influenza, is an example of an endemic virus. H1N1 influenza has had pandemic spread of variants in the past, such as the Spanish flu in 1918 and swine flu in 2009. Variants of these are now part of respiratory viruses that we encounter regularly.

“There’s not a hard and fast rule for when a pandemic becomes an endemic,” said Dr. Paul Goepfert, a professor of medicine in the University of Alabama at Birmingham’s division of infectious diseases.

Without knowing if there may be another variant on the horizon and without a predictable pattern of disease, it’s still too soon to tell if the nation has reached an endemic phase.

That’s why many Americans are concerned it’s too soon to lift mask mandates. There is still a lot of transmission, and young children and immunocompromised people are still vulnerable.

However, McQuillen said the new guidelines from the Centers for Disease Control and Prevention are a reasonable shift, as they focus on local transmission and capacity.

“We’re going from trying to prevent disease completely to going more to how do we deal with preventing severe illness and hospitalizations and how do we prevent our health care system from getting so swamped that we can’t take care of even normal problems,” he said.

This must be determined at a local level.

“I think [the new CDC guidance] reflects this need to be flexible in how to respond to the pandemic,” said Dr. Natasha Chida, assistant professor in the division of infectious diseases at Johns Hopkins University.

Pandemics are “not a static experience,” she said. Some places in the country still have very low hospital capacity, so they would struggle to handle additional cases and thus would benefit from masking. But when numbers are low, we should “be able to have a normal type of experience,” she said.

Despite the new guidelines, many experts are hesitant to say the nation has entered an endemic phase just yet, as only time will tell if a new variant will arise and cause similar upheaval.

“Endemic is where you are seeing consistently low numbers, the health care system is able to manage it [and] people are able to get the care they need,” Chida said.

While the U.S. is getting close, numbers have dropped before and then new variants emerged, so it’s “too soon to say” if we are in this phase yet, she said.

To prepare for and prevent another wave, McQuillen, Goepfert and Chida each emphasized the importance of building better infrastructure for public health initiatives. This includes equitable vaccine distribution across the globe and increasing supply of treatments and testing — items currently outlined in the White House’s new pandemic policy agenda.

Goepfert also noted the importance of supporting primary care providers, both in allowing them to administer vaccines in their clinics and ease of access to treatment.

“What the pandemic laid bare was that public health has been massively under-resourced for decades, and people suffered because of that,” Chida said.

Now, with more than 75% of Americans vaccinated, experts are hopeful that the country can move toward better control of the disease and toward a new endemic phase — where we can control the disease, and it doesn’t control us.

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(NEW YORK) — As the Russian invasion of Ukraine intensifies, children are experiencing devastating consequences of being caught up in the war zone.

At least seven children have been killed, according to United Nations High Commissioner for Human Rights, and several more have been injured during air strikes and blasts.

Dozens of children are hiding in bomb shelters, basements, metro stations and other underground areas while others have fled their homes for neighboring countries.

Psychologists and other experts say there are also mental health concerns these children face and that it’s important they have as much structure as possible to keep a sense of stability in their lives.

And adults can better provide for their children by taking care of their own mental health needs.

“Children are extremely vulnerable to insecurity, not only the physical trauma but the psychological trauma, and it can reverberate and have repercussions for a long time,” Dr. Paul Wise, a professor of pediatrics at Stanford University, told ABC News.

Mental health risks for children in war zones

There are physical risks for children that come with living in war zones, such as breathing in smoke and ash from fires and blasts that can affect the nose and lungs. But there are also mental health risks.

Studies have shown that children and families living in or fleeing war regions have an increased risk of suffering from mental health problems.

“We’ve seen past war situations like what is happening in Ukraine, an increase in depression, anxiety,” Dr. Monica Barreto, a clinical psychologist at Orlando Health Arnold Palmer Hospital for Children, told ABC News.

And while not all children will be traumatized, they may react differently to the traumatic situations they’re witnessing.

“Some children may be more agitated, they may be harder to calm down, just more unsettled,” said Dr. Jack Shonkoff, director for the Center of the Developing Child at Harvard University. “Some children in these circumstances tend to be more withdrawn, they’re not crying as much, they’re not demanding much attention.”

He continued, “Sometimes people might look at that and say, ‘This child is managing pretty well.’ Sometimes that’s a sign of the things to worry about the most because these children are withdrawing, they’re internalizing a lot of what’s going on.”

Taking care of adults’ needs helps children

Shonkoff, who is also a professor of child health and development, said one way to ensure a good outcome for children in a war zone is by making sure the adults are being taken care of too.

“The most important factor that determines how children are going to basically survive and go forward after a war experience is the nature of the adults who are caring for them,” he said. “If the parents and the caregivers are significantly traumatized, they can’t provide that sense of support. The adults’ needs become critically important to protect the children.”

He likens it to a safety presentation on a flight, when flight attendants tell passengers to secure their own oxygen masks before helping others.

“That’s not a way of saying you’re more important than your child. It’s a way of saying if you pass out, your child won’t be OK,” Shonkoff said.

As for babies, he explained they are highly attuned to what’s going on and if adults are not engaging with them, it can hurt the babies’ development.

“If the parent is so traumatized or depressed, they can’t coo back, can’t smile back. That signals danger to the brain even though the baby doesn’t know what’s going on. That can create excessive stress in the body, raise inflammation and blood pressure levels,” Shonkoff said.

Wise adds that children look to adults not only for protection but also for how frightened they should be and “for understanding what’s happening to them in a time of profound insecurity, and children will feel the best protected with a strong, coherent community life and family life.”

Children need as much as structure as possible

The experts say it’s important to make sure that children are provided structure as much as possible while living in war zones to help with their development and well-being.

Barreto mentioned videos she’s seen online of Ukrainian families in bunkers trying to provide play and teachers trying to teach lessons.

“Children are no longer in school, they’re no longer in a safe environment,” she said. “Maintaining some of that structure can be very helpful and protective during these times.”

Barreto added that the same recommendations apply for children in refugee camps, making sure they are set up with their families and that some time is provided so they can experience “normality” whether that is playtime or having lessons.

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(NEW YORK) — A North Carolina woman who had been unable to eat solid foods for over a decade due to a rare condition underwent a life-changing multiorgan transplant that gave her a new stomach, pancreas and intestines.

Sarah Granados, a mom of three from Gastonia, North Carolina, waited 444 days for the transplant, which took place in November at Indiana Health University Hospital, more than 500 miles away from her home.

“It gave my kids their mom back. It gave my husband back his wife,” Granados, 36, said of the transplant. “It gave me the chance to dream about things I haven’t dreamt about in years because I was too scared to.”

Granados has faced life-threatening medical complications since 2012, when she underwent what was considered a routine surgery to remove her gallbladder because of a potentially cancerous spot.

Though the surgery did not have complications, Granados said doctors believe she was uniquely affected by it because she has Hypermobile Ehlers-Danlos syndrome, an inherited connective tissue disorder that can cause gastrointestinal dysfunction.

After the surgery, Granados said she was unable to eat solid foods and had to be placed on a feeding tube.

Doctors diagnosed her with severe gastroparesis, a disorder that “slows or stops the movement of food from your stomach to your small intestine,” according to the National Institutes of Health.

After spending six years on a feeding tube, Granados underwent a second surgery, a gastrectomy, in 2018 to remove her stomach and part of her small intestines. Complications from that surgery, she said, sent her into intestinal failure and she was diagnosed with intestinal pseudo-obstruction, a rare condition when the intestines appear blocked, according to the NIH.

Granados, whose youngest child was around 4 years old at the time, was then placed on total parenteral nutrition, a lifesaving measure that delivers nutrients intravenously.

“I ran into complications almost immediately,” said Granados. “It was at that time that [doctors] said, ‘You’re either going to need a transplant or your life expectancy is probably only a few years.”

Doctors determined that Granados needed a transplant of her gastrointestinal system, a rare procedure that only occurs in around 100 patients worldwide each year, according to Dr. Richard Mangus, surgical director of the IU Health intestine transplant program and the doctor who performed Granados’ transplant.

Granados went on the transplant list in 2020, during the coronavirus pandemic, and spent much of the time leading up to the transplant in the hospital.

She was hospitalized in North Carolina in November 2021 when she got the call that a donor had been found with a stomach, pancreas and small and large intestines deemed a “perfect match” for Granados.

“At that point I was having conversations with my family about having my lines actually removed and going into hospice because I was ready to be done,” said Granados. “And not because I don’t love my life, and not because I wouldn’t give anything and everything, but because my body was really, really tired and couldn’t stand the thought of living in a hospital anymore.”

“I essentially had to have a perfect donor to make this this match happen,” she said.

Within 24 hours of getting the call, Granados was transported by plane to Indiana Health University Hospital in Indianapolis.

At the same time, Mangus flew to the location of the deceased donor to oversee the removal of the organs.

Once back in Indianapolis, on Nov. 14, 2021, Mangus oversaw a complex, 10-hour transplant procedure that involved several doctors.

“Usually there are a couple of surgeons taking her organs out, while a couple of surgeons are preparing the organs on a separate table, and then when her organs are out, we go ahead and bring the the new organs and put them into her abdomen,” Mangus explained. “We have to connect the blood vessels … and then we have to connect back to the intestinal tract .. and then distally we have to connect into her large intestine as well.”

Granados said she has thought every day since her transplant about the donor, whom she calls her “angel donor.”

“I can’t change that they had an untimely death, but I truly believe that there are angels that are made to save other people,” she said. “And in my case, the doctors were saying there was a one-in-a-million chance, so I’m very fortunate that I got my one-in-a-million.”

Granados continued, “There’s not an hour that goes by that I’m not very keenly aware that I’m now carrying somebody else. It’s a privilege but it’s also something I take very, very seriously.”

Both Granados and Mangus stressed the importance of organ donation, for which there is a critical need in the United States. More than 106,000 people are currently on the transplant waiting list, and 17 people die each day waiting for an organ transplant, according to U.S. government data.

“They ultimately had to be willing to share five organs with me,” Granados said of her own donor, whose identity she does not know but whose family she said she prays she can one day meet.

“I’m making the choice to honor the beauty of organ donation by talking about it,” she said. “Now every person I walk by, I’m like, ‘You have the potential to save a life or I have the potential to save yours.'”

Granados has had to stay in Indianapolis since November as doctors oversee her recovery. She had a brief visit with her husband and kids, now ages 18, 16 and 14, when the hospital allowed them to visit on Christmas Day.

“We had our first official family meal,” said Granados, who was able to sit and eat with her family for the first time in her kids’ memory. “My oldest daughter couldn’t even hardly eat her food because she was crying because she couldn’t believe that we were having a family dinner.”

In late February, Granados was also allowed to drive to North Carolina to again see her kids, whom she surprised at a local park.

“Getting to surprise them and the look on their faces when they realized it was me might be the best moment of my life,” she said, adding that the visit home gave her “the boost and the strength to go back and continue fighting.”

Granados said she is now on a regimen of 33 prescription medications daily as she fights for her body to continue to accept the transplanted organs.

She said that though her fight is far from over and though there are many hard days in the process, she is for the first time in years allowing herself to dream of a future, which includes swimming with her kids, eating meals with them and fulfilling her dream of opening an animal sanctuary.

“I owe it to my angel donor and to my family to live as best as I possibly can, and I think that means sharing hope and sharing joy wherever I possibly can, so that’s what my goal is,” said Granados. “Like I tell my kids, ‘As long as we have air in our lungs, there’s hope.'”

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(WASHINGTON) — The White House on Wednesday released a sweeping new 96-page plan on COVID, marking a new era in the pandemic in which the virus is still circulating but can hopefully be managed so that Americans can return to daily life without disruption.

The strategy, that President Joe Biden previewed Tuesday night in his State of the Union address, calls for making available more free rapid tests online starting next week, as well as setting up pharmacy clinics later this month that will hand out free antiviral pills to people who test positive.

The plan also promises the ability to mass produce 1 billion doses of vaccine each year so that a new formula can be delivered within 100 days in the event of an aggressive new variant. The administration also vows to continue its efforts to provide vaccinations globally to help prevent future mutations.

“We are not going to just ‘live with COVID,'” states the new strategy called the “National COVID-19 Preparedness Plan.”

“Because of our work, we are no longer going to let COVID-19 dictate how we live,” it adds.

The White House notes in its plan that these efforts will require more money, in addition to the $1.9 trillion COVID relief package Biden pushed through last year. That money has mostly either been spent or obligated through contracts. Officials have not said yet how much would be needed.

“Without these investments, many of the activities described below cannot be initiated or sustained,” the White House wrote.

ABC News last week first reported efforts by the White House to revise its strategy to signal a new era in the pandemic. The effort has involved private meeting with business leaders, governors and the nation’s top pandemic experts to consider the various paths the virus could take in the coming months.

The updated strategy comes after significant voter pressure to reopen fully the country and curb disruptions. Democratic strategists have warned candidates they would fare better focusing on other issues like controlling inflation.

But federal health officials defend the shift as not merely political. Case numbers and hospitalization levels have plummeted in recent weeks, easing pressure on health care workers.

Officials also note that the vaccine held up throughout the omicron wave. The vast majority of people in hospitals have been unvaccinated, while vaccinated people mostly experienced mild symptoms that did not require medical help.

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(LOS ANGELES) — Jeopardy! contestant Christine Whelchel has been competing on the popular TV game show since last week but it wasn’t just her winning performances that have been capturing viewers’ attention.

The piano teacher and church organist from Spring Hill, Tennessee, appeared without a light brown wig during Monday’s episode and explained why she wanted to do so during a Q-and-A with host Ken Jennings.

“After the winnings, I decided that I didn’t need to hide behind a wig anymore and I wanted to normalize what cancer recovery looks like,” Whelchel said.

Whelchel is a four-day Jeopardy! champion, having already won $73,602.

The game show shared a video clip of Whelchel discussing her decision on Twitter and in a caption added, “A strong Jeopardy! player and an even stronger person. ❤️”

A strong Jeopardy! player and an even stronger person. ❤️ pic.twitter.com/NQqJS2uAs1

— Jeopardy! (@Jeopardy) March 1, 2022

The tweet has already garnered over 90,000 views and more than 5,000 likes, with many commenting and sharing their own cancer recovery photos.

“Go go go, Christine! 🙌🏼 This was me with my husband, 3 months after my last chemo session,” wrote one commenter.

Another shared a smiling selfie and commented, “Go Christine! from a fellow warrior.”

Whelchel explained in an earlier Q-and-A last week that she had been diagnosed with breast cancer a year ago. Shortly after learning about her diagnosis, she said she decided to try her luck and take the Jeopardy! test, the first step in getting on to the game show. Whelchel also said she is currently cancer-free.

According to the Centers for Disease Control and Prevention, hair loss or alopecia is a common side effect of some cancer treatments like chemotherapy. After Whelchel was featured as the Play of the Day on Good Morning America Tuesday, co-anchor Robin Roberts mentioned that cancer patients who wear wigs don’t always do so for themselves.

“Sometimes we wear the wig to put others at ease,” she pointed out.

“[Whelchel] showed a lot of strength, a lot of courage. And I’m telling you, people were watching. It makes such a big, big difference,” Roberts, a cancer survivor herself, added.

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(NEW YORK) — The number of births declined in the U.S. in 2021 and the COVID-19 pandemic played a role, according to a new report published by the Centers for Disease Control and Prevention on Tuesday.

Researchers from the National Center for Health Statistics — a branch of the CDC — compared provisional data from the first half of 2021 to final data from the first half of 2020.

They found there were 1.74 million births between January and June of last year, a 2% decline from the 1.78 million births that occurred over the same period in 2020.

The drop was largely driven by the decline in births for the month of January, with 304,000 babies born in January 2020 compared to nearly 277,000 in January 2021 — a 9% decrease.

“​​The last two or so years have kind of been unparalleled” when it comes to declines in births, Dr. Brady Hamilton, a statistician at the NCHS and co-author of the report, told ABC News. “Certainly the thing that caught our eye — and we already saw a hint when we looked at the data for 2020 compared to 2019 — there was an extremely sharp decline in the number of births in January of 2021 compared to January of 2020.”

However, after that sharp drop, the number of births increased in March and April of last year compared to 2020, before dropping again in May and then rising in June by 3%.

The authors noted this is an improvement from the first year of the pandemic, during which the number of births declined for each month of the first half of 2020 compared to 2019.

The report also found that the number of births declined for all races and ethnicities in the first half of 2021.

White women saw the smallest drop — of less than 1%, from about 916,000 births to 914,000 — and Asian women saw the biggest drop — of 8%, from approximately 110,000 births to 102,000.

Additionally, white, Black, Asian and Hispanic women had the largest declines in January, while American Indian/Alaska Native and Native Hawaiian/Pacific Islander women saw their biggest drops in May and February, respectively.

The report also looked at the number of births by state and found 19 states and Washington, D.C., reported fewer births during the first half of 2021 compared to the first half of 2020. Seventeen additional states reported declines, but they were not statistically significant.

The biggest drops were seen in New Mexico and Washington, D.C., with a 5% and 9% decrease, respectively.

Meanwhile, four states — Connecticut, Idaho, New Hampshire and Tennessee — saw a jump in the number of births.

Hamilton and his team said it’s clear the COVID-19 pandemic did play a role in the decline of births, but it’s unclear if it was the sole reason and what pandemic-specific factors led to the decline, such as economic uncertainty and lack of job security.

“While our data comes from the birth certificate and it’s an amazing data set … unfortunately it has limitations and one of those limitations is factors that people consider in terms of having a child, starting a family,” he said. “That’s important because when you look at the impact of the pandemic, what are the mechanisms and how exactly does it happen?”

He continued: “So we see these associations but in terms of teasing out particulars, we sort of have to wait to see until we get survey data which asks those particular questions about the decisions people were making.”

Hamilton did acknowledge that the large decline in January 2021 compared to January 2020 means that women were not getting pregnant around March and April 2020, when the first COVID-19 lockdowns and stay-at-home orders occurred.

“When it comes to looking at these numbers, there is a nine-month lag, so the number of births you see occurring a month reflects what people’s actions were nine months before,” he said. “So that [drop] is very interesting and something we will look at in more detail.”

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(NEW YORK) — A Georgia mom is on a mission to spread joy and raise awareness after her 1-year-old son was diagnosed with uncombable hair syndrome, a hair disorder she’d never heard of until last year.

The boy’s mother, Katelyn Samples, told Good Morning America that a stranger messaged her last summer on Instagram after seeing a photo of her youngest son, Locklan Samples, and asked if he had been diagnosed with uncombable hair syndrome.

“At first, you see ‘syndrome’ and you’re like, ‘Oh my gosh,’ like is something wrong with my baby? Is he in pain or something?” Samples recalled.

She added, “I just went in a tailspin and did a Google deep dive, called his pediatrician and the pediatrician even was like, ‘Hang on, let us look into this.’ They hadn’t even heard of it. So they sent us to a specialist, a pediatric dermatologist at Emory in Atlanta and that’s where we were able to get the diagnosis.”

What is uncombable hair syndrome?

Uncombable hair syndrome is a rare hair disorder and a genetic condition that usually affects children between the ages of three months to three years, although there have been reports of cases in kids up to age 12. According to the NIH, only about 100 cases have been reported in medical studies but experts say there could be more unreported cases.

“People might just be like, ‘Oh, my child has unruly hair or hair that’s difficult to tame, but they might not have sought a medical professional, like a pediatrician or dermatologist to formally diagnose the condition,” Dr. Carol Cheng, a pediatric dermatologist at UCLA Health told GMA.

According to Dr. Cheng, children with uncombable hair syndrome, also called spun glass hair, can have hair that grows in all directions and their hair can be straw-colored, have a dull texture, or be hard to manage.

A specialist can diagnose uncombable hair syndrome through a genetic test and an examination of a hair clipping through electron microscopy, a process that uses a special type of microscope.

“When you look under that microscope, you can see that instead of having hairs that are cylinder shape … the shaft of the hair is actually more in a triangular shape,” Dr. Cheng explained. “Within the triangle, there (are) these little grooves that go up and down the long axis of the hair shaft so that’s why it makes it really uncombable.”

“To diagnose the condition, at least 50% of the hairs would have this abnormality, but not all the hairs have to be abnormal,” Dr. Cheng added.

For the genetic test, doctors would look for three specific genes that have been associated with the syndrome, she said.

“The three genes that were found are what we call an autosomal recessive condition, meaning that both the mom and the dad have to have one of these genes and pass it on to the child who’s affected,” Dr. Cheng said. “It can also be inherited in what we call an autosomal dominant condition where only one of the parents has to have this genetic trait to pass on to their child.”

Living with uncombable hair syndrome

Despite the syndrome’s name, Samples said she can still comb Locklan’s hair for now but she doesn’t need to do so often, and overall, it’s relatively low maintenance.

“It can get matted easily. It is very fragile. … It can get tangled and I do have to be careful,” she said. “That would be an example of a time I actually would wash it because I very rarely wash his hair. Just doesn’t need to be, it doesn’t really get greasy.”

The mother of two said other people have been very curious about Locklan’s hair both in public and online. “We get a lot of comments about him looking like a dandelion and that’s actually a very accurate description of appearance and how it feels,” Samples said. “His hair is extremely soft, like a little baby chick. People will ask to touch it, which is fine with us, as long as people ask.”

Samples has been sharing Locklan’s story and photos on Instagram since his diagnosis, In a post from October, she wrote that she wanted to do so in part “to spread some joy on the internet!”

“Our biggest message is to celebrate what makes you stand out and what makes you different and hopefully bring awareness to this uncombable hair syndrome and hopefully, we can get more information,” Samples said. “If you think your kid might have it, go inquire and ask questions and be your child’s advocate.”

There are no formal treatments for uncombable hair syndrome and the hair abnormalities tend to resolve themselves as time goes on.

“Interestingly, this condition does get better with age. So after puberty or into adulthood, typically the hair condition does get better,” Dr. Cheng noted. “It doesn’t stay with them for their entire life.”

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(NEW YORK) — With more scientists predicting COVID-19 boosters will be needed each year, some are now working on combining those with the annual flu vaccine. The idea, experts say, is a single injection given each fall that protects against seasonal flu and COVID-19.

Pharmaceutical companies Moderna and Novavax have already announced plans to work on a combo shot, but don’t expect them to be available this upcoming flu season. Instead, Moderna’s CEO saying a combo shot could be ready by 2023.

Although studies indicate​ COVID-19 vaccine efficacy fades over time, experts say it’s not a foregone conclusion that every American will need an annual COVID-19 booster. Dr. Anthony Fauci, the nation’s top infectious disease expert, said this week that as of right now, most Americans don’t need a fourth dose (beyond the existing booster shot), but scientists are constantly evaluating the situation.

“I think we first have to assess the long-term need for annual COVID vaccines,” says Dr. Anna Durbin, director of Center for Immunization Research at Johns Hopkins University.

However, “if there is a continued need for COVID vaccines, then combining that with influenza would make sense,” Durbin said.

There are a few technical challenges to creating a combination vaccine. One is that different scientific approaches have been used for the two types of vaccines.

“Right now, the influenza vaccine is a different platform,” said Durbin. The most widely used flu vaccines in the US contain ‘inactivated’ (killed) or attenuated (weakened) virus to trigger an immune response in the body. This differs from mRNA (or messenger RNA) vaccines which teach the body’s cells how to make proteins that trigger immune responses. The result is that they currently have to be given in separate shots.

While two of the three authorized COVID vaccines are based on mRNA technology, previous influenza vaccines have not utilized this technology. But now, Moderna and Pfizer are working on an mRNA flu vaccine.

In addition to differences in technology, an extra challenge is that the most common influenza vaccine in the U.S. is quadrivalent, meaning it is designed to protect against four different flu viruses.

“This means the combined influenza/COVID vaccine would also likely need to be quadrivalent or at least trivalent. That makes the vaccine more complicated,” says Durbin.

Similarly, the rise of new COVID variants may introduce challenges to vaccine development.

This past September, Novavax enrolled people in a Phase 1/2 study to evaluate the safety, tolerability and immune response of a combination vaccine using Novavax’ seasonal influenza and COVID-19 vaccines. Unlike Pfizer and Moderna’s vaccines which use mRNA, these vaccines use protein subunit technology, which introduces a fragment of the virus into the body that is recognized by the immune system and triggers a response. These have each previously demonstrated strong results as standalone vaccines in Phase 3 clinical trials.

Moderna has also announced that it is developing a single dose vaccine that combines a booster against COVID-19 and a booster against flu, called mRNA-1073. In preclinical studies, Moderna has observed that its seasonal flu and COVID-19 booster vaccines can be combined into one dose that produces an immune response to ​both viruses.

Moderna CEO Stéphane Bancel predicted this combo shot could be available in 2023 — not in time for this upcoming flu season, but potentially the following year.

“I think it makes a lot of sense to try to develop these vaccines, but it may take a bit of time,” Durbin said.

Aiya Aboubakr is an internal medicine resident at New York Presbyterian-Weill Cornell Medical Center, and a contributor to the ABC News Medical Unit.

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(NEW YORK) — More than 70% of Americans should be able to remove their masks indoors, including inside schools, under new metrics outlined Friday the Centers for Disease Control and Prevention that represent a seismic shift in how the public health agency plans to measure COVID risk.

Under the new metrics, more than half of U.S. counties, which make up about three-fourths of where Americans live, are now considered to be at “low” or “medium” risk because of a reduced number of new COVID hospitalizations and adequate hospital space. Accordingly, the CDC would no longer recommend that these communities insist on indoor masking.

In a press call with reporters, CDC Director Rochelle Walensky cautioned that COVID was unpredictable and that these conditions could change that put hospitals at risk of once again being overloaded.

“None of us know what the future holds for us and for this virus,” Walensky said. “And we need to be prepared and we need to be ready for whatever comes next. We want to give people a break from things like mask wearing when our levels are low, and then have the ability to reach for them again if things get worse in the future.”

While the updated guidance drops the recommendation of universal masking in schools, the CDC said it is still reviewing a federal requirement that individuals wear masks on public transportation, including on airplanes. Walensky said that a review of that requirement is ongoing and a decision will be made in the weeks ahead.

The new recommendations are a major change in how the federal government is approaching pandemic guidance. Under previous rules, the CDC primarily considered COVID case counts to determine risk. And because case counts remained high, the public health agency had stuck to its recommendation of indoor masking, including inside schools.

But that approach didn’t take into account that vaccinations are now widely available to people over age 5 and that most vaccinated people who tested positive during the omicron and delta waves experienced mostly mild symptoms that did not require hospitalization.

Accordingly, the CDC now says individuals at high-risk of COVID complications should consider taking precautions, such as avoiding crowds and wearing a high-quality mask. But for local health officials and school boards, the CDC suggests a community consider three factors: new COVID hospitalizations; hospital capacity; and new COVID cases. Taken together, an area to be “high,” “medium” or “low” risk.

Based on that risk level, which could fluctuate, a community could opt to remove mask recommendations indoors or pull back on other mitigation measures, such as surveillance testing. If those risk factors climbed, putting a community at “high” risk, the CDC recommends that a community urges its residents to return to masks and step up other precautions.

The CDC guidance is an acknowledgement that hospitalization rates in recent weeks have fallen dramatically and that highly vaccinated communities would be able to withstand an uptick in cases without overwhelming their local hospital systems.

When asked why it dropped its universal masking recommendation for schools, CDC said the lower risk of serious COVID illness with kids was a factor.

“We know that also because children are relatively at lower risk from severe illness that schools can be safe places for children. And so for that reason, we’re recommending that schools use the same guidance that we are recommending in general community settings, which is that we’re recommending people where a mask in high levels of COVID-19” risk, said Dr. Greta Massetti, a senior CDC official.

The new guidance recommends that people who are at high-risk of COVID complications should talk to their doctor about how to stay safe in a community that might have moderate risk levels. CDC has previously recommended wearing a high-quality mask, such as a tight-fitting N95 version and avoiding areas with low vaccination levels.

The updated guidance comes after weeks of pressure from governors and state officials who asked for a clear roadmap at the national level.

A majority of states have already announced plans to drop mask mandates. Still, the new benchmarks could be used by local leaders, school boards and public health officials who are facing vastly different versions of the pandemic even within the same state.

The guidance also is intended to give local officials a roadmap to re-imposing restrictions if another variant pops up, which health experts warn is a possibility.

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(NEW YORK) — Some 70% of Americans will be able to remove their masks indoors, including inside schools, under new guidance to be released by the Centers for Disease Control and Prevention Friday, two sources familiar with the plans told ABC News.

Under the new metrics in the updated guidance, more than half of U.S. counties, which make up 70% of where Americans live, will be in areas of low or medium risk and no longer recommended to wear masks, said two sources briefed on the plans but not authorized to discuss them ahead of the official announcement.

A CDC requirement that people continue to wear masks on public transportation, however, will remain in force for now, according to one official.

The official said the new guidance will consider three factors: new COVID hospitalizations, current beds occupied by COVID patients and hospital capacity, and new COVID cases.

It will mark a shift from focusing on daily spread to looking at the overall burden of COVID, with an emphasis on its most severe impacts.

Taken together, the new CDC metrics will consider an area to be “high, medium or low risk.”

Based on that risk level, which could fluctuate, a community could opt to remove mask recommendations indoors.

Schools will not be treated differently under the new guidance as other indoor spaces, according to two officials.

The updated guidance comes after weeks of pressure from governors and state officials who asked for a clear roadmap at the national level.

Though a majority of states went ahead and announced that they will drop mask mandates before the CDC’s guidance was ready, the new information could still aid local leaders and public health officials who are facing vastly different versions of the pandemic even within the same state.

And it will also give states and counties a guide to re-implement guidelines if a new variant pops up, which experts warn is a possibility.

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