Detecting cancer with a simple blood draw could soon be a reality

Detecting cancer with a simple blood draw could soon be a reality
Detecting cancer with a simple blood draw could soon be a reality
Kubra Cavus/iStock

(NEW YORK) — Every year, thousands of Americans undergo routine screening to catch cancer in its early stages, while it’s still treatable. But these routine tests can be painful and invasive, and doctors only regularly screen for five of some of the most common types of cancer.

So for decades, scientists have been working on ways to screen for cancers using a simple blood draw rather than a painful biopsy or invasive test. These so-called “blood biopsy” tests are closer than ever to dramatically improving the way doctors screen for cancer.

Galleri, a new blood test by health care company GRAIL, is one of the most advanced blood biopsy tests. It works by looking for fragments of DNA in a person’s blood that indicate the presence of more than 50 types of cancer.

According to Dr. Pashtoon Kasi, director of colon cancer research and precision medicine at Weill Cornell Medicine, the underlying technology was actually first used to serve a different purpose.

“The same technology has been around for more than 20 years,” he said. “It started with prenatal diagnostics.”

But now, similar technology has been harnessed to detect early signatures of cancer.

Dr. Michael Seiden, the former president of the US Oncology Network, sees blood biopsy tests as part of the future wave of so-called “precision medicine” — the idea that each person’s medical care can be tailored to fit their specific genetics, medical needs and unique characteristics.

Precision medicine tries “to learn as much [as possible] about a person’s health through sort of sophisticated diagnostic tests,” Seiden said.

According to Kasi, less than two thirds of Americans get screened for colon cancer, which often involves an invasive procedure called a colonoscopy. A simple blood biopsy such as Galleri may improve current cancer screening due to ease of use, he said.

But despite the recent advancements, many doctors say there’s a long way to go — and some say there are reasons to wait for more research to be done.

The Galleri test, though promising, is not yet FDA approved. It still needs to undergo more testing to show it can produce reliable results every time.

“What you want to see is evidence it detects cancers early and in a reasonably good-sized population and that there aren’t harms done,” Dr. Ann Partridge, a breast oncologist at the Dana-Farber Cancer Institute, said.

But there’s another, more complex challenge, some experts say. In routine medical care, more testing isn’t always better.

“To do a screening test for any kind of disease or disorder, you have to consider what’s the benefit of doing it,” Partridge said. “If you live for 15 minutes longer, it might not be worth it. But if you live for 10 months longer, it might be worth it.”

A common refrain in cancer treatment is “earlier is better”: that the earlier a cancer can be found, the treatment is often more successful. However, sometimes it can be difficult to tell the difference between an early cancer and a non-cancerous growth.

A final diagnosis often involves an invasive procedure, such as a needle biopsy or surgery in order to remove tissue. These procedures are not without risk, and any screening tool, such as the Galleri test, should reduce the number of unnecessary procedures by not flagging non-cancers as cancers.

That’s why some in the medical community have hesitation about the utility of a blood biopsy capable of detecting only a few cancer cells, as it may accidentally detect a non-cancer as a cancer.

But at the very least, Galleri could provide an early warning system, so doctors could monitor patients and treat them if it becomes necessary.

“This provides an additional screening test that might detect an early-stage cancer that’s not detectable by other available tests,” Seiden said. But, “It does not prove you don’t have cancer, and it does not replace currently recommended screening. It’s a supplement.”

Partridge added that she’s hopeful that someday she’ll be able to order tests like these, but right now, “I think the big picture is very optimistic, but really not ready for our patients routinely, outside a clinical trial. I look forward to seeing this important research evolve.”

Although Galleri is still not FDA approved, the test can be prescribed by any physician in the United States. Because it’s not covered by insurance, it costs $949 out of pocket.

Jacob S. Warner, an internal medicine resident at Dartmouth-Hitchcock Medical Center, is a contributor to the ABC News Medical Unit.

Copyright © 2021, ABC Audio. All rights reserved.

Diet talk can be overwhelming at Thanksgiving. Here are tips to cope

Diet talk can be overwhelming at Thanksgiving. Here are tips to cope
Diet talk can be overwhelming at Thanksgiving. Here are tips to cope
spukkato/iStock

(NEW YORK) — A holiday like Thanksgiving that is centered on food, family and more food can be a precarious time for people struggling with eating disorders or disordered eating.

Alex Mutti, 27, of New York City, said she always loved Thanksgiving until her early teens, when she began to suffer from an eating disorder and the holiday became “really terrifying.”

She said making it through Thanksgiving became even more difficult even as she went through recovery.

“In my experience, a lot of eating disorder recovery was around eating mindfully and creating routine around my eating,” Mutti told Good Morning America. “And Thanksgiving throws all that out the window. Not many people are eating mindfully on Thanksgiving.”

“Losing that kind of routine that became safe for me was always really anxiety-provoking,” she said. “And being around the extended family and friends was difficult, even if they didn’t say anything.”

Lauren Larkin, now a mental health counselor in private practice in New York City, said she recalls many Thanksgivings she “white-knuckled” her way through the worst stages of her eating disorder, prior to recovery.

“Thanksgiving is really the holiday where you talk about food and talk about regretting the food you ate,” she said. “I would push myself to show up and act like everyone else and be like everyone else, even when maybe I couldn’t, and then I would have really intense anxiety afterwards.”

This holiday is approaching as the United States has seen a mental health crisis during the coronavirus pandemic, of which eating disorders are a major part.

The number of people who were hospitalized for eating disorders doubled in the U.S. during the pandemic, according to research published recently in JAMA Network.

And even for people who may more casually struggle with disordered eating, this Thanksgiving holiday may be more fraught with discussions on weight and looks as family members see each other for the first time in months due to the pandemic.

“I think about the stereotypical great-aunt who is stuck in the diet culture and who is going to make comments about your weight,” said Larkin. “Thanksgiving is probably the most triggering holiday for anyone who has struggled.”

As Thanksgiving Day nears, here are five tips from experts to help cope with diet and negative food talk.

1. Set boundaries.

If you are at a holiday meal with supportive family members or friends, Christy Harrison, a registered dietitian and author of the book “Anti-Diet” recommends setting boundaries ahead of time, like asking loved ones to not comment on your body or what you’re eating, and to do the same for others too.

If difficult conversation does emerge at the dinner table, Harrison suggests appealing to people on an emotional level.

“They probably care about you, they’re people you’re spending the holidays with, so talk on a human level about why diet talk hurts you or what you have found to be helpful in your own relationship with food,” she said. “And keep it focused on yourself, like, ‘for me,’ and, ‘in my experience.'”

“And if you’re not quite as close, you can say something a little less personal, like, ‘I’ve found that talking about this kind of stuff just makes the meal less fun for me,” she said.

2. Remember it is one meal, one day.

“Remember that it’s just one day, it’s just another day of eating and you can have those foods anytime you want,” said Larkin. “Try to minimize the importance and the exact rules around food and remember, you can have it anytime. You can have more. “You can have less. It’s just one day out of 365 days of the year.”

Speaking of her own recovery, she added, “Those are the kinds of conversations I had to have with myself and with my individual therapist leading up those these events until it became true for me.”

Larkin and other experts also recommend staying in a routine with meals both before and after a Thanksgiving lunch or dinner, again reinforcing that it is just one meal among many.

3. Start new traditions.

Larkin said that during certain parts of her eating disorder and her recovery, she chose to travel over the Thanksgiving holiday instead of joining family.

“I had to put my needs in front of my family’s need of wanting to see me and had to say, ‘Even though you want to see me, this holiday is too triggering and I’m not going to participate in the way that I normally would,'” she said. “That’s okay.”

In other cases, a healthy new tradition may be going to a Thanksgiving dinner hosted by friends instead of family, or organizing activities before and after a Thanksgiving meal that don’t involve sitting and talking about food, according to Larkin.

4. Have an ally by your side.

Chelsea M. Kronengold, a spokesperson for the National Eating Disorders Association, said it is important to have a support system on hand around a stressful holiday like Thanksgiving.

“If you have a therapist or a nutritionist, talk to them about your concerns prior to the holiday so you can work together on helpful coping strategies,” she said. “And in addition to professional support, if you have a friend or a family member who’s either in the room with you or available for you to text if the meal is challenging or the family dynamics are challenging, that can be extremely helpful.”

5. Practice self-compassion.

“It’s okay to acknowledge that Thanksgiving and other food and family-focused holidays won’t be easy,” said Kronengold. “If you end up restricting or bingeing, remember that tomorrow is a new day.”

“When you perpetuate that cycle of shame and guilt, it’s only going to be counterproductive to your mental health and your recovery journey,” she said.

If you or a loved one is struggling with food and body image concerns this Thanksgiving, the National Eating Disorder Association (NEDA) Helpline is available via click-to-chat on Thanksgiving Day from 12 pm – 8 pm ET. For 24/7 crisis support, text “NEDA” to 741-741.

Copyright © 2021, ABC Audio. All rights reserved.

Push to vaccinate children accelerates as pediatric COVID-19 cases rise

Push to vaccinate children accelerates as pediatric COVID-19 cases rise
Push to vaccinate children accelerates as pediatric COVID-19 cases rise
Hannah Beier/Bloomberg via Getty Images

(NEW YORK) — The rush to vaccinate children against COVID-19 is accelerating amid a steady increase in coronavirus infections and hospitalizations nationwide.

Last week, nearly 142,000 child coronavirus cases were recorded, with weekly infections among children up by more than 40% since late October, according to a new report from the American Academy of Pediatrics (AAP) and the Children’s Hospital Association (CHA).

Nationally, new coronavirus cases among all age groups have been increasing for the last three weeks, with the average now topping 92,000 new cases a day. Thirty-one states, as well as Washington, D.C., have seen an uptick in daily cases of 10% or more in the past two weeks.

Last week, children accounted for about a quarter of reported weekly COVID-19 cases, despite individuals under age 18 only making up 22.2% of the U.S. population. Regionally, the Midwest continues to see the highest number of pediatric cases, as the area experiences a notable viral resurgence with winter arriving across the region.

The nation has also seen an uptick in pediatric hospital admissions, alongside other age groups. Although hospitalization totals are still significantly lower than during the nation’s most recent summer surge, across the country, just under 1,250 children are hospitalized with a confirmed or suspected COVID-19 infection. Ohio currently leads the country with 168 children receiving care, followed by Texas with 120 children.

Amid this viral resurgence, health experts are urging parents to get their eligible children vaccinated.

COVID-19 “is one of the top 10 leading causes of death in children,” Dr. Leana Wen, emergency physician and professor of health policy and management at the George Washington University Milken Institute School of Public Health, said during a briefing Wednesday with the National Press Foundation. Vaccines are a “safe and simple intervention,” she said, and significantly lower the risk of severe illness.

Earlier this month, Centers for Disease Control and Prevention Director Rochelle Walensky reported the agency had seen a surge of interest in pediatric COVID-19 vaccinations, following emergency use authorization of the Pfizer/BioNTech vaccine.

“We’re seeing strong demand for COVID vaccinations among children ages 5 to 11 across the country with hundreds of thousands of appointments booked for the next few weeks,” Walensky said at the time.

Approximately one-third of children ages 5-17 have received at least one COVID-19 vaccine dose, according to recently updated federal data. In the last two weeks alone, 2 million children ages 5-11 years-old have received their first dose.

If parents get their children vaccinated now, they will be able to be fully vaccinated by the later winter holidays, Dr. Anthony Fauci, the White House’s chief medical adviser, said during an appearance on ABC’s “This Week” on Sunday.

“We now have vaccines that are highly effective and clearly very safe, particularly now with the recent data showing that we can vaccinate children from 5 through 11,” Fauci said. “There are 28 million children within that age category. If we started vaccinating them now, they’ll be fully protected by Christmas.”

Although severe illness due to COVID-19 remains “uncommon” among children, the two organizations wrote, there is an “urgent” need to collect more data on the long-term consequences of the pandemic on children, “including ways the virus may harm the long-term physical health of infected children, as well as its emotional and mental health effects.”

Copyright © 2021, ABC Audio. All rights reserved.

What you need to know about COVID-19 boosters and how long they take to work

What you need to know about COVID-19 boosters and how long they take to work
What you need to know about COVID-19 boosters and how long they take to work
Milan Markovic/Getty Images

(NEW YORK) — COVID-19 booster shots are now authorized for anyone over the age of 18. For anyone hoping to get a COVID-19 booster dose before the Thanksgiving holiday, experts say it’s important to understand that protection doesn’t kick in right away.

Although the body starts to increase antibodies within a few days after the shot, it takes two weeks for peak protection to return.

“There is a meaningful increase in antibody titers by one week and peak responses at 2 weeks following mRNA boosting,” said Dr. Dan Barouch, director of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center in Boston.

More than 32 million people in the U.S. have already received a COVID-19 booster dose. The FDA and CDC say it’s safe to mix and match boosters.

COVID-19 booster shots are composed of the same formulation as the current COVID-19 vaccines. But the Moderna vaccine booster is given at half the dose of the primary Moderna series.

Studies show the immunity gained from the primary vaccine series may decline over time — particularly protection against mild breakthrough infections. Therefore, experts recommend booster vaccination to increase immunity.

“The booster shot will have a similar response as the second dose of the primary series. The highest antibody level will be around 10-14 days and then things will level off. The antibody levels will decline as it would with all vaccines, however the boosters help to stabilize the antibody levels,” said Dr. Simone Wildes, an infectious disease specialist at South Shore Health in Massachusetts.

Public health experts say booster shots could also help slow the spread of COVID-19 within communities. However, to truly curb the pandemic, it’s far more important for the unvaccinated to get their initial doses.

The expanded authorization of the Moderna and Pfizer boosters comes right in time for the holidays to allow many more Americans to get their booster shots before the holidays for safer travels and gatherings. The expanded authorization to now everyone over the age of 18 also helps eliminate any confusion on who may receive booster shots and ensures boosters are available to everyone who needs one.

Esra Demirel, MD is an OB-GYN resident physician at Northwell Health-North Shore University Hospital & LIJ Medical Center and is a contributor to the ABC News Medical Unit.

Copyright © 2021, ABC Audio. All rights reserved.

Fauci says ‘fully vaccinated’ definition not yet changing to include boosters

Fauci says ‘fully vaccinated’ definition not yet changing to include boosters
Fauci says ‘fully vaccinated’ definition not yet changing to include boosters
ABC News

(WASHINGTON) — Every vaccinated person should “get boosted” depending on how long it’s been since their initial shots, but those with their original vaccination protection are still considered “fully vaccinated” despite indications that immunity can wane, Dr. Anthony Fauci said Sunday.

The White House chief medical adviser appeared on ABC’s This Week on Sunday to discuss the recent announcement made by the CDC on Friday to officially recommend booster shots for all adults ages 18 years and older. This move comes after many states were already allowing all adults to get a booster against COVID-19.

“Now that you look at the data as it’s evolved in the United States, it’s very clear,” Fauci told This Week co-anchor Martha Raddatz. “They wanted to make sure that the safety signals were right, and once that became very clear, right now I’m very pleased that we’re in a situation where there’s no confusion, there’s no lack of clarity.”

Following recent statements from governors of Connecticut and New Mexico — who have said they do not consider an individual fully vaccinated unless they have received a booster due to the drop one can see in immunity — Raddatz pressed Fauci on why the White House has not adopted that standard.

By definition, Fauci said, fully vaccinated right now means someone has received two doses of the Pfizer and Moderna vaccines or one dose of the Johnson & Johnson vaccine.

“We’ll continue to follow the data, because right now when we’re boosting people, what we’re doing is following them,” Fauci said. “We’re going to see what the durability of that protection is, and as we always do, you just follow and let the data guide your policy and let the data guide your recommendations.”

As of Friday, 59% of the U.S. population has been fully vaccinated against COVID-19.

Pfizer CEO Albert Bourla said last week there’s a high chance that boosters will be needed annually, but when asked by Raddatz what he thought, Fauci did not necessarily agree.

“We would hope — and this is something that we’re looking at very carefully — that third shot with the mRNA not only boosts you way up but increases the durability so that you will not necessarily need it every six months or a year,” Fauci said. “If it doesn’t, and the data show we do need it more often, then we’ll do it, but you want to make sure you get the population optimally protected and you do whatever you need to do to make sure you do that.”

The Wall Street Journal reported Saturday that COVID-19 deaths in 2021 surpassed the number of COVID-19 deaths in 2020, with the total number of deaths now reaching more than 770,000. Raddatz pressed Fauci to explain how deaths increased, and he cited the delta variant — “which is very, very different from the original variants that we were dealing with before.”

“This is a virus that is highly transmissible,” he said. “The more people that get infected, the more people are going to get hospitalized. The more people they get hospitalized, the more people are going to die.”

Fauci noted that another difference between this year and last year is the availability of vaccines, and he stressed the importance of getting vaccinated.

“We now have vaccines that are highly effective and clearly very safe, particularly now with the recent data showing that we can vaccinate children from 5 through 11,” Fauci said. “There are 28 million children within that age category. If we started vaccinating them now, they’ll be fully protected by Christmas.”

With the holidays coming up, Raddatz also asked Fauci to explain what safety precautions families can take this holiday season.

“If you’re vaccinated — and hopefully, you’ll be boosted, too — and your family is, you can enjoy a typical Thanksgiving meal or Thanksgiving holiday with your family,” Fauci said. “The thing we are concerned about is the people who are not vaccinated, because what they’re doing is, they’re the major source of the dynamics of the infection in the community. And the higher the level of dynamics of infection, the more everyone is at risk.”

Copyright © 2021, ABC Audio. All rights reserved.

Spending Thanksgiving alone this year? Here are five tips to combat loneliness

Spending Thanksgiving alone this year? Here are five tips to combat loneliness
Spending Thanksgiving alone this year? Here are five tips to combat loneliness
Ridofranz/iStock

(NEW YORK) — While Thanksgiving will be a time to gather again this year for many people, thanks to COVID-19 vaccines, it may for other people be the start of a difficult holiday season.

Some people may be home alone on Thanksgiving by choice, following safety guidelines, while other families will be missing loved ones at the Thanksgiving table who are hospitalized with COVID-19 or who have passed away from the virus over the past nearly two years.

Still others may be coping with a non-COVID related illness that is keeping their family separated or coping with a deployment or a divorce, separation or estrangement that unfolded during the pandemic.

“What many people are going to experience this year, for a variety of reasons, is that their holiday table is not going to be as full as it normally is,” said Kory Floyd, Ph.D., an author and professor of interpersonal communication at the University of Arizona. “Many American households are going to experience a sense of deprivation this year.”

“Especially on a holiday, when it’s a time to celebrate and be around loved ones, that accentuates a sense of loneliness,” he said.

Here are five tips to make Thanksgiving a joy-filled day regardless of who you are, or are not, spending it with.

1. Make a plan:

Planning ahead the fun things you’ll do on Thanksgiving, or the new traditions you’ll start, can both help ease the stress and uncertainty of the day and help you from obsessing over what could have been, according to Floyd.

“Think now of things you’ll plan for that day that will be positive distractions,” he said. “The benefit of [planning ahead] is we’re ready and we’re prepared, and we’re prepared to enjoy and find meaning and find joyfulness in whatever we do with that time.”

Planning ahead can be as detailed as what time you’ll eat meals and do activities to a more general list of the movies you want to watch or the activities you can do outside in fresh air, experts say.

Floyd recommends planning something that feels indulgent on what is still a special day of the year.

“What feels indulgent to people will vary from person to person,” he said, giving examples of a bubble bath or a decadent dessert. “But make it something that goes beyond the ordinary and feels really special and allow yourself the freedom to enjoy it, to lean into it.”

2. Find ways to help other people:

Doing something good for someone else can take the focus off yourself and help ease feelings of loneliness or discontent, according to Nicole Beurkens, Ph.D., a holistic child psychologist and the founder and director of Horizons Developmental Resource Center in Caledonia, Michigan.

That could mean dropping items off at a nursing home, preparing boxed meals for neighbors or delivering books and needed items to women’s and children’s centers, recommends Beurkens.

“Sometimes the best way to soothe ourselves is to do something outside of ourselves,” she said.

3. Phone a friend or loved one:

Even if you can’t physically be with your loved ones on Thanksgiving, it’s important to find ways to stay in touch with people, recommend both Floyd and Beurkens.

Plan ahead to make sure you can call, Skype or Zoom with friends and relatives on Thanksgiving, whether it’s just talking to catch up or taking part in holiday traditions together via technology. If the technology is too much, spend the down time you may have that day writing letters to family and friends or simply thinking about who in your life you’re grateful for, according to the experts.

4. Think ahead to next year:

While it’s normally important to stay in the moment and not look ahead or behind, experts say this year it can be healthy to look ahead to a more hopeful time.

“It gives a sense of forward-looking motion that helps people not feel as heavy a sense of what is going on now,” said Floyd. “It reminds people that this is temporary and things will get better.”

Floyd said he is reminding his patients that no matter how bad this year feels, it is temporary, and it is okay to start thinking ahead to things like travel and gathering again in-person with family and friends.

His advice is to be specific when thinking about the future, picturing things like exactly where you want to travel to, who you will spend Thanksgiving with next year and what new traditions you may want to start.

5. Be okay with shedding some tears:

Both Floyd and Beurkens say it’s okay and perfectly normal to spend a few moments on Thanksgiving shedding tears or sitting for a bit with grief over what a strange holiday, and year, this has been.

“It’s not getting over the emotions, but getting through them,” said Floyd. “The last thing people should do is be ashamed of those emotions.”

“We can still generate joy even though there’s a sense of sadness or a sense of loss,” he said.

If you or someone you know is 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.

Copyright © 2021, ABC Audio. All rights reserved.

Should you get a booster shot? Experts say it’s time

Should you get a booster shot? Experts say it’s time
Should you get a booster shot? Experts say it’s time
Milan Markovic/iStock

(NEW YORK) — Millions more vaccinated adults across the U.S. became eligible for a COVID-19 booster shot on Friday. And yet, the vast majority of vaccinated Americans were already eligible — many just didn’t know it.

According to an October survey from the Centers for Disease Control and Prevention, 4 in 10 vaccinated adults were unsure if they qualified for a booster. So far, just 32 million Americans have received a booster, or around 18% of the more than 182 million adults who are fully vaccinated.

In announcing the latest recommendations, public health experts at the Food and Drug Administration and the CDC expressed hope that they would cut through the confusion, simplifying the decision for Americans who are wondering: Do I need a booster shot?

Here’s what the experts say.

Should you get a booster?

The question has been hotly debated for months but a larger pro-booster consensus has formed over the last week.

Why? A number of reasons, including rising cases in more than half of U.S. states right before a busy holiday travel season and lower temperatures pushing people indoors.

The FDA and CDC made the updated recommendation on Friday. It expanded booster access to all adults who were vaccinated with Moderna or Pfizer over six months ago, and while the recommendation was stronger for everyone over 50 to go get a boost, it applies to everyone 18 to 49.

For Johnson & Johnson recipients, the recommendation already applied to everyone over 18, anytime two months after their shot.

For experts who have long been loud proponents for booster shots, it was a long time coming.

“Enough is enough. Let’s get moving on here,” Dr. Anthony Fauci, chief medical adviser to the White House and a leader at the National Institutes of Health, said at an event Wednesday, before the FDA and CDC made the final call.

“There’s no doubt that immunity wanes. It wanes in everyone. It’s more dangerous in the elderly, but it’s across all age groups,” Fauci said, citing data from Israel and the U.K., where more people were vaccinated sooner and began to first document waning immunity.

Others, like Dr. Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine and co-director of the Texas Children’s Hospital Center for Vaccine Development, called the decline “both predicted and predictable.”

“And the way you fix it is you give that third immunization,” he said.

Both Hotez and Fauci believe the vaccines should be used not just to prevent hospitalizations and death, but also infection — particularly because of the risk of long-COVID, a concerning side effect of the disease that is rare in vaccinated people but can include long-term fatigue, brain fog and shortness of breath.

“When I got my third immunization, why was I so eager to do it? Well, of course I didn’t want to go to the hospital or ICU, but also I didn’t want to get COVID,” Hotez said.

“I didn’t want to get gray matter brain degeneration and cognitive decline and have a brain scan that looks like somebody 20 years older.”

But for those still on the fence about the personal choice, Dr. Anna Durbin, an associate professor at the Johns Hopkins University School of Medicine, laid out risk scenarios to consider.

“It really comes down to your comfort level and just what’s going to make you as a person feel safer,” Durbin said.

If you’re traveling overseas or live in areas of high transmission, if you’re elderly or have underlying conditions or are frequently out in the community for work, those are all reasons to get a booster, Durbin said.

For young, healthy people who don’t feel at risk, Durbin said to keep an eye on rising cases in your area. Consider getting a booster to help tamp down transmission, but also to protect yourself ahead of a surge, Durbin said.

“If we’re gonna see a new wave, it’s going to be over the winter months most likely. And if you get boosted now, that’s going to provide you really good protection through that period of time,” Durbin said.

That said, don’t panic if you can’t book an appointment right away — particularly as demand surges with the new recommendation, experts say.

“I would not view it as an emergency that people need to line up on the day of approval and get their boosters necessarily that weekend,” said Dr. Dan Barouch, director of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center in Boston.

It’s still far more important for unvaccinated people to get vaccinated, Barouch said, particularly ahead of the holidays.

“The most important thing is for everybody who will be celebrating to be vaccinated, if they’re eligible to be vaccinated. Now, additional boosts may be useful. But the most important thing is that people be vaccinated primarily,” he said.

Why has it been so confusing?

To put it simply: “The reason why there is some confusion is because it has been confusing,” Barouch said.

“Guidelines are changing,” Barouch said. “And in some cases, the guidelines are changing for good reasons: They’re changing because what we’re seeing is a changing pandemic.”

Last week, a patchwork of booster guidance emerged as governors in over a dozen states called for all adults to get a booster before the federal agencies weighed in, acting to combat spiking cases and overwhelmed hospitals.

Hotez commended the states for making the “medically correct” decision and being “more nimble” than the original decision from the CDC and FDA, but acknowledged the schism it created in the public health guidance.

“Not as elegant as you’d like — to have the states be out front by a week or so, but you know, when you’re in the middle of a pandemic, sometimes things don’t go smoothly as you’d like,” Hotez said.

Some, like Hotez, have always believed boosters would be necessary, even before data started to trickle in on waning immunity, and think confusion could’ve been avoided if the public was always told to expect a booster.

“It should have been messaged to the American people from the beginning that, by the way, don’t be surprised when the call comes out to get a third immunization,” he said.

Still, there’s a fine line to walk in urging booster shots for those vaccinated six months ago while also encouraging the most impactful group, unvaccinated people, to get their primary vaccinations. The vaccines continue to protect well against hospitalization and death for many months.

“We can give all the booster doses we want and until we get people vaccinated, or they all get infected, we’re going to continue to see transmission of COVID,” Durbin said.

Copyright © 2021, ABC Audio. All rights reserved.

1st injectable, bimonthly HIV treatment approved in UK

1st injectable, bimonthly HIV treatment approved in UK
1st injectable, bimonthly HIV treatment approved in UK
PeopleImages/iStock

(LONDON) — The UK approved a new HIV treatment that requires an injection every other month, rather than the current routine of taking pills every day.

The UK’s National Institute for Health and Care Excellence estimated that around 13,000 people will now be eligible for cabotegravir with rilpivirine, the injectable medication.

There were around 103,000 people living with HIV in the UK in 2018, according to the British government’s statistics.

“It is an exciting and progressive step in the fight against HIV,” Dr. Todd Ellerin, director of infectious diseases at South Shore Health and ABC News contributor said. Ellerin is also on the speakers bureau of ViiV Healthcare which helped develop the injectable HIV treatment.

Besides the new revolutionary injection method, the current treatment for HIV is lifelong antiretroviral tablets that are taken each day. The medication suppresses the virus in the blood to undetectable levels, thereby preventing AIDS from occurring and eliminating transmission.

The injections block the same enzymes as the pills do, as Ellerin explained, but allow the medication to stay in the body much longer permitting monthly or bimonthly re-dosing, so patients don’t need to take pills every day.

The shot called Cabenuva (a combination of cabotegravir and rilpivirine) was already approved by the FDA in January, though with a more frequent dosage of once a month.

“[The] thing I like about injectables is less is more,” Ellerin said. “The medication approved in the UK will be once every two months, which makes it easier for the patients to come to the office rather than coming every month,” he added.

“For many, taking daily pills is not easy. Sometimes they forget, some may have other issues with taking pills, but the injection is suitable for those who prefer a more intermittent method,” he added.

However, there are challenges to this method. One, is the logistics of the injection, as the jabs must be administered at the health care provider’s office for now, Ellerin said.

“The biggest challenge is the logistic hurdle for giving these [shots] in the office, especially in the pandemic,” said Ellerin.

Also, if patients don’t show up for their injection, that increases the risk of viral replication rebound, Ellerin said. With pills, you can remember to take them the next day and have a stock of them at home.

Both in Britain and the United States, cabotegravir and rilpivirine can be prescribed and used after an initial oral (tablet) lead-in period.

“This is why people who are newly diagnosed with HIV can’t start their treatment with injection,” Ellerin said.

There are hopes that by the first quarter of 2022, the FDA also approves the bimonthly injection, and with that more patients might choose this method over pills, especially if the COVID-19 situation eases, according to Ellerin.

“As of now, this is not a preventive method. It is just for maintenance treatment. There are also injections for prevention down the way. But that is another story,” Ellerin said.

Ellerin also said that the reason the injections are available at clinics only is that this is the way it was studied in clinical trials and that these are buttocks injections that are difficult to self-administer at home.

Copyright © 2021, ABC Audio. All rights reserved.

Women say pain was dismissed in lawsuit alleging fentanyl switch at fertility clinic

Women say pain was dismissed in lawsuit alleging fentanyl switch at fertility clinic
Women say pain was dismissed in lawsuit alleging fentanyl switch at fertility clinic
kuzma/iStock

(NEW YORK) — A group of seven women are suing Yale University, claiming they underwent invasive and painful procedures for in-vitro fertilization and received saline instead of fentanyl, an opioid painkiller.

According to the complaint, the women received saline after a nurse at the Yale University Reproductive Endocrinology and Infertility Clinic stole fentanyl for her personal use last year and replaced it with saline.

As a result, the women underwent a fertility procedure — oocyte retrieval — without pain management, according to the complaint, which described the process as “excruciating.”

“Oocyte egg retrieval is an extremely invasive procedure,” the law firm representing the women said in a statement. “Doctors and nurses explained to these patients that this surgery would require a dose of fentanyl to alleviate pain. However, each was then unknowingly treated with saline instead.”

The lawsuit, filed Wednesday in state court in Waterbury, Connecticut, by the women and their spouses, accuses Yale University of failing to follow protocols and thereby allowing the fentanyl to be tampered with.

The complaint also alleges there were “hundreds” of incidents in which saline was substituted for fentanyl.

“Yale University takes no responsibility for the hundreds of fentanyl substitution events that took place at the REI Clinic; it blames the single nurse who was able to steal the fentanyl, unabated, for more than twenty weeks,” the complaint said.

“But for years, Yale University recognized the lurking danger of opioid diversion and the catastrophic injuries posed by healthcare worker opioid substitution,” according to the lawsuit.

The nurse, Donna Monticone, pleaded guilty in March to one count of tampering with a consumer product and surrendered her nursing license. She was sentenced in May to four weekends in prison, three months of home confinement and three years of supervised release.

A Yale University spokesperson declined to comment on the lawsuit.

In March, following Monticone’s guilty plea, a Yale spokesperson issued a statement stating patients had been informed and that “changes are underway.”

“Yale has informed patients that there is no reason to believe that the nurse’s action harmed their health or the outcome of their treatment. The Fertility Center routinely uses a combination of pain medications during procedures and modifies the medications if there are signs of discomfort,” the spokesperson said in March, according to the New Haven Register. “Changes are underway in procedures, recordkeeping, and physical storage that will prevent this type of activity from happening again.”

The lawsuit, which seeks unspecified damages, also alleges that the women’s concerns and reports of “torturous pain” were dismissed.

“Yale University providers were alerted to the problem with its supply of fentanyl, the sole analgesic administered to women during oocyte retrievals, through patients’ intraoperative screams and postoperative reports of torturous pain, but, upon information and belief, Yale University never investigated these reports,” the complaint said. “Instead, pain was minimized as ‘normal’ for the invasive procedure, or attributed to the unavailability of an anesthesiologist on Saturdays and Sundays.”

The allegation of pain being dismissed is one that may ring true for many women, according to Dr. Jessica Shepherd, a board-certified gynecologist and chief medical officer of Verywell Health, an online medical resource.

Shepherd is not affiliated with Yale University and has no involvement with or direct knowledge of the case.

“Usually the key complaint is feeling dismissed, that patients haven’t been heard,” she said of her own personal experience with female patients who have sought her care. “It’s one thing to be able to express what you’re feeling, but even after that, what are the actions that are taken in order to reach some joint resolution of decreasing discomfort, addressing the situation, finding alternatives.”

Research through the years has also shown that women’s pain is often interpreted differently than men’s by medical providers.

A study published in April in the Journal of Pain, for instance, found that when the same level of pain was expressed by female and male patients, female patients’ pain was viewed as less intense than men’s. The study also found that female patients were prescribed more psychotherapy for for their pain, while male patients were prescribed more pain medication.

In another study, women were found to have had to wait nearly 15 minutes longer to receive pain medication in an emergency room setting than men.

“It’s a subjective symptom so it’s hard to put objectivity to it, like you would say, blood pressure, or pulse,” Shepherd said of pain. “And I think there are stereotypes about pain sensitivity and endurance of pain, so from a female perspective, it may be looked at not being able to endure as much pain, but that’s not really how pain should be monitored or evaluated.”

Copyright © 2021, ABC Audio. All rights reserved.

How to ensure your Thanksgiving doesn’t turn into a superspreader event

How to ensure your Thanksgiving doesn’t turn into a superspreader event
How to ensure your Thanksgiving doesn’t turn into a superspreader event
Liliboas/iStock

(NEW YORK) — With a winter virus surge lurking and no readily available vaccines, Thanksgiving 2020 was very different for most families. This year, expectations are much higher.

But even this year, a recent uptick in COVID-19 cases means public health experts are still urging caution. Health professionals still agree that getting vaccinated is the single best a person can do to protect themselves and their loved ones — especially unvaccinated children.

“Vaccines are only as efficacious as the number of people that get them. So a good time to remind people to get their COVID vaccines if they’re still holding out,” said Dr. Molly Fleece, an infectious disease doctor at the University of Alabama in Birmingham. “What we do not want to see this year is a so-called twin-demic, where we have peaks of influenza as well as COVID during our holiday season.”

Layering different protective measures is the best overall strategy, experts told ABC News. Dr. Anne Liu, an infectious disease and allergy specialist at Stanford University, advises people “to not rely just on vaccination, but to also be thoughtful about when to implement masking and rapid testing.”

Dr. Leana Wen, a former Baltimore health commissioner, said she’s asking family members to limit activities that could potentially expose them to COVID-19 in the days leading up to Thanksgiving.

“We are asking everybody to reduce their overall risk for the three- to five-day period before, and we’re all taking a rapid test the morning of,” she added.

Another option is testing.

“Testing ahead of time does make a low-risk situation with all vaccinated people even lower risk,” said Dr. Paul Sax, clinical director of infectious diseases at Brigham and Women’s Hospital. “I especially recommend it if someone at the gathering is older or potentially immunocompromised.”

There are multiple types of COVID-19 tests, including PCR tests, rapid tests and antibody tests. Infectious disease experts agreed that an antibody test, which looks for traces of a prior infection or prior vaccination in your blood, isn’t going to be a helpful way to protect your family over the holidays. Instead, opt for a PCR test, if you have time to wait for the results, or, a rapid test — less accurate, but faster.

“PCR test is obviously the best,” said Dr. Marc Siegel, director of infectious diseases at George Washington University. Unfortunately, during times of high demand these tests can be hard to take or results are delayed. Sax suggests that if a person is asymptomatic, doing a rapid antigen test the day before and the day of the gathering would be reasonable in lieu of a PCR test.

Once gathered, experts also suggest paying attention to ventilation. Weather permitting, have parts of gatherings outdoors helps decrease risk. It’s admittedly easier in some states.

“We’re going to actually have it outside — it’s supposed to be 65 and sunny on Thanksgiving day,” said Dr. George Rutherford, a doctor and infectious disease researcher at the University of California, San Francisco. “Plus, we can get a lot more people at the table because we can string tables together.”

But there are still options for those in colder climates.

“Even in a cold environment, it’s possible to open up a window,” said Siegel. “You might be losing some of the heat, but at least opening up a window on each side of the room to allow some room air to circulate.” Using air filters is another consideration, Sax added.

If possible, those with prior vaccinations should get their boosters before the holiday, experts said.

Ultimately, between rapid testing, better knowledge of COVID-19 transmission and the mass availability of vaccines, this year’s holiday season has the potential to be more joyous than last year’s.

Lauren Joseph, a student at Stanford Medical School, and Jacob Warner, an internal medicine resident at Dartmouth-Hitchcock Medical Center, are contributors to the ABC News Medical Unit.

Copyright © 2021, ABC Audio. All rights reserved.