Health

(KANSAS CITY, Mo.) — This is a KFF Health News story.

Abigail Arellano keeps her son Samuel’s medical bills in a blue folder in a cabinet above the microwave. Even now, four months after the 11-year-old was shot at the Kansas City Chiefs Super Bowl parade, the bills keep coming.

There’s one for $1,040 for the ambulance ride to the hospital that February afternoon. Another for $2,841.17 from an emergency room visit they made three days after the shooting because his bullet wound looked infected. More follow-ups and counseling in March added another $1,500.

“I think I’m missing some,” Arellano said as she leafed through the pages.

The Arellanos are uninsured and counting on assistance from the fund that raised nearly $2 million in the aftermath of the shooting that left one dead and at least 24 other people with bullet wounds. She keeps that application in the blue folder as well.

The medical costs incurred by the survivors of the shooting are hitting hard, and they won’t end soon. The average medical spending for someone who is shot increases by nearly $30,000 in the first year, according to a Harvard Medical School study. Another study found that number goes up to $35,000 for children. Ten kids were shot at the parade.

Then there are life’s ordinary bills — rent, utilities, car repairs — that don’t stop just because someone survived a mass shooting, even if their injuries prevent them from working or sending kids to school.

The financial burden that comes with surviving is so common it has a name, according to Aswad Thomas of the nonprofit Alliance for Safety and Justice: victimization debt. Some pay it out-of-pocket. Some open a new credit card. Some find help from generous strangers. Others can’t make ends meet.

“We’re really broke right now,” said Jacob Gooch Sr., another survivor, who was shot through the foot and has not yet been able to return to work.

“We’re, like, exhausting our third credit card.”

As is common after mass shootings, a mosaic of new and established resources emerged in this Missouri city promising help. Those include the #KCStrong fund established by the United Way of Greater Kansas City, which is expected to begin paying victims at the end of June.

Survivors must navigate each opportunity to request help as best they can — and hope money comes through.

GoFundMes, generous strangers, and a new line of credit

Mostly, it’s the moms who keep the bills organized. Tucked above the microwave. Zipped inside a purse. Screenshots stored on a phone. And then there’s a maze of paperwork: The Missouri state victims’ compensation form is five pages, including instructions. It’s another six pages for help from the United Way.

Emily Tavis keeps stacks of paperwork with color-coded binder clips in her basement: Black for her partner, Gooch Sr.; blue for her stepson, Jacob Gooch Jr.; pink for herself. All three were shot at the parade.

Tavis was able to walk after a bullet ripped through her leg, and she considered declining the ambulance ride because she was worried about the cost — she lacked insurance at the time.

Gooch Sr. was unable to walk because he’d been shot in the foot. So they shared an ambulance to the hospital with two of their kids.

“I’m not paying for this s—. I didn’t ask for this life,” Tavis, laughing, recalled thinking at the time. They soon realized 14-year-old Gooch Jr. had a bullet in his foot as well.

Tavis and Gooch Sr. received separate $1,145 bills for the ambulance. Gooch Jr. did not, possibly because he has health coverage through Medicaid, Tavis said.

She sends the medical bills to victims’ compensation, a program to help with the economic losses from a crime, such as medical expenses and lost wages. Even though Tavis and Gooch live in Leavenworth, Kansas, their compensation comes from the program in Missouri, where the shooting occurred.

The program pays only for economic losses not covered by other sources like health insurance, donations, and crowdsourced fundraisers. Gooch Sr. and Jr. both had health insurance at the time of the parade, so the family has been sending only the uncovered portion to victims’ compensation.

The family initially received a lot of support. Friends and relatives made sure they had food to eat. The founder of an online group of Kansas City Chiefs fans sent $1,000 and gifts for the family. A GoFundMe page raised $9,500. And their tax refund helped.

They knew money might get tight with Gooch Sr. unable to work, so they paid three months’ rent in advance. They also paid to have his Ford Escape fixed so he could eventually return to work and bought Tavis a used Honda Accord so she could drive to the job she started 12 days after the parade.

And because the donations were intended for the whole family, they decided to buy summer passes to the Worlds of Fun amusement park for the kids.

But recently, they’ve felt stretched. Gooch Sr.’s short-term disability payments abruptly stopped in May when his health insurance prompted him to see an in-network doctor. He said the short-term disability plan initially didn’t approve the paperwork from his new doctor and started an investigation. The issue was resolved in June and he was expecting back pay soon. In the interim, though, the couple opened a new credit card to cover their bills.

In the interim, the couple opened a new credit card to cover their bills.

“We’ve definitely been robbing Peter to pay Paul,” Tavis said.

Ideally, the money that eventually comes from the United Way, victims’ compensation, and, they hope, back pay from short-term disability will be enough to pay off their debts.

But, Tavis said, “You gotta do what you gotta do. We’re not going to go without lights.”

United Way payout expected at end of June

With every mass shooting, donations for survivors inevitably flow in, “just like peanut butter goes with jelly, because people want to help,” said Jeff Dion, executive director of the Mass Violence Survivors Fund, a nonprofit that has helped many communities manage such funds.

Typically, he said, it takes about five months to disburse the money from these large community funds. Victims can potentially get money sooner if their community has a plan in place for these types of funds before a mass shooting. Funds may also advance money to people with urgent financial needs who are certain to qualify.

The United Way hung banners in the Chiefs colors on Kansas City’s Union Station with its #KCStrong campaign within days of the shootings. Driven by large donations from the team, the NFL, quarterback Patrick Mahomes, other individuals, and local companies, it ultimately raised more than $1.8 million.

The promise of a large payout has kept the injured hopeful, even as many felt confused by the process. Some people interviewed for this story did not wish to say anything negative, fearing it would hurt their allocation.

United Way officials announced in April that donations would be closed at the end of that month. On May 1, the organization posted a notice saying it would issue “claimant forms” and that the Jackson County Prosecutor’s Office was helping verify shooting victims. The United Way affiliate’s board of trustees plans to meet June 26 to determine allocations, with payments arriving as early as June 27.

Kera Mashek, a spokesperson for United Way of Greater Kansas City, said payouts will be made to 20 of the 24 shooting survivors. The other four either couldn’t be verified as victims or turned down the funds, she said. Claimants do not include the 67 people prosecutors say were trampled in the melee, she said.

Pending board approval, money will also be disbursed to 14 community groups that support nonviolence initiatives, mental health concerns, and first responders, Mashek said.

To criticism that the United Way didn’t communicate well with the victims, Mashek said it tried to respond in a timely manner.

“We’ve tried to keep that line of communication open as fast as possible and most people have been very patient,” she said. “I think that they will be very grateful and very, I believe, pleasantly surprised with the amount of funding that they receive.”

Other resources available

Abigail Arellano hadn’t heard of victims’ compensation, which is common. A 2022 survey from the Alliance for Safety and Justice found that 96% of victims did not receive that support and many didn’t know it existed.

Arellano and her husband, Antonio, didn’t attend the parade but they’ve had medical expenses as well. Antonio has been going to therapy at a local health center to help with the stressful task of guiding his son through the trauma. It’s been helpful. But he’s been paying around $125 out-of-pocket for each session, he said, and the bills are mounting.

One of Samuel’s sisters set up a GoFundMe that raised $12,500, and Abigail said it helped that the family shared their story publicly and that Abigail reached out to help others in the Latino community affected by the shooting.

It was Abigail, for instance, who connected 71-year-old Sarai Holguin with the Mexican Consulate in Kansas City. The consulate, in turn, helped Holguin register as an official victim of the shooting, which will enable her to receive assistance from the United Way. Holguin’s bills now include a fourth surgery, to remove the bullet lodged near her knee that she had previously made peace with living with forever — until it began protruding through her skin.

‘Generous and quick’ relief to victims

Several survivors were relieved and grateful to receive funds from a less high-profile, nondenominational group called “The Church Loves Kansas City.”

The day after the shooting, Gary Kendall, who ran a Christian nonprofit called “Love KC,” started a text chain at 6 a.m. with city leaders and faith-based groups, and eventually received pledges of $184,500. (Love KC has now merged with another nonprofit, “Unite KC,” which is disbursing its funds.)

The first payout went to the family of Lisa Lopez-Galvan, the 43-year-old mother of two and popular DJ who was the sole fatality during the parade shootings. Unite KC spent $15,000 on her burial expenses.

Unite KC spent $2,800 so James and Brandie Lemons could get their health insurance restored because James couldn’t work. Unite KC also paid $2,200 for the out-of-pocket surgical costs when James decided to get the bullet removed from his leg.

“I appreciate it,” an emotional James Lemons said. “They don’t have to do that, to open their hearts for no reason.”

Erika Nelson was struggling to pay for household expenses and had to take time off from her home healthcare job to take her injured daughter, 15-year-old Mireya, to doctor appointments. Mireya was shot in the chin and shoulderYour text to link… and is recovering.

A GoFundMe page set up by Nelson’s best friend raised about $11,000, but it was frozen after Nelson tried to get into the account and GoFundMe thought it was being hacked. She feared the lights would be shut off in their apartment, because of unpaid electric bills, and was feeling desperate.

“I’m struggling with, like, you know, groceries,” Nelson said. “People were like, ‘Oh, go to food pantries.’ Well, the food pantries are not open the times I can get off. I can’t just take off work to go to a food pantry.”

After meeting with Gary Kendall, Nelson received three months of rent and utility payments, about $3,500.

“A weight off my shoulder. I mean, yeah. In a big way,” she whispered. “‘Cause you never know. You never know what can happen in two days, five days, two weeks, two months.”

Samuel Arellano’s family recently connected with Unite KC, which will pay for his ambulance bill, one of the hospital bills, and some therapy, worth about $6,000. The bill for the initial emergency room trip was about $20,000, his parents said, but the hospital had been reluctant to send it and ultimately covered the cost.

And Unite KC also intends to pay off a $1,300 credit card bill for Emily Tavis and Jacob Gooch Sr.

Unite KC has disbursed $40,000 so far and hopes to connect with more of the injured families, hoping to be as “generous and quick as we can,” Kendall said. United Way will be like a “lightning bolt” for victims’ relief, Kendall said, but his group is aiming for something different, more like a campfire that burns for the next year.

“We agree this is a horrific thing that happened. It’s a sad state of humanity but it’s a real part,” he said. “So we want to remind them that God has not forgotten you. And that although he allowed this, he has not abandoned them. We believe we can be like an extension of his love to these people.”

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(NEW YORK) — Dr. Anthony Fauci sat down with the co-hosts of “The View” to discuss advising Former President Donald Trump during the pandemic’s peak, serving under seven presidents as NIAID director and the Latin phrase that has guided his work.

Fauci was the director of the National Institute of Allergy and Infectious Diseases from 1984 to 2022. During the pandemic, he was a key White House Coronavirus Task Force member and initially had a good working relationship with Trump.

However, the dynamics of their relationship shifted when Trump began say things that were “not true,” according to Fauci. Fauci, driven by what he said is a strong sense of personal and professional integrity, found himself at odds with the former president, a situation he says was not easy for him to navigate.

As Fauci attempted to implement policies recommended by the Centers for Disease Control and Prevention, he claimed that Trump and his supporters opposed him.

ABC News sat down with Fauci to talk about his deteriorating working relationship with Donald Trump during the COVID-19 pandemic.

ABC NEWS: So before we start, people are so glad to see you. They are so glad to see you.

FAUCI: Thank you.

ABC NEWS: So thank you for coming on the show and for everything. Everything you’ve done from the very beginning. It’s extraordinary. And you’re no worse for the wear. You look good.

FAUCI: Thank you.

ABC NEWS: You say empathy has always guided you as a physician and a public servant, but there’s also a Latin phrase that has consistently come up for you and I’d love you to share it and tell everybody what it means.

FAUCI: Well, when I was getting my education in high school, Latin and Greek was an important part of our classical training. It was actually at Regis High School, a few blocks from here, a Jesuit school. And one of the things that they mentioned to us when things got down and you felt the world was caving in on you was Illegitimi non carborundum, which means ‘Don’t let the bastards wear you down.’ Boy did that hold true.

ABC NEWS: You know, you look, you are probably one of the classiest people I’ve ever watched move around in Washington, D.C.

FAUCI: Thank you

ABC NEWS: So and — you know, I just want to raise my dreads to you. But I don’t want to take up too much time, Alyssa.

ABC NEWS: Well, Dr. Fauci, it’s so good to see you. Before retiring from government in 2022, you served under seven presidents and bipartisan administrations. Fighting diseases like AIDS, Ebola, and, of course, COVID-19, where you and I got to know each other. You had addressed so many of these ailments before and never faced the backlash that you did from part of the country when you were working on COVID. Did you see that coming? We watched it in real time.

FAUCI: No, it was really unexpected. Because, as Alyssa said, I served and advised seven presidents, Democrat and Republican, both sides of the aisle. There are always disagreements, of course. But that’s why we have a great country because you have people with different ideological views.

But the disagreements were always associated with civility, with respect for each other and respect for institutions in the government. So you could have a disagreement, but at the end you try and compromise. What happened with COVID, as I think was represented by the hearing a few weeks ago, was just pure ad hominem and vitriol. And that really took me by surprise. I thought there would be the give and take and respect each other’s disagreements.

That’s the thing that worries me not only about what I have to face, but also about the direction of the country and the social order of the democracy. It’s very threatening I think.

ABC NEWS: It’s in jeopardy. It’s in jeopardy, I think. So you dedicate a chapter of your book to your dealings with Trump, the chapter is called “He loves me, he loves me not” and you describe some angry ranting expletive-filled phone calls. He would berate you and flatter you in the same breath. I’m wondering: you said you worked with seven other presidents. Did any one of them ever speak to you the way he does or did?

FAUCI: No, of course not. Not even close. What I meant by loves me, loves me not. Early on in the beginning — he is an engaging character and we had a certain rapport with each other. I was trying to figure out what it was. I think it was two guys from New York City. He was from Queens, I was from the Bronx and we kind of had that New York — he calls it swagger — with each other, that was fine.

And all that was really good in the beginning. Until you know, he wished and hoped that the outbreak would disappear because it clearly was getting in the way of both the economy and then, as a result of that, into the election cycle. So he started to say things that actually were not true. And I just felt that I had a responsibility for my own personal and professional integrity, but also my responsibility to you, the American public, so had to contradict him.

It was very difficult for me to do that. Once I did that, then things got really dicey. Because I don’t think he went away from the fact that we did have a good relationship, but he was really very upset about the fact I had to get up and say, no, it’s not going to disappear like magic and no, hydroxychloroquine doesn’t work no matter what Laura Ingram is telling you. I mean that’s the problem.

ABC NEWS: He doesn’t like when people disagree with him. That’s why cohorts in the Republican Party are kowtowing to him because they know it displeases him.

ABC NEWS: Well, speaking of hydroxychloroquine, countless of Americans lost loved ones to COVID. My husband lost both of his parents, two doctors, within three days of each other from the pandemic.

We remember those pandemic briefings. I remember the injection of bleach, perhaps. The hydroxychloroquine. Dangerous recommendations. You were particularly disturbed, I read, by his refusal to wear a mask.

What was this time like for you having to contradict the president of the United States? And what should everyone know about how he handled the crisis? Because I blame him for my in-laws’ death.

FAUCI: Well, the people who became very angry with me, people on his staff like Peter Navarro and Mark Meadows, and others thought that I was doing that because I had some sort of antipathy to the president and I did not. It was very painful for me. I have a great deal of respect for the presidency of the United States of America. I served seven presidents; it wasn’t like ‘wow, isn’t this cool I’m contradicting the president.’ It was very very painful, but I had to do it.

With regard to the masks, the thing that was a problem, is that when the CDC came out and made the recommendations — indoors we should be wearing masks. That was at a time when the infections were going like that. And what he got up and said it’s recommendation but I’m not going to do it; I choose not to do it. I consider that a missed opportunity to use the bully pulpit of the presidency to get people to do things that was for their own safety.

He has millions and millions of followers who are very loyal to him. All he had to do is say the CDC is recommending masks; we know it’s going to save lives, do it. He missed an opportunity.

ABC NEWS: I remember telling him he looked cool in the masks because I thought that might be like, ‘Fine. I’ll wear it.’ Didn’t work.

FAUCI: Nice try, Alyssa.

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A number of social media influencers have begun spreading misinformation and discouraging followers from using sunscreen, but experts say sunscreen is a vital tool in protecting your skin, the body’s largest organ, from cancer.

ABC News medical correspondent Dr. Darien Sutton joined “Good Morning America” on Friday to debunk some of the myths gaining traction online, some of which likely stem from past recalls of sunscreen contaminated with benzene, a known carcinogen.

“If you look at a lot of the products that we put on every day, we might see a chemical called oxybenzone. That is very different from benzene, and there is no conclusive evidence that that is associated to an increased risk of cancer,” Sutton said.

Oxybenzone, the typical active ingredient in sunscreen, has caused concern among some social media influencers, but the compound can absorb harmful UVB radiation and some UVA radiation.

According to the American Academy of Dermatology, skin cancer is now the most common cancer in the U.S., and the American Cancer Society projects that in 2024, over 100,000 new cases of melanoma, or cancer of the skin, are expected to be diagnosed and more than 8,000 will die from it.

The benefits of sunscreen

According to a study in the Journal of Clinical Oncology, the regular use of sunscreen can help reduce the risk of invasive melanoma by about 70% and has secondary benefits too, such as helping to prevent wrinkles and skin pigment changes caused by ultraviolet radiation.

What to look for in sunscreen

The American Academy of Dermatology recommends people use sunscreen with SPF 30 or higher, broad-spectrum protection, and water resistance. For children 6 months and older, parents and caregivers should help them apply kids sunscreen that also offers broad spectrum protection, water resistance and SPF of 30 or higher. Kids younger than 6 months should avoid direct sun exposure, wear light protective clothing and stay in shady areas.

“For kids, honestly at the end of the day, it’s whatever they’re going to keep on and be OK with reapplying. So, whatever method is best,” Sutton said.

“If you’re looking for good clothing, you want to look for that UPF signature that [indicates] that it protects against UV rays,” Sutton added.

Sunscreen is also now available in different formulations, from sprays and lotions to oils, but as a reminder, Sutton noted that sunscreen needs to be applied before any makeup.

“A lot of people will spray sunblock over their makeup. It only works if you rub it in. So unfortunately, that might be convenient, but that’s not effective. We’ve got to spray and rub in,” Sutton said.

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(NEW YORK) — Bisexual and transgender adults are more likely to face loneliness than straight and cisgender adults, according to a new Centers for Disease Control and Prevention study published Thursday.

Researchers looked at data from the 2022 Behavioral Risk Factor Surveillance System—which collects information on health risk behaviors, preventive health practices, and health care access—and examined links between loneliness and lack of social and emotional support and mental health variables.

Loneliness was highest among participants who identified as bisexual at 56.7% or transgender, which fell between 56.4% and 63.9% for transgender males, transgender females and transgender non-conforming.

Participants who identified as gay or lesbian also had high shares of loneliness at 41.2% and 44.8%, respectively.

Comparatively, those who identified as straight or cisgender had lower shares of loneliness at 30.3% and 32.1%, respectively, making bisexual and transgender individuals nearly twice as likely to face loneliness, according to the report.

“We know that people that are part of the LGBTQ+ community often face isolation but this study is important in that it highlighted the degree that they are isolated compared to people not part of that community,” Dr. Adjoa Smalls-Mantey, a New York-based psychiatrist, told ABC News.

Results showed that members of the LGBTQ+ community were more likely to report stress, frequent mental distress and a history of depression.

More than one-third of bisexual adults — 34.3% — reported feelings of stress compared to 12.6% of straight adults. Similarly, up to 37.8% of transgender adults reported feelings of stress while just 13.9% of cisgender adults reported the same.

More than half of bisexual adults and transgender adults — 54.4% and up to 67.2%, respectively — reported a history of depression. However, just 19.4% of straight adults and 21.4% of cisgender adults reported the same.

Smalls-Mantey said the results of the study did not surprise her because many LGBTQ+ patients she’s seen have discussed feeling lonely and isolated or facing rejection.

“They [often] don’t feel comfortable coming out to people that are closest to them and they may hide away, not share that part of themselves, not engaged with people that they used to. So sometimes it can be self-imposed,” she said.

Past research has shown loneliness and isolation can lead to poor health outcomes and put people at increased risk of heart disease and stroke. Additionally, social isolation can raise the risk of premature death from all causes including from obesity, smoking and physical inactivity,

The study had limitations, including data only coming from 26 states, which may make results generalizable not the entire U.S. adult population. However, the authors said addressing the mental health needs of LGBTQ+ individuals should include services that focus on loneliness and the lack of social and emotional support.

“Providing access to health services that are affirming for sexual and gender minority groups and collecting data to address health inequities might help improve the delivery of culturally competent care,” the authors wrote.

Dr. Judith Joseph, a board-certified child, adolescent and adult psychiatrist and clinical assistant professor at NYU Health, told ABC News that she encourages LGBTQ+ individuals to connect with people outside of the home if they don’t find the support they need.

“So that could be the person at the store if you go to buy something, rather than just saying. ‘Oh, thank you and have a great day,’ ask that store clerk, ‘So, how’s your day going?'” she said. “You can start a conversation with the barista at the coffee shop. These small interactions really help a lot of my clients who have cut off people because they were not accepted by their parents.”

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(NEW YORK) — Pharmaceutical company Eli Lilly issued a warning in an open letter on Thursday about the dangers of fake and compounded versions of its diabetes and weight loss medications Mounjaro and Zepbound.

The company also announced new lawsuits against wellness centers and medical spas advertising these drugs.

Eli Lilly’s main competitor, Novo Nordisk, which sells Ozempic and Wegovy, has also filed lawsuits against med spas purportedly selling knockoff versions.

Both companies say the extraordinary demand for these drugs has led to shortages, which has in turn prompted black and grey market sales of other versions of their products that may pose a health risk to consumers.

In its Thursday open letter, Eli Lilly issued a major warning to consumers, saying the company is “deeply” concerned about the proliferation of online sales of fake versions of its products, and that people should never put products labeled “research purposes only” or “not for human consumption” into their bodies.

Eli Lilly says they never sell genuine Mounjaro or Zepbound on social media.

Fake drugs aside, Eli Lilly is also raising concerns about compounding pharmacies. These are technically legal amid an ongoing drug shortage, but the Food and Drug Administration has raised concerns about bad actors making substandard products.

Eli Lilly says that the company has done testing of compounded versions of their drug, and they have observed safety, sterility and efficacy problems. Some of the products have bacteria, high impurities, different colors or a completely different chemical structure than the company’s FDA-approved medicine. In at least one instance, the product was nothing more than sugar alcohol, Eli Lilly said.

In addition to these warnings about fake and compounded products, Lilly reiterated the company’s prior stance that these drugs should not be prescribed or used for “cosmetic” weight loss. The company said they should be for people living with diabetes and/or obesity, or who are overweight with other related medical conditions.

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(NEW YORK) — This year, the American Society of Clinical Oncology — the world’s leading oncology organization — recommended palliative care for everyone with advanced cancer at the time of diagnosis and while receiving treatment.

Palliative care clinicians manage cancer-related symptoms and side effects from treatment, while addressing quality of life and stress for patients and families.

By next year, 693,000 people in the United States will have advanced breast, prostate, lung, colorectal, bladder, or skin cancer. Typically, advanced cancers spread to other parts of the body, and may cause symptoms or are difficult to cure.

Oncologists said starting palliative care when a diagnosis is made may make it easier for patients to stay on their treatment course.

“What I’m really excited to see is that these guidelines are taking a step back and thinking about [palliative care] from the time of diagnosis,” Dr. Arif Kamal, chief patient officer for the American Cancer Society and an associate professor at Duke University specializing in oncology and palliative care, told ABC News. “It should particularly be used in areas to help people stay on treatment, such as in clinical trials or hematologic malignancies.”

Here are six things to know about palliative care:

Palliative care can help you live better and longer

“Many people are surprised to hear research shows early palliative care involvement not only improves quality of life but also prolongs survival,” Dr. Allison Chang, an oncologist at the Dana Farber Cancer Institute, told ABC News.

Palliative care puts you in control of your care

Palliative care teams work closely with a patient’s oncologist throughout their cancer journey.

Palliative care supports you and those who matter most

“Palliative care is very deliberate in seeing, recognizing and assessing the needs of caregivers… [who] are such an important part of the clinical team,” said Kamal.

Palliative care increases your time at home or where you want to be

Dr. Anthony Back, a professor of medicine at the University of Washington’s Division of Oncology, told ABC News about a patient with breast cancer whose chemotherapy made her too tired to do things her two young kids needed.

Palliative care helped with her fatigue and worry so she could manage and feel like “mom” again, he said.

Palliative care is covered by most insurance companies

Find a palliative care provider near you.

Palliative care isn’t just for people with cancer

Anyone with a serious illness can get palliative care, and it’s recommended for heart and kidney failure.

Kamal recommends asking your doctor “Could the extra support of a palliative care team be helpful to me?” He finds asking is often enough for doctors to make a referral.

Palliative care is no longer something that’s “nice to have. It’s a have to have,” said Kamal.

Lindsey Ulin, MD is an internal medicine resident at Brigham and Women’s Hospital and a member of the ABC News Medical Unit.

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(NEW YORK) — As the United States heads into the summer season, early indicators show the country is likely to experience an increase in COVID-19 infections.

For the week ending June 8, the latest date for which data is available, COVID test positivity was 5.4% across the U.S., an increase of 0.8% from the previous week, according to data from the Centers for Disease Control and Prevention (CDC).

In the Western region — which is comprised of Arizona, California, Hawaii and Nevada — COVID test positivity was 12.8%, higher than any other region of the U.S. The New England region — made up of Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island and Vermont — had the next highest test positivity rate at 5.4%, matching the national rate.

Wastewater data from the CDC shows that although viral activity levels are still low nationally, levels have more than doubled in the western U.S. over the last month.

Additionally, COVID emergency department visits for the week ending June 8 rose 12.6% from the week prior, according to CDC data.

Traditionally, the U.S. has seen increases in COVID every summer, typically after the Fourth of July, but public health experts said Americans will likely see a “drift upwards” rather than a surge.

“To put it proportionally to like where we were in many winters, we are at a very, very low rate of COVID, compared to some of our peaks,” Dr. Cameron Wolfe, a professor of medicine in the infectious diseases division at Duke University, told ABC News. “Like compared to early 2022, for example, when omicron first emerged, this is night and day different. But … there’s just this little drift upwards, perhaps in the last few weeks.”

Increases have been seen in several states, most notably on the West Coast. In Los Angeles, the county’s Department of Public Health reported an average of 121 cases on June 13, up from a daily average of 106 instances one week prior.

However, experts said a combination of us learning how to better manage the virus and having high levels of immunity means COVID will not be a major threat to the average person.

“Our bodies have learned how to manage the virus over the last four years, meaning that many people have had successive waves of infection, many people have had initial vaccinations,” Dr. Peter Chin-Hong, a professor of medicine and infectious disease specialist at the University of California, San Francisco, told ABC News. “So that combined immunity gives a big force field that can help protect us during the summer. … Although most people will be fine, there are still some people that are going to get very sick.”

As of Tuesday, hospitalizations and deaths in the U.S. remain stable. For the week ending May 18, the last week of complete data, there were 311 deaths due to COVID, which is the lowest death figure recorded in the U.S. since the beginning of the pandemic.

Chin-Hong said most hospitalizations and deaths are occurring among high-risk groups, including elderly individuals aged 75 and older and people who are immunocompromised, such as those who have undergone organ transplants or are on medications that suppress the immune system.

He recommends the average person track COVID wastewater data from the CDC to see if it’s trending upwards in their area and to keep masks and COVID rapid tests handy in case they need them, but he added that an increase in COVID should not be cause for fear.

“I think there’s a fine balance between ignoring everything and being scared by everything,” Chin-Hong said. “It’s like when you’re crossing the street. You never just run across a busy road; you always look both ways, but it doesn’t mean you don’t go to the next destination. So, I think in the new… phase of COVID, that’s the way we should think about it.”

Similarly, Wolfe said people should assess their individual risk and take more precautions if they will be around high-risk individuals such as senior citizens or sick patients. He also recommended getting the newest updated COVID vaccine that will likely be rolled out in late September.

“Very much in the same way that flu vaccines are tailored each year to adapt to the strains that we see, the same is occurring with COVID,” Wolfe said. “And I think for someone who might be themselves or someone in their family or close contact known to be high risk I’m going to be still actively encouraging those people to get vaccinated.”

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(GREENWICH, Conn.) — For years, Jose Dominguez, 50, had wanted to donate blood, feeling it was part of his civic duty.

But he was restricted by rules set in place by the U.S. Food and Drug Administration that did not allow sexually active gay men from donating.

That finally changed in May 2023, when the FDA dropped all restrictions specific to gay and bisexual men donating blood, moving to a new blood donation risk assessment tool that is the same for every donor regardless of how they identify, which rolled out in August 2023.

In March of this year, Dominguez finally donated blood for the first time, and he did so with his husband, Craig Burdett. For Burdett, 62, it was the first time he had donated blood since 1997, when he began openly identifying as gay.

“I was grinning just from ear to ear, just because of the fact that we were able to do this,” Dominguez, who is the head of the American Red Cross Long Island chapter, told ABC News. “I’ve never done it before, and I was getting to do it with my husband.”

“This is something that we had talked about along during our relationship and anytime somebody said they donated blood, I’m like, ‘That is such a privilege. It is such a privilege to be able to do that and one day, we will,'” he continued. “But it was just like, ‘Whoa, this is so cool. It’s finally happening.'”

So, did the rule change bring in more donors? Blood donation organizations say although it’s a bit too soon to tell, early data seems to indicate it did make a difference.

New policy allowing gay and bisexual men to donate
In the early days of the HIV/AIDS epidemic, blood donations were not able to screen for HIV, which led to some cases of HIV via transfusion. This led to the FDA instituting a lifetime ban on gay and bisexual men from donating blood as well as women who have sex with men who have sex with men.

In 2015, the blanket ban was repealed, but the FDA placed restrictions on men who have sex with men, saying they could donate if they were abstinent from sex for at least one year. In 2020, this was shortened to a period of 90 days of abstinence.

In 2023, the FDA announced it would no longer be issuing blanket bans due to sexual orientation and instead screen potential donors on their risk of contracting and transmitting HIV, with the policy going into effect in August.

At the time, the federal health agency said it would use “gender-inclusive, individual risk-based questions” without compromising “the safety or availability of the blood supply.”

Questionnaires ask all donors about new or multiple sexual partners in the past three months. Those who have had a new sexual partner or multiple partners in the past three months and a history of anal sex during that time period will be deferred. Those taking medications to treat or prevent HIV infection will also be deferred, but LGBTQ+ advocacy groups say the new FDA rules are an important step in the right direction. The new blood donation risk assessment is the same for every donor regardless of how they identify.

‘I’m being ostracized’
Burdett, who runs a freelance web design business, grew up with a mother who was a regular blood donor due to a rare blood type, though he can’t remember what type exactly. He said she would get calls in the middle of the night to donate and, when she did, she would take him and his younger brother along with her.

“She taught us that giving blood was an important part of being part of the community,” he said. “You give blood because that’s an easy way to give back and to support your community. And so, I grew up giving blood every eight to 10 weeks, whenever I remembered that it was time, I gave blood until I came out as a gay man in the mid-90s.”

The last time Burdett donated blood was in 1997. At the time, the FDA still had a lifetime ban for blood donations from gay and bisexual men.

Not being able to do so because of sexual orientation made him feel excluded from a community he’d been part of for so many years.

“When I couldn’t give blood again, I felt like I was being pushed out the community,” Burdett said. “It felt like I lost something.”

Dominguez said that growing up, he had many family members in hospitals due to health problems. When he would visit, he would see people donating blood, but he knew he couldn’t, and it made him feel “ostracized.” Dominguez said he never attempted to donate.

“Of course, there were regulations, FDA regulations that were set in place,” he said. “But I remember in college, when I finally was able to do it, and being a gay male, I couldn’t because of the restrictions…I’m thinking, ‘Oh, my God, I’m being ostracized.'”

When the couple first heard during the COVID-19 pandemic that the FDA was considering rolling out a new policy that did away with most deferrals, Dominguez was optimistic, but Burdett was doubtful.

“I raised a skeptical eyebrow, like that’s not gonna happen,” Burdett said. “They’re gonna have some rule like you can’t have had sex for six months. … So when it was that we really [could give] blood, I was really surprised — surprised and super happy.”

People returning after being deferred
Blood donation organizations said early data indicates that the policy has made a difference — bringing back donors who were previously unable to give blood.

Since the American Red Cross implemented the FDA’s individual donor assessment last summer, about 8.5% of more than 2,000 people with the most recent three-month deferral on their donor record returned to donate in the first five months after the policy change, the organization told ABC News.

Local organizations report similar results. New York Blood Center (NYBC) said between 240 and 250 people deferred under the 90-day policy have since returned to donate blood.

Andrea Cefarelli, senior vice president for NYBC, told ABC News it’s been less than a year since the new policy and people are still learning they are now eligible to donate, so that number should increase.

“What we would never know is someone that … knew from friends or from media coverage that they were not eligible and then comes in and donates. We wouldn’t have that figure that [they] sort of self-deferred before,” she said. “So, is it making an impact? I’m sure that it is.”

OneBlood — which has service areas in Florida, Georgia, North Carolina, South Carolina — told ABC News that of 7,092 people who deferred under the previous one-year and three-month deferral periods, 902 returned to donate under the new policy over the last 10 months, equating to 1,334 donations.

While there are people like Dominguez and Burdett who donated blood after becoming eligible under the new donor assessment, they acknowledged some gay and bisexual men may still be angry that they were prevented from donating blood previously, even if they were practicing safe sex at the time.

“There were a lot of hurt feelings in the gay community about when gay men were banned from giving blood,” Burdett said. ‘There’s still a group of gay men about my age who hold a lot of animosity about it.”

“I understand the panic in the early 80s…But there are a lot of folks who are not ready to forgive and forget. As we meet them, and talk to them, encourage them to give blood because it’s part of being a community and…you’re giving to your neighbor,” he added.

Burdett and Dominguez say they plan to donate again as soon as possible and want to encourage conversations with other members of the LGBTQ+ community to consider donating if they haven’t already.

“I think we’re in the perfect month to start this conversation,” Burdett said of Pride Month. “There are a lot of Pride parades going on. So, I would encourage anyone who accepts blood to be present and be at those events and to do the education and let people know, pamphlets, flyers, tell them folks that gay men can give blood, and I would suspect that would be helpful.”

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(NEW YORK) — Creating a surgeon general’s warning for social media is a necessary step to respond to the “defining public health challenge of our time,” U.S. Surgeon General Vivek Murthy told ABC News’ Elizabeth Schulze in an interview on Monday.

“We are living in the middle of a youth mental health crisis, and I have said publicly that this is the defining public health challenge of our time. I firmly believe that. And social media has emerged as an important contributor to that youth mental health crisis, so making social media safer for our kids — warning kids and parents about the harms associated with social media — is urgent,” Murthy said.

“It’s part of addressing the broader mental health crisis that we’re living through,” he said.

The warning, which would appear universally in social media feeds to raise awareness about the risks of social media on adolescent mental health, would need congressional action to be implemented. Testing on the best messaging and frequency of the warnings would then be conducted, Murthy said, with the goal of “driving toward behavior change.”

“I was getting questions from parents all across the country about social media, and they wanted to know, is this safe for my kids? And what we can conclude, based on our research and talking to experts from around the country, was that social media, number one, has not been proven to be safe for kids. And number two, there is mounting evidence of harms associated with social media use,” Murthy told Schulze.

“So, we want to make sure that parents and kids know that. And that’s where a warning label comes into play.”

The issue is also urgent because 95% of adolescents are on social media, Murthy said, echoing the case he made in a New York Times op-ed.

“The data tells us that kids who spend an average of three hours or more on social media a day, they experience a doubling of their risk for anxiety and depression symptoms. That’s pretty profound, but also particularly disturbing when you keep in mind that the average amount of use for adolescents today is 4.8 hours a day,” he said.

When tobacco warnings were implemented in the U.S. in 1966, 42% of Americans smoked, Murthy said. Today, that’s down to 12%. However, that change took nearly six decades and was only one step in a larger effort of education and reform.

“While we are late as a society to ultimately making these platforms safer, it’s urgent that we start taking action now. Because the truth is, there’s nothing more important to the mental health and well-being of our kids,” Murthy said.

“I say that not just as surgeon general and as a doctor, but as a father to of two young kids who I’m worried about, just like millions of parents are worried about the mental health and well-being of their children,” Murthy said.

Murthy said his kids aren’t allowed to use social media until they graduate from middle school, at which point he and his wife will review the data around safety and whether any platform regulations have been implemented, as well as the ability of his kids to safely navigate it.

For kids who are already on social media, the goal should be creating phone-free zones, he said, like dinner time, social interactions and bedtime. He encouraged parents to build communities around phone-free zones, because it’s “much easier to do when we are doing them collectively as a group of parents.”

Murthy acknowledged that on a larger scale, the ball is in Congress’ court — both in implementing warnings, and in providing broader safeguards against social media risks to mental health. Particularly in a tense election year where legislative gridlock is the norm, that poses a problem.

“But as a nation, we can do hard things when it comes to protecting and safeguarding our kids. We should be ready to do everything possible to achieve that end,” Murthy contended.

In the meantime, Murthy is committed to raising awareness in hopes that parents and kids will begin limiting screen time.

“The bottom line is, again, making the platform safer is the key. But until then, until that actually happens, it’s important that we make sure parents and kids know what we now know in medicine and public health, which is this association between social media use and mental health harms.”

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(NEW YORK) — Rates of high blood pressure during pregnancy doubled between 2008-2021, but only 60% were treated for it, according to a new study published Monday in the journal Hypertension.

“One of the main drivers of adverse outcomes during pregnancy is due to high blood pressure,” Stephanie Leonard, an Assistant Professor of Obstetrics and Gynecology- Maternal Fetal Medicine at Stanford and lead author on the study, told ABC News.

Chronic hypertension in pregnancy is defined as high blood pressure diagnosed before pregnancy or before 20 weeks of pregnancy.

While it’s not clear why rates have increased so dramatically, prior research suggests it may be because more people are choosing to wait until they are older to have children.

Chronic hypertension can lead to serious complications that can be dangerous for pregnant people and their babies. The U.S. maternal death rate remains the highest among high-income countries, with Black women experiencing the highest rates and they are also disproportionately affected by hypertension in pregnancy.

“Heart disease is the number one cause of death of women in the U.S., and women have unique risk factors as compared to men,” Maria Pabon, a cardiologist at Brigham and Women’s Hospital specializing in women’s cardiovascular health, said in an email to ABC News.

“High blood pressure during pregnancy can increase the risk of different kinds of heart disease in the future,” Pabon said.

But doctors say there are concrete steps people can take to lower their risk.

“Being aware that having a history of high blood pressure during pregnancy can increase your risk of future heart disease,” Pabon said. She encourages lowering other risk factors for developing heart disease by eating a heart-healthy diet, such as the Mediterranean diet, and working on exercise, sleep, and stress management.

Annual screening for heart disease should include checking “blood pressure, weight, and cholesterol. Everyone should have a Lipoprotein A level checked once,” Pabon said.

If you have a family history of heart disease, Pabon recommends seeing a cardiologist specializing in women’s health or prevention cardiology to consider other testing.

Ask your doctor if you should check your blood pressure at home. If you have a blood pressure monitor at home, bring it to your next appointment to check for fit and accuracy.

The American Heart Association has tips for checking your blood pressure at home.

• Don’t smoke, drink caffeinated beverages or exercise within 30 minutes before taking your blood pressure.
• Don’t take measurements over clothes.
• Rest for five minutes before checking and sit still.
• Check at the same time every day.
• Sit up straight with your back supported and feet flat on the floor. Rest your arm on a flat surface.
• Take multiple measurements and record the numbers.

According to the new study, not enough people are getting treatment for their high blood pressure during pregnancy, with the study estimating that only 60% are treated.

Typically, anyone with high blood pressure during pregnancy is treated with medication if blood pressure is above 140/90.

Dr. Justin Brandt, an Associate Professor in the Department of Obstetrics and Gynecology at NYU Grossman School of Medicine and the Division Director of Maternal Fetal Medicine, said 60% may be an underestimate because not all doctors are aware of updated medical consensus about treating hypertension during pregnancy.

In 2022, a major medical group updated its guidance to commend treating people even with mild hypertension during pregnancy – a shift from prior guidance, which said to start medication if blood pressures were above 160/110.

“Our approach really changed. We realized that treatment reduced complications in pregnancy like pre-eclampsia without affecting fetal growth,” Brandt said.

Lindsey Ulin, MD is a resident in internal medicine at Brigham and Women’s Hospital and a member of the ABC News Medical Unit. 

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