(NEW YORK) — Although officials have been warning for weeks of an impending coronavirus resurgence across the country, health experts say it is impossible to know exactly how widespread the nation’s latest resurgence may actually be, given the declining availability of COVID-19 data.

“An effective public health response depends on high quality, real time data,” said Dr. John Brownstein, an epidemiologist at Boston Children’s Hospital and an ABC News contributor. “Underreporting, driven by changes in testing behavior, lack of public interest and severely underfunded local public health departments, create a perfect storm of misleading case counts and hospitalizations.”

Since last summer, dozens of states, along with federal agencies, have opted to scale back on regular COVID-19 data reporting. A dwindling number of states still offer daily COVID-19 data reports, with most now moving to an alternate-day schedule or even to a weekly schedule.

“With changing case definitions for hospitalizations, decreased testing, and increased use of at-home rapid tests, data on COVID-19 in the U.S. has become increasingly hard to interpret,” Sam Scarpino, the vice president of pathogen surveillance at the Rockefeller Foundation’s Pandemic Prevention Institute, told ABC News.

The significant decrease in data reporting and the nationwide decline in public testing have left health experts concerned that officials could be missing viral surges and in the dark about true positivity rates in the country, given the lack of information.

“I think that we’re dramatically undercounting cases. We’re probably only picking up one in seven or one in eight infections. So when we say there’s 30,000 infections a day, it’s probably closer to a quarter of a million infections a day,” Food and Drug Administration Commissioner Dr. Scott Gottlieb said during an appearance on CBS’ Face the Nation on Sunday. “They’re concentrated in the Northeast right now. And that’s because a lot of people are testing at home, they’re not presenting for definitive PCR tests, so they’re not getting counted.”

Health experts say official counts, which show small upticks, may actually be significantly higher than counted, as millions of Americans, who are taking at-home tests, rarely report their results to local health agencies

In consequence, testing levels are now at their lowest point since June 2020, with official test numbers dropping by more than 80% since the beginning of the year, with just half a million tests reported daily, compared to 2.5 million tests reported at the nation’s viral peak in January.

Dozens of states have also moved to shutter public testing sites, as at-home COVID-19 tests have become more accessible.

“These are uncharted waters for us with this virus,” Dr. Anthony Fauci told Bloomberg in an interview last week, reiterating that it is impossible to predict how COVID-19 will play out in the months to come.

“We are probably underestimating the number of infections that we’re having right now, because many of the infections are either without symptoms or minimally symptomatic, and you’ll miss that if people do it at home and it’s not reported to a central bank,” Fauci said.

In an effort to monitor the state of the current resurgence, scientists have been closely monitoring other metrics, including wastewater.

In the last 15 days, nearly 60% of wastewater sites monitored by the Centers for Disease Control and Prevention have reported an increase in the presence of COVID-19 in their samples.

Hospitalization data, once the gold standard, now becoming less straightforward

For many officials, monitoring virus-related COVID-19 hospitalizations has been key to assessing the state of the pandemic. However, in recent months, hospitalization data, too, has become less accessible.

Earlier this year, the Department of Health and Human Services ended the requirement for hospitals to report several key COVID-19 metrics, including a daily total of the number of COVID-19 deaths, the number of emergency department overflow and ventilated patients, and information on critical staffing shortages.

“Hospitalization data is now considered a key defining metric for pandemic severity by CDC. At the same time, with massive gaps in data from hospitals and states, it’s hard to peg these data as a gold standard by which policy decisions can be made,” Brownstein explained.

Further, certain states, such as Arizona, have stopped outright reporting of statistics including hospital bed usage and availability, COVID-19 specific hospital metrics and ventilator use.

And last week, one state — New Hampshire — quietly shifted the way it counts COVID-19 related hospitalizations to only include certain severely ill patients in its tally.

Despite an uptick in COVID-19 infections across the Northeast, officials from the New Hampshire Department of Health and Human Services are now counting COVID-19 hospitalizations by the number of individuals who are currently receiving treatment for the virus with remdesivir, dexamethasone or both therapies — a move that has left some health experts puzzled, as they say the shift may conceal the real impact of COVID-19 on the health system.

According to the state’s Department of Health and Human Services, the new metric is modeled on National Institutes of Health treatment guidelines and “provides a more accurate view of the how many people are hospitalized because of severe COVID-19 illness, as opposed to patients admitted for other health care needs who may incidentally have COVID-19.”

According to the current count, there are 10 patients receiving treatment for COVID-19 in New Hampshire. Comparatively, according to the New Hampshire Hospital Association, there are 83 COVID-19 positive patients receiving care across the state.

“One of the most important metrics has been the total number of people hospitalized with confirmed COVID-19, used by state leadership, hospitals and public health to monitor severity of illness and the prevalence of COVID-19 in New Hampshire,” Steve Ahnen, the president of the New Hampshire Hospital Association, told ABC News.

At this time, nationally, there is still no clear number of how many patients are admitted to the hospital for COVID-19 and how many people have coincidentally tested positive for the virus after they were admitted for other reasons.

Experts say these totals likely vary widely, community by community, and a COVID-19 diagnosis, regardless of the reason behind initial admission, can cause additional strain on a health system.

“Unfortunately, the pandemic has continually exposed the fragile infrastructure of which these data are collected. And now at this late stage in the pandemic, data collecting efforts are starting to fracture even further,” Brownstein added.

‘The pandemic phase of COVID-19 is not yet over’

In the wake of the Gridiron dinner in Washington, D.C., where more than 80 top officials, politicians and journalists — all fully vaccinated — tested positive, health officials from the White House began to shift their messaging surrounding risk levels.

“What’s going to happen is that we’re going to see that each individual is going to have to make their calculation of the amount of risk that they want to take,” Fauci said on ABC’s This Week on Sunday.

Such messaging has raised questions from some health experts who suggest that the U.S. may be leaving some vulnerable Americans behind.

“We’re at a time when U.S. public health authorities are basically declaring ‘People, you’re on your own’ when it comes to determining how to co-exist with COVID-19. Sadly, the tools we’ve relied on to determine risk levels are being discounted at best and discontinued at worst,” Dr. Maureen Miller, professor of epidemiology at Columbia University’s Mailman School of Public Health, told ABC News. “It seems we’re trying to have it both ways: People are responsible for their own decisions about risk taking as the pandemic continues but are denied the tools to make informed decisions.”

Early, proactive measures to slow transmission, such as indoor masking, will prevent more extreme measures later, Scarpino said, adding, “Saving lives and livelihoods is what good public health is all about.”

Even if this current surge, due to the omicron subvariant BA.2, is not as explosive as the previous strains, it will still likely take hold in vulnerable parts of the country, Miller said.

“COVID-19 has thrown so many curve balls. It has also provided so many predictable events. Every surge in Europe has preceded a surge in the U.S. Why should this time be different?” Miller explained. “The pandemic phase of COVID-19 is not yet over. We should treat it with the respect that it deserves.”

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(NEW YORK) — Children as young as 8 years old should be screened for anxiety, the country’s leading panel of experts on health prevention recommended Tuesday for the first time.

The new draft guidance comes amid rising rates of anxiety and depression among kids and teens in the U.S., particularly during the pandemic.

Written by the U.S. Preventive Services Task Force, the guidance suggests children and adolescents between ages 8 and 18 be screened for anxiety. It also doubles down on a prior recommendation to screen for major depressive disorder and suicide among children ages 12 to 18.

The USPSTF also said there are now high enough rates of anxiety and plenty of screening tools and treatments to recommend regular screening of anxiety among 12- to 18-year-olds.

Before COVID-19, the most recent comprehensive national survey found that 8% of children had a current anxiety disorder.

The burden of mental illness has only intensified during the pandemic. Data from the Centers for Disease Control and Prevention released this month found 37% of youth have experienced poor mental health since March 2020.

This fall, a coalition of child health providers declared that the country was facing a “National Emergency in Child and Adolescent Mental Health.”

The task force noted that untreated anxiety can be debilitating. In the short-term, it can cause physical symptoms, such as unremitting headaches or stomachaches.

Anxiety can also wreak havoc on daily life by leading kids to avoid school, interpersonal activities, or certain other situations.

In the longer term, those disruptions can lead to poor performance and developmental delays.

Additionally, anxiety can increase the risk of poor coping mechanisms such as substance use or development of other forms of mental illness commonly associated with anxiety such as panic attacks or depression.

“To address the critical need for supporting the mental health of children and adolescents in primary care, the Task Force looked at the evidence on screening for anxiety, depression, and suicide risk,” task force member Dr. Martha Kubik said in a statement. “Fortunately, we found that screening older children for anxiety and depression is effective in identifying these conditions so children and teens can be connected to the support they need.”

The agency noted that children with certain adverse childhood experiences, such as trauma, abuse and inter-parental conflict may face particularly high risks, as well as children experiencing poverty, or those from communities of color who may be subject to “historic trauma, structural racism, and biopsychological vulnerability.”

The task force did not offer recommendations on how frequently children should be screened but suggested it may be beneficial for some at-risk children to have repeated screenings over time.

“This worsening crisis in child and adolescent mental health is inextricably tied to the stress brought on by COVID-19,” the authors of the national emergency declaration wrote. “We must identify strategies to meet these challenges … [and] improve the access to and quality of care across the continuum of mental health promotion, prevention, and treatment.”

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(NEW YORK) — In recent years, tinted sunscreens have been rising in popularity, in large part because of their ability to better match a person’s skin tone without leaving a visible white film on the skin.

Responding to customer demand, large skin care brands have recently debuted new tinted sunscreen products that don’t leave a streaky white appearance on the skin.

With these sunscreens being tailored to blend in with the skin, experts are hopeful that this would encourage more people to use them, including those with darker skin tones.

“I think tinted sunscreen is absolutely changing the game in terms of inclusivity,” said Dr. Sonia Batra, a board-certified dermatologist in Santa Monica and a clinical assistant professor of dermatology at the University of Southern California. “It’s also easier to recommend and convince patients to use it as a daily form of protection when it doesn’t look so obvious on their skin and they’re able to blend it and they feel like there are formulations that have been created with them in mind.”

What are tinted sunscreens?

Unlike many traditional sunscreens, tinted sunscreens have the added benefit of protecting against visible light, which can accelerate skin darkening and pigmentation.

“By tailoring the sunscreen formulations to an individual’s skin tone, people are more likely to protect themselves from the sun, therefore reducing their risk of skin cancer,” Dr. Henry Lim, a board-certified dermatologist and the former president of the American Academy of Dermatology, said in a statement.

In a presentation on tinted sunscreens at the recent AAD Annual Meeting in Boston, Lim explained these new developments in sunscreen are now addressing the issue of sunscreen not matching some people’s skin tone.

Like traditional sunscreens products, they also help block ultraviolet radiation, which causes skin cancer and sunburn.

“It’s very important to protect against visible light because we know that in darker-skinned individuals once the skin becomes dark, for example from blemishes from acne, it will take a long time for it to go away,” Lim said. “So that is the reason that protection against visible light is important. That is the reason that tinted sunscreen is quite relevant now.”

Experts said the option of tinted sunscreens is making sunscreens more inclusive and usable for consumers.

“Accessibility has not been really appreciated for many years,” said Dr. Adam Friedman, a board-certified dermatologist, professor and chair of dermatology at George Washington School of Medicine. “But now I think that there is a real drive to make sunscreen use inclusive by providing sunscreens that are appropriate for everybody.”

What to look for in your sunscreens?

With the many new sunscreens on the market, there are some recommendations on what to look for when buying your next sunscreen.

Here are three tips:

1. If you want a tinted sunscreen, look for the word “tinted” on the label.

“Many of them, if they’re tinted will have on the front, a shade like light, medium, medium dark, or they may have a number which has like a little color associated with it,” Batra said.

2. Use a broad-spectrum, water-resistant SPF 30 or higher sunscreen. It is still important and recommended by dermatologists to use any sunscreens that are broad-spectrum, water-resistant and have an SPF of 30 or higher, in addition to wearing sun-protective clothing like breathable long sleeves and wide brim hats.

The SPF number or whether it’s broad-spectrum or water-resistant can also be found on the label. Importantly, everyone should wear sunscreen every day of the year, regardless of the weather and regardless of their skin tone.

3. Try a tinted sunscreen to see how it matches your skin tone. Experts said the appropriate tinted sunscreen shade varies from person to person, depending on each individual’s skin tone and undertone, which is the hue underneath the surface of the skin and affects the overall skin appearance.

The best way to find which one works best for you is trying it first, according to Friedman.

“I think a good rule of thumb whenever trying anything new is exactly that — do a trial, do an experiment,” he said. “Really, the best sunscreen is the one that you’re comfortable using again and again overtime.”

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