JHVEPhoto/iStockBy DAVE HARRISON, ABC News
(NEW BRUNSWICK, N.J.) -- As the race for a safe and effective coronavirus vaccine continues, one manufacturer has announced a major step in the right direction.
American pharmaceutical company Johnson & Johnson said Wednesday it will be starting Phase 3 clinical trials, joining Moderna, Pfizer and AstraZeneca to become the fourth manufacturer affiliated with the U.S. government's Operation Warp Speed.
Phase 3 clinical trials mark an important sign of progress, as the trial is expanded to tens of thousands of volunteers and is generally the last phase before a product reaches the general public.
“Four COVID-19 vaccine candidates are in Phase 3 clinical testing in the United States just over eight months after SARS-CoV-2 was identified,” Dr. Anthony Fauci said in a statement.
“This is an unprecedented feat for the scientific community made possible by decades of progress in vaccine technology and a coordinated, strategic approach across government, industry and academia,” he said.
The trial, which will be funded jointly by the company and the U.S. government, will enroll over 60,000 participants in 215 locations across the U.S. and worldwide. This will make it the largest Phase 3 trial out of the four active vaccine candidates under Operation Warp Speed.
Johnson & Johnson also aims to accomplish several firsts in the vaccine arms race.
Its vaccine will be the first to require a single dose while its competitors use two doses to achieve the expected degree of immunity. Its storage requirements are also better-suited for an average doctor’s office or clinic, compared to Pfizer’s vaccine which needs deep-freeze storage.
“It is likely that multiple COVID-19 vaccine regimens will be required to meet the global need,” Fauci said. “The Janssen [Johnson and Johnson’s parent company] candidate has showed promise in early-stage testing and may be especially useful in controlling the pandemic if shown to be protective after a single dose.”
This vaccine uses an “adenovirus vector” -- a modified copy of a common cold virus to induce immunity to COVID-19.
Dave Harrison, M.D., is a pediatric cardiology fellow in Boston and a contributor to the ABC News Medical Unit.
Copyright © 2020, ABC Audio. All rights reserved.
South_agency/iStockBy DR. LEAH CROLL and SONY SALZMAN, ABC News
(NEW YORK) -- More than 100 million COVID-19 tests have been performed in the United States, according to the Centers for Disease Control and Prevention's COVID Data Tracker.
But the true number of tests is unknown because of decentralized accounting and the fact that not all tests were created equally.
"Testing has always been at the heart of how we get out of COVID, because without insights into where infection is spreading, you're flying blind. Our response is heavily based on test results, in terms of which phase of reopenings we're in and whether we have to go into lockdown," said John Brownstein, an epidemiologist at Boston Children's Hospital and ABC News contributor.
The CDC only includes polymerase chain reaction, or PCR, tests in its count. These tests look for presence of the virus and are usually sent away from a doctor's office and processed in a large, centralized lab.
But increasingly, doctors' offices are offering a new generation of 15-minute rapid tests, which might not always be counted. A third type of test, antibody tests, also are excluded, but these tests show only if a person was previously infected -- not whether they're still contagious.
Keeping track of diagnostic testing at a national level is essential not only for accurately counting confirmed COVID-19 cases, but also for guiding our efforts to control the pandemic. Unfortunately, it seems that many states either don't report data from antigen testing to the CDC or are not keeping complete data on it.
There's no straightforward answer about whether rapid tests are counted, said Molly Polen, senior director of communications and public relations for the American Association for Clinical Chemistry. One of the most common types of rapid tests is called a nasal-swab-based antigen test -- not to be confused with an antibody test, which requires a blood sample.
"It looks like a number of states combine PCR and antigen testing, but same as with the antibody tests, not all states seem to report antigen test results," Polen added.
That's a problem because it means we may be significantly underestimating the number of people who have COVID-19 at any given time.
"There's a lot of confusion about what gets reported, when it gets reported and how it gets reported," Brownstein said.
Failure to report complete COVID-19 testing data goes against current federal guidelines, but just because doctor's offices across the country are required to report these newer "rapid" COVID test results does not mean they're actually doing so -- or doing so consistently.
The main problem is a lack of efficient and effective infrastructure for centralized data collection, said Blythe Adamson, an epidemiologist and former member of the White House Coronavirus Task Force.
"Different states may have different ways they operationalize clinical reporting to different health departments. CDC does not have a standardized infrastructure for all of this," Adamson said.
Keeping patchy testing data leaves public health officials in the dark as to the true burden of coronavirus-related disease in our country. Testing is the main tool for understanding community transmission, Brownstein added.
"So if there's testing but we don't have that data, that gives us major gaps in our understanding and it could force us into making public health decisions that are not aligned with the best possible evidence," he said.
The gap between the reported number and true number of COVID cases will only widen moving forward, as rapid antigen tests are rolled out by the millions.
Antigen tests are being used more and more because they're fast and cheap. They can produce a result in just a few minutes because they don't need to be processed in a lab, whereas PCR and antibody tests may take days. Antigen tests also are significantly less expensive.
There is even talk of using antigen tests at home, similar to pregnancy tests. That would mean we'd have to rely on regular people -- not health care professionals -- to report their own results, which could get complicated. What's more, many antigen tests results need to be confirmed with a PCR test, which could "open up a whole other Pandora's box," said Brownstein.
Testing needs to be ramped up to combat COVID-19, but data from testing needs to be more easily reportable and actionable -- more signals, less noise in the data.
"It requires more infrastructure and thought and care as we think about how to integrate all this data together," Adamson said.
Copyright © 2020, ABC Audio. All rights reserved.
PepsiCoBy KELLY MCCARTHY, ABC News
(NEW YORK) -- As consumers trend toward health and wellness products, PepsiCo has plans to drift into the functional beverage sector with a new drink intended to help people catch some shut-eye.
Driftwell, which will be manufactured for e-commerce availability this December, "is a new enhanced water beverage designed to help you relax and unwind with L-Theanine to promote relaxation and de-stress," the company shared in a fact sheet with ABC News.
The spa-water inspired blackberry and lavender flavored non-carbonated, sugar-free, calorie-free beverage contains two main active ingredients known to help with sleep -- L-theanine and magnesium.
Dr. Leah Croll, a contributor to the ABC News Medical Unit, explained that both ingredients "are said to promote better sleep and help anxiety."
"We frequently prescribe magnesium or melatonin combination pills as sleep aids," she said, adding that magnesium has been studied more as an aid for cognition or anxiety than for sleep, but some studies have cited its potential as an effective sleep aid.
L-theanine, an amino acid sometimes found in teas and mushrooms, has fewer studies behind it than magnesium, Croll said.
Maya Feller, a registered dietitian nutritionist, told ABC News' Good Morning America that the more widely recognized nutrient and sleep promoter helps regulate nerves and muscles.
"Magnesium works by regulating neurotransmitters that send signals throughout the central nervous system," Feller explained. "The mineral is also involved in interactions between internal melatonin production and GABA (gamma-amniobutyric acid) production, both of which are involved in the regulation of the sleep wake cycle."
She explained that sleep aid manufacturers who use magnesium "know that this mineral is integral to hundreds of reactions within the body" and that having adequate levels of magnesium is "necessary for restful sleep."
Although Driftwell was developed before COVID-19, it's hitting shelves at a time when sleep is in short supply for many Americans who are struggling to adapt to work from home, burnout and stress during the pandemic.
About 45% of Americans reported lying awake at night because of stress and 21% report feeling more stress when they can’t sleep, according to the American Psychological Association.
"Americans are over-stressed and as a result have difficulty sleeping, but are often forced to choose between products with little efficacy or products that rely on heavy-handed ingredients meant to quickly put people asleep resulting in groggy aftereffects," a spokeswoman for PepsiCo and Driftwell told Good Morning America.
Individual dose needs for magnesium vary from person to person and can be affected by "substance use, age and overall health status," Feller said.
According to the National Institutes of Health (NIH), daily magnesium needs range between 310mg per day to 400 mg per day.
Feller reasoned that sleep supplements can help people meet their needed recommended intake, but said an excess of magnesium in "people who are sensitive" to it can cause unwanted gastrointestinal symptoms such as loose stools.
"In general, when choosing a sleep supplement look for ones without excess added sugars and unwanted ingredients such as preservatives and fillers," she suggested.
Feller has worked with a number of patients on what she called "sleep hygiene" and daily routines to help them get their bodies ready for bed.
Some of Feller's recommendations include setting a consistent bed time, turning screens off at least 60 minutes before bed, setting a time of day to consume the news -- ideally not to close to bed as it can be very stimulating -- and for those who are sensitive to caffeine, that they limit consumption to the early part of the day.
PepsiCo said it intends to "drive an essential wellness conversation in North America" with the understanding that relaxation and stress relief is a lifestyle shift for many consumers.
Driftwell comes in a 7.5-ounce mini can and will be available nationwide in a 10-pack online for a suggested retail price of $17.99.
Copyright © 2020, ABC Audio. All rights reserved.
milehightraveler/iStockBy KARMA ALLEN, ABC News
(NEW YORK) -- With record wildfires raging throughout the West, public safety experts said it's critical for residents to protect their lungs from poor air quality.
Wildfire smoke is typically a harsh mix of gases and fine debris from scorching trees and plants, buildings and other material, according to the Centers for Disease and Control and Prevention.
The smoke can be harmful to both animals and humans, and people with preexisting lung conditions, children and pregnant women are especially at risk for becoming seriously ill from poor air quality. People with asthma are warned to keep their inhalers with them at all times when traveling to wildfire-prone areas.
Outdoor air pollution accounted for 4.2 million premature deaths worldwide -- mostly in low- or middle-income countries -- in 2016 due to stroke, heart disease, lung cancer and respiratory diseases, like asthma, according to the World Health Organization.
Here are a few simple tips from health experts on how to protect yourself from dangerous air pollution:
Monitor local air quality trackers
It's important to stay on top of daily air pollution forecasts in your area. Many cities provide forecasts to help residents navigate areas where air quality may be worse, especially neighborhoods where families were forced to evacuate due to wildfire danger.
Experts said online pollution tracking apps as well as local radio and TV weather reports are a good place to start. They also recommended the government's online tool at AirNow.gov to check for daily air quality warnings.
Be sure to familiarize yourself with the Environmental Protection Agency's Air Quality Index, which runs from 0 to 500. The higher the AQI value, the greater the level of air pollution and the greater the health risks. Anything below 50 represents good air quality, while an AQI value over 300 represents hazardous air quality, according to the EPA.
The index is color-coded and divided into six categories, making it easy for people to quickly determine if air quality is approaching unhealthy levels in their area. Each category corresponds to a different level of health concern.
Limit outdoor exercise
While it may be easier said than done for some sports enthusiasts, avoiding heavy outdoor activities is key when pollution levels are on the rise. For those desperate to meet step counts for the day, experts said walking indoors in a shopping mall or jogging up and down the stairs at home can be just as beneficial as walking thorough the park.
Naturally, indoor gyms and at-home exercise machines are also healthy alternatives to outdoor workouts when air quality is low.
Avoid heavy traffic areas
Even when air quality forecasts are good, car fumes from busy roads and highways can also worsen surrounding air quality. Experts said pollution from busy roadways can be felt up to one-third of a mile away.
If you're looking to work out outdoors on days when forecasts permit, experts say it's best to stay as far from busy roadways as possible, especially if you live in high-pollution areas.
Step it up at school
In addition to limiting outdoor play for children, consider connecting with other parents and caregivers who are also interested in protection from the air quality.
Try forming groups among parents and adults to encourage indoor play when quality is low and ask school leaders to consider more energy efficient policies.
The EPA's Clean School Bus Campaign is one of several U.S. school initiatives aimed at cleaning up emissions.
Use energy efficiently
In general, try to conserve as much energy as possible at home to cut down on long-term air pollution. Electricity and other sources of energy are major contributors to air pollution, but experts say reducing energy use can help improve air quality over time by curbing greenhouse gas emissions.
It's also important to encourage those close to you to do their share as well. Visit the EPA's website for a few tips to save energy, and money, at home.
Copyright © 2020, ABC Audio. All rights reserved.
Official White House Photo by Andrea HanksBy DR. LEAH CROLL, ABC News
(NEW YORK) -- President Donald Trump "falsely claimed" at a Monday night campaign rally that the novel coronavirus "affects virtually nobody" younger than 18 and mainly threatens seniors and people with underlying health conditions, according to the Washington Post.
Trump contradicted himself. In a March interview with Washington Post associate editor Bob Woodward, he acknowledged that "plenty of young people" were affected and admitted that he'd downplayed the risks of the virus. It's not clear exactly which age group Trump was referring to when he said that, but here's what we know about how COVID-19 affects kids and young adults:
Since March, evidence has been building that young people aren't as impervious to coronavirus as initially thought. According to the Centers for Disease Control and Prevention's Covid Data tracker, a recent analysis of 143,273 deaths revealed that 843, about 0.6%, occurred in people younger than 30, while 88, about 0.06%, occurred in people younger than 18.
In a recent MMWR report on COVID-19-related deaths in persons under 21, CDC researchers showed that nearly three quarters of SARS-CoV-2-associated deaths among infants, children, adolescents and young adults have occurred in persons aged 10 to 20 years, with a disproportionate percentage among those aged 18 to 20 years and among Hispanics, Blacks, American Indians and persons with underlying medical conditions.
Young adults also are at risk for severe complications of COVID-19. A recent JAMA Internal Medicine study of roughly 3,200 people ages 18 to 34 showed that 684 people, about 21%, required intensive care and 331, about 10%, required ventilators. Ninety people, about 3%, died.
The rates of poor outcomes in this population were lower than those reported for older adults with COVID-19, but higher than the rates reported for other diseases in young adults. For example, the death rate the authors found for COVID-19 in young adults is more than twice the death rate for heart attacks in the same age group. Morbid obesity, high blood pressure and diabetes were associated with greater risks of serious complications in this age group, which is similar to what we see in older adults. In fact, young adults with more than one of these conditions faces risks comparable to those observed in middle-aged adults without them.
In children and adults of all ages, pre-existing medical conditions undoubtedly increase the risk for severe complications and death from COVID-19. It's important to note that the cause of death in these individuals is COVID-19, not their underlying disease or old age.
Copyright © 2020, ABC Audio. All rights reserved.
Powerofflowers/iStockBy DR. LEAH CROLL, ABC News
(NEW YORK) -- It's been six months since the World Health Organization first declared COVID-19 as a pandemic. Since then, over 30 million people worldwide have been infected, and we're rapidly approaching 1 million global deaths.
The U.S. is among the world's most-affected countries, now hitting a sobering milestone: 200,000 American lives lost to COVID-19.
"This is our worst global pandemic in more than a century. And it is incredibly distressing to see the consequences. It's heartbreaking to see the ones who have been lost, the families who are grieving, other people whose livelihood has been incredibly disrupted by the economic consequences," director of the National Institute of Health, Dr. Francis Collins, told ABC News' Bob Woodruff.
Unfortunately, experts say things could get worse before they get better.
"I do think we're going to see deaths continue to increase, we'll probably expect to see another 100,000 milestone in the coming months. But I think because we've learned so much, the hope is that we'll be able to react more quickly than we were at the beginning stages of the pandemic," said John Brownstein, Ph.D., ABC News contributor and epidemiologist at Boston Children's Hospital.
Here’s what we can expect over the next six months:
Cooler months herald both flu season and fear of worsening COVID-19 outbreaks
Experts warn that colder weather and drier air will result in an uptick of COVID-19 cases this winter.
"As the colder weather will drive people indoors, we have to anticipate that there may be an acceleration in transmission and be prepared to handle the increased number of cases that may result," Amesh Adalja, MD, FIDSA, infectious disease specialist and Senior Scholar at the Johns Hopkins University Center for Health Security, told ABC News.
When flu season coincides with the ongoing pandemic, we'll have an even bigger challenge on our hands.
"If there's ever a year that you need to get your flu vaccine, get your kids vaccinated, this is the year because you really need every single protection that you can get against COVID-19. You also don't want to get exposed to COVID-19 when you're sick from another virus," Jeanne Marrazzo, MD, MPH, FIDSA, Director of the Division Infectious Diseases at the University of Alabama at Birmingham, said during an Infectious Diseases Society of America media briefing on Sept. 10.
A vaccine could be approved by 2021, but it won't be available widely for months
Public health officials say it's possible that a vaccine could be approved by the end of the year. But, approval is just the first step. Following approval, we'll need to tackle the logistical challenges of producing enough doses and distributing them fairly to everyone.
"By the time you mobilize the distribution of the vaccinations and you get the majority or more of the population vaccinated and protected, that's likely not going to happen until the mid- or end of 2021." Dr. Anthony Fauci, the nation's top expert on infectious diseases, told MSNBC's Andrea Mitchell. And that's assuming that one of the vaccine candidates works.
"But boy, Americans, we need to figure out this is not going to be a sudden snap of the fingers in December or January and everything will go back to the way it was. We're going to have many more months after that to gradually get readjusted," said Collins.
Vaccine hesitancy and pandemic fatigue will be major hurdles
Pushback on tried-and-true interventions like mask-wearing and social distancing pose serious threats to our efforts to control the spread of COVID-19. Rising vaccine safety concerns are only piling on to the problem.
"In the best of times, there are groups of people who mistrust vaccines. So that's a problem we're going to face. And if you can't get people vaccinated, we're back to where we started," Brownstein said.
As the pandemic evolves, experts are worried we will see more people become complacent with the recommended precautions.
"We are starting to see pandemic fatigue. People are getting numb to these numbers. As the numbers keep going up, people don't see the humanity in the statistics," Brownstein said.
The humanity of this particular milestone, however, is unavoidable. The virus has killed many more Americans than those who died in World War I and the Vietnam War combined. It's almost 70 times deadlier than the 9/11 attacks. Collins warned: "It's not the right time to say we're done with this. We are not. The virus is not done with us."
"We've been saying some of the same things for six months straight, and there's still an unwillingness to accept evidence-based public health decision making," said Brownstein.
We know what we have to do moving forward
We've learned a number of important lessons in the first six months: Masks and social distancing keep you and others safe. Avoiding indoor gatherings makes a big difference. Widespread testing and contact tracing are essential for controlling transmission. The flu vaccine will protect us from an even worse situation.
"Behaviors that we know work to keep the virus down may help to make the second wave not as big as we expect," Brownstein said. "But it's a matter of what this country is willing to do to stop it because we have the tools, we know what works. We have empirical evidence of these interventions, so the question is, are we willing to keep this up for another six months?"
"We ought to all look at the evidence and then make an individual decision to live up to that, because that's our best hope. Until that vaccine is in hand, and lots of people have been able to receive it, we've got many more months yet with lives at risk. And the best way to save them is for us all to take this on our own shoulders," said Collins.
We may start approaching a new normal in late spring-early summer 2021
If a vaccine is successfully deployed and public health interventions go to plan, things will begin to reopen slowly and carefully.
"If you're talking about getting back to a degree of normality, which resembles where we were prior to COVID, it's going to be toward the middle of 2021, maybe even end of 2021," said Fauci.
But, it's unlikely that life will be exactly what it was before the pandemic.
"The biggest challenge will be learning to have this virus amongst us and being able to go about our daily lives," Adalja said. "This will require an enormous amount of risk calculation for which the general public has not really had a precedent since before the measles vaccine."
Leah Croll, M.D., is a neurology resident at NYU Langone Health and a contributor to the ABC News Medical Unit.
Copyright © 2020, ABC Audio. All rights reserved.
Xesai/iStockBy KATIE KINDELAN, ABC News
(NEW YORK) -- As the United States crosses the grim milestone of 200,000 COVID-19-related deaths, experts are warning about a less visible but worrisome outbreak happening simultaneously: increasingly poor mental health.
More than half of U.S. adults -- about 53% -- reported that their mental health has been negatively impacted due to worry and stress over the pandemic, according to a nationwide poll by the Kaiser Family Foundation.
That number is a significant increase from the 32% who reported being similarly affected in March, showing that as the pandemic continues into its seventh month and the death rate continues to climb, so, too, does the toll on people's mental health.
"Keep in mind that in the U.S., we've been kind of in a mental health decline for some years now," Dr. Rheeda Walker, a psychologist and the author of The Unapologetic Guide to Black Mental Health, told Good Morning America. "National reports that have examined mental health have shown increasing stress and increasing anxiety and people feeling increasingly overwhelmed, and that was pre-coronavirus."
"Coronavirus kind of puts all of that on steroids because of the level of disruption," she said. "People's everyday lives have been disrupted on almost every single level."
Mental health experts have called the pandemic a kind of "perfect storm" for negatively impacting mental health.
In addition to the fear, grief and anxiety around the virus itself, the pandemic has brought on for many people financial instability, job loss, isolation, uncertainty around school and work and related political disagreements.
Making the pandemic even more distressing from a mental health perspective, experts have said, is both its all-encompassing nature and the uncertainty that lies ahead.
"That's what makes COVID so unique, that we don't know who has it, we don't know how bad it's going to be or how long it's going to last, and most importantly, there's no one that is not directly impacted," said Dr. Robin Gurwitch, a psychologist and professor at Duke University Medical Center. "There is no place in the world, really, but certainly in the U.S., where you can go and say, 'I don't have to worry.'"
Mental health symptoms during the pandemic range from depression and anxiety to substance abuse and thoughts of suicide, data shows.
By late June, just 13% of adults had started or increased alcohol consumption or drug use to help cope with the pandemic, and 11% of all adults, and 25% of those ages 18 to 24, had seriously considered suicide in the past month, according to the U.S. Centers for Disease Control and Prevention (CDC).
At an even more basic level, people may see signs of mental health struggles pop up when they can't sleep or find themselves unmotivated to act or even overwhelmed at the state of the world, according to Walker.
"If someone wakes up and they've slept five hours because they had difficulty falling asleep, because they were worried about their job, when they wake up they feel like I've got all these things to do, but then in their mind they can't get themselves in gear, that's about our mental health, our psychological functioning," she said. "We need our minds in order to be able to function."
Two of the populations at highest risk for mental health struggles related to the pandemic may also be the most overlooked when it comes to mental health treatment, according to both Walker and Gurwitch.
Children, who are taking on the weight of a global pandemic, the stress of their parents, the isolation from friends and the uncertainty around schooling, cannot just be thought of as "resilient," according to Gurwitch, who specializes in child psychology.
"Sometimes people say, 'Oh, kids are resilient,' but we can't just throw that out and assume that this is not an issue," she said. "I really do think that we need to consider children's mental health right now more than ever."
"One of the things that's gone down is the resources available for children's mental health, and the other issue is that caregivers and parents of our children are also at risk," Gurwitch added. "We know that one of the most protective factors for children's mental health is a positive adult in their lives."
People of color are facing both a disproportionate impact due to the coronavirus and the upheaval surrounding instances of racial injustice and police brutality across the country.
African Americans, in particular, are already 10% more likely to experience serious psychological distress than other races, according to the Health and Human Services' Office of Minority Health. Experts agree that these alarming statistics will only increase without elevated access to coping mechanisms.
"The health problems have been persistent and because we've known about them, I think there's more anger and frustration now," said Walker, adding that the pandemic has also stripped away much of the social net for people. "With those [networks] diminished now, I do think we can see increased mental health challenges for African Americans and for other communities."
In addition to the health crisis and the crisis around racial injustices, Americans are also coping simultaneously with natural disasters, from hurricanes to wildfires.
With that in mind, both Walker and Gurwitch said they and other mental health experts are preparing for a mental health crisis that will last long after the virus is contained.
"What we know about disasters and large-scale traumatic events in general, and a public health emergency is certainly a large-scale traumatic event, is that the mental health issues are often much larger and more long lasting," said Gurwitch. "We need to be thinking about how we're going to address those currently, but also tomorrow and next week and next year."
"All these things are happening that by themselves are an increased risk for mental health problems," she added. "Put them together and stir and you've got a recipe for huge spikes in mental health."
If you are in crisis or know someone in crisis, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or contact the Crisis Text Line by texting HOME to 741741. You can reach Trans Lifeline at 877-565-8860 (U.S.) or 877-330-6366 (Canada) and The Trevor Project at 866-488-7386.
Copyright © 2020, ABC Audio. All rights reserved.
Rawpixel/iStockBy KATIE KINDELAN, ABC News
(ATLANTA) -- Halloween will need to be done differently this year in order to keep people safe amid the coronavirus pandemic, according to new guidelines issued Monday by the U.S. Centers for Disease Control and Prevention (CDC).
Door-to-door trick-or-treating, indoor haunted houses, costume parties and "trunk or treating," where children go from car to car to receive treats, are among the traditional Halloween activities the CDC has deemed "higher risk activities" that should be avoided this year.
In lieu of those classic Halloween activities, the CDC recommends people try what they describe as "lower risk activities" to celebrate the holiday this year amid the global pandemic.
Those activities include socially distanced pumpkin carving, decorating your house, having a virtual costume contest, doing an outdoors Halloween scavenger hunt and having a "scavenger hunt-style trick-or-treat search" indoors with members of your household.
The CDC says people can also consider moderate risk activities like small, outdoor costume parades, outdoor Halloween movie nights where attendees are spaced at least six feet apart and participating in one-way trick-or-treating that includes individually wrapped treats and social distancing.
While masks are a Halloween staple, a costume mask is not a substitute for the types of cloth face masks that protect people from the virus, according to the CDC.
People should also not wear a costume mask over a protective cloth mask because of possible breathing difficulties, warns the CDC.
Because COVID-19 is spread through particles in the air, the CDC has issued a special warning for another staple of Halloween festivities: Screaming.
"If screaming will likely occur, greater [social] distancing is advised,” the CDC advises. “The greater the distance, the lower the risk of spreading a respiratory virus."
The CDC's guidelines for Halloween come as the United States approaches the sad milestone of 200,000 American deaths due to COVID-19.
Amid the rising death toll, public health officials in Los Angeles County issued Halloween guidelines similar to the CDC's, saying trick-or-treating and trunk-or-treating are not recommended for residents.
Halloween carnivals, festivals, live entertainment and haunted houses will not be allowed in Los Angeles County this year, according to the guidelines issued earlier this month.
When it comes to making a decision about going trick-or-treating or heading to a gathering for a socially distanced Halloween celebration in your neighborhood, people should look at how the virus is spreading in their community, according to Dr. Edith Bracho-Sanchez, an assistant professor of pediatrics and director of the pediatric telemedicine program with Columbia University Medical Center.
"You want that [positive testing rate] number to be less than 5%, ideally even lower than that," she told Good Morning America earlier this month. "Then you want to look at the number of cases and the number of hospitalizations. They just give you a sense of how widespread COVID-19 is in your community and sort of the baseline level of virus that you're starting with before you even go out trick-or-treating or to another activity."
Factoring in who you live with is also important when it comes to making a decision on whether to spend Halloween with others this year, Bracho-Sanchez said. If you are an expectant mother with young kids, Bracho-Sanchez said you may want to be careful about protecting the baby -- even though there isn't any data available on the relationship between pregnant moms and the novel coronavirus. And if you live in a multi-generational household, with young kids in the family trick-or-treating, elderly relatives in that home may be put at higher risk.
"Look at your community and look at your family circumstances to try to make some of these decisions," said Bracho-Sanchez, adding that Halloween festivities this year are "something that communities are going to have to weigh community by community, and that families are going to have to weigh family by family."
ABC News' Angeline Jane Bernabe contributed to this report.
Copyright © 2020, ABC Audio. All rights reserved.
Courtesy Nikki TeixeiraBy KATIE KINDELAN, ABC News
(NEW YORK) -- A mom in Canada is warning parents and caregivers after she says her young son ingested hand sanitizer thinking it was food.
Nikki Teixeira, of Manitoba, Canada, said her 18-month-old son, Logan, was with his grandmother last month when she handed him what she thought was a fruit puree pouch for a snack.
The pouch, packaged in cartoon branding for the Trolls movie, was hand sanitizer that Teixeira purchased for her 7-year-old stepdaughter.
"I had been shopping with my husband... and they had these hand sanitizers in the middle aisle packaged in cute packages and I had a 7-year-old stepdaughter going back to school and I thought that'd be perfect for her backpack," Teixeira told ABC News' Good Morning America. "The way it was packaged and displayed with hand sanitizers, I didn't even think of it looking like a food."
When her stepdaughter said she already had sanitizer for school, Teixeira threw it in her own bag, which Logan does not have access to.
Logan's grandmother, though, had the bag on the day that she cared for him, and handed him the pouch thinking it was a snack that Teixeira, her daughter, had packed.
"He took a sip and immediately turned red and started coughing, so she grabbed it from him and then immediately saw it was hand sanitizer," she said. "She called her neighbor and called 911 because he started to get a little bit dozy and out of it, and then five minutes later he was falling asleep."
Teixeira said that by the time paramedics arrived minutes later, Logan was alert but he was taken by ambulance to a local hospital as a precaution.
The toddler did not sustain any medical complications from ingesting the hand sanitizer, according to Teixeira, who said her son's only lingering symptoms were that he was irritable and had little appetite for the rest of the day.
She shared her experience on Facebook in an effort to warn other parents and caregivers.
"Please *SHARE* with as many people as possible to raise awareness as schools are reopening soon and the hand sanitizers will be in circulation," Teixeira wrote on the post, which has now been shared hundreds of times.
"The way that it's positioned in the aisle made it easy to buy and it's alluring and cute," Teixeira told GMA. "I don't want it to happen to anybody else."
Not long after Teixeira posted on Facebook, the company that makes the hand sanitizer, sold under the brand Smart Care, announced it had removed the product from store shelves.
"We were recently made aware of a concern expressed by a parent regarding our hand sanitizer sold in a 0.84-ounce pouch. We took this concern seriously and immediately removed the product from retail," a spokesperson for the company, Ashtel Studios, told ABC News in a statement. "As safety is our No. 1 priority, we have switched out this packaging for our bottled hand sanitizer to eliminate any misconception or concern. We regret any inconvenience this may have caused."
Teixeira's warning to caregivers comes as the U.S. Food and Drug Administration (FDA) is also warning consumers about hand sanitizers that are packaged in everything from children's food pouches to beer cans, water bottles and juice bottles.
"I am increasingly concerned about hand sanitizer being packaged to appear to be consumable products, such as baby food or beverages. These products could confuse consumers into accidentally ingesting a potentially deadly product. It's dangerous to add scents with food flavors to hand sanitizers which children could think smells like food, eat and get alcohol poisoning," FDA Commissioner Stephen M. Hahn, M.D., said in a statement last month. "Manufacturers should be vigilant about packaging and marketing their hand sanitizers in food or drink packages in an effort to mitigate any potential inadvertent use by consumers. The FDA continues to monitor these products and we'll take appropriate actions as needed to protect the health of Americans."
In its warning to consumers, the FDA noted that hand sanitizer can be toxic when ingested, and shared other complications that may occur when hand sanitizer is misused.
"The FDA continues to see an increasing number of adverse events with hand sanitizer ingestion, including cardiac effects, effects on the central nervous system, hospitalizations and death, primarily reported to poison control centers and state departments of health," the agency said in a news release.
Throughout the coronavirus pandemic, which has spiked the sales of hand sanitizer, the FDA has also warned consumers about hand sanitizers that may contain methanol, a colorless liquid that can be absorbed into the body through inhalation, ingestion, skin contact or eye contact, according to the Centers for Disease Control and Prevention (CDC).
The FDA now lists at least 75 different brands of hand sanitizer to avoid.
Washing hands with soap and water is always preferred over the use of hand sanitizers, according to the American Association of Poison Control Centers (AAPCC).
When alcohol-based hand sanitizer is used, it should contain at least 60% alcohol, according to the AAPCC.
Hand sanitizer should always be applied to children's hands by an adult and should always be stored away and out of sight of children after each use, according to the AAPCC.
Copyright © 2020, ABC Audio. All rights reserved.
sshepard/iStockBY: DR. DAVE HARRISON AND SONY SALZMAN, ABC NEWS
(WASHINGTON) — On Friday, the CDC updated its website to acknowledge that airborne transmission of the coronavirus beyond six feet may play a role in the COVID-19 pandemic, particularly indoors. The update was hailed by infectious disease experts interviewed by ABC as an overdue step.
But on Monday morning, the agency took down that language, saying it was posted in "error." Despite the CDC guidance whiplash, experts say it's time to recognize that airborne transmission beyond six feet is possible -- while continuing to emphasize that close contact within six feet is still the main way the virus is transmitted.
Scientists maintain that close, person-to-person contact is a main driver of the virus' spread. This transmission is primarily via respiratory droplets or small particles produced when an infected person coughs, sneezes, sings, talks or breathes in close proximity to someone else.
However, evidence is mounting that the virus can linger in the air, or travel distances greater than six feet -- what scientists call “airborne particles” rather than larger droplets -- especially indoors or in poorly ventilated areas.
Before it was taken down, the new CDC language described "growing evidence that droplets and airborne particles can remain suspended in the air and be breathed in by others, and travel distances beyond 6 feet (for example, during choir practice, in restaurants, or in fitness classes),” and that the risk was greatest indoors, with poor ventilation.
When the CDC briefly published its update regarding airborne transmission, experts initially expressed their support of this development.
"Although there was more data in the last three months pointing out that this airborne transmission is important, we have known that all these SARS type of viruses are indeed transmitted via airborne, going back to MERS and SARS Co-1,” says Dr. Rajat Mittal, professor in the Department of Mechanical Engineering and an expert in computational fluid dynamics at Johns Hopkins University.
"There’s been a lot of discussion about more distant transmission than 6 feet, and the question has always been, how important is that?" said Dr. William Schaffner, Professor of Preventive Medicine in the Department of Health Policy, Nashville, Tennessee.
This idea that the virus can be passed at distances of greater that six feet is anything but new. As far back as in March, up to 87% of attendees at a choir practice in Washington State were linked to one symptomatic patient, as an early example of a "super spreader event." Although the people at the choir practice took some social distancing precautions, singing loudly in an enclosed room may have contributed to infections.
In July, the World Health Organization updated its guidance to reflect these enhanced precautions. Many experts argue that the CDC should do the same.
Also in July, a panel of 239 scientists wrote a statement recognizing the risks of airborne spread as it relates to COVID-19, with an enhanced focus on indoor ventilation and continued emphasis on avoidance of overcrowding.
The difference between “airborne particles” and “droplets” is subtle, but important, experts say. Airborne particles are too small to see, and can accumulate over time in poorly ventilated areas.
Despite these new developments, nothing has changed about the virus itself and the precautions each individual needs to take to minimize the spread.
“Masks are still our number one line of defense,” said Dr. Mittal.
"If you’re indoors, keep the mask on," said Dr. Schaffner. "Don’t look for excuses to take the mask off."
Copyright © 2020, ABC Audio. All rights reserved.
sshepard/iStockBy ANNE FLAHERTY, ABC News
(ATLANTA) -- The Centers for Disease Control and Prevention said Monday that it made a mistake when it posted new guidance online citing “growing evidence” that COVID-19 is airborne, sending health experts and the public scrambling to determine if schools and business should rethink mitigation steps to prevent the spread of the virus.
The misstep is one of several in recent weeks in which the CDC has left the public scratching its head.
Since July, the agency has flip-flopped on its guidance on testing people who don’t show symptoms, finally settling on the recommendation that it’s a good idea.
Critics of the Trump administration say too much politics is at play and that the agency’s wavering is undermining its credibility with the public.
“A draft version of proposed changes to these recommendations was posted in error to the agency’s official website. CDC is currently updating its recommendations regarding airborne transmission of SARS-CoV-2 (the virus that causes COVID-19). Once this process has been completed, the update language will be posted,” the CDC stated Monday.
How long the virus lingers in the air and how far it travels after someone sneezes or coughs has been the subject of much speculation since the beginning of the pandemic. On Friday, the CDC quietly updated a page on its website on how the virus spreads.
“There is growing evidence that droplets and airborne particles can remain suspended in the air and be breathed in by others, and travel distances beyond 6 feet (for example, during choir practice, in restaurants, or in fitness classes). In general, indoor environments without good ventilation increase this risk,” the CDC stated on Friday in a post that has since been taken down.
That assessment raised serious questions about whether such practices as attending school or dining indoors were safe because people would might remove their masks if there is enough social distance. School districts have long been sounding the alarm on the lack of ventilation, including old buildings and windows that won’t open.
But soon after the CDC change was noticed by media outlets, the CDC removed the posting. It remains unclear what CDC might post, if anything, on the matter. The White House task force on coronavirus stopped holding regular briefings on the pandemic, and CDC does not host press conferences.
The CDC caused alarm last August when it released guidance suggesting people didn’t necessarily need to get tested for the virus even if they were exposed. The agency last week walked that back and returned to its guidance from earlier in the summer that anyone who has been exposed needs to be tested.
Similarly, President Donald Trump last week insisted the agency’s director, Robert Redfield, made a “mistake” when he predicted that most Americans wouldn’t have access to a vaccine until the middle of next year.
Redfield’s spokesman initially issued a statement that appeared to realign himself with the president, but then retracted the statement, leaving it unclear whether Redfield agreed with the president.
Copyright © 2020, ABC Audio. All rights reserved.
By DR. LEAH CROLL and DR. ALEXIS E. CARRINGTON, ABC News
narvikk/iStock(NEW YORK) -- Public health experts have proposed a national COVID-19 strategy based on the Obama administration's HIV/AIDS strategy.
In a newly published paper in the AIDS and Behavior journal, experts from multiple universities in the United States used the structure of the 2010 and 2015 National HIV/AIDS Strategy documents to suggest what a strategy for fighting COVID-19 should look like. These experts include prominent professors of public health and epidemiology, all of whom have worked with the CDC on prior epidemics.
A national strategy, they say, should be transparent, comprehensive and science-driven.
The National HIV/AIDS Strategy was launched by the Obama administration in 2010 and, according to the CDC, was the first-ever comprehensive coordinated HIV/AIDS roadmap; the five-year plan detailed principles, priorities and actions to guide a national response to the HIV epidemic. The strategy was updated in 2015 to include the emergence of treatments, pre-exposure prophylaxis, the implementation of the Affordable Care Act and other updates.
One of the study's authors, Dr. David Holtgrave, Dean of the School of Public Health of the University at Albany, State University of New York, said that with public health stakes so high right now, “it is really important to have a comprehensive plan for the nation in place as quickly as possible. And that plan should be one that’s comprehensive and also rooted in the best evidence and science that we possibly can use.”
The HIV/AIDS Strategy was a good starting point for drafting a COVID-19 plan because “it put in one place plans for prevention and treatment and addressing disparities and also coordinating services between the federal government, the state and local governments, and the private sector too,” he said.
Notably, President Trump pledged to end AIDS in the U.S. by 2030 in his 2019 State of the Union Address. However, “the current administration's plan to ‘End the HIV Epidemic’ addresses important core elements, but the strategy is less comprehensive than the early National HIV/AIDS Strategy,” said Holtgrave. “For that reason, we built upon the 2010 and 2015 update of the NHAS.”
The strategies presented for nationwide management of HIV/AIDS were rooted in scientific evidence and included thoroughly studied measures for disease prevention and medications proven to be efficacious for HIV/AIDS. In addition, the strategies addressed health disparities such as social and racial groups disproportionately affected by HIV/AIDS.
"Unfettered access" to high-quality treatment
However, HIV/AIDS and COVID aren’t totally torn from the same cloth. “HIV is very different than COVID, so clearly you can’t apply exactly the same interventions,” says Dr. John Brownstein, ABC News Contributor, Chief Innovation Officer and Professor at Harvard Medical School. “But similar non-pharmaceutical interventions can play a big role [with COVID]. Similar to HIV, disparities are playing such a big role in who is impacted, and education is a big component as well.”
The proposed COVID-19 strategy even includes a mission statement inspired by the National HIV/AIDS Strategy manifesto: “The United States will become a place where new SARS-CoV-2 infections are rare, and when they do occur, every person, regardless of age, gender, race/ethnicity, sexual orientation, gender identity, or socio-economic circumstance, will have unfettered access to high quality, life-extending care, free from stigma and discrimination.”
Holtgrave details what is needed to be truly comprehensive in strategizing: looking into the patterns of COVID, utilizing evidence-based treatment and preventive measures (not only for acute infections, but for long-term effects too), coordinating services on multiple levels of government, addressing racial and ethnic disparities, establishing transparent metrics for progress.
“I think now when we hear discussions about where we’re going as a nation to address COVID, the discussions tend to be kind of piecemeal," he said. "They’re either focused on vaccines or maybe treatment or a bit on masks. We need to really be truly comprehensive.”
Holtgrave added that "there’s a clear role here for the federal government to develop a comprehensive national COVID strategy. If that doesn’t come from the federal government, then we need to have some other locus of energy around that. One challenge is finding who the group of people is that could come together, develop this further, and move it forward.”
Currently strategy is a "whack-a-mole" approach
Although it isn’t certain which framework would be ideal, as the pandemic continues to affect American communities, an evidenced-based national strategy to treat, prevent and manage COVID-19 seems more and more necessary. “The lack of a national strategy has created so much confusion, has created a patchwork of response and led to this ‘whack-a-mole’ and uneven control strategy,” said Dr. Brownstein.
“The concept of creating a transparent process which brings in the right voices to help determine a strategy is what we needed all along. So, if we can leverage an example of this, having done it before, to get us a few steps ahead, then that’s fantastic,” says Brownstein.
Leah Croll, M.D., is a neurology resident at NYU Langone Health and Alexis E. Carrington, M.D., is a dermatology research fellow at the University of California, Davis. Both are contributors to the ABC News Medical Unit.
Copyright © 2020, ABC Audio. All rights reserved.
martin-dm/iStockBy CATHERINE THORBECKE and ALEXANDRA LAMBERT, ABC News
(NEW YORK) -- As the daily headlines and mounting death tolls sow widespread anxiety among a population grappling with the coronavirus pandemic, many businesses and others have sought to ease fears through a newfound and costly obsession with deep cleaning and sanitizing.
The pandemic-era trend of publicly exhibiting all sanitation efforts has taken both the private and public sector by storm, but some medical experts express concern that these surface-cleaning endeavors may not be the most effective means of combatting the spread of the respiratory virus.
Hotels in California proudly display their $100,000 UV disinfecting robots. United Airlines similarly announced it was using high-tech antimicrobial-spraying robots on some aircrafts to ensure the "deepest cleanings." United noted that it was a complementary technology used in combination with masks and other measures.
The New York City subway system, which operates around the clock, announced nighttime closures for the first time in its history in order to disinfect train cars, a move that comes with an estimated additional price tag of $500 million in 2020 alone. That price tag includes a small portion for protective gear and temperatures checks for employees.
The often-overlooked sanitizing industry has boomed. Stock for Clorox reached a new all-time high last month, and has spiked some 35% in 2020. And a slew of private firms and startups touting disinfecting wands and other gadgets have also reported skyrocketing spikes in interest.
The public-facing displays of disinfecting efforts by companies have been dubbed "hygiene theater" in a recent The Atlantic article, which equated the showy presentations to the post-9/11 "security theater" phenomena, an endeavor that was slammed for focusing more on quelling people’s worries rather than actions that actually emphasized safety.
Is there a 'danger' in so-called hygiene theater?
Dr. Emanuel Goldman, a microbiology professor at Rutgers University and co-editor of the Practical Handbook of Microbiology, warned in a commentary published in the medical journal Lancet in July that the risk of catching COVID-19 from a surface has been "exaggerated" and became one of the major voices raising concerns over misdirecting resources to so-called "hygiene theater."
Goldman told ABC News that the "danger" of hygiene theater is that "it changes the focus from what will really protect you, and that is protecting what you breathe."
Obsessive cleaning in a pandemic is not necessarily a bad thing, Goldman clarified, especially for high-touch, high-traffic locations such as grocery store checkout lanes.
"When you start applying this strategy to the New York City subways for example, public school systems, then it’s starting to be a bad thing, because it's wasting limited resources," he said. "In the case of the New York City subways, it's not only a huge hit on their budget, it’s also a tremendous inconvenience on their transportation system to be shut down every night."
Earlier this week, the New York Metropolitan Transportation Authority, the agency that runs the subway, issued a desperate plea for $12 billion in federal funding, warning that without it, all supplier contracts are in jeopardy.
Ken Lovett, a senior advisor to the chairman and CEO at the MTA, told ABC News in a statement that the MTA "resolved to do everything we could to keep our customers and heroic employees safe, and we continue to do that with round-the-clock cleaning and disinfecting of stations and rolling stock, piloting new methods like UV lights, anti-microbials and electrostatic sprayers, and requiring everyone in the system wear masks."
"Even while the subway fresh air exchange far exceeds the minimum rates required by the CDC for certain health care facilities and restaurants, we are tackling the aerosol issue by bringing new technologies to address the issue through the COVID Challenge and we will continue to respond in real-time to do everything we can to keep our customers safe," he added.
Goldman said that he also received an email recently from a teacher who read his research and told him her school board was planning on shutting the schools down one day a week for "deep cleaning."
"They have limited resources, that’s going to cost a lot of money, that’s going to cost time," he said. "I wrote the school board for her and miraculously, they listened to me, and redirected their budget to ventilation systems, because breathing is where you catch this disease."
Ultimately, high tech and pricey sanitizing equipment is not necessary in most cases, according to Goldman.
"Soap and water kills COVID," he said. "Ordinary alcohol kills COVID."
Dr. John Brownstein, an epidemiologist at Boston Children’s Hospital, told ABC News that so-called hygiene theater can be "really important" in certain circumstances -- such as healthcare settings or places where high-risk individuals live or work, where he says, "we want to do everything as much as possible to reduce transmission."
He added, however, that "these kinds of interventions are not absolutely appropriate for every setting."
What is the risk of catching COVID-19 from a surface?
Brownstein explained to ABC News that there was a "theoretical risk" that you could catch COVID-19 from a surface, but it is "probably not the predominant mode of transmission."
The U.S. Centers for Disease Control and Prevention states that "it may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this isn’t thought to be the main way the virus spreads."
The international World Health Organization says that fomite transmission is "considered a likely mode of transmission" for COVID-19, but adds that despite evidence that the virus can survive on surfaces, "there are no specific reports which have directly demonstrated fomite transmission."
The U.N. health agency also noted that people who come in contact with potentially infectious surfaces often also have close contact with an infected person, making distinctions between respiratory droplet and fomite transmission difficult to discern.
While there have been studies conducted in the past that show COVID-19 can live on surfaces, Goldman said that in real-world scenarios outside of a lab he found evidence of surface (or fomite) transmission of the virus "to be extremely weak."
"A lot of steps have to happen before you would get transmission of the virus from a surface," Goldman told ABC News. "First, you would have to have someone infected cough or sneeze on that surface. Next, you would have to have the individual touch that surface within I would say within the hour or two, and then without washing their hands in between touch their faces, mouth, ears or eyes."
He added that there is then a "presumed risk" of catching the virus that way.
"I don’t want to misinform people," he added. "Hand-washing is still important. Proper hygiene is still important. That would be important even if there was no pandemic -- That’s what we should be doing anyways."
If not obsessive surface cleaning, where should efforts be focused?
Brownstein said that one of his biggest concerns with hygiene theater is that "it's just not sustainable."
"We’re asking the population and industry to do a lot and at some point there is going to be pandemic fatigue," he added.
He noted that the more experts attempt to enforce these sorts of efforts around a theoretical risk, "the more chance people are just going to, basically, not want to implement them."
"We know that things like mask-wearing is so critical, let’s focus on the handful of issues that we know are driving those transmissions," he added.
Similarly, Goldman told ABC News that, "the most important things that can be done is to wear a mask."
While hygiene theater has been largely welcomed by an anxious public, mask-wearing, what experts say is one of the best lines of defense against the spread, has become a flashpoint in the U.S.
Besides strict adherence to mask-wearing, both experts said social distancing, moving indoor activities outdoors, and improving ventilation systems are key for combatting the virus' spread.
Finally, Goldman said if you are entering a store or restaurant or elsewhere, don't look first to their hygiene theater routine for assurance. Rather, he recommends checking out if all of the workers and people are wearing masks, what socially-distancing measures are being implemented and even asking about ventilation efforts.
Copyright © 2020, ABC Audio. All rights reserved.
grejak/iStockBy STEPHANIE EBBS and ANNE FLAHERTY, ABC News
(ATLANTA) -- The Centers for Disease Control and Prevention has reversed guidance on who should be tested for the virus that causes COVID-19, specifying that asymptomatic people who have come in contact with an infected person should get tested and quarantine for 14 days -- a change from guidance released last month that said testing might not be necessary for people without symptoms.
CDC guidance released in August caused alarm in the public health community that data would give an incomplete picture of outbreaks around the country, and The New York Times reported this week that it was published by the Department of Health and Human Services without approval from experts at the CDC.
It said that if a person came in contact with someone infected with the virus that causes COVID-19 "you do not necessarily need a test" if you don't exhibit any symptoms, but that local public health officials or health care providers might still recommend one. CDC Director Robert Redfield has tried to clarify the guidance, testifying this week that it did not mean people without symptoms shouldn't get a test but that they should consult local health guidance and that testing should be paired with other protective measures like isolating for 14 days.
The CDC removed that language on Friday, returning to instructions that say if someone has been in close contact with a person with COVID-19 infection "you need a test" and to self-isolate for 14 days, even if the test is negative.
Doctors like Thomas File, president of the Infectious Diseases Society of America, praised the reversal and called it a return to science-based decisions.
“The return to a science-based approach to testing guidance from the Centers for Disease Control and Prevention is good news for public health and for our united fight against this pandemic. We urge officials to support the work of controlling this pandemic by following medical guidance of experts in the field," File said in a statement.
This week, The New York Times reported the August guidance was pushed by officials at the Department of Health and Human Service and White House coronavirus task force over the objections of experts at CDC. But Brett Giroir, the top official at the Department of Health and Human Services leading the federal efforts on testing, pushed back on that report.
“This was a CDC document and we will continue to clarify because I want people to know that if you are asymptomatic you can still spread the virus and we want them to be tested,” he said in an interview on ABC's "Good Morning America" on Friday.
Public health officials say that a lack of testing has been a weak point in the country's response to the coronavirus pandemic since the beginning, from a lack of tests to backlogs for results, making it more difficult to trace who infected people have been in contact with.
President Donald Trump has said that more tests result in more cases, causing concern among public health experts that he could push to slow testing they say is crucial to tracking outbreaks around the country.
He has also publicly contradicted officials working on the COVID-19 response on the timeline for a potential vaccine and the effectiveness of wearing face masks, which officials at the CDC and HHS say is the most important tool in preventing the spread of the virus.
Public health experts have expressed concerns that political considerations are influencing the pandemic response and have bristled at reports that political appointees are overruling subject matter experts at the CDC and the FDA.
A top official at Health and Human Services, Michael Caputo, recently announced he was taking leave after he made comments on social media accusing CDC scientists of sedition and saying they don't care about protecting Americans, charges the CDC director and other public health officials denied. Caputo later apologized.
Officials in the Trump administration have said they were not directed to slow testing and are distributing more testing equipment to nursing homes and other vulnerable populations to help track and stop infections.
"The number of cases are going to be the number of cases; we do more testing so we can detect more and more cases. That's a good thing. We want to detect as many cases as we can...It is true that the more testing you do, the more cases you will discover. But the cases are there no, no matter what," Giroir testified at a Senate Appropriations Committee hearing on Wednesday.
Any appearance of political influence could be particularly harmful when it comes to a potential COVID-19 vaccine, experts warn. The concern is that people will decide not get vaccinated and that the virus will continue to spread.
Copyright © 2020, ABC Audio. All rights reserved.
By KATIE KINDELAN, ABC News
Hailshadow/iStock(NEW YORK) -- Olympic gold-medal-winning figure skater Tara Lipinski is opening up about undergoing endometriosis surgery in hopes of breaking down barriers around the condition that affects millions of women.
"The irony of my endometriosis diagnosis is that I knew almost nothing about a disorder that affects one in 10 women. That’s 176 million people," Lipinski shared on Instagram. "I’d never heard another woman mention 'endo' or the complications and pain that accompany it. And that definitely shows the lack of information that’s out there and the comfort level that affected women have discussing their endometriosis."
"To me, it feels like a hush hush topic that women feel they just need to tough out," the 38-year-old wrote. "No woman should live in pain or think 'this is just something I have to deal with.'"
Endometriosis, a medical condition whereby the lining of the uterus grows outside of the uterus, may affect more than 11 percent of American women between the ages of 15 and 44, according to the U.S. Department of Health and Human Services Office on Women's Health (OWH).
Lipinski said she had “intermittent pain” for years that she overlooked and didn’t discuss completely with her doctors.
“Over the last five years the pain progressed, but because it wasn’t constant or startlingly intense, I just chose to ignore it,” she wrote. “I figured that since I didn’t have crippling pain and it wasn’t significantly impacting my life, I could just block out my concern.”
When the pain became more intense this year, Lipinski said she started researching endometriosis and then found a surgeon who was able to help, writing, “I think that might be the biggest obstacle of endo care -- finding a surgeon who knows exactly how to navigate this complicated disease.”
After studying her options, Lipinski said she chose to have an “excision procedure, that uses robotic scissors to cute the endo from the places where it exists.”
Calling herself “one of the lucky ones,” the California-based Lipinski described her surgery as a success, noting that “pretty much 100 percent” of her endometriosis was removed.
“After a week or so I began to forget I had the surgery until I’d look down at the battle wounds across my stomach,” she wrote. “It felt so good to finally have a diagnosis.”
What is endometriosis?
Endometriosis strikes when endometrial tissue, the tissue that lines the uterus, grows outside of the uterus and onto other areas of the body, like the ovaries, fallopian tubes, vagina and cervix, according to the U.S. Office on Women's Health.
The cause of endometriosis is unknown but its symptoms are well-known: Painful menstrual cramps, chronic lower back and pelvis pain, pain during and after sex, bleeding or spotting between periods and digestive problems like diarrhea, constipation, bloating and nausea. These symptoms are most often experienced during menstruation.
Endometriosis also makes it harder for women to get pregnant.
Any girl or woman who has menstrual periods is vulnerable to endometriosis. It is more common, however, in women ages 25 to 35.
There is no known cure for endometriosis. There are several treatment options, including birth control and other hormonal treatments, and a medication, Orilissa, specifically studied and marketed for the treatment of endometriosis pain.
Another treatment option is laparoscopic excision surgery, where doctors remove scar tissue and growths, according to Dr. Tamer Seckin, a New York-based endometriosis specialist who co-founded the Endometriosis Foundation of America (EFA) with actress Padma Lakshmi.
What women need to know
Many women wait as long as 10 years for an endometriosis diagnosis, according to the EFA.
That is not to say though that women who take years to be diagnosed are not advocating for themselves at every point in the journey. It's quite the opposite.
"Today’s women are exceptionally educated on this," said Seckin.
Seckin's advice for female patients is to track their symptoms diligently and to note, in particular, where the symptoms fall in relation to their menstrual cycle.
Symptoms of endometriosis, like cramping and digestive issues, are often misdiagnosed as Crohn's disease or irritable bowel syndrome when doctors don't ask if the pain is associated with the patient's period, Seckin noted.
Women should also know that they should not be suffering in silence, according to Seckin. He shared six symptoms that women should watch for -- not because they mean a woman automatically has endometriosis, but because women should not have to live with pain.
These symptoms are most commonly found during menstruation, when the tissue is the most inflamed.
1. With periods, any pain that lasts beyond two days is not normal.
2. Any pain that sends them into the fetal position, even for just one day, is not normal.
3. Any pain associated with vomiting or severe GI disturbance is not normal.
4. Pain during deep [sexual] contact, deep penetration is not normal.
5. If you have pain around bowel movements or get constipated during your period, that’s not normal.
6. Increased gas and bloating associated with your period is not normal.
Most important, according to Seckin, is to find a doctor whom you trust.
"If women tell their doctors [their symptoms] and their doctors’ eyes don’t lock on them, find another doctor," he said. "There are doctors who are interested in endometriosis."
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