SeventyFour/iStockBy ALEXIS CARRINGTON, ABC NEWS
(NEW YORK) -- More pregnant women and new mothers are experiencing symptoms of anxiety and depression during the COVID-19 pandemic, according to a new study.
The disruptions of the COVID-19 on daily life has left many feeling anxious or depressed, making the future seem uncertain, but these feelings are normal, according to a new study shedding light on the emotional toll the pandemic has had on new mothers.
Researchers from the University of Alberta interviewed 900 new mothers and found that 40.7% of new moms had depressive symptoms compared to 15% before the pandemic. The study also said that 72% of new mothers felt moderate to high anxiety, a 43% increase from the number of new mothers reporting anxiety before the pandemic.
"We wanted to conduct this survey to learn more about the impact of COVID-19 on the mental health and physical activity of women during and following pregnancy," Dr. Margie Davenport Associate Professor at the University of Alberta, who co-authored the study, told ABC News. "Our data demonstrate a substantial increase in the likelihood of maternal depression and anxiety in pregnant and postpartum women during the COVID-19 pandemic."
Regardless of the current climate, previous research has shown that depression and anxiety affect one in seven women while pregnant. The many changes brought along with this pandemic, like the social and physical isolation, spending more time in the house, social distancing, and worrying about the health of those close around us, may exacerbate the pre-existing stressors of pregnancy and beginning motherhood, causing feelings of depression to anxiety rise.
"These numbers may underestimate how depressed and anxious pregnant women are in this time just because of the group of individuals who responded to this survey," Dr. Nita Landry, a board-certified obstetrics and gynecologist, told ABC News.
This study only interviewed new moms, but the emotional toll of the pandemic may in fact be much larger, affecting all pregnant women and moms.
"This [study] elucidated prioritizing yourself can help prevent and combat these feelings of anxiety and depression. Many pregnant women stay in their homes during pregnancy because they are so anxious to get infected, while the risks are very limited outside if you keep social distance," Dr. Veerle Bergink, a board-certified psychiatrist and director of the Women's Mental Health Program at Mount Sinai Medical Center, said. "This is especially a huge problem for women in small apartments, living with toddlers or many other family members."
"It may not just be a virus that pregnant women are stressing out, but there's other factors that come into play because of this virus, such as economic hardships," Nita added.
Experts say the emotional impact of anxiety and depression could also leave a lasting physical impact on both mother and baby.
"When moms aren't doing well emotionally during pregnancy, it really can have a negative impact on their pregnancy," Nita said. "As far as increasing incidence of pre-term delivery. You are developing a human being and the whole complex process of growing a tiny person, impacts baby and their cognitive development."
The good news is pregnant women and moms can help prevent or lessen the emotional toll by making it a priority to make time for themselves, their mental health and continue doing activities they enjoy. Bergink said that now more than ever, pregnant women and moms should prioritize physical activity or exercise every day.
"We also demonstrate [in the study] that women who engage in higher levels of physical activity had better mental health," Davenport said.
Although the need to socially distance and stay home remains, there are many online bloggers that are sharing creative ways to get moving and active in your own living room.
"We've also seen a rise in free online fitness classes which can help promote physical activity," said Davenport. "However, walking can provide incredible benefits for mental health, while following physical distancing measures."
"In addition to exercise and fresh air, many other things work, including yoga, mindfulness, meditation, social support groups, chatting with friends and hobbies," said Bergink.
Finding support from friends and family and connecting even if physically separated is also important, experts say.
"One thing that family can do is know that their spouse or family member may be struggling during this time period and may be reluctant to ask help," Nita said. "If you see changes in mood or behavior, then you can ask if you're concerned about them hurting themselves. Some people think if you ask someone about hurting themselves then that will increase the probability of it, but that's not the way to think about it."
If you or a loved one feel high levels of anxiety or depression, you should seek treatment, Bergink said.
"Don't hesitate to seek help from a healthcare professional. Whether it be counseling or in some instances if you do need medications, know that those things are around to assist you and it's ok to meet that type of assistance," said Nita.
If you have or know anyone who needs help or is experiencing feelings of hurting themselves or others, call the SAMHSA's National Suicide Prevention Lifeline 1-800-273-8255.
Alexis E. Carrington, M.D. is currently a Dermatology Research Fellow at the University of California, Davis in Sacramento, CA, and a contributor to the ABC News Medical Unit.
Copyright © 2020, ABC Audio. All rights reserved.
valentinrussanov / iStockBy Anne Flaherty, ABC News
Even people without symptoms should get tested for COVID-19 if they have reason to suspect they might have been exposed to the virus, including being part of a crowd, Dr. Robert Redfield, director of the Centers for Disease Control and Prevention, told ABC News on Friday.
The latest recommendation came as major commercial labs said their resources were under strain and President Donald Trump traveled to South Dakota, where a large number of Americans were expected to gather for the July 4 holiday and social distancing and masks were not required.
"Anyone who thinks they may be infected -- independent of symptoms -- should get a test," Redfield told Dr. Jennifer Ashton, ABC News' chief medical correspondent, and Aaron Katersky, ABC News Radio correspondent and host of the "Bringing Back America" podcast.
Redfield's comments come as the country faces a wave of infections that health officials warn could overwhelm hospitals and spike death rates.
As of Friday, U.S. deaths topped 129,000, with reported daily cases climbing past 52,800 on both Wednesday and Thursday.
Redfield said the numbers of asymptomatic people infected with the virus is particularly alarming and thwarting traditional methods of tracking outbreaks. Investigations into specific cases have shown that anywhere from 20% to 80% of people infected don't have symptoms, particularly those younger than 45, he said. The CDC has said 1 in 2 people with the virus don't know where they got it from.
"We're challenged with this virus," he said.
Redfield's comments represent another shift for the CDC. Early on in the pandemic, tests were limited to people in hospitals and health care workers. As capacity slowly expanded, the administration said it should be up to a person's doctor to weigh a person's risk factors.
More recently, health officials like Redfield and Dr. Anthony Fauci have urged people attending political protests or rallies to get tested, warning that asymptomatic carriers of the virus are unknowingly contributing to the worst health crisis the U.S. has faced in a century.
The CDC updated its testing guidelines online this week to include urging people without symptoms to get tested if they've come in contact with someone who has COVID-19, such as working the same shift at a job.
Encouraging more testing could be easier said than done. While capacity has increased dramatically in recent months, two of the top commercial testing labs -- Quest Diagnostics and LabCorp -- said recently that their testing capacity is under strain amid coronavirus outbreaks that hit predominantly southern and western states hardest.
This week's climbing case numbers were considered the equivalent of a five-alarm fire, as Arizona, California, Florida and Texas accounted for more than half of the new cases.
In Texas, hospitalizations have doubled in two weeks, slamming the state's health care system, according to The Texas Tribune.
One new challenge, Redfield said, was that the virus has mutated into a strain that seemed to spread more effectively. There was no evidence, however, that the strain of this virus was more deadly.
"It does have characteristics that in fact it's become more infectious," he added. "We have no evidence though that that's associated with increased pathogenicity at this time."
As for what happens next, Redfield said scientists are still learning about how the virus behaves. He said his biggest regret in the crisis was not pushing for access for CDC officials to go inside China the first week of January because they could have learned earlier the threat of asymptomatic carriers and "really changed the dynamics of our knowledge base for this outbreak."
"We do have to stay humble and recognize that we've just been introduced to this virus," he said. "We don't really know this virus. This isn't like flu, where you could sit down and ask me questions, and I can have a high degree of confidence that I know what to predict."
For most people, the best thing to do remains wearing a mask, frequently washing one's hands and staying at least 6 feet from others.
"We need all of us to take on the responsibility," he said.
ABC News' Eric Strauss contributed to this report.
Copyright © 2020, ABC Audio. All rights reserved.
lavendertime/iStockBy MEREDITH DELISO, ABC News
(NEW YORK) -- In the days leading up to the Fourth of July weekend, the U.S. has seen record numbers of new cases of COVID-19. Officials from Los Angeles County to Galveston, Texas, and Miami announced that beaches won't be opening over the holiday weekend and fireworks displays have been canceled, all in an effort to limit the spread of the novel coronavirus.
Anticipating that people might gather for July Fourth, public health departments have been busy tweeting out safety tips and reminders that COVID-19 "won't take a break for the holiday."
"We cannot be complacent," Dr. Barun Mathema, assistant professor of epidemiology at the Columbia University Mailman School of Public Health, told ABC News. "Erring on the side of caution is very much advised, because we are still very, very much in this pandemic."
Mathema said it's important to think of holidays like July Fourth and parties in general as super-spreading events, which can drive local transmission.
"As we are learning more about the transmission dynamics of this particular virus, the pools of transmission can be very, very large," he said.
Outbreaks were tied to Memorial Day weekend parties, including one on the Jersey Shore that ended up infecting 12 people in Bucks County, Pennsylvania. Several states, including South Carolina, Texas, Arizona and Arkansas, saw upward trends in new coronavirus cases and hospitalizations in the weeks following Memorial Day.
Whether or not you attend a party would depend on your risk tolerance, Dr. Amesh Adalja, a senior scholar at the Johns Hopkins University Center for Health Security, told ABC News.
"Any activity that you do is going to have some risk," he said. "The virus is going to be a risk that's always there."
To help protect yourself and those around you, it comes down to "practicing the very things we have been practicing," Mathema said.
That includes proper mask usage, hand hygiene and social distancing around those outside your household or social bubble, both doctors said. The Centers for Disease Control and Prevention recommend staying at least 6 feet from people outside of your home, and washing your hands often with soap and water for at least 20 seconds.
Holding small gatherings outdoors is also crucial, the doctors said.
"The concern is when people that haven't mixed yet are all congregating together in close quarters, where the virus is going to take that opportunity to spread," Adalja said. "That's what the biggest issue is."
When you're in small spaces indoors, you end up breathing a lot of uncirculated air, Mathema said.
"Being outdoors is far better than certainly being indoors, where the amount of air volume is restricted and recirculated quite a bit," he said.
Mathema said he would carefully consider the risks involved with including someone outside of a social bubble at a gathering.
"I would want to know, what sort of risks are they introducing to me? What sort of risks am I introducing to them and their network?" said Mathema, who stressed the importance of social distancing in those cases.
"The level of risk one wants to carry goes beyond the individual. I think that's a point we keep on having to repeat," he added. "It's really important for us as a society to think very hard about what kinds of risks we want to put ourselves, our families, our communities through."
Copyright © 2020, ABC Audio. All rights reserved.
CasPhotography/iStockBy MEREDITH DELISO, ABC News
(NEW YORK) -- Throughout the coronavirus pandemic, public health officials have gained greater visibility and in some cases, like Dr. Anthony Fauci, the longtime head of the National Institute of Allergy and Infectious Diseases, became household names.
But along with that attention has emerged a troubling trend: as states and counties revised restrictions, conducted contract tracing and reacted to our evolving understanding of combatting the virus, public health experts have been threatened and criticized, sometimes to the point of pushing them to resign.
This pushback has been especially notable for women in high-profile positions.
In the first weeks of the pandemic, Dr. Amy Acton was widely praised and admired for her tough response to the coronavirus pandemic as director of Ohio's health department. As the state slowly started to reopen, though, she received challenges to her authority from Republican lawmakers. One, Rep. Nino Vitale, called her a "medical dictator" and a "globalist," a term that is considered an anti-Semitic slur (Acton is Jewish), in Facebook posts.
In early May, Ohio House Democratic leader Emilia Sykes lambasted a vote by the Republican-led House to limit the health director's authority, saying at the time that Acton hadn't needed additional oversight "until that director in charge of a pandemic was a woman." After the vote, the House speaker said that "what happened today wasn’t about Dr. Acton."
On several occasions, protesters demonstrated against Acton at the statehouse and her home, some toting signs with sexist and anti-Semitic messages, others armed, according to local reports. Gov. Mike DeWine urged protesters to demonstrate against him instead and that Acton wasn't "fair game."
Last month, Acton resigned as director, taking a less public-facing health role in the governor's administration. Her office declined an interview request.
'I felt very unsafe'
Lauri Jones, the community health director for Okanogan County Public Health in north-central Washington, told ABC News she has never felt threatened for doing her job until now. In late April, after the department requested that a family isolate due to COVID-19 exposure, she was threatened in Facebook comments. She bought surveillance cameras as a precaution and filed a police report to document the threats.
"I felt very unsafe," Jones said. "They had threatened to publish my address, and they were all going to come to my house. ... It has been kind of a little bit of a nightmare. There were many sleepless nights."
Jones said she has heard from a couple of female colleagues in her area who said they have also received threats, though she hasn't heard the same for any male colleagues.
"I truly wonder if it disproportionately affects women in public health positions, as opposed to men in public health," Jones said. "My gut's telling me it is."
Women are more likely than men to hold top spots in local health departments. According to a 2019 report by the National Association of County and City Health Officials (NACCHO), 66% of top executives in local health departments were women, up from 62% in 2016.
They also may be more vocal about what has been happening to them during the pandemic, NACCHO CEO Lori Tremmel Freeman told ABC News. (A rare exception is Dr. Fauci, the nation's leading infectious disease expert, who said in April he had received threats.)
"These are not innocent threats," Freeman said. "Some of these are quite violent in nature."
Georgia's public health director, Dr. Kathleen E. Toomey, told NBC affiliate WXIA-TV in May that she had received threats. The health department declined to comment to ABC News on the nature of the threats, though the director was seen with armed security during coronavirus briefings in April and May.
'Casually suggested that I should be shot'
Barbara Ferrer is one of several female county health directors in California who has received threats during the pandemic. In a statement released last week, the Los Angeles County public health director said she received a death threat in May during a Facebook Live broadcast about COVID-19, "when someone very casually suggested that I should be shot."
"I didn’t immediately see the message, but my husband did, my children did, and so did my colleagues," she wrote in the statement.
Other attacks, via emails, public posts and letters, had been ongoing since March, and serious threats have been reported to a sheriff's liaison, she said. In May, one Twitter post criticized her appearance and shared an image doctored to make her look ill.
Ferrer told ABC News that she understands that people are angry about the impacts of the pandemic. They are "looking for somebody to blame -- and found a target," she said.
Ferrer believes women have been experiencing these attacks "way more than men."
"My sense is that I think it's a little bit harder for women. I think people feel freer to denigrate us," Ferrer added. "The only thing I know is that the women in California that have spoken about this the most -- there are three of us, we're all women."
One of those women is Dr. Sara Cody, Santa Clara County’s public health officer. In May, a Santa Clara County resident purchased an ad in the Mercury News titled, "Dr. CODY, YOU OWE US ANSWERS," which questioned the health director's response in reopening the county.
Last month, the county also acknowledged that Cody was "the target of serious threats." The local sheriff's office is investigating threats made against her in recent weeks, ABC News San Francisco affiliate KGO-TV reported.
"Even though those individuals represent a tiny fraction, we take those threats extremely seriously and are taking all the necessary steps to ensure the safety of our Public Health Officer," the county said in a statement.
A third woman is Dr. Nichole Quick, the former chief health officer of Orange County. After issuing a mask order on May 23, she faced death threats and protests at her home, and the local sheriff's department provided her with a security detail, county officials said. She resigned on June 8 without making a public comment.
In a statement, the Los Angeles County Medical Association said Quick's resignation "is both disheartening and disturbing." The California Medical Association said it "creates a dangerous precedent that should concern all of us."
"We must continue to protect public health based on science, and not allow bullying to drive the health recommendations that can keep us safe and healthy," the organization said in a statement.
On Wednesday, a day after Ferrer spoke with ABC News, a fourth female California health officer -- Alameda County's Dr. Erica Pan -- detailed harassment she's received over coronavirus orders.
Fired or forced out
Several women in top state positions have been fired or asked to resign during the pandemic, including in Connecticut, Wisconsin and West Virginia, where last week Dr. Cathy Slemp was ousted as the state health officer.
Gov. Jim Justice publicly criticized reporting errors at her office, saying there were discrepancies in the number of cases out of a correctional facility, and voiced his "lack of confidence" in her leadership.
Officials at Johns Hopkins Bloomberg School of Public Health, Slemp's alma mater, said they were "stunned and troubled" by her resignation and praised her "steady leadership."
Emily Brown was let go from her position as the director of the Rio Grande County Public Health Department in Colorado in May. She told Kaiser Health News she was at odds with county commissioners who wanted to loosen coronavirus restrictions faster.
“They finally were tired of me not going along the line they wanted me to go along,” she said, according to Kaiser.
More than two dozen residents of the rural county called her firing during a public health crisis "shocking and appalling." The commissioner chairman said in a local report the move was part of a restructuring "to better address the crisis."
Brown, as well as Quick and Acton, were replaced in the interim by men.
Women in leadership roles are often challenged "from a credibility standpoint, from a trust standpoint," Freeman, the NACCHO CEO, said.
Women also are often subjected to social media abuse when they "step into the public arena," Sarah Hawkes, co-director of Global Health 5050, an organization that promotes gender equality and health equity in health care, told ABC News.
During a public hearing on a proposed mask order in Palm Beach County, Florida, last week, one resident threatened to execute a citizen's arrest on Dr. Alina Alonso, the county's health director, for "crimes against humanity." Another questioned the respected health official's credentials.
"I really have many question marks about your degrees and what you really know," she said.
In May, reacting to Alameda County lockdown orders that kept his Fremont factory closed, Tesla founder Elon Musk called Pan, the county's health officer, "ignorant" in a tweet. She was recently appointed California's state epidemiologist.
A Pennsylvania official faced backlash for transphobic comments made during a virtual discussion on the township's reopening last month. Scott Township Commissioner Paul Abel said he was "tired of listening to a guy dressed up like a woman" -- referring to Pennsylvania's secretary of health, Dr. Rachel Levine, who is transgender. Abel resigned a week later. Levine has not publically commented on the incident.
Toni Van Pelt, president of the National Organization of Women, told ABC News in a statement that misogyny "prevents people from respecting women in leadership." During the pandemic, "that has meant that policymakers often look to men as scientific experts instead of women," she said, pointing to an Undark Magazine report.
"These women leaders across the United States are trying to do their jobs, making the right call and putting people over profit, but they have misogyny and sexism in their way," Van Pelt said. "When health professionals in the U.S. speak truth to power, especially those who are women, women of color or LGBTQIA , they aren’t given the respect they deserve."
Okanogan County's Jones, for her part, is undeterred.
"I am not going to back down from this, regardless of any threats," she said. "We'll continue to do our jobs. This isn't a short-term virus."
Ferrer said she isn't worried about the threats, but she is concerned about the county's case numbers and hospitalizations. On Monday, Los Angeles became the first county in the country to hit 100,000 cases of COVID-19. Hospitalizations have also increased 27% in the last two weeks, officials said earlier this week.
"I think the more important thing is, how do you work with people who have very different understandings of their risk, of other people's risk, a different tolerance for what they're willing or not willing to do? How do you get everybody together so that we can actually, successfully slow the spread?" Ferrer said. "We have a ton of work in front of us. We need to stay focused on what's important right now."
Copyright © 2020, ABC Audio. All rights reserved.
killerbayer/iStockBy DR. STEPHANIE E. FARBER, ABC News
(NEW YORK) -- In the ongoing quest for COVID-19 solutions, some researchers have said they believe wearable devices -- Apple Watches and FitBits, products by Garmin and WHOOP -- may help provide early warning signs of possible illness.
One device in particular, the Oura ring, generated headlines when the company partnered with the NBA -- Sports Illustrated called it the "key to the NBA's restart."
"There's a huge amount of promise in these new technologies," said ABC News Contributor Dr. John Brownstein, chief innovation officer for the Boston Children's Hospital and a professor of epidemiology at Harvard Medical School.
Because these devices are constantly collecting data on vital signs, they can detect subtle temperature and biometric changes that could hint at a COVID-19 infection, Brownstein said.
However, despite the Oura ring's promising potential to help diagnose COVID-19, the scientists studying it remind us that they haven't yet completed their research, and that it would be premature to jump to conclusions.
A group at the West Virginia University's Rockefeller Neuroscience Institute is currently looking at 800 health care workers and their wearable data. Meanwhile, a research group at the University of California, San Francisco is looking at more than 50,000 people.
The group at UCSF, led by Dr. Ashley Mason and Dr. Rick Hecht, is looking at two different groups -- 3,500 front-line health care employees and thousands of Oura ring users from the general population. By monitoring data collected from their devices, researchers hope to be able to study patterns to predict illnesses.
The group at West Virginia, led by Dr. Ali Rezai, connects the Oura ring to an app that tests users' alertness and other brain functions. They use artificial intelligence to analyze the data.
"We can quantify these biological cycles, and that leads to predictions of health and resilience," he said.
He believes these data profiles, which include information on heart rates and temperatures and respiratory rates, can predict a person's illness before the onset of symptoms.
And the earlier a person's illness is detected, the easier it is to prevent the virus from spreading.
"We're looking at this asymptomatic and contagious stage," Rezai added. "Our goal is to detect it early in this phase and help people manage better with work and public safety."
But Oura CEO Harpreet Singh Rai cautioned against too much optimism.
"We'll never be a medical device," he said. "I'm not trying to be a replacement for testing, but we have a shortage of tests -- can we distribute those tests in a more informed manner? Probably."
Brownstein was similarly cautious, saying even if data from a wearable device suggests an illness, a full test would be required for confirmation.
"You can't really go buy a wearable and create a diagnosis of a particular condition," he added. "We have to be very careful in terms of over-interpreting the data."
That could lead to some people misinterpreting data, thinking they're sick when they're really not, resulting in unnecessary quarantines or work absences. Wearables, Brownstein stressed, should be viewed as "complementary but not a replacement for your health care provider or telemedicine visit, or the way that you're feeling."
There also are concerns over privacy. If employees, such as NBA players, are required to wear devices, exactly how much of their health data should be shared with their bosses?
"There is going to be a lot of pressure on these companies to have well-documented privacy and security policies," Brownstein said.
Still, researchers and doctors are excited about the technology.
"We never thought we'd be here doing this kind of work about COVID, but I think the world has changed and all of us as humans have had to change," Rai added. "We had to change and focus our priorities on something that could help our world the most."
Copyright © 2020, ABC Audio. All rights reserved.
Yuricazac / iStockBy Dr. Ayodola Adigun, Dr. Alexis E. Carrington, Dr. Stephanie E. Farber, Dr. Jessica Johnson and Sony Salzman
(NEW YORK) -- Masks have become a symbol of the coronavirus pandemic -- at first largely foreign to Americans, then treated skeptically by officials looking to preserve protection for health workers and then embraced by a public desperate to stem the overwhelming tide of the virus in northeastern cities.
Since then, they have become a political flashpoint, a source of defiance and confusion, all while a debate raged about what type to wear and their effectiveness.
Early in the COVID-19 pandemic, the Centers for Disease Control and Prevention (CDC) and other government officials discouraged Americans from wearing masks, saying they were unlikely to help stop the spread of the virus, according to the best evidence at the time.
But as evidence accumulated, the CDC made an abrupt about-face on April 3, encouraging all Americans to don face coverings to slow transmission of the virus, which was largely believed to be spread through respiratory droplets.
Meanwhile, across the world, scientists were frantically marshaling resources to set up a wide range of studies to examine the issue. Some set up dummies in their laboratories, mimicking coughing or sneezing using spray canisters and capturing the distance these droplets were able to fly.
Others embarked on massive population-scale studies, trying desperately to discern whether masking policies were likely to stop the spread of the virus within communities.
By June, the World Health Organization (WHO) weighed in, agreeing with the CDC that people should wear masks -- especially when other preventative measures, like standing 6 feet away from other people -- are not possible.
Now, more than six months into this global pandemic, experts say enough evidence has been amassed to conclude that masks are critical in mitigating COVID-19 spread.
“It is a simple, inexpensive measure that can have a significant impact in reducing the spread of the virus, ” said Dr. Simone Wildes, an infectious disease physician at South Shore Health in Massachusetts. “We have to remember if we don't take these measures there will be more cases and more deaths.”
But what kind of mask is best? Experts agree that most people should not be using N-95 masks, which protect both the wearer and others from viral particles, are still in short supply and should be reserved for medical professionals. And they acknowledge that masks are not the only solution. Staying at least 6 feet away from other people when possible and washing your hands frequently are other important ways of stopping the spread of COVID-19, they said.
“The masks are not a cure for COVID-19,” said Dr. Amesh Adalja, senior scholar at Johns Hopkins Center for Health Security. “It is a simple intervention that can be used to slow the spread of the coronavirus.
Why masks probably help others
Accumulating scientific evidence points to two potential benefits of wearing a mask or homemade face covering. First, it might prevent you from spreading respiratory droplets to others if you are the one who is infected. Second, it might prevent some of the viral particles from getting into your mouth and nose -- a point that has been much murkier from scientists and public health officials.
This first potential benefit has become impossible to ignore as we have come to understand the phenomenon of “silent spreaders,” with some studies estimating that more than 40% of people may be carriers of the virus without knowing it or feeling any symptoms, according to a review published in Annals of Internal Medicine this June.
“There are many people that are out there that have mild symptoms that may not even know they are infected that may be spreading the virus. A facial covering can help prevent that from happening,” said Wildes.
The CDC has weighed in on this topic, saying that existing science supports the idea that masks can help protect the people around you, should you be infected. Right now, the agency stops short of saying that the mask itself can definitely protect you from getting infected, although research is ongoing.
Most of the good data we have on masks has looked at their effectiveness in health care settings, like hospitals and clinics. One of the strongest studies comes from the scientific journal The Lancet this June, which compiled multiple studies from both healthcare and community settings to find that wearing a mask may bring the risk of transmission of coronaviruses from 17% to 3%.
A study in Nature Medicine in April showed that masks reduce the amount of seasonal coronavirus as well as other respiratory viral particles in droplets or aerosols from exhaled breaths, however it did not study patients with COVID-19 directly. Another study in the Journal of Health Affairs in June, found that infection was 2% lower in places where mask mandates were enforced, though other factors could have contributed to this difference.
And multiple studies have found that the thicker the mask, the better. A thin, loose-fitting mask is less likely to protect the people around you compared to a multilayer mask (ideally 12-16 layers) that covers your nose and your mouth.
And why they may help you
While less conclusive, growing evidence suggests masks might also protect you, the wearer. This theory relies on the idea that while a mask might not protect you from inhaling small particles of virus through the gaps in the mask, it is likely to prevent you from inhaling massive quantities of viral particles, compared to if you were wearing no mask at all.
“Though not conferring absolute protection, wearing a mask is does provide the wearer some level of protection which should provide reinforcement for those that aren’t willing to take an altruistic public health approach” said John Brownstein, a Harvard Medical School professor and ABC News contributor.
And experts think that inhaling a little bit of virus is better than inhaling a lot of virus, because a lower viral load could mean you’re less likely to get seriously sick.
“This theory is really based on evidence that we have from almost every virus, whether it’s spread in a respirator way, gastrointestinally, sexually, that if you get a large innocuous of virus, you get more ill,” said Dr. Monica Gandhi, director of UCSF-Gladstone Center for AIDS Research (CFAR).
“If you get less of a dose, you get less sick. And if you use masks you get less of a dose,” Gandhi said. “I really do believe that population masking will lead to more mild disease. It’s the biggest argument to [wear a] mask.”
Even as evidence supporting mask use continues to accumulate, many Americans have become weary of wearing them as the pandemic drags on. Others remain skeptical of mask policies because of the government’s early messaging that masks wouldn’t help.
“We have to be humble about our assumptions,” said Dr. Anne Schuchat, principal deputy director of the CDC, during an online Q&A on Monday. “It’s not that we were wrong and then we changed our mind, it’s that we keep learning.”
Existing scientific data tells us it’s likely masks could save lives. And doctors say at the very least, they don’t hurt.
“I can understand the frustration some individuals are experiencing about the need to wear the mask at all times,” said Wildes. “But in the midst of a pandemic with more than 2.5 million cases in the US and more than 127,000 deaths with no cure or vaccine yet, we have to take all measures we can to slow the spread of the virus.”
Ayodola Adigun, M.D., M.S., is an attending in pediatric and adult psychiatry and a former fellow in child and adolescent psychiatry at Yale University. Alexis E. Carrington, M.D. is currently completing her internal medicine preliminary year at Elmhurst Hospital in New York City. Stephanie Farber, M.D. is a plastic surgeon from Pittsburgh, PA. Jessica Johnson, M.D. is a senior resident in emergency medicine at Stanford University. Sony Salzman is coordinating producer of the ABC News Medical Unit.
Copyright © 2020, ABC Audio. All rights reserved.
Myriam Borzee/iStockBy SOO RIN KIM, OLIVIA RUBIN, ALI DUKAKIS and LAURA ROMERO, ABC News
(NEW YORK) -- In New York, the original epicenter of the COVID-19 outbreak in the United States, there are signs of life returning to normal as the caseload and fatality rates have been driven down to levels not seen since early spring.
By contrast, the virus is raging in several states in the South and West, propelling the United States to record numbers of daily cases and setting the nation on edge about as leaders there debate, and in some cases, move to stem the tide.
There is also everything in between -- states that have still seen relatively little virus transmission and are bracing for an outbreak.
So why have some states been successful in their fight while others have not?
ABC News analyzed the current status and reopening process of four states that emerged with different outcomes following their shutdowns -- Florida, Texas, Ohio and Connecticut.
Texas and Florida are both seeing worrisome coronavirus outbreaks across their states as many residents ignored or abandoned social distancing practices and masking. Both are seeing increases across the board in the rate of positivity (the percentage of coronavirus tests that come back positive), hospitalizations and deaths, and have each set new records for daily cases just this past weekend.
On Tuesday, Texas saw 6,533 hospitalizations across the state -- the most yet -- and Florida reported 9,585 new cases.
In Ohio, cases and hospitalizations have been increasing over the past couple weeks but at a slower rate than in Texas and Florida, and deaths have continued to drop. It’s complicated to make a direct comparison among states because of the difference in the way cases are reported, but in Ohio, cases have increased by about 100% in the past couple of weeks, while in Texas, cases have increased by about 150%. In Florida, cases have increased by nearly 250% during the same period.
Connecticut, by contrast, seems to have a handle on its outbreak -- the state has seen a decline in all three categories for well over two months now, according to ABC News’ analysis of state-released data.
The situation these states find themselves in may be in part a reflection of their leaders’ decisions about shutting down and reopening throughout the pandemic as well as the degree of urgency the public saw in the health crisis early on, experts said. Leaders in Ohio and Connecticut have both placed a heavy emphasis on science and data to proceed with reopening cautiously, and appear to be benefitting from those decisions. Texas and Florida officials, in contrast, put economic concerns first and allowed lax social distancing and minimal face-covering requirements for the public during the crucial first few weeks of reopening, and are now suffering the consequences of an accelerated reopening, according to experts.
Texas was aggressive -- and early -- in reopening the state’s economy. Over the last several weeks, the state has emerged as a top hotspot for COVID-19, reaching record highs in daily positive rates and hospitalizations due to the deadly virus, as well as a rising number of fatalities over the last several weeks.
The state's Republican governor, Greg Abbott, was the recipient of both praise and criticism in appearing to prioritize the state’s economic comeback over stricter social distancing measures infectious disease experts urged were key to assure that reopening did not spark a wave of COVID-19 infections.
Abbott issued a stay-at-home order on April 2, and let it expire April 30. The governor was among the first to begin a phased reopening of any state May 1, and by the start of June nearly all businesses were permitted to be open by at least 50%. Within a few short weeks, massive swaths of businesses in the state were back open for business: tanning salons, gyms, parks, beaches, bodies of water, pools, barbershops and salons.
The governor has also continued to avoid mandating masks be worn in the state, calling such a move intrusive to individual freedoms, but has been increasingly -- and more fervently -- recommending face masks, a simple measure that many health officials say is life-saving.
The month of June has presented significant pitfalls and losses for the state -- with COVID-19 hospitalizations rising 36% since Memorial Day. Over the weekend, Houston stopped reporting hospitalization data. In a press conference last Monday, Abbott said, “COVID-19 is now spreading at an unacceptable rate in the state of Texas, and it must be corralled.”
Last Thursday, Abbott hit the “pause” button on the state’s reopening and ended the performance of elective surgeries in the state’s largest counties.
In recent weeks, as positive cases and hospitalizations due to COVID-19 began to surge significantly farther past Texas’ previous peaks, there has been a discernible change in tone and tenor of the governor’s remarks enforcing the importance of mask-wearing, admonishing younger people for not being more careful and, in general, warning residents of the Lone Star State to stay home.
While the governor laid out several tactics aimed at reducing the virus’ spread in Texas without leading to a shutdown of the newly reopened state economy, he said health and financial well-being don't have to be a choice.
“We can have both," he said last week. "We can protect lives while also restoring livelihoods. Together, we will keep Texans safe and we will keep our state open for business."
On Friday, Abbott ordered Texas bars to close again and restaurants to reduce to 50% occupancy as the coronavirus outbreak in the state spreads. Additionally, the governor halted river-rafting trips and outdoor events of more than 100 people without local authorities’ approval. The previous limitation was for such gatherings of more than 500 people.
Bars were forced to close by midday Friday. The restaurant capacity slashing took effect Monday.
Then on Monday, Abbott said shuttering the state's economy again completely would only be used as a last resort.
In many of Texas' largest cities, local officials have directed their ire at Abbott.
"There have been a lot of inconsistent or conflicting messages that have happened," Dr. Umair Shah, the executive director of the Harris County Public Health Department in Texas, recently told ABC News.
Ohio Gov. Mike DeWine, a Republican, was one of the first in the nation to respond to the coronavirus pandemic. He, alongside state health director Dr. Amy Acton, was the first to close schools and bars in the country, and shortly after, ordered a statewide stay-at-home order on March 22. By early April, DeWine declared the state had hit a “home run” in flattening the curve and preventing the state from becoming a major hotspot in the country.
While the state did have issues without outbreaks in nursing homes and prisons, in the two months since the state first began reopening on May 1, hospitalizations of the virus have declined and just saw their first increase last week, according to a release from the Ohio Department of Health. The daily number of new cases and hospitalizations are now increasing, according to an ABC News analysis, but fatalities in the state are also falling.
During an interview with ABC News last week, DeWine acknowledged the state is “starting to see some spikes in the southwest we’re concerned about,” but overall said the state is in “pretty good shape.”
Mike Abrams, the president and CEO of the Ohio Hospital Association, agreed. He said that while hospitalizations are increasing, the rate appears to be manageable, he said.
Hospitals are doing “fine” in terms of capacity, Abrams said. Ohio built out three temporary hospitals in convention centers and other spaces early on in the pandemic in case the system was to be overwhelmed, but never ended up using them -- and Abrams does predict they will need to in the future. A database created early on in coordination with the governor helped to track every hospital’s capacity, supplies and PPE, Abrams added.
DeWine said he was grateful he made the decision to cancel large events and shut down the state early on.
“It certainly was the right decision,” DeWine stated. “If it, you know, people question us at the time -- it looked a little premature or a lot premature-- I think two people at a time, but it was certainly in hindsight the right decision.”
DeWine’s own behavior may have played a role as well. While he did not mandate masks in the state, DeWine has been unequivocal about their importance and wears his own mask to briefings, only taking them off when at the podium. He also took a coronavirus test at a press briefing, like New York Gov. Andrew Cuomo did, a move he told ABC News was meant to “encourage” people to do the same.
Still, DeWine’s heavy emphasis on leading by science has not always been popular. His administration has faced backlash from citizens as they proceeded cautiously. Former state health director Dr. Amy Acton-- who gained national attention and praise for leading Ohio’s response to the outbreak-- stepped down in June after months of anti-shutdown protests, lawsuits and harassment to become DeWine’s chief health advisor.
"Well my message to people who were upset with Dr. Acton, or health director, is they should direct their ire to me, they should protest at my house, they should protest me,” DeWine said, defending his former health director. “And they have, but you know, they should leave her alone.”
After announcing her resignation during a press conference, Acton said it was a “deep honor” to have served in Ohio.
“I am here, I am more determined than ever to advance the health and well being of Ohioans, and to serve on behalf of the governor,” Acton said.
Still, some worrisome trends in cases and hospitals have begun to emerge in parts of the state in recent weeks -- after weeks of gradual decline, daily new cases have doubled in the past couple weeks and hospitalizations are slowly climbing back up as well -- leaving questions about how the governor will be able to handle them the second time around.
One of the hardest-hit states early on in the pandemic, Connecticut, was reporting more than 2,000 new cases and 200 new deaths a day at its peak in the third week of April. There were about 2,000 COVID patients hospitalized at that time.
About a month and a half into its reopening, on Monday, the state reported just 59 new cases and four deaths. And only 99 COVID patients were currently hospitalized.
Health experts noted the obvious difference in size of Connecticut and Texas, but emphasized the significance of a robust collaboration of the state government, local officials and health systems across the state, coupled with diligent participation from the public. They also say Gov. Ned Lamont, a Democrat, was very cautious about reopening, making sure all metrics were met before people went out again.
Importantly, by the time Lamont’s stay-at-home order expired on May 20 to kick off Phase 1 of reopening, cases, deaths and hospitalization had been on a steady decline for nearly a month.
Bars -- which have been cited as problem areas in other states -- have yet to open. They are were finally expected to open next month as part of the third phase of reopening, though the governor on Monday said he’s reconsidering opening up bars as cases in other states surge.
Lamont’s executive order mandating social distancing and face covering statewide implemented in April, is also still in effect. Dr. Victor Morris, assistant chief medical officer at Bridgeport Hospital of the Yale New Haven Health System, said the public’s close adherence to the order has also played a big role in slowing down the spread of the virus.
“When I'm indoors at a store or a grocery store, Dunkin' Donuts, or wherever I might go, everybody has a mask,” Morris said.
“I think coming out of it now, a difference is that we lived it -- people in Connecticut saw how bad it was,” Morris added.
At Bridgeport Hospital, which was one of the busiest hospitals near the New York City border, which at its peak had 226 COVID patients hospitalized, 66 of them in intensive care and 44 of them on ventilators, now has a total of 16 COVID patients, Morris said. Just five of them are in ICU and two are on ventilators.
Across Yale New Haven, COVID hospitalization has come down to 43 from 760 at its peak. Yale New Haven in total has discharged about 3,000 COVID patients so far, Yale New Haven’s chief medical officer Dr. Tom Balcezak said.
Balcezak said while he feels the state is at a very stable and comfortable level right now, he’s “absolutely” worried about a second resurgence, saying the numbers across the country are “pretty terrifying.”
He said he’s also worried about more people starting to go out and have larger gatherings in their private yards and homes in the summer, but added he believes the state has built a robust infrastructure and adequate guidelines that the public has been following well.
“This is a disease for which there is no cure,” Balcezak said. “There is no medical, meaning vaccination, prevention, and once you get it, our only therapies ... are our supportive therapies. The number one weapon we have to fight this disease is our classic good old fashioned public health measures, and the public needs to know and pay attention to that.”
Florida, on the other hand, has seen an explosion of coronavirus cases since reopening the economy, and Gov. Ron DeSantis, a Republican, has faced significant criticisms for his handling of the pandemic since the outbreak began.
As of Tuesday, Florida’s health department has reported a total of 152,434 positive cases and 3,505 deaths.
DeSantis, reluctantly issued a statewide stay-at-home order on April 1 and opened back up on May 4, with a total of 36,897 coronavirus cases statewide and reporting less than 1,000 cases per day. Florida slowly began to reopen with restaurants and retailers allowed to operate with limited capacity. That same month, even though the state saw increases larger than 1,000 in a single day three times, DeSantis announced the state would enter “full phase one” of reopening.
But nearly two months later, the state has seen a record-setting pace of new coronavirus cases and hospitalizations over the last few weeks. The explosion of cases amid the reopening has resulted in counties and cities rolling back on reopening plans and implementing stricter facial covering requirements.
After the state crushed its record for new coronavirus cases, reporting 9,585 new daily infections over the weekend, city officials announced the closure of several beaches and county-owned parks across the state for the Fourth of July weekend.
“I can foresee a Fourth of July where you have throngs of people on the beach, very difficult to keep social distancing, people getting together, especially young people getting together,” said Miami-Dade Mayor, Carlos Gimenez at a conference on Friday. “We now see this virus is prevalent in this age group and we want to keep this down.”
Miami-Dade, along with Broward and Palm Beach counties, is still in Phase 1 of the state’s reopening plan. The rest of the state has been in phase 2 since June 5.
Following the surge of cases last week, DeSantis imposed new restrictions, ordering bars in the state to stop serving alcohol.
But DeSantis said he has no plans to issue a statewide mask requirement at this time, despite the recent surge in coronavirus cases, leaving it up to local leaders to decide on mask mandates and penalties.
Miami-Dade and Broward counties issued facial covering requirements since early April, requiring people to wear masks when visiting essential businesses.
Most other counties began implementing mask requirements just last week, as the state had been reporting increases in coronavirus cases.
Florida’s elected officials have also said residents aged 18-44 are responsible for the state’s recent spike in cases. That group is going out more and socializing at a greater rate, DeSantis said Sunday. According to DeSantis, the median age of positive COVID-19 cases in March was 65 years old but in the past few weeks, it had dropped to 35.
"What we've seen, particularly over the last week, is a real explosion in new cases amongst our younger demographics," DeSantis said in a news conference in Orlando earlier this week.
Dr. Todd Husty, Seminole County’s medical director, who has seen an explosion of cases in the county in central Florida, believes younger people not following CDC guidelines are to blame.
“Since Memorial Day, we have seen the impact of other large social gatherings, people crowded shoulder to shoulder with no facial covering and no social distancing," said Husty. “Sometimes younger people think they’re invincible but they have to face the reality that they’re not immune. I think state officials really have to think about continuing to reopen because what we are seeing is very alarming.”
Copyright © 2020, ABC Audio. All rights reserved.
BackyardProduction/iStockBy DR. STEPHANIE E. FARBER, ABC News
(NEW YORK) -- In a country plagued by the opioid crisis, the race is on to find novel solutions for managing pain. One in five Americans experience some sort of chronic pain.
Opioids are powerful painkillers prescribed by a doctor. Because they are highly addictive, prescription opioids have led to a nationwide epidemic killing 128 people each day, according to the Centers for Disease Control and Prevention.
To avoid the potential dangers of opioids, many doctors and patients are now turning to medication called "neuromodulators," some of which are also used to treat depression. These medications, which include gabapentin, pregabalin and duloxetine, affect the way the nervous system perceives pain rather than targeting pain directly.
Though effective for some, they're not the right treatment for everyone.
"What happens with not just medications but with almost all of our treatments for pain [is that] about 30 to 40% of people improve with any one treatment," said Dr. Ajay D. Wasan, a professor and vice chair at the University of Pittsburgh School of Medicine, and president of the American Academy of Pain Medicine.
While a growing number of scientists are studying alternatives to opioids, finding a single pill that alleviates all pain is unlikely. Instead, researchers and doctors believe that medicine is on the cusp of a revolution in the way providers treat pain. They predict that pain management will shift toward customizing treatment for each individual patient rather than prescribing one type of drug as a cure-all.
Wasan said he is optimistic about the future, with several new pain treatments in the pipeline which could broaden options for the one in five Americans experiencing chronic pain.
His hope is that with additional research and therapy combinations, "maybe 50 to 60% of patients may respond to a particular treatment."
"As a prescriber you want an array of options," said Dr. Rebecca Baker, director of a major federal government research effort called HEAL (Helping to End Addiction Long-term) which focuses on alternative ways to help patients cope with pain.
"There are lots of different pain conditions and they each need to be treated differently," Baker said. "Right now, we don't have a lot of options."
HEAL, which is sponsored by the National Institutes of Health, has identified several drugs with the potential to treat opioid addiction or to serve as opioid alternatives, as well as multiple non-drug therapies to help people manage pain.
"The goal of the NIH HEAL initiative is to provide scientific solutions to the national crisis of opioid misuse, overdose and addiction," Baker said.
Since its founding in 2018, HEAL contributes $500 million dollars annually to over 400 research projects.
Baker says the NIH has invested in a wide range of promising pain treatments. Specifically, scientists are studying a type of medicine called antibody therapy that binds to, and therefore blocks, the body's pain signals.
There are other medications designed to target each part of the nervous system, from its genetic material to the electrical signals that travel throughout the body and to the brain, registering pain as a sensation.
Meanwhile, some companies are taking a different approach, attempting to develop medical-grade versions of one of the oldest painkillers in history -- cannabis.
The hope is that cannabinoids will be effective but not addictive for patients dealing with chronic pain, according to Greg Gorgas, CEO of Artelo Biosciences, a research-stage cannabis company. But cannabinoids and other pharmaceutical options have yet to be proven in clinical trials, and they may only be one part of the solution.
Baker also says there is promising research into new medical devices that treat pain, including an ultrasound that stimulates the body's nervous system to disrupt pain transmission. But according to Baker, pain research extends far beyond drugs and medical devices.
Scientists are also studying mindful meditation, behavioral therapy, physical exercise and group rehabilitation for managing pain.
"We need better understanding of the biologic and genetic basis of these differences and embedding of these in our research and development plans," Gorgas said.
Someday soon, Baker said, "pain [will be] treated like other health conditions . . . so that means looking at the whole person and having a number of options to offer to individuals with pain and then working with them to find the treatment approach that works best for them."
Copyright © 2020, ABC Audio. All rights reserved.
kittiyaporn1027/iStockBy DR. DANIELLE WEITZER and SONY SALZMAN, ABC News
(NEW YORK) -- Despite growing mainstream recognition in popular culture and media, transgender people in the United States still face widespread discrimination in the doctor's office, with a 2015 survey finding that over one-third have been harassed or refused medical care.
In the pursuit of living authentically, transgender people -- those whose sense of gender identity does not match the sex they were assigned at birth -- often seek medical care that recognizes their discomfort and helps them embark on transition.
In recent years, more medical centers specifically focusing on transgender patients have cropped up across the country. The most recent among them is Northwell Health's Center for Transgender Care, a first-of-its-kind medical center in Long Island, which opened Monday.
"Opening allows us to provide outstanding health care to transgender, gender nonconforming and nonbinary individuals," medical director Dr. David Rosenthal said at a press conference. "The center is highly committed to individual personal health and providing overall equity in health care."
The center forms a collaboration of over 40 doctors in various specialties, including plastic surgery, mental health, endocrinology, internal medicine, primary care and fertility, among many others.
"Sometimes people do not come for transitional issues," said Rosenthal. "Transgender people deserve the same type of health care that we see with every other person in health care."
As such, the center also treats regular medical problems such as diabetes and high blood pressure. The center has already treated many transgender patients successfully.
Byron Nicholas, who is currently being treated at the center, said that being able to seek inclusive medical care near his home has been transformative. From the start, Nicholas has lived a life of feeling trapped in his body.
"My mother questioned me about my sexual orientation, my sexual gender, my preference," Nicholas said at a press conference. "She knew deep inside that I wanted to be a male, but I kept away from revealing the whole truth from her for years."
Once he joined the military, it became especially difficult to hide his gender identity under the policy of "don't ask, don't tell."
"From birth to the military, I was still living this double life," he said.
After the military, he moved to Long Island -- where he finally felt ready to pursue his transition. But medical centers catering to transgender patients tended to be clustered in major metropolitan areas rather than suburban areas, so Nicholas found himself commuting long distances to seek medical care.
"Prior to the center opening, there was no other center for us to go to, we had to travel to and from Manhattan," he said.
Now, Northwell Health's Center for Transgender Care allows him to seek treatment closer to home.
"I appreciated not having to take the long drive to the city," he said. "I love coming here where you have everything over one roof."
Nicholas added that the center is very personal in delivering health care and also provides education for families of LGBTQ people.
"There are transgender reps that check in with you daily or weekly or just to check in with you in general to make sure everything is going well," he said.
Rosenthal said that this is one of the key components in the evolution of the center: "These are individuals that take care of our patients, connect and work with them."
"Regardless of your age, make sure you can talk to family and other people, tell your story and have a support system. Transitioning does not have a beginning, middle and end -- it's a journey. The key thing is that we are here to support people through that journey," Rosenthal said.
The center focuses on allowing its patients to safely embark on a journey toward living a better life by becoming their authentic self without bias, judgment or discrimination.
For Nicholas, this part was crucial.
"You need to be true to yourself," he said. "It does not matter how people will view you, people will view you no matter who and what you are. You want to go somewhere where you feel accepted."
Copyright © 2020, ABC Audio. All rights reserved.
narvikk/iStockBy KELLY MCCARTHY, ABC NEWS
(NEW YORK) -- As the novel coronavirus continues to spread across the U.S. and abroad, new hope may be emerging in the race to develop a vaccine.
Pfizer, one of a handful of companies racing to develop a vaccine, reported promising new data Wednesday from its early stages of trials.
Phil Dormitzer, a vaccine developer at Pfizer, spoke to ABC News about the new data from the company's vaccine, which he called "tremendously exciting," and shared more about a potential release timeline and the vaccine's efficacy.
"What we're presenting today is preliminary interim data from the United States trial for the first of those vaccine candidates," he said in an interview with "World News Tonight." "Our first vaccine candidate is eliciting antibody levels to neutralize the virus that is equivalent to or better than what you see in people who have had COVID-19."
"It's been a tremendous amount of work and there's now a lot of pride to see the results start to come forward," he added. "The potential is there to actually change a lot of people's lives."
"In this program, we're going fast. But that does not mean that we're cutting corners or having any lowering of the safety standards," he explained, adding that Pfizer is doing what is necessary to make sure the vaccine candidates are safe.
"If this is successful and is rolled out in the scale that we hope it is, we could prevent a tremendous amount of harm from occurring," he said about the possible vaccine for the virus that has killed over 512,000 people worldwide. "This is very much in line with the overall mission of Pfizer and the vaccine's division, where this is not the only major pathogen against which we either have or are developing vaccines. But it's hard to imagine another pathogen that has been as disruptive to society that is causing as much fear today as this virus is."
While the manufacturer has not given a specific release date, Dormitzer assured ABC News Pfizer is "currently on track" to meet the goal of producing 100 million doses by the end of the year and another 1.2 billion doses in 2021.
"The goal that we've set is to distribute millions of vaccine doses in 2020 and executing on that, of course, means everything has to go well," he said. "We need the regulatory approval to do so. But that is our plan."
As the trials continue, Dormitzer said they are also "tracking the evolution of the virus closely" to mitigate any possibilities of mutation that could potentially decrease the impact of the vaccine.
"You do see some mutation in the virus, but fortunately we've not seen any indication of mutations that would decrease the efficacy of the vaccine," he said.
As the company continues its work on the possible vaccine, Dormitzer said "there's no question" that demand will outmatch initial production if the vaccine hits the market.
"When an effective vaccine is first available, there will be more demand than there is supply, so we're doing a lot to, at this point, ramp up our ability to produce," he said.
Later this month, the pharmaceutical company, which is developing the vaccine alongside German partner BioNTech, will test 30,000 more volunteers in the next phase of trials.
The World Health Organization recently announced that 17 potential vaccines are in human trials with 132 in preclinical phases.
According to the WHO, AstraZeneca, which is supporting Oxford University's vaccine trials, CanSino in China, and U.S.-based Moderna are among the front-runners with promising lab results.
Oxford's vaccine is reportedly the farthest along as it is currently in phase 3 of trials and has enlisted over 10,000 volunteers. The early results found the trial to be safe and effective in emergency doses and could be ready for development by October.
The Chinese military has been greenlighted to use a vaccine developed by its research teams and CanSino Biologics.
The American biotech company Moderna is set to begin its third phase of human trials later this month with 30,000 volunteers. If the trials are a success, Moderna said it hopes to have doses ready by early 2021.
The National Institutes of Health, which backs Moderna's vaccine, said it estimates the company's success at 80% to 90%.
And while the progress in development at the trials looks promising, some experts warn that success in developing the vaccine itself isn't the only hurdle.
"Developing safe and effective vaccines isn't the only challenge. We need to have enough supply and potentially hundreds of millions of Americans to get vaccinated in order to achieve herd immunity," Dr. Todd Ellerin, director of infectious diseases at South Shore Health and an ABC News medical contributor, said.
The key, according to some doctors, is for companies to test large numbers of people both old and young during the trial phase to prove the efficacy and safety of any vaccine.
"If we sort of cut corners on those things, I don't think we'll create the confidence people need," Dr. Ashish Jha, director of the Harvard Global Health Institute, told ABC News. 'We have to do it right."
Copyright © 2020, ABC Audio. All rights reserved.
deyangeorgiev / iStockBy Eden David, ABC News
(NEW YORK) -- As states begin to adjust to a new normal and people start spending more time indoors, experts and local officials are starting to consider the role air filtration and ventilation may play in slowing the spread of COVID-19 in indoor spaces.
Most recently, New York Gov. Andrew Cuomo announced that all large malls in New York will have to install “air filtration systems that can filter out the COVID virus” before reopening.
This requirement comes as infectious disease experts start more aggressively studying the ways in which the virus can spread through inhaling small particles that could hang around in the air for hours -- otherwise known as aerosolized particles.
"As we are understanding more about this virus there is consensus that aerosolized transmission plays an important role in the transmission of the virus," said Dr. Rajat Mittal, professor of mechanical engineering at Johns Hopkins University, who is studying the dynamics of COVID-19 particles and mask efficacy.
Every time we breathe or open our mouth to speak we can exhale or inhale particles that may contain infectious viruses.
“You don’t have to be coughing or doing anything vigorous for these droplets to come out of your mouth, and if you have the infection in your mouth, those particles can carry the virus," said Dr. Jodie Dionne-Odom, Assistant professor in UAB’s Division of Infectious Diseases. “They hang out in the air and someone coming after you just has to breathe the air to get the infection."
This risk of infection through these small particles is especially high in small enclosed spaces like offices, and restaurants, where the air is not being circulated as often and many people are spending prolonged, direct contact with one another. Experts agree that efficient ventilation may likely be an important part in safely resuming indoor activities.
“Obviously cleaning surfaces is still important but cleaning the air that recirculates through buildings is now a huge focus,” according to Nancy McClellan, an industrial hygiene specialist.
Effective ventilation can clean the air through recirculation while filtering out small, potentially infectious particles. Experts are also evaluating special technologies that can disinfect incoming viral particles, like UV light.
"There are some really fascinating technologies out there but they do not get established quickly or cheaply and the research putting them into place isn’t there yet," said Dr. David Krause, a certified industrial hygienist, who is the owner of Healthcare Consulting and Contracting (HC3) and currently leading the American Industrial Hygiene Association’s initiative to develop recommendations on engineering controls in non-health care work spaces.
Experts agree that the most practical method as of right now for small business and homeowners is high efficiency particulate air (HEPA) filtration systems. HEPA filters, according to the United States Environmental Protection Agency, can theoretically remove at least 99.97% of particles as small as .3 microns.
“That is potentially good because almost all the droplets that are going to be carrying viruses are all within that range,” said Mittal.
The performance of a filter is characterized by its Minimum Efficiency Reporting Values, otherwise known as MERV rating. On the MERV rating scale, HEPA filters are rated anywhere between 17-19.
“The higher the MERV rating the more efficient and effective that filter is,” said Krause.
McClellan explained, “I think Cuomo is making a fair assumption that large malls have well-developed and hopefully well-maintained heating, ventilation, and air conditioning (HVAC) systems that are typically capable of upgrades such as improved filtration capacities that MERV filtration offers."
Most HVACs found in homes or small workplaces, however, cannot accommodate these fine HEPA filters, since they do not have motors that can produce a strong enough pressure to pull air and push it through a HEPA filter. Krause said some HVACs may be able to accommodate a filter with a MERV rating of up to 13 but that still would not achieve the necessary number of air changes per hour that would effectively reduce the viral particles in the air.
He said the three most practical steps small businesses and homeowners can take to upgrade the effectiveness of their ventilation system is to install the highest efficiency filter their HVAC system can handle, increase the amount of outside air circulating through their HVAC system and buy in-room air cleaners and purifiers with HEPA rated filters that will increase the overall amount of air exchanges.
Effective infection control in small business or homes requires a 6 to 10 air exchange rate per hour, explained Krause. He said that this can be calculated for a given space's ventilation setup using the available tools online developed by the Association of Home Appliance Manufacturers (AHAM).
The United States Environmental Protection Agency also recommends running your "system fan for longer times, or continuously, as HVAC systems filter the air only when the fan is running. Many systems can be set to run the fan even when no heating or cooling is taking place."
Experts say opening a window might also be a simple yet effective solution.
“Natural ventilation doesn’t require any advanced technology or any significant change to building codes,” said Mittal.
Although these forms of interventions are promising and experts are actively working on publishing clearer guidelines for smaller businesses, many questions still remain around the virus' transmissibility that make it difficult to quantify just how effective these air control measures may actually be.
According to Dr. John Richards, president of Air Control Techniques, “The selection of the most appropriate type of control system depends on accurate data concerning the droplet size range containing the virus.”
Mittal also raised concerns that maintenance teams must also develop safety measures for replacing HEPA filters, since used filters will collect viruses and could become infectious.
More importantly, experts still don't know how much exposure to the virus a person needs in order to be infected, otherwise known as the minimum infectious dose.
“I wish we knew more about the infectious dose. That would help us in understanding what’s going on when people stand close to each other,” said Dr. Lisa Brosseau, an aerosol specialist and research consultant at the Center for Infectious Disease Research and Policy at the University of Minnesota .
Moreover, some experts theorize that small virus containing particles in the air may be more dangerous and more easily produce an infection.
“It could be that smaller droplets are more dangerous because they deposit deeper in the lungs, which is less protective to infection,” said Mittal.
To make matters even more complicated, your age, preexisting health conditions and immune system strength may also affect what minimum dose of virus is necessary to cause infection.
Experts also want to understand how long the virus stays infectious in the air and over what distances.
"We need to be able to culture the virus from airborne particles in the room," said Dionne-Odom. "Those studies are yet to be definitive to prove that these viral particles are capable of human infection."
Krause, however, said that even though these questions persist, “it should not stop us from implementing these air controls because they are available off the shelf.” He said that knowing the infectious dose is critical in quantifying the precise risk reduction but that “historically engineering controls are always effective and achieve significant reduction as has been proven in high risk hospital settings.
Ventilation may emerge as an important tool in reducing spread of COVID-19 indoors, but Krause cautioned that it should be “part of the overall new contract we have as a society.”
Crowded indoors spaces and prolonged close contact with people can still be risky even with enhanced ventilation because the virus containing particles can reach you before they have a chance to be filtered.
“You cannot ignore cleaning and hygiene and cannot overcrowd places,” warned Krause. “Engineering controls should be layered on top of distancing, minimizing occupancy of indoor environments, personal conduct and personal behaviors inside and outside the workplace.”
Eden David, who studied neuroscience at Columbia University and is matriculating to Icahn School of Medicine at Mount Sinai later this year, is a member of the ABC News Medical Unit.
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chayakorn lotongkum / iStockBy Catherine Thorbecke, ABC News
(GENEVA) -- The World Health Organization announced on Wednesday that 60% of all COVID-19 cases globally have been reported in the last month.
"For the past week, the number of new cases has exceeded 160,000 on every single day," WHO Director General Dr. Tedros Adhanom Ghebreyesus said at a news conference in Geneva.
The recent increase in worldwide cases comes some six months since the first novel coronavirus cases were reported in China. As the pandemic spirals, the U.S. has become worst-affected nation, with more than 2.6 million diagnosed cases and at least 127,485 deaths.
So far, more than 10.3 million cases and more than 506,000 deaths have been reported to the WHO. Of those, 60% were over the past month, the director general said.
The update from the WHO comes as the U.S. is reporting around 45,000 new cases a day. Two countries once considered epicenters of the pandemic, Italy and Spain, were reporting around 10,000 and 6,500 new cases per day at their respective peaks.
"We will never get tired of saying that the best way out of this pandemic is to take a comprehensive approach," Tedros said.
He added that new rises in cases are to be expected as nations start to ease restrictions, but he remained optimistic that one of the lessons so far from the pandemic is that no matter what situation a country is in "it's never too late" to turn things around.
The WHO also said it's working to verify the exact nature of U.S. contracts for purchasing COVID-19 drug candidate Remdesivir, amid reports the country is "hoarding" it.
"Obviously, there many people around the world who are very sick with this disease, and we want to make sure that everybody has access to the necessary lifesaving interventions," WHO Emergencies Chief Dr. Mike Ryan said.
Ryan added that the WHO will continue to engage with technical counterparts in the U.S., saying, "We're very grateful for their collaboration."
ABC News' Emily Shapiro contributed to this report.
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Rike_/iStockBy IVAN PEREIRA, EVA PILGRIM and NICK COULSON, ABC News
(NEW YORK) -- Face coverings for COVID-19 protection come in all shapes, sizes, materials and colors.
From bandanas and DIY masks made from handkerchiefs to custom-made cotton masks with your favorite sports team emboldened on the front, health experts say those coverings are crucial for preventing the spread of coronavirus.
But not all face coverings are created equal, according to research from Florida Atlantic University.
Scientists put four common variations of face coverings -- a bandana, a handkerchief mask, an over-the-counter cone style mask and a two-layer quilting cotton mask -- under tests to see which ones blocked droplets. The quilting cotton masks turned out to be the covering that blocked the most droplets, according to the study.
“We are basically looking at two main characteristics for the masks. The first was the type of fabric that we used and the second was the construction of the mask,” Sid Verma, an assistant professor at Florida Atlantic University who was part of the study, told Good Morning America.
Researchers used a mannequin that simulated coughs and sneezes by spraying particles into the air from its mouth. The scientists said particles traveled eight feet from the mannequin's mouth when it had no face covering.
When the mannequin’s face was covered by a bandana, droplets traveled more than three feet, according to the study. The handkerchief covering made droplets travel more than a foot away from the mannequin’s mouth while the cone-shaped mask allowed particles to travel eight inches away from the mouth, researchers said.
The quilting cotton mask allowed droplets to travel two-and-a-half inches from the mannequin’s mouth, the study said.
“Even the bandana fabric will be able to stop the largest droplet sizes,” Verma said. “So if you use a better fabric, it will be more effective.”
Several cities across the country have mandated facial coverings for anyone traveling outside of their household as the number of coronavirus cases has risen in several parts of the country.
Verma warned that people should also adhere to social distancing in addition to face coverings to protect themselves thoroughly from the virus.
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narvikk/iStockBy ALI DUKAKIS, ABC News
(NEW YORK) -- As COVID-19 test positivity rates resurged in recent weeks, private test providers have made efforts to sound the alarm that the rising demand for testing may outpace their ability to process the new influx without accumulating a backlog.
The development is eerily reminiscent of initial coronavirus testing failures in the U.S. when the pandemic first hit earlier this year.
Despite massive increases in the ability to process COVID-19 tests across the country in recent months, in the last week, two of the top commercial testing labs -- Quest Diagnostics and LabCorp -- both said their testing capacity is under strain amid coronavirus outbreaks that hit predominantly southern and western states hardest.
In a statement last week, Quest Diagnostics said that while the company had the capacity to perform about 770,000 COVID-19 tests a week, "Despite the rapid expansion of our testing capacity, demand for testing has been growing faster. Orders for our molecular diagnostic services grew by approximately 50% over the past three weeks"
By Monday, Quest's message became more dire, with the company saying in a statement, "Demand for COVID-19 molecular diagnostic testing reaches unprecedented levels, extending turnaround times."
"We have continued to experience surging demand for these services, with recent daily orders outpacing capacity. As a result, while our average turnaround time continues to be 1 day for priority 1 patients, it is now 3-5 days for all other populations," Quest said. Priority 1 patients include hospital patients, pre-operative patients in acute care settings and symptomatic health care workers.
The commercial lab is ramping up its testing capacity with the goal of being able to process 150,000 molecular diagnostic tests a day. This week, Quest expects to ramp up our capacity to reach 115,000 of these tests a day.
"While we have the supplies to meet our current capacity target, we continue to work with our industry partners on platforms, reagent test kits and other supplies to ramp to our target capacity of 150,000 tests a day," the commercial lab added.
Quest Diagnostics has performed and reported results of approximately 5.75 million COVID-19 molecular diagnostic tests and approximately 2.20 million COVID-19 antibody tests.
As for LabCorp, the other top commercial lab company processing COVID-19 tests, the turnaround for processing tests will be delayed due to increasing demands in the supply chain, the company said in a statement issued over the weekend and updated Tuesday.
"In recent weeks, we have seen a steady increase in demand for molecular testing and we are doing everything we can to continue delivering results in a timely manner while continually increasing testing capacity," LabCorp said in the statement, adding the new update on Tuesday that "with the recent increase in demand, results on average may take 1-2 days longer."
The commercial lab added, "LabCorp also continues developing innovations in COVID-19 testing to increase capacity, eliminate supply constraints, and increase access and convenience for specific markets and populations."
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monkeybusinessimages/iStockBy GENEVIEVE SHAW BROWN, ABC News
(NEW YORK) -- In news that is sure to be music to some parents' ears and worrisome to others, the American Academy of Pediatrics has taken a clear stand on the issue of in-person school come September.
In a statement posted to its website, the AAP wrote that it "strongly advocates that all policy considerations for the coming school year should start with a goal of having students physically present in school."
The AAP stressed the importance of school in children's lives.
"Schools are fundamental to child and adolescent development and well-being and provide our children and adolescents with academic instruction, social and emotional skills, safety, reliable nutrition, physical/speech and mental health therapy, and opportunities for physical activity, among other benefits," the APP said. "Beyond supporting the educational development of children and adolescents, schools play a critical role in addressing racial and social inequity."
The stance came as part of a list of recommendations for safe re-entry to schools amid the COVID-19 pandemic. Among the six recommendations were:
- School policies must be flexible and nimble in responding to new information and administrators must be willing to refine approaches when specific policies are not working.
- Special considerations and accommodations to account for the diversity of youth should be made, especially for our vulnerable populations, including those who are medically fragile, live in poverty, have developmental challenges, or have special health care needs or disabilities, with the goal of safe return to school.
- Policies should be practical, feasible and appropriate for child and adolescent's developmental stage.
Dr. Susan Coffin, an attending physician at Children's Hospital of Philadelphia, Pediatric Infectious Disease, agreed.
"I do think it is very important that students get back to school for social, psychological as well as intellectual development," she told Good Morning America.
The AAP recognized differing needs for students when it comes to school re-entry. For example, while it may not work for younger children to wear face coverings, older kids are recommended to do so. Physical distancing, special education and bussing are all addressed.
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