Health Headlines

narvikk/iStockBy ARIELLE MITROPOULOS, ABC News

(NEW YORK) -- Since the onset of the coronavirus pandemic, the nation's health inequalities have become even more glaring, with millions of Americans of color, Black and Latino in particular, experiencing more severe illness and death due to COVID-19, than white Americans.

New data now reveals that the same racial and ethnic disparities which have affected adults throughout the pandemic, also extend to children of color. Black and Latino children have been affected by more illness and death than other children, during the pandemic.

More than 3.1 million children have tested positive for coronavirus since the onset of the pandemic, accounting for approximately 13.1% of all cases in states reporting cases by age, according to a weekly report from the American Academy of Pediatrics and the Children's Hospital Association.

At this time, severe illness due to COVID-19 remains rare among children. Between 0.1%-2.2% of all child COVID-19 cases have resulted in hospitalization, and children currently account for 0.00%-0.25% of all COVID-19 deaths.

However, new demographic data released by the Centers for Disease Control and Prevention provides the first comprehensive racial breakdown of COVID-19 cases and deaths in children.

In children between the ages of 5 and 17, Latino children currently represent 26.9% of cases, and Black, non-Hispanic children, represent 11.2% of cases.

Similarly, Latino children currently represent 25.3% of coronavirus-related deaths in children, and Black, non-Hispanic children, represent 15.9% of deaths.

"These data clearly highlight that the incredible disparities we have witnessed throughout this pandemic are consistent across all age groups," said Dr. John Brownstein, chief innovation officer at Boston Children's Hospital and an ABC News contributor. "The impact of COVID in pediatric populations mirror racial disparities in the adult population, with both cases and deaths seen more frequently among Black and Latino children."

Additionally, at least 2,060 U.S. children also have been diagnosed with MIS-C, which is short for multisystem inflammatory syndrome in children. The rare and extreme immune system response is linked to COVID-19 and has killed at least 30 people through Feb. 8, according to the CDC.

At least 69% of reported MIS-C cases have occurred in children who are Hispanic or Latino or Black, non-Hispanic.

A wide range of factors are driving the racial-ethnic disparities in COVID-19 impact among children.

The majority of cases in children of color come from exposure to the virus within their household or their communities, according to Dr. Kristin Moffitt, an infectious disease specialist at Boston Children's Hospital.

Thus, "the disproportionately high case rates in Black and Latino children largely reflect how the adults in their lives have been impacted. Affected families are more likely to include essential workers who have had to risk exposures in order to do their jobs. They are also more likely to live in multigenerational homes or more crowded conditions that make distancing or isolating difficult," Moffitt told ABC News.

Further, communities of color are more likely to experience barriers to high-quality health care and testing, or to face cultural or language challenges in having access to this health care, experts say.

Underlying chronic health conditions that occur in minority youths can worsen the course of COVID-19 infection, added Brownstein.

Experts are still struggling to understand the extent of this problem, with race data only available for 74% of the country's confirmed COVID-19-related deaths, and 52% of the U.S.' coronavirus-related cases.

"We have a lot of work to do in reducing health disparities across a number of factors; these include race (and) ethnicity, but also geographic factor(s), rural versus urban, access to medical care, and socioeconomic status," said C. Buddy Creech, director of the Vanderbilt Vaccine Research Program and associate professor of pediatric infectious diseases.

"While these descriptive data help highlight uneven COVID burden on certain populations, significant work remains to determine how race, ethnicity and underlying socioeconomic status play into the trends we are seeing in children," Brownstein added.

Although 71,000 child COVID-19 cases were reported last week, this week marked the fifth consecutive week of declining new cases for children, reflecting the overall national decline in COVID-19 cases.

However, both American Academy of Pediatrics and the Children's Hospital Association warn that there is an urgent need to collect more data on longer-term impacts of the pandemic on children, including ways that the virus may harm the long-term physical health of infected children, as well as its emotional and mental health effects.

Experts are also reporting that it is increasingly urgent to authorize a COVID-19 vaccine for children, in an effort to curb the infection rate.

"If you wipe out the infection in the younger children, they don't spread it to the adults, and so then, you can get a big handle on disease just by targeting the younger children and getting the infection out of that age group," Dr. Robert Frenck, lead investigator of the COVID-19 vaccine trials at Cincinnati Children's Hospital, explained during a briefing earlier this month.

According to White House chief medical adviser Dr. Anthony Fauci, children as young as 6 years old are expected to participate in coronavirus vaccine trials this year, in an effort to have vaccines ready for some age groups by the time school starts in September.

However, experts remain deeply concerned by the racial and socioeconomic differences among children affected by the pandemic, and its consequences for the future.

"So many of the factors driving these disparities are the result of chronic inequities in the determinants of health such as access to secure income, housing, education and health care. There is cause for serious concern that the disproportionate impacts of this pandemic on minority communities will only widen these gaps," Moffit said. "Equitable vaccine distribution, improvements in health care access, funding of public schools in these communities to allow safe return to in-class learning will all help to narrow this gap."

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simon2579/iStockBy DR. ERIC SILBERMAN, ABC News

(NEW YORK) -- Some have raised concerns that one of Johnson & Johnson's previously reported vaccine data points -- a 66% global efficacy in preventing moderately symptomatic disease -- doesn't seem as impressive as figures reported by Pfizer and Moderna, which exceeded 90% efficacy at preventing symptomatic COVID-19. But experts are quick to note that it may not be the best comparison: The Pfizer and Moderna clinical trials didn't take into account new variants and still had 100% effectiveness against hospitalizations and deaths.

"This is a very different trial than the trials that were done last fall," said Dr. Dan Barouch, director of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center and a lead researcher for the Johnson & Johnson vaccine. "We live in a much more complicated pandemic today."

While Pfizer and Moderna are conducting further research on their vaccines' efficacy against variants -- or if a booster will be required -- Barouch emphasized that the Johnson & Johnson vaccine has a leg-up in terms of its data, because it's the only one so far that's been tested against variant strains.

"Overall, the vaccine provides very robust protection throughout the world, including against the worrisome viral variants that we've been hearing so much about," Barouch added.

For many clinicians, the Johnson & Johnson vaccine performs best in what are the most important cases: severe illness that otherwise could lead to hospitalization -- or even death. So while protection from moderate cases may be less robust, a newly reported 100% protection against deaths and hospitalizations is "huge," said Dr. Darien Sutton, an emergency medicine physician and ABC News contributor.

"Knowing that this will help decrease the stress on hospital health care systems is, really, really great," he added.

Dr. Paul Goepfert, director of the Alabama Vaccine Research Clinic, also emphasized the nuances in dissecting the data, underscoring the reduction in severe cases as key.

"Severe COVID and death are the main things you want to protect against," he said, "because that's most important in terms of helping people and keeping hospitalization rates down -- and getting us back to normal."

In addition to limiting severe cases of COVID-19, Johnson & Johnson's vaccine is showing, according to the preliminary analysis, 74% protection against asymptomatic disease, which could help mitigate transmission. More research in this area is needed, but the data so far, according to Barouch, is "very promising."

Beyond the numbers, experts say the Johnson & Johnson vaccine has some significant advantages over the Pfizer and Moderna vaccines -- and not only because it requires a single dose, boosting convenience. Another advantage is its storage, as the vaccine can be kept for at least three months in normal refrigerators.

"That gives us the opportunity to put it in our primary care offices, pharmacies and community health centers, which translates into getting more people vaccinated," said Dr. Simone Wildes, an infectious diseases specialist at South Shore Health outside of Boston.

The Food and Drug Administration independent advisory committee plans to meet on Friday to review the Johnson & Johnson data and conduct a non-binding vote on whether to recommend it for emergency use. If endorsed by the FDA, the vaccine could be granted authorization as early as Friday evening, after which Johnson & Johnson forecasts 20 million doses could ready by the end of March, and 100 million by the end of June.

"It's definitely one more weapon in our arsenal to fight against COVID," said Dr. John Brownstein, chief innovation officer for the Boston Children's Hospital and professor of epidemiology at the Harvard Medical School. "These are all incredible vaccines. When it's your turn, you should take whichever one is offered."

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pinkomelet/iStockBy IVAN PEREIRA and SONY SALZMAN, ABC News

(ATLANTA) -- The Centers for Disease Control and Prevention are urging people to stop ignoring face covering and social distancing rules when they hit the gym after two new studies confirmed they are strong spreader locations.

The agency released findings Wednesday on research it undertook at gyms located in Chicago and Hawaii that saw a high "attack rate" associated with outbreaks last summer.

In Hawaii, 21 people contracted the virus in July from a cycling fitness instructor who had the disease and taught classes for three days. In the Chicago location, 55 out of 81 people who attended high-intensity fitness classes during the last week of August contracted COVID-19, the studies said.

The common factor in both outbreaks was the lack of mask use, according to the CDC report.

The Hawaii cycling class did not mandate mask use among its patrons, while gym users in Chicago rarely used face coverings, according to the report.

"Among 58 exercise class attendees who provided information on in-class behaviors, 44 (76%) reported infrequent mask use, including 32 of 38 (84%) attendees with COVID-19 and 12 of 20 (60%) without COVID-19," the report on the Chicago outbreak said.

The report added that the Hawaii cycling facility kept its doors and windows closed during the classes with the infected instructor, increasing the chances of transmission.

Two people were hospitalized in the Hawaii outbreak and one in Chicago, according to the report. Two of the Chicago patients visited the emergency room with COVID-19 symptoms, according to the CDC.

There were no reported deaths linked to the outbreaks, the CDC reports said.

The agency urged gym facilities to make sure they have proper ventilation standards, decrease capacity and enforce mask-wearing and social distancing rules among its patrons to prevent future incidents. If possible, patrons should stick to outdoor gym activities, the CDC said.

"This outbreak reinforces the need for combined COVID-19 prevention strategies, including universal mask use in public settings when persons are with others who do not live in the same household, especially indoors," the CDC said in its Chicago report.

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narvikk/iStockBy ERIN SCHUMAKER, ABC News

(NEW YORK) -- People who test positive for antibodies after being sick with the virus that causes COVID-19 may have protection against reinfection for at least a few months, according to a new study.

Researchers from the National Institutes of Health analyzed 3 million antibody test results, also known as serology tests, from five commercial labs and two health care data analytics companies between January and August of 2020.

The researchers found that people with positive antibody tests were only about one-tenth as likely as those who didn't have antibodies to test positive for the virus 90 days after their initial antibody test. After 90 days, a positive test likely represents a new infection rather than viral shedding from the original infection.

"The data from this study suggest that people who have a positive result from a commercial antibody test appear to have substantial immunity to SARS-CoV-2, which means they may be at lower risk for future infection," Dr. Lynne Penberthy, associate director of the National Cancer Institute's surveillance research program, who led the study, said in a statement.

The results could help explain why reinfection seems to be relatively rare, and they could potentially guide future decisions about reopening work and school, as well as vaccine distribution choices.

According to the researchers, additional research is needed to understand how long that protection lasts, who may have less protection and how differences between patients, such as underlying conditions, might affect protection from reinfection.

The study was published Wednesday in JAMA Internal Medicine.

ABC News' Stephanie Ebbs contributed to this report.

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valentinrussanov/iStockBy MARLENE LENTHANG, ABC News

(NEW YORK) -- New York teens who are 16 and older in juvenile detention centers, homeless shelters, and foster care facilities are now eligible for the COVID-19 vaccine.

The state's Office of Children and Family Services issued a letter on Monday to its facilities and programs "to provide for residents age 16 and over access to schedule COVID-19 vaccination appointments," following prodding by local lawmakers and advocates.

The guidance will impact 636 eligible children in Administration for Children's Services facilities and 637 in Department of Youth and Community Development facilities in New York City, officials told ABC News.

Pfizer's shot can be taken by those 16-years-old and older and the Moderna vaccine by adults 18-years-old and up, according to state and FDA guidance.

However, there may be future hurdles to getting these kids vaccinated.

Under state guidelines all residents in congregate settings require the consent of the individual's parent or legal guardian if they're under the age of 18, which may be a challenge for those without such relationships.

In January, the Office of Child and Family Services issued guidance prioritizing vaccinating staff at congregate foster care programs, juvenile detention facilities and homeless youth programs.

On Feb. 15, the New York State Department of Health issued guidance stating that under vaccination phase 1B, residents of congregate settings run by the OCFS could get a shot -- but didn't clearly state teens were included.

The Legal Aid Society, the city's largest public defender organization which advocates for runaway and homeless youth in the city, called on the OCFS to include teens in the rollout, citing that Black and Hispanic children and teens comprise the majority of youth held in OCFS facilities. Those same populations have been disproportionately affected in the pandemic.

"We welcome this news that our young clients in congregate settings will now have access to the COVID-19 vaccine," the Legal Aid Society told ABC News.

State Sen. Brad Hoylman also sent a letter to the OCFS regarding the gap in vaccine eligibility, urging them to clarify that teens would be included.

He tweeted, "19-year-olds in adult shelters qualified for a vaccine while 19-year-olds in youth shelters had been turned away. That just doesn't make sense."

The New York Coalition for Homeless Youth praised the inclusion, stating, "Too often runaway and homeless youth in New York state are an afterthought when it comes to resource allocation. Homeless youth are homeless, and they should never have been excluded from eligibility for the COVID vaccine."

ACS, which oversees the NYC foster care and juvenile justice systems, described the move as a "game-changer."

"We have been advocating for eligibility to be expanded to youth in our congregate facilities, and we're pleased that the state has heeded this request," spokesperson Marisa Kaufman told ABC News, adding the agency is working with health officials to make sure vaccines are distributed.

It's not clear if there will be Runaway and Homeless Youth-specific vaccination sites or if RHY program sites will be used to administer vaccines.

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RossHelen/iStockBy KATIE KINDELAN, ABC News

(NEW YORK) -- As more people in the United States are able to get vaccinated for COVID-19, health experts are receiving questions about possible side effects of the vaccine, especially when it comes to women and fertility.

"I get asked about this literally every day," Dr. Jennifer Ashton, ABC News chief medical editor and a board-certified OBGYN, said Wednesday on Good Morning America.

The issue of whether COVID-19 vaccines may impact women's fertility is one that has been fraught with myths, many of which are spread on social media, according to Ashton.

Larger shares of women than men are concerned about the safety and possible side effects of COVID-19 vaccines, according to a report from the Kaiser Family Foundation (KFF), a nonprofit organization focused on health issues. Around 13% of respondents to the KFF survey, taken in January, said they believed or were unsure whether the COVID-19 vaccines have been shown to cause infertility.

Right now, several weeks into the widespread distribution of COVID-19 vaccines in the U.S., the vaccines are not believed to have any "significant impact" on fertility, according to Ashton.

"This myth about causing infertility, if that were the case, we would be seeing a lot of miscarriages in women who had been naturally infected with COVID," she said. "In the field of OBGYN, [there is] really no basis for any of that at this point."

Because pregnant women were not actively included in late-stage clinical trials for the vaccines, there is no real data on the impact of COVID-19 vaccines in pregnancy.

About 20,000 women though became pregnant at some point around the time they were vaccinated, according to Ashton, who added, "There have been no untoward side effects or safety signals in that group."

"There are some published studies that suggest that pregnant women are likely to transfer antibodies to protect their fetus," said Ashton. "Certainly we’ve seen that in women who have been naturally infected and the hope is we’ll see that in vaccinated women as well."

Pfizer and BioNTech were the first to evaluate their COVID-19 vaccine in pregnant women when they announced a new trial last week.

Their vaccine, along with Moderna's, are the two mRNA vaccines currently available in the United States after being granted Emergency Use Authorization by the Food and Drug Administration.

Moderna has not yet publicly released a timeline for including pregnant women in clinical trials.

MRNA technology does not enter the nucleus of the cells and doesn’t alter the human DNA. Instead, it sends a genetic instruction manual that prompts cells to create proteins for the body to learn and develop defenses against future infection.

They are the first mRNA vaccines, which are theoretically safe during pregnancy, because they do not contain a live virus.

The World Health Organization (WHO) recently updated its guidance to say pregnant women at high risk of exposure to COVID-19 and those at risk of severe disease should be vaccinated.

"While pregnancy puts women at higher risk of severe COVID-19, very little data are available to assess vaccine safety in pregnancy," WHO said in a statement. "Nevertheless, based on what we know about this kind of vaccine, we don’t have any specific reason to believe there will be specific risks that would outweigh the benefits of vaccination for pregnant women. For this reason, those pregnant women at high risk of exposure to SARS-CoV-2 (e.g. health workers) or who have comorbidities which add to their risk of severe disease, may be vaccinated in consultation with their health care provider."

The CDC says women who are pregnant and breastfeeding "may choose to be vaccinated" and should talk with their health care provider, noting that breastfeeding is an important consideration but "is rarely a safety concern with vaccines."

The American College of Obstetricians and Gynecologists (ACOG), a professional membership organization for OB-GYNs, says both pregnant and breastfeeding women should have access to the vaccine when they are eligible for it, according the criteria of the CDC's Advisory Committee on Immunization Practices (ACIP).

Likewise, the Society for Maternal-Fetal Medicine (SMFM) recommends pregnant women have access to vaccines and says pregnant women should "engage in shared decision-making" about the vaccine with their doctors.

"In general, SMFM strongly recommends that pregnant women have access to COVID-19 vaccines in all phases of future vaccine campaigns, and that she and her health care professional engage in shared decision-making regarding her receipt of the vaccine. ... mRNA vaccines, which are likely to be the first vaccines available, do not contain a live virus but rather induce humoral and cellular immune response through the use of viral mRNA," the society said in its statement. "Health care professionals should also counsel their patients that the theoretical risk of fetal harm from mRNA vaccines is very low."

 

SMFM’s Health Policy and Advocacy Committee strongly calls for the inclusion of pregnant and lactating individuals in vaccine trials in a recently published op-ed for Vaccine. #VaccinesWork #SafeMedsforMoms @caraheuser https://t.co/ytbZLNAQAq pic.twitter.com/qUmFsG0fI3

— SMFM (@MySMFM) December 10, 2020

 

The question of whether an expecting mother should receive a COVID-19 vaccine will eventually come down to a number of factors, including everything from the trimester, risk factors for COVID-19, ability to remain socially distanced in her lifestyle and occupation, guidance from federal and state officials and recommendations from the woman's own physicians, experts say.

Similar to the flu vaccine, which was not tested on pregnant women in clinical trials, health experts will need to rely on continuously incoming data to make decisions around how safe the COVID-19 vaccines are during pregnancy.

"When the FDA granted authorization, they had just about two months of long-term data. Now that’s about four months," said Ashton. "They are continuing to follow women, including the women who have gotten pregnant after being enrolled in the clinical trials, and they will follow it for two years, so that's something that will be ongoing."

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Ridofranz/iStockBy STEPHANIE EBBS and SONY SALZMAN, ABC News

(NEW YORK) -- Johnson & Johnson and the FDA on Wednesday released respective detailed analysis on the one-shot COVID-19 vaccine, with the FDA announcing the company's data meets the requirements for the emergency use authorization review process.

FDA scientists found that the Johnson & Johnson vaccine was 85% effective at preventing severe illness in clinical trials and 66% effective at preventing COVID-19 cases with any symptoms.

Importantly, the data released shows the vaccine works against all variants. The vaccine was less effective at preventing symptomatic illness in South Africa, where the variant first detected there is dominant, but it was still highly effective at preventing severe disease there.

J&J also released preliminary data indicating the vaccine likely helps prevent asymptomatic infections, and that the Brazil variant doesn't appear to have as much of an impact on vaccine efficacy as the South African variant.

If authorized, J&J expects said they would have 4 million doses available to ship immediately, 20 million doses by March, and 100 million doses by the end of June. The Johnson & Johnson vaccine would be authorized for adults over 18.

When combined with the supply of Pfizer and Moderna vaccines, which both require two doses, the U.S. is expected to have enough vaccine for 130 million adults by the end of March.

The vaccine won't be authorized until Friday or later. First, there will be a public hearing Friday, in which the FDA's independent advisory committee will give an authorization recommendation for or against. The FDA could then make its decision as early as Friday evening.

"Although we are cautious not to prejudge the outcome of the ongoing FDA review process, we believe that our single dose vaccine will be a critical tool for fighting this global pandemic," Richard Nettles, vide president of medical affairs for Jannsen Pharmaceutical Companies testified in a congressional hearing this week.

The FDA found no serious safety concerns with mild side effects like pain at the site of injection, headache, or fatigue. About 9% of volunteers who received the vaccine had a fever.

The data released Wednesday is a more detailed version of what the company previously outlined in a press release.

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daboost/iStockBy MEGAN STONE, ABC News

(NEW YORK) -- Queer Eye star Jonathan Van Ness proudly rolled up his sleeve and received the first dose of the COVID-19 vaccine and hopes to inspire those who are HIV-positive to follow his lead.

Taking to Instagram on Monday, the 33-year-old television personality shared a snap of him getting his first jab and stressed the importance of those with preexisting conditions to check their vaccine eligibility.

"In NY, where I’m working the vaccine program expanded to include people w pre-existing conditions, being HIV is one of the conditions that allows folks to be vaccinated," he said. "If you’re HIV please check your states guidelines to see if you’re eligible and get vaccinated against covid-19!"

Van Ness, who also goes by his initials, JVN, continued, "There was a list of other conditions that allows for vaccination so wherever you are check the lists and see if you can get in line."

"Had I not been looking online everyday I wouldn’t have seen, so def get involved with your search. This was my first shot and other than minor soreness in my arm had no side effects and will get my second shot in a few weeks," he noted, before encouraging his more than 5 million followers to be extra vigilant when scheduling their vaccination appointment.

"Each state has different guidelines so you’ll want to look into yours. Definitely need patience, resolve, access to internet to do this," JVN assured. "If you can help others obtain information or access plz [do] so."

The Queer Eye star's famous friends, including co-star Tan France, congratulated him on being able to receive his first dose of the COVID-19 vaccine.

JVN first revealed he was HIV-positive in his 2019 memoir, Over the Top.

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Daisy-Daisy/iStockBy LAURA ROMERO and DR. JAY BHATT, ABC News

(NEW YORK) -- After more than 11 months of isolation, the dining room at John Knox Village was filled with laughter and joy last week. Residents of the independent 430-bed nursing facility in a Kansas City suburb -- finally feeling the pall of the devastating coronavirus pandemic lifting -- played bingo and ate together.

"It's a breath of fresh air," said Anthony Columbatto, the administrator of the facility. "Getting to walk past the main dining room and seeing people enjoy getting to have a little bit of normalcy is the best. It's the little things that I think we've taken for granted in the past that are so important."

The Knox nursing home is among the thousands of long-term care facilities that are slowly reintroducing communal activities and allowing some visitors. Though the restrictions still differ by state, a significant dip in deaths and cases is being seen across the country.

And long-term care facilities are seeing conditions improve faster than the nation overall. Experts say the numbers suggest that vaccination efforts -- which have prioritized the elderly in congregant settings -- are working. Deaths in long-term care facilities are declining not just in absolute numbers, but as a share of COVID-19 deaths across the whole country.

"There's evidence around the country that once residents are vaccinated, cases and deaths go down," said Mike Wasserman, the past president of the California Association for Long Term Care Medicine and a member of the California's Vaccine Advisory Committee. "From the beginning, this group has been the one at the greatest risk, and getting residents vaccinated has been critical. It's the final step in protecting this incredibly vulnerable group."

Nursing facilities are home to some of the populations most vulnerable to COVID-19 -- the elderly and sick. Since the start of the pandemic, more than 160,000 nursing home residents and staff have died, according to an analysis by the American Association of Retired Persons. Approximately 1.4 million people live in nursing care in the U.S.

"The pandemic's devastating toll on nursing homes has been a nightmare filled with isolation and fear for residents and staff, but we are seeing an awakening of new hope," said Terry Fulmer, president of the John A. Hartford Foundation, a nonprofit that works to improve care for older adults. "Vaccinations in nursing homes are appearing to dramatically reduce COVID-19 cases and deaths, and we know that reductions in community spread also play a role in minimizing the threat of infections in facilities."

At the Good Shepherd nursing home in West Virginia, one of the first states to complete vaccinations in all its elder care settings, residents can "finally get some fresh air" and also attend Mass, said Morgan Murphy, the assistant administrator of the facility.

"[Tuesday] was the first day Good Shepherd Nursing Home has been open to visitors since October," Murphy told ABC News. "It's been very exciting for our residents and their families."

For Mary Moscato, president of Hebrew SeniorLife Health Care Services and the Hebrew Rehabilitation Center in Boston, the challenge now is figuring out what the new normal will look like.

Regulations governing ongoing testing, the wearing of protective equipment, the implementation of infection control practices, and limitations on visitation still remain in place, she said.

"It is not expected that long-term care facilities will return to pre-pandemic operations," Moscato said. "Many regulations specific to safety measures and infection control that were instituted during the pandemic will remain in place."

The good news, said Dr. Sachin Jain, an internal medicine physician and the CEO of SCAN Health Plan, is that as the threat of the virus lifts, many long-term care residents can finally look forward to seeing their loved ones.

"Many older people have been largely alone for about a year now," said Jain. "As vaccine distribution spreads, all of us with a connection to an older adult should make it a priority to end their isolation, which has been shown to have serious negative health effects. Togetherness, on the other hand, improves all of our lives as well as our communities."

Amber Fisher, a nurse at John Knox Village, said that although the trauma of the last year will remain for a long time, she is looking forward to seeing the facility get back to "as normal as it can be."

"It's been a horrific year," Fisher said of the facility, which lost more than 20 of its residents. "But there's finally some light at the end of this dark tunnel."

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vgajic/iStockBy MARLENE LENTHANG, ABC News

(WASHINGTON) -- Pulse oximeters, medical devices used in battling COVID-19, may not work effectively on people of color, according to health officials.

The small devices clamp onto a patient's finger and measure oxygen levels in blood. During the pandemic, they've been used by people at home and in hospitals to monitor COVID-19 patients as the virus attacks the lungs, often leading to a drop in oxygen levels.

"The devices may be less accurate in people with dark skin pigmentation," The U.S. Food and Drug Administration said in a statement on Friday.

Black patients are nearly three times as likely to have dangerously low blood oxygen levels go undetected by pulse oximetry compared with white patients, the FDA said, citing December research.

Pulse oximeters use infrared light beams to estimate the oxygen saturation of the blood and pulse rate, and darker skin pigment may absorb some of that light and alter results.

"Melanin is a primary light absorber in the skin, and it's going to absorb the light. This abounds more in individuals with darker skin," Dr. Panagis Galiatsatos, an assistant professor in the Division of Pulmonary & Critical Care Medicine at Johns Hopkins, told ABC News. "These devices were evaluated on a certain population. It doesn't take into account confounders like darker skin. We'd love to calibrate for darker skin variations -- it's just never been done before."

He said these devices appear to be just another example of health care disparities that result from when studies are too focused on a homogenous group.

Pulse oximeters are popular because they're a painless way to measure blood oxygen levels. Other factors that affect the accuracy of pulse oximeters include skin temperature and thickness, tobacco use and the use of fingernail polish.

Galiatsatos warned patients who use pulse oximeters at home to closely monitor their symptoms and call a doctor if they experience trouble breathing.

"It's crucial because if there's low oxygen that's untreated, it'll result in organ failure," he said.

The FDA is now reviewing the effects of skin pigmentation on the accuracy of these devices. Similarly, the Centers for Disease Control and Prevention updated its coronavirus clinical guidance to flag that skin pigmentation may adversely affect results.

However, this issue isn't new.

Nearly a month ago Democratic Sens. Elizabeth Warren of Massachusetts, Corey Booker of New Jersey, and Ron Wyden of Oregon, called on the FDA to review the efficacy of blood oximeters among different racial groups.

"Racial disparities in health care stem from a wide variety of factors, and it is particularly disturbing that racism may be embedded in key clinical tools," the lawmakers said in a statement.

They noted that sales of pulse oximeters skyrocketed during the pandemic even though studies from 2005, 2007 and 2020 found that the devices "provide misleading measures of blood oxygen levels to patients of color."

The health disparity comes as the pandemic already has disproportionately affected communities of color.

According to CDC data, Native Americans are nearly four times more likely to be hospitalized for COVID-19 compared with non-Hispanic whites. Black and Hispanic individuals are twice as likely to die from COVID-19 as white Americans and three times more likely to be hospitalized with the virus.

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FG Trade/iStockBy ERIN SCHUMAKER, ABC News

(CANTON, Mich.) -- A vaccination clinic call center for seniors in Michigan was overwhelmed when it received nearly 1 million calls on Monday.

Janet Verdi, 62, told ABC News Detroit affiliate WXYZ that she placed more than 100 calls while trying to make an appointment for her husband, who is 73, but she kept getting the same pre-recorded message that said to call back.

"I think that there should be a better system for vaccinations here," said Verdi, who was unable to secure an appointment. "There's got to be a better way to do this."

All the appointments for the 1,000 available doses were filled Monday, according to Anne Marie Graham-Hudak, the township supervisor in Canton, Michigan, which is near Detroit.

"As a result of registering 1,000 individuals for vaccinations and over 2,000 on our growing waiting list, our vaccination appointment call center will no longer be receiving calls," according to the city website.

The city encouraged seniors to sign up for a waitlist on its website in anticipation of additional vaccine supply from the county health department. Seniors should also continue to register for vaccines through their health care providers and local pharmacies, the city said.

Snowstorms in the area delayed distribution of Pfizer and Moderna vaccines last week, but that backlog of supply should be distributed this week. In Michigan, 19,748 vaccines have been administered for every 100,000 residents, according to the Centers for Disease Control and Prevention.

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Marlene Torres took in her siblings Raymond, Juan and Angel (left to right) after their mother died from a heart attack and their father died from COVID-19. - (ABC News)By ASHLEY LOUSZKO, IGNACIO TORRES and ASHLEY RIEGLE, ABC News

(NEW YORK) -- On his 11th birthday last May, Juan Ramirez woke up to the police and fire departments of Passaic, New Jersey, outside his home. Soon after, the mayor would join them bearing gifts.

The surprise event was meant to cheer up Juan, who had lost his father just a week before to the coronavirus. But when he blew out the candles on his birthday cake later that day, he says his only wish was for everything to go back to normal and “to go back in time and stop everything from happening.”

It wasn’t just his father he was grieving, though. Juan had also lost his mother, who’d died months earlier from a heart attack. With both parents gone, his oldest sister, Marlene Torres, stepped in to help. The single mother of two took in Juan and their siblings, Raymond, 15, Angel, 17, and Beatriz, 19.

“It’s hard. Being the oldest, when my mother passed away, [it’s like], ‘Oh, you’re the oldest. You take more responsibility.’ But then, when he passed away, all of us were lost,” Torres said.

Despite the challenges of caring for four more people, Torres said she didn’t hesitate to take them in. They had to stay together, she said.

“I had to do something. They could not be separated. I’m not gonna allow other people to try and take custody. I didn’t know where they would end up,” she said. “I knew it was going to be hard. I knew it was going to be challenging. … I’m really religious. I know my mother and my father, they’re here with us. They’re helping us out.”

As the United States surpasses a staggering half-million deaths from COVID-19, stories like Torres’ have become far too common. A so far unknown number of children have been orphaned since the virus began killing their parents -- and so many others -- last year. Often, the responsibility to keep the family together has been placed on the eldest siblings.

Many of Torres’ brothers and sisters are technically half-siblings. Their mother’s death on its own was a critical blow to the fabric of the family.

“For a moment, I feel like we lost our glue because it’s not that we were ever taught that we were half-siblings… We were never raised that way. Those are my siblings in full, no matter what,” Beatriz Ramirez said.

But Ramon Ramirez worked in construction and, as the virus started spreading around the country, he still had to leave home to work. It wasn’t long before the family fell ill.

Beatriz Ramirez said her father would take care of her when she was sick, and that as he began to get sick, she would care for him, too.

“He always came into my room and he gave me hand-squeezed orange juice… He bought me food. He brought me tea. He did everything for me,” she said. “So, when I found out that he was sick, I tried to do the same thing. I squeezed orange juice. I brought him food whenever he needed it. His tea, I would make it. But there was a time where you could just tell that he wasn’t going to get any better. He was just getting worse.”

Yet, her father didn’t want to go to the hospital because he feared leaving his children. As his conditioned worsened at home, he cautioned Beatriz Ramirez to prepare for the worst.

At one point, Beatriz Ramirez said that she was sitting with her brother Raymond in their kitchen when he asked her, “Do you think he’s going to make it?” she said.

“We don’t want to let him think the worst. I was already thinking so many things. I’m like, ‘No, my dad can’t be next,’” Beatriz Ramirez said.

Finally, she said that after speaking to her sister, she decided to call an ambulance.

“He really didn’t want us to. … He couldn’t speak. His breathing was so bad he couldn’t let out a whole sentence without coughing,” Beatriz Ramirez said. “And I remember going into his room and telling him, ‘Pops, I called the ambulance. I can’t watch you anymore.’ And he looks at me, he’s like, ‘Why do you get so scared?’ And I’m like, ‘Because look at you. I told him again, ‘I don’t want to lose you.’”

Ramon Ramirez died in April 2020 at 39 years old. With viral cases still peaking, his family was unable to give him a proper funeral.

“It wasn’t even a funeral,” Beatriz Ramirez said. “I thought we were going to be able to be inside, at least a little bit. When they came over with my dad in a casket, he was in a bag. … The way I saw him was not the way I expected to. … It was bad. He wasn’t dressed in anything. He was in a bag. It wasn’t the way I wanted it to be. He deserved better than that. He deserved better than to die by himself.”

Across the country, in Palmdale, California, 19-year-old Juan Martinez found himself in a similar situation six months ago, when his mother died from the coronavirus at 43 years old. As she said goodbye to her son, he promised her that he would take care of his younger siblings. Since then, he’s been caring for four of his five siblings ranging in age from 7 to 15. The youngest, Martinez’s 2-year-old brother, is staying with his biological father.

“It just hit me hard, and I just said, ‘All right, well, I gotta do what a parent does.’ So I just started buying calendars, writing stuff down, taking all these phone calls to doctors, teachers,” Martinez said.

Although Martinez works as a security guard, he knew financial challenges lay ahead. He started a GoFundMe, writing, “My goal is to get a permanent home for my siblings and make sure they are able to further their education by attending college.”

Martinez and his siblings said they have begun to move forward. Sharing movie nights and meals together, he says they’ve all spoken about careers in which they’re of service to others, like nursing, teaching, policing and fire fighting. But losing their mother has divided their extended family, some of whom had concerns about the teenager becoming his siblings’ guardian.

“After my mother passed, people doubted me and my family, saying that I wasn’t able to handle it and stuff like that,” Martinez said. “And I guess, now that they see that I can, they just stopped talking to me.”

He went on, “I know that I’d be the best guardian for them because, one, I’m their older brother. Two, I know I’ll teach them the right path and show them you gotta work hard for the things that you want in life.”

Tara Sheoren-Khaimov, is an attorney at Lawyers for Children. It’s her job to give those becoming guardians the resources they need to be successful.

“We have families that want to stay together and need to stay together, both for the younger children for stability in terms of their school, their home, their community, their mental health, but also for the person who is stepping in as that caregiver,” she said. “There is stability there to be in a family unit; to not be sort of cast to the wind, to have your family split up or, the worst-case scenario for most kids, to be in the child welfare system and to have to then do that alone.”

“If they’ve never encountered a court system, if they’ve never encountered the child welfare system, they are truly a boat untethered,” she added.

Like Martinez, Marlene Torres also worked hard to get custody of her siblings, even taking a week off from work to focus on it. While she said it’s been financially straining, even after receiving help through a GoFundMe, she said she’s budgeting hard to make the money last.

“If I have to go to five different stores to find specials, I’m going to do it,” she said. “I’m going to take that extra step because I’m trying to stretch that money. … I know they’re going to need some type of support later on.”

Losing her father to COVID-19, Beatriz Ramirez said, is like being robbed.

“It’s robbed me of love in the sense of parents. I have love for my siblings every day, but the loving parent is a lot different, and that’s what it robbed us of. He was amazing.”

However, Torres’ siblings are looking to the future motivated by the things they learned from them. Torres said she takes comfort in knowing they’re not suffering anymore.

“I like to think that they are good,” she said. “They’re looking at us right now, but they’re smiling.”

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Myriam Borzee/iStockBy ERIN SCHUMAKER, ABC News

(NEW YORK) -- One year after former President Donald Trump told Americans that the novel coronavirus was "very much under control in this country," the United States on Monday surpassed 500,000 deaths from COVID-19, according to data from Johns Hopkins University.

The virus has spread far and wide, with reported infections in every county in the nation, but there remains a persistent undercurrent of inequality in COVID-19 infections, hospitalizations and deaths.

Black and Hispanic individuals are still twice as likely to die from COVID-19 as white Americans and three times more likely to be hospitalized with the virus, according to the Centers for Disease Control and Prevention. That disparity is even more stark for the American Indian population. Compared to white Americans, American Indian communities are almost four times more likely to be hospitalized with COVID and more than twice as likely to die from the disease.

"It’s important to realize that the 500,000-person death toll that we have crossed didn’t to have be," Dr. Amesh Adalja, a senior scholar at Johns Hopkins Center for Health Security, told ABC News.

"As we move forward into a new phase of the pandemic with a vaccine program, it is critical to remember that until the vaccine is in the arms of vulnerable populations, we will continue to experience more deaths and hospitalizations," he said.

Age has also remained a clear risk factor for dying of COVID-19, with death rates rising with each successive decade.

With their high populations, counties in Los Angeles, New York City and Chicago emerged as some of the places in the country with the most deaths during the course of the pandemic, according to data from Johns Hopkins University.

Drilling down into those numbers mirrors national data and shows that the pandemic has been disproportionately hard on people of color in those cities.

As of late February, the COVID-19 death rate was highest among Hispanic residents and second-highest among Black residents in Los Angeles County.

"Once again, our Latinx community is bearing the worst from the pandemic,” Barbara Ferrer, Los Angeles County's public health director, said during a news briefing earlier this month.

New York City reported a similar dynamic, with the highest death rates among Hispanic residents, followed by Black residents.

In Chicago, Black residents fared worst, with the highest reported death rate of any group.

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Seoul Metropolitan GovernmentBY: DR. JONATHAN CHAN, ABC NEWS

(NEW YORK) — Last month, the nation watched as Winston the gorilla came down with COVID-19 and then recovered. So far, the virus has been detected in zoo animals like Winston, domestic animals like cats and dogs, and most worryingly, in farmed and wild animals like mink and ferrets.

Now, animal experts are warning that if the virus is circulating freely in wild animals, it might develop mutations and evolve into a new version – one that is capable of jumping back into humans.

January has been the deadliest month in the United States since the start of the COVID-19 pandemic last year, as efforts to distribute and administer the new vaccines continue.

And just as the United States is ramping up its efforts to find new COVID variants among people, many scientists are speaking out that we should be doing the same for animals.

“In the current pandemic, we know that the virus originated in wildlife, most likely bats, then jumped to people,” said Dr. Jonathan Epstein, an epidemiologist and vice president for science and outreach at EcoHealth Alliance. “And we know that there are a lot of other animals that are susceptible to this virus.”

Epstein explained that the COVID virus is so widespread and so many people are infected that there is a significant possibility that wildlife could be exposed through the environment, contaminated waste water or direct contact with humans.

Minks are small, carnivorous mammals that are raised mostly for their furs. So far, six countries, Denmark, the Netherlands, Spain, Sweden, Italy and the United States, have reported COVID virus infections in their mink farms to the World Health Organization.

While there is no evidence yet that the virus found in the farmed mink population is more dangerous than what has already been detected in humans, the virus does spread easily among minks that are housed closely together.

But infections in farmed and captive animals can be managed. Some farmed mink populations in Europe, for example, have been culled. Meanwhile, zoo animals like Winston are isolated and treated for their infections to limit the spread of disease.

But it's a different story once the virus jumps into wildlife.

As scientists were investigating the outbreak of COVID among farmed minks, they discovered that the virus had already spread to wild minks as well.

“What we are seeing right now is known as a spill back infection,” said Dr. Christine Kreuder Johnson, a professor of veterinary medicine and ecosystem health at the University of California—Davis School of Veterinary Medicine. The virus, which likely originated from bats, spilled over to the human population and has now “spilled back” to infect other animal species.

According to Johnson, the threat of spill back includes both wildlife populations and zoo animals. Felines, including both tigers and domestic cats, are suspected to have been infected from their human owners or caretakers.

“Widespread transmission in any animal species could be a source of virus mutation,” she said.

While there is limited evidence that the virus can significantly spread to humans from animals, scientists are concerned that the virus could change while infecting other animal species. If it spills back, or returns, to infect humans again, it could come back as a new variant.

But more testing and research still needs to be done to better understand the extent the virus can spread in animals.

“We may never have the answer to the question about how COVID spreads in wild animals,” said Dr. Tracey McNamara, a professor of pathology at the Western University of Health Sciences College of Veterinary Medicine.

“Testing in animals was discouraged from the very beginning, largely because they were concerned that there were not enough supplies," she said. "Testing in humans and wild animals use the same types of swabs.”

In a statement, the Centers for Disease Control and Prevention does not currently recommend routine, widespread testing among animals, and animal testing is available if “public health and animal health officials agree the animal’s case merits testing.”

That doesn’t mean, however, that we won’t be able to learn more about the spread of COVID in different species, through a process known as retrospective serologic surveys. As McNamara explained, every time a staff member interacts with or handles an animal at a zoo, they obtain a blood sample and store that in a blood bank.

Those samples are saved, and with enough funding and support, scientists could look back at those samples and potentially learn more about when COVID may have first appeared in different wild and domestic animal species.

“So much funding was poured into the development of the COVID vaccine,” said McNamara. “Creating a vaccine is very expensive, but there may be less expensive modes to decrease spreading between animal species.”

That includes treatment and prevention efforts specifically designed for captive and farmed animals. And for wild animals, it means more robust monitoring and testing -- and reducing direct contact with wildlife when possible.

Ultimately, the threat of "spill back" is a reminder that almost all virus outbreaks are zoonotic, meaning they originate in animals and wildlife.

“These pandemics don’t happen by accident,” Epstein said. “They happen because of human activity that changes the environment around us and brings us into closer contact with wildlife.”

Jonathan Chan, M.D., is an emergency medicine resident at St. John’s Riverside Hospital and a contributor to the ABC News Medical Unit.

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SDI Productions/iStockBY: DANI ALKHOURI, ABC NEWS

(NEW YORK) — The pandemic has closed schools, offices, sports arenas and limited social interaction for millions of people -- perhaps an even bigger struggle for young people more used to being active.

In a recent survey conducted by the Centers for Disease Control and Prevention, 63% of 18- to-24-year-olds reported symptoms of anxiety or depression, with 25% reporting increased substance use to deal with that stress and 25% saying they'd seriously considered suicide.

"The mental health impact of the pandemic is much larger on younger adults," said Dr. Shaker Saxena of The Harvard School of Public Health and a professor for the practice of global mental health courts. "The figures that we have from the U.S. suggest that almost two-thirds of the young adults have some symptoms of anxiety or depression or other psychological problems."

According to the National Alliance on Mental Illness, 50% of all lifetime mental illnesses develop by age 14, and 75% develop by age 24.

Even when the COVID-19 crisis is over, Saxena explained that 10% of these adults will have long-lasting effects from mental health issues they're currently dealing with.

"About one-third might actually be having a problem that is severe enough for their life to be impacted in terms of their work performance and education," Saxena said. "This could actually pose a much larger burden in terms of health and disability."

Saxena added: "Many people are losing jobs. Some people are earning much less income than earlier. There is the uncertainty of where and what tomorrow will bring, which is faced much more by younger adults than by middle-aged or older adults, because this is the time for change in their lives."

The Healthy Minds Network conducted a survey and found that 80% of college students reported that COVID-19 had negatively impacted their mental health.

Experts fear many of those affected are not seeking the professional help they need, and Dr. Sarah Lipson, an assistant professor in the Department of Health Law Policy and Management at the Boston University School of Public Health and co-principal investigator of the Healthy Minds Network study, told ABC News experts are trying to quantify that.

"Students of color and low-income students are significantly less likely to seek care when they're experiencing mental health problems due to cost and availability," Lipson said. "Those are also the same students who are less likely to persist in higher education and graduate. There's sort of this intersection of the outcomes that we care so much about for young adults in that regard."

The rise of anxiety and depression

Saxena explained how the pandemic is a "perfect storm" to give rise to uncertainty, stemming from anxiety and loss, possibly leading to depression. Many young adults have lost quite a bit, especially when it comes to educational and professional opportunities.

"For the people between the ages of 21 and 25, this is a time of expansion in their life, with new connections and new things," Lipson said. "That is all being halted. I think this is a hard time for parts of life to stand still when there is normally just this fast-paced developmental time where so much is happening socially and professionally.”

"The job market that young people are entering into," she added, "is very unpredictable, which I think creates a lot of a lot of stress."

Loneliness and social isolation

Mental Health America found that between April and September of last year 70% of people reported that loneliness or isolation was the top contributing factor to mental health issues. Isolation is the actual separation from others, and loneliness is the accompanying feeling.

"One can be lonely in spite of being with others. Both loneliness and self isolation give rise to major health impacts, and the communication around the need for distancing in the pandemic has been very unfortunate," Saxena said.

He said social distancing really should have been called physical distancing, separate from social connectedness.

"People are forced to do that because there are rules put in place," he added. "However, the attempt should be to be as connected as possible."

Jordan Corcoran, an advocate and founder of Listen Lucy, a mental health organization, was diagnosed with generalized anxiety disorder and panic disorder at 19, and, now 33, she described the pandemic as very challenging.

"I feel like I'm working every minute of the day to keep my anxiety at bay," Corcoran said. "Isolation is a major part of dealing with mental illness."

Even after getting help and choosing to advocate for others who struggle with mental health disorders, Corcoran still faces her own battles each and every day.

"The world keeps putting all these obstacles in front of me. I don't know how much longer I can do this," Corcoran explained. "I check in with my mental health every day. It's part of my survival as part of my journey."

What can be done

Saxena said workplace stress -- employees being overworked, which may or may not be tied to company layoffs or restructuring -- is a big contributor, and employers can step in to help.

"They should be aware that people are going through stress and are potentially going into mental disorders," he said. "All of that should be covered as a part of the benefit package as much as any physical problem. If you're an employer and your employee needs help in terms of counseling and psychiatric help, they should actually be encouraged, supported and financed in doing that. That is a best practice that is more needed now than ever."

Lipson also said she believes that college campuses need to offer more mental health resources and require training for faculty members so they can better understand potential mental health problems among students.

"I think schools need to think about an expansion of a campus mental health system to include a broader array of resources, and investing in those, as opposed to just investing in more and more staff in a counseling center," Lipson said. "It's an imbalance that is going to continue to exist and be amplified in terms of the number of students needing services and the availability of counselors."

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