Health News

What to know about new COVID-19 variant omicron

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(NEW YORK) -- Global health authorities said they're monitoring a new COVID-19 variant first identified in Botswana, with the World Health Organization saying Friday the new strain, dubbed omicron, is a variant of concern.

Previously referred to as B.1.1.529, the WHO urged countries to step up monitoring and surveillance, citing the high number of mutations and early indications that the virus was spreading in South Africa. The global health agency said it's still not clear whether the variant is more transmissible or causes more serious illness, or if it affects vaccines. And that such studies will take time.

Scientists have now confirmed 87 cases of the new variant -- 77 in South Africa, six in Botswana, two in Hong Kong, and one each in Israel and Belgium, though hundreds more diagnoses are expected.

"We don't know very much about this yet," said WHO COVID-19 Technical Lead Dr. Maria Van Kerkhove, speaking at an "Ask WHO" briefing Thursday. But concern about this variant stems from its "large number of mutations," Kerkhove said, which could "have an impact on how the virus behaves."

Dr. Anthony Fauci told CNN on Friday that scientists from the United States and South Africa will discuss the new variant on Friday, as early indications suggest it could be spreading in South Africa.

"Literally," Fauci added, "it's something that, in real time, we're learning more and more about."

Concerns about this variant already have prompted the U.K., EU and India to propose travel restrictions from South Africa. The World Health Organization, meanwhile, is urging calm, saying it's premature to close borders.

There are thousands of COVID-19 variants, with new ones emerging all the time. Usually new variants disappear quickly because they're overrun by a more dominant strain.

The now-dominant delta variant is so highly transmissible that most of the new variants that have cropped up in recent months have been unable to gain a foothold. In the United States, the delta variant comprises an estimated 99.9% of all cases.

"There's obviously this tension between crying wolf and exacerbating concerns about the variants, but also being caught flat-footed and not responding swiftly enough," said Dr. John Brownstein, chief innovation office at Boston Children's Hospital and an ABC News Contributor. "This is where we have to cautiously respond without inciting panic, because this could easily turn out to be a variant similar to others that have never really panned out to be global concerns."

Scientists across the globe constantly monitor all newly emerged variants to see if they're spreading in a meaningful way, and global health authorities have said they're monitoring this new variant closely.

Pfizer and partner BioNTech said they will conduct experiments to see if the new variant can chip away at vaccine efficacy. Vaccine experts said current COVID-19 vaccines, which rely on genetic technology, could be easily updated to better combat emerging variants -- though so far, that hasn't been necessary.

Eight variants are currently being monitored by the WHO, which designates particularly worrisome strains as variants of "interest" or "concern." When they no longer pose a significant public health threat, the variants are reclassified -- so far during the pandemic, 13 have been removed from the WHO's list.

But public health experts said the emergence of variants underscores the urgent need to vaccinate everyone on the planet.

"It gives us a lens into why as epidemiologists we've been so concerned about global vaccine equity," Brownstein added. "It's a recognition that with not enough people around the globe immunized, it creates more opportunities for variants to emerge, and this is a very good example of that."

Copyright © 2021, ABC Audio. All rights reserved.


Tracking breakthrough cases key to pandemic response, experts say

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(NEW YORK) -- Waning immunity has become a focal point in the pandemic.

COVID-19 cases among those fully vaccinated against the virus have been cited by several state public health officials as partly responsible for recent surges in cases. They were also behind the push for boosters for all adults ahead of federal authorization -- and the reason for boosting in the first place.

"There's no doubt that immunity wanes. It wanes in everyone. It's more dangerous in the elderly, but it's across all age groups," Dr. Anthony Fauci, the White House chief medical adviser, said earlier this month, citing data from Israel and the U.K., where more people were vaccinated sooner and both began to first document waning immunity.

Experts stress that the vaccines remain highly effective against severe COVID-19 illness, and vaccinated people continue to share a lower burden of hospitalizations and deaths among COVID-19 patients as cases and hospitalizations are on the rise again in the U.S.

The data is limited and hard to track, though knowing more about breakthrough infections is an important tool in responding to the pandemic, experts say.

Vaccinated COVID-19 cases always expected

Data from the Centers for Disease Control and Prevention tracking COVID-19 case rates by vaccination status since April shows a relatively flat line for vaccinated people that started to slope up in July -- though not nearly as steeply as case rates among unvaccinated people.

Breakthrough cases were always expected -- and expected to go up over time, Dr. David Dowdy, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health, told ABC News.

"The reason is, first of all, more people are vaccinated," he said. "The more people who are vaccinated relative to being unvaccinated, the more likely it is that a person who gets sick is going to be vaccinated, just by pure numbers."

As the number of unvaccinated people who get COVID-19 also continues to increase, it may look like more cases are breakthrough when comparing cases by vaccination status, he said.

ABC News Photo Illustration, CDC
COVID-19 Case Rates by Vaccination Status

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Another reason for increasing cases is due to waning immunity, Dowdy said.

"There is this waning immunity to getting sick -- not getting really sick, but getting infected, getting that initial illness," he said. "And so over time, people have a little bit less protection against that."

No vaccine provides 100% protection, though they are intended to help prevent you from getting very sick if infected. The initial immune system response is ramped up for several months after vaccination, though those antibodies "die out over time," leaving behind a "memory response" to help protect against severe infection, Dowdy said.

When that happens varies from person to person depending on factors like age and health. In general, Pfizer's data on its COVID-19 vaccine shows a decrease from an initial 96% efficacy to 83.7% efficacy after four months. A study by Kaiser Permanente Southern California found that efficacy against infections declined from 88% during the first month after full vaccination to 47% after five months.

A booster dose brings the immune response back up to a "robust" level seen one month after two doses, Pfizer found.

Booster doses are now eligible for all adults as COVID-19 transmission remains high in many parts of the country, "creating additional challenges and exposures for those who are vaccinated," said Dr. John Brownstein, an epidemiologist at Boston Children's Hospital and an ABC News contributor.

"Just based on probability, with enough exposures to the virus, you will have breakthrough infections," he said. "But those breakthrough infections doesn't mean the vaccines aren't working -- it just means over time, the probability of getting infected through an exposure to the virus, that probability increases."

"Despite that, we know that the vast majority of those breakthrough infections are mild, especially much milder than they would be if someone wasn't previously vaccinated, and they don't lead to anywhere near the same levels of severe illness and death," he said.

In September, unvaccinated individuals had a 5.8 times greater risk of testing positive for COVID-19, and a 14 times greater risk of dying from it, as compared to vaccinated individuals, according to CDC data.

ABC News Photo Illustration, CDC
COVID-19 Death Rates by Vaccination Status

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Waning immunity a 'real phenomenon'

Although the vast majority of COVID-19 infections and severe hospitalizations are among the unvaccinated, cases in vaccinated people do appear to be on the rise due to waning immunity, according to health officials.

In New Mexico, health officials have cited waning immunity as one of the reasons behind a recent surge in COVID-19 cases. The most recent state data shows that nearly 29% of cases and 21% of hospitalizations from Oct. 18 to Nov. 15 were among vaccinated people.

Similarly, health officials in Vermont, the most vaccinated state by population, have pointed to waning immunity as partly behind its worst COVID-19 surge yet.

"Waning of vaccine immunity is a real phenomenon," Dr. Mark Levine, commissioner of the Vermont Department of Health, said during a press briefing in mid-November.

Vermont also leads the nation in administering booster doses to people ages 65 and up. This week, Levine told reporters that the health department's data reaffirms that "booster shots are working." Case rates among those ages 65 and up in the state make up only 10-12% of COVID-19 cases, he said. The most recent state data also shows case rates among that population have decreased 14% week-over-week while increasing for every other age group.

"The need for a booster does not mean the COVID-19 vaccines have failed to do their job," he said. "They are highly protective against the worst effects of COVID. But the protection we get from a vaccine can start to wear off over time."

"For COVID-19, booster shots are especially important for those at higher risk who got vaccinated early on, like the majority of Vermonters who fall into this category and were vaccinated very early in this year. And at a time when COVID-19 transmission is high, when we're indoors more and getting together over the holidays, boosters really do benefit us all," he added.

Challenges in tracking breakthrough infections
Tracking breakthrough cases can be challenging, and most efforts likely represent an undercount due to a lack of testing of asymptomatic cases and reporting of at-home test results, according to The Pandemic Tracking Collective, a group of former members of The Covid Tracking Project that offers data solutions for tracking the pandemic. Breakthrough data is also not standardized across states, and not all report breakthrough cases, hospitalizations and deaths, the group said in a recent report.

In this patchwork of breakthrough infection-related collection, 36 U.S. jurisdictions report cases, 34 report hospitalizations and 37 report deaths, according to The Pandemic Tracking Collective report. At the time of its report, the CDC tracked cases for 16 jurisdictions and deaths for 15 jurisdictions by vaccination status, updated monthly. That has since increased to 24 and 20 jurisdictions, respectively, in the tracker's latest update this week. The CDC also reports on hospitalizations by vaccination status in 14 states.

"Now we have data on COVID-19 case counts and hospitalizations at our fingertips. What we lack is nuanced and detailed information on vaccine breakthroughs, which will be key to ending this pandemic," Jessica Malaty Rivera, science communication lead at The Pandemic Tracking Collective, said in a statement.

Breakthrough infections can help scientists better understand declining vaccine efficacy and detect new variants, the group said. Having better data can also help enact effective policies, Brownstein said.

"It's very hard to make policy decisions with imperfect data," he said. "Being able to understand the extent to which we're seeing breakthrough infections and their severity is important to make decisions around things like boosters, decisions around requirements for those who've been exposed or infected."

"When you have that kind of data, it can tell you very clearly what the burden of disease is in vaccinated people," he continued. "But without that, we have very limited information. So I think that is one of the real deficiencies in public health surveillance, is a lack of clarity on the impact of this virus among vaccinated and unvaccinated."

For Dowdy, data on breakthrough cases can provide "valuable information as we think about how we can best fight this pandemic," including the duration and level of protection that the vaccines are providing. Though he warned against reading the data as "trying to split the population in two."

"At the end of the day, we're all in this together, vaccinated or unvaccinated," he said.
 

Copyright © 2021, ABC Audio. All rights reserved.


How an NBA player's genetic heart disease led to advocacy for hypertrophic cardiomyopathy

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(NEW YORK) -- A healthy athlete all his life, Jared Butler entered his college basketball physical exam as the last step before he could step on the court. But an unexpected diagnosis of a potentially lethal heart condition put him on the sidelines while he anxiously wondered if his basketball career was over.

"After a month of testing, we found out that I had hypertrophic cardiomyopathy," Butler told ABC News. "I had never heard the term before. I was worried what this would mean for my playing career -- and ultimately my life."

That was three years ago. Today, Butler is coming off a starring role in an NCAA championship run at Baylor University and playing as a rookie in the NBA for the Utah Jazz. He has been able to continue his career thanks to routine cardiac evaluation and support by his family, doctors and team.

Hypertrophic cardiomyopathy is this most common genetically inherited heart disease, estimated to affect between 1 in 200 and 1 in 500 people worldwide, according to a 2015 study published in the Journal of the American College of Cardiology. The condition causes the heart muscle to become too thick, which could lead to life-altering conditions such as arrhythmias, heart failure, stroke or death.

Dr. Steve Ommen, cardiologist and medical director of the Mayo Hypertrophic Cardiomyopathy Clinic in Rochester, Minnesota, said the disease is not gender-selective and has no ethnic or geographic hotspots.

"The disease can manifest at any time and at any age among family members carrying the mutation," said Dr. Seema Mital, pediatric cardiologist and head of cardiovascular research at The Hospital for Sick Children in Toronto. "Some may even go without any evidence of the disease throughout their lifetime."

Once someone, like Butler, is found to have the disease, immediate family members are tested for the genetic mutation. In Butler's case, his mother, Juanea, also tested positive for genetic markers of the disease. She will also be monitored regularly by a cardiologist.

"I found out that I am the culprit. I am the one who carries the gene" said Juanea. "I was really confused and in a state of shock. I grew up active as well and never had symptoms or noted to have heart problems."

Mother and son were symptom-free their whole lives. But Dr. Michael Ackerman, genetic cardiologist at the Mayo Clinic and Jared Butler's physician, said people and physicians should be aware of the most-concerning symptoms, including chest pain, fainting and shortness of breath.

The disease can be especially risky for professional athletes because it increases the risk of sudden cardiac death. But thanks to the medical field having a better understanding of this disease, not every athlete needs to give up their career.

"Every athlete [with hypertrophic cardiomyopathy] doesn't need to give up what they're doing," said Mital. "Having the disease means you are going to be followed medically to make sure we can prevent heart failure and death. In fact, we now know that patients with hypertrophic cardiomyopathy can live a long, healthy life without any complications."

Ackerman has treated over 700 athletes with genetic cardiac conditions, a majority of whom do not require extensive medical procedures.

"For Jared, we made a plan with him, his family and his team and reassess that plan frequently and alter it as needed," said Ackerman. "This is not the new and improved way, this is just the approved and best way."

Ommen added that "shared decision-making" between a doctor and patient is meant to educate patients about the potential risks and make a group decision that is best for them.

He's more concerned about the 85% of the patients -- assuming 1 in 500 Americans have the condition -- who are living undiagnosed. To raise awareness, Butler and his mom decided to launch a campaign, "Could it be HCM?" in conjunction with Bristol Myers Squibb.

Ackerman added the second aspect of the campaign is knowing your family history. Having that knowledge about the sudden death of a family member could be life saving information

"Young patients come to the doctor complaining of shortness of breath, or chest pressure, and they are mistakenly diagnosed with exercise-induced asthma," said Ommen. "Campaigns like 'Could it be HCM?' are trying to raise awareness that if a young person does come in with symptoms, think about hypertrophic cardiomyopathy as one of the potential causes."

There is no cure, but Mital said that there are medications and surgical techniques to help alleviate symptoms and a lot of research invested in finding treatments to slow progression of the disease is in the future.

"Finding out you have the condition is just the beginning. It has been a long journey, and it has changed my life," said Butler. "But I find myself lucky that I do not have symptoms and I can continue playing basketball."

Lily Nedda Dastmalchi, D.O., M.A., is a physician and cardiology fellow at Temple University Hospital and a contributor to the ABC News Medical Unit.

Copyright © 2021, ABC Audio. All rights reserved.


Why are coronavirus cases and hospitalizations on the rise in the US?

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(NEW YORK) -- With coronavirus infection rates back on the rise, many Americans are wondering why the U.S. is, once again, experiencing surge in cases and hospitalizations, despite widespread vaccinations.

The U.S. is now reporting more than 94,000 new COVID-19 cases each day -- up by 47% since late October. And 35 states -- nearly all of them in the north or mountain region -- have seen an uptick in daily cases of 10% or more in the last two weeks.

Just under 53,000 COVID-19 positive patients are currently receiving care in hospitals across the country -- up by more than 7,000 patients from earlier this month.

Several states -- including Michigan, Maine and New Hampshire -- are experiencing record-breaking surges.

Experts say a confluence of factors is likely driving the country's recent increases in infections, including the more than 100 million Americans who remain completely unvaccinated, cold weather and relaxed restrictions, the highly transmissible delta variant, and waning vaccine immunity.

Unvaccinated Americans continue to drive COVID-19 transmission

According to health officials, the vast majority of infections and severe hospitalizations continue to be among the unvaccinated.

This September, federal data showed that unvaccinated individuals have a 5.8 times greater risk of testing positive for COVID-19, and a 14 times greater risk of dying from it, as compared to those fully vaccinated.

"The thing we are concerned about is the people who are not vaccinated, because what they're doing is they're the major source of the dynamics of the infection in the community," Dr. Anthony Fauci, the White House's chief medical adviser, said during an appearance on ABC's "This Week" on Sunday. "The higher the level of dynamics of infection, the more everyone is at risk."

Across the country, more than 101 million Americans remain completely unvaccinated -- 81 million of whom are currently over the age of 5, and thus are eligible to be vaccinated.

The significant number of unvaccinated individuals -- about 30.5% of the total population -- leaves millions at-risk and completely unprotected against the virus.

Relaxed restrictions, increased travel, and colder weather pushing people indoors

With winter arriving, and the holiday season on the horizon, many Americans are spending more time indoors, as the weather gets colder. COVID-19, as well as other respiratory illnesses, has been shown to spread more in indoor settings, and when people are forced to be in close proximity to one another.

Millions of Americans are also once again traveling, taking to the air, the railways and the highways. A total of 53.4 million people are expected to travel for Thanksgiving, up 13% from 2020, according to estimates from AAA.

Although masking is required in all forms of public transportation, across the country, COVID-19 restrictions are sparse, with few jurisdictions now requiring face coverings or social distancing.

"We're seeing cases trickle up, this is probably likely due to waning immunity, but also because of the colder temperatures people are gathering indoors and adhering less to social distancing and masking," John Brownstein, an epidemiologist at Boston Children's Hospital and an ABC News contributor, told "World News Tonight." "Unfortunately, that is a recipe for an increase in transmission this holiday season."

Masking has been shown to reduce the risk of COVID-19 transmission, and is still recommended by the Centers for Disease Control and Prevention in crowded outdoor settings and for activities with close contact with others who are not fully vaccinated.

Delta variant remains highly transmissible

In the U.S., federal data shows that the delta variant accounts for 99.9% of new coronavirus cases. According to the CDC, delta is far more transmissible than prior variants.

Many of the country's northern states were not as hard hit by the delta surge over the summer. Those states are just now feeling the impacts of the delta variant. Comparatively, states like Florida, which bore the brunt of the summer delta surge, are reporting very low COVID-19 infection numbers.

"We're seeing is pockets of surges across this country, the Midwest being one but also in the Northeast," Brownstein said

The delta variant spreads more easily among vaccinated people than prior versions of the virus, though vaccinated people are still far less likely to spread the virus compared to unvaccinated people.

Vaccine immunity is waning

Although the vast majority of infections and severe hospitalizations are among the unvaccinated, breakthrough positive COVID-19 cases among the vaccinated do appear to be on the rise, due to waning immunity, according to health officials.

"There's no doubt that immunity wanes. It wanes in everyone. It's more dangerous in the elderly, but it's across all age groups," Fauci said earlier this month, citing data from Israel and the U.K., where more people were vaccinated sooner and began to first document waning immunity.

Experts stress that the vaccines remain highly effective against severe COVID-19 illness.

Boosters are now recommended for everyone 18 and older, at least six months after an initial Pfizer or Moderna vaccination, or two months after a Johnson & Johnson shot.

 

Copyright © 2021, ABC Audio. All rights reserved.


Detecting cancer with a simple blood draw could soon be a reality

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(NEW YORK) -- Every year, thousands of Americans undergo routine screening to catch cancer in its early stages, while it’s still treatable. But these routine tests can be painful and invasive, and doctors only regularly screen for five of some of the most common types of cancer.

So for decades, scientists have been working on ways to screen for cancers using a simple blood draw rather than a painful biopsy or invasive test. These so-called "blood biopsy" tests are closer than ever to dramatically improving the way doctors screen for cancer.

Galleri, a new blood test by health care company GRAIL, is one of the most advanced blood biopsy tests. It works by looking for fragments of DNA in a person’s blood that indicate the presence of more than 50 types of cancer.

According to Dr. Pashtoon Kasi, director of colon cancer research and precision medicine at Weill Cornell Medicine, the underlying technology was actually first used to serve a different purpose.

"The same technology has been around for more than 20 years," he said. "It started with prenatal diagnostics."

But now, similar technology has been harnessed to detect early signatures of cancer.

Dr. Michael Seiden, the former president of the US Oncology Network, sees blood biopsy tests as part of the future wave of so-called "precision medicine" -- the idea that each person’s medical care can be tailored to fit their specific genetics, medical needs and unique characteristics.

Precision medicine tries "to learn as much [as possible] about a person’s health through sort of sophisticated diagnostic tests," Seiden said.

According to Kasi, less than two thirds of Americans get screened for colon cancer, which often involves an invasive procedure called a colonoscopy. A simple blood biopsy such as Galleri may improve current cancer screening due to ease of use, he said.

But despite the recent advancements, many doctors say there’s a long way to go -- and some say there are reasons to wait for more research to be done.

The Galleri test, though promising, is not yet FDA approved. It still needs to undergo more testing to show it can produce reliable results every time.

"What you want to see is evidence it detects cancers early and in a reasonably good-sized population and that there aren’t harms done," Dr. Ann Partridge, a breast oncologist at the Dana-Farber Cancer Institute, said.

But there’s another, more complex challenge, some experts say. In routine medical care, more testing isn’t always better.

"To do a screening test for any kind of disease or disorder, you have to consider what’s the benefit of doing it," Partridge said. "If you live for 15 minutes longer, it might not be worth it. But if you live for 10 months longer, it might be worth it."

A common refrain in cancer treatment is "earlier is better": that the earlier a cancer can be found, the treatment is often more successful. However, sometimes it can be difficult to tell the difference between an early cancer and a non-cancerous growth.

A final diagnosis often involves an invasive procedure, such as a needle biopsy or surgery in order to remove tissue. These procedures are not without risk, and any screening tool, such as the Galleri test, should reduce the number of unnecessary procedures by not flagging non-cancers as cancers.

That’s why some in the medical community have hesitation about the utility of a blood biopsy capable of detecting only a few cancer cells, as it may accidentally detect a non-cancer as a cancer.

But at the very least, Galleri could provide an early warning system, so doctors could monitor patients and treat them if it becomes necessary.

"This provides an additional screening test that might detect an early-stage cancer that's not detectable by other available tests," Seiden said. But, "It does not prove you don't have cancer, and it does not replace currently recommended screening. It's a supplement."

Partridge added that she's hopeful that someday she'll be able to order tests like these, but right now, "I think the big picture is very optimistic, but really not ready for our patients routinely, outside a clinical trial. I look forward to seeing this important research evolve."

Although Galleri is still not FDA approved, the test can be prescribed by any physician in the United States. Because it’s not covered by insurance, it costs $949 out of pocket.

Jacob S. Warner, an internal medicine resident at Dartmouth-Hitchcock Medical Center, is a contributor to the ABC News Medical Unit.

Copyright © 2021, ABC Audio. All rights reserved.


Diet talk can be overwhelming at Thanksgiving. Here are tips to cope

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(NEW YORK) -- A holiday like Thanksgiving that is centered on food, family and more food can be a precarious time for people struggling with eating disorders or disordered eating.

Alex Mutti, 27, of New York City, said she always loved Thanksgiving until her early teens, when she began to suffer from an eating disorder and the holiday became "really terrifying."

She said making it through Thanksgiving became even more difficult even as she went through recovery.

"In my experience, a lot of eating disorder recovery was around eating mindfully and creating routine around my eating," Mutti told Good Morning America. "And Thanksgiving throws all that out the window. Not many people are eating mindfully on Thanksgiving."

"Losing that kind of routine that became safe for me was always really anxiety-provoking," she said. "And being around the extended family and friends was difficult, even if they didn’t say anything."

Lauren Larkin, now a mental health counselor in private practice in New York City, said she recalls many Thanksgivings she "white-knuckled" her way through the worst stages of her eating disorder, prior to recovery.

"Thanksgiving is really the holiday where you talk about food and talk about regretting the food you ate," she said. "I would push myself to show up and act like everyone else and be like everyone else, even when maybe I couldn’t, and then I would have really intense anxiety afterwards."

This holiday is approaching as the United States has seen a mental health crisis during the coronavirus pandemic, of which eating disorders are a major part.

The number of people who were hospitalized for eating disorders doubled in the U.S. during the pandemic, according to research published recently in JAMA Network.

And even for people who may more casually struggle with disordered eating, this Thanksgiving holiday may be more fraught with discussions on weight and looks as family members see each other for the first time in months due to the pandemic.

"I think about the stereotypical great-aunt who is stuck in the diet culture and who is going to make comments about your weight," said Larkin. "Thanksgiving is probably the most triggering holiday for anyone who has struggled."

As Thanksgiving Day nears, here are five tips from experts to help cope with diet and negative food talk.

1. Set boundaries.

If you are at a holiday meal with supportive family members or friends, Christy Harrison, a registered dietitian and author of the book "Anti-Diet" recommends setting boundaries ahead of time, like asking loved ones to not comment on your body or what you're eating, and to do the same for others too.

If difficult conversation does emerge at the dinner table, Harrison suggests appealing to people on an emotional level.

"They probably care about you, they're people you're spending the holidays with, so talk on a human level about why diet talk hurts you or what you have found to be helpful in your own relationship with food," she said. "And keep it focused on yourself, like, 'for me,' and, 'in my experience.'"

"And if you're not quite as close, you can say something a little less personal, like, 'I've found that talking about this kind of stuff just makes the meal less fun for me," she said.

2. Remember it is one meal, one day.

"Remember that it’s just one day, it's just another day of eating and you can have those foods anytime you want," said Larkin. "Try to minimize the importance and the exact rules around food and remember, you can have it anytime. You can have more. "You can have less. It’s just one day out of 365 days of the year."

Speaking of her own recovery, she added, "Those are the kinds of conversations I had to have with myself and with my individual therapist leading up those these events until it became true for me."

Larkin and other experts also recommend staying in a routine with meals both before and after a Thanksgiving lunch or dinner, again reinforcing that it is just one meal among many.

3. Start new traditions.

Larkin said that during certain parts of her eating disorder and her recovery, she chose to travel over the Thanksgiving holiday instead of joining family.

"I had to put my needs in front of my family's need of wanting to see me and had to say, 'Even though you want to see me, this holiday is too triggering and I'm not going to participate in the way that I normally would,'" she said. "That's okay."

In other cases, a healthy new tradition may be going to a Thanksgiving dinner hosted by friends instead of family, or organizing activities before and after a Thanksgiving meal that don't involve sitting and talking about food, according to Larkin.

4. Have an ally by your side.

Chelsea M. Kronengold, a spokesperson for the National Eating Disorders Association, said it is important to have a support system on hand around a stressful holiday like Thanksgiving.

"If you have a therapist or a nutritionist, talk to them about your concerns prior to the holiday so you can work together on helpful coping strategies," she said. "And in addition to professional support, if you have a friend or a family member who's either in the room with you or available for you to text if the meal is challenging or the family dynamics are challenging, that can be extremely helpful."

5. Practice self-compassion.

"It’s okay to acknowledge that Thanksgiving and other food and family-focused holidays won’t be easy," said Kronengold. "If you end up restricting or bingeing, remember that tomorrow is a new day."

"When you perpetuate that cycle of shame and guilt, it's only going to be counterproductive to your mental health and your recovery journey," she said.

If you or a loved one is struggling with food and body image concerns this Thanksgiving, the National Eating Disorder Association (NEDA) Helpline is available via click-to-chat on Thanksgiving Day from 12 pm - 8 pm ET. For 24/7 crisis support, text "NEDA" to 741-741.

Copyright © 2021, ABC Audio. All rights reserved.


Push to vaccinate children accelerates as pediatric COVID-19 cases rise

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(NEW YORK) -- The rush to vaccinate children against COVID-19 is accelerating amid a steady increase in coronavirus infections and hospitalizations nationwide.

Last week, nearly 142,000 child coronavirus cases were recorded, with weekly infections among children up by more than 40% since late October, according to a new report from the American Academy of Pediatrics (AAP) and the Children’s Hospital Association (CHA).

Nationally, new coronavirus cases among all age groups have been increasing for the last three weeks, with the average now topping 92,000 new cases a day. Thirty-one states, as well as Washington, D.C., have seen an uptick in daily cases of 10% or more in the past two weeks.

Last week, children accounted for about a quarter of reported weekly COVID-19 cases, despite individuals under age 18 only making up 22.2% of the U.S. population. Regionally, the Midwest continues to see the highest number of pediatric cases, as the area experiences a notable viral resurgence with winter arriving across the region.

The nation has also seen an uptick in pediatric hospital admissions, alongside other age groups. Although hospitalization totals are still significantly lower than during the nation’s most recent summer surge, across the country, just under 1,250 children are hospitalized with a confirmed or suspected COVID-19 infection. Ohio currently leads the country with 168 children receiving care, followed by Texas with 120 children.

Amid this viral resurgence, health experts are urging parents to get their eligible children vaccinated.

COVID-19 "is one of the top 10 leading causes of death in children,” Dr. Leana Wen, emergency physician and professor of health policy and management at the George Washington University Milken Institute School of Public Health, said during a briefing Wednesday with the National Press Foundation. Vaccines are a "safe and simple intervention," she said, and significantly lower the risk of severe illness.

Earlier this month, Centers for Disease Control and Prevention Director Rochelle Walensky reported the agency had seen a surge of interest in pediatric COVID-19 vaccinations, following emergency use authorization of the Pfizer/BioNTech vaccine.

"We're seeing strong demand for COVID vaccinations among children ages 5 to 11 across the country with hundreds of thousands of appointments booked for the next few weeks,” Walensky said at the time.

Approximately one-third of children ages 5-17 have received at least one COVID-19 vaccine dose, according to recently updated federal data. In the last two weeks alone, 2 million children ages 5-11 years-old have received their first dose.

If parents get their children vaccinated now, they will be able to be fully vaccinated by the later winter holidays, Dr. Anthony Fauci, the White House’s chief medical adviser, said during an appearance on ABC’s "This Week" on Sunday.

"We now have vaccines that are highly effective and clearly very safe, particularly now with the recent data showing that we can vaccinate children from 5 through 11," Fauci said. "There are 28 million children within that age category. If we started vaccinating them now, they'll be fully protected by Christmas."

Although severe illness due to COVID-19 remains "uncommon" among children, the two organizations wrote, there is an “urgent” need to collect more data on the long-term consequences of the pandemic on children, "including ways the virus may harm the long-term physical health of infected children, as well as its emotional and mental health effects."

Copyright © 2021, ABC Audio. All rights reserved.


What you need to know about COVID-19 boosters and how long they take to work

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(NEW YORK) -- COVID-19 booster shots are now authorized for anyone over the age of 18. For anyone hoping to get a COVID-19 booster dose before the Thanksgiving holiday, experts say it's important to understand that protection doesn't kick in right away.

Although the body starts to increase antibodies within a few days after the shot, it takes two weeks for peak protection to return.

“There is a meaningful increase in antibody titers by one week and peak responses at 2 weeks following mRNA boosting,” said Dr. Dan Barouch, director of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center in Boston.

More than 32 million people in the U.S. have already received a COVID-19 booster dose. The FDA and CDC say it's safe to mix and match boosters.

COVID-19 booster shots are composed of the same formulation as the current COVID-19 vaccines. But the Moderna vaccine booster is given at half the dose of the primary Moderna series.

Studies show the immunity gained from the primary vaccine series may decline over time -- particularly protection against mild breakthrough infections. Therefore, experts recommend booster vaccination to increase immunity.

“The booster shot will have a similar response as the second dose of the primary series. The highest antibody level will be around 10-14 days and then things will level off. The antibody levels will decline as it would with all vaccines, however the boosters help to stabilize the antibody levels,” said Dr. Simone Wildes, an infectious disease specialist at South Shore Health in Massachusetts.

Public health experts say booster shots could also help slow the spread of COVID-19 within communities. However, to truly curb the pandemic, it's far more important for the unvaccinated to get their initial doses.

The expanded authorization of the Moderna and Pfizer boosters comes right in time for the holidays to allow many more Americans to get their booster shots before the holidays for safer travels and gatherings. The expanded authorization to now everyone over the age of 18 also helps eliminate any confusion on who may receive booster shots and ensures boosters are available to everyone who needs one.

Esra Demirel, MD is an OB-GYN resident physician at Northwell Health-North Shore University Hospital & LIJ Medical Center and is a contributor to the ABC News Medical Unit.

Copyright © 2021, ABC Audio. All rights reserved.


Fauci says 'fully vaccinated' definition not yet changing to include boosters

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(WASHINGTON) -- Every vaccinated person should "get boosted" depending on how long it's been since their initial shots, but those with their original vaccination protection are still considered "fully vaccinated" despite indications that immunity can wane, Dr. Anthony Fauci said Sunday.

The White House chief medical adviser appeared on ABC’s This Week on Sunday to discuss the recent announcement made by the CDC on Friday to officially recommend booster shots for all adults ages 18 years and older. This move comes after many states were already allowing all adults to get a booster against COVID-19.

"Now that you look at the data as it's evolved in the United States, it's very clear," Fauci told This Week co-anchor Martha Raddatz. "They wanted to make sure that the safety signals were right, and once that became very clear, right now I’m very pleased that we're in a situation where there's no confusion, there's no lack of clarity."

Following recent statements from governors of Connecticut and New Mexico -- who have said they do not consider an individual fully vaccinated unless they have received a booster due to the drop one can see in immunity -- Raddatz pressed Fauci on why the White House has not adopted that standard.

By definition, Fauci said, fully vaccinated right now means someone has received two doses of the Pfizer and Moderna vaccines or one dose of the Johnson & Johnson vaccine.

"We'll continue to follow the data, because right now when we're boosting people, what we're doing is following them," Fauci said. "We're going to see what the durability of that protection is, and as we always do, you just follow and let the data guide your policy and let the data guide your recommendations."

As of Friday, 59% of the U.S. population has been fully vaccinated against COVID-19.

Pfizer CEO Albert Bourla said last week there’s a high chance that boosters will be needed annually, but when asked by Raddatz what he thought, Fauci did not necessarily agree.

"We would hope -- and this is something that we're looking at very carefully -- that third shot with the mRNA not only boosts you way up but increases the durability so that you will not necessarily need it every six months or a year," Fauci said. "If it doesn't, and the data show we do need it more often, then we'll do it, but you want to make sure you get the population optimally protected and you do whatever you need to do to make sure you do that."

The Wall Street Journal reported Saturday that COVID-19 deaths in 2021 surpassed the number of COVID-19 deaths in 2020, with the total number of deaths now reaching more than 770,000. Raddatz pressed Fauci to explain how deaths increased, and he cited the delta variant -- "which is very, very different from the original variants that we were dealing with before."

"This is a virus that is highly transmissible," he said. "The more people that get infected, the more people are going to get hospitalized. The more people they get hospitalized, the more people are going to die."

Fauci noted that another difference between this year and last year is the availability of vaccines, and he stressed the importance of getting vaccinated.

"We now have vaccines that are highly effective and clearly very safe, particularly now with the recent data showing that we can vaccinate children from 5 through 11," Fauci said. "There are 28 million children within that age category. If we started vaccinating them now, they'll be fully protected by Christmas."

With the holidays coming up, Raddatz also asked Fauci to explain what safety precautions families can take this holiday season.

"If you're vaccinated -- and hopefully, you'll be boosted, too -- and your family is, you can enjoy a typical Thanksgiving meal or Thanksgiving holiday with your family," Fauci said. "The thing we are concerned about is the people who are not vaccinated, because what they're doing is, they're the major source of the dynamics of the infection in the community. And the higher the level of dynamics of infection, the more everyone is at risk."

Copyright © 2021, ABC Audio. All rights reserved.


Spending Thanksgiving alone this year? Here are five tips to combat loneliness

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(NEW YORK) -- While Thanksgiving will be a time to gather again this year for many people, thanks to COVID-19 vaccines, it may for other people be the start of a difficult holiday season.

Some people may be home alone on Thanksgiving by choice, following safety guidelines, while other families will be missing loved ones at the Thanksgiving table who are hospitalized with COVID-19 or who have passed away from the virus over the past nearly two years.

Still others may be coping with a non-COVID related illness that is keeping their family separated or coping with a deployment or a divorce, separation or estrangement that unfolded during the pandemic.

"What many people are going to experience this year, for a variety of reasons, is that their holiday table is not going to be as full as it normally is," said Kory Floyd, Ph.D., an author and professor of interpersonal communication at the University of Arizona. "Many American households are going to experience a sense of deprivation this year."

"Especially on a holiday, when it’s a time to celebrate and be around loved ones, that accentuates a sense of loneliness," he said.

Here are five tips to make Thanksgiving a joy-filled day regardless of who you are, or are not, spending it with.

1. Make a plan:

Planning ahead the fun things you'll do on Thanksgiving, or the new traditions you'll start, can both help ease the stress and uncertainty of the day and help you from obsessing over what could have been, according to Floyd.

"Think now of things you’ll plan for that day that will be positive distractions," he said. "The benefit of [planning ahead] is we’re ready and we’re prepared, and we’re prepared to enjoy and find meaning and find joyfulness in whatever we do with that time."

Planning ahead can be as detailed as what time you'll eat meals and do activities to a more general list of the movies you want to watch or the activities you can do outside in fresh air, experts say.

Floyd recommends planning something that feels indulgent on what is still a special day of the year.

"What feels indulgent to people will vary from person to person," he said, giving examples of a bubble bath or a decadent dessert. "But make it something that goes beyond the ordinary and feels really special and allow yourself the freedom to enjoy it, to lean into it."

2. Find ways to help other people:

Doing something good for someone else can take the focus off yourself and help ease feelings of loneliness or discontent, according to Nicole Beurkens, Ph.D., a holistic child psychologist and the founder and director of Horizons Developmental Resource Center in Caledonia, Michigan.

That could mean dropping items off at a nursing home, preparing boxed meals for neighbors or delivering books and needed items to women's and children's centers, recommends Beurkens.

"Sometimes the best way to soothe ourselves is to do something outside of ourselves," she said.

3. Phone a friend or loved one:

Even if you can't physically be with your loved ones on Thanksgiving, it's important to find ways to stay in touch with people, recommend both Floyd and Beurkens.

Plan ahead to make sure you can call, Skype or Zoom with friends and relatives on Thanksgiving, whether it's just talking to catch up or taking part in holiday traditions together via technology. If the technology is too much, spend the down time you may have that day writing letters to family and friends or simply thinking about who in your life you're grateful for, according to the experts.

4. Think ahead to next year:

While it's normally important to stay in the moment and not look ahead or behind, experts say this year it can be healthy to look ahead to a more hopeful time.

"It gives a sense of forward-looking motion that helps people not feel as heavy a sense of what is going on now," said Floyd. "It reminds people that this is temporary and things will get better."

Floyd said he is reminding his patients that no matter how bad this year feels, it is temporary, and it is okay to start thinking ahead to things like travel and gathering again in-person with family and friends.

His advice is to be specific when thinking about the future, picturing things like exactly where you want to travel to, who you will spend Thanksgiving with next year and what new traditions you may want to start.

5. Be okay with shedding some tears:

Both Floyd and Beurkens say it's okay and perfectly normal to spend a few moments on Thanksgiving shedding tears or sitting for a bit with grief over what a strange holiday, and year, this has been.

"It's not getting over the emotions, but getting through them," said Floyd. "The last thing people should do is be ashamed of those emotions."

"We can still generate joy even though there’s a sense of sadness or a sense of loss," he said.

If you or someone you know is in crisis, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or contact the Crisis Text Line by texting HOME to 741741. You can reach Trans Lifeline at 877-565-8860 (U.S.) or 877-330-6366 (Canada) and The Trevor Project at 866-488-7386.

Copyright © 2021, ABC Audio. All rights reserved.


Mickey Guyton says her 9-month-old son suffered from dehydration: What parents should know

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(NEW YORK) -- Country singer Mickey Guyton is opening up about her son's recent stay at a hospital intensive care unit.

Taking to social media with an update on Saturday, she wrote, "My baby fell ill on November 11th, eventually requiring a trip to the icu. It turned out to be dehydration because of a severe stomach bug. Seeing my baby boy like this was truly terrifying."

"Grayson is doing much better, all signs are stable and improving. He is still dehydrated and weak and has lost weight from not being able to retain any liquid," she continued. "He's getting better by the minute, it's just going to take some time."

On Sunday, ahead of her performance at the 2021 American Music Awards, Guyton shared another update, writing, "My baby smiled today. He hasn't smiled since November 11th."

The saga began on Nov. 12, just two days after Guyton's much-discussed performance at the 2021 CMA Awards.

"From CMA stage to nursing my sick baby boy at home. Motherhood is a humbling experience. Nothing is greater or more important that their happiness and well being," she tweeted, sharing a photo of Grayson resting on her chest.

Guyton then sent a frightening tweet on Thursday, telling fans, "I normally don’t do this but my son is being sent to the icu. The doctors don’t know what’s wrong. Please please pray."

The "Black Like Me" singer updated fans on Grayson's status on Friday, sharing a photo of husband Grant Savoy holding their baby boy.

"He’s not in the clear but he’s on the mend," she tweeted. "Thank you for your prayers. I will update y’all as soon as I am able. Thank you thank you thank you for your love and support."

Guyton, 37, announced in February that she and Savoy had welcomed Grayson, their first child together.

What parents should know about dehydration in babies

Dr. Jen Ashton, ABC News' chief medical correspondent, told GMA this is an important story because it sheds light on how children -- and babies, in particular -- can get sick "very, very quickly even with something as common or benign-sounding as dehydration."

She said the risks with dehydration in babies are urinary and kidney problems, dangerous sodium concentration levels and lethargy, with severe cases, things like seizures, comas and potential brain damage.

Since babies cannot tell adults they are thirsty, Dr. Ashton said parents need to look for warning signs such as dry skin, dryness in the tongue or lips, rapid breathing, tearless crying, sunken soft spot in infants, sunken eyes and cool and blotchy hands and feet.

She said treatment depends on the severity of the dehydration, with mild cases being treatable at home with the advice of a pediatrician. In these situations, Dr. Ashton advised to avoid pure water or sugary beverages, which can "make things worse," and to use electrolyte replacement fluids in "tiny amounts, a teaspoon every few minutes." In severe cases, she said a trip to the hospital for IV treatments is needed.

Copyright © 2021, ABC Audio. All rights reserved.


Crime against disabled people is rising and advocates say more needs to be done

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(NEW YORK) -- Disabled people are disproportionately victims of violent crime and victimization in the United States, according to new data released by the Bureau of Justice Statistics. And the frequency of these crimes is also increasing, according to the data, though activists don't seem to know why.

The data shows that from 2017-2019 disabled people accounted for 26% of nonfatal violent crimes, even though they make up only 12% of the population and are victims of violence at almost four times the rate of non-disabled people.

For disabled women, the disparity is even greater and the prospect of victimization seems almost inevitable to some, activists say. The data also shows the ongoing prevalence of domestic and intimate partner violence against disabled women, and activists say it showcases the failings of a system that wasn't built for the well-being of disabled people.

Stefanie Lyn Kaufman-Mthimkhulu, the executive director of non-profit disability advocacy group Project LETS, is a survivor of sexual violence herself and was sexually assaulted by a friend as a senior in college.

She said she didn't report the 2017 incident partly because she thought her history in psychiatric institutions and her mental illness would have made it difficult to hold her abuser accountable.

"I've seen [the legal system] tear people apart," Kaufman-Mthimkhulu said. "And I don't think I could have handled it. That's the reality that we're up against, particularly for folks who have psychiatric histories, who are intellectually disabled."

Now, she works as a disability justice organizer in order to help try to curb attacks on disabled people like herself.

It's an uphill battle, according to activists -- with a lack of research into violence at institutions, a mistrust in law enforcement among the community, poverty and overrepresentation in the criminal justice system.

Ableism in our systems and communities

The BJS reports that the rate of violent crime against disabled women -- 49.4 per 1,000 people -- is higher than it is for disabled men and non-disabled men and women. For disabled men, that rate is 42.7 per 1,000. For all non-disabled people, it falls dramatically: 12.3 per 1,000 people.

Over the years that rate has risen for disabled people -- from 2009 to 2019, the rate of violent victimization rose from 28.8 per 1,000 disabled people to 46.2.

In a 2015 report from the U.S. Department of Human Health Services, researchers found that disabled women are more likely to experience violence or abuse compared to non-disabled women and are more likely to experience violence or abuse by a current or former partner.

Activists say that ableism -- the discrimination or bias against disabled people -- is at the root of this disparity and that misogyny puts women in greater danger.

"A lot of people don't actually see [disabled people as] full human beings that are capable of autonomous decision making," Kaufman-Mthimkhulu said. "We've all been conditioned in a way that allows for this belief that disabled people are inferior, are weaker than others. That we should be grateful for any form of attention, or love, even if that comes in the form of abuse."

Not only are disabled people seen by some as "less than," but activists at the National Coalition of Latinxs with Disabilities -- or CNLD in Spanish -- also say that various forms of ableism affect the social, political and economic standing of disabled people in the U.S.

Reporting shortcomings

In the report, BJS researchers and law enforcement agencies concede that the number of crimes actually committed against disabled people is likely to be higher than what is reported.

BJS cites a number of issues in its data collection which is based on the annual self-reported survey response collection followed by interviews hosted by the U.S. Census Bureau. The BJS says this research lacks input from institutionalized people, 54% of whom have a disability, and the interviewing and surveying methods that contributed to this dataset may be inaccessible to get accurate or full responses from disabled people.

"The data focuses on individuals who are not institutionalized, and there is a lot of violence that is being experienced by those who are institutionalized that's not being acknowledged or investigated," Torres-Gerald said.

Though recent research into this topic is limited, one 1994 study from the Behavioral Interventions journal found that about 82% of all cases of abuse and neglect of adults with developmental disabilities were carried out in institutions or group homes and that people who "were unlikely or unable to report or resist the abuse were the most common victims."

The data also did not break down the differences between racial, ethnic and gender groups.

Crime reporting statistics law enforcement agencies have also proven to be inaccurate due to undereporting, according to the Office for Victims of Crime. Barriers to financial or physical independence, as well as social and economic injustices keep crimes against the disabled in the dark, activists say.

Challenges for women and the poor

It's also often difficult for disabled people, particularly women, to leave abusive care or to report abuse, according to Centers for Disease Control and Prevention researchers.

For instance, disabled people may be financially or physically dependent on an intimate partner. They also may not be able to report because they can't communicate or are unable to access a phone, activists say.

The National Disability Institute found that disabled people can often be limited in either their ability to work or ability to get a job due to inaccessible workplaces -- and are more likely to experience poverty than non-disabled people.

"In order for people with disabilities to receive any type of services either Medicaid services they have to be means-tested. so they have to live in perpetual [poverty]," said Leonor Vanik, a co-founder of CNLD. "They have to be low income in order to receive any services."

If they rely on Supplemental Security Income, there are limits on their income and restrictions on their financial assets: disabled people often can't own more than $2,000 in countable cash at a time in order to receive benefits, the Social Security Administration (SSA) website states, leaving them in a position of being financially dependent on others or in poverty.

And if they are married, they may be disallowed of disability benefits like Social Security benefits and Medicaid due to their partner's income, according to the SSA.

But there are other forces of inequality at play as well, including the people to whom disabled people would report crimes.

Mistrust in law enforcement by some

A mistrust in law enforcement also keeps some from reporting to police, according to Kaufman-Mthimkhulu. Disabled people are often over-criminalized and over-represented in detention facilities; in 2016, nearly 2 in 5 state and federal prisoners had at least one disability, according to the BJS. In 2017, a study by Cornell University found that disabled people were also more likely to be arrested when interacting with police than their non-disabled counterparts.

And, according to research by disability research organization the Ruderman Family Foundation, almost half of people killed by police have some kind of disability.

"We really have to like ask ourselves, what is driving that desire for power?" said Kaufman-Mthimkhulu. "We have a lot of work to do as a collective society to move away from the violence that has been embedded in each of us. … We need to see these things reflected in policy, we need to see these things happen on a societal level."

For some activists, these findings aren't shocking -- but they are a warning sign that systemic and interpersonal violence against disabled people go hand-in-hand. Without accountability for hurdles and red tape against the financial and social success of disabled people, activists say,

"[Lawmakers must focus on] increasing funding and community interventions to better support and create services for survivors that can help build trust within a community for survivors to know that there's a place for them to go and receive the support they need," Catalina Galvan, CNLD's treasurer said.

Copyright © 2021, ABC Audio. All rights reserved.


Should you get a booster shot? Experts say it's time

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(NEW YORK) -- Millions more vaccinated adults across the U.S. became eligible for a COVID-19 booster shot on Friday. And yet, the vast majority of vaccinated Americans were already eligible -- many just didn't know it.

According to an October survey from the Centers for Disease Control and Prevention, 4 in 10 vaccinated adults were unsure if they qualified for a booster. So far, just 32 million Americans have received a booster, or around 18% of the more than 182 million adults who are fully vaccinated.

In announcing the latest recommendations, public health experts at the Food and Drug Administration and the CDC expressed hope that they would cut through the confusion, simplifying the decision for Americans who are wondering: Do I need a booster shot?

Here's what the experts say.

Should you get a booster?

The question has been hotly debated for months but a larger pro-booster consensus has formed over the last week.

Why? A number of reasons, including rising cases in more than half of U.S. states right before a busy holiday travel season and lower temperatures pushing people indoors.

The FDA and CDC made the updated recommendation on Friday. It expanded booster access to all adults who were vaccinated with Moderna or Pfizer over six months ago, and while the recommendation was stronger for everyone over 50 to go get a boost, it applies to everyone 18 to 49.

For Johnson & Johnson recipients, the recommendation already applied to everyone over 18, anytime two months after their shot.

For experts who have long been loud proponents for booster shots, it was a long time coming.

"Enough is enough. Let's get moving on here," Dr. Anthony Fauci, chief medical adviser to the White House and a leader at the National Institutes of Health, said at an event Wednesday, before the FDA and CDC made the final call.

"There's no doubt that immunity wanes. It wanes in everyone. It's more dangerous in the elderly, but it's across all age groups," Fauci said, citing data from Israel and the U.K., where more people were vaccinated sooner and began to first document waning immunity.

Others, like Dr. Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine and co-director of the Texas Children's Hospital Center for Vaccine Development, called the decline "both predicted and predictable."

"And the way you fix it is you give that third immunization," he said.

Both Hotez and Fauci believe the vaccines should be used not just to prevent hospitalizations and death, but also infection -- particularly because of the risk of long-COVID, a concerning side effect of the disease that is rare in vaccinated people but can include long-term fatigue, brain fog and shortness of breath.

"When I got my third immunization, why was I so eager to do it? Well, of course I didn't want to go to the hospital or ICU, but also I didn't want to get COVID," Hotez said.

"I didn't want to get gray matter brain degeneration and cognitive decline and have a brain scan that looks like somebody 20 years older."

But for those still on the fence about the personal choice, Dr. Anna Durbin, an associate professor at the Johns Hopkins University School of Medicine, laid out risk scenarios to consider.

"It really comes down to your comfort level and just what's going to make you as a person feel safer," Durbin said.

If you're traveling overseas or live in areas of high transmission, if you're elderly or have underlying conditions or are frequently out in the community for work, those are all reasons to get a booster, Durbin said.

For young, healthy people who don't feel at risk, Durbin said to keep an eye on rising cases in your area. Consider getting a booster to help tamp down transmission, but also to protect yourself ahead of a surge, Durbin said.

"If we're gonna see a new wave, it's going to be over the winter months most likely. And if you get boosted now, that's going to provide you really good protection through that period of time," Durbin said.

That said, don't panic if you can't book an appointment right away -- particularly as demand surges with the new recommendation, experts say.

"I would not view it as an emergency that people need to line up on the day of approval and get their boosters necessarily that weekend," said Dr. Dan Barouch, director of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center in Boston.

It's still far more important for unvaccinated people to get vaccinated, Barouch said, particularly ahead of the holidays.

"The most important thing is for everybody who will be celebrating to be vaccinated, if they're eligible to be vaccinated. Now, additional boosts may be useful. But the most important thing is that people be vaccinated primarily," he said.

Why has it been so confusing?

To put it simply: "The reason why there is some confusion is because it has been confusing," Barouch said.

"Guidelines are changing," Barouch said. "And in some cases, the guidelines are changing for good reasons: They're changing because what we're seeing is a changing pandemic."

Last week, a patchwork of booster guidance emerged as governors in over a dozen states called for all adults to get a booster before the federal agencies weighed in, acting to combat spiking cases and overwhelmed hospitals.

Hotez commended the states for making the "medically correct" decision and being "more nimble" than the original decision from the CDC and FDA, but acknowledged the schism it created in the public health guidance.

"Not as elegant as you'd like -- to have the states be out front by a week or so, but you know, when you're in the middle of a pandemic, sometimes things don't go smoothly as you'd like," Hotez said.

Some, like Hotez, have always believed boosters would be necessary, even before data started to trickle in on waning immunity, and think confusion could've been avoided if the public was always told to expect a booster.

"It should have been messaged to the American people from the beginning that, by the way, don't be surprised when the call comes out to get a third immunization," he said.

Still, there's a fine line to walk in urging booster shots for those vaccinated six months ago while also encouraging the most impactful group, unvaccinated people, to get their primary vaccinations. The vaccines continue to protect well against hospitalization and death for many months.

"We can give all the booster doses we want and until we get people vaccinated, or they all get infected, we're going to continue to see transmission of COVID," Durbin said.

Copyright © 2021, ABC Audio. All rights reserved.


1st injectable, bimonthly HIV treatment approved in UK

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(LONDON) -- The UK approved a new HIV treatment that requires an injection every other month, rather than the current routine of taking pills every day.

The UK's National Institute for Health and Care Excellence estimated that around 13,000 people will now be eligible for cabotegravir with rilpivirine, the injectable medication.

There were around 103,000 people living with HIV in the UK in 2018, according to the British government's statistics.

"It is an exciting and progressive step in the fight against HIV," Dr. Todd Ellerin, director of infectious diseases at South Shore Health and ABC News contributor said. Ellerin is also on the speakers bureau of ViiV Healthcare which helped develop the injectable HIV treatment.

Besides the new revolutionary injection method, the current treatment for HIV is lifelong antiretroviral tablets that are taken each day. The medication suppresses the virus in the blood to undetectable levels, thereby preventing AIDS from occurring and eliminating transmission.

The injections block the same enzymes as the pills do, as Ellerin explained, but allow the medication to stay in the body much longer permitting monthly or bimonthly re-dosing, so patients don’t need to take pills every day.

The shot called Cabenuva (a combination of cabotegravir and rilpivirine) was already approved by the FDA in January, though with a more frequent dosage of once a month.

"[The] thing I like about injectables is less is more," Ellerin said. "The medication approved in the UK will be once every two months, which makes it easier for the patients to come to the office rather than coming every month," he added.

"For many, taking daily pills is not easy. Sometimes they forget, some may have other issues with taking pills, but the injection is suitable for those who prefer a more intermittent method," he added.

However, there are challenges to this method. One, is the logistics of the injection, as the jabs must be administered at the health care provider's office for now, Ellerin said.

"The biggest challenge is the logistic hurdle for giving these [shots] in the office, especially in the pandemic," said Ellerin.

Also, if patients don’t show up for their injection, that increases the risk of viral replication rebound, Ellerin said. With pills, you can remember to take them the next day and have a stock of them at home.

Both in Britain and the United States, cabotegravir and rilpivirine can be prescribed and used after an initial oral (tablet) lead-in period.

"This is why people who are newly diagnosed with HIV can't start their treatment with injection," Ellerin said.

There are hopes that by the first quarter of 2022, the FDA also approves the bimonthly injection, and with that more patients might choose this method over pills, especially if the COVID-19 situation eases, according to Ellerin.

"As of now, this is not a preventive method. It is just for maintenance treatment. There are also injections for prevention down the way. But that is another story," Ellerin said.

Ellerin also said that the reason the injections are available at clinics only is that this is the way it was studied in clinical trials and that these are buttocks injections that are difficult to self-administer at home.

Copyright © 2021, ABC Audio. All rights reserved.


Women say pain was dismissed in lawsuit alleging fentanyl switch at fertility clinic

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(NEW YORK) -- A group of seven women are suing Yale University, claiming they underwent invasive and painful procedures for in-vitro fertilization and received saline instead of fentanyl, an opioid painkiller.

According to the complaint, the women received saline after a nurse at the Yale University Reproductive Endocrinology and Infertility Clinic stole fentanyl for her personal use last year and replaced it with saline.

As a result, the women underwent a fertility procedure -- oocyte retrieval -- without pain management, according to the complaint, which described the process as "excruciating."

"Oocyte egg retrieval is an extremely invasive procedure," the law firm representing the women said in a statement. "Doctors and nurses explained to these patients that this surgery would require a dose of fentanyl to alleviate pain. However, each was then unknowingly treated with saline instead."

The lawsuit, filed Wednesday in state court in Waterbury, Connecticut, by the women and their spouses, accuses Yale University of failing to follow protocols and thereby allowing the fentanyl to be tampered with.

The complaint also alleges there were "hundreds" of incidents in which saline was substituted for fentanyl.

"Yale University takes no responsibility for the hundreds of fentanyl substitution events that took place at the REI Clinic; it blames the single nurse who was able to steal the fentanyl, unabated, for more than twenty weeks," the complaint said.

"But for years, Yale University recognized the lurking danger of opioid diversion and the catastrophic injuries posed by healthcare worker opioid substitution," according to the lawsuit.

The nurse, Donna Monticone, pleaded guilty in March to one count of tampering with a consumer product and surrendered her nursing license. She was sentenced in May to four weekends in prison, three months of home confinement and three years of supervised release.

A Yale University spokesperson declined to comment on the lawsuit.

In March, following Monticone’s guilty plea, a Yale spokesperson issued a statement stating patients had been informed and that “changes are underway."

“Yale has informed patients that there is no reason to believe that the nurse’s action harmed their health or the outcome of their treatment. The Fertility Center routinely uses a combination of pain medications during procedures and modifies the medications if there are signs of discomfort,” the spokesperson said in March, according to the New Haven Register. “Changes are underway in procedures, recordkeeping, and physical storage that will prevent this type of activity from happening again.”

The lawsuit, which seeks unspecified damages, also alleges that the women's concerns and reports of "torturous pain" were dismissed.

"Yale University providers were alerted to the problem with its supply of fentanyl, the sole analgesic administered to women during oocyte retrievals, through patients' intraoperative screams and postoperative reports of torturous pain, but, upon information and belief, Yale University never investigated these reports," the complaint said. "Instead, pain was minimized as 'normal' for the invasive procedure, or attributed to the unavailability of an anesthesiologist on Saturdays and Sundays."

The allegation of pain being dismissed is one that may ring true for many women, according to Dr. Jessica Shepherd, a board-certified gynecologist and chief medical officer of Verywell Health, an online medical resource.

Shepherd is not affiliated with Yale University and has no involvement with or direct knowledge of the case.

"Usually the key complaint is feeling dismissed, that patients haven't been heard," she said of her own personal experience with female patients who have sought her care. "It's one thing to be able to express what you're feeling, but even after that, what are the actions that are taken in order to reach some joint resolution of decreasing discomfort, addressing the situation, finding alternatives."

Research through the years has also shown that women's pain is often interpreted differently than men's by medical providers.

A study published in April in the Journal of Pain, for instance, found that when the same level of pain was expressed by female and male patients, female patients' pain was viewed as less intense than men's. The study also found that female patients were prescribed more psychotherapy for for their pain, while male patients were prescribed more pain medication.

In another study, women were found to have had to wait nearly 15 minutes longer to receive pain medication in an emergency room setting than men.

"It's a subjective symptom so it's hard to put objectivity to it, like you would say, blood pressure, or pulse," Shepherd said of pain. "And I think there are stereotypes about pain sensitivity and endurance of pain, so from a female perspective, it may be looked at not being able to endure as much pain, but that's not really how pain should be monitored or evaluated."

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